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Prognosis of teeth involved in the line of mandibular fractures.

The management of teeth positioned in the line of mandibular jaw fractures was studied by a follow-up examination of 132 patients with mandibular fractures involving 185 teeth. The observation period varied from 1 to 3 years. The clinical and radiographic findings revealed complete recovery in 59% of the involved teeth. The degree of periodontal and pulpal complications were closely related to the displacement between the fragments and to the type of fracture. Six different fracture types were classified with regard to the extent of involvement of the tooth supporting tissue; 23% of the teeth which initially responded negatively to electric stimulation showed positive sensibility at the time of reexamination. Thus, a long time observation period is advisable with regard to the final outcome of the pulp damage. Conservative treatment of teeth involved in the line of mandibular fractures has a favorable prognosis especially if optimal reduction of the jaw fragments is achieved.

Dental Pulp Diseases

Cervical enamel: a danger zone.

The British Standards Institutions's document (1974) recommending toothpaste specifications states that 'There is no evidence that any toothpaste ever produces a level of abrasion causing harm to dental enamel'. This paper questions the assumption that the enamel crown, especially at the cervical margin, is able to cope with modern dietary insult and a 'good' oral hygiene regimen, regardless of the enamel abrasivity of the dentifrice used. Once the enamel crown is breached the underlying dentine is sensitive and vulnerable to physical damage. In this work the potential rates of erosive and abrasive loss are related to the thickness of the protective enamel and to the relevance of fluoride treatments for adults. It is suggested that improvements in dental care and an increased tooth life expectancy now make the loss of tooth tissues at the cervical margin more important than is apparent at first sight.

Dental Enamel

The teeth.

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Amelogenesis Imperfecta

Dental aspects of patients with cystic fibrosis: a preliminary clinical study.

The oral conditions of 42 patients being treated for cystic fibrosis were evaluated. The patients were grouped by age and, in some aspects, were compared with a small control group of their siblings. The patient group had a lowered incidence of plaque and less gingival disease than did the control group in which every person had some amount of plaque or gingival disease. Calculus formation was minimal. The reasons for the finding of minimal plaque in the patient group could be related to several factors, including the life-long use of various antibiotic agents, the chewing of digestive enzyme supplements, the effect of medical management on tooth hardness, and the effect of stained teeth (possible tetracycline deposition) on the plaque microorganisms. It appears that the therapy for cystic fibrosis was beneficial to the periodontal health of these patients. Much further study is needed to understand the interrelationship between an altered oral environment (salivary changes in cystic fibrosis), altered microbial flora (by antibiotics, enzymes) and even altered tooth surfaces (possible tetracycline deposition). Most patients were found to have one or more oral habits. Tooth mobility was associated with tension habits. Patients who had clubbed fingers (indicating pulmonary compromise) and possibly a severe disease process, did not appear to have either stained teeth or the severity of the gingivitis associated with this. The relationship of tetracycline to tooth staining could not be pinpointed.

Cystic Fibrosis