News for dentistry professionals
08 Nov 2011
Gerardo Gómez-Moreno1, Antonio Aguilar-Salvatierra2, Javier Guardia3 y José Luis Calvo-Guirado4
In the 90s, dental plaque became accepted as a biofilm, which is composed of bacteria that represent 15-20% of plaque volume, embedded in a matrix or glycocalyx, which constitutes the remaining 75-80%1. This matrix is a combination of exopolysaccharides, proteins, mineral salts and cell material2. The oral biofilm is the main etiological agent of caries and gum disease (gingivitis and periodontitis)3. A qualitative and quantitative alteration in this bacterial population is the key for maintaining oral health4.
Gingivitis is defined as the inflammation of gums caused by biofilm deposits that ultimately irritate and inflame them. Bacteria and their toxins cause infection and inflammation in the gums, causing gingival sensitivity5. Gingivitis affects soft gingival tissues and is reversible. If gingivitis is not kept under control, it can evolve into periodontitis, extending to the deepest areas, such as the periodontal ligament and the alveolar bone6.
Many factors exist that can favour the manifestation of gingivitis7:
Gingivitis associated with local factors: can develop both in healthy and in reduced, but stable, periodontia5, generally associated with local retention factors of the biofilm, such as deficient oral hygiene, tooth malposition, occlusal trauma, overextended restorations, fixed and removable orthodontic appliances and prostheses (bridges and crowns), the latter two possibly irritating the gums and therefore increasing the risk for gingivitis.
Gingivitis associated with systemic factors: is characterized by being modified in its evolutionary course by diverse general effects such as5
- The endocrine system, among which we find gingivitis associated with pregnancy, puberty, menstrual cycle and uncontrolled diabetes.
- Blood dyscrasia, such as thrombocytopenia purpura, due to abnormal functioning or number of blood cells.
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