Periodontal disease is one of the most common oral diseases and a leading cause of tooth loss. However, not all of these tissues are affected at the same time. Depending on the severity and extent of localized inflammation, periodontal disease can be categorized as gingivitis disease and periodontitis disease
Treating periodontal disease? Then you need to know something about subgingival scraping
Periodontal disease (PD) is a disease caused by a number of factors.The initial factors of PD are plaque and tartar attached to the neck of the teeth. Plaque is a biofilm on which inorganic substances such as calcium and phosphorus from saliva mineralize to form tartar. Pathogenic periodontal bacteria are firmly attached to the tooth surface through plaque and tartar. The toxic substances produced by the bacteria and their growth and metabolism first cause gum infection, and then cause the destruction of the alveolar bone, so that the teeth buried in the alveolar bone is less and less, and finally make the teeth loose or even fall off. This is the most direct harm of periodontal disease.
However, most people in China lack a correct understanding of periodontal disease, or incorrectly believe that periodontal disease can not be cured and give up the treatment, or delay the opportunity to treat, and ultimately have to pull out the affected teeth or fall off on their own. More seriously, periodontitis causes or aggravates systemic systemic diseases, causing great damage to health. Therefore, early prevention, diagnosis and treatment of periodontal disease, as well as regular review and re-treatment of periodontal disease, are important measures to effectively minimize the incidence of periodontal disease and its harmful effects on oral health and general health.
The main causative factors of periodontitis disease are calculus and plaque attached to the root surface of the teeth. Subgingival scraping is the use of a fine subgingival scraper to remove tartar and plaque from the root surfaces in periodontal pockets.
Supragingival scaling is commonly known as ? The main purpose is to clean the upper part of the gums. Ultrasonic methods are commonly used to remove supragingival calculus, as brushing does not remove calculus. The main purpose of subgingival scaling is to remove plaque and tartar from the subgingival area. This portion of tartar is hidden under the gums and is invisible to the naked eye, making it an easily overlooked treatment for periodontal patients. However, this portion of calculus is located in the periodontal pockets, which is the main causative factor that leads to periodontal disease and exacerbates symptoms. Therefore, the removal of subgingival calculus and the removal of some of the bacterially infected root tissue are important in the treatment of periodontal disease. Subgingival calculus is harder than supragingival calculus and is difficult to remove. The current common method is manual scraping by the doctor using special instruments. Scraping of subgingival calculus requires an experienced physician to operate and is technically demanding.
What are the disadvantages of current subgingival scraping methods
Currently, subgingival scraping for periodontal disease includes manual scraping, ultrasonic scraping and laser scraping. While effective, these methods still have significant weaknesses.
The key is that when these methods are implemented, the operator is blind, and the perception and localization of calculus is completely dependent on the operator's experience and feel, which can easily lead to missing subgingival calculus or excessive removal of root tissue. Studies have shown that the percentage of residual tartar is positively correlated with the depth of periodontal pockets. In periodontal pockets 4-6 mm deep, only 43% of the root area was free of tartar residue after manual scraping. However, in periodontal pockets greater than 6mm deep, the figure was only 32%.
In addition, some patients are sensitive to pain or even intolerable after treatment due to excessive removal of root tissue.
These situations not only greatly affect the treatment results, but also bring great pain to the patients.
What is periodontal endoscopic subgingival curettage
Because of the obvious weaknesses of the commonly used subgingival curettage methods, there is a clinical need for a more effective method that minimizes trauma while still achieving more thorough subgingival plaque removal and root planing. Periodontal endoscopy like technology should be born. Periodontal endoscopy consists of four parts: cold light source lens, optical fiber, image transmission system and screen display system, which is one of the most advanced auxiliary equipment in periodontal medicine at present. Its working principle is to irradiate the tissue surface with a cold light source, and then convert it into electrical signals and digital information through an image sensor. After processing, the image is immediately presented on the display.
The periodontal endoscope creates a state of indirect vision. With its help, the surgeon can immediately observe subgingival calculus during the procedure and thus accurately localize the subgingival calculus, including the location of the calculus at the root bifurcation. The application of ultrasound allows complete removal of subgingival calculus, as well as removal of infected tooth tissue from the root surface and root planing procedures.
Meanwhile, when removing infected tooth tissues from the root, it avoids the use of a manual sharp knife that tends to cause excessive removal of bone, is less likely to cause postoperative hot and cold sensitivity, and is conducive to the healing of periodontal tissues. Periodontal endoscopic subgingival curettage can replace most of the periodontal flap surgery, which can avoid the patient's fear due to periodontal surgery, postoperative bleeding infection and other complications, and greatly reduce the patient's pain. When the doctor operates, the patient can clearly see the subgingival calculus, which facilitates the communication between the doctor and the patient, improves the patient's understanding of his own disease, and helps to improve the patient's compliance with the treatment.
Subgingival scraping under periodontal endoscopy is performed under local anesthesia, with no pain or discomfort to the patient. The postoperative reaction is mild, with no significant swelling, bleeding, or pain in the gums. Antibiotics should be taken for three days after the procedure.
Periodontal treatment needs to be repeated several times. Self-oral care and maintenance treatment is very important and needs to be carried out throughout life. Otherwise periodontal disease can easily recur, resulting in the loss of efficacy of earlier treatments.
The treatment program and outcome is different for each individual due to the individuality of the patient. Following your doctor's instructions will yield the best treatment results.