W5 Perio risk analysis Flashcards
What is periodontal disease?
Results when the balance is changed between pathogenic bacteria and the hosts inflammatory and immune responses.
What are local risk factors?
At the site, local contributing factors ↑ plaque retention, plaque pathogenicity or directly damage the periodontium. It is possible to eliminate local factors eg - overhangs - croweded teeth malocclusion/malalignment - caries - faulty appliances - tooth morphology - food impaction (contact point) - mature plaque formation - presence of calculus - furcation involvement - incomplete lip seal (xerostomnia)
What are systemic risk factors for periodontal disease?
Modifiable and non-modifiable Smoking and alcohol Obesity - as BMI ↑ association with periodontal disease Diabetes mellitus
What is Diabetes Mellitus?
Is a metabloic disorder characterised by hyperglycaemia to to defects in insulin and or production. (excess sugar in blood). Type I and II diabetes. ↑ prevalence of periodontal disease in patients with diabetes. The degree of hyperglycaemia and severity of periodontitis. ↑ bone loss in pts with type II. May be a reduced risk for bone loss in pts that control diabetes
How can Diabetes Mellitus contribute to periodontal disease?
Systemic inflammatory response is a central feature in the pathogenesis of both disease.
- Higher levels of inflammatory mediators,chemotaxis, gingival crevicular fluid, phagosytosis (impaired)
- Accumulation of glycation end products
- Pocket microbiota
How can stress contribute to periodontitis?
Mechanisims include the disregulation of the host immune response and the impact stress may have on behaviours.
How can haematological disorder contribute to periodontitis?
Impairs the host response to biofilm and periodontal pathogens. - Leukemia, neutropenia and other rare blood disorders
How can osteoprosis contribute to periodontitis?
Systemic disoder that results in a reduction in bone-mineral density in the skeletal system - may impact alveolar bone height or clinical attachment loss and periodontitis. Further study must be undertaken
How can hormonal fluctuation contribute to periodontitis?
- Puberty - Menstruation - Pregnancy - Menopause - Oral contraceptive pill - hormone replacement therapy
How can HIV/AIDS contribute to periodontitis?
Results from immunodeficiency associated with - Linerar gingival erthea (redness) - ANUG/ANUP (acute necrotising ulcerative gingivitis) acute necrotising ulcerative peridontitis - Necrotising stomatitis (lost mucosa tissue and bone) advanced
How can genetic factors contribute to periodontitis?
Familial aggregation of aggressive types of periodontitis
What are other factors that affect the periodontium?
Medications: Gingival overgrowth common side effect of a number of medications that promote gingival overgrowth: Phenytoin (anti seizure) , cyclosporine (immunosupressant) calcium channel blockers (hypertention) Numerous medication also have an effect on saliva flow
What are risk characteristics associated with periodontitis?
Age Gender
How can age contribute to periodontitis?
Prevalence and severity of periodontal disease ↑ with age. More related to the length of time where periodontal tissues have been exposed to bacterial plaque and reflects individuals cumulative oral history
How can gender contribute to periodontitis?
Men have a higher incidence of diease experience than females 28.1% vs female 20.3%
