Periodontics › Pathology
Gingivitis
High-yield revision notes with linked practice questions, written for dental students and candidates preparing for the ADC and other licensing examinations.
High-yield notes
IL-1β alters properties of gingival fibroblasts by delaying their death via a mechanism-blocking apoptosis. This stabilizes the gingival fibroblast population in inflammation.
Under normal conditions, a constant stream of neutrophils is migrating from the vessels of the gingival plexus through the junctional epithelium, to the gingival margin, and into the gingival sulcus and oral cavity.
The initial gingivitis is also known as subclinical gingivitis.
The main fiber groups affected during early lesions are circular and dentogingival fiber.
Established lesion is characterized by plasma cells
Collagenase is produced by some oral bacteria and by PMNs.
Advanced lesion is also known as phase of periodontal breakdown.
Gingivitis will progress to periodontitis only in individuals who are susceptible.
Most common type of gingivitis is chronic gingivitis.
Bleeding on probing is a hallmark of gingivitis and periodontitis
The two earliest signs of gingival inflammation preceding established gingivitis are (1) increased gingival crevicular fluid production rate and (2) bleeding from the gingival sulcus on gentle probing
Even though gingival bleeding on probing may not be a good diagnostic indicator for clinical attachment loss, its absence is an excellent negative predictor of future attachment loss.
The most common cause of abnormal gingival bleeding on probing is chronic inflammation.
In cases of moderate or advanced periodontitis, the presence of bleeding on probing is considered a sign of active tissue destruction.
Interleukin-6 (IL-6) is associated periodontal conditions with elevated gingival inflammation and increased pocket depths in women with stress.
The normal gingival color is "coral pink".
Venous stasis will contribute a bluish hue in chronic gingivitis.
Gingival pigmentation due to heavy metals is not a result of systemic toxicity.
Receded gingiva can be inflamed but may be normal except for its position
The actual position of the gingiva is the level of the coronal end of the epithelial attachment on the tooth, whereas the apparent position is the level of the crest of the gingival margin
Stillman's clefts" is a specific type of gingival recession consisting of a narrow, triangular-shaped gingival recession.
"McCall festoons" has been used to describe a rolled, thickened band of gingiva usually seen adjacent to the cuspids when recession approaches the mucogingival junction.
It is a life preserver shaped enlargement of the gingiva.
Practice questions
Select an option to check your answer. Answers are shown below each question.
Question 1
Periodontitis fall under which stage of gingival inflammation
- AStage I gingivitis: the initial lesion
- BStage II gingivitis: the early lesion
- CStage III gingivitis: the established lesion
- DStage IV gingivitis: the advanced lesion
Answer: D. Stage IV gingivitis: the advanced lesion
Question 2
The initial lesion of gingivitis
- Afocused on acute inflammation
- Baccumulation of polymorphonuclear leukocytes
- Cseen as early as 2 days after plaque accumulates
- Dall of the above
Answer: D. all of the above
Question 3
The predominant cells in early lesions are
- APMNs
- BB-Lymphocytes
- CPlasma cells
- DT-lymphocytes
Answer: B. B-Lymphocytes
Question 4
Gingival fluid flow and the numbers of transmigrating leukocytes reach their maximum between
- A2-3 days after the onset of clinical gingivitis
- B4-6 days after the onset of clinical gingivitis
- C6-12 days after the onset of clinical gingivitis
- DBefore the onset of clinical gingivitis
Answer: C. 6-12 days after the onset of clinical gingivitis
Question 5
Rete-pegs in junctional epithelium
- APresent in case of inflammation only
- BPresent in the absence of inflammation only
- CPresent throughout regardless of the inflammation
- DNever present whether the tissue is inflamed or normal
Answer: A. Present in case of inflammation only
Question 6
Localized gingival anoxemia is seen in
- AStage I gingivitis: the initial lesion
- BStage II gingivitis: the early lesion
- CStage III gingivitis: the established lesion
- DStage IV gingivitis: the advanced lesion
Answer: C. Stage III gingivitis: the established lesion
Question 7
Untrue about established lesions
- AMay remain stable and do not progress for months or years
- BMay become more active and convert to progressively destructive lesions
- CReversible
- DAll of them are true
Answer: D. All of them are true
Question 8
In advanced lesion or phase of periodontal breakdown,
- APlasma cell predominates both connective tissue and junctional epithelium
- BNeutrophil predominates both connective tissue and junctional epithelium
- Cplasma cell predominates connective tissue and neutrophils dominate the junctional epithelium
- DNeutrophil predominates connective tissue and plasma cells dominate the junctional epithelium.
Answer: C. plasma cell predominates connective tissue and neutrophils dominate the junctional epithelium
Question 9
Not a feature of Gingivitis
- Asponginess of the gingival tissue
- Bchanges in contour
- Cbleeding on provocation
- Dradiographic evidence of crestal bone loss
Answer: D. radiographic evidence of crestal bone loss
Question 10
earliest clinical sign of gingivitis
- Adecreased GCF flow
- Bcolor change
- Cbleeding on probing
- Dloss of stippling
Answer: C. bleeding on probing
Question 11
Gingivitis that involves the gingival margin of upper right canine and include a portion of the contiguous attached gingiva is
- APapillary gingivitis
- BDiffuse gingivitis
- CMarginal gingivitis
- DGeneralized marginal gingivitis
Answer: C. Marginal gingivitis
Question 12
If a patient quits smoking, bleeding on probing
- AIncreases
- BDecreases
- CRemains the same
- DNo relation between bleeding on probing and smoking
Answer: A. Increases
Question 13
The cellular infiltrate of sites that bleed on probing predominantly is
- ANeutrophils
- BMacrophage
- CLymphocyte
- DBasophils
Answer: C. Lymphocyte
Question 14
Bleeding in probing is due to
- AThinning of epithelium
- BAtrophy of the epithelium
- CEngorged and dilated capillaries
- DAll of them
Answer: D. All of them
Question 15
Not a sign of gingivitis
- AIncreased pocket depth
- BLoss of attachment
- CSpontaneous bleeding from gums
- DIncreased gingival crevicular fluid flow
Answer: B. Loss of attachment
Question 16
The color of the gingiva is determined by all except
- ANumber and size of blood vessels
- BEpithelial thickness
- CQuantity of keratinization
- DPresence of inflammatory cells
Answer: D. Presence of inflammatory cells
Question 17
Disease that increase melanin pigmentation include all except
- ACushing syndrome
- BPeutz-Jeghers syndrome
- Cvon Recklinghausen's disease
- DAlbright's syndrome
Answer: A. Cushing syndrome
Question 18
Normal consistency of the gingiva is
- AFirm and leathery
- BFirm
- CSoft and edematous
- Dfirm and nodular
Answer: B. Firm
Question 19
Gingival ablation corresponds to
- Afaulty toothbrushing technique
- Bfriction from soft tissues
- Cabnormal frenum attachment
- Diatrogenic dentistry
Answer: B. friction from soft tissues
These notes are compiled from standard periodontology texts for study purposes. They are a revision aid, not a substitute for your own reading or current clinical guidelines. If you spot an error, please leave a comment.
