CHRONIC PERIODONTITIS

1. DEPARTMENT OFPERIODONTICS

2. Presented by
SHRISH VISHWAKARMA
B.D.S FINAL YEAR SUPPL. BATCH
ROLL NO 20

3.  INTRODUCTION
 DEFINITION
 CLINICAL FEATURE
 RADIOGRAPHIC FEATURE
 TYPES
 SYMPTOMS
 DISEASE PROGRESSION
 RISK FACTORS OF DISEASE
 TREATMENT
 CONCLUSION
 REFERENCES

4.  Chronic Periodontitis was previously known as adult
periodontitis or slowly progressive periodontitis .

5.  CHRONIC PERIODONTITIS defined as an infectious
disease resulting in inflammation within the supporting
tissues of the teeth , progressive attachment loss &
bone loss.

6.  Age of onset is usually 30 to 35 years
 The disease is usually generalized although
some area are more deeply involved than the
other areas .
 No consistent pattern of distribution of lesion
is seen except that they are usually not
isolated to one or two sites .
 Highly acute inflammatory sites are not seen
seen mostly gingiva appear to be slight to
moderately swollen & colour may be seen .

7.  Loss of stippling blunt or rolled gingival
margin and flattened or cratered papillae may
be seen .
 Spontaneous bleeding & inflammation related
exudate from pockets may also be found .

8.  When the pocket occludes it may result in
abscess formation .
 Pocket depths are variable & both suprabony
& infrabony pockets can be found .
 Conditions that enchance plaque
accumutation like open interdental contacts
defective restoration margins and malposed
teeth may be frequently seen .
 The amount of microbial deposits are
consistent with severity of the disease
 Tooth mobility is seen in advanced cases .
 No serum neutrophil / monocyte
abnormalities are seen .

9.  Pattern of bone loss observed in chronic periodontitis
may be vertical or horizontal . When attachment loss
& bone loss on one tooth surface is referred to as
vertical bone loss and is usually associated with
angular bony defects and infrabony pocket . When
attachment loss & bone loss occur at a uniform rate
on majority of tooth surfaces it is called horizontal
bone loss & is generally associated with suprabony
pockets .

11.  Types are based on the following
DISEASE DISTRIBUTION
(a) LOCALIZED PERIODONTITIS :
Periodontits is considered localized when < 30% of
sites assessed in the mouth demonsrate attachment
loss & bone loss .
( b) GENERALIZED PERIODONTITIS :
Periodontitis is considered generalized when > 30%
of the sites assesed in the mouth demonstrate
attachment loss & bone loss .

12. DISEASE SEVERITY
( a ) SLIGHT ( MILD ) PERIODONTITIS :
Periodontal destruction I generally considered slight
when no more than 1 to 2 mm of clinical attachment
loss has occerred .
( b) MODERATE PERIODONTITIS :
Periodontal destruction is generally considered
moderate when 3 to 4 mm of clincal attachment loss
has occurred .
( C) SEVERE PERIODONTITIS :
Periodontal destruction is considered severe when 5mm
or more of clinical attachment loss has occurred .

13.  Painless
 Sensitivity to hot & cold
 Localized pain radiating into jaw
 Impaction areas of food cause discomfort
 Itchiness in the gingiva

14.  The rate of disease progression is usually slow but
may be modified by systemic & / or environmental &
behavioral factors .
However , because of its slow rate of progression ,
chronic periodontitis usually becomes clinically
significant in the mild 30s or later .
Chronic periodontitis does not progress at an equal
rate in all affected sites throghout the mouth . More
rapidly progressive lesion occur -
( i) Interproximal areas
( ii) Area of greater plaque accumulation
( iii) Inaccessibilty to plaque control mesures .

15. The factor that increases the susceptibilty of disease are
( i) LOCAL FACTOR – Plaque & calculus
accumutation , subgingival restoration , crowded teeth .
Plaque retentive factor : calculus

16. Overhanging
restorations

17.  (II) SYSTEMIC FACTORS - diseases such as
diabetes .
 ( III) ENVIRONMENTAL & BEHAVIORAL
FACTORS - Smoking
 (IV) GENETIC FACTORS - Family history

18.  Improving of the oral hygiene
 Curettage
 Pocket therapy
 Scaling and root planing

19.  Chronic periodontitis an infectious disease resulting in
inflammation with in supporting tissues of the teeth ,
progressive attachment loss & bone loss.

20.  Carranza clinical periodontology 9th edition
 Essential of clinical periodontology &
periodontics ( third edition ) Shantipriya
Reddy