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PubMedDate not supplied

Management of molar teeth with periodontal disease.

Over the years patients' attitudes towards maintaining a functional and aesthetic masticatory apparatus have improved, and their expectations of delivery of care by the dental professional have risen. With the advance of new techniques and materials, the periodontist can now offer an ever-expanding range of treatments in the management of molar teeth with periodontal disease. This paper considers such treatment in relation to the levels of disease present and within the overall context of adult restorative dental healthcare.

Adult↗
PubMed2004

Behavior of partially formed roots of teeth submitted to orthodontic movement.

The occurrence of root resorption in orthodontically treated permanent incisors with partially formed roots was investigated using periapical radiographs taken before and after the orthodontic leveling in the mixed dentition. The mean age at the beginning of treatment was 9 years and the mean treatment time was 7.1 months. The findings showed that the orthodontic movement during root formation causes no root resorption. The longitudinal follow-up showed that incompletely formed roots developed normally.

Child↗
PubMed1975

An inhibitory principle in the matrix of periodontally diseased roots.

The inhibitory influence shown by the periodontally diseased root resides in its organic component. Its nature is uncertain and it may be an etiologic factor in periodontal destruction. The apatite structures of healthy and diseased roots are alike in being more receptive to the growth of bone and marrow than are their respective matrices.

Abdomen↗
PubMed1988

Collagen linkage in periodontal connective tissue reattachment. An ultrastructural study in beagle dogs.

Early stages of connective tissue reattachment to surgically denuded cementum and root dentin following citric acid application were studied in fenestration wounds. Block specimens were obtained after seven, 14, and 21 days. Continuity between newly deposited collagen fibrils in the granulation tissue and unmasked dental matrix collagen had been established within seven days by interdigitation of fibrils in an up to 0.5 micron-wide zone at the cementum or dentin surface. Splicing of collagen at the fibrillar level by direct attachment to the severed end of matrix fibrils or by juxtapositioning of new and old fibrils was seen in rare instances only. At 14 and 21 days, distinct bundles of collagen fibrils inserted deeply into the orifice of dentinal tubules. Arrested and reversed surface resorption was encountered at all time points. At these sites as well, new collagen fibrils interdigitated with denuded matrix collagen, while some resorbed surfaces were characterized by absence of collagen continuity. The results lend continued support to the concept of reattachment based on interdigitation of collagen fibrils. However, since attachment is established even in the absence of this feature, a significant role for specific attachment substances not shown can also be postulated.

Animals↗
PubMed1989

The effect of various concentrations of collagen barrier on periodontal wound healing.

Collagen membrane preparations were manufactured with the aim of enhancing wound healing following periodontal surgery. In order to clarify effects of different concentrations of collagen on wound healing, a basic study was performed. Solutions containing 0.5%, 1.0%, and 1.3% atelocollagen were treated with hexamethylenediisocyanate (HMDIC) for cross-linking, and collagen membranes were prepared with each solution. Periodontal flap surgery was performed on the palatal gingiva beside the maxillary first molar teeth in rats. The root surface of the tooth was exposed and curretted. Then, a piece of atelocollagen membrane was implanted. The healing of the wound was studied histologically and the following findings were made. (1) Apical migration of the junctional epithelium occurred within 2 weeks postoperatively. (2) The implantation of atelocollagen membrane significantly reduced the apical migration. (3) The apical migration of the epithelium did not vary with collagen concentration.

Animals↗
PubMed1992

A preliminary study on the effects of the Nd:YAG laser on root surfaces and subgingival microflora in vivo.

The purpose of this study was to examine the effects of root preparation using the pulsed Nd:YAG laser, either alone or in combination with manual instrumentation. Study specimens consisting of 18 teeth with associated periodontal pockets from 8 different patients were treated as follows: 5 specimens were root planed with curets followed by laser exposure for 3 minutes using energy settings of 3.0 W at 20 pps; 2 specimens were root planed and then laser treated for 3 minutes using settings of 2.25 W and 20 pps; 4 specimens were treated by laser for 1 minute at settings of 1.75 W and 20 pps followed by root planing; 4 specimens were treated by laser only for 1 minute using settings of 1.75 W and 20 pps; and the remaining 3 teeth served as untreated controls. Both prior to and after completion of the laser and root planing treatments, microbiological samples were obtained from the treated pockets and submitted to a commercial laboratory for analysis of levels of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia. With the exception of two 7-day specimens, all others were extracted immediately post-therapy and processed for SEM examination. All treated specimens, regardless of treatment sequence, exhibited some degree of laser-induced root surface alteration. Notably, laser-treated calculus deposits were free of their characteristic surface layer of microbial plaque. Microbial sampling indicated a post-therapy reduction in levels of all 3 putative microbial pathogens compared to pre-treatment samples and control specimens. However, SEM examination revealed residual deposits of plaque and calculus in all treatment groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1998

The effects of a single course of a calculus-softening scaling and root planing gel. A scanning electron microscopic study.

The effect of a calculus scaling gel was evaluated as an adjunct to instrumentation in a double blind, split-mouth, clinical study. Fifteen comparable periodontally involved teeth from 5 patients were instrumented on the mesio-buccal root surface with the aid of either the test gel, placebo gel, or no gel until smoothness was achieved. Test or placebo gel was applied subgingivally for 10 minutes. Instrumentation time, ease, number of strokes, and gingival/tooth surfaces changes were recorded. Scanning electronic microscopic (SEM) evaluation of root surface topography was evaluated. The results demonstrated effective calculus removal in all treatment groups with no differences found between them. Instrumentation time, ease, and number of strokes were similar for all treatment groups. There were no harmful effects to soft or hard tissues. The results of this study do not support the use of calculus scaling gel as an adjunct to root instrumentation.

Adult↗
PubMed2000

Comparison of four methods of assessing root surface debridement.

BACKGROUND: While there is great interest in measuring the efficacy of root surface debridement, there is little consensus on how this might be best achieved. The aim of this study was therefore to compare four different methods of assessing root surface debridement in their ability to discriminate between ultrasonically instrumented root surfaces and non-instrumented control surfaces. METHODS: Single-session subgingival root debridement was performed by an experienced operator on 30 teeth prior to their extraction. Following extraction, efficacy of root surface debridement was measured by percentage of remaining calculus, instrument efficiency, modified instrument efficiency, and percentage apical plaque border. In addition, the effect of probing depth landmark (apical plaque border versus connective tissue attachment) on outcomes was assessed. RESULTS: The results indicated that percentage apical plaque border demonstrated highly statistically significant differences between instrumented and control surfaces (P= 0.02). No other assessment method was able to discriminate between instrumented and non-instrumented surfaces, and this may be a function of the low amount of root surface calculus in the experimental sample. In addition, choice of probing depth landmark had a notable effect on the outcomes for instrument efficiency and modified instrument efficiency. Ninety-five percent limits of agreement of interexaminer reproducibility were found to be much higher than intra-examiner measurement for all four methods of assessment. CONCLUSIONS: Percentage apical plaque border appeared to be potentially more useful than other methods for assessing the efficacy of debridement of periodontally involved root surfaces, particularly for measuring instrument penetrability.

Coloring Agents↗
PubMed2001

A multidisciplinary approach to the diagnosis and treatment of early-onset periodontitis: a case report.

BACKGROUND: The diagnosis and treatment of early-onset forms of periodontitis (EOP) represent a major challenge to periodontists. In this case report, we describe a multidisciplinary approach for the treatment of a patient with severe generalized juvenile periodontitis (GJP). Our approach incorporates clinical laboratory evaluation with conventional concepts of periodontal pathogenesis and therapeutics to diagnose and effectively treat EOP. METHODS: The 17-year-old female patient presented with clinical and radiographic evidence of severe attachment loss. Microbiological testing showed the presence of known periodontal pathogens including Actinobacillus actinomycetemcomitans, Prevotella intermedia, and Porphyromonas gingivalis. Routine immunological tests did not reveal any of the functional defects thought to play a role in the pathogenesis of EOP After initiation of therapy, which consisted of scaling and root planing, supplemented with administration of systemic antibiotics, a reduction in probing depth and gain in clinical attachment could be demonstrated. Microbiological testing was used to monitor the composition of the periodontal microbiota and to adjust antimicrobial therapy accordingly. RESULTS: Using a non-surgical approach to treatment, except for 2 root amputations performed without flap reflection, we have been able to stabilize this patient's periodontal condition over the course of a 2-year follow-up period. CONCLUSIONS: This treatment strategy provides an efficacious alternative to more aggressive forms of therapy and should therefore be considered for the treatment of patients with severe EOP.

Adolescent↗
PubMed2005

Er:YAG laser in defocused mode for scaling of periodontally involved root surfaces: an in vitro pilot study.

BACKGROUND: The Er:YAG laser may be used on periodontally involved teeth in combination with conventional periodontal therapy in order to improve the efficacy of root instrumentation. The aim of this study was to compare the effect of hand instrumentation on root surfaces of periodontally involved teeth with Er:YAG laser application. METHODS: Thirty freshly extracted, non-carious, single-rooted, periodontally diseased human teeth from adult humans with advanced periodontal disease were used in this study. The teeth were divided into three groups of 10 specimens each. Group A was treated with scaling and root planing (SRP) with curets only (control). In group B, the root surfaces were scaled with curets and then lased with an Er:YAG laser (wavelength 2.94 microm). A handpiece with a water spray was used in non-contact mode (defocused) at a distance of 1 cm from root surface. Laser parameters were set at energy of 100 to 200 mJ/pulse, with 10 Hz of frequency. In group C, the root surfaces were lased only with power settings 250 to 300 mJ/pulse and 10 Hz frequency. An epon-araldite plastic embedding technique was used for light microscopic investigation. RESULTS: Histologic findings showed significant differences between the test and control sites. In control sites, after hand instrumentation, the surface was smooth, without a cementum layer, and the dentin layer presented opened tubules. Defects on the dentin layer were also present along root surfaces. In the test sites (B, C) root surfaces revealed no thermal damage; no cracking or tissue carbonization were observed. The superficial layers of lased surfaces appeared smooth and melted without alterations. CONCLUSION: Based on these findings, it appears that it may be feasible to use the Er:YAG laser for root instrumentation without prior root planing if the proper parameters are followed.

Adult↗
PubMed2005

Root curvature: differences among dental morphotypes and modifications after mechanical instrumentation.

BACKGROUND: This study was designed to describe a method for measuring root curvature of extracted teeth, compare root curvature of four different dental morphotypes before mechanical instrumentation, and measure root curvature after mechanical instrumentation. METHODS: Fifty-five maxillary (14 central incisors, 13 lateral incisors, 14 cuspids, 14 premolars) extracted teeth were analyzed. Measurements were recorded on the horizontal plane at the most apical point of the cemento-enamel junction (CEJ). A 4 mm wide root portion on the buccal aspect was selected and recorded on this plane. A digital scanner traced the circle coinciding with the profile of this root portion and calculated its radius, arc, chord, and arrow (i.e., the perpendicular bisector of the chord). Since root curvature is the inverse of the radius (1/r), the radius was related to root curvature; the arc to the mesio-distal dimension of the root portion; and the reduction of the arrow to root flattening after mechanical instrumentation. The measurements were recorded four times: before treatment (baseline), after polishing, after a first root planing, and after a second root planing. The radii of each dental morphotype (upper central incisors, upper lateral incisors, upper canines, upper premolars) recorded in the first measurement were calculated and used for the statistical analyses: one-way analysis of variance (ANOVA) test and the Tukey multiple comparison method were used to study the curvature. The measurements of the radius, the arc, and the arrow at the four times were used for the statistical analyses: the two-way ANOVA test and the Tukey multiple comparison method were applied in the study of the root modifications after mechanical instrumentation. The accuracy and reliability of the method were also evaluated. RESULTS: The mean radii of the four dental morphotypes were: central incisors: 3.613 +/- 0.258 mm; lateral incisors: 2.558 +/- 0.256 mm; canines: 2.822 +/- 0.238 mm; and premolars: 2.321 +/- 0.179 mm. The statistical analyses revealed differences among central incisors, canines, lateral incisors, and premolars. There was no statistically significant difference between lateral incisors and premolars. Regarding the root modifications after mechanical treatment, the radius did not show statistically significant differences in any of the comparisons. The arc and the arrow did not show significant differences between baseline and polishing, while they did show significant differences after the second root planing. CONCLUSIONS: This study indicates that: 1) the method of measuring is accurate and reliable; 2) there are statistically significant differences among the root curvatures of different dental morphotypes; and 3) polishing did not modify the root. A vigorous root planing did not modify root curvature, but it did reduce the mesio-distal dimension and flatten the root surface slightly.

Analysis of Variance↗
PubMed1978

Traumatized primary anterior teeth. Prognosis related to calcific reactions in the pulp cavity.

The frequency of a complicating pulp necrosis and the process of the physiologic root resorption were studied in traumatized primary teeth exhibiting partial or total pulp obliteration. The material comprised 88 incisors in 72 children aged 0.7--5.7 years (mean 2.9 years) at the time of injury. Trauma had resulted either in subluxation (25 teeth), or luxation (13 teeth), whereas the type of injury was unknown in 50 teeth. All cases were observed until eruption of the permanent incisors. Forty-four teeth initially displayed a reversible greyish color. The ultimate finding observed in all teeth was, however, varying degrees of yellow discoloration. Periapical pathologic findings indicative of pulp necrosis were observed in 9 teeth, from 1.6--4 years (mean 3 years) after the time of injury. Extraction was performed immediately, and none of the successional teeth showed developmental disturbances. The process of root resorption was classified as normal in all primary teeth. Subsequent eruption of the permanent successors occurred without any registered complications.

Child, Preschool↗
PubMed1981

Relationship between cell damage in the periodontal ligament after replantation and subsequent development of root resorption. A time-related study in monkeys.

The etiology of root resorption subsequent to replantation of incisors was examined in green Vervet monkeys. Cell damage to the root surface due to the extraction procedures was registered histologically 1 week after replantation. The topographical distribution of cell damage was then related to the development of root resorption in similar replanted teeth with longer observation periods. Histometric analysis showed that surface-, inflammatory- and replacement resorption was significantly related to certain topographical locations on the root surface. These surfaces represented the "corner" surfaces of the root, where the maximum damage presumably would occur during the extraction procedure. A positive and highly significant correlation between cell damage in the cementoblast layer and the presence of surface-, inflammatory- and replacement resorption was found: replacement resorption was associated with the greatest loss of vital cementoblasts per unit root surface length. Furthermore, the distance from a potential resorption site to the nearest location on the root surface with a normal number of cementoblasts was found to be related to the type of root resorption. Thus, replacement resorption was found to be significantly related to the greatest distance from a site with normal numbers of cementoblasts compared to sites with no resorption or inflammatory resorption. Based on these findings, as well as previous experiments, a theory is presented for the etiology and pathogenesis of external root resorption after immediate replantation of mature teeth.

Animals↗
PubMed1996

Root surface defects in rat molar induced by 1-hydroxyethylidene-1,1-bisphosphonate.

Cementum surface alterations induced by 1-hydroxyethylidene-1,1-bisphosphonate (HEBP) in the maxillary first molars in rats were studied by means of scanning electron microscopy. Single or triple injections of HEBP inhibit the formation of acellular extrinsic fiber cementum and delay the formation of cellular mixed-fiber cementum. The results indicate the importance of acellular extrinsic fiber cementum as a protection barrier against root resorption and the different mechanisms underlying the formation of the two cementum varieties.

Animals↗