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At least 469 records · Page 26Linked to original sources
PubMed1998

Ultrasonic root end cavity preparation assessed by an in situ impression technique.

PROBLEM: In vitro studies have demonstrated microfractures in resected roots after root end cavity preparation with ultrasonic tips. Such microfractures are of concern; however, they may be artifacts. OBJECTIVES: To assess the incidence of microfractures after ultrasonic root end cavity preparation in situ. STUDY DESIGN: Fifty-two roots in two cadavers were endodontically treated, the soft tissues excised, and the root ends exposed and resected. The resected root surfaces were replicated with polyvinylsiloxane impressions. Root end cavities were prepared with ultrasonic tips, then impressed a second time. The roots were retrieved; 25 were processed for direct SEM examination as were both the impressions of each root. The specimens were examined by stereomicroscope and scanning electron microscope. RESULTS: In the impressions, the resected and prepared surfaces appeared irregular, but none demonstrated microfractures. In contrast, 15 retrieved roots showed microfractures. CONCLUSIONS: Ultrasonic root end cavity preparation in situ did not cause root microfractures, and the impression technique could be clinically usable with minor modifications.

Artifacts↗
PubMed1990

Treatment of traumatic dental injuries. Shift in strategy.

A more conservative approach to the treatment of traumatic dental injuries has been made possible by knowledge concerning the pathogenesis of external root resorption, increased knowledge about wound healing processes in the pulp and periodontium, as well as by advances in restorative dentistry (reattachment of crown fragments with a dentin bonding system, the use of adhesive bridges, and advances in autotransplantation and implantation). However, a rethinking by the public, clinicians, and third-party payers is necessary for these procedures to gain wider acceptance. The present article describes the state of the art of treating dental trauma in the hope that these advances can become an accepted part of the dental trauma armamentarium and not merely scientific curiosities.

Cost-Benefit Analysis↗
PubMed1999

The failure of amalgam dental restorations due to cyclic fatigue crack growth.

In this study a restored mandibular molar with different Class II amalgam preparations was examined to analyze the potential for restoration failure attributed to cyclic fatigue crack growth. A finite element analysis was used to determine the stress distribution along the cavo-surface margin which results from occlusal loading of each restoration. The cyclic crack growth rate of sub-surface flaws located along the dentinal cavo-surface margin were determined utilizing the Paris law. Based on similarities in material properties and lack of fatigue property data for dental biomaterials, the cyclic fatigue crack growth parameters for engineering ceramics were used to approximate the crack growth behavior. It was found that flaws located within the dentine along the buccal and lingual margins can significantly reduce the fatigue life of restored teeth. Sub-surface cracks as short as 25 microm were found capable of promoting tooth fracture well within 25 years from the time of restoration. Furthermore, cracks longer than 100 microm reduced the fatigue life to less than 5 years. Consequently, sub-surface cracks introduced during cavity preparation with conventional dental burrs may serve as a principal source for premature restoration failure.

Journal Article↗
PubMed2000

The immediate replacement of teeth by dental implants using homologous bone membranes to seal the sockets: clinical and radiographic findings.

Placement of dental implants into fresh extraction sockets has several advantages compared to the original protocol. However, the soft-tissue handling is often complicated and the aesthetic results less rewarding. A method to use a homologous bone membrane as the sole sealer of the extraction socket after immediate implant placement is introduced and the outcome of 34 cases is presented. In 4 cases early losses of the membranes occurred (2 of these iatrogenic damage) in all other cases the homologous membranes were covered by proliferation of the surrounding mucosa within 2-4 weeks. In 2 of the 4 cases where the membranes were lost, the implants did not integrate, in the other 2 cases the implants did integrate but the sockets did not fill completely with bone and the aesthetic results were not acceptable. In all other cases bone filling of the socket occurred, the implants were stable at 180 days after insertion (functional success rate 94.1%) and the aesthetic results were excellent. The method thus seems very promising but the healing process is delicate and the operation site highly vulnerable during the first postoperative weeks. It should also be stressed that the present study offers conclusions neither about the quality of the newly formed bone nor about the quality of osseointegration offered by this bone.

Adolescent↗
PubMed2002

The palatal advanced flap: a pedicle flap for primary coverage of immediately placed implants.

The placement of implants immediately after tooth extraction has become a relatively common event. This approach has gained popularity because it reduces the time between tooth extraction and placement of the final prosthetic restoration. One problem that remains unresolved with this procedure, however, is that there is usually space left in the area surrounding the coronal portion of the implant. As none of the techniques published to date is completely satisfactory, we developed an approach that is a modification of the palatal pedicle flaps used for closure of oro-antral fistulas. This technique allows for precise rotational advancement of the palatal tissue in a coronal direction, thus facilitating complete coverage of the extraction site. The procedure was used on 38 patients treated for primary coverage of postextraction placed implants. Thirty-two of the patients required single tooth replacement, three patients received two implants each, and three patients received three implants each. In 27 of the cases, the procedure was performed in conjunction with barrier membranes; of the 38 cases, 25 patients required the use of DFDBA to fill the defect created by the extraction procedure. The average defect width was 4.70 +/- 0.2 mm. Complete primary coverage was obtained in all cases without any changes in the size or anatomy of the buccal vestibule; complete coverage was maintained over the entire healing period of 6-8 months (mean +/- SEM, 6.49 +/- 0.10 months). Even with guided tissue regeneration cases, there was no exposure of the barrier membrane or cover screw of the implant during healing. After a period of 1-5 years (mean +/- SEM, 39.35 +/- 2.69 months), none of the implants was lost. We conclude that the palatal advanced flap procedure is useful, fast, and easy to perform in cases of immediate implant placement after tooth extraction.

Adult↗
PubMed2002

Pathologic interactions in pulpal and periodontal tissues.

Both endodontic and periodontal disease are caused by a mixed anaerobic infection. The pathways for the spread of bacteria between pulpal and periodontal tissues have been discussed with controversy. This article is an attempt to provide a rational approach to the perio-endo/endo-perio question based on a review of the relevant literature. In the light of evidence, clinical concepts for the diagnosis and treatment of lesions involving both periodontal and pulpal tissues are discussed.

Bacteria, Anaerobic↗
PubMed2003

In vitro evaluation of marginal and internal adaptation after occlusal stressing of indirect class II composite restorations with different resinous bases.

Composite inlays are indicated for large cavities, which frequently extend cervically into dentin. The purpose of this study was to compare in vitro the marginal and internal adaptation of class II fine hybrid composite inlays (Herculite, Kerr) made with or without composite bases, having different physical properties. Freshly extracted human molars were used for this study. The base extended up to the cervical margins on both sides and was made from Revolution (Kerr), Tetric flow (Vivadent), Dyract (Detrey-Dentsply) or Prodigy (Kerr), respectively. Before, during and after mechanical loading (1 million cycles, with a force varying from 50 to 100 N), the proximal margins of the inlay were assessed by scanning electron microscopy. Experimental data were analysed using non-parametric tests. The final percentages of marginal tooth fracture varied from 30.7% (no base) to 37.6% (Dyract). In dentin, percentages of marginal opening varied from 9.2% (Tetric Flow) to 30.1% (Prodigy), however, without significant difference between base products. Mean values of opened internal interface with dentin varied from 11.06% (Tetric Flow) to 28.15% (Prodigy). The present results regarding dentin adaptation confirmed that the physical properties of a base can influence composite inlay adaptation and that the medium-rigid flowable composite Tetric Flow is a potential material to displace, in a coronal position, proximal margins underneath composite inlays.

Compomers↗
PubMed2000

A multidisciplinary treatment approach to a complicated maxillary dental trauma: a case report.

This case report describes the treatment of an 18-year-old male who lost two central maxillary incisors due to dental trauma. Because of a deep overbite and serious occlusal instability, the lost teeth 11 and 21 could not be replaced by a conventional fixed prosthesis. The vertical dimension of occlusion was increased using a Hawley-type appliance over a period of 1 year. When sufficient intermaxillary space was gained the alveolar ridge was augmented with a mandibular symphysis graft. Nine months later two one-stage non-submerged implants (ITI, Straumann, Waldenburg, Switzerland) were inserted. After further soft tissue adaptation to two temporary acrylic crowns, porcelain veneers were placed on the two implants and the lateral incisors.

Adolescent↗
PubMed2000

Urinary catecholamine levels and incidence of dentofacial injuries in children: a 2-year prospective study.

Urinary catecholamines have been used to measure emotionally stressful states which may have an impact on dentofacial injuries. This prospective study investigated the hypothesis that urinary catecholamines such as epinephrine, norepinephrine and dopamine do not affect significantly the incidence of dentofacial injuries in children. As a test of this hypothesis 204 children, males and females, aged 8 to 10 years, were included in the study. After a first examination, each subject was re-examined, at one-year intervals, over a period of two years. Dentofacial injuries were recorded by a clinical examination and a questionnaire. Three 24-h urine samples, with an interval of one year between each, were collected and analyzed by the high performance liquid chromatography technique to assay the catecholamine content. Socio-economic factors were recorded by a questionnaire. Using the panel of data collected, the logistic multiple regression model was employed to test whether the incidence of dentofacial injuries was affected by the studied variables. The 95% probability level was used. Specificity and sensitivity as well as the positive and negative predictive rates were computed. The results showed that epinephrine had a significant correlation with the incidence of dentofacial injuries. Other factors found to have a significant impact were child's age and gender. The values of sensitivity and specificity were 81% and 69% respectively, while the positive and negative predictive rates were 68% and 82% respectively. The data, therefore, provided evidence that emotionally stressful states measured by the urinary catecholamines were prominent etiologic factors of dentofacial injury.

Accidents↗
PubMed2000

Bone-like tissue growth in the root canal of immature permanent teeth after traumatic injuries.

Following a severe traumatic incident to permanent immature teeth, the growth of calcified tissue in the pulp space may occasionally occur. This calcified tissue may be diffuse or in intimate contact with the dentine. It has been suggested that a wide open apex, severe damage to the root sheath, and the absence of infection are only some of the predisposing factors leading to this metaplasia of pulp tissue into bone-like tissue. Five cases are described.

Adolescent↗
PubMed2001

Social deprivation and traumatic dental injuries among 14-year-old schoolchildren in Newham, London.

AIMS: To assess the epidemiology of dental injuries among schoolchildren in Newham, London. MATERIAL AND METHODS: This study was carried out as part of the annual Community Dental Service's School Dental Inspection (SDI) programme in Newham. All schoolchildren aged 14 years were invited to participate in the study. Dental examinations were carried out by one trained examiner (SM) and included presence of clinical evidence of dental injuries, treatment provided and needed in the upper and lower permanent incisors, size of incisal overjet and type of lip coverage. The postcode was recorded to assess the levels of social deprivation. FINDINGS: 2242 out of 2684 children were examined. The prevalence of dental injuries was 23.7%. Treatment of dental injuries was neglected. Being male, having an incisal overjet greater than 5 mm and living in an overcrowded household increased the risk of having dental injuries. CONCLUSIONS: The prevalence of dental injuries in Newham (23.7%), which is a deprived area of London, was much higher than the overall prevalence in the UK (17%). Traumatic dental injuries seem to be a serious dental public health problem among children in deprived areas. Thus, there is an urgent need to collect local data on dental injuries in order to obtain a more comprehensive picture of the dental health.

Adolescent↗
PubMed2001

Prevalence and correlates of traumatic injuries to the permanent teeth of schoolchildren aged 9-14 years in Belo Horizonte, Brazil.

A cross-sectional survey was carried out on 3702 boys and girls aged 9-14 years, attending public and private primary schools in Belo Horizonte, Brazil. A multi-stage sampling technique using an equal probability scheme was adopted to select the children. The response rate for the total sample was 97%. Dental examinations were carried out by one dentist (MISC). Intra-examiner agreement was very good. The prevalence of dental injuries increased from 8% at the age of 9 years to 13.6% at 12 and 16.1% at 14 years. Adjusted results showed that children from high socio-economic backgrounds were 1.4 (95% CI = 1.15-1.79) times more likely to present with a dental injury than children with low SES. Boys were 1.7 times (95% CI = 1.41-2.16) more likely to have dental injuries than girls. Children with an overjet size greater than 5.0 mm were 1.37 times (95% CI = 1.06-1.80) more likely to have a dental injury than children with an overjet size equal or lower than 5.0 mm. Finally, children with an adequate lip coverage were 0.56 times (95% CI = 0.44-0.72) less likely to have a traumatic dental injury than those with inadequate lip coverage.

Adolescent↗
PubMed2001

Factors affecting the time of onset of resorption in avulsed and replanted incisor teeth in children.

Resorption is the main reason for loss of replanted teeth. The outcome examined in this study is the timing of the onset of resorption. The effect of dichotomised dry and wet time intervals as well as the presence of additional crown damage and of contamination were determined. Of 84 replanted teeth, 67.5% developed resorptions. Twenty-eight had detectable additional crown damage with a more rapid onset being seen in these cases (P=0.009). The critical limit for dry time was 15 min (P=0.038) and significant differences persisted for greater limits also. Serial analysis of the association between the time of onset of root resorption and dichotomised wet time variables failed to yield any significant associations. There was visible contamination detected in 32 teeth and these exhibited a more rapid onset of resorption than the other cases (P=0.030). Teeth with inflammatory root resorption (12.8%) had a more rapid onset of resorption than those that developed replacement resorption (54.7%) (P<0.001). It is concluded that the risk of early resorption is increased in teeth that have additional damage or have contamination, or are kept in dry conditions for longer than 15 min.

Adolescent↗
PubMed2001

Socio-economic correlates of traumatic injuries to the permanent incisors in schoolchildren aged 12 years in Blumenau, Brazil.

This study aimed to assess the prevalence of injuries to the permanent incisors in Blumenau, Brazil. In addition, the relationship between dental injuries and socio-economic indicators was examined. A cross-sectional survey was carried out. It included a random sample of 652 children aged 12 years, from both sexes, attending public and private primary schools in Blumenau, Brazil. Multi-stage sampling technique and proportional representation were adopted. A trained and calibrated dentist collected the data through clinical examinations and interviews. Clinical examination included type of damage, treatment provided and needed, size of incisal overjet and type of lip coverage. The response rate was 82.5%. The prevalence of dental injuries was 58.6%. Boys experienced more injuries than girls, 67.2% and 50.2% (P=0.001), respectively. Children from mothers with higher schooling experienced more dental injuries than those from of mothers with lower schooling, 68.2% and 56.6% (P=0.03). Father's level of education, parents' employment status and family income were not statistically significantly associated with dental injuries (P>0.05). There was a tendency for children with incisal overjet greater than 5 mm (P=0.2) and inadequate lip coverage (P=0.1) to have more dental injuries, but differences were not statistically significant. Nearly all (97.3%) children who had dental injuries needed treatment. In conclusion, the prevalence of dental injuries in Blumenau, Brazil, was very high, treatment of dental injuries was severely neglected, and boys and children from mothers with high schooling were more likely to have experienced dental injuries.

Brazil↗
PubMed2002

Traumatic injuries in the primary dentition.

As a support for the guidelines published in 2001, a review of the literature was carried out using the evidence-based approach in order to update the state of the art regarding epidemiology and treatment of traumatic dental injuries in the primary dentition. An online search in Medline, and a review of expert literature, lead to the conclusion that most luxation injuries heal spontaneously, and unless more conclusive evidence is available, conservative treatment of acute dental trauma for preschool children is suggested. Pain control, the dentist's ability to cope with the child's anxiety, and follow-up instructions in oral hygiene techniques will allow many primary teeth that are currently lost at the time of injury to be saved.

Adolescent↗
PubMed2003

The Periotest in traumatology. Part II. The Periotest as a special test for assessing the periodontal status of teeth in children that have suffered trauma.

The research was carried out on the upper permanent incisor teeth of 101 children aged 8-12 years attending the trauma clinic at the University Dental Hospital, Manchester, UK. The double blind, cross-over study involved Periotest readings being taken by one examiner and traditional special tests being carried out by another examiner. The traditional special tests chosen were mobility testing, percussion sounds and radiographs. The Periotest readings and special tests were then repeated at the child's recall appointment. The results revealed that there was a significant difference (P < 0.001) between the number of abnormalities detected by the Periotest and those detected by the traditional special tests. There was also found to be a significant difference (P < 0.001) in the detection of undesirable sequelae between the Periotest and the traditional special tests.

Chi-Square Distribution↗