[Etiology, prevention and early treatment of periodontitis].
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Biomedical subjects
Publications and source records attributed to K H Rateitschak.
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Free gingival grafts were performed on recession areas around 42 teeth in 12 patients, with postoperative evaluation of recurrent recession after 1, 6, 12, 24 and 48 months. No changes in degree of recession were observed during the 4-year period. The vestibuloplasties, which were always wider than the transplants, exhibited recurrence up to the transplant margin 6 months after surgery, while the transplants themselves exhibited an average shrinkage of 25%. In addition, 25% of the increase in vestibular depth achieved by the surgery was lost 1 month postoperatively, but there was a tendency toward increasing vestibulum depth during the ensuing 47 months. Gingival sulcus depth was not affected by the surgery.
Failures in periodontal therapy may be caused by a faulty choice of patients, insufficient diagnosis, prognosis and planning, faulty choice of therapy, treatment and follow-up treatment. Particularly important is the motivation of the patient, his collaboration in periodontal therapy is decisive for success or failure of the treatment. Lasting success may only be expected if patients are regularly recalled, their brushing and cleaning habits may be checked and further treatments be dispensed in time.
Vestibuloplasties with free gingival grafts were performed on 42 teeth in 12 patients exhibiting gingival recession. The tendency toward recurrence was studied after postoperative intervals of 1, 6 and 12 months. The extensions (vestibuloplasties), which were always wider than the transplant, recurred up to the transplantation margin. The transplant itself underwent shrinkage averaging 25 per cent. The vestibular depth, which had been increased by the operation, showed a 25 per cent reduction within 1 month, but then had a tendency to deepen again from 1 to 12 months postoperatively. The marginal free gingiva and sulcus depth were not influenced by the operation.
The effect on marginal inflammation and tooth mobility of occlusal adjustment by grinding was investigated in 43 occlusally traumatized teeth in 29 subjects with gingivitis and marginal periodontitis. The material consisted of 4 groups with tooth mobility of varying degrees of severity, and bone destruction. In all groups increased tooth mobility decreased subsequent to occlusal adjustment. The latter was without effect on the sulcus fluid flow rate or gingivitis scores in either gingivitis or periodontitis patients.
In a first experiment, no appreciable differences in plaque formation under periodontal packs were observed in subjects rinsing with and without 0.2% chlorhexidine digluconate. In a second experiment, one gram periodontal packs were coated with 15 to 20 mg of chlorhexidine dihydrochloride powder prior to application and allowed to remain in situ for 4 days. Significantly less plaque formed under periodontal packs with chlorhexidine powder than with control packs. Chlorhexidine dihydrochloride powder may be recommended under periodontal packs for reduction of microbial plaque.
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