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••••••> Periodontal Disease

Periodontal disease is the combination of multiple diseases which includes


local n multiple factors. It consists of chronic inflammation of gums with the
loss of alveolar bone. It is a disease which has an effect on one or more
periodontal tissues. Traditionally Periodontal disease is divided into two
categories:-

(a) Gingivitis – It can be defined as inflammation of the gingival tissue


without the loss of tooth attachment i.e. periodontal ligament. It is
usually caused by bacterial plaque that accumulates in the small gaps
between the gums and the teeth and the calculus that forms on the
teeth. These bacteria appear to be tiny or microscopic but the bacteria in
them produce foreign chemicals and toxins that causes inflammation of
the gums.

(b) Periodontitis – It refers to number of inflammatory diseases which


affects the periodontium i.e. the tissue which surround and support the
teeth.This disease involves progressive loss of the alveolar bone around
the teeth and if its untreated it may result into loosing and subsequent
loss of teeth. It is caused due to microorganisms that adhere to grow on
the surface of the tooth, along with an overly aggressive immune
response against these microorganisms.

In some cases of individuals, gingivitis never results into periodontitis,


speaking in the other way gingivitis always precedes periodontitis.

TREATMENT (Conventional Therapy)

Successful treatment of this disease includes removal of plaque and calculus


that is being accumulated on the teeth. This treatment is called debridment
which is performed by using ultrasonic instruments which breaks down the
calculus resulting into its easy removal. This treatment called debridment
helps in removing the heavy staining and calculus accumulated on the lingual
surface of the mandibular anterior teeth near the gum line.
This treatment also includes instruments like -
(a) Periodontal scalers which are dental instruments used on primary
basis in the periodontal care of the human teeth, it has a narrow tip
for easy access to narrow embrasure spaces between the teeth.
(b) Periodontal curettes which are also used for the periodontal care of
the human teeth and it has blunt rounded tip which helps in
treating of sub gingival areas where calculus is accumulated. They
are classified into two:
• Universal Curette.
• Gracey Curette.
Scaling and Root planning otherwise known as conventional periodontal
therapy or non surgical periodontal therapy is to remove or eliminate the
etiological agents which cause inflammation. Periodontal scaling procedures
into removal of plaque, calculus and stain from the crown and root surfaces
of teeth, whereas root planning is a specific treatment that removes the
roughened cementum and surface dentin (calcified tissue of the teeth) that is
impregnated with calculus, microorganisms and their toxins. They are also
referred to as deep cleaning and can be performed by using a number of
dental tools including ultrasonic instruments and hard instruments such as
periodontal scalers and curettes.

Full mouth disinfection refers to an intense course of periodontitis typically


involving scaling and root planning in combination with adjunctive use of
systematic antibiotics as well as use of local antimicrobial adjuncts to
periodontal treatment such as chlorhexidine. The aim is to complete
debridment of all periodontal pocket areas within a short time frame in order
to minimize the chance of reinfection of the pocket of the pathogens.

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