Ulcerative Gingivitis (erosive or ulcerative gingivitis, necrotizing ulcerative gingivitis Vincent) - a form of gingivitis, flowing with predominantly destructive changes gum tissue. Ulcerative Gingivitis occurs in dentistry less than other clinical and morphological forms of gum lesions, but the flows are much harder, with the development of local and general changes. Most often ulcerative gingivitis occurs between 18-30 years of age. In most cases, ulcerative gingivitis is acute, however, under certain conditions, can move in the subacute or chronic phase and ulcerative stomatitis and periodontitis.
catarrhal gingivitis under the influence of the causes of local and general.
Local predisposing factors include the presence in the oral cavity of abundant soft plaque and tartar, multiple dental caries, shortness of teething (especially third molars), smoking, chronic oral injuries ruined teeth, sharp edges of fillings, incorrectly fitted orthopedic constructions.
herpetic stomatitis, acute respiratory viral infection, sore throat, and others. In some cases, resistant ulcerative gingivitis is one of the early symptoms of AIDS.
The available observations a correlation ulcerative gingivitis with hypovitaminosis C; radiation exposure; physical and mental fatigue, stress, hypothermia; diseases of the gastrointestinal tract, endocrine system and blood (agranulocytosis, leukemia); severe foodborne diseases, poisoning by salts of heavy metals.
. Thus, reduction of local and general protection creates conditions for activation of microflora (mainly anaerobic bacteria and protozoa - fuzobakterii, dental spirochetes), antigens which elicit an immune-inflammatory response gums, impaired microcirculation, increased thrombus formation. Destructive processes in ulcerative gingivitis are caused by the penetration of microflora to fuzospirillyarnoy connective tissue through the gums.
sleep disturbances, headache, dyspepsia. Against the background of pronounced catarrhal changes in the mouth develops sore and itching gums, swelling them and congestive hyperemia, hemorrhage with minimal mechanical stress.
Soon, in a limited area the gums, in the top of the gingival margin and gingival papillae, formed ulcers, necrotic fringed white-gray color, which will soon cover a large surface area of the gums. When removing necrotic ulcers on the edges of the film there is capillary bleeding.
Also ulcers, in this form of gingivitis noted the appearance of persistent, fetid putrid odor from the mouth, regardless of the limitations of the hygiene procedures. Characteristic changes in the nature of saliva (it becomes viscous and stringy), congestion in the interdental spaces and plentiful food remains soft plaque. Because of the pain in the gums, patients can not properly chew food, talk, brush your teeth, which further exacerbates the local manifestations.
At the height of the clinical manifestations for ulcerative gingivitis is accompanied by regional lymphadenitis, the phenomena of intoxication, severe violation of general health. Depending on the severity of destructive changes for ulcerative gingivitis can be mild, moderate and severe.
immunoglobulin A in saliva by ELISA, bacteriological examination of discharge from the ulcer surface.
To study microcirculation in periodontal tissues held reoparodontografiya. To assess the bone condition orthopantomography performed.
Ulcerative gingivitis, as an independent disease, should be differentiated from necrotizing gingival changes in blood diseases and HIV infection, as well as periodontitis. Important is the conclusion of other specialists (gastroenterologist, endocrinologist, immunologist, hematologist) on the state of health of the patient.
professional teeth cleaning, removal of dental plaque, removal of necrotic tissue; if necessary - prishlifovyvanie sharp teeth edges that can injure the gums. These manipulations should be done very carefully, under adequate local anesthesia.
As a means of local therapy of ulcerative gingivitis anesthetics used applications (novocaine, lidocaine), antimicrobials (chlorhexidine metrogil), proteolytic enzymes (trypsin, chymotrypsin); held mouthparts baths with antiseptic and decoction of herbs. After cleansing ulcers of necrotic mass produced periodontal applications keratoplasty drugs (solcoseryl, oil solutions of vitamins A and E). Drug treatment of ulcerative gingivitis is complemented by physiotherapy (UVR, phonophoresis, laser therapy).
General medicine ulcerative gingivitis includes receiving metronidazole, antihistamines, aspirin, vitamins.
Prediction and prevention of ulcerative gingivitis
In ulcerative gingivitis mild gingival changes are reversible. Moderate and severe ulcerative gingivitis can lead to permanent deformation of the gingival contour and the exposure of teeth necks.
In the prophylactic context it is important to eliminate all possible local and general factors predisposing to the development of ulcerative gingivitis. It is necessary to pay increased attention to oral hygiene, in t. Ch. Professional teeth cleaning, promptly contact the periodontist when a catarrhal gingivitis.