This document provides information on differential diagnosis in periodontics. It begins by defining differential diagnosis as the process of evaluating a patient's history, examinations, and tests to identify possible diagnoses in order of likelihood.
The document then discusses current classification systems for periodontal diseases, including health, gingivitis, and periodontitis. It provides examples of possible diagnoses for various types of gingival and periodontal diseases, including classifications like plaque-induced gingivitis, aggressive periodontitis, necrotizing ulcerative gingivitis, and chronic periodontitis.
Finally, it outlines the process of examining a patient during their first and second visits, including taking medical and dental histories, performing
intraoral and extraoral examination.pptxmisthysrishty
This document provides an overview of the clinical examination process for periodontal diseases. It begins with an introduction and then describes the extra-oral and intra-oral examination procedures. The extra-oral examination involves inspecting facial symmetry, lymph nodes, the temporomandibular joint, and lip competence. The intra-oral soft and hard tissue examinations include evaluating the oral mucosa, gingiva, teeth, periodontal pockets, furcations, and other structures. Factors like plaque, calculus, gingival health, attachment loss, and mobility are assessed. The document emphasizes the importance of a systematic and thorough clinical examination to diagnose periodontal diseases.
This document provides an overview of diagnosing periodontal diseases. It discusses the importance of gathering a thorough case history including social history, medical history, dental history, and clinical examination. The clinical examination involves assessing oral hygiene, gingival health using indices, probing pocket depths, clinical attachment levels, dental plaque, calculus, and radiographs. Making an accurate diagnosis is essential for determining an intelligent treatment plan.
This document discusses aggressive periodontitis, including its definition, classification, clinical characteristics, diagnostic criteria, and treatment modalities. Aggressive periodontitis is defined as a rare, severe form of periodontitis characterized by early onset and familial aggregation. It can be localized or generalized. Treatment involves nonsurgical and surgical therapies like scaling and root planing as well as adjunctive systemic or local antibiotics. Maintaining frequent periodontal maintenance visits is important for long-term disease control.
DIAGNOSIS AND MANAGEMENT OF GINGIVAL LESIONS (2).pptkemiSigbeku
This document outlines the key stages of periodontal diagnosis, which include taking a patient history, conducting an examination, performing investigations, making a diagnosis, and developing a treatment plan. The examination section describes how to assess various aspects of the gingiva such as color, contour, consistency, size, surface texture, position, bleeding on probing, and palpation. Advanced diagnostic methods like bacterial culture, immunodiagnostic tests, and molecular biology techniques are also discussed. The document concludes by covering the treatment of gingival lesions, which involves plaque control, calculus removal, restorative work, root planing, and evaluating the need for further therapy or surgery.
1) Endo-perio lesions occur when inflammation and infection spreads between the pulp and periodontium. There are three main pathways of communication: dentinal tubules, lateral/accessory canals, and the apical foramen.
2) Diagnosing endo-perio lesions can be complicated, as they involve both pulp and periodontal components. Clinical findings, radiographs, vitality tests, and probing are used.
3) Treatment depends on whether the primary source of infection is endodontic, periodontal, or both. It may involve endodontic therapy, periodontal therapy, or a combined approach. Correct diagnosis is important for determining the proper treatment plan.
This document provides an overview of interdisciplinary periodontics, covering interactions between periodontics and other dental specialties. It discusses the relationship between periodontics and endodontics, orthodontics, prosthodontics and restorative dentistry, oral surgery, oral pathology, and oral and maxillofacial radiology. For each interaction, it describes clinical findings, diagnoses, treatments, and prognoses. The document focuses in depth on endodontic-periodontal interactions and the relationship between orthodontics and periodontics.
intraoral and extraoral examination.pptxmisthysrishty
This document provides an overview of the clinical examination process for periodontal diseases. It begins with an introduction and then describes the extra-oral and intra-oral examination procedures. The extra-oral examination involves inspecting facial symmetry, lymph nodes, the temporomandibular joint, and lip competence. The intra-oral soft and hard tissue examinations include evaluating the oral mucosa, gingiva, teeth, periodontal pockets, furcations, and other structures. Factors like plaque, calculus, gingival health, attachment loss, and mobility are assessed. The document emphasizes the importance of a systematic and thorough clinical examination to diagnose periodontal diseases.
This document provides an overview of diagnosing periodontal diseases. It discusses the importance of gathering a thorough case history including social history, medical history, dental history, and clinical examination. The clinical examination involves assessing oral hygiene, gingival health using indices, probing pocket depths, clinical attachment levels, dental plaque, calculus, and radiographs. Making an accurate diagnosis is essential for determining an intelligent treatment plan.
This document discusses aggressive periodontitis, including its definition, classification, clinical characteristics, diagnostic criteria, and treatment modalities. Aggressive periodontitis is defined as a rare, severe form of periodontitis characterized by early onset and familial aggregation. It can be localized or generalized. Treatment involves nonsurgical and surgical therapies like scaling and root planing as well as adjunctive systemic or local antibiotics. Maintaining frequent periodontal maintenance visits is important for long-term disease control.
DIAGNOSIS AND MANAGEMENT OF GINGIVAL LESIONS (2).pptkemiSigbeku
This document outlines the key stages of periodontal diagnosis, which include taking a patient history, conducting an examination, performing investigations, making a diagnosis, and developing a treatment plan. The examination section describes how to assess various aspects of the gingiva such as color, contour, consistency, size, surface texture, position, bleeding on probing, and palpation. Advanced diagnostic methods like bacterial culture, immunodiagnostic tests, and molecular biology techniques are also discussed. The document concludes by covering the treatment of gingival lesions, which involves plaque control, calculus removal, restorative work, root planing, and evaluating the need for further therapy or surgery.
1) Endo-perio lesions occur when inflammation and infection spreads between the pulp and periodontium. There are three main pathways of communication: dentinal tubules, lateral/accessory canals, and the apical foramen.
2) Diagnosing endo-perio lesions can be complicated, as they involve both pulp and periodontal components. Clinical findings, radiographs, vitality tests, and probing are used.
3) Treatment depends on whether the primary source of infection is endodontic, periodontal, or both. It may involve endodontic therapy, periodontal therapy, or a combined approach. Correct diagnosis is important for determining the proper treatment plan.
This document provides an overview of interdisciplinary periodontics, covering interactions between periodontics and other dental specialties. It discusses the relationship between periodontics and endodontics, orthodontics, prosthodontics and restorative dentistry, oral surgery, oral pathology, and oral and maxillofacial radiology. For each interaction, it describes clinical findings, diagnoses, treatments, and prognoses. The document focuses in depth on endodontic-periodontal interactions and the relationship between orthodontics and periodontics.
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.
This document discusses gingival and periodontal diseases. It describes gingivitis as inflammation of the gingiva that is limited to the gingival tissue and does not involve bone loss. Periodontal disease is an infectious disease that destroys the tissues supporting the teeth, including the gingiva, periodontal ligament, and alveolar bone, potentially leading to tooth loss. It affects 75% of American adults and is classified based on severity and location of tissue destruction. Treatment involves removing dental plaque and calculus through scaling and root planing along with antibiotics in some cases.
CLINICAL IMPLICATIONS OF ENDOPERIO LESIONS.pptxSonaAnnsKuria
The actual relationship between periodontal and pulpal disease was first described by Simring and Goldberg in 1964. Since then, the term “perio-endo” lesion has been used to describe lesions due to inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. The pulp and periodontium have embryonic, anatomic and functional inter-relationships. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. A perio-endo lesion can have a varied pathogenesis which ranges from quite simple to relatively complex one. Knowledge of these disease processes is essential in coming to the correct diagnosis. This is achievable by careful history taking, examination and the use of special tests. The prognosis and treatment of each endodontic-periodontal disease type varies. Primary periodontal disease with secondary endodontic involvement and true combined endodontic-periodontal diseases require both endodontic and periodontal therapies. The prognosis of these cases depends on the severity of periodontal disease and the response to periodontal treatment. This enables the operator to construct a suitable treatment plan where unnecessary, prolonged or even detrimental treatment is avoided.
Go to:
Introduction
The endodontium and periodontium are closely related and diseases of one tissue may lead to the involvement of the other. The differential diagnosis of endodontic and periodontal diseases can sometimes be difficult but it is of vital importance to make a correct diagnosis so that the appropriate treatment can be provided. Endodontic-periodontal lesions present challenges to the clinician as far as diagnosis and prognosis of the involved teeth are concerned. Etiologic factors such as bacteria, fungi, and viruses as well as various contributing factors such as trauma, root resorptions, perforations, and dental malformations play an important role in the development and progression of such lesions. The endo-perio lesion is a condition characterized by the association of periodontal and pulpal disease in the same dental element. The relationship between periodontal and pulpal disease was first described by Simring and Goldberg in 1964.1 Since then, the term ‘perio-endo lesion’ has been used to describe lesions due to inflammatory products found in varying degrees in both periodontium and pulpal tissues.
Inter Relationship between pulpal & periodontal tissues
The effect of periodontal inflammation on dental pulp is controversial and conflicting studies abound.2–10 It has been suggested that periodontal disease has no effect on the pulp before it involves the apex.5 On the other hand, several studies suggested that the effect of periodontal disease on the pulp is degenerative in nature including an increase in calcifications, fibrosis, and collagen resorption, in addition to the direct inflammatory sequelae.11,12 Dental pulp and periodontium have embryonic..
This document provides classifications for various conditions affecting the periodontium, including:
- Gingival diseases such as dental plaque-induced and non-plaque induced gingivitis.
- Periodontitis, which is further classified into necrotizing periodontitis, periodontitis as a manifestation of systemic diseases, and other forms.
- Other conditions like periodontal abscesses, endo-peridontal lesions, mucogingival deformities, traumatic occlusal forces, and teeth/prosthesis factors.
It also defines terms like peri-implant mucositis and peri-implantitis, and discusses factors associated with soft and hard tissue deficiencies around dental
Endo perio lesion an interdisciplinary approach to solve the dilemma of which...Shruti Maroo
This document discusses endo-perio lesions, which involve both endodontic (pulp) and periodontal (gum) tissues. It presents a case study of a 34-year-old patient with pain and swelling in their lower right back molar. Diagnostic tests revealed both pulpal and periodontal involvement. The patient underwent root canal treatment followed by subgingival scaling and curettage in the same appointment. Follow-up showed resolution of the abscess and reduced probing depths, indicating the combined treatment was effective for this endo-perio lesion. In conclusion, sequential endodontic and periodontal therapies are important to fully address such lesions.
The document discusses the endodontic-periodontal interrelationship. It begins by introducing how Simring and Goldberg first described this relationship in 1964. It then discusses the classifications of endodontic and periodontal lesions put forth by various studies. The document covers the anatomical considerations between the pulp and periodontium like apical foramina, lateral canals, and dentinal tubules which allow communication between the two tissues. It also discusses the etiological factors involved like bacteria, fungi, and viruses that can lead to endodontic or periodontal diseases.
The document discusses periodontal diseases, which affect the tissues that surround and support teeth. It defines the periodontium and periodontal diseases. The most common periodontal diseases are gingivitis and periodontitis. Gingivitis is inflammation of the gums caused by plaque buildup. Periodontitis is a more advanced form involving loss of bone and tissues that support the teeth. The document outlines the classification, causes, pathogenesis, clinical presentation, and management of periodontal diseases. Effective treatment requires eliminating plaque and other contributing factors, followed by corrective procedures and long-term maintenance.
This document discusses the process of periodontal diagnosis. It begins by defining diagnosis and explaining its importance. There are several types of diagnoses discussed - provisional, differential, and final. The key stages of diagnosis are then outlined, including history taking, clinical examination, investigations, and arriving at a diagnosis. Specific aspects examined clinically are also described, such as tooth mobility, fremitus, trauma from occlusion, and pathologic migration. Periodontal charts are mentioned as an important tool for recording examination findings.
This document provides information on describing gingival characteristics. It discusses the normal color, size, consistency, contour, surface texture, and position of gingiva. It describes changes seen in these characteristics due to various inflammatory and non-inflammatory conditions. Treatment approaches for conditions that alter gingival characteristics are also summarized, such as procedures for depigmentation and techniques for treating gingival recession.
Endo perio lesions /certified fixed orthodontic courses by Indian dental acad...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
This document discusses various direct sequelae that can be caused by wearing removable dentures, including mucosal reactions, oral galvanic currents, altered taste perception, burning mouth syndrome, gagging, residual ridge reduction, periodontal disease of abutment teeth, and caries of abutment teeth. It focuses on denture stomatitis, providing classifications, causes, diagnostic methods, and management approaches. Predisposing factors, treatment with antifungals, and preventive measures are described. Other conditions addressed include flabby ridge, denture irritation hyperplasia, fibroepithelial polyp, traumatic ulcers, and burning mouth syndrome. Causes, diagnostic steps, and management of these conditions are
Aggressive periodontitis is a rapidly progressing form of periodontitis that can be localized or generalized. It typically affects younger individuals under 30 years old. Localized aggressive periodontitis (LAP) presents with severe bone and attachment loss localized to the first molars and incisors. Generalized aggressive periodontitis (GAP) affects at least three teeth besides the first molars and incisors. Both forms are associated with bacteria like Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Treatment involves non-surgical therapy like scaling and root planing along with systemic antibiotics to eliminate bacteria from tissues and prevent reinfection.
The document provides information on performing a thorough periodontal examination, including objectives, components, and techniques. It describes examining the gingiva, probing depth, clinical attachment level, bleeding on probing, tooth mobility, furcations, mucogingival tissues, occlusion, and radiographs. The goals are to identify pathological changes, document clinical findings, analyze the data, and develop an overall diagnosis for the patient. Accurately collecting and interpreting this examination data is important for understanding the periodontal condition.
Endo perio interrelation /certified fixed orthodontic courses by Indian denta...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
The periodontic-endodontic continuum describes how pulpal and periodontal diseases are interrelated and can influence each other. Pulpal infections can spread retrograde through the apical foramen and cause periodontal bone loss, while advanced periodontitis can spread infection into the pulp through lateral canals or dentinal tubules. It is important to differentiate between primary endodontic or periodontal lesions, and lesions that involve both tissues. Treatment may require endodontic therapy, periodontal therapy, or both depending on the diagnosis. Procedural accidents during endodontic treatment like perforations or sodium hypochlorite accidents can also impact the periodontium.
This document provides an overview of periodontal examination and diagnosis. It discusses taking a medical and dental history, performing a radiographic survey, examining casts, photographs, oral hygiene, the teeth, periodontium, and gingiva. Scoring indices like the Gingival Index, Plaque Index, Bleeding on Probing, and Calculus Index are also described to evaluate inflammation levels. The goal of periodontal diagnosis is to determine disease presence, type, extent, severity and develop a treatment plan.
Scaling and root planing (SRP) is a non-surgical treatment for periodontitis that aims to remove dental plaque and calculus from tooth surfaces. It involves scaling to remove deposits and root planing to smooth root surfaces. The goals are to eliminate periodontitis by removing irritants and restoring a healthy environment for tissue healing. The long-term effectiveness depends on factors like patient compliance, disease severity, and anatomical challenges. Overhanging restorations can interfere with cleaning and disturb the ecological balance, allowing disease-causing bacteria to proliferate.
1. The document discusses the relationship between endodontic and periodontal diseases and lesions. It defines endodontic lesions as inflammatory processes affecting the periapical tissues due to root canal infections, and periodontal lesions as inflammatory processes affecting the periodontal tissues due to dental plaque.
2. There are several classifications of perio-endo lesions including primary endodontic/periodontal lesions, and combined lesions where the diseases interact. Communication between the pulp and periodontium can occur through pathways like the apical foramen or lateral canals.
3. Diagnosis involves tests like vitality testing, radiographs, and probing, while treatment depends on the type of lesion and may involve endodontic, periodontal
This document discusses periodontic-endodontic lesions, which can originate from infections of the periodontium or dental pulp. It describes the anatomical connections between the tissues and various classifications of lesions. Microorganisms like Fusobacterium and Prevotella are often involved in both periodontal and pulp lesions. Accessory canals and dentinal tubules allow communication between tissues. Diagnosis considers factors like tooth vitality, lesion localization, and radiographic findings. Treatment involves completing endodontic therapy followed by periodontal treatment to address the underlying etiologies.
periodontitis associated with endodontic lesionsParth Thakkar
Periodontitis can be associated with endodontic lesions through several pathways connecting endodontic and periodontal tissues. Anatomical pathways like accessory canals, exposed dentinal tubules, and enamel-cementum disjunction allow bacteria and their byproducts to travel between the pulp and periodontium. Lesions can originate from either a primary endodontic or periodontal problem, with the other area becoming secondarily involved. It is important to diagnose the origin of combined lesions to determine the proper treatment sequence.
This document provides information on epithelial tissue and cell junctions. It discusses the general features of epithelial tissue, including that epithelial cells are closely packed with many cell junctions. It also describes the different types of epithelial tissue (simple vs stratified), the cell shapes (squamous, cuboidal, columnar), and locations in the body. The document further explains the structure and functions of the basement membrane and cell junctions, including occluding junctions, anchoring junctions, and communicating junctions. Key cellular adhesion molecules and proteins involved in different junction types are also outlined.
This document provides information about lymph nodes and the lymphatic system. It discusses the anatomy, embryology, histology, and physiology of lymph nodes and lymphatic drainage. Key points include:
- Lymph nodes act as filters for the lymphatic system and help fight infection. They are located along lymphatic vessels.
- The primary lymphoid organs are the bone marrow and thymus, where lymphocytes develop. Secondary lymphoid organs include the spleen, lymph nodes, tonsils, and skin.
- Lymph nodes have an outer cortex and inner medulla. Lymph enters through afferent vessels and exits through efferent vessels. High endothelial venules are found
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.
This document discusses gingival and periodontal diseases. It describes gingivitis as inflammation of the gingiva that is limited to the gingival tissue and does not involve bone loss. Periodontal disease is an infectious disease that destroys the tissues supporting the teeth, including the gingiva, periodontal ligament, and alveolar bone, potentially leading to tooth loss. It affects 75% of American adults and is classified based on severity and location of tissue destruction. Treatment involves removing dental plaque and calculus through scaling and root planing along with antibiotics in some cases.
CLINICAL IMPLICATIONS OF ENDOPERIO LESIONS.pptxSonaAnnsKuria
The actual relationship between periodontal and pulpal disease was first described by Simring and Goldberg in 1964. Since then, the term “perio-endo” lesion has been used to describe lesions due to inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. The pulp and periodontium have embryonic, anatomic and functional inter-relationships. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. A perio-endo lesion can have a varied pathogenesis which ranges from quite simple to relatively complex one. Knowledge of these disease processes is essential in coming to the correct diagnosis. This is achievable by careful history taking, examination and the use of special tests. The prognosis and treatment of each endodontic-periodontal disease type varies. Primary periodontal disease with secondary endodontic involvement and true combined endodontic-periodontal diseases require both endodontic and periodontal therapies. The prognosis of these cases depends on the severity of periodontal disease and the response to periodontal treatment. This enables the operator to construct a suitable treatment plan where unnecessary, prolonged or even detrimental treatment is avoided.
Go to:
Introduction
The endodontium and periodontium are closely related and diseases of one tissue may lead to the involvement of the other. The differential diagnosis of endodontic and periodontal diseases can sometimes be difficult but it is of vital importance to make a correct diagnosis so that the appropriate treatment can be provided. Endodontic-periodontal lesions present challenges to the clinician as far as diagnosis and prognosis of the involved teeth are concerned. Etiologic factors such as bacteria, fungi, and viruses as well as various contributing factors such as trauma, root resorptions, perforations, and dental malformations play an important role in the development and progression of such lesions. The endo-perio lesion is a condition characterized by the association of periodontal and pulpal disease in the same dental element. The relationship between periodontal and pulpal disease was first described by Simring and Goldberg in 1964.1 Since then, the term ‘perio-endo lesion’ has been used to describe lesions due to inflammatory products found in varying degrees in both periodontium and pulpal tissues.
Inter Relationship between pulpal & periodontal tissues
The effect of periodontal inflammation on dental pulp is controversial and conflicting studies abound.2–10 It has been suggested that periodontal disease has no effect on the pulp before it involves the apex.5 On the other hand, several studies suggested that the effect of periodontal disease on the pulp is degenerative in nature including an increase in calcifications, fibrosis, and collagen resorption, in addition to the direct inflammatory sequelae.11,12 Dental pulp and periodontium have embryonic..
This document provides classifications for various conditions affecting the periodontium, including:
- Gingival diseases such as dental plaque-induced and non-plaque induced gingivitis.
- Periodontitis, which is further classified into necrotizing periodontitis, periodontitis as a manifestation of systemic diseases, and other forms.
- Other conditions like periodontal abscesses, endo-peridontal lesions, mucogingival deformities, traumatic occlusal forces, and teeth/prosthesis factors.
It also defines terms like peri-implant mucositis and peri-implantitis, and discusses factors associated with soft and hard tissue deficiencies around dental
Endo perio lesion an interdisciplinary approach to solve the dilemma of which...Shruti Maroo
This document discusses endo-perio lesions, which involve both endodontic (pulp) and periodontal (gum) tissues. It presents a case study of a 34-year-old patient with pain and swelling in their lower right back molar. Diagnostic tests revealed both pulpal and periodontal involvement. The patient underwent root canal treatment followed by subgingival scaling and curettage in the same appointment. Follow-up showed resolution of the abscess and reduced probing depths, indicating the combined treatment was effective for this endo-perio lesion. In conclusion, sequential endodontic and periodontal therapies are important to fully address such lesions.
The document discusses the endodontic-periodontal interrelationship. It begins by introducing how Simring and Goldberg first described this relationship in 1964. It then discusses the classifications of endodontic and periodontal lesions put forth by various studies. The document covers the anatomical considerations between the pulp and periodontium like apical foramina, lateral canals, and dentinal tubules which allow communication between the two tissues. It also discusses the etiological factors involved like bacteria, fungi, and viruses that can lead to endodontic or periodontal diseases.
The document discusses periodontal diseases, which affect the tissues that surround and support teeth. It defines the periodontium and periodontal diseases. The most common periodontal diseases are gingivitis and periodontitis. Gingivitis is inflammation of the gums caused by plaque buildup. Periodontitis is a more advanced form involving loss of bone and tissues that support the teeth. The document outlines the classification, causes, pathogenesis, clinical presentation, and management of periodontal diseases. Effective treatment requires eliminating plaque and other contributing factors, followed by corrective procedures and long-term maintenance.
This document discusses the process of periodontal diagnosis. It begins by defining diagnosis and explaining its importance. There are several types of diagnoses discussed - provisional, differential, and final. The key stages of diagnosis are then outlined, including history taking, clinical examination, investigations, and arriving at a diagnosis. Specific aspects examined clinically are also described, such as tooth mobility, fremitus, trauma from occlusion, and pathologic migration. Periodontal charts are mentioned as an important tool for recording examination findings.
This document provides information on describing gingival characteristics. It discusses the normal color, size, consistency, contour, surface texture, and position of gingiva. It describes changes seen in these characteristics due to various inflammatory and non-inflammatory conditions. Treatment approaches for conditions that alter gingival characteristics are also summarized, such as procedures for depigmentation and techniques for treating gingival recession.
Endo perio lesions /certified fixed orthodontic courses by Indian dental acad...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
This document discusses various direct sequelae that can be caused by wearing removable dentures, including mucosal reactions, oral galvanic currents, altered taste perception, burning mouth syndrome, gagging, residual ridge reduction, periodontal disease of abutment teeth, and caries of abutment teeth. It focuses on denture stomatitis, providing classifications, causes, diagnostic methods, and management approaches. Predisposing factors, treatment with antifungals, and preventive measures are described. Other conditions addressed include flabby ridge, denture irritation hyperplasia, fibroepithelial polyp, traumatic ulcers, and burning mouth syndrome. Causes, diagnostic steps, and management of these conditions are
Aggressive periodontitis is a rapidly progressing form of periodontitis that can be localized or generalized. It typically affects younger individuals under 30 years old. Localized aggressive periodontitis (LAP) presents with severe bone and attachment loss localized to the first molars and incisors. Generalized aggressive periodontitis (GAP) affects at least three teeth besides the first molars and incisors. Both forms are associated with bacteria like Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Treatment involves non-surgical therapy like scaling and root planing along with systemic antibiotics to eliminate bacteria from tissues and prevent reinfection.
The document provides information on performing a thorough periodontal examination, including objectives, components, and techniques. It describes examining the gingiva, probing depth, clinical attachment level, bleeding on probing, tooth mobility, furcations, mucogingival tissues, occlusion, and radiographs. The goals are to identify pathological changes, document clinical findings, analyze the data, and develop an overall diagnosis for the patient. Accurately collecting and interpreting this examination data is important for understanding the periodontal condition.
Endo perio interrelation /certified fixed orthodontic courses by Indian denta...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
The periodontic-endodontic continuum describes how pulpal and periodontal diseases are interrelated and can influence each other. Pulpal infections can spread retrograde through the apical foramen and cause periodontal bone loss, while advanced periodontitis can spread infection into the pulp through lateral canals or dentinal tubules. It is important to differentiate between primary endodontic or periodontal lesions, and lesions that involve both tissues. Treatment may require endodontic therapy, periodontal therapy, or both depending on the diagnosis. Procedural accidents during endodontic treatment like perforations or sodium hypochlorite accidents can also impact the periodontium.
This document provides an overview of periodontal examination and diagnosis. It discusses taking a medical and dental history, performing a radiographic survey, examining casts, photographs, oral hygiene, the teeth, periodontium, and gingiva. Scoring indices like the Gingival Index, Plaque Index, Bleeding on Probing, and Calculus Index are also described to evaluate inflammation levels. The goal of periodontal diagnosis is to determine disease presence, type, extent, severity and develop a treatment plan.
Scaling and root planing (SRP) is a non-surgical treatment for periodontitis that aims to remove dental plaque and calculus from tooth surfaces. It involves scaling to remove deposits and root planing to smooth root surfaces. The goals are to eliminate periodontitis by removing irritants and restoring a healthy environment for tissue healing. The long-term effectiveness depends on factors like patient compliance, disease severity, and anatomical challenges. Overhanging restorations can interfere with cleaning and disturb the ecological balance, allowing disease-causing bacteria to proliferate.
1. The document discusses the relationship between endodontic and periodontal diseases and lesions. It defines endodontic lesions as inflammatory processes affecting the periapical tissues due to root canal infections, and periodontal lesions as inflammatory processes affecting the periodontal tissues due to dental plaque.
2. There are several classifications of perio-endo lesions including primary endodontic/periodontal lesions, and combined lesions where the diseases interact. Communication between the pulp and periodontium can occur through pathways like the apical foramen or lateral canals.
3. Diagnosis involves tests like vitality testing, radiographs, and probing, while treatment depends on the type of lesion and may involve endodontic, periodontal
This document discusses periodontic-endodontic lesions, which can originate from infections of the periodontium or dental pulp. It describes the anatomical connections between the tissues and various classifications of lesions. Microorganisms like Fusobacterium and Prevotella are often involved in both periodontal and pulp lesions. Accessory canals and dentinal tubules allow communication between tissues. Diagnosis considers factors like tooth vitality, lesion localization, and radiographic findings. Treatment involves completing endodontic therapy followed by periodontal treatment to address the underlying etiologies.
periodontitis associated with endodontic lesionsParth Thakkar
Periodontitis can be associated with endodontic lesions through several pathways connecting endodontic and periodontal tissues. Anatomical pathways like accessory canals, exposed dentinal tubules, and enamel-cementum disjunction allow bacteria and their byproducts to travel between the pulp and periodontium. Lesions can originate from either a primary endodontic or periodontal problem, with the other area becoming secondarily involved. It is important to diagnose the origin of combined lesions to determine the proper treatment sequence.
This document provides information on epithelial tissue and cell junctions. It discusses the general features of epithelial tissue, including that epithelial cells are closely packed with many cell junctions. It also describes the different types of epithelial tissue (simple vs stratified), the cell shapes (squamous, cuboidal, columnar), and locations in the body. The document further explains the structure and functions of the basement membrane and cell junctions, including occluding junctions, anchoring junctions, and communicating junctions. Key cellular adhesion molecules and proteins involved in different junction types are also outlined.
This document provides information about lymph nodes and the lymphatic system. It discusses the anatomy, embryology, histology, and physiology of lymph nodes and lymphatic drainage. Key points include:
- Lymph nodes act as filters for the lymphatic system and help fight infection. They are located along lymphatic vessels.
- The primary lymphoid organs are the bone marrow and thymus, where lymphocytes develop. Secondary lymphoid organs include the spleen, lymph nodes, tonsils, and skin.
- Lymph nodes have an outer cortex and inner medulla. Lymph enters through afferent vessels and exits through efferent vessels. High endothelial venules are found
Dr. Sonam Rani presented on the topic of cementum to several professors and colleagues. Cementum is a calcified tissue that covers tooth roots and provides attachment for periodontal ligaments. It comes in several types classified based on cellularity, presence of fibers, and origin. Cementum is formed by cementoblasts and cementocytes and plays an important role in tooth adaptation and repair. Systemic conditions like Paget's disease and cleidocranial dysplasia can affect cementum formation and structure.
This document provides an overview of pain, including its definition, classification, theories, transmission and modulation pathways, assessment, and management approaches. It begins with definitions of pain from Dorland's Medical Dictionary and Monheim. It then classifies pain according to intensity, temporal relationship, qualities, onset, and localization. Theories of pain discussed include specificity, pattern, and gate control theories. It describes the dual nature of pain and the transduction, transmission, modulation, and perception of pain. It discusses referred pain and neuropathic pain. The document concludes by covering pain assessment tools and pharmacological and non-pharmacological management strategies.
COMMON SEMINAR STERILISATION, INFECTION CONTROL AND HOSPITAL MANAGEMENT.pptxmalti19
This document discusses sterilization, infection control, and hospital management in dentistry. It defines key terms like sterilization, disinfection, and asepsis. It then describes various methods of sterilization including physical methods like heat and radiation, and chemical methods like alcohols, phenols, aldehydes, halogens, and gases. The document provides details on specific sterilization techniques and protocols for sterilizing dental instruments used in different specialties. It emphasizes the importance of proper sterilization to prevent disease transmission between patients.
This document summarizes key concepts in immunology as they relate to periodontal disease. It discusses the epithelial barrier and pattern recognition receptors that detect pathogens. Inflammatory mediators recruit immune cells through chemotaxis. T lymphocytes develop and differentiate into subsets like Th1, Th2, Th17 that activate different immune responses. B cells produce antibodies through somatic hypermutation. Regulatory T cells control self-tolerance. The adaptive response becomes antigen-specific and develops memory. Dendritic cells present antigens to activate T cells. An imbalance in T cell subsets can lead to tissue destruction in periodontal disease.
Thrombosis, embolism, and infarction are related pathological processes involving blood clots. Thrombosis is the formation of a blood clot within a blood vessel, while embolism occurs when a piece of a clot breaks off and travels to another location. Infarction results from obstruction of blood flow by a clot, causing tissue death. The document discusses the mechanisms, types, features, and progression of thrombosis, embolism, and infarction. It also covers related topics like Virchow's triad, hypercoagulable states, fat embolism, and amniotic fluid embolism.
Thrombosis, embolism, and infarction are related pathological processes involving blood clots. Thrombosis is the formation of a blood clot within a blood vessel, while embolism occurs when a piece of a clot breaks off and travels to another location. Infarction results from obstruction of blood flow by a clot, causing tissue death. The document discusses the mechanisms, classifications, and morphological features of thrombosis, embolism, and infarction. It also covers related topics like Virchow's triad, hypercoagulable states, and the development and types of infarcts over time.
Immune responses in periodontal disease final.pptxmalti19
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2. INTRODUCTION
Proper diagnosis is essential to intelligent treatment.
In current practice of periodontics it is primarily derived from
information obtained from the patient’s medical and dental
histories combined with findings from a through oral
examination.
Listing of the possible diagnosis of a patient’s condition
ranked from most likely to least likely.
Important- because it provides the clinician with other
diagnostic options if the initial diagnosis subsequently proves
to be wrong.
DIFFERENTIAL DIAGNOSIS
3. DEFINITION
It the art of chronological organisation and critical evaluation
of the information obtained of the patients history , lab
investigations , clinical examinations so as to identify the
disease type and etiology.
4. CURRENT CLASSIFICATION SYSTEM-
what are possible periodontal diagnosis
Plaque induced periodontal disease have traditionally been
divided into three categories-
HEALTH
GINGIVITIS
PERIODONTITIS
5. HEALTH- Absence of plaque induced periodontal disease
PLAQUE INDUCED GINGIVITIS- Presence of gingival
inflammation without loss of connective attachment
PLAQUE INDUCED PERIODONTITIS- Presence of
gingival inflammation at sites where there has been apical
migration of the epithelial attachment onto the root surfaces
accompanied by loss of connective tissue and alveolar bone.
6. PARTIAL LIST OF POSSIBLE DIAGNOSIS FOR
GINGIVAL DISEASE 1999 CLASSIFICATION
DENTAL PLAQUE INDUCED GINGIVAL DISEASE
plaque-induced gingivitis without local contributing factor
plaque-induced gingivitis with local contributing factor
NUG
puberty associated gingivitis
pregnancy associated gingivitis
Diabetes mellitus associated gingivitis
Leukemia-associated gingivitis
Drug-influenced gingival enlargement
Ascorbic-acid deficiency gingivitis
8. Gingival manifestation of systemic condition
Lichen planus
Mucous membrane pemphigoid
Pemphigus vulgaris
Erythema multiforme
Lupus erythematossus
Wegner granulomatosis
Psoriasis
Allergic reactions of gingiva to
Restorative material
Mouthrinses
Traumatic lesion of gingiva
Chemical injury
Physical injury
Thermal injury
9. Partial list of possible diagnoses for destructive types of
periodontal disease (1999 classification).
Chronic periodontitis(localized/generalized)
Localized form: < 30% of sites are involved
Generalized form: >30% of sites are involved
Slight: 1to 2 mm of clinical attachment loss
Moderate : 3 to 4 mm of clinical attachment loss
Severe : > 5 mm of clinical attachment loss.
Aggressive periodontitis
Periodontitis as manifestation of systemic disease
1.Hematologic disorder
2.Genetic disorders
Down syndrome
Glycogen syndrome
10. Chronic periodontitis
associated with poor oral
hygiene in a medically
healthy person.
Inflammation, gingival
recession and attachment loss
Generalized aggressive
periodontitis in
medically healthy patient
14. First visit
OVERALL APPRAISAL OF PATIENT
In the very first meeting only clinician come to know about
patient’s mental and emotional status, attitude and
physiologic age.
Age-
Prepubertal periodontitis- < 11 years
NUP- 15 – 35 years
Aggressive periodontitis – 20-35 years
Juvenile periodontitis- 11- 19 years
15. MEDICAL HISTORY
Mostly obtained in first visit
Importance of medical history should be explained to patients
as they usually omit information due to lack of awareness.
So patient should be made aware of – role of systemic disease
and condition in periodontal conditions.
A complete history of hospitalization and surgery should be
provided.
Any history of allergy or adverse drug reaction should be
provided.
Any other medical problems
Abnormal bleeding tendencies
patient’s family medical history
16. DENTAL HISTORY
A list of dental visits should be supplied, including frequency,
date of most recent visit, oral prophylaxis by dentist including
frequency and date of most recent cleaning.
Patient’s oral hygiene regimen should be noted, including
tooth brushing frequency, method, type of tooth brush.
Pain in tooth or gums
Bleeding from gums
Halitosis
Patient’s general dental habbit such as clenching and grinding
habit.
Any sort of previous periodontal problems.
17. Intraoral radiographic survey
Radiographic survey consist of 14 intraoral films and 4
posterior bitewing films.
Bitewing radiographs – height of alveolar crest .
18. Periapical radiographs – crown to
root ratio, PDL space, periapical
abnormality.
oSubstraction radiography –
change in bone density.
20. Casts:
Indicate position of gingival margin , inclination of the teeth,
proximal contact relationships, food impaction areas.
Visual aid in discussion with patient.
22. Second visit
Oral hygeine :
Cleanliness of oral cavity is appraised in terms of extent of
accumulated food debris , plaque, materia alba, and tooth
surface stains.
Oral hygeine status (John c. Green, Jack Vermillion)
determined with the help of OHI-S
good- 0.1 - 1.3
fair – 1.3 – 3.0
poor – 3.0 – 6.0
23. Foul / offensive odor emanating from oral cavity
Causes: - pathologic
- non pathologic
systemic: ear-nose-throat, pulmonary causes, GIT causes ,
drugs.
Compound responsible – volatile sulfur compound.
Microbiology involved in VSC production – T.denticoli,
P.intermedia, P. gingivalis , F. Nucleatum , H. Influenza
Diagnosis: organoleptic measurements , oropharyngeal examination
, gas chromatography.
24. Lymph node examination
Head and neck lymph nodes should be examined .
Nodes enlarged in – primary herpetic gingivostomatitis, NUG,
acute periodontal abscess etc.
25. Frenum attachment
Frenum is a fold of mucous membrane usually
with enclosed muscle fibres that attaches lips
and cheek to alveolar mucosa/ gingiva and
underlying periosteum.
CLASSIFICATION
Merco et al 1974
( depending on the attachment fibres)
mucosal
gingival
papillary
papilla penetrating
26. Examination of periodontium
Gingival status
Colour
normal – coral pink
Chronic gingivitis- red, reddish blue,
Acute gingivitis( ANUG, HIV, herpetic gingivostomatitis,
chemical irritation) – brightish red erythema, shiny slate grey,
dull whitish grey.
Bismuth , arsenic , mercury pigmentation- black line
following gingival margin countour.
Lead pigmentation – deep blue linear pigmentation
Silver pigmentation – violet marginal line.
27. Contour
Normal – scalloped ,knife edge
Chronic gingivitis – rolled , rounded marginal gingiva
flat , blunt interdental papilla.
ANUG - punched out crater like depression.
Chronic desquamative gingivitis – irregularly shaped
denuded appearance of gingiva .
Stillman’s cleft- apostrophe shaped indentations
extending from gingival margin for varying distance on
the facial surfaces.
McCalls festoons – rolled , thickened band of gingiva
usually seen adjacent to cuspid when recession
approaches mucogingival junction .
31. Consistency
Normal – firm and resilient
Chronic gingivitis- soggy puffiness that pits on pressure
- marked softness and friability, pinpoint
surface area of redness and desquamation.
- firm and leathery
Acute gingivitis – diffuse puffiness and softening
- vesicle formation
- sloughing with greyish flake like particles of
debris.
32. Surface texture
Normal – orange peel appearance
Form of adaptive specialization for function
Papillary layer of connective tissue projects into the elevations covered by
stratified squamous epithelium.
Stippling best view by drying of gingiva.
Loss of stippling – early sign of gingivitis
33. Position
Refers to the level at which the gingival margin is attached to
the tooth.
Actual position : it is the level of epithelial attachment on
tooth at CEJ.
Apparent position : level of crest of gingival margin.
Recession: exposure of root surface by apical shift in position
of gingiva .
34. Bleeding on probing
Earliest sign of gingival inflammation .
Results from increased vascularity , thinning and degeneration
of the epithelium and the proximity of engorged blood vessels
to the inner surface.
Causes of bleeding:
- chronic bleeding
- acute bleeding
- systemic factors .eg vascular abnormality , platelet disorder ,
coagulation defects , malignancy, drugs,
hypoprothrombenemia.
38. Width of attached gingiva
It is the distance between the mucogingival junction and the
projection on the external surface of the bottom of the sulcus.
Test done to determine width of attach gingiva:
1. measurement approach
2. Schillers potassium iodide solution
3. Roll test
39. A PERIODONTAL POCKET is defined as a pathologically
deepened gingival sulcus
Pocket Probing
The probe should be inserted parallel to the vertical axis of tooth
and walked circumferentially around each surface of the tooth
to detect the areas of deepest penetration
40. Level of attachment versus pocket depth
Pocket depth – distance between base of pocket and gingival
margin
Level of attachment – distance between base of pocket and a
fixed point on crown such as CEJ.
41. Determining level of attachment
When gingival margin is located on anatomical crown level
of attachment determined by subtracting from PD the
distance from GM to CEJ.
When gingival margin coincide with CEJ the loss of
attachment equals PD.
When GM located apical to CEJ , loss of attachment is
greater than PD and thus distance between CEJ and GM
should be added to PD.
42. Alveolar bone loss
Evaluated by clinical and radiographic examination
Probing helpful for determining
- height and contour of facial and lingual bones obscured on
radiograph by dense root
- architecture of the interdental bone
Transgingival probing is a more accurate technique
greenstein et al 1981
43. Recession
Apical shift of gingival margin to a position apical to CEJ
with exposure of root surface to oral cavity.
Factors responsible for recession – inflammatory
- anatomical factors
- iatrogenic factors
classification :
1. Sullivan and Atkins – shallow narrow
- shallow wide
- deep narrow
- deep wide .
44.
45. Millers classification
class I- marginal tissue recession that does not extent to the
mucogingival junction. There is no loss of bone or soft
tissue in the interdental area.
class II- marginal tissue recession that extent to or beyond the
mucogingival junction. There is no loss of bone or soft
tissue in the interdental area.
.
46. class III- marginal tissue recession that extent to or beyond the
mucogingival junction, in addition there is bone or soft
tissue loss interdentally or malpositioning of the tooth.
class IV- marginal tissue recession that extent to or beyond the
mucogingival junction, with severe bone loss & soft tissue
loss interdentally or severe malpositioning
47. Examination of teeth
Wasting disease of teeth
1. Attrition : occlusal wear resulting from
functional contact with opposing teeth .
2. Abrasion : loss of tooth substance induced by
mechanical wear .that of mastication
48. Erosion : loss of tooth substance by a chemical process that does
not involve bacterial action .
4. Abfraction : results from occlusal loading surfaces causing
tooth flexure and mechanical microfractures and tooth
substance loss in the cervical area.
49. Tooth mobility
All teeth have slight degree of physiologic mobility which is
greatest in the morning ant progressively decreases.
Leary et al 1969
Mobility checked as tooth is held firmly between handles of 2
mettalic instrument and an effort is made to move in all directions.
Tooth mobility occur in following two stages
1. Initial or intrasocket stage the tooth moves within the
confines of pdl, this is associate with viscoelastic
distortion of pdl and redistribution of periodontal fluid.
This initial movement occurs with force of about
100gm and is about 0.05-0.1mm
Muhlemann et all 1960
50. 2. The secondary stage occur gradually and entails elastic
deformation of alveolar bone in response to increase
horizontal forces.
( Leary et al 1965)
When force applied on crown is 500gm then displacement
is100-200 micro m for incisors, 50-90 micro m for canines ,8-
10 micro m for premolars and 40-80 micro m for molars.
( Muhlemann et al 1960 )
51. Gradings
• Grade I- slight more than normal upto 1mm buccolingually
• Grade II – moderate mobility (< 2mm) buccolingually and
mesiodistally.
• Grade III – severe mobility faciolingually / mesiodistally
combined with vertical displacement
52. Fremitus test
Measurement of vibratory patterns of teeth when teeth are
placed in contacting position and movements.
Test : a dampened index finger is placed along buccal and
labial surface of maxillary teeth . Patient asked to tap teeth
together in maximum intercuspal position and then grind in
lateral , protrusive movements .teeth displaced by patient in
these positions are identified.
53. Grades
• Class I fremitus- mild vibration .
• Class II – easily palpable vibrations but no
visible movememts
• Class III – movements visible with naked eyes.
• Used to diagnose TFO
54. Furcation involvement
Invasion of bifurcation of multirooted teeth by PDL disease .
Radiographs and nabers probe used for diagnosis .
55. The concavity—just above the furcation
entrance—on the root trunk can be felt
with the probe tip; however, the
furcation probe cannot enter the
furcation area.
The probe is able to partially enter the
furcation—extending approximately one
third of the width of the tooth—but it is
not able to pass completely through the
furcation.
GRADE I
GRADE II
56. In mandibular molars, the probe passes
completely through the furcation
between the mesial and distal roots.
In maxillary molars, the probe passes
between the mesiobuccal and
distobuccal roots and touches the palatal
root.
Same as a class III furcation
involvement except that the entrance to
the furcation is visible clinically owing
to tissue recession.
GRADE III
GRADE IV
57. By Hamp et al 1975
Grade 0: No involvement of the furcation.
Grade I: The furcation is detectable with a probe, but no more
than 1/3 is exposed.
Grade II: The probe can penetrate more than 1/3 of the
furcation, but not pass right through the tooth.
Grade III: The probe passes from one side of the furcation to
the other.
58. This subclassification takes into account the number of
millimeters of vertical bone loss from the roof of the furcation
apically. The following subclasses are suggested
Subclass A: 0-3 mm of probable depth from roof of the furca.
Subclass B: 4-6 mm of probable depth from roof of the furca..
Subclass C: 7 mm or greater probeable depth from the roof of
the furca.
59. conclusion
Periodontal disease is considered a sight specific
disease characterised by local inflammatory reaction to
bacterial infection . Problems often arise when
attempting to make a diagnosis of disease when using
data collection technique . So research and and
periodontal community are looking for better technique
to aid in detection and diagnosis of periodontal disease.