DOCSLIB.ORG

Idiopathic Gingival Fibromatosis Associated with Generalized Aggressive Periodontitis: a Case Report

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Idiopathic Gingival Fibromatosis Associated with Generalized Aggressive Periodontitis: a Case Report Pratique CLINIQUE Idiopathic Gingival Fibromatosis Associated with Generalized Aggressive Periodontitis: A Case Report Auteure-ressource Rashi Chaturvedi, MDS, DNB Dre Chaturvedi Courriel : rashichaturvedi@ yahoo.co.in SOMMAIRE La fibromatose gingivale idiopathique est un état génétiquement hétérogène, qui se caractérise par une prolifération lente et bénigne des tissus gingivaux. Cet état fait habi- tuellement partie d’un syndrome et est rarement isolé. La parodontite agressive est un autre trouble du parodonte d’origine génétique, qui entraîne généralement une des- truction rapide et marquée des tissus de soutien des dents. La sensibilité accrue de la population hôte atteinte de parodontite agressive pourrait être due à l’effet combiné de plusieurs gènes et à leurs interactions avec divers facteurs environnementaux. Des anomalies fonctionnelles des neutrophiles ont aussi été mises en cause dans l’étiopatho- génie de la parodontite agressive. Nous présentons un rare cas de fibromatose gingivale idiopathique non syndromique associée à une parodontite agressive généralisée. Notre diagnostic repose sur une évaluation clinique et radiologique, des observations histopa- thologiques et une analyse immunologique de la fonction des neutrophiles par un test de réduction au nitro bleu de tétrazolium. Nous décrivons une démarche interdisciplinaire pour le traitement du patient. Pour les citations, la version définitive de cet article est la version électronique : www.cda-adc.ca/jcda/vol-75/issue-4/291.html diopathic gingival fibromatosis is a rare her- ally nonsyndromic, have been genetically linked editary condition that has no specific cause.1 to the chromosome 2p21-p222 and 5q13-q22.4 IInvestigations are ongoing to establish the Recently, a mutation in the son of sevenless-1 genetic linkage and heterogeneity associated (SOS-1) gene has been suggested as a possible with it.2–5 This condition may manifest as an cause of isolated (nonsyndromic) gingival fi- autosomal-dominant6–9 or, less commonly, an bromatosis, but no definite linkage has been autosomal-recessive mode of inheritance,10–12 established.5 either as an isolated disorder or as part of a Idiopathic gingival fibromatosis is a slowly syndrome.6 Syndromic gingival fibromatosis progressive benign enlargement that affects the has been associated with ancillary features such marginal gingiva, attached gingiva and inter- as hypertrichosis, mental retardation, epilepsy, dental papilla. The fibromatosis may potentially progressive sensorineural hearing loss and ab- cover the exposed tooth surfaces, causing es- normalities of the extremities, particularly of thetic and functional problems, and in extreme the fingers and toes.6,13 Autosomal-dominant cases may distort the jaws. The gingival tissues forms of gingival fibromatosis, which are usu- are usually pink and nonhemorrhagic, and have JADC • www.cda-adc.ca/jadc • Mai 2009, Vol. 75, No 4 • 291 ––– Chaturvedi ––– Figure 1: Preoperative intraoral frontal view Figure 2: Preoperative intraoral right lat- Figure 3: Preoperative intraoral left of the maxillary and mandibular arches. eral view of the maxillary and mandibular lateral view of the maxillary and man- arches. dibular arches. a firm, fibrotic consistency.1,13–17 Histopathologically, the Case History bulbous increased connective tissue is relatively avascular Diagnosis and has densely arranged collagen-fibre bundles, num- A 23-year-old man reported to the outpatient depart- erous fibroblasts and mild chronic inflammatory cells. The ment of our institute complaining of pain and swelling in overlying epithelium is thickened and acanthotic, and has the gums and an inability to chew food. The patient was also elongated rete ridges.1,13–18 Unusual findings include the pres- concerned about the progressively increased spacing be- ence of small calcified particles, amyloid deposits, islands of tween his upper front teeth and their movement away from odontogenic epithelium and osseous metaplasia in the con- their original positions. nective tissue, and ulcerations of the overlying mucosa.19 The medical history revealed that the patient’s gums Aggressive periodontitis comprises another group of had progressively enlarged over the last 6 to 7 years and genetically inherited diseases that represent a severe and rapidly progressive form of periodontitis. Characteristically, that the patient had pain during mastication and in- these diseases tend to exhibit familial aggregation and there creased tooth mobility, especially of all 4 first molars, are no factors in the medical history that seem associated 3 of which had to be extracted about 2 years before. Nothing with the condition.20 in the patient’s medical and family history seemed related Aggressive forms of periodontitis are currently consid- to the condition, and no associated endocrinological ab- ered to be multifactorial diseases that develop as a result normality could be detected. The patient was not receiving of complex interactions between specific host genes and any anti-epileptic, antihypertensive or immunosuppressive the environment. Various factors have been identified that medications that could contribute to the gingival enlarge- increase the risk of developing aggressive periodontitis, in- ment. However, the patient had smoked up to 20 cigarettes cluding familial aggregation, single nucleotide polymorph- a day for the past 4 to 5 years and drank alcohol about 2 or isms, neutrophil functional defects, antibodies to specific 3 times a week. bacteria, herpes virus infection, smoking and stress.21 Intraoral examination revealed moderate-to-severe gin- Generalized aggressive periodontitis usually affects gival overgrowth of a firm, dense and fibrotic consist- people under 30 years of age. They have a poor serum-anti- ency that involved both the maxillary and mandibular body response to infecting agents and pronounced episodic arches (Figs. 1 to 3). The patient had generalized tooth destruction of the attachment and alveolar bone. The loss of mobility with a severe pathologic migration, especially attachment affects at least 3 permanent teeth other than first of the upper anterior teeth. Full-mouth periodontal charting, molars and incisors.22 including assessment of probing depth and clinical attach- We report here an unusual case of a nonsyndromic, ment level, revealed deep pockets throughout the mouth, idiopathic gingival fibromatosis associated with general- and scanty plaque and calculus deposits. ized aggressive periodontitis. Only one other case with The radiographic findings, which corroborated those such an association has been reported to date.18 We of the clinical examination, revealed severe generalized al- discuss our patient’s clinical findings, histopathologic veolar bone loss (Fig. 4). The peripheral blood results were evaluation, analysis of neutrophil function and treatment normal and correlated with an absence of any history of plan. systemic disease. 292 JADC • www.cda-adc.ca/jadc • Mai 2009, Vol. 75, No 4 • ––– Idiopathic Gingival Fibromatosis ––– Figure 4: Preoperative panoramic radiograph of the maxillary and Figure 5: Gingival tissues excised during mandibular arches showing severe generalized alveolar bone loss. periodontal surgery were sent for histo- pathologic assessment. Figure 6: Photomicrograph of the Figure 7: Photomicrograph of the con- Figure 8: Photomicrograph illustrating the specimen illustrating the presence nective tissue illustrating the presence of presence of dense collagen bundles in the of a thickened acanthotic epithelium densely arranged collagen bundles with connective tissue with multiple areas of with elongated rete ridges and a numerous fibroblasts and few mixed inflam- neovascularization (original magnification densely fibrous connective tissue with matory cells, mainly around blood vessels 100×). numerous fibroblasts (original magni- (original magnification 400×). fication 100×). Based on all these findings, a provisional diagnosis of Analysis of Neutrophil Function idiopathic gingival enlargement with generalized aggressive The phagocytic ability of the patient’s polymorphonu- periodontitis was made. clear leukocytic cells was assessed with a nitro-blue- Histopathologic Findings tetrazolium (NBT) reduction test. During this test, The attached gingiva excised from the buccal and inter- polymorphonuclear leucocytes (PMNLs) were stimulated dental areas during surgery (Fig. 5) was immediately fixed with heat-killed spores of Candida albicans to evaluate in 10% buffered formaldehyde solution and sent for histo- the oxidative pathway. Normal granulocytes metabolically pathologic examination. The specimen was processed and activated by phagocytosis reduce NBT to blue formazan. then embedded in paraffin wax. Multiple 5-mm serial sec- Eighty percent of the patient’s cells contained reduced blue tions were prepared, stained with hematoxylin and eosin, formazan, which was the percentage of PMNLs producing a and viewed under a trinocular light microscope with flat- respiratory burst, thereby indicating the normal functioning field objective lenses at 100× and 400× magnifications. of the oxygen-dependent leukocytic bactericidal system. The microscopic evaluation of these sections revealed parakeratinized stratified squamous acanthotic epithelia Treatment with thin long rete ridges extending into the connective The patient initially underwent phase 1 periodontal tissue. The underlying connective tissue showed dense therapy that comprised scaling and root planing, oral wavy bundles of
Load more

Recommended publications
  • Instant Update- Getting up to Speed in Periodontics for 2019 Pennsylvania Dental Association Gettysburg Meeting April 6, 2019 F
    Instant Update- Getting Up To Speed in Periodontics for 2019 Pennsylvania Dental Association Gettysburg Meeting April 6, 2019 Francis G. Serio, DMD, MS, MBA Diplomate, American Board of Periodontology Staff Dentist, Greene County Health Care, Inc. Course Synopsis Some things change and some things remain the same. The bedrocks of periodontal therapy are time-tested but new approaches to some of these therapies are providing better outcomes for patients. In addition, advances in the science of periodontics have led to both a better understanding of the disease processes and a new classification system for the periodontal diseases and conditions. In addition, as implant dentistry continues to solidify its position, complications are becoming more commonplace. This course will focus on four main areas: The changes in science that have led to the new classification of the periodontal diseases and conditions. Current understanding of the perio-systemic connection. The “semi-surgical” approach to periodontal therapy. Peri-implant mucositis and peri-implantitis and what to do about it. At the end of this presentation, each participant will be able to: Identify the differences between the 1999 and 2017 disease classification systems. Identify key factors and systemic diseases that have a strong association with the periodontal diseases. Develop a “semi-surgical” treatment plan for a patient with periodontitis. Understand the key factors that contribute to peri-implant disease and possible therapeutic approaches. Periodontitis is a disease of the non-mineralized and mineralized connective tissues- What causes and contributes to its breakdown? Bacterial infections vs. Inflammation 1 Statistical vs. Clinical Significance Clinical significance- Jacobson, et al.
    [Show full text]
  • Deep Cleaning (Scaling and Root Planing) Home Care Instructions
    Deep Cleaning (Scaling and Root Planing) Home Care Instructions Following the completion of your deep cleaning appointment please follow these home care instructions : - Days 1-3: Warm saltwater rinses 2-3 times daily. A soft food diet is recommended in these initial few days. Days 4-14: Rinse with 1 cap full of Chlorhexidine twice daily after brushing and flossing. Please refrain from eating or drinking for 30 minutes after. Resume twice daily brushing and flossing. Consistent daily oral hygiene is essential to allow proper healing of your gum tissues. - In some cases, local antibiotics may have been placed. If so, please follow the specific instructions that were given to you at your appointment. Others points to Consider: The local anesthesia administered will likely cause your lips, tongue, and cheeks to remain numb for several hours. During this time, please be very careful to not chew, burn, or otherwise injure your lips, tongue, or cheeks. If you must eat while still numb, it is advisable to do so on the opposite side. It is normal to have some mild discomfort after your cleaning. The discomfort is from cleaning plaque and calculus off of the teeth around already inflamed tissue. The multiple injections also will contribute towards your soreness. Motrin may be taken for pain relief, but do not exceed 800mg in 8 hours. After scaling and root planing, you can expect that your gum tissue will be less swollen or prone to bleeding. You may also notice that your teeth feel smoother and your breath smells better. You may experience some thermal sensitivity (especially cold) after your cleaning.
    [Show full text]
  • A Mini Review on Non-Augmentative Surgical Therapy of Peri-Implantitis—What Is Known and What Are the Future Challenges?
    MINI REVIEW published: 20 April 2021 doi: 10.3389/fdmed.2021.659361 A Mini Review on Non-augmentative Surgical Therapy of Peri-Implantitis—What Is Known and What Are the Future Challenges? Kristina Bertl 1,2* and Andreas Stavropoulos 1,3,4 1 Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden, 2 Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria, 3 Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland, 4 Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria Non-augmentative surgical therapy of peri-implantitis is indicated for cases with primarily horizontal bone loss or wide defects with limited potential for bone regeneration and/or re-osseointegration. This treatment approach includes a variety of different techniques (e.g., open flap debridement, resection of peri-implant mucosa, apically positioned flaps, bone re-contouring, implantoplasty, etc.) and various relevant aspects should be considered during treatment planning. The present mini review provides an overview on what is known for the following components of non-augmentative surgical treatment of Edited by: Priscila Casado, peri-implantitis and on potential future research challenges: (1) decontamination of the Fluminense Federal University, Brazil implant surface, (2) need of implantoplasty, (3) prescription of antibiotics,
    [Show full text]
  • Periodontal Surgery in Furcation-Involved Maxillary Molars Revisited—An Introduction of Guidelines for Comprehensive Treatment
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by RERO DOC Digital Library Clin Oral Invest (2011) 15:9–20 DOI 10.1007/s00784-010-0431-9 REVIEW Periodontal surgery in furcation-involved maxillary molars revisited—an introduction of guidelines for comprehensive treatment Clemens Walter & Roland Weiger & Nicola Ursula Zitzmann Received: 1 November 2009 /Accepted: 1 June 2010 /Published online: 23 June 2010 # Springer-Verlag 2010 Abstract Maxillary molars with interradicular loss of overview, including what constitutes accurate diagnosis and periodontal tissue have an increased risk of additional what indications there are for the different surgical attachment loss with an impaired long-term prognosis. periodontal treatment options. Since accurate clinical analysis of furcation involvement is not feasible due to limited access, morphological variations Keywords Furcation involvement . Furcation surgery. and measurement errors, additional diagnostics, e.g., with Diagnosis . Decision making . 3D imaging cone-beam computed tomography, may be required. Surgi- cal treatment options have graduated from a less invasive Abbreviations and acronyms approach, i.e., keeping as much periodontal attachment as FI Furcation involvement possible, to a more invasive approach: (1) open flap PPD Probing pocket depth debridement with/without gingivectomy or apically reposi- PAL Probing attachment level tioned flap and/or tunnelling; (2) root separation; (3) Sc&Rp Scaling and root planning amputation/trisection of a root (with/without root separation RCT Root canal treatment or tunnel preparation); (4) amputation/trisection of two SPT Supportive periodontal treatment roots; and (5) extraction of the entire tooth. Tunnelling is FDP Fixed dental prosthesis indicated when the degree of root separation allows for RDP Removable dental prosthesis opening of the interradicular region.
    [Show full text]
  • 04-301E Scaling and Root Planing
    Dental Policy Subject: Scaling and Root Planing Guideline #: 04-301E Publish Date: 05/01/2019 Status: Revised Last Review Date: 04/22/2019 Description This document addresses Scaling and Root Planing. Scaling and root planing is a nonsurgical procedure considered appropriate for the treatment of mild to severe periodontal disease. Periodontal scaling and root planing involves instrumentation of the crown and root surfaces of teeth to remove plaque and calculus. This periodontal procedure involves the removal of cementum and dentin permeated by calculus, toxins, and microorganism. It is a definitive non-surgical therapeutic procedure, rather than prophylactic, to treat periodontal disease where migration of the epithelial attachment has caused the formation of periodontal pockets of at least 4 mm. Periodontal scaling and root planing is: 1. A demanding and time-consuming procedure which is technique sensitive involving instrumentation of the tooth crown and root structures. 2. To remove plaque and biofilm, adherent calculus deposits, and diseased cementum (root structure) that may be permeated with calculus, microorganisms and microbial toxins. 3. involves hand instrumentation The plan performs review of scaling and root planing due to contractual requirements that necessitate benefits for dental services meet specific contract requirements. For example, plan contract(s) may require the provision of benefits for services that meet generally accepted standards of dental care at the lowest cost that properly addresses the patient’s condition. The conclusion that a particular service is medically or dentally necessary does not constitute an indication or warranty that the service requested is a covered benefit payable by the dental plan. Documentation Criteria #1 In order to perform review of the scaling and root planning service, diagnostic information is required.
    [Show full text]
  • The International Journal of Periodontics & Restorative Dentistry
    The International Journal of Periodontics & Restorative Dentistry © 2013 BY QUINTESSENCE PUBLISHING CO, INC. PRINTING OF THIS DOCUMENT IS RESTRICTED TO PERSONAL USE ONLY. NO PART MAY BE REPRODUCED OR TRANSMITTED IN ANY FORM WITHOUT WRITTEN PERMISSION FROM THE PUBLISHER. 217 Open Flap Debridement in Combination with Acellular Dermal Matrix Allograft for the Prevention of Postsurgical Gingival Recession: A Case Series Ramesh Sundersing Chavan, BDS, MDS1 The therapeutic objective of peri- Manohar Laxman Bhongade, MSc, BDS, MDS2 odontal flap surgery is to provide Ishan Ramakant Tiwari, BDS, MDS1 accessibility to the underlying Priyanka Jaiswal, BDS, MDS1 root surface to reduce the pocket depth,1 arrest further breakdown, and prevent additional attach- Open flap debridement with flap repositioning may result in significant gingival ment loss. Open flap debridement recession. Patients with chronic periodontitis were treated with open flap 2 debridement followed by placement of an acellular dermal matrix allograft (OFD) is a common procedure for (ADMA) underneath the flap to minimize the occurrence of postsurgical gingival the treatment of deep periodontal recession. Ten patients (total, 60 teeth) with periodontal pockets in the anterior pockets associated with horizontal dentition underwent open flap debridement combined with ADMA. Probing bone loss. This procedure is indi- pocket depth, relative attachment level, and relative gingival margin level were cated when pocket elimination is recorded at baseline and 6 months postsurgery. The mean probing pocket undesirable because of esthetic depth at baseline and 6 months was 4.4 and 1.7 mm, respectively (P < .05); the mean relative attachment level at baseline and 6 months was 12.9 and 10.7 mm, considerations, particularly in the respectively (P < .05); and the mean relative gingival margin level at baseline and anterior dentition.
    [Show full text]
  • Comparative Evaluation of Two Different One-Stage Full-Mouth
    ORIGINAL RESEARCH Comparative Evaluation of Two Different One-stage Full-mouth Disinfection Protocols using BANA Assay: A Randomized Clinical Study Arjumand Farooqui1, Vineet V Kini2, Ashvini M Padhye3 ABSTRACT Aim: The aim of this study was to evaluate and compare two different one-stage full-mouth disinfection protocols in the treatment of chronic periodontitis by assessing dental plaque and tongue coat using BANA assay. Materials and methods: The present study was a prospective randomized clinical parallel arm study design including 40 healthy subjects randomly allocated into two groups, i.e., group A (Quirynen’s protocol of one-stage full-mouth disinfection) and group B (Bollen’s protocol of one-stage full-mouth disinfection). Subjects were assessed at baseline and six weeks using plaque index, gingival index, and sulcus bleeding index. Probing depth and relative clinical attachment level were also recorded at six weeks. Winkel tongue coat index and BANA were recorded at 8 weeks using subgingival plaque and tongue coat sample. Results: Both group A and group B demonstrated statistically significant reduction in plaque index, gingival index, sulcus bleeding index, Winkel tongue coat index, reduction in probing depth, and gain in relative clinical attachment level on intragroup comparison. There was no significant difference in BANA assay score of subgingival plaque and tongue coat samples in between group A and group B. Conclusion: From the findings of this study, both Quirynen’s protocol and Bollen’s protocol of one-stage full-mouth disinfection are effective in plaque reduction and tongue coat reduction and achieve comparable clinical healing outcomes. Clinical significance: The difference in duration and mode of use of chlorhexidine as a chemical plaque control agent in the two treatment interventions of Quirynen’s and Bollen’s protocol of one-stage full-mouth disinfection did not demonstrate statistical significance in reducing sulcus bleeding index scores, reducing probing depths, and gain in relative clinical attachment levels.
    [Show full text]
  • Article Download
    wjpls, 2018, Vol. 4, Issue 8, 182-184 Case Report ISSN 2454-2229 Gavali et al. World Journal of Pharmaceutical World Journaland Life of Pharmaceutical Sciences and Life Sciences WJPLS www.wjpls.org SJIF Impact Factor: 5.088 THE MODIFIED WIDMAN FLAP TECHNIQUE: A CASE REPORT Dr. Neelam Gavali*1, Dr. Pramod Waghmare2, Dr. Vishakha Patil3, Dr. Nilima Landge4 1Post Graduate Student, Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital- Pune. 2Professor, Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital- Pune. 3Professor, Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital- Pune. 4Associate Professor, Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital- Pune. *Corresponding Author: Dr. Neelam Gavali Post Graduate Student, Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital- Pune. Article Received on 24/05/2018 Article Revised on 14/06/2018 Article Accepted on 05/07/2018 ABSTRACT The Modified Widman flap (MWF), one of the most common and conservative surgical approaches that aims to eliminate the inflamed gingival tissue and also provide access for root debridement. It is classified with the “access flap operations” because the goal of the flap reflection is primarily to provide improved visual access to the periodontally involved tissues. The modified widman flap surgery is not aimed at surgical eradication of pocket walls, including bony walls. It is aimed at maximum healing in areas of previous periodontal pockets with minimum loss of periodontal tissues during and after the surgery.[6] KEYWORDS: Modified widman flap, Gingival enlargement.
    [Show full text]
  • Surgical Management of Peri-Implantitis
    Current Oral Health Reports (2020) 7:283–303 https://doi.org/10.1007/s40496-020-00278-y PERI-IMPLANTITIS (I DARBY, SECTION EDITOR) Surgical Management of Peri-implantitis Ausra Ramanauskaite1 & Karina Obreja1 & Frank Schwarz1 Published online: 1 August 2020 # The Author(s) 2020 Abstract Purpose of Review To provide an overview of current surgical peri-implantitis treatment options. Recent Findings Surgical procedures for peri-implantitis treatment include two main approaches: non-augmentative and aug- mentative therapy. Open flap debridement (OFD) and resective treatment are non-augmentative techniques that are indicated in the presence of horizontal bone loss in aesthetically nondemanding areas. Implantoplasty performed adjunctively at supracrestally and buccally exposed rough implant surfaces has been shown to efficiently attenuate soft tissue inflammation compared to control sites. However, this was followed by more pronounced soft tissue recession. Adjunctive augmentative measures are recommended at peri-implantitis sites exhibiting intrabony defects with a minimum depth of 3 mm and in the presence of keratinized mucosa. In more advanced cases with combined defect configurations, a combination of augmentative therapy and implantoplasty at exposed rough implant surfaces beyond the bony envelope is feasible. Summary For the time being, no particular surgical protocol or material can be considered as superior in terms of long-term peri- implant tissue stability. Keywords Peri-implantitis . Treatment . Surgical therapy Introduction of further bone loss [5]. To achieve these treatment endpoints, it is currently accepted that surgical approaches that allow ade- Peri-implantitis is a plaque-associated pathological condition quate access to the contaminated implant surface are required occurring around dental implants that results in a breakdown [6–8].
    [Show full text]
  • The Treatment of Peri-Implant Diseases: a New Approach Using HYBENX® As a Decontaminant for Implant Surface and Oral Tissues
    antibiotics Article The Treatment of Peri-Implant Diseases: A New Approach Using HYBENX® as a Decontaminant for Implant Surface and Oral Tissues Michele Antonio Lopez 1,†, Pier Carmine Passarelli 2,†, Emmanuele Godino 2, Nicolò Lombardo 2 , Francesca Romana Altamura 3, Alessandro Speranza 2 , Andrea Lopez 4, Piero Papi 3,* , Giorgio Pompa 3 and Antonio D’Addona 2 1 Unit of Otolaryngology, University Campus Bio-Medico, 00128 Rome, Italy; [email protected] 2 Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Department of Head and Neck, Catholic University of the Sacred Heart, Gemelli University Polyclinic Foundation, 00168 Rome, Italy; [email protected] (P.C.P.); [email protected] (E.G.); [email protected] (N.L.); [email protected] (A.S.); [email protected] (A.D.) 3 Department of Oral and Maxillo Facial Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00161 Rome, Italy; [email protected] (F.R.A.); [email protected] (G.P.) 4 Universidad Europea de Madrid, 28670 Madrid, Spain; [email protected] * Correspondence: [email protected] † These authors contributed equally to this work. Abstract: Background: Peri-implantitis is a pathological condition characterized by an inflammatory Citation: Lopez, M.A.; Passarelli, process involving soft and hard tissues surrounding dental implants. The management of peri- P.C.; Godino, E.; Lombardo, N.; implant disease has several protocols, among which is the chemical method HYBENX®. The aim Altamura, F.R.; Speranza, A.; Lopez, of this study is to demonstrate the efficacy of HYBENX® in the treatment of peri-implantitis and to A.; Papi, P.; Pompa, G.; D’Addona, A.
    [Show full text]
  • Microbiological Outcomes from Different Periodontal Maintenance Interventions: a Systematic Review
    SYSTEMAIC REVIEW Periodontics Microbiological outcomes from different periodontal maintenance interventions: a systematic review Patricia Daniela Melchiors ANGST(a) Abstract: This study aimed to investigate the differences in the Amanda Finger STADLER(b) subgingival microbiological outcomes between periodontal patients Rui Vicente OPPERMANN(c) Sabrina Carvalho GOMES(c) submitted to a supragingival control (SPG) regimen as compared to subgingival scaling and root planing performed combined with supragingival debridement (SPG + SBG) intervention during the (a) Universidade Federal de Pelotas – UFPEL, periodontal maintenance period (PMP). A systematic literature search Dental School, Department of Semiology using electronic databases (MEDLINE and EMBASE) was conducted and Clinic, Pelotas, RS, Brazil. looking for articles published up to August 2016 and independent of (b) Augusta University, The Dental College language. Two independent reviewers performed the study selection, of Georgia, Department of Periodontics, quality assessment and data collection. Only human randomized or Augusta, GA, United States of America. non-randomized clinical trials with at least 6-months-follow-up after (c) Universidade Federal do Rio Grande do periodontal treatment and presenting subgingival microbiological Sul – UFRGS, Dental School, Department of Conservative Dentistry, Porto Alegre, RS, Brazil. outcomes related to SPG and/or SPG+SBG therapies were included. Search strategy found 2,250 titles. Among these, 148 (after title analysis) and 39 (after abstract analysis) papers were considered to be relevant. Finally, 19 studies were selected after full-text analysis. No article had a direct comparison between the therapies. Five SPG and 14 SPG+SBG studies presented experimental groups with these respective regimens and were descriptively analyzed while most of the results were only presented graphically.
    [Show full text]
  • One-Stage, Full-Mouth Disinfection: Fiction Or Reality?
    FOCUS ARTICLE One-Stage, Full-Mouth Disinfection: Fiction or Reality? Marc Quirynen, Wim Teughels, Martine Pauwels, Daniel van Steenberghe Recent research indicated that periopathogens colonize, besides the pockets, also other niches within the oral cavity including: the soft tissues, the saliva, the tongue, and even the tonsils. Since the supragingival plaque and the bacteria in these niches have a major impact on the subgin- gival plaque colonisation but especially on the recolonation after debridement, it seems reason- able to expect that a one-stage, full-mouth disinfection protocol, involving the bacteria over the entire oro-pharyngeal area, has a significantly better outcome when compared to a more staged approach (e.g. with treatments per quadrant). Since several review papers recently discussed the benefits of a one-stage, full-mouth disinfection protocol, pointing to some shortcomings in the our research protocol or with an attempt to compare the data of the new approach with other studies (with unfortunately non comparable approaches), this review paper aims to clarify some of the confusion concerning the benefits of a one-stage, full-mouth disinfection approach. Key words: periodontal breakdown; periodontopathogens; mouth disinfection INTRODUCTION logy, 1996; Slots and Rams, 1991; Socransky and Haffajee, 1992; Wolff et al, 1994). The ef- Periodontal breakdown primarily develops when ficiency of the host defence is partially hereditary the microbial load within a periodontal pocket (Kinane and Hart, 2003) but environmental fac- overrules the local and systemic host defence tors such as bad oral hygiene, smoking, immuno- mechanisms. Such an imbalance occurs in differ- suppressive medication, stress and so on can fur- ent situations, including an aspecific increase in ther impair the immune defence mechanism.
    [Show full text]