reversible inflammation of the gingiva, initiated by plaque by products entering oral sulcular epithelium

short lasting, quick on set, more pain - AUG, pericornitis, acute herpetic gingivostomatitis

long standing, no pain, frustrated repair. Chronic (marginal) gingivitis, desquamative gingivitis.

BOP BOS BOB, change in colour: red, change in texture = loss of stippling, oedematous or fibrotic, change in contour, increase in pocket depth due to false pocketing, no pain, JE at correct level, no loss of attachment or boneloss, inflammation of marginal gingiva and papilla, REVERSIBLE

presence of poor OH plaque made up of micro organisms and matrix DIRECT EFFECT 20% Plaque by products; direct effect on the gingival tissues (enzymes, exotoxins, endotoxins) part of matrix 30% micro-organisms make up 70% of plaque/biofilm gram negative anaerobic bacteria 11 bacteria associated with periodontal disease named by soscransky 1998 microbial complexes in subgingival plaque e.g Pg, Aa, Ec, Fn, Pi, Pm progressing > red complex INDIRECT EFFECT 80%- inflammatory and immune response stimulated due to the presence of plaque by products body own immune mechanisms damage gingival and periodontal tissues > PMNLs, MACROPHAGES, T CELLS, B CELLS

local (calculus, overcrowding, ledges), systemic (pregnancy, diabetes, smoking)

Assessment: BPE, Plaque score, OHI, calculus removal, correction of secondary risk factor, reassess and maintenance

Irreversible inflammation of the periodontium, initiated by plaque by products entering oral sulcular epithelium, progression depends upon host response to bacteria challenge and any contributing factors which influence response

chronic periodontitis, localised and generalised aggressive periodontitis, acute necrotising periodontitis

Nothing, gum shrinkage, bad taste/breath, suppuration/pus, loose/drifting teeth, red swollen gums, may also appear purple/blue due to lack of oxygen and frustrated repair

-inflammation of gingiva loss of PDL and bone -loss of stippling, blunting of the ID papillae -bleeding on probing, brushing, spontaneous -true pocketing -usually horizontal boneless associated with supra bony pockets -eventual mobility, drifting and possible abscess -halitosis -recession > circumferential -sensitivity -suppuration/pus -deep red gingiva -change in contour of gingiva -furcation involvement -sub calculus -pocketing over 4mm -metallic taste -possible oedema -possible discomfort -possible fibrosis

Assessment, MH, SH, DR, DH, AGE BPE, plaque score, FMPC Radiographs OHI, aetiology, smoking cessation Correction of secondary risk factors supra/sub calculus removal RSD with LA if required poss a/b reassess at 3/12- regular maintenance review with GDP