Lecture 3 Flashcards
Clinical Histological Characteristics of the Periodontium
pathogenesis
disease progression
the sequence of events that occur during the development of a disease or abnormal condition
three basic states of the periodontium
health
gingivitis
periodontitis
the term periodontal disease should not be confused with
periodontitis
gingivitis and periodontitis are both
bacterial infections
difference between gingivitis and periodontitis
gingivitis:
confined to the gingiva
damage is reversible
probing depths 1-3mm
periodontitis:
affects all parts of the periodontium
damage is irreversible
probing depths 4mm+
histological periodontium in health
JE coronal to CEJ
gingival fibers intact
alveolar bone intact
periodontal ligament intact
cementum normal
gingivitis
a type of periodontal disease/bacterial infection characterized by changes in color, contour and consistency of the gingival tissue
4-14 days after biofilm accumulation
clinical characteristics of gingivitis
increased # of bacteria from plaque biofilm
gingival tissues are: red (erythema), enlarged tissues (edema), spongy, IDP bulbous, probing depths 1-3mm, bleeding on probing
histological characteristics of gingivitis
JE coronal to CEJ (epithelial ridge formation)
some gingival fiber destruction
alveolar bone intact
periodontal ligament intact
cementum normal
clinical signs of inflammation
erythema/redness
edema/swelling
bleeding on probing
duration of acute gingivitis
sudden onset/short lasting
red
swollen gingiva due to increased fluid in CT
professional/self-care returns to health
duration of chronic gingivitis
long lasting/typically painless
body forms new collagen fibers in CT resulting in enlarged, fibrotic appearance
may conceal the redness caused by increased bloodflow
key points if diagnosis is gingivitis
there is no apical migration of the junctional epithelium
tissue damage of the CT fibers is reversible
with good patient self-care, the body can repair the damage
how can edema/swelling affect probing depths
pseudopocket or gingival pocket
probing depth that is greater than 3mm but is from swelling of the gingiva
look at radiographs
clinical characteristics of periodontitis
vast numbers of bacteria
gingival tissues are: red-bluish-red-purplish, gingival margin swollen/fibrotic/non-adaptation to tooth, blunted IDP, recession, edematous (spongy), BOP, probing depths equal or >4mm, radiographic bone loss
histological characteristics of periodontitis
JE is apical to CEJ
epithelial ridges present
gingival fiber destruction
PDL fiber destruction
alveolar bone destruction
cementum exposed to biofilm
intermittent disease progression theory
periodontal disease is characterized by periods of disease activity and inactivity
destruction does not occur in all parts of the mouth at the same time
immunity and inflammation systems
a complex system of protective responses against foreign substances
-infections by bacteria
-viruses
-fungi
-toxins
-parasites
host response
the manner in which the human body reacts to an infection
components of the immune system
cellular defenders
1. leukocytes 2. lymphocytes
compliment system
- circulating proteins
phagocytosis
the process by which leukocytes engulf and digest microorganisms
complement system
circulating proteins in the bloodstream that work to facilitate phagocytosis
inflammatory response
part of the immune response
a bodily reaction to injury or pathogenic organisms
eliminate these microorganisms and heal tissue
biochemical mediators in periodontitis
cytokines: initiate tissue destruction and bone loss
chemokines: attract additional immune cells
prostoglandins: cause bone destruction
metalloproteinases: cause collagen destruction of periodontal tissue
stages of inflammation
acute: short term, normal process that protects/heals the body, warning signs present
chronic: long lived/uncontrolled, warning signs are absent
chemotaxis
leukocytes attracted to the infection site/invading microorganisms
