BLEEDING ON PROBING
One of the earliest signs of gingivitis is bleeding on probing.
This type of gingivitis affects the anterior gingiva of chronic mouth breathers or individuals with incomplete lip closure. Note the erythematous, hypertrophic maxillary anterior gingiva.
Note the intense burgundy color and the marked gingival hypertrophy. These lesions bleed profusely.
Pyogenic granuloma is considered to be a exuberant response to a chronic mild irritant. Its clinical appearance is similar to that seen in pregnancy gingivitis but generally confined to a single area. Pyogenic granulomas also bleed easily because they contain multiple capillaries.
DIABETES MELLITUS ASSOCIATED GINGIVITIS
Note the marked inflammatory reaction and hypertrophy of the free gingiva in this patient with diabetes mellitus. This reflects an increased gingival reaction to plaque with consequent increased risk of periodontal disease.
DIABETES MELLITUS PERIODONTAL ABSCESS
There is a greater increase risk for diabetic patients to develop periodontal abscesses due to increased gingival reaction to plaque and increased risk of periodontal disease. The arrow points to the abscess.
LEUKEMIA ASSOCIATED GINGIVITIS
The gingiva is hypertrophic and shows a typical intragingival hemorrhage.
PHENYTOIN GINGIVAL HYPERTHROPHY
Phenytoin gingival hypertrophy has an incidence of 3 to 84.5%. This enlargement is produced by hyperplasia of the connective and epithelial tissues with secondary inflammation. It may have increased expression of platelet derived growth factor.
CALCIUM CHANNEL BLOCKERS – NIFEDIPINE
Nifedipine is used for coronary artery disease and hypertension to dilate blood vessel and is also used with immunosuppressant drugs in organ transplant. This medication induces gingival hypertrophy, as seen here, in 25% to 50% of patients.
Cyclosporin A is an immunosuppressant used in organ transplant and it produces gingival enlargement in at least 30% of patients under treatment.
PRIMARY HERPETIC GINGIVOSTOMATITIS
Note gingival bleeding and ulcerations which were preceded by vesicles. Also note sero-purulent exudates
AIDS RELATED KAPOSI SARCOMA
localized sarcoma mimicking a pyogenic granuloma. Herpes virus 8 is considered the etiologic agent of AIDS related Kaposi sarcoma.
AIDS RELATED PERIODONTITIS
marked gingival recession and bone exposure.These lesions can destroy tissue rapidly Both patients were HIV positive.
AUTOSOMAL DOMINANT GINGIVAL FIBROMATOSIS
Marked gingival hypertrophy in a patient with autosomal dominant gingival fibromatosis.This is seen early affecting even the deciduous dentition. The teeth are partially covered and eruption is retarded.