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PubMed1984

Further observations on dental parameters of trigeminal and atypical facial neuralgias.

One hundred thirty-one patients with primary trigeminal neuralgia and 77 patients with atypical facial neuralgia or pain were treated by oral surgical procedures, with complete or almost complete pain remission in 88% of the cases and without persistent residual anesthesias, dysesthesias, or dysalgesias. The following conditions were related to patients' pain perceptions: cavities in alveolar bone at tooth extraction sites, bone fistulas, periodontal infections, and maxillary sinus infections draining into alveolar bone. The bone cavities and fistulas mentioned above were usually not visualized by standard x-ray diagnostic procedures, and their detection required a new diagnostic approach which is described. Microbiologic findings indicated involvement of a mixed, variable flora in the above conditions. Histopathologic observations of scrapings from involved bone showed a variable incidence of bone necrosis, predominantly chronic inflammatory cell populations and fibrous tissue.

Adult↗
PubMed2006

Long-term success of implants replacing a single molar.

BACKGROUND: The aim of this study was to assess the long-term success and survival rates of implants replacing a single molar between two natural teeth and to evaluate the influence of implant characteristics on implant success. METHODS: The study was based on a consecutive cohort of 81 patients who received implants to replace a single molar between the years 1994 and 2004. Inclusion criteria for patients were having an implant replacing a molar between two natural teeth and follow-up data of at least 6 months. Data were recorded regarding the incidence of complications and success and survival rates of these implants. RESULTS: The range of follow-up was from 6 to 125 months (mean: 36 months). Smoking was reported by 18.5% of patients. The replacement of a mandibular molar was more frequent (87.7%), with 25.9% of the implants placed immediately after tooth extraction. Two implants were used to replace a single molar in seven patients (8.6%). The failure rate was 7.4% (six implants failed: three had broken necks, and three failed because of infection or bone loss). Complications included suppuration in 11.1% of implants and a pocket around the implant in two patients (2.5%). No relation was found among failure, complications, timing of implant placement, and smoking habits. CONCLUSION: A single implant can serve as a good long-term and predictable treatment modality to replace a single molar with low complication and failure rates.

Adolescent↗
PubMed2003

Localized maxillary ridge augmentation with a block allograft for dental implant placement: case reports.

Autogenous block bone grafts have been highly successful in treating human periodontal defects, restoring esthetics, and developing adequate bone volume for dental implant placement. Limitations in available donor bone, the need for an added surgical procedure, and other potential complications have made the use of allogenic bone graft materials an important alternative. One patient described in this report presented with fractured root syndrome of the right maxillary incisor with severe resorption of the buccal plate. After atraumatic tooth extraction, a staged treatment approach involving localized ridge augmentation with an allogenic iliac bone block material and dental implant placement was used. The host bone completely incorporated the graft with only minor resorption, which enabled the implant to be placed. The allogenic bone block material used in this study was an effective alternative to harvesting and grafting autogenous bone for implant site development. The cases presented in this article clinically demonstrate the efficacy of using a block allograft in generating effective new bone fill for dental implant placement.

Adult↗
PubMed1996

Gallium alloy restorations in primary teeth: a 12-month study.

The authors placed 60 Class I and Class V restorations in the primary molars of children aged 4 to 10 years using a gallium alloy. Within one year after placement, the surfaces of all the restorations had deteriorated significantly due to corrosion, and the authors found remarkable amounts of corrosion products on restorations retrieved after tooth extraction or loss. The marginal integrity of many of the Class I restorations deteriorated slightly during the study; the Class V restorations showed no marginal breakdown. No other problems were detected after one year. These data indicate that the gallium alloy tested had insufficient resistance to corrosion to serve as a permanent restorative material. However, the authors suggest consideration of this alloy for use in primary teeth to reduce the exposure of children and dental professionals to mercury-containing amalgam.

Alloys↗
PubMed1995

Long-term stability of Angle Class II, division 1 malocclusions with successful occlusal results at end of active treatment.

The purpose of this study was to examine long-term stability of Angle Class II, Division 1 malocclusions with successful occlusal results at the end of active appliance therapy, search for predictors of relapse, and look for characteristics associated with successful treatment. Records taken before and after treatment and a mean of 14.0 years postretention of adolescent patients treated for a significant Angle Class II, Division 1 malocclusion both with and without tooth extraction were evaluated. The sample was limited to successfully treated cases as judged by subjective evaluation of intercuspation and incisor occlusion of posttreatment study models and included 78 patients. Cephalometric characteristics or postretention occlusion was not considered in sample selection. The mode response was no change postretention for molar, premolar, and canine relationships and relapse of 0.5 mm for overjet and overbite. Maximum relapse was 3.5 mm for molar, premolar, and canine relationship, 3 mm for overjet, and 4.5 mm for overbite. Stepwise backward multiple regression analyses revealed no associations between either pretreatment characteristics or skeletal and dental treatment changes and relapse of overjet. However, relapse of overjet was associated with relapse of molar, premolar, and canine relationships, postretention increase in overbite, postretention proclination of maxillary incisors, and postretention retroclination of mandibular incisors. Active treatment changes included redirection or inhibition of maxillary growth and retraction of maxillary incisors. Mandibular incremental growth was favorable both during and after treatment. It was concluded that successful correction of Angle Class II, Division 1 malocclusions through differential growth adaptation and tooth movement appears to be very stable.

Activator Appliances↗
PubMed1992

Root caries prevalence in black and white North Carolina adults over age 65.

The baseline root caries prevalence of 809 dentate black and white home-dwelling North Carolinians over age 65 was determined along with the collection of a large number of demographic and behavioral, clinical, and microbiological variables in the longitudinal Piedmont over-age-65 Dental Study. In comparison to other studies of older adults, the prevalence of decayed-filled root surfaces (DFRS) was low, fewer than 2.0 DFRS in whites, and significantly fewer than that in blacks (1.3 DFRS). Although tooth loss was a substantial problem, nearly half of the white population and almost two-thirds of the black participants exhibited no evidence of root caries history. Even though DFRS prevalence was much lower in blacks, their treatment need for decayed root surfaces (DRS) was significantly higher than for white participants. Correlates with DRS within both race groups appeared to be those that reflect lack of access to dental services or neglect of oral health--decayed coronal surfaces, higher rates of tooth extraction, high CPITN scores and worst loss of attachment greater than or equal to 7 mm, and more than a year since the last dental visit. Some variables were associated significantly with one racial group, but not the other, while others, particularly root surfaces at risk and age, were not associated significantly with DRS. We concluded that although there was considerable neglect of root caries, particularly among blacks, it was not a serious problem among older North Carolinians.

Aged↗
PubMed1991

[Frialit ceramic implants--a four-year follow-up study].

Sixty-two ceramic implants (Frialit) were installed in 53 patients with agenesia or loss of single teeth due to traumata or infection. Sixty-three per cent of the implants were operated in immediately after tooth extraction, whereas the rest were installed in a healed bony alveolar ridge. Eighty-five per cent of the implants were replacements for maxillary incisors. The average observation period was 4 years. During this period 10 implants were removed due to lack of osseointegration. Seven of these implants were lost in the healing period, the remaining 3 were removed after installation of the suprastructure. Eighty-four percent of the implants were successful after 4 years. Trauma in the maxillary region have caused fracture of the implants in 5 patients. Such incidents create therapeutic problems difficult to solve satisfactorily.

Aluminum Oxide↗
PubMed1999

[Removable prosthesis: masticatory efficiency].

The late consultation in odontology often leads to tooth extraction. This negligence, in a long term, will cause complete toothlessness. This state of invalidity will be compensated by prosthesis. The removable prosthesis is often indicated because of the cost price. It is the result of a successful therapeutics, only if it fits aesthetically and functionally, within a chewing efficiency. In a first part, we will define masticatory efficiency, as different from masticatory capacity and capability. Then, in a second part, through some experimentation, we will show how fundamental research can guide the practitioner in his prosthetics choices and assessments.

Dental Materials↗
PubMed2000

Oral health status and treatment needs of 35-44-year old adults in Lebanon.

OBJECTIVES: The purpose of this study was to assess the oral health status and treatment needs of a Lebanese adult population. DESIGN: An epidemiological survey of 401 Lebanese adults aged 35-44 years was carried out in 1996. It followed the WHO methodology in assessing the oral health status and treatment needs of adult populations. A structured questionnaire and a standardised oral health exam were used for the investigation. RESULTS: Showed that the Decayed, Missing and Filled Teeth (DMFT) index was 16.3 and that 1.5 per cent of the sample had a DMFT score of zero, whereas, 55 per cent had a score of less than 4. Of the 401 subjects, 24 per cent had at least one bridge and 16 per cent had a removable prosthesis. Compared to other neighbouring countries, Lebanon ranked the highest in the DMFT index and its separate components. Close to 60 per cent of the sample was in need of operative treatment, 31 per cent needed tooth extraction and 60 per cent were in need of a crown or a bridge. Significant variations were observed in the oral health status as well as treatment needs of the sample when examining gender, socio-economic status, and place of residence differences. CONCLUSION: This study can be used as a stepping stone in the direction of building the base of knowledge on oral health in Lebanon. The planning and implementation of any strategy for oral health status improvement is crucial, alongside the country's infrastructure development.

Adult↗
PubMedDate not supplied

Interproximal papilla levels following early versus delayed placement of single-tooth implants: a controlled clinical trial.

PURPOSE: The aim of this study was to evaluate interproximal papillae and clinical crown height following the placement of single-tooth implants according to early and delayed protocols. MATERIALS AND METHODS: Forty-five patients were randomly allocated to either the "early" group or the "delayed" group. They were treated with a single-tooth acid-etched Osseotite implant in the maxillary or mandibular anterior or premolar region an average of 10 days (in the case of early placement) or 3 months (in the case of delayed placement) following tooth extraction. Interproximal papilla dimensions and clinical crown height were evaluated using a score index in 39 patients who attended a follow-up visit 16 to 18 months after prosthesis delivery. The patients were evaluated in photographs taken 1 week after crown placement (baseline) and approximately 1.5 years after crown placement (follow-up). RESULTS: It was demonstrated by logistic regression the risk of presenting no papilla or a negative papilla was 7 times greater at baseline for delayed cases than for early cases (33% versus 8%). However, the soft tissue fill in the proximal spaces improved significantly from baseline to the 1.5-year follow-up in both groups, with no significant difference between the groups found at follow-up. The papilla height almost 2 years after implant placement was inversely correlated with patient age. The clinical crown height was acceptable in significantly more cases in the early group than in the delayed group at follow-up. Half of the crowns in the delayed group exhibited an inappropriate height; of these, almost two thirds were assessed to be too short. DISCUSSION AND CONCLUSION: Early placement of single-tooth implants may be preferable to delayed implant placement technique in terms of early generation of interproximal papillae and the achievement of an appropriate clinical crown height, but no difference in papilla dimensions was seen at 1.5 years after seating of the implant crown.

Adult↗
PubMed2005

The survival of resin modified glass ionomer and stainless steel crown restorations in primary molars, placed in a specialist paediatric dental practice.

AIMS: To prospectively report on the survival of resin-modified glass ionomer cement (RMGIC), photac-fil and pre-formed stainless steel crown (SSC) restorations in primary molar teeth placed over a seven-year period in a specialist paediatric dental practice under private contract of remuneration. METHOD: All primary molar restorations placed by a specialist paediatric dentist over a seven-year period were reviewed and the outcome results recorded. Data were recorded at review visits until June 30, 2003. Data recorded included Class I restorations, Class II restorations and SSC. The Class II cavities were either mesial or distal, with or without buccal/palatal extensions. If both proximal surfaces were decayed or if after cavity preparation the resultant outline form was significantly larger than the minimal classical form, RMGIC was not used; an SSC was placed instead. Stainless steel crown preparation followed conventional guidelines. The crowns were cemented with reinforced zinc oxide and eugenol (Kalzinol). The status was recorded as satisfactory restoration, tooth exfoliated, tooth extracted for orthodontic reasons with the date of extraction, or needing replacement. If replaced then the reason for replacement was also recorded. RESULTS: A total of 544 Class I RMGICs, 962 Class II RMGICs, and 1,010 SSCs were placed. At the last review of each restoration, 98.3% of Class I, 97.3% of Class II RMGICs and 97.0% of SSCs were either satisfactory or withdrawn intact. CONCLUSION: Under the conditions of private specialist practice-based study SSCs continued to prove very successful for the restoration of larger cavities and for pulp-treated primary molar teeth. For the smaller cavities RMGIC were also very successful.

Adolescent↗
PubMed2004

Maxillary sinus disease of odontogenic origin.

Odontogenic sinusitis is a well-recognized condition and accounts for approximately 10% to 12% of cases of maxillary sinusitis. An odontogenic source should be considered in patients with symptoms of maxillary sinusitis who give a history positive for odontogenic infection or dentoalveolar surgery or who are resistant to standard sinusitis therapy. Diagnosis usually requires a thorough dental and clinical evaluation with appropriate radiographs. Common causes of odontogenic sinusitis include dental abscesses and periodontal disease perforating the Schneidarian membrane, sinus perforations during tooth extraction, or irritation and secondary infection caused by intra-antral foreign bodies. The typical odontogenic infection is now considered to be a mixed aerobic-anaerobic infection, with the latter outnumbering the aerobic species involved. Most common organisms include anaerobic streptococci, Bacteroides, Proteus, and Coliform bacilli. Typical treatment of atraumatic odontogenic sinusitis is a 3- to 4- week trial of antibiotic therapy with adequate oral and sinus flora coverage. When indicated, surgical removal of the offending odontogenic foreign body (primary or delayed) or treatment of the odontogenic pathologic conditions combined with medical therapy is usually sufficient to cause resolution of symptoms. If an oroantral communication is suspected, prompt surgical management is recommended to reduce the likelihood of causing chronic sinus disease.

Humans↗
PubMed2006

Alternative treatment strategies for carious primary teeth: an overview of the evidence.

BACKGROUND: Dental decay in children's primary teeth is a major health problem in the Great Britain with, in some areas, nearly 60% of five-year-olds having some experience of caries and 16% already having had at least one tooth extracted. Whilst currently accepted best practice for the management of carious primary teeth involves complete caries removal and placement of a plastic restoration, such conventional treatment is unpopular with general dental practitioners. Indeed, less than 15% of carious cavities in five-year-olds are currently restored and as such, there has been recent interest in alternative 'minimal intervention' treatment techniques for managing dental caries. REVIEW: This review summarises the literature and also recent research efforts directed towards understanding the role of alternative treatment regimens including: (1) alternative techniques for cavity preparation and excavation and (2) the isolation of the carious process (in some cases, using cariostatic materials) from the oral environment or sealing in dental caries.

Cariostatic Agents↗
PubMed2005

Accuracy of electronic apex locators in comparison to actual length--an in vivo study.

OBJECTIVES: The measurement precision of four electronic apex locators (Root ZX, Morita, Tokyo, Japan; Endy, Loser, Leverkusen, Germany; Justy II, Hager-Werken, Duisburg, Germany; Endox Lysis, Milan, Italy) was examined in the present in vivo study. METHODS: The root canal length of 40 single-rooted and multi-rooted teeth was determined with the four devices prior to tooth extraction. To determine the actual root canal length, the apical third was longitudinally sectioned, the root canal instrument was positioned and the apex was examined using a microscope. RESULTS: The average measurement deviation (+/-SD) in relation to the apical constriction was 0.3 mm (+/-0.6) for the Root ZX, 0.7 mm (+/-1.0) for the Endy, 0.2 mm (+/-0.7) for the Justy II and 1.3 mm (+/-1.7) for the Endox. The limit of +/-0.5 mm from the apical constriction was attained by the Root ZX in 78%, by the Endy in 67%, by the Justy II in 80% and by Endox in 31% of all measurements. CONCLUSIONS: The latest generation of apex locaters provide the clinician with an accurate and useful adjunct for the determination of root canal length.

Dental Pulp Cavity↗
PubMed2005

Radiographic evaluation of the status of third molars in the Asian-Indian students.

PURPOSE: The purpose of this study is to assess the prevalence and agenesis of third molars, their impaction status, and the time and sequence of their eruption in the students of Asian-Indian population. PATIENTS AND METHODS: One hundred students with ages ranging from 17.5 to 20.0 years were randomly selected. This age group was selected because this is the age at which third molars normally begin to erupt. Students who had undergone any tooth extraction or orthodontic treatment previously were not included in the study. RESULTS: The incidence of congenital missing third molars was 11.5%, with a higher incidence in females. Of the third molars present, 31% were in mesioangular position, 42% were in the vertical position, 27% were in the distoangular position, and none were in the horizontal position. Of the 354 teeth examined, 24% of teeth were found to be erupted and 76% were in various stages of eruption. The level of eruption of third molars was 27% at A; 39%, B; and 34%, C. CONCLUSIONS: The present study showed that at the baseline (mean age, 19.3 years), 24% of third molars were erupted, 76% were in various stages of eruption, and 11.5% were congenitally missing in the Asian-Indian student population.

Adolescent↗
PubMed2004

Post-traumatic use of dental implants to rehabilitate anterior maxillary teeth.

The treatment sequel of post-traumatic teeth for the use of dental implants in the anterior maxillary region to rehabilitate anterior maxillary missing teeth was evaluated. Files of 53 healthy patients reporting anterior dental trauma were reviewed. All patients had an anterior maxillary dental implant because of tooth loss after trauma. At initial examination, 18 patients (34%) had root canal treatment and an inflammatory lesion, 15 (28.3%) had a missing tooth on admission, 12 (22.6%) had a prior operation (i.e. root-end surgery or crown lengthening), 4 (7.5%) presented an ankylotic root, and 4 (7.5%) had a root remnant not suitable for rehabilitation, with no inflammatory periapical lesion. Treatment sequences and complications were recorded. Augmentation procedure (i.e. onlay bone graft or guided bone regeneration) was performed in 43 patients (81.1%), and 2 patients (3.8%) had orthodontic extrusion prior to tooth extraction and implantation. Implants were placed immediately in 25 patients (47.2%) and 4 (7.5%) had immediate loading at the time of implantation. Complications and postoperative incidents (fistula, inflammation, swelling hematoma, etc.) were observed in 24 patients (45.3%). There was no difference in complication and postoperative incident rates with regards to the implantation technique. Complications were found at the prosthetic phase in seven patients (13.2%; six fistula and one implant failure). When patients were divided into two groups, with and without an inflammatory lesion, a significantly lower complication and postoperative incident rate were found in the non-inflammatory group (P = 0.057). This study reaffirmed the necessity for scrupulous diagnosis of teeth and alveolar bone after a traumatic injury. Treatment is multidisciplinary, requiring surgical, orthodontic, endodontic, operative, and prosthetic compliance. A specially designed treatment plan for each patient is necessary. General rules do not apply.

Alveolar Ridge Augmentation↗
PubMed2000

Maintaining and attenuating periodontal tissues for aesthetic implant placement.

Alveolar ridge resorption and soft tissue recession after tooth extraction inevitably disrupted the harmonious pre-existing periodontal complex, compromising clinicians' ability to recreate successful aesthetic restorations. Although numerous surgical procedures had been advocated for the augmentation of both the alveolar ridge and its soft tissue to ideal contours, questions remain regarding viability and predictability of these procedures. This is especially critical in the maxillary anterior region, where a the condition of the soft tissue complex and its relationship to the implant restoration and its adjacent dentition often determines the implant's success. The described technique of retaining the root remnant and inducing the proliferation of the surrounding tissue in conjunction with immediate implant placement results in the preservation of existing soft and hard tissue, thus minimizing the necessity of grafting procedures and facilitating primary flap closure during implant placement.

Adult↗
PubMed1997

Collagen synthesis from human PDL cells following orthodontic tooth movement.

The dynamic remodelling processes in the periodontal ligament (PDL) account for the reaction of PDL cells to different orthodontic force simulations. These occur mostly by degradation and synthesis of collagen types I, III, V, VI, XII and XIV. The purpose of this study was to quantify specific collagen types in the PDL from zones of tension and compression of experimental teeth. Such changes could then be correlated with the processes of orthodontic-stimulated tissue breakdown. Maxillary and mandibular premolars of three females and one male patient were orthodontically moved with a box loop for a total of 14 days, prior to tooth extraction. Teeth from the contralateral side of either the maxilla or the mandible served as the untreated controls. A total of seven experimental and seven control teeth were used in this investigation. PDL fibroblasts from the cervical third of the roots corresponding to the compression and tension zones of the experimental and control teeth, respectively, were scraped and cultured in vitro at 37 degrees C in a humidified incubator with 5 per cent CO2/95 per cent air. Collagen synthesis of types I, III, V and VI was quantified by using an ELISA. Application of orthodontic forces in the experimental teeth showed a significant increase (P < 0.05) of the synthesis of all collagen types in the compression as opposed to the tension zones. Collagen synthesis on the compression zone of experimental teeth was not significantly different in the mandible when compared with those of the maxilla. In addition, the proportional distribution of different types of collagen was also not significantly different in the PDL fibroblasts from either zone of experimental teeth of either the maxilla or the mandible. Collagen metabolism in response to orthodontic stimulation appears to be higher in the compression zones and lower in the tension zones. Contrary to what is traditionally assumed in the literature, such findings indicate that in addition to bone resorption, tissue remodelling is very active in zones of compression following the disappearance of the hyalinized areas. These findings constitute a model for future studies on collagen metabolism during orthodontic-stimulated tooth movement.

Adolescent↗