W12 Perio classification continued Flashcards
What is a healthy periodontium?
Absense of signs and symptoms of gingival and destructive periodontal diseases, or any tissue status outside normal range.
What does the periodontium look like in health? Clinical and histologically
CLINICALLY Colour: pink, resilient in consistency. Gingival margin: scalloped outline Interdental papilla: firm, knife-edge, fills space. Bleeding: nil Sulcus: Probing depths between 1-3mm.
Histiologically: JE: JE attached along CEJ and part of the enamel Gingival fibres: intact Alveolar bone: crest intact PDL fibres: intact Cementum: normal
How does a. Clinical gingival health on an intact periodontium health appear clinically?
Gingival health: Defined as <10% bleeding sites with <3mm probing depth.
Intact periodontium: characterised by absence of BOP, erythema and edema, symptoms, CAL and bone loss. Physiological bone levels range from 1.0-3.0mm apical to the CEJ.
How does b. Clinical gingival health on an reduced periodontium health appear clinically?
Gingival health: defined as <10% bleeding sites with <3mm probing depths.
Reduced periodontium: characterized by an absence of BOP edema and pt symptoms, in the presence of reduced CAL and bone levels
How does b. clinical gingival health on a reduced periodontium appear clinically?
Successfully treated and stable periodontitis pts remain at in ↑ risk of recurrent progression of periodontitis.
Stable periodontitis: stability is characterized by successful to through control of local and systematic risk factors, resulting in minimal (<10%) BOP, no probing depths of 4mm or greater than BOP, optimal improvement in other clinical parameters and lack of progressive periodontal destruction.
NON-PERIODONTITIS PT.: Refers to recession and crown lengthening
What does gingivitis look like clinically and histologically?
Colour: red - redish/blue
Gingival margin: swollen, may cover more of the crown
Interdental papillla: bulbous, swollen
Bleeding : present
Sulcus: Probing depth 1-3mm, can be greater due to swelling only.
HISTOLOGICALLY
JE: JE attached along CEJ and part of enamel, has undergone some coronal detachment.
Gingival fibres: damage is present but reversible
Alveola bone: crest intact
PDL fibres: intact
Cementum: normal
How does Gingivitis dental biofilm induced a. associated with dental biofilm alone appear clinically?
Inflammation is consistent with the amount of plaque present.
>10% BOP <3mm
Localized gingivitis 10%-30% bleeding sites
Generalized gingivitis >30% bleeding cites.
No other local or systemic factors preent that could modify the host response
How does dental biofilm induced gingivitis b. Mediated by systemic or local risk factors appear?
Predispose a pt to plaque accumulation and induced gingivitis as a result.
Can also impact upon its rate of progression.
What are some systemic factors that impact dental biofilm-induced gingivitis?
Smoking, metabolic factors, nutritional factors, pharmacological factors, elevations in sex steroid hormones (menopause) (pregnancy) , hematological conditions
What are some local risks factors that impact dental biofilm-induced gingivitis?
Local risk factors encourages plaque accumulation at a site.
Biolfilm retention factors: subginigival restoration margins.
Hyposalivation
- Reduced cleansing of teeth, reduced dental biofilm removal, enhanced gingival inflammation, incompetent lip seal, medications
What are some drug-induced gingival enlargement that impact dental biofilm-induced gingivitis?
It is plaque bacteria in conjuctions with any of the following drugs.
- Anti epileptic drugs (phenytoin and sodium valporate).
- Certain calcium channel blockers
- Immunoregulating drugs (cyclsporine)
- High does oral contraceptives
Usually occurs within the first 3 months of medication, in younger age groups and observed in the anterior dentition/papilla first
What are non-dental biofilm induced gingival diseases?
Less common than plaque induced, areas not directly caused by plaque.
Clinical course may be exacerbated by the presence of plaque and gingival inflammation.
Eg. Fungal infections, allergic reactions, Vit C deficiencies, tooth-brushing trauma
