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> > Parodontics and microsurgery

Parodontics and microsurgery

Periodontics

One in four people suffer from periodontal (gum) disease. Periodontitis is among the most common human diseases in the oral cavity.

Initial warning signs, such as gum bleeding, are often not taken seriously. As a result, the disease may progress unknown to the patient.

This may have an affect on the overall health, including blood vessels issues, heart complications (e.g. arteriosclerosis), cardiovascular and coronary heart diseases.

Numerous studies show a clear link between a heart disease associated with poor blood circulation and periodontitis. Patients who suffer from gum disease are three times more likely to have a myocardial infarction and have an increased risk of stroke.

Pregnant women may also have a higher risk of preterm births and miscarriages if they suffer from this condition.

aMMP-8 Test

Until recently, doctors could only diagnose periodontal disease by detecting the presence of destructive changes in the bone and gum tissue of patients, because the disease destroys the soft tissue and the bones that support the teeth. If the aMMP-8 enzyme is active, the bone tissue is reduced.

Today, a new method allows for an early diagnosis before such destructive processes become active. The test determines the activity of the aMMP-8 enzyme which serves as a sign of inflammation in the tissue.

The procedure lasts about 30 seconds and is absolutely painless. Gingival fluid is collected from four places by an absorbent blotter strip which is then examined in a special laboratory.

In our clinic, we are also able to perform the PSR periodontal index, which allows to identify patients with periodontal disease.

Reasons and consequences

What factors cause periodontal disease?

•    Unbalanced diet and vitamin deficiencies
•    Inadequate hygiene of the oral cavity
•    Smoking
•    Genetic susceptibility
•    Stress
•    Pregnancy
•    Other illnesses (e.g. diabetes).

 

The oral cavity prior to a treatment. The patient, aged 36, complained of bleeding gums, bad breath and some slight movement of teeth. She was diagnosed with acute generalised periodontitis
 
Periodontal survey shows a high level of dental plaque, bleeding and considerable periodontal pockets

_____________________________   _____________________________

 

 

The patient received a periodontal treatment and appropraite training in related hygiene techniques. A significant improvement can be noted. The patient receives regular maintenance treatments. The patient's current condition is stable

 
Periodontal survey shows a significant reduction in plaque, bleeding and depth of periodontal pockets

_____________________________   _____________________________



What consequences can periodontitis have?


1 Implications for the masticatory organ.

Initially, the gum tissue may decline, which entails aesthetic problems, exposed tooth necks that are prone to sensitivity and decay. This is followed by tooth mobility and loss.

2 Consequences for the whole body.

The latest research results indicate that patients suffering from periodontal disease are three times more likely to have a myocardial infarction or stroke. It has also been shown that pregnant women with severe periodontitis are eight time more likely to have a premature birth or miscarriage.

Treatment of periodontitis

The first procedural phase (initial therapy) aims to improve the oral hygiene. A hygienist removes tartar and plaque, polishes the surface of the infected tooth and gives a personal lesson which covers all necessary hygiene matters. There is usually a noticeable improvement if a patient follows recommendations for good hygience.

Bacteria testing

Sterile paper strips collect contents of periodontal pockets as samples that are then sent to a microbiology laboratory. A few days later we get a detailed analysis (antibiogram), the amount, type and strains of the bacteria that colonises periodontal pockets. This analysis allows for the development of a personalised treatment plan.

Deep Scaling

The next procedural step is the so-called "Deep Scaling" which means thorough cleaning of gingival periodontal pockets, located under the gum tissue, and root surfaces. This procedure is painless, occurs under local anesthesia and is carried out gently by ultrasonic instruments and hand curettes.

Laser

Our clinic uses a neodymium laser, which gives excellent results in the treatment of periodontitis. Precise laser beam energy is so rich that its sphere of influence on microorganisms destroys them immediately. This treatment is painless and not traumatic.

Surgical treatment of periodontitis

If, following the completion of the conservative treatment, deep periodontal pockets are still present, surgical treatment of periodontitis may be resorted to. The aim of this surgery is to smooth the root (open curettage) and to remove the deep periodontal pockets using resection or regenerative methods.

Modern GTR or GBR methods allow us not only to treat periodontitis, but also to restore lost bone tissue. Periodontal pockets are usually filled with patient's own bone tissue and closed by a membrane. Under the protection of the membrane, the bone is rebuilt and gets fully incorporated. Blemishes caused by the diminution of the gums and bare roots can be fixed with the help of soft tissue grafting.

Observation and supportive periodontal treatment

After the active phase of the treatment, we will invite you back for regular check-ups and professional teeth cleaning. Depending on the severity of periodontitis and individual oral hygiene, frequency of visits may be once every 2-6 months. This professional service along with a personalised program of home care is the real key to the restoration and maintenance of the oral microflora.

Self testing

Do I have symptoms of periodontal disease?

Because the disease is mostly chronic and painless, early symptoms are very common. The following questions can help you identify possible signs of periodontal disease:

1 Do your gums bleed when you brush your teeth, touch them or when you eat solid food?

2 When you touch your gums, are they swollen or sensitive?

3 Do you think the gum tissue has decreased?

4 Do your teeth appear longer?

5 Have you noticed pus between your teeth and gums?

6 Has the position of your teeth changed?

7 Do you find that the upper and lower teeth connect differently? Are there any gaps between your teeth?

8 Do you have any long-term problems with bad breath?

If you answered «Yes» to one or more questions, you should have a check up with your dentist. A more detailed study can show whether you require any treatment of periodontitis.

 

Microsurgery

Doctors of our clinic successfully apply different methods of restorative parodontic surgery. All treatment is carried out under magnification ensuring the least possible traumatisation of soft tissues.

Our doctors carry out the following operations:

  • open and closed parodontal recess curettage;
  • plasty of upper lip and oral vestibule frenulum;
  • restoration of lost bone tissue;
  • supportive parodontic therapy;
  • receding gum repair.

 

 

Gum resection in canine region

 

Connective tissue transplant installation

 

   

 

 

Suturing

 

Clinical pattern in 1 year

 

 

     

 

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