Source

1-Periodontal Health and Gingival Disesases(Gingivitis)
2- Periodontitis
3- Perimplant Mucositis and Perimplantitis
4- Periodontal Manifestation of Systemic Disesase and Acquired Conditions

Periodontal Health

It is has to do with very minimal gingival inflammation even with signs and symptoms as compared to that gingivitis. It has the following clinical features;
i- Minimal bleeding on probing (less than 10% of site )
ii- Probing Depth 3mm or below

Source

Intact Periodontium= no attachment or bone loss
Reduced Periodontium= previous attachment and/or bone loss but now stable and not progressive

That is, No Periodontitis history for Intact Periodontium or stable one

Gingivitis

It has the clinical features of erythema, edema, bleeding on probing
The major characteristics are;
i-Bleeding on Probing ( greater than 10% of site)
ii- Probing Depth 3mm or below.
Stable Periodontium (no progressive attachment loss and/or bone loss)

Periodontitis

It is the loss of periodontal tissue support due to microbially related attack and host-mediated inflammatory response which causes the breakdown of periodontal tissues.

It has the following general clinical features;
i- Typically associated with deeper probing depth
ii- Presence of interproximal/ interdental attachment loss

Source

As it is clearly known that without plaque which houses microbes that infect the periodontal tissues there would be no inflammation of either the gingival or the whole periodontium.

The bone and soft tissue attachment reacts by giving an inflammatory response which is to retreat away from the plaque through recession and bone breakdown leading loss of bony components and increase in inflammatory markers and edema.

In periodontitis, the major focus is on distal and mesial attachment loss and bone loss and not on straight facial and straight lingual gingival probing as it in the case of healthy gingiva and gingivitis cases.

Now let's discuss a little bit on staging on periodontitis;

Staging

Staging is determined by severity of the attachment loss and bone loss together with extent of disease at presentation.
a- Severity
b- Complexity
c- Extent and Distribution

All are measured from stage 1 to stage 4.

Severity is mainly based on interdental CAL (Clinical Attachment Loss) at the worst site which serves as the base line for the staging of the the disease.

Clinical Attachment Loss is measured at the Cemeentoenamel junction to the base of the pocket. Like it earlier said, the worst or biggest CAL gives the baseline for the staging though it must be at interdental areas as those are the conditions for staging. It should not be straight lingual or straight facial CAL.

Source

INTERDENTAL CAL STANDARD FOR STAGING FROM 1 TO 4
1-2mm Stage I
3-4mm Stage II
Greater than or equal to 5mm is either Stage III or IV

That's all atleast for now. Extent and distribution together with complexity would be greatly reviewed in the subsequent posts. Thanks and happy blogging.

Happy Blogging and Reading 💥💥💥🦷

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