Periodontology
- if periodontitis you can see bone loss
PERIODONTITIS
- There is attachment loss
Necrotizing Periodontal Disease
 Necrotizing Gingivitis – characteristics
are its bacterial etiology, necrotic lesion,
and predisposing factors such as
psychologic stress, smoking and
immunosuppression.
 Necrotizing Periodontitis – loss of
clinical attachment and alveolar bone is
a consistent feature
 Necrotizing Stomatitis –sa mouth pwede
sa palate, sa cheeks
Periodontitis
- Its very painful and mabaho siya at
super painful talaga siya.
- pagGingivitis wala pa talagang bone
loss yung level niya pataas pa
Prelims Topic 3
na. wala na siyang mga interdental
- Specific Bacteria – Spirochetes
responsible for necrotizing disease ;
spiral shape bacteria
- Treatment – removed the bacteria. You
can do scaling, root planing if needed or
antibiotic if needed. It is painful pero
kailangan if treat.
 Chronic Periodontitis (Slow Progression)
Characteristics:
- Prevalent in adults but can occur in
children – pagmay attachment loss na
siya for adult na siya
- Amount of destruction consistent with
local factors -
- Associated with a variable microbial
pattern
- Subgingivalcalculus frequently found
- Slow to moderate rate of progression
with possible periods of rapid
progression.
- Possibly modified by or associated with
the following:
 systemic disease such as
diabetes mellitus and human
immunodeficiency virus (HIV)
infection
Periodontology Prelims Topic 3
 local factors predisposing to
periodontitis
 environmental factors such as
cigarette smoking and emotional
stress.
 Acute Periodontitis
- Otherwise clinically healthy patient
- Rapid attachment loss and bone
destruction
- Amount of microbial deposits
inconsistent with disease severity – you
don’t see that much plaque or calcular
deposit pero since rapid siya hindi pa
nagfoform yung calcular deposit meron
ng bone loss. – hyperesponsive yung
mga immune response niya. Yung Chronic Periodontitis
bacteria pumasok, pagnormal response
yung patient aatack lang siya ng
bacteria okay na. Hyperresponsive,may
bacteriang pumasok and response ng
katawan is sobrang daming niyang
isesend na macrophages and immune
response. Hindi lang bacteria naattack
niya kung yung mga macrophages din.
- Familial aggregation of diseases
individual
 Localized
- Chronic – less than 30% bone loss
- Aggressive – incisors and molars and
other 2 teeth – kunwari dalawang molar Agressive Periodontitis
and dalawang incisors plus dalawang
premolar
 Generalized
- Chronic – 30% and more bone loss
- Aggressive – Incisors and Molars and
other 3 teeth – kunwari dalawang molar
and dalawang incisors pero tatlong
premolars na
 So when we are doing diagnosis, we
need to consider if its aggressive or
chronic before localized or generalized
kasi iba yung computation nila.
Periodontology Prelims Topic 3
Periodontitis
 Stages
- Stage I- initial
- Stage II- moderate – yung bone loss
niya 3-4 mm attachment loss
- Stage III- severe w/ potential added
tooth loss – 4 mm of loss
attachment, may possibility na
malalag yung ipin
- Stage IV- severe w/ potential of loss
of dentition – 4 mm of loss
attachment and may possibility na
maubos ang ipin
Leukemia
 Extent and distribution
- Localized
- Generalized
- Molar-incisor distribution
 Less 30% Localized
 More than 30% Generalized
 Grades
- Grade A- slow – konti palang
- Grade B- moderate – 2 mm bone
loss
- Grade C- rapid – more than 2 mm
na, Malaki na yung nawawala.
Cyclic Neutropenia

Periodontitis as a Manifestation of Systemic

Other Periodontal Conditions
Disease
 Periodontal abscesses
 Endodontic- Periodontal lesions
- Endodontic – Periodontal Lesions
– Malaki yung caries tapos
nagkaron ng periapical lesion
that’s endo-perio.
- Periodontal – Endodontic Lesions
– nagkaroon ng periodontal
disease. Yung bacteria niya sa
pockets is umabot na sa ipin that
is for perio-endo.
- Combined Lesions – when a
pulpal necrosis and a periapical
Papillon-Lefevre syndrome lesion occur on a tooth that is
also periodontally involved.
Periodontology Prelims Topic 3

Orthodontic Forces / Traumatic

- Will either have bone resorption
or tooth resorption

Mucogingival deformities and conditions

around teeth
 Gingival phenotype
 Gingival/ soft tissue recessions
 Lack of gingiva
 Decreased vestibular depth
 Aberrant frenum/ muscle position
 Gingival excess
 Abnormal color

Traumatic Occlusal Forces

Primary occlusal forces – normal level
Secondary occlusal forces – wala ng bone,
Fremitus
compromised na yung periodontium
Periodontology Prelims Topic 3

Prosthesis and Tooth-related Factors

 Localized tooth-related factors
 Localized dental prosthesis- related
factors

Epulis Fissuratum

Flabby Ridge