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Pediatric Handbook QE > 6. Periodontal disease and conditions > Flashcards

6. Periodontal disease and conditions Flashcards

1
Q

When does plaque induced gingivitis occur?

A

During puberty

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2
Q

What are two conditions that commonly result in plaque induced gingival enlargement?

A

mouth breathers

active ortho treatment

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3
Q

What drugs commonly cause gingival enlargement?

A

Anti-seizure (Dilantin)
Cyclosporine (immunosuppressant)
Calcium Channel Blockers (diltiazem, nifedipine, amoldipine)

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4
Q

Does drug induced gingival enlargement occur over edentulous areas?

A

No

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5
Q

Where are gingival abscesses found?

A

marginal gingiva or interdental papilla

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6
Q

Where is it most common to see pericornitis?

A

3rd molars

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7
Q

What are the signs and symptoms associated with Vitamin C deficiency gingivitis?

A

edematous, spongy non-specific gingiva

spontaneous bleeding
delayed wound healing

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8
Q

What is the primary bacteria in chronic periodontitis?

A

P. gingivalis

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9
Q

What are the signs and symptoms of ANUG?

A

rapid painful onset of inter proximal and marginal necrosis and ulceration

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10
Q

At what age is ANUG typically seen?

A

late teens/early 20s in the US

younger in less developed

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11
Q

T/F: Patients with diabetes are at increased risk of earlier onset of periodontitis even if they have similar plaque/calculus levels as healthy controls

A

True

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12
Q

Where is localized aggressive periodontitis in the primary dentition most commonly seen

A

primary molars

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13
Q

What is the etiology of prepubertal periodontitis?

A

A.a.
Leukocyte chemotaxis defect
Cementum defect

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14
Q

What is definition of localized aggressive periodontitis?

A

bone loss around incisors, first molar and no more than 2 other teeth

pt otherwise systemically healthy, age of onset 10-15

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15
Q

What is etiology of localized aggressive periodontitis?

A

A.a
neutrophil chemotaxis and phagocytosis
over reactive monocyte response
genetic defect in gene encoding IgG2

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16
Q

What is the dental sequale of hypophosphatasia?

A

early loss of primary teeth due to abnormal cementum formation

Exfoliated with intact roots, before complete root formation, in order of eruption

permanet teeth may be unaffected

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17
Q

What are the 5 levels of severity of hypophosphatasia?

A 
perinatal (lethal)
infantile
childhood
adult 
odontohypophosphatasia
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18
Q

What is the etiology of hypophosphatasia

A

defect or deficient in tissue nonspecific alkaline phosphatase (TNSALP)

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19
Q

How do you diagnose hypophosphatasia

A 
low AKP
increased phosphoethanolamine (urine) or phosphate (blood)
20
Q

What is the enzyme therapy for treatment of hypophosphatasia

A

Asfotase Alpha

21
Q

What is the definition of mucogingival defect

A

pocket depth > width of attached keratinized gingiva (KG

22
Q

Where is it most common to have a mucogingival defect

A

lower incisors due to labial position

23
Q

How do you calculate attached keratinized gingiva

A

Attached KG = MGJ to FGM (note sites < 1 mm)

24
Q

What is pseudo-recession?

A

recession like appearance without root exposure

25
Q

What should normal bone height be and how do you measure it?

A

interproximal crest should be 1-2 mm apical of CEJ as seen on BWX

26
Q

How do you measure attachment loss

A

Attachment loss = Pocket depth - (distance from CEJ to FGM)

27
Q

What percentage of patients with downs syndrome have periodontal disease?

A

60-100%

28
Q

What systemic condition has the radiographic appearance of “floating teeth”

A

Langerhans cell histiocytosis (X)

29
Q

What is the etiology of Langerhans cell histiocytosis (X)

A

abnormal proliferation and dissemination of histiocytic cells of the Langerhans system

30
Q

What is the treatment for Neutropenia?

A

systemic granulocyte colony stimulating factor (G-CSF) to treat underlying cause

31
Q

What are systemic conditions that have periodontal consequences?

A 
Hypophosphatasia
Leukocyte adhesion defect (LAD)
Papillon-LeFevre syndrome
Downs syndrome
Chediak-Higashi syndrome
Neutropenia
Langerhans cell histiocytosis (X)
Leukemia
32
Q

What are signs/symptoms of Chediak Higashi syndrome?

A 
Oculocutaneous albinism
photophobia
nystagmus
peripheral neuropathy
periodontitis
33
Q

What are signs and symptoms of papillon-LeFevre syndrome?

A

palmar and plantar hyperkeratosis

Attachment loss (due to A.A. bacteria) causing early loss of primary/perm dentition

34
Q

What are signs and symptoms of Leukocyte adhesion defect (LAD)?

A

Generalized periodontitis in primary and permanent dentition

Frequent respiratory, skin, ear and other soft tissue bacterial infections

35
Q

What are dental manifestations of leukemia?

A

gingival enlargement

hyper plastic, edematous, blue/red gingiva due to infiltration of leukemic cells (mostly seen in AML)

petechiae or mucosal ulcerations may be present with any form of leukemia

36
Q

What condition is pyogenic granuloma commonly associated with?

A

pregnancy

37
Q

what % of teenagers have BOP?

A

60%

38
Q

what systemic factors may increase risk of plaque induced gingivitis?

A

steroid hormones - puberty, pregnancy, menstruation and oral contraception

39
Q

what local factors may contribute to plaque induced gingivitis

A

crowding, ortho appliances, mouth breathing, eruption, calculus

40
Q

What percentage of children and teenagers have calculus?

A

10% children

33% (1/3) teenagers

41
Q

what are clinical features of plaque induced gingival enlargement

A

enlarged interdental papilla and/or marginal gingiva

may be generalized or localized

42
Q

what are clinical features of drug influenced gingival enlargement

A

painless enlargement of interdental and marginal gingiva, may go over crowns

fibrous tissue
related to plaque control

43
Q

what are predisposing factors to ANUG

A

malnutrition, stress, lack of sleep

44
Q

what is the dental management for ANUG

A

local debridement
NSAIDS
ABX: penicillin or metronidazole

45
Q

What percentage of adolescents (14 to 17) have attachment loss of at least 2 mm in one or more sites?

A

20%

46
Q

What bacterial species is most commonly associated with periodontitis

A

P. gingivalis

Pediatric Handbook QE (26 decks)

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