Gingivitis Development Stages Quiz
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Questions and Answers

What is the initial stage of plaque-induced gingivitis classified as?

  • Stage IV gingivitis
  • Stage II gingivitis
  • Stage III gingivitis
  • Stage I gingivitis (correct)

    • Which of the following is a function of neutrophils in an inflammatory response?

  • Increasing blood viscosity
  • Promoting vasodilation
  • Rolling along the endothelium (correct)
  • Decreasing tissue temperature

    • Which stage of gingivitis development is characterized by no clear-cut dividing lines between stages?

  • Initial stage (correct)
  • Early stage
  • Advanced stage
  • Established stage

    • Which inflammatory mediators are secreted by neutrophils?

    <p>Prostaglandins and leukotrienes</p> Signup and view all the answers

    Which organism-related factors can contribute to tissue damage in gingivitis?

    <p>Collagenase and endotoxin</p> Signup and view all the answers

    What can be said about normal gingival tissue and the initial stage of gingivitis?

    <p>They exhibit similar histological features.</p> Signup and view all the answers

    At which stage of gingivitis do inflammatory changes become clinically apparent?

    <p>Established lesion</p> Signup and view all the answers

    What is the fundamental response of living tissues to injury in gingivitis?

    <p>Inflammation</p> Signup and view all the answers

    What typically occurs if the initial lesion does not resolve rapidly?

    <p>It develops into a chronic inflammatory lesion.</p> Signup and view all the answers

    Which type of cells predominates within the leukocyte infiltration during the early lesion?

    <p>T cells</p> Signup and view all the answers

    What happens to collagen during the development of an early gingival lesion?

    <p>70% of the collagen is destroyed around the cellular infiltrate.</p> Signup and view all the answers

    What is the primary function of polymorphonuclear leukocytes (PMNs) in the gingival tissue?

    <p>To engulf bacteria during phagocytosis.</p> Signup and view all the answers

    What is a clinical sign of the early lesion in gingival inflammation?

    <p>Early gingivitis may be observed.</p> Signup and view all the answers

    In the context of gingival inflammation, what do rete pegs or ridges signify?

    <p>The beginning of epithelial changes during inflammation.</p> Signup and view all the answers

    What is the main characteristic of an initial lesion in gingival inflammation?

    <p>No apparent change in the gingiva.</p> Signup and view all the answers

    Which type of inflammatory cells emerge in the gingival pocket area as part of the host response?

    <p>Polymorphonuclear neutrophils (PMNs)</p> Signup and view all the answers

    What characterizes the advanced lesion stage of gingival inflammation?

    <p>Extension of the lesion into alveolar bone</p> Signup and view all the answers

    What changes occur in the blood vessels during chronic gingivitis?

    <p>Congestion and sluggish blood flow</p> Signup and view all the answers

    What primarily characterizes the established lesion of gingivitis?

    <p>Active lesions potentially converting to destructive conditions</p> Signup and view all the answers

    What immune cells are predominant in the early lesion stage of gingivitis?

    <p>Lymphocytes</p> Signup and view all the answers

    What changes occur in the connective tissue after 8 days of plaque accumulation?

    <p>It is infiltrated with inflammatory cells displacing collagen fibers.</p> Signup and view all the answers

    How long after plaque accumulation does chronic gingivitis typically develop?

    <p>2-3 weeks</p> Signup and view all the answers

    What process describes the breakdown of hemoglobin contributing to the color change in chronically inflamed gingiva?

    <p>Extravasation of erythrocytes</p> Signup and view all the answers

    What does the presence of distended blood vessels in the biopsy specimen suggest?

    <p>Increased inflammation and vascular permeability.</p> Signup and view all the answers

    Which type of cells primarily infiltrate the connective tissue after 8 days of plaque accumulation?

    <p>Small and medium-sized lymphocytes.</p> Signup and view all the answers

    What occurs during the initial lesion stage of gingivitis?

    <p>Vascular dilation and vasculitis</p> Signup and view all the answers

    What degenerative change occurs in collagen fibers after prolonged plaque accumulation?

    <p>There is evidence of enzymatic digestion leading to collagen degeneration.</p> Signup and view all the answers

    What reversal mechanism occurs during successful periodontal therapy in gingivitis?

    <p>Reversal of disease progression events</p> Signup and view all the answers

    What histopathological feature indicates early stages of experimental gingivitis?

    <p>Mononuclear cell infiltrate with clear spaces.</p> Signup and view all the answers

    What clinical sign may develop over time due to plaque accumulation?

    <p>Erythema from capillary proliferation.</p> Signup and view all the answers

    What significant aspect regarding blood vessels is observed in the context of gingival inflammation?

    <p>Blood vessels show signs of distention and increased formation of capillary loops.</p> Signup and view all the answers

    What magnification is used to observe the inflammatory cell infiltrate at higher detail?

    <p>×1250.</p> Signup and view all the answers

    What is the normal consistency of healthy gingiva?

    <p>Firm and resilient</p> Signup and view all the answers

    Which change in the gingiva is primarily associated with chronic gingivitis when edematous changes are present?

    <p>Loss of stippling</p> Signup and view all the answers

    What does the term 'Stillman’s clefts' refer to?

    <p>Changes in gingival contour and recession</p> Signup and view all the answers

    What is the significance of gingival stippling?

    <p>Its loss can signal early gingivitis.</p> Signup and view all the answers

    How does chronic gingivitis occur in terms of tissue changes?

    <p>Both edematous and fibrotic changes exist.</p> Signup and view all the answers

    What common feature of gingival diseases involves alterations in size?

    <p>Inflammation</p> Signup and view all the answers

    Which description best characterizes the surface texture of normal gingiva?

    <p>Numerous small depressions and elevations</p> Signup and view all the answers

    At what age is Dental Plaque Biofilm-Induced Gingivitis most prevalent among children?

    <p>7 years and older</p> Signup and view all the answers

    Study Notes

    Gingivitis Development Stages

    • Plaque-induced gingivitis progresses through four stages: initial, early, established, and advanced (periodontitis).
    • Each stage has distinct histological changes and clinical manifestations.

    Initial Stage (Stage I)

    • Characterized by initial inflammation with no visible clinical changes.
    • Increased migration of leukocytes and their accumulation in the gingival sulcus.
    • Increased gingival fluid flow into the sulcus.
    • Characterized by infiltration of PMNs (neutrophils).

    Early Stage (Stage II)

    • Develops within a week of plaque accumulation.
    • Overlaps with the initial stage, but clinical signs of gingivitis may be present.
    • Increased leukocyte infiltration in connective tissue, mostly lymphocytes, with some neutrophils, macrophages, plasma cells, and mast cells.
    • Dense infiltration of neutrophils at the junctional epithelium and gingival sulcus.
    • Rete pegs and ridges begin to develop.
    • 70% of collagen is destroyed surrounding the cellular infiltrate.
    • Circular and dentogingival fibers are affected.

    Established Stage (Stage III)

    • Characterized by moderate to severe gingivitis.
    • Two types: stable (non-progressive) and active (progressing to periodontitis).
    • Persistent inflammatory changes with more advanced infiltration of plasma cells.
    • Blood vessels become engorged, congested, and blood flow becomes sluggish, resulting in localized gingival anoxemia.
    • Reddish/bluish hue on the gingiva due to blood stasis and hemoglobin breakdown.
    • Rete pegs and ridges are more prominent.

    Advanced Stage (Stage IV)

    • Characterized by extension of the lesion into alveolar bone.
    • Periodontal breakdown occurs.
    • Gingivitis progresses to periodontitis only in susceptible individuals.

    Clinical Manifestations of Gingivitis

    • Changes in Consistency: Firm, resilient gingiva becomes soft, friable, and bleeds easily due to edema and exudate.
    • Changes in Surface Texture: Stippling, the orange-peel appearance of normal gingiva, is lost due to inflammation.
    • Changes in Gingival Contour: The marginal gingiva can become swollen, receding, or exhibit Stillman’s clefts (recession with a V-shaped notch).
    • Changes in Gingival Size: Gingival size is altered due to inflammation and changes in cellular and intercellular elements.

    Gingivitis in Children

    • Dental plaque biofilm-induced gingivitis is common in children, affecting up to 70% of children over 7 years old.

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    Pathogenesis of Dental Biofilm-Induced Gingivitis PDF

    Description

    Test your understanding of the stages of gingivitis, including initial, early, established, and advanced stages. This quiz covers the histological changes and clinical manifestations associated with each stage. Determine how well you can identify the characteristics of gingivitis progression.

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