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PubMed1987

Tooth eruption and craniofacial development in congenital hypothyroidism: report of case.

The long-term effects of severe hypothyroidism on craniofacial growth and dental development are illustrated in this case. It is apparent that given a favorable diet, the primary dentition can persist for a long period (early childhood to at least the age of 19) without the development of dental caries. It is also clear that the dental structures can still respond to the effects of L-thyroxine at a relatively late age, with the exfoliation of primary dentition and eruption of the secondary dentition. Impacted mandibular second molars appear to be rare. The lack of proper growth of the mandible and failure of normal resorption of the internal aspect of the ramus associated with deposition of bone on the external aspect with the development of normal-size teeth, resulted in a lack of space for the eruption of mandibular second molars. The impaction of the mandibular second molars in this patient seems to be caused by a dissociation of ramus growth and dental development, resulting in insufficient space for proper eruption of these teeth.

Adult↗

PubMedDate not supplied

Spectrum of dentin dysplasia in a family: case report and literature review.

The dentin dysplasias (DD), which may be classified as type 1 (DD1) or type 2 (DD2), form a group of rare, inherited dentin abnormalities that are clinically distinct from dentinogenesis imperfecta. Studies of affected families may help to distinguish different types of DD and provide further insight into their etiology and clinical management. This report describes a family that showed characteristic dental features of DD1, including clinically normal crowns in both primary and permanent dentitions, and mobile teeth that may be associated with premature exfoliation. Radiographic features included calcification of the pulp with crescent-shaped, radiolucent pulp remnants, short, tapering, taurodontic roots, and many periapical pathoses that may be cysts or granulomas. A spectrum of dentin dysplasia was noted within the family. Strategies to prevent pulp and periapical infections and early exfoliation of the teeth include meticulous oral hygiene and effective caries-preventive measures.

Child↗

PubMed1995

Nutrition, tooth development, and dental caries.

Many studies involving small animals have clearly shown that malnutrition affects tooth formation and causes increased dental caries. We have conducted two cross-sectional studies and one longitudinal study among Peruvian children to investigate the effect of early malnutrition on oral health. The cross-sectional studies have shown that in malnourished children the pattern of caries development as a function of age is significantly altered as a result of a delayed eruption and exfoliation of the deciduous teeth. This phenomenon has made difficult the observation by other scientists of a clear effect of nutritional status on total caries experience because the comparison of age-adjusted caries data between populations of children with different nutritional status is inappropriate. The use of peak caries activity has allowed the observation of a strong association between malnutrition and increased dental caries. The longitudinal study has confirmed the results of the cross-sectional studies and has demonstrated that one mild to moderate malnutrition episode occurring during the first year of life is associated with increased caries in both the deciduous and permanent teeth many years later.

Adolescent↗

PubMed2002

Evaluation of cutting patterns produced in primary teeth by an air-abrasion system.

OBJECTIVE: The aim of this in vitro study was to assess the effect of tip diameter, nozzle distance, and application time of an air-abrasion system for cavity preparation on the enamel of primary teeth. METHOD AND MATERIALS: Forty exfoliated primary teeth were air abraded with a microabrasion machine used with a handpiece with an 80-degree-angle nozzle, 50-micron abrasive particle size, and 80-psi air pressure. The effects of 0.38- or 0.48-mm inner tip diameter, 2- or 5-mm distance from tip to tooth surface, and 15 or 30 seconds of application time on cutting efficiency were evaluated. Cutting width and depth were analyzed and measured from scanning electron micrographs. RESULTS: Statistical analysis revealed that the width of the cuts was significantly greater when the tip distance was increased. Significantly deeper cavities were produced by a tip with a 0.48-mm inner diameter. The application time did not influence the cuts. CONCLUSION: The cutting patterns found in this study suggest that precise removal of enamel in primary teeth is best accomplished when a tip with a 0.38-mm inner diameter is used at a 2-mm distance.

Air↗

PubMedDate not supplied

Bilateral fusion of the mandibular primary incisors: report of case.

Fusion is a common dental finding. However, bilateral mandibular fusion of the primary incisors is a rare event, occurring with a prevalence of less than 0.02 percent. When all four permanent successors are present, this event becomes rarer still. Once fusion has been diagnosed, careful monitoring is required, since problems with exfoliation can occur, along with caries formation in the groove of the incompletely fused teeth.

Child, Preschool↗

PubMed2006

An unusual combination of idiopathic generalized short-root anomaly associated with microdontia, taurodontia, multiple dens invaginatus, obliterated pulp chambers and infected cyst: a case report.

Generalized diminished root formation is a rare condition leading to early loss of teeth. This report describes an unusual case of generalized short roots associated with microdontia, taurodontism of posterior teeth, and multiple dens invaginatus along with short stature in a 20-year-old man, who had lost several teeth because of spontaneous exfoliation.

Adult↗

PubMed1988

Mesenchymal influences on epithelial differentiation in developing systems.

Mesenchyme tissue: cells, matrix and soluble factors, influence the morphogenesis, proliferation and differentiation of a variety of embryonic epithelia, e.g. in the tooth, skin, mammary and salivary glands. Mesenchyme derivatives also 'maintain' adult epithelia, e.g. the local proliferation rate and cytokeratin composition of oral mucosa. Abnormalities in such epithelial-mesenchymal interactions lead to a variety of pathologies such as premalignant lesions, e.g. leukoplakia, tumours and psoriasis, whilst therapeutic manipulation of such interactions can prevent the exfoliation of dental implants. In all of these systems it is critical to understand, at the cellular and molecular levels, how the mesenchyme signals to the epithelium and how the latter processes and responds to such signals. We have investigated such questions using the developing embryonic palate both as a model system and as an important organ: failure of mesenchymal signalling leads to the common and distressing birth defect of cleft palate. Bilateral palatal shelves arise from the maxillary processes of embryonic day 11 (E11) mice, grow initially vertically down the sides of the tongue, elevate on E13.8 to a horizontal position above the dorsum of the tongue and fuse with each other in the midline on E14. The medial edge epithelia of each shelf fuse with each other to form a midline epithelial seam, suprabasal cells die, and the basal (stem) cells synthesize extracellular matrix molecules and turn into mesenchymal cells. Simultaneously the oral epithelia differentiate into stratified squamous cells and the nasal epithelia into pseudostratified ciliated columnar cells. Oral, medial and nasal epithelial differentiation is specified by the underlying mesenchyme in vivo and in vitro. Signalling involves a bifurcating action of a combination of soluble growth factors e.g. TGF-alpha, TGF-beta, PDGF and FGF on palatal epithelia and mesenchyme. These factors stimulate the synthesis of specific extracellular matrix molecules by palate mesenchyme cells, and the appearance of receptors for such molecules on epithelial cells. In this way, a combination of mesenchymal soluble factors and extracellular matrix molecules direct palatal epithelial differentiation. These signals act on epithelial basal (stem) cells, causing them to synthesize unique proteins, which may direct subsequent differentiation of daughter cells. In the most extreme example, namely the medial edge epithelia, these signals result in the basal epithelial cells transforming into mesenchymal cells, thus demonstrating that they are indeed multipotential stem cells.

Animals↗

PubMed2003

Periodontal status following surgical-orthodontic alignment of impacted central incisors with an open-eruption technique.

Several factors may affect the outcome of the orthodontic/surgical modality for the resolution of impacted central incisors, but particularly the manner in which the impacted tooth is exposed. The present study aimed to evaluate the post-retention clinical appearance and periodontal status of impacted maxillary central incisors which were exposed and aligned with an open-eruption surgical-orthodontic technique. Twelve subjects (four males, eight females), aged 22 years (range 15-38 years), previously treated for a unilateral impacted central incisor (ICI), were examined 10 years (range 3-25 years) post-retention. A split-mouth method was used for the comparison with the unaffected side. One treated central incisor exfoliated 10 years post-retention, thus the results were based on the remaining 11 patients. Statistically significant differences were found between the affected and control incisors in most of the periodontal parameters measured, although some were small and of minimal clinical importance. The increase in the mesio-labial pocket depth was associated with a highly significant 10 per cent reduction in bone level at this site (P = 0.007). A highly statistically significant increase in crown length (P < 0.001) and a reduction in the width of the attached gingiva (P = 0.005) were seen in these previously impacted teeth. An abnormal gingival contour was present in eight treated incisors and positional relapse in five cases. It is concluded that the convenience of the open-eruption technique must be weighed against the long-term negative aesthetic and periodontal effects on the treated tooth, although the findings of this study should be viewed with caution due to the limited sample size.

Adolescent↗

PubMed1977

Production and origin of oral malodor: a review of mechanisms and methods of analysis.

Organoleptic studies indicate that the oral cavity is usually the principal source of physiologic malodor associated with the early morning halitosis. In all individuals, regardless of the age or health status of the oral tissues, the most intense oral malodor is exhibited after prolonged periods of reduced saliva flow and abstinence from food and liquid. This results from normal metabolic activity in the oral cavity and is accentuated in cases with periodontal involvement. Physiologic oral malodor is transient in duration as it can be controlled to varying degrees in most individuals by oral hygiene measures, such as tooth brushing, dental prophylaxis, tongue scraping and rinsing with antiseptic mouth washes. Experimental evidence strongly suggests that putrefaction of sulphur-containing proteinaceous substrates by predominantly gram-negative oral microorganisms is the primary cause of oral malodor. Optimum putrefactive activity occurs in low carbohydrate environment, physiological pH, and anaerobic conditions. Salivary sediment containing the exfoliated epithelial cells is the primary source of substrate which exists in a disulphide state. Proteolysis and reduction of disulphide bonds precedes the formation of odor. The odor intensity of putrescent saliva and plaque head-space vapor has been correlated with the concentration of volatile sulphur compounds consisting of hydrogen sulphide, methyl mercaptan, dimethyl sulphide and dimethyl disulphide. Except for dimethyl disulphide, the same sulphur-containing compounds have been found in mouth air of all tested individuals. Hydrogen sulphide and methyl mercaptan emanate an offensive putrid odor and account for approxiamtely 90% of the total sulphur content of mouth air. In half of the population tested, methyl mercaptan and hydrogen sulphide content of early morning mouth air is sufficiently high to account for the oral malodor. Brushing studies indicate that both plaque and tongue are important sources of malodor with most of the odor emanating from the dorso-posterior surface of the tongue. None of the gas chromatographic or mass spectrometric analyses have detected the presence of amines, indole, or skatole in the head-space, mouth air, or breath vapor samples.

Amino Acids↗

PubMedDate not supplied

Conservative treatment of severely luxated maxillary primary central incisors: case report.

The treatment and follow-up evaluation of two orally luxated maxillary primary central incisors in a three-year-old girl is described. The injured teeth were displaced into a cross-bite with their mandibular opposing teeth. They were repositioned shortly after the injury and splinted with composite resin for two weeks. Oral hygiene instructions and antibiotic therapy were prescribed. Two weeks after the injury a necrotic pulp was removed and the root canals filled with a resorbable paste. Thirty months after the injury, the teeth and the surrounding tissues were clinically and radiographically asymptomatic and physiologic root resorption could be noted. The permanent successors erupted soon after natural exfoliation of the injured primary teeth. Only mild hypocalcified defects were observed on the permanent incisors.

Acute Disease↗

PubMed1994

Clinical evaluation of composite resin tunnel restorations on primary molars.

Twenty children, presenting 66 proximal carious lesions in 60 primary molars, were selected to receive composite resin tunnel restorations. Thirty of these teeth were expected to exfoliate within 6 months (group I); in the remaining 30 teeth exfoliation was expected within 1 year (group II). All teeth received tunnel preparations, which were then restored with a posterior composite resin. The restorations were evaluated after 6 months and after 1 year through each of the following methods: bitewing radiographic examination, clinical examination with a probe and mirror, and direct examination of proximal surfaces after tooth extraction. The occlusal portions of the restorations were considered to be excellent both after 6 months and 1 year. Radiographic examinations and direct examinations (performed after extraction of teeth) did not reveal the same percentages of secondary caries in the proximal portion of restorations. Fracture of the marginal crest reached 3% during the first 6 months, but fracture was absent during the subsequent 6 months.

Bisphenol A-Glycidyl Methacrylate↗

PubMed2001

Investigation of an index to measure tooth wear in primary teeth.

UNLABELLED: Tooth wear, in particular erosion, has been reported to be widespread in children in the UK. Wear may affect either dentition, but epidemiological measurement has proved difficult. OBJECTIVES: The objectives of this study were: (a) to investigate use of a simple index of wear in primary teeth; and (b) to compare findings from visual examination and from photographs with those at histological examination of the same teeth. SAMPLE AND METHODS: Forty-one exfoliated or extracted primary anterior teeth were assessed visually and using photographs. Ground sections of the teeth were prepared and examined using polarised light microscopy. RESULTS: On visual examination, 31 of the 41 teeth had evidence of wear. In 14 teeth, tissue loss was confined to enamel and in 17 it extended into dentine. Findings on photographs were very similar to those on visual examination. Of the 10 teeth without erosion visually, two had evidence of loss on histological examination. Of the 14 with visual evidence of erosion confined to enamel, dentine was exposed in 11 cases. Diffuse demineralisation was evident histologically in 11 of the 31 teeth with evidence of erosion. CONCLUSIONS: It was concluded that clinical assessment of erosion may underestimate the extent of the condition. Under the conditions of the study, photographs gave results similar to those on visual examination.

Child↗

PubMedDate not supplied

Prepubertal periodontitis: a report of 2 cases.

PURPOSE: Prepubertal periodontitis is a term suggested for a form of periodontitis that starts soon after the eruption of primary teeth. There is increased awareness that the disease entity known as "periodontitis" is in all probability a family of related but reasonably discrete diseases. The purpose of this report is to describe the clinical, radiographic, and laboratory findings in 2 patients, as well as treatment of prepubertal periodontitis. METHODS: This study presents 2 cases of generalized prepubertal periodontitis: a 5-year-old girl and a 13-year-old girl. RESULTS: Case 1 presented to the clinic because of parental concern for the early exfoliation of her teeth. All of her teeth with Grade III mobility, ie, 8.5, were extracted and the rest were scaled and root planed with subgingival irrigation of 0.2% chlorhexidine. She received a program of 3-month maintenance scaling and 6 months later, there was no further progression of periodontal lesions. Case 2 demonstrated the destruction of tooth roots along with extensive loss of tooth roots and alveolar bone. Since all the permanent teeth were Grade II mobile, the patient was advised to have total extraction with replacement of teeth by complete denture prosthesis at a later date. CONCLUSIONS: In case 2 premature root resorption was occurring concurrently with unexplained extensive alveolar bone loss. In Case 1, the elimination of the pathogenic microflora during primary dentition by early extraction of the teeth involved, plus daily local, mechanical and chemical control of the irritant factors may have prevented subsequent damage to remaining teeth in prepubertal periodontitis.

Adolescent↗

PubMed2003

Induced elephant (Loxodonta africana) tusk removal.

Elephant tusk removal usually requires costly surgical procedures that are time-consuming and present a significant risk to the animal when performed using general anesthesia. Such techniques require gauges, chisels, and forceps to remove the tusk. This article reports the simple removal of the tusk of an 18-yr-old African elephant (Loxodonta africana) without the use of surgical instruments and anesthesia. Rubber elastics were placed around a tusk, causing loss of alveolar bone with subsequent exfoliation of the tusk within 3 wk. The healing process was uneventful.

Animals↗

PubMed1984

Observations on a calcium hydroxide lining in retrieved deciduous teeth, with proximal amalgam fillings.

The integrity and thickness of Dycal linings were determined on exfoliated deciduous teeth in which proximal fillings had been placed in vivo. The teeth remained in the oral cavity for more than 18 months after placement of the restorations. The average lining thickness was found to be 114 microns. One-third of the samples showed evidence for the presence of Dycal at the gingival floor, up to the proximal tooth wall. Wash-out of the lining was observed for most teeth in which Dycal had been present near the proximal tooth wall. Incipient caries formation, associated with wash-out of the lining, was noted in a few samples. Contact between amalgam and dentine was frequently observed at the line angle, pulpal floor and axial wall.

Calcium Hydroxide↗

PubMedDate not supplied

Success rate of formocresol pulpotomy in primary molars restored with stainless steel crown vs amalga.

PURPOSE: The purpose of this retrospective study was to compare the success rates of formocresol pulpotomy in primary molars restored with stainless steel crowns (SSC) to those restored with amalgam (AM). METHODS: Radiographs of pulpotomized primary molars restored with SSC or AM in the principal author's pediatric dentist practice were evaluated and defined as a "failure" when one or more of the following signs were present: internal (IR) or external (ER) root resorption and periapical (PR) or inter-radicular (IRR) radiolucency. Pulp canal obliteration was not regarded as failure. Three hundred and forty-one molars were available for follow-up evaluations ranging from 6 to 103 months. RESULTS: Forty-seven (14%) teeth were defined as "failure," with a rate of 13% (36/287) for teeth restored with SSC and 20% (11/54) for AM. This difference was not statistically significant (P>0.1). Failure rates of 2 surfaces AM was 23% (7/30), much higher than that of one surface AM (10%, 2/20). Most of the failed teeth presented more than one pathologic finding, with IR being the most frequently observed (36%), followed by ER (31%), IRR (22%) and PR (11%). Pulp canal obliteration was detected in 80% of the teeth, with similar rates in both groups. Failures were observed initially after a mean follow-up of 27 and 29 months in teeth restored with AM and SSC, respectively. CONCLUSIONS: Pulpotomized primary molars can be successfully restored with one surface amalgam if their natural exfoliation is expected within not more than two years.

Child↗

PubMed2005

Variation in elemental intensities among teeth and between pre- and postnatal regions of enamel.

Microspatial analyses of the trace element composition of dental enamel are made possible using laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS). Fine spatial resolution, multielement capabilities, and minimal sample destruction make this technique particularly well-suited for documenting the distribution of elements in sequentially calcifying layers of enamel. Because deciduous enamel forms from week 13 in utero up to 9 months postnatally (thereafter essentially becoming inert), the application of LA-ICP-MS allows for the retrospective measurement of prenatal and early postnatal trace-element uptake during a critical period of child development. In this study, we compared intra- and intertooth intensities of 25Mg, 57Fe, 66Zn, 68Zn, 88Sr, 138Ba, and 208Pb via LA-ICP-MS of 38 exfoliated deciduous incisors and canines donated by 36 participants in the Solís Valley Mexico Nutrition Collaborative Research Support Program (NCRSP). Pre- and postnatal comparisons within teeth showed significant increases (P < 0.001) and greater variation in the abundance of all isotopes in postnatal enamel, with the exception of a decrease in 25Mg (P < 0.001) and constant values for 88Sr (P = 0.681). Conversely, comparisons by tooth type and mouth quadrant revealed few significant differences between teeth of the same individual. We argue that more variation in the trace element composition of teeth occurs across developmental areas within a tooth than among different teeth of the same person. This study further demonstrates that sequentially calcifying areas of enamel have different chemical concentrations. The results support the use of microspatial analyses of enamel for understanding changes in nutrition, pollution, and residence.

Child↗

PubMed2002

Space-regaining treatment for a submerged primary molar: a case report.

The aetiology of submerged primary molars is not known and optimal treatment has still not been established. If submerged primary teeth are left untreated, the occlusal consequences are space-loss due to tipping of adjacent teeth and/or overeruption of the opposing teeth. Normally, treatment consists of extraction of the deciduous teeth or observation for normal exfoliation. Here we report a case where the submerged primary molar was extracted surgically after space-loss had been regained.

Bicuspid↗