Arnold S. Weisgold

Characteristics of periodontal biotype, its dimensions, associations and prevalence: a systematic review.

AIM The objectives of this review were as follows: What are characteristics used to define various forms of periodontal biotypes? What are their anatomic dimensions in relation to the definition? In addition, what is the association between these various characteristics in relation to the periodontal biotypes? Furthermore, what is the prevalence of various forms of periodontal biotypes in the population? MATERIAL AND METHODS The PubMed-MEDLINE, the Cochrane-CENTRAL and EMBASE databases were searched through up and till June 2013 to identify any appropriate studies regarding the aim. Appropriate studies were those reporting characteristics of various forms of periodontal biotype and its dimensions. These characteristics were gingival thickness (GT), gingival morphotype (GM), tooth dimensions (TD), keratinized tissue (KT) and bone morphotype (BM). RESULTS AND CONCLUSIONS The search yielded 2581 unique papers, after selection resulted in 12 publications that met the eligibility criteria. In general, the available definitions are found to be unclear and sometimes inconsistent. However, based on the available literature, the three biotypes thin scalloped, thick flat and thick scalloped seem a comprehensive categorization in defining periodontal biotypes in the population. The dental, gingival and osseous dimensions have a weak to moderate association. Only between gingival thickness, keratinized tissue and bone morphotype uniform positive associations are found.

Faciolingual width before and after tooth restoration: A comparative study

lh e anatomic crown of a tooth contains facial and lingual convexities that play important roles for protecting the supporting tissues. The contours contribute to the health of the gingivae.‘, 2 The convexities are the “heights of contour”3 and are usually located in the apical third of the anatomic crown on the facial surfaces and slightly more coronally on the lingual surfaces. Perel”, j and Yuodelis et a1.6 claimed that undercontoured restorations resulted in healthier periodontal tissues than overcontoured crowns. Koivuman and Wennstrom7 reported that overcontoured crowns (i.e., greater than normal convexity) resulted in exaggerated inflammatory responses when placed subgingivally. Weisgold*. ’ noted different types of gingival reactions to supragingival and subgingival differences in contour. It is important to determine the effect of the buccal and lingual contours of restorations in regard to function and health of the periodontal tissues. The purpose of this study was (1) to assess the facial-lingual width of restored teeth and to compare this data with the same unrestored teeth and (2) to determine the amount of tooth structure reduction that would permit the original contours in the restorations.

Survival rate of teeth with periodontally hopeless prognosis after therapies with intentional replantation and perioprosthetic procedures ‐ a study of case series for 5–12 years

The purpose of the present study was to evaluate the longitudinal survival rate of the treatment of teeth affected with periodontally hopeless prognosis and secondary occlusal traumatism (SOT) using intentional replantation (IR) and periodontal prosthesis. We collected data from 17 individuals who received IR and participated in the study during 1995 to 2014. Of the 17 teeth affected by periodontally extreme conditions with deep angular bone defects, severe alveolar bone loss extending to or beyond the apex, and SOT, was recognized as having hopeless prognosis. Those teeth were treated sequentially using procedures that included basic periodontal therapy, therapeutic provisional prosthesis, IR, fixed dental prosthesis, crown and sleeve‐coping telescopic dentures (CSCTDs), or fixed prosthesis and CSCTD combined. Longitudinal assessments of clinical parameters and radiographic bone change before and after IR were evaluated. Clinical results showed that the overall cumulative survival rate of assayed teeth after IR therapy (5–12 years) was 88.2%. The mean (±SD) estimated radiographic alveolar bone loss was 12.7 ± 2.1 mm (88.5% ± 13.3%) of the root length, initially, and estimated radiographic alveolar bone gain was 4.0 ± 2.2 mm ultimately, in 17 replanted teeth with SOT. Only one tooth (5.9%) exhibited root resorption. Ankylosis was not observed during the study. Periapical radiographs demonstrated that satisfactory periodontal healing of lamina dura and bone fills occurred in all replanted teeth with SOT. Generally, tooth mobility and SOT were significantly improved after therapy. Most treated teeth functioned well and remained stable clinically throughout the periods of study. The present study documented a promising outcome for autogenous IR and periprosthetic therapy of 17 periodontally hopeless teeth for 5–12 years. The present study revealed good bone gain and elimination of SOT and prominent occlusal function. We concluded that the application of IR, minocycline‐HCL and periodontal prosthetic procedures later elevated the prognosis of these otherwise hopeless teeth with SOT, which are valuable options for retaining teeth with periodontally extreme situations.

Ultrasonic Scaling Therapy in Advanced Peeiodontitis IV. A Long - Term Study Over Six Years

The objective of the present study was to evaluate the long-term effectiveness of clinical trials of ultrasonic scaling performed solely by a periodontist. A total of 51 individuals (27 males and 24 females) ranging in age from 21 to 61 years with moderate to advanced periodontitis were investigated following baseline assessments included gingival index (GI), plaque index (PlI), probing pocket depths (PPDs), and probing attachment levels (PALs). The individuals were subjected to active supra- and subgingival ultrasonic scaling by a periodontist alone following meticulous oral hygiene instruction. The results revealed a significant (p < 0.001) reduction of mean GI and PlI scores. In addition, a significant and sustained reduction of mean PPDs (p < 0.001) as well as significant sustained gain of mean PALs (p < 0.001) with initial PPDs of 4-6 mm and > or = 7 were greater than those sites with initial PPDs of 1-3 mm at each time interval. Basically, there exists a greater reduction of mean PPDs and greater gain of mean PALs on the buccal and lingual sites than those on the mesial and distal sites at each time interval.

The effect of ultrasonic scaling therapy in periodontitis III. A longitudinal study over three years.

The purpose of the present study was to examine and evaluate the effect of clinical trials of non-surgical periodontal therapy (NSPT) by ultrasonic scaling alone for three years. A total of 51 individuals (27 males; 24 females) ranging in age from 21 to 61 years with moderately to extremely advanced periodontitis were studied following baseline assessments which included gingival index, plaque index, probing pocket depths, and probing attachment levels (PALs). The patients were subjected to NSPT by using supra- and subgingival scaling with ultrasonic instrumentation alone. The results showed that this therapy resulted in a pronounced and significant reduction (p < 0.001) of gingival inflammation and dental plaque formation for the 3 years of study. In addition, a significant reduction of probing depth as well as an obvious gain of PALs were found greater in sites with initial depth of 4-6 mm and 7 mm or more (p < 0.001) than those in sites with initial probings of 1-3 mm (p > 0.05) at each survey time point.