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DS2102 Perio Hoes > WK 9: Perio & Acute Gingival Lesions > Flashcards

WK 9: Perio & Acute Gingival Lesions Flashcards

1
Q

Define Necrotizing gingivitis

A

A microbial disease of the gingiva in a n impaired host response characterized by necrosis and sloughing of the gingival tissue

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2
Q

what are the 3 clinical forms of Necrotizing Gingivitis

A
  1. Acute: most common
  2. Subacute: milde and more persistent form
  3. recurrent: Periods of revision and exacerbation.
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3
Q

List the predisposing factors for Necrotizing gingivitis

A

HIV
Immune suppression
poor nutrition (malnourishment)
tobacco
physiological stress

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4
Q

Describe oral symptoms or Necrotizing gingivitis

A

Extreme sensitivity to touch
constant radiating pain( made worse while eating)
metallic foul taste
pasty saliva.

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5
Q

Describe Clinical finding of Necrotizing gingivitis

A

Necrosis/Ulcer in Interdental papilla
gingival bleeding
pain
halitosis
pseudomembrane formation

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6
Q

What are the extra oral signs and symptoms of NG

A

Local Lymphadenopathy
Elevation in temperature

Severe cases
fever
high pulse rate
loss of appetite

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7
Q

Describe NG management

A

Gentle removal of placque and necrosis debris

Irrigation and rinse with Hydrogen peroxide 3%/ (5ml H20 + 5ml H2O2) 2x daily

Metronidazole 400mg, Orally Every 12hr, 3-5 days

analgesics : paracetamol, Ibuprofen

No smoking and OHI

Review patient 48-72hrs

periodontal examination

Thorough debridement when possible

no response= refer

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8
Q

Describe differences and when Necrotizing periodontitis can occur

A

In severely immune compromised patients Bone Sequestra can occur

Occurs due to >1 episodes of necrotizing gingivitis

OR

Occurs due to necrotizing gingivitis @ site previously affected by periodontitis

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9
Q

What is necrotizing stomatitis

A

Defined by the presence of soft tissue necrosis that extends beyond the gingiva with bone denudation (erosion) and formation of bone sequestrum.

Occurs in severely systemically compromised patients

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10
Q

what are other names for Noma (cancrumoris)

A

Necrotizing ulcerative stomatitis
gangrenous stomatitis
cancrum oris

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11
Q

Describe early clinical features of Primary hepatic gingivostomatitis

A

Diffuse (pus)
erythematous (red skin)
shiny involvement of Gingiva and adjacent oral mucosa
oedema
gingival bleeding

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12
Q

What occurs within 24 hours of infection with herpes

A

Vessicles rupture to form painful small ulcers, with a red elevated margin and depressed yellow central portion

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13
Q

What is management for herpes

A

DELAY ELECTIVE SURGIES
Antiviral medication
- Famciclovir 1500mg
-single dose
Give at sign of recurrence

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14
Q

Describe pericoronitis

A

Inflammation of the gingiva in relation to the crown of an incompletely erupted tooth

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15
Q

What is the most common site of pericoronitis

A

Most common site= impacted 3rd molar.

Space between the crown and overlying gingiva flap accumulates debris

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16
Q

clinical features of PCoronitis

A

Red swollen,

Radiating pain to ear, throat and floor of mouth

Foul taste

inability to close jaw

Trismus

fever

malaise

17
Q

Describe the issue with the spread of infection and Pericorononitis with everyday function of the oral cavity.

A

Can spread posteriorly into the orophrangeal area and medially to the base of the tongue making it difficult to swallow.

18
Q

Describe management strategies for PC

A

Cleaning the region (debridement)
antibiotics (systemic signs)
Operculectomy or Exo

19
Q

Describe Periodontal Abscess

A

Acute lesions characterized by localized accumulation of pus within the gingival wall of the periodontal pocket/sulcus.

20
Q

In what 2 types of patients can peridontal abscess occur

A

Those with a previous Perio pocket (periodontitis patient)

Those without a pre-existing periodontal pocket (non periodontal patient)

21
Q

What are the common causes of Periodontal abscess

A
  1. Periodontal patients:
    - Scaling, root planing, surgical Periodontal treatment
  2. Non Periodontal Patient:
    - Foreign bodies, harmful habits, orthodontic factors, gingival enlargement, alteration to root surface
22
Q

Clinical features of a PA

A

Presence of generalized Perio with pocketing and bone loss

tooth is vital

overlying gingival erythematous

Tender & swollen

painful @ times (eating)

pus discharge via perio pocket

cervical lymphadenopathy

23
Q

management of an abccess

A

drainage through sulcus
irrigation of accessed pocket
removal of foreign bodies
debreidgement of soft tissue wall
oral hygiene instructions
antibiotics

24
Q

What are the contents of an abscess

A

bacteria, bacterial products,

inflammatory cells,

tissue breakdown products

serum

25
Q

Get ready for Staging and grading of perio

A

Take a deep breath you got this.

26
Q

Describe the 3 forms of periodontal health.

A
  1. periodontal health
    A) clinical gingival health on intact periodontium

B) clinical gingival health on a reduced periodontium
- Stable perio patient
- non perio patient with recession

  1. Gingivitis
    a) associated with direct biofilm alone

b) mediated by systemic or local risk factors

c) Drug influenced gingival enlargement
- Ex: phenytoin induced gingival hyperplasia

  1. Gingival diseases (non biofilm induced)
    - Genetic development disorders
    - specific infections
    - Inflammatory immune conditions
    - reactive processes
    - neoplasms
    traumatic lesions
27
Q

What neuropeptide/ neurotransmitter is a key bio marker for Gingivitis

A

Substance P

28
Q

What are 3 gingivitis modifying factors

A

Biofilm associated
Systemic ( sex hormones, smoking)
drug influenced

29
Q

what are the 3 types of periodontitis

A
  1. necrotizing periodontitis
  2. periodontitis due to systemic diseases
  3. periodontitis
30
Q

What are the primary features of perio

A

Loss of periodontal tissue support manifested as clinical attachment loss

radiographic bone loss

Pocketing

gingival bleeding

31
Q

What are the requirements for a periodontal case

A
  1. Interdental clinical attachment loss (CAL) is detectable in >=2 non adjacent teeth
  2. buccal or oral CAL >= 3mm with pocketing >= 3mm is detectable in >=2 teeth
32
Q

What are 5 causes for
Non Perio Clinical attachment Loss

A

Gingival recession of traumatic origin

dental caries extending to cervical area of tooth

distal CAL of 2nd molar due to malpostion or extraction of 3rd molar

endodontics lesion draining through the marginal periodontitis

vertical root fracture

33
Q

What is required to differentiate between stable, remission and currently unstable periodontal status

A
34
Q

what are differential periodontal diagnosis for periodontitis that need to be ruled out.

A

gingivitis
vertical root fracture
cervical caries

35
Q

Describe stage 1 Periodontitis

A
36
Q

describe stage 2 periodontitis

A
37
Q

describe stage 3 periodontitis

A
38
Q

describe stage 4 periodontitis

A

DS2102 Perio Hoes (3 decks)

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