60 Questions
When did the new classification for gingivitis come out officially?
2018
Why are students being taught both the old and new classification systems?
Because some practitioners still use the old classification system
Why is it important for students to learn the old classification system?
Because some practitioners still use it
What is the reason for continuing to teach the old classification system?
Practitioners outside still use the old system
Why haven't insurances switched to the new classification system yet?
They have not caught up with the change
What is the speaker's main reason for briefly touching on treatment in this lecture?
Further lectures will cover treatment in detail
What is the color of healthy gingiva?
Pink
What is stippling a sign of in healthy gingiva?
Normal condition
What is the clinical significance of absence of stippling in gingiva?
Does not necessarily indicate disease or inflammation
What is the cause of bleeding on probing in gingivitis?
Inflammation caused by swelling of gingival capillaries
What is the main cause of gingival inflammation?
Inadequate oral hygiene and dental plaque
What is the color of severe gingivitis?
Red
What significant update occurred in the classification of gingival diseases in 2017-2018?
A huge section on gingival diseases was added
Which factor can modify plaque-induced gingival diseases?
Systemic factors like hormonal changes
What can clinical signs of inflammation in gingival diseases indicate?
They may indicate other diseases
When did the classification of gingival diseases begin?
In 1977
What can lead to inflammation in plaque-induced gingival diseases?
The presence of very small amounts of plaque influenced by hormonal changes
What did the 2015 review of the classification add?
A huge section on gingival diseases
What is the significance of bleeding on probing according to the landmark study?
It has low sensitivity but high specificity and very high negative predictive value
What is the characteristic of pristine gingiva?
Minimal neutrophil migration, rarely seen clinically
What is the indicator of stability and predictor of positive outcomes after treatment?
Absence of bleeding and probing
What are the stages of gingivitis described by Paige and Schroeder?
Initial, early, and established phases with varying clinical signs and histological changes
What can pregnancy-associated gingivitis lead to?
Development of pyogenic granuloma
What is the characteristic of the early lesion of gingivitis?
Marginal redness, inflammation, edema, and lymphocytes, with no significant attachment loss
Which condition can cause gingival changes characterized by easy bleeding and sensitivity?
Leukemia
What is the predictor of progression from the established lesion to periodontitis?
Passing through the initial, early, and established stages
What can induce gingival enlargement and fibrotic tissue changes?
Calcium channel blockers
Which condition can lead to gingival issues presenting as weakness, anemia, and bleeding?
Scurvy
Apart from plaque, what else can play a role in causing gingival diseases?
Specific bacteria and ecological changes
What may be necessary to identify specific bacterial species causing inflammation in some cases?
Bacterial cultures
What can lead to the development of pyogenic granuloma during pregnancy?
Hormonal changes
What can cause gingival changes characterized by easy bleeding and sensitivity, requiring referral for blood work?
Leukemia
Apart from plaque, what else can play a role in causing gingival diseases?
Specific bacteria and ecological changes
What can induce gingival enlargement and fibrotic tissue changes?
Calcium channel blockers
What is the main difference between healthy gingiva and gingivitis?
Healthy gingiva has a stippled texture
What can manifest in the gingiva and other parts of the oral cavity as viral infections?
Herpes stomatitis and varicella zoster
What is the significance of absence of stippling in gingiva?
It is a sign of healthy gingiva
What can lead to gingival issues presenting as weakness, anemia, and bleeding?
Malnutrition-related conditions like scurvy
What is the clinical significance of bleeding on probing in gingivitis?
It is a clinical indicator of inflammation and gingivitis
What is the main cause of gingival inflammation?
Inadequate oral hygiene and dental plaque
What are the signs of gingivitis?
Heat, redness, swelling, pain, and loss of function
What is the clinical indicator of inflammation and gingivitis?
Bleeding on probing
Which factor can modify plaque-induced gingival diseases?
Systemic factors
When did the classification of gingival diseases begin?
1977
What did the 2015 review of the classification add?
A huge section on gingival diseases
What can lead to inflammation in plaque-induced gingival diseases?
Hormonal changes
What is the main cause of gingival inflammation?
Dental plaque
What significant update occurred in the classification of gingival diseases in 2017-2018?
Gingival diseases were added to the diagnosis
What is the significance of bleeding on probing according to the landmark study?
Low sensitivity and high specificity
Which stage of gingivitis presents with marginal redness, inflammation, edema, and lymphocytes, with no significant attachment loss?
Early lesion
What is the characteristic of pristine gingiva?
Characterized by minimal neutrophil migration
What is the predictor of positive outcomes after treatment?
Absence of bleeding and probing
What did the stages of gingivitis described by Paige and Schroeder include?
Initial, early, and established phases
What is the most correct about subclinical signs of gingivitis?
May be present in a high percentage of the population, but not everyone has visible gingival injuries
What is the reason for teaching students both the old and new classification systems for gingival diseases?
Insurances have not switched to the new classification system yet, so students need to understand both to communicate effectively.
What was the response of periodontists to the new classification system presented in 2018?
Some periodontists were uncertain about the new system and its implications.
Why is it important for students to understand the normal appearance of the gingiva?
To facilitate accurate diagnosis of gingival diseases.
What prompted the need for additional readings mentioned on Blackboard?
To help students understand the implications of the new classification system presented in 2018.
Why is it necessary for students to be aware of the classification system from 1999?
Some practitioners still use the 1999 classification system, requiring students to understand and communicate using it.
What was the periodontists' reaction to the new classification system at the meeting in 2018?
Periodontists were divided in their response to the new system, with some expressing uncertainty.
Study Notes
Gingival Diseases and Their Causes
- Gingivitis during pregnancy is related to hormonal changes, with symptoms such as swelling and bleeding gums.
- Pregnancy-associated gingivitis may also lead to the development of pyogenic granuloma, which can resolve after childbirth.
- Leukemia can cause gingival changes, with patients exhibiting easy bleeding and sensitivity, requiring referral for blood work.
- Medications, such as calcium channel blockers and immunosuppressants, can induce gingival enlargement and fibrotic tissue changes.
- Malnutrition-related conditions like scurvy can lead to gingival issues, presenting as weakness, anemia, and bleeding.
- Plaque may not be the sole cause of gingival diseases, as specific bacteria and ecological changes can play a role.
- Local and systemic factors, as well as non-plaque-induced gingival diseases, can influence the presence of inflammation in the gums.
- Bacterial cultures may be necessary to identify specific bacterial species causing inflammation in some cases.
- Viral infections, such as herpes stomatitis and varicella zoster, can manifest in the gingiva and other parts of the oral cavity.
- Hormonal changes during pregnancy, medications, and systemic conditions can influence the development of gingival diseases.
- Understanding the causes of gingival diseases, including hormonal, bacterial, viral, and medication-related factors, is crucial for effective diagnosis and treatment.
- Dentists need to consider a wide range of factors, including hormonal, bacterial, viral, and medication-related influences, when diagnosing and treating gingival diseases.
Periodontal Disease and Gingivitis Stages Summary
- A landmark study showed that bleeding on probing has low sensitivity but high specificity and very high negative predictive value
- The study found that up to 30% of sites with bleeding and probing lost further attachment over the observation period
- Absence of bleeding and probing is an indicator of stability and predictor of positive outcomes after treatment
- Presentation to patients regarding bleeding on probing is crucial to address their concerns and fears
- The significance of bleeding on probing is related to the histopathology of gingival diseases, including vasculitis and progressive destruction of collagen
- The stages of gingivitis described by Paige and Schroeder include initial, early, and established phases with varying clinical signs and histological changes
- Pristine gingiva is characterized by minimal neutrophil migration, rarely seen clinically, and may exist with no inflammatory response
- The initial lesion may have plaque or biofilm formation with neutrophil migration, but may appear clinically healthy
- Subclinical signs of gingivitis may be present in a high percentage of the population, but not everyone has visible gingival injuries
- The early lesion presents with marginal redness, inflammation, edema, and lymphocytes, with no significant attachment loss
- The established lesion is the severe form of gingivitis with evident signs of inflammation, bleeding, swelling, and plasma cell infiltration
- Progression from the established lesion to the advanced stage, periodontitis, is not guaranteed and requires passing through the initial, early, and established stages.
Test your knowledge of gingival diseases and their causes with this informative quiz. Learn about the various factors, including hormonal changes, medications, bacterial and viral infections, and systemic conditions, that can contribute to the development of gingival issues. Understanding these causes is essential for accurate diagnosis and effective treatment.
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