Epidemiological studies indicated that more than 15% of the population in western countries suffer because of severe forms of periodontitis, In this respect, the recognition of the relationship between oral and systemic health is growing, thus receiving remarkable interest in scientific literature. In fact, periodontitis may increase the risk for a group of life-threatening conditions such as atherosclerosis, stroke or low birth weight. The American Diabetes Association has reported that individuals with uncontrolled diabetes (defined as 200mg/dL of glucose on three consecutive readings) undergo an increased risk of infections, abnormal wound healing and consequent increased recovery time. Moreover, diabetics may be more likely to develop periodontal and cardiovascular disease than non diabetics, if note. History of poorly controlled chronic periodontal disease can alter diabetic/glycemic control. This may originate from a likely continuous passege of bacterial toxins and/or bacteria into the bloodstream, and/or from an exaggerated release of inflammatory mediators. This review is aimed at elucidating the connections between the status of oral health and glycemic control in diabetes.
BackgroundIn some pathological conditions, gingivitis caused by plaque accumulation can be more severe, with the result of an overgrowth. Nevertheless, the overgrowth involves the gingival margin with extension to the inter-dental papilla. The lesion may involve the inter-proximal spaces, and become so extensive that the teeth are displaced and their crowns covered. Severe overgrowth may lead to impairment in aesthetic and masticatory functions, requiring surgical excision of the excessive tissue. Aim of this study is to describe an operative protocol for the surgical treatment of localized gingival overgrowth analyzing the surgical technique, times and follow-up.MethodsA total of 20 patients were enrolled and underwent initial, non surgical, periodontal treatment and training sessions on home oral hygiene training. The treatment plan involved radical exeresis of the mass followed by positioning of an autograft of connective tissue and keratinized gingiva.ResultsDuring 10 years of follow-up, all the grafts appeared well vascularized, aesthetically satisfactory, and without relapse.ConclusionsPeriodontal examinations, surgical procedures, and dental hygiene with follow-up are an essential part of the treatment protocol. However, additional effort is needed from the patient. Hopefully, the final treatment result makes it all worthwhile.
This study analyzes the effect of porcelain veneer restoration on the structural response of a maxillary incisor. Tooth deformation is evaluated, prior to and after restoration, by the synergic use of Phase‐Shifting Electronic Speckle Pattern Interferometry (PS‐ESPI) and 3D finite element (FE) analyses. The intact maxillary incisor and the porcelain veneer restored tooth are subject to flexural load. Displacement fields are measured with Phase‐Shifting Electronic Speckle Pattern Interferometry. Experimental tests are simulated with 3D FE analyses tuning materials parameters via an optimisation‐based inverse procedure. ESPI measurements indicate that the restoration design under study produced deformations very similar to those of the intact tooth under load. FE results show sharp changes in displacement and stress 1 mm above the cement–enamel junction on the facial side of the restored tooth. Severe stress concentration (about 50% increase with respect to natural tooth) appears at the interface between veneer restoration and intact enamel and dentine tissues. This confirms the hypothesis that veneer restorations can amplify the effect of occlusal loading on the loss of dental hard tissue in the tooth cervical region.
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