5: GINGIVITIS, PERIODONTITIS, PERICORONITIS, PERI-IMPLANTITIS, PERI-IMPLANT MUCOSITIS Flashcards by Secret acc

______
Inflammatory conditions affecting the gums and structures supporting the teeth(gingiva, periodontal ligament, cementum, and alveolar bone) . They range from mild, reversible gingivitis to severe, irreversible periodontitis that can lead to tooth loss.

PERIODONTAL DISEASE

How well did you know this?

Not at all

Perfectly

OVERVIEW OF MICROBIAL ETIOLOGY OF PERIODONTAL DISEASE
• Caused mainly by ______ at the ______

plaque buildup, gumline

How well did you know this?

Not at all

Perfectly

Healthy gum crevice
- mildly ______(low oxygen)and protected by ______. GCF contains immune cells like

anaerobic, gingival crevicular fluid (GCF), polymorphonuclear leukocytes (PMNLs)

How well did you know this?

Not at all

Perfectly

Plaque makes the environment more ______ and ______

anaerobic, alkaline

How well did you know this?

Not at all

Perfectly

Favors growth of proteolytic bacteria:
• ______
• ______
• ______
These bacteria colonize tooth surfaces and gums which triggers ______ and destroys ______

Porphyromonas gingivalis, Prevotella spp., Peptococcus micros, inflammation, supporting tissues

How well did you know this?

Not at all

Perfectly

______
• is a reversible inflammation of the gums caused by plaque buildup, which triggers an immune response leading to swelling, redness, and bleeding.

GINGIVITIS

How well did you know this?

Not at all

Perfectly

GINGIVITIS

PATHOGENESIS
THE ______ LESION
• Develops within 4 days of plaque accumulation

INITIAL

How well did you know this?

Not at all

Perfectly

GINGIVITIS

PATHOGENESIS
THE ______ LESION
• Shows acute inflammation, blood vessel changes (______), collagen breakdown, increased crevicular fluid, white blood cell (______) infiltration

INITIAL, vasculitis, polymorphonuclear leukocyte

How well did you know this?

Not at all

Perfectly

GINGIVITIS

PATHOGENESIS
THE ______ LESION
• No clinical signs are visible at this stage

INITIAL

How well did you know this?

Not at all

Perfectly

GINGIVITIS

PATHOGENESIS
THE ______ LESION
• Dominated by Gram-positive and facultative bacteria, mainly ______

INITIAL, streptococci

How well did you know this?

Not at all

Perfectly

GINGIVITIS

PATHOGENESIS
THE ______ LESION
• Appears after 7 days

EARLY

How well did you know this?

Not at all

Perfectly

GINGIVITIS

PATHOGENESIS
THE ______ LESION
• Visible gingival inflammation, dense lymphocyte infiltration, and collagen breakdown

EARLY

How well did you know this?

Not at all

Perfectly

GINGIVITIS

PATHOGENESIS
THE ______ LESION
• Increased Actinomyces spp., Capnocytophaga, and some Gram-negative anaerobes

EARLY

How well did you know this?

Not at all

Perfectly

GINGIVITIS

PATHOGENESIS
THE ______ LESION
• Develops over a variable period

ESTABLISHED

How well did you know this?

Not at all

Perfectly

GINGIVITIS

PATHOGENESIS
THE ______ LESION
• Pocket formation, increased plasma cells, B cells, and neutrophils; lesion may persist for years without deeper tissue damage if plaque remains

ESTABLISHED

How well did you know this?

Not at all

Perfectly

GINGIVITIS

PATHOGENESIS
THE ______ LESION
• Increased black-pigmented ______ (e.g., Porphyromonas gingivalis, Prevotella intermedia) and ______

ESTABLISHED, anaerobes, spirochetes

How well did you know this?

Not at all

Perfectly

GINGIVITIS

MANAGEMENT
Treatment is by thorough removal of ______ and ______ deposits, all plaque-retentive factors, and the introduction of good oral hygiene

plaque, calculus

How well did you know this?

Not at all

Perfectly

GINGIVITIS

MISCELLANEOUS FORMS OF GINGIVITIS:

• PREGNANCY GINGIVITIS
• DIABETES MELLITUS–RELATED GINGIVITIS
• ACUTE STREPTOCOCCAL GINGIVITIS
• HIV DISEASE ASSOCIATED GINGIVITIS
• ACUTE HERPETIC GINGIVOSTOMATITIS

How well did you know this?

Not at all

Perfectly

GINGIVITIS

MISCELLANEOUS FORMS OF GINGIVITIS:

______
• Hormone-related gingivitis

PREGNANCY GINGIVITIS

How well did you know this?

Not at all

Perfectly

GINGIVITIS

MISCELLANEOUS FORMS OF GINGIVITIS:

______
• Usually seen in the second trimester of pregnancy

PREGNANCY GINGIVITIS

How well did you know this?

Not at all

Perfectly

GINGIVITIS

MISCELLANEOUS FORMS OF GINGIVITIS:

______
• Linked to increased numbers of anaerobes, especially Prevotella intermedia

PREGNANCY GINGIVITIS

How well did you know this?

Not at all

Perfectly

GINGIVITIS

MISCELLANEOUS FORMS OF GINGIVITIS:

______
• Associated with changes in steroid hormone levels in crevicular fluid

PREGNANCY GINGIVITIS

How well did you know this?

Not at all

Perfectly

GINGIVITIS

MISCELLANEOUS FORMS OF GINGIVITIS:

______
• Commonly seen in poorly controlled diabetics

DIABETES MELLITUS–RELATED GINGIVITIS

How well did you know this?

Not at all

Perfectly

GINGIVITIS

MISCELLANEOUS FORMS OF GINGIVITIS:

______
• Diseased sites show increased levels of Capnocytophaga

DIABETES MELLITUS–RELATED GINGIVITIS

How well did you know this?

Not at all

Perfectly

GINGIVITIS MISCELLANEOUS FORMS OF GINGIVITIS: ______ • Also associated with periodontopathogens like ______ and ______

DIABETES MELLITUS–RELATED GINGIVITIS, Porphyromonas gingivalis, Treponema denticola

GINGIVITIS MISCELLANEOUS FORMS OF GINGIVITIS: ______ • Caused by Streptococcus pyogenes

ACUTE STREPTOCOCCAL GINGIVITIS

GINGIVITIS MISCELLANEOUS FORMS OF GINGIVITIS: ______ • Often follows a streptococcal sore throat and presents as a severe disease with fever

ACUTE STREPTOCOCCAL GINGIVITIS

GINGIVITIS MISCELLANEOUS FORMS OF GINGIVITIS: ______ • Gingivae appear inflamed, red (______), and swollen (______)

ACUTE STREPTOCOCCAL GINGIVITIS, erythema, edema

GINGIVITIS MISCELLANEOUS FORMS OF GINGIVITIS: ______ • Often linked to immune suppression caused by the virus

HIV DISEASE ASSOCIATED GINGIVITIS

GINGIVITIS MISCELLANEOUS FORMS OF GINGIVITIS: ______ • Caused by atypical and opportunistic bacteria

HIV DISEASE ASSOCIATED GINGIVITIS

GINGIVITIS MISCELLANEOUS FORMS OF GINGIVITIS: ______ • Common bacteria include Atypical mycobacteria, Porphyromonas gingivalis, and Treponema denticola

HIV DISEASE ASSOCIATED GINGIVITIS

GINGIVITIS MISCELLANEOUS FORMS OF GINGIVITIS: ______ • Caused by Human Herpesviruses 1 and 2 (HHV-1, HHV-2)

ACUTE HERPETIC GINGIVOSTOMATITIS

GINGIVITIS MISCELLANEOUS FORMS OF GINGIVITIS: ______ • Often in early childhood (usually subclinical or mistaken for teething); more severe if first contracted in adulthood

ACUTE HERPETIC GINGIVOSTOMATITIS

GINGIVITIS MISCELLANEOUS FORMS OF GINGIVITIS: ______ • Painful, inflamed, bleeding gums, oral ulcers, fever; incubation ~______ days; spread through skin lesions or saliva

ACUTE HERPETIC GINGIVOSTOMATITIS, 5

______ • is an inflammatory or infectious disease of the ______ — the tissues that surround and support the teeth (gingiva, periodontal ligament, cementum, and alveolar bone).

PERIODONTITIS, periodontium

______ • It is characterized by sore, swollen, and bleeding gums and, in severe cases, can cause tooth loosening or tooth loss.

PERIODONTITIS

PERIODONTITIS DISTINGUISHING FEATURES Progressive destruction of the tooth-supporting structures (______, ______, ______, ______).

gingiva, periodontal ligament, cementum, alveolar bone

PERIODONTITIS DISTINGUISHING FEATURES Presence of ______ and ______ (visible on X-rays) — key diagnostic markers.

Clinical Attachment Loss (CAL), Alveolar Bone Loss

PERIODONTITIS DISTINGUISHING FEATURES Formation of ______ (deep spaces between tooth and gum due to tissue detachment).

periodontal pockets

PERIODONTITIS DISTINGUISHING FEATURES ______ bleeding — especially when ______.

Gingival, probing

PERIODONTITIS DISTINGUISHING FEATURES Symptoms include: • ______, ______, or ______ gums. • ______ gums (teeth appear longer). • ______ teeth or tooth ______ in advanced cases. • Persistent ______ and sometimes ______.

Swollen, tender, bleeding Receding Loose, loss bad breath, pus discharge

______ • Most prevalent form of periodontal disease worldwide.

CHRONIC PERIODONTITIS

______ • A chronic, multifactorial, inflammatory condition associated with the progressive destruction of the tooth-supporting apparatus.

CHRONIC PERIODONTITIS

______ • Characterized by slow progression, primarily affecting adults.

CHRONIC PERIODONTITIS

______ CLINICAL FEATURES • Gross gingival inflammation, fibrosis, and shrinkage.

CHRONIC PERIODONTITIS

______ CLINICAL FEATURES • Periodontal pockets >3 mm with bleeding.

CHRONIC PERIODONTITIS

______ CLINICAL FEATURES • Tooth mobility and migration.

CHRONIC PERIODONTITIS

______ CLINICAL FEATURES • Irregular alveolar bone loss & gingival recession.

CHRONIC PERIODONTITIS

______ CLINICAL FEATURES • Halitosis and offensive taste.

CHRONIC PERIODONTITIS

______ CLINICAL FEATURES • Usually painless, may or may not be linked to systemic diseases.

CHRONIC PERIODONTITIS

CHRONIC PERIODONTITIS MICROBIOLOGY • Dominated by ______.

Gram-negative anaerobes

CHRONIC PERIODONTITIS MICROBIOLOGY Key Pathogens:

• Porphyromonas gingivalis • Prevotella intermedia • Fusobacterium nucleatum • Tannerella forsythia • Aggregatibacter actinomycetemcomitans • Selenomonas spp. • Capnocytophaga spp. • Spirochaetes

______ • A rapidly progressing form of periodontal disease.

AGGRESSIVE PERIODONTITIS

______ • Affects primarily young individuals, often around puberty.

AGGRESSIVE PERIODONTITIS

______ • Historically classified as “juvenile periodontitis” or “early-onset periodontitis.”

AGGRESSIVE PERIODONTITIS

______ CLINICAL FEATURES • Onset around puberty (~13 years).

AGGRESSIVE PERIODONTITIS

______ CLINICAL FEATURES • Rapid bone loss with intermittent active and quiescent phases.

AGGRESSIVE PERIODONTITIS

______ CLINICAL FEATURES • Minimal plaque and calculus in periodontal pockets, despite severe destruction.

AGGRESSIVE PERIODONTITIS

______ CLINICAL FEATURES • May or may not show signs of gingivitis.

AGGRESSIVE PERIODONTITIS

______ CLINICAL FEATURES • Often discovered through radiographs rather than symptoms.

AGGRESSIVE PERIODONTITIS

AGGRESSIVE PERIODONTITIS TYPES & MORBIDITY • ______: Primarily affects incisors and first permanent molars.

Localized

AGGRESSIVE PERIODONTITIS TYPES & MORBIDITY • ______: Affects multiple teeth beyond molars and incisors.

Generalized

AGGRESSIVE PERIODONTITIS TYPES & MORBIDITY • Relatively rare: ~______% in young white populations, more common in ______ and ______.

0.1, West Africans, Asians

AGGRESSIVE PERIODONTITIS TYPES & MORBIDITY • ______ is common; may involve genetic or immune defects.

Familial clustering

AGGRESSIVE PERIODONTITIS MICROBIOLOGY & IMMUNOLOGY Key Pathogens:

• Aggregatibacter actinomycetemcomitans • Capnocytophaga spp. • Porphyromonas gingivalis • Prevotella intermedia

AGGRESSIVE PERIODONTITIS MICROBIOLOGY & IMMUNOLOGY • Impaired immune response: Peripheral blood ______ show reduced ______ response.

lymphocytes, chemotactic

AGGRESSIVE PERIODONTITIS MICROBIOLOGY & IMMUNOLOGY Strong association with ______ due to: • High incidence in ______. • High ______ levels that drop after treatment.

A. actinomycetemcomitans, lesional sites, antibody

AGGRESSIVE PERIODONTITIS MANAGEMENT • Mechanical ______ therapy combined with strict ______.

periodontal, oral hygiene

AGGRESSIVE PERIODONTITIS MANAGEMENT • Adjunctive ______ therapy (e.g., ______ 250 mg 3x/day for 4 weeks) is often effective.

antibiotic, tetracycline

AGGRESSIVE PERIODONTITIS MANAGEMENT • Successful treatment leads to regression of ______ and reduction of ______.

disease, A. actinomycetemcomitans

______ • Defined as inflammation of the soft tissues covering or immediately subjacent to the crown of a partially erupted tooth.

PERICORONITIS

______ • The condition is frequently seen in the operculum and the soft tissues in erupting lower third molars of young adults.

PERICORONITIS

PERICORONITIS CLINICAL FEATURES ______: • sudden onset and short lived

Acute pericoronitis

PERICORONITIS CLINICAL FEATURES ______: • with significant symptoms such as trismus and extreme pain, especially when opposing tooth causes additional trauma

Acute pericoronitis

PERICORONITIS CLINICAL FEATURES ______: • repeated episodes of acute pericoronitis

Chronic or recurrent

PERICORONITIS CLINICAL FEATURES ______: • presents with varying degrees of inflammation of the pericoronal flap and adjacent structures, as well as systemic complications.

Chronic or recurrent

PERICORONITIS MICROBIOLOGY & IMMUNOLOGY Key Pathogens Strict anaerobes:

• Prevotella intermedia • Fusobacterium species • Anaerobic streptococci

PERICORONITIS MICROBIOLOGY & IMMUNOLOGY Key Pathogens Other periodontopathic organisms:

• Aggregatibacter actinomycetemcomitans • Tannerella forsythia

PERICORONITIS MANAGEMENT Mild cases: • local ______ irrigation, especially underneath the ______

saline, operculum

PERICORONITIS MANAGEMENT Mild cases: • ______ relief from the opposing tooth, if any.

trauma

PERICORONITIS MANAGEMENT Moderate to severe cases: • antibiotic therapy with ______ either with or without ______ and ______

penicillin, clindamycin, metronidazole

______ • IS A REVERSIBLE INFLAMMATORY CONDITION THAT AFFECTS THE SOFT TISSUES (MUCOSA) SURROUNDING A DENTAL IMPLANT WITHOUT ANY LOSS OF SUPPORTING BONE. IT IS CONSIDERED THE PRECURSOR TO PERI-IMPLANTITIS

PERI-IMPLANT MUCOSITIS

______ • Inflammation limited to soft tissues surrounding the implant

PERI-IMPLANT MUCOSITIS

______ • No radiographic evidence of bone loss

PERI-IMPLANT MUCOSITIS

______ • Bleeding on probing (BoP) is the most reliable clinical sign

PERI-IMPLANT MUCOSITIS

______ • Caused by bacterial plaque accumulation

PERI-IMPLANT MUCOSITIS

______ • Can be reversed with improved oral hygiene and professional care

PERI-IMPLANT MUCOSITIS

PERI-IMPLANT MUCOSITIS KEY PATHOGENS:

Streptococcus spp. Fusobacterium nucleatum Prevotella intermedia Actinomyces spp.

PERI-IMPLANT MUCOSITIS KEY PATHOGENS: • ______ - Early colonizers; initiate biofilm formation on implant surfaces

Streptococcus spp.

PERI-IMPLANT MUCOSITIS KEY PATHOGENS: • ______ - Gram-negative anaerobe; promotes inflammatory response

Fusobacterium nucleatum

PERI-IMPLANT MUCOSITIS KEY PATHOGENS: • ______ - Gram-negative anaerobic rod; associated with soft tissue inflammation

Prevotella intermedia

PERI-IMPLANT MUCOSITIS KEY PATHOGENS: • ______ - Gram-positive rods; often found in early-stage peri-implant mucositis

Actinomyces spp.

______ CLINICAL IMPLICATIONS • Acts as an early warning sign of peri-implant disease

PERI-IMPLANT MUCOSITIS

______ CLINICAL IMPLICATIONS • Progresses to peri-implantitis if not treated

PERI-IMPLANT MUCOSITIS

______ CLINICAL IMPLICATIONS • No bone loss — key to distinguish from peri-implantitis

PERI-IMPLANT MUCOSITIS

______ CLINICAL IMPLICATIONS • Indicates poor plaque control, possibly poor prosthesis design or patient hygiene habits

PERI-IMPLANT MUCOSITIS

______ CLINICAL IMPLICATIONS • Routine monitoring and maintenance are essential

PERI-IMPLANT MUCOSITIS

PERI-IMPLANT MUCOSITIS INTERVENTION:

• Mechanical Debridemen • Antimicrobial Therapy • Oral Hygiene Instruction • Maintenance and Monitoring

______ • is a biofilm-associated inflammatory condition affecting the peri-implant mucosa, with loss of supporting bone.

PERI IMPLANTITIS

______ • Additional clinical signs of inflammation, including redness, swelling, or the presence of a draining sinus, in addition to progressive bone loss.

PERI IMPLANTITIS

______ • Lesions extend beyond the pocket epithelium, have a larger size inflammatory cell infiltrate, and large proportions of plasma cells.

PERI IMPLANTITIS

PERI IMPLANTITIS KEY PATHOGENS Same with peri-implant mucositis but with high numbers of:

Staphylococcus aureus Peptostreptococci Enteric rods Yeasts

PERI IMPLANTITIS Signs and symptoms:

• Swelling or redness of gums around the implant • Bleeding on probing • Suppuration (pus) • Pain or tenderness in the gums around the implant. • A bad taste in the mouth. • Loosening of the implant.

______ CLINICAL IMPLICATIONS • Implant design and surface roughness influence biofilm accumulation.

PERI IMPLANTITIS

PERI IMPLANTITIS INTERVENTION:

• Patients should maintain meticulous oral hygiene • Professional dental management • Surgical treatment

5: GINGIVITIS, PERIODONTITIS, PERICORONITIS, PERI-IMPLANTITIS, PERI-IMPLANT MUCOSITIS Flashcards

(105 cards)