1. How is ANUG treated?
2. What is considered to be the primary stress hormone?
3. Make a list of how smoking effects the periodontal tissues.
4. How long does it take for chronic gingivitis to heal after treatment?
See how you go....
Sophie
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12 comments:
1. The most effective way to quickly control ANUG is with antibiotics along with removal of plaque and supra/subgingival calculus. As well as this, OHI and counsel regarding stress and smoking should be performed alongside the mechanical debridement.
2. Corticotropin Releasing Hormone (CRH) is the primary stress hormone.
3. Smoking (at a general level): restricts the blood flow to the periodontal tissues, alters the immune function (it impairs PMN chemotaxis & phagocytosis), causes a decrease in vitamin C levels and induces macrophages to produce large amounts of pro-inflammatory chemicals.
At a local level nicotine: is rapidly absorbed by the oral mucosa which contributes to its addictive nature, binds to the tooth surface (which can influence periodontal healing) and binds to fibroblasts which impairs their function.
4. Healing of chronic gingivitis will vary from person to person but it generally takes 2-6 weeks for complete healing.
On the right track Tim.. can you specify the type of antibiotics used n the treatment of anug.
I think it's metronidazole that's used to treat ANUG, although penicillin can also be used.
Tim.. good guess but please confirm the range of antibiotics that are used in your module and post them here.
Module 2 states that Flagyl (metronidazle) 200mg 3 x daily for 7 days is the most effective way of quickly controlling ANUG. Penicillin (Amoxil) or Azithromycin will also work.
Thats it Tim..
Well done.. have a go at the remainder of the questions and just revisit the last comment I made on the biofilm/risk factor asscoiation to get final clarification.
Ohh goodness timmy u have been an lil active blogger!!
I agree with the metranidazole(that one i actually knew)hehe..
I will get back with some responses to the rest ASAP!! :D
Go for it guys.. I am tracking..... let the others know that they can learn from this blog....
OK.. so as timmy has already said
1: Metranidazole is effective totreat ANUG as well as amoxil, and azithromycin,
2)The primarystress hormone is Corticotropin releasing hormone(CRH)thatis released by the hypothalamus and has affects on the anterior pituitary gland-causing the release of ACTH(I couldn't find/read coz of printing whatthe ATCH actually stands for)
3)smoking affects periodontal tissues via:
-affecting neutrophils function
-decreasing healing(favouring a destructive cycle)
-
4) Chronic gingivitis healing is the exact opposite of its development, So in the first 4 days, there is repeair of the JE and decreased numbers of PMN resulting in less pus and exudate and less bad taste for patient.
7-14 days,there is a decrease in the number of inflammatory cells in gingival tissues, and the vessels begin to reduce causing a decrease in swelling and less redness/bleeding, improved pocket depths(due to JE healing)
and at 2-6 weeks the fibroblasts have increased adn there is an increase in gingival collagen, with tissue becoming firmer and there is less tooth mobility and increase resistance to probing..
I have a question with this though-while this summarises the healing process-what level would we say healing has occured:atthe very end(2-6 weeks) or could we say healing is detected after 4-7days-due to the improved appearance, decrease in swelling etc??
Whatdo people think ??
Excellent discussion guys. You are working through this very systematically and coming up with good answers. Nicole, you have almost answered your own question here but I will wait and see what others think.
Sophie
I recon 7-14 days - particularly if the patient is under observation for their progress. The healing of the JE is a good sign when checking pocket depth - from listening to Dr Dooland i know she spoke about azithromycin (with a patient of mine) and that after a short while a decrease in pocket depth, among other things, is a good indicator that the drug is working (that healing is occuring) or something like that....So signs of improvement = signs of healing and recovery...that the body is showing the capability to repair itself.
Hope this makes sense :)
Yes-Emma thats what i thought aswell. Coz while 2-6 weeks is when histologically full healing has occured, at 7-14 days, if healing isn't begininnng/detected then it is not likely to be occurring very well/at all..
Thanks
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