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Chronic PeriodontitisChronic Periodontitis

By Neveen Fuad andSarah MohammedPeriodontology Clinic

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Chronic PeriodontitisChronic Periodontitis Formerly known as “chronic adultchronic adult

periodontitisperiodontitis” is the most common form of periodontitsperiodontits.

It has been definedIt has been defined as “an infectious disease resulting in inflammation with in supporting tissues of the teeth associated with progressive attachment loss and bone loss.

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Clinical FeaturesClinical FeaturesI. Accumulation of supragingival and subgingival plaque

and calculus formation.II. Gingival inflammation.III. Attachment loss either by recession or pocket

formation.IV. horizontal or vertical bone loss.V. Inflammatory swelling.VI. Changing in color from pale red to purplish red.VII. Loss of stippling.VIII. Mobility of the teeth increases. IX. In some cases suppuration from pockets can be found.X. Rounded gingival margin and flattened interdental

papilla.

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Disease DistributionDisease Distribution Chronic periodontitis is considered to be as

““site specific diseasesite specific disease”” Inflammation,pockets,attachment lossInflammation,pockets,attachment loss

and bone lossand bone loss are due to direct site-specific effects of subgingival plaquesubgingival plaque accumulation as a result of this local effect attachment loss and pockets may occur on one surface of the tooth while the other surfaces remain normal.

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Disease SeverityDisease Severity

Described by the amount of attachment amount of attachment lossloss to 3 types ::

1)1) SlightSlight (Mild) 1-2 mm CAL2)2) ModerateModerate 3-4 mm CAL3)3) SevereSevere 5 mm or more CAL

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Clinical DiagnosisClinical Diagnosis

Inflammation of the marginal gingiva extent to the attached gingiva.

Clinical attachment loss.

Radiographs(in case of bone loss).

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Prevalence Effects both sexes equally.

Increases with age.

Age associated disease not age related and occurs depending on disease duration.

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SSymptomsymptoms

1. Painless2. Sensitivity to hot and cold

3. Localized pain radiating into the jaw4. Impaction areas of food cause discomfort

5. Itchiness in the gingiva

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Progression of the diseaseProgression of the disease

The rate of disease progression is usually slow but may be modified by systemic and/or environmental and behavioral factors.

However, because of its slow rateof progression, chronic periodontitis usuallyBecomes clinically significant in the mid-30s or

later.

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Progression of the diseaseProgression of the disease

Chronic periodontitis does not progress at an equal rate in all affected sites throughout the mouth. More rapidly

progressive lesions occur: Interproximal areas areas of greater plaque accumulation inaccessibility to plaque control

measures

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Risk factors of the diseaseRisk factors of the disease

The factors that increase the susceptibility of :disease are

1.1. Local FactorsLocal Factors : (plaque and calculus accumulation , subgingival restorations, crowded teeth)

2.2. Systemic FactorsSystemic Factors : (diseases such as diabetes )

3.3. Environmental and Behavioral FactorsEnvironmental and Behavioral Factors :(smoking )

4. GeneticGenetic factorsfactors : (family history)

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Treatment 1. Improving of the oral hygiene

2. Curettage

3. Pocket therapy

4. Scaling and root planning

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Thank YouThank You