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Molar Sites (molar + site)
Selected AbstractsComparison of the validity of periodontal probing measurements in smokers and non-smokersJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2001A. J. Biddle Abstract Aim: To determine whether the reduced inflammation and bleeding and increased fibrosis reported in tobacco smokers affect the validity of clinical probing measurements by altering probe tip penetration. Method: A constant force probe was used to measure probing depths and sound bone levels at six sites on 64 molar teeth (384 sites) in 20 smoking and 20 non-smoking patients from grooves made with a bur at the gingival margin prior to extraction. Connective tissue attachment levels were measured from the grooves with a dissecting microscope following extraction. Data were analysed using robust regression with sites clustered within subjects. Results: Sites in smokers showed more calculus but less bleeding than sites in non-smokers (p<0.05). The mean clinical probing depth was not significantly different (smokers: 5.54 mm, confidence intervals=4.81 to 6.28; non-smokers: 6.05 mm, ci=5.38 to 6.72). The corresponding post-extraction pocket depth measurements (smokers: 4.95 mm, ci=4.30 to 5.61; non-smokers: 5.23 mm, ci=4.49 to 5.96) were less than clinical probing depth in sites from both smokers and non-smokers (p<0.01). However, the proportional difference was less in smokers (p<0.05), particularly in deeper pockets, indicating that clinical probe tip penetration of tissue was greater in non-smokers. Regression analysis indicated that the presence of calculus and bleeding also influenced the difference in clinical probe penetration (p<0.05). Conclusion: Clinical probing depth at molar sites exaggerates pocket depth, but the probe tip may be closer to the actual attachment level in smokers due to less penetration of tissue. This may be partly explained by the reduced inflammation and width of supra-bony connective tissue in smokers. These findings have clinical relevance to the successful management of periodontal patients who smoke. Zusammenfassung Ziel: Bestimmung, ob die reduzierte Entzündung und Blutung und verstärkte Fibrosierung, die bei Rauchern berichtet wird, die Gültigkeit der klinischen Messung der Sondierungstiefen durch Veränderung der Penetration der Sondenspitze beeinflußt. Methoden: Eine konstante Sondierungskraft wurde genutzt, um die Sondierungstiefen und das Knochenniveau (sounding) an 6 Flächen von 64 Molaren (384 Flächen) bei 20 Rauchern und 20 Nichtrauchern von einer Furche, die mit einem Fräser in der Höhe des gingivalen Randes vor der Extraktion angelegt wurde, zu messen. Das Niveau des bindegewebigen Attachments wurde von der Furche mit einem trennenden Mikroskop nach der Extraktion gemessen. Die Daten wurden unter Nutzung einer robusten Regission mit den Flächen in den Personen zusammengefaßt analysiert. Ergebnisse: Die Flächen von Rauchern zeigten mehr Zahnstein, aber weniger Blutung als die Flächen von Nichtrauchern (p<0.05). Die mittleren Sondierungstiefen unterschieden sich nicht signifikant (Raucher: 5.54 mm, Konfidenzinterval (ci)=4.81 zu 6.28; Nichtraucher: 6.05 mm, ci=5.38 zu 6.72). Die korrespondierenden Taschenmessungen nach der Extraktion (Raucher: 4.95 mm, ci=4.30 zu 5.61; Nichtraucher: 5.23 mm, ci=4.49 zu 5.96) waren geringer als die klinischen Messungen sowohl bei den Flächen bei Rauchern als auch bei Nichtrauchern (p<0.01). Jedoch war die proportionale Differenz bei Rauchern geringer (p<0.05), besonders bei tiefen Taschen, was zeigt, daß die Penetration der Sonde ins Gewebe bei der klinischen Messung bei Nichtrauchern größer war. Die Regressionsanalyse zeigte, daß das Vorhandensein von Zahnstein und Blutung die Differenz in der klinischen Sondenpenetration beeinflußte (p<0.05). Zusammenfassung: Die klinische Sondierung an Molarenflächen überschätzt die Taschentiefe, aber die Sondenspitze liegt bei Rauchern näher am wirklichen Stützgewebelevel aufgrund der geringeren Gewebepenetration. Dies mag teilweise durch die reduzierte Entzündung und die Breite des supra-alveolären Bindegewebes bei Rauchern erklärt werden. Diese Ergebnisse haben klinische Bedeutung bei der erfolgreichen Behandlung von rauchenden parodontalen Patienten. Résumé But: L'objectif de cette étude est de déterminer si la diminution de l'inflammation et du saignement, ainsi que l'augmentation de la fibrose rapportées chez les fumerus affecte la validité des mesures de sondage parodontal en modifiant la pénétration de la sonde. Methode: Une sonde a pression constante a été utilisée pour mesurer la profondeur au sondage et pour sonder le niveau osseux sur les 6 sites de 64 molaires (384 sites) chez 20 patients fumeurs et 20 patients non-fumeurs à partir de rainures faites à la fraise au niveau de la gencive marginale avant extraction. Les niveaux d'attache du tissus conjonctif furent mesurés à partir de la rainure sous microscope de dissection après extraction. Les données furent analysées par régression avec les sites groupés par patients. Résultats: Les sites des fumerus montraient plus de tartre mais moins de saignement que les sites des non-fumeurs (p<0.05). La profondeur moyenne de sondage clinique n'était pas significativement différente (fumeurs: 5.54 mm, interval de confiance=4.81 à 6.28; non-fumeurs: 6.05 mm, ci=5.38 à 6.72). Les mesures de profondeur de poche correspondantes aprés extraction (fumeurs: 4.95 mm, interval de confiance=4.30 à 5.61; non-fumeurs: 5.23 mm, ci=4.49 à 5.96) ètaient moindre que les profondeurs de sondage clinique des sites des fumeurs et des non-fumeurs ensemble (p<0.01). Cependant, la différence proportionnelle était moindre chez les fumeurs (p<0.05), particulièrement pour les poches profondes, ce qui indique que la pénétration tissulaire de la pointe de la sonde était plus importante chez les non-fumeurs. L'analyse de régression indique que la présence de tartre et le saignement influencent aussi la différence clinique de pénétration (p<0.05). Conclusion: La profondeur clinique de sondage sur des sites molaires exaggère la profondeur de poche, mais la pointe de la sonde pourrait être plus proche de l'actuel niveau d'attache chez les fumeurs en raison de la moindre pénétration des tissus. Cela peut être partiellement expliqué par l'inflammation réduite et l'épaisseur du tissus conjonctif supra-osseux chez les fumeurs. Ces résultats ont une signification clinique pour la bonne gestion des patients fumeurs atteints de maladies parodontales. [source] Validation of a dental image analyzer tool to measure alveolar bone loss in periodontitis patientsJOURNAL OF PERIODONTAL RESEARCH, Issue 1 2009W. J. Teeuw Background and Objective:, Radiographs are an essential adjunct to the clinical examination for periodontal diagnoses. Over the past few years, digital radiographs have become available for use in clinical practice. Therefore, the present study investigated whether measuring alveolar bone loss, using digital radiographs with a newly constructed dental image analyzer tool was comparable to the conventional method, using intra-oral radiographs on film, a light box and a Schei ruler. Material and Methods:, Alveolar bone loss of the mesial and distal sites of 60 randomly selected teeth from 12 patients with periodontitis was measured using the conventional method, and then using the dental image analyzer tool, by five dentists. The conventional method scored bone loss in categories of 10% increments relative to the total root length, whereas the software dental image analyzer tool calculated bone loss in 0.1% increments relative to the total root length after crucial landmarks were identified. Results:, Both methods showed a high interobserver reliability for bone loss measurements in nonmolar and molar sites (intraclass correlation coefficient , 0.88). Also, a high reliability between both methods was demonstrated (intraclass correlation coefficient nonmolar sites, 0.98; intraclass correlation coefficient molar sites, 0.95). In addition, the new dental image analyzer tool showed a high sensitivity (1.00) and a high specificity (0.91) in selecting teeth with , 50% or < 50% alveolar bone loss in comparison with the conventional method. Conclusion:, This study provides evidence that, if digital radiographs are available, the dental image analyzer tool can reliably replace the conventional method for measuring alveolar bone loss in periodontitis patients. [source] Clinical and Radiographic Evaluation of the 5-mm Diameter Regular-Platform Brånemark Fixture:2- to 5-Year Follow-upCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2002DSc Odont, Georges Tawil DDS ABSTRACT Purpose: The purpose of this study was to report the clinical results obtained with 5-mm diameter regular-platform Brånemark implants after 2 to 5 years of follow-up. A secondary aim was to compare the clinical outcome to that of adjacently placed standard 3.75-mm fixtures in the same patients under the same operative condition and in the same prosthetic construction. Materials and Methods: Sixty patients, with a mean age of 54 years, received a total of 97 5-mm diameter regular-platform fixtures. The majority of the implants were placed at molar sites. In 41 of the patients, 53 5-mm diameter implants were placed adjacent to 62 standard 3.75-mm diameter fixtures in the same prosthetic reconstruction. All implants were submerged for an average period of 4 to 6 months. Abutment connection was done according to standard protocol. The prosthetic treatment consisted of freestanding fixed bridges. Results: The cumulative survival rate of the 5-mm diameter implants loaded for a period of 2 to 5 years was 96.9%. Only three implants failed. They were placed in type 4 bone in the posterior maxilla. Bone loss over the first year was 0.70 mm and over a 3-year period 0.81 mm. Implants placed in type 4 bone showed significantly higher bone loss. No difference in the resorption rate could be found between the maxillary and the mandibular implants or between the various implant lengths. There was no significant difference between the bone loss around the 5-mm diameter fixtures and the adjacent 3.75-mm diameter standard fixtures. Conclusion: The present study demonstrated a high predictability of 5-mm diameter regular-platform implants when placed in the posterior maxilla and mandible. [source] In-patient comparison of immediate and conventional loaded implants in mandibular molar sites within 12 monthsCLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2008Güncü, M. Bar Abstract Objectives: The aim of this prospective clinical study was to evaluate the clinical outcomes of dental implants placed in the mandibular molar sites and immediately functionally restored compared with conventionally loaded controls in an in-patient study. Material and methods: Twenty-four dental implants were placed in 12 patients who had first molar loss bilaterally in the mandibular area. One site of the patient was determined as immediately loaded (IL) and the other side was conventionally loaded (CL). Resonance frequency analyses for implant stability measurements, radiographic examinations for marginal bone levels and peri-implant evaluations were performed during the clinical follow-up appointments within 12 months. Results: During the 12-month follow-up period, only one implant was lost in the IL group. The mean implant stability quotient values were 74.18±5.72 and 75.18±3.51 for Groups IL and CL at surgery, respectively, and the corresponding values were 75.36±5.88 and 75.64±4.84 at 1-year recall, respectively. The difference was not statistically significant between the two groups during the 12-month study period (P>0.05). When peri-implant parameters were evaluated, excellent peri-implant health was demonstrated during the 1-year observation period and all implants showed less than 1 mm of marginal bone resorption during the first year. Conclusions: In the present study, immediate functionally loading did not negatively affect implant stability, marginal bone levels and peri-implant health when compared with conventional loading of single-tooth implants. [source] Modeling of the buccal and lingual bone walls of fresh extraction sites following implant installationCLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2006Mauricio G. Araújo Abstract Objective: To determine whether the reduction of the alveolar ridge that occurs following tooth extraction and implant placement is influenced by the size of the hard tissue walls of the socket. Material and methods: Six beagle dogs were used. The third premolar and first molar in both quadrants of the mandible were used. Mucoperiostal flaps were elevated and the distal roots were removed. Implants were installed in the fresh extraction socket in one side of the mandible. The flaps were replaced to allow a semi-submerged healing. The procedure was repeated in the contra later side of the mandible after 2 months. The animals were sacrificed 1 month after the final implant installation. The mandibles were dissected, and each implant site was removed and processed for ground sectioning. Results: Marked hard tissue alterations occurred during healing following tooth extraction and implant installation in the socket. The marginal gap that was present between the implant and the walls of the socket at implantation disappeared as a result of bone fill and resorption of the bone crest. The modeling in the marginal defect region was accompanied by marked attenuation of the dimensions of both the delicate buccal and the wider lingual bone wall. Bone loss at molar sites was more pronounced than at the premolar locations. Conclusion: Implant placement failed to preserve the hard tissue dimension of the ridge following tooth extraction. The buccal as well as the lingual bone walls were resorbed. At the buccal aspect, this resulted in some marginal loss of osseointegration. [source] | ||||||||||||||||||||||