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Rather than a single disease entity, periodontal disease is a combination of multiple disease processes that share a common clinical manifestation. The cause includes both local and systemic factors. The disease consists of a chronic inflammation associated with loss of alveolar bone. Advanced disease features include pus and exudates.
Chronic periodontitis is initiated by Gram-negative tooth-associated microbial biofilms that elicit a host response, which results in bone and soft tissue destruction. In response to endotoxin derived from periodontal pathogens, several osteoclast-related mediators target the destruction of alveolar bone and supporting connective tissue such as the periodontal ligament.
The bone destruction patterns that occur as a result of periodontal disease generally take on characteristic forms. This X-ray film displays a horizontal defect . This X-ray film displays two lone-standing mandibular teeth, #21 and #22: the lower left first premolar and canine, exhibiting severe bone loss of 30-50%.
Although utilized for more than 50 years, the term has since been dropped in favor of a more contemporary disease classification for periodontal disease. Described by Gottlieb as a "diffuse atrophy of the alveolar bone," the term periodontosis was later applied and it gained acceptance as a disease entity, [1] being defined as:
The tooth may be mobile, and the lesion may contribute to destruction of the periodontal ligament and alveolar bone. [4] The pain is deep and throbbing. The oral mucosa covering an early periodontal abscess appears erythematous (red), swollen and painful to touch. [3] The surface may be shiny due to stretching of the mucosa over the abscess.
Classification of Periodontal Diseases 2018. In 2018, a new classification system for Periodontal diseases was released. It has 3 main parts: Periodontal health, gingival diseases and conditions; Periodontitis; Other conditions affecting the periodontium. In periodontal health, gingival diseases and conditions, there are 3 sub-types: [5]
Tooth loss implies in loss of several orofacial structures, such as bone tissues, nerves, receptors and muscles and consequently, most orofacial functions are diminished. [2] Destruction of the supporting tissues of the teeth may progress to necrosis (tissue death) of the alveolar bone , which may result in a decrease in the number of teeth.
Bone loss from aggressive periodontitis that led to an exposed furcation on an upper molar. In health, the bone exists about a millimeter and a half away from the cementoenamel junction, which is the line that separates the crown from the root trunk (the line can be seen clearly in the photo).