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Surgical Approach and Laser Applications in BRONJ Osteoporotic and Cancer Patients  [PDF]
Paolo Vescovi,Elisabetta Merigo,Marco Meleti,Maddalena Manfredi,Carlo Fornaini,Samir Nammour
Journal of Osteoporosis , 2012, DOI: 10.1155/2012/585434
Abstract: Bisphosphonates-related Osteonecrosis of the Jaw (BRONJ) has been reported with increasing frequency in literature over last years, but its therapy is still a dilemma. One hundred ninety patients affected by BRONJ were observed between January 2004 and November 2011 and 166 treated sites were subdivided in five groups on the basis of the therapeutical approach (medical or surgical, traditional or laser-assisted approach, with or without Low Level Laser Therapy (LLLT)). Clinical success has been defined for each treatment performed as clinical improvement or complete mucosal healing. Combination of antibiotic therapy, conservative surgery performed with Er:YAG laser and LLLT applications showed best results for cancer and noncancer patients. Nonsurgical approach performed on 69 sites induced an improvement in 35 sites (50.7%) and the complete healing in 19 sites (27.5%), while surgical approach on 97 sites induced an improvement in 84 sites (86.6%) and the complete healing in 78 sites (80.41%). Improvement and healing were recorded in 31 (81.5%) and 27 (71.5%) out of the 38 BRONJ sites treated in noncancer patients and in 88 (68.75%) and in 69 (53.9%) out of the 128 in cancer patients. 1. Introduction Bisphosphonates-related osteonecrosis of the jaws (BRONJ) management is controversial: there are no evidence-based guidelines in the literature associated with good results for a long-term follow-up, in particular regarding surgical procedures [1]. The main purposes of each treatment are to reduce pain and to control infection and slow the progression of the disease, taking into account as main target the eradication of BRONJ promoting the complete healing. Most of the authors privilege a noninvasive approach especially for asymptomatic stages of BRONJ (Stage I in Ruggiero’s staging) [2] but also different surgical approaches have been proposed, with variable types of surgical techniques and with or without discontinuation of bisphosphonates protocols [3–12]. Migliorati and colleagues reported percentages of healing variable from 17.3–17.6% for medical therapy or surgical debridement to 46.3% for free flap or surgical resection procedures [13]. Clinicians should always carefully consider the possibility of extensive surgery in oncological patients because of general status and life expectancy. One of the exclusion criteria was contraindications for surgery under general anaesthesia: this element appears to be an important limit to surgical procedure and confirms the choice for early minimal invasive surgical therapy in stages I and II of BRONJ. The
Surgical Approach and Laser Applications in BRONJ Osteoporotic and Cancer Patients  [PDF]
Paolo Vescovi,Elisabetta Merigo,Marco Meleti,Maddalena Manfredi,Carlo Fornaini,Samir Nammour
Journal of Osteoporosis , 2012, DOI: 10.1155/2012/585434
Abstract: Bisphosphonates-related Osteonecrosis of the Jaw (BRONJ) has been reported with increasing frequency in literature over last years, but its therapy is still a dilemma. One hundred ninety patients affected by BRONJ were observed between January 2004 and November 2011 and 166 treated sites were subdivided in five groups on the basis of the therapeutical approach (medical or surgical, traditional or laser-assisted approach, with or without Low Level Laser Therapy (LLLT)). Clinical success has been defined for each treatment performed as clinical improvement or complete mucosal healing. Combination of antibiotic therapy, conservative surgery performed with Er:YAG laser and LLLT applications showed best results for cancer and noncancer patients. Nonsurgical approach performed on 69 sites induced an improvement in 35 sites (50.7%) and the complete healing in 19 sites (27.5%), while surgical approach on 97 sites induced an improvement in 84 sites (86.6%) and the complete healing in 78 sites (80.41%). Improvement and healing were recorded in 31 (81.5%) and 27 (71.5%) out of the 38 BRONJ sites treated in noncancer patients and in 88 (68.75%) and in 69 (53.9%) out of the 128 in cancer patients.
Distribution of filled, decayed and missed teeth in North West of Tehran
Eshraghian MR; Kanzali B
Journal of Dental Medicine , 1998,
Abstract: The purpose of this article is to study distribution of DMF(T) and its D,M and F protions exactllly. 1500 subjects were examined clinicaly. They were 5 to 70 years old, with average 24 years. Only cavitated and coronal dental caries included in this research. The results of this study are:"n1. The caries lesions of upper and lower second permolars are equal."n2. Anterior to second premolars, the DMF(T) of upper jaw teeth is higher than lower jaw's one. Conversely posterior to second premolars, lower jaw teeth has higher DMF(T)."n3. Deciduous teeth of females have lower DMF(T)."n4. Permanent teeth of females have higher DMF(T)."n5. The upper Canines of females are exceptions. Upper canines of females have lower DMF(T) than males' ones."n6. It seems that sex hormones influence DMF(T) through Saliva and eruption time of teeth."n7. Susceptibility to Caries relates to microbial plaque formation and salivary protection."n8. The females have more filled teeth than males.
Periodontal conditions of teeth presenting pathologic migration
Costa, Maurício Ribeiro;Silvério, Karina Gonzales;Rossa Júnior, Carlos;Cirelli, Joni Augusto;
Brazilian Oral Research , 2004, DOI: 10.1590/S1806-83242004000400005
Abstract: the aim of the present study was to evaluate the periodontal conditions of anterior teeth that presented pathologic migration in patients with chronic periodontitis and to compare periodontal destruction in migrated versus non-migrated teeth. the sample included 32 patients of both sexes (mean age: 46.0 ± 11.6 years) diagnosed with generalized chronic periodontitis and selected on the basis of the presence of pathologic migration in one or more anterior teeth. this migration was classified according to the following categories: facial flaring, diastema, proximal tilting, rotation or extrusion. the periodontal parameters recorded were clinical attachment loss (cal) and percentage of radiographic bone loss (bl). mean cal of 5.50 ± 2.20 mm and mean bl of 41.90 ± 15.40% were found in 115 teeth assessed. the most frequent type of migration was facial flaring (34.80%), followed by diastema (27.00%). extrusion was hardly observed in the sample (4.30%). however, greater severity of bl and cal were observed in teeth with this type of migration (59.44% and 8.42 mm, respectively), and in teeth with facial flaring (45.17% of bl and 6.07 mm of cal). kruskal-wallis test indicated that bl presented by teeth with extrusion or facial flaring was greater than that observed in rotated or tilted teeth (p < 0.05), while there was no difference between groups regarding cal (p = 0.11). it was observed that anterior teeth with pathologic migration presented greater cal and bl (5.1 mm and 40%) than non-migrated teeth (4.1 and 31%). the study indicated that the most prevalent kind of pathologic migration is facial flaring, which was associated to higher level of bone loss.
DMFT (Decayed, Missing, Filled, Teeth) Oral Health Index in Sweets and Cable Industry Workers
Z Tohidast akrad,JM Beitollahi,AA Khajetorab
Iranian Journal of Public Health , 2006,
Abstract: The most important factor in evaluating dental health is DMFT (Decayed, Missing, Filled, Teeth). This research was conducted to compare DMFT index in the workers of sweets and cable factories of Shahrood (Moghan), a small city near 300 km east of Tehran. All the 127 production line workers of cable factory and 124 workers of sweets factory who had the predetermined criteria were selected. A questionnaire was filled out and dental status was recorded for each one. After analyzing the data by SPSS soft ware the results were as follows: Mean and SD of DMFT in sweets factory: 12.59± 6.5; in cable factory: 9.7± 5.4; and Caries free in both factories was less than 1% which was neglectable. Mean and SD of DMFT in 35- 44 yr age group in sweet and cable factory was 11.6± 6.05, and 10.8± 6.5, respectively. With Anova two-way analysis in two groups and with P< 0/000, there was a significant correlation between type of work and DMFT which proved the hypothesis. Accordingly, consumption of sweets and neglecting oral hygiene can be considered of great importance in increasing DMFT in the workers of sweets factory compared to the cable factory.
Effects of a Low Level Laser on Periodontal Tissue in Hypofunctional Teeth  [PDF]
Hidetaka Hayashi, Akiko Terao, Ryo Kunimatsu, Toshitsugu Kawata
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0100066
Abstract: Malocclusions, such as an open bite and high canines, are often encountered in orthodontic practice. Teeth without occlusal stimuli are known as hypofunctional teeth, and numerous atrophic changes have been reported in the periodontal tissue, including reductions in blood vessels in the periodontal ligament (PDL), heavy root resorption, and reduced bone mineral density (BMD) in the alveolar bone. Low Level Laser (LLL) has been shown to have a positive effect on bone formation and the vasculature. Although the recovery of hypofunctional teeth remains unclear, LLL is expected to have a positive influence on periodontal tissue in occlusal hypofunction. The aim of the present study was to elucidate the relationship between LLL and periodontal tissue in occlusal hypofunction. Twenty-four male rats aged 5 weeks were randomly divided into control and hypofunctional groups. An anterior metal cap and bite plate were attached to the maxillary and mandibular incisors in the hypofunctional group to simulate occlusal hypofunction in the molars. LLL irradiation was applied to the maxillary first molar through the gingival sulcus in half of the rats. Rats were divided into four groups; control, control+LLL, hypofunctional, and hypofunctional+LLL. Exposure to LLL irradiation was performed for 3 minutes every other day for 2 weeks. Animals were examined by Micro-CT at 5 and 7 weeks and were subsequently sacrificed. Heads were resected and examined histologically and immunohistologically. The hypofunctional group had obvious stricture of the PDL. However, no significant differences were observed in the PDL and alveolar bone between the hypofunctional+LLL and the control groups. In addition, the expression of basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF)-positive cells were higher in the hypofunctional + LLL group than in the hypofunctional group. These results indicated that LLL enhanced the production of bFGF and VEGF in the periodontal tissue of hypofunctional teeth.
Assessment of Knowledge , Attitude, Practice in group of poople between the age of (5-44) about Decayed, Missed- Filled- Teeth in zangan state, Iran, 1370
F. YOSEFI
Hayat Journal of Faculty of Nursing & Midwifery , 2000,
Abstract: This research is a descriptive study. The purpose of conducting this survey was to estimate the prevalence of dental carvies by calculating the mean of Decay- Missing Filling Teeth (D. M. F.) and (d.mf.) indices for about and children in the province ofzanjan in 1990."nIndependent variable was age and dependent were Decayed - Missed and Filled teeth."nThe total population of 300 were studied and chosen as sample size and consist/69 females and 131 males of those 200 people were chosen from urban (Zanjan) and 100 from rural (Dizeg-Abad)."nThe results of this study shows thefolowing indications."n1. At age 5-6 years old 100% were carries free in permanent teeth. While at age / 2 only 5% in urban and 6.5% in rural were carvies free."n2. The mean of D.M.F at age 12, 15 and 35-44 were seen between urban and rural but it was significant by applied T.Test."nBesides D.M.F. the investigator also tried togather some deta in some aspects of "knowledge", "Attitude" and "Practice", (KA.P) in regards of population oral health, by using multiple questionnaire."nThe analysis of deta indicates the following findings*"n3. Around 40% of the arban population who were interviewed indicated that they brush their"nteeth daily (once a day), 50% after each and 7% occasionally."nAnd around 28% of rural popution answered that they had the habit for daily beashing, and 20% after each meal and 46% occasion' ally."nThe X2 test were performed between these two categorize and the result was highly significant.
Glass Fibre-Reinforced Composite Post and Core Used in Decayed Primary Anterior Teeth: A Case Report
Leena Verma,Sidhi Passi
Case Reports in Dentistry , 2011, DOI: 10.1155/2011/864254
Abstract: Aesthetic requirement of severely mutilated primary anterior teeth in the case of early childhood caries has been a challenge to pediatric dentist. Among restorative treatment options, prefabricated crown and biological and resin composite restoration either by means of direct or indirect technique are mentioned in the literature. This paper presents the clinical sequence of rehabilitation of maxillary anterior primary teeth. Endodontic treatment was followed by the placement of a glass fibre-reinforced composite resin post. The crown reconstruction was done with composite restoration. Resin glass fibre post has best properties in elasticity, translucency, adaptability, tenaciousness, and resistance to traction and to impact. Along with ease of application, fiber can be used as an alternative to traditionally used materials in the management of early childhood caries.
Effects of Extremely Low Frequency Magnetic Fields on Periodontal Tissues and Teeth in Rats
Filiz Acun Kaya,Mehmet Zulkuf Akdag,Can Ayhan Kaya,Suleyman Dasdag,Izzet Yavuz,Nihal Kilinc,Arzum Guler Dogru,Ozkan Adiguzel,Ersin Uysal,Ebru Saribas,Tuba Talo Yildirim
Journal of Animal and Veterinary Advances , 2012, DOI: 10.3923/javaa.2011.3021.3026
Abstract: The aim of this study is to research the effects of ELF magnetic fields on periodontal tissues and teeth in rats histopathologically. The experiments were performed on 27 male Sprague-Dawley rats, aged 4 months at the beginning of the study, weighing (342.4±38.89) g and fed with standard pelleted food. The rats were divided into three groups; two experimental and one control (sham). Experimental groups were exposed to 100 and 500 μT ELF magnetic fields during 10 months, 2 h a day, respectively. Third group was sham that were treated like experimental group except ELF magnetic fields exposure in methacrylate boxes. There was no statistical difference between the experimental groups among all tissues (p>0.05). Alveolar bone, pulp and gingiva there were statistically significant differences among the groups of sham and 1st experimental, sham and 2nd experimental (p<0.05). The statistical difference between the experimental and sham groups in the study makes us to think that ELF magnetic fields may have effects on periodontal tissues and teeth.
Periodontal status and dental care in HIV seropositive patients  [PDF]
Maria Sueli Marques Soares,Luiz Felipe Fernandes Gon?alves,Marcus Setally de Azevedo Macena,Rita de Cássia Brand?o Bertazzoli
RGO : Revista Gaúcha de Odontologia , 2009,
Abstract: Objective: The aim of the study was to evaluate the correlation between CD4+ cell count and viral load with periodontal and dental status in HIV seropositive patient. Methods: Forty HIV seropositive patients were selected from the dental clinic of the Clementino Fraga Hospital in Jo o Pessoa, Paraíba, Brazil. The Community Periodontal Index, Simplified Oral Hygiene Index and Decayed, Missing or Filled Teeth Index were determined. The values of CD4+ lymphocyte count and viral load were collected from the medical records. Descriptive analysis was made and Spearman’s correlation test was applied, with values of p<0.05 being significant. Results: HIV seropositive patients were aged 33 to 47 years (mean = 40 years), 26 were men and 14 women. The mean CD4+ lymphocyte count was 507.82±306.4 cells/mm3, with 41% being a high, 38.5% a medium and 20.5% a low level. Sixty-five percent of the patients had undetectable viral load, 12.5% had a high, 5% a low and 5% a medium viral load. Most patients (87.5%) presented with periodontal disease, calculus was the most frequent condition (40%). The mean Decayed, Missing or Filled Tooth Index was 19.7±6.8, with prevalence of the missing component. There was significant statistical correlation between the CD4+ count and the periodontal condition, p=0.046. There was no significant correlation between the CD4+ count and the Decayed, Missing or Filled Teeth Index (p=0.469) and the Simplified Oral Hygiene Index (p=0.189) indexes, and between viral load and Decayed, Missing or Filled Teeth Index (p=0.452), the Simplified Oral Hygiene Index (p=0.158) and Community Periodontal Index (p=0.216). Conclusion: The periodontal condition was influenced to a greater by the CD4+ cell count than the viral load, while there was no correlation between the decayed condition and the CD4+ cell count or the viral load condition.
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