How does periodontal disease progress?
Oral keratinized epithelium but crevicular (sulcular) epithelium and paroxizmalnaya form epithelium not. In paroxizmalna form epithelium is attached to the tooth surface and the underlying connective tissue through the basement membrane and hemi-desmo-somes, and its free surface (which is peeling) forms the bottom of the gingival crevice. the crack is only about 0.5 mm in depth-as seen in the histology Department. Clinically, however, cleft depth is the distance at which a blunt probe will enter and because it will be easy to break the fragile paroxizmalnaya form epithelium, depth sounding healthy gums crack reaches about 2 mm
When plaque can build up freely, there is an acute exudative inflammatory response within 2-4 days in the connective tissue underlying the crown part paroxizmalnaya form epithelium. After 10-21 days persistent plaque accumulation, marked by destruction of collagen and dense infiltrate of chronic inflammatory cells can be observed in this zone. Clinical changes in chronic gingivitis can now be found: redness, swelling, reduced resistance to sensing, as well as an increased propensity gums bleeding on probing, or when the teeth brushed.
Bacterial deposits is not acting from under the edge of the gums in subclinical stage of development of gingivitis. The process of gingival enlargement, however, helps to create subgingival flora and, gradually, the apical promotion subgingival plaque occurs as paroxizmalnaya form epithelium separates from the tooth surface to become the?pocket the epithelium`, characterized by the formation and lateral extension rete pegs, and micro-ulceration.
How is chronic gingivitis, balance, usually installed between the increase in the mass of bacteria and its protective forces of the organism, maintain in a state of chronic gingivitis indefinitely. If and when periodontitis not face, he thought to deposition or by a proportional increase in pathogenic microorganisms in subgingival bacterial flora, human host resistance, or both in combination.
As soon as destructive process applies apical to influence the alveolar bone and fibre fixing the root surface, periodontitis said developed (Fig. 8.1c). Thus, parodontosis is characterized by loss (connective tissue) investments. Paroxizmalnaya form epithelium apical growing save epithelial barrier on the basis of deepening pocket, and without cement, contaminated by microorganisms and their products. Periodontitis is most easily detected using the probe involved in the blood or purulent exudate appear when testing on the basis of pocket for amelo-cemental junction.
Chronic gingivitis is a state, which may be cancelled by the court plaque control. On the other hand, fiber loss investments, which is the main feature of periodontitis, is practically irreversible. Destruction can occur at a linear rate, proceeding very slowly, in accordance with tooth survival, or progresses faster, leading, ultimately, the loss of teeth. The attachment loss also may occur with long-term, but in geometrical progression. In addition, progress can be episodic, acute episodes being alternated with periods of remission or repair shop. Different patterns of progression can affect the same area at different times, and long-term remission may not be uncommon. In addition, the speed of periodontal lesions may differ depending on the stage of the disease, between one surface of the teeth and between individuals...