牙周病的分类.ppt

1、四川大学华西口腔医学院 口腔内科学教研室 丁一,牙周病的分类,1.- why 世界临床牙周病学专题讨论会（1989年） 1999年AAP新分类,Why?, legal ramifications affects treatment plan and prognosis for communication with patients,History:, Last classification system was devised at the 1989 World Workshop in Clinical Periodontology Improved understanding of etio

2、logy of periodontal diseases Inclusion of gingival diseases,The Periodontium: supporting apparatus of the tooth and its associated components, alveolar bone, periodontal ligament, cementum, gingival attachment,Gingival Diseases:,Can occur on a periodontium with no attachment loss,or on a periodontiu

3、m with attachment loss that is not progressing Dental plaque induced Non-plaque induced,Gingivitis: general information,DEFN: inflammation of the givgiva ubiquitous occlusion analysis major cause: accumulation of plaque other causes tx: removal of the cause doesnt inevitably lead to periodontitis,Gi

4、ngivitis:pathology,4 stages: initial ,early, established, advanced lesion Summary: PMNs, exudate, collagen breakdown, plasma cells, proliferation of epithelium Major cause: accumulation of plaque,Dental plaque-induced gingival diseases,I.Gingivitis associated with dental plaque only a. without other

5、 local contributing factors b. with local contributing factors,Dental plaque-induced gingival diseases,II. Gingival diseases modified by systemic factors a. associated with the endocrine system 1.puberty-associated gingivtis 2.menstrual cycle-associated gingivitis 3.Pregnancy-associated 4.diabetes m

6、ellitus-associated gingivitis,Periodontitis,- 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 clinical attachment and radiographic evidence of bone loss.,Perio

7、dontitis,- 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 periodontitis aggressive periodontitis periodontitis as a manifest

8、ation of systemic diseasea necrotizing periodontal diseases abscesses of the periodontium periodontitis associated with endodontic lesions developmental or acquired deformaties and conditions,Chronic Periodontitis,formerly “adult” periodontitis can be: localized or generalized usually slowly progres

9、sive disease may have short periods of rapid progression,Aggressive Periodontitis,formerly “early onset” periodontitis can be: localized or generalized highly destructive forms of periodontitis not age dependment-diagnosis of “chronic” or “aggressive” depends on many criteria,Periodontitis as a Mani

10、festation of Systemic Diseases,Associated with haematological disorders Associated with genetic disorders Not otherwise specified,Necrotizing Periodontal Diseases,1.Necrotizing ulcerative gingivitis (NUG) 2.Necrotizing ulcerative periodontitis (NUP),Abscesses of the Periodontium,1.Gingival abscess 2

11、.Periodontal abscess 3.Pericoronal abscess,Periodontitis associated with Endodontic lesions,- combined periodontic-endodontic lesions,Developmental or Acquired Deformaties and Conditions,A.Localized tooth-related factors 1.Tooth anatomic factors 2.Dental restorations/appliances 3.Root fractures 4.Cervical root resorption and cemental tears,Developmental or Acquired Deformaties and Conditions,B. Mucogingival deformaties, conditions 1.Gingival/soft tissue recession 2.Lack of keratinized gingiva 3.Decreased vestibular depth 4.Frenum/mu