Oral Pathology I Third Year

1. Periodontal diseases

2. • Periodontal disease (IPD) involves a group of
diseases characterized by affecting the tissues
that sustain and affecting the tissues that
sustain and protect the tooth:
• 1.Gingiva,
• 2.Periodontal ligament,
• 3.Root cement and
• 4.Alveolar bone

3. Gingivitis
Periodontitis
Definition
•Inflammation of gingiva
Inflammatory disease that
involve supporting tissues
of the tooth
• Periodontal Ligaments
•Alveolar bone
Etiology
•Plaque induces
•Non plaque induce
•Microorganisms
Fate
•If treated early curable
•If not treated progress to
periodontitis
•Periodontal fiber
reattachement is difficult
•No regain of bone
destructed
Classification
A. Inflammatory
B. Dystrophic (degenerative)

4. Exotoxins
Enzyme
Endotoxins
Effect
Enzyme
Effect
Hyaluronidase
Increase tissue
permeability
IgA/IgG proteases
Degrades
immunoglobulins
Collagenase
Damages CT
Catalase
Decreases PMNperoxidase kill
Certain protease
Damages Cell
Membranes
Fibrolysin
Inhibits healing allow
tissue spread of
Bacteria
Phospholipase A
Induce
prostaglandinmediated bone
resorption
Endotoxins-promoted Tissue damage
through:
• Cytotoxicity
• Complement activation
• Bone resorption
Nuclease
Degrade nucleic acid
Neuraminidase
Facilitate Bacterial
tissue spread

5. Bacterial toxins
• Exotoxins:
– Is protein released extra-cellularly by living cells
• Exotoxins are secreted by many Gram positive
and Gram negative bacteria.
• Endotoxins:
– Is lipopolysaccharide in the cell wall of gram-negative
organisms released at cell death
• Endotoxins are only seen with Gram negative
bacteria.