📌 POINTS TO PONDER 

🔸 Gingival conditions/diseases that mainly involve interdental papilla and gingival margin are gingival abscess, NUG, linear gingival erythema and drug- induced gingival enlargement. 

🔸 Gingival ulcers are usually seen in NUG, herpes simplex virus stomatitis, aphthae, self-injury, malignant neoplasms, drugs, dermatoses, systemic diseases (hematological disorders, tuberculosis, syphilis, herpes virus, human immunodeficiency virus). 

🔸 Gingival changes seen in mouth -breathers are erythema, edema, enlargement, diffuse smooth and shiny surface in the exposed gingival area affecting mainly maxillary 

anterior region. 

🔸 Gingival red lesions are usually seen in erythroplasia, desquamative gingivitis, hemangiomas, orofacial granulomatosis, Crohn’s disease, Wegener’s granulomatosis, sarcoidosis and Kaposi’s sarcoma.

🔸The characteristics of plaque-induced gingivitis (Mariotti, 1999) are: 

• Plaque present in relation to gingival margin 
• Disease begins at the gingival margin 
• Change in gingival color 
• Change in gingival contour 
• Sulcular temperature change 
• Increased gingival exudates 
• Bleeding upon provocation 
• Absence of attachment and bone loss 
• Histological changes including an inflammatory lesion 
• Reversible with plaque removal

📌 VIVA VOCE 

Q1. In which stage of gingivitis plasma cells predominate? 

Ans. Plasma cells predominate in “Stage III: The Established Stage” of gingivitis. 

Q2. Name various conditions in which there is change in the surface texture of gingiva. 

Ans. The surface texture of gingiva changes under the following conditions: 

🔹Smooth surface texture (loss of stippling): Chronic gingivitis, atrophic gingivitis, chronic desquamative gingivitis 

🔹Leathery texture: Hyperkeratosis 

🔹Nodular surface: Drug-induced gingival overgrowth. 

Q3. Name conditions in which gingival contour is changed. 

Ans. Gingival contour is changed under following conditions: 

🔹Acute and chronic gingivitis 

🔹NUG 

🔹Stillman’s clefts and 

🔹McCall’s festoons. 

Q4. What is pristine gingiva? 

Ans. Histologically perfect gingiva is called pristine gingiva. 

Q5. What is “eruption gingivitis”? 

Ans. Gingivitis associated with tooth eruption is called “eruption gingivitis”. 

Q6. Which metals cause intoxication? 

Ans. Bismuth, lead, mercury, phosphorous, arsenic and chromium. 

Q7. How are Stillman’s clefts classified? 

Ans. Simple cleft: Occurs in a single direction – most common type 

Compound cleft: Occurs in more than 1 direction. 

Q8. In which stage of gingivitis Polymorphonuclear neutrophils (PMNs) predominate? 

Ans. Stage I: Initial lesion of gingivitis. 

Q9. In which stage of gingivitis bleeding on probing is usually found? 

Ans. Stage II: Early lesion of gingivitis. 

Q10. Which fiber groups are mainly affected in Stage II early lesion of gingivitis? 

Ans. Circular and dentogingival fibero groups.

📌 MULTIPLE CHOICE QUESTIONS MCQs 

💡 The radiographic findings of gingivitis will demonstrate: 

A. Vertical bone loss 

B. Horizontal bone loss 

C. Change in bone trabeculation 

D. Normal bone pattern

Answer : D 

💡 Gingivitis is initiated MOST often by: 

A. Malocclusion 

B. A hormonal imbalance 

C. Vitamin deficiency 

D. Microorganisms and their products 

E. Psychosocial factors

Answer : D 

💡 Gingival bleeding on probing appears: 

A. Before the color changes 

B. After the color changes 

C. At the same time as the color changes 

D. Not related with the color changes

Answer : A 

💡 Junctional epithelium shows formation of rete pegs in: 

A. Stage I gingivitis (Initial) 

B. Stage II gingivitis (Early) 

C. Stage III gingivitis (Established) 

D. Stage IV gingivitis (Advanced)

Answer : B 

💡 The predominant inflammatory cell in early lesion: 

A. Neutrophil 

B. T lymphocytes 

C. Plasma cell 

D. Macrophages

Answer : B 

💡 McCall’s festoon is common in: 

A. Incisor area 

B. Canine and premolar area 

C. Molar area 

D. Same in all of the above

Answer : B 

💡 Crater-like deformities are seen in: 

A. NUG 

B. Aggressive periodontitis 

C. Chronic gingivitis 

D. Chronic periodontitis

Answer : A 

💡 Which of the following is not a clinical feature of necrotizing ulcerative gingivitis: 

A. Pocket formation 

B. Spontaneous bleeding 

C. Pain 

D. All of the above

Answer : A 

💡 All of the exogenous factors can cause gingival colour changes except: 

A. Coal dust 

B. Alcohol 

C. Tobacco 

D. Amalgam

Answer : B 

💡 Endogenous gingival pigmentation can be caused by all of the following except: 

A. Iron 

B. Melanin 

C. Bilirubin 

D. Metronidazole

Answer : D 

💡 Burtonian line is a linear pigmentation of gingival margin due to over exposure to: 

A. Bismuth 

B.  Silver 

C.  Lead 

D.  Arsenic 

Answer : C