Aggressive periodontitis

侵袭性牙周炎
  • 文章类型: Case Reports
    Systemic lupus erythematosus (SLE) with oral desquamative lesions is one of the rare clinical entities. Periodontal disease and SLE display various mechanisms and possess a wide range of pathological characteristics. The tissue destruction mechanism of periodontitis and autoimmune diseases share similar pathways, and mounting reports studied the association between these two entities. The present case is of a 24-year-old female patient who complained of generalized widening of spaces in between the teeth. Along with it, She suffered from loss of hair, weakness, edema in the legs as well as arthralgia. The patient was identified to be suffering from SLE according to the American Rheumatism Association and European Academy of Dermatology and Venereology criteria 1 year before she reported to the dentist. She suffered from hair loss, weakness, arthralgia as well as edema in the legs. Based on the oral, clinical, and radiographic findings, she was diagnosed with aggressive periodontitis case. After nonsurgical periodontal treatment, the flap was reflected, debridement was done, after root conditioning with tetracycline, bovine osseous xenograft was placed in all the sites where ever there is angular bone loss, later sutured with interrupted direct loop suturing technique with 4-0 silk suture. Clinical and radiographic evaluation was done every 6 weeks to check the progress of the treatment. 6 months and 8-year follow-up revealed satisfactory clinical and radiographic outcomes. Based on the present case report and the previous literature, we recommend the use of xenograft in treating aggressive periodontitis patients.
    Résumé Le lupus érythémateux systémique (LES) avec lésions buccales desquamatives est l\'une des rares entités cliniques. La maladie parodontale et le LED présentent divers mécanismes et possèdent un large éventail de caractéristiques pathologiques. Le mécanisme de destruction des tissus de la parodontite et des maladies auto-immunes partage des voies similaires. partagent des voies similaires, et de nombreux rapports ont étudié l\'association entre ces deux entités. Le cas présent est celui d\'une patiente de 24 ans 24 ans qui se plaignait d\'un élargissement généralisé des espaces entre les dents. En plus de cela, elle a souffert d\'une perte de cheveux, de faiblesse, d\'œdème dans les jambes et d\'arthralgie. La patiente a été identifiée comme souffrant d\'un LED selon les critères de l\'American Rheumatism Association et de l\'Académie européenne de dermatologie et de vénéréologie un an avant de se présenter chez le dentiste. Elle souffrait de de perte de cheveux, de faiblesse, d\'arthralgie et d\'œdèmes dans les jambes. Sur la base des résultats buccaux, cliniques et radiographiques, elle a été diagnostiquée comme souffrant de parodontite agressive. Après un traitement parodontal non chirurgical, le lambeau a été réfléchi, un débridement a été effectué, après un conditionnement radiculaire après conditionnement radiculaire à la tétracycline, une xénogreffe osseuse bovine a été placée dans tous les sites où il y avait une perte osseuse angulaire. technique de suture en boucle directe interrompue avec une suture en soie 4-0. Une évaluation clinique et radiographique a été faite toutes les 6 semaines pour vérifier la progression du traitement. traitement. Le suivi à 6 mois et à 8 ans a révélé des résultats cliniques et radiographiques satisfaisants. Sur la base du présent rapport de cas et de la littérature précédente, nous recommandons l\'utilisation de la xénogreffe dans le traitement des patients atteints de parodontite agressive. Mots-clés: Parodontite, lupus érythémateux systémique, xénogreffe.
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  • 文章类型: Case Reports
    本报告描述了需要牙周再生治疗的III级C级牙周炎病例。该患者是一名19岁的妇女,主要主诉门牙区域牙龈萎缩。初步检查显示,有45.3%的部位的探查深度≥4mm,探查时出血为45.8%。射线照相检查显示#25、26、31、36和46中的角骨吸收和其他区域的水平吸收。基于III期C级牙周炎(广泛性侵袭性牙周炎)的临床诊断实施初始牙周治疗。在抑制炎症后,还在显示过早接触的部位(#26和#36)进行咬合调整。使用重组人成纤维细胞生长因子(rhFGF)-2的牙周再生治疗在#25、26和46上进行。在#31和36上进行rhFGF-2和去蛋白牛骨矿物质(DBBM)的联合治疗。在#31上使用非切开乳头手术方法(NIPSA)。然后重新评估牙周状况,并对患者进行支持牙周治疗。使用rhFGF-2和DBBM与NIPSA的再生疗法在临床参数和骨吸收方面产生了改善。这种改善在12个月内得到了充分的维持。需要持续护理以保持稳定的牙周状况。
    This report describes a case of Stage III Grade C periodontitis requiring periodontal regenerative therapy. The patient was a 19-year-old woman who presented with the chief complaint of gingival recession in the incisor region. An initial examination revealed that 45.3% of sites had a probing depth of ≥4 mm and 45.8% bleeding on probing. Radiographic examination showed angular bone resorption in #25, 26, 31, 36, and 46 and horizontal resorption in other regions. Initial periodontal therapy was implemented based on a clinical diagnosis of Stage III Grade C periodontitis (generalized aggressive periodontitis). Occlusal adjustment was also performed at sites showing premature contact (#26 and 36) after suppression of inflammation. Periodontal regenerative therapy using recombinant human fibroblast growth factor (rhFGF) -2 was performed on #25, 26, and 46. Combination therapy with rhFGF-2 and deproteinized bovine bone mineral (DBBM) was performed on #31 and 36. A non-incised papillae surgical approach (NIPSA) was used on #31. Periodontal conditions were then re-evaluated and the patient placed on supportive periodontal therapy. Regenerative therapy using rhFGF-2 and DBBM with NIPSA yielded an improvement in clinical parameters and bone resorption. This improvement has been adequately maintained over a 12-month period. Continued care is needed to maintain stable periodontal conditions.
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  • 文章类型: Case Reports
    骨膜下植入物可能是牙槽脊受损患者未来的一线治疗方法,尽管需要使用适当的技术和术前成像来确保治疗成功。
    严重的骨丢失使骨内植入物的成功处于危险之中。本技术报告旨在介绍通过增材制造制造的骨膜下植入物(SPI)。提出了一个案例研究,概述了使用定制的骨膜下植入物完全恢复上颌骨结构的过程和策略。病人,以前对传统的骨内植入物感到失望,收到定制的SPI。还提供了详细的3年随访。骨膜下框架和基台的设计基于患者颌骨结构的数字记录和闭塞期间的影像学支架。这确保了在牙弓内的最佳放置。然后使用钛合金对植入物和基台进行三维(3D)打印,而临时义齿是使用聚合物材料3D打印的。SPIs为严重颌骨退化的个体提供了可行的替代方案,如本报告所示,详细介绍了它们在完全上颌骨修复中的应用。这个病人特有的,假体驱动的方法避免了骨移植的需要,并通过单一的外科手术使功能立即恢复。
    UNASSIGNED: Subperiosteal implants might be the future first-line treatment in patients with compromised alveolar ridges, although the use of proper techniques and pre-surgical imaging is required to ensure treatment success.
    UNASSIGNED: Severe bone loss puts the success of endosseous implants at risk. This technical report aims to introduce the subperiosteal implants (SPIs) created through additive manufacturing. A case study is presented, outlining the process and strategies employed to fully restore a maxillary structure using a customized subperiosteal implant. The patient, who had previously faced disappointment with traditional endosseous implants, received a customized SPI. A detailed 3-year follow-up is also provided. The design of the subperiosteal framework and abutments is based on digital records of the patient\'s jaw structure and a radiographic stent during occlusion. This ensures optimal placement within the dental arch. The implant and abutments are then three-dimensional (3D) printed using a titanium alloy, while a provisional denture is 3D-printed using polymer materials. SPIs offer a viable alternative for individuals with severe jaw bone degeneration, as demonstrated in this report detailing their application in complete maxillary restoration. This patient-specific, prosthesis-driven approach avoids the need for bone grafting and enables immediate functional recovery through a single surgical procedure.
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  • 文章类型: Review
    背景:牙周炎是一种多因素病因的炎症性疾病。维生素D,一种脂溶性维生素,在各种全身性疾病中对炎症反应具有保护作用。维生素D缺乏的临床特征包括生长障碍,低张力,病理性骨折,强臂念珠,tetany等等。在这里,我们介绍了一例12岁女孩,患有早发性牙周炎并伴有维生素D缺乏。
    方法:一个12岁的女孩,牙龈发红,与刷牙相关的出血,和下颌前牙运动,在过去的两个月里咀嚼困难。无相关家族史或特殊全身性疾病史。血清微量元素检测显示维生素D水平明显低于正常范围。免疫学检查显示CD4+/CD8+(CD3+CD4+/CD3+CD8+)比值也异常。
    方法:根据临床和血清学结果,该患者最终被诊断为早发性牙周炎伴维生素D缺乏.
    方法:该患者的主要治疗方法为3倍:牙周治疗,补充维生素D和口腔卫生说明。
    结果:治疗1年后,牙周状况恢复并稳定。血清维生素D水平恢复正常范围。
    结论:感兴趣的病例是对临床医生的重要提醒,早发性牙周炎可能与微量营养素异常有关,早期诊断和治疗可以避免身体健康障碍。
    BACKGROUND: Periodontitis is an inflammatory disease with multifactorial etiology. Vitamin D, a fat-soluble vitamin, has protective effects on inflammatory response in various systemic conditions. The clinical features of vitamin D deficiency include growth failure, hypotonia, pathologic fractures, rachitic rosary, tetany and so on. Here we present a case of 12-year-old girl affected by early-onset periodontitis accompanied with vitamin D deficiency.
    METHODS: A 12-year-old girl with gingival redness, bleeding associated with tooth brushing, and mandibular anterior teeth movement, with difficulty in mastication for the past 2 months. There is no relevant family history or special systemic disease history. The serological microelement test showed vitamin D levels were significantly lower than normal range. Immunological test showed abnormal CD4+/CD8+(CD3+CD4+/CD3+CD8+) ratio as well.
    METHODS: Based on the clinical and serological findings, this patient was ultimately diagnosed with early-onset periodontitis accompanied with vitamin D deficiency.
    METHODS: The main treatments for this patient were 3-fold: periodontal therapy, vitamin D supplement and oral hygiene instructions.
    RESULTS: Following 1-year therapy, periodontal conditions recovered and became stable. And serological vitamin D levels returned to normal range.
    CONCLUSIONS: The case of interest serves as an important reminder to clinicians, that the early-onset periodontitis may be associated with micronutrients abnormalities, and early-diagnosis and treatment could avoid the body heathy disorders.
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  • 文章类型: Journal Article
    目的:本系列病例旨在评估COVID-19术后毛霉菌病的患者从临床表现到手术和药物治疗,以改善疾病预后。
    方法:该病例系列在巴格达医疗城的一家专业外科医院进行了超过10个月。15例有轻度至重度COVID-19感染,随后出现类似侵袭性牙周炎的症状,例如多颗上颌牙齿周围的活动性和骨吸收,包含在这个系列案例中。
    结果:所有患者均未接受COVID-19疫苗接种;7例有2型糖尿病病史,另外5例患者在COVID-19感染期间有糖尿病样综合征病史,其余3例患者无任何全身性疾病史。所有患者均未见颅内受累,在3例患者中发现了双侧鼻窦受累。
    结论:强烈建议高度怀疑所有感染COVID-19的患者,以避免晚期诊断毛霉菌病的并发症。此外,对于COVID-19后毛霉菌病,我们在诊断和治疗经典毛霉菌病方面的知识和方法应该进行修改。
    This case series aims to evaluate patients affected with post COVID-19 mucormycosis from clinical presentation to surgical and pharmacological treatment to improve the disease prognosis.
    This case series was conducted at a specialized surgery hospital in Baghdad Medical City for over 10 months. Fifteen cases who had mild to severe COVID-19 infections followed by symptoms similar to aggressive periodontitis, such as mobility and bone resorption around the multiple maxillary teeth, were included in this case series.
    All patients did not receive COVID-19 vaccination; seven had a history of diabetes mellitus type 2, another five patients had a history of diabetes-like syndrome during the COVID-19 infection, and the remaining three patients had no history of any systemic diseases. No intracranial involvement was seen in all patients, and bilateral sinus involvement was seen in three patients.
    Being highly suspicious of all patients affected with COVID-19 is highly recommended to avoid the complications of the late diagnosis of mucormycosis. In addition, our knowledge and methods in diagnosing and treating classical mucormycosis should be modified regarding post COVID-19 mucormycosis.
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  • 文章类型: Journal Article
    本病例系列的目的是评估在引导骨再生(GBR)后插入骨中的植入物。该研究招募了14例广泛性侵袭性牙周炎(GAP)患者,这些患者在切牙或前磨牙区域失去了一个或两个上颌牙齿。由于骨吸收,骨的横向宽度和垂直高度不足以放置植入物。使用钛增强的e-PTFE(膨胀聚四氟乙烯)膜以分阶段的方法进行GBR。没有使用骨移植物或骨替代材料。6到8个月后,将翻转表面植入物(n=47)插入增强和非增强的骨部位,并用单冠进行修复。所有患者在10至20年的3至6个月的召回计划中进行了检查,并进行了临床和影像学检查。GBR产生了4.5和7.0mm的平均垂直和外侧骨增益,分别。种植体成活率为100%,28.8%的部位存在粘膜炎,未发现种植体周围炎。牙齿部位的年度骨丢失显着高于增强骨的植入部位(0.5%vs0.2%,分别;P=.000),相邻牙齿的年骨损失显着增加(0.8%;P=.000)。因此,严重牙周受损的患者可以通过所述临床方案在长期内得到成功治疗.
    The aim of this case series was to evaluate implants inserted in bone after guided bone regeneration (GBR). Fourteen patients with generalized aggressive periodontitis (GAP) who had lost one or two maxillary teeth in the incisor or premolar region were enrolled in the study. Due to bone resorption, the lateral width and vertical height of the bone were insufficient for implant placement. GBR was carried out in a staged approach using titanium-reinforced e-PTFE (expanded polytetrafluoroethylene) membranes. No bone grafts or bone substitute materials were used. After 6 to 8 months, turned-surface implants (n = 47) were inserted in augmented and nonaugmented bone sites and prosthetically treated with single crowns. All patients were examined during a 3- to 6-month recall schedule over a 10- to 20-year period, and clinical and radiographic examinations were performed. GBR yielded mean vertical and lateral bone gains of 4.5 and 7.0 mm, respectively. The implant survival rate was 100%, mucositis was present in 28.8% of sites, and peri-implantitis was not found. The annual bone loss at tooth sites was significantly higher than at implant sites in augmented bone (0.5% vs 0.2%, respectively; P = .000), and the adjacent teeth had significantly higher annual bone loss (0.8%; P = .000). Thus, severely periodontally compromised patients can be managed successfully in the long-term with the described clinical protocol.
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  • 文章类型: Case Reports
    该病例报告概述了使用改良的Leighton's牵开器作为严重牙体发育不全患者的犬类牵开方法。有侵袭性牙周炎病史,牙齿脱落和特发性牙根吸收影响多颗牙齿。治疗涉及上部可拆卸矫治器与下部固定矫治器的组合,目的是改善患者的美学和功能。同时平衡最小化治疗持续时间和修改治疗机制以降低正畸风险的需要。
    This case report outlines the use of a modified Leighton\'s retractor as a method for canine retraction in a patient with severe hypodontia, a history of aggressive periodontitis with tooth loss and idiopathic root resorption affecting multiple teeth. Treatment involved an upper removable appliance in combination with a lower sectional fixed appliance with the aim of improving aesthetics and function for the patient, whilst balancing the need to minimise treatment duration and modify treatment mechanics to reduce the orthodontic risks.
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  • 文章类型: Case Reports
    伴有错(牙合)畸形及牙列缺损的重度牙周炎病情较复杂,其治疗应在完善牙周基础治疗的前提下进行多学科联合诊治,以达到恢复牙周组织健康、重建咬合功能及改善前牙美观的目标。在牙周再生性手术修复牙槽骨缺损过程中,可通过正畸整体移动、伸长、压低以及直立患牙等进行辅助治疗。本文报道1例多学科联合诊治广泛型重度慢性牙周炎病例的全过程,纵向观察4年,分析正畸压低在改善前牙区美学缺陷中的作用,并探讨牙周再生性手术与正畸治疗时机的个性化选择,以期为重度牙周炎的多学科治疗提供参考。.
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  • 文章类型: Case Reports
    侵袭性牙周炎主要影响年轻人,导致牙周组织的快速破坏和牙槽骨支撑的丧失。牙周组织的破坏导致病理性牙齿移动,导致各种类型的错牙合,例如牙列拥挤或间隔。该报告描述了由于广泛性侵袭性牙周炎引起的错牙合畸形的正畸治疗。患者是一名31岁的妇女,主要主诉是前牙移位。口腔检查显示,由于牙周支持的严重丧失,整个口腔中的病理性牙齿活动。还观察到移位的上颌前牙中的许多间隙和下颌前牙中的拥挤。后续治疗的目标是通过对齐牙齿并通过非拔牙正畸治疗和剥离封闭空间来获得理想的过度喷射和过度咬合。牙周病由牙周病专家管理,该专家在整个正畸治疗过程中为口腔卫生和牙周病控制提供指导。实现了适当的闭塞和良好的口腔环境。正畸治疗期间和之后牙周组织的状况稳定,在2年的随访检查中观察到良好的咬合稳定性。
    Aggressive periodontitis mostly affects young people, causing rapid destruction of periodontal tissue and loss of supporting alveolar bone. The destruction of periodontal tissue induces pathological tooth movement, resulting in various types of malocclusion such as crowding or spacing in the dentition. This report describes orthodontic treatment for malocclusion due to generalized aggressive periodontitis. The patient was a 31-year-old woman who presented with the chief complaint of displacement in the anterior teeth. An oral examination revealed pathological tooth mobility throughout the entire oral cavity due to severe loss of periodontal support. Many gaps in the displaced maxillary anterior teeth and crowding in the mandibular anterior teeth were also observed. The goal of subsequent treatment was to achieve ideal overjet and overbite by aligning the teeth and closing the spaces via non-extraction orthodontic treatment with stripping. The periodontal disease was managed by a periodontist who provided guidance on oral hygiene and periodontal disease control throughout the course of orthodontic treatment. Appropriate occlusion and a good oral environment were achieved. The condition of the periodontal tissue stabilized during and after orthodontic treatment, and favourable occlusal stability was observed at the 2-year follow-up examination.
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  • 文章类型: Case Reports
    特发性牙龈纤维瘤病,也称为特发性牙龈过度生长(IGO),是一种罕见的良性疾病,单独发生或作为综合征的一部分发生。过度生长,如果过量,阻碍咀嚼和言语等口腔功能,并导致美容毁容。如果过度生长是巨大的并且伴随着其他相关的病理,则诊断和治疗变得具有挑战性。该病例报告同时发生三种病理,即,IGO,侵袭性牙周炎,一名20岁健康男性患者的念珠菌感染。所进行的外科手术包括内斜面牙龈切除术和开放皮瓣手术。七年的随访显示,过度生长和牙周状况稳定均未复发。
    Idiopathic gingival fibromatosis, also called idiopathic gingival overgrowth (IGO), is a rare benign condition that occurs either in isolation or as a part of a syndrome. The overgrowth, if excess, impedes oral functions such as mastication and speech and causes cosmetic disfigurement. Diagnosis and treatment becomes challenging if the overgrowth is massive and accompanies other associated pathologies. This case reports concurrent occurrence of three pathologies, i.e., IGO, aggressive periodontitis, and candidal infection in a 20-year-old healthy male patient. The surgical procedure performed involved internal bevel gingivectomy combined with open-flap surgery. Seven-year follow-up revealed no recurrence of overgrowth and stable periodontal condition.
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