?????????????(1999) ?. ??? (gingival diseases) ?. ????? (chronic periodontitis)

1
?????
2
?????????????(1999) ?. ??? (gingival
diseases) ?. ????? (chronic
periodontitis) ?. ?????? (aggressive
periodontitis) ?. ??????????
(periodontitis as a manifestation of
systemic diseases) (?????) ?. ??????
(necrotizing periodontal diseases) ?. ????
(abscesses of the periodontium) ?.????????
(periodontitis associated with
endodontic lesions) ???? ?. ???????????
(developmental or acquired
deformities and conditions)
3
?????
????? Chronic Periodontitis, CP ???
4
?????Chronic Periodontitis(????? adult
periodontitis, AP)(??????? chronic adult
periodontitis, CAP)
??????????????????????,??????????????????????
???????????????????????????????????
5
?????????(Etiology of Chronic Periodontitis)
?????????? (?????????)
? ?

• ?
• ?
• ?

???????,?????
6
????????????????      ??????,???????????,
        ????????????????,?????
?????????????,          ??????????????,
??????????,????????, ??????,?????????,?????
??????????    
7
???????
??????????????????????????????????,??????????
?????,??????????30????,???30???????????
8
???????
?????????????????????? ???????4mm,????12mm,X???
? ???????????1/3?
9
???????
??????? 6mm,????35mm,X???? ????????????????1/3,
???? ???1/2???????,????????? ?????
gt6mm,????5mm,X?????????????1/2,?????????,??????
10
??????????
1.??? gt 3 mm,????,?????? 2.?????? 3.????????? 4.?
???????????? 5.????????
11
????

• ?????
• ????
• ???????????
• ????
• ??????
• ???????
• ??

12
??????????-1
????????(removal of causative factors) 1.??????,?
??????????????????(????????????,???????)
2.????, ????/?????
13
??????????-2
??????(motivated plaque control) ????????,???????
??,??????????,?????????? ?3-6????????????? ?????
?????????????
14
??????????-3
??????????(chemotherapeutic therapy) 1.??????????
,?????? 2.?????????????,????????????,??????,??????
????????

15
??????????-4
????(Surgical therapy) ????? 23???,?????,??? 5
mm??????,??????????????,????,??????????,
16
??????????-5

• ??????? ??
• (Restore of balanced occlusion)
• ???????,????????????????????????,???????????

17
??????????-6?7?8
??(Tooth extraction)?????? ?????? ( Elimination
/ correction of risk factors) ?????????????? ????
?????? (Supportive Periodontal Therapy in
Maintenance Phase)
18
???????

• ???????????????????????,?????????????????????????
  ??????,??????????????

19
?????????????(1999) 1999
international workshop for a classification of
periodontal diseases and
conditions ?. ??? (gingival diseases)
?. ????? (chronic periodontitis) ?. ??????
(aggressive periodontitis) ?. ??????????
(periodontitis as a manifestation of
systemic diseases) ?. ?????? (necrotizing
periodontal diseases) ?. ???? (abscesses of
the periodontium) ?.????????? (periodontitis
associated with endodontic
lesions) ?. ??????????? (developmental or
acquired deformities and conditions)
20
?????? ??????????????(???????????)???????????????
????????
21
?????? ????????? Localized Aggressive
Periodontitis ????????? GeneralizedAggressive
Periodontitis
22
??????
????(Clinical Features) 1.
???????????,(rapid periodontal destruction)
?CP?3-4?,4-5?,60-70?? 2. ?????(age and gender)
,???(???-35 ?),????? 3. ??????(oral
hygiene)????????? ???????????
23
??????
????(Clinical Features) 4.
????(tooth-specificity) 5.??????????,????(????
????)????? 6.?????family aggregation 7.
????(systemic conditions)??????,?????????,???????
???????(?)??????????
24
??????

• ???????????????????
• ???????(A.a)????,?????????????(P.g)??????
• ?????????,??PGE2?IL-1?????
• ????????????????

25
??????
????????????????,??????X?????????,?????????,??????
???? ????????????
26
??????
????????? Localized Aggressive Periodontitis
??????? ????(A. a)??????????
??????????,???? ?????????????
27
??????
????????? Generalized Aggressive
Periodontitis ?????30????,??????????
????????????? ?????????????????
?????????,????3??????? ????
28
??????????

• 1. ????,????
• (early treatment and prevention of recurrence)
• 2. ???????(antimicrobial therapy)
• 3.????????
• (host modulatory therapy)
• 4.????(comprehensive treatment)

29
??????????

• ????????????????????????????
• 1.?????????????????????,????,????,?????
• 2.????????

• 3.????????
• 4.????????????,????????????????????????????????
• 5.????,????(3??)?
• 6.????,??????,???????

30
??????????

• 7.??????,????????
• 8.???????????????????????????????
• 9.????????????????????????????,??????????????,????
  ???????????????