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Effects of salmon calcitonin on growth of teeth and on extraction socket healing in young rats.

The influence of salmon calcitonin on the growth of teeth and alveolar bone, and on the healing of alveolar sockets has been studied in young male rats. The experimental animals received daily injections of salmon calcitonin 0.5 MRC-U/kg body weight, whereas the control group received the vehicle. The rats were sacrificed at 14 and 28 days after the tooth extractions. Salmon calcitonin had no effect on the dry weight, calcium concentration and mineralization of the maxillary molars and the alveolar bone. Neither were there any significant effects of the hormone on the healing alveolar sockets. All sockets were healed after 4 weeks. The mineralization rate of molar teeth was only a quarter of that of tibiae, which was used as a reference.

Alveolar Process↗

[Craniofacial morphogenesis after unilateral extraction experiments on rabbits].

BACKGROUND: Many authors have observed that reduction of the posterior vertical dimension after the loss of teeth during cranio-facial growth can lead to alterations not only of occlusion but also of cranio-facial skull structure. The alteration differs according to whether the absence of teeth is mono- or bilateral. In this paper, the authors present the skeletal alterations after monolateral tooth loss. METHODS: An experiment was performed on 25 rabbits, all having undergone monolateral tooth extraction. The experiment followed two rules of procedure: in a group of rabbits we extrasted the upper teeth only (experiment A), in another group of rabbits the extractions were performed both in the upper and in the lower jaw (experiment B), the third group of rabbits was used as a control group. At regular intervals, the authors examined skeletal alterations by means of Engstrom's cephalometric analysis (the asymmetries, the vertical posterior dimension). RESULTS: It was thus possible to observe some alterations of the cranio-facial bones and to compare the data with those of the control group.

Animals↗

Dental lesions causing abnormalities on skeletal scintigraphy.

The dental lesions of periodontitis, periodontal cysts, and tooth extraction were studied by Tc-99m phosphate scintigraphy of the jaws. Inflamed apical periodontal lesions caused a localized area of increased concentration of radiotracer regardless of the presence or absence of symptoms. Scintigrams may be positive up to eight months after dental extractions but tend to return to normal thereafter unless complications arise.

Diagnosis, Differential↗

Primary trigeminal neuralgia (algophoric deafferentation hypersensitivity syndrome).

In the article the author presents his theory of the pathogenesis of primary trigeminal neuralgia, explaining the occurrence of this mysterious disease by algophoric deafferentation hypersensitivity. Tooth extraction is the sole cause of algophoric deafferentation hypersensitivity, which, culminating in epileptiform discharges of the trigeminal nociceptive pathway neurons, leads to clinical features of characteristic neuralgic paroxysms. Trigger mechanism is explained by ephaptic transmission between the broken fibers for phasic pain of the tooth pulp and neighbouring fibers of epicritic and proprioceptive sensitivity. The typical occurrence of periods with remission of neuralgic paroxysms the author explains by his original theory of biorhythms neogenesis with the involvement of two antagonistic neural subsystems (nociceptive and antinociceptive system). The concept is based on indisputable clinical, anatomical, pathoanatomical, experimental and pharmacologic facts, which the author quotes as the contribution to his theory.

Animals↗

Extraction of teeth over 5 years in regularly attending adults.

OBJECTIVES: This prospective study was conducted to describe the incidence of tooth extraction in a group of regularly attending adults and to assess factors that are predictive of tooth loss. METHODS: Baseline and annual incremental clinical data were obtained from 23 general dental practitioners on a group of their regularly attending, dentate adult patients over a 5-year period. The patients completed a postal questionnaire with questions relating to dental health behaviours, attitudes and knowledge, and social factors. RESULTS: Complete clinical data were obtained from 2799 patients. Four hundred and seventy (17%) patients underwent extractions, 72% of which were posterior teeth. The majority of extractions were for reasons other than caries (79%). Bivariate analyses revealed many significant differences between patients who underwent extractions and those who did not, with respect to the clinical, social, behavioural and attitudinal variables. The logistic regression model for tooth loss included three clinical variables, number of teeth, crowns and sites with recession. Other variables in the final model included the dentist's and patient's prediction of treatment need, having sensitive teeth, having a sweet tooth, living alone and smoking. The sensitivity for the model was 0.57 with specificity 0.72. CONCLUSIONS: This study is unique in its examination of patients and has highlighted that both clinical and other factors are important in predicting who will undergo extractions. Future investigations should assess the consequence of having extractions in terms of health benefit or detriment.

Adult↗

Five-year-old children: changes in their decay experience and dental health related behaviours over four years.

At the time of the 1989-90 survey of 5-year-old children, co-ordinated by the British Association for the Study of Community Dentistry, a questionnaire about dental health behaviour was sent home to 2,390 parents in Salford and 2,098 in Trafford. The response rates were 78 per cent and 81 per cent respectively. The questionnaire was repeated for the 5-year-old survey in 1993-94 with the aim of finding out if there had been any changes: 2,794 parents were contacted in Salford and 2,343 in Trafford. The response rates were 75 per cent and 73 per cent. The percentage of children who were having their teeth brushed before they were aged one and who had visited a dentist by their second birthday rose in both districts. Campaigns at regional and district levels are thought to have influenced these improvements. The percentage of children who had experienced toothache and the proportion who had received a general anaesthetic for tooth extraction were similar in both years.

Beverages↗

Changes in arch width. A 20-year longitudinal study of orthodontic treatment.

The changes in the dental arch dimensions that occur as a result of growth and treatment are of interest to the orthodontist and require careful consideration during treatment planning. A greater understanding of these changes could influence the patient's expectations from treatment as well as the formulation of the treatment and retention plans by the clinician. A retrospective study of the maxillary and mandibular canine and molar arch width changes in 60 patients over 20 years was carried out. Approximately half were treated orthodontically, and measurements were made on dental casts taken at four time points during the study: 1981, 1985, 1989, and 2001. Between baseline and final follow-up, the treated group demonstrated a statistically significant increase in maxillary intercanine arch width and statistically significant decreases in maxillary intermolar and mandibular intercanine and intermolar widths. No significant changes were observed for the untreated group. When comparing the orthodontically treated group with the untreated group, there was a significantly greater increase in maxillary intercanine width and a significantly greater reduction in mandibular intercanine width in the treated group over the duration of the study. No significant difference was observed between treated and untreated groups for maxillary and mandibular intermolar width changes. Sex had no statistically significant effect on these treatment differences. Type of orthodontic treatment had no effect on arch width changes within the treated group; however, the effect of tooth extraction needs further investigation.

Adolescent↗

Radicular cyst of the premaxilla in a dog.

A 13-year-old, male/neutered Border Collie dog was diagnosed with a radicular cyst of the left premaxilla. Tooth extraction and curettage of the lesion resulted in a positive clinical outcome 6-months following treatment.

Animals↗

[The use of vasoconstrictor agents in low concentration as additives to local anesthetics in ambulatory maxillofacial interventions].

The authors studied in several test series the suitability of adrenaline and noradrenaline as vasoconstrictor additives to 2% Xylocitin, in a concentration of 1:100,000. At this concentration, noradrenaline proved well suited in tooth extractions. The vasoconstrictor effect of adrenaline is sufficient in all maxillofacial interventions on an outpatient basis.

Anesthesia, Dental↗

[Dental extractions in patients taking anticoagulants: is alteration of the anticoagulant regime necessary?].

A major concern in the management of patients under anticoagulants is the potential for excessive bleeding after dental procedures. Recommendations for the administration of oral anticoagulants in conjunction with oral surgery range from complete withdrawal of anticoagulants to the maintenance of an unchanged therapy. Rising evidences show that the alteration of anticoagulation is not necessary for patients with INR of 4 or less previous to tooth extractions. Topical antifibrinolytics as tranexamic acid control successfully alveolar bleeding. It is time to stop interrupting anticoagulant therapy for oral surgery. A theoretical risk of hemorrhage after dental surgery in patients at therapeutic levels of anticoagulation exists but it is minimal and is greatly overweighed by the risk of thromboembolism after alteration of the anticoagulant therapy.

Anticoagulants↗

An in vitro study of the distribution of silver and fluoride following application of 40 per cent silver fluoride solution to dentine.

An in vitro test system involving application of 40 per cent silver fluoride solution to prepared cavities of moderate depth in extracted teeth failed to demonstrate the passage of significant amounts of fluoride into the dental pulp, despite a very high concentration of fluoride (100,000 ppm) in the applied solution. The test system used may not be conducive to quantitative investigation of ionic transfer because of disruptions to pulp circulation and fluid flow through dentine following tooth extraction. For this reason, the results are inconclusive as to whether or not application of 40 per cent silver fluoride as a cavity varnish of liner and its use in the 'atraumatic' technique for treating deep caries, can be considered safe clinical procedures.

Adolescent↗

Calculus-like deposit on the apical external root surface of teeth with post-treatment apical periodontitis: report of two cases.

AIM: To report two cases in which calculus-like material was found on external root surfaces of (i) an extracted root and (ii) an apicected part of a root, both of which were removed due to post-treatment refractory apical periodontitis. SUMMARY: In each case, there was a fistulous tract, which did not heal after conventional root canal treatment. The first case did not heal even after apical surgery, and subsequent tooth extraction revealed calculus-like material on a root surface of complex anatomy. The second case showed radiographic signs of healing after apicectomy. Histology of the apical biopsy revealed a calculus-like material on the external surface of the root apex. It is suggested that the presence of calculus on the root surfaces of teeth with periapical lesions may contribute towards the aetiology of failure. KEY LEARNING POINTS: Biofilm on the external root surface has been implicated in the failure of apical periodontitis to heal, despite adequate root canal treatment. Calculus-like material was found, in two cases, on the root surface of teeth with post-treatment apical periodontitis, where the only communication externally was a sinus tract.

Adult↗

Delayed immediate implants: alveolar bone changes during the healing period.

Delaying the placement of immediate fixtures by 6-8 weeks after extraction of the natural dentition allows for the elimination of associated infective processes, the achievement of maximum osteoblastic activity that theoretically could help the osseointegration process and complete wound covering that simplifies the placement of grafts or membranes. This study examines the healing associated with 21 fixtures in 14 patients. The fixtures were placed into sockets 6-8 weeks after tooth extraction without the use of barrier membranes or bone substitutes. Measurements were taken immediately prior to fixture placement and 3-6 months later at the abutment placement. Alveolar bone height, the remaining socket depth and diameter and the depth to which a 3.75 mm fixture could be inserted into the socket were measured. After fixture placement the vertical and horizontal measurements from the cover screw to the surrounding alveolar bone and the distance from the cover screw to the CEJ of the adjacent tooth were recorded. All fixtures were integrated at exposure with 1 failure during the follow-up period. The distance from the cover screw to the buccal plate decreased by a mean of 2.17 mm. There was an increase in the mean vertical bone height at all 4 surfaces. When horizontal defects were present, the mean vertical distance decreased from 2.5 +/- 0.37 mm to 0.36 +/- 0.64 mm. When horizontal defects were absent, the mean vertical distance decreased from 3.86 +/- 0.58 mm to 0.48 +/- 0.25 mm. There was also a marked decrease in the horizontal distance between the bone margin and the surface of the fixture from 1.6 +/- 1.73 mm to 0.02 +/- 0.02 mm. These results indicate a strong tendency for the defects to fill-in the horizontal plane and for bone growth to occur in the vertical plane to the height of the cover screw. In conclusion the delayed immediate placement of fixtures has a good short-term prognosis with bone regeneration occurring around the defect without the use of barrier membranes or bone substitutes.

Adolescent↗

Osteocavitation lesions (Ratner bone cavities): frequently misdiagnosed as trigeminal neuralgia--a case report.

The disorder termed osteocavitation lesion has been described in the literature since at least 1976. This disorder has often been misdiagnosed as trigeminal neuralgia or atypical facial pain, and, unfortunately, patients have either continued to suffer or inappropriate treatment or treatments have been prescribed in an attempt to rid the patient of this terrible pain disorder. These symptoms, which can be misinterpreted as trigeminal neuralgia, include a history of undiagnosed facial pain, a history of tooth extraction, the presence of trigger areas and normal radiographic findings. A confirmed diagnosis of osteocavitation lesion can be treated only with surgery.

Aged↗

[Comparative histological study of two methods of obtaining alveolar sections in rats].

The chronology of the wound healing process following tooth extraction was studied by means of two kinds of histological cuts. Two groups of 42 albino rats were employed. In the first one, the sockets were cut in a transversal way. In the second one the cuts were performed in a longitudinal way. The rats were sacrificed after 3, 6, 9, 15, 21, 24, and 28 days following the surgeries. After laboratorial outline the obtained pieces were stained by hematoxylin and eosin for histological purposes. It way be concluded that: 1. The results got from longitudinal cuts were in agreement to those described by other authors; 2. The transversal cuts allow us to detect intensive resorption of the lateral alveolar wall at the cervical thirs; 3. On the 21st day following dental extraction the incisor socket of the rat shows a great deal of areas not ossified; 4. The healing process of dental extraction wounds of the upper incisor of the rat is completed between 24 and 28 post operative days.

Alveolar Bone Loss↗

[Idiopathic gingival fibromatosis: a case report].

A rare case of large idiopathic gingival fibromatosis of right maxilla and mandible with extensive osseous destruction is presented. Following examination and definitive diagnosis the patient was treated by gingivectomy and tooth extraction. A denture was substituted at a subsequent time. The patient has been followed for a period of 1 year with satisfactory results.

Adult↗

Incidence and suggested surgical management of septa in sinus-lift procedures.

A variable number of septa, also referred to as Underwood's septa, divide the floor of the maxillary sinus into several recesses and may thus cause various complications during sinus-lift procedures. The incidence of Underwood's septa was evaluated by examining 41 edentulous maxillas. In 13 of these maxillas (31.7% of the cases), sinus floors with at least one septum were observed. Most of the septa were located in the region between the second premolar and the first molar. A possible cause of septal formation could be the variable phases of maxillary sinus pneumatization of the empty alveolar process following tooth extraction.

Adult↗

Bone tissue reaction around implants placed in a compromised jaw.

The present experiment was carried out to examine bone tissue alterations that occurred around implants at which the marginal level of bone support at fixture installation was different at buccal and lingual surfaces. 8 beagle dogs were randomly divided into one test group and one control group. The mandibular premolars in the left side of the mandible (P1, P2, P3, P4) were extracted. In the 4 dogs of the test group, the buccal bone plate in the mandibular premolar region was removed to establish a bone defect that was about 25 mm long, about 5-6 mm high, and about 4 mm wide. In the 4 dogs of the control group, no bone resection was performed. 8 months after tooth extraction, 3 fixtures (Astra Tech AB, Mölndal, Sweden:TiO-blast: 8x3.5 mm) were installed in each dog. In the 4 dogs of the test group, the implants were positioned in the defect sites in such a way that (i) mechanical stability was achieved and (ii) their lingual surfaces were entirely invested in bone. At the buccal and approximal surfaces of the fixtures, however, the unthreaded portion (2 mm) and the 3 marginal threads remained exposed. In the control group, all implants were following installation entirely surrounded by bone tissue. After a healing period of 3 months, abutment connection was performed and a plaque control program initiated. 4 months later, the dogs were sacrificed. The mandibles were removed and placed in a fixative. Each implant region was dissected, the tissue samples were dehydrated, embedded, sectioned in a bucco-lingual plane and used for light microscopic examination. The findings demonstrated that osseointegration occurred at implants, placed in a chronic defect with large discrepancies between the buccal and lingual bone. During the process of healing and function, however, marked modeling and remodeling of the bone tissue took place. Thus, at the buccal surface, some bone regrowth and osseointegration occurred while at the lingual wall, there was a substantial resorption of the marginal bone and an enhanced number of bone multicellular units. Concomitant with the bone tissue alterations described, there was some recession of the peri-implant mucosa.

Animals↗