The following methods of radiographic examinations are used: Half-angle technique – apical (concerning the tip) region. Parallel right angle long tube (PRL) technique – creation of a tooth film status. Panoramic slice technique or orthopantomography (OPG). X-ray subtraction analysis Digitized X-ray Computed tomography (CT; sectional imaging method (X-ray images taken from different directions with computer-based … Periodontitis: Diagnostic Tests
A deficiency symptom may indicate that there is an insufficient supply of vital substances (micronutrients). The symptoms of acute and chronic periodontitis indicate a deficiency of vital substances (micronutrients) for: Vitamin A Vitamin C Within the framework of micronutrient medicine (vital substances), the following vital substances (macronutrients) are used for supportive therapy of acute and … Periodontitis: Micronutrient Therapy
Periodontal surgical therapy Second step of dental therapy – the goal is to restore and regenerate periodontal structures. Guided tissue regeneration (GTR) – procedures aimed at restoring periodontal (tooth-supporting) structures lost in intrabony defects (see below Guided tissue regeneration (GTR)). Gingivectomy (gum removal). Gingivoplasty (modeling of the gums) – is used to correct small areas … Periodontitis: Surgical Therapy
To prevent periodontitis, attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Malnutrition – low energy and low protein (low protein) diet. Micronutrient deficiency (vital substances) – see prevention with micronutrients. Consumption of stimulants Tobacco (smoking) Drug use Amphetamines (indirect sympathomimetic): ecstasy (3,4-methylenedioxy-N-methylamphetamine, MDMA), crystal meth (methamphetamine) or methylphenidate. Cannabis (hashish … Periodontitis: Prevention
The following symptoms and complaints may indicate periodontitis: Leading symptoms Sweetish bad breath Pain when brushing teeth Bleeding gums Gum recession Tooth loosening Tooth loss Pocketing Inflamed gum pockets Gingiva (gums) No longer tight and garlanded to the tooth. No pale pink color and stippling No homogeneous surface Hyperplasia Non-inflammatory gingival atrophy Acute, purulent processes … Periodontitis: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Periodontitis is a disease with multiple causes, which include plaque with its resident bacteria (Agregatibacter actinomycetemcomitans – facultatively anaerobic, common in aggressive periodontitis; Porphyromonas gingivalis – strictly anaerobic, in aggressive and advanced periodontitis; Prevotella intermedia – strictly anaerobic, in large numbers in aggressive periodontitis) count and the associated defense reactions as … Periodontitis: Causes
General measures Pay attention to oral hygiene! Nicotine restriction (refrain from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis. BMI ≥ 25 → participation … Periodontitis: Therapy
The following are the most important diseases or complications that may be contributed to by periodontitis: Respiratory system (J00-J99) Chronic obstructive pulmonary disease (COPD) – lung disease that mainly affects smokers. Endocrine, nutritional and metabolic diseases (E00-E90). Diabetes mellitus type 2 Patients with a depth of periodontal pockets ≥ 6 mm had a 56% increased … Periodontitis: Secondary Diseases
The first step in dental treatment is initial therapy, which includes intensifying oral hygiene and tartar and plaque removal. In addition, the affected person is encouraged to stop smoking. Initial therapy consists of: Oral hygiene education including training. Mechanical plaque control – this includes toothpaste and its components. Toothbrushing technique Interdental space hygiene (interdental hygiene) … Periodontitis: Initial Therapy
A comprehensive clinical examination is the basis for selecting further diagnostic steps Dental examination – including assessment of tooth, periodontal, and gum status according to the various bleeding and plaque indices, as well as measurement of pocket depth, furcation (location where the root divides), and recession (receding gums). Based on this examination, the dentist can … Periodontitis: Examination
Diagnosis is made on the basis of the clinical picture by history and dental examination. 2nd order laboratory parameters – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification. Pathogen detection – detection of periodontitis marker germs (Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Bacteriodes forsythus, Treponema denticola). CRP (C-reactive … Periodontitis: Lab Test
Therapy target Improvement of the findings Therapy recommendations Antibiotic therapy Local antibiotic therapy (e.g., CHX-chip, tetracycline fiber; initially more efficient than during follow-up): local complementary antibiotic therapy leads to a reduction in clinical pocket depths Systemic antibiotic therapy for aggressive forms of periodontitis, e.g., amoxicillin and metronidazole. If necessary, also antifungal therapy (antifungal therapy). If … Periodontitis: Drug Therapy
