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牙周急診處理 (55:04)

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3. The treatment of acute gingival disease entails Alleviation of the acute symptoms 2. Elimination of all other periodontal disease, both chronic and acute, throughout the oral cavity

4. Characteristics Common to all Gingival Diseases - 1

5. Characteristics Common to all Gingival Diseases - 2

6. Characteristics of Plaque-Induced Gingivitis

7. Clinical Evaluation of Periodontal Diseases

8. Signs of Inflammation

9. Assessment of Inflammation in the Periodontal Tissues

10. Classification of Periodontal Diseases 1999 workshop

11. Necrotizing Periodontal Disease

12. Necrotizing Periodontal Diseases

13. Necrotizing Ulcerative Gingivitis

14. The patients affected are typically adolescents or young adults, may be cigarettes smokers, and are often psychologically stressed.During world II up to 14% of the Danish military personnel encountered NPD. Also civilians suffered from the disease After world war II the prevalence of NPD declined substantially and in industrialized countries NPD it is now rare

15. Clinical signs “NUG”

16. The ulcers are covered by a yellowish – white or grayish slough which is termed “Pseudo membrane “ The sloughed material has no coherence , and bears little resemblance to a membrane.It consists primarily of fibrin and necrotic tissue with Leucocytes, erythrocytes and masses of bacteria

17. Removing of the sloughed material results bleeding and ulcerated underlying tissue becomes exposed The necrotizing lesions develop rapidly and are painful , but in the initial stages , when the necrotic areas are relatively few and small , pain is usually moderate.Bleeding is readily provoked .And may start spontaneously as well as in response to even gentle touch.

18. In early phases of the disease lesions are typically confined to the top of a few interdental papillae

19. Removing of the sloughed material results bleeding and ulcerated underlying tissue becomes exposed The necrotizing lesions develop rapidly and are painful , but in the initial stages , when the necrotic areas are relatively few and small , pain is usually moderate.Bleeding is readily provoked .And may start spontaneously as well as in response to even gentle touch.

20. Clinical signs “NUG”

21. Necrotizing Ulcerative Gingivitis

22. Necrotizing Periodontal Diseases

23. Classification of Periodontal Diseases 1999 workshop

24. Signs of Inflammation

25. Assessment of Inflammation in the Periodontal Tissues

26. Classification of Periodontal Diseases 1999 workshop

27. Necrotizing Ulcerative Gingivitis

28. Necrotizing Ulcerative Gingivitis

29. The patients affected are typically adolescents or young adults, may be cigarettes smokers, and are often psychologically stressed.During world II up to 14% of the Danish military personnel encountered NPD. Also civilians suffered from the disease After world war II the prevalence of NPD declined substantially and in industrialized countries NPD it is now rare

30. The ulcers are covered by a yellowish – white or grayish slough which is termed “Pseudo membrane “ The sloughed material has no coherence , and bears little resemblance to a membrane.It consists primarily of fibrin and necrotic tissue with Leucocytes, erythrocytes and masses of bacteria

31. In early phases of the disease lesions are typically confined to the top of a few interdental papillae

32. Clinical signs “NUG”

33. Necrotizing Ulcerative Gingivitis

34. The patients affected are typically adolescents or young adults, may be cigarettes smokers, and are often psychologically stressed.During world II up to 14% of the Danish military personnel encountered NPD. Also civilians suffered from the disease After world war II the prevalence of NPD declined substantially and in industrialized countries NPD it is now rare

35. The ulcers are covered by a yellowish – white or grayish slough which is termed “Pseudo membrane “ The sloughed material has no coherence , and bears little resemblance to a membrane.It consists primarily of fibrin and necrotic tissue with Leucocytes, erythrocytes and masses of bacteria

36. In early phases of the disease lesions are typically confined to the top of a few interdental papillae

37. Differential Diagnosis

38. In early phases of the disease lesions are typically confined to the top of a few interdental papillae

39. Differential Diagnosis

40. Swelling of Lymph Nodes

41. Differential Diagnosis

42. Histopathology

43. Oral Hygiene

44. The treatment of the necrotizing periodontal diseases is divided into two phases :Acute Maintenance

45. Acute Phase Treatment

46. The first consultation scaling should be attempted as thorough as the condition allows.Ultrasonic scaling may be preferable, with minimal pressure against the soft tissues , ultrasonic cleaning may accomplish the removal of soft and mineralized deposits

47. Twice daily rinses with 0.2% chlorhexidine solution to reduce plaque formation, particularly when tooth brushing is not performed

48. Supplementary Treatment

49. Antibiotics are administered systemically only in patients with systemic complications or local adenopathyAntibiotics are not recommended in NUG patients who do not have these complications. A large variety of drugs have been used in the treatment of NUG.Topical drug therapy is only an adjunctive measure; no drug, when used alone, canbe considered complete therapy.

50. Percoronitis

51. Percoronitis is a special type of acute periodontal abscess that occurs when gingival tissue (operculum) overlies an erupting tooth (usually a third molar, also known as a wisdom tooth). Recurring acute symptoms are usually initiated by trauma from the opposing tooth or by impaction of food or debris under the flap of tissue that partially covers the erupting tooth

52. Prescribe oral analgesics for comfort as well as penicillin over the next 10 days (penicillin VK 500mg ). Instruct the patient on the importance of cleansing away any food particles that collect beneath the gingival flap. This can be accomplished by simply using a soft toothbrush or by using water jet irrigation

53. Percoronitis is a special type of acute periodontal abscess that occurs when gingival tissue (operculum) overlies an erupting tooth (usually a third molar, also known as a wisdom tooth). Recurring acute symptoms are usually initiated by trauma from the opposing tooth or by impaction of food or debris under the flap of tissue that partially covers the erupting tooth

54. Prescribe oral analgesics for comfort as well as penicillin over the next 10 days (penicillin VK 500mg ). Instruct the patient on the importance of cleansing away any food particles that collect beneath the gingival flap. This can be accomplished by simply using a soft toothbrush or by using water jet irrigation

55. Prescribe oral analgesics for comfort as well as penicillin over the next 10 days (penicillin VK 500mg ). Instruct the patient on the importance of cleansing away any food particles that collect beneath the gingival flap. This can be accomplished by simply using a soft toothbrush or by using water jet irrigation

56. Abscesses of the Periodontium

57. Prescribe oral analgesics for comfort as well as penicillin over the next 10 days (penicillin VK 500mg ). Instruct the patient on the importance of cleansing away any food particles that collect beneath the gingival flap. This can be accomplished by simply using a soft toothbrush or by using water jet irrigation

58. Percoronitis is a special type of acute periodontal abscess that occurs when gingival tissue (operculum) overlies an erupting tooth (usually a third molar, also known as a wisdom tooth). Recurring acute symptoms are usually initiated by trauma from the opposing tooth or by impaction of food or debris under the flap of tissue that partially covers the erupting tooth

59. Prescribe oral analgesics for comfort as well as penicillin over the next 10 days (penicillin VK 500mg ). Instruct the patient on the importance of cleansing away any food particles that collect beneath the gingival flap. This can be accomplished by simply using a soft toothbrush or by using water jet irrigation

60. Abscesses of the Periodontium

61. Classification of Periodontal Diseases 1999 workshop

62. Abscesses of the Periodontium :The classification of periodontal abscess is primarily based on location of the infection.

63. Classification of Periodontal Diseases 1999 workshop

64. Abscesses of the Periodontium :The classification of periodontal abscess is primarily based on location of the infection.

65. Type of Periodontal Abscess

66. Factors associated with development of periodontal abscesses

67. The treatment of acute gingival disease entails Alleviation of the acute symptoms 2. Elimination of all other periodontal disease, both chronic and acute, throughout the oral cavity