The document categorizes and describes various types of periodontal diseases including:
- Chronic periodontitis, which is common in adults and progresses slowly, and can be localized or generalized.
- Aggressive periodontitis, which affects younger individuals and progresses rapidly. It can be localized or generalized.
- Periodontitis as a manifestation of systemic diseases such as hematological or genetic disorders.
- Developmental or acquired deformities and conditions that can modify or predispose individuals to plaque-induced gingivitis or periodontitis.
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.
In periodontology, classifications are widely used to categorize defects due to periodontitis according to their etiology, diagnosis, treatment and prognosis.
Several classifications have been proposed in the literature in order to facilitate the diagnosis of gingival recessions.
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.
In periodontology, classifications are widely used to categorize defects due to periodontitis according to their etiology, diagnosis, treatment and prognosis.
Several classifications have been proposed in the literature in order to facilitate the diagnosis of gingival recessions.
Federación Odontológica del Perú
IX Jornada Anual
Auditorio del Colegio Odontológico del Perù
Conferencia: Abscesos Periodontales
Prof. Dr. Ricardo Benza Bedoya
Dr. Eirini Georgiou from PerioExperts.
Periodontal disease refers to the periodontal tissues that surround, bind and support the teeth into their socket. These tissues are the gums, the jaw bone, the cementum of the root and the periodontal ligament. In healthy circumstances the gums are light pink, do not bleed and are firmly attached to the tooth, like a nice frame around a picture painting.
Periodontal disease can affect all people regardless age, but as age progresses the incidence of infection increases. It is estimated that in US 80% of people over 45 years old suffer from periodontal disease. Although periodontal disease is nowadays the main cause of tooth loss in adults, early diagnosis and preventive therapy, provide effective treatment.
Recently, periodontal disease is associated with the onset of cardiovascular problems, diabetes melitus, or premature birth and underweight babies, and morbid obesity. Therefore, the preservation and restoration of periodontal health is directly related to the conservation and restoration of general health.
EPIDEMIOLOGY OF PERIODONTAL DISEASES 1.pptxDrLasya
INTRODUCTION
• Gingival and periodontal diseases in their various forms have affected humans since the dawn of the history.
• Studies in paleopathology have indicated that destructive periodontal disease, as evidenced by bone loss, affected early humans in such diverse cultures as ancient Egypt and pre-columbian America.
• Epidemiologic studies identify risk factors for diseases and provide guidance for primary prevention, recommendations and identify where to intervene in disease process.
PERIODONTAL DISEASES
GINGIVITIS
• Inflammation of the gingival soft tissues with no loss of alveolar bone or apical migration of periodontal ligament along root surface.
• It may be characterized by edema, erythema, bleeding, and occasionally pain.
• Gingivitis is usually reversible with appropriate therapy.
PERIODONTITIS
• An inflammatory disease of the supporting tissues of the teeth caused by specific microorganisms or groups of specific microorganisms, resulting in progressive destruction of the periodontal ligament and alveolar bone with pocket formation, recession, or both.
• The clinical feature that distinguishes periodontitis from gingivitis is the Loss of clinical attachment
CLASSIFICATION OF PERIODONTAL DISEASES
CHRONIC PERIODONTITIS
• The most common form of periodontitis
• Most prevalent in adults but can occur in children
• Amount of destruction consistent with local factors
• Associated with a variable microbial pattern
• Associated with accumulations of plaque and calculus
• Slow to moderate rate of progression with possible periods of rapid progression
• Localized form: < 30% of sites involved
• Generalized form: > 30% of sites involved
• Slight: 1 to 2mm CAL (clinical attachment loss)
• Moderate: 3 to 4 mm CAL
• Severe: 5mm or greater CAL
AGGRESSIVE PERIODONTITIS
• Rapid attachment loss and bone destruction
• Amount of microbial deposits inconsistent with disease severity
• Familial aggregation of diseased individuals
• Generally diseased sites are infected with a specific bacteria (Actinobacillus actinomycetemcomitans)
• Abnormalities in phagocyte function
• Hyper-responsive macrophages, producing elevated PGE2 and IL1B
• Disease progression may be self-limiting
• It is of two types- localized and generalized
LOCALIZED AGGRESSIVE PERIODONTITIS
• Circumpubertal onset of disease
• Localized first molar/ incisor
• Interproximal attachment loss on at least two permanent teeth
• Robust serum antibody response to infecting agents
GENERALIZED AGGRESSIVE PERIODONTITIS
• Usually affecting persons under 30 years of age (however, may be older)
• Generalized interproximal attachment loss affecting at least three teeth other than first molars and incisors
• Pronounced episodic nature of destruction
• Poor antibody response to infecting agents
Periodontitis as a manifestation of Systemic disease
Hematologic disorders
A) Acquired neutropenia
B) Leukemias
Genetic disorders
A) Familial & cyclic neutropenia
B) Down’s syndrome
c) Papillon-Lefevre syndrome
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classification of periodontal diseases
1.
2. • Gingival Diseases
– Dental plaque-induced gingival diseases
– Non-plaque induced gingival lesions
• Chronic Periodontitis
– Localized
– Generalized (>30% of sites are involved)
• Aggressive Periodontitis
– Localized
– Generalized (>30% of sites are involved)
3. • Periodontitis as a Manifestation of Systemic
Diseases
– Associated with hematological disorders
– Associated with genetic disorders
• Necrotizing Periodontal Diseases
– Necrotizing ulcerative gingivitis
– Necrotizing ulcerative periodontitis
• Abscesses of the Periodontium
– Gingival abscess
– Periodontal abscess
– Pericoronal abscess
4. • Periodontitis Associated with Endodontic
Lesions
– Combined periodontic-endodontic lesions
• Developmental or Acquired Deformities and
Conditions
– Localized tooth-related factors that modify or predispose to
plaque-induced gingival diseases periodontitis
– Mucogingival deformities and conditions around teeth
– Mucogingival deformities and conditions on edentulous
ridges
– Occlusal trauma
5. Dental plaque-induced gingival diseases
1 Gingivitis associated with dental plaque
only
a) Without other local contributing factors
b) With local contributing factors
6. 2. Gingival diseases modified by systemic factors
Associated with the endocrine system
puberty-associated gingivitis
menstrual cycle-associated gingivitis
pregnancy-associated
a) gingivitis
b) pyogenic granuloma
diabetes mellitus-associated gingivitis
Associated with blood dyscrasias
leukaemia-associated gingivitis
other
7. 3. Gingival diseases modified by medications
1) drug-influenced gingival enlargements
2) drug-influenced gingivitis
a) oral contraceptive-associated gingivitis
b) other
4. Gingival diseases modified by malnutrition
a.) ascorbic acid-deficiency gingivitis
b.) other
8. 1. Gingival diseases of specific bacterial origin
• a. Neisseria gonorrhoea-associated lesions
• b. Treponema pallidum-associated lesions
• c. streptococcal species-associated lesions
• d. other
2. Gingival diseases of viral origin
• a. herpesvirus infections
• 1) primary herpetic gingivostomatitis
• 2) recurrent oral herpes
• 3) varicella-zoster infections
• b. other
9. 3. Gingival diseases of fungal origin
A) candidal infections
• 1) generalized gingival candidosis
• b. linear gingival erythema
• c. histoplasmosis
• d. other
4. Gingival lesions of genetic origin
• a. hereditary gingival fibromatosis
• b. other
10. 5. Gingival manifestations of systemic
conditions
A) mucocutaneous disorders
1) lichen planus
2) pemphigoid
3) pemphigus vulgaris
4) erythema multiforme
5) lupus erythematosus
6) drug-induced
7) other
11. B) allergic reactions
1) dental restorative materials
a) mercury
b) nickel
c) acrylic
d) other
2) reactions attributable to
a) toothpastes/dentifrices
b) mouthrinses/mouthwashes
c) chewing gum additives
d) foods and additives
12. 6) Traumatic lesions (factitious, iatrogenic,
accidental)
a. chemical injury
b. physical injury
c. thermal injury
7) Foreign body reactions
13. • AAP World Workshop in Clinical
Periodontics (1988)
• European Workshop in Periodontology
(1993)
• AAP International Workshop for
Classification of Periodontal
Diseases(1999)
14. FORMS OF PERIODONTITIS DISEASE CHARCTERISTICS
1) Adult periodontitis Age of onset >35 years, slow rate of disease
progression, no defects in host defenses
2) Early-onset periodontitis (may be
prepubertal, juvenile or rapidly progressive)
Age of onset <35 years, rapid rate of disease
progression, defects in host defenses,
associated with specific microflora.
3) Periodontitis associated with systemic
disease
Systemic Diseases that predispose Rapid rate
of periodontotitis Diseases:diabetes, down’s
syndrome, HIV infection.
4) Necrotizing ulcerative periodontitis Similar to ANUG but with associated clinical
attachment loss.
5) Refractory periodontitis Recurrent, periodontitis that does not
respond to treatment.
15. FORMS OF PERIODONTITIS DISEASE CHARCTERISTICS
Adult periodontitis Age of onset:4th decade of life, slow
rate of disease progression, no defects
in host response.
Early-onset periodontitis Age of onset : before 4th decade of life,
rapid rate of disease progression,
defects in host response
Necrotizing periodontitis Tissue necrosis with attachment and
bone loss.
16. THE DISEASES PERIODONTITIS CAN BE SUBCLASSIFIED
INTO THE FOLLOWING THREE MAJOR TYPES BASED ON
CLINICAL ,RADIOGRAPHIC, HISTORICAL ,AND
LABORATORY CHARACTERISTICS:
• CHRONIC PERIODONTITIS
• Chronic periodontitis is a common disease of
the oral cavity consisting of chronic
inflammation of the periodontal tissues that is
caused by accumulation of profuse amounts of
dental plaque.
17. • THE FOLLOWING CHARACTERISTICS ARE
COMMON TO PATIENTS WITH CHRONIC
PERIODONTITIS:
• Prevalent in adults but can occur in children.
• Slow to moderate rate of progression.
Modified or associated with:
• Systemic diseases such as diabetes mellitus
and HIV infection.
• Environmental factors such as cigarette
smoking and emotional stress.
• Local factors predisposing to periodontitis.
18. Localized form
Generalized form
Slight form
Moderate form
Severe form
AGGRESSIVE PERIODONTITIS
• THE FOLLOWING CHARACTERISTICS ARE COMMON
TO PATIENTS WITH AGGRESSIVE PERIODONTITIS:
19. • RAPID ATTACHMENT LOSS AND BONE
DESTRUCTION
• AMOUNT OF MICROBIAL DEPOSIT
INCONSITENT WITH DISEASE SEVERITY
THE FOLLOWING CHARACTERISTICS ARE
COMMON BUT NOT UNIVERSAL :
• Diseased sites infected with actinobacillus
actinomycetemcomitans
• Increased prostaglandins and interleukins
20. 1. CLASSIFICATION OF AGGRESSIVE
PERIODONTITIS:
A. LOCALIZED FORM
B. GENERALISED FORM
LOCALIZED FORM
• Localized first molar or incisor disease with proximal
attachment loss at least two permanent teeth ,one of
which is a first molar.
• GENERALISED FORM
• Usually affecting persons under 30 years of age.
• Generalised proximal attachment loss affecting at least
three teeth other than first molars and incisors.
• Poor serum antibody response to infecting agents.
21. A. Associated with hematological
disorders
1. Acquired neutropenia
2. Leukemias
3. Other
B. Associated with genetic disorders
1. Familial and cyclic neutropenia
2 Down syndrome
3. Leukocyte adhesion deficiency syndromes
4. Papillon-Lefèvre syndrome
5. Chediak-Higashi syndrome