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Two cases of an atypical presentation of necrotizing stomatitis.

Antonio MAGAN-FERNANDEZ ; Francisco O'VALLE ; Elena POZO ; Jose LIEBANA ; Francisco MESA

Journal of Periodontal & Implant Science.2015;45(6):252-256. doi:10.5051/jpis.2015.45.6.252

PURPOSE: The purpose of this report was to describe the clinical and microbiological characteristics of two rare cases of necrotizing stomatitis, and the outcomes of a non-invasive treatment protocol applied in both cases. METHODS: We report two cases of necrotizing stomatitis in a rare location in the hard palate of a 40-year-old woman and a 28-year-old man. Neither had a relevant medical history and both presented with highly painful ulceration in the palate and gingival margin that was accompanied by suppuration and necrosis. 3% hydrogen peroxide was applied to the lesions using sterile swabs, and antibiotic and anti-inflammatory treatment was prescribed to both patients in addition to two daily oral rinses of 0.2% chlorhexidine. RESULTS: In both cases, radiological examination ruled out bone involvement, and exfoliative cytology revealed a large inflammatory component and the presence of forms compatible with fusobacteria and spirochetes. There was a rapid response to treatment and a major improvement was observed after 48 hours, with almost complete resolution of the ulcerated lesions and detachment of necrotic areas with partial decapitation of gingival papillae. CONCLUSIONS: Necrotizing periodontal lesions can hinder periodontal probing and the mechanical removal of plaque in some cases due to the extreme pain suffered by the patients. We present a non-invasive treatment approach that can manage these situations effectively.
Adult ; Chlorhexidine ; Clinical Protocols ; Decapitation ; Female ; Fusobacteria ; Gingivitis, Necrotizing Ulcerative ; Humans ; Hydrogen Peroxide ; Necrosis ; Palate ; Palate, Hard ; Spirochaetales ; Stomatitis* ; Suppuration ; Ulcer

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Role of gingival manifestation in diagnosis of granulomatosis with polyangiitis (Wegener's granulomatosis).

Iel Yong SUNG ; Young Min KIM ; Yeong Cheol CHO ; Jang Ho SON

Journal of Periodontal & Implant Science.2015;45(6):247-251. doi:10.5051/jpis.2015.45.6.247

PURPOSE: This report describes a case of granulomatosis with polyangiitis (GPA) in which the gingival manifestation was crucial in both making an early diagnosis and possibly in deciding the approach to treatment. METHODS: A 57-year-old sailor presented to the Department of Dentistry at Ulsan University Hospital complaining of gingival swelling since approximately 2 months. He had orofacial granulomatous lesions and the specific gingival manifestation of strawberry gingivitis. RESULTS: The diagnosis of GPA was made on the basis of clinical symptoms and signs, and confirmed by the presence of the anti-neutrophil cytoplasmic antibody and a positive biopsy. The patient was admitted to the hospital and subsequently placed on a disease-modifying therapy regimen that included methotrexate and prednisone. CONCLUSIONS: Identification of the gingival manifestation of the disease permitted an early diagnosis and prompt therapy in a disease in which time is a crucial factor. Because of its rapid progression and potentially fatal outcome, an early diagnosis of GPA is important. Therefore, dentists should be aware of the oral signs and symptoms of such systemic diseases.
Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Dentistry ; Dentists ; Diagnosis* ; Early Diagnosis ; Fatal Outcome ; Fragaria ; Gingiva ; Gingivitis ; Humans ; Methotrexate ; Middle Aged ; Military Personnel ; Prednisone ; Ulsan

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Bone formation around rhBMP-2-coated implants in rabbit sinuses with or without absorbable collagen sponge grafting.

Won Sun BAEK ; So Ra YOON ; Hyun Chang LIM ; Jung Seok LEE ; Seong Ho CHOI ; Ui Won JUNG

Journal of Periodontal & Implant Science.2015;45(6):238-246. doi:10.5051/jpis.2015.45.6.238

PURPOSE: The purpose of this study was to evaluate bone formation around recombinant human bone morphogenetic protein (rhBMP-2)-coated implants placed with or without absorbable collagen sponge (ACS) in rabbit maxillary sinuses. METHODS: The Schneiderian membrane was elevated and an implant was placed in 24 sinuses in 12 rabbits. The space created beneath the elevated membrane was filled with either blood (n=6) or ACS (n=6). In the rabbits in which this space was filled with blood, rhBMP-2-coated and non-coated implants were alternately placed on different sides. The resulting groups were referred to as the BC and BN groups, respectively. The AC and AN groups were produced in ACS-grafted rabbits in the same manner. Radiographic and histomorphometric analyses were performed after eight weeks of healing. RESULTS: In micro-computed tomography analysis, the total augmented volume and new bone volume were significantly greater in the ACS-grafted sinuses than in the blood-filled sinuses (P<0.05). The histometric analysis showed that the areas of new bone and bone-to-implant contact were significantly larger in the AC group than in the AN group (P<0.05). In contrast, none of the parameters differed significantly between the BC and BN groups. CONCLUSIONS: The results of this pilot study indicate that the insertion of ACS after elevating the Schneiderian membrane, simultaneously with implant placement, can significantly increase the volume of the augmentation. However, in the present study, the rhBMP-2 coating exhibited limited effectiveness in enhancing the quantity and quality of regenerated bone.
Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; Collagen* ; Dental Implants ; Humans ; Maxillary Sinus ; Membranes ; Nasal Mucosa ; Osteogenesis* ; Pilot Projects ; Porifera* ; Rabbits ; Sinus Floor Augmentation ; Transplants* ; X-Ray Microtomography

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Assessment of dehydrothermally cross-linked collagen membrane for guided bone regeneration around peri-implant dehiscence defects: a randomized single-blinded clinical trial.

Jae Hong LEE ; Jung Seok LEE ; Won Sun BAEK ; Hyun Chang LIM ; Jae Kook CHA ; Seong Ho CHOI ; Ui Won JUNG

Journal of Periodontal & Implant Science.2015;45(6):229-237. doi:10.5051/jpis.2015.45.6.229

PURPOSE: The aim of this study was to determine the clinical feasibility of using dehydrothermally cross-linked collagen membrane (DCM) for bone regeneration around peri-implant dehiscence defects, and compare it with non-cross-linked native collagen membrane (NCM). METHODS: Dehiscence defects were investigated in twenty-eight patients. Defect width and height were measured by periodontal probe immediately following implant placement (baseline) and 16 weeks afterward. Membrane manipulation and maintenance were clinically assessed by means of the visual analogue scale score at baseline. Changes in horizontal thickness at 1 mm, 2 mm, and 3 mm below the top of the implant platform and the average bone density were assessed by cone-beam computed tomography at 16 weeks. Degradation of membrane was histologically observed in the soft tissue around the implant prior to re-entry surgery. RESULTS: Five defect sites (two sites in the NCM group and three sites in the DCM group) showed soft-tissue dehiscence defects and membrane exposure during the early healing period, but there were no symptoms or signs of severe complications during the experimental postoperative period. Significant clinical and radiological improvements were found in all parameters with both types of collagen membrane. Partially resorbed membrane leaflets were only observed histologically in the DCM group. CONCLUSIONS: These findings suggest that, compared with NCM, DCM has a similar clinical expediency and possesses more stable maintenance properties. Therefore, it could be used effectively in guided bone regeneration around dehiscence-type defects.
Bone Density ; Bone Regeneration* ; Collagen* ; Cone-Beam Computed Tomography ; Humans ; Membranes* ; Postoperative Period

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Antimicrobial susceptibility and pathogenic genes of Staphylococcus aureus isolated from the oral cavity of patients with periodontitis.

Ga Yeon KIM ; Chong Heon LEE

Journal of Periodontal & Implant Science.2015;45(6):223-228. doi:10.5051/jpis.2015.45.6.223

PURPOSE: The goal of this study was to characterize the patterns of antimicrobial resistance and virulence genes in samples of Staphylococcus aureus (S. aureus) isolated from periodontitis patients. METHODS: From July 2015 to August 2015, oral saliva was collected from a total of 112 patients diagnosed with periodontitis, including 80 outpatients in dental hospitals and 32 patients in dental clinics located in Seoul and Cheonan. The samples were subjected to a susceptibility test to evaluate the prevalence of antimicrobial resistance, and the pathogenic factors and antimicrobial resistance factors in the DNA of S. aureus were analyzed using polymerase chain reaction. RESULTS: A susceptibility test against 15 antimicrobial agents showed that 88% of cultures were resistant to ampicillin, 88% to penicillin, and 2% to oxacillin. Resistance to at least two drugs was observed in 90% of cultures, and the most common pattern of multidrug resistance was to ampicillin and penicillin. Enterotoxins were detected in 65.9% of samples. The cell hemolysin gene hld was detected in 100% of cultures and hla was detected in 97.6% of samples. All strains resistant to penicillin and ampicillin had the blaZ gene. The aph(3')IIIa gene, which encodes an aminoglycoside modifying enzyme, was detected in 46.3% of samples. CONCLUSIONS: In the treatment of oral S. aureus infections, it is important to identify the pathogenic genes and the extent of antimicrobial resistance. Furthermore, it is necessary to study patterns of antimicrobial resistance and cross-infection in the context of periodontological specialties in which antimicrobials are frequently used, such as maxillofacial surgery, where the frequency of antimicrobial use for minor procedures such as implant placement is increasing.
Ampicillin ; Anti-Infective Agents ; Chungcheongnam-do ; Dental Clinics ; DNA ; Drug Resistance, Multiple ; Enterotoxins ; Humans ; Mouth* ; Outpatients ; Oxacillin ; Penicillins ; Periodontitis* ; Polymerase Chain Reaction ; Prevalence ; R Factors ; Saliva ; Seoul ; Staphylococcus aureus* ; Staphylococcus* ; Surgery, Oral ; Virulence

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Prediction of the alveolar bone level after the extraction of maxillary anterior teeth with severe periodontitis.

Chul Eui HONG ; Ju Youn LEE ; Jeomil CHOI ; Ji Young JOO

Journal of Periodontal & Implant Science.2015;45(6):216-222. doi:10.5051/jpis.2015.45.6.216

PURPOSE: After extraction, the alveolar bone tends to undergo atrophy in three-dimensions. The amount of alveolar bone loss in the horizontal dimension has been reported to be greater than the amount of bone loss in the vertical dimension, and is most pronounced in the buccal aspect. The aim of this study was to monitor the predictive alveolar bone level following the extraction of anterior teeth seriously involved with advanced chronic periodontitis. METHODS: This study included 25 patients with advanced chronic periodontitis, whose maxillary anterior teeth had been extracted due to extensive attachment loss more than one year before the study. Periapical radiographs were analyzed to assess the vertical level of alveolar bone surrounding the edentulous area. An imaginary line connecting the mesial and the distal ends of the alveolar crest facing the adjacent tooth was arbitrarily created. Several representative coordinates were established in the horizontal direction, and the vertical distance from the imaginary line to the alveolar crest was measured at each coordinate for each patient using image analysis software. Regression functions predicting the vertical level of the alveolar bone in the maxillary anterior edentulous area were identified for each patient. RESULTS: The regression functions demonstrated a tendency to converge to parabolic shapes. The predicted maximum distance between the imaginary line and the alveolar bone calculated using the regression function was 1.43+/-0.65 mm. No significant differences were found between the expected and actual maximum distances. Likewise, the predicted and actual maximum horizontal distances did not show any significant differences. The distance from the alveolar bone crest to the imaginary lines was not influenced by the mesio-distal spans of the edentulous area. CONCLUSIONS: After extraction, the vertical level of the alveolar ridge increased to become closer to the reference line connecting the mesial and distal alveolar crests.
Alveolar Bone Loss ; Alveolar Process ; Atrophy ; Chronic Periodontitis ; Humans ; Periodontitis* ; Tooth Extraction ; Tooth* ; Vertical Dimension

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Implant success rates in full-arch rehabilitations supported by upright and tilted implants: a retrospective investigation with up to five years of follow-up.

Luca FRANCETTI ; Andrea RODOLFI ; Bruno BARBARO ; Silvio TASCHIERI ; Nicolo CAVALLI ; Stefano CORBELLA

Journal of Periodontal & Implant Science.2015;45(6):210-215. doi:10.5051/jpis.2015.45.6.210

PURPOSE: The aim of this retrospective study was to investigate the cumulative success rate, the implant survival rate, and the occurrence of biological complications in implants supporting full-arch immediately loaded rehabilitations supported by upright and tilted implants. METHODS: The clinical records and periapical radiographs of patients who attended follow-up visits were collected, and information was recorded regarding marginal bone loss resorption, the occurrence of peri-implant infectious diseases, and the implant survival rate. Implants were classified as successful or not successful according to two distinct classifications for implant success. RESULTS: A total of 53 maxillary and mandibular restorations including 212 implants were analysed, of which 56 implants were studied over the full five-year follow-up period. After five years, the cumulative success rate was 76.04% according to the Misch classification and 56.34% according to the Albrektsson classification. The cumulative implant survival rate was 100%, although one implant was found to be affected by peri-implantitis at the second follow-up visit. CONCLUSIONS: The cumulative success rate of the implants dropped over time, corresponding to the progression of marginal bone resorption. The prevalence of peri-implantitis was very low, and the implant survival rate was not found to be related to the cumulative success rate.
Bone Resorption ; Classification ; Communicable Diseases ; Dental Implants ; Dental Prosthesis, Implant-Supported ; Dental Restoration Failure ; Follow-Up Studies* ; Humans ; Peri-Implantitis ; Prevalence ; Retrospective Studies* ; Survival Rate

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Short-term improvement of masticatory function after implant restoration.

Si Mook KANG ; Sang Soo LEE ; Ho Keun KWON ; Baek Il KIM

Journal of Periodontal & Implant Science.2015;45(6):205-209. doi:10.5051/jpis.2015.45.6.205

PURPOSE: Dental implants present several advantages over other tooth replacement options. However, there has been little research on masticatory function in relation to implant treatment. Therefore, the aim of the present study was to evaluate the improvement of masticatory function two weeks after implant restoration. METHODS: Masticatory ability was evaluated with the subjective food intake ability (FIA) and objective mixing ability index (MAI) methods. Fifty-four subjects with first and second missing molars completed the study. The subjects were asked to complete a self-reported questionnaire about 30 different food items, and to chew wax samples 10 times both before and two weeks after implant restoration. A total of 108 waxes were analyzed with an image analysis program. RESULTS: Dental implant restoration for lost molar teeth on one side increased the FIA score by 9.0% (P<0.0001). The MAI score also increased, by 14.3% after implant restoration (P<0.0001). Comparison between the good and poor mastication groups, which were subdivided based on the median MAI score before implant restoration, showed that the FIA score of the poor group was enhanced 1.1-fold while its MAI score was enhanced 2.0-fold two weeks after an implant surgery. CONCLUSIONS: Using the FIA and MAI assessment methods, this study showed that masticatory function was improved two weeks after implant restoration. In particular, the enhancement of masticatory function by implant restoration was greater in patients with relatively poor initial mastication than in those with good initial mastication.
Dental Implants ; Diagnosis ; Eating ; Humans ; Mastication ; Molar ; Tooth ; Waxes

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A comparative study of combined periodontal and orthodontic treatment with fixed appliances and clear aligners in patients with periodontitis.

Ji Young HAN

Journal of Periodontal & Implant Science.2015;45(6):193-204. doi:10.5051/jpis.2015.45.6.193

PURPOSE: With the increasing prevalence of orthodontic treatment in adults, clear aligner treatments are becoming more popular. The aim of this study was to evaluate the effect of orthodontic treatment on periodontal tissue and to compare orthodontic treatment with fixed appliances (FA) to clear aligner treatment (CAT) in periodontitis patients. METHODS: A total of 35 patients who underwent orthodontic treatment in the Department of Periodontology were included in this study. After periodontal treatment with meticulous oral hygiene education, patients underwent treatment with FA or CAT, and this study analyzed patient outcomes depending on the treatment strategy. Clinical parameters were assessed at baseline and after orthodontic treatment, and the duration of treatment was compared between these two groups. RESULTS: The overall plaque index, the gingival index, and probing depth improved after orthodontic treatment (P<0.01). The overall bone level also improved (P=0.045). However, the bone level changes in the FA and CAT groups were not significantly different. Significant differences were found between the FA and CAT groups in probing depth, change in probing depth, and duration of treatment (P<0.05). However, no significant differences were found between the FA and CAT groups regarding the plaque index, changes in the plaque index, the gingival index, changes in the gingival index, or changes in the alveolar bone level. The percentage of females in the CAT group (88%) was significantly greater than in the FA group (37%) (P<0.01). CONCLUSIONS: After orthodontic treatment, clinical parameters were improved in the FA and CAT groups with meticulous oral hygiene education and plaque control. Regarding plaque index and gingival index, no significant differences were found between these two groups. We suggest that combined periodontal and orthodontic treatment can improve patients' periodontal health irrespective of orthodontic techniques.
Adult ; Animals ; Bone Regeneration ; Cats ; Education ; Female ; Humans ; Malocclusion ; Oral Hygiene ; Orthodontics ; Periodontal Index ; Periodontitis* ; Prevalence

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A page is turned in the digital era.

Tae Il KIM

Journal of Periodontal & Implant Science.2015;45(6):191-192. doi:10.5051/jpis.2015.45.6.191

No abstract available.

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