1/8. Periodontal treatment of rapid progressive periodontitis in 2 siblings with Papillon-Lefevre syndrome: 15-year follow-up.AIMS: This paper reports the treatment of the periodontal component of the Papillon-Lefevre syndrome in 2 siblings (case A, born 1974; case B, born 1976). METHOD: The initial treatment, in 1982, consisted of extraction of all primary teeth, scaling and rootplaning of the erupted permanent teeth and systemic antibiotic therapy. During 15 years, continuous and intensive periodontal treatment consisted of chlorhexidine 0.2% rinses, bi-weekly professional prophylaxis, scaling and rootplaning or surgery if indicated. Systemic antibiotics often accompanied mechanical therapy after bacteriological analysis. RESULTS: In case A, a favourable number of permanent teeth could be maintained, but in case B, all permanent teeth were lost in spite of the intensive treatment. Darkfield microscopy at different intervals revealed high numbers of spirochetes and motile rods in both siblings. Only in case A were they temporarily reduced to zero after scaling and rootplaning combined with metronidazole. Anaerobic cultering revealed high numbers of actinobacillus actinomycetemcomitans (A.a) in both patients. In 1994, 2 years after combined amoxicillin/metronidazole therapy, no A.a could be detected in case A. In case B, A.a could still be detected and was found to be resistant to metronidazole. One year after extraction of all permanent teeth, could no A.a be detected in case B. CONCLUSION: Intensive periodontal treatment combined with antibiotic therapy was not able to prevent complete tooth loss in case B. In case A, the treatment was more effective, resulting in preserving a number of permanent teeth in a stable clinical situation. In these 2 cases, no attempt was made to create an edentulous period between the periodontally-diseased mixed dentition and the eruption of the remaining teeth, which may have contributed to treatment failure.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/8. Achieving and maintaining periodontal health and esthetics following the extraction of a central incisor.Both cases presented here involved an anterior extraction. Such cases can be very frustrating for both dentist and patient but success can be attained through good communication, attention to all details, and expert periodontic and laboratory support.- - - - - - - - - - ranking = 2.5keywords = extraction (Clic here for more details about this article) |
3/8. Localized edentulous ridge augmentation with upside down osteotomy prior to implant placement.Localized bone defects may be seen following the extraction of teeth with periapical lesion or advanced periodontal disease, or as a result of trauma. When these regions are considered for treatment with implants, localized ridge augmentation will be necessary. Autogenous bone grafts are used exclusively for ridge augmentation. This case report represents the treatment of a localized edentulous ridge with an upside down osteotomy technique at the symphysis region prior to implant placement. Systemically healthy 21-year-old female patient, who was missing a lower right incisor tooth, was scheduled for an implant treatment. However, the crestal width was only 1 mm. The augmentation was planned and the region was treated with an upside down osteotomy technique. Nine months after the augmentation procedure, the computed tomography (CT) examination of the area revealed that the width of the crest was 7 mm, and the height of the crest was in good relation with the cementoenamel junction of the adjacent teeth. Flipping a bone block graft, which was harvested from the edentulous area, upside down may provide a successful result in partially edentulous ridges, in both maxilla and mandible.- - - - - - - - - - ranking = 0.5keywords = extraction (Clic here for more details about this article) |
4/8. Utilization of third molars in the orthodontic treatment of skeletal class III subjects with severe lateral deviation: case report.AIM: This clinical report discusses the importance and use of third molars in the adult patient by presenting a case in which their use during orthodontic treatment allowed occlusal improvement. SUBJECT AND TREATMENT PLAN: The patient was a Japanese adolescent boy who had a skeletal Class III malocclusion with severe lateral deviation of the mandible, significant loss of posterior occlusal vertical dimension, due to premature loss of the maxillary and mandibular left first molars, and furthermore, both first molars had advanced carious lesions that had resulted in reduced crown heights and bilateral chewing surfaces. The mandible had shifted to the left, with a bilateral chewing pattern and a lack of posterior vertical alveolar height, which in turn had produced an abnormal occlusal plane and curve of Spee. The maxillary arch was expanded, the maxilla was moved downward and forward, and the mandible was moved slightly backward and rotated open to increase posterior vertical alveolar and crown height. The reconstruction of a functional occlusal plane was achieved by uprighting the posterior teeth to correct asymmetric posterior vertical alveolar and crown height, using a full multibracket system incorporating four third molars and closing the space from the missing first molars and extraction of the questionable first molars. RESULTS: A normal overbite and overjet and adequate posterior support and anterior guidance were established, achieving a better intercuspation of the posterior teeth. A favorable perioral environment was created, with widened tongue space to produce an adequate airway. A well-balanced lip profile and almost symmetric face were achieved using the four wisdom teeth without extraction of the four premolars. Subsequent mandibular growth, with development of posterior vertical alveolar height and temporomandibular joint adaptation, has resulted in an almost symmetric posterior vertical height and joint structure between right and left sides. These factors have contributed to the occlusal stability maintained for more than 5 years. CONCLUSION: In the growing patient, with missing and/or early advanced caries of the first molars, it may be more beneficial to plan occlusal improvement through extraction of the questionable first molar rather than premolar extraction. This method of treatment can equalize posterior vertical dimension and does not restrict tongue space. In addition, this treatment method addresses the clinician's concern about postorthopedic relapse due to tongue habits and eruption of the third molars.- - - - - - - - - - ranking = 2keywords = extraction (Clic here for more details about this article) |
5/8. herpes zoster in hiv infection with osteonecrosis of the jaw and tooth exfoliation.BACKGROUND: herpes zoster (HZ) infection of the trigeminal nerve is associated with complications such as postherpetic neuralgia, facial scarring, loss of hearing ability and conjunctivitis. Until 2005, postherpetic alveolar necrosis and spontaneous tooth exfoliation have been described in 20 cases unrelated to hiv infection. OBJECTIVE: The aim of this study was to describe hiv infection in patients (two women, two men, average age 30 years) who suffered from HZ attacks to their trigeminal nerves. MAIN OUTCOME MEASURES: None of the patients had received antiherpetic medications or antiretroviral therapy. hiv infection was only diagnosed after the development of HZ. Facial scarring with depigmentation and hyperesthesia (postherpetic neuralgia) was diagnosed in all four patients. Oral findings consisted of spontaneous loss of both maxillary or mandibular teeth. osteonecrosis of varying extent was also found. Treatment consisted of extractions of teeth and administration of antibiotics and analgesics. Healing of alveolar wounds was unremarkable. CONCLUSION: Complications affecting the alveolar bone and teeth seem to be rare in hiv-infected patients.- - - - - - - - - - ranking = 0.5keywords = extraction (Clic here for more details about this article) |
6/8. Papillon-Lefevre syndrome associated early onset periodontitis: a review and case study.A case of Papillon-Lefevre syndrome that has been managed successfully for six years is reported. Papillon-Lefevre syndrome is a rare form of early onset periodontitis that occurs at a rate of 1-3 per million. Diagnostic features include palmar-plantar hyperkeratosis and rapid periodontal destruction. Although the etiology of this syndrome is unknown, current theories on the nature of the underlying defect fall into three main categories: anatomical, bacterial and host response. Historically, Papillon-Lefevre syndrome was thought to lead to the inevitable loss of both the primary and permanent dentitions. However, a recently proposed treatment involving antibiotic coverage, extraction of the primary dentition and a period of edentulism has been shown to be effective in maintaining the permanent dentition. Since treatment may begin prior to the eruption of the permanent dentition, early recognition of Papillon-Lefevre syndrome is critical. Any young patient who exhibits palmar hyperkeratosis should be examined carefully for periodontal breakdown. Since the number of cases available for study is limited, referral of such individuals to University dental clinics may allow for a more specific analysis of immune or bacterial factors that may lead to a better understanding of this disease.- - - - - - - - - - ranking = 0.5keywords = extraction (Clic here for more details about this article) |
7/8. Autotransplantation of 45 teeth to the upper incisor region in adolescents.Young, growing individuals with one or more upper incisors missing due to trauma, agenesis or extraction of abnormal teeth can be treated with autotransplantation to restore aesthetics and function and to preserve the volume of the alveolar process. Studies have been performed to evaluate the prognosis, indicating a good prognosis, especially if an immature transplant is available, developed to 3/4 of the full root length. The purpose of this study was to analyse the result of all autotransplantation of teeth performed to the upper incisor region between 1979 and 1990 at the Department of Oral Surgery, Eastmaninstitutet, Stockholm, sweden. The material consists of 23 immature and 22 mature teeth in 40 patients with a mean age of 12 years. They were systematically followed up clinically and roentgenologically for up to four years after surgery. 22 of the 23 immature (96%) and 18 of the 22 mature teeth (82%) were observed to be without serious complications. The complications occurred, with one exception, within the first year of observation. The conclusion drawn from this study is that autotransplantation to the upper incisor region can be performed with a good prognosis, both for mature and immature teeth.- - - - - - - - - - ranking = 0.5keywords = extraction (Clic here for more details about this article) |
8/8. Loss of deciduous teeth and germs of permanent incisors in a 4-year-old child. An atypic prepubertal periodontitis? A clinical, microbiological, immunological and ultrastructural study.A 4-year-old child was referred, in April 1988, to Rennes Dental School (france) for deciduous tooth mobility with premature loss of 4 deciduous teeth and germs of 2 permanent incisors. Microbiological examinations by culture revealed the presence of the periodontal pathogen actinobacillus actinomycetemcomitans. Immunofluorescence of plaque samples revealed the presence of porphyromonas gingivalis that had not been isolated by culture. Neutrophil functions were within normal ranges. Transmission electron microscopy of gingiva showed a disorganised epithelium. The connective tissue was infiltrated by inflammatory cells. The basement membranes were normal, but the connective tissue-epithelium interface was mainly composed of short rete pegs. Scanning electron microscopy of extracted deciduous teeth revealed lack of cementum, lacunae in the cementum and lack of fibrillar insertion on the middle part of the root. skin lesions, mainly situated on face, were observed. Treatment was by extraction of mobile deciduous teeth combined with 3-week courses of metronidazole. Clinical and microbiological follow-up was continued over a 7-year period. No periodontal lesions have been detected since eruption of the permanent teeth. The present subgingival and lingual microflora (December 1995) is composed of bacteria associated with periodontal health. However, the future appearance of a hitherto undetected systemic disease is still possible.- - - - - - - - - - ranking = 0.5keywords = extraction (Clic here for more details about this article) |