The student will be able to:

1. Identify and describe the functions of the four tissues that compose the periodontium.
2. Compare and contrast the clinical and histological characteristics of the periodontium in health and disease.
3. Explain the etiology of periodontal diseases, including the role of oral biofilms, immune and inflammatory responses.
4. Identify the local contributing factors that affect periodontal disease.
5. Describe the systemic risk factors that contribute to the progression of periodontal disease.
6. Explain how periodontal disease may impact systemic health.
7. Differentiate between the types and classifications of gingival and periodontal diseases using the current American Academy of Periodontology (AAP) classification system.
8. Apply the AAP classification system to patient assessments.
9. Describe the stages of periodontal diseases progression to support patient diagnosis and treatment planning.
10. Outline the steps involved in completing a comprehensive periodontal examination to guide individualized patient care.

1. The periodontium in health
   1. Clinical and histologic characteristics of the periodontium
      1. Gingiva
      2. Cementum
      3. Periodontal ligament
      4. Alveolar bone
   2. Nerve supply, blood supply, and lymphatic system
2. Periodontal disease
   1. Pathogenesis of periodontal disease
      1. Clinical and histologic characteristics of gingivitis
      2. Clinical and histologic characteristics of periodontitis
   2. Pathogenesis of bone destruction
      1. Horizontal pathway
      2. Vertical pathway
   3. Gingival pocket
   4. Periodontal pocket
   5. Theories of disease progression
3. Etiology of periodontal disease
   1. Oral biofilms and periodontal infections
      1. Stages in biofilm development
      2. Structure of mature biofilm
      3. Sequence of bacterial colonization of the tooth structure
      4. Role of bacteria in periodontal disease
   2. Basic concepts of immunity and inflammation
      1. Components of the immune system
      2. Inflammatory biochemical mediators
      3. Stages of inflammation
         1. Acute
         2. Chronic
      4. Host immune response to periodontal pathogens
4. Local contributing factors
   1. Increase in plaque retention
      1. Dental calculus
      2. Tooth morphology
   2. Increase in plaque pathogenicity
   3. Cause direct damage to periodontium
      1. Food impaction
      2. Patient habits
      3. Faulty restorations
      4. Occlusal forces
5. Systemic risk factors
   1. Diabetes mellitus
   2. Leukemia
   3. HIV infections
   4. Hormone alteration
      1. Puberty
      2. Menstruation
      3. Pregnancy
      4. Oral contraceptives
      5. Menopause and post-menopause
   5. Abnormalities in polymorphonuclear lymphocytes
   6. Down syndrome
   7. Metabolic sydrome
   8. Stress
   9. Systemic medications
   10. Tobacco and smoking
   11. Nutrition
6. Periodontal disease as a risk factor for systemic disease
   1. Cardiovascular disease
   2. Pregnancy
   3. Diabetes mellitus
   4. Respiratory disease
   5. Chronic kidney disease
   6. Rheumatoid arthritis
   7. Cognitive impairment
   8. Obesity
   9. Metabolic syndrome
7. AAP Classification of periodontal diseases and conditions
   1. Periodontal health, gingival diseases, and conditions
   2. Periodontitis
   3. Other conditions affecting the periodontium
   4. Peri-implant diseases and conditions
8. Gingival diseases
   1. Clinical features of the gingiva
      1. Color
      2. Contour
      3. Consistency
      4. Textures
      5. Margins
      6. Bleeding
   2. Diseases of the gingiva
      1. Bioflim-induced
      2. Non-dental biofilm induced
9. Periodontitis
   1. Staging
   2. Grading
   3. Chronic and aggressive periodontitis
   4. Necrotizing periodontal disease
   5. Periodonitis as a manifestation of systemic diseases
10. Assessment for clinical decision making
    1. Clinical periodontal assessments
       1. Periodontal screening and recording (PSR)
       2. Comprehensive periodontal assessments
          1. Gingival inflammation
          2. Probing depth
          3. Bleeding on probing
          4. Presence of exudate
          5. Level of mucogingival junction
          6. Level of free gingival margin
          7. Fremitus
          8. Furcation involvement
          9. Tooth mobility
             1. Horizontal
             2. Vertical
          10. Presence of plaque
          11. Presence of local contributing factors
    2. Clinical features that require calculations
       1. Width of attached gingiva
       2. Clinical attachment level
    3. Radiographic analysis of the periodontium
       1. Radiolucent vs. radiopaque structures
       2. Normal radiographic appearance of the periodontium
       3. Radiographic signs of periodontal disease
       4. Computation for percentage of radiographic bone loss/age
       5. Benefit and limitations of dental radiographs

1. Weekly reading assignments
2. Chapter-specific assignments and review questions
3. Case studies