👉🏻 The initial lesion in the development of periodontitis is the inflammation of gingiva following bacterial challenge.

1. Formation of bacterial colony
2. Infammatory process
3. Migration of neutrophils
4. Tissue destruction
5. Activation of Neutrophils
6. Pocket formation

• Bacterial cells in dental plaque

Infammatory changes in the Connective Tissue wall of the gingival sulcus

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The cellular & fluid inflammatory exudate causes degeneration of Connective tissue & gingival fibres

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Just apical to Junctional epithelium, collagen fibres are destroyed

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Infammatory cells + edema

• Mechanisms associated with collagen loss:

1. Collagenase enzyme secreted by fibroblasts, PMN & macrophages degrade collagen & other matrix molecules into small peptides – MMP’s
2. Fibroblasts phagocytize collagen fibres by extending cytoplasmic processes to the ligament-cementum interface.

👉🏻 Apical cells of junctional epithelium proliferate along the root, Coronal portion of J.E detaches from the root & is invaded by PMN’s (60%)

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Dr. Mehnaz Memon🖊