Periodontal Treatment

Periodontitis - Summary

Periodontitis, or gum disease as it is often called, is a very common infection that causes loss of bone tissue and soft tissue that supports the teeth. If left untreated, the alveolar bone around the teeth is lost slowly and gradually.

Periodontitis means inflammation around the tooth. Microorganisms, such as bacteria, adhere to the tooth surface and within the pocket surrounding the tooth. When the immune system reacts and toxins are released, the inflammatory process begins. Untreated periodontitis often results in tooth loss. Research published in internationally recognized journals shows that periodontitis can increase the risk of stroke, heart attack and other diseases.

Bacterial plaque is a sticky, colorless and very thin structure that forms on the surface of the teeth and is the most common cause of periodontal disease. If plaque is not removed in time, it hardens and forms tartar.

Periodontitis can usually be prevented with good oral hygiene.

Brief Information About Periodontitis

• Periodontitis or gum disease affects the area around the teeth, including the alveolar bone and gums.

• It occurs with the response of the immune system following the accumulation of bacterial plaque around the teeth.

• Good oral hygiene is a step in the treatment and prevention of disease, but sometimes surgery is required.

• Smoking increases the risk of gum disease. It increases and may reduce the success of the treatment.

• There is evidence showing that there is a connection between gum disease and the general health condition of the body.

Treatment

 

The main purpose of periodontal treatment is to remove bacteria from the pockets around the teeth and prevent further losses that may occur in bone and other tissues.

 

Good Oral Hygiene

 

Even if the teeth and gums are healthy, good oral hygiene must be maintained daily. Otherwise, infection may easily occur.

Proper oral care should be done twice a day. This includes brushing your teeth and flossing once a day. If the distance between the teeth is sufficient, interdental brushes can be used instead of dental floss. Soft toothpicks can be preferred to keep the spaces between the teeth clean by keeping them in the bag or in the office during the day. Patients with arthritis or individuals with inadequate hand coordination may also be recommended to use electric toothbrushes. However, all these recommendations should be determined and followed by an expert, not by the individuals themselves. At this point, a periodontist (gum doctor) plays an important role. Depending on the oral and dental condition of the individual (bridge prosthesis, crown, removable prosthesis, implant-supported prosthesis, implant-supported hybrid prosthesis, etc.), the gum specialist makes the necessary recommendations to the individuals about what type of oral care products should be used and follows up with control appointments. Thus, in the presence of errors, recommendations can be changed and the appropriate form of care can be determined for the individual.

Periodontitis is a chronic, long-term, inflammatory disease and can reoccur even if treated as long as oral hygiene is not maintained.

 

Tooth Surface Cleaning and Root Surface Planing

 

In order to regain periodontal health (gum health), it is very important to first remove plaque and tartar. The gum specialist first removes the plaque, tartar and necrotic cementum tissue on and especially underneath the gums through tooth surface cleaning and root surface planing (curettage). It carries out these operations step by step with various ultrasonic devices and hand tools. Root surface planing is the process of removing rough, indented areas on the root surface and preparing an environment for the gum to attach to the root surface. Because uneven areas are ideal areas for food accumulation and bacteria to adhere, and this increases the risk of gum disease.

These procedures vary between 1 session and 6 sessions.

Tooth surface cleaning process is carried out in varying periods of time from person to person, depending on how much plaque and tartar are formed. Seeing a doctor twice a year is necessary to detect this accumulation.

 

Medication

Various medications can be used during gum treatment upon the recommendation of the gum specialist. However, these medications may be recommended not to treat, but to support the treatment, to prepare the ground for the treatment.

 

Antimicrobial Mouthwashes: These mouthwashes are generally used at the end of gum treatment or after gum surgery. They are prescribed to keep bacterial accumulation under control. It should be used in accordance with the doctor's recommendation.

 

Antiseptic Chips: These are gelatin chips containing chlorhexidine. By applying it into the periodontal pocket following cleaning and curettage procedures, chlorhexidine is released over time. They are used to prevent bacterial accumulation and help reduce periodontal pocket sizes.

 

Antibiotic-containing Gel: Contains doxycycline, an antibiotic. It is used to reduce the periodontal pocket and prevent bacterial accumulation. It is used after the cleaning and root planing procedures and is a slow-release drug application.

 

Oral Antibiotics: These are antibiotics in tablet or capsule form that are used orally. They are used in the short term and are used under the control of a gum specialist in the presence of acute or some local periodontal infection.

 

Advanced Periodontitis

 

Advanced periodontitis treatment is a condition that requires longer and extra different procedures. Since more tissue loss occurs in the bone and gums, various operations can be planned to maintain the existing position of the mouth or, if possible, to improve it. If good oral hygiene is not maintained and non-surgical periodontal treatment does not provide sufficient healing, surgical procedures are used. These surgical procedures can be as follows;

 

Flap Operation: The gum specialist may prefer the flap operation in cases where there is not sufficient healing with tooth surface cleaning and root surface flattening procedures. In the flap operation, the gums are opened and direct access to the root surfaces is provided. Thus, stone removal in areas that cannot be reached with ultrasonic tools and hand tools Roots are removed, root surfaces are smoothed and granulation tissues are cleaned. Following the procedure, the gums are re-stitched and the operation is completed. After this procedure, the gums are expected to heal and hold the teeth more tightly. In some cases, bone grafts and various agents that stimulate bone formation can be used during flap surgery. These applications are performed in areas where new bone formation is possible in areas with bone loss. Unfortunately, these procedures cannot work in every area with bone loss.

 

Bone and Gum Grafts: These procedures are performed for the purpose of bone regeneration and regaining lost gum tissue. The individual's own bone tissue, various natural bone tissues or synthetic bone tissues are applied to the lost bone area. For this procedure, it is important that the area where bone is lost provides the necessary conditions for new bone formation.

Guided Tissue Regeneration (GDR) is a set of surgical procedures that enable the formation of new bone and gum tissue by using membranes that act as barriers in areas where there is not enough bone and gum tissue.

In some soft tissue deficiencies, the gum specialist may find soft tissue graft appropriate. In these procedures, soft tissue or readily available synthetic material taken from a part of the mouth is transferred to the inadequate area.

The success of these procedures depends on factors such as the level of progression of the disease, the individual's success in maintaining oral hygiene, smoking, and systemic diseases.

 

_{Read: 0}