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15. Non plaque induced inflammatory gingival diseases Flashcards

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1
Q

Non plaque induced factors

A
  • Bacterial
  • Viral
  • Fungal
  • Gingival manifestation of immunosuppresion
  • Gingival lesion of genetic origin
  • Mucocutaneous disorders
  • Allergic lesions
  • Traumatic lesions
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2
Q

Non plaque induced inflammatory gingival diseases

Bacterial

A
  • Neisseria gonorrhoea
  • Treponema pallidium
  • Mycobacterium tuberculosae
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3
Q

Non plaque induced inflammatory gingival diseases

Neisseria gonorrhoea clinical features

A
  • Grey and white patches
  • Covered w/ pseudomembranes
  • Pain and paresthesia
  • Fever

Patches over soft palate, tongue, buccal mucosa and tonsils

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4
Q

Non plaque induced inflammatory gingival diseases

Treponema pallidium

A
  • Young patients
  • Small papillae
  • Ulcus durum-non painful
  • Enlarged non painful lymph nodes

Surface of lips, tongue, palate, gingiva tonsils

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5
Q

Non plaque induced inflammatory gingival diseases

Mycobacterium tuberculosae

A
  • Ulcers
  • Very painful and infectious
  • lymphadenopathy
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6
Q

Non plaque induced inflammatory gingival diseases

Viral

A
  • Herpes simplex 1 and 2
  • Varicella zoster virus
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7
Q

Non plaque induced inflammatory gingival diseases

Causes chicken pox

A

Varicella zoster virus

mainly in children

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8
Q

Non plaque induced inflammatory gingival diseases

Herpes clinical manifestation

A
  • Both manifestations can involve gingiva
  • Small ulcers on tongue, palate and gingiva
  • Chicken pox-fever, malaise and skin rash
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9
Q

Non plaque induced inflammatory gingival diseases

Herpes zoster additional symptoms

A
  • Pain and paresthesia
  • Unilateral lesions
  • 1-2 weeks to heal
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10
Q

Non plaque induced inflammatory gingival diseases

Treatment of herpes

A
  • Soft liquid diet and rest
  • Plaque removal and diluted chlorhexidine rinses
  • Acyclovir
  • Famcyclovir
  • Valacyclovir
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11
Q

Non plaque induced inflammatory gingival diseases

Fungal

A
  • Candidosis
  • Histoplasmosis
  • Aspergillosis
  • Blastomycosis
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12
Q

Non plaque induced inflammatory gingival diseases

Candidosis

A
  • -C. Albicans
  • Opportunistic
  • Rarely affects gingiva
  • Gingival lesions- redness at attached gingiva, granular surface
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13
Q

Non plaque induced inflammatory gingival diseases

Predisposing factors for candidosis

A
  • Local=>Reduced salivary flow
  • Systemic=>
  • Antibiotics
  • Corticosterioids
  • Smoking, diabetes, HIV
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14
Q

Non plaque induced inflammatory gingival diseases

Types of candidosis

A
  • Pseudomembranous
  • Erythematous
  • Plaque type
  • Nodular
  • Histoplasmosis(Granulomatous disease)
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15
Q

Non plaque induced inflammatory gingival diseases

Pseudomembranous Candidosis

A
  • Non painful whitish patches
  • Can be wiped off leaving bleeding surface
  • No major symptoms

Palatal, buccal and labial mucosa

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16
Q

Non plaque induced inflammatory gingival diseases

Erythematous Candidosis

Study These Flashcards
A
  • Intensely red lesions
  • Severe pain
  • Anywhere on oral mucosa

Palate and lingual mucosa

17
Q

Non plaque induced inflammatory gingival diseases

Plaque type Candidosis

Study These Flashcards
A
  • Whitish plaque
  • Cannot be removed
  • No symtpoms
  • Indistinguishable from oral leukoplakia
18
Q

Non plaque induced inflammatory gingival diseases

Nodular Candidosis

Study These Flashcards
A
  • Rare gingival presentation
  • Slightly elevated nodules of white or reddish colour
19
Q

Non plaque induced inflammatory gingival diseases

Diagnosis of candidosis

Study These Flashcards
A
  • Culture, smear, biopsy
  • Topical-Clotrimazole, Nystatin
  • Systemic-Ketoconazole, Fluconazole, Amphotericin B
20
Q

Non plaque induced inflammatory gingival diseases

  • Histoplasmosis (Granulomatous disease)
Study These Flashcards
A
  • Nodular=>papillary lesion
  • Can become ulcerative and painful w/ loss of gingival tissue
  • Can resemble malignant tumour
21
Q

Non plaque induced inflammatory gingival diseases

Gingival manifestation of immunosuppression

Study These Flashcards
A

Linear gingival erythema

22
Q

Non plaque induced inflammatory gingival diseases

Linear gingival erythema

Study These Flashcards
A
  • 2-3 mm marginal band or erythema in Free gingiva
  • Can extend to attached gingiva and beyond MGJ
  • Commonly generalised

If localised-1 or 2 teeth
Rinse with chx gluconate x2 daily

23
Q

Non plaque induced inflammatory gingival diseases

Gingival lesions of genetic origin

Study These Flashcards
A
  • Hereditary gingival fibromatosis
  • Lichen planus
24
Q

Non plaque induced inflammatory gingival diseases

Hereditary gingival fibromatosis

Study These Flashcards
A
  • Diffuse gingival enlargement
  • Firm dense fibrous tissue
  • Pseudopockets

Surgical removal indicated-gingivectomies

25
# Non plaque induced inflammatory gingival diseases Lichen planus
* Papules and white striae * Lesions disappear spontaneously * Skin and mucous membranes affected ## Footnote -Striae-> Wickham striae -Autoimmune component
26
# Non plaque induced inflammatory gingival diseases Mucocutaneous disorders
* Bullous pemphigoid * Mucomembranous pemphigoid * Pemphigus vulgaris * Erythema multiforme
27
# Non plaque induced inflammatory gingival diseases Pemphigoid
* Chronic autoimmune disease * Antibodies to components of lamina Lucida of basement membrane=>Detachement of epitheium from CT
28
# Non plaque induced inflammatory gingival diseases Bullous pemphigoid
* Oral=>desquamative gingivitis and bullous lesions * Bullae=>rupture and leave ulcerative lesions * Skin-Nikolsky sign ## Footnote Treatment w/ topical steroids and tetracyclines
29
# Non plaque induced inflammatory gingival diseases Mucous membrane pemphigoid
* Desquamative lesions=>Intensively erythematous gingiva * Ulcerative lesions after rupture of bullae w/ bleeding surface * Fibrin coated ulcers yellowish/red ## Footnote -Involes mucosa of nose, vagina, rectum, oesophagus -Local treatment-Plaque removal, Chx mouthwash, topical corticosteroids -Systemic treatment-Corticosteroids(prednisone, dapsone), immunosuppressive agents-methotraxate
30
# Non plaque induced inflammatory gingival diseases Pemphigus vulgaris
* Widespread bulla formation * Early lesions resemble apthous ulcers * Widespread erosions * Gingival involvement=>desquamative lesions, erosions or ulcers ## Footnote Treatment-corticosteroids, plaque removal
31
# Non plaque induced inflammatory gingival diseases Erythema multiforme
* Widespread mucosal lesions * Bullae that rupture leaving ulcers * Covered by yellowish fibrinous exudates * Pseudomembranes-swollen lips ## Footnote Oral, occular and genital lesions

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