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[Flap surgery].

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Alveolar Process↗

Oral manifestations of Schimmelpenning syndrome: case report and review of literature.

Schimmelpenning syndrome (SS) is characterised by specific skin manifestations, skeletal defects, and central nervous system abnormalities. Here, the SS is briefly reviewed, and the oral and dental manifestations are described in a patient whose medical findings were previously published and included severe hypophosphatemic rickets. Significant oral and dental features included papillomatous lesions of the gingiva, hemihyperplasia (hemihypertrophy) of the tongue, bone cysts, aplasia of teeth, enlarged pulp chambers, hypoplastic or absent enamel, and an odontodysplasia-like permanent tooth.

Adolescent↗

Rationale for the lingual approach to mandibular osseous surgery.

The definitive treatment of periodontitis for pocket elimination and the establishment of periodontal architecture that can be effectively maintained with daily personal oral hygiene techniques is sometimes an elusive goal. Performing osseous reduction, primarily from the lingual aspect of the posterior mandible, definitely helps in accomplishing such a goal. This paper should not be interpreted to mean that osseous correction of bony defects should be approached strictly from the lingual, since almost all cases require some buccal recontouring if a satisfactory soft and hard tissue architectural form is to be achieved. Clinical observation and experience have shown that the anatomical patterns, seen in relation to the mandible, have a powerful effect on normal periodontal architecture as well as the types and locations of bony defects encountered. Tooth to bone relationships deserve attention. The buccal housing of the alveolar bone is frequently thin in the premolar region and occasionally on the first molar, while the external oblique ridge causes thicknened bone over the second molar. The vestibular depth on the buccal of the molars is often quite shallow, meaning that only a very limited amount of osteoplasty-osteoectomy can be performed from the buccal. The lingual housing of the alveolar bone is normally thickened and shelf-like from the distal of the third molars to the mesial aspect of the premolar region. Because the posterior teeth are inclined lingually from the second premolar distally, the buccal marginal bone height is higher occlusally than the lingual bone margins, with the interproximal bone therefore sloping somewhat apically and lingually. Interdental craters are the most common defect seen with the onset of periodontitis. Such defects in the lower arch tend to occur beneath the contact areas of the teeth, which are much further to the lingual than in the maxilla. The highest percentage of interproximal craters are shallow and not amenable to grafting techniques in the hands of most clinicians. These shallow craters are prime candidates for osseous reduction techniques. With the progression of periodontitis, the interproximal defects frequently extend to include infrabony lingual defects. Although obtaining lingual access for osseous reduction techniques is often difficult, osteoectomy-osteoplasty techniques performed primarily from the buccal of the posterior mandible frequently result in compromise of the lingual and over treating the buccal in terms of osteoectomy procedures. The lingual embrasure spaces are usually wider than on the buccal, and with adequate reduction of the mylohyoid ridge, greater access for oral hygiene procedures is provided.

Alveolar Process↗

[Conditions for the performance of periodontal surgery].

Periodontal surgery is an integral part of systematic periodontal therapy, is performed only after establishment of good hygienic conditions in the mouth, does not aim at maintaining single teeth that would have to be extracted and is indicated only if the patient is performing adequate personal oral hygiene.

Dental Hygienists↗

Multidisciplinary full-mouth restoration with porcelain veneers and laboratory-fabricated resin inlays.

Recent advances in dental materials, laboratory technology, and adhesive protocols have significantly expanded the contemporary restorative armamentarium. Utilized in combination with comprehensive treatment planning, these innovations enable clinicians to provide enhanced aesthetic care that achieves the increasing expectations of their patients. Using a detailed case presentation, this article highlights the harmonious integration of modern smile design, material selection, and interdisciplinary communication that must be addressed in order to deliver optimal treatment with porcelain laminate veneer and laboratory-fabricated resin inlay restorations.

Adult↗

[Clinical experience with the treatment of gingival hyperplasia induced by calcium channel blocking agents].

The prevalence of the nifedipine-induced gingival hyperplasia is ranging from 0.5-83% in the dental literature. The pathomechanism of the nifedipine-induced gingival hyperplasia is not clearly understood. Evaluating the dental history and the course of disease of 34 patients treated and followed up at the Department of Periodontology the following answers were raised: What sort of local and systemic factors are enhancing the recurrence of the gingival overgrowth and how this can be anticipated in patients on continuous Ca channel blocking medication. Eight out of the 34 patients participating in the clinical trial did not remember the onset of their gingival overgrowth. 10 cases developed three years and three cases after less then one year of the onset of the drug administrations. 27 out of the 34 cases required gingival surgery and seven showed good clinical improvement after the hygienic phase of the comprehensive periodontal treatment. 70% of the gingival hyperplasia cases presented no clinical sign of recurrence one year after the completion of the active phase of the treatment. A positive correlation was found between the oral hygiene and the recurrence rate of gingival overgrowth. Oral hygiene seems to play a decisive role in the development of gingival enlargement. The present findings and substantial evidences from the dental literature indicate that the gingival enlargement can be successfully controlled even under the continuous nifedipine administration by meticulous professional and individual oral hygiene.

Calcium Channel Blockers↗