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The relationship between cigarette smoking and perceived dental treatment needs in the United States, 1988-1994.

BACKGROUND: Although factors affecting perceived dental treatment needs have been investigated, the effect of smoking status on perceptions of dental needs has not been examined. METHODS: The authors examined data on 13,227 dentate people aged 20 to 79 years from the Third National Health and Nutrition Examination Survey (NHANES III). Information was collected information on sociodemographic characteristics, cigarette smoking, perceived dental treatment needs and other factors during a home interview, and clinical oral health information was collected at a mobile examination center. RESULTS: In univariate analyses, current smokers were more likely than nonsmokers to perceive dental needs in all categories, except for the need for a dental cleaning. Multivariate regression results indicate that current smokers were more likely to report a need for periodontal treatment and dental extractions compared with nonsmokers (odds ratio [OR] = 1.40; 95 percent confidence interval [CI] = 1.05-1.87 and OR = 1.61; 95 percent CI = 1.22-2.14, respectively). The authors found an interaction between smoking and race/ethnicity in models describing the need for teeth to be filled/replaced and for orthodontic/cosmetic work. CONCLUSIONS: Current smokers were more likely to have more perceived dental needs compared with nonsmokers. Practice Implications. These results may be important for the advancement of efforts directed toward tobacco-use cessation programs and to understand factors that could affect dental care utilization.

Adult↗

Occlusion.

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Dental Occlusion↗

Veneer mania.

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Attitude of Health Personnel↗

A comparative study of coronally advanced flaps with and without the addition of enamel matrix derivative in the treatment of marginal tissue recession.

BACKGROUND: The primary aim of this randomized, controlled, clinical investigation was to evaluate the differences in clinical parameters of root coverage procedures utilizing coronally advanced flaps (CAF) with and without enamel matrix derivative (EMD). Another aim was to evaluate if EMD can influence keratinization of tissues utilizing these procedures. METHODS: Fifty-eight contralateral sites in 17 patients with > or = 2 mm of Miller Class I, II, and III buccal marginal tissue recession were treated. Test sites received CAF plus EMD while control sites were treated with CAF only, with each patient serving as his own control. Patients were followed for 3 and 6 months. All data were analyzed using the method of generalized estimating equations. A P value <0.05 was considered significant (alpha = 0.05). RESULTS: There was a mean increase in keratinized tissue of 0.60 mm for test sites and a mean decrease of 0.05 mm for control sites. Test sites demonstrated significantly better root coverage (P<0.001), 89.7% and 92.9% root coverage after 3 months and 6 months, respectively, while control sites had 56.6% and 66.8% root coverage after 3 months and 6 months, respectively. There was significantly more root coverage among test sites compared to control sites, regardless of arch or Miller classification. CONCLUSIONS: Based on the results of this study, the application of enamel matrix derivative to denuded root surfaces receiving coronally advanced flaps significantly increased the percentage of root coverage compared to CAF without EMD. In addition, EMD application was accompanied by a significant increase in keratinized tissue 6 months after surgery.

Adult↗

[Colorimetric study of color reproduction in porcelain-fused-to-metal restoration. The application of Kubelka-Munk theory in porcelain mixtures].

To get a more natural and harmonious color of porcelain-fused-to-metal restorations, an objective and precise systematic method from shade selection to color evaluation is needed. Thus, the absorption and scattering coefficients were determined to develop a CCM system for porcelain-fused-to-metal restorations. The Kubelka-Munk Theory was applied on the dental porcelain, opaque, dentin, and enamel. From these data, we predicted the color of the porcelain mixtures from the both coefficients. From the results of comparing the spectral curves and analyzing the color differences between measured values and predicted values of porcelain mixtures, the following was analysed; 1. In opaque, spectral curves of the predicted and measured values were exactly alike and the mean dE between two values was 0.39. 2. In dentin, the spectral curved of the predicted and measured values were exactly alike, and the mean dE was 1.13. The measured values indicated a slight increase in the level of chroma and lightness. 3. In enamel, the spectral curves were exactly alike and the mean dE was 1.16. The measured values indicated a slight decrease in the level of lightness. Therefore, it was possible to predict the color of opaque, dentin and enamel porcelain mixtures, by applying the Kubelka-Munk Theory.

Adhesives↗

[Improvement of aesthetics by porcelain laminate veneers].

PATIENT: The patient consulted our department with a chief complaint of aesthetic problems due to anterior tooth discoloration. Since improvement by bleaching was considered impossible, porcelain laminate veneer restorations were performed. DISCUSSION: Insertion took too long for the patient's satisfaction due to the repetition of color adjustment and recontouring. The veneer preparation area should be limited to enamel; however when dentin is exposed, it is important to treat with primer before adhesion. CONCLUSION: In this case, establishing a selection criterion for bleaching, a combined approach was also considered. Although the preparation area is limited to enamel, phosphoric acid etching should be avoided when dentin is exposed. The treatment process should be arranged so as to reduce the manipulation period.

Adult↗

[Gingival and dental parameters in the evaluation of aesthetic characteristics of fixed restoratons (II)].

This paper is a continuing evaluation of dental and facial parameters in the estimation of aesthetic characteristic of fixed restorations. First of all, attention is paid to the phenomenon describing the tooth tissue's characteristics (translucency, opalescence, and transparency). The paper also discusses tooth colour as a special occurrence, the position of the lower lip line as well as the symmetry of the smile. In addition to these fundamental objective criteria, the paper also deals with subjective criteria (tooth arrangement and position, variation in tooth form, and relative crown length), which play a part in the successful aesthetic integration of fixed restorations.

Crowns↗

A clinical evaluation of anterior conventional, microfiller, and hybrid composite resin fillings. A 6-year follow-up study.

Anterior resin fillings of seven composite resin materials--two conventional, two hybrid, and three microfiller--were evaluated over a 6-year period. Extrinsic discoloration, color match, marginal discoloration, marginal adaptation, surface roughness, and recurrent caries were investigated. The individual caries increment was compared with an estimation of the expected caries risk of the individuals. The estimation was based on the net effect of microbial counts, oral hygiene, salivary flow rates, buffer values, and fermentable carbohydrate intake. The variation of the investigated factors within each resin group was too great to enable combination of the results. The individual materials are therefore presented and compared. Unacceptable color match scores after 6 years varied markedly among the brands (3.5%-79.7%). Unacceptable marginal discoloration was seen in 1.7% of the restorations, whereas unacceptable marginal adaptation varied between 13.7% and 37.3% for the brands. Recurrent caries occurred at the margins of 18.9% of the composite fillings (range, 9.3%-29.4%) during the period. The cumulative relative frequencies of replaced fillings for the materials varied between 14.8% and 55.1%. Recurrent caries was the major reason for replacement. Patients with many caries risk factors showed clearly a higher increment of caries.

Adult↗

Effect of fluoride mouth rinse on fluoride releasing and recharging from aesthetic dental materials.

This study evaluated fluoride-release and recharging with the fluoride mouth rinsing technique on fluoridated materials. Three fluoride containing materials and one non-fluoride containing composite resin were used for this study. Samples for each material consisted of 15 discs, 9 mm diameter with a thickness of 1 mm. Initial fluoride release was assessed over a 60-day period. After that, 15 discs for each material were divided into 3 groups: distilled water group, 450-ppm and 900-ppm mouth rinsing groups. Fluoride release increased in combination with fluoride mouth rinse, and fluoride was higher in the 900-ppm group than the 450-ppm group. Moreover, S-PRG or F-PRG fillers materials released fluoride in higher than fluoroaluminosilicate glass fillers materials. In addition fluoride release from control samples was not observed. Therefore, only fluoride release material takes up fluoride. The findings of the present investigation suggest that the rate of fluoride release was different for each material, because they contained different function fillers. The results showed the importance of the fluoride mouth rinsing technique for fluoride-releasing restorative materials for the prevention of secondary caries.

Adsorption↗

Demand for orthodontic treatment among 9-18 year-olds seeking dental care in Dar-es-Salaam, Tanzania.

OBJECTIVE: To investigate the demand for orthodontic treatment among 9-18 olds seeking dental care in Dar-es-Salaam, Tanzania. DESIGN: Case-control, interview and clinical study. SETTINGS: Children seeking dental care. MAIN OUTCOME MEASURES: Demand for orthodontic treatment. RESULTS: Most of the children (85%) in the case group attended the dental clinic because of crowding. Aesthetic impairment (AC grades 8-10) and severe malocclusions (DHC grades 4-5) were higher in cases than in controls being 47 and 5%; and 67 and 18%, respectively (p<0.0001). Absolute need (combined AC grade 8-10 and DHC 4-5) was found in 29% of the cases and 5% of the controls (p<0.0001). A relative probability for a child with absolute need to seek orthodontic treatment was 7.9 higher (95%) CI for OR = (5,13), compared to a child without an absolute need for orthodontic treatment. The most prevalent severe occlusal feature placing cases in the highest need category was crowding (74%). For the cases, it was mainly a mother (45%) who first recognized the problem in the family, and tooth extraction (62%) was the most common expected mode of treatment. Most parents (96%) were prepared to pay for their children's orthodontic treatment. CONCLUSION: Most children in the case group had come to the clinic due to crowding. Ectopic canines were the driving factor for children and parents to seek orthodontic care. Further studies are recommended to map the demand for orthodontic treatment in the Tanzanian rural settings.

Adolescent↗

Awareness and concern about malocclusion among 12-15 year-old children in Moshi, Tanzania.

OBJECTIVE: To assess awareness and concern about malocclusion in 12-15 year-olds in Moshi, Tanzania. DESIGN: A cross-sectional study. SETTING: Moshi Municipality in Kilimanjaro region, Tanzania. SUBJECTS: Two hundred and ninety eight randomly selected Public primary school children aged 12-15 years (158 males and 140 females). RESULTS: About 56% of the respondents thought their teeth were properly aligned. However only 29.1% of the respondents reported being dissatisfied with the way their teeth appeared in their mouth. About 25% of the respondents found their teeth to have been worse than most of their age-mates. Children who reported to have been teased due to their malocclusion comprised 25.8%. Those who thought it was unpleasant to stay with malaligned teeth constituted 55.7% of the respondents. Subjective orthodontic treatment need was reported by 69.1% of the sample. Majority of the children (75%) were ready to accept orthodontic treatment. There were significant correlations between factors of awareness and those of concern about malocclusion among the subjects. CONCLUSIONS: In spite of very little orthodontic treatment exposure in this population, awareness and concern about malocclusion was reported by a significant proportion of the children. These findings form a baseline line for future studies on the trends of awareness and concern towards malocclusion in this population. They will also be useful in the planning of orthodontic services in Tanzania.

Adolescent↗