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Background Implant treatment to replace congenitally missing teeth often involves multidisciplinary input in a secondary care environment. High quality patient care requires an in-depth knowledge of treatment requirements.Aim This service review aimed to determine treatment needs, efficiency of service and outcomes achieved in hypodontia patients. It also aimed to determine any specific difficulties encountered in service provision, and suggest methods to overcome these.Methods Hypodontia patients in the Unit of Periodontics of the Scottish referral centre under consideration, who had implant placement and fixed restoration, or review completed over a 31 month period, were included. A standardised data collection form was developed and completed with reference to the patient's clinical record. Information was collected with regard to: the indication for implant treatment and its extent; the need for, complexity and duration of orthodontic treatment; the need for bone grafting and the techniques employed and indicators of implant success.Conclusion Implant survival and success rates were high for those patients reviewed. Incidence of biological complications compared very favourably with the literature.
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Anodoncia/terapia , Implantación Dental , Derivación y Consulta , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Escocia , Adulto JovenRESUMEN
AIM: To present two cases of external root resorption and in so doing highlight rarer causative factors as well as the difficulties in classifying root resorption. SUMMARY: Root resorption in the permanent dentition is usually pathological. Local factors are the most frequent causes of resorption, most commonly excessive pressure and inflammation. However, many systemic abnormalities have been implicated in the resorption process. Resorption is often an incidental finding during routine examination. Otherwise, late in the disease process, tooth mobility or infection may arise. A rarer form of root resorption is external apical root resorption which may or may not be linked to systemic disease. In most cases, no causative factors are found. At present there is no curative treatment for external apical root resorption. The current management for these patients is symptomatic, minimal intervention and long-term monitoring. KEY LEARNING POINTS: * Apical resorption may be associated with a systemic disease or of an idiopathic origin. It may also occur in association with orthodontic treatment or with pathoses such as tumours, cysts, etc. * In the absence of signs or symptoms of pulpal and/or periapical disease, endodontic treatment is not indicated. * Long-term monitoring of affected patients is essential.
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Resorción Radicular/etiología , Ápice del Diente/patología , Materiales Dentales , Calcificaciones de la Pulpa Dental/etiología , Cavidad Pulpar/diagnóstico por imagen , Síndrome de Ehlers-Danlos/complicaciones , Estudios de Seguimiento , Gingivitis/complicaciones , Humanos , Masculino , Polietilenos , Radiografía , Resorción Radicular/diagnóstico , Resorción Radicular/terapia , Férulas (Fijadores) , Raíz del Diente/diagnóstico por imagen , Adulto JovenRESUMEN
BACKGROUND AND OBJECTIVE: Cytokines, such as interleukin-10, and related genetic polymorphisms, have been implicated in the pathogenesis of chronic periodontitis. The aim of this study was to investigate a possible correlation between chronic periodontitis and genetic polymorphisms coding for two interleukin-10 related chemokines [interleukin-24 and regulated on activation, normal T cells expressed and secreted (RANTES)] as well as a RANTES receptor [CC chemokine receptor 5 (CCR5)]. MATERIAL AND METHODS: A single-blind, two-centre, case-controlled study was carried out with test patients from the Clinic of Periodontics, Göteborg University, and from the Department of Periodontology, Glasgow University, and control subjects from the undergraduate clinics of both schools. Blood samples were collected from 106 patients (56 women and 50 men, mean age 51.7 yr) with generalized, severe chronic periodontitis and from 69 periodontally healthy subjects (37 women and 32 men, mean age 53.3 yr). The polymerase chain reaction (PCR) was used to identify the genetic coding for interleukin-24, RANTES and CCR5. Genotype and allele frequencies were compared between the test and control groups using Fischer's exact test at the 5% level of significance. RESULTS: There were no statistically significant differences between patients with chronic periodontitis and control subjects, regarding genotype distribution or allele frequency, irrespective of smoking status, in the combined Glasgow and Gothenburg cohort or in the specific location cohorts. The allele frequencies for healthy and control subjects for RANTES gave a p-value of 0.80 (allele G was 58.8% in healthy subjects and and 54.4% in subjects with periodontitis), for interleukin-24 the p-value was 0.90 (allele T was 56.2% in healthy subjects and and 54.9% in subjects with periodontitis) and for CCR5 the p-value was 0.90 (the wild-type allele was 85% in healthy subjects and and 82.7% in subjects with periodontitis). CONCLUSION: The interleukin-24, RANTES and CCR5 polymorphisms investigated are not associated with chronic periodontitis.
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Quimiocina CCL5/genética , Interleucinas/genética , Periodontitis/genética , Receptores CCR5/genética , Adulto , Anciano , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Enfermedad Crónica , Femenino , Frecuencia de los Genes , Humanos , Masculino , Persona de Mediana Edad , Periodontitis/sangre , Reacción en Cadena de la Polimerasa , Polimorfismo de Nucleótido Simple , Método Simple CiegoRESUMEN
The purpose of this review is to evaluate the evidence implicating nonsurgical endodontic procedures in inducing infective endocarditis (IE). The literature is reviewed and findings about dental procedures that elicit bacteraemia [in particular root canal treatment (RCT)], sequelae of bacteraemia, relationship between IE and RCT and variation between antibiotic prophylaxis (AP) guidelines are highlighted. At present, there is still significant debate as to which dental procedures require chemoprophylaxis and what antibiotic regimen should be prescribed. Currently, there are insufficient primary data to know whether AP is effective or ineffective against IE. Practitioners are bound by current guidelines and medico-legal considerations. Thus, the profession requires clear, uniform guidelines that are evidence-based.
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Profilaxis Antibiótica/estadística & datos numéricos , Bacteriemia/prevención & control , Endocarditis Bacteriana/prevención & control , Tratamiento del Conducto Radicular/efectos adversos , Amoxicilina/uso terapéutico , Animales , Antibacterianos/uso terapéutico , Bacteriemia/complicaciones , Bacteriemia/etiología , Cefalosporinas/uso terapéutico , Endocarditis Bacteriana/etiología , Humanos , Guías de Práctica Clínica como Asunto , Pulpotomía/efectos adversos , Factores de RiesgoRESUMEN
UNLABELLED: Some dental procedures initiate a bacteraemia. In certain compromised patients, this bacteraemia may lead to distant site infections, most notably infective endocarditis. OBJECTIVE: To investigate whether a detectable bacteraemia was produced during non-surgical root canal therapy. METHODS: Thirty patients receiving non-surgical root canal therapy were studied. Three blood samples were taken per patient: pre-operatively, peri-operatively and post-operatively. In addition, a paper point sample was collected from the root canal. The blood samples were cultured by pour plate and blood bottle methods. The isolated organisms were identified by standard techniques. Blood samples were analysed for the presence of bacterial DNA by the polymerase chain reaction (PCR). In two cases where the same species of organism was identified in the root canal and the bloodstream, the isolates were typed by pulsed field gel electrophoresis (PFGE). RESULTS: By conventional culturing, a detectable bacteraemia was present in 9 (30%) of the 30 patients who had no positive pre-operative control blood sample. In 7 (23.3%) patients, the same species of organism was identified in both the bloodstream and in the paper point sample from the root canal system. Overall, PCR gave lower detection rates compared with conventional culture, with 10 of 90 (11%) of the blood samples displaying bacterial DNA. PFGE typing was undertaken for two pairs of culture isolates from blood and paper points; these were found to be genetically identical. CONCLUSIONS: Non-surgical root canal treatment may invoke a detectable bacteraemia.
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Bacteriemia/diagnóstico , Tratamiento del Conducto Radicular , Antiinfecciosos Locales/uso terapéutico , Bacteriemia/microbiología , Bacterias/clasificación , Técnicas Bacteriológicas , Clorhexidina/uso terapéutico , Preparación de la Cavidad Dental/instrumentación , Preparación de la Cavidad Dental/métodos , Cavidad Pulpar/microbiología , Electroforesis en Gel de Agar , Electroforesis en Gel de Campo Pulsado , Femenino , Gutapercha/uso terapéutico , Humanos , Peróxido de Hidrógeno/uso terapéutico , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Yoduro de Potasio/uso terapéutico , Materiales de Obturación del Conducto Radicular/uso terapéutico , Irrigantes del Conducto Radicular/uso terapéutico , Obturación del Conducto Radicular , Tratamiento del Conducto Radicular/métodos , Dique de Goma , Hipoclorito de Sodio/uso terapéuticoRESUMEN
Lymphomas account for 2-5% of all oral malignancies and are the third most common in this site. This case report appears to be the first in the world literature describing spontaneous regression in the oral cavity of a subset of non-Hodgkins lymphomas known as Ki-1 anaplastic large cell lymphomas (ALCL). Ki-1 ALCL account for 2-7% of all non-Hodgkins lymphomas and the clinical presentation is variable; they may arise de novo or in the setting of a separate primary lymphoma and commonly present in the extra-nodal location. Disease severity is also variable with waxing and waning lesions at one extreme which may spontaneously regress to bone marrow involvement in around 12% of cases. This case is especially interesting since the patient is a farmer, given the recent evidence that there may be a link between non-Hodgkins lymphoma and this occupation.