Multidisciplinary approach in treatment of periodontally compromised patient
-a case report
Journal name: World Journal of Pharmaceutical Research
Original article title: Multidisciplinary approach in treatment of periodontally compromised patient
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Subtitle: -a case report
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Piyush Gowrav, Sanjay Gupta, Amitandra Kumar Tripathi, Masroor Ahmad Khan, Sarita Tripathi and Sanat Mishra
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: Multidisciplinary approach in treatment of periodontally compromised patient
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr20192-14120
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Summary of article contents:
Introduction
The article discusses a case report highlighting the significance of a multidisciplinary approach in treating periodontally compromised patients, specifically through the integration of orthodontics and periodontics. A case of a 19-year-old female patient is presented, who experienced issues such as forwardly positioned upper anterior teeth, spacing, and mobility. The paper emphasizes the importance of proper tooth movement during orthodontic treatment to achieve functional and aesthetic occlusion while maintaining the health of the periodontal attachment apparatus.
Orthodontic-Periodontal Integration
A critical concept outlined is the integration of orthodontic and periodontal interventions. The article notes that orthodontic treatment can often lead to changes in the periodontal tissues, particularly loss of soft tissue in interproximal areas that can create aesthetic and functional issues, such as open interproximal spaces leading to food impaction and phonetic difficulties. The authors stress that while orthodontic treatment is necessary to achieve proper alignment and occlusion, it must be done with the awareness of its effects on periodontal health. Therefore, collaboration between orthodontics and periodontics is essential for optimal treatment outcomes.
Papilla Preservation Technique
Another important concept discussed is the papilla preservation flap technique, which is crucial for maintaining the height and architecture of the interdental papilla during periodontal surgical procedures. The report describes how this technique has evolved since its introduction by Kromer in 1956 and later detailed by Takei et al. in 1985. The surgical approach focuses on preventing tissue shrinkage and preserving the interproximal gingiva, ultimately aiding in aesthetic outcomes and promoting healing in patients with periodontal defects. This technique becomes particularly relevant when treating patients with both orthodontic and periodontal concerns.
Periodontal Health Maintenance During Orthodontic Treatment
A key point raised in the article is the critical need for maintaining periodontal health during orthodontic treatment. The case study illustrates the potential complications that could arise when periodontal health is already compromised. The authors emphasize that patients with chronic periodontal conditions should receive thorough periodontal assessments and treatments prior to orthodontic interventions to avoid exacerbating tissue loss and tooth mobility. They also highlight the importance of educating patients about oral hygiene practices and instructions tailored specifically for those undergoing orthodontic treatment.
Conclusion
In summary, the article underscores the necessity of a multidisciplinary approach that integrates orthodontics and periodontics for patients with dental alignment and periodontal issues. It highlights techniques such as the papilla preservation flap that aim to improve aesthetic results while preserving periodontal health. The case report serves as a reminder of the importance of careful planning and collaboration in dental treatments to achieve both functional and aesthetic goals, ultimately enhancing patient outcomes in dentoalveolar treatment contexts.
FAQ section (important questions/answers):
What does a multidisciplinary approach involve in periodontal treatment?
A multidisciplinary approach combines orthodontics and periodontics to address complex dentoalveolar issues, ensuring the health and integrity of the tooth's supporting structures.
What are the main concerns of the 19-year-old patient?
The patient had forwardly placed anterior teeth, spacing, and mobility, accompanied by chronic localized periodontitis and occlusal trauma, necessitating further periodontal investigation.
What is the importance of papilla preservation flap surgery?
Papilla preservation flap surgery helps maintain the height and integrity of interdental papillae during periodontal treatment, minimizing aesthetic concerns and potential shrinkage of the gingival tissue.
How was the periodontal condition of the patient assessed?
The patient's condition was evaluated through a clinical examination showing inflamed gingiva, deep periodontal pockets, and grade I mobility of the maxillary anterior teeth.
What steps were taken in the treatment plan for the patient?
The treatment plan included scaling and root planing, removal of orthodontic wires, and performing papilla preservation flap surgery to address periodontal issues.
What are the long-term benefits of periodontal therapy?
Effective periodontal therapy aims to improve aesthetic outcomes by maintaining the gingival architecture and height of interdental papillae, preventing interproximal embrasure exposure.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Multidisciplinary approach in treatment of periodontally compromised patient”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Incision:
An incision is a surgical cut made in the body tissues or organs. In the context of this report, it refers to the specific cuts made during the periodontal surgery to access underlying tissues. Proper incision techniques are crucial for minimizing trauma and promoting healing, especially in maintaining the integrity of the interdental papilla.
2) Post:
In this context, 'post' refers to the period following a surgical procedure. Post-operative care is vital to ensure that the patient heals properly after the surgery. It includes monitoring the patient, removing sutures, and taking follow-up radiographs to assess bone regeneration, as seen six months after treatment.
3) Surface:
The term 'surfaces' is used to describe multiple areas of the teeth and gums during surgical procedures. During flap surgery, the surfaces involved include both facial and lingual/palatal sides. Thorough cleaning and assessment of these surfaces are critical to eradicate infection and support tissue regeneration in periodontal therapy.
4) Lucknow:
Lucknow is a city in India where the Career Post Graduate Dental College and Hospital is located. This geographical context is significant as it gives location to the academic setting and resources available for conducting advanced dental treatments and research, such as the multidisciplinary approach to managing periodontally compromised patients.
5) Discussion:
Discussion refers to the part of the report where the authors analyze the outcomes and significance of the surgical techniques employed in the case. It highlights the relevance of combining orthodontic treatments with periodontal surgery, stressing the importance of interdisciplinary collaboration in achieving optimal patient outcomes in dental health.
6) Dressing:
In surgical terms, dressing refers to protective material applied to a surgical site post-operation. It serves to keep the area sterile, absorb exudate, and promote comfort during the healing process. The appropriate use of a surgical dressing is essential in preventing infection and ensuring optimal recovery in periodontal procedures.
7) Disease:
The singular form of 'diseases,' it conveys the concept of a pathological condition affecting oral health, such as localized chronic periodontitis in the case report. Identifying and diagnosing dental diseases is fundamental in devising appropriate interventions and maximizing the effectiveness of combined orthodontic and periodontal therapies.
8) Gupta:
Dr. Sanjay Gupta is one of the authors and a professor at the Career Post Graduate Dental College. His clinical expertise and contributions to the case study are vital for guiding treatment protocols and ensuring high standards in case management, reflecting the importance of experienced leadership in multidisciplinary dental care.
9) Kumar:
Dr. Amitandra Kumar Tripathi, mentioned as an associate professor, plays a critical role in the case report. His clinical insights and collaboration in treatment planning help emphasize the necessity of teamwork in executing complex dental procedures that integrate orthodontic and periodontal therapies for optimal patient outcomes.
10) Science (Scientific):
The term 'science', in this context, relates to the systematic study and application of knowledge regarding dental health, procedures, and practices. It underscores the evidence-based approaches used in periodontal and orthodontic treatments, signifying the need for scientifically grounded methodologies in improving patient outcomes.
11) Hygiene (Hygienic):
Hygiene refers to practices that maintain health and cleanliness, especially dental hygiene practices prescribed to patients undergoing orthodontic treatment. Ensuring good oral hygiene is critical to preventing periodontal disease and promoting healing, thus emphasizing the need for proper care instructions as part of comprehensive dental treatment.
12) Mishra (Misra):
Dr. Sanat Mishra, one of the co-authors, is part of the study team at the Career Post Graduate Dental College. His collaboration in research and case management enriches the treatment process, demonstrating the importance of interprofessional relationships in achieving comprehensive patient care in dental practices.
13) Reason:
Reason pertains to the rationale behind employing certain treatment modalities and interdisciplinary approaches in the case report. It highlights the necessity of justification for clinical decisions made during the management of periodontally compromised patients, aiming for precise restoration of oral health through combined therapies.
14) Food:
In dentofacial contexts, food reference indicates its impact on oral health, particularly regarding its role in plaque accumulation, gingival irritation, and potential contributions to periodontal disease. Addressing dietary factors is essential for patients to maintain periodontal health during and after orthodontic treatment.
15) Line:
Line refers to the anatomical boundaries considered during incisional approaches in periodontal surgery. Establishing precise incisional lines is critical for effective flap surgeries, as it ensures minimal trauma while maximizing the therapeutic outcomes, such as bone regeneration and maintenance of interdental tissues.
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