periodontitis acute periodontitis
DESCRIPTION
Periodontitis Acute periodontitis Acute inflammation of the perodontal ligament gradually involving the whole periodontium Causes (4I) Injury: trauma due to external force or bite on hard object Infection: Pulpitis, ANUG Irritation due to improper filling - PowerPoint PPT PresentationTRANSCRIPT
PeriodontitisPeriodontitisAcute periodontitisAcute periodontitis Acute inflammation of the perodontal ligament gradually Acute inflammation of the perodontal ligament gradually
involving the whole periodontiuminvolving the whole periodontium
Causes (4I)Causes (4I) Injury: trauma due to external force or bite on hard objectInjury: trauma due to external force or bite on hard object Infection: Pulpitis, ANUGInfection: Pulpitis, ANUG Irritation due to improper fillingIrritation due to improper filling Impaction of foreign body (meat bone)Impaction of foreign body (meat bone)
Etiological agent – Streptococcus, Staphylococcus, Borrelia vincentiEtiological agent – Streptococcus, Staphylococcus, Borrelia vincenti Fusiform bacillusFusiform bacillus
Dr S ChakradharDr S Chakradhar 11
Clinical featuresClinical featuresToothacheToothachePatient feels that the tooth is Patient feels that the tooth is
extrudedextrudedFeverFeverMalaiseMalaiseEnlarged cervical LNEnlarged cervical LN
Dr S ChakradharDr S Chakradhar 44
ManagementManagementTreat/remove the causeTreat/remove the causeSoft dietSoft dietAdvise not to chew from affected sideAdvise not to chew from affected sideGargle with warm salineGargle with warm salineAnalgesics and anti inflammatoryAnalgesics and anti inflammatoryAntibiotics Antibiotics Prevent further damage by proper oral hygienePrevent further damage by proper oral hygiene
Dr S ChakradharDr S Chakradhar 55
Periapical abscessPeriapical abscess Usually a progression of periodontitisUsually a progression of periodontitis HistoryHistory
Severe throbbing painSevere throbbing pain TendernessTenderness Diffuse swellingDiffuse swelling FeverFever
On examinationOn examination Inability to occludeInability to occlude Fluctuant swelling in buccal or lingual regionFluctuant swelling in buccal or lingual region Sensitive to percussionSensitive to percussion MobilityMobility X ray may show periapical radiolucencyX ray may show periapical radiolucency
ManagementManagement Incision and drainageIncision and drainageDon’t give local infiltration as chances Don’t give local infiltration as chances
of dissemination of infection is thereof dissemination of infection is thereAntibiotic coverageAntibiotic coverageAnalgesicAnalgesicMaintenance of oral hygieneMaintenance of oral hygiene
Chronic periodontitisChronic periodontitis CausesCauses
Chronic gingivitisChronic gingivitis Occlusal traumaOcclusal trauma Improper application of orthodontic appliance (excess Improper application of orthodontic appliance (excess
force)force)
PathologyPathology Destruction of periodontal ligamentDestruction of periodontal ligament Formation of periodontal pocketFormation of periodontal pocket Resorption of alveolar boneResorption of alveolar bone Loosening of teethLoosening of teeth
Clinical featuresClinical features Features of chronic gingivitisFeatures of chronic gingivitis Swollen, soft, discoloredSwollen, soft, discolored Bleeds on probingBleeds on probing Gingival pocket ( >4mm)Gingival pocket ( >4mm) False pocket if gingiva is elongated towards crown.False pocket if gingiva is elongated towards crown. Recession of gum marginRecession of gum margin Mobile toothMobile tooth HalitosisHalitosis
ManagementManagementMaintain oral hygieneMaintain oral hygiene
BrushingBrushingMouth washMouth wash
Scaling to remove plaque and calculiScaling to remove plaque and calculiSubgingival curettage of pocket, to Subgingival curettage of pocket, to allow normal reattachment of gingival allow normal reattachment of gingival and periodontal tissueand periodontal tissueMucogingival flap operation: curettage Mucogingival flap operation: curettage of granulation tissue, dead bone and of granulation tissue, dead bone and cementum beneath a flap of gingivacementum beneath a flap of gingiva
ComplicationsComplications Intraoral and extraoral abscessIntraoral and extraoral abscessMaxillary sinusitisMaxillary sinusitisOstemyelitis of jawOstemyelitis of jawCellulitis of faceCellulitis of faceDissemination of infection: Dissemination of infection:
bacteremia, septicemiabacteremia, septicemia
PericoronitisPericoronitis Inflammation of the gingival tissue around an erupting Inflammation of the gingival tissue around an erupting
toothtooth When the eruption is partial, there is an opening When the eruption is partial, there is an opening
through the mucus membrane and through the mucus membrane and rest of the crown is covered by a flap of gum which is rest of the crown is covered by a flap of gum which is
known as operculumknown as operculum Commonly occurs in the lower 3Commonly occurs in the lower 3rdrd molar at the age of molar at the age of
18 to 25 yrs18 to 25 yrs But any tooth can be affectedBut any tooth can be affected
CausesCausesFood stagnation and impactionFood stagnation and impactionUpper tooth traumatizing lower gum Upper tooth traumatizing lower gum
flapflapVincent’s infection – acute gingivitis Vincent’s infection – acute gingivitis
caused by borella vincemtis & caused by borella vincemtis & fuscobacteriumfuscobacterium
Eruption irritationEruption irritationImmunocompromised hostImmunocompromised host
Clinical featuresClinical features PainPain Swollen operculumSwollen operculum TrismusTrismus HalitosisHalitosis Fever and enlarged cervical LNFever and enlarged cervical LN Purulent exudatePurulent exudate Abscess formationAbscess formation
ManagementManagement Clean with 3%H2O2 Clean with 3%H2O2
Nascent O2 is bactericidalNascent O2 is bactericidal Normal saline washNormal saline wash Maintain oral hygieneMaintain oral hygiene
BrushingBrushing Antiseptic mouthwashAntiseptic mouthwash
Chlorhexidine, Betadine, Chlorhexidine, Betadine, Soft dietSoft diet Analgesic and anti inflammatoryAnalgesic and anti inflammatory Amoxycillin 500mg tds for 5 to 7 daysAmoxycillin 500mg tds for 5 to 7 days
Or Erythromycin 250mg qid for 5 to 7 daysOr Erythromycin 250mg qid for 5 to 7 days OperculectomyOperculectomy Removal of upper tooth may be necessaryRemoval of upper tooth may be necessary