Perio risk factors

Perio risk factors

1. Local

   • acquired
     • calculus
     • BOP
     • PPD 5mm+
   • developmental
     • crowding/tooth positioning
     • furcation involvement
     • bone defects
     • mucosal defects
     • cervical enamel projections /pearls
     • canine fossa
     • root grooves
   • iatrogenic
     • overhangs/deficiencies
     • inadequate contact points
     • restoration margins

2. systemic

   • genetics
     • 50%
       • 50% of susceptibilty is genetic Michalowicz 2000
   • Hereditary gingival fibromatosis
     • pink, firm enlargment
       • extends to mucogingival junction affects maxillary tuberosities and retromolar regions of the mandible
     • 2 types
       • familial and sporadic
     • SOS1
       • son of sevenless gene
   • smoking
     • less collagen, more collagenase
     • fewer blood vessels
     • increase baseline ROS
   • diabetes
     • bi-directional
     • lateral perio abscess
     • AGE
       • hyperglycaemic environment  increase in inflammation increased collagen thickness decreased diapadesis decreased oxygen 
   • medication
     • anti-hypertensives
     • anti-epileptics
     • immunosuppressants
   • stress
     • poor OHI?
     • decreased immune response
   • diet
     • anti-oxidants
     • obesity
   • hormonal
     • puberty
     • pregnancy
       • granuloma
   • osteoporosis
     • reduced bone, common pathological pathways?
   • haematological
     • quantitative
       • acute leukaemia
       • aplastic anaemia
       • cyclic neutropenia
     • qualitative
       • chronic granulomatous disease
       • leukocyte adhesion deficiency
       • hypophosphotasia
       • MORE!!
   • decreased collagen production
     • Ehlers - Danlos syndrome
   • age
   • immunodeficiency