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1、牙周病学医学英语1第1页，共90页，编辑于2022年，星期日The characteristic feature of periodontitis is a loss of the connective tissue and alveolar stucture,termed a loss of attachment.periodontitis牙周炎牙周炎the connective tissue 结缔组织结缔组织alveolar 牙槽的牙槽的第2页，共90页，编辑于2022年，星期日Gingival inflammation is a common concurrent feature.Gin
2、gival inflammation：牙龈炎concurrent feature：伴发症状第3页，共90页，编辑于2022年，星期日 This loss will be evidenced by an apical migration of the junctional epithelium,which can result in a periodontal pocket(and/or gingival recession)coincides with that apical migration.evidence：表现apical migration：根向迁移the junctional ep
3、ithelium：结合上皮periondontal pocket：牙周袋coincides with:coincides with:与与与与一致一致一致一致第4页，共90页，编辑于2022年，星期日Gingivitis is usually a precursorto periodontitis,but not all gingivitis progresses to periodontitis.Precursor:先兆、前兆先兆、前兆第5页，共90页，编辑于2022年，星期日 Periodontitis results from a hostresponse to microbial pla
4、que;however,mechanisms for its initiation and progression are still being studied.Result from:起因于 Host;大量的 mechanism：机制 initiation第6页，共90页，编辑于2022年，星期日 The term of periodontal disease activity refers to the stage of the disease characterized by loss of periodontal attachment.Propose:提议提议Progression：
5、进展：进展periodontal attachment：牙周附着：牙周附着第7页，共90页，编辑于2022年，星期日It implies that the natural history of periodontal disease has periods of active destruction and periods of relative inactivity,although chronic inflammation persists.Destruction:破坏、消灭破坏、消灭第8页，共90页，编辑于2022年，星期日 Coton(1989)summarizes the three
6、 theories of periodontal disease activity as:the continuous paradigms that implies a low,constant progression of periodontal degenerationsummarizes：总结：总结paradigm：范例：范例degeneration：退化、恶化：退化、恶化Three models have been proposed to explain the progression of periodontitis.第9页，共90页，编辑于2022年，星期日 The random
7、burst theory that implies that short periods of destruction are followed by periods of no destruction,occurring randomlydestruction：消灭：消灭randomly：随机地：随机地第10页，共90页，编辑于2022年，星期日The asynchronous multiple burst theory that implies that periodontal disease activity,and resultant destruction occurs within
8、 a specific period of life and is followed by remission.asynchronous：不同时存在性，异步的：不同时存在性，异步的 resultant：必然产生的：必然产生的 remission：减轻、平息：减轻、平息第11页，共90页，编辑于2022年，星期日 Loe and coworker(1986)assert that the rate of progress varies in different sites,at different ages,and between individuals and groups.第12页，共90页
9、，编辑于2022年，星期日 The periodontitis lesion progresses steadily over time,even though there may be periods of slow progress and destructive processes.Destructive：毁灭性的：毁灭性的第13页，共90页，编辑于2022年，星期日 The facts remains,however,that in the absence of treatment or interference,the lesion will continue until the e
10、ntire periodontium is involved and tooth loss result.Interference：干预、干涉：干预、干涉in the absence of:in the absence of:缺乏、没有缺乏、没有缺乏、没有缺乏、没有第14页，共90页，编辑于2022年，星期日 Loe and coworker(1986)emphasize that a steady,continuous progression does no rule out periods of exacerbation.rule out：划去、排除：划去、排除可能可能exacerbati
11、on：恶化恶化第15页，共90页，编辑于2022年，星期日 Classification systems are necessary in order to provide a framework in which the etiology,pathogenesis,and treatment of disease can be scientifically studied in an orderly fashion.etiology：病因学：病因学pathogenesis：发病机制：发病机制ScientificallyScientifically：合乎科学的：合乎科学的：合乎科学的：合乎科学
12、的FashionFashion：方式、样子：方式、样子：方式、样子：方式、样子第16页，共90页，编辑于2022年，星期日 In addition,such systems give clinicians a way to organize the health care needs of their patient.OrganizeOrganize：组织、管理：组织、管理：组织、管理：组织、管理health carehealth care：卫生保健：卫生保健：卫生保健：卫生保健第17页，共90页，编辑于2022年，星期日 The last time the scientists and cl
13、inicians in the field of periodontology and related areas agreed upon a classification system for periodontal diseases was in 1989 at the world workshop in clinical periodontics.periodontology：牙周病学：牙周病学第18页，共90页，编辑于2022年，星期日 Subsequently,a simpler classfication was agreed upon at the 1st European Wo
14、rkshop in periodontology.SubsequentlySubsequently：后来、随后：后来、随后：后来、随后：后来、随后第19页，共90页，编辑于2022年，星期日 These classification systems have been widely used by clinicians and research scientists throughout the world.第20页，共90页，编辑于2022年，星期日 There were four major forms of periodontitis:adult,early-onset,refracto
15、ry,and periodontitis associated with systemic diseases.early-onset：早发型：早发型refractory：难治性：难治性第21页，共90页，编辑于2022年，星期日 Each of these major forms has subclassifications.subclassification：亚型：亚型第22页，共90页，编辑于2022年，星期日 Diagnosis was made on the basis of clinical parameters documented in a thorough periodonta
16、l assessment,as well as consideration of the age of onset,rapidity of progression,and extendpattern of alveolar bone loss.parameter:parameter:因素特征因素特征因素特征因素特征document：证明、记录：证明、记录assessmentassessment：评估：评估：评估：评估第23页，共90页，编辑于2022年，星期日 Unfortunately,the 1989 classification had many shortcomings includi
17、ng:considerable overlap in disease categories,absence of gingival disease component,onent,ina inap ppropriate emphasis on age of onset of disease and rates of progress,and ina adequate or unclear classification crit teria.eria.considerable：相当大的：相当大的 overlap：重叠：重叠inappropriate：不适当的、不合适的：不适当的、不合适的crit
18、eria：标准：标准第24页，共90页，编辑于2022年，星期日 The need of a revised classification system for periodontal disease was emphasized during the 1996 world workshop in periodontics.第25页，共90页，编辑于2022年，星期日 In 1997 the American Academy of Periodontonogy responded to the need and formed a committee to plan and organize a
19、n international workshop to revise the classification system for periodontal diseases.第26页，共90页，编辑于2022年，星期日 On October 30-November 2,1999,the International Workshop for a Classification of Periodontal Diseases and Conditions was held and a new classification was agreed upon.第27页，共90页，编辑于2022年，星期日1、
20、Changing the Classification System for Periodontal Disease第28页，共90页，编辑于2022年，星期日1.1 Addition of a Section on“Gingival Disease”As mentioned above,the 1989 classification did not include a section gingival diseases第29页，共90页，编辑于2022年，星期日 This has been remedied by the development of a detailed classific
21、ation of gingival diseases and lesion that are either dental plaque induced or not primarily associated with dental plaque.Remedy:改正，纠正改正，纠正第30页，共90页，编辑于2022年，星期日 An important feature of the section on dental plaque-induced diseases is acknowledgement that the clinical expression of gingivitis can b
22、e substantially modified byAcknowledgement:Acknowledgement:承认、认可承认、认可承认、认可承认、认可Substantially：本质上、实质上：本质上、实质上ModifyModify：修改、更改：修改、更改：修改、更改：修改、更改第31页，共90页，编辑于2022年，星期日 systemic factors such as perturbations in the endocrines system medications malnutritionperturbation：扰乱、混乱：扰乱、混乱endocrines：内分泌：内分泌med
23、ication：药物：药物malnutrition：营养不良：营养不良第32页，共90页，编辑于2022年，星期日 The section on non-plaqueinduced gingival lesions includes a wide range of disorders that affact the gingiva.Disorders:Disorders:紊乱、障碍紊乱、障碍紊乱、障碍紊乱、障碍第33页，共90页，编辑于2022年，星期日 Many of these disorders are frequently encountered in clinical practic
24、eEncounter：遇到、遭遇：遇到、遭遇第34页，共90页，编辑于2022年，星期日1.2 Replacement of“Adult Periodontitis”with“Chronic Periodontitis”第35页，共90页，编辑于2022年，星期日 From the outset,the term“Adult periodontitis”created a diagnostic dilemma for clinicians.Outset：开始：开始 Diagnostic：诊断上的：诊断上的 Dilemma:左右为难、窘境左右为难、窘境第36页，共90页，编辑于2022年，星期日
25、 Epidemiologic data and clinical experience suggest that the form of periodontitis commonly found in adults can also be seen in adolescents.Epidemiologic:流行病学的流行病学的Adolescent：青少年：青少年第37页，共90页，编辑于2022年，星期日 If this is true,how can non-adults(e.g,adolescents)with this type of periodontitis be said to h
26、ave“adult periodontitis”？第38页，共90页，编辑于2022年，星期日 Clearly,the age-dependment nature of the adult periodontitis designation created problems.Designation：称号：称号第39页，共90页，编辑于2022年，星期日 Therefore,workshop participants concluded that it would be more accurate to adopt a nonspecific term such as“Chronic Perio
27、dontitis”to characterize this constellation of destructive periodontal disease.Constellation：一群（相关的）人：一群（相关的）人DestructiveDestructive：破坏性的：破坏性的：破坏性的：破坏性的第40页，共90页，编辑于2022年，星期日 A great deal of discussion centered round what words should be used to replace the Adult Periodontitis term？第41页，共90页，编辑于2022
28、年，星期日 Substitude terminology such as“Periodontitis-common form”and“Type Periodontitis”were considered and eventually rejected by the majority of the groupTerminologyTerminology：术语、专门用于：术语、专门用于：术语、专门用于：术语、专门用于Reject：拒绝：拒绝Subs stitudetitude：取代：取代：取代：取代第42页，共90页，编辑于2022年，星期日 The term“Chronic Periodonti
29、tis”was criticized by some participants,since“chronic”might be interpreted as “noncurable”by some people.第43页，共90页，编辑于2022年，星期日 Nevertheless,“Chronic Periodontitis”was eventually agreed upon as long as it was understood that it did not imply that this disease was nonresponsive to treatment.第44页，共90页
30、，编辑于2022年，星期日 Traditionally,this form of periodontitis has been characterized as a slowly progressive disease第45页，共90页，编辑于2022年，星期日 Indeed data from many sources confirm that patients with this form of periodontitis usually exhibit slow rates of progression.第46页，共90页，编辑于2022年，星期日 However,there are a
31、lso data indicating that some patients may experience short periods of rapid progression.第47页，共90页，编辑于2022年，星期日 Therefore,workshop participants concluded that rates of progression should not be used to exclude people from receiving the diagnosis of Chronic Periodontitis.Exclude：排除：排除第48页，共90页，编辑于202
32、2年，星期日1.3 Replacement of“Early-Onset Periodontitis”With“Aggressive Periodontitis”.第49页，共90页，编辑于2022年，星期日 The term“Early-Onset Periodontitis”(EOP)was used in the 1989 AAP and in 1993 Euopean classifications as a collective designation for a group of dissimilar destructive periodontal desease that aff
33、ect young patients(i.e prepubertal,juvenile,and rapidly progressive periodontitis).collective designationcollective designation：共同的称号：共同的称号：共同的称号：共同的称号dissimilar destructivedissimilar destructive：不同的损害：不同的损害：不同的损害：不同的损害Prepubertal:Prepubertal:青春期前的青春期前的青春期前的青春期前的JuvenileJuvenile：青少年：青少年：青少年：青少年第50页，
34、共90页，编辑于2022年，星期日 It was logically assumed that these diseases all had an early onset because they affected young people.第51页，共90页，编辑于2022年，星期日 Unfortunately,the“early-onset”designation implies that one has temporal knowledge of when the disease started.DesignationDesignation：指定、指名：指定、指名：指定、指名：指定、指名
35、第52页，共90页，编辑于2022年，星期日 However,in clinical practice and most other situation this is rarely case.第53页，共90页，编辑于2022年，星期日 In addition,there is considerable uncertainty about arbitrarily setting an upper age limit for patients with so called early-onset periodontitisconsiderableconsiderable：相当多的：相当多的Ar
36、bitrarilyArbitrarily：任意地：任意地：任意地：任意地UpperUpper：上边的、上层的：上边的、上层的：上边的、上层的：上边的、上层的第54页，共90页，编辑于2022年，星期日 For example,how does one classify the type of periodontal disease in a 21-year-old patient with classical incisor-first molar pattern of Localized Juvenile Periodontitis(LJP)？Localized Juvenile Perio
37、dontitis：局限型青少年牙：局限型青少年牙周炎周炎第55页，共90页，编辑于2022年，星期日 Since the patient is not a juvenile,should the age of the patients be ignored and the disease classifiedas LJP anyway？第56页，共90页，编辑于2022年，星期日 This type of problem stems from the age-dependent nature of the 1989 classification system.StemStem：拦住、阻挡：拦住
38、、阻挡：拦住、阻挡：拦住、阻挡第57页，共90页，编辑于2022年，星期日 Because of these similar problems,workshop participants decided that it was wise to discard classification terminologies that were age-dependent or required knowledge of rates of progression.DiscardDiscard：抛弃：抛弃：抛弃：抛弃 Terminology:Terminology:专业用语、术语专业用语、术语专业用语、术
39、语专业用语、术语第58页，共90页，编辑于2022年，星期日 Accordingly,highly destructive forms of periodontitis formerly considered under the umbrella of“Early-Onset Periodontitis”were renamed using the term“Aggressive Periodontitis”第59页，共90页，编辑于2022年，星期日 In general,patients who meet the clinical criteria for LJP or GJP are s
40、aid to have“Localized Aggressive Periodontitis”or“General Aggressive Periodontitis”,respectively.第60页，共90页，编辑于2022年，星期日 Patients who were formly classified as having RPP will,depending on a variety of other clinical criteria,be assigned to either the“General Aggressive Periodontitis”or“Chronic Perio
41、dontitis”categories.第61页，共90页，编辑于2022年，星期日 So it would be inappropriate to assume that there will be a consistent one-to-one relationship in trasferring information from the old classification system to the new.Inappropriate：不恰当的：不恰当的Consistent：一致的：一致的第62页，共90页，编辑于2022年，星期日 It should be classified b
42、y a variety of primary and secondary clinical characteristics.第63页，共90页，编辑于2022年，星期日1.4 Elimination of a Separate Disease Category for“Refractory Periodontitis”第64页，共90页，编辑于2022年，星期日 In the 1989 classification,a separate disease category was devoted to Refractory Periodontitis第65页，共90页，编辑于2022年，星期日
43、Because of the diversity of clinical condition and treatment under which periodontal therapy fails to arrest the progression of periodontitis,workshop participant were of the opinion that“refractory periodontitis”not a single disease entity.Diversity：多样化多样化多样化多样化第66页，共90页，编辑于2022年，星期日 Indeed,it was
44、considered possible that a small percentage of cases of all forms of periodontitis might be nonresponsive to treatment.第67页，共90页，编辑于2022年，星期日 Therefore the group concluded that,rather than a single disease category,the“refractory”designation could be applied to all forms of periodontitis in the new
45、classification system(e.g,refractory chronic periodontitis,refractory aggressive periodontitis,etc)第68页，共90页，编辑于2022年，星期日1.5 Clarification of the Designation Periodontitis as a Manifestation of Systemic Disease第69页，共90页，编辑于2022年，星期日 In the 1989 classification,one of disease categories was“periodonti
46、tis associated with systemic disease.”第70页，共90页，编辑于2022年，星期日 In general,this category has been retained in the new classification since it is clear that destructive periodontal disease can be a manifestation of certain systemic disease.RetainRetain：保存、保留：保存、保留：保存、保留：保存、保留manifestation：表明、显示：表明、显示第71
47、页，共90页，编辑于2022年，星期日 Replacement of Necrotizing Ulcerative Periodontitis with Necrotizing Periodontal Disease第72页，共90页，编辑于2022年，星期日 Addition of a Category on“Periodontal Abscess”（牙周脓肿）（牙周脓肿）Addition of a Category on“Periodontal-Endodontic lesion Addition of a Category“developmental or Acquired Deform
48、ities and Condition”（发育发育性或后天性异常）性或后天性异常）第73页，共90页，编辑于2022年，星期日2、Future Revision to the classification第74页，共90页，编辑于2022年，星期日 The classification of periodontal disease and conditions in this volume should provide a workable framework upon which to study and develop effective treatments for this compl
49、ex group of infections.第75页，共90页，编辑于2022年，星期日 It is anticipated that as we learn more about the etiology and pathogenesis of periodontal disease,future revisions to the classification will be needed.Etiology:Etiology:病因学病因学病因学病因学Pathogenesis：发病机制：发病机制第76页，共90页，编辑于2022年，星期日 All classification systems
50、 have inconsistencies or inaccuracies.Inconsistencies：不一致、不协调、矛盾：不一致、不协调、矛盾 InaccuraciesInaccuracies：不准确、错误：不准确、错误：不准确、错误：不准确、错误第77页，共90页，编辑于2022年，星期日The present effort is no exception.第78页，共90页，编辑于2022年，星期日 Nevertheless,the current classification represents the consensus of an international group o