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Păunica S, Giurgiu MC, Ciongaru DN, Pădure CE, Albu ȘD, Pițuru SM, Dumitriu AS. Clinical Aspects and Therapeutic Management of an Aggressive Manifestation of Stage III Grade C Periodontitis in a Female Teenager. Diagnostics (Basel) 2023; 13:diagnostics13061077. [PMID: 36980384 PMCID: PMC10047784 DOI: 10.3390/diagnostics13061077] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/27/2023] [Accepted: 03/09/2023] [Indexed: 03/16/2023] Open
Abstract
The main objective of this study was to evaluate the improvement of periodontal health in patients with periodontitis treated with non-surgical periodontal therapy and subgingival-administrated local and systemic antimicrobial agents. A female teenager with periodontitis-associated health issues and a history of dental trauma was selected for this study. Clinical indices were obtained, and radiographic examination was performed at the beginning of the study. The patient was treated with periodontal therapy and administration of antibiotics. After this therapy, visits were scheduled at regular intervals to observe the clinical changes. Non-surgical periodontal therapy and administration of local and systemic antibiotics resulted in a reduction in the patient pocket depth probing, plaque index, and bleeding on probing. Gingival and periodontal health improved in terms of gingival overgrowth, plaque, tartar index, and tooth mobility. Suppuration was eliminated, and no gingival inflammation signs were observed.
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Affiliation(s)
- Stana Păunica
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (S.P.); (Ș.D.A.); (A.S.D.)
| | - Marina-Cristina Giurgiu
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (S.P.); (Ș.D.A.); (A.S.D.)
- Correspondence: (M.-C.G.); (D.N.C.)
| | - Dragoș Nicolae Ciongaru
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (S.P.); (Ș.D.A.); (A.S.D.)
- Correspondence: (M.-C.G.); (D.N.C.)
| | - Cristiana-Elena Pădure
- Doctoral School, Faculty of Dental Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania;
| | - Ștefan Dimitrie Albu
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (S.P.); (Ș.D.A.); (A.S.D.)
| | - Silviu-Mirel Pițuru
- Department of Professional Organization and Medical Legislation-Malpractice, Faculty of Dental Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania;
| | - Anca Silvia Dumitriu
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (S.P.); (Ș.D.A.); (A.S.D.)
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Lee HN, Chen PH, Huang CY, Chen CM, Jeng JH, Chen YK, Chuang FH. Efficacy assessment of laser Doppler imager in diagnosing the pulp vitality after dental trauma. J Dent Sci 2022; 18:618-625. [PMID: 37021222 PMCID: PMC10068390 DOI: 10.1016/j.jds.2022.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
Background/purpose This is the first paper evaluating the efficacy of laser Doppler imager in diagnosis of pulpal vitality. The purpose of this study was to evaluate and compare the diagnostic benefits of laser Doppler imaging and electric pulp test (EPT) in dental trauma. Materials and methods Seven patients were selected for pulp vitality evaluation in Kaohsiung Medical University Hospital between 2018 and 2019. EPT and laser Doppler imager evaluation were performed for patients with traumatic injury to teeth. Statistical methods included the Kappa consistency test and the chi-square test. In addition, the receiver operating characteristic (ROC) curve, and the area under the curve (AUC) were used. Results There was a significant difference in Doppler flow values between the severe trauma group and the mild trauma group, regardless of patient self-reported symptoms (P = 0.043) or physicians' diagnostic classification (P = 0.018). For an EPT instrument, the Kappa coefficient was 0.67 and 1-year pulpal status findings were highly consistent (P < 0.001). Using a Doppler instrument, the Kappa coefficient was 0.85. According to the ROC curve, the AUC for EPT was 0.94, the AUC for Doppler was 1, and the optimal cut-off value was 31.55, indicating that both were superior diagnostic tools. Conclusion Both laser Doppler imager and EPT can be used as tools for diagnosing traumatic pulp necrosis. Doppler imaging instruments allow for a more timely and accurate assessment of pulp vitality in dental trauma. In the future, ongoing research and related training are necessary for interpretation of Doppler data.
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Affiliation(s)
- Hui-Na Lee
- Division of Endodontics and Operative Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ping-Ho Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Yin Huang
- Department of Nuclear Medicine, E-DA Hospital, Kaohsiung, Taiwan
| | - Chun-Ming Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jiiang-Huei Jeng
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Dentistry, National Taiwan University Medical College, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yuk-Kwan Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Oral Pathology & Maxillofacial Radiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Oral & Maxillofacial Imaging Center, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Fu-Hsiung Chuang
- Division of Endodontics and Operative Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Corresponding author. No. 100, Shih-Chuan 1st Road, Kaohsiung 807378, Taiwan.
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Pedrini D, Panzarini SR, Tiveron ARF, Abreu VMD, Sonoda CK, Poi WR, Brandini DA. Evaluation of cases of concussion and subluxation in the permanent dentition: a retrospective study. J Appl Oral Sci 2018; 26:e20170287. [PMID: 29742251 PMCID: PMC5933832 DOI: 10.1590/1678-7757-2017-0287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 10/27/2017] [Indexed: 11/21/2022] Open
Abstract
Objectives This study evaluated the evolution of cases of concussion and subluxation through a retrospective study of 20 years. Material and Methods Were examined clinical and radiographic records of 1,309 patients who underwent treatment of dentoalveolar trauma in the discipline of Integrated Clinic of the School of Dentistry of Araçatuba, UNESP, of which we selected 137 whose patients had concussion and subluxation injuries, with average age of 23.3 (SD – 10.96). The variables collected were: gender, age, history of previous and actual trauma, treatments performed, the presence of necrotic pulp, and time elapsed until the same trauma. The concussion and subluxation groups were subjected to statistical analyses using the SPSS 16.0 version software (α=0.05), Chi-square, and t-tests. Results Of the 301 teeth involved, 49 (16.3%) suffered concussion and 252 (83.7%), subluxation, being the upper anterior teeth the most affected (75.1%) for both conditions. Subluxation and concussion traumas were more prevalent in men aged 10 to 20 years, most caused by cycling accidents (36.2%). There was a concomitant presence of crown fracture in 21% of cases of concussion and 34.7% of subluxation. Pulp necrosis was detected in 16.3% (concussion) and 27.1% (subluxation) (p=0.12), and most occurred within 6 months after the trauma (p=0.29). The pulp necrosis shows a positive correlation with motorcycle accidents (p=0.01), direct impact (p≤0.0001), crown fracture with pulp exposure (p≤0.0001), darkening of the crown (p=0.004) and spontaneous pain (p≤0.0001); and negative correlation with indirect impact (p≤0.0001). Conclusions Although concussion and subluxation traumas are considered of minor degrees, they must be monitored, since the possibility of pulp necrosis exists, and its early treatment favors a good prognosis.
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Amaral MF, Poi WR, Debortoli CVL, Panzarini SR, Brandini DA. The influence of traumatic occlusion on the repair process for teeth following subluxation. Dent Traumatol 2017; 33:245-254. [DOI: 10.1111/edt.12330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Marina Fuzette Amaral
- Surgery and Integrated Clinics; Faculdade de Odontologia; UNESP-Universidade Estadual Paulista, Araçatuba; Araçatuba São Paulo Brazil
| | - Wilson Roberto Poi
- Surgery and Integrated Clinics; Faculdade de Odontologia; UNESP-Universidade Estadual Paulista, Araçatuba; Araçatuba São Paulo Brazil
| | - Caio Vinicius Lourenço Debortoli
- Surgery and Integrated Clinics; Faculdade de Odontologia; UNESP-Universidade Estadual Paulista, Araçatuba; Araçatuba São Paulo Brazil
| | - Sônia Regina Panzarini
- Surgery and Integrated Clinics; Faculdade de Odontologia; UNESP-Universidade Estadual Paulista, Araçatuba; Araçatuba São Paulo Brazil
| | - Daniela Atili Brandini
- Surgery and Integrated Clinics; Faculdade de Odontologia; UNESP-Universidade Estadual Paulista, Araçatuba; Araçatuba São Paulo Brazil
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Affiliation(s)
- L Lim
- Consultant Oral and Maxillofacial Surgeon; Westmead Hospital; Westmead New South Wales Australia
| | - P Sirichai
- Department of Oral and Maxillofacial Surgery; Westmead Hospital; Westmead New South Wales Australia
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Herrera D, Alonso B, de Arriba L, Santa Cruz I, Serrano C, Sanz M. Acute periodontal lesions. Periodontol 2000 2015; 65:149-77. [PMID: 24738591 DOI: 10.1111/prd.12022] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2012] [Indexed: 11/30/2022]
Abstract
This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute disease is under control, definitive treatment should be provided, including appropriate therapy for the pre-existing gingivitis or periodontitis. Among other acute conditions affecting the periodontal tissues, but not caused by the microorganisms present in oral biofilms, infectious diseases, mucocutaneous diseases and traumatic or allergic lesions can be listed. In most cases, the gingival involvement is not severe; however, these conditions are common and may prompt an emergency dental visit. These conditions may have the appearance of an erythematous lesion, which is sometimes erosive. Erosive lesions may be the direct result of trauma or a consequence of the breaking of vesicles and bullae. A proper differential diagnosis is important for adequate management of the case.
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Busato MCA, Pereira ALP, Sonoda CK, Cuoghi OA, de Mendonça MR. Microscopic evaluation of induced tooth movement after subluxation trauma: an experimental study in rats. Dental Press J Orthod 2014; 19:92-9. [PMID: 24713565 PMCID: PMC4299411 DOI: 10.1590/2176-9451.19.1.092-099.oar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 06/28/2012] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The objective of this study was to assess the histological alterations that occurred in the periodontal area of rat molars submitted to induced tooth movement (ITM) right after an intentional trauma (subluxation). METHODS Forty adult male Wistar rats (Rattus norvegicus albinus) were selected. The animals were divided into eight groups (n=5), according to the combination of variables: Group 1--control (neither trauma nor ITM); Group 2--ITM; Groups 3, 4, 5 and 6--dentoalveolar trauma groups corresponding, respectively, to 1, 3, 8 and 10 days after trauma; Groups 7 and 8 - the animals' molars were subjected to a 900 cN impact and, one and three days after the trauma event, tooth movement was induced. The rats' maxillary first molars were mesially moved during seven days with a closed coil (50 cN). After the experimental period of each group, the animals were sacrificed by anesthetic overdose and the right maxillas were removed and processed for histological analysis under light microscopy. RESULTS In the animals of group 3, 4, 5 and 6, the histological alterations were not very significant. Consequently, the effect of induced tooth movement right after a subluxation event (groups 7 and 8) was very similar to those described for Group 2. CONCLUSIONS There was no difference in the quality of periodontal repair when ITM was applied to teeth that had suffered a subluxation trauma.
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Affiliation(s)
| | | | - Celso Koogi Sonoda
- Full professor, Department of Orthodontics, State University of
São Paulo (UNESP)
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Pedrini D, Panzarini SR, Poi WR, Sundefeld MLMM, Tiveron ARF. Dentists' level of knowledge of the treatment plans for periodontal ligament injuries after dentoalveolar trauma. Braz Oral Res 2011; 25:307-13. [DOI: 10.1590/s1806-83242011000400005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 05/27/2011] [Indexed: 11/22/2022] Open
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Influence of a Parafunctional Oral Habit on Root Fracture Development After Trauma to an Immature Tooth. J Craniofac Surg 2011; 22:1304-6. [DOI: 10.1097/scs.0b013e31821c6d16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Fariniuk LF, Souza MHD, Westphalen VPD, Carneiro E, Silva Neto UX, Roskamp L, Cavali AE. Evaluation of care of dentoalveolar trauma. J Appl Oral Sci 2010; 18:343-5. [PMID: 20835567 PMCID: PMC5349070 DOI: 10.1590/s1678-77572010000400004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Accepted: 10/05/2009] [Indexed: 11/22/2022] Open
Abstract
Objectives The aim of this study was to evaluate cases of dental trauma treated at the
specialized center of Pontifical Catholic University of Paraná, Curitiba,
Brazil, during a period of 2 years. Material and Methods A total of 647 patients were evaluated and treated between 2003 and 2005. Data
obtained from each patient were tabulated and analyzed as to gender, age,
etiology, time elapsed after the injury, diagnosis (type of trauma), and affected
teeth. Results The results revealed that male individuals aged 7 to 13 years presented the
highest prevalence of injury, and falling was the main causal factor. In most
cases, the time elapsed between the accident and the first care ranged from 4 to
24 h. A total of 1,747 teeth were affected, with higher incidence of
concussion/subluxation and coronal fracture, followed by lateral luxation and
avulsion. The permanent maxillary central incisors were the most commonly affected
teeth. Conclusion The frequency and causes of dentoalveolar trauma should be investigated for
identification of risk groups, treatment demands and costs in order to allow for
the establishment of effective preventive measures that can reduce the treatment
duration and costs for both patients and oral health services.
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Affiliation(s)
- Luiz Fernando Fariniuk
- Endodontics, Department of Dentistry, Pontifical Catholic University of Paraná, Curitiba, PR, Brazil.
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