Fogorvosi szemle, 2006 (99. évfolyam, 1-6. szám)
2006-04-01 / 2. szám
64 FOGORVOSI SZEMLE ■ 99. évf. 2. sz. 2006. nausea, vomiting, diaorrhea and skin rashes. Frequency of postoperative wound infections, subgingival abscess, suppuration due to bacteria was compared among those two groups of patients. Implant surgery was labeled a failure in case the implant had to be removed. Conclusions: Results indicate that local antibiotics do not cause those systemic antibiotic treatment side effects of nausea, vomiting, diaorrhea and skin rashes. DR. F. DŐRI,1 DR. ZS. BARNA,1 2 DR. T. HUSZÁR,3 * DR. M. FÜZI,2 DR. I. GERA,1 DR. A. SCULEAN3 1 Semmelweis University, Budapest, Hungary; 2 B. Johan National Center for Epidemiology, Hungary; 3 Semmelweis University, Department of Oral and Maxillofacial Surgery;4 University of Nijmegen, The Netherlands BACTERIAL CONTAMINATION OF E-PTFE MEMBRANES USED IN TREATMENT OF DEEP INTRABONY PERIODONTAL DEFECTS WITH NBM AND PRP Objectives: The purpose of this study was to compare the bacterial contamination of e-PTFE barriers used in regenerative therapy of intrabony periodontal defects treated with natural bone mineral (NBM) + platelet-rich plasma (PRP) in the test group, and NBM alone in the control group, and assess the influence of their bacterial colonization on healing. Methods: 34 patients (17/17) each of whom exhibited one deep intrabony defect were treated with either PRP + NBM + GTR or with NBM + GTR. Probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at the baseline and after 6 months. For GTR e-PTFE membranes were used, which were removed in 5-6 weeks and a microbiological examination was performed. The presence of 6 selected periopathogenic microbial species, Actinobacillus actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g), Prevotella intermedia (P.i), Fusobacterium nucleatum (F.n), Actinomyces spp., Peptostreptococcus micros were investigated and identified by culture. Results: PRP + NBM + GTR group: In the 17 patients involved in the study, A. actinomycetemcomitans, and P. gingivalis were not detected. The number of pathogenic isoletes cultured from the retrieved membranes were: P. intermedia 3 (18%), F. nucleatum 8 (47%), Actinomyces spp. 16 (94%), P. micros 11 (53%). The attachment gains measured 6 months after surgery in the presence of periodontal pathogens were as follows: P. intermedia 50,6%, F. nucleatum 60,5%, Actinomyces spp., 61%, P. micros 57%. The mean for the whole group was 60,4%. NBM + GTR group: From the 17 patients involved in the study, 5 grew A. actinomycetemcomitans (30%), 2 P. gingivalis (12%), 4 P. intermedia (23%), 4 F. nucleatum (23%), 13 Actinomyces spp. (76%), 9 P. micros (53%). The attachment gains obtained 6 months after surgery in the presence of periodontal pathogens were: A. actinomycetemcomitans 60,8%, P. intermedia 34%, F. nucleatum 46,25%, P. gingivalis 39%, Actinomyces spp., 51,7%, P. micros 59%. The mean for the whole group was 52,64%. Conclusions: The mean attachment gain was higher in the PRP + NBM + GTR group, as well as the occurrence of Gram-positive bacteria (Actinomyces spp., P. micros). In the presence of PRP the mean attachment gain was higher even in the presence of P. intermedia and F nucleatum. The attachment gain showed marked individual variation. It is worth mentioning that the highest attachment gain (83%) was detected in the presence of A. actinomycetemcomitans contamination in a patient treated with NBM + GTR. DR. M. ECSÉDY, DR. P. KIVOVICS Semmelweis University, Department of Prosthodontics, Budapest THE COMPLEX TREATMENT OF TEMPOROMANDIBULAR JOINT DYSFUNCTION WITH PROSTHETIC METHODS The effective treatment of temporomandibular joint dysfunctions (TMD) is a challenge for every practicing dentist, regardless of the cause and the severity of the disorder. In most cases women are affected, whose subjective complaints draw attention to the existence of the temporomandibular joint dysfunction. The diagnosis of TMD requires the physical examination of the joints and occlusal analysis, as well as the radiological examination. The authors present the case of a 53-year-old woman, who was treated at the Department of Prosthodontics, Semmelweis University. The complaints of the patient - recurring grinding headache, localised pain in the temporomandibular joint region - suggested the existence of TMD. A slight terminal deviation of the chin to the right was to be detected while opening the mouth, however there was no sound effect to be heard and the opening of the mouth was not limited. The intraoral examination showed that the occlusal anomalies of the patient were aggravated through the improper shape of the occlusal surface of her over 10-year-old dental restorations and the loss of the second premolar in the third quadrant, followed by the mesialisation of the neighbouring molars. The lateral radiographic picture of the temporomandibular joints showed an extreme asymmetry between the two sides. Incipial osteoporosis of the condyles was also detectable, and for this reason densitometry seemed to be necessary. The results of the densitometry indicated that the T-score was below the normal range at the level of the first lumbal vertebra. The complex therapy was accomplished with prosthetic methods following the periodontal, conservative and surgical preparatory procedures. According to the Fábián and Fejérdy classification of partial edentulousness, the treatment of the 1A class requires fixed restoration. After removing the previous restorations and preparing the abutment teeth with bevel shoulders, a temporary restoration was made in the dental laboratory. The temporary restoration was cemented and adjusted in the mouth in accordance with the patient’s masticatory action. The patient already experienced significant relief following a short period of wearing the temporary restoration. At first the upper dental arch was restored with the definite, casted, ceramic fused to metal restorations, followed by treatment of the lower dental arch. The centric occlusion was defined with the help of a facial bow.
