Periodontal Disease

Excerpt

Periodontal disease refers to a group of conditions that affect the periodontium, the supporting structures of the teeth, including the gingiva, alveolar bone, cementum, and periodontal ligament. Early detection and timely management are essential to prevent long-term complications.

Gingivitis is the mildest form of periodontal disease, affecting up to 90% of the population. Gingivitis is characterized by inflammation of the gingiva caused by the accumulation of bacteria and debris along the gum line, leading to the formation of dental plaque. This condition is reversible with improved oral hygiene. However, if left untreated, gingivitis can progress to periodontitis.

Periodontitis is a chronic inflammatory disease that progressively damages the periodontal tissues. The hallmark feature of the condition is the apical migration of the junctional epithelium, which leads to loss of attachment and the formation of periodontal pockets. As bacteria penetrate deeper into the tissues, the body activates an immune response to fight the infection. However, this defense mechanism unintentionally contributes to the destruction of the periodontium. As periodontitis progresses, it causes continued attachment loss, alveolar bone resorption, and, in severe cases, tooth loss.

In 2017, the American Academy of Periodontology introduced an updated classification system for periodontal and peri-implant diseases in collaboration with the European Federation of Periodontology. This system categorizes periodontitis into 3 main forms:

1. Periodontitis

2. Periodontitis as a manifestation of systemic diseases

3. Necrotizing periodontal disease

Necrotizing periodontal disease is a severe and rapidly progressing form of periodontitis that primarily affects immunocompromised individuals, such as those with HIV. This condition is characterized by severe gingival necrosis, interproximal tissue destruction, spontaneous bleeding, and intense pain. This form of periodontal disease requires urgent intervention due to its rapid progression and significant tissue damage.