Abstract:Background: Loss of bone and soft tissue attachment are common sequelae of periodontitis that may jeopardize the aesthetic outcome and compromise the functional and aesthetic outcomes of treatment. The following case report describes one of the most predictable techniques of vertical ridge augmentation, which is orthodontic extrusion or forced eruption of hopeless teeth. Method:A 34-year-old woman who presented with severe attachment loss and deep pockets was diagnosed with generalized aggressive periodontitis. The mobile maxillary incisors were consequently extracted and were replaced with dental implants. However, prior to extraction, orthodontic extrusion of the hopeless incisors was performed to correct vertical ridge defects. Following extrusion and extraction of the maxillary incisors, to prevent soft tissue collapse and to preserve the papillae during socket healing, the crowns of the extracted teeth were used as pontics on a removable partial provisional denture. After 8 weeks, the implants were placed, and an immediate functional restoration was delivered. After 4 months of healing, a fixed definitive partial prosthesis was fabricated and delivered.Result: After periodontal treatment, over a 2-year period, the progression of aggressive periodontitis was controlled. The mean vertical movement of marginal bone was 3.6 mm. The use of the crowns of extracted teeth appears to be an effective method to maintain papillae. Conclusions:Orthodontic extrusion is a predictable method for the correction of vertical ridge defects. Orthodontic treatment does not aggravate or hasten the progression of aggressive periodontitis.

In this paper, we present a case of an uncommon and slow-growing tumor known as a central odontogenic fibroma (COF). The patient in question is a 53-year-old African-American man who was referred for periodontal evaluation of asymptomatic space formation between the mandibular central incisors. Clinical and radiological evaluations disclosed tumor-like tissue expanding the alveolar ridge in the buccolingual dimension, along with thinning of the cortical plates. Surgical excision was performed, and the specimen was sent for histopathology, which later confirmed that the lesion was a COF. Periodontal regenerative therapy was performed to rebuild the hard and soft tissue that had been compromised as a result of tumor expansion. The site was grafted, with excellent results.

Background. The purpose of this study was to evaluate the combination of an enamel matrix derivative (EMD) and an osteoconductive bone ceramic (BC) in improving bone regeneration. Materials and Methods. Four cylindrical cavities (6 × 6 mm) were prepared bilaterally in the mandible in three dogs. The defects were randomly assigned to four different treatments—filled with EMD/BC and covered with a nonresorbable membrane, filled with EMD/BC without membrane, membrane coverage only, or control (left untreated)—and healed for 2, 4, or 6 weeks. Harvested specimens were prepared for histologic, histomorphometric, and immunohistochemical analyses. Results. Sites treated with EMD/BC with or without membrane showed more total bone formation and lamellar bone formation than membrane-only and control defects. There were no statistically significant differences in total bone formation between EMD/BC with or without membrane. Conclusion. EMD with BC might improve bone formation in osseous defects more than membrane coverage alone; the use of a membrane had no significant additive effect on total bone formation.

Background and Objective:Many clinicians will not treat patients presenting with bisphosphonate-related osteonecrosis of the jaw following long-term use of bisphosphonates because of the lack of predictable outcomes. Materical and Methods:The patient presented with pain from a nonhealing lesion in the posterior maxilla following extraction of the maxillary right third molar. The lesion had not responded to any conventional dental treatment. The patient had suffered from breast cancer, and her treatment included several years of therapy with Zometa (zoledronic acid), a bisphosphonate.Results:The patient stopped taking Zometa and commenced rinsing with phosphate buffer–stabilized 0.1% chlorine dioxide–containing mouthwash. After 5 months, changes in the morphology of the lesion were noted and the soft tissue had closed over the open wound. Conclusion:Cessation of bisphosphonate therapy and usage of a phosphate buffer–stabilized 0.1% chlorine dioxide–containing mouthwash lessened the patient’s pain and resulted in closure of the soft tissue lesion.

BackgroundOral sex among teenagers is on the rise. Similarity between the oral flora and organisms recovered from nongonococcal urethritis and prostatitis, points to retrograde entry of bacteria from oral cavity into the urethra following insertive oral intercourse.Presentation of the hypothesisChlorhexidine has a wide spectrum of anti-bactericidal activity encompassing gram positive and negative bacteria. It is also effective against HIV and HBV. It produced large and prolonged reductions in salivary bacterial counts within 7-h of its use. Hence, it would seem logic to postulate that rinsing with chlorhexidine before oral sex will be effective for prevention of retrograde entry of bacteria from oral cavity into the urethra. The recommendation for rinsing will be: 15 ml of a 0.12% or 10 ml of 0.2% chlorhexidine rinse for 30 seconds. Also other drug delivery systems such as chlorhexidine chewing gum or spray can be used.Testing the hypothesisMen suffering from recurrent nongonococcal urethritis or prostatitis are good subjects for testing the hypothesis. They perform genital safe sex via consistent use of condom. Yet they generally received unprotected insertive oral intercourse. Chlorhexidine can be used for prevention of recurrences of the disease.Implications of the hypothesisThe chlorhexidine will be a new, easy, attractive and effective method for reduction of nongonococcal urethritis, prostatitis and epidydimitis following insertive oral intercourse. It is poorly absorbed from skin, mucosa and gastrointestinal tract indicating systemic safety of chlorhexidine. The agent does not cause any bacterial resistance and supra-infection.