Advanced Lesion
Many of the features of the advanced lesion are described clinically rather than histologically:
- Periodontal pocket formation
- Gingival ulceration and suppuration
- Destruction of the alveolar bone and periodontal ligament
- Tooth mobility, drifting and eventual loss
Because bone loss makes its first appearance in the advanced lesion, it is equated with periodontitis, while the first three lesions are classified as gingivitis in levels of increasing severity.
The advanced lesion is no longer localized to the area around the gingival sulcus but spreads apically as well as laterally around a tooth and perhaps even deep into the gum tissue papilla. There is a dense infiltrate of plasma cells, other lymphocytes and macrophages. The clusters of perivascular plasma cells still appears from the established lesion. Bone is resorbed, producing scarring and fibrous change.
Features of the Advanced Lesion:
- Extension of the lesion into alveolar bone, periodontal ligament with significant bone loss
- Continued loss of collagen
- Cytopathic alterations in plasma cells in the absence of altered fibroblasts
- Formation of periodontal pocketing
- Conversion of bone marrow into fibrous connective tissue
Read more about this topic: Periodontal Disease, Diagnosis
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