RESUMEN
Food impaction occasionally occurs in interproximal sites even though the contacts are tight. In this study of 14 patients with food impaction involving tight contacts, the lack of adequate food escape grooves was common to all 14 sites. Uneven marginal ridges and prominent opposing cusps were less common and, together, made up slightly more than half of the contact sites. An occlusal adjustment technique to create adequate food escape grooves, as well as reduce prominent opposing cusps and correct uneven marginal ridges, completely eliminated food impaction in all but one site. This site achieved an 80% reduction in food impaction. Based on the results of this retrospective study, the lack of adequate food escape groves in teeth adjacent to a contact point manifesting food impaction appears to be the primary factor. Creating food escape grooves adjacent to the marginal ridges eliminates, or nearly eliminates, food impaction in tight contact sites.
Asunto(s)
Ajuste Oclusal/métodos , Adulto , Oclusión Dental Traumática/terapia , Alimentos , Humanos , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
There is a preponderance of evidence in the literature that periodontal and other oral diseases, such as caries, can be treated and controlled by thorough mechanical plaque removal by the patient, the use of antimicrobial agents and antibiotics when necessary, and participation with the therapist in a well monitored, long-range program of supportive periodontal therapy. Recent evidence suggests that the control and prevention of oral disease, especially periodontitis, is especially important for patients with various systemic conditions that can be impacted by oral infections. It is far better for patients and therapists to practice primary and even secondary prevention with effective plaque control and regular, consistent supportive periodontal therapy, than having to rely on tertiary prevention for disease that has progressed to a level that requires costly treatment, is time-consuming and carries a greater risk of morbidity.
Asunto(s)
Enfermedades Periodontales/prevención & control , Adolescente , Adulto , Factores de Edad , Anciano , Antiinfecciosos Locales/uso terapéutico , Niño , Dispositivos para el Autocuidado Bucal , Placa Dental/microbiología , Placa Dental/prevención & control , Relaciones Dentista-Paciente , Progresión de la Enfermedad , Humanos , Tamizaje Masivo , Persona de Mediana Edad , Motivación , Cooperación del Paciente , Enfermedades Periodontales/diagnóstico , Enfermedades Periodontales/diagnóstico por imagen , Periodoncia/instrumentación , Prevención Primaria , Radiografía , Recurrencia , Inducción de Remisión , Medición de Riesgo , Factores de Riesgo , Cepillado Dental/instrumentación , Cepillado Dental/métodosRESUMEN
Molar teeth with deep, horizontal furcation invasions (FI) are among the most difficult to treat periodontally. Therefore, it is important that these defects be detected early when the chances for successful, long-term treatment results are good. Even advanced FI are often treatable if their extent is properly diagnosed. The role of radiographs in the diagnosis of FI is discussed with emphasis on their limitations. The importance of accurate horizontal and vertical probing of FI is stressed. Proper probing techniques are presented along with anatomical factors which may adversely affect accuracy.
Asunto(s)
Defectos de Furcación/diagnóstico , Instrumentos Dentales , Defectos de Furcación/diagnóstico por imagen , Humanos , Periodoncia/instrumentación , Radiografía DentalRESUMEN
Multirooted teeth with FI present some of the biggest challenges in periodontal therapy despite a large arsenal of therapeutic techniques. Guided tissue regeneration has improved the long-term prognosis of many deep grade II lesions but has not always shown consistent predictability. With improved barrier techniques and the development of effective growth factors, however, guided tissue regeneration may well become the treatment of choice for all grade II and III FI. Until that time, early diagnosis and treatment are critical to long-term success. Even strategically important teeth with more advanced FI often have a much better long-term prognosis than previously believed and can survive for many years, even with closed scaling and root planning and frequent, long-term maintenance. Before condemning molars with severe FI, clinicians should consider their experience in treating advanced periodontal diseases and seek consultation with a specialist when in doubt as to the prognosis and treatment of teeth with significant FI.
Asunto(s)
Defectos de Furcación/terapia , Diente Molar/patología , Raspado Dental , Predicción , Defectos de Furcación/clasificación , Defectos de Furcación/diagnóstico , Defectos de Furcación/etiología , Defectos de Furcación/patología , Sustancias de Crecimiento/uso terapéutico , Regeneración Tisular Guiada Periodontal/métodos , Humanos , Enfermedades Periodontales/terapia , Pronóstico , Derivación y Consulta , Aplanamiento de la Raíz , Raíz del Diente/patología , Resultado del TratamientoRESUMEN
Antimicrobial agents provide an additional means of combating the infective agents encountered in the periodontal diseases. Delivery methods include oral rinses, dentifrices, irrigation, local delivery, and systemic administration. Agents and delivery methods should be selected with the following criteria in mind: 1. The agent must be effective against the organisms present. 2. The agent must reach the desired site of action in appropriate concentration. 3. The agent must remain at the site for a sufficient period of time. When combined with a careful patient assessment and a considered diagnosis, the use of antimicrobial agents may prove to be an important adjunct in total periodontal therapy.
Asunto(s)
Antibacterianos/uso terapéutico , Antiinfecciosos/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Enfermedades Periodontales/tratamiento farmacológico , Enfermedades Periodontales/microbiología , Antibacterianos/administración & dosificación , Antiinfecciosos/administración & dosificación , Placa Dental/microbiología , Placa Dental/prevención & control , Dentífricos , Humanos , Antisépticos BucalesRESUMEN
The records of 5,467 periodontal patients in a military practice were reviewed for ADA case type 3 or 4, resulting in 203 patients (3.71 percent) in the two categories. These records were then examined for 1) sex of the patient; 2) occurrence of a periodontal abscess; 3) whether or not the patient was in active periodontal treatment at the time of the abscess; and 4) which tooth or teeth were involved. Periodontal treatment was shown to greatly reduce the incidence of periodontal abscesses among case type 3 patients. ADA case type 4 patients were much more likely to develop an abscess than case type 3 patients, and treatment had no effect on the rate of abscess formation in these patients. In those patients who developed an abscess while undergoing periodontal treatment, women showed a greater tendency toward abscess formation. Maxillary incisors and first premolars had the lowest rates of involvement.
Asunto(s)
Personal Militar/estadística & datos numéricos , Absceso Periodontal/epidemiología , Adulto , Distribución por Edad , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Absceso Periodontal/terapia , Prevalencia , Distribución por Sexo , España/epidemiología , Resultado del Tratamiento , Estados Unidos/etnologíaRESUMEN
Two interesting populations in periodontology have emerged this year. National and international reports have indicated that inflammatory periodontal disease is widespread in adolescents, although most of the cases of disease are considered to be in a reversible stage. Nevertheless, the attachment loss present portends serious future problems. The rapidly growing elderly population presents a unique problem of assessment. Current indices do not adequately evaluate recession. Thus, there is substantial underestimation of periodontal disease in the elderly. Further insight into the interrelationships between systemic diseases and local inflammatory periodontal diseases has been reported. Methods to improve statistical evaluation of site-specific periodontal data and address the shortcomings of currently available periodontal indices have been suggested. Finally, the major disadvantage of indices in treatment planning is the lack of specific treatment goals. Examples of the potentially misleading information that results from this lack were presented and the inclusion of treatment goals with treatment needs was suggested.
Asunto(s)
Enfermedades Periodontales/epidemiología , Adolescente , Adulto , Distribución por Edad , Factores de Edad , Anciano , Canadá/epidemiología , Europa (Continente)/epidemiología , Infecciones por VIH/complicaciones , Humanos , Persona de Mediana Edad , Enfermedades Periodontales/complicaciones , Índice Periodontal , Prevalencia , Factores de Riesgo , Estados Unidos/epidemiologíaRESUMEN
Root resection is a complex, multidiscipline technique to eliminate molar furcation invasions. In the short term of 3 or 4 years it has been highly successful, but after 10 years approximately one third fail. A substantial number of failures were attributed to recurrent periodontal disease. This study examined 70 root resected molars in 62 patients for the quality of the resections. Twenty-one (30%) of the resections were considered faulty when subgingival, residual roots, furcal lips, and/or ledges were present. Failures were more frequent in maxillary molars (33.3%) than mandibular molars (22.7%). Clinically hidden roots/lips and ledges in mandibular molars were readily observed in radiographs, but were seen radiographically only 37.5% of the time in maxillary molars. Since subgingival defects are believed to encourage future periodontal disease, it is important that the dentist detect these structures and correct them before proceeding with the permanent restoration.
Asunto(s)
Diente Molar/cirugía , Enfermedades Periodontales/cirugía , Raíz del Diente/cirugía , Adulto , Anciano , Diseño de Dentadura , Femenino , Humanos , Masculino , Mandíbula , Maxilar , Persona de Mediana Edad , Diente Molar/diagnóstico por imagen , Diente Molar/patología , Enfermedades Periodontales/diagnóstico por imagen , Enfermedades Periodontales/terapia , Prostodoncia , Radiografía , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/patologíaRESUMEN
When it is necessary to place casting margins subgingivally, it is important that they not violate the biologic width. A technique utilizing nonmedicated retraction cord during preparation is described which has several advantages. It results in bloodless, trauma-free tooth preparation and concealment of the metal margin without biologic width impingement or gingival recession. A resilient, unattached gingival margin free of inflammation is critical for the success of this technique. The physical and chemical properties of healthy gingival collagen and ground substance are briefly discussed along with the disadvantages of using this technique in the presence of gingival inflammation.
Asunto(s)
Coronas , Diseño de Dentadura/métodos , Estética Dental , Humanos , Bandas de MatrizRESUMEN
The effectiveness of diflunisal as a preoperative medication to reduce pain following periodontal surgery was evaluated. Fifty patients were divided into two groups in a double-blind random manner: Group one received preoperative difunisal and Group two received preoperative placebo. The preoperative diflunisal group reported significantly less discomfort (P less than 0.05) than the preoperative placebo group and used rescue medication significantly less often (P less than 0.01). Therapeutic doses of diflunisal, given presurgically, are significantly more effective than placebo in limiting postoperative pain associated with periodontal surgery.
Asunto(s)
Diflunisal/uso terapéutico , Dolor Postoperatorio/prevención & control , Enfermedades Periodontales/cirugía , Premedicación , Salicilatos/uso terapéutico , Adolescente , Adulto , Ensayos Clínicos como Asunto , Diflunisal/administración & dosificación , Método Doble Ciego , Humanos , Persona de Mediana Edad , Placebos , Distribución AleatoriaRESUMEN
Oxygen effects on healing gingival wedge excisions were tested using Sprague-Dawley rats. 40 operated controls were maintained at normal pressure in room air. 3 experimental groups of 40 rats each were exposed for 90 min daily to one of the following: (1) 20.8% oxygen at 2.4 atmospheres pressure, (2) 100% oxygen at 1 atmosphere, or (3) 100% oxygen at 2.4 atmospheres. 5 animals in each group were sacrificed at the following times: 30, 54, 78 h and weeks 1, 2, 3, 6 and 12. Histometric analysis was performed using light microscopy. The connective tissue healing above a reference notch on the maxillary first molar mesial root was assessed. The controls failed to show healing comparable to experimental animals until the end of 2 weeks. Enhanced connective tissue healing above the notch was most significant (p less than or equal to 0.05) in the 2.4 atmospheres pressure groups at 3 and 6 weeks when compared to controls. However, by 12 weeks, no significant differences could be detected. New cementum formation was rare and occasional root resorption was observed. Early connective tissue adaptation does not imply eventual attachment as epithelial downgrowth progressively displaced the connective tissue adjacent to the root in both experimental and control groups of this study.
Asunto(s)
Oxigenoterapia Hiperbárica , Oxígeno/farmacología , Periodoncio/fisiopatología , Cicatrización de Heridas , Animales , Presión Atmosférica , Tejido Conectivo/fisiopatología , Masculino , Ratas , Ratas EndogámicasRESUMEN
An internal mattress suture is described for suturing labial papillae to palatal flaps when using the "curtain technique." The suture is simple to perform and does not violate the intact labial sulci. It gives stability to both the labial papillae and palatal flap while maintaining maximum esthetic results.