Post on 30-Jun-2020
Chronic Periodontitis
عالج لثة 9سيميستر 16/3/2020
Chronic Periodontitis
Chronic periodontitis( formerly known
as “Adult Periodontitis”) is an
infectious disease resulting in
inflammation within the supporting
tissues of the teeth, progressive
attachment loss, and bone loss
Chronic Gingivitis
Chronic Periodontitis
• Common Characteristics
Armitage 1999
I- Gingival diseases:
A) Dental plaque-induced gingival diseases.
B) Non-plaque-induced gingival lesions.
II- Chronic periodontitis:
A) Localized.
B) Generalized.
Armitage 1999
III- Aggressive periodontitis:
A) Localized.
B) Generalized.
IV- Periodontitis as a manifestation of
systemic diseases:
A) Associated with hematological disorder.
B) Associated with genetic disorder.
Armitage 1999
V- Necrotizing periodontal diseases:
A) Necrotizing ulcerative gingivitis.
B) Necrotizing ulcerative periodontitis.
VI- Abscesses of the periodontium:
Gingival abscess, periodontal abscess, and pericoronal
abscess.
Armitage 1999
VII- Periodontitis associated with endodontic
lesions:
• Endodontic-periodontal lesion.
• Periodontal-endodontic lesion.
• Combined lesion
Armitage 1999
VIII- Developmental or aquired deformities
and conditions:
1- Localized Tooth-Related Factors That Modify or Predispose
to Plaque-Induced Gingival Diseases or Periodontitis.
2- Mucogingival Deformities and Conditions around Teeth.
3-Mucogingival Deformities and Conditions on Edentulous
Ridges.
4- Occlusal Trauma:
• Primary.
• Secondary.
• ؟؟
Pathogenesis – Pocket
Formation
Periodontal Pathogens
• Gram negative organism dominate
- Porphyromonas gingivalis, Tannerella forsythia,
Prevotella intermedia.
- Aggregatibacter actinomycetemcomitans
PERIODONTAL DISEASE
ACTIVITY
periodontal pockets go through periods of
exacerbation and quiescence, resulting from
episodic bursts of activity followed by periods of
remission.؟؟؟؟
SITE SPECIFICITY
Clinical features of chronic
periodontitis
1. Periodontal Pocket formation (clinical attachment loss)
2. Gingival inflammation
3. Gingival bleeding
4. Tooth mobility
5. Purulent exudate
6. Tooth migration
7. Gingival recession
8. Furcation involvement
Classification of Pocket
Classification of gingival recession (Miller’s classification 1985)
• Class I : Full height papillae, recession within attached gingiva. (100% coverage)
• Class II : Full height papillae, recession at or beyond mucogingival junction. (100% coverage)
• Class III : Reduced papillae height, recession at or beyond MGJ. (partial coverage related to papilla)
• Class IV : Severe loss of papillae and interdental bone. (no possible coverage)
Furcation involvement
Classification of furcation involvement (Glickman: horizontal classification)
Symptoms of chronic periodontitis
Radiographic examination of
chronic periodontitis
Disease distribution of chronic
periodontitis
Risk factors for chronic periodontitis
• Prior history of periodontitis:
• Local factors
• Systemic factors:
• Environmental and behavioral factors
• Genetic factors: