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PubMed1987

Periodontal manifestations of the heritable Mac-1, LFA-1, deficiency syndrome. Clinical, histopathologic and molecular characteristics.

The clinical, histopathologic and functional consequences of the genetic deficiency of leukocyte Mac-1, LFA-1 and p150,95 were assessed among three affected patients, heterozygotes and unaffected individuals among two generations of a single kindred. Longitudinal assessments of this family afforded the unique opportunity to characterize the natural history of severe periodontal manifestations associated with this disorder. Features uniformly observed among each patient included recurrent, necrotic soft tissue infections, impaired pus formation, delayed wound healing, constant granulocytosis, severe abnormalities of adhesion-dependent granulocyte functions and a profound deficiency (3%-6% of normal) of Mac-1 glycoproteins on granulocyte surfaces. Characteristic features of generalized prepubertal periodontitis including rapidly progressive alveolar bone loss affecting the primary and permanent dentitions (leading to premature tooth loss), recession, clefting and migration in association with intense gingival inflammation were uniformly observed. Biopsies of inflamed periodontal tissues in these individuals demonstrated dense infiltrates of mononuclear leukocytes but a striking absence of extravascular neutrophil granulocytes. Heterozygous family members demonstrated approximately half normal Mac-1 protein expression but no susceptibility to systemic infections and normal, adhesion-dependent leukocyte functions. Prepubescent heterozygotes demonstrated no periodontal manifestations but a 31-year-old heterozygous female exhibited clinical and radiographic features typical of postjuvenile periodontitis. The profound periodontal manifestations recognized in this clinical-pathologic model emphasize the physiologic importance of leukocyte adhesion reactions in defense of the periodontium and further suggest a possible pathologic role for Mac-1 proteins in other forms of early-onset periodontitis.

Adult↗
PubMed2000

Parameter on periodontitis associated with systemic conditions. American Academy of Periodontology.

The American Academy of Periodontology has developed the following parameter on periodontitis associated with systemic conditions. Patients affected by periodontal disease with concomitant systemic factors should be informed about the significance of the systemic condition(s) to the periodontal disease process. Patients should also be informed of the periodontal disease process, therapeutic alternatives, potential complications, expected results, and their responsibilities in treatment. Consequences of no periodontal treatment should be explained. Failure to treat periodontitis appropriately can result in progressive loss of periodontal supporting tissues, an adverse change in prognosis, tooth loss, and compromise of the dentition. Given this information, patients should then be able to make informed decisions regarding their periodontal therapy.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Influences of directed research and clinical observations on the development of a tartar control whitening dentifrice.

Early literature described the benefits of cleaning the mouth and teeth to prevent tartar accumulation and tooth loss. For more than a century, the need for meticulous tooth scaling and regular brushing to maintain oral health has been recorded. More recently, because of innovative research into the chemical and biological activity of saliva, dentifrices have been formulated which specifically interrupt the mineralization of plaque and food debris to stain and calculus. Proof of efficacy of these dentifrices are obtained with well-designed clinical tests which quantify stain and calculus by using reliable scoring systems.

Clinical Trials as Topic↗
PubMed2005

[Tooth tissue engineering: from cells to organ, an odyssey far from finished].

Tooth tissue engineering is an emerging biotechnique that will provide replacemental teeth for patients suffering from different diseases causing tooth loss. Although some attempts have been tried to generate whole tooth both in vivo and in vitro, the lack of the knowledge for tooth initiation and development, as well as for tooth shape controlling mechanisms greatly impede the progress of this technique. This article reviewed and discussed some recent findings in tooth tissue engineering related to the cell resource, the concept of reconstruction and regeneration, the application of artificial scaffolds, together with the methods of organ culture and implantation.

Humans↗
PubMed1982

The aetiology and pathogenesis of bone resorption in chronic periodontal disease.

Loss of bone is a characteristic feature of periodontitis and in later life assumes increasing importance as a cause of tooth morbidity and tooth loss. The rate, pattern and form of bone loss varies between individuals, from tooth to tooth and from tooth surface to tooth surface. This variation may be attributed to specific organisms or groups of organisms in subgingival plaque, factors that enhance plaque retention or factors that modify the course or nature of the disease. Certain high risk individuals should be identified at an early stage of the disease process. Plaque is the sole cause of periodontal disease and an effective plaque control programme is essential for periodontal health. The responsibility for maintaining an effective plaque control programme must rest primarily with the individual. The profession should provide active support by educating and instructing the patient and removing tooth deposits.

Adolescent↗
PubMed1998

[Masticatory function and life style in aged].

Elderly people gain enjoyment in their remaining years from eating, speaking and tasting things, and they find that the oral function is necessary to arouse in them a desire to work for society, in addition to looking after their own health, they find that over function is important. Recently, more attention has come to be paid to one's external appearance. Even if function is impaired, appearance has a strong influence on the feeling of leading a worth-while life. Though increasing age brings a steady loss of teeth, it is unlikely that physiological change resulting from tooth decay and disease are the cause of tooth loss. Degradation of the hard tissue caused by decay is unavoidable. Unless the decayed area is removed and the teeth are repaired with artificial materials, the function of the affected tooth is permanently lost. Moreover, as decay progresses and periodontal disease worsens the state of a given area, extraction becomes necessary. This is the process by which teeth are lost. However, even if teeth are lost, masticatory function may be restored through the use of dentures. Recently, we carried out a survey which showed that a group of elderly people with good masticatory functions were more healthy and lived longer than a group of elderly people with reduced physical functions (weight, grasping strength, balance, bone salt volume) and poor masticatory function.

Aged↗
PubMed2001

Soluble antagonists to interleukin-1 (IL-1) and tumor necrosis factor (TNF) inhibits loss of tissue attachment in experimental periodontitis.

BACKGROUND, AIMS: Periodontal disease is a significant cause of tooth loss among adults and is characterized by the alteration and permanent destruction of the deeper periodontal tissues. Although the presence of pathologic microbes is required to trigger this process, the amplification and progression of the diseased state is believed to rely heavily on the production of host mediators in response to bacteria or their metabolic products. The inflammatory response is effective in preventing large-scale colonization of the gingival tissues by bacteria that lie in close proximity to the tooth surface or within the gingival sulcus. It has been postulated that the host-response in some individuals may lead to an over-reaction to invading oral pathogens resulting in the destruction of periodontal tissues. METHODS: Several host-derived mediators are believed to contribute to this response. Two agents considered to be essential in periodontal destruction are interleukin-1 (IL-1) and tumor necrosis factor (TNF). We investigated the role of IL-1 and TNF in the loss of connective tissue attachment in a Macaca fascicularis primate model of experimental periodontitis. Silk ligatures impregnated with the periodontal pathogen, Porphyromonas gingivalis were wrapped around the posterior teeth and the activity of IL-1 and TNF were inhibited by soluble receptors to these proinflammatory cytokines via local injection into interdental papillae. RESULTS: Histomorphometric analysis indicates that IL-1 and TNF antagonists significantly reduced the loss of connective tissue attachment by approximately 51% and the loss of alveolar bone height by almost 91%, both of which were statistically significant. CONCLUSION: This investigation demonstrates that the loss of connective tissue attachment and progression of periodontal disease can be retarded by antagonists to specific host mediators such as IL-1 and TNF and may provide a potential treatment modality to combat the disease process.

Alveolar Bone Loss↗
PubMed1975

Studies on dentin. 2. Vestigial lacteal incisor teeth of the rat.

The presence of a vestigial, lacteal incisor tooth is described in the laboratory rat. This tooth is felt to belong to the same dental generation as the other functional teeth. Accordingly, the rat is described as having a monophyodont, first dentition containing two incisor teeth in each quadrant. These vestigial teeth are then compared with other similar mammalian teeth and are defined as transient, partially formed and non-functional. As such, they are differentiated from other transient teeth. The examination of the fossil record suggests that tooth loss is a general phenomenon in rodents, but that this vestigial tooth probably represents a condition present in forms antecedent to rodents. A critical literature review strongly suggests that the teeth of the recent rat are members of the first dental generation. The presence of such a vestigial tooth and of the postincisive diastema in the rat is felt to be an example of phylogenetic reduction and progressive retardation in the sense of de Beer's concepts. These same two phenomena were analyzed with respect to the field theory of Butler and of the Zahnreihen theory of Edmund. Placed within the context of recent data on epithelioectomesenchymal interactions, both theories were supported, and both the vestigial teeth and anodontic diastema were shown to be explicable within these conceptual frameworks.

Ameloblasts↗
PubMedDate not supplied

Immediate provisional restoration of Osseotite implants: a clinical report of 18-month results.

PURPOSE: The purpose of this study was to assess the survival rates and interproximal bone levels for Osseotite implants that were restored with fixed provisional crowns without occlusion immediately after implant placement. MATERIALS AND METHODS: Ninety-three implants were placed in 38 partially edentulous patients. All implants were immediately restored with prefabricated abutments and cement-retained provisional crowns without centric or eccentric occlusal contacts. The implants were restored with definitive restorations approximately 8 to 12 weeks after implant placement. All patients included in the study were followed for at least 18 months after implant placement (average 20.3 months). RESULTS: Seventy-seven of the 93 implants satisfied the inclusion criteria. Seventy-five implants became osseointegrated. The overall survival rate was 97.4%. Radiographic bone loss 18 months after implant placement (the mean of both interproximal surfaces) was 0.76 mm. The exact binomial confidence interval was 0.32% to 9.07%. For the exact binomial test with the null hypothesis proportion = .05, P was .3334 and was not statistically significant. DISCUSSION: Immediate nonocclusal loading of single-unit dental implants differs from immediate loading of multiple, splinted implants. Unsplinted, restored implants without occlusal loading may still be subject to lateral and occlusal loads secondary to the proximate location of the food bolus. Immediate restoration of dental implants significantly reduces treatment time and may be beneficial in reducing the morbidity associated with loss of teeth, contraction of the alveolus, and loss of interdental papillae associated with the traditional method of treatment following tooth loss. CONCLUSIONS: The results of this study suggest that immediate restoration of Osseotite implants can be accomplished with results that are similar to the results obtained with the traditional 1- or 2-stage surgical, unloaded healing protocols.

Adolescent↗
PubMed1982

Cross-sectional study of orthodontic treatment and missing of permanent teeth in two birth cohorts of Finnish students according to sex.

Undergraduate students (n = 451) at a Finnish university were studied. For analysis, the subjects were divided into two birth cohorts: those born before 1955, and those born in that year or later. Information about previous orthodontic appliance therapy was obtained from the students by using a structured questionnaire. Missing permanent teeth (second and third molars excluded) were recorded at a dental examination. Every 10th student had received orthodontic treatment; the proportion of orthodontically treated subjects was higher for females (14%) than for males (5%). Seven percent of students born in 1954 or earlier and 15% of the younger students had had orthodontic treatment before 1977. In 39% of subjects, at least one permanent tooth was missing while only 12% had lost more than two permanent teeth. The tooth missing most often was the permanent mandibular first molar (in 23% of subjects). Frequency of tooth loss was the same in males and females. At least one permanent tooth was missing in 48% of the older and in 31% of the younger students. At least one first molar had been lost by 36% of the older students and 20% of the younger ones. Fewer first molars but more permanent teeth anterior to the first molars were missing in subjects who had had orthodontic treatment than in subjects who had not had such treatment. Among Finnish students the frequency of extraction of permanent teeth because of caries is decreasing, and the frequency of orthodontic treatment is increasing. Females are more likely to seek orthodontic treatment than males are.

Adult↗
PubMed1999

Infraposition of ankylosed permanent maxillary incisors after replantation related to age and sex.

The extent of infraposition of replanted and subsequently ankylosed permanent incisors was examined in a longitudinal study of 52 patients. Study cast models were made during the follow-up period. Infraposition was evaluated on frontal photos of the study cast models taken parallel with the occlusal plane. The extent of infraposition was defined as the difference between the position of the incisal edge of the replanted incisor and the adjacent non-injured incisor in apico-coronal direction, measured with a digital caliper at 50x magnification of the negatives. The precision of this measuring procedure was 2.9% and the accuracy 2.0%. Marked infraposition was identified if the tooth was traumatized before the age of 16 in boys and before the age of 14 in girls. In addition, infraposition was observed when ankylosis developed in patients aged 20-30 years, with a yearly mean infraposition rate of 0.07 mm/year (range: 0.02-0.21 mm/year) in males and 0.07 mm/year (range: 0.00-0.12 mm/year) in females. The latter findings supported the concept of slow continuous eruption of the teeth. This phenomenon may have implications not only for the treatment of traumatized teeth but also for the treatment of tooth loss by osseointegrated implants, which represent an analogue to the ankylosed replanted tooth.

Adolescent↗
PubMed2001

Peri-implant health around screw-shaped c.p. titanium machined implants in partially edentulous patients with or without ongoing periodontitis.

The relationship between periodontitis and peri-implantitis remains a matter of debate. The present study compared, "within" randomly chosen partially edentulous patients (n=84 subjects, 97 jaws), the marginal bone loss around teeth and implants during 5 years (range 3 to 11 years) following the first year of bone remodelling. The patients had all been rehabilitated by means of screw-shape c.p. titanium implants with a machined surface (Brånemark system). During the 5 years observation interval, periodontal parameters (marginal bone and attachment loss, the latter for teeth only) were collected together with data on confounding factors (smoking, oral hygiene, tooth loss). Marginal bone loss was measured through long-cone intra-oral radiographs. The mean "interval" bone loss was significantly (P=0.0001) higher around teeth (0.48+/-0.95 mm) than around implants (0.09+/-0.28 mm). The corresponding data for the "worst" performing tooth (0.99+/-1.25 mm) and implant (0.19+/-0.32 mm) per subject showed the same tendency. Neither attachment nor bone loss around teeth correlated with marginal bone loss around implants. This study indicated that the rate of bone loss around screw-shape c.p. titanium implants with a machined surface (Brånemark system implants) was not influenced by the progression rate of periodontal destruction around the remaining teeth within the same jaw.

Adult↗
PubMed2005

Periodontal diseases.

The periodontal diseases are highly prevalent and can affect up to 90% of the worldwide population. Gingivitis, the mildest form of periodontal disease, is caused by the bacterial biofilm (dental plaque) that accumulates on teeth adjacent to the gingiva (gums). However, gingivitis does not affect the underlying supporting structures of the teeth and is reversible. Periodontitis results in loss of connective tissue and bone support and is a major cause of tooth loss in adults. In addition to pathogenic microorganisms in the biofilm, genetic and environmental factors, especially tobacco use, contribute to the cause of these diseases. Genetic, dermatological, haematological, granulomatous, immunosuppressive, and neoplastic disorders can also have periodontal manifestations. Common forms of periodontal disease have been associated with adverse pregnancy outcomes, cardiovascular disease, stroke, pulmonary disease, and diabetes, but the causal relations have not been established. Prevention and treatment are aimed at controlling the bacterial biofilm and other risk factors, arresting progressive disease, and restoring lost tooth support.

Anti-Bacterial Agents↗
PubMed2002

Inflammation and tissue loss caused by periodontal pathogens is reduced by interleukin-1 antagonists.

Periodontal disease is a significant cause of tooth loss among adults. It is initiated by pathogenic bacteria, which trigger an inflammatory response that is effective in preventing significant microbial colonization of the gingival tissues. In some individuals, the reaction to bacteria may lead to an excessive host response, resulting in periodontal tissue destruction. Recent developments suggest that interleukin (IL)-1 genetic polymorphisms may identify certain individuals who have a predisposed susceptibility to periodontal breakdown and that elevated levels of IL-1 are found in individuals with periodontal disease. However, there is no direct evidence that IL-1 per se is responsible for the critical events that occur in periodontitis. We investigated the role of IL-1 in periodontal disease in a Macaca fascicularis primate model, using human soluble IL-1 receptor type I as a specific inhibitor. The results indicate that inhibition of IL-1 alone significantly reduces inflammation, connective tissue attachment loss, and bone resorption that are induced by periodontal pathogens.

Alveolar Bone Loss↗
PubMed1997

A comparative prospective clinical study of two single-tooth implants: a preliminary report of 102 implants.

STATEMENT OF PROBLEM: Treatment of tooth loss in the anterior maxilla can involve difficult functional, esthetic, and psychologic problems, especially in young patients with otherwise good dentition. PURPOSE: The purpose of this study was to provide a preliminary comparative evaluation of two implants (ITI and Astra) in single-tooth restorations. MATERIAL AND METHODS: This prospective study of 102 single-tooth replacements with 56 ITI and 46 Astra dental implants was performed in 82 patients at the Finnish Student Health Service Foundation. One Astra implant was lost before loading. The overall survival rate of the implants was 97.8% for Astra implants and 100% for the ITI system. After the initial healing period of at least 6 months, the remaining 101 implants (56 ITI, 45 Astra) were free of periimplant infection and revealed no detectable mobility. Radiographs did not reveal signs of periimplant radiolucencies. All 101 implants received single-tooth crowns. RESULTS: Periimplant parameters and acceptable implant function were examined and demonstrated satisfactory results with preestablished clinical parameters and radiographs at 1 year. During the observation time the mean marginal bone loss was 0.13 mm with Astra implants and 0.11 mm with ITI implants. Subjectively all patients were satisfied with their single-tooth restorations supported by either ITI or Astra dental implants. CONCLUSION: The favorable results of this short-term study support the application of the two implant systems for single-tooth restorations, especially in the anterior region of the maxilla.

Adolescent↗
PubMed1997

Postmenopausal estrogen replacement and tooth retention.

PURPOSE: To determine if estrogen replacement therapy (ERT) is associated with improved tooth retention and lower risk of edentulism (no natural teeth remaining) in a cohort of elderly women. PATIENTS AND METHODS: Subjects were 488 women, aged 72 to 95, who participated in the 23rd examination cycle (1994 to 1995) of the Framingham Heart Study, a population-based study begun in 1948. The number of teeth remaining and their location were recorded by a trained observer. History and duration of ERT were obtained from records kept since cycle 10 (1960 to 1963). Third molars were excluded from all analyses. RESULTS: Women who ever used ERT were younger than nonusers by 1 year (80 +/- 4 years, n = 184, versus 81 +/- 4 years, n = 304, P = 0.019). Estrogen users had more teeth remaining than nonusers (12.5 +/- 0.8 versus 10.7 +/- 0.8 versus 10.7 +/- 0.6 teeth, P = 0.046, mean +/- SE) after controlling for age, smoking status, and education. Duration of estrogen use was an independent predictor of the number of teeth remaining (P = 0.015) such that each 4.2-year interval of use was associated with an increased mean retention of 1 tooth. Long-term estrogen users (more than 8 years, n = 48) had an average of 3.6 more teeth than women who never used estrogen (14.3 +/- 1.5 versus 10.7 +/- 0.6 teeth, P < 0.02). The association with duration of use was present among different types of teeth (incisors, canines, and premolars) but less strong for molars. The odds of being edentulous were reduced by 6% for each 1-year increase in duration of estrogen use (odds ratio = 0.94, P = 0.038, 95% confidence interval = 0.90 to 0.99). CONCLUSIONS: These data suggest that ERT protects against tooth loss and reduces the risk of edentulism. The associations of estrogen use and tooth retention are evident for all but the molars.

Age Factors↗
PubMed2005

Chairside replacement of posterior teeth using a prefabricated fiber-reinforced resin composite framework technique: a case report.

UNLABELLED: The fixed replacement of a single posterior missing tooth for those patients who cannot have either implants or conventional laboratory-generated fixed prostheses has always been a challenge to clinicians. The development of fiber-reinforced composites (FRCs) has opened up new possibilities of chairside treatment options to manage these types of clinical situations. Techniques using FRCs as frameworks with traditional restorative resin composites as veneering materials can provide chairside fixed prostheses that are esthetic and potentially durable, with minimal abutment tooth loss. A clinical case is presented that will illustrate a novel concept for tooth replacement--the use of an FRC prefabricated framework--to allow for a single visit, chairside replacement of a missing molar. The assembly of the framework and the clinical steps used in the framework placement and pontic fabrication are shown in detail. CLINICAL SIGNIFICANCE: The combination of FRC technology and adhesive techniques can provide minimally invasive and cost-effective treatment options for the chairside replacement of missing posterior teeth.

Bisphenol A-Glycidyl Methacrylate↗
PubMed2001

Mandible and mandibular first molar tooth measurements in dogs: relationship of radiographic height to body weight.

Height measurements of the mandible and the mandibular first molar tooth were obtained from 234 dogs. Statistical analysis was performed to determine possible associations between these measurements and body weight, sex, age, and body condition. There was a statistically significant association between the mandible: mandibular first molar tooth height measurement ratio and body weight (p < 0.0001) in all body weight groups. Small dogs had proportionally larger mandibular first molar teeth relative to mandibular height compared with larger dogs. This relationship may contribute to an increased susceptibility in small dogs for periodontitis and subsequent tooth loss. There was no statistically significant association between the mandible: mandibular first molar tooth height measurement ratio and other parameters evaluated in this study.

Animals↗