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Biomedical subjects

Adrian Becker

Publications and source records attributed to Adrian Becker.

17 recordsLinked to original sources
PubMed2005

Long-term follow-up of severely resorbed maxillary incisors after resolution of an etiologically associated impacted canine.

BACKGROUND: Resorption of maxillary incisor roots because of an impacted canine is a well-recognized phenomenon that occurs in a surprisingly high proportion of patients with impacted canines. In this retrospective study, we studied a sample of patients in whom the resorption was particularly severe. METHODS: The sample consisted of 11 patients (age, 11.8 +/- 1.2 years) with 20 severely resorbed maxillary incisors. The amount of resorption was measured at the outset (T1), when the impacted canine was distanced from the incisor root area (T2), at the completion of the orthodontic treatment (T3), and at a follow-up appointment at least 1 year posttreatment (T4). RESULTS: A 17.2% increase in the crown/root ratio occurred due to aggressive continued resorption between T1 and T2. The resorption rate reduced to an almost insignificant level, despite continued and often appreciable orthodontic movement of the resorbed teeth from T2 to T3. CONCLUSIONS: Patients with impacted canines should be screened for resorption and the impacted tooth treated as soon as possible. The resorption process can be halted and the affected tooth moved orthodontically without further risk of resorption. In the long term, with early treatment, even severely resorbed teeth do not suffer from increased mobility or discoloration and might not require splinting.

Child↗
PubMed2005

Patients perception of recovery after exposure of impacted teeth: a comparison of closed- versus open-eruption techniques.

PURPOSE: This prospective study compared the patients perception of immediate postoperative recovery after surgical exposure of impacted teeth, treated with a closed-eruption versus an open-eruption surgical technique. PATIENTS AND METHODS: Sixty patients (41 females and 19 males; mean age, 15.4 +/- 2.8 years) were given a Health-Related Quality of Life (HRQOL) questionnaire to be completed each postoperative day (POD) for 7 days. The questionnaire was designed to assess the patients perception of recovery regarding pain, oral function, general activity measures, and other parameters. The impact of possible predictor variables, such as age, gender, length of surgical procedure, tooth location, height of impaction, and the need for bone removal, was assessed. RESULTS: Substantial impairment and recovery time of pain and analgesic consumption, oral function (ability to eat and enjoy food, swallowing and mouth opening), and food accumulation were longer after an open-eruption exposure. No differences were recorded concerning general activity. Palatal impaction and the need for bone removal resulted in delayed recovery after exposure with an open-eruption technique. CONCLUSIONS: The immediate postoperative recovery was longer and more substantially impaired after open-eruption versus closed-eruption surgical techniques. The present study provides information to patients and clinicians assisting them in choosing the most appropriate surgical modality in relation to quality of health parameters.

Activities of Daily Living↗
PubMed2004

Orthosurgical treatment with lingual orthodontics of an infraoccluded maxillary first molar in an adult.

The biological mechanism that leads to a cessation in the normal passive eruption of a tooth is unclear, and there are differing views as to whether ankylosis is involved. When infraocclusion of a permanent molar occurs in the permanent dentition, its effects are seen (1) locally, with exaggerated tipping and relative under-eruption of the adjacent teeth; (2) regionally, with overeruption of the opposing tooth or teeth; and (3) farther afield, with deviation of the dental midline to the affected side. Treatment aimed at eliminating these adverse conditions is warranted, and this might involve the skills of both an orthodontist and an oral surgeon. When the condition occurs in an adult, the changes in facial appearance that will be caused by traditional fixed orthodontic appliances might undermine the patient's willingness to accept treatment. This report describes the successful orthosurgical treatment with lingual orthodontics of an infraoccluded maxillary first molar in an adult. The challenges, treatment alternatives, and technical refinements are emphasized.

Adult↗
PubMed2004

Patients' perceptions of recovery after exposure of impacted teeth with a closed-eruption technique.

This prospective study evaluated patients' perceptions of recovery after surgical exposure of impacted teeth treated with a closed-eruption surgical-orthodontic technique. Twenty-nine patients (16 female, 13 male; mean age, 16 +/- 2.8 years) were given a health-related quality of life questionnaire to be completed each postoperative day (POD) for 7 days. The questionnaire was designed to assess the patient's perception of recovery: pain, oral function, general activity, and other parameters. The impact of possible predictor variables, such as age, sex, length of surgical procedure, tooth location, height of impaction, and need for bone removal were assessed. Severe pain (27.6%, 13.8%, 3.4%) and consumption of analgesics (76%, 41%, 17%) declined gradually over the first 3 PODs. Improvement in oral function and other symptoms was evident by PODs 3 and 4. Absence from school outweighed interference in daily activity by 3 days (POD 6 vs POD 3). Buccolingual tooth location was the most significant predictor variable, with results showing a delayed recovery for patients with buccally impacted teeth. The most striking difference was reported with regard to swelling (P <.0001), followed by mouth opening (P =.008) and speech (P =.05). When the surgical procedure lasted 30 minutes or longer, there was prolonged recovery from pain (P =.01). This study provides information to patients and clinicians on postoperative recovery after surgical exposure of impacted teeth by the closed-eruption surgical-orthodontic technique.

Absenteeism↗
PubMed2004

Emergency orthodontic treatment after the traumatic intrusive luxation of maxillary incisors.

Treatment of traumatically intruded teeth is based largely on empirical clinical experience rather than on scientific data. The aim of this qualitative meta-analysis was to provide an evidence base to evaluate the orthodontic repositioning approach. In a MEDLINE search of the literature in English, 14 reported patients involving 22 teeth were found to have been treated by this modality. Additionally, 3 new patients, involving 9 intruded teeth and presented herein, were combined to form a total study sample of 17 subjects (7 girls, 10 boys, aged 8.9 +/- 1.2 years). Orthodontic extrusive forces were applied in the immediate posttrauma period (up to 3 months), with a variety of orthodontic appliances. Repositioning was achieved for 90.3% of the affected teeth but failed in 9.7% because of inflammatory resorption (2 teeth) or a misdiagnosis of root fracture (1 tooth). Early complications included loss of pulp vitality and external root resorption. All intruded teeth with closed root apices lost their vitality regardless of the degree of intrusion, whereas among those with incomplete apices, 45.5% that had been moderately intruded remained vital. External resorption was encountered in 54.8% of the teeth. Loss of marginal bone support was rarely encountered. Late complications included inflammatory root resorption in teeth with closed apices, in which endodontic treatment was not initially performed, and obliteration of the pulp tissue in teeth that remained vital. The results show that this method is superior to other treatment alternatives.

Child↗
PubMed2004

Forced eruption of maxillary incisor teeth from the lingual side.

A major disadvantage in using the forced eruption technique is the necessity for the placement of an unesthetic orthodontic appliance, especially when the tooth involved is a maxillary incisor. The aim of this article is to present two alternative simple, specific task-oriented devices that may be placed on the lingual side of the teeth and may be used in the anterior of the mouth without compromising appearance.

Adult↗
PubMed2004

The role of digital volume tomography in the imaging of impacted teeth.

AIM: Digital volume tomography is presented here as an alternative to routine computerized tomography in the diagnosis and treatment planning of impacted teeth. MATERIAL AND METHODS: A sample of 20 patients with a variety of types of tooth impaction was investigated and five representative cases are described. The potential disadvantages of digital volume tomography--inferior spatial resolution of subtle structures and limited representation of soft tissues--were of no clinical significance in the presented cases of impacted teeth. The method provides 3-dimensional images closely akin to regular computerized tomography imaging, yet the amount of radiation produced is less than one sixth that for regular computer tomography and its cost is considerably less. RESULTS AND CONCLUSION: There is reason to recommend the routine adoption of digital volume tomography imaging for positional diagnosis in most cases of impaction of teeth that are candidates for orthodontic resolution.

Child↗
PubMed2003

Maxillary incisor impaction and its relationship to canine displacement.

This study aimed to examine the eruption status of unerupted maxillary permanent canines in patients who also had an impacted central incisor. Seventy-five unilateral cases of the incisor anomaly were retrospectively examined. Using the initial panoramic films, we assessed the positions of the ipsilateral and contralateral canines and the lateral incisors and the timing (eruption progress) of the canines. The final position of the canines was evaluated from patient records and progress photographs. The data showed a significant increase in prevalence and severity of displaced canines in the ipsilateral side (41.3%) compared with the contralateral side (4.7%). Palatally displaced canines occurred in 9.5%, buccally displaced canines in 30.2%, and canine-lateral incisor transposition in 1.6% of the patients. Half of the buccally displaced canines in the ipsilateral side were pseudotransposed with the adjacent lateral incisor. The eruption timing of ipsilateral undisplaced canines was either similar or delayed, relative to the contralateral tooth, but never accelerated. The ipsilateral lateral incisor was strongly angulated because of a more distally located apex (5 mm) rather than a mesially tipped crown. The ipsilateral canine was relatively more superiorly positioned (undererupted). Patients who had trauma had a significantly higher prevalence and severity of canine displacement and more distally displaced lateral incisor apices. Initial height of incisor impaction did not influence the results. These data provide evidence of a significant environmental influence of an impacted maxillary central incisor in delaying and altering the eruption path of the ipsilateral maxillary canine.

Adolescent↗
PubMed2003

Success rate and duration of orthodontic treatment for adult patients with palatally impacted maxillary canines.

This study was undertaken to examine the success rate and the length of orthodontic treatment of impacted maxillary canines in adult patients. A sample of 19 adults (mean age, 28.8 +/- 8.6 years; range, 20-47 years), who had been treated for a total of 23 impacted maxillary canines, was compared with a younger control group (mean age, 13.7 +/- 1.3 years; range, 12-16 years). The control subjects were chosen for a similar degree of impaction difficulty by carefully matching the positions of the impacted canines in the 3 planes of space. The success rate among the adults was 69.5% compared with 100% among the younger controls. The lower success rate was due to 5 canines that had failed to erupt and 2 canines that had been partially extruded but could not be aligned in the arch. The duration of treating the overall malocclusion of the adults and young subjects did not materially differ. However, the adults showed significant increases in the duration and number of treatment visits required for resolving the canine impaction, in both the simpler and the more difficult cases. When further divided by age, all the failed canines were found in the older (over 30) adult subgroup. It was concluded that the prognosis for successful orthodontic resolution of an impacted canine in an adult is lower than that in a younger patient and that the prognosis worsens with age. Furthermore, when such treatment is undertaken, its successful completion should be expected to take considerably longer.

Adolescent↗
PubMed2003

Tooth size in dentitions with buccal canine ectopia.

Much interest has been expressed in recent years regarding various features common to dentitions with palatally displaced canines (PDC), particularly in relation to delayed dental development and reduced tooth size. The aims of the present study were to determine whether dentitions with buccally displaced canines (BDC) have features in common, which may be specific for the condition, when compared with PDC dentitions and those with normally erupting canines. Mesiodistal and buccolingual tooth dimensions were determined for 41 subjects with BDC (21 females and 20 males) aged between 11 and 15 years, who formed the experimental sample. The PDC sample was made up of 58 individuals (37 females and 21 males) and the control group comprised 40 age-matched and consecutively treated subjects (20 males and 20 females), exhibiting normally erupted and undisplaced maxillary canines. The results revealed marked sexual dimorphism. Larger-than-average teeth were present in BDC females, whereas the teeth in BDC males were normally sized. Unilaterally affected females had smaller teeth than bilaterally affected females. Tooth size in BDC was consistently larger than in PDC subjects, although the reason was different between the sexes. In females the PDC teeth were normally sized versus large BDC teeth, whereas in the males, the PDC teeth were small and the BDC teeth normal. It is concluded that combining male and female subjects into an overall BDC group obscures important differences that exist between the two sexes.

Adolescent↗
PubMed2002

Dental morphologic characteristics of normal versus delayed developing dentitions with palatally displaced canines.

An earlier study reported on the delayed dental age in about 50% of patients with palatally displaced canines (PDC), suggesting the possible existence of 2 different PDC phenotypes. The present study aimed to determine whether the PDC subgroup with late dental age displays different dental features from the PDC subgroup with normal dental age, supporting the above assumption. The 3 dental parameters examined were mesiodistal and buccolingual tooth sizes, the presence of anomalous maxillary lateral incisors, and other congenitally missing teeth. Fifty-eight subjects with PDC, 37 girls and 21 boys, were divided according to dental age and compared with age- and sex-matched controls. The results revealed marked sexual dimorphism. Delayed dental development was twice as prevalent among the PDC males. The existence of 2 distinct PDC subgroups was supported for males only. One subgroup was characterized by delayed dental development, smaller-than-average teeth, and a marked increase in the prevalence of anomalous lateral incisors. The second subgroup more closely resembled the controls, presenting a timely developed dentition, a moderate and nonsignificant increase of anomalous lateral incisors, and a reduction in the dimensions of only the central incisors and the first molars. In females, although the prevalence of anomalous lateral incisors was slightly increased in the late dental age subgroup, tooth sizes were remarkably similar, negating the existence of 2 distinct subpopulations. Studying the overall PDC group as a single entity produced confusing results because important differences were obscured when the 2 sexes and the 2 dental age subgroups (in males) were combined.

Adolescent↗
PubMed2002

Closed-eruption surgical technique for impacted maxillary incisors: a postorthodontic periodontal evaluation.

The aim of this study was to evaluate the clinical appearance and pulpal and periodontal status of impacted maxillary central incisors that had been exposed and aligned after a closed-eruption surgical technique. Twenty-one patients were examined 4.5 years (median) postretention. The treated central incisors showed no significant differences in plaque and gingival indexes, widths of attached gingiva, and crown lengths, whereas a small, but statistically significant, increase was found in the mean pocket depth compared with the contralateral incisors. The bone support was reduced by 5% to 6% in the treated teeth, and, in one third of the cases, an abnormal gingival contour was recorded. The lateral incisors revealed similar plaque and gingival indexes and pocket depths on each side, but the lateral incisors immediately adjacent to the treated tooth showed decreased widths of keratinized gingiva and increased crown lengths. Even though statistically significant differences were found in some of the periodontal parameters measured, the overall clinical consequences of a conservative exposure and orthodontic alignment of impacted incisors by the closed-eruption technique are minimal.

Adolescent↗
PubMed2002

Intravenous sedation: an adjunct to enable orthodontic treatment for children with disabilities.

Intravenous (i.v.) sedation has become established as an important and preferred alternative to general anaesthesia (GA), in order to overcome difficulties in patient management encountered in the delivery of routine dental treatment of the disabled. However, its potential for the delivery of orthodontics for this group has never been exploited. The present pilot study describes the use of i.v. sedation with propofol to enable the performance of certain complex orthodontic and surgical procedures, which require strict control of the oral environment for prolonged periods, in a group of 10 of the most-difficult-to-manage disabled patients. The use of i.v. sedation provided a satisfactory management modality in these patients, who had previously been referred for GA. The parents reported complete satisfaction and general agreement that the same modality would again be welcomed. I.v. sedation significantly reduces the use of GA and makes treatment more readily available to a larger number of disabled patients.

Adolescent↗
PubMed2002

Maxillary tooth size variation in dentitions with palatal canine displacement.

The association between the presence of palatally displaced maxillary canines (PDC) and other anomalies is well known, particularly with regard to the size and form of the lateral incisor. The present study investigated the connection between the maxillary canine anomaly and the existence of a reduction in the size of the other teeth in the maxilla in 58 consecutively treated patients (37 females, 21 males) aged 11-15 years, and compared these with a control group of 40 consecutively treated subjects (20 males, 20 females) with normally erupted maxillary canines. The findings indicate that the teeth of PDC males are reduced in size and similar to those of PDC females, in sharp contrast to the general population, where males have larger teeth. This is the result of a dimensional reduction in the teeth of PDC males, which was statistically significant for all teeth (P < 0.01) in the bucco-lingual (B-L) dimension, and for the first premolars and first molars in the mesio-distal (M-D) dimension. The sole teeth affected for both sexes were the lateral incisors in their B-L dimension. Bilaterally and unilaterally affected subjects presented differing M-D and B-L tooth dimensions.

Adolescent↗
PubMedDate not supplied

Stimulated parotid salivary flow rate in patients with Down syndrome.

Saliva is essential for oral defense against infections. Decreased salivary secretion may result in increased dental caries, oral mucosal changes, an altered sense of taste, difficulty in swallowing, and oral pain. A review of the literature reveals sporadic and contradictory reports on the use of sialometry and sialochemistry to explain the role of saliva in the oral health and well-being of subjects with Down syndrome. The present study documents parotid gland saliva secretion at different ages in a group of subjects with Down syndrome. Saliva was collected from 39 patients 11 to 62 years old, by means of a parotid salivary gland cup and under standardized conditions of stimulated secretion. The rate of salivary secretion in the entire group of patients with Down syndrome was lower than that of healthy controls and lower in the older study group compared with the younger group. Institutionalized subjects or those living in hostel-like apartments had a lower secretion rate than those living at home. No difference in salivary flow was found between those patients with Down syndrome with normal thyroid output and those with hypothyroidism who were receiving replacement therapy. In a four-way ANOVA with flow as the dependent variable and Down syndrome, hypothyroidism, institutionalization, and age as factors, Down syndrome was found to be the only variable significantly related to flow (p = 0.017). Our findings indicate that stimulated parotid salivary hypofunction in Down syndrome subjects is mainly related to their genetic disorder.

Adolescent↗