Akademik Veri Yönetim Sistemi
MDS & Friends Symposium 2025, Florence, İtalya, 13 - 15 Şubat 2025, (Yayınlanmadı)
Effectiveness of Step 1 and Step 2 Periodontal Therapy in Managing Stage 4 Grade C Periodontitis in a 27-Year-Old Patient: PISA and PESA Value Reductions
In a healthy periodontium, the sulcular epithelium and innate immunity act as barriers against pathogens. In periodontitis, the ulcerated epithelium allows these to enter the bloodstream, leading to bacteremia and triggering systemic inflammation, aggraveted by daily activities like chewing or brushing. Due to this inflammatory burden, periodontitis has been linked to systemic diseases, highlighting the reduction of this systemic inflammatory load as a critical objective of periodontal therapy.
A 27-year-old female patient was referred to our clinic. Anamnesis revealed that she was in the lactation period, had a family history of early tooth loss, and did not smoke. She was aware of an issue due to bleeding gums and tooth mobility but did not realize it was severe enough to result in tooth loss. Following the examination, she was diagnosed with Stage 4 Grade C periodontitis. She was informed about the potential for tooth loss even with treatment, and the expected outcomes were discussed based on the limitations of the prognosis. PESA and PISA values were initially calculated to assess the periodontal inflammatory load and the inflamed surface area.Step 1 and 2 treatments were implemented, and systemic antibiotics were administered alongside the initiation of mechanical therapy. A 0.12% chlorhexidine gel was applied intrasulcularly. After 6 weeks, PESA-PISA and other clinical measurements were reassessed. It was observed that the PESA value decreased from 3532.6/mm² to 1957.7/mm², while the PISA value decreased from 3532.6/mm² to 1091.8/mm². It was observed that the patient was able to improve oral hygiene practices, although not perfectly. A comprehensive Step 3 plan will be made to meet the patient's functional and aesthetic expectations, including the surgical elimination of residual pockets and the extraction of teeth with a poor prognosis, along with periodontal and prosthetic treatments.
The decrease in PESA-PISA values after non-surgical therapy underscores the effectiveness of periodontal treatment in alleviating inflammation. This reduction will persist, leading to the patient's complete rehabilitation during subsequent stages of treatment. By employing staged periodontal treatments and ensuring patient compliance with therapy, we can achieve optimal periodontal health and further reduce systemic inflammation.