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PubMed2001

Immediate functional loading of immediate implants in edentulous arches: two-year results.

The purpose of this study was to evaluate the clinical success of immediate functional loading of immediate implants in edentulous arches. Five maxillary and five mandibular jaws were treated, and a total of 91 implants were placed; 66 of these implants were placed immediately after tooth extraction, and 25 were placed in healed sites. No bone substitutes or barrier membranes were used. Within 24 hours, fixed temporary restorations were inserted in all cases. During the entire 6-month healing time, all fixed temporary restorations were in normal function, after which the final fixed implant-supported restorations were inserted. After 24 months, the overall success rate of the implants was 92.31% (87.50% for the maxillary implants and 97.26% for the mandibular implants). The bone level measured mesially and distally was in 93.40% of all cases between the implant shoulder and the first thread. The present study shows that the immediate functional loading of immediate implants without the use of any bone substitutes or barrier membranes for fixed complete-arch reconstructions can be successful over a 2-year period.

Adult↗
PubMed1998

Probe penetration in relation to the connective tissue attachment level: influence of tine shape and probing force.

Previous research has shown that probing force and probe tine shape influence the clinically assessed probing depth. The purpose of the present study was to investigate the effect of tine shape and probing force on probe penetration, in relation to the microscopically assessed attachment level in untreated periodontal disease. In 22 patients, scheduled for partial or full mouth tooth extraction and no history of periodontal treatment, 135 teeth were selected. At mesial and distal sites of the teeth reference marks were cut. Three probe tines, mounted in a modified Florida Probe handpiece, were tested: a tapered, a parallel and a ball-ended; tip-diameter 0.5 mm. The three tines were distributed at random over the sites. At each site increasing probing forces of 0.10 N, 0.15 N, 0.20 N, 0.25 N were used. After extraction, the teeth were cleaned and stained for connective tissue fiber attachment. The distance between the reference mark and the attachment level was determined using a stereomicroscope. The results showed that the parallel and ball-ended tine measured significantly beyond the microscopically assessed attachment level at all force levels; with increasing forces, the parallel tine measured 0.96 to 1.38 mm and the ball-ended tine 0.73 to 1.06 mm deeper. The tapered tine did not deviate significantly from the microscopic values at the forces of 0.15, 0.20 and 0.25 N. It can be concluded that for the optimal assessment of the attachment level in inflamed periodontal conditions, a tapered probe with a tip diameter of 0.5 mm and exerting a probing force of 0.25 N may be most suitable.

Connective Tissue↗
PubMed1985

Silhouette profiles in the assessment of facial esthetics: a comparison of cases treated with various orthodontic appliances.

This study uses comparisons of silhouette profiles to determine the effects of orthodontic treatment on facial esthetics. Forty-eight white patients with Class II, Division 1 malocclusions and mandibular retrognathism were treated, without tooth extraction, with the Fränkel appliance and by the Begg light-wire, the straight-wire edgewise, and the Tweed edgewise methods. One hundred first-year dental students selected the profile which they estimated had the best facial esthetics and then evaluated this preferred profile as "satisfactory" or "unsatisfactory." As more posttreatment than pretreatment profiles were preferred for each of the four treatment groups, there was no clear trend in preference among the treatment modalities assessed. Percentages of the preferred posttreatment silhouettes selected as "satisfactory" ranged from 46 to 55. The results support the use of the silhouette in the evaluation of profiles. Also, they show the advantage of determining, in surveys of facial esthetics, whether or not preferred profiles or faces are "satisfactory" to the viewers. However, since it is a simplified representation of a profile, the silhouette is a complement to other methods of profile evaluation, not a substitute.

Cephalometry↗
PubMed1998

[A survey on condition of outpatients at prosthodontics II, University Hospital, Faculty of Dentistry, Tokyo Medical and Dental University].

The number of dental patients who have medical illnesses is increasing at the hospital of the Faculty of Dentistry, Tokyo Medical and Dental University. Although prosthodontic treatments are considered less invasive in all dental treatments, invasive procedures such as tooth extraction may be required occasionally. Therefore, it is necessary to treat patients in consideration of their condition. Under this situation, a clinical survey was conducted by health questionnaires answered by the patients who visited our clinic between October 1992 and March 1997. The number of patients whose illness was heart disease, hypertension, diabetes, nephritic disease, hepatitis, tuberculosis, hemodyscrasia, asthma, epilepsy, and so on during dental treatment was higher than the national average according to the Ministry of Health and Welfare. Dental psychosomatic diseases such as TMD and dental phobia were increased every year. These data reflect the contemporary disease structure in Japan characterized by the spreading of life-style related diseases and increase of neuropsychological and infectious diseases.

Adolescent↗
PubMed1989

[Long-term observation of patients with trauma of the lower anterior primary teeth].

Three patients who had had trauma of the lower primary central incisors at the age of 1.5 years or less were observed with regard to the IIIB and/or IVA after eruption of the permanent dentition, and the findings were discussed from the viewpoint of space control. Patient 1 suffered shedding and loss of A perpendicular A following a fall downstairs at the age of 1.5 years. Measurement of the distance between B perpendicular B teeth revealed a tendency toward space closure and decrease until the age of 4 years and 6 months. At the age of 5 years and 11 months, the space was greater than that at the age of 4.5 years. The patient was also found to have brownish, partially parenchymatous defects of the permanent dentition, which were considered to be a sequela. Patient 2 suffered dislocation of A perpendicular A and root exposure at the age of 1 year and 1 month, and received treatment involving restoration and fixation for a 10-day period using a resin splint. Because of a fistula at the apical region of A and a discolored brown with internal resorption revealed by roentgenography, which were observed at the age of 4 years and 10 months, tooth extraction was performed and the course was observed with local space maintenance. When the patient was 6 years and 4 months old, eruption of 1 perpendicular 1 and hypoplasia of the labial surface were recognized. Since it proved possible to preserve A perpendicular A until the patient was 4 years old, the course was observed without any decrease in space until permanent dentition was accomplished. Patient 3 suffered shedding and loss of A perpendicular A at the age of 8 months. When the patient was 1 year and 3 months old, eruption of B perpendicular B occurred with mesial inclination. At the ages of 2 years and 7 months and 6 years and 4 months the patient underwent treatment with a space retainer and eruption of 1 perpendicular 1, respectively, without association of abnormal findings on the labial surface, probably because crown formation of 1 perpendicular 1 had not yet occurred due to the trauma suffered by the patient.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗
PubMed1997

Five-year incidence of coronal and root caries in 60-, 70- and 80-year-old Swedish individuals.

The 5-year incidence of caries was studied in a random sample of 60-, 70- and 80-year-old inhabitants of Göteborg, with 69, 51 and 28 individuals in the different age groups. One aim of the study was to introduce a root caries index (DMFRS%) in which the missing root surfaces are taken into account. This study, as well as other recent studies, has shown that dental caries is the main reason for tooth extraction. The study also revealed that coronal and root caries occurred more frequently in elderly than younger people and the incidence of root caries was positively correlated with coronal caries (r = 0.3, p < 0.001) and negatively correlated with the number of remaining teeth (r = 0.4, p < 0.0001). The 5-year DMFRS% increment values increased with advancing age from 2.7 involved root surfaces per 100 susceptible ones in the 60-year-olds to 4.8 in the 70-year-olds and 10.7 in the 80-year-olds. It should be mentioned, however, that only people able to come to the clinic were enrolled in the study and an analysis of the attrition bias indicated that oral health may be worse in those who are too ill to participate. The frequent utilization of dental care among the participants was reflected in the finding of several new fillings and prosthetic crowns. Most of the very elderly people with carious lesions at baseline, however, had developed new lesions at the margins of the newly made restorations.

Aged↗
PubMedDate not supplied

Immediate one-stage postextraction implant: a human clinical and histologic case report.

The placement of an implant immediately after tooth extraction may have the following advantages: reduction in morbidity, treatment time, and treatment costs; preservation of the residual ridge width and height; optimal esthetic result; and easier definition of implant position. The aim of the present study was the presentation of a human clinical and histologic report involving a nonsubmerged implant placed in a mandibular postextraction site and removed because of persistent pain. At low-power magnification, it was possible to see that newly formed bone with wide osteocyte lacunae was present around the implant. A 1.5-mm sulcular epithelium was visible on one side of the implant, with a 0.5-mm epithelial attachment. The thickness of the supracrestal connective tissue was 3.2 mm. This connective tissue was dense, had few cells, was well vascularized, and showed no evidence of an inflammatory infiltrate. Under polarized light, it was possible to observe that the connective fibers were arranged perpendicular to the implant surface and that these fibers became parallel near the implant. These results show that human immediate postextraction implants can have a high percentage of bone-implant contact.

Alveolar Process↗
PubMed2006

Survival of immediately loaded dental implants in deficient alveolar bone sites augmented with beta-tricalcium phosphate.

PURPOSE: Dental implant placement in atrophic alveolar ridges often necessitates grafting procedures, followed by immediate or delayed implant placement. This study assessed the survival of immediately loaded dental implants placed in deficient alveolar bone sites at bone grafting. MATERIALS: From 1999 to May 2002, 1 operator (A.P.) inserted 1065 implants (607 in mandibles, 458 in maxillae) into 338 partially edentulous patients. Most implants were placed into compromised residual ridges or prepared tooth extraction sockets. Implants placed in augmented areas were splinted to implants in nonaugmented sites for stability. In all cases, beta-tricalcium phosphate was mixed with blood from the surgical site to augment the ridge level or fill spaces between the implant and socket wall. When indicated, the same materials were used for sinus floor augmentation. All implants were tapered screws with roughened surfaces, primarily (75%) from 1 manufacturer. One of the authors (Z.O.) prosthetically restored a total of 189 implants that were placed in 35 patients. In this group of patients, complete restorative data were available. All implants were monitored for 12-48 months (mean = 19.2; median = 24). RESULTS: A total of 1039 implants survived, and 26 failed, including 5 in the anterior mandible and 21 in the maxillae. In the restorative group, 186 implants survived, and 3 maxillary implants failed. All implant failures in this study occurred in the augmented sites. CONCLUSION: Within the limitations of this study, immediate loading of splinted implants in augmented sites is a predictable procedure.

Alveolar Ridge Augmentation↗
PubMed1993

Traumatic root resorption in dentine-immunized mice.

Traumatic root resorption in a mouse model has been shown to coincide with a decline in naturally occurring serum antibody levels to dentin. It has been proposed that root resorption may be dentin antibody mediated. The purpose of this study was to examine the traumatic root resorption response in mice after hyperimmunization with a crude tooth extract (dentin). The hypothesis of this study was that elevated dentin antibody titers would positively correlate with root resorption. Mice were immunized with mouse dentin and controls were sham immunized. All mice were boosted 4 weeks later with or without mouse dentin as appropriate. All mice were then boosted two more times at weekly intervals with mouse dentin and then twice at weekly intervals with rat dentin. The change to rat dentin was made to increase mouse serum antibody titers to dentin. Serum samples were obtained before the initial immunization and weekly after each boost and were examined for antibody-to-dentin antigen by the enzyme-linked immune sorbent assay (ELISA). One week after the second boost with rat dentin, all animals were exposed to the cryoprobe procedure. Mice were killed 10 days later, and serum tested for antibody to dentin antigen. The incisors were examined by scanning electron microscopy, and root resorption quantified. Root resorption was observed on the incisors in the sham-immunized mice but not in the dentin-immunized mice. A trend toward increased serum antibody titers to dentin in immunized mice was observed over time.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1998

Enhanced angiogenesis induced by diffusible angiogenic growth factors released from human dental pulp explants of orthodontically moved teeth.

The aim of this study was to determine if diffusible angiogenic growth factors were released in human dental pulp during orthodontic tooth movement. These factors, if diffusible, could induce angiogenesis in other tissues, and may then be isolated and identified. The pulps from 14 premolar teeth treated with straight wire fixed orthodontic appliances for 2 weeks were compared with those of 14 untreated control premolar teeth from the same subjects. Following tooth extraction and sectioning, 1-mm horizontal sections of pulp tissue were embedded in collagen with 1-mm sections of rat aorta and co-cultured in growth media for up to 4 weeks. Sections of rat aorta alone were also cultured. Angiogenic changes in the form of microvessel growth were observed by light microscopy. Microvessel identification was confirmed by electron microscopy and by immunohistochemistry using staining for factor VIII-related antigen marker for endothelial cells. When compared at days 5, 10, and 14 of co-culture, the number of microvessels was significantly greater in the pulps from orthodontically moved teeth than in those from the control teeth. The number of rat aorta microvessels was also significantly greater when co-cultured with pulp from orthodontically moved teeth than with pulp from control teeth and when compared with control cultures of rat aorta alone. There were no significant differences in microvessel numbers between the rat aorta co-cultured with pulp from control teeth and control cultures of rat aorta alone. These results indicate an increase in angiogenic growth factors in the pulp of orthodontically moved teeth, and the enhanced response of the rat aorta when co-cultured with this pulp shows that these factors appear to be diffusible.

Adolescent↗
PubMed2002

Resorbable defect analog PLGA scaffolds using CO2 as solvent: structural characterization.

After tooth extraction, the immediate wound treatment by implanting an exact copy of the root could prevent alveolar bone atrophy. The implant should have an interconnected porosity in order to promote tissue in-growth. This communication reports a novel method to realize such net-shaped porous scaffolds fabricated within a few minutes. Porosity and micro-architecture are evaluated by Hg-porosimetry and by image analysis of electron and light microscopy as well as by computed micro-tomography. The total porosity of the scaffold corresponds to (63 +/- 3)%, mainly related to open interconnected porosity. Micro-tomography, as a noninvasive 3D method, is best suited to uncover pores of about 100 microm, a diameter especially important for tissue in-growth. The differentiation between open and closed porosity, however, depends on the method chosen. This effect is attributed to the spherical pores with an orifice only detected in the 3D analysis. Consequently, the closed porosity is overestimated by 8% evaluating 2D images. Finally, the mean pore diameter is found to be 106 and 100 microm for 2D and 3D analysis, respectively. Although the porosity of the scaffold needs to be further optimized for clinical applications, the procedure proposed is a promising route in manufacturing open porous implants without the use of any organic solvent.

Alveolar Bone Loss↗
PubMed2001

Effects of implant design and surface on bone regeneration and implant stability: an experimental study in the dog mandible.

BACKGROUND: Previous experimental studies have shown a higher degree of bone-implant contact for surface-enlarged implants compared with machined implants. Yet, there is insufficient evidence that such implants show higher stability and an increased survival rate. PURPOSE: The purpose of this investigation was to study the integration and stability of grit-blasted implants with retention elements on the implant neck, with and without marginal bone defects, compared with machined implants without retention elements. MATERIALS AND METHODS: After tooth extraction of the mandibular premolars in six dogs, two grit-blasted, partly microthreaded Astra Tech implants and one standard Brånemark implant were bilaterally placed in each dog. On one side, 3 x 3 mm large buccal defects were created, to expose three to four implant threads. The contralateral side served as control, and no defects were made. The animals were sacrificed after 4 months of healing. Implant stability was measured using resonance frequency analysis at implant installation and after 4 months of healing. Histologic and histomorphometric evaluation was made after 4 months of healing. RESULTS: Resonance frequency analysis indicated that all implants in the test and control groups were osseointegrated after 4 months, with a tendency toward higher implant stability for the Astra Tech implants. There was a statistically significant higher increase in resonance frequency for the Astra test implants compared with their corresponding controls. Histology and histomorphometry showed well-integrated implants with varying degrees of bone repair at the defect sites. The greater bone-implant contact for the Astra implants was statistically significant. No significant difference between the implants in amount of bone filling the threads was recorded. CONCLUSIONS: The Astra Tech implants tested showed a higher degree of bone-implant contact and higher level of bone regenerated at defect sites compared with the Brånemark implants. Resonance frequency analysis demonstrated a significantly higher increase in the Astra test implants compared with their control groups than did the Brånemark test implants versus their controls.

Alveolar Bone Loss↗
PubMed2003

The jumping distance revisited: An experimental study in the dog.

Following tooth extraction, a socket often presents dimensions that may be considerably greater that the diameter of a conventional implant. The present experiment was performed to study the healing that occurred adjacent to implants placed in recipient sites with a wide marginal defect. Four Labrador dogs were used. In the right side of the mandible, four experimental sites were prepared to receive titanium implants [sandblasted, large-grit, acid-etched (SLA) surface]. Traditional implant installation (control) was performed in one site. In the remaining three sites (test), a step drill was used to widen the marginal 5 mm of the canal. Following placement of an implant in a test site, a circumferential gap about 1-1.25 mm wide and 5 mm deep was present lateral to the implant. A resorbable barrier membrane was used to cover the implant and the bone tissue of two sites, while one site was left uncovered. Four months following implant installation, block biopsies of each implant site were obtained and prepared for ground sectioning. After 4 months of healing, the large marginal defect had been filled with newly formed bone. The degree of bone-to-implant contact between the newly formed tissue and the SLA surface was at all test sites high and similar to that obtained at control sites. The placement of a barrier membrane following implant installation did not improve the outcome of healing. We conclude that a marginal defect wider than 1 mm may heal with new bone and a high degree of osseointegration to an implant designed with a SLA surface.

Absorbable Implants↗
PubMed1984

Thrombotic and hemorrhagic complications in children with the lupus anticoagulant.

Endogenous circulating anticoagulants are unusual in children without a congenital factor deficiency. In particular, the lupus anticoagulant has only rarely been reported in children. Despite its functioning in vitro to prolong the partial thromboplastin time, patients more frequently have problems with thrombosis than bleeding, unless there is a coexistent prothrombin deficiency or thrombocytopenia. We report the cases of three children with the lupus anticoagulant. Two children had associated thromboses. One had a thrombosis of the iliofemoral system and the other had a partial Budd-Chiari syndrome, a thrombosis of the deep calf veins and ureteric obstruction. The third child had a concomitant prothrombin deficiency and bleeding after tooth extraction. Associated findings in these patients included a positive antinuclear antibody test in two, a positive anti-DNA antibody test in two, a false-positive VDRL test in two, and an antiphospholipid antibody test in two.

Adolescent↗
PubMed1984

Adenocarcinoma of the rectum metastatic to the oral cavity. Two cases and a review of the literature.

Two cases of metastatic adenocarcinoma occurring in the oral cavity are presented. One patient experienced lip paresthesias and pain as the presenting complaint. The other patient developed a growth at the site of a recent tooth extraction, and had bony erosion of the adjacent maxilla. The literature on metastatic lesions to the oral cavity including mandible is reviewed. This problem has been described almost exclusively in the oral and dental surgery literature. The clinical symptoms and signs described here should suggest the possibility of metastatic tumor to the oral cavity, and may be the initial manifestation of malignant disease.

Adenocarcinoma, Mucinous↗
PubMed1993

Combined hereditary factor XI (plasma thromboplastin antecedent) deficiency, von Willebrand's disease, and xeroderma pigmentosum in a Japanese family.

We report a 28-year-old-Japanese male who had a skin tumor derived from variant type xeroderma pigmentosum (XP), combined with factor XI (FXI) deficiency and type IIB von Willebrand's disease (vWd). The patient had abnormal bleeding history on tooth extraction. FXI clotting activity (FXI:C) and antigen (FXI:Ag) were remarkably decreased (< 0.01 U/ml, < 0.02 U/ml, respectively). Factor VIII (FVIII) clotting activity, von Willebrand factor antigen (vWf:Ag), and ristocetin cofactor (RCoF) were 0.43 U/ml, 45%, and 57%, respectively. Ristocetin-induced platelet agglutination (RIPA) revealed hyper-aggregation compared with a normal control. Multimeric composition of vWf in plasma showed a reduction in high molecular weight forms. The family study revealed two other subjects with homozygous hereditary FXI deficiency and vWd, and five subjects with heterozygous FXI deficiency. The relationship between FXI deficiency and vWd is discussed and previously reported cases are reviewed.

Adult↗
PubMed2002

Hereditary intraosseous vascular malformation of the craniofacial region: an apparently novel disorder.

Primary intraosseous vascular anomaly, previously called intraosseous hemangioma, is a very rare malformation that is usually seen in the vertebral column and in the skull. It is exclusively described in sporadic cases and no hereditary component has yet been reported. The most commonly affected bones in the skull are the mandible and the maxilla, and life-threatening bleeding after a simple tooth extraction is frequently observed. Here, we report two consanguineous families containing a total of four affected patients manifesting primary intraosseous vascular malformation (VMOS (vascular malformation osseous)) of the craniofacial region. The phenotypic expression is remarkably similar in both families. The characteristic findings include severe blood vessel expansions within the craniofacial bones and midline abnormalities such as diastasis recti, supraumbilical raphe, and hiatus hernia. Malformation is restricted to the mandibular and maxillary area in the prepubertal age, and rapid expansion starts after age 12 or 13. A 15-year follow-up of one of the patients demonstrated that the vascular malformation did not extend beyond the craniofacial region despite severe involvement of almost all bones in the skull. Detailed clinical and radiological evaluation provided neither evidence of soft-tissue involvement nor any sign of gross arterial, venous, or combined malformations, indicating that bone changes are a primary rather than a secondary effect due to any other vascular anomaly in the craniofacial region. An antibody against a universal proliferation marker, Ki-67, detected nonproliferative, single-layered endothelial cells, suggesting that this abnormality is a vascular malformation rather than a hemangioma. alpha-actin staining (antibody against perivascular tissue such as smooth muscle cells (SMCs) and/or pericytes) demonstrated that pathologic vessels lost their surrounding supportive tissues, as was previously seen in other types of vascular anomaly. Homozygosity mapping excluded the following loci and/or genes: multiple cutaneous venous malformation (VMCM1; gene, TIE2) on chromosome 9p21; venous malformation with glomus cells (VMGLOM) on chromosome 1p22-p21; hereditary hemorrhagic telangiectasia type 1 (HHT1; gene, endoglin) and type 2 (HHT2; gene, activin) on chromosomes 9q34.1 and 12q11-q14, respectively; and cerebral cavernous malformation type 1 (CCM1; gene, KRIT1), type 2 (CCM2), and type 3 (CCM3) on chromosomes 7q11.2-q21, 7p15-p13, and 3q35.2-q27, respectively. To the best of our knowledge, this is a new disorder, which we call hereditary intraosseous vascular malformation of the craniofacial region.

Antigens, CD34↗