Periodontal diseases and their systemic effects
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السلام عليكم.. في هذه المحاضرة تتم مناقشة العلاقة مابين امراض اللثة و تأثيرها على كل من مرض السكري و الحمل و امراض القلب in this lecture , we discuss the relationship between the periodontal diseases and (DM, pregnancy and heart disease)
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This document discusses endo-perio lesions, which involve both endodontic and periodontal tissues. It defines endo-perio lesions as involving pulpal disease and destruction of the attachment apparatus from the gingival sulcus to the apex. There are anatomical and non-anatomical pathways connecting the tissues. Lesions are classified based on whether the primary involvement is endodontic or periodontal. Diagnostic procedures and appropriate treatment depend on accurately distinguishing the primary pathology. Treatment may involve endodontic therapy, periodontal therapy, or both depending on the classification and extent of disease.
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The document summarizes key aspects of patient assessment and clinical examination in dentistry. It discusses performing an infection control review, collecting the patient's chief complaint, medical history, and dental history. The clinical examination involves an extraoral examination of the head and neck and an intraoral examination of the soft tissues and teeth. The intraoral examination assesses the soft tissues, examines teeth for issues like caries, fractures, restorations, and performs pulp tests to evaluate vitality.
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This document provides an overview of pathologic tooth migration (PTM). It defines PTM as tooth displacement resulting from a disruption of forces that maintain normal tooth position due to periodontal disease. The document discusses several potential etiologic factors for PTM, including the destruction of periodontal tissues, occlusal factors, soft tissue pressures, periodontal inflammation, extrusive forces, habits, missing teeth, and malocclusions. It provides examples from studies on the role of bone loss, bite collapse, arch integrity, occlusal interferences, and oral habits in contributing to PTM. The document concludes by noting that the duration of forces is important in tooth movement.
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This document discusses the influence of systemic conditions on periodontal health. It focuses on the effects of diabetes mellitus, noting that diabetes can cause increased inflammation, attachment loss, and bone loss in periodontitis patients due to alterations in host defenses, connective tissue metabolism, wound healing, and the formation of advanced glycation end products. The document also briefly discusses the effects of other conditions like endocrine disorders, hematologic diseases, genetic disorders, stress, nutrition, and medications on periodontal health.
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The document discusses the relationship between pulpal and periodontal diseases. It states that diseases of the pulp or periodontium can lead to secondary diseases in the other via the apical foramen, lateral canals, or dentinal tubules. Both endodontic and periodontal examinations are important to diagnose the origin of lesions. Treatment should focus first on the primary disease, but both may need treatment if the secondary disease is established.
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This document summarizes the effects of hormones on periodontal tissues throughout a woman's life. During puberty, increased sex hormones lead to higher levels of gram-negative bacteria and gingivitis. In pregnancy, hormones cause gingival enlargement and increased inflammation. Menopause brings thinning tissues, dry mouth, bone loss and increased risk of periodontal disease. Oral contraceptives also increase gingival inflammation through hormonal effects. Proper oral hygiene and treatment are important for managing periodontal health at all stages of a woman's life.
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This document discusses endodontic microbiology. It begins by explaining the importance of effective diagnosis and treatment of endodontic infections. It then discusses the various portals of entry for microorganisms into the root canal system. The document classifies bacteria found in endodontic infections and discusses their pathogenicity and virulence factors. It describes the different types of intra-radicular and extra-radicular infections and highlights Enterococcus faecalis as the bacteria most commonly associated with persistent infections. The final sections discuss biofilms in endodontic infections and methods to identify bacteria through culture, Gram staining, and molecular diagnostic techniques like DNA-DNA hybridization and polymerase chain reaction.
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This document summarizes various risk factors associated with periodontal disease. It discusses both modifiable and non-modifiable risk factors such as smoking, diabetes, stress, drugs, systemic diseases, nutrition, genetics, socioeconomic status, and gender. Specific conditions like type 1 and type 2 diabetes are explained in more detail. The relationship between periodontal disease and various systemic conditions is also covered briefly.
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- They are classified as suprabony, infrabony, or furcation pockets based on their location relative to alveolar bone.
- Periodontal pockets contain plaque, microorganisms, inflammatory cells and products that drive the pathogenesis of periodontitis through host immune response and tissue destruction.
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This document classifies periodontal diseases into two main categories: gingivitis and periodontitis. Gingivitis is further divided into plaque-induced gingivitis and non-plaque induced gingivitis. Periodontitis is classified as chronic periodontitis, aggressive periodontitis, periodontitis as a manifestation of systemic diseases, and several other types. The document provides detailed descriptions and examples for each category and type of periodontal disease.
classification of periodontal diseases
The document categorizes and describes various types of periodontal diseases including:
- Chronic periodontitis, which is common in adults and progresses slowly, and can be localized or generalized.
- Aggressive periodontitis, which affects younger individuals and progresses rapidly. It can be localized or generalized.
- Periodontitis as a manifestation of systemic diseases such as hematological or genetic disorders.
- Developmental or acquired deformities and conditions that can modify or predispose individuals to plaque-induced gingivitis or periodontitis.
Chronic periodontitis
Dr. Abhishek Gaur
Reader & Asst. Professor
R. R. Dental College & Hospital
Udaipur, Rajasthan (INDIA)
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The document discusses bone loss patterns in periodontal disease. It notes that the balance between bone formation and resorption maintains bone height and density under normal conditions. The most common cause of bone destruction in periodontal disease is the extension of gingival inflammation into the supporting bone and tissues. This can lead to horizontal bone loss when inflammation travels along the bone crest or vertical bone loss when it travels directly into the periodontal ligament space. Bone destruction patterns include osseous craters in the interdental bone, bulbous bone contours, reversed architecture with loss of interdental bone, and furcation involvement in multi-rooted teeth.
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This document provides an overview of diabetes mellitus and its relationship to periodontal disease. It begins with definitions of diabetes and classifications of the different types. It then discusses the history, epidemiology, diagnosis, complications, and relationship between diabetes and periodontal disease. Specifically, it notes that diabetes is a risk factor for more severe periodontal disease and periodontal disease can worsen glycemic control in diabetes patients. The two-way relationship between periodontal infections and diabetes is explored.
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This document discusses the influence of systemic conditions on periodontal health. It focuses on the effects of diabetes mellitus, noting that diabetes can cause increased inflammation, attachment loss, and bone loss in periodontitis patients due to alterations in host defenses, connective tissue metabolism, wound healing, and the formation of advanced glycation end products. The document also briefly discusses the effects of other conditions like endocrine disorders, hematologic diseases, genetic disorders, stress, nutrition, and medications on periodontal health.
Endo perio lesions
The document discusses the relationship between pulpal and periodontal diseases. It states that diseases of the pulp or periodontium can lead to secondary diseases in the other via the apical foramen, lateral canals, or dentinal tubules. Both endodontic and periodontal examinations are important to diagnose the origin of lesions. Treatment should focus first on the primary disease, but both may need treatment if the secondary disease is established.
Periodontal therapy in the female patient
This document summarizes the effects of hormones on periodontal tissues throughout a woman's life. During puberty, increased sex hormones lead to higher levels of gram-negative bacteria and gingivitis. In pregnancy, hormones cause gingival enlargement and increased inflammation. Menopause brings thinning tissues, dry mouth, bone loss and increased risk of periodontal disease. Oral contraceptives also increase gingival inflammation through hormonal effects. Proper oral hygiene and treatment are important for managing periodontal health at all stages of a woman's life.
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This document describes a case study of hemisection of the distal root of tooth 36 in a 46-year-old male patient with localized chronic periodontitis. The patient presented with pain and sensitivity in the left, lower, posterior region for 3 months. Intraoral examination revealed 13mm probing depth and grade III furcation involvement on tooth 36. Radiographs showed bone loss obliterating the distal root. After hemisection of the distal root and extraction, bone grafting was performed and the area healed well. At 8 months post-op, a fixed prosthesis involving teeth 35-38 was placed, restoring the hemisected tooth 36. The case study demonstrates that hemisection can be a conservative treatment
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This document discusses periodontal response to external forces on teeth. It defines trauma from occlusion as injury to tissues from forces exceeding their adaptive capacity. Trauma can be acute or chronic, and primary (normal support) or secondary (reduced support). It discusses classifications and concepts around how gingival inflammation spreads to bone. Glickman's concept describes zones of irritation and co-destruction that are differentially affected. Waerhaug's concept is that bone loss is due exclusively to plaque inflammation. The stages of tissue response to increased forces are injury, repair, and adaptive remodeling.
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038. endo perio lesions
The document discusses periodontal-endodontic lesions, which occur when inflammation spreads between the pulp and periodontium. It identifies three categories of pathways for communication: developmental, pathologic, and iatrogenic. Microorganisms like Porphyromonas gingivalis and Treponema denticola have been found in endo-perio lesions. Diagnosis involves tests like radiographs, probing, and pulp vitality tests. Treatment aims to address both the pulpal and periodontal involvement through approaches like root canal therapy, scaling and root planing, and sometimes extraction.
Periodontal Chart presentation
This document contains sections for recording a patient's personal and medical history, along with findings from an oral examination. The personal history includes name, age, gender, and other demographic details. The medical history covers the patient's chief complaint, present illness, past medical/dental history, family history, and habits. The oral examination documents extraoral and intraoral soft tissue and bone findings, tooth characteristics, occlusion, and periodontal measurements. Radiographic findings are also noted. The summary concludes with diagnoses and an outline of the treatment plan phases.
Aggresive periodontitis
This document discusses aggressive periodontitis, a rare and severe form of periodontitis. It is characterized by early onset, rapid progression, and familial aggregation. There are two main types: localized aggressive periodontitis, which mainly affects first molars and incisors, and generalized aggressive periodontitis, which affects at least three teeth across the mouth. Risk factors include certain bacteria like Aggregatibacter actinomycetemcomitans, genetic factors, and immune system abnormalities. The document provides details on the clinical features, causes, and differences between the chronic and aggressive forms of periodontitis.
Endodontic microbiology
This document discusses endodontic microbiology. It begins by explaining the importance of effective diagnosis and treatment of endodontic infections. It then discusses the various portals of entry for microorganisms into the root canal system. The document classifies bacteria found in endodontic infections and discusses their pathogenicity and virulence factors. It describes the different types of intra-radicular and extra-radicular infections and highlights Enterococcus faecalis as the bacteria most commonly associated with persistent infections. The final sections discuss biofilms in endodontic infections and methods to identify bacteria through culture, Gram staining, and molecular diagnostic techniques like DNA-DNA hybridization and polymerase chain reaction.
Risk factors in Periodontal Disease
This document summarizes various risk factors associated with periodontal disease. It discusses both modifiable and non-modifiable risk factors such as smoking, diabetes, stress, drugs, systemic diseases, nutrition, genetics, socioeconomic status, and gender. Specific conditions like type 1 and type 2 diabetes are explained in more detail. The relationship between periodontal disease and various systemic conditions is also covered briefly.
Periodontal pocket
The document defines and classifies periodontal pockets. Key points:
- Periodontal pockets are pathologically deepened gingival sulci with destruction of supporting tissues.
- They are classified as suprabony, infrabony, or furcation pockets based on their location relative to alveolar bone.
- Periodontal pockets contain plaque, microorganisms, inflammatory cells and products that drive the pathogenesis of periodontitis through host immune response and tissue destruction.
- Probing depth measures pocket depth while attachment loss measures loss of supporting tissues from their original position. Pocket depth does not always correlate with severity of bone loss.
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Classification of periodontal diseases
This document classifies periodontal diseases into two main categories: gingivitis and periodontitis. Gingivitis is further divided into plaque-induced gingivitis and non-plaque induced gingivitis. Periodontitis is classified as chronic periodontitis, aggressive periodontitis, periodontitis as a manifestation of systemic diseases, and several other types. The document provides detailed descriptions and examples for each category and type of periodontal disease.
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classification of periodontal diseases
The document categorizes and describes various types of periodontal diseases including:
- Chronic periodontitis, which is common in adults and progresses slowly, and can be localized or generalized.
- Aggressive periodontitis, which affects younger individuals and progresses rapidly. It can be localized or generalized.
- Periodontitis as a manifestation of systemic diseases such as hematological or genetic disorders.
- Developmental or acquired deformities and conditions that can modify or predispose individuals to plaque-induced gingivitis or periodontitis.
Chronic periodontitis
Dr. Abhishek Gaur
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R. R. Dental College & Hospital
Udaipur, Rajasthan (INDIA)
LECT 7 ETIOLOGY OF PERIODONTAL DISEASE .pptx
Periodontal disease, also known as gum disease, is a common and serious oral health condition that affects the supporting structures of the teeth, including the gums, periodontal ligament, and alveolar bone. The etiology of periodontal disease is multifactorial, involving a combination of bacterial infection, host response, and various risk factors. Here's an overview of the etiology of periodontal disease:
Dental Plaque and Bacterial Infection:
The primary etiological factor of periodontal disease is dental plaque, a biofilm that forms on the teeth and gum line.
Specific bacteria within dental plaque, such as Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola (often referred to as the "red complex"), are particularly pathogenic and play a key role in the initiation and progression of periodontal disease.
When plaque is not adequately removed through oral hygiene practices, these bacteria can proliferate and produce toxins that induce inflammation and damage to the periodontal tissues.
Host Response:
The body's immune response to the bacterial infection is a crucial component in the development and progression of periodontal disease.
In susceptible individuals, an exaggerated immune response can lead to chronic inflammation and tissue destruction.
Genetic factors may influence an individual's susceptibility to periodontal disease by affecting the immune response and inflammatory pathways.
Risk Factors:
Poor Oral Hygiene: Inadequate brushing and flossing allow plaque to accumulate, increasing the risk of periodontal disease.
Smoking and Tobacco Use: Tobacco use is a significant risk factor for periodontal disease and can impair the body's immune response to bacterial infection.
Age: The risk of periodontal disease increases with age, partly due to cumulative exposure to risk factors and changes in the oral microbiome.
Systemic Conditions: Certain systemic conditions, such as diabetes, cardiovascular disease, and immunocompromised states, can increase susceptibility to periodontal disease.
Hormonal Changes: Hormonal fluctuations during puberty, pregnancy, and menopause can affect gum health and increase the risk of periodontal disease.
Local Factors:
Anatomy of Teeth: Misaligned or crowded teeth can create areas that are difficult to clean, increasing the risk of plaque accumulation and periodontal disease.
Dental Restorations: Poorly fitting dental restorations or orthodontic appliances can contribute to plaque retention and periodontal inflammation.
Environmental and Behavioral Factors:
Diet: Consumption of a diet high in sugars and carbohydrates can promote bacterial growth and plaque formation.
Stress: Chronic stress may impair the immune response and increase susceptibility to periodontal disease.
Stages of Periodontal Disease:
Gingivitis: The earliest stage of periodontal disease, characterized by inflammation of the gums (gingiva) without loss of supporting bone.
Relation between oral and systemic Health.pptx
This document discusses the relationship between oral and systemic health. It outlines how oral diseases like periodontitis can impact overall health through direct and indirect mechanisms. Periodontitis allows bacteria and inflammatory mediators to enter the bloodstream and cause systemic inflammation, potentially contributing to diseases like cardiovascular issues, respiratory infections, and rheumatoid arthritis. Maintaining good oral hygiene through brushing, flossing, and cleanings is important to prevent oral bacteria from spreading. The document also examines various systemic conditions that can manifest in the mouth, such as cancers, liver disease, and neurological disorders.
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This document discusses the relationship between oral and dental diseases and systemic health risks. It begins by reviewing the historical focal infection theory and its discrediting. Recent evidence suggests the oral cavity can harbor and disseminate pathogens, especially in immunocompromised individuals. Bacteremia is common following dental procedures. Three pathways are proposed for how oral infections may lead to secondary diseases: metastatic infection, injury from toxins/endotoxins, and inflammation from immune complexes. Specific systemic diseases associated with oral infection include cardiovascular disease, stroke, infective endocarditis, bacterial pneumonia, and low birth weight. Maintaining good oral health through regular dental visits may help prevent exacerbation of chronic diseases.
Classification of disseases
This document summarizes various gingival and periodontal diseases. It describes diseases caused by dental plaque, such as gingivitis, and modified by factors like medications, malnutrition, and systemic diseases. It also discusses periodontitis and other conditions like necrotizing gingivitis/periodontitis, endo-perio lesions, and developmental deformities that can affect the gingiva and periodontium. Diagnostic methods and typical treatments are mentioned for several conditions.
EPIDEMIOLOGY OF PERIODONTAL DISEASES 1.pptx
INTRODUCTION
• Gingival and periodontal diseases in their various forms have affected humans since the dawn of the history.
• Studies in paleopathology have indicated that destructive periodontal disease, as evidenced by bone loss, affected early humans in such diverse cultures as ancient Egypt and pre-columbian America.
• Epidemiologic studies identify risk factors for diseases and provide guidance for primary prevention, recommendations and identify where to intervene in disease process.
PERIODONTAL DISEASES
GINGIVITIS
• Inflammation of the gingival soft tissues with no loss of alveolar bone or apical migration of periodontal ligament along root surface.
• It may be characterized by edema, erythema, bleeding, and occasionally pain.
• Gingivitis is usually reversible with appropriate therapy.
PERIODONTITIS
• An inflammatory disease of the supporting tissues of the teeth caused by specific microorganisms or groups of specific microorganisms, resulting in progressive destruction of the periodontal ligament and alveolar bone with pocket formation, recession, or both.
• The clinical feature that distinguishes periodontitis from gingivitis is the Loss of clinical attachment
CLASSIFICATION OF PERIODONTAL DISEASES
CHRONIC PERIODONTITIS
• The most common form of periodontitis
• Most prevalent in adults but can occur in children
• Amount of destruction consistent with local factors
• Associated with a variable microbial pattern
• Associated with accumulations of plaque and calculus
• Slow to moderate rate of progression with possible periods of rapid progression
• Localized form: < 30% of sites involved
• Generalized form: > 30% of sites involved
• Slight: 1 to 2mm CAL (clinical attachment loss)
• Moderate: 3 to 4 mm CAL
• Severe: 5mm or greater CAL
AGGRESSIVE PERIODONTITIS
• Rapid attachment loss and bone destruction
• Amount of microbial deposits inconsistent with disease severity
• Familial aggregation of diseased individuals
• Generally diseased sites are infected with a specific bacteria (Actinobacillus actinomycetemcomitans)
• Abnormalities in phagocyte function
• Hyper-responsive macrophages, producing elevated PGE2 and IL1B
• Disease progression may be self-limiting
• It is of two types- localized and generalized
LOCALIZED AGGRESSIVE PERIODONTITIS
• Circumpubertal onset of disease
• Localized first molar/ incisor
• Interproximal attachment loss on at least two permanent teeth
• Robust serum antibody response to infecting agents
GENERALIZED AGGRESSIVE PERIODONTITIS
• Usually affecting persons under 30 years of age (however, may be older)
• Generalized interproximal attachment loss affecting at least three teeth other than first molars and incisors
• Pronounced episodic nature of destruction
• Poor antibody response to infecting agents
Periodontitis as a manifestation of Systemic disease
Hematologic disorders
A) Acquired neutropenia
B) Leukemias
Genetic disorders
A) Familial & cyclic neutropenia
B) Down’s syndrome
c) Papillon-Lefevre syndrome
Overview of Oral Inflammation
The document discusses oral inflammation and periodontal disease, noting that inflammation is a protective response but can lead to tissue damage if bacteria are not removed, and that periodontal disease is caused by bacteria and worsens as the inflammatory response damages tissues. It also explores the potential relationship between periodontitis and systemic diseases like cardiovascular disease through the transmission of oral bacteria and an increased inflammatory response.
Chronic periodontitis
Periodontal disease comprises of a group of inflammatory conditions of the supportive tissues of the teeth that are caused by bacteria.
Periodontal disease [autosaved]
This document summarizes different types of periodontal diseases including gingivitis, chronic periodontitis, aggressive periodontitis, necrotizing periodontal disease, periodontitis associated with systemic diseases, and abscesses of the periodontium. It describes the clinical features, risk factors, stages of progression, and treatment for each type of periodontal disease. Developmental deformities and conditions are also outlined that can increase the risk of plaque-induced gingivitis and periodontitis.
oral-systemic health inteconnection 2024.pdf
one stimulus, general response
oral medicine
periodontitis
Risk factors
This document summarizes various risk factors associated with periodontal disease. It discusses both modifiable and non-modifiable risk factors such as smoking, diabetes, stress, drugs, systemic diseases, nutrition, genetics, socioeconomic status, and gender. Specific conditions like type 1 and type 2 diabetes are explained in more detail. The relationship between periodontal disease and various systemic conditions is also covered briefly.
Periodontal diseases
This document provides an overview of periodontal diseases and conditions. It begins by defining the components of the periodontium and discussing the 1999 classification system from the AAP. It then covers various gingival diseases including plaque-induced, non-plaque induced, and those modified by systemic factors. It also discusses periodontitis, necrotizing periodontal diseases, abscesses of the periodontium, lesions affecting the periodontium and pulp, and developmental deformities and conditions. The document serves to classify and describe different periodontal diseases and issues.
Chronic periodontitis
Chronic periodontitis is the most common form of periodontitis and is characterized by microbial biofilm formation, periodontal inflammation, and attachment and bone loss. It is diagnosed based on clinical attachment level assessment and radiographs showing bone loss. Risk factors include local factors like plaque and calculus that retain bacteria, and systemic factors like diabetes which impair the immune response and increase the severity of periodontitis. The condition progresses slowly over time with increased attachment and bone loss with age.
New classification of periodontal disease
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
Relation Between Periodontal Diseases and Kidney Diseases
This document discusses the relationship between chronic kidney disease (CKD), kidney transplantation (KT), and periodontal disease. It notes that periodontal disease is a risk factor for CKD, as elevated antibodies against the periodontal pathogen Porphyromonas gingivalis have been linked to CKD progression. Patients with CKD or post-KT have impaired immunity making them susceptible to infection from periodontal bacteria. The document outlines how periodontal bacteria can enter the bloodstream and cause systemic inflammation, increasing risks for vascular damage and conditions like proteinuria. Inflammatory markers associated with periodontal disease may also impact renal allograft survival. Proper management of oral health is important for CKD and KT patients.
classificationofperiodontaldiseases HOD SIR.pptx
This document classifies periodontal diseases into two main categories: gingivitis and periodontitis. Gingivitis is further divided into plaque-induced and non-plaque induced gingivitis. Periodontitis includes chronic periodontitis, aggressive periodontitis, periodontitis as a manifestation of systemic diseases, necrotizing periodontal diseases, abscesses of the periodontium, and periodontitis associated with endodontic lesions. The document also discusses developmental deformities and conditions that can modify or predispose individuals to plaque-induced gingival diseases and periodontitis.
classification of periodontal diseases
The document summarizes the classification of periodontal diseases from 1989 to 2017. It discusses the key classifications in 1999 which addressed issues with prior classifications. The 1999 classification included 8 categories: 1) plaque-induced gingival diseases, 2) chronic periodontitis, 3) aggressive periodontitis, 4) periodontitis as a manifestation of systemic diseases, 5) necrotizing periodontal diseases, 6) abscesses of the periodontium, 7) periodontitis associated with endodontic lesions, and 8) developmental or acquired deformities and conditions. It also describes features of chronic periodontitis, aggressive periodontitis, and other periodontal diseases and conditions.
Chronic periodontitis
Chronic periodontitis is the most common form of periodontitis. It is characterized by a slowly progressing inflammation caused by bacterial plaque. Key features include gingival bleeding, pocket formation, attachment loss, and bone loss. Risk factors that can modify the host response include diabetes, smoking, local factors like calculus that retain plaque, and genetic susceptibility. Chronic periodontitis is usually diagnosed in adults based on clinical signs of bone and attachment loss.
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Periodontal diseases and their systemic effects
- 1. Periodontal diseases and their systemic effects By : السالم عبد سميةرمضانالفيتوري Misurata /Libya
- 2. What is periodontitis ? Periodontal disease is a chronic bacterial infection that affects both the gingiva and the bone that supports the teeth and is caused by anaerobic Gram- negative microorganisms that are present in the bacterial plaque that adheres to the teeth
- 3. Risk factors for periodontitis *Non Genetic : • Smoking is a major risk factor • Diabetes • Conditions associated with compromised immune responses (e.g. HIV) • Nutritional defects • Osteoporosis • Medications that cause drug induced gingival overgrowth (e.g. some calcium channel blockers, phenytoin, cyclosporine) • local factors (e.g. anatomical deficiencies in the alveolar bone) Genetic factors (as yet poorly defined)
- 4. IS PERIODONTITIS A RISK FACTOR FOR………….?? • Cardiovascular disease • Diabetes mellitus • Adverse pregnancy outcomes • Respiratory infections • Rheumatoid arthritis • Renal dysfunction • Alzheimer’s disease
- 5. Mechanism
- 6. Periodontitis disturbs systemic homeostasis Chronic damage of epithelial tissues due to periodontitis may induce the periodontal pocket to ulcerate that allows access to the bloodstream Bacteria and their toxins, cytokines,mediators of inflammation disrupt homeostasis when toxins gain entry to the systemic circulation The proinflammatory cytokines TNF-α, IL-1β, and gamma interferon as well as PGE2 reach high tissue concentrations in periodontitis
- 7. So the periodontitis is sub-acute infection cause : Bacteremia: Disseminated inflammation Low grade infection , mainly gram –ve which produce LPS
- 11. The six "classic" major complications of diabetes include : •microangiopathy • nephropathy • neuropathy •macro vascular disease •delayed wound healing •Periodontitis
- 13. effect of DM on periodontitis
- 14. Role of TNF-alpha Antagonist to IRS-1. Inhibits phosphorylation and translocation of insulin receptor. Inhibits intracellular glucose transport. DM2 Insulin resistance: improper glycemic control
- 15. Diabetic patients have a stronger predisposition for periodontal disease and a greater difficulty in controlling their metabolic glucose levels if not treated. Alterations to glucose control Periodontal therapy Proper diabetic treament Proper glycemic level in blood
- 23. so it’s not related to the mouth ! But ! Solution starting from mouth