1/66. 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) |
2/66. The periodontal management of a patient with a profound immunodeficiency disorder.A case of severe, uncontrolled periodontal disease in a patient with a profound immunodeficiency disorder is reported. The periodontal disease was noted before the age of 10 years and is generalized, with marked associated alveolar bone loss, even threatening a mandibular fracture. Severely involved teeth were allowed to exfoliate, and extractions were avoided. At the age of 17 years, the patient now has only nine remaining teeth. The management adopted and alternative approaches are critically reviewed. The implications of the dental findings for current concepts of the pathogenesis of periodontal disease and dental caries are discussed.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
3/66. Subgingival plaque and loss of attachment in periodontosis as observed in autopsy material.Histologic sections from six autopsy cases which from a clinical point of view fitted into the criteria of periodontosis were examined with the aim at evaluating the role of subgingival plaque in the etiology of the loss of attachment in this condition. The following pertinent observations were made: 1. The subgingival plaque in most instances was not calcified to form calculus. 2. The thickness of the subgingival plaque varied between 20 and 200 mu (0.02-0.2 mm). 3. Where loss of attachment had taken place, the distance from the most apical part of the subgingival plaque to the most apical point of the epithelial cuff varied between 0.2 and 1.1 mm; this distance was never found to be more than 1.1 mm. This would indicate a cause and effect relationship, the plaque being the obvious cause. 4. There was very severe chronic inflammation in the soft tissue bordering upon the plaque with resulting collagenolysis. 5. The cellular infiltration and the collagenolysis may be limited to a zone of 1 to 2 mm in the immediate vicinity of the plaque. Between the inflamed area and the surface of the gingivae buccally and lingually there may be a fairly wide zone of healthy tissue which hides the symptoms of inflammation from being observed on a clinical examination. In turn this could leave the clinician with the impression that attachment has been lost and bone resorbed because of degenerative changes. The following conclusions can be made: In these six cases of "alveolar bone loss vastly out of proportion to what one would expect from the local etiologic factors in the patient at that age" there was no morphologic evidence that degenerative changes were responsible for the loss of attachment. On the contrary inflammatory changes induced by the subgingval plaque dominated the histopathologic picture.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
4/66. Congenital neutropenia. Report of a case and a biorationale for dental management.Congenital neutropenia is characterized by a marked decrease in or lack of circulating PMN's in children with no prior history of drug intake. The neutropenia is persistent and the clinical course is one of early onset of severe, recurrent, and eventually fatal infections. bone marrow studies show a maturation arrest of neutrophilic precursors. Because of their greatly increased susceptibility to infection, patients with congenital neutropenia present a difficult dental management problem. A case of congenital neutropenia has been presented, as well as a biorationale for dental treatment. On the basis of reports in the literature, the following recommendations for the management of patients with congenital neutropenia are made: 1. The prevention and control of infection and the interception of dental disease before surgical intervention becomes necessary should be the overriding considerations in the management of patients with congenital neutropenia. 2. The carious breakdown of teeth should be prevented by the daily application of a 0.4 per cent stannous fluoride gel in addition to oral hygiene and limitation of sucrose intake. 3. Periodontal therapy should be palliative only, since alveolar bone loss is progressive despite frequent oral hygiene instruction and prophylaxis. The goal of periodontal therapy for patients with congenital neutropenia should therefore be a decrease in gingival inflammation to make the patient's mouth more comfortable and to slow down alveolar bone loss. Periodontal surgery is contraindicated. 4. bacteremia and subsequent septicemia should be prevented since a minor infection can become life threatening in patients with congenital neutropenia. The patient should rinse for 30 seconds and the gingival sulci should be irrigated with a phenolated antiseptic mouthwash prior to all dental manipulations of the soft tissue. This will significantly reduce the incidence of bacteremia. 5. Surgery should be avoided if at all possible because of the high risk of post-operative infection. All surgery sholld be performed in the hospital, and the patient should be given antibiotics as determined by his physician. Primary closure should be done with fine polyglycolic acid sutures to reduce the chance of infection. If postoperative infection can be prevented, wound healing will progress normally despite the complete absence of PMN's.- - - - - - - - - - ranking = 2keywords = alveolar (Clic here for more details about this article) |
5/66. Implant site development using orthodontic extrusion: a case report.One of the most important factors in the successful placement of endosseous implants is the presence of adequate alveolar bone at the recipient site. alveolar bone loss associated with destructive periodontal disease frequently results in osseous defects that may complicate subsequent implant placement. Typically, such defects are treated prior to or at the time of implant surgery using the principles of guided bone regeneration. Under certain circumstances, however, such defects may be managed non-surgically by orthodontic extrusion. orthodontic extrusion can be used to increase the vertical bone height and volume and to establish a more favourable soft-tissue profile prior to implant placement. The addition, the increase in the vertical osseous dimension at interproximal sites may assist in the preservation of the interdental papillae and can further enhance gingival aesthetics. This report illustrates the treatment sequence for site development with orthodontic extrusion prior to immediate implant placement.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
6/66. 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) |
7/66. Periodontal and alveolar bone abnormalities associated with pachydermoperiostosis.Pachydermoperiostosis (PDP) is an unusual syndrome manifested clinically by finger clubbing, extremity enlargement, hypertrophic skin changes, and periosteal bone formation. A rare case of pachydermoperiostosis (primary hypertrophic osteoarthropathy) with oral manifestations in a 47-year-old man is presented. The possible correlation between physiological mechanisms of this disease and their influence on oral periodontal tissues and alveolar bone is discussed.- - - - - - - - - - ranking = 5keywords = alveolar (Clic here for more details about this article) |
8/66. Clinical effect of etidronate on alveolar pyorrhoea associated with chronic marginal periodontitis: report of four cases.Etidronate 200 mg daily was administered to four female patients with periodontitis and resultant alveolar pyorrhoea for periods of 2 weeks, followed by off-periods of 10 weeks or more, for 2-3 years. The macroscopic appearance of gingival mobility of the teeth, depth of periodontal pockets, and X-ray findings of alveolar bones improved markedly during this time. The effects were first observed after 6-12 months of treatment. These findings indicate that bisphosphonates may be effective in the treatment of periodontitis and resultant alveolar pyorrhoea. The effect may be mediated by the inhibitory action on bone resorption and the anti-inflammatory action of etidronate. Concomitant conventional dental management is also required.- - - - - - - - - - ranking = 7keywords = alveolar (Clic here for more details about this article) |
9/66. case reports: evolution of prosthetic rehabilitation for a patient with severe loss of periodontal support.This paper describes the development of a technique to make a fixed bridge for a patient with severe reduction of periodontal support. Initially, the bridge was temporarily cemented over copings. However, when the super-structure was periodically removed for inspection, the copings were easily dislodged, with a risk of fracture of the abutment teeth. Consequently, the technique was modified by using lateral screws to fix the bridge to the copings. This design allows easy periodical removal, cleaning, repair and inspection of the abutment teeth.- - - - - - - - - - ranking = 0.32721549351041keywords = ridge (Clic here for more details about this article) |
10/66. The mandibular molar class III furcation invasion: a review of treatment options and a case report of tunneling.BACKGROUND: The predictable management of a mandibular molar that has lost all of its interradicular periodontal support-in other words, that has experienced a Class III furcation invasion, or FI-often is a frustrating and disappointing process for both clinician and patient. The strategic value of retaining such a periodontally involved tooth must be determined by both the patient and dentist before a treatment option is selected. In this article, the authors present and describe various therapeutic plans available for Class III FIs in mandibular molars, discussing the advantages and disadvantages of each approach. They focus particularly on a surgical technique called "tunneling," which is performed to debride the remaining soft and hard tissues in the furcal area; this, in turn, allows access for effective oral hygiene and maintenance. CASE DESCRIPTION: The authors report on the 23-year result of a case involving tunneling. The procedure facilitated the retention of a mandibular molar with a Class III FI in a manner acceptable to both the patient and the clinician. CLINICAL IMPLICATIONS: Tunneling, in a properly selected patient who is motivated to perform careful oral hygiene, can result in comfortable, functional, healthy retention of the affected tooth, with a minimal commitment of time and financial outlay.- - - - - - - - - - ranking = 0.00086401508867625keywords = process (Clic here for more details about this article) |
| | Next -> |