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Quantitative assessment of tooth wear, alveolar-crest height and continuing eruption in a Romano-British population.

Although measurements from cement-enamel junction (CEJ) to alveolar crest (AC) have been used in assessing changes in alveolar-crest height as age or chronic inflammatory periodontal disease (CIPD) progresses, there is evidence from ancient populations that the position of AC remains almost constant throughout life and continuing eruption to compensate for attrition may explain why CEJ-AC measurements increase with age. Measurements of occlusal attrition and relationship of CEJ to AC were made on the cheek teeth of 500 Romano-British skulls by direct measurement or by reference to the fixed line of the inferior alveolar canal (IAC) on radiographs. Direct measurements indicated that there were usually no statistical differences between the vertical amounts of tooth substance lost by attrition and the change in the distance CEJ-AC as age progressed. Measurements on radiographs showed that posterior teeth continued to erupt to compensate for attrition and the AC remained static as age progressed. Bone deposition at the AC was seen in the majority of ground sections. Thus tooth wear appears to be compensated by continuing movement of teeth in an occlusal direction. The position of the AC remained almost constant throughout life; AC bone lost by CIPD seemed to be replaced during continuing tooth eruption.

Age Factors↗

A semiquantitative method of recording experimental tooth erosion and estimating occlusal wear in the rat.

As the erosive agent, a sport-drink mixture with pH 3.2 was given to Osborne-Mendel rats for 6 weeks. Lingual surfaces of the right first mandibular molar crowns were chosen for the recording. With the aid of a drawing tube mounted on a stereomicroscope, enlarged drawings of the surfaces were made encircling the intact and eroded areas. A computer-coupled analyser was used to measure the areas of the total surface, intact surface, eroded enamel and exposed dentine in square millimetres. The data was evaluated statistically and used to calculate erosion changes and to estimate occlusal wear.

Animals↗

Continuing tooth eruption and alveolar crest height in an eighteenth-century population from Spitalfields, east London.

Earlier studies on dried skulls have shown that continuing eruption occurs throughout life to an extent which appears to compensate for occlusal attrition. Some investigators have interpreted the increasing distance between the tooth cervical margin and the alveolar crest as an indication of horizontal bone loss due to chronic inflammatory periodontal disease. In order to determine whether continuing eruption occurs in the absence of attrition, measurements were made on the jaws of an eighteenth-century population whose tooth wear had been minimal. Horizontal bone loss at the alveolar margin was minimal or absent. Continuing eruption had occurred, indicating that facial height probably increased throughout the life time of the individuals.

Adolescent↗

Prevalence and distribution of dental caries in a late medieval population in Finland.

The aim was to document the late medieval material and to compare the results with findings in other medieval populations and present-day Finns. The sample consisted of the remains of 410 individuals and included 4581 permanent and 600 deciduous teeth. Age determination was based on the stage of dental development and on the attrition pattern in the molar region. Scoring the presence and location of caries was done visually with the aid of a dental probe. In the younger age groups, caries was most prevalent in the occlusal fissures, but the proportion of cavities at these sites declined with age, possibly because occlusal attrition progressed more rapidly than did caries. In the permanent dentition, carious lesions were most frequently observed at the cementum-enamel junction, particularly on the approximal surfaces. The prevalence of caries was lower than among modern populations of similar ages. In addition, the relative distribution of caries was strikingly different, with root caries being the most common type.

Adolescent↗

Aetiological, predisposing and environmental factors in dentine hypersensitivity.

If the hydrodynamic theory of stimulus transmission across dentine is valid, sensitive dentine has tubules open at the surface and patent to the pulp. Direct and indirect evidence supports this supposition. Factors that result in dentine exposure remove the covering enamel or periodontal tissues (gingival recession). Epidemiological and clinical data for the distribution of exposed cervical dentine indicate that chronic trauma from physical and chemical factors is the most significant aetiological factor. Brushing with a toothpaste may not open dentinal tubules. It is more likely that toothpaste ingredients, when brushed on dentine, would create a smear layer. Exposure of tubules by erosion is probably the major initiator of sensitivity. An increase in our understanding of the aetiological factors involved in dentine hypersensitivity is essential if a sound approach to its management is to evolve. Such information could emanate from epidemiological studies, clinical investigations and laboratory experiments.

Beverages↗

The relation between tooth eruption and alveolar crest height in a human skeletal sample.

It is commonly assumed that alveolar crest height increases with continuing tooth eruption unless affected by marginal inflammation. To test this hypothesis, the relation between eruption and alveolar crest height was examined in skulls from a sample consisting of the remains of 244 individuals from the late medieval period. The mandibular first and second molars and second premolars were analysed. The age of the skulls was determined on the basis of dental development and molar attrition. Radiographs were taken and points representing the levels of the inferior dental canal (IDC), root apices (AP), alveolar crest (AC), cementum-enamel junction (CEJ) and occlusal surface were determined on the radiographs. The level of the IDC was used as a reference not changing with age. The distances between the points were measured with a help of a computer-digitizer system. Variable IDC-AP increased with age, indicating continuous eruption of the teeth. The distance between AC and CEJ also increased while the distance between IDC and AC remained constant, showing that the alveolar crest height did not increase accordingly. The lack of inflammatory changes on the alveolar bone surface suggests that occlusal attrition may be compensated for by continuous eruption without bone growth in the alveolar margin.

Adolescent↗

The influence of the loss of teeth and attrition on the articular eminence.

A review of the literature revealed that changes in the articular eminence associated with changes in the dentition were usually overlooked in most reports. An attempt was made to determine whether changes in attrition and loss of teeth would correlate with a change (decreased angulation) in the articular eminence. The population consisted of 103 adult skulls and mandibles of both sexes and three different races. They included partial and totol edentulism, mild to severe attrition, and complete dentitions in good condition. An impression of each of the 206 articular eminences was made and the angulation established. The data were transferred to computer cards and a statistical analysis performed. The level of significance for each of the variables was established and conclusions were made.

Adolescent↗

The sleep-wear syndrome.

This article acknowledges sleep-wear phenomena and suggests research to study the correlation between sleeping postures and nocturnal bruxism through scientific studies. After the bruxers have been identified, the baseline muscle activity, bruxing movements, and sleep position data can be recorded. Individual treatment can be instituted in a sleep laboratory as follows: Some patients can be dismissed without treatment and others may merely need counseling in modification of sleep postures. Selective occlusal adjustment of centric relation closure interferences may be performed in some patients to test the influence of deflective contacts on nocturnal bruxism. Some patients may require the restoration of canine disclusion with composite or a bruxism splint, or both. Combinations of treatment could be performed and compared. These studies would enhance the understanding of the interaction between nocturnal bruxism and sleep postures, adding useful knowledge to the field of preventive dentistry.

Bruxism↗

Vertical dimension increases in the adult rhesus monkey: a pilot study.

Tooth impaction, increased muscle activity, and histologic changes in the bone of the temporomandibular joint have been reported following attempts to increase the vertical dimension of occlusion. The purpose of this research was to study the effects of increases in the vertical dimension of occlusion on bone density at five levels of the mandible in the adult rhesus monkey, and to assess dentoalveolar changes by lateral cephalometric radiographs and mounted diagnostic casts. Mandibular cobalt chromium splints measuring 3 mm in height at the first molar, providing even occlusal contact to the maxillary anterior and posterior teeth, were cemented in place on two monkeys. Five similar monkeys without splints were used as controls. Computed tomograms were completed to evaluate bone density bilaterally at five levels of the mandible after 3 months of splint wear. Pretreatment and posttreatment lateral cephalometric radiographs and mounted diagnostic casts were completed to assess tooth impaction. Periodontal ligament (PDL) thickening and mobility of molars and premolars were evaluated before splint placement and after splint removal. There was no statistically significant difference in the bone density levels of the animals with splints compared with the controls. Minimal dentoalveolar changes were observed.

Animals↗