A discussion of serial extraction.
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Full-mouth radiographs of ninety-six patients treated by extraction of four first premolars were taken at least 10 years postextraction. Three groups were established: one with extensive crowding in the full permanent dentition treated by extraction and fixed appliance therapy; one treated by serial extraction and fixed appliance therapy; and one treated by serial extraction only. Measurements of tooth length and alveolar bone height were made from the projected radiographs, and buccolingual socket areas were measured from direct tracings of the radiographs. Comparison between groups revealed reduced mean radiographic tooth lengths for incisors and mandibular molars in the orthodontically treated groups. The incidence of root resorption was similar for both treated groups. Reduced alveolar bone heights were noted in the extraction sites of the two orthodontically treated groups but not in the group treated by serial extraction only. Most reduction in long-term dentoalveolar support occurred as a result of root resorption except in the extraction sites, where it occurred largely as a result of bone loss. Root parallelism did not appear to influence proximal bone heights at the extraction site. In malocclusions involving arch length deficiency, maximally displaced canines had reduced long-term proximal bone compared to nondisplaced canines, supporting the concept of encouraging autonomous distal eruption through serial extraction.
BACKGROUND: According to the Third National Health and Nutrition Examination Survey, crowding and irregularity remain a consistent problem for children. Management of space problems continues to play an important role in a dental practice. It also represents an area of major interaction between the primary provider and the specialists. This article attempts to update clinicians on the current knowledge of space management. DESCRIPTION OF CONDITION: Proper management of space in the primary and mixed dentitions can prevent unnecessary loss in arch length. Diagnosing and treating space problems requires an understanding of the etiology of crowding and the development of the dentition to render treatment for the mild, moderate and severe crowding cases. Most crowding problems with less than 4.5 millimeters can be resolved through preservation of the leeway space, regaining space or limited expansion in the late mixed dentition. In cases with 5 to 9 mm of crowding, some can be approached with expansion after thorough diagnosis and treatment planning. Most of these cases will require extraction of permanent teeth to preserve facial esthetics and the integrity of the supporting soft tissue. Serial extraction or guidance of eruption is reserved for treatment of severe tooth-size/arch-size discrepancies. Due to variations in the timing and extraction sequence depending on the diagnosis, serial extraction should be reserved for those who can complete the treatment successfully. CLINICAL IMPLICATIONS: The recommended timing of referring patients with moderate crowding to specialists for treatment is in the late mixed-dentition stage of development. Patients with severe crowding will require earlier evaluation for serial extraction.
Volatile sulfur compounds (VS) are generated in the large intestine by the bacterial metabolism of sulfate and sulfur amino acids. VS are potentially harmful to the host. The effect of dietary supplementation of herb extracts on volatile sulfur production in the large intestine of pig was evaluated in this study. The extracts Perilla frutescens (Soyou), Mentha piperita (Peppermint), and Ajuga decumbens (Kiransou) were fed to pigs equipped with a permanent cannula at the cecum. Cecal digesta were sampled and analyzed for ammonia and short-chain fatty acids (SCFA). Sampled digesta were incubated anaerobically either with or without L-methionine for 24 h to estimate volatile sulfur production in vivo. L-Methionine was supplemented to enhance methanethiol (MeSH) production. At the end of the incubation, head space concentrations of volatile sulfur compounds such as hydrogen sulfide (H2S), MeSH, and dimethyl sulfide (DMS) were determined by flame-photometric gaschromatography after the addition of 6 N HCl. Sampled digesta were also subjected to the most probable number estimations for sulfate-reducing bacteria (SRB), sulfide producer from L-methionine, and MeSH producers from L-methionine. All three herb extracts significantly decreased H2S (p<0.05), MeSH (p<0.05), and ammonia (p<0.05) production, but SCFA production was not affected (p>0.05). The number of volatile sulfur-producing bacteria did not vary among groups by the dietary supplementation of these herb extracts. Serial solvent extraction was done on these herb extracts to specify the active fractions that reduce volatile sulfur production. n-Butanol fraction of all three extracts significantly reduced volatile sulfur production in vitro.
Serial extractions of premolars are submitted, in the present state of the contemporary orthodontics, in opposition to the non-extraction treatments (maxillary expansion, molar distancing...). The choice depends on many parameters including the severity and the nature of the malocclusion, the age and the morphological type of the patient and also the "orthodontic philosophy" relating to the techniques used by each orthodontist. The indications and contraindications of these teeth removals are explained showing the benefits and the disadvantages in different cases. "Orthodontics extractions" of other teeth (2nd bicuspid, 1st and 2nd molar, incisor) are also discussed.
Serial endothelial photographs were taken preoperatively and postoperatively in 200 eyes; 111 eyes contained a Rayner iris clip lens, 54 eyes contained a Fyodorov Sputnik lens, and 35 eyes had no lens. Central endothelial cell density was changed in all instances, with counts in implanted eyes declining 25 to 30%, and in nonimplanted eyes 10 to 15%. In both instances, the decline essentially ceased at about three months. The cause of the greater decline in implanted eyes appeared to be mechanical and subsequent cell loss after the 90-day period was virtually equal for the two groups. Methods that may be used to alter the difference in cell density occurring with implantation are best analyzed by using the 90-day period data for comparison.
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