1/25. 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 = alveolar (Clic here for more details about this article) |
2/25. Treatment of molar furcation involvement using root separation and a crown and sleeve-coping telescopic denture. A longitudinal study.Because of the inconsistent results of periodontal and prosthetic therapy, periodontists may choose to treat maxillary molar furcation involvements (FI) with poor root morphology utilizing a root resection technique (RRT). In addition, poor root morphology of the remaining root following RRT is usually considered a high risk factor for long-term periodontal and prosthetic success. The purpose of this retrospective study was to investigate the differences in the clinical periodontal parameters between molar abutments with and without molar root separation and/or resection (RSR) before and after periodontal and prosthetic therapy, using a crown and sleeve-coping telescopic denture (CSCTD). A total of 85 molars (47 maxillary and 38 mandibular) were treated in 25 subjects. There were 33 abutments without root separation/resection and 52 abutments with RSR. Forty-three CSCTD were placed, 23 in the maxillary arch and 20 in the mandibular arch. The mean observation period was 6.7 /-1.9 years (range, 5 to 13 years). The plaque index, gingival index, probing depth, clinical attachment level, and alveolar bone change were recorded. The differences in these parameters before and after periodontal and prosthetic therapy between the advanced furcation-involved molars with and without RSR were evaluated. The results revealed a remarkable improvement in the periodontal parameters in advanced Class II and Class III FI in molars with RSR as compared to those without RSR. It was, therefore, concluded that molar abutments with RSR in conjunction with a specifically designed telescopic device provide a modified approach for treating molars with advanced Class II and III FI.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
3/25. Human histologic evaluation of a bone graft combined with GTR in the treatment of osseous dehiscence defects: a case report.There are many possible goals and outcomes of periodontal surgical therapy, but the ultimate goal is regeneration. Since the definition of periodontal regeneration is histologic, it is difficult to document. The purpose of this study was to evaluate a technique that combined a bone graft and guided tissue regeneration (GTR) to see if regeneration occurred. Four teeth with dehiscence-type osseous defects that were scheduled for extraction were treated with bone grafts and GTR. During the surgical procedure, a notch was placed into the root at the apical extent of the calculus. The teeth were extracted with conservative block sections 7 months after the treatment. They were processed, sectioned, stained, and evaluated histologically. The results revealed that regeneration did not occur in any of the teeth treated. In 2 of the teeth new connective tissue attachment was formed. In these 2 teeth cementum could be seen in the notch with connective tissue fibers inserting into the cementum. In one of the teeth the junctional epithelium extended apical to the notch, while in 3 cases the epithelium stopped at or coronal to the notch. In this case report, no regeneration could be documented, but new attachment could be seen in 2 of the 4 teeth treated.- - - - - - - - - - ranking = 0.00071279682248994keywords = process (Clic here for more details about this article) |
4/25. Periodontal regeneration of a class II furcation defect utilizing a bioabsorbable barrier in a human. A case study with histology.This case report describes human histologic data of periodontal regeneration following guided tissue regeneration therapy (GTR) with a bioabsorbable barrier composed of polylactic acid. The tooth that was examined was part of a previously published study of the clinical effects of GTR therapy without the use of bone or bone substitutes on Class II furcation defects. Twenty-five months following the surgical procedure, the tooth was extracted for non-periodontal reasons. During this extraction, the bone within the furcation that was treated in the study was luxated with the tooth. At the completion of the study (month 12), the furcation's vertical probing depth had decreased by 2 mm with a 2 mm gain in clinical attachment. The horizontal furcation measurement decreased by 3 mm. Following extraction, the tooth was prepared for light microscopy and sectioned in the mesial-distal plane. Reference notches were not placed in the tooth at the time of surgery as there were no plans to perform histologic analysis in the study. However, using the buccal root prominences and what we interpreted to be root planing marks on the cementum, we were able to demonstrate that complete periodontal regeneration occurred on the root surface that was exposed to the pocket environment prior to surgery. New alveolar bone, cementum, and periodontal ligament were consistently observed throughout the furcation in the areas that demonstrated clinical attachment gain and a decrease in horizontal probing depth. This case report adds to the accumulating evidence of histologic periodontal regeneration following guided tissue regeneration with bioabsorbable polylactic acid barriers.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
5/25. 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) |
6/25. A concept for the treatment of various dental bone defects.Untreated dental bone defects usually lead to resorption of alveolar bone. Filling these defects with bone substitute material prevents resorption of bone, preserves the alveolar ridge, and provides sufficient bone for immediate or subsequent implant placement. A variety of bone substitutes is available. They differ in origin, consistency, particle size, porosity, and resorption characteristics. We have treated almost 1000 bony defect sites in 267 patients with the bone regeneration material Cerasorb. Being resorbed simultaneously with the formation of new bone, it is completely replaced by the patient's own vital bone within 6 to 12 months. The representative cases described in this paper demonstrate the successful use of the pure-phase beta-tricalcium phosphate ceramic in the treatment of all dental bone defects.- - - - - - - - - - ranking = 2keywords = alveolar (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 = 1keywords = alveolar (Clic here for more details about this article) |
8/25. Treatment of furcation defects with an allograft-alloplast-tetracycline composite bone graft combined with GTR: human histologic evaluation of a case report.The purpose of this study was to histologically evaluate furcation defects in humans treated with an allograft-alloplast-tetracycline composite graft combined with an absorbable membrane for guided tissue regeneration (GTR). Three teeth with Class II furcation involvement on the buccal aspects were included in this study. A notch was placed in calculus during the procedure to serve as a reference point for histologic evaluation. The defects were then treated with an allograft-alloplast-tetracycline composite graft combined with an absorbable membrane for GTR. At 6 months postoperative, the teeth were extracted with conservative block sections and processed for histologic evaluation. Regeneration (new bone, cementum, and connective tissue attachment) coronal to a notch could be seen in one of the three defects treated. In the other two defects, a new connective tissue attachment was demonstrated (new connective tissue attachment into new cementum) in the notch placed in calculus. In this study, regeneration of a furcation defect in a human was documented with histology.- - - - - - - - - - ranking = 0.00071279682248994keywords = process (Clic here for more details about this article) |
9/25. Endoperiodontal lesion. A case report.The purpose of this case report is to present an unusual endoperiodontal lesion on tooth 46 in an 8-year-old child. The absence of any carious process and the presence of the typical radiographic aspect of an infrabony defect, led us to consider the periodontal aetiopathogenesis. In spite of all this, an accurate periodontal probing of all the teeth and the use of the pulp tester for teeth 46 and 36 led us to diagnose properly a truly endodontic lesion. The endodontic treatment of the involved tooth achieved the complete healing of the lesion.- - - - - - - - - - ranking = 0.00071279682248994keywords = process (Clic here for more details about this article) |
10/25. replantation with intentional rotation of a complete vertically fractured root using adhesive resin cement.This case describes intentional replantation with rotation of a complete vertically fractured root using adhesive resin cement. The fractured root was fixed with adhesive resin cement extra-orally. The tooth was replanted into the socket with rotation in order to avoid contact with the area where the periodontal ligament of the root surface was lost and the area where the alveola bone was lost along the fracture line. At follow-up 18 months later, the tooth was asymptomatic and radiographically showed an increase in the density of the alveolar bone, and the periodontal pockets were improved.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
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