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What is a primary local risk factor that facilitates plaque accumulation at the gingival margin?
Which condition is primarily associated with reduced salivary flow leading to gingival inflammation?
Which medication class is most commonly associated with gingival tissue enlargement?
What role do plaque bacteria play in drug-influenced gingival conditions?
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Why might only some individuals taking certain medications develop gingival enlargements?
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Which of the following diseases is classified under endogenous factors affecting gingival diseases?
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What is a potential consequence of xerostomia on periodontal health?
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What condition is characterized by an increased pigmentation of the gingiva due to smoking?
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What type of condition is classified as non-dental biofilm-induced gingival disease?
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Which of the following is NOT a reactive process associated with gingival diseases?
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Which of the following is associated with drug-induced pigmentation of the gingiva?
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What factor can help reduce the risk of plaque accumulation around the gingival margin?
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Which of the following best describes a traumatic lesion that can result in gingival ulceration?
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What type of epulis is characterized by a fibrous growth in response to irritation?
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Which of the following conditions is a sign of potential malignancy in gingival diseases?
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Which of the following is a non-dental, plaque-induced gingival disease?
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Which of the following bacterial origins is associated with gingival diseases?
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Which autoimmune disease is linked to skin and mucous membrane conditions in gingival diseases?
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Which of the following viruses is associated with non-dental plaque-induced gingival diseases?
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Which systemic disease is found to be associated with granulomatous inflammatory conditions in relation to gingival diseases?
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Which of the following is NOT a type of gingival disease related to hypersensitivity reactions?
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Which of the following statements about viral origins of gingival diseases is true?
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Which organism is responsible for necrotizing periodontal diseases?
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Which of the following is a characteristic of hereditary gingival fibromatosis?
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What is a characteristic feature of hereditary gingival fibromatosis?
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Which disease condition is associated with ulceration and central necrosis of the papillae?
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What is a common clinical manifestation of candidosis in neonates?
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Which autoimmune disease is characterized by intraepithelial bullae that result in erosions?
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What appearance is characteristic of oral mucosa in Crohn's disease?
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Which of the following describes leukoplakia?
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What is the typical presentation of squamous cell carcinoma in the gingiva?
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Which condition is commonly associated with reactive gingival lesions known as epulides?
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What symptom is associated with Vitamin C deficiency?
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Which of the following is a characteristic of frictional keratosis?
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What type of insult includes agents like chlorhexidine and hydrogen peroxide?
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Which type of injury is characterized by burn-like lesions that may develop vesicles?
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What is recommended for a more accurate diagnosis of gum disease?
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What characteristic is NOT part of the features for a periodontal probe according to ISO 21672?
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Which of the following describes gingival pigmentation or melanoplakia?
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What future research need is proposed regarding gum disease testing?
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Study Notes
Local Risk Factors for Plaque Accumulation
- Prominent subgingival restoration margins, such as certain tooth anatomical features, can create areas where plaque accumulates more easily. These restorations can make it difficult to remove plaque effectively.
- Oral dryness, also known as xerostomia, reduces the saliva's ability to clean the tooth surfaces, leading to increased inflammation and difficult plaque removal. This condition can be caused by medications, Sjogren's syndrome, and mouth breathing.
Drug Influenced Gingival Enlargements
- Various medications have been linked to enlargement of the gingival tissues. These include antiepileptic drugs like phenytoin and sodium valproate, certain calcium channel blockers (e.g., nifedipine, felodipine), immunoregulating drugs (e.g., cyclosporine), and high-dose oral contraceptives.
- Plaque bacteria in combination with the drug are crucial for the development of gingival problems due to medication.
- Not everyone taking these medications experiences gingival enlargement, suggesting other factors may play a role.
Gingival Diseases: Non-Dental Plaque-Induced
Specific Infections
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Bacterial Origin
- Neisseria gonorrhoeae: Sexually transmitted infection that can manifest in the gingival tissues.
- Treponema pallidum: The bacteria responsible for syphilis can affect the gingival tissues.
- Mycobacterium tuberculosis: The bacteria responsible for tuberculosis can lead to gingival lesions.
- Streptococcal gingivitis: This condition is associated with streptococcal bacteria.
- Necrotizing Periodontal Diseases: A destructive condition that causes ulceration and necrosis of the gingival papillae.
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Viral Origin
- Coxsackie virus (hand-foot-and-mouth disease): This infection causes oral ulcers and blisters.
- Herpes simplex I & II (primary or recurrent): Herpes simplex causes painful blisters and lesions.
- Varicella zoster (chickenpox & shingles): This virus can affect the oral cavity causing lesions.
- Molluscum contagiosum: This virus can manifest as lesions in the oral area.
- Human papilloma virus: Can cause squamous cell papilloma, condyloma acuminatum, verruca vulgaris, and focal epithelial hyperplasia in the mouth.
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Fungal Origin
- Candidosis: This fungal infection can cause several types of lesions in the oral cavity.
- Other Mycoses: Various fungal infections can affect the oral cavity.
Inflammatory and Immune Conditions
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Hypersensitivity Reactions
- Contact allergy: This is an allergic reaction to substances like dental materials or other allergens.
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Autoimmune Diseases of Skin and Mucous Membranes
- Pemphigus vulgaris: This can lead to desquamative gingivitis and vesiculo-bullous lesions.
- Pemphigoid: This autoimmune disease can cause oral lesions.
- Lichen planus: This disease can affect the oral mucosa and gingiva causing white or red lesions.
- Lupus erythematosus: This disease can affect the gingiva causing swelling, pain, and ulceration.
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Granulomatous Inflammatory Conditions
- Crohn's disease: This condition can cause oral lesions, including cobblestone appearance, linear ulcers, and gingival overgrowth.
- Sarcoidosis: This disease can affect the gingiva causing lesions and inflammation.
Reactive Processes
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Epulides
- Fibrous epulis: This is a non-cancerous tumor that grows on the gingiva.
- Calcifying fibroblastic granuloma: A type of epulis characterized by calcification.
- Vascular epulis (pyogenic granuloma): A type of epulis with a rich blood supply.
- Peripheral giant cell granuloma: Characterized by giant cells.
Neoplasms
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Premalignancy
- Leukoplakia: A white patch in the oral mucosa that is not removable.
- Erythroplakia: A red patch in the oral mucosa that is often associated with cancer.
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Malignancy
- Squamous cell carcinoma: This is the most common type of oral cancer that can affect the gingiva.
- Leukemic cell infiltration: This can affect the gingiva.
- Lymphoma: This can cause lesions in the gingival tissue.
Endocrine, Nutritional, and Metabolic Diseases
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Vitamin deficiencies
- Vitamin C deficiency (Scurvy): Scurvy is characterized by bleeding, ulceration, and swelling of the gingiva.
Traumatic lesions
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Physical/mechanical trauma
- Frictional keratosis: This is a white lesion that is caused by friction from brushing or chewing.
- Mechanically-induced gingival ulceration: This can be resulted from trauma during dental procedures or even through excessive use of toothpicks.
- Factitious injury (self-harm: Lesions caused by self-inflicted injury.
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Chemical (toxic) Insults:
- Lesions can be resulted from the use of various chemicals, including etching substances, chlorhexidine, acetylsalicylic acid, cocaine, hydrogen peroxide, dentifrice detergents, paraformaldehyde, or calcium hydroxide.
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Thermal insults
- Burns of mucosa: Thermal injuries can cause erythema, sloughing of tissue, vesicles, ulceration, petechiae, or erosion.
Gingival Pigmentation
- Melanoplakia: A black or brownish pigmentation of the gingiva that is benign.
- Smoker's melanosis: A brown-black pigmentation of the gingiva caused by smoking.
- Drug-induced pigmentation (antimalarials, minocycline): Some medications can cause gingival pigmentation.
- Amalgam tattoo: This is caused by small particles of amalgam from fillings being embedded in the gingiva.
Future Research Needs
- Developing simpler tests, such as salivary tests, to detect early signs of gingival problems.
- Determining why some individuals are less susceptible to gum disease than others.
- Improving the accuracy of tests for gum disease.
- Better understanding the different types of gum disease.
- Standardizing the use of periodontal probes to ensure accurate and reliable diagnosis.
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Description
This quiz explores local risk factors for plaque accumulation and drug-induced gingival enlargements. It covers the impact of oral dryness and specific medications that can worsen gingival conditions. Test your knowledge on how these factors influence oral health.
