[Molar distalization with intraoral molar distalization bow--method for controlled position of 6-year molars in Class I relation (1)].
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The efficacy of a 1.0 molar formulation of gadobutrol was compared with that of a 0.5 molar formulation in dynamic magnetic resonance (MR) imaging of the liver in rats with hepatocellular carcinoma (HCC). Seven nodules histologically identified as moderately differentiated HCC underwent dynamic study. In the normal parenchyma surrounding these tumors, the 0.5 molar and 1.0 molar formulations yielded similar enhancement patterns, with maximum enhancement value of approximately 35% at 20 to 40 s after injection. In the tumors, the 0.5 molar formulation induced approximately 65% enhancement, whereas the 1.0 molar formulation, used at the same dose as the 0.5 molar formulation, induced significantly higher enhancement until 10 min after injection with maximum enhancement of approximately 90%. These findings indicate that the 1.0 molar formulation could be more efficacious than the 0.5 molar formulation in dynamic MR studies of moderately differentiated HCC even when injected at the same dose.
Development and eruption of lower third molars was examined in 63 subjects who were treated by extraction of second molars. Changes in mesiodistal and buccolingual lower third molar angulation were measured on 60 degrees cephalograms taken before extraction and 3 or more years later. The final position of lower third molars was assessed on models at the end of the observation period by using a scoring system. All lower third molars erupted in periods ranging from 3 to 10 years after extraction. Ninety-nine percent of the third molars upright mesiodistally, but few became as upright as the second molars they replaced. Model analysis showed that 96% of the lower third molars erupted in good or acceptable positions.
PURPOSE: Our goal was to report the detection and levels of pathogenic bacteria in subgingival plaque samples taken from the distal of all second molars in 295 patients with asymptomatic third molars. PATIENTS AND METHODS: Data assessing oral health were collected from each of these healthy patients (ASA Classes I and II). Probing depth (PD), at 6 sites per tooth, including third molars, was obtained to determine periodontal status. Subgingival plaque samples were taken from the distal of all second molars before periodontal probing. The presence and levels of 11 bacterial species were determined using whole chromosomal DNA probes and checkerboard DNA-DNA hybridization. Detected bacterial species were grouped into clusters of periodontal pathogens designated as "red" or "orange" complex microorganisms as described by Socransky et al (J Clin Periodontal 25:134, 1998) who found an association of these specific microorganisms with periodontitis. RESULTS: As a group these relatively young patients were periodontally healthy. "Orange and red" complex microorganisms were detected at levels equal to or greater than 10(5) more often if patients had a PD equal to or greater than 5 mm with periodontal attachment loss at the distal of second molars or around third molars at their entry examination. In patients with no PD equal to or greater than 5 mm in the third molar region, "orange and red" complex microorganisms were detected at levels equal to or greater than 10(5) more frequently than would be anticipated in patients with little clinical evidence of periodontal disease. CONCLUSIONS: The clinical findings of increased periodontal PDs and periodontal attachment loss coupled with colonization of periodontal pathogens support the concept that clinical and microbial changes associated with the initiation of periodontitis may present first in the third molar region in young adults.
Functional occlusion and periodontal health were investigated after orthodontic treatment that involved extraction of second molars and after eruption of the third molars in 37 patients (25 female, 12 male). The mean age was 21 years 9 months (range, 16 years 1 month-30 years 5 months). The third permanent molars invariably erupted into a position that maintained good functional occlusion. Sixty-three percent of patients had canine guidance in lateral excursion; the remainder of patients had satisfactory group function. There were only 2 non-working side interferences in the sample, 1 from a recently erupted mandibular third molar. The periodontal health of the sample was generally excellent. Plaque score and bleeding on probing was very low (1.7% of sites). Periodontal health around both maxillary and mandibular teeth was extremely good. When attachment loss was assessed, 2238 of 2240 sites were clinically healthy. One patient, who had generally poor oral hygiene, had a 4-mm probing depth interproximally on the maxillary first and third molar contact. There was no correlation between periodontal health and mandibular third molar position. Therefore, both functional occlusion and periodontal health in the sample were good after loss of second permanent molars and eruption of the third molars.
OBJECTIVE: The aim of this study was to compare the influence of two mucoperiosteal flaps on periodontal healing of adjacent second molars after extraction of impacted mandibular third molars. STUDY DESIGN: An envelope incision with a releasing incision anterior to the second molar (3-cornered flap) was used on one side and a Szmyd flap on the other side in 14 patients with bilateral impaction of mandibular third molars. The periodontal health of the second molars was evaluated before surgery and at 3 and 6 months postoperatively. A William's periodontal probe was used to measure the pocket depth, clinical attachment level, and bone level of the buccal and mesial surfaces of the second molars. The postoperative measurements were analyzed by using analysis of covariance, with the covariables being the preoperative measurements and variation factors being the type of flap used, the surface measured, and the time since the procedure. RESULTS: No statistically significant differences were found in comparing measurements of probing depth, clinical attachment level, or bone level for the 2 types of flap used or the 2 surfaces measured. However, there was a statistically significant increase in all 3 measurements from the 3-month to the 6-month postoperative time. CONCLUSION: Independent of the design of the mucoperiosteal flap used in extracting an impacted mandibular third molar, the periodontal condition of the adjacent second molar worsened from 3 to 6 months, although it remained within normal values.
Although pressure resorption of second molars is associated with impacted and/or erupting third molars, the relationship between pressure resorption and age is unclear. In order to investigate this relationship, 3883 dental radiographs were studied in 3174 individuals of various ages. The incidence of superimposition of the second molar on the third molar was not elevated in any subgroup except that of women of 16-40 years of age. There were no age or sex differences for the incidence of second molar root resorption. In older individuals, root resorption associated with a completely impacted third molar was more frequent than with a partially impacted third molar, and root resorption at the apex was mainly seen in individuals over 50 years of age. There was a higher incidence of superimposition and root resorption in men than women. Apical root resorption may be seen long after the formation of completely impacted third molars in both genders.
PURPOSE: General consensus has been reached on extracting mandibular third molars when they are involved in pathologic processes. However, early extraction is advisable in cases of eruption disturbances of the mandibular second molar, before or during orthodontic treatment. METHODS: Thirty-two patients with early extraction of the mandibular third molar before or during orthodontic treatment were examined. RESULTS: In these cases either the presence of the third molar presented an obstacle in the eruption path of the second, or third molar germ removal was considered beneficial to the course of orthodontic treatment. CONCLUSIONS: Early extraction of the mandibular third molar facilitates the eruption of the second molar, especially in cases where evidence of crowding and lack of space in the posterior mandibular region exist. Orthodontic treatment may, in some cases, aggravate eruption disturbances of the second molar.
This study sought to address the influence of a sound versus affected first and/or second deciduous molar on the incidence of visible caries experience in the adjacent permanent first molar. Clinical and questionnaire data were obtained from a 6-year prospective oral health screening project in Flanders, Belgium (Signal-Tandmobiel project), where 4,468 children (born in 1989) were examined annually during their primary school time. A multiple survival model allowing for dependent data with possible censoring was applied. The impact of timing of tooth emergence (determining the period at risk), gender, presence of sealants and reported oral hygiene habits was also considered. Cavity formation in permanent first molars was clearly influenced by the status of the adjacent primary molars;the effect of the second deciduous molar was most pronounced. Moreover, if both deciduous molars experienced caries and the child presented with poor oral hygiene, a peak in cavity formation of the permanent first molar 1-2 years after emergence was noticed. On the other hand, if a child presented with good oral hygiene, no peak was observed; caries risk increased slightly over time. No significant benefit from restoring primary molars could be demonstrated, possibly because of methodological limitations.
The aim of the present clinical study was an in vivo evaluation of an improved conventional glass ionomer cement Ketac Molar (ESPE), compared to a polyacid modified composite resin, Dyract (Dentsply/De Trey), used in primary molars. Fifty-three Ketac Molar and fifty-two Dyract restorations were placed in box-only preparations in primary molars. The application time for the chemically cured Ketac Molar, was longer compared to the light-cured Dyract. In comparing the materials, no differences were found, comparing both materials regarding secondary caries, marginal adaptation, wear and fracture toughness. One case of recurrent caries adjacent to a Ketac Molar restoration and two cases in the Dyract group were reported. Two Ketac Molar restorations and one Dyract showed bulk fracture at the time of evaluation. At the twelve-month evaluation, no difference between the investigated materials was registered, which indicates that Ketac Molar can be used as a proximal restoration in the primary dentition. It should be emphasized, however, that one-year data should not be extrapolated to indicate the long-term success of restorations.
The purpose of this study was to observe the changes of the third molars following the extraction of second molars by orthopantomograms. The subjects were consisted of 96 cases in upper second molar extraction, 74 cases in lower second molar extraction. The obtained results were as follows: 1. The favourable eruption condition of upper third molar appeared in both groups with pre-extraction angle under 25 and pre-extraction angle above 25. 2. More favourable eruption condition of lower third molar appeared in group with pre-extraction angle under 25 than the other group with pre-extraction angle above 25. 3. The favourable eruption condition of upper third molar appeared in both group extracted in Nolla's Stage 4, 5 and Nolla's Stage 6,7,8. 4. More favourable eruption condition of lower third molar appeared in group extracted in Nolla's Stage 4, 5 than the other group extracted in Nolla's Stage 6,7,8.
A case is here presented in which mandibular first molar was horizontally impacted under the submerged primary molar. The patient was an 8 year-old-boy referred from a general dentist through the Department of Pedodontics in this hospital, whose chief complaint was a horizontally impacted mandibular first molar. Skeletally, diagnosis revealed an Angle Class II Division 2 malocclusion. The impacted first molar was uprighted with a lingual arch and a utility arch following the extraction of the submerged primary molar. The submerged primary molar was probably ankylosed causing a locking of the first molar which rotated as the root formed. The result of rotation during forming twisted the roots of the first molar, which will make root canal treatment difficult if the pulp is infected in the future. It may concluded that dental arches should be carefully observed even in the deciduous dentition.
Fluctuating asymmetry (FA), random variation between left and right sides in a bilaterally symmetrical character, is a commonly used measure of developmental instability that is expected to increase with increasing environmental stress. One potential stressor is 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), a powerful toxicant known to disturb tooth development. In this study, mice in the F(2) generation produced from an intercross between two inbred strains (C57BL/6J and AKR/J) were exposed in utero to TCDD. We hypothesized that TCDD would increase FA in the molars of exposed mice over that of the control mice. In addition, we hypothesized that we would discover genes for molar size, shape or asymmetry whose expression would be affected by TCDD. We detected a very small, but significant, increase in FA of molar shape (but not size) in the TCDD-exposed mice compared to the control mice, although molar size and shape did not differ between these groups. Although we did not uncover any genes that acted differently in the TCDD exposed and control groups, we did identify two genes whose dominance by additive epistatic effect on molar size was affected by TCDD. We concluded that although TCDD may be affecting the expression of some genes governing the development of molars in our population of mice, FA of molar size and shape is not a particularly sensitive indicator of this effect.
The present investigation was designed to study the effect of stainless steel crowns (SSC), placed on second primary molars, on the periodontal tissues of neighbouring first permanent molars. 36 children (9-12 years old) with an SSC on a second primary molar on one side of the mouth only, were selected for the study. A clinical and radiographic examination was performed at the mesial surface of the first permanent molar, adjacent to the SSC, and at the corresponding area on the contralateral side of the mouth. The clinical examination included gingival and plaque index scores and probing depth measurements. In the radiographic examination, the marginal bone level was assessed. No statistically significant differences in plaque index scores, gingival index scores and probing pocket depth were noted between the mesial surface of first permanent molars and the contralateral control area. Nor were any significant differences in bone level seen. The present findings suggest that the presence of a well-adapted SSC on a second permanent molar does not affect the periodontal health of the neighbouring first permanent molar.
UNLABELLED: Appropriately timed extraction of a carious first permanent molar can result in favourable mesial drift of the second permanent molar when space is not required for orthodontic treatment. However, when the second deciduous molar adjacent to the extracted tooth is not removed, distal drift of the unerupted second premolar may occur. This paper discusses three patients who had first permanent molars extracted without removal of the adjacent second deciduous molar, encouraging unfavourable distal drift of the second premolar in the first two cases. Timely extraction of the second deciduous molar in the third case should prevent this orthodontic problem. CLINICAL RELEVANCE: Treatment of gross caries in a first permanent molar requires assessment of the patient's orthodontic status prior to treatment planning.
AIM: To present a method for correction of an extruded maxillary second molar. METHODS: A female patient, 16 years of age, presented with an impacted mandibular second molar and an extruded opposing maxillary second molar. After placement of appliances in the maxilla, an elastic was hooked between the distal end of the extended lingual arch and the lingual button of the maxillary second molar. RESULTS: After sufficient intrusion of the maxillary second molar was achieved, the conventional method for traction of an impacted mandibular second molar was used. Neither root resorption nor undesirable periodontal problems were observed. CONCLUSION: The approach used in the present case is simple and efficient for both traction and retention of a maxillary molar.