Refractory Periodontitis: Causes, Symptoms, and Advanced Treatment

Refractory Periodontitis

Write short note on refractory periodontitis.
Answer. According to American Academy of Periodontology  refractory periodontitis is not a single disease entity. It refers to destructive periodontal diseases in patients who, when longitudinally monitored, demonstrate additional attachment loss at one or more site despite well executed therapeutic measures and patient’s efforts to stop the progression of disease.

“Understanding the role of refractory periodontitis in gum health”

Refractory Periodontitis Types

On the basis of causative factors, there are two types of refractory periodontitis

• First type comprises those with refractory sites, i.e. patients with adult periodontitis in whom anatomic conditions favor the proliferation of periodontopathic microorganisms.
• Second type of refractory periodontitis is due to severe PMN defects or other immunologic problems, e.g. aggressive periodontitis associated with Papillon-Lefèvre syndrome.

“Importance of studying refractory periodontitis for better oral care”

Refractory Periodontitis Etiology

Risk factors responsible for refractory cases:

• Abnormal host response.
• Resistant strain of pathogenic periodontal microflora
• Failure to eliminate plaque retentive factors such as functional involvement, irregular root surface, etc.
• Smoking and systemic disease may result in generalized lesion which may not respond favorably to the treatment. There are three major microbial complex in refractory periodontitis
  • B. forsythus, F. nucleatum, C. rectus.
  • S. intermedius, P. gingivalis, P. microbes.
  • S. intermedius, F. nucleatum.

“Common challenges in diagnosing and treating refractory periodontitis”

Read And Learn More: Periodontics Question And Answers

“Steps to identify common causes of refractory periodontitis”

Refractory Periodontitis Clinical Features

• Diversity of clinical condition and treatment under which periodontal therapy fails to arrest the progression of periodontitis
• The refractory case can be identified by presenting new areas of attachment loss or progressive attachment loss in already treated sites.

“Role of genetic predisposition in refractory periodontitis”

Refractory Periodontitis Treatment

• Antimicrobial therapy along with mechanical debridement.
• In addition to this, intrasulcular irrigation with 10% povidone-iodine solution and chlorhexidine solution has been used successfully.