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8/18/2019 Gingivitis and Periodontitis
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GI N G I V I T I S & PER I O DO N T I
H ARS H IV KAR IA - 2 . 5 - 4 0 3 8
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HEALTHY GINGIVAS IGNS OF HEALTY G INGIVA
Pink o !o"# $ink !o#o Fi% '(i#i'n) )i((*'( +O"n,'-$''# )')*' -
()i$$#in,
S/"$' o##o1(!on)o* o )'')/- (!"##o$' ','
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9 LA SS I F Y I N G P E R I O DO N TA L D I SE A SE
P'ioon)"# i('"('
Gin,ii)i( P'ioon)i)iR''(i#' $#"7*'-in*!'in"%%")ion o )/' ,in,i"'!/""!)'i:' 6 ' (1o##'n)i((*'( 1/i!/ #'' on*(/in, o $oin,
9/""!)'i:' 6 )/' '()
;*n!)ion"# '$i)/'#i*% "n )i((*' "))"!/%'n) o )/' )o)o,')/' 1i)/ on' '()*o%")ion o $'ioon)"# $I''(i#' "%",' !"*('
G IN G IV IT IS
PR E9ED ESPER IODONT IT IS HO<EVER NOTA LL 9A S ES O F G IN G IV IT ISPROGRESSES TO
PER IO D O N T IT IS .
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P RO 9 E SS O F G I N G I V I T I S = P LA > ?EI N D?9 E D@. S*$" ,in,i"# $#"7*' "!!*%*#")'( o' 4-5 "6(.
2. In!'"(' #oo o1
3. In"%%")o6 !'## inB#)")' ''#o$( in ,in,i"# !onn'!)i' )i((*' !"*'()*!)ion.
• Ini)i"##6 /i,/ in n'*)o$/i#( )/'n /i,/ in #6%$/o!6)'( "n $#"(%" !
4. A))"!/%'n) o ;*n!)ion"# '$i)/'#i*% i(*$)' "##o1in, "$i!"# %i,")io"n in!'"(' in ,in,i"# (*#!*( '$)/ - o%in, " "#(' $o!k').
•. Co() "$i!"# $oin) o ;*n!)ion"# '$i)/'#i*% i( ()i## ") 9E 1i)/ no $'ioo"))"!/%'n).
•. 9o%$#')'#6 ''(i#' 1i)/ ''!)i' $#"7*' '%o"#.
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8/18/2019 Gingivitis and Periodontitis
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O THE R TYP E S O F G I N G I V I T I S
. N'!o)i:in, *#!'")i' ,in,ii)i(
• 9/""!)'i:' 6 $"in*# *#!'")iono )i$( o in)''n)"# $"$i##"'.
T/'' i( ,'6 n'!o)i! )i((*' "n!"n ' "((o!i")' 1i)/ /"#i)o(i(
2. P',n"n!6 "((o!i")' ,in,ii)i( -/o%on"# !/"n,'( - in!'"('in"%%")o6 '($on('
3. P*')6 "((o!i")' ,in,ii)i( -/o%on"# !/"n,'( - in!'"('in"%%")o6 '($on('
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P RO 9 E SS O F P E R I O DO N T I T I S
• E()"#i(/' ,in,ii)i( %"6 '%"in ()"#' o %"6 $o,'(( )o $'ioon
• =9/oni!@ In"%%")ion $o,'(('( ''$' )o )/' $'ioon)"# #i,"%'n"#'o#" on' !"*(in, '()*!)ion.
• K'6 '")*'(
• Lo(( o "))"!/%'n) o $'ioon)"# !onn'!)i' )i((*'( )o !'%'n)*%
• A$i!"# %i,")ion o ;*n!)ion"# '$i)/'#i*% '6on 9E
• A#'o#" on' #o((
• I''(i#'
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A G G RE SS I V E V S . 9 HRO N I 9 P E R I O DO
AGGRESSIVE CHRONIC
RAPID RATE OF PROGRESSION SLOWLY PROGRESSING
PLAQUE DEPOSITS INCONSISTENT
WITH AMOUNT OF DESTRUCTION
ASSOCIAT ED WITH POOR PLA
CONTROL
VERTICAL BONE LOSS HORIZONTAL BONE LOSS
USUALLY UNDER AGE 30 WITH
FAMILIAL TENDENCY
BONE LOSS REFLECTS AGE OF
PATIENT OVER TIM E
NO UNDERLYING MEDICAL
CONDITIONS
CAN BE ASSOCIATED WITH ME
CONDITIONS
LINKED WITH A.
ACT INOMYCETEMCOMITA NS
LINKED WITH PREVOTELLA
INTERMEDIA AND PORPHYROM
GINGIVALIS
E 9AN E LO9AL IED OR GE NERAL IED =30 OF TE<S A PATTERN <HEN LO9AL IED.
E 9LA S S ED A S
JCC
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9/oni! $'ioon)i)i( A,,'((i' $'io
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<HY IS TAK ING H ISTORY EFORE EAC INICPORTANT
•
C'i!"# /i()o6 ,i'( ino%")ion "o*) 1/") )o '$'!) 1/'n 6o*!#ini!"# '"%in")ion. Yo* !"n "(('(( o i(k "!)o( o "n6 (6%$)$")i'n) %"6 $'('n) 1i)/
• P'('n)in, !o%$#"in) "n /i()o6 o $'('n)in, !o%$#"in)
• C'i!"# /i()o6 "n *, /i()o6
• So!i"# /i()o6
• F"%i#6 /i()o6
• P"() 'n)"# /i()o6
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PRESENT ING 9OCPLA INT AND H ISTORY OPRESENT ING 9OCPLA INT
Si,n( "n (6%$)o%( o ,in,ii)i( "n $'ioon)i)i(
GINGIVIT IS PERIODONTIT IS
BLEEDING GUMS BLEEDING GUMS
REDDENING OF GUMS GINGIVAL RECESSION
MOBIL ITY OF TEETH
POSSIBLE SENSIT IV IT
HALITOSIS
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C E D I 9 A L H I ST O RY A N D DR?G H I STO
• S6()'%i! i('"('( !"n ' "((o!i")' 1i)/ !/oni! $'ioon)i)i( - i"')'( %'##i)*(.
• S6()'%i! i('"('( %"6 /"' ini!")ion( 1/i!/ '$#"in " $o((i#'''#o$in, $'ioon)"# i('"(' - '.,. "*)i(% - $oo %"n*"# '
• S6()'%i! i('"('( %"6 '7*i' ($'!i"# %oiB!")ion( - '.,. *#)"("n !"i"! $"!'%"k'(.
• C'i!")ion( - D*,( (*!/ "( !"#!i*% !/"nn'# #o!k'( =/6$')'n$/'n6)oin ='$i#'$(6@ "n !i!#o($oin ="n)i-';'!)ion *,@ !"n !"*/6$'$#"(i" - $''n) %i(i",no(i(.
• P',n"n!6 "((o!i")' ,in,ii)i(.
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SO9 IAL H ISTORY
• D'%o,"$/i!
• A))i)*'( )o1"( 'n)"# !"'
• S%okin, - '*!'( #oo o1 )o ,in,i"# )i((*'( - (*(i,n( o "n (6%$)o%( o ,in,ii)i( i%$"i( 1o*n /'"in!'"(' $o*!)ion o in"%%")o6 %'i")in, !6)okin
)o $'ioon)i)i(.
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FAC ILY H I ST ORY
• A,,'((i' $'ioon)i)( - )'n( )o *n 1i)/in "%i#i'(.
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PAST DENTAL H ISTORY
•
Si,n( "n (6%$)o%(
• F'7*'n!6 o )oo)/ *(/in,
• In)''n)"# !#'"nin,
• ?(' o $o()/'(i( - !"n "!!*%*#")' $#"7*'
• A))i)*'( )o o"# /6,i'n'
• To Bn o*) 1/") )/' $'io*( )'")%'n)( 1'' o
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R ISK FA9TORS FOR PE R IODO NTAL D I
• 9"n ' ii' in)o #o!"# "n (6()'%i! i(k "!)o(
LOCAL SYSTEMIC
ANAT OMICAL:
FURCATION
GINGIVAL RECESSIONMODIFIABLE:
SMOKING
DIABETES
ORAL HYGIENE
STRESS
OBESITY
D IET
OSTEOPOROSIS
TOOTH POSIT ION:
CROWDING
POOR ALIGNMENT
IATROGENIC:
ORTHODONTIC APPLIANCES
OVERHANGS
NON-MODIFIABLE:
AGE
GENETICS
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HO < TOD I A G N O SEG I N G I V I T I S• In)"-o"# '"%in")ion
• E"%in")ion o (o) "n /" )i((*'( - ,in,i"# !o#o !on)o*(1'##in, $'('n!' "n #o!")ion o in"%%")ion.
• #''in, !/") "n $#"7*' in'
• N*%' o (*"!'( M )o)"# (*"!'( =00@
• Goo %o)i")ion"# )oo#
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HO < TOD I A G N O SEP E R I O DO N T I T I S• PE
• >*i!k (!''nin, o "## $")i'n)( 6'"( o#.
• Co*)/ ii' in)o (')"n)( - ''$'() $o!k') o% '"!/ (')"n)'!o'.
• S!o' ')1''n 0-4.
• JPP9
•
Co' "!!*")' "n %o' ')"i#'.
• Gi'( "i)ion"# ino%")ion - %i((in, )'')/ $oin, '$)/'!'((ion %oi#i)6 *!")ion ino#'%'n) "n #''in, on $oin,.
• R"io,"$/(
• Fin o*) )6$' o on' #o(( "n "%o*n) o on' #o((.
• 9"n ' *(' )o ('' i #o!"#i:' o ,'n'"#i:'.
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> ?I
• </i!/ i( )*'
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. Gin,ii)i( i( i''(i#' 1/i#' $'ioon)i)i( i( ''(i#'
9. Gin,ii)i( "#1"6( $o,'(('( )o $'ioon)i)i(.
D. JPP9 i( *(' )o i",no(' ,in,ii)(.
E. Ini)i"##6 in ,in,ii)i( )/' in"%%")o6 inB#)")' !on)"i#''# o n'*)o$/i#(.
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> ?I
• </i!/ i( )*'
A. Gin,ii)i( i( %o' $"in*# )/"n $'ioon)i)i(.
. Gin,ii)i( i( i''(i#' 1/i#' $'ioon)i)i( i( ''(i#'
9. Gin,ii)i( "#1"6( $o,'(('( )o $'ioon)i)i(.
D. JPP9 i( *(' )o i",no(' ,in,ii)(.
E. Ini)i"##6 in ,in,ii)i( )/' in"%%")o6 inB#)")' !on)"i#''# o n'*)o$/i#(.
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> ?I
• </i!/ i( )*'
A. S%okin, '*!'( #oo o1 )o )/' ,in,i" )/''o' !"n (*$(i,n( "n (6%$)o%( o ,in,ii)i(.
. Di"')'( i( " (6()'%i! non-%oiB"#' i(k "!)o o $'ioon)
9. T"kin, ,oo /i()o6 %'"n( )/") 6o* on) /"' )o ' "( )/oo
!#ini!"# '"%in")ion.
D. A,,'((i' $'ioon)i)i( )'n( )o o!!* in "n o#' !o/o).
E. R"io,"$/( !"n ' *(' )o %oni)o ,in,ii)i(.
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> ?I
• </i!/ i( )*'
A. S%okin, '*!'( #oo o1 )o )/' ,in,i" )/''o' !"n (*$(i,n( "n (6%$)o%( o ,in,ii)i(.
. Di"')'( i( " (6()'%i! non-%oiB"#' i(k "!)o o $'ioon)
9. T"kin, ,oo /i()o6 %'"n( )/") 6o* on) /"' )o ' "( )/oo
!#ini!"# '"%in")ion.
D. A,,'((i' $'ioon)i)i( )'n( )o o!!* in "n o#' !o/o).
E. R"io,"$/( !"n ' *(' )o %oni)o ,in,ii)i(.
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RE F E RE N 9 E S
C. "n <"' <. =3@. Do'( ,in,ii)i( #'" )o $'ioon)i)i( in 6o*n,
'(.1o$'((.!o% =205@. on#in'Q A"i#"#' ")i()6.B#'(.1o$'((.!o%M20MM/'"#)/6-,*%(.;$, A!!'((' 8 F'
)' F'*"6 20JQ. A"i#"#' o%.o,.*kM$*#i!")ion(Mo1n#o"(MYo*n,P"!)i)ion'(G*i'.$ 2.
)' F'*"6 20JQ. A"i#"#' o% /))$MM111.($'io.o,.*kM$*.$