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

2006-04-01 / 2. szám

FOGORVOSI SZEMLE «99. évf. 2. sz. 2006. 71 DR. K. KÁROLYHÁZY, DR. P. FALUHELYI, DR. P. KIVOVICS, DR. ZS. ARÁNYI, DR. P. FEJÉRDY 1 Semmelweis University, Faculty of Dentistry, Department of Prosthodontics; 2 Semmelweis University, Faculty of Medicine, Department of Neurology PERIODONTAL HEALTH AND ORAL HYGIENE OF PATIENTS WITH EPILEPSY: AN EPIDEMIOLOGICAL STUDY Introduction: Oral hygiene and periodontal health of patients with epilepsy are worse as compared to healthy population. As epilepsy disease is getting more serious, periodontal indices are increasing. Our epidemiological study in 2001 supported this. Materials and methods: Data of 101 epilepsy patients were compared to an age and sex matched control group of general population. Since epilepsy produces a heteroge­nous group of patients, we have set up a new classification system, taking into account the type of seizures, frequency and mental state. We compared the subgroups of epilepsy patients to each other and the control subjects. Oral hygiene was expressed by Greene-Vermillion Oral Hygiene Index. Periodontal status was expressed by meas­uring periodontal probing depth (PPD), periodontal attachment loss (PAL), Mühlemann index, maximum CPI scores, CPITN index, tooth mobility, and attrition of the remaining teeth. Sta­tistical analysis was performed by SAS 8.2 Windows soft­ware. Results: OHI-S index was “bad” in epilepsy group (3.18+ 1.45) and “average” in control group (2.8+1.4). Visiting a dentist more frequently resulted in better periodontal health. All of the periodontal indexes were significantly worse in patient group: PPD (p=0.025), PAL (p=0.008); Mühlemann index (pcO.001). These values did not differ according to carbam­­azepine or valproat therapy. While phenytoin was succeeded by more modern antiepi­leptic drugs, we could not find gingiva hyperplasy. There was only a small difference in CPITN index between the patient (2.6+0.7) and control (2.4+0.8) group. Attrition was higher in the patient group (p=0.039), and significantly correlate with the frequency of Grand mal seizures (p=0.04). Conclusion: The neglected oral hygiene, worse condition of the remaining teeth, high number of missing teeth, frequent Grand mal seizures influenced negatively the periodontal con­dition of epilepsy patients. DR. T. KEGLEVICH, DR. P. WINDISCH, DR. A. HORVÁTH, DR. I. GERA Semmelweis University, Faculty of Dentistry, Dept, of Periodontology, Budapest EVALUATION OF THE CLINICAL RESULTS OF THE SURGICAL CORRECTION OF GINGIVAL RECESSION -4 YEARS RESULTS Introduction: It has long been one of the objectives of the corrective periodontal surgery to cover the denuded root sur­faces. There are several surgical techniques on the field of aesthetic mucogingival surgery. The most widely used tech­niques are the subepithelial connective tissue grafts and the epithelialized free gingival grafts. The long term evaluation of the results after surgical correction of gingival recession cases are scarce in periodontal literature. Material and methods: Between 2000-2001 18 epitheli­alized and 18 subepithelial connectives tissue graft operations were performed at the Department of Periodontology, Sem­melweis University. 75 percent of the cases were Miller III—IV defects. The mean age of the patients was 34 years. Only patients with excellent oral hygiene were surgically treated. Clinical results and discussion: The average improvement of the gingival recession after one year was 42 percent with the subepithelial connective tissue graft and 72 percent with the free gingival graft. The mean width of the keratinized gin­giva increased by 3.15 ± 2.01 mm and 5.25 ± 2.00 mm with the subepithelial connective tissue graft and the epithelialized graft respectively. The follow-up of our cases showed a sustain­ed gingival coverage after 4 years and only minimal additional denudation and gingival shrinkage occured during that period of time. The success and the durability of surgical results are fully dependant on the pathomorphology of the gingival recession, the surgical techniques and the periodontal sup­portive therapy. DR. E. KISS,1 I. GÁLI,2 A. GALINÉ BŐDI2 1 Hírös-Dent Private Practice Kecskemét;2 Gali-Dent Dental Lab Szeged EXPERIENCE OF THE PREPARATION OF LARGE SEGMENTING BRIDGES WITH NON-RIGID CONNECTORS IN PERIO-PROSTHODONTICS -A CASE REPORT Introduction: We planned to prepare large bridges and use them as splinting at the same time for our patients suffering from periodontitis, and having some missing teeth as well. The destruction of the tooth-supporting tissues may result in loosening of teeth. For such inclined or elongated teeth a fixed bridgework can be prepared only by sacrificing a major amount of dental tissues, for the abutments must be brought into parallel. As a solution we applied segmenting bridgeworks with non-rigid connectors. Materials and method: After the periodontal treatment, the dentist and the dental technician together plan the bridgework using a paralellometer. We have to define which groups of teeth are possible to prepare for a common path of placement and where can we apply one or more individual connectors into the bridge segments. A large bridge is made by segments, but after the fixation on the abutments it will work as one unit. The dental technician first prepares that part of the bridgework which will hold the tenon part of the connector. The walls of the tenon are custom milled at an angle of 2 degrees in order to facilite insertion, and furnish more accurate fitting. The next step is to prepare the second part of the bridge segment with the mortise part of the connectors. Results: Between 1999 and 2005, 25 ceramic fused metal bridges were prepared, with one or more individually-produced non-rigid connectors that were situated extracoronally whenever possible. All of those bridgeworks that have been made to

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