Abstract:
It is mandatory to mention that more than 95% of the global population is presenting signs of
periodontal disease (PD). The most common etiophatogenetic factor for PD is dental calculus and
plaque. This main factor however is not the only feature which affect and aggravate the disease
process, hormonal impairment are a frequent etiological factor for PD. This paper will present a
clinical case of a 32 year old woman with a severe form of periodontal disease. The patient received a
complex treatment paraclinical examination. With standard examination of PD patients (OPG, full
mouth periodontal probing), the patient was examined by a general practioner and a endocrinologist,
which revealed hypothyroidism in a low form that was treated 3 years ago. General blood analysis
was performed and chemical analysis of blood for alkaline phosphatase. Local treatment with BioR
0.5% sol. for 5 days and general treatment with metronidazole 0.5 for 8 days in combination with
doxacicline 0.25 for 8 days were administered prior to endodontic and prosthetic treatment. As stated
by the endocrinologist the patient was examined 3 years ago for hypothyroidism in a medium form
for 3 months, and no present signs of it are present. The patient related that prior to that treatment she
was examined by a stomatologist which related to her that she had PD in a mild form so scaling was
performed in a usual manner. Alkaline phosphatase shows no significant variations and general blood
analysis too. Tooth mobility of II nd degree was related in a 56% of all present teeth, III rd degree in
20%. 4 teeth were extracted as they were out of the treatment plan. Following scaling, general and
local treatment, endodontic treatment presented a significant tooth stability also stated by the patient.
Prosthetic treatment showed a high level of esthetic rehabilitation and a future stability for the rest of
the teeth. Hypothyroidism and other hormonal disease are considered lately as a major factor for
periodontal disease it is fact stated by many articles, and comparative studies presented it’s reability.
The present work is another one that supports this idea. Patients with PD especially the ones that
present severe form of it need to be examined in a complex form because most of them present
general disease and especially hormonal impairments. The metabolism of Calcium in the tissue is a
major factor that may induce the periodontal disease; its mechanism is “washing” it away from blood
and eliminates it thru natural fluid including saliva eventually it will be deposited on dental plaque
and form the calculus.
