Gingivitis and Periodontitis

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GI N G I V I T I S & PER I O DO N T I

H ARS H IV KAR IA - 2 . 5 - 4 0 3 8

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HEALTHY GINGIVAS IGNS OF HEALTY G INGIVA

Pink o !o"# $ink !o#o Fi% '(i#i'n) )i((*'( +O"n,'-$''# )')*' -

()i$$#in,

S/"$' o##o1(!on)o* o )'')/- (!"##o$' ','

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9 LA SS I F Y I N G P E R I O DO N TA L D I SE A SE

P'ioon)"# i('"('

Gin,ii)i( P'ioon)i)iR''(i#' $#"7*'-in*!'in"%%")ion o )/' ,in,i"'!/""!)'i:' 6 ' (1o##'n)i((*'( 1/i!/ #'' on*(/in, o $oin,

9/""!)'i:' 6 )/' '()

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G IN G IV IT IS

PR E9ED ESPER IODONT IT IS HO<EVER NOTA LL 9A S ES O F G IN G IV IT ISPROGRESSES TO

PER IO D O N T IT IS .

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P RO 9 E SS O F G I N G I V I T I S = P LA > ?EI N D?9 E D@. S*$" ,in,i"# $#"7*' "!!*%*#")'( o' 4-5 "6(.

2. In!'"(' #oo o1

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• Ini)i"##6 /i,/ in n'*)o$/i#( )/'n /i,/ in #6%$/o!6)'( "n $#"(%" !

4. A))"!/%'n) o ;*n!)ion"# '$i)/'#i*% i(*$)' "##o1in, "$i!"# %i,")io"n in!'"(' in ,in,i"# (*#!*( '$)/ - o%in, " "#(' $o!k').

•. Co() "$i!"# $oin) o ;*n!)ion"# '$i)/'#i*% i( ()i## ") 9E 1i)/ no $'ioo"))"!/%'n).

•. 9o%$#')'#6 ''(i#' 1i)/ ''!)i' $#"7*' '%o"#.

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O THE R TYP E S O F G I N G I V I T I S

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P RO 9 E SS O F P E R I O DO N T I T I S

• E()"#i(/' ,in,ii)i( %"6 '%"in ()"#' o %"6 $o,'(( )o $'ioon

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• K'6 '")*'(

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• A$i!"# %i,")ion o ;*n!)ion"# '$i)/'#i*% '6on 9E

• A#'o#" on' #o((

• I''(i#'

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A G G RE SS I V E V S . 9 HRO N I 9 P E R I O DO

 AGGRESSIVE CHRONIC

RAPID RATE OF PROGRESSION SLOWLY PROGRESSING

PLAQUE DEPOSITS INCONSISTENT

WITH AMOUNT OF DESTRUCTION

 ASSOCIAT ED WITH POOR PLA

CONTROL

VERTICAL BONE LOSS HORIZONTAL BONE LOSS

USUALLY UNDER AGE 30 WITH

FAMILIAL TENDENCY 

BONE LOSS REFLECTS AGE OF

PATIENT OVER TIM E

NO UNDERLYING MEDICAL

CONDITIONS

CAN BE ASSOCIATED WITH ME

CONDITIONS

LINKED WITH A.

 ACT INOMYCETEMCOMITA NS

LINKED WITH PREVOTELLA

INTERMEDIA AND PORPHYROM

GINGIVALIS

E 9AN E LO9AL IED OR GE NERAL IED =30 OF TE<S A PATTERN <HEN LO9AL IED.

  E 9LA S S ED A S

JCC

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9/oni! $'ioon)i)i( A,,'((i' $'io

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<HY IS TAK ING H ISTORY EFORE EAC INICPORTANT

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• P'('n)in, !o%$#"in) "n /i()o6 o $'('n)in, !o%$#"in)

• C'i!"# /i()o6 "n *, /i()o6

• So!i"# /i()o6

• F"%i#6 /i()o6

• P"() 'n)"# /i()o6

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PRESENT ING 9OCPLA INT AND H ISTORY OPRESENT ING 9OCPLA INT

Si,n( "n (6%$)o%( o ,in,ii)i( "n $'ioon)i)i(

GINGIVIT IS PERIODONTIT IS

BLEEDING GUMS BLEEDING GUMS

REDDENING OF GUMS GINGIVAL RECESSION

MOBIL ITY OF TEETH

POSSIBLE SENSIT IV IT

HALITOSIS

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C E D I 9 A L H I ST O RY A N D DR?G H I STO

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• P',n"n!6 "((o!i")' ,in,ii)i(.

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SO9 IAL H ISTORY

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)o $'ioon)i)i(.

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FAC ILY H I ST ORY

• A,,'((i' $'ioon)i)( - )'n( )o *n 1i)/in "%i#i'(.

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PAST DENTAL H ISTORY

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• In)''n)"# !#'"nin,

• ?(' o $o()/'(i( - !"n "!!*%*#")' $#"7*'

• A))i)*'( )o o"# /6,i'n'

•  To Bn o*) 1/") )/' $'io*( )'")%'n)( 1'' o

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R ISK FA9TORS FOR PE R IODO NTAL D I

• 9"n ' ii' in)o #o!"# "n (6()'%i! i(k "!)o(

LOCAL SYSTEMIC

 ANAT OMICAL:

FURCATION

GINGIVAL RECESSIONMODIFIABLE:

SMOKING

DIABETES

ORAL HYGIENE

STRESS

OBESITY  

D IET  

OSTEOPOROSIS

TOOTH POSIT ION:

CROWDING

POOR ALIGNMENT 

IATROGENIC:

ORTHODONTIC APPLIANCES

OVERHANGS

NON-MODIFIABLE:

 AGE

GENETICS

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HO < TOD I A G N O SEG I N G I V I T I S• In)"-o"# '"%in")ion

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• N*%' o (*"!'( M )o)"# (*"!'( =00@

• Goo %o)i")ion"# )oo#

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HO < TOD I A G N O SEP E R I O DO N T I T I S• PE

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• JPP9

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• R"io,"$/(

• Fin o*) )6$' o on' #o(( "n "%o*n) o on' #o((.

• 9"n ' *(' )o ('' i #o!"#i:' o ,'n'"#i:'.

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> ?I

• </i!/ i( )*'

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> ?I

• </i!/ i( )*'

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. Gin,ii)i( i( i''(i#' 1/i#' $'ioon)i)i( i( ''(i#'

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> ?I

• </i!/ i( )*'

A. S%okin, '*!'( #oo o1 )o )/' ,in,i" )/''o' !"n (*$(i,n( "n (6%$)o%( o ,in,ii)i(.

. Di"')'( i( " (6()'%i! non-%oiB"#' i(k "!)o o $'ioon)

9. T"kin, ,oo /i()o6 %'"n( )/") 6o* on) /"' )o ' "( )/oo

!#ini!"# '"%in")ion.

D. A,,'((i' $'ioon)i)i( )'n( )o o!!* in "n o#' !o/o).

E. R"io,"$/( !"n ' *(' )o %oni)o ,in,ii)i(.

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> ?I

• </i!/ i( )*'

A. S%okin, '*!'( #oo o1 )o )/' ,in,i" )/''o' !"n (*$(i,n( "n (6%$)o%( o ,in,ii)i(.

. Di"')'( i( " (6()'%i! non-%oiB"#' i(k "!)o o $'ioon)

9. T"kin, ,oo /i()o6 %'"n( )/") 6o* on) /"' )o ' "( )/oo

!#ini!"# '"%in")ion.

D. A,,'((i' $'ioon)i)i( )'n( )o o!!* in "n o#' !o/o).

E. R"io,"$/( !"n ' *(' )o %oni)o ,in,ii)i(.

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RE F E RE N 9 E S

C. "n <"' <. =3@. Do'( ,in,ii)i( #'" )o $'ioon)i)i( in 6o*n,

'(.1o$'((.!o% =205@. on#in'Q A"i#"#' ")i()6.B#'(.1o$'((.!o%M20MM/'"#)/6-,*%(.;$, A!!'((' 8 F'

)' F'*"6 20JQ. A"i#"#' o%.o,.*kM$*#i!")ion(Mo1n#o"(MYo*n,P"!)i)ion'(G*i'.$ 2.

)' F'*"6 20JQ. A"i#"#' o% /))$MM111.($'io.o,.*kM$*.$ 

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