Word Files
Reference for Downloading Educational Files
  2. Medical Sciences
  3. Evaluation of periodontal problems of maxillary Mullerdom after removal of bone graft from the tuberosity area

Evaluation of periodontal problems of maxillary Mullerdom after removal of bone graft from the tuberosity area

Number of pages: 104 File Format: word File Code: 32028
Year: 2014 University Degree: Master's degree Category: Medical Sciences
Tags/Keywords: Autogenous transplantation - Bone grafting - Maxillary second molar - Periodontal Mullerdom - Periodontal problems - periodontitis - Reconstruction of bone defects - Tuberosity of the maxilla
  • Part of the Content
  • Contents & Resources

  • Summary of Evaluation of periodontal problems of maxillary Mullerdom after removal of bone graft from the tuberosity area

    Dissertation for obtaining a doctorate degree in dentistry

    Abstract

    Introduction: One of the best methods for reconstructing bone defects in the mouth and teeth of patients is the use of autogenous grafting, which is still considered as the gold standard for augmentation of bone-deficient areas. Numerous intra-oral areas to harvest this bone graft It is known that the tuberosity of the maxilla is a suitable place for the removal of limited amounts of bone due to easier access and fewer surgical complications.

    The purpose of this study is to evaluate the periodontal problems of the maxillary second molar after the removal of the bone graft from the tuberosity area.

    Materials and methods: 15 patients referred to the surgery and implant department of the Faculty of Dentistry. Mashhad, with the age range of 20 to 40 years, entered the study after checking the entry and exit conditions.

    For each patient, pocket depth indicators, gingival adhesion loss, plaque index, gingival index and bleeding after probing, in three areas including middistal, distobuccal and distolingual, were measured and recorded from each tooth at two times before and 6 months after surgery.

    Results: According to the results obtained from the comparison of the average depth of the pocket in the distal second molar of the maxilla, at two times before and 6 months after the operation, it is observed that this index has decreased by 15.4%, which is significant. It was evaluated that all three have decreased significantly over time. (Plaque Index P=0.002) (Loss of gingival adhesion P=0.025) (Gingival Index P=0.077)

    The amount of bleeding observed in 6 months after surgery has decreased by 21.4%, but this decrease was not significant. (P=0.250)

    Conclusion: removing a bone graft from the tuberosity area will not lead to periodontal problems for the maxillary second molar adjacent to this area, and the supporting bone in its distal part, as if it was damaged during surgery, will be reconstructed again so that we will have a normal pocket depth and biological width.

    Key words: tuberosity Maxilla-second molar of the upper jaw-periodontitis-bone graft

    Chapter one:

    Overview and review of texts and articles

    (1-1) Introduction:

         Factors such as chronic periodontitis, trauma, malformation and neoplasias can lead to atrophy, deformity and even decrease the function of the alveolar ridge, which in this way cause disturbances in the beauty, chewing, or implant placement to renew the chewing function (1) therefore, the repair of these areas by increasing the ridge with the help of using bone grafts is considered a common method in maxillofacial surgery.

         Meanwhile, despite some recent proposals regarding bone replacement technology, autogenous bone grafts are still the most accepted in jaw and facial reconstruction surgeries due to their osteoinductive, osteoconductive and immune system properties. (30) This type of bone grafts can be prepared from intra-oral and extra-oral areas. style="direction: rtl;">     Among the intraoral sources, the symphysis and ramus of the mandible are used to prepare the bone block and the tuberosity of the maxilla to prepare the particles. Despite the importance of these bone grafts in the reconstruction of the ridge, the problems and complications resulting from its harvest for the adjacent tissues of the donor area cannot be ignored.

    One of the possible complications that can be raised for this type of surgery the occurrence of periodontal problems for the teeth adjacent to the surgical area. The loss of adhesion of the gum and periodontium tissues, followed by the formation of a pocket in the distal of these teeth and the occurrence of periodontitis, a predictable result is considered as a complication for this type of surgery.

    Studies and information related to maxillary tuberosity surgery are very limited.Most of the studies have investigated the periodontal problems arising in third molar surgeries. The gums are before and 6 months after the surgery. style="direction: rtl;">      Periodontitis is an inflammatory disease of tooth supporting tissues that is caused by specific microorganisms or a group of specific microorganisms and is characterized by extensive destruction of the periodontal ligament and alveolar bone along with the formation of a pocket, gingival recession or both.

    The clinical view that identifies periodontitis from gingivitis is the presence of Attachment Attachment loss is clinically detectable in periodontitis. This state is usually accompanied by pocket formation and changes in the density and height of the adjacent alveolar bone. In some cases, gingival resorption may occur along with attachment loss.

         Therefore, if pocket depth measurement is done without measuring the clinical attachment level (Clinical Attachment level), the progressive disease remains hidden and is not diagnosed.

    Clinical signs of inflammation such as changes in color, shape, consistency and bleeding during Probing may not always be a positive indicator for progressive attachment loss, but still, the presence of bleeding during probing in consecutive patient control sessions is a reliable indicator for the presence of inflammation and possible attachment loss (AL) in the bleeding area. rtl;">(2-2-1) How the disease spreads:

    Chronic periodontitis is a site-specific disease. The clinical symptoms of chronic periodontitis—namely, abscesses, pocket formation, loss of attachment, and bone loss—are attributed to the direct effects of localized subgingival plaque accumulation. As a result of this localized effect, pocketing, bone loss, and loss of attachment may occur on one surface of the tooth while other surfaces remain healthy and intact. For example, a proximal surface with chronic accumulation of plaque can suffer loss of connections, while the fascial surface free of plaque of the same tooth may be healthy.

         Due to the locality of periodontitis, when a few areas have loss of connections and bone loss, periodontitis is localized and when most areas of the mouth are affected, it is described as generalized.

    Chronic periodontitis can be vertical or horizontal. When the loss of connections and bone resorption in one surface of the tooth is more than the adjacent surface, it is vertical resorption, and when the rate of loss of connections and bone resorption is the same in most surfaces of the tooth, it will be horizontal resorption. Vertical bone resorption is usually associated with angular bone lesions and intrabony pockets. Horizontal bone resorption is usually associated with a suprabony pocket. style="direction: rtl;">Different intraoral donor sites to harvest the bone graft, are available that the maxillary tuberosity due to convenient surgical access and fewer complications, is a perfect place for taking a limited amount of bone.

  • Contents & References of Evaluation of periodontal problems of maxillary Mullerdom after removal of bone graft from the tuberosity area

    List:

    Abstract. 1

    Chapter One: General and review of texts and articles

    (1-1) Introduction:. 4

    (2-1) General:. 6

    (1-2-1) Definition of periodontitis:. 6

    (2-2-1) How the disease spreads:. 7

    (3-2-1) Types of periodontitis:. 9

    (4-2-1) Disease risk factors:. 10

    (5-2-1) Diagnosis of periodontitis:. 12

    (6-2-1) Factors related to periodontal defects in distal Mullerdom: 13

    (7-2-1) flap design principles:. 14

    (8-2-1) Review of maxilla anatomy:. 16

    (9-2-1) Posterior surface or subtemporal surface of the maxilla:. 17

    (10-2-1) Bone graft materials:. 19

    (11-2-1) Preparation of bone from intraoral sources:. 25

    (3-1) review of the studies done: 28

    (4-1) statement of the problem and the necessity of conducting research:. 37

    (5-1) Objectives and assumptions:. 41

    Chapter Two: Materials and Methods

    (1-2) Study population:. 44

    (2-2) Sampling method:. 44

    (2-3) sample size: 44

    (4-2) Method of implementing the plan:. 44

    (5-2) Study entry and exit criteria:. 45

    (2-6) Methods and tools for collecting information: 45

    (2-7) Silness & Leo index plate index (PI): 46

    (2-8) Gingival index (GI): 47

    (2-9) Envelope depth index (PD): 47

    (2-10) Gingival attachment loss index (AL): 48

    (2-11) Bleeding index during probing (BOP): 48

    (2-12) Surgery: 49

    (2-13) Measurements after surgery: 53

    (2-14) table of variables: 54

    (2-15) Data analysis method and statistical analysis: 55

    Chapter three: findings and results

    (1-3) Envelope depth:. 56

    (2-3) Number plate index: 59

    (3-3) Loss of gum adhesion:. 61

    (3-4) Gum index:. 63

    (3-5) Bleeding index:. 65

    Chapter Four: Discussion

    Chapter Five: Conclusion and Suggestions

    (1-5) Conclusion:. 78

    (2-5) Strengths and limitations of the study: 78

    (3-5) Suggestions:. 80

    Chapter Six: References

    Reference. 75

    English abstract. 80

    Appendices

    Source:

     

    Reference:

    1. Silva FM, Cortez AL, Moreira RW, Mazzonetto R. Complications of intraoral donor site for bone grafting prior to implant placement. Implant Dent. 2006 Dec;15(4):420-6.

    2. Novak MJ, Novak KF. Chronic periodontitis. In: Newman MG, Takei HH, Klokkevold PR, Carranza FA. Carranza's clinical periodontology. 10th ed. Philadelphia: Elsevier; 2006. P: 494-9.

    3. Socransky SS, Haffajee AD, Goodson JM, Lindhe J. New concepts of destructive periodontal disease. J Clin Periodontol, 1984; 11(1): 21-32.

    4. Beck JD, Arbes SJ. Epidemiology of gingival and periodontal diseases. In: Newman MG, Takei HH, Klokkevold PR, Carranza FA. Carranza's clinical periodontology. 10th ed. Philadelphia: Elsevier; 2006. P: 125-7.

    5. Papapanou PN. Risk assessments in the diagnosis and treatment of periodontal diseases. J Dent Educ, 1998; 62(10): 822-39.

    6.Sanz M, Newman MG, Quirynen M. Advanced diagnostic techniques. In: Newman MG, Takei HH, Klokkevold PR, Carranza FA. Carranza's clinical periodontology. 10th ed. Philadelphia: Elsevier; 2006. P: 579.

    7.Tetradis S, Carranza FA, Fazio RC, Takei HH. Radiographic aids in the diagnosis of periodontal disease. In: Newman MG, Takei HH, Klokkevold PR, Carranza FA. Carranza's clinical periodontology. 10th ed. Philadelphia: Elsevier; 2006. P: 561.

    8. Carranza FA, Takei HH. Clinical diagnosis. In: Newman MG, Takei HH, Klokkevold PR, Carranza FA. Carranza's clinical periodontology. 10th ed. Philadelphia: Elsevier; 2006. P: 541-54.

    9. Oxford GE, Quintero G, Stuller CB, Gher ME. Treatment of 3?? molar-induced periodontal defects with guided tissue regeneration. J Clin Periodontal 1997;24:464-9

    10. Penarocha Diago M, Galan Gil S. Vestibular bone window for the extraction of impacted lower third molars: four case reports. Med Oral Pathol Oral Cir Bucal 2008; 13::E508-10

    11. Dodson TTB. Is there a role for reconstructive techniques to prevent periodontal defects afterIs there a role for reconstructive techniques to prevent periodontal defects after third molar surgery? Oral Maxillofac Surg Clin North Am 2007; 19:99-104

    12. Dodson TB. Management of mandibular third molar extraction sites to prevent periodontal defects. J Oral Maxillofac Surg 2004; 62:1213-24. 13. Leung WK, Corbet EF, Kan KW, Lo EC, Liu JK. A regimen of systematic periodontal care after removal of impacted mandibular third molars manages periodontal pockets associated with the mandibular second molars. J Clin Periodontal 2005; 63:766-70

    14.Sammartino G,Tia M,Marenzi G,di Lauro AE,D? Agostino E,Claudio PP.Use of autologous platelet-rich plasma (PRP) in periodontal defect treatment after extraction of impacted mandibular third molars.J Oral Maxillofac Surg.2005;63:766-770.

    15.Pons-Vicente O , Valmaseda-Castellon E, Berini-Aytes L, GayEscoda C. Effect on pocket depth and attachment level of manual versus ultrasonic scaling of lower second molars following lower third molar extraction: a randomized controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107:e11-9

    16. Suarez-Cunqueiro MM, Gutwald R, Reichman J, Otero-Cepeda XL, Schmelzeisen R. Marginal flap versus paramarginal flap in impacted third molar surgery: a prospective study. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 2003;95(4):403-8.

    17. Jakse N, Bankaoglu V, Wimmer G, Eskici A, Pertl C. Primary wound healing after lower third molar surgery: evaluation of 2 different flap designs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Jan;93(1):7-12.

    18. Williams PL, Warwick R, Dyson M, Bannister LH: Gray`s Anatomy. 37th ed. United Kingdom: Churchill Livingstone CO. 1989. P. 267-359.

    19. Han TJ, Park KB, Surgical aspects of dental implants. in: Newman MG, Takei H, Carranza. FA. Clinical periodontology. 9th ed. Philadelphia London, New York, st. Louis, Sydney, Toronto: W.B. Saunders CO; 2002. P: 905-921.

     

    20. Coceancig PL. Alveolar bone grafts distal to the lower second molar. J Maxillofac Oral Surg. 2009 Mar;8(1):22-6.

    21. Klockkevold PR, Jovanovic SA. Advanced Implant surgery and bone grafting techniques. In Newmexn MG, Take HH, Carranza FA. Carranza's clinical periodontology. 9th ed. Philadelphia, W.B. Saunders Co., 2002; P: 905.

    22.Sweet JB, Butler DP. Predisposing and operative factors: effect on the incidence of localized osteitis in mandibular third-molar surgery. Oral Surg Oral Med Oral Pathol. 1978 Aug;46(2):206-15.

    23. Kugelberg CF. Periodontal healing two and four years after impacted lower third molar surgery. A comparative retrospective study. Int J Oral Maxillofac Surg. 1990 Dec;19(6):341-5.

    24.Kugelberg CF, Ahlstrom U, Ericson S, Hugoson A, Kvint S. Periodontal healing after impacted lower third molar surgery in adolescents and adults. A prospective study. Int J Oral Maxillofac Surg. 1991 Feb;20(1):18-24.

    25. Absi EG, Shepherd JP. A comparison of morbidity following the removal of lower third molars by the lingual split and surgical bur methods. Int J Oral Maxillofac Surg. 1993 Jun;22(3):149-53.

    26. Craig M. Misch, DDS, MDS. Use of the mandibular ramus as a donor site for onlay bone grafting. J Oral Implantol. 2000;26(1):42-9.

    27. Peng KY, Tseng YC, Shen EC, Chiu SC, Fu E, Huang YW. Mandibular second molar periodontal status after third molar extraction. J Periodontol. 2001 Dec;72(12):1647-51.

    28. Kan KW, Liu JK, Lo EC, Corbet EF, Leung WK. Residual periodontal defects distal to the mandibular second molar 6-36 months after impacted third molar extraction. J Clin Periodontol. 2002 Nov;29(11):1004-11.

    29.Chang HH, Lee JJ, Kok SH, Yang PJ. Periodontal healing after mandibular third molar surgery-A comparison of distolingual alveolectomy and tooth division techniques. Int J Oral Maxillofac Surg. 2004 Jan;33(1):32-7.

     

    30. Schwartz-Arad D, Levin L, Sigal L.

Evaluation of periodontal problems of maxillary Mullerdom after removal of bone graft from the tuberosity area
How To Access The File
Related Contents:
Number of pages: 78 Category: Medical Sciences

Abstract: Introduction: One of the main goals of treating periodontal diseases is to preserve the alveolar bone in order to continue the survival of the tooth. There is a suspicion that if the activity of osteoblast cells is stimulated and the osteoclastic activity of bone cells is prevented during the treatment process, the bone structure can be rebuilt. The positive effect of ...

Number of pages: 86 Category: Medical Sciences

Dissertation for general doctor degree in dentistry Abstract Introduction: One of the common problems after the surgery of the latent third molar tooth is the development of periodontal problems, which manifests itself in the form of a pocket in the distal second molar tooth, loss of connections and lack of adequate bone formation. To solve this problem, various methods such as ...

Number of pages: 57 Category: Medical Sciences

Abstract Introduction: One of the most common types of fractures in the jaw and face area is the fractures of the middle area of ??the face and cheekbones, in which the anterior wall of the sinus is involved in the majority of these fractures. Following the fracture of the front wall of the sinus, soft tissue prolapse, sinusitis, rhinitis, pain and tenderness can occur when ...

Number of pages: 73 Category: Medical Sciences

Dissertation for receiving the degree of Doctor of Dentistry Abstract Introduction Considering the importance of milk teeth in creating an ideal occlusion, it is essential to preserve and maintain them due to caries. One of the methods of restoring milk teeth is the use of stainless steel veneers. Maintaining the health of the tissue that supports the teeth is one of the ...

Number of pages: 64 Category: Medical Sciences

Dissertation for obtaining a professional doctorate degree in dentistry Abstract Introduction: One of the common causes of non-surgical root canal treatment failure is the inability to effectively treat all root canals due to the complex anatomy of the root canal system. Due to the fact that so far no comprehensive and extensive study has been conducted on the anatomy of the ...

Number of pages: 136 Category: Medical Sciences

Dissertation to receive a specialized doctorate degree in dentistry in the field of pediatrics Abstract History and Purpose Traumatic dental injuries are considered one of the most common events in childhood and adolescence. Among these injuries, ovalgen (falling out of the tooth from the socket) is considered a real emergency and requires quick and accurate treatment by a ...

Number of pages: 107 Category: Paramedical

Dissertation for obtaining a specialized doctorate in oral and maxillofacial radiology Abstract: Introduction and purpose: The purpose of radiological evaluation of the temporomandibular joint (TMJ) is to depict suspected clinical disorders. This study was conducted with the aim of comparing the position and morphology of the condyle in symptomatic and asymptomatic patients with ...

Number of pages: 82 Category: Medical Sciences

Dissertation for the degree of Doctor of Dentistry Abstract: Introduction: HTLV-1 virus is one of the human retroviruses, which in some patients is the cause of T lymphocyte leukemia and myelopathy related to HTLV-1 and some other inflammatory diseases. Considering the endemicity of Khorasan with respect to the HTLV-1 virus and the existence of few studies on the relationship ...

Number of pages: 65 Category: Medical Sciences

Dissertation to obtain a doctorate degree in general dentistry. Findings: The vertical changes of the soft tissue in all the measured points were lower in the test group compared to the control group, and this difference was not significant only in the midbuccal region, but it is significant in other places. The horizontal dimensional changes of the soft tissue were also less at ...

Number of pages: 147 Category: Electronic Engineering

Master's thesis in medical engineering, bioelectrical trend, abstract of the separation of prosthesis projections and tissue implants in sinogram images of spiral CT scan using active contour methods for metal implants such as prostheses and tooth filling materials during the reconstruction of CT images with different methods, creates an artifact that appears as light and dark ...