Host Microbial Interactions to Initial Biofilm Formation

Question 1

What measurement would you expect with healthy periodontal tissue?

Answer 1

3mm or less

Question 2

What should healthy gingiva look like? (5)

Answer 2

• Coral pink, uniform colour
• Knife-edge and intact margins (no swelling)
• Flat, intact papillae (firm)
• Absence of bleeding on probing, probing depths <3mm
• surface texture

Question 3

What is an important factor to consider when trying to differentiate between gingivitis and periodontitis?

Answer 3

Gingivitis still has a stable attachment at the junctional epithelium with no bone loss

Question 4

Name the 4 different stages of gingivitis

Answer 4

Initial lesion

Early lesion

Established lesion

Advanced lesion- progression to periodontitis

Question 5

Outline the characteristics of gingivitis (6)

Answer 5

• Signs and symptoms that are confined to the gingiva (free gingiva)
• The presence of dental plaque to initiate the lesion
• Clinical signs of inflammation
• Stable attachment level (junctional epithelium), no bone loss.
• Reversibility of the disease by removing the aetiology
• Possible role as a precursor to periodontitis

Question 6

What happens during the initial lesion phase of gingivitis?

Answer 6

Gram positive anaerobes provoke immune response.

Vasodilation = increase in neutrophils and GCF. Infiltrate to small area of the connective tissue under the JE.

Minimal tissue damage

Question 7

When does the initial lesion phase occur?

Answer 7

24-48 hours

Question 8

When does the early lesion phase occur?

Answer 8

4-7 days of plaque accumulation

Question 9

What happens during the initial lesion phase of gingivitis?

Answer 9

Increase of inflammatory infiltrate, it becomes richer- mainly PMNs (
Polymorphonuclear neutrophils) and lymphocytes.

Loss of collagen and fibroblasts in infiltrated area.

Proliferation and rete peg formation in JE,

Increased GCF

PMNs (neutrophils) accumulate in gingival crevice

Bleeding on probing may occur

Question 10

When does the established lesion phase occur?

Answer 10

14-21 days

Question 11

What happens during the established lesion phase of gingivitis?

Answer 11

Gingival connective tissue largely replaced by inflammatory infiltrate.

Large and increasing numbers of neutrophils, lymphocytes and plasma cells.

Blood stasis

Epithelial ulcerations (JE becomes ulcerated as blood stasis prevent nutrients getting to cells)

Question 12

What begins to happen in the advance stage of gingivitis?

Answer 12

The alveolar bone starts to recede and it begins to progress towards periodontitis