Gingivitis I

What is gingivitis

Site specific inflammatory condition of the gingiva

What are the 2 main characteristics of gingivitis

Reversible and no attachement loss

What are the 3 main categories of gingival diagnosis

Biofilm, mediated by sytsemic or local risk factors, drug induced enlargement

What are the 6 sub categories of systemic risk factors of gingivitis

Smoking, hyperglycaemia, nutritional factors, pharmacological, sex steroids, haematological conditions

What are the main local factors

Plaque retentive factors, oral dryness

What are the symptoms of gingivitis

Red, swollen, tender gums and bleeding gingiva

What are the clinical signs of gingivitis

BOP, erythema, edema, biolfilm/calc, no BL

What causes redness

Mast cells release histamines to cause vasodilation, increasing blood flow

What causes swelling

Histamines cause endothelial-cells lining the capillaries to contract and become more permeable

What causes heat

Due to increase blood flow

What causes pain

Swellling and pressure push against nerve endings as bradykins and protaglandins are released

What distribution is considered local gingivitis

10%>, <30%

What distribution is considered generalised gingivitis

30%>

What is the structure of gingivitis diagnosis?

Distribution, severity, disease, specification

Plaque in gingivitis is more positive or negative

Gram negative

In early gingivitis what first happens

PMNs form a palisade over the biofilm

In early gingivitis what happens after PMNs form over the biofilm

PMNs and tissue release cytokines and enzymes to activate macrophages

In early gingivitis what happens after PMNs release cytokines and enzymes

Lymphocytes triggered by cytokines infiltrate CT from blood

The increased vascular permeability allow what to pass through

Influx of serum proteins from blood vessels travel to connective tissue

What happens to the junctional epithelium

Junctional epithelium migrates laterally away

In established gingivitis, what happens after intense PMN infiltration at the JE and sulcus

Lymphocytes dominate the infiltrate

T cells in established gingivitis coordinate response by releasing what chemical mediator

Cytokines

What cell activates and triggers B cell differentiation into plasma

Macrophages

What type of plasma cells do B cells differentiate to?

IgG and cytokines

What do activated fibroblasts do

Produce MMPs over collagen

What forms the pseudopocket

Lateral migration of the junctional epithelium and proliferation