Periodontal treatment Cluj Napoca

Periodontal disease or periodontosis (popular name) is a general term given to an infection or inflammation of the tissues surrounding the teeth, the periodontium.

What is periodontium? Teeth are held in place by the gums, bone, and ligaments that connect the teeth to the bone and act as shock absorbers. These three tissues (gums, bone, and ligaments) together form the periodontium.

The accumulation of dental plaque and tartar can lead to inflammation of the gums, which is the mild form of periodontal disease – gingivitis. The more severe form, periodontitis, can lead to tooth loss. Good oral hygiene can prevent the onset of periodontitis and can treat the early stages of the disease. In the case of periodontitis, specialist treatment is necessary.

Because periodontal disease progresses slowly and painlessly, many people do not seek professional help. Many cases remain undiagnosed until symptoms, such as advanced gingival retraction and tooth mobility, become apparent.

Even if periodontal disease has reached advanced stages, sometimes teeth can be saved. A loose tooth is not the same as a missing tooth. The vast experience of our specialist doctors, along with the modern and innovative techniques present in our clinic, allow you to keep affected teeth even when you think there is no chance.

Periodontal disease is an inflammatory process. Unlike gingivitis, where only the gums are affected, periodontitis affects all periodontal tissues, which ensure the functionality of the teeth and keep them in the mouth. As the disease progresses, especially in the absence of treatment and hygiene, dental plaque accumulates not only around the gums, but also penetrates deep under them. Due to abundant deposits, the gums increase in volume, detach from the surface of the teeth - this is how periodontal pockets are formed. As the disease progresses, the contents of such pockets "rot", which only aggravates the whole situation - there is a gradual intoxication of the whole organism. The more severe the form of periodontitis, the more obvious all the symptoms are.

• pain that occurs during meals – many patients believe that they have cavities, although, in fact, inflamed gums and exposed tooth roots are what cause these painful sensations,
• bleeding gums – may be constant or may occur when pressing on the gums or brushing your teeth,
• redness and darkening of the gums – they become bright red, purple or blue, especially in the area of the papillae,
• the appearance of periodontal pockets – cavities that appear when the gums detach from the tooth as a result of the accumulation of a large amount of dental plaque,
• bad breath resulting from the superimposition of a bacterial infection and suppuration of the contents of the periodontal pockets,
• gum retraction along with bone tissue destruction – teeth visually „become” longer due to reduced gum volume, and appear wedge-shaped – roots being thinner and narrower than dental crowns,
• tooth mobility occurs due to the destruction of periodontal ligaments and the reduction in the volume of all periodontal tissues – from insignificant in the initial stage of the disease to pathological in the advanced stage, when the teeth move laterally and also up and down, that is, they are on the verge of being lost,
• feeling unwell, fever, general weakness.

Periodontal disease is the number 1 cause of early tooth loss. According to the WHO, some signs of inflammation are found in 86% of people aged 35 to 44. At the same time, in the same age group, approximately 20% of patients are diagnosed not only with periodontitis, but also with severe periodontitis.

Periodontal disease almost always has a generalized form, affecting the entire dentition, since the nutrition of the gums is completely disrupted. It is customary to distinguish three forms of periodontal disease: mild, moderate and severe.

But inflammation of periodontal tissues (i.e. periodontitis) occurs in a fairly wide variety of forms – depending on the severity of the disease, its spread, and the reversibility of pathological processes.

Mobility can be normal or natural, and is necessary for shock absorption during mastication, but it can also be pathological, meaning abnormal. And periodontitis is considered the main cause of pathological mobility.

As periodontal disease progresses, pathological mobility becomes one of the most striking clinical manifestations and dominates all others – bleeding gums, destruction of bone tissue, etc.

In some classifications, grade IV is also distinguished separately, in which the teeth rotate in their sockets and are on the verge of being completely lost. It is not even worth trying to save them.

Bacterial plaque is currently considered the sole or main cause of periodontal disease, although there is a wide variety of predisposing or risk factors that contribute to the development of periodontitis.

Plaque is a soft deposit that forms on the surface of teeth. It is made up of several types of bacteria, sticky substances secreted by the bacteria, food debris, and saliva. The bacteria feed on carbohydrates and sugars in food, releasing acidic substances.

Over time, the acid degrades the surface of the teeth, leading to cavities and irritates the gums, causing gingivitis. In advanced cases, it causes the gums to recede from the teeth and destroy the bone.

Everyone has millions of bacteria in their mouths. Within minutes of brushing your teeth, plaque begins to deposit on the surfaces of your teeth.

In less than 24 hours, the layer of bacterial plaque that forms will usually be thick enough to be visible. Therefore, it is recommended to brush twice a day, morning and evening. This way, plaque deposits are removed before they increase in volume and affect the teeth and gums.

Tartar is formed from bacterial plaque that has absorbed calcium and other minerals from saliva. These minerals are intended to strengthen the surfaces of teeth, but when they crystallize into plaque, they turn it into a hard substance – tartar.

Early tartar deposits are as hard as chalk and are yellow in color, but over time they become darker and increasingly harder.

Generally, tartar can only be removed by a dentist.

According to numerous studies, it has been proven that periodontal disease (periodontitis) can cause some systemic diseases, and some health problems lead to the development of periodontitis. There are cases when a patient with diabetes mellitus for many years had a catastrophically high glucose level, but after tooth extraction it decreased significantly. Diabetes mellitus aggravates the course of periodontitis, while periodontitis, on the contrary, aggravates the course of diabetes mellitus. Thus, tooth extraction breaks this „vicious circle” and leads to an improvement in the patient’s well-being.

However, there are situations when a person does not brush their teeth or has poor oral hygiene, but their teeth and gums are in good condition. And vice versa – hygiene is at the highest level, but periodontal disease continues to progress. This is where external factors come into play – for example, metabolic disorders, malocclusion, hormonal problems in women, etc.

In addition to the fact that periodontitis destroys the gums and bone, the focus of infection in the oral cavity becomes a threat to the entire body. Bacteria that develop at a high rate in periodontal pockets, and when you swallow and eat food, enter the stomach, disrupting the work of the digestive tract - constant pain and discomfort appear.

The organs of the gastrointestinal tract are affected – they suffer primarily because bacteria from the mouth enter the stomach during meals. This can lead to indigestion, pain and cramps in the digestive tract, constant discomfort, poor digestion of food, heartburn and bloating. In a reverse chain reaction, stomach problems cause malnutrition of tissues throughout the body and further weaken periodontal tissues.

It has been scientifically proven that periodontitis increases the likelihood of pyelonephritis (inflammation of the kidneys) and heart disease by 6 times.

The mechanism of development of pyelonephritis is that pathogenic bacteria, penetrating from the inflamed periodontium, together with the bloodstream, produce proteins similar in structure to kidney cells. With an immune attack on pathogens, kidney cells are simultaneously destroyed. In addition to pyelonephritis, diseases such as glomerulonephritis and chronic renal failure are also common.

Periodontitis also contributes to the development of atherosclerosis, increases the likelihood of diabetes and stroke by 6 times, and increases the risk of breast cancer by 14%. During pregnancy, the risk of miscarriage increases by 7 times. The fetus is at risk because of all the bacteria that enter the amniotic fluid. They are capable of causing irreversible deviations in the unborn child up to developmental delay, underweight and even the development of autism.

The first and most important thing to know is that treatment is only possible through a complex of procedures and procedures.

We have accumulated enough experience to take the treatment of periodontitis to a new level. The goal of our solutions is not only to stop the manifestations of the disease, but also to restore the destroyed tissues as much as possible.

Patients diagnosed with mild to moderate periodontitis are not hopeless! It is possible to stop the progression of the disease and stabilize the outcome for many years. But only with an integrated approach that uses the latest advances in periodontology.

The procedures that are included in the treatment of periodontitis are:

• supragingival and subgingival scaling, without affecting the surface of the crown or tooth roots
• supragingival air flow
• subgingival perio flow with devices and methods specially designed to not damage the tooth roots or the inside of the gum;
• polishing dental surfaces
• sterilization of periodontal pockets throughout the depth of the pockets
• antiseptic and antibacterial treatment of periodontal pockets
• stimulation of local blood circulation and tissue regeneration using the dental laser
• injections of plasma from the patient's own blood, which stimulates the restoration of damaged tissues and the closure of periodontal pockets
• use of Straumann Emdogain® or similar products to stimulate soft tissue and bone growth, 
• if necessary, bone additions accompanied by collagen membranes and/or APRF membranes obtained from the patient's blood
• immobilization of teeth, if necessary, through various methods such as fiberglass bands or dental bridges

It is important to remember that periodontitis is a chronic condition. In the future, it is very important to visit the dentist/periodontist at least once every six months, as well as strictly follow the supportive therapy, if indicated.

If the treatment is carried out in a complex, then all the factors that cause inflammation and relapse of the disease are eliminated throughout the chain of procedures. The dento-maxillary apparatus begins to function fully, metabolic processes improve, the tone and immunity of the gums increase.

• tooth preservation
• improvement of inflammatory processes, elimination of the focus of infection
• eliminating bad breath,
• creating a favorable environment for the restoration of the jaw bone and the ligaments that hold the tooth in the socket,
• prevention of tooth mobility and bone atrophy,
• the opportunity to place dental implants without removing remaining teeth, without the risk of rejection,
• stopping the spread of infection
• stable long-term results.