Perio classification

Question 1

What drugs can cause gingival enlargement

Answer 1

Amlodipine
Cyclosporins

Question 2

What are some non-plaque induced gingival disease

Answer 2

Hereditary gingival fibromatosis
Herpetic gingival stomatosis
Lichen planus (inflammatory condition)
Benign mucouse membrane pemphigoid
Vitamin C deficiency

Question 3

What are the properties of necrotising gingivitis

Answer 3

necrosis and ulcer in the interdental papilla (94–100%)​

gingival bleeding (95– 100%)​

pain (86–100%)​

pseudomembrane formation (73–88%)​

halitosis (84–97%). ​

extraoral - regional lymphadenopathy (44–61%) / fever (20‐39%)​

In children, pain and halitosis less frequent, whereas fever,
lymphadenopathy, and sialorrhea were more frequent.

Question 4

What is necrotising periodontitis

Answer 4

in addition to the signs and symptomsof NG​

periodontal attachment and bone destruction

frequent extraoral signs​

In severely immune‐compromised patients, bone sequestrum may occur

Question 5

What occurs with necrotising stomatitis

Answer 5

Bone denudation extended through the alveolar mucosa
Larger areas of osteitis and bone sequestrum

Question 6

What genetic conditions are associated with the impairment of the immne system

Answer 6

Papillon-Lefevre syndrome, Chediak-Higashi syndrome, LAS syndrome, Down’s syndrome, chronic granulomatous disease

Question 7

What is the definition of a risk factor

Answer 7

Something that increases the chanes of developing a disease

Question 8

What are examples of local risk factors

Answer 8

Acquired: plaque, calculus, overhanging
and poorly contoured restorations and
prosthetic crowns, orthodontic appliances,
occlusal trauma ​

Anatomical: malpositioned teeth,
root groves, concavities and furcations, enamel pearls

Question 9

Can occlusal trauma cause perio

Answer 9

No - it may cause bone loss but not perio

Question 10

How can poorly controlled diabetes impact perio

Answer 10

Hyperglycaemia in diabetes may modulate RANKL impacting the OPG ratio and contributing to alveolar destruction

There is also increased production of AGE (advanced glycation end products) which leads to exacerbation of inflammation

Question 11

What vitamin is important for gum health

Answer 11

Vitamin C

Question 12

What is responsible for gingival enlargement

Answer 12

More fibroblasts

Question 13

Why does scurvy increaserisk of perio

Answer 13

Abnormal collagen turnover

Question 14

What are possible mechanisms of
periodontitis being risk factor for
cardiovascular diseases

Answer 14

1.Molecular mimicry ​

Evidence of cross reactivity between oral pathogens and both inflammatory and endothelial cell components​

It might be the case in all bacterial infections​

2.The direct actions of pathogenic bacteria from periodontal pocket traveling with the blood stream to the vessels. ​

Periodontal bacteria detected in atherosclerotic plaque ​

Challenges to proof causal association and in undertaking clinical outcome studies.

3. Activation of cells of the the immune system which then can play significant role in sites of cardiovascular pathologies​

Systemic inflammation, with chronically elevated inflammatory markers, is common to both disease processes​

To what extent anatomically remote sources of inflammation interact in causative fashion is unclear.

Question 15

What are plaques

Answer 15

Plaques are deposits of a protein fragment called beta-amyloid that build up in the spaces between nerve cells.​

Tangles are twisted fibers of another protein called tau that build up inside cells