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epithelial cells releases cytokines which attract leukocytes to assist with the inflammatory response. The balance between normal cell responses and the beginning of gingival disease is when there is too much plaque bacteria for the neutrophils to phagocytose and they degranulate, releasing toxic enzymes that cause tissue damage. This appears in the mouth as red, swollen and inflamed gingiva which may bleed when probed clinically or during tooth brushing. These changes are due to increased capillary permeability and an influx of inflammatory cells into the gingival tissues. When gingival disease remains established and the aetiology is not removed, there is further recruitment of cells such as macrophages, which assist with the phagocytic digestion of bacteria, and lymphocytes, which begin to initiate an immune response. Pro-inflammatory cytokines are produced inside the gingival tissues and further escalate inflammation, which impacts the progression of chronic systemic inflammation and disease. The result is collagen breakdown, infiltrate accumulation as well as collagen breakdown in the periodontal ligament and alveolar bone resorption. At this stage, the disease has progressed from gingivitis to periodontitis and the loss of supporting periodontium structure is irreversible.
1014:: tobacco smoking is firmly established as a major risk factor for periodontal disease, with the relationship between smoking exposure and periodontal tissue destruction being supported strongly by various research papers. Smoking decreases the healing abilities of the oral tissues by destroying blood vessels and supply and preventing essential immune-defence organisms from penetrating the tissues. Therefore, pathogenic bacteria are able to destruct the periodontal tissues more rapidly and escalate the severity of disease. Although the clinical signs of inflammation are less pronounced, smokers have a larger portion of sites with deep pocketing depths and loss of clinical attachment when compared with nonsmokers. Smoking cessation and counselling is an integral part of a dental professional's work with periodontal disease patients. Smoking cessation has been proven to prevent progression of periodontal disease and to return the oral microflora to a less pathogenic microbial state.
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golden standard for surgical and non-surgical treatment in the initial therapy. It is conducted by hand instrumentation such as curettes or scalers and ultrasonic instrumentation. It requires a few appointments, depending on time and clinician skills, for effective removal of supragingival and subgingival calculus, when periodontal pockets are involved. It can assist in periodontal healing and reduce periodontal pocketing by changing the subgingival ecological environment. Prevention of periodontal disease and maintenance of the periodontal tissues following initial treatment requires the patient's ability to perform and maintain effective dental plaque removal. This requires the patient to be motivated in improving their oral hygiene and requires behaviour change in terms of tooth brushing, interdental cleaning, and other oral hygiene techniques. Personal oral hygiene is often considered an essential aspect of controlling
1344:. They work closely with dentists and a number of dental specialists including periodontists. It is common for the oral health therapist to be involved in the treatment of gingival and periodontal diseases for patients. Their scope of practice in this area includes oral health assessment, diagnosis, treatment and maintenance and referral where necessary. They also have expertise in providing oral health education and promotion to support the patient to maintain their at-home oral care. Oral health therapists are employed by the dental team to share the responsibilities of care. They are an important asset as they have been uniquely and specifically trained in preventative dentistry and risk minimization. This allows the dental team to work more competently and effectively as dentists can manage more complex treatments or significantly medically compromised patients.
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characterized by pocket formation and recession of the gingiva (shrinkage of the gums). Treatment and maintenance are important in stopping disease progression and to resolve the inflammation. Treatment usually consists of scaling and root planning, surgical therapy, and regenerative surgical therapy. After treatment, patient care and regular maintenance check-ups are important to completely eradicate the disease and present its recurrence. This is done through plaque control and removal: twice daily toothbrushing and daily interdental cleaning; chlorhexidine mouthwash can also be effective. The patient should also present to a dentist for maintenance check-ups at least every three months for an in-office check-up and if necessary, plaque control.
1059:: studies have shown that the oral tissues are affected and altered during pregnancy due to a decreased immune response and increased vascular blood supply and volume systemically. it is important to note that pregnancy does not cause gingival and periodontal diseases but may exacerbate the inflammatory response to a pre-existing disease. It is also important to note that pregnancy does not detract minerals from the oral tissues or teeth as previously thought and heard in old wives' tales. Existing disease often presents during pregnancy due to an altered oral environment, and not merely due to pregnancy causing disease. These effects can be prevented by good oral hygiene through toothbrushing and interdental cleaning.
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non-modifiable. Modifiable risk factors are often behavioural in nature and can be changed by the individual or environmental circumstances, whereas non-modifiable factors are usually intrinsic to an individual's genetics and cannot be changed. To determine risk factors for a disease, evidence-based research and studies are needed for evidence, with longitudinal studies giving the most statistically significant outcomes and the best reliability for determining risk factors. Risk factors often coexist with other variables, rarely acting alone to contribute to a disease. Risk factors can be genetic, environmental, behavioural, psychological, and demographic in nature.
1026:: diabetes falls under the category of modifiable risk factors as although it cannot be cured, it can be controlled, which greatly helps periodontal disease control. A clear two-way relationship has been established with blood glucose control directly affecting periodontal disease severity and progression, and vice versa. Periodontal disease patients with diabetes mellitus also have poorer healing abilities than those without diabetes, and hence are at an increased risk for more severe diseases if blood glucose control is poor and when healing abilities are affected by systemic disease.
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reach. The patient should also be educated on proper nutrition and diet and healthy fluid intake. Smoking cessation should occur not only to completely eradicate the disease but also for the health of the patient. Pain control can be done through ibuprofen or paracetamol/acetaminophen. In the case of an immunocompromised patient, antibiotics should be prescribed. Assessment of treatment should be done after 24 hours of treatment and continued every 3–6 months until signs and symptoms are resolved and gingival health and function restored.
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454:. Other factors may increase a person's risk of gingivitis, including but not limited to systemic conditions such as uncontrolled diabetes mellitus and some medications. The signs and symptoms of gingivitis can be reversed through improved oral hygiene measures and increased plaque disruption. If left untreated, gingivitis has the potential to progress to periodontitis and other related diseases that are more detrimental to periodontal and general health.
1446:(ADA)-accredited programs are a minimum of three years in length. According to the American Academy of Periodontology, U.S.-trained periodontists are specialists in the prevention, diagnosis and treatment of periodontal diseases and oral inflammation, and in the placement and maintenance of dental implants. Many periodontists also diagnose and treat oral pathology. Historically, periodontics served as the basis for the speciality of
543:(EFP) together collaborated to revise and adopt a new classification system for periodontal conditions to aid in a more personalized approach to patient care. In 2018 they released an updated classification system which includes a multi-dimensional staging and grading system for periodontitis classification, a recategorization of various forms of periodontitis, and the inaugural classification for peri-implant diseases and conditions.
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tip are formed by the free gingiva. The central point between the interdental papillae is called the col. It is a valley-like or concave depression that lies directly beneath the contact point, between the facial and lingual papilla. However, the col may be absent if there is gingival recession or if the teeth are not contacting. The main purpose of the interdental gingiva is to prevent food impaction during routine mastication.
1053:: various studies have demonstrated that individuals under psychological, ongoing chronic stress are more likely to have clinical attachment loss and decreased levels of alveolar bone due to periodontal destruction. This is due to the increased production of certain immune cells and interleukins, which decrease the defensive mechanisms against pathogenic bacteria, therefore increasing chances of developing periodontal disease.
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1101:: important cells and nutrients carried in the blood to the periodontal tissues are crucial for the tissues' defence mechanisms and response to toxins and pathogens, gas exchange and efficient hemostasis. Therefore, red blood cells have a pivotal role in maintaining the health of the periodontium, meaning haematological disorders can have profound detriment to the periodontal tissues and the onset of disease.
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diagnosis, treatment and management of periodontal diseases. It was previously believed that each human being had the same risk of developing periodontal diseases, but through the identification and classification of risk factors, it has become well understood that each individual will have a differing array of risk factors that generate susceptibility and contribute to severity of periodontal disease.
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results in the imbalance between host and bacterial factors which can in turn result in a change from health to disease. Other local or systemic factors can result in or further progress the manifestation of periodontal disease. Other factors can include age, socio-economic status, oral hygiene education and diet. Systemic factors may include uncontrolled diabetes or tobacco smoking.
1328:. Research has shown that it is important to appreciate the motivation of the patient behaviour changes that have originated from the patient. Patients must want to improve their oral hygiene and feel confident that they have the skills to do so. It is crucial for the clinician to encourage patient changes and to educate the patient appropriately.
911:(or a combination of both). The practitioner can also prescribe specialized plaque-removal techniques (tooth brushing, interdental cleaning). The practitioner can also perform a plaque index to indicate to the patient areas of plaque they are not removing on their own. This can be removed through the procedure of a dental prophylaxis.
406:. The periodontal ligament is composed mostly of collagen fibres, however it also houses blood vessels and nerves within loose connective tissue. Mechanical loads that are placed on the teeth during mastication and other external forces are absorbed by the periodontal ligament, which therefore protects the teeth within their sockets.
1077:: in individuals with osteoporosis, studies have shown that alveolar bone is less dense than in a healthy adult. However, this does not demonstrate a relationship with periodontal pathogens or clinical attachment loss, therefore more research is needed to investigate if osteoporosis is a true risk factor for periodontal disease.
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antibiotics are not generally used in the treatment of periodontal disease, unlike other bacterial infections around the body. The most effective way to control the plaque biofilm is via mechanical removal such as toothbrushing, interdental cleaning or periodontal debridement performed by a dental professional.
1151:. This involves full mouth periodontal probing and taking measurements of pocket depths, clinical attachment loss and recession. Along with this other relevant parameters such as plaque, bleeding, furcation involvement and mobility are measured to gain an overall understanding of the level of disease.
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A diagnosis is reached by firstly undertaking thorough examination of the patient's medical, dental and social histories, to note any predisposing risk factors (see above) or underlying systemic conditions. Then, this is combined with findings from a thorough intra and extra oral examination. Indices
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Co-adhesion: there is a natural affinity for oral microorganisms to adhere to one another which is termed co‐adhesion. Co-adhesion involves the adherence of planktonic or single culture cells to already attached organisms on a surface. The organisms which make first contact with the surface and allow
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During this phase, patients are seen 3–6 weeks after initial therapy; it is required to re-evaluate the steps carried out after the phase I therapy. Usually 3–6 week re-evaluation is crucial in severe cases of periodontal disease. The elements which are required to be re-evaluated are the results of
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Poor oral hygiene: as plaque is the only aetiological factor for periodontal disease, poor oral hygiene is the most prominent risk factor in initiating, progressing and determining severity of disease. Performing brushing and interdental cleaning is perhaps one of the most effective ways at removing
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are both risk factors for periodontal disease that go hand in hand. Obesity is generally associated with a decreased consumption of fruits and vegetables, with an increase in foods high in fat, salt and sugar. Having a poor diet not only contributes to obesity but also results in a lack of essential
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is a collar-like band that lies at the base of the gingival sulcus and surrounds the tooth; it demarcates the areas of separation between the free and attached gingiva. The junctional epithelium provides a specialized protective barrier to microorganisms residing around the gingival sulcus. Collagen
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mouthwash should be recommended to the patient to use twice daily, oral health instruction should be provided (using a soft bristle toothbrush or electric toothbrush twice a day) and an interdental cleaning aid, such as floss or interdental brushes, which cleans the areas that the toothbrush cannot
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Climax community (homeostasis): after a prolonged period of stability, the bacterial community has sufficient nutrients and protection to survive. These complex biofilms are usually found in hard to cleanse areas. Nutrition is provided from dietary consumption of the host for supra-gingival biofilm
489:. As of 2013, periodontal disease accounted for 70.8% of teeth lost in patients with the disease in South Korea. Periodontal disease is the second most common cause of tooth loss (second to dental caries) in Scotland. Twice-daily brushing and flossing are a way to help prevent periodontal diseases.
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is a common condition that affects the gingiva or mucosal tissues that surround the teeth. The condition is a form of periodontal disease; however, it is the least devastating, in that it does not involve irreversible damage or changes to the periodontium (gingiva, periodontal ligament, cementum or
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Normal gingiva may range in color from light coral pink to heavily pigmented. The soft tissues and connective fibres that cover and protect the underlying cementum, periodontal ligament and alveolar bone are known as the gingivae. The gingivae are categorized into three anatomical groups: the free,
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The reversible inflammation of the gums is easily prevented by patients. After the removal of the inflammatory product, usually plaque or calculus, this allows the gums room to heal. This is done by patients thoroughly cleaning teeth every day with a soft bristle toothbrush and an interdental aid.
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The last phase of periodontal therapy requires the preservation of periodontal health. In this phase, patients are required to re-visit through a scheduled plan for maintenance care to prevent any re-occurrence of the disease. The maintenance phase constitutes the long-term success for periodontal
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The primary aetiological factor for periodontal disease is plaque biofilm of dental biofilm. A dental biofilm is a community of microorganisms attached to a hard, non-shedding surface. In the oral cavity, hard non-shedding surfaces include teeth, dental restorative materials and fixed or removable
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takes up the space beneath a tooth contact point, between two adjacent teeth. It is normally triangular or pyramidal in shape and is formed by two interdental papillae (lingual and facial). The middle or centre part of the interdental papilla is made up of attached gingiva, whereas the borders and
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After periodontal treatment, whether it be surgical or non-surgical, maintenance periodontal therapy is essential for a long-term result and stabilization of periodontal disease. There is also a difference in the maintenance of different types of periodontal disease, as there are different types,
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and shifting the microbial flora to a favourable environment to stabilize periodontal disease. Debridement is thorough mechanical removal of calculus and dental biofilm from the root surfaces of the tooth. Debridement is the basis of treatment for inflammatory periodontal diseases and remains the
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and the host response have been shown to play an important role in periodontal disease development in studies on identical twins and isolated indigenous populations. Periodontal disease also may result due to an abnormal or decreased immune response, rather than aggressive properties of bacterial
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Bacteria contained within the biofilm are protected by a slimy extracellular polysaccharide matrix which helps to protect them from the outside environment and chemotherapeutics agents. An example of a chemotherapeutic agent is an antiseptic such as chlorhexidine mouth-rinse or antibiotics. Thus,
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and necrotizing ulcerative periodontitis, it is a type of periodontal disease different than many other periodontal diseases. Clinical characteristics include gingival necrosis (breakdown of the gums), gingival pain, bleeding, halitosis (bad breath), as well as a grey colour to the gingiva and a
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There are many risk factors that contribute to placing an individual at higher risk for developing gingival and periodontal diseases. However, the only aetiological factor for periodontal disease is bacterial plaque, or biofilm. Identification of one's risk factors plays an important role in the
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In periodontal health, the alveolar bone surrounds the teeth and forms the bony socket that supports each tooth. The buccal and lingual plates and lining of the sockets are composed of thin, yet dense compact or cortical bone. Within the cortical plates and dental sockets lies cancellous bone, a
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A risk factor is a variable that in health can be defined as "a characteristic associated with an increased rate of a subsequently occurring disease". Risk factors are variables that contribute to disease, rather than being factors that induce disease. Risk factors may be seen as modifiable and
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The inflammation of the gums and irreversible destruction of the alveolar bone and surrounding structures of the teeth, which is usually slow progressing but can have bursts. Local factors explain presence of disease, such as diet, lack of oral hygiene, plaque accumulation, smoking, etc. It is
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bacteria found in the gingival crevice or pocket. They migrate from the tissues in a specialized exudate called gingival crevicular fluid also known as GCF. Neutrophils are recruited to the gingival crevice area as they are signalled to by molecules released by plaque microorganisms. Damage to
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Periodontal diseases can be caused by a variety of factors, the most prominent being dental plaque. Dental plaque forms a bacterial biofilm on the tooth surface; if not adequately removed from the tooth surface in close proximity to the gingiva, a host-microbial interaction gets underway. This
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A periodontist is a specialist dentist who treats patients for periodontal-related diseases and conditions. They are involved in the prevention, diagnosis and treatment of periodontal disease. Periodontists receive further specialist training in periodontics after completing a dental degree.
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Duarte, Poliana Mendes; da Rocha, Marcelo; Sampaio, Eduardo; Mestnik, Maria Josefa; Feres, Magda; Figueiredo, Luciene
Cristina; Bastos, Marta Ferreira; Faveri, Marcelo (July 2010). "Serum Levels of Cytokines in Subjects with Generalized Chronic and Aggressive Periodontitis before and after
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Periodontitis and associated conditions are recognised as a wide range of inflammatory diseases that have unique symptoms and varying consequences. In order to identify disease, classification systems have been used to categorize periodontal and gingival diseases based on their severity,
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alveolar bone). It is commonly detected by patients when gingival bleeding occurs spontaneously during brushing or eating. It is also characterized by generalized inflammation, swelling, and redness of the mucosal tissues. Gingivitis is typically painless and is most commonly a result of
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fibres bind the attached gingiva tightly to the underlying periodontium including the cementum and alveolar bone and vary in length and width, depending on the location in the oral cavity and on the individual. The attached gingiva lies between the free gingival line or groove and the
1047:: not only does poor oral hygiene have a clear relationship with an increased risk of developing cardiovascular disease, high concentrations of cholesterol and the mechanisms of oral bacteria in the process of atherosclerosis may increase in individuals with chronic periodontitis.
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Michalowicz, Bryan S.; Diehl, Scott R.; Gunsolley, John C.; Sparks, Brandon S.; Brooks, Carol N.; Koertge, Thomas E.; Califano, Joseph V.; Burmeister, John A.; Schenkein, Harvey A. (November 2000). "Evidence of a
Substantial Genetic Basis for Risk of Adult Periodontitis".
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A diagram of the periodontium. A. Enamel B. Dentine C. Alveolar bone D. Oral epithelium E. Attached gingiva F. Gingival margin G. Gingival sulcus H. Junctional epithelium I. Alveolar crest fibres of periodontal ligament J. Horizontal fibres of PDL K. Oblique fibres of
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of periodontal disease. Even in a mouth where the gingiva appear healthy, there is constant low-level inflammatory response facilitated by the host to manage the constant bacterial load of plaque micro-organisms. Leukocytes and neutrophils are the main cells that
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lies apically to the gingival margin, between the tooth and the free gingiva. A non-diseased, healthy gingival sulcus is typically 0.5-3mm in depth, however, this measurement can increase in the presence of periodontal disease. The gingival sulcus is lined by a
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Certain periodontal treatment is formulated to increase sufficient tooth length for retention. Failure to accomplish these methods prior restorations can lead to the complexity or risk of failure of treatment such as impression making, tooth preparation and
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Canadian programs are accredited by the
Commission on Dental Accreditation of Canada and are a minimum of three years in length and usually culminate with a master (MSc or MDent) degree. Graduates are then eligible to sit for the fellowship exams with the
1020:: more research needs to be conducted in the form of longitudinal studies on the effects of alcohol on the periodontal tissues. However, current studies suggest that alcohol consumption moderately increases one's risk for progression of periodontal disease.
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is the connective tissue that joins the outer layer of the tooth root, being the cementum, to the surrounding alveolar bone. It is composed of several complex fibre groups that run in different directions and which insert into the cementum and bone via
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Periodontal disease is multifactorial, requiring dental and oral health professionals to have a clear and thorough understanding of the risk factors and their mechanisms in order to implement effective disease management in clinical practice.
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This can be floss, interdental brushes, or whatever is preferred by the patient. Without patient compliance and constant removal of plaque and calculus, gingivitis cannot be treated completely and can progress to irreversible periodontitis.
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Healthy gingiva can be described as stippled, pale or coral pink in
Caucasian people, with various degrees of pigmentation in other races. The gingival margin is located at the cemento-enamel junction without the presence of pathology. The
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Contemporary periodontal treatment is designed based on the trimeric model, and is performed in four phases. These phases are structured to ensure that periodontal therapy is conducted in a logical sequence, consequently improving the
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Grossi, Sara G.; Zambon, Joseph J.; Ho, Alex W.; Koch, Gary; Dunford, Robert G.; Machtei, Eli E.; Norderyd, Ola M.; Genco, Robert J. (March 1994). "Assessment of Risk for
Periodontal Disease. I. Risk Indicators for Attachment Loss".
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The non-surgical phase is the initial phase in the sequence of procedures required for periodontal treatment. This phase aims to reduce and eliminate any gingival inflammation by removing dental plaque and calculus, restoration from
1318:
Non-surgical therapy is the golden standard of periodontal therapy which consists of debridement with a combination of oral-hygiene instructions and patient motivation. It mainly focuses on the elimination and reduction of putative
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Periodontal treatment should be managed to assure the establishment of firm gingival margin prior to tooth preparation for restoration. Absence of bleeding tissue during restorative manipulation provides accessibility and aesthetic
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Mohd-Dom, Tuti; Ayob, Rasidah; Mohd-Nur, Amrizal; Abdul-Manaf, Mohd R; Ishak, Noorlin; Abdul-Muttalib, Khairiyah; Aljunid, Syed M; Ahmad-Yaziz, Yuhaniz; Abdul-Aziz, Hanizah; Kasan, Noordin; Mohd-Asari, Ahmad S (20 May 2014).
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Irreversible interaction: bacterial adhesins recognise specific host receptors such as pili and outer membrane proteins. The different species of bacteria bind together and require specific receptors to interact with the
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Risk characteristics must be considered in conjunction with risk factors as variables that may also contribute to increasing or decreasing one's chances of developing periodontal disease. Numerous studies show that age,
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attached and the interdental gingiva. Each of the gingival groups are considered biologically different; however, they are all specifically designed to help protect against mechanical and bacterial destruction.
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dental appliance such dentures. It is this adherence to non-shedding surfaces that allows bacteria in a dental biofilm to have unique characteristics of clinical significance. The stages of biofilm formation:
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The 2018 Disease
Classification of Periodontal Diseases and Conditions breaks down the category of periodontitis into three forms and each of these forms are further broken down into two or more subcategories.
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Hugoson, A.; Ljungquist, B.; Breivik, T. (March 2002). "The relationship of some negative events and psychological factors to periodontal disease in an adult
Swedish population 50 to 80 years of age".
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Grossi, SG; Zambon, J; Machtei, EE; Schifferle, R; Andreana, S; Genco, RJ; Cummins, D; Harrap, G (May 1997). "Effects of smoking and smoking cessation on healing after mechanical periodontal therapy".
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This area of tissue is non-keratinized and is located beyond the mucogingival junction. It is less firmly attached and is redder than attached gingiva. It provides for the movement of cheek and lips.
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spongy or trabecular-type bone which is less dense than compact bone. The anatomic landmarks of the alveolar process includes the lamina dura, the alveolar crest, and the periodontal ligament space.
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such as the periodontal screening record (PSR) and the
Community Periodontal Index of Treatment Needs (CPITN) are also used in making a diagnosis and to order or classify the severity of disease.
692:– Classification of these conditions should be based on the primary systemic disease according to the International Statistical Classification of Diseases and Related Health Problems (ICD) codes
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Weinberg, M., Westphal, C., Froum, S. J., Palat, M. P., & Schoor, R. S. (2010). Comprehensive
Periodontics for the Dental Hygienist (3rd ed.). Upper Saddle River, N.J.: Pearson Education
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Periodontists provide treatments for patients with severe gingival diseases or complex medical histories. Periodontists offer a wide range of treatments including root scaling and planing,
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is used to describe the group of structures that directly surround, support and protect the teeth. The periodontium is composed largely of the gingival tissue and the supporting bone.
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layer of the tooth and provides attachment for the collagen fibres of the periodontal ligament. It also protects the dentine and provides a seal for the otherwise exposed ends of the
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Neiva, Rodrigo F.; Steigenga, Jennifer; Al-Shammari, Khalaf F.; Wang, Hom-Lay (July 2003). "Effects of specific nutrients on periodontal disease onset, progression and treatment".
3548:"Periodontal Status and Self-Reported Systemic Health of Periodontal Patients Regularly Visiting Dental Clinics in the 8020 Promotion Foundation Study of Japanese Dental Patients"
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The prognosis of the restorative treatment is determined by the periodontal health. The goals for establishing periodontal health prior to restorative treatment are as follows:
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The 2018 Disease
Classification of Periodontal Disease and Conditions contains a category for other conditions that may have an effect upon the health of the periodontium.
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mechanisms and other risk factors that can lead to destruction of the supporting bone around natural teeth. Untreated, these diseases can lead to alveolar bone loss and
3454:"Efficacy of an aluminium triformate mouthrinse during the maintenance phase in periodontal patients: a pilot double blind randomized placebo-controlled clinical trial"
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Complexity of management; Probing depth, pattern of bone loss, furcation lesions, number of remaining teeth, tooth mobility, ridge defects, masticatory dysfunction.
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Izumi, Aki; Yoshihara, Akihiro; Hirotomi, Toshinobu; Miyazaki, Hideo (May 2009). "The Relationship Between Serum Lipids and Periodontitis in Elderly Non-Smokers".
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punched out appearance. It is treated through debridement, usually under local anaesthetic due to immense pain. To maintain and treat the condition completely, a
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If disease is identified through this process, then a full periodontal analysis is performed, often by dental hygienists, oral health therapists, or specialist
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patients have medical history reviewed at each visit to correctly evaluate the patient's risk and determine appropriate course of action for dental treatment.
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334:, a line around the circumference of the tooth where the enamel surface of the crown meets the outer cementum layer of the root. A natural space called the
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368:, tooth brushing and speaking. In health it is typically pale pink or coral pink in colour and may present with surface stippling or racial pigmentation.
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After post-phase I, it is necessary to evaluate the requirement of periodontium for surgery. Factors identifying if the surgical phase is required are:
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management in specific situations, irregular bony contours or deep craters, areas of suspected incomplete removal of local deposits, degree II and III
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nutrients, including vitamin C, D, and calcium, which all play important roles in ensuring a healthy immune system and healthy oral tissues and bone.
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between the tooth and the gingival should be no deeper than 1–3mm to be considered healthy. There is also the absence of bleeding on gentle probing.
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and treatments. Having a system of classification is necessary to enable dental professionals to give a label to a patient's condition and make a
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the platform for later co-adhesion of bacteria are called early colonisers; they facilitate the formation of complex multispecies dental biofilms.
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Periodontal disease encompasses a number of diseases of the periodontal tissues that result in attachment loss and destruction of alveolar bone.
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Furuta, Michiko; Fukai, Kakuhiro; Aida, Jun; Shimazaki, Yoshihiro; Ando, Yuichi; Miyazaki, Hideo; Kambara, Masaki; Yamashita, Yoshihisa (2019).
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areas of last molars with expected mucogingival junction problems, persistent inflammation, root coverage and removal of gingival enlargement.
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1419:. Dentistry is a regulated profession. To become a licensed dentist in Canada one must have a BDS, DDS, or DMD degree and be certified by the
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Van Dyke, T. E.; Serhan, C.N. (13 December 2016). "Resolution of Inflammation: A New Paradigm for the Pathogenesis of Periodontal Diseases".
1083:: many drugs and medications can have an adverse effect on the periodontal tissues, through contributing to various oral conditions such as
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Periodontal diseases take on many different forms but are usually a result of a coalescence of bacterial plaque biofilm accumulation of the
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Multiplication: through continued growth and maturation of existing plaque micro-organisms and the further recruitment of later colonisers.
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Tezal, Miné; Grossi, Sara G.; Ho, Alex W.; Genco, Robert J. (February 2001). "The Effect of Alcohol Consumption on Periodontal Disease".
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Azaripour, Adriano; Weusmann, Jens; Eschig, Carl; Schmidtmann, Irene; Van Noorden, Cornelis J. F.; Willershausen, Brita (23 May 2016).
1922:"Trends in the Incidence of Tooth Extraction Due to Periodontal Disease: Results of a 12-Year Longitudinal Cohort Study in South Korea"
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Newman, M., Takei, H. Klokkevold, P. R., Carranza, F. A. (2015). Carranza's Clinical Periodontology (12th ed.). St. Louis: Elsevier Inc
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The 2018 Disease Classification for periodontal health, gingivitis, and gingival diseases and conditions are outlined in detail below:
364:. The attached gingiva dissipates functional and masticatory stresses placed on the gingival tissues during common activities such as
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Allen, E.; Ziada, H.; Irwin, C.R.; Mullally, B.; Byrne, P.J. (2 April 2008). "Periodontics: 10. Maintenance in Periodontal Therapy".
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1195:. Phase I consists of treatment of emergencies, antimicrobial therapy, diet control, patient education and motivation, correction of
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347:; it begins at the gingival margin and ends at the base of the sulcus where the junctional epithelium and attached gingiva begins.
3116:"Effect of patient age awareness on diagnostic agreement of chronic or aggressive periodontitis between clinicians; a pilot study"
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Reversible interaction: there is electrostatic attraction or hydrophobic interaction between microorganisms and the tooth surface.
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891:. It is also advised that patients receive bi-annual check ups from their dental health provider along with thorough cleaning.
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Lee, Jae-Hong; Oh, Jin-Young; Choi, Jung-Kyu; Kim, Yeon-Tae; Park, Ye-Sol; Jeong, Seong-Nyum; Choi, Seong-Ho (October 2017).
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The 2018 Disease Classification of Periodontal Disease and Conditions divides this category into four subcategories:
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The most effective prevention method is what can be achieved by the patient at home, for example, using the correct
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Severity: Interdental clinical attachment level at site with greatest loss; Radiographic bone loss and tooth loss.
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O'Toole, George; Kaplan, Heidi B.; Kolter, Roberto (October 2000). "Biofilm Formation as Microbial Development".
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Prostheses and tooth-related factors that modify or predispose to plaque-induced gingival diseases/periodontitis
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The tissues that sit above the alveolar bone crest are considered the free gingiva. In healthy periodontium, the
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4415:
3403:
Hou, Yue; Wang, Xin; Zhang, Cong-Xiao; Wei, Yu-Dan; Jiang, Li-Li; Zhu, Xiao-Yu; Du, Yu-Jun (1 September 2017).
1852:
59:
3792:
4676:
4620:
3645:
1450:. Following successful completion of post-graduate training a periodontist becomes board-eligible for the
70:
17:
4574:
2414:
Rivera-Hidalgo, Francisco (October 1986). "Smoking and Periodontal Disease: A Review of the Literature".
1594:
Risk of progression; direct evidence by periapical radiographs of CAL loss, or indirect (bone/age ratio).
1443:
1191:
and correction of defective restoration, as these all contribute to gingival inflammation, also known as
1111:
2213:
1340:
An oral health therapist is a member of the dental team who is dual-qualified as a dental hygienist and
4564:
2879:
Armitage, Gary C. (February 2004). "Periodontal Diagnoses and Classification of Periodontal Diseases".
1220:
initial therapy (phase I therapy), oral hygiene and status, bleeding and plaque scores and a review of
530:
214:
4681:
4594:
4342:
4116:
4023:
1329:
3687:
4513:
4171:
4151:
4106:
4080:
3947:
3902:
3837:
3772:
3767:
1435:
1098:
908:
3503:
Dufty, J; Gkranias, N; Donos, N (2017). "Necrotising Ulcerative Gingivitis: A Literature Review".
1402:
Before applying to any postgraduate training program in periodontology, one must first complete a
4719:
4599:
4368:
4337:
4085:
4048:
4013:
3993:
3830:
3638:
48:
4241:
2092:
523:
Individual risk factors include: gender, smoking and alcohol consumption, diabetes, obesity and
4688:
4589:
4332:
3075:"Factors that affect individual tooth prognosis and choices in contemporary treatment planning"
1044:
676:
331:
260:, as well as diseases and conditions that affect them. The supporting tissues are known as the
3595:
964:
Detachment: from one surface to another or within biofilm allows colonization at remote sites.
4460:
4392:
4166:
4161:
3844:
3762:
3737:
3722:
3717:
1325:
1306:
1270:
361:
356:
280:. A periodontist is a dentist that specializes in the prevention, diagnosis and treatment of
249:
150:
2114:
Genco, Robert J.; Borgnakke, Wenche S. (June 2013). "Risk Factors for Periodontal Disease".
95:
4440:
4296:
4271:
4181:
4075:
3922:
3872:
3851:
3807:
3727:
3697:
3114:
Oshman, Sarah; El Chaar, Edgard; Lee, Yoonjung Nicole; Engebretson, Steven (25 July 2016).
2675:
Laine, Merja Anneli (2 July 2009). "Effect of Pregnancy on Periodontal and Dental Health".
1673:
1208:
1115:
1088:
1033:
880:
277:
3590:
8:
4625:
4615:
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4455:
4425:
4311:
4194:
4176:
4126:
4008:
3962:
3858:
3732:
1354:
1332:
is a good technique to ask open-ended questions and express empathy towards the patient.
1017:
403:
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344:
281:
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2312:
1615:
767:
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4209:
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3429:
3404:
3234:
3209:
3142:
3115:
3050:
3023:
2942:
2915:
2856:
2839:
2779:
2700:
2358:
2341:
2299:
Kinane, Denis F. (February 2001). "Causation and Pathogenesis of Periodontal Disease".
1946:
1921:
1576:
Add to Stage as descriptor: Localized < 30% teeth, generalized > or equal to 30%.
1233:
1203:, hopeless teeth, preliminary scaling, temporary splinting, occlusal adjustment, minor
904:
546:
524:
505:
3024:"Cost analysis of Periodontitis management in public sector specialist dental clinics"
2892:
2653:
1971:"The reasons for extraction of permanent teeth in Scotland: a 15-year follow-up study"
4493:
4281:
4266:
4231:
4204:
4131:
4121:
3897:
3880:
3754:
3569:
3520:
3485:
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3300:
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3187:
3147:
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2947:
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2622:
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2502:
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2131:
2127:
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1992:
1951:
1902:
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1831:
1783:
1773:
1253:
1023:
940:
936:
517:
428:
398:
3620:
3532:
3320:
American Academy of Periodontology. (2019). What is a periodontist?. Retrieved from
2783:
2704:
2498:
2277:
1431:
640:
4693:
4508:
4301:
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4199:
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2198:
2123:
2047:
1982:
1941:
1933:
1892:
1705:
1341:
1252:
During this phase, any defects need to be restored with removable or fixed through
1050:
900:
531:
2018 AAP/EFP classification of periodontal and peri-implant diseases and conditions
269:
3377:
2381:
Chahal, GurparkashSingh; Chhina, Kamalpreet; Chhabra, Vipin; Chahal, Amna (2017).
2249:
1696:
Cope, Graham; Cope, Anwen (1 July 2011). "The periodontium: an anatomical guide".
4671:
4533:
4528:
4251:
3952:
3712:
3707:
3621:
The National Institute of Cranialfacial Research's article on Periodontal Disease
3210:"Predictors of long-term outcomes in patients undergoing periodontal maintenance"
2815:
2798:
1516:
1173:
of the patient, in comparison to indecisive treatment plan without a clear goal.
1011:
924:
Formation of an acquired pellicle: involves selective absorption of salivary and
431:. It is not as hard as enamel or dentine and is typically a light yellow colour.
335:
327:
4291:
3420:
3183:
2732:
1155:
may also be performed to assess alveolar bone levels and levels of destruction.
1122:
and genetics also have strong relationships on influencing periodontal disease.
4543:
4523:
4518:
4485:
4450:
4435:
4156:
2932:
2767:
2427:
2010:
1937:
1709:
1529:
1309:
may result in the repositioning of teeth or in soft tissue and mucosal changes.
1257:
929:
876:
653:
513:
285:
3470:
3132:
2688:
2533:
2463:
1787:
4713:
4498:
4470:
4316:
4276:
3998:
3972:
3967:
3782:
3682:
2150:"2017 Classification of Periodontal and Peri-implant Diseases and Conditions"
1534:
1524:
1486:
1447:
1403:
978:
470:
444:
210:
179:
3564:
3547:
3040:
2988:
2618:
2399:
2382:
2052:
2035:
1176:
1091:(gingival hyperplasia). It is crucial that dental professionals ensure that
779:
Systemic diseases or conditions affecting the periodontal supporting tissues
4698:
4430:
4420:
4306:
4261:
4136:
4038:
4033:
4018:
3677:
3573:
3524:
3489:
3438:
3304:
3243:
3191:
3151:
3100:
3059:
2996:
2951:
2900:
2865:
2824:
2775:
2740:
2696:
2661:
2626:
2576:
2541:
2367:
2320:
2257:
2222:
2135:
2061:
1996:
1987:
1970:
1955:
1906:
1278:
1196:
1092:
1074:
982:
884:
478:
474:
451:
261:
3516:
3405:"Risk factors of periodontal disease in maintenance hemodialysis patients"
2916:"Detection and Diagnosis of Periodontal Conditions Amenable to Prevention"
2506:
2471:
2435:
1305:
Periodontal therapy should follow restorative method as the resolution of
4661:
4400:
4286:
4236:
3865:
3596:
American Academy of Periodontology's (AAP) article on Periodontal Disease
1224:
and prognosis and modification of the whole treatment plan if necessary.
1204:
1188:
1152:
987:
658:
466:
3091:
3074:
961:
organisms and from blood and GCF for the sub gingival biofilm organisms.
719:
Stage III: Severe periodontitis with potential for additional tooth loss
645:
4256:
4111:
4003:
3937:
3907:
3359:
3225:
2203:
2186:
1585:
Anticipated treatment response: case phenotype, smoking, hyperglycemia.
1539:
1084:
888:
722:
Stage IV: Severe periodontitis with potential for loss of the dentition
509:
486:
439:
2036:"A clinical guide to periodontology: Pathology of periodontal disease"
4384:
4043:
4028:
3333:
3208:
Martinez-Canut, Pedro; Llobell, Andrés; Romero, Antonio (June 2017).
1320:
1237:
1221:
1170:
1136:
1119:
1056:
527:, osteoporosis and Vitamin D conditions, stress and genetic factors.
253:
243:
231:
219:
193:
162:
547:
Periodontal health, gingivitis, and gingival diseases and conditions
37:
3912:
3692:
3605:
1067:
899:
Along with specialist periodontist treatment, a general dentist or
559:
273:
3451:
3073:
Mordohai, N.; Reshad, M.; Jivraj, S.; Chee, W. (27 January 2007).
551:
3702:
2081:"Gum Disease: Causes, Prevention, & Treatment of Gum Disease"
1360:
1282:
1274:
1029:
641:
Disease classification for the three major forms of periodontitis
447:
365:
340:
265:
2590:
Brogden, K.; Guthmiller, J. (2002). "8 – Periodontal diseases".
1269:
treatment, thus contributing to a long relationship between the
3020:
2717:
2187:"Dental biofilm: ecological interactions in health and disease"
1241:
1200:
1107:
424:
423:
Cementum is the outer layer of the tooth root; it overlies the
296:
2604:
1768:
Gehrig, Jill S.; Shin, Daniel E.; Willmann, Donald E. (2019).
935:
Bacterial transportation: bacteria will readily adhere to the
762:
3600:
2554:
2484:
1041:
dental plaque biofilm and prevention of periodontal diseases.
257:
4353:
3113:
2973:
1357:, implant surgery and other complex periodontal procedures.
3207:
3610:
1969:
McCaul, L. K.; Jenkins, W. M. M.; Kay, E. J. (June 2001).
1475:
504:
Signs and symptoms of periodontal disease: bleeding gums,
3625:
3281:"Envisioning an oral healthcare workforce for the future"
2380:
1177:
Phase I therapy (initial therapy – disease control phase)
3545:
3072:
2639:
1288:
1247:
3615:
3169:
2235:
1263:
848:
3366:. The National Dental Examining Board of Canada. 2019.
2346:
Journal of the International Academy of Periodontology
3322:
https://www.perio.org/consumer/what-is-a-periodontist
1881:"Diagnosis and classification of periodontal disease"
1667:
793:
Mucogingival deformities and conditions around teeth
3778:
Periodontitis as a manifestation of systemic disease
3661:
Dentistry involving supporting structures of teeth (
3340:. Commission on Dental Accreditation of Canada. 2013
2383:"Smoking and its effect on periodontium – Revisited"
1770:
Foundations of Periodontics for the Dental Hygienist
1506:
1335:
1313:
1227:
690:
Periodontitis as manifestation of systemic diseases
649:
Periodontal recession on maxillary central incisors
579:Clinical gingival health on a reduced periodontium
62:. Unsourced material may be challenged and removed.
3502:
2975:Non-Surgical Periodontal Therapy: A Pilot Study".
2519:
2448:
2278:"The Role of Dental Plaque Biofilm in Oral Health"
1767:
903:can perform routine scale and cleans using either
732:Localized, generalized; molar-incisor distribution
576:Clinical gingival health on an intact periodontium
450:accumulation, in association with reduced or poor
2799:"Management of Drug-Induced Gingival Enlargement"
2589:
2271:
2269:
2267:
928:molecules through an electrostatic affinity with
516:, ill-fitting dentures and buildup of plaque and
4711:
2840:"Peridonatal Manifestations of Systemic Disease"
1968:
1874:
1872:
1870:
1668:Clerehugh, V.; Tugnait, A.; Genco, R.J. (2009).
1663:
1661:
1368:List of procedures performed by a periodontist:
1163:
3402:
2335:
2333:
2331:
2229:
1737:
1735:
1733:
1731:
943:, proteins and enzymes within one to two hours.
481:) of the gingiva and teeth, combined with host
2837:
2753:
2413:
2264:
2113:
1772:(5th ed.). Philadelphia: Wolters Kluwer.
866:Peri-implant soft and hard tissue deficiencies
628:Endocrine, nutritional, and metabolic diseases
4369:
3646:
2180:
2178:
2176:
2174:
2172:
2170:
1867:
1763:
1761:
1759:
1757:
1755:
1753:
1751:
1749:
1747:
1721:
1719:
1658:
1007:Individual, modifiable risk factors include:
751:Grade B: Moderate rate of disease progression
3165:
3163:
3161:
2340:Van Dyke, Thomas E.; Dave, Sheilesh (2005).
2339:
2328:
2214:11245.1/e91456f0-e330-42d8-9c0c-319784f6777a
2029:
2027:
1926:Journal of Periodontal & Implant Science
1919:
1828:Dental Radiography Principles and Techniques
1728:
3606:Canadian Academy directory of Periodontists
3203:
3201:
2033:
1844:
1691:
1689:
1687:
1685:
1683:
842:Localized dental prostheses-related factors
763:Other conditions affecting the periodontium
609:Gingival diseases—nondental biofilm-induced
600:Medicated by systemic or local risk factors
330:is the fibrous tissue that encompasses the
4376:
4362:
3653:
3639:
2487:Journal of the American Dental Association
2184:
2167:
2107:
2075:
2073:
2071:
2034:Hasan, A.; Palmer, R. M. (25 April 2014).
1744:
1716:
754:Grade C: Rapid rate of disease progression
3563:
3479:
3469:
3428:
3285:Community Dentistry and Oral Epidemiology
3233:
3158:
3141:
3131:
3090:
3049:
3039:
2941:
2931:
2855:
2814:
2398:
2357:
2275:
2212:
2202:
2185:Marsh, P. D.; Zaura, Egija (March 2017).
2051:
2024:
1986:
1945:
1896:
1878:
1421:National Dental Examining Board of Canada
748:Grade A: Slow rate of disease progression
122:Learn how and when to remove this message
4652:Index of oral health and dental articles
4421:Orthodontics and dentofacial orthopedics
3626:South African Society for Periodontology
3198:
3066:
2969:
2967:
2965:
2963:
2961:
2878:
2797:Taylor, Barbara Anne (1 February 2003).
2276:Gurenlian, JoAnn R. (31 December 2007).
1850:
1825:
1695:
1680:
1493:
1430:
1359:
766:
652:
644:
558:
550:
295:
3798:Combined periodontic-endodontic lesions
3360:"Becoming a licensed dentist in Canada"
3016:
3014:
3012:
3010:
3008:
3006:
2914:Preshaw, Philip M (15 September 2015).
2913:
2838:Kinane, DF; Marshall, GJ (March 2001).
2282:American Dental Hygienists' Association
2068:
1482:acute necrotizing ulcerative gingivitis
1476:Necrotizing ulcerative gingivitis (NUG)
457:
392:
14:
4712:
3505:Oral Health & Preventive Dentistry
3316:
3314:
3107:
2796:
2298:
1214:
572:Periodontal health and gingival health
371:
256:that studies supporting structures of
4580:Canadian Association of Orthodontists
4560:American Association of Orthodontists
4357:
4187:Subepithelial connective tissue graft
3634:
3616:European Federation of Periodontology
2958:
2674:
1289:Periodontal and restorative interface
1248:Phase III therapy (restorative phase)
1181:
1063:Non-modifiable risk factors include:
771:Abscessed tooth periapical radiograph
740:Evidence or risk of rapid progression
541:European Federation of Periodontology
4657:Outline of dentistry and oral health
3773:Generalized aggressive periodontitis
3384:. American Academy of Periodontology
3278:
3003:
1830:(6E ed.). Evolve. p. 338.
1545:
1264:Phase IV therapy (maintenance phase)
883:aids such as interdental brushes or
849:Peri-implant diseases and conditions
603:Drug-influenced gingival enlargement
597:Associated with dental biofilm alone
434:
60:adding citations to reliable sources
31:
3311:
2313:10.1034/j.1600-0757.2001.22250102.x
1417:Royal College of Dentists of Canada
350:
291:
24:
3768:Localized aggressive periodontitis
3258:"Guidelines for scope of practice"
3214:Journal of Clinical Periodontology
2857:10.1111/j.1834-7819.2001.tb00267.x
2642:Journal of Clinical Periodontology
2557:Journal of Clinical Periodontology
2191:Journal of Clinical Periodontology
2154:American Academy of Periodontology
1857:The Australian Journal of Pharmacy
1260:, or other restoration processes.
808:Aberrant frenum or muscle position
619:Inflammatory and immune conditions
613:Genetic or developmental disorders
537:American Academy of Periodontology
384:
25:
4731:
4091:Full mouth ultrasonic debridement
3601:British Society of Periodontology
3584:
2893:10.1046/j.0906-6713.2002.003421.x
2654:10.1034/j.1600-051x.2002.290311.x
2387:Indian Journal of Dental Sciences
1336:Role of the oral health therapist
1314:Standard of periodontal treatment
1228:Phase II therapy (surgical phase)
1148:
817:Condition of exposed root surface
593:Gingivitis—dental biofilm-induced
4585:Dental Technologists Association
4570:British Dental Health Foundation
4411:Oral and maxillofacial radiology
4406:Oral and maxillofacial pathology
3788:Necrotizing periodontal diseases
3297:10.1111/j.1600-0528.2012.00734.x
2569:10.1034/j.1600-051x.2003.00354.x
2342:"Risk Factors for Periodontitis"
2128:10.1111/j.1600-0757.2012.00457.x
1898:10.1111/j.1834-7819.2009.01140.x
1509:
1452:American Board of Periodontology
1426:
716:Stage II: Moderate periodontitis
671:Necrotizing periodontal diseases
409:
36:
3539:
3496:
3445:
3396:
3370:
3352:
3326:
3279:Nash, David A. (October 2012).
3272:
3250:
2907:
2872:
2831:
2790:
2747:
2711:
2668:
2633:
2598:
2583:
2548:
2513:
2499:10.14219/jada.archive.1997.0259
2478:
2442:
2407:
2374:
2292:
2142:
2003:
1962:
1913:
1879:Highfield, J (September 2009).
1588:
1579:
1570:
1561:
1552:
1347:
994:
981:plays an important role in the
972:
839:Localized tooth-related factors
321:
47:needs additional citations for
4416:Oral and maxillofacial surgery
3591:AAP Directory of Periodontists
2677:Acta Odontologica Scandinavica
2594:. Washington, D.C.: ASM Press.
1819:
1794:
1633:
1608:
1457:
1158:
799:Gingival/soft tissue recession
788:Endodontic periodontal lesions
744:anticipated treatment response
713:Stage I: Initial periodontitis
13:
1:
4383:
3793:Abscesses of the periodontium
2250:10.1146/annurev.micro.54.1.49
2238:Annual Review of Microbiology
2011:"Periodontology: an Overview"
1851:de Vries, Kevin (July 2015).
1641:"Anatomy of the Periodontium"
1601:
1466:
1164:Phases of periodontal therapy
870:
782:Other periodontal conditions
4677:History of dental treatments
2816:10.18773/austprescr.2003.007
1438:periodontics graduate clinic
1129:
914:
894:
582:Stable periodontitis patient
7:
4575:British Orthodontic Society
3421:10.1097/MD.0000000000007892
3260:. Dental Board of Australia
3184:10.12968/denu.2008.35.3.150
2733:10.1902/jop.2000.71.11.1699
1502:
1444:American Dental Association
1397:
1390:pocket reduction procedures
418:
312:
10:
4736:
4565:British Dental Association
4147:Guided tissue regeneration
2933:10.1186/1472-6831-15-s1-s5
2768:10.1177/154405910308200202
2756:Journal of Dental Research
2428:10.1902/jop.1986.57.10.617
1938:10.5051/jpis.2017.47.5.264
1853:"Primary care: Gingivitis"
1710:10.12968/denn.2011.7.7.376
1670:Periodontology at a Glance
1393:plastic surgery procedures
822:Traumatic occlusal forces
805:Decreased vestibular depth
563:Gingivitis after treatment
237:
225:
213:
4644:
4608:
4595:Indian Dental Association
4552:
4484:
4391:
4325:
4224:
4117:Coronally positioned flap
4099:
4068:
4061:
3986:
3890:
3806:
3753:
3746:
3670:
3471:10.1186/s12903-016-0214-z
3378:"What Is a Periodontist?"
3133:10.1186/s12903-016-0258-0
2977:Journal of Periodontology
2844:Australian Dental Journal
2721:Journal of Periodontology
2689:10.1080/00016350260248210
2607:Journal of Periodontology
2534:10.1902/jop.2001.72.2.183
2522:Journal of Periodontology
2464:10.1902/jop.1994.65.3.260
2452:Journal of Periodontology
2416:Journal of Periodontology
1885:Australian Dental Journal
1616:"What Is a Periodontist?"
1409:
1330:Motivational interviewing
828:Secondary occlusal trauma
681:Necrotizing periodontitis
585:Non-periodontitis patient
185:
173:
168:
156:
144:
139:
4514:Scaling and root planing
4172:Pocket reduction surgery
4152:Enamel matrix derivative
4142:Guided bone regeneration
4107:Apically positioned flap
4081:Scaling and root planing
3987:Treatment and prevention
3948:Linear gingival erythema
3903:Clinical attachment loss
3817:A. actinomycetemcomitans
1436:UCLA School of Dentistry
1384:dental crown lengthening
1099:Haematological disorders
887:and using a fluoridated
709:complexity of management
657:Bone loss in periapical
284:and in the placement of
4600:National Health Service
4225:Important personalities
4086:Full mouth disinfection
4049:Host modulatory therapy
4014:Chlorhexidine gluconate
3994:Periodontal examination
3611:Dental Council of India
3565:10.2334/josnusd.18-0128
3552:Journal of Oral Science
3041:10.1186/1472-6831-14-56
2989:10.1902/jop.2010.090732
2619:10.1902/jop.2009.080584
2400:10.4103/ijds.ijds_96_16
2053:10.1038/sj.bdj.2014.299
1826:Iannucci, Joen (2017).
1381:regenerative procedures
1372:non-surgical treatments
825:Primary occlusal trauma
728:Extent and distribution
332:cemento-enamel junction
4689:Infant oral mutilation
4590:General Dental Council
3943:Horizontal bony defect
3079:British Dental Journal
2592:Polymicrobial diseases
2040:British Dental Journal
1988:10.1038/sj.bdj.4801068
1975:British Dental Journal
1439:
1365:
1141:periodontal diagnosis.
1081:Drug-induced disorders
1045:Cardiovascular disease
860:Peri-implant mucositis
772:
684:Necrotizing stomatitis
677:Necrotizing gingivitis
661:
650:
564:
556:
343:layer called the oral
302:
4461:Restorative dentistry
4167:Open flap debridement
4162:Lateral pedicle graft
3763:Chronic periodontitis
3723:Mucogingival junction
3718:Junctional epithelium
3517:10.3290/j.ohpd.a38766
2803:Australian Prescriber
1802:"Search the Glossary"
1674:John Wiley & Sons
1494:Chronic periodontitis
1434:
1363:
1326:chronic periodontitis
1307:gingival inflammation
1271:oral health therapist
785:Periodontal abscesses
770:
656:
648:
634:Gingival pigmentation
562:
554:
362:mucogingival junction
357:junctional epithelium
299:
264:, which includes the
4441:Dental public health
4297:Paul Roscoe Stillman
4272:Willoughby D. Miller
4242:Per-Ingvar Brånemark
4069:Conventional therapy
3978:Vertical bony defect
3923:Gingival enlargement
3873:Entamoeba gingivalis
3728:Periodontal ligament
3698:Free gingival margin
1116:socioeconomic status
1089:gingival enlargement
1034:vitamin D deficiency
881:interdental cleaning
458:Periodontal diseases
399:periodontal ligament
393:Periodontal ligament
278:periodontal ligament
236:– 'tooth', genitive
56:improve this article
4539:Socket preservation
4471:Dental traumatology
4466:Forensic odontology
4456:Geriatric dentistry
4451:Dental implantology
4426:Pediatric dentistry
4312:James Leon Williams
4177:Socket preservation
4127:Free gingival graft
4009:Bleeding on probing
3963:Periodontal disease
3733:Sulcular epithelium
3092:10.1038/bdj.2007.23
2881:Periodontology 2000
2301:Periodontology 2000
2116:Periodontology 2000
1355:periodontal surgery
1215:Re-evaluation phase
1207:tooth movement and
1018:Alcohol consumption
857:Peri-implant health
616:Specific infections
483:immuno-inflammatory
378:interdental gingiva
372:Interdental gingiva
345:sulcular epithelium
282:periodontal disease
196:, private practices
136:
4667:Dental instruments
4504:Root canal therapy
4476:Holistic dentistry
4446:Cosmetic dentistry
3958:Periodontal pocket
3933:Gingival recession
3824:Capnocytophaga sp.
3226:10.1111/jcpe.12730
2204:10.1111/jcpe.12679
2095:on 26 January 2021
1440:
1366:
1234:periodontal pocket
1182:Non-surgical phase
831:Orthodontic forces
796:Gingival phenotype
773:
662:
651:
622:Reactive processes
565:
557:
525:metabolic syndrome
506:gingival recession
303:
175:Education required
134:
27:Field of dentistry
4707:
4706:
4494:Dental extraction
4351:
4350:
4326:Other specialties
4282:John Mankey Riggs
4267:Preston D. Miller
4232:Tomas Albrektsson
4220:
4219:
4157:Implant placement
4132:Gingival grafting
4122:Crown lengthening
4057:
4056:
4024:Hydrogen peroxide
3881:Trichomonas tenax
3334:"Welcome to CDAC"
2727:(11): 1699–1707.
2089:Colgate-Palmolive
2085:Colgate Australia
1837:978-0-323-69550-3
1806:Members.Perio.org
1779:978-1-4963-8402-7
1546:Explanatory notes
1375:gum graft surgery
1254:dental prosthesis
1024:Diabetes Mellitus
937:acquired pellicle
909:ultrasonic scaler
631:Traumatic lesions
435:Gingival diseases
200:
199:
132:
131:
124:
106:
16:(Redirected from
4727:
4694:Mouth assessment
4509:Root end surgery
4378:
4371:
4364:
4355:
4354:
4343:Prosthodontology
4302:Dennis P. Tarnow
4247:Robert Gottsegen
4066:
4065:
3918:Furcation defect
3751:
3750:
3655:
3648:
3641:
3632:
3631:
3578:
3577:
3567:
3543:
3537:
3536:
3500:
3494:
3493:
3483:
3473:
3449:
3443:
3442:
3432:
3400:
3394:
3393:
3391:
3389:
3374:
3368:
3367:
3356:
3350:
3349:
3347:
3345:
3330:
3324:
3318:
3309:
3308:
3276:
3270:
3269:
3267:
3265:
3254:
3248:
3247:
3237:
3205:
3196:
3195:
3167:
3156:
3155:
3145:
3135:
3111:
3105:
3104:
3094:
3070:
3064:
3063:
3053:
3043:
3018:
3001:
3000:
2983:(7): 1056–1063.
2971:
2956:
2955:
2945:
2935:
2911:
2905:
2904:
2876:
2870:
2869:
2859:
2835:
2829:
2828:
2818:
2794:
2788:
2787:
2751:
2745:
2744:
2715:
2709:
2708:
2672:
2666:
2665:
2637:
2631:
2630:
2602:
2596:
2595:
2587:
2581:
2580:
2552:
2546:
2545:
2517:
2511:
2510:
2482:
2476:
2475:
2446:
2440:
2439:
2411:
2405:
2404:
2402:
2378:
2372:
2371:
2361:
2337:
2326:
2324:
2296:
2290:
2289:
2273:
2262:
2261:
2233:
2227:
2226:
2216:
2206:
2182:
2165:
2164:
2162:
2160:
2146:
2140:
2139:
2111:
2105:
2104:
2102:
2100:
2091:. Archived from
2077:
2066:
2065:
2055:
2031:
2022:
2021:
2019:
2017:
2007:
2001:
2000:
1990:
1966:
1960:
1959:
1949:
1917:
1911:
1910:
1900:
1876:
1865:
1864:
1848:
1842:
1841:
1823:
1817:
1816:
1814:
1812:
1798:
1792:
1791:
1765:
1742:
1739:
1726:
1723:
1714:
1713:
1693:
1678:
1677:
1665:
1656:
1655:
1653:
1651:
1637:
1631:
1630:
1628:
1626:
1612:
1595:
1592:
1586:
1583:
1577:
1574:
1568:
1565:
1559:
1556:
1519:
1514:
1513:
1512:
1342:dental therapist
977:An individual's
905:hand instruments
901:dental hygienist
863:Peri-implantitis
429:dentinal tubules
404:Sharpey's fibres
351:Attached gingiva
292:The periodontium
247:
241:
235:
229:
224:– 'around'; and
223:
217:
158:Activity sectors
137:
133:
127:
120:
116:
113:
107:
105:
71:"Periodontology"
64:
40:
32:
21:
4735:
4734:
4730:
4729:
4728:
4726:
4725:
4724:
4710:
4709:
4708:
4703:
4672:Dental material
4640:
4604:
4548:
4534:Tooth bleaching
4529:Tooth polishing
4480:
4387:
4382:
4352:
4347:
4321:
4252:Gary Greenstein
4216:
4095:
4053:
3982:
3953:Occlusal trauma
3928:Gingival pocket
3886:
3802:
3742:
3713:Gingival sulcus
3708:Gingival fibers
3666:
3659:
3587:
3582:
3581:
3544:
3540:
3501:
3497:
3458:BMC Oral Health
3450:
3446:
3401:
3397:
3387:
3385:
3376:
3375:
3371:
3358:
3357:
3353:
3343:
3341:
3332:
3331:
3327:
3319:
3312:
3277:
3273:
3263:
3261:
3256:
3255:
3251:
3206:
3199:
3168:
3159:
3120:BMC Oral Health
3112:
3108:
3071:
3067:
3028:BMC Oral Health
3019:
3004:
2972:
2959:
2920:BMC Oral Health
2912:
2908:
2877:
2873:
2836:
2832:
2795:
2791:
2752:
2748:
2716:
2712:
2673:
2669:
2638:
2634:
2603:
2599:
2588:
2584:
2553:
2549:
2518:
2514:
2483:
2479:
2447:
2443:
2422:(10): 617–624.
2412:
2408:
2379:
2375:
2338:
2329:
2297:
2293:
2288:(suppl 1): 116.
2274:
2265:
2234:
2230:
2183:
2168:
2158:
2156:
2148:
2147:
2143:
2112:
2108:
2098:
2096:
2079:
2078:
2069:
2032:
2025:
2015:
2013:
2009:
2008:
2004:
1981:(12): 658–662.
1967:
1963:
1918:
1914:
1877:
1868:
1849:
1845:
1838:
1824:
1820:
1810:
1808:
1800:
1799:
1795:
1780:
1766:
1745:
1740:
1729:
1724:
1717:
1694:
1681:
1666:
1659:
1649:
1647:
1639:
1638:
1634:
1624:
1622:
1614:
1613:
1609:
1604:
1599:
1598:
1593:
1589:
1584:
1580:
1575:
1571:
1566:
1562:
1557:
1553:
1548:
1517:Medicine portal
1515:
1510:
1508:
1505:
1496:
1478:
1469:
1460:
1429:
1412:
1400:
1387:dental implants
1378:laser treatment
1350:
1338:
1316:
1291:
1266:
1250:
1230:
1217:
1184:
1179:
1166:
1161:
1132:
1012:Tobacco smoking
997:
975:
917:
897:
873:
851:
814:Abnormal colour
811:Gingival excess
802:Lack of gingiva
765:
643:
555:Healthy gingiva
549:
533:
495:gingival pocket
469:bacteria (e.g.
460:
437:
421:
412:
395:
387:
385:Alveolar mucosa
374:
353:
341:non-keratinised
336:gingival sulcus
328:gingival margin
324:
315:
294:
286:dental implants
190:
188:
176:
159:
147:
146:Occupation type
128:
117:
111:
108:
65:
63:
53:
41:
28:
23:
22:
15:
12:
11:
5:
4733:
4723:
4722:
4720:Periodontology
4705:
4704:
4702:
4701:
4696:
4691:
4686:
4685:
4684:
4674:
4669:
4664:
4659:
4654:
4648:
4646:
4642:
4641:
4639:
4638:
4633:
4631:United Kingdom
4628:
4623:
4618:
4612:
4610:
4606:
4605:
4603:
4602:
4597:
4592:
4587:
4582:
4577:
4572:
4567:
4562:
4556:
4554:
4550:
4549:
4547:
4546:
4544:Dental implant
4541:
4536:
4531:
4526:
4524:Dental bonding
4521:
4519:Teeth cleaning
4516:
4511:
4506:
4501:
4496:
4490:
4488:
4486:Dental surgery
4482:
4481:
4479:
4478:
4473:
4468:
4463:
4458:
4453:
4448:
4443:
4438:
4436:Prosthodontics
4433:
4428:
4423:
4418:
4413:
4408:
4403:
4397:
4395:
4389:
4388:
4381:
4380:
4373:
4366:
4358:
4349:
4348:
4346:
4345:
4340:
4338:Orthodontology
4335:
4329:
4327:
4323:
4322:
4320:
4319:
4314:
4309:
4304:
4299:
4294:
4289:
4284:
4279:
4274:
4269:
4264:
4259:
4254:
4249:
4244:
4239:
4234:
4228:
4226:
4222:
4221:
4218:
4217:
4215:
4214:
4213:
4212:
4207:
4202:
4197:
4189:
4184:
4179:
4174:
4169:
4164:
4159:
4154:
4149:
4144:
4139:
4134:
4129:
4124:
4119:
4114:
4109:
4103:
4101:
4097:
4096:
4094:
4093:
4088:
4083:
4078:
4072:
4070:
4063:
4059:
4058:
4055:
4054:
4052:
4051:
4046:
4041:
4036:
4031:
4026:
4021:
4016:
4011:
4006:
4001:
3996:
3990:
3988:
3984:
3983:
3981:
3980:
3975:
3970:
3965:
3960:
3955:
3950:
3945:
3940:
3935:
3930:
3925:
3920:
3915:
3910:
3905:
3900:
3894:
3892:
3888:
3887:
3885:
3884:
3877:
3869:
3862:
3855:
3848:
3841:
3834:
3827:
3820:
3812:
3810:
3804:
3803:
3801:
3800:
3795:
3790:
3785:
3780:
3775:
3770:
3765:
3759:
3757:
3748:
3744:
3743:
3741:
3740:
3735:
3730:
3725:
3720:
3715:
3710:
3705:
3700:
3695:
3690:
3688:Biologic width
3685:
3680:
3674:
3672:
3668:
3667:
3663:Periodontology
3658:
3657:
3650:
3643:
3635:
3629:
3628:
3623:
3618:
3613:
3608:
3603:
3598:
3593:
3586:
3585:External links
3583:
3580:
3579:
3558:(2): 238–245.
3538:
3511:(4): 321–327.
3495:
3444:
3395:
3369:
3351:
3325:
3310:
3271:
3249:
3220:(6): 620–631.
3197:
3178:(3): 150–156.
3157:
3106:
3065:
3002:
2957:
2906:
2871:
2830:
2789:
2746:
2710:
2683:(5): 257–264.
2667:
2648:(3): 247–253.
2632:
2613:(5): 740–748.
2597:
2582:
2563:(7): 579–589.
2547:
2528:(2): 183–189.
2512:
2493:(5): 599–607.
2477:
2458:(3): 260–267.
2441:
2406:
2373:
2327:
2291:
2263:
2228:
2166:
2141:
2106:
2067:
2046:(8): 457–461.
2023:
2002:
1961:
1932:(5): 264–272.
1912:
1866:
1843:
1836:
1818:
1793:
1778:
1743:
1727:
1715:
1704:(7): 376–378.
1698:Dental Nursing
1679:
1672:. Chichester:
1657:
1645:DentalCare.com
1632:
1606:
1605:
1603:
1600:
1597:
1596:
1587:
1578:
1569:
1560:
1550:
1549:
1547:
1544:
1543:
1542:
1537:
1532:
1530:Gingival graft
1527:
1521:
1520:
1504:
1501:
1495:
1492:
1477:
1474:
1468:
1465:
1459:
1456:
1428:
1425:
1411:
1408:
1399:
1396:
1395:
1394:
1391:
1388:
1385:
1382:
1379:
1376:
1373:
1364:Dental implant
1349:
1346:
1337:
1334:
1315:
1312:
1311:
1310:
1303:
1299:
1290:
1287:
1265:
1262:
1258:prosthodontics
1249:
1246:
1240:involvements,
1229:
1226:
1216:
1213:
1199:factors, deep
1183:
1180:
1178:
1175:
1165:
1162:
1160:
1157:
1131:
1128:
1103:
1102:
1096:
1078:
1072:
1061:
1060:
1054:
1048:
1042:
1038:
1027:
1021:
1015:
996:
993:
974:
971:
966:
965:
962:
958:
955:
951:
947:
944:
933:
930:hydroxyapatite
916:
913:
896:
893:
877:tooth brushing
872:
869:
868:
867:
864:
861:
858:
850:
847:
846:
845:
844:
843:
840:
834:
833:
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829:
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820:
819:
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809:
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800:
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790:
789:
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780:
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760:
759:
758:
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756:
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752:
749:
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724:
723:
720:
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714:
693:
687:
686:
685:
682:
679:
642:
639:
638:
637:
636:
635:
632:
629:
626:
623:
620:
617:
614:
606:
605:
604:
601:
598:
590:
589:
588:
587:
586:
583:
577:
548:
545:
539:(AAP) and the
532:
529:
512:(bad breath),
459:
456:
436:
433:
420:
417:
411:
408:
394:
391:
386:
383:
373:
370:
352:
349:
323:
320:
314:
311:
293:
290:
203:Periodontology
198:
197:
191:
186:
183:
182:
177:
174:
171:
170:
166:
165:
160:
157:
154:
153:
148:
145:
142:
141:
130:
129:
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35:
26:
9:
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4:
3:
2:
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4690:
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4679:
4678:
4675:
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4670:
4668:
4665:
4663:
4660:
4658:
4655:
4653:
4650:
4649:
4647:
4643:
4637:
4636:United States
4634:
4632:
4629:
4627:
4624:
4622:
4619:
4617:
4614:
4613:
4611:
4607:
4601:
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4591:
4588:
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4581:
4578:
4576:
4573:
4571:
4568:
4566:
4563:
4561:
4558:
4557:
4555:
4553:Organisations
4551:
4545:
4542:
4540:
4537:
4535:
4532:
4530:
4527:
4525:
4522:
4520:
4517:
4515:
4512:
4510:
4507:
4505:
4502:
4500:
4499:Tooth filling
4497:
4495:
4492:
4491:
4489:
4487:
4483:
4477:
4474:
4472:
4469:
4467:
4464:
4462:
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4457:
4454:
4452:
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4439:
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4414:
4412:
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4407:
4404:
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4396:
4394:
4390:
4386:
4379:
4374:
4372:
4367:
4365:
4360:
4359:
4356:
4344:
4341:
4339:
4336:
4334:
4333:Endodontology
4331:
4330:
4328:
4324:
4318:
4317:W. J. Younger
4315:
4313:
4310:
4308:
4305:
4303:
4300:
4298:
4295:
4293:
4290:
4288:
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4280:
4278:
4277:Carl E. Misch
4275:
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4211:
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4198:
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4110:
4108:
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4102:
4098:
4092:
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4079:
4077:
4074:
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4064:
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4050:
4047:
4045:
4042:
4040:
4037:
4035:
4032:
4030:
4027:
4025:
4022:
4020:
4017:
4015:
4012:
4010:
4007:
4005:
4002:
4000:
3997:
3995:
3992:
3991:
3989:
3985:
3979:
3976:
3974:
3971:
3969:
3968:Periodontitis
3966:
3964:
3961:
3959:
3956:
3954:
3951:
3949:
3946:
3944:
3941:
3939:
3936:
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3926:
3924:
3921:
3919:
3916:
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3909:
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3896:
3895:
3893:
3889:
3883:
3882:
3878:
3875:
3874:
3870:
3868:
3867:
3863:
3861:
3860:
3856:
3854:
3853:
3849:
3847:
3846:
3845:P. intermedia
3842:
3840:
3839:
3838:P. gingivalis
3835:
3833:
3832:
3828:
3826:
3825:
3821:
3819:
3818:
3814:
3813:
3811:
3809:
3805:
3799:
3796:
3794:
3791:
3789:
3786:
3784:
3783:Periodontosis
3781:
3779:
3776:
3774:
3771:
3769:
3766:
3764:
3761:
3760:
3758:
3756:
3752:
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3709:
3706:
3704:
3701:
3699:
3696:
3694:
3691:
3689:
3686:
3684:
3683:Alveolar bone
3681:
3679:
3676:
3675:
3673:
3669:
3664:
3656:
3651:
3649:
3644:
3642:
3637:
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3472:
3467:
3463:
3459:
3455:
3448:
3440:
3436:
3431:
3426:
3422:
3418:
3415:(35): e7892.
3414:
3410:
3406:
3399:
3383:
3379:
3373:
3365:
3361:
3355:
3339:
3335:
3329:
3323:
3317:
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3306:
3302:
3298:
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3286:
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3275:
3259:
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3223:
3219:
3215:
3211:
3204:
3202:
3193:
3189:
3185:
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3177:
3173:
3172:Dental Update
3166:
3164:
3162:
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3149:
3144:
3139:
3134:
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3121:
3117:
3110:
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3017:
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3009:
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2523:
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2496:
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2469:
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2295:
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2255:
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2247:
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2239:
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2196:
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2175:
2173:
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2155:
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2145:
2137:
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2117:
2110:
2094:
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2063:
2059:
2054:
2049:
2045:
2041:
2037:
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2012:
2006:
1998:
1994:
1989:
1984:
1980:
1976:
1972:
1965:
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1611:
1607:
1591:
1582:
1573:
1564:
1555:
1551:
1541:
1538:
1536:
1535:Periodontitis
1533:
1531:
1528:
1526:
1525:Bone grafting
1523:
1522:
1518:
1507:
1500:
1491:
1488:
1487:chlorhexidine
1483:
1473:
1464:
1455:
1454:examination.
1453:
1449:
1448:oral medicine
1445:
1437:
1433:
1427:United States
1424:
1422:
1418:
1407:
1405:
1404:dental degree
1392:
1389:
1386:
1383:
1380:
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1210:
1206:
1202:
1198:
1194:
1190:
1174:
1172:
1156:
1154:
1150:
1149:periodontists
1145:
1142:
1138:
1127:
1123:
1121:
1117:
1113:
1109:
1100:
1097:
1094:
1093:poly-pharmacy
1090:
1086:
1082:
1079:
1076:
1073:
1069:
1066:
1065:
1064:
1058:
1055:
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1031:
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1025:
1022:
1019:
1016:
1013:
1010:
1009:
1008:
1005:
1001:
992:
989:
984:
980:
979:host response
970:
963:
959:
956:
952:
948:
945:
942:
938:
934:
931:
927:
923:
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892:
890:
886:
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878:
865:
862:
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855:
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841:
838:
837:
835:
830:
827:
824:
823:
821:
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801:
798:
795:
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792:
787:
784:
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781:
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776:
769:
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750:
747:
746:
745:
741:
738:
735:
733:
729:
726:
721:
718:
715:
712:
711:
710:
706:
702:
699:
698:
697:
696:Periodontitis
694:
691:
688:
683:
680:
678:
675:
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673:
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581:
580:
578:
575:
574:
573:
570:
569:
568:
561:
553:
544:
542:
538:
535:In 2017, the
528:
526:
521:
519:
515:
511:
507:
502:
498:
496:
490:
488:
484:
480:
476:
472:
471:P. gingivalis
468:
463:
455:
453:
449:
446:
441:
432:
430:
426:
416:
410:Alveolar bone
407:
405:
400:
390:
382:
379:
369:
367:
363:
358:
348:
346:
342:
337:
333:
329:
319:
310:
308:
298:
289:
287:
283:
279:
275:
271:
270:alveolar bone
267:
263:
259:
255:
251:
246:
240:
234:
228:
222:
216:
212:
211:Ancient Greek
208:
204:
195:
192:
184:
181:
180:Dental degree
178:
172:
167:
164:
161:
155:
152:
149:
143:
138:
126:
123:
115:
104:
101:
97:
94:
90:
87:
83:
80:
76:
73: –
72:
68:
67:Find sources:
61:
57:
51:
50:
45:This article
43:
39:
34:
33:
30:
19:
4699:Oral hygiene
4682:Ancient Rome
4431:Periodontics
4307:Hom-Lay Wang
4292:Jørgen Slots
4262:Brian Mealey
4137:Gingivectomy
4039:Tetracycline
4034:Oral hygiene
3879:
3871:
3864:
3859:T. denticola
3857:
3852:T. forsythia
3850:
3843:
3836:
3831:F. nucleatum
3829:
3822:
3815:
3678:Periodontium
3662:
3555:
3551:
3541:
3508:
3504:
3498:
3461:
3457:
3447:
3412:
3408:
3398:
3386:. Retrieved
3381:
3372:
3364:NDEB-BNED.ca
3363:
3354:
3342:. Retrieved
3337:
3328:
3288:
3284:
3274:
3262:. Retrieved
3252:
3217:
3213:
3175:
3171:
3123:
3119:
3109:
3085:(2): 63–72.
3082:
3078:
3068:
3031:
3027:
2980:
2976:
2923:
2919:
2909:
2884:
2880:
2874:
2847:
2843:
2833:
2806:
2802:
2792:
2762:(2): 82–90.
2759:
2755:
2749:
2724:
2720:
2713:
2680:
2676:
2670:
2645:
2641:
2635:
2610:
2606:
2600:
2591:
2585:
2560:
2556:
2550:
2525:
2521:
2515:
2490:
2486:
2480:
2455:
2451:
2444:
2419:
2415:
2409:
2390:
2386:
2376:
2349:
2345:
2304:
2300:
2294:
2285:
2281:
2244:(1): 49–79.
2241:
2237:
2231:
2194:
2190:
2157:. Retrieved
2153:
2144:
2122:(1): 59–94.
2119:
2115:
2109:
2097:. Retrieved
2093:the original
2084:
2043:
2039:
2016:17 September
2014:. Retrieved
2005:
1978:
1974:
1964:
1929:
1925:
1915:
1888:
1884:
1860:
1856:
1846:
1827:
1821:
1809:. Retrieved
1805:
1796:
1769:
1701:
1697:
1669:
1648:. Retrieved
1644:
1635:
1623:. Retrieved
1619:
1610:
1590:
1581:
1572:
1563:
1554:
1497:
1479:
1470:
1461:
1441:
1413:
1401:
1367:
1351:
1348:Periodontist
1339:
1317:
1302:restoration.
1292:
1279:periodontist
1267:
1251:
1231:
1218:
1192:
1185:
1167:
1146:
1140:
1133:
1124:
1104:
1075:Osteoporosis
1062:
1006:
1002:
998:
995:Risk factors
983:pathogenesis
976:
973:Pathogenesis
967:
918:
898:
874:
852:
774:
743:
739:
736:
731:
727:
708:
704:
700:
695:
689:
669:
663:
608:
592:
571:
566:
534:
522:
514:mobile teeth
503:
499:
491:
479:T. denticola
475:T. forsythia
464:
461:
452:oral hygiene
438:
422:
413:
396:
388:
375:
354:
325:
322:Free gingiva
316:
307:periodontium
306:
304:
262:periodontium
244:
232:
220:
207:periodontics
206:
202:
201:
135:Periodontist
118:
112:January 2015
109:
99:
92:
85:
78:
66:
54:Please help
49:verification
46:
29:
18:Periodontics
4662:Dental fear
4621:Philippines
4401:Endodontics
4393:Specialties
4287:Jay Seibert
4237:Frank Beube
4076:Debridement
3866:Red complex
3344:27 February
3291:: 141–147.
2887:(1): 9–21.
2850:(1): 2–12.
2809:(1): 11–3.
2307:(1): 8–20.
2197:: S12–S22.
2159:21 February
1891:: S11–S26.
1863:(1141): 64.
1458:Maintenance
1209:debridement
1205:orthodontic
1189:tooth decay
1153:Radiographs
988:phagocytose
879:technique,
467:red complex
366:mastication
169:Description
4609:By country
4257:Jan Lindhe
4182:Sinus lift
4112:Bone graft
3999:Ante's law
3938:Gingivitis
3908:Edentulism
3388:26 January
3338:CDA-ADC.ca
2926:(S1): S5.
2352:(1): 3–7.
1811:21 October
1788:1054269026
1650:21 October
1625:21 October
1602:References
1540:Sinus lift
1467:Gingivitis
1197:iatrogenic
1193:gingivitis
1071:pathogens.
889:toothpaste
871:Prevention
659:radiograph
487:tooth loss
440:Gingivitis
276:, and the
189:employment
140:Occupation
82:newspapers
4385:Dentistry
4062:Treatment
4044:Triclosan
4029:Mouthwash
3876:(amoebic)
3808:Infection
3755:Diagnoses
3738:Stippling
3464:(1): 57.
3382:Perio.org
3126:(1): 27.
3034:(1): 56.
2393:(1): 44.
1620:Perio.org
1463:such as:
1321:pathogens
1238:furcation
1222:diagnosis
1171:prognosis
1159:Treatment
1137:aetiology
1130:Diagnosis
1120:education
1085:dry mouth
1057:Pregnancy
950:pellicle.
915:Aetiology
895:Treatment
703:Based on
625:Neoplasms
510:halitosis
305:The term
254:dentistry
250:specialty
248:) is the
194:Hospitals
187:Fields of
163:Dentistry
151:Specialty
4714:Category
4645:See also
4200:Membrane
4019:Flossing
4004:Brushing
3913:Fremitus
3898:Calculus
3693:Cementum
3574:31217373
3533:32401805
3525:28761942
3490:27216479
3439:28858105
3409:Medicine
3305:22998319
3244:28419497
3192:18507223
3152:27456238
3101:17255985
3060:24884465
2997:20192617
2952:26390822
2901:14717852
2866:11355236
2825:11709926
2784:40812937
2776:12562878
2741:11128917
2705:25407488
2697:12418714
2662:11940145
2627:19405827
2577:12834494
2542:11288791
2368:15736889
2321:11155179
2258:11018124
2223:28266111
2136:23574464
2062:24762896
1997:11453155
1956:29093985
1907:19737262
1503:See also
1398:Training
1298:outcome.
1281:and the
1068:Genetics
941:adhesins
939:through
705:severity
518:calculus
419:Cementum
313:Gingivae
274:cementum
268:(gums),
4195:Curette
4100:Surgery
3747:Disease
3703:Gingiva
3671:Anatomy
3481:4878033
3430:5585499
3235:5519943
3143:4960759
3051:4033493
2943:4580822
2507:9150643
2472:8164120
2436:3534210
2359:1351013
1947:5663665
1283:patient
1275:dentist
1030:Obesity
737:Grades:
701:Stages:
448:biofilm
425:dentine
266:gingiva
245:odóntos
239:ὀδόντος
96:scholar
4626:Israel
4616:Canada
4210:Scaler
4191:Tools
3973:Plaque
3572:
3531:
3523:
3488:
3478:
3437:
3427:
3303:
3242:
3232:
3190:
3150:
3140:
3099:
3058:
3048:
2995:
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