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Periodontics

Periodontics

Periodontics: An Overview

1. What is Periodontics?

Periodontics is a specialized branch of dentistry that focuses on the structures surrounding and supporting the teeth, primarily the gums, alveolar bone, and periodontal ligament. This field is concerned with the prevention, diagnosis, and treatment of periodontal disease, which affects these supporting tissues. Periodontists are dental professionals who specialize in managing periodontal disease and performing related surgical procedures.

2. Overview of Periodontal Disease

Periodontal disease, also known as gum disease, is a chronic inflammatory condition that affects the tissues surrounding the teeth. It ranges from simple gum inflammation (gingivitis) to severe damage to the soft tissue and bone that support the teeth (periodontitis). If left untreated, periodontal disease can lead to tooth loss and has been associated with other systemic conditions such as cardiovascular disease and diabetes .

3. Classification of Periodontal Disease

Periodontal diseases are classified based on the severity and extent of the disease. The main categories include:

  • Gingivitis: This is the mildest form of periodontal disease, characterized by inflammation of the gums without loss of bone or connective tissue.
  • Chronic Periodontitis: This is the most common form of periodontitis, characterized by slow progression and the destruction of the supporting structures of the teeth.
  • Aggressive Periodontitis: This form progresses rapidly and can lead to significant bone loss and tooth loss at an early age.
  • Periodontitis as a Manifestation of Systemic Diseases: This includes periodontitis associated with systemic conditions such as diabetes and cardiovascular diseases.
  • Necrotizing Periodontal Diseases: These are severe forms of periodontal disease that result in tissue necrosis, often seen in individuals with compromised immune systems.

4. Causes of Periodontal Disease

The primary cause of periodontal disease is the accumulation of bacterial plaque on the teeth and gums. Other contributing factors include:

  • Poor Oral Hygiene: Inadequate brushing and flossing can lead to plaque buildup.
  • Smoking: Smoking is a significant risk factor for periodontal disease and can affect the response to treatment.
  • Genetic Factors: Certain genetic variations can increase susceptibility to periodontal disease .
  • Systemic Conditions: Diseases such as diabetes can exacerbate periodontal disease due to impaired immune response and increased inflammation.
  • Diet and Nutrition: Poor nutrition can weaken the immune system and affect oral health.
  • Stress: Stress can affect the body’s ability to fight infection, including periodontal disease.

5. Symptoms of Periodontal Disease

The symptoms of periodontal disease vary depending on the stage and severity of the condition. Common symptoms include:

  • Red, Swollen Gums: Inflammation and redness of the gums are early signs of gingivitis.
  • Bleeding Gums: Gums that bleed during brushing or flossing indicate inflammation.
  • Bad Breath: Persistent bad breath can be a sign of periodontal disease.
  • Receding Gums: Gums that pull away from the teeth, making them appear longer.
  • Loose Teeth: As the disease progresses, the supporting structures of the teeth are destroyed, leading to tooth mobility.
  • Painful Chewing: Discomfort or pain while chewing can be a symptom of advanced periodontal disease.

6. Subjects at Risk of Periodontal Disease

Certain individuals are at higher risk of developing periodontal disease, including:

  • Smokers: Smoking is a major risk factor for periodontal disease and can impair treatment outcomes.
  • Diabetics: Individuals with diabetes are more susceptible to infections, including periodontal disease.
  • Genetic Predisposition: Genetic factors can influence susceptibility to periodontal disease .
  • Older Adults: The risk of periodontal disease increases with age.
  • Individuals with Poor Oral Hygiene: Inadequate oral care can lead to plaque buildup and periodontal disease.
  • Patients with Systemic Conditions: Conditions such as cardiovascular disease and osteoporosis can increase the risk of periodontal disease .

7. Diagnostic Measures for Periodontal Disease

Diagnosing periodontal disease involves a comprehensive dental examination, which includes:

  • Clinical Examination: The dentist examines the gums for signs of inflammation, bleeding, and recession.
  • Probing Depth Measurement: A periodontal probe is used to measure the depth of the pockets between the teeth and gums. Deeper pockets indicate more severe disease .
  • Radiographic Examination: X-rays are taken to assess bone loss around the teeth.
  • Microbial Analysis: Analysis of the subgingival microbiota can help identify specific pathogens associated with periodontal disease .

8. Treatments for Periodontal Disease

The treatment of periodontal disease depends on the severity of the condition and may include:

  • Non-Surgical Treatments:
    • Scaling and Root Planing (SRP): This deep cleaning procedure removes plaque and tartar from below the gum line and smooths the root surfaces to promote healing .
    • Antimicrobial Therapy: The use of antimicrobial gels or mouth rinses to reduce bacterial load.
    • Dietary Supplements: Omega-3 polyunsaturated fatty acids (PUFA) have been shown to have anti-inflammatory properties and can be used as an adjunct to non-surgical treatment.
  • Surgical Treatments:
    • Flap Surgery: This procedure involves lifting the gums to remove tartar and reduce pocket depth.
    • Bone and Tissue Grafts: These procedures are used to regenerate lost bone and tissue.
    • Guided Tissue Regeneration: A technique that uses a barrier membrane to direct the growth of new bone and tissue.
  • Supportive Periodontal Therapy: Regular maintenance visits to monitor and manage periodontal health.

In conclusion, periodontics is a vital field in dentistry that addresses the prevention, diagnosis, and treatment of periodontal disease. Understanding the various aspects of periodontal disease, including its causes, symptoms, risk factors, and treatment options, is essential for maintaining oral health and preventing tooth loss. Regular dental check-ups and good oral hygiene practices are crucial in managing and preventing periodontal disease.

References

    1. Home Oral Care of Periodontal Patients Using Antimicrobial Gel with Postbiotics, Lactoferrin, and Aloe Barbadensis Leaf Juice Powder vs. Conventional Chlorhexidine Gel: A Split-Mouth Randomized Clinical Trial.
    2. Omega-3 Polyunsaturated Fatty Acids EPA and DHA as an Adjunct to Non-Surgical Treatment of Periodontitis: A Randomized Clinical Trial.
    3. Periodontitis Increases the Risk of a First Myocardial Infarction: A Report From the PAROKRANK Study.
    4. Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-centre, investigator-masked, randomised trial.
    5. Identification of Salivary Microbiota and Its Association With Host Inflammatory Mediators in Periodontitis.
    6. The Subgingival Microbiome of Periodontal Pockets With Different Probing Depths in Chronic and Aggressive Periodontitis: A Pilot Study.
    7. Identification of Potential Oral Microbial Biomarkers for the Diagnosis of Periodontitis.
    8. LTF and DEFB1 polymorphisms are associated with susceptibility toward chronic periodontitis development.
    9. A genome-wide association study identifies nucleotide variants at SIGLEC5 and DEFA1A3 as risk loci for periodontitis.
    10. Subgingival microbiota in health compared to periodontitis and the influence of smoking.

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The Vietnamese version is the main version and has reference value. We have tried to make the other versions (English, Japanese, etc.) as good as possible. Despite these efforts, errors persist, particularly regarding foreign languages. We hope our readers will notify us of these errors via the contact form or at [email protected]
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