Periodontal status of teeth facing extraction sites long-term after orthodontic treatment

The present study was undertaken to examine the long-term periodontal status of teeth orthodontically moved into extraction sites. Patients were examined 14 to 34 years after active orthodontic treatment involving extraction of four first premolars. Three groups were established: one with closed tooth contacts and parallel adjacent teeth, one with closed tooth contacts and tipped adjacent teeth, and one with open contacts between adjacent teeth. Within each group accumulation of plaque, gingival health status, probing pocket depth, and probing attachment level of interproximal tooth surfaces, facing extraction sites and adjacent control sites between canine and lateral incisor were compared. Significantly more probing attachment loss was found in extraction sites with open tooth contacts (P less than 0.01) and with parallel adjacent teeth and closed tooth contacts (P less than 0.05) than in control sites. However, the mean differences were less than 0.5 mm, which may not be considered clinically significant. Tipping of teeth into the extraction sites had no long-term detrimental effect on the probing attachment level. No differences in accumulation of plaque and in gingival health status were observed.     

Periodontal status of neighboring teeth after orthodontic closure of mandibular extraction sites

abstract — The gingival health, pocket depth and loss of fiber attachment of the mandibular first molars and first premolars were studied by clinical and radiographic methods after the embedded second premolar had been surgically removed on one side and extracted after eruption on the other, and the spaces had been closed orthodontically. Twenty-nine children participated in the study. Their mean age at the time of tooth removal was 11 years 3 months. The mean duration of the treatment was 20 months, and the children were examined 1 1/2 to 2 years after removal of the bands. The gingival status was generally similar on both sides. Some constriction of the alveolar process was observed in more than half the cases, both after extraction and after surgical removal. The loss of attachment on the buccal and lingual surfaces was approximately the same in both groups, whereas the radiographic distance from the cementoenamel junction to the bone margin on the proximal surfaces adjacent to the removed tooth was somewhat greater after extraction than after surgical removal.     

Long-term periodontal status after orthodontic treatment

This study evaluated the clinical periodontal status of persons who had completed orthodontic therapy at least 10 years previously (study) and compared the findings to those of adults with untreated malocclusions (control). Subjects in the study (n = 112; 63 female subjects, 49 male subjects; mean age 29.3 +/- 4.2 [SD] years) and control (n = 111; 62 female subjects, 49 male subjects; mean age 32.9 +/- 6.5 years) populations underwent a comprehensive periodontal examination that consisted of measurements taken at six points around the circumference of each tooth: (1) plaque, (2) visual inflammation, (3) bleeding after probing, (4) pocket depth, (5) gingival recession, and (6) loss of connective tissue attachment. Data from the individual measuring points were organized into 14 different combinations of either tooth types or surface locations; each was subjected to a four-way ANOVA partitioned on group (study vs. control), sex, socioeconomic status, and malocclusion type. The results showed that differences in age distribution within the groups were affecting the comparisons between the groups. Consequently, the groups were balanced for age and analyses were done to investigate group differences by means of multiple regression techniques. The comparisons showed no significant differences between the groups for any of the periodontal variables. It was concluded that orthodontic treatment during adolescence had no discernible effect upon later periodontal health.     

The clinical effectiveness of implants placed immediately into fresh extraction sites of molar teeth

BACKGROUND: Studies concerning immediate implantation describe its use in the anterior and premolar regions. However, its clinical effectiveness in immediately replacing molar teeth has rarely been challenged. The purpose of this study was to evaluate the survival rate of implants placed immediately after extraction of molar teeth to support a fixed ceramo-metal prosthesis. METHODS: From 1989 to 1996, 56 immediate implants were placed in 43 patients following extraction of 51 molars; 46 molars were replaced by 1 implant and 5 molars replaced by 2 implants. All implants were restored with fixed prostheses (4 single crowns and 52 splinted). Mean follow-up period was 15 months (range, 4 to 60 months). The influence of the following parameters on implant failure was evaluated: gender, arch, smoking, pre-extraction vertical bone loss, implant length, and severity of complications between the two stages of surgery. RESULTS: The 5-year cumulative survival rate (5-year CSR) was 89%. The 5-year CSR among men was 84% compared to 93.5% among women. The maxillary 5-year CSR was 82% and the mandibular 92%. Among non-smokers (50 implants), the 5-year CSR was 90% compared to 83% among smokers (6 implants). Complications were evident in 8 (6 minor, 2 major) out of 50 non-failing implants compared to 2 (minor) of the 6 failing implants. No differences were evident in the other study variables. CONCLUSIONS: Immediate implantation in the molar region is an alternative, predictable surgical treatment. Immediate implantation in the posterior mandible has a better prognosis than in the posterior maxilla.     

Periodontal conditions of teeth adjacent to extraction sites

The purpose of the present clinical study was to evaluate the effect of tooth extractions on the periodontal conditions of adjacent teeth. 40 patients were selected for the study. Prior to the extractions, baseline data of the adjacent teeth were obtained. Plaque (PII) and gingival indices (GI), pocket probing depths and probing attachment levels were scored. In addition, the alveolar bone height was determined radiographically in relation to the CEJ adjacent to the extraction sites. The contralateral side of the jaw, where no tooth had to be removed, was examined as a control. A limited hygienic phase (scaling and root planing of all surfaces examined) was performed immediately prior to the extractions. Using the same parameters, all sites were reexamined 2-4 months and 6-9 months following the extractions. After the hygienic phase, the teeth adjacent to the extraction sites indicated a decrease in the pocket probing depths by 0.5 to 1.5 mm. In shallow pockets (1-3 mm), this decrease was less pronounced than in moderate to deep pockets (4-9 mm), where it was composed of shrinkage of the gingival tissues and gain of probing attachment. The radiographic level of the bony alveolar crest in relation to the CEJ of the adjacent teeth was not altered by the extraction procedure. The oral hygiene performances of the patients were not influenced during the 9-month observation period. Therefore, neither PII nor GI scores showed relevant improvements.(ABSTRACT TRUNCATED AT 250 WORDS)     

组织工程修复及不同加力时间点对正畸移动牙牙周BMP 表达的影响

目的:了解组织工程修复及不同加力时间点对正畸移动牙牙周骨形成蛋白BMP表达的影响。方法:应用牙颈部结扎、高糖高粘饮食配合牙石植入法建立角形缺损慢性牙周炎新西兰大白兔动物模型,并随机分成两组:20 d加力组、40 d加力组;使用壳聚糖磷酸钙/PRP/骨髓基质干细胞复合物组织工程材料结合GTR技术修复牙槽骨缺损;分别于修复术后20 d和40 d开始正畸加力。另设正常牙周对照组,以相同条件正畸加力。加力30 d后处死实验动物,使用LSAB免疫组化法及图像分析仪对各组进行牙周BMP分布灰度测量分析。结果:20 d加力组BMP平均灰度值为4.522±0.057,40 d加力组为4.321±0.071,正常对照组为3.372±0.051,差异具有统计学意义。结论:组织工程修复术后正畸移动牙的牙周BMP表达高于正常对照组,术后20 d加力组牙周BMP表达高于40 d加力组。     

Long-term periodontal status of labially erupted canines following orthodontic treatment

Periodontal status was studied at the mesiobuccal, midbuccal and distobuccal aspects of contralateral pairs of canines in 22 postorthodontic patients aged 30 to 51 years with a mean time of 26.4 years (SD, 5.6) out of active treatment. The pretreatment models showed one canine erupting severely to the labial ("ectopic") with a contralateral canine in good arch alignment (control). None of the patients experienced relapse of the "ectopic" canine in a labial direction, and none had missing teeth, malalignment, overhanging restorations or open tooth contacts adjacent to the canines evaluated. Periodontal parameters were examined using a Michigan #0 probe with Williams markings. A nonstandardized light force was used and the measurements were rounded to the nearest millimeter. The results demonstrated statistically significant differences between the canines in probing attachment and bone levels (mean, 0.75; SD, 0.92; P less than 0.01) and width of attached gingiva (mean, 0.50; SD, 1.07; p less than 0.05) at the midbuccal aspects. The reason for these differences could only be speculated upon.     

The use of six selected teeth in population measures of periodontal status

Selected teeth have been used to represent the entire dentition in many epidemiological and clinical investigations. The present study sought to assess the relationship between the six selected teeth described by Ramfjord and the entire dentition for the Plaque Index, Gingival Index, Calculus Index and Loss of Attachment. The computations were performed on measurements obtained in investigations of the natural history of periodontal disease in Norway and Sri Lanka. A consistently strong correlation was observed between the tooth subset and whole mouth for all indices in both populations. This relationship persisted even though single members or pairs of the subset of teeth were removed from the calculations. Some bias, however, was observed with all indices. Plaque and gingival indices obtained from the six teeth underestimated whole mouth scores in the low range (less than 1.0) and overestimated scores in the high range (greater than 2.0). Use of the tooth subset for calculus and loss of attachment consistently overestimated scores for the entire dentition.     

Placement of endosseous implants into tooth extraction sites

This study reports 4-year experiences with placement of hydroxylapatite-coated dental implants into extraction sites immediately after tooth extraction. Small defects present after implant placement were treated with dense, nonresorbable hydroxylapatite. Larger defects present after implant placement were treated with demineralized bone. Indications and contraindications for placement, as well as surgical techniques, are discussed.     

Mandibular second molar periodontal status after third molar extraction.

BACKGROUND: Extraction and treatment of third molars have been cited as causing periodontal problems. To evaluate the long-term effects of third molar extraction on the periodontal health of the mandibular second molar, a comparison of the periodontal status was performed around 2 groups of mandibular second molars, with and without third molar extraction. METHODS: A total of 312 sites in 57 adult periodontitis patients were examined and the buccal and lingual locations of the mesial and distal root surfaces around the second molars were recorded. Two-hundred and thirty-two sites were experimental teeth; i.e., third molars had been surgically removed more than 5 years ago, 80 sites served as control molars; i.e., congenitally missing third molars. Clinical periodontal parameters including probing depth, attachment loss, and gingival recession and radiographic intrabony level were measured. The effects of the surgery and the examination (buccal or lingual) locations on the measurements were statistically analyzed. RESULTS: Neither extraction history nor examination location affected the probing depth on mesial surfaces. However, significant effects of the surgical history on the probing depth were observed on the distal surfaces. Similar results of greater attachment loss and radiographic alveolar bone loss were observed only at the distal sites of the experimental group. In addition, the increased radiographic bone loss was only found at the distal sites (adjacent to the surgical location) and not at the mesial sites (distant from the surgical location) on the experimental group. CONCLUSIONS: In this study, greater periodontal breakdown, including probing depth, attachment loss, and radiographic alveolar bone loss, was found at the distal sites, but not at the mesial sites, of the experimental molars where the third molar was surgically extracted compared with the control teeth (no surgery). In the experimental molars, more radiographic bone loss was found at the sites adjacent to the surgical location than at the sites distant to the surgical location. Therefore, we suggest that the surgical removal of the mandibular third molar may lead to a periodontal breakdown on the distal surface of the second molar. Periodontal re-evaluation after the initial healing of third molar extraction is indicated.     

In vitro determination of the forceps level for extraction of teeth for periodontal reasons

Abstract The aim of the present study was to validate dentists' periodontal reasons for extraction by comparison with the in vitro periodontal status of extracted teeth. A national systematic random sample of Norwegian dentists (n= 500) was requested to record primary, secondary and tertiary reasons for tooth extraction for a period of 2 weeks in 1988. The response rate was 70%. The extracted permanent teeth from the first 2 patients of each dentist were collected. Of the 365 teeth, 329 satisfied the criteria for assessment of periodontal attachment after staining. Using a dissecting microscope (10 ×), 4 to 8 linear measurements were recorded per tooth. 159 of the 329 teeth had loss of periodontal support. Of the 93 teeth for which the dentists' reason for extraction included periodontal considerations, 1% had 1–10% loss of attachment, 59% had 11-50% loss and 40% had 51–76% loss of periodontal support. There was a significant correlation between in vitro measurements of attachment loss and a ranking of teeth on a scale from 1 to 3 based on the dentists' emphasis on periodontal reasons for extraction (The Spearman Rs = 0.29, p<0.01). The results suggest that the forceps level for removal of teeth for periodontal reasons was set at a relatively early stage of the disease process by Norwegian dentists, and that there was a weak association between attachment loss and the dentists' emphasis on periodontal reasons for extraction.     

Long-term effect of mandibular midline distraction osteogenesis on the status of the temporomandibular joint, teeth, periodontal structures, and neurosensory function

Purpose: This study retrospectively evaluated the long-term effects of transverse symphyseal distraction osteogenesis (DO) on the temporomandibular joint (TMJ) symptoms, periodontal health, tooth vitality, and nerve injury after surgery.Patients and Methods: Twenty-three patients were treated with symphyseal DO during a 4-year period. Fifteen patients were available for follow-up from 7 to 45 months postoperatively (ave, 24.5 months). The patients were clinically evaluated for TMJ symptoms, periodontal pocket formation, tooth vitality and mobility, crestal bone loss, and attached gingival tissue changes. Radiographs of the mandibular anterior teeth were used to evaluate for periodontal bone loss, periapical lesions, or widening of the periodontal ligament (PDL).Results: Preoperatively, 47% of the patients had TMJ symptoms. No patient had symptom worsening or developed new symptoms postoperatively. Five patients' TMJ symptoms improved, and 3 experienced complete resolution of symptoms. No periodontal bone loss or soft tissue recession were evident. Tooth vitality was maintained in 13 patients. Two patients developed Class II mobility of 1 mandibular central incisor, 1 patient had tooth pain and a widened PDL adjacent to the osteotomy/corticotomy site, and 1 patient experienced mental nerve paresthesia.Conclusions: DO can be used to treat transverse discrepancies of the mandible with limited morbidity.     

Surface-specific effect of a mineralizing agent on the permanent teeth and on periodontal status

In a two-year clinical trial the surface-specific effect of a mineralizing agent on selected permanent teeth was evaluated as well as the effect of this agent on periodontal health in children. Compared with positive controls (Control group, n = 123, biweekly mouthrinsing with placebo and 0.2% NaF solutions), among children in the test group (n = 123, biweekly mouthrinsing with 2% Remodent and 0.2% NaF solutions) the mineralizing agent clearly affected periodontal health (as determined by the prevalence of subjects with gingival bleeding and occurrence of affected sextants at risk) positively, in addition to having a positive effect on the incidence of EFD lesions. The mineralizing agent tested was not found to have adverse effects (as determined by the prevalence of subjects with dental calculus and occurrence of affected sextants at risk). Use of the mineralizing agent is recommended especially during posteruptive maturation of permanent teeth.     

Effects of furcation involvements on periodontal status and healing in adjacent proximal sites

BACKGROUND: In a recent study it was found that following non-surgical treatment, probing depth (PD) reduction in proximal sites is significantly less in the presence of a vertical destruction in the adjacent site of the neighboring tooth. The present investigation was undertaken to study whether the presence of a proximal furcation involvement also influences the periodontal conditions in the adjacent site of the neighboring tooth. METHODS: The investigation was conducted as a retrospective study on a consecutive referral population based on full-mouth oral radiographic examinations and PD and plaque score registrations. The statistical analyses were performed on a final sample of 136 patients, with 153 (periodontal status) and 123 (periodontal healing) second maxillary premolars with an adjacent first maxillary molar. RESULTS: Baseline pockets were significantly deeper, relative radiographic attachment levels significantly reduced, and periodontal PD significantly less reduced after non-surgical treatment in the distal sites of second maxillary premolars adjacent to first maxillary molars with a mesial furcation involvement of degree > or = 2, compared to distal sites adjacent to first maxillary molars with a mesial furcation involvement of degree < or = 1. CONCLUSIONS: Periodontal status and healing after non-surgical treatment in proximal sites are negatively influenced by the presence of a deep furcation involvement in the adjacent site in the same proximal space. The presence of a deep proximal furcation involvement should consequently be considered a risk factor for the adjacent site of the neighboring tooth.