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Inflammatory periodontal tissue
diseases. Papilitis. Gingivitis. Etiology.
Pathogenesis, clinical manifestations,
diagnosis, differential diagnosis,
treatment and prevention.
Papilit - inflammation of gingival papilla.
Gingivitis - an inflammation of the gums, caused by unfavorable
effect of local and general factors and proceeds without breach
of teeth-gingival connection.
Form: catarrhal, hypertrophic, ulcerative.
Complexity of the process: light, medium, hard.
Leakage: acute, chronic, exacerbation, remission.
Prevalence process: localized, generalized.
• Hormonal changes, such as those occurring during pregnancy,
puberty, menopause make gums more sensitive
• Illnesses may affect the condition of your gums. This includes
diseases such as cancer or HIV that interfere with the immune
system.
• Medications can affect oral health, because some lessen the flow
of saliva, which has a protective effect on teeth and gum
• Bad habits such as smoking
• Poor oral hygiene habits Family history of dental disease can be a
contributing factor for the development of gingivitis.
Gingivitis is caused by dental plaque.
1. Gingivitis, which is associated exclusively with dental plaque:
a) no other local factors
b) strengthening of local factors
2. Systematically reinforced gingivitis:
a) endocrine factors
- Pubescent gingivitis
- In connection with the menstrual cycle
- In connection with pregnancy
- Due to diabetes (Diabetes mellitus)
b) in connection with hematologic diseases
3. Gingivitis caused by medication:
a) hypertrophy of the gums caused by medicines
b) gingivitis caused by medicines
c) oral contraceptives
4. Gingivitis is caused by insufficient and / or malnutrition:
a) lack of ascorbic acid
B. gingivitis, is caused by dental plaque
1. Gingivitis is caused by specific bacterial infections
a) infected with Neisseria gonorrhoeae
b) infected with Treponema pallidum
c) infected with Streptococcus spp.
d) other
2. Gingivitis due to specific viral infections
a) infected with herpes
1) Primary Gingivostomatitis herpetics
2) recurrent oral herpes
3) infection with Varicella-Zoster
b) infected with other viruses
3. Gingivitis is caused by specific fungal infections
a) infected with Candida spp.
1) gingival candidiasis? 2) linear gingival erythema
Gingivitis due to specific viral infections
What Are the Symptoms of Gum Disease?
• Gum disease may progress painlessly, producing few obvious signs, even in the late
stages of the disease. Although the symptoms of periodontal disease often are subtle,
the condition is not entirely without warning signs. Certain symptoms may point to
some form of the disease. The symptoms of gum disease include:
• Gums that bleed during and after tooth brushing
• Red, swollen, or tender gums
• Persistent bad breath or bad taste in the mouth
• Receding gums
• Formation of deep pockets between teeth and gums
• Loose or shifting teeth
• Changes in the way teeth fit together upon biting down or in the fit of partial
dentures
Gingivitis
Inflammation of the gingiva characterized
clinically by:
• erythema,
• edema,
• hyperplasia,
• retractibility,
• gingival pocket formation,
• no bone loss
Acute necrotizing ulcerative gingivitis (acute
infection of the gingivae)
 Edematous interdental papillae
 Crateriform lesions, most commonly in the anterior
incisor and posterior molar regions
 Erythema
 Spontaneous gingival hemorrhage
 Necrosis with formation of a grayish pseudomembrane
over affected area
 Pain with rapid onset
 Halitosis
 Blunted gingivae between the teeth (normally coneshaped)
Symptoms of Chronic Gingivitis
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Red, swollen gums
Gums may be tender to touch
Gums that bleed easily on brushing or flossing
Chronic bad breath
Sensitive teeth
PERIODONTAL TREATMENTS AND
PROCEDURES
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Non-Surgical Treatments
Gum Graft Surgery
Laser Treatment
Regenerative Procedures
Dental Crown Lengthening
Dental Implants
Pocket Reduction Procedures
Plastic Surgery Procedures
NON-SURGICAL PERIODONTAL TREATMENT
• SCALING AND ROOT PLANING
• Scaling and root planing is a careful cleaning of the root
surfaces to remove plaque and calculus [tartar] from deep
periodontal pockets and to smooth the tooth root to remove
bacterial toxins.
• Scaling and root planing is often followed by adjunctive
therapy such as local delivery antimicrobials and host
modulation, as needed on a case-by-case basis.
• Most periodontists would agree that after scaling and root
planing, many patients do not require any further active
treatment.
• Causal treatment is to identify and reduce local input
factors: plaque, tartar, caries cavities, faults and sealing
prosthesis. That patient provides professional cleaning of
teeth and teach proper oral care.
Pathogenetic therapy is the medicinal effects of
pathophysiological levels of inflammatory process taking
into account the nature of treatment and intensity of
inflammation. When choosing a medical mullion is
necessary to consider the phase of inflammation and
mechanism of action of the drug.
• The purpose of symptomatic treatment is the elimination
of symptoms of periodontal disease (pain, cosmetic
defect, breath), is always combined with pathogenic and
etiotropic treatment.
Treatment of
gingivitis
Application mullion having cytotoxic effect:
befunhin, prospidyn, neotsyd, celandine,
Vagothyl, maraslavin, 40-60% glucose
solution, 10% calcium gluconate solution.
Surface sklerosing-input solutions in gingival
pocket.
Deep sklerosing - input solutions directly to
the gingival papilla.
1. Disinfection (0.1 -0.2% solution
chlorheksidine)
2. Anesthesia
3. Marking point cut
4. Incision
5. Removing tissue
6. Skeylinh and smoothing the root surface
7. The formation of gingival edge
8. Treatment of wounds
9. Gingival surgical bandage.
Daily oral hygiene measures to prevent
periodontal disease include:
• Brushing teeth properly at least twice daily.
• Flossing daily and using interdental brushes as well as
cleaning behind the last tooth, the third molar, in each
quarter.
• An antiseptic mouthwash should be used daily after
flossing to reduce bacterial growth.
• Chlorhexidine gluconate-based mouthwash in
combination with careful oral hygiene may cure
gingivitis, although they cannot reverse any
attachment loss due to periodontitis.
• Regular dental examinations
Remember:
• If left untreated, early gingivitis will develop into periodontitis or
severe gum disease, which will lead to:
• Infection that can affect your overall health
• Sore bleeding gums
• Discomfort
• Bone loss
• Tooth loss
• Changes affecting your appearance
• Poor nutrition
• Possible surgery
• Costly treatments
• Systemic complications
Thank you!