Inflammatory periodontal tissue diseases. Papilitis. Gingivitis. Etiology. Pathogenesis, clinical manifestations, diagnosis, differential diagnosis, treatment.

Inflammatory periodontal tissue diseases. Papilitis. Gingivitis.

Etiology. Pathogenesis, clinical manifestations, diagnosis,

differential diagnosis, treatment and prevention.

Papilit - inflammation of gingival papilla. Gingivitis - an inflammation of the gums, caused by unfavorable effect of local and general factors and proceeds without breach

of teeth-gingival connection. Form: catarrhal, hypertrophic, ulcerative.

Complexity of the process: light, medium, hard. Leakage: acute, chronic, exacerbation, remission.

Prevalence process: localized, generalized.

• Hormonal changes, such as those occurring during pregnancy, puberty, menopause make gums more sensitive

• Illnesses may affect the condition of your gums. This includes diseases such as cancer or HIV that interfere with the immune system.

• Medications can affect oral health, because some lessen the flow of saliva, which has a protective effect on teeth and gum

• Bad habits such as smoking

• Poor oral hygiene habits Family history of dental disease can be a contributing factor for the development of gingivitis.

Gingivitis is caused by dental plaque. 1. Gingivitis, which is associated exclusively with dental plaque:

a) no other local factors b) strengthening of local factors

2. Systematically reinforced gingivitis: a) endocrine factors

- Pubescent gingivitis - In connection with the menstrual cycle - In connection with pregnancy - Due to diabetes (Diabetes mellitus)

b) in connection with hematologic diseases 3. Gingivitis caused by medication: a) hypertrophy of the gums caused by medicines b) gingivitis caused by medicines c) oral contraceptives 4. Gingivitis is caused by insufficient and / or malnutrition: a) lack of ascorbic acid

B. gingivitis, is caused by dental plaque 1. Gingivitis is caused by specific bacterial infections a) infected with Neisseria gonorrhoeae b) infected with Treponema pallidum c) infected with Streptococcus spp. d) other 2. Gingivitis due to specific viral infections a) infected with herpes 1) Primary Gingivostomatitis herpetics 2) recurrent oral herpes 3) infection with Varicella-Zoster b) infected with other viruses 3. Gingivitis is caused by specific fungal infections a) infected with Candida spp. 1) gingival candidiasis? 2) linear gingival erythema

Gingivitis due to specific viral infections

What Are the Symptoms of Gum Disease?What Are the Symptoms of Gum Disease?

• Gum disease may progress painlessly, producing few obvious signs, even in the late stages of the disease. Although the symptoms of periodontal disease often are subtle, the condition is not entirely without warning signs. Certain symptoms may point to some form of the disease. The symptoms of gum disease include:

• Gums that bleed during and after tooth brushing

• Red, swollen, or tender gums

• Persistent bad breath or bad taste in the mouth

• Receding gums

• Formation of deep pockets between teeth and gums

• Loose or shifting teeth

• Changes in the way teeth fit together upon biting down or in the fit of partial dentures

GingivitisGingivitis

Inflammation of the gingiva characterized clinically by:

• erythema, • edema, • hyperplasia, • retractibility, • gingival pocket formation, • no bone loss

Acute necrotizing ulcerative gingivitis (acute Acute necrotizing ulcerative gingivitis (acute infection of the gingivae)infection of the gingivae)

Edematous interdental papillae Crateriform lesions, most commonly in the anterior

incisor and posterior molar regions Erythema Spontaneous gingival hemorrhage Necrosis with formation of a grayish pseudomembrane

over affected area Pain with rapid onset Halitosis Blunted gingivae between the teeth (normally cone-

shaped)

Symptoms of Chronic GingivitisSymptoms of Chronic Gingivitis

• Red, swollen gums• Gums may be tender to touch• Gums that bleed easily on brushing or flossing • Chronic bad breath • Sensitive teeth

PERIODONTAL TREATMENTS AND PERIODONTAL TREATMENTS AND PROCEDURESPROCEDURES

• Non-Surgical Treatments• Gum Graft Surgery• Laser Treatment• Regenerative Procedures• Dental Crown Lengthening• Dental Implants• Pocket Reduction Procedures• Plastic Surgery Procedures

NON-SURGICAL PERIODONTAL TREATMENTNON-SURGICAL PERIODONTAL TREATMENT

• SCALING AND ROOT PLANING

• Scaling and root planing is a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins.

• Scaling and root planing is often followed by adjunctive therapy such as local delivery antimicrobials and host modulation, as needed on a case-by-case basis.

• Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment.

• Causal treatment is to identify and reduce local input factors: plaque, tartar, caries cavities, faults and sealing prosthesis. That patient provides professional cleaning of teeth and teach proper oral care. Pathogenetic therapy is the medicinal effects of pathophysiological levels of inflammatory process taking into account the nature of treatment and intensity of inflammation. When choosing a medical mullion is necessary to consider the phase of inflammation and mechanism of action of the drug.

• The purpose of symptomatic treatment is the elimination of symptoms of periodontal disease (pain, cosmetic defect, breath), is always combined with pathogenic and etiotropic treatment.

Treatment of gingivitis

Application mullion having cytotoxic effect: befunhin, prospidyn, neotsyd, celandine, Vagothyl, maraslavin, 40-60% glucose solution, 10% calcium gluconate solution.Surface sklerosing-input solutions in gingival pocket.Deep sklerosing - input solutions directly to the gingival papilla.

1. Disinfection (0.1 -0.2% solution chlorheksidine)2. Anesthesia3. Marking point cut4. Incision5. Removing tissue6. Skeylinh and smoothing the root surface7. The formation of gingival edge8. Treatment of wounds9. Gingival surgical bandage.

Daily oral hygiene measures to prevent Daily oral hygiene measures to prevent periodontal disease include:periodontal disease include:

• Brushing teeth properly at least twice daily.• Flossing daily and using interdental brushes as well as

cleaning behind the last tooth, the third molar, in each quarter.

• An antiseptic mouthwash should be used daily after flossing to reduce bacterial growth.

• Chlorhexidine gluconate-based mouthwash in combination with careful oral hygiene may cure gingivitis, although they cannot reverse any attachment loss due to periodontitis.

• Regular dental examinations

Remember:Remember:• If left untreated, early gingivitis will develop into periodontitis or

severe gum disease, which will lead to:• Infection that can affect your overall health• Sore bleeding gums• Discomfort• Bone loss• Tooth loss• Changes affecting your appearance• Poor nutrition• Possible surgery• Costly treatments• Systemic complications

Thank you!