Periodontal Pocket PDF
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Summary
The document provides an overview of periodontal pockets, their characteristics, and associated factors like tissue destruction, bacterial invasion, and histopathology. It details the different types of pockets, such as active and inactive, and their clinical and histopathological features. The document also delves into the processes of periodontal inflammation and the influence of bacterial plaque on periodontal pocket formation.
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Occur due to Periodontal (True) pocket It is clinical term Intrabony pocket according to number of walls One osseous wall 2 osseous wall deffect 3 osseous wall Examples of bony defects guess type of defect Fibrotic wall Edematous wall act...
Occur due to Periodontal (True) pocket It is clinical term Intrabony pocket according to number of walls One osseous wall 2 osseous wall deffect 3 osseous wall Examples of bony defects guess type of defect Fibrotic wall Edematous wall active and inactive periodontal pocket Active pocket show clinical criteria of bleeding or bleeding and suppuration The pocket epithelium of bleeding lesions consistently demonstrated thinned or ulcerated areas. the activity not related to depth of pocket. Active pocket (tissue destruction note discharge from pocket) In active Mechanisms of Tissue Destruction The inflammatory response triggered by bacterial plaque unleashes a complex cascade of events aimed at destroying and removing bacteria, necrotic cells, and deleterious agents. However, this process is nonspecific; in an attempt to restore health, the host’s cells (e.g., neutrophils, macrophages, fibroblasts, epithelial cells) produce proteinases, cytokines, and prostaglandins that can damage or destroy the tissues. Histopathology The connective tissue is edematous and densely infiltrated with plasma cells (approximately 80%), lymphocytes, and a scattering of PMNs. The blood vessels are increased in number, dilated, and engorged, particularly in the sub epithelial connective tissue layer. The connective tissue exhibits varying degrees of degeneration. Single or multiple necrotic foci are occasionally present. In addition to exudative and degenerative changes. The junctional epithelium at the base of the pocket is usually much shorter than that of a normal sulcus The most severe degenerative changes in the periodontal pocket occur along the lateral wall. The epithelium of the lateral wall of the pocket presents striking proliferative and degenerative changes. changes is not necessarily related to pocket depth. Ulceration of the lateral wall may occur in shallow pockets, and deep pockets are occasionally observed in which the lateral epithelium is relatively intact or shows only slight degeneration. Bacterial Invasion Bacteria may invade the intercellular space under exfoliating epithelial cells, but they are also found between deeper epithelial cells as well as accumulating on the basement lamina. Some bacteria traverse the basement lamina and invade the subepithelial connective tissue. Scanning electron frontal micrograph of the periodontal pocket wall. Different areas can be seen in the pocket wall surface. A, Area of quiescence; B, bacterial accumulation; C, bacterial–leukocyte interaction; D, intense cellular desquamation. Arrows point to emerging leukocytes and holes left by leukocytes in the pocket wall. Areas of emergence of leukocytes, in which leukocytes appear in the pocket wall through holes located in the intercellular spaces
