Prevention of Periodontal Disease
It is of absolute necessity, for periodontal health (functional ankylosis (bone adherence)), to undertake regular hygiene of the teeth and oral cavity, to have regular restoration of caries and damaged crowns and to replace any lost teeth with ceramic crowns, bridges or implants.
The basic prerequisite for the health of the bone adherence are full dental arches. A full dental arch implies the existence of all the teeth, at least up to the first molar (commonly known as the mandibular first molar or six-year molar) on both sides of the upper and lower jaw and their proper position and appearance.
To keep up your periodontal health, regular visits to your dentist and professional cleaning of dental plaque and calculus (scaling or debridement) are necessary two times a year!!
The periodontal is a bone adherence system by which the tooth is held in the bones of the jaw.
It consists of several supporting tissues such as the gum (gingiva), the bone and periodontal (connective tissue fibres) that essentially attach a tooth to the alveolar (periodontal ligament or PDL).
Periodontal disease (periodontitis)
Periodontal disease (periodontitis) is a disease of the functional ankylosis (bone adherence) and, alongside with caries, is the most widespread illness in the world. This is a bacterial inflammatory condition affecting the tissues surrounding the teeth, caused by bacteria from food which forms the plaque (biofilm).
Overview of periodontal disease development
It usually presents itself first with inflammation, redness of the gums and slight bleeding to the touch. This condition is referred to as gingivitis.
If the inflammation progresses deeper into periodontal structures and bone and periodontal ligaments, periodontal pockets are formed and the gums bleed and become red and swollen. There is bad breath and tooth mobility is present. In this case we are talking about periodontitis.
Another very common cause of periodontal disease is the chewing or mastication system dysfunction.
When there is a tooth or a group of teeth missing from the oral cavity (the teeth from the support zone - molars and premolars are especially important), the remaining teeth are overloaded and tilted. This then leads to the displacement of the lower jaw to an unnatural position and increases the activity of the chewing muscles.
All this results in the occurrence of excessive pressure on the remaining teeth, leading to degradation of the bone and dental ligament, the appearance of periodontal pockets and infection. All this sums up to a full form of Periodontal Disease.
Važno je istaknuti da razvijena parodontna bolest povećava rizik od kardiovaskularnih bolesti, artritisa i kroničnih bolesti bubrega!
Treatment of Periodontal Disease
There are different treatments for Periodontal Disease. The one we choose and apply depends on how far the periodontal disease has advanced. Currently, the prevalent trend in Periodontology is conservative, non-surgical therapy.
The therapy commonly commences with a thorough professional cleaning of dental plaque and calculus (scaling or debridement) and polishing the surface of the teeth. The goal of this procedure is to reduce bacterial flora, so we remove calculus deposits that are porous and retain bacterial biofilm in its structure.
Following this procedure, an antiseptic or a mouthwash fluid is introduced to the daily routine of oral hygiene.
The following option would be to introduce a targeted antibiotics therapy and deep periodontal pocket cleaning with polishing the root of the tooth, by which we remove the inflamed tissue around the teeth and the prospect of re-healing of periodontal tissue and gums adhering at the root of the tooth is created.
A portion of the lost bone and soft periodontal tissue can be restored using micro-surgical periodontal regenerative techniques.
Namely, these are the Guided Bone Regeneration (GBR) and Guided Tissue regeneration (GTR) techniques.
For regenerative material we use artificial bone substitutes and collagen membranes that are incorporated by micro-surgical interventions into the damaged periodontal and thus enable the process of healing and the formation of new periodontal tissue.
The goal of these procedures is to eliminate inflammation, reduce the depth of the periodontal pockets, and restore part of the lost bone tissue and periodontal ligament, thereby strengthening the teeth.
Functional Therapy in Periodontal Diseases
Alongside Classic Periodontal Therapy, it is necessary to eradicate the existing functional difficulties of the chewing system in the treatment of periodontal diseases.
We need to replace all lost teeth, restore damaged crowns and correct the unnatural position of the teeth and the lower jaw i.e. temporomandibular joint disorder (commonly known as bite correction). This procedure eliminates the increased activity of chewing muscles and prevents the formation of excessive pressure on teeth and re-establishes the normal function of the chewing system.
If there is a chewing dysfunction present, and there is excessive pressure on teeth, all other conservative and micro-surgical periodontal therapies will not be effective.
Along with regular dental check-ups 2 - 3 times a year and contemporary methods of treating periodontal diseases, the prognosis in the treatment of the most severe forms of periodontal disease is extremely favourable!