1/5. Management of periodontitis associated with endodontically involved teeth: a case series.The pulp and the periodontal attachment are the two components that enable a tooth to function in the oral cavity. Lesions of the periodontal ligament and adjacent alveolar bone may originate from infections of the periodontium or tissues of the dental pulp. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. The function of the tooth is severely compromised when either one of these is involved in the disease process. Treatment of disease conditions involving both of these structures can be challenging and frequently requires combining both endodontic and periodontal treatment procedures. This article presents cases of periodontitis associated with endodontic lesions managed by both endodontic and periodontal therapy.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
2/5. Origin, diagnosis, and treatment of the dental manifestations of vitamin d-resistant rickets: review of the literature and report of case.Previous discussions center on early diagnosis, initial treatment, and follow-up therapy for the patient with vitamin d-resistant rickets. Both the medical and dental aspects of treatment for these patients has a long-range effect on the normal developmental patterns. Although treatment is begun at an early age, some rachitic skeletal effects such as minor bowing of the legs and bossing of the skull will invariably be noticed. In patients with controlled rickets the alveolar processes undergo normal development, with apparent normal dental eruption. The poor development and calcification of the alveolus seen in the untreated patient leads to loss of the lamina dura and periodontal ligament of the teeth. patients with resistant rickets possess a functional dentition, although not without inherent defects. Various degrees of fracture and attrition of enamel can be seen, and hypoplasia of dentin is nearly a universal result. Defects extending to the dentinoenamel junction have been shown in repeated cases. Cementum, because of its close relationship with dentin calcification, also appears abnormal. Pulp tissue may undergo abberations of physiology in resistant rickets, although further work in this respect is needed. With respect to the possible dental pathoses seen in this disease, the dental history of the patient with resistant rickets discussed in this report showed that several of the deciduous teeth, possibly the mandibular left second premolar and right first molar, and definitely the maxillary right second premolar and canine and the mandibular left canine had all undergone pulpal degeneration of apparently unknown causation. In the maxillary right second premolar and the mandibular left canine, enamel fractures were clinically and radiographically apparent. However, the maxillary right canine originally had an acute abscess with no defects other than normal, minimal wear facets. No causative factor for its necrosis could be found. Overt enamel fractures in the maxillary right second premolar and the mandibular left canine may have led to microexposures of the pulp with subsequent bacterial pulpal contamination. suppuration present in several of the pulps when first entered during endodontic treatment, as well as chronic fistulas in several areas, support the conclusion that contamination by some means does indeed occur.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
3/5. Histologic and clinical assessment of long-term pulpal-periodontal therapy.A 20-year follow-up of cases published in 1959 involving the treatment of pulpal-periodontal disease suggests the following: 1. The periodontal results have been stable except for one case of root resorption and one case in which there was gingival recession with no pocket formation. 2. The histologic evidence in the resorbed case would suggest that repair had occurred with the formation of new bone, ligament, and cementum. 3. There was also evidence from the histologic sections that the inflammatory response was localized to the region of the apical foramen. 4. There was secondary osteocementum on the dentin surface inside the root canal which had narrowed the width of the apical foramen. 5. There was x-ray and histologic evidence that previously well-condensed gutta-percha had been resorbed during a 20-year period in all of the four treated root canals.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
4/5. Multidisciplinary approach to apical surgery in conjunction with the loss of buccal cortical plate.The treatment of advanced periodontal breakdown as a result of an associated endodontic lesion continues to challenge the practitioner. Two cases of teeth with endodontic pathologic conditions that required apical surgery are presented. On raising the flap, no buccal cortical plate was found, significantly lowering the prognosis of the surgery. A barrier membrane was used in addition to the apical surgery, which on postoperative follow-up appears to have resulted in the reestablishment of the buccal cortical plate.- - - - - - - - - - ranking = 0.0240598222057keywords = membrane (Clic here for more details about this article) |
5/5. A new approach to the treatment of true-combined endodontic-periodontic lesions by the guided tissue regeneration technique.Clinicians often have difficulty in the diagnosis and treatment of the combined endodontal and periodontal (endo-perio) lesion. A case of an endo-perio true-combined lesion on a maxillary premolar was first treated with conventional endodontic therapy. Periodontal surgery was then completed, which included scaling and root planing and apical curettage on the tooth. The facial bony defect was then filled with a decalcified freeze-dried bone allograft mixed with tetracycline powder. A non-resorbable Teflon membrane was then used to cover the bone material and the periodontal flap sutured over this. This combined treatment resulted in minimal probing depth (2 mm), maximal clinical attachment gain (8 mm), as well as radiographic evidence of alveolar bone gain. This case report demonstrates that proper diagnosis, followed by removal of etiological factors and utilizing the guided tissue regeneration technique combined with osseous grafting, will restore health and function to a tooth with severe attachment loss caused by an endo-perio lesion.- - - - - - - - - - ranking = 0.0240598222057keywords = membrane (Clic here for more details about this article) |