Diseases of gums – group of the diseases which are characterized by defeat of tissues of gum. Patients complain of hyperaemia, puffiness of gums, bleeding during cleaning. At a hypertrophic gingivit there is a giperplaziya of desnevy edge. In case of ulcer and necrotic diseases of gums reveal the sites of defeat covered with a gray-green raid. Interproksimalny nipples gape. Diagnosis of diseases of gums comes down to collecting complaints, drawing up the anamnesis of a disease, carrying out clinical and radiological researches. Treatment includes sanitation of an oral cavity, elimination of the local irritating factors, increase in local and general resistance of an organism.
Diseases of gums
Diseases of gums – an inflammation of desnevy edge infectious (bacterial, virus, kandidozny) or a traumatic origin, proceeding without violation of integrity of a zuboepitelialny attachment. The expressed gain of an indicator of prevalence of diseases of gums falls on the puberty period that is connected with change of a hormonal background at teenagers. Researches showed that after 60 years the frequency of diagnosing of a gingivit reaches 100%. Diseases of gums meet at males more often that is explained by the unsatisfactory level of hygiene, existence of addictions. In the predictive relation at in due time begun complex treatment of diseases of gums it is possible to stop completely an inflammation, to prevent involvement in pathological process of fabrics of a parodont.
Reasons of diseases of gums
Firm and soft tooth deposits are the main local reasons for diseases of gums. Owing to toxic impact on tissues of a gum of waste products of the microorganisms which are a part of a tooth plaque the catarrhal form of a gingivit develops. Also diseases of gums of virus, mikotichesky, bacterial (fuzospirokhetozny) genesis meet. Mechanical, thermal and chemical irritants are capable to provoke development of an inflammation with prevalence of an ekssudativny component. Productive hyper plastic processes arise at a progesteronzavisimy gingivit. This form of diseases of gums meets mainly in the pubertatny period, during pregnancy, and also at reception of hormonal medicines.
The forced orthodontic treatment with use of high forces also causes a gum giperplaziya. Along with primary inflammation allocate the secondary (symptomatic) diseases of gums which are shown at hypovitaminosis, endocrine violations, blood diseases, pathologies of bodies of a gastrointestinal tract. Carry to the local contributing factors promoting development of a gingivit bite pathologies, density of tooth alignments. At the sharp course of diseases of gums of fabric become edematous, zones of hemorrhages appear. Around blood vessels cells of inflammatory infiltrate concentrate: lymphocytes, gistiotsita. Microscopically at a chronic gingivit maturing of granulations, replacement of collagenic fibers with rough connecting fabric is observed. Congestions of leukocytes are presented in insignificant quantity.
Classification of diseases of gums
In stomatology distinguish three groups of diseases of gums:
1. The diseases of gums provoked by pathogenic microflora of a tooth plaque. Refer also symptomatic to this category gingivit, confirming existence of background somatic pathology.
2. The diseases of gums of a traumatic or infectious etiology (caused by viruses of simple herpes, barmy mushrooms). Distinguish also gingivit a yatrogenny origin, developing at violation of the protocol of treatment of patients.
3. Ulcer and necrotic diseases of gums. Arise against the background of the reduced local and general reactivity of an organism owing to activization of the microbic association consisting of fuzobakteriya and spirokht. Guinguivit Vincent is revealed more often at men aged up to 30 years.
On localization of an inflammation distinguish defeats of interproksimalny nipples, marginal edge and an alveolar gum. On prevalence pathological process can be localized or generalized.
Symptoms of diseases of gums
At a catarrhal gingivit the gum becomes edematous, hyperemic. Quite often patients complain of bleeding at reception of rigid food or during toothbrushing. The diseases of gums proceeding with prevalence of a productive component are followed by growth of desnevy edge. The marginal gum gets a valikoobrazny form. The unpleasant smell from a mouth is noted. At ulcer and necrotic diseases of gums defeat of interdental nipples comes to light. When progressing inflammatory process the zone of a necrosis extends to a marginal part. During survey reveal a necrosis of desnevy edge. In attempt to remove a dirty-gray raid the bleeding painful surface is bared. The general state at patients with ulcer and necrotic diseases of gums worsens. The hyperthermia, a sleep disorder, lack of appetite is observed. Regionarny lymph nodes are increased.
The Deskvamativny form of a gingivit proceeds with formation of sites of a slushchivaniye of an epithelium against the background of the inflamed gum. If the herpetic infection is the reason of diseases of gums, during the incubatory period the feeling of burning of mucous appears. During the next 1-2 days on mucous there are bubbles which are very quickly opened owing to what erosion are formed. At a severe form there is a repeated podsypaniye of elements of defeat. At survey it is possible to reveal not only bubbles, but also erosion, crusts. Temperature increase, regionarny lymphadenitis is observed.
At mikotichesky diseases of gums on mucous find a whitish raid which easily is removed the pallet or a wadded ball, but during a small interval of time appears again. Patients are disturbed by an itch, burning, dryness of mucous. At mechanical damage on a gum the erosive site is formed. At influence of a thermal factor there is a deskvamation of a superficial epithelium. Rejection of tissues of gum with formation of an ulcer surface is also possible. The diseases of gums developing as a result of contact mucous with alkali proceed with formation of a zone of a kollikvatsionny necrosis. The site of defeat extends both in depth, and in width. The coagulative (dry) necrosis is observed at influence of acids.
Diagnosis of diseases of gums
Diagnosis of diseases of gums comes down to collecting complaints, drawing up the anamnesis, performing clinical examination and additional methods of a research. During fizikalny inspection at diseases of gums reveal puffiness, hyperaemia of desnevy edge. At hypertrophic gingivit dentist finds a thickening and growth of a gum. At ulcer and necrotic diseases of gums define gray-green stratifications which covered a marginal part of a gum. During removal of a raid the painful bleeding erosive surface becomes bare.
In most cases an index of hygiene of Fedorov-Volodkina at patients with diseases of gums unsatisfactory. At survey note multiple over - and poddesnevy deposits, carious defects. Schiller-Pisarev's test at diseases of gums positive. Gum tissue coloring in yellowy-brown color after putting iodinated medicines confirms development of inflammatory process. Determine defeat level by the PMA index. At an inflammation of interproksimalny nipples value of an indicator makes 25%, when involving in pathological process of marginal edge of PMA – 50%. In case of diseases of the gums which are followed by defeat of an alveolar part, value exceeds 50%. For diagnosis of a herpetic infection the virologic test, immunochemical and cytologic analyses are shown.
The Mikotichesky etiology of diseases of gums is established by a bacterioscopy method. Identification in dab of the budding cages and threads of a pseudo-mycelium confirms development of a kandidozny gingivit. Unlike a periodontal disease, at a gingivita destructive changes of a bone tissue on the roentgenogram are absent. Differentiate diseases of gums with inflammatory and dystrophic diseases of a parodont. The patient is examined by the stomatologist-therapist. At suspicion on development of a symptomatic (secondary) gingivit consultations of the therapist, the hematologist, the endocrinologist, the gastroenterologist are shown.
Treatment of diseases of gums
Treatment of diseases of gums is directed to elimination of microbic contamination, acceleration of processes of regeneration. For this purpose carry out sanitation of an oral cavity – the procedure of professional hygiene, treatment of caries and its complications. At irrational prosthetics repeated orthopedic treatment is shown. Locally at diseases of gums appoint rinsings of an oral cavity antiseptic solutions on the basis of a hlorgeksidin of a biglyukonat. Broths of officinal herbs have good anti-inflammatory activity. Treatment of ulcer and necrotic diseases of gums consists of the following stages: anesthesia, antiseptic processing, removal of nekrotizirovanny fabrics, stimulation of processes of an epitelization.
At diseases of the gums which are followed by a giperplaziya carry out a gingivektomiya. Etiotropny therapy of herpetic defeat includes use of the antiviral medicines showing activity of rather intracellular viruses. The general treatment includes the immunomodulators desensibilizing means, polyvitaminic complexes. At diseases of gums of the mikotichesky nature appoint antifungal medicines. At a gingivita of a traumatic origin rinsings of an oral cavity by antiseptic solutions, and also use of keratoplastik in the form of applications are shown. The forecast at diseases of gums favorable. At early identification and complex treatment it is possible to stop an inflammation, to prevent involvement in pathological process of fabrics of a parodont.