scholarly journals Orthodontic-Periodontics: An Interdisciplinary Approach

2021 ◽  
Author(s):  
Shreya Kishore ◽  
Vanita Barai ◽  
Suvetha Siva ◽  
Keerthi Venkatesan

Periodontal pathogenesis is a multi-factorial process and the orthodontist must recognize the clinical forms of inflammatory periodontal disease. Orthodontics is the most conservative and predictable treatment to improve numerous local etiological factors that contribute to periodontal disease including periodontal breakdown. Proper occlusal function and masticatory function are stimulatory to the gingival tissue and the attachment apparatus, while, conversely, a lack of function predisposes to disease that increases plaque retention and calculus formation along with gingival inflammation leading to increased loss of bony support. No matter how talented the orthodontist, a magnificent orthodontic correction can be destroyed by failure to recognize periodontal susceptibility. Therefore, identifying periodontally susceptible patients is critical for the outcome of the treatment. This chapter will highlight the importance of the short-term and long-term outcomes of orthodontic treatment, which are influenced by the patient’s periodontal status before, during and after active orthodontic therapy.

2016 ◽  
Vol 4 (2) ◽  
pp. 65
Author(s):  
Sneha Dani ◽  
Savitha A.N ◽  
Kenneth Tan ◽  
Anand Naik ◽  
Charan Chhatrala ◽  
...  

Objective: In recent years, advances in technique as well as a growing public interest in developing and maintaining a healthy and attractive smile, has resulted in a greater understanding of the interrelationships between periodontics and orthodontics. The primary objective of periodontal therapy is to restore and maintain the health and integrity of the attachment apparatus of teeth. In adults, the loss of teeth or periodontal support can result in pathological teeth migration involving either a single tooth or a group of teeth. This may result in the development of a diastema, incisal proclination, rotation with collapse of the posterior occlusion.Materials and methods: This case report is of a 32 year old female patient who reported with swollen gums, generalized spacing between the teeth and extruded upper anterior tooth. Periodontal therapy followed by fixed orthodontic therapy was planned.Results: At the end of 2 years a stable healthy periodontium was established that was both functional and esthetic.Conclusion: Adjunctive orthodontic therapy is often necessary for successful restoration of periodontal health. On the other hand, successful orthodontic treatment will depend on the periodontal preparation before and after treatment and the maintenance of periodontal health throughout all phases of mechano-therapy.


2020 ◽  
Vol 17 (2) ◽  
pp. 54
Author(s):  
Anindita L. ◽  
Aris Aji K. ◽  
Arcadia Sulistijo J.

Hypertension presents an increase in blood pressure following the oral manifestations, such as gingival enlargement. A 42-year-old woman came to the General Sudirman University Dental and Oral Hospital complaining of enlarged front gums seven years ago. The patient had a history of hypertension and regularly consumed drugs, amlodipine 5 mg. Extraoral examination revealed no lymphadenopathy and no swelling of the head and neck area. Intraoral examination revealed a gingival enlargement involving the papilla to the gingival margin present on the entire upper and lower labial gingival surface. The patient's diagnosis was gingival enlargement caused by gingival enlargement due to the use of amlodipine. Gingival enlargement has been noted with long-term or high-dose amlodipine use. The mechanism of amlodipine in causing gingival enlargement is through the role of fibroblasts with abnormal susceptibility to the drug, resulting in increased levels of protein synthesis, especially collagen. The role of pro-inflammatory cytokines occurs through an increase in interleukin-1β (IL-1β) and IL-6 in the inflamed gingival tissue due to the gingival fibrogenic response to drugs. Therapies were DHE and scaling and root planning as phase I in periodontal treatment. Plaque elimination is vital to reduce gingival inflammation that may occur. Substitution of the drug amlodipine may be needed if there is no improvement. Based on case reports, hypertension patients who took amlodipine could have gingival enlargement. The therapy given was plaque elimination in the form of DHE and Scaling and regular check-ups with the dentist.


2020 ◽  
Vol 9 (7) ◽  
pp. 2210
Author(s):  
Yeon-Jee Yoo ◽  
Dong-Won Kim ◽  
Hiran Perinpanayagam ◽  
Seung-Ho Baek ◽  
Qiang Zhu ◽  
...  

The aim of this study was to analyze the long-term outcomes of endodontic microsurgeries in a cohort and identify their association with prognostic factors. A cohort of endodontic microsurgeries followed up periodically with complete clinical and radiographic records for at least 5 years were reviewed retrospectively. Their survival and healing status and profile characteristics were analyzed by Pearson chi-square test and logistic regression (α = 0.05) to identify prognostic factors that influenced outcomes. Of 652 cases in the cohort, 225 (34.5%) were included. The mean follow-up period was 90.4 months (range, 60–168 months). The long-term success rate was 80.5%, and the 5-year survival rate was 83.5%. Logistic regression showed higher success in anteriors compared to molars (OR = 5.405, (95% CI, 1.663–17.571; p = 0.005)) and in teeth with crown restorations (OR = 10.232, (95% CI, 3.374–31.024; p < 0.001)). Conversely, lower success was found in teeth with periodontal disease (OR = 0.170, (95% CI, 0.032–0.900; p = 0.037)) and maxillary sinus involvement (OR = 0.187, (95% CI, 0.035–0.994; p = 0.049)). Endodontic microsurgery has a highly favorable long-term outcome. Tooth position, crown restoration, periodontal disease, and maxillary sinus involvement were identified as main prognostic factors.


2019 ◽  
Vol 92 ◽  
pp. S20-S32 ◽  
Author(s):  
Radu Chifor ◽  
Alexandru Florin Badea ◽  
Ioana Chifor ◽  
Delia-Alexandrina Mitrea ◽  
Maria Crisan ◽  
...  

The periodontal disease and gingival bleeding are highly prevalent in the adult population worldwide. The World Health Organization (WHO) data shows that 90–100% of the 34-year-old adults present gingival inflammation. Therefore, an investigation method is required to allow the assessment of the periodontal disease as well as the monitoring of the evolution of the gingival inflammation after periodontal treatments. Non-invasive and operator-independent methods for periodontal examination are necessary for diagnosing and monitoring the periodontal disease. The periodontal ultrasonography is a reliable technique for visualizing the anatomical elements which are necessary to diagnose the periodontal status. Using this imaging technique the dentino-enamel junction, the cortical bone, the radicular surface from the crown to the alveolar bone, the gingival tissue can be seen without interfering with those elements during the examination. Also, calculus visualization is possible before and after scaling in order to evaluate the quality of the treatment. Using 2D ultrasonography is not feasible in dental practice as it requires extensive experience and is also time consuming. The reproducibility of the 2D slices is very difficult in order to have the possibility to compare different investigations efficiently. 3D reconstructions of the periodontal tissue can be a very good alternative to eliminate the operator dependence. Ultrasonography allows the practitioner to visualize the anatomic elements involved in making a periodontal diagnosis. It also allows tracking of subsequent changes. This method is not commonly used for periodontal examination and further studies are required. Previous studies show that ultrasonography can be a reliable non-invasive method to diagnose and monitor the periodontal disease.


2016 ◽  
Vol 6 (1) ◽  
pp. 7-11
Author(s):  
Bhageshwar Dhami ◽  
Priti Shrestha ◽  
Sujaya Gupta ◽  
Sujita Shrestha ◽  
Rabindra Man Shrestha

Introduction: Gingival recession is characterized by apical migration of gingival margin from the cementoenamel junction. Prevalence varies from 3-100%, and appears to be lower in younger age groups.Objective: To determine the prevalence and severity of gingival recession in young adult Nepalese population and to assess the relationship between brushing technique, smoking habit and past orthodontic treatment with gingival recession.Materials & Method: A cross-sectional study was carried out among 160 healthy patients (age 18-25 years) with routine dental examinations and information regarding age, smoking habit, oral hygiene habits, brushing technique and past orthodontic treatment. Clinical examination included visible gingival inflammation, visible dental plaque, and gingival recession. SPSS version 20 was used to analyze the data. Chi-Square test was used to evaluate relationships between the variables.Result: Out of total participants; gingival recession was found in 21.3%, gingivitis in 40% and plaque in 20%. The prevalence, extent, and severity of recession were correlated with past orthodontic treatment. There was association between gingivitis, past orthodontic treatment and smoking with gingival recession.Conclusion: Orthodontic patients must undergo regular oral hygiene performance and periodontal maintenance in order to maintain healthy gingival tissue during active orthodontic therapy. The combined orthodontic-periodontic interdisciplinary approach could be effective in these situations.Orthodontic Journal of Nepal, Vol. 6 No. 1, June 2016, pp.7-11


2021 ◽  
Vol 10 (13) ◽  
pp. 2870
Author(s):  
Jung-Sub An ◽  
Wonchae Jeong ◽  
Liselotte Sonnesen ◽  
Seung-Hak Baek ◽  
Sug-Joon Ahn

This research aimed to evaluate the effects of presurgical mandibular incisor decompensation on long-term outcomes of Class III surgical orthodontic treatment. Thirty-five patients with skeletal Class III malocclusion who received conventional surgical orthodontic treatment were included. Mandibular incisor brackets with −6° of inclination were placed normally in 18 patients (NB group) and inversely in 17 patients (RB group). Between-group differences and relationships between incisal and skeletal variables were analyzed based on lateral cephalograms at pretreatment, presurgery, postsurgery, posttreatment, and retention. Mandibular incisors were more labially inclined in the RB group than in the NB group from presurgery to retention. No significant between-group differences were observed in presurgical and postsurgical skeletal relationships. The NB group exhibited a larger overjet with deficient interincisal contact at postsurgery than the RB group. Skeletal Class III relationship was also more severe in the NB group at retention. More lingually inclined mandibular incisors at presurgery and larger overjet at postsurgery were correlated with a more severe skeletal Class III relationship at retention. Thus, establishing appropriate postsurgical overjet by sufficient presurgical mandibular incisor decompensation may play a significant role in postsurgical stability of Class III surgical orthodontic treatment.


2018 ◽  
Vol 2018 ◽  
pp. 1-12
Author(s):  
Ayako Taira ◽  
Shiho Odawara ◽  
Shuntaro Sugihara ◽  
Kenichi Sasaguri

Comprehensive and appropriate occlusion reconstruction therapy is necessary for orthodontic treatment of adult patients with malocclusion with periodontal disease associated with occlusal trauma. We report the case of a patient with extensive moderate chronic periodontitis associated with occlusal trauma. The patient was diagnosed with extensive moderate chronic periodontitis associated with occlusal trauma and underwent thorough treatment for periodontal disease, oral management, and 20 months of orthodontic therapy. Moreover, reconstructed occlusion was performed to evaluate occlusal trauma for visualization using Brux Checker (BC) analysis before and after active orthodontic treatment. The patient acquired stable anterior guidance and a functional occlusal relationship. BC findings revealed weakening of the functional contact between the lateral occlusal force of the dentition and the front teeth and alveolar bone regeneration. The laminar dura became clearer, and the periodontal tissue improved. Our results suggest that assessment of occlusion function using BC analysis and periodontal examination was effective in enabling occlusal treatment goal clarification through orthodontic treatment in case of periodontal disease associated with occlusal trauma.


2021 ◽  
pp. 194338752110276
Author(s):  
Atilla Gül ◽  
Stephen T. H. Tjoa ◽  
Jan P. de Gijt ◽  
Justin T. van der Tas ◽  
Hadi Sutedja ◽  
...  

The main objective of this study was to provide an overview of the current practice for transverse mandibular and maxillary discrepancies in the Netherlands using a web-based survey. Orthodontists (ORTHO) and Oral and Maxillofacial Surgeons (OMFS) in the Netherlands were invited to the web-based survey via their professional association. Three cases were presented which could be treated non-surgically and surgically. Participants were asked what treatment they preferred: no treatment, orthodontic treatment with optional extractions or surgically assisted orthodontic treatment. The web-based survey ended with questions on various technical aspects and any experienced complication. Invitation was sent to all 303 members of professional association for ORTHO and to all 379 members of professional association for OMFS. Overall response number was 276 (response rate of 40.5%), including 127 incomplete responses. Generally, ORTHO prefer orthodontic treatment with optional extractions and OMFS lean towards surgically assisted orthodontic treatment. Mandibular Midline Distraction appears to be less preferred, possibly due to lack of clinical experience or knowledge by both professions despite being proven clinical stable surgical technique with stable long-term outcomes. There seems to be consensus on technical aspects by both professions, however, there are various thoughts on duration of consolidation period. Complications are mostly minor and manageable.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Johanna Schlein ◽  
Paul Simon ◽  
Gregor Wollenek ◽  
Eva Base ◽  
Günther Laufer ◽  
...  

Abstract Background The choice of aortic valve replacement needs to be decided in an interdisciplinary approach and together with the patients and their families regarding the need for re-operation and risks accompanying anticoagulation. We report long-term outcomes after different AVR options. Methods A chart review of patients aged < 18 years at time of surgery, who had undergone AVR from May 1985 until April 2020 was conducted. Contraindications for Ross procedure, which is performed since 1991 at the center were reviewed in the observed non-Ross AVR cohort. The study endpoints were compared between the mechanical AVR and the biological AVR cohort. Results From May 1985 to April 2020 fifty-five patients received sixty AVRs: 33 mechanical AVRs and 27 biological AVRs. In over half of the fifty-three AVRs performed after 1991 (58.5%; 31/53) a contraindication for Ross procedure was present. Early mortality was 5% (3/60). All early deaths occurred in patients aged < 1 year at time of surgery. Two late deaths occurred and survival was 94.5% ± 3.1% at 10 years and 86.4% ± 6.2% at 30 years. Freedom from aortic valve re-operation was higher (p < 0.001) in the mechanical AVR than in the biological AVR cohort with 95.2% ± 4.6% and 33.6% ± 13.4% freedom from re-operation at 10 years respectively. Conclusions Re-operation was less frequent in the mechanical AVR cohort than in the biological AVR cohort. For mechanical AVR, the risk for thromboembolic and bleeding events was considerable with a composite linearized event rate per valve-year of 3.2%.


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