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Disability weights for the burden of oral disease in South Australia.

BACKGROUND: Australian burden of disease estimates appeared inconsistent with the reported repetitive and ubiquitous nature of dental problems. The aims of the study were to measure the nature, severity and duration of symptoms for specific oral conditions, and calculate disability weights from these measures. METHODS: Data were collected in 2001-02 from a random sample of South Australian dentists using mailed self-complete questionnaires. Dentists recorded the diagnosis of dental problems and provided patients with self-complete questionnaires to record the nature, severity and duration of symptoms using the EuroQol instrument. Data were available from 378 dentists (response rate = 60%). RESULTS: Disability weights were highest for pulpal infection (0.069), caries (0.044) and dentinal sensitivity (0.040), followed by denture problems (0.026), periodontal disease (0.023), failed restorations (0.019), tooth fractures (0.014) and tooth wear (0.011). Aesthetic problems had a low disability weight (0.002), and both recall/maintenance care and oral hygiene had adjusted weights of zero. CONCLUSIONS: Disability weights for caries (0.044), periodontal disease (0.023) and denture problems (0.026) in this study were higher than comparable oral health conditions in the Australian Burden of Disease and Injury Study (0.005 for caries involving a filling and 0.014 for caries involving an extraction, 0.007 for periodontal disease, and 0.004 for edentulism). A range of common problems such as pulpal infection, failed restorations and tooth fracture that were not included in the Australian Burden of Disease and Injury Study had relatively high disability weights. The inclusion of a fuller range of oral health problems along with revised disability weights would result in oral health accounting for a larger amount of disability than originally estimated.

Journal Article↗

Tooth crown fractures in 3-year-old Andalusian children.

PURPOSE: The purpose of this study was to determine the prevalence of tooth crown fractures affecting primary incisors of 3-year-old Andalusian children. METHODS: Clinicians examined 337 three-year-old children (mean age=3.6 years) of Seville, Andalusia, southern Spain. They examined the children for several dental and oral conditions, including tooth trauma. RESULTS: Crown fractures were found in 15% of the examined children. The prevalence of tooth crown fractures was significantly higher in males (18%) than in females (10%) (P=.04; odds ratio:0.5). In both genders, the upper central incisors had the most fractures, 77% in males and 71% in females. The most common crown fracture was found in enamel only (82%), followed by fracture into dentin (12%), and fracture involving the dental pulp (7%). CONCLUSIONS: Dentists have a responsibility to examine primary tooth injuries at the initial presentation of children because a dental injury to a primary tooth may include more severe injuries, such as dento-alveolar fractures.

Child, Preschool↗

[Root fracture and tooth luxation. Endo-orthodontic technic after 15 years].

The authors described a personal treatment method for the traumatic root fractures in the permanent incisors, and the review of their results after 15 years. The method consists in the good immobilisation and fixation of the injured teeth, with orthodontic bands and brackets and arch wire. They put this orthodontic contention for one-two months, and after x-ray control and pulp vitality checks, removed it. They presented also the use of the same technique in the luxations of permanent incisors, and compared the results. In the root fractures the authors obtain good long distance results, such as pulp vitality, good health, calcified tissue in the fracture zone, good stability of the tooth. Otherwise in the incisors luxations they frequently founded pulp necrosis, and root resorption in the long distance controls.

Child↗

Restoration fractures, cusp fractures and root fragments in a diverse sample of adults: 24-month incidence.

BACKGROUND: There are few reports in the literature regarding estimates of the occurrence of tooth fractures. Most studies have assessed tooth fractures in people seeking dental care, which may underestimate the incidence of the problem. METHODS: This study sought to estimate the incidence and prevalence of cusp and restoration fractures, as well as root fragments in participants in the Florida Dental Care Study, a diverse representative sample of community-dwelling residents of four north Florida counties made up of people who seek dental care regularly and those who do not. Participants received a dental examination and an in person interview at baseline and at a 24-month follow-up session. RESULTS: At least 20 percent of the participants were diagnosed as having bulk restoration fractures, cusp fractures or root fragments at the baseline visit. At the 24-month follow-up session, 26 percent of the participants had at least one new occurrence of these problems. Of those subjects presenting with tooth fracture, 25 percent had multiple teeth affected. African-Americans and people who sought care on a problem-oriented basis experienced twice the rate of cusp fracture and a higher rate of root fragments as did those who sought care on a regular basis. These data represent consecutive prevalence estimates rather than the true incidence, in that fractures that occurred after baseline may have been treated in the intervening 24 months. Thus, these data represent "lower-bound" incidence estimates. CONCLUSIONS: These results suggest that restoration fractures, cusp fractures and root fragments are a significant dental health problem, and that selected segments of the population are at greater risk of developing these problems. CLINICAL IMPLICATIONS: These data are useful for dentists in understanding the magnitude of the problem and the potential progression of fractures and root fragments.

Adult↗

Causes of failure among cuspal-coverage amalgam restorations: a clinical survey.

BACKGROUND: Investigations of cuspal-coverage amalgam restorations suggest that tooth fracture is the leading cause of failure, while for Class I and II restorations, the leading cause is caries. In this study, the authors evaluated the causes of failure for a large number of cuspal-coverage restorations. METHODS: The causes of failure for 706 cuspal-coverage amalgam restorations were determined through the use of a questionnaire. Dentists from a variety of dental schools; Army, Navy, Air Force, Public Health and Veterans Affairs dental clinics; and private practice were asked to record pertinent information regarding patients and restoration failures from choices provided on a survey form. RESULTS: The survey documented 706 failed restorations. Mandibular first molars accounted for 36.25 percent of all failures. The majority of failures were caused by fractured teeth (24.3 percent), caries (20 percent) and fractured restorations (17.1 percent). Among all of the failed restorations, 82.15 percent were restorable, 9.35 percent were repairable and 8.50 percent were nonrestorable. Among the fractured teeth, 80 percent were restorable, 14.5 percent were nonrestorable and 5.5 percent were repairable. Among the carious teeth, 84 percent were restorable, 8 percent were nonrestorable and 8 percent were repairable. A chi 2 analysis revealed that tooth fracture was more likely to be associated with nonrestorability than either caries (chi 2 = 5.013, P < .05) or restoration fracture (chi 2 = 6.202, P < .05). CONCLUSIONS: The leading cause of failure among the 706 restorations was tooth fracture, which resulted in significantly greater numbers of nonrestorable teeth than either caries or fractured restorations. CLINICAL IMPLICATIONS: Tooth fracture creates a greater risk of nonrestorability than any other cause of failure. Replacement or coverage of fracture-prone cusps is likely to improve the life expectancy of complex amalgam restorations.

Adolescent↗