50 research outputs found
Periodontal considerations during orthodontic intrusion and extrusion in healthy and reduced periodontium.
In patients with advanced periodontal disease, pathological tooth migration may occur, which may require subsequent orthodontic treatment for both aesthetic and functional purposes. When planning orthodontic treatment mechanics, intrusive or extrusive forces are frequently indicated. Understanding tissue reactions during these movements is essential for clinicians when devising a comprehensive orthodontic-periodontal treatment plan. This knowledge enables clinicians to be fully aware of and account for the potential effects on the surrounding tissues. The majority of our understanding regarding the behavior of periodontal tissues in both healthy and compromised periodontal conditions is derived from animal studies. These studies offer the advantage of conducting histological and other assessments that would not be feasible in human research. Human studies are nevertheless invaluable in being able to understand the clinically relevant response elicited by the periodontal tissues following orthodontic tooth movement. Animal and human data show that in dentitions with reduced periodontal support, orthodontic intrusion of the teeth does not induce periodontal damage, provided the periodontal tissues do not have inflammation and plaque control with excellent oral hygiene is maintained. On the contrary, when inflammation is not fully controlled, orthodontic intrusion may accelerate the progression of periodontal destruction, with bacterial plaque remnants being displaced subgingivally, leading to further loss of attachment. Orthodontic extrusion, on the other hand, does not seem to cause further periodontal breakdown in dentitions with reduced periodontal support, even in cases with deficient plaque control. This is attributed to the nature of the tooth movement, which directs any plaque remnants coronally (supragingivally), reducing the risk of adverse effects on the periodontal tissues. This specific type of tooth movement can be leveraged to benefit periodontal conditions by facilitating the regeneration of lost hard and soft periodontal tissues in a coronal direction. As a result, orthodontic extrusion can be employed in implant site development, offering an advantageous alternative to more invasive surgical procedures like bone grafting. Regardless of the tooth movement prescribed, when periodontal involvement is present, it is essential to prioritize periodontal therapy before commencing orthodontic treatment. Adequate plaque control is also imperative for successful outcomes. Additionally, utilizing light orthodontic forces is advisable to achieve efficient tooth movement while minimizing the risk of adverse effects, notably root resorption. By adhering to these principles, a more favorable and effective combined orthodontic-periodontal approach can be ensured. The present article describes indications, mechanisms, side effects, and histological and clinical evidence supporting orthodontic extrusion and intrusion in intact and reduced periodontal conditions
Periodontal outcome of buccally impacted maxillary canines after orthodontic traction following closed eruption technique
치의학과/석사The aim of this investigation was to evaluate the periodontal status of the buccally impacted maxillary canines after orthodontic traction following closed eruption technique by clinical and radiographic methods and to investigate pre-treatment orthodontic variables affecting the periodontal changes. 54 patients (21 males and 33 females) having one maxillary canine in a buccally impacted position was choosed (impaction group) and a contralateral canine in a normal position served as a control group. Probing depth, bone probing depth, keratinized gingiva width, attached gingiva width, clinical crown length, distance from cemento-enamel junction (CEJ) to alveolar crest (AC) and bone support were measured at 1.4 months after the end of treatment. The following results were observed.1. Probing depth on midbuccal and mesiolingual sides was significant increased in the impaction group (mean difference 0.20 mm, 0.25 mm, respectively, P <0.05). Bone probing depth on mesiolingual and distolingual sides was increased in the impaction group than the control group (mean difference 0.24 mm, 0.48 mm, respectively, P < 0.05).2. The attached gingiva width was significant shorter in the impaction group compared to the control group (mean difference 0.62 mm,P < 0.01). The buccal clinical crown length was longer on the impaction group than the control group (mean difference 1.12 mm, P < 0.001).3. The distance from CEJ to AC was significant longer in the impaction group on mesial and distal sides compared to the control group (mean difference 0.89 mm, 0.82 mm, P < 0.001). There were significant smaller bone supports at mesial and distal sides in impaction group compared to control group (mean difference 7.30%, 8.80%, P < 0.001).4. If the impacted canine was localized at the more mesial angulation (to the horizontal) and the deeper from occlusal plane at the beginning of treatment, the distance from CEJ to AC on distal side was increased significantly at the end of treatment (P < 0.01). These results revealed that forced eruption of the maxillary impacted canine after orthodontic traction following closed eruption technique, resulted in significant gingival recession on the buccal side and alveolar bone loss on the interproximal sides. Initial intraosseous position and the inclination of impacted canine were related with the periodontal changes.ope
Periodontal outcome of buccally impacted maxillary canines after orthodontic traction following closed eruption technique
치의학과/석사The aim of this investigation was to evaluate the periodontal status of the buccally impacted maxillary canines after orthodontic traction following closed eruption technique by clinical and radiographic methods and to investigate pre-treatment orthodontic variables affecting the periodontal changes. 54 patients (21 males and 33 females) having one maxillary canine in a buccally impacted position was choosed (impaction group) and a contralateral canine in a normal position served as a control group. Probing depth, bone probing depth, keratinized gingiva width, attached gingiva width, clinical crown length, distance from cemento-enamel junction (CEJ) to alveolar crest (AC) and bone support were measured at 1.4 months after the end of treatment. The following results were observed.1. Probing depth on midbuccal and mesiolingual sides was significant increased in the impaction group (mean difference 0.20 mm, 0.25 mm, respectively, P <0.05). Bone probing depth on mesiolingual and distolingual sides was increased in the impaction group than the control group (mean difference 0.24 mm, 0.48 mm, respectively, P < 0.05).2. The attached gingiva width was significant shorter in the impaction group compared to the control group (mean difference 0.62 mm,P < 0.01). The buccal clinical crown length was longer on the impaction group than the control group (mean difference 1.12 mm, P < 0.001).3. The distance from CEJ to AC was significant longer in the impaction group on mesial and distal sides compared to the control group (mean difference 0.89 mm, 0.82 mm, P < 0.001). There were significant smaller bone supports at mesial and distal sides in impaction group compared to control group (mean difference 7.30%, 8.80%, P < 0.001).4. If the impacted canine was localized at the more mesial angulation (to the horizontal) and the deeper from occlusal plane at the beginning of treatment, the distance from CEJ to AC on distal side was increased significantly at the end of treatment (P < 0.01). These results revealed that forced eruption of the maxillary impacted canine after orthodontic traction following closed eruption technique, resulted in significant gingival recession on the buccal side and alveolar bone loss on the interproximal sides. Initial intraosseous position and the inclination of impacted canine were related with the periodontal changes.ope
A Novel Decisionâ Making Process for Tooth Retention or Extraction
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141780/1/jper0476.pd
Pathogenesis and Treatment of Periodontitis
Pathogenesis and Treatment of Periodontitis includes comprehensive reviews on etiopathogenic factors of periodontal tissue destruction related to microbial dental plaque and also host response components. Adjunctive treatment modalities are also addressed in the book. Topics covered range from microbial pathogenic factors of P. gingivalis to the relationship between metabolic syndrome and periodontal disease, and from management of open gingival embrasures to laser application in periodontal treatment
A CBCT evaluation of root position within bone, long axis inclination, and the WALA Ridge
Background and Objectives: Correct tooth position in all planes of space while respecting the boundaries of the underlying bone has been proposed as a necessary hallmark to providing a foundation of stability for the teeth as well as the supporting periodontium. The aim of this study was to determine 1) If teeth centeredness over basal bone improves when teeth are more upright or approach WALA Ridge norms 2) If teeth centeredness in alveolar bone improves when teeth are more upright or approach WALA Ridge norms 3) If the WALA ridge is located at or near the estimated center of resistance of molar and premolar teeth. Methods: 34 pre-treatment CBCT and mandibular cast samples of patients ages 12-18 were randomly selected and analyzed. WALA ridge cast measurements were transferred to CBCT images. The centeredness of the teeth within bone was then quantified. The WALA Ridge location was measured and compared to the center of resistance location. Results: 1) No statistical significance was found across the board for centeredness of teeth over basal bone when they are more upright or approach WALA Ridge norms. 2) No statistical significance was found across the board for centeredness of teeth in alveolar bone when they are more upright or approach WALA Ridge norms. 3)Statistical significance (p-value \u3c.05) was found for the center of resistance and WALA Ridge being located at or near each other for all mandibular posterior teeth. 4) Statistical significance (p-value \u3c.05) was found for posterior teeth center of resistance being centered in the alveolar bone regardless of the long axis inclination or WALA Ridge norms. Conclusion: 1) More upright posterior teeth based on long axis inclination or teeth more closely related to the WALA ridge landmark are not more centered over basal bone. 2) More upright posterior teeth based on long axis inclination or teeth more closely related to the WALA ridge landmark are not more centered in alveolar bone. 3) The WALA Ridge soft tissue landmark is located at or near the center of resistance for all posterior teeth. 4) The center of resistance of all posterior teeth can most often be found in the center of the alveolar bone regardless of inclination
Periodontology
This Edited Volume Periodontology - Fundamentals and Clinical Features is a collection of reviewed and relevant research chapters, offering a comprehensive overview of recent developments in the field. The book comprises single chapters authored by various researchers and edited by an expert active in the dental medicine research area. All chapters are complete in themselves but united under a common research study topic. This publication aims at providing a thorough overview of the latest research efforts by international authors in periodontology, and opening new possible research paths for further novel developments
The effect of platelet rich fibrin (PRF) on inter-proximal papillary height around dental implants
The original study design called for twenty patients. Fourteen patients with 13 implants have thus far been recruited for a prospective proof of principle study to assess the effect of addition of Platelet Rich Fibrin (PRF) on interproximal papillary height (I.P.H.) at the restorative line angles when used during the second stage uncovering procedure for dental implants. The secondary objective of this study was to assess the effect on the height of the direct interproximal tissue thickness (I.T.T.) at 6 weeks following uncovering. Implants placed 3 or more months prior at Boston University School of Dental Medicine Periodontics Department were scheduled to be uncovered by the principal investigator. Second stage uncovering was performed with a conventional mid-crestal incision to place standard healing abutments. PRF membrane(s) were inserted around the implants before flap closure in an attempt to augment or thicken the interproximal papillary area. The I.P.H. was measured at the four line angles of each abutment at the highest aspect of the interproximal tissue immediately following the uncovering procedure and at 2, 4 & 6 week intervals. I.T.T. was also measured prior to surgical exposure and at 6 weeks following the uncovering procedure. Results: The use of PRF membranes around dental implants did not significantly improve I.P.H. However, a positive correlation was observed between the use of P.R.F and I.T.T. Further studies are warranted to assess the effect of PRF on the peri-implant papillary tissue