Parodontologie (Berlin, Germany)最新文献

The biologic principle of guided tissue regeneration with a e-PTFE membrane was used to gain alveolar bone in combination with the installation of a titanium dental implant. For an acceptable esthetic result, the use of the UCLA abutment with a ceramometal butt-joint crown is recommended.

By common methods like scaling and root planing, flap procedures or surgical furcation treatment, a successful therapy of periodontal disease is possible in about 90% of the cases. The remaining 10%, mainly patients with juvenile or rapidly progressive periodontitis, are causing great problems, due to poor treatment response and frequent, local or general recidives. In the future, microbiological tests for a precise diagnosis of the pocket flora will be used in the dental office. They can provide better indications for additional antibiotic therapy. The present article reviews several microbiological investigation methods and their future use in the office during periodontal treatment.

Electrically powered devices represent a hazard for patients with cardiac pacemakers. The aim of the present investigation was an in vivo evaluation of possible interactions between electrically powered dental instruments and the function of artificial pacemakers in humans. In 26 patients with artificial pacemakers, different dental instruments were applied, including air scaler, ultrasonic curets, electric pulp tester and electrotome. These devices were applied at highest intensity. Immediately prior to, during, and immediately after applications of these instruments, the pulse rate and the electrocardiogram (EKG) were recorded. The EKG recordings were assessed for irregularities in the distances between the pacemaker peaks. The dental devices were assessed for magnetic fields or induction tension. The results showed that none of the dental devices caused an irregularity in the pacemaker function. The air scaler, Piezon ultrasonic curet and the electric pulp tester caused no measurable magnetic fields. The Sonus 2 ultrasonic curet and the electrotome magnetic fields were measured up to 60 and 50 cm, respectively. All dental devices caused induction tension. The highest value was produced by the electrotome. It seems that cardiac pacemaker function is not affected by electrically powered dental devices. However, there remains a risk in relation to older pacemakers or defective dental devices.

The gingiva and the dental health situation of patients after an organ transplantation are determined within the regular dental examination. The findings are recorded by different indices, which are summarized as CsA-indices, on a special data collection sheet. They indicate the gravity of the hyperplasia, the inflammation degree based on the color of the tissue, the tonus and the bleeding of the gingiva as well as plaque and calculus and therefore renders possible the dental supervision and the comparison of the gingival situations during a long recall period. Additionally, situation casts, photos from different visual angles and a full month radiograph are required. This systematic recording of the findings facilitates a therapy and follow-up treatment, which are adapted to each individual situation.

This case report describes the treatment planning and the therapy of a 50-year-old patient with advanced adult periodontitis. It was possible to satisfy the patient's need for oral health and to achieve esthetics function and comfort by the insertion of the fixed prosthesis. After the professional prophylaxis was finished, periodontal surgery, guided tissue regeneration, alveolar ridge augmentation with connective tissue grafts and trisection were performed.

Therapeutic failure appears to be more frequent in periodontology than in other fields of dentistry. Such failure may be caused by errors in patient selection, incomplete diagnostic procedures, diagnostic or prognostic errors, treatment difficulties and obstacles, non-controlled healing, or the absence of maintenance therapy. Most failures can be avoided by instituting a regular recall system.

Localized periodontal recession (LPR) is not rarely found in adults: 10.4% in subjects age 16-19 years, 24.8% in 20-24-year-old persons, and 46.8% in the age group of 35-44 years (N = 11,401 subjects). There is an accumulation of LPR-patients, who referred to the Department of Periodontology, in young adults. Patients suffering from LPR show, in comparison to healthy people, a smaller diameter of the canine's apical basis both in the maxillary and mandibular arches, a smaller circumference of the alveolar crest as well as an upper canine-crown which is turned out from the teeth arcus in a more labial direction. The vestibular sites of teeth 44, 23, 34, 13, 14, 24, and 43 are mainly affected by LPR. Right-handers generally show more and stronger LPR in both arches as well as a smaller value of oral hygiene index. The chronic trauma of teeth brushing is very important in the pathogenesis of the LPR. Prevention of LPR involves individual oral health education to protect the vestibular gingiva from chronic brushing trauma.

In the last years, guided tissue regeneration (GTR) and implantology have opened new possibilities for practical periodontologists in the treatment of advanced cases. For both techniques the successful therapy of the local infection of the pocket is a prerequisite. In the near future rapid tests for microbiological diagnoses and slow release devices for antibiotics will be available to achieve this aim easier. The following article will present the microbiological aspects of periodontitis and plaque control and show their relevance for the practitioner.

This case report presents the planning and clinical treatment of a patient with advanced periodontitis and insufficient prosthetic reconstruction. After initial therapy with extraction of the unrestorable teeth, periodontal surgery was performed partly by means of the implantation of hydroxyapatite into bony defects. The prosthodontic treatment consisted of a fixed/removable prosthesis in the maxilla, together with a shortened teeth arch in the mandible. This clinical treatment, combined with regular recalls, has ensured the patient a functional and esthetic reconstruction for a period of 4 years.