Rationale For Periodontal Treatment
Question 1. Describe healing process of periodontal therapy.
Answer. Regeneration, repair and new attachments are the aspects of healing that have a special bearing on the outcome of periodontal treatment.
“Understanding the role of rationale in periodontal care decisions”
- Regeneration: It is a biological process by which the architecture and function of lost tissues are completely restored by formation of new periodontal ligament, alveolar bone and cementum.
- Repair: It is the healing of tissues without completely restoring the lost tissues.
- New attachment: This is the reunion of connective tissue and a root surface that has been pathologically exposed.
- Reattachment: This is the reunion of connective tissue and a root surface not have been separated by incision or injury.
“Early warning signs of poor treatment goal alignment”
During healing, the area may be involved by cells from four different sources:
- Oral epithelium proliferates along the tooth surface before the cells from other tissues reach the area, the result will be long junctional epithelium.
- If cells from connective tissue populate, the result will be fibers parallel to the tooth surface and remodeling of bone and no attachment to cementum.
- If bone cells arrive first, root resorption and ankylosis may occur.
- When only cells from periodontal ligament proliferate coronally, there is new formation of cementum and periodontal ligament.
“Importance of studying rationale for periodontal treatment in dentistry”
“Common challenges in justifying periodontal treatment plans”
Read And Learn More: Periodontics Question And Answers
Healing Process Affected by Various Factors
- Local factors: Microorganisms, irritation from plaque, food debris, trauma from occlusion, excessive tissue manipulation during treatment, necrotic tissue remnants they delays healing.
- Systemic factors: Healing delayed in:
- Older patient
- Generalized infections
- Insufficient food intake, Vitamin C deficiency, deficiency of proteins, etc.
- Increase level of hormones like cortisone.
- Systemic stress, thyroidectomy, testosterone and large doses of estrogen.
“Steps to establish treatment goals based on periodontal rationale”
Question 2. Define new attachment and repair.
Answer.
New Attachment
It is the embedding of new periodontal ligament fibers into new cementum and the attachment of gingival epithelium to the tooth surface previously denuded by the disease.
“Role of inflammation reduction in periodontal treatment rationale”
Repair
It simply restores the continuity of the diseased marginal gingiva and re-establishes the normal gingiva at same level on the root as the base of the pre-existing periodontal pocket. Healing is by scar formation.
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