DOCSLIB.ORG

The International Journal of Periodontics & Restorative Dentistry

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The International Journal of Periodontics & Restorative Dentistry Checchi.qxd 8/4/08 9:54 AM Page 366 The International Journal of Periodontics & Restorative Dentistry Checchi.qxd 8/4/08 9:54 AM Page 367 367 Osseous Resective Surgery: Long-term Case Report Luigi Checchi, MD, DDS* The principles of osseous surgery in Monica Mele, DDS** periodontal therapy were set forth by Vittorio Checchi, DDS*** Schluger1 in 1949 and subsequently by Giovanni Zucchelli, DDS**** Ochshenbein2 in 1958 and Prichard3 in 1961. Schluger4 suggested that alve- olar bone loss caused by inflamma- tory periodontal disease produced an altered outline of the bony crest, but This case report evaluated the long-term effects of osseous resective therapy in that the gingiva retained an attach- the treatment of a patient with moderately advanced periodontal disease. In ment “memory” aroused by bone and 1984, the patient underwent initial therapy followed by a periodontal surgical bony spicules left in situ. According to phase consisting of osseous recontouring with an apically positioned flap. After 20 this understanding, gingival contour years, in 2003, the patient presented with a traumatic complication. An explorato- ry surgery revealed a fracture on the roof of the pulp chamber on the maxillary left is determined by the underlying first molar. The buccal roots were resected, preserving the palatal root, and a osseous topography and the anatomy reevaluation of the long-term outcome of osseous resective surgery was per- of adjacent dental surfaces; for this formed. It is suggested that the positive treatment result is the consequence of reason, it was considered necessary to the reestablishment of tissue morphology favorable for oral hygiene and plaque recontour the bone to recreate the control by the patient. (Int J Periodontics Restorative Dent 2008;28:367–373.) original architecture to achieve minimal probing depth and reestablish an opti- mal gingival contour. The technique of osseous resective surgery is the combined use of both osteoplasty and 5 *Professor, Department of Periodontology and Implantology, Alma Mater Studiorum, ostectomy to reestablish the marginal Bologna University, Italy. bone morphology around the teeth **Resident, Department of Periodontology and Implantology, Alma Mater Studiorum, to recreate healthy, beneficial archi- Bologna University, Italy. tecture6 in a more apical position. ***Research Doctorate, Biomedical Technologies Applied to Odontostomatological Sciences, Second University of Naples, Italy. This report shows the long-term ****Associate Professor, Department of Periodontology and Implantology, Alma Mater (20 years) clinical results of a patient Studiorum, Bologna University, Italy. treated with an apically positioned flap Correspondence to: Prof Luigi Checchi, Via S. Vitale 59, 40125 Bologna, Italy; fax: 0039 with osseous contouring aimed to 051439 1718; e-mail: [email protected]. achieve a favorable bony architecture. Volume 28, Number 4, 2008 Checchi.qxd 8/4/08 9:54 AM Page 368 368 Fig 1 (left) Preoperative radiograph in 1984. Subgingival calculus and enamel pearls can be seen distally on the maxillary left premolars and second and third molars. Fig 2 (right) Buccal view showing the heal- ing of gingival tissue after initial therapy. Fig 3 (left) Buccal view after osteoplasty and ostectomy. Fig 4 (right) Healing at 5 months. The buccal tissue appears uniformly pale and pink, the consistency is firm and stippled in texture, and some tissue rebound is present between the first and second molars. Case report Maxillary left posterior sextant in 1984 A 43-year-old Caucasian man was referred to the Department of The maxillary left posterior sextant Periodontology at the University of exhibited 20% to 30% bone loss in the Southern California for treatment of molar area. There were furcation inva- periodontal disease. Clinical examina- sions on the first, second, and third tion revealed moderate supra- and molars. Subgingival calculus and/or subgingival calculus. The buccal gin- enamel pearls were seen distally on giva appeared pink in color and was the second premolar and third molar firm in consistency, with a large amount (Figs 1 and 2). of keratinized tissue. Interdental papil- The diagnosis was generalized lae were cratered and materia alba was moderate periodontitis,7 with associ- present. The posterior sextants had ated primary occlusal trauma. The many old alloy restorations, and some overall prognosis was considered were overcontoured. Radiographic good provided that the patient main- examination revealed approximately tained proper oral hygiene, received 20% to 30% horizontal bone loss. new restorations, and followed a good The International Journal of Periodontics & Restorative Dentistry Checchi.qxd 8/4/08 9:54 AM Page 369 369 Fig 5 (left) Clinical view in 2003 showing extrusion of the third molar and an increase of gingival recession on the distal root of the first molar. Fig 6 (right) Fracture on the pulp roof overhanging the mesial root. recall program for supportive peri- and ostectomy were carried out, leav- probably because it is more difficult to odontal therapy. ing a residual defect of 4 mm between keep that area free from plaque (Fig 4). At that time, the treatment plan the first and second molars and 2 mm was as follows: between the second and third molars (Fig 3). Continuous sling sutures with Maxillary left posterior sextant 1. Initial therapy consisting of scaling 4.0 silk were used, and a periodontal in 2003 and root planing with oral hygiene pack was placed. The patient was instruction given tetracycline (250 mg every 6 In 2003 (after 20 years), the patient 2. Reevaluation hours for 6 days). presented to the Department of 3. Pocket reduction surgery The overall prognosis at that time Periodontology at the University of was good. The original goal of pocket Bologna, with moderate pain and a In March of 1984, the patient reduction was achieved, creating a sit- temporary filling on the first molar (Fig underwent osseous surgery with bone uation in which the patient could main- 5). After the filling was removed, a frac- contouring and an apically positioned tain a plaque-free environment. The ture was observed on the roof of the flap.8 Buccal and palatal full-thickness healing was uneventful. The buccal tis- pulp chamber. Thus, it was decided to flaps were raised, and all granulation sue appeared uniformly pale and pink. perform exploratory surgery (Fig 6). tissue was removed. All teeth were Some tissue rebound was evident scaled and root planed. Osteoplasty between the first and second molars, Volume 28, Number 4, 2008 Checchi.qxd 8/4/08 9:54 AM Page 370 370 Fig 7 Radiograph showing the amount of Fig 8 Buccal view during the exploratory Fig 9 Healing 3 months after osseous bone left on the second molar and the pres- surgery showing a similar position of bone resective surgery and extraction of the distal ence of enamel pearl distally on the third on the two premolars, an increase of bone and mesial roots. The palatal root was pre- molar, as well as its extrusion. recession on the distal root of the first pared for prosthetic reconstruction. molar, and bone loss on the mesial root of the second molar. The clinical comparison between ison of the two buccal sides showed a the two buccal sides (1984 vs 2003) similar position of the bone on the two showed extrusion of the third molar premolars, an increase of bone reces- and an increase in gingival recession sion on the distal root of the first molar, on the distal root of the first molar (Figs and 1 mm of bone loss on the mesial 4 and 5). root of the second molar (Figs 3 to 8). Radiographic comparison showed As a result of these clinical findings, it an absence of calculus, the presence of was decided to resect both the mesial an enamel pearl distally on the third and distal roots on the first molar, pre- molar along with its extrusion, bone serving the palatal root (Fig 9). The loss mesially on the second molar, and root was then re-prepared and a pro- bone loss distally on the first molar visional restoration was provided. The (Figs 1 to 7). definitive restoration was placed after Full-thickness buccal and palatal 3 months of healing. flaps were elevated. Surgical compar- The International Journal of Periodontics & Restorative Dentistry Checchi.qxd 8/4/08 9:54 AM Page 371 371 Discussion dominant mode of failure is related to either endodontic or technical com- The objective of periodontal therapy is plications such as root fracture, as to maximize the longevity of the nat- opposed to periodontal failure.11 ural dentition and maintain a healthy, Restorative preparations modify functional, and pain-free status. the natural relationship between cusp Periodontal treatment can successfully and fossa and consequently increase achieve this goal; indeed, the low rates masticatory stress effects.12 Hiatt13 of tooth mortality in patients treated reported that fractures resulting from with conventional therapy are in clear Black Class I preparations represent contrast to the rates of tooth loss 39% of all incomplete coronal/radic- occurring in untreated populations or ular fractures, and the percentage is in patients treated but not followed even higher for teeth with a reduced up with continuing maintenance care.9 periodontium. Olsen et al10 reported increased The patient presented 19 years recurrence of probing depth in sites after his active periodontal treatment treated by apically positioned flaps with a temporary filling on the first without osseous resective surgery than molar in place of an amalgam restora- in those with osseous resective surgery. tion. After removal of the filling, a frac- The sites treated with osseous resec- ture was evident, and so the site was tive surgery had greater reduction of surgically reentered and the involved probing depth in the 5-year report of roots were removed. eight patients. Clinical attachment lev- It was impossible to perform con- els in sites treated by osseous resective servative treatment to preserve the surgery were located significantly more entire first molar, but there are several apically at the 5-year examination (3.9 studies on the efficacy of resective ther- mm versus 3.5 mm).
Load more

Recommended publications
  • Periodontal Re-Treatment in Patients on Maintenance Following Pocket Reduction Surgery Roberto Galindo1, Paul Levi2, Andres Pascual Larocca1, José Nart1
    Periodontal Re-treatment in Patients on Maintenance Following Pocket Reduction Surgery Roberto Galindo1, Paul Levi2, Andres Pascual LaRocca1, José Nart1 1Periodontics Department, Universitat Internacional de Catalunya, Spain. 2Periodontics Department, School of Dental Medicine, Associate Clinical Professor at Tufts University, USA. Abstract When pocket elimination has been done and periodontal stability has been achieved, patients are advised to be on Maintenance Therapy (MT), also known as Supportive Periodontal Care (SPC). The compliance rate for patients on MT is low, and efforts to optimize acquiescence are only partly successful. The question of re-treatment of periodontal diseases is rarely addressed in the literature, and it warrants further clinical research. Aim: To quantify the extent of additional periodontal treatment needed for patients who had previous pocket reduction periodontal surgery and have been on SPC for a minimum period of 12 months. Methods: Patients in this study had received periodontal treatment, which included pocket reduction osseous surgery with an apically positioned flap. The periodontal residents at Universitat Internacional de Catalunya performed the surgeries. After active periodontal therapy, patients were placed on SPC. Erratic patients are defined when they attended less than 75% of their scheduled maintenance appointments within 1 year. Re-treatment is judged necessary when deep pockets (≥ 5mm) are identified, presenting with bleeding on probing. For this study, patients were recalled randomly for a re-evaluation of periodontal conditions. Clinical periodontal parameters are recorded and each patient fills a questionnaire evaluating SPC perception. Results: 64% of patients showed recurrence of periodontal disease. Smokers who were erratic with SPC showed a 100% recurrence rate.
    [Show full text]
  • Dental Rehabilitation Center Implant, Cosmetic, & Reconstructive
    Dental Rehabilitation Center Implant, Cosmetic, & Reconstructive Dentistry Consent For Clinical Treatment/Procedure Name of the treatment(s)/procedure(s): PERIODONTAL BONE REGENERATIVESURGERY PERIODONTALCROWN LENGTHENINGSURGERY Part of the body on which the treatment/procedure will be performed: INFORMATION ABOUT THE TREATMENT/PROCEDURE Reason for treatment/procedure (diagnosis, condition, or indication): Periodontal disease which has weakened the support of the teeth by separating the gum from the teeth and destroying some of the bone that supports the tooth roots. Inadequate tooth structure above the gum line to accommodate a filling, crown, or other restoration, or current restoration set too deep into the gum. To remove excess gum tissue and/or bone. Brief description of the treatment/procedure: PERIODONTAL BONE REGENERATIVE SURGERY This procedure involves regenerating lost bone and gum tissue due to gum disease. Your teeth are kept in place by your jaw bone and gum tissue. When you have gum disease, bacteria causes a pocket to form around your teeth and gums. When this happens, you may get infection and/or your teeth may become loose. You will be given an injection of local anesthesia. With local anesthesia, an injection of drugs causes numbness in the exact location of a minor surgery or dental procedure. Your dentist will make an incision (cut) in your gum to expose the eroded bone and tooth roots. The area will be cleaned to get rid of calculus (tartar), infected gum tissue, and bacteria. Graft material will be placed in the areas of bone loss around the teeth. Different types of graft material may be used: Allograft.
    [Show full text]
  • Milk As Desensitizing Agent for Treatment of Dentine Hypersensitivity Following Periodontal Treatment Procedures Dentistry Section
    Original Article DOI: 10.7860/JCDR/2015/15897.6751 Milk as Desensitizing Agent for Treatment of Dentine Hypersensitivity Following Periodontal Treatment Procedures Dentistry Section MOHAMMAD SABIR1, MOHAMMAD NAZISH ALAM2 ABSTRACT group two patients were advised to rinse with luke warm water as Background: Dentinal hypersensitivity is a commonly observed control. A four point Verbal Rating Score (VRS) was designed to problem after periodontal treatment procedures in periodontal record the numerical value of dentine hypersensitivity. patients. This further complicates preventive oral hygiene Results: The results show incidence of 42.5% and prevalence procedures by patients which jeopardize periodontal treatment, or of 77.5% for dentine hypersensitivity after periodontal treatment even may aid in periodontal treatment failure. procedures. After rinsing with milk following periodontal treatment Aims and Objectives: The aims and objectives of present study procedures, there was found a significant reduction of dentine were to assess the problem of dentine hypersensitivity after non- hypersensitivity with probability by unpaired t-test as 0.0007 surgical periodontal treatment and selection of cases for evaluation and 0.0001 at tenth and fifteenth day post periodontal treatment of commercially available milk at room temperature as mouth rinse procedures respectively. for the treatment of dentinal hypersensitivity caused by periodontal Conclusion: This study demonstrated that the milk rinse is a treatment. suitable, cheaper, fast acting, home-use and easily available Materials and Methods: Patients were selected randomly for solution to the problem of dentine hypersensitivity after non- nonsurgical periodontal treatment and then were assessed for surgical periodontal treatment. Milk can be used as desensitizing dentine hypersensitivity. Those having dentine hypersensitivity agent and rinsing with milk for few days is effective in quick were assigned in two groups.
    [Show full text]
  • University of Florida Thesis Or Dissertation
    THE EFFECT OF MICROBIAL PROFILE ON RESPONSE TO NONSURGICAL TREATMENT OF LOCALIZED AGGRESSIVE PERIODONTITIS By ALEXANDER FETNER A THESIS PRESENTED TO THE GRADUATE SCHOOL OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE UNIVERSITY OF FLORIDA 2017 © 2017 Alexander Fetner To my girlfriend, Jackie, for her support during this tedious process ACKNOWLEDGMENTS I would like to thank my family for all of their support over the years, without which, I would not be where I am today. I would like to thank my colleagues at the University of Florida. Finally, I would also like to thank my mentors at the University of Florida, both clinical and research faculty, who have had a profound impact on my education. 4 TABLE OF CONTENTS page ACKNOWLEDGMENTS .................................................................................................. 4 LIST OF TABLES ............................................................................................................ 7 LIST OF FIGURES .......................................................................................................... 9 LIST OF ABBREVIATIONS ........................................................................................... 10 ABSTRACT ................................................................................................................... 11 CHAPTER 1 INTRODUCTION .................................................................................................... 13 Periodontitis ...........................................................................................................
    [Show full text]
  • Plain Facts About Periodontal Disease
    Plain Facts about Periodontal Disease bcbsfepdental.com Learn what it might mean to have swollen gum and what can be done about it. What is Periodontitis? Periodontitis (per-e-o-don-TIE-tis), also called Gum Disease, is defined as a serious gum infection that damages the gum tissue and can, over time, destroy the bone that supports your teeth. Healthy gums are generally firm, pale pink, and wrap closely around teeth. Symptoms of periodontitis can include: • Swollen gums • Bright red to purplish gum tissue • Tender gums • Blood when flossing or brushing Prevention of Periodontal Disease • Bad breath The easiest way to prevent periodontitis is to practice good oral hygiene – • Pus between teeth and gums brushing twice daily, for two minutes, • Painful chewing using a soft bristled brush and flossing daily. • Gums pulling away from teeth Regular dental visits with cleanings are • New spaces between teeth also necessary to maintain a healthy • Loose teeth mouth. Cleanings should generally occur every six to 12 months, however, if • Loss of tooth/teeth you are at a higher risk for periodontal • Changes to how your teeth fit together when you disease (see Risk Factors), your dentist bite What Causes Periodontitis? According to the Centers for Disease Control and Prevention, 46% of Americans age 30 and over show signs of periodontal disease. Periodontitis is common, but usually preventable. It starts with plaque – the sticky film you find on your teeth each day, composed of food particles, saliva, and bacteria. If you don’t remove all of the plaque from around your gum line when you brush or floss, that plaque will eventually harden into tartar (calculus).
    [Show full text]
  • Dental Policy
    Dental Policy Subject: Periodontal Maintenance Guideline #: 04-901 Publish Date: 03/15/2018 Status: Revised Last Review Date: 02/05/2018 Description This document addresses periodontal maintenance. Note: Please refer to the following documents for additional information concerning related topics: Prophylaxis: 01-101 Scaling and Root Planing: 04-301 Gingivectomy or Gingivoplasty: 04-202, Mucogingival Surgery and Soft Tissue: 04-204 Osseous Surgery: 04-205 Clinical Indications Periodontal maintenance is a nonsurgical treatment considered appropriate, following periodontal therapy, that continues for the life of the dentition or any implant replacements and provides treatment and continuing care of patients with a history of/and ongoing periodontal disease. Periodontal maintenance is considered therapeutic, rather than prophylactic, and constitutes continuing treatment for patients with a diagnosis of periodontal disease. The therapeutic objective of Periodontal Maintenance is to reduce or eliminate causative factors responsible for initiating host inflammatory responses. The desired outcome should result in maintenance of the periodontal health status attained as a result of active periodontal therapy. Periodontal Maintenance is: 1. A demanding and time-consuming procedure involving instrumentation of the tooth crown and root structures. 2. A procedure to remove etiological factors such as plaque and biofilm, adherent calculus deposits, and diseased cementum (root structure) that may be permeated with calculus, microorganisms and microbial
    [Show full text]
  • Periodontal Disease Dr. Rohinton J. Patel, DMD Director, Hawaii Pacific
    Periodontal Disease Dr. Rohinton J. Patel, DMD Director, Hawaii Pacific Dental Group, Inc. Adjunct Clinical Professor, Boston University, School of Dental Medicine [email protected] 6700 Kalanianaole Highway, Suite 216, Honolulu, HI 96825; (808) 955-0008 Disclaimer • I have no vested nor monetary interests regarding this presentation 1 What is Periodontal Disease • Periodontitis, or inflammation of the periodontium, is a serious infectious disease that inflicts the gums, jawbones and teeth, resulting in tooth loss, infection and degradation of bone, and bleeding gums. • It is strongly shown to be a significant risk factor for heart and lung diseases. How Common is Periodontal Disease? • Periodontal Disease inflicts over 3 Million Americans each year. • The disease can be halted in a few moths after treatment is initiated and judiciously maintained by the patient, if not, likely relapse will occur. • Periodontal Disease is usually painless in its initial stages. • A recent CDC report provides the following data related to prevalence of periodontitis in the U.S.: 47.2% of adults aged 30 years and older have some form of periodontal disease. Periodontal disease increases with age, 70.1% of adults 65 years and older have periodontal disease. 2 What are the risk factors for developing periodontal disease? ● Gingivitis. ● Poor oral health habits. ● Smoking or chewing tobacco. ● Hormonal changes, such as those related to pregnancy or menopause. ● Recreational drug use, such as smoking marijuana or vaping. ● Obesity. ● Inadequate nutrition, including vitamin C deficiency. ● Genetics. Prevention of Periodontal Disease Professional dental cleanings, electric toothbrush, waterpik and floss 3 Symptoms of Periodontal Disease (mayoclinic.com) Signs and symptoms of periodontitis can include: ● Swollen or puffy gums.
    [Show full text]
  • Wednesday, April 14, 2021
    The Use of Lasers in Implant Dentistry: Examining The LANAP® and LAPIP Protocols for the Treatment of Periodontitis and Peri-implantitis In Association with Mancini Periodontics Speaker Dr. Sabrina Mancini Wednesday, April 14, 2021 Time 7:00 PM - 8:30 PM Program Location Zoom https://zoom.us/meeting/register/tJMoc- PROGRAM DESCRIPTION qspzIqGNDoteIMkWLznNfthGvassK- The use of lasers in dentistry has been increasing over the last 10 years. Depending on their varying wavelengths, they can be used for specific functions, but there Audience G - General Dentist S - OMS, Perio, Prosth is no one laser wavelength that does all procedures equally well. The traditional D - Dental Technician treatment of periodontal disease, via pocket reduction surgery, may be perceived by periodontal patients as invasive and painful, which can lead them to being fearful of SAC Advanced / Complex seeking treatment. With periodontal disease being associated with or a contributing Type Lecture factor in many systemic diseases, the need for addressing this disease process can CE credit 1.5 Hours be essential for the patients’ overall health. The LANAP® protocol is an FDA approved and tissue sparing protocol, which now Tuition Complimentary allows for the treatment of periodontal disease, through a procedure that follows the basic tenets of biology, regeneration and wound healing. Treatment is through regeneration of the periodontal apparatus, rather than resective and results in new RSVP bone growth and gum tissue reattachment. Moreover, the patient perception of being able to treat their disease via the use of a laser-based protocol is seen to be First-time Using SKiLL? more high-tech, “patient-friendly” and less painful than other therapies.
    [Show full text]
  • World Journal of Advance Healthcare Research and Gums That Bound and Support the Teeth
    SJIF Impact Factor: 5.464 WORLD JOURNAL OF ADVANCE ISSN: 2457-0400 Prashant et al. World Journal of Advance HealthcareVolume: Research 5. HEALTHCARE RESEARCH Issue: 1. Page N. 146-154 Year: 2021 Review Article www.wjahr.com FORMULATION AND EVALUATION OF DENTAL GEL CONTAINING CLOVE OIL FOR THE TREATMENT OF PERIODONTAL DISEASE- A REVIEW Prashant Kumar Katiyar*, Dr. Smita Takerkhade, Madhavi Ashika Lahu, Masne Mangala Ambanna, Mhatre Prajkta Bhagvan, Mishra Mithilesh Kumar Rakesh, Mishra Saurabh Mangalprasad Ideal College of Pharmacy and Research, Kalyan, Mumbai. (University of Mumbai). Received date: 20 November 2020 Revised date: 10 December 2020 Accepted date: 30 December 2020 *Corresponding author: Prashant Kumar Katiysr Ideal College of Pharmacy and Research, Kalyan, Mumbai. (University of Mumbai). ABSTRACT The study was aimed to formulate and evaluate dental gel containing clove oil as the chief constituent for the treatment of periodontitis. Clove oil has a wide spectrum of antibacterial activity against a number of periodontal pathogens, hence it is selected for the treatment of periodontitis. Clove oil gel is formulated by using carbopol 934 as gelling agent, clove oil as medicinal agent, polyethylene glycol as co-solvent, methyl paraben and propyl paraben as preservative and required quantity of distilled water as vehicle. The periodontal disease commonly refers to inflammatory diseases that are plaque induced i.e. gingivitis and periodontitis. Gingivitis, the moderate stage of disease caused by an accumulation of supragingival plaque and characterized by swelling, light bleeding and redness of the marginal gingival. Gingivitis is associated with a change in the microflora, shifting from a Gram-positive anaerobic flora to a more Gram negative one.
    [Show full text]
  • Are You Suprised ?
    QUESTIONS AND ANSWERS - 1998 BOARDS/Revised 2001 DAPE 761 - Periodontology Dr. Dwight McLeod October 26, 2001 1998 - Boards 1. When would you prescribe an antibiotic in conjunction with periodontal scaling and root planing? a. Severe gingivitis b. Localized juvenile periodontitis c. Advanced adult periodontitis d. Linear gingival erythema 2. Polly Pontic is a 50 - year - old female patient who presented with a Class III furcation lesion, on tooth # 3 that communicates with the facial and distopalatal furcations. The distal root showed bone loss approaching the apex of the root. The tooth exhibits no significant mobility and the other remaining roots showed minimal bone loss. The patient showed strong interest in saving the tooth. Which would be the best definitive treatment option? a. Vital root amputation of the distal root b. Osseous surgery c. Guided tissue regeneration d. Periodontal scaling and root planing 3. Which one (s) of the following antimicrobial agents has (have) been shown to have a substantivity of 12 hours? a. The essential oils in listerine b. The chlorhexidine digluconate in Peridex c. The triclosan in Colgate Total toothpaste d. B and C e. All of the above 1 QUESTIONS AND ANSWERS - 1998 BOARDS/Revised 2001 4. In performing a gingivectomy incision in a person with drug induced gingival hyperplasia, the tip of the scalpel is held in what direction relative to the base of the pocket? a. At right angle to the base of the pocket b. Coronal to the base of the pocket c. Apical to the base of the pocket d. None of the above 5.
    [Show full text]
  • Dentin Hypersensitivity: Recent Concepts in Management Dentin Hypersensitivity: Recent Concepts in Management
    JIAOMR 10.5005/jp-journals-10011-1108 REVIEW ARTICLE Dentin Hypersensitivity: Recent Concepts in Management Dentin Hypersensitivity: Recent Concepts in Management 1Vijay Mantri, 2Rahul Maria, 3Neeraj Alladwar, 4Savita Ghom 1Reader, Department of Conservative Dentistry and Endodontics, Modern Dental College and Research Center Indore, Madhya Pradesh, India 2Professor, Department of Conservative Dentistry and Endodontics, Modern Dental College and Research Center Indore, Madhya Pradesh, India 3Professor, Department of Orthodontics, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital Nagpur, Maharashtra, India 4Postgraduate Student, Department of Oral Medicine and Radiology, Chhattisgarh Dental College and Research Institute Rajnandgaon, Chhattisgarh, India Correspondence: Vijay Mantri, Reader, Department of Conservative Dentistry and Endodontics, Modern Dental College and Research Center, B-307, Staff Quarters, Airport Road, Gandhi Nagar, Indore, Madhya Pradesh, India e-mail: [email protected] ABSTRACT Tooth sensitivity is a very common clinical presentation which can cause considerable concern for patients. Dentin hypersensitivity (DH) is characterized by short sharp pain arising from exposed dentin in response to stimuli. The most widely accepted theory of how the pain occurs is Brannstrom’s hydrodynamic theory, fluid movement within the dentinal tubules. The condition generally involves the facial surfaces of teeth near the cervical aspect and is very common in premolars and canines. This condition is frequently encountered by dentists, periodontists, hygienists and dental therapists. Some dental professionals lack confidence in treating DH. The management of this condition requires a good understanding of the complexity of the problem, as well as the variety of treatments available. This review considers the etiopathogenesis, incidence, diagnosis, prevention and management of dentinal hypersensitivity. DH is diagnosed after elimination of other possible causes of the pain.
    [Show full text]
  • Are You Suprised ?
    1998 Board Questions and Answers DAPE 761 – Advanced Periodontology Dr. Dwight E. McLeod November 12, 2004 1998 BOARD QUESTIONS AND ANSWERS (ASSIGNMENT #3) These questions and answers were provided for your convenience to allow you to study for the National Board Part II. The explanations were included to give you a clear understanding of why each choice was selected. Should you encounter any doubts or problems in your interpretation of the explanation, it is your responsibility to consult your textbook, journal articles or handouts for further clarification. I will also be available to assist you if needed. I hope that the explanations below will not only help you to understand each question better but will help to broaden your knowledge in Periodontics as you prepare for the examination. Good Luck! 1. When would you prescribe an antibiotic in conjunction with periodontal scaling and root planing? a. Severe gingivitis b. Localized aggressive periodontitis* c. Advanced Chronic periodontitis d. Linear gingival erythema Antibiotic therapy is not generally recommended for patients with a diagnosis of chronic periodontitis, unless there are some unique systemic problems or compromised conditions. Patients with chronic periodontitis and severe gingival inflammation usually respond well to elimination of the local factors (nonsurgically and/or surgically) and compliance with oral hygiene and supportive periodontal care. Patients with the more aggressive forms of periodontitis (Localized Aggressive Periodontitis and Generalized Aggressive Periodontitis) are generally treated with antibiotics. There is usually a specific microbe that is associated with the disease process, which may have the potential to invade the host’s connective tissues. The microbe, Actinobacillus actinomycetemcomitans, is associated with LAP.
    [Show full text]