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PubMed2005

Bone loss and teeth.

Loss of teeth results in irreversible alveolar bone resorption, and untreated dental disease causes alveolar bone lysis that ultimately leads to loss of teeth. In addition to anchoring the teeth in the alveolar ridge, the maxillary and mandibular bone allows dental restoration procedures, such as construction of root-supported implants, fixed dentures, or removable dentures. However, the functional and cosmetic results depend on the quantity and quality of the maxillary or mandibular bone, which can be affected by many normal and abnormal processes. The alveoli are particularly fragile and labile. Changes in alveolar bone vary considerably across individuals and depend directly on local factors. Many studies have investigated associations between alveolar bone status and bone mass at other skeletal sites. These studies focused chiefly on the course of parodontal disease, alveolar ridge resorption after tooth extraction, and density differences across various mandibular sites. They produced conflicting results, probably because of differences in measurement methods. Measurement sites and methods should be standardized to ensure that reliable and comparable data are obtained. To date, there are few reliable methods for obtaining quantitative measurements of bone mineral content in maxillary and mandibular bone.

Bone Density↗
PubMed1997

Oral health status of an industrial population in Romania.

The purpose of this survey was to assess the oral health situation of an industrial population in Romania. A total of 311 male and female employees (18-62 years-of-age) were clinically examined according to the WHO Basic Methods criteria and responded to an oral health questionnaire on dental knowledge and health care habits. In the younger age groups, the amount of untreated dental caries was high (18-24 years: DT = 5.7, DMFT = 8.9) whereas missing teeth were prominent in older employees (45 years or more: MT = 7.6, DMFT = 11.9). At age 25-44, 72 per cent had gingival bleeding and calculus. Dental knowledge was relatively poor, and 28 per cent of the participants indicated actual need for treatment. Dental visits within the previous 12 months were reported by 24 per cent of the employees, and 39 per cent had had a tooth extracted at their most recent visit. The study emphasises the need for reorientation of oral health care in Romania, and the relevance of industrial dental services for the implementation of oral health promotion and prevention is highlighted.

Adolescent↗
PubMed2005

Implant restoration of external resorption teeth in the esthetic zone.

PURPOSE: The purposes of this article were to review the literature for treatment of teeth with external resorption secondary to avulsive injuries and to illustrate treatment of patients with teeth following different clinical scenarios to develop a predictable course of therapy. MATERIALS AND METHODS: Cases that demonstrate treatment of teeth with external resorption following injury during the growing period, external resorption treated with a delayed approach after tooth extraction, immediate grafting of the extraction site to repair labial bone loss, and immediate implant placement with provisionalization are shown. CONCLUSION: Based on a review of the literature, the decision to place dental implants to replace teeth with external resorption can be timed depending on the location and type of the resorption, with excellent esthetic results.

Adolescent↗
PubMed2004

Haemostatic management of intraoral bleeding in patients with congenital deficiency of alpha2-plasmin inhibitor or plasminogen activator inhibitor-1.

Haemostatic management of intraoral bleeding was investigated in patients with congenital alpha2-plasmin inhibitor (alpha2-PI) deficiency or congenital plasminogen activator inhibitor- 1 (PAI-1) deficiency. When extracting teeth from patients with congenital alpha2-PI deficiency, we advocate that 7.5-10 mg kg(-1) of tranexamic acid be administered orally every 6 h, starting 3 h before surgery and continuing for about 7 days. For the treatment of continuous bleeding, such as post-extraction bleeding, 20 mg kg(-1) of tranexamic acid should be administered intravenously, and after achieving local haemostasis 7.5 mg kg(-1) of tranexamic acid should be administered orally every 6 h for several days. In addition, when treating haematoma caused by labial or gingival laceration or buccal or mandibular contusion, haemostasis should be achieved by administering 7.5-10 mg kg(-1) of tranexamic acid every 6 h. Tranexamic acid can also be used for haemostatic management of intraoral bleeding in patients with congenital PAI-1 deficiency, but is less effective when compared with use in patients with congenital alpha2-PI deficiency. Continuous infusion of 1.5 mg kg(-1) h(-1) of tranexamic acid is necessary for impacted tooth extraction requiring gingival incision or removal of local bone.

Adult↗
PubMed1999

Temporomandibular disorders and mandibular function in relation to Class II malocclusion and orthodontic treatment. A controlled, prospective and longitudinal study.

The relationship between orthodontic treatment and symptoms and signs of temporomandibular disorders (TMD) was studied prospectively and longitudinally in 65 adolescent girls with Class II malocclusion. The subjects received orthodontic fixed appliance treatment with the straight-wire technique combined with or without extractions and were examined for symptoms and signs of TMD before, during, after, and finally one year post-treatment. Both symptoms and signs of TMD showed considerable fluctuations over the three-year period within the individuals. The general tendency was a decreased prevalence of symptoms of TMD over the three years. The prevalence of pain on mandibular movement and tenderness to palpation of the masticatory muscles was significantly less common during and after orthodontic treatment than before. Clinically registered TMJ clicking increased slightly over the three year period. One orthodontic treatment effect when normalizing Class II malocclusions with fixed appliances was a decreased prevalence of functional occlusal interferences. We concluded that the orthodontic treatment either with or without tooth extractions did not increase the risk for TMD or worsen pre-existing signs of TMD. Subjects with Class II malocclusion and pre-treatment signs of TMD of muscular origin seemed rather to benefit functionally from orthodontic treatment in a three-year perspective.

Adolescent↗
PubMed2006

Analysis of odontogenic cysts of the jaws.

In this study 850 cases of odontogenic cysts of the jaws, treated in Kaunas University of Medicine Hospital during the period of 1986-2004, were analyzed in order to evaluate the incidence of these cysts and other aspects of clinical and therapeutic interest such as their clinical features, changes they caused in the facial and mandible structures, and the teeth that had caused the pathology. Case histories of 455 men and 395 women had been analyzed. The age of the patients varied from 4 to 87 years, with the average of 35.8. More than half of the diagnosed cysts (63%) were present in the maxilla, 37% of them--in the mandible. The common complaints of the patients were bump, swelling, pain, discharge leaking from the fistula or alveolus after tooth extraction, increased teeth mobility, paresthesia; changes in the maxillofacial system - intraoral or facial asymmetry, inflated bone with sensation of an egg shell cracking revealed under palpation, swelling at the mucofacial fold, mobile teeth and fistula. While comparing the causative groups of antagonistic teeth in the maxilla and mandible, we found the proportion to be (in order from the right to the left): molars--1:1, premolars 1.3:1, fore teeth--3.3:1, fore teeth 3.8:1, premolars 1.2:1, molars 0.7:1. Odontogenic cysts may be present in both sexes; maxillary cysts are 1.5 times as frequent as mandibular cysts. The pathology may equally affect both sides of jaws, most cysts being diagnosed in the maxillary fore teeth area from tooth 13 to tooth 23. The following pairs of changes in maxillofacial system are frequently present: inflated body of bone or alveolus--increased mobility of teeth; the formed fistula--swelling at the mucofacial fold, swelling at the mucofacial fold--pain. The applied treatment of cysts was surgical--cystotomy or cystectomy.

Adolescent↗
PubMed1998

Five-year results of maxillary intramobile Zylinder implants.

We retrospectively analysed the time-dependent function of 501 Intramobile Zylinder (IMZ) implants inserted between August 1983 and December 1994 to restore partially and fully edentulous maxillae. To ensure the independence of implants when calculating level of significance, we chose one implant per patient at random. This was done 500 times to obtain a representative result. The simplified success rate was 473/501 (92%) whereas the time-related survival probability was 76% after 60 months. In 31% (156/500) of the life-table calculations, implants placed in completely edentulous maxillae showed a significantly lower probability of survival than did those placed in partially edentulous patients (P mean: 0.17; SD: 0.19). Implants, that had been placed in the anterior and premolar regions of edentulous maxillae, had a survival probability of 60%, after 60 months. The survival probability of implants placed in the molar region was 100%, over the same observation period. The patient's age, sex, and the time of placement of the implant after tooth extraction had no significant influence on the implant's prognosis. The prognosis of implants inserted for partial edentulism meets the criteria proposed for a viable implant system. Our findings indicate that in complete edentulous maxillae, implants should be placed in the posterior rather than in the anterior region, even though this necessitates augmentation procedures such as sinus lift.

Adult↗
PubMed1993

In vivo measurement accuracy in vital and necrotic canals with the Endex apex locator.

Currently apex locators are being used to determine working length. This study was undertaken to see what is actually being measured and if the pulp status, i.e. vital or necrotic, makes a difference in the determination. In this in vivo study, 33 teeth, both vital and necrotic, were measured by the Endex apex locator and then radiographed. After the length determination, the file was cemented to place, the tooth extracted, and then shaved back until the file and the apex were exposed. The position of the file was measured in relation to the apical foramen. Results indicate that all measurements were within a narrow range (-0.86 mm to 0.50 mm). There was no statistical difference in measurements between vital and necrotic canals.

Dental Pulp Cavity↗
PubMed1998

[Causes of late odontostomatologic consultations in Ivory Coast].

In Africa, particularly in Ivory-Coast, dental patients present late with life threatening complications. The authors designed a questionnaire to be filled by each patient who presented with serious dental pathology whose only remedy was tooth extraction. Causes of late consultation including financial deprivation, fear of dentist, self medication are some of the factors identified by the authors as the most frequent factors. Dental health education and a comprehensive, social policy are advanced as possible ways of prevention.

Adolescent↗
PubMed1994

Clinical evaluation of composite resin tunnel restorations on primary molars.

Twenty children, presenting 66 proximal carious lesions in 60 primary molars, were selected to receive composite resin tunnel restorations. Thirty of these teeth were expected to exfoliate within 6 months (group I); in the remaining 30 teeth exfoliation was expected within 1 year (group II). All teeth received tunnel preparations, which were then restored with a posterior composite resin. The restorations were evaluated after 6 months and after 1 year through each of the following methods: bitewing radiographic examination, clinical examination with a probe and mirror, and direct examination of proximal surfaces after tooth extraction. The occlusal portions of the restorations were considered to be excellent both after 6 months and 1 year. Radiographic examinations and direct examinations (performed after extraction of teeth) did not reveal the same percentages of secondary caries in the proximal portion of restorations. Fracture of the marginal crest reached 3% during the first 6 months, but fracture was absent during the subsequent 6 months.

Bisphenol A-Glycidyl Methacrylate↗
PubMed1991

[Stomatological problems related to pregnancy. A statistical study].

Pregnancy is related to particular dental issues, such as the increased incidence of diseases( gingivitis, caries, epulis), the fluoride supplementation, and the limits of diagnostics and therapy. Moreover, the mysterious halo surrounding pregnancy often makes the dentist uneasy. In order to objectively evaluate the implications of pregnancy in dentistry, we distributed a form to 100 pregnant women. The results of the form showed that 53 of them had gingival bleeding, 22 had toothache, 19 had caries but that just 12 of them had gone to the dentist because of dental troubles while 54 had not gone at all. Among the pluri-gravidae, all the women with dental diseases in their previous pregnancies had them again in their current pregnancy but nonetheless only some had undergone a dental check-up. The dentists did not show any uneasiness, as they performed tooth extractions in 5 women, endodontics in 2 women and fillings in 11 women. Just 4 out of 100 women had taken a fluoride supplementation. We deem advisable a stronger collaboration between physician, gynecologist and dentist in order to resolve specialist problems and to make pregnant women more aware of the need for dental follow-ups and fluoride supplementations.

Adult↗
PubMed1996

Root perforations: classification and treatment choices based on prognostic factors.

Root perforations are common complications of endodontic treatment or post preparation and often lead to tooth extraction. Successful treatment depends mainly on immediate sealing of the perforation and prevention of infection. Several factors affect the achievement of these goals, most important of which are: time of occurrence, size, and location of the perforation. A classification of root perforations, based on the above factors, is presented to assist the clinician in the choice of the treatment protocol which will give the best possible results when a perforation is diagnosed.

Dental Instruments↗
PubMed2000

Nasolacrimal duct obstruction secondary to ectopic teeth.

OBJECTIVE: To describe two patients with nasolacrimal duct obstruction (NLDO) caused by ectopic eruption of teeth. The literature concerning nasal and other unusual ectopic sites of tooth eruption is reviewed. DESIGN: Two interventional case reports and literature review. PARTICIPANTS: A 3-year-old girl with epiphora and recurrent dacryocystitis of the right eye. Previous medical and surgical management was unsuccessful. A 32-year-old female with a long history of right eye discomfort and epiphora. Previous examinations and workup were negative. INTERVENTION: A computed tomographic (CT) scan of the orbits and sinuses was performed in both patients. The ectopic teeth were surgically removed. MAIN OUTCOME MEASURES: Nasolacrimal system function and response to treatment at the last follow-up were recorded. RESULTS: In the first patient, CT imaging disclosed two teeth within the right inferior meatus compressing the nasolacrimal duct. In the second patient, CT revealed a large dental structure in the maxillary sinus compressing the nasolacrimal duct. Endoscopic tooth extraction and nasolacrimal duct probing in the first patient and surgical removal of the dental structure in the second patient effected complete resolution of symptoms. Both patients were symptom free at last follow-up. CONCLUSIONS: These cases suggest that ectopic eruption of teeth should be added to the differential diagnosis of NLDO. Surgical removal of the ectopic teeth compressing the nasolacrimal duct results in resolution of the lacrimal drainage obstruction.

Adult↗
PubMed1993

Autotransplantation of a tooth using guided tissue regeneration.

Autotransplantation is an alternative treatment to replace missing or periodontally-involved hopeless teeth. A prerequisite for performing this procedure is having a recipient site with sufficient bone volume to support the transplant. Often, however, crestal bone resorption following tooth extraction or periodontitis results in a reduced alveolar ridge with inadequate dimensions to properly house the transplant. In these cases, the procedure is contraindicated. A case is presented in which the biologic principle of guided tissue regeneration was used to gain periodontal support around an autotransplanted 3rd molar. The results suggest the potential use of guided tissue regeneration in conjunction with autotransplantation. This may represent a new area in reconstructive dentistry.

Alveolar Bone Loss↗
PubMed2002

Oro-dental manifestations of the Schwartz-Jampel syndrome.

A boy with the Schwartz-Jampel syndrome (chondrodystrophic myotonia) had a number of oro-dental complications. These included difficulty in tooth extraction and orthodontic care due to a small oral aperture and rigidity of the temporo-mandibular joints. General anaesthesia was hazardous because of a propensity to malignant hyperthermia, and endotracheal intubation was difficult because of shortness and rigidity of the neck and the small size of the laryngeal structures. Awareness of these potential problems is crucial for anaesthesia and comprehensive dental management. The radiological demonstration of dentigerous cysts is a hitherto unreported observation in this disorder.

Adolescent↗
PubMedDate not supplied

Optimal esthetics in single-tooth replacement with the Re-Implant system: a case report.

PURPOSE: This report demonstrates the use of root-analogue titanium implants for single-tooth replacement. MATERIALS AND METHODS: A maxillary lateral incisor was removed and a custom-made one-stage, root-analogue titanium implant (Re-Implant) with an apical extension and a healing cap was fabricated and placed immediately after tooth extraction. Six months later the healing cap was removed, an impression was taken, and a porcelain-fused-to-metal crown was fabricated and cemented. RESULTS: No complications occurred during the healing period. A good esthetic result was achieved with the final ceramometal crown. Bony resorption and buccal soft tissue recession led to a slight discoloration of the marginal periimplant mucosa. CONCLUSION: Further research into the modalities of the immediate placement of root-analogue implants is needed to obtain predictable esthetic results concerning the soft tissue environment.

Dental Implantation, Endosseous↗
PubMed1993

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↗
PubMed2004

Immediate implants supporting single crown restoration: a 4-year prospective study.

BACKGROUND: The placement of implants at the time of tooth extraction has several clinical advantages, such as preservation of the alveolar ridge width and height and reduction of the restorative treatment time. The aim of this study was to evaluate the cumulative success rate of dental implants placed in fresh extraction sockets with and without guided bone regeneration (GBR) used to support a single crown restoration. All of the patients were preselected as candidates for implants. METHODS: Ninety-five patients aged 20 to 68 years with 163 implants were included. All patients were partially edentulous and participated in a personally tailored recall schedule. The follow-up period was 48 months. Patients underwent a clinical and radiographic evaluation annually. RESULTS: The 4-year cumulative success rate was 97%. Five of the 163 implants failed, two during the initial healing time, which were considered early failures and three a year after prosthetic rehabilitation, which were considered late failures. No failure of prosthetic rehabilitation was observed. CONCLUSIONS: Implants placed into fresh extraction sockets with or without regenerative procedures and used to support single crown prosthesis showed a very high cumulative success rate (97%) in a 4-year prospective study. Several observations should be made: 1) all the patients were preselected as candidates for implants and were following a strict oral hygiene regimen; 2) all efforts were made to reduce the number of cases requiring GBR procedures; 3) all the implants had an acid etched/sandblasted implant surface; and 4) all the prosthetic restorations were single crowns.

Adult↗