Chronic generalized severe periodontitis
Chronic generalized severe periodontitis is the development, running, often "terminal" stage of the inflammatory-dystrophic process in the periodontium. Treatment in case of chronic generalized periodontitis severe usually ineffective, leads only to short-term improvement and requires the physician and the patient's significant efforts to at any time to maintain the relative usefulness of the dental system and delay the loss of teeth.
Severe periodontitis: complaints bleeding and sore gums, bad breath, mobility and shifting teeth, difficulty chewing food.
The clinical picture of severe periodontitis is characterized by complaints of bleeding and sore gums, bad breath, mobility and shifting teeth, difficulty chewing food. As a rule violated the general condition of the patient. In-depth examination of the patient revealed endogenous intoxication, changes in the immune system, deviations from the internal organs associated with the pathogenesis of inflammatory-dystrophic process in the periodontium.
An objective examination of patients with chronic generalized severe periodontitis is determined by chronic inflammation of the gums with suppuration from the periodontal pockets, periodic exacerbations and abstsedirovaniem. There are abundant over-and subgingival deposits of tooth. A marked articulation of traumatic, pathological tooth mobility of 1-2 degree, their displacement.
Diagnostic criteria that allow diagnosis of "chronic severe generalized periodontitis" is:
- the presence of periodontal pockets deeper than 5 mm
- resorption (thinning and dissolution) of alveolar bone on radiographs by more than ½ the length of the root, possibly a complete absence of bone
In a study of patients with chronic generalized periodontitis severe diagnosis and plan of treatment will perform the following scope of diagnostic manipulation:
- sensing gingival pockets
- definition of tooth mobility
- display and quantitative assessment of the "dental" plaque
Patients with chronic generalized severe periodontitis held Schiller-Pisarev. As with other forms of periodontitis, chronic generalized severe periodontitis should produce X-ray examination (orthopantomography). Made a clinical analysis of blood and blood test for glucose.
The course of treatment for chronic generalized severe periodontitis consists of 8-12 visits and continues 20-40 days depending on the state of dental system and the chosen treatment strategy.
In the first visit with chronic generalized severe periodontitis, after a patient examination and diagnosis, schedule of oral rehabilitation plan and treatment of periodontal pathology, determine which teeth to be removed (usually at a depth of pocket more than 8 mm). Together with your dentist, orthopedist, orthopedic treatment plan (selective prishlifovyvanie, temporary splinting, immediate denture, making permanent dentures with splinting elements, etc.).
In the first 3-4 visits for chronic generalized periodontitis severe degree of tooth deposits removed, treated with periodontal pockets of antiseptic solutions, make application to the gums or injected into the pockets of pastes containing antiseptics, metronidazole, proteolytic enzymes.
In the case of chronic generalized severe periodontitis showed antibiotic therapy:
- metronidazole - for the diagram: the first day - 0,5 g, 2 times (at intervals of 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), metronidazole should be taken with or after food
- with persistent suppuration from the periodontal pockets, as well as the presence of concomitant somatic pathology prescribe antibiotics, lincomycin better - 0,5 g 4 times a day (every 6 hours) for 1-2 hours before eating during the day 07/05/1910
In parallel with drug therapy for chronic generalized severe periodontitis prescribe physiotherapy (on the course - 5-7 procedures): EUV, IGNL, galvanizing, hydrotherapy.
Patient with chronic generalized severe periodontitis taught the rules of oral hygiene, provide advice on cleaning your teeth, help to choose a toothbrush and toothpaste, are taught to use floss. At this stage, should be preferred toothpaste having anti-inflammatory and antimicrobial action. At home, the patient with chronic generalized periodontitis severe recommend doing mouthparts bath with 0.06% chlorhexidine, 0.2% sodium Frc, 1% hydrogen peroxide solution, decoction of chamomile, sage, calendula, 3-4 times a day for 20 minutes after a meal.
Control of oral hygiene should be maintained throughout the course of treatment of chronic generalized severe periodontitis.
After arresting inflammation of chronic generalized severe periodontitis do quilting operation (one stage of 8.6 teeth) with the correction of the edge of the gums and application of simulating the reparative osteogenesis. The main objective of chronic generalized periodontitis severe surgery - removal of periodontal pockets.
Upon completion of the above-described treatment of chronic generalized periodontitis severe conduct activities, normalizes microcirculation and homeostasis in periodontal tissues: physical therapy, injections of drugs in the transitional fold, the drugs the "general" effects. It is mandatory to orthopedic treatment, which is planned taking into account the functional status of periodontal tissues and dental system as a whole.
It should be recognized that, despite the use of the whole arsenal of means and methods of periodontal therapy, the treatment of severe periodontitis is rarely successful and long-term remission is not causes. Therefore, the efforts of dentists and health education work should be aimed primarily at detecting and treating early stages of inflammatory periodontal disease - chronic catarrhal gingivitis and mild periodontitis.
If you have any questions about the diagnosis or treatment of chronic periodontitis severe, you can specify them with our dentist or dentist on the phone: (903) 167–99–20
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