What effects does chronic gingivitis have on the blood vessels supplying the gingival tissues?
What are the causes of chronic gingivitis? What are some of the systemic conditoning factors? How are each of these causes managed?
What is the role of diabetes and periodontal conditions? How does diabetes affect the gingival tissues histologically?
Off you go team......
Sophie
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7 comments:
Ok..so i justtyped this out.. and accidentally deleted it all. :(
here it goes again...
-blood vessels with proliferate(increase in number) and also dilate, which is what contributes to the increased redness and BOP that are signs of chronic gingivitis.
-causes of chronis gingivitis are plaque in duced(cause-effect relationship), thatcan occur with local contributing factors(suchas tooth morphology) or without. The systemic conditioning factors thatmaycontribute to gingivitis include endocrine conditions such as pregnancy, puberty, uncontrolled diabetes, also blood dyscrasias such as leukaemia.
im Not 100% how each of these conditions are managed but my notes say..if a gingival lesion appears"abnormal"or not caused directly from plaque(severe reaction)then we need to recognize this and should arrange for further tests(ie.blood tests), with patients Dr...
Then fromthis i would assume management would include controlling/manageing the systemic condition first(such as getting diabetes under control) as well as undertaking usual hygiene therapy.??
-inpatients withuncontrooled diabetes, vascular changes occur thatcandecrease the PMN migration abilities, alsod ecrease oxygen..which will affect healing abilities. Neutrophil function can alsobe impaired, these are the frontline defence in chronic gingivitis, and if this is affected disease will be able to progress much more easily, there can also be an increase indestruction of the gingival tissues as PMN relesae their enzymes(cytotoxic products)that can contribute to tissue damage.??
I pretty much agree with what Nicole has said, I'll just chip in so I feel as though my study is worth it :p
1) Blood vessels proliferate and dilate, which means there is an increased blood flow to the area. This results in inflammation as there is an increased amount of inflammatory cells in the area, tissue oedema, redness, and BOP.
2) Chronic gingivitis is caused by plaque, and the host response to this is modified by various systemic factors. Diabetes (I'll go into detail next question) which can only be managed by the patient, but with support from us and their GP. Sex hormones (from puberty and pregnancy) which can't really be managed, but I think the gingivitis will subside over time with the help of mechanical debridement and good OH. Blood disorders (leukaemia, cyclic neutropenia), if these are suspected to be involved a blood test with the patient's GP needs to be organised. Drug induced gingivitis can occur, and in this case the GP should be contacted about a possible change in medication. Low vit C levels also cause gingivitis, and this can be managed by talking with the patient about their diet and giving them Vit C supplements if needed.
4) Diabetes is now a recognised risk factor for perio, IF it is uncontrolled, controlled diabetics don't necessarily suffer from perio. There are numerous changes that occur in the bodies of poorly controlled diabetics which affects the perio tissues: PMN function is altered and they can't migrate to sites of bacterial infiltration and destroy the bacteria, vascular changes lead to decreased oxygen diffusion, AGE (advanced glycated end-product) is produced by hyperglycemia and this activates macrophages and causes a decreased production of fibroblasts (less CT produced therefore weaker CT attachment?).
Tim you said that so much better than i did.. I didn't understand the AGE stuff with diabetics.. I just learnt something.. so there.. your study is definatly worth while.. :
Well between the 2 of you I am learning alot. Thanks smarty pants:)
Nicole and Tim you have summed it in a nut shell! I am going to have to get on really early so i can beat you to answering some of these questions!
The A Team is at it again...
I hope this has been a beneficial forum for you guys. I am thrilled with the learning and discovery that has occurred on the blog. Well done to all and go into the exam tomorrow knowing that you are well prepared.
See you at 1.20!!
Sophie
Sorry I meant 1.50pm in S210....
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