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  • Periodontitis symptomatology

Periodontitis symptomatology

Periodontitis is a chronic disease with a poly-microbial and site-specific etiology that affects the tissues supporting the teeth: the radicular cementum, the alveolar bone, the periodontal ligament, and the gingivae.

Recent epidemiological data indicates that the prevalence of periodontitis and the risk of irreversible damage with subsequent tooth loss increases with age, with a peak incidence between 50 - 60 years.

With regards to gender distribution, women are more susceptible than men. Otherwise, distribution is ubiquitous, even though some ethnic and geographic predisposing factors have been identified (race and/or ethnic ancestry, genetic background, geographic location, social customs, socio-economic status, and the nutritional habits of populations all play their part). The disease initially presents with the clinical symptoms of marginal gingivitis. Patients often report bleeding, reddening, swollen, and painful gums. The presence of bacteria on the marginal gingiva activates the host immune response: the capillaries dilate, blood flow increases, white cells rush in and mobilized by the body's defense mechanisms, activate a series of immune system (interleukins, etc.) and enzymatic responses (collagenases).

These uncontrolled responses cause detachment and destruction of the fibers in the marginal gingiva which normally connect the gingival tissue to the surface of the root and the tooth.

The gingival sulcus (the groove at the point at which the gum forms a sort of "fibrous-mucosal ring" around the tooth, which impedes passage of bacteria), normally a maximum of 2-mm depth, gradually deepens and, as the process of destruction of the periodontal fibers progresses, is transformed into a periodontal pocket. There is a concurrent marked increase in the share of obligate anaerobes bacteria for which the periodontal pocket, into which oxygen does not penetrate, is the ideal habitat.

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