2. OUTLINE
Definition.
Classification
Pathogenesis
Clinical features and
histopathology
Pocket Contents
Morphology of pocket boundaries
Measurement of periodontal
pockets
Treatment.

3. pOCKET
DEFINITION
“Pathological deepening of
the gingival sulcus”

4. CLassIFICaTION
Gingival pocket
Periodontal pocket
o suprabony pocket
o infrabony pocket

6. sUprabONy INFrabONy
pOCKET pOCKET
1.Base of pocket is is coronal to 1.Base of pocket is apical to crest
the level of alveolar bone. of alveolar bone.
2.Horizontal pattern of bone 2.Vertical (angular) pattern of
destruction. bone destruction.
3.On facial and lingual surfaces 3.They follow angular pattern.
, pdl fibers beneath pocket
follow their norma;l oblique
course.
4.Transeptal fibers are arranged 4. Transeptal fibers are arranged
horizontally. obliquely.

7. CLassIFICaTION
OF pOCKETs a/C
TO INvOLvED
TOOTh sUrFaCEs
Simple pocket Compound pocket Complex pocket

8. CLINICaL hIsTOpaThOLO
FEaTUrEs GIC FEaTUrEs
1.Varios degrees of bluish red 1.Circulatory stagnation.
discoloration.
Flaccidity. Destruction of gingival fibers.
Smooth shiny surface. Atrophy of epithelium.
Pitting on pressure. Edema and regeneration.
2.Gingival wall may be pink and 2.Fibrotic changes .
firm.
3.Bleeding on probing. 3.Increased vascularity,thinning
and degeneration of epithelium.
4.On probing inner aspect of 4.Ulceration of inner aspect of
wall is generally painful. pocket wall.
5.Pus may be expressed on 5.Suppuratiove inflammation of
applying digital pressure. inner wall.

9. paThOGENEsIs

10. PATHOGENESIS

11. MICrOTOpOGraphy
OF ThE GINGIvaL
waLL OF ThE
pOCKET
1-Area of relative quiescence.
2-Area of bacterial accumulation.
3-Area of emergence of leukocytes.
4-Area of leukocyts-bactria interaction.
5-Area of intense epithelial desquamation.
6-Area of ulceration.
7-Area of hemorrhage.

13. pOCKET
CONTENTs
1.Debris consisting of microorganisms & their
products.
2.Gingival fluid, food remnants.
3.Salivary mucin.
4. Desquamated epithelial cells.
5.leukocytes.
6.plaque covered calculus.

14. rOOT sUrFaCE
waLL
Structural changes in the cementum include:
1-presence of pathologic granules. (Due to the
degeneration of the Sharpey’s fibers in the cementum).
2-areas of increased mineralization. (Decrease the
sensitivity).
3-areas of demineralization (increase sensitivity, caries, &
pulpitis may occur).

15. sUrFaCE
MOrphOLOGy OF ThE
TOOTh waLL OF ThE
pErIODONTaL
pOCKETs
1-cementum covered by calculus.
2-attached plaque.
3-the zone of unattached plaque.
4-the zone where the junctionl epithelium is attached to the
tooth.
5-the zone of semi destroyed C.T. fibers.

17. rELaTION OF ThE
aTTaChMENT LOss
& bONE LOss TO
ThE pOCKET DEpTh
Periodontal pocket measured from base of the pocket to the
gingival margin.
-Loss of attachment measured from base of pocket to the
CEJ

18. HOW TO DETECT
PERIODONTAL POCKET??????

21. CrITErIa FOr
DETErMINING ThE
pOCKET
CLassIFICaTION
Gingival pocket:
T he probe should not penetrate apically beyond
the CEJ

22. Suprabony periodontal pocket:
Penetrate beyond CEJ
but not pass apical to the
crest of the alveolar bone.
Infrabony pockets
Probe should penetrate
beyond CEJ and pass
apical to the crest of the
adjacent alveolar bone.

23. TrEaTMENT
Non surgical treatment
1.oral hygiene instructions and their follow through.
2.Scaling.

24. 3.Root planning.
Periodontal Medications
Tetracycline
Metranidazole

25. Surgical Treatment
Pocket depth reduction through different
surgical procedures :
1.Gingival curettage.
2.Gingivectomy.
3.Periodontal flap procedures.
4.osseous surgery
5.Periodontal regenration preocedures.

27. G
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