CHRONIC PERIODONTITIS

VS
AGGRESSIVE PERIODONTITIS

18 April 2011
drg. Michael A. Leman
CHRONIC
PERIODONTITIS
AGRESSIVE
PERIODONTITIS
CLASSIFICATION OF PERIODONTITIS

DISEASE DISTRIBUTION
 localized periodontitis (less 30% of desruction site), usually in incisior and
first molar
 generalized periodontitis (30%or more of desruction site)

DISEASE SEVERITY
 mild periodontitis
 moderate periodontitis
 severe periodontitis

DISEASE PROGRESSION
 Chronic periodontitis
 aggressive periodontitis
 CLASSIFICATION OF PERIODONTITIS

CHRONIC PERIODONTITIS AGGRESSIVE PERIODONTITIS

Localized chronic periodontitis Localized aggressive periodontitis=LAP

Localized juvenile periodontitis = LJP
Generalized chronic periodontitis
Generalized aggressive periodontitis= GAP
Rapidly progressive periodontitis = RPP
 How to distiguish chronic and aggressive
periodontitis
CHRONIC ? AGGRESSIVE
Clinical features • the amount of periodontal •Minimal plaque accumulation and
destruction is equivalent with oral rarely mineralizes to form calculus,
hygiene or plaque levels which inconsistent with the amount
•Supragingival and subgingival of periodontal destruction
calculus(associated with calculus • deep periodontal pocket
formation) Advanced bone loss (3-4 times faster
•Gingival inflamation than chronic periodontitis)
•Pocket formation •The presence of periodontal abscess
•Loss of periodontal attachment •Lymph node enlargement
•Vertical or horizontal bone loss
•Occasional supuration
•Bleeding of gingival in response
to periodontal probe
•Tooth movement/ become loose

Radiographic •Vertical or horizontal bone loss •Advanced bone loss (vertical bone
findings loss)
 How to distiguish chronic and aggressive
periodontitis ?
CHRONIC AGGRESSIVE
Disease Slow, but may be modified by Rapid
progression systemic (diabetes ) or
environmental and behavioral
factors(smoking and stress
emosional)

Bacteria Porphyromonas gingivalis Elevated

pathogenic Bacteriodes forsytus Porphyromonas gingivalis
Treponema denticola A. Actinomycetemcomitans

Prevalence No age-associated Systemically healthy individuals less

Length of time that periodontal than 30 years old
tissues are chalengged by chronic Familial aggregation of diseased
plaque accumulation individuals (neutrophile anomalies)

Treatment Conventional mechanical Conventional mechanical

therapy(scaling and root planing) therapy(scaling and root planing)
Practising adequate home care Microbiology testing
procedure Systemic antimicrobial therapy