* initial lesion
* early lesion
* established lesion
* advanced lesion
Initial lesion
Healthy gingiva are characterized by small numbers of leukocytes migrating towards the gingival sulcus and residing in the junctional epithelium. Sparse lymphocytes, and plasma cells in particular, may exist just after exiting small blood vessels deep within the underlying connective tissue of the soft tissue between teeth. The initial lesion appears within two to four days of gingival tissue being subjected to plaque accumulation. Periodontal diseases are infections of the gums and bone that surround and support the teeth. Periodontal disease is mostly seen in adults. Periodontal disease and tooth decay are the two biggest threats to dental health. Early lesion Features of the Early Lesion: - Accentuation of features of the initial lesion, such as the considerably greater loss of collagen
- Accumulation of lymphocytes subjacent to junctional epithelium
- Preliminary proliferation of basal cells of junctional epithelium
Established lesion
The hallmark of the established lesion if the overwhelming presence of plasma cells in relation to the prior stages of inflammation. In health, the junctional epithelium creates the most coronal attachment of the gum tissue to the tooth at or near the cementoenamel junction. In the established lesion of periodontal disease, the connective tissue lying subjacent to the junctional epithelium is nearly destroyed, failing to properly support the epithelium and buttress it against the tooth surface. While many established lesions continue to the advanced lesion (below), most either remain as established lesions for decades or indefinitely; the mechanisms behind this phenomenon are not well understood.'' Features of the Established Lesion:
* Predominance of plasma cells without bone loss
* Presence of extravascular immunoglobulins in the connective tissue and junctional epithelium
* Continuing loss of collagen Bacteria in the mouth infect tissue surrounding the tooth, causing inflammation
Around the tooth leading to periodontal disease. When bacteria stay on the teeth long enough, they form a film called plaque, which eventually hardens to tartar, also called calculus. Then, only a dental health professional can remove the tartar and stop the periodontal disease process. The following are warning signs of periodontal disease:
*Red or swollen gums
*Tender or bleeding gums
*Loose teeth
*Sensitive teeth
*Gums that have pulled away from your teeth Certain factors increase the risk for periodontal disease: *Diabetes
*Poor oral hygiene
*Crooked teeth To help prevent or control periodontal diseases, it is important to: Brush and floss every day to remove the bacteria that cause gum disease. What is the CDC doing about periodontal disease? CDC collaborations related to periodontal disease and diabetes Advanced lesion - Periodontal pocket formation - Destruction of the alveolar bone and periodontal ligament - Tooth mobility, drifting and eventual loss The clusters of perivascular plasma cells still appears from the established lesion. Features of the Advanced Lesion:
* Extension of the lesion into alveolar bone, periodontal ligament with significant bone loss
* Continued loss of collagen
* Formation of periodontal pocketing
* Conversion of bone marrow into fibrous connective tissue
Treatment
The treatment of periodontal disease begins with the removal of sub-gingival calculus (tartar) and biofilm deposits. Dental calculus deposits harbor harmful bacteria. The bacteria responsible for most periodontal disease are anaerobic, and oxygenation reduces populations. Periostat has been clinically proven to decrease alveolar bone loss and improve the conditions of periodontal disease with minimal side-effects. Laser-assisted periodontal therapy has been shown to kill the bacteria that causes periodontal disease as well as grow bone in certain cases. Bacteria around teeth cause the destruction and foul odors in a person with gum disease, specifically sulfur-containing compounds. Once the calculus builds up around the teeth, in between them, and the gums, it causes the gums to pull away from the teeth.''
Periodontal Disease.?
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