Repair of a Gingival Fenestration Using an Acellular Dermal Matrix Allograft.

A case report illustrating the successful treatment of a gingival fenestration with an acellular dermal matrix (ADM) allograft. After 2½ months of healing, the ADM was completely integrated into the soft tissues of the mandibular anterior gingiva with complete resolution of the gingival fenestration, resulting in excellent gingival esthetics.

The subepithelial connective tissue graft: part II. Histologic healing and clinical root coverage.

Periodontal plastic surgical techniques have evolved to meet the demands of today's dental patient. Free gingival grafts (FGGs), pedicle flaps, subepithelial connective tissue grafts (SCTGs), acellular dermal matrix (ADM) grafts, and guided tissue regeneration (GTR) have all been used to cover denuded root surfaces. FGGs have demonstrated inconsistent results. Pedicle flaps have provided consistent results, but adequate tissue must be present initially. ADM grafts have also demonstrated success, but long-term stability may be a problem. Presently, SCTGs and GTR should be considered the treatment of choice for root coverage. They are the most predictable with average root coverage as high as 98.9% and 92.3%, respectively.

An innovative tobacco use cessation program for military dental clinics.

Tobacco use is the chief avoidable cause of death and illness in our society. Military leaders are concerned with rising medical costs and the related negative effects on combat readiness associated with tobacco use. Tobacco use cessation (TUC) programs available in the military services have not reached their full potential. Dental officers have an opportunity to assume a more active role as first-line providers in TUC programs. This paper presents a model TUC program for use in military dental clinics. It emphasizes the dentist's role in directly prescribing pharmacologic agents in nicotine replacement therapy (NRT) combined with appropriate patient counseling. Other key elements of this TUC program include the non-threatening manner in which patients are offered access to TUC, its convenience when compared with other programs, and the minimal cost to implement this program.

The subepithelial connective tissue graft: part I. Patient selection and surgical techniques.

Periodontal mucogingival techniques continually evolve. This provides the patient more treatment alternatives for common problems such as gingival recession. General practitioners should be familiar with these techniques in order to identify patients who might benefit from them. Currently, subepithelial connective tissue grafts (SCTG) remain the most reliable techniques used to cover denuded root surfaces. This paper reviews patient selection and the numerous surgical approaches for subepithelial connective tissue grafting.

Fixed prosthetics with a connective tissue and alloplastic bone graft ridge augmentation: a case report.

Augmentation of the partially edentulous ridge can significantly improve the final prosthodontic rehabilitation. For enhancing soft tissue contours in the anterior region, the subepithelial connective tissue graft is the treatment of choice. The combination of connective tissue grafts with alloplastic bone graft material can optimize the ridge augmentation and reduce post extraction defects. The aim of this clinical report is to describe the use of subepithelial connective tissue in conjunction with an alloplastic bone graft for augmentation of a maxillary anterior ridge prior to prosthetic rehabilitation.

Local chemotherapeutics as an adjunct to scaling and root planing.

Gingival diseases are the most widely held diseases in America. In some patients, periodontal disease appears in a generalized form, but more often it appears in localized areas. Furthermore, after treatment with scaling and root planing (SRP) in generalized cases, the disease is often reduced to a few local areas in the patient's mouth. Since periodontitis is a bacterial infection with known pathogenic microorganisms, the local delivery of antimicrobials has been considered to be a possible solution for treating and controlling localized forms of periodontal disease. Three current local chemotherapeutic agents are reviewed in this paper: doxycycline gel, chlorhexidine chip and minocycline microspheres. With the advancement of local drug delivery systems, clinicians and their patients have new alternatives for treatment of periodontal disease.

The application of Periodontal Screening and Recording (PSR) in a military population.

Periodontal Screening and Recording trade mark (PSR) is a diagnostic screening tool for the early detection of periodontal disease. The purposes of this study are to utilize PSR to estimate the periodontal health status of a representative military population and to compare the results with other studies of varying populations. When used to evaluate the periodontal health of a randomly-selected military population, PSR demonstrated the following: (1) males and females had a similar prevalence of being designated PSR+ (having PSR Code 3 score in two or more sextants or a PSR Code 4 score in at least one sextant), (2) Blacks and Hispanics had a similar prevalence of PSR+, and (3) both groups were twice as likely to be PSR+ as were Caucasians. Although income did not appear to be a significant predictor of PSR+, PSR+ did appear to be inversely proportional to education levels. When comparing PSR scores by sextant, the following was noted: (1) the maxillary central sextant was the most disease-free, (2) the mandibular central sextant most often presented with calculus, (3) mucogingival defects were observed more frequently in maxillary posterior sextants, and (4) the maxillary right sextant demonstrated the most destruction from periodontal disease.

Ailing and failing endosseous dental implants: a literature review.

Although the overall success rate of implant dentistry is very high, dental implants occasionally fail. It is essential for the clinician to recognize unhealthy implants and to determine whether they are ailing, failing, or failed prior to beginning any salvage efforts. Ailing and failing implants are amenable to therapy. Implants diagnosed as failed should be removed. This review provides the reader with information on non-surgical and surgical therapies available for managing ailing and failing implants. Undoubtedly, the best steps to avoid encountering ailing or failing implants involve proper case selection, excellent surgical technique, placing an adequate restoration on the implant, educating the implant patient to maintain meticulous oral hygiene, and evaluating the implant both clinically and radiographically at frequent recall visits.