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PubMed1991

Correlation analysis for clinical and gingival crevicular fluid parameters at anatomically related gingival sites.

This study was designed to evaluate the relationship of certain clinical and biochemical measures of periodontal pathology at anatomically related gingival sites. The maxillary first molar--second bicuspid region was studied in patients with gingivitis and periodontitis. The mesiobuccal site on the first molar was compared to the mesiopalatal and direct buccal sites on the molar and the distobuccal site on the second bicuspid. Probing depth, attachment level, gingival index, gingival crevicular fluid (GCF) volume, and GCF levels of the lysosomal enzyme B-glucuronidase (BG), the cytoplasmic enzyme lactate dehydrogenase, IgG and the protease-inhibitor alpha-2-macroglobulin were studied. For the 3 anatomical pairs that were analyzed, the correlation coefficients for the GCF constituents were generally higher than the correlations for the clinical parameters. The mean correlations for the GCF constituents were higher for the periodontitis patients as compared to the gingivitis patients. For the periodontitis patients, BG activity was correlated at adjacent proximal sites, approached significance at adjacent papillary sites, but was not significantly correlated at adjacent facial-proximal sites. This data suggests that sampling of BG activity from a mesiobuccal site provides information about the anterior papillary unit. In contrast, IgG in GCF collected from the mesiobuccal site on the first molar was significantly correlated with the total IgG in the 3 other sites.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Radiological evaluation of bone status in the jaw and in the vertebral column in a group of women.

Vertebral bone mineral content was determined in a group of 56 women, ages 30-62. These measurements were compared with the status of supporting bone in the jaws (alveolar, molar and bicuspid) and with gingival health. There was a significant decline in vertebral bone mineral content from the pre- to post-menopausal group. Molar and bicuspid measurements were highly correlated. There was some association between lumbar bone mineral content and molar bone status for postmenopausal women. For postmenopausal women, the cases of greatest percent bone loss in alveolar crest were associated with lower lumbar bone mineral content. Gingival health did not confound the bone status measurements. The 56 subjects did not exhibit the degree of reduction in bone density that is observed in the general population. Further investigation using these radiographic techniques may reveal a link between substantial bone loss in the jaw and moderate to severe bone loss in the lumbar vertebrae.

Absorptiometry, Photon↗
PubMed1998

The effect of smoking on individuals with minimal periodontal destruction.

Recent studies have demonstrated that smoking is associated with periodontal destruction. The majority of these studies have focused on periodontal disease groups with moderate or severe periodontal destruction. Additionally, there have been few reports investigating the relationship between smoking and gingival recession. The goal of this report was to investigate the effect of smoking on periodontal destruction and recession in subjects with minimal or no interproximal attachment loss. This is a cross-sectional study of 142 non-smoking subjects and 51 smoking subjects. Subjects could have no more than one tooth with a site of interproximal attachment loss > or =2 mm. Subjects could, however, have attachment loss associated with recession. For three different methods of summarizing attachment loss measurements at a subject level, including average attachment loss, percentage of teeth with one site of 2 mm of attachment loss, and the percentage of teeth with one site of 5 mm of attachment loss, smoking subjects had approximately twice as much attachment loss than their non-smoking counterparts. Smoking subjects also had significantly greater recession (P < 0.05) [0.056+/-0.017 mm] than non-smoking subjects (0.025+/-0.005 mm). Recession sites occurred primarily on the facial surface of maxillary molars and bicuspids and mandibular central incisors and bicuspids. The results suggest a strong association between smoking and both attachment loss and recession in subjects who have minimal or no periodontal disease.

Adolescent↗
PubMed2000

Buccal alveolar exostoses: prevalence, characteristics, and evidence for buttressing bone formation.

BACKGROUND: Buttressing bone formation has been described as the development of thickened or exostotic buccal alveolar bone in response to heavy occlusal forces. Little supporting evidence for this model has been found in previous literature, however, and there is little seen on the prevalence or characteristics of buccal alveolar exostoses. METHODS: A sample of 416 selected teeth and investing bone in 52 modern skeletal specimens at the National Museum of Natural History were examined. Two measures of heavy occlusal function--periodontal ligament (PDL) width and occlusal attrition--were analyzed for their relationship to three parameters of buccal alveolar bone (exostoses, lipping, and overall thickness). RESULTS: Buccal alveolar bone enlargements were found in 25% of all teeth examined: 18% were expressed as marginal bony lippings and 7% as buccal exostoses. Exostoses were mainly seen around maxillary molars and bicuspids, especially in males, while lippings were seen in molars, bicuspids, and mandibular incisors, with even gender distribution. When findings were controlled for arch and tooth type, no significant correlations were found between wider PDL spaces or occlusal attrition and exostotic, lipped, or thicker alveolar bone. CONCLUSIONS: These results indicate a lack of anatomic evidence for the theory of buttressing bone formation and suggest that other factors may be of greater importance in the etiology of buccal bone enlargements. Incidentally, no correlation was found between widened PDL spaces or severe occlusal attrition and the presence of cervical loss of tooth structure, which casts doubt on the currently popular concept of abfraction.

Adult↗
PubMed2001

Clinical evaluation and comparison of 2 topical anesthetics for pain caused by needle sticks and scaling and root planing.

BACKGROUND: Pain generated by needle sticks (Ns) for the delivery of local anesthetic and/or scaling and root planing (SRP) instrumentation is commonly addressed by the use of topical anesthetics, such as a benzocaine-gel preparation (BGP). Pain suppression following such use has been highly variable. Development of medicine-containing patches and adhesives for intraoral use have led to a new approach for topical anesthesia in the form of a transoral lidocaine delivery system (LDS). The purpose of this double-blind study was to evaluate the efficacy of the LDS and also to compare LDS with BGP for pain suppression to Ns and SRP. METHODS: One group of 20 subjects randomly received in both maxillary and mandibular molar-bicuspid areas LDS or BGP on one side and non-anesthetic control on the other side. A second group of 20 subjects compared the effectiveness of LDS directly with BGP in molar-bicuspid areas of both arches. Random order determined the selection for each anesthetic tested between the arches and bilateral. Pain perception was separately scored to a pain-inducing Ns simulation without anesthetic injection at each area and subsequently also to SRP using both a verbal pain scale (VPS) and a visual analog scale (VAS). RESULTS: VPS and VAS results analyzed by Bonferroni-adjusted Wilcoxon matched-pairs signed-rank tests found pain suppression scores significantly (P < 0.005) reduced for Ns by LDS to controls and to BGP. Comparing LDS directly with BGP, LDS was significantly (P < 0.05) more effective in reducing pain to Ns in both arches, to SRP in the maxillary arch, and equally effective as BGP in the mandibular arch. CONCLUSIONS: LDS is more effective than BGP for topical pain suppression to Ns and SRP in both arches.

Administration, Topical↗
PubMed2005

Clinical and other risk indicators for early periodontitis in adults.

BACKGROUND: Periodontal diseases affect over half the adults in the U.S., disproportionately affecting minority populations. Periodontitis can be treated in early stages, but it is not clear what features indicate, or could be risk factors for, early stages of periodontal attachment loss. This study aimed to evaluate associations between clinical and other risk indicators of early periodontitis. METHODS: A cross-sectional evaluation of 225 healthy and early periodontitis adults aged 20 to 40 years was performed. Clinical measurements, demographic information, and smoking histories were recorded. Analyses evaluated demographic and clinical associations with health and early periodontitis disease categories and periodontal attachment loss. Patterns of attachment loss at interproximal and buccal/lingual sites were evaluated. RESULTS: Subject age, plaque, and measures of gingivitis exhibited associations with attachment loss and probing depth. More periodontal attachment loss was detected in African-American and Hispanic subjects compared to Asian and Caucasian subjects. Smoking history was associated with attachment loss. At interproximal sites, lower molars most frequently had attachment loss, whereas at buccal/lingual sites, higher proportions of lower bicuspid teeth demonstrated attachment loss compared with other sites. CONCLUSIONS: In this study of subjects with minimal attachment loss, gingival inflammation was associated with early periodontitis. Lower molar interproximal sites were frequently associated with interproximal attachment loss, whereas lower bicuspid teeth were at risk for gingival recession on buccal surfaces.

Adult↗
PubMed2002

[A study on central zone contour of tooth-crown vesticular surface among young people with normal occlusion].

UNLABELLED: To evaluate the effects of preadjusted bracket base shape, the morphology of tooth surface where bracket locates, and the suitability relevant to location of bracket on the preadjusted edgewise appliance technique. 1 vertical curve and 3 horizontal curves of the clinical crown surface of anterior teeth and bicuspid teeth were measured with the precise contour instrument on the 60 plaster models of the subjects who have normal occlusion in Sichuan province. It was found that variation of identical curve exists at the different heights between the teeth and between the individuals; the surface of the central zone of tooth-crown gradually protrudes from incisors to bicuspid teeth in the vertical direction, and the mesial contour of cuspid is more prominent than the distal in the horizontal direction. CONCLUSION: The 4 mm X 3 mm contour of the vestibular central zone of identical tooth-crown in different individuals is fairly stable; it is suitable for the location of preadjusted brackets. The vertical shifts of brackets could change the preadjusted torque value and the design of cuspid bracket should have the distinction between mesial and distal shape.

Bicuspid↗
PubMed2002

A 3-year clinical evaluation of a compomer, a composite and a compomer/composite (sandwich) in class II restorations.

PURPOSE: To compare the clinical performance of Dyract, Spectrum-TPH and Dyract layered with Spectrum-TPH (sandwich) in Class II restorations of permanent dentitions. MATERIALS AND METHODS: 23 adult patients aged 25-62 were selected at random in a general dental practice. Each patient had 3 bicuspid teeth restored with Dyract, Spectrum-TPH and a "sandwiched" combination where Dyract was covered by the composite resin TPH. During the entire study, three patients were lost. Restorations were clinically evaluated using a modified Ryge/USPHS system. RESULTS: Over 36 months all three types of restorations performed well clinically. No post-operative sensitivity was reported by any patient indicating proper bonding and sealing. Only one Dyract/TPH sandwich restoration had to be replaced after 2.5 years due to root caries. The Dyract restorations exhibited significantly higher (P = 0.0039) occlusal wear than the TPH and the Dyract/TPH sandwiched restorations. The marginal integrity was also found to be significantly better (P = 0.001) for the TPH and Dyract/TPH restorations compared to Dyract alone, while no significant difference (P > 0.05) could be demonstrated between TPH and Dyract/TPH restorations. The low rate of failure in the three different restorative systems suggests that they are reliable restorative materials in permanent bicuspids over a 3-year period.

Acetone↗
PubMed2005

[Dental arch characteristics of the facial asymmetry].

OBJECTIVE: To study the characteristics of dental arches in the patients with facial asymmetry. METHODS: 20 facial asymmetrical patients were chosen as the study subjects. They were 8 boys and 12 girls, aged from 12-year to 16-year old. 20 normal occlusion persons without signs of facial asymmetry were chosen as control. Dental casts were measured by 3-dimension measuring machine. Dental arch asymmetry, coordination between upper and lower dental arch, and dental inclination were measured. SAS 6.03 was used in statistical analysis. RESULTS: The distance from cuspid and the first bicuspid to the median palatal raphe in the side of crossbite was larger than that of contralateral side in maxilla. The distance from cuspid, bicuspids and the first molar to the midline in the side of crossbite was smaller than that of contralateral side in mandible (P < 0.05). The dental arch width of cuspid and first premolar in maxilla was smaller than that of mandible (P < 0.05) . Significant buccal inclination of the maxillary posterior teeth coupled with lingual inclination of the mandibular posterior teeth was found on the crossbite side. In contrast, significant lingual inclination of the maxillary posterior teeth coupled with buccal inclination of the mandibular posterior teeth was found on the contralateral side (P < 0.05). CONCLUSION: The width of upper anterior dental arch was smaller, and the inclination of upper and lower posterior teeth between crossbite side and counterside was different in facial asymmetry patients.

Bicuspid↗
PubMed1989

[Upper premolars: study of the number of roots and their canals].

The number of roots and cannals were observed and studied in upper bicuspids. For the study of the root cannals was used a diafanization technique. The results were prosessed by stadistic analysis and compared with those published. By the observation, in this work, was stated that the first upper bicuspid has one root and two cannals in the most of the cases. This situation was confirmed by stadistic analysis. Conclusions were extracted refering them to the clinical application.

Bicuspid↗
PubMed1980

[Aplasia of the premolars as a leading symptom of ectodermal dysplasia].

The primary symptom in the tooth system, a tendency toward aplasia of the bicuspid teeth in both dentition periods, was reported for an ectodermal syndrome which has seldom been described. In agreement with the observation by BOOK (1950), we also observed excessive perspiration (hyperhidrosis) and premature graying of the scalp hair (canities prematura). The syndrome, which is limited to ectodermal disturbances, is a dominant trait, the incidence of which is apparently higher in Northern European countries. Trigeminal neuralgias seem to appear in conjunction with this genetic disturbance. Compared with other partial anodontic and oligodontic syndromes, it is striking that no other groups of teeth are affected; the bicuspid teeth however show signs of aplasia, hypoplasia, structural disturbances (discoloration), and premature loss of even the deciduous teeth.

Bicuspid↗
PubMed1998

Dens evaginatus: review of the literature and report of several clinical cases.

Dens evaginatus (DE) presents as an innocuous looking tubercle of enamel on the occlusal surface of a tooth, most commonly a bicuspid. Problems can arise when the tubercle is either worn, ground, or fractured off, resulting in pulpal exposure and possible loss of vitality of the tooth. Dentists who perform orthodontic treatment should be aware of this dental anomaly, which occurs in at least two per cent of the Asian and Native Indian populations. Bicuspid extraction cases should involve the extraction of the anomalous premolars rather than the normal ones. In addition, the dentist should be mindful of occlusal changes that may occur during treatment or occlusal equilibration, both of which can jeopardize the vitality of teeth with DE. Pulp capping or partial pulpotomy has been postulated to be one of the most reliable forms of vital tooth treatment when pulp exposure is encountered following the sterile removal of the tubercle. When pulp exposure is not encountered, preventive resin composite sealing of the dentin or class I amalgam cavity preparation seems to be the treatment of choice.

Adolescent↗
PubMed1999

Human radicular veins: regulation of venous reflux in the absence of valves.

In the literature it is generally assumed that venous reflux within the radicular veins is prevented by the presence of bicuspid valves and narrowing of the transdural part of these vessels. Recently, we performed a human cadaver study of the internal vertebral venous plexus. Surprisingly, a large number of radicular and perimedullary veins appeared to be filled with Araldite CY 221 mixture, after injection of this material into the vertebral venous system, implicating reflux via the radicular veins and suggesting insufficiency of the presumed anti-reflux mechanism. Therefore, it was decided to study the radicular veins in order to determine and to investigate the presence or absence of anti-reflux mechanisms within this system. The vertebral venous systems of ten fresh human cadavers, between 64 and 93 years of age, were injected with Araldite CY 221 mixture. After polymerization, all cadavers were dissected and the spinal nerve sheaths, including nerve roots, radicular veins and epidural veins, were excised as a whole. After macroscopical examination, serial sections (40 microm) were cut on a freezing microtome and stained in Von Gieson medium. Every third section was stained immunohistochemically with smooth muscle antigen (SMA), to visualize smooth muscle cells. In all cadavers, a number of intradural radicular veins was filled with Araldite. Employing microscopical examination, no bicuspid valves were found. However, four structures were encountered that might serve as ananti-reflux-mechanism: 1) intravenous dural folds, 2) meandrous configuration, and 3) narrowing of the radicular veins at the point of penetration of the dura mater, and 4) varying numbers of smooth muscle fibers in the walls of the intradural and extradural parts of the radicular veins. Reflux via the radicular veins seems to be a physiological phenomenon. Structural valves have not been encountered during this study. Intravenous dural folds, meandrous configuration and narrowing of the transdural part of the radicular veins, and the presence of large numbers of smooth muscle cells in the radicular venous walls suggest the existence of a dynamic reflux-regulating system that has the ability to increase the intravascular resistance under conditions of venous hyperpression, in order to protect the spinal cord from venous pressure waves. Possibly, venous reflux via the radicular veins has a role in selective cooling of the spinal cord.

Actins↗
PubMed1996

The positions of coronary arterial ostia.

The positions of the coronary arterial ostia were examined in the cadavers of 38 adults. All the ostia were related to the aorta and none to the pulmonary artery. The aortic valves in 37 specimens were normal and possessed three cusps, while one was bicuspid. In the normal specimens, the main right and left coronary ostia were confined to the anterior and left posterior aortic sinuses respectively, apart from one specimen in which the right ostium was related to the right posterior sinus. Six specimens had small accessory ostia, close to the main right ostium. The majority of ostia were situated on or immediately below the supravalvular ridge. Circumferentially, the ostia clustered near the maximum curvature of the sinus. In the single specimen where the aortic valve was bicuspid, both ostia lay more-or-less symmetrically in the sinus above an anterior cusp which showed evidence of formation from two components. The reasons for confinement of the coronary ostia two of the three aortic sinuses are not clear. Microscopic examination of serial sections through 22 human embryos of 5.0-17.5 mm CR length (Carnegie stages XIII-XIX) confirmed that the earliest vessels in the heart wall develop subepicardially near the apex at stage XV. The network extends centripetally and only at stage XVII could coronary arterial stems, communicating with the aortic lumen, be identified. The sequence suggests that confinement of the coronary ostia to the interior and left posterior sinuses probably occurs because these represent the most accessible contact points for the centripetally growing vascular plexus.

Adult↗
PubMed1990

Rare or unusual causes of chronic, isolated, pure aortic regurgitation.

Six patients undergoing aortic valve replacement had rare or unusual causes of isolated, pure aortic regurgitation. Two patients had congenitally bicuspid aortic valves with a false commissure (raphe) displaced to the aortic wall ("tethered bicuspid aortic valve"), two had floppy aortic valves, one had a congenital quadricuspid valve, and one had radiation-induced valve damage.

Adult↗
PubMed1991

Development and progression of aortic valve stenosis: atherosclerosis risk factors--a causal relationship? A clinical morphologic study.

Hospital records of 120 patients undergoing aortic valve replacement were retrospectively reviewed for risk factors associated with early aortic valve replacement. Patients were separated into four groups (rheumatic, congenital bicuspid, degenerative, and miscellaneous) based upon the morphologic etiology of aortic stenosis. Multiple regression analysis was performed using age at surgery as the dependent variable. Independent variables for the study were race, gender, systemic hypertension, total triglyceride level, total serum cholesterol level, tobacco smoking history, diabetes mellitus, and angiographic coronary artery disease. In the rheumatic valve group only race showed a statistically significant risk effect whereas in the congenital bicuspid valve group race, gender, and triglycerides were statistically correlated with age at surgery. In the degenerative valve group gender and smoking were found to be statistically significant risk factors. The establishment of aortic stenosis risk factors might be an indication for clinical trials of risk factor modification in patients with aortic stenosis.

Adult↗
PubMed1994

Pathology of aortic valve stenosis and pure aortic regurgitation. A clinical morphologic assessment--Part I.

This two-part article examines the histologic and morphologic basis for stenotic and purely regurgitant aortic valves. Part I discusses stenotic aortic valves and Part II will discuss causes of purely regurgitant aortic valves. In over 95% of stenotic aortic valves, the etiology is one of three types: congenital (primarily bicuspid), degenerative, or rheumatic. Other rare causes of stenotic aortic valves include active infective endocarditis, homozygous type II hyperlipoproteinemia, and systemic lupus erythematosis. The causes of pure aortic regurgitation are multiple but can be separated into diseases affecting the valve (normal aorta) (infective endocarditis, congenital bicuspid, rheumatic, floppy), diseases affecting the walls of aorta (normal valve) (syphilis, Marfan's, dissection), disease affecting both aorta and valve (abnormal aorta, abnormal valve) (ankylosing spondylitis), and diseases affecting neither aorta nor valve (normal aorta, normal valve) (ventricular septal defect, systemic hypertension). Diseases affecting the aortic valve alone are the most common subgroup of conditions producing pure aortic valve regurgitation.

Adolescent↗
PubMed1994

Pathology of aortic valve stenosis and pure aortic regurgitation: a clinical morphologic assessment--Part II.

This two-part article examines the histologic and morphologic basis for stenotic and purely regurgitant aortic valves. Part I discussed stenotic aortic valves and Part II discusses causes of purely regurgitant aortic valves. In over 95% of stenotic aortic valves, the etiology is one of three types: congenital (primarily bicuspid), degenerative, and rheumatic. Other rare causes included active infective endocarditis, homozygous type II hyperlipoproteinemia, and systemic lupus erythematosis. The causes of pure aortic regurgitation are multiple but can be separated into diseases affecting the valve (normal aorta) (infective endocarditis, congenital bicuspid, rheumatic, floppy), diseases affecting the walls of aorta (normal valve) (syphilis, Marfan's dissection), disease affecting both aorta and valve (abnormal aorta, abnormal valve) (ankylosing spondylitis), and disease affecting neither aorta nor valve (normal aorta, normal valve) (ventricular septal defect, systemic hypertension). Diseases affecting the aortic valve alone are the most common subgroup of conditions producing purely regurgitant aortic valves.

Aortic Diseases↗