SlideShare a Scribd company logo
RATIONALE FOR
PERIODONTAL TREATMENT
WHAT DOES PERIODONTAL THERAPY
ACCOMPLISH??
LOCAL THERAPY
• The cause of periodontitis and gingivitis is bacterial plaque
accumulation on the tooth surface in close proximity to gingival
tissue.
• Factors Favouring : calculus , overhanging margins of
restorations and food impaction
SYSTEMIC THERAPY
SYSTEMIC THERAPY EMPLOYED AS AN ADJUNCT TO LOCAL
MEASURES
1. The control of systemic complications from acute infections or chemotherapy 
2. To prevent harmful effects of post treatment bacteremia
3. Supportive nutritional therapy
4. The control of systemic disease that aggrevate patients periodontal condition
• Systemic therapy for treatment of the periodontal condition and in
conjunction with local therapy is indicated in localized and
generalized aggressive periodontitis
• In these diseases, systemic antibiotics are used to completely
eliminate the bacteria that invade the gingival tissues and can
repopulate the pocket after scaling and root planning
RECENT STUDIES STATED:
FACTORS AFFECTING HEALING
LOCAL FACTORS
• Systemic conditions that impair healing may reduce the
effectiveness of local periodontal treatment and should be
corrected before, or along with, local procedures.
• Plaque microorganisms are the most common detterents to
healing after periodontal treatment.
HEALING IS DELAYED BY:
IMPORTANCE OF BLOOD SUPPLY
• Adequate blood supply is needed for the increased cellular activity
during healing
• If blood supply is impaired or insufficient areas of necrosis will develop
and delay the healing process
HOW HEALING IS IMPROVED?
• DEBRIDEMENT: Removal of degenerated and necrotic tissue
• Immobilization of the healing area
• Pressure on the wound
• Cellular activity in healing entails an increase in oxygen
consumption
SYSTEMIC FACTORS
• AGE:
Healing capacity diminishes with age because of atherosclerotic vascular
changes common in ageing resulting in reduction in blood circulation.
• Healing is delayed in patients with generalized infections and in those with
diabetes and other debilitating diseases
• INSUFFICIENT FOOD INTAKE
Bodily conditions that interfere with the use of nutrients; and
deficiencies in vitamin C, proteins, and other nutrients
• HORMONES
Systemically administered glucocorticoids such as cortisone
hinder repair by depressing the inflammatory reaction or by inhibiting the
growth of fibroblast, the production of collagen, and the formation of
endothelial cells
•
• Systemic stress, thyroidectomy ,testosterone, adrenocorticotropic
hormone, and large doses of estrogen suppress the formation of
granulation tissue and retard healing Progesterone increases
and accelerates the vascularization of immature granulation
tissue and appears to increase the susceptibility of the gingiva to
mechanical injury by causing dilation of the marginal vessels
HEALING AFTER PERIODONTAL
THERAPY
REGENERATION
IN PERIODONTIUM
• Gingival epithelium is replaced by epithelium
• Underlying connective tissue and periodontal ligament derived from
connective tissue
• Bone and cementum replaced by connective tissue
• Undifferenciated connective tissue cells develop into osteoblast and
cementoblast form bone and cementum
WEAR AND TEAR REPAIR
• In periodontium regeneration is a continuous physiologic process.
• Under normal conditions , new cells and tissues are constantly being
formed to replace those that mature and die. This is termed as ‘Wear
and Tear’ repair.
• Manifested by
1. Mitotic activity
2. New bone formation
3. Continuous deposition of cementum
REPAIR
• Restoration of the destroyed periodontium involves:
1. Mobilization of epithelial and connective tissue cells into the
damaged area
2. Increased local mitotic divisions to provide sufficient number of cells
NEW ATTACHMENT
REATTACHMENT
EPITHELIAL ADAPTATION
“It is the close apposition of the gingival epithelium to the tooth
surface, with no gain in height of gingival fiber attachment, without
complete obliteration of the pocket.”
RECONSTRUCTION OF PERIODONTIUM
• According to Melcher The regeneration of the periodontal ligament is
the key to new attachment because it “provides continuity between
the alveolar bone and the cementum and also because it contains
cells that can synthesize and remodel the three connective tissues of
the alveolar part of the periodontium”
During the healing stage of a periodontal pocket, the area is invaded
by cells from four different sources:
•Oral epithelium,
•Gingival connective tissue,
•Bone,
•Periodontal ligament
SEQUENCE OF EVENTS DURING HEALING STAGE
• If the epithelium proliferates along the tooth surface before other
tissues reach the area, the result will be along junctional
epithelium.
• If the cells from the gingival connective tissue are the first to
populate the area, the result will be fibers parallel to the tooth
surface are remodeling of the alveolar bone with no attachment
to the cementum
• If bone cells arrive first, root resorption and Ankylosis may occur
• Finally, onlywhen cells from the periodontal ligament proliferate
coronally is there new formation of cementum and periodontal
ligament
Rationale for periodontal treatment

More Related Content

What's hot

periodontal pocket
periodontal pocketperiodontal pocket
periodontal pocket
Dr.Jaffar Raza BDS
 
RADIOGRAPHIC AIDS IN THE DIAGNOSIS OF PERIODONTAL DISEASE
RADIOGRAPHIC AIDS IN THE DIAGNOSIS OF PERIODONTAL DISEASERADIOGRAPHIC AIDS IN THE DIAGNOSIS OF PERIODONTAL DISEASE
RADIOGRAPHIC AIDS IN THE DIAGNOSIS OF PERIODONTAL DISEASERupal Patle
 
Biologic width
Biologic widthBiologic width
Biologic width
Dentalorg.com DR.DEBAISH
 
Resective osseous surgery
Resective osseous surgeryResective osseous surgery
Resective osseous surgery
Shilpa Shiv
 
Trauma from occlusion
Trauma from occlusionTrauma from occlusion
Trauma from occlusion
Navneet Randhawa
 
Endodontics periodontal lesions
Endodontics periodontal lesionsEndodontics periodontal lesions
Endodontics periodontal lesions
Arshe Gs
 
General principles of Periodontal surgery
General principles of Periodontal surgeryGeneral principles of Periodontal surgery
General principles of Periodontal surgery
Jignesh Patel
 
ROOT COVERAGE PROCEDURES
ROOT COVERAGE PROCEDURESROOT COVERAGE PROCEDURES
ROOT COVERAGE PROCEDURES
Dr Ripunjay Tripathi
 
"GUIDED TISSUE REGENERATION"
"GUIDED TISSUE REGENERATION""GUIDED TISSUE REGENERATION"
"GUIDED TISSUE REGENERATION"
Dr.Pradnya Wagh
 
Gingival crevicular fluid
Gingival crevicular fluidGingival crevicular fluid
Gingival crevicular fluid
Dr. Virshali Gupta
 
local drug delivery in periodontics
local drug delivery in periodonticslocal drug delivery in periodontics
local drug delivery in periodontics
Aishwarya Hajare
 
Prognosis in periodontics
Prognosis in periodonticsPrognosis in periodontics
Prognosis in periodontics
DrRoopse Singh
 
Furcation involvement and management
Furcation involvement and managementFurcation involvement and management
Furcation involvement and management
Aishwarya Hajare
 
Chronic periodontitis (1)
Chronic periodontitis (1)Chronic periodontitis (1)
Chronic periodontitis (1)
Navneet Randhawa
 
Management of aggressive periodontitis
Management of aggressive periodontitisManagement of aggressive periodontitis
Management of aggressive periodontitisParth Thakkar
 
Guided tissue regeneration
Guided tissue regenerationGuided tissue regeneration
Guided tissue regenerationParth Thakkar
 
Root biomodification
Root biomodificationRoot biomodification
Root biomodification
Dr Deepu Mathews
 
Periodontal Diesase Classification (presentation)
Periodontal Diesase Classification (presentation)Periodontal Diesase Classification (presentation)
Periodontal Diesase Classification (presentation)
Neil Pande
 
Furcation involvement
Furcation involvementFurcation involvement
Furcation involvement
neeti shinde
 

What's hot (20)

periodontal pocket
periodontal pocketperiodontal pocket
periodontal pocket
 
RADIOGRAPHIC AIDS IN THE DIAGNOSIS OF PERIODONTAL DISEASE
RADIOGRAPHIC AIDS IN THE DIAGNOSIS OF PERIODONTAL DISEASERADIOGRAPHIC AIDS IN THE DIAGNOSIS OF PERIODONTAL DISEASE
RADIOGRAPHIC AIDS IN THE DIAGNOSIS OF PERIODONTAL DISEASE
 
Biologic width
Biologic widthBiologic width
Biologic width
 
Resective osseous surgery
Resective osseous surgeryResective osseous surgery
Resective osseous surgery
 
Trauma from occlusion
Trauma from occlusionTrauma from occlusion
Trauma from occlusion
 
Endodontics periodontal lesions
Endodontics periodontal lesionsEndodontics periodontal lesions
Endodontics periodontal lesions
 
General principles of Periodontal surgery
General principles of Periodontal surgeryGeneral principles of Periodontal surgery
General principles of Periodontal surgery
 
Gingival recession
Gingival recession Gingival recession
Gingival recession
 
ROOT COVERAGE PROCEDURES
ROOT COVERAGE PROCEDURESROOT COVERAGE PROCEDURES
ROOT COVERAGE PROCEDURES
 
"GUIDED TISSUE REGENERATION"
"GUIDED TISSUE REGENERATION""GUIDED TISSUE REGENERATION"
"GUIDED TISSUE REGENERATION"
 
Gingival crevicular fluid
Gingival crevicular fluidGingival crevicular fluid
Gingival crevicular fluid
 
local drug delivery in periodontics
local drug delivery in periodonticslocal drug delivery in periodontics
local drug delivery in periodontics
 
Prognosis in periodontics
Prognosis in periodonticsPrognosis in periodontics
Prognosis in periodontics
 
Furcation involvement and management
Furcation involvement and managementFurcation involvement and management
Furcation involvement and management
 
Chronic periodontitis (1)
Chronic periodontitis (1)Chronic periodontitis (1)
Chronic periodontitis (1)
 
Management of aggressive periodontitis
Management of aggressive periodontitisManagement of aggressive periodontitis
Management of aggressive periodontitis
 
Guided tissue regeneration
Guided tissue regenerationGuided tissue regeneration
Guided tissue regeneration
 
Root biomodification
Root biomodificationRoot biomodification
Root biomodification
 
Periodontal Diesase Classification (presentation)
Periodontal Diesase Classification (presentation)Periodontal Diesase Classification (presentation)
Periodontal Diesase Classification (presentation)
 
Furcation involvement
Furcation involvementFurcation involvement
Furcation involvement
 

Similar to Rationale for periodontal treatment

Cancer therapy induced Mucositis
Cancer therapy induced MucositisCancer therapy induced Mucositis
Cancer therapy induced Mucositis
Deepika Malik
 
"GINGIVAL-ENLARGEMENT"
"GINGIVAL-ENLARGEMENT""GINGIVAL-ENLARGEMENT"
"GINGIVAL-ENLARGEMENT"
Dr.Pradnya Wagh
 
Gingival enlargement
Gingival enlargementGingival enlargement
Gingival enlargement
Kalaivani Gunalan
 
influence_of_systamic_conditionn[1].pptx
influence_of_systamic_conditionn[1].pptxinfluence_of_systamic_conditionn[1].pptx
influence_of_systamic_conditionn[1].pptx
nz4pz8tmd8
 
Presentation1 [autosaved]
Presentation1 [autosaved]Presentation1 [autosaved]
Presentation1 [autosaved]
Dr Ambalika
 
Prosthodontic failures in systemic disease
Prosthodontic failures in systemic diseaseProsthodontic failures in systemic disease
Prosthodontic failures in systemic disease
manipal college of dental sciences
 
prosthodontic implications of oral mucosa.pptx
prosthodontic implications of oral mucosa.pptxprosthodontic implications of oral mucosa.pptx
prosthodontic implications of oral mucosa.pptx
Prenisha Preethi
 
ORTHOPEDIC CONDITIONS-2-1 infections.pptx
ORTHOPEDIC  CONDITIONS-2-1 infections.pptxORTHOPEDIC  CONDITIONS-2-1 infections.pptx
ORTHOPEDIC CONDITIONS-2-1 infections.pptx
KeyaArere
 
Frailty syndrome and periodontal disease ppt
Frailty syndrome and periodontal disease pptFrailty syndrome and periodontal disease ppt
Frailty syndrome and periodontal disease ppt
jegede lilian
 
Rationale for periodontal therapy
Rationale for periodontal therapyRationale for periodontal therapy
Rationale for periodontal therapy
Dr. Shashi Kiran
 
ORTHOPEDIC CONDITIONS.pptx
ORTHOPEDIC  CONDITIONS.pptxORTHOPEDIC  CONDITIONS.pptx
ORTHOPEDIC CONDITIONS.pptx
omondidennis011
 
Osteomyelitis
OsteomyelitisOsteomyelitis
Osteomyelitis
Ruhi Kashmiri
 
Impact of periodontal infection on systemic health By Dr Sachin Rathod
Impact of periodontal infection on systemic health By Dr Sachin RathodImpact of periodontal infection on systemic health By Dr Sachin Rathod
Impact of periodontal infection on systemic health By Dr Sachin Rathod
Dr Sachin Rathod
 
Peritonitis
PeritonitisPeritonitis
Peritonitis
abhishekmehta149
 
Wound healing
Wound healingWound healing
Wound healing
Gaurav Salunkhe
 
Pathogenesis of periodontitis
Pathogenesis of periodontitisPathogenesis of periodontitis
Pathogenesis of periodontitis
Gabriel Ketemepi
 
Trophic ulcers
Trophic ulcersTrophic ulcers
Trophic ulcers
Raghav Shrotriya
 
CHRONIC PERIODONTOTITIS-DR JEEVANAND DESHMUKH.pptx
CHRONIC PERIODONTOTITIS-DR JEEVANAND DESHMUKH.pptxCHRONIC PERIODONTOTITIS-DR JEEVANAND DESHMUKH.pptx
CHRONIC PERIODONTOTITIS-DR JEEVANAND DESHMUKH.pptx
DentalYoutube
 
periodontal health..WORLD WORKSHOP 2017
periodontal health..WORLD WORKSHOP 2017periodontal health..WORLD WORKSHOP 2017
periodontal health..WORLD WORKSHOP 2017
Dr.SANDIP Bhattacharyya
 

Similar to Rationale for periodontal treatment (20)

Cancer therapy induced Mucositis
Cancer therapy induced MucositisCancer therapy induced Mucositis
Cancer therapy induced Mucositis
 
"GINGIVAL-ENLARGEMENT"
"GINGIVAL-ENLARGEMENT""GINGIVAL-ENLARGEMENT"
"GINGIVAL-ENLARGEMENT"
 
Gingival enlargement
Gingival enlargementGingival enlargement
Gingival enlargement
 
influence_of_systamic_conditionn[1].pptx
influence_of_systamic_conditionn[1].pptxinfluence_of_systamic_conditionn[1].pptx
influence_of_systamic_conditionn[1].pptx
 
Overview of Oral Inflammation
Overview of Oral InflammationOverview of Oral Inflammation
Overview of Oral Inflammation
 
Presentation1 [autosaved]
Presentation1 [autosaved]Presentation1 [autosaved]
Presentation1 [autosaved]
 
Prosthodontic failures in systemic disease
Prosthodontic failures in systemic diseaseProsthodontic failures in systemic disease
Prosthodontic failures in systemic disease
 
prosthodontic implications of oral mucosa.pptx
prosthodontic implications of oral mucosa.pptxprosthodontic implications of oral mucosa.pptx
prosthodontic implications of oral mucosa.pptx
 
ORTHOPEDIC CONDITIONS-2-1 infections.pptx
ORTHOPEDIC  CONDITIONS-2-1 infections.pptxORTHOPEDIC  CONDITIONS-2-1 infections.pptx
ORTHOPEDIC CONDITIONS-2-1 infections.pptx
 
Frailty syndrome and periodontal disease ppt
Frailty syndrome and periodontal disease pptFrailty syndrome and periodontal disease ppt
Frailty syndrome and periodontal disease ppt
 
Rationale for periodontal therapy
Rationale for periodontal therapyRationale for periodontal therapy
Rationale for periodontal therapy
 
ORTHOPEDIC CONDITIONS.pptx
ORTHOPEDIC  CONDITIONS.pptxORTHOPEDIC  CONDITIONS.pptx
ORTHOPEDIC CONDITIONS.pptx
 
Osteomyelitis
OsteomyelitisOsteomyelitis
Osteomyelitis
 
Impact of periodontal infection on systemic health By Dr Sachin Rathod
Impact of periodontal infection on systemic health By Dr Sachin RathodImpact of periodontal infection on systemic health By Dr Sachin Rathod
Impact of periodontal infection on systemic health By Dr Sachin Rathod
 
Peritonitis
PeritonitisPeritonitis
Peritonitis
 
Wound healing
Wound healingWound healing
Wound healing
 
Pathogenesis of periodontitis
Pathogenesis of periodontitisPathogenesis of periodontitis
Pathogenesis of periodontitis
 
Trophic ulcers
Trophic ulcersTrophic ulcers
Trophic ulcers
 
CHRONIC PERIODONTOTITIS-DR JEEVANAND DESHMUKH.pptx
CHRONIC PERIODONTOTITIS-DR JEEVANAND DESHMUKH.pptxCHRONIC PERIODONTOTITIS-DR JEEVANAND DESHMUKH.pptx
CHRONIC PERIODONTOTITIS-DR JEEVANAND DESHMUKH.pptx
 
periodontal health..WORLD WORKSHOP 2017
periodontal health..WORLD WORKSHOP 2017periodontal health..WORLD WORKSHOP 2017
periodontal health..WORLD WORKSHOP 2017
 

Recently uploaded

一比一原版(SLU毕业证)圣路易斯大学毕业证成绩单专业办理
一比一原版(SLU毕业证)圣路易斯大学毕业证成绩单专业办理一比一原版(SLU毕业证)圣路易斯大学毕业证成绩单专业办理
一比一原版(SLU毕业证)圣路易斯大学毕业证成绩单专业办理
keoku
 
Comptia N+ Standard Networking lesson guide
Comptia N+ Standard Networking lesson guideComptia N+ Standard Networking lesson guide
Comptia N+ Standard Networking lesson guide
GTProductions1
 
History+of+E-commerce+Development+in+China-www.cfye-commerce.shop
History+of+E-commerce+Development+in+China-www.cfye-commerce.shopHistory+of+E-commerce+Development+in+China-www.cfye-commerce.shop
History+of+E-commerce+Development+in+China-www.cfye-commerce.shop
laozhuseo02
 
急速办(bedfordhire毕业证书)英国贝德福特大学毕业证成绩单原版一模一样
急速办(bedfordhire毕业证书)英国贝德福特大学毕业证成绩单原版一模一样急速办(bedfordhire毕业证书)英国贝德福特大学毕业证成绩单原版一模一样
急速办(bedfordhire毕业证书)英国贝德福特大学毕业证成绩单原版一模一样
3ipehhoa
 
Internet-Security-Safeguarding-Your-Digital-World (1).pptx
Internet-Security-Safeguarding-Your-Digital-World (1).pptxInternet-Security-Safeguarding-Your-Digital-World (1).pptx
Internet-Security-Safeguarding-Your-Digital-World (1).pptx
VivekSinghShekhawat2
 
1比1复刻(bath毕业证书)英国巴斯大学毕业证学位证原版一模一样
1比1复刻(bath毕业证书)英国巴斯大学毕业证学位证原版一模一样1比1复刻(bath毕业证书)英国巴斯大学毕业证学位证原版一模一样
1比1复刻(bath毕业证书)英国巴斯大学毕业证学位证原版一模一样
3ipehhoa
 
一比一原版(CSU毕业证)加利福尼亚州立大学毕业证成绩单专业办理
一比一原版(CSU毕业证)加利福尼亚州立大学毕业证成绩单专业办理一比一原版(CSU毕业证)加利福尼亚州立大学毕业证成绩单专业办理
一比一原版(CSU毕业证)加利福尼亚州立大学毕业证成绩单专业办理
ufdana
 
Latest trends in computer networking.pptx
Latest trends in computer networking.pptxLatest trends in computer networking.pptx
Latest trends in computer networking.pptx
JungkooksNonexistent
 
This 7-second Brain Wave Ritual Attracts Money To You.!
This 7-second Brain Wave Ritual Attracts Money To You.!This 7-second Brain Wave Ritual Attracts Money To You.!
This 7-second Brain Wave Ritual Attracts Money To You.!
nirahealhty
 
How to Use Contact Form 7 Like a Pro.pptx
How to Use Contact Form 7 Like a Pro.pptxHow to Use Contact Form 7 Like a Pro.pptx
How to Use Contact Form 7 Like a Pro.pptx
Gal Baras
 
1.Wireless Communication System_Wireless communication is a broad term that i...
1.Wireless Communication System_Wireless communication is a broad term that i...1.Wireless Communication System_Wireless communication is a broad term that i...
1.Wireless Communication System_Wireless communication is a broad term that i...
JeyaPerumal1
 
The+Prospects+of+E-Commerce+in+China.pptx
The+Prospects+of+E-Commerce+in+China.pptxThe+Prospects+of+E-Commerce+in+China.pptx
The+Prospects+of+E-Commerce+in+China.pptx
laozhuseo02
 
BASIC C++ lecture NOTE C++ lecture 3.pptx
BASIC C++ lecture NOTE C++ lecture 3.pptxBASIC C++ lecture NOTE C++ lecture 3.pptx
BASIC C++ lecture NOTE C++ lecture 3.pptx
natyesu
 
一比一原版(LBS毕业证)伦敦商学院毕业证成绩单专业办理
一比一原版(LBS毕业证)伦敦商学院毕业证成绩单专业办理一比一原版(LBS毕业证)伦敦商学院毕业证成绩单专业办理
一比一原版(LBS毕业证)伦敦商学院毕业证成绩单专业办理
eutxy
 
APNIC Foundation, presented by Ellisha Heppner at the PNG DNS Forum 2024
APNIC Foundation, presented by Ellisha Heppner at the PNG DNS Forum 2024APNIC Foundation, presented by Ellisha Heppner at the PNG DNS Forum 2024
APNIC Foundation, presented by Ellisha Heppner at the PNG DNS Forum 2024
APNIC
 
Multi-cluster Kubernetes Networking- Patterns, Projects and Guidelines
Multi-cluster Kubernetes Networking- Patterns, Projects and GuidelinesMulti-cluster Kubernetes Networking- Patterns, Projects and Guidelines
Multi-cluster Kubernetes Networking- Patterns, Projects and Guidelines
Sanjeev Rampal
 
test test test test testtest test testtest test testtest test testtest test ...
test test  test test testtest test testtest test testtest test testtest test ...test test  test test testtest test testtest test testtest test testtest test ...
test test test test testtest test testtest test testtest test testtest test ...
Arif0071
 
原版仿制(uob毕业证书)英国伯明翰大学毕业证本科学历证书原版一模一样
原版仿制(uob毕业证书)英国伯明翰大学毕业证本科学历证书原版一模一样原版仿制(uob毕业证书)英国伯明翰大学毕业证本科学历证书原版一模一样
原版仿制(uob毕业证书)英国伯明翰大学毕业证本科学历证书原版一模一样
3ipehhoa
 
guildmasters guide to ravnica Dungeons & Dragons 5...
guildmasters guide to ravnica Dungeons & Dragons 5...guildmasters guide to ravnica Dungeons & Dragons 5...
guildmasters guide to ravnica Dungeons & Dragons 5...
Rogerio Filho
 
Bridging the Digital Gap Brad Spiegel Macon, GA Initiative.pptx
Bridging the Digital Gap Brad Spiegel Macon, GA Initiative.pptxBridging the Digital Gap Brad Spiegel Macon, GA Initiative.pptx
Bridging the Digital Gap Brad Spiegel Macon, GA Initiative.pptx
Brad Spiegel Macon GA
 

Recently uploaded (20)

一比一原版(SLU毕业证)圣路易斯大学毕业证成绩单专业办理
一比一原版(SLU毕业证)圣路易斯大学毕业证成绩单专业办理一比一原版(SLU毕业证)圣路易斯大学毕业证成绩单专业办理
一比一原版(SLU毕业证)圣路易斯大学毕业证成绩单专业办理
 
Comptia N+ Standard Networking lesson guide
Comptia N+ Standard Networking lesson guideComptia N+ Standard Networking lesson guide
Comptia N+ Standard Networking lesson guide
 
History+of+E-commerce+Development+in+China-www.cfye-commerce.shop
History+of+E-commerce+Development+in+China-www.cfye-commerce.shopHistory+of+E-commerce+Development+in+China-www.cfye-commerce.shop
History+of+E-commerce+Development+in+China-www.cfye-commerce.shop
 
急速办(bedfordhire毕业证书)英国贝德福特大学毕业证成绩单原版一模一样
急速办(bedfordhire毕业证书)英国贝德福特大学毕业证成绩单原版一模一样急速办(bedfordhire毕业证书)英国贝德福特大学毕业证成绩单原版一模一样
急速办(bedfordhire毕业证书)英国贝德福特大学毕业证成绩单原版一模一样
 
Internet-Security-Safeguarding-Your-Digital-World (1).pptx
Internet-Security-Safeguarding-Your-Digital-World (1).pptxInternet-Security-Safeguarding-Your-Digital-World (1).pptx
Internet-Security-Safeguarding-Your-Digital-World (1).pptx
 
1比1复刻(bath毕业证书)英国巴斯大学毕业证学位证原版一模一样
1比1复刻(bath毕业证书)英国巴斯大学毕业证学位证原版一模一样1比1复刻(bath毕业证书)英国巴斯大学毕业证学位证原版一模一样
1比1复刻(bath毕业证书)英国巴斯大学毕业证学位证原版一模一样
 
一比一原版(CSU毕业证)加利福尼亚州立大学毕业证成绩单专业办理
一比一原版(CSU毕业证)加利福尼亚州立大学毕业证成绩单专业办理一比一原版(CSU毕业证)加利福尼亚州立大学毕业证成绩单专业办理
一比一原版(CSU毕业证)加利福尼亚州立大学毕业证成绩单专业办理
 
Latest trends in computer networking.pptx
Latest trends in computer networking.pptxLatest trends in computer networking.pptx
Latest trends in computer networking.pptx
 
This 7-second Brain Wave Ritual Attracts Money To You.!
This 7-second Brain Wave Ritual Attracts Money To You.!This 7-second Brain Wave Ritual Attracts Money To You.!
This 7-second Brain Wave Ritual Attracts Money To You.!
 
How to Use Contact Form 7 Like a Pro.pptx
How to Use Contact Form 7 Like a Pro.pptxHow to Use Contact Form 7 Like a Pro.pptx
How to Use Contact Form 7 Like a Pro.pptx
 
1.Wireless Communication System_Wireless communication is a broad term that i...
1.Wireless Communication System_Wireless communication is a broad term that i...1.Wireless Communication System_Wireless communication is a broad term that i...
1.Wireless Communication System_Wireless communication is a broad term that i...
 
The+Prospects+of+E-Commerce+in+China.pptx
The+Prospects+of+E-Commerce+in+China.pptxThe+Prospects+of+E-Commerce+in+China.pptx
The+Prospects+of+E-Commerce+in+China.pptx
 
BASIC C++ lecture NOTE C++ lecture 3.pptx
BASIC C++ lecture NOTE C++ lecture 3.pptxBASIC C++ lecture NOTE C++ lecture 3.pptx
BASIC C++ lecture NOTE C++ lecture 3.pptx
 
一比一原版(LBS毕业证)伦敦商学院毕业证成绩单专业办理
一比一原版(LBS毕业证)伦敦商学院毕业证成绩单专业办理一比一原版(LBS毕业证)伦敦商学院毕业证成绩单专业办理
一比一原版(LBS毕业证)伦敦商学院毕业证成绩单专业办理
 
APNIC Foundation, presented by Ellisha Heppner at the PNG DNS Forum 2024
APNIC Foundation, presented by Ellisha Heppner at the PNG DNS Forum 2024APNIC Foundation, presented by Ellisha Heppner at the PNG DNS Forum 2024
APNIC Foundation, presented by Ellisha Heppner at the PNG DNS Forum 2024
 
Multi-cluster Kubernetes Networking- Patterns, Projects and Guidelines
Multi-cluster Kubernetes Networking- Patterns, Projects and GuidelinesMulti-cluster Kubernetes Networking- Patterns, Projects and Guidelines
Multi-cluster Kubernetes Networking- Patterns, Projects and Guidelines
 
test test test test testtest test testtest test testtest test testtest test ...
test test  test test testtest test testtest test testtest test testtest test ...test test  test test testtest test testtest test testtest test testtest test ...
test test test test testtest test testtest test testtest test testtest test ...
 
原版仿制(uob毕业证书)英国伯明翰大学毕业证本科学历证书原版一模一样
原版仿制(uob毕业证书)英国伯明翰大学毕业证本科学历证书原版一模一样原版仿制(uob毕业证书)英国伯明翰大学毕业证本科学历证书原版一模一样
原版仿制(uob毕业证书)英国伯明翰大学毕业证本科学历证书原版一模一样
 
guildmasters guide to ravnica Dungeons & Dragons 5...
guildmasters guide to ravnica Dungeons & Dragons 5...guildmasters guide to ravnica Dungeons & Dragons 5...
guildmasters guide to ravnica Dungeons & Dragons 5...
 
Bridging the Digital Gap Brad Spiegel Macon, GA Initiative.pptx
Bridging the Digital Gap Brad Spiegel Macon, GA Initiative.pptxBridging the Digital Gap Brad Spiegel Macon, GA Initiative.pptx
Bridging the Digital Gap Brad Spiegel Macon, GA Initiative.pptx
 

Rationale for periodontal treatment

  • 2.
  • 3.
  • 4. WHAT DOES PERIODONTAL THERAPY ACCOMPLISH??
  • 5.
  • 7. • The cause of periodontitis and gingivitis is bacterial plaque accumulation on the tooth surface in close proximity to gingival tissue. • Factors Favouring : calculus , overhanging margins of restorations and food impaction
  • 8.
  • 10. SYSTEMIC THERAPY EMPLOYED AS AN ADJUNCT TO LOCAL MEASURES 1. The control of systemic complications from acute infections or chemotherapy  2. To prevent harmful effects of post treatment bacteremia 3. Supportive nutritional therapy 4. The control of systemic disease that aggrevate patients periodontal condition
  • 11. • Systemic therapy for treatment of the periodontal condition and in conjunction with local therapy is indicated in localized and generalized aggressive periodontitis • In these diseases, systemic antibiotics are used to completely eliminate the bacteria that invade the gingival tissues and can repopulate the pocket after scaling and root planning
  • 13.
  • 14.
  • 16. LOCAL FACTORS • Systemic conditions that impair healing may reduce the effectiveness of local periodontal treatment and should be corrected before, or along with, local procedures. • Plaque microorganisms are the most common detterents to healing after periodontal treatment.
  • 18. IMPORTANCE OF BLOOD SUPPLY • Adequate blood supply is needed for the increased cellular activity during healing • If blood supply is impaired or insufficient areas of necrosis will develop and delay the healing process
  • 19. HOW HEALING IS IMPROVED? • DEBRIDEMENT: Removal of degenerated and necrotic tissue • Immobilization of the healing area • Pressure on the wound • Cellular activity in healing entails an increase in oxygen consumption
  • 20. SYSTEMIC FACTORS • AGE: Healing capacity diminishes with age because of atherosclerotic vascular changes common in ageing resulting in reduction in blood circulation. • Healing is delayed in patients with generalized infections and in those with diabetes and other debilitating diseases
  • 21. • INSUFFICIENT FOOD INTAKE Bodily conditions that interfere with the use of nutrients; and deficiencies in vitamin C, proteins, and other nutrients • HORMONES Systemically administered glucocorticoids such as cortisone hinder repair by depressing the inflammatory reaction or by inhibiting the growth of fibroblast, the production of collagen, and the formation of endothelial cells •
  • 22. • Systemic stress, thyroidectomy ,testosterone, adrenocorticotropic hormone, and large doses of estrogen suppress the formation of granulation tissue and retard healing Progesterone increases and accelerates the vascularization of immature granulation tissue and appears to increase the susceptibility of the gingiva to mechanical injury by causing dilation of the marginal vessels
  • 24.
  • 26. IN PERIODONTIUM • Gingival epithelium is replaced by epithelium • Underlying connective tissue and periodontal ligament derived from connective tissue • Bone and cementum replaced by connective tissue • Undifferenciated connective tissue cells develop into osteoblast and cementoblast form bone and cementum
  • 27.
  • 28.
  • 29. WEAR AND TEAR REPAIR • In periodontium regeneration is a continuous physiologic process. • Under normal conditions , new cells and tissues are constantly being formed to replace those that mature and die. This is termed as ‘Wear and Tear’ repair. • Manifested by 1. Mitotic activity 2. New bone formation 3. Continuous deposition of cementum
  • 30.
  • 31.
  • 33. • Restoration of the destroyed periodontium involves: 1. Mobilization of epithelial and connective tissue cells into the damaged area 2. Increased local mitotic divisions to provide sufficient number of cells
  • 36. EPITHELIAL ADAPTATION “It is the close apposition of the gingival epithelium to the tooth surface, with no gain in height of gingival fiber attachment, without complete obliteration of the pocket.”
  • 38.
  • 39. • According to Melcher The regeneration of the periodontal ligament is the key to new attachment because it “provides continuity between the alveolar bone and the cementum and also because it contains cells that can synthesize and remodel the three connective tissues of the alveolar part of the periodontium”
  • 40.
  • 41. During the healing stage of a periodontal pocket, the area is invaded by cells from four different sources: •Oral epithelium, •Gingival connective tissue, •Bone, •Periodontal ligament
  • 42.
  • 43. SEQUENCE OF EVENTS DURING HEALING STAGE • If the epithelium proliferates along the tooth surface before other tissues reach the area, the result will be along junctional epithelium. • If the cells from the gingival connective tissue are the first to populate the area, the result will be fibers parallel to the tooth surface are remodeling of the alveolar bone with no attachment to the cementum
  • 44.
  • 45. • If bone cells arrive first, root resorption and Ankylosis may occur • Finally, onlywhen cells from the periodontal ligament proliferate coronally is there new formation of cementum and periodontal ligament