What is periodontology
Periodontology is the branch of dentistry that deals with the diagnosis and treatment of the supporting tissues of the tooth, that is, the periodontium.
The periodontium consists of:
Gingiva
Tooth root
Periodontal ligament
Alveolar bone
Periodontology:
Treats diseases affecting the supporting organ of the tooth
What is pyorrhea or periodontitis?
Infection of the gums caused by bacteria
Symptoms:
Reddened, bleeding, swollen, sore, receding gums
Causes:
Improper hygiene, smoking, stress, predisposition, certain medications, diet, pregnancy
Types of treatment:
Periodic specialist visits, non-surgical periodontal therapy, in advanced stages surgery is used
Gingivitis and periodontitis
Gingivitis is the first phase of periodontal disease characterised by reddened and bleeding gums.
Periodontitis is the most advanced stage and is a chronic degenerative disease that causes the destruction of the supporting apparatus of the teeth, consisting of the alveolar bone, periodontal ligament, root and gingiva.
It is therefore not easy to realise that one is suffering from periodontitis until it is too late. As soon as you notice one or more of these symptoms, it is a good idea to make an appointment with your dentist:
Reddening
Bleeding, swollen and sore gums
Persistent bad breath
Tooth sensitivity during chewing
Teeth appearing longer than before
Development of space between teeth
Appearance of pus between teeth and gums
Causes
Periodontitis is caused by bacteria, which remain on the teeth if daily oral hygiene is not thorough.
The formation of plaque, and its subsequent transformation into tartar, increases the proliferation of bacteria that slowly destroy tissue.
The concomitant causes of increased bacterial activity are:
smoking;
pregnancy;
stress;
diseases (example: diabetes);
certain medications taken continuously;
individual predisposition;
nutrition.
What can be done
Regular oral hygiene sessions and checkups allow prevention of the disease.
In the case of people who are genetically predisposed, they will have to undergo treatment and checkups closer in time.
If we go to the dentist when the disease has reached an advanced stage, it is impossible to completely regenerate the lost periodontium, but it is possible to prevent it from getting worse.
Making a diagnosis as early as possible allows us to regenerate the lost periodontium and keep the disease under control over time.
To treat periodontitis, we have devised a specific pathway, the "Tooth Saver."
Phase One: Periodontal Diagnosis
Phase Two: Non-surgical periodontal therapy
Phase Three: Re-evaluation
Phase Four: Surgical Therapy, if necessary
Fifth Phase: Maintenance
How to treat
Depending on the stage of development of periodontitis (Pyorrhoea) there are various types of treatment.
Prevention and regular specialist visits positively influence the type of treatment.
In advanced stages of pyorrhoea, surgical treatment is required:
Resective crown lengthening surgery
In order to gain space for the crown support, in the absence of dental tissue, the gingival tissue is removed.
Regenerative surgery of periodontal pockets
After non-surgical therapy, if there are still residual periodontal pockets, it is necessary to intervene with bone regeneration: the operation consists of reconstructing the missing bone with the aim of maintaining the patient's tooth for as long as possible.
Mucogingival aesthetic surgery
If, due to periodontitis, there are gingival recessions that can create tooth sensitivity, one can intervene to restore gingival tissue by lowering the gingiva itself or with grafts.
Rhizectomy
Performed on molars when there is severe bone loss from a root, it consists of separating and extracting the root.
Rhizotomy
The crown of the tooth is separated with a horizontal cut, directed from the occlusal surface to the floor of the pulp chamber. It is performed on molars in case of bone resorption in the area where the roots bifurcate.
Le fasi del percorso
The periodontal dental examination
This phase involves a diagnostic study of the health status of the supporting tissues of the teeth, through:
Periodontal status: multiple radiographs showing bone levels, tartar, pockets, caries.
Photographs: for analysis of gingival recessions, dental anatomy and status of adherent gingiva.
Periodontal chart: using a millimeter probe, the stage of pockets, bleeding, plaque, gingival recessions, tooth mobility are assessed.
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Reevaluation
After treatment, the stage of the pathology is re-evaluated through:
new intraoral examination
evolution of symptoms
new periodontal chart
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Non-surgical periodontal therapy (TPNC)
The goal is to recover as much of the previously lost periodontal tissue as possible, without resorting to surgery.
The course includes:
oral hygiene instruction and motivation;
elimination of bacteria;
tissue stimulation;
Repeated sessions of: dental hygiene and non-surgical periodontal therapy (TPNC) will be performed. Microscope, Glycine Powders, Laser, manual curettes are the tools to be able to treat the disease through:
the thorough cleaning of the pockets with the removal of plaque and tartar;
the removal of diseased tissue;
the stimulation of the body's antibacterial activity.
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The maintenance
Once the treatment is over, the maintenance phase of the achieved health status will begin with periodic oral hygiene sessions.
In the early stages, maintenance will be carried out every 4 to 6 months while, in the advanced stages, maintenance sessions should be carried out every 3 to 4 months.
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