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Query: UMLS:C0031099 (periodontitis)
 12,489 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Absence of periapical healing after orthograde retreatment using an apical plug with mineral trioxide aggregate (MTA) can require surgical intervention. A patient with a root-filled maxillary central incisor with chronic apical periodontitis and sinus tract was referred for endodontic retreatment. Excessive apical enlargement was verified, indicating an MTA apical plug placement; however, an unintentional extrusion of MTA occurred during this step. The root canal was filled with gutta-percha and sealer, and periodic recalls were scheduled. The sinus tract was observed after six months and the lesion remained unaltered, although the extruded MTA had resorbed; therefore, an apicoectomy and retrograde root-end filling with MTA were performed. Absence of sinus tract, normal clinical aspect, and complete repair of the lesion were observed at the two-year follow-up.
Gen Dent
PMID:Orthograde retreatment failure with extruded MTA apical plug in a large periradicular lesion followed by surgical intervention: case report. 2241 24

This article discusses the diagnosis and treatment of vertical bony defects in patients with periodontitis. Defect- and tooth-related factors that impact treatment decisions and prognosis of regenerative therapy are reviewed. Etiologic and contributing factors are also discussed, as are follow-up and long-term maintenance of treated sites.
Gen Dent
PMID:Diagnosis and management of vertical bony defects in periodontal disease. 2278 40

The purpose of this study was to determine the effectiveness of scaling and root planing using a closed and open approach (papilla reflection) with and without a locally delivered antibiotic (minocycline hydrochloride microspheres) in the treatment of moderate to advanced chronic periodontitis. Twenty-five periodontal recall patients with four or more probing depths of 5.0 to 9.0 mm and bleeding on probing (BOP) participated in this double-blind trial. Each of four sites per patient was randomly assigned a different treatment: scaling/root planing only; scaling/root planing followed by minocycline placement; gingival papilla reflection followed by scaling/root planing and flap closure; and gingival papilla reflection, scaling/root planing, minocycline placement, and flap closure. At baseline and each subsequent appointment, probing depth, BOP, and clinical crown length were recorded. Patients returned at three months for measurements and supportive periodontal therapy, and at six months for final measurements. Patients followed their usual oral hygiene regimens. Data were analyzed for significant differences using a repeated measure ANOVA and a Student t-test. All treatments resulted in reduction of probing depths (average of 1.76 mm) and a marked reduction in BOP at six months. While the papilla reflection plus minocycline showed the greatest reduction in probing depth (1.91 mm) and the greatest decrease in BOP (20% at three months and 28% at six months), the differences were not significant (p > 0.05). Clinical crown lengths did not change significantly in the treatment sites; therefore, improvements in probing depth can be attributed to improved clinical attachment levels (long junctional epithelium). The combination therapies did not differ significantly from scaling/root planing alone in decreasing probing depths and BOP.
Gen Dent
PMID:The effectiveness of scaling and root planing with adjunctive time-release minocycline using an open and closed approach for the treatment of periodontitis. 2278 41

Periodontitis is a primarily bacterial infection that is common in dentate individuals, while denture stomatitis is a predominantly fungal infection that is common among denture wearers. Both infections may increase a patient's risk for chronic systemic infection dissemination, and may in turn increase the risk of chronic, inflammatory-based systemic diseases. Systemic diseases for which chronic oral infections are believed to confer attributable risk include atherosclerotic and coronary disease, stroke, chronic obstructive pulmonary disease, diabetes, and hypertension. It appears that invasive oral pathogens trigger a systemic inflammatory response via mediators released by the cardiovascular system and liver, putting the patient at increased risk for these diseases. Data comparing gene expression between denture wearers with and without denture stomatitis (and associated Candida albicans infections) has demonstrated unique up- and down-regulation patterns for a number of genes. It appears that down-regulated genes (whose functions are thereby diminished) are associated with reduced epithelial barrier integrity. By contrast, there appears to be an association between up-regulated genes (which have enhanced function) and inflammatory responses that facilitate the ability of C. albicans to bind with and penetrate the oral mucosa. Molecular biological approaches suggest that future therapeutic development could target reducing either the local inflammatory processor, the binding and attachment of C. albicans to the oral mucosa, or both. Ongoing investigations are attempting to incorporate interventions into matrices, to provide a local and sustained presence to therapeutic interventions.
Gen Dent
PMID:Impact of tooth loss on oral and systemic health. 2322 Mar 4

Obesity and periodontitis are both diseases that represent significant health problems. Obesity currently impacts approximately one-third of the United States population and periodontitis affects an estimated 50% of the same population, ages 30 and over. It has been suggested that the possible relationship between obesity and periodontitis lies in the diseases' underlying inflammatory processes. The aim of this paper is to present those inflammatory pathways and to review the literature that has examined the association between obesity and periodontitis.
Gen Dent
PMID:Obesity and periodontitis: a link. 2330 66

The presence of apical periodontitis in teeth which have undergone initial root canal treatment is largely attributed to bacteria residing in or invading from the apical root canal space. Bacteria-associated apical periodontitis will not heal spontaneously, nor will systemic antibiotics eradicate the infection. Only endodontic retreatment, endodontic surgery, or extraction will control the bacterial etiology. Modern retreatment is an effective means of addressing apical periodontitis. A mandibular premolar with apical periodontitis, apical root resorption, and overfilled gutta percha was retreated with post removal, retrieval of gutta percha from beyond the apex, ultrasonic irrigation and disinfection, and placement of a collagen internal matrix to facilitate a well-controlled MTA apical fill. The magnification and illumination imparted by the operating microscope was integral to achievement of treatment objectives. The patient's symptoms were resolved and complete osseous healing occurred. During treatment planning, clinicians should consider the capability of modern endodontic techniques to overcome technical challenges, often allowing the natural dentition to be preserved and restored to function days after retreatment.
Gen Dent
PMID:Healing of apical periodontitis through modern endodontic retreatment techniques. 2345 16

Periodontitis tends to be associated with bacteria that use sulfate as an energy source and produce thiol compounds that contain sulfhydryl (-SH) groups. This study used a chromogenic thiol-detecting strip to investigate whole saliva -SH concentration (SS) in subjects with and without periodontal disease. Ninety-six subjects were enrolled; all underwent periodontal evaluations, including plaque index (PI), gingival index (GI), probing depth measurements (PD), and attachment levels (AL). Subjects were divided into 3 groups: those who were periodontally healthy (n = 17), those with gingivitis (n = 54), and those with periodontitis (n = 25). Of the 96 subjects, 33% (n = 32) were cigarette smokers. A chromogenic strip was used to collect a whole saliva sample from the mouth. Color reaction was scored based on a color chart. Good-to-moderate correlations were found between SS scores and PI (r = 0.47, P = 0.0001), GI (r = 0.45, P = 0.0001), PD (r = 0.42, P = 0.0001), and AL (r = 0.30, P = 0.002). Analysis of variance showed significant differences in SS scores among the 3 study groups (P = 0.0001); post-hoc analysis showed higher SS scores in subjects with periodontitis than in those without (P = 0.05). Logistic regression, adjusting for smoking, showed the odds ratio of periodontitis increased by a factor of 12.76 for each increase of one unit of measure of SS. These results indicate that assessing whole saliva thiol levels with a chromogenic strip could be used as a screening test for periodontal diseases.
Gen Dent 2013 Aug
PMID:Salivary thiol levels and periodontal parameters assessed with a chromogenic strip. 2392 40

Management of post-treatment apical periodontitis after surgery--assuming the tooth is restorable, periodontally sound, and the patient desires to retain it--includes nonsurgical retreatment and surgical reintervention. This article presents 2 cases of surgical reintervention using a modern surgery technique that utilized an operating microscope, ultrasonic tips, and biocompatible materials. After the reinterventions were performed, adequate periradicular healing was observed in both cases. These cases reinforce the precept that combining knowledge about the biologic aspects of endodontics with surgical endodontic treatment using a modern technique is a predictable treatment option.
Gen Dent
PMID:Surgical endodontic reintervention using a modern technique: 2 case reports. 2518 14

Periodontitis may act as a risk factor for diabetes and its various complications such as cardiorenal complications. The current literature is deficient regarding the association between periodontal disease and diabetic retinopathy (DR). This cross-sectional study of 100 type II diabetes patients sought to evaluate the association of periodontal disease with the occurrence and severity of DR. The results showed a definite association between periodontal disease status and the occurrence of DR, although a cause and effect relationship could not be established.
Gen Dent
PMID:Evaluation of the association between periodontal disease and diabetic retinopathy. 2536 98

Organ abscesses are rare, life-threatening complications that can be caused by bacteremia from oral infections. Metastatic infection is a well-established concept. Dental and periapical infections can cause infections in distant organs and tissues. The frequency of these systemic infections and systemic diseases is open to debate, as some patients are more susceptible to infections than others. This article presents the case report of a 52-year-old woman who was hospitalized with a hepatic abscess after a routine periodontal maintenance procedure. The patient had poor oral health, involving several nonrestorable teeth, multiple failed endodontic treatments, and asymptomatic chronic periapical pathologies. Her dental history included previous diagnoses of moderate generalized chronic periodontitis and advanced localized periodontitis. It was possible that bacteremia developed during her most recent dental treatment, leading to the hepatic abscess. Systemic antibiotic therapy, drainage of the hepatic abscess, and oral rehabilitation resulted in complete recovery.
Gen Dent
PMID:Hepatic abscess linked to oral actinomycetes: a case report. 2573 87


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