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PubMedDate not supplied

Decayed/missing/filled teeth and shortened dental arches in Tanzanian adults.

PURPOSE: This study assessed decayed/missing/filled teeth (DMFT), presence of occlusal units, and prevalence of shortened dental arches in a Tanzanian adult population. MATERIALS AND METHODS: The dental state of samples of the Tanzanian population was studied. Oral examinations were conducted on 5,532 adults from rural and urban cluster samples. DMFT was related to age, gender, and residence. The pattern of tooth loss within dental arches was mapped, and the prevalence of shortened dental arches was estimated. RESULTS: Mean DMFT scores increased gradually from 1.8 (20- to 29-year-olds) to 3.8 (50- to 59-year-olds). A steep increase was observed in the > or = 60-year-olds (DMFT 8.1). "Missing" was the dominant component of DMFT. The mean number of present teeth ranged from 27 in the youngest to 20 in the oldest age group. Under 60 years of age, DMFT was significantly higher for women than for men. No differences were found between residence categories. Molars were more frequently decayed, missing, and mobile than premolars. Of all subjects, 41% had complete dental arches, 44% had interruptions (of these, 73% were in posterior regions only), and 15% had shortened dental arches; 0.5% were edentulous. Of the subjects with shortened dental arches, about 65% had at minimum three pairs of occluding premolars. CONCLUSION: An initial low DMFT rate increased after the age of 60 years. Molars had the highest risk of dental decay and were most frequently absent. Shortened dental arches develop as a consequence of the pattern of tooth decay and tooth loss, although interruptions were frequently seen in the posterior regions.

Adult↗
PubMed1995

Peripheral giant cell granuloma: a clinical study of 77 cases from 62 patients, and literature review.

OBJECTIVES: The aim of this study was to identify the principle clinical features of the peripheral giant cell granuloma (PGCG), and to recognise clinical features of PGCG that are poorly defined. DESIGN: We reviewed retrospectively 77 cases of PGCG from 62 patients, from our files with respect to incidence, sex, patient age, race, clinical symptoms and signs, radiographic features and recurrence following excision. RESULTS AND CONCLUSIONS: Our results were largely in agreement with previous reports, although there is wide variation in the results published between series. In addition, some clinical features of PGCG are poorly defined. Little is known about the relative incidences of PGCG and central giant cell granuloma. An association between PGCG and tooth loss may exist, but is poorly defined, and not all PGCG that involve edentulous areas follow recent tooth loss. Information about PGCG recurrence after excision is limited, and does not necessarily follow incomplete excision. Despite the large number of reported cases of PGCG, clarification of some clinical features is required, and may help formulation and interpretation of future laboratory-based research into this poorly understood lesion.

Adolescent↗
PubMed2006

The biomechanics of abfraction.

The role of occlusal loading in the development of non-carious cervical lesions is becoming increasingly prominent. It is suggested that high occlusal loads result in large stress concentrations in the cervical region of the teeth. These stresses may be high enough to cause disruption of the bonds between the hydroxyapatite crystals, eventually resulting in the loss of cervical enamel. This article reviews the evidence to support the thesis that occlusal loading can contribute to the process of non-carious cervical tooth loss or abfraction. It also reviews the potential interactions between occlusal loading and erosion that may contribute to non-carious cervical tooth loss.

Animals↗
PubMed1999

Osseoperception: sensory function and proprioception.

Tooth loss and its replacement have significant functional and psychosocial consequences. The removal of intra-dental and periodontal mechanoreception accompanying tooth loss changes the fine proprioceptive control of jaw function and influences the precision of magnitude, direction, and rate of occlusal load application. With the loss of all teeth, complete denture restoration is a compromise replacement which only partially restores function. Implant-supported prostheses restore jaw function more appropriately, with improved psychophysiological discriminatory ability and oral stereognosis. Osseoperception is defined as depending on central influences from corollary discharge from cortico-motor commands to jaw muscles, and contributions from peripheral mechanoreceptors in orofacial and temporomandibular tissues. The processing of central influences is considered with the recognition of the plasticity of neuromotor mechanisms that occurs to accommodate the loss of dental and periodontal inputs.

Bite Force↗
PubMedDate not supplied

Tissue-engineered hybrid tooth and bone.

Tooth loss accompanied by alveolar bone resorption presents a significant clinical problem. We have investigated the utility of a tissue-engineering approach to provide corrective therapies for tooth-bone loss. Hybrid tooth-bone tissues were bioengineered as follows. Tooth implants were generated from pig third molar tooth bud cells seeded onto polyglycolide (PGA) and polyglycolide-colactide (PLGA) scaffolds, and grown for 4 weeks in the omenta of adult rat hosts. Bone implants were generated from osteoblasts induced from bone marrow progenitor cells obtained from the same pig, seeded onto PLGA fused wafer scaffolds, and grown for 10 days in a rotational oxygen-permeable bioreactor system. The tooth and bone implants were harvested, sutured together, reimplanted, and grown in the omenta for an additional 8 weeks. Histological and immunohistochemical analyses of the excised hybrid tooth-bone constructs revealed the presence of tooth tissues, including primary and reparative dentin and enamel in the tooth portion of hybrid tooth-bone implants, and osteocalcin and bone sialoprotein-positive bone in the bone portion of hybrid tooth-bone constructs. Collagen type III-positive connective tissue resembling periodontal ligament and tooth root structures were present at the interface of bioengineered tooth and bone tissues. These results demonstrate the utility of a hybrid tooth-bone tissue-engineering approach for the eventual clinical treatment of tooth loss accompanied by alveolar bone resorption.

Animals↗
PubMed1998

The role of cuspal flexure in the development of abfraction lesions: a finite element study.

A tooth flexure mechanism has been proposed over the past 15 yr to explain non-carious cervical tooth loss. It is well established that cavity preparation weakens a tooth, resulting in more cuspal movement under occlusal load. The aim of this study was to investigate the effect that an occlusal restoration would have on the stress profile in the cervical region of a lower second premolar using two-dimensional finite element stress analysis. Under an eccentric 100 N occlusal load, a premolar with an occlusal amalgam restoration showed peak tensile and shear stresses in the buccal cervical region that were in excess of the known failure stress for enamel. Increases in the cavity depth of the occlusal amalgam restoration were found to increase cervical stress more than increases in cavity width. It was concluded that the weakening effect of cavity preparation may contribute to the development of non-carious cervical tooth loss.

Bicuspid↗
PubMed2001

The genetic basis of modularity in the development and evolution of the vertebrate dentition.

The construction of organisms from units that develop under semi-autonomous genetic control (modules) has been proposed to be an important component of their ability to undergo adaptive phenotypic evolution. The organization of the vertebrate dentition as a system of repeated parts provides an opportunity to study the extent to which phenotypic modules, identified by their evolutionary independence from other such units, are related to modularity in the genetic control of development. The evolutionary history of vertebrates provides numerous examples of both correlated and independent evolution of groups of teeth. The dentition itself appears to be a module of the dermal exoskeleton, from which it has long been under independent genetic control. Region-specific tooth loss has been a common trend in vertebrate evolution. Novel deployment of teeth and reacquisition of lost teeth have also occurred, although less frequently. Tooth shape differences within the dentition may be discontinuous (referred to as heterodonty) or graded. The occurrence of homeotic changes in tooth shape provides evidence for the decoupling of tooth shape and location in the course of evolution. Potential mechanisms for region-specific evolutionary tooth loss are suggested by a number of mouse gene knockouts and human genetic dental anomalies, as well as a comparison between fully-developed and rudimentary teeth in the dentition of rodents. These mechanisms include loss of a tooth-type-specific initiation signal, alterations of the relative strength of inductive and inhibitory signals acting at the time of tooth initiation and the overall reduction in levels of proteins required for the development of all teeth. Ectopic expression of tooth initiation signals provides a potential mechanism for the novel deployment or reacquisition of teeth; a single instance is known of a gene whose ectopic expression in transgenic mice can lead to ectopic teeth. Differences in shape between incisor and molar teeth in the mouse have been proposed to be controlled by the region-specific expression of signalling molecules in the oral epithelium. These molecules induce the expression of transcription factors in the underlying jaw mesenchyme that may act as selectors of tooth type. It is speculated that shifts in the expression domains of the epithelial signalling molecules might be responsible for homeotic changes in tooth shape. The observation that these molecules are regionally restricted in the chicken, whose ancestors were not heterodont, suggests that mammalian heterodonty may have evolved through the use of patterning mechanisms already acting on skeletal elements of the jaws. In general, genetic and morphological approaches identify similar types of modules in the dentition, but the data are not yet sufficient to identify exact correspondences. It is speculated that modularity may be achieved by gene expression differences between teeth or by differences in the time of their development, causing mutations to have cumulative effects on later-developing teeth. The mammalian dentition, for which virtually all of the available developmental genetic data have been collected, represents a small subset of the dental diversity present in vertebrates as a whole. In particular, teleost fishes may have a much more extensive dentition. Extension of research on the genetic control of tooth development to this and other vertebrate groups has great potential to further the understanding of modularity in the dentition.

Animals↗
PubMed2002

Nutrition as a mediator in the relation between oral and systemic disease: associations between specific measures of adult oral health and nutrition outcomes.

Recent associations between oral health and systemic disease have led to renewed interest in the mouth and its contribution to health outcomes. Many pathways for this relationship have been postulated, among them the potential mediating role of nutrition. The link between various nutrients and systemic disease has been established, but relatively little work has been done in relating oral conditions with nutrition. We searched MEDLINE, from 1966 to July, 2001, to identify articles relating specific oral measures to nutrition outcomes. We included original articles written in English with a sample size greater than 30 that used objective oral health measures. We reviewed a total of 56 articles. Only a small proportion of these studies were methodologically sound. Although many studies were small and cross-sectional, the literature suggests that tooth loss affects dietary quality and nutrient intake in a manner that may increase the risk for several systemic diseases. The impact of tooth loss on diet may be only partially compensated for by prostheses. To date, there is little information relating periodontal disease and oral pain and nutrition. A few studies suggest poorer nutrition among individuals with xerostomia and altered taste. Further, impaired dentition may contribute to weight change, depending on age and other population characteristics. There is a paucity of well-designed studies addressing oral health and nutrition. Before we can acquire a better understanding of how nutrition and oral health interrelate, however, more studies will be required to confirm these associations-preferably longitudinal studies with larger sample sizes and better control of important confounders.

Adult↗
PubMed2002

Tooth surface loss: does recreational drug use contribute?

OBJECTIVE: This pilot study was designed to measure tooth wear in a sample of 13 subjects who regularly use amphetamine-like drugs (Ecstasy, amphetamines) and compare the observed wear with a matched sample of nondrug users. DESIGN: The two groups, both composed of 13 undergraduate students, were matched for age and sex. Other factors influencing tooth wear were controlled by matching the groups on their responses to a questionnaire asking about recognised common causes of tooth wear. The participants teeth were examined and the degree of wear scored according to a tooth wear index. RESULTS: Severity of occlusal tooth wear of the lower first molar teeth was significantly greater in the drug user group than in the control group (P<0.05). No other statistically significant differences between the groups were found. CONCLUSION: Regular use of amphetamine-like drugs could be associated with increased posterior tooth wear.

Adolescent↗
PubMed2005

Classification, reproducibility and prevalence of root proximity in periodontal patients.

AIM: The primary aim of this study is to define and classify root proximity. The secondary aim is to examine the reproducibility of the measurement tools, to study the prevalence per inter-dental area and to examine whether the distance from the cemento-enamel junction (CEJ) to the bone crest (BC) differs between sites with root proximity and their contra-lateral sites without root proximity. MATERIAL AND METHODS: In order to indicate the location of root proximity, a modification of the Shei ruler was developed, dividing the roots into three equal parts. A radiographic template was used to measure the distance between the roots, in this way determining the severity of the root proximity. The reproducibility of the measurement tool was tested, the prevalence was calculated and the distances CEJ-BC for root proximity sites and contra-lateral sites were recorded. RESULTS: A two-digit classification was obtained dividing the root into three locations [apical (A), between (B) and coronal (C)], with each location having the possibility of three different severities of root proximity. The described modification of the Shei ruler and the measurement tool for the severities can be considered as reproducible measurement tools. Root proximity was most prevalent in maxillary molars and between central and lateral incisors in the maxilla and mandible. There was no difference in CEJ-BC distance between the root proximity sites and their contra-lateral sites. CONCLUSION: We can conclude that a two-digit classification for root proximity was established. Root proximity in untreated periodontal patients has no influence on the distance CEJ-BC. However, the location of root proximity becomes important from the moment that periodontal disease has been established at that site. The severity of root proximity is important for choosing treatment options. There is a striking similarity between bone loss patterns and tooth loss and the location of inter-dental spaces where root proximity is most prevalent.

Adolescent↗
PubMed1993

Oral health status of a long-term-care, veteran population.

The Department of Veterans Affairs (VA) operates the largest, integrated health care system in the United States of America. The projected need for long-term-care in the VA health care system parallels an expected increase in need for care in the United States, but precedes the need for care in the general population by 25-30 yr. The VA's Office of Dentistry, in an effort to estimate the resource requirements of this swelling group of veterans, initiated in 1986-7 an oral health survey of long-term care patients. The overall goals were to describe the oral health status of VA nursing home care units (NHCU) residents and to develop a methodology for estimating future dental health services utilization. This study describes the oral health status of the study population. Demographic and oral health data were collected for 650 long-term care residents of six VA NHCUs between October 1986 and July 1987. Data were collected on sociodemographic status, medical history, dental caries, periodontal diseases, oral soft tissue pathology, and the presence of dental prostheses. Caries and periodontal disease were evaluated using the United States National Institute of Dental Research Survey of Employed Adults and Seniors protocols. The oral health status of the population is described using DMF and ESI indices, the prevalence of oral lesions, levels of tooth loss, oral hygiene scores, and the status of existing dentures. Findings show moderate levels of untreated dental caries and periodontal disease and significant tooth loss which increased with age. A need for preventive therapy, restorative dentistry, conservative periodontal therapy, and prosthodontic care was evident.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2002

The relative impact of local and endogenous patient-related factors on implant failure up to the abutment stage.

The aim of the present study was to assess the influence of endogenous and local factors on the occurrence of implant failure up to the abutment stage. The study comprised a group of 399 consecutive patients, which represented the total of patients who had been treated from 1995 to 1997 (with a total of 1263 Brånemark Brån-system implants) at the Department of Periodontology of the University Hospital, Catholic University Leuven. For each patient, the medical history was carefully examined. Data collection and analysis were mainly focused on endogenous factors such as hypertension, osteoporosis, hypo- or hyperthyroid function, chemotherapy, diabetes type I or II, Crohn's disease, some local factors (e.g. bone quality, reason for tooth loss) and breach of sterility during surgery. The reason for tooth loss, smoking habits, radiotherapy and other local bone factors (bone quality and quantity) were also recorded. Implant failures were recorded up to the abutment connection. The present study indicated a success rate until this stage of 97.8%. General factors such as heavy smoking, chemotherapy plus poor bone quality increased implant failure rate. Radiotherapy, limited bone volume and claustrophobia, which led to breaching the strict preoperative rules of asepsis, appeared to be the most relevant local factors for early implant failures.

Adolescent↗
PubMed1997

[Trend of aging on the number of teeth investigated through a survey of dental health representation in a simple equation by using a kinetic method and its application].

A survey of dental health was conducted on 6,933 residents (aged 61.8 +/- 11.1) in 4 villages Nara Prefectural Uchiyoshino Health Center administers. Examinees were divided into 7 ages groups. The mean value of present teeth at each age group was calculated. Age dependency of number of teeth was investigated with a kinetic model based on the following premise. 1. Changes between age groups can be treated as a time series occurrence. 2. Number of missing teeth can be estimated as 29 - that of present teeth. Results show that the rate of decrease of the number of present teeth is of a first order in itself and the number of missing teeth. It can be mathematically expressed as follows: -dX/dt = k.X.(29 - X).......eq. (1). in which X = number of present teeth, 29 - x = number of missing teeth k = rate constant, t = time. From this simple relationship the following are suggested 1. Tooth loss is caused by the interaction of present teeth and sites where teeth are lost. 2. Integration of eq. (1) yields ln¿(29 - X)/X¿ = 29.k.t + a.......eq. (2). in which 0 < X < 29, t = time from the youngest age group (20-29), a = constant. It appears that, from eq. (2), the dental health of a community is determined by two coefficients, 29.k and a. 3. Helping a person realize his present and future dental state and to motivate action for prevention of tooth loss by showing him his rate of decrease, "tooth age" and the predicted number of teeth a certain years later calculated from eq. (1) and eq. (2), can be of great value. 4. Eq. (2) is transformed to X = 29/¿exp(29.k.t + a) + 1¿, which represents the reverse S-shaped curve of the age dependency of the number of teeth. 5. Applying this method to cohort analysis will enable forecast of the trend of the number of teeth.

Adult↗
PubMed1996

Dental effects of diet and coca-leaf chewing on two prehistoric cultures of northern Chile.

Two ancient cultures of northern Chile, the Chinchorro (9000-3500 BP) and the Maitas Chiribaya (850-700 BP) were examined for dental pathology in search of possible correlations between dental health, diet, and the cultural practice of coca-leaf chewing. The Chinchorro occupied the river mouth of the Azapa valley, subsisting almost exclusively on a maritime economy. The Maitas Chiribaya, descendants of migrant highlanders, had a rather well-developed agricultural subsistence base. The Chinchorro demonstrated extreme attrition rates and a correspondingly high frequency of periapical abscesses. They were essentially caries-free and enjoyed a moderate antemortem tooth loss frequency. The Maitas Chiribaya suffered light attrition; a high caries frequency, especially at the cementoenamel junction of crown and root, and a remarkably high antemortem tooth loss frequency. The cultural practice of coca-leaf chewing is implicated in the excessive posterior edentulism of the Maitas Chiribaya.

Adult↗
PubMed1996

Supportive care after active periodontal treatment: a review.

This review concerns the most significant questions regarding supportive (maintenance) care after active periodontal treatment: the effectiveness and ideal frequency of maintenance appointments, the adequacy of the supportive therapy according to patient needs, the possible alternatives to currently accepted protocols, and the relative value of personal oral hygiene in the overall context of supportive care. Periodontal diseases are infections with a high potential for recurrence, progressive loss of attachment and eventually, tooth loss. Current therapies for periodontal diseases are highly predictable in arresting disease activity. Supportive periodontal care has been shown to be very effective in maintaining support when adapted to each particular case. Nevertheless, current maintenance therapies may be unsuccessful in preventing further loss of attachment in a small number of sites for some patients. Tests aiming at bacterial identification and the subgingival application of antimicrobials may be helpful in the management of such cases, however the practical value in a specific setting is not known. There is growing evidence of the fundamental role of personal oral hygiene in supportive periodontal care. In cases with rapid and severe periodontal destruction and where local and/or systemic risk factors are present, personal oral hygiene becomes a key factor in the long-term preservation of periodontal support.

Anti-Bacterial Agents↗
PubMed2005

Direct restoration of worn maxillary anterior teeth with a combination of composite resin materials: a case report.

Tooth loss, alterations on tooth structure, and reduced vertical dimension are known to severely compromise the stomatognathic system. This case report describes the treatment of a patient who presented with an extremely worn maxillary anterior dentition with a loss of posterior support owing to the loss of almost all the posterior teeth, except the mandibular premolars. Provisional removable partial dentures were used to create an optimum maxillomandibular relationship and to provide restorative space prior to the restoration of the remaining teeth. This restoration was accomplished with a combination of layered hybrid and microfilled composite materials, which restored the maxillary anterior teeth to optimum esthetics and function.

Bisphenol A-Glycidyl Methacrylate↗