NUG generally responds to initial therapy of debridement, antimicrobial oral rinses, and antibiotic therapy (37). When the process heals, the altered gingival anatomy resulting from tissue loss through necrosis creates anatomic forms that predispose to recurrence of NUG and to the development of chronic periodontitis. NUG may progress from gingival soft-tissue involvement to produce loss of periodontal attachment (necrotizing ulcerative periodontitis) and may extend to involve the adjacent oral soft tissues (necrotizing ulcerative stomatitis). Extension of the infectious process through the soft tissues to the facial skin is termed "Noma" (cancrum oris).
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