Post on 27-Oct-2014
description
Chronic periodontitis
Diego Halabí RoblesPrograma de Doctorado en Ciencias Médicas
Unversidad Austral de Chile
Periodontitis
Highfield, 2009
Chronic periodontitis
Clinical
Highfield, 2009 Corbet, 2009
Epidemiology
93.4%35 to 44 years old
97.5%65 to 74 years old
38.6%35 to 44 years old
69.3%65 to 74 years old
>6 mm
>3 mm
Gamonal et al., 2010
Microbiology
Red complex: P. gingivalis, T. denticola and T. forsythia
Silva et al., 2008
Immunology
Periodontitis
IL-1β
TNF-α
Biofilm
(Mörmann et al., 2008)
(Zappa et al., 1991)
Zappa, U. et al., 1991
Kaushik, R., Yeltiwar, R.K. & Pushpanshu, K., 2011. Salivary interleukin-1β levels in patients with chronic periodontitis before and after periodontal phase I therapy and healthy controls: a case-control study . Journal of periodontology, 82(9), pp.1353-9.
CD4+/CD8+ ratios
Th17
Periodontitis
IL-1β
TNF-α
Biofilm
IL-17
RANKL
TFG-β
IL-6
IL-23
Th17
↑RORC2
Th1/Th17
Periodontitis
IL-1β
TNF-α
Biofilm
IL-17
RANKL
TFG-β
IL-6
IL-23
Th17
↑RORC2
IL-12
Th1
↑ T-bet
IL-1β
IFN-γ
Th17, Th1 and Treg
Periodontitis
IL-1β
TNF-αBiofilm
IL-17
RANKL
TFG-β
IL-6
IL-23
Th17
↑RORC2
IL-12Th1
↑ T-bet
IL-1β
IFN-γTFG-β
TregCTLA-4
TGF-β1
IL-10
diegohalabi@gmail.com
↑Foxp3
TherapyPatient
Chronic periodontitis Health
Oral health instruction Plaque control Supragingival debridement Subgingival debridement Reevaluation
Chronic periodontitis
Chronic periodontitis
Antibiotics (amoxicillin + Metronidazole)
Chlorhexidine 0.05% per 3 months
Reevaluation
Oral health instruction
References• Corbet, E., 2009. Radiographs in periodontal disease diagnosis and management. Australian
dental journal, 54 Suppl 1, pp.S27–43.• Dutzan N, Gamonal J, Silva A, Sanz M, Vernal R (2009). Over-expression of forkhead box P3 and
its association with receptor activator of nuclear factor-kappa B ligand, interleukin (IL) -17, IL-10 and transforming growth factor-beta during the progression of chronic periodontitis. J Clin Periodontol 36:396-403.
• Gamonal, J. et al., 2010. Clinical attachment loss in Chilean adult population: First Chilean National Dental Examination Survey. Journal of periodontology, 81(10), pp.1403–10.
• Hernández, M. et al., 2011. Host-pathogen interactions in progressive chronic periodontitis. Journal of dental research, 90(10), pp.1164–70.
• Highfield, J., 2009. Diagnosis and classification of periodontal disease. Australian dental journal, 54 Suppl 1, pp.S11–26.
• Silva, N. et al., 2008. Characterization of progressive periodontal lesions in chronic periodontitis patients: levels of chemokines, cytokines, matrix metalloproteinase-13, periodontal pathogens and inflammatory cells. Journal of clinical periodontology, 35(3), pp.206–14.
• Zappa, U. et al., 1991. Cell populations and episodic periodontal attachment loss in humans. Journal of clinical periodontology, 18(7), pp.508–15.