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Maternal smoking and tooth formation in the foetus. I. Tooth crown size in the deciduous dentition.

Altogether 2159 pregnancies among black and white Americans in the Collaborative Perinatal Study and dental casts from the children at the age of 5-12 years were studied to find out the effect of maternal smoking on deciduous tooth crown growth. Minor crown size reduction (2-3%) in some dimensions was found in children whose mothers had smoked during pregnancy. The possible change in dimensions seems to be influenced by sex, race and smoking habit. The critical time periods of the gestational development (16th to 19th) weeks would possibly appear from these data to be targeted by the detrimental effect of maternal smoking. It is concluded that deciduous tooth sizes seem to be greatly unaffected when compared to reduction in birthweight.

Black People↗

Social and biological correlates of localized enamel hypoplasia of the human deciduous canine tooth.

Recent studies of teeth from prehistoric children have reported a localized, roughly circular patch of deficient enamel on the labial aspect of the primary canine, which reaches its highest prevalence in the Upper Paleolithic of Europe. This study reports social and biological correlates of 33 affected kindergarten-aged children from Vancouver, Canada (2.4% of 1,350 examined). Affected children can be characterized as coming from low-income families often of East Asian or Chinese origin in which there is a degree of milk avoidance and reduced breastfeeding. The defect appears to be due to minor physical trauma to the face approximately 6 months after birth occasioned by normal motor development, involving handling and mouthing objects, which damages the developing tooth crown through deficient cortical bone over the canine crypt. Reduced cortical bone in the face of the infant is attributed to nutritional factors, involving calcium deficiency, of the mother and/or developing infant.

British Columbia↗

Tissue contributions to sex and race: differences in tooth crown size of deciduous molars.

This study describes size of constituent deciduous tooth crown components (enamel, dentine, and pulp) to address the manner in which males characteristically have larger teeth than females, and the observation that teeth of American blacks are larger than those of American whites. Measurements were collected (n = 333 individuals) from bitewing radiographs using computer-aided image analysis. Tissue thicknesses (enamel, dentine, pulp) were measured at the crown's mesial and distal heights of contour. Deciduous mesiodistal molar crown length is composed of about 1/7 enamel, 1/3 dentine, and 1/2 pulp. Details differ by tooth type, but males typically have significantly larger dentine and pulp dimensions than females; there is no sexual dimorphism in marginal enamel thickness. Males scale isometrically with females for all variables tested here. Blacks significantly exceed whites in size of all tissues, but tissue types scale isometrically with blacks and whites with one exception: enamel thickness is disproportionately thick in blacks. While the absolute difference is small (5.56 mm of enamel in blacks summed over all four deciduous molar tooth types vs. 5.04 mm in whites), the statistical difference is considerable (P < 0.001). Aside from enamel, crown size in blacks is increased proportionately vis-à-vis whites. Principal components analysis confirmed these univariate relationships and emphasizes the statistical independence of crown component thicknesses, which is in keeping with the sequential growth and separate embryonic origins of the tissues contributing to a tooth crown. Results direct attention to the rates of enamel and dentine deposition (of which little is known), since the literature suggests that blacks (with larger crowns and thicker enamel) spend less time in tooth formation than whites.

Anthropology, Physical↗

The mythology of the killer deciduous canine tooth in southern Sudan.

In Southern Sudan it is a commonly held belief that the unerupted deciduous canine tooth is injurious to the health of infants and that it causes diarrheal diseases. The teeth are therefore often removed by native extractors in an attempt to alleviate the symptoms of these dangerous diseases. This study examined the prevalence of this practice among babies presenting at a hospital, and examined the health status of the infants involved. The 90 infants in the study had all had at least one deciduous tooth removed, and the great majority were suffering from dehydration, caused by various abdominal diseases. It is clear that an educational campaign aimed at reducing the prevalence of this practice is required.

Child↗

Removal of deciduous canine tooth buds in Kenyan rural Maasai.

The removal of deciduous canine tooth buds in early childhood is a practice that has been documented in Kenya and in neighboring countries. This paper describes the occurrence, rationale and method of this practice amongst rural Kenyan Maasai. In a group of 95 children aged between six months and two years, who were examined in 1991/92, 87% were found to have undergone the removal of one or more deciduous canine tooth buds. In an older age group (3-7 years of age), 72% of the 111 children examined exhibited missing mandibular or maxillary deciduous canines. It was found that the actual removal of a deciduous tooth bud is often performed by middle-aged Maasai women who enucleate the developing tooth using a pointed pen-knife. There exists a strong belief among the Maasai that diarrhoea, vomiting and other febrile illnesses of early childhood are caused by the gingival swelling over the canine region, and which is thought to contain 'worms' or 'nylon' teeth. The immediate and long-term hazards of this practice include profuse bleeding, infection and damage to the developing permanent canines. A multi-disciplinary approach involving social anthropologists in addition to dental and medical personnel, is recommend in order to discourage this harmful operation that appears to be on the increase.

Child↗

[Adenomatoid odontogenic tumor in calcifying odontogenic cyst].

BACKGROUND: Adenomatoid odontogenic tumors (AOT) and calcifying odontogenic cysts (COC, Gorlin's cyst) are rare benign specificities of odontogenic tumors. Most odontogenic tumors are lesions of embryonic odontogenic tissue. Radiographically, odontogenic tumors may mimic an odontogenic follicular cyst. CASE REPORT: This paper describes the case of an 11-year-old female patient with a remarkable combination of these two entities. The lesions were found at the site of a retained first premolar and a persistent deciduous tooth 84 of the right lower jaw. Without clinical symptoms the tumor had expanded the vestibular cortical bone of the premolar region. Radiographically, the lesion appeared as a typical follicular cyst. During the operation, excochleation of the cyst was performed and the premolar was extracted. Finally, the epithelium of the cyst was treated by curettage. The histologic specimen revealed the diagnosis of an adenomatoid odontogenic tumor (AOT) in a calcifying odontogenic cyst (COC). DISCUSSION: The described case shows that symptoms of odontogenic tumors are usually nonspecific. For that reason one should always take a biopsy for histological investigation when patients present atypical cysts of the jaw. In rare cases even malignant odontogenic neoplasms could occur.

Bicuspid↗

[Calcium hydroxide and treatment of inflammatory inter-radicular bone resorption of non-vital deciduous molars].

On non-vital deciduous molars, inter-radicular bone resorption is often an indication of extraction. The endodontic treatment of these teeth by means of zinc oxide-eugenol (ZOE) paste also showed its limits. To mitigate the deficiencies of this material, we suggested a preliminary treatment by means of calcium hydroxide (Ca(OH)2) for its anti-inflammatory and antiseptic properties as well as its ability to stimulate calcified tissues apposition or remineralisation. This study concerns 21 non-vital deciduous molars. X-rays excluded any lesion of the underlying permanent bony crypt (bone tissue) as well as any inflammation of the dental follicle. After preparation, root canals were filled by means of Pulpdent. An initial X-ray check was made 15 days and then every 3 months. After disappearance of the inflammatory resorption, root canal fillings were performed with ZOE paste. The remineralisation of the inter-radicular alveolar bone was observed for 14 deciduous molars, which were then filled using ZOE. The remineralisation period varies from 3 to 18 months depending on the scale of the lesion. Of the 7 failed treatments, 3 failed following downfall of the crown filling material, and 2 due to failure to keep appointments and late replacement of resorbed Ca(OH)2. On 2 teeth, the treatment did not stop the lesion forming. Calcium hydroxide (Ca(OH)2) give encouraging results in the treatment of inter-radicular alveolar bone resorption of non-vital deciduous tooth. Its fast resorption requires rigorous controls, frequent refills, and thus strong motivation on the part of the child and parents. It cannot, on any account, be considered as permanent filling material.

Alveolar Bone Loss↗

[A study of trace elements in deciduous teeth. The differences of Cd, Zn, Pb, and levels in prenatally and postnatally formed deciduous teeth].

It has been reported by some investigators that deciduous teeth could be useful materials for the analysis of the trace elements available to the human body burden. In this study, an attempt was made to define that uptake of trace elements (Cd, Zn, Pb and Cu) take place during formation of the deciduous tooth. Samples were prepared from exfoliated human upper deciduous central incisors divided into two or three sections at incremental lines includes neonatal line. Samples were dissolved with nitric acid and dried at 80 degrees C. Each element was separated chromatographically using acetone-HCl gradient solution with a cation exchange resin and then analyzed by flameless atomic absorption spectrophotometry. The results were as follows: 1. Ca, P, Ca/P ratio levels showed no significant differences between prenatally and postnatally formed teeth. 2. In the enamel, (1) Cd level showed a tendency to be higher in the postnatally formed enamel, but not significant. (2) Zn and Pb levels were found to be significantly higher in the postnatally formed than in the prenatally formed enamel. (3) Cu level was reversed significantly. 3. In the dentin, (1) Cd and Cu levels in the postnatally formed dentin I were significantly less than prenatally formed denin, and these were almost equal to the postnatally formed dentin II. (2) Zn level in the postnatally formed dentin I was almost equal to the prenatally formed dentin, but that was significantly less than the postnatally formed dentin II. (3) Pb level in the postnatally formed dentin I was significantly less than the prenatally formed dentin and the postnatally formed dentin II. Therefore, the results suggest that the accumulation of Cd and Cu to the deciduous tooth mainly occur in the prenatal and the accumulation of Zn and Pb to the deciduous tooth occur not only in the prenatal but also continuously in the postnatal, and the deciduous tooth can be a useful materials for environmental contamination recorder.

Cadmium↗

Orthodontic tooth movement in the mixed dentition. Histological study of a human specimen.

MATERIAL AND METHOD: We present a retrospective analysis of periodontal tissue reactions and clinically relevant phases of permanent tooth eruption and deciduous tooth resorption after half a year of orthodontic tooth movement in the upper and lower jaw of a deceased male (age 9 years 3 months). Specimens of the horizontal plane (lower jaw) and sagittal plane (upper jaw) were prepared by the ground microsection technique without prior decalcification. RESULTS: Histologically, reactions in the periodontal ligament presented as characteristic appositional/resorptive metaplastic processes in the areas of tension and pressure, with side effects such as root resorption and periodontal necrosis being only minor. In the upper jaw, an erupting permanent canine was closely associated with the tooth germ of the first premolar. Resorptive follicle activity had resulted in extensive erosion of the interradicular bone and root resorption in the area of the first premolars. CONCLUSION: These findings suggest that it might prove useful to take critical topographic findings as parameters for differential therapeutic decisions. Follicle-driven deciduous tooth resorption presenting partly as resorption lacunae and partly with linear characteristics was accompanied by resorptive/appositional remodeling of the alveolar socket as well as regressive changes in the supracrestal fibers of the marginal gingiva.

Child↗

[Comparative study of friction and wear behavior of different human enamel in vitro].

OBJECTIVE: To investigate the friction and wear behavior of different human enamels. METHODS: 24 enamel samples selected from aged, young permanent and faded deciduous teeth were classified into 3 groups and slid against artificial porcelain teeth in the presence of artificial saliva on an oscillating friction and wear test rig. The wear volume loss, microhardness and toughness of each group of the enamel specimens were measured, the wear scars were observed with a scanning electron microscope, and the elemental compositions of Ca, P, and Si of the wear scar and wear debris were determined with an energy dispersion spectrometer. RESULTS: The wear volume losses of aged, young permanent and deciduous tooth enamels are (2.40 +/- 1.10) x 10(-12) m(3), (3.50 +/- 1.83) x 10(-12) m(3) and (4.86 +/- 2.49) x 10(-12) m(3). The data of aged tooth enamels are statistically greater than that of deciduous tooth enamels (P < 0.05). There is no significant difference between the wear volume loss of aged and young permanent tooth enamels or between the young permanent and deciduous tooth enamels (P > 0.05). However, the friction and wear behavior of each group of enamel specimens is different from each other. CONCLUSIONS: In the present testing condition, the wear scars of each kind of enamel specimens is characterized by ploughing and cracking. The different wear resistance of the three kinds of enamels is attributed to the different microstructure of the enamel, while the hardness and toughness of the enamels are not correlated with the wear resistance.

Adolescent↗

[Traumatic injuries to the teeth for children].

For modern medical care, social background may be an essential factor, and medical care through out the individual's life time appears to have significant meaning. From this point of view, total dental care throughout childhood is being carried out in the field of pediatric dentistry. It can be stated that we pedodontists have a degree of farsight in the treatment of traumatic injuries to the teeth regarding children (the theme of the lecture), since the injured teeth are treated not only as items to be restored but also as a part of the growing body with careful consideration on the effects with regard to orlo-facial growth. It is obvious that epidemiological surveilance is necessary to understand the cause of dental injuries, and also careful attention ought to be paid to the activity of the children to grasp the potential background of dental trauma. Here, I would like to explain the consequences of the serial work on the traumatic injuries to teeth which were carried out in our department. 1) The prevalence of dental injuries in children appeares to be on the increase according to a judgement based on the surveilances form in and out of the country. Also as the parental recognition for dental injuries became higher, more patients visited dental clinic or hospital looking for improved treatment techniques. 2) Careful consideration must be paid to the succedaneus permanent tooth germ, when a deciduous tooth suffered from traumatic injury. The effect of the direction applied and the area of the traumatic force on the root of the deciduous tooth, the successor and the surrounding tissue was investigated by means of kinetic analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗

Radiographic examination of dentigerous cysts in the transitional dentition.

OBJECTIVES: To examine radiographically the relationship between the deciduous tooth and dentigerous cyst of the permanent successor during the transitional dentition. METHODS: From a retrospective review of all patients who visited our institution from April 1988 to August 2001, 70 patients under 16 years of age who had histologically confirmed dentigerous cysts that had developed from the central incisor to the second premolar were identified. These 70 patients were investigated using panoramic and periapical radiographs. RESULTS: In most cases (54 cases; 77.1%) the cyst was in the premolar region. Of the 54 premolars with dentigerous cysts, the overlying deciduous tooth had already been lost in 7 cases. Of the 47 remaining premolars with associated deciduous tooth, 35 (74.5%) had bone resorption of the periapical or bifurcation region, or irregular resorption of the associated deciduous tooth. Of the remaining 12 deciduous teeth with no periapical lesions, 9 had been treated with root canal therapy. Thus, 44 of these 47 cases (93.6%) had the possibility of inflammation at the deciduous tooth associated with the dentigerous cyst. Evidence from one case in the present study suggesting the process by which cyst development occurs is also given. CONCLUSION: Inflammatory change at the apex of the deciduous tooth may bring on a dentigerous cyst of the permanent successor.

Adolescent↗

Dental development, dental age and tooth counts.

Emergence data on the 20 deciduous teeth and the first 29 permanent teeth were collected from 212 randomly selected urban Swedish children who were followed from birth to 18 years of age. The sex difference in the emergence of the deciduous teeth is less than one month, which is not statistically significant. Boys are consistently ahead of girls until the 17th deciduous tooth. From the 17th deciduous tooth on through most of the permanent dentition, girls are consistently ahead of boys. In the permanent dentition the sex difference ranges from 3 MO to 11 MO; these differences are statistically significant except for the 29th tooth. Reference data on dental age based on counts of 1-19 deciduous and 1-27 permanent teeth are tabulated and tooth emergence curves constructed. The tooth emergence curves can be used to express individual dental development in terms of standard deviation scores. Validity of dental age assessed by counts of permanent teeth is evaluated by a cross-sectional comparison with another sample of Swedish boys and girls. The mean difference between estimated age and chronological age is about one month in either sex. Precision of an individual estimate of dental development in terms of 95% confidence level (approximately equal to +/- 2 S.D.) varies from about +/- 4 months in the deciduous dentition to +/- 3 years in the permanent dentition. Assessment of dental development and dental age by means of tooth counts is a convenient and simple method, although it can only be applied at ages when emergence can be expected. It is especially useful in cross-sectional evaluations, as no serial data are required. In populations with a low incidence of caries the impact of such disturbing factors on emergence is correspondingly low, further increasing the validity of assessments of dental development based on tooth emergence.

Adolescent↗

Characterization of stem cells from exfoliated deciduous teeth from a patient with Alagille syndrome carrying a JAG1 mutation.

PURPOSE: Alagille syndrome (ALGS) is an autosomal dominantly inherited disorder primarily caused by mutations in the Jagged Canonical Notch Ligand 1 (JAG1) gene. Although many pluripotent stem cells are well established, no patient-derived stem cells from exfoliated deciduous teeth (SHED) have been developed. In this study, we aimed to establish SHED from an ALGS patient carrying a heterozygous JAG1mut mutation. METHODS: We isolated SHED from a deciduous tooth of an ALGS patient with a heterozygous JAG1 mutation (ALGS-SHED) by the colony-forming unit-fibroblast (CFU-F) method. We then compared the characteristics of ALGS-SHED and healthy donor-derived control SHED (CONT-SHED). RESULTS: ALGS-SHED displayed mesenchymal stem cell features as indicated by CFU-F formation, immunophenotype, and mesenchymal multipotency into adipocytes, chondrocytes, and osteoblasts. ALGS-SHED showed reduced population doubling capacity and exhibited induced chondrogenic potency and diminished osteogenic potency, but similar hepatic potency. ALGS-SHED damaged in situ potency to form bile duct-like tubular structures in the livers of chronically CCl4-injured mice. CONCLUSIONS: We successfully established ALGS-SHED from an ALGS patient carrying a heterozygous JAG1 mutation. Our established ALGS-SHED may represent a potential model for studying ALGS involving a JAG1 mutation.

Alagille Syndrome↗