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PeriodontitisAka: Pyorrhea

Definition
1. Loss of tooth supporting bone structure due to chronic Gingivitis
Epidemiology
1. Common cause of adult tooth loss
Pathophysiology
1. Chronic Gingivitis results in inflammation of deeper tissues around teeth
  1. Crevices between gums and teeth enlarge
  2. Pockets develop in crevices with
    1. Debris
    2. Purulent materials
2. Consequences
  1. Loss of tooth supporting bone structure
  2. Periodontal ligament detaches from tooth
Types
1. Localized Juvenile Periodontitis
  1. Onset as adolescent (ages 12 to 17 years old)
  2. Not related to Plaque
  3. Vertical alveolar bone loss
2. Adult periodontitis
  1. Onset after age 30 years
  2. Associated with subgingival dental Plaque
Signs
1. Gum margins recede exposing roots of teeth (deep pockets may be present)
2. Subgingival dental Plaque
3. Friable gums that bleed easily when probed
4. Teeth may be loose
Management
1. Surgical debridement of infected or necrotic tissue by dentist or periodontist
2. Mouth rinses
  1. Chlorhexidine Gluconate 0.12% Rinse (Peridex)
  2. Hexetidine 0.1% Rinse (Oraldene)
3. Systemic antibiotics in diffuse involvement
  1. Oral: Doxycycline or Metronidazole
  2. Topical: Minocycline
Complications
1. Periodontal Abscess
References
1. Albandar (1997) J Am Dent Assoc 128:1393
2. Nguyen (2008) Am Fam Physician 77:797

Periodontitis (C0031099)
Definition (MSH)	Inflammatory reaction of the tissues surrounding a tooth (periodontium), usually resulting from the extension of gingival inflammation (gingivitis) into the periodontium. (From Dorland, 27th ed)
Definition (CSP)	inflammatory reaction of the tissues surrounding a tooth (periodontium), usually resulting from the extension of gingival inflammation into the periodontium.
Concepts	Disease or Syndrome (T047)
ICD9	523.4
English	Chronic pericementitis, Chronic periodontitis, Periodontitides, Periodontitis
Spanish	pericementitis crÃ³nica, pericementitis cronica, periodontitis, periodontitis crÃ³nica, periodontitis cronica
Credits	Derived from the NIH UMLS (Unified Medical Language System)

Alveolar pyorrhea (C0034219)
Concepts	Disease or Syndrome (T047)
ICD9	523.4
English	Alveolar pyorrhea, Alveolar pyorrhoea, Chronic suppurative pericementitis, Fauchard's disease, Marginal periodontitis, Periodontitis simplex, Pyorrhea, Pyorrhea Alveolaris, Pyorrhoea, Pyorrhoea alveolaris, Riggs' disease, Simple periodontitis
Spanish	enfermedad de Fauchard, enfermedad de Rigg, enfermedad de Riggs, pericementitis supurativa crÃ³nica, pericementitis supurativa cronica, periodontitis marginal, periodontitis simple, piorrea, piorrea alveolar
Credits	Derived from the NIH UMLS (Unified Medical Language System)