Periodontitis
is a serious gum infection that
damages the soft tissue around
teeth. Without treatment,
periodontitis can destroy the
bone that supports your teeth.
This can cause teeth to loosen or
lead to tooth loss.
Etiology
Dental plaque: The accumulation
of dental plaque on the teeth
provides a suitable environment
for the growth of bacteria. The
bacteria within the plaque
produce various virulence
factors that can cause damage to
the periodontal tissues.
Host response: The host response to
the bacterial biofilms plays a crucial
role in the development of
periodontitis. The immune response
can lead to the destruction of
periodontal tissues, as well as the
release of inflammatory mediators that
can contribute to tissue damage.
Genetics: Genetic factors can influence an individual's susceptibility to
periodontitis. Some genetic polymorphisms have been associated with an
increased risk of periodontitis.
Systemic factors: Systemic diseases, such as diabetes, have been shown
to increase the risk of periodontitis. Other factors such as smoking,
smoking and poor nutrition can also be cause of development the
periodontitis
Microbial factors: Specific bacterial
species, such as Porphyromonas
gingivalis, have been implicated in
the development of periodontitis.
These bacteria possess virulence
factors that allow them to invade
and damage periodontal tissues.
Pathogenesis
1. Formation of dental plaque: Dental plaque is a biofilm that forms on the tooth
surface, consisting of a complex community of bacteria. The first stage of
periodontitis pathogenesis is the formation of dental plaque.
2. Initiation of inflammation: The bacteria within the dental plaque stimulate
the host immune response, leading to the release of pro- inflammatory
cytokines and chemokines. This results in the recruitment of immune cells to
the site of infection and the initiation of inflammation
3. Destruction of periodontal tissues: The chronic inflammation caused by
the bacterial infection leads to the destruction of periodontal tissues,
including the gingiva, periodontal ligament, and alveolar bone. This results
in the formation of periodontal pockets
4. Bacterial invasion: Some bacterial species, such as Porphyromonas
gingivalis, can invade and persist within host cells, contributing to tissue
destruction and immune evasion.
5. Host response: The host response to bacterial infection can also
contribute to tissue destruction. For example, the activation of matrix
metalloproteinases by immune cells can lead to the breakdown of
periodontal tissues. and eventual tooth loss.
6. Systemic effects: The chronic inflammation associated with periodontitis
can also have systemic effects, contributing to the development of
conditions such as cardiovascular disease, diabetes, and rheumatoid
arthritis.
Symptomes
.Swollen or puffy gums.
.Bright red, dark red or dark purple gums.
.Gums that feel tender when touched.
.Gums that bleed easily.
.A toothbrush that looks pink after brushing your teeth.
.Spitting out blood when brushing or flossing your teeth.
.Bad breath that won't go away.
.Pus between your teeth and gums.
.Loose teeth or loss of teeth.
.Painful chewing.
.New spaces that develop between your teeth that look like black triangles.
.Gums that pull away from your teeth, making your teeth look longer than usual,
called receding gums.
.A change in the way your teeth fit together when you bite.
Acute periodontitis
characterized by the sudden onset of painful, bleeding gums, bad breath, and a
foul taste in the mouth. It is caused by a bacterial infection, usually by a
combination of anaerobic bacteria such as Fusobacterium, Prevotella, and
Treponema.
Features
Features
1. Sudden onset: Acute periodontitis typically develops rapidly, with symptoms
appearing suddenly and progressing quickly.
2. Painful, bleeding gums: The gums become inflamed and painful, and may bleed
easily, especially when brushed or flossed.
3. Foul odor and taste: The bacterial infection in acute periodontitis can cause a
foul odor and taste in the mouth.
4. Tissue necrosis: The infection can lead to tissue necrosis, with the gums
appearing grayish or black in color.
5. Systemic symptoms: In severe cases, systemic symptoms such as fever and
lymphadenopathy may also be present.
Chronic periodontitis
Develops slowly over time. It is characterized by the progressive destruction of the
periodontal tissues, including the gums, periodontal ligament, and alveolar bone.
The following are some of the key features of chronic periodontitis:
1. Slow onset: Chronic periodontitis typically develops slowly over time, with
symptoms appearing gradually.
2. Pocket formation: As the disease progresses, pockets may form between the
teeth and gums, allowing bacteria to accumulate and contribute to tissue
destruction.
3. Gum recession: The gums may recede, exposing the roots of the teeth and
making them more vulnerable to decay and sensitivity.
4. Tooth mobility: As the alveolar bone is lost, the teeth may become loose and
mobile.
5. Systemic effects: Chronic periodontitis has been associated with an increased
risk of systemic diseases such as cardiovascular diceace diabetes
Differential diagnosis
. Gingivitis
. Ulcerative gingivities
. Peri-implantities
. Oral cancer
. systemic diseases s leukemia, diabetes, HIV
. Taruma