Chronic periodontitis: causes and identification
Generally speaking, we all know that periodontitis can be defined as the inflammation of periodontal protection and inclusion, with the loss of alveolar bone, periodontal ligament and cementum. Clinically, there was bleeding and gingival probing depth equal to or greater than 4 mm. It can be seen increased tooth mobility, suppuration and gingival recession. Although this concept is quite broad, it is necessary to understand that there are several types of periodontal diseases. Among these, there is the chronic periodontitis, which is quite common incidence in our offices.
The primary etiologic agent of chronic periodontitis is a bacterial infection. However, clinical signs are a result both of the microbiota of aggression as the host response to this aggression. Yet, it seems to be consensus that the amount of a chronic periodontitis plate is usually intensive with tissue destruction not so great, which characterizes certain host resistance and bacterial specificity.
Histological findings include migration of the junctional apical epithelium to the cementoenamel junction, the presence of periodontal pockets, loss of collagen fibers underlying the epithelium of the bag, increasing the number of polymorphonuclear leukocytes in the pocket epithelium and junctional epithelium, infiltration of inflammatory cells, lymphocytes and macrophages.
Chronic periodontitis is characterized by slow and / or moderate loss of alveolar bone, predominantly in the horizontal direction. The most important etiological factors include local factors card holders, as calculated above and subgingival. However, some systemic factors and habits can increase the severity of the disease, such as HIV, diabetes and smoking. Although chronic periodontal disease is the most common form of periodontitis in adults, may also occur in children, can affect the first and second teeth.
Chronic periodontitis can be classified according to the extent and severity. The extension is based on the number of sites involved, and can be divided into generalized and localized. Located refers to periodontitis which affects up to 30% of the sites and generally more than 30%. The severity is related to the clinical attachment loss. It is divided into light (loss of 1-2 mm), moderate (3-4 mm loss) to severe (loss equal to or greater than 5 mm). Figures 1 to 3 show a case of chronic periodontitis.
Treatment of this type of periodontal disease involves the removal and control of biofilm and elimination of factors that increase the buildup of plaque, such as dentures and ill-fitting restorations that make it difficult to care for the patients. Regular maintenance of these patients avoid relapse and improves the prognosis of teeth involved. Briefly, we note that non-surgical therapy (scaling, smoothing and prophylaxis) is the key success to treat a chronic periodontitis.
Although it seems to be a very academic topic, the identification of this type of periodontal disease in our offices can avoid losing teeth prematurely. In addition, the correct treatment of chronic periodontitis will surely prevent future peri-implant problems in patients that may receive dental implants, given that one of the risk factors for developing a periimplantitis is the previous periodontitis.
Source: INPN, by Marco Bianchini
Image takes from: http://www.inpn.com.br/Materia/SextaBianchini/132223