ANUG

Associated micro organisms

Predisposing factors

By
-Pavithran E
RA2041001010037

Tobacco use

Malnutrition

Change in living habits

Psychological stress

Immunocompramised

Fusospirochetal complex

Vibrio

T.microdentium

Borellia vincentii

P.intermedia

Systemic signs and symptoms

Oral signs

ANUG

ANUG

Oral symptoms

Histopathological features

Punched out crater like depression at the crest of interdental papilla

Marginal gingiva is red,shiny and hemorrhagic

Well demarcated by linear erythema

Spontaneous gingival bleeding

Covered by gray psuedomembraneous slough

Fetid odor and increased salivation

Metallic followed taste

Pain aggrevated by intake of hot and spice food

Constant radiating gnawing pain

Excessive amount of pasty saliva

Lesions extremely sensitivity to touch

Severe cases

Mild and moderate
Cases

Usually ambulatory

Local lymphadenopathy

High fever

Increase pulse rate

Leucocytosis

Loss of apetite

More severe in children

Spontaneous gingival bleeding

Slight elevation in temperature

General lassitude

Insomnia

Headache

Constipation

Mental depression

GI disorders

Staging

Listgarten Zones

Zone 3: Necrotic zone

Zone 2: Neurtrophil rich zone

Zone 4: Spirochatal infiltration

Zone 1: Bacteria zone

Necrosis of buccal and labial mucosa

Necrosis of alveolar bone

Necrosis of marginal gingiva

Necrosis perforating skin and cheek

Necrosis of entire papilla

Necrosis of tip of interdental papilla

Smoking

Replaced by meshwork of fibrin,necrotic epithelial cell,PMN

Cell exhibits hydrophic degeneration

Epithelium is destroyed

Engorged capillaries in connective tissue

Involvement epithelium and connective tissue

Differential diagnosis

Management

Desquammative gingivitis

Streptococcal gingivo stomatitis

Chronic periodontitis

Apthous stomatitis

Herpetic gingivostomatitis

Typically xylocaine application

NSAID
Ibuprofen,Advil

Antibiotic treatment
Amoxicillin,erthromycin,tetracycline

Correction of predisposing factors

Rise mouth with 1.5% hydrogen peroxide mouth wash

Management of systemic symptoms