Apical migration of the junctional epithelium and destruction of the connective tissue, PDL, and alveolar bone
Attachment loss
What is the most common form of gingival disease?
Plaque induced gingivitis
What are the four subtypes of plaque induced gingival disease
Associated with dental plaque biofilm only, modified by systemic factors, modified by medications, and modified by malnutrition
Can gingivitis persist for years without ever progressing to periodontitis?
Yes
What causes non plaque induced gingivitis?
Viral, fungal infections, allergic reactions, mechanical trauma, skin disease.
Gonorrhea, herpes type 1 and 2, varicella zoster and candidiasis may cause?
Non plaque indices gingivitis
How is periodontitis subdivided?
1. Chronic perio 2. Aggressive perio 3. Perio as a manifestation of systemic disease 4. Necrotizing perio disease 5. Abscesses of periodontium 6. Perio associated with endo lesions 7. Developmental or acquired conditions
The most common type f periodontitis
Chronic
Bacterial infection within the supporting tissues of the teeth
Chronic perio
Previously known as adult periodontitis
Chronic
Bacterial infection characterized by a rapid loss of attachment and a less predictable response to perio therapy may be localized or generalized
Aggressive periodontitis
Previously known as early inset periodontitis
Aggressive perio
Can aggressive perio occur in primary and adult dentition a?
Yes
Perio as a manifestation of systemic vids eases is associated with what two categories of systemic diseases?
Hematological blood disorders such as leukemia and genetic disorders such as Down's syndrome
With perio as a manifestation of systemic diseases clinical manifestations of perio diseases occur when?
At an early age
Unique type of perio disease that involves tissue necrosis
Necrotizing periodontal disease
Two types of necrotizing perio disease?
Necrotizing ulcerative gingivitis and necrotizing ulcerative periodontitis
A diminished systemic resistance to bacterial infection of the periodontal tissues is a characteristic that is common for what?
NUG and NUP
Spontaneous bleedig blunted papillae necrotic papillary covered by a yellowish or grayish coating
Necrotizing periodontal disease
Localized collection of pus that forms in a circumscribed area of the periodontal tissues
Periodontal abscess
Periodontal abscesses are a common feature of?
Moderate or advanced periodontitis
Involves infection or death of the tissues of the dental pulp
Periodontitis associated with endodontic lesions
Can a tooth be affected by periodontitis and pulp disease at the same time?
Yes
Study of health and disease within the total population and the risk factors that influence health and disease
Epidemiology
The number of new disease cases in a population that occurs over a given period of time
Incidence
The number of all cases of a disease that can be identified within a specific population at a given time
Prevalence
Who has a greater chance of having periodontal disease?
Males
What was the theory for periodontal disease before 1960?
Calculus
Theory for periodontal disease between 1965 and 1985
Bacteria
Current theory on periodontal disease
Bacteria + host response to bacterial infection
States that periodontal disease is characterized by periods of disease activity and inactivity
Intermittent disease progression theory
What are the major established risk factors for periodontitis?
Specific bacterial pathogens, smoking, and diabetes mellitius
Species if bacteria that is not harmful
Innocuous
Species of bacteria that is capable of causing disease
Pathogenic
Another term for pathogenic
Virulent
A tough protective layer that encloses nearly all bacteria
Cell membrane
Single thick cell membrane. Associated with healthy periodontium
G + purple stain
Double cell membranes believed to have role in tissue destruction
G - red stain
Require oxygen to live
Aerobic
Cannot live in presence of oxygen
Anaerobic
Can exsist with with or without oxygen
Facultative anaerobic bacteria
Free floating bacteria
Planktonic bacteria
Bacteria that can attach to surfaces and one another
Attached bacteria
What percentage of bacteria on earth lives as attached bacteria?
99%!
A living film containing a well organized community of bacteria
Biofilm
Biofilms form rapidly on what type of surface?
A wet one!
Legionnaires disease was the result of?
Bacterial biofilm in the hotels air conditioning system
Biofilm induced diseases are?
TB, cystic fibrosis, subacute bacterial endocarditis and periodontal disease
What is the primary source of contaminated water delivered by dental units?
Biofilms thrives in dental unit water and suction lines
What are the three stages of the biofilm life cycle?
Attachment growth and detachment
In the growth stage attached bacteria secrete a film known as?
Extra cellular slime layer
This slimy layer helps to keep the bacteria attached to the surface and acts as a protective shield for the bacteria
Extracellular slime layer
Mushroom shaped mature Biofilms attach to a surface in a narrow base in what stage?
Growth
In health the number if bCteria that can be cultures in a healthy sulci is?
100-1000
About 75% of bacteria found in periodontially healthy sites are?
G + facultative rods and cocci
Are most of the bacteria in a healthy state motile?
No. They are nonmotile.
In gingivitis the number of bacteria is?
1000-100000
What is the percentage of bacteria found in chronic gingivitis?
Equal portions of G + and G - bacteria
Associated with an enormous amount of G- bacteria 74%
Periodontitis
The number of bacteria found in periodontitis
100,000-100,000,000
3 periodontal pathogens?
A.acitinomycetemcomitans, P.gingivalis, T.forsythia
Strongly associated with aggressive periodontitis
A. Acitnomycetemcomitans
Most common species recovered from periodontal
Pockets
T. Forsythia
This species is commonly seen in recurrent perio disease
P.gingivalis
Is periodontal disease a mixed infection?
Yes
Phase 1 of plaque biofilm development
Film coating
Phase 2
Initial attachment of bacteria to pellicle
Phase 3
New bacteria join in
Phase 4
Extracellular slime layer and microcomputer formation
Phase 5
Mature biofilm:mushroom shaped microcolonies
The purpose of the acquired pellicle is?
To protect the enamel from acidic activity
Hundreds of hairlike structures that enable bacteria to attach rapidly
Fimbriae
Periods when specific species or groups grow at rapidly accelerated rates
Bacterial blooms
Dense protective barrier that surrounds the bacterial micro colonies
Extra cellular slime layer
The cell to cell adherence if one oral bacterium to another
Coaggregation