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Movement of teeth adjacent to posterior bounded edentulous spaces.

Bounded edentulous spaces (BES)-a missing posterior tooth with intact adjacent teeth-are thought to lead to arch collapse resulting from the movement of adjacent teeth. To determine the rate of change in distance between teeth adjacent to a BES, we examined three successive measurable radiographs of 116 untreated posterior BES cases. The distance between the teeth (DBT) adjacent to the space was measured, and change in DBT (delta DBT) between pre-extraction and follow-up radiographs was calculated. We used linear spline regression to construct models for tooth movement and to identify factors associated with delta DBT. The mean delta DBT was < 1 mm during the first year post-extraction, and the DBT continued to decrease at a successively slower rate each following year. Overall and for each tooth type, the greatest rates of decrease in DBT were seen in the zero to two-year period. In a multivariable model, time since extraction and tooth type were significantly associated with delta DBT. These findings suggest that movement of teeth adjacent to a posterior BES after the first two years is usually gradual and minor within the time frame of this study.

Adult↗

Bisphosphonate effects on alveolar bone during rat molar drifting.

The remodeling of bone during molar drifting and cortical growth in the rat maxilla and the effects of dichloromethylene bisphosphonate (Cl2MBP) on these processes were investigated in 30 age-matched rats. A control group of six rats was killed at 10 weeks of age. Beginning at 10 weeks of age, 12 rats were treated with daily subcutaneous injections of Cl2MBP (10 mg/kg), and 12 control rats were injected daily with normal saline. Six rats of each group were killed at 12 and at 20 weeks of age. All rats were injected with fluorescent bone labels eight and one days before termination. Calcified and decalcified vertical sections through the lingual roots of maxillary molars were prepared for histomorphometry. Bone apposition rates, remodeling activity, and bone cell populations were quantified by image analysis on depository and resorptive surfaces of alveolar bone and on cortical bone surfaces. The drift rates of the first and second molars were calculated. Results showed that in control animals the drift rate of the first molar exceeded that of the second molar (p less than 0.05), supporting a previously proposed mechanism for age-dependent narrowing of interdental bone. Cl2MBP treatment decreased remodeling activity on resorptive surfaces of alveolar bone, despite a transient increase in osteoclasts. Cl2MBP also decreased the osteoblast number and bone apposition rate on depository surfaces of alveolar bone, and reduced the rate of molar drifting (p less than 0.05). However, Cl2MBP treatment had no detectable effect on osteoblast number or bone apposition on cortical bone surfaces. These results support the concept that bisphosphonates influence bone formation indirectly through a coupling mechanism which links formation with resorption.

Alveolar Process↗

The relationship of crowding to the eruptive position of the lower permanent incisors.

The aim of this study was to examine the positions of newly erupted lower permanent incisors and their relationship to crowding. Forty-one crowded and 37 uncrowded dental casts of children in the early mixed dentition were examined by means of digitization using a reflex microscope. Two aspects of alignment were considered: rotation and labio-lingual displacement. Rotations of the incisors were defined as deviations from 'ideal' predicted angles. Displacement of the incisors was measured as the distance between the most labial and most lingually placed incisors. The study showed an increase in rotations amongst the crowded sample. The result of the investigation of the relationship between crowding and displacement was inconclusive. There would appear to be significant differences between the positions of newly erupted crowded and uncrowded incisors. Crowding, however, was not the only factor causing irregularity.

Child↗

Late lower arch crowding in relation to skeletal and dental morphology and growth changes.

Skeletal and dental morphology, and related growth changes during a 3-year period following second permanent molar eruption, were compared in a group of 21 subjects who had no increase in lower arch crowding, with another group of 21 subjects whose lower arch crowding had increased by 1.0 mm or more during the same period. The crowding group showed a significantly greater increase in M3 space, forward movement of the second permanent molar and increase in the inter-incisal angle than the non-crowding group. None of the other parameters examined differed significantly.

Adolescent↗

Radiographic findings of Ewing's sarcoma of the jaws.

The radiographic findings in eight cases of Ewing's sarcoma of the jaws are analysed in detail. Similar findings to those in peripheral skeletal involvement were demonstrated including: (a) permeative bone destruction, (b) periosteal reaction, and (c) extraosseous soft tissue mass. Specific to the jaws is the occurrence of dental displacement without destruction. The differential diagnosis of Ewing's sarcoma of the jaws is discussed in detail and illustrated.

Adolescent↗

Drug-induced gingival overgrowth: a case with auto-correction of incisor drifting.

Drug-induced gingival overgrowth is an iatrogenic clinical condition, which affects a proportion of patients medicated for conditions such as hypertension, epilepsy and the prevention of organ transplant rejection. Clinical manifestation can vary in severity from minor problems to complete coverage of the standing teeth. Drifting of teeth can also occur, producing further aesthetic and functional problems for the patient. This report documents a case of a renal transplant patient in whom drifting of the upper incisor teeth spontaneously resolved following surgical reduction of the overgrown gingivae. Clinical issues relating to the management of gingival overgrowth are also discussed.

Calcium Channel Blockers↗

Transposition of teeth.

Transposition is a rare dental anomaly. Two cases of transposition of canines have been presented, the causes are discussed, and modes of treatment are suggested.

Adult↗

The role of orthognathic surgery in the treatment of severe dentoalveolar extrusion.

BACKGROUND: When mandibular molars are not replaced after extraction, the long-term problem of inadequate interarch space for either a fixed or removable prosthesis can occur. In the past, practitioners needed to decide whether to shorten the teeth, extract the supererupted maxillary molars to recapture space or leave the area unrestored. The authors present another option. CASE DESCRIPTION: A 61-year-old man was referred to a periodontist by his general dentist for placement of mandibular implants in the posterior sextant. Extreme supereruption of the maxillary dentoalveolar segment prevented restoration of the opposing edentulous area. An oral and maxillofacial surgeon performed a segmental osteotomy of the posterior right maxilla to gain needed interarch space. After the osteotomy was stabilized, the periodontist placed implants that were subsequently restored with a fixed prosthesis. CLINICAL IMPLICATIONS: The role of orthognathic surgery in treatment planning should not be overlooked in the comprehensive management of severe extrusion. It offers patients the opportunity to gain both function and esthetics that might otherwise be impossible.

Ambulatory Surgical Procedures↗