secondary factors for periodontal disease

Secondary Factors for Periodontal Disease

Ravi Morjaria and Rohan Chopra

Periodontal Disease

What is a Secondary Factor?

Causes disease progression

Divided into local and systemic

Local Factors

Calculus

Dental Factors

Iatrogenic Factors

Calculus

Two types: supra and sub

Three theories of formation: CO2 theory Ammonia theory Seeding theory

Composition of Calculus

Two thirds of the inorganic component of calculus consists of different types of crystals: Hydroxyapatite – 58% Magnesium whitlockite – 21% Octacalcium phosphate – 12% Brushite – 9%

Calculus

Dental Factors

Root Morphology and anatomical anomalies

Dental Factors

Tooth alignment

Dental Factors

Carious lesions

Dental Factors

Mouth breathing Incompetent lipseal

Dental Factors

Tongue thrusting During swallowing the tongue is thrusted

forward against the teeth instead of being pushed upward towards the palate, leading to increased mobility, spacing and altered occlusion of the anterior teeth.

Iatrogenic Factors

Overhanging or poorly contoured restorations

Subgingival margins of restorations

Prosthodontics – crowns, bridges, dentures

Orthodontic treatment

Iatrogenic Factors

Systemic Factors

Smoking and Tobacco Systemic Disease Medications Hormonal Influences Poor Nutrition Stress

Systemic Factors

Smoking and Tobacco use

Systemic Factors

Systemic Disease Diabetes Downs Syndrome