Learning+Group+5

= Learning Group #5 - 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 #1
**__Mandibular Free__:** **__Mandibular Attached__:** 
 * Erythematous: caused from alteration in vascular permeability and dilation, often with the infiltration of leukocytes into affected tissues resulting in the glossy and shiny apperance.
 * Edematous: caused by the infiltration by fluid and cells of inflammatory exudate as a result of the inflmation process increasing the amounts of WBC's and Macrophages as part of the inflammatory cascade of events taking place.
 * Bulbous: chronic inflammatory gingival enlargement begins in the interdental papilla and marginal gingiva which produces a bulge shape around the involved teeth. The gingiva has an abundance of inflammatory cells and fluid with vascular engorgement, new capillary formation and associated degenerative changes.
 * Suppuration facial #27: Crevicular fluid increased because when gingiva is unhealthy the amount of sulcular fluid increases and its composition starts to resemble that of exudates and exits the basement membrane and enters the sulcus. The fluid contains components of C.T. epithelium inflammatory cells, serum, and microbial flora.
 * Firmly bound to bone
 * Erythematous: caused from alteration in vascular permeability and dilation, often with the infiltration of leukocytes into affected tissues
 * Glossy/shiny: Caused from the loss of stippling due to gingival atrophy. Stippling usually occurs from the presence of rete pegs; during a state of disease the rete pegs are lost causing a smooth appearance.

Picture #2
** __Maxillary Free__: ** **__Maxillary Attached:__** 
 * Erythematous: due to inflmation of the capillaries, caused from alteration in vascular permeability and dilation, often with the infiltration of leukocytes into affected tissues induced by the adherence of bacterial biofilms adhering to the tooths surface.
 * Fibrotic and suppuration: The fibrous gingiva is caused by the degeneration of connective tissue and epithelium associated with injurious substances that provoke the inflammation and exudate. There is a thinning of epithelium and degeneration associated with edema and leukocyte invasion caused from inflammation. The suppuration is caused when the gingiva is unhealthy the amount of sulcular fluid increases and its composition starts to resemble that of exudates and exits the basement membrane and enters the sulcus. The fluid contains components of C.T. epithelium inflammatory cells, serum, and microbial flora.
 * Clefted and Rolled on lingual:  Clefting is caused from recession consisting of a narrow triangular shaped. As the recession progresses apically the cleft becomes broader, this is caused from inflammatory changes in the marginal gingiva. The gingiva has an abundance of inflammatory cells and fluid with vascular engorgement, new capillary formation and associated degenerative changes which causes the rolled appearance.
 * <span style="font-family: 'Comic Sans MS',cursive; font-size: 120%;">Keratinized <span style="font-family: 'Comic Sans MS'; font-size: 10pt; mso-ansi-language: EN-US; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"><span style="font-family: 'Comic Sans MS',cursive; font-size: 120%;">/Firm/leathery: fibrosis and epithelial proliferation associated with longstanding chronic inflammation.
 * <span style="font-family: 'Comic Sans MS',cursive; font-size: 120%;">Erythematous: caused from alteration in vascular permeability and dilation, often with the infiltration of leukocytes into affected tissues
 * <span style="font-family: 'Comic Sans MS',cursive; font-size: 120%;">Fibrotic: The fibrous gingiva is caused by the degeneration of connective tissue and epithelium associated with injurious substances that provoke the inflammation and exudate. There is a thinning of epithelium and degeneration associated with edema and leukocyte invasion caused from inflammation.
 * <span style="font-family: 'Comic Sans MS',cursive; font-size: 120%;">Hyperkeratinized<span style="font-family: 'Comic Sans MS',cursive; font-size: 12pt; line-height: 200%;">/leathery/firm: fibrosis and epithelial proliferation associated with longstanding chronic inflammation.