pathogenesis of periodontal disease

periodontium

•Gingiva

•Free gingiva

•Attached gingiva

•Mucogingival line

•Gingival sulcus

•Junctional epithelium

Where are teeth seated in the jaw?

Teeth are seated in sockets in the incisive bones (premaxilla), maxillae, and mandibles.

What is the function of the alveolar process?

The alveolar process encompasses and supports tooth structure.

What is another name for the alveolar bone that supports teeth?

Alveolar Bone Proper

What type of bone is trabecular bone?

Trabecular bone is a type of spongy bone found in the interior of bones.

What is compact bone?

Compact bone is a dense and strong type of bone that forms the outer layer of bones.

What does cortical bone contain?

Cortical bone contains cortical plates with perforations for the entry of blood vessels into the inner parts of the teeth.

Where are cortical plates least and most prominent?

Cortical plates are least prominent in the maxillary region and most prominent in the molar region of the mandibular bone.

What is spongy bone also called?

Spongy bone is also called Spongiosa.

What are the two types of spongy bone?

The two types of spongy bone are Type I and Type II.

How is Type I spongy bone characterized?

Type I spongy bone contains trabeculae that are regularly arranged in a ladder-like arrangement.

How is Type II spongy bone characterized?

Type II spongy bone contains trabeculae in an irregular arrangement.

Where is Type I spongy bone more commonly seen?

Type I spongy bone is more commonly seen in the mandibular alveolar bones and type II is more in the maxillary alveolar bone

factors

•Health status

•Homecare

•Professional care

•Bacteria

•Age

•Breed

•Genetics

•Chewing behavior

•Diet

•Grooming habits

•Orthodontic occlusion

What is periodontal disease?

Inflammation and infection of the periodontium.

What characterizes periodontal disease?

Apical migration of the junctional epithelium.

What is a consequence of periodontal disease?

Loss of attachment.

What bone is affected by periodontal disease?

Crestal alveolar bone.

apical

pertaining to an apex

periodontium

tissue investing and supporting the teeth, cementum, periodontal ligament, alveolar bone, gingiva

periodontal disease in dogs and cats > 3years

dogs - 85%

cats - 75%

What is the acquired pellicle?

An acellular film composed of salivary glycoproteins that closely and firmly adheres to the oral cavity.

How quickly does the acquired pellicle attach to the tooth surface?

Within 20 minutes.

What role does the acquired pellicle play in oral health?

It helps bacteria attach to the tooth surface.

How long after the acquired pellicle forms does bacterial plaque start to colonize on the tooth?

6 to 8 hours later.

What is dental plaque?

A soft thin film of food debris, mucin, and dead epithelial cells on the teeth, providing the medium for bacterial growth.

What is gingivitis?

Inflammation of the gingiva.

What is calculus in dental terms?

An abnormal concretion, usually composed of mineral salts, occurring within the animal body.

What types of bacteria can grow in the oral cavity?

Gram Positive aerobes, Gram Negative aerobes, Gram Negative anaerobes, and Spirochetes.

What is brown pellicle?

Acquired pellicle that has become discolored as a result of poor oral hygiene.

What happens as bacteria infiltrate and colonize in a patient?

The patient attempts to fight the infection.

What occurs in response to bacterial infection?

Inflammation occurs.

What do white blood cells produce to help fight infection?

White blood cells produce antibodies.

What do white blood cells send to stimulate other cells during an infection?

White blood cells send chemicals to stimulate other cells.

What do bacteria often contain that is toxic to gingival tissues?

Bacteria often contain endotoxins and enzymes.

initial signs

•Halitosis (bad breath) -- most common compliant

•Not eating well

•Excessive salivation

•Oral discomfort

What leads to furcation exposure?

Gingival recession and bone loss

What is the furcation?

The area where two roots join

What characterizes Class 1 Furcation?

Exposure less than 1 mm

What characterizes Class 2 Furcation?

Exposure greater than 1 mm but not fully through

What characterizes Class 3 Furcation?

Complete furcation; probe able to pass through furcation

What is Stage I of periodontal disease?

Gingivitis

What is the attachment loss in Stage I of periodontal disease?

No loss of attachment or bone loss

What is Stage II of periodontal disease?

Early periodontitis

What is the attachment loss in Stage II of periodontal disease?

What is Stage III of periodontal disease?

Moderate periodontitis

What is the attachment loss in Stage III of periodontal disease?

25% to 50% attachment loss, stage 2 furcation exposure

What is Stage IV of periodontal disease?

Severe periodontitis

What is the attachment loss in Stage IV of periodontal disease?

> 50% attachment loss, stage 3 furcation exposure

What does Stage 0 (M0) of the mobility index indicate?

No movement

What does Stage 1 (M1) of the mobility index indicate?

Movement in any direction—0.2 to 0.5 mm

What does Stage 2 (M2) of the mobility index indicate?

Movement in any direction of 0.5 to 1.0 mm

What does Stage 3 (M3) of the mobility index indicate?

Movement of over 1.0 mm

early gingivitis

•Redness

•Gingival inflammation

•Mild amount of plaque

Reversible with tx

advanced gingivitis

•Redness with edema

•Topography becomes irregular

•No root exposure or change in bone

•Reversible

the "real disease is periodontitis"

tissue resorption

gingival sulcus becomes periodontal pocket

bone loss

increased leverage forces leading to more tissue destruction and tooth mobility

a gingival sulcus deepened into the periodontal ligament apically to the original level of the resorbed alveolar crest

periodontal pocket

stage 2 = early periodontitis

•Probing and radiographic signs of attachment loss

stage 3 = moderate periodontitis

•Probing and radiographic signs of attachment loss 25-49%

•Pocket formation

•Furcation exposure

•Vertical defects and infrabony pockets

•Tooth mobility

What is stage 4 of periodontal disease?

Established periodontitis

What characterizes advanced breakdown in periodontal disease?

Severe pocket depth or recession

What is a common symptom of stage 4 periodontitis during probing?

Bleeds easily on probing

What are signs of infection in established periodontitis?

Pus, bone loss, mobility

What percentage of attachment loss is indicated in stage 4 periodontitis?

Probing and radiographic signs of attachment loss >50%

periodontal eval

systemic and methodical

radiographs

periodontal probing

charting

perioceutic therapy

Doxirobe(TM) - Doxycline gel

What is perioceutic therapy?

A treatment involving the infusion of medication into the periodontal pocket.

When is perioceutic therapy administered?

After periodontal debridement.

How should the medication for perioceutic therapy be prepared?

Mix 100 times and place into the pocket.

What is used to set up the medication for perioceutic therapy?

Water.

How long is antibiotic therapy typically administered in perioceutic therapy?

30 days.