Periodontal Health and Gingival Disease Flashcards
What is the importance of \_\_\_\_\_\_? To find the common reference point for assessing disease and determining the meaningful treatment outcomes
Periodontal Health
What is the component of the gingival epithelium that is keratinized?
Oral epithelium
What is the component of the gingival epithelium that is Non-keratinized, no rete pegs,
semipermeable membrane
Sulcular epithelium
What is the component of the gingival epithelium that is Non-keratinized, attached to
tooth with hemidesmosomes,
infiltrate by PMN?
Junctional epithelium
The _______ presents a
diffuse, amorphous ground
substance and collagen fibers.
connective tissue
_______ stand out clearly in
the papillary projections of the
connective tissue.
Blood vessels
What are the 2 gingival components that make up the supracrestal tissue attachment/biologic width? How large is it?
JE and Connective tissue
~ 2mm
What color should marg/attached gingiva be? Alveolar mucosa?
Coral Pink; Red
Whta should the consistency of healthy gingiva be?
Firm and resilient
What should the surface texture of the gingiva be?
Stippled on attached gingiva
What should the contour of healthy gingiva be?
Scalloped and collar-like
What should the shape of healthy gingiva in anterior and posterior?
Ant: Pyramidal
Post: Flattened
Absence of clinically
detectable inflammation
There is a biological level of immune
surveillance that is consistent with clinical
gingival health and homeostasis
Periodontal health
What are the 3 factors that determine periodontal health?
Microbiological Factors
Host Factors
Environmental Factors
What are the 4 indicators of periodontal health?
BOP
Periodontal probing
Radiographic features
Tooth mobility
What can the probing depths of a stable periodontitis patient be?
Greater than 4 mm without BOP or 4mm w/ BOP
Which one of the following indicators
describes the clinical periodontal health?
A. Bleeding on probing is less than 10%
B. Probing depths are within 4 mm
C. Radiography shows 4 mm distance from the most coronal part
of the alveolar crest to CEJ
D. Tooth is mobile
A. Bleeding on probing is less than 10%
- Bleeding when brushing
- Blood in saliva
- Gingival swelling and redness
- Halitosis
- Bleeding on gentle probing
- Increased gingival crevicular fluid
production rate - Change in gingival clinical features
Gingivitis
Gingival recession is correlated to _____
Clinical attachment loss
Narrow triangular-shaped
gingival recession
Cleft becomes broader when
progressing apically
Stillman’s clefts
A rolled, thickened band of gingiva
Close to the mucogingival junction
Usually adjacent to the cuspid
McCall festoons
An inflammatory response of gingiva resulting from plaque biofilm accumulation located and below the gingival margin
Gingivitis
Under microscope
Dilation and engorgement of the capillaries
and thinning or ulceration of the sulcular
epithelium.
Vasculitis of blood vessels adjacent to the
junctional epithelium
Progressive destruction of the collagen fiber
network (collagen-poor)
Cytopathologic alterations of resident
fibroblasts (cell-rich)
Progressive infiammatory immune cellular
infiltrate (predominantly lymphocytic)
Gingivits
____ Gingival Diseases
Genetic abnormalities
Hereditary gingival fibromatosis (Son of the Sevenless gene)
Specific infection
Bacteria (Necrotizing Periodontal Disease), Viral, Fungal
Inflammatory and immune conditions
Contact allergy, pemphigus vulgaris, pemphigoid, lichen planus
Neoplasms
Leukoplakia, erythroplakia, squamous cell carcinoma, leukemia, lymphoma
Endocrine, nutritional, metabolic disease
Scurvy (Vit C deficiency), toothbrushing trauma, etching, burning
Gingival pigmentation
Non-Plaque-Induced
These inflammation indicators may manifest clinically in _____ as:
a. Swelling, seen as loss of knife-edged gingival
margin and blunting of papillae
b. Bleeding on gentle probing
c. Redness
d. Discomfort on gentle probing
gingivitis
T/F: Radiographs can’t be used to diagnose gingivitis
True
Based on available methods to assess gingival
inflammation, gingivitis case could be simply,
objectively and accurately identified and graded
using ______
Bleeding on Probing Score
BOP%
If the BOP score is more than 30%, is it generalized or localized?
Generalized
If the BOP score is less than 30% and more than 10%, is it generalized or localized?
Localized
a peculiar condition characterized by intense erythema, desquamation and ulceration of the free and attached gingiva. a gingival response associated with a variety of conditions.
Desquamative Gingivitis
______ is a clinical term
NOT a DIAGNOSIS
Need a series of laboratory result for final diagnosis and
corresponding treatment
Desquamative gingivitis
- A immunologically-mediated mucocutaneous disorder
- T lymphocytes play a central role
- Prevalent in middle aged and older females
- Five subtypes:
- Reticular, erosive, patch, atrophic, bullous
- Oral lesion: more than gingiva is involved
- Gingival lesion: restricted in gingiva
Lichen planus
- A cutaneous, immune-mediated, subepithelial disease
- Separation of the basement membrane zone
- Three conditions:
- Pemphigoid gestationis, bullous pemphigoid,
mucous membrane pemphigoid
Pemphigoid
- Pemphigus disease is a group of autoimmune disorders
- Produces cutaneous and mucous membrane blisters
- It is the most common of all.
- Lethal chronic condition (10% mortality rate)
- Predilection in women (after 4th decade of life)
Pemphigus vulgaris
- An autoimmune disease with three clinical presentations:
- Systemic/Chronic cutaneous/Subacute cutaneous
- Cutaneous lesion
- Butterfly pattern
- Discoid lesion
- Scar and atrophy production
- Oral lesion: ulcerative or lichen Planus-like
Lupus erythematosus
- Reactive acute vesiculobullous disease
- Mucocutaneous inflammatory disease
- Broad spectrum from self-limiting to severe progression
- Predominant in young individuals
Erythema multiforme
- An inflammatory, destructive gingival condition
- Young adults, (HIV)‐infected individuals
- Characteristics of gingival lesion
- Punched‐out appearance
- Pseudomembrane
- May develop fever and malaise
Necrotizing stomatitis
A: Nikolsky’s sign and linear deposits of IgG at basal membrane
Pemphigoid
B: Nikolsky’s sign and intercellular deposits of IgG in epithelium
Pemphigoid vulgaris
C: Wickham’s striae and saw tooth appearance of rite pegs
Lichen planus
