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At least 433 records · Page 24Linked to original sources
PubMed1980

Clinical evaluation of swinglock removable partial dentures.

Fifty-three patients were recalled for clinical examination to determine oral changes which occurred during the time that they wore swinglock removable partial dentures. Pertinent findings were as follows: 1. The swinglock removable partial denture should be considered as a treatment alternative for patients with unfavorable periodontal support and for patients missing key abutments. 2. Patients who have worn swinglock removable partial dentures for periods of 13 to 75 months did not demonstrate a continued periodontal breakdown, even when there was unfavorable periodontal support. 3. The swinglock removable partial denture may aid in reducing tooth mobility when the patient can maintain good levels of oral hygiene to control inflammation and the dentist can provide a proper occlusion. 4. As evidenced by responses to a satisfaction questionnaire, patient acceptance of the swinglock design was good. 5. The high prevalence of patients reporting for recall examination with one or more decayed teeth (22.4%) and removable partial dentures requiring relines (28.3%) emphasizes the need for proper recall of patients. 6. The swinglock removable partial denture will function satisfactorily if the dentist follows basic principles of removable partial denture construction and if the patient maintains a good level of oral hygiene and returns for regular recall visits.

Bone Resorption↗
PubMed1992

The effects of the Le Fort I osteotomy on the periodontium.

Two age-matched populations of equal size (n = 40), one having orthodontic therapy and the other combined orthodontic therapy and orthognathic surgery, were evaluated for their periodontal status 1 to 10 years posttherapy. The parameters investigated were plaque index, gingival index, tooth mobility, width of keratinized tissue, probing depth, gingival recession, and attachment level. No significant differences were found (P less than .05). Within the surgery group, patients with maxillary osteotomies segmentalized between the central incisors (n = 11) and between the canines and second premolars (n = 12) were evaluated using the same parameters and compared with their nonsegmental counterparts. No significant differences were found for patients with osteotomies segmentalized between the central incisors. However, a statistically significant increase in probe depth and loss of attachment level of up to 0.3 mm was found at the sites of osteotomies segmentalized between the canine and second premolar (P less than .05). This difference was not considered clinically significant.

Adolescent↗
PubMed1978

[Periodontal conditions in patients with crowns and bridgework].

A study evaluating supragingival and subgingival placement of restoration margins in 24 patients following periodontal and reconstruction therapy is presented. After 1 year no significant differences in supragingival plaque retention, tooth mobility, and width of attached gingiva were observed between the two types of restorations. The gingiva of those restorations with supragingival termination of margins showed, however, significantly (p less than 0.001) less inflammation. The pocket depth of restored teeth was significantly greater (p less than 0.001) than that of non-restored. It is concluded that whenever feasable, restorations should terminate above the free margin of the gingiva. Every restoration terminating in the immediate vicinity of or in actual contact with surrounding soft tissue is a potential irritant to that tissue and increases the chance of precipitating periodontal disease. It is mandatory that the patients with such restorations participate in a regular dental hygiene recall program where oral hygiene can be evaluated, physiotherapy procedures reviewed and motivation reenforced.

Crowns↗
PubMed2001

Generalized aggressive periodontitis in a prepubertal patient: a case report.

A 10-year-old boy presented with generalized gingival inflammation, extensive alveolar bone loss, and tooth mobility. Clinical and radiographic examination supplemented by microbiologic investigation led to a diagnosis of classically termed prepubertal periodontitis (now known as generalized aggressive periodontitis). Other than severe periodontitis, the child was systemically healthy. Neither unusual infections nor abnormalities in neutrophil functions were detected. Microbiologic examinations by culture revealed the presence of the periodontal pathogen Actinobacillus actinomycetemcomitans. Treatment consisted of extraction of mobile teeth, supragingival and subgingival debridement, subgingival curettage, and root planing combined with a 1-week prescription of a combination of metronidazole and amoxicillin. Scanning electron microscopy of extracted teeth revealed hypoplastic and aplastic cementum at the periodontally exposed and intact surfaces. Clinical and microbiologic follow-up was continued over a 1-year period. No periodontal lesions have been detected, and A actinomycetemcomitans could not be isolated from the subgingival areas of the remaining teeth at the end of the first year. Since A actinomycetemcomitans was the main pathogen present in the subgingival microflora of the patient, it might play a key role in the etiology of prepubertal periodontitis.

Actinobacillus Infections↗
PubMed1991

Mandible metastasis as the initial manifestation of breast carcinoma--report of a case.

A case is presented in which the only positive subjective and clinical findings were numbness of the lower lip and chin, generalized tooth mobility with dull pain, and swelling of the right lower jaw. After an appropriate and careful workup, in conjunction with other medical colleagues, a definitive diagnosis of adenocarcinoma of breast metastasis to the mandible was made, which was confirmed by a histopathologic examination. Radiographs disclosed radiolucent change with an irregular and a moth-eaten appearance in the mandibular trabeculation and loss of the lamina dura of several teeth. As this case demonstrates, the diagnosis of metastatic disease of the jaws requires a high degree of diagnostic astuteness, because of the many possible clinical signs and symptoms which can be nonspecific and can resemble diseases of an inflammatory origin. Accordingly, a histologic evaluation is essential in establishing a definitive diagnosis. The case report emphasizes the need for consideration of metastatic disease in the differential diagnosis of unknown oral lesions, especially in the mandible.

Adenocarcinoma↗
PubMed1992

[Clinical and microbiological study of factors determining effective scaling and root planing].

The aim of the present study was to monitor longitudinally the clinical and microbiological parameters after root debridement in order to determine the factors affecting successful and unsuccessful results. Nine patients with moderate and severe periodontitis participated. Four sites of single root with over 5-mm periodontal pockets in each quadrant were selected. The oral hygiene was controlled in all patients, then root debridement was performed without anesthesia at the three sites of the quadrants every two weeks during eight weeks. The clinical parameters consisted of plaque index, gingival index, probing depth, clinical attachment level, bleeding on probing, tooth mobility and the value of gingival crevicular fluid (GCF). The microbiological parameters such as percentages of cocci, motile rods, non-motile rods and spirochetes and the number of microorganisms were examined and the percentages of black pigmented Bacteroides (BPB) and Actinobacillus actinomycetemcomitans as well as the number of anaerobic colonies were counted. The results demonstrated that a reduction in the probing depth was observed in all sites except four. The successful sites clinically showed a decrease of the probing depth and GCF value and, microbiologically, reduced percentages of the spirochetes and BPB. The results indicated that the decrease of the probing depth and GCF under 50 Periotoron units in coincidence with the bacterial reduction can be used to determine the successful response of root debridement.

Adult↗
PubMed2002

[Periodontal diseases in a university setting in Ivory Coast].

The aim of this study was to measure the prevalence and severity of periodontal diseases, and also to evaluate periodontal treatment needs of the students of Abidjan University, in Ivory Coast. 647 students were randomly selected and interviewed to determine age, sex and oral hygiene habits; the subjects were examined for tooth mobility, plaque, calculus, gingival bleeding, periodontal probing depths and gingival recessions. The oral hygiene was insufficient: 86.08% of the subjects presented calculus--The average of sextants presenting gingival bleeding was to 4.03 and to 3.43 for calculus. The prevalence and severity of periodontal pockets were low: only 0.36 sextants on average presented pockets of 4-5 mm and 0.025 sextants presented pockets of 6 mm or more. As concerns periodontal treatment needs, 89.64% of subjects needed oral hygiene advises, 84.85% needed scaling/root planning, and 1.39% needed complex periodontal treatment. Our findings confirm the fact that destructive periodontal disease is not an inevitable consequence of gingivitis. The information, screen, and prevention should begin reality in our daily practice.

Adolescent↗
PubMedDate not supplied

Two-unit cantilevered resin-bonded fixed partial dentures--a retrospective, preliminary clinical investigation.

PURPOSE: The aim of this study was to retrospectively evaluate the clinical retention and abutment movement of 2-unit cantilevered resin-bonded fixed partial dentures (FPD) that were inserted at Prince Philip Dental Hospital in Hong Kong. MATERIALS AND METHODS: Of 45 patients who were identified from a hospital computer search after receiving a 2-unit cantilevered resin-bonded FPD, 31 were clinically examined (33 FPDs). For each patient the following data were recorded: gender, age, cementation date, endodontic treatment if performed, bone support, tooth mobility, and FPD tipping or drifting. Data about any debonds with subsequent treatment and patient satisfaction on a 10-point scale were also recorded. RESULTS: The mean service life for the 33 prostheses was 30 +/- 18 months, with a range of 72 days to 67 months. One prosthesis debonded, resulting in a clinical retention rate of 97%. No rotation, drifting, or tipping was observed for any of the prostheses during the short period of this study. CONCLUSION: Two-unit cantilevered resin-bonded FPDs are successful in the short term, but further research is required to determine if they offer a viable alternative to fixed-fixed resin-bonded FPD designs.

Adolescent↗
PubMed2004

Further evidence of the association between periodontal conditions and coronary artery disease.

BACKGROUND: There is increasing evidence that chronic infections, such as periodontal diseases, could play a role in the initiation and development of coronary artery disease (CAD). The present study was intended to test for a possible association between presence and severity of periodontitis and coronary artery disease in a Belgian population. METHODS: A total of 108 CAD patients (mean age 59.2 +/- 11 years) and 62 presumably healthy controls (mean age 57.7 +/- 9 years) were enrolled in the study. Probing depth, periodontal pocket bleeding index (PPBI), plaque index, furcation involvements, and tooth mobility were evaluated to compare periodontal health in both groups. The subjects were also ranked according to a novel index of periodontitis severity, the periodontal index for risk of infectiousness (PIRI), aimed at quantifying the risk of release of proinflammatory mediators from the periodontal sites. RESULTS: Periodontitis was significantly more frequent in CAD patients than in controls (CAD patients: 91%; controls: 66%). The mean number of pockets was 18 +/- 17.1 in cardiac patients versus 7.6 +/- 12.7 in controls (P < 0.0001), despite the fact that the mean number of missing teeth was significantly greater in cases than in controls (14 +/- 7.1 versus 9 +/- 5.2; P < 0.0001). Furthermore, proportions of mobile teeth, bleeding sites, periodontal pockets, and involved furcations were significantly higher in CAD patients than in controls. In addition, the extent of the periodontal disease present was also greater in cases than in controls. A logistic model, adjusted for known cardiovascular risk factors, showed a strong association between CAD and periodontitis (odds ratio [OR] = 6.5). Moreover, there was a significant dose-response relationship between increasing scores of the periodontal risk of infectiousness and the presence of CAD (adjusted OR = 1.3 per PIRI unit). CONCLUSION: In the present study, periodontitis was revealed to be a significant risk factor for CAD after adjusting for other confounding factors, with the level of association increasing with the individual extent of the periodontal lesions.

Belgium↗
PubMed2003

Treatment of angular bone defects with a composite bone grafting material in combination with a collagen membrane.

BACKGROUND: The purpose of this study was to evaluate the effect of a bioabsorbable collagen barrier (CB) in combination with a composite bone substitute (deproteinized bovine bone mineral with collagen, DBBM + C) in periodontal regeneration of angular bone defects in humans using a new application technique. METHODS: Twelve patients participated, each contributing at least 1 defect site, which exhibited a probing depth (PD) of > or = 5 mm, a clinical attachment level (CAL) of > or = 6 mm, and was positive for bleeding on probing (BOP) following initial therapy. Twenty-two angular bone defects were filled with DBBM + C. A hole was placed in the membrane, which was then pulled over the tooth. The observation period was 2 years and included measurements of plaque, gingivitis, tooth mobility, PD, CAL, soft tissue recession, and bone level as assessed from standardized radiographs. RESULTS: The residual PD and CAL were reduced to 3.3 mm (PD) and 5.6 mm (CAL) with a CAL gain of 3.2 mm at 24 months. The radiographic defect reduction (bone fill) was 4.0 mm after surgery and 2.2 mm at 24 months. The changes measured clinically and radiographically were more pronounced in sites with a deep intrabony defect component than in sites with shallow ones. CONCLUSIONS: These findings indicate that angular bone defects can be successfully treated with DBBM + C in combination with CB. A degradation of the filler material seems to occur particularly during the first 6 months, but without affecting the clinical parameters, which improved consistently.

Absorbable Implants↗
PubMed1993

A cross-sectional study on osteocalcin levels in gingival crevicular fluid from periodontal patients.

The purpose of the present study was to determine the levels of osteocalcin, a bone specific matrix protein, in gingival crevicular fluid (GCF) from periodontal disease patients and to investigate the relationship between GCF osteocalcin levels and clinical parameters. Nineteen initial visit patients, 5 patients with gingivitis and 14 patients with adult periodontitis, participated in this study. The clinical parameters including probing depth, attachment level, gingival index, and tooth mobility were recorded following careful sampling of GCF with a filter paper strip harvested for 3 minutes. Osteocalcin adsorbed on a strip was extracted in a plastic tube containing 150 microliters of 10 mM sodium phosphate buffer (pH 6.5). GCF osteocalcin was determined by a newly-developed, high sensitive enzyme immunoassay which could recognize the N-terminal 20 residue peptide. In gingivitis patients, no significant amounts of osteocalcin were detected. In periodontitis patients, on the other hand, osteocalcin levels were detected, ranging between 0 and 540 pg/tube and positively correlated with these clinical parameters (P < 0.01). Moreover, in several sites in GI = 3 group, extremely higher levels of GCF osteocalcin were detected. These results strongly suggest that in addition to the presence of GCF osteocalcin the levels of osteocalcin may reflect the degree of the periodontal inflammation at the sampled sites.

Adolescent↗
PubMed1990

Phenotypic overlap of Ehlers-Danlos syndrome types IV and VIII.

An 18-year-old Caucasian woman has been followed since age 12 years for Ehlers-Danlos syndrome (EDS) with easy bruisability and "cigarette paper scars." Her chief complaint at age 17 years was tooth mobility, especially in the anterior mandible, necessitating the removal of the four incisors. Initial biochemical analysis of cultured skin fibroblasts indicated the presence of pepsin-sensitive type III collagen. Subsequent analysis of cultured skin fibroblasts by the same laboratory and another laboratory found no abnormality in the type III collagen with or without protease treatment. This is in distinction to the finding of abnormal type III collagen in the only two reported patients with EDS and early-onset periodontitis who have had collagen analyses. One of them was diagnosed as EDS type IV and the other as EDS type VIII, although the defects of type III collagen were consistent with EDS type IV. The defect in type III collagen in some patients with early periodontitis and the considerable overlap of the clinical manifestations of EDS types IV and VIII point out the need for further studies of collagen formation and maturation in any patient who has early periodontitis and who has been classified with EDS type IV or VIII.

Aggressive Periodontitis↗
PubMed1996

Missing teeth and lost teeth of adults aged 30 years and over in south-western Finland.

The majority of Finnish adults have lost one, some or all of their teeth. The prosthetic replacement of missing teeth has thus been an important element of adult dental care. However, there have been no longitudinal studies focusing on the development of oral health among the Finnish adult population in terms of further tooth loss. A baseline sample from 1977-78 was selected from the city of Turku to represent the adult population aged 30 years and over. Ten years later, a follow-up examination was carried out on this baseline study group. A new sample of persons aged 30-39 years was also obtained to provide cross-sectional information, allowing comparisons between this study group and the youngest age-group of the 1977-78 study. In 1977-78, 52 per cent of all subjects had 20 or more remaining teeth. The mean number of missing teeth was 15.8 (SD 11.05) and the corresponding median 12 teeth. The number of missing teeth was on average higher in the older age-groups (P < 0.001). Women had more missing teeth than men (P < 0.01). In the ten-year follow-up study, the mean number of lost teeth was 1.5 (SD 2.32) and the median one tooth. The average number of lost teeth increased with age (P < 0.01). The rate of tooth loss was highest for those with 10 to 19 teeth at baseline, second highest for those with one to nine teeth and lowest for those with 20 to 32 teeth (P < 0.001). The reasons most often reported for tooth extraction were tooth mobility, pain and prosthetic treatment. In the cross-sectional study groups of persons aged 30-39 years, the proportion of subjects with a complete natural dentition of 28 to 32 teeth was 63.4 per cent in 1989, compared with 40.0 per cent ten years earlier. The average number of missing teeth was lower in 1989 than in 1977-78 (mean 4.7, SD 3.81 vs. mean 7.8, SD 6.92; P < 0.001). In both cross-sectional examinations women had a higher mean number of missing teeth than men. However, the difference between the genders was statistically significant only in 1977-78 (P < 0.01). Among the age-group of 30-39 years, there has been a considerable improvement in retention of natural teeth during the ten-year interval. However, among the middle-aged and elderly population reduced dentition was common; in addition, extraction was still used as a dental treatment especially among persons with reduced dentition. This suggests that the need for prosthetic replacement of lost teeth will continue to play a role in adult dental care in Finland for some decades to come.

Adult↗
PubMed2000

In vivo and in vitro natural frequency analysis of periodontal conditions: an innovative method.

BACKGROUND: When measuring periodontal disease, various types of equipment for making objective measurements of tooth mobility have been proposed. However, these devices and methodology are insufficient in terms of reliability. An innovative method using vibrational theories to assess the periodontal attachment level of natural teeth is presented in this study. METHODS: Modal testing technique, a non-destructive and time-saving method, was used for non-invasive and quantitative measurement of the natural frequencies of the upper central incisor in vivo and in vitro. A finite element model was established, and modal testing experiments were simulated to assess the relationship between bone level and teeth. RESULTS: The first dominant natural frequency of healthy human upper central incisors ranges from 710 Hz to 3,360 Hz, with an average of 1,701+/-679 Hz. Both in vitro experiment and finite element simulation showed that lowering of the attachment level causes a significant decrease in the natural frequencies, and a strong relationship (r = -0.99, P <0.01) was observed between the frequency and the bone level height. CONCLUSIONS: Our results suggested that natural frequency is an important parameter for assessing the periodontal condition and that the modal testing technique is a useful supplemental method for assessing the attachment conditions of the periodontium.

Acceleration↗
PubMed2004

Hereditary gingival fibromatosis associated with generalized aggressive periodontitis: a case report.

BACKGROUND: Hereditary gingival fibromatosis is a rare, genetically inherited overgrowth condition that is clinically characterized by a benign fibrous enlargement of maxillary and mandibular keratinized gingiva. A syndromic association between gingival fibromatosis and a wide variety of other genetically inherited disorders has been described. However, its coexistence with aggressive periodontitis has not been reported. METHODS: A 24-year-old African-American female, patient (proband X, [Px]) reported with a chief complaint of tooth mobility and gingival enlargement. Clinical examination revealed moderate to severe gingival overgrowth on both mandible and maxilla. Generalized attachment loss and mobility of the teeth were observed. Radiographic evaluation demonstrated severe alveolar bone loss. The patient was diagnosed with gingival fibromatosis and aggressive periodontitis based on the clinical and radiographic findings. Her brother (Bx) and her mother (Mx) were evaluated and diagnosed with gingival fibromatosis suggesting that this is a dominant trait in the family and gingival fibromatosis might be of hereditary origin. In addition, the brother also exhibited localized aggressive periodontitis. Medical history revealed no other systemic or local contributory factors associated with the oral findings in any of the subjects. RESULTS: Surgical therapy included internal bevel gingivectomy combined with open flap debridement procedures for Px and Bx. Only internal bevel gingivectomy was performed for Mx since there was mild bone resorption and no intrabony defects. At the time of surgery, gingival biopsies were obtained and fixed in 4% paraformaldehyde. Multiple serial sections were stained with hematoxylin and eosin. Microscopic evaluation of the gingival specimens revealed large parallel collagen bundles associated with scarce fibroblasts in the connective tissue. The collagen bundles reached into the subepithelial connective tissue where elongated rete-pegs were also observed. Following the completion of the treatment, no signs of recurrence or bone resorption were observed over 2-year follow-up. CONCLUSIONS: This is the first report of hereditary gingival fibromatosis associated with aggressive periodontitis. Combined treatment comprising removal of fibrotic gingival tissue and traditional flap surgery for the elimination of intrabony defects represents a unique treatment approach in periodontal therapy. Two-year follow-up revealed that both the gingival overgrowth and the destructive lesions were successfully treated.

Adult↗
PubMed2001

Periodontal risk assessment, diagnosis and treatment planning.

The prevention and treatment of the periodontal diseases is based on accurate diagnosis, reduction or elimination of causative agents, risk management and correction of the harmful effects of disease. Prominent and confirmed risk factors or risk predictors for periodontitis in adults include smoking, diabetes, race, P. gingivalis, P. intermedia, low education, infrequent dental attendance and genetic influences. Several other specific periodontal bacteria, herpesviruses, increased age, male, sex, depression, race, traumatic occlusion and female osteoporosis in the presence of heavy dental calculus have been shown to be associated with loss of periodontal support and can be considered to be risk indicators of periodontitis. The presence of furcation involvement, tooth mobility, and a parafunctional habit without the use of a biteguard are associated with a poorer periodontal prognosis following periodontal therapy. An accurate diagnosis can only be made by a thorough evaluation of data that have been systematically collected by: 1) patient interview, 2) medical consultation as indicated, 3) clinical periodontal examination, 4) radiographic examination, and 5) laboratory tests as needed. Clinical signs of periodontal disease such as pocket depth, loss of clinical attachment and bone loss are cumulative measures of past disease. They do not provide the dentist with a current assessment of disease activity. In an attempt to improve the ability to predict future disease progression, several types of diagnostic tests have been studied, including host inflammatory products and mediators, enzymes, tissue breakdown products and subgingival temperature. In general, the usefulness of these tests for predicting future disease activity remains to be established in terms of sensitivity, specificity and predictive value. Although microbiological analysis of subgingival plaque is not necessary to diagnose and treat most patients with periodontitis, it is helpful when treating patients with unusual forms of periodontal disease such as early-onset, refractory and rapidly progressive disease. There appears to be a strong genetic component in some types of periodontal disease and genetic testing for disease susceptibility has potential for future use, but more research is needed to determine its utility for use in clinical practice. Treatment of the periodontal diseases may be divided into four phases: systemic, hygienic, corrective and maintenance or supportive periodontal therapy. Regardless of the type of treatment provided, periodontal therapy will fail or will be less effective in the absence of adequate supportive periodontal therapy.

Bacteriological Techniques↗