Diagnostics of diseases of parodont

Efficiency of treatment of diseases of parodont is determined by the thoroughness of compliance and implementation of the principles of individual approach, consistency and comprehensiveness of remedial measures.
In turn, the possibility of implementing these principles requires a detailed qualitative and quantitative study:
1. Local reasons of pathology and clinical signs of its manifestations.
This includes taking into account the presence and intensity of microbial and traumatic factors, their localization; a statement and determine the degree of inflammatory and destructive processes in periodontal tissues;
2. State and local mechanisms of nonspecific protection of fabrics of parodont in response to pathogenic factors and physiological processes in periodontal that provide the activity of tissue trophism.
The study of these processes is carried out using functional and immunological methods;
3. The General status of patients. This type of research is shown in cases where the pathological process in periodontal develops as a consequence of the reduction of the body's defence mechanisms, and is a reflection of the functional and morphological violations of certain systems: pancreatic or thyroid, kidneys, liver, stomach and intestinal, cardiovascular and nervous system.
These studies are conducted by appointment dentist relevant experts.
When there are common violations of local therapy of diseases of parodont is only a part of complex treatment.
Thus, the diagnosis of periodontal disease involves several levels (I. I. Lamarca, 1983).
The first level. Initial examination: the study of complaints, acquaintance with the history of the disease development, inspection and instrumental clinical studies.
The research allows us to set the initial diagnosis is based on clinical manifestations of inflammatory process and to outline the nature of local measures of treatment and prevention.
The second level. The study of the physiological processes in periodontal using functional and immunological methods allows to supply a detailed diagnosis and determine a complex of medical and preventive actions in order to correct the local functional disorders.
The third level. Along with the survey of local status and study of local physiological processes includes the research of General condition of an organism of the patient.
At this level it is possible to establish a definitive diagnosis, prognosis of process in periodontal and the appointment of an integrated curative and preventive measures.
The inspection is exposed scheme is a complex and time-consuming. In practice, very often inflammatory process in periodontal is the result of actions of local pathogenic factors. Consequently, the use of diagnostic methods should be strictly differentiated.
If the thorough elimination of local causal factors steady remission or complete liquidation of pathological phenomena, it is sufficient application of diagnostic methods only the first level.
When saving signs of inflammation after eliminating microbial and traumatic factors the need to expand the Arsenal of medical means directed action makes more fully explore the local physiological and protective mechanisms in the periodontium.
Persistent progression of the pathological process after the implementation of local multifactor therapy requires the research of General condition of an organism of the patient and determine the nature of complex treatment together with the specialists of other profiles.
Currently widely used in the diagnosis of the so-called periodontal indices. They are used to quantify the clinical manifestations of pathology in periodontal: the presence and intensity of the inflammatory reaction in the gums (probe test, PMA), the degree of destruction of alveolar bone (periodontal index - PEE index Ramfjord, the index of the who - CPITN), hygiene of the oral cavity (indexes green-Vermion, OLE-Silvassa).
A common feature of all indexes on the account of periodontal status in the field of individual teeth (GI, Ramfjord, Russell), is that they can only give a rough estimate of periodontal status, which does not always reflect the true picture. Therefore, they can only be recommended when conducting epidemiological studies to obtain a General idea of the expected volume of therapeutic interventions.
In practice the application of index assessment should be combined with more detailed indicators of periodontal status.
X-ray examination is the most informative and common method, it allows you to make an objective assessment of the condition of the bone of the alveolar process of the jaws.
Panoramic radiography and orthopantomography give the opportunity to trace the structure of bones just alveolar process one or both jaws, in some cases to identify the presence of a local pathological factors.
Initial changes in periodontal appear razvlecheniem cortical slices interdental partitions, the appearance of lesions spotted osteoporosis. Developed stage of the process is characterized by varying degrees of reduction in the height between the alveolar walls, by pockets of osteolysis and expressed osteoporosis alveolar bone.
With the active throughout the process are revealed lesions spotted osteoporosis, disappears cortical plate along holes teeth, and reduced height between crests of alveolar process.
The decrease foci of osteoporosis, increase the contrast of bone trabeculae and clarity bone edges with appropriate clinical picture is testimony to the stabilization process in periodontal.
Functional and laboratory methods allow you to obtain diverse information.
These methods are currently very numerous: reproduktorove, osteometry, polarography, the study of the concentration of hydrogen ions and electrochemical potentials, quantitative and qualitative analysis of the gingival fluid, capillaroscopy and capillaroscopy, microbiological, cytological, immunological, biochemical studies.
In absolute value, consider that in the conditions of practical activities they can get quite limited use. First, this is due to their complexity. The second and very important reason is that the clinical picture remains decisive for the attending physician.

The inflammatory process in periodontal