Inflammatory periodontal diseases associated with dental plaque are among the most common human diseases.
Periodontitis is a chronic disease of the periodontium and periodontium. It is usually caused by a bacterial infection that first causes gingivitis and then spreads to the jawbone. If left untreated, periodontitis can lead to tooth loss.
Very often periodontitis is only diagnosed in the 4th or even 5th decade of life, usually the degree of destruction is already very advanced. The first signs of periodontitis can be detected much earlier by a specialist in this field. The treacherous thing about this chronic disease is that its slow, painless and insidious progression is also noticed very late by the affected person. Do not let it get that far and use the preventive periodontal screening measure to be able to intervene quickly and effectively in the case of cases.
Gingivitis is regarded as a kind of precursor to periodontitis. It is caused by a bacterial mixed infection, the so-called biofilm "bacterial plaque". Due to neglected oral hygiene, such an acute inflammation can establish itself within a few days. The clinical symptoms for this are for example redness and swelling of the gums or increased bleeding of the gums, the classic bite into an apple is known from advertising and can definitely be an indicator for not completely healthy gums.
When the dentist has diagnosed gingivitis, a complete healing of the periodontal structures can be expected within a few weeks through appropriate therapy measures. A dental hygienist will work with you to optimize oral hygiene to such an extent that a healthy, strong periodontium is formed again very quickly.
If the body cannot defend itself against gingivitis and if it is also not recognized as a precursor of periodontitis, further destruction processes can occur due to the constant inflammation.
The bacterial toxins and the patient's own immune defence lead to the incipient dissolution of periodontal structures such as the periodontium and the jawbone. A therapy is already absolutely necessary at this stage!
Untreated, the disease can progress further and further into the depths and ultimately lead to tooth loss. As with most diseases, the earlier the disease is diagnosed, the better the chances of recovery.
However, in this case it is a chronic disease that requires lifelong monitoring and therapy. The patient's own motivation and cooperation, the so-called compliance of the patient, contributes significantly to the success of periodontitis therapy.
The aim of the hygiene phases is to reduce or eliminate the germs that cause periodontitis. Poor dentures or leaking old fillings are frequent causes of periodontitis, the degree of destruction is particularly dramatic at these sites. In a kind of preliminary treatment to the restorative phase, this poor denture and the old or marginal fillings must be replaced. Even in the hygiene phase, conditions must be created that enable the patient to carry out adequate oral hygiene independently.
Ca. 6-8 weeks after hygiene phase I, the health status of the gums is reassessed. In most cases, optimal hygienic conditions have already been created so that nothing stands in the way of a definitive new, more esthetic dental prosthesis. The restorative phase can be initiated.
If the conditions are not so optimal, hygiene phase II should be performed, either completely over the entire gum or locally at the critical sites. The treatment procedure is the same as in hygiene phase I..
The corrective phase describes a surgical procedure if hygiene phase II has still not led to the desired result. The overall objective of this phase is to create a morphology of hard and soft tissues that allows both the patient and the dental hygienist to achieve optimal cleaning. In terms of methodology, regenerative treatment methods are predominantly used here.
The optimum result at the end of the hygiene phases or the corrective phase is a pocket probing depth of 3 mm, also referred to as "zero-pocket" among experts.
The restorative phase is not in the true sense of the term periodontal treatment. New esthetic, functional and periodontally-friendly restorations optimize the treatment result and stabilize it over the long term. The interdisciplinary aspect becomes more than clear here.
The maintenance phase serves the maintenance of the treatment result, it has a prophylactic character but differs from the primary prophylaxis in that it concerns patients who are already ill, even if currently symtom-free. Since the risk of relapse is higher than in a primary healthy patient, individual recall intervals are defined.
This supportive periodontal therapy (UPT) is performed by a specially trained dental hygienist.
In addition to the classic conservative manual therapy, scaling/rootplaning (SRP) with hand instruments, which still represents the gold standard, vibrating piezo instruments are also used. Piezo technology makes gentle, delicate and effective work deep in the pocket possible To achieve further germ reduction in hygiene phase I or II, additional optional or adjuvant therapies are recommended.
Further bacteria reduction through the use of a diode laser. The laser can be used 2-3 days after the hygiene phases. Local anaesthesia is usually not necessary because of the gentle treatment. The laser has a bacterial sterilizing, hemostatic and healing effect.
Most periodontitis-causing bacteria are eliminated by laser treatment, eliminating the need for drug therapy with antibiotic side effects. The laser periodontitis treatment stops the bone resorption of the jawbone and stabilizes the strength of the teeth.
A tiny chip only 4x5mm small, with the active ingredient chlorhexidine is bound in a fine gelatine layer and dissolves completely after approx. 7-10 days - but works up to 3 months.
The tiny chip is inserted exactly into the previously treated gingival pocket using tweezers. The chip disappears completely and remains invisible from the outside. From this moment the effect against the periodontitis-causing bacteria begins.