What are the two types of periodontal diseases and what are they dependent upon?
- Gingival diseases
- Destructive periodontal diseases
- the severity of destruction
What are the main characteristics of gingival diseases?
- confined to the gingiva
- presence of dental plaque to initiate and or exacerbate
- severity of lesion
- inflammation
- no loss of attachment
- reversibility of disease
- precursor to attachment loss
What systemic factors can modify gingival diseases?
- endocrine
- blood dyscrasias
- medications
- nutrition
What are the endocrinotropic gingival diseases?
- puberty
- menstrual
- pregnancy-associated
- pregnancy associated pyogenic
- diabetes melitus-associated
What is leukemia associated gingivitis?
- a blood dyscrasia type of gingivitis
- gingival lesions that are found in acute leukemia
- reductions in dental plaque can limit severity of lesions
What are the effects of medication on gingival diseases?
- drug influenced gingival enlargement
- oral contraceptive associated gingivitis
What is ascorbic acid-deficiency gingivitis?
- malnourished individuals have compromised host defense system which may make individuals susceptible to gingivitis
- not a strong relationship between nutrition and gingivitis
What are the general characteristics of chronic periodontitis?
- most prevalent in adults
- destruction consistent with local factors
- subgingival calculus
- variable microbial pattern
- slow-moderate progression
- tooth related
- associated with systemic diseases
- modified by environment
What are the classifications of chronic periodontitis?
- extent: localized <30% vs. generalized >30%
- severity: slight 1-2mm CAL vs. moderate 3-4mm vs. severe 5+
What are the common features of aggressive periodontitis?
- systemically healthy
- rapid attachment loss and bone destruction
- familial aggregation
What are the secondary features of aggressive periodontitis?
- generally but may not be universally present
- microbial deposits are inconsistent with the amount of periodontal destruction
- elevated AA and P. gingivalis
- phagocyte abnormalities
- hyper-responsive macrophage phenotype (elevated PGE2 and IL-1B)
- progression may be self-arresting
What are the characteristics of Localized Aggressive Periodontitis?
- puberty
- robust serum Ab response to infection
- localized first molar/incisor presentation
- interproximal attachment loss on @ least 2 permanent teeth (one a molar)
- involving no more than 2 teeth other than 1st molar and incisors
What are the characteristics of generalized aggressive periodontitis?
- usually affects persons under 30 but patients may be older
- poor serum Ab response to infecting agents
- pronounced episodic nature of destruction of attachment and bone
- generalized interproximal attachment loss on @ least 3 teeth other than 1st molars and incisors
What other hematologic diseases are associated with periodontitis?
- acquired neutropenia
- leukemias
What other genetic disorders are associated with periodontitis?
- familial/cyclic neutropenia
- down syndrome
- leukocyte adhesion deficiency syndrome
- papillion-lefevre (mutation in cathepsin C gene needed for survival of periodontium)
What are the characteristics of down syndrome periodontitis?
- autosomal trisomy Chr. 21
- severe inflammation
- accelerated attachment loss
- PMN chemotaxis and killing defects
What are the characteristics of Papillion-Lefevre syndrome periodontitis?
- autosomal recessive
- rapid periodontal destruction around primary and permanent teeth
- occurs before puberty
What are the characteristics of Chediak-Higachi syndrome periodontitis?
- autosomal recessive
- rapid periodontal destruction around primary and permanent teeth
- occurs before puberty
What are the characteristics of Ehlers-Danlos syndrome IV & VIII periodontitis?
- aggressive periodontitis (primary and permanent)
- fragilitiy of gingivitis
- excessive hemorrhage
What is the diference between Necrotizing Ulcerative Gingivitis and Periodontitis?
- one is confined to gingival tissues
- one is confined to periodontal tissues
What is the prevalence of necrotizing periodontal disease (NPD)?
- <0.1% in developed countries
- still relevant in developing countries
What are the early clinical signs of NPD?
- necrotic lesion of papilla initially
- progression to gingival margin
- punched out appearance
- spontaneous bleeding
- pain
What are the clinical signs of advanced lesion NPD?
- lack of deep pockets
- merging of papillary and marginal involvement
- central necrosis results in crater formation
- involvement of periodontal ligament and alveolarbone
What are the characteristics of necrotizing ulcerative periodontitis?
- involvement of palatal mucosa (necrotizing stomatitis)
- involvement of regional lymph nodes
- typically related to severe compromised immune system
- may develop into life-threatening situation
- white membrane of desquamated cells
- fever and malaise
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Classification28
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Efficacy of Diagnostic Techniques62
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Radiographic Examination19
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Perio Indices7
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Epidemiology14
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WBC130
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Pulmonary 1 and 297
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Renal 1 and 2122
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Perio sweep 176
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Perio Sweep 1.165
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Perio sweep 1.275
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Perio Swep 1.362
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Sweep 258
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Sweep 2.150
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Sweep 2.259
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Sweep 2.358
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Sweep 3100
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Sweep 415
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Sweep 4.116
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Midterm 2 Review41
