Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
27 Cards in this Set
- Front
- Back
What are the 3 elements that make up the structure of I&R Lesions?
|
1. Angioblastic elements
eg Capillaries and endothelial cell proliferation 2. Inflammatory Cells Chronic - lymphocytes, macrophages, plasma cells Acute - neutrophils Foreign body giant cells 3. Fibroblastic elements Fibroblasts and collagen |
|
What is the cause of most I&R Lesions?
|
chronic irritation
|
|
What is Chronic Hyperplastic Gingivits and what is its cause?
(1) |
It is a hyperplastic tissue response to chronic inflammation associated with local factors such as plaque, calculus and bacteria
|
|
Why and with What drugs does Drug-Mediated Gingival Hyperplasia occur?
|
There is an increased production of extra-cellular ground substance in the crevicular fluid which causes inflammation and subsequantly hyperplasia.
Some examples are: Phenytoin (Dilatin) for epilepsy Ca Channel Blockers (treat HT) eg Nifedipine Cyclosporin (immunosupressant for organ transplants) Also dependent on patient's oral hygiene |
|
What are the clinical signs of Drug-Mediated Gingival Hyperplasia? (6)
|
- Marked localised or generalised gingival hyperplasia which appears to originate from an overgrowth of the interdental papillae
- Spreads over the labial/buccal/lingual/palatal surfaces of the crowns of the teeth - More prominent anteriorly - Firm tissue, show prominent stippling - normal colour unless markedly inflamed -Pseudopockets may result in plaque accumulation |
|
What is the histology of DMGH?
|
- covered by overlying gingival SS
- underlying collagenous fibrous CT - interspersed blood vessels - variable chronic inflammatory cell infiltrate |
|
What is the treatment of DMGH?
|
- Discontinue offending medication (under supervision of the attending MD)
- Substitution another drug -Gingivectomy and vigorous oral hygiene, prevent re-development |
|
What is a Pyogenic Granuloma?
|
A common, reapidly growing, painless, reddish mass, which appears tumour like. Its NOT due to pyogenic organisms, but rather an exuberant response to local irritation or trauma.
Can be anywhere on the body, bleeds easily. Gingiva, lips, tongue are all common sights. Frequently occurs during pregnency |
|
What is another name for a granuloma on the gingiva
|
Epulis
|
|
What is the treatment for a PG?
|
Remove the irritant. Can excise, but best wait until it becomes fibrous, or better let a surgeon do it due to the heavy bleeding expected.
15% recur - this is due to not removing the cause/initiating factor |
|
What is in a PG?
|
Granulation tissue = vessels + inflammatory cells + collagen
|
|
If women get a Pregnancy Granuloma, when is it most likely, and why does it ocur?
|
Begins in first trimester. Increases to the seventh month.
May be related to increasing levels of oestrogen and progesterone |
|
What is the tx for a Pregnancy Granuloma?
|
May resolve post-partum. Will undergo fibrous maturation and develop into a fibrous epulis, can excise then.
|
|
Whats another name for Fibroepithelial Polyp?
|
Irritation Fibroma!!!
|
|
Whats another name for an Irritation Fibroma?
|
Fibroepithelial polyp!
|
|
What do PGCG's look like?
|
Usually less than 2cm, sessile or pedunculated, red-blue nodular mass similar to a Pyogenic Granuloma
|
|
What is the epidemiology of a PGCG?
|
60% in females. Mandible>Maxilla.
Peak incidence in 5th/6th decades |
|
What are some histological aspects of a PGCG?
|
The (possibly ulcerated) SSE is seperated from the rest of the lesion by dense fibrous CT called the Grenz Zone
The core contains Fibrovascular stroma containing plump spindle shaped cells, osteoclast-like giant cells, erythrocytes and haemosiderin pigment There may be reactive woven bone |
|
What is the Treatment for a PGCG?
|
Conservative local excision.
10-15% recur. Scaling and polishing of adjacent teeth to remove source of irritation |
|
What are other names for denture epulis?
|
Epulis fissuratum
Denture-induced fibrous hyperplasia Inflammatory Fibrous Hyperplasia |
|
What is Inflammatory Fibrous Hyperplasia/Epulis Fissuratum?
|
Usually single or multiple folds of hyperplastic tissue caused by the flange of an ill fitting denture
Can also take on a leaf like form, called Leaflike Denture Fibroma. |
|
Describe Leaf-like Denture Fibroma
|
Usually found beneath a denture. Pedunculated with a serrated edge. Resembles a leaf, oddly enough
|
|
What is the histology of Inflammatory Denture Hyperplasia?
|
Elongated mucosal covered soft tissue containing a core of hyperplastic fibrous CT and possibly inflammation and salivary glands.
|
|
What is the treatment for Epulis Fissuratum?
|
Conservative excision, remake denture
|
|
What is Inflammatory Papillary Hyperplasia? What is it associated with?
|
Numerous asymptomatic red papules on the central region of the hard palatal mucosa.
It is associated with Candida infection |
|
What is the histology of Inflammatory Papillary Hyperplasia?
|
Pseudoepitheliomatous hyperplasia may be seen.
Fine papillary projections with central connective tissue cores |
|
Treatment of Inflammatory Papillary Hyperplasia???
|
Excision???
|