Acute periodontal conditions

DR.HINA ADNAN

1. Abscesses of periodontium.2. Necrotizing periodontal diseases.3. Gingival disease of viral origin – herpes

virus.4. Recurrent aphthous stomatitis.5. Allergic reaction.

Abscesses of periodontium1. Gingival abscess.2. Periodontal abscess.3. Pericoronal abscess.

Periodontal Vs periapical abscessperiodontal periapical

• Vital tooth.• No Carious.• Pocket .• lateral radioluicency.• Mobility.• Percussion sensitivity

variable.• Sinus tract open via

keratinized gingiva.

• Non vital.• Carious.• No pocket.• Apical radioluicency.• No or minimal mobility.• Percussion sensitivity.• Sinus tract via alveolar

mucosa.

Necrotizing periodontal diseases

Gingival disease of viral origin – herpes virusAcute manifestation of viral infections of

oral mucosa characterized by redness and multiple vesicles that easy rupture to form painful ulcers affecting the gingiva.

Primary herpetic gingivostomatitisClassic initial infection of herpes simples

virus type 1.Mainly in young children.90% of primary oral infection are

asymptomatic.

Clinical features1. Painful severe gingivitis with ulcerations ,

edema and stomatitis.2. Vesicles rupture coalesce and form ulcers.3. Fever and Lymphadenopathy are classic

features.4. lesion usually resolve in 7-14 days.

Treatment 1. Bed rest.2. Fluid.3. Nutrition.4. Antipyretics. 5. Pain relieve .6. Antiviral medications.

Recurrent oral herpes ‘Fever blisters’ or ‘cold sores’.Oral lesion usually herpes simples type 1.Recurrent infections in 20%-40% of those

with primary infection. herpes labials are common.Less severe than primary infection.

Clinical features 1. Prodromal syndrome.2. lesion start as vesicles and then rupture

leave ulcers. 3. A cluster of small painful ulcers on attached

gingiva or lip is characteristic.4. Can cause post operative pain following

dental treatment.

Virus reactivation1. Fever .2. systemic infection.3. Ultraviolet reaction.4. Stress.5. Immune system changes.6. Trauma .7. Undefined cases.

Treatment 1. Palliative care .2. Antiviral medication.

Recurrent aphthous stomatitis Canker sores.Etiology unknown.10%-20% of population.Usually begins in childhood.Decreasing with age.

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Clinical features 1. Affect mobile mucosa.2. Three forms:I. Minor.II. Major.III. Herpitiform.

Minor aphthousClinical features: 1. most common.2. Small shallow ulceration with slightly

raised erythematous borders.3. Central are covers by white-yellow

pseudomembrane. 4. Heal without scarring in 10-14 days.

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Major aphthous Clinical features:1. Herpetiform aphthae : small recurrent

ulcerations Lesion usually small than herpetic stomatitis.

2. Similar to herpetic stomatitis but no vesicles.

3. Heal with 7-10 days without scaring.

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Predisposing factors 1. Stress.2. Trauma.3. Food hypersensitivity.4. Previous viral infection.5. Nutritional deficiency.

Allergic reactionDental restorative materials.( mercury,

nickel, gold , zinc).Toothpaste and mouthwashes.Foods ( peanut, red peppers )

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