Treatment of gingivitis and periodontitis

What is periodontology ?

ART 1. M. B. July 27, 2001 The field extends to :
prevention, diagnosis, planning of treatment, and treatment of all periodontal diseases (both plaque-related and non-plaque-related, with the exception of the therapy of cancerous lesions) and this, by means of surgical / non-surgical therapy, periodontal tissue regeneration, treating cysts of periodontal origin in the gingival and alveolar region, treatment of furcation, the surgical extraction, trans-and reimplantation of teeth as well as the placement of dental implants and their abutments in the mandible and the alveolar process of the maxilla. Periodontology does not include the prosthetic rehabilitation.

 

ART 2. M. B. July 27, 2001 Conditions for recognition :
To be recognized and acknowledged to continue as a dental specialist in Periodontology, the candidate must:

  • 1 ° meet the common criteria for the recognition of dental specialists;

  • 2 ° have received specific training of at least three years in which the knowledge and skills acquired during basic training to dentists are deepened, and which acquire additional knowledge and skills in well-defined areas (see M. B.)

What is periodontitis ?

Bacterial infectious disease in which the supporting tissue of the teeth is aborted In Belgium, more than 40% of people over age 35 one or more "pockets" (Lambert et al, 2003).

Healthy
Healthy
Gingivitis
Gingivitis
Periodontitis
Periodontitis

Symptoms Periodontitis

  • bleeding gums, swelling, pus
  • breath odor ( "halitosis", "Halitosis")
  • receding gums
  • loosening of teeth / tooth loss

Effects

  • socio-economic impact
  • loss of teeth
  • loss of supporting tissue complicates prosthetic restoration
  • breath odor
  • more expensive prosthetic restoration

Increasing evidence for impact on

  • diabetes
  • cardiovascular diseases
  • prematurity / low birth weight

Diagnosis

Screening: Dutch Periodontal Screening Index (usually in the first line)

Category A Category B Category C
DPSI 0, 1, 2 DPSI 3- DPSI 3+, 4

Further Periodontal examination( with dspi 3+ and 4)

Category A Category B Category C
DPSI 0, 1, 2 DPSI 3- DPSI 3+, 4
No further examination required Periodontal chart
Local x-ray
Treatment plan
Periodontal chart
x-ray status
Treatment plan
Oral hygiene (supragingival) calculus Oral hygiene
Remove calculus (supragingival-subgingival)
re-evaluation
recall
Oral hygiene
Remove calculus (supragingival-subgingival)
re-evaluation
recall
 

Initial (non-surgical)

  • removal of bacterial plaque / calculus from the root surface
  • individualized oral hygiene instruction

Surgical

Removal of deep pockets by ressection
Removal of deep pockets by ressection
Regeneration of lost bone in certain specific cases
Regeneration of lost bone in certain specific cases

Recall

  • Removing plaque /calculus not only supragingival but also subgingival cleaning/ inspection during recall
  • Follow up through periodontal charting
  • Regular X-ray control
  • Follow-up of oral hygiene and regular instructions