Diagnosis and Treatment of Periodontal Disease dr shabeel pn 1
Transcription
Diagnosis and Treatment of Periodontal Disease dr shabeel pn 1
Diagnosis and Treatment of Periodontal Disease dr shabeel pn 1 STAGES OF GINGIVITIS AND PERIODONTAL DISEASE dr shabeel pn 2 Did you know? Gum disease is a common dental problem that may result in tooth loss. Gingivitis and Periodontitis are the most common types of adult gum disease. dr shabeel pn 3 HEALTHY GUMS dr shabeel pn 4 Healthy teeth and gums are maintained by daily plaque removal from all surfaces of the tooth (through tooth brushing and interdental cleaning) dr shabeel pn 5 Healthy gums are characterized by the following features: • pink or coral pink color, (normal variations in color depend on race and complexion) • firm, resilient tissues • 'orange-peel' texture (known as stippling) • shape that follows the contour of the teeth and forms a scalloped edge • no areas of redness, swelling or inflammation • no bleeding during daily plaque removal • no discomfort dr shabeel pn 6 dr shabeel pn 7 WHAT IS GINGIVITIS ? dr shabeel pn 8 WHAT IS GINGIVITIS ? • Gingivitis is inflammation of the gum tissue. • The gums are irritated and swollen due to a plaque or calculus (tartar) buildup along the gum line. • The gums may be sore, bleed easily and appear puffy, soft and swollen. dr shabeel pn 9 WHAT IS GINGIVITIS ? • No bone structure is lost around the teeth at this stage of gum disease. • Blood on the toothbrush or dental floss is one of the earliest and most common signs of gingivitis. • Your gums should never bleed while brushing or flossing. • The good news about gingivitis is that it is preventable and reversible through good brushing and flossing techniques (or other interdental tooth cleansing). • On the other hand, if oral hygiene habits are poor, dr shabeel pn gingivitis may progress to periodontitis. 10 Gingivitis: Notice the gums are red and swollen dr shabeel pn 11 WHAT IS PERIODONTAL DISEASE? • Periodontal disease is destruction of bone and the structures supporting the teeth. Unfortunately periodontitis is irreversible, but you can stop its progression through good oral hygiene and visiting your dental professional. dr shabeel pn 12 Eight Warning Signs of Periodontal Disease: • gums that bleed when you brush or floss your teeth • gums that are red, swollen or tender • gums that have pulled away from teeth • infection including purulence (pus) between the teeth and gums when the gums are pressed • permanent teeth that are loose or separating • any changes in the way your teeth fit together when you bite • any changes in the fit of your partial denture • bad breath • itchy sensation dr shabeel pn 13 EARLY AND MODERATE PERIODONTITIS: dr shabeel pn 14 EARLY AND MODERATE PERIODONTITIS: • Periodontitis occurs when the inflammation of the gums progresses into the deeper underlying structures and bone. • In the most common form of periodontitis, plaque (and sometimes calculus) is found below the gum line. • The gums may feel irritated, appear bright red, and bleed easily. dr shabeel pn 15 EARLY AND MODERATE PERIODONTITIS: • The ligaments holding the tooth in its socket break down and the gums pull away from the teeth, resulting in a periodontal pocket or space between the tooth and gum. • The periodontal pocket deepens and fills with more bacteria. Supportive ligaments and bone start to show damage. dr shabeel pn 16 EARLY AND MODERATE PERIODONTITIS: dr shabeel pn 17 dr shabeel pn 18 ADVANCED PERIODONTITIS: dr shabeel pn 19 ADVANCED PERIODONTITIS: • When periodontitis progresses to the advanced stage, the gums severely recede (pull away from the tooth ); pockets deepen and may be filled with pus. dr shabeel pn 20 Advanced Periodontitis • There may be swelling around the root and you may experience sensitivity to hot or cold or feel pain when brushing your teeth. This is due to the severely receding gums exposing the root surface. dr shabeel pn 21 Advanced Periodontitis • As bone loss increases, your teeth may lose so much support that they need to be removed to preserve the overall health of your mouth. dr shabeel pn 22 Advanced Periodontal Disease dr shabeel pn 23 dr shabeel pn 24 Treatment of Periodontal Disease • • • • • • Prevention Detection Assessment Scaling, debridement, root surface planing Periodontal surgery Bone grafting dr shabeel pn 25 Prevention • Regular homecare – Brush – Floss – Rinse – Aids to oral hygiene • Regular dental visits • Dietary consideration dr shabeel pn 26 dr shabeel pn 27 dr shabeel pn 28 Detection • Signs and Symptoms – Bleeding, inflamed gums – Halitosis – Discoloration/Stain – Long in the tooth – Mobility • Radiographic findings • Periodontal probing depths dr shabeel pn 29 Detection dr shabeel pn 30 dr shabeel pn 31 dr shabeel pn 32 dr shabeel pn 33 dr shabeel pn 34 Assessment • Radiographs • Periodontal Charting • Diagnosis –I – II – III – IV • Prognosis dr shabeel pn 35 Scaling, debridement, root surface planing dr shabeel pn 36 dr shabeel pn 37 Periodontal surgery dr shabeel pn 38 Deep pocket with calculus dr shabeel pn 39 Flap Reflected to Visualize Calculus dr shabeel pn 40 Gum sutured back to normal height, leaving a deepened space dr shabeel pn 41 Gum sutured down to bone to reduce residual space dr shabeel pn 42 Bone grafting dr shabeel pn 43 Flap reflected to allow bone implant dr shabeel pn 44 Flap resutured over bone implant dr shabeel pn 45 Flap reflected to insert membrane dr shabeel pn 46 Flap resutured over membrane dr shabeel pn 47 Mucogingival Surgery dr shabeel pn 48 Oral Irrigation dr shabeel pn 49 Pharmacological Intervention • Topical Antibiotics – Tetracycline – Doxycycline – Minocycline dr shabeel pn 50 Pharmacological Intervention • Periochip (cholorhexidine, and bacteriocidal drug) • Atridox (doxycycline antibiotic, a form of tetracycline) • Arestin (minocycline antibiotic, a form of tetracycline) dr shabeel pn 51 dr shabeel pn 52 Post Treatment Care • Regular periodontal maintainance – 3 month recare – Monitor probing depths – Follow up radiographs • Empahasis on Homecare dr shabeel pn 53