Periodontology

Periodontology is the dental specialty that deals with the supporting structures of teeth, including the gingiva, periodontal ligament, cementum, and alveolar bone, as well as the tissues surrounding dental implants. It encompasses the prevention, diagnosis, and treatment of diseases and conditions affecting the periodontium, and the maintenance of periodontal health.

Healthy periodontium is characterized by stable gingival tissues, a lack of bleeding on probing, and shallow probing depths. Periodontal diseases range from gingivitis, which is inflammation of the gingiva without attachment loss, to periodontitis, in which inflammation leads to destruction of the supporting tissues, clinical attachment loss, bone loss, pocket formation, and potential tooth mobility or loss. Chronic periodontitis is the most common form, with aggressive periodontitis occurring less frequently and often at a younger age. Risk factors include plaque biofilm, smoking, diabetes, age, genetics, and certain systemic conditions.

Diagnosis relies on a comprehensive periodontal examination. Key measurements include probing depth, clinical attachment level, and bleeding on probing, along with plaque assessment, radiographs to evaluate bone loss, tooth mobility, furcation involvement, and other signs of periodontal involvement. Classification systems have evolved, with contemporary frameworks acknowledging stages and grades of periodontitis and recognizing peri-implant diseases when implants are involved.

Management emphasizes both non-surgical and surgical approaches. Non-surgical therapy includes thorough scaling and root planing, professional cleaning, oral hygiene instruction, and antiseptics. Surgical options encompass flap procedures, resective or regenerative osseous surgery, and regenerative techniques such as bone grafts and guided tissue regeneration. Long-term success depends on risk factor control, patient adherence, and structured maintenance visits. Periodontology continues to integrate advances in microbiology, host response, and regenerative science to improve outcomes.