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PRD seminars / lectures > Acute perio diseases- NUG/NUP > Flashcards

Acute perio diseases- NUG/NUP Flashcards

1
Q

How is NUG diagnosed?

A

Clinically

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2
Q

Describe the pain in NUG?

A

Sudden onset (acute), can be severe, may affect eating.

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3
Q

What are the clinical features of NUG? (8)

A

Necrotic ulcers
Initial red swollen interdental papilla
Ulceration starts on tip of ID papillae- spreads laterally along ging margin
SLOUGH- yellow fibrinous tissue consisting of fibrin and pus.
Halitosis (foetor oris)
Spontaneous bleeding (metallic taste)

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4
Q

How long do the acute symptoms last?

A

2-3 days - 2-3 weeks

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5
Q

What does acute symptoms turn into?

A

Chronic gingivitis

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6
Q

NUG creates stagnation areas and likely to come back due to loss of ID papilla

A

YES

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7
Q

What is cancrum oris?

A

Sequelae of NUG in developing countries resulting in facial tissue loss.

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8
Q

What is the microbiology if NUG? (principle bacteria)

A 
Anaerobic fuso-spirochaetal complex (destructive)
TREPONEMA VINCENTII & DENTICOLA
FUSOBACTERIUM NUCLEATUM 
PREVOTELLA INTERMEDIA
PORPHYROMONAS GINGIVALIS
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9
Q

What are the predisposing factors of NUG? (4)

A

Poor OH
Smoking (causes vasoconstriction creating anearobic state, it suppresses serum igG levels against subgingival bacteria, reduces motility of PMNs so healing is impaired)
Stress (changes behaviour (poor oh, increased smoking, poor diet)
Immunodeficiency

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10
Q

Histopathology of NUG (4)

A 
Bacterial zone (surface slough creates lots of bacteria)
PMNs rich zone (epithelium and CT full of lots of PMNs 
Necrotic zone (many spirochetes)
Deeper tissues (still variable with plasma and macrophages)
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11
Q

What is the treatment of NUG/

A

OHI & explanation of disease
Gentle USS- cleans out anaerobic bacteria and water is soothing
Metronidazole- 200mg given if systemic symptoms
Review every 48 hours

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12
Q

What treatment can you do subsequently?

A

OHI, Smoking advice, RSD, review and maintenance

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13
Q

NUP is associated with what?

A

AIDS and immuno-suppression.

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PRD seminars / lectures (5 decks)

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