What are the various clinical symptoms and radiology findings in periodontitis

Clinical Symptoms

Characteristic clinical findings in patients with chronic periodontitis include supragingival and subgingival plaque accumulation that is frequently associated with calculus formation, gingival inflammation, pocket formation, loss of periodontal attachment and loss of alveolar bone.

The gingival ordinarily is slightly to moderately swollen and exhibits alterations in color ranging from pale red to magenta. Loss of gingival stippling and changes in the surface topography may include blunted or rolled gingival margins and flatted or cratered papillae.

In many patients, the changes in color, contour, and consistency that are frequently associated with gingival inflammation may not be detected only as bleeding of the gingival in response to examination of the periodontal pocket with a periodontal probe .

Gingival bleeding, either spontaneous or in responses to probing, is frequent, and inflammation – related to probing is frequent, and inflammation related exudates of crevicular fluid and suppuration from the pocket also may be found.

In some cases, probably as a result of long standing, low – grade inflammation, thickened, fibrotic marginal tissues may obscure the underlying inflammation changes.

Pocket depths are variable, and both horizontal and vertical bone loss can be found. Tooth mobility often appears in advanced cases when bone loss has been considerable.

Chronic periodontitis can be clinically diagnosed by the detection of chronic inflammatory changes in the marginal gingival, presence of periodontal pocket, and loss of clinical attachment.

It is diagnosed radiographically by evidence of bone loss. These findings may be similar to those seen in aggressive disease.

A differential diagnosis is based on the age of the patient, rate of disease progression over time, familial nature of aggressive disease, and relative absence of local factors in aggressive disease, and relative absence of local factors in aggressive disease compared with the presence of abundant plaque and calculus in chronic periodontitis.

Radiographic Criteria :

The following diagnostic criteria can be used to aid in the diagnosis of periodontal disease:

Radiopaque horizontal line across the roots. This line demarcates the portion of the root where the labial and lingual bony plate has been partially or completely destroyed from the remaining bone – supported portion.

Vessel Canals in the alveolar bone. It described linear and circular radiolucent area produced by interdental canals and their foramina, respectively.

These canals indicate the course of the vascular supply of the bone and are normal radiographic findings. The radiographic image of the canals is often so prominent, particularly in the anterior region of the mandible that they might be confused with radiolucency resulting from periodontal disease.

Different Between treatment and untreated periodontal disease. It is sometimes necessary to determine whether the reduced bone level is the result of periodontal disease that is no longer destructive or if destructive periodontal disease is present.

Clinical examination is the basic determinant. However , radiographically detectable alterations in the normal clear cut peripheral outline of the septa are corroborating evidence of destructive periodontal disease.



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