Periodontosis is a lesion of periodontal tissues of a dystrophic nature. Periodontosis develops gradually, over 10-15 years, against the background of trophic disorders of the central or peripheral parts of the nervous system, atherosclerotic changes in blood vessels, metabolic disorders with a sharp delay in the processes of protein synthesis, bone renewal, and construction, systemic osteoporosis.
Diagnosis and symptoms of periodontosis
The clinical picture of periodontal disease is characterized by retraction of the gums, exposure of the necks and roots of the teeth. There is no inflammation of the gums. The gum in periodontal disease has a pale, anemic color. Gingival and periodontal pockets are also absent in periodontal disease. The presence of dental deposits in periodontal disease is not characteristic. Even with 2-3 degrees of atrophy of the alveolar process in periodontal disease, the teeth are stable. There are lesions of teeth of non-carious origin: enamel erosion, wedge-shaped defects, hyperesthesia, etc.
The radiological picture of periodontal disease is characterized by a uniform decrease in the height of the interdental septa without violating the integrity of the cortical plate, alternating foci of osteosclerosis and osteoporosis in the deep parts of the alveolar process and the body of the jaw, as well as in other bones of the skeleton. With periodontal disease, there are concomitant diseases of the cardiovascular system (atherosclerosis, hypertension), the endocrine system, and metabolic disorders.
The examination of the patient with periodontal disease should be aimed at identifying the causes of the impaired trophic periodontal tissues, predicting the further course of the process, and the possibility of developing inflammatory complications. To make a diagnosis in this case, the following volume of diagnostic manipulations is performed:
- probing the gingival groove
- mobility of teeth
The Schiller-Pisarev test is negative for periodontal disease. To assess the severity of the processes of osteoporosis of the jaw bone, an X-ray examination (orthopantomography) is shown. To assess the severity of microcirculation disorders in periodontal disease, gum biomicroscopy or rheoparodontography is performed. Also, with periodontal disease, it is necessary to assess the severity of non-carious lesions. Patients with the periodontal disease require an in-depth examination by a general practitioner to identify and treat general somatic pathology.
Complex periodontosis treatment has its characteristics. When planning the treatment of such patients with periodontal disease, first of all, one should strive to slow down the degenerative processes in the periodontal tissues and prevent the development of inflammatory complications. Also, with periodontal disease, treatment of non-carious dental lesions should be planned. In parallel with periodontal disease, the patient's common diseases should be treated.
Complex therapy of periodontal disease includes monitoring of oral hygiene, timely indication, and removal of dental plaque. In the case of periodontal disease, the normalization of the occlusal relationship is mandatory: selective grinding of teeth, prosthetics with the use of splinting elements, etc.
Effective for periodontal disease is the local use of biogenic stimulants (extracts of aloe, vitreous, actovegin, vinylin, etc.), vitamins, agents that improve microcirculation (heparin, nicotinic acid).
In the complex therapy of periodontal disease, physiotherapeutic procedures (physiotherapy) should be widely used, which improve microcirculation, mineral and protein metabolism, and the nervous tropism of periodontal tissues:
- galvanization or electrophoresis with aloe extract, ascorbic acid, heparin, nicotinic acid, etc.
- diadynamic currents
- amplipulse therapy
- darsonvalization of the gums
- UHF in an oligothermic dose
- radiation of a helium-neon laser on the gum area
- all kinds of gum massage
- hyperbaric oxygenation
- local hypo-hyperthermia
- ultrasound therapy
Complex periodontosis treatment should also include the elimination of hyperesthesia, filling of erosions, and wedge-shaped defects.
Also, treatment of general diseases should be carried out: pathology of the cardiovascular system (atherosclerosis, hypertension), vegetative-vascular dystonia, metabolic disorders, etc.