L10--GINGIVITIS!!! Flashcards
Gingivitis is an inflammation of gingival tissues, due to ______ build-up.
plaque
What are the three conditions that separate gingivitis from periodontitis?
- no distruction of PDL 2. No Bone loss 3. No apical migration of the junctional epitlelium
What is the catalyst to change from reversible, chronic gingivitis to irreversible periodontitis?
no one knows!!
During periodontitis, what is the perivascular infiltrate composed of?
Plasma cells, especially macrophages (the hallmark of chronic inflammation!)
Has osteoclast activity been changed since making the plunge to periodontitis?
yes, osteoclast activity has been stimulated
What causes loss of collagen during periodontitis?
PMN’s spewing their end products
When is the pseudo-pocket formed?
During acute gingivitis
Do MOST chronic gingivitis sites go on to periodontitis?
Most chronic gingivitis sites DO NOT go on to periodontitis, even when not treated!
What percent of Americans have gingivitis?
Over 50%
What is the estimated underlying cause to pregnancy gingivitis?
hormonal
What is NUG!? What is ANUG? (even though he just wanted us to know NUG…)
Necrotizing Ulcerating Gingivitis…Acute Necrotizing Ulcerating Gingivitis
How do you typically measure periodontitis?
Usually its a measurement of PAST loss
What are the three types of periodontitis we discussed? What is the most common? General or local?
1.Chronic (adult) (general) (most common) 2. Aggressive Juvenile (mostly juvenile) (both local and general) 3.Systemic disease (no se)
“All” periodontitis pockets display “_________”.
“Climax Community Flora”
What is the key to the induction of exudate and bleeding in gingivitis (as well as periodontitis)?
more anaerobic, gram- negative bacteria show up!
Initially supragingival plaque contains primarily _______ and _______ species.
streptococcus and actinomyoces
As the plaque load grows a more anaerobic environment begins to appear. This leads to the increase in microaerophilic, gram-positive ________, and the emergence of gram negative anaerobic rods and _______.
actinomyces…..Spirochetes
Which organisms use haemin for fuel? How do they access it?
Black-Pigmented-Bacteriodes…gram negative bacterial toxins
What’s an example of a gram + rod found in supra gingival plaque?
Actinomyces Israelli
What is the pathway that ends in more sulcular fluid after Black Pigmented Bacteriods have shed lots of LPS?
T-helper cells call on Macrophages which release cytokines.. These cytokines cause capillary dilation and increased blood flow…Hence more sulcular fluid
Following Loe’s experiments: what is one hallmark bacterium in the beginning? What are 3 that come on strong in gingivitis?
Start: S. Mutans Gingivitis: Veillonella Al-Cal-Es-Cens, Treponema Denticola, Fusobacterium Nucleatum
What are 5 common things that increase susceptibility to gingivitis?
1.Hormonal (prego, pubery) 2.Drugs (xerostomia) 3.Dieseases (hiv, diabetes) 4.STRESS 5. “oral habits”(braces, smoking, mouth breathing)
_________ is a painful gingival lesion characterized by a gray pseudo-membrane on the gingiva that readily sloughs off revealing a bleeding, necrotic area.
Necrotizing Ulcerative Gingivitis
Review: which oral lesion involves a gray pseudo membrane? which one involves a white pseudo-membrane?
gray: NUG……. white: candidiasis
NUG: This lesion has a rapid onset and causes considerable _____ and ________. The lesions are usually limited to _________.
pain and bad breath….. the TIPS of the gingival papillae
What is the classic case of NUG?
Trench mouth
Although bacteria invasion is uncommon in gingivitis, _________ is a true tissue infection.
NUG (FOUND IN THE TISSUE)
What is the Spirochete and the Rod that produce noxious sulfur products causing bad breath in NUG? (and are found IN the tissue!)
Spirochete: TREP-o-Nema Vincentii…….Rod: Pre-Vo-Tell-a Intermedia
Which age group is most affected by NUG?
16-30 years of age
What is the similar condition to NUG that is found in poor, malnourished children in sub-Saharan Africa?
NOMA (no, its not an acronym)
What are the three bugs associated with NUG? What is their stain and shape? What % of total bug population do they make?
Gram - rods……POR-PHY-ROMONAS Gingivalis…..Pre-VO-Tella Intermedia (PI)…Fuso-Bacterium Nucleatum…70% of bug population (trep-o-nema=30%)
Which region of the mouth does NUG usually affect more?
Anterior teeth
Is NUG transmissible?
NOT TRANSMISSIBLE
How do you treat NUG?
IT DEPENDS!….No systemic effects-debridement, peroxide…..Systemic effects (fever): antibiotics
What would I find in the gray pseudo membrane of NUG?
PMNs and Bacteria (P.G., P.I., Spirochetes)
What are the three zones of NUG?
1.gray pseudo membrane 2.Necrotic Zone 3.Deeper tissues (G - )
What are the 3 main causes of NUG?
NUMERO UNO: STRESS (glucocortocoids) 2.decreased immunity 3.poor oral hygiene.
