Management of Necrotizing Periodontal Diseases at Different Stages: A Case Series

Necrotizing periodontal diseases (NPD) are acute diseases of bacterial dental plaque origin and they are divided into four categories based on the affected tissues: Necrotizing gingivitis, necrotizing periodontitis, necrotizing stomatitis and noma. According to studies, these diseases are rarely seen in the practice of industrialized countries (0.19% to 0.5%) when it does occur, it tends to affect young individuals more frequently in accordance with its etiological factors. The disease presents specific clinical features such as necrotic papillae resembling punched-out lesions, severe pain and the formation of pseudomembrane. Diagnosis is typically based on clinical findings. The development of the disease is influenced by host response and along with predisposing factors such as systemic conditions, HIV infection and stress. The treatment of the disease consists of the acute phase treatment and the supportive/maintenance phase treatment. Between these two main stages, there are stages for controlling the predisposing factors and correcting the sequelae resulting from the disease. In this case series, we have reported on the clinical examination, diagnosis, treatment, and follow-up of three patients referred to the Department of Periodontology Ege University Faculty of Dentistry, diagnosed with Necrotizing Periodontal Diseases (NPD). The changes in terms of social and oral care habits during the 3-6 months post-treatment period and maintenance phase were also documented.