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PubMed1984

Masticatory efficiency: the effect of age, the loss of teeth and prosthetic rehabilitation.

Methods for studying efficiency and the results of studies using self-assessment and laboratory tests in subjects with various patterns of tooth loss are reviewed. It is concluded that age-related impairment of the dentition explains most of the decline in masticatory efficiency, while age per se has little influence. Many edentulous individuals are oral invalids and even when provided with optimal complete dentures their chewing efficiency is much lower than in those with natural teeth, with fixed prostheses on natural teeth, or with osseointegrated oral implants. The maintenance of a reasonable number of healthy natural teeth is the best guarantee for good masticatory efficiency with increasing age.

Adolescent↗
PubMed2003

Assessment of axonal loss in Charcot-Marie-Tooth neuropathies.

Sensory loss and weakness in Charcot-Marie-Tooth (CMT) neuropathy is due to axonal loss. However, the pattern and degree of axonal loss cannot be accurately determined from routine electrodiagnostic or strength testing due to collateral reinnervation. We sought to quantify axonal loss in two upper extremity muscles in CMT1A and CMT2 subjects using the electrophysiologic endpoint measure of motor unit number estimation (MUNE). Hypothenar and biceps-brachialis muscle groups were studied in 9 CMT1A, 9 CMT2, and 10 control subjects. The spike-triggered averaging (STA) technique was used to collect surface motor unit potentials for MUNE calculations, and a needle electrode was used to collect corresponding intramuscular data. Maximal voluntary hypothenar and handgrip strength was measured quantitatively, while biceps-brachialis strength was measured qualitatively. Compared to normal subjects, CMT1A and CMT2 subjects had significantly lower MUNE values in hypothenar muscles. Biceps-brachialis MUNE values were reduced in CMT2 but not in CMT1A subjects. In support of proximal axonal loss in CMT2 subjects, surface motor unit and intramuscular potential amplitudes were higher in biceps-brachialis muscles compared to controls. Correlations between quantitative strength and MUNE were significant for hypothenar but not for grip muscle groups. Axonal loss is demonstrated in distal muscles in CMT1A and CMT2 supporting a length-dependent axonopathy. Despite clinical findings of normal or near-normal strength and small reductions in compound muscle action potential (CMAP) amplitude, MUNE values were significantly lower in CMT2 subjects in proximal muscles, consistent with more diffuse denervation. These data indicate that subclinical axonal loss is present that cannot be appreciated using clinical examination or routine electrodiagnostic techniques.

Action Potentials↗
PubMedDate not supplied

Aesthetic management of extractions for implant site development: delayed versus staged implant placement.

Resorption of the dentoalveolar bone and collapse of the gingival ridge following tooth loss often results in aesthetic compromise and inadequate bone for "prosthetically driven" implant placement. Preventing alveolar bone resorption with a conservative procedure at the time of extraction can enhance aesthetics and reduce the duration and extent of treatment required for implant placement. This article describes the aesthetic management of extraction sites using a conservative bone grafting procedure at the time of extraction for implant site development. The case presented demonstrates staged and delayed implant placement techniques.

Adult↗
PubMed2006

Alveolar bone loss and reported medical status among a sample of patients at a Saudi dental school.

PURPOSE: Periodontitis is a common chronic disease globally. It is a major cause of tooth loss among adults, and recently has been suggested as a possible risk factorfor some systemic diseases such as cardiovascular disease. In Saudi Arabia, research on periodontitis prevalence, as well as its relation to systemic diseases, is lacking. The objectives of this study were: (1) to determine the prevalence of periodontitis among a sample of Saudi Dental School patients population; and (2) to examine the association between periodontitis and systemic diseases in the selected sample. MATERIALS AND METHODS: Retrospective evaluations of 282 randomly selected dental records were conducted. Age, gender, nationality and medical history were abstracted from these records. Number of remaining teeth and number of teeth with more than 20% of bone loss were determined from panoramic radiographs. Descriptive statistics, t-test, chi-square and regression models were used for data analyses. RESULTS: About 68% of the sample had radiographic alveolar bone loss; of these, 28% had a localised and 40% had a generalised form. Prevalence of systemic diseases was generally higher among individuals with the generalised form. About 21% and 13% of those with generalised periodontitis reported history of diabetes and hypertension respectively, whereas only about 2% of those with localised periodontitis reported history of these diseases. CONCLUSION: The findings of the present study showed a high prevalence of periodontitis in the selected sample. There is an urgent need for further studies with larger sample size to confirm these findings and to implement an effective measure to reduce periodontitis prevalence in Saudi Arabia.

Adolescent↗
PubMed1987

Autotransplantation of teeth (I). Indications for transplantation with a follow-up of 51 cases.

The indications for autotransplantation of teeth in 45 patients have been analysed together with a follow-up of the success rate of surgery. Most of the transplants were mature teeth, 37 out of 51, with closed apex. The majority of transplantations were carried out in order to replace single tooth losses (40) but in 11 cases, the teeth were used as an abutment in prosthetic rehabilitation. In 14 cases, an impacted tooth was transplanted to its normal position. The follow-up ranged from 3 months up to 10 years. No progressive root resorption has been observed so far; only 6 cases with slight surface resorption. Clinical signs of anchylosis were noticed in 4 teeth and shallow bone defects in 6 patients. Small- or medium-sized periapical destructions were observed in 4 cases. Mature transplanted teeth were always subjected to endodontic therapy within a month; the immobilisation varied between 2-4 weeks, while trying to keep it as short as possible with maintained stability. The experiences so far achieved do encourage a more comprehensive use of the method to solve problems associated with oral rehabilitation, from both prosthodontic and orthodontic points of view.

Adolescent↗
PubMedDate not supplied

Variation of tooth number in mammalian dentition: connecting genetics, development, and evolution.

A major question in modern biology is how gene mutations affect development and are translated into macroevolutionary changes in morphology. Variations in tooth number, a strategy used by many mammals to develop specialized dentitions, has been an important factor for species diversification. Changes in the number of teeth tend to occur in the reverse of the order teeth are formed during development, which also characterizes the general pattern of tooth loss observed during the evolution of placental mammals. To understand how changes at the molecular level affect the distinct stages of tooth development, we analyzed the ontogenesis of tooth growth arrest in sciurids and mice and in single and double knockout mutant mice. We show that the complexity of the genetic network that governs tooth development can change during ontogenetic trajectory, and these changes may be related to macroevolutionary changes. Furthermore, we show that the variation in tooth number in the affected members of human families bearing mutations in the MSX1 and PAX9 genes can help to understand how the genetic variations within a population can modulate evolutionary changes in dental patterning.

Animals↗
PubMed1992

Age-related changes of the craniofacial skeleton: an anthropometric and histologic analysis.

With the development of increasingly sophisticated methods for the alteration of bony facial form consequent to age, it is imperative that the surgeon have a fundamental knowledge of the age-related changes the skeleton may undergo. To understand these changes better, a detailed anthropometric and histomorphic analysis of the craniofacial skeleton as a function of age was undertaken. The study consisted of a detailed craniometric analysis of 160 skulls selected randomly from a Caucasian population of skeletal remains totaling 1500 specimens. Additionally, a histologic analysis of the supraorbital ridge in a separate preserved cadaver population was performed. Although the results showed individual variation as expected, definite changes in craniofacial morphology were observed. These included (1) appreciable reduction of facial height, most marked in the maxilla and mandible, and strongly correlated with loss of teeth, (2) modest increase in facial width, (3) modest increase in facial depth, except in those regions associated with tooth loss, and (4) general coarsening of bony prominences. Histomorphic analysis demonstrated increasing porosity with age, more marked in the female population. Although these changes represent population trends, in any given patient, any or all of them may be present to varying degrees. Surgeons should be aware of these possibilities and consider selective alterations of the skeletal foundation, either separately or in concert with the overlying soft-tissue envelope, in order to optimize the results of surgery for the aging face.

Adult↗
PubMed1989

Health maintenance issues of the elderly. Oral health.

The risk for the most serious oral disease, oral cancer, increases with age as does the prevalence of other oral soft tissue diseases. Tooth loss is not part of normal aging. As more elderly retain their natural dentition, they are at continued risk for tooth-related diseases such as caries and periodontal disease. Preventive dental programs, including an oral exam as part of the physical examination, will be indicated for adults.

Aged↗
PubMed1998

Aesthetics in implantology.

A young man presented himself with a missing maxillary central incisor and a depressed defect due to a trauma. The trauma caused the loss of No. 8 and its surrounding supportive structure. The defective results were seen by the labial bone loss in the area and a depression. The depression became a food-and-plaque trap and an unaesthetic eyesore. Before the tooth loss, iatrogenic factors from a root canal or retrograde amalgam caused a permanent gingival tattoo. The bonded temporary pontic was larger mesio-distally than the adjacent teeth, and this was very noticeable. It was dull in its finish and poor aesthetically. The patient requested an implant to avoid excess drilling of natural teeth. A combined effort was used to achieve the pleasing final result. To correct the area and improve the physiology and aesthetics, several techniques had to be understood. These techniques also need to be mastered, recalled, and used almost instinctively, and done in a proper team-like sequence. In this case we performed an aesthetic ridge augmentation and tissue surgical manipulation to acquire the form, shape, and correct color background. Deciding upon which implant and material involved choosing the size, type, and shape for the area involved. The techniques used included implant insertion, surgical second stage abutment, mucosal periosteal flap design, various suturing and gingival grafting techniques, ridge buildup augmentation, and GTR. Other choices included which resorbable membrane to use, what bone graft materials, and what oral hygiene to recommend to maintain final health. The restorative technique included full crown coverage, laminate veneers, provisional pontic design and bonding, control of porcelain materials, computer imaging, occlusion, cementing, smile designs, and implant prosthodontics.

Adult↗
PubMed2000

The not-so-harmless maxillary primary first molar extraction.

BACKGROUND: Premature loss of primary molars has been associated with space loss and eruptive difficulties, especially when the loss occurs to the primary second molars and when it occurs early. This has not been thought to be the case for primary first molars. METHODS: The author revisited 13 cases from an earlier study on the effects of premature loss of maxillary primary molars. These longitudinal cases were scrutinized, using serial panoramic radiographs, to explain the irregular response in terms of dental migration. The author presents two case reports. RESULTS: In the earlier study, the author used digitized study casts and the concept of D + E space--the space occupied by the primary first and second molars--to describe the dental migration that occurred after premature tooth loss. Using analysis of variance on data generated using an instrument capable of measuring in tenths of millimeters, the author produced findings regarding the amount of space loss, rate of space loss, effect of age at loss, amount of space regained at the time of replacement by the permanent tooth and effect on Angle's classification. Finally, the author created a simulation describing directional change; this revealed that the maxillary primary first molar loss resulted in a mesial displacement of the permanent canine during eruption. CONCLUSIONS: When the maxillary primary first molar is lost prematurely, the first premolar erupts in a more mesial direction than normal, as a result of the mesial incline of the primary second molar, and consumes the space of the permanent canine, which becomes blocked out. CLINICAL IMPLICATIONS: Rather than use a space maintainer after the premature loss of the maxillary primary first molar, the author suggests, clinicians can choose from a number of other options for preventing the first premolar from erupting too far in a mesial direction.

Adolescent↗
PubMed1980

A discussion of dental homology with reference to primates.

The inconsistencies which exist when the traditional tooth-to-bony-landmark/tooth-to-occlusal-relationship criteria of identification of teeth are maintained are discussed. It is pointed out how these (e.g., "the canine is the tooth behind the premaxillary-maxillary suture") can be falsified. It is also suggested that some mammals, including Tarsius and Homo sapiens, develop homologies of three sets of "teeth," and that the "adult" antemolar dentition of a mammal may be composed of retained deciduous teeth as well as permanent teeth. Following a revision of dental homologies in most primates, an approach to reevaluating dental homologies is proposed, and a model of tooth "loss" presented.

Animals↗
PubMed2005

Replacement of two mandibular central incisors using a zirconium resin-bonded fixed partial denture: a clinical report.

Maxillary and mandibular anterior tooth loss may cause esthetic and functional problems. Successful treatment for these situations may necessitate a minimally invasive technique to preserve sound remaining abutment tooth structure. This article describes the use of zirconium resin-bonded fixed partial denture as a conservative treatment option for the replacement of 2 mandibular central incisors.

Adult↗
PubMed2006

A proposal for a new classification of lesions of exposed tooth surfaces.

In the presence of improved methods of identification and treatment of lesions on the exposed surfaces of teeth, it should now be acknowledged that the GV Black "classification of carious cavities" is out of date. This paper describes a new system, proposed in 1997, discussed broadly throughout the profession, and eventually modified. The system has been adopted in several regions around the world as being a useful corollary to the current developing concept of minimal intervention dentistry. It is now desirable to adopt a new approach to the identification and recording of the lesions caused by both caries and non-carious tooth loss. A major advantage arising from its adoption would be that it would encourage the profession to minimise the amount of normal healthy tooth structure that is often sacrificed in pursuit of the cavity designs as suggested by Black. The authors are members of a Project Group of the FDI Science Committee, and this paper explains the concept and offers justification for the adoption of the system.

Dental Caries↗
PubMed2006

Acro-dermato-ungual-lacrimal-tooth-like syndrome: report of a family with variable expression.

We report the case of a young boy with fine hair, mild nail dysplasia, blocked nasolacrimal ducts, absence of central incisors, bilateral oligodactyly of feet and anal stenosis. His father showed the same spectrum of anomalies with mild expression. He had mild nail dysplasia, blocked nasolacrimal ducts, inferior dental cysts with consequent premature tooth loss, frequent dental decays consequent to enamel abnormality and cutaneous syndactyly of the second and third right toe. The acro-dermato-ungual-lacrimal-tooth syndrome was suspected and molecular analysis of the P63 gene was performed, but no mutation was found. Although P63 gene analysis was negative, we think that both cases show clinical overlap with the acro-dermato-ungual-lacrimal-tooth syndrome and confirm the wide expression of this condition, even in the same family.

Abnormalities, Multiple↗
PubMed1990

Periodontal defects of pulpal origin: evidence in early man.

False assumptions have led to the widespread opinion that periodontitis of gingival origin is a ubiquitous disease and a common cause of tooth loss among ancient populations. Evaluation of dry skulls reveals that horizontal loss of crestal alveolar bone was unusual and of minor severity. Localized vertical bone defects of pulpal etiology were common and severe, often resulting in tooth mortality. The present paper identifies a number of factors that have contributed to the development of some important misconceptions about the nature of periodontal disease, its incidence, and its etiology.

Bone Resorption↗
PubMedDate not supplied

The potential benefits of dietary and/or supplemental calcium and vitamin D.

Osteoporosis is a significant problem in women and men. In addition, as osteoporosis has garnered more attention there should be more attention than ever placed on the potential benefits of calcium and vitamin D. Clinicians need to inform patients that there are numerous healthy dietary sources of calcium and vitamin D. Calcium and vitamin D supplements seem to act synergistically to reduce fracture risk in men and women; therefore, they need to be taken together to impact fracture risk. In addition, almost every randomized trial of an effective osteoporosis drug therapy has utilized calcium and vitamin D to enhance the efficacy of the drug itself. Several forms of calcium supplements are commercially available today and clinicians need to understand the similarities and differences between them. Calcium and vitamin D in moderation also have a good safety profile and may actually have benefits far beyond osteoporosis therapy. For example, calcium may increase high-density lipoprotein (HDL), prevent colon polyps, reduce blood pressure, reduce kidney stone recurrence, and may promote weight loss. Vitamin D may reduce the risk of some cancers, provide an enhanced response to some chemotherapeutic agents, prevent type I diabetes, and may reduce tooth loss along with calcium. Clinicians need to encourage individuals to receive the recommended daily allowance of these two agents because they seem to have an impact on numerous health conditions besides osteoporosis.

Adult↗
PubMed1997

[Craniofacial morphogenesis after unilateral extraction experiments on rabbits].

BACKGROUND: Many authors have observed that reduction of the posterior vertical dimension after the loss of teeth during cranio-facial growth can lead to alterations not only of occlusion but also of cranio-facial skull structure. The alteration differs according to whether the absence of teeth is mono- or bilateral. In this paper, the authors present the skeletal alterations after monolateral tooth loss. METHODS: An experiment was performed on 25 rabbits, all having undergone monolateral tooth extraction. The experiment followed two rules of procedure: in a group of rabbits we extrasted the upper teeth only (experiment A), in another group of rabbits the extractions were performed both in the upper and in the lower jaw (experiment B), the third group of rabbits was used as a control group. At regular intervals, the authors examined skeletal alterations by means of Engstrom's cephalometric analysis (the asymmetries, the vertical posterior dimension). RESULTS: It was thus possible to observe some alterations of the cranio-facial bones and to compare the data with those of the control group.

Animals↗
PubMed2004

The effect of alendronate on resorption of the alveolar bone following tooth extraction.

Maintenance of alveolar bone width and height following tooth loss is essential with regard to the restoration of missing teeth with endosseous dental implants or prosthodontics approaches. A various amount of alveolar ridge resorption is likely to occur after tooth extraction at the buccal and lingual alveolar bone plates. Bisphosphonates, alendronate, is well known for its potent inhibition of osteoclast-mediated bone resorption. The objective of this study was to examine the inhibitory effect of alendronate on alveolar bone resorption following tooth extraction in rats. Male Wistar Albino rats were divided into three groups: baseline group, saline-treated group and alendronate-treated group. The saline-treated group was administered with daily saline solution for 2 and 4 weeks respectively while the alendronate-treated group was given a daily amount of 0.25 mg/kg alendronate subcutaneously for the same periods. The level of urinary calcium, creatinine, and serum calcium, alkaline phosphatase and phosphate were measured. Serum alkaline phosphatase level was measured as a marker of osteoblastic activity. Histopathological sections of 4 microm thickness were obtained from the right first mandibular molar region in a bucco-lingual direction. The number of osteoclasts, osteoblasts, and haversian canals, the number and size of resorptive lacunae, and osteoid formation were evaluated histopathologically. The mean thickness of buccal and lingual alveolar bone was measured. In the alendronate-treated group, both buccal and lingual alveolar bone volume reduction was significantly less than the saline treated group. Significant reduction in serum and urinary calcium levels and the number of osteoclasts revealed the pronounced suppression of bone resorption in the alendronate-treated group.

Alendronate↗