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Context: Periodontal diseases are multifactorial infectious pathologies. They affect tissues of support of the tooth and so end in dental losses. No sector of society is spared., Objective: To estimate the state of periodontal health of the patients admitted in consultation in the dental services of the city of Kinshasa., Material and Methods: It is a descriptive and transverse study. It was led on patients admitted in consultations in three dental services of the city of Kinshasa during the period going from January to August, 2015. The study included patients of 12 years old and more who consulted in one of the selected dental service. The selected patients supplied sociodemographic information in particular zone of residence, gender, level of education and social level. Dutch Periodontal Screening Index (DPSI) was used to estimate the periodontal state of every patient., Results: On a total of 642 patients 374 were females and 268 were males. The mean age was of 38.12 years ± 16,303. The patients of upper or more university level and those who had no employment represented successively 58.3% and 35.5%. Dental pain was the main motive for consultation. Majority of the patients had a DPSI around 3, that is 49.1%. 99.9% of the patients presented gingivitis whereas those 64% who suffered from periodontitis were subject to specialized periodontal care., Conclusion: Periodontal disease was present in all patients. The majority of the people had consulted dental surgeons only when they had pain.

In the western countries, the acute necrotizing gingivitis occurs mainly in early adulthood. It is characterized by a marginal necrosis of the gingiva. The papillae appear to be punched out. The gingiva is painful and bleeds, and the patient often presents halitosis. This fusospirochetal infection invades the epithelium and the underlying connective tissue in its most superficial layer. With early acute necrotizing gingivitis, the use of chlorhexidine 0.2% is recommended, but a thorough scaling is still necessary. Antibiotics are used when the disease becomes more severe. Gingivoplasty may be required at the end of the treatment but a meticulous oral hygiene is the only way to prevent any recurrence of the disease.

Periodontal surgery is (too) often utilized but there seems to exists a lack of evidence to justify its application. Only an indirect evidence justifying periodontal surgery can be offered. In presence of shallow pockets, an individual can himself reach and stay at a high degree of gingival health and maintain a healthy periodontium during many years with practically no loss of attachment. In presence of deep pockets, a subject has very little chance to keep his periodontium healthy. It seems thus necessary to diminish the depth of those periodontal pockets by surgical treatment. With an optimal level of oral hygiene, periodontal disease can be cured and further destruction of the periodontal tissues avoided irrespective of the surgical technique utilized for pocket elimination. However, the most favourable healing is obtained when complete soft tissue coverage of the alveolar bone is ensured.

A well known development of the chronic periodontal disease is reviewed. However, the histological picture of a gingiva varies at a much lower speed than its clinical picture, and slower than previously described. In presence of periodontitis there may exit a zone of reversible disease of about 2 mm, which give the possibility of obtaining a re-attachment of unknown magnitude. A new connective tissue attachment (on top of the re-attachment) seems only possible if the periodontal ligament cells are allowed to proliferate coronally.