Mainly limited to the gingival margin (free gingival and gingival papillary), also known as marginal gingivitis (there is no change in the deep periodontal maxillary and alveolar bone). When inflammation is mainly limited to the gingival papillary, it is called gingival papillaryitis

Causes: Chronic nonspecific inflammation of gingival tissue caused by oral bacteria and their toxic products Plaque, soft dirt, tartar

1. Inflammation and edema

2. Fiber hyperplasia type:

A group of diseases caused by multiple reasons, with fibrous connective tissue hyperplasia as the main pathological changes. It is mostly caused by systemic factors and is often accompanied by local bacterial infection.

1. Gingival hyperplasia caused by endocrine factors Hormonal gingivitis, including pubertal gingivitis and pregnancy gingivitis (gingivitis is the target organ of sex hormones)

2. Drug-induced gingival hyperplasia Phytoin sodium, immunosuppressants and other drugs

3. Nutritional deficiency gingival hyperplasia (VitC deficiency)

4. Gingival hyperplasia caused by hereditary factors (familial gingival fibromatosis)

Acute necrotizing gingivitis, Fenson gingivitis, trench troughitis

1. Causes Flosprotein, Fenson spirochete Malnutrition and extreme weakness Highly mentally nervous person--the host's resistance is low

2. Clinical manifestations The gingival margin and gingival papillae are acutely necrotic, and the gingival margin is nibbling-like missing; the surface is covered with off-white pseudo-membrane; Severe corrupt bad breath; Pain, burning sensation, systemic symptoms.

3. Pathological changes The most surface layer: bacterial spirochete; Pseudo-membrane of surface: fibrous exudation and denaturation and necrosis tissue bacteria, which contain a large number of infiltrated inflammatory cells; gingival smear: see a large number of fusprout bacteria and fessen spirochetes

Plasma gingivitis, allergic gingivitis

1. Causes: Allergic reactive diseases, with various allergens

2. Clinical manifestations Gums, back of the tongue: red, swollen, shiny Lip: Scaly scaly desalination Angle of mouth: Angle of mouth

3. Pathological changes are characterized by diffuse infiltration of plasma cells, and the epithelium is mostly intact, and the plasma cells in the lamina propria are flake-like or focally aggregated.

Limited to redness and desquamation-like lesions of the gums, it is the manifestation of various diseases in the gums

1. Clinical manifestations Gums are bright red and shiny, and the epithelium is peeled off. Burning and pain

2. Pathological changes

1. Bacteria Mainly G-anaerobic bacteria, with many bacterial hairs

1. Direct damage to periodontal tissue by bacteria and their toxic products

2. Secondary damage to periodontal tissue caused by host defense reaction

3. Host systemic factors

To sum up, the destruction process of periodontitis is the result of the interaction between the plaque and the host through complex molecular mechanisms.

Periodontal pus and loose teeth Swelling gums, deep peripartum bag formation X-ray: The periodontal space widens, the alveolar ridge cap disappears, and in severe cases, all alveolar bones are absorbed

Pathological changes in periodontitis during active period

Pathological changes in periodontitis

Normal: Bonding epithelium attaches to the enamel or enamel cementum boundary During periodontitis, it proliferates to the root with the epithelium, and its attachment is lost, resulting in the pathological deepening of the gingival sulcus, forming a blind bag of >3mm, called periodontal bag.

1. Gingival pockets are more common in gingivitis, also known as pseudoperiodic pockets. The alveolar bone has not been significantly absorbed, and the height of the alveolar bone has not been lost. It is just the gingival pocket formed by the gingival tissue due to inflammatory hyperplasia and swelling, resulting in the gingival margin covering the crown. 2. Supragingival pocket The bottom of the periodontal pocket is above the top of the alveolar ridge. Since the alveolar ridge is horizontally absorbed, its height is significantly reduced, resulting in the formation of the supragging pocket. 3. Intrabony pocket The periodontal pocket is located below the top of the alveolar ridge, the alveolar bone is on the side of the bag, and the periodontal pocket is between the root surface and the alveolar bone, which is caused by vertical bone resorption of the dente bone.

It refers to non-inflammatory and dystrophic changes in periodontal tissue, and the pathology is manifested as aquatic degeneration, mucus degeneration, glass-like degeneration, etc. of periodontal tissue. Most of them are local manifestations of systemic diseases. If bacterial infection is combined, it will lead to rapid progressive severe periodontitis.

Primary occlusal trauma: refers to periodontal support tissue damage caused by abnormal occlusal relationship or inconsistent occlusal force, such as early contact, tooth tip interference, etc., which can aggravate the occurrence and development of periodontitis. It is a traumatic occlusal relationship that causes pathological changes in periodontal tissue, which is called traumatic dentation.

Secondary occlusal trauma: Due to periodontitis and other reasons, periodontitis itself lacks support and is unable to perform normal occlusal trauma, resulting in further damage to periodontal tissue. Pathological changes: trabecular bone reconstruction, widening periodontal space, rebirth of the inherent alveolar bone on the traction side, degeneration of the compressed periodontal lining, disappearance of the inherent alveolar bone, root absorption

1. Atrophy after anti-inflammatory 2. Age-increasing atrophy 3. Premature atrophy 4. Atrophy caused by local factors

Pathological changes: reduced epithelial cell hierarchy, decreased connective tissue composition