A rare case of gingival necrosis following an extraoral injection of dermal filler.

Background: The utilization of dermal fillers for cosmetic procedures has increased dramatically in the past several years, and so is the number of reported adverse events and complications. Most of these reports are centered on extraoral facial structures such as skin, nose, forehead, and eyes. However, as this report illustrates, intraoral complications are also possible and require appropriate management.

Use of Collagen Matrix Scaffolds as a Substitute for Soft Tissue Augmentation: Case Series.

Introduction: The presence of keratinized mucosa (KM) around natural teeth is believed to be beneficial in certain restorative, prosthetic, and orthodontic situations. Lack of adequate KM is common and predictably treated by autogenous gingival grafts (AGGs); however, AGGs have the disadvantages of harvest site morbidity, limited donor site availability, and compromised esthetics.

Case Presentation: This case series presents the use of the xenogeneic porcine bilayer collagen matrix (BCM) in increasing the width of attached KM around natural teeth.

Management of heat-induced bone necrosis following thermal removal of gutta-percha.

Many endodontically treated teeth require a post to improve the retention of the coronal restoration, which necessitates removal of the coronal part of the gutta-percha from the canal by thermal method, among other techniques. However, this technique carries the risk of heat conduction to the attachment unit of the periodontium and infliction of permanent damage especially in cases where the remaining root's dentin walls are thin. The overall objective of this article is to report on the clinical manifestations, histologic description, and periodontal management of three cases of heat-induced damage following thermal removal of gutta-percha.

The Potential Role of Curcumin in Periodontal Therapy: A Review of the Literature.

Periodontitis is a chronic inflammatory disease in the oral cavity caused by bacterial biofilm attached to tooth surfaces. The periodontal pathogenic microorganisms trigger the disease process; however, the destruction of the periodontium is mostly caused by the host's immune response to the bacterial insults. The main thrust of periodontal therapy has been centered traditionally on reducing the microbial load by mechanical and antimicrobial means.

Managing a Lateral Periodontal Cyst With Bone Graft: A Computed Tomography Assessment 18 Months Postoperatively.

The lateral periodontal cyst is a rare benign lesion that is generally asymptomatic and commonly discovered by routine intraoral radiography. Reports on proper management of this lesion are readily available. However, the literature is sparse regarding the long-term outcomes following surgery.

Surgical Management of Implant-Associated Gingival Fenestrations.

Soft tissue fenestrations are extremely rare in the natural dentition and have only recently been reported on dental implants. Although the pathogenesis of their formation is not completely understood, several predisposing risk factors have been identified, some of which may affect dental implants as well. This article presents a thorough review of the literature pertaining to gingival fenestration.

Surgical Management of Implant-Associated Gingival Fenestrations.

Soft tissue fenestrations are extremely rare in the natural dentition and have only recently been reported on dental implants. Although the pathogenesis of their formation is not completely understood, several predisposing risk factors have been identified, some of which may affect dental implants as well. This article presents a thorough review of the literature pertaining to gingival fenestration.

Non-Orthodontic, Non-Restorative Closure of Acquired Diastemata.

Aim: To illustrate the reversibility of "pathologic tooth migration" in several patients that were managed by periodontal therapy alone, along with a review of the relevant literature.

Background: Pathologic tooth migration (PTM) is a common phenomenon among patients seeking dental care. Different etiologic factors have been implicated in PTM: loss of periodontal support, occlusal interferences, posterior bite collapse, and various oral habits such as: lip biting, tongue thrusting, and playing wind instruments.

A comprehensive clinical competency-based assessment in periodontics.

Traditional periodontics clinical examinations in dental education frequently assess a narrow set of clinical skills and do not adequately assess the ability of students to independently manage a periodontal patient. As an alternative, the authors developed a comprehensive periodontics competency case experience (CCCE) for senior dental students and surveyed students regarding their experience with the CCCE. Students challenging the CCCE must treat a patient with moderate periodontitis and must independently decide when a state of periodontal and oral health has been achieved.

Root amputation: a new look into an old procedure.

A treatment option for managing furcation invasions is root amputation. Long-term survival of resected molars requires a complete harmony of sequential endodontic, periodontic, restorative and maintenance procedures. The main objective of this article is to provide a concise historical perspective of this procedure and to review available literature regarding its efficacy and limitations.

Provisional prostheses during ridge augmentation and implant dentistry.

Recent advancements in ridge augmentation and bone regeneration have expanded the pool of patients that could benefit from dental implants. However, providing the patient with a temporary prosthesis during the wound healing phase without impairing the process is a challenging task. This article summarizes available information pertaining to provisional prostheses, both tooth-supported and soft tissue-supported, that may meet the patient needs.

An unusual case of gingival enlargement: peripheral odontogenic fibroma.

The peripheral odontogenic fibroma (POdF) is an uncommon gingival enlargement. It is a benign, unencapsulated exophytic gingival mass, which is composed of fibrous connective tissue associated with various amounts of calcifications and islands of odontogenic epithelium.The lesion is usually firm to palpation and non-tender, and it could be mistaken for other more common exophytic gingival lesions, such as peripheral ossifying fibroma, pyogenic granuloma, or peripheral giant cell granuloma.

Calcium channel blocker-induced gingival enlargement.

Despite the popularity and wide acceptance of the calcium channel blockers (CCBs) by the medical community, their oral impact is rarely recognized or discussed. CCBs, as a group, have been frequently implicated as an etiologic factor for a common oral condition seen among patients seeking dental care: drug-induced gingival enlargement or overgrowth. This enlargement can be localized or generalized, and can range from mild to extremely severe, affecting patient's appearance and function.

The effect of long-term aspirin intake on the outcome of non-surgical periodontal therapy in smokers: a double-blind, randomized pilot study.

Objective: The objective of this parallel, double-blind, randomized pilot study was to determine the effect of a daily dose of 325 mg of aspirin (ASA) on the clinical outcomes of scaling and root planing in a selected group of adult smokers.

Background: The response to periodontal therapy is inferior among smokers compared to non-smokers. Long-term intake of ASA has been shown to exert a positive impact on reducing both the prevalence and severity of periodontitis, among high-risk groups of subjects such as heavy smokers and diabetics.

Odontogenic keratocyst: a case report and review of an old lesion with new classification.

The odontogenic keratocyst (OKC) is distinctive among jaw cysts given its tendency toward recurrence and aggressive clinical behavior. This paper presents a well-documented case of OKC and a review of the diagnostic features, treatment modalities and new evidence supporting the reclassification and renaming of this unique pathologic process.

Management of oral melanin pigmentation.

Melanin is an endogenous pigment responsible for human tissue coloration of the skin, mucosa, hair, eyes and parts of the brain. In the skin, its function is protection from the harmful effects of UV radiation. Its purpose in oral tissues has not yet been determined.

Gummy smile: could it be genetic? Hereditary gingival fibromatosis.

Gingival enlargement is common among patients and can be caused by a variety of etiological factors. The most common reason is poor oral hygiene and high bacterial load that leads to gingival inflammation and enlargement. Other implicated factors include systemic drugs, such as Phenytoin (Dilantin) taken by epileptic patients, Calcium Channel Blockers such as Nifedipine (Procardia) and Verapamil (Calan) for the treatment of hypertension, arrhythmia and angina.

Gummy smile: could it be genetic? Hereditary gingival fibromatosis.

Gingival enlargement is common among patients and can be caused by a variety of etiological factors. The most common reason is poor oral hygiene and high bacterial load that leads to gingival inflammation and enlargement. Other implicated factors include systemic drugs, such as phenytoin (Dilantin) taken by epileptic patients, calcium channel blockers such as nifedipine (Procardia) and verapamil (Calan) for the treatment of hypertension, arrhythmia and angina.

Comparison of the Hydrabrush powered toothbrush with two commercially-available powered toothbrushes.

Introduction: An examiner-blinded, randomized, parallel, three-cell, controlled clinical trial was conducted to compare the efficacy of a new powered toothbrush (Hydrabrush) to that of two presently marketed power brushes (Oral-B and Sonicare) in reducing stain, supragingival plaque, gingivitis and the signs of periodontitis while monitoring safety.

Methods: One hundred ten subjects were randomly assigned to three groups (35--Oral-B group, 36--Sonicare group, and 39--Hydrabrush group). Subjects were instructed to use the assigned powered toothbrush according to the manufacturer's instructions for 2-minutes duration twice per day.

The prevalence of pathogenic periodontal microflora in healthy young adult smokers.

Background: Smoking is a major risk factor in periodontitis, although the mechanisms of its effects are not well understood. The overall goal of this clinical study was to determine if smoking enhances the colonization of the oral cavity by pathogenic bacteria in a periodontitis-free population. The prevalence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Campylobacter rectus, Eikenella corrodens, Bacteroides forsythus, and Treponema denticola was investigated in 25 smokers and 25 non-smokers by using DNA probes.

The prevalence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Bacteroides forsythus in humans 1 year after 4 randomized treatment modalities.

The relationship between probing attachment changes in treated periodontal pockets and the prevalence of selected periodontal pathogens was assessed in 10 patients with adult periodontitis 1 year following randomized therapy. All patients had at least 1 tooth in each quadrant with an inflamed pocket of probing depth > or =5 mm and clinical attachment loss and harbored at least one of the following 3 major periodontal pathogens: Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, or Bacteroides forsythus. The number of target organisms per site was determined preoperatively; at 1 week; and at 1, 3, 6, and 12 months postoperatively utilizing DNA probes.

The survival rate of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Bacteroides forsythus following 4 randomized treatment modalities.

The overall goal of this clinical study was to determine the short-term anti-infective effects of four randomized treatment modalities on Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Bacteroides forsythus (Bf) and determine the effects of bacterial survival on treatment outcomes in patients with adult periodontitis. Twelve adult patients requiring therapy for moderate periodontitis were selected for this study. All patients had at least one tooth in each quadrant that had an inflamed pocket of probing depth > or =5 mm with probing attachment loss that harbored at least one of the following three periodontal pathogens: Aa, Pg, or Bf.

Repopulation of periodontal pockets by microbial pathogens in the absence of supportive therapy.

This clinical study evaluated the reinfection incidence by Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Prevotella intermedia (Pi) in periodontal pockets following scaling and root planing (SRP) and intra-pocket irrigation with antimicrobial agents in a patient population who did not receive supportive maintenance therapy. The number of target organisms was determined utilizing DNA probes. Forty-one (41) inflamed pockets > or = 5 mm with attachment loss and containing at least one target species were selected in 6 adult patients.

DNA probe analyses of the survival of selected periodontal pathogens following scaling, root planing, and intra-pocket irrigation.

This clinical study evaluated the survival rates of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia in periodontal pockets following scaling and root planing and intra-pocket irrigation with antimicrobial agents in patients with moderate and severe periodontitis. The number of target organisms was determined utilizing DNA probes. Adult periodontitis patients were selected on the basis that the subgingival flora contained at least one of the target organisms.