Management of Periodontitis Associated with Endodontically Involved Teeth: A Case Series

2005 ◽  
Vol 6 (2) ◽  
pp. 118-129 ◽  
Author(s):  
Pradeep S. Anand ◽  
K. Nandakumar
Keyword(s):  
Oral Cavity ◽  
Periodontal Disease ◽  
Treatment Planning ◽  
Dental Pulp ◽  
Periodontal Ligament ◽  
Alveolar Bone ◽  
Case Series ◽  
Disease Process ◽  
Simultaneous Existence ◽  
Treatment Procedures

Abstract The pulp and the periodontal attachment are the two components that enable a tooth to function in the oral cavity. Lesions of the periodontal ligament and adjacent alveolar bone may originate from infections of the periodontium or tissues of the dental pulp. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. The function of the tooth is severely compromised when either one of these is involved in the disease process. Treatment of disease conditions involving both of these structures can be challenging and frequently requires combining both endodontic and periodontal treatment procedures. This article presents cases of periodontitis associated with endodontic lesions managed by both endodontic and periodontal therapy. Citation Anand PS, Nandakumar K. Management of Periodontitis Associated with Endodontically Involved Teeth: A Case Series. J Contemp Dent Pract 2005 May;(6)2:118-129.

Endo-perio lesions-the problem and the solutions

2017 ◽  
Vol 9 (2) ◽  
pp. 28-36
Author(s):  
B S Keshava Prasad ◽  
Suchetha A ◽  
Soorya K V ◽  
BharwaniAshit G ◽  
Rohit Prasad ◽  
...  
Keyword(s):  
Periodontal Disease ◽  
Treatment Planning ◽  
Successful Treatment ◽  
Correct Diagnosis ◽  
Case Series ◽  
Dentinal Tubules ◽  
Simultaneous Existence ◽  
Diagnostic Modalities ◽  
Treatment Procedures ◽  
Insight Into

Periodontium is anatomically interrelated with the pulp through different pathways like dentinal tubules, lateral and accessory canals and apical foramen. The simultaneous existence of pulpal problems and periodontal disease can complicate diagnosis and treatment planning. When examining and treating the combined or individual lesion in endodontics and periodontics, the clinician must bear in mind that successful treatment depends on a correct diagnosis. This case series gives an insight into the various diagnostic modalities and treatment procedures that can be applied for the resolution of the endo-perio lesions.

scholarly journals Dental Pulp Mesenchymal Stem Cells as a Treatment for Periodontal Disease in Older Adults

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Beatriz Hernández-Monjaraz ◽  
Edelmiro Santiago-Osorio ◽  
Edgar Ledesma-Martínez ◽  
Itzen Aguiñiga-Sánchez ◽  
Norma Angélica Sosa-Hernández ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Periodontal Disease ◽  
Dental Pulp ◽  
Alveolar Bone ◽  
Statistical Significance ◽  
Collagen Scaffold ◽  
Control Group ◽  
Mineral Density

Periodontal disease (PD) is one of the main causes of tooth loss and is related to oxidative stress and chronic inflammation. Although different treatments have been proposed in the past, the vast majority do not regenerate lost tissues. In this sense, the use of dental pulp mesenchymal stem cells (DPMSCs) seems to be an alternative for the regeneration of periodontal bone tissue. A quasi-experimental study was conducted in a sample of 22 adults between 55 and 64 years of age with PD, without uncontrolled systemic chronic diseases. Two groups were formed randomly: (i) experimental group (EG) n=11, with a treatment based on DPMSCs; and a (ii) control group (CG) n=11, without a treatment of DPMSCs. Every participant underwent clinical and radiological evaluations and measurement of bone mineral density (BMD) by tomography. Saliva samples were taken as well, to determine the total concentration of antioxidants, superoxide dismutase (SOD), lipoperoxides, and interleukins (IL), before and 6 months after treatment. All subjects underwent curettage and periodontal surgery, the EG had a collagen scaffold treated with DPMSCs, while the CG only had the collagen scaffold placed. The EG with DPMSCs showed an increase in the BMD of the alveolar bone with a borderline statistical significance (baseline 638.82±181.7 vs. posttreatment 781.26±162.2 HU, p=0.09). Regarding oxidative stress and inflammation markers, salivary SOD levels were significantly higher in EG (baseline 1.49±0.96 vs. 2.14±1.12 U/L posttreatment, p<0.05) meanwhile IL1β levels had a decrease (baseline 1001.91±675.5vs. posttreatment 722.3±349.4 pg/ml, p<0.05). Our findings suggest that a DPMSCs treatment based on DPMSCs has both an effect on bone regeneration linked to an increased SOD and decreased levels of IL1β in aging subjects with PD.

scholarly journals Imaging in the Diagnosis of Cemento-Ossifying Fibroma: A Case Series

2012 ◽  
Vol 2 ◽  
pp. 52 ◽  
Author(s):  
R Mithra ◽  
Pavitra Baskaran ◽  
M Sathyakumar
Keyword(s):  
Treatment Planning ◽  
Fibrous Dysplasia ◽  
Case Series ◽  
Disease Process ◽  
Ossifying Fibroma ◽  
Imaging Findings ◽  
The Third ◽  
Osseous Lesion ◽  
Essential Tool ◽  
Slow Growing

Cemento-ossifying fibroma is a benign fibro-osseous lesion belonging to the same category as fibrous dysplasia and cementifying dysplasia. These are slow-growing lesions that are seen in the third and fourth decades of life. Both the ossifying fibroma and cemento-ossifying fibroma represent two extremes of the same disease process since histologically both contain bone and cementum. However, the term cemento-ossifying fibroma is justified on the basis of clinical and radiological correlation. Radiographs have become an essential tool in the diagnosis of lesions in the jaw, where the anatomy is complex. Nowadays, CT provides information for diagnosis as well as treatment planning. In this case series, we report three cases of cemento-ossifying fibroma that were histologically confirmed and discuss the imaging findings.

scholarly journals Mice lacking PLAP-1/asporin counteracts high fat diet-induced metabolic disorder and alveolar bone loss by controlling adipose tissue expansion

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hiromi Sakashita ◽  
Satoru Yamada ◽  
Masaki Kinoshita ◽  
Tetsuhiro Kajikawa ◽  
Tomoaki Iwayama ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Periodontal Disease ◽  
Lipid Accumulation ◽  
High Fat Diet ◽  
Periodontal Ligament ◽  
Metabolic Disorders ◽  
Alveolar Bone ◽  
High Fat ◽  
Knock Out ◽  
Knock Out Mice

AbstractAdipose tissue fibrosis with chronic inflammation is a hallmark of obesity-related metabolic disorders, and the role of proteoglycans in developing adipose tissue fibrosis is of interest. Periodontal disease is associated with obesity; however, the underlying molecular mechanisms remain unclear. Here we investigated the roles of periodontal ligament associated protein-1 (PLAP-1)/asporin, a proteoglycan preferentially and highly expressed in the periodontal ligament, in obesity-related adipose tissue dysfunction and adipocyte differentiation. It was found that PLAP-1 is also highly expressed in white adipose tissues. Plap-1 knock-out mice counteracted obesity and alveolar bone resorption induced by a high-fat diet. Plap-1 knock-down in 3T3-L1 cells resulted in less lipid accumulation, and recombinant PLAP-1 enhanced lipid accumulation in 3T3-L1 cells. In addition, it was found that primary preadipocytes isolated from Plap-1 knock-out mice showed lesser lipid accumulation than the wild-type (WT) mice. Furthermore, the stromal vascular fraction of Plap-1 knock-out mice showed different extracellular matrix gene expression patterns compared to WT. These findings demonstrate that PLAP-1 enhances adipogenesis and could be a key molecule in understanding the association between periodontal disease and obesity-related metabolic disorders.

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

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 (&gt;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.

scholarly journals Inflammatory Response Mechanisms of the Dentine–Pulp Complex and the Periapical Tissues

2021 ◽  
Vol 22 (3) ◽  
pp. 1480
Author(s):  
Kerstin M. Galler ◽  
Manuel Weber ◽  
Yüksel Korkmaz ◽  
Matthias Widbiller ◽  
Markus Feuerer
Keyword(s):  
Immune Response ◽  
Inflammatory Response ◽  
Oral Cavity ◽  
Root Canal ◽  
Dental Pulp ◽  
Defense Mechanisms ◽  
Alveolar Bone ◽  
Cell Types ◽  
Root Tip ◽  
Periodontal Tissues

The macroscopic and microscopic anatomy of the oral cavity is complex and unique in the human body. Soft-tissue structures are in close interaction with mineralized bone, but also dentine, cementum and enamel of our teeth. These are exposed to intense mechanical and chemical stress as well as to dense microbiologic colonization. Teeth are susceptible to damage, most commonly to caries, where microorganisms from the oral cavity degrade the mineralized tissues of enamel and dentine and invade the soft connective tissue at the core, the dental pulp. However, the pulp is well-equipped to sense and fend off bacteria and their products and mounts various and intricate defense mechanisms. The front rank is formed by a layer of odontoblasts, which line the pulp chamber towards the dentine. These highly specialized cells not only form mineralized tissue but exert important functions as barrier cells. They recognize pathogens early in the process, secrete antibacterial compounds and neutralize bacterial toxins, initiate the immune response and alert other key players of the host defense. As bacteria get closer to the pulp, additional cell types of the pulp, including fibroblasts, stem and immune cells, but also vascular and neuronal networks, contribute with a variety of distinct defense mechanisms, and inflammatory response mechanisms are critical for tissue homeostasis. Still, without therapeutic intervention, a deep carious lesion may lead to tissue necrosis, which allows bacteria to populate the root canal system and invade the periradicular bone via the apical foramen at the root tip. The periodontal tissues and alveolar bone react to the insult with an inflammatory response, most commonly by the formation of an apical granuloma. Healing can occur after pathogen removal, which is achieved by disinfection and obturation of the pulp space by root canal treatment. This review highlights the various mechanisms of pathogen recognition and defense of dental pulp cells and periradicular tissues, explains the different cell types involved in the immune response and discusses the mechanisms of healing and repair, pointing out the close links between inflammation and regeneration as well as between inflammation and potential malignant transformation.

scholarly journals Wnt Signaling in Periodontal Disease

2021 ◽  
Vol 2 ◽  
Author(s):  
David González-Quintanilla ◽  
Nicolás Abásolo ◽  
Pablo Astudillo
Keyword(s):  
Periodontal Disease ◽  
Wnt Signaling ◽  
Periodontal Ligament ◽  
Chronic Condition ◽  
Wnt Pathway ◽  
Alveolar Bone ◽  
Canonical Pathways ◽  
Canonical Wnt ◽  
Proper Balance

Periodontitis is a multifactorial and chronic condition associated with the formation of a dysbiotic biofilm, leading to a pro-inflammatory environment that can modulate cell signaling. The Wnt pathway plays fundamental roles during homeostasis and disease, and emerging evidence suggests its involvement in the maintenance of the periodontium and the development of periodontitis. Here, we summarize the role of the Wnt/β-catenin and non-canonical Wnt signaling pathways in periodontitis. The accumulated data suggests specific roles for each branch of the Wnt pathway. Wnt5a emerges as a critical player promoting periodontal ligament remodeling and impairing regenerative responses modulated by the Wnt/β-catenin pathway, such as alveolar bone formation. Collectively, the evidence suggests that achieving a proper balance between the Wnt/β-catenin and non-canonical pathways, rather than their independent modulation, might contribute to controlling the progression and severity of the periodontal disease.

Oral Myiasis in a Captive Hippopotamus

2009 ◽  
Vol 26 (3) ◽  
pp. 168-170 ◽  
Author(s):  
João Luiz Rossi Junior ◽  
Flaviana L. Guião-Leite ◽  
Marco Antonio Gioso ◽  
Léslie M. Domingues Falqueiro ◽  
Roberto Silveira Fecchio
Keyword(s):  
Oral Cavity ◽  
Periodontal Disease ◽  
Adult Male ◽  
Dental Pulp ◽  
Canine Tooth ◽  
Dental Eruption ◽  
In Captivity ◽  
Mandibular Canine ◽  
Dental Infections

Causes of dental infections can be related to failed dental eruption, malocclusion, abrasion, fractures with or without exposure of the dental pulp, and periodontal disease. Reports of oral myiasis in megavertebrates in captivity are infrequent, perhaps due to the difficulty in observing the oral cavity in such species. This report describes a case of oral myiasis in an adult male hippopotamus in the gingival area and alveolar mucosa of the left mandibular canine tooth.

scholarly journals TheTreponema denticolaChymotrypsin-Like Protease Dentilisin Induces Matrix Metalloproteinase-2-Dependent Fibronectin Fragmentation in Periodontal Ligament Cells

2010 ◽  
Vol 79 (2) ◽  
pp. 806-811 ◽  
Author(s):  
Di Miao ◽  
J. Christopher Fenno ◽  
John C. Timm ◽  
Nam Eok Joo ◽  
Yvonne L. Kapila
Keyword(s):  
Periodontal Disease ◽  
Periodontal Ligament ◽  
Alveolar Bone ◽  
Inflammatory Responses ◽  
Tissue Homeostasis ◽  
Matrix Metalloproteinase 2 ◽  
Periodontal Ligament Cells ◽  
Treponema Denticola ◽  
Periodontal Pathogens ◽  
Culture Supernatants

ABSTRACTPeriodontal disease is a bacterially mediated chronic inflammatory disease that results in destruction of the periodontal ligament (PDL) and alveolar bone that surround and support the dentition. While their precise roles are not well understood, periodontal pathogens, includingTreponema denticola, are believed to initiate the destructive inflammatory responses and dysregulation of tissue homeostasis that characterize the disease. These responses are believed to result from both proinflammatory effects of acylated bacterial membrane components (lipopolysaccharides and lipoproteins) and degradative effects of secreted bacterial proteases. Host-derived matrix metalloproteinases (MMPs) are key enzymes both in tissue homeostasis and tissue destruction. MMP expression is modulated in part by specific proteolytic fragments of fibronectin (FN), which are associated with periodontal disease. FN is a predominant extracellular matrix component in the periodontium. We examined the ability ofTreponema denticolaand its acylated outer membrane PrtP protease complex to induce both activation of MMP-2 and generation of FN fragments in human PDL cell culture supernatants.T. denticolaparent and isogenic mutant strains, as well as MMP-2 small interfering RNA and specific inhibitors of MMP-2 and PrtP activity, were used to examine protein expression, gelatinolytic activity, and FN fragmentation in culture supernatants.T. denticolaand its purified protease induced both MMP-2 activation and FN fragmentation. Here, we demonstrate that PrtP proteolytic activity induces the activation of MMP-2 and that active MMP-2 is required for FN fragmentation. These results suggest a specific mechanism by which theT. denticolaprotease may disrupt homeostatic processes required for the maintenance of periodontal health.

scholarly journals Endodontic-Periodontal Interrelationship, a phenomenon dealt with dilemma: a Review

2013 ◽  
Vol 3 (1) ◽  
pp. 36-44
Author(s):  
F Rashid ◽  
CM Jan ◽  
MAA Polan ◽  
NA Nomann ◽  
AJ Rashid ◽  
...  
Keyword(s):  
Periodontal Disease ◽  
Treatment Planning ◽  
Periodontal Diseases ◽  
Treatment Plan ◽  
Correct Diagnosis ◽  
Hippocratic Oath ◽  
Subsequent Treatment ◽  
Periodontal Tissues ◽  
Suitable Treatment ◽  
Simultaneous Existence

The term “perio-endo” lesion has been established to describe any lesion caused by any inflammatory product found in varying degrees in both the periodontium and the pulpal tissues and this inter-relationship between periodontal and pulpal disease was first described by Simring and Goldberg in 1964. As the pulpal and periodontal tissues have close embryonic, anatomical and functional inter-relationship; so, simultaneous existence of pulpal problems and inflammatory periodontal disease can be found frequently. This certainly can complicate diagnosis and also influencing outcome of treatment planning. A perio-endo lesion can have a varied pathogenesis which ranges from quite simple to relatively most complex one, thus coming to a definitive diagnosis a hard judged one. Having a thorough knowledge over these disease processes plays a key role in coming to the correct diagnosis and also subsequent treatment planning. This certainly can be achieved by careful history taking, a thorough intra and extra oral examination and the use of modern day special test apparatuses. Radiographic evaluations can also aid in clarifying the nature of the problem, even modern day Radio-Visio Graph or, RVG can also be a great tool that can come into aid. The prognosis and treatment of each endo-perio disease type varies a lot. Stating so, primary periodontal disease with secondary endodontic involvement and true combined endodontic-periodontal diseases require both endodontic and periodontal therapies along with proper medication & oral hygiene maintenance. The prognosis of each case depends on the severity of periodontal disease and the response to periodontal treatment, while the treatment of affected tooth/teeth with endodontic involvement also requires the same. This review paper is focused on enabling the operator to construct a suitable treatment plan where unnecessary, prolonged or even detrimental treatment is avoided, thus avoiding breaking of Hippocratic Oath taken by a dental surgeon in his/her maiden practice life. DOI: http://dx.doi.org/10.3329/bjdre.v3i1.16594 Bangladesh Journal of Dental Research & Education Vol.3(1) 2013: 36-44

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