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PubMed2001

[Splinting--a review of the literature].

Early evidence for the use of splints can be seen in ancient civilizations, but the concept of Splinting teeth to support and immobilize teeth, by joining several teeth together continues to be a topic of controversy. Splints can be classified based on their purpose and duration of use, the way of fabrication, and the location of the splinted teeth in the jaw. The biomechanical mechanism of splint is related to the mechanism of tooth mobility. The indications for splint usage in the healthy and diseased periodontium are variable, among them are: prevention of mobility after acute trauma, for occlusal therapy, to allow function, to allow periodontal repair, in case of occlusal trauma, to prevent teeth drifting after orthodontic treatment or when a tooth is missing. Due to the many disadvantages splints have, splinting should be used cautiously, specially in splinting teeth and implants.

Dental Occlusion, Traumatic↗
PubMed1995

Tooth splinting for severely mobile mandibular incisor teeth in a dog.

Periodontal disease, in its advanced stages, causes tooth mobility. The tooth movement further damages the periodontium, accelerating the disease process leading to tooth loss. Dental splinting can provide coaptive stability to the teeth as an important component of a periodontal treatment plan. This report documents results four years following splinting of the mandibular incisor teeth in a 3 year old Miniature Schnauzer dog.

Animals↗
PubMed2002

Outcome of tooth transplantation: survival and success rates 17-41 years posttreatment.

The literature contains no follow-up studies of transplanted teeth with mean observation times exceeding 10 years. This article describes long-term outcomes, including gingival and periodontal conditions, and the patients' attitudes about treatment and outcome. The material comprised all accessible patients in the files of the Department of Orthodontics, University of Oslo, Norway, on whom treatment had been performed at least 17 years ago (n = 28). Established clinical criteria were used to assess tooth mobility, plaque and gingival indexes, and probing pocket depth. Standardized radiography was used to evaluate the presence of pathology, pulp obliteration, and root length. Similar recordings were obtained from the in situ tooth contralateral to the initial position of the grafted tooth. Criteria for determining treatment success were established. All patients responded to questions about their treatment using visual analogue scales. The mean age at surgery was 11.5 years, and the mean observation period was 26.4 years (range, 17-41 years). Of the 33 teeth transplanted in the 28 patients, 3 teeth were lost after 9, 10, and 29 years, respectively. Therefore, the 30 teeth in the 25 patients we examined yielded a survival rate of 90%. The success rate was 79% because 2 transplants had ankylosed, and 2 others failed to fulfill the proposed criteria. The patients generally responded very favorably regarding their perception of the treatment. Their only hesitation was related to some discomfort during surgery. It was concluded that survival and success rates for teeth autotransplanted when the root is partly developed compare favorably in a long-term perspective with other treatment modalities for substituting missing teeth.

Adolescent↗
PubMed1987

Biochemical changes in periodontal ligament ground substance associated with short-term intrusive loadings in adult monkeys (Macaca Fascicularis).

Proteoglycan-like fractions (PG) were isolated from the ligaments of teeth undergoing various degrees of intrusive loadings. The PG were characterized by their molecular-size profiles on Sepharose 4B, the presence of uronic acid in the separated fractions and by the electrophoretic detection of constituent glycosaminoglycans including heparan sulphate, hyaluronic acid, dermatan sulphate and chondroitin-4-sulphate. The high molecular-weight fraction, peak i (estimated minimum size, 2 X 10(6) daltons) of the normal-functioning (stressed) ligament was reduced approx. 70 per cent, compared with ligament undisturbed for 3 h. There was a decrease in peak-i size between 0.25 and 1 N loadings of approx. 72 per cent. The 4 N loadings produced a further decrease followed by an increase during a 3 h undisturbed recovery phase. Thus changes in the chemistry and properties of the ground-substance components of the periodontal ligament could partly explain changes in tooth mobility.

Animals↗
PubMed2005

Anterior transmandibular osteodistraction: clinical and model observations.

INTRODUCTION: The aim of this paper was to study the effect of transmandibular distraction on the periodontal and dental structures, and the initial movements of the mandibular halves, when using an axial plane non-rigid bone-borne distractor (TMD). MATERIAL AND METHODS: Fourteen patients undergoing bimaxillary transverse osteodistraction had their six lower anterior teeth assessed for mobility, sensitivity, and pocket depth. Recordings were made pre-operatively, post-distraction, post-consolidation and at 1-year follow-up. Selected landmarks on pre-operative and post-consolidation models were also digitised in three dimensions to study individual tooth movements, and positional changes of the mandibular halves. RESULTS: Pockets depths around the incisor teeth increased during the consolidation period (probably due to reduced oral hygiene), but returned to normal by the 1-year post-operative consultation. Tooth mobility increased temporarily in the active phase (central incisors, lateral incisors) and in the consolidation phase (lateral incisors, canine teeth). Sensitivity to cold was temporarily lost in the incisor teeth, probably as a result of 'apical contusion'. One central incisor was inadvertently apically osteotomized and needed root canal treatment. The angle between the mandibular halves closed by 9.4 degrees. CONCLUSION: Periodontal and dental morbidity is transient and limited to the distraction and consolidation period, as long as the tooth apices are avoided when the osteotomy is performed. A step-design osteotomy may be preferable when the central incisor apices are close to each other. The transmandibular distractor (TMD) allows for rotation at the temporomandibular joints.

Adolescent↗
PubMed2002

A review of the clinical management of mobile teeth.

The clinical management of mobile teeth can be a perplexing problem, especially if the underlying causes for that mobility have not been properly diagnosed. In some cases, mobile teeth are retained because patients decline multidisciplinary treatment that might otherwise include strategic extractions. This article discusses the relationship between occlusion and tooth mobility with an emphasis on identifying differences between increased mobility and increasing mobility. The indications, contraindications, and basic principles of tooth splinting are also reviewed. Provisional and definitive splints are defined and described with their respective occlusal considerations. Some mobile teeth can be treated through occlusal equilibration alone (primary occlusal trauma). Whereas mobile teeth with a compromised periodontium can be stabilized with the aid of provisional and/or definitive splinting (secondary occlusal trauma). It is important to consider splint therapy, because it may not only improve the prognosis of teeth, but may actually enhance the stability of the final prosthodontic treatment. The ultimate goal of successful management of mobile teeth is to restore function and comfort by establishing a stable occlusion that promotes tooth retention and the maintenance of periodontal health.

Dental Occlusion, Traumatic↗
PubMed1999

Clinical rationale for tooth stabilization and splinting.

Tooth mobility can be a consequence of periodontal inflammation, attachment loss, and occlusal trauma. At times, this mobility may be tolerable, whereas at other times mobility may contribute to occlusal instability and/or patient discomfort. This article describes the clinical rationale for and the effects of splinting mobile teeth.

Bite Force↗
PubMed1995

[The mobility of the anterior teeth after the direct bonding of lingual retainers. A comparison of in-vitro and in-vivo measurements].

Lingual retainers are today widely used in the long-term stabilization of incisors. In that they are left in place for a period of years, the question arises to what extent lingual retainers allow sufficient physiological movement. To answer this question first an in-vitro study of the inflexibility of various retainers under horizontal and vertical load was carried out. Next the retainer which limited physiological movement to the least degree was studied in-vivo. Both dynamic and static mobility measurements of the lower jaw front teeth were carried out on 5 patients before and after bonding the retainers. A self developed measuring instrument was used to make the static measurements and a periotest device was employed in the dynamic measurements. The in-vitro tests indicated that, with the exception of the retainer made of multistranded 0.0155" wire or glass fiber, a significant reduction in tooth mobility can be expected with all the retainers. However, the static in-vivo measurement carried out with the 0.0155" wire resulted in a distinct reduction in tooth movement. The dynamic measurements using the periotest device confirmed this finding. With regard to clinical practice within the framework of long-term retention, highly flexible retainers appear to be the most suitable and are to be recommended.

Cuspid↗
PubMed1977

Dental aspects of patients with cystic fibrosis: a preliminary clinical study.

The oral conditions of 42 patients being treated for cystic fibrosis were evaluated. The patients were grouped by age and, in some aspects, were compared with a small control group of their siblings. The patient group had a lowered incidence of plaque and less gingival disease than did the control group in which every person had some amount of plaque or gingival disease. Calculus formation was minimal. The reasons for the finding of minimal plaque in the patient group could be related to several factors, including the life-long use of various antibiotic agents, the chewing of digestive enzyme supplements, the effect of medical management on tooth hardness, and the effect of stained teeth (possible tetracycline deposition) on the plaque microorganisms. It appears that the therapy for cystic fibrosis was beneficial to the periodontal health of these patients. Much further study is needed to understand the interrelationship between an altered oral environment (salivary changes in cystic fibrosis), altered microbial flora (by antibiotics, enzymes) and even altered tooth surfaces (possible tetracycline deposition). Most patients were found to have one or more oral habits. Tooth mobility was associated with tension habits. Patients who had clubbed fingers (indicating pulmonary compromise) and possibly a severe disease process, did not appear to have either stained teeth or the severity of the gingivitis associated with this. The relationship of tetracycline to tooth staining could not be pinpointed.

Cystic Fibrosis↗
PubMed2001

Stability of implants and natural teeth as determined by the Periotest over 60 months of function.

Various methods for evaluating tooth mobility have been developed throughout the years, but their acceptance has been limited because of the subjectivity associated with their use. In recent years, the Periotest has been studied and used to evaluate the mobility of natural teeth and is claimed to b e potentially reliable in assessing the stability of the implant-bone interface. Few clinical implant studies have used natural teeth as controls to monitor changes in mobility associated with dental implants. The Dental Implant Clinical Research Group initiated a long-term clinical study in 1991 to assess the influence of design, application, and site of placement on clinical success and crestal bone height. As part of the study, Periotest values (PTVs) were recorded for 2,623 of the 2,998 implants placed and uncovered. For the statistical analysis, 2,623 implants were tested at second-stage surgery, with the number of implants tested varying at each follow-up visit. Data were collected from investigators at 32 study centers for periods ranging up to 60 months. A total of 975 natural teeth from 409 partially edentulous study subjects served as controls. FPVs on natural teeth and implants were combined, and the overall average Periotest values (OA-PTVs) were compared with values for individual subjects. The effect of implant and natural tooth locations on mobility were evaluated and compared with each other. The combined OA-PTV for all natural teeth was +1.8 and the OA-PTV for all implants was -3.4 PTVs. Compared with those in the maxillae, mandibular teeth and implants were found to be more stable Implants were found to be significantly more stable as compared with natural teeth. The recorded variations in PTVs for natural teeth and implants over the entire evaluation period were not found to be significantly different. This study developed the following conclusions: (1) implants were found to be significantly less mobile as compared with natural teeth for individual subjects; (2) the PTVs for natural teeth and implants did not exhibit significant variation over the evaluation period; (3) the Periotest can provide reproducible assessment of stability in a long-term clinical study; and (4) changes in PTVs may be helpful in evaluating improvement or degradation of the implant-bone complex.

Dental Implantation, Endosseous↗
PubMed2004

Development of implant movement checker for determining dental implant stability.

Noninvasive and nondestructive mobility assessment of dental implants is very important and useful for dental implantation diagnostic-aids. The development of implant movement (IM) checker based on microcontroller is presented in this paper. Data acquisition system and bender-type piezoelectric probe were used to improve measurement quality to the original tooth mobility (TM) tester. The adoption of a microcontroller and the use of a dental drill-sized measuring probe were sufficient in the reproducibility and reliability of the IM checker. When the implant was subjected to a constant force and amplitude, the acceleration of the model was detected using the measuring probe. The data acquisition system controlled for obtaining the appropriate acceleration signals based on the preload detection during measurement. Dental implant models of Molteno and Rigolac were made at different stiffness and were used to verify the reliability and validity of measurements. The values of measurements obtained by the IM checker were reliable and precise. The maximum error for perpendicular measurements was less than 12% measured by a new operator and decreased to 2% by an experienced operator. The IM checker was applied to monitor the stability of dental implantation, which compared the relative IM score of the new 5[see text] implant with the adjacent old 6 [see text] implant that had been used functionally for 3 years.

Dental Implants↗
PubMed1990

Other dental treatment needs in patients who requested removable partial dentures.

The aims of this study were to determine the dental and periodontal status and the associated treatment needs, other than that for prosthetic care, in patients who requested removable partial dentures. Forty-six patients who had never worn removable partial dentures before were examined for plaque index, tooth status, gingival index, loss of periodontal attachment and tooth mobility. Prior to prosthetic treatment, 15% of the teeth needed conservative treatment and 1% needed extractions. From the periodontal point of view, 65% of the teeth needed some form of related therapy, and 2% of the teeth were at risk of extraction due to advanced mobility.

Adult↗
PubMed1990

Positional changes after mandibular advancement by sagittal split osteotomies and wire osteosynthesis. Do combined orthodontics and the Dal Pont modification of the buccal osteotomy contribute to long-term stability?

Thirty-five cases of sagittal split ramus osteotomies with wire osteosynthesis as the exclusive procedure used to correct a dentoskeletal Class II deformity, were selected to form a homogeneous group for cephalometric evaluation of the short- and long-term, skeletal and dental changes. The group was statistically described as having severe micromandibulism, mild micromaxillism and mild dento-alveolar maxillary protrusion. The skeletal relapse within the first postoperative year was due to horizontal and dorsocranial rotational changes of the tooth-bearing segment. The joint-bearing segment rotated ventrocranially. As an overall result, the mandibular body was not lengthened but advanced. The relapse at the occlusal level was considerably less, partly due to the rotational component of the skeletal relapse mechanism, partly due to the compensating retroclination of the upper anterior teeth. With the condyles correctly repositioned at surgery, no relationship could be found between postoperative changes in condylar position and skeletal relapse. There was no difference in the average amount of skeletal relapse between the subgroup with the Dal Pont modification of the buccal osteotomy and the subgroup with the buccal osteotomy directed to the mandibular angle. The average skeletal relapse was greater in the combined surgical orthodontic cases, due to increased alveolar tooth mobility.

Adolescent↗
PubMedDate not supplied

[Use of intracoronal splints in therapy of periodontal disease].

The study concerns the evaluation of the efficacy of intracoronal composite splints (ICS) in the therapy of periodontal disease in its full clinical state. Maxillar and mandibular front teeth were splinted over the period of 12 weeks as a part of a complex therapy procedure of developed periodontal disease. The results of the therapy were evaluated using periodontal indexes, parameters for oral hygiene and other relevant clinical parameters. Values were processed with Student's t-test. With the use of ICS very good results in the therapy of periodontal disease in a short period of time were obtained. Parameter values decreased, especially the index of tooth mobility: before therapy by 2.84 and after therapy to 1.12. Intracoronal composite splints, in comparison with other type of splinting, satisfy both functional and aesthetic aspects.

Composite Resins↗
PubMed1997

Oral malodor in beagles: association with indicators of periodontal disease.

The study of oral malodor continues to receive attention. Most bad breath is of oral origin and can be corrected with proper oral hygiene. Studies performed with saliva from people with periodontal disease and from healthy individuals showed that saliva from diseased patients produced a more objectionable odor faster than that of healthy people, and that the volatile sulfur components (VSC) produced may actually play a role in the etiology of periodontal disease. However, not all people or animals with bad breath have periodontal disease. The objectives of this study were to determine if a trained panel could discriminate between 10 dogs with clinically defined periodontal disease and those with relatively healthy periodontium. Second, this study attempted to establish a correlation between odor intensity and six clinical parameters of oral health. The judges were able to differentiate between the two groups of dogs based only on oral malodor (p < 0.02). There were strong associations of the intensity of oral malodor with oral health index scores. The correlations established between odor and gingivitis (r = 0.81) and between odor and furcation exposure (r = 0.88) were very high and statistically significant. Similarly, probing depth (r = 0.73), plaque (r = 0.07) and tooth mobility (r = 0.66) showed clear, positive relationships with oral malodor.

Animals↗
PubMed2006

Localized periodontitis as a long-term effect of oral piercing: a case report.

Recent years have seen a dramatic increase in the number of published articles on short-term complications of oral piercing, possibly reflecting an increase in the popularity of this practice. Long-term effects of oral piercing, however, have had minimal documentation. This case report of a 28-year-old woman with piercing of the tongue and lower lip demonstrated localized severe periodontitis as a destructive long-term outcome related to oral piercing. The patient reported that she had worn 2 tongue rings and a mandibular labrette (lip piercing) in the form of a bar for 12 years. Plaque and calculus accumulation, severe inflammation, tooth mobility, severe horizontal radiographic bone loss, and deep pocketing were observed in teeth affected by the jewelry.

Adult↗
PubMed1991

[The effect of bedding type on implant and abutment tooth in tooth/implant-supported bridgework].

17 distal extension cases were treated with IMZ implants supporting a fixed-removable bridge connected to a natural tooth abutment with a precision attachment. Instead of the polyoxmethylene internal shock absorber an identically dimensioned titanium element was incorporated in the implants of every second patient. Patients were monitored on a recall schedule. Implant and tooth mobility, pocket probing depth, and bone loss were the parameters evaluated. The results after a mean incorporation time of 16.5 months indicate that, at least during this initial time of function, there are no differences between a mobile and rigid bedding of the superstructure on the implants.

Aged↗
PubMed1993

[Langerhans cell histiocytosis].

The authors describe a case of a 4 years old boy. In connection with this case they discuss the latest classification of histiocytosis accepted by the Histiocytosis Society, and the stomatological aspects of the disease (severe gingivitis, necrosis of the gingivae, ulceration, and high degree of tooth mobility). The new classes of the disease: Langerhans cell's histiocytosis, Non-Langerhans cell's histiocytosis, malignant histiocytosis.

Antineoplastic Agents↗