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PubMed1995

[Long-term follow-up of tooth transplantation from the functional and periodontal viewpoint].

The outcome of 81 of 99 patients being treated from 1980 to 1993 by transplantation of autologous teeth was investigated. The overall transplant survival rate was 91% after 1 year, 81% after 5 years and 70% after 9 years. The early loss of transplanted teeth was due to healing disorders. The long-term losses were due to caries and replacement resorption. Caries in tooth transplants has to be treated very early, because deep caries or deep drilling leads to an infection of the nutrient canals of the osteodentine. If the pulp chamber of a transplant is once obliterated by osteodentine, endodontic treatment can no longer be performed in many cases. The periodontal condition of the transplants did not differ from that of normal teeth. In 23% there was a decreased tooth mobility, caused by ankylosis of the transplant. 51% of the transplants showed occlusal disturbances but none of the patients had signs of occlusal traumatization of the teeth or of the temporomandibular joint. In comparison to success rates taken from the literature it is pointed out that tooth transplantation has a better long-term prognosis than endodontic treatment. Therefore, in young patients requiring root canal treatment, tooth transplantations should be considered.

Adolescent↗
PubMed1995

Fixed bonded prosthodontics: a 10-year follow-up report. Part I: Analytical overview.

Developments in biomaterials in the field of adhesion have made possible a less invasive dentistry. Improvements in adhesive polymers along with the analysis of certain failures in resin-bonded prostheses have suggested the micropreparation of abutment teeth. A long-term study of resin-bonded prostheses and splints was undertaken. The success rate of this protocol is presented for a study period of 10 years (1984 to 1993). These results indicated that the resin-bonded prosthesis is a viable option in patients who are missing one or two teeth. Of 145 prostheses, 11 failed, resulting in an overall survival rate of 83% (Kaplan-Meier test). Furthermore, the study confirmed that, for splints, preparation is important to counter the major stresses related to tooth mobility in patients with periodontal disease.

Dental Stress Analysis↗
PubMed1997

Attractive magnets for orthodontic extrusion of crown-root fractured teeth.

A subgingival crown-root fracture presents the clinician with a difficult restorative problem, including reaching the fracture line, and is complicated by the need to maintain the periodontal tissues in good health. The treatment options up to now have usually been limited to extrusion of the remaining root with a conventional orthodontic appliance, surgical intraalveolar transplantation of the root or extraction with bridge replacement. In this report, a new method of orthodontic extrusion with attractive magnets is presented. One or two neodymium-iron-boron magnets were attached to the remaining root and a second, larger neodymium-iron-boron magnet was incorporated in a removable appliance. The roots were extruded 2 to 3 mm with a force range from 50 to 240 cN during a treatment period of 9 to 11 weeks. Good force control at short distances, no friction, and no material fatigue of permanent rare earth magnets resulted in successful rapid extrusion. No evidence of soft tissue dehiscences, aberrant tooth mobility, or root resorption was found.

Adolescent↗
PubMed2005

[Usefulness of hydroxyapatite implants for the management of alveolar bone lesions at tooth hemisection sites].

INTRODUCTION: Hemisection is a surgical method for treating lesions of two- and multi-rooted teeth. This procedure includes amputation of one or two lesioned roots together with the attached dental crown, leaving an endodontically treated root and the remaining dental crown prepared for future prosthetic restoration. The results of this study demonstrate that HA Biocer implants create optimal conditions for new bone growth. MATERIAL AND METHODS: The study was done in 51 patients after hemisection treated with HA Biocer in the form of granules implanted into the alveolus. The control group consisted of 45 patients without an alloplastic implant. The following indices were assessed: radiological index of alveolar bone atrophy in the maxilla and mandible according to Engelberger, Marthaler and Rateischak [EMR]; gingival pocket depth with WHO 621 probe; tooth mobility index according to Entin; root denudation index according to Cieszyfiski; bacterial plaque index (P1.1.) according to Silness and Löe. Measurements were done before hemisection and were repeated after 1.5, 6, 12, 24, 36, 48, and 60 months thereafter. It was found that hydroxyapatite implants improved the condition of the hemisected tooth and arrested the destruction process in the alveolar bone. RESULTS: (1) In the study group (HA Biocer), no bone atrophy was noted in the root region after hemisection, whereas bone loss in the control group reached 11%. (2) The depth of gingival pockets in the study group was half of the depth in the control group. (3) Significant tooth stabilization was achieved in the study group, mainly during the first two years after implantation. Improved tooth stability was noted three times less often in the control group during the same period. (4) Root denudation diminished in patients treated with HA Biocer and increased or remained unchanged in controls. (5) A steady decrease in mean P1.1. index values was observed in both groups over the five-year follow-up period. However, the mean P1.1. value in the study group was one-third of the value in the control group.

Adolescent↗
PubMed1992

Oral-dental findings in dyskeratosis congenita.

A 13-yr-old girl with dyskeratosis congenita is presented. Besides oral leukoplakia and nail dystrophies, there was evidence of pancytopenia, growth retardation, alopecia, mental retardation and microcephaly. The oral findings included caries, gingival recession, short-blunted roots, gingival bleeding, tooth mobility and severe alveolar bone loss resembling juvenile periodontitis.

Adolescent↗
PubMed1997

Smoking, smoking cessation, and tooth loss.

Smoking is associated with an increased risk of tooth loss, but it is not known if this risk decreases significantly when individuals quit smoking. The objectives of this study were to describe the rates of tooth loss by smoking status in two populations of medically healthy men and women. Among the men, rates of tooth loss and edentulism in relation to smoking cessation were also evaluated. The subjects were drawn from a group of 584 women (aged 40 to 70) recruited from the Boston, MA, area and a separate population of 1231 male veterans (aged 21 to 75) who participated in the VA Dental Longitudinal Study in Boston. In cross-sectional baseline analyses, current cigarette smokers of either sex had significantly more missing teeth than never-smokers or former smokers. Former smokers and pipe or cigar smokers tended to have an intermediate number of missing teeth. Current male smokers had more teeth with calculus, but the differences in plaque, tooth mobility, probing depth > 2 mm, filled and decayed teeth, and bleeding on probing by smoking history were not significant. Prospective observations of 248 women (mean follow-up time = 6 +/- 2 years) and 977 men (mean = 18 +/- 7 years) indicated that individuals who continued to smoke cigarettes had 2.4-fold (men) to 3.5-fold risk (women) of tooth loss compared with non-smokers. The rates of tooth loss in men were significantly reduced after they quit smoking cigarettes but remained higher than those in non-smokers. Men who smoked cigarettes had a 4.5-fold increase in risk of edentulism, and this risk also decreased upon smoking cessation. These findings indicate that the risk of tooth loss is greater among cigarette smokers than among non-smokers. Smoking cessation significantly benefits an individual's likelihood of tooth retention, but it may take decades for the individual to return to the rate of tooth loss observed in non-smokers.

Adult↗
PubMed2005

The fate of a mid-root fracture: a case report.

The present report describes a case of a mid-root fracture in a maxillary central incisor of a 19-year-old patient. The fractured tooth was splinted with composite that was removed only 3 years later, as the patient did not appear for follow-up examinations. At this time, the radiographs revealed a normal periodontal ligament, rounding of the borders of the fragments and pulp obliteration of both fragments. Eight years later, the tooth was clinically normal and blurred calcification of the root canal was disclosed radiographically. After 13.5 years the patient complained of tooth mobility and radiographic examination revealed an advanced cervical root resorption. As no conservative approach was possible at this stage, the patient was referred to a prosthodontist for esthetic rehabilitation.

Adult↗
PubMed1988

Longitudinal radiographic analysis of carious lesion progression.

Information on the rate at which carious lesions progress through the enamel of human teeth in an adult population was obtained from dental radiographs taken at 3-yr intervals, over a 10-yr period on 602 men. Clinical measures of calculus deposition, plaque accumulation, gingival inflammation, tooth mobility, periodontal pocket depth, and gingival recession were studied to find predictors that might be of value to the clinician for determining how frequently radiographs should be taken. We estimate that 50% of the enamel lesions on mesial and distal surfaces, if left untreated, would not progress into the dentin until 73 months had elapsed after the lesion was initiated. Significant differences in the progression rate were associated with the arch and tooth type. Patient age, number of decayed or filled surfaces, degree of gingival inflammation, amount of recession, and plaque accumulation were positively associated with more rapid caries progression, while greater numbers of teeth present were predictive of slower disease progression.

Adult↗
PubMed1984

The effect of orthodontic extrusion on traumatically intruded teeth.

The management of traumatically intruded permanent incisors is controversial. Some authors suggest a decreased incidence of ankylosis in cases treated with orthodontic extrusion. The purpose of this study was to examine two common management techniques for traumatic intrusion, orthodontic extrusion, and observation for re-eruption. The four first premolars of three shepherd dogs were traumatically intruded with a mallet while a holding device was used to prevent tooth fracture. Five to 7 days following the injury, orthodontic force was applied unilaterally while the contralateral tooth served as the untreated control. To facilitate serial periapical radiography, x-ray jigs were fabricated for each animal and tantalum implants were placed in the bone distal to the permanent canine and first and second premolars. Observations included radiographic measurement of tooth movement, clinical estimates of tooth mobility, and radiographic and histologic assessment of root resorption, ankylosis, and periapical pathosis. The amount of traumatic intrusion varied from less than 0.5 to 4.1 mm. Following 11 to 13 weeks of force activation, 10 of 12 traumatized teeth showed clinical, radiographic, and histologic evidence of ankylosis irrespective of orthodontic treatment. Whereas the ankylosed teeth did not move with orthodontic forces, the teeth used for force application were orthodontically intruded 1.7 to 6.5 mm. When the injury to the tooth was severe, orthodontic extrusion had little effect on repositioning of the injured tooth but resulted in undesirable movement of the anchorage teeth. When the injury was less severe, orthodontic forces facilitated repositioning of the affected tooth.

Animals↗
PubMed1998

[Preliminary study on HA-coated titanium implants used as anchorage for protraction of dog molar teeth].

HA-coated titanium implants were placed surgically into dog mandible to protract the mandibular second molars with an orthodontic force of 150 g. During the force application period of 3 months, the movement of the molars was tested periodically and relevant reasons of movement were analysed. The results showed that the mesial moving distances of the second molar were respectively 1.04 mm, 1.68 mm and 1.76 mm at the first, second and third month, and the main reason of tooth mobility was ascribed to the implant anchorage. It can be concluded tiat HA-coated titanium implant can be used as anchorage for moving and fixing posterior teeth in the orthodontic treatment.

Animals↗
PubMed1998

Transplantation of displaced and dilacerated anterior teeth.

The therapy of dilacerated permanent anterior teeth usually involves surgically removing the tooth. Subsequently, orthodontic methods for closing the space or keeping it open are preferred until the patient reaches an age when definitive implantological or prosthetic treatments may be used. Anterior tooth transplantation should be considered as an alternative to surgically extracting the tooth. This study describes a period of investigation covering 3 years during which neither replacement resorption nor inflammatory resorption was diagnosed in the five transplanted teeth. The clinical tooth mobility was similar to that of the adjacent teeth. In spite of the vertical loss of bone shown radiographically no pathologically enlarged pockets or recessions have been found. It is not yet possible to make any comments on the prognosis for the long term.

Apicoectomy↗
PubMed2001

Severe dental open bite malocclusion with tongue reduction after orthodontic treatment.

We treated a 21-year-old woman with a severe open bite and macroglossia with a standard edgewise appliance and without partial glossectomy. This was followed by retention using a Begg-type plate retainer for the upper dental arch and a fixed canine-to-canine for the lower arch. A crib was added to the upper plate retainer for suppression of a tongue thrust. The lower arch relapsed during the retention period, with a widening of the intermolar distance, flaring of the anterior teeth, and increased mobility of the teeth. We chose tongue reduction to resolve these problems and one-third of the middle dorsal part of the tongue was excised. After the tongue reduction, the patient experienced no functional problem in mastication, swallowing, and gustation, but she complained of mild speech difficulty and slight pain on the dorsal portion of her tongue. These symptoms disappeared 6 months after surgery. At this time, the mandibular dental arch was markedly improved. The flared lower dental arch had returned to an upright position and the tooth mobility reduced to normal. No appliance was used after surgery. Most of the recovery changes occurred within 4 months. This case highlights the importance of the teeth tending to move toward a balance between the tongue pressure from the inside and labio-buccal pressure from the outside.

Adult↗
PubMedDate not supplied

Aneurysmal bone cyst of the maxilla--an association with tooth resorption.

The aneurysmal bone cyst is an uncommon lesion of the jaws. Cases involving the maxilla have been reported infrequently. Despite uncertainty as to the aetiology of the aneurysmal bone cyst, it is regarded as a benign lesion. Conservative surgical treatment with regular postoperative follow-up is recommended. The case described here presented with tooth mobility resulting from extensive root resorption. A review of the literature reveals that significant root resorption is not a commonly reported feature of aneurysmal bone cysts. For the present case we interpret the evidence as supporting a diagnosis of idiopathic root resorption complicated by the formation of a aneurysmal bone cyst.

Adult↗
PubMed1985

Triangular-shaped radiolucent area between roots of the mandibular right canine and first premolar.

The squamous odontogenic tumor is a rare odontogenic neoplasm occurring primarily in the anterior maxilla and posterior mandible. The clinical presentation is that of tooth mobility with a semicircular or triangular, well-defined radiolucent area. Histologic features include dense fibrous connective stroma with scattered islands of bland epithelium exhibiting no ameloblastomatous features. Conservative surgical treatment in most cases is sufficient; however, lesions in the maxilla may require more extensive surgical procedures to ensure resolution.

Adult↗
PubMed1987

Mandibular dysfunction and periodontitis. A comparative study of patients with periodontal disease and occlusal parafunctions.

Fifty-one patients (mean age, 47.3 years) with moderate to severe periodontal disease and 40 patients (mean age, 48.9 years) with symptoms related to bruxism (occlusal parafunctions such as grinding and/or clenching of the teeth) were compared with regard to periodontal conditions and signs and symptoms of mandibular dysfunction. The bruxists reported more symptoms of pain and dysfunction of the masticatory system than the periodontal patients. The clinical dysfunction index was significantly higher among the bruxists, while there was a similarity between the groups in the variation of occlusal conditions, except for occlusal wear, which was more pronounced in the bruxist group. Attrition was in general positively correlated to alveolar bone height. This correlation was stronger (and statistically significant) for the canines than for other teeth. Attrition was negatively correlated to tooth mobility. It is concluded that patients with moderate to severe periodontal disease and patients with bruxism/occlusal parafunctions are distinctly different with regard to signs and symptoms of mandibular dysfunction. The results support the opinions that there is no or only weak correlation between periodontal disease and bruxism, and between bruxism and occlusal status.

Adult↗
PubMed1992

Two critical confounding factors in periodontal epidemiology.

The prevalence and severity of periodontitis is considerably lower than was previously estimated. The available epidemiological methods are based on the premise that loss of periodontal attachment is a unique sign of periodontitis. However, additional factors resulting in loss of periodontal attachment confound data obtained from modern studies. The physiological process of continuous tooth eruption results in loss of periodontal attachment over a lifetime, at an approximate rate of 0.1 mm/year. Anthropological and clinical evidence for continuous tooth eruption is reviewed. The position of the alveolar crest appears to be stable; loss of periodontal attachment occurs as the teeth erupt and less of the root is embedded in bone. Retrograde periodontitis caused by pulpal disease is a known cause of severe, localised destruction of periodontal tissues. Its signs and symptoms include periodontal pocket formation, purulent inflammatory exudates, angular bone loss, swelling and bleeding of the gingival tissues and increased tooth mobility. Anthropological, experimental and clinical evidence for retrograde periodontitis is discussed. Misdiagnosis of angular (hemiseptal), furcal and other forms of localised periodontal damage as periodontitis has probably resulted because of the inability to determine the quality of pulpal health and the assumption of a gingivitis-periodontitis continuum. New epidemiological methods need to be developed in which physiological and all pathological conditions which affect the periodontal attachment are recognised and appropriately categorised.

Confounding Factors, Epidemiologic↗
PubMed1998

Association of occlusal, periodontal, and dietary factors with the presence of non-carious cervical dental lesions.

PURPOSE: To investigate in vivo the relationship of occlusal stress factors, periodontal health status, and acidic dietary patterns to the presence of non-carious cervical lesions (NCCL) in a convenience sample of undergraduate clinic, adult dental patients. MATERIALS AND METHODS: Forty three subjects who met the entry criteria were admitted into the study; 178 teeth exhibiting NCCL were evaluated. A dietary assessment focusing on acidic food/beverage intake was used to evaluate nutritional intake over the most recent 24-hour period. Periodontal evaluation included intraoral measurement of gingival attachment loss, assessment of tooth mobility, and radiographic interpretation of percent bone loss using the Schei ruler method. Among the occlusal factors evaluated were shape and orientation of NCCL, presence and location of wear facets, and symptoms and characteristics of centric and eccentric occlusal function. RESULTS: 95% of teeth examined exhibited functional wear facets, indicating a systematic relationship with presence of NCCL (Chi Square = 16.9, P < 0.0001); 48% displayed buccal or incisal facets; 64% were accompanied by balancing interferences in lateral excursion; 98.3% had mobility scores < or = 1; there was no significant association between mobility and facets present (Chi Square = 3.04, P = 0.21); and, no relationship with dietary patterns was found. Group function, that may evolve with age, and/or traumatic occlusion factors may be related to etiology of NCCL. Longitudinal controlled clinical trials are needed to confirm suspected etiologies and establish treatment guidelines for non-carious cervical lesions.

Adult↗
PubMedDate not supplied

Indirect pulp treatment: in vivo outcomes of an adhesive resin system vs calcium hydroxide for protection of the dentin-pulp complex.

PURPOSE: The purpose of this prospective and randomized in vivo study was to compare the clinical and radiographic outcomes of an adhesive resin system vs a calcium hydroxide liner for protection of the dentin-pulp complex of primary molars treated with indirect pulp treatment. METHODS: Forty-eight primary molars with deep occlusal caries, but without preoperative signs and symptoms of irreversible pulpitis, received indirect pulp treatment and were restored with a composite resin (Z100). The teeth were randomly divided into 2 groups according to the material used for protection of the dentin-pulp complex: (1) adhesive resin system (Scotchbond MultiPurpose); and (2) calcium hydroxide liner (Dycal). These teeth were evaluated clinically and radiographicaly for 2 years. RESULTS: After 2 years, 83% (19/23) of the teeth treated with calcium hydroxide and 96% (24/25) of teeth treated with only the adhesive resin system presented a successful outcome, as determined by clinical and radiographic examination. Interradicular and/or periapical lesions were the most predominant signs of treatment failure, since 3 out of 23 teeth treated with calcium hydroxide and 1 out of 25 teeth treated with only adhesive resin presented this outcome. One tooth treated with the calcium hydroxide liner was diagnosed with internal root resorption at the 18-month examination. Of the 5 teeth diagnosed from radiographs as a failure of the indirect pulp treatment, none presented clinical signs/symptoms of pulpitis or necrosis such as the presence of fistula, enhanced tooth mobility, or pain. CONCLUSIONS: This study demonstrates that protection of the dentin-pulp complex of primary molars with an adhesive resin system results in similar clinical and radiographic 2-year outcomes as compared to calcium hydroxide when indirect pulp treatment is performed in Class I composite restorations.

Calcium Hydroxide↗