Periodontitis – Periodontal disease

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Does your gums bleed when brushing your teeth? Are you prone to bleeding from the gums at minimal provocation (a powerful bite, when using toothpicks, etc.)? Do you feel the presence of a foreign body, although you have recently cleaned your teeth? Do you feel dull, vague pain around the teeth? Did your teeth move past years, either in advance or in width, increasing the distance between your teeth? Do some tooth slaughter?

If at least on one of these questions answer is YES, you need to contact your dentist, as it is possible to have periodontal disease, also known colloquially as periodontitis.

Periodontal disease is a chronic inflammatory disease of dental apparatus, piece of tissue surrounding the tooth and gives it strength and stability. Periodontal disease leads to the destruction of deep periodontal tissue, which leads to the loss of teeth. This disease can occur at all ages, starting from early childhood (aggressive periodontitis), to appear in the medium and mature age (chronic periodontitis). Another form is far more common and is characterized by slow and gradual loss of periodontal tissue. Main etiological factors in the development of periodontal disease are microorganisms subgingival dental plaque and their products, and in addition to the presence of microorganisms to periodontal disease development is helping poor oral hygiene, smoking, inadequate prosthetics and fillings, as well as some diseases of the body.

First and the most common phase of the disease is an inflammation of the gums (gingivitis), which, if not treated in time, develops into periodontitis, goes around bone and later leads to displacement, loosening and finally loss of teeth. The main goal of periodontal therapy is to eliminate pathogenic microorganisms from the periodontal gap through removal of supragingival and subgingival deposits around the teeth and in the periodontal gap. Milder forms, such as inflammation of the gums can be completely neutralized by removing plaque and tartar, with educating patients about oral hygiene, so the inflammation does not appear again.

If periodontal disease has increased, and if periodontal gaps and bone loss are present, which can be observed by clinical examination and analysis of digital radiographs, but is often evident from severe inflammation of the gums and bleeding, it is necessary to reach for more advanced treatment techniques. At this stage, removal of sediments will not eliminate the large part of harmful microorganisms because they remain present in periodontal gaps and deeper periodontal areas inaccessible for hand-held dental instruments (eg. the tooth root or the bottom of the deep periodontal gap), and microorganisms can survive even in radicular cement and dentinal tubules. The use of antibiotics as a therapeutic procedure, either locally or systemically, in the treatment of chronic periodontal disease has a significant limitation because it can create undesirable side effects, and to make bacteria more resistant in the long run.

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Fast and daily improvement of laser technology over the past two decades has led to the introduction of lasers in everyday dental practice. Laser has found its application in periodontics, in the treatment of periodontal disease, periodontal surgery and therapy of periimplantitis, endodontics, then after tooth extraction, when cutting the top of the root canal and other treatments.

However, LASER IS NOT SUFFICIENT as a therapeutic agent for periodontal disease, but is a very useful auxiliary. The first problem is that the laser destroys all microorganisms, including those that are useful for the organism. Also, although the laser allows precise elimination of periodontal gaps, the use of lasers for cutting tissue, although it may seem like an ideal solution because there is no pain and blood, may also have counter-effects. In fact, there are often solid deposits in the depth of periodontal gaps, which are invisible to the naked eye, which absorb laser light, heat and produce a lot of warmth. Often, this heat causes damage and necrosis of tissue, which is the worst possible scenario for the patient.

For these reasons, at the dental practice Cvejanovic it is used exclusively special PHOTODYNAMIC LASER THERAPY, which excludes antibiotics and allows the least painful way to destroy all harmful microorganisms, viruses and fungi in periodontal gaps.

PDLT is an oxygen-dependent reaction which involves the combination of diode lasers of low wavelength (from 630 to 700 nm), and photoactive materia. The photoactive materia (photosensitizer) binds to the target cell and color them. Laser beams are activating photoactive materia and lead to death targeted cells. This therapy destroys target bacteria without adverse effects on surrounding periodontal tissues.

Treatment of periodontitis with photodynamic laser therapy begins with manual cleaning and with treatment of periodontal gaps under local anesthesia, removal of tartar and plaque. Then, blue color is applied which is then activated by a laser, whereby with the paint is possible to target many places otherwise inaccessible to instruments. The technique is extremely effective and leads to the complete elimination of harmful microorganisms or to their reduction for such an insignificant number of years that will not be able to cause the patient any harm. The technique is painless and very quick.

When the most serious forms of periodontal disease are in question, if there is a greater destruction of bone tissue, it is necessary in addition to laser therapy also a surgical intervention such as raising gums, laser treatment and placement of artificial bone and growth factors (Emdogain) in the bare place, which together allows the process of regeneration of bone and periodontal tissue.

While all of these techniques are successful and proven, parodontopatic processes can never be reversed. The disease can be stopped, but the bone and soft tissues of the patient will never again be as vital as it is the case with healthy, young people. Treatment can prevent periodontal disease lead to loss of teeth and swinging in the next 10 or even 20 years, which is very close to complete recovery, but that a positive outcome is possible only if the patient after treatment strictly adhere to medical advice and come for check-ups.