1/12. Dynamics of dental implants and orthodontics in today's periodontal prosthesis.periodontal prosthesis refers to multidisciplinary efforts to stop disease progression, correct deformities created by dental diseases, and establish a therapeutic occlusion to restore the form and function of the masticatory system. These efforts are critical for the long-term prognosis and maintenance of the guarded teeth and the overall prosthesis. This article presents a functionally and esthetically challenging case, which illustrates a multidisciplinary approach--specifically implantology and orthodontics--and how they impact on each other during treatment. The role and importance of dental implants and orthodontics in setting up a case is illustrated in this article.- - - - - - - - - - ranking = 1keywords = disease progression, progression (Clic here for more details about this article) |
2/12. Periodontal management of an adolescent with Down's syndrome--a case report.A case of periodontitis in a young adolescent Japanese girl with Down's syndrome is presented in this report. The patient received a monthly preventive course of dental care consisting of mechanical plaque control and oral hygiene instruction. After 2.5 years she recovered from progression of periodontal disease both clinically and microbiologically. The importance of clinical care for periodontitis in Down's syndrome patients is discussed.- - - - - - - - - - ranking = 0.0064796113914933keywords = progression (Clic here for more details about this article) |
3/12. Cervical enamel projection with gingival fenestration in a maxillary central incisor: report of a case.Bacterial plaque has been implicated as the primary etiologic factor in the initiation and progression of periodontal disease. Anatomic factors, such as cervical enamel projections, enamel pearls, and radicular grooves, are often associated with advanced localized periodontal destruction. Enamel projections and pearls are most often associated with molars, while radicular grooves are usually located on the palatal aspect of maxillary incisors. Gingival fenestrations are of uncertain etiology and have rarely been reported in the dental literature. An unusual case is presented of a cervical enamel projection located on the facial aspect of a maxillary central incisor in association with gingival fenestration. Rationale for therapy and likely healing results are discussed.- - - - - - - - - - ranking = 0.0064796113914933keywords = progression (Clic here for more details about this article) |
4/12. aggressive periodontitis in a patient with chronic cutaneous lupus erythematosus: a case report.Lupus erythematosus is considered to be a high risk factor for periodontitis. As an autoimmune disease of unknown origin, cutaneous lupus erythematosus (CLE) is subdivided into 3 categories: chronic (CCLE), subacute (SCLE), and acute (ACLE). While the ACLE has a high prevalence of conjunctive periodontal lesions, aggressive periodontitis in patients with CCLE has been rarely reported. This article describes the case of a patient diagnosed with aggressive periodontitis. Three months after the diagnosis of periodontitis, the patient experienced advancing hair loss (alopecia), pale fingers and toes, as well as edema in the legs and around the eyes. skin biopsy showed follicular hyperkeratosis with perivascular mononuclear cell infiltrate. Colliquation of the basal cells, thickening of the basal lamina, and vacuolar degeneration of basal keratinocytes were also found. A lupus band test was positive, and diagnosis of CCLE was established. Three months following the treatment of lupus with antimalarial agents, the periodontal condition became stable with no further exacerbation or progression of the existing periodontitis. An 11-month postsurgical follow-up revealed stable periodontal and general medical conditions. A patient's medical history should be re-evaluated in the event of recurrence of periodontal lesions refractory to periodontal treatment. The control of systemic conditions like lupus erythematosus is essential for a good prognosis in the treatment of periodontitis as well as for the general health of the patient.- - - - - - - - - - ranking = 0.0064796113914933keywords = progression (Clic here for more details about this article) |
5/12. Progressive osseous destruction as a complication of hiv-periodontitis.A pathologic condition is described, characterized by rampant necrosis of gingival mucosa, periodontium, and related osseous structures associated with systemic infection with the human immunodeficiency virus (hiv). It is believed that this condition is an extension beyond the normal clinical course of hiv-periodontitis (hiv-P) and manifests itself in three progressive stages: (1) hiv-associated gingivitis, (2) hiv-P, and (3) an extension of hiv-P to osseous necrosis. Two cases of osseous destruction attending hiv-P are reported, one of which led to initial diagnosis of hiv infection. They represent the final stage of disease progression with localized necrosis of gingiva, periodontium, and alveolar bone.- - - - - - - - - - ranking = 1keywords = disease progression, progression (Clic here for more details about this article) |
6/12. Rapid periodontal destruction in adult humans with poorly controlled diabetes. A report of 2 cases.Out of a pool of 12 middle-aged or elderly diabetic patients demonstrating rapid periodontal break-down, the 2 oldest cases with follow-up periods of 19 and 16 years are described. The common feature of all 12 patients was that they were either unaware of or unable to control their diabetic condition at the time of the active stage of their periodontal disease. The bone loss progressed in spite of specialist periodontal care and the patients again responded to treatment only after their elevated blood glucose levels had been brought back to normal. Thus, the rapid periodontal breakdown was not found to be associated with the diabetic condition per se, but rather with the hyperglycemia. This clinical follow-up study does not answer the question of whether rapid periodontal destruction occurs in all patients with poorly controlled diabetes. Neither do the observations imply that rapid bone loss would be pathognomic of high blood glucose levels. However, the observations seem to suggest that there may be an inter-relationship between rapid periodontal breakdown and elevated blood glucose levels. Therefore, any sudden change towards an increased progression rate of periodontal breakdown at adult age, as observed from periodic radiographs with intervals of only a few years, should be followed up with a medical examination in order to outrule or verify the possibility of a high blood glucose level.- - - - - - - - - - ranking = 0.0064796113914933keywords = progression (Clic here for more details about this article) |
7/12. Abnormal lymphocyte profiles and leukotriene b4 status in a patient with Crohn's disease and severe periodontitis.THIS CASE REPORT DESCRIBES clinical and laboratory findings for a 60-year-old woman with recently diagnosed Crohn's disease and severe generalized periodontitis. Comparison of dental radiographs taken in 1975, in 1983, and at the time of our evaluation in 1986 revealed dramatic progression of alveolar bone loss over that period. Standard laboratory blood tests did not reveal any remarkable significant leukocyte abnormalities, but flow cytometric analysis of lymphocytes revealed a paucity of B cells stained with anti-light chain antibodies, and an increased proportion of T lymphocytes which were dully-stained with anti-CD5 monoclonal antibody. B cell function as determined by in vitro proliferative responsiveness to anti-IgM antibody was only about 50% of that observed with cells from two healthy normal subjects. serum leukotriene b4 (LTB4) was elevated to 150% of normal values, in spite of the fact that the patient was taking a systemic anti-inflammatory drug which is known to reduce LTB4 levels. The microbial flora was highly mixed and included several putative periodontopathic bacteria. Therapy consisted of oral hygiene instruction, scaling and root planing, mucoperiosteal-flap curettage, extracoronal splinting, and selective extraction of three teeth. The periodontal status improved markedly with therapy. Possible relationships between the patient's immunological status, her Crohn's disease, and the severe periodontal breakdown are discussed.- - - - - - - - - - ranking = 0.0064796113914933keywords = progression (Clic here for more details about this article) |
8/12. Manifestations and treatment of periodontal disease in a patient suffering from cyclic neutropenia.A case of severe periodontitis in a young man suffering from cyclic neutropenia is reported. The periodontal status as evaluated from oral radiographs at the age of 13 reveals advanced periodontal breakdown around the molars and the incisors in both jaws. At the age of 21, when clinical examination was performed, all teeth were found to be periodontally involved. The treatment was divided into three phases: (1) a causative treatment phase (oral hygiene phase) aimed at achieving the highest possible level of oral cleanliness, (2) a corrective phase including periodontal surgery and prosthetic rehabilitation and (3) a maintenance phase aimed at prevention of recurrence of periodontal disease. The oral hygiene phase was markedly extended both in time (2 years) and intensity. Several reexaminations were carried out during the course of this phase to evaluate the patient's ability to exercise proper plaque control and the response of the tissues to treatment. The progression of the periodontal disease could be arrested and the prosthetic treatment indicated was successfully performed. Following the corrective treatment phase a maintenance care program was designed including frequent recall appointments in order to prevent disease recurrence. Four years after active treatment no further periodontal breakdown could be observed as evaluated from pocket depth, attachment level and bone height measurements. The result of the treatment of this patient shows that treatment, designed to eliminate plaque infection, is effective also in an individual with defective host defense against bacterial infections, but the demand on the patient's cooperation must be extraordinary high as well as the demand on the effectiveness of the maintenance care program.- - - - - - - - - - ranking = 0.0064796113914933keywords = progression (Clic here for more details about this article) |
9/12. Microbial identification and antibiotic sensitivity testing, an aid for patients refractory to periodontal therapy. A report of 3 cases.The importance of microbial surveillance is illustrated in 3 clinical cases. Each case demonstrated a continued lack of response to conventional periodontal treatment. Repeated bouts of periodontal abscess formation and bone loss occurred over a 3- to 4-year period, despite numerous surgeries supplemented with antibiotics. As a result, patients were termed refractory to treatment and extensive microbiological analysis and sensitivity testing was performed. Following institution of the appropriate antibiotic and conservative therapy consisting of several sessions of scaling and root planning, each of these cases demonstrated a dramatic remission of disease progression. No further breakdown has been seen for a minimum of 2 1/2 years. While anecdotal in nature, these cases support the usefulness of microbial identification coupled with antibiotic sensitivity as an adjunct to conventional conservative periodontal therapy.- - - - - - - - - - ranking = 1keywords = disease progression, progression (Clic here for more details about this article) |
10/12. Wegener's granulomatosis: a case study in general dental practice.Wegener's granulomatosis is a disease involving renal, lung and vascular tissue, but patients also present to the general dental practitioner with intra-oral manifestations. This case study describes the early onset, progression and treatment of the presenting intra-oral manifestations and the periodontal and endodontic implications of Wegener's granulomatosis.- - - - - - - - - - ranking = 0.0064796113914933keywords = progression (Clic here for more details about this article) |
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