1/5. oral manifestations of congenital neutropenia or Kostmann syndrome.Infantile congenital agranulocytosis or Kostmann syndrome is a rare hereditary kind of severe neutropenia. The typical symptoms, which appear since the first days of life, are abscesses located on various parts of the body: ear, cutis, lung and oral cavity. These abscesses are due to an almost total disimmunity typical of the neutropenia. The aim of this article is to describe the most typical signs of this pathology in the oral cavity, reporting a case observed in our department in Florence, italy. On the basis of the personally observed case and of the review of the literature, it is possible to consider, as a characteristic finding in Kostmann syndrome, a typical very serious periodontal pathology, which is similar to the prepubertal periodontitis in deciduous dentition. At the age of 19 years the patient showed a dramatic compromise of the masticatory function. It is obvious that the lack of response of the host can obstruct the interaction between the host and the microbic flora, because the lack of neutrophils increases the susceptibility of the patient to every kind of infection, even to periodontitis. A periodontal prophylaxis, since the very first observations, followed by a rigorous maintenance with frequent and regular professional hygienic treatments could be effective in controlling the effects of periodontal disease and could reduce the tragic evolution. We need to recognise that it could be hard to monitor the oral situation correctly in these patients, as they have a continuously poor systemic condition. Finally in these cases the rehabilitative therapy is very problematical.- - - - - - - - - - ranking = 1keywords = periodontal disease (Clic here for more details about this article) |
2/5. Localized edentulous ridge augmentation with upside down osteotomy prior to implant placement.Localized bone defects may be seen following the extraction of teeth with periapical lesion or advanced periodontal disease, or as a result of trauma. When these regions are considered for treatment with implants, localized ridge augmentation will be necessary. Autogenous bone grafts are used exclusively for ridge augmentation. This case report represents the treatment of a localized edentulous ridge with an upside down osteotomy technique at the symphysis region prior to implant placement. Systemically healthy 21-year-old female patient, who was missing a lower right incisor tooth, was scheduled for an implant treatment. However, the crestal width was only 1 mm. The augmentation was planned and the region was treated with an upside down osteotomy technique. Nine months after the augmentation procedure, the computed tomography (CT) examination of the area revealed that the width of the crest was 7 mm, and the height of the crest was in good relation with the cementoenamel junction of the adjacent teeth. Flipping a bone block graft, which was harvested from the edentulous area, upside down may provide a successful result in partially edentulous ridges, in both maxilla and mandible.- - - - - - - - - - ranking = 1keywords = periodontal disease (Clic here for more details about this article) |
3/5. Periodontal status in two siblings with severe congenital neutropenia: diagnosis and mutational analysis of the cases.BACKGROUND: Severe congenital neutropenia (SCN), also known as Kostmann syndrome, was originally reported as an autosomal recessive disease of neutrophil production. The disease is characterized by a maturation arrest of neutrophil precursors at the promyelocytic stage of differentiation and by extremely low levels of mature neutrophils in peripheral blood. methods: A 6-year-old male presented with a complaint of gingival swelling and bleeding, and swelling at the left side of his face. Upon clinical examination, severe inflammation of all gingival tissues was apparent, and a periapical abscess with mobility was noted on the left mandibular second molar. Medical and dental histories revealed numerous recurrent bacterial infections associated with oral and non-oral tissues. His medical history with recurrent infections led us to evaluate his 3-year-old sister to determine the status of her oral health. inflammation of her oral tissues and recurrent bacterial infections were apparent. Their consanguineous parents were in good health. To assist in identifying possible systemic diseases underlying the inflammatory situation in the siblings, consultations were requested from the Pediatric hematology Department at Selcuk University and Pediatric Oncology Department at Gulhane Military Medical Academy. RESULTS: Based on absolute neutrophil count (< or =200/mm(3)) and bone marrow aspiration findings consistent with early maturation arrest in myelopoiesis, the cases were diagnosed as SCN. No chromosomal abnormality was detected upon cytogenetic examination. Sequencing analysis also revealed no mutation in the neutrophil elastase or growth factor independent-1 (GFI-1) genes in these patients. Severe periodontal disease, attachment loss, and mobility for over 50% of the deciduous teeth were noted. Within 6 months, the male sibling lost all of his deciduous teeth due to periapical and periodontal infections. His sister presented with tooth mobility for all mandibular incisors. Monthly visits, including scaling, polishing, and 0.2% chlorhexidine digluconate irrigation were performed to support their oral hygiene and to avoid recurrent oral infections. We have been able to stabilize these patients' periodontal conditions during a 2-year follow-up period. CONCLUSION: This case report emphasizes the role of periodontists and pediatric dentists in the diagnosis of diseases linked with neutrophil and other systemic disorders and highlights the need to optimize the health of oral tissues with regular appointments.- - - - - - - - - - ranking = 1keywords = periodontal disease (Clic here for more details about this article) |
4/5. An interdisciplinary approach for improved functional and esthetic results in a periodontally compromised adult patient.In contemporary dental care, an increasing number of adult patients are seeking orthodontic treatment. In such adult patients, a combined orthodontic and other specialized therapy often offers the best option for achieving a predictable outcome to solve complex clinical problems. This case report demonstrates a combined therapy with orthodontic, periodontic, and implant-prosthodontic treatments in a 56-year six-month-old female patient with mild diastemata in the maxillary anterior region and a missing left maxillary second premolar caused by a periodontal disease with medium bone loss. The patient had improved her oral hygiene condition through periodontal treatment before orthodontic treatment. The patient was orthodontically treated with a maxillary lingual arch and a maxillary edgewise orthodontic appliance. Active orthodontic treatment was completed in 18 months, and an implant-supported prosthesis was placed with a single crown in the region of the left maxillary second premolar. The treatment outcomes, including the periodontal condition and the dental implant treatment, were stable at two years after the active orthodontic treatment. We demonstrate that combined orthodontic-periodontic-implant-prosthodontic treatment can achieve an improved masticatory function, esthetics, occlusion, and periodontal condition.- - - - - - - - - - ranking = 1keywords = periodontal disease (Clic here for more details about this article) |
5/5. Posterior bite collapse--revisited.Although there are different definitions of posterior bite collapse, only the classical definition of Amsterdam provides a definite diagnosis and treatment plan. This situation entails a subtle loss of the occlusal vertical dimension with resultant flaring of the maxillary incisors. Other causes for flaring, such as derangements of form and functions of lips and tongue, bruxism, habits, as well as the presence of advanced periodontal disease or malocclusions, should be ruled out before the diagnosis of posterior bite collapse can be made. The complexity of differential diagnosis is illustrated with three case reports.- - - - - - - - - - ranking = 1keywords = periodontal disease (Clic here for more details about this article) |