The application of tooth-separation in clinical pedodontics.
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Abscess↗
Biomedical subjects
W K Seow
Publications and source records attributed to W K Seow.
Dental development and molar root length in children with cleidocranial dysplasia.
Cleidocranial dysplasia (CD) is an autosomal dominant skeletal disorder with characteristic dental findings of numerous supernumerary teeth and noneruption of permanent teeth. This investigation compared the dental development and root lengths of the mandibular first permanent molar in 11 CD patients with those of 22 healthy, normal children matched for race, age and sex. The results showed that children with CD experienced a delay in dental development of approximately 3 years compared with normal children (P < 0.05). In addition, the root lengths of the mandibular first permanent molar were significantly longer than those of the comparison children (17.8 +/- 1.6 mm vs 13.6 +/- 1.2 mm (P < 0.001). This study thus revealed two significant clinical features of CD: 1) severe delay in dental development, and 2) excessive root lengths of mandibular permanent first molars. These features may be important in the pathogenesis of delayed dental eruption observed in this disorder.
Adolescent↗
Spectrum of dentin dysplasia in a family: case report and literature review.
The dentin dysplasias (DD), which may be classified as type 1 (DD1) or type 2 (DD2), form a group of rare, inherited dentin abnormalities that are clinically distinct from dentinogenesis imperfecta. Studies of affected families may help to distinguish different types of DD and provide further insight into their etiology and clinical management. This report describes a family that showed characteristic dental features of DD1, including clinically normal crowns in both primary and permanent dentitions, and mobile teeth that may be associated with premature exfoliation. Radiographic features included calcification of the pulp with crescent-shaped, radiolucent pulp remnants, short, tapering, taurodontic roots, and many periapical pathoses that may be cysts or granulomas. A spectrum of dentin dysplasia was noted within the family. Strategies to prevent pulp and periapical infections and early exfoliation of the teeth include meticulous oral hygiene and effective caries-preventive measures.
Child↗
Dental development in amelogenesis imperfecta: a controlled study.
The present investigation studied dental development in 23 subjects with amelogenesis imperfecta (AI), aged 4.2 to 15.6 years, compared with 46 race-, age-, and sex-matched, healthy, normal controls. The dental ages of the children were assessed from panoramic radiographs using previously established methods. Their chronologic ages at the time of radiographic examination were compared with their dental ages. The results showed that all subjects with AI showed a significant acceleration of dental age of approximately 1.13 +/- 0.78 years compared with control children (P < 0.001). All children were consistently affected regardless of the AI variant. Furthermore, the study found a six-fold increase (26.1 vs. 4.3%) in tendency of AI patients to show impaction of the permanent teeth and associated anomalies such as follicular cysts. These results may be important in planning orthodontic treatment in AI patients, and indicate that they should have early screening to detect these abnormalities.
Adolescent↗
Dental fluorosis as a complication of hereditary diabetes insipidus: studies of six affected patients.
Hereditary diabetes insipidus is a rare endocrine disorder caused by a deficiency of the antidiuretic hormone, vasopressin. The disease is characterized by polyuria, extreme thirst, and polydipsia. In this study of six affected members from two families with hereditary diabetes insipidus, it was found that two children who drank water fluoridated at optimum levels developed moderate to severe fluorosis. By contrast, four other affected patients who did not consume fluoridated water showed normal dentitions. This report indicates that dental fluorosis may be an important complication of diabetes insipidus, and demonstrates the possibility that excessive consumption of optimally fluoridated water can lead to severe developmental enamel defects.
Adolescent↗
Enamel hypoplasia and dental caries in Australian aboriginal children: prevalence and correlation between the two diseases.
This study investigated the prevalence of enamel hypoplasia and dental caries and the relationship between the two diseases in all 4- to 6-year-old Australian Aboriginal children of the Tiwi tribe on Bathurst Island. Seventy-nine of 80 children (99%) had enamel hypoplasia, with a mean of 12.0 +/- 4.1 hypoplastic teeth per child. Dental caries was noted in 66 (83%) of children and the mean number of decayed teeth per child was 3.9 +/- 3.3. A strong association between enamel hypoplasia and dental caries (P < 0.01) suggests that enamel hypoplasia may be a significant caries risk factor in this group. Furthermore, while high levels of medical morbidity were found, the relative importance of each medical condition in the pathogenesis of enamel hypoplasia could not be determined because nearly all patients with enamel hypoplasia had the full range of medical problems. It is likely that all the medical conditions commonly encountered contribute to enamel hypoplasia and may act synergistically.
Australia↗
Root agenesis associated with chronic infection and traumatic curettage of the maxillary sinus.
A healthy 13-year-old female was found to have no roots on the maxillary left second premolar and permanent first and second molars. Her history included chronic sinus infections treated with maxillary sinus curettage at approximately 4 years of age. The infection, or more likely the trauma associated with the surgery, may have caused agenesis of the roots. Other causes of rootless teeth such as odontodysplasia, dentin dysplasia, trauma, infection, radiation therapy, and neoplasia were excluded from her history and clinical and radiographic findings. This report suggests that damage to the developing dentition may be a serious complication of maxillary sinus surgery or chronic infection.
Adolescent↗
Clinical diagnosis and management strategies of amelogenesis imperfectavariants.
Amelogenesis imperfecta (AI) is a group of inherited disorders primarily affecting dental enamel. Variants of AI generally are classified as hypoplastic, hypocalcified, or hypomaturation types based on the primary enamel defect. The aim of this study was to analyze the clinical presentations, diagnostic features, and clinical complications of different variants of AI. Thirty-two patients from 17 families with several subtypes of AI were studied. The results showed that distinctive clinical features may be observed in each variant. However, all AI patients suffered common clinical problems of poor esthetics, teeth sensitivity, and loss of occlusal vertical dimension. The mildest problems were found in the pitted hypoplastic type whereas the most severe problems were encountered in the hypocalcified type of AI. Management strategies include composite resin veneers and jacket crowns for anterior teeth as well as steel crowns for posterior teeth. Knowledge of the clinical features and dental complications of each variant of AI helps in the diagnosis of the condition and allows institution of early preventive measures.
Adolescent↗
Evaluation of the novel anti-inflammatory agent tetrandrine as a pulpotomy medicament in a canine model.
Tetrandrine, a bisbenzylisoquinoline alkaloid with unique broad-spectrum anti-inflammatory properties, was evaluated as a pulpotomy medicament in a canine model. Histological sections were evaluated after three days (acute inflammation) and six weeks (chronic inflammation) by two criteria: 1) intensity and degree of inflammation, and 2) extent of pulp involvement. The results of the three-day dressings revealed significant neutrophil infiltration in only 30% of teeth treated with tetrandrine, compared with 81%, 84%, and 100% of teeth treated with Ledermix, (Lederle Pharmaceuticals, Wolfrathausen, Germany), formocresol (Creighton Pharmaceuticals, Sydney, Australia) and saline (controls) respectively (P < 0.01). After six weeks, there was significant lymphocyte infiltration in only 30% of teeth treated with tetrandrine, compared with 66%, 90%, and 100% on teeth treated with Ledermix, formocresol, and saline controls respectively. (P < 0.01). In both three-day and six-week specimens in tetrandrine-treated teeth the extent of inflammation was limited to less than one-third of the coronal section of the pulp, whereas teeth treated with Ledermix or formocresol showed cellular infiltration extending to greater than two-thirds of the pulp (P < 0.01). Comparative studies with berbamine, a natural analog of tetrandrine, showed that it was less potent than tetrandrine, but significantly better than Ledermix and formocresol on both acute and chronic pulp inflammation (P < 0.05 and P < 0.01 respectively). These results suggest that tetrandrine may have value as a pulpotomy medicament.
Alkaloids↗
Trichodentoosseous (TDO) syndrome: case report and literature review.
Trichodentoosseous (TDO) syndrome is an autosomal dominant condition characterized by dysplastic nails, curly hair, bone sclerosis of the long bones and calvarium, taurodontism, and enamel hypoplasia that occurs with hypomaturation/hypocalcification defects. To date, nine previous case reports of TDO in the dental literature have shown that while taurodontism and enamel defects are consistently present in TDO, the changes in the nails, hair, and bones may be variably expressed and occasionally not noted. Because of this, a few previous cases of TDO syndrome had been diagnosed simply as amelogenesis imperfecta. This case report highlights the typical clinical findings, diagnostic problems, and the clues to diagnosing this interesting condition. Clinical management of TDO is centered on preventing dental abscesses with stainless steel crowns and improving appearance with esthetic restorations.
Abnormalities, Multiple↗
Effect of familial hypophosphatemic rickets on dental development: a controlled, longitudinal study.
Familial or X-linked hypophosphatemic rickets (XLHR) is the most common type of rickets in developed countries today. While the dental manifestations of rickets are well reported, there is little information regarding its relationship to dental development and other dental anomalies. This investigation studied the rate of dental development and associated dental anomalies in 19 XLHR subjects compared with 38 race-, age-, and sex-matched control children. The results showed that in both XLHR and control children, no significant differences existed in dental age compared with the respective chronological age, indicating that rickets did not affect the rate of dental development. Longitudinal growth curves of seven XLHR and matched control children substantiated that relationships of dental to chronological ages were comparable in both groups. Male XLHR subjects showed significantly increased tendency for dental taurodontism with mean Crown-Body (CB):Root (R) ratio of 1.1 compared with 1.0 in females and 0.8 in controls (P < 0.02). Male XLHR children also showed significantly increased prevalence (50%) of ectopic permanent canines compared with control children (8%, P < 0.01).
Adolescent↗
Pre-eruptive resorption of dentin in the primary and permanent dentitions: case reports and literature review.
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Child↗
A study of the development of the permanent dentition in very low birthweight children.
There have been no previous studies on dental maturation of prematurely born, very low birthweight (< 1500 g, VLBW) Caucasian children. This study investigated dental development and prevalence of enamel defects in a group of 55 VLBW children (mean age at dental examination 7.7 +/- 2.2 years, mean birthweight 1203 +/- 240 g, and mean gestational age 29.8 +/- 2.4 weeks) compared to 55 normal birthweight (NBW) children matched for race, sex, and age. Dental maturity was determined from panoramic radiographs. Overall, VLBW children experienced a delay in dental maturation of approximately 0.29 +/- 0.54 years compared with NBW children (P < 0.02). The VLBW children younger than 6 years of age showed the greatest delay of 0.31 +/- 0.68 years (P < 0.001). In contrast, children aged 9 years and older had no difference in their dental ages compared to controls (P > 0.01), showing that "catch-up" growth had occurred by age 9 years. Children of birthweight < 1000 g with gestational ages < 30 weeks showed the greatest lag period in dental maturation. Clinical examination also showed that VLBW children had a higher percentage of enamel defects in the permanent first molars (21% versus 11%, P < 0.02) and lateral incisors (12% versus 0%, P < 0.01). As the permanent teeth commence their mineralization of few mouths after premature birth, it is hypothesized that there is persistent systemic derangement sufficient to affect enamel formation postnatally for some time in VLBW children.
Calcium↗
Enamel hypoplasia and dental caries in very-low birthweight children: a case-controlled, longitudinal study.
This longitudinal study investigated the sequelae of enamel defects in a group of 25 white, very-low birthweight (VLBW), preterm children (mean birthweight 969 +/- 218 g, mean gestational age 27 +/- 1.9 weeks). Twenty-five race-, age-, and sex-matched, full-term normal birthweight (NBW) control children born at the same hospital, were selected randomly from hospital records. The children were examined at approximate ages of 30, 44, and 52 months. At all examinations, VLBW children had significantly higher prevalence of enamel hypoplasia than did the NBW children. At the last recall examination, 96% of VLBW group, and 45% of the NBW group had at least one tooth with enamel defect, with a mean of 7.6 +/- 4.9 affected teeth per VLBW child, and only 1.0 +/- 1.3 affected teeth per control child (P < 0.001). A significant association of enamel defects with dental caries was observed only in the VLBW group on the second and third examinations (P < 0.001). The defect identified to be most significantly associated with dental caries was a variant showing both enamel hypoplasia and opacity. In spite of a high prevalence of enamel defects, the overall prevalence of dental caries in the VLBW children was not significantly different from that of NBW controls at all three examinations (P < 0.1). Other caries risk factors such as levels of Streptococcus mutans infection, fluoride supplementation, plaque scores, toothbrushing frequency, and daily sugar exposures were examined but none was found to be related significantly to development of dental caries.
Birth Weight↗
Developmental dental changes in isolated cleft lip and palate.
Isolated cleft lip and/or palate, CL(P), may be associated with multiple changes in the developing dentition. To test the hypothesis that permanent tooth formation is delayed in patients with CL(P), dental maturity was assessed from panoramic radiographs. The dental maturity ratio (DMR, dental age divided by chronological age) of a group of CL(P) patients (23 girls, 30 boys) was compared with matched control subjects (38 girls, 41 boys). The mean DMR in cleft boys (0.97 +/- 0.01) was significantly lower than in control boys (1.06 +/- 0.01), P < 0.05. The mean DMR in cleft boys was lower than in cleft girls (1.02 +/- 0.02), with a tendency toward statistical significance. No significant difference in DMR was found between the cleft versus control girls, or between the control girls and boys. Among cleft boys, the prevalence of dental age delay was 67% (20/30), with a mean delay of 0.6 +/- 0.4 years. These results suggested that CL(P) may be associated with delay in permanent tooth formation.
Analysis of Variance↗
Alveolar bone height of primary and first permanent molars in healthy seven- to nine-year-old children.
The purpose of the study was to establish baseline values of the alveolar bone height of the primary molars and first permanent molars in sample of healthy U.S. seven- to nine-year-old children. Direct measurements of the distance from the cementoenamel junction (CEJ) to the alveolar crest (AC) on 223 pairs of bitewing radiographs from 223 subjects were made using a digimatic caliper under standardized conditions. The distance from the CEJ to the AC had medians from 0.58 mm to 1.39 mm (range 0.0 to 4.44 mm) for the primary molars and from 0.00 mm to 0.64 mm (range -1.35 to 2.15 mm) for the mesial aspect of the permanent molars. There were no statistically significant differences in the distance from CEJ to AC between teeth on the right and left sides of the mouth. The distances from CEJ to AC were always greater in the maxilla than in the mandible for similar primary molar sites, but only true for the mesial aspect of the permanent first molar at age nine. As a tooth is positioned more anteriorly in the mouth, the distance from CEJ to AC was greater. On the whole, males had greater distances than females and eight-year-olds had larger distances than seven- or nine-year-olds. Differences were observed in the measured distances for the different age and sex-groups and may be attributable to variations in eruption and exfoliation patterns. The distance was significantly greater in areas of interproximal restorations and open contacts, and there was a tendency for the distances to be greater in areas of interproximal caries.
Alveolar Process↗
The effects of acid-etching on enamel from different clinical variants of amelogenesis imperfecta: an SEM study.
PURPOSE: Successful bonding of resins to teeth affected by amelogenesis imperfecta (AI) may be highly dependent on how the enamel responds to acid etching. The aim of this study was to determine, using scanning electron microscopy (SEM), the types of etching pattern achieved with 37% phosphoric acid on dental enamel of 5 clinical variants of AI, namely, pitted hypoplastic, smooth hypoplastic, X-linked (male), X-linked (female), and hypomineralized. METHODS: A normal premolar and primary molar from two healthy patients were used as controls. The enamel was scanned before and after acid etching for 1 min. In the normal, control teeth, the three classical etching patterns were produced: type 1, in which the prism cores are preferentially removed; type 2, in which the prism peripheries are removed, and type 3 in which the removal of enamel does not relate to prism structure. RESULTS: In the normal primary molar, patterns of types 2 and 3 were generally produced. In the AI teeth, the effects of acid etching reflected the clinical variant of AI. All three etch patterns were observed in the enamel surrounding the pits in the pitted type of AI and in the bands of normal enamel in the female with X-linked AI, as well as in the hypomineralized variant. In contrast, no typical etch patterns could be detected in the enamel from the male patient with X-linked variant, as well as from the enamel affected by the smooth hypoplastic variant. CONCLUSIONS: The lack of typical etching patterns in these variants may be the result of abnormal prism structure, or the standard etching time and/or acid concentration may be inappropriate for the abnormal enamel. The results of this study may have useful applications in the restoration of teeth affected by AI.
Acid Etching, Dental↗
Multiple pre-eruptive intracoronal radiolucent lesions in the permanent dentition: case report.
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Adolescent↗