4th L-4, Acute G. Infection

7/29/2019 4th L-4, Acute G. Infection

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Acute Gingival Infections

ByAssist. Lec.

Dr. Bangen Mohammed


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Pericoronitis

- Definition

- Clinical features


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Definition:

It is inflammation of the gingiva in relation to thecrown of an incompletely erupted tooth.

It occurs most often in the mandibular third molar

area. It may be acute, subacute, or chronic.


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Clinical features:1-The most common site is the partially

erupted or impacted mandibular third molar.

2

-The space between the crown of the toothand the overlying gingival flap is an ideal areafor the accumulation of food debris andbacterial growth.


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3-The related G. shows a markedly red, swelling,suppuration & tender to touch.

4-Pain is radiating to the ear, throat, and floor of themouth.

5-Foultasteand an inability to close the jaws.6-Swelling of the cheek in the region of the angle of the

jaw.7-Lymphadenitis are common.8-The patient may also have toxic systemic complications

such as fever, leukocytosis, and malaise.


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Treatment:First visit

1- Superficial debris & exudates are

removed by flushing with warm H2O.

2- Application of topical anesthetic agent.


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3

-HCI:- Hourly rinsing with normal saline

- Rest

- Copious fluid intake- Antibiotics

4- If the G. flap is swollen andfluctuant, drainage is establishedfollowed by insertion of gauze wick.


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Next visit:1- The tooth is retained if erupted

fatherly to functional position.

Then, need surgery (wedge technique)to remove the covering tissues.

2- Otherwise the tooth is extracted.


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Gingival Recession (GR):- Definition

- Types

- Classification

- Etiological factors


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- Definition:

Gingival recession: is exposure of the root surface bythe apical migration of the gingiva.

Recession may be localized to one tooth or a group of

teeth, or it may be generalized throughout the mouth.


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According to the concept of continuous eruption (active,

passive), the gingival sulcus may be located on thecrown, CEJ, or root, depending on the age of the patientand stage of eruption.

Active eruption:is the movement of the teeth in the

direction of the occlusion. Passive eruption:is the exposure of the tooth by apical

migration of the gingiva.


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Types of GR:1- the apparent position

(visible) is the level of the

crest of the gingival margin.2- The actual position

(visible + hidden) is the

level of the epithelialattachment on the tooth.


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The severity of recession

is determined by the

actual position of the

gingiva not its apparentposition.


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Classification (Miller):Class I. Marginal tissue recession

does not extend to the MGJ.

There is no loss of bone or

soft tissue in the interdental

area.

This type of recession

can be narrow or wide.


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Class II. Marginal tissue recession

extends to or beyond MGJ.

There is no loss of bone or

soft tissue in the interdental area.

This type of recession can be

sub-classified into wide and

narrow.


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Class III. Marginal tissue recession

extends to or beyond the MGJ.

There is bone and soft tissue

loss interdentally or

malpositioning of the tooth.


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Class IV.Marginal tissue recession

extends to or beyond

the MGJ.

There is severe bone and

soft tissue loss interdentallyor severe tooth malposition.


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Etiological factors:1- faulty tooth brushing technique ( gingival

abrasion).

2- tooth malposition.

3- friction from soft tissues (gingival ablation).4- gingival inflammation.

5- abnormal frenum attachment.

6- iatrogenic dentistry (Ortho. Treatment)7- trauma from occlusion has been suggested in

the past, but its mechanism of action has never

been demonstrated.


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THANK YOU

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4th L-4, Acute G. Infection

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