Dental implants in a patient with suspected leucocyte adhesion deficiency.

Aggressive periodontitis and premature tooth loss in leucocyte adhesion deficiency (LAD) have adverse functional and psychological consequences on affected individuals. Dental implant rehabilitation might become necessary to overcome the functional and psychological adverse effects of LAD periodontitis, especially in patients with milder forms who are expected to have a relatively normal life expectancy. Outcome of dental implants in patients with LAD has not been previously reported; we describe the dental rehabilitation of a 24-year-old man with clinical features of LAD using endosseous dental implants.

Immediate implant and rehabilitation based on All-on-4 concept in patients with generalized aggressive periodontitis: A medium-term prospective study.

BACKGROUND: Aggressive periodontitis renders a great challenge to the conventional implant due to the risks of infection and ongoing marginal bone loss (MBL). A study about full-arch immediate implant and restoration in patients with advanced generalized aggressive periodontitis (GAP) was not read, even though the All-on-4 concept has been proven to be predictable for edentulous patients. PURPOSE: This prospective study aimed to evaluate the feasibility and medium-term outcomes of immediate implant and rehabilitation based on the All-on-4 concept in patients with advanced GAP via clinical and radiographic analyses. MATERIALS AND METHODS: Seventeen patients (mean age 39.4 years) with advanced GAP received immediate postextraction implant and rehabilitation based on the All-on-4 concept between January 2009 and January 2014. Eighty implants were inserted into 20 arches (7 maxillae and 13 mandibles). The average follow-up duration was 5 years (range 2-7). Complications, probing depth, and plaque, bleeding, and gingiva indices were evaluated. MBL was measured based on the panoramic radiographs taken immediately after surgery and annually thereafter. RESULTS: The cumulative survival rate (CSR) of the implants was 98.75% (79/80) after an average of 5 years. One tilted implant failed due to peri-implantitis. The average peri-implant MBL was 0.8 ± 0.4 and 1.2 ± 0.3 mm after 1 and 7 years, respectively. The CSR was 100% (20/20) for definite prostheses, while 85% (17/20) for provisional prostheses. The average probing depth, and plaque, bleeding, and gingiva indices at the last recall visit were 3.0 ± 0.5, 1.2 ± 0.4, 0.5 ± 0.5, and 0.4 ± 0.4 mm, respectively. Patient showed high satisfaction to the overall effects. CONCLUSIONS: Based on this study, the All-on-4 concept provided predictable outcomes in patients with GAP in 2- to 7-year follow-ups, and averted the severe bone defect area of aggressive periodontitis.

Prosthodontic rehabilitation of a patient with aggressive periodontitis.

Aggressive periodontitis previously termed as juvenile periodontitis is characterised by rapid destruction of the periodontium at a relatively young age. Rehabilitation of these patients is often challenging and difficult. Controlling the disease and restoring periodontal health is essential for successful prosthodontic rehabilitation. This clinical report describes an interdisciplinary approach in the rehabilitation of a young adult patient with generalised aggressive periodontitis. Treatment objectives included plaque control, prevention of further attachment loss, reduction/elimination of pockets, and prosthetic rehabilitation to enhance aesthetics and restore masticatory function. One year recall evaluation revealed stable periodontal support with no further loss of attachment and no other complications.

[Recurrent European missense mutation in a Hungarian pedigree with Papillon-Lefèvre syndrome]. / Rekurrens európai misszensz mutáció egy magyar Papillon-Lefèvre szindrómában szenvedo családban.

Papillon-Lefèvre syndrome, a rare disease with autosomal recessive inheritance, is characterized by aggressive periodontitis and palmoplantar hyperkeratosis. Mutations of the cathepsin C gene are responsible for the development of the disease. In this study, we aimed to describe in details the clinical symptoms and to determine the underlying genetic abnormality in two Hungarian siblings affected by Papillon-Lefèvre syndrome. The siblings are under regular dental and dermatological care since their symptoms appeared, but, due to the fact that genetic analysis of Papillon-Lefèvre syndrome has been available for one or two years in Hungary, their mutation screenings were just recently performed. We have identified a homozygous missense mutation on the cathepsin C gene, which is an already published mutation and was originally reported from Germany. Our investigations would like to draw attention to a rare disease, Papillon-Lefèvre syndrome, in which first symptom can be the aggressive periodontitis, and in which genetic testing and for helping child-bearing and family planning is now available.

Role of psychotherapy in managing a case of generalised aggressive periodontitis.

Generalised aggressive periodontitis is characterised by "generalized interproximal attachment loss affecting at least three permanent teeth other than first molars and incisors." The management of generalised aggressive periodontitis is challenging as it involves an interdisciplinary approach. When the patient presents himself late to the clinician, the tooth and bone loss can be up to 60%. Natural teeth and alveolar bone contribute to the contour and aesthetics of the face. Loss of teeth in younger age may lead to attitude, behaviour changes and may cause psychological depression and withdrawal from society. The main distinguishing feature of this case report is the psychological counselling provided along with periodontal and prosthetic treatment.

Rehabilitation of periodontally compromised teeth with fiber-reinforced composite resin: a case report.

The rehabilitation of prosthetic spaces resulting from severe periodontitis represents a challenge in terms of functional and esthetic aspects. Generally, tooth extraction is followed by alveolar ridge volume reduction, which increases the esthetic problem. The aim of this article is to report the integration of esthetics and functional parameters in the oral rehabilitation of extracted periodontally compromised mandibular central incisors through the construction of a direct glass fiber-reinforced composite fixed partial denture (DFPD). After periodontal therapy, the patient received a periodontal subepithelial graft, enabling an increase in the thickness and height of the alveolar ridge. The DFPD was fabricated with the use of extracted teeth. Mandibular canines and lateral incisors received cavities 2 mm deep and wide. After fiber insertion, tooth adaptation, and composite resin coverage, the teeth were finished and polished. Results showed an excellent esthetic result with stabilization and function of the remaining periodontally affected teeth.

Fixed rehabilitation of patient with aggressive periodontitis using zygoma implants.

Treatment of patients with aggressive periodontitis has always been a challenge to the clinician. Both young and old are known to be affected by this progressive destructive condition of the supporting dental structures. Although dental implants have been offered as a viable treatment alternative for such patients, additional procedures (like bone grafting) and delayed protocols have limited their usage. This case report describes the treatment of a young patient with aggressive periodontitis using a graftless implant solution. Zygoma implants in conjunction with conventional implants were used with immediate loading.

Immediate tooth replacement using fiber-reinforced composite and natural tooth pontic.

The loss and replacement of anterior maxillary teeth poses several challenges. In patients refusing implant surgery, when minimal tooth reduction is desired, a fiber-reinforced composite fixed-partial denture may be used as a conservative alternative to a conventional fixed-partial denture for replacement of a single missing tooth. This article describes a clinical technique and six-year follow-up. The patient presented with a missing maxillary central incisor due to localized juvenile periodontitis. The abutment teeth were clinically stable. The advantage of supragingival margins and minimal tooth structure removal made the bonded bridge with a natural tooth pontic a viable procedure for this compromised restorative situation.

Cosmetic rehabilitation following successful treatment of aggressive periodontitis.

UNLABELLED: With advances in periodontal therapy, many sufferers from aggressive periodontitis are retaining their teeth after successful treatment. This presents the practitioner with aesthetic and restorative challenges in these relatively young patients. Lifelong motivation is essential to the supportive therapy for these patients, and the maintenance of good aesthetics, combined with biologically acceptable corrective therapy, may help maintain a high level of motivation. Any treatment provided must naturally be conducive to maintaining long-term dental and periodontal health. This paper aims to demonstrate options for dealing with the aesthetic challenges posed by a number of patients who have undergone initial cause-related therapy for aggressive periodontitis. CLINICAL RELEVANCE: Loss of gingival tissue, tooth positional changes and tooth loss present practitioners with challenges in relation to patient satisfaction with aesthetics following advanced periodontal breakdown. A range of techniques will be required, tailored to the consequences of periodontal attachment loss, in order to satisfy patient demands.

Rehabilitative management offered Nigerian localized and generalized aggressive periodontitis patients.

This paper highlights the typical clinical features of aggressive periodontitis (formerly known as juvenile periodontitis in the South Western region of Nigeria), the attending psychological effect following tooth loss, and the rehabilitative management offered which included periodontal therapy, psychotherapy, and prosthetic replacement of the missing teeth. The psychotherapy is the main distinguishing treatment in this study from previously reported modes of management of this disease entity. Subjects were from a part of the South Western region of Nigeria, and ages ranged from 15 to 22 years. They all presented very late with subsequent gross periodontal breakdown and subsequent psychological depression. The mean values of the probing depth (mm), degree of mobility, and the amount of bone fill (mm) from the periapical radiographs were recorded pre and post-operatively. The missing teeth were replaced with acrylic dentures, and psychotherapy was offered at three levels (individual, group, and conjoint-family psychotherapy). There was significant improvement of these clinical parameters six months after treatment, and the partial denture replacement of the missing teeth improved their appearance as expected but did not totally improve the initial depressive state. The psychotherapy offered gave the patients positive psychological effects that further restored their ability to socialize in their environment, which added to their positive experience of life. In conclusion the typical clinical features of localized aggressive periodontitis (LAP) and generalized aggressive periodontitis (GAP) patients in our environment are late presentation with gross periodontal tissue breakdown. Psychotherapy is an important aspect in the management of this group of patients in conjunction with the periodontal and prosthetic management, which gives total rehabilitation.

Rehabilitation of a periodontal patient with rapidly progressing marginal alveolar bone loss: 1-year follow-up.

BACKGROUND: The present case report describes a 1-year follow-up of functional rehabilitation of a young periodontal patient with severely advanced, rapidly progressing marginal bone loss treated by using a new splinting material, i.e., glass fiber-reinforced composite (FRC). Apart from one single tooth, the young man had retained all his natural teeth. TREATMENT: Periodontal treatment was based on cleaning and root planing enabled by partial-thickness-flap operations. This method was selected to avoid further damage to the remaining alveolar bone. After healing for 6 months, a cavity retained internal FRC splint was constructed and 1 missing lower molar was replaced by an inlay-retained FRC resin-bonded fixed partial denture (FPD). A 12 months follow-up period revealed a healthy periodontium and good functional and esthetic results. CONCLUSIONS: The new material allows the use of periodontal treatment methods instead of prosthetic alternatives, which until now have been a more generally used approach in the treatment of severely advanced periodontal cases. Internal fiber-reinforced composite splinting being affordable for the patient, easy for the clinician to construct and giving good esthetic and functional results, suggests that the method may be a valuable aid in periodontal treatment.

[Periodontitis--a ubiquitous illness]. / Parodontitis--eine Volkskrankheit.

In recent years, periodontitis has been receiving increasing attention, since it not only impairs the general state of health (loss of the teeth), but also appears to have a relationship with cardiovascular and cerebrovascular illnesses (thrombocyte aggregation, insult). Periodontitis is a very frequent, chronic recurrent, unspecific bacterial inflammation of the periodontium that arises in accumulated plaques on the teeth at the gingiva. It leads to an irreversible destruction of soft tissue followed by loss of bony substance. Three types of periodontitis can be distinguished: 1. adult periodontitis (AP), 2. rapidly progressive periodontitis (RPP) and juvenile periodontitis (JP). Periodontitis appears to have a genetic component. Additional risk factors include juvenile diabetes mellitus and smoking. The diagnosis, prevention and treatment are discussed. The basis for prevention and treatment is individual hygiene and professional dental care.