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Dietary consistency and craniofacial development related to masticatory function in minipigs.

Since the 1890s oral biological researchers have been interested in the idea that strenuous mastication of unprocessed food will stimulate proper oral-facial growth and occlusal relationships. Conversely, lack of such function due to consumption of refined food is one hypothesis among many for the etiology of malocclusion in industrialized humans. Adequately controlled experimental testing of the idea has been limited to rats. To investigate the "disuse" theory in a larger-bodied and more occlusally relevant animal model, we raised four Yucatan minipigs from weaning on hard diet (HD) and another four on softened but equivalent diet (SD). The animals were monitored for eight months, sacrificed, and then occlusal and osteometric data collected. Variations due to dietary regime are pervasive and not due to caries, periodontitis, or attrition differences. Whereas HD body weight is 10% greater than SD, the deep masseter is 25% greater, with similar disproportion in superficial masseter and temporalis weight. Facial prognathism, arch narrowness, tooth crowding/maleruption and posterior cranial tapering are markedly different in the two groups. A curious posterior torsional difference in the mandibular rami, as well as broadness and flatness of the mandibular symphysis, also occur in SD. We performed a Q-mode principal coordinates analysis of the 19 logged variables for the specimens, bootstrapping the variable list, to demonstrate a statistically significant (P < .01) overall pattern of dramatic differences. Having controlled other celebrated orthodontic etiologies (genetic background, respiratory mode, infectious degeneration and interproximal attrition), these results support the proposition that dietary consistency relates directly to human craniofacial growth.

Animals↗
PubMed1998

Surgical management of impacted third molars.

Teeth may become impacted when they fail to erupt or develop into the proper functional location. As such, impacted teeth are considered nonfunctional, abnormal, and pathological. The mandibular third molar is the most common tooth to become impacted. The cause of impacted third molars is thought to be inadequate space. Several studies indicate that a change from a coarse, attritive diet to a modern, refined diet has lead to an increased incidence of impacted teeth. Interproximal attrition allows for greater mesial migration of teeth and space for third molar teeth. Teeth that fail to attain a functional position may be pathological and should be considered for removal. The indications for removing impacted teeth can be divided into those of acute or chronic pathology. Impacted third molars are often associated with pain, infection, cyst formation, benign tumors, root resorption, bone loss, periodontal disease, and caries. The decision to surgically remove impacted third molars is often unclear. There are no absolute treatment protocols established. The dentist must consider a variety of factors and make an informed decision with the patient. Most experienced clinicians combine objective data and common sense to arrive at a logical treatment plan. The purpose of this article is to discuss factors related to impacted teeth and help the orthodontist understand the general management of impacted third molars. The decision for surgery will be assisted by an understanding of all of the risk factors associated with impacted teeth and presenting the options to the patient.

Decision Trees↗
PubMed1991

Localised palatal tooth surface loss and its treatment with porcelain laminates.

Localised tooth surface loss and subsequent caries in a young patient due to an unusual dietary habit is reported. The treatment and management of such conditions is discussed. Tooth surface loss is a condition seen with increasing frequency, often associated with the retention of the natural dentition into older age. In these older patients, abrasion and attrition tend to predominate as the causative factors but, in younger patients, acid erosion is frequently implicated. The acid involved may be dietary, in the form of carbonated beverages, fruit juices, vinegar or excessive intake of citrus fruits. If not derived from the diet, gastric acid may be the source if the patient has gastric reflux, perhaps associated with an ulcer or, in cases of anorexia nervosa or bulimia, where the patient deliberately induces vomiting and bathes the teeth in acid. There is a preponderance of female patients in the latter categories, although not exclusively so. Sometimes patients develop habits where an acidic substance is held in contact with certain teeth and the erosive process is more localised. This is illustrated in the case quoted by Reuter where grapefruit was held against the palatal surfaces of the upper anterior teeth resulting in enamel loss affecting that area. In all these cases of erosion the affected tooth surface was reported as being hard and shiny, lacking any of the features normally associated with dental caries.(ABSTRACT TRUNCATED AT 250 WORDS)

Bicuspid↗
PubMed2002

Transverse dental and dental arch depth dimensions in the mixed dentition in a skeletal sample from the 14th to the 19th century and Norwegian children and Norwegian Sami children of today.

Secular changes in transverse dental arch dimensions and dental arch depth were studied. Four cohorts with mixed dentitions were selected. The skull group comprised 48 skulls dating from the 14th to the 19th century and belonging to The Schreiner Collection at the Department of Anatomy, University of Oslo. The 1980s Sami group was comprised of 39 boys and 34 girls born in 1987 and living in the northern part of Norway. The 1960s Oslo group was comprised of 31 boys and 30 girls born in 1963 and living in the southern part of Norway. The 1980s Oslo group was comprised of 32 boys and 26 girls born in 1983 and living in the same area in southern Norway as the previous Oslo group. Sex was unknown in the skeletal sample, and the groups were analyzed with the sexes pooled; separate descriptive values are presented for the modern groups. The mandibular intercanine distance was smaller in the skulls compared with the modern groups. The transverse intermaxillary difference between the molars was larger in the skull group than in the 1980s Oslo group. The difference between the maxillary and mandibular intercanine distances was larger in the skulls compared with the modern groups, although the small number of measurements in the skull group impeded further analysis. The arch depth was smaller in the skull group compared with the modern groups; the 1960s Oslo group deviated because of a higher prevalence of caries in the second deciduous molars. The overjet was smaller among the skulls. The arch form measured as the angle between the left and right molar tooth rows was more acute in the skulls than in the modern groups. It was concluded that smaller arch depths are found in skeletal samples at early ages and that attrition does not explain the more upright incisors found in skeletal samples. A secular trend was found in the intermaxillary relation, which indicated that children in the 1980s Oslo group were at greater risk of developing a posterior cross-bite than children born in the 14th to 19th centuries.

Cephalometry↗