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牙周病的主要症状和临床病理医学课件英文版
Chapter 5 : Main Symptoms and Clinical Pathology
of Tooth
looness
and migration Section 1:
Gingival
bleeding
and
periodont -4
days
-
cute
logic alteration of plasma cells
Incread vascular supply Early lesion Advanced
lesion Established lesion Initial lesion 2. Clinical
defective margins are detected. Gingival tissues are healthy
with no bleeding after gentle probing.
bleeding after gentle probing.
- or subgingival calculus and/or defective margins are
detected.
-edged, with pointed
interdental papilla. Chronic marginal gingivitis Blunted papillae healthy gingiva gingivitis
Pockets of the same depth may be associated with different
degrees of attachment loss, and pockets of different depths may
be associated with the same amount of attachment loss. Same
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pocket depth with dif邲之战
ferent amounts of recession. A, Gingival
pocket with no recession. B, Periodon黑茶是什么茶
tal pocket of similar
depth as in A, but with some degree of recession. C, Pocket depth
same as in A and B, but with still more recession. Different
pocket depths with the same amount of attachment loss. Arrows
point to bottom of地震安全
the pocket. The distance between the arrow
and the cementoenamel junctions remains the same despite
different pocket depths. A, In a normal sulcus with a long
junctional epithelium (between arrows), the probe penetrates
about one third to one half the length of the junctional
epithelium. B,
In a periodontal pocket with a short junctional
epithelium (between arrows), the probe penetrates beyond the
apical end of the juncpet怎么读
tional epithelium. Section 2: The
starts as an inflammatory change in the connective tissue wall
of the gingival sulcus.什么是神经性皮炎
The cellular and fluid inflammatory
exudate caus degeneration of the surrounding connective
tissue, including the gingival fibers. Just apical to the junctional epithelium, collagen fibers are destroyed and the
area becomes occupied by inflammatory cells and edema.
ciated
with collagen loss: (1) collagenas and other enzymes creted by various cells in healthy and inflamed tissue such as fibroblasts, polymorphonucl如何收藏网页
ear leukocytes, and macrophages become extra
cellular and destroy collagen; the enzymes that degrade collagen and other matrix macromolecules into small peptides are called matrix metalloproteinas; (2) fibroblasts phagocytize collagen fibers by extending cytoplasmic process to the ligament-cementum interface and degrade the inrted collagen fibrils a
As a conquence of the loss of collagen, the apical cells of the junctional epithelium proliferate along the root, extending fingerlike projections two or three cells in
e junctional epithelium detaches from the root as the apical portion migrates. As a result o
f inflammation, polymorphonuclear neutrophils (PMNs) invade the coronal end of the junctional epithelium in increasin
g numbers. When the relative volume of PMNs reaches approximately 60% or more of the junctional epithelium, the tissue los cohesiveness and detaches from the toot
h surface. Thus the sulcus bottom shifts apically, and the oral sulcular epithelium occupies a gradually increasing portion of the sulcular (pock
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deepening of the pocket has been described as occurring between
the junctional epithelium and the tooth or by an
intraepithelial cleavage within the junctional epithelium.
ontal
pocket creates an area where plaque removal becomes impossible,
and the following feedback mechanism is
established: Plaque
Gingival inflammation Pocket formation
More plaque
(2) Root surface wall (3) Contents the pocket is
usually much shorter than that of a normal
sulcus.
striking proliferative and degenerative changes
and
ulceration. are incread in number, dilat
Periodontal pockets are chronic inflammatory lesions and as
iew of
the bacterial biofilm covering the subgingival root surface.
