Regenerating bone in clinical periodontics

Article Abstract:

In periodontal disease, the bacterial film known as plaque invades the space between the tooth and surrounding gum, leading in time to deterioration of the gum tissue and bone that support the root of the tooth. The bone tissue is gradually broken down until the teeth become loose and may fall out or require extraction. One method of treating advanced periodontal disease is grafting, or transplantation, of bone tissue to the tooth socket; the goal is to fill the gaps created by destruction of the original bone. If this is successful, the tooth root will reattach to the socket, and the tooth will be saved. There are three possible sources of grafts used for this purpose. Autografting uses bone taken from the patient, often from another location in the mouth. Allografting is done when the patient does not have adequate bone tissue available; bone is taken from a cadaver. These specimens are freeze-dried and, consequently, they can be stored indefinitely. Freeze-drying also reduces the chance that the transplant recipient's immune system will reject the graft as a ''foreign'' substance. The risk of contracting a disease from donated bone tissue is slim if the tissue bank follows careful screening and testing protocols. The freezing process further lowers the risk of acquiring disease to 1 in 8 million. A third source of tissue for treating gaps caused by periodontal disease is alloplastics, which are synthetic materials that serve as non-irritating fillers. Since this material is not human tissue, the bony attachment between tooth and socket will not actually regenerate, or grow together again, as it does with autografts and allografts. These various techniques are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Standards, Prevention, Tooth loss, Bone-grafting, Bone transplantation, Tissue banks

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Using periodontal plastic surgery techniques

Article Abstract:

Gingivitis, the first stage of periodontal disease, is characterized by inflammation of the gums and degeneration of the bony structures that support the teeth. Early signs are red, puffy gums that bleed easily when probed by a dental instrument. The gums eventually recede, exposing part of the tooth root, and pockets may form as the gum tissue pulls away from the tooth. At this stage, periodontal plastic surgery may be needed to treat the condition and improve the appearance of the teeth and gums. The techniques of this specialty have evolved in recent years from the original approach, in which diseased gum tissue was simply cut away and removed (gingivectomy), to the new reconstructive approach, in which tissue is actually transplanted onto areas where the original tissue has receded or broken down. Soft tissue or the underlying connective tissue may be taken from the palate (roof) of the mouth and attached to the area in need of coverage, usually a place where the gums have receded. Several specific plastic surgery techniques are discussed and illustrated with photographs taken before and after reconstructive surgical treatment. For two weeks after these procedures, cigarette smokers should refrain from smoking because it interferes with healing; smoking causes tiny blood vessels to constrict, reducing blood flow to the region. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Surgery, Plastic, Plastic surgery, Gingivitis, Gums, Gingiva

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An accurate, time-efficient method to assess plaque accumulation

Article Abstract:

A technique for assessing plaque accumulation appears to give comparable results to one in common use but saves time. Examiners compared the commonly used technique with the new one in 35 adults. The common technique requires rinsing with a disclosing solution and recording the presence or absence of plaque on four surfaces of every tooth. With the new technique, the examiner selects five teeth and sweeps each of four surfaces with a probe. The two techniques gave comparable scores, but the new technique averaged only 1.5 minutes versus 7 minutes for the common technique.

Measurement, Dental plaque

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