DOCSLIB.ORG

(Periodontosis) a Review

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
(Periodontosis) a Review Treatment of Localized Juvenile Periodontitis (Periodontosis) A Review David B. Krill* and Hiram R. Fryt Accepted for publication 2 July 1986 Localized juvenile Periodontitis is a disease of the adolescent periodontium character- ized by rapid alveolar destruction around molar and incisor teeth ofthe permanent dentition. Early treatment methods were variable and often empirical due to lack of knowledge concerning etiology. Elucidation of factors associated with the disease has led to different therapeutic approaches. A comprehensive review of these modalities is presented. The concept of periodontosis as a distinct clinical showing the greatest resistance to the disease. This entity was introduced by Gottleib1 in 1923 in a report condition was further clarified by Baer7 in an article of a fatal case of influenza. He noted that the collage- that forms the basis for clinical diagnosis of what is nous periodontal ligament fibers had lost their orien- currently recognized as a distinct disease entity. He tation and had become loose connective tissue. He also defined periodontosis as a disease of the periodontium observed extensive résorption of the root apices and a occurring in an otherwise healthy adolescent which is widened periodontal ligament space, which he termed characterized by a rapid loss of alveolar bone about one "diffuse atrophy." The degenerative histologie appear- or more teeth in the permanent dentition, with minimal ance led Orban and Weinmann2 to describe the condi- accumulation of plaque, and little or no clinical inflam- tion in three stages: ( 1 ) degeneration of the periodontal mation. He described two forms of the disease: a local- ligament, (2) apical epithelial proliferation, and (3) ized form in which only permanent first molars and pocket formation. However, Wannemacher3 had earlier incisors are affected, and a more generalized form. questioned the degenerative nature ofthe disease, point- Other criteria described by Baer were: ( 1 ) age of onset ing out that an inflammatory process was dominant. 11 to 13 years—terminating at age 20, (2) vertical bone He noted that even in the presence of deep pockets, the loss in the molar regions with characteristic "arc-like" gingiva appeared healthy, but bleeding was produced defects and horizontal bone loss in the incisiors, (3) upon probing with a blunt instrument. Bernier4 and bilaterally symmetrical patterns of bone loss in the Ramfjord5 also dissented from the degenerative theory molar regions, (4) rapid progression of the disease, (5) with the observation that inflammation was always predilection for females, (6) tendency to occur in fam- present at the histologie level. ilial patterns, and (7) lack ofinvolvement ofthe primary The molar-incisor pattern of bone loss was first ob- dentition. served by Wannemacher in 1938.3 Tenenbaum et al.6 No uniform terminology for the condition has been stated that the disease was found primarily in adolescent accepted. In the recent literature the most frequently females and displayed a distinctive radiographie pat- used term for the molar-incisor form has been localized tern. Radiographie examination revealed arc-shaped juvenile Periodontitis (UP).8 There has been less con- bone loss in the molar region, starting from the mesial sensus concerning nomenclature of the generalized surface of the second molar and extending to the distal form. In 1977 Socransky9 described the microbiota surface ofthe second bicuspid. Bone loss was also noted associated with a "rapidly destructive Periodontitis" as in the incisor areas, with the mandibular bicuspid area separate from that seen in "periodontosis." More re- cently Page et al.10 have described a form of "rapidly * a of Tennessee at Formerly Resident in Periodontics, University as a distinct clinical condi- TN 38163. in in progressive Periodontitis" Memphis, Memphis. Currently private practice tion. How these conditions relate to the Akron. OH. may generalized t Professor and Director of Postgraduate Periodontics, University form of periodontosis described by Baer'1 is unclear. In of Tennessee at Memphis. this review the term LJP will be used for the localized 1 J. Periodontol. 2 Krüh Fry January, 1987 form, except when "Periodontitis" is quoted directly that the maxillary sinus enlarges by pneumatization from the literature. from the 3rd month of fetal life until age 18, thereafter A series of studies by Newman et al.12"14 and New- becoming more stable. Likewise, he observed that ac- man and Socransky15 established a credible microbial celerated pneumatization of the maxillary sinus into component for the etiology of LJP. They isolated "five the resultant edentulous ridge occurs following extrac- periodontosis groups" which are largely Gram-negative tion, thereby complicating any future periodontal ther- anaerobic rods (78% of the total cultivable flora), the apy. This led him to the opinion that these teeth should majority of which could not be identified by conven- be retained as long as possible. tional methods of classification. The periodontopathic One of the first studies involving treatment was per- potential of these organisms has been demonstrated in formed by Tenenbaum et al.34 in 1957. Patients with germ-free rats.16 Of interest relative to treatment was LJP were divided into five groups. Group I received the fact that all groups were found to be susceptible to "local dental treatment" consisting of oral hygiene in- tetracycline.13 structions, root and soft tissue curettage, selective tooth Considerable progress has been made in identifying grinding, and periodontal surgery over a period of 13 and characterizing the microorganisms in LJP.17"19 months. During the last 7 months, the patients received Numerically important organisms include various daily doses of vitamins A, complex, C, D, and dibasic Gram-negative facultative rods, mainly Actinobacillus calcium phosphate. Group II received the same local actinomycetemcomitans (A.a.) and Capnocytophaga. dental treatment but without the vitamin-calcium- Barbanell et al.20 demonstrated cytotoxic activity of phosphate therapy. Group III received only vitamin- endotoxin from LJP micoroorganisms. calcium-phosphate therapy. Group IV consisted of fe- Differences in lymphocytes,2'-22 polymorphonuclear male patients who were given daily 50-mg doses of the leukocytes (PMNs),23-24 structure of Immunoglobu- hormone methylandrostenediol. (The rationale for this lins,25 Immunoglobulin levels,21 and complement hormone therapy was the positive response seen when activation26 have been reported between patients with similar hormones were used in treating postmenopausal LJP and healthy controls, or between LJP patients and and senile osteoporosis.) Group V consisted of selected those with other forms of destructive periodontal dis- patients from the first and second groups who had ease. More recently, Genco et al.27 and Ranney et al.28 completed their "local dental treatment." Subsequently, have reported precipitating antibodies to bacteria splints were constructed of orthodontic bands and wires strongly associated with LJP, but not from patients with for temporary stabilization of the involved teeth. other forms of periodontal disease. Evaluation of the five groups over a period of 3 years There have been few direct genetic analyses regarding showed that local dental treatment with or without the LJP. Fourel29 has classified those studies into two vitamin-calcium-phosphate therapy improved the clin- groups: ( 1 ) familial patterns and (2) consanguinity de- ical appearance ofthe tissues and reduced pocket depth. terminations. Newman30 suggested that familial pat- Comparable radiographie improvement did not occur, terns may result from: (1) genetic predispositions to however. Group HI (vitamin-calcium-phosphate ther- specific groups of bacteria, (2) a genetically determined apy alone) and Group IV (hormone therapy) showed immunodeficiency, and (3) faulty or impaired forma- no appreciable clinical or radiographie improvement. tion and maintenance of periodontal tissue integrity. Group V ("local dental treatment" with or without (For a more complete review see Saxen, 1980.31) nutritional therapy, combined with splinting) was the Various therapeutic approaches to LJP have been only group to show radiographie improvement. This described, usually in the form of isolated case reports. consisted of a small increase in the per cent of radi- Few controlled studies have been carried out, and no ographie alveolar bone fill, plus an increase in the comprehensive review oftreatment modalities has been number of regions showing a "lamina dura" at the crest. published. This article offers such a review. Due to this response, the authors undertook permanent splinting in some of the patients. In a follow-up study35 REVIEW OF TREATMENT three of the patients were recalled 17 to 20 years after the permanent splints had been inserted. The patients treatment methods Early had not received regular dental care and the gingival The clinical management of LJP has not received the tissues were in poor condition, but no teeth had been same intensity of interest as its etiology and pathogen- lost due to periodontal disease, leading the authors to esis. Robinson32 in 1951 stated that local therapy is of speculate as to the value of long-term stabilization in little avail in "periodontosis," and until the last decade advanced periodontal conditions. little had been published on treatment approaches. This Another early method of treatment was proposed by tended to
Load more

Recommended publications
  • Cytokines and Their Genetic Polymorphisms Related to Periodontal Disease
    Journal of Clinical Medicine Review Cytokines and Their Genetic Polymorphisms Related to Periodontal Disease Małgorzata Kozak 1, Ewa Dabrowska-Zamojcin 2, Małgorzata Mazurek-Mochol 3 and Andrzej Pawlik 4,* 1 Chair and Department of Dental Prosthetics, Pomeranian Medical University, Powsta´nców Wlkp 72, 70-111 Szczecin, Poland; [email protected] 2 Department of Pharmacology, Pomeranian Medical University, Powsta´nców Wlkp 72, 70-111 Szczecin, Poland; [email protected] 3 Department of Periodontology, Pomeranian Medical University, Powsta´nców Wlkp 72, 70-111 Szczecin, Poland; [email protected] 4 Department of Physiology, Pomeranian Medical University, Powsta´nców Wlkp 72, 70-111 Szczecin, Poland * Correspondence: [email protected] Received: 24 October 2020; Accepted: 10 December 2020; Published: 14 December 2020 Abstract: Periodontal disease (PD) is a chronic inflammatory disease caused by the accumulation of bacterial plaque biofilm on the teeth and the host immune responses. PD pathogenesis is complex and includes genetic, environmental, and autoimmune factors. Numerous studies have suggested that the connection of genetic and environmental factors induces the disease process leading to a response by both T cells and B cells and the increased synthesis of pro-inflammatory mediators such as cytokines. Many studies have shown that pro-inflammatory cytokines play a significant role in the pathogenesis of PD. The studies have also indicated that single nucleotide polymorphisms (SNPs) in cytokine genes may be associated with risk and severity of PD. In this narrative review, we discuss the role of selected cytokines and their gene polymorphisms in the pathogenesis of periodontal disease. Keywords: periodontal disease; cytokines; polymorphism 1.
    [Show full text]
  • Periodontitis and Peri-Implantitis Biomarkers in Human Oral Fluids and the Null-Allele Mouse Model
    Department of Cell Biology of Oral Diseases Institute of Dentistry, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland Department of Oral and Maxillofacial Diseases Helsinki University Central Hospital (HUCH), University of Helsinki, Helsinki, Finland Department of Diagnostics and Oral Medicine Institute of Dentistry, University of Oulu, Oulu University Hospital, Oulu, Finland PERIODONTITIS AND PERI-IMPLANTITIS BIOMARKERS IN HUMAN ORAL FLUIDS AND THE NULL-ALLELE MOUSE MODEL Heidi Kuula Academic Dissertation To be presented with the permission of the Faculty of Medicine, University of Helsinki, for public discussion in the Lecture Hall 1 at Biomedicum Helsinki, Haartmaninkatu 8, Helsinki, on June 12th 2009, at 12 noon Helsinki 2009 Supervised by: Professor Timo Sorsa, DDS, PhD, Dipl Perio Department of Cell Biology of Oral Diseases, Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital (HUCH) Helsinki, Finland Professor Tuula Salo, DDS, PhD Department of Diagnostics and Oral Medicine, Institute of Dentistry, University of Oulu, and Oulu University Hospital (OYS) Oulu, Finland Reviewed by: Assistant Professor Marja L. Laine, DDS, PhD Department of Oral Microbiology, Academic Centre for Dentistry Amsterdam Amsterdam, the Netherlands Professor Denis F. Kinane, BDS, PhD Associate Dean for Research and Enterprise Delta Endowed Professor Director, Oral Health and Systemic Disease Research Group University of Louisville Louisville, Kentucky, USA Opponent: Professor Anders Gustafsson, DDS, PhD Institute of Odontology Department of Periodontology Karolinska Institutet Huddinge, Sweden ISBN 978-952-92-5634-1 (paperback) ISBN 978-952-10-5603-1 (PDF) Helsinki 2009 Yliopistopaino 2 CONTENTS List of original publications Abbreviations Abstract 1. Introduction 2.
    [Show full text]
  • Periodontal Practice Patterns
    PERIODONTAL PRACTICE PATTERNS A Thesis Presented in Partial Fulfillment of the Requirements for the Degree Master of Science in the Graduate School of the Ohio State University By Janel Kimberlay Yu, D.D.S. Graduate Program in Dentistry The Ohio State University 2010 Dissertation Committee: Dr. Angelo Mariotti, Advisor Dr. Jed Jacobson Dr. Eric Seiber Copyright by Janel Kimberlay Yu 2010 Abstract Background: Differences in the rates of dental services between geographic regions are important since major discrepancies in practice patterns may suggest an absence of evidence-based clinical information leading to numerous treatment plans for similar dental problems and the misallocation of limited resources. Variations in dental care to patients may result from characteristics of the periodontist. Insurance claims data in this study were compared to the characteristics of periodontal providers to determine if variations in practice patterns exist. Methods: Claims data, between 2000-2009 from Delta Dental of Ohio, Michigan, Indiana, New Mexico, and Tennessee, were examined to analyze the practice patterns of 351 periodontists. For each provider, the average number of select CDT periodontal codes (4000-4999), implants (6010), and extractions (7140) were calculated over two time periods in relation to provider variable, including state, urban versus rural area, gender, experience, location of training, and membership in organized dentistry. Descriptive statistics were performed to depict the data using measures of central tendency and measures of dispersion. ii Results: Differences in periodontal procedures were present across states. Although the most common surgical procedure in the study period was osseous surgery, greater increases over time were observed in regenerative procedures (bone grafts, biologics, GTR) when compared to osseous surgery.
    [Show full text]
  • Application of Vibroacoustic Diagnosis in Assessing Bridges Connecting Teeth and Implants to Treat Tooth Absence in Sea Vessel Crews
    POLISH MARITIME RESEARCH 1 (105) 2020 Vol. 27; pp. 188-194 10.2478/pomr-2020-0020 APPLICATION OF VIBROACOUSTIC DIAGNOSIS IN ASSESSING BRIDGES CONNECTING TEETH AND IMPLANTS TO TREAT TOOTH ABSENCE IN SEA VESSEL CREWS Artur Rasinski Military Institute of Medicine, Clinics of Otorhinolaryngology and Laryngological Oncology with the Clinical Ward of Oral and Maxillo-facial Surgery , Poland Grzegorz Klekot Warsaw University of Technology, Faculty of Automotive and Construction Machinery Engineering, Poland Piotr Skopiński Department of Histology and Embryology, Centre for Biostructure Research, Medical University of Warsaw, Poland ABSTRACT Implant treatment is a proven method in dentistry for partial and complete missing teeth reconstruction. In some clinical situations it is advisable to limit the number of implants, which can be obtained by making a bridge connecting the patient’s own tooth with the implant. So far, the possibility of using safe and permanent connections of natural teeth with implants has been examined to a small extent due to the dangers resulting from the different mobility of dental implants and teeth. An attempt was made to use vibro-acoustic techniques to evaluate various combinations of teeth and implants. Pilot studies were carried out on cadavers-pig mandibles with implants. There were recorded sounds in the immediate vicinity of the mandible formed in response to impulse excitations carried out with a point hit against a tooth or implant before and after their joining with a bridge. The comparison of spectra allows to see features indicating a high probability of being able to distinguish between the examined configurations. The results of the research should contribute to a better understanding of the mutual relations between the dental implant and the tooth, which are included in bridge.
    [Show full text]
  • American Academy of Periodontology Task Force Report on the Update to the 1999 Classification of Periodontal Diseases and Conditions*
    J Periodontol • July 2015 American Academy of Periodontology Task Force Report on the Update to the 1999 Classification of Periodontal Diseases and Conditions* The American Academy of Periodontology (AAP) peri- 4 mm CAL, and Severe =‡5 mm CAL.’’ Numerous odically publishes reports, statements, and guidelines important studies since 1999 have used similar pa- on a variety of topics relevant to periodontics. These rameters to define periodontitis. For example, the papers are developed by an appointed committee of recent epidemiologic studies outlining the prevalence experts, and the documents are reviewed and ap- of periodontitis in the United States used attachment proved by the AAP Board of Trustees. loss parameters to define various severities of peri- odontitis.2,3 It is recognized that CAL is of importance for the scientific advancement of the knowledge of n 2014, the American Academy of Periodontology periodontitis. However, in clinical practice, measure- Board of Trustees charged a Task Force to develop ment of CAL has proven to be challenging, and is time Ia clinical interpretation of the 1999 Classification consuming. Measuring the location of the cemento- of Periodontal Diseases and Conditions to address enamel junction (CEJ) when the gingival margin is concerns expressed by the education community, the located coronal to the CEJ is difficult and may involve American Board of Periodontology, and the practic- some guesswork when the CEJ is not readily evident ing community that the current Classification pres- via tactile sensation. These issues can result in ex- ents challenges for the education of dental students aminations being performed in which, rather than and implementation in clinical practice.
    [Show full text]
  • Common Icd-10 Dental Codes
    COMMON ICD-10 DENTAL CODES SERVICE PROVIDERS SHOULD BE AWARE THAT AN ICD-10 CODE IS A DIAGNOSTIC CODE. i.e. A CODE GIVING THE REASON FOR A PROCEDURE; SO THERE MIGHT BE MORE THAN ONE ICD-10 CODE FOR A PARTICULAR PROCEDURE CODE AND THE SERVICE PROVIDER NEEDS TO SELECT WHICHEVER IS THE MOST APPROPRIATE. ICD10 Code ICD-10 DESCRIPTOR FROM WHO (complete) OWN REFERENCE / INTERPRETATION/ CIRCUM- STANCES IN WHICH THESE ICD-10 CODES MAY BE USED TIP:If you are viewing this electronically, in order to locate any word in the document, click CONTROL-F and type in word you are looking for. K00 Disorders of tooth development and eruption Not a valid code. Heading only. K00.0 Anodontia Congenitally missing teeth - complete or partial K00.1 Supernumerary teeth Mesiodens K00.2 Abnormalities of tooth size and form Macr/micro-dontia, dens in dente, cocrescence,fusion, gemination, peg K00.3 Mottled teeth Fluorosis K00.4 Disturbances in tooth formation Enamel hypoplasia, dilaceration, Turner K00.5 Hereditary disturbances in tooth structure, not elsewhere classified Amylo/dentino-genisis imperfecta K00.6 Disturbances in tooth eruption Natal/neonatal teeth, retained deciduous tooth, premature, late K00.7 Teething syndrome Teething K00.8 Other disorders of tooth development Colour changes due to blood incompatability, biliary, porphyria, tetyracycline K00.9 Disorders of tooth development, unspecified K01 Embedded and impacted teeth Not a valid code. Heading only. K01.0 Embedded teeth Distinguish from impacted tooth K01.1 Impacted teeth Impacted tooth (in contact with another tooth) K02 Dental caries Not a valid code. Heading only.
    [Show full text]
  • Biodental Engineering V
    BIODENTAL ENGINEERING V PROCEEDINGS OF THE 5TH INTERNATIONAL CONFERENCE ON BIODENTAL ENGINEERING, PORTO, PORTUGAL, 22–23 JUNE 2018 Biodental Engineering V Editors J. Belinha Instituto Politécnico do Porto, Porto, Portugal R.M. Natal Jorge, J.C. Reis Campos, Mário A.P. Vaz & João Manuel R.S. Tavares Universidade do Porto, Porto, Portugal CRC Press/Balkema is an imprint of the Taylor & Francis Group, an informa business © 2019 Taylor & Francis Group, London, UK Typeset by V Publishing Solutions Pvt Ltd., Chennai, India All rights reserved. No part of this publication or the information contained herein may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, by photocopying, recording or otherwise, without written prior permission from the publisher. Although all care is taken to ensure integrity and the quality of this publication and the information herein, no responsibility is assumed by the publishers nor the author for any damage to the property or persons as a result of operation or use of this publication and/or the information contained herein. Library of Congress Cataloging-in-Publication Data Names: International Conference on Biodental Engineering (5th: 2018: Porto, Portugal), author. | Belinha, Jorge, editor. | Jorge, Renato M. Natal editor. | Campos, J.C. Reis, editor. | Vaz, Mario A.P., editor. | Tavares, Joao Manuel R.S., editor. Title: Biodental engineering V: proceedings of the 5th International Conference on Biodental Engineering, Porto, Portugal, 22–23 June 2018 / editors, J. Belinha, R.M. Natal Jorge, J.C. Reis Campos, Mario A.P. Vaz & Joao Manuel R.S. Tavares. Description: London, UK; Boca Raton, FL: Taylor & Francis Group, [2019] | Includes bibliographical references and index.
    [Show full text]
  • Association of Periodontal Diseases with Genetic Polymorphisms
    International Journal of Genetic Engineering 2012, 2(3): 19-27 DOI: 10.5923/j.ijge.20120203.01 Association of Periodontal Diseases with Genetic Polymorphisms Megha Gandhi*, Shaila Kothiwale KLE V K Institute of Dental Sciences, KLE University, Belgaum, Karnataka, India Abstract Periodontal diseases are multifactorial in nature. While microbial and other environmental factors are believed to initiate and modulate periodontal disease progression, there now exist strong supporting data that genetic polymorphisms play a role in the predisposition to and progression of periodontal diseases. Variations in any number or combination of genes that control the development of the periodontal tissues or the competency of the cellular and humoral immune systems could affect an individual's risk for disease. A corollary of this realization is that if the genetic basis of periodontal disease susceptibility can be understood, such information may have diagnostic and therapeutic value. This review aims to update the clinician about various genetic polymorphisms associated with periodontal diseases to aid in a better approach to the condition in the future. Ke ywo rds Periodontal Disease, Gene Polymorphisms, Chronic Periodontitis, Aggressive Periodontitis, Hereditary Gingiva l Fibro matosis the susceptibility of an individual to periodontal diseases. 1. Introduction Identifying genes and their polymorphisms can result in novel diagnostics for risk assessment, early detection o f Periodontal disease is an inflammatory illness that disease and individualized treatment approaches[6]. Thus, represents the main cause of tooth loss in developed genetic epidemiology, including knowledge of genetic countries, with increasing prevalence in the developing polymorphisms, holds promise as one of the tools that may world [1].
    [Show full text]
  • As If Nothing Had Ever Happened — Implants for Larger Tooth Gaps
    Ask your dentist for the other Friadent brochures: As if nothing had ever happened — implants for larger tooth gaps FRIADENT GMBH | STEINZEUgstrasse 50 | 68229 MANNHEIM/GERMANY 5-252023 Ank_Indikationbr_Ian_GB.indd 2-3 04.05.2007 8:27:55 Uhr 3 Dental implants. One hundred percent yourself! Introduction 3 Patient experience Dear patient, You may remember Ian from the poster in "Finally normal teeth again" Do you want to put an end to your problems with gaps your dentist's waiting room. He lost two premolars in Ian, 47 years old, manager 4 — 5 in your teeth and obvious or uncomfortable dentures? succession. The manager has decided to have two Do you want a relaxed and natural smile again? Do you implant-borne crowns and in this way can avoid having want to be able to chew without problems again and a removable partial denture. Since then he has been are you interested in implants and have you already able to go to his office with his normal self-confidence Treatment asked your dentist about the options? and feels years younger. To give you an idea how others Implants are definitely something for me! 6 — 7 experience the time before, during and after implant We congratulate you on your decision, it is the first placement, Ian would like to tell you about his ex- step on the way to showing your teeth proudly and perience. After that this brochure will tell you all you without embarrassment. need to know about these tiny artificial tooth roots What can I expect after and important information on the probable sequence the initial consultation? 7 Original Friadent dental implants are small but extreme- of your treat-ment, such as what you will have to do ly robust titanium screws that the dentist can use to and how your dentist can support you.
    [Show full text]
  • Molecular Basis for Soft Tissue Management of Gingivitis
    Dental, Oral and Craniofacial Research Case Series ISSN: 2058-5314 Molecular basis for soft tissue management of gingivitis, periodontitis and peri-implant mucositis using an FDA cleared inflammation-targeting hydrogel – high potency polymerized cross-linked sucralfate - A case series illustrated profile of a drug device (Orafate) and the clinical rationale for use Ricky W. McCullough1,2* 1Translational Medicine Clinic and Research Center, Mueller Medical International, Storrs Connecticut, USA 2Department of Medicine & Emergency Medicine Veterans Administration Medical Center, Teaching Hospital, Warren Alpert Medical School of Brown University Providence, Rhode Island 02908, USA Abstract Background: Current practice of soft tissue management (STM) targets the biofilm and its invasion into gingival soft tissue and periodontal space. Prior to FDA clearance of high potency polymerized cross-linked sucralfate (Orafate) there were not therapeutic options that targeted inflammation of the gingival and periodontal soft tissue structures. High potency polymerized cross-linked sucralfate (HPPCLS) for soft tissue management of oral inflammation represents an advance toward balanced medical management of oral inflammatory disease and wounds of oral surgery. Aim: To profile an FDA-cleared sucralfate-based medical device, covering the dental proof of concept, its pharmacology, mechanisms of action and the clinical rationale of its use which is to target oral inflammation. To provide initial rationale for the use of Orafate as an adjunctive treatment of gingivitis, periodontitis and peri-implant mucositis. Methods: Profile the clinical use of an inflammation-targeting hydrogel using a case series of 6 patients -severe periodontitis, deep pockets, post-cleaning dental pain, peri-implant mucositis, acute gingivitis, and dentin hypersensitivity. Review the concept and practice of STM and the pathophysiology of biofilm-induced soft tissue inflammation so as to provide the molecular basis of signs and symptoms of gingival inflammation.
    [Show full text]
  • Classifying Periodontal Diseases – a Long-Standing Dilemma
    Periodontology 2000, Vol. 30, 2002, 9–23 Copyright C Blackwell Munksgaard 2002 Printed in Denmark. All rights reserved PERIODONTOLOGY 2000 ISSN 0906-6713 Classifying periodontal diseases – a long-standing dilemma G C. A A long-standing dilemma have been superimposed on a matrix of older ideas that are still considered to be valid. Only those ideas Any attempt to group the entire constellation of peri- that are believed to be clearly outmoded or incorrect odontal diseases into an orderly and widely accepted have been discarded. In a sense, the newest or domi- classification system is fraught with difficulty, and nant paradigm rests on a foundation of the still valid inevitably considerable controversy. No matter how components of the older or previous paradigms. carefully the classification is developed, and how One of the interesting historical features of classi- much thought and time are invested in the process, fication systems is the often intense resistance to choices need to be made between equally unsatis- their modification. Many people appear to believe factory alternatives. Despite this dilemma, in the that classification systems are rigid and fixed entities past hundred years, experts have periodically as- that should not be changed. In fact, classification sembled to develop a new classification system for systems should be viewed as dynamic works-in-pro- periodontal diseases, or to refine an existing one (1, gress that need to be periodically modified based on 2, 4, 5, 11, 19, 58, 80, 81, 86, 91, 106, 122, 139). current thinking and new knowledge. Unfortunately, it seems that once people learn and accept a given classification, no matter how flawed it may be, they are extremely reluctant to accept revisions to their Dominant paradigms in the favorite system of nomenclature.
    [Show full text]
  • Section 1 – What Is Periodontitis?
    www.periodontal-health.com 1 Section 1 – What is periodontitis? Contents • 1.1 How is the tooth held in place in the jawbone? 3 • 1.2 What is the gingiva? 5 • 1.3 What is gingivitis and how common is it? 6 • 1.4 What is the periodontium? 8 • 1.5 What is periodontitis and how common is it? 9 • 1.6 Why is it called periodontitis, not periodontosis? 10 www.periodontal-health.com 2 Section 1 – What is periodontitis? Legal notice The website www.periodontal-health.com is an information platform about the causes, consequences, diagnosis, treatment, and prevention of peri- odontitis. The contents were created in media dissertations for a doctorate at the University of Bern. Media dissertations under the supervision of PD Dr. Christoph A. Ramseier MAS Periodontology SSO, EFP Periodontology Clinic, Dental Clinics of the University of Bern Content created by Dr. Zoe Wojahn, MDM PD Dr. Christoph A. Ramseier, MAS Declaration of no-conflict-of-interest The production of this website and its hosting was and is being funded by the lead author. The translation of this website into the English language was funded by the European Federation of Periodontology (EFP). The pro- duction of the images was supported by the School of Dental Medicine of the University of Bern. Illustrations Bernadette Rawyler Scientific Illustrator Department of Multimedia, Dental Clinics of the University of Bern Correspondence address PD Dr. med. dent. Christoph A. Ramseier, MAS Dental Clinics of the University of Bern Periodontology Clinic Freiburgstrasse 7 CH-3010 Bern Tel. +41 31 632 25 89 E-Mail: [email protected] Creative Commons Lisence: Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) https://creativecommons.org/licenses/by-nc-sa/4.0/deed.en www.periodontal-health.com 3 Section 1 – What is periodontitis? 1.1 How is the tooth held in place in the jawbone? Every tooth consists of a crown, a root, and a nerve.
    [Show full text]