1/16. Generalized periodontal involvement in a young patient with systemic lupus erythematosus.inflammation is considered to be a leading cause of morbidity in systemic lupus erythematosus (SLE), yet inflammatory periodontal involvement is rarely encountered. A young lady suffering from active SLE accompanied by severe periodontal loss, manifested by gingival recession of all her teeth, was referred to our clinic for treatment. The association between periodontal involvement and connective tissue diseases is unclear, and the literature dealing with periodontal involvement in patients suffering from sjogren's syndrome and rheumatoid arthritis is comprised of studies showing both normal and pathological periodontal status. We discuss the possible underlying mechanisms.- - - - - - - - - - ranking = 1keywords = connective (Clic here for more details about this article) |
2/16. Using platelet-rich plasma to accelerate soft tissue maturation in esthetic periodontal surgery.The transposition of connective tissue to increase the zone of keratinized tissue and/or for root coverage has become an integral part of the surgical dental practice. In an effort to reduce the incidence of postoperative complications occasionally observed with these procedures, the incorporation of platelet-rich plasma and its growth factors has been introduced into the surgical protocol. documentation of several cases requiring esthetic soft tissue grafting procedures and the use of regenerative barriers to obtain root coverage with the incorporation of platelet-rich plasma is presented.- - - - - - - - - - ranking = 1keywords = connective (Clic here for more details about this article) |
3/16. Periodontal healing in humans using anorganic bovine bone and bovine peritoneum-derived collagen membrane: a clinical and histologic case report.The authors report the clinical and histologic data on the healing of a severe periodontal lesion obtained in a one-walled intrabony defect using anorganic bovine bone under a bovine peritoneum-derived collagen membrane. Eight months after surgery, a bone-like tissue replaced the lost tissues. A biopsy of this tissue was carried out. In the part of the specimen closer to the residual bony wall of the original defect, anorganic bone particles (ABP) appeared to be surrounded by a layer of newly formed bone; its osteocyte lacunae were colonized by osteocytes from the host, and actively secreting osteoblasts were observed in many microscopic fields. No resorption phenomena were observed in the ABP Newly formed cementum with actively secreting cementoblasts was present on the tooth surface, and well-oriented fibers inserting in both newly formed cementum and bone were observed. In an area far from residual bone, all ABP did not appear to be surrounded by newly formed bone. Osteocytic lacunae appeared not to be colonized by cells, and ABP was surrounded by dense connective tissue without osteoblasts near the grafted particles. A very limited amount of newly formed bone, without relations with ABP, was observed close to the root surface. From a clinical point of view, anorganic bone in association with a collagen membrane can be effective in the treatment of bony defects characterized by an unfavorable architecture. From a histologic point of view, the clinical appearance of bone regeneration is not always confirmed in the part of the defect far from the bony walls.- - - - - - - - - - ranking = 1keywords = connective (Clic here for more details about this article) |
4/16. Treatment of periodontal disease in a patient with ehlers-danlos syndrome. A case report and literature review.BACKGROUND: ehlers-danlos syndrome (EDS) designates a heterogeneous group of connective tissue disorders characterized by skin elasticity, tissue fragility, and chronic joint pain. Dental findings have been reported with some types of EDS. This case report describes the periodontal findings in a patient with a previously undiagnosed EDS type VIII. methods: Diagnostic aids utilized included microbial testing, histological examination, gingival crevicular fluid (GCF) analysis for the levels of C-telopeptide pyridinoline cross-links (ICTP), and genetic counseling. Periodontal treatment consisted of mechanical debridement and adjunctive antibiotic therapy. RESULTS: genetic counseling and clinical presentation confirmed the diagnosis of EDS type VIII. Periodontal treatment led to marked clinical improvements and GCF levels of the bone resorptive marker ICTP were significantly reduced. The patient and her siblings are currently pursuing appropriate medical care and genetic counseling. CONCLUSION: Periodontal involvement may lead to the diagnosis of an underlying systemic condition. Identification of suspected etiological factors of periodontal disease may prove critical for the general well-being of some patients.- - - - - - - - - - ranking = 1keywords = connective (Clic here for more details about this article) |
5/16. 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 = 1keywords = connective (Clic here for more details about this article) |
6/16. Combined bone grafting and orthodontic treatment of an iatrogenic periodontal defect: a case report with clinical reentry.BACKGROUND: This case report discusses the treatment of an iatrogenic periodontal defect caused by an inadequate orthodontic appliance in a 9-year-old girl. methods: The multidisciplinary approach to this case consisted of periodontal treatment using a bone grafting technique to restore the 10 mm bone dehiscence. Three months later orthodontic treatment was initiated to straighten and level the central incisors. Six months later mucogingival surgery was performed to cover 2 to 3 mm gingival recession. RESULTS: The bony defects were completely filled and the 10 mm dehiscence was reduced to 4 mm. The connective tissue graft resulted in a complete coverage of the recessions and a thickening of the keratinized gingiva. The patient is still undergoing orthodontic treatment. So far, straightening of the upper central incisors and closure of the diastema are satisfactory. CONCLUSIONS: Inadequate orthodontic appliances can cause iatrogenic periodontal defects. A multidisciplinary approach in a well-defined sequence can restore lost periodontal tissue, thus achieving comfort, function, and esthetics.- - - - - - - - - - ranking = 1keywords = connective (Clic here for more details about this article) |
7/16. Electron microscopical evaluation of connective tissue healing to periodontally involved teeth.The present study was undertaken to examine if our novel root treatment for human periodontally involved teeth can facilitate a new connective tissue attachment. The novel treatment was in two parts: 1) planning and surface decalcification with citric acid on the coronal quarter of the exposed root corresponding to pocket, and 2) curettage of superficial cementum of the apical three quarters of the exposed root. The interface of the root surface and regenerating connective tissue was observed 2 and 3 weeks after surgery by light and electron microscopy. The apical migration of junctional epithelium was effectively prevented. The fibroblasts synthesized new fibrillar materials and collagen fibrils towards the curetted cementum. The results suggested the possibility that this treatment for periodontally involved teeth would provide ideal root surface conditions for the formation of new fibrous attachment.- - - - - - - - - - ranking = 6keywords = connective (Clic here for more details about this article) |
8/16. Human clinical and histologic responses to the placement of HTR polymer particles in 11 intrabony lesions.Eleven intrabony periodontal lesions in five volunteer patients received surgical debridement followed by site implantation of a porous particulate polymeric composite (HTR polymer). These patients were observed over time periods varying from 4 weeks to 26 weeks. At the end of the individual observation periods, treated sites were surgically removed in block for histologic analysis. Clinical observations indicated a reduction in pocket depth following treatment which consisted of both gingival recession and gain in clinical closure. No untoward effects were observed clinically in any treated patient during the observation periods. Histologic responses varied from gain in closure by epithelial adhesion to new attachment of varying magnitude. Such varied responses were seen within the same patient and between patients. Graft particles were present at sites from 4 weeks to 26 weeks after implantation and were surrounded by connective tissue capsules. At the periphery of some particles, limited bone formation was present. The alveolar bed was remodeling, at times surrounding specific particles. In our sample, HTR polymer, therefore, appeared to be a well tolerated synthetic graft material when implanted in human intrabony lesions.- - - - - - - - - - ranking = 1keywords = connective (Clic here for more details about this article) |
9/16. Infantile agranulocytosis with survival into adolescence: periodontal manifestations and laboratory findings. A case report.A case of infantile agranulocytosis with survival into adolescence is presented. The polymorphonuclear leukocyte is considered an important source of lysosomal enzymes in gingival crevicular fluid, and evaluation of connective tissue-degrading enzymes in the fluid was performed. The activity of beta-glucuronidase, a ground substance-degrading enzyme that may serve as a marker for polymorphonuclear leukocytes, was markedly reduced in the fluid compared to samples from systemically healthy adults with periodontitis. The activities of the ground substance-degrading enzyme arylsulfatase, and collagenase, were in the low-normal range. The plaque microbiology, as characterized by dark-field microscopy and selective culturing, was consistent with advanced periodontitis. A review of the medical history revealed a series of bacterial infections since infancy. Improvement in the systemic health of the patient occurred at about the age of 15, and the intake of antibiotics to control infections was correspondingly reduced after this time. An exacerbation of the patient's periodontal disease, as evaluated by loss of alveolar bone on radiographs, occurred 1 to 2 years later. The progression of periodontal disease observed in this patient was apparently associated with the withdrawal of antibiotics administered for control of systemic (nonoral) infections.- - - - - - - - - - ranking = 1keywords = connective (Clic here for more details about this article) |
10/16. Root isolation for new attachment procedures. A surgical and suturing method: three case reports.A surgical and suturing method is described for the subgingival placement of Gore-tex periodontal material during new attachment procedures. The periodontal material isolates the root surface from epithelium and gingival connective tissue. Three cases were treated. Clinical new attachment was evident from clinical probings and reentry. The term "open probing new attachment" describes the type of tissue that was evident at reentry after treatment of a Class III furcation. A combination of new bone and "open probing new attachment" was evident after one-wall defects were treated adjacent to a mandibular cuspid. A two-wall defect was treated and biopsied three months later. A reference notch was placed 1 mm coronal to the apical aspect of the defect. Histologic examination of the biopsy showed new bone, cementum and periodontal fibers coronal to the notch. Clinical and histologic new attachment was achieved using the technique for root isolation. The long-term predictability and stability of this type of new attachment is not known at this time.- - - - - - - - - - ranking = 1keywords = connective (Clic here for more details about this article) |
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