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Clinical practice - IODC > Classification of periodontal diseases > Flashcards

Classification of periodontal diseases Flashcards

1
Q

Classifications

A

Gingival diseases
Chronic periodontitis
Aggressive periodontitis
Periodontitis as a manifestation of systemic diseases
Necrotising periodontal diseases
Abscesses of the periodontium
Periodontitis associated with endodontic lesions
Developmental or acquired deformities and condition

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2
Q

Gingival diseases - surgical sieve

A 
Developmental - acquired or hereditary
Infective
Non-plaque induced or plaque induced
Allergic
Modified by or attributable to systemic factors
Inflammatory or non-inflammatory 
Traumatic
Elephantine - overgrowth (hypertrophy, hyperplasia, oedema) - e.g. from anti-epileptic drugs
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3
Q

Plaque related gingivitis

A

Purely affecting gingiva

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4
Q

Thermal trauma

A

From hot food, damages gingiva

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5
Q

Herpes

A

Painful, inflamed gingiva

Viral infection

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6
Q

Gingival diseases

A

Contained within gingival tissue
-no evidence of periodontal attachment loss
-may produce pseudo-pocketing
Inflammation usually = bleeding no probing

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7
Q

Chronic periodontitis

A

Progression of infection and inflammation of gingivitis into deeper tissues
All periodontitis develops from gingivitis but not vice versa
Local/ generalised (30% of sites affected)
Destruction consistent with local factors (e.g. overcrowding, furcation areas)
Subgingival calculus is a frequent finding
Associated with variable microbial pattern
Progression slow but rapid bursts can occur
Associated with local predisposing factors
-overhangs, grooves, crowding
Breakdown of periodontal fibre bundles at cervical margin, alveolar bone resorption and apical proliferation of junctional epithelium beyond ACJ

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8
Q

Severity of chronic periodontitis

A

Mild: 1-2mm
Moderate: 3-4mm
Severe: 5mm +
(clinical attachment loss, attachment loss + recession)

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9
Q

Chronic periodontitis risk factors

A

Non modifiable: genetics, age, gender

Modifiable risk factors: smoking, plaque levels (test by painting fluid on), systemic disease (diabetes), stress

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10
Q

Lots of abscesses in the mouth

A

Suggest they go to the doctors and get tested for diabetes

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11
Q

Aggressive periodontitis

A

Rarer, often severe
Rapid attachment loss and bone destruction
Possible familial aggregation of disease
Patients are systemically healthy, non smokers
Onset - earlier age, less than 30 years
Amount of plaque out of proportion with severity of disease

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12
Q

Aggressive periodontitis subcategories

A

Localised (1st molar and incisor involvement)

Generalised >/ 3 teeth other than in localised

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13
Q

Bone loss aggressive vs chronic

A

Aggressive more vertical, deep pockets

Chronic slower, more sloping

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14
Q

Generalised aggressive periodontitis

A

Severe, generalised form, young adults <30
Interproximal attachment loss affecting at least 3 permanent teeth other than 1st molar and incisors
Episodic nature of destruction of AB and attachment
1-2% of Western pop, > in Afro-carribeans

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15
Q

Localised aggressive periodontitis

A

Severe, localised
Onset around puberty
Localised attachment loss of at least 2 permanent teeth one of which is a first molar and involving no more than 2 teeth other than first molars and incisors

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16
Q

Aggressive perio secondary features that may be present

A

Destruction greater than local factors suggest
Elevated levels of
-Ag. actinomycetemcomitans
-Porph. gingivalis
Phagocyte abnormalities and > PGE2 and IL-1β
Attachment and bone loss may be self-arresting

17
Q

Where are aggressive perio bacteria found

A

Often in soft tissues not pockets
Systemic antibiotics prescribed
e.g. metronidazole

18
Q

Periodontitis as a manifestation of systemic diseases

A 
Systemic diseases can modify
-immune function
-inflammatory response
-tissue organisation
These include
-haematological disorders
-genetic disorders
19
Q

Haematological disorders

A

Acquired neutropenia
Leukamias
Anaemia

20
Q

Genetic disorders

A 
Familial and cyclic neutropenia
Down syndrome
Leukocyte adhesion deficiency syndromes
Papillon-Lefevre syndrome
Chesiak-Higashi syndrome
Histiocytosis syndromes
Glycogen storage disease
Infantile genetic agranulocytosis
Cohen syndrome
Ehlers-Danlos syndrome types IV and VIII
Hypophosphatasia
21
Q

Ehrles Danlos syndrome types IV and VIII

A 
Hyperflexibility of joints
> bleeding and bruising
Hyperextensible skin
Underlying molecular abnormality of collagen
Type 4 -bleeding more common 
Type VIII - AP, early onset
ALl types - pulp stones
22
Q

Papillon-Lefevre

A

Palmoplantar hyperkeratosis and AP
affects 1. and 2. dentition
Normal dental development until hyperkeratosis of palms and soles appears
Mechanisms poorly understood

23
Q

Necrotising periodontal diseases

A

Includes
-necrotising ulcerative gingivitis (NUG)
-necrotising ulcerative periodontitis (NUP)
Related to < systemic resistance to bacterial infection
Destructive inflammatory condition - rapid, debilitating, acute
Only differ in term of tissue affected, with NUP extending into periodontal attachment

24
Q

Down syndrome

A

Commonest malformation syndrome
1:6000 births
> risk with age
Bradycephaly, mid-face retrusion, small nose, flattened nasal brudge, upward sloping palpebral fissues
Macroglossia, delayed eruption of teeth
Heart defects, atlanto-axial subluxation (C1-C2 disorder causing impairment in rotation of teeth), anaenia, > risk of leukaemia

25
Q

Chediak-Higashi syndrome

A

Combination of defective neutrophil function, abnormal skin pigmentation and > susceptibility to infection

26
Q

NUG and NUP symptoms

A

Painful ulcerated necrotic papillae and gingival margins, ‘punched out’ appearance’
Ulcers with yellow-grey slough
Metallic taste, teeth feel wedged, foetor oris
Craters- interproximal, loss of crestal bone
Loss of attachment can lead to NUP
Regional > LN, fever, malaise can occur
Associated with poor OH, stress, smoking
Gram -ve anaerobic infection

27
Q

Abscesses of the periodontium

A

A localised, purulent infection

  • Gingival abscess: involves marginal gingivae/ interdental papilla
  • Periodontal abscess: in tissue adjacent to PD pocket and leads to destruction of perio ligament and bone
  • Pericoronal abscess: in tissue around crowns of partially erupted teeth
28
Q

Periodontitis associated with endodontic lesions

A

Periodontal origin
Endodontic origin
Combination of both
-sensibility testing heavily restored teeth with periodontal involvement essential
-management depends upon primary cause
-when combined, usually endo then perio treatment

29
Q

Developmental or acquired deformities and conditions: localised factors

A 
Developmental
-groove (e.g. mesial side of upper 4 root)
-enamel pearl
Acquired
-root fracture
30
Q

Developmental or acquired deformities and conditions: mucogingival deformities and conditions around teeth gingival soft tissue

A

Recession
Abnormal gingival contour (incomplete eruption)
Aberrant fraenum

31
Q

Developmental or acquired deformities and conditions

A 
Localised
-developmental
-acquired
Mucogingival deformities and conditions around teeth gingival soft tissue
Occlusal trauma e.g. toothbrushing

Clinical practice - IODC (18 decks)

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