SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Some of the treatment procedures just described are, admittedly, heroic, but there are many times in today's practice of dentistry when heroics are indicated. Posterior vertical crown-root fractures seem to occur most often in terminal abutments, in periodontal disease-free mouths, and in individuals who do not easily accept the idea of tooth extraction. For these, the reward compensates for the effort and time involved.
This article describes a surgical procedure to predictably obtain primary closure over extraction sockets in the maxilla. The technique offers a valuable treatment approach for the achievement of primary soft tissue closure over bone grafts and/or occlusive osteopromotive membranes, although the use of an osteopromotive membrane may not always be necessary in cases of single-tooth extraction. The surgical technique is based on a split-thickness palatal flap in which the pediculated deep portion is rotated to cover the grafted alveolus or membrane. This procedure was used in a total of 40 sites in 32 consecutive patients; a barrier membrane was used in 20 sites. All treated sites allowed proper implant placement after healing. Two membranes became prematurely exposed and one was removed before implant surgery. Proper soft and hard tissue anatomy was predictably obtained prior to implant placement. This surgical procedure is useful in preserving and/or augmenting the alveolar ridge prior to or during implant placement in cases of advanced alveolar bone loss.
Aesthetic restoration of anterior teeth with implant supported restorations is one of the most difficult procedures to execute. Bone resorption following anterior tooth extraction often compromises gingival tissue levels for the implant restoration. In the last 10 years the focus has shifted from osseointegration, to creation of an implant borne restoration which is in harmony with the surrounding hard and soft tissue. Complete reconstruction of tooth and gingival related aesthetics remains the primary objective and in some instances can be very difficult to achieve.
OBJECTIVES: Superoxide dismutase (SOD) is an antioxidant enzyme that acts against superoxide, an oxygen radical, released in inflammatory pathways and causes connective tissue breakdown. In this study, SOD activities in gingiva and gingival crevicular fluid (GCF) from patients with chronic periodontitis (CP) and periodontally healthy controls were compared. MATERIAL AND METHODS: Twenty-six CP patients and 18 controls were studied. In patients, teeth with moderate-to-severe periodontal breakdown and > or =5 mm pockets that required full-thickness flap surgery in the right or left maxillary quadrant, and in controls, teeth scheduled for extraction for orthodontic reasons were studied. After the clinical measurements (probing depth, clinical attachment level, gingival index, gingival bleeding index, plaque index), GCF samples were collected. Tissue samples were harvested from the same teeth, during flap operation in patients and immediately after tooth extraction in controls. SOD activities were spectrophotometrically assayed. The results were statistically analysed. RESULTS: Gingival SOD activity was significantly higher in the CP group than in controls (p<0.05). No significant difference was found in GCF SOD activity between the groups (p>0.05). Correlations between gingival and GCF SOD activities were not statistically significant in CP and control groups (p>0.05). CONCLUSION: In CP, SOD activity seems to increase in gingiva, probably as a result of a higher need for SOD activity and protection in gingiva in CP than in periodontal health, while not significantly changing in GCF, suggesting a weak SOD activity in GCF in periodontal disease state. The weak correlation between gingival and GCF SOD activities suggests distinct actions of these SODs.
Immediate placement of dental implants into tooth extraction sites is an effective treatment option. When immediate placement procedures are performed with a round implant, a void is often evident between the implant and the orifice of the socket. Previous treatment focused on the use of membranes or special closure techniques to induce bone growth into the void. Anatomically shaped dental implants provide a predictable alternative to previous filling techniques since the anatomical implants decrease or completely fill the void at the socket opening. This article describes a surgical technique developed for the immediate placement of these implants in extraction sites.
A rare case of severe deep neck infection caused by clostridia after extraction of the left lower canine is presented. The patient was a 63-year-old Japanese woman who had a history of diabetes. The pertinent literature in Japan is reviewed and discussed.
Current, relevant knowledge on the outcome of endodontic therapy is key to clinical decision making, particularly when endodontic treatment is weighed against tooth extraction and replacement. Inherent to reviewing the outcome is a definition of "success" in relation to the goals of therapy. As the specific goal set out by the individual patient may either be healing/prevention of disease (apical periodontitis) or just functional retention of the tooth, the potential for both healing and functionality is reviewed. Based on selected follow-up studies that offer the best evidence, the chance of teeth without apical periodontitis to remain free of disease after initial treatment or orthograde retreatment is 92 percent to 98 percent. The chance of teeth with apical periodontitis to completely heal after initial treatment or retreatment is 74 percent to 86 percent, and their chance to be functional over time is 91 percent to 97 percent. Thus there does not appear to be a systematic difference in outcome between initial treatment and orthograde retreatment. The outcome of apical surgery is less consistent than that of the nonsurgical treatment. The chance of teeth with apical periodontitis to completely heal after apical surgery is 37 percent to 85 percent, with a weighted average of approximately 70 percent. However, even with the lower chance of complete healing, the chance for the teeth to be functional over time is 86 percent to 92 percent. Considering the favorable outcome, conservative endodontic therapy, both nonsurgical and surgical, is definitely justified and should be attempted when a good restorative and periodontal prognosis is projected, unless the patient is not motivated to retain the tooth.
The ablation effects of the Erbium:YAG laser (wave length: 2.94 microns) on the human extracted teeth were examined histopathologically. The enamel surface of the human extracted tooth was irradiated by the laser at 500 mJ, 1 pps or 3 pps: 3, 15, 30, 50 and 100 shots. After observation under a dissecting microscope, the teeth were placed in a demineralizing solution of 0.1 M lactate buffer with 6% hydroxyethyl cellulose (pH 4.5) in order to evaluate the acid resistance of the enamel adjacent to the ablated area. After 4 days, the degree of demineralization of the surrounding enamel was assessed by contact microradiography. The result showed that every irradiated tooth had a clear-cut defect, and almost all the teeth had acquired acid resistance at the enamel surrounding the ablated portion. The other experiment was carried out to estimate the effects of the Er:YAG laser through a contact probe. The enamel, dentin and cementum of the extracted teeth were irradiated at 39 mJ or 74 mJ, 10 pps; 10 shots. The teeth were observed under a dissecting microscope. The result clearly indicated that the Er:YAG laser guided by the contact probe could also produce a defect in the dental hard tissue. The above-mentioned findings suggested that the Er:YAG laser could pave the way for the cavity preparation with acid-resistant cavity margin.
OBJECTIVE: The clinical, radiographic, and histologic features of the mandibular buccal bifurcation cyst were studied to further define this lesion. The treatment and outcomes were also analyzed. STUDY DESIGN: This prospective study, which spanned 3 years, included 32 patients. Their ages ranged from 5.5 to 11 years (mean of 7.5). A total of 44 buccal bifurcation cysts were treated solely with enucleation, and patients were followed up for 2.5 to 3 years. RESULTS: All lesions were located at the buccal bifurcation of the mandibular first molar. Tilting of the buccal cusps, causing prominence of the lingual cusps, occurred in 75% of the cases. The lesion extended from the buccal bifurcation to the tooth apex in 81.2%, and a periosteal reaction on the lateral surface of the mandible adjacent to the cyst was noted in 68.8% of the cases. All of the 44 histologic reports were nonspecific, but showed a cyst lining of stratified squamous epithelium with chronic inflammation. Microbiology consisted of mixed oral flora. Complete radiographic healing in all sites without recurrence was noted in 2.5-year follow-up. The periodontal pocket depth around all the involved teeth was normalized. No loss of the mandibular first molars occurred. CONCLUSIONS: The mandibular buccal bifurcation cyst is a distinct site-specific and age-specific clinical entity treatable by enucleation without tooth extraction.
In the course of life the mandible undergoes substantial morphological and dimensional changes. The changes concerning mandibular angle, relation between the length of the mandibular corpus and ramus as well as roughness in the place of insertion of masseteric and pterygoid muscles do not depend upon age or sex but (apodictical) exclusively upon the dentition. In the complete dentition all masticatory muscles take part in chewing and grinding. The function of the temporal and masseter muscle is (reduced) weakened in partial or complete loss of teeth. The most evident morphological change of the lower jaw consists of an apparent elongation of its corpus resulting in a characteristic senile appearance. Measurements have been performed on 114 macerated mandibles of individuals ranging from 4 months to 68 years of age. The following measures have been taken: number of teeth in the lower jaw, angle between the corpus and ramus of mandible, length of the mandibular corpus, height of the mandibular ramus and angle of the mandibular incisure. The angle between the mandibular corpus and ramus is significantly lower in mandibles with 11 and more teeth (p < 0.001). The length of the mandible is significantly larger (p < 0.02) in mandibles with less than 11 teeth. The mandibular ramus is significantly higher in mandibles with more teeth (p < 0.01). There were no significant differences in the angle of the mandibular incisure within the groups (p > 0.05). The discriminant analysis reveals that 62.3% of the variability of mandibles is dependent upon the number of teeth. The rest of proportional variability of 37.7% is probably due to new circumstances and adjustment of the mandible in the period from tooth extraction.
BACKGROUND: Temporomandibular disorders are not an uncommon finding in adult patients undergoing orthodontic treatment. PATIENT AND METHODS: In a 25-year-old female patient with neutroclusion, bialveolar protrusion with anterior crowding, and mesial tipping of tooth 27 due to early loss of tooth 26, a unilateral clicking in the right temporomandibular joint was recorded as a secondary finding. Clinical and instrumental functional analysis revealed right-sided anterior disc displacement with reduction, which had been induced by forced guidance of the mandible to posterior. Space was to be gained by extracting tooth 41, by closing the residual gap at tooth 26, and by interproximal reduction of the dental enamel in the right upper buccal region. In addition, occlusal adjustment was to be undertaken subsequently to eliminate the forced guidance and to achieve a slightly overcorrected Class I relationship. RESULT: Treatment wit a complete fixed appliance fulfilled the treatment objectives, with normal functioning of the temporomandibular joint being achieved. This case of a patient with a temporomandibular disorder is used to illustrate steps in diagnosis and functional analysis. Steps which ensure not only a successful orthodontic outcome but also a beneficial orthopedic effect on the temporomandibular joint.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
BACKGROUND: In most studies using submerged hydroxyapatite implants, maintenance of alveolar bone after tooth extraction was attempted with plain hydroxyapatite materials. However, clinical results have shown that hydroxyapatite may require biological modification with a bone resorption-inhibiting agent which may be beneficial for maintenance of alveolar bone. We conducted experimental and clinical studies to evaluate the effect of highly bisphosphonate-complexed hydroxyapatite implants on osteoconduction and repair in alveolar bone. METHODS: Porous hydroxyapatite implants were pre-incubated in 10(-2)M bisphosphonate solutions at pH 3.49. The implants had a diameter of 2.1 mm and a height of 2 mm and adsorbed 115 microg bisphosphonate. Five goats were implanted with 4 plain hydroxyapatite implants on each side of the mandible in root extraction sockets for the precision analysis of dual x-ray absorptiometry (DEXA) measurements. Ten goats were implanted with 4 bisphosphonate/hydroxyapatite implants on one side of the mandible and 4 plain hydroxyapatite implants on the opposite mandible. In a clinical study, 23 bisphosphonate/hydroxyapatite implants were placed in periodontally destroyed tooth root sockets and followed up during one year. RESULTS: The range for the bone mineral density (BMD) measurement errors for goat histologic sections was 0.48% to 1.03%. There were large differences in peri-implant BMDs in the left and right mandible of the same goat, irrespective as to whether hydroxyapatite or bisphosphonate/hydroxyapatite implants were present. This was due to local anatomical differences typical of alveolar bone. These differences were not significant. Histologically, all bisphosphonate/hydroxyapatite as well as hydroxyapatite controls appeared to be fully integrated and effective as bone replacement material in goat alveolar bone. They exhibited vascularization and osteoconduction of alveolar bone growth along and inside their porous structure. In patients peri-implant healing was clinically and radiographically comparable to plain hydroxyapatite implants. All implants were retained and no dehiscences developed. Radiographically, peri-implant radiolucencies disappeared and alveolar bone was deposited in close proximity to the implants. CONCLUSIONS: This study contributes to the understanding of the biological properties of hydroxyapatite implants as carriers for the bone-modulating agent bisphosphonate. Our study suggests that normal osteoconduction and repair occurred in alveolar bone around the highly bisphosphonate-complexed hydroxyapatite implants.
The treatment of a skeletal Class III open bite malocclusion with Turner's syndrome is described. Although the patient had a negative overbite of 9 mm, a positive overbite of 2 mm was obtained through treatment, without any tooth extractions; however, an excessive vertical growth of the anterior regions was noted.
A 12.5-year-old dog was presented for severe periodontal disease and bilateral maxillary enlargement. Radiographs of the maxilla showedgeneralized root resorption, ankylosis, and rarefaction of bone with focal radiodense areas. Surgical tooth extraction of multiple maxillary teeth and bilateral incisional biopsies of the periodontal tissue and maxilla in the region of the maxillary fourth premolars were performed. Histopathologic examination showed features typical of fully differentiated periodontal ligament with abundant cementum/alveolar lining bone and sparce odontogenic epithelial cell rests. Histopathology in conjunction with radiographic and clinical signs suggested a diagnosis of bilateral periodontal ligament hamartoma. Examination 3-months postoperatively indicated uncomplicated healing of the extraction and biopsy sites with no resolution of the maxillary enlargement.
Over a period of 4-1/2 years, patients having model cast dentures that had been inserted in the dental office were checked and submitted to follow-ups. It became evident that the socalled pre-prosthetical measures had been performed in a non-satisfying manner. In 69% of the patients, teeth had been extracted directly before inserting the model cast denture. As a result thereof, a majority of the dentures was sagging after a relatively short time and 70% of the dentures revealed non-occlusion in the final follow-up. 47% of the dentures had to be modified because of necessary tooth extractions, thereby reducing the original number of abutment teeth by 19%. About a third of the inserted model cast dentures showed gross deficiences, the percentage of socalled "collar" constructions was relatively high.