Inflammation in the Periodontal Lesion

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a) Study the picture and the table and answer the questions:

1) What anatomical structures support the teeth?

2) How many stages of periodontal lesion do you know?

3) What changes is the initial lesion stage characterized by?

4) What are the clinical changes of the acute gingivitis stage?

5) How can you recognise transition from gingivitis to periodontitis?

Stages	Time	Clinical changes	Histological changes
I. Initial lesion - initial response of tissue to bacterial plaque; - subclinical gingivitis.	2 – 4 days	none	Increase in gingival crevicular fluid
II. Early lesion - acute gingivitis	4 – 7 days	Redness Bleeding upon probing Loss of tissue tone	Continuation of initial lesion; Chronic inflammatory cells appear Connective tissue fibre destruction
III. Established lesion - chronic gingivitis	14 or more days	Moderate-to-severe inflammation	Chronic inflammation: blood vessels congested, blood flow impaired, Continuation of changes in early lesions
IV. Advanced lesion - transition from gingivitis to periodontitis	Dependent on host response	True periodontal pockets Attachment loss Bone loss	Inflammation extending into connective tissue; Attachment and alveolar bone; Bone resorption

b) Speak about the consequences of the inflammation of the periodontal lesion.

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