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Are perio diseases a single disesase entity
no
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a group of lesions affecting the tissues that form the attachment apparatus of a tooth or teeth
Periodontal disesases
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defiened as an inflammatory lesion, mediated by host/microorgansim interactions, which remains limited to the gingival tissues and does not involve the underlying PDL, cementum, or alveolar and supporint bone
Gingival diseases
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events that occur in the periodontal tissues that lead to the development of gingivitis and periodontitis
histopathogenesis
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who designed the stages of pathogenesis of PD
Page and schroeder
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four stages of PD
- Initial: 2-4 days
- Early: 4-7 days
- Established: 2-3 weeks
- Advanced: Undetermined
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Histopathological signs: T-cell lesion
Early
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Histopathological signs:B-cell lesion; plasma cells; macrophages
Established
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Histopathological signs:alveolar bone loss, Periodontal pocket formation; B-cell lesion
Advanced
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Histopathological signs: Acute inflammation; machrophages; vasculitis
Initial
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Features: subclinical; no signs of gingivitis; increased flow of GCF
Initial
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Features: clinical signs of gingivitis first seen (redness, bleeding on probing, edema)
Early
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Features: Chronic gingivitis (gingiva may appear bluish-red with increased probing depths)
Established
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Features: Periodontisis
Advanced
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pmn dominated stage
initial lesion
-
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Few b cells/plasma cells
Established
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Is the initial lesion seen clinically?
No
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In what stage do antigens cross the permeable junctional epithelium and enter the gingival connective tissue?
Initial lesion
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approximately 60-70% of collagen is lost in teh connective tissue during this stage
Early
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psudopocket
gingival pocket
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psudopocket forms in which stage
estalished
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what pocket is seen is drug induced (phynetoin, cyclosporine, calcium channel blockers) gingivitis
Pseudopocket
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AAP
American Academ of Periodontology
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begins at the gingival margin and can spread throughout the remaining gingival unit. Will not develope unlessthere are bacteria present
Gingivitis Associated with Dental Plaque
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Dental Plaque Induced Gingivitis includes
- systemic system: puberty, menstrual cycle, pregnancy
- Blood dyscrasias: leukemia
- Drug-induced
- Malnutrition
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Nonplaque induced gingivitis includes
- diseases of bacterial origin
- diseases of viral origin
- diseases of fungal origin
- Lesions of genetic origin
- gingival manifestations of systemic condiditons (mucotaneous and allergic rxns)
- traumatic lesions (chemical, physical, thermal injury)
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Altered hormonal balances elicit an exaggerated response to
dental plaque
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Hormonal-influenced gingivitis manifests as
- puberty associated
- menstrual cycle associated
- pregnacy associated
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During puberty, there is a dramatic elevation in which hormones
steroid
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The distinguishing feature between plaque-induced gingivitis and puberty gingivitis is the...
the development of gingival inflammation in teh presence of a small amout of dental plaque
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During the menstrual cycle there are increased levels of which two hormones
estrogen adn progesterone
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estrogen and progesterone causegingival inflammation characterized as
enlarged, red interdental papilla
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incidence of pregancy gingivitis
30-100%
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time of greatest severity of pregnancy gingivitis
eight month (peak hormones)
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do pregnant patients with healthy gingiva usually develop gingivitis?
no
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dormant inactive, non-neoplasmic tumor
Pregnancy tumor/pyogenic granuloma
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Tx of pregnancy gingivitis consists of
periodontal debridement debridement and oral home care instruction
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hyperglycemia leads to...
- artherosclerosis
- retinopathy
- renal failure
- neuropathy
- altered wound healing
- periodontal conditions
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plaque induced gingivitis is more likely seen in which type of diabetes
type 1
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Gingivitis Associated with Blood dyscreasias
leukemia-associated gingivitis
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disease characteriazed by an abnormal proliferation of leukocytes in the blood and bone marrow
leukemia
-
tx for leukemia
- get systemic disease under control
- peridontal debridemnt and mainitenace of oral home care
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drug induced gingival changes are commonly referred to as
gingival overgrwoth or enlargement
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What is reduced in drug-induced gingivitis
fibroclasts
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What med is used as an antidepressant and caused gingival overgrowth
sodium valproate
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other calcium channel blockers associated with gingival enlargement
- diltiazem
- verampamil
- amlodipine
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Drug INFLUENCED gingivitis
oral contraceptives
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neisseria gonorrhea, treponema pallidum, streptococci, and other microorganism cause
Gingival diseases of bacterial origin
-
appearance of gingival diseases of specific bacteria origin
erythematous, edematous ulcers, or inflamed, nonulcerated gingiva
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gingival diseases of viral origin
- herpes viruses type 1 and 2
- primary herpetic gingivostomatitis
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candidiasis, coccidioidomycoosis, cryptococcosis, histoplasmosis are found in
gingival disease of fungal origin
-
band of erythema of the attached gingiva (termed linear gingival erythema-LGE)
seen in HIV or immunocompromised patients
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Gingival lesions of genetic origin
hereitary gingival fibromatosis
-
clincal appearance of hereditary gingival fibromatiosis
fibrotic gingival enlargemment
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erosive lichen planus is a type of
mucocutaneous disease
-
benign mucous membrane pemphigoid, bullous pemphigoid and pemphigus vulgaris
mucocutaneous diseases
-
In what condition is there desquamation or sloughing of the epithelium, leaving a red, painful underlining connective tissue surface
mucocutaneous diseases
-
traumatic lesions
- physical injury
- chemical injury
- thermal injury
-
Thermal injury
burns from hot beverages
-
chemical injury
chemical products that cause sloughing of tissues from mouth rinses or dentifrices, asprin burn
-
Physical injury
- aggressive tooth brushing
- incorrect use of dental flossing, fingernails or toothpicks
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