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Interproximal contact points and proximal caries in posterior primary teeth.
PURPOSE: The purpose of this study was to investigate the hypothesis that the risk of proximal caries in posterior primary teeth is higher when interproximal contact points are closed than when they are open. METHODS: A cross-sectional study design was used with a sample of 286 children aged 24 to 72 months (mean age 54 months +/- 16 months). Children with any permanent dentition were excluded. Caries (defined as a lesion halfway through enamel or further) was assessed radiographically by a single dentist. The open/closed nature of contact points was assessed by a different dentist through resistance to dental floss. Data concerning known risk factors and indicators for caries were also collected. Analyses were performed at the level of the contact point, comparing the same contact points in different children. Multiple logistic regression was used to asses the relationship between open/closed status and caries status for each posterior contact point. RESULTS: In 7 of the 8 contact points examined, the odds for caries were significantly increased when contact points were dosed. CONCLUSIONS: This research suggests that the risk for proximal caries in the posterior primary dentition is raised if contact points are dosed compared to those that are open.
Comparison of two methods of space prediction in the mixed dentition.
PURPOSE: This study compares the accuracy of space prediction for the unerupted permanent canines and premolars by a recognized method of mixed dentition space analysis (Moyers technique) vs estimation by simple visual observation (SVO). METHODS: Twenty clinicians with varying levels of dental experience and training blindly assessed study models of 4 intact arches (2 maxillary and 2 mandibular) from 3 patients in the mixed dentition using both Moyers and SVO space prediction methods. Corresponding full-mouth panoramic radiographs were available for each case. Follow-up records of the eventual outcome in the permanent dentition for each case available (ie, study models prior to any form of orthodontic intervention) served as the standard for further comparison of the space predictions made. Predictions by both methods were compared with each other as well as with the eventual space situation in the permanent dentition. RESULTS: The differences in overall mean space prediction between the Moyers technique (excluding molar shift) and SVO ranged between 3.67 mm to 6.9 mm (lower arches) and 4.3 mm to 4.8 mm (upper arches). Diagnostic consistency between both methods' predictions was highly variable, with correlation ranging from moderate (r = 0.53, P = .01) to very weak (r = -0.1). Generally, more crowding was estimated with the SVO method's predictions. However, the inclusion of molar shift in the Moyers analysis resulted in the prediction of more crowding in the mandible compared to SVO and eventual outcome in the permanent dentition. The range and variability in predictions were always smaller with the Moyers technique compared to SVO. Neither technique's mean space prediction more closely resembled the eventual space situation in the permanent dentition. CONCLUSIONS: This study demonstrated that although the Moyers technique demonstrated less variation and more reproducibility than SVO in its space predictions, neither of the techniques was any more accurate in predicting the final space outcome in the permanent dentition.
NATAL AND NEONATAL TEETH: FOLKLORE AND FACT.
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The normal development of teeth.
Even though a dental assessment is not often a part of a child's regular medical check up, an understanding of the normal dental development and its variations is a valuable diagnostic tool. Dental health is a part of total health, and there is a need for increased communication between medical and dental practitioners to achieve this goal (Figure 32).
Distribution of the epithelial rests of Malassez and their relationship to blood vessels of the periodontal ligament during rat tooth development.
BACKGROUND: There is some evidence that the epithelial cell rests of Malassez partition the root surface from the periodontal ligament blood vessels, and may protect the root from resorption. OBJECTIVE: The aim of the present study was to determine the distributions of the epithelial rests of Malassez (ERM) and blood vessels in the periodontal ligament (PDL) of the developing rat first molar before, during and after emergence. METHODS: Four Sprague-Dawley rats were sacrificed at two days, one week, two weeks, three weeks, four weeks and six weeks of age. After processing, the maxillae were embedded in paraffin, and sectioned longitudinally and transversely. The sections were stained with a double immuno-histochemical technique which utilised a keratin antibody AE1-AE3 (1:2,000) and an endothelial antibody Factor VIII (1:10,000) to enable simultaneous labelling of ERM and blood vessels. ERM and blood vessel counts were obtained from the mesio-buccal roots of three week, four week and six week-old rats, whilst qualitative observations were made for the earlier developmental stages. RESULTS: ERM cells and cell clusters were found in the tooth third of the PDL width at the three, four and six week stages. Cells and cell clusters increased in number with age, especially in the upper third of the mesio-buccal root. The largest numbers of cells and clusters were found on the distal surfaces of the roots in all age groups. Cells and clusters in all root surfaces increased from three to four weeks, but decreased from four to six weeks. The greatest number of blood vessels was found in the bone-side third of the PDL. The distal surface had the highest proportion of blood vessels, and the palatal surface the least proportion. The number of blood vessels in all surface quadrants did not vary much from three to four weeks of age, but increased from four to six weeks of age, possibly as a reaction to tooth emergence and occlusal function. Physiological root resorption was only observed after tooth emergence, and appeared to be related to loss of continuity of the ERM network and the incursion of blood vessels. CONCLUSIONS: Orthodontic root resorption can be regarded as an exaggerated response to loss of PDL homeostatic control, possibly mediated by the epithelial rests of Malassez.
The validity of estimated age in rural Pakistani children based on interviews with mothers and tooth counts of primary teeth.
Assessment of chronological age in children aged 6-30 months was made by obtaining information from uneducated rural Pakistani mothers and by means of counting the number of emerged primary teeth. There was found no statistically significant difference in the validity in age assessment between two methods. The average difference between true chronological age and perceived age was -0.8 months (SD 2.5 months) in boys, and 0.9 months (SD 3.9 months) in girls. The average difference between true chronological age and dental age was -0.4 months (SD 3.5 months) in boys, and 0.8 months (SD 4.8 months) in girls.
Malocclusion resulting from a retained deciduous tooth: report of a case.
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Teething in infancy. A part of normal development.
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Space maintenance and endodontic follow-up: case reports.
Early extraction of carious primary teeth may result in functional and/or loss of arch length problems. That is the rationale behind root canal therapy and/or space maintenance after the extraction of pulpally involved primary molars. What follows is a short radiographic and photographic history of unexpected results in well established and routine space therapy treatments.
Short tooth syndrome: diagnosis, etiology, and treatment management.
The periodontal-restorative team is uniquely positioned to provide the esthetic procedures that today's sophisticated patient population has come to expect. Not only is health and function of great desire but also esthetics is in demand. Armed with periodontal-plastic procedures and technically advanced restorative materials, the periodontal-restorative team can provide these patient needs. The challenge becomes making the correct diagnosis and selecting the appropriate treatment regimen.
Factors regulating and modifying dental root resorption.
A comparison is made between the resorption of bone and the resorption of the mineralized tissues of teeth. The structure and function of osteoclasts are described well as the factors that regulate their activity. The cells resorbing the dental mineralized tissues are of the same cell type as osteoclasts. The dental tissues are covered by cementoblasts or odontoblasts which differ from the osteoblasts in that they do not respond to hormones and cytokines that stimulate bone resorption. Root resorption therefore seem to require damage of the cementoblastic layer in combination with necrosis or inflammation or replacement of the cementoblastic layer by osteoblasts. The root resorption that occurs at the shedding of the primary teeth is induced in a different way possibly by substance(s) from the reduced enamel epithelium. There seems to be no systematic study on the frequency and extension of root resorption in association with inflammatory or neoplastic conditions. It is suggested that dentigerous cysts and some epithelial tumors induce root resorption in the same way as the erupting tooth. The mechanisms by which some other tumors or tumor-like conditions cause root resorption are essentially unknown.
Immunoassay evidence for a role of nerve growth factor in development of dental innervation.
Nerve growth factor (NGF) is known to have an essential role in prenatal development of spinal and trigeminal primary sensory neurons serving nociceptive functions. Investigation of a possible function of NGF in development of intradental innervation has recently begun with the demonstration by others of NGF mRNA and NGF receptor in the pulp. The pulp is of special interest in this respect because of its late development and unusual properties of its innervation. In the present study, use of a sensitive ELISA for NGF has made it possible to detect and measure NGF antigen in pulps of developing rat molars. Pulps contained relatively high concentrations of NGF before and during the time of innervation development.
[Analysis of oral microflora early colonized in infants].
OBJECTIVE: To observe the dynamic changes of oral microflora early colonized in infants. METHODS: The oral swab samples for the study were taken in 1 day, 1, 3, 6, 9, 12 months after birth from 12 healthy neonates. By choosing suitable diluted concentration, the samples were incubated aerobically, facultative anaerobically and anaerobically. The strains were identified by observing colony characteristics, Gram staining and biochemical tests. RESULTS: S. salivarius was the most frequent microflora, followed by S. mitis, S. sanguis, S. gordonii and S. mutans occurred in oral cavity after tooth eruption. Veillonella spp. can be detected in oral cavity of 1-month-old babies, A. odontolyticus was isolated from 8.3% infants of more than 3 months old. L. acidophilus maintained the lower prevalence in oral cavity of babies. Leptotrichia buccalis and Capnocytophaga spp. occurred in oral cavity of some dentate infants. CONCLUSION: S. solivarius and S. mitis are predominant species in oral cavity of the infants, Veillonella spp. is the first and the most anaerobic species appeared in oral cavity of healthy babies. A. odontolyticus is the first actinomyces detected in oral cavity. With the increasing months, kind and amount of microflora increase dramatically.
Differences between primary and permanent teeth in posteruptive age dependency of radiological changes in enamel during the development of approximal caries.
A longitudinal radiological study of children (N = 549) who participated in a comprehensive preventive maintenance program showed that caries related events in the approximal surfaces of permanent teeth differed from those in deciduous teeth. Changes in the approximal surfaces of the younger permanent teeth were more pronounced than of the older primary teeth and differed significantly from 1 year to 2.5 years. These findings can be explained by posteruptive maturation of tooth enamel.
[Pedodontics--review of general aspects of importance for the general clinic].
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Diet counseling during the infant oral health visit.
Diet counseling is an integral part of anticipatory guidance during the infant oral health visit. Similar to dietary instructions for children of all ages, the primary emphasis is on sugar intake frequency. There are, however, other infant-specific dietary issues that must also be addressed during the infant oral health visit. Breast-feeding should be promoted during the first year of life, although ad libitum nocturnal breast-feeding should be discouraged after the first primary tooth erupts. Bottle-fed infants should not be put to sleep with the bottle. Weaning from the breast or the bottle should be encouraged by 12 to 14 months of age. Infants older than 6 months and with exposure to less than 0.3 ppm fluoride in their drinking water need dietary fluoride supplements of 0.25 mg fluoride per day. Only 4 to 6 oz of fruit juice should be consumed by infants per day. Infants should not be given powdered beverages or soda pop, as these drinks pose increased risk for dental caries. Iron-fortified infant cereals, along with breast milk or infant formula, should be consumed by infants who are at least 6 months of age. Cow's milk should be completely avoided in the first year of life and restricted to less than 24 oz per day in the second year of life. Parents should be cautioned regarding the potential of various foods to constitute a choking hazard for infants.