[Time course in the mobility of the clasped tooth].
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Denture Precision Attachment↗
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The effects of sympathetic trunk stimulation on the position and mobility of the canine tooth of the cat.
The effects of cervical sympathetic trunk stimulation on the position of the maxillary canine tooth and its movements in response to mechanical loading were studied using an ultrasonic transit time technique. Stimulation of the ipsilateral sympathetic trunk for 10-60s and frequencies between 1 and 20 Hz caused both longitudinal and transverse movements of the tooth. Bilateral carotid occlusion caused negligible movements in either direction. When a controlled force was applied in the palatal direction, sympathetic stimulation caused a labial shift of the tip of the tooth and usually an increase in the load-induced palatal displacement; i.e. the mobility of the tooth was increased and appeared to be dependent on the amount of labial shift of the tooth. It is concluded that interference with the vascular component has little, if any, direct effect on the tooth mobility.
Animals↗
Tooth-specific and person-level predictors of 24-month tooth loss among older adults.
OBJECTIVES: To describe: (1) the 24-month incidence of tooth loss in a diverse sample of dentate adults; and (2) the clinical, attitudinal, behavioral, and sociodemographic correlates of tooth loss incidence. METHODS: The Florida Dental Care Study is a prospective longitudinal cohort study of persons who at baseline had at least one tooth, were 45 years or older, and who resided in north Florida. An in-person interview and clinical examination were conducted at baseline and 24-months after baseline, with 6-monthly telephone interviews between those times. A two-level hierarchical generalized linear regression (logit model) was used to quantify tooth-specific and person-level factors simultaneously. RESULTS: Of the 739 persons who attended for a 24-month examination, 24% lost one or more teeth during follow-up. Tooth loss was more common in persons with dental disease at baseline, incident dental signs or symptoms, those with negative attitudes toward dental care and dental health, those with limited financial resources, older adults, blacks, females, and problem-oriented users of dental care (as distinct from regular attenders). Although disease presence at baseline was a major factor associated with incident tooth loss, most diseased teeth were in fact still present 24 months after baseline. CONCLUSIONS: Other than periodontal attachment loss, severe tooth mobility, and dental caries, no single factor was a dominant predictor of tooth loss; instead, numerous factors made statistically significant but small contributions to variation in tooth loss. Tooth loss apparently is the result of complex interactions among dental disease, incident dental signs and symptoms, tendency to use dental care in response to specific dental problems, dental attitudes, and ability to afford non-extraction treatment alternatives.
Aged↗
[A 10-year longitudinal study of the progression of destructive periodontal disease in adult and elderly].
OBJECTIVE: To study the progression of destructive periodontal disease in adult and elderly aged 20 to 80. The examinees were followed 10 years to determine whether the rates for progression of periodontal disease were different than the populations in the more developed countries. METHODS: In 1984, at baseline, 587 subjects had been examined and by 1994, 440 of them still available for follow-up study, and 398 persons remained dentate. Tooth mobility, plaque, calculus, gingival conditions, attachment levels, and probing depths on 4 sites of each tooth present were checked and recorded by the same two examiners. RESULTS: All subjects had > or = 2 mm attachment loss over 10-year period. Some teeth, such as mandibular incisors and maxillary molars, had higher progression rate than others. The mean attachment loss rate did not differ significantly between age groups, and were similar to those reported for populations in the more developed countries. CONCLUSIONS: The rate for progression of periodontal disease in this study were not significantly different between the examinees and the populations in more developed countries; and also were not significantly different among the different age groups. The causes of destructive periodontal disease in humans are more likely intrinsic factors.
Adult↗
Theoretical study of the effects of tooth and implant mobility differences on occlusal force transmission in tooth/implant-supported partial prostheses.
STATEMENT OF PROBLEM: Despite their mobility differences under occlusal loads, a natural tooth and an implant are often used together to support fixed prostheses. In some situations, tooth/implant-supported partial prostheses include cantilever extensions, especially in the posterior region where the bone is inadequate for placement of an additional implant. PURPOSE: In this study, engineering beam theory was used to study the effects of the mobility differences between the implant and the tooth on the force and moment distribution, due to occlusal loads in tooth/implant-supported prostheses. METHODS: The prosthesis was treated as a linear elastic beam and the supports were modeled as springs with (vertical) translational and rotational stiffness. The bending moments and forces on the supports were calculated as functions of the parameters that describe the geometry, position of the occlusal load, and stiffness ratios (namely, implant or tooth) of the springs. RESULTS: Bending moments on the supports were more sensitive to the relative rotational mobility between the supports and their individual values than to the relative translational mobility. The moment at the implant was minimized when the supports had similar mobilities. A preliminary design concept was introduced and eliminated the moment at the implant without significantly increasing the magnitude of the moment at the tooth. Cantilevering the prosthesis resulted in moderately increased bending moments and considerable tensile forces on the supports for a broad range of the parameters that describe the geometry and loading. CONCLUSIONS: From this simulation, it is suggested that cantilever extensions should be avoided or supported by a short implant, which will only restrain the vertical movement of the cantilever end.
Algorithms↗
[Definitive injuries to the teeth. Lesions of hard tissue and pulp].
Tooth infraction and enamel fracture are the most simple traumatic crown lesions. When necessary the lesions can be covered with composite material. Follow-up of the traumatized tooth is necessary since pulp necrosis and obliteration can develop. In case of an uncomplicated fracture involving enamel and dentine immediate protection of the dentinal wound is important for the preservation of tooth vitality. In case of a negative vitality test, an endodontic treatment will be performed in case of a tooth with open apex only when supplemental clinical and or radiological signs of pulp necrosis are present. When a complicated enamel-dentine fracture is present, an endodontic treatment will be performed when root formation is complete. In case of a wide open apex, a pulp capping, partial pulpotomy or cervical pulpotomy will be performed in order to preserve vitality of pulpal tissues at the level of the root. Crown root fractures can be superficial, deep or vertical. In case of a superficial localisation of the fracture line, restoration with composite material or with the fractured tooth segment is indicated. Deep crown-root fractures can only be restored when the fracture line is localized not deeper than at 1/3 of the length of the root. In case of a vertical fracture, extraction is the only possibility. Root fractures on immature teeth are in most cases unilateral and have a good prognosis. In teeth with completed root formation, fractures at the level of the cervix have a poor prognosis. The fractured segment will be removed. Only when the remaining root segment is long enough, this part can be maintained. In case of a fracture at the mid-root level, repositioning and rigid splinting for a period of 8 weeks is necessary. When the tooth becomes non-vital, endodontic treatment is performed on the coronal part. Root fracture in the apical part does not necessary result in enhanced tooth mobility and immobilisation is not always necessary. Healing of a root fracture is only possible when the tooth is immobilized for a sufficiently long period. Regular control of tooth vitality is necessary since pulp necrosis can lead to an inflammatory reaction at the level of the fracture line.
Dental Enamel↗
[Injuries to the permanent teeth. Periodontal lesions].
Tooth luxations are relatively common. In case of concussion or subluxation the tooth is not displaced. The treatment will consist of relief of the tooth. Most frequent complications are pulp necrosis and obliteration of pulpal tissues. In case of extrusive luxation pulpal tissues and the periodontal ligament are injured. When tooth mobility is increased flexible splinting should be considered. Endodontic treatment is necessary after extrusive luxation of a tooth with completed root formation. Teeth with open apex often show pulpal obliteration after extensive luxation. Lateral luxation is more complex than extrusive luxation since the alveolar bone is also damaged. Repositioning and splinting of the tooth are necessary. When the apical foramen in closed, endodontic treatment will be necessary. Teeth with incomplete root formation will develop pulp obliteration. Following lateral luxation, external root resorption and loss of marginal bone are not infrequent. Intrusive luxation is the type of trauma with most unfavorable prognosis. All intruded teeth will become necrotic and external root resorption and marginal bone loss are frequent. There is no consensus regarding the therapeutic approach. Orthodontic extrusion or surgical mobilisation are possible options. In case of avulsion, both the pulpal tissues and the periodontal ligament are disrupted. Preservation of the vitality of the periodontal ligament covering the root will determine the prognosis of the reimplanted tooth. Therefore the tooth will be repositioned as soon as possible. When this is not possible, milk or a specific solution are most appropriate for tooth conservation. When the reimplanted tooth has complete root formation, devitalization will be performed one week after after repositioning. In case of a tooth with open apex revascularisation can be awaited. Healing of the periodontal ligament will determine prognosis. When a normal ligament is obtained during healing or when surface resorption is obtained, the tooth can be preserved for a long period. When progressive replacement resorption (ankylosis) develops, most teeth can remain in position for about 10 years. When inflammatory resorption develops, the tooth will be lost within a short time.
Dental Pulp Calcification↗
[Semi-automatic generation of finite element meshes fo dental preparations].
The mechanical properties and elastic behaviour of periodontal tissue are a decisive factor in understanding initial tooth mobility and bone remodelling processes in orthodontics. An experimental set-up was designed to precisely determine a tooth's elastic response to different loading conditions. Segments of pig's maxilla bearing separated molars were used, and their mechanical response to loading was recorded. Subsequently, finite element analysis (FEA) was performed on the basis of the experimental data. The combination of experimental and numerical methods was used to determine the material properties of the periodontal ligament (PDL). The geometries of the preparations were reconstructed and FE meshes generated semi-automatically with the aid of the special computer program, CAGOG (Computer Aided Generator for Orthodontic Geometries) to optimally match the experimental geometry. Nonlinear material parameters were determined for the PDL and verified by comparing experimental and numerical results obtained in other specimens with an error of about 10%. This good correlation indicates that the selected method of mesh generation is appropriate for creating realistic FE models that can be compared with experimental results.
Animals↗
Periodontal diseases in adult Kenyans.
This study comprised 1131 persons who constitute a stratified random sample of the entire population aged 15-65 years in Machakos District, Kenya. Each person was examined for tooth mobility, plaque, calculus, gingival bleeding, loss of attachment and pocket depth on the mesial, buccal, distal and lingual surface of each tooth. The oral hygiene was poor with plaque on 75-95% and calculus on 10-85% of the surfaces depending on age. Irrespective of age, pockets greater than or equal to 4 mm was seen on less than 20% of the surfaces, whereas 10-85% of the surfaces had loss of attachment greater than or equal to 1 mm. The proportion of surfaces per individual with loss of attachment greater than or equal to 4 mm or greater than or equal to 7 mm, and pocket depths greater than or equal to 4 mm or greater than or equal to 7 mm, respectively, showed a pronounced skewed distribution, indicating that in each age group, a subfraction of individuals is responsible for a substantial proportion of the total periodontal breakdown. The individual teeth within the dentition also showed a marked variation in the severity of periodontal breakdown. Our findings provide additional evidence that destructive periodontal disease should not be perceived as an inevitable consequence of gingivitis which ultimately leads to considerable tooth loss. A more specific characterization of the features of periodontal breakdown in those individuals who seem particularly susceptible is therefore warranted.
Adolescent↗
Periotest--a dynamic procedure for the diagnosis of the human periodontium.
The Periotest is a new instrument for the diagnosis of periodontal diseases. The Periotest value depends to some extent on tooth mobility, but mainly on the damping characteristics of the periodontium. The Periotest measures the reaction to a reproducible impact applied to the tooth crown.
Humans↗
The Periotest method.
The Periotest is a new instrument for the diagnosis of periodontal diseases. The 'Periotest value' depends to some extent on tooth mobility, but mainly on the damping characteristics of the periodontium. The Periotest measures the reaction to a reproducible impact applied to the tooth crown. The Periotest value is a biophysical parameter.
Electronics, Medical↗
[Changes of vibration frequency due to root resorption of deciduous tooth].
The purpose of this study was to investigate the changes of vibration frequency of a deciduous tooth due to physiological root resorption. The author developed an analysis system for tooth vibration by applying an impact-hammer to the tooth. Peak frequency (Hz) of the tooth stimulated by the impact-hammer was observed by the analysis system. The following results were obtained: 1) Peak frequency of the tooth vibration shifted to a lower range according to the root resorption both in vitro (simulation model) and in vivo (15 children) and a high positive correlation was found between the peak frequency and the crown-root length ratio (r = 0.840). 2) A cause of the frequency shift to the lower range was not related to the tooth weight but to the change of tooth gravity due to the root resorption. 3) It was considered that the vibration analysis system could be useful on measuring tooth mobility in vivo and in clinic as well.
Child↗
Prognosis and actual treatment outcome of periodontally involved teeth.
The purpose of this study was to determine to what extent a given long-term prognosis of a periodontally involved tooth is in agreement with the actual outcome after periodontal therapy. Five hundred and eighty teeth in 24 subjects diagnosed with adult periodontitis and treated 5-13 years ago were evaluated. Subject's age, gender, race, plaque index, gingival index, missing teeth, tooth mobility, probing depth, presence of furcation, alveolar bone level, and frequency of supportive periodontal therapy were recorded. A prognosis was then determined for each tooth and compared to the initial prognosis using the same measures retrieved from the subject's record. Results of the study suggest that (1) it is less common to project accurately the progress of individual teeth when a prognosis is other than good; and (2) it is more difficult to predict correctly the outcome of multirooted teeth than single-rooted ones.
Adult↗
Impact of posterior occlusal support on the condylar position.
The purpose of this study was to investigate condylar displacement related to the loss of posterior occlusal support. Each of 23 subjects received one occlusal adjusted splint that covered all teeth from the right to the left second mandibular molar. None of the subjects had a third molar and none of them had a missing tooth or showed tooth mobility. The splint was inserted and vertical and horizontal condylar position was measured by an ultrasonic motion analyser. The splint was then unilateraly shortened tooth-by-tooth up to the canine tooth and the measurement was repeated after each shortening. Cutting off the splint's second molar on one side lead to a slight ipsilateral cranial motion of the condyle if subjects clenched with maximum voluntary force. If the second and first molar were cut off, a noticeable cranial condylar movement of about 0.3 mm was observed even when teeth occluded with low force. These results suggest that loss of posterior occlusal support as it happens in routine oral rehabilitation leads to a noticeable cranial condyle movement during registration, even if the clenching force is low.
Adult↗
[Prospective study on results of the surgical crown lengthening and its associated factors].
OBJECTIVE: To observe the results of surgical crown lengthening procedure and the factors which affected the success of the surgery. METHODS: Crown lengthening surgery was performed on 27 teeth. The distance between margin of tooth and bone crest (MT-B) was obtained greater than 4 mm during the surgeries on 10 teeth which were considered as satisfying group. The other 17 teeth were as temporized group with MT-B < or = 3 mm. The position of the tooth margin was evaluated before surgery, immediately after suturing, and at 4 - 6 weeks after surgery. The occlusal force and tooth mobility were measured immediately after restoration, at 3 and 6 months after surgery. RESULTS: MT-B was obtained > or = 4 mm and all margins and sites of the teeth were exposed in satisfying group (10/10). At least 1 site with MT-B < 3 mm in temporized group in which there still were 11 sites (16%) in 5 teeth (29%) with subgingival tooth margin at 4 - 6 weeks after surgery. There were more teeth showing increased mobility in temporized group (12/17) than in satisfying group (1/10) after surgery (P < 0.05). The occlusal force of the teeth after surgery and restoration in temporized group was significantly lower than that of their counterpart teeth (P < 0.01), but it was not the case in satisfying group (P > 0.05). CONCLUSIONS: It is suggested that ideal exposure of tooth margin could be obtained if 4 mm from tooth margin to alveolar crest could be created during the crown lengthening surgery. The teeth both with 4 - 5 mm subgingival margin sites and factors limiting surgical performance are not the suitable indications for the surgical crown lengthening.
Alveolectomy↗
Periodontal manifestations of hyperoxaluria and oxalosis.
Dental and periodontal findings associated with primary hyperoxaluria in a 29-year old male patient are described. This is a rare, inherited, metabolic disease which results in excessive calcium oxalate synthesis. The predominant and early manifestation of hyperoxaluria is nephrocalcinosis which results in chronic renal failure. Widespread extrarenal deposits of calcium oxalate crystals, however, is a consistent finding. Extensive infiltration of crystals was noted in the pulps of the teeth, in the marrow spaces of the alveolar bone, in the gingival corium, and in the periodontal ligament. Crystalline calcium oxalate deposits in the periodontal ligament provoked a granulomatous foreign-body reaction. This resulted in aggressive external root resorption leading to pulp exposure and tooth mobility.
Adult↗
The periodontal abscess (I). Clinical and microbiological findings.
BACKGROUND/AIMS: Little information is available regarding the diagnosis and microbiology of periodontal abscesses. The aim of this descriptive clinical and microbiological study was to provide more information in order to help in the characterisation of the periodontal abscess associated to periodontitis. METHOD: 29 consecutive patients with a periodontal abscess were studied by the assessment of clinical variables, including both subjective (pain, edema, redness and swelling) and objective (bleeding on probing, suppuration, probing pocket depth, tooth mobility and cervical lymphadenopathy) parameters. Microbiological samples were taken for anaerobic microbiology and processed by means of culture. Systemic involvement was also studied through the analysis of blood and urine samples using conventional laboratory standards. RESULTS: 62% of the abscesses affected untreated periodontitis patients, and 69% were associated with a molar tooth. More than 75% of the abscesses had moderate-severe scores related to edema, redness and swelling, and 90% of the patients reported pain. Bleeding occurred in all abscesses, while suppuration on sampling was detected in 66%. Mean associated pocket depth was 7.28 mm, and 79% of teeth presented some degree of mobility. Cervical lymphadenopathy was seen in 10% of patients, while elevated leucocyte counts were observed in 31.6%. The absolute number of neutrophils was elevated in 42% of the patients. High prevalences of putative periodontal pathogens were found, including Fusobacterium nucleatum, Peptostreptococcus micros, Porphyromonas gingivalis, Prevotella intermedia and Bacteroides forsythus. CONCLUSIONS: The periodontal abscess has clear clinical characteristics and is usually associated with severe periodontal destruction. This condition may cause systemic involvement and the lesion generally has a large bacterial mass with a high prevalence of well-recognised periodontal pathogens.
Acute Disease↗
Prognosis of permanent teeth with internal resorption: a clinical review.
This study was performed in order to report the clinical features of internal resorption cases and evaluate their prognosis after endodontic treatment. Twenty-seven patients with 28 teeth with internal resorption were referred to our clinic and 20 teeth were treated endodontically. Sixteen teeth had non-perforating internal resorption and were treated by conventional root canal therapy. The remaining 4 teeth had perforating internal resorption and were initially treated by remineralization therapy with calcium hydroxide. The teeth treated by conventional root canal therapy showed clinical and radiographic evidence of healing. However, the remineralization therapy was successful in only one case. The three failed cases were subsequently treated by endodontic surgery. The surgical therapy was unsuccessful in one case due to extensive loss of marginal alveolar bone and increased tooth mobility.
Adolescent↗