Biomedical subjects

Michael A Brunsvold

Publications and source records attributed to Michael A Brunsvold.

5 recordsLinked to original sources

PubMed2006

Maxillary sinusitis and periapical abscess following periodontal therapy: a case report using three-dimensional evaluation.

BACKGROUND: Maxillary sinusitis may develop from the extension of periodontal disease. In this case, reconstructed three-dimensional images from multidetector spiral computed tomographs were helpful in evaluating periodontal bony defects and their relationship with the maxillary sinus. METHODS: A 42-year-old woman in good general health presented with a chronic deep periodontal pocket on the palatal and interproximal aspects of tooth #14. Probing depths of the tooth ranged from 2 to 9 mm, and it exhibited a Class 1 mobility. Radiographs revealed a close relationship between the root apex and the maxillary sinus. The patient's periodontal diagnosis was localized severe chronic periodontitis. Treatment of the tooth consisted of cause-related therapy, surgical exploration, and bone grafting. A very deep circumferential bony defect at the palatal root of tooth #14 was noted during surgery. After the operation, the wound healed without incidence, but 10 days later, a maxillary sinusitis and periapical abscess developed. To control the infection, an evaluation of sinus and alveolus using computed tomographs was performed, systemic antibiotics were prescribed, and endodontic treatment was initiated. RESULTS: Two weeks after surgical treatment, the infection was relieved with the help of antibiotics and endodontic treatment. Bilateral bony communications between the maxillary sinus and periodontal bony defect of maxillary first molars were shown on three-dimensional computed tomographs. The digitally reconstructed images added valuable information for evaluating the periodontal defects. CONCLUSION: Three-dimensional images from spiral computed tomographs (CT) aided in evaluating and treating the close relationship between maxillary sinus disease and adjacent periodontal defects.

Adult↗

PubMed2005

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.

Adult↗

PubMed2005

Pathologic tooth migration.

Pathologic tooth migration (PTM) is a common complication of moderate to severe periodontitis and is often the motivation for patients to seek periodontal therapy. In this review of the literature, available information concerning prevalence, etiology, treatment, and prevention of pathologic tooth migration is summarized. Prevalence of PTM among periodontal patients has been reported to range from 30.03% to 55.8%. A survey of the literature regarding chief complaints of periodontal patients support these high prevalence findings. The etiology of PTM appears to be multifactorial. Periodontal bone loss appears to be a major factor in the etiology of PTM. Many aspects of occlusion can contribute to abnormal migration of teeth, and more than one of those factors may be present in an individual patient. Soft tissue forces of the tongue, cheeks, and lips are known to cause tooth movement and in some situations can cause PTM. Also considered important in the etiology of PTM is pressure produced from inflammatory tissues within periodontal pockets. Because extrusion is a common form of PTM, clinical observations support the theory that eruption forces sometimes play a role in the etiology of PTM. Many oral habits have been associated with PTM which are often difficult for the therapist to detect. Most cases of severe PTM require a team approach to achieve success. Periodontal, orthodontic, and prosthodontic treatment are often required. Many patient variables enter into the selection of treatment for PTM. In early stages of PTM, spontaneous correction of migrated teeth sometimes occurs after periodontal therapy. Light intrusive forces are used successfully to treat extrusion and flaring forms of PTM. Based on the literature reviewed, it appears that many cases of PTM could be prevented through the early diagnosis and treatment of periodontal disease, occlusal contributing factors, gingival enlargement, and oral habits.

Bite Force↗

PubMed2003

Clinical and histologic evaluation of bone-replacement grafts in the treatment of localized alveolar ridge defects. Part 1: Mineralized freeze-dried bone allograft.

The purpose of this study was to evaluate the use of mineralized freeze-dried bone allograft (FDBA) in conjunction with a titanium-reinforced expanded polytetrafluoroethylene (TR e-PTFE) barrier in the treatment of localized alveolar ridge deficiencies prior to endosseous dental implant placement. Twelve patients (aged 23 to 65 years) requiring tooth replacement with ridge augmentation were recruited to participate in this study. During ridge augmentation surgery, measurements were made prior to grafting with FDBA plus a TR e-PTFE barrier. Six months later, ridge measurements were repeated, and suitability for implant placement was assessed. At each implant site, a biopsy was taken from the grafted site. The implants were placed and allowed to osseointegrate for 13 weeks prior to phase-two surgery. Clinical data analyzed were horizontal ridge width changes and vertical ridge height changes. Histologic evaluation revealed the formation of new bone and residual particles in each graft site at the time of implant placement Ten patients completed the study. The mean alveolar ridge width increased by 3.2 +/- 1.0 mm (P < .0005). Histomorphometric analysis revealed a range of new bone from 42.9% to 70.5%, with a mean of 47.6%. Graft particles remaining ranged from 29.5% to 57.1%, with a mean of 52.4%. The clinical and histologic findings of this study demonstrate that sites grafted with FDBA in conjunction with an e-PTFE barrier can provide a predictable way to augment deficient alveolar ridges prior to implant placement.

Adult↗

PubMed2002

A clinical comparison of a bovine-derived xenograft used alone and in combination with enamel matrix derivative for the treatment of periodontal osseous defects in humans.

BACKGROUND: Enamel matrix protein derivative (EMD) and particulate anorganic cancellous bovine-derived bone xenograft (BDX) have both shown favorable clinical results in reducing intrabony periodontal defects as compared to open flap debridement alone. These materials have shown results comparable to those obtained with guided tissue regeneration. The primary aim of the present study was to evaluate the effectiveness of EMD combined with BDX as compared to BDX alone, with a secondary aim to compare the treatment outcomes of the 2 modalities. METHODS: Seventeen patients with paired intrabony defects and probing depths measuring > or = 5 mm who were being treated for chronic periodontitis were selected for this controlled, blinded, split-mouth study. Following non-surgical periodontal therapy, sites were randomly selected to receive either a combination of EMD and BDX (test group) or BDX alone (positive control group). Baseline and 6-month surgical reentry measurements were taken by a calibrated examiner blinded to the treatment. A paired Student t test was utilized to evaluate differences between baseline and post-treatment and between the treatment groups. RESULTS: Favorable clinical outcomes for both hard and soft tissue measurements were achieved for both treatment groups when compared to baseline (P < 0.001). There was no statistically significant difference for any of the measured clinical parameters. Probing depth reduction for the test group and control group was 4.2 +/- 1.1 mm and 3.9 +/- 1.3 mm, respectively (P > 0.8). Mean gain in clinical attachment levels for the test and control groups was 3.8 +/- 0.9 mm and 3.7 +/- 1.5 mm, respectively (P > 0.6). Hard tissue measurements obtained at surgical reentry were used to calculate the bone fill (BF) and percent bone fill (%BF). The BF was 3.2 +/- 1.4 mm and 3.0 +/- 1.2 mm (P > 0.6), and the %BF was 63.3 +/- 16.3% and 67.0 +/- 19.0% (P > 0.4) for the EMD + BDX and BDX groups, respectively. CONCLUSIONS: In summary, both the particulate anorganic cancellous bovine-derived bone xenograft used alone and in combination with enamel matrix derivative are effective for the treatment of human intrabony periodontal lesions.

Adult↗