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Assessment of age-at-death from mandibular molar attrition in medieval Danes.

Stages of occlusal attrition of the permanent mandibular molars were recorded in 235 Danish medieval skulls, 52 of which were in various states of mixed dentition. For the first and second molar, ages at emergence and ages at occurrence of the earlier stages of attrition were estimated from the mixed dentitions, on the assumptions 1) that the age at eruption of a given number of permanent teeth was similar in medieval and contemporary Danish children, and 2) that the rate of attrition was similar for the first and second molars. Estimation of ages at occurrence of the later attrition stages and of the age at third molar emergence was based on percentage frequency distributions of the stages of attrition using reiterative calculating procedures. Third molar emergence was estimated at the early age of 14 years. It is argued that assessments of age-at death could be made fairly accurately for the age range 5-30 years, and with decreasing accuracy until about 40 years of age.

Adolescent↗

Occurrence of malocclusion in attritive environment: a study of a skull sample from southwest Finland.

Occlusal variation and occurrence of malocclusion were examined in a Finnish skull sample derived from the 15th and 16th centuries. The material consisted of 207 adult individuals; 141 maxillas and 159 mandibles, including 93 pairs, were in observable condition. In the skull sample, only dental anomalies were observed; no skeletal malocclusions were found. The frequency of an Angle Class I lateral relationship was 97.7%. The mean values for overjet and overbite were 1.6 and 1.4 mm, respectively. A comparison with present-day Finns revealed that the skull sample showed less variation in all occlusal variables studied. An Angle Class II type occlusion, deep bite, crowding, spacing, and lateral crossbite occurred with significantly lower frequencies in the skull sample than in the present-day Finns. Advanced dental wear in the skull sample shows that a hard and attritive diet was eaten at that time. It is suggested that a dietary transition from hard to soft food is the most probable cause of the increased occlusal variation and high frequency of malocclusion in present-day Finns.

Diet↗

Covariation of some factors associated with occlusal tooth wear in a selected high-wear sample.

The aim of the present study was to investigate the significance of some factors associated with occlusal tooth wear in a selected high-wear Swedish sample. The material comprised 59 subjects having a mean age of 35 yr within the range 16-70 yr, the criteria for selection being a full or nearly full complement of natural teeth, and the presence of definite clinical signs of occlusal wear. A dentition wear index was derived from a tooth-by-tooth evaluation of casts. The results showed that men had significantly greater wear than women. Other factors which were found to correlate significantly with increased occlusal wear were: age, increased bite force, decreased occlusal tactile sensitivity, increased endurance time, and reduced tendency for crowding in the dental arches. In the salivary analysis, it was found that low buffer capacity and low rate of secretion were significantly correlated with high wear. Cephalometric variables shown to be correlated with increased wear were retroclination and position of maxillary incisors, and greater interincisal angle. The results from this study also suggest that the associations of attrition with certain dentoalveolar morphologic features are similar in the present contemporary sample and various noncontemporary populations.

Adolescent↗

Longitudinal relationship between incisal tooth wear and periodontal condition.

The purpose of the study was to examine the relationship between the longitudinal development of incisal tooth wear and periodontal conditions in 51 persons. Stone casts obtained at the ages of 15 and 27 yr were used to assess incisal wear according to a graded scale, the Incisal wear Index (IwI). The wear increase after 12 yr, delta IwI, was related to the various health index scores at the age of 15 yr, including the Plaque Index (PlI) and Gingival Index (GI) systems. The chi-square tests showed a statistically significant association between delta IwI and periodontal condition in 15-yr-olds. Thus, relatively low PlI and GI values were accompanied by relatively high delta IwI values. It was concluded that in 15-yr-olds, PlI and GI levels are clinical predictors of future wear (delta IwI) of maxillary and mandibular central incisors. Pocket depth (PD) was a less valuable clinical predictor of such wear.

Adolescent↗

Bite force and dentofacial morphology in men with severe dental attrition.

Patients with severely worn dentition were interviewed and clinically examined, and only those were included who had no or minimal subjective symptoms or clinical signs of craniomandibular disorder. During a 14-month screening period, only 7 patients fulfilled the inclusion criteria; all were men. Maximal bite force was measured in the molar regions and in the incisal region. Facial morphology was evaluated from lateral cephalometric radiographs, and the form of dental arches from dental casts. Average maximal bite force in the molar region was 911 N and in the incisal region 569 N. The most characteristic findings concerning bite force were the high force levels in the incisal region and an incisal/molar bite-force ratio of 63%. The facial morphology of the patients was rectangular, with an anteriorly rotated mandible, small anterior face height, and great interincisal angle. Moreover, the form of the maxillary dental arch was more rectangular than normal. The high bite forces of these patients, especially in the incisal area, can probably be explained by strong masticatory muscles and mechanically favorable skull morphology, which in its turn has been influenced by the surrounding muscles.

Adult↗

Longitudinal study of incisal tooth wear in children and adolescents.

This report was derived from a longitudinal study of the development and progress of incisal tooth wear in children and adolescents. The study group was established in 1991/1992 and consisted of 79 participants between 8 and 15 yr. They were reexamined in 1993 and the time span between the first and second examination was 12-14 months. Assessment of incisal wear was made on stone casts based on silicone impression material according to the Incisal wear Index (IwI). The index used was shown to have good reproducibility. The results showed that the pattern of incisal wear had been maintained during the observation period. Prevalence and severity of incisal wear had increased significantly with age. The strength of the suggested linear relationship between age and incisal wear decreased during the observation period. At the same time the growth increments of wear, delta IwI, were negatively correlated with age, indicating that the progression of incisal wear slowed down with increasing age. Description of the true relationship between age and incisal wear outside the age range represented in the sample must await the results of forthcoming studies.

Adolescent↗

Restorative and Invisalign: a new approach.

This case report describes an interdisciplinary treatment approach using the Invisalign System (Align Technology, Inc., Santa Clara, California) for orthodontics in combination with restorative dentistry. This combined approach was selected for an optimum esthetic and functional result. This case report demonstrates how a restorative case can be improved with prerestorative orthodontic alignment. The Invisalign System was used for opening the bite anteriorly, space distribution, and midline correction. The restorative dentistry procedures involved veneering to enhance the maxillary incisor length-to-width ratio and provide anterior guidance. The cosmetic alternative treatment modality to conventional fixed orthodontics allowed the clinician to accomplish the prerestorative orthodontic goals to help meet the desires of an esthetically conscientious patient.

Adult↗

Direct restoration of worn maxillary anterior teeth with a combination of composite resin materials: a case report.

Tooth loss, alterations on tooth structure, and reduced vertical dimension are known to severely compromise the stomatognathic system. This case report describes the treatment of a patient who presented with an extremely worn maxillary anterior dentition with a loss of posterior support owing to the loss of almost all the posterior teeth, except the mandibular premolars. Provisional removable partial dentures were used to create an optimum maxillomandibular relationship and to provide restorative space prior to the restoration of the remaining teeth. This restoration was accomplished with a combination of layered hybrid and microfilled composite materials, which restored the maxillary anterior teeth to optimum esthetics and function.

Bisphenol A-Glycidyl Methacrylate↗

Oral function in dentate elderly with reduced dentitions.

This study covers the characteristics of reduced dentitions in a population of elderly people. The sample consisted of 329 independently living individuals between 55 and 75 years of age. They all had one or more natural teeth and were all interviewed and investigated clinically. The findings showed that 13% of the subjects had a natural dentition with at least the first molars; 4-7 natural occlusal units (defined as 'pairs of opposing teeth that support the occlusion') occurred in 37% of the subjects; 1-4 natural occlusal units in 41% and 0 units in 9% (only anterior contacts). A removable partial denture was worn by 39% of the subjects; most of them were acrylic based dentures (61%). The percentages of restored teeth per subject were high. The need for further restorations, however, was low. Periodontal problems were uncommon; 25% of the subjects had one pocket above 5 mm; 8% had severe problems. Poor oral hygiene was present in a quarter of the cases. Most of the subjects (70%) had no pain or noises in the temporomandibular joint. Only 10% of subjects had more than one sign of craniomandibular dysfunction. Most of the subjects (85%) visit their dentist regularly and 65% had their last tooth extraction more than three years ago. A majority mentioned that they have never had problems with their dentition in the past; 50% had had no real toothache for the last five years. However, problems with food-packing were often mentioned. It can be concluded that, although the dentitions of the elderly in this population are often reduced, their dentitions are in general in good condition and few give TMJ problems.

Aged↗

General and oral characteristics in Rett syndrome.

Rett syndrome (RS) is a neurodegenerative disorder characterized by developmental arrest of parts of the brain. It is an X chromosome-linked condition which affects females almost exclusively. Recent reports have been generated concerning the multidisciplinary management of individuals exhibiting Rett syndrome. The aim of the present report was to provide an update on the oral manifestations of the disorder. We evaluated the general and oral characteristics of RS in 13 female patients. The most frequent manifestations were stereotyped hand movements and bruxism. The treatment we carried out included the use of biteplanes and acupuncture.

Acupuncture Therapy↗