1/25. 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 = 1keywords = periodontitis (Clic here for more details about this article) |
2/25. Periodontal disease associated with Langerhans' cell histiocytosis: case report.A clinical case of Langerhans' cell histiocytosis, type eosinophilic granuloma, in a young adult patient is presented. Because of the occurrence of oral manifestations in initial stages of the disease, there is a need for a differential diagnosis, especially with the early-onset periodontitis.- - - - - - - - - - ranking = 0.16666666666667keywords = periodontitis (Clic here for more details about this article) |
3/25. Combined mechanical and antibiotic periodontal therapy in a case of Papillon-Lefevre syndrome.BACKGROUND: Papillon Lefevre syndrome (PLS) is a rare entity and, as such, it is almost impossible to evaluate an effective therapy in a randomized controlled study. The amount of success reported after therapy for prepubertal periodontitis (PP) in PLS is highly variable from case to case. The goal of this case report is to evaluate the effects of a combined mechanical and antibiotic periodontal therapy regimen in the management of PLS. methods: A male patient was diagnosed as suffering from PP associated with PLS at the age of 7 years. He showed hyperkeratosis of the palms and soles, as well as advanced periodontal disease already affecting permanent teeth with maximal probing depth and vertical attachment loss of 12 mm and 11 mm, respectively. Subgingival debridement was performed with simultaneous administration of oral 250 mg amoxicillin 3 times daily and 250 mg metronidazole twice daily for one week. Clinical parameters were assessed and subgingival plaque was collected from all teeth prior to therapy and 7 and 26 months after treatment. Selective cultures for A. actinomycetemcomitans were incubated for each individual tooth and DNA probe analysis was performed for various periodontal pathogens. RESULTS: Prior to combined mechanical and antibiotic treatment, all teeth but one harbored actinobacillus actinomycetemcomitans subgingivally. However, at 7 and 26 months after therapy A. actinomycetemcomitans could be detected neither by culture nor by dna probes. Clinical parameters improved markedly and teeth erupting after therapy did not exhibit attachment loss of more than 1.5 mm during the observation period. CONCLUSIONS: Eradication (suppression beneath detection levels) of A. actinomycetemcomitans seems to play a significant role in the successful treatment of localized prepubertal periodontitis in PLS.- - - - - - - - - - ranking = 0.33333333333333keywords = periodontitis (Clic here for more details about this article) |
4/25. Metal piercing through the tongue and localized loss of attachment: a case report.The piercing of intraoral structures to accommodate different types of jewelry has increased in popularity in the last few years. The association of an intraoral piercing with localized periodontitis is not well documented in the literature. A 22-year-old male presented to our clinic with a tongue stud placed through the mid-dorsum of his tongue. The inferior sphere was coated with plaque and calculus. Teeth #24 and #25 exhibited 6 mm interproximal probing depth and recession, horizontal radiographic bone loss, and tissue indentations consistent with the shape of the inferior ball of the tongue stud directly on the lingual surfaces of both teeth. The treatment consisted of an adult prophylaxis, flap curettage of the mandibular anterior region, oral hygiene instructions, and removal of the tongue stud. At our follow-up visit, the patient's oral hygiene had improved, he has removed the jewelry, and the attachment loss appears to have stabilized.- - - - - - - - - - ranking = 0.16666666666667keywords = periodontitis (Clic here for more details about this article) |
5/25. Treatment of rapidly progressive periodontitis: a review and case report.This article presents a case of rapidly progressive periodontitis in an otherwise healthy 21-year-old man. Etiologic, diagnostic, and therapeutic procedures are described and the rationale for therapy is discussed. Eighteen months after surgery, clinical and radiographic results showed improvement, and marked probing attachment level gain and probing depth reduction were observed.- - - - - - - - - - ranking = 0.83333333333333keywords = periodontitis (Clic here for more details about this article) |
6/25. aggressive periodontitis associated with Fanconi's anemia. A case report.BACKGROUND: Fanconi's anemia is an autosomal recessive disease associated with chromosomal breakage as well as pancytopenia, skin pigmentation, renal hypoplasia, cardiac defects, microcephaly, congenital malformations of the skeleton, hypogonadism, and increased risk of leukemia. The present report describes the periodontal clinical and microbiological status of an 11-year old male having Fanconi's anemia. methods: polymerase chain reaction analysis to detect human cytomegalovirus (HCMV), Epstein-Barr type 1 virus, and herpes simplex virus (HSV) was performed on paper-point samples pooled from either 3 periodontal sites with advanced attachment loss or 3 gingivitis sites with no clinical attachment loss. Anaerobic bacterial culture examination was performed on the pooled periodontitis sample. RESULTS: The patient suffered from pancytopenia, allergy, asthma, hearing impairment, and mental retardation. dentition consisted of 7 primary teeth, 11 erupted permanent teeth, and 14 unerupted permanent teeth. Most erupted teeth showed severe gingival inflammation with some gingival overgrowth and various degrees of periodontal attachment loss. Genomes of HCMV and HSV were detected in the pooled periodontitis sample and HCMV in the pooled gingivitis sample. The periodontitis sample but not the gingivitis sample revealed HCMV mRNA of major capsid protein, suggestive of active viral infection. The periodontitis sample also yielded actinobacillus actinomycetemcomitans (1.1% of total isolates), fusobacterium species (7.9%), campylobacter species (2.2%), peptostreptococcus micros (3.4%), and candida albicans (0.3%). CONCLUSIONS: Oral features of Fanconi's anemia may include increased susceptibility to periodontitis. It is likely that underlying host defense impairment coupled with periodontal infection by HCMV and A. actinomycetemcomitans contribute to the severe type of periodontitis associated with Fanconi's anemia.- - - - - - - - - - ranking = 1.6666666666667keywords = periodontitis (Clic here for more details about this article) |
7/25. Treatment of Papillon-Lefevre syndrome periodontitis.BACKGROUND, AIMS: Conventional mechanical treatment of Papillon-Lefevre syndrome periodontitis has a poor prognosis. This report describes an effective antimicrobial treatment of rapidly progressing periodontitis in an 11-year old girl having Papillon-Lefevre syndrome. METHOD: Clinical examination included conventional periodontal measurements and radiographic analysis. Occurrence of major suspected periodontopathic bacteria was determined by selective and non-selective culture and by polymerase chain reaction (PCR) identification. Presence of cytomegalovirus and Epstein-Barr type 1 virus was determined by a nested-PCR detection method. Therapy included scaling and root planing, oral hygiene instruction, and systemic amoxicillin-metronidazole therapy (250 mg of each/3 times daily/10 days) which, based on follow-up microbiological testing, was repeated after 4 months. Supportive periodontal therapy took place at 2 visits during a 16-month period. RESULTS: At baseline, 10 of 22 available teeth demonstrated severe periodontal breakdown. At 16 months, probing and radiographic measurements revealed no teeth with additional attachment loss, and several teeth exhibited significant reduction in gingivitis and pocket depth, increase in radiographic alveolar bone height and clinical attachment level, and radiographic evidence of crestal lamina dura. Baseline subgingival microbiota included actinobacillus actinomycetemcomitans (3.4% of total isolates), prevotella nigrescens (16.4%), Fusobacteriumnucleatum (14.3%) and peptostreptococcus micros (10.6%), as well as cytomegalovirus and Epstein-Barr type 1 virus. At termination of the study, culture and PCR examinations showed absence of A. actinomycetemcomitans, P. micros and herpesviruses, and P. nigrescens and F.nucleatum each comprised less than 0.1 % of subgingival isolates. CONCLUSION: This study suggests that controlling the periodontopathic microbiota by appropriate antibiotic and conventional periodontal therapy can arrest Papillon-Lefevre syndrome periodontitis.- - - - - - - - - - ranking = 1.1666666666667keywords = periodontitis (Clic here for more details about this article) |
8/25. The use of orthodontic intrusive movement to reduce infrabony pockets in adult periodontal patients: a case report.Clinicians often encounter osseous defects that are best treated by conventional surgical techniques, including bone grafting and guided tissue regeneration, with a goal of establishing a new connective tissue attachment. On occasion, the recognition of an infrabony defect proximal to a tooth with a large diastema may present an opportunity to consider resolution by orthodontic tooth movement. Ideally, the tooth could be moved in the proximal direction until there was no further radiographic or clinical evidence of the predisposing defect. The authors decided to treat an advanced case of adult periodontitis, with extrusion and migration of a maxillary central incisor, using a multidisciplinary approach. Radiologically, a large infrabony defect was present on the mesial aspect of the incisor, with an initial probing depth of 9 mm. After the surgical periodontal therapy, the orthodontic movement started and the incisor was repositioned using an intrusive mechanism, also leading to the closure of the diastema. At the end of the treatment, there was a significant clinical decrease in the probing depth values, and radiographs showed a remarkable reduction of the infrabony defect volume.- - - - - - - - - - ranking = 0.16666666666667keywords = periodontitis (Clic here for more details about this article) |
9/25. 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 = 0.16666666666667keywords = periodontitis (Clic here for more details about this article) |
10/25. A combined approach of enamel matrix derivative gel and autogenous bone grafts in treatment of intrabony periodontal defects. A case report.Enamel matrix derivative (EMD) has recently been introduced as a new modality in regenerative periodontal therapy. This case report demonstrates a combined approach in topical application of EMD gel (Emdogain) and autogenous bone grafts for treatment of intrabony defects and furcation involvement defects in a patient with chronic periodontitis. The seven-month post-surgery clinical and radiographic results were presented. The combined application of EMD gel with autogenous bone grafts in intrabony osseous defects resulted in clinically significant gain of attachment on diseased root surfaces and bone fill on radiographs. Further controlled clinical studies are required to confirm the long-term effectiveness of the combination of EMD gel and autogenous bone grafts in treatment of various osseous defects in subjects with chronic periodontitis.- - - - - - - - - - ranking = 0.33333333333333keywords = periodontitis (Clic here for more details about this article) |
| | Next -> |