Академический Документы
Профессиональный Документы
Культура Документы
3. Pericoronitis
4. Streptococcal Gingivostomotitis
6. Acute Candidasis
7. Aphthous Stomatitis
Gingival Abscess
Localized painful rapidly expanding lesion of sudden onset.
Etiology Due to impaction of foreign object such as tooth brush bristle or fibrous food.
Clinical Features
Short duration
Limited to marginal gingiva and interdental papilla. Appears as red swelling with smooth surface. Lesion become fluctuant within24 to 48 hr. Adjacent teeth often sensitive to percussion.
Management
HERPES SIMPLEX VIRUS Occurs most frequently in infants and children younger than 6years of age.
Clinical Features
The condition appears as diffuse erythematous,
Oral Symptoms
- Herpetic involvement of lips and face -Cervical Lymphadenitis and Fever are common
A.H.G.S. is contagious
Histpathology
The fully developed vesicles:
Is cavity in the epithelial cells with occasional PMNs.
Inclusion body are found in nuclei of epithelial cells bordering vesicles
- ANUG. - Erythema Multiforme. - Bullous lichen planus - Desquamative gingivitis - Aphthous stomatitis
Management
1. Palliative measurement.
PERICORONITIS
Its the inflammation of the gingiva in relation
Clinical Features
Acute pericoronitis is identified by varying
Complications
Pericoronal Abscess
May spread posteriorly into the oropharyngeal area and medially to the base of the tongue.
Treatment
STREPTOCOCCAL GINGIVOSTOMATITIS
Rare condition, More commonly, secondy infection Of the gingiva with Haemolytic streptococci occurs In tissue aleady irritated inflamed, eg. Around partialy Erupted teeth or due to lowered body immunity .
Diffuse or Marginal Erythema the gingiva and other Oral tissue become intensely red and sensitive and lymph gland enlarged.
Clinical Features
Diagnosis
1. History 2. Clinical finding
Management
1. Nystatin suspension (100,000 Iu)
1 tsp. - held in the mouth for 5 minutes and then swallowed, repeated four times a day.
APHTHOUS STOMATITIS
-Recurrent aphthae
Etiology is unknown
Predisposing factors
Hormonal disturbances
Allergic phenomena
Gastrointestinal disorders Psychosomatic
Clinical Features
They are usually circular ulcers less than 1 cm in diameter. Have light yellow central area surrounded by prominent band of erythema.they are usually painful Occurs in the oral cavity any where except the attached gingiva, hard palate and lips
Management
A.N.U.G. is an inflammatory destructive disease of the gingiva presents characteristic clinical signs and symptoms.
They rapidly destructive and debilitating, and they appear to represent various stages of the same disease process.
Etiology:
Unknown
Certain bacterial strains has been incriminated Spirochaetal organisms and Fusiform bacilli
Predisposing Factors
local
Systemic
Psychosomatic factors
Clinical Feature
CLINICAL FEATURES
It can be classified as ACUTE, SUBACUTE OR RECURRENT. It affects elders. Relatively uncommon in children. No definitive duration. History- Sudden onset sometimes followed an episode of debilitating disease or acute respiratory tract infection.
Oral signs
Characteristic lesions are PUNCHED OUT CRATER LIKE DEPRESSIONS at crest of interdental popilla, subsequently extend to marginal gingiva.
The surface of the gingival craters is covered by grey pseudomembranous sloughs demarcated from the rest of the gingiva by a linear erythema.
Spontaneous gingival hemorrhage. Fetid odor. Increased salivation. It may progressively destroy gingiva and underlying periodontal tissues
Oral symptoms
Lesions extremely sensitive to touch. Constant radiating gnawing pain. Metallic foul taste. Excessive pasty saliva.
Differential Diagnosis:
1. Streptococcal gingivo-stomatitis.
2. Gonococal stomatitis.
3. Vincent's angina
4. Agranulocytosis.
Management
TREATMENT
Alleviation of acute symptoms first complete patients information, general and systemic. Complete intraoral examination and bacterial smear if require. Local treatment should be in orderly sequence. For non-ambulatory patients, vigorous treatment should not be undertaken until systemic symptoms subside.
General removal of necrotic pseudomembrane with cotton pellet saturated with H2O2 (hydrogen peroxide). Superficial scaling with ultrasonic scalers first. Later scalers and curettes are used after some days of gingival shrinkage.
Systemic orally, one of the following is usually given. PENICILLIN 250 or 500mg 6 hourly for 5-7 days. For penicillin sensitive patients ERYTHROMYCIN 250 or 500mg 6 hourly for 5-7 days. METRANIDAZOLE 250 or 500mg 8 hourly for 5-7 days. Supportive treatment fluids, analgesics, nutritional supplements. After the acute condition subsides, recontour gingiva (gingivoplasty)
Instructions to ANUG patient Avoid alcohol, tobacco, and condiments. Rinse with equal amounts of water and 3% H2O2 every 2 hours.