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Disease Progression, Characteristics - Coggle Diagram
Disease Progression
INITIAL LESION
EARLY LESION
ESTABLISHED LESION
ADVANCED LESION
characteristics
Clinical appearance:
Inflamed, red gums
BOP
may have recession
Cells:
-PMNs, macrophages, epithelial cells produce cytokines
Lots of Plasma, lymphocytes and neutrophils
-macrophage produce PGE and MMP
-MMP mediate destruction of CT collagen an dPDL
-PGE destroy bone by stimulating osteoclasts
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characteristics
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Cells:
Cytokines make more PMS, macrophages and lyphocytes
-lots of plasma cells
-macrophages exposed to bacteria produce cytokines, PGE, and MMPs
-PGE and MMP initiate collagen destruction
Tissue effect:
epithelial ridges exted in CT
-loss of collagen in CT
-JE loosens attachment to tooth and becomes pocket making it more permeable
Clinical appearance:
inflamed, red and with significant plaque
Characteristics
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Cells:
cytokines released by JE cells attract defender cells
-increased tide destruction/permeability allow more PMNs to make cell wall
-macrophages release more PGE and MMP causing loss of collagen in the CT
-T lymphocytes migrate to the CT and produce antibodies
Tissue Effect:
-vascular permeability, vasodialtion, increased GCF
-JE cells begin to proliferate
-Degeneration of fibroblasts and destruction of collagen in CT
-collagen destruction in JE causes gingival sulcus to be deeper
Clinical Appearance:
-tissue slightly inflamed
Characteristics
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Cells:
-Cytokines, PGE2, MMPs, TNFa
-the cytokines destroy healthy connective tissue to make pathway for PMNs( neutrophils) to reach the sulcus
-Neutrophils migrate through CT and gingiva into the sulcus
Clinical appearance:
tissue appears clinically healthy, pink and stippled :
Tissue Effect:
-low/no tissue inflammation
-Increased vascular permeability/vasodilation
-increase of gingival crevicular fluid