1/124. 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 = root (Clic here for more details about this article) |
2/124. 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 = 3keywords = root (Clic here for more details about this article) |
3/124. Human histologic evaluation of root coverage obtained with a connective tissue with partial thickness double pedicle graft. A case report.The use of a connective tissue graft combined with a pedicle graft has been proven an effective method to achieve root coverage. However, little is known about the histologic results in humans. A connective tissue with partial thickness double pedicle graft was performed on 2 teeth scheduled for extraction for prosthetic reasons. The procedures were clinically successful (100% and 83.3% root coverage). At 6 months postoperative, the teeth were extracted with conservative block sections and analyzed histologically. Two different healing patterns were seen. The first was characterized by a long junctional epithelial attachment that extended well beyond the original gingival margin and occasionally almost to the original bone level with minimal connective tissue adjacent to the tooth. The other pattern was a short junctional epithelium that stopped at the previously exposed root surface. In this pattern, there was predominately connective tissue adjacent to the tooth with some isolated areas of epithelium. No new bone or cementum was seen in any section. The use of a technique that combines a connective tissue graft with a pedicle graft can produce root coverage and a successful clinical result. However, the histological evaluation of this case report revealed that true regeneration was not seen in this study, only repair.- - - - - - - - - - ranking = 8keywords = root (Clic here for more details about this article) |
4/124. 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 = 3keywords = root (Clic here for more details about this article) |
5/124. 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 = 6keywords = root (Clic here for more details about this article) |
6/124. Periodontal esthetics and soft-tissue root coverage for treatment of cervical root caries.As the pace of change accelerates in periodontics and esthetic dentistry, an increasing number of procedures are being developed that require knowledge and treatment from both fields. The synergy developed by combining these two fields of dentistry allows for better esthetic outcomes for our patients. Two of these procedures include esthetic crown lengthening and soft-tissue root coverage. As demonstrated in this article, soft-tissue root coverage can be performed on previously restored roots and as an option for treating root caries.- - - - - - - - - - ranking = 12keywords = root (Clic here for more details about this article) |
7/124. 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 = 7keywords = root (Clic here for more details about this article) |
8/124. Root coverage and papilla reconstruction in Class IV recession: a case report.While root coverage is predictable for Miller Class I and II recessions, the surgical regeneration or reconstruction of a lost interdental papilla is more difficult to obtain. To date only a few successful case reports have been reported, and there are no studies that report a predictable technique to obtain papilla reconstruction or root coverage on Class IV recessions. This case report, which is part of a preliminary study, outlines a surgical technique to obtain simultaneous root coverage and papilla reconstruction.- - - - - - - - - - ranking = 3keywords = root (Clic here for more details about this article) |
9/124. Severe gingival recession in trisomy 18 primary dentition. A clinicopathologic case report of self-inflicted injury associated with mental retardation.This clinicopathologic case report documents severe gingival recession in the primary dentition of a trisomy 18 patient. Primary molar and canine teeth exhibited recession extending beyond the midpoint of the buccal aspect of the root, occasionally reaching the root apex. Radiographic examination revealed taurodontism in both primary and permanent teeth. Clinical and histopathologic findings, along with case history, eliminated the possibility of prepubertal periodontitis and suggested a diagnosis of self-inflicted injury associated with mental retardation. Histologic examination of the primary teeth revealed normal cementum and dentin structure. Taurodontism, histologic structure of the dentition, and severe attachment loss in the primary dentition have not been described previously in trisomy 18.- - - - - - - - - - ranking = 2keywords = root (Clic here for more details about this article) |
10/124. Desensitization of exposed root surfaces using a semilunar coronally positioned flap.A definitive treatment is described for cervical dentinal sensitivity, featuring a semilunar coronally positioned flap to cover the denuded root surface. Many patients who complain of having sensitive teeth from exposed dentin secondary to gingival recession can be easily and conservatively treated with a semilunar flap procedure.- - - - - - - - - - ranking = 5keywords = root (Clic here for more details about this article) |
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