1/10. The role of orthognathic surgery in the treatment of severe dentoalveolar extrusion.BACKGROUND: When mandibular molars are not replaced after extraction, the long-term problem of inadequate interarch space for either a fixed or removable prosthesis can occur. In the past, practitioners needed to decide whether to shorten the teeth, extract the supererupted maxillary molars to recapture space or leave the area unrestored. The authors present another option. CASE DESCRIPTION: A 61-year-old man was referred to a periodontist by his general dentist for placement of mandibular implants in the posterior sextant. Extreme supereruption of the maxillary dentoalveolar segment prevented restoration of the opposing edentulous area. An oral and maxillofacial surgeon performed a segmental osteotomy of the posterior right maxilla to gain needed interarch space. After the osteotomy was stabilized, the periodontist placed implants that were subsequently restored with a fixed prosthesis. CLINICAL IMPLICATIONS: The role of orthognathic surgery in treatment planning should not be overlooked in the comprehensive management of severe extrusion. It offers patients the opportunity to gain both function and esthetics that might otherwise be impossible.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
2/10. Subgingival plaque and loss of attachment in periodontosis as observed in autopsy material.Histologic sections from six autopsy cases which from a clinical point of view fitted into the criteria of periodontosis were examined with the aim at evaluating the role of subgingival plaque in the etiology of the loss of attachment in this condition. The following pertinent observations were made: 1. The subgingival plaque in most instances was not calcified to form calculus. 2. The thickness of the subgingival plaque varied between 20 and 200 mu (0.02-0.2 mm). 3. Where loss of attachment had taken place, the distance from the most apical part of the subgingival plaque to the most apical point of the epithelial cuff varied between 0.2 and 1.1 mm; this distance was never found to be more than 1.1 mm. This would indicate a cause and effect relationship, the plaque being the obvious cause. 4. There was very severe chronic inflammation in the soft tissue bordering upon the plaque with resulting collagenolysis. 5. The cellular infiltration and the collagenolysis may be limited to a zone of 1 to 2 mm in the immediate vicinity of the plaque. Between the inflamed area and the surface of the gingivae buccally and lingually there may be a fairly wide zone of healthy tissue which hides the symptoms of inflammation from being observed on a clinical examination. In turn this could leave the clinician with the impression that attachment has been lost and bone resorbed because of degenerative changes. The following conclusions can be made: In these six cases of "alveolar bone loss vastly out of proportion to what one would expect from the local etiologic factors in the patient at that age" there was no morphologic evidence that degenerative changes were responsible for the loss of attachment. On the contrary inflammatory changes induced by the subgingval plaque dominated the histopathologic picture.- - - - - - - - - - ranking = 0.2keywords = alveolar (Clic here for more details about this article) |
3/10. Combined periodontal-prosthodontic treatment of early-onset periodontitis--an alternative to implant therapy.A variety of treatment systems should be available for patients whose dentitions are seriously compromised so that they may select customized treatment modalities that satisfactorily restore occlusal function, consider systemic conditions, and lessen the surgical and financial burdens. These requirements become more demanding when clinicians are faced with advanced cases of rapidly progressive periodontitis. Therefore, it is critical to establish sophisticated multidisciplinary treatment modalities for the successful management of these compromised patients. Obviously, because of various limitations, implant therapy cannot be the only solution. This article reports on the successful long-term management of seriously compromised early-onset periodontitis by a combined periodontal-prosthetic treatment as an alternative to implant therapy.- - - - - - - - - - ranking = 7792.7424435286keywords = periodontitis (Clic here for more details about this article) |
4/10. The use of orthodontic intrusive movement to reduce infrabony pockets in adult periodontal patients: a case report.Clinicians often encounter osseous defects that are best treated by conventional surgical techniques, including bone grafting and guided tissue regeneration, with a goal of establishing a new connective tissue attachment. On occasion, the recognition of an infrabony defect proximal to a tooth with a large diastema may present an opportunity to consider resolution by orthodontic tooth movement. Ideally, the tooth could be moved in the proximal direction until there was no further radiographic or clinical evidence of the predisposing defect. The authors decided to treat an advanced case of adult periodontitis, with extrusion and migration of a maxillary central incisor, using a multidisciplinary approach. Radiologically, a large infrabony defect was present on the mesial aspect of the incisor, with an initial probing depth of 9 mm. After the surgical periodontal therapy, the orthodontic movement started and the incisor was repositioned using an intrusive mechanism, also leading to the closure of the diastema. At the end of the treatment, there was a significant clinical decrease in the probing depth values, and radiographs showed a remarkable reduction of the infrabony defect volume.- - - - - - - - - - ranking = 1298.7904072548keywords = periodontitis (Clic here for more details about this article) |
5/10. Interdisciplinary treatment of a patient with severe pathologic tooth migration caused by localized aggressive periodontitis.An interdisciplinary approach was used to treat a patient with pathologic migration of teeth, with severe anterior proclination and molar mesial inclination due to localized aggressive periodontitis. The combination of regenerative periodontal therapy, prosthodontic rehabilitation, and orthodontic treatment greatly improved function and esthetics.- - - - - - - - - - ranking = 6493.9520362739keywords = periodontitis (Clic here for more details about this article) |
6/10. Reactive correction of a maxillary incisor in single-tooth crossbite following periodontal therapy.BACKGROUND: The reactive correction of a single tooth anterior crossbite following periodontal therapy is described. This case report provides new information regarding correction of a crossbite relationship and con- firms existing reports of tooth movement following periodontal therapy. methods: A 39-year-old woman in good general health presented with a history of recurrent periodontal abscesses of a maxillary incisor. Probing depths of the abscessed tooth ranged from 5 to 12 mm, and class 1 mobility was noted. Radiographs revealed that the tooth had previously been treated endodontically. The patient's periodontal diagnosis was generalized chronic moderate to severe periodontitis. Treatment considerations were complicated by a single-tooth crossbite relationship of the involved incisor and clinical evidence that the periodontal abscess communicated with an apical infection. Treatment of the abscess consisted of cause-related therapy, bone grafting, and occlusal adjustment. RESULTS: Five months after surgical treatment, an edge-to-edge incisal relationship was observed, the first indicator of tooth movement. Further correction to a normal incisal relationship resulted 1 year after modification of the proximal contact. At this time, there was normal probing depth with only slight recession and mobility. Bone fill was radiographically noted. CONCLUSION: It appears that some cases of maxillary incisor crossbite that are complicated by periodontal disease may be corrected, without orthodontic appliances, following periodontal treatment.- - - - - - - - - - ranking = 1298.7904072548keywords = periodontitis (Clic here for more details about this article) |
7/10. Bizarre pathologic tooth migration.An extreme example of pathologic tooth migration associated with bruxism and severe periodontitis is presented. The prognosis of the tooth was deemed hopeless; it subsequently was extracted. Various etiological factors of abnormal tooth displacement are discussed.- - - - - - - - - - ranking = 1298.7904072548keywords = periodontitis (Clic here for more details about this article) |
8/10. gingival recession and pathologic migration due to an unusual habit.Various etiologies are implicated as causes of gingival recession and pathological tooth migration, most prevalent among these being the tissue destruction caused by periodontal pathogens. One of the least documented causes is a parafunctional habit, such as digit-sucking or sucking on objects like pencils, pens or toothpicks, all of which can lead to adverse effects on the dentition and the periodontal tissues resulting in midline diastema, alveolar bone loss, gingival recession, mobility, and ultimately tooth loss. This case report describes the periodontal injury caused by an unusual habit of placing a coin between the mandibular anterior teeth. The potential effects of this habit on the dentition and periodontium are discussed; the preventive measures to be taken and the outline for the management of such cases, to ensure periodontal health of the patient are dealt with in this report.- - - - - - - - - - ranking = 0.2keywords = alveolar (Clic here for more details about this article) |
9/10. Hyperkeratosis palmoplantaris (Papillon-Lefevre syndrome). A case report.A 16-year-old female presented with a severe chronic periodontitis and with associated hyperkeratotic lesions of her palms and soles. Investigations revealed it as a case of hyperkeratosis palmoplantaris (Papillon-Lefevre syndrome), which is a rare form of an ectodermal dysplasia. Previously it was speculated that this disease entity is not all that uncommon in nigeria especially amongst the rural population. However, recent investigations revealed that this is not correct.- - - - - - - - - - ranking = 1298.7904072548keywords = periodontitis (Clic here for more details about this article) |
10/10. Repair of an extensive periodontal defect after tetracycline administration. A case report.A pathologically migrated maxillary central incisor tooth with a poor periodontal prognosis was treated successfully with conventional periodontal therapy. After almost 4 years, an extensive periodontal lesion developed on the same tooth and extraction was recommended. The patient did not comply and the acute symptoms disappeared after the administration of 1 gm of tetracycline a day for 2 weeks. Although no definitive periodontal therapy was done, complete resolution of the lesion occurred with the healing of the structures of the periodontium and a dramatic reduction in mobility of the tooth. Antibacterial therapy could be an effective means of treating some periodontal lesions once a more exact and direct association is established between the various clinical forms of periodontitis and specific periodontal or groups of pathogens.- - - - - - - - - - ranking = 1298.7904072548keywords = periodontitis (Clic here for more details about this article) |
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