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PubMed1986

Longitudinal observation of "unattached," mobile gingival areas.

Facial gingival surfaces over cuspids and bicuspids in 20 patients were monitored for 5 years to evaluate the importance of attached gingiva in the maintenance of a stable periodontium. 43 surfaces "at risk" were compared to 36 "non-risk" surfaces within these patients. Surfaces "at risk" had to meet the following 3 criteria as established by both of 2 independent examiners: width of keratinized gingiva less than or equal to 1.0 mm; absence of attached gingiva; mobility of the gingival margin. During the 5 years of observation, "non-risk" surfaces showed a trend toward decrease in mean width of keratinized gingiva, while this measurement remained unchanged for the surfaces "at risk" Probing depths remained unaltered for both groups. A trend toward gingival recession and loss of probing attachment was observed for both "risk" and "non-risk" surfaces. Thus, this study failed to demonstrate that "unattached" and mobile facial gingival surfaces are more susceptible to periodontal breakdown than "attached" surfaces.

Adult↗
PubMed1996

Effect of local application of delmopinol hydrochloride on developing and early established supragingival plaque in humans.

The aim of the study was to investigate the effect of delmopinol hydrochloride on the development of dental plaque and on newly established plaque. In addition, the influence of this compound on the composition of the microbiota colonizing the gingival mucous membrane was studied. 14 healthy male volunteers took part. After a 3 week pre-experimental period of intense oral hygiene, the participants refrained from all oral hygiene for 14 days. The buccal surfaces of cuspids and bicuspids on one side of the jaws were treated with a 1% aqueous solution of delmopinol hydrochloride (applied with a paint brush) 2 x a day for 7 days, while the contralateral side received placebo solution. On day 7, the application procedures were changed in that the test compound was applied on the teeth previously treated with placebo and vice versa. Plaque development was assessed clinically and by photo-based planimetric determination. The clinical recordings revealed that 89.3% of the placebo-treated surfaces displayed visible plaque on day 7, compared to 6.0% of the delmopinol hydrochloride treated surfaces. Delmopinol hydrochloride treatment of the previously placebo-treated surfaces resulted in a decrease in the number of surfaces with visible plaque from 89.3% on day 7 to 6% on day 14. These results were confirmed by the planimetric data. No significant change in the composition of the mucosal flora was observed during the experimental period. The present results indicate that delmopinol hydrochloride markedly reduces the formation of dental plaque on a clean tooth surface exposed to conditions which favour bacterial colonization. Furthermore, the substance appears to possess plaque-dissolving properties.

Administration, Topical↗
PubMed1997

Guidelines for the design and conduct of clinical trials on dentine hypersensitivity.

Clinical trials on dentine hypersensitivity have been numerous and protocols varied. To date there is little consensus as to the conduct of studies on this poorly-understood yet common and painful dental condition. A committee of interested persons from academia and industry was convened to discuss the subject of clinical trials on dentine hypersensitivity and a consensus report is presented. A double-blind randomized parallel groups design is recommended, although cross-over designs may be used for the preliminary screening of agents. Subjects may have multiple sites scored. Sample size will be determined by estimating the variability in the study population, the effect to be detected and the power of the statistical test to be used. Subject selection is based on a clinical diagnosis of dentine hypersensitivity, excluding those with conflicting characteristics such as currently-active medical or dental therapy. The vestibular surfaces of incisors, cuspids and bicuspids are preferred as sites to be tested. A range of sensitivity levels should be included. Tactile, cold and evaporative air stimuli should be applied. Negative and benchmark controls should be incorporated. Most trials should last 8 weeks. Sensitivity may be assessed either in terms of the stimulus intensity required to evoke pain or the subjective evaluation of pain produced by a stimulus using a visual analog or other appropriate scale. The subject's overall assessment may be determined by questionnaire. Outcomes should be expressed in terms of clinically significant changes in symptoms. Follow-up evaluation is required to determine the persistence of changes. At least 2 independent trials should be conducted before a product receives approval.

Air↗
PubMed1997

Effect of exposure time on in vitro caries diagnosis using the Digora system.

The aim of this study was to determine the in vitro diagnostic performance for approximal caries and occlusal dentine caries diagnosis of the Digora system for digital radiography in relation to the exposure time. Radiographs were made of 220 extracted human posterior teeth and cuspids at exposure time levels of 3%, 6%, 10%, 20%, and 78% of the exposure time needed for E-speed film (image sets I, II, III, IV, and V, respectively). The image sets were put in random order (III, I, IV, II, V) and assessed independently by 3 observers using a 5-point confidence scale. True caries status was determined histologically after sectioning of the teeth. Evaluated parameters were: interexaminer kappa, sensitivity, specificity, Dz3/4 (the distance of one operating point to the diagonal in the ROC domain) and area under the ROC curve. The Spearman correlation coefficients between the parameters and both exposure time and order of viewing of the sets were calculated. For approximal surfaces, the ranges of mean parameter values were: sensitivity 26-33%, specificity 93-95%, Dz3/4 0.63-0.84, area 0.61-0.69. For occlusal surfaces, the ranges were: sensitivity 52-60%, specificity 91-95%, Dz3/4 1.03-1.34, area 0.79-0.87. Out of 24 pairwise comparisons between sets V and I, 5 were significant. Out of 24 comparisons between set V and II, only 2 were significant. It was concluded that diagnostic performance is unlikely to be impaired for an exposure time as short as 6% of E-speed film exposure. When reducing the exposure time to 3% of E-speed film exposure, caries diagnosis may be impaired.

Bicuspid↗
PubMed2001

Apical sealing ability of five endodontic sealers.

Because apical leakage may be a cause of failure of endodontic treatment, the purpose of this study was to compare the apical seal provided by five endodontic sealers. After cleaning and shaping procedures, the root canals of 75 human cuspids were obturated by lateral condensation using gutta-percha and the following sealers: Kerr Pulp Canal Sealer EWT, Grossman's sealer, ThermaSeal, Sealer 26, and AH Plus. These root-filled teeth were then maintained at 37 degrees C and 100% humidity for two days. After immersion in a solution containing black India ink and fetal bovine serum for five days, the teeth were demineralised and rendered transparent. The extent of dye penetration was examined under a stereomicroscope. The results showed that Grossman's sealer exhibited significantly more leakage than the other sealers, except ThermaSeal. There was no significant difference between ThermaSeal and AH Plus. No significant differences were observed for Kerr Pulp Canal Sealer EWT when compared with either ThermaSeal or AH Plus. There was significantly less leakage for Sealer 26 when compared with the other sealers tested, except AH Plus.

Bismuth↗
PubMed1964

CALCIFICATION OF DECIDUOUS TEETH IN RHESUS MONKEYS.

The rhesus monkey probably has the same sequence of calcification of deciduous teeth as man: central incisor, first molar, lateral incisor, cuspid, and second molar. Initial calcification of the deciduous molar cusps is somewhat similar to that of man.

Animals↗
PubMed1990

Mineral density and mineral loss after demineralization at various locations in human root dentine. A longitudinal microradiographic study.

From intact roots of human cuspids 83 dentine specimens were cut. The specimens with known location and thickness were embedded in a holder of polymethyl methacrylate and microradiographic images were made. From the longitudinal microradiography (LMR) measurements the average mineral density (kg/m3) of the sound human dentine specimens was calculated. All specimens were subsequently demineralized using a constant composition method in a solution containing 3 mM CaCl2.2H2O, 3 mM KH2PO4, 50 mM CH3COOH and 0.2 ppm fluoride as NaF at pH = 5 for 24 h. After demineralization the LMR measurements were repeated to calculate the amount of mineral lost. The data show that there is no correlation between: (1) the location of a dentine specimen in the root and the mineral density of sound human dentine, (2) the location of a dentine specimen in the root and the degree of demineralization after 24 h and (3) the mineral density of sound human dentine and the demineralization degree. This information is useful for future in vitro and in vivo studies on human roots.

Analysis of Variance↗
PubMed1977

Effect of interdental flossing on the incidence of proximal caries in children.

A clinical study was designed to evaluate the effect of frequent interdental flossing on the incidence of proximal dental caries. School children from a fluoride-deficient area were studied after clinical and radiographic examinations. Each child had at least one contralateral pair of intact, contacting proximal tooth surfaces between the distal surface of the primary cuspid and the mesial surface of the first permanent molar. Randomly selected test surfaces were flossed each school day with unwaxed dental floss by researchers. The contralateral surfaces served as controls. Flossing was done for eight months, discontinued for four months, and reinstituted for another eight months. A significant reduction in the incidence of proximal caries resulted.

Child↗
PubMed2005

Transmigration of a maxillary canine. A case report.

In the oral cavity, transmigration is defined as a tooth that crosses the mid-line by more than half its length. Following extensive literature review, it was found that, although well documented with respect to mandibular canines, there were only two publications detailing maxillary cuspid transmigration. This report presents a case of transmigration where the left maxillary canine gradually crossed the mid-line and migrated to the right side in a patient with hemifacial microsomia and cleft palate. The Mupparapu classification of the migratory pattern of the mandibular canines is discussed. Various clinical considerations, as well as guidelines for general practitioners to diagnose and manage such a condition, are also discussed.

Child↗
PubMed2001

The relationship between occlusal factors and bruxism in permanent and mixed dentition in Turkish children.

The aim of this study was to investigate the relationship between occlusal factors (overjet, overbite, Angle's Classification of molars and cuspids, the relationship of the primary molars, openbite, lateral openbite, scissorbite and crossbite) and bruxism in permanent and mixed dentition in Turkish children. For this reason 182 children with mixed dentition and 212 children with permanent dentition were included in this study. Occlusal conditions were examined clinically and bruxism was assessed by using interview and questionnaires. Z Test was used to compare the results. It was found that in both dentitions some occlusal factors related with bruxism (overjet > 6 mm, overbite > 5 mm, negative overjet, openbite in permanent dentition; overjet > 6 mm, overbite > 5 mm, scissorbite, anterior-posterior multiple teeth crossbite, Angle Class I occlusion in mixed dentition.

Adolescent↗
PubMed1978

The temperature of the gingival sulci.

The interproximal sulcular temperatures of the central, cuspid and the first molar regions of both jaws of 28 adults were recorded with a thermistor probe. The mean sulcular temperatures were 1.80 to 2.90 degrees C lower than the mean sublingual temperature. In both jaws the lowest temperature was recorded in the anterior region and the highest in the molar region. The temperature increased from the anterior to the posterior region on both buccal and lingual sides of both arches. The sulcular temperatures of the lower arches were higher than those of the upper arches. Further, analyses of the data of each individual subject showed interesting differences between the male and the female subjects. This work suggests that studies on dental plaque and on the growth and metabolism of microorganisms of the gingival sulci should consider the lower temperature of the gingival sulci and the regional temperature differences within the oral cavity.

Adult↗
PubMed1988

Detection and distribution of Actinobacillus actinomycetemcomitans in the primary dentition.

The occurrence of actinobacillus actinomycetemcomitans (A.a.) in plaque samples from the primary dentition was studied in 55 healthy Finnish children from four to seven years of age. A.a. was isolated in seven (13%) children, four boys and three girls. A further examination of the distribution and infection level of A.a. in the oral cavity of five of the A.a.-positive children revealed that A.a. was found in 26 of 45 plaque samples (7-10 samples from each child) and in all samples obtained from the dorsum of the tongue. The individual detection rates of A.a. were 3/7, 5/10, 6/10, 6/10 and 6/8 of the dental sites examined. A.a. occurred in 9/10 of the second primary molars, 8/10 of the first primary molars, 5/10 of the cuspids, 4/8 of the upper incisors and in none of the lower incisors examined. The proportions of A.a. within the dentition had a wide range. In 58% of the A.a.-positive samples, the proportions were less than 1%, and none exceeded 10% of the flora. Gingival bleeding after sampling with floss occurred more than twice as frequently in the A.a.-positive as in the A.a.-negative sites (16%/42%). The results indicate that A.a. was a rather frequent member of the oral flora in the children with primary teeth. The primary molars and the dorsum of the tongue seemed to be preferred sites for A.a. More than one site should be sampled to determine the infection level of A.a. within the dentition.

Actinobacillus↗
PubMed1990

The retrocuspid papilla of the mandibular lingual gingiva.

The retrocuspid papilla (RCP) is a circumscribed nodule that lies lingual to the mandibular cuspid on the gingival tissue. RCP is observed more frequently in young children and seems to regress or disappear with age. Little information is available in the literature on this entity and there are contradictory reports regarding its histologic features. Histomorphologic analysis of 30 specimens diagnosed as RCP revealed that in most cases (80%) it is composed of loosely-arranged delicate fibrous connective tissue with stellate and multinucleated fibroblasts. Elongation of the rete ridges and/or increased vascularity are also present in a significant number of cases. Stellate and multinucleated fibroblasts are not unique to RCP and they have been described as prominent histologic features in other lesions of skin and mucous membrane. RCP is considered to be a "normal anatomical structure" or an "anatomic variation" of the gingiva. The clinical significance of RCP is that it may simulate pathological gingival conditions from which it must be differentiated.

Adolescent↗
PubMed1997

Blur reduction of conventional film-based tomograms for pre-surgical evaluation of potential mandibular implant sites.

The usefulness of motion-based cross-sectional tomography to evaluate osseous support and adjacent anatomical structures for dental implant placement is limited by the inherent blurring in these images. The goal of this study was to develop a method to remove blurring while permitting accurate dimensional analysis of the potential implant site. Defined regions (anterior, cuspid, premolar, molar) on two preserved human mandibles were imaged using cross-sectional linear tomography. Algorithms were developed as a personal computer application to remove the blur and to aid in identification of the cortical plate borders and the mandibular canal. The data set of eight tomograms was digitized and the blur reduced with the developed algorithm. An operator measured the height and width of the mandible on each original tomogram and each deblurred tomogram in triplicate. Method error was calculated as the difference between direct caliper measurements of the respective skull regions and image measurements of height and width for both the original digitized tomograms and the deblurred tomograms. Method error using the original images (height: -2.72 +/- 2.15 mm; width: -0.58 +/- 1.36 mm) compared to the deblurred tomograms (height: -0.58 +/- 1.16 mm; width: 0.37 +/- 0.59 mm) was significantly greater for both height (t-test level of significance, P = 0.0047) and width (t-test level of significance, P = 0.0001). These findings suggest that the method developed may greatly improve the ability of clinicians to accurately assess the implant site using cross-sectional film-based linear tomograms.

Algorithms↗
PubMed2000

Coronally positioned flap procedures with or without a bioabsorbable membrane in the treatment of human gingival recession.

BACKGROUND: A variety of surgical techniques have been used to cover recession type defects. New data have indicated that the outcome of coronally positioned flap procedures may be augmented by supporting the flap with a membrane. METHODS: The present study aimed at comparing the clinical outcome following treatment of localized gingival recessions by a coronally positioned flap procedure alone, or combined with a bioabsorbable membrane. Twenty patients with buccal bilateral Miller Class I or Class II gingival recessions in cuspids or premolars participated in the study. The split-mouth design, randomized selection of site treatment, and blind evaluation provided 20 sites in a membrane group and 20 sites in a non-membrane group for examination at baseline, and at 3 months and 6 months postoperatively. Clinical variables included the apical extent of the gingival recession, the width of the recession defect measured at the cemento-enamel junction (CEJ), and the width of keratinized tissue at the recession site as well as probing depth and attachment level. RESULTS: Both treatments resulted in a significant gain (P <0.0001) of root coverage, amounting to an average of 2.3 mm in the membrane group and 2.5 mm in the non-membrane group at the 6-month evaluation. There was no significant difference between the treatments. Similarly, a significant gain of clinical attachment level was seen in the membrane (1.3 mm; P <0.001) as well as in the non-membrane (1.5 mm; P <0.0001) group, but without a significant difference between the groups. The reduction of the recession width from baseline to 6 months was significantly greater (P <0.01) for the non-membrane (2.3 mm) than for the membrane (1.4 mm) group. Probing depth changes were small and not significant for either of the treatments. When patients were grouped as smokers (8) and non-smokers (12), no significant differences were revealed for any of the response variables. Overall, among the 20 membrane sites, one showed no change while the remaining 19 gained root coverage at the 6-month examination. Five sites obtained coverage to the CEJ. Among the non-membrane sites, all gained root coverage at 6 months and 10 sites showed complete coverage to the CEJ. CONCLUSIONS: The coronally positioned flap operation offers a predictable, simple, and convenient approach as a root coverage procedure in Miller Class I and Class II recession defects. Combining this technique with the placement of a bioabsorbable membrane does not seem to improve the results following surgical treatment of such defects.

Absorbable Implants↗
PubMed2005

Root curvature: differences among dental morphotypes and modifications after mechanical instrumentation.

BACKGROUND: This study was designed to describe a method for measuring root curvature of extracted teeth, compare root curvature of four different dental morphotypes before mechanical instrumentation, and measure root curvature after mechanical instrumentation. METHODS: Fifty-five maxillary (14 central incisors, 13 lateral incisors, 14 cuspids, 14 premolars) extracted teeth were analyzed. Measurements were recorded on the horizontal plane at the most apical point of the cemento-enamel junction (CEJ). A 4 mm wide root portion on the buccal aspect was selected and recorded on this plane. A digital scanner traced the circle coinciding with the profile of this root portion and calculated its radius, arc, chord, and arrow (i.e., the perpendicular bisector of the chord). Since root curvature is the inverse of the radius (1/r), the radius was related to root curvature; the arc to the mesio-distal dimension of the root portion; and the reduction of the arrow to root flattening after mechanical instrumentation. The measurements were recorded four times: before treatment (baseline), after polishing, after a first root planing, and after a second root planing. The radii of each dental morphotype (upper central incisors, upper lateral incisors, upper canines, upper premolars) recorded in the first measurement were calculated and used for the statistical analyses: one-way analysis of variance (ANOVA) test and the Tukey multiple comparison method were used to study the curvature. The measurements of the radius, the arc, and the arrow at the four times were used for the statistical analyses: the two-way ANOVA test and the Tukey multiple comparison method were applied in the study of the root modifications after mechanical instrumentation. The accuracy and reliability of the method were also evaluated. RESULTS: The mean radii of the four dental morphotypes were: central incisors: 3.613 +/- 0.258 mm; lateral incisors: 2.558 +/- 0.256 mm; canines: 2.822 +/- 0.238 mm; and premolars: 2.321 +/- 0.179 mm. The statistical analyses revealed differences among central incisors, canines, lateral incisors, and premolars. There was no statistically significant difference between lateral incisors and premolars. Regarding the root modifications after mechanical treatment, the radius did not show statistically significant differences in any of the comparisons. The arc and the arrow did not show significant differences between baseline and polishing, while they did show significant differences after the second root planing. CONCLUSIONS: This study indicates that: 1) the method of measuring is accurate and reliable; 2) there are statistically significant differences among the root curvatures of different dental morphotypes; and 3) polishing did not modify the root. A vigorous root planing did not modify root curvature, but it did reduce the mesio-distal dimension and flatten the root surface slightly.

Analysis of Variance↗
PubMed1990

In vitro fluoride uptake by enamel and dentin. A comparative study of two varnishes.

The uptake of fluoride in enamel and dentin after application of an experimental fluoride varnish has been studied and compared with the uptake from a commercially available varnish (Duraphat). Each varnish was applied to 10 extracted human cuspid teeth. Successive etchings with perchloric acid were carried out separately in enamel and root dentin to obtain samples at three different depths. The concentrations of fluoride and calcium in the samples were determined, and the fluoride uptake was calculated. The experimental varnish gave a significantly greater fluoride uptake at all three sample depths in both enamel and dentin.

Cuspid↗
PubMed1995

A 2-year follow-up study of incisal tooth wear in dental students.

This report was derived from cross-sectional and longitudinal analyses of prevalence, pattern, and severity of incisal wear in 64 dental students who had virtually complete dentitions at the first examination and unchanged dentitions at the re-examination. They were first examined in 1991 and re-examined after 24 months in 1993. The average age of the students in 1991 was 23 +/- 1.7 years. Assessment of incisal wear was made on stone casts based on silicone impression material in accordance with the Incisal wear Index (IwI). The results showed that the prevalence of incisal wear had not changed during the observation period. The severity of incisal wear for maxillary and mandibular central and lateral incisors had remained essentially the same, whereas the severity of wear of maxillary and mandibular canines had increased during the observation period. There was no statistically significant relationship between age and IwI. The wear pattern found for anterior teeth is discussed in relation to the cuspid protection and the group function theories of occlusion.

Adult↗