1/14. Tissue necrosis after subgingival irrigation with fluoride solution.Irrigation of periodontal pockets with fluoride solution after scaling and root planing is occasionally recommended to inhibit the growth of pathogenic bacteria in the periodontal pocket. At the same time, irrigation enables mechanical removal of loosely adhering plaque and debris. Due to its toxicity, fluoride solution deposited in the periodontium may lead to tissue damage. We report in this paper, a case of extensive periodontal tissue necrosis and permanent loss of alveolar bone after irrigation of periodontal pockets with stannous fluoride solution. The literature on the toxic effects of fluoride on the local tissues is briefly reviewed and arguments for a re-evaluation of the use of stannous fluoride for pocket irrigation are provided.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
2/14. The periodontal management of a patient with a profound immunodeficiency disorder.A case of severe, uncontrolled periodontal disease in a patient with a profound immunodeficiency disorder is reported. The periodontal disease was noted before the age of 10 years and is generalized, with marked associated alveolar bone loss, even threatening a mandibular fracture. Severely involved teeth were allowed to exfoliate, and extractions were avoided. At the age of 17 years, the patient now has only nine remaining teeth. The management adopted and alternative approaches are critically reviewed. The implications of the dental findings for current concepts of the pathogenesis of periodontal disease and dental caries are discussed.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
3/14. Subgingival plaque and loss of attachment in periodontosis as observed in autopsy material.Histologic sections from six autopsy cases which from a clinical point of view fitted into the criteria of periodontosis were examined with the aim at evaluating the role of subgingival plaque in the etiology of the loss of attachment in this condition. The following pertinent observations were made: 1. The subgingival plaque in most instances was not calcified to form calculus. 2. The thickness of the subgingival plaque varied between 20 and 200 mu (0.02-0.2 mm). 3. Where loss of attachment had taken place, the distance from the most apical part of the subgingival plaque to the most apical point of the epithelial cuff varied between 0.2 and 1.1 mm; this distance was never found to be more than 1.1 mm. This would indicate a cause and effect relationship, the plaque being the obvious cause. 4. There was very severe chronic inflammation in the soft tissue bordering upon the plaque with resulting collagenolysis. 5. The cellular infiltration and the collagenolysis may be limited to a zone of 1 to 2 mm in the immediate vicinity of the plaque. Between the inflamed area and the surface of the gingivae buccally and lingually there may be a fairly wide zone of healthy tissue which hides the symptoms of inflammation from being observed on a clinical examination. In turn this could leave the clinician with the impression that attachment has been lost and bone resorbed because of degenerative changes. The following conclusions can be made: In these six cases of "alveolar bone loss vastly out of proportion to what one would expect from the local etiologic factors in the patient at that age" there was no morphologic evidence that degenerative changes were responsible for the loss of attachment. On the contrary inflammatory changes induced by the subgingval plaque dominated the histopathologic picture.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
4/14. Features of severe periodontal disease in a teenager with chediak-higashi syndrome.BACKGROUND: chediak-higashi syndrome (C-HS) is a rare congenital disease characterized by defective neutrophil function with abnormal lysosomal inclusions, neutropenia, and reduced chemotaxis. The complete syndrome includes oculocutaneous albinism with photophobia, neurologic features, recurrent infections, and enterocolitis. methods: A 14-year-old male C-HS patient was referred to us because of serious periodontal destruction with acute inflamed gingiva and ulcers. Clinical and biological investigations were performed, leading to the diagnosis of C-HS. RESULTS: Laboratory findings included neutropenia and hypergammaglobulinemia. Peripheral blood smears showed giant granules in neutrophils, eosinophils, and granulocytes. Bone marrow smears showed giant inclusions in leukocyte precursor cells. These granules and inclusions were characteristic of chediak-higashi syndrome. Oral radiographic status showed extensive loss of alveolar bone leading, in most cases, to tooth exfoliation. bacteria often associated with periodontitis were detected in subgingival plaque samples, including fusobacterium nucleatum, campylobacter rectus, prevotella melaninogenica, peptostreptococcus anaerobius, and clostridium sp. Biopsies of periodontal tissues for light and electronic microscopic examinations revealed massive bacterial invasion of the epithelial tissue, epithelial cells, and connective tissue. Ultrastructural observations of periodontal polymorphonuclear leukocytes showed defective granulation, with abnormal granules not discharging their lysosomal content against engulfed bacteria. Viable dividing bacteria were found in the cytoplasm. CONCLUSIONS: In this case, early-onset periodontitis seems to be the expression of C-HS granulocyte deficiency. Periodontal treatment of these patients is often unsuccessful. This case report illustrates the importance of the dentist in initiating clinical and biological investigations in such early aggressive periodontitis in young patients.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
5/14. Enhanced periodontal response and esthetics of implant-supported bridge by the use of galvanoforming technique: case report.BACKGROUND: Galvanoforming restorations have been placed over the past 15 years successfully. They offer several advantages over alloy restorations, including enhanced response to the periodontal tissues, biocompatibility, and superior esthetics. PURPOSE: The purpose of this report is to show the use of the galvanoforming process in dental implant restorations to transfer the benefits of this technique. MATERIALS AND methods: Two standard Branemark fixtures were placed submerged in the lower mandible for the restoration of a three-unit bridge. The impression was taken at fixture level, and two cast individual telescope abutments were inserted. The galvanoforming restoration was seated conventionally without any screw retention. RESULTS: An implant-supported galvanoforming bridge is functioning successfully. The use of biocompatible materials does not compromise the stability of the restoration; instead, the effect on the periodontal tissues is excellent, resulting in less plaque accumulation and bleeding on probing. Microgaps were avoided by conventional seating on the individual telescope gold abutments, revealing superior occlusal esthetics. CONCLUSIONS: This case report demonstrates the practicability of the biocompatible galvanoforming procedure for implant-supported restorations enhancing periodontal response and esthetics.- - - - - - - - - - ranking = 0.0021357160926781keywords = process (Clic here for more details about this article) |
6/14. Periodontal concerns associated with the orthodontic treatment of impacted teeth.Impacted teeth are common and are often treated with orthodontic eruption, but periodontal problems associated with the process can evade detection. Profound destruction of the periodontium of an impacted tooth or adjacent teeth can occur. This case report describes the orthodontic eruption of 4 impacted canines in a 19-year-old woman. An open surgical approach was used. Within 6 months of treatment, the maxillary right canine and the lateral incisor experienced severe periodontal destruction, resulting in questionable prognoses for the teeth. Plaque control, periodontal architecture, and subgingival microflora were examined as local etiologic factors of periodontal destruction associated with orthodontic eruption of impacted teeth. Plaque control measures were evaluated, and the consequences of orthodontic tooth movement in the presence of inadequate plaque control were considered. Areas of periodontal architecture made vulnerable by the surgical exposure of the impacted teeth were identified, and the effect of orthodontic force on the periodontium was explored. An increase in putative periopathogens in the subgingival microflora after orthodontic appliance placement was observed. Microbiologic monitoring for pathologic levels of periopathogens and antibiotic therapy were considered. Orthodontic treatment of impacted teeth might require additional professional and personal plaque control measures, 3-dimensional diagnostic imaging, and control of putative periopathogens to preserve the health of the periodontium.- - - - - - - - - - ranking = 0.0021357160926781keywords = process (Clic here for more details about this article) |
7/14. Clinical and microbiological changes in a child with rapid alveolar bone loss and refill.A 10-year-old Japanese girl with severe tooth mobility in her lower permanent incisors was examined clinically, as well as radiographic and microbiological means. The incisors had severe alveolar bond loss and pocket depths exceeding 7 mm at the first visit, however, 10 periodontal bacteria were not detected in subgingival plaque samples taken from the lower central incisors using a 16S rRNA-based polymerase chain reaction method. Periodontal treatment consisting of mechanical debridement and antibiltic medication resulted in a significant improvement of the clinical parameters. Three months after the first examination, dental radiographs showed refilling of alveolar bone in the region. Further, microbiological examinations after remission detected only oral microflora commonly found in health children including A. actinomycetemcomitans. Based on the clinical, readiographic, and microbiological findings, the present case was diagnosed as acute periodontitis.- - - - - - - - - - ranking = 6keywords = alveolar (Clic here for more details about this article) |
8/14. Periodontitis as manifestation of Crohn's disease in primary dentition: a case report.The purpose of this case report is to detail an initial periodontal manifestation of Crohn's disease in a 6-year-old boy. The first clinical diagnosis, localized aggressive periodontitis, was based on the microbiological isolation of actinobacillus actinomycetemcomitans from subgingival sites. On examination, gingival lesions, together with bleeding on probing, edema, and erythema, were observed. Although an increased probing depth was detected, no radiographically visible alveolar bone loss was observed. According to these findings, periodontitis as a manifestation of a systemic disease was assumed. Furthermore, fissural ulcerations of the lips were noted. The patient also reported a swelling of the upper lip in the morning. oral hygiene procedures, scaling, root planning, and the application of metronidazole and amoxicillin were not successful. Metabolic and several immunological tests, however, showed normal values. Two months after the first periodontal signs, the child suffered from severe malnutrition, accompanied by diarrhaea and abdominal pain. Active colitis with multiple granulomas was detected histopathologically from biopsies. Crohn's disease was then diagnosed by the internist. If in doubt, medical examinations in every case of childhood periodontitis are recommended to determine whether the findings speak for initial symptoms of a systemic disorder (eg, Crohn's disease).- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
9/14. Tetraploid/diploid mosaicism with generalized aggressive periodontitis.BACKGROUND: Changes of chromosome number diploid to triploid or tetraploid states are rare in human pregnancies, where the main clinical features of tetraploidy are delayed growth and/or craniofacial abnormalities. The present report describes the oral features of tetraploid/diploid mosaicism. Although the medical literature described the physical manifestations of this genetic abnormality, the oral features of this disorder were not previously described. methods: A 13-year-old patient presented because of his severe periodontal conditions. Clinical, radiological, microbiologic, immunologic, and genetic examinations were conducted. RESULTS: Long eyelashes and mandibular micrognathia were noticeable in his extraoral examination. Intraoral examination revealed significant generalized edema of the gingiva and severe sulcular bleeding on probing. Generalized maxillary and mandibular alveolar destruction was determined with radiographic examination. actinobacillus actinomycetemcomitans was also detected in his subgingival samples. He was diagnosed as generalized aggressive periodontitis. His medical cytogenetic examination revealed 92,XXYY (25%)/46,XY (75%) karyotype indicating tetraploid/diploid mosaicism. He was given initial and advanced periodontal therapy and he is currently under a routine follow-up period. CONCLUSIONS: This report provides information on the oral characteristics of tetraploid/diploid mosaicism and describes periodontal treatment. Severe periodontal conditions such as aggressive periodontitis may accompany tetraploid/diploid mosaicism subjects and these patients should be frequently seen by their dental practitioners. It is suggested that initial and/or advanced periodontal procedures may be a way of treating tetraploid/diploid mosaicism subjects with aggressive periodontitis. The importance of physical examination and medical consultation is also discussed.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
10/14. dyskeratosis congenita: dental management of a medically complex child.dyskeratosis congenita (DKC) is a rare syndrome characterized by cutaneous hyperpigmentation, nail dystrophy, leukoplakia, and pancytopenia. The purpose of this case study was to describe the management of a 7-year-old girl diagnosed with DKC who urgently needed dental treatment under general anesthesia before bone marrow transplantation (BMT). The patient presented normal skin, nails, and hair, but oral examination revealed a number of ulcers, leukoplakia, gingival recessions, alveolar bone loss, and dental caries. Hematologic preparation included raising blood parameters, and the anesthesiologist to had consider pulmonary infection. The alveolar bone loss and the gingival recessions required the consultation of a periodontist. Avoiding stainless steel crowns was necessary due to potential plaque accumulation in the crown margins. The goal of this dental treatment was eliminating potential sources of infection before transplantation was conducted. It is important for the pediatric dentist to recognize the medical aspects associated with dental management prior to BMT, and to incorporate them into the treatment plan.- - - - - - - - - - ranking = 2keywords = alveolar (Clic here for more details about this article) |
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