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The diagnostic dilemma of barodontalgia. Report of two cases.

Although rare, barodontalgia can be a problem for those who fly. Two cases are presented, one which occurred during simulated high-altitude flight in the altitude chamber and the other during actual flight. The case that occurred during actual flight was resolved by treatment of the most suspect tooth after diagnostic tests failed to identify the problem. The other case was eventually treated successfully when symptoms became localized. The difficulties encountered in making a diagnosis are described.

Adult↗

An evaluation of etiologic factors in 382 patients treated in a postgraduate endodontic program.

A survey was completed to determine and to evaluate the reason for endodontic treatment performed by endodontic residents at the Baltimore College of Dental Surgery, University of Maryland at Baltimore. On the basis of patient data and the reasons for endodontic treatment, as stated by the treating residents, the results showed that necrotic pulp and irreversible pulpitis were the most frequent reasons for endodontic therapy. Other reasons for treatment included restorative considerations, retreatment, and trauma. The majority of cases involved posterior teeth, and the average age of patients was 40.0 years. The frequency by arch demonstrated approximately equal distribution between maxillary (54.8%) and mandibular (45.2%) teeth. A total of 224 (58.6%) of the 382 patients surveyed had preoperative pain.

Adolescent↗

Oral lesions caused by habits.

Oral lesions caused by habits can be of teeth only, of teeth and the soft tissues of the mouth or may be only of the soft tissues. Lesions of teeth are permanent and may remain even when there has been total destruction of soft tissues. Recognition of lesions due to habits such as betel chewing, snuff dipping, pipe smoking and certain sexual practices may help towards establishing the sex, the ethnic grouping or even the place of origin of a person or their remains. Certain dental and gingival changes may indicate a person's working circumstances and even the type of treatment received.

Areca↗

Dentistry in the emergency department.

Dental problems are commonly seen in the emergency department. Although most emergency physicians have had little formal training in dentistry, the majority of these problems can be diagnosed and treated without the need for emergent dental consultation. The necessary procedures may require initial instruction by a cooperative consultant but are easily learned and well within the scope of practice of the emergency physician. Time invested in familiarization with the diagnosis and treatment of the more common dental problems will be rewarded with patient satisfaction.

Anesthesia, Dental↗

Traumatic root resorption in dentine-immunized mice.

Traumatic root resorption in a mouse model has been shown to coincide with a decline in naturally occurring serum antibody levels to dentin. It has been proposed that root resorption may be dentin antibody mediated. The purpose of this study was to examine the traumatic root resorption response in mice after hyperimmunization with a crude tooth extract (dentin). The hypothesis of this study was that elevated dentin antibody titers would positively correlate with root resorption. Mice were immunized with mouse dentin and controls were sham immunized. All mice were boosted 4 weeks later with or without mouse dentin as appropriate. All mice were then boosted two more times at weekly intervals with mouse dentin and then twice at weekly intervals with rat dentin. The change to rat dentin was made to increase mouse serum antibody titers to dentin. Serum samples were obtained before the initial immunization and weekly after each boost and were examined for antibody-to-dentin antigen by the enzyme-linked immune sorbent assay (ELISA). One week after the second boost with rat dentin, all animals were exposed to the cryoprobe procedure. Mice were killed 10 days later, and serum tested for antibody to dentin antigen. The incisors were examined by scanning electron microscopy, and root resorption quantified. Root resorption was observed on the incisors in the sham-immunized mice but not in the dentin-immunized mice. A trend toward increased serum antibody titers to dentin in immunized mice was observed over time.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Enamel loss associated with orthodontic adhesive removal on teeth with white spot lesions: an in vitro study.

Teeth with white spot lesions (WSL) might be more prone to enamel loss during bracket debonding. This in vitro study compared enamel loss from teeth with (n = 14) and without (n = 14) WSL after polishing with low-speed finishing burs or disks (Sof-Lex, 3M ESPE, St Paul, Minn). Debonded surfaces were analyzed with a contact stylus profilometer, and digitized data were compared with baseline readings by using AnSur NT software (Regents, University of Minnesota, Minneapolis, Minn). Specimen surfaces were also examined with a scanning electron microscope. Two-way analysis of variance was performed to analyze the data. In teeth without WSL, the volume losses were 0.16 mm(3) for the bur group and 0.10 mm(3) for the disk group; the mean maximum depths were 47.7 microm for the bur group and 54.3 microm for the disk group. In teeth with WSL, the volume losses were 0.06 and 0.17 mm(3), and the mean maximum depths were 35.1 and 48.7 microm for the bur and disk groups, respectively. There were no significant differences in enamel loss between the 2 groups of teeth without WSL (P =.12). However, in teeth with WSL, the burs removed less enamel than the disks (P = 0.006). Scanning electron microscope examination showed that any damage on the enamel surface was usually located in the cervical third of the teeth. On most specimens, even though tooth surfaces appeared resin-free to the naked eye, there were remnants of it. The differences between groups were so small that they might be clinically insignificant.

Analysis of Variance↗

The outlook for implants and endodontics: a review of the tissue engineering strategies to create replacement teeth for patients.

Ideally, root canal therapy involves the removal of diseased pulp tissues and permanent replacement with healthy pulp to revitalize teeth. Rather than placing implants, the ideal solution is to grow new replacement teeth. Success rates of implants and endodontic treatments can exceed 90%, which presents a formidable challenge to tissue engineering researchers to ensure that future dental treatments are even more successful. The purpose of this article is to explain how tissue engineering can be used to create replacement teeth. The science of tissue engineering has evolved from growing simple tissues in cell culture incubators to a multistep process. Although the problems of introducing tissue engineering therapies as part of routine dental treatments are substantial, the potential benefits are equally ground breaking.

Biomimetic Materials↗

Intra-urban differentials in child dental trauma in relation to healthy cities policies in Curitiba, Brazil.

This paper is concerned with developing methods for assessing the potential impact of healthy public policies on health outcomes, particularly on dental trauma. The hypothesis is that in deprived areas of Curitiba, Brazil, there would be a lower prevalence of dental trauma in 12-year-old schoolchildren related to different degrees of implementation of healthy public policies. Fourteen socio-environmental variables gathered from 29 deprived areas were factor-analysed and three principal components (PCA) extracted: physical environment, public social policies, and social cohesion. Individual clinical data on dental trauma were collected for 2,126 children from public schools in the areas. Rank correlation indicated that the relationship between components' scores and dental trauma was statistically significant. The PCA scores explained 42% of the variance for dental trauma.

Brazil↗

Pediatric ear, nose, and throat emergencies.

Acute otitis media is the most common infection for which antibiotics are prescribed in children, resulting in more than 20 million antibiotic prescriptions annually. New practice guidelines published by the American Academy of Pediatrics and the American Academy of Family Physicians call for the judicious use of antibiotics in view of increasing antibiotic resistance and the unclear necessity of the use of antibiotics in children with uncomplicated acute otitis media. This article reviews those guidelines, several other common ear, nose, and throat entities, including sinusitis and dental emergencies, and current strategies in diagnosis and treatment.

Anti-Bacterial Agents↗

Using composite bonding in oral and maxillofacial surgical office practice.

OBJECTIVE: Composite bonding plays a significant role in all phases of dental practice from orthodontics to restorative dentistry and even endodontics, yet, at the present time has had limited use by the oral and maxillofacial surgeon. The purpose of this article is 3-fold: to recommend a material for bonding and the method of application for composites; to describe the requirements of the orthodontist when referring a patient for the uncovering of teeth because this is usually the surgeon's primary, if not only, experience with bonding; and to describe situations that may present in the office that will benefit with the use of composite bonding. PATIENTS AND METHODS: Patients with various problems requiring the stabilization of teeth are presented and in a number of cases the effectiveness of the wired bar and the bonded bar is compared. These cases include the management of dentoalveolar fractures, avulsed or displaced teeth, its application to porcelain restorations without ill effects, and other situations that may arise in the office where fixation and stabilization of teeth is mandatory for success. RESULTS: Composite bonding provides the most effective method of stabilizing and immobilizing teeth with successful results in almost all cases. On the other hand, the wired arch bar and other wire combinations, which at the present time is the primary, if not the only treatment for these cases, are second to it from all aspects. CONCLUSION: The successful results with composite bonding along with its case of placement without pain or bleeding or psychological stress on the patient or operator warrants consideration by the oral and maxillofacial surgeon for greater utilization of this material in his office.

Composite Resins↗

E- and N-cadherin distribution in developing and functional human teeth under normal and pathological conditions.

Cadherins are calcium-dependent cell adhesion molecules involved in the regulation of various biological processes such as cell recognition, intercellular communication, cell fate, cell polarity, boundary formation, and morphogenesis. Although previous studies have shown E-cadherin expression during rodent or human odontogenesis, there is no equivalent study available on N-cadherin expression in dental tissues. Here we examined and compared the expression patterns of E- and N-cadherins in both embryonic and adult (healthy, injured, carious) human teeth. Both proteins were expressed in the developing teeth during the cap and bell stages. E-cadherin expression in dental epithelium followed an apical-coronal gradient that was opposite to that observed for N-cadherin. E-cadherin was distributed in proliferating cells of the inner and outer enamel epithelia but not in differentiated cells such as ameloblasts, whereas N-cadherin expression was up-regulated in differentiated epithelial cells. By contrast to E-cadherin, N-cadherin was also expressed in mesenchymal cells that differentiate into odontoblasts and produce the hard tissue matrix of dentin. Although N-cadherin was not detected in permanent intact teeth, it was re-expressed during dentin repair processes in odontoblasts surrounding carious or traumatic sites. Similarly, N-cadherin re-expression was seen in vitro, in cultured primary pulp cells that differentiate into odontoblast-like cells. Taken together these results suggest that E- and N-cadherins may play a role during human tooth development and, moreover, indicate that N-cadherin is important for odontoblast function in normal development and under pathological conditions.

Adolescent↗