Chapter 16: Periodontics Part I

periodontology

the field of dentistry that deals with the treatment of diseases of the tissues around the teeth (gums), commonly called the periodontium

gingival

fibrous, epithelial tissue surrounding a tooth; may be divided into three types: attached, marginal, papillary

attached gingiva

the portion that is firm, dense stippled, and bound to underlying periosteum, tooth, and bone.

marginal gingiva

the portion that is unattached to underlying tissues and helps to form the sides of the gingival crevice; also called the free margin gingiva and forms the gingival sulcus

papillary gingiva

the part of the marginal gingiva that occupies the interproximal spaces. Normally this tissue is triangular and fills the tooth embrasure area, and slosh called the interdental papilla

cemetnum

outer hard, rough surface covering of the root section of the tooth that permits the fiber attachment for tooth retention

alveolar bone process

compact bone that forms the tooth socket; supported by stronger bone tissue of the mandible and maxilla and accepts periodontal fiber attachment.

periodontal ligaments

bundles of fibers that support and retain the tooth in the alveolar socket.

alveolar crest fibers

located at the cementoenamel junction; assists with the control of lateral movement

oblique fibers

connects the majority of the root in the alveolar socket; assists with the tooth's resistance to axial forces

apical fibers

arranged in bundles and located in the furcation of multiple rooted teeth; assists the tipping, turning, and dislocation of the tooth.

plaque

plate or buildup

calculus

deposit of hard mineral salts on the tooth surfaces

pellicle

adhering film on the surface of the teeth

erythema

the gingiva is red and appears inflamed

edema

the tissue is overgrown from hyperplasia and hypertrophy. The gingiva looks swollen and irritated.

hyperplasia

excessive tissue cells

hypertrophy

excessive cellular growth

loss of stripping

tone or tissue attachment loosens and puffy gums become smooth and shiny

pocket formation

gingiva is unattached, recession occurs, and the root may be observed

alveolar bone loss with exudate

a foul odor is present as supporting bone resorbs; retention in lessening

mobility

the tooth seems loose and moves under pressure because of loss of attachment. The tooth eventually is lost from lack of support or from extraction

dental plaque involvement

most common periodontal disease; tissues react to irritants

dental plaque with systemic factors included

pregnancy, hormone, medication, or malnutrition may modify and intensify the disease course of action; sometimes called induced gingiva

nondental plaque tensions

these are specific bacterial, viral, fungal, or genetic origin, such as gonorrhea, herpes, HIV, and candida infections

allergies

the patient may be allergic to dental-restoratice materials and have reactions to food, additives, and so forth

traumatic lesions, injury

the patient may have been subjected to an external force or have been injured in some way

chronic periodontitis

this is the most common type of slowly progressive periodontal disease. May be subdivided according to extent and severity into localized area

aggressive periodontitis

previously termed early-onset periodontitis, this is a rapidly progressive disease. There are 2 types: localized aggressive periodontitis and generalized aggressive periodontitis

refractory periodontitis

the periodontitis progresses inspire of excellent patient compliance and provision of periodontal therapy

periodontitis as manifested of systemic disease

periodontal inflammatory reactions occur as a result of diseases and genetic disorders, such as leukemia, HIV, malnutrition, and hormones

necrotizing periodontal disease

rapid gingival tissue destruction with bacterial invasion of connective tissue may be a manifestation of systemic disease, such as HIV infection

necrotizing ulcerative gingivitis

with foul odor and a loss of interdental papilla, sometimes called "trench mouth"

necrotizing ulcerative periodontitis

with bone pain and rapid bone loss

abscesses of the periodontium

abscess are classified according to location, such as gingival, periodontal, and pericoronal

periodontitis associated with endodontic lesions

this simple classification was added to distinguish between periodontitis and periodontitis with endodontic inflammation involvement

developmental or acquired deformities

deformities appear around teeth, edentulous ridges, and from trauma

medical history

questions regarding diabetes, pregnancy, smoking, hypertension, dedication substance abuse, and so forth

dental history

chief complaint, past dental records and radiographs, complete assessment of restoration condition, tooth position, mobility

extraoral structure assessment

exam or oral mucosa, muscles of mastication, lips, floor of mouth, tongue, palate, salivary glands, and the oropharynx area

periodontal probing depth

charting and recording finding of robe depths, assessing plaque and calculus presence, soft tissue and implant conditions

assessing intraoral findings

exam for tori palatinus or tori mandibularis growths abnormal frenum placement and size, and furcation involvement

prophylaxis

scaling, root planing, and polishing of teeth

index

measurement of conditions to a standard

periodontal probe

a round- or flat-bladed hand instrument marked in millimeter increments; used to measure the depth of the periodontal pocket

prophylaxis debridement

removing supragingival and subgingival plaque, calculus, stain, and irritants through tooth-crown and root-surface scaling and root planning.

tooth and surface polishing

polishing surfaces to remove accumulated extrinsic stains on the tooth surface and surfaces. This treatment can be completed using air polishers, abrasive cleansing

patient education

customized instruction in oral hygiene; the care go teeth and gingival tissue