Aetiopathogenesis of Perio PDF

**AETIOPATHOGENESIS OF PERIO** **1. Aetiology of Inflammatory Process in Periodontal Disease** - **Key Points**: - Caused by an imbalance between **host immune response** and the **bacterial biofilm**. - Bacteria like **Porphyromonas gingivalis** and **Treponema den...

**AETIOPATHOGENESIS OF PERIO** **1. Aetiology of Inflammatory Process in Periodontal Disease** - **Key Points**: - Caused by an imbalance between **host immune response** and the **bacterial biofilm**. - Bacteria like **Porphyromonas gingivalis** and **Treponema denticola** are key pathogens in the biofilm. - **Inflammation** is initiated by the immune system responding to bacterial endotoxins (e.g., LPS). - Host factors (e.g., genetics, immune dysregulation) contribute to progression. **2. Risk Factors in Periodontal Disease** - **Modifiable Risk Factors**: - **Smoking**: Impairs immune response and healing. - **Poor oral hygiene**: Leads to biofilm accumulation. - **Diabetes mellitus**: Hyperglycemia increases inflammation and susceptibility. - **Non-Modifiable Risk Factors**: - Genetics. - Age (older individuals at higher risk). **3. Soft and Hard Tissue Changes in Periodontal Disease** - **Soft Tissue**: - Gingival inflammation, bleeding, and swelling. - Loss of gingival attachment. - **Hard Tissue**: - **Alveolar bone loss** (resorption driven by inflammation). - Formation of periodontal pockets. **4. Tissue Response to Periodontal Treatment** - **Key Goals**: - **Reduce inflammation** and stabilize the periodontal attachment. - Allow regeneration of **soft tissues** (gingiva) and limit further **bone loss**. - **Healing Response**: - Reduction in pocket depth. - Formation of a long junctional epithelium. - Bone regeneration in some cases (guided tissue regeneration). **5. Periodontal Treatment Terminology Over Time** - **Scaling and Root Planing (SRP)**: Traditional mechanical removal of plaque and calculus. - **Debridement**: Comprehensive cleaning to disrupt biofilm and remove calculus without aggressive root planing. - **Periodontal Surgery**: - **Flap surgery**: Exposes the root for thorough cleaning. - **Regenerative therapy**: Uses membranes or grafts to restore lost bone. - Newer terms often emphasize **minimally invasive techniques** and **biological approaches**. **6. 2017 BSP Guidelines for Periodontal Classification** - Aligns with the **2017 World Workshop** classification system. - **Key Categories**: - **Periodontal Health**: Intact or reduced periodontium. - **Gingival Diseases**: - Non-dental biofilm-induced (e.g., trauma, systemic conditions). - **Periodontitis**: - Staged by severity (bone loss, clinical attachment loss) and complexity. - Graded based on progression risk and systemic impact. - **Other Conditions**: Abscesses, endo-perio lesions, mucogingival deformities.