Inicio > Odontología y Estomatología > Manejo odontológico de la gingivitis ulcerativa necrotizante aguda > Página 4

Manejo odontológico de la gingivitis ulcerativa necrotizante aguda

Los colutorios antisépticos sólo tienen efecto sobre los patógenos que están en la mucosa oral y en las zonas supragingivales, por lo que un enjuague bucal tiene un mínimo efecto en el biofilm subgingival; por lo que la terapia debe ser conjunta de tratamiento antibiótico, desbridamiento y enjuagues antisépticos.(37)

CONCLUSIONES

Los pacientes con gingivitis ulcerativa necrotizante aguda (GUNA) deben tratarse médicamente con antibióticos junto con un desbridamiento inicial de las zonas enfermas y la realización posterior de un raspado y alisado radicular, para mejorar el cuadro clínico.

Sin tratamiento para la gingivitis ulcerativa necrotizante aguda (GUNA), el paciente está avocado a la rápida destrucción del periodonto y extenderse a los tejidos vecinos, mejillas, labios o al hueso; y manifestarse como Noma o Estomatitis necrotizante.

BIBLIOGRAFÍA

1. Eley BM, Soory M, Manson JD. Chapter 25: acute necrotizing ulcerative gingivitis. In Eley BM, Soory M, Manson JD (eds). Periodontics, 6th Edn. Edinburgh/New York: Saunders/ Elsevier, 2010:376-9.

2. Carranza N. Carranza`s Clinical Periodontology. 11th Ed. St. Louis: Saunders, 2012;97:110-81.

3. Armitage GC. Development of a Classification System for Periodontal Diseases and conditions. Ann Periodontol 1999;4:1-6.

4. Lang N, Meng HX, Soskolne WA, Newman M, Greenstein G, Novak MJ, Cochran D, Tenenbaum H and Corbet E. Consensus Report: Necrotizing Periodontal Diseases. Annals Periodontol 1999;4(1):65-78.

5. Horning G and Cohen M. Necrotizing ulcerative gingivitis, periodontitis and stomatitis: Clinical staging and predisposing factors. J Perio 1995;66:990-8.

6. Holmstrup P, Westergaard J. Enfermedad periodontal necrosante. En: Lindhe J (ed). Periodontología clínica e implantología odontológica. Madrid: Editorial Médica Panamericana;2002:261-81.

7. Corbet EF. Diagnosis of acute periodontal lesions. Periodontol 2000 2004;34:204-16.

8. Bascones Martínez A, García Nuñez JA, Sanz Alonso MS, Gabriel Sánchez J. Gingivitis ulcerativa necrotizante aguda. Concepto y tratamiento actual. Av Odontoestomatol 1985;1:175-81.

9. Brown LJ & Löe H. Prevalence, extent, severity and progression of periodontal disease. Periodontol 2000 1993;2:57-71.

10. Regezzi JA, Sciuba JJ. Patología bucal correlaciones clínico-patológicas. 3era Ed, México, Ed. McGraw-Hill Interamericana, 2000.

11. Rowland RW. Necrotizing ulcerative gingivitis. Ann Periodontol 1999;78(4):65-73.

12. Petersen E. Strengthening the prevention of HIV/AIDS – related oral disease: A global approach. Community Dentistry and Oral Epidemiology.2004

13. Jenkins W & Papapanou PN. Epidemiology of periodontal disease in children and adolescents. Periodontol 2000 2001;26:16-32.

14. Sangani I, Watt E and Cross D. Necrotizing ulcerative gingivitis and the orthodontic patient: A case series. J Orthodontics 2013;40:77-80.

15. Campbell CSM, Bradshaw M, Deas DE. Necrotising ulcerative gingivitis: a discussion of four dissimilar presentations. Tex Dent 2011;128:1041-51.

16. EC-Clearinghouse on Oral Problems Related to HIV Infection and WHO Collatoratins Centre on Oral Manifestations of the Immunodeficiency Virus. Copenhagen. Classification and diagnosis criteria for oral lesions in HIV infection. J Oral Pathol Med 1993;22:289-91.

17. Klokkevold PR. Necrotizing ulcerative periodontitis.IN: Newman MG, Takei H, Klokkevold PR, Carranza FA, editors. Carranza`s Clinical Periodontology.11th Ed. St. Louis: Saunders: 2012:165-8.

18. Okudaa T, Kokubua E, Kawanaa T, Saitob S, Okudaa K, Ishihara K. Synergy in biofilm formation between Fusobacterium nucleatum and Prevotella species. Anaerobe.2012;18(1):110-6.

19. Hooper PA, Symour GJ. The histopathogenesis of Acute Ulcerative Gingivitis. J Periodontol 1979;50:419-23.
20. Clower BR, Andy OJ, Montalvo AM, Peeler D. The hippocampus and stress induced 17-OHCS elevations. Pavlov J Biol

Sci 1979;14(2):86-92.

21. Novak MJ. Necrotizing ulcerative periodontitis. Ann Periodontol 1999;4(1):74-4.

22. Batista EL, Novaes AB, Calvano LM, do Prado EA, Goudouris ES, Batista FC. Necrotizing ulcerative periodontitis associated with severe congenital immunodeficiency in a prepubescent subject: clinical findings and response to intravenous immunoglobulin treatment. J Clin Periodontol 1999;26(8):499-504.

23. Holmstrup P, Westergaard J. HIV-associated periodontal disease. En: Lang NP, Karring T eds. Proceedings of the 1st European Workshop on Periodontology. London: Quintessence Publishing Co. Ltd;1994:439-61.

24. Califano JV. Research, Science and Therapy Committee American Academy of Periodontology. Position paper: periodontal diseases of children and adolescents. J Periodontol 2003;74:1696-704.

25. Howell TH. Blocking periodontal disease progression with anti-inflammatory agents. J Periodontol 1993;64:828-33.

26. Lucartorto FM, Franker CK, Maza J. Postscaling bacteremia in HIV- associated gingivitis and periodontitis. Oral Surg Oral Med Oral Pathol 1992;73:550-4.

27. Ghayoumi N. The use of metronidazole in the treatment of periodontal diseases. J West Soc Periodontol Periodontal Abstr 2001;49:37-40.

28. Atout RN, Todescan S. Managing patients with Necrotizing ulcerative gingivitis. J Can Dent Assoc 2013;79(d46).

29. Todescan S, Nizar R. Managing patients with Necrotizing ulcerative periodontitis. J Can Dent Assoc 2013;79(d44).

30. Pihlstrom BL, Ammons WF. Treatment of gingivitis and periodontitis. Research, Science and Therapy Committee of the American Academy of Periodontology. J Periodontol 1997;68:1246-53.

31. Dewhirst FE, Chen T, Izard J, Paster BJ, Tanner AC, Yu WH, Lakshmanan A & Wade WG. The Human oral microbiome. J Bacteriol 2010;192:5002-17.

32. Gmür R, Wyss C, Xue Y, Thurnheer T & Guggenheim B. Gingival crevice microbiota from Chinese patients with gingivitis or necrotizing ulcerative gingivitis. Eur J Oral Sci 2004;112:33-41.

33. Lüdin ND. Phylogenetic characterization of subgingival plaque associated with aggressive or chronic periodontitis. Doctoral Dissertation, Faculty of Medicine, University of Zürich, Switzerland.

34. Mitchell DA. Metronidazole: its use in clinical dentistry. J Clin Periodontol 1984;11:145-58.

35. Vartoukian SR, Palmer RM & Wade WG. Diversity and morphology of members of the phylum “Synergistetes” in periodontal health and disease. Appl Environ Microbiol 2009;75:3777-86.

36. Gordon JM, Walker CB. Current status of systemic antibiotic usage in destructive periodontal disease. J Periodontol 1993;64:760-71.

37. Zerón A. Biofilm Microbiano, Nuevas perspective en el control de placa bacteriana. Rev Odontología Actual 2006;43.