incision.pdf
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This document discusses incisions and tissue management in periodontal surgery. It describes different types of incisions used in periodontal surgery like horizontal, sulcular, parapapillary, marginal, paramarginal, and vertical incisions. Horizontal incisions can be internal or external, while vertical incisions help provide better access. The document emphasizes the importance of selecting the right incision based on factors like osseous topography and blood supply. Proper incision techniques and tissue management are crucial for wound healing and obtaining good surgical outcomes.
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Nanotechnology in Periodontics by Dr. Neelam Das.pptx
Nanotechnology in Periodontics by Dr. Neelam Das.pptxRama Dental College Hospital and Research Center
The emerging science of nanotechnology, especially within the dental and medical fields, sparked a research interest in their potential applications and benefits in comparison to conventional materials used. Therefore, a better understanding of the science behind nanotechnology is essential to appreciate how these materials can be utilized in our daily practice. Nanotechnology is the research and development of materials, devices and systems exhibiting physical, chemical and biological properties that are different from those on a large scale. Nanotechnology offers a broad range of innovations and improvement in prevention, diagnostics, and treatment of oral diseases. Periodontal disease is one of the major dental illnesses that affect millions of people around the globe. It is estimated that 90% of the world population suffers from the disease. Recent nanotechnology advancement and innovations through Nano dentistry are increasingly providing a suitable solution for the treatment of many dental disorders including periodontal disease. This review aimed to provide an overview of the role of nanotechnology in periodontics and to evaluate its applicability in prevention and treatment of oral diseases and also to provide important recent updates on the various nanotechnology-based approaches for periodontal disease therapy.chronic periodontitis.pptx
Chronic periodontitis is an infectious disease that results in inflammation of the gums and bones supporting the teeth. It is characterized by progressive gum attachment loss and bone loss over time. Symptoms include bleeding gums, spaces opening between teeth, and occasional pain. Risk factors include poor oral hygiene, smoking, diabetes, and genetic factors. Treatment involves nonsurgical approaches like deep cleaning below the gumline to remove bacterial plaque and tartar, followed by surgical procedures if needed. Regular maintenance care is important to prevent further progression of the disease.
clinical diagnosis.pptx
This document discusses the process of clinical diagnosis in periodontology. It describes how periodontal diagnosis involves analyzing the case history, clinical signs and symptoms, and test results. Diagnostic procedures should be systematic and organized. It also outlines the steps for periodontal examination, which includes screening and recording the periodontal status, examining the teeth and periodontium, and using laboratory aids for clinical diagnosis. Key aspects examined are plaque, calculus, gingiva, pockets, mobility, and sensitivity.
Dental plaque.ppt
The document discusses dental plaque, which represents a biofilm that forms on teeth. It begins by describing how plaque formation starts after birth as microorganisms colonize the oral cavity. Plaque is defined as a structural entity resulting from the colonization of microorganisms on tooth surfaces. Over time it can calcify to form calculus. Plaque formation involves an initial phase where a pellicle layer forms, followed by the adhesion and colonization of bacteria. As plaque matures it develops a complex structure and composition. Certain bacterial complexes like the red complex are associated with periodontal disease. The document also discusses the nonspecific and specific plaque hypotheses for the causes of periodontal disease.
Controversies in Periodontal Practice - CDD.ppt
This document discusses several controversies in periodontal practice, including classification systems, diagnosis, prognosis, and surgical versus non-surgical treatment. It notes that there is a lack of complete knowledge and understanding of periodontal diseases, leading to controversies. Classification systems have evolved over time as paradigms have changed, and existing systems have limitations. Current diagnostic methods have drawbacks and cannot always establish etiological factors or cause-effect relationships. Prognosis is difficult to determine accurately given the complexity of periodontal pathology and incomplete understanding. There is conflict over whether surgical or non-surgical treatment leads to better long-term outcomes, as studies have shown variable results.
Periodontal Indices by Dr. Neelam Das .pptx
Dental indices can be considered as the main tool of epidemiological studies in dental diseases, to find out the incidence, prevalence and severity of the diseases, based on which preventive programmes are adopted for their control and prevention.
crown lengthening.pptx
Crown lengthening is a surgical procedure used to expose more of the clinical crown for esthetic or restorative purposes. There are several techniques for crown lengthening including gingivectomy, flap surgery, and lasers. Gingivectomy involves removing gum tissue while flap surgery involves raising a flap and removing underlying bone. The biologic width must be considered to avoid compromising tissue health. Crown lengthening can allow for improved restoration margins or smile appearance.
mechanical plaque control.pptx
The document discusses various methods and tools for mechanical plaque control, including manual and powered toothbrushes in different designs, orthodontic toothbrushes, and novel designs. It also covers different toothbrushing techniques as well as ingredients in dentifrices that provide benefits like fluoride, plaque inhibition, tartar control, and whitening. The goal of mechanical plaque control is to regularly remove dental plaque using oral hygiene practices in order to prevent its accumulation and promote proper oral health.
Interdisciplinary Periodontics ppt.pptx
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.
Endo – Perio lesions.ppt
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.
Lynn-GINGIVAL RECESSION.ppt
Gingival recession is the displacement of gingival tissue away from the tooth surface, exposing the root surface. It can be caused by periodontal disease, traumatic brushing, occlusal issues, or iatrogenic factors. Treatment depends on the severity and classification of the recession. For mild cases with no sensitivity or aesthetic concerns, improved brushing may suffice. More severe recession involving sensitivity or aesthetics may be treated with surgical root coverage procedures like laterally positioned pedicle grafts or coronally advanced flaps, which can achieve 65-98% root coverage depending on the technique and recession classification. The laterally positioned pedicle graft involves sliding keratinized gingiva from an adjacent tooth to cover the exposed root
Periodontal ligament.pptx by Dr. Ira Gupta
The document provides an overview of the periodontal ligament (PDL). It discusses the development, cells, extracellular substances like fibers and ground substance, structures present, and functions of the PDL. The PDL is a soft connective tissue that surrounds tooth roots and attaches them to the alveolar bone. It is derived from the dental follicle during root formation and contains fibroblasts, cementoblasts, osteoblasts and other cells. Collagen fibers are the main component and help attach the PDL to cementum and bone. The PDL acts to support teeth, absorb chewing forces, and allow limited movement.
STRESS & PERIODONTAL DISEASE.pptx by Dr. Neelam Das
When the body is under stress, it produces more of the hormone cortisol, which acts as an anti-inflammatory agent. When cortisol is produced peripherally in the gums, it stimulates mast cells to produce more proteins, simultaneously increasing inflammation and the progression of periodontal disease.
Antimicrobials in periodontics.pptx by Dr. Shruti Gupta
Antimicrobials in periodontics.pptx by Dr. Shruti GuptaRama Dental College Hospital and Research Center
This document discusses various local drug delivery systems used as adjuncts to scaling and root planing for the treatment of periodontal disease. It describes chlorhexidine gluconate chips, doxycycline hyclate gel, tetracycline fibers, and minocycline microspheres that are applied directly into periodontal pockets for sustained release. The document also discusses the host modulation effects of systemic doxycycline and reviews prophylactic antibiotic regimens for medically compromised patients undergoing dental procedures.Periodontal therapy in female patients.pdf
[1] A woman's life cycle is influenced by hormones from puberty through menopause, which impact oral and periodontal health.
[2] During puberty, pregnancy, menstruation, use of oral contraceptives, and menopause, hormone levels fluctuate and can cause gingival inflammation and other oral manifestations if not properly managed.
[3] Periodontal therapy must be customized for each patient based on their stage of life and hormone levels, with treatments adjusted accordingly to provide optimal care while avoiding risks associated with hormonal changes.
agressive periodontitis.pptx
Aggressive periodontitis is distinguished from chronic periodontitis with respect to,
Age of onset
Rapid rate of disease progression
Nature & composition of the associated subgingival micro flora
Alterations in the host’s immune response
Familial aggregation of the disease
Types of Aggressive Periodontitis
Localized Aggressive Periodontitis-LAP
Generalized Aggressive Periodontitis-GAP
Localized aggressive periodontitis
Historical background,
Diffuse atrophy of the alveolar bone (Gottlieb-1923)
Deep cementopathia (Gottlieb-1928)
Parodontitis marginalis progressiva(Wannenmacher- 1938)
Periodontosis (world workshop in periodontics -1966)
Juvenile periodontitis (Chaput etal-1971)
Localized Juvenile periodontitis (world workshop in periodontics- 1989)
Localized aggressive periodontitis (International workshop by american academy of periodontology – 1999)
Clinical characteristics LAP
LAP is localized to first molar or incisor with interproximal attachment loss on at least two permanent teeth ,one of which is a first molar & involving no more than two teeth other than first molars & incisors.
Possible reasons for limitation of the destruction
After initial colonization of the first permanent teeth( first molars & incisors) Aa evades the host defenses by different mechanisms they are –
-PMN chemotaxis inhibiting factors
-Endotoxin
-Collagenases
-Leukotoxin
After this initial attack adequate immune defenses are stimulated to produce opsonic antibodies to enhance the clearance & phagocytosis of invading bacteria & neutralize leukotoxic activity there by colonization of other sites may be prevented
Bacteria antagonistic to Aa may colonize the periodontal tissues & inhibit Aa from further colonization of periodontal sites in the mouth ,hence Aa infection & tissue destruction is localized
Aa may lose its leukotoxin producing ability for unknown reasons
A defect in cementum formation may be responsible for the localization of the lesions
Clinical features of LAP
Age of onset –puberty & around 20 years of age
It affects both male & female
There will be a lack of clinical inflammation despite the presence of deep periodontal pockets & advanced bone loss
The amount of plaque is minimal & is rarely mineralizes to calculus
Plaque Contains elevated levels of Aa & Pg
The Rate of boneloss is about 3 to 4 times faster than in chronic periodontitis
Clinical features of LAP
Distolabial migration of the maxillary incisors with concomitant diastema formation
Increasing mobility of the maxillary & mandibular incisors & first molars
Sensitivity of denuded root surfaces to thermal & tactile stimuli
Deep dull radiating pain during mastication
Robust antibody response to pathogens
Radiographs reveal ‘arc shaped loss of alveolar bone extending from distal surface of the second premolar to the mesial surface of the second molar’
Localized Aggressive periodontitis
Generalized Aggressive Periodontitis
SURGERY TO INCREASE WIDTH OF ATTACHED GINGIVA.pptx
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Free Gingival Auto graft
Free connective tissue auto grafts
The Apically Positioned Flap.
NON-SURGICAL PERIODONTAL INSTRUMENTS.pptx
NON SURGICAL PERIODONTAL INSTRUMENT has been designed for specific purposes such as diagnosing the periodontal disease, removing calculus, planning root surfaces, curetting the gingiva and removing diseased tissue.
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incision.pdf
- 1. INCISIONS AND TISSUE MANAGEMENT IN PERIODONTAL SURGERY--- 1
- 2. INTRODUCTION ❖ Incision: A cut or surgical wound made by a knife, electrosurgical scalpel, laser, or other such instrument. --- GPT Severing of tissue by means of a knife, scalpel --- Peterson 2
- 3. ESSENTIAL PRECONDITIONS FOR SELECTION ❖ Osseous topography ❖ Blood supply ❖ Protection to anatomic structures ❖ Primary wound closure ❖ Unseen findings ? 3
- 4. WHY PROPER INCISIONS? ❖ Impaired wound healing ❖ Injured nerves and anatomic structures ❖ Esthetic impairment ❖ Anatomical limits 4
- 5. INCISIONS FOR PERIODONTAL SURGERY ❖ Horizontal incisions Internal / Apically directed External / Coronally directed 5
- 6. 6
- 10. INDICATIONS ❖ Access flap surgery ❖ Access flap surgery for GTR ❖ Narrow keratinized gingiva < 3 mm ❖ Esthetically relevant areas 10
- 12. INDICATIONS ❖ Maintain interdental gingiva ❖ Treatment confined to oral/buccal surfaces 12
- 13. PAPILLA PRESERVING INCISION ❖ Takei et al Papilla preservation flap incision ❖ Cortellini et al Modified papilla preservation flap incision 13
- 14. 14
- 16. ❖ Difficult to perform ❖ No guidance at tooth surface ❖ Slippage ❖ Gingival biotype ( thick) 16
- 18. INDICATIONS ❖ >5 mm pocket depth ❖ Esthetics not relevant ❖ Crown lengthening 18
- 22. 22
- 24. 24
- 26. 26
- 27. TISSUE MANAGEMENT ❖ Inflammation free ❖ Oral hygiene proper ❖ Sufficient deep anesthesia ❖ Sharp instruments ❖ Proper instrumentation 27
- 28. ❖ Sutures ❖ Periodontal pack ❖ Microsurgery 28
- 29. CONCLUSION ❖ Proper incisions and proper management of the tissues will lead to a good healing to occur by repair of the tissues Hence proper instrumentation and proper use wherever necessary will help for the periodontal procedures to be precise and will help to obtain good results. 29