Learning+Group+1

= Learning Group #1 - Gingival Description = 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 #
The **__free gingiva__** is generalized pink, smooth and shiny and looks resilient. With rolled in between #7 and #8 due to the interdental papilla receding 1mm.There is a localized blunted papilla between #6 and #7. The **__attached gingiva__** is generalized pink, shiny, stippled, resilient and firmly bound to underlying bone. There is a localized area of 1mm recession on # 8. The facial aspect of the free gingiva is knife like.
 * __Histologically__** There must have been loss of some gingival fibers in this localized area due to a past perio condition, tooth brush abrasion, or some other trauma. In healthy gingiva like this one, the tissues of the periodontium, the dentogingival junctional tissues, the crevicular fluid and high turn over rate of the epithelium and dentogingival junction would all be working in harmony to protect against the various microorganisms found in plaque bioflm. A normal number of WBC including PMNS would also be present due to the permeability of the junctional epithelium.

 I think it looks generalized whitish pink, with localized rolled on #8 and blunted papilla, and also edematous. (I don't see it knifedged, it's blunted) First there is a presence of inflammation and an increase in fluid which is caused by an increase of neutraphils and macrophages in response to the irritant, such as bacterial plaque. (I do not agree with the blunted papilla between #7 and #8-- I think it looks like that because of the recession, however I could see how it looks blunted in between #6 and #7. I do not agree that it is edematous because the tissue is pink and even slightly stippled; it may look whitish due to the shinny light.   (I do not see any blunting on the facial aspect of the free gingiva because it is surrounding the teeth like a collar-- and I can see a definite line where the free margin is firmly attached-- giving it a knife edge appearance. #8 has a rolled appearance because of the mucogingival defect associated with the recession)  (I do not think there is any inflammation therefore no immune response) 
 * 1) 8 has 1mm of recession and is slightly extruded.



The **__free gingiva__** is generalized erythmatous, and edematous, blunted and shiny.The **__attached gingiva__** is generalized erythmatous, fibrotic and glossy. The **__histological__** changes occuring with the erythmatous color is due to a local irritant which may be due to calculus,microorganisms in plaque biofilm and their toxins. It also looks there is a faulty restoration on the mesial aspect of the tooth and possible mesial decay creating a reservoir for the microorganisms. Histologically there is an inflammatory response effecting and increasing the vascularity of the capillaries in the lamina propria underlying the epithelum of the free gingival margin. The tissue is becoming fibrotic because it is loosing the attachment because of the destruction of the gingival fibers. The shinny and glossy is occuring because of the epithelial atrophy. This is causing it to lose the stippled texture as the epithelium and lamina dura start to loose their tight junction with each other thus hindering the flow of nutrients needed for a healthy periodontium..