Dm & pd
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This document discusses the relationship between diabetes mellitus (DM) and periodontal disease. Uncontrolled DM can lead to microvascular and macrovascular complications and increases susceptibility to infections with poor wound healing. Periodontitis is considered the 6th complication of DM. Bacterial pathogens are altered in the gingival crevicular fluid and blood of diabetics, which contributes to increased severity of periodontal disease. Poorly controlled DM also impairs the functions of polymorphonuclear leukocytes, monocytes, and macrophages that normally help defend against periodontal pathogens. Chronic hyperglycemia in diabetics affects collagen structure and metabolism, reducing periodontal tissue integrity and increasing susceptibility to destruction from infection.
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The effect of diabetes mellitus on periodontium
A Literature Review Submitted to the Council of the College of Dentistry at Hawler Medical University in partial Fulfillment of the Requirement for the B.D.S. degree in Degree
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This document discusses the relationship between diabetes and periodontal disease. It begins by introducing diabetes and explaining the role of insulin. It then describes the two main types of diabetes and some of their characteristics. The document outlines some common oral manifestations of diabetes, including dental caries, oral lichen, and oral candidiasis. It provides an overview of periodontitis and discusses how diabetes can exacerbate periodontal disease through impaired immune function, altered collagen metabolism, impaired wound healing, and increased advanced glycation end products that damage tissues. The document also explores how diabetes can influence the periodontal microflora and immune response.
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This document provides an overview of diabetes, including its classification, pathophysiology, clinical symptoms, diagnostic criteria, complications, and relationship to periodontal disease. Diabetes is classified into type 1, type 2, and gestational diabetes. It results from either a deficiency in insulin production or resistance to insulin. Poorly controlled diabetes is associated with increased risk and severity of periodontal disease through mechanisms like impaired immune response and increased inflammation. Maintaining good glycemic control can help reduce the negative impacts of diabetes on periodontal health.
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This document discusses the relationship between diabetes mellitus and periodontal disease. It defines the two main types of diabetes, type 1 and type 2, and describes their causes and characteristics. It explores how diabetes can increase susceptibility to periodontal disease by impairing host defenses and altering the subgingival microbiota. Specifically, it examines how hyperglycemia and advanced glycation end products associated with diabetes can impact immune cells, collagen metabolism, vascular function, and wound healing in the periodontium. The two-way relationship between diabetes and periodontitis is described, whereby periodontal infections can worsen glycemic control in diabetes patients. Guidelines are provided for managing periodontal disease in both well-controlled and poorly-controlled diabetes patients
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The effect of diabetes mellitus on periodontium
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This document provides an overview of diabetes, including its classification, pathophysiology, clinical symptoms, diagnostic criteria, complications, and relationship to periodontal disease. Diabetes is classified into type 1, type 2, and gestational diabetes. It results from either a deficiency in insulin production or resistance to insulin. Poorly controlled diabetes is associated with increased risk and severity of periodontal disease through mechanisms like impaired immune response and increased inflammation. Maintaining good glycemic control can help reduce the negative impacts of diabetes on periodontal health.
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HERE YOU WILL FIND ALL TYPES OF PPTS OF PERIODONTICS FOR BDS AND MDS
PLS SUBSCRIBE TO MY YOUTUBE CHANNEL FOR MORE UPDATES
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Diabetes and periodontitis
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HI,
HERE YOU WILL FIND ALL TYPES OF PPTS OF PERIODONTICS FOR BDS AND MDS
PLS SUBSCRIBE TO MY YOUTUBE CHANNEL FOR MORE UPDATES
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This document discusses the influence of systemic diseases on the periodontium. It focuses on the effects of diabetes and hormonal changes. Regarding diabetes, it explains how the disease can impair the host response and increase proinflammatory cytokines, advanced glycation end products, and periodontal bacteria. It also discusses impaired wound healing. For hormonal changes, it describes how puberty, menstruation, pregnancy, and hormone therapy can aggravate gingivitis through their effects on tissues, host response, and subgingival microbiota. The document provides details on the pathogenesis and clinical manifestations of periodontitis relating to different systemic conditions.
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This document discusses drugs that can cause hyperlipidemia, including diuretics, beta-blockers, oral contraceptives, corticosteroids, cyclosporine, alcohol, and hepatic enzyme inducers. It provides details on how each of these drugs can increase lipids like total cholesterol, LDL-C, VLDL-C, and triglycerides. Statins are mentioned as a treatment option to lower lipids, but their use requires caution when combined with drugs like cyclosporine due to increased risk of side effects. The document concludes with a case study of a patient taking a statin who developed muscle aches, possibly due to consuming grapefruit juice.
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This document discusses the effect of various systemic diseases on complete dentures. It begins with an introduction on the importance of evaluating a patient's systemic status during treatment planning. Several systemic diseases are then described in terms of their oral manifestations and prosthetic management considerations, including diabetes mellitus, tuberculosis, anemia, osteoporosis, bone diseases like fibrous dysplasia and Paget's disease. For many conditions, special attention to infection control, wound healing, blood sugar control and dietary adjustments are advised when providing dental treatment.
DIABETES MELLITUS.pptx
This document provides information on diabetes mellitus including its definition, classification, epidemiology, pathophysiology, complications, and clinical presentation. It defines diabetes as a group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion and/or action. The two main types of diabetes are type 1 resulting from beta cell destruction and type 2 associated with insulin resistance. Obesity and genetic factors contribute to the development of type 2 diabetes. Acute complications include diabetic ketoacidosis.
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Treatment of gingival enlargement
This document discusses different types and treatments of gingival enlargement. Chronic inflammatory enlargement is treated with scaling, root planing, or surgery. Drug-induced enlargement is caused by medications and treated by discontinuing the drug, substituting it, or surgery. Surgical treatments for enlargement include gingivectomy and gingivoplasty/flap procedures. Leukemic enlargement requires medical treatment and antibiotics before periodontal work. Enlargement in pregnancy is treated by eliminating local factors and surgery for tumor-like cases. Recurrence is common if the underlying cause is not addressed.
The periodontal flap
A periodontal flap is a section of gingiva or mucosa surgically separated to provide access to the bone and root surfaces. There are full thickness and conventional flaps, which are classified based on how the flap is positioned after surgery, such as coronally or laterally. Different incisions are used in periodontal flaps, including internal bevel, crevicular, and vertical incisions, to allow removal of tissue from around the tooth for examination and treatment of bone and root surfaces.
The flap techniques for pocket therapy
This document discusses two techniques for periodontal flap surgery: the modified Widman flap and the apically positioned flap. The modified Widman flap provides access for root instrumentation and removal of pocket lining without attempting to reduce pocket depth. It involves a internal bevel incision, reflection of the gingiva, crevicular incision, and removal of granulation tissue before suturing the flap back to its original position. The apically positioned flap aims to eradicate pockets, widen the zone of attached gingiva, and improve accessibility. It uses internal bevel, crevicular, and vertical incisions to displace the flap apically after scaling, root planing, and possible osseous surgery before s
Root conditioning
Periodontal disease is mainly caused by bacterial plaque containing gram-negative bacteria that form in pockets between the soft and hard tissues around teeth. Scaling and root planing alone are not enough to remove endotoxins from infected root surfaces, so root conditioning is done as an adjunct to mechanical debridement. Root conditioning agents like citric acid, tetracycline HCL, EDTA, fibronectin, and enamel matrix protein are applied following mechanical debridement to break down the smear layer barrier formed on roots and more effectively remove bacteria.
Radiographs
This document discusses the use of radiographs in assessing periodontal disease and bone destruction. It provides information on normal interdental bone appearance and outlines criteria for evaluating bone loss patterns seen in periodontal disease. Key findings include lamina dura disruption being an early sign of periodontitis and interdental cratering appearing as irregular reduced bone density. Furcation involvement is suggested by diminished bone trabeculae radiodensity or marked bone loss on a single root. Additional imaging techniques like CBCT can provide further detail on lesion morphology.
Peri implantitis
This document discusses peri-implantitis, a disease affecting the tissues surrounding dental implants. Peri-implant mucositis is a mild inflammatory condition confined to soft tissues, similar to gingivitis. Peri-implantitis is a more severe condition involving bone loss due to infection. Treatment involves initial therapy like antibiotics and implant surface decontamination, followed by surgical therapies like regenerative treatment or resective surgery depending on the severity of bone loss. Long-term supportive therapy and plaque control are important to prevent disease recurrence.
Pdl
The periodontal ligament connects the cementum of teeth to the alveolar bone and contains transseptal fibers that extend between adjacent teeth. It provides sensory innervation to the teeth and helps anchor them in place. Nerves from the trigeminal nerve provide sensory innervation.
Medically compromised
This document provides guidelines for treating periodontal disease in patients with medical complications. It discusses how to modify treatment for patients with cardiovascular diseases like hypertension, ischemic heart disease, and congestive heart failure. It also addresses managing patients with endocrine disorders such as diabetes and thyroid disease. For all medically compromised patients, it emphasizes consulting their physician, using stress-reducing protocols, and being prepared to treat medical emergencies that could arise during dental procedures.
Med compro 2
This document discusses periodontal treatment considerations for medically compromised patients with bleeding disorders or who take anticoagulant medications. Key points include checking patients' medical histories and bleeding risks, performing examinations to check for signs of bleeding problems, consulting physicians as needed, and using conservative non-surgical treatments or minor surgical procedures only when a patients' coagulation levels are within an acceptable range to reduce bleeding risks. For patients taking anticoagulants, the drugs may need to be temporarily discontinued before certain periodontal procedures while closely monitoring coagulation levels. Removing infected teeth is also important before renal transplantation to reduce infection risks.
Med comp 3
This document discusses various pulmonary diseases including asthma, emphysema, and bronchitis. It outlines signs and symptoms of pulmonary diseases like increased respiratory rate, cyanosis, and clubbing of fingers. It provides considerations for treating patients with pulmonary diseases during dental procedures.
Hiv
This document discusses oral and periodontal manifestations in patients with HIV/AIDS. It notes that oral candidiasis and oral hairy leukoplakia are the most common oral lesions associated with HIV/AIDS. Kaposi's sarcoma, an angioproliferative tumor caused by human herpes virus 8, is the most common oral malignancy in AIDS patients. Non-Hodgkin's lymphoma can also present as oral lesions in AIDS patients. Bacillary angiomatosis, caused by Bartonella or Rickettsia bacteria, can cause red-purple gingival lesions and bone destruction if left untreated.
Gingivectomy
Gingivectomy is a periodontal procedure that removes diseased gum tissue to reduce deep pockets and expose more of the tooth crown. It is indicated when there is inadequate attached gum tissue or deep periodontal pockets. Contraindications include inadequate attached gingiva. The external bevel gingivectomy technique involves removing gum tissue with an external bevel cut to control bleeding from the wound edges. Healing occurs through secondary intention. Post-operative instructions should be provided and a diode laser can also be used for excising gum growths.
Gingival recession
This document discusses gingival recession and techniques for gingival augmentation. It classifies gingival recession based on depth and width. It describes different grafting techniques used for root coverage, including free gingival autograft, free connective tissue graft/subepithelial connective tissue graft, and acellular dermal matrix. The free connective tissue graft with coverage of the graft by an overlying flap is considered the gold standard technique. Factors such as graft thickness, blood supply, and healing are discussed for the different techniques.
General principles of periodontal surgery
This document discusses principles of periodontal surgery. It covers indications for periodontal surgery, patient preparation including scaling and root planing, premedication with antibiotics and NSAIDs. It emphasizes the importance of infection control measures like sterilizing instruments and preventing the spread of diseases. The document also discusses sedation techniques, tissue management during surgery, and concludes that immense advances have been made in surgical procedures and sterilization.
Female sex hormones 1
1. During puberty, menses, pregnancy and menopause, sex hormone levels fluctuate dramatically which can impact the periodontium. Gingival inflammation increases due to higher levels of estrogen and progesterone.
2. During pregnancy, progesterone levels reach 100ng/ml which suppresses the immune system. This along with higher levels of estrogen can lead to pregnancy gingivitis and increase the risk of preterm birth if periodontitis is present.
3. At menopause, declining estrogen levels cause oral changes like gingival recession and bone loss as collagen production decreases. Hormone replacement therapy can help treat oral discomfort during this stage.
Defense mechanism of gingiva
The gingiva has a defense mechanism to protect the underlying tissues from damage. The epithelial surface has keratinization and a high turnover rate to serve as a barrier. Gingival crevicular fluid (GCF) and saliva also help in the defense mechanism. GCF composition can be analyzed to study the defense mechanisms. Different techniques like absorbent paper strips, capillary tubes, and crevicular washings can be used to collect GCF for analysis. Cellular immunity components like cytokines and humoral immunity components like antibodies present in GCF also contribute to the gingival defense mechanism.
Biologic width
The document discusses the importance of biological width for dental restorations to ensure periodontal health. It defines biological width as the 2mm zone of connective tissue and junctional epithelium above the alveolar bone crest. Violating this space can cause inflammation, bone loss, or gingival recession as the body attempts to reestablish the biological width. The document provides guidelines for restoration margin placement based on sulcus depth to avoid biological width violation. Surgical crown lengthening or orthodontic extrusion may be needed to move margins out of the biological width zone.
Ahgs
Acute herpetic gingivostomatitis is an acute viral infection of the gingiva caused by herpes simplex virus-1. It typically affects children ages 6 months to 6 years, initially forming numerous vesicles that rupture into painful shallow ulcers covered by yellow fibrin on an inflamed and swollen mucosa. It differs from necrotizing ulcerative gingivitis in that acute herpetic gingivostomatitis is a viral infection while necrotizing ulcerative gingivitis has other causes.
Advances in clinical diagnosis
- Conventional periodontal diagnosis has limitations as it only measures current signs of inflammation and damage, but cannot identify ongoing destruction or consider other factors.
- Advanced diagnostic techniques include assessing gingival bleeding, temperature, probing depths, and microbiology to provide more information on disease activity, progression, and host susceptibility.
- Generations of probes have improved from manual to automated and aim to standardize force and precision while making measurements electronic and digitally accessible. The Florida probe system was an early automated probe but newer probes aim to improve tactile sensitivity and account for variability between sites.
Aging and perio
The document discusses the relationship between ageing, the gingiva (gums), and the periodontium (tissues that surround and support the teeth). It covers how ageing impacts the gingiva and periodontium, as well as how systemic diseases can affect the periodontium. Finally, it addresses the role of saliva on the periodontium.
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Dm & pd
- 1. DIABETES MELLITUS & PERIODONTAL DISEASE
- 3. HOW DO YOU DEFINE DM???
- 7. MAIN SIGNS & SYMPTOMS OF DM
- 8. UNCONTROLLED DM is associated with LONG TERM COMPLICATIONS • MICROVASCULAR DISEASES • Retinopathy • Nephropathy • Neuropathy • MACROVASCULAR DISEASES • Cardiovascular disease • Cerebrovascular disease • These patients have increased susceptibility towards infection, poor wound healing
- 9. 6TH COMPLICATION OF DM -PERIODONTITIS
- 10. • Mucosal drying • Mainly seen in uncontrolled DM
- 12. • BACTERIAL PATHOGENS • Increased glucose in GCF & blood of patients with diabetes changes the environment of micro flora. • Thus qualitative changes in bacteria contribute to severity of PD in those with uncontrolled DM • Patients with type 1 DM & periodontitis have shown to have subgingival flora composed of Capnocytophaga, anaerobic vibrios. Actinomyces spp • Pgingivalis, P intermedia, AA present in low numbers in diabetic patients with PD • Black pigmented spp- P gingivalis, P intermedia &C rectus are prominent in severe periodontal lesions of Pima Indians with type 2 DM • THESE RESULT SUGGEST ALTERED FLORA IN PERIODONTAL POCKET OF PATIENTS WITH DIABETES … evidence lacking to support their role in periodontal destruction in patients with DM
- 13. PMN FUNCTION • POORLY CONTROLLED DM ,functions of PMNS ,monocytes and macrophages are impaired • So primary defense by PMNs against periodontal pathogens is diminished • No alteration in immunoglobulins A,g or M is found in these patients
- 14. ALTERED COLLAGEN METABOLISM • DM-chronic hyperglycemia • Chronic hyperglycemia affects collagen structure and function-affect integrity of periodontium • Decreased collagen synthesis, osteoporosis, reduction in alveolar bone height have been demonstrated in diabetic animals • Chronic hyperglycemia affects synthesis , maturation ,maintainence of collagen & extracellular matrix.
- 15. •In hyperglycemic state numerous proteins and matrix molecules undergo NON ENZYMATIC GLYCOSYLATION resulting in formation of AGEs ( ACCUMULATED GLYCATION END PRODUCTS)
- 17. WHAT HAPPENS AFTER AGES ARE FORMED???
- 18. • SO …. Collagen in tissues of patients with poorly controlled diabetes is older and more susceptible to pathogenic breakdown ( ie less resistant to destruction by periodontal infection) • AGEs and receptors for AGEs play a central role in classic complications of diabetes… • Poor glycemic control, with associated increase in AGEs renders the periodontal tissues susceptible to destruction
- 19. • The cumulative effects of altered cellular response to local factors , impaired tissue integrity & altered collagen metabolism play significant role in susceptibility of patients with diabetes to infections and destructive periodontal disease.