Periodontology

presentation

AMNA HASSANROLL NO : 12

Aggressive periodontitis

CONTENTS:

1. INTRODUCTION2. CLASSIFICATION3. CLINICAL FEATURES4. RADIOGRAPHIC FEATURES5. DISTINGUISHING FEATURES6. RISK FACTORS

DEFINITION :

“Periodontitis is defined as an inflmmatory disease of the supporting tiisue of the teeth caused by specific micro organisms,resulting in progressive destruction of PDL and alveolar bone with increased probing depth formation,recesion or both”

Aggressive periodontitis describes a type of periodontal disease and includes two of the seven classifications of periodontitis:

Localized aggressive periodontitis (LAP)

Generalized aggressive periodontitis (GAP)

• Rapid rate of disease progession

•An absence of large accumulation of plaque• And claculus

• Family history

Aggressive vs chronic

LOCALIZED AGGRESSIVE PERIODONTITIS

•Onset at about puberty

•Affects primarily molars and incisor teeth

•Deep pockets and advanced bone loss

Etiology is unknown BUT connection between the disease & presence of of anaerobic gram negative bacteria

AGGREGATIBACTER ACTINOMYCETEMOCOMI

Clinical characteristics :

Localized first molar / molars presentation with interproximal attachment loss on atleast two

permanent teeth,one of which is a first molar , and involving no more

than two teeth other than first molar and incisors”

•LAP lack of clinical inflammation despite the presence of deep periodontal pockets and advanced bone

•Amount of plaque on affected teeth is minimal

•Distolabial migration of maxillary incisors with concomitant diastema formation

•Increasing mobility of the maxillary and mandibular incisors and first molars

•Senstivity of denuded root surfaces to thermal and tactile stimuli•Deep ,dull,radiating pain during mastication causedby irritation of supporting srructures by mobile teeth and impacted food

RADIOGRAPHIC FINDINGS :

•Vertical loss of alveolar bone around the first molars and incisors•Begiining at puberty in otherwise healthy

teenagers is a daignostic sign

•Arc shaped loss of alveolar bone extending from distal surface of the premolar to the mesial surface of the second molar

THE rate of bone loss can b 3 to 4 times

faster han that seen in chronic periodontitisMost reports show low prevelence

<about 0.2%

White females teenagers are more

likely to have LAP than white males

Generalized aggressive

periodontitis

characterised by “ generalized interproximal attachment loss affecting atleast three permanent teeth than first molars and incisors”

•Destruction appears with periods of advanced followed by quiescence of varaible length

GAP often have small amount of plaque associated with the affected teeth

P.gingivalis,A.actinomycetemocomitans and tannerella forsythia are detected in plaque

Two gingival tissue responses

1)Severe ,acutely inflammed ,proliferating,ulcerated and fiery redBleeding may occur spontaneously

• Suppuration may be an important features

2)Gingival tissues may appear pink, free of inflammationSome stippling may be presentDeep pocket can be demostrated by probing

•Patients with GAP may have systemetic manifestation

•Like weight loss,general malasie n mental depression

•As seen with LAP may be arrested spontaneously or after therapy,where as others may continue to progress to tooth loss.

Radiographic findings

•severe boneloss associated with minimal number of teeth

•Advanced bone loss affecting the majority of teeth in the dentition

PREVELENCE :

• Black were at much higher risk than white s for all forms of aggressive periodontitis

•Male teenagers were more likely to have GAP than female adolescents

Risk factors for aggressive periodontitis

•Microbiologic factors

•Immunologic factors

•Genetic factors

•Environment factors