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PubMed1995

[Orthodontic possibilities for young patients with missing maxillary incisors].

In the orthodontic treatment of young patients with missing maxillary incisors one should make an effort to avoid prosthetic solutions. This not only applies to situations with agenesis of maxillary lateral permanent incisors, but also to those cases in which maxillary incisors cannot be maintained after trauma. Standard solutions are presented for various sagittal jaw relationships and types and number of teeth missing. Specific rules have to be observed for the closure of spaces due to missing teeth in order to reduce the occurrence of papillae retraction and to place the substituting teeth in such a position that their crowns can be built up to look like the originals. This requires mesiodistal angulations that deviate from the standard ones, a proper distribution of crown width and in most cases a permanent retention with a palatally bonded thin multistranded wire.

Anodontia↗
PubMedDate not supplied

Survival rate and fracture strength of endodontically treated maxillary incisors with moderate defects restored with different post-and-core systems: an in vitro study.

PURPOSE: This study compares the survival rate and fracture strength of endodontically treated maxillary incisors with moderate coronal defects restored with different post-and-core systems after exposure to an artificial mouth. MATERIALS AND METHODS: Sixty-four caries-free human maxillary central incisors were selected for standardized size and quality, endodontically treated, and decoronated 2 mm coronal to the cementoenamel junction. Group 1 was restored with titanium posts and composite cores, group 2 received zirconia posts and a composite core, and in group 3 zirconia posts with a heat-pressed ceramic core were used. Teeth restored with cast posts and cores served as controls. All teeth were prepared and restored with complete cast crowns. All samples were exposed to 1.2 million cycles in a computer-controlled chewing simulator with simultaneous thermocycling. In addition, the samples were loaded until fracture in a static testing device. RESULTS: The survival rates of the different groups were: 94% for titanium/composite, 63% for zirconia/composite, 100% for the all-ceramic post and core, and 94% for the cast post and core. The following mean fracture strengths were obtained: titanium/composite = 425 +/- 155 N, zirconia/composite = 202 +/- 212 N, zirconia/ceramic = 378 +/- 64 N, cast post and core = 426 +/- 178 N. The lower fracture load in the group with zirconia posts and composite cores was statistically significant. The use of zirconia posts resulted in fewer oblique root fractures. CONCLUSION: Prefabricated titanium posts with composite cores, zirconia posts with heat-pressed ceramic cores, and cast posts and cores yield comparable survival rates and fracture strengths for the restoration of crowned maxillary incisors with moderate coronal defects. Survival rates and fracture strengths for zirconia posts with composite cores are significantly lower, so this combination cannot be recommended for clinical use.

Cementation↗
PubMed2003

Over- and ectopic expression of Wnt3 causes progressive loss of ameloblasts in postnatal mouse incisor teeth.

Intercellular signaling is essential for the development of teeth during embryogenesis and in maintenance of the continuously growing incisor teeth in postnatal rodents. WNT intercellular signaling molecules have been implicated in the regulation of tooth development, and the Wnt3 gene shows specific expression in the enamel knot at the cap stage. We demonstrate here that Wnt3 also is expressed in specific epithelial cell layers in postnatal incisor teeth. To begin to delineate the functions of Wnt3 in developing and postnatal teeth, we determined the effects of over- and ectopic expression of Wnt3 in the tooth epithelium of mice carrying a keratin 14-Wnt3 transgene. Expression of the transgene caused a progressive loss of ameloblasts from postnatal lower incisor teeth. Loss of ameloblasts may be due to defective proliferation or differentiation of ameloblast precursors, progressive apoptosis of ameloblasts, or loss of ameloblast stem cells.

Ameloblasts↗
PubMed1992

Study of the incidence of radicular grooves in maxillary incisors.

The purpose of this investigation was to determine the incidence of radicular grooves in the upper incisors of 642 patients from the region of Ribeirão Preto, SP, Brazil. Radicular grooves, present in 3.9% of the patients, were found mainly on the lingual surface of the maxillary lateral incisor (3.0%). The maxillary central incisors showed radicular grooves on both the buccal and lingual surfaces with an incidence of 0.9%. It was not possible to relate the incidence of these grooves with race (white and negro) or with sex.

Adolescent↗
PubMed1992

Case report of dentigerous cyst of lower incisor.

This paper reviews the pathogenesis, clinical features and the behaviour of dentigerous cyst. A case of mandibular dentigerous cyst involving the incisor tooth (an unusual site) is presented to illustrate this pattern of behaviour. A recurrent pyogenic granuloma in the region of the lower incisors prevented the eruption of the lower left incisor with subsequent cystic formation around the tooth. The histological and radiological presentation is consistent with that of a dentigerous cyst. The significance of the potential of the cyst lining is stressed. The cyst was enucleated with the associated tooth as the latter was not in a favourable position to erupt. There was no recurrence after one year of treatment.

Adolescent↗
PubMed2003

Molar incisor hypomineralisation (MIH).

REVIEW: Molar Incisor Hypomineralisation (MIH) is defined as a hypomineralisation of systemic origin of one to four permanent first molars frequently associated with affected incisors. MIH molars are fragile and caries can develop very easily in those molars. Although MIH molars are well known by paediatric dentists and their occurrence is related in severe cases to major clinical problems, only limited data of the size of the problem are available. The prevalence of MIH ranges in the literature from about 3.6 to 25% and seems to differ in certain regions and birth cohorts. Unfortunately more complete comparable valid data are lacking at the moment. It seems that several aetiological factors can cause the enamel defects and that their occurrence is child related. CONCLUSION: For children with repeated illnesses in the first years after birth and children with opacities on erupted molars or incisors it seems useful to increase the frequency of dental check-ups during the period of erupting first permanent molars.

Child↗
PubMedDate not supplied

[Single maxillary central incisor and holoprosencephaly].

A holoprosencephalic female was born to a mother with a single central maxillary incisor. The newborn had microcephaly, hypotelorism, cebocephaly, palatoschisis, micrognathia, and normal chromosomes. Her brain computed tomography showed alobar holoprosencephaly. The mother was of normal intelligence and stature, and her brain computed tomography was normal. Other relatives did not have single central maxillary incisors, hypotelorism, or oral clefts. We show a further evidence of a single central maxillary incisor as an indicator of potential holoprosencephaly in the next generation, confirming an autosomal dominant trait with wide variety in penetrance and expressivity.

Adult↗
PubMed1992

Relationship between the lingual fossa depth, mesiodistal and bucolingual diameter of dental crown in permanent maxillary incisors with the living Slovenians.

On 311 dental stone casts of living children aged from 8 to 12 years, were measured the lingual fossa depth, MD diameter, and the BL diameter of the permanent maxillary incisors. The correlations and the differences of measured variables between left and right incisors, centrals and laterals, male and female incisors as well as the correlations between measured variables themselves were analysed. High left-right symmetry was established, except for directional asymmetry in female centrals. A significant positive correlation in terms of positive allometry between the lingual fossa depth and MD diameter was found. In the light of these results, the significance of the lingual fossa depth as a factor of strength is discussed.

Child↗
PubMedDate not supplied

Antecedents and correlates of hypoplastic enamel defects of primary incisors.

Four hundred and fifty-five exfoliated primary incisors were obtained from children whose mothers provided information about a wide range of pre-, peri-, and postnatal characteristics of both the mother and child. These teeth then were examined for the presence of hypoplastic enamel defects (HED). The basic form of the null hypothesis tested was that children who had HED of a primary incisor did not differ from those who did not have such a defect. Of the primary incisors examined, 18.5% had HED (25.0% maxillary and 10.1% mandibular). The following items were found to be associated most strongly (P less than 0.003) with an increase in a child's risk of developing HED; 1) maternal antenatal history of smoking, higher prepregnancy weight, and failure to obtain prenatal care during the first trimester; 2) prematurity, low birth-weight and their associated correlates; and 3) postnatal measles infection. Left-handedness, maternal tea and Tylenol (McNeil Consumer Products Co., Fort Washington, PA) consumption, and failure to screen for undue lead burden were associated less prominently (P less than 0.05) with HED prevalence. Season of birth and serum and dentin lead levels were not related to the prevalence of HED. Many of these risk factors are also covariates of low socioeconomic status such as suboptimal nutrition and increased risk of infection. Additional investigation is needed to delineate the associations between specific pre- and perinatal nutritional and infectious factors, socioeconomic status, and HED development.

Child, Preschool↗
PubMedDate not supplied

Parental satisfaction with bonded resin composite strip crowns for primary incisors.

PURPOSE: The purpose of this study was to evaluate the parental satisfaction of bonded resin composite strip crowns for the treatment of maxillary anterior primary incisors and compare their satisfaction with the clinical evaluation and success of the crowns. METHODS: This was a retrospective, clinical study of patients who had strip crowns (SC) placed on maxillary primary incisors, returned for at least 1 recall examination, and whose parents gave consent for them to participate in the study. Color photographs were used for evaluation by 2 independent pediatric dentists. Parental satisfaction regarding the esthetics of the crowns was evaluated by a questionnaire. RESULTS: One hundred and twelve restorations placed in 40 children were evaluated. The evaluations were performed after the crowns had been in place for an average of 18 months (range=6-25 months). Overall parental satisfaction with the treatment was excellent; however, satisfaction with regard to color received the lowest rating. No significant differences were found between dentist and parent evaluations of color, size, and overall appearance (Fisher exact test; P=.194,.776,.291, respectively). Parents rated their overall satisfaction as being positive regardless of their poor ratings of color, size, or overall appearance. However, a significant relationship was found between durability and overall satisfaction (P=.046). Parents who gave poor ratings to durability also rated their overall satisfaction as being poor. CONCLUSIONS: Parental satisfaction with bonded resin composite SCs for the treatment of primary incisors with large or multi-surface caries was excellent. Parents' dissatisfaction was most often related to color of the restorations. However, this did not affect their overall satisfaction with the crowns. The durability of restorations negatively affected the rating of overall satisfaction with the crown. Durability seems to be of more concern than excellent color match to this group of parents.

Acrylic Resins↗
PubMed2004

Use of the apically repositioned flap in the management of labially impacted maxillary central incisors.

Management of labially impacted maxillary central incisors often requires a coordinated surgical and orthodontic approach. In such cases, the treatment objective is surgical exposure of the unerupted incisor, preferably with a functional width of keratinized gingiva on the labial surface. Tooth exposure is then followed by orthodontic intervention to move the tooth to the line of occlusion. This paper describes three cases where the apically repositioned flap technique was used to manage labially impacted maxillary central incisors.

Child↗
PubMed2005

A case of maloccluded incisor teeth in a beaver: castor canadensis.

A three-year-old female beaver (Castor canadensis) was referred to the Veterinary Teaching Hospital of Chungbuk National University. It had been raised in the Cheong-ju zoo and had a history of malocclusion caused by improper feeding. General anesthesia was induced, and preoperative intraoral dental radiographs of the rostal maxillary and mandibular dentition were taken and lateral and ventrodorsal extraoral radiographs of the cheek teeth were also taken. The radiographs were negative for apical pathology and revealed a normal appearance of the cheek teeth. The lesion was likely to be related to the excessive length of the maxillary and mandibular incisors. Odontoplasty was performed to reduce overgrowth of the crowns of the incisors. Sequential transverse sections were removed until the crown was reduced by approximately its original length. The pulp chamber was not approached during the operation, as confirmed by postoperative intraoral radiographic evaluation of the incisors. Recovery from anesthesia was uneventful and the beaver returned to normal masticatory activities immediately after the operation.

Animals↗
PubMed2005

Immediate substitution of central incisors with an unusual enamel paraplasia by a newly developed titanium implant: a case report.

The replacement of incisors with an unfavorable hard and soft tissue environment in the maxilla can be a challenging procedure in terms of esthetic outcome. The present report describes the replacement of two hopeless central incisors by newly developed titanium implants (TE Implant, Straumann) for immediate placement. This type of implant was chosen to compensate for the natural esthetics, which became compromised because of periodontitis and an unusual root anatomy. Both incisors presented with an atypical enamel paraplasia characterized by a circumferential enamel projection in apical direction. The consequence was a markedly reduced surface for periodontal attachment. Two weeks after implant placement, two acrylic resin crowns were cemented onto the new temporary titanium abutments. Five months later, the definitive prosthetic restoration was processed by porcelain pressed onto galvanic-cap crowns, which were cemented to standard wide-neck abutments. Control radiographs showed uneventful healing.

Adult↗
PubMed2005

Ankylosis of traumatized permanent incisors: pathogenesis and current approaches to diagnosis and management.

Ankylosis is a known complication of replanted or severely intruded permanent incisors and can be diagnosed by the characteristic sound emitted when the tooth is tapped. The ankylosed incisor demonstrates a lack of physiologic mobility and, later, radiographic evidence of replacement resorption. If the patient is pre-adolescent or adolescent at the time of trauma, infraocclusion relative to adjacent teeth will become apparent during jaw growth. Despite considerable knowledge about the pathogenesis of ankylosis garnered from animal studies and observation of human replanted teeth, there is no known treatment to arrest this condition. Management techniques and rehabilitation options for addressing ankylosis and its consequences are supported by little evidence, do not appear to be widely adopted and do not offer any proven long-term benefit. Avulsion and severe intrusion of permanent incisors are rare injuries. Should the decision be made to intervene by replantation or reduction of the intrusion, the clinician must be prepared to diagnose ankylosis, identify its negative consequences and develop treatment plans accordingly.

Adolescent↗
PubMed2005

The congenitally missing maxillary lateral incisor. Part 2: assessing dentists' preferences for treatment.

AIM: To (1) determine if there are different preferences among general dentists, a combined group of dental specialists, and orthodontists concerning whether a patient with congenitally missing lateral incisors should have the teeth restored or if the canines should be orthodontically moved into the position of the missing teeth; (2) determine the role that esthetics and function of the final result has on the respondents' treatment preferences; and (3) compare the respondents' opinions about treatment preferences to their rankings of esthetics reported in part 1. METHODS: The questionnaire accompanied the photographic evaluation in part 1. Percentages were computed and chi-squares were used to compare response patterns. RESULTS: Compared to orthodontists, a significantly greater percentage of general dentists and combined dental specialists would restore the lateral incisors and would do so primarily for esthetic reasons. Interestingly, for those dental professionals who responded that the missing teeth should be restored, many did not rank any photograph of a restorative option as the best option. CONCLUSIONS: Dental professionals should attempt to eliminate their personal opinions when recommending treatment options for a congenitally missing maxillary lateral incisor because discrepancies exist between the treatment result judged as most esthetic and the one most likely to be recommended.

Anodontia↗
PubMed2004

Prediction and causes of open gingival embrasure spaces between the mandibular central incisors following orthodontic treatment.

BACKGROUND: An open gingival embrasure space (OGES) between the mandibular incisors, also known as a "black triangle" (BT), can be an undesirable outcome of adult orthodontic treatment. OBJECTIVES: The purpose of this study was to determine the parameters that contributed most to the occurrence of an OGES between the mandibular central incisors, the area with the highest incidence of BT in the lower arch following orthodontic treatment. METHODS: A stepwise regression model was used to identify the variables (age, crowding, treatment duration, alveolar bone height, and six variables describing crown morphology) related independently to OGES score. Intra-oral photographs taken before and after orthodontic treatment, study models and intra-oral radiographs of 60 patients were used. Embrasures between the mandibular central incisors were measured and classified into three types: papilla filling, pinpoint, and BT. RESULTS: Age at the first consultation, length of active treatment and maximum crown width were larger in the BT group than in the normal group. In contrast, incisal edge - centre of the contact point, upper contact point - lower contact point, mesial CEJ - distal CEJ, and mesial CEJ - distal CEJ / maximum crown width were smaller in the BT group than in the normal group. Variation in OGES score was explained by the independent contributions of age at the first consultation, duration of active treatment, maximum crown width, and mesial CEJ - distal CEJ width. The multiple regression coefficient was 0.98, and the regression coefficient square was 96 per cent. CONCLUSION: We conclude that age at the first consultation, duration of active treatment, and crown morphology are involved in OGES manifestation. We suggest also that BT occurrence may be predictable prior to treatment.

Adolescent↗