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At least 199 records · Page 11Linked to original sources

PubMed2005

Noncarious cervical lesions in adults: prevalence and occlusal aspects.

BACKGROUND: The factors that induce the formation of noncarious lesions are not understood fully, particularly those that are related to occlusal aspects. The authors conducted a study to evaluate the prevalence of noncarious cervical lesions in adults and their association with occlusal aspects. METHODS: The authors examined 70 people (35 men and 35 women) aged 25 to 45 years to determine the presence and type of noncarious cervical lesions, wear facets, tooth contacts in maximal intercuspal position, and lateral and protrusive movements. The assessment involved a questionnaire and clinical examination. RESULTS: Among the teeth the authors evaluated, 17.23 percent had cervical lesions, 80.28 percent of which had wear facets (P < .01). The authors found a significant difference between the prevalence of noncarious lesions and the presence of wear facets (P = .0484). CONCLUSIONS: The authors found that cervical lesions were related significantly to wear facets. These findings strengthen evidence for the role of occlusal forces as an etiologic factor for noncarious lesions. CLINICAL IMPLICATIONS: The presence of wear facets should be considered in the treatment of noncarious cervical lesions.

Adult↗

PubMed2005

A three-year clinical evaluation of two-bottle versus one-bottle dentin adhesives.

BACKGROUND: The authors conducted an in vivo investigation to compare the clinical performance of two commercial one-bottle adhesives and a two-bottle adhesive for restoration of noncarious cervical lesions (NCCLs). METHOD: The patient pool consisted of 57 patients and 171 teeth (three teeth per patient), with one NCCL per tooth. Each patient received three resin-based composite restorations, each with a different adhesive: one tooth with a two-bottle, water-based adhesive as the control; another tooth with a one-bottle, ethanol-based adhesive; and a third tooth with a one-bottle, solvent-free adhesive. The authors assessed restorations in terms of retention, marginal integrity, margin discoloration and air sensitivity at baseline, six months, one year, two years and three years after initial placement. RESULTS: The retention rates at 36 months were 88 percent for the first adhesive, 81 percent for the second adhesive and 90 percent for the third adhesive. No statistically significant differences in retention rates could be shown, with 86 percent of restorations retained overall. Measures of marginal integrity, marginal discoloration and sensitivity also had no statistically significant differences between the three adhesives (P > .05). CONCLUSIONS: All three adhesives performed with acceptable outcomes after a 36-month period, with small differences between the one- and two-bottle systems and between the various solvents. Retention rate was moderately high and air sensitivity was markedly reduced; however, superficial marginal discoloration and marginal degradation was notable. Certain lesion, tooth and patient characteristics may predispose restorations to retention failure. CLINICAL IMPLICATIONS: The type of solvent may not be a major factor in retention of Class V restorations in NCCLs. Both single-bottle adhesives and conventional two-bottle adhesives performed acceptably.

Adhesives↗

PubMed2005

Educational material of dental anatomy applied to study the morphology of permanent teeth.

The purpose of this report is to present educational material that would allow the dental student to learn to easily identify the morphologic characteristics of permanent teeth, and how they fit together (occlusion). In order to do this, macro models of permanent teeth with no attrition were carved in wax and later molded with alginate. These molds were filled with plaster, dental stone and/or cold-cured acrylic resin. The large individual dental stone tooth models were mounted on a wax base, thus obtaining maxillary and mandibular arches which were occluded. These dental arches were molded with plaster or dental stone. The authors suggest that these types of macro models allow an excellent visualization of the morphologic characteristics of permanent teeth and occlusion. Dental students are able to carve the permanent dentition in wax with great facility when they can observe macro models.

Acrylic Resins↗

PubMed2006

Evaluation of alveolar bone support of the permanent canine in cleft and noncleft patients.

OBJECTIVE: To quantitatively compare the alveolar bone support ratio of the permanent canine in cleft patients who received secondary alveolar bone graft with that of the population without clefts. DESIGN: Retrospective study utilizing periapical radiographs of the subjects with and without clefts. SETTING: Hospital and university based. PATIENTS: Eighteen unilateral and 9 bilateral cleft patients who had secondary bone graft procedures. MAIN OUTCOME MEASURES: Alveolar bone support of the permanent canine utilizing the ratio of bone height to root length. RESULTS: Average bone support for the permanent canine was 88.55% in patients with clefts and 95.59% in patients with no history of clefts. This difference was statistically significant. There was no statistically significant difference in alveolar bone support ratio between the unilateral and bilateral cleft patients. CONCLUSIONS: Although alveolar bone support was significantly higher in the noncleft control group, a successful level of alveolar bone support was achieved for the permanent canine on the cleft site after secondary bone graft. There was no difference in alveolar bone support achieved for the permanent canine whether the type of the cleft was unilateral or bilateral.

Adolescent↗

PubMed2002

A new scale to assess radiographic success of secondary alveolar bone grafts.

OBJECTIVES: To propose a new scale for evaluating the position of the bone graft within the cleft and assess its inter- and intraobserver reliability. DESIGN: Sixty-six patients (70 cleft sites) over a 14-year period were assessed, 90% of patients retrospectively and 10% prospectively. The radiographs were reviewed by two clinicians in controlled conditions twice, with 1 week between assessments. Both clinicians were blind to patient identity. OUTCOME MEASURES: A new scale subdividing the position of the bone into one of six categories was used. The radiographs were also assessed using the Bergland scale. RESULTS: Using the Bergland scale, 62.9% of the cleft sites were type I, 21.4% type II, 4.3% type III, and 5.7% type IV. It was not possible to assess 5.7% of the clefts with this scale because the canine was unerupted. Using the Chelsea alveolar bone graft scale, 58% were category A, 20% B, 7% C, 3% D, 3% E, and 9% F. CONCLUSIONS: The above scale can be used to determine accurately the position of bone within the cleft site. It can be used in the mixed dentition prior to eruption of the canine. It demonstrated moderate to substantial inter- and intraobserver reliability and offers several advantages, compared with other scales.

Adolescent↗

PubMed2004

Alveolar bone height in infraoccluded primary teeth.

The purpose of this research is to describe the distance from the cemento enamel junction (CEJ) to the alveolar bone crest (ABC) of infra occluded primary molars and the adjacent and opposing teeth. Bitewing radiographs from 29 children (mean age 98.8 months; SD 21.2), who had infra occluded molars, were scanned and measured. The results of these measurements found that the means of the CEJ-ABC distances of the mesial and distal aspects of the infra occluded teeth were 0.78 mm (SD 0.3) and 0.94 mm (SD 0.32) respectively. Pearson correlation coefficient analysis revealed no significant correlation between the different measurements, except when comparing the measurements in the infra occluded tooth and those of the opposing tooth. It was concluded that the CEJ-ABC values for infra occluded primary molars are shorter than normal values. The CEJ-ABC distances of the opposing and adjacent teeth to the infra occluded tooth are within normal limits.

Adolescent↗

PubMed2006

Black stains in the mixed dentition: a PCR microbiological study of the etiopathogenic bacteria.

The aim of this work is to emphasize that particular stains on the third cervical of the buccal and lingual surfaces in mixed dentition, called "black stain." Previous research showed the microbiological etiology of this discoloration by chromogen bacterias. Our study shows bacteria spp involved in stains by means of PCR process and electrophoresis gel on the agarose medium. Sample was formed by 100 subject with black stain and 100 control subjects stain-free. A statistical analysis (SPSS 10.0) using X2 was performed in this study. Porphyromonas gingivalis and Prevotella melaninogenica, were not involved in both in black stain subjects and in the control. On the contrary, Actinomyces could be involved in the pigmentation process.

Actinomyces↗

PubMed1996

The free rotated papilla autograft: a new bilaminar grafting procedure for the coverage of multiple shallow gingival recessions.

The aim of this clinical pilot study is to evaluate the possibility and from a statistical point of view, the predictability of a new mucogingival technique. The purpose of this surgical procedure is to cover the exposed buccal root surface with less than 5 mm clinical probing attachment loss either in corono-apical or mesio-distal aspects. This surgical procedure is particularly indicated in either single or multiple gingival recessions with perfectly preserved mesial and distal interproximal osseous crests, and with a papillary dimension not inferior to the defect which needs to be treated. A sharp incision is performed at a 90 degrees angle to the vestibule, following the mucogingival line. A sharp dissection is accomplished to create a partial thickness envelope flap on the underlying alveolar mucosa. The epithelium from the facial aspect of the papilla is debrided with a full thickness approach, the facial papillary tissue is removed from the underlying tissue bed. The papilla is then reversed in such a way that the base of the papilla is at the cemento-enamel junction (CEJ) and the apex is at the base of the gingival recession area. The papilla is then sutured in place and completely covered by a coronally displaced partial thickness flap. The results obtained either as root coverage, or as an aesthetic result, may be considered positive. This procedure has the decided advantage of a single surgical site, avoiding any palatal patient discomfort, good color compatibility with adjacent tissue, and healing by primary intention.

Adult↗

PubMed1997

Cervical enamel projection and intermediate bifurcational ridge correlated with molar furcation involvements.

In this study, we investigated the cervical enamel projection (CEP) and intermediate bifurcational ridge (IBR) correlated with localized molar furcation involvement (FI). Study samples consisting of 87 hopeless permanent mandibulars (56 first and 31 second molars), which required extraction for periodontal therapy, were randomly collected from the School's Dental Clinic. The furcal defects, CEPs, and IBRs of molars were diagnosed via clinical probing, periapical radiographs, and inspection of ground tooth sections of extracted teeth with a stereomicroscope. Prevalence and distribution of molars with CEPs and/or IBRs were also analyzed. Probing depths (PD), clinical attachment loss (CAL), gingival index (GI), and plaque index (PLI) were measured for the buccal and lingual surfaces of molar furcal areas. Moreover, the relationships between the molar FI with and without CEPs and IBRs and periodontal status were analyzed using Student's paired t-test. Based on those results, we can conclude the following: 1) among 87 molars with FIs examined, 63.2% (55/87) had cervical enamel projections and bifurcational ridges, and the prevalence was greatest in mandibular first (67.9%, 38/56) and second (54.8%, 17/31) molars; and 2) the differences in mean PD, CAL, PLI, and GI between the molars with and without CEPs and IBRs were highly significant (P < 0.001) in the mandibular first and second molars.

Coloring Agents↗

PubMed1997

Creeping attachment associated with the connective tissue with partial-thickness double pedicle graft.

The occurrence of creeping attachment has been documented with epithelialized autogenous masticatory mucosa grafts (free gingival grafts) and suggested in other root coverage techniques. The purpose of this study was to examine whether or not creeping attachment occurred after a connective tissue with partial-thickness double pedicle graft had been performed. This study examined 22 defects, in 19 patients, treated where less than complete root coverage was obtained at 4 weeks postoperative. Creeping attachment occurred in 21 of the 22 defects (95.5%), in 18 of the 19 patients (94.7%). Complete root coverage occurred in 17 of the 22 defects (77.3%), in 15 of 19 patients (78.9%). The mean creeping attachment obtained was 0.8 mm. Additionally, it was the goal of this study to see if any factor could be associated with creeping attachment. This study did not find any factors that could be associated with the amount of creeping attachment seen. Creeping attachment seems to occur commonly, but complete root coverage is not predictable.

Adult↗

PubMed1998

Root surface characteristics of primary teeth from children with prepubertal periodontitis.

This study describes the histologic characteristics of root surfaces of primary teeth from children with prepubertal periodontitis (PP). Fifteen primary teeth from 4 children with PP, and 2 control primary teeth from 2 healthy children were examined. Light microscopy revealed normal root surfaces in the control teeth. In contrast, the PP specimens revealed bacteria inside dentin tubules or covering cementum, a cuticle, or resorbed dentin; normal, wider than normal, or hypoplastic cementum; resorption lacunae with various depths; aplastic root resorption; alternate resorption and repair; and active repair. No cementoclasts were found in the resorption lacunae. Scanning electron microscopy revealed intrabony and suprabony root areas, and a "plaque free zone" (PFZ). Colonies of filaments were evident at the cemento-enamel junction (CEJ). The suprabony root surfaces had resorption lacunae, isolated short rods, calculus, colonies of filaments, or colonies composed by an heterogeneous bacterial population. The coronal boundary of the PFZ was the border of a sheet-like structure, which included isolated rods or filaments. At the PFZ, isolated filaments and rods, and a fibril matrix were evident. The apical boundary of the PFZ consisted of bundles of soft tissue remnants or the insertion of the periodontal fibers. The intrabony surfaces were mostly covered by soft tissue, which included isolated filaments and short rods. Resorption lacunae with or without soft tissue were also evident in this area. Crystals of calcium oxalate dihydrate and erythrocytes in distinct forms were found at various root areas. The present findings are different from those previously reported for hypophosphatasia specimens.

Aggressive Periodontitis↗

PubMed1998

Treatment of a previously placed autogenous masticatory mucosa graft (free gingival graft). A case report.

The autogenous masticatory mucosa graft (free gingival graft) has been used to treat various mucogingival conditions. Unfortunately, the esthetics of the procedure are often less than ideal. This case report examines the treatment of an unesthetic free gingival graft. The goal was to create a result so that it was impossible to tell there had ever been a free gingival graft or any surgery performed to correct a problem. To achieve this goal, 3 periodontal plastic surgical procedures were utilized and a crown was placed. This integration of multiple surgical procedures and prosthetics produced an outstanding result.

Connective Tissue↗

PubMed1999

Comparative clinical study of a bioabsorbable membrane and subepithelial connective tissue graft in the treatment of human gingival recession.

BACKGROUND: Connective tissue grafts and guided tissue regeneration (GTR) are the most current procedures in the treatment of gingival recession, but very few clinical comparative studies have been conducted. METHODS: The purpose of this study was to compare 2 types of treatment of gingival recession in the same patients. Fourteen pairs of Miller Class I defects were selected in 14 patients. In each pair, one recession was randomly assigned for treatment by GTR using a bioabsorbable membrane, and the other treated by subepithelial connective tissue graft (CTG). Height of recession (HR), clinical attachment level (CAL), probing sulcus depth (PSD), height of keratinized tissue (HKT), and distance from the cemento-enamel junction to the mucogingival junction (CEJ-MGJ) were recorded before surgery and 6 months postoperatively. RESULTS: The initial width and height of recession were, respectively, 3.73 mm (SD 0.56) and 3.85 mm (SD 1.15) for the CTG group, and 4.04 mm (SD 0.92) and 4.28 mm (SD 1.20) for the GTR group. The differences were not significant. CAL changes were not different. Both in the CTG group and in the GTR group, mean HR reduction was 2.89 mm (SD 1.18), representing a mean root coverage of 76% and 70.2%, respectively. The difference was not significant. HKT mean gain was significantly greater (P = 0.0001) with CTG (2.03 mm, SD 0.92) than with GTR (0.42 mm, SD 0.91). The GTR technique displaced the mucogingival junction significantly (P = 0.007) more coronally (2.35 mm, SD 1.44) than the CTG technique (0.78 mm, SD 1.23). CONCLUSIONS: Within the limits of this study, no difference could be found between subepithelial connective tissue graft and GTR with a bioabsorbable membrane with regard to root coverage, but the GTR technique did not increase the height of keratinized tissue and displaced the mucogingival junction more coronally at 6 months.

Absorption↗

PubMed1999

Coronally advanced flap procedure for root coverage. Treatment of root surface: root planning versus polishing.

This clinical study was designed to determine if mechanical instrumentation (root planing) of the exposed root is useful in treating gingival recession caused by traumatic toothbrushing following a coronally advanced flap (CAF). Ten patients with high levels of oral hygiene (full-mouth plaque score <20%), from 25 to 57 years of age, were selected for the study. Each patient showed 2 bilateral Class I or II maxillary recessions. A total of 20 recessions were treated. The difference in the recessions was < or =1 mm. In each patient, one recession was randomly assigned to the test group and the contralateral one to the control group. In the test group, the exposed root surface was polished at slow speed with a rubber cup and prophylaxis paste for 60 seconds. In the control group, the exposed root surface was planed with a sharp curet. In both test and control groups, a trapezoidal full- and partial-thickness flap was elevated, coronally displaced, and sutured to cover the treated root surface. Before treatment, the mean recession depth in the test group (polishing) was 3.1+/-1.1 mm; and in the control group (root planing), 2.9+/-1.0 mm. Three months after the described procedures, the test group (polishing) showed a mean recession reduction of 2.6+/-0.6 mm; mean percent root coverage was 89+/-14%. In the control group (root planing), the mean recession reduction was 2.3+/-0.7 mm and mean percent root coverage was 83+/-16%. The difference of recession reduction between the test and control group was not statistically significant (P = 0.1405), even though the test group showed slightly better clinical results in terms of root coverage. This prospective clinical, controlled, randomized study shows that mechanical instrumentation (root planing) of the exposed root surfaces is not necessary when shallow recessions caused by traumatic toothbrushing are treated using a coronally advanced flap (CAF) in patients with high levels of oral hygiene.

Adult↗

PubMed1999

Coronally advanced flap procedure for root coverage. Is flap thickness a relevant predictor to achieve root coverage? A 19-case series.

This clinical study was designed to determine whether the thickness of the flap can influence root coverage when gingival recessions associated with traumatic toothbrushing are treated using a coronally advanced flap (CAF). Nineteen patients, aged from 25 to 57 years, with high levels of oral hygiene (full-mouth plaque scores <20%) were selected for the study. Each patient contributed with one Miller Class I or II maxillary or mandibular recession. A total of 19 recessions > or =2 mm were treated. After local anesthesia and before flap elevation, the exposed root surface was planed with a sharp curet. A trapezoidal full- and partial-thickness flap was then elevated, displaced coronally, and sutured to cover the treated root surface. Before suturing, flap thickness was measured in the alveolar mucosa with a gauge. After surgery, all patients were recalled for control and professional prophylaxis once a week during the first month and monthly up to the third month. The mean initial recession depth was 3.0+/-0.9 mm. Mean flap thickness (FT) was 0.7+/-0.2 mm. Three months later, mean recession depth was 0.6+/-0.6 (P <0.0001) and mean recession reduction was 2.4+/-0.7 mm. Mean root coverage was 82+/-17%. Flap thickness >0.8 mm was associated with 100% of root coverage. The results of this study indicate that there is a direct relation between flap thickness and recession reduction (P <0.0001).

Adult↗

PubMed2000

Coronally positioned flap procedures with or without a bioabsorbable membrane in the treatment of human gingival recession.

BACKGROUND: A variety of surgical techniques have been used to cover recession type defects. New data have indicated that the outcome of coronally positioned flap procedures may be augmented by supporting the flap with a membrane. METHODS: The present study aimed at comparing the clinical outcome following treatment of localized gingival recessions by a coronally positioned flap procedure alone, or combined with a bioabsorbable membrane. Twenty patients with buccal bilateral Miller Class I or Class II gingival recessions in cuspids or premolars participated in the study. The split-mouth design, randomized selection of site treatment, and blind evaluation provided 20 sites in a membrane group and 20 sites in a non-membrane group for examination at baseline, and at 3 months and 6 months postoperatively. Clinical variables included the apical extent of the gingival recession, the width of the recession defect measured at the cemento-enamel junction (CEJ), and the width of keratinized tissue at the recession site as well as probing depth and attachment level. RESULTS: Both treatments resulted in a significant gain (P <0.0001) of root coverage, amounting to an average of 2.3 mm in the membrane group and 2.5 mm in the non-membrane group at the 6-month evaluation. There was no significant difference between the treatments. Similarly, a significant gain of clinical attachment level was seen in the membrane (1.3 mm; P <0.001) as well as in the non-membrane (1.5 mm; P <0.0001) group, but without a significant difference between the groups. The reduction of the recession width from baseline to 6 months was significantly greater (P <0.01) for the non-membrane (2.3 mm) than for the membrane (1.4 mm) group. Probing depth changes were small and not significant for either of the treatments. When patients were grouped as smokers (8) and non-smokers (12), no significant differences were revealed for any of the response variables. Overall, among the 20 membrane sites, one showed no change while the remaining 19 gained root coverage at the 6-month examination. Five sites obtained coverage to the CEJ. Among the non-membrane sites, all gained root coverage at 6 months and 10 sites showed complete coverage to the CEJ. CONCLUSIONS: The coronally positioned flap operation offers a predictable, simple, and convenient approach as a root coverage procedure in Miller Class I and Class II recession defects. Combining this technique with the placement of a bioabsorbable membrane does not seem to improve the results following surgical treatment of such defects.

Absorbable Implants↗

PubMed2000

The deceptive nature of root coverage results.

BACKGROUND: The purposes of this article are to: 1) propose a new method of reporting root coverage data; 2) compare existing root coverage techniques using the proposed data analysis method; and 3) discuss additional refinements to root coverage data analysis. Past studies have equated percent defect coverage with root coverage. This gives deceptive information about the magnitude of the residual recession defect. Defect coverage of 67% could actually amount to 92% root coverage. METHODS: The use of mean root lengths will permit the determination of true root coverage data. This should be reported in addition to defect coverage data. Also including frequency data will provide a better assessment of the predictability of the surgical techniques. RESULTS: A comparison table of root coverage studies demonstrates that the connective tissue graft is the most effective and predictable method that has been tested. CONCLUSIONS: Further refinements to data analysis may help researchers identify the determinants of predictable root coverage.

Connective Tissue↗

PubMed2001

Comparison of 2 clinical techniques for treatment of gingival recession.

BACKGROUND: In early case studies, use of a collagen barrier as a guided tissue regeneration (GTR) material has shown particular promise in procedures aimed at root coverage. The similarities between collagen membrane and subepithelial connective tissue graft (SCTG) have made collagen membrane an attractive and a possible alternative material for root coverage. The purpose of this randomized clinical trial was to compare these 2 techniques, SCTG versus a GTR-based procedure (GTRC), for root coverage/recession treatment. METHODS: Sixteen patients with bilateral Miller's Class I or II (gingival recession > or = 3.0 mm) recession defects were treated either with SCTG or GTRC using a newly designed collagen membrane. Clinical parameters monitored included recession depth (RD), clinical attachment level (CAL), probing depth (PD), width of keratinized gingiva (KG), attached gingiva (AG), and recession width (RW), each measured at the mid-buccal area to the nearest 0.5 mm. Measurements were taken at baseline and 6 months. A standard mucogingival surgical procedure was performed. Data were reported as means +/- SD and were analyzed using the paired t test for univariate analysis and restricted/residual maximal likelihood (REML)-based mixed effect model for multivariate analysis. RESULTS: No statistically significant differences were observed in RD, CAL, KG, and AG between test and control groups at either time period. However, SCTG showed significantly more residual PD and more RW gain when compared to GTRC at 6 months. Both treatments resulted in a statistically significant (P < 0.05) reduction of recession defects (2.5 mm and 2.8 mm), gain of CAL (2.8 mm and 2.3 mm), reduction of RW (1.9 mm and 2.7 mm), and increase of KG (0.7 mm and 1.1 mm) and AG (0.7 mm and 0.5 mm) for GTRC and SCTG, respectively, when comparing 6-month data to baseline. Mean root coverage of 73% (collagen membrane) and 84% (subepithelial connective tissue graft) was achieved. CONCLUSIONS: The 2 techniques are clinically comparable. Use of a modified collagen membrane to attain root coverage may alleviate the need for donor site procurement of connective tissue.

Adult↗