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Periodontitis

Inflammation of the
supporting tissues of the teeth.
A destructive change leading
to loss of bone and
periodontal attachment.
Clinical Features of Periodontitis
• Fetid odor
• Itching gums
• Usually painless
• Loose teeth
• Migration of teeth
• Gingival bleeding
• Bluish or red gingiva
• Pocket
• Bone loss
• Attachment loss
Periodontitis
Dr. Larry Wolff
Periodontology I
Summer Semester, 2009
School of Dentistry
University of Minnesota
1 of 7
Periodontitis Periodontitis
Modes of Progression of
Periodontitis
• Progressive loss (long period)
• Random burst (long period)
• Multiple burst (short period)
Progressive Loss of Clinical Attachment
Random Burst Loss of Clinical Attachment Multiple Burst Loss of Clinical Attachment
Dr. Larry Wolff
Periodontology I
Summer Semester, 2009
School of Dentistry
University of Minnesota
2 of 7
Classification of Pockets
1. Gingival Pocket
2. Periodontal Pocket
Classification of Pockets
• Gingival Pocket
(Pseudo pocket)
(Relative Pocket)
Gingival Pocket
Periodontal Pocket
(True or Absolute Pocket)
A. Suprabony (supracrestal)
B. Infrabony (subcrestal)
Suprabony Pocket Infrabony Pocket
Dr. Larry Wolff
Periodontology I
Summer Semester, 2009
School of Dentistry
University of Minnesota
3 of 7
Types of Infrabony Pockets
Three
osseous
walls
Two
osseous
walls
One
osseous
wall
Four
osseous
walls
One Osseous Wall
Two Osseous Walls
Three Osseous Walls
Suprabony Pocket
1. Base of pocket coronal to
crestal bone
Infrabony Pocket
1. Base of pocket apical
to crestal bone
Dr. Larry Wolff
Periodontology I
Summer Semester, 2009
School of Dentistry
University of Minnesota
4 of 7
Suprabony Pocket
2. Pattern of destruction
horizontal
Infrabony Pocket
2. Pattern of destruction
vertical or angular
Suprabony: Horizontal Bone Loss
Infrabony: Vertical Bone Loss
Suprabony Pocket
3. Transeptal fibers are
horizontal
Infrabony Pocket
3. Transeptal fibers are
oblique
Suprabony Pocket
Infrabony
Pocket
Dr. Larry Wolff
Periodontology I
Summer Semester, 2009
School of Dentistry
University of Minnesota
5 of 7
Suprabony Pocket
4. Supracrestal fibers follow
normal bone contour
Infrabony Pocket
4. Supracrestal fibers follow
angular pattern of osseous
defect
Infrabony
Pocket
Periodontal Pocket
1. Simple
2. Compound
3. Complex
Simple
Pocket
Compound
Pocket
Complex
Pocket
Dr. Larry Wolff
Periodontology I
Summer Semester, 2009
School of Dentistry
University of Minnesota
6 of 7
Simple Compound Complex
Furcation
Involvement
Furcation Involvement
with Periodontitis
Mandibular first molar
furcation area
Maxilliary first molar
furcation area
Curet often does not fit into
furcation
Dr. Larry Wolff
Periodontology I
Summer Semester, 2009
School of Dentistry
University of Minnesota
7 of 7