Podcast
Questions and Answers
What is NOT a result of acute Vitamin C deficiency?
What is NOT a result of acute Vitamin C deficiency?
- Hemorrhage
- Edema of gingival connective tissue
- Collagen degeneration
- Gingival inflammation (correct)
What characterizes a gingival abscess associated with acute Vitamin C deficiency?
What characterizes a gingival abscess associated with acute Vitamin C deficiency?
- Localized, painful, rapidly expanding lesion (correct)
- Chronic inflammation with no swelling
- Localized, non-painful lesion
- Persistent, slow-growing mass
What might exacerbate drug-induced gingival enlargement?
What might exacerbate drug-induced gingival enlargement?
- Lack of daily plaque control (correct)
- Daily brushing
- Frequent dental cleanings
- Plaque control
Which drug is NOT typically associated with drug-induced gingival enlargement?
Which drug is NOT typically associated with drug-induced gingival enlargement?
What is a common clinical feature of plasma cell gingivitis?
What is a common clinical feature of plasma cell gingivitis?
How soon after starting medication might drug-induced gingival enlargement begin?
How soon after starting medication might drug-induced gingival enlargement begin?
What type of enlargement is associated with acute Vitamin C deficiency?
What type of enlargement is associated with acute Vitamin C deficiency?
Which statement is true regarding the management of gingival enlargement due to medication?
Which statement is true regarding the management of gingival enlargement due to medication?
What defines acute pericoronitis?
What defines acute pericoronitis?
Which factor is NOT considered when determining the treatment for acute pericoronitis?
Which factor is NOT considered when determining the treatment for acute pericoronitis?
Which treatment method is used for acute pericoronitis?
Which treatment method is used for acute pericoronitis?
What is a characteristic feature of lichen planus?
What is a characteristic feature of lichen planus?
Which systemic complication may be associated with pemphigus vulgaris?
Which systemic complication may be associated with pemphigus vulgaris?
Which type of lesion is NOT associated with lichen planus?
Which type of lesion is NOT associated with lichen planus?
Which of the following is a systemic form of lupus erythematosus?
Which of the following is a systemic form of lupus erythematosus?
What is a common treatment approach for inflammatory mucocutaneous disorders?
What is a common treatment approach for inflammatory mucocutaneous disorders?
What is a key characteristic of a gingival pocket?
What is a key characteristic of a gingival pocket?
What is the highest stage of necrosis according to the provided classification?
What is the highest stage of necrosis according to the provided classification?
Which of the following clinical features indicates a periodontal pocket?
Which of the following clinical features indicates a periodontal pocket?
What differentiates a periodontal pocket from a gingival pocket?
What differentiates a periodontal pocket from a gingival pocket?
Which grade indicates no sign of gingival enlargement?
Which grade indicates no sign of gingival enlargement?
What is a common sign of gingivitis observed in gingival pockets?
What is a common sign of gingivitis observed in gingival pockets?
What is included in the treatment for necrotizing ulcerative gingivitis?
What is included in the treatment for necrotizing ulcerative gingivitis?
Which of the following classifications of pockets is marked by quiescent periods?
Which of the following classifications of pockets is marked by quiescent periods?
Which stage of necrosis involves necrosis of the entire papilla?
Which stage of necrosis involves necrosis of the entire papilla?
Which symptom is NOT typically associated with a periodontal pocket?
Which symptom is NOT typically associated with a periodontal pocket?
What is a recommended patient instruction for managing necrotizing ulcerative gingivitis?
What is a recommended patient instruction for managing necrotizing ulcerative gingivitis?
Which grade of gingival enlargement indicates that the enlargement covers three-quarters or more of the crown?
Which grade of gingival enlargement indicates that the enlargement covers three-quarters or more of the crown?
What anatomical feature is associated with a suprabony pocket?
What anatomical feature is associated with a suprabony pocket?
What is the primary cause of a periodontal pocket?
What is the primary cause of a periodontal pocket?
Which of the following is NOT a common stage of necrosis described?
Which of the following is NOT a common stage of necrosis described?
What factor contributes to the initiation or progression of acute necrotizing ulcerative gingivitis (ANUG)?
What factor contributes to the initiation or progression of acute necrotizing ulcerative gingivitis (ANUG)?
What characterizes localized marginal gingivitis?
What characterizes localized marginal gingivitis?
Which condition is indicative of generalized diffuse gingivitis?
Which condition is indicative of generalized diffuse gingivitis?
What is a sign of active tissue destruction in gingival tissues?
What is a sign of active tissue destruction in gingival tissues?
What often triggers episodes of gingival inflammation?
What often triggers episodes of gingival inflammation?
Which type of gingivitis is confined to one or more interdental spaces?
Which type of gingivitis is confined to one or more interdental spaces?
Which injury type can lead to active gingival inflammation?
Which injury type can lead to active gingival inflammation?
Which of the following conditions involves gingival margins in relation to all teeth?
Which of the following conditions involves gingival margins in relation to all teeth?
What is a characteristic feature of spontaneous bleeding in gingival conditions?
What is a characteristic feature of spontaneous bleeding in gingival conditions?
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Study Notes
Gingival Enlargement
- Causes:
- Vitamin C Deficiency:
- Does not directly cause gingival inflammation.
- Causes hemorrhage, collagen degeneration, and edema of gingival connective tissue.
- Modifies gingival response to plaque.
- Acute Infection or Trauma:
- Can lead to gingival abscess.
- Presents as a localized, painful, rapidly expanding lesion.
- Drug-Induced:
- Occurs within 3 months of taking medication like phenytoin, cyclosporine A, and calcium channel blockers.
- Exaggerated inflammatory response to plaque.
- Daily plaque control limits severity.
- More prevalent among children.
- Plasma Cell Gingivitis:
- Also known as atypical and plasma cell gingivostomatitis.
- Mild marginal enlargement.
- Red and friable gingiva that bleeds easily.
- Associated with cheilitis and glossitis.
- Thought to be allergic.
- Diffuse Gingivitis:
- Affects the gingival margin, attached gingiva, and interdental papillae.
- Can be localized or generalized affecting all parts of the gingiva.
- Vitamin C Deficiency:
Hemorrhage
- Occurs due to ruptured and damaged blood vessels.
- Hemostatic mechanism starts:
- Contraction of the vessel wall.
- Decrease in blood flow.
- Platelets adhere to the damaged tissue forming a clot.
- Bleeding can start again when the area is irritated.
- Signs of bleeding:
- Bleeding on probing is a sign of active tissue destruction.
- Spontaneous bleeding can occur.
- Seen in ANUG (acute necrotizing ulcerative gingivitis).
Necrotizing Ulcerative Gingivitis (NUG):
- Classified by degree of gingival enlargement:
- Stage 1: Necrosis of interdental papilla tip.
- Stage 2: Necrosis of the entire papilla.
- Stage 3: Necrosis extending to gingival margin.
- Stage 4: Necrosis extending to attached gingiva.
- Stage 5: Necrosis extending into buccal or labial mucosa.
- Stage 6: Necrosis exposing alveolar bone.
- Stage 7: Necrosis perforating skin of cheek (Noma)
Classifications of Pockets
- According to morphology:
- Gingival pocket (Pseudo or false):
- Occurs with gingivitis.
- No destruction of periodontium.
- Deepened gingival sulcus due to increased gingiva bulk.
- Periodontal pocket (Absolute or true):
- Occurs with periodontitis.
- Apical migration of the JE and destruction of supporting tissues.
- Types:
- Suprabony pocket (supracrestal or supraalveolar pocket).
- Infrabony pocket.
- Gingival pocket (Pseudo or false):
Acute Pericoronitis
- Inflammation of the gingiva around the crown of an incompletely erupted tooth, most commonly the mandibular third molar.
- Characterized by inflammatory involvement of the pericoronal flap and adjacent structures.
- Treatment:
- Gentle flushing to remove debris.
- Swabbing with antiseptic after elevating the flap.
- Apical displacement of the gingival attachment.
- Treatment can be multi-visit.
Gingival Lesions
- Lichen Planus:
- Inflammatory mucocutaneous disorder.
- Involves oral mucosa, genital tract, skin, and nails.
- T-lymphocytes play a role.
- Gingival lesions can present in 4 patterns:
- Keratotic: raised, white lesions.
- Erosive: ulcerative lesions with patchy distribution.
- Coronal movement of gingival margin.
- Apical displacement of epithelial attachment.
Periodontitis
- Characterized by:
- Bleeding on probing.
- Increased attachment loss.
- Exudation.
- Inactive pockets:
- Periods of remission.
- Reduced inflammatory response.
- Little or no bone loss.
- Clinical features:
- Enlarged, bluish-red marginal gingiva.
- Bluish-red vertical zone extending from gingival margin to alveolar mucosa.
- Break in faciolingual continuity of interdental gingiva.
- Shiny, discolored, and puffy gingiva associated with exposed root surfaces.
- Bleeding with probing.
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