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PubMedDate not supplied

Intracoronal bleaching of discolored non-vital teeth.

This clinical study compared the effectiveness of bleaching non-vital teeth with an open pulp chamber during bleaching using 10% carbamide peroxide compared to the modified walking bleach technique and extracoronal bleaching. Sixty discolored, non-vital teeth were treated. They were divided into three groups. Each group was treated with one of the bleaching materials and methods: extracoronally using 10% carbamide peroxide for two weeks as negative control (Group A), intracoronally using sodium perborate mixed with 3% hydrogen peroxide (modified walking bleach technique) (Rotstein, Mor & Friedman, 1993) for four weeks (Group B) and intracoronally and extracoronally using 10% carbamide peroxide for two weeks (Group C) (Liebenberg, 1997). Tooth color was measured at baseline, (BL), immediately post-bleaching (IP) and six months post-bleaching (SP) with a colorimeter (Castor, Sigma, Germany) using a tooth-positioning jig. The color was determined according to the CIELAB system, which records lightness as L* and chromaticity coordinates as a* and b*. The difference in L* and b* among the three groups was significant between BL and IP examination. The post-bleaching, whitening effect in Group C was significantly better, but after six months, in Group C, it was as effective as in Group B.

Adult↗

PubMed2006

Clinical evaluation of self-etch adhesives in Class V non-carious lesions.

PURPOSE: To evaluate the clinical performance of two self-etching and one total-etch adhesives in Class V non-carious cervical lesions (NCCL). METHODS: Two self-etching primers, Clearfil SE Bond and Hybrid Bond, and one total etch adhesive, Admira Bond, were placed in 195 NCCL. Restorations were evaluated at baseline, 1 and 2 years using the USPHS criteria. RESULTS: No restoration was lost after 1 and 2 years for all materials. There was no significant difference between the baseline and 2-year results for Admira Bond and Clearfil SE Bond restorations. In contrast, Hybrid Bond restorations showed significant deterioration in marginal adaptation and cavosurface marginal discoloration after 2 years. Also, there was no significant difference between Admira Bond and Clearfil SE Bond at each recall period.

Acid Etching, Dental↗

PubMed2004

Development of clinical and radiographic signs associated with dark discolored primary incisors following traumatic injuries: a prospective controlled study.

The purpose was to evaluate late complications of asymptomatic traumatized primary incisors with dark coronal discoloration. The clinical and radiographic signs of 97 teeth of the study group were recorded along a follow-up period that ranged between 12 and 75 months (mean >36 months). Children's age at time of injury ranged between 18 and 72 months (mean 40). The control group consisted of 102 non-discolored maxillary primary central incisors in 51 children older than 54 months with no history of dental trauma. In 50 teeth (52%) the color faded or became yellowish and in 47 (48%) it remained dark. Clinical signs of infection, that were diagnosed 5-58 months after the injury, were associated significantly more with dark than yellowish hues (83 and 17%, respectively). Teeth that had changed their color to become yellow presented more PCO than teeth with black/gray/brown coronal discoloration (78 and 6%, respectively). Arrest of dentine apposition was found in 15 teeth, one had yellow coronal discoloration and the remaining 14 had a dark shade. Eleven teeth showed inflammatory root resorption all with dark discoloration. Two atypical types of root resorption were observed: a surface resorption restricted to the lateral aspects of the apical half of the root while the root length remained unchanged and in the other expansion of the follicle of the permanent successor was observed. Expansion of the dental follicle was observed in 72% of all teeth with no significant difference between the various types of coronal discoloration but only half of the cases were associated with resorption of the root of the primary incisor. The various pathologic findings observed in the study group were either absent or rarely seen in the control group. It can be concluded that more than 50% of the primary incisors that retain their dark coronal discoloration acquired after dental injuries remain clinically asymptomatic till the eruption of the permanent successor even if they present accelerated root resorption. Asymptomatic traumatized primary incisors that retain their dark coronal discoloration may develop a sinus tract and inflammatory root resorption years after the injury. There is still a dilemma: which treatment is better for dark discolored primary incisors: early endodontic treatment or follow-up with the risk of development of infection and root resorption that may require extraction?

Bacterial Infections↗

PubMed1981

Ion probe analysis of discolored areas in the enamel of deciduous teeth.

Discolored and normal areas in the enamel of eleven primary teeth from children born to diabetic mothers were analysed with ion probe technique. These teeth were compared with four teeth from children born to healthy mothers. Fourteen different mass numbers were recorded. The affected areas showed a proportionally higher content of organic material, but the differences in recorded values reached statistical significance only in the postnatal enamel. The study revealed a considerable biological variation in the chemical composition of deciduous tooth enamel. The brown areas may be partly related to variation in physical properties.

Child↗

PubMed2004

Minimally invasive aesthetic treatment for discolored and fractured teeth in adolescents: a case report.

This article describes a minimally invasive treatment of a young patient who presented with generalized enamel white spots and hypocalcification in combination with a severely fractured central incisor. Enamel microabrasion technique was used to remove discolored and/or pitted enamel. A direct composite restoration was then placed according to the anatomical layering technique. These procedures are described step-by-step herein. The advantages of microabrasion and composite restoration over conventional prosthetic procedures are also discussed.

Adolescent↗

PubMed1996

The direct/indirect composite resin veneers: a case report.

Veneer restorations are well suited for conservative and aesthetic improvement of the anterior dentition. Laboratory fabricated porcelain and composite resin veneers present optimal aesthetics and durability. Although there are disadvantages associated with direct bonding, it provides control of color and contour for the operator, particularly in the case of a single anterior central incisor. Direct/indirect composite resin veneers utilize the advantages of both direct and indirect techniques in reconstruction of restorations with improved physical properties. The learning objective of this article is to review the available composite resins, opaquers, and tints, and present a step-by-step protocol for predictable restoration of discolored anterior dentition with direct/indirect heat-treated composite resin veneers in a single appointment. Patient evaluation, preoperative aesthetic considerations, selection of the restorative composite resins, and the clinical procedure are discussed.

Adolescent↗

PubMed1980

Diagnosis and treatment of pulp necrosis in permanent anterior teeth with root fracture.

A follow-up study was made of 20 traumatized permanent incisors with pulp necrosis observed as a sequel to root fracture. The material included 19 patients aged 8-17 years (mean 11.6 years) at the time of injury. Negative response to electric stimulation was noted in 16 teeth from the first examination. In four teeth an initial positive response changed to negative within 2-9 months. The negative response was supported by additional signs and symptoms of necrosis in 19 teeth. Radiolucencies adjacent to the fracture line or coronal discolorations were the most important diagnostic factors. Discolorations occurred within 2 months, whereas radiographic changes in the fracture area took from 3 to 5 months to develop. Four teeth were extracted without attempting endodontic therapy. Endodontic treatment confined to the coronal fragment was performed in 16 teeth. In most cases the canal was filled temporarily with calcium hydroxide until a closure at the fracture site was observed. Two apical fragments showing radiographic changes were surgically removed in conjunction with the permanent filling of the coronal fragments. During the postoperative observation period one tooth was extracted due to communication between the fracture area and the oral cavity. The treatment of the remaining 15 teeth was judged as successful after a mean observation period of 4.2 years, ranging from 2 to 5 years.

Adolescent↗

PubMed2006

Clinical evaluation of posterior composite restorations in endodontically treated teeth.

OBJECTIVE: The purpose of this study was to evaluate the two year clinical performance of posterior composite restorations in endodontically treated premolars and molars using a hybrid composite (Filtek Z-250, 3M ESPE) and a total etch bonding system (Single Bond, 3M ESPE). METHOD AND MATERIALS: Thirty-nine class II restorations in endodontically treated premolars (n=11) and molars (n=28) of 27 patients (14 female, 13 male, mean age 36.51) in 16 maxillar and 23 mandibular teeth were placed by one operator. Restorations were evaluated by two experienced investigators at baseline, 12 months, and 24 months according to the modified United States Public Health Service (USPHS) criteria that included retention, color match, marginal discoloration, secondary caries, anatomic form, marginal adaptation, and surface texture. All restorations were able to be evaluated at baseline, 12 months, and 24 months. RESULTS: Paired samples t-test showed only marginal discoloration showed a statistically significant difference (p<0.05) at the end of 24 months, and no other significant differences were observed for the other variables examined over the duration of the study. None of the restored teeth showed periapical pathology at the end of 24 months. CONCLUSION: At two years, limited deterioration in marginal discoloration was detected. The clinical performance of posterior composite restorations in endodontically treated teeth using Filtek Z250 was found clinically acceptable after two years.

Adult↗

PubMed1993

Evaluation of occlusion, trauma, and dental anomalies in African-American children of metropolitan Headstart programs.

493 African-American children between the ages of three and four years were examined for evaluation of molar occlusion with frequency of anterior and posterior crossbite, fractured and/or darkened teeth from trauma and dental anomalies in the primary dentition. Overall results from both age groups revealed 90% had a mesial step, 8% a flush and 2% a distal step molar occlusion. Crossbite, either anterior or posterior, occurred in 12% of all children examined. Posterior crossbite was seen in 7% and anterior crossbite in 5%. Anterior openbite was seen in 8% of the children. Trauma to the primary dentition occurred in 23% of the children, 16% as fractured and 7% as discolored teeth. The most frequently involved teeth were the maxillary primary central incisors. Fused primary teeth were observed in two children. There were no congenitally missing primary teeth and only one supernumerary maxillary primary lateral incisor was observed.

Black or African American↗

PubMed1992

[Drug-induced changes in the teeth and mouth. II].

As in the previous paper the unwanted effects of drugs or chemicals in the orofacial region are described. The authors take into consideration alterations such as gingival hyperplasia and hypertrophy, discoloration of the oral mucosa and teeth, oral ulceration and stomatitis, cervical lymphadenopathy, drug induced blood dyscrasias, bleeding caused by aspirin and other drugs, and cleft lip and cleft palate.

Cleft Lip↗

PubMed2004

Federal University of Santa Catarina follow-up management routine for traumatized primary teeth -- part 1.

The objective of this study was to verify if the follow-up management routine of traumatized primary teeth set up by Federal University of Santa Catarina, which performs clinical and radiographic assessments (15 and 45 days; 4, 8 and 12 months) after the oral trauma, enabled an early diagnosis of sequelae which would indicate the need for endodontic intervention, as well as the influence a type of trauma and the child's age could have in the severity of the sequelae. In this study 52 sets of records were used of patients being seen in the last 6 months, with a total of 70 teeth that were receiving follow-up treatment. Patients returned for regular visits set up by the management routine, where clinical and radiographic examinations were performed to check for sequelae, which justified endodontic intervention. Mobility (51.2%) and crown discoloration (25.6%) were the most common sequelae found in the patient's first appointment. In the follow-up visits, replacement root resorption (22.5%) was the second most common sequela found, suggesting endodontic intervention. No significant association was found between severe sequelae, types of trauma and a child's age (chi(2) = 0.3, P = 0.8613). During the intervals of the follow-up visits, it was noticed that between 46 days and 8 months a higher number of sequelae were diagnosed (P < 0.05). The diagnosis of sequelae such inflammatory and replacement root resorption, which can lead to an early loss of a primary tooth, are frequent and that the interval between the follow-up visits has to be changed, suggesting the setting up of management routine 2. The study also concluded that the type of trauma and the child's age are not fundamental factors in the diagnosis of severe sequelae.

Child, Preschool↗

PubMed2004

Comparative clinical evaluation of slot versus dovetail Class III composite restorations in primary anterior teeth.

This study compares the clinical characteristic evaluations of slot against dovetail class III composite restorations. Focusing on the primary anterior teeth of children aged 2 years 6 months to 5 years 3 months with the mean age of 4 years, thirty-six matched pairs of class III of slot and dovetail preparations were made by one investigator These preparations were evaluated for marginal adaptation, anatomic form, secondary caries and marginal discoloration after 6, 12, and 24 months by another investigator with the intra-examiner reliability of 0.95 - 1 (Kappa Statistic). The results revealed no statistical significance in the difference of clinical characteristics between the two designs (p > 0.05).

Child, Preschool↗

PubMedDate not supplied

Placement and replacement of restorations in general dental practice in Iceland.

Ninety-one Icelandic practicing dentists (51% response rate) provided information related to the reasons for placement and replacement of 8,395 restorations and 741 sealants in 5,997 patients. Information included the patient's gender and age, the clinician's gender and experience in years since graduation, the defined criteria for replacement of restorations, the estimated past use of material in five-year increments and the records of 100 consecutively placed restorations. The materials used include composite (52.7%), amalgam (29.2%), glass ionomer (9.5%), resin-modified glass ionomer (7.1%) and other materials (1.4%). Although material selection was independent of the clinician's gender, female patients received more composite and fewer amalgam restorations than their male counterparts. Reasons for placing restorations comprised replacement of failed restorations (47.2%), primary caries (45.3%) and non-carious defects (7.5%). Secondary caries was the main reason for replacement for all types of restorations. Chi square analysis related to the dependence between the reasons for replacement and clinician's experience showed that more experienced clinicians recorded a lower frequency of secondary caries than less experienced ones (p<0.0001), while the diagnoses of discoloration and fracture of restorations increased with the clinicians' experience (p<0.0001).

Adolescent↗

PubMed1998

A retrospective evaluation of patients with uncomplicated crown fractures and luxation injuries.

This paper is a review of the clinical findings from my thesis "Pulp survival and hard tissue formation subsequent to dental trauma". Traumatic injuries in children and adolescents are a common problem, and the prevalence of such injuries has increased over the last 10-20 years. The purpose of the present investigations was to evaluate the long-term results following uncomplicated crown fractures and luxations involving subsequent pulp canal obliteration. A total of 241 patients with 545 injured teeth were available for clinical examination, of whom 102 answered a questionnaire and were interviewed before oral examination. In addition, 82 permanent incisors presenting with pulp canal obliteration were followed for a period of 7 to 22 years (mean 16 years). The findings showed little pulpal response to crown fracture and subsequent restorative procedures as long as there was no concomitant periodontal injury (15-year follow-up). Approximately every fourth resin composite filling was rated as unacceptable at clinical examination. The interview showed that half of the individuals were dissatisfied with the color and/or anatomic form of the composite restoration. Pulp canal obliteration was found in all luxation categories, and 69% of the teeth demonstrated yellow crown discoloration. According to the survival curve the 20-year pulp survival rate diagnosed radiographically was 84%. Although the risk of pulp necrosis increased with time, routine endodontic intervention of teeth with ongoing pulp canal obliteration of the root canal did not seem justified.

Adolescent↗

PubMed1998

Apparently new syndrome of sensorineural hearing loss, retinal pigment epithelium lesions, and discolored teeth.

We report on a family with early-onset sensorineural hearing loss, abnormal retinal pigment epithelium granularity, accumulation of creamy-white lesions at the level of the retinal pigment epithelium particularly superior to the arcade, and selective discoloration (brown) of molars or canine deciduous teeth that follows an apparent autosomal recessive inheritance pattern. This appears to be a new syndrome that can be distinguished from the known otodental, oculo-acoustic and flecked retina syndromes by the occurrence of distinct dental and ocular abnormalities.

Child, Preschool↗

PubMed1994

Prediction of the need for bitewing radiography in detecting caries in the primary dentition.

In recent literature some controversy has been reported regarding the prescription of bitewing radiography for caries diagnosis, particularly in children. While the low prevalence of caries justified the decision not to take radiographs, it has also been reported that the benefits of detecting slowly progressing, clinically undetectable lesions could outweigh the "costs" of radiography. It was the aim of this study to investigate whether specific risk factors could predict the presence of additional dentinal lesions (ADL) in the primary dentition on radiographs which could not be detected by visual inspection. Bitewing radiographs were taken in 182 children aged 5 yr. Risk factors for ADL were identified and appropriate rating scales were designed. Sensitivities, specificities and relative risks expressing the relation between scale values and ADL were computed for each of the risk factors and direct and stepwise discriminant analyses were performed. The results indicate that particularly the presence of lactobacilli and mutans streptococci in saliva and the detection of three or more discolored enamel lesions or dentinal lesions were good predictors of ADL. It is suggested that these risk factors be used in the timing of bitewing radiography in children with a primary dentition.

Child, Preschool↗

PubMed1993

Dental findings in a patient with biliary atresia.

The dental treatment of a 3-year-old male with biliary atresia is discussed. The patient was scheduled for a liver transplant and was receiving Cyclosporine A. Due to the severity of the dental condition and to reduce the possibility of infection, all twenty primary teeth were extracted. The extracted teeth displayed a marked greenish discoloration of both the crowns and the roots. Histological examination revealed extensive interglobular dentin, a number of faint yellow-brown lines contouring the developmental pattern and a distinctive fluorescent line. The dental and pharmacological considerations relating to the treatment plan for this case are reviewed.

Biliary Atresia↗

PubMed1998

Combining treatment modalities for tetracycline-discolored teeth.

Tetracycline-discolored teeth that are to be restored by porcelain laminate veneers present a clinical challenge. Successfully bleaching such teeth prior to veneering will permit the clinician and technician to overcome the technical difficulties associated with masking dark teeth. This article describes a combined treatment modality in which the teeth are bleached after the preparation for porcelain laminate veneers.

Carbamide Peroxide↗