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Tooth loss and caries prevalence in older Floridians attending senior activity centers.

Older adults attending 14 senior activity centers in six countries of Florida cooperated for a questionnaire and an oral examination. The mean age was 76.5 yr, and about one-third were 80 yr or older. One-third of the dentate persons had dental caries. Most of the carious lesions were on the crown, not the root, and most of the decay was primary, not recurrent. Most of the persons with a need for caries treatment were likely to seek dental care; however, the majority of carious surfaces were in persons who reported being infrequent users of care. These results from ambulatory older adults suggest that older adults have significant caries treatment needs, and provide support for the view that the treatment of older U.S. adults may grow in the coming decades.

Aged↗

[Prosthetic rehabilitation and accompaniment of growth in cases of early tooth loss in children].

Teeth, in the general phenomenon of growth contribute to the blooming and the growth of the young child. It plays a paramount role in the communication while taking part in the development of the language and of the phonation, and by perfecting the shape of the face. The prosthetic rehabilitations are addressed to children who present more or less significant early losses of teeth, whose origin could be congenital, structural, post-decays or traumatic, and bearing on temporary, mixed or final teeth. The series of case presented clarifies the methods which we employ in our service for the design and the practical realization of the prosthetic rehabilitations. The dental lose seriously disturbs the physical development of the child, it can slow down its school development and affect in a pathological way its relational life. The installation of prosthesis makes it possible to the child to feel like the others, to eat normally, to better sleep, to be able to present its face without causing mocking remarks. Among our patients candidates with the prosthetic rehabilitation, the children in low-age are most numerous and present the highest frequency of the traumatisms. Their first real smile is already the justification of the decision of the specialist. Nevertheless, the number of toothless children who profit from this type of rehabilitation is very small.

Child↗

[Premolar autotransplantation after front tooth loss in the maxilla].

The general rules for autotransplantation of human premolars in cases of traumatic loss of upper incisors are given. The basic conditions for tooth transplantation concerning the donor side as well as the recipient side are presented. Technical details and the principles of indication are outlined. If a correct technique is combined with a precise indication, the long-term results after tooth transplantation are excellent, with a more than 90% rate of success. Thus the concept of premolar transplantation to the front of the upper jaw in cases of traumatic loss of the upper incisors in children will need more attention in the future.

Bicuspid↗

Single-tooth implant treatment in the anterior region of the maxilla for treatment of tooth loss after trauma: a retrospective clinical and interview study.

The aim of this study was to evaluate the results of single-tooth implant treatment in patients where teeth have been lost as a result of trauma. Also, the patients' and professionals' opinions regarding the final outcome of treatment were assessed. Thirty-four patients with 42 lost teeth were evaluated by clinical and radiographic examinations and interviews 2-5 years after treatment. A professional who had not taken part in the treatment evaluated the implant crowns. Central maxillary incisors were the most frequently lost and replaced teeth after trauma (75%) followed by lateral incisors (21%). In patients with incomplete growth, implant treatment was generally postponed until completion of growth. Lack of space was treated by presurgical orthodontics (7%) or by selecting an implant with a reduced diameter (5%). Deficiency of bone was seen in 17% and was treated by bone grafting or local augmentation prior to implant surgery. Patients who had lost two or more teeth after trauma were all subjected to bone grafting. Preservation of roots in the alveolar process seemed to maintain the bone volume enabling better conditions for later implant placement. Forty-one implants (97.6%) were integrated successfully. Complications were few and of minor importance (9.5% before and 12% after cementation of crowns) and could all be managed. No or minimal bone loss was seen. In general, the patients felt that they received good care and that they were well informed about their treatment. Some patients reported that the local anesthesia procedure was not pain-free, but 71% of the patients experienced the treatment as pain-free. For each of the variables (color, shape, height, and size of the crowns), the highest degree of satisfaction was noted in 93-98% of the patients and 91-95% of the single evaluating professional. Given that the patients have finished growth and a careful treatment planning and timing are performed, the functional and esthetical outcome of single-tooth implant treatment today is excellent and can be recommended for replacing tooth losses after trauma in the anterior region of the maxilla.

Adolescent↗

Pleiotropy in Coffin-Lowry syndrome: sensorineural hearing deficit and premature tooth loss as early manifestations.

We report on 7 patients (6 M, 1 F) with Coffin-Lowry syndrome who have a sensorineural hearing deficit in addition to developmental delay and characteristic facial changes. One of the patients also had a history of premature exfoliation of primary teeth. These are previously unappreciated clinical signs that may aid in the early diagnosis of Coffin-Lowry syndrome. Early diagnosis and recognition of a hearing deficit in the patient can lead to the use of hearing aids to help the patient achieve his or her full potential. These "new" clinical manifestations expand the phenotype of Coffin-Lowry syndrome and constitute an additional indication of pleiotropy.

Child↗

The informativeness of attachment loss on tooth mortality.

BACKGROUND: In periodontal clinical trials, clinical attachment level measurements are commonly used as surrogates for tooth loss. Conclusions regarding treatment efficacy in these trials are valid if: 1) the surrogate is informative on tooth loss, and 2) the surrogate captures the effect of treatment on tooth loss. The goal of this study was to evaluate the first criterion: Are serial clinical attachment loss measurements informative on overall tooth mortality? METHODS: Young Norwegian men (aged 17 to 35) were first examined in 1969 (n=565) and followed for 26 years with examinations in 1971 (n=381), 1973 (n=292), 1975 (n=245), 1981 (n=228), 1988 (n=202), and 1995 (n=223). Several aspects of the serial attachment loss measurements were related to tooth mortality risk using statistical models that take into account the time-dependent changes of the clinical attachment loss measurements. RESULTS: The results provided evidence that moderate attachment losses were informative on tooth mortality. Both the lifetime cumulative attachment loss, as well as attachment loss since young adulthood, of > or = 2 mm or > or = 3 mm was informative on tooth mortality. Tooth mortality risk increased as the attachment loss increased; loss > or = 3 mm at the buccal or mesial site increased tooth mortality risk, by 91% (relative risk, 1.91; 95% confidence interval, 1.01-3.60) and 270% (RR, 3.70; 95% CI, 1.83-7.49), respectively. CONCLUSIONS: We concluded that clinical attachment loss was moderately informative on overall tooth mortality in this Norwegian population. Since this finding has now been demonstrated in 3 different populations, the focus of further research should be on evaluating whether the second criterion for a valid surrogate is satisfied: Does clinical attachment loss capture the effect of periodontal treatments on tooth loss?

Adolescent↗