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PERIO - Periodontal Practice Today
PERIO - Periodontal Practice Today 4 (2007), No. 2     13. June 2007
PERIO - Periodontal Practice Today 4 (2007), No. 2  (13.06.2007)

Page 93-107

Necrotising periodontal diseases
Rathe, Florian / Chondros, Panagiotis / Chistodoulides, Nicos / Junker, Rüdiger / Sculean, Anton
The aetiology of necrotising periodontal diseases is still unknown. However, specific microorganisms and a weakened immune system seem to play a major role in the disease pathogenesis. The clinical pattern for necrotising gingivitis is characterised by painful, necrotic papillae. Initially, the necroses are restricted to the tip of the papillae. However, they then spread rapidly to the apical tissue, causing attachment loss. The condition is then considered to be necrotising periodontitis. A differential diagnosis reveals primary herpetic gingivostomatitis caused by the herpes simplex virus. If possible, the teeth should be brushed carefully during the first appointment and chemical plaque inspection should be carried out using oral rinses. In cases of impaired ingestion or if general health is affected, the use of systemic antibiotics such as metronidazole is indicated. Periodontal treatment with scaling and root planing should initially be carried out once the acute symptoms have abated.

Keywords: necrotising gingivitis, necrotising periodontitis, necrotising stomatitis, primary herpetic gingivostomatitis