TREATMENT CONSIDERATIONS FOR AGGRESSIVE PERIODONTITIS
1. Screening for aggressive periodontitis
. A small but significant proportion of children and young adults are considered to be affected by aggressive periodontitis
. Early diagnosis is important, given the severity and progression aggressive periodontitis
A. screening adolescents and adults
1. Periodontal probing is the most accurate method of screening for detection of loss of investments currently available. Measurement attachment sensing is screening method of choice for adolescents and adults.
2. If aggressive periodontitis is suspected, the patient should be updated and revised to eliminate the possibility of systemic factors. Periodontal disease as a manifestation of systemic disease-a disease Category that is used when the system state is the major predisposing factor for periodontal disease.
B. screening of primary and mixed dentition
1. The measurement of loss of investment in milk teeth or partially erupted teeth can be difficult.
Measure the distance between the FAC and the alveolar bone
comb on bitewing radiographs is a useful screening approach with children (Fig. 16-8). Bitewing radiographs regularly accepts children caries screening and these x-rays should also be examined for the presence of limiting the loss of alveolar bone.
3. "Normal" distance between the FAC and the alveolar bone crest evaluated the results of the latest research [4,5].
a. The median distance between the FAC and the alveolar ridge primary molars in the 7 - to 9-year-old children is 0,8-1,4 mm
B. FAC permanent molars from 0 to 0.5 mm coronal to alveolar crest, 7 - 9 years.
c. Large distances between the FAC and the alveolar ridge is visible on sites with caries, restorations, or to open contacts. These conditions may contribute to localized bone loss in children in a similar manner as adults, and are not indicative of aggressive periodontitis.
d. Distance 2 mm between the FAC and the alveolar ridge, in the absence of domestic factors, you should call the doctor suspected of periodontitis. If the measurement exceeds this value, periodontal disease must be suspected and comprehensive screening should be performed.
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2. Initial therapy for aggressive periodontitis. Methods of treatment aggressive periodontitis are similar to those used for chronic periodontitis.
And because of the potential genetic links in aggressive periodontitis, evaluation and consulting other members of the family are specified.
B. the plan should include care
1. Smoking cessation counseling should be offered to patients who smoke
2. Customer-specific training, support, and evaluation of the patient plaque biofilm control skills
3. Periodontal instruments teeth surface, in combination with antibacterial therapy
4. Removal or control of the local inflammatory factors
5. Surgical wounds of soft tissues
C. to be examined and revaluation of initial therapy, the results should be made after the approval of the time interval for the resolution of inflammation and tissue repair.
3. The Goals Of Treatment. Periodontitis is controlled, if further attachment loss can be prevented-that is, no additional defeat of parodontium affections and alveolar bone. Control loss of investment may not be possible in aggressive periodontitis. In such cases it is reasonable treatment goal is to slow the progression of the disease.
A. Desired outcome of periodontal therapy in patients with aggressive periodontitis
1. A significant decrease inflammation of the gums
2. Reduction of plaque biofilm to a level compatible with periodontal health
3. Prevent further loss, affection and support of the alveolar bone
B. the best long-term results will be achieved when there is a good observation of self-help and periodontal maintenance (recall that the meeting) at appropriate intervals.
C. disease sites that do not meet successful treatment can occur and are characterized by
2. The increase in loss of investment
3. Plaque biofilm levels that are not compatible with gingival health
4. Increase of mobility of the teeth.