Diagnosis of periodontal disease: a modern approach and methods

Periodontal disease refers to the systemic lesions of the periodontal( periodontal tissue).The disease is quite rare, has a destructive character, can occur in various forms.

As a result of the progression of the disease, atrophy of the gums and the alveolar branch of the jaw develops.

Diagnosis of periodontal disease includes several stages: anamnesis collection, examination of the dentist, special samples, instrumental examination, radiography, laboratory studies and others.

History history for the diagnosis

Anamnesis collection involves the accumulation and analysis of information abouthealth status of the subject. This method of diagnosis and medical research is carried out by asking the patient or his loved ones.

Important information can be information about hereditary diseases, diet and the patient's working conditions. Such information often allows us to identify the root cause of the development of pathology and to find the right approach to its treatment. Often it is necessary to involve other medical specialists - endocrinologists, gastroenterologists, etc.

Primary examination and differentiation at the

Clinic Diagnosis of periodontal disease requires a thorough examination of the dentist. When studying the state of the mouth, the doctor draws attention to the following points:

• level of sensitivity of tooth enamel and gums, their coloration;
• degree of openness of the neck of the teeth and their roots;
• the size and depth of the dentogingival pockets;
• gum bleeding.

Together, these phenomena indicate the presence of periodontal disease. Defects of the enamel in combination with the exposed neck of the teeth are the most striking signs of the developing disease.

Depending on the degree of spread, periodontal disease can be localized( develops in a certain area of ​​the dentition) and generalized( covers both jaws).

Based on the nature of the pathology, two of its forms are distinguished: chronic and acute. Unlike chronic acute it is accompanied by uncomfortable sensations and frequent bleeding.

The initial stage of the disease is able to proceed without significant signs of bone tissue atrophy, and if severe, there is a significant risk of complete loss of teeth.

Special tests

For the effective diagnosis and adequate treatment the doctor can prescribe the sowing procedure. This helps to identify the presence of strains of bacteria and harmful microflora.

Schiller-Pisarev test, benzidine test is often done, the parameters of the gingival fluid are determined, a study is conducted for the presence of bacteria in the contents of the periodontal pockets.

Instrumental and other diagnostic methods

Instrumental examination using dental mirrors, tweezers and probes is helpful in establishing a reliable diagnosis.

Mirrors and tweezers allow you to examine hard-to-reach areas of the oral cavity, and the probe - to identify signs of inflammation and the degree of mobility of the teeth.

Other effective diagnostic methods are:

• intraoral and panoramic radiography;
• laboratory studies;
• reoparodontography;
• thermometry.

Confirmation of the clinical diagnosis requires an x-ray examination - intraoral and panoramic radiography. This allows to detect the presence of changes in bone tissue, atrophy of the gums, the presence of calculus and the reduction of interdental septa.

With parodontosis, an X-ray photograph fixes the development of osteoporosis.

Laboratory studies involve traditional biochemistry - blood and urine analysis.

With the help of rheoparodontography, the functional state of the vessels in the periodontal tissues is evaluated, pathological processes that lead to a change in the periodontal tissues are determined.

Thermometry of the gums and periodontal pockets takes into account the temperature difference in the normal state and in the stage of the disease development. With periodontitis, it rises to 34.3-36.2 ° C.Special thermometers are used for the procedure.

Differential Diagnosis of Clinical Similar Diseases

Differential diagnosis is very important in the process of establishing the correct diagnosis. It makes it possible to distinguish diseases similar in the clinic from each other and to choose the necessary method of treatment.

Gingivitis, which develops due to infectious diseases, avitaminosis, gastrointestinal diseases and cardiovascular system, can give a clinical picture that differs little from periodontitis. Only the area of ​​localization of the disease will change. With gingivitis, mucous membranes become such, while the bone structure and teeth do not lose their original characteristics.

In the initial stage of periodontal disease there is no bleeding of the gums and loosening of the teeth, so the patient has little to worry about. Such phenomena are peculiar to the beginning of periodontitis development. For periodontal disease, a gradual atrophy of the tissues surrounding the tooth is characteristic.

Differentiation is also performed with such diseases as reticuloxantomatosis( Christian-Schuiller's disease), keratodermia( Papillon-Lefevre syndrome), eosinophilic granuloma, scleroderma and some diseases of glandular organs accompanied by degeneration of periodontal tissues.

The method of differential diagnosis is based on the results of anamnesis, the features of the clinic and X-ray data.

Probability of medical error

At the initial stages of development of periodontitis, correct diagnosis often causes difficulties. The similarity of some symptoms does not exclude the possibility of medical error and can be misleading. Often even experienced periodontists definitively diagnose the disease only in the 2 nd or 3 rd stages. At these stages, the clinic of periodontitis is already seen quite well.

The final reliable diagnosis can be made only on the basis of laboratory, clinical and radiological studies.

Periodontal disease belongs to progressive diseases, which are difficult to cure. With all the development of modern medicine, there is only an opportunity to suspend the process and alleviate the patient's condition.

After the diagnosis is made and the stage of development of the pathology is determined, treatment is indicated. With its successful outcome, the chances of a partial restoration of the damaged gum increase.