Periodontal Disease 牙周疾病 Chang Liu Dental Hygiene Student

Tooth Morphology 牙齿结构 Enamel 牙釉质/珐琅质 Dentin 牙本质/象牙质 Pulp 牙髓 Cementum 牙骨质

Periodontium 牙周组织 Gingiva 牙龈 Cementum 牙骨质 Periodontal Ligament 牙周膜/牙周韧带 Alveolar Bone 牙槽骨

Alveolar Bone 牙槽骨

Healthy Gingiva No Infection 无感染 No Odors/Tastes 无异味 No Blood 无出血 No Pus 无脓 No Pain 无痛

National Survey in China 根据第三次全国口腔健康流行病学调查结果显示，我国牙周健康者不足两成。 全国35岁～44岁年龄段人群牙周健康率为14.5%，牙龈出血检出率为77.3%。 全国65岁～74岁老年人牙周健康率为14.1%，牙龈出血检出率为68.0%。

Classification of Periodontal Disease 牙周疾病的分类 Gingival Disease 牙龈疾病 Periodontitis 牙周炎

Classification of Gingival Diseases

The Most Common Form of Gingivitis Plaque Induced Gingivitis 牙菌斑引发的牙龈炎/慢性牙龈炎 most common form of gingivitis bleeding on probing, redness, edema 探诊出血，红肿 the longer biofilm is present the more severe gingivitis can develop within 1-3 weeks reversible 可治愈

Plaque Induced Gingivitis

Treatment 治疗方法 Oral self care 良好的口腔护理 Deplaquing/debridement/scaling 清创/除垢 Eliminate local contributory factors 消除起促成作用的因素 If not responding or seems severe consider physician consultation 无好转或恶化，及时就医

Classification of Periodontitis

The Most Common Form of Periodontitis Chronic Periodontitis 慢性牙周炎 most common form of periodontitis slow rate of progression typical age of onset is 35 bleeding loose teeth food impaction bad taste

Chronic Periodontitis 慢性牙周炎 (cont.) bone loss 牙槽骨流失 periodontal pocket formation 牙周袋形成 Severity is determinded by bone loss & loss of attachment Can become inactive, active (recurrent), refractory irreversible 无法治愈

Chronic Periodontitis 慢性牙周炎

Chronic Periodontitis 慢性牙周炎

Chronic Periodontitis 慢性牙周炎 Bone loss 蓝色代表正常高度 红色代表骨流失后的高度

Chronic Periodontitis 慢性牙周炎 Subgingival Calculus 龈下结石

Treatment 治疗方法 Oral self care 良好的口腔护理 Root planning/deep cleaning/ debridement/scaling 深度清洗 Depending type of defects & severity - possibly surgery & periodontal referral 根据病情与程度，可能需要牙周医生诊断与手术

The Cause of Periodontal Disease 牙周疾病的病因 Biofilm (plaque) 牙菌斑生物膜 a complex aggregation of microorganisms marked by the excretion of a protective and adhesive matrix 一种细菌性生物膜，由微生物自身产生的多聚物基质所包围而形成，附着在物体或生物表面的具有结构的群落。

Biofilm Formation 1-2 days: aerobic, Gram+ cocci 好氧菌, 革兰氏阳性菌，球菌 4-7 days: filamentous forms & rods 放线菌, 杆菌 7-14 days: vibrios & spirochetes, Gram-, anaerobic 厌氧菌, 弧菌, 革兰氏阴性菌，螺旋菌 14-24 days biofilm maturation: dense vibrios, spirochetes filamentous

The direct damage is caused by microorganisms

Host Response 宿主反应 A defense mechanism of the body to protect and defend the individual against exogenous microorganisms The indirect damage is caused by host response The indirect response is usually causing more destruction

Risk Factors 致病因素 Factors that increase the probability of the disease 增加得病机率的因素 Poor oral hygiene Smoking Systemic disease 全身性疾病（免疫力低下, 骨质疏松, 糖尿病） Medications Hormones 荷尔蒙（经期, 青春期, 妊娠期）

Risk Factors 致病因素 (cont.) Genetics Viruses Stress Chronic alcohol 长期酗酒 Nutritional deficiencies 营养不良 Obesity Previous periodontal disease

Contributory Factors 起促成作用的因素 Calculus 牙结石 (harbors microorganism) Xerostomia 口干 Mouth breathing 张口呼吸 Incomplete lip closure 嘴唇闭合不全 Food impaction 食物嵌塞 Position of teeth/ Malocclusion 咬合不正 Occlusal discrepancies 咬合偏差 Toothbrush trauma 刷牙创伤

Contributory Factors (cont.) 起促成作用的因素 Faulty restorations 修补有缺陷 Root morphology 牙根形态问题 Partial dentures 局部假牙 Orthodontic appliances 矫正器 Un-replaced teeth Pulpal involvement Piercings 穿孔

Nutrition suggestion Vitamin D helps make calcium and phosphorus available to bones - milk, eggs, sunshine Calcium strenthens bone - milk/milk products, green vegetables, shellfish 贝壳类

Healthy Smile!!