Localized Periodontal Disease Research Articles

Treatment of periodontal lesion caused by palatogingival groove in maxillary lateral incisor: case reports

Purpose: The palatogingival groove is a developmental anomaly of the incisor teeth, which often presents severe localized periodontal disease. The purpose of this study was to evaluate the clinical outcome of palatogingival groove-associated pe- riodontal lesion following flap operation with glass ionomer filling. Methods: Four patients with periodontal lesion associated with the palatogingival groove were chosen for this case study. Clinical indices were taken and radiographic exam was performed at the baseline of the study and four patients were treat- ed by flap operation with GI filling. Post-surgical visits were scheduled at regular intervals to check clinical and radio- graphic changes. Results: Symptoms and signs of periodontal lesion were almost completely resolved with improvement of periodontal indices. Conclusions: Flap operation with direct glass ionomer restoration is thought to be an acceptable method which can produce favorable results in the treatment of periodontal lesion caused by palatogingival groove on the maxillary lateral incisor. (J Korean Acad Periodontol 2009;39:425-429)

Mandibular Disto‐Lingual Root: A Consideration in Periodontal Therapy

Developmental and morphological abnormalities may contribute to the progression of localized periodontal disease. Although the presence of a disto-lingual root in the mandibular first molar is rare, its role in periodontal destruction has not been examined. The purpose of this study was to evaluate whether the presence of this root contributes to localized periodontal destruction. The presence of the disto-lingual root was identified by examination of two periapical radiographs in each of 197 Taiwanese patients with 332 mandibular first molars. Regression analysis was used to evaluate the relationship between the presence of the root and probing depth, gingival recession, and periodontal attachment loss at the disto-buccal and disto-lingual sites of the molars. The adjusted variables included patient characteristics (age, gender, diagnosis, and general periodontal conditions), tooth (right and left location, tooth mobility, and periodontal category of the molar), and site (bleeding on probing and adjacent furcation involvement). A disto-lingual root was present in 26.9% of patients and in 21.7% of molars examined. A significant interaction between periodontal category and the presence of disto-lingual root on probing depth and attachment loss at disto-lingual but not disto-buccal sites was observed. Multivariable regression analysis showed a significantly higher probing depth and attachment loss at the disto-lingual site in molars with the disto-lingual root than in molars without the root in teeth classified as having advanced periodontitis. Greater probing depth and attachment loss occurred at disto-lingual sites of molars with the roots. The presence of a disto-lingual root may contribute to localized periodontal destruction.

The palato-gingival groove - anatomical anomaly occurred in maxillary lateral incisors: case reports

This report describes clinical cases of a palato-gingival groove on a maxillary lateral incisor with associated localized periodontal disease and pulp necrosis. The tooth of the first case was extracted because of severe bone destruction. The palato-gingival groove of the second case was eliminated using a round bur, and the resulting defect was filled with synthetic graft and covered by an absorbable membrane. Both diagnosis and treatment of palato-gingival groove were very difficult and usually extraction of the involved tooth is the treatment of choice, but combined endodontic-periodontic treatment allowed the tooth to be saved. [J Kor Acad Cons Dent 32(6):483-490, 2007]

Squamous Odontogenic Tumor: Diagnosis and Management

The squamous odontogenic tumor (SOT) is a rare, benign, locally infiltrative neoplasm of the jaws that appears to originate from the rests of Malassez. It has been confused with other pathologic entities such as ameloblastomas, carcinomas, and fibromas and clinically may resemble localized periodontal disease. The tumor is often asymptomatic, although it can present with symptoms of pain and tooth mobility. A characteristic radiographic appearance is that of a triangular-shaped or semi-circular lucency associated with the roots of erupted teeth. Histologically, the tumor is characterized by the formation of variably sized nests and cords of uniform, benign-appearing, squamous epithelium with occasional vacuolization and keratinization. Treatment of SOT by conservative surgical excision is normally curative with rare episodes of recurrence reported. Since the clinical presentation of SOT may mimic more common pathologic entities, this case report reinforces the need for careful histologic evaluation of all lesions found in the periodontium.

Systemic effects of oral infections: A possible preventive role for the oral and maxillofacial surgeon

Systemic effects of oral infections: A possible preventive role for the oral and maxillofacial surgeon

Enamel pearls and cervical enamel projections on 2 maxillary molars with localized periodontal disease: Case report and histologic study

Presented here is an unusual case of teeth with aberrant enamel. One small and 3 large enamel pearls were identified in 2 maxillary third molars of a patient. One long enamel projection was connected to one of the large enamel pearls, along with 2 short cervical enamel projections. The ectopic enamel was associated with advanced localized periodontal destruction. After extraction, the molars were investigated radiographically and under the scanning electron microscope. The 3 large pearls contained distinct dentinal cones. The enamel of the pearls and the long cervical projection exhibited most of the structural attributes of crown enamel but were somewhat irregular, with variable shape and course of the prisms. Morphologic considerations suggest that these enamel pearls were aberrations and should not be regarded as attempts at new cusp or new tooth formation. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89:493-7)

Anterior mandibular osteotomy for tumor extirpation: a critical evaluation.

Anterior mandibular osteotomy gives excellent access to the oropharynx for oncologic resections. Although rigid internal fixation has improved results in stability and bone healing, side effects and complications of the surgical procedure must be considered. Between 1991 and 1997, 64 patients underwent a transmandibular approach for benign or malignant tumors of the head and neck. Sixty-one of them were included in a 6-month follow-up study. Final results and major and minor complications were recorded. Three (5%) cases of non-union and infection of the osteotomy site required plate removal, curettage, and reosteosynthesis. Occlusal disturbances and local periodontal disease occurred in 2 (3%) patients. Thirty-two (52%) patients complained of sensitivity disturbances, 18 (30%) of temporomandibular joint pain, and 44 (72%) of a limitation in opening the mouth. Six patients (10%) had a cosmetic complaint. Dental condition and periodontal care in the vicinity of the osteotomy are important factors in reducing the risk of major complications. Trismus, limitation of joint motion, and pain cannot be directly related to the technique; they depend on the extent of tumor resection and postoperative radiotherapy.

The palato-gingival groove: A cause of failure in root canal treatment

The authors describe a clinical case of a palato-gingival groove on a maxillary central incisor with associated localized periodontal disease and pulp necrosis. The general clinician's initial diagnosis was incorrect; this led to incomplete treatment and subsequent loss of the tooth. Recognition of the palato-gingival groove is critical, especially because of its diagnostic complexity and the problems that may arise if it is not properly interpreted and treated.

Smokeless Tobacco Use and Health Effects Among Baseball Players

The effects of smokeless tobacco (ST) use were studied in 1109 members of major and minor league professional baseball teams during spring training in 1988. The prevalence of current ST use was 39%. The median age at initiation among users was 18 years, and the median duration of use was 5 years. Among users, 75% cited a snuff brand as their usual ST product. Oral leukoplakia was present in 46% (196/423) of current-week ST users and 1.4% (7/493) of nonusers (odds ratio, 60; 95% confidence interval, 28 to 130). Prevalence of oral leukoplakia among ST users increased with hours used per day and decreased with time lapsed since last use, and was higher in snuff users than in chewing tobacco users. Of the subjects with oral leukoplakia who underwent punch biopsy, 91 had benign hyperkeratosis and one had mild dysplasia. Overall prevalence of dental caries, gingivitis, and plaque did not differ between ST users and nonusers. In analyses confined to facial surfaces of mandibular incisor teeth, where ST is most commonly used, there were significant increases among users in both gingival recession and attachment loss. Users of ST did not differ from nonusers in blood pressure, pulse, total or high-density lipoprotein cholesterol level, or white blood cell count, but among users high-density lipoprotein cholesterol levels were inversely associated with serum cotinine levels. The major health effects of ST use among professional baseball players are oral leukoplakia and localized periodontal disease. The study population was young, physically fit, and characterized by relatively moderate short-term ST use.

Detection of cathepsin B- and L-, elastase-, tryptase-, trypsin-, and dipeptidyl peptidase IV-like activities in crevicular fluid from gingivitis and periodontitis patients with peptidyl derivatives of 7-amino-4-trifluoromethyl coumarin.

Crevicular fluid samples were collected from 20 gingivitis and periodontitis patients using filter paper strips; these were then eluted into buffer. Portions of each sample were combined and the activities of this pooled eluate against different peptidyl derivatives of 7-amino-4-trifluoromethyl coumarin (AFC) were examined with respect to their pH profiles and effector responses. Ca-thepsin B- and L-like activity was detected with Bz-Val-Lys-Lys-Arg-AFC; elastase-like activity with MeOSuc-Ala-Ala-Pro-Val-AFC; tryptase-like activity with Z-Ala-Ala-Lys-AFC; trypsin-like activity with Z-Gly-Gly-Arg-AFC; and dipeptidyl peptidase (DPP) IV-like activity with Ala-Pro-AFC. The selectivity and sensitivity of these assays were improved by choice of appropriate conditions. The cathepsin B- and L-, elastase-, tryptase-, and trypsin-like activities all had properties consistent with those from host sources, whilst partial inactivation of the DPP IV-like activity by heat treatment (60 degrees C for 30 min) suggested that it may have represented a mixture of human and Bacteroides gingivalis enzymes. Individual patient eluates showed wide variations in enzyme concentrations, but generally elastase-like activity was by far the highest. The sensitivity of the assays with AFC-linked substrates was such that it should prove possible to measure all five different types of activity in crevicular fluid samples from local periodontal disease sites.

The prevalence, location and conformation of palato-radicular grooves in maxillary incisors.

Palato-radicular grooves in maxillary lateral incisors have been implicated as an initiating factor in localized gingivitis and periodontitis. Focal loss of periodontal attachment associated with these grooves, some of which may extend to the apical third of the root, could result in a hopeless prognosis for tooth retention. There is disagreement as to the prevalence of this anomaly. As well, little is known about the shape, location and length of the defect. This study examined 3168 extracted maxillary lateral and central incisors. Of these teeth 4.6% had a palato-radicular groove. About half of the grooves terminated on the root and 58% of these extended more than 5 mm from the cementoenamel junction. A poorly described deformity, displacement of the cementoenamel junction, occurred in 38% of the grooves which crossed that structure. Although an extension of enamel in the groove has been suggested as a possible factor in the progression of localized periodontal disease, its presence was rarely observed.

Periodontal disease in the prehistoric Ipiutak and Tigara skeletal remains from Point Hope, Alaska.

Two large groups of prehistoric Eskimo skeletons from Point Hope, Alaska, were evaluated for dental wear and several measures of periodontal disease. Occlusal attrition was found to increase steadily with increasing age. Crown height decreased proportionately. Assessing periodontal disease by inspecting apparent alveolar recession was judged ineffective due to possible supereruption. Infrabony pockets, the result of severe localized periodontal disease indicated that in Ipiutak people between the ages of 25 and 30, and Tigara people between 35 and 40, more dental sites were affected by periodontal disease than were not. This suggests a cultural, genetic, or dietary difference between the two groups. Male/female differences were slight in all parameters studied.

The Disto-Palatal Groove in Maxillary Incisors; A Predisposing Factor in Periodontal Disease

AbstractDisto-palatal grooving of the maxillary lateral incisor is discussed in relation to localised periodontal disease, and a clinical case is demonstrated. The clinical and radiographic appearance of the malformation is described.