Periodontitis is the most dangerous complication of caries lesion.
In case of chronic periodontitis the inflammation is developed very slowly, sometimes without pain, and as a rule is not aggravated. In case of chronic periodontitis everything is expressed weaker, but may be accompanied by swell, reddening of gingiva, high temperature which already is typical to acute periodontitis. The chronic periodontitis is especially dangerous because the microbes breeding freely around the tooth extract toxics that intoxicate the human organism for long years becoming reason of heart, kidney, articulation diseases.
The causes of the origin of periodontitis
The main cause of periodontitis is infection that may penetrate to periodontal tissue through caries cavity, to root canal through gingival pockets, or with blood (hematogenic way).
Another reason for periodontitis may be the trauma or provocative effect of medicine. In this case the periodontitis is called traumatic or toxic.
Because of provocative effects of infections, toxics, medical preparations, or traumas inflammation is developed in the periodontium. It causes tissue swelling and as the flow of inflamed liquid becomes difficult in periodontium, the lesion is accompanied by acute pain.
The pain gradually strengthens. As a result the liquid finds a way either through the root canal or gingival pocket or mandibular periosteum and the acute development calms down. In some cases the inflammation may not acquire acute development and the lesion becomes chronic.
Periodontitis is a caries complication, when the infection passes from carious cavity to pulp from where it penetrates to periodontium and generates the disease. The tooth starts to move and aches even in case of a light touch. The body temperature rises. The periodontitis may last without pain; in this case resorption of the bone around the root takes place, granuloma which later may change into cyst-granuloma and cyst, which demand more serious treatment in order not only for keeping tooth but also for preventing intoxication of the organism. If the patient has more than one tooth infected with periodontitis then there is great possibility of diseases of kidneys, heart, joints.
The periodontitis may also be developed because of the low quality treatment of root canals. Following teeth are often sentenced to be extracted if the roots are not possible to treat. The canals are elaborated with special needles, antiseptic materials, ultrasound. Often several visits to clinic are needed in this case. Usually the ‘salvation’ of tooth is important for later prosthetics.
Periodontitis, as it has already been mentioned, is expressed by sharp pain around the tooth that strengthens even from a light touch. The lip, cheek, gingiva swell and there is fetid odor in the mouth, sometimes there is fistula on the gingiva.
Periodontitis may be infection or not infection.
The main roles in the development process of periodontitis acquire the microorganisms and the poison extracted by them. They penetrate to periodontium through root canal, periodontal pocket or in hematogenic way generating dangerous inflammation.
The microorganisms and the extracted poison
It is developed because of the following reasones:
а. Immediately, acute (knock, trauma while filling the canals, trauma of periodontium while treating pulpitis, cracking nuts with teeth or while biting a bone)
b. chronic micro-trauma (biting off pipe, brass instruments, pens, pencils, inlay put highly and so on)
2. the effect of medicine
When a strong effecting medicine is reached to periodontium while enlargement of the root canals, disinfecting them, etc.
The treatment of periodontitis is multi-stage. The methods are chosen according to a concrete case. Special gels are used that help the vesicle, granulоma resorbtion and restoration of bone tissue.
Sulfanilamides preparations are prescribed that have antibiotic effect, as well as allergic preparations to calm down the pain. But these methods are not comparable for the main treatment is done by the dentist.
During the first visit the following steps are done:
1. diagnostic X-ray imaging
3. caries treatment
4. extraction of necrotic pulp from the crown, root canals cleaning with antiseptic medicine.
5. measurement of the length of root canales
6. mechanical enlargement of those canals (simultaneously performing ablution of canals with antiseptic medicine)
7. injection of antiseptic medicine in the root canal until the next visit.
8. temporary stopping
During the next visit:
1. extraction of temporary inlay
2. canal cleaning with antiseptics
3. quality stopping with gutta-percha.
In some cases of acute or chronic periodontitis when the therapeutic methods of treatment are insufficient, tooth extraction is necessary to do. The extraction is indicated to prevent the spreading of inflammatory lesion in the bone and soft tissues. Sometimes the quick extraction needs only several hours. Sometimes in case of chronic periodontitis the tooth is so decayed that it becomes impossible to restore its anatomic form, or use the root as a basis of pin.
Meanwhile the tooth extraction is indicated in that case when there is a complicated periodontitis and in order the inflammatory liquid would come out a necessity to snick the periodontium in the upper part of dental root in between the gingiva. This interference is indicated in case of swell of the soft tissue.
The combination of the surgical interference and medical treatment allows eliminating quickly the inflammatory lesion.