Cases reported "Alveolar Bone Loss"

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1/109. Tomodensitometric and histologic evaluation of the combined use of a collagen membrane and a hydroxyapatite spacer for guided bone regeneration: a clinical report.

    In this report, the problems of insufficient bone and soft tissue after extraction of maxillary incisors were addressed concurrently prior to endosseous implant placement, by combining the use of a diphenylphosphorylazide-cross-linked Type I collagen membrane and a resorbable space-making biomaterial composed of 200-micron porous hydroxyapatite granules blended in Type I collagen and chondroitin-4-sulfate. Upon flap reflection 8 months postsurgery, the horizontal deficiencies were almost completely resolved, membranes completely resorbed and the defects filled with hard, bonelike tissue, with a few superficial hydroxyapatite granules. Histologic evaluation of the bone biopsies obtained at the implantation sites revealed dense, well-reconstructed alveolar bone with a few traces of hydroxyapatite granules that had been completely resorbed. Tomodensitometric evaluation indicated that bone regeneration ranged from 14% to 58%, with an average bone gain of 29.77%. Four nonsubmerged ITI titanium implants placed in the augmented bone have been in function for more than 5 years, with no clinical or radiographic signs of hard or soft tissue breakdown. Bacterial sampling at dental sites with periodontitis 1 month prior to periodontal therapy and at implant sites for up to 30 months demonstrated rapid colonization of implant surfaces by periodontopathogens without causing any detrimental effect to implant integration.
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2/109. bone regeneration around an osseointegrated implant. A simultaneous approach in a fenestrated defect: a case report.

    The use of a barrier membrane, with or without osseous allograft, has been shown to establish regeneration of osseous tissue around dental implants. Following three episodes of persistent symptomatic failed apicoectomy and subsequent tooth extraction, an osseointegrated implant was placed in a wide fenestrated defect. Demineralized freeze-dried bone allograft was covered by an occlusive expanded polytetrafluorethylene membrane. The reentry procedure revealed complete bone fill that followed the texture of the augmentation material beyond the previous buccal bony envelope.
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3/109. Esthetic restoration of a single-tooth dental implant using a subepithelial connective tissue graft: a case report with 3-year follow-up.

    This case report describes the use of a subepithelial connective tissue graft to restore the gingival papillae and augment ridge soft tissues adjacent to a dental implant. The patient was referred for periodontic and prosthodontic evaluation after the placement of an implant--with the implant head 6.5 mm below the adjacent cementoenamel junction--in an area of inadequate bone volume with deficient interproximal papillae and ridge soft tissues. The resulting esthetic defect was restored by means of a combined technique that used a subepithelial connective tissue graft and an emergence profile-contoured crown. A 3-year clinical follow-up with complete regeneration of the gingival papillae is described.
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4/109. Contemporary treatment of the resorbed avulsed tooth: a case report.

    This report describes the treatment sequence after traumatic loss of a maxillary central incisor in a 15-year-old patient. Following extraoral root canal treatment and initially successful replantation, the case presented 9 years later with complete root resorption. After augmentation with an autologous mandibular corticocancellous graft, a dental implant was placed in a second stage surgery. The case highlights the challenge facing clinicians in providing the appropriate standard of care for today's treatment options.
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5/109. Localized ridge maintenance using bone membrane.

    The immediate placement of a dental implant into a fresh extraction socket has been limited in many instances by the quantity of bone that remains after the extraction. This article presents two clinical cases that demonstrate successful regeneration of alveolar ridges in which there was extensive loss of the buccal plate of bone. This lack of alveolar process impeded the immediate placement of dental implants into fresh extraction sockets. The surgical technique performed in these cases was based on the principles of guided bone regeneration using a demineralized freeze-dried bone membrane. The bone membrane acted as an efficient barrier that excluded the nonosteogenic tissues. Bone formation took place for the placement of endosseous dental implants 8 months after the procedures were initiated. These human clinical cases confirm positive results of previous animal findings.
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6/109. Implant site development using orthodontic extrusion: a case report.

    One of the most important factors in the successful placement of endosseous implants is the presence of adequate alveolar bone at the recipient site. alveolar bone loss associated with destructive periodontal disease frequently results in osseous defects that may complicate subsequent implant placement. Typically, such defects are treated prior to or at the time of implant surgery using the principles of guided bone regeneration. Under certain circumstances, however, such defects may be managed non-surgically by orthodontic extrusion. orthodontic extrusion can be used to increase the vertical bone height and volume and to establish a more favourable soft-tissue profile prior to implant placement. The addition, the increase in the vertical osseous dimension at interproximal sites may assist in the preservation of the interdental papillae and can further enhance gingival aesthetics. This report illustrates the treatment sequence for site development with orthodontic extrusion prior to immediate implant placement.
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7/109. microbiology of subgingival plaque from children with localized prepubertal periodontitis.

    Localized prepubertal periodontitis has been described as a host-defect mediated form of bacterially induced periodontitis, with an early onset and rapid progression around a few teeth in children prior to puberty. To further our understanding of the etiology of this disease, we have examined the microbiological components of subgingival dental plaque in 9 children with localized prepubertal periodontitis to determine if patterns of putative pathogens existed, and have compared these results with those obtained from 4 children with no periodontitis. Subgingival plaque samples were plated onto a selective medium for actinobacillus actinomycetemcomitans and onto a non-selective medium for anaerobes, and the predominant cultivable microbiota of 2 sites per child was determined. The subgingival microbiota of children with localized prepubertal periodontitis clearly differs from non-diseased children in the detection of high levels of several suspected pathogens, including A. actinomycetemcomitans, bacteroides intermedius, eikenella corrodens, and capnocytophaga sputigena. These putative pathogens were found in various combinations. These findings suggest that localized prepubertal periodontitis is associated with specific subgingival bacteria which are generally not found in children without periodontitis.
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8/109. Radiographic osseous regeneration after initial therapy with systemic doxycycline.

    Early-onset periodontal diseases are often diagnosed in the military as a result of the requirements for annual dental examinations and the youthful population served. A young soldier diagnosed with rapidly progressive periodontitis completed initial therapy of root planing with the systemic antibiotic doxycycline but was poorly compliant with additional treatment. During a subsequent mandatory dental examination, new radiographs demonstrated a significant improvement in the quantity and quality of alveolar bone, illustrating the regeneration potential of the young patient with early-onset periodontal disease.
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9/109. Aplastic anemia: current concepts and dental management.

    Aplastic anemia (AA) is a rare blood dyscrasia in which the peripheral blood cells are decreased because of bone marrow failure. The clinical course reflects the severity of pancytopenia and is unpredictable for the individual. hemorrhage and infection remain the major threats to these patients. Recent advances in transfusion medicine, infection management, bone marrow transplantation, and immunosuppressive therapy have improved survival of patients with AA. oral manifestations of AA are common and may have serious sequelae. Two cases of acute periodontal infection associated with AA are presented. Dental management guidelines are presented in the context of interdisciplinary care.
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10/109. Ridge preservation of dentition with severe periodontitis.

    Severe loss of alveolar bone height and width can occur following the removal of teeth with advanced periodontitis. This compromise of the alveolar bone can limit the options available for achieving an acceptable dental restoration. Two case reports are presented of alveolar ridge augmentation after tooth removal and before implant placement using bone grafting and a biodegradable membrane. The resultant alveolar ridges in both patients were adequate for the placement of dental implants.
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