Severe, rapidly progressing peri-implantitis.

The replacement of teeth by means of titanium implants is a safe and predictable procedure in most patients. Some studies show that a small number of patients lose the majority of their implants. Unfortunately, it is impossible to identify these patients prior to surgery. It is important to report such cases so that we may, in the future, be able to identify them before surgery. The present case showed a severe and rapid exfoliation of titanium implants. Out of 8 implants inserted in the anterior lower jaw of this patient, only two maintained osseointegration over a 2-year period.

Palmar plantar keratosis and unusual periodontal findings. Observations from a family of 4 members.

The connection between palmar plantar hyperkeratosis and severe periodontal disease was first reported in 1924 by Papillon and Lefevre. The 2 major components of this syndrome (PLS) can also occur as distinct entities. The literature describes a number of cases which do not fit the classical disease descriptions. In this paper, we report on a family with an atypical PLS. The father had marked palmar plantar hyperkeratosis but a very late onset of destructive marginal periodontitis. The son also had palmar plantar hyperkeratosis, but despite the fact that he initially harboured Actinobacillus actinomycetemcomitans, Prevotella intermedia and Porphyromonas gingivalis, he did not develop periodontal disease over a seven-year observation period when improved oral hygiene and professional tooth cleaning were instituted.

Rare case of keratin-producing multiple gingival cysts.

A rare case of multiple keratin-containing gingival cysts is presented. It is suggested that either a common dental lamina stem cell with diverging differentiation pathways or another cell of origin may be responsible for the formation of these unique cysts.

A quantitative analysis of the migration, attachment, and orientation of human gingival fibroblasts to human dental root surfaces in vitro.

The purpose of this study was to assess the migration, attachment, and orientation of human gingival fibroblasts to human dental roots over a period of 21 days in vitro. The fibroblasts were incubated with a total of 120 periodontally diseased and non-diseased root slices (200 microns thickness) which had been treated in the following manner: 1) Root planed diseased root (DT); 2) Root planed and citric acid demineralized diseased root (DTD); 3) Non-treated diseased root (DNT); 4) Citric acid demineralized diseased root (DNTD); 5) Non-diseased control (ND); 6) Citric acid demineralized non-diseased root (CA); 7) Citric acid and collagenase digested non-diseased root (CAC); 8) EDTA demineralized non-diseased root (E); and 9) EDTA-demineralized and collagenase-digested non-diseased root (EC). The results showed that that most active phase of cell attachment and orientation occurred during the first 10 days of the experiment. Statistical differences were observed between the variables, and, in terms of cell attachment and orientation to the root slices, it was concluded that: 1) Root planing improves diseased roots; 2) Acid demineralization subsequent to root planing improved diseased roots to such an extent as to render them comparable to non-diseased roots; 3) Citric acid demineralization alone improved diseased roots to the same extent as root planed diseased roots; 4) The exposure of collagen fibrils resulting from acid demineralization of the tools is not the sole reason for the improvement of the root surface, but rather a combination of the exposed collagen fibrils with the creation of a more hospitable environment was found to be responsible.

[Use of freeze-dried demineralized bone in periodontal therapy]. / Bruk av demineralisert og frysetorret ben i periodontal behandling.

A procedure for the use of freeze-dried demineralised bone in periodontal surgery is described. Reference is made to other reconstructive procedures, and comparisons with these are made. Although there are limitations for its use, it is concluded that the method is a useful tool in the treatment for periodontitis. It approaches the ideal aim of periodontal therapy because it combines the treatment of the disease as well as induces a regeneration of the periodontium.

Initial attachment of fibroblast-like cells to periodontally-diseased root surfaces in vitro.

The precise factors mediating both initial cell attachment and longer term connective tissue reattachment after tissue destruction due to periodontal disease are not known. An in vitro model was used to assess initial attachment of fibroblast-like cells to periodontally-diseased root surfaces. Root fragments were obtained from freshly extracted teeth from 6 different patients. Individual roots were prepared such that a comparison could be made of initial attachment to non-instrumented diseased root surface, curetted diseased root surface and the non-diseased, non-instrumented portion of the same root. The amount of hard tissue removed by instrumentation was quantitated and kept constant between 0.9-1.0 mm. The unsterilized fragments were incubated with human gingival fibroblasts (HGF) for 1 h at 37 degrees, after which the roots were first washed to remove non-adherent cells and then photographed. The number of attached cells per unit area was quantitated from the photographs using a grid system. No significant differences could be detected between the numbers of cells attached to the 3 types of root surfaces studied on the individual roots or between any of the roots studied. Thus, initial attachment of HGF to diseased root surfaces is not inhibited by the presence of plaque or endotoxins.

A review of the literature on use of chlorhexidine in dentistry.

In addition to its plaque-inhibiting effect, chlorhexidine possesses other properties beneficial for use in dentistry. These effects are outlined, and specific recommendations are given regarding chlorhexidine's use by general practitioners. The side effects of long-term use, such as staining, and the availability of chlorhexidine also are discussed.