PERIODONTICS

This is the specialty that diagnoses and treats conditions affecting the gums and periodontal tissues. Periodontal tissues are those structures that help support the tooth, including bone.

WHAT ARE THE CAUSES OF PERIODONTAL DISEASE?

Plaque: is the main cause of periodontal disease. Plaque is a yellowish-white film composed of bacteria and food debris, which is deposited on the surface of the teeth, especially near the gum line; if not constantly removed, it hardens into a rough limestone formation called tartar. Tartar, depositing below the gum, makes the daily removal of plaque more difficult. The bacteria in plaque produce toxins, which can inflame the gums, bone, and other tissues surrounding the tooth.

Other risk factors are:

  • SMOKING, is one of the most important risk factors
  • HEREDITARY PREDISPOSITION, one in three people is genetically predisposed to the development of periodontal disease
  • PREGNANCY, and other hormonal changes in women, can make the gums weaker
  • STRESS, can weaken the immune response to fight infections
  • DRUGS, immunosuppressants, contraceptives, antidepressants, antihypertensives and other medications can adversely affect oral health
  • BRUXISM and occlusal trauma, can cause the weakening of the tooth support structures
  • SYSTEMIC DISEASES, such as diabetes, congenital and acquired immune deficiencies can favor the development of periodontal disease.

DIAGNOSIS OF PERIODONTAL DISEASE

The correct evaluation of each individual clinical case is always very important to achieve success in periodontal therapy. To this end, it is essential to carry out an in-depth family and personal anamnesis before starting any therapy in order to know his general and oral health status and if there are any possible familiarities with the pathology. Subsequently, the following diagnostic tests are performed to formulate a definitive diagnosis of periodontal disease and ascertain its degree of severity.

  • Probing of the periodontal pockets: a millimeter probe inserted between the tooth and the gum measures the depth of the periodontal pocket.
  • Plaque index: evaluation of the amount of plaque present.
  • Bleeding index: assessment of the bleeding present.
  • Mobility index: evaluation of the present dental mobility.
  • Radiographic examination: it allows to evaluate the amount of bone surrounding the tooth.
  • Pado Test 4-5®: a sample is taken from the periodontal pockets with sterile paper points. A specialized microbiological laboratory will make a quantitative and qualitative analysis of the bacterial flora that colonizes the pockets.
  • Correct occlusal diagnosis

CONSEQUENCES OF PERIODONTITIS

  1. Premises
  2. In periodontitis, the gums, bone, and other structures that support the tooth are damaged, the teeth lose their supporting tissue and become mobile. In the most serious cases, they can fall off and then be replaced by implants to restore correct masticatory function and aesthetics.
  3. Gingival recessions lead to serious esthetic impairment. Furthermore, exposed collars cause root hypersensitivity (cold/hot) and caries if not treated adequately.
  4. Generals
  5. Recent studies have demonstrated a direct correlation between periodontal disease and atherosclerosis, stroke, myocardial infarction.
  6. Spontaneous abortion and premature delivery have been reported in pregnancy.

THERAPY

For gingivitis: removal of supragingival and intrasulcular plaque and calculus (scaling). You can associate chlorhexidine-based rinses. In this way, healing and the “restored ad integrity” of the tissues is obtained.

For periodontitis: removal of plaque and tartar above and below the gums (root planing or Root Planing). Curettage of periodontal pockets is also generally associated.

The number of sessions necessary to treat periodontal disease depends on its extent and severity; the treatment is usually made more comfortable by local anesthesia.

In some cases these mechanical maneuvers associated with adequate antibiotic therapy give excellent results by eliminating bacteria from the periodontal pockets.

Thus, healthy tissue is obtained, but bone loss and gum recession are irreversible.

In our office for decades now these therapies have always been associated with adequate occlusal therapy.

PERIODONTAL SURGERY

  • Resective periodontal surgery

It is now used only in very selected cases to eliminate periodontal pockets that have not responded to the initial therapy (root planing).

  • Regeneration Wizard

The GBR (Guided Bone Regeneration) and the GTR (Guided Tissue Regeneration) are the current techniques that allow to regenerate and reconstruct the lost tissue. Bone defects are filled with biomaterials and covered with resorbable membranes. Protected by the membrane, this material turns into its own bone.

AESTHETIC MUCO-GINGIVAL SURGERY

  • Mucogingival grafts

They allow gingival recessions to be covered with autologous mucosal grafts. In this way, the correct tooth-gum relationship is restored, which is the basis of the aesthetics of the smile.

  • Clinical crown lengthening

It is used when the gums cover too much of the teeth which consequently appear too short (Gummy Smile). With this method, excess tissue is removed, restoring harmony between teeth and gums.

PREVENTION

Early diagnosis is essential to prevent periodontal disease. Specialist dental visits and regular professional hygiene sessions (2-3 times a year) are the basis for early diagnosis and maintenance of periodontal health. Brush your teeth properly after every meal, using a fluoride-based toothpaste. Use floss or an interdental brush to remove plaque between teeth at least once a day. Eat in a healthy and balanced way.

CONSULT YOUR DENTIST IF YOU HAVE:

  • Gums that bleed easily.
  • Red, swollen or sensitive gums.
  • Gums separated from the teeth.
  • Pus-flowing gums.
  • Persistent bad breath or unpleasant taste.
  • Teeth with evident mobility.
  • Movement of the teeth with the creation of spaces (diastema) between one tooth and another.
  • Changing the habitual chewing position.