1/20. guided tissue regeneration in the management of severe periodontal-endodontic lesions.diagnosis of combined periodontal-endodontic lesions can prove difficult and frustrating. They are often characterised by extensive loss of periodontal attachment and alveolar bone, and their successful management depends on careful clinical evaluation, accurate diagnosis, and a structured approach to treatment planning for both the periodontic and endodontic components. Recent advances in regenerative periodontics have led to improved management of periodontal-endodontic lesions. This paper reviews the management of such lesions in light of these recent advances and illustrates this through reports of two patients who had severe periodontal involvement.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
2/20. Effective periodontal treatment in a patient with type IIA von Willebrand's disease: report of a case.von Willebrand's disease (vWD) is one of the most common hereditary hemorrhagic disorders. A mild to moderate deficiency of factor viii and von willebrand factor (vWf) often is associated with gingival bleeding. In this case report, the periodontal treatment of a patient with vWD is described. A 45-year-old woman with type IIA vWD was referred for periodontal therapy because of an episode of gingival hemorrhage and percussion pain of teeth #18 and #47. The periodontal findings included probing depths ranging from 2 to 6 mm, horizontal bone loss, and Class II furcation involvement of tooth #46. After consultation with a hematologist, apically positioned flap surgery and hemisection were performed on tooth #46 following completion of oral hygiene instruction, scaling and root planing, and endodontic therapy. The patient was given 500 units of factor viii including vWf multimer 30 minutes before surgery. After healing of the periodontal tissue, prosthodontic treatment was undertaken on the posterior mandibular sextants. At follow-up, the probing depths ranged from 2 to 3 mm, and gingival bleeding on probing was minimal. The patient's children all had vWD. They had mild to moderate periodontitis with probing depths ranging from 2 to 5 mm and gingival bleeding on probing. With the combined efforts of the periodontist and hematologist, effective periodontal treatment can be provided to patients with von Willebrand's disease.- - - - - - - - - - ranking = 1754.1738510522keywords = periodontitis (Clic here for more details about this article) |
3/20. Treatment of molar furcation involvement using root separation and a crown and sleeve-coping telescopic denture. A longitudinal study.Because of the inconsistent results of periodontal and prosthetic therapy, periodontists may choose to treat maxillary molar furcation involvements (FI) with poor root morphology utilizing a root resection technique (RRT). In addition, poor root morphology of the remaining root following RRT is usually considered a high risk factor for long-term periodontal and prosthetic success. The purpose of this retrospective study was to investigate the differences in the clinical periodontal parameters between molar abutments with and without molar root separation and/or resection (RSR) before and after periodontal and prosthetic therapy, using a crown and sleeve-coping telescopic denture (CSCTD). A total of 85 molars (47 maxillary and 38 mandibular) were treated in 25 subjects. There were 33 abutments without root separation/resection and 52 abutments with RSR. Forty-three CSCTD were placed, 23 in the maxillary arch and 20 in the mandibular arch. The mean observation period was 6.7 /-1.9 years (range, 5 to 13 years). The plaque index, gingival index, probing depth, clinical attachment level, and alveolar bone change were recorded. The differences in these parameters before and after periodontal and prosthetic therapy between the advanced furcation-involved molars with and without RSR were evaluated. The results revealed a remarkable improvement in the periodontal parameters in advanced Class II and Class III FI in molars with RSR as compared to those without RSR. It was, therefore, concluded that molar abutments with RSR in conjunction with a specifically designed telescopic device provide a modified approach for treating molars with advanced Class II and III FI.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
4/20. Successful treatment of pulpal-periodontal combined lesion in a birooted maxillary lateral incisor with concomitant palato-radicular groove. A case report.Palato-radicular groove (PRG) is a common developmental anomaly of maxillary incisors, whereas PRG associated with a birooted maxillary incisor is relatively infrequent. The clinical significance of PRG is related to the incidence of localized periodontitis with or without pulpal pathosis, depending on the depth, extent, and complexity of the groove. Successful treatments of PRG in single-rooted incisors have been reported in the literature. However, treatment of PRG in birooted incisors has often been ineffective. This case report describes a pulpal-periodontal combined lesion occurring on a birooted maxillary left lateral incisor with concomitant PRG in a 13-year-old boy which was successfully treated by conventional endodontic therapy in combination with periodontal treatment including accessory root resection, radiculoplasty and bone grafting. Seven-year follow-up is included in this report. The basis of a successful result is accurate diagnosis and elimination of inflammatory irritants and contributory factors. awareness of the existence of this abnormality by the clinician is important.- - - - - - - - - - ranking = 1754.1738510522keywords = periodontitis (Clic here for more details about this article) |
5/20. Furcation involvement in posterior teeth.This article presents two cases in which different treatments were used for mandibular molars with furcation lesions. In the first case, a conventional amputation treatment of the distal root was performed to save the mesial root as a terminal tooth, which was used as a partial denture abutment. The second case describes a relatively new technique in which a root perforation was filled with graft material (synthetic bioglass) and covered with a resorbable membrane to treat an iatrogenic furcation lesion adjacent to the mesial root. Twelve months after surgery, periapical radiographs of both treated cases showed increased bone density. Follow-up in both cases--30 months in the first case and 12 months in the second--showed no pathological recurrence or clinical dysfunction. Root amputation may provide an alternative to extraction in periodontally involved molars. Synthetic bone replacement materials combined with guided tissue regeneration may also help to correct osseous defects incurred by recent furcation perforations with associated bone loss.- - - - - - - - - - ranking = 100.88678625067keywords = periapical (Clic here for more details about this article) |
6/20. Combined periodontal-prosthodontic treatment of early-onset periodontitis--an alternative to implant therapy.A variety of treatment systems should be available for patients whose dentitions are seriously compromised so that they may select customized treatment modalities that satisfactorily restore occlusal function, consider systemic conditions, and lessen the surgical and financial burdens. These requirements become more demanding when clinicians are faced with advanced cases of rapidly progressive periodontitis. Therefore, it is critical to establish sophisticated multidisciplinary treatment modalities for the successful management of these compromised patients. Obviously, because of various limitations, implant therapy cannot be the only solution. This article reports on the successful long-term management of seriously compromised early-onset periodontitis by a combined periodontal-prosthetic treatment as an alternative to implant therapy.- - - - - - - - - - ranking = 10525.043106313keywords = periodontitis (Clic here for more details about this article) |
7/20. A multidisciplinary approach to the diagnosis and treatment of early-onset periodontitis: a case report.BACKGROUND: The diagnosis and treatment of early-onset forms of periodontitis (EOP) represent a major challenge to periodontists. In this case report, we describe a multidisciplinary approach for the treatment of a patient with severe generalized juvenile periodontitis (GJP). Our approach incorporates clinical laboratory evaluation with conventional concepts of periodontal pathogenesis and therapeutics to diagnose and effectively treat EOP. methods: The 17-year-old female patient presented with clinical and radiographic evidence of severe attachment loss. Microbiological testing showed the presence of known periodontal pathogens including actinobacillus actinomycetemcomitans, prevotella intermedia, and porphyromonas gingivalis. Routine immunological tests did not reveal any of the functional defects thought to play a role in the pathogenesis of EOP After initiation of therapy, which consisted of scaling and root planing, supplemented with administration of systemic antibiotics, a reduction in probing depth and gain in clinical attachment could be demonstrated. Microbiological testing was used to monitor the composition of the periodontal microbiota and to adjust antimicrobial therapy accordingly. RESULTS: Using a non-surgical approach to treatment, except for 2 root amputations performed without flap reflection, we have been able to stabilize this patient's periodontal condition over the course of a 2-year follow-up period. CONCLUSIONS: This treatment strategy provides an efficacious alternative to more aggressive forms of therapy and should therefore be considered for the treatment of patients with severe EOP.- - - - - - - - - - ranking = 10525.043106313keywords = periodontitis (Clic here for more details about this article) |
8/20. Periodontal regeneration of a class II furcation defect utilizing a bioabsorbable barrier in a human. A case study with histology.This case report describes human histologic data of periodontal regeneration following guided tissue regeneration therapy (GTR) with a bioabsorbable barrier composed of polylactic acid. The tooth that was examined was part of a previously published study of the clinical effects of GTR therapy without the use of bone or bone substitutes on Class II furcation defects. Twenty-five months following the surgical procedure, the tooth was extracted for non-periodontal reasons. During this extraction, the bone within the furcation that was treated in the study was luxated with the tooth. At the completion of the study (month 12), the furcation's vertical probing depth had decreased by 2 mm with a 2 mm gain in clinical attachment. The horizontal furcation measurement decreased by 3 mm. Following extraction, the tooth was prepared for light microscopy and sectioned in the mesial-distal plane. Reference notches were not placed in the tooth at the time of surgery as there were no plans to perform histologic analysis in the study. However, using the buccal root prominences and what we interpreted to be root planing marks on the cementum, we were able to demonstrate that complete periodontal regeneration occurred on the root surface that was exposed to the pocket environment prior to surgery. New alveolar bone, cementum, and periodontal ligament were consistently observed throughout the furcation in the areas that demonstrated clinical attachment gain and a decrease in horizontal probing depth. This case report adds to the accumulating evidence of histologic periodontal regeneration following guided tissue regeneration with bioabsorbable polylactic acid barriers.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
9/20. Clinical application of a new compact computed tomography system for evaluating the outcome of regenerative therapy: a case report.BACKGROUND: The limitations of conventional 2-dimensional (2-D) radiographs have been emphasized in many studies. Because the image is a 2-D map of the 3-dimensional (3-D) tooth and periodontal tissue, these structures may be superimposed on each other. Recently, 3-D image analysis by computed tomography (CT) was introduced to dentistry, but it has been used only rarely in the periodontal field. methods: The purpose of this case report was to introduce the clinical application of a newly developed, compact computed tomography system for evaluating the outcome of regenerative therapy in an adult patient with periodontitis (male, aged 55 years). To evaluate the bone defects including furcation involvement, we took an intraoral radiograph and performed CT scanning on tooth #19. We recorded a number of clinical parameters at the time of surgery. We compared the images of the bone defect obtained by CT images and the conventional radiograph with the true bone defect morphology at the surgical site. RESULTS: One year after the periodontal surgery, we again took CT scans and a conventional radiograph, and the new images of the bone defect were compared and evaluated. The new CT images were reconstructed for 3-D evaluation and compared with those taken before surgery. The CT provides 3-D images of excellent quality for evaluating the morphology of the periodontal bone defect and furcation involvement. CONCLUSIONS: We consider that CT is a useful aid in periodontal examination and diagnosis, and in the prediction and evaluation of periodontal treatment outcomes.- - - - - - - - - - ranking = 1754.1738510522keywords = periodontitis (Clic here for more details about this article) |
10/20. rothmund-thomson syndrome: a case report.rothmund-thomson syndrome (RTS) is an extremely rare genetic disorder characterized by poikilodermatous skin changes, photosensitivity, and an increased risk of developing skin and bone malignancies. In this case report, the dental and periodontal features of RTS in a 16-year-old female patient are presented. The transmission electron microscopy performed on a gingival biopsy specimen showed structural defects of connective tissue. If the unusual ultrastructural findings of this case are confirmed as being consistent with other RTS patients, it is our opinion that this syndrome can be considered among the systemic diseases associated with early-onset periodontitis.- - - - - - - - - - ranking = 1754.1738510522keywords = periodontitis (Clic here for more details about this article) |
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