Periodontal treatment 2 lecture

Question 1

characteristics of necrotising periodontal diseases?

Answer 1

 The most severe inflammatory periodontal disorder caused by plaque bacteria
 Rapidly destructive and debilitating
 predisposing factor is stress
 Opportunistic infection – caused by the bacteria inhabiting healthy oral cavity

Question 2

what are main features for necrotising periodontal diseases?

Answer 2

The main features of the NPD are
- painful,
- bleeding gums and
- ulceration and
- necrosis of the interdental papilla - punched-out appearance

Question 3

what are the classification of necrotising periodontal diseases?

Answer 3

necrotizing gingivitis
necrotizing periodontitis
necrotizing stomatitis

Question 4

what is necrotising ginigivits?

Answer 4

when only the gingival tissues are affected.

Question 5

what is necrotising periodontitis?

Answer 5

when the necrosis progresses into the periodontal ligament and the alveolar bone, leading to attachment loss.

Question 6

what is necrotising stomatitis?

Answer 6

when the necrosis progresses to deeper tissues beyond the mucogingival line, including the lip or cheek mucosa, the ton- gue, etc.

Question 7

what does foetor ex ore mean?

Answer 7

halitosis - bad breath

Question 8

what does halitosis mean?

Answer 8

bad breath

Question 9

what are the first lesions that are seen in necrotising gingivitis?

Answer 9

interproximally in mandiular anterior region

Question 10

what are necrotising periodonitis ulcers associated with?

Answer 10

deep pockets formation as gingival necrosis coincides with loss of crestal alveolar bone

Question 11

what happens with adenopathies?

Answer 11

submandibular lymph nodes are more affected than those in the cervical area

Question 12

what people have a greater severity of necrotising stomatitis lesions?

Answer 12

patients with severe systemic compromises pt - those with aids and pts with severe malnutrition

Question 13

what are some risk factors of necrotising periodontal diseases?

Answer 13

o In developed countries, NPD occurs mostly in young adults with predisposing factors such as psychological stress, sleep deprivation, poor oral hygiene, smoking, immunosuppression (HIV infection and leukaemia) and/or malnutrition.
o In developing countries, NPD occurs mostly in malnourished children.

Question 14

what are 2 main objectives of treatment of the acute phase for therapy?

Answer 14

1) to arrest the disease process and tissue destruction
2) to control the pt general feeling of discomfort and pain that is interfering with nutrition and oral hygiene practices

Question 15

what is treatment during the supportive or maintenance phase of treatment?

Answer 15

main goal is compliance with the oral hygiene practices and control of the predisposing factors

Question 16

what is necrotising periodontal disease suggestive of in systematically healthy individuals without any predisposing factors in background?

Answer 16

must be screened for HIV

Question 17

what is the treatment for the acute necrotising disease?

Answer 17

1. ultrasonic debridement
2. pain prevent patient from brush - instead 0.2 percent chlorohexidine mouth wash twice daily (previously 3% or 6% hydrogen peroxide)
3. pts with malaise, fever and lassitude, lack of response to mechanical therapy and with impaired immunity
   200mg metronidazole TID (3 times daily) for 3 days
   400mg Metronidazole TID for 3 days
4. smoking cessation, vitamin supplementation, dietary advice
5. in case of necrotising periodontitis after remedy of acute symptoms you need to carry out hygiene phase therapy to treat perio disease