1/12. Successful periodontal maintenance of a case with Papillon-Lefevre syndrome: 12-year follow-up and review of the literature.BACKGROUND: Various approaches to treating the periodontal condition associated with Papillon-Lefevre syndrome have been reported. These include oral hygiene instruction, use of mouthrinses, frequent debridement, multiple antibiotic regimens, periodontal surgery, extraction of hopeless teeth, and extraction of all deciduous teeth. Because Papillon-Lefevre syndrome is rare, most publications are case reports, and very few document long-term successful treatment of the periodontal condition. methods: In 1986, a 3.5-year-old Indo-Canadian male was diagnosed with Papillon-Lefevre syndrome and began periodontal treatment. Initial therapy consisted of debridement every 3 weeks, a 0.12% chlorhexidine mouthrinse, 2 regimens of metronidazole, and oral hygiene instruction for his parents. After 10 months it became apparent that the treatment was having little beneficial effect, since the periodontal destruction continued and teeth 51 and 61 exfoliated. At age 4, all remaining deciduous teeth were extracted and complete dentures inserted for the following 2-year edentulous period; then a 3-month maintenance schedule was maintained. RESULTS: The patient is now 17 years old and all his adult teeth are present with the exception of the third molars. His oral hygiene varies between moderate and good, with his most recent plaque score at 80% effectiveness. There are no probing depths greater than 4 mm, with the exception of the distal of the lower second molars where opercula are present. CONCLUSIONS: Extraction of all the deciduous teeth followed by a period of edentulousness may partially explain the fact that there has been no recurrent attachment loss in the permanent teeth up to age 17. Other explanations are discussed as part of the literature review of Papillon-Lefevre syndrome.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
2/12. Characterization of streptococcus constellatus strains recovered from a brain abscess and periodontal pockets in an immunocompromised patient.BACKGROUND: There have been a number of reports of brain abscesses suggesting an odontogenic etiology. However, no efforts have been made to compare brain abscess isolates with isolates from the oral cavity using highly discriminative methods. We report a brain abscess caused by streptococcus constellatus in an immunocompromised patient where oral infection (periodontitis) was suspected to be implicated. methods: The brain abscess and oral isolates were compared by means of one phenotypic and three genetic (restriction fragment length polymorphism [RFLP], ribotyping, and random amplified polymorphic dna [RAPD]) fingerprinting techniques. RESULTS: The phenotypic method and RFLP showed identical profiles between brain and periodontal isolates, while ribotyping and RAPD showed very close similarity, with only one band difference in one of the three ribotypes and in one of the three polymorphic RAPD. CONCLUSIONS: Gene transfer by genetic recombinational events in the periodontal pocket might have been responsible for the emergence of a strain variant of S. constellatus that had the potential to cause an abscess at a distant site (brain). The importance of odontogenic sources as potential foci of infection for brain abscesses is discussed.- - - - - - - - - - ranking = 2.966963433264keywords = oral cavity, cavity (Clic here for more details about this article) |
3/12. Severe localized periodontal destruction associated with cervical cemental separation.Cemental separations and tears are secondary etiological factors that may lead to rapid periodontal destruction if the lesion communicates with the oral cavity and allows bacterial invasion. Although many cemental tears that occur on proximal surfaces can be diagnosed radiographically, separations on the facial or lingual surface that cannot be detected on radiographs may present a diagnostic dilemma. This article describes a case of lingual cemental separation on a maxillary incisor, with subsequent successful surgical correction utilizing an osseous graft.- - - - - - - - - - ranking = 2.966963433264keywords = oral cavity, cavity (Clic here for more details about this article) |
4/12. aggressive periodontitis in a 16-year-old Ghanaian adolescent, the original source of actinobacillus actinomycetemcomitans strain HK1651 - a 10-year follow up.The highly leukotoxic JP2 clone of actinobacillus actinomycetemcomitans is strongly associated with periodontitis in adolescents. Availability of the dna sequence of the complete genome of A. actinomycetemcomitans strain HK1651, a representative strain of the JP2 clone (http://www.genome.ou.edu/act.html), has provided new possibilities in basic research regarding the understanding of the pathogenesis of A. actinomycetemcomitans in periodontitis. This case report describes the periodontal treatment of the original source of A. actinomycetemcomitans HK1651, a 16-year-old Ghanaian adolescent girl with aggressive periodontitis. The bacterial examination involved polymerase chain reaction analysis for presence of JP2 and non-JP2 types of A. actinomycetemcomitans. The treatment, including periodontal surgery supplemented by antibiotics, arrested the progression of periodontitis for more than 10 years. Initially, infection by A. actinomycetemcomitans, including the JP2 clone, was detected at various locations in the oral cavity and was not limited to the periodontal pockets. Post-therapy, the JP2 clone of A. actinomycetemcomitans disappeared, while the non-JP2 types of A. actinomycetemcomitans remained a part of the oral microflora.- - - - - - - - - - ranking = 2.966963433264keywords = oral cavity, cavity (Clic here for more details about this article) |
5/12. Periodontal therapy in siblings with Papillon-Lefevre syndrome and tinea capitis: a report of two cases.OBJECTIVE: Report of clinical and microbiological periodontal findings before and 6 months after treatment of two siblings with Papillon-Lefevre syndrome (PLS) and tinea capitis. methods: Two brothers, RG 3 years and NG 5 years of age, were referred for treatment due to premature mobility of their deciduous teeth. Probing depths (PPD), attachment levels (PAL-V), and furcation involvements were examined clinically. Panoramic radiographs were taken. Subgingival plaque samples within the deepest pocket of each tooth were taken and analysed by real-time polymerase chain reaction (PCR) for actinobacillus actinomycetemcomitans (AA), porphyromonas gingivalis, Tannerella forsythensis, treponema denticola, fusobacterium nucleatum, and prevotella intermedia. One-stage full-mouth scaling and extraction of hopeless teeth were performed under general anaesthesia, followed by systemic amoxicillin and metronidazole for 7 days. Clinical and microbiological analyses were performed 6 months after treatment. RESULTS: Before treatment, both siblings had exhibited PPD of up to 13 mm, Class III furcation defects at four teeth, and marginal suppuration. AA was detected in both patients and at all teeth at levels ranging from 3.0 x 10(2) to 5.1 x 10(6). Both patients exhibited palmar and plantar hyperkeratosis. Seven teeth were extracted from RG, and nine from NG. Six months after treatment, PPD had been reduced to- - - - - - - - - - ranking = 0.5keywords = mouth (Clic here for more details about this article) |
6/12. Untreated periodontal disease: a longitudinal study.Thirty diagnosed but untreated patients with moderate to advanced periodontal disease were examined a minimum of two times. The examination time intervals ranged between 18 and 115 months. 2. A total of 83 teeth were lost between examinations. 3. Excluding a patient who lost 25 teeth, a total of 58 teeth were lost. The adjusted tooth loss was 0.61 tooth per patient per year (or 0.36 with the elimination of 22 "hopeless" teeth). 4. The mandibular and maxillary molars had the greatest percentage of tooth loss between examinations. 5. All 29 patients completing the study had progessive increases in pocket depth during their time in the study. Increases in the mean annual pocket depths per tooth per patient varied from 0.24 millimeter per year to 2.46 millimeters per year. 6. The disto-lingual and mesio-lingual interproximal surfaces had the greatest increases in surface pocket depths. The lingual and buccal surfaces had the smallest increases in pocket depth. 7. The rate of increase in pocket depths was less in patients over 44 years of age. 8. The teeth which were lost had greater initial pocket depths and mobility scores than those which were present at both examinations. 9. There was no correlation between increases in pocket depth and changes in mobility. 10. All 29 patients showed radiographic evidence of progressive bone resorption between examinations. The posterior segments of the mouth had the largest amounts of bone loss between the first and last examinations.- - - - - - - - - - ranking = 0.5keywords = mouth (Clic here for more details about this article) |
7/12. Changing concepts of periodontal treatment: surgical and non-surgical.Periodontal disease can be successfully treated by non-surgical procedures including supra- and subgingival scaling and root planing with hand or ultrasonic instruments. This non-surgical treatment is recommended for the initial management of all cases with the institution of a plaque control programme. Such management should be the basis of all periodontal therapy. The results obtained are mainly dependent on the skillfulness of the operator and the morphology of the pockets as well as upon patient related factors. Additional treatment, i.e. periodontal surgery, may be necessary if resolution of subgingival inflammation is not obtained. Pocket elimination by the use of surgical procedures (gingivectomy, flap operation with bone surgery) may be preferred in regions of the mouth where the aesthetic result is unimportant and where the removal of alveolar bone does not jeopardize the periodontal support of neighbouring teeth. In situations with deep infrabony pockets especially in anterior regions and in furcation areas a reconstructive surgical technique is the therapy of choice. Recent research in the field of guided tissue regeneration may, in the future, change the traditional approach to periodontal surgery.- - - - - - - - - - ranking = 0.5keywords = mouth (Clic here for more details about this article) |
8/12. Oral findings in Fanconi's anemia. A case report.A case of fanconi's anemia was referred to the Dental School from the Department of pediatrics. The patient was a 24-year-old male and a product of a consanguineous marriage. His chief complaint was loose and falling teeth, which has started at the age of 16 years. The first teeth to fall out were the first permanent molars followed by mandibular and maxillary anteriors. General examination showed that the patient was of normal intelligence and small for his age. He had no palmar plantar hyperkeratosis and was not diabetic. A total of 19 teeth remained in the mouth, most of them with grade three mobility. The remaining molars and first maxillary premolars had grade three furcation involvement. Most of the teeth had periodontal pockets more than 10 mm deep. Full mouth intraoral periapical radiographs and orthopantomographic views showed severe horizontal bone loss uncommensurate with the patient's age. In view of the patient's history and severe bone loss at an early age, the diagnosis was juvenile periodontitis associated with Fanconi's anemia.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
9/12. New dimensions in guided tissue regeneration treatment modalities for profound marginal periodontitis.This article presents two methods of guided tissue regeneration with polytetrafluoroethylene membranes that promote extensive regeneration of periodontal supporting tissue around several adjacent teeth. These techniques are effective in patients with profound marginal periodontitis and advanced horizontal and vertical bony defects affecting large areas of the mouth. In method A, the goal of regeneration is reached by covering the defect with a row of several overlapping membranes. However, the favorable results obtained with this method had to be weighed against various problems concerning the surgical procedure and wound healing. These unsolved difficulties prompted the development of method B, in which only one large membrane is used. After appropriate relieving incisions are made in the membrane, it is placed into the interdental space and thus able to cover an extensive periodontal defect. During the last 4 years, favorable results have been obtained with both new methods of guided tissue regeneration.- - - - - - - - - - ranking = 0.5keywords = mouth (Clic here for more details about this article) |
10/12. Clinical, bacteriological, and immunological examinations and the treatment process of two Papillon-Lefevre syndrome patients.Papillon-Lefevre syndrome (PLS) is a rare disease associated with the early onset of periodontal breakdown in deciduous and permanent dentition. The etiology of the destruction has not been completely clarified. Two female patients (ages 4 and 7 years) with severe destruction of the periodontal structures were examined. Except for palmar and plantar hyperkeratosis, dermatologic examination revealed no other medical disorders. On immunological analysis, measurement of serum antibody titers to 7 periodontopathic bacteria including porphyromonas gingivalis and actinobacillus actinomycetemcomitans was performed by enzyme-linked immunosorbent assay (ELISA). Further immunoblot analysis of A. actinomycetemcomitans and microbial culture of samples collected from deep periodontal pockets and mouthrinse solution were performed. The serum of the two patients showed high IgG titer against A. actinomycetemcomitans. Immunoblot results of the two patients against sonicated extract of A. actinomycetemcomitans Y4 strain exhibited a similar pattern. The band pattern differed from that observed in other forms of early onset periodontitis patients or periodontally healthy subjects. Moreover, A. actinomycetemcomitans colonies were cultured in high percentages from the pocket samples. Antibiotic therapy was instituted in addition to conventional periodontal therapy. In the younger patient, all deciduous teeth were extracted as part of the treatment and A. actinomycetemcomitans was no longer detected. All four permanent first molars and 8 permanent incisors subsequently erupted with healthy periodontium. However, the older patient did not improve after periodontal and antibiotic (minocycline and erythromycin) treatments and A. actinomycetemcomitans was consistently detected. ofloxacin medication finally eliminated A. actinomycetemcomitans from the periodontal pockets. This antibiotic was also associated with reduced gingival inflammation and probing depth.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 0.5keywords = mouth (Clic here for more details about this article) |
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