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PubMed2003

[Direct application of fiber-reinforced composites in splinting in a case of periodontitis. II].

Attachment loss through advanced periodontitis results in tooth mobility, and then loss of teeth. To prevent progression it is needed to eliminate any exciting agent and correct functional disorders in consequence of disease. Regeneration of periodontium is impossible and mastication is difficult because of tooth mobility. Long-term maintenance of mobile teeth is doubtful. We have to prevent the extraction of these teeth to stabilise them by a splint made of material that is inexpensive, reparable, provides sufficient support for the artificial tooth. Fiber-Reinforced Composite (FRC) fulfills the above requirements. In their case-reports the authors demonstrate the practical application of splinting with FRC materials. In these cases the FRC splints are not only periodontal splints but they act as orthodontic retainers or supports for an artificial tooth.

Adult↗
PubMed1989

[Evaluation of hydroxyapatite implants in human periodontal osseous defects].

In this clinical study we evaluated the use of hydroxyapatite ceramic (HAP) implant in conjunction with the surgical treatment of periodontal osseous defects. Fifty-five defects in 23 patients were treated and filled with HAP particles (BDHAP-101). At 6 months and 12 months after the placement of particles, the sites were evaluated by gingival margin heights, periodontal pocket depths, attachment levels, tooth mobility, the gingival index (GI), and radiographic analyses. Oral hygiene status was estimated by the plaque index (PlI). There were significant improvements with regard to probe depth, attachment level, tooth mobility, and GI. The radiographic analysis showed a similar density of the adjacent bone and the particles, suggesting excellent biocompatibility. There were no changes in PlI before or after the placement of implants.

Bone Resorption↗
PubMed2005

Evaluation of dental injury following endotracheal intubation using the Periotest technique.

The hazards of damage to teeth and their periodontal attachment during tracheal intubation are well known. Dental trauma represents the commonest single reason for complaints against anesthesiologists. In order to predict the possible risk of perianesthetic iatrogenic tooth luxation we evaluated the use of a measuring method (Periotest technique), being well established for the diagnosis of periodontal disease. In 120 patients undergoing elective surgery, we compared the amount of tooth mobility before and after general anesthesia to different scores assessing the difficulty of tracheal intubation. Furthermore, the level of work experience of the intubating anesthetist was compared with the degree of postoperative tooth mobility. Changes of periodontal attachment could not be detected by the Periotest technique. The Periotest technique does not seem to have the ability to detect early periodontal changes associated with endotracheal intubation.

Adolescent↗
PubMed1982

The effect of elimination of jiggling forces on periodontally exposed teeth in the dog.

The aim of the present investigation in dogs was to analyze the effect on periodontal disease induced by a combination of ligatures and jiggling trauma, when the jiggling forces are eliminated. The experiment was performed in six dogs. On Day 0 a phase of periodontal tissue breakdown was initiated around the mandibular fourth premolars (4P; P4) by placing plaque retention ligatures around the necks of the teeth. The ligatures were changed once a month during a 90-day period. On Day 90 the ligatures were removed. On Day 0 trauma from occlusion (jiggling) was also produced in the 4P and P4 region. On Day 90 the jiggling trauma was removed from the 4P-region (test) while it was maintained in the P4-region (control). Tooth mobility measurements and radiographic examinations were carried out on experimental Days 0, 30, 60, 90, 180, and 360. One dog was sacrificed on Day 90 and the remaining five on day 360. Following sacrifice, tissue sections comprising 1M, 4P, 3P, P3, P4, M1 were obtained and subjected to microscopic analysis. Removal of the jiggling trauma from the test teeth resulted in a markedly decreased tooth mobility, but the loss of connective tissue attachment on Day 360 was similar in the test and control sites. This means that although the control teeth had an increased mobility and a widened periodontal ligament space, the height of the remaining periodontal tissue support was similar in the test and control tooth regions.

Animals↗
PubMed2001

Pre-treatment conceptions of periodontal disease and treatment in periodontal referrals.

BACKGROUND: Patients preconceptions of periodontal therapy have not been extensively studied and are poorly understood. AIMS: To register specific anxieties and preconceptions held by patients referred for specialist periodontal treatment and to investigate the risks such patients were prepared to take of progressive periodontal problems before deciding that periodontal treatment was necessary. MATERIALS AND METHODS: 79 patients referred for specialist treatment completed a structured questionnaire. Participants completed visual analogue scales to quantify the risks which they were prepared to take of various symptoms of periodontal disease before they believed treatment was essential. RESULTS: The majority (71%) had anxieties about pending treatment with the main concern being pain. Those who had sought information prior to treatment mainly did so from close relatives. The majority of patients opted to take no or a very low (<20%) risk of any periodontal problems and, therefore, were supportive of treatment. The loss of many teeth due to periodontal disease was the least acceptable outcome followed by tooth mobility. Patients were prepared to accept a significantly higher risk of bleeding on brushing (p<0.0001) than any of the other outcomes investigated. Females recorded substantially lower risk scores than males particularly in relation to developing recession or tooth mobility in the absence of treatment. Patients who were worried about experiencing pain during treatment recorded lower risk scores than those who had no anxiety regarding pain. CONCLUSION: It is concluded that the Norwegian periodontal referrals studied were prepared to take very low risks of further periodontal symptoms despite high levels of anxiety and evidence of a lack of knowledge regarding periodontal treatment.

Adult↗
PubMed1988

A comparative clinical study of solid and granular porous hydroxylapatite implants in human periodontal osseous defects.

Solid and granular porous hydroxylapatite implants were compared in the surgical treatment of angular interproximal periodontal defects in 10 subjects. After completion of initial therapy, presurgical measurements of pocket depth, attachment level, gingival recession, gingival fluid and tooth mobility were recorded. Six months after the surgery the measurements were repeated. The use of both forms of porous hydroxylapatite resulted in reduction in pocket depth, and probeable attachment level gains as well as gingival recession and reduction of gingival fluid and tooth mobility. These changes were similar for both granular and solid forms of porous hydroxylapatite.

Adult↗
PubMed1987

The effect of excision of the root apex on the intrusive mobility of anterior teeth in adult monkeys (Macaca fascicularis).

Intrusive tooth mobility was recorded on anterior teeth in four adult male animals by linear variable-differential transformers. Reflection of the labial mucosa caused a significant increase in mobility at 4 N when the loading rate was slow (1 N s-1) but not when fast (100 N s-1). No significant additional increase in mobility was recorded after the apices were removed from eight incisors and canines. A further study on five incisors was made in which the displacement at 4 N load was noted half hourly during a control period of 5 or 6 h. Some weeks later, the sequence was repeated but the apices were resected after 3 or 4 h. As there was no increase in mobility for the majority of teeth following apicoectomy and, for two teeth studied in detail where there was an increase, that change was short lived; it seems that compression in the fundus of the socket is not a mechanism of importance in supporting the tooth against small intrusive loads.

Animals↗
PubMed1977

The role of dental compensations in the orthodontic treatment of mandibular prognathism.

Thirty-six patients with orthodontically treated mandibular prognathism were recalled for cephalometric and clinical evaluation. A comparison group of 32 non-Class III patients was similarly examined. Analysis of variables associated with the anterior dentition and documentationtion of labial gingival recession and tooth mobility led to the following conclusions concerning the role of dental compensations in the orthodontic treatment of mandibular prognathism. 1. Vertical and horizontal dental compensations were quantitated in the dentition of the study group (pretreatment to postretention). 2. Increased labial gingival recession and increased tooth mobility in functional jaw positions were present in anterior maxillary and mandibular teeth of the study group relative to the comparison group. 3. Proper diagnosis and the establishment of realistic treatment objectives by clinician and patient are necessary to avoid undesirable sequelae and/or undesirable facial esthetics in the treatment of mandibular prognathism.

Humans↗
PubMed1988

[Follow-up study of periodontal tissues around the abutment teeth in Konus telescope denture].

The purpose of this study was to evaluate the periodontal tissues around the 47 abutment teeth in patients with advanced periodontitis for 5 years maintenance periods. The periodontal and prosthetic treatment were carried out and 16 Konus telescope dentures were applied for 11 patients. During 5 years maintenance therapy, periodontal conditions were observed once a year assessing probing depth, attachment level, tooth mobility index, gingival index, marginal alveolar bone height, width of periodontal ligament and loss of lamina dura. The results showed that increase of probing depth in 0.61 mm and attachment loss in 0.78 mm were observed for 5 years. A slight gingival inflammation occurred and tooth mobility increased in some extent. Enlargement of periodontal ligament space and loss of lamina dura in 40% of abutment teeth were observed for 5 years. There were six decayed teeth, six teeth, from which a intracoronal crown was removed, and two extracted teeth in 47 abutment teeth. In conclusion, the periodontal tissues around abutment teeth in Konus telescope denture changed slightly at one year after denture placement, after which, the periodontal tissues were well maintained.

Dental Abutments↗
PubMed1977

Endosteal oral implantology: two-year results of mobility and hysteresis measurements; A human study.

Clinical experience with tooth mobility measurements for assessment of periodontal health was employed in evaluating endosteal implant status. Mobility and hysteresis measurements of 14 implants in 11 patients were carried out regularly during a 2-year period. Immediate postsurgical implant post displacement was 5 hundreths of a millimeter (5.10(-2) mm). After 1, 6, and 24 months, mobility had increased to 13, 21, and 54.10(-2) mm respectively. Viscoelastic recoil patterns were recognized as diagnostic indicators of profound changes in the biophysical properties of periimplant environment.

Dental Implantation, Endosseous↗
PubMed1996

Relationships between clinician variability and radiographic guidelines.

This study evaluated the replicability of clinical measurements under careful calibration of multiple dentists and how the replicability can relate to their use as selection criteria in guidelines for prescribing dental radiographs. For 48 consenting patients, three dentists clinically examined each patient and recorded the presence of all clinical findings using standardized selection criteria. The examinations were performed independently of each other, but with periodic conferences of the dentists to clarify general measurement criteria. The degree of agreement among the dentists is described by the interrater agreement kappa for several standard clinical indications such as rating of caries, periodontal disease, and tooth mobility. Almost perfect agreement was obtained for tooth status, restoration size, and restoration material. Moderate agreement resulted for measures of caries, defective restoration presence, and gingival recession presence. Only fair agreement was obtained for other periodontal disease measures. The relationship between extent of agreement and guidelines' results was examined for the FDA Guidelines. The differences among the dentists' clinical measurements resulted in considerable differences among the radiographs that were selected by the FDA Guidelines' criteria. Even so, the missed disease rates for 490 patients in a larger study of the FDA Guidelines' efficacy were very low and did not vary greatly among the three dentists. We conclude that guidelines' criteria can be quite robust to variation from dentists' clinical measurement differences, as seen from the FDA Guidelines applied under the idealized setting where the dentists are periodically recalibrated through group discussions of the clinical measurements' definitions and interpretations.

Adolescent↗
PubMed1991

Characteristics of periodontal mechanoreceptors supplying reimplanted canine teeth in cats.

These characteristics were investigated 12 weeks and one year after tooth reimplantation. Electrophysiological recordings were made from single mechanosensitive units dissected from the inferior alveolar nerve and each unit was characterized by applying forces to the crown of the tooth. The characteristics were compared with those of receptors innervating normal teeth. The periodontal mechanoreceptors supplying teeth reimplanted 12 weeks earlier responded to applied forces over a narrower range of directions, had higher force thresholds, lower discharge frequencies and adapted more rapidly than controls. One year after reimplantation their characteristics were nearer to normal but they remained significantly different from those of control units. It seems likely that the altered receptor characteristics could have resulted from a combination of changes in tooth mobility, disorganisation of the collagen matrix and direct injury to the nerve terminals.

Action Potentials↗
PubMed1989

[Topical chemotherapy of chronic periodontitis using controlled-release insert containing ofloxacin (PT-01) without root planing].

Topical chemotherapy of periodontal disease using several drug delivery systems (DDS) is currently being attempted. PT-01 is a DDS which consists of fast- and sustained- release parts containing ofloxacin as an antibacterial agent. Since PT-01 was found to sustain the antibacterial effect for 7 days in a periodontal pocket, it was used tor periodontal patients without root planing or scaling in this study. PT-01 and a placebo were applied to two separate and opposite pockets of 46 patients, once a week from the first visit (week 0) to week 3. The clinical parameters (plaque index, gingival index, tooth mobility, bleeding on probing, pus discharge, and probing depth) were evaluated from weeks 0 to 4. At the end of the test (week 4), global improvement at the two sites was assessed. The clinical parameters and the global improvement of the PT-01 and placebo-treated sites were compared statistically. All parameters at the PT-01 sites except for tooth mobility showed much greater improvement than at the placebo sites. The global improvement of PT-01 sites was also significantly greater than that of the placebo sites. No side effects could be seen in patients treated with PT-01. These results indicate that topical chemotherapy using PT-01 could be effective and safe for periodontal therapy.

Chronic Disease↗
PubMed1979

Proceedings of the workshop on quantitative evaluation of periodontal diseases by physical measurement techniques.

Most of the participants agreed that the destruction of connective tissue is the single most significant criterion for assessing the severity of periodontal disease. Members were equally divided between favoring a measure of bone height or density and a measure of soft tissue destruction, such as attachment level or pocket depth. A measure of the rate of destruction of bone at the time of examination was considered to be especially useful. Opinion was equally divided as to the second most important parameter related to periodontal disease, either measures of gingival inflammation or measures of dental plaque. Measurements of gingival fluid and measures of tooth mobility were less favored by the group as a whole, but each measurement area was favored by strong proponents.

Alveolar Process↗
PubMed2005

Clinical efficacy of semiconductor laser application as an adjunct to conventional scaling and root planing.

BACKGROUND AND OBJECTIVES: The aim of the in vitro study was to examine the clinical efficacy of semiconductor laser periodontal pocket irradiation as an adjunct to conventional scaling and root planing. MATERIALS AND METHODS: Twenty-two healthy patients with a need of periodontal treatment (15 women, 7 men, mean age 45.0 +/- 10.8 years) with at least four teeth in all quadrants, were included. All of them underwent a conventional periodontal treatment including scaling and root planing. Using a split mouth design, two randomly chosen quadrants (one upper and the corresponding lower one) were subsequently treated with an 809 nm GaAlAs laser operated at a power output of 1.0 Watt using a 0.6 mm optical fiber. The teeth in the control quadrants were rinsed with saline. The clinical outcome was evaluated by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), sulcus fluid flow rate (SFFR), Periotest (PT), probing pocket depth (PPD), and clinical attachment loss (CAL) at baseline and at 3 months after treatment. A total of 492 teeth in both groups were evaluated and differences between the laser and the control teeth were analyzed using the Wilcoxon test (P < 0.05). RESULTS: Teeth treated with the laser revealed a significantly higher reduction in tooth mobility, pocket depth, and clinical attachment loss. Twelve percent of the teeth in the laser group showed an attachment gain of 3 mm or more, compared to 7% in the control group. An attachment gain of 2-3 mm was found in 24% of the teeth in the laser group and 18% in the control group. No significant group differences, however, could be detected for the plaque index, gingival index, bleeding on probing, and the sulcus fluid flow rate. CONCLUSIONS: The higher reduction in tooth mobility and probing depths is probably not predominantly related to bacterial reduction in the periodontal pockets but to the de-epithelization of the periodontal pockets leading to an enhanced connective tissue attachment. The application of the diode laser in the treatment of inflammatory periodontitis at the irradiation parameters described above is a safe clinical procedure and can be recommended as an adjunct to conventional scaling and root planing.

Adult↗
PubMed2000

Autotransplantation of premolars to replace maxillary incisors: a comparison with natural incisors.

The published literature contains no comprehensive studies that compare the outcome of premolar autotransplantation to the maxillary anterior region with natural incisors in the same patients. This article describes the gingival and periodontal conditions around premolars transplanted to the maxillary incisor region, subsequent to restoration. Forty-five premolars autotransplanted to the maxillary incisor region in 40 adolescent patients were evaluated after a mean observation period of 4.0 years. Mean age at surgery was 11.0 years. Established clinical criteria were used to assess tooth mobility, plaque and gingival indexes, probing pocket depth, and percussion. Recession and hyperplasia of interproximal gingival papillae were assessed according to a recently proposed index. Standardized radiography was used to evaluate presence of pathosis, pulp obliteration, root length, and crown-root ratios. Clinical variables for transplants did not differ from those of the natural incisors, except for increased mobility and more plaque in a few transplanted premolars. The interproximal gingival papillae adjacent to all transplanted teeth were normal or slightly hyperplastic. Radiographically, all transplants showed varying degrees of pulp obliteration, but no signs of pathosis. Crown-root ratios were similar for natural and transplanted teeth as were distances from cementoenamel junction to marginal bone. The overall status of the transplanted premolars and surrounding tissues indicated that this treatment modality may be recommended when maxillary incisors are missing in adolescents. In addition, tooth transplantation represents an inherent potential for bone induction and reestablishment of a normal alveolar process.

Adolescent↗
PubMedDate not supplied

[The clinico-anatomical characteristics of the dental arches as an objective method for assessing periodontal reserve force].

A method for the assessment of the reserve force of the periodontium is described, based on the estimation of the tooth root square size, degree of well atrophy, and tooth mobility. Periodontal strength coefficient was derived and a table, based on this coefficient, plotted. This coefficient and the table were used to assess the periodontal status of the remaining teeth when planning orthodontic treatment and to predict the immediate and late results of treatment.

Alveolar Process↗
PubMed1997

A multiparametric analysis of occlusal and periodontal jaw reflex characteristics in young adults with normal occlusion.

Periodontal jaw reflex, duration of percussion sounds, tooth mobility, and time-moment analysis of occlusal contacts by the T-scan system was recorded in nine periodontally healthy volunteers. The results showed that (i) reflex responses to the pressure applied to the uppercentageral incisors in the lingolabial direction varied, depending on the background jaw-clenching force (BCF) of the same-sided first molars. The BCF levels to elicit excitatory reflexes were 6-8 Kgf, and inhibitory reflexes were clearly elicited with a BCF of 10 Kgf and beyond. (ii) Duration of percussion sounds via an occlusal sound analyser (4.73-4.84 mS: upper first molars, 4.89-5.00 mS: uppercentageral incisors) and tooth mobility using a 'Periotest' (3.3-3.5: upper first molars, 5.5-5.6: uppercentageral incisors) showed a normal value. (iii) The time moments of occlusal contacts were symmetrical toward the midsagittal axis of the occlusal plane. The centre of the anteroposterior occlusal contacts was located in the first molar regions.

Adult↗