Many patients with chronic gum disease, as well as periapical tissues, are wondering if recurrence of periodontitis can be cured. The answer cannot be unambiguous. Much depends on the type of inflammation, the form of the process, the classification of the disease. Sometimes the doctor has to make an incision in the gums with periodontitis. Who is shown this procedure? What is periodontitis? Let's take a closer look.
Periodontium
The connective tissue filling the space between the tooth itself and its fastening with the alveolar processes of the jaw is called periodontium. The periodontal fissure begins at the base of the gingival membrane, and ends at the alveolar process. In different parts of the gap has a different thickness, near the middle of the root it is the narrowest.
Periodontium contains lymph vessels and nerve endings, due to this there is a nutrition of incisors and numerous collagen fibers. Each fiber is formed by a huge amount of polysaccharides and various proteins. The main objective of the structure is to ensure tooth mobility. To perform this task, sections of fibers must penetrate into the bone tissue.
Periodontal inflammation
Inflammation of the basal membrane and connective tissue of the tooth is called periodontitis. Chronic periodontitis is fraught with some threat, since the symptoms of the disease do not appear immediately. The disease can occur in patients of any age, it has no age restrictions.
The first and minor symptom of the disease is an unpleasant odor, bleeding gums when brushing your teeth. Often patients complain of some discomfort when eating. The main symptom of the disease is localized pain, which is pulsating in nature, increases with time and does not have a specific location. With a large load on the incisors, the pain increases, with gritting of the teeth grows stronger, sometimes it is impossible to eat even liquid food. In this case, an increase in body temperature occurs. In such cases, the help of a dentist is simply necessary. In advanced cases, surgical intervention may be required. An incision in the gums during periodontitis is performed in extreme cases, but often this action helps to save the tooth.
Acute periodontitis
If a sharp pain has entered a stage where it is impossible to even touch a tooth, the gum swells, often the cheek and lip, the tooth staggers and the body temperature jumps - this means the pulpitis has completed its black mission. Your indifference led to the fact that inflammation from the root of the incisor went beyond the limits, captured all the tissues surrounding the tooth, and acute periodontitis began. Urgent need to contact a dentist who will try to save your tooth, you may need a gum incision with periodontitis, this is not to be afraid. After the procedure, the doctor will explain what further needs to be done to heal the wound.
Often periodontitis can be the result of an injury: the consequence of an unsuccessful treatment of pulpitis, after biting something hard. Dentists urge you to take care of the incisors and never crack something solid.
Chronic periodontitis
Chronic periodontitis ultimately leads to the fact that the dentition is loosened, cracks form between the teeth, the gums bleed not only when cleaning, but also in a calm state (even at night). A characteristic feature of this course is that the stage passes alternately from acute to chronic. For example, a patient may say that the tooth hurt, but after some time the pain stopped, often this phenomenon occurs with granulomatous periodontitis. If the disease proceeds according to this scenario, only an x-ray helps to identify the pathology, since the patient can only feel slight discomfort, darkening of the tooth, an unpleasant odor. When examining the carious cavity with a probe after a loss of a filling, painful sensations do not even arise.
An x-ray is assigned, the area with a rounded formation will be clearly visible in the image. Such tissue destruction is granuloma, if its size is more than 1 cm, then it is cystogranuloma. In a chronic form, it is unlikely that a gum section will be required for periodontitis, but the consequences of the disease are very insidious. Inflammation in the dental canal occurs in stages, pathogenic bacteria, multiplying, secrete many toxins. Intoxication can lead to various diseases of the heart, kidneys, joints and other organs.
Methods
Having revealed chronic and acute periodontitis of teeth, treatment by a doctor is prescribed immediately. This issue is resolved in two ways:
- conservative therapeutic;
- surgical.
An effective addition is physiotherapy, when a positive result is obtained using electrophoresis with potassium iodide, magnetotherapy, UHF for the inflamed area, laser therapy, paraffin baths.
Periodontitis is never cured in one step. The patient will have to visit dentistry repeatedly until complete recovery. The procedure for providing assistance has certain stages.
Treatment of periodontitis: stages. Gum section
After the diagnosis is made, the doctor should first of all:
- provide an outflow of pus;
- relieve intoxication symptoms.
To determine the degree of development of inflammation, an X-ray procedure will be prescribed. After that, the dentist will work with the affected tissues, having previously resorted to anesthesia. Tissues can be damaged by pulpitis, carious process, careless previous treatment.
Periodontitis will continue with root canal filling, where problems have arisen. With the help of antiseptics, the doctor should treat them.
For the smooth discharge of pus, it will be necessary to expand the apical opening of the upper part of the root of the tooth.
If the disease passes against the background of flux, then you can not do without a gum incision. Further, to close the root canals, the doctor uses a cotton swab.
There are several ways to treat periodontitis. In more detail, consider the extreme method - the surgical one.
Surgical treatment of chronic periodontitis, methods
In the treatment of periodontal inflammation, only in extreme cases resort to periodontal surgery. It involves the complete or partial removal of a tooth or root. In modern dentistry, extraction is less and less practiced, today surgery is committed to tooth preservation and has all the means for this.
But sometimes you have to make an incision in the gums (above the wisdom tooth, for example). This occurs in cases where it is required to produce an outflow of pus with periodontitis.
Surgeons are increasingly resorting to resection of the root apex, and not the entire apex is removed, but only the affected part. The removal procedure takes place with maximum anesthesia, the operation is carried out very quickly. It is possible not only to save the tooth, but also to restore it with a crown or other methods in the future.
Using the laser method for resection allows you to simultaneously remove the granuloma, cyst. The method is quite effective and at the same time bloodless. Laser technologies are widely used in the surgery of premolars, incisors, fangs.
With periodontal inflammation, hemisection is performed in molars, while the tooth is sawn, the affected root is removed, while healthy and the tooth is restored by orthopedic methods.
Gingivotomy (vertical gingival incision)
In some cases, it is not possible to open the tooth to make a conservative treatment, in such cases you have to resort to an incision. Often the cause of this intervention may be periodontitis. After an incision of the gum, an outflow of exudate and pus occurs. It is also indicated for inflammatory processes of the periosteum to prevent more serious complications.
The gingival incision in such cases is called gingivotomy. What are the indications for gingivotamia? They may be as follows:
- very deep, large, but at the same time narrow gum pocket;
- periodontal single large abscess;
- marginal inflammation or a type of marginal periodontitis;
- often periodontitis wisdom tooth.
How is a gum incision made?
The process of gingivotomy occurs in stages:
- Anesthesia.
- Dissection along the entire depth of the gums in the area of the gingival pocket.
- Cuts vertically (in the side sections).
- Flap retrieval.
- Remediation of the pocket. Removal of affected epithelium and granules.
- Suturing and dressing.
Treatment after a gum incision usually takes place without complications, the wound heals up fairly quickly and does not subsequently have tissue defects.
The incision is made in different ways, it all depends on the severity of inflammation, as well as indications for manipulation. A decision may be made to have a gingivectomy (horizontal incision). In any case, for the successful outcome of surgery, great attention should be paid to asepsis. Aseptic helps to avoid infection of wounds, prevents the entry of pathogenic organisms into the surgical field. In addition, it is necessary to use sterile gloves, tools, napkins, tampons.
How does the gum heal?
Wound healing after periodontal surgery is the formation of new anatomical and physiological connections between cells and tissues. The process itself has several stages:
- After the intervention, a blood clot forms, which forms within 10 minutes, it serves as a barrier, protection against harmful microbes and infections.
- Within 3-4 hours, a young connective (granulation) tissue is formed.
- Collagen formation and epithelization takes 7-10 days. It can sometimes cause a slight itch.
- Maturation and regeneration lasts from 2 to 3 weeks. The wound is delayed, but complete healing occurs only after a few months.
What to do after the procedure
Many people wonder what to do after a gum incision. What to do to make wound healing quick? After surgery, the dentist must warn the patient how to care for the gums. But some patients do not remember a bit in a “shock” state when they came home what the doctor advised them. So, recommendations after gum incision:
- After surgery, the doctor will put a gauze swab in the wound to stop the bleeding. You need to hold it for at least 20 minutes.
- Arriving home, you need to lie down and relax a bit.
- You should not eat after the operation, drink any drinks for three hours. Further, only soft food should be present in the diet in order to avoid injury to the incision site.
- If you experience severe pain, you can take any pain medication. On the second day after the manipulations, it is necessary to start rinsing, this will avoid infection of the wound, as well as the development of inflammatory processes. Can be used to rinse "Furacilin", infusions of chamomile and sage.
- Within three days after the intervention, do not eat hot, hard foods, and also open your mouth wide.
- Limit all physical, emotional stress.
- Gym classes, sauna, hot tub are prohibited.
- For a week, it is better to give up smoking and alcohol.
- In no case do not burn the wound with brilliant green or iodine. Do not apply anything hot. So you only make it worse!
- The dentist can prescribe applications for wounds of antimicrobial and wound healing preparations ("Solcoseryl", "Chrysal", "Stomatophyte").
- To strengthen the immune system, you can take multivitamin complexes and immunomodulating agents.
- To monitor the healing after five days, you should consult a doctor.