Classification and epidemiology of periodontal diseases Flashcards
What are the 2 basic classifications of periodontal disease?
- Gingivitis
2. Periodontitis
What is the main difference between periodontitis and gingivitis?
Gingivitis is reversible where as periodontitis is irreversible
Describe the clinical appearance of gingivitis
Redness of gingiva
Swelling of gingiva
Bleeding on probing
Inflammation of the gingival tissues
What is the main debate surrounding gingivitis?
There been discussion on whether it is a disease as almost 90% of people have gingivitis
So is it a normal response or a disease?
Which classification for periodontal disease do we use?
Classification of 1999 International Workshop for a Classification of Periodontal Diseases and Conditions has been used until now
What are the 2 main 1999 classifications of periodontitis?
- Chronic
2. Aggressive
Why has a new updated version of the classification been published?
Because we have a lot of new knowledge now that needs to be added
The new classification tries to also acknowledge what we do not know
What are the 4 main titles given to periodontal diseases and condition according to the 2017 classification?
- Periodontal health, gingival diseases and conditions
- Periodontitis
- Other conditions affecting the periodontium
- Peri-implant diseases and conditions
What categories fall under Periodontal health, gingival diseases and conditions?
- Periodontal health and gingival health
- Gingivitis: dental biofilm induced
- Gingivitis: non-dental biofilm induced
What categories fall under Periodontitis?
- Necrotising periodontal diseases
- Periodontitis
- Periodontitis as a manifestation of systemic disease
What categories fall under Other conditions affecting the periodontium?
- Systemic diseases or conditions affecting the periodontal supporting tissues
- Periodontal abscesses and endodontic periodontal lesions
- Mucogingival deformities and conditions
- Traumatic occlusal forces
- Tooth and prosthesis related factors
What categories fall under Peri-implant diseases and conditions ?
- Peri-implant health
- Peri-implant mucositis
- Peri-implantitis
- Peri- implant sort and hard tissue deficiencies
What does periodontal and gingival health describe?
- Patients that have clinical gingival health on an intact periodontium
- Patients that may have had periodontitis but are now stable may have Clinical gingival health on a reduced periodontium
What is gingivitis categorised into?
- Dental biofilm induced
2, Non-dental biofilm induced
What is another name for dental biofilm?
Dental plaque
Describe some clinical symptoms someone with dental biofilm induced gingivitis may display
- False gingival pockets
- Inflamed gingiva
- Normal sulcus depth
What is
dental biofilm induced gingivitis associated with?
- May be associated with dental biofilm alone
- Can be mediated by systemic or local risk factors
- Could be drug influenced gingival enlargement
What are some local contributing factors that contribute to
dental biofilm induced gingivitis?
- Lack of saliva
- Tooth anatomic factors
- Dental restoration/ appliances that are harder to clean
Name some local risk factors that cause dental plaque induced gingivitis
- High fraenal attachments
- Fixed orthodontic appliance
- Incompetent lips, mouth breather, lack of saliva
- Amelogenesis imperfecta
- calculus
Name some systemic risk factors associated with dental biofilm induced gingivitis
- Associated with endocrine system like puberty, menstrual cycle, pregnancy, diabetes
- Associated with endocrine system like leukaemia
What is a common condition some pregnant women may have?
Epulis are common
Name some drugs that can contribute to gingival enlargement
- Phenytoin (for epilepsy)
- Ciclosporin (immunosuppressant for prevention of organ rejection after transplants)
- Calcium channel blockers eg amlodipine, nifedipine, diltiazem for heart problems (high blood pressure, angina prophylaxis)
Name some drugs that can contribute to gingivitis
oral contraceptive associated gingivitis
What is
dental non biofilm induced gingivitis associated with?
- Genetic/ developmental disorders
- Specific infections
- Inflammatory and immune conditions
- Reactive processes
- Neoplasms
Endocrine, nutritional and metabolic diseases - Traumatic (eg finger nail picking)
- Gingival pigmentation
Name some genetic/ developmental disorders that contribute to periodontal disease
- hereditary gingival fibromatosis
2. herpetic gingivostomatitis
How do we classify periodontitis?
Classified by Staging and Grading as periodontitis in now on a spectrum from slow to rapid progression
How are the 2 theories digesting how periodontal disease spreads
- Linear / Continuous
- Bursts of activity (either random burst or asynchronous multiple bursts clustered during a particular period of patient’s life?
How are we now classifying periodontitis ?
We now classify by:
- stages
- Extent and distribution
- Grades