Control of spasm, swelling and pain with repository tubocurarine after removal of impacted third molars.
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[Experimental study of radiation effects on the mandibular microvasculature of the guinea-pigs].
In the experiment, both 180 kV X-ray and cobalt-60 radiation were delivered to right mandibles of 128 guinea-pigs with different dose (1000 cGy x 4, 800 cGy x 4, 600 cGy x 4, 400 cGy x 4 within 1 week). Dental extractions were conducted 1, 3, 5 months after radiation and the irradiated animals were examined by using microvascular corrosion castings of mandibles. It was found that the number of capillaries reduced and microvascular networks broke off after radiation with small veins shrinking subsequently while the alterations of arteries were slight. This result indicated that capillary was the most vulnerable part to the damage of radiation in the vascular system. In addition the defects of vascular networks around the non-healing tooth extraction sites were also discovered with irregularly capillary proliferation in the periphery of the lesion. The phenomena suggested that microcirculation failure induced by trauma-repairing process lead to occurRence of osteoradionecrosis of jaws.
Animals↗
[Will root caries become a treatment problem of the future?].
Based upon the present prevalence of root caries an attempt is taken to evaluate the future importance of this carious type. A population sample of 2,261 men and women aged 35 to 74 years were examined. The participation rate was 81%. Root caries was recorded when the lesion was obviously soft and located on cementum. The prevalence of root caries increased for both sexes almost consistently with age and ranged between 49 and 73%. In the mean 1.8 to 2.9 teeth were affected. Root caries was found more often among men than women. Over the sixth decades the reduction of the relative frequency of root caries was stated. Up to this age the rates of tooth extraction were higher than the rates of incidence. If it succeeded that in the future aged people will retain more teeth than nowadays a increase of root caries can be expected.
Adult↗
Nontraumatic dental emergencies in a pediatric emergency department.
The objectives of this study were to describe nontraumatic dental emergencies among children treated in a pediatric emergency department. The children studied received emergency treatment for a nontraumatic dental problem from December 1992 through November 1993. Among the 1,459 children treated for dental emergencies, 949 had a nontraumatic emergency (65%) and were enrolled in this study. Patients ranged in age from 1 month to 19 years, with a mean age of 6.9 years. Fifty-two percent of patients were male. The teeth were involved in 99% of cases. An abscess was present in 33% of patients; and among these patients, 26% also had a fistula. Pericoronitis was seen in 4% of patients, primary viral stomatitis in 1%, and an eruption hematoma in 0.5%. Caries is the etiology of the problem prompting the emergency department visit in 73% of patients, and baby bottle caries accounted for 18% of all cases of caries. Other etiologies included the late effects of trauma (8%), iatrogenic (7%), idiopathic (3%), and periodontal processes (2%). Tooth extraction was performed in 45% of patients. Findings of this large consecutive series provide a better understanding of this type of visit to the pediatric emergency department.
Adolescent↗
Implant treatment and the role of platelet rich plasma.
Implant supported restorations have become and continue to be a very popular clinical option for patients who are either partially or completely edentulous. This article, the third in a series dealing with implant dentistry, describes the role of platelet rich plasma as an adjunct to help with the healing process following tooth extraction, socket preservation, and, ultimately, replacement with implant supported restorations. A clinical case is used to illustrate surgical options available in the restoration of the posterior partially edentulous maxilla.
Alveolar Ridge Augmentation↗
A case of amelogenesis imperfecta, cleft lip and palate and polycystic kidney disease.
OBJECTIVE: Amelogenesis imperfecta (AI) is a heterogeneous group of genetic disorders characterized by developmental abnormalities of tooth enamel. The AI is also seen as part of multi-organ abnormalities, e.g. with cone-rod dystrophy, hypothalamo-hypophyseal insufficiency and renal failure. The present patient with AI and nephrocalcinosis exhibited a phenotype different from previous cases with renal failure. To highlight the characteristics of this rare case, extensive analysis that included histological, biochemical and genetic examinations was performed. PATIENT: The present Japanese male patient exhibited dentition with AI and bilateral cleft lip and palate. Ground sections of his extracted tooth showed that it was hypomaturation-type AI, unlike previous cases with nephrocalcinosis were hypoplastic-type. He showed nephrocalcinosis and hematuria at 15 years of age but these symptoms appeared to be secondary to polycystic kidney disease. He showed skeletal Class II pattern with a retrognathic profile and retroclined incisors of both arches. A dolicofacial appearance was seen with an enlarged gonial angle. Biochemical makers including serum alkaline phosphatase, parathyroid hormone, calcitonin, calcium, and phosphate, were all in the normal range. Sequence analysis of the genes encoding amelogenin and enamelin, which are known to be responsible for hypoplastic-type AI, did not reveal any mutations. Since mouse null mutant of homeobox transcription factor, Msx2, exhibits a phenotype resembling AI, the human homolog of this gene, MSX2, was sequenced. There was a missense mutation of T447C that resulted in the conversion of methionine to threonine at 129.
Adult↗
Clinical and biologic factors related to oral implant failure: a 2-year follow-up study.
The purpose of this study is to evaluate urinary biomarkers of bone formation and resorption as predictive factors for oral implant failure, and to contribute to the knowledge of factors related to oral implant failure. A total of 93 patients between 18 and 85 years old, with an indication of oral implant, were eligible in this 2-year prospective, open, and nonrandomized study. Patients who had bone graft before implantation or presented with prosthetic difficulties (implant-to-crown ratio < 1, and/or unfavorable intermaxillary space) were excluded. All patients received either Frialit-2 (Friadent, Mannheim, Germany), cylinder, or screwed implants or IMZ Twin Plus (Friadent), cylinder implants, with FRIOS (Friadent) titanium coating. Serum osteocalcin, and urinary pyridinoline and deoxypyridinoline were measured, together with bone density at implant location. The primary endpoint (implant failure) was the implant removal (radiographic evidence of peri-implant bone loss and/or pockets). Factors related to implant failure were analyzed using multilevel logistic regression models to consider within-patient effects. Of the 93 patients included, 61% were female, and 16% were current smokers. A total of 266 oral implants were placed and analyzed, with a mean number of 3.1 implants by patient. Eleven and 15% of bone locations scored at D1 and D4, respectively, for the Misch bone density scoring. The majority of implants (72%) were placed more than 3 months after tooth extraction, using a Frialit-2 system in 73% of cases. The mean of osteocalcin was 17.3 (+/-9.4) ng/L; those of pyridinoline and deoxypyridinoline were 33.2 (+/-15.8) and 10.2 (+/-11.9) mmol per creatinine mmol, respectively. At one-year, 95.5% (95% confidence interval 92.5-97.5) of implants have not been removed. One year later, no further implant failed. In both univariate and multivariate analysis, osteocalcin, pyridinoline, and deoxypyridinoline were not significant predictive factors of oral implant failure. In multilevel logistic regression analysis, only tobacco consumption and single-tooth replacement or removable prosthesis were independent and significant predictive factors of oral implant failure. Serum osteocalcin, and urinary pyridinoline and deoxypyridinoline were not predictive of oral implant failure in this study. These results suggest that oral implants are more likely to fail for posterior single-tooth replacements and removable prostheses rather than for complete edentulous fixed bridgeworks or overdentures. Tobacco smoking has been identified as a major risk factor of oral implant failure.
Adolescent↗
Immediate provisional for single-tooth implant replacement with Brånemark system: preliminary report.
BACKGROUND: The success of osseointegrated implants ad modum Brånemark for single-tooth restorations is documented. Future developments should aim at improving the benefits to patients by decreasing treatment time, minimizing surgical stages, and maximizing esthetic outcomes. Using knowledge from studies of immediate implant placement, one-stage, immediate loading protocols, the authors developed the immediate provisional. PURPOSE: The purpose of this study was to develop a protocol to provide an immediate solution for restoring a single missing tooth in the esthetic zone. The protocol should be simple, predictable, cost effective, and allow the use of other techniques to improve esthetic outcome. MATERIALS AND METHOD: This prospective clinical study included 24 patients treated from August 1999 to October 2000. Single-tooth implant replacement was done according to immediate provisional protocol. Thirteen of the 24 patients had immediate implant placement after tooth extraction. All implants were placed in the esthetic zone. During surgery, emphasis was placed on obtaining primary stability by achieving bicortical anchorage and maximum insertion torque of at least 40 Ncm. CeraOne (Nobel Biocare) abutments were used, and provisional crowns were fabricated immediately before wound closure. The occlusion was protected by adjacent teeth. RESULTS: Within the follow-up period of between 1 month and 15 months, all fixtures in the 24 patients were stable. Crestal bone loss greater than one thread-width was not detected. The esthetic result was considered satisfactory by all patients. CONCLUSIONS: The implant placement and restoration protocol used in this study showed promising initial results for both the immediate implant and healed extraction site groups. The desirable goals of patient satisfaction, excellent esthetic outcomes, and no increase in treatment cost were achieved in this protocol. Further studies to elucidate the potential of the immediate provisional protocol are justified.
Adolescent↗
[Dentogenic sources of infection in patients with awaiting heart valve replacement].
The detection of all teeth with periapical pathological conditions and optimal treatment of the affected teeth are a part of the evaluation program for patients who are scheduled to undergo cardiac value replacement. 48 patients (50 value replacement operations) were evaluated for the incidence of periapical pathological conditions, as well as for the different kinds of oral surgical interventions. A periapical pathological condition was present in 28 of 48 patients (58.3%). In general, the incidence of a dental focus was significantly higher in patients awaiting aortic valve replacement than in patients undergoing mitral valve replacement (69.7% vs. 23.1%; p < 0.01). Patients for aortic valve replacement presented significantly more periapical pathological conditions than patients for mitral valve replacement (1.7 vs. 0.8). Optimal timing of dental consultations is helpful in the oral rehabilitation of patients about to undergo a valve replacement procedure. Furthermore, close interdisciplinary cooperation is necessary to minimize the social and psychological problems following unexpected tooth extractions. Cardiologists and heart surgeons have an important role in the organisation of the oral rehabilitation of patients undergoing valve replacement procedures.
Adult↗
Titanium implant anchorage in orthodontic treatment an experimental investigation in monkeys.
Tooth loss can be a problem when orthodontic appliances have to be stabilized for treatment. It has been shown that endosseous titanium implants are well integrated during treatment of edentulous patients with intra-osseous anchored bridges. In the present investigation titanium implants were inserted immediately after tooth extraction. After tissue-integration of the implants they were successfully used for anchorage when orthodontic treatment was performed. In a clinical situation the implants may simultaneously be used for reconstruction of the bite.
Alveolar Process↗
Dental and oral manifestations of sclerosteosis.
AIMS AND OBJECTIVES: Documentation of the oral and dental manifestations of Sclerosteosis. SETTING AND PARTICIPANTS: Sclerosteosis is a member of the family of genetic craniotubular hyperostoses. This severe progressive sclerosing bone dysplasia has important orofacial manifestations and a wide geographical distribution. Comprehensive oral and dental evaluation of eight affected adults in the Afrikaner community of South Africa was undertaken. RESULTS: Gross asymmetrical hypertrophy of the mandible was present in all eight patients, bilateral or unilateral facial paralysis with weakness of facial muscles due to facial nerve entrapment was present in six. Drooling of saliva and difficulties with mastication were frequent problems in these persons. The teeth were structurally and mechanically normal although there was partial anodontia in two patients and delayed eruption in another. Maxillary (palatal) and mandibular tori were present in every affected person. Due to the hyperostosis of the maxilla and mandible, tooth extraction was often a very difficult matter. There were no instances of post-extraction osteomyelitis of the mandible. CONCLUSIONS: Accurate differentiation of sclerosteosis from the other sclerosing bone dysplasias is crucial for effective dental prognostication and management.
Adult↗
Effect of human bone morphogenetic protein 2 implant on tooth eruption in an experimental design.
This study evaluated the influence of recombinant human bone morphogenetic protein 2 (rhBMP-2) on the development and eruption of the secondary dentition. Primary premolar tooth extraction sockets in 12 16-week-old felines were implanted with either rhBMP-2, in collagen sponge or with buffer/absorbable collagen sponge (ACS). Unoperated jaw quadrants served as controls. Experimental conditions were randomized between jaw quadrants in all animals. Two animals receiving rhBMP-2/ACS and buffer/ACS in two quadrants per implant were sacrificed at 4 weeks postsurgery. Ten animals receiving rhBMP-2/ACS (two quadrants), buffer/ACS implants (one quadrant), and one quadrant serving as an unoperated control were evaluated at 12 weeks postsurgery. Clinical assessments included healing, eruption patterns, and crown development. Radiographic assessments included tooth development, eruption patterns, and bone formation. Histological observations were also made from the 4-week animals. The secondary dentition remained unerupted at 4 weeks postsurgery. Histological analysis showed normal alveolar bone coronal to the erupting teeth in rhBMP-2/ACS-implanted quadrants. At 12 weeks postsurgery, all teeth were erupted without differences between quadrants. Clinically, the crowns of all teeth were normal. Radiographs suggested that teeth in rhBMP-2/ACS- and buffer/ACS-implanted jaw quadrants exhibited similar tooth development and eruption patterns as the normal control. The evidence from this study suggests that surgical implantation of rh-BMP-2/ACS in the pathway of the developing and erupting secondary dentition does not interfere with the normal development and eruption patterns of the teeth.
Absorbable Implants↗
Histopathologic study of squamous cell carcinoma of the gingiva in edentulous and dentulous jaws of hamsters treated with N-methylnitrosourea.
Unilateral maxillary or mandibular molars were extracted from twenty-four, 25-day-old male syrian golden hamsters; 25 days after extraction, 20 received MNU intragastrically twice a week for 3 months. All animals were killed 1 month later. High degrees and incidence of invasion of gingival SCC were observed in dentulous jaws without functional occlusion, followed by dentulous jaws with functional occlusion and edentulous jaws. Invasion of carcinomas with extensive bone destruction was observed commonly in the gingiva of dentulous maxillary jaws without functional occlusion, but was scarcely observed in the gingiva of edentulous jaws. By analogy, disuse atrophy of the periodontium due to loss of functional occlusion may result in early deeper invasion, while loss of periodontal ligament due to tooth extraction and disappearance of so-called inner gingival epithelium may result in less invasive carcinomas.
Alveolar Process↗
Bone regeneration around an osseointegrated implant. A simultaneous approach in a fenestrated defect: a case report.
The use of a barrier membrane, with or without osseous allograft, has been shown to establish regeneration of osseous tissue around dental implants. Following three episodes of persistent symptomatic failed apicoectomy and subsequent tooth extraction, an osseointegrated implant was placed in a wide fenestrated defect. Demineralized freeze-dried bone allograft was covered by an occlusive expanded polytetrafluorethylene membrane. The reentry procedure revealed complete bone fill that followed the texture of the augmentation material beyond the previous buccal bony envelope.
Adult↗
A mini-implant for orthodontic anchorage in a deep overbite case.
This article describes the orthodontic treatment of a 19-year-old female patient with anterior crowding. There was a moderate arch length discrepancy in the lower dental arch, a significant deep overbite, and a "gummy smile." We inserted an orthodontic mini-implant as anchorage for the intrusion of the upper incisor segment, followed by alignment of the upper and lower dental arches with an edgewise appliance without tooth extraction. The overbite was corrected from +7.2 mm to +1.7 mm by upper incisor intrusion, and the gummy smile was improved. Good occlusion and facial esthetics were achieved, and these results have been maintained for two years after completion of the active treatment.
Adult↗
Soft tissue management around implants in the esthetic zone.
The concept of overbuilding the implant site in the esthetic zone is paramount in creating the inconspicuous implant restoration. If teeth are congenitally missing, the site may be underdeveloped. Tooth extraction and trauma may lead to ridge deformities. The goal is to create an enhanced site for the restorative clinician. This site can then be molded to an ideal gingival framework. Cases are used to illustrate surgical and orthodontic techniques for preserving and overbuilding the implant site in the esthetic zone.
Adult↗
When is an implant ready for a tooth?
The capability of placing an osseointegrated implant at the time of tooth extraction and immediately placing a restoration on the implant depends upon a number of factors. This paper describes the traditional Brånemark protocol, the evolution of single-stage surgery, the guidelines for immediate placement, the measurement of implant stability, and the considerations critical to immediately loading.
Dental Implantation, Endosseous↗
[Studies on sex determination using human dental pulp. II. Sex determination of teeth left in a room].
The appearance rate of Y chromatin was calculated in the dental pulp with the staining by Quinacrine Mustard. The morphological findings of the tissue were observed with the HE stained section and the change of the appearance rate of Y chromatin was studied along with the morphological change of the tissue. The average of the appearance rate of Y chromatin in the male dental pulp was 42.2% immediately after the tooth extraction, 34.8% after one month, 27.9% after 3 months, 20.8% after 6 months, 20.6% after 1 year, 19.1% after 18 months and 11.4% after 2 years, respectively. On the other hand, the appearance rate of the pseudo-Y chromatin spot in the female pulp was below 4.2% through the two years' observation which enabled to determine the sexuality. By the HE staining observation about the dental pulp, left at a room temperature, it was revealed that the pulp tissue can be well preserved for a long time because of the natural drying. The degree of the staining declined with the lapse of time after the removal of tooth. Degeneration of tissue did not offer any discrete criteria for the estimation of the lapse of time after the removal of tooth.
Adolescent↗