Influence of Systemic Conditions on Periodontium
Systemic diseases, disorders, and conditions can affect the periodontium by impairing the host's barrier function and immunity, leading to periodontal destruction. Endocrine disorders like diabetes mellitus and hormonal changes, as well as female sex hormones during puberty, menstruation, pregnancy, and menopause, can have significant impacts on the periodontium. Hyperparathyroidism can also cause oral changes such as malocclusion and tooth issues.
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Presentation Transcript
INFLUENCE OF SYSTEMIC CONDITIONS ON PERIODONTIUM
INTRODUCTION Systemic diseases,disorders&conditions Altered host tissue&physiology Impair the host s barrier function&immunity Creating opportunity periodontal destruction
ENDOCRINE DISORDERS&HARMONAL CHANGES DIABETES MELLITUS: -Complex metabolic disorders-ch. Hyperglycem -6thcomplication-Periodontitis -Type I (IDDM) -TypeII(NIDDM) -Gestational diabetes
DIABETES MELLITUS Contd ORAL MANIFESTATION -Cheilosis -Mucosal drying -Cracking -Burning mouth&Tounge -Decrease salivary flow -Greater predominance of Candida albicance
DIABETES MELLITUS Contd PERIODONTIUM -Tendency towards enlarge gingiva -Sessile/Pedunculated gingival polyps -Abscess formation/Rapid bone loss -Mobile teeth -Function of PMNs/Monocyte/Macrophages impaired -Decrease collagen synthesis&Alv bone height ->>AGEs(accumulated glycation end-products)
FEMALE SEX HORMONES PUBERTY -Pronounced Inflammation -Edema -Gingival Enlargement MENSTRUATION -Bleeding gums -Tense feeling of gums
FEMALE SEX HORMONES Contd PREGNANCY -Gingivitis due to Bacterial plaque -Greater senstivity-2nd&3rdtrimester -Raspberry gingiva -Pregnancy tumor -P.intermedia increase HORMOANAL CONTRACEPTIVES -Increase gingival response to local factors ->>1.5ys incresaes periodontal destruction
FEMALE SEX HORMONES Contd MENOPAUSE -Gingiva&oral mucosa-shiny,dry,paleness to redness&bleed easily -Burning sensation -Excess senstivity to thermal changes -Abnormal taste sensation -Ch. Desquamative gingivitis
HYPERPARTHYROIDISM -Generalized demineralization of the skeleton -Increased osteoclast -Formation of bone cyst&giant cell tumor -Loss of lamina dura ORAL CHANGES -Malocclusion -Tooth mobility -Widening of Pdl -Brown Tumors (bone cyst+fibrous tissuse+hemosiderin- laden macrophages&giant cells)
HEMATOLOGIC DISORDERS NEUTROPENIA -Decrease levels of circulating neutrophils -<500 l severe life threting AGRANULOCYTOSIS -Ulcerative necrotising lesion-oral/skin/GIT/UTI -Fever,malaise,weakness&sore throat -Gingival haemorrage -Fetid odor
HEMATOLOGIC DISORDERS Contd LEUKEMIA ORAL MANIFESTAION: -Gingival enlargement -Bleeding gingiva -Oral ulceration -Petechiae&Ecchymosis -Infection
HEMATOLOGIC DISORDERS Contd.. ANEMIA -Glossitis(painful&burning lingual sensatiion) -Craked/fissure at the corner of mouth -pallor skin -Dysphagia -Koilonychia THROMBOCYTOPENIA -Focal hemorrhages-various tissues&organs -Petechiae/echymosis
GENETIC DISORDERS DOWN SYNDROME -Trisomy of 21,mangolism -Growth retardation -Mental deficiency -Increase prevalence of periodontal diseases -Deep periodontal pocket -Poor PMNs chemotaxis,phagocytosis
STRESS -ANUG(Trench mouth) -Desquamative lesions -Decreasse level of IL-1&MMP-9 -Influence outcomes of periodontal therapy -Grinding&clenching teeth&periodontium
MEDICATIONS BISPHOSPHONATES -Cancer&osteoporesis -Inhibit osteoclasic activity -BRON -BION -Pathologic fracture CARTICOSTEROIDS -Osteoporesis of alv bone -Capillary dilatation -Hemorrhage Pdl&gingival CT -Reduction collagen fibers
MCQ-1 Which of the following ulteration can be observed in the Periodontium due to Chronic hyperglycemia (a)Gingival polyp (b)Gingival bleeding (c)Widening Periodontal ligament (d)Necrotic gingiva
MCQ-2 Which of the following is related with poorly controlled diabetic patients (a)Impaired functions of PMNs (b)Increase collagen synthesis (c)Normal AGEs formation (d)Impaired bone loss
MCQ-3 In which of the following condition Raspberry like gingiva can be seen (a)Puberty (b)Pregnancy (c)Menopause (d) Menstruation
MCQ-4 The following is a clinical picture of gingiva in leukemic patients (a)Gingival bleeding (b)Gingival necrosis (c)Gingival abscess (d)Gingival atrophy
MCQ-5 Radiographic widening of periodontal ligament space and loss of lamina dura are the important findings of (a)Diabetes mellitus (b)Hyperparathyroidism (c)Leukemia (d)Agranulocytosis
