Parodontologie (Berlin, Germany)最新文献

Through the use of osseointegrated fixtures ad modum Brånemark we have the possibility to solve prosthetic problems. Three cases are described. They demonstrate that the use of osseointegrated fixtures combined with the concept of a reduced occlusal table can provide good functional stability.

Achievements in bacteriology and immunology have significantly contributed to the understanding about the etiology and pathogenesis of periodontal diseases. Studies have demonstrated that interactions between bacteria and the immune system play a central role in the etiology of periodontal disease. In the immune system four components can be distinguished according to their function in the periodontium. These include a) the secretory system; b) the polymorphonuclear leukocytes, antibody and complement system; c) lymphocytes and monocytes; d) the immunoregulatory system. Polymorphonuclear leukocytes are of utmost importance for the maintenance of periodontal health. In neutrophil defects severe periodontal diseases are frequently found. Prepubertal periodontitis, juvenile periodontitis and rapidly progressing periodontitis are examples for the periodontal manifestation of neutrophil defects. Therapy of periodontal disease that is related to immune defects requires a modified treatment plan. Efforts are being made to extend the diagnosis, prevention and therapy of periodontal diseases. Presently, biochemical, immunological and microbiological methods are being evaluated for their clinical applicability. Preliminary results indicate that, in the future, biochemical markers in the gingival crevicular fluid may be used for the diagnosis of active sites. Therapy may be enhanced by the administration of non-steroidal anti-inflammatory drugs and specific antimicrobials. However, before these methods can be applied in clinical periodontics, further long-term studies are needed.

This case report presents a 43-year-old woman who was not happy with her complete dentures both from the functional and the esthetic point of view. The combined therapy of orthognathic surgery, insertion of endosteal oral implants and the loading with all-porcelain cantilevered bridges made out of In-Ceram is reported.

Since the introduction of scalers in the beginning of the century for the mechanical removal of plaque, instruments with few major modifications are still in clinical use today. New approaches in diagnosis of periodontal disease such as microbiological analysis, enzyme diagnosis of crevicular fluid or computer-aided procedures are presently in clinical trials. A set of periodontal instruments is presented which has been well established and is recommended for the treatment of periodontal disease. The discussion of the specific instruments is presented according to the sequence of patient treatment, which is divided into diagnosis, initial therapy, scaling and root planing, periodontal surgery and maintenance therapy.

Dental hygienists in most European countries and in America are highly qualified assistants to the dentist's daily professional life. Especially for long lasting achievements in periodontal therapy and maintenance, the hygienist's help is absolutely essential. All attempts to introduce a similar vocational reputation, as well as an adequate career training course throughout the Federal Republic have failed so far.

A clinical case is presented where a 100% root coverage is performed with a free gingival graft in a one step method. The surgery technique is described in detail.

During HIV infection different lesions may occur in the area of the gingiva and/or the periodontium. An increased frequency and severity of periodontal diseases has been observed. Different forms of Candida albicans infection have been clinically characterized as pseudomembranous, erythematous (atrophic) or hyperplastic form or as papillary variant. While infection with Candida albicans may occur frequently in other areas of the oral mucosa, candidiasis of the gingiva seems to be quite rare. Due to the underlying immunodeficiency, HIV-infected patients are prone to infection with and/or reactivation of different viruses, which may cause oral lesions as well. Recurrent progressive ulcerations may occur due to herpes simplex virus 1/2, while ulcerations with a punched-out appearance may result from disseminated CMV infection. Oral Kaposi's sarcoma may clinically present as bluish or red spots, which may increase into exophytic tumors during the progress of the disease.