1/34. 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) |
2/34. Periodontal and peri-implant bone regeneration: clinical and histologic observations.The principle of guided tissue regeneration by barrier membranes to restore lost periodontal tissue around natural teeth has also been used around osseointegrated implants in an attempt to restore alveolar ridge defects. While most periodontal procedures in the literature describe root coverage by mucogingival surgery, which achieves healing through soft tissue attachment, regeneration of denuded root surfaces is performed by guided tissue regeneration using expanded polytetrafluoroethylene barrier membranes and demineralized freeze-dried bone allografts as inductive/conductive materials. In this study the technique is applied in two partially exposed cylindrical hydroxyapatite-coated implants in extraction sites in one patient. Surgical reentry in both sites is presented, with histologic examination revealing new bone formation on the exposed root surface and the hydroxyapatite-coated implants.- - - - - - - - - - ranking = 1.4873528136059keywords = alveolar, ridge (Clic here for more details about this article) |
3/34. Resin-ionomer and hybrid-ionomer cements: part II, human clinical and histologic wound healing responses in specific periodontal lesions.Twenty-five subjects with a total of 50 subgingival restorations participated in this study. At the beginning of the investigation, nine teeth that were considered hopeless because of the extent of their pathology were selected for extraction to evaluate histologically the restorations and their effect on the adjacent tissues. The purpose of this article is to demonstrate the responses to the clinical applications as well as to the placement of resin-ionomers in subgingival lesions. Clinical and histologic evidence of epithelial and connective tissue adherence to resin-ionomer restorative materials was observed during the healing process.- - - - - - - - - - ranking = 0.00049313479862943keywords = process (Clic here for more details about this article) |
4/34. Esthetic restoration of a single-tooth dental implant using a subepithelial connective tissue graft: a case report with 3-year follow-up.This case report describes the use of a subepithelial connective tissue graft to restore the gingival papillae and augment ridge soft tissues adjacent to a dental implant. The patient was referred for periodontic and prosthodontic evaluation after the placement of an implant--with the implant head 6.5 mm below the adjacent cementoenamel junction--in an area of inadequate bone volume with deficient interproximal papillae and ridge soft tissues. The resulting esthetic defect was restored by means of a combined technique that used a subepithelial connective tissue graft and an emergence profile-contoured crown. A 3-year clinical follow-up with complete regeneration of the gingival papillae is described.- - - - - - - - - - ranking = 0.97470562721173keywords = ridge (Clic here for more details about this article) |
5/34. Improvement of multiple facial gingival recession by non-surgical and supportive periodontal therapy: a case report.We report a case of multiple facial gingival recession which was improved by non-surgical and supportive periodontal therapy. The patient, a 28-year-old Japanese woman, presented for treatment of multiple facial gingival recession ranging from 1 to 4 mm on teeth 5 through 12 and 19 through 30. Periodontal plastic surgery to cover the exposed multiple root surfaces was suggested. However, because of emotional problems, the patient did not wish to undergo the procedures and instead accepted non-surgical periodontal therapy including oral hygiene instruction, scaling, and root planing. The exposed root sites were monitored at periodic maintenance visits, and gradual improvement through a coronal increase of the gingival margin was noted. The possible etiologic factors and healing process associated with this case are discussed.- - - - - - - - - - ranking = 0.00049313479862943keywords = process (Clic here for more details about this article) |
6/34. Subgingival acellular dermal matrix allograft for the treatment of gingival recession: a case report.Root coverage procedures using subgingival soft tissue grafts or guided tissue regeneration have attracted much interest within the past 2 decades. Recently, acellular dermal matrix allograft (ADMA) has been introduced as a substitute for palatal donor tissue in gingival augmentation procedures. This study was undertaken to examine the potential of ADMA to be used as a substitute for autogenous connective tissue graft material in a root coverage procedure in a case with moderate gingival recession combined with reduced keratinized attached gingiva. After thorough root planing and conditioning of the root surface with a saturated solution of tetracycline-HCl, a trapezoidal mucoperiosteal flap was raised and the papillae were de-epithelialized. The exposed bone surrounding the exposed root surface was perforated with a No. 2 round drill, and the exposed root and surrounding bone were covered by ADMA. The allograft was stabilized by 5-0 vicryl sutures. The flap was coronally positioned to completely cover the ADMA. Healing was uneventful. Eight-month observations and measurements showed root coverage of more than 3.5 mm (>80%), a gingival margin that was harmonious with the neighboring teeth, and an increase of the zone of keratinized attached gingiva, from 1 to 3 mm. Within the limitations of these clinical observations, it is suggested that ADMA may be a possible substitute to free autogenous connective tissue grafts and/or bioabsorbable barrier membranes. Further clinical and histological studies are necessary to understand the healing process of this surgical wound.- - - - - - - - - - ranking = 0.00049313479862943keywords = process (Clic here for more details about this article) |
7/34. Successful root coverage: a human histologic evaluation of a case.connective tissue grafts combined with pedicle grafts (subepithelial grafts) have been shown to be effective in obtaining root coverage. Unfortunately, little is known about the histology of the results in humans. This is a case report of a tooth with a recession defect that was treated with a subepithelial graft. Complete root coverage was obtained. However, at 5 months postoperative the tooth had to be extracted because of a vertical root fracture. With the patient's permission, a small collar of tissue was removed with the tooth. The sample was processed and evaluated histologically. The results revealed areas of regeneration, with new bone, cementum, and connective tissue attachment coronal to the original gingival margin. No bone grafts or guided tissue regeneration membranes were used. This case report confirms that regeneration is possible with subepithelial grafts.- - - - - - - - - - ranking = 0.00049313479862943keywords = process (Clic here for more details about this article) |
8/34. Clinical and histologic evaluation of human gingival recession treated with a subepithelial connective tissue graft and enamel matrix derivative (Emdogain): a case report.A mandibular canine with significant gingival recession was selected for a pilot study to measure the attachment modalities resulting from mucogingival surgery. The tooth had 6 mm of recession as measured from the cementoenamel junction to the gingival margin, minimal pocketing, and no keratinized gingiva. The treatment regimen consisted of a subepithelial connective tissue graft (SCTG) plus Emdogain applied to the root surface. The tooth was extracted en bloc 6 months after surgery and processed histologically in a buccolingual plane. The tooth demonstrated a 2-mm gain of attachment and a 3-mm gain in keratinized tissue. The histologic study evidenced the migration of the junctional epithelium 1.2 mm apical to the sulcus. New cementum, evidence of newly formed woven bone, and connective tissue fibers anchored in the new cementum were evident.- - - - - - - - - - ranking = 0.00049313479862943keywords = process (Clic here for more details about this article) |
9/34. Human histologic evaluation of a bone graft combined with GTR in the treatment of osseous dehiscence defects: a case report.There are many possible goals and outcomes of periodontal surgical therapy, but the ultimate goal is regeneration. Since the definition of periodontal regeneration is histologic, it is difficult to document. The purpose of this study was to evaluate a technique that combined a bone graft and guided tissue regeneration (GTR) to see if regeneration occurred. Four teeth with dehiscence-type osseous defects that were scheduled for extraction were treated with bone grafts and GTR. During the surgical procedure, a notch was placed into the root at the apical extent of the calculus. The teeth were extracted with conservative block sections 7 months after the treatment. They were processed, sectioned, stained, and evaluated histologically. The results revealed that regeneration did not occur in any of the teeth treated. In 2 of the teeth new connective tissue attachment was formed. In these 2 teeth cementum could be seen in the notch with connective tissue fibers inserting into the cementum. In one of the teeth the junctional epithelium extended apical to the notch, while in 3 cases the epithelium stopped at or coronal to the notch. In this case report, no regeneration could be documented, but new attachment could be seen in 2 of the 4 teeth treated.- - - - - - - - - - ranking = 0.00049313479862943keywords = process (Clic here for more details about this article) |
10/34. Ehlers-Danlos type VIII. review of the literature.Ehlers-Danlos type VIII is a rare disorder characterized by soft, hyperextensible skin, abnormal scarring, easy bruising, and generalized periodontitis with early loss of teeth. To illustrate the clinical dermatological and dental features, we present the case history of a 20-year-old patient who has suffered from poor healing of wounds at the shins and knees since childhood, which have developed into hyperpigmented atrophic scars. In the course of orthodontic treatment during the last 3 years, severe apical root resorption, gingival recession, and loss of alveolar bone were observed. family history was noncontributory for any skin or tooth disorders. The typical clinical signs confirmed the diagnosis of ehlers-danlos syndrome type VIII. As there is no specific treatment for the disorder, management is limited to the symptomatic treatment of the dental disease. It seems advisable to consider carefully the indications for orthodontic treatment in patients with Ehlers-Danlos type VIII syndrome.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
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