Osseo-integrated implant treatment of a patient with rapidly progressive periodontitis. A case report

The case report presented describes placement of osseointegrated fixtures in a patient with a probable history of rapidly progressive periodontitis. A 12-year history is presented. The post-operative sequelae of placing fixtures in a fully edentulous maxilla and partially edentulous mandible were the worst seen by the Implant Team at Emory University. The hypothesis presented is that patients with aggressive forms of periodontal disease should be subjected to appropriate mechanical and antimicrobial therapy to produce a healthy oral flora before any implants are placed.     

Intra-familial transmission and distribution of Prevotella intermedia and Prevotella nigrescens

The periodontal bacteria Prevotella intermedia and Prevotella nigrescens have been recently separated from each other. The purpose of this study was to investigate the distribution and routes of transmission of these bacteria among family members. Seven patients with moderate to severe periodontitis were selected. These probands, their spouses and 14 of their children were investigated. The presence of Pr. Intermedia and Pr. nigrescens was determined by culture techniques in pooled subgingival plaque samples, in the saliva, on the tongue, tonsils and buccal mucosa. Differentiation of Pr. intermedia and Pr. nigrescens was performed by enzyme electrophoretic mobility. From all 7 patients, as well as 4 spouses and 3 of the children, Pr. intermedia could be isolated. Pr. Nigrescens was found in 2 of the 7 patients, in 5 of the spouses and in 5 of the 6 children aged 5–10 yr. In the 8 children aged 0–4 yr both species were seldom isolated. These data are in accordance with earlier findings that Pr. Intermedia is associated with periodontitis and Pr. Nigrescens with a relatively healthy periodontal condition. Ribotyping of bacteria was performed by hybridization of Hindlll restriction endonuclease digests of chromosomal DNA with ribosomal DNA. Isolates from unrelated individuals always had distinct ribotypes. Indistinguishable ribotypes of Pr. intermedia and Pr. Nigrescens were found both among married couples and among parents and children. This indicates that intrafamilial transmission of Pr. intermedia and Pr. Nigrescens is possible both between adults and between parents and children.     

Java project on periodontal diseases: the relationship between vitamin C and the severity of periodontitis

OBJECTIVE: To study the relationship between vitamin C and the severity of periodontitis. MATERIAL AND METHODS: The study population consisted of subjects from the Malabar/Purbasari tea estate on West Java, Indonesia. In 2002, clinical measurements were performed in 128 subjects, including evaluation of plaque, bleeding on probing, pocket depth and attachment loss. In 2005, 123 out of 128 subjects could be retrieved who were present at the examination of 2002. Blood samples were taken to measure plasma vitamin C levels. Information about the subject's dietary habit was obtained by means of a personal interview guided by a questionnaire. RESULTS: Plasma levels of vitamin C ranged from 0.02 to 34.45 mg/l with a mean of 7.90 mg/l (+/-5.35). The correlation coefficient between plasma vitamin C level and periodontal attachment loss was -0.199 (p<0.05); stepwise linear regression revealed that vitamin C levels explained 3.9% of the variance in periodontal attachment loss. Subjects with vitamin C deficiency (14.7% of the study population) had more attachment loss compared with those with depletion or normal plasma vitamin C values. CONCLUSION: The negative association between plasma vitamin C levels and periodontal attachment loss suggests that vitamin C deficiency may contribute to the severity of periodontal breakdown.     

Genetic studies of syndromes with severe periodontitis and palmoplantar hyperkeratosis

The Papillon-Lefevre and Haim Munk syndromes are characterized by the presence of both palmoplantar hyperkeratosis (PPK) and severe early onset periodontitis. It is the early onset periodontal disease component that distinguishes these from other more common forms of PPK. It has been proposed that the periodontal disease component may be a casual association in individuals with PPK. Genetic syndromes with palmoplantar keratosis and severe early onset periodontitis may be due to specific bacterial infections in individuals with PPK. Recently, keratin gene mutations have been identified in several conditions typified by palmoplantar keratosis. The present study sought to test the hypothesis that a keratin gene defect similar to those previously identified in other PPK conditions is responsible for the Haim Munk and the Papillon-Lefevre syndromes. We have performed genetic linkage studies to test for linkage between polymorphic DNA loci within 2 cytokeratin gene families and the disease phenotype in Haim Munk syndrome and Papillon-Lefevre syndrome. Families with individuals segregating for the Haim Munk syndrome and the Papillon-Lefevre syndrome were examined to determine disease status, and genotyped for microsatellite DNA markers closely linked to the acidic (type I) and the basic (type II) cytokeratin genes on chromosomes 12 and 17. Genotype data were evaluated for microsatellite allele homozygosity in affected individuals. Results of these preliminary genetic studies suggest that the gene defect in Haim Munk syndrome is not due to a gene defect in either the type I or the type II keratin gene clusters. These findings suggest that Haim Munk syndrome may be genetically distinct from other more common forms of PPK that have been linked to the cytokeratin gene families, and suggest that mutations in genes other than keratin genes are responsible. Additional family studies are needed to confirm these preliminary findings.     

Dermatography, a treatment for sequelae after head and neck surgery: a case report.

Two patients with discolouration fo skin grafts after head and neck surgery, were treated with dermatography, a refined method of tattooing, and with intra-cicatricial keloidectomy, of which the results are described.     

Bonding to ground versus unground enamel in fluorosed teeth.

OBJECTIVES: To determine the effect of grinding on the bonding effectiveness of a self-etch and an etch-and-rinse adhesive to fluorosed enamel. METHODS: The teeth were classified using the Thylstrup and Fejerskov index (TFI). Fluorosed teeth (TFI=5) obtained from Isparta (Turkey) and control teeth (TFI=0) obtained from Leuven (Belgium) were used. Using a depth-marking diamond bur, 0.3mm of enamel was removed from mid-buccal and mid-palatal/lingual surfaces of the teeth, whereas the area adjacent to the ground area was left unprepared. A two-step self-etch (Clearfil Protect Bond, Kuraray) and a three-step etch-and-rinse adhesive (Optibond FL, Kerr) were used to bond the resin composite to the ground and unground enamel. Rectangular micro-specimens were prepared using the slow-speed diamond saw and tested in tensile to determine the micro-tensile bond strength (microTBS). RESULTS: The microTBS to unground fluorosed enamel was significantly lower than to ground fluorosed enamel for Clearfil Protect Bond (15.8+/-15.2 and 45.0+/-12.4MPa, p<0.0001) and for Optibond FL (35.5+/-21.4 and 50.5+/-12.3MPa, p<0.05), respectively. In control teeth, Clearfil Protect Bond bonded better to ground enamel (p<0.01), whereas OptiBond FL exhibited a similar bonding effectiveness to ground and unground enamel (p=0.0634). SIGNIFICANCE: Preparation of enamel improved the resin-enamel bond strength in fluorosed teeth. The bonding effectiveness to unground enamel was lower in fluorosed teeth than in control teeth for the self-etch adhesive tested.     

Levels of mutans streptococci and lactobacilli in plaque on aged restorations of an ion-releasing and a universal hybrid composite resin

The purpose of this in vivo study was to evaluate the cariogenic microflora of plaque on aged restorations of a hydroxyl, fluoride, and calcium ion-releasing composite resin (IRCR) (Ariston pHc), and to compare it intra-individually with a universal hybrid composite resin and enamel. Each of 19 subjects received one proximal restoration of the IRCR, one proximal universal hybrid composite resin restoration (CR) and each subject had one non-filled proximal enamel control surface to make intra-individual comparisons possible. To avoid peak ion releases from the materials, aged restorations were studied. Plaque was collected from 57 surfaces using sterile applicator tips. Samples were cultured to determine the numbers of mutans streptococci, lactobacilli, and total microorganisms. The relative numbers for mutans streptococci (% of total bacteria) were: IRCR 0.59%, CR 0.40%, enamel 0.22%. Two outliers were found in the IRCR group. Excluding these outliers resulted in a relative number of 0.33%. Lactobacilli were detected in the plaque from only 9 surfaces and at very low relative proportions for all three surfaces: 0.01%. The enamel surfaces showed the lowest relative numbers of mutans streptococci and lactobacilli, but the differences were not significant. It can be concluded that the ion release of the IRCR did not influence the growth of cariogenic microorganisms in dental plaque.     

Squamous cell carcinoma arising in the lining of odontogenic cysts. Report of 5 cases

The lining of odontogenic cysts seldom gives rise to the development of a carcinoma. In a review of the literature by Gardner in 1975, 25 cases were accepted as such. In the present paper, 5 new cases are reported. These cases were encountered during a 14-year-period in which 292 oral carcinomas were registered, emphasizing the rarity of carcinomas arising from odontogenic cysts.     

Studies of the oxidation of a hydroxychromium(III)-[hydrotrispyrazoylborate]pyrazolyl complex

The oxidation of the Cr^III hydroxy complex, Tp^tBu,MeCr(pz^′)(OH), 1, (Tp^tBu,Me=hydrotris(3-tert-butyl-5-methylpyrazolyl)borate; pz^′=3-tert-butyl-5-methylpyrazolyl anion) was studied in methylene chloride at a glassy carbon electrode. There are two oxidation peaks, Ia and IIa, that are totally irreversible and Cr^IV oxo complex 2 is the product at both peaks. Peak Ia grows with respect to IIa as the scan rate is reduced and the voltammograms were quantitatively accounted for by a CE_irr mechanism involving two interconverting forms of 1, 1a giving peak Ia and 1b giving peak IIa. The reduction of 2 is detected on the return scan along with a small amount of 3 that arises from hydrogen-atom abstraction by 2 from hydrogen-atom donors in the medium. The processes giving rise to peaks Ia and IIa have the characteristics of dissociative electron- transfer reactions. It is suggested that they may be concerted electron-proton transfer reactions. It is speculated that the postulated minor form of 1, 1a, may be an isomer having axial OH rather than the equatorial OH found in the favored isomer, 1b.