PEDIATRIC PERIODONTAL CONDITIONS T L A N C EL A N C EPediatric Periodontal Conditions Normal...

RR I C H A R D I C H A R D YY O O NO O N 11

PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©

Pediatric Periodontal ConditionsPediatric Periodontal Conditions

NormalNormal Gingival Diseases & ConditionsGingival Diseases & Conditions PeriodontitisPeriodontitis Systemic ConditionsSystemic Conditions

ChronicChronic

PericoronitisPericoronitis

ANUGANUG

FibromatosisFibromatosis

RecessionRecession

EOPEOP PrepubertalPrepubertal

LocalLocal GeneralizedGeneralized

Six ZonesSix Zones EruptionEruption

ActiveActive PassivePassive

HypophosphatasiaHypophosphatasia

Cyclic Cyclic NeutropeniaNeutropenia

LeukemiaLeukemia

PapillonPapillon--LeFevreLeFevre

HystiocytosisHystiocytosis XX

AcrodyniaAcrodynia

RicketsRickets

DownDown

AA T T AA GG L A N C EL A N C E

Normal FindingsNormal Findings

GingivitisGingivitis

PeriodontitisPeriodontitis

Systemic ConditionsSystemic Conditions

S S I XI X C C O M P O N E N T SO M P O N E N T S

Papillary Papillary GingivaGingiva

Marginal Marginal GingivaGingiva

Attached Attached GingivaGingiva

Alveolar MucosaAlveolar Mucosa

Periodontal LigamentPeriodontal Ligament

Alveolar BoneAlveolar Bone

PPAPILLARYAPILLARY GGINGIVAINGIVAMMARGINAL ARGINAL GGINGIVAINGIVAAATTACHED TTACHED GGINGIVAINGIVAAALVEOLAR LVEOLAR MMUCOSAUCOSA

Alveolar BoneAlveolar BonePDLPDLAlveolar MucosaAlveolar MucosaAttached Attached GingivaGingivaMarginal Marginal GingivaGingivaPapillary Papillary GingivaGingiva

InterdentalInterdental ColColInterdentalInterdental SaddleSaddle

I I N T E R D E N T A LN T E R D E N T A L C C O LO L

IINTERDENTALNTERDENTAL CCOLOL

IINTERPROXIMALNTERPROXIMAL CCONTACTONTACT

7 8D E

I I N T E R D E N T A L N T E R D E N T A L SS A D D L EA D D L E

IINTERPROXIMALNTERPROXIMAL CCONTACTONTACT

IINTERDENTALNTERDENTAL CCOLOL

SSADDLEADDLE

Gingival Gingival sulcussulcus + free gingival margin.+ free gingival margin.Thicker and rounder.Thicker and rounder.Flaccid and retractable.Flaccid and retractable.

M M A R G I N A LA R G I N A L G G I N G I V AI N G I V A

GGINGIVALINGIVAL SSULCUSULCUS

FFREEREE GGINGIVALINGIVAL MMARGINARGIN

7 8D E

M M A R G I N A LA R G I N A L G G I N G I V AI N G I V A

RROUNDEDOUNDEDKKNIFENIFE--EDGEDEDGED

Base of Base of sulcussulcus to the to the mucogingivalmucogingival line.line.

InterdentalInterdental cleftcleft

RetrocuspidRetrocuspid papillapapilla

I I N T E R D E N T A LN T E R D E N T A L C C L E F TL E F T

CCLEFTLEFT

R R E T R O C U S P I DE T R O C U S P I D P P A P I L L A A P I L L A

RRETROCUSPIDETROCUSPID PPAPILLAAPILLA

PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©A A T T A C H E DT T A C H E D G G I N G I V A I N G I V A

Alveolar BoneAlveolar BonePDLPDLAlveolarAlveolar MucosaMucosaAttached Attached GingivaGingivaMarginal Marginal GingivaGingivaPapillary Papillary GingivaGingiva

KeratinKeratin

Thin epitheliumThin epithelium

Width Width ↑↑’’ss

A A L V E O L A RL V E O L A R M M U C O S AU C O S A

WiderWider

Less denseLess dense

Less calcifiedLess calcified

Larger marrow spacesLarger marrow spaces

P P E R I O D O N T A LE R I O D O N T A L L L I G A M E N TI G A M E N T

I I N F L U E N C EN F L U E N C E O O FF T T O O T HO O T H E E R U P T I O NR U P T I O N

ActiveActive

PassivePassive

A A C T I V EC T I V E E E R U P T I O NR U P T I O N

Contact with functional antagonist.Contact with functional antagonist.

P P A S S I V EA S S I V E E E R U P T I O NR U P T I O N

SulcularSulcular epithelium epithelium ∆∆’’ss in position.in position.

P P A S S I V EA S S I V E E E R U P T I O NR U P T I O N

ChronicChronic

ANUGANUG

RecessionRecession

LeukemiaLeukemia

AcrodyniaAcrodynia

RicketsRickets

DownDown

Chronic Chronic

ANUGANUG

FibromatosisFibromatosis & Hyperplasia& Hyperplasia

RecessionRecession

C C L A S S I F I C A T I O NL A S S I F I C A T I O N

FF E A T U R E SE A T U R E S

Inflammation Inflammation

Loss of Attachment Loss of Attachment

Bone Loss Bone Loss

Reversible Reversible

Prevalence Prevalence

E E R U P T I O NR U P T I O N G G I N G I V I T I SI N G I V I T I S

P P U B E R T YU B E R T Y G G I N G I V I T I SI N G I V I T I S

P P R E G N A N C YR E G N A N C Y G G I N G I V I T I SI N G I V I T I S

EE T I O L O G YT I O L O G Y

Bacterial Plaque Bacterial Plaque

Species Species

Other Factors Other Factors

EE T I O L O G Y : T I O L O G Y : OO T H E R T H E R FF A C T O R SA C T O R S

BacterialBacterialViralViralFungalFungalDiet, NutritionDiet, NutritionMedicationsMedications

EndocrineEndocrineHereditaryHereditaryChronic IllnessChronic Illness

SystemicSystemic

CalculusCalculusAppliancesAppliancesOral HabitsOral HabitsMouthbreathingMouthbreathing

Eruption/ExfoliationEruption/ExfoliationMalocclusionMalocclusionCariesCaries

LocalLocalExtrinsicExtrinsicIntrinsicIntrinsicFactorsFactors

G G I N G I V I T I SI N G I V I T I S

RecessionRecession

FibromatosisFibromatosis && HyperplasiaHyperplasia

AcuteAcute NecrotizingNecrotizing UlcerativeUlcerative

ChronicChronic

RecessionRecession

ChronicChronic

RecessionRecession

ChronicChronic

RecessionRecession

ChronicChronic

A A N U GN U G

PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©G G I N G I V I T I SI N G I V I T I S

RecessionRecession

Acute Necrotizing UlcerativeAcute Necrotizing Ulcerative

ChronicChronic

PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©G G I N G I V A L I N G I V A L FF I B R O M A T O S I SI B R O M A T O S I S

PP H E N Y T O I NH E N Y T O I N

CC Y C L O S P O R I NY C L O S P O R I N

RecessionRecession

Acute Necrotizing UlcerativeAcute Necrotizing Ulcerative

ChronicChronic

PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©C C R O S S B I T ER O S S B I T E

H H I G HI G H F F R E N U MR E N U M

ChronicChronic

ANUGANUG

RecessionRecession

LeukemiaLeukemia

AcrodyniaAcrodynia

RicketsRickets

DownDown

C C L A S S I F I C A T I O NL A S S I F I C A T I O N

Early Onset Early Onset

PrepubertalPrepubertal

F F E A T U R E SE A T U R E S

Loss of Gingival Attachment Loss of Gingival Attachment

Loss of Bony Support Loss of Bony Support

PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©P P R E P U B E R T A LR E P U B E R T A L P P E R I O D O N T I T I SE R I O D O N T I T I S

LocalizedLocalizedGeneralizedGeneralized

PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©P P R E P U B E R T A LR E P U B E R T A L P P E R I O D O N T I T I SE R I O D O N T I T I S

P P R E P U B E R T A LR E P U B E R T A L P P E R I O D O N T I T I SE R I O D O N T I T I S

E E A R L YA R L Y O O N S E TN S E T P P E R I O D O N T I T I SE R I O D O N T I T I S

Generalized Juvenile Generalized Juvenile PeriodontitisPeriodontitis

Incidental Juvenile Incidental Juvenile PeriodontitisPeriodontitis

Localized Juvenile Localized Juvenile PeriodontitisPeriodontitis

ChronicChronic

ANUGANUG

RecessionRecession

LeukemiaLeukemia

AcrodyniaAcrodynia

RicketsRickets

DownDown

Leukemia Leukemia

PapillonPapillon--LeFLeFéévrevre

HistiocytosisHistiocytosis X X

Down Down

PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©S S Y S T E M I CY S T E M I C C C O N D I T I O N SO N D I T I O N S

DownDownHistiocytosisHistiocytosis XXPapillonPapillon--LeFLeFéévrevreLeukemiaLeukemiaCyclic Cyclic NeutropeniaNeutropeniaHypophosphatasiaHypophosphatasia Genetic DisorderGenetic Disorder

Premature Loss Premature Loss

Deficient Alkaline Deficient Alkaline PhosphatasePhosphatase

Permanent DentitionPermanent Dentition

PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©H H Y P O P H O S P H A T A S I AY P O P H O S P H A T A S I A

DownDownHistiocytosisHistiocytosis XXPapillonPapillon--LeFLeFéévrevreLeukemiaLeukemiaCyclic Cyclic NeutropeniaNeutropeniaHypophosphatasiaHypophosphatasia

S S Y S T E M I CY S T E M I C C C O N D I T I O N SO N D I T I O N S

Rhythmic reductionRhythmic reduction

21 day cycles21 day cycles

PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©C Y C L I C N E U T R O P E N I AC Y C L I C N E U T R O P E N I A

DownDownHistiocytosisHistiocytosis XXPapillonPapillon--LeFLeFéévrevreLeukemiaLeukemiaCyclic Cyclic NeutropeniaNeutropeniaHypophosphatasiaHypophosphatasia Gingival enlargementGingival enlargement

Hyperkeratosis

Premature loss of 1º & 2º

PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©P P A P I L L O NA P I L L O N –– L L E F E F ÉÉ V R EV R E

Necrotic gingivitis

Bony loss of the molars

Radiolucent lesions

PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©S S Y S T E M I CY S T E M I C C C O N D I T I O N SO N D I T I O N S

TrisomyTrisomy 21 21

T T R I S O M YR I S O M Y 2 12 1

ChronicChronic

ANUGANUG

RecessionRecession

LeukemiaLeukemia

AcrodyniaAcrodynia

RicketsRickets

DownDown

PEDIATRIC PERIODONTAL CONDITIONS T L A N C EL A N C EPediatric Periodontal Conditions Normal...

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