gingival disease Flashcards
gingivitis associated with dental plaque only (or only with local contributing factors)
- inflammation of the gingiva in the absence of clinical attachment loss
- redness/edema/surface texture changes
clinical attachment loss (gingival diseases do not have this)
-detachment of PDL fibers so you can probe onto root surface
clinical features of gingivitis associated with dental plaque only (or local contributing factors)
- changes in color (red/magenta)
- bleeding on probing/spontaneous
- changes in consistency, edema, fibroma
- changes in CONTOUR: enlarged (marginal/papillary), blunted or cratered (papilary), rolled (marginal)
- changes in texture: lose stipppling, interdental groove, and/or free gingival groove
- changes in position: enlargement (pseudopocket)
changes in contour, gingivitis assoc.w/dental plaque
- bulbous papilla
- papilla should be concave, but become straight or even convex
- pap and marginal: enlarged
- pap: blunted/cratered
- marg: rolled
2 types of plaque: which causes gingival inflammation
supra and sub gingival
**sub gingival causes it
gingivitis: radiograph shows what
- no evidence of crestal bone loss
- bone should be 1-2mm apical of CEJ
- in that 1-2mm space, you have gingival CT and PDL fibers
health or plaque induced gingivitis on a reduced but stable periodontium
- generally follows active perio therapy
- tissue is healthy or has slight gingivitis
- no evidence of progressive attachment loss/active disease (12 months)
- must have longitudnal atatchment measurements to support this dx
- could also be used in presence of recession from a non-perio etiology
clinical patterns of gingivitis - extent
- probe 6 sites per tooth
- old system: by % of sites affected
- new: by % of teeth affected
- 30% or less= localized
- more than 30% = generalized
- diagnose by sextant and whole mouth
clinical pattersn of gingivitis - severity
- slight, moderate, severe
- more subjective
gingivitis - histology
- many changes: CT breakdown leads to inflammation
- no apical migration of ATTACHMENT
- jxnal epithelium’s apical part can migrate apically, but the point of attachment (which is the coronal part at base of sulcus) does not move
- attachment is still at CEJ
**jxnal epithelium gets longer before it moves apically from attachment at CEJ
gingival diseases modified by systemic factors
- endocrine system changes: puberty, menstrual cycle, pregnancy, diabetes
- blood dyscrasias
periodontitis associated with…
- hematologic disorfers
- genetic disorder
**NOT DIABETES - clinically looks the same as chronic, so there is no ‘diabetes assoc-periodontitis’
gingival enlargement
-frequently without primary inflammatory etiology
- *often caused by drugs!
- can occur in absence of attachment loss or superimposped on attach.loss
- features = enlargement of papillary adn marginal gingiva AND increased probing depth, without change in attachment levels
drugs that cause gingival enlargement
- calcium channel blockers - nifedipine
- anti-convulsants - phenytoin (dilantin, anti-seizure)
- cyclosporin (kidney transplant)
non plaque induced gingival lesions - herpetic gingivitis
viral infection of oral mucosa/gingiva with clinical features…
- generalized painful gingiva/mucosa
- inflammation
- vesiculation/ulceration
- lymphadenopathy
- fever
- malaise
