Systemic risk factors part 2 Flashcards
what does the features of chronic periodontitis include in the old 1999 classification
most prevalent in adults but can occur in children and teenagers
- slow to moderate progression + exacerbations
- plaque aetiology
- destruction consistent with local factors
-subgingival calculus frequent finding
-modifying factors include : local and systemic factors, smoking , stress, poorly controlled diabetes
-treat in usual 3 phases - no systemic antibiotics
what common features are present In aggressive periodontitis
- rapid attachment loss and bone destruction
- familial aggregation
- localised form
- generalised form
what are the clinical and radiographic features found in aggressive periodontitis
- localised first molar/ incisor presentation
- CAL - clinical attachment loss
- deep pockets in association with CAL
- alveolar bone loss
- angular defects incisors
- arc shaped bone loss first molars
- often symmetrical distribution right/left
what are the secondary features of aggressive periodontitis
- amounts of microbial deposits inconsistent with severity of periodontal tissue destruction
- elevated proportions of aggregatibacter actinmycetmcomitons
- phagocyte abnormalities
- hyper responsive macrophage phenotype, including elevated levels of PGE and IL-1Beta
- progression of attachment loss and bone loss may be self arresting
what are features of localised aggressive periodontitis
- specific features
- cicumpubertal onset
- robust serum antibody response to infecting agent
- localised first molar/ incisor presentation
- interporximal attachment loss CAL on at least 2 permanent teeth , one of which is a first molar and involving no more than two teeth other than first molars/ incisors
what is the difference between the 1999 and the 2018 class-action of periodontal disease
which terms do not exist in the 2018 classification pf periodontal disease
- chronic periodontitis
- aggressive periodontitis
define periodontitis following the EFP S3 clinical guidelines
Periodontitis is defined by the loss of periodontal tissue support, which is commonly;y assessed by radiographic bone loss or interproximal loss of clinical attachment measured by probing
Other meaningful description of periodontitis include the number and proportions of teeth with probing pocket depth over certain thresholds , the number of teeth lost due to periodontitis, the. number of teeth with intrabony lesions and the number of teeth with furcation lesions
what 3 dimensions should a periodontitis diagnosis encompass
- definition of a periodontitis case based on detectable CAL loss at tow non-adjacent teeth
- Identification of the form of periodontitis- necrotising periodontitis, periodontitis as a manifestation systemic disease or periodontitis
- description of the presentation and aggressiveness of the disease by stage and grade
what are the notes on diagnosis of localised aggresive periodontitis
- history and exam - correct diagnosis
- BPE for initial screening should flag warning
- Per indices with periodontal probe - PCP10
- radiographs where indicated/ justified
- early detection important
- start apropriotate therapy, improve prognosis
how do we detect aggressive periodontitis for under 18s
- simplified BPE
- index teeth
- BPE codes 0,1,2 ages 7-11 years
- full range BPE codes 0,1,2,3,4*
what are specific feature of generalised aggressive periodontitis
- usually affects age <30 yrs, may be older
- poor serum antibody response to infecting agents
- pronounced episodic nature of extraction of attachment and alveolar bone
- Generalised interproximal attachment loss CAL affecting at least 3 teeth other than first molars and incisors
what are the principles of management of aggressive periodontitis
- early diagnosis is essential- screening
- establish correct diagnosis - affects therapy
- is there an underlying modifying factor or systemic factor that needs managing
- poorly controlled diabetes mellitus
- refferal to a specialist should be considered by the GDP
what are the principles of managemtns of aggressive periodontitis.
management is directed to
- suppression of infecting organisms
- providing environment conducive to long term maintenance
Therapy in usual 3 phases
- initial cause related
- corrective
-supportive
what are the differences in managements of chronic and aggressive periodontitis
- Initial cause related therapy (GDP can do both)
- Corrective therapy ( consider specialist for aggressive peirodontitis/ stage 3 or 4 Grade C in younger individuals or disproportionate bone loss to the amount of plaque and calculus)
- Supportive therapy (GDP can do both)
