Antibacterial treatment of periodontal disease.
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Clinical data characterizing the results of non-surgical, conservative versus surgical modalities of periodontal treatment are presented and summarized, as they appeared in the international literature. Primarily, the clinical disease status prior to treatment is discussed. Thereafter, the therapeutic success of either modality was measured on the basis of the following parameters: reduction of probing depth, changes in attachment levels, cleanliness of root surfaces, elimination of inflammation, and longlasting tooth survival. The literature review revealed that the choice of either treatment modality influences the therapeutic success only indirectly. More important is that the diseased root surface is meticulously cleaned from all bacterial debris. In the presence of shallow (1 to 3 mm) and medium-sized (4 to 6 mm) pockets, surgical and non-surgical treatment provides equally good results. Deep pockets (7 mm or deeper) and, in particular, crater-like bony pockets as well as furcation involvement respond with better results, if surgical treatment is assigned. In the long run, however, therapeutic success can be secured only by means of a consequent periodical recall and with support of the patient's willingness to perform optimal oral hygiene.
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Medical advances for treating organ diseases have resulted in thousands of organ transplants being performed each year. Every patient receiving a transplanted organ will also be placed on drugs that may induce gingival hyperplasia as a side effect. This article discusses the multiphasic approach to treating the disfiguring hyperplasia through chemical and mechanical plaque control, surgical removal of the tissue by lasers, and postsurgical rinses with folate.
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This paper reviews the newest advances in and opinions about cosmetic periodontal surgery. It includes a review of basic periodontal anatomy as it relates to restoring ideal health and esthetic gingival and osseous tissues. Treatments for excessive gingival tissue, ridge augmentations, and gingival deficiencies are discussed. These procedures are important in creating the illusion of a natural cosmetic smile in otherwise compromised situations.
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The maxillary anterior region presents a difficult and unique therapeutic challenge in the treatment of periodontal disease. The periodontist should use therapeutic procedures to prevent or minimize esthetic problems, such as increased tooth length and loss of interdental papilla, without compromising the main goals of periodontal treatment. This article presents various periodontal treatment modalities that can be used in the anterior maxillary area with acceptable esthetic results. A better understanding of the problem, the treatment steps, and the various options available may improve the communication between the general practitioner and the periodontist, producing satisfactory long-term results.
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Several studies have shown that gingivitis is common in children and adolescents. Introduction of orthodontic devices may exacerbate the gingival inflammation. Orthodontically induced gingival hyperplasia in adolescents, its etiology, and treatment alternatives are discussed. Three instances in which laser therapy was used are described.
A patient in whom gingival hyperplasia was caused by prolonged use of an anticonvulsant drug (hydantoin) is described. Advanced gingival hyperplasia and significant displacement of the remaining teeth caused severe damage, especially to the patient's appearance. It was not possible to cure the problems completely with routine periodontal treatment. It was decided to extract all the remaining teeth and restore function and esthetics early with complete dentures. Cephalometric analysis was used to determine the degree to which the teeth had drifted. During fabrication of the dentures, the analysis was very useful in deciding the position of the anterior teeth and checking the vertical dimension of occlusion.
Gingival overgrowth is a known side effect of several seizure, immunosuppressant and calcium channel-blocker medications. Gingival overgrowth is not a reported side-effect of phenobarbital. This case report describes two patients with marked gingival overgrowth who had been medicated with phenobarbital exclusively since the initiation of seizure disorders. The clinical findings, surgical management, bleeding complications, and recommendations in management are discussed.