DEPARTMENT OFPERIODONTICS

CHRONIC PERIODONTITIS

Presented by SHRISH VISHWAKARMA

B.D.S FINAL YEAR SUPPL. BATCH ROLL NO 20

INTRODUCTION DEFINITION CLINICAL FEATURE RADIOGRAPHIC FEATURE TYPES SYMPTOMS DISEASE PROGRESSION RISK FACTORS OF DISEASE TREATMENT CONCLUSION REFERENCES

CONTENTS

Chronic Periodontitis was previously known as adult periodontitis or slowly progressive periodontitis .

INTRODUCTION

CHRONIC PERIODONTITIS defined as an infectious disease resulting in inflammation within the supporting tissues of the teeth , progressive attachment loss & bone loss.

DEFINITION

Age of onset is usually 30 to 35 years The disease is usually generalized although

some area are more deeply involved than the other areas .

No consistent pattern of distribution of lesion is seen except that they are usually not isolated to one or two sites .

Highly acute inflammatory sites are not seen seen mostly gingiva appear to be slight to moderately swollen & colour may be seen .

CLINICAL FEATURE

Loss of stippling blunt or rolled gingival margin and flattened or cratered papillae may be seen .

Spontaneous bleeding & inflammation related exudate from pockets may also be found .

When the pocket occludes it may result in abscess formation .

Pocket depths are variable & both suprabony & infrabony pockets can be found .

Conditions that enchance plaque accumutation like open interdental contacts defective restoration margins and malposed teeth may be frequently seen .

The amount of microbial deposits are consistent with severity of the disease

Tooth mobility is seen in advanced cases . No serum neutrophil / monocyte abnormalities

are seen .

Pattern of bone loss observed in chronic periodontitis may be vertical or horizontal . When attachment loss & bone loss on one tooth surface is referred to as vertical bone loss and is usually associated with angular bony defects and infrabony pocket . When attachment loss & bone loss occur at a uniform rate on majority of tooth surfaces it is called horizontal bone loss & is generally associated with suprabony pockets .

RADIOGRAPHIC FEATURE

Types are based on the following DISEASE DISTRIBUTION (a) LOCALIZED PERIODONTITIS : Periodontits is considered localized when < 30% of

sites assessed in the mouth demonsrate attachment loss & bone loss .

( b) GENERALIZED PERIODONTITIS : Periodontitis is considered generalized when > 30%

of the sites assesed in the mouth demonstrate attachment loss & bone loss .

TYPES

DISEASE SEVERITY ( a ) SLIGHT ( MILD ) PERIODONTITIS : Periodontal destruction I generally considered slight

when no more than 1 to 2 mm of clinical attachment loss has occerred .

( b) MODERATE PERIODONTITIS :Periodontal destruction is generally considered

moderate when 3 to 4 mm of clincal attachment loss has occurred .

( C) SEVERE PERIODONTITIS : Periodontal destruction is considered severe when 5mm

or more of clinical attachment loss has occurred .

Painless Sensitivity to hot & cold Localized pain radiating into jaw Impaction areas of food cause discomfort Itchiness in the gingiva

SYMPTOMS

The rate of disease progression is usually slow but may be modified by systemic & / or environmental & behavioral factors .

However , because of its slow rate of progression , chronic periodontitis usually becomes clinically significant in the mild 30s or later .

Chronic periodontitis does not progress at an equal rate in all affected sites throghout the mouth . More rapidly progressive lesion occur -

( i) Interproximal areas ( ii) Area of greater plaque accumulation ( iii) Inaccessibilty to plaque control mesures .

DISEASE PROGRESSION

The factor that increases the susceptibilty of disease are ( i) LOCAL FACTOR – Plaque & calculus

accumutation , subgingival restoration , crowded teeth .

Plaque retentive factor : calculus

RISK FACTORS OF DISEASE

Overhanging restorations

(II) SYSTEMIC FACTORS - diseases such as diabetes .

( III) ENVIRONMENTAL & BEHAVIORAL FACTORS - Smoking

(IV) GENETIC FACTORS - Family history

Improving of the oral hygiene Curettage Pocket therapy Scaling and root planing

TREATMENT

Chronic periodontitis an infectious disease resulting in inflammation with in supporting tissues of the teeth , progressive attachment loss & bone loss.

CONCLUSION

Carranza clinical periodontology 9th edition Essential of clinical periodontology &

periodontics ( third edition ) Shantipriya Reddy

REFERENCES