Which organism is primarily associated with acute necrotizing ulcerative gingivitis?

Acute necrotizing ulcerative gingivitis (ANUG), also known as Vincent's disease, is primarily associated with Treponema denticola. This organism is a spirochete that plays a significant role in the pathogenesis of ANUG by contributing to tissue destruction and the characteristic necrotic ulcers seen in the condition. Treponema denticola is often present in polymicrobial infections, but it is particularly noted for its association with deeper periodontal tissue destruction.

The condition is frequently characterized by symptoms such as painful ulceration at the gingival margins, bleeding, and a foul odor, all of which may be exacerbated by the presence of spirochetes like Treponema denticola. Understanding the particular role of this organism helps in diagnosing and managing acute necrotizing ulcerative gingivitis effectively.

While other options like Fusobacterium nucleatum and Porphyromonas gingivalis are involved in various periodontal diseases, and Streptococcus mutans is more commonly related to dental caries rather than acute periodontal infections, their associations are not as specific to ANUG as that of Treponema denticola.