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Periodontal disease in children

Periodontal disease in children. 1 Periodontal diseases. Comprise a group of infections that affect the supporting structures of the teeth. Periodontal tissue. Gingiva Periodontal ligament Cementum Alveolar bone. 2 Anatomy of the periodontium in children. 2.1 Gingiva.

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Periodontal disease in children

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  1. Periodontal disease in children

  2. 1 Periodontal diseases • Comprise a group of infections that affect the supporting structures of the teeth

  3. Periodontal tissue • Gingiva • Periodontal ligament • Cementum • Alveolar bone

  4. 2 Anatomy of the periodontium in children

  5. 2.1 Gingiva • Marginal gingiva • Attached gingiva • Junctional epithelium

  6. More highly vascular and fewer connective tissue fibres The epithelia are thinner, lesser degree of keratinization 2.1.1 Marginal Gingiva

  7. 2.1.1 Marginal Gingiva • Clinical significance 1) Giving an appearance of increased redness 2) It’s easy for marginal gingiva to be affected

  8. 2.1.2 Attachedgingiva • Maintain the sulcus depth • Resist the functional stress during mastication • Resist the tensional stress between the gingival margin and the alveolar mucosa

  9. The width is less variable in the primary dentition Significance: less mucogingival problem in the primary dentition 2.1.2 Attached gingiva

  10. During eruption of the teeth When the teeth are fully erupted Stability of the gingiva 2.1.3 Junctional epithelium

  11. What happens During eruption of the teeth? • Migrate apically

  12. There continue to be an apical shift when the teeth are fully erupted

  13. Clinical significance: Frequently at different levels Sometimes gives an erroneous appearance 2.1.3 Junctional epithelium

  14. Stability is achieved at 12 years for 1 2 3 5 6, • 16 years for the other teeth

  15. 2.2.Periodontal ligament • Periodontal ligament space is wider in children • Is less fibrous and more vascular

  16. 2.3 Cementum • Thinner 2.4 Alveolar bone • Thinner cortical plates(皮质层） • Larger marrow spaces（骨髓腔） • Greater vascularity • Fewer trabeculae

  17. Clinical significance • Enhance the rate of progression of periodontal disease

  18. 3 A classification of periodontal disease in children

  19. Gingival conditions Periodontal conditions without with loss of connective tissue attachment

  20. 3.1Gingival conditions • Acute gingivitis • Chronic gingivitis • Gingival overgrowth • Factitious（自伤性）gingivitis • Mucogingival problems

  21. 3.2 Periodontal conditions • Chronic periodontitis • Early-onset periodontitis • Prepubertal（青春期前的）periodontitis associated with systemic disease

  22. Gingival conditions withoutloss of connective tissue attachment Periodontal conditions withloss of connective tissue attachment A classification of periodontal disease in children

  23. 3.1Gingival conditions • Acute gingivitis • Chronic gingivitis • Gingival overgrowth • Factitious gingivitis • Mucogingival problems

  24. 4 Acute gingivitis • 4.1 Primary herpetic gingivostomatitis（原发性疱疹性龈口炎） • 4.2 Necrotizing ulcerative gingivitis（坏死性溃疡性龈炎）

  25. 5 Chronic gingivitis • Plaque induced • Puberty gingivitis

  26. Acute gingivitis • Chronic gingivitis • Gingival overgrowth • Factitious gingivitis • Mucogingival problems

  27. 4.1 Primary herpetic gingivostomatitis

  28. Definition Clinical features Pathogeny Course Diagnosis Transimission Treatment Prevalence

  29. An acute infectious disease of the gingiva caused by the herpesvirus

  30. Pathogeny: • Herpes simplex viruses (HSVs) （单纯疱疹病毒） Two types exist: type 1 (HSV-1) type 2 (HSV-2)

  31. Type-1 Gingivostomatitis • Type-2 Genitalia（生殖器）

  32. Transmission HSV-1: chiefly by contact with infected saliva HSV-2: from a mother's genital tract infection to her newborn

  33. Prevalence • HSV infection appears to have increased worldwide in the last 2 decades, making it a major public health concern.

  34. HSV infections are asympto- matic in as many as 80% of patients

  35. Symptomatic infections may be characterized by significant morbidity and recurrence

  36. Clinical features • 1) Age: 6 months to 3years • 2) Incubation period(潜伏期): 1 week

  37. 3) Prodrome: a febrile（发烧的） illness b headache, malaise, oral pain, mild dysphagia（吞咽困难） c cervical lymphadenopathy （淋巴结病）

  38. 4) Symptom • a Gingivitis • bVesicular lesions

  39. a Gingivitis • Gingivitis is the most striking feature • With markedly swollen, erythe-matous, friable gums

  40. Viral infections of the mouth. Note the redness around the marginal gingiva

  41. b. Vesicular lesions Site: Oral cavity Perioral skin

  42. Characteristic, fluid-filled vesicles rupture and coalesce yellowish, painful ulcers Progress:

  43. Prognosis • Oral lesions heal without scarring

  44. Infection of skin • Feel an itch, burning and tumid • Vesicle

  45. Clinical features • Age • Incubation period • Prodrome • Symptom

  46. Course • Acute disease lasts 5-7 days • Symptoms subside in 2 weeks • Viral shedding from the saliva may continue for 3 weeks or more

  47. Diagnosis • Clinical features • History • Age

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