[Variants in attaching the gingiva to the alveolar process of the jaw in children].
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Child, Preschool↗
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[A review of the technics used in the plastic surgery of the gums and alveolar process].
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Alveolectomy↗
[Sandwich technic with cartilage transplant for raising the alveolar process in the lower jaw].
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Alveoloplasty↗
The course, relations and distribution of the inferior alveolar nerve and its branches in the cat.
The course, relations and distribution of the inferior alveolar nerve and its branches in the cat are described. The nerves have been studied by dissection, histologically and by using electrophysiological techniques. Dissection revealed a basic pattern on which some individual variation was superimposed. The inferior alveolar nerve has three branches supplying the alveolar process (alveolar branches), one branch supplying the canine and incisor region (canine/incisor branch) and four mental branches (posterior, main and 2 anterior). Fibres supplying the teeth were found in all except the mental branches. Pulpal, periodontal and buccal gingival margin fibres from an individual tooth generally travelled together, but often in more than one branch. Branched axons supplying both tooth pulp and an area of mental skin were found. The axons branched at the point of separation of the appropriate mental nerve from the main trunk. A cutaneous midline overlap of 1-2 mm was found, but there was no transmedian innervation of tooth pulps.
Animals↗
Splinting and replantation after traumatic avulsion.
A rational approach can be taken in the dental office to avulsion and replantation. Consideration must be given to: Extraoral time. During this critical time, the prognosis for successful replantation noticeably decreases as the out-of-mouth time increases. Transport. Preferably the tooth will be transported in the socket, but milk or water may be used to keep the tooth moist. The buccal vestibule may be recommended for adults and teenagers but not for young children. Root surface. The root surface must not be handled, scraped, brushed, or have any part removed; it can be rinsed with sterile water, saline, or tap water but not with caustic solutions, disinfectants, or medicaments to clean the surface. Endodontic treatment. A tooth with an open apex should be evaluated bimonthly for revitalization. A tooth with a fully formed apex should have the pulp removed in 7 to 14 days after avulsion. Status of the alveolar process. Alveolar fractures may require a modified splint design to provide additional strength for a longer splinting duration. Obturation materials. Calcium hydroxide paste is used for a minimum of 6 to 24 months before filling permanently with gutta-percha. Selection of a splint. Each case is different and should be treated as such. Special consideration must be given to splint design, which will directly influence the desired result. Although any number of splints may be effective, inherent advantages and disadvantages of each should be understood fully by the clinician. This is where the art, the clinical experience, and the common sense of endodontic therapy dictate the proper splint and appropriate duration of splinting for the patient.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Msx1/Bmp4 genetic pathway regulates mammalian alveolar bone formation via induction of Dlx5 and Cbfa1.
In the developing mammalian tooth, the cranial neural crest derived dental mesenchyme consists of the dental papilla and dental follicle. The dental papilla gives rise to odontoblasts and dental pulp and the dental follicle gives rise to the periodontium, including the osteoblasts that contribute to the alveolar process. The alveolar process is a specialized intramembranous bone that forms the primary support structure for the dentition. The Msx1 gene controls many aspects of craniofacial development, as evidenced by craniofacial abnormalities seen in Msx1(-/-) mice, including the arrest of tooth development and the absence of the alveolar bone. Previous studies demonstrated that ectopic expression of Bmp4, a downstream target of Msx1, in the Msx1(-/-) dental mesenchyme rescued alveolar bone formation. Here we confirm an early requirement of BMP activity for alveolar bone formation. We show that the expression of Cbfa1 and Dlx5, two genes encode transcription factors that are critical for bone differentiation, overlaps with that of Msx1 and Bmp4 in the developing tooth and alveolar process. We have demonstrated that Dlx5 and Cbfa1 expression is down-regulated in Msx1(-/-) dental mesenchyme and that Msx1 and Bmp4 expression are unaltered in Cbfa1(-/-) mice. These data place Dlx5 and Cbfa1 downstream from the Msx1/Bmp4 in the genetic pathway that regulates tooth development. Ectopic expression of Bmp4 in Msx1 mutants restores the expression of Dlx5, but not Cbfa1, in the dental mesenchyme, and rescues the expression of both Dlx5 and Cbfa1 in the developing alveolar bone. Therefore, the early expression of Cfba1 in the dental mesenchyme appears dispensable for the development of the alveolar bone. Taken together with in vitro gene induction studies, our results demonstrate that BMP4 controls Dlx5 expression in dental mesenchyme, and functions upstream to both Dlx5 and Cbfa1 to regulate alveolar bone formation during tooth development.
Alveolar Process↗
Catch-up in mandibular growth after short-term dietary protein restriction in rats during the post-weaning period.
Catch-up growth has been defined as growth with a velocity above the statistical limits of normality for age during a defined period of time which follows a period of impaired growth. Since no data are available on catch-up in mandibular growth, the present study was designed to estimate the dynamics of the mandibular size after short-term dietary protein restriction in rats during the post-weaning period. Weanling male rats, 22 d of age, were divided into two groups, control (C) and experimental (E). E rats were fed a protein-free diet during the first 10 d; from this time on, they were placed on a 20% protein diet, as were C rats during the entire experimental period, which lasted 70 d. Five rats from both groups were randomly selected every 10 d and sacrificed. Mandibular growth was estimated directly on the right mandible by measuring several dimensions (mandibular area, base length, mandibular height, mandibular length, alveolar length and incisor alveolar process length). Alveolar and incisor alveolar process lengths did not change with age or dietary protein. All other dimensions increased with age and were thus negatively affected by protein restriction. After growth restriction ceased, the rate of increase of all affected dimensions was above normal values and deficits were swiftly eliminated. Since age-independent dimensions compose roughly the anterior portion of the mandible, this portion of the bone was not affected by protein restriction. It was, thus, the posterior part of the mandible which stopped growth during the nutritional insult and showed catch-up during nutritional rehabilitation. In summary, the rat mandible has a high potential for catch-up during the post-weaning period, showing the ability to achieve complete catch-up in about 30 d.
Age Factors↗
The role of incision design and location in the healing processes of alveolar ridges and implant host sites.
This research examined the nature and role of a linea alba, found consistently at the crest of edentulous ridges in dogs. Angiovist dye was used to outline the microvasculature in these regions. The findings demonstrated a zone of avascularity directly beneath each linea alba. When novel incision designs were used in the gingivae and the outlined mucoperisteal flaps were elevated and then replaced, alterations in underlying bone morphology were noted. In a subsequent study during which implants were placed, a direct relationship was noted between incision design and level of pericervical bone support.
Alveolar Process↗
Unilateral demonstration of the atlas in ipsilateral maxillary alveolar bone destruction.
In conventional sinus films in occipito-frontal projection, the atlas is superimposed on the maxillary alveolar processes. If destruction of the alveolar process is present, the atlas-half on the affected side may be unusually clearly demonstrated. The value of this 'unilateral demonstration of the atlas' was confirmed by comparing a group of 20 patients with alveolar process destruction with two groups of 50 patients, one reported as normal and another with mucosal thickening, fluid levels or entirely dense sinuses.
Aged↗
Transverse skeletal and dentoalveolar changes during growth.
INTRODUCTION: We previously reported that, on average, maxillary molars erupt with buccal crown torque and upright with age, mandibular molars erupt with lingual crown torque and upright with age, and these molar crown torque changes are accompanied by concurrent increases in maxillary and mandibular intermolar widths. Our purpose in this study was to determine the transverse skeletal changes that accompany these molar movements during growth. METHODS: Thirteen maxillary and mandibular transverse measurements were made by using casts and posteroanterior radiographs from 36 Class I untreated subjects from the Iowa Facial Growth Study at approximately ages 7.6, 10.3, 12.9, 16.5, and 26.4 years. Intermolar arch widths, maxillary basal bone widths (bijugale), and mandibular basal bone widths (bigonion, biantegonion) were recorded for each subject. Also recorded were the maxillary and mandibular cross-arch alveolar process widths measured at the molar gingival crest and the midalveolar level. RESULTS: The results indicate a pattern of width changes in the maxilla, the maxillary alveolar process, the maxillary first molars, the mandibular first molars, and the mandibular alveolar process that occurs as a gradient in the vertical dimension. The greatest width change occurs superiorly (jugale point). The smallest width change occurs inferiorly (midalveolar point of the mandible). On average, the basal bone of the maxilla increased in width by 5.37 mm; maxillary cross-arch midalveolar process width increased by 3.20 mm (left buccal surface to right buccal surface) and 4.94 mm (left palatal surface to right palatal surface); maxillary intermolar width increased by 3.08 mm; mandibular intermolar width increased by 2.05 mm; and mandibular cross-arch crest level alveolar width increased by 1.60 mm (left buccal surface to right buccal surface) and 1.02 mm (left lingual surface to right lingual surface). The basal bone of the mandible increased in width by 14.54 mm. CONCLUSIONS: We concluded that transverse molar movements during growth mirror transverse maxillary basal bone width increases, maxillary cross-arch alveolar process width increases, and mandibular cross-arch alveolar process width increases. Furthermore, there is a pattern of width changes in the maxilla, the maxillary alveolar process, the maxillary first molars, the mandibular first molars, and the mandibular alveolar process that occurs as a gradient in the vertical dimension. On the other hand, transverse mandibular basal bone changes, measured as bigonion and biantegonion, do not fit this pattern.
Adolescent↗
Disorganizing-fibrosing processes in alveolar walls of interstitial pneumonia, "alveolopneumonitis": a morphopathological study.
Disorganizing-fibrosing processes of alveolar walls in 13 autopsied (including 4 previously biopsied) and 3 biopsied cases of acute and chronic interstitial pneumonia were presented. The processes of alveolar walls were characterized initially by histolysis of the alveolar walls and transformation of the tissue into mesh or reticular structure caused by proliferation of fixed cells probably of endothelial cell origin, subsequently by formation of basement membrane-like structures along the proliferated cells, and ultimately by either fibrosis of the entire thickness of the disorganized tissue or axial fibrosis with accumulation of proliferated cells towards axis and peripheral recanalization. These processes tended to occur in the subpleural regions and extend thereafter to the deeper portions of lungs. In some cases recurrent alveolitis which occurred on the basis of axial fibrosis as aforementioned was noted. Problems concerning genesis and nature of these processes were discussed, and a new nomenclature "alveolopneumonitis" was proposed instead of interstitial pneumonia.
Adult↗
Prenatal development of the alveolar bone of human deciduous incisors and canines.
The formation of the human alveolar process around the incisors and canines is a hitherto unreported aspect of fetal oral development. The question is how, where, and when the alveolar process is formed. The purpose of this study was to elucidate the questions where and when and hence to analyze the pattern of formation of the alveolar bone around developing human deciduous canine and incisor teeth. The study was conducted with material selected from a sample of 61 normal human fetuses, legally or spontaneously aborted. Fertilization ages ranged from 9 to 22 weeks, crown-rump Length from 25 to 205 mm, and foot length from 4 to 34 mm. From this material, 7 maxillae and 10 mandibles were selected for the study according to developmental stages of the canines and incisors and according to the orientation of the histological sections. The skeletal investigation consisted of macroscopic and microscopic analysis of the mandibles and maxillae. The investigations revealed the absence of bone between the central and lateral incisors in the mandibles and maxillae of fetuses below the ages of 21 and 22 weeks, respectively. In three specimens, alveolar bone between the central and lateral incisors was recorded (21, 21, and 22 weeks of fertilization). Absence of bone labial to the canine was recorded in all fetuses investigated. In all other regions, alveolar bone occurred as a regular finding. The present study has shown that alveolar bone formation is strictly coordinated with tooth formation. Alveolar bone occurs later in the area labial to the canine and in the region between the central and lateral incisors than it does in other areas associated with the incisor/canine regions. Knowledge of this pattern in the formation of the alveolar process seems to be of importance for a future elucidation of how the alveolar process is initially formed.
Alveolar Process↗
[Comparative morphometrical study on development of palatal shelves in cleft and non-cleft palate mice].
OBJECTIVE: To quantitatively compare the relationship between the congenital cleft palate and development of the palatal shelf. METHODS: Fifty two pairs palatal shelves were macroscopic measured, and 60 series coronal sections were microscopically measured, which were precisely orientated in the coronal plane and serially sectioned at 7 micro m thickness. With the aid of computer imaging analysis system the widths and areas of the palatal shelves in vertical and coronal direction, the maximal areas of the palatal bone and palatal process and alveolar process were measured and compared quantitatively between the cleft group and non-cleft group. RESULTS: The widths and areas of palatal shelves in cleft foetuses showed significant reduction macroscopically and microscopically as well as the maximal areas of the palatal bone, in addition, both of two processes of the maxilla showed significant developmental deficiency. CONCLUSIONS: The palatal shelves show significant developmental hypoplasia in three dimension directions, which have significant correlation between palatal cleft and trisomic condition.
Animals↗
Early cleft lip repair in children with unilateral complete cleft lip and palate: a case against primary alveolar repair.
All children with complete unilateral cleft lip and palate will develop some degree of malocclusion regardless whether the alveolar cleft is repaired primarily or bone grafting is deferred. To evaluate the impact of early gingivoperiosteoplasty on occlusal relationships, dental models were obtained in 5-year-old patients who underwent early cleft lip and palate repair with primary boneless bone grafting (Skoog's method) (56 children) and without alveolar intervention (51 children). The Goslon's occlusion grading system was applied to evaluate occlusal relationships in both groups. Patients with early surgical intervention to repair alveolar cleft demonstrated poor occlusal relationship with the Goslon score 4 and 5, which will likely need an orthognathic corrective procedure (50% vs. 19.6% in patients without early primary dissection of the alveolar process). Results reaffirm that an inclusion of the alveolar process into the early primary lip repair adds to the severity of occlusal maldevelopment.
Alveolar Process↗
Digital dental image processing of alveolar bone: Macintosh II personal computer software.
Dental radiographs are amenable to digital image processing and analysis for both subjective interpretation and quantification of scene features. Four general-purpose image processing programs for the Apple Macintosh II computer (NIH Image, Enhance, IP Lab and DIP Station) were applied to digital analysis of dental radiographs. These programs can manipulate and quantitatively analyse the gray scale and spatial data of dental images and improve their subjective quality. They can interactively make geometric measurements of features. The programs were evaluated for their versatility and applicability in the quantification of alveolar bone. Overall, NIH Image was judged most suitable for current dental imaging needs. Each of the other programs offered unique features that may be valuable in specific applications.
Alveolar Process↗
A classification of the edentulous jaws.
A classification of the edentulous jaws has been developed based on a randomised cross-sectional study from a sample of 300 dried skulls. It was noted that whilst the shape of the basalar process of the mandible and maxilla remains relatively stable, changes in shape of the alveolar process is highly significant in both the vertical and horizontal axes. In general, the changes of shape of the alveolar process follows a predictable pattern. Such a classification serves to simplify description of the residual ridge and thereby assist communication between clinicians; aid selection of the appropriate surgical prosthodontic technique; offer an objective baseline from which to evaluate and compare different treatment methods; and help in deciding on interceptive techniques to preserve the alveolar process. An awareness of the pattern of resorption that takes place in various parts of the edentulous jaws, enables clinicians to anticipate and avert future problems.
Alveolar Process↗
Position of upper permanent central incisors prior to eruption in unilateral cleft lip and palate.
The position and degree of eruption of permanent central incisors within the premaxilla were measured on x-ray films obtained in 102 patients with unilateral cleft lip and palate and in 52 normal individuals aged 5 years. The patients were subdivided according to sex and to the method of surgical repair (bone grafting or periosteal flap surgery). Individuals with rotated incisors were assessed separately. The results showed that maxillary depth was not significantly reduced prior to palate surgery while the alveolar process was markedly retroclined. An unerupted central upper incisor on the side of the cleft was situated more anteriorly than in controls. Because of the distortion of the alveolar process, it was retroclined and produced a deformation of the subspinal concavity. Both this deformation and the distortion of the alveolar process interfered with the measurements of maxillary depth and rendered it inadequate. The incisor on the normal side was situated more posteriorly than in controls and was less retroclined than the incisor on the affected side. The degree of eruption of incisors on both the normal and affected sides did not differ from controls. The type of surgical repair influenced only the retroclination of the alveolar process and of the incisors within this process. The retroclination was more marked after primary bone grafting than after periosteal flap surgery. The position and degree of eruption of rotated incisors did not differ from nonrotated incisors, and the presence of rotated incisors was not related to the degree of the shortening of maxillary depth. There were no significant differences between males and females.
Bone Transplantation↗
Mandibular shape and skeletal divergency.
Pre-treatment lateral cephalograms of 41 skeletal Class I girls aged 11 to 15 were divided according to MP-SN angle: lower than 28 degrees (hypodivergent, 10 girls), between 31 and 34 degrees (normodivergent, 18 girls), or larger than 37 degrees (hyperdivergent, 13 girls). The mandibular outlines were traced and digitized, and differences in shape were quantified using the elliptic Fourier series. Size differences were measured from the areas enclosed by the mandibular outlines. Shape differences were assessed by calculating a morphological distance (MD) between the size-independent mean mathematical reconstructions of the mandibular outlines of the three divergency classes. Mandibular shape was different in the three classes: large variations were found in hyperdivergent girls versus normodivergent girls (MD = 4.61), while smaller differences were observed in hypodivergent girls (MD versus normodivergent 2.91). Mean size-independent mandibular shapes were superimposed on an axis passing through the centres of gravity of the condyle and of the chin. Normodivergent and hyperdivergent mandibles differed mostly at gonion, the coronoid process, sigmoid notch, alveolar process, posterior border of the ramus, and along the mandibular plane. A significant size effect was also found, with smaller mandibles in the hyperdivergent girls.
Adolescent↗