plaque induced gingivitis

Question 1

what are the 4 types of Dental Gingival Diseases?

Answer 1

1) Gingivitis associated with dental plaque only
2) Gingival diseases modified by systemic factors
3) Gingival diseases modified by medications
4) Gingival diseases modified by malnutrition

Question 2

the signs and symptoms of gingivitis are limited to the ______

Answer 2

gingiva

Question 3

T/F: there must be plaque and signs of clinical inflammation for gingivitis

Answer 3

true

Question 4

T/F: Reversibility of the disease by removing the etiology is a characteristic of ALL types of gingivitis

Answer 4

true

Question 5

Normal gingival color:

Answer 5

“coral pink”+ pigmentation

Question 6

Severly inflammed gingiva looks ____ and _____

Answer 6

red and cyanotic

Question 7

why does severely inflamed gingiva look red and cyanotic?

Answer 7

vascular proliferation and reduction in keratinization

venous stasis

Question 8

color changes start at the __________ and ________, and spread to the attached gingiva.

Answer 8

interdental papillae and gingival margin

Question 9

why does gingival bleeding increase with inflammation?

Answer 9

Dilation and engorgement of the capillaries

Thinning or ulceration of the sulcular epithelium

Question 10

_________ bleeding occurs in acute/severe gingival disease and may be related to systemic health problems

Answer 10

spontaneous

Question 11

how does the consistency of gingiva change with inflammation?

Answer 11

• Increase in extracellular fluid and exudate,
• Degeneration of connective tissue and epithelium,
• Engorged connective tissue and thinning of epithelium.

Question 12

what is the consistency of gingiva in severe gingival diseases?

Answer 12

Sloughing with grayish flake-like debris (necrosis)

Question 13

Chronic inflammation can induce ______ and ________ proliferation

Answer 13

fibrosis and epithelial proliferation

Question 14

what causes Firm, leathery gingival tissue?

Answer 14

fibrosis and epithelial proliferation (in chronic inflammation)

Question 15

what are the changes in the surface texture of gingival tissues during inflammation? (both with exudative and fibrotic changes)

Answer 15

smooth and shiny: exudative changes

firm and nodular: fibrotic changes

Question 16

what is the shape of healthy gingiva?

Answer 16

Scalloped with gingiva filling interdental spaces ( presence of papilla)

Question 17

how does the shape of gingiva change due to inflammation?

Answer 17

• Knife edge gingival adaptation or loose gingival margins

- In some cases, clefts (Stillman’s) or festoons (McCall’s) may develop

Question 18

the chronic inflammatory response during gingival enlargement has characteristic _______ and _______ features

Answer 18

exudative and proliferative features

Question 19

what are the clinical characteristics of gingival enlargement?

Answer 19

Clinically deep red lesions with soft, friable, smooth, shiny surface and bleeding tendency

Also, relatively firm, resilient and pink lesions with greater fibrotic component, abundant fibroblasts and collagen fibers

Question 20

the primary etiologic factor for gingivitis is __________

Answer 20

Bacterial plaque

Question 21

what are the secondary/local factors for gingivitis?

Answer 21

• Calculus
• Marginal deficiencies in restorations and rough surfaces
• Malocclusion
• Tooth/root anomalies

Question 22

what is the “average” biological width?

Answer 22

2.73 mm

or 2.04

Question 23

A minimum dimension of ______ mm coronal to the alveolar crest is needed to permit healing and proper restoration

Answer 23

3 mm

Question 24

what happens if a restoration is placed below the necessary biologic width?

Answer 24

Marginal tissue recession, apical migration of the attachment apparatus, or both, may result

Question 25

T/F: Periodontitis starts with gingivitis, but gingivitis does not always progress into periodontitis

Answer 25

true

Question 26

what causes the transition from gingivitis to periodontitis?

Answer 26

Progression of the inflammatory process to the | underlying connective tissue attachment and periodontal ligament

Question 27

T/F: The return of inflammation to sites treated for | periodontitis is not common

Answer 27

FALSE it is common

Question 28

________ inflammation may be confined to the gingival tissues and may not cause further attachment loss

Answer 28

recurrent

Question 29

Gingival diseases can be modified by ________ factors, which is why pregnant women (and moody teenagers) are at a higher risk

Answer 29

endocrine

Question 30

why are pregnant women at a higher risk for gingivitis? when is this risk the highest?

Answer 30

Exaggerated localized host response modulated by levels of endogenous hormones Changes often appear during 2nd trimester and regress upon parturition

Question 31

______-______ can be a secondary factor in puberty associated gingivitis

Answer 31

Mouth-breathing

Question 32

An increase in GCF (Gingival Crevicular Fluid) | by 20% has been described in what type of gingivitis?

Answer 32

Menstrual cycle associated gingivitis

Question 33

t/f: clinically detectable changes in gingivitis can be seen during menstruation

Answer 33

false

Question 34

Pyogenic granuloma of pregnancy arise from where?

Answer 34

Commonly arises from the proximal gingival tissues and has a pedunculated base.

Question 35

what is a Pyogenic granuloma?

Answer 35

A highly vascularized mass of granulation tissue | often found in women in their 2nd or 3rd trimester

Question 36

what dietary deficiencies can cause Gingival diseases modification?

Answer 36

Deficiency in vitamin C (Scurvy). Lack of vitamins A, B2 and B12 complex.

Question 37

Acute _______ _______ is associated with gingival changes.

Answer 37

Acute myeloid leukemia

Question 38

Persistent unexplained gingival bleeding may indicate underlying _____________

Answer 38

thrombocytopenia

Question 39

cyclic neutropenia can lead to gingival ________

Answer 39

ulcerations

Question 40

what are the 3 commonly used drug types that are associated with gingival overgrowth?

Answer 40

Anticonvulsants (Phenytoin sodium or epinutin) Immunosuppressant (Cyclosporin A) Calcium channel blocking agents (Nifedipine)

Question 41

what groups are at a higher risk for necrotizing ulcerative gingivitis (NUG)?

Answer 41

Adolescents or young adults, may be smokers and individuals often with psychological stress

Question 42

the clinical signs of NUG include:

Answer 42

Pain, ulceration and necrosis of the interdental papillae, bleeding

Question 43

The resolution of NUG often requires __________

Answer 43

systemic antibiotics

Question 44

what are the predisposing factors for NUG? (theres 3)

Answer 44

* Systemic diseases like ulcerative colitis, blood dyscrasias and nutritional deficiency states. * Abnormalities of white blood cell function. * Patients suffering from AIDS

Question 45

___________ may progress to Noma or cancrum oris

Answer 45

necrotizing ulcerative gingivitis

Question 46

what is the difference in etiology (cause) between NUG and PHS?

Answer 46

Bacteria (NUG), Herpes simplex virus (PHS)

Question 47

how do the symptoms of NUG and PHS differ?

Answer 47

Ulceration and necrotic tissue, yellowish white plaque (NUG) Multiple vesicles which burst leaving small round fibrin covered ulcers (PHS)

Question 48

while _____ is contagious, _____ is not

Answer 48

PHS is contagious (caused by herpes) NUG is not (its bacterial)

Question 49

where in the oral cavity is PHS found that NUG is not?

Answer 49

PHS is found in the attached gingiva

Question 50

gingivitis around an implant is known as __________

Answer 50

Peri-mucositis