Parodontiittia

Parodontiittia, commonly referred to as periodontitis, is a chronic inflammatory disease of the periodontium—the gums, periodontal ligament, cementum, and supporting bone. It results from a sustained inflammatory response to dental plaque and leads to progressive attachment loss, periodontal pockets, gum recession, and potential tooth loss.

The condition is primarily caused by subgingival bacterial biofilm, with local factors such as calculus and tooth misalignment contributing to progression. Systemic and lifestyle factors, including smoking, diabetes, immunosuppression, and genetic predisposition, influence risk and severity.

Pathophysiology involves inflammatory mediators driving connective tissue breakdown and osteoclastic bone resorption, producing pocket formation around teeth and loss of supporting structures. If untreated, progression can vary in rate and extent based on risk factors and oral hygiene.

Common signs include bleeding on probing, red and swollen gums, persistent bad breath, gum recession, tooth mobility, and sensitivity. Diagnosis is clinical, using measurements of attachment loss and probing depths, with radiographs showing alveolar bone loss. Modern classifications describe periodontitis by stage (I–IV) reflecting severity and complexity, and by grade (A–D) indicating progression risk and constraints posed by systemic factors.

Treatment begins with non-surgical therapy, such as scaling and root planing, along with thorough oral hygiene instruction. If necessary, surgical options like flap procedures, regenerative techniques, or osseous resection may be employed. Ongoing maintenance therapy is essential, often paired with risk-factor modification and reinforcement of oral hygiene.

Prognosis varies with disease stage, patient adherence, and control of risk factors. Prevention focuses on effective plaque control, regular professional cleanings, smoking cessation, and management of systemic conditions such as diabetes.