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PubMed1989

[DMF study on extracted deciduous teeth].

The aim of the present investigation was to study the number of the carious surfaces of extracted primary teeth in order to determine component m in the dmf-s index. Altogether 903 deciduous teeth were examined under artificial light with a dental probe. The surfaces were evaluated separately. The examined teeth were divided into two groups according to the amount of root resorption. On the basis of the present study the following conclusion can be drawn: 1. The average of df surfaces of molars was 2.34, whereas it was 0.74 at the front teeth. The df number shows practically only caries, because filled surfaces were found in only 1.99% of the cases. 2. In any type of the teeth df lesions were the rarest on the vestibular and oral surfaces. 3. Caries (filling) was found most frequently on the occlusal surfaces of the upper and lower 1st molars. Caries (filling was the rarest on the vestibular surfaces of the upper 1st and 2nd molars. 4. The amount of root resorption did not show much influence on the df score. 5. During the calculation of the dmf-s average of the primary teeth the m value can be substituted for 2.0.

Child↗
PubMed1990

Cross-sectional study of patients fitted with fixed partial dentures with special reference to the caries situation.

The caries situation among 30 patients with fixed partial dentures was examined 3 yr after cementation of the constructions. The fit of the crowns on the abutment teeth, the size of the interproximal areas and the relation between the crown margin and the gingival margin were registered. Risk factors for caries development, such as salivary factors, microbiologic factors, oral hygiene and diet were evaluated for each patient. During the 3-yr period 54 caries lesions occurred in 25 patients. Eleven lesions were found on abutment teeth. Two were located on the root surfaces unconnected with the crown margin (greater than 2mm from the gingival margin), three were recurrent lesions, where the crown margin was located above the gingival margin but closer than 2 mm and six were recurrent lesions where the crown margin was located under the gingival margin. No single caries risk factor seemed to be so closely correlated to the number of caries lesions developed that it could be used alone to select of patients at risk. When the sum of the assumed negative factors was used, more caries was found among the patients with three or more factors with negative values in the group as a whole. However, predicting the development of caries in an individual case with a high degree of probability seems to be complicated. Generally speaking there was no indication that caries disease development was caused by the presence of the fixed partial denture per se.

Adult↗
PubMed1993

Critique of Kingman's methods of projecting long-term relative efficacy of products exhibiting small short-term efficacy.

This paper critically reviews Kingman's "methods of projecting long-term relative efficacy of products exhibiting small short-term efficacy," a report he prepared for a scientific workshop on the relative anticaries efficacy of fluoride dentifrices, which reveals serious deficiencies. Of the three specific models that Kingman suggests, the compound growth model (CGM), which leads to the largest projected future percentage reductions, is based on a false premise of an increasing universe of caries-free surfaces available for caries-attack with the passage of time. The second suggested model, the demineralization square root model (DSR), is supported only by a personal communication, unavailable for scrutiny. The third suggested model, a stabilization model (STA) is plausible, but unsupported. Other plausible models for extrapolating short-term observed effects are ignored by Kingman. Most of Kingman's choices of data illustrations to fit his suggested models are ill-chosen because the studies were repeated cross-sectional surveys or involved the delivery of systemically and topically delivered fluorides, which contraindicate their use. The most serious breach is Kingman's selective use of subsets of data from two long-term studies of fluoride dentifrices that support his premise, when other, more comprehensive data from the same studies do not. He also ignores findings from other studies that fail to support his suggested models. Kingman's report fails to prove that studies which show small short-term effectiveness after 1, 2 or 3 years will lead to greater relative effectiveness after long periods of use.

Cariostatic Agents↗
PubMed2006

Maturogenesis of a cariously exposed immature permanent tooth using MTA for direct pulp capping: a case report.

Successful direct pulp capping of cariously exposed permanent teeth with reversible pulpitis and incomplete apex formation can prevent the need for root canal treatment. A case report is presented which demonstrates the use of mineral trioxide aggregate (MTA) as a direct pulp capping material for the purpose of continued maturogenesis of the root. Clinical and radiographic follow-up demonstrated a vital pulp and physiologic root development in comparison with the contralateral tooth. MTA can be considered as an effective material for vital pulp therapy, with the goal of maturogenesis.

Aluminum Compounds↗
PubMed2004

The continuum of dental caries--evidence for a dynamic disease process.

The eventual outcome of dental caries is determined by the dynamic balance between pathological factors that lead to demineralization and protective factors that lead to remineralization. Pathological factors include acidogenic bacteria, inhibition of salivary function, and frequency of ingestion of fermentable carbohydrates. Protective factors include salivary flow, numerous salivary components, antibacterials (both natural and applied), fluoride from extrinsic sources, and selected dietary components. Intervention in the caries process can occur at any stage, either naturally or by the insertion of some procedure or treatment. Dental caries covers the continuum from the first atomic level of demineralization, through the initial enamel or root lesion, through dentinal involvement, to eventual cavitation. The dynamic balance between demineralization and remineralization determines the end result. The disease is reversible, if detected early enough. Since demineralization can be quantified at early stages, before frank cavitation, intervention methods can be tested by short-term clinical trials.

Cariostatic Agents↗
PubMed1999

Clinical, radiologic, and histopathologic features of invasive cervical resorption.

Invasive cervical resorption is a relatively uncommon form of external root resorption. There may be no external signs, and the resorptive condition is often detected by routine radiographic examination. Where the lesion is visible, the clinical features vary from a small defect at the gingival margin to a pink coronal discoloration of the tooth crown resulting in ultimate cavitation of the overlying enamel. The condition is usually painless unless pulpal or periodontal infection supervenes. Radiographic features of lesions vary from well-delineated to irregularly bordered mottled radiolucencies, and these can be confused with dental caries. A characteristic radiopaque line generally separates the image of the lesion from that of the root canal, because the pulp remains protected by a thin layer of predentin until late in the process. Histopathologically, the lesions contain fibrovascular tissue with resorbing classic cells adjacent to the dentin surface. More advanced lesions display fibro-osseous characteristics with deposition of ectopic bonelike calcifications both within the resorbing tissue and directly on the dentin surface. Secondary invasion of microorganisms into the pulp or periodontal ligament space will elicit a normal inflammatory response.

Adolescent↗
PubMed1988

In vivo progress of enamel and root surface lesions under plaque as a function of time.

This paper deals with enamel and root surface demineralization under plaque in vivo as a function of time. The enamel was demineralized using the Ogaard method in which preformed orthodontic bands are attached to the premolars in situ for 4, 6, and 8 weeks; a niche in the bands is responsible for plaque accumulation. In a second experiment cement-covered root surfaces (and enamel) were mounted on a removable appliance (Hawley retainer). Also in this case an orthodontic band was placed over the samples to create a space for plaque accumulation of about 0.8 mm between sample and band. All samples were analyzed by means of microradiography. The results show that (1) demineralization of enamel with the Ogaard method and using the Hawley retainer gives values for lesion depth and mineral loss that are statistically not significantly different; (2) lesion progress and mineral loss in vivo is about 2.5 times faster in roots than in enamel; (3) the demineralization in enamel is roughly linear with time, and (4) roots demineralize in vivo very fast during the 1st week and much more slowly there after.

Dental Caries↗
PubMed1978

Therapeutic pulpotomies in primary molars with the formocresol technique. A clinical and histological follow-up.

The results of therapeutic pulpotomies in primary molars with formocresol technique were studied by systematic follow-up. Of 84 primary lower molars in the clinical study, 56 became available for histological examination. The radiographic follow-up revealed periradicular osteitis in 10 per cent of the teeth treated. Internal root resorption was seen in 37 per cent of the teeth, or one-fifth of the roots treated. The histological examination revealed a very capricious diffusion of the medicament throughout the pulp tissue. Vital pulp remnants in the apical part of the treated roots showed no signs of healing. All pulps presented a varying number of inflammatory cells in the border zone adjacent to the formocresol-fixed region. In 80 per cent of the roots the histological sections revealed signs signs of internal resorption with or without incomplete repair tissue formation.

Child↗
PubMed1977

Aging of tissues of the roots of nonfunctional human teeth (impacted canines).

In order to examine the aging of dentin and cementum, seventy-two impacted human canines, nonfunctional and not affected by external factors, such as attrition, abrasion, caries, etc., were surgically extracted. Ground sections were prepared and the areas of sclerotic dentin and cementum were measured with the aid of a planimeter and expressed as a percentage of the total root area. It was found that there is a significant increase in sclerotic dentin and apposition of cementum with an increase in age.

Aging↗
PubMed1984

Garre's osteomyelitis of the mandible resolved by endodontic treatment.

A case of Garre's osteomyelitis of the mandible is presented. The occlusal radiographs are good examples of the redundant cortical layering of the bone (onion skinning) that is classically found with this phenomenon. The cause of this case was a necrotic pulp in a carious molar with a periapical radiolucent area. We believe this is the first reported case in which an odontogenic source of infection (carious tooth) was treated not by extraction but by endodontic therapy. During the year after the root canal filling, the periapical radiolucent area filled in with new bone and the bony expansion of the mandible was completely resolved.

Child↗
PubMed1990

Release of organic matrix components from bovine incisor roots during in vitro lesion formation.

The solubilization of organic matrix components during demineralization of powdered and intact root sections from adult bovine incisors was investigated. Root powder was demineralized with 0.1 mol/L acetic acid, pH 4.0, at 4 degrees C and 37 degrees C. Surfaces of intact root sections were subjected to 0.1 mol/L acetic acid, pH 4.0 (for production of erosive lesions), or to 0.1 mol/L lactic acid, 0.2 mmol/L methane hydroxy diphosphonate, pH 5.0 (for production of subsurface lesions at 37 degrees C). The solubilized organic material was analyzed for collagen, total noncollagenous protein (NCP), organic phosphate (Po), and proteoglycans (PGs), which were measured as chondroitin 4-sulfate (C-4-S). For root powder, a maximal release of NCPs and PGs was found only after neutralization of the extraction mixture. For both temperatures tested, the average amounts of liberated noncollagenous components (NCCs) were the same, i.e., 0.68 micrograms [NCP - Po], 0.11 microns Po, and 0.10 micrograms C-4-S per mumols released calcium. The amino acid composition of the NCP fraction revealed relatively high amounts of aspartic acid and serine. These findings indicate that the NCCs were easily liberated from the tissue, and that the NCP fraction consisted mainly of phosphoprotein. Demineralization of intact root sections resulted in average amounts of solubilized NCCs of 0.21 micrograms [NCP - Po], less than 0.01 micrograms Po, and less than 0.01 micrograms C-4-S per mumols released calcium, independent of incubation time and lesion type. The amino acid composition of all NCP fractions was virtually the same, high in glutamic acid, but lower in aspartic acid and serine when compared with the neutralized powder extracts. For both demineralization solutions, the amounts of solubilized collagen were 0.07 and 0.16 micrograms per micromol released calcium after three and 28 days of incubation, respectively. Our experiments indicate that phosphoprotein and proteoglycans may be released from root surfaces during the periods of neutral pH that follow acid demineralization.

Amino Acids↗
PubMed2004

Oral health status and oral treatment needs of dependent elderly people in Christchurch.

AIM: To describe the general health, oral health status, and treatment needs of dependent older people living in Christchurch rest homes. METHODS: 210 Grade 3 residents from seven randomly selected care facilities were examined for: dental/denture status, caries, periodontal disease, and oral cleanliness. RESULTS: Age ranged from 65 to 103 with an average age of 84.6 years. The female-to-male ratio was 3:1. Thirty-two percent of residents were dentate (average 14 teeth). This figure was up from 16-19% one decade ago (p<0.01; chi-squared test). Sixty-five percent of dentate residents had caries. Each dentate person had an average of 2.38 teeth with carious lesions in the root or crown. 51.5% of residents required restorative treatment and 38.2% required an extraction. Twenty residents had at least one 'carious stump'. Eighty-two percent of residents required scaling of the teeth. Two thirds had no natural teeth, and one third of those with dentures required treatment. Eighty-nine residents (42%) were unable to communicate about past dental behaviours. CONCLUSIONS: These data indicate that (compared to one decade ago) more dependent elderly people are retaining their natural teeth--but they are keeping no more teeth, and the health of the teeth has not improved. Most elderly people do not regularly receive dental assessments or care.

Aged↗
PubMed1981

Pain: a poor parameter of evaluation in dentistry.

In summary, we must be aware of the limitations of our instruments for determining success. A diagnosis is achieved by developing a composite picture through a keen gathering of all factors leading to the disease. Pain must surely be considered in patient management and patient-dentist rapport, but to allow our judgment to be swayed by pain alone is no more rational than to hinge our diagnosis upon a single other test. It is of paramount importance that we realize that, pulpally, periodontally, and periapically, there is no correlation between amount of destruction and reported presence or absence of pain. Pain is a poor parameter of evaluation.

Dental Caries↗