Responses to Treatment of Gingivitis

Question 1

What are the 2 possible responses to treatment of gingivitis?

Answer 1

-Resolution of inflammation (favourable response to treatment by healing/treatment success)

-Persistence of inflammation

Question 2

Describe the histopathogenisis in established gingivitis:

Answer 2

look at the slides

Question 2

How is plaque induced gingivitis managed?

Answer 2

Aims: Reduce gingival inflammation, restore gingival health

-Supragingival scaling to remove plaque and calculus.

-Eliminate/modify local plaque retentive factors

-Improve oral hygiene

-Smoking cessation advice

Question 3

What does resolution of inflammation look like?

Answer 3

-Changes in colour-pink
-Changes in gingival contour
-Presence of stippling
-Changes in texture-gingiva is more firm
-Reduction in plaque score
-Reduction in bleeding on probing score

look at slides

Question 4

How does the histopathogenesis change from healthy gingivae, to gingivitis, to periodontitis?

Answer 4

look at the slides

Question 5

What happens when you carry out supragingival scaling?

Answer 5

1. Microbiological changes:
   -Major disruption to biofilm
   -Converts a predominantly anaerobic flora to predominantly aerobic flora
2. Cellular events during healing:
   -Initial acute inflammatory response
   -Initiation of resolution of inflammatio

Question 6

Describe the cellular events that occur during supragingival scaling in more detail.

Answer 6

First 24-48hrs = acute inflammatory response

Week 1-4 = reduction in inflammation, reduction in GCF, reduction in inflammatory cells.

Fibroblasts migrate into the area, proliferate, lay down ground substance and produce collagen fibres. New gingival connective tissues form with time

look at slides

Question 6

Describe the microbiological changes that occur during supragingival scaling in more detail.

Answer 6

-Reduction in total number of organisms

-Proportion of Gram -ve anaerobic is reduced

-Residual flora is predominately Gram +ve and aerobic

look at slides

Question 6

What is the resolution of inflammation consistent with?

Answer 6

-Reduction in redness
-Colour goes to a more healthy pink
-Reduction in bleeding on probing
-Reduction in swelling
-Gingival contour becomes more knife edged
-Gingiva is more firm
-Presence of stippling

Question 7

What are some possible reasons for the persistence of inflammation following gingivitis treatment?

Answer 7

Clinician factors:
-Wrong diagnosis
-Inadequate removal of calculus and other plaque retentive factors
-Other- failure to remove local plaque retentive factors

Patient factors:
-Inadequate plaque control
-Lack of compliance/ motivation
-Lack of dexterity
-Poor/ incorrect technique