chapter 4 perio

Question 1

chronic hyperplastic gingivitis underlying path processes

Answer 1

enlargement from edema or fibrosis

Question 2

bacteria in NUG

Answer 2

Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas gingivalis, Treponema spp, Selenomonas spp

Question 3

NUG breakthrough to skin

Answer 3

noma

Question 4

localized aggressive perio affected teeth

Answer 4

1 molars and incisors; max 2 other teeth

Question 5

severe perio dz and palmoplantar keratosis – dzz, genetics

Answer 5

Papillon Lefevre – severe perio; cathepsin C on chr 11

Haim Munk less severe peio but also more severe skin infx and skeletal abnormalitis; genetics same

Question 6

cathepsin C

Answer 6

chr 11
haim munk (skin + skel) and papillon lefevre (perio more severe)
both palmoplantar keratosis

Question 7

related to haim munk/papillon lefevre but only skin changes with no oral findings

Answer 7

Unna-Thost syndrome and Meleda disease

Question 8

Unna Thost

Answer 8

related to haim munk/papillon lefevre but only skin changes with no oral findings

Question 9

Meleda dz

Answer 9

related to haim munk/papillon lefevre but only skin changes with no oral findings

Question 10

Haim Munk vs Papillon Lefevre

Answer 10

both – perio dz and palmoplantar keratosis
Cathepsin C, chrom 11

PL – severe perio
HM – also skin infx and skel abnorm, perio milder tho

Question 11

age of increased susc to gingivitis

Answer 11

9-14yo (puberty)

Question 12

gingivitis of only free ging margins

Answer 12

marginal gingivitis

Question 13

gingivitis only interdental papilla

Answer 13

papillary

Question 14

NUG underlying pathologic processes

Answer 14

decreased neutrophilic chemotaxis and phagocytic response

Question 15

abx for NUG

Answer 15

penicillin and metronidazole

Question 16

NUG –> NUP

Answer 16

loss of attachment

Question 17

NUP –> NUM/NUS

Answer 17

(mucositis/stomatitis) – spread to soft tissue

Question 18

NUM –> noma

Answer 18

sptread to skin

Question 19

NUG NUP NUM NOMA spectrum?

Answer 19

necrotizing gingivostomatitis

Question 20

what to rule out for granulomatous gingivitis

Answer 20

foreign body, infx, crohns, sarcoid, wegeners

Question 21

foreign body gingivitis vs lichen planus

Answer 21

single lesion and no migration

Question 22

histology foreign body gingivitis

Answer 22

80% lichenoid or mixed inflammation

20% granulomatous

Question 23

drug related gingival hyperplasia drugs and prevalences

Answer 23

phenytoin (~50%), nifedipine (CCB), cyclosporine (~25%)
all affect Ca remodeling (reduce Ca influx)

also erythromycin and verapamil

Question 24

drug related gingival hyperplasia drugs and ages

Answer 24

phenytoin (<25yo), nifedipine (older), cyclosporine (broad range)

Question 25

pts w GVHD on cyclosporine gingiva

Answer 25

hyperplasia and PG-like soft tissue growth

Question 26

location for juvenile spongiotic gingival hyperplasia

Answer 26

almost all on anterior gingiva | 81% maxillary

Question 27

familial gingival fibromatosis concurrent findings

Answer 27

hypertrichosis, periodontitis, epilepsy, mental retardation, deafness, hypothyroidism, GH deficinecy

Question 28

syndromes with gingival fibromatosis

Answer 28

can be isolated syndromes: Zimmermann-Laband, Murray-Puretic-Drescher, Rutherfurd, Cowden, Cross, Ramon, Jones, and prune belly)

Question 29

GINGF mutations

Answer 29

1, 2, 3 mutations chromosome 2 and 5

Question 30

SOS1 locus

Answer 30

GINGF

Question 31

Ramon sybdrome components

Answer 31

mental and grwoth retardation, fibrous duspalsia, cherubism, and gingival fibromatosis

Question 32

Jones syndrome components

Answer 32

gingival fibromatosis + sensorineural hearing loss

Question 33

gingival fibromatosis + sensorineural hearing loss

Answer 33

Jones syndrome

Question 34

mental and grwoth retardation, fibrous duspalsia, cherubism, and gingival fibromatosis

Answer 34

Ramon sybdrome

Question 35

1, 2, 3 mutations chromosome 2 and 5

Answer 35

GINGF

Question 36

risks for chronic periodontitis

Answer 36

50% genetics, 20% tobacco, 20% specific bacteria

Question 37

risk factors for periodontal abscess

Answer 37

closure of pocket entrance, furcation invovlement, enamel pearls, dens invaginatus, and diabetes

Question 38

risk factors pericoronitis

Answer 38

stress, tonsillitis, pharyngitis can give rise to localized NUG like necrosis

Question 39

aggressive periodontitis what's up

Answer 39

neutrophil dysfx (deficiency in immune response) not assoc w systemic dz no systemic manifestations

Question 40

localized vs generalized aggressive perio

Answer 40

localized more common 11-13yo; strong serum AB response, 1 molars and incisors + max 2 other teeth; little plaque, predom pathogen -- AA generalized: <30yo, poor serum AB response, 1st molars and incisors + 3 teeth; heavy plaque; more complex pathogens

Question 41

cathepsin C mutation

Answer 41

chromosome 11 papillon lefevre defect in neutrophil chemotactic and impaired B/T activity

Question 42

focal palmopplantar and oral mucosa hyperjeratosis syndrome related to

Answer 42

papillon lefevre | no perio dz

Question 43

NUG ddx

Answer 43

agranulocytosis and gonorrhea (latter no odor)

Question 44

age for gingival fibroamtosis

Answer 44

<20yo

Question 45

additional clinical with gingival fibromatosis

Answer 45

Hypertrichosis / Gen.Aggressive periodontitis / Epilepsy / Hypothyroidism / deafness / intellectually disabled

Question 46

serum aggressive perio

Answer 46

generalized -- poor | localized -- robust

Question 47

papillon lefevre inheritance

Answer 47

AR -- 1/3 consanguinity