CLASSIFICATION-OF-GINGIVAL AND PERIODONTALDISEASES.ppt

CLASSIFICATION-OF-GINGIVAL AND PERIODONTALDISEASES.ppt

• 1.
  CLASSIFICATION OF CLASSIFICATION OF DISEASESAFFECTING DISEASES AFFECTING THE PERIODONTIUM THE PERIODONTIUM
• 2.
  CLASSIFICATION OF PERIODONTALDISEASES AND CONDITIONS (1999 WORLD WORKSHOP CLASSIFICATION BY AAP) GINGIVAL DISEASES Plaque induced gingival diseases Non-plaque induced gingival diseases CHRONIC PERIODONTITIS Localized Generalized AGGRESSIVE PERIODONTITIS Localized Generalized
• 3.
  PERIODONTITIS AS AMANIFESTATION OF SYSTEMIC DISEASES NECROTIZING PERIODONTAL DISEASES Necrotizing ulcerative gingivitis (NUG) Necrotizing ulcerative periodontitis (NUP) ABSCESSES OF THE PERIODONTIUM Gingival abscess Periodontal abscess Pericoronal abscess PERIODONTITIS ASSOCIATED WITH ENDODONTIC LESIONS Endo perio lesion Perio endo lesion Combined lesion
• 4.
  DEVELOPMENTAL OR ACQUIREDDEFORMITIES AND CONDITIONS Localized tooth related factors predisposing to plaque induced gingival disease or periodontitis Mucogingival deformities and conditions around the teeth Mucogingival deformities and conditions on edentulous ridge Occlusal trauma
• 5.
  GINGIVAL DISEASES DENTAL PLAQUE-INDUCEDGINGIVAL DISEASES Disease may occur on a periodontium with no attachment loss or with attachment loss that is stable and not progressing. I. GINGIVITIS ASSOCIATED WITH DENTAL PLAQUE ONLY A. without local factors B. with local contributing factors
• 6.
  II. GINGIVAL DISEASESMODIFIED BY SYSTEMIC FACTORS A. Associated with the endocrine system 1. Puberty associated gingivitis 2. Menstrual cycle associated gingivitis 3. Pregnancy associated a. Gingivitis b. Pyogenic granuloma 4. Diabetes mellitus associated gingivitis B. Associated with blood dyscrasias 1. Leukemia associated gingivitis 2. Others
• 7.
  III. GINGIVAL DISEASEMODIFIED BY MEDICATIONS A. Drug influenced gingival disease 1. Drug induced gingival enlargement 2. Drug induced gingivitis a. oral contraceptive associated b. others IV. GINGIVAL DISEASES MODIFIED BY MALNUTRITION A. Ascorbic acid deficiency gingivitis B. Others
• 8.
  NON-PLAQUE INDUCED GINGIVALLESIONS I. Gingival disease of specific bacterial origin a. Neisseria gonorrhea b. Treponema pallidum c. Streptococcal sp d. Others II. Gingival disease of viral origin a. Herpes virus infections 1. primary herpetic gingivostomatitis 2. recurrent oral herpes 3. varicella zoster
• 9.
  III GINGIVAL DISEASEOF FUNGAL ORIGIN A. Candida sp infection – gingival candidosis B. Linear gingival erythema C. Histoplasmosis D. Others IV. GINGIVAL LESIONS OF GENETIC ORIGIN A. Hereditary gingival fibromatosis B. Others
• 10.
  V. GINGIVAL MANIFESTATIONOF SYSTEMIC CONDITIONS A. Mucocutaneous lesions 1. Lichen planus 2. Pemphigoid 3. pemphigus vulgaris 4. Erythema multiforme 5. Lupus erythematosis 6. Drug induced 7. Others B. Allergic reactions 1. Dental restorative materials ( mercury, acrylic) 2. Reactions to toothpaste, mouth rinse, chewing gum additives food and additives 3. Others
• 11.
  VI. TRAUMATIC LESIONS( IATROGENIC OR ACCIDENTAL) A. Chemical injury B. Physical C. Thermal VII. FOREIGN BODY REACTIONS VIII. NOT OTHERWISE SPECIFIED
• 12.
  CLASSIFICATION OF VARIOUSFORMS OF PERIODONTITIS AAP WORLD WORKSHOP 1989 Adult Periodontitis – Age of onset > 35 years Slow rate of disease progression No defect in host defense Early onset periodontitis - Age of onset < 35 years (Prepubertal, Juvenile or Rapid rate of disease Rapidly progressive) progression Defect in host defense Associated with specific
• 13.
  Periodontitis associated -Systemic disease that predispose to with systemic disease rapid rate of periodontitis Diabetes, down syndrome, HIV infection, Papillon Lefevre syndrome Necrotizing ulcerative - Similar to ANUG but with associated clinical periodontitis attachment loss Refractory Periodontitis - Recurrent periodontitis that does not respond to treatment
• 14.
  EUROPEAN WORKSHOP ON EUROPEANWORKSHOP ON PERIODONTOLOGY 1993 PERIODONTOLOGY 1993  Adult periodontitis Adult periodontitis - Age of onset fourth - Age of onset fourth decade of life decade of life Slow rate of disease Slow rate of disease progression progression No defect in host response No defect in host response Early onset Early onset - Age of onset prior to - Age of onset prior to Periodontitis Periodontitis fourth decade of life fourth decade of life Rapid rate of disease Rapid rate of disease progression progression defect in the host defense defect in the host defense Necrotizing Necrotizing - Tissue necrosis with attachment and - Tissue necrosis with attachment and periodontitis bone loss periodontitis bone loss
• 15.
  AAP WORKSHOP FORCLASSIFICATION AAP WORKSHOP FOR CLASSIFICATION OF PERIODONTAL DISEASE 1999 OF PERIODONTAL DISEASE 1999  Chronic periodontitis Chronic periodontitis  Aggressive Aggressive periodontitis periodontitis  Periodontitis as a Periodontitis as a manifestation of manifestation of systemic diseases systemic diseases
• 16.
  CHRONIC PERIODONTITIS CHRONIC PERIODONTITIS Prevalent in adults Prevalent in adults  Destruction consistent with local factors Destruction consistent with local factors  Variable microbial pattern Variable microbial pattern  Subgingival calculus present Subgingival calculus present  Slow to moderate rate of progression Slow to moderate rate of progression  Modified by systemic diseases like Diabetes, Modified by systemic diseases like Diabetes, HIV HIV  Local factors predisposing to periodontitis Local factors predisposing to periodontitis  Smoking and stress Smoking and stress
• 17.
  Chronic periodontitis Chronic periodontitis Classifiedinto Classified into Localized form < 30% of sites involved Localized form < 30% of sites involved Generalized form > 30% of sites involved Generalized form > 30% of sites involved Slight Slight : 1-2mm of CAL : 1-2mm of CAL Moderate Moderate : 3-4mm of CAL : 3-4mm of CAL Severe Severe : :   5mm of CAL 5mm of CAL
• 18.
  AGGRESSIVE PERIODONTITIS AGGRESSIVE PERIODONTITIS clinically healthy pt clinically healthy pt  Rapid attachment and bone loss Rapid attachment and bone loss  Microbial deposits inconsistent with disease severity Microbial deposits inconsistent with disease severity  Familial aggregation Familial aggregation  Diseased site infected with Aa Diseased site infected with Aa  Abnormal phagocyte function Abnormal phagocyte function  Hyperresponsive macrophage Hyperresponsive macrophage  Increased PGE2 and IL-1 Increased PGE2 and IL-1β β  Self arresting disease progression Self arresting disease progression
• 19.
  AGGRESSIVE PERIODONTITIS AGGRESSIVE PERIODONTITIS Classified into Classified into Localized form Localized form circumpubertal onset circumpubertal onset first molar or incisor disease with attachment first molar or incisor disease with attachment loss on two permanent teeth with one first loss on two permanent teeth with one first molar molar Robust serum antibody response Robust serum antibody response Generalized form Generalized form under 30 years of age under 30 years of age generalized attachment loss other than 1 generalized attachment loss other than 1st st molars and incisors molars and incisors episodic nature of periodontal destruction episodic nature of periodontal destruction poor serum antibody response poor serum antibody response
• 20.
  PERIODONTITIS AS AMANIFESTATION PERIODONTITIS AS A MANIFESTATION OF SYSTEMIC DISEASE OF SYSTEMIC DISEASE 1.Hematological disorders 1.Hematological disorders a. Acquired neutropenia a. Acquired neutropenia b. Leukemia b. Leukemia c. Others c. Others 2. Genetic disorders 2. Genetic disorders a. Cyclic neutropenia a. Cyclic neutropenia b. Down Syndrome b. Down Syndrome c. Papillon Lefevere c. Papillon Lefevere d. Chediak Higashi syndrome d. Chediak Higashi syndrome e. Leukocyte adhesion deficiency e. Leukocyte adhesion deficiency f. Hypophosphatasia f. Hypophosphatasia 3. Not otherwise specified 3. Not otherwise specified