Plaque induced gingivitis

Question 1

What is gingivitis around an implant called?

Answer 1

Peri-mucositis

Question 2

What are some signs and symptoms related to all gingival diseases?!

Answer 2

1. Signs and symptoms limited to gingiva
2. Plaque
3. Clinical signs on tooth w/ no attachment loss or stable reduced periodontium
4. Inflammation
5. Reversible if etiology removed
6. Possible precursor to attachment loss

Question 3

Color changes in healthy vs diseased gingiva

Answer 3

coral pink to red
increased vascularization and decreased keratinaization
Changes start at papilla and margin then go to attached
if severe: red and cyantosis from the above symptoms and venous stasis

Question 4

With increasing inflammation comes:

Answer 4

Decease in thickness of epithelium and increase in capillary size

Spontaneous bleeding in acute or sever forms

Question 5

changes in consistency of gingiva

Answer 5

Normal: firm and resiliient

With inflammation:
More exudate
Soft, swollen, friable

In severe disease: gray specks with sloughing

Question 6

What about the consistency of chronic gingivitis?

Answer 6

It can induce fibrosis and epithelial proliferation and cause a firm, leathery texture

Question 7

Surface texture: healthy vs inflammed

Answer 7

Dull with stippling sometimes
Smooth and shiny if exudate changes occur
firm and nodular if fibrotic changes occur

Question 8

Shape: healthy vs inflammed

Answer 8

Healthy: scalloped w interdental papilla
Inflammed: knife-edged or loose gingival margins
Sometimes clefts or festoons develop

Question 9

Primary etiologic factor of gingival disease

Answer 9

plaque

Question 10

Secondary etiological factors

Answer 10

Local factors like:
marginal deficiencies in restorations and rough surfaces
calculus
malocculusion
tooth root abnormalities

Question 11

Other local contributing factors

Answer 11

enamel pearl or cemetal tears
dental restorations
root fractures
cervical root resorption

Question 12

Dento gingival junction width

Answer 12

Sulcus depth: 0.69
Epithelial attachment: 0.97
Connective tissue attachment: 1.07

Question 13

Gingivitis modified by endocrine factors

Answer 13

MUST HAVE DENTAL PLAQUE

Pregnancy: changes happen durring second trimester. Often get pyogenic granuloma that is pedunculated
Menstrual: dont have clinically detectable changes but ofen have more GCF
Puberty: often with mouth breathing

Question 14

Malnutrition and gingival diseases

Answer 14

Related to scurvy

Vitamen A, B2, B12

Question 15

Gingival diseases modified by medication

Answer 15

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

Question 16

Nectrozing Ulcerative Gingivitis

Answer 16

Adolescents or young adults, may be smokers and
individuals often with psychological stress.
Pain, ulceration and necrosis of the interdental
papillae, bleeding.
Differential diagnosis with primary herpetic
gingivostomatitis.

Often fixed with antibiotic

Question 17

Predisposing factors of NUG

Answer 17

Predisposing factors:
* Systemic diseases like ulcerative colitis, blood
dyscrasias and nutritional deficiency states.
* Abnormalities of white blood cell function.
* AIDS

Often have attachment loss

Question 18

Differential diagnosis with NUG and primary herpetic gingivostomatitis

Answer 18

• EtiologY:Bacteria (NUG),
  Herpes simplex virus (PHS)
• Symptoms: Ulceration and necrotic tissue, yellowish white
  plaque (NUG)
  Multiple vesicles which burst leaving small
  round fibrin covered ulcers (PHS)
• Duration…. 1-2 days if treated (NUG)
  1-2 weeks (PHS)
• Contagious… No (NUG)
  Yes (PHS)
  Location: Not attached gingiva (NUG)
  Anywhere (PHS)