Cases reported "Periodontal Pocket"

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1/10. Successful periodontal maintenance of a case with Papillon-Lefevre syndrome: 12-year follow-up and review of the literature.

    BACKGROUND: Various approaches to treating the periodontal condition associated with Papillon-Lefevre syndrome have been reported. These include oral hygiene instruction, use of mouthrinses, frequent debridement, multiple antibiotic regimens, periodontal surgery, extraction of hopeless teeth, and extraction of all deciduous teeth. Because Papillon-Lefevre syndrome is rare, most publications are case reports, and very few document long-term successful treatment of the periodontal condition. methods: In 1986, a 3.5-year-old Indo-Canadian male was diagnosed with Papillon-Lefevre syndrome and began periodontal treatment. Initial therapy consisted of debridement every 3 weeks, a 0.12% chlorhexidine mouthrinse, 2 regimens of metronidazole, and oral hygiene instruction for his parents. After 10 months it became apparent that the treatment was having little beneficial effect, since the periodontal destruction continued and teeth 51 and 61 exfoliated. At age 4, all remaining deciduous teeth were extracted and complete dentures inserted for the following 2-year edentulous period; then a 3-month maintenance schedule was maintained. RESULTS: The patient is now 17 years old and all his adult teeth are present with the exception of the third molars. His oral hygiene varies between moderate and good, with his most recent plaque score at 80% effectiveness. There are no probing depths greater than 4 mm, with the exception of the distal of the lower second molars where opercula are present. CONCLUSIONS: Extraction of all the deciduous teeth followed by a period of edentulousness may partially explain the fact that there has been no recurrent attachment loss in the permanent teeth up to age 17. Other explanations are discussed as part of the literature review of Papillon-Lefevre syndrome.
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2/10. Unusual surgical approach in a bilateral case of mandibular buccal infected cyst.

    In the new edition of WHO's "Histological typing of odontogenic tumors", the mandibular infected buccal cyst, that is associated with the lower first or second permanent molars, is considered a paradental cyst as well as the inflammatory collateral cyst, which is usually related to the lower third molar. The lesion occurs on the buccal and lateral aspects of the roots of mandibular molars with vital pulp, at the eruption time, in children aged between 6 and 10 years. The inflammation is always present in these cysts and may have an important role in their pathogenesis because it stimulates hyperplasia and cystic change of the reduced enamel epithelium or the epithelial cell rests of Malassez. The authors report the case of a 7-year-old girl, in whom both first mandibular molars were affected by an infected buccal cyst. A different surgical approach was performed with marsupialization on the left side and cystectomy on the right side. The case reported here seems to be interesting because it is the second well documented case of bilateral mandibular infected cyst associated with unerupted molars and because the adopted treatment differs from the therapeutical approach suggested in the literature. A 6-year follow-up demonstrates a correct dental and bone evolution on both mandibular molar sides.
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3/10. Management of an implant case that required retreatment: a case report.

    The presented case represents how the lack of a preoperative panoramic radiograph or any radiograph contributed to incorrect case planning, poor implant selection, and the careless surgical placement of an implant into or dangerously close to the lower left mental foramen, resulting in a paresthesia of 9 months duration. Two implants were surgically removed and the bone defects were grafted with a mixture of irradiated cancellous bone plus Biogran. One implant was sectioned and intentionally "put to sleep." The case was successfully completed with a lower bar overdenture supported by 4 screw implants placed in alternate sites, opposing a custom fabricated maxillary denture with a lingualized occlusal scheme.
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4/10. Laser irradiation inhibition of open gingival embrasure space after orthodontic treatment.

    The purpose of this study was to investigate the inhibitory effect of low-energy laser irradiation on an incidence of open gingival embrasure space after orthodontic treatment. The patient was a 20-year, 7-month-old Japanese female with an Angle Class I malocclusion and crowding in the mandible. Treatment consisted of extraction of maxillary and mandibular first premolars and use of the Edgewise technique. A Ga-Al-As diode laser was used to irradiate an area of 0.5 cm2 at the labial and lingual gingival papilla between the canines. The time of exposure was 6 minutes for 3 days, carried out between the relevelling and en masse stages of movement. The total energy corresponding to 6 minutes of exposure varied from 1.90 J/cm2. There was no further evidence of open gingival embrasure space, except at the mandibular central incisor. Further: an improvement in the gingival inflammation caused by a periodontal disease was observed, and periodontal pocket depth was maintained. These results suggest that low-energy laser irradiation may inhibit the incidence of open gingival embrasure space after orthodontic treatment.
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ranking = 353.09912504997
keywords = mandible
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5/10. The development of osteoradionecrosis from sites of periodontal disease activity: report of 3 cases.

    osteoradionecrosis may develop following radiation therapy that involves bone, and most particularly following treatment of cancers within the head and neck. The mandible is at greatest risk of osteoradionecrosis because of the nature of its blood supply and its dense bone configuration. This paper describes 3 cases which demonstrate the development of osteoradionecrosis in the mandible from sites of periodontal disease activity following external beam radiotherapy. The pathogenesis of these events is reviewed, and recommendations for their management are discussed. A proposal for the use of chlorhexidine digluconate and hyperbaric oxygen in the periodontal management of this condition is outlined.
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ranking = 706.19825009993
keywords = mandible
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6/10. paresthesia of the inferior alveolar nerve caused by periodontal-endodontic pathosis.

    paresthesia, one of the more common complaints involving sensory disturbances, can be attributed to various causes. A case is reported in which paresthesia of the right lower buccal gingiva and lip occurred as a result of combined endodontic-periodontal pathosis associated with the right mandibular first molar.
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7/10. Treatment of compromised teeth: a multidisciplinary approach.

    Treatment for uprighted abutment teeth that may have infrabony pockets can be considered complete when the following criteria are met: 1. The uprighted tooth is in its proper vertical axis. 2. There is a significant decrease in soft-tissue pocket depth. 3. Crestal leveling is evident radiographically. 4. Adequate space has been created to accommodate a pontic (minimally 6.5mm). The advantages of employing this orthodontic-periodontal technique are as follows: 1. Leveling of the osseous crest fosters pocket elimination obviating the necessity for removal of a great deal of supporting bone. Concomitantly, a significant decrease in pocket depth usually eliminated the need for periodontal surgery. 2. The resulting occlusal forces are placed in favorable axial inclinations. 3. There is an improved crown-to-root ratio, since the uprighted and extruded tooth is reduced to the level of the occlusal plane. This reduction is sufficient to improve considerably the prognosis of a questionable abutment tooth. 4. A pontic space is created for an esthetic and properly contoured pontic. 5. Parallelism is attained, so that the marginal integrity is more easily accomplished. 6. The orthodontic procedures are relatively uncomplicated, efficient, and esthetic, provided there is little or no lower anterior crowding. 7. The restorative dentist has a proper abutment tooth with a good prognosis for prosthesis.
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8/10. eosinophilic granuloma of the mandible involving the periodontal tissues. A case report.

    This case reports on a 14-year-old boy with multiple radiolucent lesions widely distributed in the mandible, particularly in the right side (body-angle-ascending ramus). The lesion was first diagnosed as early-onset periodontitis and treated accordingly. It continued to grow very quickly, however, over a 6-month period, resulting in involvement of the entire mandible, with complete destruction of the lingual cortical bone, erosion of the external cortex with expansion in the neighboring soft tissues, and with a periosteal reaction in some areas. This case may serve to illustrate the rapid progress of eosinophilic granuloma, the importance and the difficulties of an early diagnosis, and the consequences of late diagnosis and treatment.
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ranking = 2118.5947502998
keywords = mandible
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9/10. Mandibular cementifying fibroma in relation to a large periodontal bone defect. Report of a case.

    A cementifying fibroma associated with a large intraosseous periodontal defect is reported. This tumor was located in the lingual aspect of the first lower left molar. Therapy consisted on flap surgery, tumor excision, and placement of a bone autograft in order to fill the residual bone defect. Six months after the treatment, clinical and radiographic signs of periodontal regeneration were evidenced.
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10/10. Periodontal infection leading to periostitis ossificans ("Garre's osteomyelitis") of the mandible. Report of a case.

    periostitis ossifications ("Garre's osteomyelitis") of the mandible is a rather rare pathology that occurs as a hard swelling at the mandibular angle, persists for a long period, and is mostly painful on palpation. Clinical signs of infection are rarely noted. The etiological factor is generally a carious first permanent molar with a periapical infection or a fracture of the jaw. In this case, a 10 year-old girl showed a fixed painful swelling of the right mandibular angle. This revealed to be periostitis ossificans, although none of the classical causes were present. The symptoms were evoked by a periodontal infection: there was an osseous crater and a probing pocket depth of more than 10 mm disto-lingually of the first right permanent molar of the mandible. This was likely the etiological factor. Extraction of the first and second permanent right molar, curettage of the corresponding alveoli, and antibiotic treatment resulted in complete healing, clinically and radiologically, after 9 months.
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keywords = mandible
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