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PubMed1984

Ultrastructure of transganglionic degeneration in brain stem trigeminal nuclei during normal primary tooth exfoliation and permanent tooth eruption in the cat.

Electron microscopy is used to study changes in the axons and terminals in the cat brain stem trigeminal nuclei, main sensory, and partes interpolaris and caudalis, during the process of natural tooth shedding. Areas previously showing light optical argyrophilic degeneration products and adjacent areas lacking this degeneration are included. Various types of alteration occur early during tooth loss, including increased presumed glycogen, increased cytoplasmic density, flocculence, lucency, and neurofilamentous hyperplasia. By the stage of maximum exfoliation, terminals and axons of marked density become prominent in areas showing argyrophilia, whereas nondense forms occur elsewhere. By late eruption ages, all forms of degenerated terminals and axons are rare, but phagocytes are heavily laden with similar forms of debris. The sequence of ultrastructural events is discussed in light of recent studies of transganglionic degeneration, their correlation with light microscopic findings, and the potential implications for central plasticity in this system.

Age Factors↗
PubMed1987

Pathways to full mouth extraction.

The process of not attending the dentist is a vicious cycle in which anxiety plays a crucial role. A research project concerning the disease and non-disease reasons for full mouth extraction provided an opportunity to describe the dental histories in terms of dental attendance pattern and related factors which resulted in full dentures. Three profiles of dental histories could be outlined: 1) The regular attenders (19%). Because of their age (means = 47 yr), their positive attitude towards dentistry together with their positive attitude towards full dentures, it is suggested that the possibilities of keeping the natural dentition were exhausted so that full mouth extraction was an acceptable solution. 2) The symptomatic attenders (38%). Because anxiety, which was widespread in this group, was not based on negative experiences, it is suggested that anxiety is caused by social learning. Together with their positive attitude towards full dentures, the high prevalence of full dentures in their social environment and their low socioeconomic status, the conclusion is drawn that these patients lived in a culture which supports behavior that leads to total tooth loss. 3) Once regular attenders (43%). In this group anxiety leads to a negative perception of dental visits and to a negative attitude towards dentists. As a consequence dental visits are deferred, which results in deterioration of the dentition. Experiences with dentists are distorted in a negative way, which increases dental anxiety. Facilitated by a positive attitude towards full dentures, their bad dental condition finally urges them to take full dentures at early age.

Adult↗
PubMed1990

Anatomy of cusps of posterior teeth and their fracture potential.

Fracture of cusps on posterior teeth, especially those carious or restored, is a major cause of tooth loss, Nonfunctional cusps fracture more often than the functional; mandibular cusps fracture more often than maxillary cusps. This study examined functional and nonfunctional cusps of the maxillary and mandibular posterior teeth in four different parameters; (1) buccolingual width, (2) angle of cuspal inclination, (3) thickness of enamel, and (4) angle of inclination of the dentinoenamel junction. Measurements of functional cusps, except those in maxillary premolars established differences that may explain the frequency of frequency of fracture. These parameters of functional and nonfunctional cusps suggest that the cuspal anatomy has a relationship to the fracture potential of cusps.

Bicuspid↗
PubMed2002

The dental health status of dialysis patients.

BACKGROUND: The number of patients with kidney failure who require dialysis is growing by 10% to 15% annually, and the likelihood that dentists will treat such patients is also increasing. The dental care of patients undergoing dialysis can be complex, given the prevalence of comorbid conditions such as diabetes, hypertension, renal osteodystrophy and immunosuppression, the presence of nondental prosthetic devices, and the use of antihypertensives and anticoagulants or antiplatelet agents. These patients appear to be predisposed to a variety of dental problems such as periodontal disease, narrowing of the pulp chamber, enamel abnormalities, premature tooth loss and xerostomia. Dental care, as well as primary preventive measures, seems to have been neglected in these patients. Therefore, a study of the dental health of dialysis patients was undertaken. METHOD: Completion of a questionnaire and a noninvasive oral examination was obtained from hemodialysis and peritoneal dialysis patients registered in the dialysis program at St. Paul's Hospital in Saskatoon, Saskatchewan, as of March 1, 1999. Information was also gathered from the medical chart. Medication history as well as history of diabetes, hypertension, and nondental prosthetic devices were also recorded. RESULTS: Of 226 dialysis patients in central and northern Saskatchewan, 147 were interviewed and examined. Of these, 94 (64%) were dentate, and the same number had been on dialysis for a mean of more than 2 years; about a third were diabetic, almost all were hypertensive and all had nondental prosthetic devices or arteriovenous fistulae, or both. Sixty (64%) of the dentate patients were candidates for kidney transplantation. Most of the dentate patients reported brushing once or more daily, but they flossed infrequently or never. Dental visits were infrequent, less than every 5 years in 59 (63%) of the dentate patients. Findings in the dentate group included increased tooth mobility, fractures, erosion, attrition, recession, gingivitis and a high plaque index. A patient's dentist was contacted if the patient had seen him or her since starting dialysis (31 of the 94 dentate patients). Most (81%) of the dentists were aware that they were treating a dialysis patient. Medication records were incomplete for 29% of the patients, and only 2 (6%) of the patients had received antibiotic prophylaxis despite the fact that all had prosthetic devices or arteriovenous fistulae. CLINICAL SIGNIFICANCE: We conclude that the dental health of dialysis patients is poor and requires greater attention.

Adolescent↗
PubMed2005

Overeruption without root exposure of third molars and periodontal health in the mandible.

Bone formation is seen around the third molar even when the tooth is exposed to the oral environment due to overeruption. To determine if overeruption of the third molar with or without root exposure is related to the status of the exposure of other teeth in the mandible, using orthopantomographs, 424 third molars were studied in 371 patients who were over 41 years of age. The rate of overeruption and root exposure in third molars was measured, and its relationship to the number of teeth lost and the rate of root exposure in other teeth in the mandible was analyzed. Tooth loss in the group of third molars with overeruption without root exposure was greater than in that without overeruption or root exposure in men, whereas the relationship was not seen in women. We found that root exposures of other teeth in the group of third molars with overeruption without root exposure were significantly smaller than in those with root exposure in both genders. Third molars with overeruption without root exposure, in which bone formation was easy to observe for radiographic diagnosis, were correlated with periodontal health in the mandible, suggesting a component of precision determination for predicting resistance to periodontitis.

Adult↗
PubMedDate not supplied

Cytokine expression in feline osteoclastic resorptive lesions.

Feline osteoclastic resorptive lesions (FORL) of the teeth are common in cats, and lead to pain, destruction of the periodontal ligament, and tooth loss. The expression of interleukin (IL)-1 beta and IL-6 mRNA was higher in teeth with FORL than in normal teeth (P<0.01 and P<0.001, respectively), but no such differences were found between pathological and normal gingival tissue samples. There were no differences between teeth affected with FORL and normal teeth in respect of the expression of receptor activator of NF kappa B ligand (RANKL) mRNA or osteoprotegerin (OPG) mRNA. However, OPG mRNA expression was higher in gingival tissue associated with teeth affected with FORL than in normal gingival tissue (P<0.05), whereas the reverse was true of RANKL mRNA expression (P<0.05). OPG mRNA expression was significantly higher in teeth than in femoral and alveolar bone (P<0.001). RANKL and OPG mRNAs were detected in all tissues examined. The data suggest that the elevated expression of IL-l beta and IL-6 mRNA plays a role in the mediation of osteoclast activity in advanced FORL. In contrast, OPG and RANKL do not appear to regulate osteoclasts in advanced disease. The results also suggest that OPG and RANKL mRNA play a role in mediating inflammatory responses in gingival cells, and that OPG has an inhibiting effect on tooth resorption.

Animals↗
PubMed2002

The effect of variation in occlusal loading on the development of abfraction lesions: a finite element study.

Abfraction or non-carious cervical tooth loss is poorly understood and one factor thought to contribute to the development of these lesions is the effect of occlusal loading. The aim of this study was to examine the effect that varying the position of an occlusal load would have on the stress contour in the cervical region of a lower second premolar using a two-dimensional plane strain finite element model. A 500 N load was applied vertically to either of the cusp tips or in various positions along the cuspal inclines. It was found that loads applied to the inner aspects of the buccal or the lingual cuspal inclines produced maximum principal stress values of up to 358 MPa that exceed the known failure stresses for enamel.

Bite Force↗
PubMed1997

Dental disease in the late Medieval population from Nova Raca, Croatia.

Male and female dental disease frequencies were compared to test the hypothesis of differential stress levels between the sexes in the late Medieval population from Nova Raca, Croatia. The following categories of dental disease were compared: alveolar bone pathology defined by the presence of periodontal or periapical abscesses or antemortem tooth loss, caries, hypoplastic defects in the enamel and occlusal surface wear. The results show clear gender differences in the frequencies of alveolar bone pathology, carious lesions and occlusal surface wear. In all cases males exhibited significantly greater frequencies. Further analyses indicated that these differences were related to younger (15-29 years) adults and to the upper jaw. Together with paleodemographic data and the fact that females exhibited higher frequencies of enamel defects, this dichotomy in dental disease frequencies is interpreted as the result of a culturally imposed defensive mechanism which selectively buffered young males from malnutrition, exposing them at the same time to higher levels of cariogenic food and thus to higher frequencies of carious lesions and alveolar bone disease.

Croatia↗
PubMed1997

The effect of the loss of molar teeth on spatial memory and acetylcholine release from the parietal cortex in aged rats.

It has been demonstrated that a loss of teeth is a troublesome problem among age-related pathological phenomena of the oral cavity, which influences the entire body, due to the impairment of mastication. The present studies investigated the abilities of learning and memory and acetylcholine (ACh) release in the parietal cortex in aged rats without molar teeth (hereafter referred to as 'teethless'). After the molar teeth of rats were extracted, the rats were fed with powdered food for 135 weeks. Although the performance in the radial arm maze was progressively acquired by daily training, an increase in the number of errors and a decrease in the initial correct responses were observed in the teethless aged rats compared to the control aged rats, indicating impaired acquisition of spatial memory in the teethless aged rats. The basal level of extracellular ACh in the parietal cortex was not different between the teethless aged rats and the control aged rats. However, the extracellular ACh level of the teethless aged rats under high-concentration of K+ and atropine sulfate stimulation was significantly low compared to that of the control aged rats. These results suggest that the impairment of spatial memory in the teethless aged rats may be due to the functional deterioration of the cholinergic neuronal system induced by tooth loss and that there is a possibility that the loss of teeth may be one of the risk factors for senile dementia.

Acetylcholine↗
PubMed2001

[Prosthodontic correction of severe deep vertical overbite combined with dimensional discrepancy of the upper and lower dental arch. 31 years follow-up].

Sz. S. a 39-years-old patient was referred to our department in 1968. Patient's masticatory dysfunction, orofacial pain syndrome and substantial weight loss was due to a combined genuine and acquired deep vertical overbite aggravated by a marked difference between the size of the lower and upper jaw bones. The premolars and molars had already been extracted. The lower incisors bit onto the palatal gingiva in centric occlusion causing direct mechanical irritation on the palate. Consequently the centric occlusion position of the mandible was only defined by the contact between the lower central incisors and the palatal soft tissue. According to the literature this kind of defect can only be corrected by a combined surgical prosthodontic therapy (increasing the mandibular arch by vertical osteotomy combined with bone grafting followed by complex prosthodontic reconstruction). Because patient refused any kind of surgical treatment a special upper full arch bridge was constructed with an extended occlusal surface on the palatal surfaces of the front crowns to provide full occlusal contact for the mandibular anterior teeth. The OVD was raised by 11 mm. The present paper reports the history of a 31 years long prosthodontic treatment and patient's follow up. It is shown how the correct centric occlusion, the masticatory functions, the phonetics and also the esthetics could have been maintained by a series of gradually changing fixed restorations meeting the demands imposed by the continuing tooth loss.

Adult↗
PubMed2006

A novel homeobox mutation in the PITX2 gene in a family with Axenfeld-Rieger syndrome associated with brain, ocular, and dental phenotypes.

Axenfeld-Rieger Syndrome (ARS) is a genetically heterogeneous birth defect characterized by malformation of the anterior segment of the eye associated with glaucoma. Mutation of the PITX2 homeobox gene has been identified as a cause of ARS. We report a novel Arg5Trp missense mutation in the PITX2 homeodomain, which is associated with brain abnormalities. One patient had a small sella turcica likely to reflect hypoplasia of the pituitary gland and consistent with the critical role identified for Pitx2 in pituitary development in mice. Two patients had an enlarged cisterna magna, one with a malformed cerebellum, and two had executive skills deficits one in isolation and one in association with a below average intellectual capacity. The mutation caused a typical ARS ocular phenotype. All affected had iris hypoplasia, anterior iris to corneal adhesions, and corectopia. The ocular phenotype varied significantly in severity and showed some asymmetry. All affected also had redundant peri-umbilical skin, a hypoplastic maxilla, microdontia, and hypodontia missing between 20 and 27 teeth with an unusual pattern of tooth loss. Dental phenotypes were documented as they are often poorly characterized in ARS patients. All affected individuals showed an absence of first permanent molars with variable absence of other rarely absent teeth: the permanent upper central incisors, maxillary and mandibular first and second molars, and the mandibular canines. Based on the distinctive dental anomalies, we suggest that the dental phenotype can assist in predicting the presence of a PITX2 mutation and the possibility of brain abnormalities.

Abnormalities, Multiple↗
PubMed2001

Tooth and periodontal disease: a review for the primary-care physician.

Dental diseases are widespread and are often underrecognized and treated. Caries and periodontal disease are common dental conditions that cause the majority of tooth loss. Although these conditions are preventable, many persons do not receive regular dental care and have acute problems when seen by their physician. Dental diseases frequently affect patients with multiple systemic disorders, including autoimmune disorders, diabetes, and human immunodeficiency virus (HIV) infection. The presence of dental disease may trigger inflammatory responses and have systemic consequences. Since dental disease affects almost all individuals, physicians should be able to recognize common conditions such as caries, periodontal disease, pulpitis, and dental abscess. In addition to initiating treatment and appropriate dental referrals, physicians should be familiar with the management of antibiotics and medications in the perioperative period. Another important role for physicians is to help reduce the societal and economic impact of these diseases through patient education and prevention.

Humans↗
PubMed1993

Oral health status of a group of elderly Canadian Inuit (Eskimo).

Fifty-four Inuit elders, representing 90% of the individuals 60 yr of age and older in three communities in the Keewatin region of the Canadian Northwest Territories, were examined for dental caries, periodontal disease, levels of edentulism, and the fit and quality of denture prostheses. These elders had a mean of 2.8 +/- 3.5 decayed teeth and a DMFT of 26 +/- 13 which reflected significant tooth loss. The Root Caries Index for subjects with gingival recession was 19%. Periodontal pocket assessments revealed that 86% of the individuals examined had CPITN readings of either 3 or 4. Over one third of the elders were totally edentulous, most of them female. Only 47% of these individuals wore complete dentures. Denture fit assessment revealed that 36% of the complete maxillary dentures and 42% of the complete mandibular dentures fit poorly. The overall oral health findings for these Inuit elders differed from those found in other older populations; however, the present findings may be the norm for a population undergoing a cultural transition.

Aged↗
PubMed1992

Dental paleopathology and agricultural intensification in south Asia: new evidence from Bronze Age Harappa.

Patterns of dental disease among Bronze Age people of the Indus Valley Civilization are currently based on early and incomplete reports by non-specialists. This deficiency precludes accurate diachronic analysis of dental disease and its relationship with increasing agriculturalism in the Indian subcontinent. The objective of this paper is to document prevalence of dental disease at Harappa (2500-2000 B.C.), Punjab Province, Pakistan, comparatively evaluate the Harappan dental pathology profile, and use these data to assess theories regarding the dental health consequences of increasingly intensive agricultural dependence. Pathological conditions of the dentition included in the study are abscesses, ante-mortem tooth loss (AMTL), calculus, caries, hypoplasia, hypercementosis, pulp chamber exposure, and alveolar resorption. The Harappan dentition exhibits a dental pathology profile typical of a population whose subsistence base is agriculture. Dental caries at Harappa are present in 6.8% (n = 751) of the teeth and 43.6% (n = 39) of the more completely preserved dental specimens. The use of a caries correction factor is recommended to permit an estimate of caries induced AMTL in calculating the caries prevalence. All dental lesions are present at higher rates in this Harappan study sample than were reported in previous investigations, and important differences in prevalence of dental disease occur between the genders. Prevalence of dental disease increases in the greater Indus Valley as subsistence becomes more intensive and as food preparation and storage technology becomes more efficient.

Dental Caries↗
PubMed2001

Quantitative analysis of apical root resorption by means of digital subtraction radiography.

OBJECTIVE: This study was performed to assess the diagnostic and quantifying ability of digital subtraction images for simulated apical root resorption, as well as to compare the diagnostic accuracy of conventional intraoral radiographs with digital subtraction images for this condition. STUDY DESIGN: Digital and intraoral radiographs of 10 sound maxillary central incisors and those with simulated apical root resorption were taken with varying horizontal and vertical angulations of the x-ray beam. Paired t tests were used to compare the lengths of the sound teeth on the images with their actual lengths, and the estimated amount of simulated apical root resorption was compared with the actual amount of tooth loss by means of Emago software. The diagnostic accuracy for detecting lesions was also evaluated on conventional intraoral radiographs and digital subtraction images through receiver operating characteristic (ROC) analysis. RESULTS: There were no statistically significant differences between the actual lengths and those measured on the reconstructed images of the sound teeth. The calculated amounts of apical root resorption showed no statistically significant differences in comparison with the actual amounts (P >.05). The diagnostic accuracy of the conventional intraoral radiographs in detecting the lesions was low (ROC area = 0.6446). CONCLUSION: A quantitative analysis of small amounts of apical root resorption can be performed by means of digital subtraction radiography.

Humans↗
PubMed1985

Caries and total extraction in a medium-sized city in the Netherlands.

In 1982 a combined sociodental research project was started in the city of Groningen in order to gain insight into the dental and social reasons for total extraction. 91% of the dentists in the city participated in this study by collecting the extracted teeth, filling out a questionnaire and asking their patients to fill out another questionnaire concerning the behavioral aspects of total tooth loss. 78% of the 134 patients returned the questionnaire. In this article the caries status in relation to the social background and dental attendance pattern has been described. The mean age at the time of extraction was 44.2 yr. The patients were a good cross-section of the Dutch population as regards education level, type of health insurance and sex. The average number of teeth was 14.2. The average DEMFT value was 22.8. Although regular attenders had less D-teeth than irregular attenders they had an average of 3.5 teeth with active caries. Regular attenders had more F-teeth but less sound teeth than irregular attenders. The contribution of the dental health care system to the dental health of the population is discussed.

Adolescent↗
PubMed1997

Surveying removable partial dentures: the importance of guiding planes and path of insertion for stability.

STATEMENT OF PROBLEM: Although removable partial dentures are a favored option for the restoration of many situations that involve partial tooth loss, some patients are not satisfied with a removable partial denture, especially when it is not stable during mastication. A dental surveyor can be used to prevent countless problems related to the production of removable partial dentures. Many professionals working with oral rehabilitation fail to take advantage of the many uses of a surveyor in planning and designing chromium alloy and other metal removable partial denture frameworks. PURPOSE: This article uses an academic approach to describe the criteria used to determine the path and removal of a removable partial denture. A fundamental requirement for understanding the correct use of the dental surveyor is to prevent indiscriminate use of a path of insertion perpendicular to the occlusal plane, and extreme inclinations of the cast in the attempt to create undercuts on some teeth.

Chromium Alloys↗
PubMed1989

Smokeless tobacco addiction: a threat to the oral and systemic health of the child and adolescent.

The use of smokeless tobacco (ST) within the United States has increased greatly in recent years, especially among adolescent boys and young men. Recent national data completed from several large scale studies indicate that 10-12 million Americans use some form of ST. Representing a significant systemic and oral health risk, ST usage can produce a wide range of negative effects on both soft and hard oral tissues. These oral conditions include bad breath, discolored teeth and restorative materials, excessive tooth surface wear (abrasion), decreased ability to taste and smell, gingival (gum) recession, advanced periodontal soft and hard tissue destruction, tooth loss, soft tissue erythema and leukoplakia. Long-term ST usage is directly correlated to an increased risk of cancer of the mouth, larynx, throat and esophagus. Much of the destruction of oral tissues is related to the localization of the tobacco quid; i.e., it is habitually held in only one spot in the mouth. Nicotine from ST can activate the sympathetic nervous system thereby significantly increasing heart rate, blood pressure, cardiac stroke volume and output and coronary blood flow. A common misconception is that ST is a 'safe' alternative to smoking cigarettes. Several recent Surgeon General's Reports list ST as being addictive. It is highly possible that ST users will 'graduate' to cigarettes if they eventually conclude that these products are socially unacceptable, inconvenient or out of vogue. Health professionals, educators, parents and schoolchildren need to be informed about the significant health risks associated with ST use.

Adolescent↗