A study on factors associated with pathologic tooth migration

Abstract The purpose of this cross-sectional epidemiological study was to determine the prevalence of pathologic tooth migration (PTM) among periodontal patients and to investigate the relationship and degree of association between PTM and the following factors: bone loss, tooth loss, gingival inflammation according to the gingival index, age, lingual interposition, parafunctions and oral habits. 852 periodontal patients (36.7% male, 63.3% female) whose ages ranged from 19 to 72 years (mean 42.5± 9.9) were studied. PTM was defined as the presence of a developing diastema in the upper anterior sextant, which was not present in the past or already existed but increased. Statistical analysis was performed using the Wald test and the Mantel-Haenszel test. Estimates odds ratio were also calculated to assess increased PTM probability as a function of a single variable, or a combination of several. PTM prevalence of 55.8% was found, and it was statistically associated with bone loss (P<0.001), tooth loss (p<0.001) and gingival inflammation (p<0.001), while no association was observed with the remaining variables. The odds ratio indicated that PTM probability increased between 2.95 to 7.97 times as bone loss increased. For tooth loss this probability increased 2.76 times when no tooth loss was compared to 4 or more teeth lost. Likewise the probability increased 2.23 times when the gingival index was above 2. According to the single effect as well as the combined effect of these 3 main factors, it was concluded that: (1) no single factor by itself is clearly associated with PTM: (2) the factor mainly related to PTM is bone loss, followed by tooth loss and gingival inflammation: (3) as bone loss increases, the association of additional factors with PTM, such as tooth loss and gingival inflammation, increases.     

Interdisciplinary treatment of a patient with severe pathologic tooth migration caused by localized aggressive periodontitis.

An interdisciplinary approach was used to treat a patient with pathologic migration of teeth, with severe anterior proclination and molar mesial inclination due to localized aggressive periodontitis. The combination of regenerative periodontal therapy, prosthodontic rehabilitation, and orthodontic treatment greatly improved function and esthetics.     

A single visit, multidisciplinary approach to the management of traumatic tooth crown fracture

An immediate restorative technique resolving the acute problem of traumatic tooth fracture with pulpal and periodontal involvement, in which the fragment(s) are re-alignable. Repositioning facilitated by a custom stent, using dentine/enamel bonding. A challenging, conservative and economically viable procedure within the compass of a single visit.     

Managing the maxillary partially edentulous patient with extensive anterior tooth loss and advanced periodontal disease using a removable partial denture: a clinical report

The treatment modality, a continuous occlusal rest removable partial denture, not only restored missing teeth but also stabilized the remaining dentition in a patient with advanced periodontal attachment loss. By engaging the guiding planes at the mesial surfaces of the abutments anteriorly and also the distal surfaces of the abutments posteriorly, the remaining teeth, with varying amounts of mobility, were splinted together by the framework. This conservative treatment option allows flexibility for easy repair during the life span of the prosthesis.     

Spontaneous correction of pathologic tooth migration and reduced infrabony pockets following nonsurgical periodontal therapy: a case report

This case report describes the spontaneous correction of pathologic tooth migration and reduced infrabony pockets after nonsurgical periodontal therapy. A 3-mm diastema between the maxillary incisors was closed completely, and the mandibular teeth, which had migrated pathologically, returned to the optimal position. Clinical evaluation showed a significant reduction in probing depth, with increased clinical attachment and bone deposition demonstrated radiologically.     

Immediately loaded fixed maxillary implant treatment for a patient with advanced periodontal disease: a clinical report

Patients with a failing maxillary dentition typically require an extended treatment sequence that involves extractions, interim prosthesis wear, grafting and subsequent implant placement, and restoration with an implant-supported fixed or bar-retained prosthesis. Established maxillary implant protocols can take up to 15 or more months to complete. The purpose of this report is to describe a treatment sequence using zygomatic implants in a patient with advanced periodontal disease. A fixed prosthesis was fabricated without grafting, resulting in a shortened treatment time.     

高强纤维牙周夹板配合牙得安牙粉治疗老年中重度牙周病疗效分析

目的:观察牙周基础治疗术后高强纤维牙周夹板固定松动患牙以及牙得安牙粉在维护期内控制老年中重度牙周炎的临床效果。方法:将55例中重度牙周炎患者随机分成实验组27例、对照组28例。实验组为基础治疗后高强纤维牙周夹板固定松动患牙,维护期用牙得安牙粉作日常口腔护理;对照组为基础治疗后尼龙丝牙周夹板固定松动患牙,维护期用普通牙膏作日常口腔护理。观察术前、维护期1个月、6个月牙周指标(PLI SBI PD)的变化和临床疗效以及高强纤维牙周夹板在术后6个月、12个月的松动情况。结果:实验组术前牙周指标与术后1个月、6个月差异有统计学意义(p<0.05);对照组术前牙周指标与术后6个月差异有统计学意义(p<0.05);两组术后1个月的牙周指标相比差异无统计学意义(p>0.05)。两组术后1个月疗效比较无统计学意义(p>0.05)、术后6个月疗效比较有统计学意义(p<0.05)。两种牙周夹板术后6个月均无一例松动、12个月实验组有2例松动,对照组有6例松动,两种夹板的有效率存在显著差异(p<0.05)。结论:牙得安牙粉用于牙周基础治疗术后,其控制牙周炎效果良好。高强纤维牙周夹板用于中重度牙周炎松牙固定疗效确切。     

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提要：牙齿松动是牙周病主要的临床症状之一。如何治疗松动牙、防止牙周炎进行性加重、尽可能地保存牙齿、促进牙周组织的重建再生,是牙周科医生致力于解决的主要问题。经牙周基础治疗、去除危险因素、消除牙周组织炎症并建立平衡牙合后,多数患牙的松动度可不同程度减轻。而松动度较大的患牙经牙周治疗也很难恢复正常,并影响咀嚼功能,产生继发性牙合创伤,使得牙周组织破坏、吸收加剧。对动度较大的松动牙进行固定,消除其创伤,减轻牙合力负担,使之行使正常咬合功能,牙周膜接受功能性刺激,从而促进牙周组织的修复和愈合。因此,松牙固定是牙周治疗的必要措施。牙周炎的松牙固定是将单根或多根患牙与健康牙通过夹板连接成一个稳固的“多根牙”,建立起一个新的咀嚼单位。本文对牙周病的松动牙固定、各类牙周夹板在临床上的使用及夹板固定技术做一介绍。     

A multidisciplinary approach for the management of hypodontia: case report

Hypodontia is the congenital absence of one or more teeth and may affect permanent teeth. Several options are indicated to treat hypodontia, including the maintenance of primary teeth or space redistribution for restorative treatment with partial adhesive bridges, tooth transplantation, and implants. However, a multidisciplinary approach is the most important requirement for the ideal treatment of hypodontia. This paper describes a multidisciplinary treatment plan for congenitally missing permanent mandibular second premolars involving orthodontics, implantology and prosthodontic specialties.     

A rationale for the management of advanced tooth wear (ATW)

An approach to the treatment of patients with significant loss of tooth tissue is presented. Alternative treatment modes are discussed and the possible outcome of treatment considered. Guidelines are offered for the management of such cases including a flow-chart concerning the use of temporary appliances.