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PubMed1984

Histochemical study of giant tubule content in dentin of unerupted cow incisors.

Incisal dentin of mandible cow incisors was studied by incident light. The material consisted of 12 intact permanent unerupted incisors from 2-yr-old cows removed immediately after bleeding. These specimens were kept in an isotonic EDTA-sucrose solution to be decalcified while maintaining vitality of cellular components. Three of the specimens were successfully dissected in a mesiodistal plane, exposing the giant tubule lumens and their content. By the use of NBT, a compound reduced by the dehydrogenase enzymes of the electron transport in the inner mitochondrial membrane, it was concluded that the giant tubules contained vital cells. The giant tubules were also shown to communicate with the incisal part of the pulp cavity by wide openings.

Animals↗

PubMed1990

The diagnostic significance and management of Gardner's syndrome.

Gardner's syndrome is a hereditary disorder characterised by gastrointestinal polyposis, bony osteomata, epidermoid cysts, desmoid tumours and unerupted teeth and odontomes. The major significance of the condition lies in the gastrointestinal polyposis and the high propensity of these polyps to undergo malignant change. The syndrome is no longer considered as a separate genetic entity to familial adenomatous polyposis (FAP) and the multiple stigmata are common to both conditions. A case of Gardner's syndrome is reported and the condition reviewed. The aim being to emphasise those features seen in the head and neck region and their particular importance in terms of early recognition and diagnosis of the underlying disease. The subsequent management of such patients is discussed.

Adult↗

PubMed1992

Comparison of the safety and efficacy of a combination analgesic Myprodol and Ponstan in the treatment of dental pain.

A comparison of the efficacy of Myprodol, a combination analgesic (Ibuprofen, Paracetamol and Codeine phosphate) and Ponstan (Mefenamic acid) was undertaken in a randomised double blind trial of 52 patients who underwent surgical removal of impacted or unerupted teeth. Pain scores were measured for patients pre- and post operatively by means of a visual analogue scale and data was analysed using the BMPD package on the ISM main frame computer at the Medical Research Council. The results indicated that although Myprodol and Ponstan were equally adequate and well tolerated in the control of post operative dental pain, Myprodol exceeded Ponstan in duration of analgesia and in the degree of pain intensity control experienced by the patient.

Acetaminophen↗

PubMed1998

Eruption and function of maxillary third molars after extraction of second molars.

After extraction of maxillary second molars, will the third molars erupt into a functional position in a timely manner? To answer this question, 56 consecutively treated cases of maxillary second molar extraction were reviewed. The unerupted positions of the maxillary third molars were measured on cephalometric radiographs, ages of eruption were evaluated, positions of erupted third molars analyzed, and interproximal periodontal health of adjacent first molars compared. The results showed that, generally, the eruption of third molars was accelerated. Most of the third molars had acceptable interarch and intra-arch occlusal relationships. The interproximal periodontal health of the third molars was similar to that of adjacent first molars. Most maxillary third molars will successfully erupt into an acceptable position by the late teens.

Adolescent↗

PubMed1989

The unerupted or impacted third molar--a critical appraisal of its pathologic potential.

The prophylactic removal of asymptomatic unerupted or impacted third molars constitutes a major proportion of all oral surgical procedures. Patients are advised to have this preventive surgery on the basis that such teeth, if retained, are likely to cause certain pathologic lesions. The evidence in the scientific literature on the prevalence of dentigerous cysts, mural ameloblastoma, epidermoid carcinoma and root resorption indicates that this concern is exaggerated. The retrospective data on the reasons for extractions of third molars confirm this conclusion. Until there are prospective studies which demonstrate a significant patient benefit from surgery exceeding the risks of retention, the practice should be discontinued. Third molars should be removed only where there is a defined pathologic indication.

Dentigerous Cyst↗

PubMedDate not supplied

Unerupted maxillary anterior supernumerary teeth: report of 204 cases.

Two hundred and four cases of unerupted maxillary anterior supernumerary teeth were found among Hong Kong school children between the ages of six to 9.5 years. The anomaly was prominent in the male with a sex ratio of 5.4:1. There was no significant difference in the distribution of unilateral and bilateral supernumerary teeth, between the two sexes. Most of the supernumeraries were located within the central incisor region. The inverted type was found to be associated with bodily displacement, median diastema and torsiversion, while the normally oriented ones were related to delayed eruption. The association of maxillary anterior supernumeraries with clinical symptoms was compared with studies on Caucasian populations, and guidelines were described for their early diagnosis.

Child↗

PubMed1998

Bilateral alveolar bone grafting: a report of 55 consecutively-treated patients.

A retrospective study was undertaken to evaluate the long-term results of bilateral alveolar bone grafting carried out at Great Ormond Street Hospital from 1983 to 1993. Fifty-five consecutive complete bilateral cleft lip and palate patients (36 males and 19 females) who had the operation were included in this study. The total number of cleft sites was 110. At the time of alveolar bone grafting, the mean age of the patients was 12.3 years with a range of 8.4-19.9 years. Cancellous bone from the iliac crest was grafted into the alveolar cleft areas. The cleft sites were studied in two groups according to whether the cleft canine had erupted prior to bone grafting or not. The erupted canine group was composed of 43 cleft sites and the unerupted canine group of 67 sites. At the time of this study, the cleft canine had subsequently erupted at 101 sites. Anterior occlusal radiographs were taken before and after bone grafting. The minimum period of observation after alveolar bone grafting was one year. Criteria described previously were utilized to assess the height of the interdental septum. The results show that bone grafting before canine eruption has a higher clinical success rate compared with that carried out after canine eruption. The critical variable affecting the quality of bilateral alveolar bone grafting is the timing of the surgery.

Adolescent↗

PubMed1998

Fluoride profiles of perikymata in enamel surfaces of human premolars.

Twenty-five premolars (from Nagoya, Japan < 0.1 parts/10(-6)F in drinking water) were sampled to determine the fluoride content in imbrication lines of Retzius between the grooves and ridges of perikymata on the enamel surface. Eight small windows were formed on each surface in groove and ridge regions using an etched microsampling technique. By using a regression curve, y = ax(-b), fluoride concentrations were compared at depths of 1, 3, 5, 10, 20, 30 and 50 microm in the perikymata regions. Fluoride concentrations increased gradually from the age of 10 to 12 years on the premolar surfaces, but were significantly higher in 12-year-olds or older (erupted teeth) than in 10-year-olds or younger (unerupted teeth). No obvious difference in fluoride concentrations was found between males and females. In the outermost enamel ( < 5 microm depth), fluoride concentrations were significantly higher in the grooves than the ridges of the perikymata. Comparison of the exponential regression coefficients (-b) of the fluoride profiles showed a significant difference between the grooves and ridges. It was concluded that fluoride concentrations and profiles were higher in grooves than in ridges of perikymata, probably because they are naturally porous and are stagnation areas attracting dental plaque.

Acid Etching, Dental↗

PubMed1984

Periodontal conditions following surgical exposure of unerupted maxillary canines--a long term follow-up study of two surgical techniques.

Two surgical techniques for exposure of impacted labially positioned maxillary canines were compared as to periodontal conditions at the end of the orthodontic treatment period. In the radical exposure group the alveolar mucosa and bone covering the crown were removed. In the other group a pedicle flap including keratinized gingiva was used for exposure. After the removal of bone the flap was apically positioned and sutured. The non-treated contralateral canines served as controls. The result showed that radical exposure in the region of alveolar mucosa resulted in significantly reduced width of buccal keratinized gingiva, reduced sulcus depth, increased gingival recession and increased gingivitis. The difference between the apically positioned flap group and the non-treated control groups was not significant.

Adolescent↗

PubMed1999

Change in clinical status of third molars in adults during 12 years of observation.

PURPOSE: The aim of the study was to follow the clinical changes in third molar status during a 12-year period in patients aged 20 to 32 years. PATIENTS AND METHODS: The study was based on a follow-up of 81 university students (32 men, 49 women). They were clinically examined and panoramic radiographs were taken at baseline (mean age, 20.7+/-0.5 years) and at the end of the study (mean age, 32.6+/-0.6 years). RESULTS: The students had 285 unerupted, partially erupted, or fully erupted third molars at the beginning of the study, and 150 at the end. On final examination, 115 teeth were erupted. During the first 6 years from age 20 to 26, various clinical changes took place in the status of the third molars. In the second 6 years, until age 32, the two main changes were either removal or eruption. During the 12-year follow-up, 22% of third molars erupted, a few even after 26 years of age; the percentage of third molars removed was 42%. CONCLUSION: Third molars undergo continuous clinical change at least up to the age of 32 years.

Adult↗

PubMed2001

Gardner's syndrome--the importance of early diagnosis: a case report and a review.

Gardner's syndrome (familial polyposis coli) is a genetic condition characterised by colonic polyps that carry a 100% risk of malignancy if untreated. Early diagnosis, in which an astute and knowledgeable dentist can play an essential role, is therefore of paramount importance. The presence of multiple unerupted teeth provides the dentist with a major pointer to the possible presence of this disease, which may be provisionally diagnosed on the detection of two other obvious features, namely osteomas and cutaneous lesions. This fact is clearly illustrated by the accompanying case report. Extracolonic manifestations increase the morbidity and make treatment more difficult. The presence of large desmoid tumours may be a serious complicating factor. Gardner's syndrome may be accompanied by adenomas of the stomach and duodenum and very rarely by malignant tumours of the central nervous system. Regular surveillance by means of colonoscopies must be carried out on all individuals suspected of having the disease in order to implement timeous life-saving prophylaxis.

Adult↗

PubMed1980

The sequelae of surgical exposure of unerupted teeth.

The late effects of surgical exposure of unerupted teeth were analyzed. Of 121 teeth, 62 had only the crowns exposed; additional traction was applied to 31 teeth and 28 were repositioned. Postoperative observation time ranged from eight months to 13 years. One hundred and eleven teeth assumed their position in the arch and were deemed successfully treated; ten teeth failed to erupt. Of the successfully treated teeth, 23% showed biological aberrations such as obliteration of the pulp, dwarfed roots, and denervation. These pathophysiologic changes, alone or in combination, were commensurate with the amount of trauma inflicted on the teeth. Teeth that wer repositioned showed the most change, whereas teeth that only had crowns exposed showed the least change.

Dentin, Secondary↗

PubMed1996

Enamel fluoride concentrations in unerupted third molars and the influence of fluoridated water on caries scores.

Enamel fluoride concentrations in buccal and lingual surfaces were determined in successive layers obtained by the acid etch method. The 48 unerupted third molar teeth were from subjects who had lived continuously since birth in two Brazilian towns (Barretos and Ribeirão Pr-eto) with different fluoride levels in the drinking water but with similar socioeconomic conditions. The DMFT index was determined for children 7-12 years old living in the two towns. Enamel fluoride concentrations were significantly higher in the teeth from the town with higher fluoride levels in drinking water. The children residing in the community with near-optimum fluoride concentration in the water had mean DMFT scores that were less than half those found in the community with a low level of fluoride in the drinking water.

Acid Etching, Dental↗

PubMed2001

Accuracy of the Third Molar Eruption Predictor in predicting eruption.

OBJECTIVE: To evaluate the possibility of applying the Third Molar Eruption Predictor to all panoramic radiographs. STUDY DESIGN: Panoramic radiographs were retrospectively analyzed from a 4-year follow-up study of third molars carried out at the University of Copenhagen, Denmark. The radiographs, taken at a mean age of 20.6 years, included 45 unerupted or partially erupted mandibular third molars in 28 subjects. Because the device was calibrated both with simple proportions and by use of the methods of Bayes' Decision Theory, the separation point of the device was therefore adjusted at 12 mm from the distal surface of the second molar. RESULTS: The predictions of future eruption or impaction made with the calibrated device and the actual clinical outcome 4 years later were in conformity for 80% of the mandibular third molars. CONCLUSION: The Third Molar Eruption Predictor may be applied to all panoramic radiographs, but it seems to require calibration before use.

Adult↗

PubMed1990

Contiguous enlarged dental follicles with histologic features resembling the WHO type of odontogenic fibroma.

Defective odontogenesis and/or retarded eruption of teeth can be associated with histologic features akin to odontogenic fibroma in the dental follicles. Unerupted mandibular premolar and molar teeth of a 24-year-old man were surgically exposed, yet the teeth failed to erupt. About a year and a half later, radiographs indicated further enlargement of the follicle of the premolar, and both teeth were subsequently surgically removed. Histologically, the follicles were composed of mature collagenous tissue among which epithelial islands and numerous clusters of calcified bodies were present. Indirect immunofluorescence showed positive staining for type I and type III collagen, which exhibited a sparse distribution, but not for the aminoterminal propeptide of type III procollagen. The hamartomatous nature of the lesions is discussed with emphasis on their histologic resemblance to the WHO type of odontogenic fibroma.

Adult↗

PubMed1992

Changes in lower third molar position in the young adult.

Changes in position of unerupted lower third molars between 18 and 21 years were examined in a group of 17 men and 24 women with intact lower arches. Mesiodistal third molar angulation, molar space, molar space condition, and buccolingual third molar angulation and the changes in these dimensions were measured on 60 degree cephalograms taken at 18 and 21 years. At 18 years molar space was inadequate by an average of 5.0 mm. Average changes in dimensions were statistically nonsignificant except for an increase in molar space of 0.7 mm. Changes in third molar position ranged from 39 degrees to -46 degrees in the mesiodistal and from 24 degrees to -24 degrees in the buccolingual dimension. Only 10 third molars did not change their mesiodistal angulation. Four third molars erupted fully during the observation period.

Adolescent↗

PubMed2000

Prevalence of malocclusion and orthodontic treatment need in 10-year-old New Zealand children.

The need for orthodontic treatment was determined in a random sample of 10-year-old Dunedin, New Zealand schoolchildren using the Dental Aesthetic Index (DAI); an index based on the social acceptability of dental appearance. When absent or unerupted teeth were disregarded, orthodontic treatment was considered to be "mandatory" for one-third of the children. The remaining children were almost equally divided into the three other treatment-need groups: "highly desirable", "elective", and "not necessary". The majority of the children had crowding and spacing in at least one incisor segment, and a molar occlusion other than Angle Class I. In this predominately mixed-dentition sample, more children were considered to need orthodontic treatment than older children in studies using the DAI. This raises some questions about the suitability of the DAI as a tool to assess orthodontic treatment need in mixed-dentition samples.

Chi-Square Distribution↗

PubMed1994

Dental complications associated with repeated orotracheal intubation in infancy: a case report.

Various oral and dental problems have been attributed to orotracheal intubation in the neonatal period. A case is described of a child whose dental anomalies are ascribed to multiple orotracheal intubations for the management of a complex cardiac abnormality. Six intubations were required between the ages of 9 days and 4 years for investigation and surgery. His maxillary right primary central incisor did not erupt until 3 years of age and the maxillary left was still unerupted at 6 years and 10 months and was rotated in its crypt. At this time, the mandibular primary incisors were physiologically mobile but the maxillary right primary central incisor remained firm. Both maxillary primary central incisors were extracted and examined histologically and showed abnormal morphology, enamel hypoplasia, and disordered dentine formation and root resorption. Subsequent eruption of the left permanent central incisor revealed hypoplasia of its incisal edge. It is suggested that the delayed eruption and abnormal morphology of the primary incisors were due to pressure effects on the overlying mucosa, follicular displacement and localized trauma caused by intubation. This case highlights the importance of monitoring the developing dentition of patients with a history of orotracheal intubation, so that interceptive treatment may be instituted when appropriate.

Dental Enamel Hypoplasia↗