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Results for “Radiography, Bitewing”

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PubMed1999

Clinical performance of indirect composite resin inlays/onlays in a dental school: observations up to 34 months.

The aim of this retrospective clinical study was to evaluate the clinical performance of indirect composite resin inlays and onlays. Patients among the dental school clientele in need of posterior approximal filings and preferring esthetic restorations were included. Clinical teachers or trained students under supervision carried out the preparations, made impressions and prepared stone casts. Inlays made from either Tetric, Z100 or Maxxim were light-cured and placed in a light oven for secondary curing, before being luted with a dual cure cement. At recall, the inlays were evaluated using slightly modified US Public Health Service (USPHS) criteria. Twenty-two patients with 50 fillings presented for the assessment. The right censored observation periods ranged from 12 to 34 months, with a mean of 20. With the only exception of an early fracture of one onlay, all restorations were classified as successful. This was based on 15 "A" (optimal) and 34 "B" (acceptable) ratings, each of which representing the lowest rating for the individual restoration. The major reason for the "B" ratings was imperfect gingival marginal adaptation due to a small surplus of bonding material and/or luting cement.

Adult↗

PubMed1991

Ankylosis of primary molars--a future periodontal threat to the first permanent molars?

Most infra-occluded and ankylosed primary molars with a permanent successor will exfoliate normally. Continuous supervision of occlusal development and radiographic control of normal root resorption have been recommended. The decreased height of the alveolar bone level at the site of the infra-occluded primary molar has been reported to normalize after the eruption of the permanent successor. However, opinions that infra-occlusion of primary molars entails a risk of future periodontal damage to the first permanent molars have been presented. The aim of this study was to perform a long-term follow-up of the alveolar bone level mesial to the first permanent molars after spontaneous exfoliation or necessary extraction of the infra-occluded second primary molars. The material consisted of 143 permanent molars adjacent to 119 infra-occluded primary molars and 24 normal contralateral primary molars in 68 individuals. The subjects were re-examined about 8 years after the exfoliation or extraction of the infra-occluded second primary molars. The subjects were examined both clinically and radiographically. Alveolar bone level mesial to the first permanent molars was measured in bite-wing radiographs. All but two permanent first molars showed a normal alveolar bone level mesially. In two first permanent molars where the primary molar was extracted, mesial approximal bone loss amounted to 4 and 3 mm, respectively, but no pocket formation was found. Infra-occlusion and ankylosis of primary molars does not constitute a general risk of future alveolar bone loss mesial to the first permanent molars. The general treatment recommendation to await normal exfoliation and eruption of successors remains valid.

Adolescent↗

PubMed2003

Comparative reproducibility of three methods of radiographic assessment of alveolar bone grafting.

The aims of this study were to compare the reproducibility of three radiographic methods of assessing the quality of alveolar bone grafts, namely the Bergland, Kindelan and Chelsea Scales, and evaluate their application in the mixed and permanent dentitions. Additionally the use of occlusal versus periapical radiographs was assessed. Three examiners applied each scale on two occasions to the radiographs of 48 cleft lip and palate patients who had received alveolar bone grafts in 59 sites (11 had bilateral clefts). The agreement between repeated assessments by the same observer at different time points was measured by the kappa statistic, for each of the three assessors and each of the types of radiographic scale in turn. None of the three scales was found to be more reproducible than the others (kappa statistics for intraobserver variation ranged from 0.61 to 0.70). The agreement between observers was also similar across the three radiographic scales (multiple kappa statistics for inter-observer variation ranged from 0.45 to 0.51). Likewise, neither occlusal nor periapical radiographs were found to enable greater reproducibility of assessment. Surprisingly there was a tendency to greater reproducibility in the mixed than in the permanent dentition, which suggests the outcome of alveolar bone grafting may be assessed at an earlier stage than currently adopted. The outcome of alveolar bone grafting in this group of patients was generally successful.

Alveolar Process↗

PubMed1992

Morphometric analysis of the dental pulp chamber as a method of age determination in humans.

Eighty bite-wing radiographs from 40 female and 40 male patients were selected from the patient record system at the University of Texas Dental School at San Antonio, Texas. All samples were equally divided into four age groups, with a range from 15 to 55 years of age. The lower right first permanent molar tooth was chosen as the representative tooth for measuring the maximum height and width of the pulp chamber. The reproducibility of the method was checked by repeating all measurements on two different occasions. Regression analysis indicates that the height and width of the pulp chamber were negatively correlated with age (height r = -0.376 and width r = -0.125). The coefficient of determination (r2) for pulp chamber height and width were 0.123 and 0.058, respectively. This indicates that although there appears to be a definite relationship between the age of an individual and the height and width of the dental pulp chamber, these measures cannot be used as a reliable method of age determination.

Adolescent↗

PubMed2002

Evaluating IL-2 levels in human pulp tissue.

In murine and human CD4+ T cell populations, there are three subpopulations of T helper cell types. Hahn et al. demonstrated the ratio of CD4/ CD8 + cells significantly increases in inflamed dental pulps compared with normal pulps. Elevated levels of interleukin (IL)-2 have been detected in inflamed dental pulps and the level of IL-2 could be used as a marker for inflammation. In this study, levels of IL-2 were evaluated by using a human IL-2 cytokine assay kit on 80 samples of freshly extracted human pulp tissue. Applying standard diagnostic procedures, the tissue samples were clinically categorized into one of three experimental groups. The results demonstrated that there were no significant differences between the concentrations of IL-2 in any of the experimental groups. Our findings are different from results reported previously. Further investigation is warranted to determine if a correlation exists between the concentration of IL-2 or other interleukins and the degree of inflammation present in the dental pulp.

Adolescent↗

PubMed2002

Delayed onset of altered sensation following dental implant placement and mental block local anesthesia: a case report.

A case of a delayed-onset post-operative altered sensation of the mental nerve is reported with speculations as to etiology. There is a discussion concerning intraoperative radiographs and osteotomy positioning. When postoperative altered sensation occurs, etiologic considerations should always include local anesthetic administration technique. The importance of pulp testing from the first molar to the contralateral lateral incisor is key to determining whether the deficit is in the mandibular nerve or only the mental nerve, which may be a result of mental block local anesthetic administration and not implant placement. This differentiation may be important in treatment and/or legal exposure. The altered sensation was probably caused by the mental block anesthetic technique. The partial anesthetic area in this case was probably a result of crossover innervation from the contralateral mental nerve.

Anesthesia, Dental↗

PubMed2002

Assessment of endodontically treated teeth adjacent to proposed implant sites.

Many partially dentate dentitions are now being restored using dental implants; but assessment of endodontically treated teeth adjacent to the proposed implant sites has seldom been reported. Assessment criteria are given for sound- and endodontically compromised teeth to ensure adequate preimplant preventive and restorative treatment and to minimize the chances of failure of dental implants adjacent to these teeth. Cases are used to illustrate pitfalls in the treatment planning process.

Clinical Protocols↗

PubMed2005

The impact of instrument fracture on outcome of endodontic treatment.

Adoption of rotary nickel-titanium instruments has renewed concerns regarding instrument fracture and its consequences. The frequency of instrument fracture and its impact on treatment outcome were determined from an analysis of specialist endodontic practice records involving 8460 cases. A case-control study of treatment outcomes was conducted on a subset of 146 teeth with a retained instrument fragment (plus 146 matched controls), for which clinical and radiographic follow-up of at least 1 year was available. Masked radiographs were assessed by two calibrated examiners. Overall prevalence of retained fractured instruments was 3.3% of treated teeth. In the case-control study, overall healing rates were 91.8% for cases with a fractured instrument and 94.5% for matched controls (p > 0.05, Fisher's exact test). Healing in both groups was lower in teeth with a preoperative periapical radiolucency (86.7% versus 92.9%, p > 0.05). In the hands of skilled endodontists prognosis was not significantly affected by the presence of a retained fractured instrument.

Case-Control Studies↗

PubMed1995

Clinical and radiographic diagnosis of occlusal caries: a study in vitro.

Various methods of diagnosing occlusal caries have been described, but only visual, clinical examination and radiographic examination are commonly used in dental practice. This laboratory study investigated the ability of 12 examiners to detect the presence or absence of occlusal caries in 48 extracted molar teeth using these two techniques. The presence or absence of caries was subsequently verified by sectioning the teeth. Diagnosis from visual examination was poor, only 48.7% of lesions in dentine being detected. Radiographic diagnosis was better with 62.2% of dentine lesions being found. However, this increase in sensitivity of the diagnosis was accompanied by a decrease in specificity with the number of false positive diagnoses increasing when the radiograph was used. Therefore, although the bite-wing radiograph may be regarded as a safety net for the diagnosis of occlusal caries, it must be interpreted with caution bearing in mind the possibility of false positive diagnoses.

Dental Caries↗

PubMed1992

Prevalence of juvenile periodontitis in a circumpubertal population.

A cross-sectional radiographic screening was performed on bite-wing pairs (BW) from 1872 10-12 year old schoolchildren in the Greater Worcester, Massachusetts area to assess the prevalence of juvenile periodontitis (JP). The 3-stage screening process entailed: (1) visual identification of possible cases based upon a visual assessment of BW for interproximal crestal bone levels greater than or equal to 2 mm from the cemento-enamel junction (CEJ) on greater than or equal to 1 permanent first molar; (2) identification of probable cases based upon BW from possible cases measured with a transparent ruler calibrated in millimeters; (3) finally, clinical confirmation of JP in consenting probable cases. A total of 1038 subjects were eligible to be included in the study (greater than or equal to 3 mesial sites readable). Of the 1038 eligible subjects, 117 possible and 103 probable cases were identified in stage 1 and stage 2, respectively. A total of 99 probable cases could be contacted and 43 were examined clinically. Two cases of JP were confirmed clinically in stage 3, yielding a prevalence rate of 4.6/1000. Specifically, this report defines a rate of JP in 10-12 year-old schoolchildren for the first time. In addition, these results indicate that BW can be used to identify children with JP from large data sets. However, further studies including complete clinical and radiographic examinations are necessary to determine whether this method is adequate for large epidemiologic studies.

Adolescent↗

PubMed1992

The relation between periodontitis and systemic bone mass in women between 46 and 55 years of age.

It has been suggested that periodontitis and systemic bone mass might be related. In order to evaluate this possible relationship, we performed an intra-oral examination and measured lumbar bone mineral density (lumbar BMD) and metacarpal cortical thickness (MCT) in 286 female volunteers between 46 and 55 years of age. In addition, the alveolar bone height was measured on bite wing radiographs of the dentate subjects. Of the subject, n = 60 (21%) were edentulous. Compared to the dentate subjects, the lumbar BMD and MCT of the edentulous women were not significantly different. In the dentate subjects, no significant correlation was observed between the clinical parameters of periodontitis (mean probing depth, occurrence of bleeding after probing and number of missing teeth) and the bone mass parameters (lumbar BMD and MCT); nor was a significant relation observed between the bone mass measurements and alveolar bone height. We therefore suggest that systemic bone mass is not an important factor in the pathogenesis of periodontitis.

Absorptiometry, Photon↗

PubMed1992

Marginal bone level in the normal primary dentition.

The aim of the present study was to establish the normal range for the radiographic distance between the cemento-enamel junction (CEJ) and the marginal bone level (MBL) in the primary dentition, and to relate this distance to various physiological and pathological factors. 128 children at the ages 7, 8 and 9 years took part in the study. Clinical and radiographic examinations of the mesial and distal surfaces of all primary molars and the distal surface of the primary canines were performed. The clinical examination included measurements of the amounts of plaque, bleeding on probing, probing depth and probing attachment loss. In addition, increased mobility of the primary teeth and stage of eruption of the neighbouring permanent teeth were recorded. The radiographic examination included measurements of the CEJ-MBL distance and the remaining root length. Also, exfoliating teeth, presence of proximal dentin caries, restorations and calculus were recorded from the radiographs. Associations between various explanatory variables and the CEJ-MBL distance were tested with both a chi 2 test and a variance components analysis. The mean CEJ-MBL distance for all primary tooth surfaces was 1.0 mm. Individual surfaces displayed distances ranging from 0.0-4.0 mm. Of the variables tested for association with the CEJ-MBL distance, eruption of neighbouring permanent tooth and exfoliation of neighbouring primary tooth seemed to be associated with large CEJ-MBL distances. When surfaces with these characteristics were excluded, a CEJ-MBL range of 0.0-2.0 mm was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Alveolar Process↗

PubMed1993

Marginal bone loss in the primary dentition of patients with juvenile periodontitis.

118 patients with juvenile periodontitis (JP), diagnosed when the patients were 13-19 years old, were studied retrospectively with respect to radiographic marginal bone loss in the primary dentition, experienced when the patients were 5-12 years old. 168 other 13-19 year old patients without any signs of bone loss in the permanent teeth were used as a reference group. The JP patients were classified into 2 groups according to the number of sites with bone loss in the permanent dentition: JP group I having 1 site with bone loss (n = 45) and JP group II having > or = 2 sites with bone loss (n = 73). It was found that 35 patients (52%) of JP group II displayed 1 or more sites with bone loss in the primary dentition during the age of 5-12 years. The corresponding numbers for JP group I and the reference group were 9 (20%) and 8 (5%) respectively. These findings indicate that juvenile periodontitis, at least in some individuals, may have its onset already in the primary dentition.

Adolescent↗

PubMed1994

A cohort study of radiographic alveolar bone loss during adolescence.

The aim of the present study was to assess the changes in prevalence of early radiographic alveolar bone loss in a birth cohort (all subjects born 1970) over a period of 8 years as related to sex, ethnic origin, orthodontic treatment and socio-economic status. In 1984, the target population consisted of 2767 subjects. In 1986, 1988 and 1992, sets of bite-wing radiographs were obtained from samples of the same population. Alveolar bone loss was recorded if the distance from the cemento-enamel junction to the alveolar crest exceeded 2 mm measured on posterior bite-wing radiographs. The frequency of subjects with radiographic alveolar bone loss increased significantly with age (p < 0.05). The number of subjects with 3 or more lesions also increased with age. The demographic variables studied did not seem to influence the prevalence of bone loss significantly in the present cohort study.

Adolescent↗

PubMed1994

Alveolar bone loss in 5-year-old New Zealand children: its prevalence and relationship to caries prevalence, socio-economic status and ethnic origin.

This study investigated the prevalence of alveolar bone loss (ABL) in 5-year-old New Zealand children. The relationship of bone loss with the prevalence of caries, socio-economic status and ethnic origin was examined. Standardized bite-wing radiographs from 317 children were used to examine the alveolar bone in 1784 sites. Questionable bone loss (QBL) was evident in 8.5% of the children and definite bone loss (DBL) in 2.1%. The children with suitable radiographs had a mean dmft of 1.8 +/- 2.9 and mean dmfs of 2.7 +/- 5.0. When the children were divided into 3 groups having no bone loss (NBL), QBL only or DBL, analysis of variance on the logarithmic transformation of both the dmft and dmfs scores showed significant differences among the groups. Post hoc tests showed that the means for the DBL group were significantly different from those of the other 2 groups for both dmft and dmfs scores. Logistic regression analysis indicated that the odds ratio for having definite alveolar bone loss was slightly increased in children with a dmft of > or = 9.

Alveolar Bone Loss↗

PubMed1995

The relationship between alveolar bone height and age in the primary dentition. A retrospective longitudinal radiographic study.

The natural history of changes in attachment level in the primary dentition should be determined before considering diagnostic criteria for periodontal diseases in children. The present study was designed to describe longitudinal changes in the distance between the alveolar bone crest and the cementoenamel junction (ABC-CEJ) determined radiographically. Bite-wing radiographs were obtained from 33 children as part of a routine annual dental examination in a rural community. The ABC-CEJ distance of 1500 sites located at the mesial and distal aspects of primary molars and distal aspect of primary cuspids were measured. An analysis of variance model was used to assess the effect of age, sex, tooth, side of the mouth, jaw, site and patient on the ABC-CEJ measurements. The side of the mouth (left, right) and the site (mesial, distal) had no significant effect on the ABC-CEJ distance. ABC-CEJ distances in the upper jaw were greater than in the lower jaw, and different teeth exhibited different ABC-CEJ distances. Canines had the greatest distance and second molars the smallest. The most interesting relationship was between alveolar bone height and age. The overall ABC-CEJ distance seemed to increase with age; however, this was not a linear relationship but followed the pattern of facial growth, with two spurts separated by a period of minimal increase. The results indicate that different levels of ABC-CEJ distance might be considered as a cut-off value for radiographic diagnosis of alveolar bone loss at different ages, for different primary teeth and for different jaws.

Age Factors↗

PubMed1997

A logistic regression model for the decision to perform access surgery.

Access surgery may be recommended to about 80% of patients who present with advanced forms of periodontal disease. In this report, a multivariate logistic regression analysis which incorporated several clinical parameters for each tooth examined, i.e., tooth type, furcation involvement, bleeding on probing, attachment level, probing depth, mobility and BANA test score, was conducted using generalized estimating equations (GEE). This approach identified parameters that were significantly associated at p < 0.05 level with the need for access surgery or extraction for periodontal purposes. The estimated probabilities derived from the GEE model were plotted over the complete spectrum of operating conditions to obtain a receiver-operator characteristic (ROC) curve. At a probability cutpoint of 0.8, the decision threshold for surgery/extraction at the pretreatment examination would have a sensitivity of 76.1% and a specificity of 75.3%. We have taken this 0.8 cut point to look at specific clinical decisions made by our examiners after the patients had received scaling and root planing plus 2 weeks unsupervised usage of systemic antimicrobials. The clinicians' decision was taken as the primary reference standard. The model's estimated decision agreed with the clinicians' decision in 226 of the 284 teeth, for an accuracy of 80%. The specificity was 90% and the sensitivity was 43%.

Algorithms↗

PubMed1998

Longitudinal changes in TCRB variable gene expression and markers of gingival inflammation in experimental gingivitis.

The aim of this study was to gain information of the cellular and molecular events which occur during the development of experimental gingivitis and to determine whether such changes occur in the presence or absence of alveolar bone resorption. Clinical, radiographic, biochemical and immunological variables were monitored in a 3-week, single-centre, experimental gingivitis study of 10 healthy volunteers. Following screening and professional prophylaxis to achieve visibly healthy gingival status, subjects abstained from all oral hygiene practises in one maxillary (test) quadrant for a period of 21 days. At days 0 and 21, in test and (contralateral) control quadrants, % bleeding on controlled pressure probing (% BOP) was calculated, and radiographic alveolar bone status was assessed using bilateral standardised vertical bite-wing radiographs and digital subtraction radiography (DSR) analysis. In test quadrants, gingival crevicular fluid (GCF) was sampled from 4 sites per subject with Periopaper strips, and prostaglandin E2 (PGE2) levels measured using an enzyme immunoassay (EIA) kit. At days 0, 7 and 21, one interdental papilla was surgically excised from the test quadrant, and the expression of T cell receptor B variable (TCRBV) genes was investigated using a reverse transcription-polymerase chain reaction (RT-PCR) procedure. At days 0, 7 and 21, peripheral blood lymphocytes (PBL) were isolated and additionally investigated for TCRBV gene expression. Following 21 days of plaque accumulation in test quadrants, a statistically significant increase in % BOP scores confirmed the presence of gingival inflammation (p<0.001). DSR analysis revealed that there were no significant alveolar bone changes in either the test or control quadrants between days 0 and 21 (p>0.05). EIA analysis of GCF samples identified a significant decrease in mean GCF PGE2 concentrations from day 0 to day 21 (p<0.05). RT-PCR analysis indicated that genes from all 3 TCRBV families studied (TCRBV-2, -6, -8) were expressed in the PBL samples at all time points and in healthy gingival tissues at day 0. A restriction in the expression pattern of TCRBV genes similar to those which have previously been reported in chronic periodontitis was noted at gingivitis sites. It is possible that such an event may identify susceptibility to periodontal disease independently of other positive predictive markers such as GCF-PGE2.

Adolescent↗