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KMID : 0381219710030030245
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Journal of RIMSK
1971 Volume.3 No. 3 p.245 ~ p.248
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PERIODONTAL DISEASE CAUSED BY SYSTEMIC ORIGIN
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Abstract
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The factors that influence the health of the periodontium are broadly classified into those of extrinsic (local) origin and those of intrinsic (systemic) origin.
The extrinsic causes include both irrational and functional factors associated with mastication, deglutition, and speech. The intrinsic factors, although very important, are difficult to demonstrate. Treatment directed primarily toward the elimination or correction of local factors in the presence of demonstrable systemic etiology, however, always leads to failure. Undoubtedly, periodontal disease is an expression of the interplay of local and systemic factors. Clinical expressions of disease may result from a basic insult, physical, chemical, or microbial. The influence of this exogenous insult will be modified by the resistance of the host. For example, not all patients are equally susceptible to communicable diseases such as poliomyelitis, and, therefore, not all who are exposed to the virus will contract the disease. Similarly, if calculus were the sole cause of periodontal disease, there would be a total equivalency between calculus and periodontal disease. All patients with calculus would have periodontitis, and no patients without calculus would have periodontitis. Whereas the presence of calculus is usually associated with the presence of inflammation, there are some instances in which calculus is present and no disease occurs and some others in which disease is present without calculus. It can therefore be concluded that calculus alone is not responsible for periodontal disease. Following is a list of systemic factors in periodontal disease:
A. Demonstrable
1. Endocrine
(a) Pubertal
(b) Pregnancy
(c) Postmenopausal
2. Metabolic and other diseases
(a) Diabetes
(b) Hyperkeratosis palmoplantaris (c) Cyclic neutropenia (d) Hypophosphasia (e) Debilitating disease
3. Psychosomatic or emotional 4. Drugs and metabolic poisons
(a) Dilantin sodium
(b) Hematological effects
(c) Allergy
(d) Heavy metals 5. Diet and nutrition
B. Nondemonstrable
1. Resistance and repair
2. Nutritional, emotional, metabolic, hormonal
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