– common destructive inflammatory process, affecting the entire complex of periodontal tissues. Generalized periodontitis occurs with bleeding and swelling of the gums, painful sensations, unpleasant smell from the mouth, the presence of dental plaque, the formation of periodontal pockets, mobility and dislocation of teeth. Diagnostics generalized periodontitis carried out by a periodontist using an examination of the oral cavity, determination of the hygiene index and periodontal index, orthopantomography, and biopsy of gum tissue. Treatment of generalized periodontitis includes local conservative and surgical treatment; general anti-inflammatory and immunomodulatory therapy.
Generalized periodontitis is diffuse damage to the periodontal complex, covering most or all teeth. Generalized periodontitis is one of the most complex and is still unresolved problems clinical dentistry. Periodontitis, especially its generalized form, is 5-6 times more likely than caries, leading to partial and complete secondary adentia, and long-term persistence of infection in periodontal pockets is a risk factor for the development of rheumatoid arthritis, infective endocarditis, atherosclerosis, myocardial infarction, stroke, etc. .
The term “periodontium” refers to a complex of periodontal tissues that have a common innervation and blood supply and are closely related to each other in morphological and functional terms. The periodontal complex is formed by the gum, periodontium, bone tissue of the alveolar processes, cement of the roots of the teeth and performs the most important functions - support-retaining, protective, reflex. Periodontal pathologies include gingivitis, periodontitis, periodontal disease, and tumor-like processes (periodontomas). When widespread dystrophic-inflammatory changes occur in the entire complex of periodontal tissues, they speak of generalized periodontitis.
The prerequisites for the occurrence of generalized periodontitis are factors of exogenous and endogenous origin, with the dominant influence of the latter. Besides this, everything etiological factors are divided into local and general. The first group includes the presence of plaque and tartar, malocclusion, bruxism, abnormalities in the position of the teeth, strands of the mucous membrane, anomalies in the attachment of the frenulum of the tongue and lips, etc. The second group includes general diseases - diabetes mellitus, diffuse toxic goiter, obesity , osteoporosis, hypovitaminosis, pathology of the blood system, rheumatism, cholecystitis, hepatitis, gastritis, enterocolitis, hypoimmunoglobulinemia, etc., affecting the condition of the periodontium.
Using microbiological studies, it has been proven that the leading etiological role in the development of generalized periodontitis belongs to periodontopathogenic microorganisms - Prevotella intermedia, A. Actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus, Peptostreptococcus, etc. The main “microbial depot” is dental plaque - subgingival plaque that accumulates in the gingival sulcus, periodontal pockets, on the root of the tooth, etc. Waste products pathogenic microflora activate the secretion of cytokines, prostaglandins, hydrolytic enzymes, causing destruction of periodontal tissue. Risk factors for generalized periodontitis, reducing local and general nonspecific protection, are tobacco smoking, radiation damage, poor oral hygiene.
The development of generalized periodontitis is preceded by an inflammatory lesion of the gingival margin, leading to disruption of the dentogingival junction, destruction ligamentous apparatus and alveolar bone resorption. These changes are accompanied by pathological mobility of teeth, overload of certain groups of teeth, and the occurrence of traumatic occlusion. Without adequate and timely treatment generalized periodontitis leads to tooth loss or removal, impaired functioning dental system and the body as a whole.
Depending on the severity of the developed disorders (depth of pathological pockets and severity of destruction bone tissue) there are three degrees of generalized periodontitis.
Taking into account clinical course There are generalized periodontitis with frequent exacerbations (1-2 times a year), rare exacerbations (once every 2-3 years) and chronic course without exacerbations.
IN initial stage generalized periodontitis is characterized by bleeding gums, their swelling and looseness; itching, pulsation and burning in the gum area, pain when chewing food, unpleasant odor from the mouth. Dental pockets are shallow and located mainly in the interdental spaces. There is no mobility or displacement of teeth; general condition the patient is not impaired.
The clinical picture of developed generalized periodontitis, in addition to the listed symptoms, is characterized by loosening and displacement of teeth, increased sensitivity (hyperesthesia) of teeth to temperature stimuli, and difficulties with chewing food. In severe cases, generalized periodontitis leads to disruption of general well-being - weakness and malaise, increased body temperature, acute pain in the gum area. Regional lymph nodes enlarge and become painful. A dental examination reveals signs of diffuse hypertrophic gingivitis, abundant accumulations of soft plaque, supra- and subgingival dental plaque, severe traumatic occlusion, multiple periodontal pockets various shapes and depth, often with serous-purulent or purulent contents. In advanced stages of generalized periodontitis, tooth loss, formation of periodontal abscesses and fistulas may occur.
When assessing the dental status of a patient with generalized periodontitis, attention is paid to the amount and nature of dental plaque, the condition of the gums, the depth of the vestibule of the mouth, bite, the condition of the frenulum of the tongue and lips, tooth mobility, the presence and depth of periodontal pockets. In progress initial examination The Schiller-Pisarev test is performed, the hygiene index and periodontal indices are determined, and a periodontogram is compiled.
In case of generalized periodontitis, a study of scrapings from the gingival pocket using PCR, chemiluminescence of saliva, and bacterial culture of the discharge from the periodontal pockets is indicated. From additional examinations A biochemical blood test for glucose, CRP may be recommended; determination of serum IgA, IgM and IgG.
In order to determine the stage of generalized periodontitis, orthopantomography, targeted intraoral radiography, and biopsies of gum tissue are performed. With generalized periodontitis, differential diagnosis is required with gingivitis, periodontal disease, periostitis and osteomyelitis of the jaw.
Considering the multifactorial nature of the pathology, treatment of chronic generalized periodontitis should be complex and differentiated, carried out with the participation of periodontists, dental therapists, surgeons, and orthopedists. An important role is played by teaching the patient the rules of hygiene and professional assistance in selecting oral care products.
At mild degree generalized periodontitis is indicated
Introduction
In our country, we use the terminology and classification of periodontal diseases approved at the XVI Plenum of the All-Union Society of Dentists.
Periodontitis is an inflammation of periodontal tissues, characterized by progressive destruction of the periodontium and bone of the alveolar process of the jaws.
Gravity: light, medium, heavy.
Flow: acute, chronic, exacerbation, abscess, remission.
Prevalence:
Periodontitis is an inflammation of periodontal tissues, characterized by destruction of the periodontal ligaments and alveolar bone.
Flow: chronic, aggressive.
Process phases: exacerbation, remission.
The severity is determined according to the clinical and radiological picture. Its main criterion is the degree of destruction of bone tissue of the alveolar process (in practice, it is determined by the depth of periodontal pockets/PC/mm).
Severity: light (PC no more than 4 mm), medium (PC 4-6 mm), heavy (PC more than 6 mm).
Process prevalence: localized, generalized.
The commission considered it necessary to identify an independent group of periodontal diseases - aggressive forms of periodontitis (prepubertal, juvenile, rapidly progressing. The latter develops in individuals aged 17 to 35 years).
mild severity
Develops as a complication of untreated chronic catarrhal gingivitis and is characterized by progressive destruction of periodontal tissue and bone of the alveolar processes of the jaws.
Clinic:
Characterized practically complete absence unpleasant subjective sensations in the patient, hence the low appeal for medical care at this stage of disease development. Patients, as a rule, note slight itching in the gums and bleeding due to mechanical irritation (when brushing teeth, eating hard foods). The general condition is not disturbed, although an in-depth, targeted examination usually reveals changes in immune system, deviations from other organs and systems, pathogenetically associated with periodontal pathology. From the anamnesis it should be clear that the disease began gradually and was practically asymptomatic for a long time.
An objective examination reveals chronically mild inflammation of the gums (swelling, bleeding, hyperemia). Supra- and subgingival dental deposits (mineralized and non-mineralized) are detected. The teeth are motionless and not displaced.
Diagnostic criteria are: the presence of periodontal pockets up to 3.5 mm deep, mainly in the area of interdental spaces, and the initial degree of destruction of the bone tissue of the alveolar process (x-ray picture: absence of a compact plate at the apexes of the interalveolar septa, foci of osteoporosis, expansion of the periodontal gap in the cervical region).
To make a diagnosis V in this case it is enough to question the patient, examine the oral cavity, probe clinical pockets, assess tooth mobility, conduct the Schiller-Pisarev test, as well as indication and quantification"dental" plaque. To clarify the diagnosis, an X-ray examination is performed, preferably orthopantomography. It is advisable to do clinical analysis blood, and for patients over 40 years of age - a blood glucose test. The listed methods are usually sufficient to diagnose mild chronic generalized periodonitis, if it is not accompanied by pathology internal organs, pronounced occlusal disorders, etc.
Treatment:
Conducted in 3-4 visits. First, after antiseptic treatment of the gums, dental plaque is thoroughly removed. It is advisable to apply antimicrobial and anti-inflammatory drugs to the gums. From antimicrobial agents in this case, 0.06% chlorhexidine solution and metronidazole (Trichopol) are effective. Among anti-inflammatory drugs, preference is given to non-steroidal anti-inflammatory drugs (NSAIDs) - acetylsalicylic acid, indomethacin, ortofen.
The patient is taught the rules of oral hygiene and is helped to choose toothbrush And toothpaste, give recommendations on the use of floss. At this stage, toothpastes that have anti-inflammatory and antimicrobial effect, as well as oral baths with antiseptic solutions, decoctions of chamomile, sage, and calendula.
Physiotherapy gives good results: CUF on the gum area (antibacterial effect), anode galvanization, electrophoresis medicinal substances from the anode (calcium chloride, vitamin B1), UHF EP in an oligothermic dose, local hypothermia, helium-neon laser radiation, argon plasma flow (anti-inflammatory effect).
Periodontitis, as a rule, is accompanied by functional overload of the teeth, so the patient must be referred to a consultation with an orthopedist for selective grinding and other types of orthopedic treatment.
On the second, third and fourth visits (with an interval of 1-2 days), the level of oral hygiene is checked, the removal of dental plaque, and the application of pastes based on metronidazole and NSAIDs are continued. After the inflammatory phenomena are relieved, the granulations are scraped out - curettage. This procedure improves long-term treatment results.
After completing the described course therapeutic manipulations As a rule, the disease goes into remission.
A follow-up examination is scheduled after 3-6 months.
Chronic generalized periodontitis
medium degree gravity
It is the result of further progression of the inflammatory-dystrophic process in the periodontium. This stage of the disease is characterized by more pronounced clinical symptoms and noticeable dysfunction of the dental system, which forces the patient to seek medical help.
Clinic:
It is characterized by complaints of bleeding gums, sometimes soreness, bad breath, mobility and displacement of teeth. The general condition, as a rule, is not disturbed, although an in-depth examination reveals changes in the immune system, signs endogenous intoxication, deviations from other organs and systems.
When examining the oral cavity, signs are revealed chronic inflammation gums: hyperemia, bleeding, there may be purulent discharge from clinical pockets. There are supra- and subgingival deposits. As a rule, tooth mobility is observed I-II degrees, their displacement is possible.
Diagnostic criteria allowing the diagnosis of “chronic generalized periodontitis of moderate severity” are: the presence of periodontal pockets up to 5 mm deep and resorption of the bone tissue of the alveolar process according to the radiograph at 1/3-1/2 of the height of the interdental septum.
For examination of the patient and making a diagnosis in this case, we recommend performing the following scope of diagnostic manipulations: questioning, examination, probing of clinical pockets, assessment of tooth mobility, Schiller-Pisarev test, indication and assessment of “dental” plaque. An X-ray examination (orthopantomography) is required. In addition, you need to do a clinical blood test and a blood glucose test. The patient should be consulted by an orthopedic dentist, and if indicated, by an internist.
Course of treatment chronic generalized periodontitis of moderate severity consists of 6-10 visits over 20-30 days.
Therapy is aimed primarily at eliminating periodontal pathogenic factors (removal of dental plaque, selective grinding of teeth, plastic vestibule and frenulum, etc.), as well as at stopping inflammatory phenomena in the gums, eliminating periodontal pockets, stabilizing protective rows, normalizing trophism, microcirculation And defensive reactions in periodontal tissues.
On the first visit after examination and drawing up a plan complex therapy carry out antiseptic treatment of the gums with a 0.06% solution of chlorhexidine, 1% solution of hydrogen peroxide, 0.2% solution of furatsilin. Then supragingival and accessible subgingival dental deposits are removed. Usually, dental plaque removal is carried out in 2-3-4 visits, although this procedure can be carried out in one visit.
The patient is taught the rules of oral hygiene, helped to choose a toothbrush and toothpaste, and given recommendations on the use of floss. At this stage, toothpastes with anti-inflammatory and antimicrobial effects should be recommended. At home, the patient is also recommended to make oral baths with a solution of furatsilin (1:5000), chlorhexidine 0.06%, decoctions of chamomile, sage, calendula 3-4 times a day for 20 minutes after meals.
Oral hygiene should be monitored throughout the entire course of treatment.
During the same visit, they decide on the removal of damaged teeth, teeth with degree III mobility, replacement of defective fillings, incorrectly made dentures, and selective grinding of teeth.
The first visit ends with an application to the gums and the introduction of a paste consisting of antimicrobial drug(metronidazole) and non-steroidal anti-inflammatory drug (aspirin, ortofen, etc.). In case of severe suppuration, local use of proteolytic enzymes (trypsin, stomatozyme, imozymase) and sorbents (helevin, digispon) is also advisable.
Metronidazole is prescribed orally: on the first day - 0.5 g 2 times (with an interval of 12 hours), on the second day - 0.25 g 2 times (every 8 hours). The drug is taken during or after meals.
General, or generalized periodontitis, is the process of inflammation that destroys the soft tissue of the periodontium throughout the oral cavity with damage to the teeth. The progression of the disease leads to atrophy or destruction of the bone and periodontal tissues that hold the tooth in the socket, and the formation of periodontal pockets (voids at the site of attachment of the gums to the tooth root). This contributes to infection of periodontal tissues, mobility and tooth loss. The most common generalized periodontitis is chronic with different periods remission.
Taking into account the depth of periodontal pockets and the severity of bone tissue destruction, experts diagnose three stages of the disease with different symptoms:
The pathological process can exist for quite a long time in the absence of bright clinical picture. Therefore, patients rarely turn to specialists for medical assistance, and the disease, progressing, enters the most severe stage.
The impetus for the development of chronic periodontitis can be gingivitis or other diseases of the oral cavity. Insufficient hygiene, neglect of treatment when the first signs of periodontal inflammation are detected are the most common reasons development of the chronic form. It has two stages:
Treatment of chronic generalized periodontitis is complex and depends on the severity of the disease. Medical and preventive measures are aimed at:
Chronic generalized periodontitis of mild severity is treated in stages. First you need to remove plaque and other hard deposits on the tooth enamel. Then local antibacterial drugs are prescribed, which are applied as applications to the affected areas. In addition, it is recommended to rinse the mouth with solutions containing antiseptic components.
Collateral successful treatment is competent and regular hygiene procedures using medicinal pastes, special toothbrushes and floss. Daily thorough care oral cavity, timely visits to the dentist prevent re-exacerbation of periodontitis.
Treatment for a moderately severe disease takes longer. In addition to the above procedures, it includes the removal of damaged and severely loose teeth, the use of steroidal and non-steroidal anti-inflammatory drugs. Physiotherapeutic procedures are also prescribed:
A follow-up visit to the periodontist should be made 2-3 months after therapy.
Chronic generalized severe periodontitis requires not only enhanced conservative treatment, but also surgical intervention. Since at this stage of the disease the destruction of periodontal tissues is pronounced, in addition to the use of powerful antibiotics, it is necessary to carry out measures to restore the affected areas and dental prosthetics. Taking into account the individual clinical picture, the following surgical operations may be prescribed:
An important component of the treatment of the chronic form of generalized periodontitis is the use of strong anti-inflammatory drugs, immunomodulators, and a complex of vitamins.
The prognosis of the disease is unfavorable: the remission stage practically does not occur. In addition to tooth loss and gum destruction, systemic complications may occur from cardiovascular system.
Recognition of generalized periodontitis by early stages and adequate treatment can achieve long-term remission. To preserve the functions of the dental system, it is necessary to carry out not only daily procedures for the care of the oral organs, but also regularly perform professional cleaning to remove dental plaque.
Chronic generalized periodontitis. It usually occurs against the background of general diseases of the body.
Etiology and pathogenesis. Disturbances play a significant role in these processes endocrine system and metabolism (diabetes mellitus, thyrotoxicosis), diseases gastrointestinal tract (peptic ulcer, long-term gastritis, cholecystitis, colitis), diseases of the blood and cardiovascular system, allergic and autoimmune conditions, vitamin balance disorders. As a rule, these conditions of the body change the protective and adaptive mechanisms of tissues and organs of the oral cavity, and therefore inflammatory processes in the periodontium have a number of characteristic features. The role of local factors cannot be excluded, since they aggravate the course of the disease. Modern ideas about the essence of the inflammatory-destructive process in generalized periodontitis emphasize the role of tissue and microbial enzymes in the violation metabolic processes and trophism of the entire periodontal complex. Great value have microcirculatory disorders, allergic and autoimmune processes. These ideas correspond to pathophysiological changes in the periodontium, which are characterized by increasing dystrophic and destructive processes in the periodontium. Dystrophy of the epithelium is accompanied by its desquamation in the periodontal pocket and simultaneous growth into the underlying connective tissue. Connective tissue The gums contain a significant amount of lymphoplasmocellular infiltrate, which indicates an immunological restructuring of tissues. An increase in eosinophils indicates the accumulation of antigen-antibody complexes in the gum stroma, and an increase in the number of mast cells and their active degranulation indicates changes in the level of metabolism in periodontal tissues. Along with this, proliferation of blood vessels and a high content of acidic mucopolysaccharides around them, as well as mucoid swelling of the walls of blood vessels are indicators of tissue damage of an allergic nature. Simultaneously with the inflammatory growth of the epithelium into the underlying stroma with the formation of granulation tissue, resorption of alveolar bone is observed. Inflammatory changes in bone tissue can manifest themselves in the form of lacunar, smooth and axillary types of resorption.
Clinical picture and diagnosis. The clinical picture of generalized periodontitis largely depends on the severity of inflammation in the periodontium, on the general condition of the body and has typical symptoms initial and developed stages. Initial signs generalized periodontitis - bleeding, swelling of the gums, pain in the gum area, itching and burning, bad breath. Unlike gingivitis, shallow periodontal pockets can be detected already in the initial stage of the disease, mainly in the area of interdental spaces. Will help diagnose the initial stage of periodontitis x-ray examination(preferably orthopantomography), since the radiograph reveals the absence of a compact plate at the tops of the interdental septa, widening of the periodontal gap in the cervical region, sharp foci of osteoporosis and the first signs of bone tissue destruction. At this stage of development of periodontitis, as a rule, the teeth are immobile, not displaced, and obvious signs disorders of the general condition of the body. In the developed stage of periodontitis, multiple pathological periodontal pockets of different depths and shapes appear, often with purulent compartments, mobility and dislocation of teeth, and subsequently traumatic occlusion is formed. Characterized by an abundance of soft plaque, supra- and subgingival dental plaque. The exposure of the necks and roots of the teeth is accompanied by hyperesthesia, sometimes resorption of cement and dentin of the root. Retrograde pulpitis may develop. X-ray picture The developed stage of generalized periodontitis is characterized by severe osteoporosis and bone destruction, the vertical type of resorption predominates with the formation of bone pockets.
In the developed stage of periodontitis, degrees I, II, and III of the disease can be distinguished. The criteria are the depth of the pathological pockets and the degree of bone resorption. I degree: pocket depth 3.5 mm and bone resorption no more than 1/3 of the length of the tooth root; II degree: pocket depth is up to 5 mm, and bone resorption is up to ½ of the root length; III degree: pocket depth more than 5 mm, destruction of bone tissue by more than ½ of the length of the tooth root. The chronic progressive course of periodontitis can give rise to exacerbations, the clinical picture of which has a number of features that require special doctor tactics. The cause of exacerbation can be both local and common factors, and more often their combinations. Patients are concerned about spontaneous pain, significant pain and bleeding, “swelling” of the gums, bad breath, difficulty eating, brushing teeth, and talking. The formation of abscesses and fistulas, ulceration of the gums follow one after another with an interval of several days. In parallel, changes in the general condition of the body develop - a rise in body temperature, weakness, malaise, enlargement and soreness of regional lymph nodes. The X-ray picture in these cases does not characterize the severity of the inflammatory process. Additional Methods studies will help clarify the depth and severity of periodontal damage. The state of remission that occurs as a result of treatment of generalized periodontitis is distinguished following signs: gums pale pink, dense, possibly exposing the roots of the teeth. There is no dental plaque, and there is no discharge from the pockets either. The radiograph shows no signs of active destruction of the interdental septa; the bone tissue is dense.
Differential diagnosis carried out with gingivitis based on clinical symptoms and especially the X-ray data.
Generalized periodontitis (hereinafter referred to as GP) is a common pathological process of a destructive-inflammatory nature that affects all periodontal tissues. The disease occurs with swelling and bleeding of the gums, severe pain in the affected areas, bad breath, and the formation of periodontal canals. Chronic generalized periodontitis leads to mobility and loose teeth. Differential diagnosis pathological process carried out by a periodontist using laboratory and instrumental methods.
GP is still one of the most complex and unresolved issues in clinical dentistry. Periodontitis is 5–6 times more likely than caries, leading to partial or complete loss teeth, and the chronic inflammatory process in soft tissues oral cavity increases the risk of developing diseases such as rheumatoid arthritis, infective endocarditis(inflammation of the heart muscle), stroke, myocardial infarction, etc.
Generalized mild periodontitis is caused by external and internal factors. In addition, dentists divide all causes leading to HP into general and local. The list of the latter includes:
Symptoms of GP of moderate severity usually appear against the background systemic diseases:
Important! Results clinical trials confirm that the main role in the development of HP is played by so-called periodontopathogenic microorganisms.
The main “culprit” in the list is considered to be dental plaque - subgingival plaque deposited in periodontal pockets, near the roots of teeth, in the gingival sulcus. The waste products of “local” bacteria lead to the destruction of periodontal tissue.
GP is defined as “local” dental problems, and systemic diseases of the immune, hormonal, metabolic nature
The development of chronic generalized severe periodontitis is certainly affected by bad habits(smoking, drinking alcohol), radiation therapy(suppresses the immune system), as well as non-compliance elementary rules oral care. As a rule, the onset of HP is preceded by gingivitis, an inflammatory process that affects the gums. Its course is accompanied by a pronounced focal pain syndrome, discomfort while eating, instability, looseness of individual teeth, hyperemia, swelling of the soft tissues of the oral cavity.
Stages of the pathological process:
Exacerbation of HP, depending on the severity of the course, can occur 1–2 times a year or occur every 2–3 years. HP can occur in acute and chronic forms. The first, as a rule, develops due to medical error when carrying out one or another dental treatment, affects 1-2 teeth, with timely measures taken, it responds well to treatment.
HP begins with inflammation, increased bleeding, sore gums, after which indicated symptoms loose teeth and general manifestations(weakness, hyperthermia, apathy). Chronic HP is accompanied by a full range of classical signs of a destructive-inflammatory process (about them we'll talk below) and most often is the result of neglect of the rules of oral hygiene or a complication of a certain systemic disease.
The first symptoms of the disease are looseness, swelling, swelling of the affected gums, burning, pain while eating. The course of mild HP is accompanied by bad breath and the formation of shallow periodontal pockets, mainly in the spaces between the teeth.
Important! On initial stages the development of pathology, loose teeth is not determined, systemic signs(weakness, no fever).
Moderate and severe degrees of HP are characterized by the following symptoms:
On late stages Its development causes general weakness, malaise, hyperthermia, and severe pain in the affected areas. A dental examination reveals traumatic nodes, powerful accumulations of hard and soft dental plaque, numerous periodontal pockets of varying depths, in which, as a rule, purulent or serous exudate is found.
Periodontitis can occur in acute and chronic forms; if left untreated, the pathological process becomes generalized (affects most teeth)
Advanced forms of HP are accompanied by tooth loss, the formation of abscesses and fistulas. Remission of chronic GP is diagnosed by the pale pink tint of the gums, the absence of plaque and pus from the periodontal pockets, and the roots of the “affected” teeth may be exposed. Based on the results X-ray examination There are no symptoms of damage (resorption) of dental bone tissue.
In the process of diagnosing a disease, the degree of its severity and the general health of the patient take on leading importance. So, if there is one or more accompanying pathologies The periodontist refers the patient to specialists of another profile (therapist, immunologist, hematologist, rheumatologist, etc.). During the examination, the doctor mandatory pays attention to the following indicators:
The visual inspection is supplemented by a whole list of laboratory and instrumental studies(in particular, periodontogram, biochemical analysis blood, orthopantomography, etc.). Differential diagnosis of HP is carried out with gingivitis, osteomyelitis of the jaw, periostitis.
Treatment of generalized periodontitis is difficult to carry out due to the multifactorial nature of this pathology. As a rule, the patient comes to the aid of not only a periodontist, but also a surgeon, dental therapist, and orthopedist. Teaching the patient the rules of oral hygiene plays an important role in the success of the fight for healthy gums and teeth.
Resorption of bone tissue in HP sooner or later leads to partial or complete adentia (tooth loss)
Complex treatment initial forms GP involves professional removal of hard and soft plaque, cleaning and disinfection of formed periodontal pockets using antiseptic solutions(Furacillin, Miramistin, Chlorhexidine). Periodontal applications are applied to areas affected by periodontitis.
Orthopedic treatment of moderately severe GP includes selective grinding of “affected” dental surfaces, removal of subgingival deposits from periodontal pockets (using the occlusion method), and application of therapeutic bandages. At the same time, a specialist may consider removing one or more affected teeth.
Local anti-inflammatory methods for the treatment of HP are complemented by systemic symptomatic measures, which are selected based on the overall picture of the disease. Severe stages of HP usually require surgical intervention. This may be extraction of teeth of 3–4 degrees of mobility, excision of soft tissue foci, opening of abscesses or cleaning (drainage) of periodontal pockets filled with purulent exudate.
This form of pathology necessarily involves complex systemic therapy - taking antibiotics, anti-inflammatory drugs, immunomodulators, vitamins and minerals. Treatment of HP is not complete without physiotherapeutic procedures (electro-, ultraphonophoresis, darsonvalization, hirudo-, herbal therapy).
At early diagnosis and timely treatment measures taken, HP responds well to drug correction, and a prolonged remission occurs. The main role in the success of the fight against this pathology in the future is played by the patient’s careful compliance with the basic rules of oral care.
Important! Severe forms of HP can lead not only to partial or complete loss of teeth (edentia), but also result in serious disturbances in the functioning of the cardiovascular system.
The fight against periodontitis is complex, depends on the severity of the pathological process, includes conservative and surgical methods treatment
To prevent the appearance of signs of periodontitis, it is recommended:
As we can see, the generalized form of periodontitis is severe dental disease, the development of which is associated with external and internal factors. The main “provocateurs” of the pathological process are pathogenic microorganisms that live en masse in the oral cavity.
Their activity increases against the background of systemic diseases (diabetes mellitus, digestive problems, immune failure) and is the result of poor daily care of teeth and gums. Treatment of HP is complex and includes local and systemic measures. If the fight against periodontitis is not started in a timely manner, it can lead to complete or partial adentia and provoke disturbances in the functioning of the heart (vessels).
