Journal de parodontologie最新文献

Epidemiologic methods can be used for the diagnosis of periodontal disease and the evaluation of its progression. Indices can be used to check the frequency of pathogenic events, the location of etiologic agents and the effectiveness of therapy. Such techniques can be employed in everyday practice and could conceivably be used to motivate patients.

The utilization of implants requires a close interrelationship between the prosthodontist and the surgeon who performs the implant procedure. The choice of abutments and other aspects of the work should be in the domain of both individuals. After the surgical procedures, the prosthodontist can wait until soft tissue healing occurs before deciding the type and length of the abutments that will be utilized for the reconstruction. If necessary, the surgeon can perform mucogingival surgery to enhance the implant-gingival environment.

The pathogenesis of the various periodontal diseases cannot only be explained on the basis of the relationship of specific bacteria to the clinical features of the disease. The microbiologic examination of various members of the same family, either by culturing or by the use of the DNA probe often showed similarities among several individuals in the same family. This could be accounted for on the basis of bacterial transmission or by contamination. These observations suggest the incidence of familial and genetic factors in the etiology of some forms of periodontitis.

The use and limitation of mucogingival surgery to cover denuded root surfaces is discussed in terms of the necessity of the procedures and what technique to employ. Four classical techniques are described along with case reports demonstrating their usage. Once it is established that the procedure is of value to the patient, a suitable form of therapy can be utilized.

The beneficial effects of chlorhexidine on plaque formation have been well documented. This study was undertaken to evaluate the dual effects of chlorhexidine irrigation and root planing with an ultrasonic scaler. The parameters measured were plaque and gingival indices and bleeding on probing. A statistically significant decrease in all indices measured was demonstrated when compared with the test group of patients who received ultrasonic scaling and irrigation with sterile water.

An unusual case of spontaneous and rapidly destructive lesions involving the periodontal structures is described in a 54 year old, bi-sexual patients suspected of having AIDS. Concomitant with the periodontal breakdown, the patient developed a severe case of Herpes Zoster involving the area of the face innervated by the 5th cranial nerve. The dermal lesions involved the face, nose, eyes and scalp. Similar lesions were noted on the gingival and palatal mucosa on the same side of the jaw as the skin lesions. The differences between this type of periodontal destruction and more conventional forms of periodontitis are discussed.

Bactericidal activities of five mouthrinses containing cetylpyridinium chloride, hexetidine or chlorhexidine have been tested in vitro, against the main microorganisms involved in buccal affections. Mouthrinses containing hexetidine or chlorhexidine are effective, but chlorhexidine activity appears more extensive and homogeneous.

In periodontal therapy, frenectomy is indicated when the frenum exerts tension on the gingival margin and interferes with proper oral hygiene. The procedure is also employed when the frenum prevents closure of a diastema during orthodontic therapy. Frenectomy should be done after the canines have erupted and before retention is started to prevent separation of the teeth. For an improved surgical and cosmetic result, the authors propose a triangular-shaped gingival graft after the frenum has been excised. The advantage of the procedure is to create an area of attached gingiva and enhance healing.

The treatment of an exposed root surface may be indicated for an aesthetic improvement of a gingival recession. The surgical technic depends on the type of the recession, the quality and the quantity of the keratinized gingiva apically or laterally from the recession. The purpose of this study is to evaluate the minimal quantity of keratinized gingiva necessary to obtain a root coverage. 10 recessions on maxillary cuspids were treated with coronally repositioned flap. Less than 3 mm of keratinized gingiva was present apically to the exposed root surface. All patients received oral hygiene instructions, plaque control and scaling and root planing. Gingival recession, width of keratinized gingiva and loss of attachment were measured at the time of surgery and three months postoperatively. The mean recession was 5.20 mm (+/- SE = 0.36) prior to treatment and the keratinized gingiva was 1.70 mm (+/- 0.16) high at T0. The mean gain of root coverage was 3.43 mm (+/- 0.29) at three months post-operatively. At T0 and 3 months post-operatively, the measures of recessions showed a statistically difference confirming the validity of the technic. The absence of correlation between initial height of keratinized gingiva and the coverage result (r = 0.05) indicates that initial width of keratinized gingiva does not affect the coverage results.

A solution of formaldehyde and tyrothricin was placed in periodontal pockets of 14 patients. One maxillary quadrant was used as the experimental side, while the contralateral quadrant was employed as the control. A placebo solution was placed in the pockets of the control side. Both the experimental and control sides were treated on days -3, 0, +4, +7, +11 and +14. Scaling and root planing was accomplished on day 0. Plaque and gingival indices, and gingival fluid volume were recorded on all of the treatment days, as well as on day +28. Pocket depths were noted on days -3, 0, +14 and +28. Improvements were noted in all parameters measured on both the experimental and control sides, although statistical analyses revealed that plaque and gingival indices were slightly better in the experimental side. The author concludes that placing a Formaldehyde-Tyrothricin solution in periodontal pockets offers some therapeutic gain over scaling and root planing alone.