The document discusses gingival inflammation and clinical features of gingivitis, detailing its progression from initial to advanced lesions and categorizing types of gingivitis based on duration and distribution. It emphasizes the importance of recognizing gingival bleeding as an early sign of inflammation and outlines classifications of gingival recession. The etiology of gingivitis primarily involves plaque-induced inflammation and highlights the clinical significance of gingival recession.

2. GINGIVAL
INFLAMMATION
&
CLINICAL FEATURES
OF GINGIVITIS
DR. ABHISHEK GAUR
BDS, MDS, F.A.G.E. (PH. D)
DEPARTMENT OF PERIODONTICS
R. R. DENTAL COLLEGE & HOSPITAL
UMRA, UDAIPUR

3. GINGIVITIS ?

4. CAUSE OF GINGIVITIS
???
Absence of treatment of gingivitis can lead to
progress of gingivitis into periodontitis.

5. STAGES
OF
GINGIVAL
INFLAMMATION

6. INITIAL LESION (2ND TO 4TH DAY)
Vascular Changes :
Classical Vasculitis subjacent to junctional epithelium.
Clinical Changes :
Exudation of fluid from the gingival sulcus.
Sub-clinical gingivitis.
GINGIVAL INFLAMMATION & CLINICAL FEATURES OF GINGIVITIS

7. EARLY LESION (4TH TO 7TH DAY)
Vascular Changes :
Vascular proliferation.
Clinical Changes :
Erythematous, Gingival Bleeding on Probing.
GINGIVAL INFLAMMATION & CLINICAL FEATURES OF GINGIVITIS

8. ESTABLISHED LESION (14TH TO 21ST DAY)
Vascular Changes :
Vascular proliferation.
Clinical Changes :
Changes seen in consistency & surface texture.
Bluish colour around the reddened gingiva.
GINGIVAL INFLAMMATION & CLINICAL FEATURES OF GINGIVITIS

9. ADVANCED LESION
Vascular Changes :
Vascular proliferation.
Clinical Changes :
Formation of periodontal pocket and its progressions
towards Periodontitis.
GINGIVAL INFLAMMATION & CLINICAL FEATURES OF GINGIVITIS

10. TYPES
OF
GINGIVITIS

11. TYPES OF GINGIVITIS
Depending on course and duration
Depending on distribution
Depending on the course and duration :
1. Acute gingivitis is of sudden on-set and short duration; and can be painful.
2. Sub-acute gingivitis is a less severe phase of acute infection.
3. Recurrent gingivitis re-appears either after treatment or disappears spontaneously.
4. Chronic gingivitis is show in onset, of long duration, usually painless and the
most commonly occurring gingival condition.
GINGIVAL INFLAMMATION & CLINICAL FEATURES OF GINGIVITIS

12. DEPENDING ON DISTRIBUTION
Localised gingivitis : It is the condition is involving a single tooth or group of
tooth.
Generalised gingivitis : It is the condition involving entire mouth.
According to distribution :
1. Marginal gingivitis: In this the inflammation is limited to the marginal gingiva.
2. Papillary gingivitis: In this the inflammation is limited to interdental papilla.
3. Diffuse gingivitis: In this the inflammation involves attached gingiva.
GINGIVAL INFLAMMATION & CLINICAL FEATURES OF GINGIVITIS

13. GINGIVAL
FEATURES IN HEALTH IN DISEASE
Color Coral Pink Reddish blue or deep blue
Contour
Scalloped & Knife
edged
Rolled and round
edges
Consistency Firm & Resilient
Edematous, Spongy
Shape
Position At CEJ
Apically or
Coronally Placed
Size Normal
Enlargement or
Recession

14. GINGIVAL
FEATURES
IN
HEALTHY IN DISEASE
Surface Texture Stippling +nt Loss of Stippling
B.O.P. -
Present
Chronic Recurrent,
Spontaneous
Bleeding Present

15. GINGIVAL
BLEEDING

16. SIGNIFICANCE
It is one of the earliest visual signs of inflammation.
It can appear earlier than colour changes or any other
visual signs of inflammation.
It also provides an additional advantage, by being a
more objective sign that requires less subjective
estimation by the examiner.
The severity and ease with bleeding can be provoked
indicates the integrity of the inflammation.
GINGIVAL INFLAMMATION & CLINICAL FEATURES OF GINGIVITIS

17. GINGIVAL
RECESSION

18. GINGIVAL
RECESSION
Classification
Two classification systems are available :
1. According to Sullivan & Atkins : Shallow-narrow,
shallow-wide and Deep-Wide.
2. According to PD Miller’s : Class-I ,Class-II, Class III,
Class IV.
GINGIVAL INFLAMMATION & CLINICAL FEATURES OF GINGIVITIS

21. ETIOLOGY
Plaque-induced gingival inflammation is
the primary etiological factor responsible
for gingival recession.
Other common cause is faulty tooth-
brushing.
Anatomic factors.
Habits.
GINGIVAL INFLAMMATION & CLINICAL FEATURES OF GINGIVITIS

22. CLINICAL SIGNIFICANCE OF GINGIVAL RECESSION
The exposed root surface may be extremely
sensitive.
Inter-proximal recession creates oral hygiene
problems thereby resulting in plaque accumulation.
Finally, it is aesthetically unacceptable.
GINGIVAL INFLAMMATION & CLINICAL FEATURES OF GINGIVITIS