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[The relationship of wire offset and lingual component force on first molar].

OBJECTIVE: To measure the strength of lingual component force on first molar while retraction canine by 150 g tractive force with different sizes of arch wire and with different widths of molar offset on the wire. METHODS: Wires with different sizes and different materials [0.40 mm and 0.45 mm stainless round wires, 0.40 mm and 0.45 mm Australia wires, 0.41 mm x 0.56 mm (0.016 x 0.022 inch) and 0.46 mm x 0.63 mm (0.017 x 0.025 inch) rectangular stainless wires] were ligated in ideal arch Typodont when the canine was retracted with 150 g force in the direction from the molar buccal hook to the central point of canine bracket's distal wing under different widths of molar offset (1 mm, 2mm, 3mm). the lingual force applied on the first molar was measured by a self-made dynamometer. RESULTS: 1. There is lingual component force applied to the first molar while retracting canine with 150 g tractive force. 2. the bigger the cross section area of the wire and the stronger the rigidity of the wire, the smaller the lingual component force turns. The ability of the wire in deducting the lingual component force is in direct ratio with the cross section area and the rigidity of the wire. 3. While the width of wire offset increases, the lingual force produced by the tractive force applied to the first molar decreases lineally. CONCLUSION: There is lingual force produced on the anchorage molar when retracting canine. In clinic for avoiding the lingual movement of the first molar, increasing the size of wire or increasing the width of wire offset is suggested.

Cuspid↗

Morphologic study of the maxillary molars. Part II: Internal anatomy.

The internal anatomy of three hundred and seventy (370) decalcified and cleared human maxillary molars was studied. Seventy-five percent of the first molars, 58% of the second molars and 68% of the third molars studied presented three (3) root canals and 25% of the first molars, 42% of the second molars and 32% of the third molars presented four (4) root canals. The authors observed that the incidence of two root canals in the mesiobuccal root was higher in second maxillary molars than in first maxillary molars.

Dental Pulp Cavity↗

[Uprighting of mesially or horizontally impacted mandibular molars].

OBJECTIVE: To assess the treatment method and outcome of mesially or horizontally impacted mandibular molars. METHODS: Eleven patients with mandibular impacted molars, including 9 horizontally impacted molars and 5 mesially impacted molars were treated with fixed appliance in conjunction with molar band soldered with pushing spring. Crowns of impacted molars were moved occlusally and distally. RESULTS: All mesially or horizontally mandibular impacted molars were uprighted and brought into occlusion. Mean treatment period was 7.4 months (6 to 12 months). CONCLUSIONS: This orthodontic molar uprighting technique was effective in uprighting and distalizing the impacted molars.

Adolescent↗

[Diagnostic method for assessment of possible distalization of the first upper molars].

The therapeutic method of distalization of the first upper molars by external traction has been considerably extended in recent years. Some failures are, however, encountered. The cause is lack of space. The author elaborated a method which helps to assess the future spatial possibilities in the molar region. The distance between the distal margin of the first upper molar from the normal from the posterior margin of the maxilla on the bispinal plane is assesed: +6:M. Point "M" is the most posterior point on the anterior border of the fissura pterygopalatina. At the same time the breadth of the second and third molar is taken into account where considerable individual differences exist. The growth of the maxilla in the molar region was investigated in a group of 146 probands. Growth increments, on average 1 mm per year, were recorded up to the age of 18 years. Based on this information the author elaborated a formula for assessment of possible distalization of the molars: M2 + M3 + PP = + 6:M + (age 18-of the patient). The sum of the width of the crowns of the second molar (M2) and third molar (M3) and the planned distal shift of the first molar (PP) equals distance + 6 from the normal from point M on the bispinal plane (+6:M) plus the difference between 18 and the patient's age.

Adolescent↗

[A new technique for the treatment of ectopically erupting permanent first molars].

The problem and treatment of the ectopically erupting permanent first molars have been addressed by many authors since they were first mentioned in the literature by Chapman in 1923. Many treatments involve techniques using the primary second molar. It is better for correcting the eruption of the permanent first molar into normal occlusion to maintain the primary second molar in its normal position. However severe mobility and root resorption are often present when an ectopic eruption is found. An 8-year-old male with ectopic eruption of the maxillary right permanent first molar was examined and treated. The right primary second molar demonstrated severe mobility and root resorption, and therefore a new appliance using the primary first molar was designed. After 4 months from the beginning of the treatment the mobility of the primary second molar decreased, and after 6 months the permanent first molar almost erupted in its normal position.

Child↗

[Anatomical studies on a supernumerary tooth considered to be a successional tooth of the lower first molar].

The purpose of this study is to investigate features of the successional tooth of the lower first molar. Materials investigated in this study deal with a supernumerary tooth formed at the distolingual deep part to the lower right first molar of a male patient aged twenty-four. It was observed with binocular microscopy and under X-ray. The occlusal surface of it was observed with scanning electron microscopy. Horizontal ground sections of it were prepared and observed with polarizing microscopy, fluorescent microscopy, and scanning electron microscopy. It is thought that this supernumerary tooth is a true successional tooth of the lower first molar because it was formed at the distolingual deep part to the lower first molar and the fissure of it is Y-shaped and it has five cusps. It is considered that two impressions at buccal and distal surfaces of it isn't original hereditary features but was accidentally formed by pressures of mesial and distal roots of the lower first molar. The rough form of it has most resemblance to the lower second premolar and distal and lingual parts of it are smaller than that of the lower first molar. But fundamental features of the lower first molar are preserved in it. It is thought that the center of the molarization field of human lower successional teeth lies at the successional tooth of the lower first molar because the form of the occlusal surface of it is more complex and functional than those of the lower first and second premolars.

Adult↗

Use of amalgam and stainless steel restorations for primary molars.

The findings of this study agree with those of Braft, namely, stainless steel crowns for primary molars are superior to multisurface amalgams. This is viewed in terms of the number of teeth requiring retreatment. Because of the eventual loss of primary molars, the actual longevity of restorations may be difficult to establish. Based on the information found in this study it is concluded that: In primary first molars, 75 percent of one-surface and 70 percent of two-surface amalgams will need replacement before the age of eight. In primary second molars, 32 percent of one-surface and 71.4 percent of two-surface amalgams will need replacement before the age of eight. Stainless steel crowns will need further treatment in 12.8 percent of primary first molars and in 11 percent of second molars. Before the first permanent molars erupt into occlusion (before the age of eight) stainless steel crowns are the treatment of choice, for the primary molars, particularly for multisurface lesions in the primary first molar.

Child↗

Prevalence of third molars in dental practice attenders aged over 35 years.

There is a lack of information in the United Kingdom on the prevalence of third molars in older patients. The aim of this study was therefore to define the pattern of lower third molar retention in UK dental practice attenders aged 35 years and over. A random sample of 599 eligible patients from a rural dental practice were included in the study. Information was obtained from clinical notes and panoramic radiographs. Data collected included age, gender, presence or absence of lower third molars, number of teeth present in the lower arch and eruption status. Two hundred and sixty-four (44.1 per cent) had at least one lower third molar present (mean age = 57.1 years) while 335 (55.9 per cent) had no lower third molars (mean age = 50.2 years). The data suggest that a greater proportion of men than women retain at least one lower third molar although this finding was not statistically significant. Seventy per cent of retained lower third molars reported in the study were fully erupted. Sixty per cent were vertically placed. There was an association between age and number of teeth present (chi 2 = 38.85, 4DF, P < 0.05), older patients having fewer lower teeth. These data suggest that a large number of patients can expect to keep their lower third molars beyond the age of 35 years and that in many cases a conservative "wait and see' policy for lower third molars in the early twenties is appropriate.

Adult↗

Direct and indirect methods for molar-mass analysis of fragments of the capsular polysaccharide of Haemophilus influenzae type b.

Two methods are described for direct molar-mass measurement of low-molar-mass fragments obtained by oxidative cleavage of the capsular polysaccharide of Haemophilus influenzae type b. Absolute molar masses were determined by size-exclusion chromatography (SEC) with detection by multiangle laser-light-scattering photometry (MALLS) and differential refractometry (RI). The end-group structure of the polysaccharide fragments allowed the direct measurement of average chain length by quantitative 1H NMR, from which molar masses were derived. Variation between the molar masses obtained by the two methods ranged from 5 to 7%. When molar masses estimated by indirect methods were compared to SEC-MALLS/RI data, significant deviations were observed. Analysis by SEC with secondary calibration with dextran standards gave molar masses that exceeded the SEC-MALLS/RI data by as much as 2.5-fold. Molar masses estimated by a combination of colorimetric assays varied from the SEC-MALLS/RI data by as much as 50%. These results demonstrated the applicability and superior accuracy of the direct methods of molar-mass determination of the polysaccharide fragments.

Bacterial Capsules↗

The diagnostic implications of routine ultrasound examination in histologically confirmed early molar pregnancies.

OBJECTIVE: Early ultrasound examination is being used increasingly in the diagnosis of molar pregnancy. The aim of this study was to examine the diagnostic implications of routine ultrasound examination for histologically confirmed molar pregnancies. METHODS: This was a retrospective review of sonographic and histological findings in a series of consecutive cases referred to the National Trophoblastic Disease Surveillance Centre with suspected molar pregnancies. In 194 cases referred to the center over a 6-month period in whom results of a preceding ultrasound examination were documented, review of ultrasound findings and final histological diagnosis was carried out. RESULTS: There were 155 cases with a reviewed histological diagnosis of complete or partial hydatidiform mole. In 131 (67%) cases, the sonographic diagnosis was that of a missed miscarriage/anembryonic pregnancy with no documented suspicion of molar pregnancy, referral being on the basis of histological examination of products of conception. In 63 cases, ultrasound examination suggested molar pregnancy; in 53 (84%) of these, the diagnosis of molar pregnancy was correct. Overall, 37 of 64 (58%) complete moles had sonographic evidence of molar pregnancy compared to 16 of 91 (17%) partial moles. Of 155 histologically confirmed complete or partial hydatidiform moles, only 53 (34%) were suspected as molar sonographically. CONCLUSION: The majority of cases of molar pregnancy now present as missed miscarriage/anembryonic pregnancy sonographically, highlighting the importance of histological examination to diagnose gestational trophoblastic disease.

Abortion, Missed↗

Supernumerary molar teeth: observations in the skulls.

OBJECTIVE: To study the prevalence of supernumerary molar teeth in the skull collection of the Zimbabwe Museum of Human Sciences. DESIGN: Cross sectional anatomical observations on human skulls. SETTING: Zimbabwe Museum of Human Sciences, Harare, and the Department of Anatomy, University of Zimbabwe, Mount Pleasant, Harare. SUBJECTS: 153 skulls with intact maxillae and 112 mandibles from the skeletal collections of the Zimbabwe Museum of Human Sciences representing the Black Zimbabwean population. MAIN OUTCOME MEASURES: Observations on the presence and location of supernumerary molars in the upper and the lower jaws of the human skulls as well as the diameters of supernumerary molars. RESULTS: Two fourth molars were observed in two upper jaws and their prevalence was 0.76%. One fully erupted fourth molar was observed on the left side of the upper jaw distal to the third molar in the alveolar arch of the female skull aged 40 years. Another impacted fourth molar was observed on the right side of the upper jaw of the female aged less than 25 years and was present on maxillary tuberosity. No fourth molars were observed in lower jaw collections. CONCLUSIONS: It appears that the supernumerary molars occur rarely. It would be appropriate to evaluate the prevalence of supernumerary teeth in Zimbabwean population based on clinical and radiological examination rather than observations in the skulls.

Adult↗

Wisdom tooth eruption secondary to localized lower molar mesialization in patients with aplastic lower second premolars.

OBJECTIVE: After localized space closure in the mandible it is desirable to preserve lower wisdom teeth as natural replacements for missing second premolars and as antagonists for upper second molars. The aim of this study was to determine whether this treatment method can obviate the need for prosthodontic restorations, implants, and third molar osteotomy. Furthermore the time point of possible third molar eruption was to be determined and whether further orthodontic interventions were required to achieve their alignment. PATIENTS AND METHODS: The test group comprised 34 patients who exhibited agenesis of one or both lower second premolars (n = 45) in conjunction with a corresponding number of third molar tooth germs. Follow-up examinations were performed 2 to 8 years after conclusion of orthodontic treatment involving push-and-pull mechanics (PPM) without extraction of any contralateral teeth. The results of the clinical retrospective follow-up examination at consecutive post-treatment endpoints were compared with two orthodontic control groups (A: 4-premolar extraction group, B: non-extraction group). RESULTS: After an average of 4 years and 2 months, the percentage of fully-erupted third molars in the agenesis group with localized space closure was 82%, compared to 29% and 28%, respectively, in the controls. These differences were statistically significant (p < or = 0.01). The success rate in the agenesis group reached 94% when the 4- to 8-year results were considered in isolation. Compared with the contralateral (non-aplastic) side, teeth on the aplastic side erupted prematurely. In 9% of the cases, minor orthodontic interventions were required to exactly position the third molars. CONCLUSION: There is high probability that mandibular third molars can be preserved after localized space closure, obviating the need for prosthodontic restorations, dental implants, and third molar osteotomies.

Adolescent↗

The effect of removal of all third molars on the dental arches in the third decade of life.

The intent of this study was to evaluate any change in the dental arches of adults in the third decade of life after the removal of all third molars in relation to occlusal factors, gender and the status of the third molars prior to extraction. The subjects were 24 healthy students (9 women, 15 men; mean age 23.2; age range 20-32) whose third molars were all removed. All extractions in the lower arch were performed because of impaction and complicating symptoms such as pain and swelling. Full occlusal registrations were performed before the extractions and one year afterwards, including the production of dental casts. The dimensions of the lower dental arch showed a small, but significant, increase one year after the removal of all the third molars. No significant change took place in the lower anterior area during the year. In the maxillary arch (in the lateral and transversal dimensions), the direction of change was similar to that of the lower arch, but smaller than in the mandibular arch. This indicated a minor space gain during the year after the removal of all third molars. The changes in the dental arches did not correlate significantly with changes in craniomandibular disorders (CMDs). It can be concluded that the extraction of an impacted third molar allows at least the second molar to drift posteriorly and laterally in the dental arch. The results give no further indication, in this age group, to extract the lower third molars in order to prevent lower anterior crowding.

Adult↗

Use of orthodontic treatment as an aid to third molar extraction: a method for prevention of mandibular nerve injury and improved periodontal status.

BACKGROUND: Impaction of mandibular third molars predisposes to pathological conditions including periodontal disease. Extraction of these teeth also may lead to damage to the nerve and to periodontal involvement of the second molars. This report describes a series of cases in which the third molars were orthodontically induced to erupt to prevent the sequelae associated with extraction. METHODS: Impacted mandibular third molars in 18 patients were surgically exposed following placement of an orthodontic appliance. Depending on the individual case, 1 of 3 approaches was used: attachment of a bracket, placement of a post in the root canal, or placement of an orthodontic wire through a bucco-lingual canal. After suturing the mucoperiosteal flap, the orthodontic appliance was activated. After the tooth erupted, it was removed and periodontal parameters were measured on the second molar. RESULTS: No damage to the inferior alveolar nerve was found. Probing depths on the second molar were reduced from 7.9 +/- 1.6 mm on the buccal and 7.4 +/- 1.0 mm on the lingual to 1.8 +/- 0.7 mm and 1.9 +/- 0. 7 mm, respectively. There was an average gain of 5.0 mm in attachment. Keratinized tissue increased from 2.9 +/- 0.7 to 3.8 +/- 0.6 mm. CONCLUSIONS: The interdisiplinary use of periodontics and orthodontics results in non-surgical removal of impacted mandibular third molars without damage to the inferior alveolar nerve and iatrogenic periodontal sequelae to the second molars.

Adolescent↗

Effect of mechanical treatment on healing after third molar extraction.

The aim of this study was to determine the effect of subgingival scaling and root planing on healing of the distal surface of second molars following extraction of third molars. Twenty-eight patients with contralateral erupted third molars and pocket depths greater than or equal to 3 mm on the distal surface of the second molars participated in this study. Measurements of supragingival bacterial plaque, bleeding on probing, pocket depth, and relative attachment level were performed at baseline and 2 months after treatment. Extraction of contralateral third molars was carried out simultaneously. The experimental site received thorough scaling and root planing of the distal surface of the second molar, while the control site received extraction alone. Experimental sites showed significant improvement in all clinical parameters assessed compared to the control sites. In conclusion, periodontal lesions on the distal of second molars can be significantly improved following scaling and root planing after extraction of third molars.

Adult↗

Crown morphology, enamel distribution, and enamel structure in mouse molars.

BACKGROUND: Biomolecular research and genetic manipulations have stressed the importance of thorough knowledge of normal organ morphology. Mouse molar teeth are convenient models for studying basic interactions in organ development and morphogenesis. The aim of the present study was to provide basic information on their morphology. METHODS: Intact and sectioned/ground molars of mice of various ages were observed with SEM. RESULTS: Enamel-free areas (EFA) were present on cusp tips at time of eruption. The dominating structural configuration in enamel was prism decussation in inner enamel and parallel prisms in outer enamel. Prism decussation tended to be absent at cusp ridges and in the bottom of grooves. In the former location, the distinction between prisms and interprism was often obscured in the middle enamel zone due to decreased difference in orientation of their crystals. A thin layer of enamel, often aprismatic, covered the distal aspect of cusps in maxillary molars and the mesial aspect of cusps in mandibular molars. The enamel abutting on EFA was often aprismatic. Aprismatic enamel exhibited incremental lines with a periodicity of about 1 microm and was often traversed by cracks. The enamel surface was porous in the bottom of grooves. Parts of mouse molar enamel were incompletely mineralized at the time of eruption. CONCLUSIONS: SEM is a convenient method for combined studies of crown morphology and enamel structure. Based on morphological criteria, a modification of the cusp nomenclature is proposed. Enamel thickness and structure in mouse molars show regional variations. Fundamental similarities exist between mouse molar cusps and mouse incisors. Mouse molar enamel undergoes posteruptive maturation.

Animals↗

Third molar agenesis in human prehistoric populations of the Canary Islands.

The occurrence of third molar agenesis was recorded in a sample of 1,492 maxillary and 1,718 mandibular arches belonging to the prehistoric settlers of the Gan Canaria, Tenerife, and La Gomera Islands (Canary Islands). There were significant sex differences only in the Tenerife sample for the maxilla, the incidence in females being higher than in males. In the Gran Canaria sample, the total frequency (male and female combined) of third molar agenesis (individual count method) was 8.7% for the maxilla and 9.3% for the mandible. In the Tenerife and La Gomera samples, the frequencies were 11.1% and 10.7% for the maxilla and 14.6% and 13.3% for the mandible. In the Tenerife sample, the differences between both jaws were statistically significant. The incidence of missing third molars in the mandible was significantly higher in Tenerife than in Gran Canaria, but the other sample differences were statistically nonsignificant. Bilateral absence of third molars was observed in about two-thirds of the specimens examined. Some correlation between both jaws for the occurrence of third molar agenesis was found. The hypotheses that have been proposed in order to explain third molar agenesis in man are discussed. It is suggested that the loss of the third molar in Homo sapiens could be produced by a heterochronic phenomenon of postdisplacement, as a consequence of the phylogenetic tendency toward the delay of the onset of the third molar formation, and that the genetic factors responsible for the absence of these teeth could be related to the general process of delay in tooth formation.

Atlantic Islands↗

Enamel thickness of human maxillary molars reconsidered.

Forty-four modern human maxillary molars (M1 = 21, M2 = 12, and M3 = 11) were sectioned through the mesial cusps in a plane perpendicular to the cervical margin of the crown. Eight measurements of enamel thickness as well as bucco-lingual (BL) and mesio-distal (MD) diameters were recorded for each tooth in order to investigate differences in these dimensions between tooth categories. Uni- and multi-variate analyses revealed first maxillary molars to have generally thinner enamel than second or third upper molars, especially with regard to the occlusal basin. Furthermore, the decrease of MD diameters from anterior to posterior is greater than that of BL diameters. Principal Component Analysis using enamel thickness measurements resulted in complete separation of first molars, while second and third maxillary molars showed a certain amount of overlap. This finding casts doubt on using an overall measure of "molar enamel thickness" derived from mixed samples of molars for taxonomic purposes. There appears to be a relationship between bite force and enamel thickness such that posterior molars, where masticatory forces are stronger, have thicker enamel than anterior teeth. It is suggested that the gradient of enamel thickness between (and within) teeth in extant and extinct species may thus provide further information about relative wear resistance as well as the biomechanical constraints of the orofacial skeleton.

Adolescent↗