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The most common causes for odontogenic infection to be established are dental caries, deep fillings, failed root canal treatments, periodontal disease, and pericoronitis. [2] Odontogenic infection starts as localised infection and may remain localised to the region where it started, or spread into adjacent or distant areas.
Treponema denticola is a Gram-negative, obligate anaerobic, motile and highly proteolytic spirochete bacterium. It is one of four species of oral spirochetes to be reliably cultured, the others being Treponema pectinovorum, Treponema socranskii and Treponema vincentii [2].
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.
Dental plaque, the precursor of periodontal disease, is a complex biofilm consisting mainly of bacteria, but also archaea, protozoa, fungi and viruses. Viruses that specifically infect bacteria—bacteriophages—are most common in the oral cavity. Viral roles in the progression of periodontal disease as of 2017 remains poorly explored. [1]
Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. [5] In its early stage, called gingivitis, the gums become swollen and red and may bleed. [5] It is considered the main cause of tooth loss for adults worldwide.
Wisdom teeth are not included because pericoronitis and tooth impaction may cause isolated periodontal defects which do not represent the general periodontal condition of the rest of the mouth. At least 2 teeth must be present in a sextant for it to be scored. If only 1 tooth is present in a sextant, the tooth is included in the adjoining sextant.
Necrotizing gingivitis is part of a spectrum of disease termed necrotizing periodontal diseases. It is the most minor form of this spectrum, with more advanced stages being termed necrotizing periodontitis, necrotizing stomatitis, and the most extreme, cancrum oris.
To complete the diagnosis, the extent of the disease must be assessed. This is defined as: mild (1-2mm), moderate (3-4mm) or severe (≥ 5mm) depending on the amount of attachment loss present. Radiographs such as bitewings, intra-oral periapicals or a panoramic radiograph can be taken to help assess the bone loss and aid in diagnosis.