Case report: treatment of posterior bite collapse with secondary occlusal traumatism.
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A group of 19 patients where traumatic root fractures were treated with surgical extrusion procedure has been clinically and radiographically followed up for 10 years. Except for one out of 21 intraalveolar transplanted roots all functioned with different kinds of crown restorations and without pathological complications. The surgical extrusion method should thus be a useful tool in the treatment of teeth with cervical root-fractures and also teeth with deep cervical root caries which are difficult to treat conservatively.
The usefulness of splinting of severely loosened teeth in advanced periodontitis has been discussed extensively, both positively and negatively. Retention of patients own teeth through the aid of this simple and inexpensive resin composite splint provides a satisfactory solution for many affected patients. The fabrication and placement techniques for splints for the anterior and posterior regions are described, as are additional indications for such splints, which are fabricated from resin composite and glass fiber bundles. Such splinting can be provided even for severely loosened, periodontally diseased teeth without danger of intraoperative tooth loss. Long-term retention of such teeth can be ensured only through a risk-oriented postoperative program of oral hygiene and regular examination of the splint.
Multiple myeloma is a neoplastic disorder of bone that originates from cells of bone marrow. It is most commonly seen within the age range of 50-80 years, cases under the age of 40 being rare. Men are affected more frequently than are women. Bone pain is the cardinal clinical symptom in multiple myeloma. Because of the destruction of bone, pathologic fracture is fairly common. In the oral manifestations, the mandible is involved far more frequently than the maxilla, especially the most active hematopoietic areas-the remus, angle and molar region of the mandible. Other signs and symptoms of jaw involvement include swelling, pain, and increased tooth mobility. Extraosseous lesions may result in paresthesia of soft tissue and gingival enlargement with bleeding tendency. Roentgenographic examination will usually reveal numerous punched-out lesions in a variety of bones. In addition, blood examination will reveal hyperglobulinemia and Bence-Jones protein may be present in the urine of myeloma patients. The histological features of myeloma are closely packed cells resembling plasma cells. Case 1 in this report is a 64-year-old female, who has been diagnosed as having multiple myeloma (IgG, lambda). She was referred to our hospital because of gingival swelling, bleeding and pain. Case 2 is a 60-year-old female suffering from spontaneous gingival bleeding. After blood, urine examination and bone marrow biopsy, multiple myeloma was diagnosed (IgG, lambda). This paper reports the clinical manifestations and treatment courses of these two cases, and the concerns of treatment of multiple myeloma are also discussed.
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Management of avulsed permanent teeth requires perfect knowledge of the different parameters influencing the short and mid-term and above all long-term prognosis. Based on a review of the literature and the analysis of 50 cases cared for in our unit enables us to propose, in accordance with the extra oral delay and the degree of dental maturation, a protocol for the different emergency situations. This clarification emphasizes the contribution of new preserving solutions which allow reimplantation delays up to 24 hours without effect on prognosis.
Several authors have established a relationship between osteoporosis and periodontal disease. The ageing process is associated with a loss of both oral and total bone mass. It has been shown that a reduction of bone mineralization aggravates pathological periodontal changes, resulting in less support for the teeth. The present study investigates the nutritional influences that may condition the appearance of both pathological process. Insufficient dietary calcium and a reduction in the calcium: phosphorous ratio may favour the appearance of both these conditions by promoting bone reabsorption. Bone loss affects the following in descending order: jaw bones (especially alveolar bone), cranial bones, ribs, vertebrae and long bones. Alveolar bone which has the highest rate of renewal, is affected first and consequently is the most severely affected in the long term. The role of calcium in the etiology of osteoporosis is a controversial issue. Nevertheless, its implication has been proven in numerous investigations. The effect of adequate calcium intake on dental health has formed the basis of several recent studies. These investigations have demonstrated that increased calcium intake improves the suffering of inflammatory processes and tooth mobility in patients suffering from gingivitis with haemorrhaging. Based on the results of studies which link dietary calcium and phosphorous to the risk of osteoporosis and periodontal disease, and bearing in mind that in a large proportion of the Spanish population calcium intake is below that recommended, there is a need for a general improvement of the diet. It may be of special interest to increase the calcium intake of patients suffering periodontal disease. It may also help in the prevention of osteoporosis.
The design and use of fixed partial dentures as a definitive restoration to stabilize and splint teeth have been reviewed. The provisionalization of the splinted patient has been described as it is incorporated into the treatment plan of patients with a weakened periodontium. The current controversy of incorporating implants in the patient requiring splinting was discussed, and recommendations are made. Dentists are encouraged to explain all potential ramifications of splinting with fixed partial dentures, including cost, frequency of office visits, and potential alterations or remakes of the prosthesis should physiologic demands surpass the capabilities of the remaining teeth.
Thorough evaluation and correct treatment of traumatized teeth improve their chances for survival. This article provides an overview clinical evaluation and how best to treat the tooth that has been traumatized. The rationale and techniques for tooth stabilization of the traumatized tooth will also be presented.
CADIA can only be performed on geometrically standardized images converted in Al equivalents. The aim of this study was to develop the ability of the new CADIA software to quantify bone density on dental radiographs without previous standardization. A total of 36 examines with periradicular lesions were treated surgically, the defects were filled with Hydroxylapatite and followed up for 1, 6, and 12 months. Before and after surgery the operated areas were clinically evaluated using intraoral radiographs, tooth mobility index and relapses. Clinical results revealed satisfactory bone healing in 27 cases and relapses in 9 cases. The radiographs were then digitized with a high resolution CCD camera. Densitometric analysis was done in 10 points at the edge of the bone defect. Correction of geometric and brightness distortions was done with mathematical manipulation from three referral points positioned at the same place on each radiograph. Density values observed no bone loss in 23 cases and loss of bone in 13 cases. The differences between clinical evaluation and CADIA were not statistically significant.
The pattern of mobility of the mandibular incisor with intrusive loads was consistent with the view that the periodontal tissues are viscoelastic. A significant time-dependency of the response was observed. The pattern of mobility was similar to that reported for axially directed extrusive loads and for horizontal loads.
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Several investigations have evaluated the degree of discomfort that patients experience during orthodontic treatment, but most of the research centered on tactile sensory (touch) threshold, reaction to spacers used to separate the teeth or reaction to the initial leveling wires, and the periodic adjustment of the appliances. The purpose of this investigation is to determine the discomfort threshold for patients undergoing orthodontic treatment at the time immediately before appliance removal. Such information will be useful in determining the force levels that patients can tolerate during debonding. From the findings in this study the following can be concluded: (1) The threshold of patient discomfort, at the time of debonding, is significantly influenced by two factors: the mobility of the tooth and the direction of force application. Sex and tooth type differences also influence the discomfort threshold but to a lesser degree. (2) At the time of debonding, patients can withstand intrusive forces significantly more than forces applied in a mesial, distal, facial, lingual, or an extrusive direction. The clinical implications of these findings are discussed.
During function, every R.P.D. shows denture movement that is converted into stress to the abutments. Our two investigations revealed that guide surfaces on the retainers was effective in reducing the stress. In R.P.D. treatment, many different designs of clasp systems have been used with less consideration of this guiding function. In this study, four types of clasps, Aker's clasp, Krol R.P.D., Kratochvil R.P.D. and the Crown Ledge preparation, having different guide surfaces were examined to measure the mobility of abutments under the pull out force. Metal frame dentures were provided in order to measure these movement with electronic sensor. Each retainer had interchangeable feature to facilitate the investigation. The following results were obtained, 1. Aker's clasp showed small amplitude with high frequency during removal periods. 2. Both R.P.I. clasps give only small vibration when the path of removal is adjusted. To get this direction is difficult. 3. Guide surface of Crown Ledge clasp. is effective in reducing the mobility of abutment tooth. 4. The guiding surface therapy has an effect in reducing the abutment vibration.
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