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Periodontal splinting in general dental practice.
Splinting periodontally involved teeth is a technique that has been in use for centuries. This article gives a brief history and review of the literature concerning periodontal splinting and outlines the rationale and indications for the correct application of periodontal splinting in modern dental practice. The common types of splint and clinical techniques involved are described, addressing some of the clinical problems.
Late lower arch crowding: the aetiology reviewed.
This article reviews the causes of the crowding that commonly occurs, particularly in the lower arch, after eruption of the second permanent molars. Factors discussed include mesially directed forces, in treated and untreated subjects, distally directed forces, occlusal changes, direction of eruption, tooth morphology, periodontal forces, and degenerative connective tissue changes.
Positional changes in mesio-angular impacted mandibular third molars during a year.
The results of this study show that positional changes occur in the mandibular third molar at least until 20 years of age. A significant number of mandibular third molars in young adults in positions of mesio-angular impaction attain an upright position in a year. A significant relationship exists between the initial age of the patient and the amount of change in the inclination of the third molar. Initial inclination is closely related to the change in inclination in mandibular third molars.
Chief complaints of patients seeking treatment for periodontitis.
BACKGROUND: Hardly any data are available concerning the chief complaints, or CCs, of patients with periodontitis. The authors conducted a study to determine the most common CCs among a group of subjects with periodontitis. METHODS: The authors examined the dental records of 191 patients with periodontitis to determine what CCs they orally reported having at an initial examination. Patients were referred mainly by other members of the dental health team. Eighty percent of the patients were diagnosed with moderate or moderate-to-severe periodontitis. The authors recorded the frequency of different CCs to determine the most common complaints. RESULTS: The authors recorded 336 CCs from the records of 191 subjects with periodontitis. There were 21 different CCs. The most common CC reported was, "I was told I have gum disease." The second most common CC reported was, "I would like to save my teeth." Neither of these CCs are true periodontitis symptoms. Bleeding gums--a true periodontitis symptom--was the third most common CC. Only 6.2 percent of the subjects reported having painful gingiva, and only 29.3 percent of the subjects reported having dental-emergency-related CCs. CONCLUSIONS: The authors found that the motivation to seek periodontal treatment was most commonly based on information given to the subjects by a member of the dental health team, rather than a periodontitis symptom. CLINICAL IMPLICATIONS: Renewed efforts and increased responsibility of the dental health team members to inform patients about the presence of periodontitis are needed, as well as emphasizing to the public the risk of losing teeth as a result of periodontitis.
Localization of first permanent molars in lateral cephalometric and panoramic radiographs from early mixed dentition to early permanent dentition.
Changes in position and mesiodistal angulations of maxillary and mandibular first permanent molars from early mixed dentition to early permanent dentition were measured on panoramic radiographs and compared with the values measured on lateral cephalometric radiographs. It was found that the maxillary and mandibular first permanent molars were uprighted gradually, drifted mesially and vertically, and that the changes in mesiodistal angulations were clearly on the panoramic radiographs in comparison with the cephalometric radiographs.
The use of laser beams for measuring tooth mobility and tooth movements.
The laser reflexion method, a direct contactless measuring technique with a high accuracy, has been applied for clinical purposes. A prototype has been tested using a laser beam to illuminate a patient's tooth fixed to the equipment by an impression plate. The reflected patterns were thrown onto a screen with a coordinate system and photographically recorded, and the movement of the tooth has been geometrically calculated. The relapse tendency after orthodontic treatment of a patient with periodontal disease and parafunctions was studied by repeated measurements of the left medial upper incisor. By use of the method, it was possible to observe that the velocity of the studied tooth was highest during the 1st day and, besides the horizontal movement, a rotation of the tooth began at the end of the measuring period.
Subgingival plaque and loss of attachment in periodontosis as observed in autopsy material.
Histologic sections from six autopsy cases which from a clinical point of view fitted into the criteria of periodontosis were examined with the aim at evaluating the role of subgingival plaque in the etiology of the loss of attachment in this condition. The following pertinent observations were made: 1. The subgingival plaque in most instances was not calcified to form calculus. 2. The thickness of the subgingival plaque varied between 20 and 200 mu (0.02-0.2 mm). 3. Where loss of attachment had taken place, the distance from the most apical part of the subgingival plaque to the most apical point of the epithelial cuff varied between 0.2 and 1.1 mm; this distance was never found to be more than 1.1 mm. This would indicate a cause and effect relationship, the plaque being the obvious cause. 4. There was very severe chronic inflammation in the soft tissue bordering upon the plaque with resulting collagenolysis. 5. The cellular infiltration and the collagenolysis may be limited to a zone of 1 to 2 mm in the immediate vicinity of the plaque. Between the inflamed area and the surface of the gingivae buccally and lingually there may be a fairly wide zone of healthy tissue which hides the symptoms of inflammation from being observed on a clinical examination. In turn this could leave the clinician with the impression that attachment has been lost and bone resorbed because of degenerative changes. The following conclusions can be made: In these six cases of "alveolar bone loss vastly out of proportion to what one would expect from the local etiologic factors in the patient at that age" there was no morphologic evidence that degenerative changes were responsible for the loss of attachment. On the contrary inflammatory changes induced by the subgingval plaque dominated the histopathologic picture.
Rationale for stabilization.
1. The subjective separation of the normal and the diseased periodontium for splinting purposes is artificial. With the exception of cases of secondary trauma from occlusion, the diseased periodontium should be treated in the same manner as the normal periodontium with regards to splinting. 2. Retionales for stabilization found to be valid are: I. Prevention of mobility A. Post acute trauma. B. In occlusal therapy. II. Prevention of drifting A. Replacement of missing teeth. B. Postorthodontics. III. In treatment of secondary trauma for occlusion. A. For functional stability. B. With unknown effects on the progression of periodontitis. 3. The relationship of trauma from occlusion and periodontitis is unclear at this time. 4. A need exists for a clinical test correlating histologic signs of trauma from occlusion and clinical findings. 5. Temporary splinting generally is not indicated during the initial or surgical phase of treatment of the periodontal patient, because mobility short of secondary trauma from occlusion does not impair healing.
Relationship of occlusion and periodontal disease. Part XI. Relation of axial inclination (mesial-distal) and tooth drift to periodontal status.
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[An experimental study on the periodontal vasculature from orthodontic viewpoint. II. Responses of the periodontal vasculature to orthodontic pressure].
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[Observation of alveolar bone remodeling accompanied with tooth movement by in situ hybridization--expression of type I collagen and bone sialoprotein mRNAs].
The purpose of this study was to investigate expression of type I collagen and bone sialoprotein (BSP) mRNAs in the alveolar bone accompanied with tooth movement. The right side of the upper jaw of the rat was used for orthodontic tooth movement, and the left side was used for physiological tooth movement. After the proper number of days of movement, histological specimens were decalcified and sliced into paraffin sections. The expression of mRNAs was examined by the in situ hybridization method. In the samples of physiological tooth movement, a high level of expression in both mRNAs was observed in osteoblasts along the mineralization front and adjacent osteocytes in the interradicular septum (IRS). In contrast, a low level of mRNA expression was observed on the opposite side of the IRS. In the specimens of experimental tooth movement, a high level of expression was detected in the osteoblasts on the tension side of IRS, but negligible reaction in those on the compression side. These results suggest that BSP gene expression as well as that of collagen are related not only to mineralization in physiological bone remodeling but also to the process by activated osteoblasts induced by orthodontic force. In addition, response to the artificial force was observed in osteocytes in IRS.
Regaining space by using elastic orthodontic separators.
When an extensive carious lesion is present, interproximal space may be lost due to drifting of adjacent teeth. This may encroach upon the space needed to restore the tooth to proper occlusal and interproximal contours. Although the space may be regained with conventional orthodontics, this may not be an option in some cases due to financial or technical considerations. The outlined clinical technique uses elastic orthodontic separators in conjunction with an incrementally modified acrylic crown to regain lost interproximal space. The results of this technique were achieved rapidly and allowed for the placement of a physiologically contoured restoration. This procedure is technically simple, provides quick results, and is less expensive for the patient than conventional orthodontics.
Case report: transmigration of an impacted mandibular cuspid.
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Effect of constant currents on orthodontic tooth movement in the cat.
Constant 10 muA currents were applied to the mandibles of 12 cats via electrodes implanted mesial and distal to premolars undergoing orthodontic treatment. A third were moved toward the cathode, a third were moved toward the anode, and a third were moved in the absence of an applied field. No significant difference in total movement was seen at the end of five weeks.
[The premature loss of temporary teeth].
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Occlusal trauma and inflammatory periodontal disease.
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