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Role of Systemic Diseases in the Etiology of Periodontal Diseases

Role of Systemic Diseases in the Etiology of Periodontal Diseases. By Hani S. AlMoharib. Outline. Endocrine Disorders: - Diabets Mellitus. Hematologic Disorders: - Anemia. - Leukemia. Genetic Disorders: - Down Syndrome. - Papillon-Lefevre Syndrome. Hormonal Changes:

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Role of Systemic Diseases in the Etiology of Periodontal Diseases

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  1. Role of Systemic Diseases in the Etiology of Periodontal Diseases ByHani S. AlMoharib

  2. Outline • Endocrine Disorders: - Diabets Mellitus. • Hematologic Disorders: - Anemia.- Leukemia. • Genetic Disorders: - Down Syndrome. - Papillon-Lefevre Syndrome. • Hormonal Changes: - Female Sex Hormones.

  3. Introduction • Many systemic diseases, disorders, and conditions have been implicated as risk factors in periodontal disease. • Systemic diseases have several effects that includes: • Physiological response. • Vascular system. • Inflammatory response. • Immune system. • Tissue repair.

  4. Outline • Endocrine Disorders and Hormonal Changes: - Diabets Mellitus. • Hematologic Disorders: - Anemia.- Leukemia. • Genetic Disorders: - Down Syndrome. - Papillon-Lefevre Syndrome. • Hormonal Changes: - Female Sex Hormones.

  5. Diabetes Mellitus

  6. What is Diabetes Mellitus?

  7. Diabetes Mellitus • It is a complex metabolic disorder characterized by chronic hyperglycemia. • DM may either diminish insulin production, impair insulin action, or combination of both. • This result in inability of glucose to be transported from blood stream into tissues.

  8. What are the types of DM?

  9. Diabetes Mellitus • Insulin-dependent DM (IDDM-Type I): • Caused by cell-mediated autoimmune destruction of the insulin-producing beta cells of the islets of Langerhans in the pancreas. • This results in a lack of insulin production. • Age? • Occurs in children and young adults. • Precentage? • 5-10% of DM cases.

  10. Diabetes Mellitus • Non-insulin-dependent DM (NIDDM-Type II): • Caused by: • Peripheral resistance to insulin action. • Impaired insulin secretion. • Increased glucose production by liver. • Usually has an adult onset. • 90-95% of DM cases.

  11. What are the symptoms of DM?

  12. Diabetes Mellitus • Typical signs and symptoms include: • Polydipsia. • Polyphagia. • Polyuria. • Pruritus. • Weakness and fatigue.

  13. What are the complications of uncontrolled DM?

  14. Diabetes Mellitus • Uncontrolled DM complications includes: • Microvascular diseases: Retinopathy, nephropathy, or neuropathy. • Macrovascular diseases: Cardiovascular or cerebrovascular. • Increased susceptibility to infections. • Poor wound healing.

  15. What are the Oral manifestations of DM?

  16. Diabetes Mellitus • Oral changes in diabetic patient includes: • Cheilosis. • Mucosal drying and cracking. • Burning mouth and tongue. • Diminshed salivary flow. • Alterations in the flora of the oral cavity. • Increased rate of dental caries. • These changes are less likely to be observed in well-controlled diabetic patients.

  17. What are the manifestations of DM on periodontium?

  18. Diabetes Mellitus • Changes of DM on periodontium includes: • Tendency toward enlarged gingiva.

  19. Diabetes Mellitus • Changes of DM on periodontium includes: • Sessile or pedunculated gingival polyps. • Polypoid gingival proliferations. • Abscess formation.

  20. Diabetes Mellitus • Changes of DM on periodontium includes: • Periodontitis.

  21. How does DM effects the periodontium?

  22. Diabetes Mellitus • Bacterial Pathogens: • Glucose content of gingival fluid is higher in diabetic patient. • This increase change the environment of the microflora. • This induce qualitative changes in bacteria and severity of disease.

  23. Diabetes Mellitus • Polymorphonuclear Leukocyte Function: • DM results in: • Impaired chemotaxis. • Defective phagocytosis. • Impaired adherence. • This leads to increased susceptibility to infections.

  24. Diabetes Mellitus • Altered Collagen Metabolism: • Chronic hyperglycemia adversely affects the synthesis, maturation, and maintenance of collagen and extracellular matrix. • As a result, collagen in the tissues of DM patients are more susceptible to pathogenic breakdown. • This also will affect vascularity, in such:

  25. Outline • Endocrine Disorders and Hormonal Changes: - Diabets Mellitus. • Hematologic Disorders: - Anemia.- Leukemia. • Genetic Disorders: - Down Syndrome. - Papillon-Lefevre Syndrome. • Hormonal Changes: - Female Sex Hormones.

  26. Anemia

  27. What is Anemia?

  28. Anemia • Anemia is reduction in the number of erythrocytes and in the amount of hemoglobin. • Anemia results in poor tissue oxygenation, making tissues more friable and susceptible to breakdown. • Anemia results from: • Extensive blood loss. • Defective blood formation. • Increased RBC destruction.

  29. What are the oral manifestations of Anemia?

  30. Anemia • The tongue appears red, smooth, and shiny because of atrophy of the papillae. • There is also marked pallor of the gingiva.

  31. Leukemia

  32. What is Leukemia?

  33. Leukemia • Leukemias are malignant neoplasias of WBC precursors. • Leukemia is characterized by: • Diffuse replacement of the bone marrow with proliferating leukemic cells. • Abnormal numbers and forms of immature WBCs in the circulating blood. • Widespread infiltrates in the liver, spleen, lymph nodes, and other body sites. • This leads to anemia, leukopenia and thrombocytopenia.

  34. What are the effects of Leukemia on periodontium?

  35. Leukemia • Leukemic gingival enlargement: • Caused by infiltration of gingiva by leukemic cells.

  36. Do we have Leukemic Gingival Enlargement on edentulous patients?

  37. Leukemia • Bleeding: • Spontaneous gingival hemorrhage can be an early sign of leukemia. • It is caused by the thrombocytopenia.

  38. Leukemia • Oral Infection: • Granulocytopenia (diminished WBC count) results from the displacement of normal bone marrow cells by leukemic cells. • This increases the host susceptibility to opportunistic microorganisms and leads to ulcerations and infections.

  39. Leukemia • Oral Infection:

  40. Leukemia • Oral Ulceration: • These lesions occur in sites of trauma such as the buccal mucosa in relation to the line of occlusion or on the palate.

  41. Outline • Endocrine Disorders and Hormonal Changes: - Diabets Mellitus. • Hematologic Disorders: - Anemia.- Leukemia. • Genetic Disorders: - Down Syndrome. - Papillon-Lefevre Syndrome. • Hormonal Changes: - Female Sex Hormones.

  42. Down Syndrome

  43. What is Down Syndrome?

  44. Down Syndrome • Down syndrome is a congenital disease caused by a chromosomal abnormality. • Characterized by mental deficiency and growth retardation. • Almost 100% of patients have periodontal diseases.

  45. What is the effect of Down Syndrome on periodontium?

  46. Down Syndrome • Periodontal condition characterized by deep pockets with substantial local factors and moderate recessions. • The disease progresses rapidly because of: • Poor PMN chemotaxis. • Deficient phagocytosis. • Intercellular killing.

  47. Down Syndrome

  48. Papillon-Lefevre Syndrome

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