periodontal pockets revise

8/8/2019 Periodontal Pockets REVISE

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By Dr.Hina Waseiy


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May occur by :Coronal movement of gingival margin Apical displacement of gingival attachment

or combination of two


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GINGIVAL POCKET(PSEUDO POCKET):GINGIVAL POCKET(PSEUDO POCKET):Formed by the gingival enlargement withoutdestruction of underlying periodontal tissues.Sulcus is deepened b/c of the inc. bulk of the gingiva.

PERIODONTAL POCKET:PERIODONTAL POCKET:Occurs with destruction of the supportingperiodontal tissues.

Progressive pocket deepening leads to thedestruction of supporting periodontal tissues &loosening & exfoliation of the teeth.


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SUPRABONY(SUPRACRESTAL ORSUPRABONY(SUPRACRESTAL ORSUPRAALVEOLAR):SUPRAALVEOLAR):

In which bottom of the pocket is coronal tothe underlying alveolar bone

INTRABONY(INFRABONY,SUBCRESTAL ORINTRABONY(INFRABONY,SUBCRESTAL ORINTRAALVEOLAR):INTRAALVEOLAR):

In which the bottom of the pocket is apical tothe level of adjacent alveolar bone


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Principal difference b/w the two:

In supra bony pockets, there is horizontal patternof bone loss.Intrabony pockets are associated with vertical

bone loss.


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Bluish-red,thickened marginal gingivaGingival bleeding

SuppurationTooth mobility Diastema formationLocalized pain

We can locate & measure periodontal pocket byprobe.


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Periodontal pocket are caused by microorganisms & their products whichproduce pathologic tissue changes that lead todeepening of the gingival sulcus. The cellular &fluid inflammatory exudates cause

degeneration of the surrounding C.T.,including gingival fibers.


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-Contains1- Debris consisting of microorganisms &their products

2- Gingival fluid.3- Food remenants4- Salivary mucin.5- Desquamated epi. Cells.

6- Leukocytes.7- Plaque covered calculus.-Purulent exudates if present consists of living degenerated &necrotic leuocyte,living dead bacteria, serum& fibrin.


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Spread of infection from periodontal pocketsmay cause pathologic changes in the pulp.

May give rise to painful symptoms.Involvement of the pulp in periodontal

disease occurs through either the apical

foramen or the lateral canals in the root afterinfection spreads from the pocket through theperiodontal ligament leads to atrophic &inflammatory pulpal changes.


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It is localized purulent inflammation inthe periodontal tissues.

Also known as a lateral or parietal abscess.May occur in the presence or absence of

periodontal pocket.


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Scaling means scraping off the tartar fromabove and below the gum line. Root

planning gets rid of rough spots on the toothroot where the germs gather, and helpsremove bacteria that contribute to thedisease.


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There are few medicaments available for localizeddelivery of medicine in the pockets. The principal isthe local delivery of anti-microbial substance directly into gum pocket, where it fights the bacteria andinflammation. One thing: this drugs do not workalone, they will work good in conjunction with rootplanning and scaling and good oral hygiene, but it isnot the substitution for any of the above.


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Arestin ( Minocycline HC I)

Atridox (Doxicyline hyclate 10%)

Periostat


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Here are some things you can do to prevent periodontaldiseases:

Brush your teeth twice a day ( with a fluoride toothpaste)Floss every day Visit the dentist routinely for a check-up and professional

cleaningEat a well balanced dietDon't smoke


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periodontal pockets revise

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