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Systemic Disease in PDD PDF
Systemic Disease in PDD PDF
systemic factors that can alter the response of the tissue to plaque.
certain systemic disorders can have a direct effect on the periodontal tissues
and these represent the periodontal manifestations of systemic diseases.
Dr Jaffar Raza
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Dr Jaffar Raza
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Dr Jaffar Raza
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Clinical Manifestations
Dr Jaffar Raza
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Dr Jaffar Raza
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Vitamin D Deficiency
Vitamin D is essential for the absorption of calcium from the gastrointestinal
tract and the maintenance of calciumphosphorus balance.
Radiographically, there is a generalized partial to complete disappearance of
the lamina dura
Reduced density of supporting bone.
Dr Jaffar Raza
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Vitamin E
vitamin E acts as a antioxidant
plays an important role in maintaining the stability of cell membranes
protecting blood cells against hemolysis.
interfere with the production of prostaglandins.
Dr Jaffar Raza
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Vitamin A
It is essential for growth, differentiation and maintenance of epithelial tissues
For bone growth and embryonic development.
Vitamin B-Complex
Oral changes common toVitamin B-complex deficiencies are
gingivitis,
glossitis,
glossodynia,
angular cheilitis
inflammation of the entire oral mucosa
Dr Jaffar Raza
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Dr Jaffar Raza
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Dr Jaffar Raza
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Dr Jaffar Raza
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Treatment:
Plaque control,
supportive measures like antiseptic mouth wash,
antimicrobial therapy
Dr Jaffar Raza
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Leukemia
malignant disease caused by proliferation of WBC forming tissue,
tissue especially
those in bone marrow.
Acute leukemia is more frequent in people under 20 years of age.
Chronic leukemias occur in people over 40 years of age.
Periodontal Manifestations
1..gingival enlargement,
2..gingival bleeding
3..periodontal infections.
Dr Jaffar Raza
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Dr Jaffar Raza
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Dr Jaffar Raza
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Thrombocytopenic Purpura
characterized by a low platelet count
Prolonged bleeding time
Prolonged clotting time
Clinical manifestation
spontaneous bleeding into skin or mucous membranes.
Petechiae and hemorrhagic vesicles occur in the oral cavity.
Gingiva is swollen, soft and friable.
Bleeding occurs spontaneously
Dr Jaffar Raza
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Treatment
1. Physician referral for a definitive diagnosis.
2. Oral hygiene instructions.
3. Prophylactic treatment of potential abscesses.
4. No surgical procedures are indicated unless platelet count is at least 80,000
cells/mm3.
5. Scaling and root planning.
Disorders of WBC Function
Chdiak-Higashi Syndrome
Lazy Leukocyte Syndrome
Chronic Granulomatous Disease
Dr Jaffar Raza
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Dr Jaffar Raza
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Pathogenesis
1. Vascular changes:
thickening and hyalinization of vascular walls.
swelling and occasional proliferation of the endothelial cells
changes in the capillary basement membrane may have an inhibitory effect on
the transport of oxygen, white blood cells, immune factors and waste products
Dr Jaffar Raza
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2. PMNLs function
Reduced Phagocytosis
Reduced intracellular killing
Reduced adherence
Impaired chemotaxis
3. crevicular fluid:
Alterations in the constituents and flow rate of crevicular fluid is noted
Dr Jaffar Raza
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Treatment
a. Periodontal treatment in patient with uncontrolled diabetes is
contraindicated.
b. If suspected to be a diabetic, following procedures should be performed:
1. Consult the patients physician.
2. Analyze laboratory tests, FBS, RBS and GTT
3. prophylactic antibiotics should be given.
4. Glucose levels should be continuously monitored and periodontal treatment
should be performed when the disease is in a wellcontrolled state.
5.Prophylactic antibiotics should be started 2 days preoperatively
Dr Jaffar Raza
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Thyroid Gland
Hypothyroidism leads to cretinism in children and myxedema in adults.
There are no notable periodontalchanges.
Treatment
1. Patients with thyrotoxicosis should not receive periodontal therapy until the
condition is stabilized.
2. Medications such as epinephrine, atropine should be given with caution.
3. caution with administration of sedatives and narcotics because of their
diminished ability to tolerate drugs.
Dr Jaffar Raza
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Pituitary Gland
Hyperpituitarism causes enlarged lips
localized areas of hyperpigmentation.
It is also associated with food impaction
hypercementosis is seen.
Hypopituitarism leads to crowding and malposition of teeth.
Dr Jaffar Raza
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Parathyroid Glands
Parathyroid hypersecretion produces generalized demineralization of the
skeleton.
Oral changes include malocclusion and tooth mobility,
radiographically alveolar osteoporosis, widening of the periodontal space
and absence of lamina dura.
Treatment:
Routine periodontal therapy must be instituted but the dental practitioner
must be attuned to the oral and dental changes.
Dr Jaffar Raza
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Sex Harmones
There are several types of gingival diseases in which modification of the sex
hormones is considered to be either an initiating or complicating factor.
factor
Gingivitis in Puberty
Pronounced inflammation,
bluish-red discoloration,
edema
enlarged gingiva may be seen
Dr Jaffar Raza
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Dr Jaffar Raza
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Menopausal Gingivostomatitis
Clinical manifestations include
dry, shiny oral mucosa,
dry burning sensation of oral mucosa,
abnormal taste sensation
Dr Jaffar Raza
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Dr Jaffar Raza
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Treatment:
Elimination
mination of all local irritants by scaling and root planing.
Treatment of tumor-like gingival enlargements consists of surgical excision,
scaling and planing of tooth surfaces.
In pregnancy emphasis should be on:
Preventing gingival disease bef
before it occurs.
Treating existing gingival disease before it becomes worse.
Dr Jaffar Raza
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CARDIOVASCULAR DISEASES
Arteriosclerosis
In aged individuals, arteriosclerotic changes in the blood vessels are
characterized by,
initial thickening,
narrowing of lumen,
thickening & hyalinization of media and adventitia
Dr Jaffar Raza
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Dr Jaffar Raza
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HIV gingivitis:
In HIV gingivitis persistent, linear, easily bleeding, erythematous gingivitis.
lesions may be localized or generalized in nature.
HIV periodontitis: NUP (Necrotizing ulcerative periodontitis)
characterized by soft tissue necrosis
rapid periodontal destruction, marked interproximal bone loss.
severely painful at onset.
Dr Jaffar Raza
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Treatment:
Dr Jaffar Raza
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Metal Toxications
Ingestion of metals such as mercury, lead, bismuth may result in oral
manifestations
Bismuth Intoxication
gastrointestinal disturbances,
nausea, vomiting and jaundice
ulcerative gingivostomatitis
metallic taste and a burning sensation of the oral mucosa.
The tongue may be sore and inflamed.
Urticaria, and different types, bullous and purpuric lesions
bluish-black discoloration of the gingival margin
Dr Jaffar Raza
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Lead Intoxication
increased salivation,
coated-tongue,
peculiar sweetish taste,
gingival pigmentation and ulceration.
steel gray dicoloration, associated with local irritation.
Dr Jaffar Raza
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Mercury Intoxication
ulceration of the gingiva
destruction of underlying bone
Other Chemicals may cause necrosis of the alveolar bone with loosening and
exfoliation of teeth
Phosphorus
arsenic
chromium
Dr Jaffar Raza
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