Aetiology & Pathogenesis of periodontal disease Flashcards
Which % of patients will have perio?
40%
What two things need to be done before treating a perio patient in the PDH?
- Take radiographs
- Have good plaque scores
What are the two things that cause perio?
Inherited (particularly more aggressive)
Behavioural (smoking)
What are the two main stages of perio progression?
- Decreased host resistance (e.g. stress etc)
- Increased microbial activity (particularly virulent strains)
What will happen if you treat a patient with a high plaque score?
Perio treatment will not succeed!!
Why do we disclose?
To show plaque visually
What is the probing pocket depth?
The distance from the gingival margin to the location of the tip of a periodontal prove inserted in the pocket with moderate probing force
What does PAL stand for?
Probing attachment level
What does CAL stand for?
Clinical Attachement level
What is the PAL/CAL measurement?
The distance from the amelocemental junction to the botton if the pocket (recession + pocket depth)
What is the recession measurement?
The distance from the amelodentinal junction to the gingival margin
What does stippled mean?
icroscopic elevations and depressions of the surface of the gingival tissue due to the connective tissue projections within the tissue
What are the 6 key features of healthy gingivae?
- Triangular interdental papilla
- Knife edged margin
- Stippled gingivae
- pink
- firm
- no bleeding

What is the name of this junction?

Mucogingival junction
What is free mucosa more prone to than attached?
Trauma
What is the rate of turnover for epithelial cells in the mouth?
8-10 days
Why is there permenantly a slight level of inflammation of the gingivae even in health?
The tissues are constantly being exposed to bacteria
What is gingivitis?
Reversible inflammation of the gingivae (/the gingival crevice)
What are the 7 clinical signs of gingivitis?
- Redness (starts at papillae and progresses along the gingival margin) = associated with plaque build up
- Loss of stippling
- Surface smooth and glossy
- Swelling (tissues become softer and depress on touch)
- Rolling of the gingival margin = bulbous areas between teeth
- Loss of triangular shape of the interdental papillae
- Bleeding on gentle probing

In gingivitis is the junctional epithelium still attached?
Yes
What is the histopathology of plaque induced gingivitis (4)?
- Increased gingival crevicular fluid
- Increased vasodilation and capillary permeability
- Collagen breakdown
- More inflammatoru cells (difficult to fight bacteria in plaque as most is not in tissue!)

What is periodontitis?
Inflammation of tissues supporting the teeth (i.e. gingivae, periodontal ligament & alveolar bone)
= progressive destruction = loss of junctional epithelium, periodontal ligament, alveolar bone and eventually the teeth (irreversible)
Following periodontitis what type of epithelium does the junctional epithelium become?
What are the properties of this?
‘long’ junctional epithelium
more friable and likely to break down
What is the classification system for Periodontal disease?
Armitage
(no clear system on clinic)









