Bacterial/Cellular Features Early Lesion

Bacterial accumulation continues and subgingival plaque biofilm maturation occurs. Intensified immune/inflammatory response (cytokines continue to cause destruction of connective tissue) Causes increased dilation and permeability of blood vessels which then brings PMNs to the site of infection and they destroy gingival connective tissue on the way Macrophages and T-cells migrate to the gingival connective tissue Macrophages release biochemical mediators – cytokines, PGE2, MMPs T-cells produce cytokines and antibodies Gingivitis is reversable when biofilm is controlled and inflammation is reduced, if not progression to established gingivitis occurs