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Chapter 7: Ginigival Diseases (Classification of Periodontal Diseases…
Chapter 7: Ginigival Diseases
Gingivitis
: an inflammatory lesion mediated by host/microorganism interactions
Does not involve the underlying periodontal ligament, cementum, or alveolar and supporting bone.
Reflection: I feel like I've had gingivitis most of my life, even if it is slight.
4 Stage Progression of Inflammation
Established:
2 to 3 weeks -> B Cell lesion; plasma cells
Chronic gingivitis (gingiva may appear bluish-red with increased probing depths)
Initial:
2 to 4 days -> Acute inflammation; PMNs. macrophage; vasculitis
Subclinical; no signs of gingivitis; increased flow of GCF
Advanced:
Undetermined -> Alveolar bone loss, periodontal pocket formation; B cell lesion
Periodontitis
Early:
4 to 7 days -> T cell lesion
Clinical signs of gingivitis first seen (Redness, bleeding on probing, edema)
Reflection: This stage is probably the extent to which my gingiva has gotten to.
Gingival Pocket
is formed by gingival enlargement and coronal migration of the gingival margin
No loss of clinical connective tissue attachment (the gingival fibers remain attached to the root surface, and the junctional epithelium has not migrated apically onto the root surface
Not true pockets; they are false or "pseudo"
There is no attachment of gingival connective tissue above the cementoenamel junction, and because there is no loss of clinical connective tissue attachment to the root surfaces, it is not a true pocket
Classification of Periodontal Diseases
Gingival Diseases Modified by Systemic Factors
Hormonal-influenced gingivitis manifest as puberty-associated gingivitis, menstrual cycle-associated gingivitis and pregnancy-associated gingivitis
Gingivitis Associated with Blood Dyscrasias
Leukemia is a disease characterized by an abnormal proliferation of leukocytes (WBC) in blood and bone marrow
Dental Plaque-Induced Gingival Diseases
Dental biofilms as the etiology or cause of gingivitis have been confirmed. Will not develop unless there are bacteria present.
Gingival Diseases Modified by Medication
Many types of medications can cause gingival overgrowth or enlargement
Drug-Influences Gingivitis
The etiology of oral contraceptive-induced gingival inflammation is similar to that seen in pragnancy