Chronic periodontitis is the most common form of periodontitis. It is characterized as a slow progressing, chronic inflammatory disease caused by bacterial plaque that leads to progressive loss of attachment and bone. If left untreated, chronic periodontitis can cause deep pockets, furcation involvement, tooth mobility, and eventual tooth loss. Risk factors include poor oral hygiene, pre-existing periodontitis, systemic diseases like diabetes, smoking, and genetic factors. Treatment involves nonsurgical and surgical therapies aimed at reducing the bacterial load and regenerating lost tissues through improved plaque control.
AGGRESSIVE PERIODONTITIS
PRESENTER
DR. REBICCA RANJIT
DEPT. OF PERIODONTOLOGY & ORAL IMPLANTOLOGY
Why is there localisation of disease to 1st molars and incisors in LAP?
Often subjects present with attachment loss that does not fit the specific diagnostic criteria (AP or chronic periodontitis).
Schenkein et al. 1995: cigarette smoking was shown to be a risk factor for patients with generalized forms of AgP.
Smokers with GAP had more affected teeth and greater mean levels of attachment loss than patients with GAP who did not smoke.
IgG2 serum levels as well as antibody levels against A.a. are significantly depressed in subjects with GAP who smoked.
Certains medications have been associated with gingival enlargement.
the seminar gives a complete analysis of etilogy and pathogenesis involved in digo as well as sequlae of it
Diabetes and periodontal disease ,at two way relationshipLobna El Khatib
The document discusses the bidirectional relationship between diabetes and periodontal disease. It begins by providing overviews of diabetes and periodontal disease. It then explains how diabetes can increase the risk and severity of periodontal disease by altering oral microorganisms, the host immune response, blood vessels, and wound healing. Conversely, periodontal disease can negatively impact blood sugar control in diabetes by increasing systemic inflammation. Maintaining good oral hygiene and treating periodontal disease may help manage diabetes and reduce complications.
This document discusses food impaction, including its causes, types, mechanisms, signs and symptoms, detection, and management. Food impaction occurs when food becomes forcefully wedged between teeth or in the gingiva. It is often caused by factors like uneven tooth wear, missing teeth, or poor restorations. Left untreated, food impaction can lead to inflammation, bone loss, and tooth mobility. Detection involves examining contacts, using dental floss or casts. Management includes nonsurgical treatments like cleaning and occlusal adjustment, as well as restoring proper contacts and replacing missing teeth.
2017 classification of periodontal and periimplant diseasesDr. Bibina George
The document summarizes the key changes in the 2017 classification of periodontal and peri-implant diseases compared to the 1999 classification. The 2017 classification introduces staging and grading systems for periodontitis to indicate disease severity and risk of progression. It also includes classifications for peri-implant health, mucositis, and implantitis, as well as mucogingival deformities. The document reviews these changes and provides references for the revised classification system.
Chronic periodontitis is an inflammatory disease that causes the destruction of tissues that support the teeth. It is caused by an accumulation of plaque and calculus on the teeth over time. It is characterized by pocket formation, attachment loss, and bone loss. Risk factors include smoking, diabetes, and certain bacteria. The disease progresses slowly through periods of destruction and remission. Treatment involves plaque control, scaling and root planing to reduce bacteria and inflammation.
This document discusses trauma from occlusion (TFO). It begins by defining TFO as pathologic alterations or adaptive changes that develop in the periodontium as a result of undue force from chewing muscles. It describes primary TFO resulting from sudden impacts and secondary TFO from gradual changes that occur with reduced bone support. Clinical features include tooth pain and mobility. Radiographic features include widened ligament space and buttressing bone. Treatment focuses on reducing tooth mobility, eliminating prematurities, and using splints. While TFO alone may increase mobility, inflammation is required for attachment loss.
AGGRESSIVE PERIODONTITIS
PRESENTER
DR. REBICCA RANJIT
DEPT. OF PERIODONTOLOGY & ORAL IMPLANTOLOGY
Why is there localisation of disease to 1st molars and incisors in LAP?
Often subjects present with attachment loss that does not fit the specific diagnostic criteria (AP or chronic periodontitis).
Schenkein et al. 1995: cigarette smoking was shown to be a risk factor for patients with generalized forms of AgP.
Smokers with GAP had more affected teeth and greater mean levels of attachment loss than patients with GAP who did not smoke.
IgG2 serum levels as well as antibody levels against A.a. are significantly depressed in subjects with GAP who smoked.
Certains medications have been associated with gingival enlargement.
the seminar gives a complete analysis of etilogy and pathogenesis involved in digo as well as sequlae of it
Diabetes and periodontal disease ,at two way relationshipLobna El Khatib
The document discusses the bidirectional relationship between diabetes and periodontal disease. It begins by providing overviews of diabetes and periodontal disease. It then explains how diabetes can increase the risk and severity of periodontal disease by altering oral microorganisms, the host immune response, blood vessels, and wound healing. Conversely, periodontal disease can negatively impact blood sugar control in diabetes by increasing systemic inflammation. Maintaining good oral hygiene and treating periodontal disease may help manage diabetes and reduce complications.
This document discusses food impaction, including its causes, types, mechanisms, signs and symptoms, detection, and management. Food impaction occurs when food becomes forcefully wedged between teeth or in the gingiva. It is often caused by factors like uneven tooth wear, missing teeth, or poor restorations. Left untreated, food impaction can lead to inflammation, bone loss, and tooth mobility. Detection involves examining contacts, using dental floss or casts. Management includes nonsurgical treatments like cleaning and occlusal adjustment, as well as restoring proper contacts and replacing missing teeth.
2017 classification of periodontal and periimplant diseasesDr. Bibina George
The document summarizes the key changes in the 2017 classification of periodontal and peri-implant diseases compared to the 1999 classification. The 2017 classification introduces staging and grading systems for periodontitis to indicate disease severity and risk of progression. It also includes classifications for peri-implant health, mucositis, and implantitis, as well as mucogingival deformities. The document reviews these changes and provides references for the revised classification system.
Chronic periodontitis is an inflammatory disease that causes the destruction of tissues that support the teeth. It is caused by an accumulation of plaque and calculus on the teeth over time. It is characterized by pocket formation, attachment loss, and bone loss. Risk factors include smoking, diabetes, and certain bacteria. The disease progresses slowly through periods of destruction and remission. Treatment involves plaque control, scaling and root planing to reduce bacteria and inflammation.
This document discusses trauma from occlusion (TFO). It begins by defining TFO as pathologic alterations or adaptive changes that develop in the periodontium as a result of undue force from chewing muscles. It describes primary TFO resulting from sudden impacts and secondary TFO from gradual changes that occur with reduced bone support. Clinical features include tooth pain and mobility. Radiographic features include widened ligament space and buttressing bone. Treatment focuses on reducing tooth mobility, eliminating prematurities, and using splints. While TFO alone may increase mobility, inflammation is required for attachment loss.
Chronic periodontitis is the most common form of periodontitis and is characterized by microbial biofilm formation, periodontal inflammation, and attachment and bone loss. It is diagnosed based on clinical attachment level assessment and radiographs showing bone loss. Risk factors include local factors like plaque and calculus that retain bacteria, and systemic factors like diabetes which impair the immune response and increase the severity of periodontitis. The condition progresses slowly over time with increased attachment and bone loss with age.
Dentists play an important role in the diagnosis and management of desquamative gingivitis. The importance of being able to recognise and properly diagnose this condition is accentuated by the fact that a serious and life threatening disease may initially manifest as desquamative gingivitis.
Gingival enlargement can result from chronic or acute inflammation, drugs, or systemic conditions. Drug-induced enlargement is common with anticonvulsants like phenytoin and presents as a painless, bead-like enlargement of the papillae that progresses to cover tooth crowns. Histologically, there is pronounced hyperplasia of connective tissue and epithelium. While the enlargement is caused by the drug, secondary inflammation from plaque complicates the condition, adding to the size and producing redness. Approximately 50% of patients on phenytoin experience gingival overgrowth.
Chronic periodontitis is an infectious disease resulting in inflammation within the supporting tissues of the teeth, progressive attachment loss, and bone loss. It is no more a separate entity, as earlier it had Aggressive periodontitis as a differential diagnosis. According to the New Classification from the 2017 World Workshop on Periodontal and Peri- Implant Disease and Conditions, it is now classified further into stages and grades under Periodontitis.
This document discusses different types of necrotizing ulcerative periodontitis including non-AIDS type and AIDS-associated type. It also discusses refractory periodontitis caused by abnormal host response, resistant bacteria, failure to remove plaque, and smoking. Microbial complexes associated with refractory periodontitis include Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia. Treatment involves antimicrobial therapy and local drug delivery. The document also discusses periodontitis caused by systemic diseases that impair neutrophil function such as Papillon-Lefèvre syndrome, Chédiak-Higashi syndrome, and Down syndrome.
2017 classification of periodontal and periimpalnt diseasesPerio Files
In World Workshop 2017, American Academy of Periodontology (AAP) and European Federation of Periodontology (EFP) with expert participants updated the 1999 classification of Periodontal Diseases.
Since 1999, new evidences have emerged regarding environmental and systemic risk factors, prompting the experts to develop new classification.
This document discusses the diagnosis and treatment of aggressive periodontitis. Key points include:
- Aggressive periodontitis is characterized by rapid bone loss and minimal plaque. Microbial testing can identify pathogens like P. gingivalis.
- Treatment involves scaling, root planing, surgery, and adjunctive antibiotics like amoxicillin with metronidazole. Regenerative therapies and local drug delivery aim to regenerate bone and treat pathogens.
- Maintenance therapy through frequent cleanings and home care is important to control the disease long term. Some severe cases may be refractory to standard treatment and require further testing and customized therapies.
This document discusses prognosis in periodontal disease. Prognosis is the prediction of the probable course and outcome of a disease based on knowledge of pathogenesis and risk factors. It is determined before treatment based on disease characteristics and previous experience. Prognosis can be excellent, good, fair, poor, questionable or hopeless depending on factors like bone loss, furcation involvement, and patient compliance. Systemic factors like smoking and diabetes can affect prognosis. Anatomical root characteristics also influence prognosis. The relationship between diagnosis and prognosis is discussed.
Periodontal diseases Classifications and treatmentsRiad Mahmud
Prof. Dr. Md. Zahid Hossain, Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, Najran University, Saudi Arabia.Former Professor of Periodontology, City Dental College, Dhaka
Periodontal abscess is a localised purulent infection in the tissues adjacent to the periodontal pocket that may lead to the destruction of the periodontal ligament and alveolar bone. Periodontal abscess is the third most prevalent emergency infection after acute alveolar abscess and pericoronitis. It could lead to complications due to bacteremia that may cause infection at distant locations. Proper management of the abscess is crucial to alleviate pain, establish drainage and control the spread of infection.
This document provides an overview of chronic periodontitis. It discusses the introduction, history, prevalence, etiology, pathogenesis, clinical features, models of disease progression, microbiological and immunological considerations, and risk factors of chronic periodontitis. Chronic periodontitis is a complex polymicrobial infection that results from an imbalance between pathogenic bacteria in plaque and the host immune response. It begins as plaque-induced gingivitis and progresses to the destruction of connective tissue and alveolar bone through periods of activity and remission, leading to pocket formation and potential tooth loss over time if left untreated. Systemic and environmental risk factors like smoking can increase the risk and rate of disease progression.
This document discusses Necrotizing Ulcerative Gingivitis (NUG), also known as trench mouth. It defines NUG as a microbial disease of the gingiva caused by an impaired host response. Key clinical features include necrosis of gingival tissue and pain. Diagnosis is based on these clinical findings and microscopic examination. Management involves reducing the microbial load, removing necrotic tissue, treating any systemic conditions, and supportive periodontal therapy. Prognosis is generally good with treatment but recurrence is possible without ongoing maintenance of oral hygiene.
This document defines and discusses trauma from occlusion (TFO). It describes the physiologic capacity of the periodontium to adapt to occlusal forces. Factors that can increase traumatic forces include magnitude, direction, and duration of forces. TFO is classified as acute, chronic, primary, secondary, or combined. Clinical features may include mobility, pain, fremitus, and radiographic findings like increased periodontal ligament space. Treatment aims to maintain the periodontium in comfort and function through approaches like occlusal adjustment, parafunctional habit management, stabilization, orthodontics, reconstruction, or extractions.
periodontal management of medically compromised patientsVishal Mishra
This document summarizes periodontal management considerations for various medically compromised patients. It covers cardiovascular diseases, renal diseases, pulmonary diseases, immunosuppression/chemotherapy, radiotherapy, endocrine disorders, and hemorrhagic/blood disorders. For each condition, it discusses precautions, management of dental treatment, and management of medical emergencies that could arise during treatment. The goal is to minimize risk and stress for patients with underlying medical conditions.
This document discusses patterns of bone destruction in periodontal disease. It covers various causes of bone loss such as the extension of gingival inflammation, trauma from occlusion, and systemic disorders. Factors that determine bone destruction include normal bone variation, exostoses, buttressing bone formation, and food impaction. Common bone destruction patterns include horizontal loss, vertical defects, intrabony defects of one to three walls, furcation involvement, osseous craters, and ledges. Systemic conditions like osteoporosis and Paget's disease can also cause alveolar bone destruction.
The document discusses age-related changes in the periodontium and their effects. It notes that with age, the gingival epithelium thins and becomes less keratinized. The gingival connective tissue becomes coarser and denser. The periodontal ligament has fewer fibroblasts and a more irregular structure. Cementum increases in width, especially apically and lingually. The alveolar bone surface becomes more irregular and collagen fiber insertion less regular. Aging may increase the inflammatory response to plaque and the progression of periodontal disease if plaque is not controlled. Response to periodontal treatment can be successful if patients maintain meticulous plaque control and thorough debridement is performed.
This document discusses aggressive periodontitis, a rare and severe form of periodontitis. It is characterized by early onset, rapid progression, and familial aggregation. There are two main types: localized aggressive periodontitis, which mainly affects first molars and incisors, and generalized aggressive periodontitis, which affects at least three teeth across the mouth. Risk factors include certain bacteria like Aggregatibacter actinomycetemcomitans, genetic factors, and immune system abnormalities. The document provides details on the clinical features, causes, and differences between the chronic and aggressive forms of periodontitis.
This document provides information on periodontal management of HIV patients. It discusses the stages of HIV infection and common oral manifestations such as oral candidiasis, oral hairy leukoplakia, Kaposi's sarcoma, and non-Hodgkin's lymphoma. It also covers HIV-related periodontal diseases including linear gingival erythema, necrotizing ulcerative gingivitis, and necrotizing ulcerative periodontitis. Treatment protocols are provided for oral lesions and periodontal diseases seen in HIV patients.
Chronic periodontitis is the most common form of periodontitis, which generally progresses slowly. It is caused by bacterial plaque and influenced by other factors. Symptoms may include bleeding gums, recession, sensitivity, and mobility. It is generally diagnosed in adults and progresses gradually, causing attachment and bone loss. Treatment involves plaque control, scaling, and sometimes surgery. Supportive periodontal therapy is important for long-term maintenance.
Chronic periodontitis is the most common form of periodontitis. It is characterized by a slowly progressing inflammation caused by bacterial plaque. Key features include gingival bleeding, pocket formation, attachment loss, and bone loss. Risk factors that can modify the host response include diabetes, smoking, local factors like calculus that retain plaque, and genetic susceptibility. Chronic periodontitis is usually diagnosed in adults based on clinical signs of bone and attachment loss.
Chronic periodontitis is the most common form of periodontitis and is characterized by microbial biofilm formation, periodontal inflammation, and attachment and bone loss. It is diagnosed based on clinical attachment level assessment and radiographs showing bone loss. Risk factors include local factors like plaque and calculus that retain bacteria, and systemic factors like diabetes which impair the immune response and increase the severity of periodontitis. The condition progresses slowly over time with increased attachment and bone loss with age.
Dentists play an important role in the diagnosis and management of desquamative gingivitis. The importance of being able to recognise and properly diagnose this condition is accentuated by the fact that a serious and life threatening disease may initially manifest as desquamative gingivitis.
Gingival enlargement can result from chronic or acute inflammation, drugs, or systemic conditions. Drug-induced enlargement is common with anticonvulsants like phenytoin and presents as a painless, bead-like enlargement of the papillae that progresses to cover tooth crowns. Histologically, there is pronounced hyperplasia of connective tissue and epithelium. While the enlargement is caused by the drug, secondary inflammation from plaque complicates the condition, adding to the size and producing redness. Approximately 50% of patients on phenytoin experience gingival overgrowth.
Chronic periodontitis is an infectious disease resulting in inflammation within the supporting tissues of the teeth, progressive attachment loss, and bone loss. It is no more a separate entity, as earlier it had Aggressive periodontitis as a differential diagnosis. According to the New Classification from the 2017 World Workshop on Periodontal and Peri- Implant Disease and Conditions, it is now classified further into stages and grades under Periodontitis.
This document discusses different types of necrotizing ulcerative periodontitis including non-AIDS type and AIDS-associated type. It also discusses refractory periodontitis caused by abnormal host response, resistant bacteria, failure to remove plaque, and smoking. Microbial complexes associated with refractory periodontitis include Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia. Treatment involves antimicrobial therapy and local drug delivery. The document also discusses periodontitis caused by systemic diseases that impair neutrophil function such as Papillon-Lefèvre syndrome, Chédiak-Higashi syndrome, and Down syndrome.
2017 classification of periodontal and periimpalnt diseasesPerio Files
In World Workshop 2017, American Academy of Periodontology (AAP) and European Federation of Periodontology (EFP) with expert participants updated the 1999 classification of Periodontal Diseases.
Since 1999, new evidences have emerged regarding environmental and systemic risk factors, prompting the experts to develop new classification.
This document discusses the diagnosis and treatment of aggressive periodontitis. Key points include:
- Aggressive periodontitis is characterized by rapid bone loss and minimal plaque. Microbial testing can identify pathogens like P. gingivalis.
- Treatment involves scaling, root planing, surgery, and adjunctive antibiotics like amoxicillin with metronidazole. Regenerative therapies and local drug delivery aim to regenerate bone and treat pathogens.
- Maintenance therapy through frequent cleanings and home care is important to control the disease long term. Some severe cases may be refractory to standard treatment and require further testing and customized therapies.
This document discusses prognosis in periodontal disease. Prognosis is the prediction of the probable course and outcome of a disease based on knowledge of pathogenesis and risk factors. It is determined before treatment based on disease characteristics and previous experience. Prognosis can be excellent, good, fair, poor, questionable or hopeless depending on factors like bone loss, furcation involvement, and patient compliance. Systemic factors like smoking and diabetes can affect prognosis. Anatomical root characteristics also influence prognosis. The relationship between diagnosis and prognosis is discussed.
Periodontal diseases Classifications and treatmentsRiad Mahmud
Prof. Dr. Md. Zahid Hossain, Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, Najran University, Saudi Arabia.Former Professor of Periodontology, City Dental College, Dhaka
Periodontal abscess is a localised purulent infection in the tissues adjacent to the periodontal pocket that may lead to the destruction of the periodontal ligament and alveolar bone. Periodontal abscess is the third most prevalent emergency infection after acute alveolar abscess and pericoronitis. It could lead to complications due to bacteremia that may cause infection at distant locations. Proper management of the abscess is crucial to alleviate pain, establish drainage and control the spread of infection.
This document provides an overview of chronic periodontitis. It discusses the introduction, history, prevalence, etiology, pathogenesis, clinical features, models of disease progression, microbiological and immunological considerations, and risk factors of chronic periodontitis. Chronic periodontitis is a complex polymicrobial infection that results from an imbalance between pathogenic bacteria in plaque and the host immune response. It begins as plaque-induced gingivitis and progresses to the destruction of connective tissue and alveolar bone through periods of activity and remission, leading to pocket formation and potential tooth loss over time if left untreated. Systemic and environmental risk factors like smoking can increase the risk and rate of disease progression.
This document discusses Necrotizing Ulcerative Gingivitis (NUG), also known as trench mouth. It defines NUG as a microbial disease of the gingiva caused by an impaired host response. Key clinical features include necrosis of gingival tissue and pain. Diagnosis is based on these clinical findings and microscopic examination. Management involves reducing the microbial load, removing necrotic tissue, treating any systemic conditions, and supportive periodontal therapy. Prognosis is generally good with treatment but recurrence is possible without ongoing maintenance of oral hygiene.
This document defines and discusses trauma from occlusion (TFO). It describes the physiologic capacity of the periodontium to adapt to occlusal forces. Factors that can increase traumatic forces include magnitude, direction, and duration of forces. TFO is classified as acute, chronic, primary, secondary, or combined. Clinical features may include mobility, pain, fremitus, and radiographic findings like increased periodontal ligament space. Treatment aims to maintain the periodontium in comfort and function through approaches like occlusal adjustment, parafunctional habit management, stabilization, orthodontics, reconstruction, or extractions.
periodontal management of medically compromised patientsVishal Mishra
This document summarizes periodontal management considerations for various medically compromised patients. It covers cardiovascular diseases, renal diseases, pulmonary diseases, immunosuppression/chemotherapy, radiotherapy, endocrine disorders, and hemorrhagic/blood disorders. For each condition, it discusses precautions, management of dental treatment, and management of medical emergencies that could arise during treatment. The goal is to minimize risk and stress for patients with underlying medical conditions.
This document discusses patterns of bone destruction in periodontal disease. It covers various causes of bone loss such as the extension of gingival inflammation, trauma from occlusion, and systemic disorders. Factors that determine bone destruction include normal bone variation, exostoses, buttressing bone formation, and food impaction. Common bone destruction patterns include horizontal loss, vertical defects, intrabony defects of one to three walls, furcation involvement, osseous craters, and ledges. Systemic conditions like osteoporosis and Paget's disease can also cause alveolar bone destruction.
The document discusses age-related changes in the periodontium and their effects. It notes that with age, the gingival epithelium thins and becomes less keratinized. The gingival connective tissue becomes coarser and denser. The periodontal ligament has fewer fibroblasts and a more irregular structure. Cementum increases in width, especially apically and lingually. The alveolar bone surface becomes more irregular and collagen fiber insertion less regular. Aging may increase the inflammatory response to plaque and the progression of periodontal disease if plaque is not controlled. Response to periodontal treatment can be successful if patients maintain meticulous plaque control and thorough debridement is performed.
This document discusses aggressive periodontitis, a rare and severe form of periodontitis. It is characterized by early onset, rapid progression, and familial aggregation. There are two main types: localized aggressive periodontitis, which mainly affects first molars and incisors, and generalized aggressive periodontitis, which affects at least three teeth across the mouth. Risk factors include certain bacteria like Aggregatibacter actinomycetemcomitans, genetic factors, and immune system abnormalities. The document provides details on the clinical features, causes, and differences between the chronic and aggressive forms of periodontitis.
This document provides information on periodontal management of HIV patients. It discusses the stages of HIV infection and common oral manifestations such as oral candidiasis, oral hairy leukoplakia, Kaposi's sarcoma, and non-Hodgkin's lymphoma. It also covers HIV-related periodontal diseases including linear gingival erythema, necrotizing ulcerative gingivitis, and necrotizing ulcerative periodontitis. Treatment protocols are provided for oral lesions and periodontal diseases seen in HIV patients.
Chronic periodontitis is the most common form of periodontitis, which generally progresses slowly. It is caused by bacterial plaque and influenced by other factors. Symptoms may include bleeding gums, recession, sensitivity, and mobility. It is generally diagnosed in adults and progresses gradually, causing attachment and bone loss. Treatment involves plaque control, scaling, and sometimes surgery. Supportive periodontal therapy is important for long-term maintenance.
Chronic periodontitis is the most common form of periodontitis. It is characterized by a slowly progressing inflammation caused by bacterial plaque. Key features include gingival bleeding, pocket formation, attachment loss, and bone loss. Risk factors that can modify the host response include diabetes, smoking, local factors like calculus that retain plaque, and genetic susceptibility. Chronic periodontitis is usually diagnosed in adults based on clinical signs of bone and attachment loss.
Chronic periodontitis is an infectious disease resulting in inflammation with in supporting tissues of the teeth, progressive attachment loss and bone loss. With all emerging technologies, a successful diagnosis and treatment will only be achieved through open sharing of ideas, research findings and thorough testing .
The document provides an overview of chronic periodontitis, including its definition, classification, etiology, clinical features, disease progression, risk factors, diagnosis, and treatment. It discusses how chronic periodontitis is caused by an inflammatory response to bacterial plaque biofilm and is influenced by both local and systemic risk factors. Key points include that it is a slowly progressive disease involving loss of attachment and bone, and that risk is increased by factors like smoking, diabetes, genetic predispositions, and a prior history of periodontitis.
Chronic periodontitis is an inflammatory disease that causes the destruction of the tissues that support the teeth. It is caused by bacterial plaque accumulating at and below the gumline. It is characterized by pocket formation, attachment loss, and bone loss. The disease progresses slowly over time and is generally classified as slight, moderate, or severe depending on the amount of attachment loss. A clinical diagnosis involves measuring pocket depths and looking for signs of inflammation, recession, and bone loss. Radiographs can also help assess bone level changes over time. Risk factors include poor oral hygiene, smoking, diabetes, and genetic factors. Treatment involves nonsurgical debridement or surgical procedures to reduce pockets and regenerate lost tissues.
Chronic periodontitis is an inflammatory disease that causes the destruction of the tissues that support the teeth. It is caused by bacterial plaque accumulating at and below the gumline. The disease is characterized by pocket formation, attachment loss, and bone loss. It is usually slowly progressive and can range from mild to severe. Diagnosis involves measuring pocket depths, attachment levels, bleeding, and bone loss visible on radiographs. Risk factors include poor oral hygiene, smoking, diabetes, and genetic factors. Treatment aims to eliminate plaque and bacteria through nonsurgical methods like scaling and root planing or sometimes surgical procedures to reduce pocket depths and regenerate lost tissues.
Chronic periodontitis is the most common form of periodontitis, characterized by a slowly progressive inflammation and destruction of the tissues surrounding the teeth. It is caused by an excessive host response to bacterial plaque accumulated at and below the gumline. Symptoms include bleeding gums, deepening pockets between teeth, and loose or mobile teeth. The disease progresses gradually over time as plaque accumulates. Risk factors include a prior history of periodontitis, poor plaque control, diabetes, smoking, stress, and certain genetic factors.
This document provides an overview of chronic periodontitis. It defines chronic periodontitis as an infectious disease resulting in inflammation within the supporting tissues of the teeth, progressive attachment loss, and bone loss. It is most commonly seen in adults and has a slow to moderate rate of progression. Risk factors include poor oral hygiene, smoking, systemic diseases like diabetes, and genetic factors. The microbiology involves an increase in gram-negative bacteria like Porphyromonas gingivalis. Diagnosis is based on clinical signs of inflammation, pocket formation, attachment and bone loss, and radiographic evidence of bone destruction.
Periodontitis is a chronic, slowly progressing disease which mainly results in the destruction of tooth supporting apparatus. Earlier it was classified as Chronic and Aggressive periodontitis with different clinical features and etiology. Current classification ( 2017) of periodontal disease involves periodontitis with is further divided into 4 stages and 3 grades depending on severity and rate of disease progression respectively. Diabetes meelitus and smoking are the validated risk factors for the progression of periodontitis.
Chronic periodontitis is an infectious disease that results in inflammation of the gums and bones supporting the teeth. It is characterized by progressive gum attachment loss and bone loss over time. Symptoms include bleeding gums, spaces opening between teeth, and occasional pain. Risk factors include poor oral hygiene, smoking, diabetes, and genetic factors. Treatment involves nonsurgical approaches like deep cleaning below the gumline to remove bacterial plaque and tartar, followed by surgical procedures if needed. Regular maintenance care is important to prevent further progression of the disease.
Chronic periodontitis is a bacterial infection that causes inflammation within the tissues supporting the teeth and leads to progressive bone and attachment loss. It is characterized by biofilm formation, periodontal inflammation, and attachment/bone loss. While usually slow-progressing, it can occur at different ages and have intermittent active destructive periods followed by inactive periods. Key microbial pathogens associated with chronic periodontitis include Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Aggregatibacter actinomycetemcomitans. Periodontitis progression may be influenced by systemic and environmental factors like smoking and diabetes.
Localized aggressive periodontitis (LAP) and generalized aggressive periodontitis (GAP) are rare, severe forms of periodontitis that primarily affect younger individuals. LAP is characterized by localized periodontal destruction limited to first molars and incisors, while GAP affects at least three permanent teeth. Both forms have a familial pattern and rapid progression of attachment and bone loss. The main pathogens associated with LAP and GAP are Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis, respectively. Patients generally present with deep pockets and bone loss disproportionate to plaque levels.
odontogenic inflammatory disease of the jaw. chronic periodontitis and apical...SagharMousavi1
Odontogenic inflammatory diseases refer to infections or inflammatory processes originating from the teeth and surrounding structures. Common examples include pulpitis, periapical abscess, and chronic periodontitis. These conditions pose a significant global burden and can impact quality of life through pain, impaired function, and tooth loss. Risk factors include poor oral hygiene, smoking, and systemic diseases. Treatment may involve nonsurgical approaches like scaling and root planing or surgical options such as apical surgery to address advanced or persistent cases.
Chronic periodontitis is a slowly progressing infectious disease resulting in inflammation of the supporting tissues of the teeth and progressive bone and attachment loss. It is caused by bacterial plaque accumulation at the gumline. Key characteristics include site-specific or generalized bone and attachment loss, commensurate with plaque levels and modified by systemic and environmental risk factors like smoking and diabetes. The disease progresses in an episodic, intermittent manner with periods of rapid tissue destruction. Risk factors include prior history of periodontitis, specific pathogenic bacteria like P. gingivalis, local factors like calculus, and environmental factors like smoking which impair the host response.
Chronic periodontitis is an infectious disease that results in inflammation of the tissues supporting the teeth and progressive bone and attachment loss. It is caused mainly by plaque and can be localized, affecting less than 30% of sites, or generalized, affecting more than 30% of sites. Risk factors include diabetes, smoking, poor oral hygiene, and a genetic predisposition. Symptoms include bleeding gums, loose teeth, and pain. Diagnosis is based on clinical signs of inflammation, pocket formation, attachment and bone loss seen during examination and on radiographs.
This document provides an overview of aggressive periodontitis. It begins with definitions and historical background. It then discusses the pathobiology and risk factors, classification, clinical characteristics, diagnosis, and management. Aggressive periodontitis is defined as a severe, rapidly progressive form of periodontitis that primarily affects young patients. It can be localized or generalized. Diagnosis involves assessing features like early age of onset, pattern of bone loss, and lack of systemic factors. Management includes non-surgical therapies like antimicrobials, surgical therapies like bone grafting and guided tissue regeneration, and emphasis on plaque control.
Periodontal diseases iii / dental implant courses by Indian dental academy Indian dental academy
The document defines and describes key periodontal diseases: Chronic Periodontitis, Aggressive Periodontitis, and Necrotizing Ulcerative Periodontitis. Chronic Periodontitis is the most common form and involves plaque-induced inflammation that causes progressive bone and attachment loss. Aggressive Periodontitis affects otherwise healthy individuals and causes rapid destruction, while Necrotizing Ulcerative Periodontitis involves necrosis, ulceration and pain between teeth with potential systemic involvement. The document provides details on etiology, clinical features, classifications and prevalence for each disease.
This document discusses gingivitis and periodontal disease. It defines gingivitis as inflammation of the gums that does not affect the underlying tooth structures. Periodontitis is defined as inflammation that extends below the gumline and can cause bone and tissue loss. The document outlines the signs and symptoms, causes, and types of both gingivitis and periodontitis.
Can coffee help me lose weight? Yes, 25,422 users in the USA use it for that ...nirahealhty
The South Beach Coffee Java Diet is a variation of the popular South Beach Diet, which was developed by cardiologist Dr. Arthur Agatston. The original South Beach Diet focuses on consuming lean proteins, healthy fats, and low-glycemic index carbohydrates. The South Beach Coffee Java Diet adds the element of coffee, specifically caffeine, to enhance weight loss and improve energy levels.
R3 Stem Cell Therapy: A New Hope for Women with Ovarian FailureR3 Stem Cell
Discover the groundbreaking advancements in stem cell therapy by R3 Stem Cell, offering new hope for women with ovarian failure. This innovative treatment aims to restore ovarian function, improve fertility, and enhance overall well-being, revolutionizing reproductive health for women worldwide.
Exploring the Benefits of Binaural Hearing: Why Two Hearing Aids Are Better T...Ear Solutions (ESPL)
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2. INDEX
1. Introduction
2. History
3. Definition
4. Classification
5. Prevalence
6. Risk factors
7. Major clinical and etiological features
8. Clinical features
4. INTRODUCTION
● Chronic periodontitis, formerly known as “adult
periodontitis” or “chronic adult periodontitis”, is the most
prevalent form of periodontitis.
● It is generally considered as a slow progressing disease.
5. INTRODUCTION
● Chronic periodontitis is considered to start as plaque-
induced gingivitis, a reversible condition that, left
untreated, may develop into chronic periodontitis.
● Chronic periodontitis lesions include loss of attachment
and bone and are regarded as irreversible.
6. INTRODUCTION
● Chronic periodontitis occurs most frequently in adults.
● It may also be diagnosed in children and adolescents
when associated with chronic plaque and calculus
accumulation.
● Therefore, it should be understood as age-associated, but
not age-dependent, complex chronic inflammation of the
periodontal tissues.
8. 1989
-Early onset periodontitis
A. Prepubertal
~Generalized
~Localized
A. Juvenile
~Generalized
~Localized
-Adult periodontitis
-Necrotising ulcerative
-Refractory periodontitis
-Periodontitis associated with
systemic disease
By AAP
1999
-Chronic periodontitis
~Generalized
~Localized
-Aggressive periodontitis
~Generalized
~Localized
-Periodontitis as manifestation of
systemic disease
By AAP
9. DEFINITION
By Carranza 10th ed;
Chronic periodontitis is defined as “an
infectious disease resulting in inflammation
within the supporting tissues of the teeth,
progressive attachment loss, and bone loss.”
10. CLASSIFICATION
● BASED ON DISEASE DISTRIBUTION:
1) Localized chronic periodontitis:
meaning that less than 30% of the teeth show
attachment and bone loss
1) Generalized chronic periodontitis:
meaning that 30% or more of the teeth show
attachment and bone loss
11. CLASSIFICATION
● BASED ON DISEASE SEVERITY:
1. Slight (mild) periodontitis:
Periodontal destruction no more than 1-2 mm of CAL.
1. Moderate periodontitis:
Periodontal destruction - 3-4 mm of CAL.
1. Severe periodontitis:
Periodontal destruction - more than 5mm of CAL.
12. PREVALENCE
Effects both gender equally
Prevalence increases with age
(From 11% to 30% of patients develop severe
periodontitis at the age of 40 years or older.)
The worldwide prevalence for severe chronic
periodontitis is estimated at 10.5% to 12% of
the world's population
13. RISK FACTORS
01 02
03
04
05
06
Prior history of
periodontitis Local factors
Systemic factors
Environmental and
Behavioural factors
Immunologic
factors
Genetic factors
14. 1. Prior history of periodontitis:
● Previous history of periodontitis enhances risk of further
loss of tooth attachment and bone destruction due to
bacterial plaque accumulation
● Though it is not a true risk factor for disease development
but acts as a disease predictor.
15. 2. Local factors:
● These include plaque and plaque retentive factors.
● Plaque attached to the tooth and gingival surfaces at the
dentogingival junction is considered to be the primary
etiologic factor in chronic periodontitis.
● Porphyromonas gingivalis, Tannerella forsythia and
Treponema denticola (red complex microorganism )are
frequently associated with chronic periodontitis.
16. 2. Local factors:
● Plaque retentive factors are those that facilitate plaque
accumulation or prevent the removal of plaque by routine
oral hygiene procedures.
● They allow plaque microorganisms to be in close
proximity to periodontal tissues.
● Some of these factors include ;
- Calculus
17. - Subgingival and/or overhanging
margins of restoration
- Deep carious lesions that extend
subgingivally
- Crowded or malaligned teeth
- Root surface irregularities
18. 3. Systemic factors:
● The rate of progression of plaque-induced chronic
periodontitis is generally considered to be slow.
● However, when chronic periodontitis occurs in a patient
who also suffers from a systemic disease that influences
the host response, the rate of periodontal destruction may
be significantly increased.
19. 3. Systemic factors:
● Diabetes mostly type II, a non-insulin dependent diabetes
mellitus can increase the severity and extent of
periodontal disease.
20. 4. Environmental and behavioural
factors:
● It is not only the risk of developing the disease that is
enhanced by smoking, but also the response to
periodontal therapy is impaired in smokers. Also, clinical
features of both gingivitis and chronic periodontitis such
as gingival redness and bleeding on probing get obscured
due to dampening of inflammation.
21. 4. Environmental and behavioural
factors:
● Stress and other psychosomatic conditions induce direct
anti-inflammatory, anti-immune effects and behavior-
mediated effects on the body’s defenses.
22. 5. Immunologic factors:
● Chronic periodontitis is a disease induced by bacteria
organized in the dental biofilm. Onset, progression, and
severity of the disease depend, however, on the
individual host immune response.
● Patients may show alterations of peripheral monocytes,
which relate to reduced reactivity of lymphocytes or
enhanced B-cell response.
23. 5. Immunologic factors:
● Periodontal ligament cells, gingival fibroblasts, and
epithelial cells synthesize proinflammatory mediators—
such as IL-1α, IL-1β, IL-6, IL-8, PGE2, TNF-α- and many
others— modify innate and adaptive immune responses
at periodontal sites.
24. 5. Immunologic factors:
● Increased activity of MMPs and RANKL promotes bone
degradation.
● Reduced counts in neutrophils influence the degree of
periodontal inflammation.
25. 6. Genetic factor:
● Genetic basis for periodontal disease in recent studies that
have demonstrated periodontal destruction among the
family members and different generations within a family.
● Recent data indicate that a genetic variation or
polymorphism in the genes encoding IL-1α and IL-1β is
associated with increased susceptibility to more
aggressive form of chronic periodontitis.
26. MAJOR CLINICAL AND ETIOLOGIC
FEATURES
2. Periodontal
inflammation
3. Loss of
attachment and
alveolar bone
1. Microbial plaque
formation
27. CLINICAL FEATURES
● Supra and subgingival plaque accumulation
● Gingival inflammation
● Pocket formation
● Loss of periodontal attachment
● Occasional suppuration
● Poor oral hygiene- gingiva
typically may be slightly to moderately swollen
28. ● Color - pale red to magenta
● Consistency - soft or firm
● Surface topography - loss of stippling
● Blunted to rolled gingival margin
● Flattened or cratered papillae
● Furcation involvement
● Tooth mobility
● Pocket depths are variable and both suprabony and
infrabony pockets can be found.
29. CLINICAL FEATURES
Attachment loss with or without deep periodontal pocket
Pocket depth are variable and both horizontal and vertical
bone loss can occur
31. SYMPTOMS
●Bleeding gums during brushing or eating.
●Increasing spacing between teeth as a result of tooth
movement.
●Loose teeth
●Usually painless, but sometimes localized dull pain
radiating deep into the jaw
●Sensitivity to heat, cold or both due to exposed roots
●Food impaction
33. DISEASE PROGRESSION
● The progression rate of chronic periodontitis is slow.
● Onset and the rate of disease progression, however,
may be influenced by a number of modifiable (e.g.,
smoking, diet) and nonmodifiable (e.g., genetic
disorders) factors.
● The progression pattern does not show equal degrees
of attachment loss on each affected site over time.
34. DISEASE PROGRESSION
● More rapidly progressive lesions occur at :
1. Interproximal areas
2. Areas of greater plaque accumulation
3. Inaccessibility to plaque control measures (eg furcation
areas, overhanging margins, sites of malposed teeth ,
or areas of food impaction)
35. DISEASE PROGRESSION
The different models have been proposed to describe
the rate of disease progression and determine the
degree of attachment loss over time :
1. The Continuous Model (SOCRANSKY et al 1984)
2. The Random or Episodic-burst Model
3. The Asynchronous, Multiple-burst Model
36. THE
CONTINUOUS
MODEL
• Describes slow and continuous
disease progression
• Suggests that sites exhibit a constant
progression rate of attachment loss
throughout the duration of the disease
37. THE
RANDOM OR
EPISODIC
BURST
MODEL:
• Describes the episodic occurrence of
short progressive bursts of periodontal
destruction followed by periods of
stagnation
• Sites, teeth, and the chronology of
bursts and stagnation are subject to
random effects
38. THE
ASYNCHRONOUS,
MULTIPLE BURST
MODEL:
• Describes the occurrence of
periodontal destruction (bursts) during
defined periods, which are
asynchronously interrupted by periods
of stagnation or remission for individual
sites and teeth
39. DISEASE DISTRIBUTION
● Chronic periodontitis is a site- specific disease.
● Periodontal pocket formation, attachment, and bone
loss may develop on one or more sites of a tooth,
while other sites remain at a physiologic attachment
level.( i.e. it may occur on one surface and other may
be free of symptom)
40. Localized chronic
periodontitis( < 30% of
sites affected)
DISEASE DISTRIBUTION
On basis of the site- specific nature and number of
teeth with clinical attachment loss :
Generalized chronic
periodontitis( ≥ 30% of
sites affected)
41. PATTERNS OF BONE LOSS
1. When attachment and
bone loss on one tooth
surface is greater than
that on adjacent
surface.
2. Associated with angular
bony defects and
infrabony pocket
formation.
1. When attachment and
bone loss proceeds at
uniform rate on the
majority of tooth
surfaces.
2. Associated with
suprabony pockets.
VERTICAL HORIZONTAL
45. DIAGNOSIS
Clinically diagnosed as:
● Detection of chronic inflammatory changes in the
marginal gingiva
● Presence of periodontal pockets
● Loss of clinical attachment
Radiographically as:
● Evidence of bone loss
46. DIAGNOSIS
A differential diagnosis is based on :
1. Age of patient
2. Rate of progression over time
3. Familial nature of aggressive disease
4. Relative absence of local factors in aggressive disease
47. RADIOGRAPHIC FEATURES
Widening of PDL space
Loss of corticated interdental crestal margin
Localised or generalized loss of alveolar crest due to
beginning of bone resorption
Blunting of alveolar crest due to beginning of bone resorption
Bone loss may be either horizontal or vertical
49. MANAGEMENT
Chronic periodontitis can be treated effectively by a
systematic periodontal therapy that includes:
1. Optimal long-term plaque control
2. Debridement of soft and hard deposits
3. Surgical pocket reduction (case-dependently either
resective osseous surgery or regenerative surgery)
51. MANAGEMENT
Depending on the individual periodontal risk, each patient
should be remotivated, reinstructed, and retreated (if
necessary) during a systematic supportive periodontal
therapy regimen (revisits every 3, 6, or 12 months)
52. CONCLUSION
● Chronic periodontitis is an infectious inflammatory
disease of the tooth supporting apparatus with
progressive attachment loss and loss of alveolar bone.
● The effective management of periodontal disease in
clinical practice presents with many challenges and
cannot be completely cured, hence, must be controlled in
order to stabilise the progression of this destructive
process in long-term.
53. REFERENCES
Carranza’s Clinical Periodontology (10th ed)
Newman and Carranza’s Clinical Periodontology (13th ed)
Periobasics : A textbook of periodontology and
implantology (2nd ed)
Clinical Periodontology and Implant Dentistry
(Jan Lindhe - 5th ed)