periodontitis
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Etiology
- accumulation of bacterial plaque*
- pathogens
- adult periodontitis
- Porphyromonas gingivalis
- Prevotella intermedia
- other gram-negative organisms
- juvenile periodontitis
- adult periodontitis
- necrotizing ulcerative periodontitis is associated with HIV
- host factors
* mineralization of plaque is called calculus
Pathology
- starts as gingivitis
- spreads to involve the periodontal ligament & alveolar bone
- resorption of alveolar bone & loss of periodontal ligament attachment of tooth to bone
- soft tissue separates from tooth surface
- acute inflammation may be superimposed on chronic process
- abscess formation may occur
- loosening & loss of tooth
- association with cardiovascular disease, not causal[3]
Clinical manifestations
- necrosis or ulcer of the interdental papilla
- gingival bleeding
- pain
- rapid bone loss
- may be noted in the area of a prior extraction[4]
Management
- prevention:
- oral hygiene (brushing, flossing, mouthwash)
- professional cleaning, plaque removal
- root canal
- tooth extraction may become necessary
- antibiotic prophylaxis indicated for patients with valvular heart disease
- systemic antibiotics may be indicated
More general terms
More specific terms
References
- ↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 185-86
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 16 American College of Physicians, Philadelphia 2012
Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022 - ↑ 3.0 3.1 Friedewald VE, Kornman KS, Beck JD, The American Journal of Cardiology and Journal of Periodontology Editors' Consensus: periodontitis and atherosclerotic cardiovascular disease. Am J Cardiol. 2009 Jul 1;104(1):59-68. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19576322
Lockhart PB et al AHA Scientific Statement Periodontal Disease and Atherosclerotic Vascular Disease: Does the Evidence Support an Independent Association? A Scientific Statement From the American Heart Association Circulation April 18, 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22514251 <Internet> http://circ.ahajournals.org/content/early/2012/04/18/CIR.0b013e31825719f3 - ↑ 4.0 4.1 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022 - ↑ Darveau RP. Periodontitis: a polymicrobial disruption of host homeostasis. Nat Rev Microbiol. 2010 Jul;8(7):481-90. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20514045
- ↑ Papapanou PN, Sanz M, Buduneli N et al. Periodontitis: consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018;89(Suppl 1):S173-S182 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29926951 https://aap.onlinelibrary.wiley.com/doi/10.1002/JPER.17-0721