Gasner Noah S., Schure Ryan S.
University of Toronto
Faculty of Dentistry, University of Toronto
Periodontal disease refers to a group of conditions that affect the periodontium, the supporting structures of the teeth, including the gingiva, alveolar bone, cementum, and periodontal ligament. Early detection and timely management are essential to prevent long-term complications. Gingivitis is the mildest form of periodontal disease, affecting up to 90% of the population. Gingivitis is characterized by inflammation of the gingiva caused by the accumulation of bacteria and debris along the gum line, leading to the formation of dental plaque. This condition is reversible with improved oral hygiene. However, if left untreated, gingivitis can progress to periodontitis. Periodontitis is a chronic inflammatory disease that progressively damages the periodontal tissues. The hallmark feature of the condition is the apical migration of the junctional epithelium, which leads to loss of attachment and the formation of periodontal pockets. As bacteria penetrate deeper into the tissues, the body activates an immune response to fight the infection. However, this defense mechanism unintentionally contributes to the destruction of the periodontium. As periodontitis progresses, it causes continued attachment loss, alveolar bone resorption, and, in severe cases, tooth loss. In 2017, the American Academy of Periodontology introduced an updated classification system for periodontal and peri-implant diseases in collaboration with the European Federation of Periodontology. This system categorizes periodontitis into 3 main forms: Periodontitis. Periodontitis as a manifestation of systemic diseases. Necrotizing periodontal disease. Necrotizing periodontal disease is a severe and rapidly progressing form of periodontitis that primarily affects immunocompromised individuals, such as those with HIV. This condition is characterized by severe gingival necrosis, interproximal tissue destruction, spontaneous bleeding, and intense pain. This form of periodontal disease requires urgent intervention due to its rapid progression and significant tissue damage.
牙周病是指影响牙周组织（牙齿的支持结构，包括牙龈、牙槽骨、牙骨质和牙周韧带）的一组病症。早期检测和及时治疗对于预防长期并发症至关重要。牙龈炎是牙周病最轻微的形式，影响高达90%的人口。牙龈炎的特征是牙龈线处细菌和碎屑积聚导致牙龈发炎，进而形成牙菌斑。通过改善口腔卫生，这种情况是可逆的。然而，如果不进行治疗，牙龈炎可能会发展为牙周炎。牙周炎是一种慢性炎症性疾病，会逐渐损害牙周组织。该病症的标志性特征是结合上皮向根尖迁移，这会导致附着丧失和牙周袋形成。随着细菌深入组织，身体会激活免疫反应来对抗感染。然而，这种防御机制无意中会导致牙周组织的破坏。随着牙周炎的进展，它会导致持续的附着丧失、牙槽骨吸收，严重时还会导致牙齿脱落。2017年，美国牙周病学会与欧洲牙周病学联合会合作推出了牙周病和种植体周围疾病的更新分类系统。该系统将牙周炎分为3种主要形式：牙周炎。作为全身性疾病表现的牙周炎。坏死性牙周病。坏死性牙周病是一种严重且进展迅速的牙周炎形式，主要影响免疫功能低下的个体，如艾滋病毒感染者。这种病症的特征是严重的牙龈坏死、邻面组织破坏、自发性出血和剧痛。由于其快速进展和严重的组织损伤，这种形式的牙周病需要紧急干预。
