Hygiene Atlas

Atlas · Plate X · Periodontology · 02

Etiology and pathogenesis

Plaque biofilm starts gingivitis and periodontitis, but most tissue breakdown comes from the host's own response, through enzymes and mediators such as MMPs, IL-1, TNF-alpha and PGE2. Smoking is the strongest modifiable risk factor and diabetes roughly triples risk. Local factors like calculus, overhangs and open contacts help biofilm stay in place.

High-yield facts · 8

  1. Plaque biofilm is the primary cause of gingivitis and periodontitis; the host response causes most of the tissue destruction.S38
  2. Page and Schroeder lesions: initial (2-4 days), early (4-7 days), established (2-3 weeks, plasma cells), advanced (periodontitis, bone loss).S38
  3. Destructive mediators include MMPs (collagenases), IL-1, TNF-alpha and PGE2.S38
  4. Smoking is the strongest modifiable risk factor; smokers have about 2-7 times the periodontitis risk and less bleeding (vasoconstriction masks inflammation).S38
  5. Diabetes raises periodontitis risk about 3-fold; poor control (HbA1c 7% or higher) shifts grade to C.S38S11
  6. Local contributing factors: calculus, overhangs, open contacts, malposition, enamel projections, palatogingival grooves, mouth breathing, food impaction.T3
  7. Systemic modifiers include pregnancy hormones, leukemia, HIV, osteoporosis, stress and some medications.S38
  8. Periodontitis is linked to cardiovascular disease, diabetes control and adverse pregnancy outcomes (associations, not proven causation).S38

Facts are written in our own words; each tag links to its source. Values marked "sources vary" differ between references, so check the one your program uses.