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PubMed1988

Difficulties with tooth protectors in endotracheal intubation.

The suitability of three tooth protectors for routine use during endotracheal intubation was studied in 300 consecutive patients undergoing elective operations under general anaesthesia. The main disadvantages of the protectors were lack of space and the consequent difficulty of guiding the endotracheal tube into the larynx, and poor visibility, especially when the Camo protector was used. These difficulties could be avoided in most cases by cutting off the right angle of the Camo protector. The less experienced anaesthesiologists especially had difficulties with the protectors: 20% of patients in the Camo group were considered impossible to intubate unless the protector was removed. The silicone inlay of the Camo protector melts and becomes adhesive at body temperature, which makes its prolonged use hazardous. Two patients lost a maxillary incisor despite the proper use of a protector (Denex). Thus the use of a tooth protector alone does not guarantee avoidance of dental trauma. Better results could be obtained by improving the design of the protectors and by careful pre-anaesthetic dental examination.

Adult↗
PubMed2005

Effect of augmented visual feedback from a virtual reality simulation system on manual dexterity training.

Little research has been published about the impact of simulation technology on the learning process of novel motor skills. Especially the role of augmented feedback (FB) on the quality of performance and the transfer of the acquired behaviour to a no-augmented FB condition require further investigation. Therefore, novice dental students were randomly assigned to one of three groups and given the task of drilling a geometrical class 1 cavity. The FB group trained under augmented visual FB conditions, provided by the virtual reality (VR) system (DentSim). The no-FB group practised under normal vision conditions, in the absence of augmented FB. A control group performed the test sessions without participating in any training programme. All preparations were evaluated by the VR grading system according to four traditional (outline shape, floor depth, floor smoothness and wall inclination), and two critical, criteria (pulp exposure and damage to adjacent teeth). Performance analyses revealed an overall trend towards significant improvement with training for the experimental groups. The FB group obtained the highest scores. It scored better for floor depth (P < 0.001), whilst the no-FB group was best for floor smoothness (P < 0.005). However, at the retention tests, the FB group demonstrated inferior performance in comparison with the no-FB group. The transfer test on a traditional unit revealed no significant differences between the training groups. Consequently, drilling experience on a VR system under the condition of frequently provided FB and lack of any tutorial input was considered to be not beneficial to learning. The present data are discussed in view of the guidance hypothesis of FB, which refers to the apprentice's dependence on FB.

Adolescent↗
PubMed1997

Absence of adult dental anomalies in familial hypophosphatasia.

This paper is a supplemental report on 3 previous publications about a family in which 3 male children manifested gingival recession, alveolar bone resorption and premature exfoliation of their deciduous teeth without apical root resorption and without clinical signs of inflammation. Laboratory blood and urine studies in conjunction with an analysis of periodontal microflora and family pedigrees established a diagnosis of hypophosphatasia in these 3 children, as well as their father, the paternal grandmother and paternal great-uncle. Clinical data also revealed that a son of the paternal great-uncle and his daughter were similarly affected. The family pedigree is consistent with an autosomal dominant mode of transmission. The 3 brothers are now between the ages of 18 and 22 yr and all have complete permanent dentitions. Aside from some periodontal manifestations of prior dentoalveolar trauma, most of the findings of the periodontal assessment are within normal limits. All 3 exhibit moderate to severe caries and some degree of gingival inflammation, but minimal periodontal pathosis.

Adolescent↗
PubMed2004

The association between incisor trauma and occlusal characteristics in individuals 8-50 years of age.

To explore the association between incisal trauma and occlusal characteristics using oral examination and health interview data from the Third National Health and Nutrition Examination Survey 1988-1994 (NHANES III). Incisal trauma examinations were performed on 15 364 individuals 6-50 years of age using an ordinal scale developed by the National Institute of Dental and Craniofacial Research. Occlusal examinations were performed on 13 057 individuals 8-50 years of age. We fitted separate multivariate logistic regression models for maxillary and mandibular incisor trauma adjusting for socio-demographic variables (age, gender, race-ethnicity) and occlusal characteristics (overbite, overjet, open bite). 23.45% of all individuals evidenced trauma on at least one incisor, with trauma more than four times more prevalent on maxillary (22.59%) than on mandibular incisors (4.78%). Males (OR = 1.67) had greater odds of trauma than females; Whites (OR = 1.37) and non-Hispanic Blacks (OR = 1.37) had greater odds of trauma than Mexican-Americans. The odds of trauma increased with age, peaked from age 21 to 30 (OR = 2.92), and declined. As overjet increased, so did the odds of trauma. Compared to individuals with < or =0-mm overjet, odds of trauma increased from 1-3 mm (OR = 1.42) to 4-6 mm (OR = 2.42) to 7-8 mm (OR = 3.24) to >8 mm (OR = 12.47). Trauma to incisors is prevalent but mostly limited to enamel. Trauma to maxillary incisors is associated with overjet, gender, race-ethnicity, and age, while trauma to mandibular incisors is associated with gender, age, and overbite.

Adolescent↗
PubMed1989

Etched metal prostheses to retain severely traumatized teeth in function.

Acid-etch retained appliances of the Rochette and Maryland designs have proved valuable for the replacement of permanent anterior teeth in adolescents and adults. This article describes 2 patients for whom traumatized teeth of poor or "hopeless" prognosis were retained by splinting them to their neighbours with a Maryland-type etched cast framework. Appearance and function have been maintained over several years, while the need for extraction and the provision of a conventional fixed prosthesis has been delayed or avoided.

Acid Etching, Dental↗
PubMed1991

Endodontology--epidemiologic considerations.

The limited information available from endodontic epidemiologic research indicates an increase in prevalence of apical periodontitis with increasing age. Furthermore, apical periodontitis seems mainly to be present in connection with already endodontically treated teeth. This finding should be of particular concern since there is a discrepancy between the quality and results of endodontic therapy performed in general practice compared with the results obtained in specialty clinics. Pulpitis and acute apical periodontitis are main reasons for seeking emergency treatment and affect many people. Dental trauma frequently involving the dentin/pulp organ are likewise prevalent, affecting 30% of children and adolescents. Most information available regarding endodontic treatment is derived from well-controlled clinical studies performed by specialists. Epidemiologic data should be considered a necessary complement to this source of knowledge regarding etiologic factors and proper treatment procedures in order to improve the results of endodontic practice.

Dental Pulp Necrosis↗
PubMed1993

Repair of untreated root fracture: a case report.

A case is presented in which an untreated root fracture in a maxillary central incisor of an adult male was found radiographically 10 years after injury. The tooth was removed and the area of the root corresponding to the fracture line was examined by SEM while the remaining tooth was processed for decalcified sections. Calcification of the coronal pulp associated with extensive tissue atrophy and normal pulp tissue apically was observed. Two barriers composed of dentinal and cemental hard tissue were present apically in the coronal fragment and in the fracture line.

Adult↗
PubMed1995

Treatment of extraoral sinus tracts from traumatized teeth with apical periodontitis.

When a draining lesion is encountered on the skin of the face, an endodontic origin should always be considered in differential diagnosis. Non-surgical endodontic therapy, sometimes complimented by surgery, or extraction are the choices for the treatment of these cases. Three cases of extraoral sinus tract on the chin caused by necrotic pulp of traumatized lower anterior teeth are presented. A paste consisting of calcium hydroxide and barium sulfate powder mixed with glycerin was used. Usage of calcium hydroxide paste was advocated for rapid and successful treatment of extraoral lesions communicating with necrotic teeth.

Adult↗
PubMed1997

Tooth discoloration by blood: an in vitro histochemical study.

An in vitro model, using a modification of a technique devised by Freccia & Peters, was developed to investigate tooth staining following pulpal haemorrhage. Samples of whole blood, erythrocytes, plasma and platelet concentrate and saline were individually placed in the pulp chambers of groups of five teeth and centrifuged twice daily for 25 min over a period of 3 consecutive days. This confirmed that the blood pigment responsible for the staining was found only in those samples containing erythrocytes. Teeth stained with packed red cells were then prepared for histological examination and subjected to four histochemical tests: (1) benzidine, (2) zinc leuco, (3) Perl's and (4) Turnbull Blue to analyse some of the biochemical changes following haemorrhage into the pulp chamber. These tests showed that, following haemolysis of erythrocytes within dentine, haemoglobin was found either intact or as one of the haematin molecules with no further breakdown of the haem structure and no evidence of any free ferric ions or haemosiderin.

Adolescent↗
PubMed1999

Patient and parental awareness of the importance of immediate management of traumatised teeth.

The purpose of this study was to assess patient and parental awareness of the importance of immediate management of traumatised teeth. A three-part questionnaire comprising questions on demographic data, attitude and knowledge was distributed to patients or accompanying parents who presented to the principal author for treatment in an 8-week period. One hundred and fifty-seven respondents with a mean age of 31.1 years participated in the study. Only 30% of the respondents recalled having had previous experience of dental trauma. The majority of the respondents, especially those with a higher educational background, had a positive attitude, expressing enthusiasm for public education on emergency management of dental trauma (85%). The availability of an emergency service during office hours was known by 71% of the respondents while only 26% were aware of the after-office-hour emergency service. Participants generally had a better concept of management of avulsed teeth (63%) compared to that of fractured teeth (35%). Knowledge on some critical aspects of the handling of avulsed teeth was poor (6%). Using multiple logistic regression analysis, it was found that the respondents' attitude tended to be influenced by their educational background (P = 0.08). In addition, subjects with higher education were more knowledgeable regarding the emergency service available during office hours (P = 0.05) and the concept of management of fractured teeth (P = 0.02). Educational background appeared to influence the level of awareness of the importance of immediate management of traumatised teeth.

Adolescent↗
PubMed1999

Silent trauma.

Patients who present with discolored and/or symptomatic anterior teeth for which there are no obvious etiologic factors should be carefully questioned regarding their past surgical history. If the patient denies a history of trauma yet relates a recent, (2-5 years) history of undergoing general anesthesia, a differential diagnosis including trauma secondary to endotracheal intubation should be considered.

Anesthesia, Dental↗
PubMed2005

Humoral immune response of patients with dental trauma and consequent replacement resorption.

Replacement dental resorption may be a consequence of trauma and may cause dental transplants or reimplants to fail. Previously, we demonstrated the participation of the immunopathological response in inflammatory dental resorption. The induction mechanisms of the two types of dental resorption are well known to be different. The aim of the present study was to observe the immune response of patients who suffered dental trauma with subsequent replacement dental resorption. Four patients with replacement radicular resorption and four healthy individuals with no evidence of radicular resorption participated in the study. The results of ELISA demonstrated that serum from patients with replacement dental resorption contained larger amounts of IgG and smaller amounts of IgM anti-total human-dentin extract and anti-fractions of extract than did serum from control individuals. These results signal the hypothesis that dentin is immunogenic and the serological profile of patients with replacement dental resorption may be identified through biochemical analysis of their blood. Precise screening by this method may allow early diagnosis of dental resorption before it becomes visible radiographically.

Adolescent↗