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PubMedDate not supplied

Influence of root anatomy on periodontal disease.

One of the essential elements of periodontal therapy is long-term maintenance. Anatomic factors that favor localized plaque accumulation may contribute to the progression of disease. The purpose of this investigation was to evaluate the influence of root concavities on the severity of furcation involvement. Measurements were recorded clinically at the time of surgical treatment. Statistical analysis revealed no significant association between the degree of root concavity and the severity of furcation involvement.

Chi-Square Distribution↗
PubMed1997

Pedicle procedure use in the management of regenerative therapy problems.

Regenerating a periodontium that has been lost because of disease has been made possible by the use of demineralized freeze-dried bone allografts (DFDBA), guided tissue regeneration with e-PTFE membranes, and combination therapies involving DFDBA covered by either an e-PTFE membrane or calcium sulfate. During regenerative therapy, problems may arise because of an adverse mucogingival condition, loss of a papilla, or significant exposure of the membrane from soft-tissue recession, slough, or fenestration leading to direct exposure of the site to the oral environment. Pedicle procedures can be used to cover these regenerative sites while providing mucogingival repair.

Adult↗
PubMed1997

Oral malodor in beagles: association with indicators of periodontal disease.

The study of oral malodor continues to receive attention. Most bad breath is of oral origin and can be corrected with proper oral hygiene. Studies performed with saliva from people with periodontal disease and from healthy individuals showed that saliva from diseased patients produced a more objectionable odor faster than that of healthy people, and that the volatile sulfur components (VSC) produced may actually play a role in the etiology of periodontal disease. However, not all people or animals with bad breath have periodontal disease. The objectives of this study were to determine if a trained panel could discriminate between 10 dogs with clinically defined periodontal disease and those with relatively healthy periodontium. Second, this study attempted to establish a correlation between odor intensity and six clinical parameters of oral health. The judges were able to differentiate between the two groups of dogs based only on oral malodor (p < 0.02). There were strong associations of the intensity of oral malodor with oral health index scores. The correlations established between odor and gingivitis (r = 0.81) and between odor and furcation exposure (r = 0.88) were very high and statistically significant. Similarly, probing depth (r = 0.73), plaque (r = 0.07) and tooth mobility (r = 0.66) showed clear, positive relationships with oral malodor.

Animals↗
PubMed1998

The diagnosis and treatment of molar furcation invasions.

Multirooted teeth with FI present some of the biggest challenges in periodontal therapy despite a large arsenal of therapeutic techniques. Guided tissue regeneration has improved the long-term prognosis of many deep grade II lesions but has not always shown consistent predictability. With improved barrier techniques and the development of effective growth factors, however, guided tissue regeneration may well become the treatment of choice for all grade II and III FI. Until that time, early diagnosis and treatment are critical to long-term success. Even strategically important teeth with more advanced FI often have a much better long-term prognosis than previously believed and can survive for many years, even with closed scaling and root planning and frequent, long-term maintenance. Before condemning molars with severe FI, clinicians should consider their experience in treating advanced periodontal diseases and seek consultation with a specialist when in doubt as to the prognosis and treatment of teeth with significant FI.

Dental Scaling↗
PubMedDate not supplied

The treatment dilemma of the furcated molar: root resection versus single-tooth implant restoration. A literature review.

Successful treatment of furcated molar teeth presents the periodontist and prosthodontist with a challenging dilemma. Accepted treatment modalities include chemotherapeutic maintenance, root planning, open flap debridement, modified Widman flap, bone grafting with and without guided tissue regeneration, and osseous resection with and without root removal. Determining the appropriate treatment for an individual patient that is both cost-effective and offers the greatest long-term prognosis can be a daunting task. The literature is replete with studies of different therapeutic alternatives for furcated molar teeth. A relatively new treatment option is complete removal of the tooth combined with ultimate placement of an endosseous implant and restoration with a single crown. A review of the relevant literature with special emphasis on root resection therapy and single molar implant placement is presented. The relative merits of each treatment modality and guidelines for their use are discussed.

Dental Implantation, Endosseous↗
PubMed1998

The Swedish National Dental Insurance's periodontal diagnosis. Used on an individual level.

The Swedish National Dental Insurance Board requires a periodontal diagnosis (FKF 2030 86.12GR) from general practitioners before treating patients, a process which is expensive. The Swedish National Dental Insurance-index (SNDI-index) is based on clinical data and radiographs and every tooth is assigned a rating between 0 and 4. From the time of introduction of the Swedish National Dental Insurance plan in 1974, data can have been collected for 1.7 million patients if the regulations were followed according to the Swedish National Dental Insurance Board in Stockholm, Sweden. It is of interest to examine whether all of these collected periodontal data reflect periodontal status. In this study includings 56 individuals, the Swedish National Dental Insurance-index, used on an individual level, correlated significantly with the individual changes in bone support (as percent of toothlength) of the tooth in 1979 (rs = -0.80, t = -9.7, p < 0.001, ci 95% = -0.88(-)-0.68) as well as in 1989 (rs = -0.79, t = -9.5, p < 0.001, ci 95% = -0.87(-)-0.67).

Alveolar Bone Loss↗
PubMed1998

A morphometric analysis of the furcation region of mandibular molars.

This study examined furcation dimensions and morphology in first and second mandibular molar teeth. One hundred thirty-four extracted human mandibular molars with divergent roots were selected. Teeth were viewed at 7X magnification on a dissecting microscope interfaced with a computer equipped with a state-of-the-art histomorphometry software program. Various aspects of furcation anatomy were measured and recorded. Data were examined by using analysis of variance for all paired comparisons. For nonparametric data, the Kruskal Wallis test was used. Results indicated that 61.94% of buccal and 50.75% of lingual molar surfaces presented with cervical enamel projections (CEPs), with the highest frequency noted in second molars. CEPs ranged from 0.98 mm to 1.33 mm, whereas root trunk heights varied between 2.23 mm and 2.93 mm. Generally, lingual molar surfaces had longer root trunks when compared to buccal surfaces. Root separation increased by approximately 0.5 mm at each 1-mm increment apical to the furcal roof. This study provides new information regarding the furcal anatomy of mandibular molar teeth and supplements previous reports that suggest the CEP is a common problem which must be addressed by clinicians when treating molar teeth.

Analysis of Variance↗
PubMed1994

Association of age and body weight with periodontal disease in North American dogs.

Thirteen hundred and fifty dogs were examined under anesthesia at veterinary hospitals in the USA and Canada. Periodontal health was recorded in detail. Teeth were frequently absent (particularly lower third molar, upper and lower first premolars, and incisor teeth). Calculus was most extensive on the upper fourth premolar and molar teeth. Missing teeth, mobility of remaining teeth, extent of calculus and gingival inflammation, and furcation exposure and attachment loss all were more common in small dogs compared with larger dogs, and in order dogs compared with younger dogs.

Age Factors↗
PubMed1995

Endodontic therapy and management of grade II furcation periodontal disease in a mandibular first molar tooth of a dog.

Conventional endodontic therapy, necessitated by the development of a carious lesion coronal to the furcation area of a mandibular first molar tooth, and management by gingivoplasty of a resultant Grade II furcation lesion are described. In addition, the significance of radiographic changes associated with the periapical region of an undercondensed mesial root is addressed.

Animals↗
PubMed1998

Guided tissue regeneration. Nonabsorbable barriers.

Nonabsorbable barriers are considered the material by which all other barriers are judged. They have a well-established record of safety and efficacy. They are not a panacea, however. Practitioners must take special care when selecting both patients and surgical sites for GTR. Extensive experience, superior surgical ability, and meticulous attention to detail are also required if one is to achieve predictably favorable results.

Adult↗
PubMed1998

A new classification of molar furcation involvement based on the root trunk and horizontal and vertical bone loss.

This study presents a new classification of molar furcation involvement based on the root trunk and horizontal and vertical attachments, and relates them to guidelines in diagnosis, prognosis, and treatment of molar furcation involvements. The type of root trunk were classified on the basis of the ratio of vertical dimension of root trunk to root length as types A, B, and C. Based on the results of this study, the authors conclude that consideration of the root trunk type as well as the horizontal and vertical attachment loss in the classification of molar furcation involvements may facilitate prognosis, diagnosis, and treatment planning.

Alveolar Bone Loss↗
PubMed1998

The buccal bifurcation cyst: in non-surgical treatment an option?

The mandibular buccal bifurcation cyst (BBC) was first described by Stoneman and Worth in 1983. It is a lesion with a specific location, classically the buccal surface of the mandibular first molar and less frequently the mandibular second molar. There have been numerous reports in the literature describing the BBC and its treatment. Treatment advocated thus far includes extraction of the involved first molar, marsupialization and enucleation of the cyst. In their most recent article, Pompura, Sándor and Stoneman reported on the successful treatment of 44 cysts with enucleation without tooth extraction. This article will describe the diagnostic features of the BBC and present three cases with a total of five cysts, which were treated non-surgically and ultimately resolved. The authors, therefore, propose that a more conservative non-surgical approach to these lesions may be considered.

Cheek↗
PubMed1998

The predictability of periodontal treatment as measured by tooth loss: a retrospective study.

OBJECTIVE: This study evaluated the predictability of periodontal treatment as measured by tooth loss in 114 patients. METHOD AND MATERIALS: The patients were selected for the study if they had been treated for moderate-to-advanced periodontitis and had received continuous periodontal maintenance every 3 to 6 months for 5 years or longer. The patients averaged 53 years of age, were equally divided by gender, and were maintained an average of 12.5 years. Patients were retrospectively assigned, according to the number of teeth lost following active periodontal treatment, to the well-maintained group (96 patients, 0 to 3 teeth lost), downhill group (15 patients, 4 to 9 teeth lost), or extreme downhill (three patients, 10 to 23 teeth lost) group. Teeth were retrospectively assigned a questionable or hopeless prognosis. RESULTS: Of the 2,899 teeth present during maintenance care, 378 had a questionable prognosis because of furcation involvement, and 63 (16.7%) of these teeth were lost. Of the 529 nonfurcated teeth that had a questionable prognosis, 68 (12.9%) were lost during the maintenance phase of treatment. Ninety-six teeth were given a hopeless prognosis, and 32 (33.3%) of these teeth were lost. Surgical treatment of teeth with questionable or hopeless prognosis did not improve the retention of these teeth in the downhill and extreme downhill groups. CONCLUSION: The prognosis of a periodontally compromised tooth in individual patients in difficult to predict accurately. A hopeless prognosis is more accurate than a questionable prognosis in predicting tooth loss in these patients.

Female↗
PubMed1989

[Hydroxyapatite implant for human periodontal osseous defects].

The purpose of this study was to evaluate the efficacy of porous hydroxyapatite (HAP) as an implant material into human periodontal defects. Thirty three patients affected by marginal periodontitis were studied. Following initial therapy, 44 periodontal osseous defects received grafts of HAP granules and blocks during flap surgery. Radiographic and various clinical examinations were performed before surgery and 1 and 2 weeks, and 1, 2, 3, 6 and more than 6 months after surgery. The results were as follows: 1. Postsurgical inflammation of the gingiva disappeared in a short time. Further more open wounds and discharges of HAP disappeared in the first month. There were no clinical problems in the sites receiving HAP implantation. 2. Radiographic demarcation lines between the implanted HAP and the surrounding alveolar bone became unclear at the beginning of bone repair. 3. At six months after surgery, the mean values of gingival recession, decrease in pocket depth and clinical attachment gain were respectively 0.9 mm, 2.7 mm, 1.9 mm. Additional observation beyond 6 months showed an attachment gain of 2.0 mm. 4. The attachment gain was less in the cases of one wall osseous defect and of furcation involvement in lower molars. These results suggest that HAP implantation is clinically effective, however, careful application is needed for the cases of one wall osseous defect or furcation involvement.

Dental Implants↗