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Questions and Answers
What is another name for necrotizing periodontal disease if severe and depending on the extent of the disease?
Who first described the microbes associated with necrotizing periodontal disease?
What was necrotizing periodontal disease called during the time of the First World War in soldiers fighting in trenches?
What is the estimated disease prevalence of necrotizing periodontal disease in U.S. Military recruits according to Horning GM et al. 1990, 1995?
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What is the basis for diagnosing necrotizing periodontal disease?
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Which of the following is NOT included in the differential diagnosis of necrotizing periodontal disease?
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What are the primary causes of necrotizing periodontal disease?
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What factors determine the likelihood of successful disease control?
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What is involved in the treatment of necrotizing periodontal disease?
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Which type of necrotizing periodontal disease is associated with a hopeless and life-threatening prognosis?
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What is the primary determinant of prognosis in necrotizing periodontal disease?
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What is essential for successful treatment of necrotizing periodontal disease?
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What is the primary cause of necrotizing periodontal disease?
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What is the primary focus of disease diagnosis in necrotizing periodontal disease?
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What is the likelihood of successful disease control primarily dependent on?
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Which condition is NOT included in the differential diagnosis of necrotizing periodontal disease?
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Which of the following is a symptom of necrotizing periodontal disease?
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What can trigger necrotizing ulcerative gingivitis?
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What is the key diagnostic sign of necrotizing periodontal disease?
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What do necrotizing periodontal lesions contain?
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What happens with increasing disease severity in necrotizing periodontal disease?
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What is the likely cause of foul odor in necrotizing periodontal lesions?
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What is the association of necrotizing ulcerative periodontitis?
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What is the structure of a necrotizing periodontal lesion?
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What can necrotizing periodontal disease lead to in extreme cases?
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What is the likely microbial flora in necrotizing periodontal lesions of patients with severe immunodeficiency?
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What is the effect of spirochetes invading the gingival tissues in necrotizing periodontal disease?
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What is a likely consequence of interdental tissue necrosis in necrotizing periodontal disease?
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Study Notes
Necrotizing Periodontal Disease: Diagnosis, Differential Diagnosis, Etiology, Prognosis, and Treatment
- Disease diagnosis is based on the extent of tissue destruction, as described by the Pindborg stages in the Journal of Periodontology 1966.
- The differential diagnosis includes conditions such as herpetic gingivostomatitis, squamous cell carcinoma, severe periodontitis, linear gingival erythema, and linear IgA disease.
- The disease is caused by a disease-causing microbial community and a depressed immune response, often triggered by severe stress, viral infections, malnutrition, and chemotherapy.
- The likelihood of successful disease control depends on the amount of tissue destruction and the control of etiologic factors, with prognosis varying based on the extent of tissue damage and reversibility of contributing etiology.
- Treatment involves urgent dental treatment, oral hygiene instruction, systemic antibiotics, multivitamin/protein food supplements, follow-up to check for improvement, and follow-up medical/dietary care.
- The extent of tissue destruction in necrotizing ulcerative gingivitis is associated with an excellent/good prognosis, while necrotizing ulcerative periodontitis has a fair/poor prognosis, and necrotizing stomatitis/noma is considered hopeless and life-threatening.
- The differential diagnosis for necrotizing periodontal disease includes conditions that resemble it in some way, such as herpetic gingivostomatitis, squamous cell carcinoma, and severe periodontitis.
- The disease is caused by a disease-causing microbial community and a depressed immune response, often triggered by severe stress, viral infections, malnutrition, and chemotherapy.
- The likelihood of successful disease control depends on the amount of tissue destruction and the control of etiologic factors, with prognosis varying based on the extent of tissue damage and reversibility of contributing etiology.
- Treatment involves urgent dental treatment, oral hygiene instruction, systemic antibiotics, multivitamin/protein food supplements, follow-up to check for improvement, and follow-up medical/dietary care.
- The extent of tissue destruction in necrotizing ulcerative gingivitis is associated with an excellent/good prognosis, while necrotizing ulcerative periodontitis has a fair/poor prognosis, and necrotizing stomatitis/noma is considered hopeless and life-threatening.
- Successful treatment of necrotizing periodontal disease is only possible if all etiologic factors can be reversed during treatment, with a sequence including urgent dental treatment, oral hygiene instruction, systemic antibiotics, and follow-up medical/dietary care.
Necrotizing Periodontal Diseases Overview
- Necrotizing periodontal diseases include necrotizing gingivitis, necrotizing periodontitis, necrotizing stomatitis, and noma.
- Two varieties of the disease behave differently clinically, with one being fatal and the other typically not progressing past the necrotizing periodontitis stage.
- Symptoms of necrotizing periodontal disease include severe pain, fever, foul mouth odor, and punched-out lesions in the gingiva.
- Necrotizing ulcerative gingivitis can be triggered by stressful events, while necrotizing ulcerative periodontitis is usually associated with severe immunodeficiency.
- The key diagnostic sign is the presence of punched-out, crater-like depressions at the crest of the interdental papilla where gingival tissue is missing.
- With increasing disease severity, tissue destruction becomes more severe and results in exposure of underlying bone.
- In extreme cases, the condition spreads to the rest of the oral cavity and then to the outside of the face as in noma.
- Necrotizing periodontal lesions contain a large and diverse population of oral Treponema spirochetes and Selemonas species, likely responsible for the foul odor.
- In patients with severe immunodeficiency, the microbial flora in these lesions may contain opportunistic pathogens such as Candida albicans or Aggregatibacter species.
- As spirochetes invade the gingival tissues, they cause damage to the gingival capillaries leading to coronal tissue infarction and necrosis.
- The structure of a necrotizing periodontal lesion consists of necrotic tissue, exposed and ulcerated soft tissue, and fibrin deposits and accumulated leukocytes along with infiltrating spirochetes.
- A patient exhibiting signs of interdental tissue necrosis coupled with severe pain likely has necrotizing periodontal disease.
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Description
"Necrotizing Periodontal Disease: Diagnosis, Treatment, and Prognosis" Quiz Test your knowledge of necrotizing periodontal disease with this quiz. Learn about the diagnosis, differential diagnosis, etiology, prognosis, and treatment of this severe oral condition. Explore the symptoms, microbial factors, and treatment options for necrotizing ulcerative gingivitis, necrotizing ulcerative periodontitis, necrotizing stomatitis, and noma.
