Plaque Induced Gingivitis Lecture

Study Notes

Definition and Overview

Plaque-induced gingivitis is inflammation of the gingiva without attachment loss, distinguishing it from periodontitis.
Chronic periodontitis involves apical migration of the junctional epithelium (JE) and clinical attachment loss (CAL).

Clinical Features

Clinical signs of gingivitis include:
- Changes in color from pale pink to bluish-red.
- Pitting edema, indicating fluid accumulation in gingival tissues.
- Loss of stippling, with smooth and shiny appearance due to deterioration of collagen attachment.
- Easy retraction of the gingiva due to destruction of fibers.
- Increased bleeding tendency upon gentle probing or during brushing.
- Discomfort or soreness of the gingiva, sometimes accompanied by an unpleasant taste.

Types of Gingivitis

Localized gingivitis is confined to a single tooth or group of teeth.
Generalized gingivitis affects the entire mouth.
Diffuse gingivitis may involve the gingival margin and attached gingiva.
Marginal gingivitis is situated along the gingival margin, while papillary gingivitis is verified at the interdental papilla.

Clinical Classification

Clinical features can include:
- Changes in color due to vascularization and blood stasis.
- Pitting edema resulting from the extravasation of plasma fluid.
- Loss of stippling, which refers to the healthy appearance of gingiva when collagen fibers are intact.
- Signs of bleeding can result from probing or even biting into solid foods.

Histopathology of Gingivitis

Three stages of histopathological changes:
- Initial Lesion (2-4 days):
  - Increased vascularization with capillary permeability.
  - Presence of serum proteins and few T-lymphocytes.
- Early Lesion (4-7 to 14 days):
  - Significant infiltration of T-lymphocytes and macrophages.
  - Basal cells of the junctional epithelium begin proliferation.
  - Breakdown of dentogingival fibers occurs.
- Established Lesion:
  - Further accumulation of immune cells, characterized by neutrophil migration through the sulcular epithelium.

Clinical and Histopathological Differentiation

Students should be able to define key clinical and histopathological features of gingivitis and periodontitis.
Importance of differentiating between periodontal pockets (depth of tissue loss) and gingival pockets (superficial inflammatory pockets).
Classification of various types of periodontal pockets and understanding furcation involvement are vital for diagnosis and treatment planning.

Description

This quiz covers the essentials of plaque induced gingivitis and chronic periodontitis, as taught by Prof. Hakem Hussein ElSayed. Students will explore definitions, clinical and histological features, classifications of periodontal pockets, and the correlation between pocket depth and clinical attachment loss.