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GUM
DISEASES |
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Believe it or not, gum problems are the most
common diseases affecting the human population.
Most of the people think that teeth are the only
element of a beautiful smile. However, the fact
is that the size, shape, integrity and health of
gum tissue greatly influence the aesthetic
appearance of even the most perfect teeth. Too
much gum tissue can lead to teeth that look
short and wide while too little gum tissue can
lead to exposure of root surfaces of teeth that
look way too long.
Periodontics is an area of expertise that deals
with treatment of the gum and bone supporting
the teeth. |
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In
health, the gums firmly grip the neck of the
tooth. If food is allowed to accumulate between
the tooth and the gum margin, it forms plaque
along with the microbes. The resultant
irritation of the gum margins produces a
condition called as GINGIVITIS characterized by
redness, bleeding and swelling of the gums. If
proper attention is paid at this stage the
condition is perfectly reversible. However in
untreated cases the condition further
deteriorates leading to the destruction of the
tooth-supporting tissues. The condition is then
called PERIODONTITIS or PYORRHOEA. At this stage
the teeth start shaking, they are unable to
withstand chewing forces, pus forms in the gums
and foul smell starts from the mouth. |
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Treatment |
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1.
Non-surgical treatment involves
scaling and
polishing of teeth. The procedure aims to remove
food particles, plaque and calculus accumulating
around the tooth. The effectiveness of the
procedure depends largely on the stage of the
disease, the efficiency of instrumentation and
the maintenance on the part of the patient.
No matter how good we are at brushing, we cannot
achieve 100% efficiency in cleaning. So, small
depositions continue to occur on a daily basis.
For long term maintenance of teeth, it is
therefore advisable to go in for a professional
cleaning once in six months even if you do not
have an evident gum problem.
2. The Surgical approach to treatment is usually
recommended for resistant cases where complete
removal of the irritants from root surface of
the tooth is not possible by scaling alone due
to the deep penetration of the deposits. The
procedure also called as
flap surgery or flap
operation involves reflection of the gums by 1-1
1/2 mm and debriding the area under local
anesthesia with direct visualization of the
deposits. The procedure is completely painless
and involves minimum post-operative pain or
discomfort.
In certain cases however it is possible to
regrow the lost bone by use of certain bone
substitutes called Bone grafts. Such cases
provide the ideal outcome of therapy by
regenerating the lost tissues.
Gum Recession
Another commonly encountered problem with
respect to gums is the recession of gum margins.
The etiology of the condition is related to
faulty tooth brushing technique or the use of
hard-bristle brush. The significance of the
condition to the patient lies in the fact that
the exposed root surfaces left by the receding
gums are sensitive to hot and cold and that the
exposed root surfaces are prone to decay. Also,
receded gums can make your teeth look
unnaturally long robbing you of your beautiful
smile.
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Treatment of gingival recession:
The treatment of gingival recession involves
coverage of the exposed root surface. This is
achieved either by
1.) pulling the gum margin coronally
2.) by covering the recessed area by a
transplanted tissue. The tissue may be derived
either from one's own body (palate) or some
commercially available substitutes (alloderm)
may be used. In the past this procedure required
that a piece of tissue be harvested from the
roof of your mouth to serve as the graft
material. Unfortunately, not everyone has enough
tissue available or wants to have tissue taken
from this sensitive area. Now, however, you have
a choice: AlloDerm. Every patient is different
and patient results may vary. Only a trained
clinician can determine the best treatment plan
for you.
What is AlloDerm ?
AlloDerm is donated human tissue that has been
processed to remove all cells,leaving behind a
regenerative collagen matrix. The matrix is
preserved with a patented freeze-drying process.
How safe is AlloDerm?
The donor tissue undergoes the same stringent
screening criteria as any other implantable
tissue or organ (heart, lungs &kidneys,etc.).
AlloDerm is a processed tissue that comes from
donors who are extensively screened and tested
for presence of diseases including HIV and
hepatitis Since its introduction in 1994,there
have been more than 750,000 AlloDerm grafts
placed with no incidence of disease
transmission.
Why choose AlloDerm for my procedure?
1.AlloDerm allows you to receive the necessary
grafting treatment without the concern and
discomfort associated with palatal tissue
harvesting.
2.Alloderm is available in unlimited quantities
allowing treatment of all necessary areas in
fewer visits than would be possible with palatal
harvesting.
3.AlloDerm results are equivalent to those with
palatal tissue.
How does AlloDerm work?
AlloDerm repairs damaged tissue by providing a
foundation for new tissue regeneration. The
components preserved in AlloDerm contain the
information that will help your own tissue to
grow into the graft after placement. Soon after
placement, blood flows from your tissue into the
AlloDerm. Next, your own cells move into
AlloDerm and begin the process of tissue
regeneration. This is the way your body replaces
cells during its regular maintenance cycle.
As the healing progresses, more of your cells
move into the AlloDerm and transform it into
tissue that looks and functions naturally.
What happens after the healing process?
Over time, AlloDerm allows regrowth of your own
healthy gum tissue. Once recovery is complete,
you won ’t be able to tell the AlloDerm was ever
there. |
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Splinting- Managing mobile teeth
Splinting refers to "the joining of two or more
teeth into a rigid unit by means of fixed or
removable restorations or devices.” The overall
objective is to create an environment where
tooth movement can be limited within physiologic
limits with simultaneous restoration of function
and patient comfort.
The splint may be indicated because of
individual tooth mobility or mobility of the
entire dentition. Splinting may be a way to gain
stability, reduce or eliminate the mobility, and
relieve the pain and discomfort. Splints may be
classified as provisional and definitive. The
type of splint depends on the intended goal of
therapy.
Temporary splints may be worn for less than 6
months and may not be followed by additional
splint therapy. They provide an insight into
whether or not stabilization of the teeth
provides any benefit before any irreversible
definitive treatment is even initiated. These
splints typically are fabricated using thin
stainless steel wires, and tooth colored
composite resin restorative materials. The
splint can also be reinforced in several ways
using one of the following materials: ligature
wire, glass fiber, or a |
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polyethylene fiber reinforced polymer( Ribbond Fiber). When
anterior teeth require splinting, tooth colored
restorative resin reinforced with polyethylene
fiber is the material of choice. Such an interim
restoration not only can improve esthetics, it
can restore the occlusal scheme to be
incorporated into any definitive prostheses.
Only after the interim restoration has been worn
by the patient can the design and occlusal form
of the final prosthesis be evaluated and
incorporated. in the definitive restoration. In
patients with a history of bruxism and
clenching, special occlusal splints are
recommended to help stabilize teeth following
selective occlusal adjustment.
Permanent splints maintain long term stability
of the dentition. Definitive splints are placed
only after stability has been achieved in order
to increase functional stability, and improve
esthetics on a long-term basis. Such treatment
includes conventional fixed prostheses (Dental
Bridges) because they provide definitive
rigidity and are better able to control and
direct occlusal forces than removable splints.
However, the mere presence of tooth mobility
does not justify the need to splint teeth.
Splinting is best viewed as a preventive
treatment measure for teeth that have minimal or
no bone loss, yet are clinically mobile.
Therefore before treatment is started, the cause
of any mobility must be identified. Extraction
is an appropriate treatment for extremely mobile
teeth. |
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