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Sites with periodontitis exhibit clinical signs of gingival inflammation and loss of connective tissue attachment. Connective tissue attachment loss refers to the pathological detachment of collagen fibers from cemental surface with the concomitant apical migration of the junctional or pocket epithelium onto the root surface. [2]
1: Total loss of attachment (clinical attachment loss, CAL) is the sum of 2: Gingival recession, and 3: Probing depth. Gingival recession, also known as gum recession and receding gums, is the exposure in the roots of the teeth caused by a loss of gum tissue and/or retraction of the gingival margin from the crown of the teeth. [1]
Ultimately, tooth loss may occur if the condition is not halted. It is termed localized when less than 30% of sites around teeth are involved, and generalised when more than 30% are involved. clinical attachment loss can be used to determine the severity of the condition, where 1–2mm is slight, 3–4mm is moderate and more than 5mm is severe. [5]
The "severity" of disease refers to the amount of periodontal ligament fibers that have been lost, termed "clinical attachment loss". According to the 1999 classification, the severity of chronic periodontitis is graded as follows: [67] Slight: 1–2 mm (0.039–0.079 in) of attachment loss; Moderate: 3–4 mm (0.12–0.16 in) of attachment loss
The rate of loss of attachment and bone loss is rapid. [19] Loss of attachment refers to the destruction of periodontium whereas the bone refers to the alveolar bone supporting the teeth. [23] The loss can be determined by using a calibrated periodontal probe and taking radiographs of the dentition. [24] Usually the loss of attachment is ...
Necrotizing periodontitis (NP) is where the infection leads to attachment loss (destruction of the ligaments anchoring teeth in their sockets), but involves only the gingiva, periodontal ligament and alveolar ligament. If attachment loss is present in the disease, it is termed NP, unless the disease has progressed beyond the mucogingival ...
Age increases the risk of periodontal disease but does not cause it. [29] Most of the geriatric community have moderate levels of attachment loss, with less having advanced stages of the disease. [25] Active periodontitis is a risk factor for certain systemic diseases as well, including cardiovascular disease, stroke and aspiration pneumonia. [20]
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 endotoxin derived from periodontal pathogens, several osteoclast-related mediators target the destruction of alveolar bone and supporting connective tissue such as the periodontal ligament.