1/66. Effective periodontal treatment in a patient with type IIA von Willebrand's disease: report of a case.von Willebrand's disease (vWD) is one of the most common hereditary hemorrhagic disorders. A mild to moderate deficiency of factor viii and von willebrand factor (vWf) often is associated with gingival bleeding. In this case report, the periodontal treatment of a patient with vWD is described. A 45-year-old woman with type IIA vWD was referred for periodontal therapy because of an episode of gingival hemorrhage and percussion pain of teeth #18 and #47. The periodontal findings included probing depths ranging from 2 to 6 mm, horizontal bone loss, and Class II furcation involvement of tooth #46. After consultation with a hematologist, apically positioned flap surgery and hemisection were performed on tooth #46 following completion of oral hygiene instruction, scaling and root planing, and endodontic therapy. The patient was given 500 units of factor viii including vWf multimer 30 minutes before surgery. After healing of the periodontal tissue, prosthodontic treatment was undertaken on the posterior mandibular sextants. At follow-up, the probing depths ranged from 2 to 3 mm, and gingival bleeding on probing was minimal. The patient's children all had vWD. They had mild to moderate periodontitis with probing depths ranging from 2 to 5 mm and gingival bleeding on probing. With the combined efforts of the periodontist and hematologist, effective periodontal treatment can be provided to patients with von Willebrand's disease.- - - - - - - - - - ranking = 1keywords = root (Clic here for more details about this article) |
2/66. Orthodontic, genetic, and periodontal considerations in the treatment of impacted maxillary central incisors: A study of twins.Treatment of twins each with one impacted maxillary central incisor and a mesiodens is described. Treatment included rapid expansion, extraction of the mesiodens, surgical exposure of the impacted central incisor, and its forced eruption. The impacted incisor was brought into functional position in one patient but was lost in the other because of insufficient root length and high mobility. Orthodontic, genetic, and periodontal considerations of these 2 cases are evaluated.- - - - - - - - - - ranking = 1keywords = root (Clic here for more details about this article) |
3/66. The relationship between peripheral levels of leukocytes and neutrophils and periodontal disease status in a patient with congenital neutropenia.BACKGROUND: Congenital neutropenia is characterized by an almost total absence of neutrophils and increased susceptibility to infection. oral manifestations include ulcerations of mucous membranes, acute gingival inflammation with focal necrosis, and rapid loss of attachment. Treatment with recombinant human granulocyte colony-stimulating factor (rhG-CSF) increases neutrophil numbers and ameliorates the periodontal status. methods: We report the treatment of a 22-year-old male with congenital neutropenia (Kostman syndrome), referred to us due to periodontal disease, and the effect of treatment on peripheral neutropenia. diagnosis of neutropenia was made at year 1; at age 15, the patient started to receive injections of rhG-CSF, reducing the occurrence of infection and improving neutrophil count, although levels remained below normal. The patient underwent extraction of a molar at age 8; scaling, root planing, and modified Widman flaps at age 9; and oral hygiene maintenance every 2 to 3 months from age 18 to 21. At age 23, he initiated treatment at our periodontal clinic. The patient's gingiva was severely inflamed, and the dentition was covered with plaque and calculus. Attachment loss was advanced, all teeth were mobile, and bone loss was approximately 75% in most sites. Neutrophil counts were below normal, but other hematologic parameters were normal. Scaling and root planing were performed and the patient received antibiotics and chlorhexidine rinses twice each day for 2 weeks. Extracoronal splinting was performed, fluoride varnish was used to desensitize cervical areas, and tooth FDI #46 was restored. root planing and deplaquing were repeated, and the patient received subgingival chlorhexidine irrigation 13 times over one year. Assessments were made on presentation, after the initial treatment, and at 1 and 2 years post-treatment. RESULTS: Mean probing depth was reduced posttreatment with a further reduction during the maintenance period. This was correlated with an increase in attachment levels. Total white blood cells increased, due in part to an increase in neutrophils, reaching normal levels. CONCLUSIONS: This report demonstrates for the first time that periodontal therapy, resulting in decreased bacterial load, may result in restoration of normal levels of circulating neutrophils in individuals with congenital neutropenia under treatment with rhG-CSF. The results also suggest that periodontal pathogens may be associated with depressed neutrophil levels, even when patients receive treatment for neutropenia.- - - - - - - - - - ranking = 2keywords = root (Clic here for more details about this article) |
4/66. Malformations in maxillary incisors: case report of radicular palatal groove.This report describes malformations of anterior teeth and a case of a palatal radicular groove in an upper lateral incisor with periodontal complications. The patient was first diagnosed with an endodontic problem. Endodontic treatment alone failed to resolve the pain. Therefore, after the palatal groove had been properly diagnosed, a palatal flap procedure was carried out including removal of the granulation tissue and careful scaling and root planing of the area with the groove. No odontoplasty was done. Endodontic therapy of the tooth was completed and periapical healing was evident. The treatment effectively reduced the gingival probing depth and led to an asymptomatic tooth.- - - - - - - - - - ranking = 1keywords = root (Clic here for more details about this article) |
5/66. 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 = 38.314161583188keywords = root resorption, resorption, root (Clic here for more details about this article) |
6/66. A clinical application of autotransplantation using furcation-involved root.BACKGROUND, AIMS: The present case report describes the clinical application of autotransplantation using furcation involved roots. METHOD: After initial therapy, root resection was performed upon the patient's molar teeth with furcation involvement in the mandible. 2 distal roots of the molar teeth were autotransplanted as abutments to replace missing premolar and molar teeth in the mandible. RESULTS: On re-examination, 1 year after the transplantation, these roots showed no signs of periodontal or technical complications. The results suggest the potential use of autotransplantation techniques using furcation involved roots in reconstructive therapy. This may be a new approach in periodontal therapy.- - - - - - - - - - ranking = 9keywords = root (Clic here for more details about this article) |
7/66. Palatal radicular multigrooves associated with severe periodontal defects in maxillary central incisors.BACKGROUND: This case report describes a rare condition of palatal radicular multigrooves on teeth 11 and 21 with severe periodontal defects and the findings at 3-year follow-up. METHOD: Radiculoplasty using hand curettes and rotary burs were used to remove the multigrooves on the root surfaces and change the wrinkled root form to the relatively flat and smooth normal root morphology. Minor tooth movement and frenotomy were performed for a diastema between teeth 11 and 21. Supportive periodontal therapy started immediately after completion of the active treatment. RESULTS: Improved healthy periodontal tissues and adequate plaque control have been maintained.- - - - - - - - - - ranking = 3keywords = root (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 = 5.860658261527keywords = resorption (Clic here for more details about this article) |
9/66. Generalized cervical root resorption associated with periodontal disease.BACKGROUND AND DESCRIPTION OF CASE: The etiology and pathogenesis of generalized cervical root resorptions is not well understood. In the present report, a case of severe cervical root resorption involving 24 anterior and posterior teeth is presented. The lesions developed within a period of 2 years after the patient had changed to an acid-enriched diet. They extended far into the coronal dentin and were associated with gingival inflammation and crestal bone resorption. However, no generalized clinical attachment loss had occurred. Culturing of subgingival plaque revealed the presence of several putative periodontal pathogens among which actinobacillus actinomycetemcomitans and porphyromonas gingivalis. Treatment consisted of mechanical debridement supported by systemic antibiotics (amoxycillin plus metronidazole) and dietary advice. RESULTS: Within 1 year after the onset of treatment, all resorptive lesions had repaired by ingrowth of a radio-opaque mineralized tissue. The crestal areas showed radiological evidence of bone repair. 3 years after the onset of therapy, one premolar was extracted and examined histologically. It appeared that irregularly-shaped masses of woven bone-like tissue had invaded into the domain of the resorbed coronal dentin and were bordered by thin layers of acellular cementum. CONCLUSION: It is concluded that, in this patient, the cervical resorptions were likely the result of an osteoclastic response extending into the roots because the root-protective role of the junctional epithelium did not develop. We hypothesize that this was due to the combined effects of a periodontopathogenic microflora and a dietary confounding factor.- - - - - - - - - - ranking = 243.60628602218keywords = root resorption, resorption, root (Clic here for more details about this article) |
10/66. 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 = 2keywords = root (Clic here for more details about this article) |
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