Periodontitis surgery: Difference between revisions
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If good [[oral hygiene]] is not yet already undertaken daily by the patient, then twice daily [[toothbrush|brushing]] with daily [[flossing]], [[mouthwash]]ing and use of an interdental brush needs to be started. Technique with these tools is very important. Aged persons may find that use of these interdental devices more necessary and easier, since the gaps between the teeth may become larger. | If good [[oral hygiene]] is not yet already undertaken daily by the patient, then twice daily [[toothbrush|brushing]] with daily [[flossing]], [[mouthwash]]ing and use of an interdental brush needs to be started. Technique with these tools is very important. Aged persons may find that use of these interdental devices more necessary and easier, since the gaps between the teeth may become larger. | ||
A dental hygienist or a [[periodontist]] can use professional scraping instruments, such as scalers and currettes to remove bacterial plaque and [[Calculus (dental)|calculus]](formerly referred to as tartar) around teeth and below the gum-line. There are devices that use a powerful ultra-sonic vibration and irrigation system to break up the bacterial plaque and calculus. Local anesthetic is commonly used to prevent discomfort in the patient during this process. | A dental hygienist or a [[periodontist]] can use professional scraping instruments, such as scalers and currettes to remove bacterial plaque and [[Calculus (dental)|calculus]] (formerly referred to as tartar) around teeth and below the gum-line. There are devices that use a powerful ultra-sonic vibration and irrigation system to break up the bacterial plaque and calculus. Local anesthetic is commonly used to prevent discomfort in the patient during this process. | ||
It is difficult to induce the body to repair bone that has been destroyed due to periodontitis. Much depends on exactly how much bone was lost and the architectural configuration of the remaining bone. Vertical defects are those instances of bone loss where the height of the bone remains somewhat constant except in the localized area where there is a steep, almost ''vertical'' drop. Horizontal defects are those instances of more generalized bone loss, resulting in anywhere from mild to severe loss of initial bone height. | It is difficult to induce the body to repair bone that has been destroyed due to periodontitis. Much depends on exactly how much bone was lost and the architectural configuration of the remaining bone. Vertical defects are those instances of bone loss where the height of the bone remains somewhat constant except in the localized area where there is a steep, almost ''vertical'' drop. Horizontal defects are those instances of more generalized bone loss, resulting in anywhere from mild to severe loss of initial bone height. | ||
Sometimes [[bone graft]]ing [[surgery]] may be tried, but this has mixed success. Bone grafts are more reliable in instances of vertical defects, where there might be a sufficient "hole" within which to place the added bone. Horizontal defects are rarely if ever able to be grafted properly, as there is nowhere to secure the bone. | Sometimes [[bone graft]]ing [[surgery]] may be tried, but this has mixed success. Bone grafts are more reliable in instances of vertical defects, where there might be a sufficient "hole" within which to place the added bone. Horizontal defects are rarely if ever able to be grafted properly, as there is nowhere to secure the bone. | ||
Dentists sometimes attempt to treat patients with periodontitis by placing tiny wafers dispensing | Dentists sometimes attempt to treat patients with periodontitis by placing tiny wafers dispensing [[antibiotic]]s underneath the gumline in affected areas. However, the general scientific consensus is that antibiotic treatment is of minimal value in treating bone loss due to periodontitis. It may help to recover about one millimeter of bone, but it is questionable if this is of significant therapeutic value. | ||
Alternatively, regular subgingival flushing with an anti-calculus composition can dissolve subgingival calculus (tartar) thus facilitating natural healing without surgery. This process is widely used for supragingival tartar via tartar-control toothpastes. Subgingival application of an anti-calculus composition requires a subgingival syringe or an oral irrigator. | Alternatively, regular subgingival flushing with an anti-calculus composition can dissolve subgingival calculus (tartar) thus facilitating natural healing without surgery. This process is widely used for supragingival tartar via tartar-control toothpastes. Subgingival application of an anti-calculus composition requires a subgingival syringe or an oral irrigator. |
Revision as of 19:01, 13 December 2012
Periodontitis Microchapters |
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Treatment |
Case Studies |
Periodontitis surgery On the Web |
American Roentgen Ray Society Images of Periodontitis surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Surgery
If good oral hygiene is not yet already undertaken daily by the patient, then twice daily brushing with daily flossing, mouthwashing and use of an interdental brush needs to be started. Technique with these tools is very important. Aged persons may find that use of these interdental devices more necessary and easier, since the gaps between the teeth may become larger.
A dental hygienist or a periodontist can use professional scraping instruments, such as scalers and currettes to remove bacterial plaque and calculus (formerly referred to as tartar) around teeth and below the gum-line. There are devices that use a powerful ultra-sonic vibration and irrigation system to break up the bacterial plaque and calculus. Local anesthetic is commonly used to prevent discomfort in the patient during this process.
It is difficult to induce the body to repair bone that has been destroyed due to periodontitis. Much depends on exactly how much bone was lost and the architectural configuration of the remaining bone. Vertical defects are those instances of bone loss where the height of the bone remains somewhat constant except in the localized area where there is a steep, almost vertical drop. Horizontal defects are those instances of more generalized bone loss, resulting in anywhere from mild to severe loss of initial bone height.
Sometimes bone grafting surgery may be tried, but this has mixed success. Bone grafts are more reliable in instances of vertical defects, where there might be a sufficient "hole" within which to place the added bone. Horizontal defects are rarely if ever able to be grafted properly, as there is nowhere to secure the bone.
Dentists sometimes attempt to treat patients with periodontitis by placing tiny wafers dispensing antibiotics underneath the gumline in affected areas. However, the general scientific consensus is that antibiotic treatment is of minimal value in treating bone loss due to periodontitis. It may help to recover about one millimeter of bone, but it is questionable if this is of significant therapeutic value.
Alternatively, regular subgingival flushing with an anti-calculus composition can dissolve subgingival calculus (tartar) thus facilitating natural healing without surgery. This process is widely used for supragingival tartar via tartar-control toothpastes. Subgingival application of an anti-calculus composition requires a subgingival syringe or an oral irrigator.
One such anti-calculus composition (Periogen) contains Sodium Tripolyphosphate, Tetrapotassium Pyrophosphate, sodium bicarbonate, Citric Acid and sodium fluoride.
In the composition, tetrapotassium pyrophosphate (TKPP) is a cleaning agent designed to clear away biofilms in order to facilitate chemical access to calculus. Sodium tripolyphosphate (STPP) acts as the anti-calculus agent, activated by sodium fluoride (0.04%), providing a chelating action on the structure of the calculus.
Sodium bicarbonate and citric acid are product activators which assist in dissolving the composition in water for periodontal delivery via a subgingival syringe or oral irrigator with a periodontal tip.