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PubMed2002

Identification of second canals in the mesiobuccal root of maxillary first and second molars using magnifying loupes or an operating microscope.

Various authors have investigated the frequency of second canals (MB2) in the mesiobuccal roots of maxillary molars, predominantly first molars. Further, it has been reported that the percentage of MB2 canals that are treated during routine endodontic therapy is much lower than the number of second canals identified in vitro. It was the purpose of this study to investigate whether the use of an operating microscope may improve the diagnosis of MB2 canals in mesiobuccal roots of maxillary molars. The canal orifices of 100 maxillary first and second molars (50 of each) were initially inspected by Examiner 1 using individually-adapted x2 magnifying loupes. Subsequently, all teeth were examined by a second investigator using an operating microscope (OPM) with x8 magnification. Finally, the mesiobuccal roots of all teeth were separated. Then, the sections were analysed histologically and by SEM. The histological investigation revealed a total number of 63 MB2 canals, 39 in first, and 24 in second molars. Only 26 (41.3%) of those canals were identified using magnifying loupes, whereas 59 (93.7%) were found by means of an operating microscope.

Dental Equipment↗

PubMed1980

First molar eruption in cattle and its use in age determination.

Two studies were undertaken into the intraoral eruption of the first molar in live cattle. The first was a longitudinal survey using monthly observations of Welsh Black bulls and the second involved 300 animals of both sexes and varying breeds, reared under different management systems, using the cross-sectional technique. There were significant differences between the ages at most successive molar codes in both studies. However, a comparison between the two studies showed the mean age at each stage of molar development was higher in the longitudinal study and at three stages this was significant. The age range for each molar code, obtained from the two studies combined, varied between 2.0 and 4.7 months but indicated that the eruption of the first molar tooth was of use in age assessment.

Age Determination by Teeth↗

PubMed2003

Receptive field properties of human periodontal afferents responding to loading of premolar and molar teeth.

Impulses in 45 single mechanoreceptive afferents were recorded from the human inferior alveolar nerve with permucosally inserted tungsten microelectrodes. All afferents responded to mechanical stimulation of one or more premolar or molar teeth and most likely innervated their periodontal ligaments. For each afferent, isolated "ramp-and-hold" shaped force profiles of similar magnitudes (252 +/- 24 mN; mean +/- SD) were applied to the lower first premolar, the second premolar, and the first molar on the recording side. The tooth loads were applied in six directions: lingual, facial, mesial, and distal in the horizontal plane and up and down in the vertical direction of the tooth. The afferents response during the static phase of the stimulus was analyzed. All afferents were slowly adapting, discharging continuously in response to static forces in at least one stimulation direction. Twenty-nine afferents (64%) were spontaneously active, exhibiting an ongoing discharge in the absence of external stimulation. Stimulation of a single tooth was found to excite each afferent most strongly. The most sensitive tooth (MST) was the first premolar for 23, the second premolar for 13, and the first molar for 9 afferents. About half of the afferent population also responded to loading of one or two more teeth. The response profiles of these afferents indicated that the multiple-teeth receptive fields were due to mechanical coupling between the teeth rather than branching of single afferents to innervate several teeth. The afferent responses to loading the mesial and distal halves of the first molars were very similar. Thus both intensive and directional aspects of the afferent response when loading one side of the tooth was preserved to a great extent when loading the other side. When loading the MST, the afferents typically showed excitatory responses in two to four of the six stimulation directions, i.e., the afferents were broadly tuned to direction of tooth loading. In the horizontal plane, the afferent populations at the premolar teeth expressed no clear directional preferences. The afferents at the molar, however, showed a strong directional bias in the distal-lingual direction. In the vertical plane, there was a preference for downward-directed forces with a gradually decreasing sensitivity distally along the dental arch. The present results demonstrate that human periodontal afferents supplying anterior and posterior teeth differ in their capacity to signal horizontal and vertical forces, respectively.

Adult↗

PubMed2006

Fluoride intake levels in relation to fluorosis development in permanent maxillary central incisors and first molars.

Gaps remain in our knowledge about the levels of fluoride intake that cause dental fluorosis. The purpose of this study was to report the fluorosis prevalence by levels of estimated fluoride intake in an effort to understand the importance of different levels of daily fluoride intake. As part of the longitudinal Iowa Fluoride Study, subjects were followed from birth to 36 months with questionnaires every 3-4 months to gather information on fluoride intake from various sources. Daily fluoride intake in mg per kg body weight (BW) was estimated from water, beverages and selected foods, fluoride supplements and dentifrice. Six hundred and twenty-eight subjects were examined for fluorosis on permanent incisors and first molars at about age 9 by two calibrated examiners using the Fluorosis Risk Index categories. Fluorosis prevalence rates were determined separately for maxillary central incisors and first molars by levels of estimated fluoride intake. There were significant positive associations between fluorosis prevalence and levels of fluoride intake. Cumulatively from birth to 36 months, average daily intake of 0.04 mg F/kg BW or less carried relatively low risk for fluorosis (12.9% for maxillary central incisors, 6.8% for first molars). Average daily intake of 0.04-0.06 mg F/kg BW showed a significantly elevated risk for fluorosis (23.0% for maxillary central incisors, 14.5% for first molars), while fluorosis risk was even higher for average intake above 0.06 mg F/kg BW (38.0% for maxillary central incisors, 32.4% for first molars). The study suggests that fluorosis prevalence is related to elevated fluoride intake when averaged over the first 3 years of life, but is even more strongly related to fluoride intake that is elevated for all of the first 3 years of life.

Adult↗

PubMed1990

Effects of easily chewable diet and unilateral extraction of upper molars on the masseter muscle in developing mice.

The effects of easily chewable diets and unilateral extraction of upper molars on the masseter muscle were studied in developing mice. A liquid diet requiring no mastication suppressed the development of the masseter muscles more than a fine-grained diet, and extraction of unilateral upper molars also caused inhibition of muscle development. Moreover, both unilateral extraction of upper molars and a liquid diet had an additive effect on the suppression of the postnatal development of the masseter muscle, and bilateral suppression of the development of the masseter muscle was induced following unilateral extraction of upper molars. These findings suggest that the sensory input from the sensory endings in the periodontal ligament may also play an important role in the postnatal development of the masseter muscle and that there may be some crossing pathways to convey the sensory input coming from the side of the extracted upper molars to the contralateral motor neurons via the interneuronal circuits.

Animals↗

PubMed1990

Fordyce's granules of the incisor and molar gingiva in F344 rats.

Fordyce's granules were observed in the gingiva of the upper incisor and molar teeth in F344 rats. The data were based on 734 males and 722 females that were used as control and treated animals in 26-week, 65-week, and 2-year studies by the National Toxicology Program. The incidence of Fordyce's granules was markedly different when comparing sex, age, and site of the lesion. Fordyce's granules were very common in the midsagittal gingiva of the upper incisor in males and increased in incidence with age (34.2, 50, and 56.3% in 26-week, 65-week, and 2-year studies, respectively). The granules of the incisor gingiva were rare in females (0,0, and 2.8% in 26-week, 65-week, and 2-year studies, respectively). Fordyce's granules of the molar gingiva were very rare in both sexes and were found only in 9/734 (1.2%) males and in 3/722 (0.4%) females. Only three unilateral granules of the molar were grossly recognized as focal swelling of the gingiva or a white nodule with a huge cyst in the third upper molar. Histologically, Fordyce's granules were arranged as a collection of sebaceous glands unassociated with hair follicles. In addition, the granules of the molar gingiva were associated with cystically dilated ducts filled with sebum. Ultrastructurally, the sebaceous cells were characterized by varying numbers of cytoplasmic lipid droplets and occasional desmosome and hemidesmosome formation. Fordyce's granules previously reported in rats of other strains were also reviewed and compared with those in F344 rats in regard to incidence, location, and age.

Animals↗

PubMed2001

Pulp-capping with recombinant human insulin-like growth factor I (rhIGF-I) in rat molars.

The aim of this study was to explore pulp healing and reparative dentinogenesis following pulp-capping by using recombinant human insulin-like growth factor I (rhIGF-I). Exposures were made through the mesial pulp horn in first upper molars in two-month-old Wistar rats. The pulp was covered with one dose of sterile 4% methylcellulose gel containing either 400 ng rhIGF-I or saline in contralateral controls. The exposure site was closed with sterile Teflon membrane, and the cavity was filled with IRM cement. Additional molars were capped with Dycal as controls. After 3, 7, or 28 days, animals were anesthetized and fixed by intravascular glutaraldehyde perfusion. Molars were decalcified and processed for histological analysis and cut with membrane and residual methacrylate from IRM in situ. Only specimens with acceptable pulp sealing according to blinded microscopy control were included. On day 3, identical inflammatory responses in the upper pulp were observed in molars with rhIGF-I gel or control gel. On day 7, granulation tissue ingrowth had partly replaced inflammatory infiltration in both groups. After 28 days, complete dentin bridging and tubular dentin formation were observed more frequently and closer to the test substance containing rhIGF-I. The reparative dentin response to capping with rhIGF-I was similar to that after the use of Dycal. In conclusion, microscopic control of membrane sealing in situ gives valid information on the more subtle pulp effects of growth factors. The observations suggest that pulp-capping of rat molars by means of rhIGF-I enhances reparative dentinogenesis in comparison with vehicle controls.

Animals↗

PubMed2004

Asymmetry in the condylar long axis and first molar rotation.

Asymmetric growth occurs frequently in the mandibulofacial region, but little attention has been given to asymmetry in the temporomandibular joint. The purpose of this study was to clarify the feature of asymmetry in the condylar long axis and its relation to upper first molar rotation. Records of 148 pre-orthodontic patients were used. The angle of the condylar long axis and that of the molar rotation were both larger on the left side than on the right side. Positive correlations were found between the corresponding bilateral measurements of condylar long axes and also between those of molar rotations, whereas no correlation was found between the condylar long axis and molar rotation. These findings were found in most subgroups classified by dental age, skeletal pattern, bite force balance, or gender. These results suggest that consistent left-right differences in the condylar long axis and first molar rotation are common.

Adolescent↗

PubMed2005

Runx2 (Cbfa1) inhibits Shh signaling in the lower but not upper molars of mouse embryos and prevents the budding of putative successional teeth.

Heterozygous mutations in the RUNX2 (CBFA1) gene cause cleidocranial dysplasia, characterized by multiple supernumerary teeth. This suggests that Runx2 inhibits successional tooth formation. However, in Runx2 knockout mice, molar development arrests at the late bud stage, and lower molars are more severely affected than upper ones. We have proposed that compensation by Runx3 may be involved. We compared the molar phenotypes of Runx2/Runx3 double-knockouts with those of Runx2 knockouts, but found no indication of such compensation. Shh and its mediators Ptc1, Ptc2, and Gli1 were down-regulated only in the lower but not the upper molars of Runx2 and Runx2/Runx3 knockouts. Interestingly, in front of the mutant upper molar, a prominent epithelial bud protruded lingually with active Shh signaling. Similar buds were also present in Runx2 heterozygotes, and they may represent the extension of dental lamina for successional teeth. The results suggest that Runx2 prevents the formation of Shh-expressing buds for successional teeth.

Animals↗

PubMed1995

Recruitment of immunocompetent cells after dentinal injuries in innervated and denervated young rat molars: an immunohistochemical study.

The dental pulp represents a peripheral end-organ deprived of a collateral nerve supply. After inferior alveolar nerve (IAN) axotomy, rat molar pulp is denervated over a period of at least 6 days. Therefore, rat molar pulp was used as an experimental model to study the effect of sensory nerve fibers on influx of immunocompetent cells after dentinal injury. In the present study we performed a quantitative analysis of CD43+, CD4+, CD11b+, and I-A antigen-expressing cells subjacent to dentinal cavities in denervated and innervated first mandibular molars. For visualization of nerve fibers, antibodies to protein gene product (PGP) 9.5, the sensory neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP), and the sympathetic neuropeptide Y (NPY) were used. Immunohistochemistry was performed by the avidin-biotin-peroxidase method. In the innervated teeth, a correlation between increased sensory nerve density and influx of immunocompetent cells was found. Compared to the contralateral innervated molars, a significant reduction in recruitment of immunocompetent cells was found in the denervated pulp tissue subjacent to the dentinal cavities. The rat molar represents a unique model to illustrate the influence of sensory nerves and neuropeptides on inflammation and recruitment of immunocompetent cells.

Animals↗

PubMed1988

Spatial- and temporal-restricted pattern for amelogenin gene expression during mouse molar tooth organogenesis.

Position- and time-restricted amelogenin gene transcription was analysed in developing tooth organs using in situ hybridization with asymmetric complementary RNA probes produced from a cDNA specific to the mouse 26 x 10(3) Mr amelogenin. In situ analysis was performed on developmentally staged fetal and neonatal mouse mandibular first (M1) and maxillary first (M1) molar tooth organs using serial sections and three-dimensional reconstruction. Amelogenin mRNA was first detected in a cluster of ameloblasts along one cusp of the M1 molar at the newborn stage of development. In subsequent developmental stages, amelogenin transcripts were detected within foci of ameloblasts lining each of the five cusps comprising the molar crown form. The number of amelogenin transcripts appeared to be position-dependent, being more abundant on one cusp surface while reduced along the opposite surface. Amelogenin gene transcription was found to be bilaterally symmetric between the developing right and left M1 molars, and complementary between the M1 and M1 developing molars; indicating position-restricted gene expression resulting in organ stereoisomerism. The application of in situ hybridization to forming tooth organ geometry provides a novel strategy to define epithelial-mesenchymal signal(s) which are believed to be responsible for organ morphogenesis, as well as for temporal- and spatial-restricted tissue-specific expression of enamel extracellular matrix.

Amelogenin↗

PubMed2003

Accuracy of digital and film panoramic radiographs for assessment of position and morphology of mandibular third molars and prevalence of dental anomalies and pathologies.

OBJECTIVES: To compare the accuracy of digital and film panoramic radiographs for determining (1) the position and morphology of mandibular third molars before surgical removal and (2) the prevalence of dental anomalies and pathologies. METHODS: Three hundred and eighty-eight third mandibular molars were available for examination. Position and morphology of third molars observed on film radiographs and on digital panoramic images from five systems (DenOptix, DigiDent, Digora, Dimax2 and Orthophos Plus) were recorded by two observers and were compared with surgeons' findings at the time of the operation (gold standard). One observer further recorded the prevalence of dental anomalies and pathologies on both imaging modalities. RESULTS: Few differences were found between the digital and film-based panoramic systems in the assessment of accuracy of position and morphology of mandibular third molars. The prevalence of dental anomalies and pathologies determined with the two modalities was roughly similar. CONCLUSION: The five digital panoramic systems evaluated in this study were equally as useful for third molar treatment planning and diagnosis of dental anomalies and pathologies as conventional film-based panoramic radiographs.

Adolescent↗

PubMed2006

Molar tooth development in caspase-3 deficient mice.

Tooth morphogenesis is accompanied by apoptotic events which show restricted temporospatial patterns suggesting multiple roles in odontogenesis. Dental apoptosis seems to be caspase dependent and caspase-3 has been shown to be activated during dental apoptosis.Caspase-3 mutant mice on different genetic backgrounds were used to investigate alterations in dental apoptosis and molar tooth morphogenesis. Mouse embryos at E15.5 were analyzed to reveal any changes in enamel knots, which are transient structures eliminated by apoptosis. In caspase-3(-/-) mice on the B57BL/6 background, disorganization of the epithelium was found in the original primary enamel knot area and confirmed by altered expression of Shh. Despite this early defect in molar tooth development, these mutants showed correct formation of secondary enamel knots as indicated by Fgf-4 expression. Analyses of adult molar teeth did not reveal any major alterations in tooth shape, enamel structure or pattern when compared to heterozygote littermates. In caspase-3(-/-) mice on the 129X1/SvJ background, no defects in tooth development were found except the position of the upper molars which developed more posteriorly in the oral cavity. This is likely, however, to be a secondary defect caused by a physical squashing of the face by the malformed brain. The results suggest that although caspase-3 becomes activated and may be essential for dental apoptosis, it does not seem fundamental for formation of normal mineralised molar teeth.

Animals↗

PubMed1981

Fracture resistance of mandibular molars with occlusal class I amalgam preparations.

The finding that large occlusal Class I restorations weaken premolars is not confirmed for natural mandibular molars because no statistically significant difference was found in the mean loads needed to fracture mandibular molars that were unprepared, minimally prepared, or prepared with a large occlusal amalgam restorations. Similarly, there was no statistically significant change in the amount of force necessary to fracture natural mandibular molars prepared with sharp vs round internal line angles (a no. 56 vs a no. 330 bur). Duplication of the experiment in acrylic resin mandibular molars confirmed the results of a previous experiment by Re and Norling as well as the results relating to sharp vs round internal line angles found in this experiment on natural mandibular molars. Acrylic resin teeth of homogeneous shape and substance overcome some of the sampling problems inherent in obtaining suitable human teeth for testing purposes; however, further testing of this material is indicated.

Dental Amalgam↗

PubMed1982

Preparation of space for posting: effect on thickness of canal walls and incidence of perforation in molars.

A total of 150 extracted maxillary and mandibular molars separated into six groups of 25 teeth each were prepared to the size of a 30 endodontic file. Numbers 2, 3, and 4 Peeso drills were used to produce a post cavity preparation in the root canals of these teeth. After use of each size of Peeso drill, the thickness of the canal walls was measured at two levels: the middle level, 4 mm from the canal orifice; and the apical level, 7 mm from the canal orifice. Mean thickness of all walls was determined for each tooth and drill size. The incidence of root perforations and strippings was recorded also. We found that distal roots of mandibular molars and palatal roots of maxillary molars are best suited for post cavity preparation. Most perforations and strippings occurred on the distal walls of mesial roots of mandibular molars or on the proximal walls of the buccal roots of maxillary molars.

Crowns↗

PubMed2000

The clinical performance of laboratory-fabricated crowns placed on first permanent molars with developmental defects.

BACKGROUND: Young permanent molars with developmental enamel defects commonly are treated with stainless steel crowns. However, allergic reactions to nickel and chromium have been reported by some patients. The literature contains no evaluations of alternative treatments. METHODS: In a retrospective study, the authors evaluated the clinical performance of cast gold crowns and tooth-colored composite or ceramic crowns placed on first permanent molars with developmental defects in children 6 to 8 years of age. A total of 41 molars were prepared. After crown preparation, an impression was made, and crowns of cast gold, Artglass (J.F. Jelenko & Co.) composite or Empress (Ivoclar) leucite-containing ceramic were fabricated and clinically evaluated every six months for a period ranging from two to five years postoperatively (mean three years). RESULTS: After two to five years, all crowns were fully retained. The marginal adaptation of 39 of the 41 crowns was rated excellent, and the marginal adaptation of the remaining two crowns (both gold) received acceptable ratings. In two cast gold crowns, the margins were subgingival at cementation; the remaining 39 crowns had supragingival margins at the time of luting. By the end of the second year, all margins were supragingival. All teeth were vital and asymptomatic at all evaluation points. No secondary caries was recorded. Neither gingival inflammation nor loss of vertical dimension was recorded in any case. All crowns were well-accepted by the patients and their parents. CONCLUSIONS: Laboratory-fabricated crowns can be used for the treatment of young permanent molars with developmental defects. CLINICAL IMPLICATIONS: Cast gold, composite or ceramic crowns can be used successfully to treat developmental defects of first permanent molars in children.

Child↗

PubMed2004

Reliability of panoramic radiography in evaluating the topographic relationship between the mandibular canal and impacted third molars.

BACKGROUND: The authors conducted a study to evaluate the predictive value of five radiographic markers on the panoramic radiograph, or PR, to point out the relationship between the mandibular canal and the impacted third molar. METHODS: The authors evaluated the accuracy of the radiographic markers by comparing the PR with an axial computed tomographic, or CT, scan. They identified a sample of 73 third molars that showed a close relationship between the tooth roots and the mandibular canal on the PR, and then classified them on the basis of five radiographic markers. They also detected contact between the third molar and the mandibular canal on the CT scan. RESULTS: The distribution of the five radiographic markers was as follows: 37 teeth exhibited increased radiolucency, 13 exhibited superimposition, 14 exhibited interruption of the radiopaque border, 14 exhibited narrowing of the canal and seven exhibited diversion of the canal. In 11 cases, two or more markers were recognizable. The predictive values of a positive test result were as follows: increased radiolucency, 73 percent; superimposition, 38.5 percent; interruption of the radiopaque border, 71.4 percent; narrowing, 78.6 percent; and diversion, 100 percent. The authors detected contact in all of the cases that exhibited two or more markers. CONCLUSION: Increased radiolucency, narrowing and interruption of the radiopaque border, as well as the concomitant presence of two or more radiographic markers, on the PR were highly predictive of contact between the third molar and the mandibular canal. An axial CT scan probably is indicated in such cases. CLINICAL IMPLICATIONS: The results of this study may lead to some guidelines for oral surgeons evaluating whether to obtain an axial CT scan for further investigation after examining an impacted mandibular third molar via PR.

Adolescent↗

PubMed2006

Efficacy and safety of combined piroxicam, dexamethasone, orphenadrine, and cyanocobalamin treatment in mandibular molar surgery.

Third molar extraction is a common procedure frequently accompanied by moderate or severe pain, and involves sufficient numbers of patients to make studies relatively easy to perform. The aim of the present study was to determine the efficacy and safety of the therapeutic combination of 10 mg piroxicam, 1 mg dexamethasone, 35 mg orphenadrine citrate, and 2.5 mg cyanocobalamin (Rheumazin) when compared with 20 mg piroxicam alone (Feldene) in mandibular third molar surgery. Eighty patients scheduled for removal of the third molar were included in this randomized and double-blind study. They received (vo) Rheumazin or Feldene 30 min after tooth extraction and once daily for 4 consecutive days. Pain was determined by a visual analogue scale and by the need for escape analgesia (paracetamol). Facial swelling was evaluated with a measuring tape and adverse effects and patient satisfaction were recorded. There was no statistically significant difference in facial swelling between Rheumazin and Feldene (control group). Both drugs were equally effective in the control of pain, with Rheumazin displaying less adverse effects than Feldene. Therefore, Rheumazin appears to provide a better risk/benefit ratio in the mandibular molar surgery. Since the side effects resulting from nonsteroidal anti-inflammatory drug administration are a severe limitation to the routine use of these drugs in clinical practice, our results suggest that Rheumazin can be a good choice for third molar removal treatment.

Adolescent↗