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PubMed1992

Keratinization of palatal mucosa beneath metal-based removable partial dentures.

Exfoliative cytology provides a non-invasive method of examining changes in epithelial differentiation beneath dentures. Cell sampling by mechanical scraping may introduce errors due to collection of deeper epithelial cells, therefore an alternative sampling method was evaluated. Cells collected from the hard palates of 24 dentate subjects using either a wooden tongue depressor or transparent, adhesive-coated tape were fixed and stained by Papanicolaou's technique. The percentage of the total epithelial cells counted that were anucleate (the orthokeratinization index) was 99.95 per cent using the tape technique but 15 per cent lower using the smear technique. It appears that the tape technique gives a more accurate representation of the orthokeratinization of superficial cell layers. The tape technique was used to examine epithelial changes beneath tooth-supported removable partial dentures (RPDs). In 26 subjects, who had worn cobalt chromium based RPDs for at least 6 months, samples taken from beneath the metal denture base had a 50 per cent lower orthokeratinization index than those from uncovered areas of the palate.

Adolescent↗

PubMed2001

Hypodontia, ankylosis and infraocclusion: report of a case restored with a fibre-reinforced ceromeric bridge.

Retained primary molars without permanent successors often undergo progressive infra-occlusion, without predictable exfoliation. Early prophylactic removal, after assessment of root resorption and adjacent periodontal support loss as well as age of onset, is often indicated. This article describes the joint orthodontic-restorative care of such a case and describes an alternative method of restoration using a fibre-reinforced ceromeric bridge. As well as a conservative preparation and good aesthetics, an overlay restoration provided a fully functional occlusion.

Anodontia↗

PubMed2000

A review of impacted permanent maxillary cuspids--diagnosis and prevention.

As impacted permanent maxillary cuspids occur in 1-2% of the population, the general dentist should know the signs and symptoms of this condition and the interceptive treatment. Features of buccal or palatal cuspid impaction include lack of canine bulges in the buccal sulcus indicating a lingual eruption path and possible impaction; lack of symmetry between the exfoliation and eruption of cuspids that may indicate palatal or lingual impaction; and abnormal mesiodistal location and angulation of the developing maxillary permanent cuspids on radiographs. Diagnosis of impacted cuspid teeth at age 8-10 years can significantly reduce serious ramifications, including surgical exposure and orthodontic alignment as well as root resorption of the lateral incisors. In specific cases, extraction of the primary maxillary cuspids can prevent impaction of the permanent maxillary cuspids and additional sequelae.

Child↗

PubMed2006

Palatal displacement of canines and maxillary skeletal width.

INTRODUCTION: The purpose of this study was to determine whether a clinically significant association exists between maxillary skeletal width and palatal canine impaction, also known as palatally displaced canine (PDC). METHODS: Seventy-nine patients with PDC were matched for age, sex, and malocclusion to 79 controls. Maxillary and mandibular skeletal widths and nasal cavity widths were measured on posteroanterior cephalograms; maxillary and mandibular intermolar widths were measured on dental casts; and maxillary interalveolar arch widths at 3 levels (canine, premolar, and first molar) were measured on occlusograms. RESULTS: Only maxillary alveolar arch width at the canine level was significantly different between the 2 groups. However, further analysis showed that the presence of erupted deciduous or permanent canines, rather than their absence in the canine area (whether due to extraction, exfoliation, impaction, or not yet having erupted), was strongly associated with maxillary intercanine alveolar arch width. CONCLUSIONS: The additional finding in this study that the eruptive status of canines significantly affects maxillary alveolar arch width in this area suggests that maxillary intercanine alveolar arch width as measured in this or other studies is not a good predictor of PDC.

Adolescent↗

PubMedDate not supplied

Estimation of the caries-related risk associated with infant formulas.

PURPOSE: Baby bottle tooth decay (BBTD) affects 6% of children under three years of age and is associated with inappropriate bottle use. The objective of this study was to estimate the caries-related risk associated with 26 infant formulas and whole milk. METHODS: First, the plaque pH of adult volunteers was monitored before and after an oral rinse with infant formula to determine the minimum pH obtained in response to each formula. Second, Streptococcus sobrinus 6715 was cultured in each infant formula, and the increase in the number of colony forming units was measured. Third, each infant formula was incubated with powdered enamel and the solubility of enamel mineral was calculated in the absence of bacteria. Fourth, each formula was mixed with standardized concentrations of acid to determine the buffering capabilities. Finally, enamel windows were created on extracted permanent molars and exfoliated primary incisor crowns that were then colonized with mutans streptococci and incubated with infant formula. Caries was assessed visually and radiographically for 18 weeks. The length of time required for the development of enamel caries, dentinal caries and pulpal involvement was recorded. RESULTS: One-way or two-way ANOVA of these five assays demonstrated that 1. Plaque pH varied in response to oral rinsing with infant formula and most formulas did have the ability to reduce the pH significantly below the pH obtained after rinsing with water 2. Some infant formulas supported significant bacterial growth 3. Enamel mineral was dissolved by incubation with certain infant formula 4. The buffer capacity varied among the infant formulas tested 5. The length of time required for caries to reach dentin or pulp differed for the formulas, with some formulas causing dentinal caries by 3.4 weeks and pulpal involvement by 7.2 weeks.

Acids↗

PubMed1999

Dental findings in three siblings with Morquio's syndrome.

Three siblings with Morquo's syndrome are described. Cultured fibroblasts from the youngest sibling demonstrated a total absence of N-acethylgalactosamine-6-sulphate-sulphatase whereas beta-galactocidase activity was normal, thus verifying the diagnosis of MPS-IV A. Dental features such as pointed cusps, spade-shaped incisors, thin enamel and pitted buccal surfaces were observed in all three children. Furthermore, in all three siblings the TMJ was affected with severe resorption of the head of the condyle. Histological examination of exfoliated primary molars showed a band of increased porosity following the striae of Retzius in the outer part of the enamel. These developmental disturbances were occasionally associated with minor localized defects in the enamel surface. The importance of close monitoring of dental development and regular dental care in order to prevent attrition of the teeth, loss of vertical face height and subsequent risk of TMJ dysfunction is emphasized.

Adolescent↗

PubMed1989

[Longitudinal study of the gingival status during transitional dentition].

253 milk teeth with inflamed gingiva were observed for 19 months (on average) around the time of exfoliation and changeover to the secondary dentition. The criteria used were the gingival index by Löe and Silness, the intravital staining of glycogen with iodine solution by Zabinska and the plaque index by Quigley and Hein. In about one third of the cases, there was residual inflammation following loss of the milk teeth in the original area. With eruption of the permanent teeth, plaque level increased as did the degree of gingival inflammation. On full eruption of the permanent dentition the values fell under their former level.

Child↗

PubMed1999

Dentinal dysplasia type I: report of a case.

A case of dentinal dysplasia type I is presented. This rare hereditary disturbance of dentine is characterized by short-rooted teeth with sharp conical apical constrictions, aberrant growth of dentine in the pulp chamber leading to reduced pulp space in permanent teeth and total pulpal obliteration in the primary dentition. Clinical, radiographic and histopathological material from a 7-year-old boy, showing the typical features of this disorder in which teeth are prematurely lost through periapical abscesses, cysts or spontaneous exfoliation, is described. A review of the theories of pathogenesis of this condition is included. Management of patients with dentinal dysplasia is difficult and a discussion of the shortcomings of various treatment strategies, including conventional endodontic therapy, periapical curettage and retrograde root filling, and a preventive regimen, are discussed. In this case, despite diagnosis being made at an early age and the provision of regular dental care, the patient is now losing teeth because of spontaneous abscess formation.

Child↗

PubMed2003

Advances in pediatric esthetic dentistry.

The introduction of low-shrinkage composite and no-rinse conditioners has created an opportunity for pediatric dentists to change their standard operative regimen. The low-shrink composite solves many of the problems that have discouraged clinicians from routinely providing posterior composites for their patients. The reduction in polymerization shrinkage decreases problems with contraction stresses, sensitivity, microleakage, recurrent caries, and negative pulpal sequelae. No-rinse conditioners simplify the process and shorten the time required for bonding procedures. Liquid polish reduces the tedious finishing previously required with resin-based composites. The combination of the easier bonding and more user-friendly composite could add a new operative technique to the pediatric dentist's armamentarium. A study of low-shrink, resin-based composite restorations was performed to determine the effectiveness of these new materials for pediatric dental practice. The restorations were placed in primary molars to allow for their retrieval when exfoliated. The preparation and restorative techniques were standardized to match a similar study that used the "open-sandwich" method. The modified US Public Health Service ranking was used to evaluate marginal integrity at 6-month intervals for the 40 restorations placed in primary molars as a pilot study. TESCERA ATL restorations and prostheses were also evaluated for clinical effectiveness.

Acid Etching, Dental↗

PubMed1992

Guided tissue regeneration using biodegradable membranes of polylactic acid or polyurethane.

The purpose of the present investigation was to evaluate the use of biodegradable membranes of polylactic acid or polyurethane for obtaining regeneration following treatment of circumferential periodontal defects in monkeys with the "guided tissue regeneration" procedure. Orthodontic elastic bands were placed around selected test and control teeth in 4 monkeys in order to induce breakdown of the periodontal tissues. When the destruction of the supporting tissues had progressed to a level corresponding to approximately half the length of the roots, the elastic bands were removed. After 1 to 8 months, full thickness flaps were raised on the buccal and lingual aspects of both test and control teeth. The exposed root surfaces were scaled and a notch was prepared in the root surface at the level of the reduced bone crest. Membranes of polylactic acid or polyurethane were placed circumferentially around the test teeth, while no membranes were placed around the control teeth. The tissue flaps were then sutured in a coronally displaced position. The surgical procedures and sacrifice of the animals were scheduled to provide observation times of 1, 4 and 8 months. During the healing period, various complications such as recession of the flap margins and exposure or exfoliation of the membranes were noticed. The histological analysis showed that the amount of new connective tissue attachment on test and control teeth did not differ and was restricted to the most apical part of the lesions. The bio-degradable membranes could be identified in a few specimens, and they were always surrounded by an epithelial layer.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1995

Clinical and histologic appearance in enamel of primary teeth from children with neonatal hypocalcemia induced by blood exchange transfusion.

This investigation was undertaken to study the clinical and histologic appearance of deciduous enamel from 11 infants who were subjected to blood exchange transfusions (ET) during the first days of life. As a result of the treatment they had a mean of 3 consecutive hypocalcemic days. At the age of 5 years a dental examination of their primary teeth was performed. Four of the children had clinically recorded enamel aberrations correlated with the neonatal period. Exfoliated teeth were then examined histologically. All had a normal major enamel morphology, and the neonatal line was present in all teeth. Histologically investigated teeth with enamel hypoplasia had the aberrations located close to the neonatal line. The conclusions drawn from this study are that hypocalcemia caused by ET in the newborn period did not affect the width of the neonatal line or the major enamel morphology to any extent. Enamel aberrations occurred only when four or more ETs were performed.

Dental Enamel↗

PubMed2001

Clinical performance of a condensable metal-reinforced glass ionomer cement in primary molars.

OBJECTIVE: Aim of the present study was to evaluate the clinical suitability of the condensable metal-reinforced glass ionomer cement Hi-Dense in classes I and II cavities of primary molars. METHODS: Seventeen children received a total of fifty four Hi-Dense fillings (nineteen class I and thirty five class II). The restorations were clinically assessed at baseline, after one and after two years of clinical service according to modified USPHS codes and criteria. The restorations were replicated in each recall and representative samples were qualitatively analysed under a SEM. RESULTS: Over the observation period of two years, five restorations failed due to total retention loss, two fillings needed replacement because of persisting hypersensitivity, one filling was lost because of an unsuccessful endodontic treatment, and four restorations remained intact until natural exfoliation (Two year survival rate: 92% for Class I and 66% for Class II). The SEM analysis of surfaces and marginal areas exhibited an inferior adhesive performance primarily in proximal areas, whereas a negative step formation due to wear was frequently observed in occlusal parts. CONCLUSIONS: The results clearly indicate that the condensable, metal-reinforced GIC Hi-Dense reveals no enhanced performance and lifetime expectancy for class II restorations in primary molars when compared to other non-resin-modified GICs.

Cermet Cements↗

PubMed1987

Mineralization disturbances in the deciduous teeth of children with so called minimal brain dysfunction.

Exfoliated deciduous teeth from 14 children with so called Minimal Brain Dysfunction (MBD) and from 14 age-matched comparison children without MBD were collected and ground sections prepared. The sections were analysed by means of polarized light and microradiography. The enamel in ground sections of deciduous teeth from children with MBD showed a wider neonatal line than normal. The prenatal enamel showed a slight tendency to an increase in the degree of porosity, and the overall severe pathology was more common in the MBD group than in the comparison group.

Attention Deficit Disorder with Hyperactivity↗

PubMed2006

Bond strength and failure patterns of adhesive restorations in primary teeth aged in the oral environment.

PURPOSE: To evaluate the bond strength and micromorphology of the fracture pattern of adhesive composite restorations in primary teeth after long-term clinical function. METHODS: Subjects (8-10 years-old) with deep carious lesions in primary molars had their teeth restored with resin composite (Z250). The teeth were randomly divided into two groups, according to the adhesive system used: (1) Scotchbond Multi-Purpose (SMP); and (2) Clearfil SE Bond (CSE). After the clinical and radiographic follow-up period (15-17 months), the teeth were exfoliated and the adhesive restorations were subjected to microtensile bond test. RESULTS: Student's t-test revealed a statistical difference (P= 0.001) between the two adhesive systems tested (SMP = 16.8 +/- 2.62 MPa; CSE = 27.3 +/- 2.28 MPa). The micromorphology evaluation of the failure zone revealed a weak area in the demineralized dentin (SMP) and at the top of the hybrid layer (CSE).

Child↗

PubMed1996

The congenital insensitivity-to-pain syndrome (analgesia congenita): report of a case.

The congenital insensitivity-to-pain syndrome is one of several entities of sensory neuropathies in which pain sensation is absent from birth. This report describes a female child with the syndrome, who in all other aspects was normal. The most severe oral consequence of her disorder was self-inflicted exfoliation at an early age of all single-rooted primary teeth and one primary molar (a total of 13 teeth). The child was monitored from age 8. The primary aim in management was to monitor the eruption of the permanent teeth and occlusal development. At eruption of the mandibular incisors a protective splint was constructed to prevent their sharp edges injuring the tongue and the oral mucosa. The child was also instructed not to agitate her newly erupted teeth. Further occlusal development of the permanent dentition was uneventful.

Child↗

PubMed1997

Paediatric dentistry discussion paper and case report. Management of small carious lesions in primary teeth: caries removal versus fluoride application and periodic 'observation' until exfoliation.

Differences in treatment rationale exist between dental practitioners with respect to the management of small carious lesions in primary teeth. Some do not consider it necessary to use a conventional restorative approach, preferring to apply topical fluoride and/or 'monitor' the lesion(s). This paper advocates the alternative approach which entails complete caries removal by mechanical means, the rationale being to eliminate the pool of cariogenic microorganisms and thereby protect sound teeth from succumbing to carious attack. A case is presented to illustrate the extent to which caries can progress and also involve other teeth if small cavitated lesions are simply treated by 'spot' application of fluoride. Clinical treatment of caries must be based on scientific knowledge of the microorganisms involved and an understanding of its transmissible and infectious nature.

Child, Preschool↗

PubMed1975

Osseous autografts. II. Histological responses to osseous coagulum-bone blend grafts.

Three human intraosseous lesions were treated using osseous coagulum-bone blend as graft material. These sites were surgically removed 6 to 13 weeks after treatment and the blocks prepared for histologic analysis. Periodontal remodeling at the site of grafting was noted in all specimens. This remodeling involved the osseous walls, periodontal ligament, cementum and graft spicules. Both osteoclastic and osteoblastic activities were seen at the borders of the spicules. Exfoliation of spicules was particularly frequent in the six-week specimen. Nevertheless, regenerating of both bone and cementum was actively taking place even in this early specimen and was still evident in the older specimens. Of particular interest was the apparent marked increase in cementogenesis at the graft sites and the variations in parallel or functional orientation of the periodontal ligament in these areas. Significant functional orientation of segments of the periodontal ligament were seenin the early specimens, but not in the latter one. The reason for such variations in ligament pattern is not known at this time.

Adult↗

PubMed2005

Application of the total etching technique or self-etching primers on primary teeth after air abrasion.

Since the use of air abrasion has grown in pediatric dentistry, the aim of this study was to evaluate, by means of shear bond strength testing, the need to use the total etching technique or self-etching primers on dentin of primary teeth after air abrasion. Twenty-five exfoliated primary molars had their occlusal dentin exposed by trimming and polishing. Specimens were treated by: Air abrasion + Scotchbond MultiPurpose adhesive (G1); 37% phosphoric acid + Scotchbond MP adhesive (G2); Clearfil SE (G3); Air abrasion + 37% phosphoric acid + Scotchbond MP adhesive (G4); Air abrasion + Clearfil SE (G5). On the treated surface, a cylinder of 2 mm by 6 mm was made using a composite resin (Z100). Duncan's test showed that: (G2 = G3 = G5) > (G1 = G4). The use of a self-etching primer on air abraded dentin is recommended to obtain higher bond strengths.

Acid Etching, Dental↗