Chronic periodontitis

Diego Halab Robles Programa de Doctorado en Ciencias Mdicas Unversidad Austral de Chile

Periodontitis

Highfield, 2009

Chronic periodontitis

Clinical

Highfield, 2009

Corbet, 2009

Epidemiology

93.4%
35 to 44 years old

>3 mm

97.5%
65 to 74 years old

38.6%
35 to 44 years old

>6 mm

69.3%
65 to 74 years old

Gamonal et al., 2010

Microbiology
Red complex: P. gingivalis, T. denticola and T. forsythia

Silva et al., 2008

Immunology

Periodontitis Biofilm
(Mrmann et al., 2008)

TNF- IL-1
(Zappa et al., 1991)

Zappa, U. et al., 1991

Kaushik, R., Yeltiwar, R.K. & Pushpanshu, K., 2011. Salivary interleukin-1 levels in patients with chronic periodontitis before and after periodontal phase I therapy and healthy controls: a case-control study. Journal of periodontology, 82(9), pp.1353-9.

CD4+/CD8+ ratios

Th17

Periodontitis Biofilm

TNF-
IL-1

TFG- IL-6 Th17 IL-23 RORC2

IL-17 RANKL

Th1/Th17

Biofilm

Periodontitis TNF- IL-1 Th1 IL-12

T-bet IL-1

IFN-
TFG- IL-6 Th17 IL-23 RORC2 IL-17 RANKL

Th17, Th1 and Treg

Periodontitis Biofilm TNF- IL-1

Treg

CTLA-4
TGF-1 IL-10

Foxp3 TFG- IL-12

Th1

IL-1 IFN- T-bet

TFG- IL-6 Th17 RORC2

IL-17

RANKL

IL-23

diegohalabi@gmail.com

Therapy
Patient Chronic periodontitis

Health

Oral health instruction Plaque control Supragingival debridement Subgingival debridement Reevaluation
Chronic periodontitis

Oral health instruction

Antibiotics (amoxicillin + Metronidazole) Chlorhexidine 0.05% per 3 months Reevaluation

Chronic periodontitis

References

Corbet, E., 2009. Radiographs in periodontal disease diagnosis and management. Australian dental journal, 54 Suppl 1, pp.S2743. Dutzan N, Gamonal J, Silva A, Sanz M, Vernal R (2009). Over-expression of forkhead box P3 and its association with receptor activator of nuclear factor-kappa B ligand, interleukin (IL) 17, IL-10 and transforming growth factor-beta during the progression of chronic periodontitis. J Clin Periodontol 36:396-403. Gamonal, J. et al., 2010. Clinical attachment loss in Chilean adult population: First Chilean National Dental Examination Survey. Journal of periodontology, 81(10), pp.140310. Hernndez, M. et al., 2011. Host-pathogen interactions in progressive chronic periodontitis. Journal of dental research, 90(10), pp.116470. Highfield, J., 2009. Diagnosis and classification of periodontal disease. Australian dental journal, 54 Suppl 1, pp.S1126. Silva, N. et al., 2008. Characterization of progressive periodontal lesions in chronic periodontitis patients: levels of chemokines, cytokines, matrix metalloproteinase-13, periodontal pathogens and inflammatory cells. Journal of clinical periodontology, 35(3), pp.20614. Zappa, U. et al., 1991. Cell populations and episodic periodontal attachment loss in humans. Journal of clinical periodontology, 18(7), pp.50815.