Monthly Archive September 2016

Periodontal pockets Classification, symptoms and Treatment

Periodontal pockets are caused by microorganism so and their products, which produces pathological tissue changes that lead to the depending of the gingival sulcus. Pocket formation starts as an inflammatory change in the connective tissue wall of the gingival sulcus.

Periodontal pocket

Classification of periodontal pockets

Gingival pocket

It is also known as pseudo pocket or relative pocket or false pocket. It is formed by gingival enlargement, without destruction of the underlying periodontal tissues. The sulcus is deepened because of the increased bulk of the gingiva.

Periodontal pocket

It is also known as absolute or true pocket. There is destruction of the supporting periodontal tissue; progressive pocket deepening leads to destruction of the supporting periodontal tissues and loosening and exfoliation of the teeth.

Supra bony pocket:

Also known as supracrestal or supra alveolar pocket. Bottom of the pocket is coronal to the underlying alveolar bone. Bone destruction pattern is horizontal.

Infrabony pocket:

Also known as subcrestal or intraalveolar pocket. Bottom  of the pocket is apical to the level of the adjacent alveolar bone. Bone destruction pattern is vertical.

classification based on tooth surfaces involved:

Simple pocket:

only one tooth surface involved

complex pocket:

involves more than one surface

compound or spiral pocket:

Originating on one tooth surface and twisting around the tooth to involve one or more additional surfaces.

Signs and symptoms

  • Gingival bleeding
  • Gingival suppurations
  • Tooth mobility
  • In some cases pus may be expressed by applying digital pressure.
  • Localised pain or deep pain in the bone.
  • There may be bluish red vertical zone from the gingival margin to the alveolar mucosa.

    How to manage periodontal pockets?

  • Reducing pocket depth and eliminating existing bacteria are important to prevent damage caused by the progression of periodontal disease and to help you maintain a healthy smile. Eliminating bacteria alone may not be sufficient to prevent disease recurrence. Deeper pockets are more difficult for you and your dental care professional to clean, so it’s important for you to reduce them. Reduced pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth – and decrease the chance of serious health problems associated with periodontal disease.
  • pocket irrigation- devices like squeeze bottles and blunt hypodermic needles can be used to irrigate the pocket with chemotherapeutic agents.
  • flap surgery to eliminate pockets.