Oral contraceptive pill induced periodontal endocrinopathies and its management: A case report

ABSTRACTThe purpose of this article is to report a case of unusual oral contraceptive induced periodontal endocrinopathies and its treatment approach. A 32-year-old female patient, having fair oral hygiene, presented with painless, soft, diffuse gingival enlargement on severely compromised periodontium (≥ 4 mm generalized alveolar bone loss and attachment loss). The patient had on oral contraceptive over five years that was discontinued six months ago. When the lesion was not reversed following withdrawal of the pill or by repeated non-surgical measures, biopsy was performed to establish the diagnosis that revealed microscopic findings similar to that seen in gingival enlargement in pregnancy. Pocket depth, tooth mobility and gingival enlargement were reduced remarkably following periodontal surgery. After surgical intervention, close follow-up for over three years revealed no evidence of recurrence of gingival enlargement and progressive attachment loss. We conclude that periodontal surgery, patient compliance and comprehensive maintenance care are effective to return healthy periodontal status in such conditions. (Eur J Dent 2012;6:324-329)

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AUTOTRANSPLANTASI GIGI-GIGI IMPAKSI INSISIVUS MAKSILA KANAN DISERTAI KISTA DENTIGEROUS DENGAN PENAMBAHAN GRAFT KOLAGEN KARBONAT APATIT

ODONTO Dental Journal ◽

10.30659/odj.5.1.9-17 ◽

2018 ◽

Vol 5 (1) ◽

pp. 9

Author(s):

Indah Wulansari ◽

Maria Goreti Widiastuti ◽

Prihartiningsih Prihartiningsih

Keyword(s):

Alveolar Bone ◽

Dentigerous Cyst ◽

Apical Part ◽

Maxillary Incisor ◽

Carbonate Apatite ◽

Horizontal Position ◽

Surgery Patient ◽

Dentigerous Cysts ◽

Collagen Graft

Background: Autotransplantation is a surgical movement to reposition teeththat have been erupted, partially erupted or not yet erupted from one place to another in the same individual, either on post-extraction sockets or artifcial sockets made by surgery. Dental folicle from impacted teeth may develope dentigerous cysts that will result in destruction of the jaw bone. There are many factors that inﬂuence the success of autotransplantation, one of which is adequate bone support.The purpose of this poster is to present the successful autotransplantation treatment of impacted right maxillary incisor teeth associated with dentigerous cyst and bone support replacement after cyst enucleation using a carbonate apatite collagen graft, GAMACHA®, at RSUP Dr. Sardjito.Case management: A 9-year-old girl, referred to the Oral and MaxillofacialSurgery Department of RSUP Dr. Sardjito with the complaint of right deciduous maxillary incisor persistence. Radiological examination showing persistent of 51 and 52 radices and impaction of teeth 11 and 12 in a horizontal position above radix 53. Also visible radiolucent image with a frm limit around the crown of 11 that supports the image of cyst. This patient performed cyst enucleation under general anesthesia, removal of impacted 11 and 21, followed by an artifcial socket drilling at the alveolar bone that could support all aspects of the root wall although only on the apical part of the tooth root for teeth 11 and 12 placement. Autotransplantation of teeth11 and 12 followed by the application of GAMACHA® and wire fxation, strengthen with acrylic splint.Conclusion: Two years follow up after surgery, patient have no complaintseither from aesthetic or functional and the result of clinical and radiologicalexamination did not found existence of any pathological abnormalities around teeth 11 and 12.

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Periodontal Therapy in Dogs Using Bone Augmentation Products Marketed for Veterinary Use

Journal of the American Animal Hospital Association ◽

10.5326/jaaha-ms-6421 ◽

2017 ◽

Vol 53 (3) ◽

pp. 172-179

Author(s):

Molly Angel

Keyword(s):

Bone Loss ◽

Periodontal Disease ◽

Periodontal Ligament ◽

Bone Repair ◽

Alveolar Bone ◽

Clinical Symptoms ◽

Oral Examination ◽

Bone Augmentation ◽

Attachment Loss

ABSTRACT Periodontal disease is extremely common in companion animal practice. Patients presenting for a routine oral examination and prophylaxis may be found to have extensive periodontal disease and attachment loss. Vertical bone loss is a known sequela to periodontal disease and commonly involves the distal root of the mandibular first molar. This case report outlines two dogs presenting for oral examination and prophylaxis with general anesthesia. Both patients did not have any clinical symptoms of periodontal disease other than halitosis. Both patients were diagnosed with three-walled vertical bone loss defects of one or both mandibular first molars utilizing dental radiography as well as periodontal probing, measuring, and direct visual inspection. These defects were consistent with periodontal disease index stage 4 (>50% attachment loss). The lesions were treated with appropriate root planing and debridement. Bone augmentation products readily available and marketed for veterinary use were then utilized to fill the defects to promote both the re-establishment of normal alveolar bone height and periodontal ligament reattachment to the treated surface. Follow-up assessment and owner dedication is critical to treatment outcome. Both patients' 6 mo follow-up examinations radiographically indicated bone repair and replacement with visible periodontal ligament space.

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Recurrent Chest Pain, as a Presenting Sign of Ovarian Endometrioma

ISRN Surgery ◽

10.5402/2011/837501 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4

Author(s):

Mehmet Yildirim ◽

Ozgur Oztekin ◽

Deniz Oztekin

Keyword(s):

Oral Contraceptive ◽

Chest Pain ◽

Medical Treatment ◽

Combined Oral Contraceptive ◽

Surgery Patient ◽

Ovarian Endometrioma

Chest pain is a rare sign of thoracal endometriosis associated with endometrioma of the tubo-ovarian endometrioma. We report the case periodic episodes of chest pain concurrent with menstruation in a 35-year-old female, in which ovarian endometrioma was diagnosed and left-sided oophorectomy was performed. After surgery, patient underwent medical treatment which included a Gn-RH agonist and a combined oral contraceptive. In the follow-up period, there was no evidence of chest pain.

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USE OF THE NOVABONE® AUGMENTATION MATERIAL IN THE TREATMENT OF CHRONIC PERIODONTITIS. PRELIMINARY COMMUNICATION

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2014.11 ◽

2013 ◽

Vol 56 (4) ◽

pp. 157-161

Author(s):

Radovan Slezák ◽

Vladimíra Paulusová

Keyword(s):

Chronic Periodontitis ◽

Alveolar Bone ◽

Gingival Recession ◽

Clinical Results ◽

Clinical Parameters ◽

Periodontal Surgery ◽

Pocket Depth ◽

Posterior Teeth ◽

Before And After ◽

New Generation

The pilot study deals with the clinical results of the regenerative therapeutical method in intraosseous periodontal defects done by surgical augmentation procedure using a material of a new generation prepared on the basis of a bioactive glass. A group of 10 individuals were treated properly for chronic periodontitis. Some of treated infraalveolar periodontal lesions, both periodontal pockets and interradicular defects, persisted or recurred in posterior teeth. In order to eliminate them they were indicated for advanced periodontal surgery or regenerative surgical therapy stimulating healing processes of supportive tissues, mostly alveolar bone around treated teeth. Relevant clinical parameters, i. e. values of the pocket depth, gingival recession, and loss of attachment were evaluated before and after the periodontal surgery and compared with each other. The therapy led to significant improvement of clinical parameters in terms of the reduction of pocket depth and loss of attachment values.

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Dental Investigations: Efficiency of Nonsurgical Periodontal Therapy in Moderate Chronic Periodontitis

Folia Medica ◽

10.2478/folmed-2014-0016 ◽

2014 ◽

Vol 56 (2) ◽

pp. 109-115 ◽

Cited By ~ 6

Author(s):

Antoaneta M. Mlachkova ◽

Christina L. Popova

Keyword(s):

Chronic Periodontitis ◽

Alveolar Bone ◽

Incidence Rates ◽

Periodontal Therapy ◽

Pocket Depth ◽

Attachment Loss ◽

Dental Biofilm ◽

Nonsurgical Periodontal Therapy ◽

Root Planning ◽

Scaling And Root Planning

Abstract INTRODUCTION: Chronic periodontitis is defined as an inflammatory disease of the supporting tissues of teeth caused by microorganisms in the dental biofilm, resulting in progressive destruction of the periodontal ligament and alveolar bone with pocket formation and gingival recession. Treatment of chronic periodontitis aims at arresting the inflammation and stopping the loss of attachment by removal and control of the supra- and subgingival biofilm and establishing a local environment and microflora compatible with periodontal health. The AIM of this study was to evaluate the effectiveness of non-surgical therapy (scaling and root planning) in the treatment of moderate chronic periodontitis. MATERIALS AND METHODS: The study included 30 patients aged between 33 and 75 years, of which 46.7% women and 53.3% men, diagnosed with moderate and, at some sites, severe periodontitis. They were treated with non-surgical periodontal therapy methods (scaling and root planning and curettage if indicated). Additionally, chemical plaque control with rinse water containing chlorhexidine was applied. The diagnostic and reassessment procedures included measuring the periodontal indices of 601 periodontal units before and after the therapy. The indices measured were the papillary bleeding index (PBI), the hygiene index (HI), the probing pocket depth (PPD) and the clinical attachment level (CAL). RESULTS: Significant reduction of plaque and gingival inflammation was found in all treated patients; we also found a statistically significant reduction of periodontal pockets with clinically measured depth ⋋ 5 mm (PD ⋋ 5 mm). Pockets with PD > 5 mm did not show statistically significant lower incidence rates probably due to the initially small percentage of deep pockets in the patients studied. There was a statistically significant reduction of all sites with attachment loss, the highest significance found at sites where the attachment loss was greater than 5 mm. CONCLUSION: The results of the study suggest that nonsurgical periodontal therapy is effective in managing the moderate chronic periodontitis. Given a good patient compliance, the antimicrobial periodontal therapy can be quite efficient in arresting the inflammatory process and reducing the depth of periodontal pockets; it can also achieve a stable attachment loss level and obviate the need to use a surgical periodontal treatment modality.

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Effect of locally delivered adjunctive antibiotics during surgical periodontal therapy: a systematic review and meta-analysis

Clinical Oral Investigations ◽

10.1007/s00784-021-04056-7 ◽

2021 ◽

Author(s):

Sarah Yusri ◽

Ahmed Elfana ◽

Weam Elbattawy ◽

Karim M Fawzy El-Sayed

Keyword(s):

Randomized Clinical Trials ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Periodontal Therapy ◽

Current Evidence ◽

Periodontal Surgery ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Reported Data

Abstract Aim The present study aimed to systematically assess current evidence on effects of locally delivered antibiotics during periodontal surgery compared to periodontal surgery alone on clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction, recession depth (RD) changes, gingival index (GI), bleeding on probing (BOP), and plaque index (PI). Methodology MEDLINE-PubMed, Cochrane-CENTRAL and Scopus databases were searched up to April 2021 for randomized clinical trials (RCT), evaluating effects of locally delivered antibiotics during periodontal surgery. CAL gain served as primary, while PPD reduction, RD changes, GI and PI as secondary outcomes. The Cochrane Risk of Bias Tool was used to assess possible bias. Data were extracted, and meta-analysis was performed where appropriate. Result Screening of 2314 papers resulted in nine eligible studies. No adverse events were reported. Data on outcome variables were pooled and analyzed using generic inverse variance model and presented as weighted mean difference (WMD) and 95% confidence interval (95% CI). Statistically significant improvements in favor of antibiotics’ delivery were observed in studies with follow-up of ≤6 months for CAL gain (WMD = 0.61 mm (95% CI [0.07, 1.14]; p = 0.03), PPD reduction (WMD = 0.41 mm (95% CI [0.02, 0.80]; p = 0.04)) and BOP (WMD = −28.47% (95% CI [−33.00, −23.94]); p < 0.001), while for GI improvements were notable for >6 to 12 months (WMD = −0.27 (95% CI [−0.49, −0.06]; p = 0.01)). Conclusion Within the current review’s limitations, locally delivered antibiotics during surgical periodontal therapy results in post-surgical improvements for CAL, PPD, and BOP (≤6 months) with a longer-lasting GI improvement. Further randomized controlled trials are needed with true periodontal end-points to assess the ideal antibiotic agent, dosage, and delivery methods. Clinical relevance Local delivery of antibiotics during periodontal surgery improved clinical parameters for up to 6-month follow-up, with beneficial longer effects on gingival inflammation. Within the current study’s limitation, the presented evidence could support the elective usage of locally delivered antibiotics during surgical periodontal therapy.

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A Prospective Study of Adolescents Who Choose Among Levonorgestrel Implant (Norplant), Medroxyprogesterone Acetate (Depo-Provera), or the Combined Oral Contraceptive Pill as Contraception

PEDIATRICS ◽

10.1542/peds.94.5.687 ◽

1994 ◽

Vol 94 (5) ◽

pp. 687-694

Author(s):

Barbara A. Cromer ◽

R. David Smith ◽

Jennifer Dwyer ◽

Jamie McArdle Blair ◽

Robert T. Brown

Keyword(s):

Oral Contraceptive ◽

Birth Control ◽

Medroxyprogesterone Acetate ◽

Insertion Site ◽

Oral Contraceptive Pill ◽

Contraceptive Pill ◽

Sexually Transmitted ◽

Combined Oral Contraceptive ◽

Depo Provera

Objectives. Levonorgestrel implants (Norplant) and medroxyprogesterone acetate injections (Depo-Provera) represent additional contraception options for adolescents. The purpose of this study was to examine prospectively clinical profiles among adolescents who chose one of the two long-term contraceptives compared with profiles among those who chose the combined oral contraceptive pill (OCP). Methods. Girls who needed contraception and did not require confidentiality were presented with a contraceptive menu consisting of Norplant (n = 58), Depo-Provera (n = 66), or OCP (n = 75). At baseline and follow-up visits over 6 months, patients were interviewed regarding gynecologic history, side effect symptoms, and satisfaction. The average age of subjects was 15.5 years (range 11 to 20 years); 66% were African-American and 34% white. Results. Significantly more teens who chose Depo-Provera (73%) reported having used some method of birth control previously than those selecting either Norplant (30%) or OCP (26%). Adolescents who chose either Norplant (34%) or Depo-Provera (43%) were significantly more likely to have been pregnant previously than those choosing OCP (12%). Those selecting Depo-Provera were significantly more likely to report a history of genital infection with Chlamydia trachomatis (42%) than those in the other two contraceptive groups (22%). Prevalences of reported recent depression and fatigue before initiation of treatment were high, exceeding 35% across the three groups. A total of 105 and 40 adolescents were assessed at 3 and 6 months, respectively. At follow-up, more than 80% of OCP users maintained regular menstrual cycles, whereas over 80% of those choosing Norplant or Depo-Provera had disrupted cycles. Complaints of nausea and dizziness among Norplant users and fatigue among Depo-Provera and OCP users increased significantly between the baseline and follow-up visits. Reports of local reactions to the Norplant device were common but not clinically significant. Blood pressure readings, facial acne, and body mass index did not change over time in any treatment group. Subjects in the Norplant and Depo-Provera groups appreciated freedom from daily compliance to maintain contraceptive effectiveness and the "hidden" nature of the method. Appointment compliance at the end of 6 months was 78% for Depo-Provera, 40% for Norplant, and 46% for OCP. Conclusions. The implant and injection forms of contraception appear to be especially popular among girls with previous pregnancies or birth control use. The common occurrences of medical symptoms and sexually transmitted diseases before initiation of therapy underscore the importance of baseline evaluation. Norplant users may be warned about nausea and dizziness as well as minor local symptoms around the insertion site and unpredictable uterine bleeding patterns. Adolescent patients choosing Depo-Provera may expect amenorrhea by the end of 6 months of therapy along with possible fatigue. Early intervention may be needed with adolescents who choose Norplant or OCP to encourage better compliance with follow-up appointments.

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