Periodontal Disease: A Case Study

Introduction
Periodontal disease refers to any form of pathologic inflammation of the tissues that surround the teeth and it is considered one of the most common causes of teeth loss on adults in United States. According to a recent report from CDC (Control Disease Center), 47.2% of adults aged 30 years and older have some form of periodontal disease. There are two general categories of periodontal diseases, and their classification is based on whether there is attachment or bone loss involved in the clinical findings. Furthermore, periodontal disease can be gingivitis if no attachment loss or periodontitis if the gingival attachment moved from its healthy position which is coronal to cementum-enamel-junction(CEJ). Gingivitis refers to inflammation
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Malocclusion refers to a misalignment or incorrect relation between the teeth of the two dental arches when they approach each other as the jaws close; and, when the interproximal contact area between neighbor teeth on a same arch is bigger due to tooth rotation or when such contact is open. Consequently, this unusual alignment cause the teeth of one arch not to have a nice contact area between them, fact that may predispose an individual to be more susceptible to dental biofilm accumulation and calculus formation. Eventually, such biofilm formation attract pathogenic bacterias that affect negatively the tissues of the periodontium causing any form of periodontal disease, either gingivitis and/or periodontitis. Some of the negative effects, that can be seen clinically, are gum inflammation, bleeding, suppuration, apical migration of the free gingival margin, exposure of cementum-enamel junction. Radiographically, clinicians can observe reduction of the crestal bone levels or other changes like fuzziness of the lamina dura at the crestal bone, widening of the periodontal ligaments (PDL). Patient with malocclusion can go under orthodontic treatment to improve esthetic and to avoid some type of periodontal disease; but still they can compromised the bone …show more content…
When individuals presents with some types of periodontal disease, either gingivitis or periodontitis, there are some local factor that exacerbate the destruction of the periodontium. Such is the case when teeth are misalign or have an greater contact area between them, fact that makes difficult the proper daily removal of bacterial biofilm leading inflammation response of the body to such bacterial accumulation and consequently the periodontium becomes diseased. Other local factors are bruxism and traumatic occlusion. Bruxism by itself does not cause periodontal disease when the host presents a healthy periodontium, but if bruxism coexist on an individual who has a history of periodontitis with bone loss and apical migration of the junctional epithelium, then the progresses of the disease occurs more rapidly than if the individual would have periodontitis only. Similar to bruxism as a contributing factor is the case of trauma from occlusion. Traumatic occlusion can be primary if the individual 's periodontium is healthy and an extreme occlusal force is applied to teeth, or it can be secondary if a normal occlusal force is applied to a diseased periodontium. Trauma from occlusion does not cause periodontal pockets or gingivitis as long as inflammation is limited to the gingiva. In cases where primary occlusal trauma cause some damage of the

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