Periodontal diseases: gingivitis, periodontitis, periodontomas

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Types of periodontal diseases

Gingivitis is an inflammation of the gums caused by the adverse effects of local and general factors and proceeding without violating the integrity of the periodontal junction. The form of gingivitis is distinguished:

According to the severity of the clinical course of gingivitis, gingivitis of mild severity, moderate severity, and gingivitis of severe severity are distinguished. The course of gingivitis is divided into acute gingivitis, chronic gingivitis, and exacerbated gingivitis. In terms of prevalence, gingivitis is divided into localized gingivitis and generalized gingivitis.

Periodontitis is an inflammation of the periodontal tissues, characterized by progressive destruction of the periodontium and bone of the alveolar process of the jaw. By severity, periodontitis is divided into:

According to the clinical course, periodontitis is divided into acute periodontitis, chronic periodontitis, exacerbation of periodontitis, abscess with periodontitis, and remission of periodontitis. The prevalence of periodontitis is distinguished by generalized periodontitis.

Idiopathic diseases with progressive lysis of periodontal tissues (periodontolysis) - Papillon Lefebvre syndrome, neutropenia, agammaglobulinemia, uncompensated diabetes mellitus, and other diseases.

Periodontomas are tumors and tumor-like diseases (epulis, fibromatosis, etc.).


Causes and clinical picture of chronic inflammatory periodontal diseases

The primary cause of chronic inflammatory periodontal diseases is considered to be dental deposits — soft "dental" plaque and "dental" plaque. Dental deposits are formed due to insufficient oral hygiene, anatomical features of the dentoalveolar system, changes in the qualitative and quantitative composition of the microflora, and a decrease in the body's protective factors.

When the dynamic balance between the pathogenic effect of the "dental" plaque (microbial attack), the protective forces of the periodontium, and the body is disturbed, chronic inflammation develops in the gum tissues — chronic catarrhal gingivitis. This is a reversible condition, and if at this stage a high-quality, complete treatment is carried out, the process is stopped and recovery occurs. However, as a rule, at this stage, the patient does not seek help or the treatment is inadequate.

If you continue pathogenic exposure to "dental" plaque in the gingival tissue on the background of systemic disorders occur further pathological changes, and gingivitis turns into periodontitis: destroyed periodontal attachment, the periodontal pocket is formed, it grows the oral epithelium, there subgingival tooth accretion, which in turn contributes to the deepening of the pocket.

A long-term inflammatory process in the periodontal tissues leads to atrophy of the cellular elements of the gum, periodontium, and then the bone tissue of the alveoli, with their replacement by granulation tissue. Pathological changes in the periodontal tissues are accompanied by an impaired microcirculation and metabolic processes, the development of autoimmune reactions.

Thus, the main pathological components and links of chronic generalized periodontitis are:

  • supra- and subgingival dental deposits
  • the chronic inflammatory process in periodontal tissues
  • periodontal pocket
  • impaired tropism and microcirculation in periodontal tissues

These pathological manifestations form a kind of "vicious circle", therefore, for effective treatment of chronic generalized periodontitis, it is necessary to influence all these pathological links.

It is hardly possible to cure the developed periodontitis, however, stable remission is quite achievable, i.e. stopping or slowing down the pathological process (primarily atrophy of the alveolar process) at the level at which treatment was started.