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••••••> Periodontal Disease

Periodontal disease is the combination of multiple diseases which includes local n multiple factors. It consists of chronic inflammation of gums with the loss of alveolar bone. It is a disease which has an effect on one or more periodontal tissues. Traditionally Periodontal disease is divided into two categories:-

(a)  Gingivitis – It can be defined as inflammation of the gingival tissue without the loss of tooth attachment i.e. periodontal ligament. It is usually caused by bacterial plaque that accumulates in the small gaps between the gums and the teeth and the calculus that forms on the teeth. These bacteria appear to be tiny or microscopic but the bacteria in them produce foreign chemicals and toxins that causes inflammation of the gums.

(b)  Periodontitis – It refers to number of inflammatory diseases which affects the periodontium i.e. the tissue which surround and support the teeth.This disease involves progressive loss of the alveolar bone around the teeth and if its untreated it may result into loosing and subsequent loss of teeth. It is caused due to microorganisms that adhere to grow on the surface of the tooth, along with an overly aggressive immune response against these microorganisms.

In some cases of individuals, gingivitis never results into periodontitis, speaking in the other way gingivitis always precedes periodontitis.

TREATMENT (Conventional Therapy)

Successful treatment of this disease includes removal of plaque and calculus that is being accumulated on the teeth. This treatment is called debridment which is performed by using ultrasonic instruments which breaks down the calculus resulting into its easy removal. This treatment called debridment helps in removing the heavy staining and calculus accumulated on the lingual surface of the mandibular anterior teeth near the gum line.

This treatment also includes instruments like -

(a)             Periodontal scalers which are dental instruments used on primary basis in the periodontal care of the human teeth, it has a narrow tip for easy access to narrow embrasure spaces between the teeth.

(b)             Periodontal curettes which are also used for the periodontal care of the human teeth and it has blunt rounded tip which helps in treating of sub gingival areas where calculus is accumulated. They are classified into two:

• Universal Curette.
• Gracey Curette.

Scaling and Root planning otherwise known as conventional periodontal therapy or non surgical periodontal therapy is to remove or eliminate the etiological agents which cause inflammation. Periodontal scaling procedures into removal of plaque, calculus and stain from the crown and root surfaces of teeth, whereas root planning is a specific treatment that removes the roughened cementum and surface dentin (calcified tissue of the teeth) that is impregnated with calculus, microorganisms and their toxins. They are also referred to as deep cleaning and can be performed by using a number of dental tools including ultrasonic instruments and hard instruments such as periodontal scalers and curettes.

Full mouth disinfection refers to an intense course of periodontitis typically involving scaling and root planning in combination with adjunctive use of systematic antibiotics as well as use of local antimicrobial adjuncts to periodontal treatment such as chlorhexidine. The aim is to complete debridment of all periodontal pocket areas within a short time frame in order to minimize the chance of reinfection of the pocket of the pathogens.

For more information you can visit: http://www.ddperio.com

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[Microbiology Question] How do you determine motility of an endospore?

When observe an endospore under a microscope and find it to be large and swollen, almost like a big round pocket, but after a few weeks, you repeat the same process of staining and mounting on a glass and re-observing it under a microscope, but then you find that the old large round spore cell is gone only to discover a hundred different round spore cells under a microscope. Would this endospore microbacterium be considered positive for motility?

No. Spores are not motile, only the Firmicute bacteria themselves are. The simplest way to determine motility is to either observe them under a microscope or plate them out in a soft agar plate (less agar than the normal plates). Motile bacteria will spread out within the agar into a diffuse, large colony while non-motile ones will form tight, compact colonies.

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