The ımpact of handicap severity on oral and periodontal status of patients with mental retardation

Aim: Mental retardation (MR) subjects comprise a considerable amount of the community and are susceptible to oral and periodontal problems due to insufficient oral care. The aim of this cross-sectional study was to determine the oral health and periodontal status of MR patients in Turkey with regard to periodontal indices and Decay missed filling teeth (DMFT) scores and compare findings according to severity of the MR. Materials and methods: One hundred and five MR patients were included to the study and divided into 3 groups according to MR severity diagnoses. Demographic variables like age, gender, disabled sibling, BMI, living an institution and clinical parameters like plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), missing teeth and DMFT scores were recorded from all subjects. Appropriate statistical analyses were used to compare the findings. Results: There were no statistically significant differences between groups according to age, gender, disabled sibling, living status and DMFT scores. Clinical periodontal indices and the number of missing teeth were showed a statistically significant increasing trend with the severity of MR (p < 0.05). Correlation analysis showed significant positive correlations between PI and periodontal disease measures like GI, PD, CAL and BOP and also between PI and DMFT (p < 0.05). Conclusion: The deteriorated teeth condition and deprived periodontal health of MR patients may be most likely caused by the poor oral hygiene and may be worsen with the severity of the MR

Assessment of Radiodensity at Mandibular Periapical Bone Sites using Three-Dimensional Cone-Beam Computed Tomography

Objectives: The aims of this retrospective study were to objectively assess bone density values obtained by cone-beam computed tomography and to map the periapical and inter-radicular regions of the mandibular bone. Material and Methods: In total, periapical bone regions of 6898 roots scanned by cone-beam computed tomography were evaluated retrospectively, and the results were recorded using Hounsfield units (HU). Results: The correlation between periapical HU values of adjacent mandibular teeth were strongly positive (P ˂ 0.01). The anterior region of the mandible yielded highest mean HU value (633.55). The mean periapical HU value of the premolar region (470.58) was higher than that was measured for molar region (374.58). The difference between furcation HU values of the first and second molars was unnoticeable. Conclusions: The results of this study have tried to evaluate the periapical regions of all mandibular teeth, which could ease to predict the bone radiodensity before implant surgery. Even though the Hounsfield units provide the average radio-bone density, a site-specific bone tissue evaluation of each case is essential for appropriate cone-beam computed tomography preoperative planning

Morphological Classification of Extraction Sockets and Clinical Decision Tree for Socket Preservation/Augmentation after Tooth Extraction

Objectives The aim of present study was to review current literature concerning extraction socket classification immediately following tooth extraction and the rationales for socket preservation/augmentation procedures and with reference to it suggest novel clinical decision tree for extraction socket preservation/augmentation in aesthetic and non-aesthetic area. Material and Methods The search protocol used the electronic MEDLINE (PubMed) and EMBASE databases for articles published between January 1 2009 and May 1 2019. The search included only human studies published in English. Outcomes were the indications and reasons for socket preservation/augmentation and classification of extraction sockets. Results Ten studies fulfilled the inclusion criteria and were selected for the study. Although there are various types of extraction socket classifications none of them could completely evaluate all morphological parameters of alveolar ridge. Furthermore, present study revealed that indications for extraction socket preservation/augmentation have wider spectrum than socket morphology and are related to surrounding tissue anatomy or dental implantation operation indications and timing. Based on currently proposed extraction socket classifications and rationales, a novel decision tree for extraction socket preservation/augmentation immediately after tooth extraction in aesthetic and non-aesthetic area was suggested. Conclusions The need of extraction socket preservation/augmentation immediately after tooth extraction should be determined by the aesthetic, functional and risk-related viewpoint. A novel clinical decision tree for extraction socket preservation/augmentation immediately after tooth extraction in aesthetic and non-aesthetic zones can be useful tool in socket preservation/augmentation procedures.PubMe

Effects of Crest Morphology on Lingual Concavity in Mandibular Molar Region: an Observational Study

Objectives: The aim of this radiological study is to evaluate the lingual concavity dimensions and possible implant length in each posterior tooth region according to posterior crest type classification by using cone-beam computed tomography. Material and Methods: According to inclusion criteria, 836 molar teeth regions from 209 cone-beam computed tomography images were evaluated. Posterior crest type (concave, parallel, or convex), possible implant length, lingual concavity angle, width, and depth were recorded. Results: In each posterior tooth region, concave (U-type) crest was detected most frequently while convex (C-type) was the lowest. Possible implant length values were higher in second molar regions than first molars. Lingual concavity width and depth were decreasing from second molars to first molars for both sides. Additionally, lingual concavity angle showed higher values in second molar sites than first molars. In all molar teeth regions, lingual concavity width values were the highest in concave (U-type) crest type while they were the lowest in convex (C-type) crest type (P < 0.05). Lingual concavity angle values were recorded as the highest in concave (U-type) and the lowest in convex (C-type) crest type at the left first molar and right molars (P < 0.05). Conclusions: The lingual concavity dimensions and possible implant length may vary according to crest type and edentulous tooth region. Due to this effect, the surgeons should examine crest type clinically and radiologically. All parameters in the present study are decreasing while moving from anterior to posterior as well as from concave (U-type) to convex (C-type) morphologies

Vertical and horizontal dimensional evaluation of free gingival grafts in the anterior mandible: a case report series

The shrinkage of free gingival grafts ( FGGs) is a well-known clinical phenomenon but there are limited studies demonstrating the dimensional changes during healing in FGGs. The aim of the study is to examine the shrinkage of FGG in both horizontal and vertical dimensions and calculate the changes in the surface area of the graft at early and delayed periods of healing. The FGG procedure was applied to 15 consecutive patients in their mandibular anterior area. The graft sizes and areas were measured and the shrinkage of the graft was calculated at baseline and days 10, 21 and 180. Hemorrhage, sense alteration and pain symptoms were also examined. Change in the horizontal direction was not statistically significant during the whole study period ( p> 0.05). However, there was a statistically significant reduction in the vertical direction in all visits, except day 10 ( p< 0.05). Calculated graft area was also significantly reduced during the study period at all time-points compared to the baseline ( p< 0.001). At day 10, 4 (26.7%) recipient sites and 5 (33%) donor sites demonstrated paresthesia. Only one ( 0.07%) recipient site demonstrated paresthesia at day 21 where the donor site resulted with an uneventful healing. At day 10, 5 ( 33%) patients demonstrated bleeding at their donor regions and resulted with a complete cessation of bleeding at day 21. Pain symptom was found in 8 (53.3%) recipient sites where 3 (20%) donor regions presented pain symptom at day 10. Graft shrinkage in the vertical dimension seems to affect the clinical outcomes of the FGG procedure. However, the influence of horizontal graft shrinkage was minimal

Treatment of gingival recession: Comparison of two techniques of subepithelial connective tissue graft

Background: The increasing interest in esthetics and the subsequent need to solve related problems such as hypersensitivity and root caries have favored the development of many surgical procedures that permit the coverage of exposed roots. This clinical study was conducted to examine the coverage of gingival recession defects, where two different subepithelial connective tissue graft (SCTG) techniques (Langer and Langer and modified tunnel) were used