Root abnormalities and nonsurgical management of generalized aggressive periodontitis

Background: One of the most common inflammation disease in the oral cavity for the past few years is the aggressive form of periodontitis. Common signs of aggressive periodontitis is the mobility of teeth especially in incisive and first molars, and occuring mostly in young patient. Young patients whose losing her anterior teeth, are a real challenge for dentist and prosthodontist. Prosthodontist need to consider both functional and esthetic aspects. Objective: Rehabilitation of young adult patient with aggressive periodontitis by an interdisciplinary approach of orthodontist and prosthodontist. Case Description: A young woman, suffered from aggressive periodontitis with major complain of her teeth mobility, especially incisive and first molar in mandible. She had undergone periodontal treatment, but the result was failed. The anterior teeth in mandible need to be extracted, therefore patient wished not to be in edentulous state. As preliminary treatment, we choose immediate denture to replace the anterior mandible teeth. We faced difficulties in mandible, because her right canine weren’t in the proper dental arch. So we asked orthodontist to place fixed orthodontics in mandible, to get the canine back in the proper arch. We’ve chosen orthodontic treatment,because we didn’t want to extract the canine teeth. We evaluated in six months and after the canine back in the proper arch, we proceed to long span bridge in mandible as our definitive treatment. Conclusion: By not extracting the canine teeth, we got some advantages, especially patient psychically was happier with her own teeth. The collaboration with another dentistry field, provides us better treatment for patient. After treatment, patient had no complaints and was happy with her new smile.Keywords: Prosthodontic rehabilitation, aggressive periodontitis, orthodontic treatment, esthetic.Correspondence: Chaterina Diyah Nanik. K; Department of Prostodontitics, Faculty of Dentistry, Hang Tuah University, Arif Rahman Hakim 150, Surabaya; Phone 031-5912191, Email: <a href="mailto:[email protected]">[email protected]</a>

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Management and outcomes of isolated interhemispheric subdural hematomas associated with falx syndrome

Journal of Neurosurgery ◽

10.3171/2018.8.jns181812 ◽

2019 ◽

Vol 131 (6) ◽

pp. 1920-1925

Author(s):

Daniel A. Tonetti ◽

William J. Ares ◽

David O. Okonkwo ◽

Paul A. Gardner

Keyword(s):

Neurological Deterioration ◽

Neurological Deficits ◽

Motor Deficits ◽

Study Cohort ◽

Venous Infarction ◽

Nonsurgical Management ◽

Subdural Hematomas ◽

Poor Outcomes ◽

Contemporary Management

OBJECTIVELarge interhemispheric subdural hematomas (iSDHs) causing falx syndrome are rare; therefore, a paucity of data exists regarding the outcomes of contemporary management of iSDH. There is a general consensus among neurosurgeons that large iSDHs with neurological deficits represent a particular treatment challenge with generally poor outcomes. Thus, radiological and clinical outcomes of surgical and nonsurgical management for iSDH bear further study, which is the aim of this report.METHODSA prospectively collected, single-institution trauma database was searched for patients with isolated traumatic iSDH causing falx syndrome in the period from January 2008 to January 2018. Information on demographic and radiological characteristics, serial neurological examinations, clinical and radiological outcomes, and posttreatment complications was collected and tallied. The authors subsequently dichotomized patients by management strategy to evaluate clinical outcome and 30-day survival.RESULTSTwenty-five patients (0.4% of those with intracranial injuries, 0.05% of those with trauma) with iSDH and falx syndrome represented the study cohort. The average age was 73.4 years, and most patients (23 [92%] of 25) were taking anticoagulants or antiplatelet medications. Six patients were managed nonoperatively, and 19 patients underwent craniotomy for iSDH evacuation; of the latter patients, 17 (89.5%) had improvement in or resolution of motor deficits postoperatively. There were no instances of venous infarction, reaccumulation, or infection after evacuation. In total, 9 (36%) of the 25 patients died within 30 days, including 6 (32%) of the 19 who had undergone craniotomy and 3 (50%) of the 6 who had been managed nonoperatively. Patients who died within 30 days were significantly more likely to experience in-hospital neurological deterioration prior to surgery (83% vs 15%, p = 0.0095) and to be comatose prior to surgery (100% vs 23%, p = 0.0031). The median modified Rankin Scale score of surgical patients who survived hospitalization (13 patients) was 1 at a mean follow-up of 22.1 months.CONCLUSIONSiSDHs associated with falx syndrome can be evacuated safely and effectively, and prompt surgical evacuation prior to neurological deterioration can improve outcomes. In this study, craniotomy for iSDH evacuation proved to be a low-risk strategy that was associated with generally good outcomes, though appropriately selected patients may fare well without evacuation.

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Does Adjunctive Use of Hyaluronic Acid Improve Clinical Outcome of Mechanical Therapy for Cases of Mild Aggressive Periodontitis

Revista de Chimie ◽

10.37358/rc.17.3.5513 ◽

2017 ◽

Vol 68 (3) ◽

pp. 612-614

Author(s):

Andreea A. Pogan ◽

Roxana Buzatu ◽

Dan Onisei ◽

Doina Onisei

Keyword(s):

Hyaluronic Acid ◽

Antimicrobial Effect ◽

Aggressive Periodontitis ◽

Gingival Tissue ◽

Potential Benefits ◽

Therapeutic Properties ◽

Acid Gel ◽

Mechanical Therapy ◽

Improve Clinical Outcome ◽

Hyaluronic Acid Gel

Hyaluronic acid is an essential component of the periodontal ligament matrix and it has shown a number of clinical therapeutic properties, especially an anti-inflammatory effect on the gingival tissue. The aim of this study is to evaluate the potential benefits of using hyaluronic acid gel in topical application as an adjunct to mechanical therapy in the management of aggressive periodontitis. Results show an obvious improvement of clinical parameters, especially regarding the evolution of healing of the gingival tissue after periodontal therapy. Nevertheless, the antimicrobial effect needs to be proven in further studies.

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