Maintenance Of Good Oral Hygiene Research Articles

Radiographic evaluation of infra-bony defects treated by bone graft procedures

Purpose: A number of techniques and materials have been used for periodontal regeneration and bone graft procedures with guided tissue regeneration(GTR) have been suggested as alternatives to osseous surgery in the management of local infra-bony defects. However, the long-term stability and treatment outcome following bone graft procedure of infra-bony defects is poorly documented. The purpose of this study was to assess radiographic change in infra-bony defects over 2 years after bone graft procedures with various graft materials. Material and Methods: Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients showed clinical and radiographic evidence of infra-bony defect(s). 44 sites of 34 patients aged 31 to 69 (mean age 48.3) were treated by bone graft procedure with a bone graft material. Baseline and 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, defect depth, defect angle, bone graft materials) using the paired t-test were examined. Result: We observed 1.15±1.95 mm of bone fill, 0.40±1.19 mm of crestal resorption, 1.55±1.77 mm of defect resolution, and 40±44% of percentage of defect resolution. Deeper initial defect depth, narrower initial defect angle showed significantly greater bone fill, defect resolution, and % of defect resolution. But no significant difference was observed in graft sites and graft materials. Conclusion: If good oral hygiene maintenance and periodic recall check of patients is assured, bone graft procedure using various graft materials is one of the appropriate treatment modality for regenerative therapy of infra-bony defects. (J Korean Acad Periodontol 2008;38:437-444)

Long-term radiographic evaluation of GTR treatment in intrabony defect

【Periodontal surgery as part of the treatment of periodontal disease is mainly performed 1) to gain access to diseased areas for adequate cleaning; 2) to achieve pocket reduction or elimination; and 3) to restore the periodontal tissues lost through the disease; i.e., a new attachment formation of periodontal regeneration. To accomplish the latter, often referred to as the ultimate goal of periodontal therapy, a number of surgical procedures have been advocated throughout the years. Clinical studies have demonstrated that considerable gain of clinical attachment and bone can be achieved following guided tissue regeneration (GTR) therapy of intrabony defects. The aim of this study was to analyse the radiographic bone changes 2-year after GTR using a bone graft material and nonresorbable membrane. Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients had clinical and radiographic evidence of intrabony defect(s), 33 sites of 30 patients aged 32 to 56 (mean age 45.6) were treated by GTR with a bone graft material and nonresorbable membrane. Baseline and 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, defect depth, defect angle, bone graft materials) using the paired t-test were examined. We observed $2.86{\pm}1,87mm$ of bone fill, $065{\pm}0.79mm$ of crestal resorption, $3.49{\pm}2.11mm$ of defect resolution, and $44.42{\pm}19.51%$ of percentage of defect resolution. Mandible, deeper initial defect depth, narrower initial defect angle showed greater bone fill, defect resolution, and % of defect resolution. But no difference was observed between xenograft and allograft. Outcome of GTR as a therapy of intrabony defect was better than other therapy, but herein, good oral hygiene maintenance as a anti-infective treatment and periodic recall check of patients are essential.】

Early experience of implant-supported prostheses in patients with neurologic disabilities

The purpose of this prospective study was to provide a preliminary report of implant treatment in patients with neurologic disabilities.Patients had been referred to the National Orofacial Resource Centre with different disabilities, specifically neurologic disorders causing various orofacial dysfunction problems, and were suitable for prosthodontic treatment with implants. Patients were treated with single implant-supported crowns, fixed partial dentures, or complete implant-supported dentures. Implants used were threaded titanium cylinders placed under general or local anesthesia. All surgical complications in the healing period or at second-stage surgery were noted, as were all prosthodontic complications.Fourteen patients were treated with 35 implants. Three implants were lost before or at second-stage surgery, and two implants were lost after loading. These complications were observed in two patients. Implant failures and other complications were observed in two patients in the mandible because of dehiscence of the mucoperiosteal flap and infection. Some patients had developed finger or oral habits, such as excessive tongue movements, that were probably responsible for these complications. One of the patients with Down syndrome possibly had reduced resistance to infections. No major complications were observed for the other 12 patients treated.Strict adherence to a surgical protocol is needed for the management of patients with neurologic disabilities. It is important to inform the patient's caregiver about maintenance of good oral hygiene and the increased risk of complications caused by finger or oral habits.

A Six -Year Clinical, Microbiological and Radiological Study Outcome Following Treatment of Peri-implantitis

The present study evaluated the long-term outcome of a combined surgical and composite graft (bovine porous bone mineral BPBM and autogenous bone) in the treatment of peri-implantitis. Six individuals with titanium implants demonstrating a marginal bone loss. Baseline ,1 and 6 years measurements, including introral digital radiographs, gingival index (GI), probing depth(PD) and probing bone level (BL) were performed. In each implant subgingival bacterial samples were obtained and subjected to microbiological analysis by culture. Surgical exposure of the lesions and cleaning of the implants using hydrogen perioxide and2% aqueous solution of chlorohexidine gluconate were performed. The autogenous bone was harvested from the chin combined with BPBM and packed into the bony defects. The treatment was evaluated clinically, microbiologically and radiographically at 1 and 6 years. Results: revealed a significant reduction in plaque and gingival bleeding. The mean probing depth was 6.94+ 1.16 at the baseline and it was 1.91 + 1.21 at the end of the study period. All treated implants showed bonegain. The mean gain in bone level was 5.12 + 0.5 and radiological evaluation of bone density was measured at crest, mid-implant and lateral apical area of interest AOI 32.0 + 0.87, 72.91 +0.83, 63.0 + 0.94 at baseline and it reached 109.5 + 0.53, 141.63 + 1.19 and 144.0 + 0.47 respectively. The presence of putative periodontal pathogens significantly declined at the end of the study period. Conclusions: The results of the study suggest that the use of composite bone grafts as the treatment strategy for peri-implantitis lesions with maintenance of good oral hygiene appears to be an efficacious treatment approach for restoring year follow-up period.

A Six -Year Clinical, Microbiological and Radiological Study Outcome Following Treatment of Peri-implantitis

The present study evaluated the long-term outcome of a combined surgical and composite graft (bovine porous bone mineral BPBM and autogenous bone) in the treatment of peri-implantitis. Six individuals with titanium implants demonstrating a marginal bone loss. Baseline ,1 and 6 years measurements, including introral digital radiographs, gingival index (GI), probing depth(PD) and probing bone level (BL) were performed. In each implant subgingival bacterial samples were obtained and subjected to microbiological analysis by culture. Surgical exposure of the lesions and cleaning of the implants using hydrogen perioxide and2% aqueous solution of chlorohexidine gluconate were performed. The autogenous bone was harvested from the chin combined with BPBM and packed into the bony defects. The treatment was evaluated clinically, microbiologically and radiographically at 1 and 6 years. Results: revealed a significant reduction in plaque and gingival bleeding. The mean probing depth was 6.94+ 1.16 at the baseline and it was 1.91 + 1.21 at the end of the study period. All treated implants showed bonegain. The mean gain in bone level was 5.12 + 0.5 and radiological evaluation of bone density was measured at crest, mid-implant and lateral apical area of interest AOI 32.0 + 0.87, 72.91 +0.83, 63.0 + 0.94 at baseline and it reached 109.5 + 0.53, 141.63 + 1.19 and 144.0 + 0.47 respectively. The presence of putative periodontal pathogens significantly declined at the end of the study period. Conclusions: The results of the study suggest that the use of composite bone grafts as the treatment strategy for peri-implantitis lesions with maintenance of good oral hygiene appears to be an efficacious treatment approach for restoring year follow-up period.

Acute bacterial suppurative parotitis: microbiology and management.

The parotid gland is the salivary gland most commonly affected by inflammation. The most common pathogens associated with acute bacterial parotitis are Staphylococcus aureus and anaerobic bacteria. The predominant anaerobes include gram-negative bacilli (including pigmented Prevotella and Porphyromonas spp.), Fusobacterium spp., and Peptostreptococcus spp. Streptococcus spp. (including S. pneumoniae) and gram-negative bacilli (including Escherichia coli) have also been reported. Gram-negative organisms are often seen in hospitalized patients. Organisms less frequently found are Arachnia, Haemophilus influenzae, Klebsiella pneumoniae, Salmonella spp., Pseudomonas aeruginosa, Treponema pallidum, cat-scratch bacillus, and Eikenella corrodens. Mycobacterium tuberculosis and atypical mycobacteria are rare causes of parotitis. Therapy includes maintenance of hydration and administration of parenteral antimicrobial therapy. Once an abscess has formed surgical drainage is required. The choice of antimicrobial depends on the etiologic agent. Maintenance of good oral hygiene, adequate hydration, and early and proper therapy of bacterial infection of the oropharynx may reduce the occurrence of suppurative parotitis.

Three patients whose oral complaints disappeared with the maintenance of good oral hygiene

Three patients whose oral complaints disappeared with the maintenance of good oral hygiene

Gingival recession related to removable partial dentures in older patients

One hundred forty-six patients, living in the community and attending a general dental practice, were examined on two occasions separated by 3 years to determine relationships among removable partial dentures, their design, and gingival recession. This study confirmed the relationship between the presence of a partial denture and an increase of gingival recession, but was unable to demonstrate any predictable relationship to the lack of tooth support, the material used for the dentures, or covering the gingival margins with lingual plates. These design factors may be less important than the maintenance of good oral hygiene for the prevention of periodontal disease in patients wearing removable partial dentures.

Dental plaque ? associated infections and antibacterial oral hygiene products

Synopsis Dental plaque accumulates on hard non-shedding surfaces such as teeth, dentures and orthodontic appliances. This accumulation is facilitated by the absence of adequate oral hygiene procedures. The term 'plaque' describes a mass of microorganisms embedded in an organic matrix of host and microbial origin. In addition to the aesthetic desirability of 'clean teeth, healthy gums and fresh breath' associated with the absence of plaque, obvious consequences of the presence of plaque include tooth decay (dental caries), gingivitis and periodontal (gum) disease and denture associated problems. Thus the prevention of plaque formation, the reduction of plaque accumulation and the effective removal of plaque are considerations of the cosmetic and health professions alike. There are many oral hygiene products available to the general public - toothpastes, mouthwashes, denture cleaners, and, more recently, chewing gums and novel mouthwashes. Several of these products have antimicrobial components. This paper reviews the microbiology of plaque and plaque associated problems, and surveys the type of products currently available for maintenance of good oral hygiene. Potential areas for future development are also explored.

The present status of the gingivectomy procedure.

The use of the conventional gingivectomy procedure is indicated to achieve optimum gingival contour and to eliminate supra-alveolar pockets where these do not extend beyond the muco-gingival junction. The instrument of choice for the procedure is a gingivectomy knife. Where a blood-free field is required, electrosurgery may be used provided the instrument is not brought into contact with bone. The maintenance of good oral hygiene is essential.

The Pedodontic Patient with Heart Disease

The child with congenital heart disease and acquired heart disease can have dental treatment done in the general practitioner's office. It is important that the dentist be familiar with the inherent risk of bacterial endocarditis that is always present when treating the child with cardiac disease. Some knowledge of the type of congenital heart disease and the forms which are more susceptible to bacterial endocarditis is advantageous to the dentist when treating these children. The child with a history of rheumatic heart disease who is on regular chemoprophylaxis for recurrent streptococcal infections requires additional coverage when undergoing dental treatment. The controversy that exists in regard to rendering dental treatment for this type of patient should be appreciated by the dentist, and a method of antimicrobial prophylaxis for these children should be formulated in consultation with the child's physician. Most dental procedures can be done for the child with cardiac disease if the following suggestions are observed: 1. Obtaining a proper history to uncover any previous episodes of rheumatic fever or presence of congenital heart defects. 2. A close professional relationship between the dentist and the child's physician in order that optimal treatment of the child with heart disease will be accomplished. 3. Elimination of all oral infection by the removal of all abscessed teeth and other foci of infection. 4. Maintenance of good oral hygiene, preservation of all carious teeth by the placement of good restorations. 5. Adequate antimicrobial chemotherapy for dental procedures that require prophylaxis.

The Management of Pregnant Patients in Dental Practice

1. It is imperative to avoid anoxic episodes in the mother. 2. The optimal time for dental treatment is within the fourth through the seventh months of pregnancy. 3. Only procedures necessary to relieve pain or discomfort, or of other emergency nature, should be undertaken in the first 3 months of pregnancy. 4. Long, complicated, elective procedures should be postponed until after the termination of pregnancy. 5. In the normal pregnant patient, dental roentgenography presents no special hazards. 6. Appointments or sittings should be short, preferably not to exceed about ½ hour. 7. Pain should be avoided. 8. Home care should be emphasized in the general maintenance of good oral hygiene. 9. Oxygen in an administrable form should be on hand at all times. The presence of the expectant mother in the dental chair gives us an opportunity to impress upon her the importance of the care of children's teeth as they grow older. We should enlighten the mother-to-be concerning the benefits of water fluoridation, so that the citizen in utero gets 9 months of good dental prophylaxis. The expectant mother should and must get proper dental care during pregnancy. It behooves us as dentists to see that this is accomplished.