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PubMed2001

The use of plasma-rich growth factors (PRGF) in oral surgery.

The therapeutic objective of utilizing growth factors in oral surgery is to improve upon the body's regenerative capacity. In many situations, the unaided regeneration process is insufficient to allow complete repair of both bone and soft tissues. This article presents two clinical cases that describe different applications of growth-factor preparation applied at the surgical site in order to stimulate regeneration of osseous and epithelial tissues. Both clinical cases demonstrate the therapeutic effectiveness of utilizing the described technique for the incorporation of plasma-rich growth factors as an adjuvant in regenerative procedure.

Alveoloplasty↗
PubMed2001

The influence of restorative materials on marginal gingiva.

BACKGROUND: A great variety of dental materials are now available for use in restorative treatments. Much attention has been devoted to physical and chemical properties, but the biological effects of these materials have been less frequently studied. AIM: The aim of this study is to test the influence of resin based restorations, amalgams and gold alloys, as restorative materials in immediate contact with the gingival tissues. METHODS: In 103 patients (54 male and 49 female, 39 smokers and 64 non-smokers, mean age: 34 +/- 13 years) with 255 restored teeth (101 resin-based materials, 98 amalgams, and 56 gold inlays), the marginal gingiva was examined. The restorations selected had to be in place more than 6 months. The patients participating in the study had no systemic diseases and pregnant patients were excluded, as were those under long-term medication and those with severe periodontal disease. The filling materials were examined for surface roughness, secondary carious lesions and gaps. The marginal gingiva in contact with the restorative materials was tested by reference to Bleeding Index (BI), Gingiva Index (GI), probing depth and degree of tooth mobility. As controls 255 teeth without fillings, of the same type, in the opposite jaw were used. RESULTS: The 101 resin-based restorations had a mean age of 3.1 (+/- 2.0) years, the amalgam fillings were in place 6.6 (+/- 4.1) years and the gold inlays had an average age of 4.7 (+/- 4.6) years. Surface roughness was observed in 66.3% of the resin-based restorations, in 47.9% of the amalgams and in 10.7% of the gold inlays. Absence of bleeding after probing was observed for 25.7% of the resin-based restorations, for 55.1% of the amalgam fillings, and for 58.9% of the gold inlays. All classes of restored teeth showed significant differences from the controls without fillings. The mean probing depth for the resin-based fillings was 3.6 mm (control 2.4 mm), for teeth with amalgams 3mm (control: 2.4 mm) and for teeth with gold inlays 2.5 mm (control 2.1 mm). A significant difference between smokers and non-smokers was only found in the group of resin-based restorations. The Bleeding Index was significantly higher in the group of smokers (p = 0.0005) in comparison to the non-smokers, as was the Gingiva Index (p=0.0106). CONCLUSION: The marginal adaptation of the restored teeth examined showed materially specific differences. The handling of resin-based materials, in comparison to amalgam or gold remains very sensitive and consequently there is prevalent error of technique. The high prevalence of gingival irritation in association with resin based materials may be caused by non-indicated applications, failures of technique, or simply the chemical properties of the materials.

Adolescent↗
PubMedDate not supplied

Swing-lock removable partial dentures.

The swing-lock removable partial denture (RPD) is a little-taught RPD concept that offers clinicians additional choices in the treatment of perplexing situations involving periodontally compromised dentitions, missing key abutments, and other clinical situations in which a conventional RPD design may not be feasible. This article reviews past and current literature concerning the swing-lock RPD and provides some clinical and laboratory considerations involving the treatment planning and fabrication of this often-useful RPD.

Contraindications↗
PubMed2002

[Oral health care in young people insured by a health insurance fund. 2. Prevalence and treatment of malocclusions in the Netherlands between 1987-1999].

In this paper data are presented about malposition of teeth in 5-, 11-, 17- and 23-year-olds in the time period between 1987-1999. Furthermore, results are shown of a longitudinal study in youngsters 11-17-years of age of whom some were and others were not treated orthodontically. Between 1987 and 1999, the percentage of youngsters who received orthodontic treatment increased from 23% to 40%. In the same time period the percentage of youngsters 17- and 23-year-olds with a malposition of teeth decreased. In youngsters involved in the longitudinal study and treated orthodontically, a strong improvement of the tooth position was found between the age of 11 and 17. Such an improvement did not appear in the non-treated group. The outcomes are considered as an indication that orthodontic treatments have positive effects on individual and on population level.

Adolescent↗
PubMedDate not supplied

Clinical and microbiological changes in a child with rapid alveolar bone loss and refill.

A 10-year-old Japanese girl with severe tooth mobility in her lower permanent incisors was examined clinically, as well as radiographic and microbiological means. The incisors had severe alveolar bond loss and pocket depths exceeding 7 mm at the first visit, however, 10 periodontal bacteria were not detected in subgingival plaque samples taken from the lower central incisors using a 16S rRNA-based polymerase chain reaction method. Periodontal treatment consisting of mechanical debridement and antibiltic medication resulted in a significant improvement of the clinical parameters. Three months after the first examination, dental radiographs showed refilling of alveolar bone in the region. Further, microbiological examinations after remission detected only oral microflora commonly found in health children including A. actinomycetemcomitans. Based on the clinical, readiographic, and microbiological findings, the present case was diagnosed as acute periodontitis.

Acute Disease↗
PubMed2002

Longevity of two-unit cantilevered resin-bonded fixed partial dentures.

PURPOSE: To examine the clinical performance of two-unit cantilevered resin-bonded fixed partial dentures that were inserted at The Prince Philip Dental Hospital, Hong Kong by students and staff between 1992 and 1998. MATERIALS AND METHODS: A search of the Hospital computer records system revealed a list of 130 patients who had received two-unit cantilevered resin-bonded fixed partial dentures (RBFPD) placed more than 24 months previous to the review date. For each patient clinically examined, the following data were recorded: gender, age, operator, cementation date, endodontic treatment if performed, bone support, tooth mobility, the presence of shimstock contacts on abutment or pontic in intercuspal position, the presence of interproximal contacts adjacent to the prosthesis assessed by dental floss. Date of any debonds with subsequent treatment was recorded and the patient was asked qualitative questions about their prosthesis. RESULTS: 82 prostheses were placed in 69 patients and were found to have a mean service life of 36.7 +/- 15.4 months and a range of 4.3 months to 95.4 months. In total, four prostheses were reported to have debonded resulting in a clinical retention rate of 95.1%. No rotation, drifting or tipping was observed for any of the prostheses during the time of this study. Overall patients' satisfaction with RBFPDs was good with an average assessment rating of 8.2.

Adolescent↗
PubMed2002

Proximal contact formation with different restorative materials and techniques.

PURPOSE: To determine, whether different tooth colored materials and application techniques influence the proximal contact strengths (PCS) in vitro. MATERIALS AND METHODS: Standardized MO-cavities for direct restorations were prepared into 360 artificial lower first molars. Eight groups were formed (n = 45) and restored with amalgam (1), low (2, 3), medium (4, 5) and high (6, 7) viscosity hybrid composites and compared to the original contact strengths of the unprepared teeth (8). The restored teeth were mounted into a socket simulating physiological tooth mobility. PCS were quantified by measuring the forces necessary for passing the proximal contact with floss under standardized conditions using a universal testing machine. RESULTS: PCS ranged from 1.32 +/- 0.56 N for the low viscosity composite to 9.90 +/- 1.98 N for the Amalgam restoration. Medium (5.65 +/- 1.08 N) and high viscosity hybrid composites (5.90 +/- 1.45 N) inserted in a multi-layer technique showed no statistically significant differences to the original PCS of the unprepared teeth (5.76 +/- 0.53 N).

Analysis of Variance↗
PubMed2002

[A new splint technique in dental traumatology].

The treatment of displacement injuries and fractures of permanent teeth is an important emergency therapy in the dental office. Due to new sport trends and various outdoor activities, the frequency of dental trauma of children and adolescents alike is steadily rising. The standard treatment of displacement or avulsion injuires of permanent teeth is repositioning or replantation with subsequent splinting. The dental trauma splint must be flexible to allow for the physiologic movement of the repositioned or replanted teeth in order to reduce the risk for ankylosis or external root resorption. Stabilization of a repositioned tooth with a flexible splint over a short time period optimises the rehabilitation of the periodontal tissues. In the literature various splinting techniques have been described. This paper presents a new splinting technique; the Titanium Trauma Splint (TTS), which is made of pure titanium and was specifically developed for the treatment of traumatically displaced or avulsed permanent teeth. The TTS-splint has certain advantages when compared to traditional splinting techniques. These advantages are beneficial both for the dentist and patient alike.

Adolescent↗
PubMed2003

Immobilization of root-compromised maxillary anterior teeth: a case report with 14-year clinical follow-up.

The efficacy of a modified cast-metal resin-bonded splint was evaluated after 14 years in service. The splint was used to immobilize the root-compromised maxillary central and lateral incisors of a teenage male following relapsed orthodontic treatment. The affected teeth were indirectly traumatized, before their eruption, in a bicycle accident that resulted in avulsion of their primary predecessors. The rationale for selecting this treatment modality rather than the alternatives is discussed. The clinical protocol employed during the treatment and subsequent follow-up is described.

Adolescent↗
PubMed2003

The benzoyl-DL arginine-naphthylamide (BANA) test and polymerase chain reaction measurement of pathogenic bacteria can assess the severity of periodontal disease.

The benzoyl-DL arginine-naphthylamide (BANA) test for detecting digesting peptidase and polymerase chain reaction (PCR) measurement of pathogenic bacteria were performed in 15 patients with periodontal disease. The number of Porphyromonas gingivalis, Bacteroides forsythus and Treponema denticola, which are the most potent accelerators of alveolar bone resorption, were determined. Attachment loss and the BANA test showed significant close correlations with the number of pathogenic bacteria as well as with the tooth mobility and pocket depth. In conclusion, the BANA test and PCR measurement of bacteria are useful methods for detecting pathogenic bacteria that promote alveolar tissue destruction.

Adolescent↗
PubMed2003

Ameloblastic carcinoma: case report and literature review.

Ameloblastic carcinoma is a rare malignant lesion with characteristic histologic features and behaviour that dictates a more aggressive surgical approach than that of a simple ameloblastoma. However, reliable evidence of its biologic activity is currently unavailable due to the scarcity of well-documented cases. It occurs primarily in the mandible in a wide range of age groups; no sex or race predilection has been noted. It may present as a cystic lesion with benign clinical features or as a large tissue mass with ulceration, significant bone resorption and tooth mobility. Because the lesion is usually found unexpectedly after an incisional biopsy or the removal of a cyst, a guide to differential diagnosis is not usually useful. The identifying features of ameloblastic carcinoma must be known and recognized by dental practitioners. Our understanding of the histologic features of ameloblastic carcinoma is somewhat vague. The tumour cells resemble the cells seen in ameloblastoma, but they show cytologic atypia. Moreover, they lack the characteristic arrangement seen in ameloblastoma. The clinical course of ameloblastic carcinoma is typically aggressive, with extensive local destruction. Direct extension of the tumour, lymph node involvement and metastasis to various sites (frequently the lung) have been reported. Wide local excision is the treatment of choice. Regional lymph node dissection should be considered and performed selectively. Radiotherapy and chemotherapy seem to be of limited value for the treatment of ameloblastic carcinomas. At the moment, there are too few reported cases to make a definite recommendation regarding treatment. Close periodic reassessment of the patient is mandatory.

Aged↗
PubMed2003

Autogenous free tooth transplantation with a two-stage operation technique.

If tooth transplantation is to succeed, it is crucial to preserve the vitality of the cells on the root surface of the tooth transplant. Insufficient postoperative nutrition to the cells on the root surface of the tooth transplant was thought to contribute to their devitalization of these cells. Impaired nutrition may be a result of poor contact between the recipient bed and the root surface of the transplanted tooth, and development of an interposed blood clot. To improve postoperative nutrition to the root surface cells, teeth were transplanted to the recipient beds in which the tissues were regenerated during a 14 day period, i.e., using the two-stage transplantation technique. In a clinical study of this technique, a total of 95 autogenous teeth with fully developed roots were transplanted in 84 patients, and examined both clinically and radiographically for up to 13 years after the transplantation. In a dog model, a comparative experimental study was made between teeth transplanted to beds left to heal for 5 days and teeth transplanted to beds prepared immediately before the transplantation. The clinical study showed a low prevalence of tooth graft loss and root resorption even when infection of the root canal occurred. Periodontal attachment loss of less than 3 mm was found in 97% of 6 defined surfaces around the transplanted teeth. Transplanted teeth which were later extracted were often hypermobile, and signalled pain when provoked with heavy loading. Excessive extraction trauma, fixation failure, and excessive plaque accumulation after transplantation were all shown to be detrimental to tooth transplant. Transplanted teeth were used as abutments for fixed partial dentures and provided the necessary dental support for crowns and bridges even in patients with atrophic alveolar bone. The experimental histological study showed no differences between test and control teeth in terms of the prevalence of root resorption, which was suspected to be caused by traumatic injuries to the roots during extraction and non-rigid fixation of the transplanted teeth.

Age Factors↗
PubMedDate not supplied

Tongue indentations as an indicator of clenching.

This study examines the diagnostic efficacy of lateral tongue indentations as an indicator of clenching. A retrospective study of 113 patients (85 active and 28 recall) using radiographic indicators, excessive tooth mobility and self-report by the patient suggests that tongue indentations when present are indicators of clenching and warrant routine examination.

Adolescent↗