牙周病的主要症状和临床病理-ppt课件.ppt

1、（一）临床病理（二）临床表现二 牙周袋形成1.结合上皮增殖、炎性浸润1.软组织壁1.根据牙周袋底与牙槽嵴顶的位置关系分 骨上袋（suprabony pocket） 骨下袋（infrabony pocket） （一）牙槽骨吸收的临床病理 1.炎 症 2.牙合创伤I度：牙槽骨吸收在牙根的颈1/3以内四四 牙齿松动和移位牙齿松动和移位1.牙槽骨吸收1.牙周支持组织的破坏Why? legal ramifications affects treatment plan and prognosis for communication with patients History: Last classific

2、ation system was devised at the 1989 World Workshop in Clinical Periodontology Improved understanding of etiology of periodontal diseases Inclusion of gingival diseasesThe Periodontium: supporting apparatus of the tooth and its associated components alveolar boneGingival Diseases:- Can occur on a pe

3、riodontium with no attachment loss,or on a periodontium with attachment loss that is not progressing- Dental plaque induced- Non-plaque inducedGingivitis: general information- DEFN: inflammation of the givgiva- ubiquitous- occlusion analysis- major cause: accumulation of plaque- other causes- tx: re

4、moval of the cause- doesnt inevitably lead to periodontitisGingivitis:pathology- 4 stages: initial ,early, established, advanced lesion - Summary: PMNs, exudate, collagen breakdown, plasma cells, proliferation of epithelium- Major cause: accumulation of plaqueDental plaque-induced gingival diseasesI

5、.Gingivitis associated with dental plaque only a. without other local contributing factors b. with local contributing factors Dental plaque-induced gingival diseasesII. Gingival diseases modified by systemic factors a. associated with the endocrine system 1.puberty-associated gingivtis 2.menstrual c

6、ycle-associated gingivitis 3.Pregnancy-associated 4.diabetes mellitus-associated gingivitisPeriodontitis- Definition: Inflammation involving the gingival unit (gingiva and alveolar mucosa) and extending to the periodontal ligament, alveolar bone, and cementum.Periodontitis involves the loss of clini

7、cal attachment and radiographic evidence of bone loss.Periodontitis- evidence of loss of periodontal attachment - previously classified by age - now classified by “nature” of diseases: progression,clinical presentation, associated systemic diseases Periodontitis: classification overview - chronic pe

8、riodontitis- aggressive periodontitis- periodontitis as a manifestation of systemic diseasea- necrotizing periodontal diseases- abscesses of the periodontium- periodontitis associated with endodontic lesions- developmental or acquired deformaties and conditionsChronic Periodontitis- formerly “adult”

9、 periodontitis- can be: localized or generalized- usually slowly progressive disease- may have short periods of rapid progressionAggressive Periodontitis- formerly “early onset” periodontitis- can be: localized or generalized- highly destructive forms of periodontitis- not age dependment-diagnosis o

10、f “chronic” or “aggressive” depends on many criteriaPeriodontitis as a Manifestation of Systemic Diseases1. Associated with haematological disorders2. Associated with genetic disorders3. Not otherwise specifiedNecrotizing Periodontal Diseases1.Necrotizing ulcerative gingivitis (NUG)2.Necrotizing ulc

11、erative periodontitis (NUP)Abscesses of the Periodontium1.Gingival abscess2.Periodontal abscess3.Pericoronal abscessPeriodontitis associated with Endodontic lesions- combined periodontic-endodontic lesionsDevelopmental or Acquired Deformaties and ConditionsA.Localized tooth-related factors 1.Tooth a

12、natomic factors 2.Dental restorations/appliances 3.Root fractures 4.Cervical root resorption and cemental tearsDevelopmental or Acquired Deformaties and ConditionsB. Mucogingival deformaties, conditions 1.Gingival/soft tissue recession 2.Lack of keratinized gingiva 3.Decreased vestibular depth 4.Frenum/muscle position 5.Gingival excess 6.Abnormal colourDevelopmental or Acquired Deformaties and ConditionsC. Mucogingival deformaties and conditions on edentulous ridgesD. Occlusal trauma