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GOOD AFTERNOONAGING AND THE PERIODONTIUMCONTENTS:

Introduction Effects of aging on the Periodontium Gingiva and Gingival Epithelium Gingival connective tissue Periodontal ligament Cementum Alveolar bone Bacterial plaque Immune responseEffects of aging on progression of periodontal diseaseAging and response to the treatment of periodontiumConclusionReferencesIntroduction:Aging is the process of becoming older and the periodontium includes the investing and the supporting tissues.This topic Aging and the Periodontium focuses on the impact of aging on the periodontal health. Risk factors do change as people age or atleast relative importance of risk factors change. Moreover, it concerns with the fundamental aspects of aging on the periodontal tissues, examines broader aspects of aging and possible effects on the treatment outcomes.Effects Of Aging On The PeriodontiumA. Gingival Epithelium

Keratinization decreasesThickness decreasesIncrease in epithelial permeability to bacterial antigensDecrease resistance to functional trauma Stippling decreases-flattening of rete pegs and altered cell densityWidth of attached gingiva increasesChange in the location of junctional epithelium

Gingival marginContinued eruption resulting from attrition and tooth surface lossOcclusal planeOriginal gingival margin locationMucogingival junctionOriginal cementoenamel junctionThe distance from mucogingival junctionto the gingival margin approximatesto the width of attached gingiva

B. Gingival Connective TissueCoarser and denser gingival connective tissueIncreased- mechanical strength denaturing temperature collagen stabilizationRate of collagen synthesis decreasesRate of conversion of soluble to insoluble collagen increasesCollagen content increases

8C. Periodontal Ligament

Fibroblasts decreasesDecreased organic matrix productionEpithelial cell rests decreasesElastic fibres increasesWidth of periodontal space decreases if tooth is hypofunction or will increase with excessive occlusal loading

Cementicles in PDLD. Cementum

Width of cementum increasesPermeability of cementum decreases with ageSurface irregularity increases

E. Alveolar Bone

Number of osteoblasts decreases with agingOsteoporosisRate of bone deposition decreasesF. Bacterial Plaque

Accumulation of dentogingival plaque increasesSupragingival and subgingival plaqueIncreased role of Porphyromonas gingivalis and decrease role of Actinobacillus actinomycetemcomitans

G. Immune Responses

Host responseChanges for T & B cells, cytokines and natural killer cells but not for polymorphonuclear cells and macrophage activityEffects Of Aging On Progression Of Periodontal DiseaseGreater size of infiltrated connective tissue, increased gingival crevicular fluid flow and increased gingival indexAge is inevitably associated with an increased loss of connective tissue attachmentOld age is not a true risk factor for periodontal diseaseOlder adults may have difficulty in performing adequate oral hygiene because of compromised health, altered mental status, medicationsSteroid-induced gingivitisAging And Response To Treatment Of The PeriodontitisFor both younger and older person, the most important factors determining a successful outcome of periodontal treatment are plaque control and frequency of professional carePeriodontal healing and recurrence of disease are not influenced by age Conclusion:The effects of aging on the periodontium, the function of immune response, and the nature of of either supragingival or subgingival plaque have a negligible impact on an individual s experience with periodontal disease. Medical diseases and conditions that occur more often with age may require modification to periodontal preventive tools as well as for the planning and treatment phases of periodontal care.Reference: CARRANZAS Clinical Periodontology; 10th edition

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