Chronic Periodontitis Case Study

Being the most prevalent form of periodontitis, chronic periodontitis is defined as “an inflammatory disease of the supporting tissue of the teeth caused by specific microorganisms, resulting in progressive destruction of the supporting structures of the teeth.”1 It is most prevalent in elderly patients with the presence of causative factors such as calculus, plaques, associated systemic conditions, smoking and overhanging restorations.2 Clinically, chronic periodontitis is often associated with a decrease in bone level, decrease in periodontal attachment level and loss of stippling effect of the healthy gingival, periodontal pockets formation and gingival inflammation. As chronic periodontitis may be asymptomatic with the gingival appearing healthy despite the presence of ongoing underlying infection, patients may be totally unaware of the existence of the condition and continue assuming that their gingival health is good.3 This makes it particularly difficult for the patient to accept treatment, further contributing to the progression of the disease. Because plaques and calculus are the primary initiating factors in gingivitis and periodontitis, plaque retentive factors are notably important in the development of
Generally, there would be come areas which are advancing faster than the rest while some areas remain dormant or static over a long period of time.7 According to Novak et al, the interproximal areas has the most rapidly progressive lesion. This could be due to inaccessibility to brushing as well as higher plaque accumulation if proper plaque removal technique such as flossing or interproximal brushing are not properly executed.8 To further complicate matters, chronic periodontitis is a disease with periods of remission and exacerbation.9 This means that the activity of chronic periodontitis is fluctuating with no constant rate of