Periodontal diseases are classified as gingival diseases or periodontitis. Gingival diseases include plaque-induced and non-plaque induced inflammation, with plaque-associated gingivitis being more common. Periodontitis is primarily classified by clinical presentation into chronic, aggressive, or as a manifestation of systemic disease. Radiographs provide a two-dimensional view that can show early bone loss signs like rounding of the alveolar crest but have limitations and do not replace a clinical exam. Successful periodontal therapy can halt and potentially reverse bone loss, while periodontal changes may also be associated with conditions like squamous cell carcinoma or lichen planus.

1. Periodontal Diseases
Dr. Hadi Munib
Oral and Maxillofacial Surgery Resident

2. Introduction
• Periodontal diseases are broadly classified as gingival diseases
and periodontitis.
• Gingival diseases may be dental plaque-induced or non –
plaque-induced.
• Bacterial plaque-associated gingivitis is much more common
than non – plaque-induced inflammatory diseases

3. Introduction
• Periodontitis is classified, primarily by the clinical presentation.
• Chronic, aggressive, and periodontitis as a manifestation of a
systemic disease, necrotizing periodontal diseases, periodontal
abscesses, and periodontitis associated with endodontic lesions.
• Clinical Difference between Gingivitis and Periodontitis

4. How do Radiographs help?

5. Limitations of Radiographs
1. Radiographs provide a two-dimensional view of a three-dimensional
situation. [Overlapping tooth structure]
2. Radiographs typically show less severe bone destruction than is actually
present.
3. Radiographs do not demonstrate the soft-tissue-to-hard-tissue
relationships and thus provide no information about the depth of soft
tissue pockets.
4. Bone level is often measured from the cementoenamel junction;
however, this reference point is not valid in situations where there is
overeruption or where there is severe attrition with passive eruption

6. Normal Alveolar Crest

7. Initial Periodontal Disease: Rounding of AC and LD and loss of density in
the Alveolar Crest

8. Bone level to CEJ distance

9. Horizontal Bone Loss

10. Vertical Bony Defect

11. GP to inspect the infrabony defect’s depth

12. Buccal/ Lingual Plate Loss

13. Interdental Craters

20. Successful Periodontal Therapy

21. Periodontal Changes associated with SCC and LCH

22. • Treatment Options

23. References
• Chapter 18: Periodontal Diseases

24. THANK YOU