Dental Clinical Practice 2: Gingival Diseases
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Questions and Answers

What local risk factor is known to encourage plaque accumulation by inhibiting its removal?

  • Excessive fluoride usage
  • Poor oral hygiene habits
  • Diet high in sugar
  • Prominent subgingival restoration margins (correct)
  • Which clinical condition arises from reduced salivary flow, contributing to increased gingival inflammation?

  • Gingival hyperplasia
  • Periodontitis
  • Oral dryness/Hyposalivation (correct)
  • Gingival recession
  • What is a requirement for drug-influenced gingival conditions to produce a gingival response?

  • Presence of excessive plaque bacteria alone
  • Presence of the drug without plaque bacteria
  • Normal salivary flow
  • Combination of plaque bacteria and the drug (correct)
  • Which of the following medications is most commonly associated with gingival tissue enlargement?

    <p>Nifedipine</p> Signup and view all the answers

    What role do individual characteristics play in drug-influenced gingival enlargements?

    <p>Play a pivotal role in susceptibility</p> Signup and view all the answers

    Which of the following is not considered a local risk factor for gingival diseases?

    <p>Use of fluoride toothpaste</p> Signup and view all the answers

    Which type of gingival disease is characterized by conditions independent of dental biofilm?

    <p>Non-dental biofilm-induced gingival disease</p> Signup and view all the answers

    What is one expected outcome for periodontal health concerning plaque-associated diseases?

    <p>Stable gingival attachment</p> Signup and view all the answers

    What characteristic distinguishes drug-influenced gingival enlargement from inflammatory reactions?

    <p>Significantly greater size of the gingival unit</p> Signup and view all the answers

    Which pattern is commonly observed in drug-influenced gingival enlargement?

    <p>Commonly begins at the papilla and may affect bone</p> Signup and view all the answers

    What is the most prevalent age group affected by drug-influenced gingival enlargement?

    <p>Younger age groups</p> Signup and view all the answers

    Which factor is NOT associated with drug-influenced gingival enlargement?

    <p>Radiographic bone loss</p> Signup and view all the answers

    Which bacterial origin is associated with specific infections that can lead to gingival diseases?

    <p>Neisseria gonorrhoeae</p> Signup and view all the answers

    Which of the following viral infections is known to cause gingival conditions?

    <p>Coxsackie virus</p> Signup and view all the answers

    What type of gingival enlargement involves only the enlargement of the gingival papilla?

    <p>Mild gingival enlargement</p> Signup and view all the answers

    What is a common autoimmune disease that can manifest in the gingiva?

    <p>Pemphigus vulgaris</p> Signup and view all the answers

    Which statement about localized and generalized gingivitis is true?

    <p>Both types exhibit no probing attachment loss</p> Signup and view all the answers

    What differentiates non-dental biofilm-induced gingival diseases from plaque-induced gingivitis?

    <p>Non-dental biofilm diseases are systemic conditions</p> Signup and view all the answers

    Which genetic or developmental disorder is linked to gingival diseases?

    <p>Hereditary gingival fibromatosis</p> Signup and view all the answers

    What is the characteristic of the BOP score in generalized gingivitis?

    <p>Greater than or equal to 30%</p> Signup and view all the answers

    Which systemic condition is categorized under granulomatous inflammatory conditions associated with gingival disease?

    <p>Crohn's disease</p> Signup and view all the answers

    Which viral pathogen is known for causing conditions that may affect the gingiva?

    <p>Herpes simplex virus</p> Signup and view all the answers

    Which hypersensitivity reaction can lead to gingival disease?

    <p>Contact allergy</p> Signup and view all the answers

    Which of the following is a condition with associated systemic involvement that leads to gingival disease?

    <p>Plasma cell gingivitis</p> Signup and view all the answers

    Which condition is classified as a reactive process involving gingival diseases?

    <p>Fibrous epulis</p> Signup and view all the answers

    Which type of oral pigmentation is specifically linked to smoking habits?

    <p>Melanoplakia</p> Signup and view all the answers

    Which of the following is a neoplasm that can be a premalignant condition in the oral cavity?

    <p>Leukoplakia</p> Signup and view all the answers

    What type of lesion results from physical or mechanical trauma to the gingiva?

    <p>Frictional keratosis</p> Signup and view all the answers

    Which of the following is a systemic manifestation that can be associated with fungal infections like candidosis?

    <p>Sarcoidosis</p> Signup and view all the answers

    Which of the following conditions is primarily a drug-induced pigmentation of the gingiva?

    <p>Melanoplakia</p> Signup and view all the answers

    What type of lesion can occur due to thermal insults to the gingiva?

    <p>Burns to gingiva</p> Signup and view all the answers

    Which of the following describes a peripheral giant cell granuloma?

    <p>A reactive process seen in the gingiva</p> Signup and view all the answers

    What is a common symptom of Vitamin C deficiency?

    <p>Enhanced gingival bleeding and ulceration</p> Signup and view all the answers

    Which of the following is NOT a thermal insult to the mucosa?

    <p>Irritation from chlorine exposure</p> Signup and view all the answers

    What characterizes frictional keratosis?

    <p>Homogeneous whitish plaques on gingiva</p> Signup and view all the answers

    Which of the following is a characteristic of a standard periodontal probe as per ISO 21672?

    <p>Tip diameter of 0.5 mm</p> Signup and view all the answers

    What is gingival pigmentation also known as?

    <p>Melanoplakia</p> Signup and view all the answers

    Which of the following is a potential future research need regarding gum diseases?

    <p>Creating simple saliva tests for early gum problem detection</p> Signup and view all the answers

    Which chemical agent could cause surface sloughing in the oral mucosa?

    <p>Acetylsalicylic acid</p> Signup and view all the answers

    What is the recommended tip diameter for the ISO periodontal probe?

    <p>0.5 mm</p> Signup and view all the answers

    What is characteristic of hereditary gingival fibromatosis?

    <p>Generalized fibrous gingival enlargement</p> Signup and view all the answers

    Which condition is associated with ulceration and crater formation in the gingiva?

    <p>Necrotizing periodontal diseases</p> Signup and view all the answers

    What is the major clinical manifestation of candidosis?

    <p>Various types including pseudomembranous and nodular</p> Signup and view all the answers

    Which hypersensitivity reaction can cause lichenoid lesions in the gingiva?

    <p>Contact allergy</p> Signup and view all the answers

    What clinical characteristic is common with pemphigus vulgaris?

    <p>Intraepithelial bullae and erosions</p> Signup and view all the answers

    What can characterize Crohn's disease in the oral cavity?

    <p>Cobblestone appearance of the oral mucosa</p> Signup and view all the answers

    Leukoplakia is defined as which of the following?

    <p>Not-removable white spot with a smooth surface</p> Signup and view all the answers

    What is a common presentation of gingival squamous cell carcinoma?

    <p>Painless exophytic masses</p> Signup and view all the answers

    Study Notes

    Dental Clinical Practice 2: Non-Dental Biofilm-Induced Gingival Diseases

    • This presentation focuses on gingival diseases and conditions resulting from non-dental biofilms, as opposed to plaque-induced gingivitis.

    Learning Objectives

    • List the local etiological factors of dental biofilm-induced gingival diseases.
    • Interpret the classification of non-dental biofilm-induced gingival conditions and diseases.
    • List the outcomes for periodontal health for plaque-associated periodontal diseases.
    • Describe the types of non-dental biofilm-induced gingival diseases.
    • Summarize future research needs for classifying and diagnosing gingival diseases and conditions.

    Local Risk Factors/Predisposing Factors

    • Local risk factors encourage plaque accumulation at specific sites by inhibiting its removal during oral hygiene or creating a biological niche for increased plaque accumulation.
    • Examples include: prominent subgingival restoration margins, which facilitate plaque accumulation and hinder mechanical removal; and oral dryness/hyposalivation, leading to reduced cleansing of tooth surfaces, increased gingival inflammation, and reduced biofilm removal. The causes of dry mouth include certain medications, Sjogren's syndrome, and mouth breathing.

    Drug-Influenced Gingival Enlargements

    • Certain medications, including antiepileptic drugs, calcium channel blockers, immunoregulating drugs, and high-dose oral contraceptives, can affect gingival tissue size.
    • Plaque bacteria and the specific medication are necessary for drug-influenced gingival conditions.
    • Gingival enlargements may occur but not in every individual taking the drug, suggesting specific characteristics play a role.
    • Clinical manifestations of the gum enlargement may differ at various sites/patients, sometimes with little to no clinically visible gingivitis.

    Common Clinical Characteristics of Drug-Influenced Gingival Enlargements

    • Enlargement patterns differ between patients likely due to genetic predisposition.
    • Anterior gingiva is more frequently affected.
    • Enlargement often presents within three months of drug use, potentially with or without bone loss.
    • No observed association with attachment loss or tooth mortality.
    • Clinical and histological characteristics appear indistinguishable.

    Classification of Gingivitis

    • Gingivitis in an Intact Periodontium: Probing attachment loss and radiographic bone loss are absent; BOP scores vary between localized (≤10%) and generalized (>30%).
    • Gingivitis in a Reduced Periodontium Without a History of Periodontitis: Probing attachment loss and potential radiographic bone loss are present; BOP scores again vary between localized (≤10%) and generalized (>30%); probing depths (all sites) are less than or equal to 3mm.

    Outcomes of Periodontal Health for Plaque-Associated Periodontal Disease

    • Various periodontal health outcomes exist depending on whether the periodontium is intact or reduced and the presence of gingivitis. Variables considered include bleeding on probing, normal gingival sulcus depth, normal bone heights, modifying factors, and predisposing factors.

    Non-Dental Biofilm-Induced Gingival Diseases

    • Plaque-induced gingivitis is common; non-dental-induced gingivitis is less common but significantly impacts patients.
    • Non-dental biofilm-induced gingival lesions can represent systemic conditions.

    Gingival Diseases: Non-Dental Plaque-Induced

    • Genetic/developmental disorders
    • Specific infections (bacterial, viral, fungal)
    • Inflammatory and immune conditions/lesions
    • Reactive processes
    • Neoplasms
    • Endocrine, nutritional, and metabolic diseases
    • Traumatic lesions
    • Chemical/toxic insults
    • Gingival pigmentation/melanoplakia

    Future Research Needs

    • Developing simple tests (e.g., saliva-based) to detect early gum disease signs.
    • Identifying factors contributing to gum disease susceptibility.
    • Understanding differences among various types of gum diseases.
    • Standardizing periodontal probe use to improve diagnostic accuracy and consistency, using the ISO 21672 probe specifications including tip diameter (0.5 mm), structure (cylindrical tine), constant force limiter (0.25 N), scale (15 mm with markings), and taper (1.75°).

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    Description

    This quiz covers non-dental biofilm-induced gingival diseases, exploring local etiological factors and their classification. It also addresses outcomes for periodontal health and highlights future research needs in the field. Test your knowledge on these important aspects of dental clinical practice.

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