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ODDR- PERIO > Acute periodontal diseases > Flashcards

Acute periodontal diseases Flashcards

1
Q

What are the 4 tissues that make up the periodontium?

A
  1. Gingiva
  2. Periodontal ligament
  3. Cementum
  4. Alveolar bone
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2
Q

What is an acute disorder?

A

Anything that is sudden and onset that forces a person to seek immediate help

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3
Q

What are the 4 stages of treatment?

A
  1. Emergency treatment
  2. Initial therapy
  3. Corrective therapy
  4. Supportive therapy
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4
Q

What is an abscess by definition?

A

An acute lesion

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5
Q

Name some periodontal disorders that may present in acute phase?

A
  1. Periodontal abscess
  2. Necrotising periodontal diseases (NPD)
  3. Necrotising ulcerative gingivitis / Necrotising ulcerative periodontitis
  4. Primary herpetic gingivostomatitis
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6
Q

Define what a periodontal abscess is

A

A localised purulent infection within the tissues adjacent to the periodontal pocket that may lead to a rapid destruction of the periodontal ligament and alveolar bone

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7
Q

What are the 2 broad reasons a periodontal abscess may form in a pre existing periodontal pocket ?

A

Due to:

  1. Acute exacerbation
  2. After treatment
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8
Q

How can a periodontal abscess form due to acute exacerbation?

A
  1. Due to untreated periodontitis
  2. Non responsive to therapy periodontitis
  3. Supportive periodontitis
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9
Q

How can a periodontal abscess form after treatment?

A
  1. Post scaling
  2. Post surgery
  3. Post medication eg some drugs or systemic antibiotics can lead to the formation of abscesses
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10
Q

What are some of the broad reasons a periodontal abscess may form in a non periodontal patient?

A
  1. Impaction of any foreign object
  2. Harmful habits like naiver biting
  3. Orthodontic factors and forces
  4. Gingival overgrowth
  5. Alterations of root surfaces
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11
Q

Name some foreign objects that can lead to the formation of abscesses in non periodontal patients/

A
  1. Dental floss
  2. Orthodontic elastic
  3. Toothpicks
  4. Rubber dams
  5. Stuck food
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12
Q

What can periodontal abscesses primary be classified by?

A

The abscesses are classified according to the source of the infection:
periapical (dento-alveolar),
periodontal
peri-coronal abscess

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13
Q

What can abscess in the periodontium be secondary to?

A
  1. Pulp necrosis
  2. Periodontal infections
  3. Pericoronitis
  4. Trauma or surgery
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14
Q

Which microbes cause periodontal abscesses?

A 
Mainly gram negative anaerobes:
1. P. gingivalis
2. P. intermedia
3. F. nucleatum
4. C. rectus
5. Capnocytophaga spp
6. Tannerella forsythia
7. Spirochaetes
and one aerobe: S. viridans
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15
Q

Name some of the hypothesises aetiological factors that causes periodontal abscesses?

A
  1. Occlusion of pocket orifice
  2. Furcation involvement
  3. Systemic antibiotic therapy
  4. Uncontrolled Diabetes
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16
Q

How is a pocket occluded?

A

Due to:

  1. Incomplete removal of calculus
  2. Impaction of food, foreign body
  3. Bacterial invasion after instrumentation trauma
17
Q

How can occlusion of a pocket orifice lead to a periodontal abscess?

A
  1. Leads to Reduced clearance of bacteria which results in the accumulation of host cells
  2. Tissue damage can also occur due to lysosomal enzymes released from neutrophils taking part in host defence
18
Q

What is furcation involvement?

A

In a mult rooted tooth if the alveolar bone is lost that is furcation involvement

19
Q

How can furcation involvement lead to a periodontal abscess?

A
  1. Furcation is difficult to instrument and keep clean

2. You can get enamel pearl

20
Q

How can Systemic antibiotic therapy lead to a periodontal abscess?

A

Super-infections can arise with opportunistic organisms

21
Q

What are the general features of a periodontal abscess?

A
  1. Vital pulpal response
  2. Swollen full of pus
  3. Affected tooth will have deep pockets and attachment loss
22
Q

What are some clinical features of a periodontal abscess?

A
  1. Swelling of gingiva on lateral aspect of root,
  2. Gingiva will be red & swollen with smooth & shiny surface
  3. Suppuration from pocket (gentle pressure)
  4. Mobile tooth
  5. May be slightly extruded
  6. May be painful to bite on, may have sensation of wanting to grind tooth
23
Q

Can you see a periodontal abscess on a radiograph?

A

NO but you can look for bone loss or furcation of the molar teeth

24
Q

What will the diagnosis be based on if you find a periodontal abscess?

A 
The diagnosis will be based on:
Clinical examination findings
special tests results:
Radiographic examination 
Pulp vitality tests
25
Q

How would you manage an abscess?

A

Depends on the stage if it it ready to be friend then drain if not wait
Need to look at the overall prognosis of the teeth
YOU will need to:
1. Control of infection
2. Relief from pain
3. Assessment of prognosis/need for further therapy

26
Q

How would yo manage a periodontal abscess with pus not draining?

A
  1. Check no impacted material in pocket
  2. Relieving occlusion is advocated
    Although affected tooth may be slightly extruded, may be more comfortable to grind opposing tooth?
  3. Advise hot salt mouthwashes to encourage drainage (several times a day)
  4. Advise pain killers like ibuprofen
    5 Review patient in a. couple of days
27
Q

How would yo manage a periodontal abscess with pus to drain?

A
  1. Achieve drainage
  2. Advise hot salt mouthwashes
  3. Relieve occlusion
  4. Advise pain killers as appropriate
  5. Review in a few days
28
Q

How would you drain a periodontal abscess?

A

Three ways:
1. Local gentle debridement in the pocket
2. Remove any impacted material
3, Incision and drainage if indicated

29
Q

What are some systemic involvements associated with periodontal abscesses?

A
  1. Extraoral swelling
  2. Lymphadenopathy
  3. Rarely cellulitis
  4. Malaise
  5. Raised temperature
30
Q

What is a pericoronal abscess?

A

A localised purulent infection within tissue surrounding crown of partially erupted tooth

31
Q

What is a gingival abscess?

A

Localised purulent infection that involves the marginal or interdental papilla
It is quite painful and rapidly expanding

ODDR- PERIO (9 decks)

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