The document discusses different types of gingivitis. It begins by reviewing aspects of module 1, then discusses the expected learning outcomes of module 2 which focuses on gingivitis. The main types discussed are plaque-induced gingivitis, gingivitis modified by systemic factors like puberty, pregnancy, and diabetes, gingivitis modified by medications, and gingivitis modified by malnutrition. Key points include plaque-induced gingivitis being the most common type, and systemic factors influencing the severity and duration of the inflammatory response.
aggressive periodontitis, its pathogenesis, risk factors, differential diagnosis, radiographic and clinical aspects of the disease, its management and how's it different from chronic form of periodontitis
recent studies, schoransky's postulates, biomarkers
genetic predisposition of the disease
The term probiotics is a relatievly new word meaning “for life” and is currently used to name bacteria associated with beneficial effects for humans and animals. The development of resistance to range of antibiotics by some important pathogen has raised a possibility of return to pre antibiotic dark ages. So there was need of new treatment paradigm to be introduced to treat periodontal diseases. This need was fulfilled by the introduction of probiotics. Probiotics are counterparts of antibiotics thus are free from concerns for developing resistance, further they are body’s own resident flora hence are most easily adapted to host. The buzz about probiotics has become a roar but despite great promises, probiotics work is limited to gut. Periodontal works are sparse and need validation by large randomized trials. It can be said probiotics are still in “infancy” in terms of periodontal health benefits, but surely have opened door for a new paradigm of treating disease on a nano molecular mode. Novel species are likely to be added in the future as research data
accumulate. In-depth understanding of the intrinsic microbial ecological control of commensal microbiota may introduce new putative species to this discussion.
aggressive periodontitis, its pathogenesis, risk factors, differential diagnosis, radiographic and clinical aspects of the disease, its management and how's it different from chronic form of periodontitis
recent studies, schoransky's postulates, biomarkers
genetic predisposition of the disease
The term probiotics is a relatievly new word meaning “for life” and is currently used to name bacteria associated with beneficial effects for humans and animals. The development of resistance to range of antibiotics by some important pathogen has raised a possibility of return to pre antibiotic dark ages. So there was need of new treatment paradigm to be introduced to treat periodontal diseases. This need was fulfilled by the introduction of probiotics. Probiotics are counterparts of antibiotics thus are free from concerns for developing resistance, further they are body’s own resident flora hence are most easily adapted to host. The buzz about probiotics has become a roar but despite great promises, probiotics work is limited to gut. Periodontal works are sparse and need validation by large randomized trials. It can be said probiotics are still in “infancy” in terms of periodontal health benefits, but surely have opened door for a new paradigm of treating disease on a nano molecular mode. Novel species are likely to be added in the future as research data
accumulate. In-depth understanding of the intrinsic microbial ecological control of commensal microbiota may introduce new putative species to this discussion.
this ppt depicts pattern of bone destruction. its a very good slide show showing the process of bone formation, bone destruction and their patterns in periodontal diseases.
AIDS is a lethal viral infection caused by human immunodeficiency virus (HIV) and is characterized by severe depletion of T4 lymphocytes with associated opportunistic infections.
Oral and perioral lesions are common in patients infected with human immune deficiency virus (HIV), are often the presenting feature, and may predict deterioration in general health and a poor prognosis.
Due to multiple oral conditions and periodontal involvement, periodontists are in a unique position to recognize possible HIV infection in its early stage and to be involved in the oral care of these patients.
this ppt depicts pattern of bone destruction. its a very good slide show showing the process of bone formation, bone destruction and their patterns in periodontal diseases.
AIDS is a lethal viral infection caused by human immunodeficiency virus (HIV) and is characterized by severe depletion of T4 lymphocytes with associated opportunistic infections.
Oral and perioral lesions are common in patients infected with human immune deficiency virus (HIV), are often the presenting feature, and may predict deterioration in general health and a poor prognosis.
Due to multiple oral conditions and periodontal involvement, periodontists are in a unique position to recognize possible HIV infection in its early stage and to be involved in the oral care of these patients.
Periodontal diseases Classifications and treatmentsRiad Mahmud
Prof. Dr. Md. Zahid Hossain, Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, Najran University, Saudi Arabia.Former Professor of Periodontology, City Dental College, Dhaka
Pathogenesis is derived from the Greek work ‘pathos’ meaning suffering and ‘ genesis’ meaning generation or creation. Plaque is considered as the main etiologic factor in the pathogenesis of periodontal disease.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
1. 9/12/2011
Year 2
Lecture 1
GINGIVITIS
11-9-2011 Classification of gingivitis- lecture 1 1
GINGIVITIS
Module Introduction
In Module 1, you gained an insight into the form and function of the
periodontal tissues. The natural defence mechanisms of the gingival
tissues were described and the role of commensal bacteria explained. It
is assumed that you will carry forward this knowledge and build upon
it, as more of the Modules in periodontics are presented.
11-9-2011 Classification of gingivitis- lecture 1 slide 2
1
2. 9/12/2011
Review of aspects of Module 1
q p gg g
Sequence of developing gingivitis
Increased gingival crevicular fluid flow
Bleeding on probing
Colour change
g
Changed gingival contours
Retractability of the gingival tissues
11-9-2011 Classification of gingivitis- lecture 1 slide 3
GINGIVITIS
When you have completed Module 2, you are expected to
y p ,y p
be able to:
♦ Describe the anatomy and physiology of the gingival tissues in detail.
♦ Understanding the microbiology, etiology and pathogenesis of chronic gingivitis
♦ Have an overview of the many different gingival diseases and conditions.
♦ Be able to recognise chronic and acute forms of gingivitis and know the
appropriate treatment for these conditions
i t t t t f th diti
♦ Understand the medical conditions that can cause modified/exaggerated
gingival responses to dental biofilm.
11-9-2011 Classification of gingivitis- lecture 1 slide 4
2
3. 9/12/2011
GINGIVITIS
Gingival health represents a
balance between biofilm and
host resistance factors.
Gingivitis most often occurs
as a CHRONIC disease and is
present over many
years/decades. It is
reversible, meaning that
gingiva can return to clinical
and histological health when
biofilm and calculus is
removed.
Classification of gingivitis- lecture 1 slide 5
GINGIVITIS
Classification of gingivitis- lecture 1 slide 6
3
4. 9/12/2011
Gingival Diseases
These diseases may occur on a periodontium with no
y p
attachment loss or on a periodontium with attachment loss
that is stable and not progressing.
I. Gingivitis associated with dental plaque
only
II. Non‐plaque‐Induced Gingival Lesions
Classification of gingivitis- lecture 1 slide 7
Dental Plaque‐Induced Gingival Diseases
Gingivitis has been previously characterized by the presence of
clinical signs of inflammation that are confined to the gingiva and
associated with teeth showing no attachment loss.
It has been concluded that plaque‐induced gingivitis may occur on a
It h b l d d th t l i d d i i iti
periodontium with no attachment loss or on a periodontium with
previous attachment loss that is stable and not progressing.
I. Gingivitis associated with dental plaque only
II. Gingival diseases modified by systemic factors
III. Gingival diseases modified by medications
IV. Gingival diseases modified by malnutrition
IV Gingival diseases modified by malnutrition
Classification of gingivitis- lecture 1 slide 8
4
5. 9/12/2011
Gingivitis
Non‐specific Inflammation
Response
of the gingival tissues towards a
Non‐specific Plaque Challenge
Classification of gingivitis- lecture 1 slide 9
The most common type
of gingivitis is
Plaque induced gingivitis
caused by biofilm.
Chronic’ means that
h ’ h
gingivitis is present
for a long time… usually
years or decades.
Plaque induced gingivitis
caused by biofilm
Plaque induced gingivitis is
the most common
periodontal disease you will
be treating.
Classification of gingivitis- lecture 1 slide 10
5
7. 9/12/2011
II. Gingival diseases modified by systemic factors
A. Associated with endocrine system
1. Puberty‐associated gingivitis
2. Menstrual cycle–associated gingivitis
3. Pregnancy associated
a. Gingivitis
b. Pyogenic granuloma
4. Diabetes mellitus–associated gingivitis
B. Associated with blood dyscrasias
B Associated ith blood d scrasias
1. Leukemia‐associated gingivitis
2. Other
Classification of gingivitis- lecture 1 slide 13
Plaque‐induced gingival
disease is the result of an
di i h l f
inter‐action between the
microorganisms found in
the dental plaque biofilm
and the tissues and
inflarnmatory cells of the
host.
Modified by factors which
y
can influence the severity
and duration of the
response:
Systemic factors.
Medications
Malnutrition.
Classification of gingivitis- lecture 1 slide 14
7
8. 9/12/2011
Systemic factors contributing to gingivitis, such as the
y g g g ,
endocrine changes associated with puberty, the menstrual
cycle, pregnancy, and diabetes, may be exacerbated
because of alterations in the gingival inflammatory response
to plaque.
• This altered response appears to result from the effects of
systemic conditions on the host's cellular and immunologic
functions.
Classification of gingivitis- lecture 1 slide 15
Puberty‐associated gingivitis
The incidence of marginal gingivitis
g g g
peaks at 11 to 13 years of age, then
decreases slightly after puberty.
The most frequent manifestations in
adolescents is bleeding and
inflammation in the interproximal
areas. This is usually the result of
hormonal changes that magnify the
tissue inflammatory response to
dental plaque.
It occurs in both males and females
and reduces in severity after puberty,
it resolves as the person matures.
Classification of gingivitis- lecture 1 slide 16
8
9. 9/12/2011
Gingival Disease in Pregnancy
Pronounced ease of
bleeding is the most
striking clinical feature.
The gingiva is inflamed
and varies in color from a
bright red to bluish
The marginal and
interdental i i
i t d t l gingiva are
edematous, pit on
pressure, appear smooth ,
shiny and are soft.
Classification of gingivitis- lecture 1 slide 17
The extreme redness results
from marked vascularity, and
there is an increased tendency to
bleed.
Gingivitis in pregnancy is caused
by bacterial plaque, just as it is
in nonpregnant women.
Pregnancy accentuates the
gingival response to plaque and
modifies the resultant clinical
picture .
Pregnancy affects the severity of
previously inflamed areas; it
does not alter healthy gingiva.
Classification of gingivitis- lecture 1 slide 18
9
10. 9/12/2011
Tumor‐like Gingival Enlargement
The so‐called pregnancy
tumor is not a neoplasm; it
is an inflammatory response
to bacterial plaque and is
modified by the patient's
condition.
Classification of gingivitis- lecture 1 slide 19
Diabetes mellitus–associated gingivitis
Gingivitis caused by biofilm, modified by poorly
g y , y p y
controlled diabetes
Diabetes may be first picked up by the oral health
practitioner because of the unusual response of the
gingival tissues to plaque.
Classification of gingivitis- lecture 1 slide 20
10
11. 9/12/2011
The most striking
changes in
uncontrolled diabetes
are the reduction in
defense mechanisms
and the increased
susceptibility to
infections, leading to
destructive periodontal
disease.
Classification of gingivitis- lecture 1 slide 21
Diabetes: What to look for?
Severe gingival
g g
inflammation
Deep periodontal
pockets,
Rapid bone loss,
Frequent periodontal
abscesses.
Slow resolution of
gingivitis after
conventional
treatment.
Classification of gingivitis- lecture 1 slide 22
11
12. 9/12/2011
Blood dyscrasias such as leukemia may alter immune function
y y
by disturbing the normal balance of immunologically
competent white blood cells supplying the periodontium.
Gingival enlargement and bleeding are common findings and
may be associated with swollen, spongy gingival tissues caused
by excessive infiltration of blood cells.
Classification of gingivitis- lecture 1 slide 23
III. Gingival Diseases Modified by
Medications
A. Drug influenced gingival diseases
A. Drug‐influenced gingival diseases
1. Drug‐influenced gingival enlargements
2. Drug‐influenced gingivitis
a. Oral contraceptive–associated gingivitis
b. Other.
Classification of gingivitis- lecture 1 slide 24
12
13. 9/12/2011
Gingival diseases modified by medications are increasingly
p
prevalent because of the increased use of anti‐convulsant
drugs known to induce gingival enlargement, such as phenytoin,
immunosuppressive drugs such as cyclosporine , and calcium
channel blockers such as nifedipine.
The development and severity of gingival enlargement in
response to medications are patient specific and may be
influenced by uncontrolled plaque accumulation.
The increased use of oral contraceptives by premenopausal
women has been associated with a higher incidence of gingival
inflammation and development of gingival enlargement, which
may be reversed by discontinuation of the oral contraceptive
Classification of gingivitis- lecture 1 slide 25
Phenytoin
Anticonvulsant drug used in
the treatment of epilepsy.
h f il
Classification of gingivitis- lecture 1 slide 26
13
14. 9/12/2011
Cyclosporine
Potent immunosuppresive
pp
drug used to prevent organ
rejection following
transplantation.
Classification of gingivitis- lecture 1 slide 27
Nifedipine
Are drugs developed to treat
g p
several cardiac diseases such as
hypertension, angina pectoris,
coronary artery spasms.
In patients of Kidney transplant it
is used in combination of both
Cyclosporin and nifedipine
leading to larger enlargements of
the gingiva.
Classification of gingivitis- lecture 1 slide 28
14
15. 9/12/2011
IV. Gingival diseases modified by
malnutrition
A. Ascorbic acid deficiency gingivitis
B. Others.
Gingival diseases modified by malnutrition have
received attention because of clinical
descriptions of bright‐red, swollen, and bleeding
gingiva associated with severe ascorbic acid (
vitamin C) deficiency or scurvy.
Nutritional deficiencies are known to affect
immune function and may affect the host s ability
immune function and may affect the host's ability
to protect itself against some of the detrimental
effects of cellular products, such as oxygen
radicals.
Classification of gingivitis- lecture 1 slide 29
Classification of gingivitis- lecture 1 slide 30
15
16. 9/12/2011
Non—Plaque‐Induced Gingival Lesions
I. Gingival diseases of specific bacterial origin
II. Gingival diseases of viral origin
III. Gingival diseases of fungal origin
IV. Gingival lesions of genetic origin
V. Gingival manifestations of systemic conditions
VI. Traumatic lesions (factitious, iatrogenic, or
g
accidental)
VII. Foreign body reactions
VIII. Not otherwise specified Gingival Diseases
Classification of gingivitis- lecture 1 slide 31
I. Gingival Diseases of Specific Bacterial
Origin
A. Neisseria gonorrhoeae
B. Treponema pallidum
B Treponema pallidum
C. Streptococcus species
D. Other
Gingival diseases of specific bacterial origin are increasing in prevalence,
especially as a result of sexually transmitted diseases such as gonorrhea
(Neisseria gonarrhoeae) and to a lesser degree, syphilis (Treponenra
pallidum).’
Oral lesions may be secondary to systemic infection or may occur
y y y y
through direct infection. Streptococcal gingivitis or gingivostomatitis is
a rare condition that may present as an acute condition with fever,
malaise, and pain associated with acutely inflamed, diffuse, red, and
swollen gingiva with increased bleeding and occasional gingival abscess
formation.
Classification of gingivitis- lecture 1 slide 32
16
17. 9/12/2011
II. Gingival diseases of viral origin
A. Herpesvirus infections
1. Primary herpetic gingivostomatitis
2. Recurrent oralherpes
2 Recurrent oralherpes
3. Varicella zoster
B. Other.
Gingival diseases of viral origin may be caused by a
variety of deoxyribonucleic acid (DNA) and
ribonucleic acid (RNA) viruses, the most common
being the herpesviruses. Lesions are frequently
b i h h i L i f l
related to reactivation of latent viruses, especially as
a result of reduced immune function.
Classification of gingivitis- lecture 1 slide 33
Types of gingivitis
Acute gingivitis Acute
Viral gingivitis
• Viral
Herpes virus-induced gingivitis
Classification of gingivitis- lecture 1 slide 34
17
19. 9/12/2011
IV. Gingival lesions of genetic origin
A. Hereditary gingival fibromatosis
A Hereditary gingival fibromatosis
B. Other.
Gingival diseases of genetic origin may involve the tissues of the
periodontium. One of the most clinically evident conditions is hereditary
gingival fibromatosis, which exhibits autosomal dominant or (rarely)
autosomal recessive modes of inheritance. The gingival enlargement may
completely cover the teeth, delay eruption, and present as an isolated finding
or may be associated with several more generalized syndromes.
Classification of gingivitis- lecture 1 slide 37
V. Gingival manifestations of systemic conditions
A. Mucocutaneous lesions B. Allergic reactions
1. Lichen planus
1 Lichen planus 1. Dental restorative materials
1 Dental restorative materials
2. Pemphigoid a. Mercury
3. Pemphigus vulgaris b. Nickel
4. Erythema multiforme c. Acrylic
5. Lupus erythematosus d. Other
6. Drug induced 2. Reactions attributable to:
7. Other a. Toothpastes or dentifrices
b. Mouth rinses or mouthwashes
b M th i th h
c. Chewing gum additives
d. Foods and additives
3. Other.
11-9-2011 Classification of gingivitis- lecture 1 slide 38
19
20. 9/12/2011
Gingival manifestations of systemic conditions may appear
as desquamative lesions, ulceration of the gingiva, or both.
Allergic reactions that manifest with gingival changes
are uncommon but have been observed in association with
several restorative materials, tooth‐pastes, mouthwashes,
chewing gum, and foods .
Classification of gingivitis- lecture 1 slide 39
Non plaque‐induced gingival lesions
VI. Traumatic lesions (factitious, iatrogenic, or accidental)
A. Chemical injury
B. Physical injury
j y
C. Thermal injury
Traumatic lesions may be factitious (produced by artificial
means; unintentionally produced), as in the case of
toothbrush trauma resulting in gingival ulceration, recession,
or both; iatrogenic (trauma to the gingiva induced by
the dentist or health professional), as in the case of
preventive or restorative care that may lead to traumatic
injury of the gingiva; or accidental, as in the case of
damage to the gingiva through minor burns from hot foods
And drinks.
11-9-2011 Classification of gingivitis- lecture 1 slide 40
20
21. 9/12/2011
VII. Foreign body reactions
Foreign body reactions lead to localized inflammatory conditions of
the gingiva and are caused by the introduction of foreign material
into the gingival connective tissues through breaks in the epithelium.
Common examples are the introduction of amalgam into the gingiva
during the placement of a restoration or extraction of a tooth, leaving
an amalgam tattoo, or the introduction of abrasives during polishing
procedures.
VIII. Not otherwise specified
11-9-2011 Classification of gingivitis- lecture 1 slide 41
11-9-2011 Classification of gingivitis- lecture 1 slide 42
21