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PubMed1995

The relationship between alveolar bone height and age in the primary dentition. A retrospective longitudinal radiographic study.

The natural history of changes in attachment level in the primary dentition should be determined before considering diagnostic criteria for periodontal diseases in children. The present study was designed to describe longitudinal changes in the distance between the alveolar bone crest and the cementoenamel junction (ABC-CEJ) determined radiographically. Bite-wing radiographs were obtained from 33 children as part of a routine annual dental examination in a rural community. The ABC-CEJ distance of 1500 sites located at the mesial and distal aspects of primary molars and distal aspect of primary cuspids were measured. An analysis of variance model was used to assess the effect of age, sex, tooth, side of the mouth, jaw, site and patient on the ABC-CEJ measurements. The side of the mouth (left, right) and the site (mesial, distal) had no significant effect on the ABC-CEJ distance. ABC-CEJ distances in the upper jaw were greater than in the lower jaw, and different teeth exhibited different ABC-CEJ distances. Canines had the greatest distance and second molars the smallest. The most interesting relationship was between alveolar bone height and age. The overall ABC-CEJ distance seemed to increase with age; however, this was not a linear relationship but followed the pattern of facial growth, with two spurts separated by a period of minimal increase. The results indicate that different levels of ABC-CEJ distance might be considered as a cut-off value for radiographic diagnosis of alveolar bone loss at different ages, for different primary teeth and for different jaws.

Age Factors↗
PubMed2005

Coronally positioned flap procedures with or without a biodegradable membrane in the treatment of human gingival recession. A 6-year follow-up study.

BACKGROUND: Short-term data have indicated that treatment of gingival recession type defects by coronally positioned flap procedures with or without biodegradable membranes may result in similar treatment outcome. The aim of this study was to compare 12-month and 6-year follow-up results for these two treatment approaches. METHODS: Twenty patients with buccal bilateral Miller Class I or Class II gingival recession defects in cuspids or bicuspids were treated randomly by coronally positioned flap alone (20 sites) or in combination with a biodegradable membrane (20 sites). Clinical measurements at baseline, 6, 12 months and 6 years included apical extent of gingival recession, width of the defect at the cemento-enamel junction (CEJ), width of keratinized tissue, as well as attachment level and probing depth. Eleven patients were available for the 6-year evaluation. RESULTS: At 12 months (20 sites), both treatments resulted in significant gain of root coverage (p<0.001), stable probing depth, and increased attachment level (p<0.001). The 6-year evaluation (11 sites) showed a significant gain of root coverage for the non-membrane group only (p<0.05). No significant between-group differences were detected for any other treatment variable regardless of smoking status (p>0.05). Compared with baseline, the 6-year results showed that seven membrane sites gained root coverage, three were unchanged and one lost root coverage. For the 11 non-membrane sites, eight gained root coverage, and three were unchanged. The five membrane and the 10 non-membrane sites exhibiting complete root coverage at 6 months were reduced to two and one, respectively, at the 6-year evaluation. CONCLUSIONS: The coronally positioned flap procedure offers a simple and reliable treatment alternative as a root coverage procedure in Class I and Class II recession type defects. Placement of a biodegradable membrane underneath the flap does not seem to improve neither the short- nor the long-term results. Long-term outcome stability seems to be critically dependent on a continuous follow-up program with re-instruction in non-traumatic brushing habits.

Absorbable Implants↗
PubMed1976

The effect of oral physiotherapy on dilantin gingival hyperplasia.

Gingival hyperplasia was studied in 13 boys with epilepsy living in a state hospital. Boys were selected on the basis of having gingival hyperplasia, having all teeth between cuspids (upper and lower), having no occlusal abnormality and being cooperative. After gingivectomy, regrowth of gingiva was compared around lateral incisors on one side of the mouth having operator-assisted oral hygiene with that around lateral incisors on the other side of the mouth without operator-assisted oral hygiene. Regrowth of tissue was documented by precise photogrammetry. Oral hygiene, gingival inflammation and crevicular fluid were monitored. Less inflammation, less crevicular fluid and less regrowth of gingival tissues occurred around teeth subjected to good oral hygiene. Precise periodic photographic documentation of the clinical status of patients during studies such as this is considered very valuable.

Adolescent↗
PubMed1997

Impact of nocturnal bruxism on mercury uptake from dental amalgams.

The mercury (Hg) release from dental amalgam fillings increases by mechanical stimulation. The aim of this study was to investigate the possible impact of nocturnal bruxism on Hg exposure from dental amalgams and to evaluate the effect of an occlusal appliance. 88 female patients from an orofacial pain clinic with a complete maxillary and mandibular dentition, a normal frontal vertical overbite with cuspid guidance, and at least 4 occlusal amalgam fillings in contact with antagonists in intercuspidal position, were examined with the Bruxcore bruxism monitoring device to measure the level of on-going nocturnal bruxism. Based on the degree of abrasion recorded, the subjects were divided into a group defined as bruxists, (n = 29), another group defined as non-bruxists, (n = 32), serving as controls, the intermediate group being discarded. The Hg exposure was assessed from the Hg concentration in plasma and urine, corrected for the creatinine content. In a regression model with bruxism as the only explanatory variable, no significant effect of bruxism was found, but when the number of amalgam fillings, chewing gum use, and other background variables were taken into account, there was a limited impact of bruxism on Hg in plasma. The nocturnal use of an occlusal appliance did not, however, significantly change the Hg levels. This study indicates that mechanical wear on amalgams from nocturnal bruxism may increase the Hg uptake, but the magnitude of this effect seems to be less than from the use of chewing gum.

Absorption↗
PubMed2006

Histological evaluation of dog permanent teeth after traumatic intrusion of their primary predecessors.

The aims of this study were to analyze the histomorphology of developing permanent teeth whose primary teeth had suffered traumatic intrusion, as well as to compare the influence of immediate extraction of the intruded tooth to passive re-eruption. Nine dogs from 45 to 50 days old were submitted to the intrusion of the maxillary central and lateral primary incisors using a force applicator adapted to the teeth incisal cuspids. The right side intruded teeth were kept in their sockets and the ones on the left side were extracted 30 min later. After a postoperatory periods of 30 and 60 days, four (group 1) and five (group 2) dogs, respectively, were killed by perfusion. The histological evaluations showed that, in group 1, alterations had occurred in the odontoblastic layer and deposition of the enamel matrix had taken place in some specimens while in group 2, a portion of non-mineralized matrix was observed. We concluded that the morphological changes were because of the immediate trauma of intrusion. No differences were found between the groups where the primary tooth was immediately extracted or left to passively re-erupt.

Ameloblasts↗
PubMed1994

Ectopic eruption of transposed mandibular permanent lateral incisors beneath primary first molars. Case report.

Mandibular permanent lateral incisors showing bilateral transposition and ectopic eruption were seen beneath primary first molars on bitewing radiographs in a female aged 9 years. This report chronicles management of the case during the mixed dentition period. Appropriate space maintenance after extraction of mandibular primary first molars, cuspids and lateral incisors on both sides facilitated eruption and repositioning of the permanent lateral incisors without the need to sever supracrestal gingival fibres.

Child↗
PubMed1991

The value of the echo-Doppler in cardiomyoplasty procedures.

UNLABELLED: Echo-Doppler determinations were performed in patients submitted to cardiomyoplasty procedure using the latissimus dorsi muscle graft (LDMG). In four patients who had 1 year of follow-up or more the left ventricular internal dimension in diastole (LVIDd), left ventricular internal dimension in systole (LVIDs), septal-E point separation (E-septum), distance of the mitral valve (E-E'), maximal aortic cuspid separation (MACS) and left atrium dimension (LA) were determined by two-dimensional echocardiogram. With a pulsed Doppler in the aortic root the following parameters were obtained: aortic peak flow (AoPF), velocity time integral (VTI), and ejection period (EP). With the stimulator on, the determinations were done using a ventricle muscle (VM) delay of 25, 75, and 250 msec. RESULTS: No significant differences were observed by Echo determinations between the stimulator off and on. With the supporting contraction of the LDMG the best hemodynamic performance was obtained when the VM delay ranged between 75 and 250 msec. Values with the stimulator off and on were as follows: AoPF: 90.8 +/- 8 cm/sec and 104.5 +/- 9 cm/sec; VTI: 14.8 +/- 2 cm and 19.2 +/- 2 cm; EP: 230 +/- 10 msec and 245 +/- 20 msec. A decrease in the systolic pressure of the pulmonary artery and a decreased functional regurgitation of the mitral and tricuspid valve were observed in the follow-up determinations. All patients showed restricted mitral flows that remained unchanged during the follow-up. CONCLUSIONS: In this group of patients the echo-Doppler showed an improvement of the systolic function of the left ventricle when it is supported by the LDMG.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Caries prevalence measured with QLF after treatment with fixed orthodontic appliances: influencing factors.

Caries prevalence on the buccal surfaces of teeth in orthodontic patients was determined with QLF and visual examination immediately after removal of fixed appliances. The number of lesions found by QLF far outnumbered that found by visual examination, but the distribution pattern was similar. 97% of all subjects and on average 30% of the buccal surfaces in a person were affected. On average, in males 40% of surfaces and in females 22% showed white spots (p < 0.01). Caries prevalence was lower (p < 0.01) in incisors and cuspids than in molars and premolars. A positive correlation with caries prevalence was found for the bleeding scores 6 weeks after debonding and lactobacillus counts before debonding. Mutans streptococci counts, age, treatment duration, socioeconomic status and dietary habits showed no correlation with caries prevalence.

Child↗
PubMed1983

Three-dimensional measurements of the occlusal surface of upper first molars in a modern Japanese population.

Moiré photographs of the occlusal surface of first molars of Japanese children were taken by means of a specially designed moiré contourograph apparatus. They were then used for three-dimensional measurements. The heights of 4 cusps and some other points were measured by counting contour lines. Distances and angles between them were also measured. Sex differences of these measurements are found mainly around the metacone and hypocone. There is no clear correlation of the four cuspidal heights to the distances between them.

Dental Occlusion↗
PubMed1984

Tooth ultrastructure of late triassic Haramiyidae.

Six molars of Haramiyidae from the French lower Rhaetic were examined by scanning and transmission electron microscopy, and by electron diffraction. Typical polished wear facets were located on the tops and on the occlusal bases of cuspids. Enamel was found to have had a structural pattern defined as "pre-prismatic", consisting of a repetitive pinnate orientation of the c-axes of apatite crystallites but without interprismatic material. Peritubular dentin was not found, but hydroxyapatite deposition in the dentinal tubular lumens was observed, whereas typical denticles with dentinal tubules and hydroxyapatite deposits were located in the pulp chambers. Taken together, these different features are strongly indicative of mastication, and hence enforce the suspected mammalian status of the Haramiyidae.

Animals↗
PubMed1998

Forty-five-year tooth survival probabilities among men in Oslo, Norway.

Changes in tooth survival probabilities over a person's lifetime have remained largely unexplored. The goal of this study was to evaluate changes in the 45-year tooth survival probabilities in a cohort of 565 Norwegian males who were examined in 1969 as young adults, and followed up into mid-life (examination years and sample sizes (n): 1971 (n = 381), 1973 (n = 292), 1975 (n = 245), 1981 (n = 228), 1988 (n = 202), and 1995 (n = 223). The results indicated that the tooth survival probabilities varied considerably both (i) among teeth within individuals, and (ii) over time. The 45-year survival probabilities for the 28 teeth fell into the following ranges: larger than 95% for incisors and cuspids; between 84% and 92% for premolars; and between 59% and 96% for molars. Over the first 4 post-eruptive decades, the tooth mortality risks (excluding orthodontic extractions) were: 1st decade, 2.0% (from 1.7 to 2.4%); 2nd decade, 0.2% (from 0.1 to 0.4%); 3rd decade, 0.6% (from 0.4 to 0.8%); and 4th decade, 1.1% (from 0.8 to 1.5%). The tooth mortality risks in the 2nd, 3rd, and 4th decades were probably somewhat underestimated (due to dropout bias), suggesting that the true underlying tooth mortality hazard function may have been V-shaped. The conclusions were that the tooth mortality hazard during the first 4 post-eruptive decades was bathtub-shaped and that it varied considerably among teeth within individuals.

Adolescent↗
PubMed2006

Osteonecrosis of the jaw in multiple myeloma patients: clinical features and risk factors.

PURPOSE: To describe the clinical, radiologic, and pathologic features and risk factors for osteonecrosis of the jaw (ONJ) in multiple myeloma (MM) patients. PATIENTS AND METHODS: A retrospective review of 90 MM patients who had dental assessments, including 22 patients with ONJ. There were 62 men; the median age was 61 years in ONJ patients and 58 years among the rest. Prior MM therapy included thalidomide (n = 67) and stem-cell transplantation (n = 72). Bisphosphonate therapy included zoledronate (n = 34) or pamidronate (n = 17) and pamidronate followed by zoledronate (n = 33). Twenty-seven patients had recent dental extraction, including 12 patients in the ONJ group. Median time from MM diagnosis to ONJ was 8.4 years for the whole group. RESULTS: Patients usually presented with pain. ONJ occurred posterior to the cuspids (n = 20) mostly in the mandible. Debridement and sequestrectomy with primary closure were performed in 14 patients; of these, four patients had major infections and four patients had recurrent ONJ. Bone histology revealed necrosis and osteomyelitis. Microbiology showed actinomycetes (n = 7) and mixed bacteria (n = 9). More than a third of ONJ patients also suffered from long bone fractures (n = 4) and/or avascular necrosis of the hip (n = 4). The variables predictive of developing ONJ were dental extraction (P = .009), treatment with pamidronate/zoledronate (P = .009), longer follow-up time (P = .03), and older age at diagnosis of MM (P = .006). CONCLUSION: ONJ appears to be time-dependent with higher risk after long-term use of bisphosphonates in older MM patients often after dental extractions. No satisfactory therapy is currently available. Trials addressing the benefits/risks of continuing bisphosphonate therapy are needed.

Adult↗
PubMed2005

The effect of venous pulsation on the forehead pulse oximeter wave form as a possible source of error in Spo2 calculation.

Reflective forehead pulse oximeter sensors have recently been introduced into clinical practice. They reportedly have the advantage of faster response times and immunity to the effects of vasoconstriction. Of concern are reports of signal instability and erroneously low Spo(2) values with some of these new sensors. During a study of the plethysmographic wave forms from various sites (finger, ear, and forehead) it was noted that in some cases the forehead wave form became unexpectedly complex in configuration. The plethysmographic signals from 25 general anesthetic cases were obtained, which revealed the complex forehead wave form during 5 cases. We hypothesized that the complex wave form was attributable to an underlying venous signal. It was determined that the use of a pressure dressing over the sensor resulted in a return of a normal plethysmographic wave form. Further examination of the complex forehead wave form reveal a morphology consistent with a central venous trace with atrial, cuspidal, and venous waves. It is speculated that the presence of the venous signal is the source of the problems reported with the forehead sensors. It is believed that the venous wave form is a result of the method of attachment rather than the use of reflective plethysmographic sensors.

Female↗
PubMed2005

Analysis of the bite force and mechanical design of the feeding mechanism of the durophagous horn shark Heterodontus francisci.

Three-dimensional static equilibrium analysis of the forces generated by the jaw musculature of the horn shark Heterodontus francisci was used to theoretically estimate the maximum force distributions and loadings on its jaws and suspensorium during biting. Theoretical maximum bite force was then compared with bite forces measured (1) voluntarily in situ, (2) in restrained animals and (3) during electrical stimulation of the jaw adductor musculature of anesthetized sharks. Maximum theoretical bite force ranged from 128 N at the anteriormost cuspidate teeth to 338 N at the posteriormost molariform teeth. The hyomandibula, which connects the posterior margin of the jaws to the base of the chondrocranium, is loaded in tension during biting. Conversely, the ethmoidal articulation between the palatal region of the upper jaw and the chondrocranium is loaded in compression, even during upper jaw protrusion, because H. francisci's upper jaw does not disarticulate from the chondrocranium during prey capture. Maximum in situ bite force averaged 95 N for free-swimming H. francisci, with a maximum of 133 N. Time to maximum force averaged 322 ms and was significantly longer than time away from maximum force (212 ms). Bite force measurements from restrained individuals (187 N) were significantly greater than those from free-swimming individuals (95 N) but were equivalent to those from both theoretical (128 N) and electrically stimulated measurements (132 N). The mean mass-specific bite of H. francisci was greater than that of many other vertebrates and second highest of the cartilaginous fishes that have been studied. Measuring bite force on restrained sharks appears to be the best indicator of maximum bite force. The large bite forces and robust molariform dentition of H. francisci correspond to its consumption of hard prey.

Animals↗
PubMed1996

Case report. Diagnosis and management of an anterior lingual mandibular salivary gland defect.

OBJECTIVES: To describe an anterior lingual mandibular salivary gland defect (ALMSGD). A review of the literature shows only twenty-five previously reported cases. METHODS: A twenty-six-year-old female was examined for comprehensive dental treatment when a well-circumscribed, corticated 1.5 cm diameter radiolucent lesion was noted in the mandibular left cuspid region. The patient's previous panoramic radiographs demonstrated that the lesion was present nine years ago and had not changed in size during this interval. RESULTS: The radiographic and clinical findings support the diagnosis of ALMSGD. Surgical intervention is not indicated due to the lack of symptoms and stability of the lesion. CONCLUSIONS: This case is unique because the patient is the youngest reported. It also supports the significance of a radiological diagnosis in the management of hard tissue lesions of the jaws and the importance of access to previous radiographs.

Adult↗
PubMed1977

Scanning microscopy of cervical erosion.

The dentitions of 900 dentists were examined for the presence of cervical erosion. Of these, 48 individuals of 5.3% had obserable erosion. Silicone impressions were made of the eroded labial surfaces in a typical quadrant, and epoxy resin models were constructed. These were examined in the scanning electron microscope. Cross sections of the replicas were examined in the light microscopy. Of the 48 replicas (24 of the maxilla and 24 of the mandible), the most severe erosion was found on the first premolars in 62% of the individuals, on second premolars in 19% on cuspids in 12%, and on first molars in 6%. The margin of the defect toward the gingiva was level with or just below and parallel to the gingival crest. The erosion pattern was distinguished by two shapes--an angular lesion with a flattened floor associated with deep lesions (68%), and a rounded, smaller defect with no sharp interior angles and less tooth damage (32%). It is postulated that cervical erosion may result from two different mechanisms--a more common, destructive process, angular and deep; and a less severe, shallow process with rounded form.

Dental Cementum↗
PubMed1999

Mitral restenosis in the early postoperative period of a patient with systemic lupus erythematosus.

A forty-eight year old woman, who had undergone mitral comissurotomy and subsequently developed early restenosis, presented with major comissural fusion and verrucous lesions on the cuspid edges of the mitral valve, with normal subvalvar apparatus. Patient did well for the first six months after surgery when she began to present dyspnea on light exertion. A clinical diagnosis of restenosis was made, which was confirmed by an echocardiogram and cardiac catheterization. She underwent surgery, and a stenotic mitral valve with verrucous lesions suggesting Libman-Sacks' endocarditis was found. Because the diagnosis of systemic lupus erythematosus (SLE) had not been confirmed at that time, a bovine pericardium bioprosthesis (FISICS-INCOR) was implanted. The patient did well in the late follow-up and is now in NYHA Class I.

Bioprosthesis↗