Plaque induced Gingivitis Flashcards
Plaque can accumulate in
- Overhanging restorations
- Clasps on removable dentures
- Rough margins on restorations
- Rough Root (Cementum) surfaces
- Calculus (Supra- or Subgingival)
- Orthodontic therapy
- Carious lesions
- Enamel pearls
- Crowding of teeth
Plaque induced gingivitis
Usually begins at interdental papillae
Bacteria should be present
- Modified by systemic factors (Endocrine system)
- Puberty
- Pregnancy
- Menstrual cycle
- Gingivitis
- Modified by medication
- Modified by malnutrition
Non plaque induced gingivitis
- Bacterial
- Viral
- Fungal infections
- Genetic origin
- Traumatic lesions
- Allergic reactions
- Mucocutaneous disorders
- Blood dyscrasias
Puberty
Elevation in steroid hormones
Prevotella intermedia is able to substitute progesterone and oestrogen for vit K as an essential nutrient
Pregnancy
There are oestrogen and progesterone receptors in the gingiva
Prevotella intermedia
- Elevation of hormones during pregnancy cause an increase in the capillary permeability and dilation causing an increase in GCF
- Elevated hormones also cause a decrease in the degree of the keratinization
- High levels of these hormones reduce the immune response to plaque
- This is due to the neutrophil chemotaxis and phagocytosis as well as T cell responses may be impaired
Diabetes mellitus
P.intermedia, P.gingivalis, A.actinomycetemcomitans
Release of IL-1beta, Prostaglandin E2 and TNF alpha (By Monocytes)
Wound healing is impaired due to decreased synthesis of collagen by fibroblasts and degradation by collagenase
Medication causing gingival hyperplasia
- Phenytoin
- Cyclosporin (immunosuppressants)
- Calcium Channel Blockers e.g. Nifedipine
Malnutrition
Vitamin C deficiency which results in scurvy
and maintains the basal membrane
Deficiency may result in Inc pocket depth and loss of attachment
