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PubMed1988

Wear of composite resin restorations in primary versus permanent molar teeth.

The purpose of this investigation was to compare the wear rates of posterior composite resin restorations in primary versus permanent teeth. Based on theories of composite wear in primary molars, as well as on empirical observations, we hypothesized that wear would be greater in permanent tooth restorations. In Part I of the study, quantitative wear data from four different clinical trials (three permanent tooth studies and one primary tooth study) were compared. The same posterior composite restorative material was investigated in each of the four studies. In Part II of the study, quantitative wear data were drawn from a single clinical trial wherein the same experimental posterior composite material was placed in primary and permanent molars in the same children. In Part II, the baseline sample size included posterior composite restorations placed in 92 primary and 95 permanent molars in all children (ages 7-10). Quantitative wear data were obtained by the cast assessment method at baseline, six, 12, and 24 months. The 24-month sample size was based on 48 available primary molar restorations and 89 permanent molar restorations. The loss of primary restorations was due almost exclusively to natural exfoliations. Findings in Part I revealed no significant difference in the wear of primary versus permanent molar restorations. In Part II, wear findings for primary molar versus permanent teeth, respectively, were as follows (in micrometers): 47 versus 49 at six months; 86 versus 80 at 12 months; and 133 versus 131 at 24 months. With a Wilcoxon two-sample test and an alpha level of 0.05, there were no significant differences at any recall for the wear rate of primary versus permanent restorations. These results differ sharply from findings reported by others.

Child↗

PubMedDate not supplied

Macroscopic enamel defects of primary anterior teeth--types, prevalence, and distribution.

A total of 40.7% of 509 exfoliated primary anterior teeth from children who were healthy products of uneventful pregnancies exhibited at least one macroscopic enamel defect. Twenty percent of the teeth exhibited hypoplastic defects (HD), 12.4% exhibited white-cream opacities (WCO), and 9.8% exhibited yellow-brown opacities (YBO). Slightly more than a third (33.6%) of the teeth had defects we considered to be developmental enamel defects (DED). The occurrence of DED did not vary with gender, side of mouth, individual tooth types, or racial background. DED occurred with increased frequency on maxillary teeth, facial surfaces, and the middle third of affected surfaces. These locations have thicker enamel than other sites and may be more susceptible to insult if vulnerability is a function of metabolic demand of the rapidly secreting ameloblasts. Twenty-five per cent of the maxillary incisors and 10.1% of the mandibular incisors exhibited HD whose locations coincided with enamel forming at birth. A third (33.3%) of the canines exhibited HD, which occurred most commonly in the middle third of the facial surfaces. These defects are believed to occur approximately six months postnatally and may be primarily due to mechanical trauma. YBO most commonly occurred on the middle third of the facial surfaces, while WCO on the gingival third. Neither YBO nor WCO followed a chronologic pattern.

Child↗

PubMedDate not supplied

Marginal leakage of impregnated Class 2 composites in primary molars: an in vivo study.

In vivo impregnation of the cervical margin was used in an attempt to prevent leakage of class 2 composite restorations in primary molars. Examination after 18 months demonstrated clinical success of the restorations. However, the exfoliated teeth presented extensive dye penetration at the approximal margins of the restorations, suggesting that impregnation did not prevent marginal leakage.

Bisphenol A-Glycidyl Methacrylate↗

PubMedDate not supplied

Development of caries in permanent first molars adjacent to primary second molars with interproximal caries: four-year prospective radiographic study.

PURPOSE: This study investigated the effect of the primary second molars' distal surface caries on the incidence of the permanent first molars' mesial surface caries in 613 paired tooth surfaces of children ages 6 to 8 years at baseline examination. METHODS: Proximal caries and its progression were diagnosed by bite-wing radiographs taken at a 1-year interval over a period of 4 years. The permanent first molars' mesial surfaces and primary second molars' distal surfaces were examined. Recorded were: (1) sound surfaces; (2) carious lesions on the enamel's external and internal half and on the dentin's external, middle, and internal third; (3) filled, extracted, and exfoliated teeth. The logistic model for panel data was employed to estimate the effect of proximal caries of the primary second molars' distal surfaces on the incidence of the permanent first molars' mesial surface caries. The 95% confidence interval probability was used. Sensitivity and specificity as well as the positive and negative predictive rates were computed. RESULTS: The results showed that the presence of proximal caries on each primary second molars' distal surfaces significantly affected the development of proximal caries on the corresponding permanent first molar's mesial surfaces. Age was estimated to exert a positive and highly significant impact, while gender had no effect. The odds ratio values ranged from 4.86 to 63.43. The values of sensitivity and specificity ranged from 45% to 97% and 80% to 89%, respectively, while the positive and negative rates ranged from 40% to 56% and 90% to 99%, respectively. CONCLUSIONS: Proximal caries present on the primary second molars' distal surfaces increases the risk of developing caries on the permanent first molars' mesial surfaces. This risk, however, is different among the paired surfaces studied.

Age Factors↗

PubMed1997

Cortical bone resorption secondary to endodontic-implant pathology. A case report.

A single implant was inserted to replace the mandibular right lateral incisor in a 50-year-old Caucasian woman. After one month, an endodontic lesion formed on the adjacent canine, which went on to engulf the fixture. Even though endodontic therapy was instituted expeditiously on the canine, the implant exfoliated spontaneously the following month. There was a large radiolucency afterwards, suggesting resorption of both the labial and lingual cortical plates. A follow-up radiograph four months later revealed a residual detect along with delayed wound repair.

Alveolar Bone Loss↗

PubMed1997

Scanning electron microscopic study of hypoplastic type amelogenesis imperfecta in primary teeth.

Amelogenesis imperfecta (AI) comprises a diverse group of hereditary enamel disorders that are characterized by hypoplastic and in some cases hypomineralized defects. Purpose of this investigation was to characterize the ultrastructure of autosomal recessive smooth hypoplastic amelogenesis imperfecta enamel. The primary teeth that exfoliated physiologically were studied by scanning electron microscopy. By using scanning electron microscope, multiple shallow depressions and deep tubular voids were observed. Irregular enamel, irregularities in enamel crystallites, hypoplastic areas on the enamel surface were seen.

Amelogenesis Imperfecta↗

PubMedDate not supplied

Surface topography and enamel-resin interface of pit and fissure sealants following visible light and argon laser polymerization: an in vitro study.

This in vitro study compared the effects of visible light and argon laser polymerization of pit and fissure sealants on surface topography and the enamel-sealant interface. Twenty caries-free human molars and premolars underwent soft tissue debridement and a fluoride-free prophylaxis. Fluoride-releasing sealant (UltraSeal XT Plus, South Jordan, UT 84095) was placed on the occlusal surfaces per the manufacturer's instructions, but underwent either visible-light polymerization for 30s (n = 10), or argon laser polymerization (0.231 J/cm2) for 10s (n = 10). The sealed teeth were thermocycled (500 cycles, 5 degrees to 50 degrees C) in artificial saliva. Surface morphology was evaluated by SEM. The teeth were sectioned for polarized light and SEM evaluation of the enamel-sealant interface, with two sections per tooth prepared for SEM. Phosphoric acid was used to unmask the enamel-sealant interface with one section; while the other section was not exposed to the phosphoric acid. Surface morphology of the sealant material was similar with both visible light and argon laser polymerization; however, there was a tendency for occasional areas of mild, focal cratering of the sealant surface with laser-curing. The junction between sealant and adjacent unsealed enamel was a relatively smooth transition without gaps, microspaces, crazing, exfoliative changes, or microfractures with both visible light and laser cured sealants. Acid treatment of the sections revealed resin tags which extended into the adjacent enamel for a considerable distance on SEM examination. The resin tas were similar in length and morphology with both visible light and argon laser curing. The enamel-sealant interface with visible light and laser curing showed intimate contact between the sealant and etched occlusal enamel with close apposition of the sealant. No microspaces were identified between the sealant and the occlusal enamel. An intact, interdigitating interface between a sealant and the adjacent etched enamel provides the first line of defense against a cariogenic challenge. Visible-light and argon laser curing allows for an intimate enamel-sealant interface without microspaces and protects sealed enamel from cariogenic challenges. The benefit of argon laser polymerization, fluoride release and mechanical protection of sealant material may provide improved caries resistance in sealed pits and fissures and adjacent nonsealed enamel surfaces.

Argon↗

PubMed1992

Scanning electron microscopic study of primary teeth in X-linked amelogenesis imperfecta.

Exfoliated primary teeth from a boy and a girl from a family with X-linked amelogenesis imperfecta (XAI) were studied by scanning electron microscopy. Teeth from the boy featured multiple shallow depressions on the enamel surface interspersed with deeper tubular voids. Shallow depressions and similar tubular defects were also apparent in control teeth from an unaffected individual but these were less frequent, irregularly distributed and less marked. Teeth from the heterozygous girl had broad furrows running longitudinally from the cusp(s) of the tooth cervically. These furrows were formed by a series of saucerized depressions which merged together in some areas. The bases of these depressions featured tubular voids extending into the enamel. These similar voids in teeth from both boy and girl probably represent enamel prism spaces vacant because of defective enamel protein synthesis and/or mineralization. Although the scanning electron microscopic features of teeth from females observed in this and previous studies of XAI differ, the enamel appears to be more similar in males with differing clinical XAI phenotypes.

Amelogenesis Imperfecta↗

PubMed1994

[Hypercalcitoninemia and disorders of dentition development. A family study].

INTRODUCTION: A lot of factors interfere in the physiopathology of the exfoliation of the primary teeth. One of the most important factors is bone shuffle which is due to osteoclastic activity; this activity is controlled by a hormonal equilibrium. CLINICAL CASE: The aim of the present study was to correlate primary teeth's exfoliation delay in two brothers with their hypercalcitoninemia. They had a positive familiar anamnesis for thyroid medullar cancer; this disease is notoriously associated with hypercalcitoninemia. CONCLUSIONS: The connection between a high basal and after-stimulation seric level of calcitonin and a lower activity of osteoclasis is evident. Thus, i also appeared evident to us the connection between the hormonal disease of the two children and the delay of exfoliation of their primary teeth. In these cases, it is important to control periodically the patients in order to prevent or to diagnose early isolated medullar thyroid cancer or a multiple endocrine adenomatosis.

Adolescent↗

PubMed1995

Leeway space and the resolution of crowding in the mixed dentition.

The leeway space provides adequate space to resolve crowding that is present in the mixed dentition in the majority of individuals. This space can be maintained by preserving arch length with a lingual arch as the primary teeth begin to exfoliate, unless conditions such as the premature loss of a primary canine require earlier intervention. A lip bumper can also be inserted after the eruption of the first premolars to preserve arch length.

Child↗

PubMed1991

Overviews of pediatric-endodontics.

Pediatric-endodontics is an expanding part of pediatric dental practice. Emphasis is centered on the retention of primary teeth until the normal exfoliation time utilizing indirect pulp therapy, pulpotomy, pulpectomy and root canal fillings. The preservation of vitality in young permanent teeth via pulp capping and pulpotomy is paramount until root formation is completed. When pulpless, these young teeth may be salvaged by apexification procedures.

Child↗

PubMed2005

Assessment of a novel alternative to conventional formocresol-zinc oxide eugenol pulpotomy for the treatment of pulpally involved human primary teeth: diode laser-mineral trioxide aggregate pulpotomy.

OBJECTIVE: The purpose of this study was to investigate whether a diode laser pulpotomy with mineral trioxide aggregate (MTA) sealing could be an acceptable alternative to the conventional formocresol pulpotomy and zinc oxide eugenol (ZOE) sealing in human primary teeth. METHODS: A randomized, single-blind, split-mouth study was used with a sample of 16 children aged from 3 to 8 years (mean age=5.10 years). A total of 26 pairs of teeth from these 16 patients were selected based on clinical and radiographic criteria. One tooth from each pair was randomly assigned to either the laser-MTA pulpotomy group or the formocresol-ZOE pulpotomy group. All teeth were followed up clinically and radiographically at 2.3, 5.2, 9.5 and 15.7 months. All extracted failures were sectioned and photographed to assess possible reasons for this. RESULTS: A total of seven laser-MTA-treated teeth were deemed to be radiographic failures (mean time until failure=9.1 months) compared to three formocresol-ZOE treated teeth (mean time until failure=12.5 months). These results were not significant using Fisher's exact test (P>0.05). Six of the laser-MTA failures and all three formocresol-ZOE failures exhibited furcal and/or periapical radiolucencies with or without pathologic root resorption. One of the laser-MTA failures displayed premature root resorption and is being observed for exfoliation. Analysis of photographs of teeth available for extraction revealed errors in clinical technique in addition to expected signs of a disease process such as the presence of granulation tissue and areas of pathologic root resorption. CONCLUSIONS: The laser-MTA pulpotomy showed reduced radiographic success rates compared to the formocresol-ZOE pulpotomy at 15.7 months; however, these results were not statistically significant. Improved success rates among a larger patient sample and a longer follow-up period would be required for the laser-MTA pulpotomy to be considered a routine alternative to the conventional formocresol-ZOE procedure. Meticulous restorative techniques must be followed to ensure the success of laser-MTA pulpotomies.

Aluminum Compounds↗

PubMed2001

Dental erosion in deciduous teeth--an in vivo and in vitro study.

OBJECTIVE: The aims of this study were to report on severe dental erosion and its associated etiological factors in deciduous teeth of Saudi children (n=16, X macro=6.5 years, R=5--8) in vivo, and to confirm (or reject) the clinical diagnosis by scanning electron microscopy (SEM). Another aim was to study progression of erosion in vitro using extracted healthy deciduous and permanent teeth. METHOD: For the in vivo study, a questionnaire and clinical examination was completed, medical history obtained and exfoliated eroded teeth (n=8) examined by SEM. For the in vitro study, enamel specimens were prepared from Saudi (n=21) and Finnish (n=19) deciduous teeth as well as Finnish permanent teeth (n=20), immersed in 2% citric acid for 5--30 min, microhardness measurements performed, and the specimens studied by SEM. RESULTS: The in vivo investigation showed that high intake of acidic drinks and fruits, upper respiratory tract problems and frequent medications may constitute possible etiological and/or aggravating factors for severe dental erosion in Saudi children. Deciduous tooth enamel was softer than permanent tooth enamel. SEM showed no clear differences in the ultrastructure of the enamel specimens amongst the three groups. The clinical diagnosis of severe dental erosion in those cases studied was reliable as verified by SEM. CONCLUSIONS: The presence of dental erosion in children is likely to be associated with a number of general health and dietary factors but is also aggravated by the relatively more rapid progression of erosion in the deciduous teeth.

Analysis of Variance↗

PubMedDate not supplied

Adaptation of Class II Vitremer restorations with and without primer: a morphometric study.

PURPOSE: The aim of this study was to assess the adaptation of Vitremer with and without primer and compare to that of Z100 with Scotchbond Multi-Purpose. METHODS: Fifty-seven Class II cavities were prepared in 32 extracted or exfoliated primary molars. The cavities were randomly assigned to one of three groups and restored as follows: group A, Vitremer with primer (20 preps); group B, Vitremer without primer (19 preps); and group C, Z100 with Scotchbond Multi-Purpose (18 preps). The restored teeth were thermocycled, embedded in acrylic resin, and sectioned. At least three 1-mm thick sections were obtained from each restoration. Adaptation of the materials was assessed by computerized quantitative morphometry using an image analysis system. In addition to the margin, the entire contact length between the tooth and the restorative material was measured. Voids were recorded separately for the base and cavity margins, and the percentage of defected length was calculated. At least three sections of each restoration were assessed. The section with the worst results was selected as the representative of the restoration. RESULTS: Margin defects were present in 14% of all the restorations, equally distributed between the three groups (A, 10%; B, 16%; C, 17%). A significant difference was found between groups B and C when the percentage of defects in the base was assessed. CONCLUSIONS: Vitremer without primer presented considerably fewer voids when compared with Z100/Scotchbond Multi-Purpose. Although no difference in margin defects could be observed between the three groups a better adaptation to the cavity base was seen in the Vitremer restorations without primer. This finding might be of clinical importance and should be tested in other in-vitro and in-vivo studies.

Composite Resins↗

PubMed1978

Bone reaction to orthodontic forces on vitreous carbon dental implants.

On the basis of a very small sample in dogs, it appears that orthodontic techniques cannot be used to move a vitreous carbon implant. Therefore, one should not use implants before the completion of orthodontic treatment in persons who may require orthodontic service unless the implants are to be used for anchorage. Alveolar bone heals in very close apposition to vitreous carbon implants in dogs. Prior experiments with vitreous carbon implants have been conducted with free-standing implants; in this study a substantial number of implants became excessively mobile and exfoliated. Therefore, it is recommended that implants be stabilized through the bone-healing period. Because of the small sample, this study should be considered as only a pilot study and observations made should be considered solely as guidelines.

Animals↗

PubMed1999

Oral health in pre-school children living in Sweden. Part III--A longitudinal study. Risk analyses based on caries prevalence at 3 years of age and immigrant status.

A decreasing proportion of children require operative treatment each year and an increasing proportion of children will at recall require no operative care. This would provide resources to give individualised prevention to children at risk for developing new carious lesions. From 3 years of age, however, the prevalence of caries increases up to the age when the primary dentition exfoliates, even though the children attend regular dental service programmes yearly, and for some children dental caries remains a significant problem. The purpose of the present study was to describe the dental health of a group of 6-year-old children living in Sweden, with special reference to caries prevalence at 3 years of age and to immigrant status. At 6 years of age, 45% of the children were free of initial and manifest carious lesions in the primary cuspids and molars. The mean caries increment between 3 and 6 years was 0.9 tooth surfaces for children who were caries free at 3 years of age compared to 4.5 tooth surfaces for children with manifest carious lesions at the same age. The mean caries increment from 3 to 6 years was 1.3 in the non-immigrant group and 3.6 in the immigrant group. For the majority of the children in this study, current preventive dental care seems sufficient. However, for about one-third of the children (children with carious lesions at 3 years of age and/or immigrant status), current caries preventive programme used in the Public Dental Service are inadequate.

Child↗

PubMed1995

Fine incremental lines observed on the enamel surfaces with a prismless structure in human teeth after phosphoric acid etching.

In human tooth enamel, the surface prismless layer contains liner laminas homologous to the cross-striations of enamel prisms other than the Retzius lines, while these lines terminate on the perikymata or run in parallel with the enamel surface. In our present scanning electron microscope observations after phosphoric acid etching, many fine incremental lines (FIL) running transversely were found on the inner occlusal enamel with a prismless structure in a young permanent premolar. Almost the same structures were also found on the upper-coronal enamel with scattered prismless and indistinct prism structures in an exfoliated deciduous molar, and the FIL occasionally went across the indistinct prisms or caused the lower half of the prisms to disappear. Their intervals ranged from about 0.5 to 2 microns; less than the diameter of the prisms. Such results suggest that the FIL are not the termination of the laminate striations in the surface prismless layer, but that the previously unnoticed patterns sometimes formed by the sequential completion of the activity of ameloblasts which interact with each other in a transverse row at the final stage of matrix formation.

Acid Etching, Dental↗

PubMed1979

The Papillon-Lefèvre syndrome: keratosis palmoplantaris with periodontopathy. Report of a case and review of the cases in the literature.

The Papillon-Lefévre syndrome (PLS) is an autosomal recessive trait characterized by diffuse transgredient palmar-plantar keratosis (PPK) and premature loss of both the deciduous and permanent teeth. In most cases, the PPK is noted within the first 3 years of life. The periodontal lesions begin shortly after the start of both the primary and the permanent dentitions. The teeth are affected in the order of their eruption, exhibiting inflammation of the periodontal tissue, bleeding of the gums, pocket formation, loosening, and finally spontaneous exfoliation without showing definite signs of root resorption. After an edentulous interval, the same process begins anew shortly after the second dentition. Ectopic intracranial calcifications, mental retardation, and increased susceptibility to infections have often been seen in PLS patients and may thus be regarded as facultative signs.

Child↗