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Dental esthetic satisfaction in adults.

This study determined the influence of teeth, mouth, and face on self-image and personal esthetic satisfaction in adults. A random sample of 125 patients completed a five-item questionnaire about personal esthetic satisfaction and oral self-image. As a group, general dental variables were stronger predictors of esthetic satisfaction than orthodontic variables (P less than .01). Discrepancies between clinical findings and patterns of self-perception and satisfaction suggest the dentist and patient should plan together for esthetic dental treatment.

Adolescent↗

Root caries and root defects in urban and rural adults: the Florida Dental Care Study.

As part of the Florida Dental Care Study--a longitudinal study of risk factors for changes in dental health--the authors examined and interviewed 873 adults aged 45 years and older. During the examination, clinicians noted the number of teeth present and the participant's dental condition, including presence of root caries and fillings or noncarious defects on the roots. The interview was conducted to collect demographic and other information such as the adults' perceptions about dental care and their perceptions about their own dental health. The authors found that men, African-Americans, adults living in rural areas and those living in poverty were significantly more likely to have root caries than other participants. The data reported in this article will serve as baseline information for subsequent research.

Aged↗

Multirooted anomalies in the primary dentition of Native Americans.

The dental literature contains a small number of reports of primary multirooted anomalies and even fewer reports on the clinical significance of these findings. When conducting routine clinical examinations, the authors found multirooted anomalies in three Native American children. The anomalies included a primary bifurcated maxillary left canine, a primary three-rooted mandibular right first molar and bilateral primary three-rooted mandibular first and second molars. The clinical significance of these types of anomalies is discussed.

Child, Preschool↗

A visual analog scale for measuring dental fluorosis severity.

BACKGROUND: To date, no continuous scale exists for measuring the severity of dental fluorosis (DF). OBJECTIVES: The authors developed and validated a visual analog scale (VAS) for DF. They tested the scale in clinical (DF-endemic area) and laboratory settings. METHODS: Dentists and nondentists (23 per group) were asked to grade the DF severity in photographs of 23 anterior teeth with different DF levels (using a 100-millimeter VAS) to create a VAS for DF. Statistical analysis was performed to validate the new scale. The authors used clinical and laboratory (unerupted third molars) analyses to assess the usefulness of the VAS. RESULTS: The authors used an intraclass correlation coefficient (ICC) to assess the interexaminer (ICC = .79: good agreement) and intraexaminer (.88 < ICC < .97: excellent agreement) reliability during creation of the scale. They used the Spearman rank correlation (r(s)) to validate the VAS against the gold standards (that is, the Thylstrup-Fejerskov index [TFI] and Dean's index [DI]) (the results showed excellent or good correlation for 45 examiners). Two dentist examiners clinically tested the new VAS, and the results showed excellent (r(s) = .922, P < .001) correlation and excellent ICC between the examiners (ICC = .96), as well as good ICC between the TFI and the VAS for DF (ICC = .6). The laboratory study showed better correlation between fluoride concentration and the VAS for DF than between fluoride concentration and the TFI. CONCLUSION: Because of its simplicity, precision and utility in statistical applications, the VAS for DF can be useful in DF studies.

Adolescent↗

Oro-maxillofacial development in patients with Turner's syndrome.

Detailed oro-maxillofacial studies using dental casts, pantomograms and cephalograms were performed in 28 patients with Turner's syndrome and compared statistically to the results from 23 normal short children. Small tooth crown size, short tooth roots and advanced dental age were characteristic of patients with Turner's syndrome. However, the incidence of peg shaped teeth, malocclusion, high arched palate and congenital anodontia were not characteristic of patients with Turner's syndrome. The coronal arch width (C.A.W.) and basal arch width (B.A.W.) were greater and the coronal arch length (C.A.L.) and basal arch length (B.A.L.) were less in patient's with Turner's syndrome. These data indicate underdevelopment of the maxilla in the forward direction forming the wide-, flat-shaped facial characteristic of patients with Turner's syndrome.

Adolescent↗

Early detection of dens evaginatus appearing on the premolars and clinical management: histological study.

A review of the methods for the prevention of central cusp fracture is presented, with a case of central cusp protection of a premolar by self-curing acrylic resin by early detection. The anomalous tooth was extracted for histological observation. Closure of the pulpal horn, could be accomplished by early detection and adequate treatment for the central cusp fracture of premolars. In this case, if the gradual attrition of a central cusp were not possible, a protecting the cusp using a self-curing acrylic resin would be an effective form of treatment.

Acrylic Resins↗

The use of overdentures in the management of severe hypodontia associated with microdontia: a case report.

Dental anomalies may compromise both esthetics and function in the pediatric patient. The present paper reports a rare case associated with both microdontia and severe hypodontia in a 13 year-old girl. The treatment was accomplished through the use of overdentures, which also served as a bite plane to increase vertical dimension of occlusion and as a potential space maintainer.

Adolescent↗

Tooth transpositions associated with dental anomalies and treatment management in a sample of orthodontic patients.

The purpose of this study was to determine the distribution of tooth transpositions in a sample of orthodontic patients, describe the accompanying anomalies and report on the management and therapeutic outcome. Overall, the male to female ratio was 4:3, left side predominance was evident, and there was a high incidence of associated dental anomalies. Attempts to correct tooth order usually resulted in untoward effects on periodontal tissues. Consequently, individual anatomical conditions may be decisive in successful clinical management of such cases.

Adolescent↗

Dental implications of Tooth-Nail dysplasia (Witkop syndrome): a report of an affected family and an approach to dental management.

Tooth-Nail dysplasia is a rare genetic disorder, which is classified as an ectodermal dysplasia. Diagnostic differentiation from other conditions in this category is necessary for effective dental management and genetic counseling. The oro-dental and clinical manifestations of Tooth-Nail dysplasia in an affected male infant and his father are documented. Other family members have the condition and pedigree data are in keeping with autosomal dominant inheritance. A comprehensive approach to the dental management of an affected child is proposed.

Adult↗

Managing morphologically atypical impacted teeth orthodontically.

Impactions with severely dilacerated root is seldom reported, especially the maxillary incisor. It is probably because of the high clinical difficulty of bringing the dilacerated tooth into position: most patients probably would choose extraction with replacement by prosthesis instead. However, the philosophy seems to have changed recently. We report two cases one in which an impacted central incisor was brought in the arch by orthodontic traction. In the second case the impacted premolar was brought into the arch and was shaped as a mandibular canine for achieving a good functional occlusion.

Anodontia↗

Atypical Hallerman-Streif syndrome: a case report.

Hallerman Streif syndrome is a rare congenital disorder characterized by dyscephaly, dental anomalies, proportionate nazism, hypotrichosis, cutaneous atrophy limited to the head, bilateral congenital cataracts and bilateral microphthalmia. Despite the marked craniofacial characteristics and oral findings, a relative lack of reports in the dental literature has been noted. In this article, a case of a 8 year old boy with dental problems is described.

Abnormalities, Multiple↗

Orthodontic treatment of an impacted dilacerated maxillary incisor: a case report.

Dilaceration is one of the causes of permanent maxillary incisor eruption failure. It is a developmental distortion of the form of a tooth that commonly occurs in permanent incisors as result of trauma to the primary predecessors whose apices lie close to the permanent tooth germ. We present a case of post-traumatic impaction of a dilacerated central maxillary left incisor in a young patient with a class II malocclusion.

Cephalometry↗

Tooth-related issues.

Several conditions exist around teeth that may predispose the periodontium to disease. These situations may occur as a result of the condition or position of teeth or as a result of tooth treatment. In certain cases these tooth-related factors may contribute to the initiation of periodontal disease. While the etiology of periodontal disease is bacterial, factors that enhance bacterial accumulation or allow the ingress of bacteria into the periodontium should be considered in the classification and diagnosis of periodontal diseases. This is because many times these tooth-related issues can cause site-specific problems that require treatment in an otherwise intact periodontium. Several factors related to tooth/root anatomy, restorative, and endodontic considerations have been associated with gingival inflammation, attachment loss, and bone loss. These factors will be reviewed as they relate to their potential to promote damage to the periodontium.

Dental Pulp Diseases↗

Root fusion in molars: incidence and sex linkage.

The study was done to determine the incidence and distribution of root fusion in 1340 maxillary and mandibular molars in 170 patients. A second objective was to determine whether root fusion of molars is sex-linked. A substantial percentage, 29% of all molars, had fused roots. Root fusion was found more frequently in maxillary than mandibular molars, 35% to 24%, and it occurred in many patients, rather than being limited to a few. Root fusion was most common in third molars, followed by second molars, in both jaws. It occurred in almost equal numbers in corresponding molars of opposite sides, approaching bilateral symmetry. The proportion of molars with root fusion was approximately 5% greater in females than in males, and about 13% more females had molar root fusion than males.

Adult↗

A fused central incisor. Periodontal considerations in comprehensive treatment.

This report details the treatment of a permanent central incisor fused to a supernumerary tooth. The level of fusion was first determined by radiographs, but surgical visibility indicated a more extensive fusion. The two roots were separated, and the supernumerary tooth was removed. At 10 weeks postoperatively, orthodontic treatment was instituted, bringing the retained tooth through the healing socket left by the supernumerary, and into contact with the interdental septum. After endodontic treatment and splinting, a periodontal re-entry procedure was necessitated by the persistence of inflammation caused by incomplete removal of the furcation-like area between the fused teeth. The improved periodontal prognosis of this case at 1-year follow-up can be attributed to careful postsurgical evaluation and subsequent removal of this plaque-retentive area.

Child↗

Treatment of the palato-gingival groove with guided tissue regeneration. Report of 10 cases.

The purpose of this study is to demonstrate the potential of using a barrier in the treatment of palato-gingival groove defects. The study group consisted of 10 patients. Prior to treatment, the palato-gingival groove on maxillary lateral incisors was measured with calibrated periodontal probe from the cemento-enamel junction (CEJ) to the free gingival margin (FGM) and from the FGM to the base of the pocket (BP). Probing depth (PD) was calculated and bleeding on probing indicated. Surgical procedures consisted of flap reflection, removal of granulation tissue, and scaling and root planning of the groove. An expanded polytetrafluoroethylene membrane was sutured over the palato-gingival groove. Six months postsurgery, all measurements were repeated. Statistical analysis compared results using means, standard deviations, and paired t tests. Results showed an improvement in clinical attachment gain, probing depth reduction, and decreased bleeding on probing. This study demonstrates the potential of guided tissue regeneration in the treatment of palato-gingival groove defects. A random blinded clinical trial is necessary, however, to fully assess the potential of this procedure in treatment of palato-gingival groove defects.

Adult↗

A combined approach for treatment of developmental groove associated periodontal defect. A case report.

Developmental grooves are not rare and often appear on maxillary lateral incisors. This may represent a challenge and sometimes tooth extraction is inevitable. This case report describes a combined technique of regenerative and antimicrobial/root conditioning used to treat a maxillary lateral incisor in a 32-year-old woman. Tooth #10 presented a periodontal probing depth of 8 mm below the cingulum, associated with a developmental groove. The tooth was vital. After initial preparation, a palatal mini-flap was raised, granulation tissue was eliminated by means of ultrasonic bactericidal curettage and radicoloplasty performed. The surface was then treated for 3 minutes with tetracycline-HCl solution (100mg/ml), and the defect filled with sterile, medical grade, calcium sulfate. Clinical measurements were retaken at 6, 12, and 18 months. The results indicated a reduction of probing depth to 2 mm, reestablishment of the lamina dura, and radiographical evidence of bone growth. This combined treatment allowed the tooth to be saved, the palatal surgical approach did not alter the esthetics of the area, and its simplicity is recommended.

Adult↗