Periodontology

parodontologie-tratament parodontoza

Periodontology

The bacterial plaque and the scale comprise a very high quantity of high pathogenic bacteria, that will determine the start of periodontal disease.

The periodontal disease is an inflammatory disease that may be chronic or acute.

 

The trials carried-out since 1997 until present have proven that the existence of a reduced number of periodontopathogenic bacteria may trigger a deep periodontal disease.

 

The following are strongly related to the development of the periodontal disease and transmissible, with pathogenic effects at small concentrations:

 

Aa– Actinobacillus actinomycetemcomitans

Pg– Porphyromonas gingivalis

Td– Treponema denticola

Tf– Tannerella forsythia

Ec– Eikenella corrodens

Cr– Campylobacter rectus

Pi– Prevotella intermedia

Fn– Fusobacterium nucleatum

Pn– Prevotella nigrescens

Co– Capnocythophaga ochrea

Cs– Capnocythophaga sputigena

Cg– Capnocythophaga gingivalis

 

Generally, these bacteria (Aa, Pg, Td, Tf) are related to aggressive forms of periodontal disease. These bacteria are not identified in the chronic periodontal disease.

There are many strep tests based on the Polymerase chain reaction (PCR) technique and present a high species for identifying the periodontopathogenic bacteria and establishing their relative quantity. The tests are also more sensitive than the bacterial cultures, being able to identify pathogenic germens, regardless of their viability.

The periodontitis caused by Aa, Pg, Tf, Pi, Td bacteria is characterized by the occurrence of some diverse metabolic modifications, related to virulence factors determining either the destruction of the tissues that surround the periodontium, or the inactivation of the immune mechanisms.

Particularly, the highly pathogenic species such as Aa, Pg, Tf have a wide range of pathogenic factors, and their presence in the gingival bags are the potential to cause the teeth loss.

In association with the highly pathogenic species, other species, moderately pathogenic, they might trigger a pathogenic risk, depending on the concentration in which they are present.

Very strongly pathogenic:

Aa– Actinobacillus actinomycetemcomitans

Pg– Porphyromonas gingivalis

Td– Treponema denticola

Tf– Tannerella forsythia

Moderately pathogenic:

Ec– Eikenella corrodens

Cr– Campylobacter rectus

Pi– Prevotella intermedia

Fn– Fusobacterium nucleatum

Pn– Prevotella nigrescens

Low pathogenic:

Co– Capnocythophaga ochrea

Cs– Capnocythophaga sputigena

Cg– Capnocythophaga gingivalis

It is very important that the eco-system of the oral cavity be balanced. When the quantity of the bacteria increases without control, then this ecosystem is imbalanced and the risk to lose the attachment increases (periodontal bags).

In order to determine the quantity of bacteria, a test is necessary to detect these periodontopathogenic bacteria, that are involved in the periodontal disease.

This strep test consists in sampling from the periodontal bags or from the inner mucosa of cheeks and lips, of the samples.

Only this way we can identify the accurate quantity and the type of periodontal pathogens.

Following this result, the doctor can choose the adequate antibiotics and the efficient treatment plan.

Such a test is also important if the surgery of dental implants follows, because following such a strep test we can assess the implanting risk.

The patients suffering from not solved periodontal problems present the high risk of losing the implants and an implant is not recommended in this case.

This periodontal disease, when becoming chronic also has impacts on other organs: heart, kidneys and rheumatic disease may occur.