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PubMed2003

Ridge preservation with freeze-dried bone allograft and a collagen membrane compared to extraction alone for implant site development: a clinical and histologic study in humans.

BACKGROUND: Tooth extraction typically leads to loss of ridge width and height. The primary aim of this 6-month randomized, controlled, blinded, clinical study was to determine whether ridge preservation would prevent post-extraction resorptive changes as assessed by clinical and histologic parameters. METHODS: Twenty-four patients, 10 males and 14 females, aged 28 to 76 (mean 51.5 +/- 13.6), requiring a non-molar extraction and delayed implant placement were randomly selected to receive either extraction alone (EXT) or ridge preservation (RP) using tetracycline hydrated freeze-dried bone allograft (FDBA) and a collagen membrane. A replaced flap, which did not completely cover the sockets, was used. Following extraction, horizontal and vertical ridge dimensions were determined using a modified digital caliper and an acrylic stent, respectively. Prior to implant placement, a 2.7 x 6.0 mm trephine core was obtained and preserved in formalin for histologic analysis. RESULTS: The width of the RP group decreased from 9.2 +/- 1.2 mm to 8.0 +/- 1.4 mm (P<0.05), while the width of the EXT group decreased from 9.1 +/- 1.0 mm to 6.4 +/- 2.2 mm (P<0.05), a difference of 1.6 mm. Both the EXT and RP groups lost ridge width, although an improved result was obtained in the RP group. Most of the resorption occurred from the buccal; maxillary sites lost more width than mandibular sites. The vertical change for the RP group was a gain of 1.3 +/- 2.0 mm versus a loss of 0.9 +/- 1.6 mm for the EXT group (P<0.05), a height difference of 2.2 mm. Histologic analysis revealed more bone in the RP group: about 65 +/- 10% versus 54 +/- 12% in the EXT group. The RP group included both vital bone (28%) and non-vital (37%) FDBA fragments. CONCLUSIONS: Ridge preservation using FDBA and a collagen membrane improved ridge height and width dimensions when compared to extraction alone. These dimensions may be more suitable for implant placement, especially in areas where loss of ridge height would compromise the esthetic result. The quantity of bone observed on histologic analysis was slightly greater in preservation sites, although these sites included both vital and non-vital bone. The most predictable maintenance of ridge width, height, and position was achieved when a ridge preservation procedure was employed.

Adult↗
PubMedDate not supplied

Management strategies of the unsalvageable tooth.

UNLABELLED: A tooth is deemed unsalvageable when it can no longer be preserved for use of function or aesthetic purposes. If proper treatment planning is done, tooth extraction can be performed with adjunctive procedures, to provide a more predictable restorative outcome for the patient. This review paper summarizes the possible treatment strategies available for the management of a tooth with a poor prognosis, so as to manage the patient better before the restorative treatment phase commences. CLINICAL RELEVANCE: The management of an unsalvageable tooth using interdisciplinary approaches offers the clinician strategies for providing a more favourable restorative outcome.

Alveolar Bone Loss↗
PubMedDate not supplied

Observation of a child with multiple submerged primary teeth.

The authors presented a case report of a seven-year-old male with eight submerged primary molars and a primary lateral incisor. Two major treatment modalities, tooth extraction and observation, were reported. In this case we applied the two alternative modalities and observed the patient for five years. The permanent successors were in the process of almost normal eruption after the extraction of the submerged primary teeth; no eruption and more severe submerging were observed, however, in the permanent successors of the submerged primary teeth that were not extracted. These results suggest that submerged or impacted primary teeth should be extracted immediately when they are moderately or severely submerged.

Anodontia↗
PubMed1999

Oral health behaviour of 12-year-old children in Kuwait.

OBJECTIVES: The objectives of the study were: (1) to describe the pattern of oral health behaviour of 12-year-old children in Kuwait, (2) to analyse this in relation to parental education, dental visiting habits and location, and (3) to establish a baseline for planning and evaluation of an oral health care programme for secondary schoolchildren. DESIGN: Cross-sectional, interviews with children in 1995. SAMPLE AND METHODS: The sample included 500 12-year-old schoolchildren (250 boys and 250 girls) selected from schools in Kuwait. All the children agreed to take part. Interviews with the children were carried out in the schools by four trained and calibrated Arabic speaking interviewers. RESULTS: During the previous 12 months, 28% of the children had experienced oral health problems--toothache (10%), or had felt discomfort (18%) either often or occassionally. The children reported that they needed oral hygiene instruction (71%), fillings (32%) and tooth extraction (23%). For 53% of the children the reason for the most recent visit to a dentist was pain or problems with teeth or gums. At their last dental visit 26% of the children had undergone a tooth extraction. The consumption of sugary foods and drinks was extremely high. Children who had visited a dentist within the last 12 months and children whose parents had higher education levels more often claimed frequent toothbrushing than those with no previous dental visiting experience and those whose parents had a low level of education. CONCLUSIONS: Oral health education and oral health care programmes should be established in secondary schools in Kuwait to influence the oral health behaviour of the children and to avoid further deterioration in their oral health.

Child↗
PubMed1998

Vertical root fractures in adjacent maxillary premolars: an endodontic-prosthetic perplexity.

Vertical root fractures in endodontically treated teeth occur frequently in teeth or roots in which their mesiodistal dimension is narrow, such as the maxillary upper premolars. Two cases of vertical root fractures in two adjacent maxillary reconstructed teeth are presented. As in many cases of vertical root fractures, the primary diagnosis was of endodontic treatment failure. The final diagnosis of the fractures was made either by the radiograph showing separation of root segments in one case, or by surgical exploration in the other. In both cases, tooth extraction was unavoidable.

Adult↗
PubMedDate not supplied

The assessment of anesthetic efficacy of ropivacaine in oral surgery.

This paper describes the application of ropivacaine, local, amid, long-acting anesthetic in oral surgery. For infiltrative anesthesia, 0.75% of Naropin (ropivacaine) was used in eight patients undergoing various operations (maxillary sinus with oro-antral communication, extraction of upper and lower impacted wisdom teeth, cystectomy, apicoectomy and tooth extraction). The achieved anesthesia in all patients enabled analgesia in the course of the operation, and the expected intraoperative and postoperative bleeding, whereas postoperative analgesia lasted long enough (up to 380 minutes) to prevent the intake of analgesics. Side effects or local reaction on ropivacaine were not detected.

Adult↗
PubMed1989

[Five cases referred to the First Department of Oral Surgery due to failure of impacted mandibular third molar extraction].

Of patients referred to our department over the post two years due to failure of tooth extraction 5 with impacated mandibular third molars were treated. We found that extraction had been hindered by the narrow operative field due to inadequate incision of the overlying mucosal tissue, insufficient bone resection and inadequate separation of the crown and root.

Humans↗
PubMed1987

Local anaesthesia and dry socket. A clinical investigation of single extractions in male patients.

1533 single intra-alveolar permanent tooth extractions in males were investigated in a study to determine if the type and technique of local anaesthesia influenced the occurrence of dry socket. The results show that the incidence of dry socket was significantly greater after the use of Xylocaine compared to Citanest and that the use of repeated injections or intraligamental techniques increased the likelihood of this painful post-extraction condition.

Anesthesia, Dental↗
PubMed2005

Messenger RNA expression of periostin and Twist transiently decrease by occlusal hypofunction in mouse periodontal ligament.

Periostin, which is a secreted protein that supports cell adhesion, is highly expressed in the periodontal ligament (PDL). Twist, a basic helix-loop-helix (bHLH) transcription factor and a negative regulator of osteoblast differentiation, has been found to regulate the periostin gene transcription. Since occlusal force is thought to be important in the homeostasis of the PDL, in this study we investigated the expression of periostin and Twist mRNA in the mouse periodontal tissue following removal of antagonizing teeth. Unilateral maxillary tooth extraction was performed in 3-week-old male mice to produce occlusal hypofunction of the right mandibular molars. The expressions of periostin and Twist mRNA were examined by real time-PCR and in situ hybridization at 12, 24, 72 and 168 h after the tooth extraction. The real-time PCR analysis showed that periostin and Twist mRNA significantly decreased at 24 h to 14.5 and 49.9% of those in control group, respectively. But the recovery began at 72 and 168 h, no significant difference was observed. As determined by in situ hybridization analysis, the number of periostin and Twist mRNA-expressing PDL cells showed a marked decrease at 24 h, although an increase was observed from 72 h until the distribution was almost similar to that of the control group at 168 h. These results suggested that occlusal force might have putative roles in periostin and Twist gene expression in the PDL and the changes in their expression level during hypofunction may be considered a form of adaptation to environmental changes.

Animals↗
PubMed2001

Site development for anterior single implant esthetics: the dentulous site.

An inevitable loss of soft and hard tissue after tooth extraction often results in a compromised site for anterior implant esthetics. Various augmentation techniques have been advocated as corrective procedures, but these techniques are time-consuming and not always predictable. Therefore, the fundamental concept of site development for anterior single implant esthetics in the event of a failing tooth is to preserve the existing gingival and osseous tissue. This article identifies factors that affect tissue changes and describes an integration of surgical and prosthodontic approaches that can optimize the tissue maintenance in the anterior esthetic zone.

Alveolar Bone Loss↗
PubMed2005

Reasons for early loss of primary molars.

PURPOSE: The aims of this study were to investigate the principal reasons for untimely loss of primary molars and to evaluate the risk factors of early primary molar loss in children aged four to nine years. MATERIALS AND METHODS: 1150 untimely lost primary molars were analyzed from 546 patients. The early loss of primary molars was analyzed in relation to age, sex, dmf (t), DMF (T) scores, toothbrushing frequency, history of treatment and maternal education. The data were converted to SPSS format. Pearson Chi-square test was used for statistical analysis. RESULTS: Among the investigated subjects, 15.2% of children reported regular toothbrushing. Only 23.1% of subjects had a history of treatment before the tooth extraction and 33% of mothers had a low education level. Untimely loss of primary molars due to pain, caries and sepsis were 30.2%, 31% and 38.8%, respectively. The frequency of 'only one primary molar loss' was significantly higher in group 1 (p < 0.05), however the frequency of 'more than one primary molar loss' for group 2 was more than group 1 (p < 0.05). Irregular toothbrushing for the children in group 2 was found significantly high than in group 1 (p < 0.05). Irregular toothbrushing was associated with number of early primary molar loss in group 2 (p < 0.05). The level of maternal education was associated with dmf (t) scores (p < 0.05). The caries incidence was associated with number of early primary molar loss in both groups (p < 0.05). The mean number of treated teeth before extraction for group 2 was significantly higher than for group 1 (p < 0.05). CONCLUSION: Results of this study suggested that irregular toothbrushing, high dmf (t) scores and untreatment of carious primary molars were significant risk factors in early loss of primary molars. Every effort must be taken into account in restoring rather than extracting carious teeth.

Chi-Square Distribution↗
PubMed2005

Dens invaginatus of the mandibular first molars in a dog.

A 6-year-old dog was presented for draining tracts associated with both mandibular first molar teeth. Radiographs of the affected teeth showed periapical bone lysis. Surgical tooth extractions were performed and the tooth segments were submitted for histopathologic examination. Microscopic evaluation of the teeth showed in folding of the enamel and dentin consistent with a diagnosis of dens invaginatus. Examination performed 13-months following the extraction procedures indicated uncomplicated healing at the extraction sites and no other visible evidence of endodontic disease.

Animals↗
PubMed1983

Edentulous orodyskinesia.

Twelve of 75 (16%) edentulous patients (mean age, 62 years) were found to have orofacial dyskinesias. Tooth extraction averaged 12 years before the onset of movements. No dentures were present in 50% of dyskinetic patients and in 9.5% of edentulous patients without dyskinesia. Movements of the lips, tongue, and jaw were marked in 3 patients and mild in 9. Functional disability was minimal. None of 75 elderly patients (mean age, 68 years) without tooth extractions had oral dyskinesias.

Denture, Complete↗
PubMedDate not supplied

Immediate loading of an implant following implant site development using forced eruption: a case report.

In restoring periodontally involved hopeless teeth, implant treatment has been widely used with combinations of various grafting techniques or guided bone regeneration. Instead of traditional surgical procedures, forced tooth eruption may be used successfully for implant site development. In this case, the authors orthodontically erupted a hopeless central incisor with an angular bony defect. Subsequently, they placed an implant immediately after tooth extraction and immediately loaded it with a temporary resin restoration.

Adult↗
PubMed2006

Immediate implant placement: treatment planning and surgical steps for successful outcomes.

Diagnosis and treatment planning are key factors in achieving successful outcomes after placing and restoring implants placed immediately after tooth extraction. The efficacy of immediate implant placement has been established and shown to be predictable if reasonable guidelines are followed. Some or all of the following suggestions, depending on individual circumstances, should be considered when evaluating a patient for dental implants: thorough medical and dental histories, clinical photographs, study casts, periapical and panogram radiographs as well as a linear tomography or computerised tomography of the proposed implant sites. Reasons for tooth extraction include but are not limited to: insufficient crown to root ratios, remaining root length, periodontal attachment levels, periodontal health of teeth adjacent to the proposed implant sites, unrestorable caries, root fractures with large endodontic posts, root resorption, teeth with deep furcation invasions being considered as abutments for fixed partial dentures and questionable teeth in need of endodontic retreatment.

Animals↗
PubMed1979

[Causes of tooth loss in Switzerland. Results of an inquiry of private dental practitioners].

The reasons for tooth loss in different age groups were analysed. The data were compiled from questionnaires sent to 99 private dental practices chosen at random in Switzerland. Caries was the most common reason given for tooth extraction in younger age groups. After 40 years of age, however, the number of teeth extracted because of periodontal disease was higher than the number removed for any other reason.

Adolescent↗