“Is defined as an inflammatory disease of thesupporting tissues of the teeth caused byspecific microorganisms or group of specificmicroorganisms, resulting in progressivedestruction of the periodontal ligament andalveolar bone with increased probing depthformation, recession or both”.

The clinical features of chronic periodontitisinclude symptoms such as:

(1) Color, texture and volume alterations of themarginal gingiva.

(2) Bleeding on probing (BoP) from the gingivalpocket area.

(3) Increased pocket depth or periodontalpocketing).

(4) Loss of probing attachment level(5) Recession of the gingival margin(6) Loss of alveolar bone(7) Root furcation exposure(8) Increased tooth mobility(9) Drifting and eventually exfoliation of teeth.

Periodontal pockets are pathologically deepened gingival sulci that develop at infected sites.

Deepening of the gingival sulcus may occur by:

coronal movement apical displacement

of the gingival OR of the

margin gingival attachment

Gingival pocket:( pseudo or false pocket)

- Is formed by gingival enlargement withoutdestruction of the underlying periodontaltissues.

-The sulcus is deepened because of theincreased bulk of the gingiva.

Periodontal pocket: (absolute or true pocket)

Produces destruction of the supportingperiodontal tissues.

Intrabony (infrabony, subcrestal,

intraalveolar)

Suprabony (supracrestal or supraalveolar

-The bottom of the

pocket is coronal to the underlying alveolar bone

-Pattern of bone destruction is horizontal

-The bottom of the pocket is apical to the level of the adjacent alveolar

bone- Pattern of bone destruction is

vertical

A) Simple pocket.

Is a pocket which involve one tooth surface

B) Compound pocket.

Is a pocket which involve two or more toothsurfaces and can be of different depths and ondifferent surfaces of the same tooth

C) Complex pocket

Is a Pocket which originate on one tooth surfaceand twists around the tooth to involve one or moreadditional surfaces, most common in furcationareas.

Clinical Signs:

- bluish red,thickened marginalgingiva

- bluish red, verticalzone from thegingival margin tothe alveolar mucosa

- gingival bleedingand suppuration

- tooth mobility

- diastema formation

Symptoms:

- Localized pain or pain deep in the bone.

- Sensation of pressure after eating

- A foul taste in localized areas

- Sensitivity to hot and cold

- Toothache in the absence of caries is alsosometimes present.

Pocket can develop at any points around thetooth.

Probing involves stepping a calibratedperiodontal probe around the tooth andrecording the deepest point at each of sixtooth surfaces:◦ distofacial,◦ facial,◦ mesiofacial◦ Distoligual,◦ lingual and

Hold the probe parallel

to the long axis of the tooth

The millimeter measurement

indicates the distance from

the gingival margin to the

base of the pocket.

‘Penetration of a probe is by a

standardized force of 25g’

Calculus: can be a hindering factor, make itdifficult to assess the correct depth, howeverwe need to overcome the calculus and try tomeasure the depth

Write down all readings that are 4mm ordeeper at the corresponding site (facial,lingual, mesial, distal, etc.)

Biologic or Clinical or

Histologic depth Probing depth

Distance between Distance to which a

gingival margin and probe penetrates

base of the pocket into the pocket

Periodontal pockets contain:

Debris consisting principally of microorganisms and their products (enzymes, and other metabolic products)

Gingival fluid Food remnants Salivary mucin Desquamated epithelial cells, and leukocytes. Plaque-covered calculus Purulent exudate, if present, consists of living,

degenerated, and necrotic leukocytes Living and dead bacteria

Give four differences between suprabonypocket and infra bony pocket!!

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