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PubMed1995

Perinatally acquired Pseudomonas infection: a newly recognized maternal risk factor.

Pseudomonas aeruginosa is a less common but, nonetheless, serious bacterial pathogen implicated in early-onset neonatal sepsis. This report demonstrates perinatal transmission from a mother with a long smoking history who had an oral abscess surgically drained prior to delivery and never received antibiotic therapy. This case emphasizes the need to consider prophylactic antibiotic coverage in similar patients to prevent the morbidity and mortality associated with this type of perinatally acquired infection.

Adult↗
PubMed2000

Short-term effects of fiberotomy on relapse of anterior crowding.

The effects of fiberotomy were evaluated in alleviating dental relapse of incisors after orthodontic treatment. The study sample consisted of 23 patients with crowded maxillary and mandibular incisors before orthodontic treatment. The amount of initial crowding was determined according to Little's irregularity index. Fiberotomy procedures were performed on 11 of the patients 1 week before debonding. The other 12 subjects served as the control group. All patients wore Hawley retainers. Lateral cephalometric headfilms and dental casts of the patients were taken at the beginning (T1) and at the end (T2) of treatment, 6 months into the retention phase (T3), and 1 year after orthodontic treatment (T4). Significant increase of irregularity index was noted in the control group at T3 and T4 for both maxillary and mandibular anterior segments (P <.05, P <.01). Meanwhile, in the group where circumferential supracrestal fiberotomy was performed, no significant increase of the irregularity index was noted.

Adolescent↗
PubMed2001

Comparison of monopolar and bipolar electrosurgical modes for restorative dentistry: a review of the literature.

This review of the literature was undertaken as part of a wider investigation of effective hemostasis in vital pulp therapy. Two general types of electrosurgical units are available: monopolar and bipolar. This review compares the features of both systems. An important hazard referred to as channeling, funneling, or current crowding is described and associated with pulp therapy injury for the first time. Important safety features of bipolar electrocoagulation are identified and applied to dental procedures. Articles were selected by means of a search of MEDLINE, the U.S. National Library of Medicine's bibliographic database, for literature published between 1966 and 2001 on the topics of electrosurgery, electrocautery, electrolysis, and lasers. A search also was completed from a pulp therapy perspective to determine the use of electrosurgery on the pulp. Numerous articles and texts published between 1900 and 1965 had been reviewed previously; their bibliographies were explored and cross-referenced for pertinent reports. Laparoscopic applications of electrosurgery were reviewed for general background information and for clarification of safety and hazard issues; no exclusionary criteria or date limitations were imposed. Beyond the literature review, numerous authors and developers in the field of electrosurgery were contacted for clarification of concepts and controversies. More than 120 articles and texts related to electrosurgery were reviewed, and another 100+ articles were reviewed in the area of pulp therapy.

Dental Pulp↗
PubMed1996

Clinical assessments of the erbium:YAG laser for soft tissue surgery and scaling.

We evaluated the clinical usefulness of an erbium:YAG laser for soft tissue surgery, and scaling. Thirty-one patients with soft tissue lesions (13 males and 18 females from 24 to 71 years old), and 60 patients with calculus deposits (21 males and 39 females from 19 to 72 years old) were treated with the laser. The clinical parameters evaluated were pain, redness, swelling of the gingiva, and the subjective patient comfort parameters including uneasiness with the sound and vibration associated with laser treatment. Additionally, hemorrhage and wound healing during and after the surgery, the roughness of the root surface after scaling, and the effectiveness of scaling using the laser were examined. Laser surgery caused less hemorrhage and resulted in better wound healing when compared with conventional methods. It was easy to remove calculi from the root surface with the laser in 95% of the cases. Although the scaled site showed some irregularity, it was not clinically significant in 98% of the cases. Only a few patients complained about the unpleasant sound and vibration. There were no complications or side effects during this clinical trial. Thus, this study suggests that an Er:YAG laser is useful for soft tissue surgery and scaling.

Adult↗
PubMed1997

First case of surgical treatment of Farber's disease.

Farber's disease (Farber's lipogranulomatosis), which is inherited as an autosomal recessive trait, was first reported by Farber in 1952. We report a case of Farber's disease in a 12-year-old female. Her younger brother was affected with Farber's disease and died of it at 2 years of age. When she first presented, our patient's main clinical features were a shrill voice; subcutaneous nodules; contracture of the joints throughout the body; and granulomas of the oral cavity, the pharynx, and the upper and lower eyelids. Serial radiographs disclosed deformation of the joints throughout the body. Due to the granulomas in her oral cavity, she could take little food orally and therefore was malnourished. We performed a granulectomy under general anesthesia, and her difficulty with feeding and upper airway obstruction improved. There is no specific treatment for Farber's disease, and most patients reported have died by 2 years of age. This is the first reported patient with Farber's disease who has been surgically treated.

Ceramides↗
PubMed1998

Treatment of oral granulation tissue with the flashlamp pulsed dye laser.

BACKGROUND: Surgical excision and debridement is the standard therapy for cutaneous and intraoral pyogenic granulomas (PGs). Occasionally the mass of granulation tissue proves unresponsive to the usual treatment methods. OBJECTIVE: We report a case in which the flashlamp pulsed dye laser (PDL), previously reported as useful in cutaneous PGs, was used in a patient with persistent granulation tissue around dental implant posts. METHODS: An illustrative case is presented with a brief discussion of the use of lasers in dentistry and in the treatment of PGs. RESULTS: Previously resolute tissue responded well to a series of treatments with the PDL. CONCLUSION: The PDL may have utility in this oral condition, providing a new venue for cooperation between dentists and dermatologists.

Aged↗
PubMed1978

A comparison of the scalloped and linear incisions as used in the reverse bevel technique.

Using a split-mouth technique in 20 patients, a comparison was made of the linear and scalloped incisions as used in the reverse bevel technique. Forty full thickness periodontal flap procedures were evaluated. The PlI and GI were recorded and gingival fluid collected at operation and at weeks 1, 2, 3, 4 and 12 after operation. Pocket depths and attachment levels were noted and gingival contour assessed, using the Contour Index, pre-operatively and 12 weeks after operation. Pain experience during the first week after operation was evaluated. No significant changes in PlI occurred throughout the study. The GI and gingival fluid flow showed comparable trends. More inflammation was present after the linear incision during the first 2 weeks after operation. Clinically, satisfactory results were achieved for both scalloped and linear incision procedures as shown by the improvement in gingival contour, reduction in pocket depth, slight gain in attachment, lack of gingivitis and low plaque scores.

Epithelial Attachment↗
PubMed1987

Some periodontal tissue reactions to orthodontic tooth movement in monkeys.

The purpose of the experiment reported was to study soft tissue changes at teeth which were orthodontically moved into areas with varying thickness and quality of periodontal tissues. The maxillary central incisors and first premolars in 5 adult monkeys were used as experimental teeth. 6 months prior to the start of the orthodontic treatment phase, the maxillary second premolars were extracted. By surgical means, areas with varying width of the keratinized gingiva were established in the incisor and premolar region. Following a clinical baseline examination which involved assessments of gingival width, location of the gingival margin in relation to cemento-enamel junction and probing attachment level, fixed orthodontic appliances were inserted in order to bodily move the two contral incisors in labial direction through the alveolar bone envelope and the first premolars in distal direction into contact with the first molars. Orthodontic forces were applied for a period of 3-4 months. The lateral incisors and first molars were selected as non-moved control teeth. After the experimental teeth had been retained in their new positions for 1 month, the clinical examination was repeated. Tissue blocks containing test and control specimens were subsequently dissected and prepared for microscopic analysis. The analysis included histometric assessments of loss of connective tissue attachment and height of alveolar bone. The results showed that at every second labially moved incisor, the gingival margin had become displaced in apical direction. The degree of displacement, however, was small and only at 2 teeth accompanied by loss of connective tissue attachment. Throughout the study, these particular teeth also showed obvious signs of gingival inflammation.(ABSTRACT TRUNCATED AT 250 WORDS)

Alveolar Process↗
PubMed1987

Lack of association between width of attached gingiva and development of soft tissue recession. A 5-year longitudinal study.

The purpose of this study was to longitudinally monitor changes in the position of the soft tissue margin at 26 buccal sites surgically deprived of all gingival tissue. A baseline examination carried out 6 months after treatment revealed that the sites to be monitored were lacking or had only a minimal zone (less than 1 mm) of regenerated attached gingiva. 12 control sites with an "adequate" width of attached gingiva (greater than 1 mm) were also examined. Assessments of oral hygiene and gingival conditions, probing pocket depths, probing attachment levels, position of the soft tissue margin, and gingival width were carried out at baseline and after 5 years. The results revealed that in the test sites, a slight increase of the width of the gingiva occurred during the observation period. 7 out of the 26 areas showed a coronal regrowth of the soft tissue margin, while 2 sites showed a further apical displacement of the soft tissue margin. In the control areas, 3 sites developed recession accompanied by a reduction in the width of the gingiva. Hence, it appears that in patients maintaining a proper plaque control, the lack of an "adequate" zone of attached gingiva does not result in an increased incidence of soft tissue recessions.

Dental Plaque Index↗
PubMed1988

Forced eruption combined with gingival fiberotomy. A technique for clinical crown lengthening.

A new approach to clinical crown lengthening has been developed and described. The technique combines controlled eruptive tooth movement and incision of the supracrestal gingival attachment. The procedure was performed in patients with severe destruction of a tooth crown and in whom clinical crown lengthening procedures were essential before the teeth could be properly restored. Controlled eruptive forces were activated by simple orthodontic appliances. During the active phase of forced eruption, repeated intrasulcular incisions through the junctional epithelium and the supracrestal connective tissue attachment were performed. The technique prevented coronal displacement of the gingiva and the attachment apparatus during the orthodontic extrusion, thus overcoming the need for corrective osseous surgery.

Adolescent↗
PubMed1990

On the inability of root debridement and periodontal surgery to eliminate Actinobacillus actinomycetemcomitans from periodontal pockets.

In a previous study, we observed that root debridement was inefficient in eliminating Actinobacillus actinomycetemcomitans from adult periodontitis lesions. The present report describes the effects on A. actinomycetemcomitans of subsequent treatments of 6 patients that had at least 2 separate sites still harboring A. actinomycetemcomitans 6 months following debridement. 1 site or more in each individual was treated with renewed root debridement and at least 1 other site was treated by surgical excision of the gingival tissue. The results indicated that retreatment with either repeated root debridement or with surgical excision of the gingival tissue was not more effective in eliminating A. actinomycetemcomitans than initial debridement. The possible reasons for this limited therapeutic effect on the subgingival presence of A. actinomycetemcomitans are discussed.

Actinobacillus↗
PubMed1991

Healing of sites within the dog periodontal ligament after application of cold to the periodontal attachment apparatus.

The potential of periodontal ligament-derived tissues to regenerate periodontal attachment after cryosurgical trauma to the PDL in dogs was evaluated. The buccal alveolar plate of each canine tooth was exposed by a semi-lunar excision. A 3 mm thick cryoprobe, cooled to -81 degrees C, was placed on the bone 5 mm apical to the crest for 10 s. This induced cellular devitalization in the bone directly in contact with the probe and the PDL under it. The freezing-thawing cycle was repeated 3 times. Control sites were sham-operated at room temperature. Histologic sections from the center of the lesions were obtained from 1 h, 48 h and 30 d specimens. 1-h control and experimental histologic sections were similar. At 48 h post-surgery, the cellular component of the frozen PDL could not be identified and inflammatory response was minimal. The collagenous framework, however, appeared to form a continuum between the alveolar bone and cementum. Lacunae in the bone at the frozen segment were empty. The injured PDL was surrounded by normal PDL. Control specimens appeared normal. At 30 d, the PDL space in the frozen segments was populated by PDL-like tissue which did not differ significantly from the PDL coronal or apical to it. Collagen fibers appeared to be attached to the cementum on one side and to the alveolar bone on the other. Bone resorption or ankylosis was not observed in the experimental sites. It is suggested that the extracellular matrix in the devitalized area was preserved, supporting regeneration of the cryolesion.

Alveolar Process↗
PubMed2005

Management of inter-dental/inter-implant papilla.

OBJECTIVES: The aims of this paper are to review and compare existing techniques for creation of interdental/interimplant papillae, to address factors that may influence its appearance and to present an approach that authors developed that could help clinicians to manage and recreate the interproximal papillae. METHODS: Papers related to interdental and interimplant papillae published over the last 30 years were selected and analyzed. RESULTS: Thorough treatment planning is essential for maintenance of the height of the interproximal papillae following tooth removal. The key for achieving an esthetically pleasing outcome is the clinicians' ability of properly managing/creating interdental/interimplant papillae. Bone support is the foundation for any soft tissue existence, techniques such as socket augmentation, orthodontic extrusion, guided bone regeneration, onlay graft and distraction osteogenesis are often used for this purpose. Soft tissue grafts as well as esthetic mimic restorations can also be used to enhance the esthetic outcomes. CONCLUSIONS: An esthetic triangle is developed to address the foundations that are essential for maintaining/creating papilla. These include adequate bone volume, proper soft tissue thickness as well as esthetic appearing restorations.

Alveolar Bone Loss↗
PubMed1977

The effects of length of surgery on healing of full and partial thickness flaps.

Partial and full thickness flaps which were were made in the facial gingiva of 10 dogs were reflected for 15 or 90 min. Specimens were examined histologically and biochemically from 3 to 28 days after initial surgery. The results indicate that flaps refelected for 15 min exhibited faster epithelial closure than those reflected for 90 min. Partial thickness flaps reflected for both 15 and 90 min showed less inflammation than full thickness flaps at 3 and 7 days post surgery and healed faster in respect to epithelial closure, mesenchymal healing, and bone regeneration. Biochemical analysis of the collagen concentration of the tissure flaps revealed similar collagen content in full and partial thickness flaps reflected for 15 min; however, the collagen concentration of partial thickness flaps opened for 90 min was higher than that in full thickness flaps.

Animals↗
PubMed1986

Changes in cAMP phosphodiesterase activity during oral mucosal regeneration.

Preliminary studies (Lineweaver-Burk, Ca2+ calmodulin sensitivity) suggest that oral mucosa contains at least two cyclic AMP phosphodiesterases, one a high affinity (low Km) enzyme and the other a low affinity (high Km) enzyme. Analysis of the distribution of both enzymatic forms during oral mucosal regeneration revealed that the low Km, and high Km cAMP phosphodiesterase activities were significantly elevated prior to the first wave of cAMP accumulation and during the second cAMP wave. Although the cAMP peaks declined between 20-24 h, both cAMP phosphodiesterases remained significantly elevated at the wound site. The apparent Km of the low Km form increased from 5.3 to 7.5 microM, while that of the high Km form remained essentially unaltered 20 h after wounding. The low Km, and high Km cAMP phosphodiesterase activities in normal rat oral mucosa were not affected by epinephrine or insulin; were slightly inhibited by glucagon, and significantly inhibited by methylprednisolone. Imidazole and histamine activated both forms and theophylline was inhibitory to the enzyme. The high Km cAMP phosphodiesterase was sensitive, and the low Km form insensitive to Ca2+ calmodulin stimulation.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1976

Periodontal health following fibrotomy of the supra-alveolar fibers.

A clinical follow-up study has been carried out in order to study the periodontal health of orthodontically derotated teeth where the supra-alveolar fibers have been severed by an incision through the bottom of the marginal pocket to the border of the alveolar bone in order to reduce the tendency towards a posttreatment relapse. The material consisted of 30 rotated teeth treated orthodontically in 27 patients between the ages of 9 and 22 years. Following an average retention period of 8.3 months, the supra-alveolar fibers were severed down to the alveolar bone border. The control material consisted of untreated, banded contralateral teeth in the same jaw. The patients were examined for plaque, gingival health and depth of the marginal pockets. No significant difference in periodontal health could be found on comparison between, on the one hand, teeth treated with fibrotomy and, on the other hand, untreated teeth.

Adolescent↗
PubMed1993

Epithelial alpha-naphthyl acetate esterases in the green vervet monkey gingiva before and after periodontal surgery and during tooth eruption.

To provide enzymatic information on de novo formed junctional (JE) and sulcular epithelium (SE), we performed periodontal surgery on 24 teeth. Ten to 14 days postoperatively, all experimental and 16 control teeth were extracted with adjacent buccal gingiva. In addition, specimens from unerupted and partly erupted teeth containing enamel epithelium (EE) were examined. Fixed cryostat sections were cut in series, stained with HE, or incubated with and without substrate for demonstration of alpha-naphthyl acetate esterase activity and for control purposes, respectively. The distribution and intensity of the alpha-naphthyl acetate esterase activity of newly reformed JE and SE was identical to that of the original JE and SE, i.e. suprabasal and very strong. In contrast, both the oral gingival epithelium (OGE) and the EE displayed a very weak enzyme reaction. These observations indicate that the presence of alpha-naphthyl acetate activity of original and reformed JE and SE is probably site specific and of nondevelopmental origin. Heavy inflammation after healing was associated with enhanced epithelial proliferation of OGE and, in addition, marked esterase activity of these proliferations and corresponding OGE. This points at a possible inflammatory induction of the marked esterase activity seen in JE and SE as well as site-specific, connective tissue influences. Further investigation is needed to elucidate the effect of inflammation on the esterase activity.

Animals↗