Acute Necrotising Ulcerative Gingivitis

12,022 views

Published on

Published in: Education, Health & Medicine
1 Comment
18 Likes
Statistics
Notes
No Downloads
Views
Total views
12,022
On SlideShare
0
From Embeds
0
Number of Embeds
31
Actions
Shares
0
Downloads
575
Comments
1
Likes
18
Embeds 0
No embeds

No notes for slide

Acute Necrotising Ulcerative Gingivitis

  1. 1. ACUTE NECROTISING ULCERATIVE GINGIVITIS Dr shabeel pn
  2. 2. <ul><li>Acute necrotising ulcerative gingivitis is a relatively rare condition and is characterised clinically by necrosis of the free gingival margin,the crest of the gingiva and the interdental papillae,etc. </li></ul>
  3. 3. <ul><li>SYNONYM- </li></ul><ul><li>- VINCENT’S INFECTION </li></ul><ul><li>-TRENCH MOUTH </li></ul><ul><li>- ACUTE ULCEROMEMBRANEOUS </li></ul><ul><li>GINGIVITIS </li></ul><ul><li>-PHAGEDENIC GINGIVITIS </li></ul><ul><li>-FUSOSPIROCHETAL GINGIVITIS </li></ul>
  4. 4. EPIDEMIOLOGY <ul><li>It frequently occur in an epidemic pattern. </li></ul><ul><li>Especially apparent during World War I-and the term ‘trench mouth’ originated. </li></ul><ul><li>Sporadic outbursts also occurred in World War II </li></ul><ul><li>Global increase associated with HIV infection </li></ul><ul><li>More common among young and middle aged adults,15-35 years old. </li></ul>
  5. 5. ETIOLOGY <ul><li>Most investigators believe that it’s caused by a fusiform bacillus and Borrelia vincentii </li></ul><ul><li>- a spirochete. </li></ul><ul><li>Some workers also included vibrio and coccal forms as agents in the etiology of this disease. </li></ul><ul><li>Frequently occurs in the presence of psychologic stress. </li></ul>
  6. 6. <ul><li>Stress-related corticosteroids are thought to alter T4/T8 lymphocyte ratios and may cause the decreased neutrophilic chemotaxis and phagocytic response. </li></ul><ul><li>Immunosuppresion. </li></ul><ul><li>Smoking. </li></ul><ul><li>Local trauma. </li></ul><ul><li>Poor nutritional status. </li></ul><ul><li>Poor oral hygeine. </li></ul><ul><li>Inadequate sleep. </li></ul>
  7. 7. <ul><li>Recent illness. </li></ul><ul><li>Sudden change in lifestyle </li></ul><ul><li>Debilitating disease(eg:infectious mononucleosis,bacterial infections,diabetes,blood dyscrasias,etc) </li></ul><ul><li>Emotional stress </li></ul><ul><li>Down’s syndrome </li></ul>
  8. 8. CLINICAL FEATURES <ul><li>Males are more frequently involved </li></ul><ul><li>Gingiva becomes red and painful. </li></ul><ul><li>Later on a sharply “punched-out” erosion of the interdental papillae occurs. </li></ul><ul><li>Gingiva often covered by a “pseudomembrane” and moreover it has a pronounced bleeding tendency and always produces extremely unpleasant fetid odor. </li></ul>
  9. 9. <ul><li>Rarely, the gingival lesion may extend to the mucosal surfaces of soft palate and tonsils. </li></ul><ul><li>Patient often develops headache,fever,malaise and lymphadenopathy,etc. </li></ul><ul><li>Difficulty in taking food due to increased salivation and a metallic taste in the mouth. </li></ul>
  10. 10. <ul><li>Most of the patients develop systemic manifestation in the form of leukocytosis, tachycardia and gastro intestinal disturbance etc. </li></ul><ul><li>Process sometimes lead to a loss of attachment and the development of associated periodontitis(necrotizing ulcerative periodontitis)or spread to adjacent soft tissue(necrotizing ulcerative mucositis;necrotizing stomatitis) </li></ul><ul><li>If necrotizing infection extends through the mucosa to the skin of the face,it is typically termed noma(cancrum oris) </li></ul>
  11. 11. REFERENCE <ul><li>ORAL AND MAXILLOFACIAL PATHOLOGY(2 ND EDITION)-NEVILLE </li></ul><ul><li>ESSENTIALS OF ORAL PATHOLOGY(2 ND EDITION)-SWAPAN KUMAR PURKAIT </li></ul><ul><li>SHAFER’S TEXTBOOK OF ORAL PATHOLOGY(5 TH EDITION) </li></ul>

×