Host Microbial Interactions to Initial Biofilm Formation Flashcards
What do clinically healthy gingivae look like?
Coral pink, firm gingivae with uniform colour and no swelling
Knife edged and intact margins
Flat, intact papillae
Absence of bleeding on probing, probing depths ≤ 3mm
Surface texture (gingival stippling)
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What is inflammation?
Protective tissue response to injury, irritation or infection.
Walls off both the injurious agent and the injured tissue.
Usual signs include : swelling(tumour), pain(dolor), redness and loss of function.
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What are the characteristics of dental plaque-induced gingival diseases?
Signs and symptoms that are confined to the gingiva (free gingiva)
The presence of dental plaque to initiate the lesion
Clinical signs of inflammation
Stable attachment level (junctional epithelium), no bone loss
The disease is reversible by removing the aetiology but if not removed, it plays a possible role as a precursor to periodontitis
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What are the aetiological factors of gingivitis?
Primary aetiological factor- dental plaque
Local contributing factors- calculus, faulty restorations, developmental anomalies, patient habits
Systemic factors- diabetes, smoking, immunodeficiencies
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What are the stages of gingivitis?
-Initial lesion
-Early lesion
-Established lesion
-Advanced lesion- gingivitis to periodontitis
When does the initial lesion develop?
24-48 hours after plaque accumulation
What happens because of the initial lesion?
- Gram +ve anaerobes provoke immune response
-Vasodilatation with increase in neutrophils and GCF. Infiltrate confined to small area of connective tissue under the Junctional epithelium.
-Tissue damage minimal
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When does the early lesion develop?
4-7 days after plaque accumulation
What happens when there is an early lesion?
-Increase in inflammatory infiltrate (neutrophils, lymphocytes)
-Loss of fibroblasts and collagen in infiltrated area
-Proliferation and rate peg formation in junctional epithelium
-Increased GCF (gingival … fluid)
-Neutrophils accumulate in gingival crevice
-Bleeding on probing may occur
When does an established lesion develop?
14-21 days after plaque accumulation
What is an established lesion characterised by?
-gingival connective tissue largely replaced by inflammatory infiltrate
-Large and increasing numbers of neutrophils, lymphocytes and plasma cells.
-Blood stasis
-Epithelial ulcerations (blood stasis means epithelial cells can’t get enough nutrients so they die)
How do you treat gingivitis?
-Oral hygiene instructions (plaque removal)
-Address local factors involved
-Be aware of the systemic factors involved
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