Gingival Diseases 2 Flashcards Preview

AU 15- Periodontology Exam 2 > Gingival Diseases 2 > Flashcards

Flashcards in Gingival Diseases 2 Deck (60):
1

True or False: When gingival lesions are of systemic origin, controlling plaque has no effect because it is not the cause of inflammation.

False: although it is NOT the cause, plaque makes the lesions worse

2

Gingival lesions of systemic origin include _______ disorders such as: lichen planus, pemphigoid, pemphigus vulgaris, erythema multiforme, lupus erythematosus.

mucocutaneous

3

_______ _______ is a mucocutaneous disorder of which oral involvement alone is common and for which there are characteristic Wickham Striae.

Lichen Planus

4

What are Wickham Striae?

lesions that are red with projecting web-like white lines

 

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5

True or False: Lichen planus is rare in children.

True

6

What are the various clinical appearances of Lichen Planus?

1. Papular

2. Reticular

3. Plaque-like

4. Atrophic

5. Ulcerative

6. Bullous

7

True or False: Lichen Planus can occur on any area of the oral mucosa.

True

8

Atrophic and Ulcerative lesions are usually associated with _____.

Pain

9

____ is a large blister or skin vesicle filled with fluid.

Bulla

10

What does "reticular" mean?

meshlike, in the form of a network

11

Sometimes if a biopsy is taken for the lichen planus, nothing will be seen.  What is the test that should be done (labeling of specific proteins)?

immunohistochemistry

12

What are "oral lichenoid lesions"?

a mucocutaneous disorder of uncertain background, that could be associated with dental restoration contact, medication reactions, or systemic disease (such as liver disease)

13

How is lichen planus differentiated from oral lichenoid lesions?

Oral immunohistochemistry:

  •  heavy accumulation of CD4 and CD8 at the basement membrane for Lichen Planus

14

A group of disorders in which autoantibodies toward components of the basement membrane results in detachment of epithelium from the connective tissue.  This definition describes?

Pemphigoid

15

True or False: Complement-mediated cell destructive processes may be involved in the pathogenesis of pemphigoid disorders.

True

16

For pemphigoid disorders, autoantibody reactions occur against _______ and _______ components.

hemidesmosome

lamina lucida

17

What is the Nicholsky sign?

removal of epithelium that occurs after rubbing of the gingiva and creation of a bulla; associated with pemphigoid disorders (ie. disorders in which autoantibodies result in detachment of epithelium)

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18

What are the three manifestations of pemphigoid disorders?

  1. bullous
  2. benign mucous membrane
  3. cicatricial (scar formation)

19

Pemphigoid disorders are associated with deposits of C3, Ig___ and other _____.

G

antibodies

20

When pemphigoid lesions are suspected, which other body part should you inspect?

the eyes, scars can cause blindness

21

What is pemphigus vulgaris?

formation of intraepithelial bullae in the skin and mucous membranes; like a "pimple at the basal membrane"

  • strong genetic background (Jewish/mediterranean)
  • Painful desquamative lesions
  • Recurrent bullae, chronic course
  • middle age and ederly most common
    • acantholysis = clearing of CT

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22

Clearing of connective tissue is also known as ________ and is associated with pemphigus vulgaris.

acantholysis

23

What is erythema multiforme?

vesiculobullous disease affecting both mucous membranes and skin

  • red skin lesions
  • swollen lips with crust formation
    • bullae rupture and leave ulcers
  • sometime recurrent
  • Characteristic: iris appearance + bullae
  • occurs at any age but mostly young

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24

Extensive Necrosis (of eyes, skin, genitals, and mouth) associated with Erythema multiforme is known as _____ syndrome.

Stevens-Johnson

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25

Erythema multiforme of palatal mucosa appears to be a cytotoxic immune reaction toaward keratinocytes precipitating from a variety of factors such as _____ and _____.

herpes simplex

various drugs

26

What is lupus erythematosus?

autoimmune connective tissue disorder in which autoantibodies form to various cellular constituents

  • lesions can be ulcerated and cannot be differentiated from lichen planus or leukoplakia
  • characteristic butterfly skin lesions (face/nose)

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27

Atrophic gingival discoid lupus erythematosus is characterized by degeneration of ____ cells and increased ____ of the basement membrane due to deposits of various ______ and _____.

basal

width

antibodies and fibrin

28

True or False: Systemic forms of lupus erythematosus reach the heart and nervous system.

True! can be fatal

29

What are three common drugs that cause mucocutaneous disorders?

  1. immunosuppressants
  2. calcium channel blockers
  3. anti-epileptic drugs

30

True or False: Gingival enlargement is associated with drug-induced mucocutaneous disorders.

True

31

True or False: Oral ulceration, erythema multiforme, epithelial atrophy, and intense erythema are all conditions that are solely associated with genetics.

False: all of these are drug-induced

32

What are two systemic conditions that have gingival manifestations?

  1. Gastro-Intestinal Diseases (Crohn's)
  2. Hematological Disorders (leukemia)

33

How does Crohn's disease effect the mucosa?

mucosal folding

defective neutrophil functions

34

How does leukemia present in the mouth?

swelling, ulceration, petecchia, and erythema

  • 69% of patients have oral manifestation
  • a child with spontaneous bleeding should be a tip-off!

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35

True or False: Periodontal tumors and cysts may have the appearance of gingivitis or periodontitis.

True

36

Periodontal tumors can be ____, _____, or _____.

Reactive Processes

Benign Neoplasms

Malignant Neoplasms

37

True or False: Periodontal tumors can affect the hard or soft tissues.

True

38

Reactive processes of periodontal ____ tissues include:

  • Fibroma/Focal Fibrous Hyperplasia
  • Calcified Fibroblast Granuloma
  • Pyogenic Granuloma
    • Peripheral Giant Cell Granuloma

soft

"granuloma" or "fibroma" always think REACTIVE

39

A _____ is a focal fibrous hyperplasia caused by irritation. It is sessile, well-circumscribed, and smooth.

Fibroma

40

Granulomas are ______ of periodontal soft tissues and include:

  • ________ =fibrous proliferation in which bone-like tissue forms
  • _________ = highly vascular, ulcerated, reddish-bluish
    • ______ = pedunculated, originates in PDL, focal location of multi-nucleated giant cells

Reactive processes

  • calcified fibroblastic
  • pyogenic
    • peripheral giant cell

41

A periapical cemental dysplasia is a _____ ______ of periodontal hard tissues.

reactive process

42

In a periapical  cemental dysplasia, the periapical bone is replaced by ____ _______ tissue through a cementoblastic phase.  These are usually symptomatic/asymptomatic?

cellular fibroblastic

NO symptoms (though tooth is usually vital)!

43

____ _______ of periodontal soft tissues include:

  • hemangioma
  • nevus
  • papilloma
  • verruca vulgaris
    • peripheral odontogenic tumors

Benign neoplasms

44

_________ will blanch when you apply pressure and appear as flat or raised soft lesions.  They are asymptomic but will bleed uncontrollable if you attempt to biopsy...just keep an eye on it.

Hemangiomas

45

_______ is a benign neoplasm that is often confused with amalgam tattoos due to pigmentation of soft tissue.  Most often seen in palate though.

Nevus

46

Which benign neoplasm of the soft tissue will appear histologically as a "flower with four petals?"

Papilloma

  • there are four-five different types
    • commonly associated with HPV

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47

Verruca Vulgaris is one type of benign soft tissue ______ that is associated with HPV type ___ and ____.

Papilloma

2, 4

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48

Which benign neoplasms of the soft tissue will often form around unerupted teeth and interfere with tooth eruption?

Peripheral Odontogenic tumors

49

Ameloblastomas, Squamous odontogenic tumors, and benign cementoblastomas are benign neoplasms of the _____ tissues.

hard

50

True or False: Ameloblastomas are benign neoplasms of the hard tissue that appear radiographically as though there would be deep probe depths, however PD are normal.

True

51

Squamous odontogenic tumors are benign neoplasms of the hard tissue that are derived from ______ and are rarely seen.

epithelial rests of Malassez

52

Benign ________ are slow-growing neoplasms around the apex of a tooth that appear as radiopacity surrounded by a radiolucent margin.

cementoblastomas

53

Malignant neoplasms of the ____ tissues include: 

  • squamous cell carcinoma
  • metastasis 
  • Kaposi's sarcoma
    • Malignant lymphoma

SOFT

54

________ carcinoma appears as nodular lesions, often with ulceration and surrounding leukoplakia. Lymph node metastasis is common and tissue samples should be sent straight to the lab.

Squamous Cell

(what grandma had!..."very rapid metastasis")

55

Most metastasis to the gingiva is _____, not sarcoma.

carcinoma

(which means they originate in the epithelial tissue not CT, bone, or fat)

56

_____ sarcoma is mostly detected in the palate and is associated with AIDS.

Kaposi's

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57

______ neoplasms of the periodontal ____ tissues include:

  • Lymphoma (HIV-associated)
  • Osteosarcoma (widening of PDL)
    • Langerhan's Cell Disease (loosening of teeth +pain)

Malignant

Hard

58

What are the effects of chemotherapy and radiotherapy on oral mucosa?

Major mucositis

  • pain
  • unable to eat

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59

Cysts of the periodontium mostly occur around the ______.

root

60

How should cysts be treated?

removal without poking it or allowing it to "open up" and spill its infective contents