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PubMed2002

Predictors of Norwegian dentists' decisions to recommend replacement of teeth at the time of extraction.

OBJECTIVE: To study predictors of dentists' recommendations to replace the teeth which they extracted for adult patients in Norway in 1998. DESIGN: Cross-sectional postal questionnaire survey. PARTICIPANTS: A systematic random sample of 1,500 Norwegian general dental practitioners and response rate of 67% after two reminders. After exclusions, 302 dentists who had extracted 822 permanent teeth for 587 patients (16-92 years old) over a period of two weeks, were accepted for the study. RESULTS: According to the dentists, 30% of the patients were in definite need of a replacement for the extracted tooth or teeth, 29% were cases open to question and 41% had no need for a replacement. Model I: Tooth type extracted and the number of teeth extracted per patient were the most important predictors of the dentists definitely recommending a replacement after tooth extraction. Model II: When including the group of patients for whom a replacement was open to question, the odds of the dentists recommending a replacement for having an extracted anterior tooth or premolar increased from 13 (95% CI 6.16, 26.07) to 21 (95% CI 10.51, 40.69). Demographic characteristics had no significant effect on the dentists' decision. CONCLUSIONS: The two most important predictors for recommending a replacement after extraction were the position of the tooth or teeth and the number of teeth extracted. The reason why the number of remaining teeth had no significant independent effect was possibly because this group of patients had a relatively high number of natural teeth.

Adolescent↗
PubMed1999

[A very unusual complication of the extraction of a wisdom tooth].

We report here a case of a 42-year-old man who presented a major complication during wisdom tooth extraction. Secondarily after an extraction attempt to tooth migrated into the temporal fossa which required hemi-coronal surgical removal. We present a description of the surgical technique.

Adult↗
PubMed2002

Early bone healing events in the human extraction socket.

The tooth extraction socket is unique in terms of a bone-healing defect in that it contains the remnants of periodontal ligament fibroblasts attached to the socket wall. Although these cells have an osteogenic potential in vitro, the origin of cells populating the human extraction socket is unknown and may include bone marrow, periosteum and pericytic cells. Recently, monoclonal antibodies (AML-3, SB-10 and SB-20) have become available which can identify cells undergoing osteogenic differentiation. The aim of this work was to investigate the pattern of osteoblast differentiation in the human extraction socket using these markers. Immunolocalization was used to identify the osteoprogenitor cell population in the extraction sockets of three patients. Runx2 was most strongly expressed by the osteoblasts at the socket margin and in the surrounding marrow spaces. Osteoprogenitor, pre-osteoblast and osteoblast cells surrounded the newly formed trabeculae, and expressed on their cell surface antigens which reacted with the SB-10 and SB-20 antibodies. In a specimen with the tooth and periodontium present, both osteo-blasts and periodontal ligament fibroblasts were immunoreactive with SB-10, and SB-20 and also expressed Runx2. There was heterogeneity of expression of these osteogenic markers e.g. not all osteoblasts expressed Runx2. We have shown that osteoprogenitor cells in the residual periodontal ligament and bone marrow may contribute to bone regeneration following tooth extraction.

Activated-Leukocyte Cell Adhesion Molecule↗
PubMedDate not supplied

An innovative approach to chairside provisional replacement of an extracted anterior tooth: use of fiber-reinforced ribbon-composites and a natural tooth.

Immediate chairside replacement of an extracted anterior tooth may contribute to a patient's comfort, treatment acceptance, and expectations of treatment; however, fabrication of a custom restoration in the anterior region of the mouth may result in an esthetic compromise for patients during the fabrication period. Chairside tooth replacement is an excellent application of fiber-reinforced composite resin technology. This article presents an innovative, affordable chairside procedure in which Ribbond Multi-Purpose Bondable Reinforcement Ribbon is used to replace a single extracted anterior tooth using the patient's own tooth.

Adult↗
PubMed2006

Influence of premolar extractions on tooth size discrepancy. Part two: Analysis of Bolton values.

The purpose of this study is to investigate whether the extraction of four premolars as a requirement of orthodontic therapy is a factor in the creation of tooth size discrepancies (TSD) (Bolton value (BV)), and to determine whether any tooth extraction combinations create more severe discrepancies comparing our result with the results from analogical studies. Hypothetical tooth extractions were performed in all cases by the following combinations: all first premolars, all second premolars, upper first and lower second premolars, and upper second and lower first premolars, estimating extraction influence on TSD frequency and size. 148 pretreatment dental casts were examined. It has been determined that in normal TBI group the smallest discrepancies were created after the second (1.087 mm) and fourth types of combinations have been chosen (1.174 mm). In a low TBI group, the smallest discrepancies occur after first (1.544 mm) and third (1.568 mm) types of removal. In high TBI group the smallest discrepancies appear after type two (3.379 mm) and type four (3.586 mm) have been chosen.

Bicuspid↗
PubMed2004

Modified approach to the Bio-Col ridge preservation technique: a case report.

With today's esthetic conscious population, the day of simply extracting a tooth and replacing it at a later date is unacceptable to many patients. It is vital to preserve and maintain the edentulous ridge and normal gingival architecture, which often collapses after tooth extraction. As clinicians, we must have multiple techniques available to preserve or restore the function and esthetics when teeth are unrestorable. This case report describes a modified approach to the "Bio-Col Technique." This modification simplifies the procedure without compromising the esthetic result.

Adult↗
PubMed1989

[A case of a so-called congenital tooth appeared in maxilla].

The congenital teeth are not only classified by Massler et al. as a natal tooth that has erupted at birth and a neonatal tooth that erupts at neonatal period, but also divided into a normal deciduous tooth and a supernumerary tooth. The congenital teeth are mostly found in the mandibular anterior region, but extremely rare in other regions. The authors met a rare case, that had a so-called congenital tooth in the maxillary anterior region, which was a supernumerary and fused tooth. The case was a boy patient, 4 months of age, who visited the pedodontic clinic, of Ohu University Dental Hospital, with the complaint of ruber and swelling of the maxillary anterior gum pad, October 17th in 1986. By oral inspection of the dental radiogram and his past history, the authors found a odontoid material in the swelled gum pad and diagnosed it as a so-called congenital and supernumerary tooth. The tooth was extracted. The extracted tooth was investigated histopathologically. It had the v-shaped incisula at the middle of its edge, and seemed as if two teeth had coalesced. The serial preparations by the labio-lingual section showed no partition, such cementum as to divide the enamel, the dentin and the pulp near the incisula. Therefore it was diagnosed as fused tooth correctly. In the labial surface of the root formed about a third root length, the thickness of the cellular cementum was observed. It was considered as a physiological reaction to no support of the alveolar bone and to the excess mobility of the tooth. The prognosis after its extraction was good, and all normal deciduous incisors appeared in his mouth, 7 month later.

Fused Teeth↗
PubMed2004

Postextraction tissue management: a soft tissue punch technique.

The aim of this prospective clinical study was to analyze graft-enhanced soft tissue healing during the initial phases after tooth extraction. Twenty patients in need of tooth extraction (incisors, canines, and premolars) and implant replacement were included. In patients with multiple extractions, one tooth was randomly selected for treatment. After administration of antibiotics, the selected tooth was gently removed. The socket was completely filled with deproteinized bovine bone mineral integrated in a 10% collagen matrix to fill out the space of the alveolus and support the soft tissue. A biopsy punch with a diameter corresponding to the socket orifice was chosen to harvest a free gingival graft of 2- to 3-mm thickness from the palate. The punched graft was carefully sutured to the deepithelialized soft tissue margins of the socket. One week after graft insertion, 64.3% of the mean graft area was fully integrated, 35.6% was fibrinoid, and 0.1% showed necrotic parts. Three and 6 weeks postsurgery, the mean integrated graft surface increased to 92.3% and 99.7%, respectively. After 6 weeks, a mean of 0.3% of the surface in four grafts showed incomplete wound closure, and no fibrin or necrosis was present. Colorimetry of the graft and adjacent tissue revealed a mean color match of deltaE = 2.91, lower than the critical threshold of 3.7 for intraoral visibility of different colors. This soft tissue punch technique led to successful biologic and esthetic integration of the transplanted graft into the local host tissues.

Adult↗
PubMed2002

Predictors of norwegian adult patients' perceived need for replacement of teeth at the time of extraction.

OBJECTIVE: To report on adult patients' perceived need for replacement of teeth at the time of extraction and to study predictors of their perceived need for treatment. DESIGN: Cross-sectional postal questionnaire survey. PARTICIPANTS: A systematic random sample of 1,500 Norwegian general dental practitioners. The response rate was 67% after two reminders and 75% of their patients responded. After exclusions, the final sample consisted of 438 patients (16-92 years old), who had had 599 permanent teeth extracted by 248 dentists over a period of two weeks. RESULTS: The median number of remaining teeth was 23 (range: 0-31). The patients' wish for a replacement of the extracted tooth was coded as necessary (47%) and unnecessary (53%). Factor analysis (varimax rotation) was used to create two unidimensional variables, measuring the attitude to the importance of dental appearance and dental function. Logistic regression analysis showed that, compared to molars, the odds ratio for wishing a replacement for an incisor or canine was 13.7 (95% CI 5.6, 33.3) and for a premolar 4.1 (95% CI 2.4, 7.1). The likelihood of patients wanting a replacement when >1 tooth was extracted, or they did not believe that they would keep their teeth for life, was 2.5 (95% CI 1.2, 4.4) and 1.7 (95% CI 1.1, 2.8), respectively. Demographic characteristics and attitude to appearance and function had no significant effect on the patients' wish. CONCLUSIONS The most important predictors of patients' wish for a replacement were tooth type, number of teeth extracted and not believing in keeping their teeth for life.

Adolescent↗
PubMed1996

Missing teeth and lost teeth of adults aged 30 years and over in south-western Finland.

The majority of Finnish adults have lost one, some or all of their teeth. The prosthetic replacement of missing teeth has thus been an important element of adult dental care. However, there have been no longitudinal studies focusing on the development of oral health among the Finnish adult population in terms of further tooth loss. A baseline sample from 1977-78 was selected from the city of Turku to represent the adult population aged 30 years and over. Ten years later, a follow-up examination was carried out on this baseline study group. A new sample of persons aged 30-39 years was also obtained to provide cross-sectional information, allowing comparisons between this study group and the youngest age-group of the 1977-78 study. In 1977-78, 52 per cent of all subjects had 20 or more remaining teeth. The mean number of missing teeth was 15.8 (SD 11.05) and the corresponding median 12 teeth. The number of missing teeth was on average higher in the older age-groups (P < 0.001). Women had more missing teeth than men (P < 0.01). In the ten-year follow-up study, the mean number of lost teeth was 1.5 (SD 2.32) and the median one tooth. The average number of lost teeth increased with age (P < 0.01). The rate of tooth loss was highest for those with 10 to 19 teeth at baseline, second highest for those with one to nine teeth and lowest for those with 20 to 32 teeth (P < 0.001). The reasons most often reported for tooth extraction were tooth mobility, pain and prosthetic treatment. In the cross-sectional study groups of persons aged 30-39 years, the proportion of subjects with a complete natural dentition of 28 to 32 teeth was 63.4 per cent in 1989, compared with 40.0 per cent ten years earlier. The average number of missing teeth was lower in 1989 than in 1977-78 (mean 4.7, SD 3.81 vs. mean 7.8, SD 6.92; P < 0.001). In both cross-sectional examinations women had a higher mean number of missing teeth than men. However, the difference between the genders was statistically significant only in 1977-78 (P < 0.01). Among the age-group of 30-39 years, there has been a considerable improvement in retention of natural teeth during the ten-year interval. However, among the middle-aged and elderly population reduced dentition was common; in addition, extraction was still used as a dental treatment especially among persons with reduced dentition. This suggests that the need for prosthetic replacement of lost teeth will continue to play a role in adult dental care in Finland for some decades to come.

Adult↗