Chronic periodontitis

 #periodontic 

#Chronic_periodontitis

Chronic periodontitis 

🍂is common disease of oral cavity consist of chronic inflammation of periodental tissues 🍂

🔴Clinical signs 

may include 👉👉

🔺gingival inflammation 

▫️ bleeding, 

▪️pocketing, 

▫️gingival recession, 

▪️tooth mobility, 

▫️tooth migration, 

▪️discomfort,

▫️ halitosis .

😐Affects gingiva, PDL, cementum, and alveolar bone...

👀At earlier stages usually

 very little in the way of obvious signs or symptoms therefore

👌 probing is essential. 👌

🚫It can be regarded as a progression of the combination of

💢 infection and 💢inflammation of gingivitis into the deep tissues of the periodontal membrane.

All periodontitis develops out of gingivitis 🙂

but not all gingivitis progresses to periodontitis.🙃

#Chronic_periodontitis 

👲Some people with 

poor OH (oral hygeine ) 

↗️may develop gingivitis but not periodontitis.🙂

👳 Some people with good OH  

and little in the way of gingivitis may develop periodontitis.😥

♻️The proportion of sites that do progress in a subject or population is 

not known 

and the factors leading to progression are not well understood.😓😓

 

Periodontitis is classifed 

as🔴 localized when

 <30% of sites are afected .

Destruction is localized to first molars / incisors 

as 🔵generalized when 

>30% of sites are afected.

Generalized interproximal attachment loss .

#Chronic_periodontitis 

⛔️Severity of disease is classifed as follows:

🎲Mild: 

1–2mm of clinical attachment loss.

🎲Moderate: 

3–4mm of clinical attachment loss.

🎲Severe: 

≥5mm of clinical attachment loss.

🐚Periodontal pocketing🐚

Periodontal pockets can be divided:

👿• False pockets are 

due to gingival enlargement with the pocket epithelium 

at or above the amelocemental junction.

😈• True pockets imply

 apical migration of the junctional epithelium beyond the amelocemental junction 

😈True pocket can be divided into:

⏫ suprabony and ⏬intrabony pockets.

⏬ Intrabony are described according to the number of bony walls:

3⃣Three-walled defect is the most favourable, 

as it is surrounded on three sides by cancellous bone and on one side by the cementum of the root surface.

2⃣Two-walled defect may be either 

🌋a crater between teeth having bone on two walls and cementum

 on the other two, 

or have two bony walls, the root cementum, and an open aspect to the overlying soft tissues.

1⃣ One-walled defects may be hemiseptal through-and-through defects,

 or one bony wall, two root cementum, and one soft tissue.

✍Probing pocket depths are measured from 

👉the gingival margin to the 👉estimated base of the pocket

📶Clinical attachment levels (CAL) 

are measured from a fxed reference point:✅

 🌀the cement–enamel junction

 or

 🌀margin of a restoration

 to 

➿the base of the pocket.

 *⃣Pockets are therefore dependent on the position of the gingival margin.

⚠️ If recession is present:

 CAL = recession + periodontal probing depth.

🚨Mobility assessed using instrument handles:

☝️• Grade I: 

<1mm horizontal mobility.

✌️• Grade II:↔️

 >1mm horizontal mobility.

 No vertical displacement possible.

👌• Grade III: ↕️

vertical displacement of tooth in its socket is possible.

.....

😎Diagnosis

Periodontitis is diagnosed

 if there is :

⚡️CAL 

⚡️bleeding on probing ,🕵 

 it is localized or generalized, 🕵

 mild, moderate, or severe, 🕵

..........................................................

Dr/ Mohammed Riyadh Hassan