🌹‏إِنَّ رَبِّي لَسَمِيعُ الدُّعَاءِ🌹

#periodontic #Aggressive_periodontitis

#periodontic #Aggressive_periodontitis

asonic debridement, but the difference does not appear to have any clinical significance. ✅The combination of using both the ultrasonic machine and manual scaling can greatly benefit the patient, but not all the patient's are candidate for both. ✅The ultrasonic scaler should produce effective and less abrasive results than a hand scaler depending on opporator skill as well as the selection of ultrasonic scaler tip. 🌟In brief, ultrasonic scaling has more adventages as : 🍁It is as effective as manual instruments for calculus removal in shallow gum pockets and significantly more effective in pockets greater than 4mm. 🍁They are very effective in disrupting biofilm from root surfaces and from within periodontal pockets making them especially helpful when patients require frequent maintenance (cleanings). 🍁Specially designed tips can penetrate deeper into periodontal pockets than manual instruments and are more effective at cleaning difficult nooks and crannies like furcations, (areas where roots join each other in multi-rooted teeth). 🍁When used correctly they are kinder to tooth structure, which is especially important with repeated cleanings (when used correctly). 🍁Coolant sprays provide irrigation (flushing of the area), which improves healing by removing bacteria and their bi-products as well as the hygienist's ability to see when scaling. 🍁They require less time than manual instruments for the same job. 🍁Their smaller tips cause less tissue distention and require very little pressure — thus making it more comfortable for the patient.

#periodontic #manual_vis_ultrasonic 🌟First of all, there are two main techniques for removing plaque and tartar from teeth : manual and ultrasonic. 🌸MANUAL VIS ULTRASONIC: ✅A manual cleaning is done using hand instruments . ✅An ultrasonic cleaning means that the dentist is using a special instrument that vibrates at a very high frequency to remove the plaque and tartar. The ultrasonic instrument also sprays a stream of water toward teeth. ✅The same effectiveness of calculus removal with manual scaling and power scaling : 🍂Although ultrasonic scaling does not allow for the same tactile sense as does manual scaling, it is still efficient at removing calculus in a timely manor 🍂 ✅Although there may be no significant difference or evidence when using ultrasonic and manual scaling, the use of the ultrasonic may help expedite treatment time, comfort, and less operator fatique ✅Power scaling has more advantages than hand instrumatation alone with better access to root variations,pocket depth, irrigating abilities, and the reduction of over scaling root surface and cementum : 🍂 the hand scaling removing more healthy cementum than power scaling🍂 ✅Manual root planing does attain a smoother root surface at the microscopic level than does ultrasonic debridement, but the difference does not appear to have any clinical significance. ✅The combination of using both the ultrasonic machine and manual scaling can greatly benefit the patient, but not all the patient's are candidate for both. ✅The ultrasonic scaler should produce effective and less abrasive results than a hand scaler depending on opporator skill as well as the selection of ultrasonic scaler tip. 🌟In brief, ultrasonic scaling has more adventages as : 🍁It is as effective as manual instruments for calculus removal in shallow gum pockets and significantly more effective in pockets greater than 4mm. 🍁They are very effective in disrupting biofilm from root surfaces and from within periodontal pockets making them especially helpful when patients require frequent maintenance (cleanings). 🍁Specially designed tips can penetrate deeper into periodontal pockets than manual instruments and are more effective at cleaning difficult nooks and crannies like furcations, (areas where roots join each other in multi-rooted teeth). 🍁When used correctly they are kinder to tooth structure, which is especially important with repeated cleanings (when used correctly). 🍁Coolant sprays provide irrigation (flushing of the area), which improves healing by removing bacteria and their bi-products as well as the hygienist's ability to see when scaling. 🍁They require less time than manual instruments for the same job. 🍁Their smaller tips cause less tissue distention and require very little pressure — thus making it more comfortable for the patient. 🌟First of all, there are two main techniques for removing plaque and tartar from teeth : manual and ultrasonic. 🌸MANUAL VIS ULTRASONIC: ✅A manual cleaning is done using hand instruments . ✅An ultrasonic cleaning means that the dentist is using a special instrument that vibrates at a very high frequency to remove the plaque and tartar. The ultrasonic instrument also sprays a stream of water toward teeth. ✅The same effectiveness of calculus removal with manual scaling and power scaling : 🍂Although ultrasonic scaling does not allow for the same tactile sense as does manual scaling, it is still efficient at removing calculus in a timely manor 🍂 ✅Although there may be no significant difference or evidence when using ultrasonic and manual scaling, the use of the ultrasonic may help expedite treatment time, comfort, and less operator fatique ✅Power scaling has more advantages than hand instrumatation alone with better access to root variations,pocket depth, irrigating abilities, and the reduction of over scaling root surface and cementum : 🍂 the hand scaling removing more healthy cementum than power scaling🍂 ✅Manual root planing does attain a smoother root surface at the microscopic level than does ultr

(Gingival over growth GOG) ✳️Gingival over-growth is due to may causes, one of the causes is 👇 🚫MEDICATION🚫 💊1- phenytion, a seizure medication, cause GOG of 50% of patients 💊2- syclosporine, used to prevent transplantation rejection, cause GOG of 25-80% of patients. 💊3- blood pressure medication called calcium channel blocker. ⛔️ MANAGMENT⛔️ 1- plaque control: 👉 improve oral hygiene 👉professional cleaning of teeth 👉periodontal surgery to remove excess tissue. 2- change or reduce to anther druge when the enlargment cover more than about third of tooth surface, 👉may bring partial or complete regression of the lesion.

#periodontic #gingval_over_growth

#periodontic #gingval_over_growth

#periodontic #Chronic_periodontitis Treatment

#periodontic #Chronic_periodontitis #Treatment ✅Scaling and root planning combined with personal plaque control (ppc) in the treatment of chronic periodontitis have been validated. These include ✅ reduction of clinical infammation, ✅microbial shifts to a less pathogenic subgingival fora, ✅ decreased probing depth, ✅gain of clinical attachment, ✅less disease progression. 🤖Re evaluation 🤖 🔘several weeks after scaling and root planning and ppc: ✖️ if there's no adequate ppc 👇👇👇👇👇👇 Additional instruction using topical chemotherapeutics (local drug delivary device) 🤖Re evaluation 🤖 🔘several weeks after scaling and root planning and ppc: ✖️ if there is no response to treatment because of 🔸systemic disease🔸 👇👇👇👇👇👇 Control of systemic factors is necessary 🤖Re evaluation 🤖 🔘several weeks after scaling and root planning and ppc: ✖️ if there is no response to treatment because of 🔸anatomical factors🔸 (Furcation ) 👇👇👇👇👇👇 Surgery is required 💊pharmacological therapy 💊Systemic drug delivery 💊Local drug delivary Chlorhexidine, tetracyclines, metronidazole, clindamycin, and ofloxacin are among the antimicrobials that have been used in the formulation of local delivery devices for the treatment of periodontitis 🚨Systemic drug delivery🚨 Indicated when: 🚥Acute infection 🚥patient with multiple sites not responed to scaling and root planning 🚥Medically compromised patient 🚥Presence of tissue invasive organism 🚥Ongoing disease progression

#periodontic #Chronic_periodontitis TREATMENT

#periodontic #Chronic_periodontitis ☢Treatment Terapeutic approaches for periodontitis fall into two major categories: 1) anti-infective treatment, which is designed to halt the progression of periodontal attachment loss by removing etiologic factors 2) regenerative therapy, which includes anti-infective treatment and is intended to restore structures destroyed by disease.

#periodontic Risk of sever periodontitis

#periodontic #Chronic_periodontitis 🌺Monitoring: The results of X-rays, clinical assessment, and assessment of pocket depth can all be marked on an updatable periodontal chart to monitor progress with rx. It is widely accepted that disease active and inactive pockets exist. 📶Progression is episodic and more likely in susceptible patients. 😐Bleeding on probing has traditionally been the most useful indicator of disease activity; however, 🔴only 30% of sites which bleed will go on to lose attachment. Absence of bleeding on probing is an indicator of periodontal stability.😃

#periodontic #Chronic_periodontitis

#periodontic Chronic periodontitis 🍂is common disease of oral cavity consist of chronic inflammation of periodental tissues 🍂 #periodontic #Chronic_periodontitis 🔴Clinical signs may include 👉👉 🔺gingival inflammation ▫️ bleeding, ▪️pocketing, ▫️gingival recession, ▪️tooth mobility, ▫️tooth migration, ▪️discomfort, ▫️ halitosis . 😐Affects gingiva, PDL, cementum, and alveolar bone... #periodontic #Chronic_periodontitis 👀At earlier stages usually very little in the way of obvious signs or symptoms therefore 👌 probing is essential. 👌 🚫It can be regarded as a progression of the combination of 💢 infection and 💢inflammation of gingivitis into the deep tissues of the periodontal membrane. #periodontic #Chronic_periodontitis All periodontitis develops out of gingivitis 🙂 but not all gingivitis progresses to periodontitis.🙃 #periodontic #Chronic_periodontitis 👲Some people with poor OH (oral hygeine ) ↗️may develop gingivitis but not periodontitis.🙂 👳 Some people with good OH and little in the way of gingivitis may develop periodontitis.😥 ♻️The proportion of sites that do progress in a subject or population is not known and the factors leading to progression are not well understood.😓😓 Periodontitis is classifed as🔴 localized when <30% of sites are afected . Destruction is localized to first molars / incisors as 🔵generalized when >30% of sites are afected. Generalized interproximal attachment loss . #periodontic #Chronic_periodontitis ⛔️Severity of disease is classifed as follows: 🎲Mild:  1–2mm of clinical attachment loss. 🎲Moderate:  3–4mm of clinical attachment loss. 🎲Severe:  ≥5mm of clinical attachment loss. 🐚Periodontal pocketing🐚 Periodontal pockets can be divided: 👿• False pockets are due to gingival enlargement with the pocket epithelium at or above the amelocemental junction. 😈• True pockets imply apical migration of the junctional epithelium beyond the amelocemental junction 😈True pocket can be divided into: ⏫ suprabony and ⏬intrabony pockets. ⏬ Intrabony are described according to the number of bony walls: 3⃣Three-walled defect is the most favourable, as it is surrounded on three sides by cancellous bone and on one side by the cementum of the root surface. 2⃣Two-walled defect may be either 🌋a crater between teeth having bone on two walls and cementum on the other two, or have two bony walls, the root cementum, and an open aspect to the overlying soft tissues. 1⃣ One-walled defects may be hemiseptal through-and-through defects, or one bony wall, two root cementum, and one soft tissue. ✍Probing pocket depths are measured from 👉the gingival margin to the 👉estimated base of the pocket 📶Clinical attachment levels (CAL) are measured from a fxed reference point:✅  🌀the cement–enamel junction or 🌀margin of a restoration to ➿the base of the pocket. *⃣Pockets are therefore dependent on the position of the gingival margin. ⚠️ If recession is present: CAL = recession + periodontal probing depth. 🚨Mobility assessed using instrument handles: ☝️• Grade I:  <1mm horizontal mobility. ✌️• Grade II:↔️  >1mm horizontal mobility. No vertical displacement possible. 👌• Grade III: ↕️ vertical displacement of tooth in its socket is possible. 😎Diagnosis Periodontitis is diagnosed if there is : ⚡️CAL ⚡️bleeding on probing from base of pockets. ✍A note should be made as to which type of periodontitis,🕵 it is localized or generalized, 🕵 mild, moderate, or severe, 🕵 the presence of any risk factors.🕵

#periodontic #Chronic_periodontitis

#periodontic #Classifcation 1⃣Gingival diseases : 👽A Plaque-induced Gingivitis. 💠 associated with plaque only 🔺a. Without local contributing factors. 🔻b. With other local contributing factors. 💠Gingival disease modifed by systemic factors 🔺a. Endocrine system:  puberty-associated gingivitis, menstrual cycle-associated gingivitis, pregnancy-associated gingivitis, pyogenic granuloma, diabetes mellitus-associated gingivitis. 🔻b. Gingivitis associated with blood dyscrasias, e.g. leukaemia-associated gingivitis. 💠. Gingivitis modifed by medications These would include 🔺 drug-influenced gingival enlargement and 🔻drug-induced gingivitis, e.g. oral contraceptive- associated gingivitis and drug-induced gingival overgrowth due to phenytoin or ciclosporin. 💠. Gingival disease modifed by malnutrition These would include: 🔺 ascorbic acid-defciency gingivitis (scurvy) and 🔻gingivitis due to protein defciency. 1⃣Gingival disease: 👽 Non-plaque-induced  💠gingival lesions of 🔹specifc bacterial, 🔹 viral , 🔹 fungal origin (e.g. primary herpetic gingivostomatitis E herpes simplex. 🔹 lesions of genetic origin (e.g. hereditary gingival fbromatosis), 🔹 🔹gingival manifestations of systemic conditions (mucocutaneous disorders, allergic reactions), 🔹traumatic lesions and foreign body reactions. 2⃣ Chronic periodontitis: ♦️Localized 🔷Generalized 3⃣ Aggressive periodontitis: ♦️ Localized 🔷Generalized 4⃣Periodontitis as a manifestation of systemic disease 5⃣Necrotizing periodontal diseases. 🔷 Necrotizing ulcerative gingivitis (NUG) 🔶Necrotizing ulcerative periodontitis (NUP) 6⃣Abscesses of the periodontium 7⃣Periodontitis associated with endodontic lesions. 8⃣ Developmental or acquired deformities and conditions.

#periodontic #Classifcation Classifcation of Periodontal Diseases and Conditions

#Perio لا تظهر أي أعراض في بداية التهاب اللثة ولكن في الحالة المتقدّمة من الالتهاب قد تظهر بعض الأعراض مثل: *نزول الدّم من اللثة عند تنظيف الأسنان بالفرشاة و المعجون *وأحياناً قد تنزف اللثة دون سبب *حدوث التورّم والانتفاخ في اللثة. * تغيّر لون اللثة إلى الأحمر القاني. *خروج الروائح الكريهة من الفم بسبب الالتهاب. * تراجع حدود اللثة وظهور مناطق أكبر من الأسنان. *البدء بسقوط الأسنان. *ظهور الفراغات بين الأسنان.

التهاب اللثة Gingivitis --------------------------- التهاب اللّثّة: هو مرض من أمراض اللّثّة أين يكون سبب الالتهابات تكوّن بيوفيلمات بكتيريّة، معروفةباللّويحات السّنّيّة، على سطح الأسنان. تعتبر اللويحة الجرثومية (البلاك) المسبب الرئيسي لأمراض اللثة ولهذا السبب يجب إزالة التراكمات القلحية بشكل مستمر حيث أنها تعتبر مكاناً مناسباً لنمو وتثبيت الجراثيم. ◾التصنيف: ◀التهاب اللثة الحاد ◀التهاب الثة المزمن ◀انحسار اللثة ◾العلامات والأعراض: إن أعراض التهاب اللثة هي إلى حد ما غير واضحة وتظهر في أنسجة اللثة كعلامات الالتهاب الكلاسيكية: ◀تورّم اللثةلثة حمراء أو بنفسجية اللونلثة طرية أو مؤلمة عند اللمسنزيف اللثة أو النزف بعد تنظيف الأسنان بالفرشاة ◀بالإضافة إلى ذلك فإن التنقير الذي يوجد عادةً على أنسجة اللثة عند بعض الأفراد غالباً ما يختفي وقد تبدو اللثة ناعمة عندما تصبح أنسجتها منتفخة وتمتدّ فوق الأنسجة الضامة الملتهبة. هذا التراكم قد يسبّب رائحة كريهة في الفم. -يتحول لون اللثة عند التهابها إلى اللون الأحمر اللامع المحتقن وكلما زاد الالتهاب تغير اللون إلى الأحمر القاني ثم المشرب بالأزرق ثم الأزرق الغامق وأحياناً يتغير اللون في بعض الأمراض مثل فقر الدم حيث يصبح باهتاً وفي مرض السكري تكون متورمة وحمراء. ◀من أهم علامات التهاب اللثة تورمها ونزفها خصوصاً عند التنظيف بالفرشاة. ◀وجود رائحة كريهة غير مستحبة عند التنفس (بخر الفم). ◀وجود تقيحات وصديد على اللثة. ◀قد يتطور التهاب اللثة من التهاب الحواف البسيط إلى التهاب يصيب الأنسجة الداعمة ويؤدي إلى تأكل العظم. ◀التهاب الأنسجة الداعمة قد يؤدي إلى تراجع اللثة وتعري الجذور مما يسبب ازدياد حساسية الأسنان. ◀قد يصل تأكل العظم إلى مرحلة متقدمة تفقد معها الأسنان ثباتها داخل عظام الفك وتتخلخل. ◾الأسباب: ◀ترك الاسنان دون الاهتمام بنظافتها لفترة طويله مما أدى إلى تكون البلاك وبكثره السبب الرئيسي هو تراكم اللويحة الجرثومية (البلاك) أو الجير على الأسنان واللثة. ◀إلا أن هناك عوامل أخرى تزيد من قابلية الإصابة بأمراض اللثة. 1➖ مرض السكر. 2➖ التدخين. 3➖العوامل الوراثية. 4➖ بعض أنواع الأدوية. 5➖ أمراض نقص المناعة. 6➖عدم العناية بتنظيف الفم والأسنان. ◾التشخيص: ◀انحدار اللثه " تكون اللثه نازله عن مستواها الطبيعي" بحيث يبان الجزء المخفي من السن " الجذر" الاسنان قابله للحركه ◾العلاج: العلاج إذا كان السبب من تراكم البلاك والجير: أولا◀ بتفريش الاسنان 3 مرات بمعجون أسنان ينصح بمنعجون paradontics فرشاة ناعمة سوف يكون هناك نزيف في اللثة ولكن هذا دم فاسد متحجر في اللثه ثانيا◀استخادم غسول فم cosodyl مره وحده قبل النوم استخدام الخيط السني مرة واحدة قبل النوم زيارة طبيب الأسنان لتنظيف اللثه scaling ضروري، سوف يحس المريض بالحساسية في البداية لكن مع استخدام الفرشاة والمعجون تذهب الأعراض 🔴ملاحظة: يمكن أن تكون رائحة الفم من اللسان، لذا ينصح بغسل اللسان رائحة الفم أسبابها كثيره التهاب اللوز ،أوالحنجرة ،أوالمعدة لكن أهم شيء اللثه والتسوس أما الأسباب الثانية : يجب مراجعة الطبيب للتشخيص.أحيانا يحتاج لتدخل الجراحي أو بالعلاج بالادوية