Pathogenesis

Question 1

Pathogenesis

Answer 1

● Initial Lesion = PMNs
o Develops in 2 to 4 days
o Cells of acute inflammation present
o Increased GCF flow
o Start of pseudopocket formation
▪ Acute = PMNs

Question 2

● Early Lesion = T-Cell lesion

Answer 2

o Early lesion occurs after 4-7 days
o Acute inflammation persists (from initial lesion), increased GCF, pseudopocket formation
o Cells of chronic inflammation appear and then dominate
o Collagen loss up to 70%*
o Rete pegs proliferation of JE into CT
o Loss of gingival stippling

Question 3

● Established Lesion

Answer 3

o Shift to a B-cell/Plasma Cell lesion
o Micro-ulcerations of pocket/sulcular epithelium 🡪 bleeding on probing
▪ BOP means pt is in the established lesion phase of gingivitis
o Erythema
o Bleeding on probing (BOP)
o Gingival changes: color, contour, consistency
o No bone loss

Question 4

● Advanced Lesion = PERIODONTITIS

Answer 4

o Pocket formation
▪ PDL destruction
▪ Apical migration of JE
▪ Bone resorption/loss
o Loss of fiber attachment – Cementum and PDL
o B-Cells, plasma cells dominate