🌹‏إِنَّ رَبِّي لَسَمِيعُ الدُّعَاءِ🌹

#periodontic 🔴Definitions Gingivitis:  inflammation of the gingival tissues. Periodontitis:  inflammation of the periodontium including periodontal ligament and alveolar bone.

#periodontic #Plaque_and_Calulus 🔴 Periodontal disease and risk for systemic disease: 🐤 There is a growing body of evidence suggesting an association between periodontal disease and atherosclerotic cardiovascular disease, pregnancy complications, diabetes, respiratory disease, kidney disease, and certain cancers. 🐤 No conclusions can yet be drawn as to whether these are causal associations; however, it highlights the importance of oral health as part of a generally healthy lifestyle.  🔴 Clinical features of gingivitis and periodontitis: 🐋 Gingivitis The classic triad of redness, swelling, and bleeding on gentle probing are diagnostic and are usually associated with a complaint by the patient that their ‘gums bleed on brushing’. 🐋 The ‘knife-edge’ margins and stippled appearance associated with health disappear and are replaced by a more rounded, shiny appearance. 🐋 Pain is not usually a feature. 🐋 halitosis may be present. 🐋Afects gingiva only. It is not associated with alveolar bone resorption or apical migration of the junctional epithelium. 🐋 Probing depths >3mm can occur in chronic gin- givitis due to an increase in gingival size because of oedema or hyperplasia (false pockets).

#periodontic #Plaque_and_Calulus 🔴 Pathological efect Calculus : (particularly, subgingival calculus), is associated with periodontal disease. This may be because it is invariably covered by a layer of plaque. Its principal detrimental efect is probably that it acts as a retention site for plaque and bacterial toxins. The presence of calculus makes it difcult to implement adequate oral hygiene. Anticalculus dentifrices Contain crystal growth inhibitors, e.g.👉👉( tri- closan, zinc citrate, ) to prevent formation of supragingival calculus. They have not been shown to be efective against subgingival deposits. 🔴 Risk factors: 🍒 Local factors Those which predispose to plaque accumulation, e.g. tooth position and morphology, calculus ,overhangs and appliances, occlusal trauma, and mucogingival state. 🍒 Systemic factors Those which modify the host response, e.g. smoking, dibbetes, obesity, genetic factors, immune status, stress, age, and nutrition. 🍒 Modifable risk factors such as smoking are important in managing periodontal disease.

#periodontic #Plaque_and_Calulus 🔴It can be subdevided in to : 🌊 Supragingival calculus: 💎 most often found opposite the openings of the salivary ducts, i.e. (76|67 ) opposite the parotid (Stensen’s) duct and on the lingual surface of the lower anterior teeth opposite the submandibular/ sublingual (Wharton’s) duct. 💎 It is usually creamy-coloured, but can become stained a variety of colours. 🌊 Subgingival calculus : 💎 is found, not surprisingly, underneath the gingival margin and is frmly attached to tooth roots. 💎 It tends to be brown or black, is extremely tenacious, and is most often found on interproximal and lingual surfaces. 💎 It may be identifed visually, by touch using a WhO 62 probe, or on radiographs. 💎 It is associated with subsequent periodontitis. With gingival recession it can become supragingival.

Calculus grading scale

#periodontic #Plaque_and_Calulus ❄️ Dental plaque, which is👉 a bioflm, is 👉an adherent mass of diverse micro-organisms in a muco-polysaccharide matrix. It cannot be rinsed of but can be removed by brushing. 🌑 Plaque and caries: 🍃 As several oral strepto- cocci, most notably mutans streptococci, secrete acids and the matrix component of plaque, there is a clear relationship between the two. however, various other factors complicate the picture, including: 👉 saliva 👉other micro-organisms 👉and the structure of the tooth surface. 🔴 Plaque and periodontal disease : 🌟 There is a direct correlation between the amount of plaque at the cervical margin of teeth & the severity of gingivitis, and experimental gingivitis can be produced and abolished by suspending and reintroducing oral hygiene. 🌟 It is commonly accepted that plaque accumulation causes gingivitis, the major variable being 👉host susceptibility. 🌟 While there are numerous interacting components which determine the progression of chronic gingivitis to periodontitis, particularly host susceptibility, the presence of plaque, particularly ‘old’ plaque with its high anaerobe content, is widely held to be crucial, and most rx is based on the meticulous, regular removal of plaque. 🌺 Calculus 🌸Calulus (tartar) is : a calcifed deposit found on teeth (and other solid oral structures) and is formed by mineralization of plaque deposits. ☀️ The mineral content of supragingival calculus derives from (saliva), that for subgingival is from gingival crevicular fuid.

What is plaque ؟؟؟؟؟

#periodontic #Aetiology 👻Oral microbiology👻 👈The mouth is colonized by microorganisms 👅 🕕👶a few hours after birth, mainly by aerobic and facultative anaerobic organisms. 🔼The eruption of teeth allows the development of a complex ecosystem of microorganisms. 🚫More than 700 diferent species can colonize the mouth and over 🚫400 species may be found in periodontal pockets. 👽resident oral microflora form multispecies bioflms on oral surfaces. 😈Microbial composition alters with health and disease 😎Primary aetiology is ⚡️plaque.⚡️ 🌀 It exists in a bioflm at the ⬆️ supragingival margin and can progress⤵️subgingivally. 👹Microbiology👹 👻Streptococcus mutans group Able to produce acid from most sugars. Most important organisms in the aetiology of caries. 👻 Streptococcus oralis group heavily implicated in 50% of cases of infective endocarditis. 👻 Streptococcus salivarius group Inconsistent producer of dextran. 👻 S. intermedius, S. anginosus, S. constellatus Believed to contribute to periodontal disease progression. 👻 Porphyromonas gingivalis Obligate anaerobe associated with chronic periodontitis and aggressive periodontitis. 👻 Aggregatibacter actinomycetemcomitans(A.a) Particular pathogen in aggressive periodontitis 👻 Tannerella forsythia Anaerobic, Implicated in periodontal diseases. 👻 Prevotella intermedia Found in chronic periodontitis, localized aggressive periodontitis, necrotizing periodontal disease, and areas of severe gingival infammation without attachment loss. 👻 Fusobacterium Obligate anaerobes. Originally thought to be principal pathogens in necrotizing periodontal disease. 🕸Virulence factors🌎 Pathogens use a number of mechanisms to exert damage on host tissue:  🕸adherence, 🎃proteases, 🌪bone resorption factors, 🎭cytotoxic metabolites, 🎟leucotoxins, 🔥 induction of the infammatory response via cytokines and chemotaxins ⚔ Host defences🛡 The host response to the bioflm is meant to be protective but can also cause ☠local tissue damage (‘bystander damage’). ✌️Both infammatory and immunologically mediated pathways can contribute to periodontal damage. The 1996 World Workshop in Periodontics identifed three species as 🔴causative factors for periodontitis. These are : 💥Aggregatibacter actinomycet- emcomitans Aa (previously calledActinobacillus actinomycetemcomitans) , 💥Porphyromonas gingivalis , 💥 Tannerella forsythia.

#periodontic #Aetiology

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#periodontic #manual_ultrasonic ☘First of all, there are two main techniques for removing plaque and tartar from your teeth – manual and ultrasonic. ✅A manual cleaning is done using hand instruments . ✅An ultrasonic cleaning means that the dentist is using a special instrument that vibrates at a very high frequency to remove the plaque and tartar. The ultrasonic instrument also sprays a stream of water toward your teeth. #manual_ultrasonic 📀Aside from the same effectiveness of calculus removal with manual scaling and power scaling; there is no significant difference in root defects and surface roughness after hand scaling, and use of a power scaler. 💿Although ultrasonic scaling does not allow for the same tactile sense as does manual scaling, it is still efficient at removing calculus in a timely manor. 💿Their is no significant difference in the use of Manual scaling and root planing versus power scaling, especially in efficacy of calculus removal and healing time but, there is a difference in the hand scaling removing more healthy cementum than power scaling 💿Although there may be no significant difference or evidence when ultrasonic and manual scaling, the use of the ultrasonic may help expedite treatment time, comfort, and less operator fatique 📀Power scaling has more advantages than hand instrumatation alone with better access to root variations,pocket depth, irrigating abilities, and the reduction of over scaling root surface and cementum. #periodontic #manual_ultrasonic ☑️Manual root planing does attain a smoother root surface at the microscopic level than does ultrasonic debridement, but the difference does not appear to have any clinical significance. ☑️The combination of using both the ultrasonic machine and manual scaling can greatly benefit the patient, but not all the patient's are candidate for both. ☑️Mechanical scaling is more effective and less damaging and abrasive to the root surface than hand scaling. These findings are managed by opporator skill as well as tip and selection of ultrasonic scaler chosen for patients. If appropriate instrument tip is chosen and clinician is competent the ultrasonic scaler should produce effective and less abrasive results than a hand scaler. 🍁Ultrasonic scaling is as effective as manual instruments for calculus removal in shallow gum pockets and significantly more effective in pockets greater than 4mm. 🍁They are very effective in disrupting biofilm from root surfaces and from within periodontal pockets making them especially helpful when patients require frequent maintenance (cleanings). 🍁Specially designed tips can penetrate deeper into periodontal pockets than manual instruments and are more effective at cleaning difficult nooks and crannies like furcations, (areas where roots join each other in multi-rooted teeth). 🍁When used correctly they are kinder to tooth structure, which is especially important with repeated cleanings (when used correctly). 🍁Coolant sprays provide irrigation (flushing of the area), which improves healing by removing bacteria and their bi-products as well as the hygienist's ability to see when scaling. 🍁They require less time than manual instruments for the same job. 🍁Their smaller tips cause less tissue distention and require very little pressure — thus making it more comfortable for the patient.

#Periodontic #Manual_scalling

#Periodontic #Ultrasonic_scalling

#periodontic #terminology 💟Peri-implant diseases are classified into two categories: 💠In peri-implant mucositis, gum inflammation is found only around the soft tissues of the dental implant, with no signs of bone loss. ♻Generally peri-implant mucositis is a precursor to peri-implantitis. Evidence suggests that peri-implant mucositis may be (successfully treated )and is (reversible )if caught early Per-implant mucositis 💠In peri-implantitis, gum inflammation is found around the soft tissue and there is deterioration in the bone supporting the dental implant. Peri-implantitis usually requires (surgical treatment) 💟Peri-implant diseases are classified into two categories: 💠In peri-implant mucositis, gum inflammation is found only around the soft tissues of the dental implant, with no signs of bone loss. ♻Generally peri-implant mucositis is a precursor to peri-implantitis. Evidence suggests that peri-implant mucositis may be (successfully treated )and is (reversible )if caught early Per-implant mucositis 💠In peri-implantitis, gum inflammation is found around the soft tissue and there is deterioration in the bone supporting the dental implant. Peri-implantitis usually requires (surgical treatment).

#periodontic #Terminology ✳attached gingiva. ✳free gingiva. ✴attached gingiva :that portion of the gingiva which is firm and resilient and is bound to the underlying cementum and the alveolar bone, thus being immovable. ✴free gingiva :the portion that surrounds the tooth and is not directly attached to the tooth surface. 😷 classification of periodontal diseases and condition: ♣️ Gingival diseases ♣️chronic periodontitis ♣️Agressive periodontitis ♣️periodontitis as manifestation of systemic diseases ♣️Necrotizing periodontal diseases. ♣️ Absesses of the periodontium ♣️ periodontitis associated with endodontic lesion. ♣️ developmental or acquired deformation &conditions. ⚫️🔴defination (AgP)= comprises a group of rare, 😮 sever, 😮 rapidly progressive form of periodontitis Characterized by: 😯 an early age of clinical manifestation & 😯 destinctive tendency for cases to agregate in families. ⚫️🔴classification ☑️ localized ✅Circumpubertal onset ✅Localized to permanent first molar and incisors Serum antibiotic can be detect ✅pathogen 🔻Actinobacillus 🔻actinomycetemcomitans ⚫️🔴classification ☑️ generalized ✅affect peoplr under 30 year. ✅affec at least 3 permenant teeth other than first molar&incisors ✅pathogen 🔻Actinobacillus 🔻actinomycetemcomitans 🔻porphyromonas gingivalis 🔴⚫️Successful treatment dep on: -Early diagnosis -Elimination of bacteria mechanically and chemically https://t.me/densitysecond99

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