Periodontitis is a common chronic infectious disease, so as to be the leading cause of tooth loss in adults. Numerous studies have confirmed the interrelationship between periodontitis and systemic diseases. However, evidence-based reviews reporting the interrelationship between them and treatment strategies for periodontitis with systemic diseases were still absent currently. Therefore, based on evidence-based medical researches in recent years, this article will summarize the interrelationship between periodontitis and systemic diseases, and briefly state the treatment strategies for periodontitis with systemic diseases.
Adult ; Humans ; Periodontitis/therapy* ; Tooth Loss/therapy*

Devitalization has been widely used in the root canal therapy of primary and permanent teeth in China more than ten years ago. With the development of local anesthetic drugs and injection technologies, this treatment method with high potential risks has been gradually abandoned. However, a questionnaire survey targeted all the participants at the 2018 China Pediatric Dentistry Conference showed that the devitalizer utilization proportion was still as high as 38.1% (383/1 005), even though the ratio was much lower than 75.5% (105/139) in 2003. These doctors had pay more attention to tissue burn caused by devitalizer marginal leakage or direct leakage, and know how to identify and handle with devitalizer burn. Devitalizers were usually made of arsenic trioxide, metal arsenic or paraformaldehyde, which have cytotoxicity, allergenicity, mutagenicity, carcinogenicity, and teratogenic effects on animals. Marginal leakage of devitalizers have high risks of causing soft and hard tissue necrosis. Most of the dentists have an understanding of the potential damages of arsenic containing devitalizers, so they will choose parafor maldehyde with relatively less toxicity. Paraformaldehyde has a certain self limitation, and there are few cases reported, so some dentists lack of vigilance. Paraformaldehyde can also causes tissue necrosis if leakage happens, and the treatment methods are similar to that of arsenic containing devitalizers. When handling with devitalizers burn, the necrosed soft and hard tissue, for example gingiva, alveolar bone or teeth that cannot keep, must be completely removed until fresh blood appears, then rinse with large amount of saline and seal with iodoform gauze. This paper described two cases of devitalizer burn during the root canal treatment of primary molars, both of the doctors failed to identify the devitalizer burn symptoms in the early stage, thus didn't do proper treatments immediately after burning. Resulting in the necrosis of large area of gingiva and alveolar bone, loss of primary molars and permanent tooth germs 1-2 months after devitalizer burn. This paper reported these two cases in detail in order to warn dentists the high risks of using any kind of devitalizers, help them learn how to identify and treat devitalizer burn, and remind them to stop using devitalizers as soon as possible.
Arsenic/toxicity* ; China ; Dental Pulp Devitalization ; Humans ; Necrosis ; Root Canal Therapy ; Tooth Germ ; Tooth Loss/chemically induced* ; Tooth, Deciduous

Although intentional replantation is frequently used as a treatment modality for endodontic problems, severe periodontal involvement has usually been regarded as a contraindication. However, there are some studies suggesting that intentional replantation could be a successful treatment alternative for periodontally involved teeth. This paper reports the treatment of a tooth with severe periodontal involvement using intentional replantation. The tooth, which had had root canal therapy due to endodontic-periodontal combined lesion but showed extensive bone loss, was gently extracted and replanted after thorough debridement of the root surface. By intentional replantation, a tooth with severe periodontal involvement in this case could be preserved, without extraction, over the course of a 3-year follow-up period.
Alveolar Bone Loss ; Debridement ; Follow-Up Studies ; Periodontal Attachment Loss ; Periodontal Diseases ; Replantation ; Root Canal Therapy ; Tooth Replantation ; Tooth

OBJECTIVE: To evaluate the survival rate and peri-implant clinical parameters of Locking-Taper implants in patients having lost their teeth due to non-periodontitis (NP) reasons, chronic periodontitis (CP) and aggressive periodontitis (AgP). METHODS: In the study, 145 subjects were installed with 315 Bicon Locking-Taper implants and followed up for 1-5 years. The subjects and implants were classified into three groups, tooth loss by NP, CP and AgP. NP included 44 subjects with 100 implants, CP 70 subjects with 132 implants and AgP 31 subjects with 83 implants. Periodontal parameters before subgingival scaling and root planning (T0), at the end of active periodontal therapy (T1) and at the time of last recall (T2) were recorded. Right after the installation of final restoration and at the time of last recall (T2), peri-implant probing parameters were recorded. RESULTS: After active periodontal therapy, mean probing depth (PD) in CP and AgP were reduced from 4.05 mm, 5.20 mm at T0 to 3.07 mm, 2.96 mm at T1 (P<0.001, P<0.001), (PD≥6 mm)% were reduced from 33.2%, 58.5% at T0 to 14.4%, 10.5% at T1 (P<0.001, P<0.001). The periodontal parameters remained stable at T2 compared with T1 (P>0.05). Cumulative survival rates of implants in NP, CP and AgP were 100%, 97.6% and 100% for 1-5 years' follow-ups with no statistical significance found. At T2, mean implant PD was 2.78 mm, 2.96 mm and 2.97 mm in NP, CP and AgP, with NP significantly lower than the other two groups (P=0.006, P=0.01). The percentage of implant sites with PD≥6 mm was 3.7% in CP and 4.8% in AgP, both significantly higher than NP (P=0.003, P<0.001). 8.4% implant sites showed at least 2 mm deeper than those at prosthesis installation were found in CP group, significantly higher than NP (4.3%, P=0.003). CONCLUSION Periodontal conditions of patients having lost their teeth for chronic and aggressive periodontitis were significantly improved after active periodontal therapy and remained stable during 1-5 years. Short-term survival rates of Locking-Taper implants in patients treated for CP and AgP was no less than those who lost their teeth for non-periodontitis reasons. More sites with increasing peri-implant probing depth were found in CP and AgP patients, compared with NP.
Aggressive Periodontitis/therapy* ; Chronic Periodontitis ; Dental Implants ; Dental Scaling ; Humans ; Periodontal Index ; Tooth Loss ; Treatment Outcome

OBJECTIVETo evaluate the orthodontic treatment outcome in patients with impacted maxillary central incisor in the mixed dentition.

METHODSNine patients, aged 8 to 11 years, with impacted maxillary central incisor were treated orthodontically. The cone-beam CT(CBCT) was taken before treatment, after treatment and one year out of retention to evaluate the root length, root canal wall thickness, width of the apical foramen, and degree of root bending, alveolar bone height and thickness. The crown-to-root ratio was calculated. The periodontal and endodontic conditions were evaluated. The parameters of the treated incisors and contralateral ones served as controls were compared.

RESULTSNine impacted teeth were treated successfully. Throughout the treatment, the root of impacted central incisor continued to develop and the alveolar bones also continued to develop and remodel. The condition of the alveolar bone of vertically impacted teeth was better than that of horizontally impacted ones. No periodontal pocket or pulp necrosis was found after treatment. Seven patients were examined one year after treatment. No significant difference was found in root length, palatal alveolar bone level and palatal alveolar bone thickness. The control group root length was (13.07±2.15) mm, the treatment group root length was (12.06±2.00) mm. No further alveolar bone loss, gingival recession and pulp necrosis were found. The control group labial and palatal alveolar bone levels were (0.90±0.62), (0.45±0.52) mm, labial and palatal alveolar bone thickness were (0.85±0.14), (1.21±0.41) mm. The treatment group labial and palatal alveolar bone levels were (2.18±1.59) mm, (0.57±0.71) mm, labial and palatal alveolar bone thickness were (0.48±0.29), (1.43±0.31) mm.

CONCLUSIONSOrthodontic therapy for impacted maxillary central incisor in the mixed dentition could promote root development and alveolar bone remodeling. Good periodontal and endodontic conditions were achieved.

Alveolar Bone Loss ; diagnostic imaging ; Child ; Cone-Beam Computed Tomography ; Dentition, Mixed ; Gingival Recession ; diagnostic imaging ; Humans ; Incisor ; diagnostic imaging ; Maxilla ; Orthodontics ; methods ; Tooth Apex ; diagnostic imaging ; Tooth Crown ; diagnostic imaging ; Tooth Root ; diagnostic imaging ; Tooth, Impacted ; diagnostic imaging ; therapy ; Treatment Outcome

PURPOSE: The aim of this study was to identify a role for endodontic intervention in enhancing the regenerative potential of the periodontal ligament when combined with periodontal treatment in seriously involved teeth with a secondary endodontic component. METHODS: Patients who exhibited radiolucency extending to the periapical region, abnormal electric pulp testing values, and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Intentional root canal treatment was applied to those teeth in which the apical lesions were presumed to communicate with those of the periodontal lesion of the teeth that remained vital. In all three selected cases, regenerative periodontal therapy incorporating either bone graft or guided tissue regeneration was instituted 3 months after the endodontic intervention. RESULTS: Remarkable enhancement in radiographic density was noticeable around the affected teeth as evidenced by changes in radiopacity. There was a significant reduction in the probing pocket depth and gain in the clinical attachment level. Chewing discomfort gradually disappeared from the commencement of the combined treatment. CONCLUSIONS: An intentional endodontic intervention may be a worthwhile approach for the sophisticated management of teeth suffering from serious attachment loss and alveolar bone destruction with concomitant secondary endodontic involvement.
Dental Pulp Cavity ; Guided Tissue Regeneration ; Humans ; Periodontal Attachment Loss ; Periodontal Diseases ; Periodontal Ligament ; Root Canal Therapy ; Stress, Psychological ; Tooth

Humans ; Orthodontics, Corrective ; adverse effects ; Peri-Implantitis ; etiology ; Periodontal Attachment Loss ; etiology ; Risk Management ; Root Resorption ; etiology ; Temporomandibular Joint Disorders ; therapy ; Tooth Root ; injuries

Chronic Periodontitis ; diagnosis ; diagnostic imaging ; therapy ; Dental Scaling ; Follow-Up Studies ; Furcation Defects ; diagnosis ; diagnostic imaging ; therapy ; Gingival Hyperplasia ; diagnosis ; diagnostic imaging ; therapy ; Humans ; Male ; Middle Aged ; Periodontal Index ; Radiography, Panoramic ; Root Canal Therapy ; Tooth Loss ; diagnosis ; diagnostic imaging ; therapy ; Tooth, Artificial

Adult ; Aggressive Periodontitis ; diagnosis ; diagnostic imaging ; therapy ; Combined Modality Therapy ; Dental Scaling ; Female ; Humans ; Orthodontics, Corrective ; Radiography ; Tooth Loss ; diagnosis ; diagnostic imaging ; therapy

Adult ; Chronic Periodontitis ; diagnosis ; diagnostic imaging ; therapy ; Combined Modality Therapy ; Dental Implantation ; Dental Scaling ; Female ; Follow-Up Studies ; Guided Tissue Regeneration, Periodontal ; Humans ; Orthodontics, Corrective ; Radiography, Panoramic ; Tooth Loss ; diagnosis ; diagnostic imaging ; surgery ; Toothbrushing