Other Periodontal Conditions Flashcards
(41 cards)
What are the different mucogingival deformities and conditions?
- gingival phenotype: Thin gingiva covering bone/ teeth
- Decrease vestibular depth: atrophy
- Aberrant frenum/muscle position: Frenum pull
- Gingival excess
- Condition of the exposed root surface (Fenestration, dehiscence)
- gingival soft tissue recession
- Lack of keratinized gingiva
- Abnormal color
What are the different types of gingival excess?
- Delayed passive eruption
- Pseudopocket
- inconsistent gingival margin
- gingival enlargement
How do abscess of the periodontium presents?
- circumscribed collection of purulence in periodontium
- fluctant on palpation
- incidental finding in early stages
- requires immediate treatment
What are the signs and symptoms?
- Rapid onset
- localized swelling
- usually painful: constant, easy to pinpoint
- Drainage- delay in treatment
- Radiographs- Often non-contributory, Bone loss not involving apical areas.
What are the classification based on location?
- Periocoronal abscess- tissue around the crown of partially erupted tooth
- Gingival abscess- occurs in the free gingval margin
- Periodontal abscess- tissues adjacent to periodontal pocket
Pericoronal Abscess is?
A localized infection of tissue around crown of partially erupted impacted tooth ( most common is 3rd molars)
- Gram negative anaerobes
- Food/debris entrapment under operculum
What are the signs and symptoms associated with pericoronal abscess ?
- Pain
- Edema
- Erythema
- Opposing molar tissue trauma
- Difficulty swallowing
- Limited mouth opening (TRISMUS)
- Fever and lymphadenopathy
What are the treatments for pericoronal abscess?
- Drainage
- irrigation with saline
- analgesics (painkiller)
- Antibiotics if infection severe or systemic involvement ( can spread to pharyngeal spaces
- Extraction
What is gingival abscess ?
- acute localized painful infection
- coronal location : free gingival margin, interdental papilla
- no signs of periodontitis
- caused by foreign objects (not cal)
- Develops rapidly
- Fluctuant in 24 to 48 hours
- Usually self limiting
What is the treatment for gingival abscess ?
- Removal of etiologic agent (debridement)
- Careful manipulation of tissue
- May require anesthesia
- Scaling establishes drainage through crevice
- Warm saline rinses
- Systemic antibiotics NOT indicated
What are periodontal abscess/ lateral abscess?
- Most common abcess involving periodontium
- Localized purulence within wall of periodontal pocket
- Common site: molar furcation areas deep pockets
What are the causes of periodontal abscess?
- Similar organisms as in periodontitis
- Gram negative anaerobic rods
What are the Gram negative anaerobic rods for periodontal abscesses?
- P gingivalis (most common)
- Prevotella intermedia
- Fusobacterium nucleatum
- Tannerella forsythia
- Aa not typically cultured
What are the common cause of periodontal abscess within a non-perio patient?
- Foreign objects
- Harmful habits
- Orthodontic factors
- Root surface alterations
What are the common cause of periodontal abscess within a perio patient?
- Disease exacerbation- complex pockets, furcations, vertical defects
- Post-scaling
- Post surgery
- Post medication
What happens with incomplete calculus removal with a periodontal abscess?
- Calculus removed from coronal aspect of deep pocket
- calculus remains deep due to difficult access
- Coronal tissue heals and tightens
- Prevents drainage of toxins and waste: abscess formation
What are the differential diagnosis for a periodontal abscess?
- periocoronitis
- endo-perio abscess
- pyogenic granuloma
- osteomylelitis
- odontogenic keratocyst
- Tumor lesion: metastic lesin, odontogenic myxomam non-hogkins lymphoma, squamous cell carcinoma
What is the occurrence of periodontal abscess?
- Obstruction
- Inability to drain/formation of fistuka
- Diabetics more susceptible
- Acute condition
What are the signs and symptoms of periodontal abscess?
- Pain and pressure
- Shiny mass
- Deep probing depths
- Mobility
- Tender to percussion
- Feels high
- Purulence on pressure
- Untreated or unresolved abscess
What is the treatment for periodontal abscess?
- First phase involves management of acute signs and symptoms: alleviate the pain, establish drainage, control spread
- Second phase (treatment of underlying perio lesions, pocket elimination): Subgingival debridement, soft diet, analgesics, saline rinse, antibiotics only if systemic involvement, surgery if no resolution, follow up
What are periapical abscess?
- Results from infection and death of pulp by toxins (non- vital)
- Trauma, caries or adjacent infected tooth
- Usually a radiolucency at apex
What are the different ways a periapical adbcess can drain?
- Drain via sulcus or fistula
- require endodontic treatment or extraction
If a periapical abscess is left untreated then it can?
- Lead to life threatening situations and death
What are the differences between periodontal abscess and periapical abscess
Periodontal
⚫ Foreign object
⚫ Preexisting pocket
⚫ Lateral radiolucency
⚫ Vital tooth
⚫ Fistula at lateral aspect of tooth
⚫ Swelling in attached gingiva
⚫ Dull pain/constant
⚫ Mild percussion pain
⚫ Mobility
Periapical
⚫ Associated with decay/ large
restoration
⚫ Usually no pocket
⚫ Apical radiolucency
⚫ Nonvital tooth
⚫ Fistula in apical area
⚫ Swelling at MGJ
⚫ Severe pain/ throbbing
⚫ Intermittent pain
⚫ Severe percussion pain
⚫ No or minimal mobility
