Periodontal Diseases

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



Periodontal diseases (parodontopathies) include an array of conditions ranging from simple to complicated ones, from repairable to irreparable ones. Their diagnostics and therapy is a domain of specialists - periodontists - however, it would be a professional neglect if a doctor of general medicine would have lacked a basic knowledge from the field that is so important for preservation of teeth and thus health of his/her future patient.

The periodontium are tissues surrounding a tooth. These are the following:

1. The gum (gingiva) which may be:

a) free - forms a kind of rim around a tooth neck. Between the rim and the tooth surface there is a sulcus that may be up to 1 mm in depth.

b) attached - divided from a free gingiva by the paramarginal groove that marks the sulcus’ depth from the outside

c) interdental papilla filling the interdental space.

2. Periodontal membrane that lines the periodontal slit.

3. The tooth root surface cement.

4. Compacts of a tooth socket.

A tooth is set in an alveolus in such a way that it may move slightly upon a mastication load. This movement distributes a chewing pressure evenly on the whole bone socket and prevents a momentary localized overloading. The periodontal membrane that fills the space between an alveolus and a tooth root, provides for this function. The main structures of this membrane are bundles of collagenous fibrils arranged into several groups of ligaments. Some fasten a tooth to its socket, others fix a gum to the bone base. Another groups of ligaments project along a tooth to the socket’s edge at the interdental space, connect adjacent teeth and their net forms ligamentum circulare at the alveolus edge, that closes a periodontal slit. Ligaments in an alveolar slit lead from lamina dura of an alveolus to the cement of a root’s surface. They are S-shaped at rest and straighten, stretch and distribute a tooth load by pulling on the whole socket’s walls not until a stress is applied. Two areas are important for good health of the periodontium: attached gingiva and its width, and the place where an epithelium attaches to a tooth neck at the bottom of a sulcus - the attachment.

Category: Periodontics Notes

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