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PubMed1997

An adolescent female Neandertal mandible from Montgaudier Cave, Charente, France.

In 1974, an incomplete human mandible was discovered in the site of Montgaudier Cave, along the Tardoire (Charente), France. The mandible was found in association with stone tools and animal bones in geological deposits referable to the very end of the Middle Pleistocene or the beginning of the Upper Pleistocene. The mandible preserves much of the anterior part of the body and three permanent teeth: left lateral incisor, canine and first molar. Estimates based on tooth eruption of modern humans, as well as occlusal wear and root development, suggest an age at death of between 12.5 and 14.5 years. Morphologically, the fossil possesses features, such as a lack of a chin and multiple mental foramina, which have been observed on immature Neandertal mandibular specimens from Europe. Comparison with these immature European Neandertals indicates that the jaw and teeth of the Montgaudier mandible are small for its chronological age, suggesting it was that of a female.

Adolescent↗
PubMed1991

Iliac versus cranial bone for secondary grafting of residual alveolar clefts.

Secondary bone grafting of the maxilla in the mixed transitional dentition stage has become a well-accepted procedure in the surgical protocol for rehabilitation of patients with residual alveolar clefts. This retrospective study was undertaken to evaluate and compare the long-term results obtained with iliac or cranial cancellous bone graft material in the area of alveolar clefts and was based on the independent experience of two plastic surgeons from the same center using exclusively cranial or iliac cancellous bone, respectively. The criteria for surgery were similar. The surgical technique, with the exception of the bone-grafting material, also was similar, and all patients were treated by the same group of orthodontists. Fifteen patients from each group, from a total of over 100 patients, were randomly selected and included in the study. All patients were followed up from 18 to 60 months. Operative and perioperative parameters, donor-site morbidity, and long-term results were evaluated, compared, and analyzed. There were no significant differences between the two groups, and equally good results in terms of bone incorporation, tooth eruption, and appearance were obtained with both iliac and cranial bone grafts. We conclude from our study that successful bone grafting is primarily achieved by adherence to meticulous surgical technique, simultaneous closure of coexisting oronasal or palatal fistulae, use of cancellous bone particles only, and coverage of the grafts with well-vascularized flaps. The source of bone graft does not seem to primarily influence the success of the outcome.

Alveolar Process↗
PubMed1992

Administration of colony stimulating factor-1 corrects some macrophage, dental, and skeletal defects in an osteopetrotic mutation (toothless, tl) in the rat.

The toothless (tl/tl) mutation in the rat results in a paucity of osteoclasts and osteopetrosis that cannot be corrected by bone marrow transplantation. In the present study we demonstrate that tl/tl rats also have profound deficiencies of femoral, peritoneal, and pleural cavity macrophages. Furthermore, the macrophage colony stimulating activity of post-endotoxin sera from tl/tl rats is substantially reduced, suggesting that, as in the case of the op mutation in mice, the basis of the tl mutation is a deficiency of the macrophage growth factor, colony stimulating factor-1 (CSF-1). Consistent with this suggestion, treatment of tl/tl rats from birth for up to six weeks with CSF-1 reduced the osteopetrosis, increased body weight, and permitted tooth eruption. In addition, CSF-1 treatment induced large numbers of osteoclasts in tl/tl bones and macrophages in the peritoneal cavity and bone marrow. Persistence of metaphyseal sclerosis, however, indicated that the disease was not totally corrected by this treatment. These studies indicate that the basis of the tl mutation is most likely another CSF-1 deficiency, and further emphasize the role of this growth factor in osteoclast differentiation.

Animals↗
PubMed2000

Prospective analysis of secondary alveolar bone grafting using computed tomography.

PURPOSE: This study radiographically evaluated the quantity and quality of secondary alveolar bone grafts from the anterior iliac crest to maxillary alveolar clefts in cleft lip and palate patients with the use of computed tomography. PATIENTS AND METHODS: A 1-year prospective study was conducted by using 14 unilateral and bilateral cleft lip and palate patients. Axial and coronal computed tomography (CT) scans were obtained during the immediate postoperative phase and at 1-year follow-up. RESULTS: This study showed that the average alveolar cleft requires a bone graft volume ranging from 0.9 to 3.6 cm3, with a mean volume of 2.10 cm3. The percentage of bone loss derived from the linear dimensional changes to the alveolar bone graft between the immediate postoperative and follow-up CT scans were as follows: 17.9% in maximal bone height, 29.9% in maximal anteroposterior bone width, and 13.7% in maximal transverse width. As compared with the linear measurements, the volumetric analysis showed a disproportional amount of volume loss equaling 43.7% and 42.5% in the coronal and axial studies, respectively. This showed a total average volume loss of 43.1% at approximately 1 year after the secondary alveolar cleft repair. However, as the canine tooth erupts through the bone graft, it can account for up to 53.4% of the total average volume loss. All 14 patients (17 clefts) showed bone bridging between the alveolar cleft radiographically, with good incorporation and maturation of the bone graft, and no recurrence of the oronasal fistula. CONCLUSION: The CT scan is a valuable radiographic imaging modality to assess and follow the clinical outcome of secondary alveolar bone grafting.

Adolescent↗
PubMed2000

Use of modified functional appliances for the correction or amelioration of facial asymmetry and joint dysfunction in post adolescents and adults.

Correction of mandibular deviation (facial asymmetry) and temporomandibular joint dysfunction in the adult patient is possible using modified "twin block" appliances. Final occlusal detailing involves fixed appliances. The method incorporates arch development and correlation together with dental decompensation with mandibular repositioning. Facial appearance is markedly enhanced. In mandibular deviation, (facial asymmetry), the condyle on the side to which the mandible deviates, rotates and moves slightly backward. The condyle on the balancing side moves down the eminence opening the vertical dimension on that side and allows excess maxillary posterior tooth eruption. This lengthens the face on the balancing side and gives rise to the typical can't of the occlusal plane. The condition is almost always due to maxillary arch constriction with tapering form (Division I), or upper incisor retro-inclination (Division II). It is hypothesized that negative pressure from joint distraction allows for advantageous fossa and condyle remodelling, disc recapture or pseudo-disc formation.

Adolescent↗
PubMed2006

Effect of vascular endothelial growth factor on RANK gene expression in osteoclast precursors and on osteoclastogenesis.

OBJECTIVE: The aim of this study was to determine if vascular endothelial growth factor (VEGF) can upregulate the gene expression of receptor activator of nuclear factor kappa B (RANK) in osteoclast precursors, as does CSF-1. A secondary aim was to determine if VEGF can promote osteoclastogenesis in vitro comparable to CSF-1. DESIGN: Osteoclast precursors (mononuclear cells) were incubated with different concentrations of VEGF, CSF-1, or a combination of the two, and the gene expression of RANK was determined by RT-PCR. A TRAP assay also was conducted to determine their effect on osteoclastogenesis. An Alamar blue assay was done to analyse the effect of the molecules on proliferation of the osteoclast precursors. RESULTS: VEGF upregulated RANK expression in osteoclast precursors as effectively as CSF-1. VEGF did not promote osteoclastogenesis, as did CSF-1. A combination of the two did. CSF-1 enhanced proliferation of the osteoclast precursors but VEGF did not. However, VEGF in combination with CSF-1 did increase proliferation. CONCLUSIONS: At the time of the secondary burst of osteoclastogenesis prior to tooth eruption, VEGF expression in the dental follicle is high but the expression of CSF-1 is low. This study demonstrates that VEGF can fully substitute for CSF-1 to upregulate the RANK expression in osteoclast precursors that is needed for osteoclastogenesis. However, VEGF alone neither can promote osteoclastogenesis nor stimulate proliferation of the osteoclast precursors in vitro. For proliferation and osteoclastogenesis, a low dose of CSF-1 in combination with VEGF is needed.

Animals↗
PubMedDate not supplied

Knowledge of male and female midwestern college students about baby bottle tooth decay.

The purpose of this bellwether study was to establish the level of knowledge a group of young men and women college students had about baby bottle tooth decay (BBTD) and the associated risk factors. The results show that knowledge about BBTD is very limited even among a well-educated group of young adults. Overall 39% of the respondents had heard of BBTD whereas 87% had heard of sudden infant death syndrome (SIDS). Thirty-two percent thought BBTD was a fictional (vs. "real" or "unsure") health problem, while 3% of the respondents thought SIDS was a fictional health problem. Knowledge about overall risk factors for oral disease was greater than that for BBTD. Further, these subjects report that if they believed that adopting a certain feeding practice would reduce the risk of tooth decay for their babies, they would be likely to adopt it. Men and women significantly differed on the age at which a child should first see a dentist (chi sq = 19.56, df = 5, P < 0.01). Forty-five percent of the men selected either when the first tooth erupts or between 6-18 months as the time a child should first be seen by a dentist. Only 11% of the women thought a child should be seen that early. Forty-five percent of the women students selected 2-3 years as the earliest age at which a child should be seen by a dentist. Implications of this research are discussed.

Adult↗
PubMed2001

Adaptive and phylogenetic significance of ontogenetic sequences in Archaeolemur, subfossil lemur from Madagascar.

Among the best known of recently extinct Malagasy lemurs is Archaeolemur, which is represented by many hundreds of specimens. The phylogenetic affinities of this taxon are unclear, especially in light of recent preliminary analysis of ancient DNA which does not support its previously accepted close relationship with the living Indridae. We examined the nearly complete skeletons of two adults and one juvenile and other less complete specimens to reconstruct aspects of the ontogeny of Archaeolemur. To compare the development of Archaeolemur to that of living strepsirrhines we collected data on Propithecus verreauxi, Eulemur fulvus, and Lemur catta. Additionally, because Archaeolemur exhibits some morphological convergences with distantly related papionins, we tested for convergence in the developmental patterns of Archaeolemur and Macaca fascicularis. Data include the status of tooth eruption, craniofacial sutural closure, and postcranial epiphyseal fusion, as well as linear measurements. We used discriminant function analysis and other tools to explore ontogenetic similarities and differences. The adaptive and phylogenetic significance of ontogenetic information is discussed. Our analysis shows that Archaeolemur displays a clear strepsirrhine pattern of development with only minor macaque convergences. Among the Strepsirrhini, Archaeolemur is slightly more similar developmentally to E. fulvus and L. catta than to P. verreauxi. Some of the distinctive features of the ontogeny of Archaeolemur may be related to diet, while others bear apparent testimony to a relatively rapid absolute pace of growth and development.

Adaptation, Physiological↗
PubMed1994

Understanding bone cell biology requires an integrated approach: reliable opportunities to study osteoclast biology in vivo.

The relative simplicity of all in vitro methods to study bone cell biology will at best result in oversimplification of the development and functional capacity of the skeleton in vivo. We have shown this to be true for selected aspects of bone cell biology, but numerous other examples are available. One alternative is to undertake skeletal research in vivo. It is important that those in bone research be willing to move increasingly in this direction not only to understand the true complexities of skeletal versatility, but also to avoid repetition and perpetuation of erroneous or irrelevant conclusions which waste resources. Toward this end we have described two situations, osteopetrosis and tooth eruption, in which reproducible abrogations or local activations of bone resorption can be examined in vivo. The application of emerging molecular and morphological techniques that permit the subcellular dissection of metabolic pathways and their precise cellular localization, such as a combination of the variety of in situ hybridization technologies with PCR, antisense probes, and antibody blockase, will allow the investigator greater control of variables in vivo. We expect that these technologies, largely worked out in vitro, combined with highly selected, appropriate models, as we have ourlined here for osteoclast biology, will make research in vivo less intimidating and increase the frequency with which the real biology is studied directly.

Animals↗
PubMed1979

A new concept regarding the origin of the junctional and crevicular epithelium in rat molars.

The substitution of the internal enamel epithelium by a squamous epithelium during tooth eruption has been studied histologically in rat molars. Just prior to eruption, cytolysis of the connective tissue covering the cusp tip determines hyperplasia in the oral epithelium. A conspicuous infiltration results. Infiltrated undifferentiated cells form distinct cords which seem to be attracted by the internal enamel epithelium. They reaggregate when they come into its contact and form an underlying epithelium. The process starts in the superficial part and progressively extends towards the cervix. Finally, the internal enamel epithelium is expelled when desquamation begins. The lack of mitoses in both stratum intermedium and internal enamel epithelium and the pyknosis observed in the former, clearly show that the cells of the embryonic dental bell do not take part in the formation of the squamous epithelium as some authors still suppose.

Ameloblasts↗
PubMed2001

Orofacial findings in the Klippel-Trénaunay syndrome.

The Klippel-Trénaunay syndrome is a triad of congenital anomalies characterised by haemangiomas, varicosities, and unilateral bony and soft tissue hypertrophy. Hypertrophy usually affects one distal limb, but trunk or face may be affected. Cutaneous haemangiomas (nevus flammeus) of varying extent and irregular contour are often present in the hypertrophic regions. Varicosities may also be part of the vascular lesions of the syndrome. Orofacial manifestations include facial asymmetry, jaw enlargement, and malocclusions as well as premature tooth eruption. Two cases of the Klippel-Trénaunay syndrome are presented here. Both of these show the typical hemifacial hypertrophy and premature eruption of teeth on the affected side. In the first case only the left mandibular region was affected. In contrast, in the second there was hypertrophy of the whole left side of the body including upper and lower jaws. This boy also suffers from congenital ideokinetic retardation, while the first was otherwise normal. Both cases differ from previously reported cases of the Klippel-Trénaunay syndrome in lacking any prominent facial nevus flammeus. In the first case there was also malformation of the crown of the first permanent molar on the affected side that has not been described previously.

Child↗
PubMed2003

Tooth by tooth survival analysis of dental health in girls with epilepsy.

AIM: The aim of this study was to analyse, tooth by tooth, the timing of caries attacks leading to dental restoration in girls with epilepsy. STUDY DESIGN: The series comprised 60 girls with epilepsy, 8-18 years old, treated in the Departments of Paediatrics or Neurology of the Oulu University Hospital. A group of healthy age matched girls served as control. METHODS: A tooth by tooth survival analysis of the time between tooth eruption and caries attacks to a stage leading to the restorations of the permanent teeth was conducted retrospectively using data from the dental health records with annual examinations. RESULTS: The rate of dental restorations placed due to caries was constantly higher in the girls with epilepsy than in their controls. STATISTICS: The difference was significant between the first molars (p=<0.03), second molars (p=<0.02) and central incisors (p=<0.02) in the maxilla. CONCLUSION: The present observation supports the hypothesis that factors related to epilepsy, the antiepileptic medication in particular, might increase the risk of caries.

Adolescent↗
PubMed2000

Segmental odontomaxillary dysplasia: a case report and review of the literature.

Segmental odontomaxillary dysplasia (SOD) is a rare, unilateral developmental disorder of the maxilla involving abnormal growth and maturation of the bone, lack of one or both premolars, altered primary molar structure, delayed tooth eruption, and fibrous hyperplasia of the gingiva. In this, the twenty-third reported case of SOD, the literature is reviewed, and the clinical, radiographic, and histopathologic data are described. Computed tomographic scans of this case showed that the involved segment of the maxilla extends mesiodistally from the permanent cuspid to the mesial portion of the first permanent molar, largely limited to the area of the missing premolars. However, the affected bone extends superiorly in the lateral wall of the maxilla to the zygoma and base of the orbit. This article is intended to serve as baseline data for a future article, describing the natural history and possible treatment of SOD, which remain undocumented.

Child↗
PubMed1988

Neonatal hyperthyroidism alters hepatic epidermal growth factor receptor ontogeny in mice.

Epidermal growth factor (EGF) liver receptor ontogeny and somatic growth were studied in mice from day 7 to day 70 postnatally to assess long-term effects of short-term postnatal thyroxine treatment. The mice were given 0.4 micrograms thyroxine/g body weight/day for the 1st wk of life. EGF receptor binding in liver tissue was studied on days 7, 15, 20, 30, and 70 postnatally. Treated animals had accelerated eyelid opening and tooth eruption, and permanent growth retardation was obvious from the second week of life. Hepatic EGF receptor-binding capacity increased markedly in control mice with increasing age in contrast to a very slow increase in treated mice, making the difference statistically significant (P less than 0.01) from day 30. The affinity of EGF receptor binding initially was similar in the two groups of animals (1.09 x 10(9) M-1 and 1.02 x 10(9) M-1) and increased by day 30 in controls (2.57 x 10(9) M-1), an increase that was not observed in treated animals either at day 30 or 70. These results suggest a sensitive period of imprinting during the first 7 days postnatally, a period when thyroxine can exert a permanent effect on later growth and later hepatic EGF receptor number.

Animals↗
PubMed2005

Evaluation of a photo-poster on nurses' perceptions of teething problems in South-western Nigeria.

BACKGROUND: Health problems commonly associated with the eruption of teeth in babies continue to pose problems in Nigeria. Even nurses who should be well informed have misconceived views. In order to enlighten mothers and healthcare workers on this issue, a photo-poster was developed as a health-education tool. The objective of this study was to assess the effect of the poster, displayed in the workplace for 18 months, on the knowledge, attitude and reported practice of nurses. The study also aimed to assess the outcome of the inclusion of the photo-poster in training materials in a workshop setting. METHODS: The study was conducted in two parts. In the first part, 542 nurses working in children's units within the city of Ibadan, South-western Nigeria were selected using a stratified sampling technique. A questionnaire was used to gather information on their perceptions of teething problems at baseline. Photo-posters were displayed in the nurses' workplaces for 18 months, and a follow-up survey was conducted using the same questionnaire. In the second part of the study, two groups of nurses (n = 21 and n = 18 nurses) working in similar healthcare facilities in Ibadan participated in two separate workshops. One workshop used the photo-poster in addition to the standard educational materials, and the other workshop did not. Percentage differences between pre- and postintervention responses to perceived health problems were calculated. Intervention effects were the differences between the percentage changes in the intervention (with poster) and comparison (without poster) groups. Statistical differences were determined by Chi-squared test or one-tailed t-test, as appropriate. RESULTS: Five hundred and forty-two nurses (519 female and 23 male) completed the questionnaire survey at baseline and 403 (371 female and 32 male) at follow-up. Their ages ranged between 23 and 56 years, with the greatest percentage aged 25-40 years. At baseline, many respondents indicated that several of the listed health problems were a consequence of tooth eruption. After exposure to the posters at their workplace for 18 months, there were slight changes in their opinions but most were not statistically significant (P > 0.05). The use of posters in a workshop setting revealed percentage changes ranging from -11 to 61% for the different associated health problems. Many of these changes were statistically significant (P < 0.05). CONCLUSION: Displaying photo-posters in the workplace did little to change nurses' perceptions of teething problems; the posters had more influence when they were used in an instructional, interactive atmosphere. It is recommended that the use of photo-posters in health education for such culturally entrenched health issues should be accompanied by discussion of the same subject wherever possible.

Adult↗
PubMed2000

Oral manifestations and dental status in paediatric HIV infection.

OBJECTIVE: To describe the incidence and prevalence of oral manifestations of HIV infection in a population of perinatally infected children. DESIGN: Retrospective and prospective study of a cohort of perinatally HIV-infected children. SETTING: Community hospital and community-based paediatric clinic. SAMPLE AND METHODS: Forty perinatally HIV-infected children with a median age of 12 months were eligible and selected for the study, which included a medical chart review from birth and prospective follow-up. Each child was examined quarterly for oral manifestations, tooth eruption, and for 27 children, caries and periodontal status. RESULTS: The incidence of pseudomembranous candidiasis was 43% (95% CI, 27-58%) within 6 months of birth. Oral candidiasis (defined as pseudomembranous or erythematous) was positively associated with low CD4 counts and the occurrence of plaque. Children with low CD4 counts were also found to have fewer teeth than children with high CD4 counts, after adjusting for age. CONCLUSIONS: Oral manifestations are common in paediatric HIV infection and are possible predictors of HIV disease progression. Primary care of HIV-infected children should include periodic oral examinations to monitor their HIV disease progression and to alleviate symptoms associated with oral opportunistic infections.

AIDS-Related Opportunistic Infections↗
PubMed2003

Management of alveolar clefts.

The management of alveolar clefts has changed through the years as medical knowledge has improved. An alveolar cleft is the result of abnormal primary palate formation during weeks 4 to 12 of gestation. The rationale for its closure includes 1) stabilizing the maxillary arch, 2) permitting support for tooth eruption, 3) eliminating oronasal fistulae, and 4) providing improved esthetic results. Methods for closure of the alveolar cleft have been solidified during the last century with the use of bone grafting. Secondary bone grafting is now the preferred method of treatment, because early grafting has proven detrimental to midfacial growth. Various materials for bone grafting have been proposed, including iliac crest, cranium, tibia, rib, and mandibular symphysis. Regardless of the timing and materials used, the main principles in approaching alveolar clefts have been well described. They include 1) appropriate flap design, 2) wide exposure, 3) nasal floor reconstruction, 4) closure of oronasal fistula, 5) packing bony defect with cancellous bone, and 6) coverage of bone graft with gingival mucoperiosteal flaps. Certain alveolar clefts are difficult to manage by grafting alone, and orthodontic preparation may be required. Complications of alveolar bone grafts include donor site morbidity as well as graft exposure and loss.

Age Factors↗