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PubMed2003

[Periradicular surgery with and without endoscopy: a prospective clinical comparative study].

A total of 129 teeth with periradicular surgeries (apicoectomies) were analyzed in a prospective clinical study. In the test group including 62 teeth, an endoscope (Tele-Otoscope with a 70 degrees viewing angle) was used as an intraoperative visualization aid to monitor the following surgical steps: root-end resection, root-end cavity preparation and retrograde root-canal obturation. In the control group including 67 teeth, intraoperative diagnostics were carried out using micromirrors. Fifty-four and 61 teeth could be re-examined after one year. Based on the clinical and radiographic findings they were categorized as success, uncertain healing or failure. In the test group with endoscopy, the success rate was 88.9%, whereas in the control group it was only 75.4%. However, statistically no significant difference was found between the two groups. Additional experimental and clinical studies will show if endoscopy will improve the success rates in periradicular surgery any further.

Apicoectomy↗
PubMed2004

Transurgical restoration in the absence of attached gingiva. A case report.

A 45-year-old woman needing a Class V restoration in a mandibular molar without attached gingiva is presented. In an interdisciplinary intervention, transurgical restoration was accomplished, including flap surgery with a slight ostectomy and restoration with a bonding system and a resin composite. A 1-year clinical evaluation showed satisfactory marginal adaptation and restoration contour associated to gingival tissue health.

Alveolectomy↗
PubMed1992

The endodontic microflora revisited.

The microbial flora of 35 dental root canals were examined, taking care to maintain the viability of obligate anaerobes which accounted for 45% of total isolations, while streptococcal species accounted for 24% of the total species isolated. Individual root canals yielded a maximum of eight bacterial species. A total of 40 different species was isolated of which the most prevalent were the facultative anaerobe Streptococcus sanguis and the obligate anaerobe, Peptostreptococcus micros (both in 23% of root canals), followed by Eubacterium aerofaciens and the 'Streptococcus milleri group' (both 17%) then Prevotella melaninogenica (formerly Bacteroides melaninogenicus), Enterococcus faecalis and Prevotella oralis (formerly Bacteroides oralis), which were each isolated from 14% of root canals. Highly significant associations were discovered between four pairs of species, viz P. melaninogenica with P. micros, P. melaninogenica with P. oralis, Prevotella corporis with Streptococcus morbillorum and Actinomyces odontolyticus with E. faecalis.

Dental Pulp Cavity↗
PubMed1992

The oral health and attitudes to dental treatment of a dentate elderly population in Mosgiel, Dunedin.

As part of the Mosgiel Community Study, a longitudinal investigation of the health of the elderly, a dental survey was used to determine the oral health status and treatment needs, both objective and subjective, of a group of dentate older adults. Sixteen percent of the 817 subjects were dentate. Of these, 95 were available for the dental survey, and they were questioned and examined at their homes. The mean age was 77 years, and 55 percent of subjects were male; disproportionately more older males than females had retained some of their natural teeth. Seventy-two percent regularly sought dental treatment, and 39 percent felt they were in need of treatment. Few real barriers to treatment were identified, although a major obstacle preventing many from seeking treatment was their lack of perceived need. However, even the realisation that they required treatment was not sufficient cause for many to seek treatment. All subjects required some form of dental treatment. Eighty-five of the 95 subjects required at least one restoration, and 16 percent advanced restorative treatment. The frequencies of coronal and root surface caries were similar. Oral mucosal pathology was also common. Sixty-five percent of denture wearers required prosthetic treatment. Most subjects needed simple periodontal treatment, but 11 percent required advanced therapy. The main oral health problems of this group related to the simple management of plaque-related disease, and the wearing of dentures. However, 24 percent of people required complex restorative and periodontal treatment, or both.

Aged↗
PubMed2004

A new approach using the surgical extrusion procedure as an alternative for the reestablishment of biologic width.

A modification of the surgical extrusion technique to treat fractured teeth was realized as an alternative periodontal therapy to avoid ostectomy following orthodontic extrusion of teeth with their biologic widths compromised by different etiologic involvements. After delicate luxation and arrested avulsion, the teeth were coronally positioned to allow room for a new biologic width. Clinical and radiographic monitoring showed the ability of the periodontium to adapt function and esthetic recovery. The advantages and disadvantages of this therapeutic procedure for resolution of a periodontal involvement are presented.

Bicuspid↗
PubMed2004

Subgingival foreign body embedment in a preschool child: management with three and a half years follow-up.

CASE REPORT: This is a case report of diagnosis and management of a foreign body embedded in the gingivae of a preschool child. A 3 year-old girl presented with pain, mobility and intraoral oedema of the upper left primary canine (#63). An angular, diffuse radiolucency on the mesial aspect of the primary canine was observed in the periapical radiograph and within this radiolucency, a linear radiopacity was noted in contact with the mesial surface of the root. A clinical diagnosis of severe localized periodontal involvement due to foreign body embedment was made. It was initially attempted unsuccessfully to remove the foreign body by subgingival root scaling and planning. The area was then surgically exposed. Upon flap elevation, a tubular plastic material similar to those used for the insulation of electric wires was found to encircle tightly the cervical area of the root of the primary canine, which was removed. Three months after the surgery, the gingiva of the affected tooth had attained its normal color but had started to recede for about 1 mm. One year post surgery, the gingival recession had progressed to 3 mm and a carious lesion had already developed at the denuded root surface. Three and a half years post surgery a mild inflammation of the buccal gingivae was apparent, but periodontal healing had occurred. CONCLUSION: The dentist must always consider the possibility of a foreign body embedment in the periodontal tissues of children and be familiar to the clinical signs and symptoms as well as the proper treatment procedures.

Child, Preschool↗
PubMedDate not supplied

Technique on restoring sub-gingival cervical lesion.

This article outlines an atraumatic isolation approach and a conservative instrumentation sequence, followed by use of a highly viscous, rapid-setting, capsulated glass ionomer cement to manage a difficult deep proximal-cervical Class V lesion.

Aged↗
PubMed2004

Alginate impressions for fixed prosthodontics. A 20 year follow up study.

The aim of this study was to estimate whether the survival ratios after 20 years of fixed prosthodontics made of alginate impressions was higher, equivalent or lower, compared to the survival ratios, shown in studies, where different impression materials were used. 151 females and 104 males were screened regarding the condition and age of the restorations at the annual check-up in one of the author's surgeries. Average ages were 55 and 54 years respectively, when the fixed prosthodontics were seated. A total of 1.271 units were produced during the twenty years, 911 abutment teeth and 360 pontics. The type of prosthetic work was divided into three groups: 1) larger fixed prosthodontics 6-14 units (469), 2) smaller fixed prosthodontics 2-5 units (541) and 3) single crowns (261). The results show that alginate impressions can produce fixed prosthodontics with survival ratios similar to those presented in other studies, after 5 years (99%), 1o years (93-96%) and 15 years (74-96%). After 20 years the survival ratio was 61-63%. In conclusion, fixed prosthodontics made according to the syringe-tray alginate impression method may have the same success rates after 20 years compared to that of fixed prosthodontics presented in previous longitudinal clinical studies where other impression materials had been used. In this study, caries and root fractures were the main reasons for removing abutment teeth and pontics.

Adult↗
PubMed2005

[Dental care of patients with leukemia].

Leukemias include a variety of acute and chronic malignant hematological diseases that require antineoplastic chemotherapy. Hematological stem cell transplantation allows an aggressive chemotherapy during which patients suffer from severe immunosuppression. Oral infections may cause serious complications during this immunosuppression. Therefore, professional diagnosis and elimination of oral infection foci must be carried out as early as possible before such treatment. Aggressive chemotherapy causes hyposalivation and as a consequence an increased risk for oral hard and soft tissue diseases. Adequate oral care before, during and after chemotherapy combined with a stem cell transplantation is necessary to prevent oral diseases and systemic complications of oral origin.

Acute Disease↗
PubMed2005

Immediate restoration of implants placed into fresh extraction sockets for single-tooth replacement: a prospective clinical study.

The aim of the present clinical study was to evaluate the placement of transmucosal implants into fresh extraction sockets and their immediate restoration with temporary crowns. A series of 22 cases with a 12-month follow-up is presented. Twenty-two patients (15 women and 7 men; mean age 39 years) who needed a single tooth replaced because of vertical or horizontal root fracture, caries, endodontic lesions, or periodontal disease were treated with immediate postextraction implant placement. The implant was then restored with a screw-retained prosthetic restoration within 24 hours. Radiographic assessments were made at baseline and 12 months after implant placement. Clinical parameters, such as plaque score, mucositis score, probing attachment level, mucosal margin position, variation of gingival level, and variation of papilla position, were also measured at baseline and after 12 months of follow-up. At 12 months, no implants had failed. Radiographic examination revealed mean bone resorption of 0.5 mm at 12 months compared to baseline. The mean variation of gingival level, compared to the neighboring teeth, was -0.75 mm. Probing attachment levels were 0.79, 0.45, and 0.54 mm at proximal, buccal, and lingual sites, respectively. The values for the mucosal margin position were 2.9, 2.2, and 2.4 mm at proximal, buccal, and lingual sites, respectively. Regarding variation of papilla position, according to Jemt's index, 27 papillae presented with a score of 2 (61%) and 17 with a score of 3 (39%). An examination of oral hygiene and peri-implant soft tissue conditions at the 12-month follow-up visit revealed an overall frequency of plaque-carrying implant surfaces of 13%. Furthermore, mucositis (score 2) was not observed at any of the peri-implant units. Primary implant stability did not significantly increase over time. The immediate restoration of dental implants placed into fresh extraction sockets was shown to be a safe and predictable procedure. The success rate and radiographic and clinical results were comparable to those obtained following the standard protocol. Within the limits of the present investigation, immediate restoration of single-tooth implants placed in fresh extraction sockets can be considered a valuable option to replace a missing tooth. However, long-term clinical trials are needed to confirm the present results.

Adult↗
PubMed2003

Oral health status and treatment needs of institutionalized elderly and disadvantaged population in Fiji (1997).

Information on the oral health of institutionalized elderly populations in a number of countries is available but, no data is available nor published on the elderly population of Fiji. A pilot survey was carried out at the nursing homes in the Suva area. The aim of this study was to investigate the dental status and treatment needs of institutionalized elderly people. Examiner was calibrated and consent approved from the relevant institutions. This study found that residents were institutionalized, because family members could not care for them; did not receive any form of financial assistance and therefore totally relied on the institution; generally had medical problems such as neurological disorders, cardiovascular disease and diabetes. Generally had poor oral health status such as root stumps, many missing teeth, calculus and shallow pockets were common, oral hygiene practices were poor, high demand for dentures/or the dentures were not clean, some cases of leukoplakia were found and there was an urgent need for the dental profession to deliver dental care. Recommendations include issues in developing a supporting environment, provision of adequate and appropriate access, community education and skill development, workforce development and research in geriatric dentistry in Fiji.

Adult↗
PubMed1991

Simplified trimming and finishing of glass-polyalkenoate (ionomer) cement restorations.

Shaping and fine working of restorations necessitated by cervical lesions, abrasions at the necks of teeth, or root surface caries can often be arduous to complete. As an example of a facilitated trimming and simplified finishing technique for cervical restorations, the use of "tissue-protective" finishing diamonds to adapt a Class V Type II glass-polyalkenoate (ionomer) cement restoration is demonstrated. Because of their noncutting guiding tips, these "safe-ended" diamond instruments can help prevent discontinuous and nonanatomic contouring of restorations. In addition, these special instruments allow a less traumatic working procedure in areas of marginal gingiva.

Carbon↗
PubMed1989

[Crown lengthening by orthodontic extrusion. Principles and technics].

Forced Eruption by orthodontic means is an effective way of managing subgingival caries and root fractures at the level of the osseous crest or below. It allows the dentist to construct restorations on otherwise hopeless teeth and maintains the biologic distance between the apical portion of the junctional epithelium and the alveolar crest.

Epithelial Attachment↗
PubMed1989

Trends in oral health in the aging population.

Increased survival of the natural dentition, persistence of periodontal disease, deterioration of prior dental restorations, root surface caries, and continued incidence of oral cancer represent a complex of emerging oral health problems of the aged in the United States. Additional data on the epidemiology of oral mucous membrane syndromes will help to characterize the prevalence of these diseases in the aging population as well. Improvement in the utilization and accessibility of dental services by the aging cohorts will contribute to the prevention of oral disease in the future. Combined with the substantial growth in the size of this cohort of the population and alterations in the prevalence of these oral health status indicators, changes in the need for and projected utilization of professional oral health services can continue to be anticipated. Clinical research directed toward assessment of efficacy of treatment modalities for prevention of dental disease and maintenance of dental health are essential for the projection of dental health manpower needs for the future. This should also lead to the development of appropriate academic and training programs to meet the changing needs of the elderly.

Aged↗