Periodontics is the specialty of dentistry that studies the diagnosis, treatment and prevention of diseases and conditions that affect the tissues that support the dental organs (gingiva, periodontal ligament, root cement and alveolar bone), for the maintenance of the health, function and aesthetics of the teeth and their adjacent tissues.
Periodontal disease
Periodontal disease is considered an infectious-inflammatory disease that, depending on the degree of involvement, can lead to the total loss of the tooth’s supporting tissues. Considering that the etiology of the disease is mainly infectious (bacterial plaque), the treatment is mainly focused on controlling the infection and reducing inflammation.
Periodontal disease is the leading cause of tooth loss worldwide.
Periodontal disease can be considered an important factor to take into account in the appearance of certain systemic disorders, such as cardiovascular disorders, psychosocial factors, cerebrovascular disorders, respiratory diseases, gastrointestinal disorders, diabetes mellitus, among others.
Gingivitis
Gingivitis is inflammation in different degrees of intensity of the gum without affecting the supporting tissues (ligament, cementum, bone). Signs of gingivitis include inflammation, redness and swelling of the gums, bleeding on probing (at clinical evaluation) or when the patient is hygienic. It is reversible if professionally treated with plaque removal and tooth surface calculus through prophylaxis (cleanings), and non-surgical debridement of the root surface. It is important to motivate and teach the patient to take good oral hygiene care, with the aim of ensuring that the oral cavity is clean and free of infections.
Then the patients go to periodontal support or maintenance therapy, so that the beneficial therapeutic treatment is maintained for a long time, visiting the dental professional at regular intervals according to the needs of each patient.
Periodontitis
Periodontitis, unlike gingivitis, is the inflammation of the gingiva and the supporting periodontium, significantly affecting the gingival connective tissue, periodontal ligament, cementum and bone. Signs of periodontitis include inflammation, redness and swelling of the gums, bleeding on probing (at clinical evaluation) or when the patient is hygienic, formation of periodontal pockets, attachment loss and radiographic bone loss, recessions or enlargement (overgrowth) gum size, suppuration, bad breath, increased mobility, pathological dental migration, pain (generally asymptomatic) which can lead to tooth loss.
In these cases, treatment begins, as in gingivitis, with the removal of plaque and calculation of the tooth surface through prophylaxis (cleanings), and non-surgical debridement of the root surface. We motivate and teach the patient to have good oral hygiene care, with the aim of ensuring that the oral cavity is clean and free of infections.
Then we evaluate whether it is necessary to perform surgical treatment, either due to the need to create accessibility for the correct professional debridement of the root surfaces, establish a gingival morphology that facilitates self-control of plaque and improve long-term preservation of teeth, removal of deep periodontal pockets, treatment of bone shape defects to restore the physiological bone contour of the alveolar bone, mucogingival problems (enlargements, gingival recessions, unevenness in the gingival margin), either for aesthetic or cosmetic reasons or due to hypersensitivity of the pieces dental.
For surgical treatment we use various techniques: access procedures, gingivectomies, periodontal plastic surgery (gum grafts, clinical crown lengthening, correction of alveolar ridge defects, regenerative-bone grafts.
Then the patients go to maintenance periodontal therapy for the prevention of reinfection and recurrence of periodontal disease, performing periodic controls at 3-6-month intervals according to the needs of each patient. Treated periodontal patients who comply with regular periodontal maintenance sessions have a better prognosis than non-compliant patients. The latter should be considered at high risk of progression of periodontal disease.
