Fig 32 - uploaded by Tidu Mankoo
Content may be subject to copyright.
Source publication
The esthetic rehabilitation of advanced periodontal cases remains a challenge, despite the numerous advances in treatment of periodontitis and regenerative therapies. Whilst understanding of periodontal diseases deepens with advances in cell biology, cell signaling, and genomic research, the restoration of the gingival tissues to anatomical norms r...
Similar publications
Advances in adhesive technology and esthetic dental materials have permitted clinicians to perform conservative preparation of the dentition for onlay restorations. Indirect resin onlays are a great alternative to dental crowns for reestablishment the function and esthetic in teeth with great destruction.
Key messages
Indirect resin onlay is econo...
The improvements in tooth-coloured filling materials generated more direct conservative techniques, making possible the achievement of optimal functional and aesthetic outcomes, in anterior and posterior teeth. Erosive acid-induced lesions of enamel or dentin often need restorative procedures. Nowadays, mostly aesthetic direct restoratives, which a...
Background:
The width ratio of teeth is an important factor in dental and facial esthetics. The Golden proportion (62%) and the recurring esthetic dental proportion (RED) are two theories in this field that have been suggested to create harmony among anterior teeth. These have rarely been studied among the Iranian population.
Objectives:
The aim o...
With immediate implant placement and provisionalization (IIP) in the esthetic zone, measures to counter hard and soft tissue loss are frequently necessary. To reduce the morbidity associated with bone and connective tissue procurement, various exogenous materials are utilized. The “Dermal Apron Technique” presented in this article demonstrates the...
Citations
... Among them, 56 patients were treated with PTR as a regular group, while the rest 62 were treated with PTR combined with orthodontic treatment as a joint group. All enrolled patients met the diagnostic criteria of periodontitis [10]. Exclusion criteria: Patients who had undergone periodontal therapy in the last 3 months; patients with other comorbid oral diseases or severe organ dysfunction; patients with severe auto-immune diseases, patients who had taken antibiotics recently; and those in pregnancy or menstrual period. ...
Objective:
To determine the efficacy of periodontal tissue regeneration (PTR) combined with orthodontic treatment in patients with periodontitis.
Methods:
A total of 118 patients with periodontitis admitted to our hospital between March 2017 and May 2019 were enrolled. Among them, 56 patients were treated with PTR as a regular group, while the rest 62 were treated with PTR combined with orthodontic treatment as a joint group. The two groups were compared in efficacy, total treatment time, recovery time for periodontal function, periodontal function-associated indexes before and after treatment, pain, serum inflammatory factors, adverse reactions, and treatment satisfaction.
Results:
The joint group showed significantly higher effective treatment rate (P<0.05), and experienced significantly shorter total treatment time and recovery time for periodontal function than the regular group (both P<0.05). Before treatment, there was no meaningful difference between the two groups in plaque index (PLI), periodontal pocket probing depth (PD), sulcus bleeding index (SBI), attachment loss (AL), visual analog scale (VAS) score, and serum IL-6, IL-1β and TNF-α levels, while after treatment, these indexes of both groups improved (all P<0.05), and the improvement in the joint group was more notable (P<0.05). Additionally, there were no significant difference between the two groups in the incidence of adverse reactions (P>0.05), and the joint group expressed significantly higher treatment satisfaction (P<0.05).
Conclusion:
With a high safety, PTR combined with orthodontic treatment can effectively alleviate the clinical symptoms of patients and promote the recovery of their periodontal function, and is more acceptable, so it is worthy of clinical promotion.
... Therefore, in order to obtain satisfactory results, it is essential the presence of adequate alveolar bone at the implant site, because the gingival contour follows the alignment of the alveolar bone crest [5,[10][11][12]. There are also many studies that recommend orthodontic extrusion as a viable treatment solution which results in significant increase of alveolar bone and soft tissue prior to dental implant placement [2][3][4][12][13][14]. Therefore, the aim of the present study is to report two cases in which the orthodontic extrusion was performed in anterior teeth in order to rehabilitate patients by the placement of dental implants. ...
... Orthodontic extrusion is a method by which bone defects can be eliminated or altered, yielding encouraging outcomes [12,14,16]. Introduced by Heithersay [17] in 1973, it was also later used by Ingber [18] and Pontoriero et al. [19]. ...
The aim of this study was to report two cases of orthodontic extrusion performed prior to dental implant placement. The first one reports the case of a 57 year-old-female who presented internal root resorption in the left central incisor, and orthodontic extrusion of this element was indicated. The treatment lasted 24 weeks. At the end of this period, the dental implant was placed. The second clinical event refers to a patient of 66 years of age who had vertical fracture in the left central incisor. In this case, the orthodontic extrusion was conducted in 12 weeks. At the end of this period, the dental implant was placed and also the temporary crown, but without occlusal contact. Both cases reported consisted of the involvement of the left central incisor in the aesthetic area and low bone density. The cases reported demonstrated that orthodontic extrusion is a viable alternative to the aesthetic and functional reconstruction with prosthesis over dental implants.
... Although the aesthetic needs of patients have increased, aesthetic defects due to periodontitis are inevitable. Many case reports of the treatment of aesthetic defects using forced eruption have been reported [21,22]. The resorbed alveolar bone causes compression of the periodontal membrane, and new bone is deposited whenever there is stretching force acting upon the alveolar bone [23]. ...
The aim of this clinical trial was to explore the impact of intentional passive eruption (IPE) using occlusal reduction on the periodontal parameters of teeth with moderate chronic periodontitis and traumatic occlusion.
This study was performed on 40 teeth from 16 subjects. At baseline, 4 weeks after initial periodontal treatment, and 6 months after IPE, clinical and radiographic examinations were performed. The 20 teeth in the test group underwent IPE using occlusal reduction, whereas the 20 control teeth did not undergone occlusal reduction.
All the periodontal parameters were improved by the initial periodontal treatment. The teeth in the test group showed a significantly greater decrease in pocket depth, tooth mobility, and marginal bone loss than did the control group (P<0.05), but there were no significant changes in the attachment level. Significantly greater improvements in all the parameters were observed in the test group after 6 months of IPE compared to 4 weeks after the initial periodontal treatment (P<0.05).
Within the limits of this study, performing initial periodontal therapy combined with IPE using occlusal reduction was shown to be very simple and effective. Moreover, IPE would be helpful in improving periodontal parameters.
... Currently, these new (digital) technologies must still prove themselves, 24 compared with conventional techniques, and there are still considerable doubts regarding the feasibility of using digital technology to work completely cast-free such as in chairside applications. 25,26 There is still a strong notion that casts are needed to allow the use of different types of reconstruction materials and achieve the expected quality. However, there is a significant belief that further development in digital technologies will bring equal and far more superior quality achievements. ...
... The management of these cases involves establishing the etiology and goals of treatment in each particular case. [8][9][10][11][12][13][14][15][16][23][24][25][26][27] The severity of the case will clearly influence the extent of treatment required, and while there are some cases that may be suitable for simple monitoring and prevention methods, for the sake of this essay we have focused on more advanced cases where restorative treatment was required. Hence, we established the restorative goals and appropriate treatment options available and indicated (Table 1). ...
... In cases where it is not feasible or rational to maintain the teeth, orthodontic extrusion can also improve the bone and soft tissue volume and architecture prior to tooth extraction and rehabilitation with implant-supported restorations. [19][20][21][22][23][24][25][26][27][28] In the lead author's experience, orthodontic extrusion is rarely useful for single-tooth sites where extraction and implant placement are necessary if the interproximal bone levels are normal on the adjacent teeth because, in these circumstances, single-tooth sites can generally be managed effectively either by periodontal regeneration to maintain the tooth, if possible, or by well-established implant and bone/tissue regeneration procedures. However, in multiple-tooth situations where there is horizontal bone loss affecting adjacent teeth, orthodontic extrusion can be valuable to increase the vertical height and the volume of bone and soft tissue prior to extraction of the teeth and immediate implant placement. ...
Aim
To assess the beneficial and adverse effects of periodontal-orthodontic treatment of teeth with pathological tooth flaring, drifting and elongation in patients with severe periodontitis on the dental and periodontal tissues.
Materials and methods
Nine databases were searched in April 2020 for randomized/non-randomized clinical studies. After duplicate study selection, data extraction, and risk-of-bias assessment, random effects meta-analyses of mean differences (MDs) and their 95% confidence intervals (CIs) were performed, followed by subgroup/meta-regression analyses.
Results
A total of 30 randomized and non-randomized clinical studies including 914 patients (29.7% male; mean age 43.4 years) were identified. Orthodontic treatment of pathologically migrated teeth was associated with clinical attachment gain (-0.24 mm; 7 studies), pocket probing depth reduction (-0.23 mm; 7 studies), marginal bone gain (-0.36 mm; 7 studies), and papilla height gain (-1.42 mm; 2 studies), without considerable adverse effects, while patient sex, gingival phenotype, baseline disease severity, interval between periodontal-orthodontic treatment, and orthodontic treatment duration affected the results. Greater marginal bone level gains were seen by additional circumferential fiberotomy (2 studies; MD=-0.98 mm; 95% CI=-1.87 to -0.10 mm; P=0.03), but the quality of evidence was low.
Conclusions
Limited evidence of of poor quality indicates that orthodontic treatment might be associated with small improvements of periodontal parameters that don’t seem to affect long-term prognosis, but more research is needed.
Objective:
This systematic review aims to define the recommendations allowing an optimized clinical implementation for orthodontic extraction as a pre-implant soft tissue management procedure.
Materials and methods:
A digital search was performed in the Cochrane Library, PubMed, Scopus, and DOSS databases; a pre-screening was conducted according to the title and summary of the articles. After a complete reading, only the articles meeting all of our inclusion criteria were selected, and a second search, this time manual, was performed within their references. The selected articles were then analysed according to twelve parameters.
Results:
Thirty-nine articles were included. Despite low statistical evidence in the available literature, some principal guidelines, which seem generally accepted by the scientific community, could be highlighted based on this analysis. However, no ideal clinical protocol could be established.
Conclusions:
Orthodontic extraction is an efficient procedure for pre-implant soft tissue management, however, further studies are needed to establish full clinical recommendations and optimize its clinical implementation.
The technique of immediate implantation has been widely used to reduce treatment time and bone loss after extraction. However, immediate implant placement in infected extraction sockets is generally contraindicated. This clinical report describes a treatment protocol for immediate implantation after the extraction of teeth with generalized chronic periodontitis. The technique used for the oral rehabilitation used computer-assisted design and computer-assisted manufacturing (CAD-CAM) titanium frameworks and cemented zirconia crowns. The titanium frameworks overcame suboptimal implant position and the cemented crowns provided excellent function and esthetics despite the locations of screw-access openings. No clinical complications occurred during a 13-month follow-up.
The relationship between occlusion and periodontal health has been studied extensively. Despite this, there are few reports on the effects of intentional passive eruption (IPE) using an occlusal reduction. The aim of this clinical report was to present the favorable long-term results of IPE using an occlusal reduction combined with scaling and root planing. After periodontal examination, teeth were diagnosed as moderate chronic periodontitis with intrabony defects and mobility. IPE was performed using periodic occlusal reduction combined with initial periodontal therapy. All teeth examined healed uneventfully and the patients did not complain of discomfort. It has been clinically well maintained during 8 years after completion of IPE. Overall, these results suggest that the IPE would be helpful in improving periodontal health.
