Chronic gereralized periodontitis–chronic apical periodontitis

Posted by Dental News Team On April - 22 - 2010

Double chronic periodontitis-what does that mean?

The attempt of this newsletter is to inform you about the difference between chronic generalized periodontitis and chronic apical periodontitis.

The main difference is the etiology, or otherwise said the genesis, which results in bone destruction.  

The periapical abscess starts in the dental pulp whereas periodontal abscess begins in the supporting bone and tissue structures of the teeth.

Chronic Apical Periodontitis is caused by dead and untreated tooth, or a bad root canal performed on a tooth. A radiographic image shows a dark spot on the root tip. The inflammation causes bone resorption, therefore the x-rays can get through much easier, which is visible as a dark spot.

Chronic Generalized Periodontitis is caused mainly by the accumulation of plaque, and the lack of periodontal therapy throughout the years. The microorganisms adhere and grow on the root surface which leads to progressive bone loss around the teeth. Fortunately, periodontitis is easily controlled by good oral hygiene. (red=bone, green=bone)

Both diseases have one thing in common: If untreated, they result in tooth loss due to bone loss.

If you are observing your x-rays and notice dark spots on the root tip and/or the jaw bone is built horizontally or vertically, please seek the help of a periodontist. 

 

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Periodontitis, oral cancer and overall health – Pt 2

Posted by Dental News Team On November - 24 - 2009

I part one you read all about how defensines affect our overall health, but the connection is even more complex!

Our cells use various substakrebszellences to communicate with each other – the general term being “cytokines“. These cytokines activate signal paths in the cells.

You can look at it this way: Cell A (an immune cell) tells Cell B (a cell in the mucous membrane of the mouth) – “produce more mucus, since there are bacteria around”. But Cell A does not really speak to Cell B, but pours out signal molecules  – called cytokines.

Like a key and lock system, these cytokines activate signal paths in Cell B which lead to an increased production of mucus. Think of these signal paths as a factory, in which the boss gives an instruction to the foreman, who then proceeds to shout it into a microphone. The employees hurry up and change into their uniforms, etc. … this is exactly what takes place in the cell – a cascade of signals. When the cascade is over, the organelles in the cell produce more mucus!

Researchers have discovered that in cases of periodontitis, bacteria in the gum pockets activate the same signal paths as are activated in oral cancer,so there is very likely to be a connection between these illnesses.

Source: 2009_ Parodontitis Mundkrebs und Allgemeingesundheit (periodontitis, oral cancer and overall health)

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Periodontitis, oral cancer and overall health

Posted by Dental News Team On November - 24 - 2009

Are periodontitis, oral cancer and overall health in any way related?

They are!

krebszelleOur immune system continuously produces substances (loaded proteins, called defensines) which target bacteria, fungi and viruses. Immune cells inject these defensines into bodily fluids, and this “Defensine Cocktail” protects us from attack by bacteria, fungi and/or viruses.

In evolutionary terms, defensines appeared about the same time as the insects, so they represent a very old component of our immune system, and can be found throughout the animal kingdom. For example, the immune cells make sure a high concentration of these proteins gets into the fluid around the eyes, the saliva, lungs, vaginal fluid etc. Wherever our bodies are faced with invasion, these proteins go!

But defensine production only runs smoothly in a healthy „household“. This means the well-balanced functioning of our organs, e.g. non-microbial digestion takes place in the small intestine, while microbial digestion takes place in the large intestine. This makes the large intestine an organ of fermentation, and if the small and large intestines don’t „coordinate“ their functions, this can have harmful results on defensine production. The lower the level of defensines, the less protection against micro-organisms.

What causes an imbalance? Well, a carbohydrate allergy can lead to excessive fermentation in the large intestine. This means an excess of gas, which causes the intestine to blow up like a balloon, to the point where the passage between the large and small intestines no longer closes properly, which enables bacteria to move between the intestines. This results in an inflammation of the small intestine, and along with the reduced production of defensine, years later this can lead to bowel cancer.

But the connection is even more complex than this – in Part II you will find out just how!

Source: 2009_ Parodontitis Mundkrebs und Allgemeingesundheit (periodontitis, oral cancer and overall health)

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Periodontitis or Periodontosis?

Posted by Dental News Team On November - 12 - 2009

Why do so many dentists still refer to periodontitis as periodontosis?

periodontitisIn medical terms, the ending –itis refers to an inflammation, while -osis stands for a degenerative dysfunction caused by problems inwith metabolism.

Arthrosis, for example, refers to a degeneration in a joint due to excess strain on that joint. Arthritis, on the other hand, means an inflammation of a joint, a bacterial infection after an accident.

The terms periodontosis, periodontopathy and periodontitis come from the word “periodont“. This refers to the bone and tissue complex which holds the teeth, i.e. the anchoring system which attaches the tooth to the bone (perio = around, dont = tooth). This periodontal apparatus consists of the gums, bone, periodontal membrane and root element.

For a long time it was impossible to isolate bacteria in the gum pockets of patients with periodontitis, since it was common practice to use oxygen in germ cultures. But these bacteria were able to survive in gum pockets because of the absence of oxygen there. It was assumed, wrongly, that if there were no bacteria present, then this was a case of –osis! However, 25 years ago methods used in molecular biology finally made it possible to prove the existence of bacterial DNA, later on special incubators were used to grow these bacteria – in the absence of oxygen. And bacteria means -itis.


This is not just word-play, but crucial to finding the right kind of treatment. An inflammation requires a different kind of therapy than does a degenerative dysfunction, so you have to make the right diagnosis in the first place! But although scientific proof was found 25 years ago, doctors  are still in the habit of using the term periodontosis.

Periodontitis therapy requires two things, first that the doctor actually knows the illness at hand and second, the causes. Failing any of these two things prevents successful treatment. But gathering enough information takes time.


More on the topic of periodontitis and the right kind of treatment here!

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