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Tuesday, December 23, 2014

Periodontitis - Periodontal Disease Treatment

What is periodontal disease / periodontitis ?


Periodontal disease is a term used in dentistry. The literal meaning is inflammation (= itis) around (= para) the tooth (= odont); or the inflammation of the tissues around the tooth.

It is a bacterial infectious disease which is caused by inflammation of the gums in other words gingivitis. In a more advanced stage of the jaw bone can be impaired, some loss of choosing and teeth can result.

Where gingivitis in particular by the amount of dental plaque is caused (in other words, therefore, all bacteria), is to periodontal disease due to the activities of specific bacteria, such as Actinobacillus actinomycetemcomitans, Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia, ... also play still consider several other factors, such as smoking, systemic diseases such as diabetes and genetic factors.

The degradation of bone is mainly caused by the body's defense against the bacteria (such as Interleukin 1), which is also directed against the periodontium.

Specific periodontal


By the scientific associations in the field of periodontics, the following parodontopathiƫn or specific forms of periodontitis can be distinguished:

-Chronic adult paradontitis
-Refractory paradontitis
-Localized, juvenile periodontitis (LJP)
-Snelverlopende, progressive periodontitis (RPP)
-Periimplantitis

Chronic adult periodontitis
Chronic periodontal disease is the most common form of periodontal disease in persons over 30 years. It is a very slowly varying form of periodontal disease. Periods of chronic inflammation can also be alternated with rest phases wherein the inflammatory hardly progresses. Also, very occasionally short intense periods of inflammation that can be associated with pain and swelling. However, this is rare.

In the course of time will be the loss of attachment of the supporting fabric to the tooth gradually to increase, after probing the gingival bleeding, taking the pockets increased to 3-5 mm, and also bone degradation starts to occur around the affected teeth.

Periodontal disease can occur throughout the teeth (generalized periodontal disease), or only locally at the molars and / or incisors (local adult periodontitis).

Refractory periodontitis
Refractory periodontitis periodontitis who returns after treatment. This recidivism by some not recognized as a separate form of periodontal disease, but as a failure of the previous therapy. However, it is often a different bacteriological image again found. Bacteroides forsythus is more common than with traditional juvenile or adult periodontitis.
One can decide to proceed with surgical therapy, i.e., a cleaning of the tooth roots in open field (the gum is temporarily cut open).

Localized, juvenile periodontitis (LJP)
Although the above shows that gingivitis periodontitis usually preceded, that's not always the case. For example, around puberty years may experience a localized juvenile periodontitis (associated with severe bone loss around the incisors and the first permanent molars), whereby a long time is not always a gingivitis present. Therefore it is important that the depth of the pockets is measured at a young age.

Snelverlopende, progressive periodontitis (RPP)
In about 10-20% of the cases, the process is fast. Then there is usually a specific bacterial flora that predominates in the plaque and is very aggressive. In this case we speak of a rapidly progressive periodontitis or Rapidly progressive periodontitis (RPP). Sometimes this form is also among young people (under 20 years). We speak of juvenile periodontitis. The aggressive form of periodontal disease may be local, but also occur throughout the teeth.

Periimplantitis
Periimplantitis is the phenomenon of peri-implant bone is broken down by chronic inflammation, causing loosening of the implant. The cause usually lies with poor oral hygiene, smoking, the presence of high numbers of periodontal microorganisms and can be facilitated by a genetic predisposition. One should know that the gums can attach itself to teeth (epitheelaanhechting) but not to an implant. The gums focuses just around the implant, without there to grow onto. Hence, bacteria easily under the gum, can proliferate around the implant. Therefore, people with dental implants must observe a very good dental hygiene.

Effect of periodontal disease on the body


Periodontal disease increases the risk of coronary heart defects, stroke, pregnancy complications and especially focal infection. Periodontitis is associated with bad breath or halitosis.

Diagnostics


At each semi-annual checkup, your dentist should also measure the DPSI. If this score is higher than 2 then there is a periodontal treatment should be initiated.

Periodontitis / Periodontal disease treatment


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Treatment of periodontitis is done according to the paroprotocol. The treatment can take place at the dentist in private practice, the dental hygienist or dentist periodontist. Since the Protocol has a lot of control moments in which the patient is evaluated, many general dentists are preferred to send periodontitis patients for specific treatment. Also, in difficult and / or severe forms of periodontitis enjoy this preferred.
The protocol is as follows:

-Intake
-Initial treatment
-Mid-term oral hygiene / control after 6 weeks
-Reassessment after 3 months
-If necessary. specific treatments
-Aftercare

Intake
During the intake, a number of studies performed such as taking the medical history, oral examination, x-ray examinations and sometimes additional studies. Finally, the results, the requirements of the patient and the treatment plan discussed with the patient.

Initial treatment
In the initial treatment, the parts in which the space between the tooth and the gum is too deep ('pocket') cleaned and smoothed.

Reassessment

Surgery / Antimicrobial therapy

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