
👉🏻 The initial lesion in the development of periodontitis is the inflammation of gingiva following bacterial challenge.
- Formation of bacterial colony
- Infammatory process
- Migration of neutrophils
- Tissue destruction
- Activation of Neutrophils
- Pocket formation

PERIODONTAL POCKET TYPES:
• 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:
- Collagenase enzyme secreted by fibroblasts, PMN & macrophages degrade collagen & other matrix molecules into small peptides – MMP’s
- 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%)
Dr. Mehnaz Memon🖊