Periodontics

Caring for gums and tooth suspensory apparatus is a natural part of dentistry. We emphasize preventive measures but we also perform conservation treatment and, in a greater degree of periodontal damage, the necessary periodontal surgery. We also perform surgery with insertion of material that helps to replace patient’s own damaged bone.

Periodontitis (periodontal disease, periodontitis, paradentosis) is a disease of the tooth suspensory apparatus. In its bone alveolus, the tooth is suspended on a complex system of connective tissue fibers and may perform very discrete movements while chewing. An integral part of this system is a good gum seal around the tooth – the attachment of the edge of the gum to the tooth neck. If the system is constantly damaged, periodontitis develops. The whole process starts with a soft film sticking to the surface of the tooth. When not removed with cleaning, a reaction - hyperemia and inflammation of the gum - occurs. Untreated inflammation progresses along the tooth into its suspensory apparatus and, at last, it is transferred to the bone that is dissolving and the tooth begins to move excessively in the alveolus. This condition leads either to extraction or spontaneous release of the tooth.

 

Causes of periodontal disease (common term – paradentosis, periodontitis):

• poor hygiene or improper brushing technique
• plaque and tartar
• smoking
• quality and quantity of saliva
• systemic diseases
• bad habits - biting pencils, grinding teeth
• orthodontic anomalies, defects of occlusion and teeth position
• variations in the anatomical structure (attached mucosal folds, shallow vestibule)
• overhanging fillings and poor prosthetics
• genetic predisposition
• effects of stress
• medicines the patient is using
• mouth breathing
• self-harm (e.g., piercing)

 

Treatment options – this condition cannot be completely cured but may be significantly slowed. This may be achieved by proper techniques of cleaning teeth and interdental spaces, regular professional removal of plaque even from under the edge of the gum, thorough dental treatment - fillings, crowns, bridges, and removable dentures.

The consequences of untreated gum disease - gingivitis include retreat of the gum edge from the tooth neck exposing the neck. Teeth are sensitive to warm and cold and the aesthetic aspect cannot be ignored either, especially in the front sections of the dentition. In most cases, this situation may be solved by plastic surgery of the gum performed by a periodontologist at a specialized periodontal center. In large defects it is sometimes necessary to use so-called gingival prostheses, which is a removable substitute for the missing gum; its color is customized for the individual patient.

Bone defects caused by advanced periodontal disease (paradentosis, periodontitis) may be solved by a so-called augmentation. It is the application of artificial bone substance into the previously prepared and cleaned defect and its subsequent covering with a special membrane. This membrane prevents the penetration of unwanted cells into the substituted bone. The bone filler serves as a substrate for the patient’s own bone cells to fill the defect faster.

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