RISK ASSESSMENT

Department of Periodontology
Faculty of Dental Medicine
Universitas Airlangga
 Risk assessment :

local and systemic factors

disease severity

poor prognosis
Risk assessment :

Risk factors
Risk determinants / background characteristics
Risk indicators
Risk markers / predictors
 Risk factors

 Smoking
 Diabetes mellitus
 Periodontal pathogen
(anatomic factors → potential bacterial accumulation)
 smoking
- nicotine
- tar

microbiology immunology physiology

 gingivitis
 periodontitis
microbiology

 Bacterial plaque → increase bacterial invasion

 Porphyromonas gingivalis & Tannerella forsythia:
 Periodontal response to mechanical therapeutic:
 Bacterial prevalence: maxilla > mandible
immunology

 Immune response:
(quantity & quality of neutrophil )
→ neutrophil function: chemotaxis, phagocytosis, bacterial killing
 Change in subgingival bacteria composition
 Increase inflammatory mediators in GCF
→ TNF-α, MMP-8, PGE2
phyisiology

➢ Microsirculation: oxygen disribution

➢ Gingival crevicular fluid flow:
➢ Bleeding on probing:
➢ Subgingival temperature:
 Diabetes Mellitus

Oral manifestation:
Cheilosis, burning syndrome, xerostomia, salivary flow ,
Candida albicans
Manifestation in periodontal tissue:
Periodontitis, periodontal abscess, tooth mobility
 periodontopathogen

 Aggregatibacter actinomycetemcomitans
 Porphyromonas gingivalis
 Prevotella intermedia
 Fusobacterium nucleatum
 Tannerella forsythia
Tooth anatomy

furcation
Tooth anatomy

root concavity
Tooth anatomy

Developmental groove
Tooth anatomy

Cervical enamel projection

Tooth anatomy

Enamel pearl
Risk determinants / background characteristics

periodontal
genetic stress
disease

age gender socio economic

 Risk indicators

➢ HIV/AIDS
➢ Osteoporosis
➢ Frequency of dental visits
 Risk markers / predictors

➢ Past phatologic experience

➢ Bleeding on probing