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PubMed2004

Solitary central myofibroma presenting in the gnathic region.

Solitary myofibroma of adults is an uncommon neoplasm that typically arises in soft tissue and subcutaneous sites in the head and neck, but rarely within bone. When encountered in the jaws, the lesions exhibit clinical and radiographic features suggestive of an odontogenic tumor or cyst as well as several other neoplastic conditions. Tooth mobility, displacement of teeth, and dramatic jaw expansion may be observed. Analogous to other sites of involvement, gnathic myofibromas are biologically indolent and show little or no recurrence following excision. In rare instances, however, the ability to obtain adequate surgical margins by conservative measures may be limited; thus, issues of local control may supercede the importance of biologic potential. We present the radiologic and histopathologic findings in a case of central myofibroma presenting as a large lytic lesion of the mandible. Myofibroma involving the jaw bones represents a unique diagnostic and therapeutic challenge, and accurate diagnosis and management is predicated on careful correlation of radiographic and pathologic findings.

Adult↗
PubMed2004

Autotransplantation of immature third molars into edentulous and atrophied jaw sections.

The aim of the present study was to assess the results after transplantation of 85 immature third molars. Recipient site conditions varied and different surgical techniques were used. The long-term results after preparation of a new alveolus, splitting osteotomy of the alveolar process or use of free bone autografts were compared with the results after transplantation into a fresh extraction site (control group). Transplantations into prepared sockets showed equal results to the control group (94% respectively). Transplantations in connection with free bone autografts (84%) or after splitting osteotomy of the alveolar process (63%) showed poorer success rates, the differences between the latter and the control group being statistically significant. A possible correlation to revascularization disturbances of the pulp due to an insufficiency of the recipient site or to postoperative infection is suspected. The results show that transplantation of immature third molars is a safe, useful procedure when appropriate conditions of the recipient site are present. Where the alveolus is atrophic, a splitting osteotomy should be performed only in exceptional cases and preference should be given to alternative methods such as primary bone augmentation or bone-regenerative procedures.

Adolescent↗
PubMed2004

Odontogenic myxoma: a clinicopathological study of 33 cases.

Odontogenic myxoma, a rare tumour that occurs in the jaws, has been reported to be the second commonest odontogenic tumour in many countries. Few studies, however, provide detailed clinicopathological findings of a large series of cases and no study so far has attempted to calculate the incidence of this condition. Retrospective and prospective studies were carried out in Tanzania from 1982 to 1998 (16 years) and 1999 to 2002 (4 years), respectively. A total of 33 cases of myxomas were found with a male:female ratio of 1:1.83. Most of the tumours were located in the mandible compared to the maxilla and were predominantly multilocular. Pain, diasthesia, ulceration, invasion of the soft tissues and tooth mobility were among the symptoms that patients presented with although the majority had no clinical signs or symptoms. Based on the prospective study only, an annual incidence of 0.07 per million can be ascertained. Late reporting was a common feature in this group of patients. Radical surgery with resection of the tumour with a safe margin is advocated.

Adolescent↗
PubMed2005

Tooth transplantations: a descriptive retrospective study.

The aim of the present study was to perform a retrospective study of autogeneously transplanted teeth in order to examine the influence of clinical criteria such as the type of the donor tooth, the root length at the time of transplantation, donor eruption stage and others on the overall success rate of the transplantation. The material of this study consisted of 194 patients in whom 273 teeth were transplanted. The mean age at the time of autotransplantation was 18.1 years with a standard deviation of 7.5 years. Transplantations were performed in two hospitals. The follow-up period varied from 15 days to 11 years, and the mean follow-up time was 3.8 years. 58/273 teeth showed one or other form of resorption, 37/273 teeth showed ankylosis, 30/273 showed no important changes in pulp chamber size, 104/273 showed major discoloration after transplantation, 92/273 teeth showed positive results for cold test after transplantation and 26/273 teeth showed clinically unacceptable pocket depth. Clinical and radiological evaluations were performed. An association was found between successful transplantation and donor tooth type (P<0.01), root length at the time of transplantation (P<0.0001) and recipient tooth site (P=0.03). There was a borderline association between successful transplantation and donor eruption stage (P=0.05). In conclusion, autotransplantation of teeth performed with a careful surgical procedure at the stage of 1/2-3/4 of their intended or expected root length can render a very useful service to patients.

Adolescent↗
PubMed2005

Comparison of the finite helical axis and the rectangular coordinate system in representing orthodontic tooth movement.

In orthodontics, tooth movement is typically described using the rectangular coordinate system (XYZ); however, this system has several disadvantages when performing biomechanical analyses. An alternative method is the finite helical axis (FHA) system, which describes movement as a rotation about and a translation along a single axis located in space. The purpose of this study was to examine differences between the FHA and the XYZ systems in analyzing orthodontic tooth movement. Maxillary canine retraction was done using sliding mechanics or a retraction spring with midpalatal orthodontic implants used as measuring references. Tooth movement calculated with the FHA was compared with the corresponding movement in the rectangular coordinate system weekly over a 2-month interval in eight patients. The FHA showed that sliding mechanics controlled rotation of the canine better than the retraction spring (Ricketts retractor), and that the Ricketts retractor controlled tipping better. Changes in the FHA direction and position vectors with time showed that the biomechanical forces are not uniform during the treatment period. In both mechanics, the FHA provided a simple biomechanical model for canine retraction.

Adult↗
PubMed2004

Basic behavior of the finite helical axis in a simple tooth movement simulation.

A finite helical axis (FHA) analysis can provide precise three-dimensional information on orthodontic tooth movement compared to an analysis based on a rectangular coordinate system. The FHA has already been applied in an analysis of orthodontic tooth movement. Interestingly, the position of the FHA changes dramatically in different stages of treatment; however, no previous report has provided detailed information of its basic behavior for clinicians. The purpose of this study was to clarify the basic behavior of the FHA in simple tooth movement, which could promote a better understanding of the 3-D orientation of and rotation about the FHA during tooth movement. Parameters of the FHA were calculated from a simulation of canine retraction. As the tipping angle of the canine was increased from 5 degrees to 30 degrees , the orientation vector of the FHA approached the most affected axis of rotation (on a rectangular coordinate system) in a non-linear manner. The angle of rotation about the FHA also increased in a non-linear manner. This non-linear problem was solved analytically. The basic behavior of the orientation vector of the FHA and the non-linear characteristics of the FHA parameters clarified in this study should be important for the future analysis of actual tooth movement based on the FHA. However, we must be aware that the non-linearity of the FHA itself may affect the analysis of the mechanical properties of the periodontal tissue.

Computer Simulation↗
PubMed1995

Orthodontic and restorative procedures for retained deciduous teeth in the adult.

The restorative dentist will occasionally be confronted with complex treatment planning such as (1) tooth-to-arch dimensional discrepancies, (2) teeth tilted from the vertical midline, (3) teeth overlapped with root contact, (4) horizontal loss of arch dimension from retained deciduous teeth, (5) an impacted adult canine tooth, and (6) peg lateral incisors. Pretreatment diagnostic tooth positioning on replica casts, radiographs, pertinent clinical information, and strategic prosthodontic and orthodontic therapy can ensure predictable treatment. Orthodontic and restorative procedures for three patients with these described discrepancies are detailed to support the direction of treatment planning.

Adult↗
PubMed1997

Tooth intrusion in implant-assisted prostheses.

STATEMENT OF PROBLEM: Numerous reports and surveys have been published on natural tooth abutment intrusion with implant-connected fixed partial dentures. The consensus of these publications was that the cause of intrusion was multifactorial, with causative factors such as disuse atrophy, debris impaction, impaired rebound memory, and mechanical binding. It was also believed that the process was irreversible. PURPOSE: In this article, the limitations with these theories are discussed, and two patient reports of tooth intrusion reversal are reviewed. A review of the current literature is discussed, as well as the current theory of tooth movement in response to dynamic mechanical stimulus, a brief discussion of current experimental procedures and results, and the current recommendations for reversal of intrusion.

Alveolar Process↗
PubMed1992

Endodontic stabilizers.

With the recent influx of osseointegrated endosseous implants in dentistry, attention has been drawn away from using endodontic stabilizers as a means of stabilizing and retaining teeth. It is our opinion that endodontic stabilizers should be considered in the treatment planning of seemingly nonretainable teeth. They are biocompatible and have the additional advantage of maintaining the periodontal membrane attachment of the remaining tooth. Extraction and subsequent replacement with osseointegrated implants should only be considered after all other means of retaining the natural tooth have been fully explored. Selective case studies from various areas of the dentition demonstrate the broad applicability of stabilizers. A technique is presented for the use of endodontic stabilizers.

Dental Abutments↗
PubMed1990

A 3-year follow-up of a homotransplanted tooth from a tooth bank.

A successful case of homologous tooth transplantation is presented. A maxillary second premolar obtained from a tooth bank was implanted into a fresh central incisor extraction site. A 3-yr follow-up radiograph indicated satisfactory apical healing and minimal replacement resorption. Clinically, the transplantation site was free of symptoms and there was no evidence of periodontal disease or tooth mobility.

Adult↗
PubMed1985

Intraalveolar transplantation of teeth with crown-root fractures.

Intraalveolar transplantation using a simple extraction technique with extrusion of the root sufficiently to allow crown preparation was performed in 23 cases of crown-root fractures. A normal periodontal membrane was present after three months in all cases. Signs of superficial root resorption were observed in two cases, and small periapical radiolucencies were seen in another two, probably as a reaction to the presence of excess root-filling material. Minor remodeling of the marginal bone adjacent to the extruded roots was observed in eight cases.

Adult↗
PubMed1982

The oral effects of prolonged intermaxillary fixation by interdental eyelet wiring.

The oral effects of prolonged intermaxillary fixation were investigated in 106 severely obese patients who had been jaw wired as an aid to weight loss. The principal complications during fixation were episodes of periodontal pain and tooth mobility (40%). After removal of fixation, the principal sequelae were residual periodontal problems (9%) and mandibular limitation (9%). These findings were confirmed in a subgroup of 11 patients who had detailed measurements made of their periodontal index, oral hygiene index and range of jaw movements. These findings were discussed in relation to other methods of management of obesity.

Adult↗
PubMed1988

The effect of interdental continuous loop wire splinting and intermaxillary fixation on the marginal gingiva.

To study the influence of interdental loop-wire splinting and intermaxillary fixation on the marginal gingiva, 30 patients were evaluated clinically using different periodontal parameters, at 5 examination times. It was shown that despite a standardized oral hygiene regime including the use of a mouthrinse, gingival inflammation occurred for the duration of the splinting period. Factors other than the presence of limited plaque, such as gingival trauma due to splint application and subsequent mechanical irritation should be considered as possible aetiological factors. All investigated marginal gingival changes had totally reversed 2 weeks following loop-wire splint removal, apart from tooth mobility which did not re-attain pre-operative levels, the difference, however, being statistically insignificant.

Bone Wires↗
PubMed1998

Dentin dysplasia type I: five cases within one family.

Five cases of dentin dysplasia type I within one family are described. Clinically and radiologically, such patients are characterized by a delayed eruption pattern, opacity of the incisional margins, hypermobility of the teeth, short and defective roots, and obliterated pulp chambers. A conservative attitude toward the treatment of common conditions in dentin dysplasia type I favors the preservation of a vulnerable dentition.

Child↗