Generally speaking, periodontology deals with treatment of gum inflammation and subsequent bone resorption around the teeth. When inflamed, gums bleed and generate a foul mouth odour. If they are not treated, bone resorption may develop leading to tooth mobility and tooth loss.
The most common reason for inflammation is bad oral hygiene habits and dental calculus deposit. Poor-fitting and poor-shaped crowns and fillings are also a prerequisite for inflammation and damaging of the tissue around the teeth. Often, this inflammation is underestimated, since any severe symptoms appear rarely - usually, bleeding during teeth-brushing is observed, but most patients consider this normal and do not seek timely help from a dentist.
Therefore, correct teeth brushing in the morning and in the evening, as well as the regular preventive examinations by your dentist, are very important.
Treatment depends entirely on the stage of damage. Sometimes, only professional cleaning of the pockets, patient training, replacement of old fillings and crowns is sufficient, then teeth start to heal and the disease is discontinued (managed) for years.
In case of tooth mobility and resorption of the surrounding bone with one half or more, tooth splinting is one treatment option. Splinting may be performed via light-curing resin and fibre-glass splint or splinted crowns. We often recommend strengthening and thickening the gums using AlloDerm RTM or Novo Matrix TM.
If the inflammation is at a rather advances stage, extraction of the teeth with the most severe bone resorption is necessary, whereby the bite is restored by means of fixed bridges.
And when the dentist assesses that inflammation cannot be managed, but may damage other organs of the human body, all teeth are extracted. We always try not to leave the patient without teeth even for a day. Hence, one option is that, before extracting the teeth, our dental technicians fabricates a denture which immediately replaces the missing teeth. Another option is implants with immediate missing teeth restoration.
Whenever possible, we restore the bone around the teeth surgically using a mixture of a bone replacement substance and patient’s growth factors.
What are the growth factors?
A concentrate of platelets prepared after collecting blood from the patient in a tube and subsequent centrifugation.
Platelets are key factors of the mechanisms for recovery of hard and soft tissues. They provide for important growth factors, such as FGF, PDGF, TGF-β, EGF, VEGF, which take part in the stem cell migration, differentiation and proliferation. They also stimulate the fibroblasts and the endothelial cells to induce new deposition of an extracellular matrix and neovascularization, respectively. Platelets are concentrated from the patient own blood plasma.
Plasma contains many factors important for the cell survival, including nutrients, vitamins, hormones, electrolytes, growth factors, such as IGF and HGF, and proteins. The plasma proteins comprise molecules vital for the coagulation process and for generation of a fibrin mesh which acts as a scaffold for cell migration and new tissue generation.
If the inflammation is at a rather advanced stage, extraction of the teeth with the most severe bone resorption is necessary, whereby the bite is restored by means of fixed bridges.
Treatment of the gum recessions
Recession is the visible exposure of the tooth cervical areas /usually in a triangular shape/ and is almost always related to increased sensitivity to cold and warm. The reasons are anomalies in the bite wherein teeth are overloaded in an incorrect direction; recessions appear often after orthodontic treatment using brackets.
Treatment is always surgical.
If sufficient tissue is available adjacent to the recession, it is simply moved and the tooth is covered with it.
If the tissue adjacent to the recession is not enough, a connective tissue graft may be harvested from another location in the mouth where it is in excess.
If recession is multiple, the treatment recommended is by using AlloDerm.
Our experience has shown that this is the most predictable and efficient method. Since 1997, AlloDerm has found wide application as an acellular dermal matrix graft for soft tissue replacement.
AlloDerm supports soft tissue regeneration by creating prerequisites for fast revascularization, leucocyte migration and cell population, and transforms into an own tissue of the patient, thus leading to healthy and natural recovery.
The latest tissue matrix is: NovoMatrixTM Reconstructive Tissue Matrix /on the market since 2017/.NovoMatrixTM is a porcine acellular dermal matrix developed for soft tissue replacement. The LifeCell tissue process was designed to keep the biomechanical tissue integrity which is critical for optimal regeneration.
PREVENTION AND ELIMINATION OF DENTAL CALCULUS (PROFESSIONAL ORAL HYGIENE)
We recommend to our patients to visit the clinic twice a year. During these visits, we make examinations and evaluate the tooth status, we remove the dental calculus and, when necessary, we make Air-flow polishing.