Necrotizing Ulcerative Periodontitis Refractory Periodontitis Short Essay Question And Answers

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Necrotizing Ulcerative Periodontitis Refractory Periodontitis Important Notes

AIDS-associated necrotizing ulcerative periodontitis Features:

  • Severe soft tissue necrosis with rapid destruction of bone leading to its exposure
  • Destruction may extend to the vestibular area and palate
  • May result in necrotizing stomatitis

Read And Learn More: Periodontics Question and Answers

Necrotizing Ulcerative Periodontitis Refractory Periodontitis Short Essays

Question 1. Necrotizing ulcerative periodontitis (NUP).
Answer:

When ulcerative gingivitis extends deeper into the periodontal structures, it results in loss of attachment and bone loss

Necrotizing Ulcerative Periodontitis Types:

  • AIDS-associated
  • Non-AIDS type NUP

Necrotizing Ulcerative Periodontitis Clinical Features:

  • Ulceration and necrosis of the gingival margin
  • Presence of pseudo-membranous slough
  • Pain
  • Bleeding spontaneously
  • Deep pockets
  • Osseous craters, Gingival recession

Necrotizing Ulcerative Periodontitis General Features:

  • Localized lymphadenopathy
  • Fever
  • Malaise

Question 2. Refractory Periodontitis.
Answer:

Refractory Periodontitis Definition:

  • According to AAP, it is defined as those cases which do not respond to any treatment provided, whatever the thoroughness or frequency

Refractory Periodontitis Etiology:

  • Abnormal host response
  • Resistant strains of microorganisms
  • Failure to treat plaque retentive factors Smoking
  • Systemic diseases
  • Micro-organisms
    • B.forsythus, F.nucleatum, C.rectus
    • S.intermedius, P.gingivalis

Refractory Periodontitis Clinical Features:

  • Failure to restrict the progression of the disease
  • No response of treatment on
    • Plaque accumulation
    • Attachment loss
  • Persistent bleeding on probing
  • Development of new areas of attachment loss

Refractory Periodontitis Treatment:

  • Scaling and root planning
  • Followed by antibiotic therapy
    • Tetracycline 250 mg QID
    • Amoxicillin 250 mg + 125 mg TID
    • Clindamycin 150 mg QID for 1 week
    • Metronidazole 400 mg TID
    • Local drug delivery – gels, fibers, or chips
    • Sub-antimicrobial dose of doxycycline SDD – 20 mg BID for 3 months

Question 3. Differentiate between Recurrent and Refractory Periodontitis.
Answer:

Necrotizing Ulcerative Periodontitis Refractory Periodontitis Differentiate between recurrent and refractory periodontitis

Question 4. Retrograde periodontitis.
Answer:

Periodontitis caused by pulpal infections that have entered the periodontal ligament either through the apical foramen or through lateral canals is termed retrograde periodontitis

Retrograde Periodontitis Pathways Of Communications

1. Pathways of developmental origin:

  • Apical foramen
  • Accessory canals and lateral canals
  • Developmental grooves
  • Enamel projections and pearls

2. Pathways of pathologic origin

  • Tooth fracture
  • Idiopathic resorption
  • Loss of cementum

3. Pathways of iatrogenic origin

  • Exposure of dentinal tubules following root planning
  • Accidental lateral perforation during an endodontic procedure
  • Root fracture due to endodontic procedure

Retrograde Periodontitis  Pathogenesis:

Necrotizing Ulcerative Periodontitis Refractory Periodontitis Pathogenesis

Necrotizing Ulcerative Periodontitis Refractory Periodontitis Viva Voce

Cases that do not respond to therapy or recur soon after adequate treatment are referred to as refractory periodontitis

 

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