Periodontology

STAGES OF GINGIVITIS #NEETMDS #Pearls

Anisha ValliLeave a comment
  1. Stage 1 – Initial stage
    1. Starts at 2 – 4 days after beginning of plaque accumulation 
    2. Increase vascularity 
    3. Increase GCF flow 
    4. Stage of subclinical gingivitis = no clinical changes
    5. Immune cells = PMNs are main line of defense
    6. Important feature = increase in GCF flow 
  2. Stage 2 – Early stage
    1. Early lesion evolves from initial lesion 4 – 7 days after the beginning of plaque accumulation 
    2. Clinical signs appear in this stage
      1. BOP 
      2. Erythema 
    3. Important feature = clinical signs appear 
    4. Immune cells = lymphocytes 
    5. Collagen destruction increases
      1. 70% of collagen fibers are affected
      2. Main fiber groups involved
        1. Circular 
        2. Dentogingival
  3. Stage 3 – Established lesion
    1. Severely inflamed gingiva/chronic gingivitis 
    2. It occurs for 14 – 21 days after the beginning of plaque accumulation 
    3. Immune cells = Plasma cells 
    4. Important feature = change in color, size, texture 
    5. Bluish hue on the reddened gingiva
      1. Blood flow sluggish 
      2. Impaired venous return 
  4. Stage 4 – Advanced lesion
    1. Gingivitis progresses to periodontitis 
    2. CT loss 
  • Gingivitis is T-cell lesion 
  • Periodontitis is B cell lesion 
  • When gingivitis is dominated by T cells = Contained gingivitis 
  • Term subclinical gingivitis was coined by LINDHE, synonym of stage 1 
  • Number of transmigrating leukocytes and amount of GCF = between 6 to 12 days of gingivitis = these values become maximum 

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