Classification of periodontitis, causes, diagnosis, treatment

It's good when the teeth are beautiful and healthy, and the smile is dazzling. But, unfortunately, many of us, in order to achieve all this, have to make considerable efforts and spend impressive amounts, because sick teeth are not only a cosmetic defect, it is also unbearable physical pain. Poison lives to us, except for all known caries, many other dental diseases, one of which is periodontitis. Its manifestation and methods of treatment depend on various causes. To somehow systematize the symptoms and develop a single strategy for the same type of cases, there is a classification of periodontitis. In the world of their invented a few, but in Russia basically use the system developed by Lukomsky IG. Let's try to understand clearly what it is.

Periodontitis

Before we tell what the classification of periodontitis is, let's look at the disease itself. People often confuse him with periodontitis or do not see a difference at all, because their names sound very similar. In fact, periodontitis is caused by problems with periodontium - a whole system of various tissues that strengthen our teeth in the jawbones (alveoli). Periodontium is one of the components of this large system. It is a tissue or ligaments that occupy the space between the plate of the alveoli and the cement of the root of the tooth. The thickness of periodontal is only 0.2 mm, but it keeps our teeth in the alveoli, evenly distributes the load between the alveolus and the tooth during chewing, performs sensory, protective and trophic functions. If for some reason periodontitis becomes inflamed, the disease begins apical periodontitis. It can lead to the most unfortunate results, up to the loss of the tooth, so it is very important to know the causes, its causing, and the characteristic symptoms.

The acute form of periodontitis, the first stage

In medicine, among very many diseases, forms that are associated with the causes of their origin (etiology) and the nature of the course (pathogenesis) are distinguished. This greatly facilitates the diagnosis and, as a result, helps to conduct effective treatment. Classification of periodontitis by pathogenesis identifies 2 forms - one acute, the other chronic.

Further acute periodontitis has two stages - serous (first) and purulent (second). In the first case, severe pain in the tooth from any touch, but the patient is able to clearly indicate where it hurts. This condition can last from a few days to two weeks. The doctor during the examination sees a patient in the tooth caries hole, but her probing of unpleasant sensations in the patient does not cause. An important symptom of acute periodontitis is inflammation around the problematic tooth mucous. Treatment consists in the elimination of infection in the root canal and its subsequent sealing. At the same time, it is necessary to remove the nerve to completely mechanically clean the channels, disinfect them, treat periodontium and qualitatively seal the tooth.

Acute form, second stage

This disease is also called acute purulent periodontitis. It can develop from serous periodontitis, if it was treated incorrectly or not to the end. Patients at the same time suffer pain very strong, pulsating, tearing, amplifying from any touch, spilled (the patient can not say exactly where it hurts).

In addition to these, there are other symptoms:

General malaise;

- headache;

- swelling of the gums, and sometimes cheeks;

- temperature;

- sometimes the mobility of the tooth.

On examination, it is often found that there is already a seal in the aching tooth or a crown is put on it. How to cure a tooth in this case? The main task of the doctor is to remove pus and infected contents from the root canal, to remove inflammation, which is done with the help of drug therapy and physiotherapy. The treatment ends with the filling. If the tooth decay is irreversible, it is torn out.

Chronic periodontitis fibrotic

In addition to acute, there is a chronic periodontitis, flowing without visible and perceived symptoms, which greatly complicates the diagnosis. There are such forms of it:

- Fibrous;

- granulomatous;

- granulating.

All these three forms are sometimes difficult to distinguish "by eye", so the diagnosis is carried out using X-rays, sometimes tomography. As a rule, chronic periodontitis manifests itself only during periods of exacerbation. In fibrotic form, the patient's teeth may have slightly different, darker tone than healthy teeth, there may also be some very insignificant sensitivity when chewing, difficult to explain discomfort. Treatment of this form of the disease difficulties, as a rule, does not cause. The first visit is to remove the fibrous part of the pulp, expand the canals, remove the nerve (under anesthesia), and temporarily seal Metapex. After 3-7 days, the channels are reopened, temporary materials are removed, a permanent seal is placed. If after the first session the tooth begins to ache, its cavity is opened and remains open for a couple of days, for which the patient is given medication.

Chronic periodontitis granulomatous

With a granulomatous form around the periodontal, a special cavity is formed - granuloma, which practically does not give any symptoms, only sometimes there are complaints of patients for some sensitivity of the diseased tooth. The shell of the granuloma is made up of fibers of fibrous tissue, which often overgrow in periodontium. Show this can X-ray. At a clinical examination, the doctor discovers a fallen out seal or a large carious hole under a standing seal or crown, but the probe does not cause pain in the patient. How to cure a tooth in this case and whether it is necessary to do it, if there are no complaints? To conduct treatment it is necessary to ensure that chronic periodontitis does not degenerate into acute and not to lose a tooth. Therapy is to eliminate the focus of infection. According to the indications, endodontic (classical) treatment is carried out with the cleaning from the dead tissue of the canals and their sealing, however, if this method proves to be ineffective, surgical intervention such as tooth resection, or rather, resection of the root of the problem root and removal of adjacent tissues, hemisection or separation Coronary-radicular.

Chronic periodontitis granulating

This form is characterized by frequent exacerbations and fistula formation in periodontal tissues. As a rule, patients complain of soreness in the tooth, which is strengthened by pressing on it (chewing). Often, the surrounding mucosal tissue site is inflamed, swollen, fistulas, of which granulosa can protrude, pus can be secreted. Probing channels and palpation of the gums may be painful. Therapy is similar to that which is carried out with granular periodontitis. The doctor performs endodontic treatment, and in case of his inability to resect the tooth (the tip of his root), complete excision or hemisection. It should be remembered that the causes of granulating periodontitis may be unsatisfactory dental care and penetration into the periodontitis of infection, and in addition, an incorrect bite, diabetes and other diseases. If the granulating periodontitis begins to be treated on time, the tooth can be preserved.

Classification of periodontitis on the etiology of the disease

Depending on the causes that caused periodontitis, the following forms are distinguished:

- infectious;

- traumatic;

- medicamentous.

In children, the etiology of periodontitis is often more infectious when biogenic amines or microorganisms and their toxins penetrate into periodontium from neglected carious cavities.

Infectious periodontitis

This form of the disease is caused by various microorganisms (streptococci, veylonelli, yeast-like fungi and others) that penetrate into the periodontal tissues from the root canal, the gingival pocket, surrounding tissues, and also with blood or lymph in diseases that do not touch teeth (typhoid, influenza, sepsis , Sinusitis). The main symptom of the disease is a sharp toothache. Often in the periapical region, exudate accumulates, externally expressed by swelling of the mucous membranes and cheeks, and a putrid smell is felt from the root canals. Treatment should be done only by specialists, for which you need to contact the dentistry center. There is an opportunity to get the whole complex of therapeutic services, including magneto- and laser therapy. Filling of the dental canals, from which the nerve is necessarily removed, is not made in the first, but often not in the second visit. The doctor is obliged to leave the tooth open until the exudate completely exits, perform disinfection of the canals and only then put the seal. If the therapy does not work, the patient's tooth is removed.

Traumatic periodontitis

The cause of this form of the disease are the most different mechanical injuries of the tooth, which can occur during the following actions:

- clicking nuts or seeds with teeth;

- snacking of thread, wire;

- fanatic cleansing of teeth with floss;

- blow, bruise;

- poorly performed prosthetics (protruding or not fitted under the tooth row of the crown);

- serving seal.

All this can cause inflammation in the upper (rarely marginal) parts of periodontal pain, bleeding gums and eventually exacerbation of periodontitis. The treatment is carried out according to the indications, but the main thing is that they perform the first visit to the sick dental clinic - they eliminate the source of the trauma (remove the protruding part of the filling, correct the crown).

Medication periodontitis

This form of the disease can occur through the fault of the doctor or the patient. It happens that during treatment, a medicine (for example, arsenic, piocin) is injected into the region of the periodontal disposition, which destroys the root canals. The result is a burn of tissues surrounding the tooth, or even their necrosis, and in children, medical periodontitis can lead to the destruction of the rudiment of the future permanent tooth. Therefore, it is vitally important to contact the dentistry center at the first signs of the disease.

Also, medical periodontitis can be caused by the use of toothpaste-containing pastes containing formalin, tricresol, and the like. Symptoms of the disease are:

- severe soreness of the problem tooth;

- aching pain of the entire jaw or its segment, where the problem tooth is located;

Mobility of the patient tooth.

Treatment consists in removing the cause of inflammation and the introduction of drugs into the tooth (antibiotics, sulfonamides), sealing. After the inflammation is eliminated, the tooth is sealed.

Prophylaxis and prognosis

As recent research by scientists has shown, it is vitally important for every person to treat all dental diseases, in particular periodontitis, without fail. Diagnosis should be carried out on the basis of a clinical examination of a problem tooth, an X-ray or panoramic image that shows the extent of the problem (suppuration, bone destruction, etc.). This is necessary to choose the right and effective methods of treatment, since untreated or not treated periodontitis leads to loss of teeth. Some do not attach any serious importance to this, considering only a cosmetic defect. But the scientists found out that the absence of only 5 teeth in the dentition approximately by 140% increases the risk of stroke and myocardial infarction. This was established experimentally. The study involved more than 8 thousand people of different ages. Why the absence of teeth worsens the work of the heart, until it was found out.

As a prophylaxis of periodontitis, doctors are advised to regularly check the condition of teeth, observe the rules of hygiene of teeth and oral cavity, avoid actions that injure tooth enamel and the whole tooth, and at the first signs of the disease do not engage in self-treatment, but go to dental clinics.