Chapter 4: Periodontal Diseases

Question 1

what is described as a distinctive pattern of gingival inflammation, where most cases are related to hypersensitivity (ex. from Big Red gum), and patients usually experience a rapid onset of sore mouth?

Answer 1

plasma cell gingivitis

Question 2

what causes foul odor (halitosis), blunted papillae (“punched out”), and a gray pseudomembrane

Answer 2

necrotizing ulcerative gingivitis

Question 3

what bacteria are associated with NUG?

Answer 3

fusobacterium nucleatum, prevotella intermedia, porphyromonas gingivalis, treponema spp., and selenomonas spp

Question 4

NUG frequently occurs in the presence of ___ and/or ___

Answer 4

• psychological stress - think about WWII: NUG was referred to as “trench mouth”
• immunosuppression

Question 5

Answer 5

NUG

Question 6

Answer 6

NUG

Question 7

Answer 7

plasma cell gingivitis

*histology will show lots of plasma cells

Question 8

localized juvenile spongiotic gingival hyperplasia is also called ___

Answer 8

localized juvenile spongiotic gingivitis

Question 9

localized juvenile spongiotic gingival hyperplasia is idiopathic, but it has been suggested that the alteration represents an isolated patch of exteriorized ___ or ___ epithelium that may be altered secondarily by local factors (like mouth breathing)

Answer 9

junctional or sulcular

Question 10

what is the most common presentation of localized juvenile spongiotic gingival hyperplasia?

Answer 10

a small bright red velvety or papillary alteration that often bleeds easily upon manipulation

Question 11

localized juvenile spongiotic gingival hyperplasia has a predilection for the ___ gingival with a ___ predominance, and the vast majority occur under ___ with a median age of ___ years.

Answer 11

• maxillary anterior facial gingiva
• female
• 20
• 12

Question 12

Answer 12

localized juvenile spongiotic gingival hyperplasia

Question 13

Answer 13

localized juvenile spongiotic gingival hyperplasia

Question 14

___ is used to describe gingival epithelium that spontaneously sloughs or can be removed with minor manipulation

Answer 14

desquamative gingivitis

Question 15

desquamative gingivitis is a ___ diagnosis, not a ___ diagnosis. this means a ___ is required

Answer 15

• clinical
• pathologic
• biopsy

Question 16

the differential for desquamative gingitivis includes what 5 things?

Answer 16

• lichen planus
• mucous membrane pemphigoid
• pemphigus vulgaris
• systemic lupus erythematosis
• hypersensitivity

Question 17

___ is an abnormal growth of gingival tissues secondary to the use of systemic medication

Answer 17

drug-related gingival hyperplasia (drug-related gingival overgrowth)

Question 18

Answer 18

desquamative gingivitis

differs from plasma cell gingivitis in that desquamative gingivitis is usually present with recession

Question 19

what 3 drugs are mostly responsible for drug-related gingival hyperplasia? of these drugs, what percentage of patients taking each drug is likely to get drug-related gingival hyperplasia?

Answer 19

• phenytoin (anticonvulsant) - 50%
• cyclosporine (transplant therapy) - 25%
• nifedipine (calcium channel blocker) - 25%

Question 20

Answer 20

lichen planus

Question 21

Answer 21

lichen planus

Question 22

Answer 22

cyclosporine-related gingival hyperplasia

Question 23

Answer 23

nifedipine-related gingival hyperplasia

Question 24

Answer 24

cyclosporine- and nifedipine-related gingival hyperplasia

Question 25

Answer 25

phenytoin-related gingival hyperplasia

Question 26

Answer 26

phenytoin-related gingival hyperplasia

Question 27

Answer 27

phenytoin-related gingival palatal hyperplasia

Question 28

\_\_\_ is a slowly progressive gingival enlargement caused by a collagenous overgrowth of the gingival fibrous connective tissue

Answer 28

gingival fibromatosis

Question 29

Answer 29

gingival fibromatosis

Question 30

Answer 30

gingival fibromatosis

Question 31

is gingival fibromatosis familial or idiopathic?

Answer 31

it can be both

Question 32

what are common findings with gingival fibromatosis?

Answer 32

* hypertrichosis (lots of hair) * generalized aggressive periodontitis * epilepsy * mental retardation * growth hormone deficiency

Question 33

what are the clinical problems associated with gingival fibromatosis?

Answer 33

* poor esthetics * retention of deciduous teeth * malocclusion * inadequate lip closure * difficulty eating and speaking

Question 34

\_\_\_ is inflammation of the gingival tissues in association with some loss of both the attachment of the PDL and bony support

Answer 34

periodontitis

Question 35

includes loss of attachment of the PDL and bony support

Answer 35

adult periodontitis

Question 36

what are 6 patient characteristics associated with chronic periodontitis?

Answer 36

* advanced age * smoking * diabetes * osteoporosis * HIV infection * lower socioeconomic level

Question 37

Answer 37

pericoronitis

Question 38

\_\_\_ is an inflammatory process that arises within the tissues, surrounding the crown of the partially erupted tooth

Answer 38

pericornitis

Question 39

pericornitis most commonly affects which teeth?

Answer 39

mandibular 3rd molars

Question 40

what syndrome is described as a mutation and loss of function of cathepsin C gene on chromosome 11?

Answer 40

papillon-lefevre syndrome

Question 41

is papillon-lefevre syndrome autosomal dominant or recessive?

Answer 41

recessive

Question 42

describe the oral and dermatologic manifestations that are predominant in papillon-lefevre syndrome

Answer 42

* accelerated periodontitis (defect in neutrophil function) * teeth "floating in air" * actinobacillus actinomycetemcomitans * palmar plantar keratosis (tylosis) (calouses on the palms and feet)

Question 43

this radiograph represents what syndrome?

Answer 43

papillon lefevre syndrome "teeth floating in air"

Question 44

what is the bacteria associated with papillon lefevre syndrome?

Answer 44

actinobacillus actinomycetemcomitans