Periodontal disease
Student of Asia International University
There is review of the literature deals with an actual problem in dentistry which is modern methods of treatment of periodontal disease. Diagnosis and treatment of periodontal diseases are a modern problem of dentistry due to their high frequency and intensity of damage. Periodontal disease is the most complex nosological unit among periodontal diseases. The issue of the efficiency and having long-term results of treatment measures for this pathology remains important nowadays. Modern methods and means of treatment which are described here have a great importance for practical use in dental practice.
Key words: periodontal disease, PerioScan device, Vector, PRF-therapy.
В представленном обзоре литературы рассматривается актуальная проблема в стоматологии -современные методы лечения пародонтоза. Диагностика и лечение пародонтоза в связи с их высокой частотой и интенсивностью поражения являются современной проблемой стоматологии. Пародонтоз представляют собой наиболее сложную нозологическую единицу среди заболеваний пародонта. Вопрос об эффективности и долговременности результатов лечебных мероприятий данной патологии остается важным и на сегодняшний день. Описаны современные методы и средства лечения, знание которых имеет большое значение для их практического использования в стоматологической практике.
Ключевые слова: пародонтоз, аппарат PerioScan, Вектор, PRF-терапия.
INTRODUCTION:
Currently, one of the most pressing problems in dentistry is inflammatory periodontal diseases. Periodontitis is the most complex nosological entity among periodontal diseases. The development of periodontal diseases is unique to each patient, so treatment is primarily based on an individual approach to the patient. It should be comprehensive and include not only the elimination of gum disease symptoms, but also the normalization of periodontal tissues and the impact on the general condition of the patient.
LITERATURE REVIEW:
Of course, the means and methods that allow you to restore or improve the condition of the main sources of tissue metabolism are important. The following groups of drugs are prescribed for this:
■ antiseptics (Chlorhexidine 0.05% and 0.12%, Miramistin, etc.)
■ local injections of NSAIDs;
■ enzyme preparations (Trypsin, Chymotrypsin, etc.);
■ blood circulation improving agents (nicotinic, ascorbic acid, etc.);
■ vitamin preparations (vit. A, E, C, group B, etc.);
■ immunocorrective preparations (Imudon, Lizobact);
■ bacteriophages with mandatory introduction into the periodontal pocket under the supervision of a doctor, training in independent introduction into the pockets;
■ homeopathic preparations (usually mouthwashes Stomatofit, Chlorophyllin, etc.) [1-4]. Symptomatic therapy is aimed at eliminating and reducing individual symptoms of the disease that cause suffering to the patient:
painkillers (Nimesil, Nurofen, Nise, Ketorol, etc.);
■ preparations for relieving hypersensitivity of the necks and roots of the teeth (coating teeth with fluoride-containing preparations in 1 or several doses depending on the situation). Elimination of the bacterial component and occlusal loads:
■ removal of microbial plaque and prevention of its formation on the surface of teeth;
■ removal of mineralized deposits;
■ high-quality sanitation of carious defects with restoration of interdental contacts;
■ alignment of occlusal surfaces of teeth by selective grinding;
■ splinting of mobile teeth that are not capable of bearing the chewing load [5-9]. Alternative therapy (for example, homeopathy) is used in the treatment of periodontal diseases in cases where the use of traditional treatment methods is impossible due to allergies or severe concomitant diseases, as well as in the absence of sensitivity of microflora to drugs commonly used in periodontology [10,11].
Methods of administering medications in periodontology:
■ rinsing is one of the main methods of administering medications both for periodontal diseases and for diseases of the mucous membrane;
■ mouth baths;
■ applications to the pathological dental pocket Hyaludent No. 1,2,3, as well as to the mucous membrane adhesive paste Solcoseryl, adhesive ointment Asepta;
■ injections (homeopathic preparations Traumeel-S, Mucosa compositum submucosal; in severe cases, antimicrobial therapy is prescribed intramuscularly);
■ dressings (self-adhesive films “Diplen – Denta” with various medicinal inclusions can be used as an independent treatment, and used as a periodontal dressing to retain compositions of antiseptics, antibiotics and anti-inflammatory drugs introduced into the pocket, on the marginal periodontal or mucous element in a higher concentration than in films, the area of intervention during the treatment of periodontitis is usually covered with a periodontal dressing – Periodontal Pak, Soy Pak, Woco Pak, Sept Pak.);
■ physical methods (electrophoresis, phonophoresis, magnetophoresis);
■ traditional methods of administration – per os and intramuscularly (usually anti-inflammatory and antimicrobial drugs for severe and moderate degrees of the disease);
■ subgingival administration involves the use of “delivery” systems that provide a high concentration of drugs directly at the site of injury. These include: tetracycline and chlorhexidine threads, doxycycline polymers, Periochips, etc. [12-18].
Along with classical methods of treating periodontitis, non-surgical treatment is carried out using the Perioscan device [19].
PerioScan is an ultrasonic device that allows not only to remove deposits, but also to recognize them thanks to a unique feedback system.
PerioScan is an intelligent, highly sensitive, new-generation ultrasonic device in which the examination of the tooth surface is based on the analysis of ultrasound characteristics. When the instrument comes into contact with enamel, crown or filling material during the examination of the patient, the device not only analyzes the condition of the surface structures, but also detects the dental tissue itself or artificial tooth material. As a result of this analysis, PerioScan provides an objective assessment of the condition of the tooth surface, shows the presence of dental deposits and (if necessary) signals the need for treatment. Therefore, the uniqueness of the device is that it not only removes dental plaque, but also pre-recognizes it [20,21].
DISCUSSION:
Convenient color indication (green – clean surface, blue – presence of dental plaque) will allow patients to observe the process of professional oral hygiene.
The Vector device is used for ultrasonic cleaning of periodontal tissues (with periodontitis or periodontosis).
Gum retraction methods are carried out only on a healthy field. These include mechanical (displacement with threads), surgical (with the help of preparation) and chemical (introduction of special drugs) methods. The retraction procedure is the pulling of the gum to improve the quality of impressions during prosthetics [22].
Modern dentistry offers both traditional and new therapeutic methods for the treatment of oral diseases. PRF therapy (also known in various sources as plasma therapy, “plasmolifting” [23]) is successfully used for the treatment and prevention of periodontal phenomena. It, as a natural method of combating various diseases, appeared in 2004, when the positive effect of plasma on various organ systems was discovered.
This procedure, which has no analogues, is based on PRF therapy technology.
This technique, called Plasmodent in dentistry, is successfully used in our clinic for the treatment of atrophic and inflammatory diseases of the oral cavity, as well as for optimizing and accelerating the regeneration of bone tissue during implantation and bone grafting.
The goal of plasma lifting is to achieve not just the removal of the inflammatory process of periodontitis, but to start the process of natural restoration of the color, shape and structure of the gums, and prevent the loss of bone tissue.
Plasmolifting is performed in the form of an injection of plasma obtained from the patient’s blood – autoplasma, into the problem area.
Plasma is injected locally into the damaged gum tissue, the site of the implant installation or bone grafting during sinus lifting, extraction, in the area of osteosynthesis or installed membrane in the soft tissues of the oral cavity and maxillofacial region in acute and chronic infectious and inflammatory processes [24].
RESULTS:
Thrombocyte plasma introduced into tissues, due to the growth factors it contains, causes capillary growth, normalizes hemodynamics, tissue respiration and metabolism. At the same time, the process of strengthening bone tissue, forming a collagen matrix and bone with the participation of bone morphogenetic collagen proteins, and activating local immunity occurs [25].
The components contained in plasma are absolutely natural for humans, they are not mutagens and cannot cause cancer, tumors and other negative reactions.
In dental practice, plasma therapy is considered completely safe, since plasma is isolated from the patient’s blood. No chemical additives are added to it. Therefore, the risk of developing allergic reactions is practically excluded. In addition, this is done absolutely painlessly: no anesthesia is required [26,27].
Plasma therapy can be used in combination with various therapeutic methods and drugs, including antibacterial, anti-inflammatory and immunomodulatory drugs [28]. To obtain plasma, a small amount of blood (approximately 10 ml) is taken from the patient, the blood is processed in a centrifuge under special conditions to separate the plasma itself from other formed elements of the blood. The resulting platelet-rich plasma concentrate contains specific proteins, the so-called growth factors, which participate in the regeneration of all tissues of the body, attracting its own stem cells to the area of damage and stimulating their division [29-35].
CONCLUSION:
Thus, the availability and knowledge of modern technologies, methods and means of treating periodontal diseases is important for their practical use in dental practice.
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