Résumé
Si bien el conocimiento científico para el tratamiento de la periimplantitis ha avanzado significativamente en los últimos años, sigue en discusión qué tipo de abordaje quirúrgico genera los mejores resultados clínicos y si el uso de biomateriales da mejoras significativas en dicho tratamiento. Este reporte de caso describe un abordaje quirúrgico reconstructivo de un defecto intraóseo por periimplantitis en una paciente que refería dolor y un intenso sangrado en sus implantes dentales, empleando un sustituto óseo anorgánico mineral bovino, sin el uso de una membrana o barrera, y con un protocolo de descontaminación de la superficie del implante mecánico y químico. Posteriormente, a las 20 semanas de realizado el procedimiento, se hizo la evaluación del defecto, obteniendo profundidades al sondeo menores a 5 mm, ausencia de sangrado al sondeo en todos los sitios y un llenado óseo radiográfico de aproximadamente 90%; cumpliendo con los criterios de éxito de la terapia periimplantaria. Lo anterior muestra que la terapia reconstructiva para los defectos por periimplantitis puede ser posible mediante el uso de un sustituto óseo xenogénico únicamente y con una correcta descontaminación de la superficie del implante (AU)
Although scientific knowledge for the treatment of peri-implantitis have advanced significantly in recent years, the type of surgical approach that generates the best clinical results is still under discussion and whether the use of biomaterials gives significant improvements in said treatment. This case report describes a reconstructive surgical approach for a periimplantitis intrabony defect using an anorganic bovine bone substitute, without the use of a membrane or barrier, and with a mechanical and chemical implant surface decontamination protocol. Twenty weeks after the procedure, the defect was reassessed, obtaining probing depths of less than 5 mm, no bleeding on probing in all sites, and radiographic bone filling of approximately 90%; meeting the success criteria for the peri-implant therapy. This shows that reconstructive therapy for periimplantitis defects may be possible using a xenogeneic bone substitute only and proper decontamination of the implant surface (AU)
Sujets)
Humains , Femelle , Adulte d'âge moyen , Substituts osseux/usage thérapeutique , Procédures de chirurgie maxillofaciale et buccodentaire/méthodes , Pose d'implant dentaire endo-osseux/effets indésirables , Péri-implantite/chirurgie , Poche parodontale/diagnostic , Lambeaux chirurgicaux , Brossage dentaire/méthodes , Indice parodontal , Décontamination/méthodes , MexiqueRésumé
Objective@#To study the clinical effect of a polyetheretherketone (PEEK) bonding bridge on the loss of 3 internal incisors in patients with periodontitis.@*Methods@#This study was reviewed and approved by the ethics committee, and informed consent was obtained from the patients. Thirty-eight patients with periodontitis and 3 missing central or lateral teeth were selected to undergo restoration with a PEEK bonding bridge and then returned to the hospital 3, 6, 12, and 24 months after the restoration was completed. The survival rate of the restorations was assessed by the modified USPHS/Ryge criteria. The plaque index, gingival index, periodontal probing depth and attachment loss of the abutments were recorded, and the changes in periodontal tissues after restoration were observed and compared.@*Results@#Over 24 months of clinical follow-up observation of 38 patients, only 1 patient underwent secondary bonding after partial debonding (evaluated as grade B), while bonding was successful in the other 37 cases (evaluated as grade A). The plaque index, gingival index and periodontal probing depth were significantly lower after restoration than before (P<0.05). There was no significant change in attachment loss between before and after restoration (P>0.05).@*Conclusion@#For periodontitis patients missing 3 internal incisors, short-term PEEK bonding bridge repair has good clinical efficacy.
Résumé
Objective@#To investigate the efficacy of antibacterial photodynamic therapy (aPDT) as an adjunct to subgingival scaling and root planning in the treatment of chronic periodontitis.@*Methods@#This study followed medical ethics guidelines, and informed consent was obtained from all patients. Sixteen patients were recruited for this randomized split-mouth controlled trial. The control group underwent subgingival scaling and root planning (SRP), while the experimental group received subgingival scaling and root planing plus aPDT treatment using Perowave® with a toluidine blue O solution photosensitizer. The probing pocket depth (PD), recession, plaque index (PLI), bleeding index (BI) and proportion of positive sites of bleeding on probing (BOP) (BOP%) at all sites were examined at baseline (before treatment) and at 1, 3 and 6 months after treatment.@*Results@#Follow-up was completed for 13 patients. On the control side, 356 teeth were tested at 2 136 sites. A total of 360 teeth on the test side and 2 160 sites were included in the study. Before treatment, there was no significant difference in the baseline indicators between the two groups. After treatment, both groups showed significant improvement in clinical parameters, including PD, PLI, BI, and BOP%,compared with baseline. At 3 months, the BOP% and PLI in the experimental group were significantly lower than those in the control group (P<0.05). The improvement in BOP% and PLI in the experimental group was significantly greater than that in the control group 3 months after treatment (P<0.05).@*Conclusion@#aPDT, as an adjuvant treatment to SRP for chronic periodontitis, can improve gingival bleeding and control periodontal inflammation in the early stage.
Résumé
Objective @#To evaluate the clinical effect of enamel matrix derivative(EMD) assisted with connective tissue graft(CTG) in the treatment of gingival recession.@*Methods @#Search The Cochrane Library, PubMed, EMbase, Web of Science, Wanfang Public Database,VIP database and CNKI to search for randomized controlled trials of EMD in the treatment of gingival recession. The search period is from the establishment of the databases to October 3, 2022. The test group was treated with EMD+CTG, while the control group was treated with CTG alone. Meta-analyses were performed using Review Manager 5.4.1 and Stat12.0.@*Results@# Meta analysis results showed that only 12 months after treatment, there was a statistically significant difference in the PD and CAL outcome indicators between the EMD assisted treatment group and the control group [MDPD=-0.10, 95% CI (-0.19, -0.01), P = 0.03], [MDCAL=-0.38, 95% CI(-0.71, -0.04), P = 0.03]. There was no significant difference between the test group and the control group in other indicators.@*Conclusion @#EMD assisted CTG in the treatment of gingival recession may be beneficial to the reduction of PD and CAL.
Résumé
Abstract The aim of the present case-control observational study was to evaluate the peri-implant clinicoradiographic status among betel-quid chewers and controls. Self-reported betel-quid chewers and controls were included. Participants were categorized into 3 groups: Group-1: Individuals chewing betel-quid with tobacco; Group-2: Individuals chewing betel-quid without tobacco; and Group-3: Controls (individuals not using tobacco in any form). Demographic data was collected using a questionnaire. Periodontal and peri-implant clinicoradiologic parameters (plaque and gingival indices [PI and GI], probing depth [PD] and crestal bone loss/marginal bone loss [CBL/MBL]) were assessed. Clinical attachment loss (AL) around teeth was also assessed. Group comparisons were done using the one-way analysis of variance and Bonferroni Post-hoc adjustment tests. Correlation of periodontal and peri-implant inflammatory parameters with the duration of betel-quid chewing habit and duration of placement in the mouth were assessed using logistic regression analysis. P<0.05 was considered statistically significant. Thirty, 30 and 30 patients were included in groups 1, 2 and 3, respectively. Full-mouth PI (P<0.01), GI (P<0.01), clinical AL (P<0.01), PD (P<0.01) and mesial and distal MBL (P<0.01) were higher in groups 1 and 2 than Group-3. Peri-implant mPI (P<0.01), mGI (P<0.01), PD (P<0.01) and MBL/CBL (P<0.01) were significantly higher in groups 1 and 2 than Group-3 with no significant difference in groups 1 and 2. Betel-quid chewing habit either with or without tobacco is a risk-factor of peri-implant soft-tissue inflammation and CBL.
Resumo O objetivo do presente estudo observacional de casos-controles foi avaliar o estado clínico-radiográfico periimplantar dos usuários de bétele. Foram incluídos usuários que relataram utlizar a substância bétele como tabaco de mascar. Os participantes foram categorizados em 3 grupos: Grupo-1: Indivíduos que mascam bétele com tabaco; Grupo-2: Indivíduos que mascam bétele sem tabaco; e Grupo-3: Controle (indivíduos que não usam tabaco sob qualquer forma). Os dados demográficos foram recolhidos utilizando um questionário. Foram avaliados parâmetros clínico-radiográfico e periimplantares (índices placa e gengivais [IP e IG], profundidade de sondagem [PS] e perda de crista óssea/ perda óssea marginal [PCO/POM]). Também foi avaliada a perda inserção clínica (IC) em torno dos dentes. As comparações de grupo foram feitas utilizando a análise de variância unidireccional e os testes de ajustamento post-hoc de Bonferroni. A correlação dos parâmetros inflamatórios periodontais e periimplantares com a duração do hábito de mastigação da bétele e duração da colocação na boca foi avaliada utilizando a análise de regressão logística. P<0,05 foi considerado estatisticamente significativo. Foram utilizados 30 pacientes em cada grupo. O IP de boca inteira (P<0,01), IG (P<0,01), IC clínica (P<0,01), PS (P<0,01) e POM mesial e distal (P<0,01) foram mais elevados nos grupos 1 e 2 do que no grupo 3. O mPI peri-implantar (P<0,01), '(P<0,01), PD (P<0,01) e POM/PCO (P<0,01) foram significativamente mais elevados nos grupos 1 e 2 do que no grupo 3, sem diferença significativa nos grupos 1 e 2. O hábito de mastigar a substância bétele com ou sem tabaco é um fator de risco de inflamação dos tecidos moles periimplantares e PCO.
Résumé
RESUMEN: Los dientes adyacentes a la hendidura alveolar, en pacientes con labio y paladar hendido, presentan mayor incidencia de problemas periodontales, según la literatura. El objetivo de este trabajo fue evaluar si los dientes temporales adyacentes a la hendidura alveolar presentan mayor incidencia de problemas periodontales en niños con labio y paladar hendido unilateral completo no sindrómico, nacidos en 2010 y 2011, atendidos en el Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Caja Costarricense de Seguro Social. Este estudio prospectivo, transversal, descriptivo, e intervencional evaluó variables epidemiológicas, clínicas y radiográficas (placa bacteriana, profundidad de bolsa, nivel de inserción, recesión gingival, sangrado, encía queratinizada e insertada, cálculo y movilidad dental, tipo de hendidura alveolar). Se utilizó técnicas de análisis estadísticos descriptivas (distribución de frecuencias, cruce de variables y construcción de intervalos de confianza). El análisis de datos y procesamiento estadístico se realizó en SPSS versión 17.0 y en Excel. El grupo constó de 17 pacientes, con edad promedio de 5 años. Se encontró 47 % de placa dental y 0 % de cálculo dental. La profundidad de bolsa y el sangrado fueron estadísticamente mayores para los dientes dentro de la hendidura alveolar. Los dientes adyacentes a la hendidura presentaron menor cantidad de encía queratinizada e insertada. Referente a la movilidad dental no existe diferencia estadísticamente significativa. Solo un diente presentó recesión gingival. La hendidura alveolar completa predominó radiográficamente. Los dientes cercanos a la hendidura alveolar tienen mayor predisposición a problemas periodontales, por lo que es relevante el seguimiento regular de la salud periodontal.
ABSTRACT: The teeth adjacent to the alveolar cleft, in patients with cleft lip and palate, present a higher incidence of periodontal problems, according to the literature. The purpose of this study was to evaluate whether the temporary teeth adjacent to the alveolar cleft present a higher incidence of periodontal problems in children with non-syndromic complete unilateral cleft lip and palate, born in 2010 and 2011, treated at the Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Caja Costarricense de Seguro Social. This prospective, cross-sectional, descriptive, and interventional study evaluated epidemiological, clinical and radiographic variables (bacterial plaque, pocket depth, insertion level, gingival recession, bleeding, keratinized and inserted gingiva, dental calculus and mobility, type of alveolar cleft). It used descriptive statistical analysis techniques frequency distribution, crossing of variables and construction of confidence intervals. Data analysis and statistical processing was performed in SPSS version 17.0 and in Excel. The group consisted of 17 patients, with an average age of 5 years. 47 % dental plaque and 0 % dental calculus were found. Pocket depth and bleeding were statistically higher for teeth in the alveolar cleft. The teeth adjacent to the cleft had less keratinized and inserted gingiva. Regarding dental mobility, there is no statistically significant difference. Only one tooth had gingival recession. The complete alveolar cleft predominated radiographically. Teeth close to the alveolar cleft have a greater predisposition to periodontal problems, so regular monitoring of periodontal health is relevant.
Résumé
Objective @# To investigate the clinical effect of periodontal endoscope-assisted scaling and root planing (SRP) in treating advanced periodontitis. @*Methods@# Nineteen cases of grade Ⅲ and Ⅳ periodontitis selected from June 2017 to January 2019 in the Nanjing Stomatological Hospital, Medical School of Nanjing University were divided into the periodontal endoscope and control groups. In the periodontal endoscope group, SRP was performed under a periodontal microscope in one treatment after initial supragingival scaling; in the control group, SRP was performed under regular conditions, and additional SRP was conducted in positive bleeding on probing sites twice every other week as needed. Periodontal status, including probing depth (PD), bleeding on probing (BOP) and attachment loss (AL), was recorded by a Florida probe.@*Results@# For sites of 4<PD ≤ 6 mm, there was no significant difference in PD- and BOP-positive rates or AL between the two groups at baseline. The PD- and BOP-positive rates and AL in the endoscope group and control group decreased significantly from baseline at 3 and 6 months. PD in the endoscope group was smaller than that in the control group at 3 months (P < 0.05). There was no significant difference between the two groups at 6 months (P >0.05). There was no significant difference in the BOP positive rate or AL change between the two groups at 3 months and 6 months (P > 0.05). For sites with PD > 6 mm, at baseline, the positive rates of PD, BOP and AL in the endoscope group were more serious than those in the control group, and the differences were statistically significant. The PD- and BOP-positive rates and AL in the endoscope group and control group decreased significantly from baseline at 3 and 6 months. However, PD in the endoscope group became shallower than that in the control group (P < 0.05) after 3 and 6 months. There was no significant difference in the BOP positive rate or AL between the two groups (P>0.05). @*Conclusion @#When compared to regular SRP, periodontal microscope-assisted SRP achieves better improvement in PD and is more beneficial for reducing the BOP and AL of deeper sites.
Résumé
Objective@#To investigate the changes and significance of human beta-defensin-2 (HBD-2) and LL-37 in the gingival crevicular fluid of patients with periodontitis and type 2 diabetes mellitus (T2DM).@*Methods@#This study was conducted among 45- to 85-year-old patients in the Department of Stomatology and Internal Medicine of Shenzhen Center for Chronic Disease Control, including a healthy control group of 22 people, a systemically healthy control group of 19 people with periodontitis, a T2DM periodontal health group of 15 people, and a T2DM group of 21 people with periodontitis. The Florida periodontal probe was used for periodontal examination, and the clinical indexes, including probing depth (PD), clinical attachment level (CAL) and probing on bleeding (BOP), were recorded. The concentrations of HBD-2 and Ll-37 in gingival crevicular fluid were determined by ELISA. The differences in HBD-2, LL-37 and periodontal clinical indexes between the groups were compared, and correlation analysis was conducted.@*Results@#The PD values in T2DM with the periodontitis group were higher than those of the systemically healthy controls with periodontitis group (P < 0.05); the levels of HBD-2 and LL-37 in gingival crevicular fluid in systemically healthy controls with periodontitis group were significantly higher than those in the healthy control group (P < 0.05), the level of HBD-2 in gingival crevicular fluid in systemically healthy controls with periodontitis group was significantly higher than that in T2DM with periodontitis group (P < 0.05); and the antimicrobial peptides HBD-2 and LL-37 in gingival crevicular fluid were significantly positively correlated with the PD and CAL in systemically healthy controls with periodontitis group (P < 0.05), and there was no significant correlation between the antimicrobial peptides HBD-2, LL-37 in gingival crevicular fluid and PD, CAL in T2DM with periodontitis group (P > 0.05).@*Conclusion@#The levels of antimicrobial peptides HBD-2 and LL-37 in gingival crevicular fluid of middle-aged and elderly patients with T2DM periodontitis were lower, and there was no significant correlation with PD and CAL in periodontal clinical indicators.
Résumé
Objective @#The purpose of this study was to investigate the relevant social and environmental factors affecting the occurrence of periodontal diseases during pregnancy in pregnant women and to analyze the influence of the periodontal status of women in the second trimester of pregnancy on small for gestational age (SGA) delivery.@*Methods@# A total of 215 pregnant women were enrolled in this study in the Department of Periodontology of the West China Hospital of Stomatology of Sichuan University from May 2015 to May 2018. Periodontal parameters, such as bleeding on probing (BOP), probing depth (PD) and clinical attachment loss (CAL), were recorded at 16-24 weeks of gestational age. Subjects were divided into the periodontitis (n=32) group, gingivitis (n=171) group and periodontally healthy (n=12) group according to their periodontal conditions. With the patient′s informed consent, the patient decided whether to receive periodontal treatment. Basic and socioeconomic information was collected through questionnaires. After delivery, subjects were divided into the SGA group and non-SGA group according to their birth results. The periodontal clinical indicators, questionnaire results and delivery results were compared among the groups.@*Results @#The mean PD (P=0.005, r=-0.192) and BOP% (P=0.003, r=-0.199) were negatively correlated with economic income. The family income in the periodontitis group was significantly lower than that in the healthy group and the gingivitis group (P < 0.05). The flossing use rate was significantly higher in the healthy group than that in the gingivitis group (P < 0.05). A total of 106 pregnant women received scaling and root planing, while 109 patients only received oral hygiene instruction. After delivery, SGA occurred in 23 cases (10.7%), and there were no significant difference in SGA incidence among the three groups (P > 0.05). PD ≥ 5 mm% and PD ≥ 4 mm% (P < 0.05) were significantly higher in the SGA group than in the non-SGA group. There was no significant difference in SGA incidence between the treated group and the untreated group (P > 0.05).@*Conclusion@#Family income and dental flossing use have an impact on the incidence of periodontal diseases during pregnancy. The severity of periodontitis in pregnant women is correlated with the incidence of SGA.
Résumé
BACKGROUND: Conventional implantation at anterior aesthetic region is difficult to achieve ideal three-dimensional position, and needs high implantation accuracy. OBJECTIVE: To evaluate the clinical application effect of three-dimensional printed digital guide technology in anterior dental implant. METHODS: Eighty-six cases of dental implants were divided into two groups. Control group (n=43, 52 implants) received conventional dental implantation. Trial group (n=43, 52 implants) received implantation under three-dimensional printed digital guides. The accuracy of the three-dimensional position of the implants was measured. The modified plaque index, modified bleeding index, probing depth and the satisfaction of patients with implant denture were measured at 6 months after implantation. RESULTS AND CONCLUSION: (1) The errors of vertical and horizontal directions at the top and the root after implantation in the trial group were significantly fewer than those in the control group (P < 0.05). (2) The modified plaque index, modified bleeding index, and probing depth in the trial group were significantly lower than those in the control group (P < 0.05). (3) The satisfaction of patients in the trial group was 98% (42/43), which was higher than 86% (37/43) in the control group. (4) In summary, three-dimensional printed digital guide plate used in dental implant dentures can improve the three-dimensional position accuracy after implantation and improve the postoperative clinical effect.
Résumé
Objective @#To investigate the effect of the clinical application of molar uprighting in the treatment of impacted mandibular second molars.@*Methods@# A total of 16 cases of impacted mandibular second molars were chosen, and the impacted molars were treated with straight wire appliances and molar uprighting. Before and after treatment, the vertical angle of the molar, the height of the distal buccal tip, the height of the distal buccal tip of the anchorage molar, the depth of the periodontal pocket and the height of the alveolar bone were measured. Moreover, the treatment cycles of the third molar extraction group, the premolar group and the nonextraction group were compared.@*Results @#All impacted molars responded well to treatment. The vertical time of impacted molars was (1.34 ± 0.45) months, (2.20 ± 0.57) months, and (2.30 ± 0.45) months in the third molar extraction group, the premolar extraction group and the nonextraction group, respectively. The treatment time of the third molar extraction group was shorter than that of the other two groups, and the difference was statistically significant (P < 0.05). After treatment, the inclination of impacted second molars increased by (25.94 ± 8.85)°, the elongated distal buccal tip was depressed by (1.00 ± 1.48) mm, the depth of the proximal and middle periodontal pocket of impacted molars decreased by (1.21 ± 1.03) mm, and the height of the alveolar bone of the proximal and middle adjacent surfaces of impacted second molars increased by (4.57 ± 1.45) mm; these differences were statistically significant (P < 0.05). There was no significant difference in the height of the distal buccal tip of the first molar before and after treatment (P > 0.05).@*Conclusion @#Molar uprighting is an efficient, reliable, and convenient method that can shorten the treatment period. Extraction of crowded third molars is beneficial for the vertical and periodontal health of impacted second molars.
Résumé
Objective@#To explore the application and effect of the PDCA cycle nursing management model in the treatment of peri-implant mucositis.@*Methods @#Thirty patients with peri-implant mucositis were treated nonsurgically. Before treatment, the 30 patients had no history of systemic diseases, drug allergies, or bad habits. According to the principle of single-blind randomized control, the patients were divided into two groups: 15 patients were assigned to the control group and received routine clinical nursing and oral hygiene education according to the doctor′s prescription; and 15 patients were assigned to the intervention group, in which the PDCA cycle nursing management model was adopted. The four steps of “plan, do, check and act” were carried out. The plaque index (PL), gingival index (GI) and probe depth (PD) in the two groups were recorded before treatment and 3 and 6 months after treatment.@*Results@# There was no significant difference in the PL, GI or PD between the intervention group and the control group before treatment (P > 0.05). Three months after treatment, the PL in the intervention group was 1.25 ± 0.44, while the PL in the control group was 1.49 ± 0.39, with a significant difference (t=2.56, P=0.008); the GI in the intervention group was 1.21 ± 0.43, while the GI in the control group was 1.56 ± 0.37, with significant difference (t=2.94, P=0.006); and the PD in the intervention group was 4.39 ± 0.41 while the PD in the control group was 4.47 ± 0.52 mm, with no significant difference (t=2.24, P=0.062). Six months after treatment, the PL in the intervention group was 1.26 ± 0.48, while the PL in the control group was 1.51 ± 0.42, with a significant difference (t=2.66, P=0.007); the GI in the intervention group was 1.34 ± 0.28, while the GI in the control group was 1.74 ± 0.48 (t=2.98, P=0.008); and the PD in the intervention group was 4.46 ± 0.52 mm, while the PD in the control group was 4.54 ± 0.66, with no significant difference (t=2.28, P=0.077).@*Conclusion @#The PDCA cycle nursing management model can enhance patients′ awareness of oral health maintenance, reduce gingival plaque accumulation, and effectively improve the health status of peri-implant tissues.
Résumé
Objective@#To investigate the clinical effect of a titanium-zirconium small-diameter implant in anterior teeth with bone deficiencies in the esthetic area and to provide a basis for clinical application of this implant. @* Methods @# A retrospective analysis was performed using clinical data from 30 patients with a missing alveolar ridge width < 5.5 mm and a titanium-zirconium 3.3 mm diameter implant prosthesis in the anterior esthetic region. A total of 38 titanium-zirconium implants with a diameter of 3.3 mm were implanted in 30 patients. Clinical examination and CBCT were performed 12 and 24 months after implantation to evaluate the success rate and marginal bone resorption of the 3.3 mm small-diameter titanium-zirconium implants. The modified plaque index, improved gingival sulcus bleeding index, exploration depth, pink esthetic score (PES) and prosthetic complications were measured and recorded.@*Results @#The 24-month success rate of the implant was 100%. The average marginal bone resorption height was 0.51 ± 0.20 mm at 12 months after implant placement and 0.59 ± 0.18 mm at 24 months. The edge bone height did not change significantly (t=1.381, P=0.178). No significant differences were found in the modified plaque index around the implant, modified sulcus bleeding index and probing depth between 12 and 24 months (P > 0.05), and the gingival health was good. The PES value was 9.77 ± 1.48 at 12 months and 10.77 ± 1.50 at 24 months (t=0.426, P=0.672). The PES was increased at 24 months versus 12 months, but this difference was not significant (P > 0.05). The overall esthetic effect was good, and no complications occurred after repair.@*Conclusion@# Titanium-zirconium small-diameter implants can achieve good short-term clinical results in the esthetic area of the anterior teeth.
Résumé
Objective@#To evaluate the clinical effect of a digital whole-process surgical guide for immediate implantation in the molar area. @*Methods @#Twenty-six patients with molar extraction plans were accepted for preoperative CBCT and model construction. Computer software was used to design the ideal three-dimensional position of the implant. The control group of 13 patients underwent immediate implantation with a free hand operation, whereas the experimental group of 13 patients underwent preparation and implant insertion under the guidance of a surgical guide. Bone grafting was performed, and a good initial stability was achieved. After 5 to 6 months, osseointegration was achieved, and the final restoration was delivered. After surgery, the accuracy of the three-dimensional position of the implants was measured, and at the 6 month return visit, the modified Plaque Index (mPLI), modified Sulcular Bleeding Index (mSBI) and probing depth (PD) were measured. @*Results @# In the control group and experimental group, the vertical errors at the top of the implants were 1.246 ± 0.072 mm and 0.628 ± 0.046 mm (t = 26.078, P < 0.001), respectively, and the horizontal errors were 1.563 ± 0.086 mm and 0.546 ± 0.056 mm (t = 35.813, P < 0.001), respectively; and the vertical errors at the root of the implants were 1.352 ± 0.042 mm and 0.532 ± 0.030 mm (t = 57.021, P < 0.001), respectively, and the horizontal errors were 1.645 ± 0.076 mm and 0.625 ± 0.072 mm (t = 35.086, P < 0.001), respectively. For the experimental group, the mPLI value was 0.923 ± 0.760, the mSBI value was 0.846 ± 0.689, and the PD value was 3.460 ± 0.713 mm, which were significantly lower than those of the control group. For the control group, the mPLI value was 1.769 ± 0.927 (t = 2.546, P = 0.018), the mSBI value was 1.692 ± 0.947 (t = 22.605, P = 0.016) and the PD value was (4.579 ± 0.475) mm (t = 4.709, P < 0.001). @*Conclusion@#A digital surgical guide plate can increase the precision of immediate implantation and the peri-implant health in the molar area.
Résumé
Objective; To analyze the clinical manifestion and treatment method of one patient with severe periodontitis complicated with oral lichen planus, and to clarify the effect of combined treatment method and the importance of regular follow-up. Methods; The clinical manifestion of the patient was that the bilateral moral teeth had become looseness and the gum had bled for six months, and the patients had a history of oral lichen planus in gum for 2 years old. The probing depth (PD) of all the teeth was 5-6 mm and the attachment loss (AL) was 8-9 mm, with II °-IE "mobility and bleeding on probing (BOP) (+). The teeth was treated with the regular basis periodontal treatment combined with gingival triamcinolone acetonide injection treatment. When the inflammation situation remained stable, the delayed implantation was performed and the crown restoration treatment was done for 26, 27, 36 and 37. The splinting treatment was done for 31 and 41 II mobile teeth. The regular follow-up periods were 1 week, 2 weeks, 1 month, 3 months, and 6 months after treatment during periodontal maintenance. Results; After combined treatment and regular follow-up, the PD of both anterior and premolar were 4 mm, and the BOP was negative. The clinical symptom of oral lichen planus of the patient was relieved, and there were no symptoms of congestion and erosion on the gum. After the inflammation situation was controlled, the chewing function of the left molar region was restored by implantation rehabilitation. A 3-month-follow-up cycle and excellent treatment compliance were beneficial for the control of disease. The optimal follow-up period of gingival condition maintained best was once per 2 weeks. Conclusion: The combined treatment can relieve the clinical symptoms of the patient with severe periodontitis complicated with oral lichen planus. Regular follow-up and excellent treatment compliance are conducive to controlling the condition of disease.
Résumé
Objective: To detect the peri-implant soft tissue with Florida probes, and to provide the clinical basis for choosing the appropriate clinical examination method, probing strength, and treatment of peri-implant soft tissue in the maintenance period. Methods: The common periodontal probes and Florida probes were used to examine the probing depth (PD) values in 62 patients who underwent implantation for more than 6 months for two times, and the contralateral teeth were natural teeth. The natural teeth and the implants were divided into inflammation group (n=32) and healthy group (n=30) according to whether the bleeding was probed. The coefficient of variation (CV) values of PD values of natural teeth and peri-implant soft tissues detected by two probes were compared. Results: There were no statistically significant differences in the PD values between natural teeth and implants of the patients measured by common periodontal probes in healthy and inflammation groups (P> 0. 05). There were no statistically significant differences in the PD values between natural teeth and implants of the patients measured by Florida probes in healthy and inflammation groups (P>0. 05). The CV value of PD value detected by Florida probes of the patients in healthy group was less than that detected by common periodontal probes (t=2. 489, P=0. 019); the CV value of PD value detected by Florida probes of the patients in inflammation group was less than that detected by common periodontal probe (t=2. 238, P = 0. 033). The CV value of PD value of implants of the patients in inflammation group was higher than that in healthy group (Z=3. 804, P0. 05). Conclusion: Both two probes have good reproducibility in probing the healthy and inflammatory sites of the natural teeth and implants. The Florida probes are more reproducible than the common periodontal probes in probing the healthy and inflammatory peri-implant soft tissues.
Résumé
Objective@#The aim of this study is to investigate the periodontal status of senior high school students in Dongcheng District, Beijing. @*Methods @#750 Beijing senior high school students were recruited in this study. The periodontal examination assessed the calculus, bleeding on probing, probing depth, and clinical attachment loss. The prevalences of gingivitis and periodontitis were assessed. @*Results @#A total of 73.5% of the subjects had gingivitis, the prevalences of gingivitis in male and female were 76.7% and 69.2% respectively. The prevalence of periodontitis was 10.9% in total, with 11.8% in male and 9.8% in female respectively.@*Conclusion @#The prevalence of gingivitis was high in senior high school students, and significantly higher in male. The prevalence of periodontitis was relatively low, and there was no difference in gender.
Résumé
Objective@#To explore the training pattern of periodontal probing practice so as to improve the accuracy of probing depth measurements of undergraduate students.@*Methods@#Sixty-two undergraduate dental students in their pre-clinical training course were divided into two groups (31 students in each group): the reform group and the control group. The students in reform group learned and practiced periodontal probing by using transparent gingiva models for 30 minutes, and using conventional periodontal probing models for further 90 minutes in two sessions. The total practicing time was 2 hours. The students in control group learned and practiced periodontal probing using conventional periodontal probing models only for 1 hour of practicing time. After the training, new conventional periodontal probing models were used to evaluate the accuracy of probing depth measurements of the students in the two groups. The probing depths of Ramfjord index teeth were recorded by the students and were compared with the results of an experienced teacher's measurements.@*Results@#The percentage of absolutely consistent sites in the reform group (63.4% [708/1 116]) was significantly higher than that of the control group (60.0% [670/1 116]) (P=0.012). In both reform group and control group, the percentages of absolutely consistent sites of the incisors (reform group: 69.1% [257/372], control group: 65.9% [245/372]) were significantly higher than those of the molars (reform group 58.9% [219/372], control group 54.3% [202/372])(P< 0.01), meanwhile, the percentages of absolutely consistent sites of the buccal-lingual sites (reform group: 88.7% [330/372], control group: 80.4% [299/372]) were significantly higher than those of the interproximal sites (reform group: 50.8% [378/744], control group: 49.9% [371/744])(P<0.01).@*Conclusions@#The comprehensive reform of periodontal probing training could improve the accuracy of probing depth measurement of the undergraduate students. During the pre-clinical practice, probing training in the molar areas and the interproximal sites should be reinforced.
Résumé
Se evaluó la eficacia de la terapia fotodinámica como complemento de terapia periodontal convencional comparándola con la terapia convencional en el tratamiento de sacos periodontales en pacientes adultos con periodontitis crónica basándose en ensayos clínicos comprendidos entre los años 2010 y 2015, para determinar si su uso otorga mejores resultados para el tratamiento de esta enfermedad. Se seleccionaron ensayos clínicos aleatorios prospectivos, aleatorizados o no aleatorizados, controlados y no controlados que permitieron la comparación entre el tratamiento convencional y la terapia fotodinámica, con un grupo en el cual se utilizó sólo la terapia convencional. Los datos de los ensayos clínicos fueron ingresados al software Review Manager®. Se realizaron tres metaanálisis para las variables: Nivel de inserción clínica (NIC) y profundidad de sondaje (PS), el test de I2 fue utilizado para medir la heterogeneidad del estudio y posteriormente un análisis de sensibilidad para determinar los estudios heterogéneos. Se pudieron analizar 7 estudios, con un total de 186 pacientes, quienes fueron controlados 3 meses post tratamiento. Se utilizó la diferencia de medias, un intervalo de confianza de 95 % para medir el NIC y PS. A los 3 meses, no se encontró diferencias significativas en NIC (p= 0,93) y PS (p= 0,71). Conclusión: La terapia fotodinámica en complementación a la terapia convencional no otorga mejor resultado clínico ni estadístico comparado con la terapia convencional al evaluar el nivel de inserción clínica. Al evaluar la profundidad de sondaje es recomendable la utilización de terapia convencional sola.
The efficacy of photodynamic therapy as an adjunct to conventional periodontal therapy evaluated by comparing with conventional therapy alone in the treatment of periodontal pockets in adult patients with chronic periodontitis based on clinical trials between 2010 and 2015, to determine if its use can provide better results for treating this disease. Prospective randomized clinical trials and randomized clinical trials or non-randomized, controlled and uncontrolled that allowed comparison between a group which was applied to conventional therapy and photodynamic therapy, a similar group was selected to which you He applied only conventional therapy. Data from clinical trials entered into Review Manager®. Three meta-analyzes for the variables analyzed were performed: Level clinical attachment (NIC) and probing depth (PS), the test of I2 was used to measure the heterogeneity of the study and then a sensitivity analysis to determine which studies awardedheterogeneity. As results, seven studies analyzed in 186 patients who underwent treatment at least controlled within 3 months post treatment. The mean difference was used, a confidence interval of 95 % to measure the NIC and PS. At 3 months, no significant differences in NIC (p= 0.93) and PS (p= 0.71). In conclusion, the photodynamic therapy complementary to conventional therapy does not provide better clinical or statistical results compared with conventional therapy to evaluate the clinical attachment level. In assessing probing depth, is advisable to use conventional therapy alone.
Sujets)
Humains , Adulte , Photothérapie dynamique , Parodontite chronique/traitement médicamenteux , Thérapies complémentaires , Parodontite chronique/diagnosticRésumé
The aim of this paper is to compare nonsurgical and surgical treatment for periodontitis by longitudinal trials. Treatment of periodontits can be broadly classified into either surgical or non-surgical approaches. Non-surgical therapy includes plaque control, supra- and subgingival scaling, root planing (SRP), and the adjunctive use of chemotherapeutic agents. Surgical therapy can be divided into either resective or regenerative procedures. The majority of articles reviewed agree that when adequate access for root debridement is achieved, non-surgical treatment of chronic periodontal diseases seems to be as effective as surgical treatment in the long-term maintenance of clinical attachment levels (CAL). SRP is limited by the presence of furcation involvements, deep pocket depths, and root anatomy. Conclusion: Decision-making in periodontal therapy requires a thorough understanding of the long-term outcomes of all available treatment modalities. Studies have consistently shown that SRP can provide similar improvements of clinical attachment levels when compared to surgical treatment. However, several factors need to be considered when deciding on which treatment approach to select for the treatment of chronic periodontal disease