Catarrhal gingivit – the disease of a parodont which is characterized by a serous (catarrhal) inflammation of a gum. Local changes at a catarrhal gingivit include hypostasis, hyperaemia (or a tsianotichnost) a mucous membrane of a gum, morbidity and bleeding of desnevy edge, existence of tooth deposits, unpleasant smack in oral cavities. In diagnostics of a catarrhal gingivit clinical examination, definition of dental indexes, a radiological research is used. Treatment of a catarrhal gingivit can be local (removal of tooth deposits, parodontalny applications and bandages, physical therapy, massage) and the general (reception of the anti-inflammatory, desensibilizing, vitamin medicines).
Catarrhal gingivit – the gum inflammation mentioning surface fabrics of a parodont and proceeding without damage of a zubodesnevy attachment. In stomatology distinguish the following kliniko-morphological forms of a gingivit: catarrhal, erosive and ulcer, hypertrophic, plazmotsitarny, deskvamativny, granulematozny and atrophic. In structure of inflammatory damages of gums catarrhal gingivit meets most often – in 90% of cases. Usually catarrhal gingivit it is diagnosed for children and persons of young age (up to 30 years). Men are subject to development of a catarrhal gingivit more often than women.
Reasons of a catarrhal gingivit
Catarrhal gingivit arises under the influence of local and system factors. Catarrhal gingivit at children it can be connected with process of a teething; in this case after an exit from a tooth crown gum the inflammation abates.
As the local factors promoting development of a catarrhal gingivit tooth injuries (a crown change, tooth dislocation, etc.), prisheechny caries, the wrong bite, anomalies of teeth (an allotopia, density) and soft tissues of a mouth (a short bridle of lips, a small threshold) can serve; unsatisfactory care of teeth, scale, defects of statement of seals, dentures, esthetic vinir or orthodontic devices etc.
In an etiology of a catarrhal gingivit the large role is played by the general factors causing the increased susceptibility of some people to inflammatory diseases of a parodont. Among them such physiological periods of life as pubertatny age, pregnancy, menopause; addictions (smoking); diseases (diabetes, stomach ulcer of a stomach, chronic hepatitis, hypo - and , leukemia, HIV infection, etc.); viral infections (flu, SARS); hypo - and avitaminosis (a scurvy, a pellagra); reception of medicines (tsitostatik, immunodepressants, oral hormonal contraceptives).
Now existence of a dental plaque (a microbic plaque, or a biofilm) is considered the conventional trigger of development of a catarrhal gingivit. Also anaerobic microorganisms (fuzobakteriya, prevotella, porfiromonada, treponema, etc.) with prevalence of the last are a part of a microbic plaque aerobic (staphylococcus, streptococci, actinomycetes). The damaging potential of microbic congestions in many respects depends on a condition of protective forces of an organism and the immune status. Thus, as the main provocative moments in development of a catarrhal gingivit unsatisfactory hygiene of an oral cavity and violation of the general homeostasis of an organism act.
Classification of a catarrhal gingivit
Depending on character of a current catarrhal gingivit happens sharp and chronic. On degree of prevalence of an inflammation catarrhal gingivit can have localized (in 1-3 teeth) or generalized, diffusion (in one or both jaws) a form.
Taking into account weight of defeat in a parodontologiya distinguish 3 degrees of a catarrhal gingivit:
- easy – with inflammatory defeat of zubodesnevy nipples
- average – with an inflammation of interdental and free desnevy area (a marginal part of a gum)
- heavy – with involvement in inflammatory process of all gum, including its alveolar part.
Symptoms of a catarrhal gingivit
At a sharp catarrhal gingivit hyperaemia, puffiness of a gum in several or all teeth is defined. Bleeding of gums which expressiveness depends on intensity of an inflammation is characteristic. Burning and pain in affected areas is noted. Pain and bleeding of a mucous gum amplify during meal, a palpation, toothbrushing, sounding. With rare exception, the general state at a catarrhal gingivit usually is not broken. At a heavy current of a catarrhal gingivit there can be a hyperthermia, muscular pains, a general malaise.
At a chronic form of a catarrhal gingivit the gum gets tsianotichny coloring (stagnant hyperaemia), a valikoobrazny thickening. Bleeding arises at the slightest trauma. The feeling of a raspiraniye in a gum, constant smack of blood is noted, it is frequent - an unpleasant smell from a mouth. In the period of an aggravation the present complaints amplify.
At survey change of color and a relief of a gum comes to light: it becomes bright red and friable; desnevy the edge loses the festonchatost; interdental nipples get a dome-shaped form; sometimes sites of a deskvamation mucous and single erosion are defined. Existence of the increased maintenance of not mineralized dental plaque or a scale is typical. Pathological zubodesnevy pockets at a catarrhal gingivit are absent; teeth keep stability and an immovability.
Diagnostics of a catarrhal gingivit
Catarrhal gingivit is diagnosed during survey of an oral cavity by the qualified stomatologist or parodontology on the basis of the listed above clinical signs and subjective feelings corrected taking into account objective and tool data.
For the purpose of assessment of the local status at a catarrhal gingivit dental indexes - the semi-quantitative indices reflecting a condition of an oral cavity are used: the Silnesa-Loe index or Green Vermilion (for determination of quantity of a microbic raid in prisheechny area), a papillary and marginal and alveolar index (Schiller-Pisarev's test for assessment of intensity of an inflammation), probe test (for assessment of degree of bleeding of gums), etc.
At a catarrhal gingivit these reoparodontografiya, vital microscopy, a Doppler floumetriya allowing to estimate microcirculation in fabrics of a parodont can be of a certain interest. According to indications the analysis of qualitative and quantitative composition of desnevy liquid, a biopsy and a morphological research of tissues of gum is carried out.
At a panoramic X-ray analysis and an orthopan-tomography at patients do not decide on a catarrhal gingivit of change in an alveolar bone; in rare instances, at a long current of a chronic gingivit, osteoporosis or a resorption of a compact plate of interdental partitions can come to light. Chronic catarrhal gingivit it is necessary to distinguish from an edematous form of a hypertrophic gingivit, a periodontal disease of easy degree, intra oral manifestations of various dermatosis - red flat depriving, a vulgar puzyrchatka, etc.
Treatment of a catarrhal gingivit
Therapeutic actions at a sharp and chronic catarrhal gingivit begin with elimination of the local factors supporting an inflammation. Under local anesthesia atraumatic removal of tooth deposits (removal of a scale, ultrasonic toothbrushing, removal of a raid the device "Air-flow"), treatment of caries, replacement of seals, reprosthetics, plasticity of bridles, etc. is made. Sometimes already these measures appear enough for knocking over of the inflammatory phenomena.
In other cases local and general medicamentous therapy is connected to treatment of a catarrhal gingivit. Local procedures can include parodontologichesky applications, processing mucous and rinsings of an oral cavity solutions of anti-septic tanks (Furacilin, hlorgeksidiny, miramistiny) and broths of officinal herbs, imposing of mazevy medical bandages on gums, etc. At preservation of signs of a catarrhal gingivit nonsteroid anti-inflammatory medicines, polyvitamins, physical therapy (an electrophoresis, a darsonvalization, , UVCh, hydrotherapy), massage of gums (a hydromassage, vacuum massage, vibromassage, self-massage) are appointed.
If development of a catarrhal gingivit is connected with the general diseases, then profile experts are involved in treatment: endocrinologists, hematologists, gastroenterologists, etc.
Forecast and prevention of a catarrhal gingivit
In general at the correct therapy of a sharp catarrhal gingivit the forecast favorable. As possible complications can serve transition of a catarrhal gingivit to a chronic form or ulcer and necrotic gingivit, development of a periodontal disease.
In the preventive purposes stomatologists-hygienists need to train patients in the correct toothbrushing, to give professional help in selection of individual means of hygiene (the toothbrushes, irrigators, floss, pastes and mouthwashes containing medical additives), to make recommendations about the mode and character of food. Patients should not neglect periodic professional hygiene of an oral cavity.