Periodontal status of teeth facing extraction sites long-term after orthodontic treatment

The absence of proximal contact point on periodontal parameters of teeth moved into extraction sites

The aim of study was to evaluate periodontal conditions of upper canines and second premolars with and without proximal contact of individuals undergoing orthodontic treatment associated to extractions of the upper first premolars. The study selected upper canines and premolars of individuals undergoing orthodontic treatment without extractions (30 hemiarches - control group), or with extraction of the upper first premolars and whose canines and second premolars had interproximal contact (16 hemiarches - group 1) or diastema (17 hemiarches - group 2). Clinical (plaque index, probing depth, gingival bleeding index, height of the gingival margin, clinical attachment loss and gingival clefts) and radiographic (crest height, bone height and bone-crest discrepancy) parameters of the distal surfaces of canines and mesial surfaces of premolars were evaluated. Group 1 had worse results when compared to the control group for the levels of plaque in canines and premolars and for probing depth in canines (distal and mean) and in premolars (lingual and mean), as well as increasing tendency of clinical attachment loss (lingual and mean) in premolars. Plaque level in canines in group 1 was also significantly higher than in group 2. There was no difference between group 2 and the control group. The lack of proximal contact between canines and second premolars did not significantly affect their periodontal characteristics.

Interdisciplinary management of a patient with advanced dental needs

The present case report outlines the interdisciplinary management of an adult patient presenting with advanced generalised periodontal attachment loss, an upper dental midline discrepancy following the previous extraction of the upper left central incisor, and significant lower arch crowding. The endodontic and periodontal condition was stabilised prior to the commencement of fixed appliance orthodontic treatment and subsequent prosthetic replacement of the upper left central incisor. Interdisciplinary management provided a functional occlusion and stability of the periodontal condition along with pleasing facial and smile aesthetics.

Cone-beam computed tomography evaluation of periodontal and bone support loss in extraction cases

Background

The aim of this study was to evaluate, in particular, whether bone resorption occurred at the extraction sites of a group of patients under orthodontic treatment, and, in general, whether extraction treatment predisposes patients to a greater degree of root resorption.

Methods

The study group comprised 12 class II division 1 malocclusion patients who underwent orthodontic treatment and extraction, and the control group comprised 10 class II division 1 patients who underwent orthodontic treatment without extraction. In both groups, treatments were carried out by the same operator using the same techniques. Cone-beam computed tomography performed before (T1) and after (T2) treatment was used to determine and compare the root length, the distance from the cementoenamel junction to the base of the defect and to the bone peak, the width of the defect and the buccolingual bone thickness.

Results

Root length was reduced following treatment in both groups, although to a statistically significantly greater extent in the study group. The buccolingual bone thickness was reduced after treatment in both groups, with no differences found between the study and control groups. The bone loss at the sites assessed was greater in the patients after extraction treatment, with a statistically significant difference revealed between the two groups. The site that showed the greatest variation in both groups was distal to the upper canines.

Conclusions

In the present study, extractive orthodontic treatment appeared to predispose patients to a greater degree of root resorption. Indeed, the bone at the extraction site showed greater resorption in the study group with respect to the control group, and the appearance of intraosseous defects was noted in the former.

Periodontic and orthodontic treatment in adults

The purpose of this article is to provide an update of the interrelationship between periodontics and orthodontics in adults. Specific areas reviewed are the reaction of periodontal tissue to orthodontic forces, the influence of tooth movement on the periodontium, the effect of circumferential supracrestal fiberotomy in preventing orthodontic relapse, the effect of orthodontic treatment on the periodontium, microbiology associated with orthodontic bands, and mucogingival and esthetic considerations. In addition, the relationship between orthodontics and implants (eg, using dental implants for orthodontic anchorage) is discussed.

Evidence-based care in orthodontics and periodontics: a review of the literature

BACKGROUND

In this article, the author reviews the evidence-based literature in the fields of periodontics and orthodontics to clarify the relationship between orthodontic tooth movement and various types of common periodontal disorders.

TYPES OF STUDIES REVIEWED

The first section is a review of the literature on common periodontal disorders. The second is a review of evidence-based studies in the combined fields of orthodontics and periodontics, with a focus on orthodontic treatment possibilities, limitations and risks inherent in patients with periodontal disorders, particularly active periodontal disease.

RESULTS

The literature on orthodontic tooth movement as it relates to periodontal disease shows that proper orthodontic treatment in patients with excellent oral hygiene and the absence of significant periodontal disorders should not pose any significant periodontal risk. In the presence of poor oral hygiene, however, and under circumstances of certain types of periodontal disorders, fixed orthodontic appliances and tooth movement can contribute to significant deleterious periodontal consequences.

CLINICAL IMPLICATIONS

This review provides a clear understanding of what is known about orthodontic treatment possibilities, limitations and inherent risks in patients who may have certain types of periodontal disorders. It also underscores the importance of teamwork among the restorative dentist, periodontist and orthodontist when planning treatment for these patients. The author also offers a specific patient management protocol for this interdisciplinary dental team to follow.

Effect of chlorhexidine (0.12%) rinses on periodontal tissue healing after tooth extraction. (I). Clinical parameters

The aim of the present study was to evaluate the effects of a 1-month period of chlorhexidine (CHX) rinses on the periodontal conditions of teeth adjacent to extraction sockets. 40 patients signed consent forms for this double blind trial and were randomly assigned to either the test group rinsing 2 x daily with 15 ml of a 0.12% CHX solution (Peridex) starting 2 days after tooth extraction or the control group rinsing with a placebo solution for 30 days. Clinical periodontal parameters were obtained from test sites located adjacent to as well as matched controls distant to the extraction sites. The measurements were performed at baseline before the extraction and 1, 2, 3 and 6 months thereafter. During the observation period, the patients were exposed to initial periodontal therapy. The test sites of the group rinsing with CHX demonstrated significantly reduced (p < 0.05) plaque indices, gingival indices and lower %s of sites bleeding on probing one month following the extraction. The test sites of the control group rinsing with the placebo demonstrated a tendency for loss of clinical attachment between 1 and 2 months after the tooth extraction. The mean pocket probing depth (PPD) at test sites of the CHX rinsing group was smaller than in the placebo rinsing group at the one month examination. Also, the mean PPD of the test sites in the CHX group was significantly smaller than at the control sites at 1 month. This difference was not observed in the control group rinsing with placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

Periodontal status of teeth adjacent to nongrafted unilateral alveolar clefts

The purpose of this study was to compare the periodontal condition of teeth adjacent to the cleft with contralateral teeth in adult subjects with a nongrafted unilateral alveolar cleft. Periodontal parameters were evaluated in 18 subjects who had at least one tooth immediately adjacent to the cleft. For each tooth investigated, plaque index, gingival index, and probing depth were recorded and each tooth was assigned a mobility score. Width of attached gingiva and extent of recession was measured. Bone level was assessed using standardized magnified radiographs and a computerized digitizing system. The overall findings of this study support those of other studies and indicate that in individuals with a nongrafted alveolar cleft, teeth adjacent to the defect show signs of gingivitis but not of periodontal disease. The anatomic defect, eruption pattern, orthodontic tooth movements, and the presence of restorations appear to contribute to the reduced bone level on the central incisor adjacent to the cleft and to the presence of gingivitis.

Eruption of mandibular third molars after second-molar extractions: a radiographic study

The purpose of the present study was to analyze the posteruptive contact relationship and inclination of mandibular third molars after extraction of second molars and to determine whether predictors could be formulated for the dental relationships observed. In all, 140 mandibular quadrants were evaluated from 95 sets of panoramic radiographs taken at the time of second molar extraction (T1) and at the time of final evaluation (T2). For analysis of a consecutive sample of patients, a subsample of 25 sets of radiographs from all the patients who had received such treatment during one calendar year was also quantified. Subjective evaluation indicated that 46% of the sites examined had satisfactory tooth contact relationship between the first and third molars at T2. Third-molar impaction was found in 4% of the sites in the subsample of 25 consecutively treated patients. Measurements of crown axis inclination revealed that the third molar invariably erupted into a mesially tilted position. The first molar showed only minor distal tipping between T1 and T2. Inclination of the third molar bud at the time of second molar extraction was not found to be a useful predictor for posteruptive third molar position. The clinical significance of these results and the need for studies regarding a rationale for mandibular second molar extraction are discussed.