Flashcards in plaque induced gingivitis Deck (50):
what are the 4 types of Dental Gingival Diseases?
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
the signs and symptoms of gingivitis are limited to the ______
T/F: there must be plaque and signs of clinical inflammation for gingivitis
T/F: Reversibility of the disease by removing the etiology is a characteristic of ALL types of gingivitis
Normal gingival color:
“coral pink”+ pigmentation
Severly inflammed gingiva looks ____ and _____
red and cyanotic
why does severely inflamed gingiva look red and cyanotic?
vascular proliferation and reduction in keratinization
color changes start at the __________ and ________, and spread to the attached gingiva.
interdental papillae and gingival margin
why does gingival bleeding increase with inflammation?
Dilation and engorgement of the capillaries
Thinning or ulceration of the sulcular epithelium
_________ bleeding occurs in acute/severe gingival disease and may be related to systemic health problems
how does the consistency of gingiva change with inflammation?
-Increase in extracellular fluid and exudate,
- Degeneration of connective tissue and epithelium,
- Engorged connective tissue and thinning of epithelium.
what is the consistency of gingiva in severe gingival diseases?
Sloughing with grayish flake-like debris (necrosis)
Chronic inflammation can induce ______ and ________ proliferation
fibrosis and epithelial proliferation
what causes Firm, leathery gingival tissue?
fibrosis and epithelial proliferation (in chronic inflammation)
what are the changes in the surface texture of gingival tissues during inflammation? (both with exudative and fibrotic changes)
smooth and shiny: exudative changes
firm and nodular: fibrotic changes
what is the shape of healthy gingiva?
Scalloped with gingiva filling interdental spaces ( presence of papilla)
how does the shape of gingiva change due to inflammation?
- Knife edge gingival adaptation or loose gingival margins
- In some cases, clefts (Stillman’s) or festoons (McCall’s) may develop
the chronic inflammatory response during gingival enlargement has characteristic _______ and _______ features
exudative and proliferative features
what are the clinical characteristics of gingival enlargement?
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
the primary etiologic factor for gingivitis is __________
what are the secondary/local factors for gingivitis?
*Marginal deficiencies in restorations and rough surfaces
what is the "average" biological width?
A minimum dimension of ______ mm coronal to the alveolar crest is needed to permit healing and proper restoration
what happens if a restoration is placed below the necessary biologic width?
Marginal tissue recession, apical migration of the attachment apparatus, or both, may result
T/F: Periodontitis starts with gingivitis, but gingivitis does not always progress into periodontitis
what causes the transition from gingivitis to periodontitis?
Progression of the inflammatory process to the
underlying connective tissue attachment and periodontal ligament
T/F: The return of inflammation to sites treated for
periodontitis is not common
it is common
________ inflammation may be confined to the
gingival tissues and may not cause further attachment
Gingival diseases can be modified by ________ factors, which is why pregnant women (and moody teenagers) are at a higher risk
why are pregnant women at a higher risk for gingivitis? when is this risk the highest?
Exaggerated localized host response modulated by levels of endogenous hormones
Changes often appear during 2nd trimester and regress upon parturition
______-______ can be a secondary factor in puberty associated gingivitis
An increase in GCF (Gingival Crevicular Fluid)
by 20% has been described in what type of gingivitis?
Menstrual cycle associated gingivitis
t/f: clinically detectable changes in gingivitis can be seen during menstruation
Pyogenic granuloma of pregnancy arise from where?
Commonly arises from the proximal gingival tissues and has a pedunculated base.
what is a Pyogenic granuloma?
A highly vascularized mass of granulation tissue
(often found in women in their 2nd or 3rd trimester)
what dietary deficiencies can cause Gingival diseases modification?
Deficiency in vitamin C (Scurvy).
Lack of vitamins A, B2 and B12 complex.
Acute _______ _______ is associated with gingival changes.
Acute myeloid leukemia
Persistent unexplained gingival bleeding may indicate underlying _____________
cyclic neutropenia can lead to gingival ________
what are the 3 commonly used drug types that are associated with gingival overgrowth?
Anticonvulsants (Phenytoin sodium or epinutin)
Immunosuppressant (Cyclosporin A)
Calcium channel blocking agents (Nifedipine)
what groups are at a higher risk for necrotizing ulcerative gingivitis (NUG)?
Adolescents or young adults, may be smokers and individuals often with psychological stress
the clinical signs of NUG include:
Pain, ulceration and necrosis of the interdental papillae, bleeding
The resolution of NUG often requires __________
what are the predisposing factors for NUG? (theres 3)
* Systemic diseases like ulcerative colitis, blood dyscrasias and nutritional deficiency states.
* Abnormalities of white blood cell function.
* Patients suffering from AIDS
___________ may progress to Noma or cancrum oris
necrotizing ulcerative gingivitis
what is the difference in etiology (cause) between NUG and PHS?
Herpes simplex virus (PHS)
how do the symptoms of NUG and PHS differ?
Ulceration and necrotic tissue, yellowish white plaque (NUG)
Multiple vesicles which burst leaving small round fibrin covered ulcers (PHS)
while _____ is contagious, _____ is not
PHS is contagious (caused by herpes)
NUG is not (its bacterial)
where in the oral cavity is PHS found that NUG is not?
PHS is found in the attached gingiva