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PubMed1996

The dental pathology of feral cats on Marion Island, part II: periodontitis, external odontoclastic resorption lesions and mandibular thickening.

Skulls (n = 301) of adult feral cats from Marion Island were examined macroscopically. Dental calculus was found infrequently (9.0% of cats, 0.76% of teeth), unlike the hard tissue lesions of moderate and advanced periodontitis and tooth loss (presumably due to periodontitis), which were commonly seen (61.8% of cats, 14.8% of teeth). Relatively few of these abnormalities were associated with external odontoclastic resorption lesions, which affected 14.3% of cats and 1.2% of teeth-less than in most recent surveys in domestic cats. Abnormal thickening of the mandibula, found in 39.5% of specimens, was most commonly bilateral (83.3%). The lesions ranged from a focal periosteal reaction, to localized exostosis, to generalized swelling and loss of density, to grossly enlarged mandibles with increased bone density. Mandibular swelling was significantly associated with other abnormalities (periodontitis, dental fractures, external odontoclastic resorption lesions and periapical lesions), but many cases of mandibular swelling were accompanied by only minor dental defects.

Animals↗
PubMed2005

Predisposing conditions for retrograde peri-implantitis, and treatment suggestions.

BACKGROUND: Recent case reports introduced the term retrograde peri-implantitis as a lesion (radiolucency) around the most apical part of an osseointegrated implant. It develops within the first months after insertion. This retrospective study aimed to find predisposing conditions for such peri-apical lesions and to evaluate treatment strategies. METHODS: All single implants (426 in the upper, 113 in the lower jaw, all Brånemark system type) placed at the department of Periodontology of the University Hospital (Catholic University Leuven) were included in this retrospective evaluation to check the incidence of retrograde peri-implantitis. Eventual predisposing factors such as patient characteristics (age, medical history), recipient site (local bone quality and quantity, cause of tooth loss), periodontal and endodontic conditions of neighboring teeth, implant characteristics (length, surface characteristics), and surgical aspects (guided bone regeneration, osseous fenestration, or dehiscency) were considered. Moreover, implants with retrograde peri-implantitis were followed longitudinally to verify their treatment outcome by means of different parameters (Periotest values (PTV), marginal bone level, radiological size of peri-apical defect). RESULTS: Seven implants in the upper (1.6%) and 3 in the lower jaw (2.7%) showed retrograde peri-implantitis, before or at abutment connection. In comparison with successful implants, such peri-apical lesions occurred preferably at sites with a history of an obvious endodontic pathology of the extracted tooth to be replaced. The incidence of retrograde peri-implantitis was significantly higher (P<0.0001) for TiUnite implants when compared with the machined implants (8/80 vs. 2/459). The machined implant surface, however, showed a higher failure rate (6.8%) than the TiUnite implants (2.5%). Failures with machined surfaces preferably occurred at extraction sites of teeth with a history of endodontic pathology or sites adjacent to teeth with an obvious endodontic pathology. No other predisposing factors could be identified. A curettage of the peri-apical lesions and the use of a bone substitute material prevented further progression of such lesions in the upper jaw (implants maintained their marginal bone and low PTV scores). A treatment in the lower jaw was less successful. CONCLUSIONS: Within the limitations of a retrospective study, these results seem to indicate that retrograde peri-implantitis is provoked by remaining scar or granulomatous tissue at the recipient site: endodontic pathology of extracted tooth (scar tissue-impacted tooth) or possible endodontic pathology from a neighboring tooth.

Causality↗
PubMed2001

[Oral health of 18-year-old adolescents in Hungary].

UNLABELLED: It is strongly suggested by WHO to undertake a regular epidemiological survey in 5-year intervals to monitor changes in oral health. In Hungary national epidemiological examinations were carried out in 1985, 1991 and 1996 according to the WHO basic criteria, using the pathfinder methodology in children and adults. But nationwide oral data among 18-year-olds were never collected before 1998. The aim of the present paper is to give up-to-date information on the oral disease status and treatment needs in adolescents based on the recent pathfinder survey. A total of 710 persons were examined at 16 sample sites. The basic findings were: The prevalence of caries free adolescents was 6.1%. The mean DMFT score was 7.64. 66.5% of the examined probands had no tooth loss. The parodontal condition was poor. 84.7% of the sample had gingivitis and needed oral hygiene instruction and 61.7% of them had dental calculus as well. CONCLUSION: Our "health for all" efforts were not effective enough, therefore further considerable activities and financial support will be needed to achieve the appropriate goals.

Adolescent↗
PubMed1995

Replantation of 400 avulsed permanent incisors. 1. Diagnosis of healing complications.

A material of 322 patients with 400 avulsed and replanted permanent teeth were followed prospectively in the period from 1965 to 1988 (mean observation period = 5.1 yrs). The age of the patients at the time of replantation ranged from 5 to 52 yrs (mean = 13.7 yrs and median = 11.0 yrs). Standardized patient records were used through the entire period in order to obtain valid data concerning the extent of injury and treatment provided. At the follow-up period, pulpal and periodontal healing were monitored by clinical examination, mobility testing and standardized radiographic controls. Thirty-two of the replanted teeth (8%) showed pulpal healing. When related to teeth with incomplete root formation, where pulpal revascularization was anticipated (n = 94) the frequency of pulpal healing was 34%. Periodontal ligament healing (i.e. with no evidence of external root resorption) was found in 96 teeth (24%). Gingival healing was found in 371 teeth (93%). During the observation period, 119 teeth (30%) were extracted. Tooth loss was slightly more frequent in teeth with incomplete root formation at the time of replantation than in teeth with completed root formation.

Adolescent↗
PubMed1982

Effects of age and dentition status on measures of food acceptability.

The current cross-sectional investigation was undertaken to determine whether observed losses in masticatory function due to missing teeth impair perceptual estimates of food acceptability. To quantify the effect of impaired masticatory ability, 566 male participants from the Veterans Administration Dental Longitudinal Study were subdivided into three age groups (less than 40 years, 40 to 49 years, and 50 or more years) and three dentition categories (intact, partially compromised, and compromised). Bivariate analysis revealed that dentition status significantly influenced the acceptance modalities of taste, texture, perceived ease of chewing, and frequency of ingestion. Age, per se, had little effect. Significant changes in the acceptance variables were noted only in persons with compromised dentition. These findings suggested that a moderate degree of unreplaced tooth loss had no significant effect on perceptual estimates of food acceptability, and unilateral intact dentition can provide sufficient masticatory performance for maintaining food acceptance.

Adult↗
PubMed1993

Papillon Lefevre syndrome: treatment of two cases with a clinical microbiological and histopathological investigation.

Papillon Lefevre syndrome is presented in the cases of two female patients of the ages of 7 and 9, who exhibited all typical symptoms of the disease. Microbiological and histopathological studies were done and treatment provided. Actinobacillus actinomycetemcomitans, which is suspected as a pathogenic factor in the disease was identified as well as some other gram negative microorganisms and an antibiogram was performed in which amoxycillin plus clavulanic acid was most effective. Histopathological investigation also confirmed the presence of gram negative bacteria. Granular cell infiltration was predominant in the surface epithelium. Prosthetic appliances were provided for the patients after mechanical and chemical plaque control. In addition to this, antibiotics (amoxycillin plus clavulanic acid) were prescribed every six months. No tooth loss was observed in both patients after more than two years follow-up period. At the moment only one patient is under review and because she is uncooperative, mild periodontal inflammation is still present around the teeth which erupted before the antibiotic regime, but not in the other teeth.

Aggregatibacter actinomycetemcomitans↗
PubMed1996

Types, uses, and evaluation of the plate-form implant.

Plate-form blades have shown a high rate of success over their 25+ years of service. Contributing to their longevity is the design of the implant, which transfers the applied forces over a large area of bone. Three types of implants are being considered: (1) the Ramus Blade, designed for the body and ramus region of the mandible; (2) the Ramus Frame, designed for the totally edentulous mandible with moderate to severe bone atrophy; and (3) the single-tooth replacement, an implant for single or multiple tooth loss. Both 316-L stainless steel and titanium metal types have been used to fabricate each implant type. Blades are, in the author's opinion, the most universal of the implants used today, for they are utilized in so many variable bone widths and heights. Besides being in service for periods of up to 27 years, they are patient-acceptable in terms of comfort, function and minimal maintenance.

Blade Implantation↗
PubMed1998

Dentin-bonded all-ceramic crowns: current status.

Dentin-bonded all-ceramic crowns employ contemporary techniques to lute the crown to the tooth using a resin luting material and dentin-bonding system. The advantages of these crowns are that they provide good esthetics and fracture resistance and can be used in cases of substantial tooth loss. Their principal disadvantages are that the luting procedure is more time-consuming and that these crowns should not be used where margins are subgingival. Dentin-bonded all-ceramic crowns may be a useful addition to the dentist's armamentarium, but long-term clinical studies are needed to fully assess their performance.

Contraindications↗
PubMed1995

Compression implants: case report of a surgical, prosthetic, and cosmetic failure.

A case involving the use of non-submergible compression-type implants in an effort to rehabilitate a patient who had experienced tooth loss as a consequence of a motor vehicle accident is reported. The implants were placed in the maxillary arch without consideration of their contribution to subsequent prosthetic rehabilitation. The literature pertaining to compression-type implants is reviewed, and the difficulties related to their correct usage are delineated.

Accidents, Traffic↗
PubMed1995

Papillon-Lefèvre syndrome--successful treatment with a combination of retinoid and concurrent systematic periodontal therapy: case reports.

Papillon-Lefevre syndrome is a rare autosomal-recessive congenital differentiation disorder; the external signs are hyperkeratosis of the palms and soles. Intraorally, the most salient manifestations are dystrophic periodontal problems that affect both the primary and permanent dentitions and frequently lead to premature tooth loss. Two children were treated with acitretin 0.5 mg/kg of body weight per day from November 1992 to November 1993, and another child since October 1993. Concurrently, the children received professional oral hygiene care (scaling, root planing, and curettage). The combination of retinoid therapy and periodontal treatment improved the dermatologic and periodontal conditions.

Acitretin↗
PubMed1996

A critical evaluation of methods for root coverage.

Gingival recession is the exposure of root surfaces due to apical migration of the gingival tissue margins. Although it seldom results in tooth loss, marginal tissue recession is associated with thermal and tactile sensitivity, esthetic complaints, and a tendency toward root caries. This article reviews the current surgical procedures for the coverage of exposed root surfaces, including their advantages and disadvantages. Today, the outcome of root coverage procedures is predictable, aesthetically acceptable, and, together with the use of guided tissue regeneration, at the forefront of regenerative procedures.

Citrates↗
PubMed1992

Food habits and dental disease in an iron-age population.

Tooth diseases and wear record valuable information on diet and methods of food preparation in past human populations. In this paper the teeth of an Iron-Age population (Monte Bibele, Bologna) are analyzed to reconstruct their nutritional situation. The analysis of caries frequency and distribution indicates a level of carbohydrate consumption which is consistent with an agricultural way of life. The presence of calculus indicates that proteins were present in the diet of the Monte Bibele population. The frequency of antemortem tooth loss and of dental abscesses is in harmony with the results of the analysis of caries and calculus. The examination of dental wear suggests the presence of a substantial vegetable component in the diet. From the analysis of the dental characteristics one can conclude that the population of Monte Bibele had a prevalent agricultural economy. The presence of some diachronic variations in the distribution of the examined characters suggest changes in the diet in the course of time.

Feeding Behavior↗
PubMed2004

Reasons for extraction of permanent teeth in urban and rural populations of Croatia.

The survey aimed to determine the reasons for extraction of permanent teeth by general dental practitioners in urban and rural population of the Senj region, Adriatic coast, Croatia. During a two-year period (1998-9), a total of 2006 teeth were extracted in both regions, in patients aged 15+. The causes were defined as follows: (1) decay or root without a crown (radix relicta), (2) periodontal disease, (3) endodontic or periapical diseases and (4) other reasons--orthodontics/prosthodontics and dental trauma. The statistical Chi-square-test was used to determine the significant difference between the populations and the sexes. Dental caries was the most frequent cause for extraction (over 50%), followed by endodontic and periapical diseases (23%) as the result of untreated caries and at the end periodontal disease (21%). Urban population more often lose teeth due to periodontal disease (22.75%) than rural (18.93%, p < 0.05). Similarly, this is more frequent in the urban male population (25.61%) than the female urban population (20%, p < 0.05). In rural areas, people more often lost teeth as a result of endodontic and periapical disease (25.85%) than in the urban locations (19.07%, p < 0.01) and this is more frequent in women from rural areas (28.37%) than the rural men (22.44%, p < 0.05). Periodontal disease was not the main cause of tooth loss in either the rural or the urban population. Dental caries and its sequel remain the most important challenge for the dental service. It also reveals the inadequacy of dental services. Education of both the population and the general dental practitioners must be conducted in order to improve oral hygiene and to insist on conservative rather than extraction therapy.

Adolescent↗
PubMed1990

A comparison of the position of the mental foramen in Chinese and British mandibles.

The antero-posterior position of the mental foramen was studied in 68 Chinese and 44 British skulls of known or calculated age at death. All skulls showed low pre-mortem tooth loss and had a good occlusion. The position of the foramen was related to the body of the mandible as well as to the standing mandibular teeth using two previously published methods. There was no significant difference in the size of the Chinese and British mandibles. There was a significant difference between the two groups when measurements relating the foramen to the body of the mandible (symphysis menti) were considered, the foraminal position being more distal in the Chinese group. The modal position of the foramen in the Chinese sample was along the long axis of the second premolar, whereas in the British sample it lay between the apices of the first and second premolar. The foraminal position apparently moved distally in both groups with age and this was likely to be associated with mesial tooth drift and age-related attrition.

Adolescent↗
PubMed1984

Periodontal treatment without maintenance. A retrospective study in 44 patients.

This study presents our findings on 44 patients who were treated for periodontal disease and for varying reasons elected not to participate in the maintenance aspect of periodontal care. All patients were initially given intensive instructions in personal oral hygiene, along with initial scaling and root planing. Each patient had two or more quadrants of pocket reduction therapy. Tooth mortality revealed a mean annual adjusted tooth loss rate of 0.22 (4.7%). Between examinations, breakdown in the health status of furcations was noted. Mean probing depth scores at the second examination showed no significant differences from the first examination scores. Measurements of bone levels revealed a worsening of bone scores between examinations. The results of this study show that periodontal therapy without maintenance is of little value in terms of restoring periodontal health.

Adult↗
PubMed2000

Use of the feed additive sodium hexametaphosphate to prevent dental calculus in squirrel monkeys (Saimiri spp.).

Dental calculus and associated periodontal disease are serious clinical problems in captive squirrel monkeys. Calculus begins to appear as early as 2 years of age, with subsequent development of periodontal disease, dental abscessation, tooth loss and other sequelae. When used as a feed additive, sodium hexametaphosphate (HMP) retards the growth of calculus on previously cleaned teeth in rhesus monkeys, lemurs, and other species. We wanted to determine whether HMP would reduce dental calculus in squirrel monkeys (Saimiri spp.) whose teeth had not been pre-cleaned. The study animals were divided into two groups. One received a standard diet; the other received an identical diet containing the HMP additive at a concentration effective in other primate and non-primate species that had received dental cleaning prior to treatment with HMP. Teeth were graded for extent of calculus formation at the start of the study and at 3 and 6 months during HMP treatment. We compared the results from the two groups both by total score per animal and according to tooth type (e.g., incisors versus incisors in test and control groups). At the end of 6 months, dental calculus did not differ significantly between the experimental groups. Therefore, we conclude that HMP is ineffective in squirrel monkeys with preexisting dental calculus.

Animal Feed↗
PubMed1985

Pathology and the posture of the La Chapelle-aux-Saints Neandertal.

The depiction of the Neandertals as incompletely erect was based primarily on Boule's (1911, 1912a, 1913) analysis of the La Chapelle-aux-Saints 1 partial skeleton. The inaccurate aspects of Boule's postural reconstruction were corrected during the 1950s. However, it has come to be believed, following Straus and Cave (1957), that Boule's errors of reconstruction were due to the diseased condition of the La Chapelle-aux-Saints 1 remains, rather than to Boule's misinterpretation of morphology. The abnormalities on the La Chapelle-aux-Saints 1 postcranium include: lower cervical, upper thoracic, and lower thoracic intervertebral degenerative joint disease (DJD), a distal fracture of a mid-thoracic rib, extensive DJD of the left hip, DJD of the right fifth proximal interphalangeal articulation, bilateral humeral head eburnation, and minor exostosis formation on the right humerus, ulna, and radius. These were associated with extensive alveolar inflammation including apical abscesses and antemortem tooth loss, some temporomandibular DJD, bilateral auditory exostoses, and minimal occipital condyle DJD. None of these abnormalities significantly affected Boule's Neandertal postural reconstruction, and a review of his analysis indicates that early twentieth century interpretations of skeletal morphology (primarily of the cranium, cervical vertebrae, lumbar and sacral vertebrae, proximal femora and tibiae, posterior tarsals, and hallucial tarsometatarsal joint), combined with Boule's evolutionary preconceptions, were responsible for his mistaken view of Neandertal posture.

Arm↗
PubMed1997

Is the chemical prevention of gingivitis necessary to prevent severe periodontitis?

Gingival inflammation seldom causes discomfort, social embarrassment or loss of function. As most sites with gingival inflammation do not progress to severe periodontal disease, gingivitis should not be considered a public health problem. Periodontitis is always preceded by gingivitis. But most gingivitis remains stable for years without progressing to periodontitis. The number of gingivitis sites that do convert is small. The levels of oral cleanliness achieved by the majority of populations in industrialized countries are below the threshold for severe destructive periodontal disease of personal and public health concern. Because methods of measuring the progression of periodontal disease are unreliable, definitive answers regarding conversion of gingivitis to severe periodontitis are lacking. Gingival inflammation frequently remains contained; most gingivitis remains stable for years without progressing to periodontitis. Decreasing gingivitis does reduce shallow pocketing, but the effect on severe periodontitis is not clear. Although the underlying justification for the reduction of plaque is to reduce gingival inflammation to prevent or reduce severe periodontitis and tooth loss, the basis for the approach is equivocal. A reasonably high level of plaque appears to be compatible with acceptably low levels of periodontal disease. Reducing nonspecific plaque levels to such levels is therefore a rational goal. The conventional methods of controlling periodontal disease involve mechanical removal of plaque and calculus. A complimentary ecological approach, using chemicals, would be to alter the environment of the pocket to prevent growth of putative pathogens. Any ecological approach should be sensitive to the dangers of disrupting the natural ecology of dental plaque. Some antimicrobial and antimetabolic agents such as fluoride, chlorhexidine and triclosan and zinc citrate can selectively suppress certain organisms or inhibit bacterial proteases implicated in tissue damage. The uncertainties about factors that convert gingival inflammation into periodontitis and periodontitis into severe periodontitis coupled with insufficient data from controlled clinical trials on the effectiveness of chemical reduction of gingivitis to prevent severe periodontitis leads one to conclude that more research is required before the need for the chemical prevention of gingivitis to prevent severe periodontitis can be justified.

Dental Plaque↗