REVIEW KULIAH PERIODONTITIS

Oleh : SILVY AMALIA FALYANI 2071210016 Pembimbing : drg. WAHYU, Sp.Ort SMF KESEHATAN GIGI DAN MULUT KEPANITERAAN KLINIK MADYA RSUD KANJURUHAN KEPANJEN MALANG FAKULTAS KEDOKTERAN UNIVERSITAS ISLAM MALANG MALANG 2013

Acute periodontitis Acute inflammation of the perodontal ligament gradually involving the whole periodontium Causes Injury : trauma due to external force or bite on hard object Infection : Pulpitis, ANUG Irritation due to improper filling Impaction of foreign body (meat bone)
Etiological agent
Streptococcus Staphylococcus Borrelia vincenti

Fusiform bacillus

Clinical features Toothache Patient feels that the tooth is extruded Fever Malaise Enlarged cervical LN

Management Treat/remove the cause Soft diet Advise not to chew from affected side Gargle with warm saline Analgesics and anti inflammatory Antibiotics Prevent further damage by proper oral hygiene

Periapical abscess Usually a progression of periodontitis History

Severe throbbing pain Tenderness Diffuse swelling Fever

On examination Inability to occlude Fluctuant swelling in buccal or lingual region Sensitive to percussion Mobility X ray may show periapical radiolucency

Management Incision and drainage Dont give local infiltration as chances of dissemination of infection is there Antibiotic coverage Analgesic Maintenance of oral hygiene

Chronic Periodontitis
Clinical Appearance: pockets

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Chronic Periodontitis
Etiology: plaque and calculus, disease activity/patient resistance

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Chronic periodontitis
Microbiology: multibacterial; primary = Porphyromonas gingivalis

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Chronic Periodontitis
Histopathology: attachment loss, bone resorption

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Chronic periodontitis
Radiographic features: horizontal bone loss

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Chronic periodontitis
Diagnosis: probing depth

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Chronic periodontitis
Treatment and prognosis: remove local etiologic factors, education, control of associated factors

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Aggressive Periodontitis:
Clinical Appearance: severe inflammation, rapid bone loss, and early tooth loss

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Aggressive Periodontitis:
Etiology: white blood cell defects

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Aggressive Periodontitis
Radiographic features: advanced bone loss

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Aggressive Periodontitis
Treatment: responds poorly to conventional treatment such as scaling and root planing; antibiotics may help but it usually slows rather than stops disease
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Aggressive Periodontitis
Prognosis: Poor; individuals with prepubertal gingivitis frequently become edentulous at an early age

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Localized
Aggressive Periodontitis:
Clinical appearance: extreme bone loss around 1st molars and incisors; loose, drifting teeth; no plaque or inflammation; good OH

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Localized
Aggressive Periodontitis:
Etiology: Aa, large percentage of neutrophils with slow chemotactic response

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Localized
Aggressive Periodontitis
Microbiology: Aa Histopathology: neutrophils with slow chemotactic response Radiographic features: extreme bone loss around 1st molars and incisors

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Localized
Aggressive Periodontitis
Diagnosis: radiographs and probing; often younger than 20

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Localized
Aggressive Periodontitis
Treatment/Prognosis : mechanical debridement, systemic antibiotics (tetracycline), periodontal surgery

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Generalized Aggressive Periodontitis:

Clinical appearance: affects most or all the teeth with 1st molars and incisors being the most severely involved; inflammation IS present with heavy plaque and calculus

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Generalized Aggressive Periodontitis

Etiology: neutrophil chemotactic disorder

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Generalized Aggressive Periodontitis

Microbiology: P. gingivalis, Eikenella corrodens, A. a

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Generalized Aggressive Periodontitis

Diagnosis: generally younger than 20 Treatment/Prognosis: improved OH, scaling and root planing, antibiotic therapy, periodontal surgery

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Necrotizing Periodontal Disease

Clinical: intensely red gingiva, extensive necrosis of soft tissues with white pseudomembrane, severe loss of attachment but no pockets, pain, odor, punched out papillae, spontaneous bleeding

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Necrotizing Periodontal Disease

Etiology: systemic immune deficiency diseases such as HIV; may be a predictor of AIDS; nutritional deficiency; stress

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Necrotizing Periodontal Disease

Microbiology P.intermedia

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Necrotizing Periodontal Disease

Histopathology: severe destruction of gingiva and alveolar mucosa that spreads to deeper tissues; severe attachment loss

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Necrotizing Periodontal Disease

Radiographic features Diagnosis: clinical presentation Treatment/prognosis: Poor due to HIV

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Necrotizing Periodontal Disease

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Conclusion
Periodontitis is a collection of diseases that are characterized by the destruction of the attachment apparatus of the teeth

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Conclusion
RDH is first line of recognition & therapy, thus it is important to be familiar with all of the forms of perio, recognize diseases that are unusual or may represent systemic involvement, and suggest referral to specialist when symptoms suggest advanced or unusual periodontal diseases
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