Chronic generalized periodontitis of moderate severity
Chronic generalized periodontitis of moderate severity is a result of further progression of inflammatory-dystrophic process in the periodontium. This stage of chronic generalized periodontitis is characterized by more severe clinical symptoms and palpable dysfunction dental system.
Periodontitis of moderate severity: complaints of bleeding gums and pain, halitosis, tooth mobility and displacement.
The clinical picture of periodontitis of moderate severity is characterized by complaints of bleeding gums, sometimes - pain, halitosis, tooth mobility and displacement. Overall condition is usually not disrupted, although in-depth examination revealed changes in the immune system, signs of endogenous intoxication, the deviations from other organs and systems.
When viewed from the oral cavity with periodontitis of moderate severity revealed signs of chronic gum inflammation: redness, bleeding, may be purulent discharge from the clinical pocket. There are over-and subgingival deposits of tooth. In periodontitis of moderate severity observed tooth mobility 1-2 degree may offset them.
Diagnostic criteria that allow diagnosis of "chronic generalized periodontitis of moderate severity, are: the presence of periodontal pockets with depth up to 5mm and resorption of alveolar bone on radiographs at 1/3-1/2 of the height of the interdental septum.
For patient examination and diagnosis of chronic generalized periodontitis of moderate severity in this case, we recommend that you perform the following scope of diagnostic manipulation:
- clinical probing pocket
- assessment of tooth mobility
- Indication and assessment of the "dental" plaque
In chronic periodontitis of moderate severity necessarily need to spend x-ray (orthopantomography). In addition, you need to do blood counts (KLA) and a blood glucose level. Patient with periodontitis of moderate severity is needed to consult with a dentist, orthopedist, and on the testimony - a general practitioner, internist.
The course of treatment of chronic generalized periodontitis of moderate severity consists of 6-10 visits for 20-30 days.
Therapy for chronic periodontitis of moderate severity is directed primarily at eliminating parodontopatogennyh factors (removal of tooth deposits, electoral prishlifovyvanie teeth, plastic arches and bridles, etc.), as well as relief of inflammation of the gums, the elimination of periodontal pockets, the stabilization of teeth series, normalization of the trophic, protective reactions of the microcirculation in periodontal tissues.
In the first visit after the survey and plan the treatment is carried out antiseptic treatment of gum 0.06% chlorhexidine, 1% hydrogen peroxide solution, 0,2% solution Frc. Then remove supragingival and accessible subgingival deposits of tooth. Typically, the removal of tooth deposits produce a 2-3-4 visits, although this procedure may be carried out in one visit.
Patient with chronic generalized periodontitis of moderate severity are taught the rules of oral hygiene, help to choose a toothbrush and toothpaste, make recommendations on the use of floss. At this stage, should be encouraged to toothpaste, have anti-inflammatory and antimicrobial action. At home, the patient also recommend doing mouthparts bath with a solution of Frc, chlorhexidine, decoction of chamomile, sage, calendula, 3-4 times a day for 20 minutes after eating. Control of oral hygiene should be maintained throughout the course of treatment.
During this visit to decide whether to remove decayed teeth, teeth with mobility grade 3, replacement of defective seals, properly made dentures, polling prishlifovyvanii teeth.
Ends first visit to the application on the gums and the introduction into clinical pockets paste, consisting of an antimicrobial drug (metronidazole) and nonsteroidal antiinflammatory drugs (acetylsalicylic acid, ortofena, etc.). In marked suppuration useful as topical application of proteolytic enzymes (trypsin, stomatozima, imozimazy) sorbents (gelevina, digispona).
Inside appoint metranidazol: the first day - 0,5 g, 2 times a day (12 hours), the second day - at 0.25 g 3 times (8 hours) in the next 4 days - on 0, 25 g 2 times (12 hours).
Conducted by the treatment of chronic generalized periodontitis of moderate severity combined with appropriate physiotherapy procedures (on the course - 3-7 procedures), have antimicrobial and anti-inflammatory action:
- hydromassage of gums
- anodgalvanizatsiya or electrophoresis of drugs with anodes of nicotinic acid
- local hypothermia, etc.
During the second visit (2-3 days) evaluate the implementation of patient advice on oral hygiene, this is carried out staining of plaque, iodine-potassium iodide solution. Continued removal of tooth deposits available, wash your pockets antiseptic solutions from a syringe with a blunt needle, applique on the gums and the introduction into the pockets of a mixture of metronidazole and one of the NSAIDs.
After arresting inflammation in the gums begin to eliminate periodontal pockets. In periodontitis moderate for this purpose produce an "open" curettage. In the outpatient surgery this idea to make one segment of the mandible, ie, of six teeth in the hospital - in all the teeth of one jaw. Rounding out the imposition of an open curettage gingival protective bandage for 1-2 days.
- to the area of postoperative wound - cold
- buccal antiseptic baths
- thorough hygienic oral care
- restriction of use of rough, sharp and irritating foods
In a subsequent visit by quality control operations previously performed and an "open" curettage of periodontal pockets in the other teeth, preferably against a background of antibacterial therapy.
After the removal of tooth deposits, eliminating parodontopatogennyh other factors, relief of inflammation in the gums and the elimination of periodontal pockets periodontal disease goes into remission.
At this stage, therapeutic measures in chronic generalized periodontitis of moderate severity should be aimed at normalizing the microcirculation of nervous trophic and homeostasis of periodontal tissues. To a large extent, these processes are normalized independently after the elimination of microbial attack and the inflammatory process in periodontal tissues.
Usually, to solve the problems listed above prescribe physiotherapy (5-10 procedures per course):
- cathode-galvanization or electrophoresis from the cathode of nicotinic acid, aloe extract, heparin, etc.
- darsonvalization gum
- local hypo-hyperthermia
It is also possible injection of vitamins, promotional and other drugs on the transition to the fold (on the course - 10-12 injections).
After completing the course of treating a patient with chronic generalized periodontitis of moderate severity should take the dispensary observation and assign a control examination after 2-3 months.
All subsequent treatments and preventive measures in patients with chronic generalized periodontitis of moderate severity should be aimed at maintaining the protective forces of periodontal education and prevention of tooth deposits. For this purpose, carry out periodic check-ups and courses "supportive" therapy intervals of 2-3 and then 5-6 months. Their main purpose - the control of oral hygiene, timely removal of tooth deposits, trophic stimulation, microcirculation and the protective forces of the periodontal tissues in order to prevent relapses and further progression of the disease.
If you have any questions about the diagnosis or treatment of chronic generalized periodontitis of moderate severity, you can specify them with our dentist or dentist on the phone: (903) 167–99–20
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