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PubMed1998

Fluoride distribution in sound and carious root tissues of human teeth.

Proton probe analysis has been used to provide for the first time quantitative F concentration data in carious root tissues from subjects consuming water containing 1 ppm F. In small lesions at the neck of the tooth with minimal tissue loss the F concentration was significantly higher at the outer lesion edge than at the outer edge of adjacent sound root tissue. In one sample with high F values the lesion edge had 19,000 ppm F and the adjacent sound root surface 5,400 ppm F microg F/g apatite). In large lesions with extensive cavitation F was again concentrated in the outer edge of the lesion and was significantly higher (1,800-4,100 ppm) than in adjacent sound inner dentine (190-290 ppm). Fluoride concentrations varied markedly along the outer edge of both normal and carious root tissues. Fluoride increase at the lesion edge is not an effect of tissue shrinkage but probably a result of remineralisation events during caries. This additional F may be expected to increase tissue resistance to further acid attacks.

Acids↗
PubMed2001

A case report of reattachment of fractured root fragment and resin-composite reinforcement in a compromised endodontically treated root.

The composite reinforcement technique has been used clinically to salvage damaged root-filled teeth compromised by caries, trauma, developmental abnormalities, internal resorption and iatrogenic causes. This clinical case report describes the use of the technique to reattach a fractured fragment in a compromised endodontically treated root besides reinforcing it for continued function in the mouth. Factors of clinical importance related to this additional application; including reattachment of tooth fragments, post crown retention, coronal microleakage and fracture resistance and strength, are also briefly discussed.

Acid Etching, Dental↗
PubMed1989

[Two case reports of extraction with the upper central incisors].

Although extraction of the upper central incisors is very rare because of their esthetical importance, they are sometimes extracted when impaction, root resorption, abnormal morphology, severe caries and/or trauma are involved. When extracted, tooth size adjustment, crown-bridge and/or orthodontic treatment are proposed for functional and/or esthetic improvement. Two present cases were reported of Angle class I crowding with root resorption of the upper central incisors caused by apical abscess (case 1) and impacted canines (case 2). The above central incisors were extracted and orthodontic tooth alignment was performed on both cases prior to final occlusal adjustment. Problems we encountered in through these cases were tooth size ratio between the upper and lower teeth causing spacing arch and/or disharmony of occlusion. In case 1, edge to edge anterior relationship was established because the over-all tooth ratio was 93.30% which was out side one standard deviation although the upper lateral incisors were tipped mesially to create some spaces. The over-all tooth ratio in case 2, however, was 92.13% which was inside one standard deviation and normal occlusion was restored. It is suggested that final tooth size adjustment is necessary for good occlusion in extraction cases of upper central incisors.

Adolescent↗
PubMed1989

[In vivo study of bacterial invasion in root planed and citric acid treated radicular surfaces of periodontally involved human teeth].

The purpose of this study was to investigate whether plaque bacteria invade the exposed radicular dentin after root planing or chemical root treatment in vivo. Eighteen caries-free human periodontally involved teeth with hopeless prognoses were studied. Fourteen teeth were scaled and root planed with hand curette type scalers. The proximal surface of each treated tooth was designated as the RP surface. The remaining half of the proximal surface was treated with citric acid (pH 1.0) for 3 minutes and was designated as the CA surface. Four untreated teeth served as controls. After 4 weeks, the teeth were extracted, and were processed for light microscopy and for scanning electron microscopy concerning bacterial invasion into the supragingival radicular dentin. The following results were obtained. 1. Radicular cementum was present on most untreated tooth surfaces. However, bacteria were never seen in the dentinal tubules. 2. Bacterial invasion into the dentinal tubules was observed in five of the 10 proximal surfaces (50% of the RP surfaces) and in nine of the 10 proximal surfaces (90% of the CA surfaces). 3. The depth (9.5 +/- 24.1 microns vs 84.6 +/- 136.3 microns) and percentage (0.8 +/- 2.1% vs 20.3 +/- 17.3%) of bacterial invasion in the dentinal tubules of the RP surfaces was lower than that of the CA surfaces. 4. Cocci and short rods were present in the supragingival dentinal tubules. 5. Since CA surfaces may accelerate bacterial invasion the citric acid treatment might be harmful in patients with inadequate plaque control.

Citrates↗
PubMed2004

Fixed restoration of sectioned mandibular molar teeth.

A mandibular molar tooth may have its furcation area or one of its roots severely affected by periodontal disease or caries. Multiple factors must be favorable to restore health to such a compromised tooth. Adequate bone support for stabilization of the individual roots and coronal segments must be available after periodontal therapy. Root morphology and separation space must allow for ease of preparation and cleaning between the sectioned roots. Endodontic therapy should be uncomplicated and provide an excellent prognosis for long-term success. All caries must be removed and adequate tooth structure must remain after root and crown sectioning. Appropriate resistance and retention form must be achievable after tooth preparation of a sectioned mandibular molar. If these conditions can be met and the patient wants to keep the tooth, fixed restoration of a sectioned molar tooth is a viable treatment alternative to extraction and replacement with a removable partial denture or a dental implant. This article has described factors and procedures that should be considered for successful fixed prosthodontic treatment of sectioned multirooted mandibular molar teeth. The authors recommend an interdisciplinary diagnostic and treatment planning approach before performing endodontics, providing periodontal therapy, and restoring bicuspidized or hemisectioned multirooted teeth.

Crowns↗
PubMed1990

The risk of intentional dissolution of the smear layer after mechanical preparation of root canals.

The root canals of 27 caries-free human cuspids were divided into 3 groups of 9 teeth each. Group I was mechanically prepared with reamers and files. Alternate irrigation with 5.25% NaOCl and 3% hydrogen peroxide was used between each instrument. The group II root canals were prepared with the use of alternate irrigation with the same concentrations of NaOCl and hydrogen peroxide and finally flushed with 17% EDTA and NaOCl solution. Group III was prepared mechanically with the use of sterile distilled water as an irrigant followed by a final flush with 17% EDTA solution. The root canals of all specimens were obturated with gutta-percha points and Tubliseal by means of the lateral condensation technique. After the root canals were obturated, samples of each of the three groups were immersed in separate flasks containing Streptococcus mutans, Staphylococcus epidermidis, and Corynebacterium hofmannii. All the microorganisms tested invaded the coronal dentin--where the access cavity had been sealed with Fynal--and/or the main foramen.

Adult↗
PubMed2000

Compomer materials and secondary caries formation.

PURPOSE: To evaluate the role of compomers in secondary caries formation in vitro. MATERIALS AND METHODS: 36 human teeth with caries-free enamel (coronal) and root surfaces underwent a fluoride-free prophylaxis. Class V cavities were prepared in buccal and lingual coronal and root surfaces. The teeth were divided into two groups with 3 treatment subdivisions [12 teeth per restorative material (6 with coronal restorations and 6 with root surface restorations)]). The preparations were restored with: (1) filled composite (Filtek Z250 with Single Bond), (2) fluoride-releasing compomer [Hytac with Prompt L-Pop (fluoride-releasing water-based adhesive)]; or (3) fluoride-releasing compomer [Dyract AP with Prime & Bond NT (fluoride-releasing acetone-based adhesive)]. 24 cavities (6 teeth with 2 cavities/tooth) were available with each treatment. The teeth were thermocycled (500 cycles at 5-50 degrees C) in synthetic saliva prior to artificial caries formation. After lesion formation, 5 longitudinal sections were taken from each specimen for polarized light evaluation. Mean surface lesion depths and wall lesion frequencies were determined. RESULTS: The Filtek Z250 group had significantly (P < 0.05, ANOVA, DMR) greater mean body of the lesion depths in coronal (205 microm) and root surfaces (221 microm) than either the Hytac (119 microm coronal and 161 microm root surfaces) or the Dyract AP (127 microm coronal and 149 microm root surfaces) groups. Likewise, wall lesion frequency was significantly higher (P < 0.05, ANOVA, DMR) for the Filtek Z250 group (41% coronal and 37% root surfaces) compared with either the Hytac (31% coronal and 25% root surfaces) or Dyract AP (26% coronal and 21% root surfaces) groups. No differences in outer body of the lesion depths or wall lesion frequencies were found between Hytac and Dyract AP for coronal and root surface restorations (P > 0.05, ANOVA, DMR).

Analysis of Variance↗
PubMed1997

Incidence of tooth loss and dental caries in 60-, 70- and 80-year-old Swedish individuals.

The retention of natural teeth among the elderly is increasing and, in recent studies, dental caries has been identified as the main reason for teeth being extracted. The 5-year incidence of tooth loss and dental caries and the most crucial dental factors for tooth extraction were studied in a random sample of 60-, 70- and 80-year-old inhabitants of Gothenburg. Of the 208 persons examined at baseline, 148 (71%) participated in the follow-up examination: 69, 51 and 28 respectively in the different age groups. In all, 110 teeth had been extracted during the period in 40% of the participants. Only 9 persons had lost three or more teeth. The mean numbers of remaining teeth were 22. 18 and 15 respectively in the 60-, 70- and 80-year age groups and the mean numbers of teeth lost during the 5-year period increased with age from 0.4 in the 60-year-olds to 0.8 and 1.4 in the 70- and 80-year-olds (P < 0.05). The major reason for tooth extraction was dental caries and it was found in 60% of all cases and at a higher rate of 77% in the oldest age group. Fifty-one per cent had developed new coronal carious lesions and 61% had new root carious lesions, while 27% had not developed caries during the period. The mean 5-year increment in decayed and filled coronal surfaces increased with age from 2.3 in the 60-year-olds to 3.7 and 5.3 in the 70- and 80-year-olds (N.S.I. The increment in decayed and filled root surfaces was higher in women than men, 3.4 compared with 1.8 (N.S.), which also increased with age from 1.4 in the 60-year-olds to 2.4 and 5.5 in the 70- and 80-year-olds (P < 0.0001). It was concluded from this study that few teeth had been lost during the 5-year period but that dental caries still appeared to be a serious problem among some very elderly people.

Aged↗
PubMed1999

Zinc in primary teeth from children in Norway.

Human primary teeth have been used as indicators of exposure to several heavy metals both in Norway and elsewhere. Local dentists in all 19 counties of Norway collected 2747 primary teeth during 1990-1994. Samples of tooth powder from whole, ground teeth were analyzed for zinc concentration by flame atomic absorption spectrophotometry. The overall geometrical mean was 144.5 micrograms of Zn/g of tooth substance (S.D. = 1.6). The result represents a small increase (5.2%) compared with a similar investigation in the 1970s. However, the mean zinc concentrations in the geographically matching parts of the two materials did not differ significantly. The variation in tooth zinc concentrations between the different counties declined from the 1970s to the 1990s. We found no correlation between the tooth zinc concentration and available environmental data on zinc in drinking-water, discharge of zinc from industrial point sources or population density in the same geographical areas. The zinc concentrations varied significantly with caries status, tooth type and root length. Few samples had a zinc concentration below 90 micrograms/g, indicating that most children consume sufficient zinc. Some very high values could not immediately be explained, but may be caused by contamination from zinc-containing dental restorations.

Child↗
PubMed2006

An in vitro study of affected dentin as a risk factor for the development of secondary caries.

The objective of the study was to investigate the association between the presence of residual caries (inner affected dentin) on the cavity walls of cavity preparations and the further development of secondary caries lesions. Two 2 x 5 x 2 mm cavities, one in the apical portion (A) and one in the cervical portion (C) of the root, were prepared on both the lingual (L) and buccal (B) surfaces of 18 extracted human roots. The apical cavities (AB and AL) were artificially demineralized for 30 min using a decalcifying solution, followed by staining with a caries detector dye and then excavation of irreversibly demineralized dentin, leaving behind a layer of inner carious dentin. The cervical cavities (CB and CL) remained intact with sound dentin on the cavity walls. All cavities were then restored with composite resin. Following restoration, lingual specimens (AL and CL) were completely covered by an acid-resistant varnish to prevent further demineralization. All specimens were then incubated in an in vitro microbial artificial mouth model for 3 days in order to develop secondary carious lesions. At the end of the study all specimens were processed for energy-dispersive X-ray analysis of Ca concentration adjacent to the border between dentin and restoration. Statistical analysis of Ca concentrations revealed that the presence of affected inner dentin does not increase the susceptibility to secondary caries. Therefore, it was concluded that conservative cavity preparations leaving behind affected dentin do not increase the risk of secondary caries development.

Analysis of Variance↗
PubMed2006

In vitro anti-cariogenic activity of dichloromethane fraction from Rheum undulatum L. root.

This study aimed to evaluate in vitro effects of Rheum undulatum L. root on the development of dental caries, especially its effects on viability, dental plaque formation, and glycolytic acid production of Streptococcus mutans and Streptococcus sobrinus. Methanol extract of Rheum undulatum L. root and its fractions were prepared and tested. Among the test extract and fractions, dichloromethane fraction (DF) showed the most active antibacterial activity (inhibition zone: 13-17 mm) against S. mutans and S. sobrinus in a disc diffusion method. Minimal inhibitory concentrations (MICs) of DF against these bacteria ranged from 0.25 to 0.5 mg/mL. Furthermore, DF significantly inhibited the caries-inducing factors of these bacteria. At sub-MIC levels, DF inhibited in vitro dental plaque formation by S. mutans and S. sobrinus (IC50= 0.079 and 0.142 mg/mL, respectively), which was caused, in part, by the inhibitory effect on the activity of glucosyltransferases. A significant reduction of glycolytic acid production was found at the concentration as low as 0.032 mg/mL for S. mutans and 0.063 mg/mL for S. sobrinus. The possible bioactive compounds that are inducing in vitro anti-cariogenic activity of DF are unknown. Based on the preliminary phytochemical analysis, the activity of DF may be related to the presence of anthraquinones, cardiac glycosides, coumarines, sterols/terpenes, and phenolics. These results indicate that DF is probably useful for the control of dental plaque formation and subsequent dental caries development.

Anti-Bacterial Agents↗
PubMed1995

Coronal leakage and treatment failure.

This report presents a case in which undiagnosed coronal leakage resulted in failure in the endodontic management of a tooth. Coronal leakage occurred during root canal treatment as a result of the presence of deficient composite resin fillings and secondary caries. Despite repeated visits of cleaning and dressing, the canal continued to be contaminated and symptoms persisted. On referral, the reason for treatment failure was diagnosed. The tooth was successfully treated by the replacement of the deficient fillings, after the elimination of underlying caries. Symptoms resolved enabling the completion of the root canal treatment.

Adult↗
PubMed1985

Computerized registration of epidemiological data from intraoral radiographs.

Software was developed for graphic registration of epidemiological dental data from intraoral radiographs. The measured variables included marginal bone level in relation to tooth and root length as well as proximal caries and restoration areas. Caries and peridontitis progress nowadays slowly in large populations. Registration methods must, therefore, offer high precision. The hard and software were first tested. After that the method's reliability or precision was studied. The precision of measuring marginal bone level as a per cent of total tooth or root length was found to vary between 0.3-4.3. The corresponding precision of measuring a caries area in relation to the whole crown area was 1.4%. Precision was also divided into its components and analysed in more detail. All registered tooth variables except the angle between the proximal marginal bone and the root surface gave satisfactory results indicating good reliability.

Adult↗
PubMed1994

Tooth and root conditions in the middle-aged and the elderly in Hong Kong.

In an oral health survey of Hong Kong Chinese conducted in 1991, a sample of 372 35-44-yr-olds and 537 noninstitutionalized 65-74-yr-olds were interviewed and clinically examined. The examination procedures, instruments, and diagnostic criteria used to detect coronal caries followed those recommended by the World Health Organization (1987). The diagnostic criteria used to assess root-surface caries were based on those used in a national oral health survey of US employed adults (National Institute of Dental Research, 1987). Calibration of examiners was conducted before the survey and the interexaminer reliability was found to be very high; the kappa statistics were 0.93 and 0.91 for the younger and older age groups, respectively. None of the 35-44-yr-olds were edentulous and 96% had 21 teeth or more. The prevalence of edentulousness among the elderly was 12%. The DMFT indices of the younger and older age groups were 8.7 and 18.9, respectively. In both age groups, MT was the major component of the DMFT index, and female subjects had a slightly higher score. The prevalences of decayed/filled roots were 7% and 26% for the 35-44- and 65-74-yr-olds, respectively. As compared with previous surveys conducted in Hong Kong, there has been a 40% reduction in the DMFT index of the 35-44-yr-olds since 1968, but little change in the tooth and root conditions was noted between 1984 and 1991.

Adult↗
PubMedDate not supplied

Prevalence of Candida albicans in oral cavities and root canals of children.

The aim of this study was to examine the prevalence of C. albicans in the oral cavities and root canals of children. Twenty healthy and caries-free children and 13 children with caries, were screened. Imprint samples and sterile paper points were used to obtain the samples from oral cavities and root canals respectively. The production of germ tubes and the development of chlamydospores identified yeast cultures. Sixty-nine percent of children with caries and 5% of caries-free children were found to be Candida carriers. The difference in candidal prevalence between two groups was significant (p < 0.05). Sixty-one point five percent of children were positive for Candida in the root canal. Since, increase in the C. albicans in the oral cavity provides a potential source of the fungus particularly when resistance falls below a certain threshold, attention to strategies for the reduction of this pervasive and persistent pathogen becomes important. Therefore, reduction of caries and or introduction of antifungal agents during root canal treatment of children may be offered.

Candida albicans↗
PubMed1988

An in vitro evaluation of the prevention of caries on overdenture abutments.

Teeth prepared as overdenture abutments are susceptible to caries, and it has been shown that brushing by itself is not sufficient to prevent this process. This study evaluated the preventive effect of a remineralization gel which has a low fluoride concentration and compared its effects with those of a phosphate fluoride gel (Karigel), which has a much higher concentration of fluoride. Twenty extracted anterior teeth from patients aged 50 to 70 years were prepared as for overdenture abutments. Each tooth was sectioned into three fragments. An acidified gel system was used to produce artificial caries lesions on the occlusal and root surfaces of each fragment. One fragment of each tooth was treated with the remineralizing gel, the second fragment with a high-fluoride gel, and the third fragment served as the control. Ten teeth were removed at two weeks and again at four weeks, and were sectioned and prepared for histological examination. The depth of the lesions was measured from standardized photomicrographs by means of a sonic digitizer. The conclusions were: (1) Lesions on the occlusal tended to be deeper than those on the root surfaces at four weeks but not at two weeks; and (2) the high-fluoride gel was more protective than the low-fluoride remineralizing solution at both time periods on the occlusal but not on the root surface.

Aged↗