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Differences in morphological age-related dental changes depending on postmortem interval.

Morphological methods for age estimation from teeth have been developed and applied to samples without taking the postmortem interval into consideration. We studied differences in morphological age-related changes between fresh extracted teeth and teeth from human skeletal remains in order to develop appropriate dental age estimation methods according to the time after death. Forty-three permanent teeth from dental patients were compared to 37 teeth obtained from human skeletal remains with a postmortem interval from 21 to 37 years. Morphological age-related changes were investigated by measuring variables on intact and half-sectioned teeth. A new computer assisted image analysis procedure to avoid subjectivity was developed to measure variables in sectioned specimens. Dental color, translucency length, attrition, cementum apposition, and secondary dentin showed higher values in teeth from human skeletal remains than in fresh extracted teeth. Variables obtained by morphometric analysis of computer-generated images (tooth length, tooth width, root length, and root area) showed higher values in fresh extracted teeth than in teeth from skeletal remains. The postmortem interval affects age-related morphological changes, and therefore different methods should be used for teeth of unknown postmortem interval.

Adult↗

The visible portion of anterior teeth at rest.

The visibility of anterior tooth surfaces with lips at rest or during function is an important factor in determining prosthodontic outcome. There is a lack of sufficient information published on this subject. The aim of this study was to investigate the degree of visibility of maxillary and mandibular anterior teeth surfaces when the lips are at rest. Four hundred seventy three adults were examined. All the subjects had maxillary and mandibular anterior teeth present with no caries, restorations, severe attrition, mobility, extrusion, or obvious deformities. The portions of anterior teeth that were visible were measured vertically using a Boley gauge from the border of the lip to the incisal edge for the incisors and to the cusp tip for the canines. The measurement was taken at the midpoint of the tooth when the lips and lower jaw were at the rest position. The length of the upper lip was measured from the base of the columella to the tip of the philtrum at the midline of the face. Males showed more of the maxillary lateral, canine, and mandibular anterior teeth than females. With increasing age, the amount of maxillary anterior teeth that was visible at rest decreased. The subjects with shorter upper lips displayed more maxillary central incisor structure than those with longer upper lips. Racial differences were not found. The amount of visible portions of anterior teeth is determined by muscle positions that vary from person to another. It provides an excellent starting point for vertical positioning anterior teeth that can be modified as necessary in any clinical situation. The findings of this study should help the dentist in providing aesthetic prosthodontic treatment that involves replacement of anterior teeth. A useful guideline for positioning anterior teeth is suggested.

Adult↗

Dentinogenesis imperfecta in the Brandywine isolate (DI type III): clinical, radiologic, and scanning electron microscopic studies of the dentition.

Teeth of seven patients from the Brandywine isolate who had dentinogenesis imperfecta (DI) type III were evaluated by clinical, radiologic, and scanning electron microscopic techniques. The deciduous and permanent teeth were opalescent, and there was marked attrition. Enamel pitting was present on some permanent teeth. Anterior open bites were found in all persons with complete permanent dentitions. Pulps of developing teeth were larger than normal during early development but rapidly became almost completely obliterated. There was increased constriction at the cementoenamel junctions. While radiolucencies were noted at the apices of teeth which had pulp exposures due to attrition, several patients had similar radiolucencies which could not be attributed to caries or attrition. Scanning electron microscopy showed a significant reduction in the number of dentin tubules on fractured dentin surfaces; calcospherites at the calcification front were either irregularly shaped or absent. A single tooth from a patient with DI type II was studied and had similar abnormalities on scanning electron microscopy, although tubules were easier to find and calcospherites at the calcification front were more regular than in DI type III. The findings in DI type III of enamel pitting, enlarged pulps early in tooth development, and radiolucencies at the apices of teeth without pulp exposures support the hypothesis that DI type II and DI type III are different disorders.

Adolescent↗

Current controversies in late incisor crowding.

Although the terminology is mildly controversial, late incisor crowding (tertiary crowding, late secondary crowding, post-adolescent crowding) is widely regarded as a normal maturation event which is likely to affect most individuals to some extent. Disagreement arises when attempts are made to quantify the change and to predict the timing of the crowding. Most young adults experience some degree of loss of incisor alignment, usually near the anticipated emergence time for the third molars, and almost characteristically it is the lower anterior teeth which best demonstrate the phenomenon. Unfortunately, the physiological crowding changes are frequently confused with orthodontic treatment relapse. Greater controversy surrounds the aetiology of the undesirable crowding changes and despite many attempts we are still not in the enlightened position of explaining, predicting or preventing the problem (except by permanent retention). It is illogical to assume a single cause as the beguilingly simple observation of crowding belies the complexity of possible interacting factors. Perhaps it is a capricious combination of: tooth size and arch form; facial growth pattern (differential soft tissue and skeletal maturation); continuing late growth rotations; cumulative effects of resting, functional and parafunctional soft tissue pressures; lack of compensating attrition; and an ill-defined, mesially acting force emanating from the back of the dental arch. Many theories have attempted to resolve the mystery of the mesially acting force, including: pressure from erupting third molars; an inherent mesial migration; continuing mesial and occlusal dental drifting; maturation and contraction of periodontal soft tissues (particularly the transseptal fibres); the anterior component of occlusal forces; and the lower anterior arch contracting influence of the incisor overbite.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The effect of age on morphology and eruption of the lower incisors in mature rats.

OBJECTIVE: This study investigated the effect of age on tooth and periodontium morphology and on tooth eruption in the lower incisors of 28 female rats, initial age 10 weeks. DESIGN: Morphometric data of the incisors in three young mature rats (weight 199+/-2.4 g) were compared to that of three 18-week-old (weight 260+/-5 g) animals. The rate of eruption was monitored during 12 months in 11 rats with all teeth in occlusion and in 11 rats with one lower incisor kept constantly out of occlusion. RESULTS: : The incisors continued to enlarge after the animals reached maturity with the size of the teeth increasing both longitudinally and circumferentially. Tooth volume increased by 21%, while that of the periodontal ligament was enlarged by only 12%. The rate of impeded eruption declined steadily from a mean value of 542+/-49 microm/day during the first experimental month to a mean value of 443+/-25 microm/day during the concluding month (p<0.05). The eruption rate of the teeth exceeded that of attrition rate by 2.4%. The unimpeded eruption proceeded steadily throughout the experimental year, at a mean rate of 811+/-12. CONCLUSIONS: Apparently in mature rats age has no effect on the genetic potential as expressed by the unimpeded eruption. In the impeded teeth age does affect the phenotypic expression of the eruptive function governed by occlusal forces as well as by the form and size ratio of the tooth and its PDL.

Age Factors↗

Enlarged occlusal surfaces on first molars due to severe attrition and hypercementosis: examples from prehistoric coastal populations of Texas.

During an examination of prehistoric samples from the Texas coast, individuals consistently exhibited a suite of traits on the first molars that included severe wear, hypercementosis, and resorption of the buccal margin of the alveolus. The occlusal surface of the tooth was worn below the cervical margin, with the subsequent incorporation of the buccal surface of the buccal roots into the occlusal plane. This expanded occlusal surface, which extends the buccal surface beyond the normal edge of the tooth, is composed of a combination of original enamel, secondary dentin, and cementum. There is a marked rounding of the buccal aspect of the occlusal surface. These conditions were noted in both maxillary and mandibular first molars. The resorption of alveolar bone surrounding the buccal roots resembles resorption associated with periodontal infection and is thought to be the result of severe levels of stress being applied to this portion of the dentition.

Dental Occlusion↗

Gingival phenotypes in young male adults.

In a previous study on 42 young adult, periodontally healthy subjects without any attrition, abrasion or crown restoration, gingival thickness (GTH) was determined at facial aspects of premolars, canines and incisors by a novel ultrasonic device. GTH strongly depended on periodontal probing depth, width of gingiva (WG), and tooth type. Whereas the ratio of crown width to its length (CW/CL) was not identified as an explanatory variable, a significant influence of the subject was ascertained. The aim of the present study was to extend these analyses in order to identify subjects with different morphological characteristics of gingiva, i.e., gingival phenotypes. When employing cluster analysis on standardized parameters mean GTH, WG and CW/CL of upper canines, lateral and central incisors, 3 clusters were identified. Cluster A comprised 2/3 of subjects, displaying "normal" GTH, WG and CW/CL. Cluster B (n = 9, 21%) had a significantly thicker and wider gingiva, and a more quadratic form of upper front teeth. A 3rd cluster (cluster C, n = 5, 12%) was identified showing "normal" GTH, high CW/CL, but a narrow zone of keratinized tissue. Some characteristics of gingival phenotype of the upper front tooth region were also found at upper premolars (WG, CW/CL) but in general not at mandibular teeth. Present results clearly indicate evidence for the existence of different gingival phenotypes. Clinical relevance of these observations has to be tested in longitudinal studies.

Adult↗

Caring for the dentate elderly.

The proportional increase of elderly persons in most communities and increasing tooth retention among them betoken considerable change in gerodontic needs. Servicing dentate older patients will occupy progressively more practising time. This committment requires the development of somewhat different skills, knowledge and philosophy from those customarily propounded in dental teaching to date which has concentrated mostly on matters relevant to young and middle-aged persons. Dentists must become proficient in managing clinical entities of prevalence in the elderly. Xerostomia, a frequent, but often neglected symptom can have distressing consequences. Practitioners have a responsibility to detect it, analyse its likely cause or causes and select appropriate therapy. Root caries is re-emerging as a common finding. Its aetiology must be understood in order to institute effective preventive measures and treatment. Dentate elderly persons typically have heavily restored teeth subject to various iatrogenic problems. Some of the restorative work required can be provided exactly as for younger patients. However, optimum care is not necessarily the most elaborate. It is often desirable, when health or financial considerations dictate, to adopt expedients which reduce treatment extent and/or expense. Adhesive materials are extremely useful. The 'sandwich technique' for bonding composite resin to dentine via glass ionomer cement often facilitates the provision of extensive restorations in a minimally invasive fashion. Adhesive procedures can also be applied to treat attrition, mend fatigue fractures, splint teeth deficient in periodontal support, and provide simplified cosmetic treatment for elderly patients.

Aged↗

[The effect of lead exposure in utero on the teeth eruption and enamel development of rat offspring.].

OBJECTIVE: To investigate the effects of lead exposure at different levels in utero on the teeth eruption and enamel development of rat offsprings. METHODS: 27 pregnant SD rats were divided into three groups randomly: high level lead group (HLG), low level lead group (LLG) and control group with nine rats in each group. The three groups from the gestation day to the end of the gestation were given either deionized water in control group or deionized water containing 200 mg/L Pb2+ as lead acetate through drinking method in high level lead experimental group and 50 mg/L Pb2+ as lead acetate through drinking method in low level lead experimental group. The incisors of newborn rats were marked at the level of the gingival papilla on the 26th day after birth. On the 36th day, the incisors of newborn rats were marked again at the same level. Then the rat offsprings were killed and their blood was collected for lead analysis. The mandible incisors of rat offspring were separated and the content of Pb in incisors was determined by using a graphite furnace atomic absorption spectrometric method. The teeth of rat offspring were observed and the distance between two marks were measured by means of stereomicroscope. The ratio of calcium to phosphate of enamel of rat offspring was compared by electron probe microanalyses. RESULTS: The level of blood lead in 200 mg/L, 50 mg/L treated rat offspring groups was higher than that in control group. The tooth lead of 200 mg/L, 50 mg/L treated rat offspring groups [(77.3 +/- 6.3), (27.8 +/- 4.5) microg/g] were higher than the control [(6.6 +/- 0.8) microg/g, P < 0.01]. Compared with the control group, the teeth of lead exposure experimental groups were smaller and severity of attrition was obvious and pulpal perforations were often observed. These appearances was more distinct in rats of high level lead experimental group. The incisors of lead-treated rat offspring erupted [(0.25 +/- 0.08), (0.30 +/- 0.09) mm/d] more slowly than control ones [(0.39 +/- 0.09) mm/d, P < 0.01]. The ratio of calcium to phosphate (Ca/P) decreased with the increase of lead exposure. It was found that Ca/P in lead exposure experimental groups (1.68 +/- 0.54), (1.37 +/- 0.47) was significantly lower than that in the control group (2.14 +/- 0.33). CONCLUSION: Lead exposure in utero affects the normal eruption of teeth and enamel formation and the degree was related with the lead exposure level.

Animals↗

Overdentures for treatment of severe attrition.

This treatment of dentinogenesis imperfecta presented many problems because of the severe attrition of the existing teeth. An overdenture may be used in similar situations of extreme attrition.

Adolescent↗

The relation between tooth eruption and alveolar crest height in a human skeletal sample.

It is commonly assumed that alveolar crest height increases with continuing tooth eruption unless affected by marginal inflammation. To test this hypothesis, the relation between eruption and alveolar crest height was examined in skulls from a sample consisting of the remains of 244 individuals from the late medieval period. The mandibular first and second molars and second premolars were analysed. The age of the skulls was determined on the basis of dental development and molar attrition. Radiographs were taken and points representing the levels of the inferior dental canal (IDC), root apices (AP), alveolar crest (AC), cementum-enamel junction (CEJ) and occlusal surface were determined on the radiographs. The level of the IDC was used as a reference not changing with age. The distances between the points were measured with a help of a computer-digitizer system. Variable IDC-AP increased with age, indicating continuous eruption of the teeth. The distance between AC and CEJ also increased while the distance between IDC and AC remained constant, showing that the alveolar crest height did not increase accordingly. The lack of inflammatory changes on the alveolar bone surface suggests that occlusal attrition may be compensated for by continuous eruption without bone growth in the alveolar margin.

Adolescent↗

Prior fluoridation in childhood affects dental caries and tooth wear in a south east Queensland population.

Fluoride exposure in early life has an effect on dental caries experience, but does it affect tooth wear in later life? Ninety-six South East Queensland subjects were studied. Their histories revealed three groups; a fluoride (F-) in water supply, a F- by supplement, and a non-fluoridated (non F-) group. Significantly higher caries experience was found in the non-F- group compared with F- in water group and the F- supplement group. No statistically significant difference in caries experience was found between the F- in water and F- supplement groups. Overall, tooth wear affected more sextants of the dentitions of non-fluoridated, high-caries subjects than of fluoridated low-caries subjects. Comparisons of wear patterns on sextants of the dentitions, between the fluoridated and non-fluoridated groups, revealed that in sextants where attrition was present no marked differences were discernible between the two groups. However, in most sextants where incisal, palatal, occlusal or non-occlusal erosion was found, this type of wear was commoner in non-fluoridated subjects. The exceptions were the mandibular molar sextants, where prior fluoride-exposure did not appear to protect against occlusal erosion patterns. This study showed that fluoride exposure during the first 12 years of life, which reduced dental caries in this population, may also protect teeth from wear to some extent.

Adolescent↗