scholarly journals Dental management of patients treated with intravenous bisphosphonates. A case report

2017 ◽  
Vol 25 (3) ◽  
pp. 248
Author(s):  
Keico Graciela Sano Trauth ◽  
Marilena Chinali Komesu ◽  
Claudia Helena Lovato Silva ◽  
Valéria Oliveira Pagnano ◽  
Leandro Dorigan De Macedo ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Treatment Plan ◽  
Osteonecrosis Of The Jaw ◽  
Periodontal Therapy ◽  
Dental School ◽  
Invasive Procedures ◽  
Osteonecrosis Of The Jaws ◽  
Dental Management ◽  
Supportive Periodontal Therapy ◽  
Intravenous Bisphosphonates

Bisphosphonates are drugs used for the inhibition of osteoclastic bone resorption. Their therapeutic use is indicated for Paget’s disease, hypercalcemia of cancer, bone metastases, and osteoporosis. The main side effect of these drugs is osteonecrosis of the jaw, which is difficult to control. The aim of the present study was to report a patient, who was referred to the Special Needs Clinics of the Ribeirão Preto Dental School, University of São Paulo, for dental treatment. His medical history revealed a diagnosis of multiple myeloma with bone marrow transplantation in November 2007. Since then, he has been using zometa every 3 months. After physical examination and complementary exams, a diagnosis of angular cheilitis, erythematous candidiasis, caries, localized chronic periodontitis, pulp necrosis and partial edentulousness was established. The treatment plan was based on control of angular cheilitis candidiasis, basic periodontal therapy, supportive periodontal therapy, endodontic treatment, and partial mandibular and maxillary dentures. All invasive procedures were performed with antibiotic prophylaxis. The patient is under treatment and care is being taken to avoid osteonecrosis of the jaws. The authors highlight the need for knowledge of the side effects of bisphosphonates to prevent such effects and to maintain the oral health of the patients.

scholarly journals Phenytoin-Induced Gingival Overgrowth Management with Periodontal Treatment

2015 ◽  
Vol 26 (1) ◽  
pp. 39-43 ◽  
Author(s):  
Bruno César de Vasconcelos Gurgel ◽  
Carlos Roberto Batista de Morais ◽  
Pedro Carlos da Rocha-Neto ◽  
Euler Maciel Dantas ◽  
Leão Pereira Pinto ◽  
...  
Keyword(s):  
Oral Hygiene ◽  
Dental Treatment ◽  
Treatment Plan ◽  
Pocket Depth ◽  
Gingival Overgrowth ◽  
Probing Pocket Depth ◽  
Supportive Periodontal Therapy ◽  
Continuous Use ◽  
Oral Hygiene Instruction

Phenytoin-induced gingival overgrowth (PIGO) is a common complication of the continuous use of medications. This paper presents a case of PIGO hindering oral function and compromising oral hygiene and aesthetics, which was treated with a combination of nonsurgical and surgical periodontal therapies. A 39-year-old male patient was referred for dental treatment with several complaints, especially upper and lower gingival overgrowth that hindered speech and swallowing. Generalized deep probing pockets and bone loss were detected. Diagnosis of gingival overgrowth associated with phenytoin and chronic periodontitis was established. The treatment plan consisted of conservative therapy with education on oral health, motivation and meticulous oral hygiene instruction in combination with scaling and root planing. During the revaluation period, a marked reduction in the clinical parameters was noted, particularly probing pocket depth reduction. Surgical therapy for removal of gingival overgrowth was also performed to achieve pocket reduction. Supportive periodontal therapy was proposed and the patient is currently under follow-up for 4 years. Management of PIGO may be obtained by the use of periodontal procedures combined with good oral hygiene and periodontal supportive care.

scholarly journals Aesthetics in Periodontal Therapy!

2018 ◽  
pp. 272-277
Author(s):  
Grishmi Niswade ◽  
Salman Ansari
Keyword(s):  
Multidisciplinary Approach ◽  
Dental Treatment ◽  
Treatment Plan ◽  
Correct Diagnosis ◽  
Periodontal Therapy ◽  
Comprehensive Treatment ◽  
Aesthetic Outcome ◽  
Effective Implementation ◽  
Complete Treatment ◽  
Attention To Detail

Aesthetics is an inseparable part of today’s dental treatment, the demands of which are continually increasing. The ultimate goal of periodontal therapy is to provide an aesthetic, functional, periodontally healthy and easily maintainable dentition to the patient. It needs to be emphasized that complete and accurate diagnosis is essential to provide an effective aesthetic periodontal therapy which often requires a multidisciplinary approach for complete treatment. Other prerequisites fora good aesthetic outcome apart from correct diagnosis include thorough attention to detail, development of a comprehensive treatment plan and effective implementation of the advanced techniques and materials.

Dental management of severe dentinogenesis imperfecta in a mild form of osteogenesis imperfecta

2003 ◽  
Vol 26 (2) ◽  
pp. 131-136 ◽  
Author(s):  
L. Stephen ◽  
P. Beighton
Keyword(s):  
Osteogenesis Imperfecta ◽  
Dental Treatment ◽  
Treatment Plan ◽  
Cost Effective ◽  
Western Cape ◽  
Clinical Expertise ◽  
Dentinogenesis Imperfecta ◽  
Dental Management ◽  
Affected Woman ◽  
The University

Dentinogenesis Imperfecta (DI), in which the teeth are discolored, translucent and brittle, can occur in isolation as a familial trait and as a component of the skeletal dysplasia Osteogenesis Imperfecta (OI). In a Cape Town family, 20 persons in 3 generations had mild OI, with the additional manifestation of severe DI. The family was assessed at the Dental Genetic Unit of the University of the Western Cape and appropriate dental treatment was provided. In this setting, a detailed treatment plan was devised for a severely affected woman. This plan proved to be efficient and cost effective, and the final outcome was pleasing to the patient. Dentinogenesis Imperfecta is not uncommon and may well be encountered in conventional dental practice. The necessary clinical expertise is within the scope of the skills of the general dentist.

scholarly journals Bisphosphonate-related osteonecrosis of the jaw: specificities

2014 ◽  
Author(s):  
Siri Paulo ◽  
Ana Margarida Abrantes ◽  
Mafalda Laranjo ◽  
Lina Carvalho ◽  
Arménio Serra ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Morphological Changes ◽  
Pathological Condition ◽  
Treatment Strategies ◽  
Osteonecrosis Of The Jaw ◽  
Local Trauma ◽  
A Minor ◽  
Intravenous Bisphosphonates ◽  
Direct Toxicity ◽  
Clinical Diagnostic Criteria

Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a severe complication that has recently emerged in patients treated with intravenous bisphosphonates for malignant diseases. This complication usually presents after a minor local trauma during a dental treatment. Several etiopathogenic mechanisms of this pathological condition have been proposed, but no model can explain all morphological changes observed at the macroscopic and microscopic level. BRONJ is likely to be related to direct toxicity in the bone and soft tissue cells, due to nitrogen-containing bisphosphonates. This review elucidates the clinical indications and mechanism of action of bisphosphonates, reports some clinical diagnostic criteria for BRONJ, describe the histopathological criteria for BRONJ diagnosis, the potential triggering pathways and the available treatment strategies.

scholarly journals Rubinstein-Taybi Syndrome: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
A. P. Münevveroglu ◽  
B. B. Akgöl
Keyword(s):  
Case Report ◽  
Dental Treatment ◽  
Treatment Plan ◽  
Genetic Disorder ◽  
Mental Deficiency ◽  
Mentally Retarded ◽  
Facial Dysmorphism ◽  
Nasal Bridge ◽  
Dental Management ◽  
Broad Nasal Bridge

Rubinstein-Taybi syndrome or Broad Thumb-Hallux syndrome is a genetic disorder characterized by facial dysmorphism, growth retardation, and mental deficiency. A seven-year-old girl had come to the Department of Pedodontics, Istanbul Medipol University, Faculty of Dentistry, Turkey, with a complaint of caries and bleeding of gingivae. The patient was mentally retarded. Extraoral features revealed distinctive facial appearance with a broad fore head, hypertelorism, broad nasal bridge, and beaked nose. Intraoral features observed were talons cusps in the upper lateral incisors, carious teeth, and plaque accumulation. Since the patient was mentally retarded, the dental treatment was done under GA. The treatment plan and dental management of this patient are discussed in this case report.

scholarly journals Development of a prognostic tool: based on risk factors for tooth loss after active periodontal therapy

2021 ◽  
Author(s):  
Sonja Rahim-Wöstefeld ◽  
Dorothea Kronsteiner ◽  
Shirin ElSayed ◽  
Nihad ElSayed ◽  
Peter Eickholz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
Tooth Loss ◽  
Treatment Plan ◽  
Periodontal Therapy ◽  
Outcome Variable ◽  
Individual Treatment ◽  
Risk Indicator ◽  
Related Factors ◽  
Prognostic Tool

Abstract Objectives The aim of this study was to develop a prognostic tool to estimate long-term tooth retention in periodontitis patients at the beginning of active periodontal therapy (APT). Material and methods Tooth-related factors (type, location, bone loss (BL), infrabony defects, furcation involvement (FI), abutment status), and patient-related factors (age, gender, smoking, diabetes, plaque control record) were investigated in patients who had completed APT 10 years before. Descriptive analysis was performed, and a generalized linear-mixed model-tree was used to identify predictors for the main outcome variable tooth loss. To evaluate goodness-of-fit, the area under the curve (AUC) was calculated using cross-validation. A bootstrap approach was used to robustly identify risk factors while avoiding overfitting. Results Only a small percentage of teeth was lost during 10 years of supportive periodontal therapy (SPT; 0.15/year/patient). The risk factors abutment function, diabetes, and the risk indicator BL, FI, and age (≤ 61 vs. > 61) were identified to predict tooth loss. The prediction model reached an AUC of 0.77. Conclusion This quantitative prognostic model supports data-driven decision-making while establishing a treatment plan in periodontitis patients. In light of this, the presented prognostic tool may be of supporting value. Clinical relevance In daily clinical practice, a quantitative prognostic tool may support dentists with data-based decision-making. However, it should be stressed that treatment planning is strongly associated with the patient’s wishes and adherence. The tool described here may support establishment of an individual treatment plan for periodontally compromised patients.

scholarly journals Risk factors for tooth loss with a mean follow-up period of 13.9 years in supportive periodontal therapy patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tomotaka Kato ◽  
Natsuki Fujiwara ◽  
Tomohisa Ogawa ◽  
Yukihiro Numabe
Keyword(s):  
Risk Factors ◽  
Tooth Loss ◽  
Periodontal Therapy ◽  
Dental Hygienists ◽  
Multiple Classification Analysis ◽  
Hazard Ratios ◽  
Dental Office ◽  
Multiple Classification ◽  
Supportive Periodontal Therapy

Abstract Background Clinical evidence indicates that there are various risk factors of tooth loss. However, the degree of this risk among other risk factors remains unclear. In this retrospective cohort study, the authors evaluated the hazard ratios of several risk factors for tooth loss. Methods Included patients had all been treated for dental disorders, were in the supportive phase of periodontal therapy by dental hygienists, and visited a Japanese dental office continually during a 10-year period. Periodontal parameters, tooth condition, and general status of all teeth (excluding third molars) at the initial visit and at least 10 years later were evaluated by using multiple classification analysis. Results The authors evaluated a total of 7584 teeth in 297 patients (average age: 45.3, mean follow-up time: 13.9 years) Non-vital pulp was the most significant predictor of tooth loss according to Cox hazards regression analysis (hazard ratio: 3.31). The 10-year survival rate was approximately 90% for teeth with non-vital pulp and 99% for teeth with vital pulp. Fracture was the most common reason for tooth loss. Conclusions Non-vital pulp had the most significant association with tooth loss among the parameters. Therefore, it is very important to minimize dental pulp extirpation.

scholarly journals Clinical and Microbiological Evaluation of Local Doxycycline and Antimicrobial Photodynamic Therapy during Supportive Periodontal Therapy: A Randomized Clinical Trial

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 277
Author(s):  
Raluca Cosgarea ◽  
Sigrun Eick ◽  
Ionela Batori-Andronescu ◽  
Søren Jepsen ◽  
Nicole B. Arweiler ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Bacterial Species ◽  
Periodontal Therapy ◽  
Local Drug Delivery ◽  
Control Group ◽  
Periodontal Pathogens ◽  
Supportive Periodontal Therapy ◽  
Group A ◽  
Group B ◽  
Attachment Level

The aim of this study was to evaluate the clinical and microbiological effects of subgingival instrumentation (SI) alone or combined with either local drug delivery (LDD) or photodynamic therapy (PDT) in persistent/recurrent pockets in patients enrolled in supportive periodontal therapy (SPT). A total of 105 patients enrolled in SPT were randomly treated as follows: group A (n = 35): SI +PDT and 7 days later 2nd PDT; group B (n = 35): SI+LDD; group C (n = 35): SI (control). Prior intervention, at 3 and 6 months after therapy, probing pocket depths, clinical attachment level, number of treated sites with bleeding on probing (n BOP), full mouth plaque and bleeding scores (gingival bleeding index, %BOP) were recorded. At the same time points, 8 periodontopathogens were quantitatively determined. All three treatments resulted in statistically significant improvements (p < 0.05) of all clinical parameters without statistically significant intergroup differences (p > 0.05). Several bacterial species were reduced in both test groups, with statistically significantly higher reductions for LDD compared to PDT and the control group. In conclusion, the present data indicate that: (a) In periodontal patients enrolled in SPT, treatment of persistent/recurrent pockets with SI alone or combined with either PDT or LDD may lead to comparable clinical improvements and (b) the adjunctive use of LDD appears to provide better microbiological improvements for some periodontal pathogens than SI alone or combined with PDT.

Sign in / Sign up

Export Citation Format

Share Document