Facultatea de Medicina Dentara Student:Aluculesei Andrei Ciprian Grupa 30,seria B,anul 3

Gum diseases

Gum diseases

Periodontium is a complex tissue that is to fix your teeth in jaws. Tissue components are: gum, hardened root, alveolar bone and ligaments alveolo-dental. Content periodontal space: Lateral surface of the tooth root surface covered with cement and alveolar cavity, bordering a small space, the hourglass-shaped vertical section called alveolo-dental or periodontal space. Periodontal space is occupied by alveolo-dental ligament sheaves, forming a true ligament called desmodontiu. Round or oval in the spaces between fibers ligament is a loose connective tissue, connective tissue containing numerous cells, epithelial cell debris and network rich blood, lymph and nerves, ligaments make the link between tooth root and alveolar bone, fiber network also connects tooth and gum synergists marginal neighborhood. Alveolodentar ligament has the following functions: -Turn in occlusal forces pressure on alveolar bone traction and disperse them throughout the internal alveolar compacted surface. -Teeth in place securely. -Keep tightly applied to the gum tissue around the tooth package. -Occlusal pressure shock-cushioning. -Protect vessels and nerves, by crushing their periodontal alveolar walls, with its suspension systems and damping, while acting as a protective soft coatings. -In case of general conditions or in different functional deviations in alveolar bone and root hardened-atrophic degenerative processes occur, these aspects must be taken into account in restorative therapy. -Occlusal trauma -Atrophy of periodontal manifestations of periodontal disease, general

In 1945, the American Academy of Periodontology, periodontal diseases classified marginal in: inflammation including: -Gingivitis -Primary periodontitis

- Side-periodontitis -Dystrophies caused by occlusal trauma-Atrophy through lack of occlusal contact -Gingivoza and periodontitis In 1996, Fermin Carranza Jr. describes these forms of periodontal disease marginal: 1 - Slowly progressive periodontitis, also known as chronic periodontitis in adults. 2- Rapid progressive adult periodontitis 3- Rapidly progressive Periodontitis Early has two forms: a)Prepubertal periodontitis b)Juvenile Periodontitis 4- Necrotic ulcerative periodontitis 5- Refractory periodontitis - occlusal trauma - periodontal atrophy Based on these criteria, the Department of Periodontology Bucharest, marginal periodontal disease classification: 1. Chronic marginal periodontitis superficial -The phenomenon hyperplasia -The fund early involution 2. Chronic marginal periodontitis deep: A) in children: a) early prepubertal b) juvenile periodontitis B) in adults: a) chronic marginal periodontitis deep: localized, extended, generalized b) Rapidly progressive periodontitis aggressive marginal c) deep marginal periodontitis rebellious to treatment d) dystrophy periodontitis: chronic periodontitis marginal mixed. Marginal inflammatory periodontal disease

Gingivitis: are inflammatory processes,located in gum mucosa, without changes in the lining of the junction and no alveoliza. In all forms of gum damage, there is a degree of inflammation, damage through an inflammatory process starts with installing amarginal gingivitis, especially in the interdental papilla. Marginal,gum swells, enlargement occurs in gum-dental space, where organic matter accumulates, bacteria, tartar, which maintain inflammation.

Refractory periodontitis Subsequently, the beam is necroses and are replaced by granulation tissue. Granulation tissue gradually occupy the whole space periodontal infiltrate adhere cement and alveolar bone. Granulation tissue is composed of residual inflammatory cells, histiocite, macrophages, fibroblasts, fibrocim, capillary neoformation. Maturation of granulation tissue fibroscleroase the formation of a structure, with retraction of the gum, tooth root finding has consequences. Chronic marginal periodontitis superficial It is a chronic inflammatory process limited to the level of cover periodontium characterized by: -supraalveolare ligament-insertion-present epithelial over-ligament -presence of granulation tissue in ulcer epithelium gingival groove. -Epithelium present at the intermediate layer with vacuolation and dystrophic lesions baloon aspect, but is compensate the basal layer, indicating reversibility of the process and allow treatment by chronic irritation eliminated factors. Inset shows a tendency to epithelial proliferation and a beginning of separation (but above the ligaments supraalveolar). In the lining of the gingival groove is an ulcer, which is replacement with granulation tissue. In the presence of a chorionic chronic lymphocytic inflammatory infiltrate, plasmocitar, fibroblasts, diffuse or nodular histocitar endarterita and injuries, reducing vascular lumen. Ligaments are dissected supraalveolare a diffuse inflammatory infiltrate, with the appearance of oedematous spaces between fibers. Chronic marginal periodontitis profound Begins insidiously and is installed without disturbing simtomatologie subjective, so that patients not present at the consultation, except in advanced stages. Subjective signs -Feeling of tension-gingival -Itching gingilal -Gingival Mouth-cacosmia

-Physiognomic-accusations An objective symptoms: -Gum discoloration -Gingival epithelium surface-modification -Change the shape and volume gum (papillitis, edema, fibrosis) -Gingival groove depth changes -The change of the position gumline, from tooth anatomy package -Presence of irritative factors (bacterial plaque, tartar, debris) -Presence of gum abscesses, fistulas, scars. Juvenile periodontitis It is a destructive lesion affecting children`s desmodontion, adolescents and young people between 12 and 30 years, with rapid evolution to edentulous. Incisors and first molars are interested in localized form, or teeth, in generalized form. Ligaments swells, and finally the fragment necroses. Necrosis ligaments cause a repair process, by the appearance geranulatie tissue. After expulsion tooth regenerate alveolar bone, which proves that osteolysis is a process secuntar. The cause of this damage is still unclear. Recent studies converge towards a determinism bacterial plaque to disruption of chimiotactismului neutrophils. These bacteria would probuce a substance, leucotoxina that destroys polymorphonuclear neutrophils. Marginal degenerative gum disease Are periodontal disease with dystrophic and degenerative changes without inflammatory changes, followed by a retraction limited or generalized marginal periodontium without training bags. The process begins with the structures desmodontale degenerative lesions, with subsequent involvement atrofiae progressive and alveolar bone. Periodontitis and meets young age, with generalized atrophic changes of the marginal periodontium in the absence of occlusal dysfunction. Has a purely endogenous and cause damage atrofodistrofice manifest as a particular reaction to the action of a periodontal applications. In periodontitis describe two forms: *Marginal periodontitis: Introduce reducing the volume of marginal periodontium through horizontal alveolar bone atrophy and generalized gingival retraction. The presence of an inflammatory process causes periodontal distrofoatrofic superadd the framing of the lesions to be mixed periodontitis.

*Periodontitis desmodontal: Introduce the primitive degenerative phenomena desmodontale ligaments. Is found to reduce the number of beams, which lose their normal orientation and are distributed diffusely. Lama last alveolar looks embattled. This form of periodontitis may be a local response in general diseases. Gum disease (mixed and mixed inflammatory) Lesion that can occur is the association provided by the onset of disease or a result of overlapping lesion in relapse, representing in this case lesions of different ages, sequelae possibly with evolutionary processes. Cement is demineralized initially delayed the necroses.Alveolar bone is resorbed, due to granulation tissue. The treatment must be: -Early, the chances of success are best. -Supported by procedures designed to lead to process improvement, for healing. -Simple removal of local factors is not enough, -Supported and complemented by suppressing the soft wall of the trench microulcerations gum and biostimulation procedures. -Complex procedures-order multiple-drug (antibiotic and antiiflamator) -surgical -restoration of teeth and arch morphology -occlusion-balancing -The more diversified, with CT disease presents an advanced degree in evolution - Individual, is the main condition of success, to improve, for healing -Treatment of periodontal disease must take into account the general condition of the patient, treatment can be both local and general.

-Bibliography-

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