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: