Chronic periodontitis is an infectious disease that causes inflammation of the tissues supporting the teeth and progressive bone and attachment loss. It typically affects people aged 30-35 and causes variable pocket depths and bone loss patterns, including horizontal and vertical loss. Symptoms may include pain, sensitivity, and food impaction. Risk factors include poor oral hygiene, smoking, diabetes, and genetic factors. Treatment involves improving oral hygiene, nonsurgical therapies like scaling and root planing, and sometimes surgery.

1. DEPARTMENT OFPERIODONTICS

2. Presented by
SHRISH VISHWAKARMA
B.D.S FINAL YEAR SUPPL. BATCH
ROLL NO 20

3.  INTRODUCTION
 DEFINITION
 CLINICAL FEATURE
 RADIOGRAPHIC FEATURE
 TYPES
 SYMPTOMS
 DISEASE PROGRESSION
 RISK FACTORS OF DISEASE
 TREATMENT
 CONCLUSION
 REFERENCES

4.  Chronic Periodontitis was previously known as adult
periodontitis or slowly progressive periodontitis .

5.  CHRONIC PERIODONTITIS defined as an infectious
disease resulting in inflammation within the supporting
tissues of the teeth , progressive attachment loss &
bone loss.

6.  Age of onset is usually 30 to 35 years
 The disease is usually generalized although
some area are more deeply involved than the
other areas .
 No consistent pattern of distribution of lesion
is seen except that they are usually not
isolated to one or two sites .
 Highly acute inflammatory sites are not seen
seen mostly gingiva appear to be slight to
moderately swollen & colour may be seen .

7.  Loss of stippling blunt or rolled gingival
margin and flattened or cratered papillae may
be seen .
 Spontaneous bleeding & inflammation related
exudate from pockets may also be found .

8.  When the pocket occludes it may result in
abscess formation .
 Pocket depths are variable & both suprabony
& infrabony pockets can be found .
 Conditions that enchance plaque
accumutation like open interdental contacts
defective restoration margins and malposed
teeth may be frequently seen .
 The amount of microbial deposits are
consistent with severity of the disease
 Tooth mobility is seen in advanced cases .
 No serum neutrophil / monocyte
abnormalities are seen .

9.  Pattern of bone loss observed in chronic periodontitis
may be vertical or horizontal . When attachment loss
& bone loss on one tooth surface is referred to as
vertical bone loss and is usually associated with
angular bony defects and infrabony pocket . When
attachment loss & bone loss occur at a uniform rate
on majority of tooth surfaces it is called horizontal
bone loss & is generally associated with suprabony
pockets .

11.  Types are based on the following
DISEASE DISTRIBUTION
(a) LOCALIZED PERIODONTITIS :
Periodontits is considered localized when < 30% of
sites assessed in the mouth demonsrate attachment
loss & bone loss .
( b) GENERALIZED PERIODONTITIS :
Periodontitis is considered generalized when > 30%
of the sites assesed in the mouth demonstrate
attachment loss & bone loss .

12. DISEASE SEVERITY
( a ) SLIGHT ( MILD ) PERIODONTITIS :
Periodontal destruction I generally considered slight
when no more than 1 to 2 mm of clinical attachment
loss has occerred .
( b) MODERATE PERIODONTITIS :
Periodontal destruction is generally considered
moderate when 3 to 4 mm of clincal attachment loss
has occurred .
( C) SEVERE PERIODONTITIS :
Periodontal destruction is considered severe when 5mm
or more of clinical attachment loss has occurred .

13.  Painless
 Sensitivity to hot & cold
 Localized pain radiating into jaw
 Impaction areas of food cause discomfort
 Itchiness in the gingiva

14.  The rate of disease progression is usually slow but
may be modified by systemic & / or environmental &
behavioral factors .
However , because of its slow rate of progression ,
chronic periodontitis usually becomes clinically
significant in the mild 30s or later .
Chronic periodontitis does not progress at an equal
rate in all affected sites throghout the mouth . More
rapidly progressive lesion occur -
( i) Interproximal areas
( ii) Area of greater plaque accumulation
( iii) Inaccessibilty to plaque control mesures .

15. The factor that increases the susceptibilty of disease are
( i) LOCAL FACTOR – Plaque & calculus
accumutation , subgingival restoration , crowded teeth .
Plaque retentive factor : calculus

16. Overhanging
restorations

17.  (II) SYSTEMIC FACTORS - diseases such as
diabetes .
 ( III) ENVIRONMENTAL & BEHAVIORAL
FACTORS - Smoking
 (IV) GENETIC FACTORS - Family history

18.  Improving of the oral hygiene
 Curettage
 Pocket therapy
 Scaling and root planing

19.  Chronic periodontitis an infectious disease resulting in
inflammation with in supporting tissues of the teeth ,
progressive attachment loss & bone loss.

20.  Carranza clinical periodontology 9th edition
 Essential of clinical periodontology &
periodontics ( third edition ) Shantipriya
Reddy