Restorative dentistry 1: periodontology

This chapter covers the fundamentals of the diagnosis, prevention, and treatment of periodontal disease, alongside the most recent classification system. The epidemiology of periodontal disease is discussed before the key aspects of clinical examination are explained. The relevance and implications of plaque and calculus are detailed including their composition and pathological effects. The chapter includes the clinical features of periodontal diseases, including aggressive periodontitis, necrotizing periodontal diseases, and periodontal abscesses, as well as periodontitis associated with endodontic lesions. The principles of periodontal surgery are described, covering local anaesthetic techniques, flap design, and suturing techniques, as well as regenerative techniques and mucogingival surgery.

Author(s):  
David A. Mitchell ◽  
Laura Mitchell ◽  
Lorna McCaul

Contents. Classification. Epidemiology of periodontal disease. Oral microbiology. Aetiology of periodontal disease. Plaque biofilm. Calculus. Progression and risk factors. Pathogenesis of gingivitis and periodontitis. Clinical features of gingivitis and periodontitis. Diagnosis and monitoring. Aggressive periodontitis. Necrotizing periodontal diseases. Periodontal abscess. Periodontitis associated with endodontic lesions. Principles of treatment. Non-surgical treatment—plaque control. Non-surgical periodontal therapy—scaling and root surface debridement. Treatment with antimicrobials. Periodontal surgery—principles. Periodontal surgery—types of surgery. Periodontal surgery—regenerative techniques. Periodontal surgery—mucogingival surgery. Furcation involvement. Occlusion and splinting. Peri-implant mucositis and peri-implantitis. Supportive periodontal therapy.


2019 ◽  
Vol 8 (4) ◽  
pp. 62-66
Author(s):  
Len D'Cruz

This article reviews the key aspects of reducing the litigation aspects of the management of periodontal diseases and in particular periodontitis. Litigation arising from gingivitis, the other type of periodontal disease, is very rare and is therefore not considered in this article. This paper considers diagnosis, record keeping, communication, management of periodontitis including non-engaging patients and referrals. It provides guidance to reduce risks and improve the care for patients.


2020 ◽  
Vol 9 (1) ◽  
pp. 784-788

Periodontitis is a chronic inflammatory disease of the vascularized supporting tissues of the teeth. Angiogenesis (neovascularization) is the budding of new capillaries and is thought to be an essential process in the development of chronic inflammatory diseases. Inflamed tissues (such as gingiva coincident in periodontal disease) have evidence of enhanced expression of inflammatory mediators, many of which can promote angiogenesis. Of the various cytokines and growth factors that are involved in angiogenesis, the most potent agent that acts specifically on vascular epithelium is Vascular Endothelial Growth Factor. Even though angiogenesis is a prominent feature of both inflammation and healing, information about its role in periodontal lesions is limited. Hence the aim of the present study was the immunohistochemical evaluation of the expression of VEGF in the gingival tissues of chronic and aggressive periodontitis patients compared to the healthy controls. The present study was carried out in a total of 45 subjects with age range of 18-55 years, reporting to the Department of Periodontology, Rajarajeswari Dental College and Hospital, Bangalore. Gingival tissue samples were collected from all the 45 subjects and categorized into three groups based on their clinical findings as follows: Group 1 (Healthy), Group II (Chronic Periodontitis), Group III (Aggressive Periodontitis). Following sample collection, immunohistochemical staining of tissues was carried out and evaluation was done to compare the grades of expression of VEGF in the three groups. The expression of VEGF in blood vessels was also quantitatively evaluated. The results were statistically analyzed using Kruskal Wallis ANOVA and Mann Whitney test. There was a statistically significant higher expression of VEGF in both chronic periodontitis and aggressive periodontitis group as compared to the control group. Aggressive periodontitis cases showed higher grades of expression of VEGF compared to the chronic periodontitis cases and healthy controls. However, the difference in expression of VEGF was not statistically significant between the two forms of periodontitis. The presence of VEGF in both chronic and aggressive periodontitis clearly indicates the potent role played by VEGF as an inflammatory agent in the initiation and progression of periodontal diseases. Thus, VEGF might be used as a potential vascular marker for the assessment of severity and inflammatory status in periodontal disease.


2012 ◽  
Vol 6 (2) ◽  
pp. 97-101 ◽  
Author(s):  
Deepika Bali ◽  
Nymphea Pandit ◽  
Rouble Kathuria ◽  
Amit Bali

ABSTRACT Periodontitis is an inflammatory condition of supporting tissues of teeth, for which several risk and susceptibility factors are proposed. Periodontal disease results when balance between host factors and etiologic agents is disrupted. Bacteria have a primary role in the initiation of periodontal disease, and a range of host related factors influence the clinical presentation and rate of progression of disease. Genetic variations that modify immunological reactions identify the disease susceptibility in various individuals. Many studies have proved the effect of various single or composite nucleotide polymorphisms to susceptibility, progression or severity of periodontal diseases. Despite these studies, association between periodontal disease and candidate genes is still not clear. The reports of familial nature of chronic periodontitis are less frequent as compared to aggressive periodontitis. The striking familial aggregation of trait in aggressive periodontitis is consistent with significant genetic etiology. In this paper, an attempt has been made to summarize recent views on various genes involved in the pathogenesis and progression of aggressive periodontal disease. Data were identified by searches of the Medline, and Pubmed. Articles published in English were selected, and most up-to-date or relevant references were chosen.


Author(s):  
Valeriy Minukhin ◽  
◽  
Anatoliy Mel’nyk ◽  
Inna Torianyk ◽  
◽  
...  

Dental pathology is represented by a wide range of diseases of hard and soft tissues of these organs, various types of injuries, anomalies of shape, number, location, periodontitis. Inflammatory periodontal diseases are one of the most common human diseases, which lead to significant socio-economic losses and reduced quality of life. At the beginning of the XXI century, prevention and treatment of inflammatory periodontal diseases remains an urgent problem of medicine. The high frequency of periodontal lesions is largely due to the peculiarities of its structure and function, general human health, the constant influence of microorganisms, among which the dominant role is played by opportunistic and pathogenic bacteria. The microflora in inflammatory periodontal diseases differs from the microflora of the oral cavity of a healthy person by the presence of peculiar symbiotic associations with a specific dominant species of the pathogen. The main element of the modern protocol of medical care for periodontal disease is the systemic or local use of antimicrobials. Modern antibiotics and chemotherapeutics used in dental practice for the treatment of CPD, totally affect all parts of the biocenosis of the oral cavity and lead to its undesirable changes. In addition, even a short-term positive effect of the use of these drugs can be combined with a selective increase in the resistance of pathogens to antibacterial drugs, which generally reduces the expected effectiveness of traditional therapy. Inflammatory periodontal diseases, prospects of their treatment by classical methods and with the use of modern medical technologies were studied in the work. For the objectification of the study used archival materials and their own work over the past 15 years. The purpose of the study: to identify promising areas of integrated use of traditional and innovative treatments for inflammatory periodontal disease. The subject of the study was to clarify the issues of antibacterial, antifungal activity of hop products, the rate of formation of resistance in microorganisms, the adequacy of physical, physicochemical properties of gel compositions. Particular attention was paid to the use of antibacterial properties of gel compositions based on hop products. It is established that the use of antibiotics and chemotherapeutics in modern medical practice for the treatment of inflammatory periodontal diseases has a number of significant limitations due to the short duration of their therapeutic effect, negative impact on human microbiocenosis and the formation of acquired resistance of pathogenic microflora to widely used drugs. The results of previous studies have demonstrated the prospects of herbal medicines, namely, created on the basis of hop products for the prevention and treatment of diseases of microbial origin. It was found that the antibacterial and antifungal action of gel preparations of optimal composition with EHV 0.5% significantly exceeds the specified indicators of such known and currently used drugs. Therefore, it is clear the scientific and practical meaning of the use in protocols for the treatment of inflammatory periodontal diseases (as drugs for local therapy) phytomedicine based on hop herbal substance. Thus, a clear prospect of using new compositions of drugs with high antibacterial properties based on plant raw materials (including hops) for the treatment and prevention of periodontal disease. Solving this problem is a timely and socially appropriate fact.


2017 ◽  
Vol 18 (10) ◽  
pp. 970-976 ◽  
Author(s):  
Zoubeida Al Yahfoufi

ABSTRACT Aim Periodontal diseases are associated with microorganisms rich in Gram-negative species. Several studies have indicated the presence of few a periodontopathic microorganisms in the same family. A parent with severe adult periodontitis, who is infected with bacteria associated with periodontal disease, may function as a source of infection. Their children may be at a greater risk to become colonized with bacteria. The purpose of this investigation was (1) to explore the presence of three bacteria, such as Porphyromonas gingivalis (PG), Prevotella intermedia (PI), and Aggregatibacter actinomycetemcomitans (AA) in the same Lebanese family and (2) to study the clinical destruction in the same family and their relations as members of this family due to the presence of PG. Materials and methods A total of 10 families were screened; only 5 (13 females and 5 males) were selected for this study, and at least one member of the family had untreated periodontal disease, chronic or aggressive. Every participant signed an informed consent form. A total of 18 available deoxyribonucleic acid (DNA) samples were taken to analyze the presence of three periodontal bacteria. Statistics Multiple logistic regression was used for the exact methods. Results All 18 patients showed a positive result for PI. Also, PG. was recognized in 15 patients while AA was not detected in any of the subjects. All couples suffered from periodontitis, chronic or aggressive forms, five children suffered from gingivitis, three children had no clinical manifestation, and only one suffered from localized aggressive periodontitis. The statistical analysis showed with each 1 year of increase in age, the odds of having periodontal disease multiply by 1.39, i.e., age as a risk factor for periodontal disease due to the presence of PG and sharing the same plate. Conclusion This investigation demonstrates a high prevalence of periodontal microorganisms in children and young adults of Lebanese periodontitis parents and a microbiological similarity between the children and their mothers. All these factors could be a high risk of developing periodontal disease in the future. Clinical significance This article shows that vertical transmission of microorganisms is a possible risk factor for developing periodontal disease in the offspring. How to cite this article Al Yahfoufi Z. Prevalence of Periodontal Destruction and Putative Periodontal Pathogens in the Same Lebanese Family. J Contemp Dent Pract 2017;18(10):970-976.


Author(s):  
Milind Wasnik ◽  
Suryakant Kumar ◽  
Arun Sajjanar ◽  
Niharika Gahlod ◽  
Sneha Khekade ◽  
...  

The term “periodontal diseases” includes any inherited or acquired disorders of the tissues that are supporting the teeth i. e Gingiva, Cementum, PDL, and Alveolar bone. The periodontal disease can be either localized or generalized. Localized aggressive periodontitis (LAgP) patients have interproximal attachment loss on at least two permanent first molars and incisors, with attachment loss on no more than two teeth other than first molars and incisors. In children and adolescents LAgP occurs without clinical evidence of systemic disease and it is characterized by the severe loss of alveolar bone around permanent teeth [10]. Most commonly the disease is localized to the permanent first molars and incisors. Aim: The aim of this review article is explain in details about aggressive periodontitis including different management aspect of the same. Methods: This paper presents a review of the aggressive periodontitis in children. An electronic search was conducted using Pub Med®/MEDLINE, and Google search using the terms: Periodontium, Localized Aggressive Periodontitis, Children and periodontal health, periodontal health in adolescents, gingival disease in children, periodontal disease in children,  gingivitis, periodontitis, gingival disease and its prevalence, periodontal disease and its prevalence.


Author(s):  
M. O. Iskiv

Summary. Prevention and treatment of periodontal diseases remains one of the most important tasks of modern dentistry in connection with their high prevalence among all age groups of the population. Recently, much attention has been paid to the study of gum recession, as one of the clinical forms of periodontal disease. The paper presents data on paraclinical indexes in patients with gum recession, depending on age and biotype of periodontal disease. The aim of the study – to evaluate the intensification of inflammatory processes in periodontal tissues in patients with gum recession, depending on age and periodontal biotype using paraclinical indices. Materials and Methods. The article presents a comparative assessment of the intensity of inflammatory processes in periodontal tissues, depending on age and periodontal biotype in 204 somatically healthy patients who had a recession of the gums caused by different etiological factors. Results and Discussion. As a result of our research, it was found that with increasing age, there was a clear tendency to increase the indexes of all paraclinical indexes analyzed by us. Also, attention was drawn to the fact that the carriers of biotype periodontal A1-Thin S flow of inflammatory processes proceeded more pronounced and more intense.Conclusions. In persons with recession gum, the intensification of inflammatory processes in periodontal tissues increased with age, but depended on the periodontal biotype.Conclusions. In persons with recession gum, the intensification of inflammatory processes in periodontal tissues increased with age, but depended on the periodontal biotype.


2020 ◽  
Vol 210 ◽  
pp. 06005
Author(s):  
Vladimir Evstropov ◽  
Galina Zelenkova ◽  
Sergei Tresnitskii ◽  
Anna Spirina ◽  
Pavel Bykadorov ◽  
...  

Clinical and immunological parallels in inflammatory periodontal diseases are considered taking into account some features of the functioning of general and local structures of the immune system in periodontitis of varying severity, chronic generalized periodontitis, aggressive periodontitis. In the analysis of immunopathogenesis of inflammatory periodontal diseases, an essential role is given to an imbalance in the immune and cytokine system.


Pteridines ◽  
2003 ◽  
Vol 14 (3) ◽  
pp. 77-81 ◽  
Author(s):  
Aysen Bodur ◽  
Terken Baydar ◽  
Nurdan Ozmeric ◽  
Ayse Basak Engin ◽  
Ahu Uraz ◽  
...  

Abstract Periodontal disease results from the interaction of the host defence mechanisms with the microbial dental plaque. Analysis of gingival crevicular Huid (GCF) provides a non-invasive means of evaluating the role of the host response in periodontal disease. Based on our previous study, demonstrating increased levels of neopterin in GCF and saliva from patients with aggressive periodontitis (AgP), the aim of this study was to evaluate the effect of periodontal treatment on the levels of neopterin in GCF, saliva and urine of patients with AgP.Pre-treatment values of neopterin in GCF were 4.04 ± 0.86 nmol/ml for the AgP group (n=8) and 2.68 ± 0.90 nmol/ml fyr the control group (n=8; difference not significant). After periodontal treatment, the level of ncoptei in was found 2.38 ± 0.72 nmol/ml in the patient group which did not differ f r om pre-treatment levels. The salivary neopterin concentration was higher in both AgP groups (14.14 ± 2.85 nmol/1 and 8.02 ± 3.12 nmol/1, before and after periodontal treatment) than in controls (2.58 ± 0.3 nmol/1; both p<0.05). No significant difference in salivary neopterin level was observed in patients before and after periodontal treatment.Concentrations of urine neopterin in patients before treatment were 188.5 ± 30.98 μηιοί neopterin/mol creatinine and 168.1 + 20.21 μηιοί in controls (difference not significant). Following periodontal treatment, the urinary neopterin levels (310.1 ± 39.82 μηιοί neopterin/mol creatinine) were higher when compared to the baseline levels and to controls (p<0.05).Our results suggest that neopterin in saliva and GCF might be associated with the periodontal diseases process.


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