(Pyorrhea)

Periodontal disease is a chronic inflammatory disease of the gums caused by an opportunistic infection of endogenous plaque biofilm formation. As a rule, it manifests itself as a worsening of gingivitis and if left untreated, with loosening and loss of teeth. Other symptoms are rare, except in patients when developing with HIV infection or abscesses, which often leads to pain and swelling. The diagnosis is based on examination, periodontal probing and radiographs. The treatment comprises a teeth cleaning, which extends under the gum, and a strict domestic oral hygiene program. In advanced cases, antibiotics and surgery may be required.

Periodontal disease is a chronic inflammatory disease of the gums caused by an opportunistic infection of endogenous plaque biofilm formation. As a rule, it manifests itself as a worsening of gingivitis and if left untreated, with loosening and loss of teeth. Other symptoms are rare, except in patients when developing with HIV infection or abscesses, which often leads to pain and swelling. The diagnosis is based on examination, periodontal probing and radiographs. The treatment comprises a teeth cleaning, which extends under the gum, and a strict domestic oral hygiene program. In advanced cases, antibiotics and surgery may be required. Pathophysiology periodontal disease usually develops when gingivitis, usually with abundant plaque and tartar below the gingival margin, has not been adequately treated. When periodontitis the deep pockets can accommodate anaerobic microorganisms that cause more damage than the normally present at a simple gingivitis agents. The organisms trigger a chronic release of inflammatory mediators, including cytokines, prostaglandins, enzymes and of neutrophils and monocytes. The resulting inflammation damages the periodontal ligament, the gingiva, the cementum and the alveolar bone. The gingiva is increasingly losing its attachment to the teeth, which starts bone loss and periodontal pockets are deeper. With progressive bone loss teeth can become loose and the gums recede. In the later stages of tooth migration are common and tooth loss may occur. Risk Factors Modifiable risk factors that contribute to periodontal disease, dental plaque include smoking obesity diabetes (especially type 1) Emotional stress vitamin C deficiency (scurvy) The elimination of these factors can contribute to improve patient outcomes. Classification The classifications described herein are based on the American Academy of Periodontology (AAP) classification system for periodontal diseases and conditions (1999): Chronic periodontal disease (formerly adult periodontal disease called) Aggressive periodontal disease (formerly the early onset and juvenile periodontitis periodontal disease as a manifestation of systemic diseases necrotizing ulcerative periodontitis (formerly known as HIV-periodontitis) Other AAP designations are abscesses of the periodontium, periodontitis with endodontic lesions, and developmental or acquired deformities and conditions. developmental or acquired deformities and conditions, an erroneous occlusion, the functional in excessive cause stress on individual teeth as well as the indispensable plaque and gingivitis, may for Fortsch riding some form of periodontal disease contribute, which is characterized by angular bone defects. Chronic periodontitis chronic periodontal disease is the most common form of periodontal disease. It occurs most often in adults> 35 years, but young people and even children with milk teeth can be affected. It is characterized by its slow rate of progression, with periods of exacerbation and remission and also a correlation between the extent of the destruction and the presence of local factors such as plaque. About 85% of the population is affected to a small degree, but most of the fortgeschrittenene cases are reported in <5% of the population. Due to the slow progression of the patient's age at presentation is not always an indicator of when the disease has begun. Patients with significant disease are more likely to> 35 years old, and tooth loss usually begins in a patient aged 40 years. Based on the extent of the disease, chronic periodontitis is further classified as Localized: ? 30% of teeth affected Generali:> 30% of teeth affected Aggressive periodontitis Aggressive periodontal disease is much less common than chronic periodontal disease. It usually occurs in children (sometimes before the age of 3 years), or young adults, but also occurs in older adults before. It is characterized by its family history and rapid progression of bone loss and even tooth loss. The extent of destruction is usually disproportionate to the extent of plaque or tartar. By definition, patients have no systemic disease, while as a manifestation of systemic disease, patients have a systemic disease in periodontitis. Neutrophil and macrophage / monocyte function may be abnormal. Localized aggressive periodontitis (Formerly localized juvenile periodontitis called) occurs mostly in healthy adolescents. Patients often have a significant colonization of Aggregatibacter actinomycetemcomitans previously Actinobacillus actinomycetemcomitans) and a strong antibody response to infecting bacteria. Typically, the signs of inflammation are poorly known. The disease is detected by periodontal probing or x-ray photographs showing a localized, low (vertical) bone loss. The disease includes at least two of the first molars and incisors and no more than two other teeth. The bone loss progresses faster than in chronic periodontitis, often with a rate of 3 to 4 microns / day; it is unclear whether a localized aggressive periodontitis may be self-locking manner. Generalized aggressive periodontitis (formerly called rapidly progressive periodontitis) occurs most often in patients aged 20 to 35 years. It is often accompanied by corrodensund A. actinomycetemcomitans, Porphyromonas gingivalis, Eike Ella many gram-negative bacteria, but cause and effect are not clear. It often occurs a weak antibody response to infectious bacteria. All teeth may be affected, which must contain ? 3, which is not the first molars or incisors. Prepubertal periodontitis, a rare type of aggressive periodontitis (and not recognized in the AAP classification of 1999), is one of the genetic disorders that are listed below, derived (see periodontitis as a manifestation of systemic disease), but also their own mutation respectively. It affects the milk teeth, usually shortly after the outbreak. Its typical features are a generalized acute proliferative gingivitis and rapid destruction of the alveolar bone. Patients also have frequent episodes of otitis media and are usually diagnosed at the age of 4 years. In some patients the disease disappears before the permanent teeth durchbrechen.Parodontose as a manifestation of systemic disease periodontitis as a manifestation of systemic disease is considered in patients considered to have the disproportionate inflammation against plaque or other local factors and also suffer from a systemic disease , However, it is often difficult to distinguish whether a disease periodontitis caused or contributes to plaque-induced periodontitis. Among the systemic diseases that are associated with hematological disease, and can manifest as periodontitis include Acquired neutropenia agranulocytosis leukemia Loeffler’s syndrome Hypogammaglobulinaemia Systemic diseases associated with genetic disorders that can manifest as periodontitis include Familial and cyclic neutropenia Down syndrome Leukozytenadh√§sionsdefektsyndrome Papillon-Lef√®vre syndrome Chediak-Higashi syndrome histiocytosis syndromes Glycogen Infantile genetic agranulocytosis Ehlers-Danlos syndrome (type IV and VIII) hypophosphatasia Cohen syndrome Crohn’s disease necrotizing ulcerative periodontal disease necrotizing A ulcerative periodontitis is a particularly virulent, rapidly progressing disease. It is often called HIV-associated periodontal disease because HIV is a common cause. Clinically it resembles acute necrotizing ulcerative gingivitis, combined with rapidly progressive periodontitis. Patients can lose 9 to 12 mm Attachment in just six months. Symptoms and complaints pain usually absent unless an acute infection in one or more periodontal pockets forms or if an associated with HIV periodontitis is present. The impaction of food in the pockets can cause pain at meals. Abundant plaque along with redness, swelling and exudate are characteristic. Gums can be sensitive to touch and bleed easily, and it can be offensive breath occur. Chewing becomes painful when teeth become loose, especially when only a third of the root in the bone. Periodontitis CNRI / SCIENCE PHOTO LIBRARY var model = {thumbnailUrl: ‘/-/media/manual/professional/images/m7820188-periodontitis-science-photo-library-high_de.jpg?la=de&thn=0&mw=350’ imageUrl ‘ /-/media/manual/professional/images/m7820188-periodontitis-science-photo-library-high_de.jpg?la=de&thn=0 ‘, title:’ periodontitis ‘description:’ u003Ca id = “v37894097 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eDiese figure shows the gums and periodontal abscess (white

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