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Periodontology > Chp 6 PP > Flashcards

Chp 6 PP Flashcards

1
Q

Most common fungal disease

A

Candida albicans

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2
Q

Gingival diseases of fungal origin are treated with

A

antifungal or antiseptic therapies or both.

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3
Q

Causes of candida albicans

A

Immunoc, HIV, organ transplant

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4
Q

is an inflammation of the gingival tissues.

A

Gingivitis

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5
Q

Gingivitis occurs in a periodontium with

A

no attachment loss or in a periodontium with attachment loss that is not progressing.

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6
Q

Gingivitis manifestations include

A

Color change (redness)
Edema (swelling of the tissues)
Exudate (drainage of gingival fluid from the sulcus)
Spontaneous bleeding (hemorrhage in response to gentle periodontal probing or toothbrushing)
gingival contour, loss of tissue adaptation to the teeth, and an increased flow of gingival crevicular fluid

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7
Q

refers to the events in the development and progression of a disease.

A

Pathogenesis

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8
Q

The development of gingival inflammation can be separated into four stages:

A

Initial
Early
Established
Advanced

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9
Q

The extension of inflammation into the alveolar bone, at which point the gingival disease has progressed to

A

periodontal disease, characterizes the fourth (or advanced) stage.

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10
Q

Stage I gingivitis occurs in how many days

A

first few days of contact.

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11
Q

Symptoms of stage 1 gingivitis

A

The dilation of the blood vessels
Polymorphonuclear neutrophils (PMNs) attach to the vessel walls and begin to migrate into the surrounding connective tissues.
Lymphocytes appear (mostly T)
Activation of the host immune

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12
Q

are the principal defense in acute inflammation.

A

PMNs

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13
Q

PMNs do?

A

phagocytize bacteria, their products, and other products of destroyed tissue.

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14
Q

Medications that can cause gingiva enlargement

A

Phenatonin
Calcium blockers
Gabbapentin

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15
Q

What causes Linear gingival erythema

A

HIV

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16
Q

Number one reason for gingiva enlargement

A

Seizures

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17
Q

Are the first tissue reactions in stage 1 gingivitis visible

A

No

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18
Q

Stage II gingivitis is referred to as

A

early gingivitis

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19
Q

Clinical evidence of gingivitis occurs at this stage.

A

Stage 2

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20
Q

Lesions begin to form __ to ___ days after plaque has accumulated in the gingival sulcus.

A

4-7

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21
Q

Symptoms of stage 2 gingivitis

A

T lymphocytes increase
The inflammatory exudate increases and may appear white or yellow
Tissues appear slightly red and swollen
Collagen fibers are destroyed, and gingival stippling begins to disappear, causing the gingiva to appear shiny.
The junctional epithelium begins to lengthen
Gingival tissues tend to bleed

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22
Q

This early stage of gingivitis may continue for ___ days or longer.

A

21 days

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23
Q

After 15 to 21 days, the gingival inflammation reaches the stage ___ gingivitis

A

Stage III

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24
Q

Sypmtoms of stage 3 gingivitis

A

Plasma cells, intense antigen-antibody response, are present.
T and B lymphocytes are found in equal amounts, Tissue destruction inflammatory reaction
B lymphocytes are related to cell surface immunity and release lymphokines.
More connective tissue collagen is destroyed.
The junctional epithelium thickens and extends apically into the underlying connective tissues.
The clinical probing depth increases
The blood vessels proliferate, permitting more seepage of serum into the tissues and through the sulcular epithelium.
Visible pus formation.

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25
Q

In extreme cases of Stage III gingivitis what occurs

A

the tissue appears blue, or cyanotic, because of the presence of many oxygen-depleted red blood cells.

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26
Q

The clinical probing depth increases for two reasons in stage III gingivitis

A

1) The periodontal probe penetrates more deeply through the junctional epithelium into the connective tissue by approximately 1 mm as a result of the loss of collagen.
2) Edema in the tissues moves the gingival margin coronally, increasing the probe readings.

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27
Q

How long can stage III gingivitis last

A

The established gingivitis stage may persist unchanged for months or years.
The condition is reversible when plaque is regularly removed, permitting the tissues to return to normal.
When healing occurs, no residual tissue destruction remains.

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28
Q

Stage IV gingivitis is referred to as the

A

advanced stage of gingivitis.

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29
Q

What stage of gingivitis has the inflammatory processes have extended beyond the gingiva and into the other periodontal tissues.

A

Stage 4

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30
Q

The extension of disease into the bone is referred to as

A

periodontitis.

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31
Q

Healing of gingivitis begins in the

A

connective tissues.

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32
Q

Fibroblast do what to help the gingiva heal

A

Fibroblasts, which lay down a firm extracellular matrix of collagen, replace the inflammatory cells.
These fibers produce a dense subgingival connective tissue.
This connective tissue does not permit penetration of the periodontal probe, reducing the probing depth.

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33
Q

Gingivitis is classified into a number of categories on the basis of:

A

Clinical manifestations of the disease
Cause
Association with systemic diseases
Association with medications

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34
Q

Recession of the gingiva refers to

A

the location of the margin of the tissue.

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35
Q

Etiologic factors associated with recession include:

A

Gingival abrasion
Tooth malposition (rotated, tilted, or displaced tooth)
Gingival ablation (friction from other soft tissues)
Gingival inflammation
Abnormal frenum attachment

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36
Q

T/F Recession can occur in gingivitis, or it can be associated with clinically healthy tissue.

A

True

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37
Q

T/F Recession can be localized to one tooth or extend to any number of teeth.

A

True

38
Q

Recession is of significance in dental hygiene care because:

A

Root surfaces can decay.
Cemental surfaces can wear away, creating sensitivity.
Recessed areas can be more difficult for the patient to clean.

39
Q

The most common form of gingivitis found in the general population is

A

gingivitis associated with dental plaque only; it is also called plaque-associated gingivitis or gingivitis.

40
Q

Aka bleeding gums

A

gingivitis associated with plaque biofilm only

41
Q

This disease is directly related to the presence of bacterial plaque on the tooth surface.

A

Gingivitis associated with plaque biofilm only

42
Q

Gingivitis Associated with Dental Plaque Biofilm Only Epithelium lining the gingival sulcus is

A

ulcerated.

Ulceration causes a tendency to bleed on probing.

43
Q

Gingivitis is directly related to the amount of

A

plaque biofilm on the teeth and the amount of time the plaque is allowed to remain undisturbed.

44
Q

Plaque biofilm is considered nonspecific or specific?

A

nonspecific because it is not associated with any specific type of microorganism.

45
Q

Mature plaque biofilm has a large percentage of gram positive or gram negative bacteria.

A

gram-negative bacteria

46
Q

How is gingivitis distributed in the mouth

A

It may be limited to the interdental papilla, spread along the entire gingival margin, or involve all of the attached gingival tissues.

47
Q

The terms commonly used to describe the tissues in relation to gingivitis include:

A

Extent of involvement: localized, generalized
Tissues affected: marginal, papillary
Degree of inflammation: slight, moderate, severe
Color, shape and shininess of tissues

48
Q

Can systemic factors cause gingivitis

A

systemic factors do not cause gingivitis but act to intensify it, resulting in gingival diseases modified by systemic factors.

49
Q

Steroid-type hormones produced by the endocrine glands influence

A

gingivitis

50
Q

What hormones are associated with gingival disease

A

Hormones associated with puberty, pregnancy, birth control medications

51
Q

When female hormone levels are increased, some subgingival bacteria increase, such as

A

Bacteroides species, possibly causing the increased gingival inflammation.

52
Q

Estrogen may also regulate

A

cellular proliferation, keratinization, and vascular proliferation and fragility in the gingival tissues.

53
Q

As hormone levels increase during the second trimester of pregnancy, _____ may increase

A

gingival inflammation

54
Q

pregnancy gingivitis appears as

A

The gingiva may become dark red and hyperplasic and may bleed excessively

55
Q

pregnancy tumor.

A

is not a tumor but a localized area of pyogenic granulation tissue.
The tissues are highly inflamed, easily bleed, and may cause the teeth to be mobile and possibly migrate out of the way.
Poor plaque biofilm control is related to the severity of the inflammation.

56
Q

Gingival changes associated with pregnancy may occur in women who are

A

taking oral contraceptives or in women who are taking hormone replacement therapy.

57
Q

Two mechanisms may cause this gingival response during pregnancy

A
  1. An increase in some pathogenic bacteria, such as Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans
  2. Possible increase in prostaglandin E, a mediator of inflammation
58
Q

an antiseizure medication, is associated with gingival hyperplasia (overgrowth).

A

Phenytoin,

59
Q

What cell creates a denser connective tissue cause the enlargement.

A

Fibroblast

60
Q

How to treat overgrowth

A

Treatment of this type of gingival enlargement requires good homecare, regular scaling and root planing, and, often, surgical reduction of the enlargements with surgical gingivectomy procedures.

61
Q

Cyclosporine,

A

the major drug used for immunosuppression in patients who have undergone organ transplantation
Can cause overgrowth

62
Q

Deficiencies in many vitamins can produce changes in the oral tissues and is referred to as

A

gingival diseases modified by malnutrition.

63
Q

Although rare, vitamin C deficiency can cause scurvy, a condition resulting in defective

A

collagen formation and maintenance.

64
Q

Systemic and fungal infections are referred to as

A

as nonplaque-biofilm–induced gingival lesions.

65
Q

The rapid onset of pain and the development of necrotic ulcerative lesions of the gingiva characterize is

A

NUG

66
Q

NUG is a condition that

A

can occur with no bone loss but with a specific identifiable bacterial component

67
Q

Microorganisms of NUG

A

a fusiform bacillus and a spirochete.

68
Q

T/F NUG has been related to excessive stress.

A

True

69
Q

NUG begins in the

A

interdental papillae.

70
Q

NUG after a few days the tips of the papillae

A

the tips of the papillae appear punched out and covered by a white necrotic pseudomembrane.

71
Q

White necrotic pseudomembrane in NUG is a collection

A

This pseudomembrane is a collection of PMNs trapped in the fibrin clot.

72
Q

NUG has a distinctive breath odor that has been termed _____ is evident.

A

fetor oris

73
Q

When are antibiotics prescribed to patients with NUG

A

Antibiotics are useful in the treatment of NUG but are recommended only if the patient has systemic symptoms of fever and severe malaise.

74
Q

Untreated, NUG may lead to

A

bone loss and become necrotizing ulcerative periodontitis (NUP).

75
Q

Primary herpetic gingivostomatitis

A 
Elevated temperature 
Malaise
Vesicle formation 
The vesicles associated with herpesvirus coalesce to form ulcerative lesions on the gingiva or oral mucosa. 
Primary herpetic gingivostomatitis
76
Q

The gingival conditions caused by Candida range from initial signs of redness at the gingival margin, called

A

linear gingival erythema, to severe redness with white patches on the gingiva.

77
Q

Gingival enlargement, termed ______ or _____, is a pathologic overgrowth of the gingiva.

A

hyperplasia or hypertrophy

78
Q

Causes of gingival enlargement

A

Excessive reactions to bacterial plaque biofilm
Certain medications
Certain infections
Side effect of systemic diseases

79
Q

T/F Gingival conditions related to blood dyscrasias are not often observed in the dental office.

A

true

80
Q

Which gingival condition is sometimes first seen in the dental office because of the quick onset of gingival changes.

A

acute leukemia

81
Q

Acute leukemia may initially be observed in the

A

gingival tissues.

82
Q

Acute leukemia symptoms

A

Hemorrhagic and swollen gingival tissues, far more pronounced than would be expected from the amount of plaque and calculus present.
The patient often reports that the tissues were normal until recently.
The gums easily bleed and are swollen and tender.

83
Q

The reticular form usually identified as lacy white lines (Wickham’s striae) with a bumpy appearance is known as

A

Lichen Planus

84
Q

The severity of lichen planus appears to be related to the

A

stress level of the patient.

85
Q

_____ have been used to control lichen planus during flare-ups, but no known cure

A

Topical steroids

86
Q

When cicatricial pemphigoid lesions are limited to the gingival tissues, the disease may be termed

A

desquamative gingivitis or gingivosis.

87
Q

This condition is most often described as sloughing of the gingival epithelium, leaving a painfully raw, red surface.

A

desquamative gingivitis or gingivosis.

88
Q

Cause of desquamative gingivitis or gingivosis.

A

The cause is suspected to be autoimmune related, but an allergic reaction to drugs, food, or other substances may also be the cause

89
Q

Length of desquamative gingivitis or gingivosis.

A

The disease may continue for many years or, particularly in children, may spontaneously disappear

90
Q

What helps fight off desquamative gingivitis or gingivosis.

A

Topical and systemic steroid therapy may help control the disease process

Periodontology (2 decks)

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