Perio Lesion 4: Development of Gingivitis and Progression to Periodontitis Flashcards
What is the first stage of gingivitis development?
Bacterial Biofilm
What response does the biofilm invoke (2nd stage)
Acute inflammatory response
PMNs and Initial Lesion
What bacteria predominate at the initial lesion stage?
Gram positive aerobic
After the initial immune response what tissue changes are witnessed?
Vascular
CT
Junctional Epithelium
After the tissue changes what new cells arrive on the scene?
T cells
B cells
Macrophages
Plasma cells
What bacteria are present at the early lesion stage?
Still more gram positive aerobic and less gram negative
What is the bacterial balance for an established lesion?
Equal numbers of gram positive and negative
What is an indicator of chronic gingivitis?
Presence of IgG antibodies
What are the first 4 stages of the progression of gingivitis to periodontitis?
Dental Plaque
Host Immune Response
Balance b/w plaque and immune response
Chronic Gingivits (equal gram+/gram-)
What are the second 3 stages of the progression of gingivitis to periodontitis?
Susceptible host
Disruption of balance between bacteria and host response
Peri/odontal pocket/Periodontitis
What is Periodontitis?
Inflammation of the periodontium involving the supporting tissues of the teeth
Histopathologically, how does Periodisease compare the established lesion stage of gingivitis?
Similar in terms of the types of cells and connective tissue elements.
Bone resorption is the added element
What are the 5 Clinical Presentations of Periodontitis?
Bluish red, thickened marginal gingiva Bluish red vertical zone from gingival margin to alveolar mucosa Bleeding and suppuration Tooth mobility/Diastema Localized Pain
On a microscopic level what is happening to the gingiva during periodontitis?
It is becoming fibrotic and there is increased tissue damage from the immune response
What is happening to the connective tissue that leads to mobility?
Gingival collagen is lost along with the loss of attachment
