Forced orthodontic eruption of fractured teeth before implant placement: case report.
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The treatment of esthetic areas with single-tooth implants represents a new challenge for the clinician. Placement of a single-unit implant is indicated for fractured or periodontally compromised teeth. In 1993, a modification of the forced eruption technique, called "orthodontic extrusive remodelling," was proposed as a way to augment both soft- and hard-tissue profiles at potential implant sites. This case report describes augmentation of the coronal soft and hard tissues around a fractured tooth, which was achieved by forced orthodontic extrusion before implant placement. This technique may be used to improve primary anchorage of a dental implant, fill the alveolar socket with bone, preserve interdental bone height and increase the amount of attached gingiva. (+info)
A marker of oxidative stress in saliva: association with periodontally-involved teeth of a hopeless prognosis.
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The aim of this study was to determine the association between levels of a marker of oxidative stress, 8-hydroxydeoxyguanosine (8-OHdG), in saliva and the presence of teeth with a hopeless prognosis as a result of advanced periodontitis. Thirty-four periodontitis patients were divided into two groups based on the presence or absence of periodontally-involved teeth of hopeless prognosis. Salivary levels of 8-OHdG in those with were significantly higher than in subjects without periodontally-involved teeth of hopeless prognosis (4.78 +/- 0.14 ng/ml and 2.35 +/- 0.18 ng/ml, respectively). We also evaluated 8-OHdG levels in gingival crevicular fluid (GCF) of teeth with advanced periodontal destruction (mean probing depth = 7.2). In this case, 8-OHdG was detected only from those periodontally-involved teeth of hopeless prognosis, and only in some cases (8 out of 18 samples). These data suggest that periodontally-involved teeth of hopeless prognosis are a major source of salivary 8-OHdG. Measurement of salivary 8-OHdG levels may prove to be useful in identifying patients with teeth of hopeless prognosis. (+info)
Gamma interferon positively modulates Actinobacillus actinomycetemcomitans-specific RANKL+ CD4+ Th-cell-mediated alveolar bone destruction in vivo.
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Recent studies have shown the biological and clinical significance of signaling pathways of osteogenic cytokines RANKL-RANK/OPG in controlling osteoclastogenesis associated with bone pathologies, including rheumatoid arthritis, osteoporosis, and other osteolytic disorders. In contrast to the inhibitory effect of gamma interferon (IFN-gamma) on RANKL-mediated osteoclastogenesis reported recently, alternative new evidence is demonstrated via studies of experimental periodontitis using humanized NOD/SCID and diabetic NOD mice and clinical human T-cell isolates from diseased periodontal tissues, where the presence of increasing IFN-gamma is clearly associated with (i) enhanced Actinobacillus actinomycetemcomitans-specific RANKL-expressing CD4(+) Th cell-mediated alveolar bone loss during the progression of periodontal disease and (ii) a concomitant and significantly increased coexpression of IFN-gamma in RANKL(+) CD4(+) Th cells. Therefore, there are more complex networks in regulating RANKL-RANK/OPG signaling pathways for osteoclastogenesis in vivo than have been suggested to date. (+info)
Orthodontically induced root and alveolar bone resorption: inhibitory effect of systemic doxycycline administration in rats.
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The aim of the present study was to investigate the effect of systemic administration of low-dose doxycycline (DC) on orthodontic root resorption. The effect on alveolar bone, the cell population involved, and the amount of tooth movement were also evaluated.Fifty-six 40-50-day-old male Wistar rats were used. Six animals served as untreated controls. Six animals were only administered DC for 7 days, by means of a mini-osmotic pump implanted subcutaneously. In 44 animals the maxillary first molar was mesialized by a fixed orthodontic appliance exerting 50 g force upon insertion. In 28 of these animals DC was administered at the time of appliance insertion and throughout the experiment. The animals were sacrificed 7, 10 or 14 days after force application and block sections processed for analysis. An area including the mesial aspect of the distopalatal root and the adjacent inter-radicular alveolar bone was histomorphometrically evaluated. The root resorption area, absolute alveolar bone area, distance between first and second molars, number of odontoclasts, osteoclasts, mononuclear cells on the root, tartrate-resistant acid phosphatase (TRAP)-positive cells on the root, bone, and in the periodontal ligament (PDL) were compared between DC-treated and non-DC-treated animals. The results revealed a significant reduction in root resorption, the number of odontoclasts, osteoclasts, mononuclear cells on the root surface, and TRAP-positive cells on the root and bone for the DC-administered group. The absolute alveolar bone area was greater, whereas the distance between the first and second molars did not differ between groups. In conclusion, systemic administration of low-dose DC in rats may have an inhibitory effect on orthodontically induced resorptive activity. (+info)
Radiographic evaluation of destructive periodontal disease in blue mink in relation to age and blood morphology.
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In this study, blood samples and jaws were collected from 2 genotypes of blue mink (n = 289) in order to examine phenotypic expression of specific characteristics of Chediak-Higashi Syndrome (C-HS). Blood samples were subjected to differential counts to assess the proportion of abnormal polymorphonuclear leukocytes characteristic for CH-S (C-HS-leukocytes). Abnormal leukocytes with characteristic signs of C-HS were found in blood smears from all mink included in this study. Four teeth in one half of the mandible (P3, P4, M1, M2) were subjected to quantitative radiographic evaluation of alveolar bone loss and tooth loss. There was a high prevalence of destructive periodontal disease among blue mink included in this study. Mild to moderate periodontal disease (defined by less than 50% alveolar bone loss related to 1 or more teeth) affected 73.7% of young mink (age = 7 mo) and 67.9% of older animals (age > or = 19 mo). Severe periodontal disease (defined by more than 50% bone loss related to one or more teeth) was not detected in mink aged 7 mo, but affected 15.3% of mink aged 19 mo and 39.6% of mink aged 31 mo. The positive relationship between age and periodontal disease was statistically significant (P < 0.01). The prevalence of tooth loss was found to be high among blue mink aged > 19 mo (21.6%) and was also significantly related to age (P < 0.01). A significant positive interaction between alveolar bone loss and tooth loss (P < 0.01), implies that the highly prevalent tooth loss in the mink was related to and possibly caused by destructive periodontal disease. There was no significant difference in the prevalence of periodontal disease between the 2 genotypes and age was found to be the only statistical predictor of poor production results (P < 0.01) in blue mink. (+info)
Preprosthetic and implantological surgery in patients with severe maxillary atrophy.
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AIMS: To evaluate the success of the osseointegration of dental implants in patients with severe maxillary atrophy after sinus lift augmentation and onlay graft surgery with autologous bone grafts. DESIGN: A descriptive and analytic study of 27 patients with severe maxillary atrophy and partial or total edentulism, after 4 years follow-up. All cases underwent to autologous bone graft sinus lift augmentation with or without onlay grafts in the anterior maxillae. After this, reconstruction with osseointegrated implants was performed. RESULTS: After the follow-up period, 89.1% of implants were osseointegrated and loaded. Anterior iliac crest bone graft provides good results with respect to implant osseointegration. The achievement of two surgical procedures for bone grafts surgery and implants surgery, separated 2 or more months, provides better results for osseointegration in comparison to a sole surgical procedure (p<0.01). CONCLUSIONS: Implants survival predictability is greater when a second surgical procedure is performed, once bone grafts have experimented an appropriate consolidation. The use of onlay graft and sinus lift augmentation techniques is useful in the resolution of complex problems such as the severe maxillary atrophy. (+info)
Bioactive glass efficacy in the periodontal healing of intrabony defects in monkeys.
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The purpose of this study was the histomorphologic analysis of the efficacy of bioactive glass particles with a narrow size range (Biogran) in the periodontal healing of 2-wall intrabony defects in monkeys. The 2-wall defects were made in the mesial area of the left and right second premolars of four monkeys, filled with gutta-percha and, after 15 days, they were debrided and either naturally filled with coagulum (control) or implanted with bioactive glass (test). In the control sites, the junctional epithelium migrated up to the base of the defect. The presence of newly formed cementum was more significant in the test defects. Both control and test sites showed newly formed bone at the base of the defect. The test defects presented foci of newly formed bone around and within the glass particles localized in the middle third, distant from the defect walls. Histologic analysis showed that the 300- to 355-microm bioactive glass particles aided new periodontal insertion. In conclusion, the tested bioactive glass had better healing potential than debridement only. The graft material showed a promising inhibition of apical migration of the junctional epithelium and greater cementum deposition on the radicular surface of the intrabony defects. The replacement of bioactive glass particles by new bone occurred due not only to an osteoconductive property, but also to an osteostimulatory capacity. Future investigations should evaluate this potential comparatively or together with other grafting materials, regenerative techniques and biological modifiers, as well as assess the longitudinal stability of the new attachment. (+info)
An immune response directed to proteinase and adhesin functional epitopes protects against Porphyromonas gingivalis-induced periodontal bone loss.
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Porphyromonas gingivalis, a pathogen associated with periodontitis, bound to fibrinogen, fibronectin, hemoglobin, and collagen type V with a similar profile to that of its major virulence factor, the cell surface RgpA-Kgp proteinase-adhesin complex. Using peptide-specific, purified Abs in competitive inhibition ELISAs and epitope mapping assays, we have identified potential adhesin binding motifs (ABMs) of the RgpA-Kgp complex responsible for binding to host proteins. The RgpA-Kgp complex and synthetic ABM and proteinase active site peptides conjugated to diphtheria toxoid, when used as vaccines, protected against P. gingivalis-induced periodontal bone loss in the murine periodontitis model. The most efficacious peptide and protein vaccines were found to induce a high-titer IgG1 Ab response. Furthermore, mice protected in the lesion and periodontitis models had a predominant P. gingivalis-specific IL-4 response, whereas mice with disease had a predominant IFN-gamma response. The peptide-specific Abs directed to the ABM2 sequence (EGLATATTFEEDGVA) protected against periodontal bone loss and inhibited binding of the RgpA-Kgp complex to fibrinogen, fibronectin, and collagen type V. Furthermore, the peptide-specific Abs directed to the ABM3 sequence (GTPNPNPNPNPNPNPGT) protected against periodontal bone loss and inhibited binding to hemoglobin. However, the most protective Abs were those directed to the active sites of the RgpA and Kgp proteinases. The results suggest that when the RgpA-Kgp complex, or functional binding motif or active site peptides are used as a vaccine, they induce a Th2 response that blocks function of the RgpA-Kgp complex and protects against periodontal bone loss. (+info)