Periodontal Diagnosis And Classification
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Periodontal Diagnosis And Classification
In dentistry, numerous types of classification schemes have been developed to describe the teeth and gum tissue in a way that categorizes various defects. All of these classification schemes combine to provide the periodontal diagnosis of the aforementioned tissues in their various states of health and disease. Alveolar ridge deficiency In 1983, Seibert classified alveolar crestal defects: Class I: buccolingual loss of tissue with normal apicocoronal ridge height Class II: apicocoronal loss of tissue with normal buccolingual ridge width Class III: combination-type defects (loss of both height and width) Furcation defect Gingival recession The magnitude of a receding gumline, commonly referred to as the measurement of ''gingival recession'', is most often described using Miller's classification: :Class I: Recession that does not extend to the mucogingival junction A mucogingival junction is an anatomical feature found on the intraoral mucosa. The mucosa of the cheeks ...
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Dentistry
Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions of the mouth, most commonly focused on dentition (the development and arrangement of teeth) as well as the oral mucosa. Dentistry may also encompass other aspects of the craniofacial complex including the temporomandibular joint. The practitioner is called a dentist. The history of dentistry is almost as ancient as the history of humanity and civilization with the earliest evidence dating from 7000 BC to 5500 BC. Dentistry is thought to have been the first specialization in medicine which have gone on to develop its own accredited degree with its own specializations. Dentistry is often also understood to subsume the now largely defunct medical specialty of stomatology (the study of the mouth and its disorders and diseases) for which reas ...
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Teeth
A tooth ( : teeth) is a hard, calcified structure found in the jaws (or mouths) of many vertebrates and used to break down food. Some animals, particularly carnivores and omnivores, also use teeth to help with capturing or wounding prey, tearing food, for defensive purposes, to intimidate other animals often including their own, or to carry prey or their young. The roots of teeth are covered by gums. Teeth are not made of bone, but rather of multiple tissues of varying density and hardness that originate from the embryonic germ layer, the ectoderm. The general structure of teeth is similar across the vertebrates, although there is considerable variation in their form and position. The teeth of mammals have deep roots, and this pattern is also found in some fish, and in crocodilians. In most teleost fish, however, the teeth are attached to the outer surface of the bone, while in lizards they are attached to the inner surface of the jaw by one side. In cartilaginous fish, s ...
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Gingiva
The gums or gingiva (plural: ''gingivae'') consist of the mucosal tissue that lies over the mandible and maxilla inside the mouth. Gum health and disease can have an effect on general health. Structure The gums are part of the soft tissue lining of the mouth. They surround the teeth and provide a seal around them. Unlike the soft tissue linings of the lips and cheeks, most of the gums are tightly bound to the underlying bone which helps resist the friction of food passing over them. Thus when healthy, it presents an effective barrier to the barrage of periodontal insults to deeper tissue. Healthy gums are usually coral pink in light skinned people, and may be naturally darker with melanin pigmentation. Changes in color, particularly increased redness, together with swelling and an increased tendency to bleed, suggest an inflammation that is possibly due to the accumulation of bacterial plaque. Overall, the clinical appearance of the tissue reflects the underlying histology, b ...
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Alveolar Bone
The alveolar process () or alveolar bone is the thickened ridge of bone that contains the tooth sockets on the jaw bones (in humans, the maxilla and the mandible). The structures are covered by gums as part of the oral cavity. The synonymous terms ''alveolar ridge'' and ''alveolar margin'' are also sometimes used more specifically to refer to the ridges on the inside of the mouth which can be felt with the tongue, either on roof of the mouth between the upper teeth and the hard palate or on the bottom of the mouth behind the lower teeth. Terminology The term ''alveolar'' () ('hollow') refers to the cavities of the tooth sockets, known as dental alveoli. The alveolar process is also called the ''alveolar bone'' or ''alveolar ridge''. The curved portion is referred to as the alveolar arch. The alveolar bone proper, also called bundle bone, directly surrounds the teeth. The term alveolar crest describes the extreme rim of the bone nearest to the crowns of the teeth. The portion of ...
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Mucogingival Junction
A mucogingival junction is an anatomical feature found on the intraoral mucosa. The mucosa of the cheeks and floor of the mouth are freely moveable and fragile, whereas the mucosa around the teeth and on the palate are firm and keratinized. Where the two tissue types meet is known as a mucogingival junction. There are three mucogingival junctions: on the facial of the maxilla and on both the facial and lingual of the mandible. The palatal gingiva of the maxilla is continuous with the tissue of the palate, which is bound down to the palatal bones. Because the palate is devoid of freely moveable alveolar mucosa, there is no mucogingival junction.Carranza's Clinical Periodontology, W.B. Saunders 2002, page 17. Clinical importance The clinical importance of the mucogingival junction is in measuring the width of attached gingiva. Attached gingiva is important because it is bound very tightly to the underlying alveolar bone and provides protection to the mucosa during functional u ...
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Gingivitis
Gingivitis is a non-destructive disease that causes inflammation of the gums. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms (also called plaque) that is attached to tooth surfaces, termed ''plaque-induced gingivitis''. Most forms of gingivitis are plaque-induced. While some cases of gingivitis never progress to periodontitis, periodontitis is always preceded by gingivitis. Gingivitis is reversible with good oral hygiene; however, without treatment, gingivitis can progress to periodontitis, in which the inflammation of the gums results in tissue destruction and bone resorption around the teeth. Periodontitis can ultimately lead to tooth loss. Signs and symptoms The symptoms of gingivitis are somewhat non-specific and manifest in the gum tissue as the classic signs of inflammation: *Swollen gums *Bright red gums *Gums that are tender or painful to the touch *Bleeding gums or bleeding after bru ...
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