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A restorative solution is presented for dealing with two crowded root form implants. When crowding is unavoidable as a result of tipped teeth adjacent to an edentulous space, minor modifications in sequence and technique permit an otherwise dormant implant to be utilized.
Forty-eight per cent of patients with clinical involvement of the lower alveolus by an intraoral squamous carcinoma showed radiological evidence of bone involvement. This was usually an irregular invasive bone defect, but a smooth pressure erosion is also common. 'Floating teeth', displaced bony fragments, pathological fractures, and rarely an expanded inferior canal are less common radiological signs.
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Lateral displacement of the mandible was induced experimentally in five adult male Rhesus monkeys. Following from 2 1/2 weeks to 19 months, the animals were sacrificed and examined histologically. Two of the monkeys received H3 proline 4 months prior to sacrifice and radioautographs were prepared. The lateral displacement apparently caused great discomfort because the monkeys refused to eat and lost weight rapidly for a few months. After about 12 months, the monkeys could again eat their normal diet to the extent they started to gain weight slowly. The histological and radio-autographic findings indicated almost no changes of the articular surfaces of the temporomandibular joints. However, extensive reorganization of the neck of the condyles was observed. Severe periodontal trauma and extensive movements of the teeth occurred in spite of the fact that the teeth in each jaw were splinted firmly together.
Reinclusion of permanent molars was found in 55 individuals from 9 families. Inheritance is clearly autosomal dominant with complete penetrance. The provisional assignment of its gene locus to the same linkage group as the gene locus of blood group P (Bosker & Nijenhuis 1975) could not be confirmed.
A series of destructive changes occurring in the jaws of patients wearing a complete maxillary denture opposed by a mandibular distal extension removable partial denture have been described as the combination syndrome. However, the syndrome does not occur in all patients. Those patients who have not developed signs of the combination syndrome and whose mandibular anterior teeth are well preserved and not overerupted may be treated conservatively with a mandibular removable partial denture. A properly designed removable partial denture that distributes occlusal stresses over hard and soft tissues minimizes the risk of developing the combination syndrome. Nevertheless, the overdenture seems to provide a more predictable prognosis, especially for patients who already have the combination syndrome or whose mandibular anterior teeth are structurally or periodontally compromised or overerupted. The treatment modality is determined by the apparent potential of the patient to develop the combination syndrome and by the condition of the remaining mandibular anterior teeth.
When restoring partially edentulous arches with implants, there are some practitioners who believe it is occasionally beneficial to connect implants to natural teeth. This connection is performed to gain shared support from the natural tooth and implant, prevent rotation of the restoration, or sometimes merely to retain the natural tooth. A discussion and review of the literature concerning this connection is presented, and a patient treatment is shown to illustrate potential complications.
This article reviews the literature dealing with the combination implant-to-natural-tooth-supported fixed partial denture. The restoration of masticatory function with a combination implant-to-natural-tooth fixed partial denture is associated with a variety of undesirable clinical sequelae, including the breakage of implant components, damage to the abutment teeth, or intrusion of the abutment teeth. Theories regarding intrusion of abutment teeth combined with implants for fixed partial dentures are only speculative. Several theories are presented to explain the intrusion of natural teeth in association with implant-to-natural-tooth fixed partial dentures. One of the first theories was based on the idea that a lack of normal stimulation of the periodontal ligament produces atrophy of the periodontal ligament and intrusion of the tooth. The remaining theories relate to excessive forces being placed on the natural tooth, resulting in movement of the tooth to a less stressful position. These forces are placed on the tooth by differential energy dissipation, mandibular flexion and torsion, flexion of the fixed partial denture framework, impaired rebound memory, debris impaction or microjamming, or ratchet effect related to the use of precision attachments. Based a review of the literature, a philosophy for treating combination implant-to-natural-tooth restorations is presented.
Anterior teeth within the human dentition have a specific numerical rotation value. Bite marks show an array of angled indentations, abrasions, microlacerations, and contusions. These marks generally represent the incisal surfaces of the suspect's dentition reflecting the rotation values of the teeth in the dental arch. This study described a method for capturing and analyzing anterior dental rotations. The rotations of individual anterior teeth within the study population were categorized as common, uncommon, and very uncommon according to Allen's classification. In the absence of a large number of incisal patterns present in a bite mark, a single but heavily weighted tooth rotation could be of equal discriminatory potential to several common rotation values. No prevalence studies quantifying individual tooth rotations are available. The measurement of each individual tooth rotation together with its individual discrimination potential will enhance the evaluation of the concordant features observed in bite marks.
Maxillary and mandibular anterior permanent teeth in 38 children aged 7-12 years were examined 2 x with an interval of 2 years to determine whether spontaneous facial/lingual tooth position changes were related to alterations of the widths of keratinized and attached gingiva and the clinical crown height. Measurements included dental plaque, gingival inflammation, probing depth, and width of keratinized and attached gingiva. In addition, study casts from the baseline and 2-year examinations were used to measure clinical crown height and tooth position. The results showed that significant alterations in the widths of the keratinized and attached gingiva took place when the teeth changed positions in facial or lingual directions. The changes in gingival widths could to some extent be coupled to changes in clinical crown height. In teeth moving lingually, the gingival widths increased and the clinical crown height decreased. In teeth moving facially, the gingival widths decreased, and the facial gingiva sometimes receded. These gingival alterations call for examination of the facial gingiva as part of the monitoring of the development of the permanent dentition.
Two hundred Skolt Lapps aged 8 to 16 years were examined for malocclusion with the aid of intraoral radiography and dental casts. The frequency of loss of permanent teeth was high, particularly of the first molars. Also, many teeth were severely defective because of caries. Hypodontia was very common. The frequency of tipped and rotated teeth was high, probably as a consequence of the frequent loss of neighboring teeth. Space and occlusal anomalies were roughly as common as in urbanized Swedish and Danish materials. The need for orthodontic treatment, judged on a 5-grade scale by one examiner, was found to be greater than in Swedish materials.
Since 1972, the Medical Services Branch (MSB), Pacific Region of Health Canada, has conducted quadrennial surveys of the dental health status of Native children in British Columbia (B.C.), Canada. This paper will analyze the findings related to dental malocclusion. Data from the most recent survey in 1988 are compared to data from 1980, and also to similar data from the most recent B.C. Children's Dental Health Survey. Prevalences of abnormal and severe malocclusion are also compared to the original 1972 data. Methods used in the surveys were detailed in a previous paper (I). Significant decreases in the percentage of children with drifting due to premature space loss (P < 0.05), as well as a slight decrease in the percentage of children with crowding were observed. A trend towards an increase in Class II molar relationship was demonstrated, but was not consistent for all age groups. In contrast, there was a slight, but consistent, trend towards a decrease in the percentage of children with an anterior openbite. Comparisons between the age groups demonstrated an increased prevalence of abnormal molar relationship, drifting due to space loss, crowding, crossbite, and overjet greater than 4 mm in children older than 7 years. Native children had a significantly greater prevalence of Class III molar relationship, crossbite, crowding, negative overjet, and anterior openbite than other schoolchildren in B.C. (P < 0.05). However, percentage of Native children with a severe malocclusion decreased significantly from 1972 to 1988 for 7, 9, and 11 year old children (P < 0.05), but for 13 and 15-yr-olds. Improvement has occurred over time in some aspects of dental malocclusion in these Native Canadian children, but malocclusion continues to be a frequent problem, especially amongst adolescents.
A case of odontogenic fibromyxoma of over 5 years' duration which was evident roentgenographically (but not diagnosed) at the time of treatment for a fractured zygoma of the ipsilateral side is presented. The rate of growth did not appear to be significantly altered by trauma. The tumor was successfully treated by enucleation and curettage with removal of the associated teeth. No evidence of recurrence was noted 6 months postoperatively.
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The role of glycosaminoglycans (GAGs) and proteoglycans during cementogenesis is not known. In this study, we have analysed the temporal and spacial expression of GAGs in the cellular cementum of 10-30 weeks old rats, immunohistochemically using monoclonal antibodies 2B6 and 3B3, specific for chondroitin 4-sulfate/dermatan sulfate and chondroitin 6-sulfate, respectively. Both 2B6- and 3B3-epitopes were expressed at similar position and time in the rat cellular cementum. Two types of cellular cementum were identified; GAG-positive and GAG-negative cementum. The former corresponded to the lightly stained and the latter to the darkly stained cementum in sections stained with haematoxylin and eosin. The GAG-positive cementum was seen at the distal side of dentine surface and appeared most thick at, middle of the apical half roots, whereas the other parts of the cementum were the GAG-negative. Distribution of GAG-positive cementum showed changes with age of animals. In 10-15 week old rats, the GAG-positive cementum occupied most of the cementum layer, covering a thin layer of the GAG-negative cementum. The cellular cementum of 20-30 week old rats consisted of three layers; GAG-negative, GAG-positive and GAG-negative cementum from dentine to cementum surface, reducing the GAG-positive area. Because our previous study has demonstrated that the lightly stained cementum is uncalcified, the present result suggests a correlation between calcification and contents of GAGs in the cellular cementum. Further, time- and position-specific expression of GAGs indicates their relation to the physiological tooth movement, which has been known in the rat molars.
BACKGROUND: Osseointegrated implants behave as ankylotic abutments, and their positions are not affected by dentofacial changes. PURPOSE: To measure changes in occlusion in relation to single implants in one patient after more than 15 years in function. MATERIALS AND METHODS: One 25-year-old female was treated with two single implants in the upper central incisor and bicuspid area after trauma. Study casts made prior to treatment (1987) and after 16 years in function (2004) were scanned by means of an optical scanner. Using the palate as the reference, the models were placed in the same coordinate system and analyzed and compared in a computer-aided design (CAD) program. The results of the measurements of the casts were also compared with clinical photographs taken at the time of treatment (1988), after 9 years (1997), and after 16 years (2004) in function. RESULTS: The clinical photographs showed obvious signs of implant infraposition after 9 years. New crowns were made in the incisor region after 15 years (2002), but signs of infraposition were again present at the final examination (2004). Measurements of the casts indicated small tooth movements with a pattern of slight eruption of upper teeth combined with a palatal inclination, mesial drift, and lingual inclination and crowding of the lower anterior teeth. The small measured vertical eruption of the teeth was less than the observed clinical infraposition of the implant crowns, indicating that the vertical position of the palatal may have changed in relation to the implants as well. CONCLUSION: Obvious dentofacial changes may take place in adult patients. Teeth may adjust for this, and no major problems may arise in the dentate patient. However, because the positions of implants are not affected by dentofacial changes, other patterns of clinical problems can be seen when implant patients present with these changes. The character and frequency of these dentofacial changes that may compromise implant treatment in the long term are not yet known.
The authors report on an oral health survey among Hong Kong Chinese homeless people. A total of 140 homeless men underwent clinical examination and were interviewed with a structured questionnaire. More than 90% had evidence of caries experience; most (75%) were related to untreated caries. The mean DMFT score was 9.0 (DT = 3.2, MT = 5.2, FT = 0.6). Periodontal disease was highly prevalent, with 96% having periodontal pockets. The dental problems most frequently reported by the homeless were: bleeding gums or drifting teeth (62%), dental pain (52%) and tooth trauma (38%). More than 70% of the study's participants perceived a need for dental care. The population surveyed had poorer oral health compared to the general population. High levels of dental needs, both normative and perceived, were found. There is a need to provide more accessible and affordable oral health services to this group of people.