Figure 5-8.Acute necrotizing ulcerative gingivitis (ANUG).
interdental papillae, which become ulcerated and
finally are destroyed.
As the inflammation continues, micro-organisms
and their products progress toward the apex of the
tooth, forming a pocket in which additional calculus
forms. Frequently, the gingival margin also recedes
toward the apex and the pocket is shallow. With pocket
formation, the gingival tissue bleeds easily, and
shelflike projections of calculus form between the
teeth. These calculus formations irritate the
As the rest of the alveolar bone is resorbed, the
attachment fibers of the periodontal membrane are
loosened. They may remain attached to the tooth for a
time, but finally they are destroyed, and the pocket can
extend farther toward the apex of the tooth.
Eventually, if the condition remains untreated, the
tooth will be lost through destruction of its supporting