Carranza book of periodontology

2. Javaria Baig
3rd year BDS
Batch 18
Periodontal
Pathogenesis

3. Outlines
 What is Pathogenesis?
 What is periodontal disease?
 Healthy gums
 Gum diseases
 Inflammatory response in periodontium
 Inflammatory mediators
 Clinical signs
 Model of periodontitis

4. Whatis
pathogenesis?
Pathos ( suffering), Genesis
( generation)
Pathogenesis is origination
and development of disease.

5. Whatis
periodontal
disease?
Periodontal diseases are
infections of the structures
around the teeth, which
include the gums, periodontal
ligament and alveolar bone.

6. Periodontitis

7. HealthyGums
Pink in appearance
Not swollen
Not inflamed
Firmly attached to bone
Minimal bleeding on
probing

9. GUMdiseases
Gingivitis is an inflammation
of the gums caused by a
bacterial infection.
Periodontitis is inflammation
of the gums and supporting
structures of the teeth.

10. 

11. Inflammatory
responsein
periodontium
They are divided into two:
Microbial virulence factors
Host derived inflammatory
mediatiors

13. Microbial
virulence
factors
 Lipopolysaccharide ( endotoxins)
 Bacterial enzyme ( directly damage tissue)
 Noxious products ( ammonia and H2S)
 Microbial invasion ( P.gingivalis,
Aggregatibacter actinomycetemcomitans,
fusobacterium nucleatum)
 Fimbriae ( stimulate immune response)
 Bacterial deoxyribonucleic acid
 Extracellar deoxyribonucleic acid

15. Hostderived
inflammatory
mediators
Cytokines ( inflammatory
mediators)
Prostaglandins ( vasodilation)
Matrix metalloproteinases (
degrade extra cellular matrix
molecules)

16. Inflammatory
mediators

17. Inflammatory
mediators
Interleukin 1
Tumor necrosis factor
Interleukin 6
Prostaglandin E2
Matrix metalloproteinase
Anti inflammatory cytokines
Chemokines

19. Clinicalsignsof
periodontal
disease
Gingivitis
Swollen gums
Red gums at margins
Bleeding on probing
Bad breath
Tooth sensitivity
Pressure change
Pocket formation
Bone loss around tooth
Abscesses formation

20. Biological
systemsmodel
ofperiodontitis

21. Reference