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A radiographic comparison of apical root resorption after orthodontic treatment with a standard edgewise and a straight-wire edgewise technique.

The purpose of this study was to compare the severity of apical root resorption occurring in patients treated with a standard edgewise and a straight-wire edgewise technique, and to assess the influence of known risk factors on root resorption incident to orthodontic treatment. The sample consisted of 80 patients with Angle Class II division 1 malocclusions, treated with extraction of at least two maxillary first premolars. Variables recorded for each patient included gender, age, ANB angle, overjet, overbite, trauma, habits, invagination, agenesis, tooth shedding, treatment duration, use of Class II elastics, body-build, general factors, impacted canines, and root form deviation. Forty patients were treated with a standard edgewise and 40 with a straight-wire edgewise technique, both with 0.018-inch slot brackets. Crown and root lengths of the maxillary incisors were measured on pre- and post-treatment periapical radiographs corrected for image distortion. Percentage of root shortening and root length loss in millimetres were then calculated. There was significantly more apical root resorption (P < 0.05) of both central incisors in the standard than in the straight-wire edgewise group. No significant difference was found for the lateral incisors. Root shortening of the lateral incisors was significantly associated with age, agenesis, duration of contraction period (distalization of incisors), and invagination, while root shortening of the central incisors was related to treatment group and trauma.

Adolescent↗

Meningococcal septicaemia and dental complications: a literature review and two case reports.

The present report describes two cases of dental complications of meningococcemia at an early age. The meningococcal infection in these young children resulted in limb amputation and significant plastic surgery. Dental treatment and psychological considerations are described in both cases. Similar dental complications, especially in the premaxilla, were found. Some of the severely affected teeth were extracted.

Bacteremia↗

Periodontal manifestation of hypophosphatasia. A family case report.

Hypophosphatasia is a rare inherited disease, the 1st clinical sign of which is often a premature loss of deciduous teeth. We describe clinical, histological and SEM findings of 2 cases of hypophosphatasia from a single family and discuss the pathological mechanisms with reference to the literature.

Alkaline Phosphatase↗

Loss of deciduous teeth and germs of permanent incisors in a 4-year-old child. An atypic prepubertal periodontitis? A clinical, microbiological, immunological and ultrastructural study.

A 4-year-old child was referred, in April 1988, to Rennes Dental School (France) for deciduous tooth mobility with premature loss of 4 deciduous teeth and germs of 2 permanent incisors. Microbiological examinations by culture revealed the presence of the periodontal pathogen Actinobacillus actinomycetemcomitans. Immunofluorescence of plaque samples revealed the presence of Porphyromonas gingivalis that had not been isolated by culture. Neutrophil functions were within normal ranges. Transmission electron microscopy of gingiva showed a disorganised epithelium. The connective tissue was infiltrated by inflammatory cells. The basement membranes were normal, but the connective tissue-epithelium interface was mainly composed of short rete pegs. Scanning electron microscopy of extracted deciduous teeth revealed lack of cementum, lacunae in the cementum and lack of fibrillar insertion on the middle part of the root. Skin lesions, mainly situated on face, were observed. Treatment was by extraction of mobile deciduous teeth combined with 3-week courses of metronidazole. Clinical and microbiological follow-up was continued over a 7-year period. No periodontal lesions have been detected since eruption of the permanent teeth. The present subgingival and lingual microflora (December 1995) is composed of bacteria associated with periodontal health. However, the future appearance of a hitherto undetected systemic disease is still possible.

Aggregatibacter actinomycetemcomitans↗

Prevalence of malocclusion in relation to premature loss of primary teeth.

The influence of premature extraction of primary teeth. The influence of the site of extraction was analyzed by studying the frequency of malocclusion in the group of children with extraction in the mandible or maxilla only. It was found that early loss of primary teeth would result in an increased frequency of sagittal, vertical as well as transversal malocclusion. As a consequence the need for treatment would increase significantly by early extraction of primary teeth. Whereas extraction in the maxilla would tend to result in need for extraction of permanent teeth; extraction in the mandible would often lead to need for orthodontic treatment of longer duration. On the basis of these findings it could be concluded that maintaining a high standard of dental service for preschool children must be considered good economy, since the need for premature extractions is reduced.

Child↗

Longitudinal study of accuracy of clinical examination for detection of permanent tooth aplasia.

It was the aim of the present investigation to evaluate the accuracy of clinical examination for the detection of permanent tooth aplasia in the 3rd/4th grade and again 1 yr later and to record the number of children initiating orthodontic treatment in the interval between the two examinations. The validating criterion for tooth aplasia was a panoramic radiograph taken in a routine procedure. 628 children participated in the study. The clinical examinations were performed without knowledge of the radiographic evidence. During the examination children exhibiting symptoms of permanent tooth aplasia were selected for radiography. At both occasions clinical examination was very sensitive for the detection of children with aplasia of permanent incisors (nosological sensitivity = 1.00). It was, however, less sensitive for the detection of children with premolar aplasia (nosological sensitivity = 0.22 at both examinations). The nosological specificity for identification of children without aplasia of incisors and premolars was more than 0.90 at both examinations. Twenty-two children had started orthodontic treatment in the timespan between the two clinical examinations, but only three on the basis of observations on their radiographs alone (aplasia of permanent teeth). The present clinical method would have selected two of these children, thus in only one child postponing panorama screening might have affected treatment prognosis. Between the two examinations all permanent teeth mesial to the permanent second molars had erupted in 181 children who might therefore totally avoid screening radiography.

Adolescent↗

Clinical and histologic appearance in enamel of primary teeth in relation to neonatal blood ionized calcium values.

The purpose of this investigation was to study the relationship between low values of blood ionized calcium measured in the first days of life postpartum and the clinical and histologic appearance of enamel of primary teeth. Twenty-five healthy children selected on the basis of optimality with known blood values of ionized calcium from the first days of life participated in a dental examination at the age of 5 yr. Twenty-four of the children contributed one exfoliated tooth each, which was histologically examined. The infants had lower mean values of ionized blood calcium on days 1 and 3 than day 5 postpartum. Thirteen of the 25 children had enamel aberrations, mainly on one tooth each. The histologic examination showed normal overall enamel morphology. The neonatal line was present in all teeth, and these lines were mostly thin. The registered findings about the enamel morphology could not, in any case, be correlated with the measured values of neonatal blood ionized calcium.

Calcium↗

Federal University of Santa Catarina follow-up management routine for traumatized primary teeth -- part 1.

The objective of this study was to verify if the follow-up management routine of traumatized primary teeth set up by Federal University of Santa Catarina, which performs clinical and radiographic assessments (15 and 45 days; 4, 8 and 12 months) after the oral trauma, enabled an early diagnosis of sequelae which would indicate the need for endodontic intervention, as well as the influence a type of trauma and the child's age could have in the severity of the sequelae. In this study 52 sets of records were used of patients being seen in the last 6 months, with a total of 70 teeth that were receiving follow-up treatment. Patients returned for regular visits set up by the management routine, where clinical and radiographic examinations were performed to check for sequelae, which justified endodontic intervention. Mobility (51.2%) and crown discoloration (25.6%) were the most common sequelae found in the patient's first appointment. In the follow-up visits, replacement root resorption (22.5%) was the second most common sequela found, suggesting endodontic intervention. No significant association was found between severe sequelae, types of trauma and a child's age (chi(2) = 0.3, P = 0.8613). During the intervals of the follow-up visits, it was noticed that between 46 days and 8 months a higher number of sequelae were diagnosed (P < 0.05). The diagnosis of sequelae such inflammatory and replacement root resorption, which can lead to an early loss of a primary tooth, are frequent and that the interval between the follow-up visits has to be changed, suggesting the setting up of management routine 2. The study also concluded that the type of trauma and the child's age are not fundamental factors in the diagnosis of severe sequelae.

Child, Preschool↗

Development of clinical and radiographic signs associated with dark discolored primary incisors following traumatic injuries: a prospective controlled study.

The purpose was to evaluate late complications of asymptomatic traumatized primary incisors with dark coronal discoloration. The clinical and radiographic signs of 97 teeth of the study group were recorded along a follow-up period that ranged between 12 and 75 months (mean >36 months). Children's age at time of injury ranged between 18 and 72 months (mean 40). The control group consisted of 102 non-discolored maxillary primary central incisors in 51 children older than 54 months with no history of dental trauma. In 50 teeth (52%) the color faded or became yellowish and in 47 (48%) it remained dark. Clinical signs of infection, that were diagnosed 5-58 months after the injury, were associated significantly more with dark than yellowish hues (83 and 17%, respectively). Teeth that had changed their color to become yellow presented more PCO than teeth with black/gray/brown coronal discoloration (78 and 6%, respectively). Arrest of dentine apposition was found in 15 teeth, one had yellow coronal discoloration and the remaining 14 had a dark shade. Eleven teeth showed inflammatory root resorption all with dark discoloration. Two atypical types of root resorption were observed: a surface resorption restricted to the lateral aspects of the apical half of the root while the root length remained unchanged and in the other expansion of the follicle of the permanent successor was observed. Expansion of the dental follicle was observed in 72% of all teeth with no significant difference between the various types of coronal discoloration but only half of the cases were associated with resorption of the root of the primary incisor. The various pathologic findings observed in the study group were either absent or rarely seen in the control group. It can be concluded that more than 50% of the primary incisors that retain their dark coronal discoloration acquired after dental injuries remain clinically asymptomatic till the eruption of the permanent successor even if they present accelerated root resorption. Asymptomatic traumatized primary incisors that retain their dark coronal discoloration may develop a sinus tract and inflammatory root resorption years after the injury. There is still a dilemma: which treatment is better for dark discolored primary incisors: early endodontic treatment or follow-up with the risk of development of infection and root resorption that may require extraction?

Bacterial Infections↗

Loss of upper permanent central incisor teeth. Case report.

A case is reported in which elastic bands caused irreversible periodontal destruction around upper central incisor teeth. Every practitioner should be aware of the hazards associated with the use of elastic bands in minor tooth movement.

Alveolar Process↗

Root resorption.

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Humans↗