Lecture 6- Chronic Periodontitis

Question 1

Chronic periodontitis

Answer 1

irreversible
starts as plaque induced gingivitis
loss of attachment and bone
years and years to develop

Question 2

Clinical features of chronic periodontitis

Answer 2

loss of attachment
loss of alveolar bone
root furcation involvement
increased tooth motility
drifting and eventual tooth loss

Question 3

chronic periodontitis is most prevelant in?

Answer 3

adults but can happen in children and adolescents

Question 4

chronic periodontis is ass. with what frequent finding

Answer 4

subgingival calculus and variable microbial patterns

Question 5

Localized vs. Generalized Chronic Periodontitis

Answer 5

Localized-less than 30% of teeth

Generalized-greater than 30% of teeth

Question 6

Classification of severity of chronic periodontitis

Answer 6

Slight: 1-2 Clinical Attachment Loss (CAL)
Moderate: 3-4mm CAL
Severe: greater/equal to 5mm CAL

Question 7

Norwegian Longitudinal Study (20 years)

Answer 7

Found that No inflammation - significantly less attachment loss than those with clinical inflammation.
-1st step–control inflammation thus attachment loss

Question 8

Asynchronous multiple burst model

Answer 8

slowly progressing then exacerbation

Question 9

Aggressive Periodontitis formerly known as

Answer 9

Early Onset Periodontitis aka Juvenile Periodontitis

Question 10

Aggressive Periodontitis signs, features, and txt?

Answer 10

Systemically healthy
family aggregation (cases usu. aggregate in families)
rare, severe, early age of clinical manifestation

Tx: strict maintenance and cleaning plaque

Question 11

Primary criteria for Aggressive Periodontitis

Answer 11

• rapid attachment loss and bone destruction

- familial aggregation

Question 12

Secondary criteria for Aggressive Periodontitis

Answer 12

• amts of mircrobial deposits are inconsistent with the severity of periodontal tissue destruction
• elevated AA and P. gingivalis
• Phagocyte abnormality
• Hyper-responsive macrophage phenotype (elevated PGE2, IL-1B)
• Progression of attachment loss and bone loss may be self-arresting

Question 13

Classification of Localized Aggressive Periodontitis

Answer 13

Circumpubertal onset
Robust serum Ab response to infecting agents
Localized first molar/ incisor presentation with interproximal attachment loss on at least 2 perm teeth (one being the M1)–involving no more than 2 teeth other than M1 and Is.

Question 14

Classification of Generalized Aggressive Periodontitis

Answer 14

• Usu. in pts under 30
• Poor serum Ab response to infecting agents
• pronounced episodic nature of the destruction of attachment and alveolar bone
• Generalized interproximal attachment loss affecting at least 3 perm teeth other than M1 and I.

Question 15

The only diff. between aggressive and chronic perio is that after an SRP, in aggressive, you will give .

Answer 15

systemic antibiotic treatment

Question 16

what can prevent localized to generalized aggressive perio from forming?

Answer 16

ability to mount higher titres of Ab IgG2