This document discusses chronic periodontitis, the most common form of periodontitis. It is defined as an infectious disease resulting in inflammation and destruction of the tissues supporting the teeth. The key clinical features are plaque, gingivitis, attachment loss, bone loss, and inflammation. Chronic periodontitis is considered a site-specific disease where inflammation and bone loss occur at specific sites due to local plaque accumulation. The severity is classified as slight, moderate, or severe based on the amount of attachment loss. Risk factors include poor plaque control, systemic diseases, environmental/behavioral factors like smoking, and genetics. Treatment involves improving oral hygiene, nonsurgical treatments like scaling and root planing, and sometimes surgery.

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CChhrroonniicc PPeerriiooddoonnttiittiiss
By Neveen Fuad and
Sarah Mohammed
Periodontology Clinic

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CChhrroonniicc PPeerriiooddoonnttiittiiss
 Formerly known as “cchhrroonniicc aadduulltt
ppeerriiooddoonnttiittiiss” is the most common
form of ppeerriiooddoonnttiittss.
 IItt hhaass bbeeeenn ddeeffiinneedd as “an
infectious disease resulting in
inflammation with in supporting
tissues of the teeth associated with
progressive attachment loss and bone
loss.

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CClliinniiccaall FFeeaattuurreess
I. Accumulation of supragingival and subgingival plaque
and calculus formation.
II. Gingival inflammation.
III. Attachment loss either by recession or pocket
formation.
IV. horizontal or vertical bone loss.
V. Inflammatory swelling.
VI. Changing in color from pale red to purplish red.
VII. Loss of stippling.
VIII. Mobility of the teeth increases.
IX. In some cases suppuration from pockets can be found.
X. Rounded gingival margin and flattened interdental
papilla.

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DDiisseeaassee DDiissttrriibbuuttiioonn
 Chronic periodontitis is considered to be as
““ssiittee ssppeecciiffiicc ddiisseeaassee””
 IInnffllaammmmaattiioonn,,ppoocckkeettss,,aattttaacchhmmeenntt lloossss
aanndd bboonnee lloossss are due to direct site-specific
effects of ssuubbggiinnggiivvaall ppllaaqquuee
accumulation as a result of this local effect
attachment loss and pockets may occur on
one surface of the tooth while the other
surfaces remain normal.

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DDiisseeaassee SSeevveerriittyy
Described by the aammoouunntt ooff aattttaacchhmmeenntt
lloossss to 3 types ::
11)) SSlliigghhtt (Mild) 1-2 mm CAL
22)) MMooddeerraattee 3-4 mm CAL
33)) SSeevveerree 5 mm or more CAL

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CClliinniiccaall DDiiaaggnnoossiiss
 Inflammation of the marginal gingiva
extent to the attached gingiva.
 Clinical attachment loss.
 Radiographs(in case of bone loss).

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Prevalence
 Effects both sexes equally.
 Increases with age.
 Age associated disease not age
related and occurs depending on
disease duration.

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SSyymmppttoommss
1. Painless
2. Sensitivity to hot and cold
3. Localized pain radiating into the jaw
4. Impaction areas of food cause discomfort
5. Itchiness in the gingiva

9. PPrrooggrreessssiioonn ooff tthhee ddiisseeaassee
The rate of disease progression is usually slow
but may be modified by systemic and/or
environmental and behavioral factors.
However, because of its slow rate
of progression, chronic periodontitis usually
Becomes clinically significant in the mid-30s or
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later.

10. PPrrooggrreessssiioonn ooff tthhee ddiisseeaassee
Chronic periodontitis does not progress
at an equal rate in all affected sites
throughout the mouth. More rapidly
progressive lesions occur:
 Interproximal areas
 areas of greater plaque accumulation
 inaccessibility to plaque control
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measures

11. RRiisskk ffaaccttoorrss ooff tthhee ddiisseeaassee
The factors that increase the
susceptibility of :disease are
11.. LLooccaall FFaaccttoorrss : (plaque and calculus accumulation ,
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subgingival restorations, crowded teeth)
22.. SSyysstteemmiicc FFaaccttoorrss : (diseases such as diabetes )
33.. EEnnvviirroonnmmeennttaall aanndd BBeehhaavviioorraall FFaaccttoorrss :(smoking )
4. GGeenneettiicc ffaaccttoorrss : (family history)

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Treatment
1. Improving of the oral hygiene
2. Curettage
3. Pocket therapy
4. Scaling and root planning

13. TThhaannkk YYoouu
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