Novel treatment approach of localized juvenile spongiotic gingival hyperplasia with use of Nd:YAG laser.

Introduction: This article describes the management of two patients who presented with localized juvenile spongiotic gingival hyperplasia. This disease entity is poorly understood, and literature regarding successful treatment is scant. However, there are common themes to management including proper diagnosis and treatment via removal of the affected tissue.

Considerations for using a removable prosthesis with attachments for a staged approach to a failing implant reconstruction.

Full-arch implant reconstructions are being utilized in clinical practice today. Very often these prostheses are prosthetically driven, but not periodontally maintainable. Often the patient presents to the general practitioner with a failing implant reconstruction, where several fixtures need to be removed and others are maintainable.

Laser-Assisted Therapy for the Treatment of Peri-implantitis. Part I. Clinical Outcomes.

The purpose of this 12-month randomized, controlled clinical trial was to evaluate the efficacy of a monotherapy protocol with the neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for treatment of peri-implantitis. Twenty patients with 36 implants exhibiting probing pocket depths (PPDs) > 4 mm and evidence of radiographic bone loss (RBL) were randomly divided into two groups. The test group was treated with the Nd:YAG laser, and the control group was managed with mechanical debridement only.

Effectiveness of Adjunctive Use of Low-Level Laser Therapy and Photodynamic Therapy After Scaling and Root Planing in Patients with Chronic Periodontitis.

The aim of this split-mouth, randomized controlled clinical trial was to evaluate the efficacy of low-level laser therapy (LLLT) and photodynamic therapy (PDT) as an adjunct to scaling and root planing (SRP) in treatment of chronic periodontitis. Each quadrant was categorized into control group (SRP alone; two quadrants per patient), test group 1 (SRP + PDT), and test group 2 (SRP + LLLT. The test groups showed significantly higher reductions in Gingival Index, probing depth, and clinical attachment level as well as reductions in Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans counts at 1-, 3-, 6-, and 9-month follow-ups when compared with the control group.

Novel Approach to Overcome Limitations Associated With Immediate Implant Placement: Osteotome Technique.

This case series introduces a novel osteotome technique as an alternative to conventional drilling protocols for immediate fixtures. Immediate implant placement is associated with significantly less bone-to-implant contact, and navigating the anatomy of the socket can be difficult. Osteotomy drills remove already-limited bone following atraumatic extractions.

Amniotic Band Syndrome: A Multidisciplinary Care Approach to the Treatment of a Rare Case.

Amniotic band syndrome (ABS) is a rare developmental disorder associated with defects such as syndactyly, facial and/or palatal clefts, and dental anomalies like malformed or impacted teeth. In this report, a patient with ABS was successfully treated with orthodontic, endodontic, and periodontal therapies. Cone beam computed tomography revealed a unique eruptive path of the impacted central incisor through the incisive canal and cleft area.

Lip Repositioning with Vestibular Shallowing Technique for Treatment of Excessive Gingival Display with Various Etiologies.

Improvement of smile esthetics is a major goal of modern dentistry. Various treatment modalities have been proposed to correct excessive gingival display (EGD), depending on the identified etiologies. This study reports on the clinical and patient-centered outcomes of a novel lip repositioning technique with vestibular shallowing approach in the treatment of three types of EGD with varying etiologies.

Comparison of Osteotome and Conventional Drilling Techniques for Primary Implant Stability: An In Vitro Study.

It may be difficult to achieve primary stability in the posterior maxilla because of poor quality and quantity of bone. Studies have shown that the osteotome technique immediately increases bone density thereby increasing primary stability. An in vitro study was conducted to compare the stability achieved by the osteotome and conventional drilling techniques in low density bone.

Resonance frequency analysis (RFA) and insertional torque (IT) stability comparisons of implants placed using osteotomes versus drilling techniques: A preliminary case study.

Objective: Poor bone density in the posterior maxilla often presents challenges in achieving implant stability. Insertional torque (IT) and resonance frequency analysis (RFA) have been used to objectively monitor the process of osseointegration. This study was designed to quantitatively assess the primary and secondary stability of fixtures placed using the osteotome or conventional drilling technique, in soft bone.

Novel Techniques with the Aid of a Staged CBCT Guided Surgical Protocol.

The case report will present some novel techniques for using a "staged" protocol utilizing strategic periodontally involved teeth as transitional abutments in combination with CBCT guided implant surgery. Staging the case prevented premature loading of the grafted sites during the healing phase. A CBCT following a tenting screw guided bone regeneration procedure ensured adequate bone to place an implant fixture.

Reconstruction of the narrow ridge using combined ridge split and guided bone regeneration with rhPDGF-BB growth factor-enhanced allograft.

In clinical situations where the presence of severe horizontal ridge deficiencies precludes simultaneous implant placement and bone augmentation, a staged approach may be desirable to allow optimal implant placement. Numerous therapeutic options are available for the treatment of the horizontally deficient ridge. With advances in tissue engineering, the use of growth factors can significantly improve wound healing with more rapid bone formation and maturation.

Maintaining space in localized ridge augmentation using guided bone regeneration with tenting screw technology.

Prosthetic guided implant surgery requires adequate ridge dimensions for proper implant placement. Various surgical procedures can be used to augment deficient alveolar ridges. Studies have examined new bone formation on deficient ridges, utilizing numerous surgical techniques and biomaterials.

Novel decision tree algorithms for the treatment planning of compromised teeth.

In clinical practice, dentists are faced with the dilemma of whether to treat, maintain, or extract a tooth. Of primary importance are the patient's desires and the restorability and periodontal condition of the tooth/teeth in question. Too often, clinicians extract teeth when endodontic therapy, crown-lengthening surgery, forced orthodontic eruption, or regenerative therapy can be used with predictable results.

Considerations for a staged approach in implant dentistry.

Full-arch and partial reconstruction is demanding for the clinician and a challenge for the patient. Traditionally, teeth are extracted, and implants are placed; the patient wears a provisional removable prosthesis during implant osseointegration. The patient is left to deal with a difficult transition from a fixed dentition to a removable one, albeit temporarily.

Gastroesophageal reflux after sleeve gastrectomy in morbidly obese patients.

Background: Gastroesophageal reflux disease (GERD) is highly prevalent in morbidly obese patients and a high body mass index is a risk factor for the development of this co-morbidity. The effect of laparoscopic sleeve gastrectomy (LSG) on GERD is poorly known.

Methods: We studied the effect of LSG on GERD in patients with morbid obesity.

Decreasing morbidity and mortality in 100 consecutive minimally invasive esophagectomies.

Introduction: Esophagectomy is a complex invasive procedure that requires exploration of multiple body cavities for removal and subsequent restoration of gastrointestinal continuity. In many institutions, esophagectomy morbidity and mortality rates remain high despite improvement of intensive care treatment. We reviewed our minimally invasive esophagectomy (MIE) experience of a consecutive series of 100 patients to analyze trends in morbidity and mortality as we transitioned from open to MIE.

Sequencing osteotomes to overcome challenges presented by deficient bone quantity and quality in potential implant sites.

The combination of inadequate bone volume, poor bone quality, and elevated occlusal forces contributes to the posterior maxilla being the least predictable site for implant survival. Osteotomes are surgical instruments that have been designed in an attempt to improve bone quantity and quality. Conflicting reports in the literature compare the percentages of bone-to-implant surface contact between the implants placed using osteotomes and conventional drills.

Retrograde jejunojejunal intussusception status following Roux-en-Y gastrojejunostomy.

Reported herein is an experience with retrograde intussusception. The index case was a 25-year-old African American woman who was status post-multiple previous intraperitoneal procedures, including a truncal vagotomy, distal gastrectomy, and Roux-en-Y gastrojejunostomy for the treatment of gastric outlet obstruction secondary to type 2 peptic ulcer disease. The patient presented most recently with symptoms and signs of a high-grade mechanical intestinal obstruction.

Alternative to the gold standard for alveolar ridge augmentation: tenting screw technology.

Studies have discussed the potential issues associated with the placement of implants in unfavorable locations. Today, it is possible to optimize implant placement despite the significant ridge resorption that often occurs after tooth extraction. This objective is achievable because techniques exist to augment resorbed alveolar ridges to prerequisite widths and heights for proper implant position.

Incidence of surgical site infections postcolorectal resections without preoperative mechanical or antibiotic bowel preparation.

This study was performed to determine the incidence of surgical site infections (SSIs) after colorectal resection in patients without mechanical or antibiotic bowel preparation. A retrospective review of the medical records of 136 consecutive patients undergoing an elective colorectal resection between April 2004 and April 2006 was performed. Indications for colon resection in this series were malignant neoplasia (48%), inflammatory bowel disease (18%), diverticular disease (17%), or other benign disease (17%).