DISEASES OF PERIODONTIUM

Get Started. It's Free
or sign up with your email address
DISEASES OF PERIODONTIUM by Mind Map: DISEASES OF PERIODONTIUM

1. 2. PERIODONTITIS

1.1. Definition

1.1.1. inflammation of gingival tissues in association with some loss of attachment of PDL and alveolar bone.

1.1.2. Due to progressive loss of attachment, destruction of PDL and adjacent alveolar bone occurs

1.1.3. The sulcular epithelium shifts apically along the root surface, resulting in formation of periodontal pockets.

1.2. CAUSATIVE FACTORS

1.2.1. Dental Plaque / calculus

1.2.2. Advancing age

1.2.3. Smoking

1.2.4. DM

1.2.5. Lower socioeconomic status

1.2.6. Poor oral hygiene

1.2.7. AIDS

1.2.8. Other systemic diseases

1.2.8.1. bleeding disorders

1.2.8.2. sarcoidosis

1.2.8.3. Hypophosphatasia

1.3. PATHOGENESIS

1.3.1. From > 100 yrs

1.3.1.1. periodontitis cause dental plaque and dental plaque causes periodontitis

1.3.1.2. But periodontitis absent in patients with extensive plaque also

1.3.2. Recent evidence

1.3.2.1. periodontitis results not from mere presence of plaque but from changes in proportions of bacterial species in plaque

1.3.3. periodontitis associated with

1.3.3.1. Actinobacillus actinomycetecomitans, Bacteroides forsythus and Prevotella intermedia

1.3.3.2. pathogenic bacteria exist inside the plaque where they are protected from host defenses

1.3.3.3. also show increased resistance to local / systemic antibiotics

1.3.3.4. These bacteria then release lipopolysaccharides which bring about the release of catabolic inflammatory mediators as host response

1.3.4. only presence of pathogenic bacteria is not sufficient to cause periodontitis

1.4. Classifications/types

1.4.1. Chronic

1.4.1.1. Type

1.4.1.1.1. Localized

1.4.1.1.2. Generalised

1.4.1.2. CF

1.4.1.2.1. Age

1.4.1.2.2. Sex

1.4.1.2.3. Signs n symptoms

1.4.2. Aggressive

1.4.2.1. Localized

1.4.2.2. Generalised

1.4.2.2.1. Age

1.4.2.2.2. Signs n symptoms

1.4.2.2.3. HP

1.4.3. Periodontitis as manifestation of systemic diseases

1.4.3.1. hematologic disorders

1.4.3.2. genetic diseases

1.4.3.3. Diabetes mellitus

1.4.4. NECROTIZING PERIODONTAL DISEASES

1.4.4.1. Necrotizing ulcerative gingivitis

1.4.4.1.1. Similar features as ANUG

1.4.4.1.2. shows loss of PDL attachment and alveolar bone loss.

1.4.4.1.3. Can arise within pre existing periodontitis or as a sequela of ANUG

1.4.4.1.4. Affects younger persons

1.4.4.2. Necrotizing ulcerative periodontitis

1.4.5. Abscesses of periodontium

1.4.5.1. Gingival abscess

1.4.5.2. Periodontal abscess

1.4.5.2.1. arises in preexisting PDL lesion

1.4.5.2.2. Due to ?

1.4.5.2.3. CAUSATIVE FACTORS

1.4.5.2.4. CF

1.4.5.3. PERICORONITIS

1.4.5.3.1. Infection occurs around impacted / partially erupted teeth when food debris and bacteria collect between gingiva and tooth

1.4.5.3.2. Most commonly seen on third molars.

1.4.5.3.3. Pain, foul taste and inability to close the mouth are common symptoms

1.4.5.3.4. HP

1.4.5.4. Pericoronal abscess

1.4.6. Periodontitis associated with endodontic lesions.

1.4.7. JUVENILE PERIODONTITIS

1.4.7.1. Also called as “Early onset periodontitis” or “Aggressive periodontitis”

1.4.7.2. occurs in younger persons with no association with any systemic disease

1.4.7.3. Diagnosis

1.4.7.3.1. by exclusion and all systemic diseases known to cause premature loss of PDL attachment must be ruled out first.

1.4.7.3.2. This disease is associated more with deficiency of immune response rather than plaque / calculus .

1.4.7.3.3. Suspected pathogens are

1.4.7.4. CF

1.4.7.4.1. LOCALIZED AGGRESSIVE PERIODONTITIS

1.4.7.4.2. Age

1.4.7.4.3. Signs n symptoms

1.4.7.5. RADIOGRAPHIC

1.4.7.5.1. around anterior teeth

1.4.7.5.2. Tooth mobility and migration is common

1.4.7.5.3. Bilaterally symmetrical vertical bone loss.

1.4.7.5.4. In 1/3rd of cases, disease progresses to a more generalized pattern

1.4.8. PAPILLON-LEFEVRE SYNDROME

1.4.8.1. Autosomal recessive disorder

1.4.8.2. Shows oral and dermatological manifestations.

1.4.8.3. Similar dermatological findings are also seen in absence of oral findings??

1.4.8.3.1. findings – Meleda’sdisease.

1.4.8.4. PATHOGENESIS

1.4.8.4.1. Oral manifestation are due to accelerated periodontitis that appears to be due to?::

1.4.8.5. CF

1.4.8.5.1. Age

1.4.8.5.2. Prevalence

1.4.8.5.3. Skin manifestations appear as

1.4.8.5.4. Oral findings consist of rapidly advancing periodontitis , seen in both deciduous and permanent dentitions.

1.4.8.5.5. Widespread hyperplastic and hemorrhagic gingivitis is seen

1.4.8.5.6. Tooth mobility, migration and eventual loss of teeth occurs without therapy.

1.4.8.6. Radiologically

1.4.8.6.1. teeth appear to “float” in soft tissue why??

1.4.8.7. HP

1.4.8.7.1. Features = adult periodontitis

1.4.8.7.2. Hyperplastic sulcular epithelium and infiltration with WBC’s.

1.4.8.7.3. Underlying CT

2. 1-GINGIVITIS

2.1. inflammation of soft tissues surrounding the teeth.

2.2. Does not include inflammation of alveolar ridges, PDL or cementum.**

2.3. FACTORS RELATED TO GINGIVITIS: -

2.3.1. Hormonal (progesterone)

2.3.2. Smoking

2.3.3. Stress

2.3.4. Poor nutrition

2.3.5. Medication

2.3.6. DM

2.4. CF

2.4.1. Age

2.4.1.1. Increase with age

2.4.1.2. between 9 – 14 years.

2.4.2. Sex

2.4.2.1. Less in females

2.4.2.2. Female susceptibility increase with increase levels of progesterone associated with pregnancy or oral contraceptives.

2.4.3. Signs n symptoms

2.4.3.1. Can be localized (marginal or papillary gingivitis) or diffuse.

2.4.3.2. Early signs

2.4.3.2.1. loss of stippling

2.4.3.2.2. bleeding on minimal probing.

2.4.3.3. Early inflammation

2.4.3.3.1. gingiva light red.

2.4.3.3.2. As progress

2.4.3.4. Gingivitis can take various forms

2.4.3.4.1. Mouth breathing

2.4.3.4.2. Puberty

2.4.3.4.3. Chronic hyperplastic gingivitis

2.4.3.4.4. Hyperplastic gingivitis with Pyogenic granuloma

2.5. HF

2.5.1. Early

2.5.1.1. presence of PMNL’s in the CT adjacent to sulcular epithelium.

2.5.2. Inflammation progresses

2.5.2.1. Lead (infiltrate becomes mixed (lymphocytes, plasma cells and PMNL’s).

2.5.3. Fibrosis, edema and hemorrhage may also be seen.

2.6. Characteristics/types

2.6.1. Plaque related

2.6.2. Acute necrotizing ulcerative gingivitis (ANUG)

2.6.2.1. called “Vincent’s infection” & “Trench Mouth”.

2.6.2.2. caused by bacteria like – Borrelia vincentii, Fusobacterium nucleatum, Prevotella intermedia and species of Treponema and Selenomona.

2.6.2.3. CAUSATIVE FACTORS: -

2.6.2.3.1. Psychological stress

2.6.2.3.2. Immunosupression

2.6.2.3.3. Smoking

2.6.2.3.4. Local trauma

2.6.2.3.5. Poor nutritional status

2.6.2.4. CF

2.6.2.4.1. Age

2.6.2.4.2. Sex

2.6.2.4.3. Site

2.6.2.4.4. Signs n symptoms

2.6.2.5. HP

2.6.2.5.1. Non specific features

2.6.2.5.2. Interdental papillae show surface ulceration covered by a fibrinopurulent membrane.

2.6.2.5.3. Underlying connective tissue shows acute or mixed inflammatory infiltrate along with extensive hyperemia

2.6.3. DESQUAMATIVE GINGIVITIS

2.6.3.1. gingival epithelium that spontaneously sloughs off or can be removed after minimal manipulation.

2.6.3.2. represents one of the several vesiculobullous lesions.

2.6.3.3. Histological and immunological examinations

2.6.3.3.1. lichen planus or pemphigoid and sometimes of SLE, pemphigus vulgaris, epidermolysis bullosa.

2.6.3.4. CF

2.6.3.4.1. Age

2.6.3.4.2. Sex

2.6.3.4.3. Site

2.6.3.4.4. Signs n symptoms

2.6.3.5. HP

2.6.3.5.1. Most patients report features of lichen planus or pemphigoid.

2.6.4. Drug related

2.6.4.1. GINGIVAL HYPERPLASIA

2.6.4.1.1. abnormal growth of gingival tissues related to use of systemic medications.

2.6.4.1.2. Increased gingival size is due to overproduction of extracellular matrix, mainly collagen

2.6.4.1.3. severity of hyperplasia is linked to patient’s susceptibility and level of oral hygiene

2.6.4.1.4. CAUSATIVE DRUGS

2.6.4.1.5. CF

2.6.4.1.6. HP

2.6.5. GINGIVAL FIBROMATOSIS

2.6.5.1. Also called “Elephantiasis gingivae” and “Fibromatosis gingivae”.

2.6.5.2. Slowly progressing gingival enlargement

2.6.5.2.1. caused by??? (overproduction of collagen).

2.6.5.3. CF

2.6.5.3.1. Age

2.6.5.3.2. Signs n symptoms

2.6.5.3.3. Gingival changes

2.6.5.3.4. Either of the jaws can be affected

2.6.5.3.5. New Topic

2.6.5.4. HP

2.6.5.4.1. Enlarged tissue

2.6.5.4.2. Surface epithelium

2.6.5.4.3. Inflammation is usually absent or mild

2.6.6. Specific infection related

2.6.7. Dermatosis related

3. INTRODUCTION

3.1. What is periodontium?

3.1.1. Group of such tissues that support and surround the teeth.

3.1.2. Comprised of 4 CT

3.1.2.1. 2 are mineralized (Cementum & Alveolar bone)

3.1.2.2. 2 are soft tissues (PDL and Lamina propria of gingiva)

3.2. ETIOLOGY

3.2.1. Pulpitis (infection spreading from pulp)

3.2.2. Trauma

3.2.3. Endodontic treatment

3.2.4. Drug induced