Figure 5-8. - Acute necrotizing ulcerative gingivitis (ANUG).
Figure 5-9. - Periodontitis.
As the inflammation continues, micro-organisms and their products progress toward the apex of the tooth, forming a pocket in which additional calculus forms. Frequently, the gingival margin also recedes toward the apex and the pocket is shallow. With pocket formation, the gingival tissue bleeds easily, and shelflike projections of calculus form between the teeth. These calculus formations irritate the interdental papillae, which become ulcerated and finally are destroyed.
As the rest of the alveolar bone is resorbed, the attachment fibers of the periodontal membrane are loosened. They may remain attached to the tooth for a time, but finally they are destroyed, and the pocket can extend farther toward the apex of the tooth. Eventually, if the condition remains untreated, the tooth will be lost through destruction of its supporting tissues.Continue Reading