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PubMed2000

[Incidence of dental, mouth, and jaw injuries and the efficacy of mouthguards in top ranking athletes].

The aim of the study was to determine the prevalence of orofacial injuries among German top athletes and their attitudes to mouthguards. A questionnaire was mailed to athletes of 10 German contact sports associations. 64.3 percent (303) of the athletes returned questionnaires. 62 percent (188) of the respondents reported that at some time they wore a mouthguard for sports participation. 47.3% (male: 57.8%, female: 38.3%) of these were currently using one. 50% of the mouthguards were custom made by dentists, and 50% were shop bought (boil-and-bite). 32 percent of the participants had, at some time during their sports career, suffered an orofacial injury. The incidence of fractured anterior upper teeth and completely knocked out teeth for athletes without mouthguards was 7 and 14, respectively. Whereas for athletes wearing mouthguards one fractured tooth was reported. Athletes with mouthguards complained of problems with speaking (19.9%) rather than of breathing (3.4%) and fitting difficulties (4.8%). Boil-and-bite mouthguards caused more fitting problems than custom-made ones. As prevalence of oral injuries in body-contact sports is high, athletes should be advised that custom-made mouthguards offer the greatest comfort, fit, durability, and protection against dental injuries.

Adult↗
PubMed2000

Effect of crown lengthening and ferrule placement on static load failure of cemented cast post-cores and crowns.

STATEMENT OF PROBLEM: Restoration of mandibular second premolars with completely missing clinical crowns in the Kennedy Class I and II arches is costly and the risk of failure is high. Should the dentist choose crown-lengthening to allow the addition of a ferrule, despite incurring the disadvantage of an increased crown/root ratio? PURPOSE: This in vitro study determined the combined effect of crown lengthening and placement of a ferrule on the failure resistance to static load of decoronated and restored mandibular second premolar analog teeth. MATERIAL AND METHODS: An extracted mandibular second premolar of average dimensions was selected to form molded composite root analogs and metal crowns. Ten specimens prepared with no-ferrule root and negligible axial wall lengths and 10 specimens with ferrule root, apically repositioned finish lines, were made. Cast gold alloy post and cores and complete crowns were made and cemented. Each root was placed in bone-simulating resin located 3 mm from the finish line. Crown lengthened/ferrule and no-crown lengthened/no-ferrule groups were equally subdivided, whereby 5 crowns were compressively loaded on the buccal cusp tip and 5 were compressively loaded on the mesial marginal ridge. A testing machine applied force until failure occurred. Failure loads were examined with 2-way ANOVA. Significant differences were accepted at P </=.05. RESULTS: Mean failure loads for the crown lengthened/ferrule and no-crown lengthened/no-ferrule groups were as follows: buccal load, 0.61 kN (SD +/- 0.11) and 0.83 kN (SD +/- 0.08); mesial load, 0.70 kN (SD +/- 0.08) and 1.00 kN (SD +/- 0.15), respectively. Crown lengthened/ferrule and no-crown lengthened/no-ferrule groups were significantly different (P <.001). CONCLUSION: The combination of simulated surgical crown-lengthening and more apical crown margin placement to provide a 2-mm crown ferrule on a decoronated mandibular second premolar analog resulted in a reduction of static load failure for the restored analog tooth.

Analysis of Variance↗
PubMed2000

Effect of variable light intensity on composite shrinkage.

STATEMENT OF PROBLEM: Polymerization shrinkage is a critical limitation of dental composites and may contribute to postoperative pain, tooth fracture, microleakage, and secondary caries. Polymerization with high-intensity light sources has been related to increased depth of cure and improved mechanical properties. However, high-intensity light initiation has also been associated with greater polymerization shrinkage. PURPOSE: The purpose of this study was to investigate the effect of sequentially increasing light intensity on the polymerization shrinkage of 2 composites, a hybrid and a microfil. A Knoop hardness test was used to evaluate effectiveness of the cure with each intensity increase. MATERIAL AND METHODS: Four groups of 12 samples were measured for polymerization shrinkage by using a linometer. Light intensity curing sequences were as follows: full-intensity control (100% intensity for 40 seconds), low-intensity control (25% intensity for 40 seconds), test group 1 (25% intensity for 20 seconds, 50% for 10 seconds, 100% for 10 seconds), and test group 2 (25% intensity for 10 seconds, 50% for 10 seconds, 100% for 20 seconds). Statistical comparisons were made using a 1-factor ANOVA and a Tukey multiple comparisons test within each material. RESULTS: Results showed a significant difference (P<. 05) in mean linear shrinkage between the full-intensity control group and the other 3 sequences for both composites. No difference existed within the other 3 groups for either composite. Knoop hardness was similar for the full-intensity control and test group 2. The low-intensity control group and test group 1 were also similar but significantly lower. CONCLUSION: Curing composites for 10 seconds at 25% intensity, 10 seconds at 50%, and 20 seconds at 100% significantly reduced polymerization shrinkage while not compromising depth of cure.

Analysis of Variance↗
PubMed2002

Treatment time of traumatic dental injuries in a cohort of 16-year-olds in northern Sweden.

The aim of the present study was to account for treatment time and number of visits required for treatment of traumatic dental injuries in a cohort of 16-year-olds, born in 1975, and residing in the county of Västerbotten, Sweden, and to analyze the correlation between total treatment time and background factors. The study material comprised 1012 dental records from the Public Dental Health Service containing information on dental injuries to primary and/or permanent incisors or canines. The mean total treatment time per individual was 1.3 h, with a range of 0.1 to 27.5 h. For injuries to the primary dentition, the mean number of visits per individual was 2.2. One visit was sufficient in 21% of the trauma episodes. In the permanent dentition, each trauma episode required a mean of 3.4 visits, and 90% of the patients had to return for follow-up visits. The correlation between explanatory variables and total treatment time was described and analyzed by linear multiple regression analyses. Degree of severity and number of injured teeth were two parameters of major significance to treatment time. Treatment by a specialist had an impact on time in the permanent but not in the primary dentition. In the permanent dentition, the treatment time increased if the dental injury occurred before the age of 11 years. Treatment time was not dependent on where the clinic was located or on gender of the injured child. Different diagnoses could explain 33% of the variation in treatment time in the permanent dentition.

Adolescent↗
PubMed2000

Apexification of an infected untreated immature tooth.

A case of a traumatized permanent young tooth in which apexification occurred without the benefit of endodontic treatment is reported. It illustrates how a immature incisor that underwent pulp necrosis and periapical inflammation could progress to complete apical formation.

Child↗
PubMed2004

Outpatient endoscopic Zenker diverticulotomy.

OBJECTIVES/HYPOTHESIS: Staple-assisted, endoscopic Zenker diverticulotomy has been shown to decrease both cost of treatment and length of convalescence when compared with the standard open approach. Although the endoscopic technique is generally considered to be safe, the feasibility of outpatient endoscopic Zenker diverticulotomy has never been reported. STUDY DESIGN: Retrospective cohort study. METHODS: All endoscopic Zenker diverticulotomy procedures performed at Oregon Health and Science University (Portland, OR) between 1998 and 2002 were reviewed. The study group was limited to patients whose surgeries were planned on an outpatient basis. Medical charts were reviewed for indications, demographics, operative findings, complications, and resolution of symptoms. RESULTS: Of the 51 patients who underwent endoscopic, staple-assisted Zenker diverticulotomy, 40 were treated with the intent of outpatient management. Thirty-two cases were primary surgeries, and eight cases were revision treatments. The average patient age was 68 years (age range, 35-91 y), and the mean follow-up period was 5.9 months (range, 1-37 mo). Eight (20%) complications were noted in the study group. Intraoperative complications included 3 patients (7.5%) with mucosal disruptions. These patients underwent uneventful suture repair of small hypopharyngeal mucosal tears encountered intraoperatively and were temporarily observed in the hospital. One patient was admitted for postoperative urinary retention and another for fever and tachycardia 48 hours after surgery. One patient sustained a myocardial infarction. The remainder of patients were fed immediately and discharged home on the day of surgery. Two patients (5%) had iatrogenic tooth fracture. CONCLUSION: Appropriately selected patients undergoing endoscopic, staple-assisted Zenker diverticulotomy can be managed safely on an outpatient basis. Intraoperative complications, such as a mucosal disruption, warrant conversion to inpatient monitoring.

Adult↗
PubMed2003

Management of the implant periapical lesion: a case report.

The implant periapical lesion (IPL), a possible cause for implant failure, may occur from the presence of pre-existing microbial pathology such as endodontic/periodontal lesions. This case report presents a case history related to IPL, which was caused by a pre-existing endodontic lesion. In addition, other possible causes such as surgical trauma and the management strategies of IPL are suggested. For the treatment of the infected form of IPL, a sequential surgical therapy can be utilized. This includes surgical removal of the implant or implant apical region, thorough debridement of the infected lesion, systemic antibiotics, and/or guided bone regeneration. The implant therapy should be directed to minimize the occurrence or consequences of IPL by careful diagnosis, systematic treatment planning, and appropriate treatment procedures.

Anti-Bacterial Agents↗
PubMed2004

Establishment and evaluation of a trauma clinic based in a primary care setting.

OBJECTIVES: The aim of this study was to establish and evaluate a referral centre for the treatment of children with traumatized teeth in an area remote from a dental hospital. SETTING: The study was conducted in a Community Dental Service clinic in Cheshire, UK. METHODS: A dentist from the Cheshire Community Dental Service was trained in the treatment and management of traumatized teeth. Invite referrals to the trauma clinic in a health centre. The number and types of patients referred and treated at the trauma clinic were monitored. In addition, the parents of referred children and referring dentists were asked to comment on the acceptability of the service. RESULTS: During the first 12 months, 49 patients with 74 traumatized teeth were referred to the trauma clinic. The majority of the patients were referred by their dentist because problems arose following their initial management. Both parents and referring dentists were very satisfied with the service. CONCLUSIONS: The trauma clinic fulfilled a clinical need, and was well received by the parents of children referred to the clinic and by the local dentists.

Attitude of Health Personnel↗
PubMed1987

The metal post and composite core combination.

Restoring broken down non-vital teeth implies in general the provision of a post and core foundation. Many materials and techniques have been introduced for this purpose in recent years. In this article the advantages and disadvantages of the cast and the non-cast post and core are discussed. The problems involved with the application of the post and core are reviewed. An efficient procedure for restoring a broken down tooth with a prefabricated post in combination with a composite core is presented.

Composite Resins↗
PubMed1987

Resistance to horizontal forces of dowel and amalgam-core restorations: a comparative study.

Four designs of amalgam-core anchorage were compared in a laboratory study for the inability to withstand the horizontal component of occlusal force. Amalgam cores were constructed for extracted teeth with either composite resin-cemented Dentatus dowels, or with Para-post or Flexi-post dowels cemented with phosphate cement. All the posts were of comparable length and diameter. These anchorage designs were compared with each other and to a self-threading (TMS) pin-retained amalgam core, by application of horizontal force and recording forces causing failure. Flexi-post-retained amalgam cores failed at a mean force of 36.5 (+/- 8.5) kg while Dentatus-retained and Para-post-retained cores failed at 41.7 (+/- 8.0) kg and 46.6 (+/- 11.4) kg, respectively. TMS-retained cores resisted forces up to a mean force of 53.5 (+/- 4.5) kg. Patterns of failure varied widely among these groups. Composite resin-cemented Dentatus dowels were retained in the tooth in nine out of ten samples, while none of the ten Flexi-post dowels and only one of the ten Para-post dowels did so. Tooth fracture on failure occurred in seven out of ten Flexi-post-retained cores, while only three out of ten of the Para-post-retained cores and none of the Dentatus dowel-retained cores presented this unrepairable type of failure. Possible reasons for these differences are discussed.

Bite Force↗
PubMed1988

Forced eruption combined with gingival fiberotomy. A technique for clinical crown lengthening.

A new approach to clinical crown lengthening has been developed and described. The technique combines controlled eruptive tooth movement and incision of the supracrestal gingival attachment. The procedure was performed in patients with severe destruction of a tooth crown and in whom clinical crown lengthening procedures were essential before the teeth could be properly restored. Controlled eruptive forces were activated by simple orthodontic appliances. During the active phase of forced eruption, repeated intrasulcular incisions through the junctional epithelium and the supracrestal connective tissue attachment were performed. The technique prevented coronal displacement of the gingiva and the attachment apparatus during the orthodontic extrusion, thus overcoming the need for corrective osseous surgery.

Adolescent↗
PubMed1997

The effects of CO2, Nd:YAG and Er:YAG lasers with and without surface coolant on tooth root surfaces. An in vitro study.

The objective of this study was to compare and contrast the morphologic changes in tooth root surfaces treated in vitro by scaling and root planing followed by irradiation with the Er:YAG laser using air/water surface cooling and the CO2 and Nd:YAG lasers, both with and without surface coolant. The experimental unit consisted of 42 freshly extracted teeth which were divided equally and randomly assigned to the following 7 treatment groups: untreated control, S/RP only, CO2 laser with and without air/water surface cooling, Nd:YAG laser with and without/air water surface cooling, and Er:YAG laser with air/water surface coolant. Specimens treated with CO2 laser irradiation were subjected to energy densities ranging from 100 to 400 J/cm2; those treated with the Nd:YAG from 286 to 1857 J/cm2; and the Er:YAG was used within a range of 20 to 120 J/cm2. The degree of morphologic change following CO2 and Nd:YAG irradiation appeared directly related to energy density but unrelated to the use of surface coolant. Laser induced surface changes included cavitation, globules of melted and resolidified mineral, surface crazing, and production of a superficial char layer. In contrast, the Er:YAG laser produced root surface changes that might be expected from acid etching, i.e., removal of the smear layer and exposure of the collagen matrix. In addition, sharply defined microfractures of the mineralized structure were noted and unlike the CO2 and Nd:YAG lasers, there was no evidence of melting or surface char. Given the parameters of this study, it appears that both the CO2 and Nd:YAG lasers alter the root surface in an undesirable manner. The Er:YAG laser, however, when used at low energy densities shows sufficient potential for root surface modification to warrant further investigation.

Acid Etching, Dental↗
PubMed1990

Consumer product-related tooth injuries treated in hospital emergency rooms: United States, 1979-87.

The database of the National Electronic Injury Surveillance System was used to analyze episodes of consumer product-related traumatic injuries to teeth treated in hospital emergency room in the United States from 1979 through 1987. Results showed a slight but consistent increase in episodes of such injuries during this 9-yr period. Over 75% of such episodes occurred in persons under 15 yr of age. Over 60% of the tooth injuries in such episodes could be crudely classified into the following types by descending rank order: avulsed-, broken-, loosened-, chipped-, intruded-teeth and soft tissue injuries. The most common categories of consumer products and activities associated with such episodes were sports and play, followed by falls on floors, stairs or showers, and bicycles and other wheeled vehicles. The age composition of specific episodes of dental injuries varied considerably for different products and activities, suggesting a need for specific strategies for prevention of episodes of consumer product-related injuries to teeth for different age categories of the population.

Adolescent↗
PubMed1984

Infraocclusion of primary molars: a histologic study.

In order to analyze the occurrence and character of ankylosis in primary molars in infraocclusion, 102 primary molars, 62 in infraocclusion and 40 in normal position, in children aged 3-17 yr, were studied histologically. Ankylosis was demonstrable in most of the infraoccluded teeth while ankylosis was not found in teeth with normal positions. The ankylosis was always located at the inner root surface. Progression of the resorption of the root with age was seen in both groups of teeth. In teeth of younger children, in contrast to teeth of older children, the ankylosis was never found in the cervical portion of the roots. In the mandible, a thicker buccal marginal bone crest could be found in infraoccluded teeth than in teeth in normal position. Bone biopsies revealed no pathologic changes. Pulps of infraoccluded teeth more often demonstrated degenerative changes like fibrosis and calcifications. It is suggested that ankylosis is a local phenomenon, most likely due to developmental disturbances of the periodontium, and that ankylosis in infraoccluded primary molars is not a static condition but part of an ongoing process during root resorption.

Adolescent↗
PubMed1994

Dental injuries, temporomandibular disorders, and caries in wrestlers.

The aim of this study was to examine the prevalence of dental injuries, temporomandibular disorders (TMD), and dental caries in a group of champion wrestlers. Twenty-six male wrestlers, with a mean age of 23 yr, and an age-matched control group participated in the study. A questionnaire was used with questions on trauma, frequency of headache, intensity of practicing sports, use of sugar-containing "sports drinks", use of mouth guards, and previous TMD problems. Four bitewing radiographs were taken in all subjects. In addition, three intraoral apical radiographs of maxillary and mandibular frontal regions were taken in the wrestlers. The number of existing teeth, dental caries, amount and type of restorations, and dental injuries were recorded. Examination of the stomatognathic system comprised bilateral palpation of the masseter and temporal muscles and temporomandibular joints, and evaluation of the mandibular movements. None of the subjects had drunk sports drinks or worn mouth protectors regularly. The wrestlers had more frequent and severe dental injuries localized to the frontal region of the maxilla than the controls. No statistical differences were found in the prevalence of caries or TMD between the groups.

Adolescent↗