Sobretratamento: uma alternativa eficaz na terapia com implante em elemento unitário com reabsorção radicular em paciente portador de periodontite crônica: relato de caso / Overtreatment: an effective alternative in implant therapy on a single tooth with root resorption in patient with chronic periodontitis: a case report

Paciente do sexo masculino, 54 anos de idade, leucoderma, compareceu a uma clínica privada para tratamento odontológico. Na anamnese, verificou-se tratar de um paciente saudável sistemicamente; os exames clínico e radiográfico demonstraram reabsorção dos terços apical e médio da raiz do dente 21. A opção de tratamento foi a realização da extração do elemento dentário e realização de implante imediato com carga tardia, utilizando-se o dente do próprio paciente como provisório fixado aos dentes vizinhos. O paciente foi informado sobre os detalhes das fases pré-, trans- e pós-cirúrgica, e autorizou a execução do tratamento e da documentação fotográfica com fins de publicação e divulgação. A utilização de periótomo foi necessária para uma exodontia atraumática. Após remoção atraumática da raiz, e com o osso alveolar remanescente preservado, optou-se por realizar a instalação imediata do implante (Neodent, Curitiba/PR, Brasil), com formato cônico e encaixe cone morse. O espaço alvéolo- implante foi preenchido com Bio-Oss®; removeu-se do palato um enxerto conjuntivo subeptelial, rotacionado para vestibular, e fez-se a obliteração do alvéolo — nessa fase, é importante garantir a imobilidade do enxerto, para sua revascularização. Passou-se, então, à fase protética do provisório, utilizando a coroa do elemento extraído como provisório e estabelecendo um pôntico, afixado com resina composta nos elementos 11 e 22. Assim, após a etapa de provisório utilizando o pôntico reembasado com resina composta, começou-se a confecção da coroa protética final. Após acompanhamento de três anos do caso, foi possível concluir que a associação das técnicas obteve resultados estéticos previsíveis e satisfatórios para a prevenção da saúde peri-implantar, conforme planejado...

A male, 54‐year‐old, Caucasian patient attended a private clinic for dental treatment. Hismedical history revealed a systemically healthy patient. Clinical and radiographic examination revealed resorption in the apical and middle thirds of tooth 21 root. A treatment option was to perform extraction of tooth 21 and implant placement with late loading, using patient's own tooth as a provisional secured to adjacent teeth. The patient was made aware of the details before, during and after surgery, and authorized the implementation of treatment and photographic documentation for purposes of publication and dissemination. The use of Periotome was required for atraumatic extraction. After atraumatic removal of the root, andwith the remaining alveolar bone being preserved, we chose to perform immediate implantplacement (Neodent‐Curitiba‐PR, Brazil). The implant was of conical shape and of the MorseTaper type. The alveolar‐implant space was filled with Bio‐Oss®, subepithelial connective graftwas harvested from the palate, with buccal rotation, and alveolar obliteration was carried out. At this stage, it is important to ensure graft immobility for vascularization. Subsequently, the prosthetic phase was carried out with the crown of the extracted tooth used as a temporary tooth, establishing a provisional pontic secured to between teeth 11 and 22 with compositeresin. Accordingly, after the temporary tooth phase with a pontic secured with composite resin, the final prosthetic crown was manufactured. After a three‐year follow‐up, we conclude that the combination of techniques yielded predictable and satisfactory outcomes for themaintenance of peri‐implant health, as planned ...

Awareness of association between periodontitis and PLBW among selected population of practising gynecologists in Andhra Pradesh.

Context: Preterm low-birth-weight (PLBW) infants are at a higher risk for a number of acute and chronic disorders. Studies point to an association between periodontal infection and increased rates of preterm birth, and pregnant mothers with periodontal diseases are at increased risk of subsequent preterm birth or low birth weight. However, the awareness level of gynecologists about this relationship is unknown. Aims: The aim of the present survey was to assess the awareness about the effects of periodontal disease on pregnancy among practicing gynecologists, and also compare such awareness between gynecologists in two places-Khammam (a district headquarter) and Hyderabad (a state capital). Settings and Design: Random, cross-sectional study in a population of practicing gynecologists from Andhra Pradesh. Materials and Methods: A random study population was selected from the practicing gynecologists in Khammam and Hyderabad. Sixty practicing gynecologists, 30 each in Khammam and Hyderabad, were approached and they consented to join the study. Data were collected in questionnaire format from the subject population. Collected data were statistically analyzed. Chi-square test with Yates correction was used to analyze the data. A " P" value of <0.05 was taken as a significant difference. Results: 73.3% of the gynecologists said that their patients complain of bleeding gums, swellings and mobility. 58.3% of the gynecologists were aware that gum diseases occur at a higher rate in pregnant females. 38.3% of the gynecologists were aware that periodontal diseases can affect the outcome of delivery. No significant difference was found between the awareness levels of gynecologists in Khammam and in Hyderabad. Conclusions: There is a need for interdisciplinary approach for the prevention of PLBW cases by the integration of periodontal care into obstetric management. Effort should be made to increase awareness among the gynecologists.

Management of a rare combination of dental trauma: a case report.

The occurrence of combined injury of intrusion, avulsion and lateral luxation is rare and the mechanism responsible for this is intriguing. This case report describes such a combined injury and its management. The rationale behind the treatment modalities is discussed.