1/7. Furcation involvement in posterior teeth.This article presents two cases in which different treatments were used for mandibular molars with furcation lesions. In the first case, a conventional amputation treatment of the distal root was performed to save the mesial root as a terminal tooth, which was used as a partial denture abutment. The second case describes a relatively new technique in which a root perforation was filled with graft material (synthetic bioglass) and covered with a resorbable membrane to treat an iatrogenic furcation lesion adjacent to the mesial root. Twelve months after surgery, periapical radiographs of both treated cases showed increased bone density. Follow-up in both cases--30 months in the first case and 12 months in the second--showed no pathological recurrence or clinical dysfunction. Root amputation may provide an alternative to extraction in periodontally involved molars. Synthetic bone replacement materials combined with guided tissue regeneration may also help to correct osseous defects incurred by recent furcation perforations with associated bone loss.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/7. Periodontal regeneration of a class II furcation defect utilizing a bioabsorbable barrier in a human. A case study with histology.This case report describes human histologic data of periodontal regeneration following guided tissue regeneration therapy (GTR) with a bioabsorbable barrier composed of polylactic acid. The tooth that was examined was part of a previously published study of the clinical effects of GTR therapy without the use of bone or bone substitutes on Class II furcation defects. Twenty-five months following the surgical procedure, the tooth was extracted for non-periodontal reasons. During this extraction, the bone within the furcation that was treated in the study was luxated with the tooth. At the completion of the study (month 12), the furcation's vertical probing depth had decreased by 2 mm with a 2 mm gain in clinical attachment. The horizontal furcation measurement decreased by 3 mm. Following extraction, the tooth was prepared for light microscopy and sectioned in the mesial-distal plane. Reference notches were not placed in the tooth at the time of surgery as there were no plans to perform histologic analysis in the study. However, using the buccal root prominences and what we interpreted to be root planing marks on the cementum, we were able to demonstrate that complete periodontal regeneration occurred on the root surface that was exposed to the pocket environment prior to surgery. New alveolar bone, cementum, and periodontal ligament were consistently observed throughout the furcation in the areas that demonstrated clinical attachment gain and a decrease in horizontal probing depth. This case report adds to the accumulating evidence of histologic periodontal regeneration following guided tissue regeneration with bioabsorbable polylactic acid barriers.- - - - - - - - - - ranking = 2keywords = extraction (Clic here for more details about this article) |
3/7. Treatment of intrabony defects associated with interradicular root proximity/fusion in molar furcations.To treat furcation involvement is a crucial challenge to periodontists, not only because of the limitation in pocket reduction by osteoplasty and apically positioned flap, but also because of the unpredictability in regenerative approaches. Therefore, if the first molar is absent and the second molar has to be retained strategically for prosthetic reasons, very few alternatives besides nonsurgical/surgical debridement can be taken in treating the furcation of the second molar, where the interradicular root proximity and fusion frequently occur. On the other hand, root amputation/hemisection has long been considered a contraindication in treating furcations with two close roots; however, this impression is only empirical. A series of clinical cases involved in the treatment of intrabony defects associated with interradicular root proximity and fusion by root amputation/hemisection has been reported. Without any help of regenerative material, thorough root debridement and pocket reduction were attained. Based on these cases, we suggested that the cut surface created by odontoplasty during root amputation was compatible for periodontal healing and the extraction socket provided striking potential for defect repair. We re-examined the clinical feasibility and benefit of treating intrabony defects associated with interradicular root proximity and fusion in molar furcations by root amputation/hemisection, and suggested that its role should be favorably reconsidered on case basis. The short-term success in periodontal and prosthetic aspects needed to be further evaluated at long-term follow-up.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/7. Progressive, generalized, apical idiopathic root resorption and hypercementosis.BACKGROUND: root resorption is a multifactorial process that results in loss of tooth structure. The causes of root resorption may vary, leading to several types of resorptions. Some factors have been identified and may be categorized into physiological resorption, local factors, systemic conditions, and idiopathic resorptions. The objective of this report was to present a case of a 17-year-old white female with progressive, generalized, apical idiopathic root resorption followed up for 34 months. methods: Two panoramic radiographs, 14 and 34 months after initial clinical and radiological examinations, showed the rapid progression of apical root resorption. Two molars, teeth #15 and #16, which had to be extracted, and a bone sample from the distal aspect of tooth #15 were processed for histologic analysis. RESULTS: Two millimeters apical to the cemento-enamel junction, an abrupt increase in the cementum thickness was noted, amounting to 300 and 800 microm in teeth #15 and #16, respectively. The thickening of the cementum layer was due to an accelerated deposition of cellular intrinsic fiber cementum. An unusually high number of mineralization foci were observed in association with acellular extrinsic fiber cementum, and both free and fused cementicles were seen. In contrast to tooth #16, tooth #15 revealed extensive dentin replacement by a bone-like and a cementum-like tissue. Furthermore, ankylosis was demonstrated in tooth #15 and confirmed in the bone sample. CONCLUSIONS: At present, there is no preventive or therapeutic regimen for the type of root resorption seen in this case report. Treatment usually consists of the extraction of teeth with advanced lesions.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
5/7. Periodontal therapy in siblings with Papillon-Lefevre syndrome and tinea capitis: a report of two cases.OBJECTIVE: Report of clinical and microbiological periodontal findings before and 6 months after treatment of two siblings with Papillon-Lefevre syndrome (PLS) and tinea capitis. methods: Two brothers, RG 3 years and NG 5 years of age, were referred for treatment due to premature mobility of their deciduous teeth. Probing depths (PPD), attachment levels (PAL-V), and furcation involvements were examined clinically. Panoramic radiographs were taken. Subgingival plaque samples within the deepest pocket of each tooth were taken and analysed by real-time polymerase chain reaction (PCR) for actinobacillus actinomycetemcomitans (AA), porphyromonas gingivalis, Tannerella forsythensis, treponema denticola, fusobacterium nucleatum, and prevotella intermedia. One-stage full-mouth scaling and extraction of hopeless teeth were performed under general anaesthesia, followed by systemic amoxicillin and metronidazole for 7 days. Clinical and microbiological analyses were performed 6 months after treatment. RESULTS: Before treatment, both siblings had exhibited PPD of up to 13 mm, Class III furcation defects at four teeth, and marginal suppuration. AA was detected in both patients and at all teeth at levels ranging from 3.0 x 10(2) to 5.1 x 10(6). Both patients exhibited palmar and plantar hyperkeratosis. Seven teeth were extracted from RG, and nine from NG. Six months after treatment, PPD had been reduced to- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
6/7. Intentional replantation for iatrogenic perforation of the furcation: a case report.Intentional replantation is an accepted endodontic procedure for treatment of teeth in which conventional surgical endodontic treatment is contraindicated. This article presents a rare case of intentional replantation of a mandibular molar that had severe periodontal destruction resulting from iatrogenic perforation of the furcation. A 17-month follow-up evaluation revealed an asymptomatic and functional tooth with no radiographic signs of pathosis. The favorable results obtained might be attributed to the preservation of the vitality of the periodontal ligament; the absence of damaging pressure during extraction; the minimal extraoral treatment time; the use of nonrigid splinting; and the immediate repair of the perforation during a one-visit endodontic procedure. The results obtained with this tooth may indicate the possibility of a successful surgical technique for this otherwise hopeless complication of endodontic therapy.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
7/7. The buccal bifurcation cyst: in non-surgical treatment an option?The mandibular buccal bifurcation cyst (BBC) was first described by Stoneman and Worth in 1983. It is a lesion with a specific location, classically the buccal surface of the mandibular first molar and less frequently the mandibular second molar. There have been numerous reports in the literature describing the BBC and its treatment. Treatment advocated thus far includes extraction of the involved first molar, marsupialization and enucleation of the cyst. In their most recent article, Pompura, Sandor and Stoneman reported on the successful treatment of 44 cysts with enucleation without tooth extraction. This article will describe the diagnostic features of the BBC and present three cases with a total of five cysts, which were treated non-surgically and ultimately resolved. The authors, therefore, propose that a more conservative non-surgical approach to these lesions may be considered.- - - - - - - - - - ranking = 2keywords = extraction (Clic here for more details about this article) |