11/23. Rare and abnormal massive dental calculus deposit: an investigative report. An unprecedented case is presented involving a massive calculus buildup on the mandibular incisors. The clinical and radiographic findings were reviewed, probable causes were investigated, and results were outlined and discussed. The composition, origin, and formation of dental calculus and its interrelationship with dental plaque and saliva were highlighted. The role of dental calculus in the pathogenicity of periodontal diseases, in view of epidemiological data, research, and clinical study findings, is discussed. Both the case management and the benefit of total calculus removal for resolving periodontal disease are underlined. ( info) |
12/23. Takayasu's arteritis: what should the dentist know? Takayasu's arteritis is a chronic inflammatory disease that affects large blood vessels, especially the aorta and/or its major branches. The condition presents with segmental lesions adjacent to normal, apparently unaffected, areas. The lesions include stenosis, occlusion, dilatations or aneurysm formations along the path of the affected artery. Because of the severity of the disease and the possibility of cardiovascular complications, patients with Takayasu's arteritis require medical treatment based on immunosuppressive and antihypertensive drugs, as well as regular follow up and surgical intervention in many instances. The aim of this paper was to describe the characteristics of Takayasu's arteritis, to report dental treatment carried out on an affected patient, and to discuss the main implications and care required during routine treatment for children in the dental office. ( info) |
13/23. Calculus-like deposit on the apical external root surface of teeth with post-treatment apical periodontitis: report of two cases. AIM: To report two cases in which calculus-like material was found on external root surfaces of (i) an extracted root and (ii) an apicected part of a root, both of which were removed due to post-treatment refractory apical periodontitis. SUMMARY: In each case, there was a fistulous tract, which did not heal after conventional root canal treatment. The first case did not heal even after apical surgery, and subsequent tooth extraction revealed calculus-like material on a root surface of complex anatomy. The second case showed radiographic signs of healing after apicectomy. histology of the apical biopsy revealed a calculus-like material on the external surface of the root apex. It is suggested that the presence of calculus on the root surfaces of teeth with periapical lesions may contribute towards the aetiology of failure. KEY learning POINTS: Biofilm on the external root surface has been implicated in the failure of apical periodontitis to heal, despite adequate root canal treatment. Calculus-like material was found, in two cases, on the root surface of teeth with post-treatment apical periodontitis, where the only communication externally was a sinus tract. ( info) |
14/23. Calculus in a toddler with end-stage renal disease due to prune-belly syndrome. Prune-belly syndrome is a congenital kidney and urinary tract anomaly which may lead to end-stage renal failure (ESRF). The present case describes an infant suffering from end-stage kidney disease due to prune-belly syndrome, undergoing chronic hemodialysis, with excessive calculus deposits which disappeared following kidney transplantation. Possible explanations are discussed. The first mechanism is associated with lack of oral function which may have caused pooling of saliva around the teeth enhancing precipitations of minerals. The second possible mechanism is associated with the child's uremic state. The third mechanism could be a disturbance in calcium-phosphor metabolism. It is possible that in the present case, the gastrostomy and the electrolyte disturbances characterizing ESRF had an additive effect. ( info) |
15/23. Unusual radiographic presentations. Report of five cases. Five examples of radiographic oddities, culled from the records of private dental practitioners, are presented. Two cases feature radiographic manifestations of systemic disease, and three cases display anomalous oral findings. Each illustration is furnished with a short narrative and interpretation. ( info) |
16/23. nifedipine-induced gingival overgrowth. Report of a case treated by controlling plaque. A review of the literature reveals little evidence that controlling plaque reduces and controls nifedipine-induced gingival overgrowth. The case presented suggests that significant reduction and control of nifedipine-induced gingival overgrowth can be achieved by thorough scaling and root planing along with meticulous plaque control. ( info) |
17/23. Generalized juvenile periodontitis in a thirteen-year-old child. There have been two previous cases reported in which children with a possible history of Prepubertal periodontitis (PP) developed Generalized Juvenile periodontitis (GJP) in their permanent dentitions at circumpubescent ages. This paper reports a case in which an apparently healthy 13-year-old girl, whose radiographs at 6 1/2 years of age showed horizontal bone loss around the primary molars, developed GJP. Blood tests (CBC, WBC differential, fasting glucose level, serum alkaline phosphatase) and a gingival biopsy were performed to exclude possible systemic diseases that might have been associated with alveolar bone resorption. Neutrophil (PMN) chemotaxis (CX) and adhesion molecule CD11b levels were also examined. The results of these tests were all within the normal range. This case report illustrates that an apparently healthy patient with PP may develop advanced periodontitis at a circumpubescent age. ( info) |
18/23. Healing potential of periodontal osseous defects treated by scaling and root planing. The healing potential of periodontal osseous defects treated by scaling and root planing is demonstrated by the presentation of two clinical cases. ( info) |
19/23. The effect of an airbrasive instrument on soft and hard tissues around osseointegrated implants. A case report. A 40-year-old woman with natural teeth in the upper jaw and a complete lower denture was treated with six osseointegrated implants connected to a fixed bridge. On a recall visit 6 months posttreatment an air powder abrasive devise Prophy-Jet had been used to remove calculus and debris from the titanium abutments by the referring dentist. This resulted in an acute clinical reaction characterized by pain and submucosal emphysema. Furthermore, radiographs revealed break down of the marginal bone surrounding the fixtures. The treatment and follow-up period became long. These observations suggest that the use of air powder abrasive instruments is not the treatment of choice in the maintenance care of osseointegrated titanium implants. ( info) |
20/23. A case report of unusual dental calculus formation. A case is presented in which an unusual amount of intraoral calculus was seen in a 59-year-old woman. The deposits completely covered all surfaces of most teeth and extended over the facial and lingual gingivae. The relationship between certain chemical salivary parameters and heavy calculus formers is briefly described. ( info) |