PEDIATRIC PERIODONTAL CONDITIONS T L A N C EL A N C EPediatric Periodontal Conditions Normal Gingival Diseases & Conditions Periodontitis Systemic Conditions Chronic Pericoronitis

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RR I C H A R D I C H A R D YY O O NO O N 11

PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©

Pediatric Periodontal ConditionsPediatric Periodontal Conditions

NormalNormal Gingival Diseases & ConditionsGingival Diseases & Conditions PeriodontitisPeriodontitis Systemic ConditionsSystemic Conditions

ChronicChronic

PericoronitisPericoronitis

ANUGANUG

FibromatosisFibromatosis

RecessionRecession

EOPEOP PrepubertalPrepubertal

LocalLocal GeneralizedGeneralized

Six ZonesSix Zones EruptionEruption

ActiveActive PassivePassive

HypophosphatasiaHypophosphatasia

Cyclic Cyclic NeutropeniaNeutropenia

LeukemiaLeukemia

PapillonPapillon--LeFevreLeFevre

HystiocytosisHystiocytosis XX

AcrodyniaAcrodynia

RicketsRickets

DMDM

DownDown

AA T T AA GG L A N C EL A N C E



Normal FindingsNormal Findings

GingivitisGingivitis

PeriodontitisPeriodontitis

Systemic ConditionsSystemic Conditions

S S I XI X C C O M P O N E N T SO M P O N E N T S

Papillary Papillary GingivaGingiva

Marginal Marginal GingivaGingiva

Attached Attached GingivaGingiva

Alveolar MucosaAlveolar Mucosa

Periodontal LigamentPeriodontal Ligament

Alveolar BoneAlveolar Bone




PPAPILLARYAPILLARY GGINGIVAINGIVAMMARGINAL ARGINAL GGINGIVAINGIVAAATTACHED TTACHED GGINGIVAINGIVAAALVEOLAR LVEOLAR MMUCOSAUCOSA

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Alveolar BoneAlveolar BonePDLPDLAlveolar MucosaAlveolar MucosaAttached Attached GingivaGingivaMarginal Marginal GingivaGingivaPapillary Papillary GingivaGingiva


InterdentalInterdental ColColInterdentalInterdental SaddleSaddle



I I N T E R D E N T A LN T E R D E N T A L C C O LO L

IINTERDENTALNTERDENTAL CCOLOL

IINTERPROXIMALNTERPROXIMAL CCONTACTONTACT



7 8D E

I I N T E R D E N T A L N T E R D E N T A L SS A D D L EA D D L E

IINTERPROXIMALNTERPROXIMAL CCONTACTONTACT

IINTERDENTALNTERDENTAL CCOLOL

SSADDLEADDLE

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Gingival Gingival sulcussulcus + free gingival margin.+ free gingival margin.Thicker and rounder.Thicker and rounder.Flaccid and retractable.Flaccid and retractable.



M M A R G I N A LA R G I N A L G G I N G I V AI N G I V A

GGINGIVALINGIVAL SSULCUSULCUS

FFREEREE GGINGIVALINGIVAL MMARGINARGIN



7 8D E

M M A R G I N A LA R G I N A L G G I N G I V AI N G I V A

RROUNDEDOUNDEDKKNIFENIFE--EDGEDEDGED

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Base of Base of sulcussulcus to the to the mucogingivalmucogingival line.line.

InterdentalInterdental cleftcleft

RetrocuspidRetrocuspid papillapapilla



I I N T E R D E N T A LN T E R D E N T A L C C L E F TL E F T

CCLEFTLEFT



R R E T R O C U S P I DE T R O C U S P I D P P A P I L L A A P I L L A

RRETROCUSPIDETROCUSPID PPAPILLAAPILLA

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PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©A A T T A C H E DT T A C H E D G G I N G I V A I N G I V A



Alveolar BoneAlveolar BonePDLPDLAlveolarAlveolar MucosaMucosaAttached Attached GingivaGingivaMarginal Marginal GingivaGingivaPapillary Papillary GingivaGingiva


KeratinKeratin

Thin epitheliumThin epithelium

Width Width ↑↑’’ss



A A L V E O L A RL V E O L A R M M U C O S AU C O S A

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WiderWider

Less denseLess dense

Less calcifiedLess calcified

Larger marrow spacesLarger marrow spaces



P P E R I O D O N T A LE R I O D O N T A L L L I G A M E N TI G A M E N T



P P E R I O D O N T A LE R I O D O N T A L L L I G A M E N TI G A M E N T

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I I N F L U E N C EN F L U E N C E O O FF T T O O T HO O T H E E R U P T I O NR U P T I O N

ActiveActive

PassivePassive



A A C T I V EC T I V E E E R U P T I O NR U P T I O N

Contact with functional antagonist.Contact with functional antagonist.



P P A S S I V EA S S I V E E E R U P T I O NR U P T I O N

SulcularSulcular epithelium epithelium ∆∆’’ss in position.in position.

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P P A S S I V EA S S I V E E E R U P T I O NR U P T I O N





ChronicChronic


ANUGANUG


RecessionRecession







LeukemiaLeukemia



AcrodyniaAcrodynia

RicketsRickets

DMDM

DownDown








Chronic Chronic

ANUGANUG

FibromatosisFibromatosis & Hyperplasia& Hyperplasia

RecessionRecession

C C L A S S I F I C A T I O NL A S S I F I C A T I O N


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FF E A T U R E SE A T U R E S





Inflammation Inflammation

Loss of Attachment Loss of Attachment

Bone Loss Bone Loss

Reversible Reversible

Prevalence Prevalence



E E R U P T I O NR U P T I O N G G I N G I V I T I SI N G I V I T I S



P P U B E R T YU B E R T Y G G I N G I V I T I SI N G I V I T I S

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P P R E G N A N C YR E G N A N C Y G G I N G I V I T I SI N G I V I T I S



EE T I O L O G YT I O L O G Y





Bacterial Plaque Bacterial Plaque

Species Species

Other Factors Other Factors



EE T I O L O G Y : T I O L O G Y : OO T H E R T H E R FF A C T O R SA C T O R S

BacterialBacterialViralViralFungalFungalDiet, NutritionDiet, NutritionMedicationsMedications

EndocrineEndocrineHereditaryHereditaryChronic IllnessChronic Illness

SystemicSystemic

CalculusCalculusAppliancesAppliancesOral HabitsOral HabitsMouthbreathingMouthbreathing

Eruption/ExfoliationEruption/ExfoliationMalocclusionMalocclusionCariesCaries

LocalLocalExtrinsicExtrinsicIntrinsicIntrinsicFactorsFactors

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G G I N G I V I T I SI N G I V I T I S


RecessionRecession

FibromatosisFibromatosis && HyperplasiaHyperplasia

AcuteAcute NecrotizingNecrotizing UlcerativeUlcerative

ChronicChronic





RecessionRecession



ChronicChronic




RecessionRecession



ChronicChronic


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RecessionRecession



ChronicChronic



A A N U GN U G



A A N U GN U G

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PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©G G I N G I V I T I SI N G I V I T I S


RecessionRecession


Acute Necrotizing UlcerativeAcute Necrotizing Ulcerative

ChronicChronic


PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©G G I N G I V A L I N G I V A L FF I B R O M A T O S I SI B R O M A T O S I S



PP H E N Y T O I NH E N Y T O I N

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CC Y C L O S P O R I NY C L O S P O R I N





RecessionRecession


Acute Necrotizing UlcerativeAcute Necrotizing Ulcerative

ChronicChronic


PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©C C R O S S B I T ER O S S B I T E

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PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©C C R O S S B I T ER O S S B I T E



H H I G HI G H F F R E N U MR E N U M




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ChronicChronic


ANUGANUG


RecessionRecession







LeukemiaLeukemia



AcrodyniaAcrodynia

RicketsRickets

DMDM

DownDown








C C L A S S I F I C A T I O NL A S S I F I C A T I O N

Early Onset Early Onset

PrepubertalPrepubertal

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F F E A T U R E SE A T U R E S

Loss of Gingival Attachment Loss of Gingival Attachment

Loss of Bony Support Loss of Bony Support


PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©P P R E P U B E R T A LR E P U B E R T A L P P E R I O D O N T I T I SE R I O D O N T I T I S

LocalizedLocalizedGeneralizedGeneralized


PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©P P R E P U B E R T A LR E P U B E R T A L P P E R I O D O N T I T I SE R I O D O N T I T I S

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P P R E P U B E R T A LR E P U B E R T A L P P E R I O D O N T I T I SE R I O D O N T I T I S



E E A R L YA R L Y O O N S E TN S E T P P E R I O D O N T I T I SE R I O D O N T I T I S

Generalized Juvenile Generalized Juvenile PeriodontitisPeriodontitis

Incidental Juvenile Incidental Juvenile PeriodontitisPeriodontitis

Localized Juvenile Localized Juvenile PeriodontitisPeriodontitis




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ChronicChronic


ANUGANUG


RecessionRecession







LeukemiaLeukemia



AcrodyniaAcrodynia

RicketsRickets

DMDM

DownDown


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Leukemia Leukemia

PapillonPapillon--LeFLeFéévrevre

HistiocytosisHistiocytosis X X

Down Down


PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©S S Y S T E M I CY S T E M I C C C O N D I T I O N SO N D I T I O N S

DownDownHistiocytosisHistiocytosis XXPapillonPapillon--LeFLeFéévrevreLeukemiaLeukemiaCyclic Cyclic NeutropeniaNeutropeniaHypophosphatasiaHypophosphatasia Genetic DisorderGenetic Disorder

Premature Loss Premature Loss

Deficient Alkaline Deficient Alkaline PhosphatasePhosphatase

Permanent DentitionPermanent Dentition


PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©H H Y P O P H O S P H A T A S I AY P O P H O S P H A T A S I A

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PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©H H Y P O P H O S P H A T A S I AY P O P H O S P H A T A S I A



DownDownHistiocytosisHistiocytosis XXPapillonPapillon--LeFLeFéévrevreLeukemiaLeukemiaCyclic Cyclic NeutropeniaNeutropeniaHypophosphatasiaHypophosphatasia

S S Y S T E M I CY S T E M I C C C O N D I T I O N SO N D I T I O N S

Rhythmic reductionRhythmic reduction

21 day cycles21 day cycles


PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©C Y C L I C N E U T R O P E N I AC Y C L I C N E U T R O P E N I A

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DownDownHistiocytosisHistiocytosis XXPapillonPapillon--LeFLeFéévrevreLeukemiaLeukemiaCyclic Cyclic NeutropeniaNeutropeniaHypophosphatasiaHypophosphatasia Gingival enlargementGingival enlargement



PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©L L E U K E M I AE U K E M I A





Hyperkeratosis

Premature loss of 1º & 2º

A.A.

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PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©P P A P I L L O NA P I L L O N –– L L E F E F ÉÉ V R EV R E





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Necrotic gingivitis

Bony loss of the molars

Radiolucent lesions


PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©H H Y S T I O C Y T O S I SY S T I O C Y T O S I S XX


PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©H H Y S T I O C Y T O S I SY S T I O C Y T O S I S XX

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PPEDIATRICEDIATRIC PPERIODONTALERIODONTAL CCONDITIONSONDITIONS ©S S Y S T E M I CY S T E M I C C C O N D I T I O N SO N D I T I O N S

TrisomyTrisomy 21 21




T T R I S O M YR I S O M Y 2 12 1



T T R I S O M YR I S O M Y 2 12 1

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ChronicChronic


ANUGANUG


RecessionRecession







LeukemiaLeukemia



AcrodyniaAcrodynia

RicketsRickets

DMDM

DownDown


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PEDIATRIC PERIODONTAL CONDITIONS T L A N C EL A N C EPediatric Periodontal Conditions Normal Gingival Diseases & Conditions Periodontitis Systemic Conditions Chronic Pericoronitis