chronic periodontitis
DESCRIPTION
Seminario de inmunologíaTRANSCRIPT
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Chronic periodontitis
Diego Halabí RoblesPrograma de Doctorado en Ciencias Médicas
Unversidad Austral de Chile
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Periodontitis
Highfield, 2009
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Chronic periodontitis
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Clinical
Highfield, 2009 Corbet, 2009
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Epidemiology
93.4%35 to 44 years old
97.5%65 to 74 years old
38.6%35 to 44 years old
69.3%65 to 74 years old
>6 mm
>3 mm
Gamonal et al., 2010
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Microbiology
Red complex: P. gingivalis, T. denticola and T. forsythia
Silva et al., 2008
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Immunology
Periodontitis
IL-1β
TNF-α
Biofilm
(Mörmann et al., 2008)
(Zappa et al., 1991)
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Zappa, U. et al., 1991
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Kaushik, R., Yeltiwar, R.K. & Pushpanshu, K., 2011. Salivary interleukin-1β levels in patients with chronic periodontitis before and after periodontal phase I therapy and healthy controls: a case-control study . Journal of periodontology, 82(9), pp.1353-9.
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CD4+/CD8+ ratios
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Th17
Periodontitis
IL-1β
TNF-α
Biofilm
IL-17
RANKL
TFG-β
IL-6
IL-23
Th17
↑RORC2
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Th1/Th17
Periodontitis
IL-1β
TNF-α
Biofilm
IL-17
RANKL
TFG-β
IL-6
IL-23
Th17
↑RORC2
IL-12
Th1
↑ T-bet
IL-1β
IFN-γ
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Th17, Th1 and Treg
Periodontitis
IL-1β
TNF-αBiofilm
IL-17
RANKL
TFG-β
IL-6
IL-23
Th17
↑RORC2
IL-12Th1
↑ T-bet
IL-1β
IFN-γTFG-β
TregCTLA-4
TGF-β1
IL-10
↑Foxp3
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TherapyPatient
Chronic periodontitis Health
Oral health instruction Plaque control Supragingival debridement Subgingival debridement Reevaluation
Chronic periodontitis
Chronic periodontitis
Antibiotics (amoxicillin + Metronidazole)
Chlorhexidine 0.05% per 3 months
Reevaluation
Oral health instruction
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References• Corbet, E., 2009. Radiographs in periodontal disease diagnosis and management. Australian
dental journal, 54 Suppl 1, pp.S27–43.• Dutzan N, Gamonal J, Silva A, Sanz M, Vernal R (2009). Over-expression of forkhead box P3 and
its association with receptor activator of nuclear factor-kappa B ligand, interleukin (IL) -17, IL-10 and transforming growth factor-beta during the progression of chronic periodontitis. J Clin Periodontol 36:396-403.
• Gamonal, J. et al., 2010. Clinical attachment loss in Chilean adult population: First Chilean National Dental Examination Survey. Journal of periodontology, 81(10), pp.1403–10.
• Hernández, M. et al., 2011. Host-pathogen interactions in progressive chronic periodontitis. Journal of dental research, 90(10), pp.1164–70.
• Highfield, J., 2009. Diagnosis and classification of periodontal disease. Australian dental journal, 54 Suppl 1, pp.S11–26.
• Silva, N. et al., 2008. Characterization of progressive periodontal lesions in chronic periodontitis patients: levels of chemokines, cytokines, matrix metalloproteinase-13, periodontal pathogens and inflammatory cells. Journal of clinical periodontology, 35(3), pp.206–14.
• Zappa, U. et al., 1991. Cell populations and episodic periodontal attachment loss in humans. Journal of clinical periodontology, 18(7), pp.508–15.