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[Observation of the clinical effect on the treatment of traumatic intrusion of upper anterior teeth using orthodontic method].

OBJECTIVE: To observe the clinical effect on the treatment of traumatic intrusion of upper anterior teeth using orthodontic extrusion combined with fixation. METHODS: 24 cases, 27 teeth included, were treated by means of orthodontic extrusion combined with composite-resin split fixation. The clinical effect of 2-year-period was recorded. RESULTS: After the treatment of 27 selected teeth (16 immature teeth,11 mature teeth),11 teeth achieved the standard of success,16 teeth achieved the standard of efficiency, none of them was failing. CONCLUSION: Orthodontic extrusion combined with composite-resin split fixation is an active and atraumatic method in the treatment of traumatic intrusion of upper anterior teeth, and the effect is ideal.

Adolescent↗

Long-term observation of endodontic surgical intervention to treat root perforation and apical periodontitis: a case report of an amalgam-restored tooth.

A case of crestal root perforation and periapical lesion in a maxillary left lateral incisor is reported. Teeth with root perforation present technical difficulties in their clinical management because of their complex defects. In the present case, surgical endodontic treatment was chosen. The apical and lateral pathology was curetted, the tooth root was resected, and a retrograde root restoration of amalgam was placed in a root-end cavity and perforation site. A 10-year follow-up clinical and radiographic examination showed an asymptomatic tooth with osseous healing proceeding.

Adult↗

Oral diseases and conditions throughout the lifespan. I. Diseases and conditions directly associated with tooth loss.

This is the first of two articles providing an overall view of oral diseases and conditions, taking the oral cavity and its organs and tissues as integrated parts of the human body. This article provides an overview of three oral diseases and conditions that are associated directly with loss of tooth structure or loss of teeth and reviews their risk factors and preventive and treatment interventions. Two of these conditions, dental caries and periodontal diseases (or their sequelae), remain the main cause of tooth loss in the U.S. Prevention, treatment, and control of these diseases require many hours of training during dental education and many hours of treatment in dental practice. The profession has fragmented into specialties based on diseases; as a result, many dentists fail to see them as integral elements of the human experience. As primary care specialists, dentists must be reminded that they need to make prevention the first choice, provide the best treatment possible based on available scientific evidence, and keep informed of new advances in research while always remembering that the oral cavity is an integral part of the human body. The changes and trends observed in the epidemiology of oral diseases will demand new skills in our dental graduates. Future dental graduates may achieve a solid understanding of oral diseases at both the biological and population level by using oral tissues and saliva to diagnose systemic diseases, relying on medical facilities to order laboratory tests, and diagnosing and treating patients in close collaboration with their medical colleagues.

Dental Caries↗

[Indications for oral implantology in a referral clinic. A three-year retrospective analysis of 737 patients with 1176 implants].

The following study reviews patients from the Department of Oral Surgery and Stomatology at the University of Berne undergoing implant therapy. Between 2000 and 2002, 737 patients received 1176 ITI screw-type implants. At least 70% of these patients were 50 years or older. The main reason for tooth loss in this group was often periodontitis, followed by carious, periapical infection and root fractures. Only 15% of the patients were younger than 30 years. They had lost their teeth mainly due to trauma or agenesis of teeth. This study reports a trend towards treatment of partially edentulous patients (>90%), with single tooth gaps (>50%) being the most frequent indication for implant therapy. The analysis also demonstrated the importance of augmentation procedures prior to implant placement. Almost 40% of the implant cases required either ridge augmentation or sinus lift procedures. The GBR technique was frequently utilized in the anterior maxilla, especially with bone defects resulting from dental trauma. Data also showed that with these augmentation procedures more implants were inserted in the maxilla (53%) than in the mandible. During the healing or early loading phase only six implants out of 1176 were lost, resulting in an early failure rate of 0.51%. Our study has demonstrated that a high level of implant success can be achieved with the ITI system when using a strict selection criteria and stringent operating protocols.

Adult↗

Pattern of tooth loss in Nigerian juvenile and plaque-induced chronic periodontitis patients.

The aim of this study was to determine the pattern of tooth loss in chronic periodontitis patients and hence help the clinician to plan preventive treatment against the loss of these teeth. Dental record notes of all the subjects, the periapical radiographs and actual intra-oral examinations of the juvenile periodontitis patients were done to determine the number and types of tooth loss. It was observed that the pattern of tooth loss in both groups of chronic periodontitis (plaque Induced periodontitis (PIP) and juvenile periodontitis (JP) was different as the most frequently lost teeth in PIP was incisors and lower incisor in JP while the least lost in PIP was the upper canines and the lower premolars in JP.

Adolescent↗

[Laser Doppler flowmetry for vitality testing of traumatized maxillary incisors].

Pulp sensitivity and vitality changes were evaluated in 69 traumatized maxillary incisors and in 38 control teeth during a follow-up period of 20 months. Examinations included thermal testing using carbon dioxide snow (CO2) and the laser Doppler flowmetry (LDF). These measurements were compared to the clinical and radiological findings. In 47.8% of the traumatized teeth and in 55.3% of the control group the three LDF measurements corresponded with the sensitivity testing using CO2 and with the clinical and radiological findings. In 31.9% of the traumatized teeth and in 7.9% of the control group the LDF-measurements differed from the CO2-measurements, but were in agreement with the other clinical and radiographic findings. The information obtained by laser Doppler flowmetry is of additional importance for the treatment planning. Since the clinical examination of traumatized teeth is sometimes inconclusive, the laser Doppler flowmetry is a further diagnostic tool but it cannot replace the radiological or clinical examination.

Adolescent↗

Fibre reinforced composites--alternative for lost teeth replacement.

The loss of an anterior tooth can affect a patient psychologically and socially. This trauma can be minimized by the immediate replacement of the lost tooth, preferably using a fixed prosthesis. This paper describes the immediate replacement of anterior lost teeth by using fibre reinforced composite materials, although these techniques can be employed very successfully in the replacement of posterior teeth as well. The abutment teeth can be conserved, with little or no preparation, making this procedure truly minimally invasive and keeping the technique reversible. Additional advantages are that the procedure is completed at the chairside in a single visit, thereby avoiding laboratory costs and saving time while waiting for the finished prosthesis. This technique can be used as an interim measure or as a permanent prosthesis.

Aged↗

Accidental death resulting from acetylene cylinder impact.

Acetylene is an inflammable gas commonly used for welding in small-scale industries. We present a case of a 34-year-old male welder who died following injuries sustained from explosion of an acetylene gas-welding cylinder. In this case report, we discuss the circumstances leading to the explosion of the welding cylinder, the autopsy findings, and a brief review of the literature on deaths resulting from blasts of acetylene cylinders.

Accidents, Occupational↗

Splinting of traumatized teeth with focus on adhesive techniques.

Splinting of traumatized teeth is an important step in the treatment of periodontally injured teeth and a precondition of healing of the periodontal tissues. Although it has been shown in animal experiments that replanted teeth without splinting showed analogous healing outcomes compared to splinted teeth, the placement of a splint in dental trauma situations is warranted for medico-legal reasons, for the comfort of the patient, and for the avoidance of additional trauma during periodontal healing. Ideally, the splinting of traumatized teeth should be an easy and fast procedure for the dentist. Trauma splints should be comfortable and easy to keep clean for the patient. The splint should allow some physiologic mobility to promote healing of the periodontal tissues. The widely used and recommended wire-composite splint, with material variations, meets the ideal requirements of current splinting concepts in dental traumatology. Times of using destructive tissue-coverage splints are definitely gone. They are too rigid, compromise periodontal and gingival healing, and are uncomfortable to the patient. The objective of this article is to present the current concepts in splinting of traumatized teeth. The given recommendations about splinting techniques and splinting periods are based on experimental and clinical studies.

Composite Resins↗

A retrospective assessment of zinc oxide-eugenol pulpectomies in vital maxillary primary incisors successfully restored with composite resin crowns.

PURPOSE: The purpose of this retrospective study was to evaluate, via clinical and radiographic assessments, the treatment outcome of zinc oxide-eugenol (ZOE) pulpectomies performed in vital maxillary primary incisors successfully restored with composite resin crowns. METHODS: Pulpectomized vital primary incisors were treated by a uniformed technique, filled with ZOE paste, and successfully restored with composite resin crowns. Those that remained intact and noncarious for the assessment interval were evaluated for the outcome (success or failure) based on clinical and radiographic findings and compared to: (1) the reason for treatment; (2) the canal filling extent; (3) the type of composite resin crown restoration performed; and (4) the eruption status of its succedaneous tooth. RESULTS: For 104 maxillary primary incisors meeting the inclusion criteria, failure, as judged by presence of pathologic root resorption and/or apical lucency, was determined to be 24% (25/104), for a mean duration of 18 months observation. Failures were statistically associated with the reason for treatment (higher for trauma), the extent of ZOE paste filler in the pulp canal (higher for gross overfill), and the eruption status of the associated succedaneous permanent incisor (higher for delayed eruption). CONCLUSIONS: This study determined a failure rate (24%) for pulpectomies-using ZOE paste and performed on vital primary incisors-comparable to that reported for nonvital pulpectomies. A statistically significant increase in failure rates was found for: (1) incisors treated for trauma (42%) vs those treated for dental caries (19%); and (2) grossly overfilled canals (80%) vs canals filled to the apex (0%).

Child, Preschool↗

Persistent sinus tract formation 1 year following cast post-and-core replacements: a case report.

Sinus tracts are paths of drainage for abscesses and can occur both intraorally and extraorally. It is a fact that sinus tracts can heal with proper endodontic therapy. However, there are those types that are persistent and will not respond to any treatment. In these perplexing cases, it may be necessary to elevate a surgical flap to unveil the real etiologic factor. In this article, a case is presented in which 2 persistent and nonhealing sinus tracts were observed around the maxillary left incisor area of a 53-year-old female patient. A difficult cast post-and-core removal had been accomplished to the compromised tooth 1 year previously. A surgical flap had to be reflected, and the cause of the persistent inflammation was determined to be 2 separate root perforations. The granulation tissue was removed, the perforations were sealed with mineral trioxide aggregate, and bone graft was packed in the resorptive bone areas. The symptoms subsided by the time of the 2-week recall. No complaints were noted from the patient during the 4-month follow-up period. This case is a good example that demonstrates the possible complications of post preparation and the necessity of explorative surgery for unveiling the etiologic factor of persistent sinus tract formation.

Aluminum Compounds↗

Restoring the oral health of the child.

We practice in a country in which 80 percent of oral disease is localized in 20 percent of the children. Restorative care is not about to vanish from the face of the earth, however. Present practice and treatment protocols, and those of the future, are necessarily based on an evolutionary development of restorative dentistry over a period of the last twenty years. The explosion in the use of adhesive technologies and the attention to acceptable esthetics come to the forefront of important developments, as will be the identifying and employing of truly biologically compatible materials. What are also needed are continuing efforts to develop new modalities of restorative care, pulp therapy, and trauma care. Advances in these areas are reviewed; they first appeared in the Journal under editor George Teuscher's selecting and publishing for the profession significant articles that advanced dentistry for the child and the adolescent.

Adolescent↗