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