PubMed · 5282641
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E Plüss, K H Rateitschak. 1971. [The initial lesion in ulcerative gingivitis].. https://pubmed.ncbi.nlm.nih.gov/5282641/
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Necrotizing periodontal disease (NPD) is an infection characterized by gingival necrosis presenting as "punched-out" papillae, with gingival bleeding, and pain. Prevotella intermedia and spirochetes have been associated with the gingival lesions. Predisposing factors may include emotional stress, immunosuppression, especially secondary to human immunodeficiency virus (HIV) infection, cigarette smoking, poor diet and pre-existing gingivitis. During the last few years, diagnosis of NPD has became more important not only because of its contribution to the appearance of clinical attachment loss and gingival sequelae, but also because it has been revealed as a marker for immune deterioration in HIV-seropositive patients.
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In the course of infection by the Human Immunodeficiency Virus (HIV) typical changes of inflammatory periodontal diseases can arise. The prevalence of these illnesses may be up to 5%. The HIV-associated periodontal diseases include linear gingival erythema (LGE), necrotizing ulcerative gingivitis (NUG) and necrotizing ulcerative periodontitis (NUP). The necrotizing forms appear particularly in severe or advanced immunosuppression. It can be safely assumed that the HIV infection and the resulting immunological defects are responsible for these severe forms of destruction of the periodontal tissue. Periodontal therapy consists in the removal of necrotic tissues and removal of soft and hard plaque-deposits. This is supported by a chlorhexidine digluconate mouthrinse and antibiotics. In the interest of further prophylactics a strict system of recall appointments is recommended.