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Sexual dimorphism in modern human permanent teeth.

On average, males possess larger tooth crowns than females in contemporary human populations, although the degree of dimorphism varies within different populations. In previous studies, different amounts of either enamel or dentine were implicated as the cause of this dimorphism. In this study, we attempt to determine the nature of sexual dimorphism in the crowns of permanent modern human teeth and to determine if two contrasting tooth types (permanent third molars and canines) show identical patterns of dimorphism in enamel and dentine distribution. We estimated the relative contributions of both enamel and dentine to total crown size, from buccolingual sections of teeth. Our sample consisted of a total of 144 mandibular permanent third molars and 25 permanent mandibular canines of known sex. We show that sexual dimorphism is likely due, in part, to the presence of relatively more dentine in the crowns of male teeth. However, whatever the underlying cause, dimorphism in both tooth root and tooth crown size should produce measurable dimorphism in tooth weight, though this has not been previously explored. Therefore, we provide some preliminary data that indicate the usefulness of wet tooth weight as a measure of sexual dimorphism. Both male permanent third molars and canines are significantly heavier than those of females. The weight dimorphism reported here for both classes of teeth may prove a useful finding for future forensic studies. In particular, weights of canines may be more useful as a means of sexing modern human skeletal material than linear or area measurements of teeth.

Anthropology, Physical↗

Periodontal considerations in tooth preparation for crowns and bridges.

Correct tooth preparation and adequate reconstruction of the anatomy of the crown are essential to the maintenance and preservation of a healthy periodontium. Adequate tooth preparation requires careful attention to many details and clear knowledge of the features of the finished product. The anatomic reconstruction of the crown with a perfect marginal adaptation will provide an adequate environment for maintaining the health of surrounding periodontal tissues.

Crowns↗

The novel use of extracted teeth as a dental restorative material--the 'Natural Inlay'.

OBJECTIVE: This preliminary study aimed to find out whether it is possible to produce a well fitting Class II inlay from an extracted tooth using a copy-milling technique. METHODS: Two pairs of matching sound extracted permanent molar teeth were used. The molars were matched for mesio-distal size of the tooth crown and the convexity of the approximal surfaces. One tooth of each pair was assigned to be the 'donor' tooth, the other tooth being the 'host'. MO inlay preparations were made in the host teeth. These were restored with the milled 'Natural Inlays' produced from the donor teeth using the CELAY system. The restored host teeth were sliced and examined using light-microscopy. RESULTS: The specimens showed the desired location of enamel and dentine, and a clinically acceptable fit. CONCLUSION: This study has shown that by using the CELAY milling machine it is possible to 'recycle' extracted teeth for the production of dental restorations.

Cementation↗

Brånemark single tooth implants: a preliminary report of 76 implants.

Seventy-six Brånemark single-tooth implants were inserted over a 6-year period. Two implants (2.63%) were removed during the follow-up period. All other implants received esthetic and functional single tooth crowns placed on a single tooth abutment or a CeraOne abutment. The most common complication observed was abutment screw loosening, which occurred with 12 crowns. However, it was possible to clearly reduce the occurrence of screw loosening by applying a defined torque. Peri-implant parameters were investigated on 56 implants that were in place for more than 1 year. Acceptable implant function was demonstrated with preestablished clinical parameters and radiographs. Despite the submucosal edge of the crown, peri-implant mucositis was not a major problem. The favorable clinical and esthetic results found in the study encourage an increased application of implants for single tooth restorations.

Adolescent↗

Biologic outcome of implant-supported restorations in the treatment of partial edentulism. Part 2: a longitudinal radiographic study.

The purpose of this study was to evaluate over time the marginal bone level changes around implants installed to treat partial edentulism and to investigate the possible effect of several confounding variables. Consecutive intraoral radiographs taken with the paralleling technique were used. In all, 660 partially edentulous patients ever treated in the departments (248 males; 15-83 years of age) with 1655 implants, which were successfully integrated at abutment connection, were loaded by means of fixed partial prostheses. The observation period starting at abutment connection reached 16 years (mean 5.1). Implants were divided into three groups: 235 implants supported single-tooth crowns, 398 supported implant-tooth connected and 1022 free-standing fixed partial prostheses. Implants were placed in maxilla and mandible, both anteriorly and posteriorly. No significant difference in bone level evolution was predicted between the three groups of implants, either for posterior or for anterior sites. The estimated marginal bone loss for the first 6 months is 0.31 mm/year and after that 0.015 mm/year higher in the maxilla than in the mandible. More bone loss was predicted for the first 6 months when dehiscences existed, when a membrane or a bone graft were used, or when metal/ceramic prosthesis material was applied. Age and gender did not affect the change in bone level. The use of subsequently situated single-implant crowns to restore an edentulous space did not lead to more marginal bone loss than around splinted implants. Based on marginal bone height maintenance, the excellent prognosis of the presently used implants to support restorations in the treatment of partial edentulism was confirmed.

Adolescent↗

A retrospective multicenter evaluation of single tooth implant experience at three centers in the United Kingdom.

STATEMENT OF PROBLEM: Implant treatment in the United Kingdom has been provided mainly in specialist, regional dental hospitals. However, increasingly, general dentists are providing implant-supported prostheses in a private office setting. PURPOSE: This study investigated the nature, timing, and frequency of complications associated with single tooth implant therapy in a dental hospital and two dental offices. METHODS: The dental records of 58 patients provided with 76 implants during the period of 1989-95 were reviewed retrospectively. Fifty-three single tooth crowns on implants were placed by general dentists and 23 by specialists in the dental hospital. RESULTS: Implant survival rate was 96%. Twenty-eight guided bone regeneration procedures were required, including 13 unplanned ones. Prosthodontic complications included the need for recontouring of three crowns and the recementation of three crowns. Only two abutment screws required retightening. Peri-implant soft tissue inflammation occurred around six crowns and recession around two. CONCLUSION: The single tooth implant-supported crown appears to be an effective and durable restorative treatment with a relatively low prevalence of postoperative complications.

Adolescent↗

Aesthetic solution for large maxillary anterior diastema and frenum attachment.

Resin-bonded porcelain veneer restorations can be used to correct unaesthetic diastemata caused by tooth position or discrepancies in the tooth size/arch development. The size of the diastema, size and proportion of the clinical crowns, tooth preparation, and dental occlusion require special attention; an excessive frenum attachment requires additional care and coordination of the treatment. This article describes the placement of six resin-bonded porcelain veneer restorations in a patient with a large diastema between the maxillary central incisors and associated frenum and soft tissue involvement. The learning objective of this article is to demonstrate the importance of pretreatment planning and problem solving in achieving predictable final restorations.

Adult↗

Fluctuating dental asymmetry of multiple crown variables measured by an image analysis system.

OBJECTIVE: Fluctuating dental asymmetry as an indication of the effect of environmental insults during tooth development requires further investigation. The aim of this study was to assess asymmetry in tooth crown dimension for the increased range of parameters possible with image analysis compared to previous manual measurements. METHODS: Study models of 25 male and 25 female white Caucasian subjects were measured from buccal and occlusal views to determine mesio-distal, bucco-lingual, occluso-gingival and tooth surface area dimensions using image analysis. Method errors were assessed by the repeatability coefficient RC and asymmetry assessed calculating intra-class correlation coefficients between pairs of antimere teeth. RESULTS: The method errors calculated using RC were small. There was a high degree of symmetry with correlation coefficients with a range of 0.67-0.96 for linear measurements and 0.80-0.97 for tooth surface areas. No significant differences were found between the genders or between the upper and lower jaws. Asymmetry tended to follow a pattern in morphogenic tooth fields with the mesial tooth showing greater symmetry than the more distal. There were differences in the degree of symmetry among the variables measured with the mesio-distal dimension showing the greatest symmetry. CONCLUSIONS: This new technique was reliable and readily applicable, providing also a greater range of measurements. While the asymmetry generally followed a similar pattern to earlier manual studies, there were variations in the degree of symmetry between different parameters.

Adolescent↗

A histological reconstruction of dental development in the common chimpanzee, Pan troglodytes.

Much is known about the dental development of Pan compared with that for other extant great apes. The majority of information available has concentrated either on the emergence times of teeth or on the sequence of mineralization stages of the teeth as revealed from radiographs. However, the problems of defining stages of tooth formation sufficiently accurately on radiographs are only now becoming recognized. All of the data available to date suggest the presence of a more variable picture for the timing of mineralization stages in chimpanzees than for the timing of tooth emergence. In particular, arguments persist in the literature over the time of initial mineralization and the time it takes to form each anterior tooth crown in chimpanzees. Therefore we attempt to provide a more precise chronological time scale for dental development in our closest living relative. Furthermore, we examine the sequence of molar cusp formation relative to enamel formation times related specifically to those cusps and to try to tie these data in with information from functional studies of molar crowns. Histological sections of 14 maxillary and 28 mandibular teeth from four chimpanzee (Pan troglodytes) individuals and three molar teeth from three chimpanzees of unknown origin were prepared in accordance with a well-established protocol. By combining data on short-period and long-period incremental lines (including daily secretion rates, periodicity, prism lengths and enamel thickness) in both enamel and dentine, we reconstruct times for the onset and duration of crown formation as well as construct a schedule for the pattern and timing of dental development in this one hominoid species. Interestingly, our histologically-derived data confirms that the data from radiographic studies underestimate crown formation times by the following amounts for each tooth type: I1 2.5 years, I2 3.1 years, C 1.6 years, P3 1.9 years, P4 0.1 years, M1 0.8 years, M2 1.1 years and M3 0.3 years. When combined with data on gingival emergence, it seems that chimpanzee teeth have a greatly reduced time for root growth before emergence occurs and that the major differences between Homo sapiens and Pan lie in the first part of the root formation rather than in the total period of crown formation. Maxillary and mandibular molar functional cusps take longer to complete enamel formation to the cervix than any other cusp in that same tooth, which makes sense as these cusps are thick enamelled. These results suggest that new links can be made between developmental aspects, occlusal morphology and tooth function.

Aging↗

Evaluation of the clinical performance and effectiveness of adhesively-bonded metal crowns on damaged canine teeth of working dogs over a two- to 52-month period.

In this clinical study, 41 metal full crown restorations of canine teeth were placed in 18 working dogs. Twenty-six canine teeth had severe attrition with no involvement of the pulp cavities; 15 fractured canine teeth were endodontically treated. With the exception of one tooth, at least one-third of the coronal part of each canine tooth was available for a supragingivally performed, minimal tooth crown preparation. A dental resin luting cement technique was used to bond the electrolytically etched crown (made from an alloy of cobalt-chrome-molybdenum) to the tooth. The metal crowns were slightly shorter and with a more rounded tip than the original tooth. Posts or post-and-core techniques were not used. Median follow-up period was 30 months (range 2 to 61 months), at which time 36 crowns were found to be intact and functional. Five crowns were lost; three as a result of subsequent injury and fracture of the tooth below the crown; one as a result of use of less than one-third of the coronal portion of the tooth for retention of the crown; and one as a result of an oblique fracture of the root.

Animals↗

Alternative management of a crown root fractured tooth in a child.

A crown root fracture of a tooth in a young person may necessitate the removal of the root and the placement of a space-maintaining partial denture followed by provision of a bridge. A case is reported of an alternative approach to treatment, in which the root fragment is retained in situ until the end of the pubertal growth spurt, in order to preserve alveolar bone, following which it is removed and replaced by an implant.

Child↗

Hereditary and environmental dental findings in identification of human remains.

The paper presents the results on hereditary and environmental dental findings in identification of human remains exhumed from mass graves in the Republic of Croatia. The total of 17,880 teeth from all the categories (incisors, canines, premolars and molars) was examined. Hereditary findings of the teeth such as shape, size, position, as well as age were used in all of the cases confirming and completing the identification. In only 15% of the cases they were the starting points for the identification that would be later confirmed with another 3-5 traditional identification procedures. Disturbances in tooth eruption were recorded in 22% of the cases, impaction of teeth in 10%, and retarded eruption of teeth in 12%. Disturbances of tooth position were recorded in 65% of the cases. Tooth rotation in 26% and diastema mediana in maxilla or mandible in 39%. Disorders of tooth number in the form of unilateral and bilateral missing of lateral maxillary incisors were recorded only in 2% of the monitored cases. Abnormalities of the tooth shape were found in 11% of the cases. The majority of them were found on the tooth crowns 6%, and less on the tooth roots 5%. Environmental dental findings that were the most significant for the identifications were prosthetic appliances in 30% of cases. Prostheses were helpful in the identification of 3% of the cases, while crowns and bridges were helpful in 27% of the cases. Ante mortem teeth extractions were helpful in 25% of the cases. Teeth restorations were recorded in 20% of the identified cases, amalgams in 19% and aesthetic filings in 1%. Dental caries was helpful in only 10% of the cases, superficial caries in 3% and caries of dentin in 7% of cases.

Croatia↗

Analysis of artificial radiocarbon in different skeletal and dental tissue types to evaluate date of death.

Radiocarbon dating, with special reference to the modern bomb-curve, can provide useful information to elucidate the date of death of skeletonized human remains. Interpretation can be enhanced with analysis of different types of tissues within a single skeleton because of the known variability of formation times and remodeling rates. Analysis of radiocarbon content of teeth, especially the enamel in tooth crowns, provides information about the date of formation in the childhood years and in consideration of the known timing of tooth formation can be used to estimate the birth date after 1950 ad. Radiocarbon analysis of modern cortical and trabecular bone samples from the same skeleton may allow proper placement on the pre-1963 or post-1963 sides of the bomb-curve as most trabecular bone generally undergoes more rapid remodeling than does most cortical bone. Pre-1963 bone formation would produce higher radiocarbon values for most trabecular bone than for most cortical bone. This relationship is reversed for formation after 1963. Radiocarbon analysis was conducted in this study on dental, cortical, and trabecular bone samples from two adult individuals of known birth (1925 and 1926) and death dates (1995 and 1959). As expected, the dental results correspond to prebomb-curve values reflecting conditions during the childhoods of the individuals. The radiocarbon content of most bone samples reflected the higher modern bomb-curve values. Within the bone sample analyses, the values of the trabecular bone were higher than those of cortical bone and supported the known placement on the pre-1963 side of the bomb-curve.

Adult↗

Application of laser measuring, numerical simulation and rapid prototyping to titanium dental castings.

OBJECTIVES: This paper describes a method of making titanium dental crowns by means of integrating laser measuring, numerical simulation and rapid prototype (RP) manufacture of wax patterns for the investment casting process. METHODS: Four real tooth crowns (FDI No. 24, 25, 26, 27) were measured by means of 3D laser scanning. The laser digitized geometry of the crowns was processed and converted into standard CAD models in STL format, which is used by RP systems and numerical simulation software. Commercial software (MAGMASOFT) was used to simulate the casting process and optimize the runner and gating system (sprue) design. RP crowns were 'printed' directly on a ModelMaker II 3D Plotting System. A silicone negative mold (soft tool) was made from the RP crowns, then more than hundreds wax crowns were duplicated. The duplicated crowns were joined to the optimized runner and gating system. By using the investment casting process 20-25 replicas of each crown were made on a centrifugal casting machine. All castings were examined for porosity by X-ray radiographs. RESULTS: By using the integrated scanning, simulation, RP pattern and casting procedure, cast crowns, free of porosity, with excellent functional contour and a smooth surface finish, were obtained from the first casting trial. SIGNIFICANCE: The coupling of laser digitizing and RP indicates a potential to replace the traditional 'impression taking and waxing' procedure in dental laboratory, with the quality of the cast titanium prostheses also being improved by using the numerically optimized runner and gating system design.

Calcium Sulfate↗

Impact fracture characteristics of intact and crowned human central incisors.

Dynamic fracture energies and patterns of fracture in extracted human central incisors were determined for groups of intact controls, groups with Vita Dur N crowns, Vita Hi Ceram crowns, Dicor crowns and porcelain veneers. Teeth were struck on their middle labial surfaces by a pendulum impact device. The mean fracture energy for teeth with Dicor crowns was significantly lower than for all other groups (P < 0.05). Control tooth crowns fractured obliquely in an apical-direction. Vita Dur N and Dicor crowns shattered, the underlying tooth usually fracturing in the plane of the impact force. Vita Hi Ceram crowns chipped at the site of impact and some fractures were located in the roots. Gold crowns remained cemented and fracture occurred at the crown/root junction, or in the root. Porcelain veneers fractured at the site of impact but remained cemented. Dicor crowns were less fracture resistant than other restoration types tested. Porcelain veneers and full gold crowns stiffened teeth which led to more root fractures than the porcelain crowns.

Adsorption↗

Radiographic study of bone loss of mandibular lingual cortical plate accompanied by third molar development.

OBJECTIVE: The purpose was to determine the features of mandibular lingual cortical bone loss around the root of the mandibular third molar. STUDY DESIGN: We examined occlusal radiographs in 2210 persons aged 11 to 78 years. RESULTS: Prominent increase of incidence of bone loss was evident in subjects in their third decade compared with those in their second decade. The incidence was not decreased into the sixties. The incidence of bone loss in men was significantly higher than that in women. The incidence was not influenced by inflammation around the tooth crown of the third molar, by tooth caries, or by metal fillings present in the third molar. CONCLUSIONS: The present observations suggest that bone loss is induced by physiologic processes that accompany root formation of the third molar after mandibular growth.

Adolescent↗

[The Berlin crown--a study from the prosthetic and periodontologic point of view].

The present study deals with the assessment of 112 Berlin crowns from the viewpoints of prosthodontics and periodontics. In the anterior region, porcelain-plastic jacket crowns offer the advantage of optimal esthetic achievement. In the cervical and palatine regions, the Berlin crown has no advantage over the plastic jacket crown. The confection of the Berlin crown requires exact preparation of the plastic portion and anatomical reproduction of the crowned tooth. Reactions of the periodontium to crowning were observed only in case of faulty technique.

Crowns↗

Dental characteristics in Williams syndrome: a clinical and radiographic evaluation.

Williams syndrome is a rare congenital syndrome with distinctive craniofacial features, cardiovascular abnormalities, and behavior characteristics including mental retardation. The dental abnormalities have received scant attention in previous literature. The aim of this study was to describe dental characteristics in individuals with Williams syndrome. In a group of 41 individuals more than 10 years of age, 40.5% had agenesis of one or more permanent teeth and 11.9% had agenesis of 6 permanent teeth or more. The mesio-distal and labio-lingual dimensions of permanent tooth crowns were measured on 31 dental study casts from individuals older than 12 years. The mesio-distal and labio-lingual dimensions were significantly smaller compared with a reference sample. An analysis of tooth morphology was performed on the same dental study casts revealing altered tooth morphology. A high proportion of maxillary and mandibular incisors was tapered or screwdriver shaped. An evaluation of taurodontism on mandibular permanent molars was performed using a metric crown-body/root ratio. However, most of the molars rated as being taurodontic had short or extremely short total tooth lengths and could thus be rated taurodontic without meeting the classical definition. The results of this study indicate that although there is variation in dental development in individuals with Williams syndrome, agenesis of permanent teeth in combination with aberrations in tooth size and morphology may affect dental esthetics and complicate orthodontic and prosthodontic treatment.

Adolescent↗