Learning+Group+2

= Learning Group #2 - Gingival Assignment =

Please provide a through and detailed gingival description for the two pictures provided and then provide the histological changes that are occuring based off your description.

Picture #1

 * The **__free gingival__** aspects on tooth numbers #22 thru #27 appear generalized pink with __localized erythmatic__ gingiva on the facial of #__24 and #25__ and rolled free gingiva there as well. Generalized smooth, and shiny, with generalized areas of recession which caused the fusion of the COL in the anterior region which extends from the mesial of #22-the mesials of #27 which is all we can see entirely from the photo. There could be greater recession on the facial of #27, although due to plaque acumulation in that area that canno't be assesed at this time. There are localized areas which seem to be blunted on the mesials of #24 and #25 due to 1mm recession on the facial of 24 and 25. Then there are localized areas that appear bulbous in between #25 and #26. If you look closely there looks like a 2mm recesion on the facial of #22 which explains the blunted appearance on the buccal aspect of the gingiva.
 * The **__attached gingiva__** appear generalized pink, smooth, shinny and firmly bound to bone. Due to the recession, there seemes to be mucogingival defects from #22-#27, but we can't be sure until we probe the area and get less than 1mm of attached gingiva.

The **__histologic changes__** along the bulbous areas may be due to inflammatory changes that include, but not limited to are edematous (indicating destructive changes) or fibrous (indicating reparative changes).The loss of rete pegs in the attached gingiva gives it a smooth appearance rather than stippled, and may be an early indicator of gingivitis. The fusion of the col has also taken place, which is usually not the case in the anterior region. Also, the generalized pink color is due to the tissue being healthy but the localized erythmatous area in between 24 and 25 would be due to the inflammatory response increasing the vascularity of the capillaries in the lamina propria underlying the epithelum of the free gingival margin.



Picture #2

 * The **__free gingiva__** on the lingual aspects of #'s 6 thru #9 appear to be generalized erythatic with a localized area of cyanotic along the free gingival margin of #8, rolled, boulbous. flaccid and possibly friable, free gingiva looks rolled, rounded and festooned. Embrasures are showing signs of inflamation on the mesial of #7-#9.
 * The **__attached gingiva__** appears generalized erythmatic, edematous, flaccid and possibly perulent, and shinny due to infammation.

The histologic changes along the cyanotic area of #8 may be due to an increase in vascularization, and/or the decrease of keratinization. These changes can be indicative of a chronic inflammation or an inflammation that is becoming chronic. The attached gingiva that is not stippled may indicate signs of gingivtitis or chronic inflammation. Once the free gingiva is not healthy it will allow the microorganisms to enter and cause inflammation due to the immune response. As this occurs, the tissue will become highly vascularized due to the engorging of the cappilaries located in the lamina propria giving the gingiva the erythmatic appearance.


