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At least 1,009 records · Page 56Linked to original sources
PubMed1998

Evaluation of dental midline position.

Maxillary midline position relative to the facial midline is stressed as an important diagnostic feature in orthodontic treatment planning. Depending on the patient, however, movement of the dental midline to be coincident with the facial midline may be difficult to achieve. In addition, evaluation of dental midline position may be complicated if other midline facial structures are not well aligned. The two objectives of the current study were to determine how far the maxillary dental midline could deviate from the facial midline and still be considered aesthetically acceptable, and to determine how the position of various midline facial landmarks affect overall facial aesthetics. One hundred twenty individuals, including orthodontists, general dentists, orthodontic patients, and parents of patients, evaluated digitally altered images of two patient-subjects to rate the acceptability of dental midline deviations and to prioritize the importance of location of various midline facial structures. The mean threshold for acceptable dental midline deviation was 2.2 +/- 1.5 mm. There was a significant difference in deviation thresholds between the two patient-subjects (P < .05). Orthodontists and dentists were significantly less tolerant of midline deviations than were patients (P < .001), with the tolerance of parents in between. When deviations of various midline facial structures were evaluated, photographs with maxillary midline and/or nose deviations were considered less aesthetic (P < .001). There were no apparent differences noted among orthodontists, dentists, patients, and parents in this part of the study.

Adult↗
PubMed1996

Surgical correction of malpositioned implants. A case report.

A new technique for surgical correction of malpositioned implants is described. A 64-year-old female got her first fixed prosthesis anchored to 6 Brånemark implants in her upper jaw, in April 1993. The implants were poorly positioned and despite great efforts to make the construction aesthetically acceptable, the patient did not approve. In order to obtain better aesthetics, it was decided to move some of the osseointegrated implants to other positions. With a trephine drill, fixtures were removed including the surrounding bone, and 2 of them were placed in new sites made with the same drill. After a healing period of 6 months, abutments were connected and a new fixed prosthesis was made. After 1 year of loading, all implants were still stable. A marginal bone resorption to the 3rd thread was found around one of the implants.

Dental Implantation, Endosseous↗
PubMed2003

Relationship of dental status, sociodemographic status, and oral symptoms to perceived need for dental care.

OBJECTIVE: Previous studies have noted a discrepancy between clinically determined oral health status (normative need), patients' perceptions, and perceived significance of dental signs and symptoms. Our objective was to quantify the relationships between normative need and self-reports to improve our understanding of the factors that contribute to perceived need for care. METHODS: Clinical examination and questionnaire data were derived from the Florida Dental Care Study, a study of oral health and dental care, in a representative sample of community-dwelling adults aged > or = 45 years. The questionnaire provided information about presence of signs and symptoms, self-ratings of oral health, perceived need for dental care, and sociodemographic status (SDS). Perceived need was measured on a 4-point nominal scale. RESULTS: Self-reported broken filling, broken denture, cavities, loose tooth, teeth that look bad, and toothache were strongly associated with self-reported perceived need for dental care. Satisfaction with dental health was also associated with perceived need, but self-rated oral health was not. Most measures of SDS were associated with perceived need. However, in a single multiple regression, with self-reported signs and symptoms accounted for, race, age group, sex, and educational attainment were not significantly associated with a currently perceived dental problem. CONCLUSIONS: Certain dental signs and symptoms were significantly associated with perceived need for dental care, as were certain aspects of SDS; even once differences in dental signs and symptoms had been taken into account. Disaggregating measurement of perceived need from a single dichotomous ('yes/no') scale to a 4-point nominal scale was elucidative.

Aged↗
PubMed2001

Periodontal considerations in restorative and implant therapy.

The successful integration of periodontal and restorative dentistry for both natural teeth and implants requires knowledge and application of both mechanical and biological principles. In areas of aesthetic concern, an adequate band of attached gingiva can increase patient comfort, reduce the probability of gingival recession following tooth preparation and simplify restorative procedures. While some restorative margins need to be placed at or below the margin of the free gingiva, this should be considered to be a compromise, and margins should not be placed more than 0.5 mm into a healthy gingival sulcus. Approximately 2-3 mm of healthy, natural supra-alveolar tooth surface is needed for attachment of the gingival tissues to the tooth. This dimension is called the biological width. If adequate biological width does not exist, surgical or orthodontic procedures to expose healthy tooth structure are recommended before final restorations are placed. Retraction of soft tissues for impressions is best accomplished with mechanical methods rather than lasers or electrosurgery because of the potentially harmful effects of these devices to the cementum, bone and soft tissues surrounding the teeth. Implants function best and withstand occlusal forces optimally when loaded in a vertical direction. Therefore, planning implant placement is critical for success. Because of increased proprioception, it is suggested that natural teeth be used to guide the occlusion in partially edentulous patients. Cantilevers should be used with caution and with appropriate attention to occlusal forces. While occlusal trauma does not cause periodontal disease, it may contribute to bone loss around teeth and implants. In the opinion of the authors, provisional restorations are an integral part of dental and periodontal therapy. They can be used to establish aesthetic and physiological contours that can be easily cleaned by patients and they can also be used as a guide for any needed surgical tissue modification.

Crown Lengthening↗
PubMed1999

Fluoride release, weight loss and erosive wear of modern aesthetic restoratives.

OBJECTIVE: In this investigation, the in vitro sustained fluoride release, weight loss and erosive wear of three conventional glass ionomer cements (Fuji IX, ChemFil Superior, Ketac-Silver), three resin-modified glass ionomer cements (Fuji II LC, Vitremer, Photac-Fil), a polyacid-modified resin composite (Dyract), and a resin composite control material (Z100) were compared. METHODS: The amounts of fluoride released and weight changes were measured for 12 weeks using a fluoride electrode with TISAB III buffer. After 12 weeks, the specimens were recharged with fluoride using 2 mL of 1.23% APF gel. The recharged specimens were assessed for the amounts of fluoride released and weight changes over another 12 weeks. At the end of the experiment, the specimens were examined with SEM and surface profilometry. RESULTS: All materials, with the exception of Z100, showed the highest initial fluoride release rates during the first 2 days, dropping quickly over 2 weeks and becoming largely stabilised after 5 weeks, in an exponential mode. The recharging of the specimens with APF gel caused a large increase in the amounts of fluoride released during the first 2 days only. Analyses for all cements showed strong correlations between mean weight loss and cumulative fluoride release over a 5-week period following the application of the APF gel. SEM and surface profilometry found that roughness increased from the polyacid-modified resin composite to the conventional glass ionomer cements. CONCLUSIONS: APF gel caused erosive wear of the glass ionomer cements especially, and the wear correlated well with the weight losses. To minimise surface erosion, APF gel should not be used on these cements, especially as the recharging effects are transitory.

Analysis of Variance↗
PubMed2001

The relationship between Index of Complexity, Outcome and Need, and patients' perceptions of malocclusion: a study in general dental practice.

AIM: To examine the relationship between the Index of Complexity, Outcome and Need (ICON) and the subjective opinions of patients attending for routine dental care. MATERIALS AND METHODS: This study was undertaken at two general dental practices in Cardiff and Bedford. 50 patients aged between 11-14 years and 50 patients aged 30-40 years presenting for routine dental treatment were selected in each. The subjects were assessed objectively using the ICON guidelines by two examiners trained and calibrated in the use of this index. The scores were recorded directly from the patient. Subjective assessments were obtained from the patients by means of a questionnaire consisting of four simple questions addressing aesthetics, function, speech and treatment need using a five point Likert scale. RESULTS: The mean ICON scores for the different genders and age groups participating in this study were; 11-14 year old males 58.4 (SE 3.17); 11-14 year old females 51.8 (SE 3.51); 30-40 year old males 51.2 (SE 2.70); 30-40 year old females 45.3 (SE 2.56). There were statistically significant differences in ICON scores between the younger and older groups (P = 0.024) and females and males (P = 0.04). Adult patients were more likely to reject treatment than younger patients. Analysis of the professional scores in relation to subjective assessments, using the Spearman rank correlation coefficient, for 11-14 and 30-40 year olds, and for the male and female genders, revealed that the ICON has a significant correlation with patients' perceptions of aesthetics, function, speech and treatment need (r2 = 0.01 to 0.28). The only exceptions were patients' perceptions of speech in the 30-40 year old group, and function in the female gender, which did not show a statistically significant correlation to the professional assessments. CONCLUSION: In this study, the ICON was found to correlate with patients' opinions of aesthetics, function, speech and treatment need. The strength of association, however, was low. It can be concluded that the ICON alone is not necessarily a suitable predictor for appearance, function, speech or treatment need for those individuals attending general dental practice for routine dental care. In combination with a simple question to assess the patients desire for treatment, the shared decision for any particular individual to enter the treatment process can be determined.

Adolescent↗
PubMed2002

Crowns and extra-coronal restorations: materials selection.

Materials selection is the second in the series on crowns and other extra-coronal restorations. Some of us are less than inspired by dental materials science. Nevertheless, many of the things that concern us clinically with crowns and their alternatives are based on material properties. We worry about the strength of the restoration, how well it fits and its aesthetics. We also worry about wear, occlusal control and biocompatibility. Not least of our concerns are dental laboratory charges, which inevitably have to be passed on to the patient.

Biocompatible Materials↗
PubMed2002

Crowns and other extra-coronal restorations: provisional restorations.

The important role of provisional restorations is often overlooked. This may be because they are left until the end of an appointment when time for construction is short or because they generally do not need to last for long. However, not only can good provisional restorations help produce better final restorations, they can also save a lot of time and expense at subsequent appointments. In fact time spent in their construction will be more than repaid in time saved doing additional procedures, adjustments and remakes later on.

Acrylic Resins↗
PubMed2002

Crowns and other extra-coronal restorations: try-in and cementation of crowns.

Having successfully negotiated the planning, preparation, impression and prescription of your crown, the cementation stage represents the culmination of all your efforts. This stage is not difficult, but a successful outcome needs as much care as the preceding stages. Once a restoration is cemented there is no scope for modification or repeat You have to get it right first time. Decemented crowns often have thick layers of residual cement suggesting problems with either initial seating or cement handling. When the fate of restorations costing hundreds of pounds depends on correct proportioning of cements and the quality of the mix, the value of a well-trained and experienced dental nurse is easy to see. Both dentist and nurse need a working knowledge of the materials they are handling.

Cementation↗
PubMed1997

A field trial of an orthodontic treatment need learning package for general dental practitioners.

OBJECTIVE: To evaluate whether GDPs using an index of Orthodontic Treatment Need (IOTN) learning package in a practice setting referred (or treated) more patients with a definite need for orthodontic treatment. DESIGN: A randomised controlled trial. SUBJECTS AND METHODS: 20 GDPs (test group) used the package when selecting patients for orthodontic care during normal dental practice. A control group of 20 GDPs did not use the package. Over a 12-month period impressions were taken by the participating GDPs of all patients selected for orthodontic treatment, either referred to another practitioner or to be treated by the GDP. MAIN OUTCOME MEASURE: IOTN used by two expert examiners. RESULTS: Among the patients selected for orthodontic treatment by the test group there were more patients with a definite objective need for orthodontic treatment (78.1% versus 62.5% in the control group). After adjustment for potential confounding variables, the odds on a patient selected by a test group dentist being in definite need were 2.24 (95% CI 1.25, 4.01) more than the odds on a patient selected by a control group dentist (P = 0.007). CONCLUSIONS: Use of the IOTN learning package by GDPs would reduce the proportion of patients selected for orthodontic treatment with low or moderate objective need.

Adolescent↗
PubMed2005

Anterior dental aesthetics: Dental perspective.

The purpose of this series is to convey the principles governing our aesthetic senses. Usually meaning visual perception, aesthetics is not merely limited to the ocular apparatus. The concept of aesthetics encompasses both the time-arts such as music, theatre, literature and film, as well as space-arts such as paintings, sculpture and architecture.

Age Factors↗
PubMed2006

The orthodontic condition of children in the United Kingdom, 2003.

BACKGROUND: The 2003 Children's Dental Health Survey is the fourth in a series of decennial national children's dental health surveys in the United Kingdom. AIMS: This paper reports on the orthodontic condition of children aged 12 and 15 years. METHODOLOGY: A representative sample of children across the UK were invited to participate in a clinical dental examination in school. Two thousand, five hundred and ninety-five 12-year-olds and 2,142 15-year-olds were examined. Current and past orthodontic treatment and type of appliance worn were recorded. Orthodontic treatment need was assessed by the Modified IOTN in those not undergoing treatment. A postal questionnaire sought parents' views on the orthodontic condition of their children and perceived need for treatment. RESULTS: At age 12, 35% were judged to have an orthodontic treatment need, 57% had no need and 8% were wearing an appliance. The corresponding figures at age 15 were, 21% (need), 65% (no need) and 14% (wearing appliance). A higher proportion of girls (p < 0.05) were wearing an appliance than boys. A greater proportion of 15-year-olds were undergoing treatment than in the 1993 and 1983 surveys and the use of fixed appliances had increased. CONCLUSIONS: In this representative sample of UK children, one in five were still judged as having an orthodontic treatment need at age 15 years, as determined by the modified index of orthodontic treatment need. However, considerable variation was observed between professional and lay perceptions of need.

Adolescent↗
PubMed1998

Substances released from dental resin composites and glass ionomer cements.

An increasing number of cavities in the primary and permanent dentition is restored with tooth-colored materials, especially dental resin composites or glass ionomer cements. Several investigations have revealed that various components are segregated from different composite filling materials into an aqueous environment after polymerization. Most organic substances can be extracted from a set resin by organic solvents (methanol, tetrahydrofuran, ethanol). Furthermore, in most studies, the co-monomer TEG-DMA has been identified as the main compound released from polymerized resin composites into aqueous media. However, small quantities of the monomers (Bis-GMA, UDMA) and other co-monomers, as well as additives, may also be released into water. Very little data have been published about substances released from various types of glass ionomer cements (GIC), except the liberation of fluoride. Erosion studies have revealed that there is a considerable disintegration of GICs at lower pH-values. However, the nature of the eroded substances has not yet been clarified. Altogether, the data presented in this review indicate that information is comparably scarce for resin composites and GICs in comparison to the rich amount of knowledge concerning amalgams. Therefore, further studies are necessary to determine quality and quantity of substances segregated from resin composites and GICs.

Bisphenol A-Glycidyl Methacrylate↗
PubMed1999

Longevity of new hybrid restorative materials in class III cavities.

The aim of this study was to evaluate the durability of two new tooth-colored restorative materials, a polyacid-modified resin composite (compomer) and a resin-modified glass ionomer cement. In an intra-individual comparison with a resin composite, the materials were studied during a 5-yr period. In 50 patients, 154 large class III restorations were placed. Most patients received one of each of the three materials. The restorations were evaluated by modified United States Public Health Service (USPHS) criteria. Of the 144 restorations evaluated, 15 were found unacceptable. No significant differences were seen between the materials concerning recurrent caries incidence. The resin composite showed a significantly better color match. No difference was found between resin composite fillings in enamel- or total-etched cavities. Significantly higher surface roughness was found in the aged resin-modified glass ionomer cement restorations. Fracture of the incisal enamel corner was observed adjacent to 10 restorations. None of the three total-etch techniques resulted in postoperative sensitivity or loss of vitality. All the restorative techniques showed a low failure rate during the 5-yr follow-up.

Acid Etching, Dental↗