the periodontium in health

Question 1

in clinical health what does good oral hygiene maintain?

Answer 1

maintains a dynamic balance between resident biofilm bacteria and host defences (symbiosis) = homeostasis

Question 2

What is the concept of physiological immune surveillance (Land and Bartold (2018) and Chapple et al. (2018))?

Answer 2

Histiology in clinical health there is always a low level of inflammatory infiltrate (mainly neutrophils and some B cell lymphocytes) in the connective tissue underlying the junctional epithelium.

(basically although gingival health appears healthy, histologicaly there is an inflammatory reaction to plaque bacteria)

Question 3

What is PRISTINE gingival health in clinical features?

(very rare as requires long term excellent oral hygiene)

Answer 3

• no inflammation
• no pockets deeper than 3mm
• no BOP
• no LOA
• virtually zero plaque scores
• free gingival groove likely to be seen

Question 4

What is PRISTINE gingival health in histological features?

Answer 4

• low level of neutrophils in connective tissue underlying leaky junctional epithelium

Question 5

What is HEALTHY gingival health in clinical features?

Answer 5

same as pristine but not likely to see gingival groove and might be some plaque.

Question 6

What is HEALTHY gingival health in histological features?

Answer 6

same as pristine but more neutrophils in underlying connective tissue and more neutrophils undergoing chemotaxis.

Question 7

What is gingival Crevicular fluid?

difference in volume in health compared to diseased

Answer 7

serum ( part of blood without cells) like substance that comes from dental ginigval plexus , it is a denses network of blood vessesl that sits beneath the junctional epithelium just within the gingival connective tissue

Fclows into the connecve tissue and then into junctional epithelium then straight through into sulcus and into mouth.

volume in health is small but greater in gingivitis and periodontitis

Question 8

What is in gingival crevicular fluid?

Answer 8

• plasma proteins
• defence cells
• neutrophils
• antibodies
• complement
• growth factors

Question 9

is there an high or low turnover of junctional epithelium cells?

Answer 9

HIGH

any invading bacteria attatched to junctional epithelium cells are rapidly shed into gingival sulcus

Question 10

In the new 2017 classifaction of periodontal disease what is now classed as gingival health in regagrds to BOP?

Answer 10

less than 10% bleeding in pockets 3mm or less (but no BOP in 4mm pockets)