Etiology of Periodontal Diseases Flashcards
‘Pathogenesis’ is
the step-by-
step process that leads to the
development of disease
Pathogenesis of periodontal
disease is the
series of
structure changes and
function within the
periodontium
What is Gingivitis
• Inflammatory response only
affecting the gingiva
Gingivitis
• Occurs as a results of
biofilm
(plaque) accumulation that is
not removed
Gingivitis
reversible?
yes
Gingivitis
• Precedes — but does
not always progress to
—
periodontitis
Sri Lankan Tea
Worker Study
1978
Results published May 1986 in the Journal of Clinical Periodontology
2 groups, approximately 500 healthy Norwegian men and
approximately 500 Sri Lanken tea workers had oral evaluations
Findings concluded that although plaque/calculus accumulation was
significant in the Sri Lanken group, periodontitis did not affect all
Gingivitis
Characterized by:
(2)
• Inflammation of gingival
margins and interdental papilla,
redness, bleeding on probing
• NO attachment loss
Periodontitis
Characterized by:
(2)
- Bone loss
- Apical migration of the Junctional
Epithelium
What is
Periodontal
Disease??
(3)
• A chronic inflammatory disease affecting the periodontium
• Complex and multifactorial
• Initiated by a dysbiosis of biofilm (plaque) and modulated by the host
response
Dysbiosis-
an imbalance between the types of organism present in a person’s
natural microflora thought to contribute to a range of conditions of ill health.
Differences between Gingivitis & Periodontitis
GINGIVITIS
(4)
• Inflammatory response only
affecting the gingiva
• Occurs as a results of biofilm
(plaque) accumulation that is not
removed
• Reversible
• Precedes periodontitis but does
not always progress to
periodontitis
Differences between Gingivitis & Periodontitis
PERIODONTITIS
(3)
• Follows gingivitis
• Not reversible
• Inflammatory process extends to
affect the PDL and alveolar bone,
resulting in clinical attachment loss
(CAL)
- Initial Lesion
(2)
• Clinically healthy gingival tissues
• Develops within 2-4 days of the accumulation of plaque
- Early Lesion
(2)
• Early gingivitis that is clinically evident
• Develops approximately 1 week of continued plaque
accumulation
- Established Lesion
(2)
• Established chronic gingivitis
• Progression to this stage dependent on many factors
- Advanced Lesions
(2)
• Transition from gingivitis to periodontitis
• Progression to this stage dependent on many factors
*periodontitis, although irreversible, can be brought to a state of stable
periodontal health, however, on a
reduced periodontium
Stages of Gingivitis & Periodontitis (4)
health teeth and gums
gingivitis
periodontitis
advanced periodontitis
Gingival Pocket(pseudo-pocket/false pocket)
(3)
Pocket caused by hyperplasia;
coronal movement of the gingival
margin
• No apical migration of the
junctional epithelium
• No bone loss
Periodontal Pocket (true pocket)
(3)
pocket cause by bone loss associated with apical migration of the junctional epithelium
suprabony
infrabony
suprabony
bottom of the pocket is coronal to the crest of the alveolar bone
infrabony
bottom of the pocket is apical to the crest of the alveolar bone
pseudo pockets are always
suprabony
Complete Periodontal Assessment
Requires:
(5)
• Description of the clinical
appearance of the soft tissues
• Probing depths
• Plaque and bleeding index
• Recession/ Clinical Attachment
Loss (CAL)
• Radiographs
Causative Factors of
Periodontal Disease
Primary etiology:
plaque in a
susceptible host
Causative Factors of
Periodontal Disease
Secondary etiology:
local/environmental factors
Etiologic Factors
(3)
• Gingival diseases are initiated
primarily by plaque on tooth and
gingival surfaces
• Plaque initiates inflammation,
which leads to pocket formation,
and the pocket provides shelter
for more plaque
• Removal of subgingival plaque
and calculus constitutes the
cornerstone of periodontal
therapy
skipped
Local Contributing Factors:
(10)
- Calculus
- Carious lesions
- Overhangs
- Malpositioned teeth
- Xerostomia
- Furcations
- Food impaction
- Occlusal trauma
- Orthodontics
- Poor crown margins
skipped
Systemic Factors:
(10)
- Medication
- Stress
- Diabetes
- Obesity
- Cardiovascular disease
- Immuno-compromised
- Smoking
- Nutritional deficiencies
- Age
- Genetics
skipped
Primary Bacterium
Associated with
Periodontitis
(5)
- Aggregatibacter actinomysetemcomitan
(Aa) - Porphyromonas gingivalis (Pg)
- Prevotella intermedia (Pi)
- Tannerella forsythia (T. forsythia)
- Treponema denticola (T. denticola)
