Cases reported "Root Caries"

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1/19. Resin-ionomer and hybrid-ionomer cements: part II, human clinical and histologic wound healing responses in specific periodontal lesions.

    Twenty-five subjects with a total of 50 subgingival restorations participated in this study. At the beginning of the investigation, nine teeth that were considered hopeless because of the extent of their pathology were selected for extraction to evaluate histologically the restorations and their effect on the adjacent tissues. The purpose of this article is to demonstrate the responses to the clinical applications as well as to the placement of resin-ionomers in subgingival lesions. Clinical and histologic evidence of epithelial and connective tissue adherence to resin-ionomer restorative materials was observed during the healing process. ( info)

2/19. Simultaneous team approach of a crown-lengthening procedure and an operative restoration: technique and long-term effect.

    Traditionally, crown-lengthening procedures to expose subgingival caries for operative restorative work are carried out in a two-stage approach. A disadvantage of this procedure is that the gingival margin associated with the treated tooth moves apically; this may create an esthetic problem. Resin-modified glass-ionomer cement has been demonstrated to have good biocompatibility with dental hard and soft tissues. Surgical and restorative procedures were combined at the same appointment in an effort to achieve a restoration with minimal change in the gingival margin. Four patients have been treated with this one-stage team approach and followed for 8 to 13 months. The clinical results demonstrated this team approach procedure is excellent for the dentition when esthetics is a consideration. ( info)

3/19. Periodontal esthetics and soft-tissue root coverage for treatment of cervical root caries.

    As the pace of change accelerates in periodontics and esthetic dentistry, an increasing number of procedures are being developed that require knowledge and treatment from both fields. The synergy developed by combining these two fields of dentistry allows for better esthetic outcomes for our patients. Two of these procedures include esthetic crown lengthening and soft-tissue root coverage. As demonstrated in this article, soft-tissue root coverage can be performed on previously restored roots and as an option for treating root caries. ( info)

4/19. Soft tissue root coverage as treatment for cervical abrasion and caries.

    Root exposure caused by gingival recession may result in cervical abrasion, root caries, root sensitivity, and compromised esthetics. Although cervical root lesions can be treated with Class V restorations, there may be advantages in treating them with soft tissue grafts for root coverage since they restore the dento-gingival unit to its prerecession condition. The rationale for root coverage with soft tissue grafts is reviewed and two cases are presented of successful root coverage procedures in which gingival recession associated with cervical abrasion and caries was present. ( info)

5/19. rehabilitation of a bulimic patient using endosteal implants.

    This article describes the dental rehabilitation of a bulimic patient using endosteal implants. Although the patient, a 31-year-old woman with a long history of bulimia nervosa, had been receiving medical and psychological treatment, the condition was not completely controlled. Clinical examination revealed multiple crowns with extensive cervical caries. The prognosis for all remaining teeth was poor. After extractions, implant therapy was implemented to provide support for fixed prostheses. After the implants were uncovered and during provisional therapy, the peri-implant tissue exhibited inflammation and lack of keratinized tissue requiring additional periodontal procedures before definitive restorations could be placed. Because of the difficulty in managing the peri-implant tissue during the many phases of implant therapy, treatment was challenging. One year after treatment, the patient's low self-esteem had improved substantially and her restorations provided satisfactory esthetics and function. ( info)

6/19. Coverage of carious roots by a subepithelial connective tissue graft.

    PURPOSE: To assess whether coverage of an untreated or restored carious root lesion with a subepithelial connective tissue graft would provide a predictable, esthetically acceptable result and prevent further caries progression. MATERIALS AND methods: Twenty-seven teeth from 13 patients with root caries and gingival recessions of 3.4 /- 0.2 mm (mean /- SEM) were treated with subepithelial connective tissue grafts. Eighteen teeth had untreated caries, and the other nine had composite or glass-ionomer restorations. The carious dentin and the plastic restorations were removed prior to the surgical procedure. The exposed roots were thoroughly planed and covered by a subepithelial connective graft with no further root treatment or conditioning. The teeth were examined periodically from 1-6 years post-treatment for retention of root surface coverage and presence of carious lesions. RESULTS: The mean root coverage recession left after the treatment was 0.3 /- 0.1 mm, with coverage of 92.4 /- 2.4%. Significant differences (P< 0.05) were found between the coverage of roots with carious lesions that had not been restored and those that had restorations removed. However, since the number of teeth with restorations was limited, further study is required to confirm this difference. In 18 cases, complete coverage of the recession was achieved. The results were stable, and no further recessions or recurrent caries were detected. ( info)

7/19. Treatment of combined endodontic-periodontic lesions by intentional replantation and application of hydroxyapatites.

    A case of combined endodontic-periodontic lesions on a mandibular first molar was treated by intentional replantation and application of hydroxyapatites. Four months after the surgery, a porcelain-mental full crown restoration was completed. The 15-month follow-up examination showed that the tooth was clinically and radiographically healthy and functioned well. ( info)

8/19. Periodontal regenerative therapy with coverage of previously restored root surfaces: case reports.

    Two case reports are presented to demonstrate a treatment that restores proper esthetics, cures hypersensitivity, and enhances periodontal support for cases of root caries or failing Class V restorations associated with gingival recessions. The procedure involves removing the existing restoration, elevating a trapezium-shaped full thickness flap, root planing to achieve a desired concave shape, and placing a barrier membrane. In both cases, satisfying clinical results have been maintained for 18 months. ( info)

9/19. Transurgical restoration in the absence of attached gingiva. A case report.

    A 45-year-old woman needing a Class V restoration in a mandibular molar without attached gingiva is presented. In an interdisciplinary intervention, transurgical restoration was accomplished, including flap surgery with a slight ostectomy and restoration with a bonding system and a resin composite. A 1-year clinical evaluation showed satisfactory marginal adaptation and restoration contour associated to gingival tissue health. ( info)

10/19. A new approach using the surgical extrusion procedure as an alternative for the reestablishment of biologic width.

    A modification of the surgical extrusion technique to treat fractured teeth was realized as an alternative periodontal therapy to avoid ostectomy following orthodontic extrusion of teeth with their biologic widths compromised by different etiologic involvements. After delicate luxation and arrested avulsion, the teeth were coronally positioned to allow room for a new biologic width. Clinical and radiographic monitoring showed the ability of the periodontium to adapt function and esthetic recovery. The advantages and disadvantages of this therapeutic procedure for resolution of a periodontal involvement are presented. ( info)
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