Fogorvosi szemle, 2006 (99. évfolyam, 1-6. szám)

2006-12-01 / 6. szám

258 FOGORVOSI SZEMLE99. évf. 6. sz. 2006. patients was 53 women and 31 men out of 84 (of 59,2 years average age at the insertion). The 84 bridges of different length included 163 implants and 203 natural teeth. 105 implants were used at free-end saddle situ­ations, 58 in bounded edentate spans. This proportion was just the opposite at the natural teeth: 147 were mesial abutment teeth in the bridges, 56 were distal abutments. The high number of natural tooth abutments used in the implant and tooth supported fixed partial dentures at elderly patients can be explained with the replacement of crowns on previously prepared teeth. We have evaluated the distal teeth and implants sep­arately, and those located in bounded areas. The re­ceived values were graphically charted. Results: We found that, in spite of the rigid connection of natural teeth and implants, no damaging tendency can be detected in the first five years. Around Ankylos implants practically we have not found any changes yet. In case of new bridges, due to the splinting, in many cases bone apposition can be shown by the natural teeth. Based on the 5-year control it can be assumed, that mixed supported fixed bridges are functioning ap­propriately in the long run as well. IMMEDIATE IMPLANT PLACEMENT OF AN UPPER LEFT SMALL INCISOR REMOVED AFTER ROOT RESORPTION. /Case study/ TÁLOS, M„ KRÁNITZ, I. Private dental practitioner, Budapest, Hungary Prosthetic rehabilitation was carried out with the early load of the implant. Because of the root resorption due to orthodontia, we removed the upper left incisor of our 20-year-old patient, immediately replacing it with implantation. We also replaced the missing alveolar bone with tutogen microchips bone replacement ma­terial. After that, we closed the scarring with a mem­brane. We used the crown of the removed tooth and fiberglass Ribbond guide to make an immediate pros­thesis. After 6 weeks, we loaded the implantation with a temporary plastic crown. After 5 months, to replace the gingival mucosa, we made a gingivaplasty with re­moved soft palate. After the recovery of the gingival footing, which was 8 months after the first intervention, our patient got a permanent metal-ceramic crown. THE INCIDENCE OF LOCAL PLAQUE RETENTIVE FACTORS IN CHRONIC PERIODONTITIS TIHANYI, D., KOVÁCS, V., GERA, I. Department of Periodontology, Semmelweis University, Budapest, Hungary Introduction: One of the leading local risk factors for chronic periodontitis is the presence of plaque reten­tive factors in the oral cavity. The main objective of the study was to assess how the local irritation and plaque retention caused by untreated carious lesions, subgin­gival and approximal overhanging crown margins can affect the attachment loss at patients with chronic per­­j iodontitis. Material & methods: The incidence of plaque reten­tive factors were evaluated on 200 panoramic radio­graphs randomly selected from the archive of the De­partment of Periodontology. Also randomly selected patients referred for periodontal treatment were ex­amined looking for local plaque retentive factors. On the radiographs each fully erupted tooth were studied under magnifying glasses (1:2 magnification), and the ; distance between CEJ and the most coronal bone level ! was measured with a ruler with mm scales. The qual­ity of restorations were evaluated based on the approx­imal adaptation of their margins. During the clinical examination the presence of local plaque retentive factors were registered by tooth, and clinical attach­ment level and probing pocket depth were recorded around both the healthy and restored or filled teeth. Statistical analyzes were made with linear regression analysis and ANOVA. Results: Only 177 out of the randomly selected 200 radiographs met the incursion criteria and could be evaluated. The average age of patients was 49,98 years and the average attachment loss was 5,439 mm, showing increasing tendency with ages. The 177 pa­tients had a total of 3618 teeth, out of which 1407 teeth presented plaque retentive factors including 164 untreated approximal carious lesions, and 1243 faulty restorations with approximal overhangs or open mar­gins. Radiographically 82,5% of the restorations had incorrect approximal marginal adaptation. The ma­jority of the untreated carious lesions occurred in the molar as well as in the front regions. The average at­tachment loss at the teeth with faulty restorations was higher than at the sound teeth. 113 patients had an ! average attachment loss higher than > 4mm. In those ; patients there were no statistically significant differ­­; ences between teeth with faulty restoration and sound teeth. Discussion: In mild to moderate periodontitis local plaque retentive factors, overhanging crown margins or carious lesions are decisive aggregating factors both in gingivitis and periodontitis, especially in the suscep­tible population. In severe periodontitis, according to our data, there were only minimal differences between the attachment level around sound teeth and teeth with faulty restorations, and local plaque retentive factors at that stage had only minimal effect on the disease progression.

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