Bài 3

Necrotizing ulcerative gingivitis (NUG) results from an impaired host response to a potentially pathogenic microflora. Depending on the degree of immunosuppression, NUG may:

• Occur in a mouth essentially free of other gingival involvement.

• Be superimposed on underlying acute gingival disease.

• Never occur in free gingiva.

• Occur in an edentulous mouth.

Treatment of NUG should include:

• Remove calculus from the first appointment.

• Correction of the underlying acute gingival disease.

• Correction of factors that contribute to the initiation or progression of the gingival changes.

• Take antibiotics and some medicine to reduce pain.

Treatment of NUG should follow an orderly sequence according to specific steps at:

• Three clinical visits.

• Two clinical visits.

• Only one clinical visit.

• Five clinical visits.

Treatment of NUG, the goals of initial therapy are:

• To reduce symptom by medicine.

• To remove necrotic tissue to the degree that repair and regeneration of normal tissue barriers are reestablished.

• To carry out subgingival scaling and curettage.

• To remove necrotic tissue to the degree that repair and regeneration and carry out subgingival scaling and curettage

Treatment of NUG during the initial visit is confined to the acutely involved areas, which are isolated with cotton rolls and dried. A topical anesthetic is applied, and after 2 or 3 min the areas are gently swabbed with a moistened cotton pellet to remove:

• The pseudo - membrane and food debris, .

• Nonattached surface debris and calculus.

• The pseudo - membrane and nonattached surface debris.

• Calculus, dental plaque and bacteria.

Treatment of NUG during first visit, subgingival scaling and curettage are:

• Indicated at this time.

• Indicated at this time with antibiotics.

• Indicated at this time with a topical anesthetic.

• Contraindicated at this time.

Treatment of NUG, extractions or periodontal surgery:

• Are carry out at the first visit.

• Are carry out at the first visit with systemic antibiotic.

• Are postponed until the patient has been symptom free for 4 weeks

• Are postponed until the second visit.

Instruction to the patients in treatment of NUG at the first clinical visit:

• Do not rinse your mouth the first day and eat cold foods.

• Avoid brushing your teeth at the damaged area.

• Eat lots of fruits, drink lots of water.

• Avoid tobacco, alcohol, and condiments.

Instruction to the patient in treatment of NUG at the first clinical visit:

• Rinse with a glassful of with 0.2% chlorhexidine solution every 2 hours.

• Rinse with a glassful of an equal mixture of 3% hydrogen peroxide and warm water every 2 hours.

• Rinse with a glassful of cold water.

• Rinse with a glassful of warm water.

Instruction to the patient in treatment of NUG at the first clinical visit:

(1) Pursue usual activities

(2) Prolonged exposure to the sun.

(3) Active physical training

(4) Get adequate rest.

• (1), (2), (3)
  

• (2), (3), (4)
  

• (1), (3), (4)
  

• (1), (2), (4)