Examination, diagnosis and treatment of periodontal diseases Flashcards
Periodontitis defintion
- Inflammatory process in periodontal space
- Affects alveolar bone, soft tissues and lymphatics
Two main parts of periodontium
- Periodontium periapicale(around root tip)
- Periodontium marginale(Around alveolar ridge)
Periodontitis can be classified according to:
- Aetiology
- Type of inflammation
- Location
- Clinical course
Periodontitis classifications according to aetiology
- Infectious
- Trauma
- Chronic
- Chemotaxic
- Allergic
Infectious organisms of Periodontitis
- Micro-organisms from infected root canals or periodontal pockets
- Aerobes
- Anaerobes
- Lactobacillus
- Fusobacterium
- Staphylococci
- Streptococci
- Actinomyces
- Clostridium
Causes of infectious periodontitis
- Untreated pulpitis
- Improper treatment
- Failure of root canal
- Gangrenous roots
- Periodontal defects
Types of trauma that cause periodontitis
- Acute
- Chronic
Acute trauma in periodontitis
- Fracture of crown->
- Disruption of vascular bundle
- Influx of MO
- Necrosis of pulp
Chronic trauma in periodontitis
- Poorly designed restorations overload periodontium
- Crowns
- Bridges
- Parafunction
Allergic causes of periodontitis
- Allergy to dental materials
- Hyperergic antigen antibody reactions
Chemotoxic causes of periodontitis
- Irritating toxic drugs
- Arsenic
- Phenolic derivatives
- Improper use of composite materials
Periodontitis classification according to location
- Periapical
- Total
Periodontitis classification according to type of inflammation
- Exudative
* Serous
* Purulent - Proliferative
* Granulomatous
Periodontitis classification according to Clinical course
- Sharp
- Chronic
- Excacerbated
Acute periodontitis classifications
- Periodontitis periapicalis acuta- serosa et purulenta
- Periodontitis marginalis acuta- Serosa et purulenta
- Periodontitis totalis acuta
Chronis periodontitis classifications
- Periodontitis periapicalis chronica granulomatosa diffuse(sin/cum fistulae)
- Periodontitis periapicalis chronica granulomatosa localisata
- Periodontitis periapicalis chronica fibrosa
- Periodontitis chronica exacerba
The clinical course of periodontitis depends on:
- Aetiology
- Location and type of process
- Microbial contamination
- Virulence of microorganisms
- Local and general immune status
- Age
- Contomitant diseases
Important anamnestic data for diagnosis of periodontitis
- Presence of pain
- Socrates
- Site
- Onset
- Character
- Radiation
- Associated symtoms
- Time
- Exacerbating factors
- Severity
Important criteria assessed during periodontitis examination
- Adjacent teeth
- Mucous membranes
- Percussion of tooth-horiontal/vertical
- Pressure on tooth(V/H)
- Palpation(root tip/marginal gingiva)
Acute periapical periodontitis definition
Acute inflammation of periapical periodontium and adjacent bone
Acute serous periodontitis characteristics
Inflammation of pulp causing:
* Hyperemia
* Extravasation of cellular elements and exudate
* Edema
* Bone resorption
* Serous exudate->purulent
Acute serous periodontitis clinical presentation
- Pain similar to pulpitis
- Pain on percussion
- May or may not be able to localise
Treatment of Acute serous periodontitis
- Endodontic treatment