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INTRODUCTION
 Welcome to Our Presentation

Our Group 2 Members

1.Aisyah Rahma Artini (NPM : 1710070110002)

2.Siti Larasaty (NPM : 1710070110006)

3.Istyana Prelesamudra (NPM : 1710070110010)

4.Nurul Alfiyah (NPM : 1710070110019)

5.Fanny Fennisa (NPM : 1710070110023)

6.M.Hafidh Alim Dihan Edi (NPM : 1710070110025)

7.M.Riski Baihaqi Hardiansyah (NPM : 1710070110029)

8.Ananda Putri (NPM : 1710070110052)

9.Subhani Yunus (NPM : 1710070110059)

10.Siti Nurmalina (NPM : 1710070110063)

11.Meilani Rizky Novia (NPM : 1710070110069)

12.Anggilia Irjuanti (NPM : 1710070110075)

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13.Rika Noprianti (NPM : 1710070110097)
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 A 56-year-old man came to the
dentist's practice and complaints of
his maxillary front tooth rocking and
feeling forward. This began to be
felt since 1 year ago, causing
patients to have difficulty biting
food. He also feel the front teeth
getting longer and more painful when
exposed air. As a result of these
conditions the patient rarely laughs
wide because he is ashamed to be seen
by his office mates. He asks the
dentist what treatment can be done
and how the treatment will be done
later. He admitted that he rarely
checked his oral cavity to the
dentist, and there was no systemic
history and allergies.
Extra oral examination: no abnormalities

Intra-oral examination: gingival erythema, pathological migration, namely on

12 teeth 11 cross bite, 21 and 42 teeth with extrusion accompanied by
mobility grade 2. Anterior occlusion trauma with an average of 3-4 mm, 2
mm attachment level and gingival recession. as high as 2 mm. Bad OHI-S
score and 84% Index Plaque.

Radiographic examination: visible bone damage reaches 1/3 cervix with a

horizontal pattern.
 Clarification of Terms
short describe here for you to study and understand

a. Cross bite: also called cross bites or locked teeth, is a more lingual maxillary anterior tooth position abnormality than the lower
anterior teeth.

b. Pathological migration: a tooth shift that occurs when the balance between factors that maintain the position of the tooth is disrupted
by periodontal disease.

c. Mobility grade 2: the degree of tooth mobility that is seen to move both in vestibular and oral directions up to more than 1 mm.

d. Instructions: A state of teeth extending out from the bone hole where the tooth is located where the root follows the crown.

e. Trauma occlusion: injury or injury that occurs in the periodontium tissue due to occlusal pressure received by the periodontium has
exceeded its adaptability.

f. True pocket: pathological sulcus deepening which is a sign of periodontal disease.

g. Level attachment: distance from cemento enamel junction (CEJ) to pocket base.

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 What is the diagnosis in this
1 scenario?

Are there bacteria that affect

2 disease in these patients?

Why can pathological migration

3 occur?
Determination What treatment is done for these
of Problems 4 patients?

5 How are the results of treatments?

Whether after treatment, the gingiva

6 returned to normal?

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 What is the diagnosis in this
1 scenario?
Chronic periododntitis
Are there bacteria that affect disease
2 in these patients?
Porphiromonas gingivalis (P.gingivais), Prevotella intermedia (P.intermedia),
Capnocytophaga, A.actinomycetemcomitans (A.a), Eikenella corrodens, Campylobacter
Why can pathological migration
rectus (C.rectus).

3 occur?
Brainstormin Because abnormalities have occurred in the periodontal tissues, and are an
early sign of periodontal disease.
What treatment is done for this

g 4 patient?
a. There are 2 non-surgical and surgical gimgival recession treatments
How are the results of
b. There are 3 phases, non-surgical, corrective, restorative
c. Scaling and root planning

5 treatments?
After gingival surgical treatment is grafted, the color of the gingiva is different,
it is not returned aesthetically
Whether after treatment, the gingiva
6 returned to normal?
Yes, after gingival surgical treatment is grafted, the color of the gingiva is different and
does not return aesthetically

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 Learning Objectives
An airplane to describe a structure or parts

Part 1
Students are able to know and explain
the classification of periodontitis.

Part 4

Part 2 Students are able to know and

explain the clinical features of
Students are able to chronic periodontitis.
know and explain the
diagnosis of the
disease from the Part 3
scenario.
Students are able to know and
explain the etiology of chronic
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periodontitis. thepopp.com
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 Learning Objectives
4 icons and items

Part 5 Part 6 Part 7 Part 8

Students are able to Students are able to Students are able to Students are able to
know and explain the know and explain the know and explain plans know and explain the
pathology of chronic prognosis of chronic for treatment of chronic evaluation of chronic
periodontitis. periodontitis. periodontitis. periodontitis.

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2

Deepening of the
material
 Classification of periodontitis.
2. Aggressive
2 images, captions and descriptions Periodontitis

1. Chronic General characteristics in patients with aggressive periodontitis:

Periodondontitis a. In general the clinical condition of the patient is healthy

b. attachment loss and rapid bone destruction

Common characteristics in patients with chronic periodontitis:
c. The number of microbial deposits is not consistent with the severity of the disease
a. More prevalence in adults but can occur in children
d. There are factors inherited from individuals
b. The amount of destruction is consistent with local factors
Common but not universal characteristics
c. Relate to microbial pattern variations
a. The disease is usually infected by Actinobacillus actinobacillus actinomycetemcomitans.
d. Subgingival calculus is often found
b. The normal function of phagocytes
e. Travel to a slow to moderate disease, but it is possible in some periods to run fast.
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c. Hyperresponsive macrophages, increased production of prostaglandin E2 (PGE2) and interleukin-1β

d. In some cases, the progression is self-arresting. thepopp.com

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Diagnosis of the disease from the scenario
1 image and description

Chronic periodontitis
Oral exams: no abnormalities

Intra oral examination:

1.Gingiva erythema

2. Pathological migration is on teeth 12 11

3. Cross bite on teeth 21

4. Dental obstruction 42

5. Mobility grade 2

6. Looks for trauma to the anterior occlusion

7. Gingival region recession 33-43

8. There is a periodontal pocket (true pocket) on the anterior regi with an average of 3-4 mm

9. The attachment level is 2 mm

10. Gingival lesions as high as 2 mm

11. Poor OHI-S score and 84% index plaque

Radiographic examination: visible bone damage reaches 1/3 cervix with a horizontal pattern

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 • Plaque accumulation and calculus (tartar) calcification above (supra) and / or below
(subgingiva) at the gingival border.

Organisms that cause chronic periodontitis, among others:

a. Porphiromonas gingivais (P.gingivais)

Etiology b. Prevotella intermedia (P.intermedia)

c. Capnocytophaga

d. A.actinomycetem comitans (A.a)

of chronic e. Eikenella corrodens

f. Campylobacter rectus (C.rectus)

periodonti
• Inflammatory reactions that begin with the presence of plaque associated with progressive
loss of the periodontal ligament and alveolar bone, and eventually mobility and tooth loss:

a. Gingival attachment of the teeth

tis
b. Periodontal membrane and alveolar bone are damaged.

c. An abnormal gap (pocket) that develops between the teeth and gingiva.

d.Debris and pocket produced by poet (pyorrhea)

Subjects tend to be vulnerable due to genetic and / or environmental factors such as:

a. Smoking

b. Polimorf interleukin-1 gene

c. Immune depression

d. Diabetes

e. Osteoporosis

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 Clinical features of chronic
periodontitis
2 images and description

Clinical signs and characteristics of chronic periodontitis:

a. Generally it occurs in adults but can also be seen in adolescents.
b. The amount of damage corresponds to the number of local factors.
c. Subgingival calculus is often found.
d. Related to microbial patterns
e. The speed of progression is slow but has a period of exacerbation and remission.
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f. Can be further classified based on the extent and severity. thepopp.com
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Pathology of chronic
periodontitis
4 steps

Inflammation of the gingiva for response to

First bacterial attacks

Host susceptibility factors play a role in the

process of periodontitis influenced by genetics,
Second environmental influences and behaviors such as
smoking, stress and diabetes

The stage of tissue destruction is the transition

Third stage of gingivitis to periodontitis when there is a
disturbance in the balance of the number of
bacteria with the host response

Collagen loss causes the apical epithelial cells

to proliferate along the root of the tooth and the
Fourth corona part of the fused epithelium detaches
from the tooth root

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Prognosis of chronic periodontitis

The prognosis is moderate.

Because in chronic periodontitis the characteristics of bone support

remain inadequate, teeth are less mobility, and furcation lesions

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 Treatment of chronic periodontitis
3 columns

Phase I
Initial therapeutic phase

Phase II
Corrective therapeutic phase

Phase III
Maintenance therapy phase

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 Evaluation of chronic
periodontitis.
A windmill for a looping process

The success of periodontal therapy

depends on negative environmental
management and habitual factors and
reduction of pathogenic bacteria
Through a better combination of
environmental returns, the
atmosphere is less anaerobic.
Various treatment methods,
including mechanical
instrumentation, ultrasonic
debridement, supragingival
irrigation, subgingival irrigation,
local administration of drugs,
systemic antibiotics, and host
response modulation

Non-surgical periodontal treatment

measures and methods that can be
done to achieve the success of
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Life can only be understood backwards;
but it must be lived forwards.
Thank You for Watching!
Any Questions?