Factors Causing Parodontopathies

By Dr. Vishaal Bhat on Monday 24 December 2007 with 0 comments

Factors that cause parodontopathies to occur are both internal and external with mutually overlapping effects.

1. Internal causes:

Age - changes of the periodontium may occur already in childhood and the time factor just enable the disease to evolve.

Heredity - concerns anatomic anomalies only (upper or lower frenulum, shallow vestibule).

Toxic substances - damages by hydantoinates and salts of heavy metals.

Infection - exacerbations and multiple abscesses arise during infectious diseases after stopping a treatment with antibiotics.

Race - does not play a role, differences are caused only by exogenous factors at different races.

Gender - men have higher incidence of parodontopathies. Worse dental hygiene plays certain role at men as well.

Vitamins - vitamin deficiency does not exist in our country, so there are no reasons for a vitamin therapy.

Endogenous factors - high levels of estrogen cause growth of bacteroides melaninogenes in a plaque. Incidence of parodontopathies is significantly higher at liver cirrhosis, chronic alcoholism, juvenile diabetes and Down’s syndrome.

2. External causes.

Orthodontic anomalies worsen hygienic conditions of the oral cavity.

Traumatic occlusion worsens an existing damage of the periodontium, although it does not cause a disease by itself.

Anatomical deviations of mucous membranes - lip frenula that have a high attachment and pull the marginal gingiva, makes it to become anemic and chronically irritated. Shallow vestibule causes chronic irritation by an analogous mechanism.

Wrong stomatologic work - overhanging fillings, non-fitting crowns, crowns in supra-occlusion or infra-occlusion, braces of dentures etc.

Tartar - both supra- and sub-gingival that acts as a plaque carrier and is basically a mineralized plaque by itself.

Soft dental coating - the plaque - is the most significant factor of a parodontopathy origin. It is an acquired item and it plays a key role in the occurrence of dental caries. It covers surfaces of teeth and dentures and may be removed by mechanical means only. The plaque undergoes certain maturation during which its microbial flora changes (it is developed in 14 days). At the deepest layers, filamentous bacteria form a palisade layer, the middle part is made of a mesh of the same microorganisms, filled with other microbes. There is materia alba on the surface, a structureless thin layer, removable by a spray. Microbial composition of the plaque varies, although it seems that the higher the number of gram-negative rods, the more invasive the plaque is. New data are being generated on the plaque’s influence on the periodontium and course of immunological reactions inside periodontal tissues. It seems that the plaque produces many antigenic substances that induce B and T lymphocytes sensitization and their increased counts in a gingiva. An immunological reaction in the periodontium neutralizes the plaque antigens. On the other hand, during binding of the complement, the tissue necrosis and lymphokines release take place causing an inflammation.

Category: Periodontics Notes



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