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PubMed2005

Surgical and orthodontic treatment of an impacted permanent incisor: case report.

This case report presented a combined surgical/orthodontic treatment of an impacted permanent incisor of a 10-year-old boy. Trauma to the primary dentition caused the impaction of the maxillary left permanent central incisor. Application of push coil spring between the adjacent teeth created space for the impacted tooth. A button with an extension of ligature wire was bonded to the maxillary left permanent central incisor to bring it into the arch. The maxillary left permanent central incisor was brought to its proper position after 16 months of active orthodontic treatment.

Child↗
PubMed2006

Maxillary incisor torque with conventional and self-ligating brackets: a prospective clinical trial.

OBJECTIVES: To test the hypothesis that the engagement mode of wire to bracket affects the buccolingual inclination of maxillary incisors in extraction and non-extraction treatment with self-ligating and conventional brackets. DESIGN: A randomized clinical trial employing a random distribution of variables among the studied populations. SETTING AND SAMPLE POPULATION: Private practice of one author. A total of 105 patients followed prospectively, were divided into two groups based on the inclusion of extraction in the treatment planning. These groups were further divided in two subgroups each, one receiving a self-ligating bracket and the other treated with a conventional Edgewise appliance of the same slot size and prescription. EXPERIMENTAL VARIABLE: Difference in the buccolingual inclination of maxillary incisors before and after treatment with the two appliances across the two treatment groups (extraction and non-extraction). OUTCOME MEASURE: Angular measurements of the Sella-Nasion and Nasion-A point to maxillary incisor axis. RESULTS: No difference was found in the mean difference of the two angles measured for the two bracket groups studied. CONCLUSION: Self-ligating brackets seem to be equally efficient in delivering torque to maxillary incisors relative to conventional brackets in extraction and non-extraction cases.

Adolescent↗
PubMed2005

Managing congenitally missing lateral incisors. Part III: single-tooth implants.

UNLABELLED: Three treatment options exist for the replacement of congenitally missing lateral incisors. They include canine substitution, a tooth-supported restoration, and a single-tooth implant. Selecting the appropriate treatment option depends on the malocclusion, anterior relationship, specific space requirements, and condition of the adjacent teeth. The ideal treatment is the most conservative option that satisfies individual esthetic and functional requirements. Today, the single-tooth implant has become one of the most common treatment alternatives for the replacement of missing teeth. This article closely examines the many interdisciplinary issues that arise when treatment planning the placement of single-tooth implants in patients with congenitally missing lateral incisors. The specific criteria that must be evaluated illustrate the importance of an interdisciplinary treatment approach to achieve optimal esthetics and long-term predictability. This is the final article of a three-part series discussing the three treatment alternatives for replacing congenitally missing lateral incisors. CLINICAL SIGNIFICANCE: When treatment planning single-tooth implants to replace congenitally missing lateral incisors, an interdisciplinary approach is necessary to provide the most predictable treatment outcome.

Age Factors↗
PubMed2006

Vital pulp therapy of mandibular incisors: a case report with 11-year follow up.

This report describes a case of a young patient in whom all the mandibular incisor teeth suffered complicated crown fractures because of a car accident. For all mandibular incisors, pulpotomy with calcium hydroxide were performed in order to achieve apexogenesis and the teeth were restored with a double-seal of glass ionomer cement and composite resin. The patient was reviewed over 11 years. All the mandibular incisor teeth showed continued root development and complete apex formation. Pulp canal obliteration was observed in only the mandibular right central incisor.

Accidents, Traffic↗
PubMedDate not supplied

Four maxillary incisors: a case report.

This case report describes the dentofacial morphology and treatment of a 9-year-old female who presented with four maxillary incisors, and a combination of rare oral and cervical vertebral anomalies. The patient had a Class II division I malocclusion which was complicated by the presence of supernumerary permanent teeth: two supplemental maxillary central incisors, and a supplemental mandibular central incisor. She also had abnormalities of the cervical vertebrae, which were symptom-free. In addition, a number of surgical procedures had been performed in early childhood to treat a benign oral teratoma, cleft tongue, and an isolated cleft of the secondary palate. The dental treatment involved the extraction of the two most centrally placed maxillary central incisors, and the alignment of the maxillary arch with fixed orthodontic appliances.

Abnormalities, Multiple↗
PubMed1989

Innervation of the incisors and periodontal ligament in several rodents: an immunohistochemical study of neurofilament protein and glia-specific S-100 protein.

The present immunohistochemical study by use of antisera against neurofilament protein (NFP) and S-100 protein dealt with the innervation of the upper incisors and periodontal ligament in five species of rodents including the guinea pig, hamster, Mongolian gerbil (Meriones unguicularis), mouse and squirrel (Tamias sibiricus). The innervation pattern of the periodontal ligament and dental pulp in the incisors of five rodents was fundamentally identical to that in the rat, which we have previously demonstrated by the same method. The NFP-positive Ruffini-like corpuscles were concentrated in the middle region of the lingual periodontal ligament in all the species examined, suggesting that this particular arrangement of Ruffini-like corpuscles, possibly stretch receptors, was essential to the rodent incisor. The labial periodontal ligament, on the other hand, contained less numerous NFP-positive nerves, these terminating among collagen fibers as free endings. The gerbil and squirrel in particular possessed only a few nerve fibers in the labial periodontal ligament. It was thus presumed that the labial periodontal ligament might be less significant as a mechanoreceptive site than the lingual periodontal ligament. The NFP-positive pulpal nerves, beaded or smooth in shape, ran parallel to the tooth axis, but never extended to the odontoblastic layer; no subodontoblastic plexus was found in the incisors of any of the rodents. S-100-immunopositive nervous elements were distributed in the periodontal ligament and dental pulp of all the rodent species examined, showing a distribution pattern similar to the NFP-positive nerves. Only in the squirrel did odontoblasts show an intense S-100 immunoreactivity.

Animals↗
PubMedDate not supplied

Incisor teeth status in patients with reflux oesophagitis.

A retrospective non-controlled inventory study was done in order to assess the dental status, with specific attention paid to the incisor teeth, in patients with reflux oesophagitis. A questionnaire was sent to 293 consecutive patients in whom reflux oesophagitis was diagnosed endoscopically. A complete dental prosthesis was present in 46.8% of the patients, the remainder had a complete set of teeth or a partial dental prosthesis. Damage in the upper incisors was present in 32.5% of the cases, in the lower incisors in 7.8%, and in both in 26.9%. In the remainder no damage was present. No complaints were significantly associated with the presence or absence of dental damage. There was, however, a significant association between duration of complaints and presence of damage in the upper incisors. Although it is not certain that all cases of damage actually are the result of gastro-oesophageal reflux, and the data presented possibly overestimate the true prevalence, dental erosions as a complication of gastro-oesophageal reflux are likely to occur in a large number of patients.

Adolescent↗
PubMed1987

Movement of fibroblasts in the periodontal ligament of the mouse incisor is related to eruption.

Movement of fibroblasts in the periodontal ligament of the lower incisor of the mouse was studied by pulse-labeling with tritiated thymidine and proline. 3H-Thymidine was administered to mark the nuclei of the cells in the proliferative compartment near the basal end of the tooth; 3H-proline gave rise to a narrow band of radioactivity in the dentin, which served as a reference line for measurement of eruption. One or three weeks after injection in each animal, the lower right incisor was prevented from further eruption by being pinned to its alveolar process. The animals were killed 0, 1, or 2 weeks later, and their mandibles processed for LM-radioautography. It was found that in the left incisors, which were not inhibited in their eruption, labeled cells in the tooth-half of the periodontal ligament moved incisally at a rate similar to the eruption rate. In the pinned incisors, no further incisal migration could be established. It is concluded that fibroblast migration in the tooth-half of the ligament is strictly coupled to the eruptive process.

Animals↗
PubMed1990

Long-term effects of orthodontic forces on the morphology of the rat-incisor socket and its location in the mandible.

The effect of orthodontic force application on the rat-incisor socket and mandible was studied on roentgenograms. A mean linguo-intrusive force of 19 +/- 0.6 g was applied continuously to the shortened left lower incisor for a period of two (group A) and four weeks (group B). A third group of rats, subjected to shortening of the left mandibular incisor only, served as a hypofunctional control (group C). A fourth group of normal rats constituted the intact control (group D). After a recovery period of three months, the animals were killed, and standardized roentgenograms of the cleaned mandibles were taken. Socket and mandibular dimensions were measured on magnified tracings of the roentgenograms. Comparison of groups A and B with the control groups, on the one hand, and of group C with group D, on the other, facilitated isolation of the hypofunctional factor. In groups A and B, the orthodontic forces caused changes in the parameters affected (i.e., socket area, alveolar bone thickness, mandibular dimensions) and not affected by hypofunction (i.e., socket angulation and location, anterior-socket length). The former findings implies modification of the adaptive capability of dental structures to functional demands. It is concluded that mechanical loading of the incisor for two to four weeks causes long-lasting changes in the socket and its surrounding bone.

Adaptation, Physiological↗
PubMed1995

Genetic covariance structure of incisor crown size in twins.

Previous studies of tooth size in twins and their families have suggested a high degree of genetic control, although there have been difficulties separating the various genetic and environmental effects. A genetic analysis of variation in crown size of the permanent incisors of South Australian twins was carried out, with structural equation modeling used to determine the relative contributions of genetic and environmental factors. Maximum mesiodistal crown dimensions of maxillary and mandibular permanent incisors were recorded from dental models of 298 pairs of twins, including 149 monozygous (MZ) and 149 dizygous (DZ) pairs. The analysis revealed that: (i) an adequate fit required additive genetic and unique environmental components; (ii) augmenting the model with non-additive genetic variation did not lead to a significant improvement in fit; (iii) there was evidence of shared environmental influences in the upper central incisors of males; (iv) the additive genetic component constituted a general factor loading on all eight teeth, with group factors loading on antimeric pairs of teeth; (v) unique environmental effects were mostly variable-specific; (vi) most factor loadings on antimeric tooth pairs could be constrained to be equal, indicating a symmetry of genetic and environmental influences between left and right sides; and (vii) estimated heritability of the incisor mesiodistal dimensions varied from 0.81 to 0.91.

Adolescent↗
PubMed1996

Prevalence of incisor trauma in persons 6-50 years of age: United States, 1988-1991.

Traumatic injuries to the teeth are among the most serious of dental conditions, yet little is known about the prevalence of tooth or dental trauma at the national level. The National Institute of Dental Research (NIDR) modified existing indices for specific use in national epidemiologic studies of tooth trauma among both children and adults. The NIDR index was developed not only to track the status of the tooth from sound (no evidence of trauma) through missing due to trauma, but also to reflect selected sequelae of trauma. The index is based on clinical, non-radiographic evidence of tooth inujury and treatment received in the eight permanent incisors, including a positive history of injury obtained from the subject. The trauma assessment index was applied immediately following the caries examination for dentate participants ages 6-50 years old (n=7,707) in Phase 1 of the NHANES III oral examination. This article reports the first national overall and age-specific population-based prevalence of dental trauma among gender, racial, and ethnic groups. There is a higher prevalence of incisal trauma, of both maxillary and mandibular incisors, in males than females, in both the younger and older age groups. The prevalence of incisal trauma of both maxillary and mandibular incisors in whites and blacks in both younger and older age categories is similar. The study found that half of the individuals with trauma had only one incisor tooth classified as having trauma. Males and older age groups showed larger numbers of traumatized teeth. Further study and examination of methodological issues are desirable for additional understanding of incisal trauma in the general population .

Adolescent↗
PubMed1994

Determination of the distance between the laryngoscope blade and the upper incisors during direct laryngoscopy: comparisons of a curved, an angulated straight, and two straight blades.

We compared visibility and dental complications from a variety of blades during tracheal intubation. Ninety-eight patients who received tracheal intubation were enrolled. They were divided into two groups: Study 1 (n = 50) and Study 2 (n = 48). Four laryngoscopic evaluations were planned for each patient using Miller and Wisconsin straight blades with different heel heights, a Macintosh curved blade, and a Belscope angulated straight blade (Study 1: Miller No. 3, Wisconsin No. 3, Macintosh No. 4, and Belscope medium; and Study 2: Miller No. 2, Wisconsin No. 2, Macintosh No. 3, and Belscope medium, respectively). All laryngoscopies were performed by the same anesthesiologist. The distance between the blade and the upper central incisors was measured when the optimum visibility of the glottis was obtained. The visibility was determined according to the Cormack and Lehane grading. Analysis of the distance between the blade and upper incisors was performed using the results of the 44 patients (166 distances) in Study 1 and the 48 patients (181 distances) in Study 2 who had a visibility of two or better. The Belscope blade provided a significantly greater visual field than the other types of blade. Two patients sustained a fracture of the central incisor and subluxation of the central incisor, respectively, during laryngoscopy in which a Wisconsin blade was used. The average incidence of dental injury was 1/191. The Belscope blade may contribute to a reduced likelihood of upper dental injuries during laryngoscopy.

Adult↗
PubMed1998

[A method of measuring eruptive movement of the rat incisor using a non-contacting displacement detector].

The axial movements of rat incisors were recorded continuously for over 20 hr. The rats were anesthetized with halothane delivered by intratracheal intubation using an artificial respirator. A hemostatic clamp was used to immobilize the jaw. The displacement detector that detects changes in the electric eddy current exhibited high resolution, good linearity and low drift. The average eruption rates of the rat incisor were estimated to be 406 and 516 microns/ 24 hr at 34 and 37 degrees C of the rectal temperature, respectively. The values were within the normal range. We also measured the force needed to restrain eruptive movement of the rat incisor using the same apparatus combined with a load cell. The maximum pushing force was estimated to be 9 mN or 29 mmHg (converted value) on average. Then the effects of adrenaline on axial movement of the incisor and arterial blood pressure were examined. Adrenaline caused a rapid extrusive tooth movement with a nearly simultaneous increase in the blood pressure, followed by a marked intrusive tooth movement and a decrease in blood pressure. These results support the view that the systemic arterial blood pressure and vasculature in the tooth socket play important roles to determine the position of teeth. We assume that our method would be useful to clarify the precise relationship between tooth displacement and vascular change in the tooth socket.

Alveolar Process↗
PubMed2005

Presence of anti-cystatin C-positive dendritic cells or macrophages and localization of cysteine proteases in the apical bud of the enamel organ in the rat incisor.

Cystatin C, a cysteine protease inhibitor, was examined in the apical buds of rat incisors by immunohistochemistry, because in transition and maturation zones most of the dendritic cells in the papillary layer are anti-cystatin C-positive. Anti-cystatin C-labeled cells were sparse and localized to the proliferation and differentiation zones, constituting the apical bud of 5-week-old rat incisors. These cells were considered macrophages or dendritic cells, based on their reactivity with OX6 and ED1, as well as their ultrastructure. Basement membrane at the periphery of apical bud was also labeled by anti-cystatin C antibody. The apical buds included a few apoptotic fragments and weak reactivity with antibody to cathepsin L, a cysteine protease. Reactivity to anti-cystatin C and anti-cathepsin L antibodies was also detected in the apical bud of newborn rat incisors. These results suggest that the cystatin C-positive macrophages or dendritic cells are involved in normal incisor formation. They may be related to the clearance of apoptotic cells or protection from putative cysteine protease activity.

Animals↗
PubMed1999

Management of missing maxillary lateral incisors.

BACKGROUND: Missing maxillary lateral incisors create an esthetic problem with specific orthodontic and prosthetic considerations. The purpose of this article is to describe treatment protocols and problems encountered in the management of this disorder. CASE DESCRIPTION: The two common treatment options are orthodontic space opening for future restorations or orthodontic space closure using canines to replace the missing maxillary lateral incisors. The required amount of space opening and the various prosthetic options are discussed. The methods for reshaping canines in orthodontic space closure and building them up to simulate lateral incisors also are described. The indications, advantages and disadvantages of both treatment modalities are outlined to help clinicians make decisions in borderline situations. CLINICAL IMPLICATIONS: Teamwork between the orthodontist, general practitioner and restorative dentist is important when analyzing factors related to individual patients and establishing overall treatment plans. This also will allow treatment modalities and the various options for replacing missing maxillary lateral incisors in space opening to be discussed between team members and the patient.

Anodontia↗
PubMed2005

Dental development of the permanent lateral incisor in patients with incomplete and complete unilateral cleft lip.

OBJECTIVE: This study aimed to evaluate a possible delay in root development of the permanent lateral incisor on the cleft side compared with its contralateral tooth in patients with incomplete and complete unilateral cleft lip. DESIGN: Retrospective. SETTING: Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Bauru, São Paulo, Brazil. PATIENTS: A sample of 95 panoramic radiographs of patients with incomplete and complete unilateral cleft was obtained from the files of HRAC/USP. The patients were both boys and girls of various races, aged 5 to 11 years, and did not have any syndrome or associated congenital malformation. The sample was divided into three groups according to the severity of the cleft lip. MAIN OUTCOME MEASURE: Radiographs were analyzed to compare root development stage of the lateral incisor on the cleft side with the noncleft side according to the classification of Nolla. RESULTS: The mean delay in root development of the permanent lateral incisor on the cleft side ranged from 0.5 to 1.6 scores for all three groups investigated. CONCLUSIONS: Root development of the permanent lateral incisor on the cleft side was delayed compared with the noncleft side.

Anodontia↗
PubMed2002

Dental development of permanent lateral incisor in complete unilateral cleft lip and palate.

OBJECTIVE: The objective of this retrospective study was to verify whether the root development of the permanent lateral incisor on the cleft side was delayed, compared with its contralateral tooth in subjects with complete unilateral cleft lip and palate. SETTING: Craniofacial Anomalies Rehabilitation Hospital (HRAC)-University of São Paulo-Bauru, Brazil. PATIENTS: A sample of 98 panoramic radiographs of HRAC patients with complete unilateral cleft lip and palate was selected, regardless of sex and race. MAIN OUTCOME MEASURE: Panoramic radiographs were analyzed and the root development stage of the cleft-side permanent lateral incisor was compared with its contralateral tooth. RESULTS: Overall, the permanent cleft-side lateral incisor was significantly delayed in root development in relation to the non-left side contralateral tooth (p <.05). However, no significant differences were observed between boys and girls. CONCLUSIONS: Root development of the permanent cleft-side lateral incisor was delayed, compared with its contralateral tooth. The cleft itself may play an important role in this delay because the results from boys and girls were very similar.

Child↗
PubMed2002

External root resorption of the maxillary permanent incisors caused by ectopically erupting canines.

In this study, we analyzed the root resorption of 10 maxillary permanent incisors (two central and eight lateral incisors) in seven cases associated with ectopic eruption of adjacent canines. Two incisors were extracted because of marked root resorption. Two erupted after traction, whereas, five erupted after surgical exposure or without any treatment, although one lateral incisor submerged due to ankylosis. This suggests that self-correction of the ectopic canine occurs in some cases.

Child↗