Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.32
no.4
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pp.348-351
/
2006
Purpose The purpose of this study was to evaluate the success rate of dental implant on post-traumatic region to rehabilitate missing teeth. Patients and Methods 5 patients who had been treated due to maxillofacial trauma during 2000 to 2004 at samsung medical center were selected for this study. 22 dental implants were installed to them for restoring missing teeth. The success rate of these dental implants was evaluated with criteria by T. Albrektsson. We divided installed 22 implants into 2 categories. One category consisted rough surface implants group and smooth surface implants group. And the other category consisted more healing group and less healing group. The healing time was calculated from point of trauma. Results The success rate of dental implants is 68.2% that is lower than other studies because of poor vascularity of bone bed and mechanical stress according to trauma. Rough surface implants group and More healing group showed superior success rate to others. (P < 0.05). Conclusion We found that to increase success rate, it may need rough surface implants and longer healing period.
The purpose of this study was to determine the relationship between the third molar and periodontal status of the adjacent second molar. Fifty patients who had four maxillary and mandibular second molars were consecutively selected for the study subjects. The subjects provided a total of 200 molars, i. e., 100 maxillary and 100 mandibular molars, and classified the groups as follows; third molars that are normally erupted are control group, that are impacted are test 1 group, that are simply extracted are test 2 group, that are surgically extracted are test 3 group. Probing depth, plaque index, gingival index and mobility were measured. The results were as follows. 1. In mesial probing depth, there was no significantly difference. In distal probing depth, there was a significantly difference between control group and test 1 & 3 group in maxilla and between control & test 2 group and test 1& 3 group in mandible(p<0.05). 2. In buccal probing depth, there was a significantly difference between test 2 group and test 3 group in mandible. In lingual probing depth, there was a significantly difference between control group and test 1 & 3 group in mandible(p<0.05). 3. In plaque index, there was a significantly difference between test 1 group and test 2 group in maxilla, between test 1 group and control & test 2 group in mandible(p<0.05). 4. In gingival index, there was a significantly difference between control group and test 1 & 3 group in mandible. In mobility, there was no significantly difference(p<0.05). As a result of this study, the second molars adjacent to the third molars that are impacted or surgically extracted had poor prognosis, so impacted third molars should be extracted in early time and the second molars are actively treated for periodontal health.
The masticatory function of tooth is maintained by the periodontal health, and periodontal health is also maintained by the masticatory function. Bite forces are withstanded by the PDL, and this thought to be through the viscoelastic theory. Mobility test and Bite force test are used to evaluate the viscoelastic theory of the PDL. In this study, the bite force test was used. In the same conditions of quantity of the supporting tissue, the maximum bite force according to the quality of the supporting tissue was evaluated. The study was conducted on 40 patients with moderate adult periodontitis, who were indications to the modified widman flap treatment. The maximum bite force in the premolar and molar regions were tested before treatment, 3weeks and 4 weeks after treatment. and the results were as follows. 1. In the premolar region, 3 weeks and 4 weeks after treatment showed higher maximum bite force than before treatment. And in the molar region the maximum bite force decreased 3 weeks after treatment, but increased after 4 weeks, compared to before treatment. 2. In the 1st premolar, there were only significant difference between before and 3 weeks after treatment, and between and 4 weeks after treatment. 3. In the 2nd premolar, there were only significant difference between before and 3 weeks after treatment, and between and 4 weeks after treatment. 4. In the 1st molar, there were no significant difference between before, 3 weeks after treatment, 4 weeks after treatment. 5. In the 2nd molar, there were no significant difference between before, 3 weeks after treatment, 4 weeks after treatment. From the results above, it shows that there were improvements in the maximum bite force through specific periodontal treatments, and thus it can be considered in clinical situations, that selection of the prosthodontic material, decisions of extraction, evaluation of the prognosis after periodontal treatment is a helpful method.
Purpose: Tunneling is a periodontal surgical procedure that creates access for patient cleansing and maintenance within the furcal area of a molar tooth with severe furcation involvement. Up to date, there are few studies about a long term clinical and radiographic stability of tunneling. The purpose of this retrospective study is to evaluate the long term prognosis after tunnel preparation of molars with through and through furcation. Material and Methods: 25 teeth of 23 patients aged 36 to 70 (mean age 51.7) were treated surgically with tunnel preparation. These cases were followed for 2 to 13 years (mean 6.5years) after surgery. Patients were recalled for an evaluation which was based on a questionnaire, a clinical examination, and radiographic analysis. Clinical assessment included plaque index, caries registration, probing pocket depth, bleeding on probing, tooth mobility. Baseline and over 2-year follow-up radiographs were collected and evaluated for this study. Result: 3 teeth(12%) had been extracted and 1 tooth(4%) hemisected. Root caries was detected in 3 teeth(12%). Thus 72% of the teeth were still caries tree and in function. Clinical parameters including PI, PD, BOP, mobility showed somewhat favourable results. Radiographic furcal bone loss showed no statistically significant difference compared to interproximal crestal bone loss ($3.59{\pm}1.69%$ vs $3.42{\pm}2.95%$) when root length was used as reference. There was no correlation between root trunk length and furcal bone loss. Conclusion: Over 2 years after tunneling procedure, teeth showed a clinically and radiographically stable condition, despite of slight root caries and alveolar bone loss within clinically acceptable range. The tunnel procedure may be considered as a viable periodontal treatment option for molar teeth with severe furcation involvement in individuals following a regular maintenance program.
Kim, Cheol-Woo;Park, Jin-Woo;Suh, Jo-Young;Lee, Jae-Mok
Journal of Periodontal and Implant Science
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v.39
no.1
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pp.53-58
/
2009
Purpose: The resective treatment in mandibular Degree III furcation areas includes root resection and tunnel preparation. The purpose of this retrospective study is to evaluate which treatment procedure(root resection vs tunnel preparation) has more favorable prognosis in mandibular Degree III furcation involvement. Materials and methods: The subjects of this study were patients who were treated their mandibular posteriors with either root resection(22 teeth on 22 patients) or tunnel preparation(24 teeth on 22 patients) and have participated in periodic recall check program for at least 2 years. Failure rate, plaque index, bleeding on probing and probing pocket depth were measured and the results were compared and statistically analysed. Results: Failure rates of root resection and tunnel praparation were 13.6% and 16.7%, respectively, and showed no significant difference between two procedures. No significant differences were observed between two procedures with respect to plaque index, bleeding on probing and probing pocket depth. Conclusion: root resection and tunnel preparation are both effective procedures to treat mandibular posterior furcation involvement, if adequate treatment of choice is made and patient's cooperation is accompanied. However, tunnel preparation is more preservative procedure in mandibular posterior furcation involvement since root canal treatment and prosthetic restoration are needed additionally, in case of root resection.
The purpose of this study was to evaluate the clinical validity of multi-rooted teeth subjected to root-resection treatment. Over a period of 1-7 years, 60 root-resected molars in 59 patients were examined clinically and radiographically. All patients were p0eriodically recalled once or twice a year. Root-resections were due to periodontal, more specifically furcal bone loss or marginal bone loss,in 34 cases and extensive dental carious destruction in 10 cases. In other cases,root-resections resulted from 6 cases of root fracture, 6 cases of periodontal-endodontic combined lesion, and 1 case of endodontic problem. Root-resection was carried out on 26 maxillary molars and 34 mandibular molars. The results are as follows; 1. 14 cases(23.3%) were considered failures. 8 cases(13.3%) of them occurred within the first year(8 cases, 13.3%), 4 cases(6.7%)between 1-3 years, and 2 cases(3.3%) between 4-7 years. 2. 8 cases(13.3%) were considered failures due to periodontal reasons, 3 cases(5%) due to root fracture, 2 cases(3.3%) due to endodontic problem, and 1 case(1.7%) due to prosthetic problem. 3. 37 cases(61.7%) showed up for the recall appointments, and the percentage of failures(13.5%) was lower compared with that of all patients(23.3%). The results of the present study indicate that the prognosis of root-resected teeth is favourable if attention is paid to the selection of proper case and to achieving optimal oral hygiene and periodic check up.
The socket preservation procedure was a simple and effective technique, and has better prognosis for implantation. The socket preservation usually used barrier membrane in combination with/without alloplastic bone materials. A recently study had shown that a regenerative therapy to tooth extraction utilizing growth factors made better results. Platelet-rich plasma was clinically easy method that acquired the growth factors, and is known that accelerated new bone formation and mineralization of bone graft materials. The purpose of this study was to evaluate clinical and histopathologic results which occur following socket preservations using platelet-rich plasma and bovine bone powder. Twelve patients who required extraction of one or more teeth for implantation at the department of periodontics in Dankook University Dental Hospital were selected. Extraction sockets were treated by using platelet-rich plasma and bovine bone powder. 3 months later, we observed clinical and histopathological results as follows: 1. Internal vertical measurement was an average of 7.33mm preoperatively and statistically significantly decreased to an average of 1.42mm postoperatively(p<0.05). 2. External vertical measurement was an average of 3.33mm preoperatively and decreased to an average of 2.75mm postoperatively; therefore there was no significant difference. 3. Horizontal measurement was an average of 7.75mm preoperatively and statistically decreased to an average of 6.08mm postoperatively(p<0.05). 4. Osteocyte-like cells and new bone formation connected with bovine bone grafts were observed in histopathologic examination. This study implied that platelet-rich plasma and bovine bone powder grafts were effective treatment for socket preservation and regeneration of severe bony defect made by implantation failure.
Chae, Yong Kwon;Shin, Seo Young;Kang, Sang Wook;Choi, Sung Chul;Nam, Ok Hyung
Journal of Periodontal and Implant Science
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v.52
no.2
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pp.127-140
/
2022
Purpose: In dental avulsion, delayed replantation usually has an uncertain prognosis. After tooth replantation, complex inflammatory responses promote a return to periodontal tissue homeostasis. Various types of cytokines are produced in the inflammatory microenvironment, and these cytokines determine the periodontal tissue response. This study aimed to identify the gene expression profiles of replanted teeth and evaluate the functional differences between immediate and delayed replantation. Methods: Maxillary molars from Sprague-Dawley rats were extracted, exposed to a dry environment, and then replanted. The animals were divided into 2 groups according to the extra-oral time: immediate replantation (dry for 5 minutes) and delayed replantation (dry for 60 minutes). Either 3 or 7 days after replantation, the animals were sacrificed. Periodontal soft tissues were harvested for mRNA sequencing. Hallmark gene set enrichment analysis was performed to predict the function of gene-gene interactions. The normalized enrichment score (NES) was calculated to determine functional differences. Results: The hallmark gene sets enriched in delayed replantation at 3 days were oxidative phosphorylation (NES=2.82, Q<0.001) and tumor necrosis factor-alpha (TNF-α) signaling via the nuclear factor kappa light chain enhancer of activated B cells (NF-κB) pathway (NES=1.52, Q=0.034). At 7 days after delayed replantation, TNF-α signaling via the NF-κB pathway (NES=-1.82, Q=0.002), angiogenesis (NES=-1.66, Q=0.01), and the transforming growth factor-beta signaling pathway (NES=-1.46, Q=0.051) were negatively highlighted. Conclusions: Differentially expressed gene profiles were significantly different between immediate and delayed replantation. TNF-α signaling via the NF-κB pathway was marked during the healing process. However, the enrichment score of this pathway changed in a time-dependent manner between immediate and delayed replantation.
Periodontal defects of the furcation are characterized by several inherent anatomic factors that can make successful periodontal therapy difficult and results unpredictable. The severity and rate of occurrence of periodontal disease are directly related to the location of the furcation relative to the cementa-enamel junction and anatomical form of the root by limiting the accessibility and effectiveness of the periodontal instrumentation. This study investigated the reliability and accuracy of panoramic radiograph diagnoses of the periodontal state of mandibular molars, particularly regarding the diagnosis of furcation area periodontal defects, treatment planning, and prognosis prediction. This study examined a total of 110 teeth belonging to 33 subjects (19 male, 14 female) presenting with incipient to moderate periodontitis 4-7mmpocket depth. The alveolar bone level, length and width of the root trunk, and root separation angle were measured using the panoramic radiograph and compared to the results taken directly by retracting a full-thickness flap. The results of the study are as follows: 1. Data regarding the alveolar bone level of the mandibular first molar showed that the directly taken surgical measurements resulted in $5.1{\pm}0.9mm$ that was slightly deeper than the corresponding panoramic measurement resulted in $4.8{\pm}0.8mm$, but these differences were statistically insignificant (p>0.05). 2. The data of the directly taken surgical measurement of the mandibular second molar $(5.1{\pm}1.1mm)$ was slightly deeper than the corresponding panoramic measurement $(4.7{\pm}1.2mm)$, but these differences were statistically insignificant (p>0.05). 3. The measured values of the length and width of the mandibular first molar root trunks were determined to be $4.1{\pm}0.6mm$ and $7.3{\pm}0.9mm$, respectively, while the values of the mandibular second molar root trunks were determined to be $4.6{\pm}1.3mm$ and $7.6{\pm}0.9mm$ respectively. The differences between these values were found to be statistically significant (p<0.01). 4. The measured values of the root separation angle showed that the mandibular first molars averaged $34.5{\pm}4.4^{\circ}$, while the mandibular second molars averaged $23.0{\pm}10.0^{\circ}$. The differences between these values were found to be statistically significant (p<0.01).
With the introduction of dental implants, restoration of missing teeth with conventional fixed or removable partial dentures is being replaced with implants. Especially, with young patients, not only longevity but also esthetic factors need to be considered. Implant restorations provide long-term success functionally but, esthetic complications such as, marginal exposure due to gingival recession, loss of the papilla and dark color of metal abutments may occur. Recently, zirconia restorations with CAD/CAM technology provide functional, biocompatible and esthetic restorations possible. All-ceramic restorations using the pressed ceramic technique show better fracture toughness values than those of the conventional porcelain veneering technique. Pressed ceramic technique creates the veneer design in wax and the lost wax technique is used to create the restoration. The final contour of the restoration may be controlled during wax-up. A 22-year old female patient was restored with dental implants and zirconia restorations using the pressed ceramic technique presenting short-term but optimistic prognosis.
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