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Dr. Parvez A. Khan

Authors : Dr. Parvez A. Khan

Chronic periodontitis is a common disease of the oral cavity consisting of chronic inflammation of the periodontal tissues that is caused by accumulation of profuse amounts of dental plaque. It is diagnosed as one of the seven destructive periodontal disease.

Symptoms may include redness or bleeding of gums while brushing teeth, using dental floss or biting into hard food. Deep pockets between the teeth and the gums. Gingival inflammation and bone destruction are often painless. Patients sometimes assume that painless bleeding after teeth cleaning is insignificant, although this may be a symptom of progressing chronic periodontitis in that patient. Subgingival calculus is a frequent finding. There is a slow to moderate rate of disease progression but the patient may have periods of rapid progression.

Chronic periodontitis can be associated with local predisposing factors (e.g. tooth-related or iatrogenic factors). The disease may be modified by and be associated with systemic diseases (e.g. diabetes mellitus, HIV infection). It can also be modified by factors other than systemic disease such as smoking and emotional stress. Major risk factors: smoking, lack of oral hygiene with inadequate plaque. The disease progression is carried out by measuring probing pocket depth (PPD) and bleeding indices using a periodontal probe. Pockets greater than 3mm in depth are considered to be unhealthy.

Bleeding on probing is considered to be a sign of active disease. Discharge of pus, involvement of the root furcation area and deeper pockets may all indicate reduced prognosis for an individual tooth. Chronic periodontitis is initiated by gram negative tooth-associated microbial biofilms that elicit a host response, which results in bone and soft tissue destruction. In response to endotoxins derived from periodontal pathogens, several osteoclasts -related mediators target the destruction of alveolar bone and supporting connective tissues such as the periodontal ligaments. Major drivers of this aggressive tissue destruction are matrix metalloproteinase (MMPs), cathepsins and other osteoclast-derived enzymes.


Dr. Parvez A. Khan
Dr. Parvez A. Khan