Classification of Periodontal Diseases 9/23/15 Flashcards
What is the attachment level?
Distance from CEJ to attachment of Gingiva, ideally should be 0.
What are the Characteristics common to all gingival diseases?
- Inflammation
- signs and symptoms confined to the gingiva
- Presences of dental plaque to initiate or exacerbate the severity of the lesion
- Reversible when etiology is removed
- Attachment loss does not have to occur, yet can be a precursor to attachment loss.
What systemic factors modify gingival diseases?
- The endocrine system
- Blood dyscrasias
- Medications
- Nutriton
What are the Endocrinotropic gingival diseases?
- Puberty-Associated gingivitis
- Menstrual cycle-associated gingivitis
- Pregnancy associated gingivitis
- Pregnancy associated pyogenic granuloma
- diabetes mellitus-associated gingivitis
What is a gingival disease associated with blood dycrasias?
Leukemia associated gingivitis
What medications can modify gingival diseases?
- Drug induced gingival enlargements
- oral contraceptive associated gingivitis (rare)
What is a gingival disease that is modified by nutrition?
Ascorbic acid-deficiency gingivitis
- Malnourished individuals
- Scurvy
What are the 4 major groups of periodontal disease?
- Chronic periodontitis
- Agressive Periodontitis
- Necrotizing Periodontitis
- Plaque induced gingivitis
What are the signs and symptoms of Chronic periodontitis?
- Pocket formation
- Loss of attachment (must exist)
- Bleeding
- Bone loss
- tooth mobility
* most prevalent in adults
How fast is the progression of chronic periodontitis?
slow to moderate progression
What environmental factors modify chronic periodontitis?
smoking and stress
What disease can modify chronic periodontitis?
Diabetes
How is chronic periodontitis classified?
Extent:
- Localized = less than 30% of dentition effected
- Generalized = more than 30% of dentition effected
Severity:
- slight = 1-2 mm CAL
- Moderate = 3-4mm CAL
- Severe = more than 5mm CAL
- CAL = Clinical attachment level
What are the signs and symptoms of Aggressive periodontitis?
- often systemically healthy
- rapid attachment loss and bone destruction
- familial aggregation
- can be localized or generalized
What are the secondary features of Aggressive periodontitist?
May not be present, but:
- Microbial deposits are inconsistent with the amount of periodontal destruction
- elevated A.a and P. gingival levels
- Phagocyte abnormalities (lazy phagocytes)
- Hyper-responsive macrophage phenotype
- progression may be self-arresting
What are the characteristics of Localized Aggressive periodontitis?
- Circumpubertal onset
- robust serum antibody response to infecting agnets
- Localized first molar/incisor presentation (Has to be a molar)
- Interproximal attachment lost on at least 2 permanent teeth.
- involving no more that 2 teeth other than first molars and incisors.
What are the characteristics of generalized aggressive periodontitis?
Usually patient is under 30…
- poor serum antibody response to infecting agents
- Pronounced episodic nature of destruction of attachment and bone.
- Generalized inter proximal attachment loss affecting at least 3 permeant teeth other than first molar and incisors
Can Periodontitis be a manifestation of systemic disease?
Yes!
- associated with hematologic disorders
- Associated with genetic disorders (down syndrome)
What are the 2 types of Necrotizing periodontitis?
- Necrotizing Ulcerative gingivitis (NUG) = limited to gingival tissues
- Necrotizing ulcerative periodontitis (NUP) = confined to periodontal tissues.
Where might you find Necrotizing periodontitis?
HIV patient
What are the symptoms of NPD?
Early signs = necrotic lesion of the papilla, then progression into the gingiva (punched out appearance and spontaneous bleeding)
Advanced lesion = lack of deep pockets, merging of papillary and marginal involvement. Results in crater formation. *Involvement of periodontal ligament and alveolar bone (NUG–>NUP)
What are the signs of NUP?
- Involvement of palatal mucosa
- Involvement of lymph nodes
- Typically related to severely compromised immune system (HIV)
- May develop into life-threatening disease
What are the 3 types of periodontal lesions?
- Gingival
- Periodontal
- Pericoronal
