2. periodontitis and systemic disease Flashcards
(24 cards)
is desquamatous gingivitis a diagnosis?
no
what is desquamatous gingivitis?
Appearance on the gingivae: red, glazed with ulceration and desquamation of the attached gingivae
is desquamatous gingivitis plaque induced?
○ Isn’t plaque induced - but poor OH exacerbates it
what diseases can present as desquamatous gingivitis? 4
Lichen planus
benign mucous membrane pemphigoid
plasma cell gingivitis
erythema multiforme
how is diagnosis made for desquamatous gingivitis?
from history, clinical examination and biopsy
what 2018 classification is desquamatous gingivitis in?
gingival diseases: non-dental biofilm-induced
what is drug induced gingival enlargement DIGE?
Drugs cause the gingivae to excessively overgrow
what 2018 classification in drug induced gingival enlargement DIGE in?
gingivitis: dental biofilm induced
is drug induced gingival enlargement a periodontitis risk?
yes
Difficult for pt to maintain OH
what is typically the first place affected by DIGE?
papilla
what drugs increase the risk of DIGE?
anti epileptic drugs
calcium channel blockers
immune regulators
name some anti-epileptic drugs that increase the risk of DIGE
phenytoin (associated with fibrotic enlargement)
sodium valproate
name some calcium channel blockers that increase the risk of DIGE
amlodipine, nifedipine, veramapil, diltiazem
name an immune regulator that increases the risk of DIGE
cyclosporine (associated with high levels of inflammation with little fibrosis - red and bleeding)
what is the cause of DIGE
drugs that affect fibroblasts
- Increased production of ECM proteins
- Reduced collagenase production leading to reduced tissue turnover
plaque biofilm is required along with the drug
how is DIGE prevented?
Good plaque control
Folic acid supplementation for phenytoin related
what is the management of DIGE?
if significant request GP to change drug
Surgical removal - open wound gingivectomy - healing by secondary intention
what is factitious injury
self harm
Localised lesions on gingiva of young people which may be ulcerated or have marginal keratosis from chronic trauma
what 2018 classification is factitious injury in?
gingival diseases: non-dental biofilm-induced - section G traumatic lesions
what is the most common cause of gingival enlargement in general?
plaque induced inflammation
are plaque bacteria directly involved in the pathogenesis of desquamatous gingivitis?
no
what connective tissue cell is thought to be directly involved in the development of DIGE
fibroblasts
which group of medications results in the highest incidence of DIGE
anti-epileptic
which group of medications of the 3 results in lowest incidence of DIGE?
calcium channel blockers
