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Periodontics

Periodontal disease, known colloquially as periodontitis, is a protracted bacterial disease, thus the basic condition for the success of periodontic treatment is control of the bacterial factors responsible for the destruction of periodontic tissue. The first symptom of the initial stages of the disease is usually bleeding from the gums while the teeth are being brushed. A later symptom is the appearance of the surface of the roots of teeth, which become visible as a result of the destruction of periodontal tissue in an inflammatory process, which gradually leads to increasing mobility of the teeth.

Treatment of periodontal disease consists in the elimination of tartar above and below the gums (using ultrasound or manual tools), the smoothing of the surface of the roots, antibiotic therapies, and the use of substances that work on a local area, such as mouthwashes containing chlorhexidine. These conventional methods used to treat periodontal disease do not, however, guarantee complete elimination of the bacteria that are to be found not only on the surface of the teeth, but can also occur in the mucous membrane of the periodontal pockets, and in the attached tissue. These areas are inaccessible to traditional periodontal instruments. The above limitations, linked to an ever-improving understanding of the mechanisms of periodontal disease suggest that it is better to abandon the purely mechanical approach and seek out alternative methods of combating bacterial factors. Alongside antibiotics and antiseptic substances in the form of mouthwashes (for example made of chlorhexidine), we also use an Er:YAG laser. The laser beam causes the detoxification of the gums and the liquidation of surface bacteria. The bacteria are destroyed by thermal effects and the cavitation effect. Low-energy biostimulatory lasers also aid the treatment of periodontal disease by stimulating cell metabolism and raising the regenerative potential of tissue, as has been proved by numerous analyses and clinical observations. The effect of low-energy lasers is to induce a process of fibroblast proliferation. Another instrument that helps us to combat bacteria in the deep pockets of the gums is the ozone generator: ozone is an allotropic variety of oxygen, which shows a very high success rate against bacteria (it kills 99.9% of bacteria).

The methods described allow us to limit the infected area and stop the spread of the disease, but they do not lead to reconstruction of the destroyed tissue. The loss of bone tissue that arises is usually an indicator of the need for secondary reconstruction using the patient’s own tissue or synthetic biomaterials. The fate of every transplant is similar. Gradual resorption and replacement with the receiving tissue occurs, which leads to a liberation of the factors inducing osteogenesis (the creation of bones). Finally, new bone tissue forms, which is based on the modified surfaces of the transplant. The process of modification of bone transplants is a gradual one, taking place over months or even years.