periodontal pocket classification
Role of trauma from occlusion in initiation of periodontal pocket formation in experimental animals. If the disease is caught early CLASSIFICATION 1: POCKET Gingival pocket Periodontal pocket Suprabony pocket Infrabony pocket GINGIVA POCKET PERIODONTAL POCKET
- Also known as pseudo pocket or relative pocket or false pocket
- Seen in the gingivitis
- Formed by the gingiva enlargement without extraction of the underlying periodontal tissues. Updated on September 21, 2016
Add 2-3 drops of tea tree, clove, aloe vera, guava leaf, lemongrass, or basil essential oil to a 240 ml cup of warm water and swish it around your mouth and spit it out. Periodontology 2000. On probing, there could be bleeding and suppurations. The collagen fibers degrade by two methods, one by collagenases 24 and other enzymes of host and the bacterial origin and second by fibroblasts which phagocytize collagen fibers. Complex pocket: Where the base of the pocket is not in direct communication with the gingival margin. The information presented in this website has been collected from various leading journals, books and websites. As the reparative process starts simultaneously, areas of bone apposition can also be seen. Author information: (1)Columbia University School of Dental and Oral Surgery, Division of Periodontics, USA. Once a patient has had any periodontal treatment (non-surgical, surgical, or a combination of both), they will require periodontal maintenance recalls at more frequent intervals in order to try to maintain their disease and try to prevent recurrence. Neutrophils play a very important role in the pathogenesis of periodontal pocket formation as they are the first line of defense around the teeth, epithelial barrier being the second 17. Pocket Irrigation: With the help of Pocket irrigation, bacteria in the periodontal pockets will be removed and prevents the destruction of the surrounding soft tissue and bone. at cementoenamel junction. Thus, pus formation in periodontal pockets should be considered as the reflection of inflammatory changes occurring in the pocket and not as an indicator of disease severity. Hence, the adjoining epithelial cells do not get their normal nutrition. Classification of Periodontal Pockets Periodontal pockets are classified according to the relation of the base of the pocket to the alveolar crest into: Suprabony (supracrestal or supraalveolar) The bottom of the pocket is coronal to the underlying alveolar bone. There may be a bluish red vertical zone from the gingival margin to the alveolar mucosa. The mineral content of exposed cementum is increased and chemical analysis shows an increase in calcium, magnesium, phosphorus and fluoride, Endotoxins produced by plaque bacteria can be detected. This will help in cleaning and healing gum pockets. 2010 Feb;52(1):38-52. Periodontal Pockets causes the destruction of the supporting periodontal tissue; progressive Periodontal Pockets pocket deepening leads to the destruction of the supporting periodontal tissues and loosening and exfoliation of the teeth. Suprabony (supracrestal or supraalveolar) pocket, Infrabony (intrabony, subcrestal or intraalveolar) pocket. Gingival pocket is formed by gingival enlargement without destruction of the underlying periodontal tissues. It is suggested to eat green leafy foods and anti-inflammatory foods to reduce the risk of gum problems and periodontal pockets. Dentists would remove calculus in deep pockets, tartar will be removed by lifting the gums and then sutured back into place to fit close to the tooth. These actions of neutrophils have been demonstrated by studies on neutropenic dogs. Bacterial plaque was seen penetrating into the enlarged intercellular spaces of the pocket epithelium). We might feel swelling or observe reddish gums which are caused by tartar or plaque around the gums and teeth resulting in pocket formation. The pattern of destruction of underlying bone is horizontal. Kuboniwa M, Lamont RJ. Following the detachment of principal periodontal fibers, the epithelial attachment proliferates down onto the cementum of the tooth to occupy the area that was previously taken up by these fibers. Drink at least 2 liters of water to keep your mouth dry and your body will also get hydrated. The periodontal pocket usually contains the following. In deep chronic pockets, tooth mobility and formation of pathological diastema are evident. The bone destruction pattern is horizontal in Suprabony pockets. (c) Copyright 2020. Use Dental floss to clean between micro spaces, Use Mouthwash every day after brushing your teeth. it is suggested consult the dentist before taking any supplements as it is a must to know the suitable quantity and kind of supplements you need. Periodontal probe in a periodontal pocket SAMPLE. The clinical features vary according to the severity of the condition. Watch Queue Queue. In a periodontal pocket, the extension of this zone is reduced to less than 100 μm as compared to the normal sulci where it is usually more than 500 μm. The superficial layers of the epithelium show signs of parakeratosis i.e. Essential Oil Mouth Wash: Using essential oils for teeth and gum health is recommended by many dentists. The Infrabony Pocket: Classification and Treatment ... Aman Bhagat, Anchal Ohri, Vishakha Grover, Gender-Associated Oral and Periodontal Health Based on Retrospective Panoramic Radiographic Analysis of Alveolar Bone Loss, Gender-related Differences in Health and Disease [Working Title], 10.5772/intechopen.78906, (2020). Periodontitis must be graded, and staged under the new classification. Intrabony (Infrabony, Subcrestal or intraalveolar) - In this, bottom of the pocket is apical to the level of the adjacent alveolar bone and the lateral pocket wall lies between the tooth surface & alveolar bone. Formation of new blood vessels is seen as an attempt to repair the damaged tissue. It must be remembered that loss of attachment may or may not correlate with periodontal pocket depth. As the plaque matures, there is a microbial shift towards Gram -ve bacteria, which is the result of a change in subgingival environment. Save my name, email, and website in this browser for the next time I comment. In the case of pseudopockets, there is no clinical attachment loss as the junctional epithelial attachment is at its normal position i.e. Electonic toothbrushes will reach much deeper than traditional toothbrushes and very effective in cleaning teeth. In some cases, pus may be expressed by applying digital pressure. Glickman I, Weiss LA. Zone where the junctional epithelium is attached to the tooth: This is the zone where the junctional epithelium is attached to the tooth. This video is unavailable. According to the number of surfaces involved: According to the nature of the soft tissue trail of the pocket. Dentist Consultation: it is the most ignored routine for everyone. Periodontal pocket may be considered as a healing lesion. Once a pocket develops, purulent exudates, food remnants, serum/blood by-products, dead bacteria, leukocytes and desquamated epithelial cells overlaying the layer of calculus or plaque are usually detected in the periodontal pocket. The periodontal pocket formation is the first step in periodontal breakdown cascade. The bottom of the pocket is apical to the level of the adjacent alveolar bone. Periodontal epidemiology literature lacks consistency in methodology of research, which includes various definitions for periodontal disease and health; different approaches to measuring periodontal indices of pocket depth, and attachment loss; inconsistent study designs and … As we know that bacteria are the primary etiology of periodontal diseases, the formation of periodontal pocket is the result of host-microbial interaction in the gingival sulcus. Porphyromonas gingivalis and Prevotella intermedia have been found in the gingiva of aggressive periodontitis cases 32. Fifteen teeth with a part of periodontal pockets from 10 adult periodontitis patients were obtained, and the localization of bacteria was examined immunohistochemically. Classification of periodontal diseases has, ... mesial of 11, indicative of a periodontal pocket and an apical. Pathologic granules can be found in areas of collagen degeneration, Areas of variable calcification can be found on the cemental surface. Periodontal pockets identification is hard for common people and only dentists can identify the problem. Eliminating bacteria alone may not be sufficient to prevent disease recurrence. For example, two teeth having same pocket depth, one associated with the recession and the other with no recession have different loss of attachment. In response, the junctional epithelial cells produce various pro-inflammatory mediators like IL-8, TNF-α, PGE, The perivascular mast cells produce histamine, which causes the endothelium to release IL-8, which causes the polymorphonuclear cell recruitment. Periodontology 2000. Saglie et al. Presently, we are focusing on periodontal regeneration so in this respect changes on the cementum surface facing periodontal pocket play an important role. Thus, periodontal destruction can be observed adjacent to a tooth with no periodontal breakdown. The coronal movement of the gingival margin (gingival enlargement) without the destruction of underlying periodontal tissues is designated as a pseudo pocket or gingival pocket, whereas apical migration of the junctional epithelium with the destruction of supporting periodontal tissues is designated as a true pocket or periodontal pocket. The 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions resulted in a new classification of periodontitis characterized by a multidimensional staging and grading system. Since guidelines changed in 2017, the major change was the classification framework for periodontitis. Infrabony pockets also known as subcrestal or interalveolar pockets. In dentistry, numerous types of classification schemes have been developed to describe the teeth and gum tissue in a way that categorizes various defects. Periodontal treatment methods depend upon the type and severity of the disease. Pus discharge from periodontal pocket does not indicate the severity of periodontal destruction. Under normal conditions, junctional epithelium is present at the cementoenamel junction. Virulence factors produced by bacteria in the pocket or junctional epithelium along the surface! 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