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PubMed2006

Dental therapists' experience in the immediate management of traumatized teeth.

The optimal immediate management of traumatized teeth is known to be important for long-term success. One hundred and sixty-seven school dental therapists with General Certificate of Education 'Ordinary' (GCE 'O') level qualification were surveyed on their knowledge and experience on immediate management of dental trauma. The results showed only 41.2% felt comfortable with their present knowledge on the subject. A high proportion of the respondents (94.6%) indicated a need for more knowledge. All therapists concurred on the need to replant a permanent tooth and most (85.1%) agreed that this should be done within 30 min. More than half (54.8%) were not sure of the optimal storage medium for avulsed teeth. Their attitude towards acquiring knowledge in this aspect was good (80.5%) and all would take immediate action to settle appointments for trauma cases.

Appointments and Schedules↗
PubMed2006

Exposed human pulp caused by trauma and/or caries in primary dentition: a histological evaluation.

The aim of this study was to compare the pulpal reactions after exposure due to trauma and/or caries and to suggest the appropriate treatment options for the management of pulp, in the light of the histological findings in the primary teeth. Fifteen primary maxillary incisors with pulpal exposure were examined with light microscope in a blind study. After the histological evaluation, teeth were divided into three groups for the etiological factors due to the exposure according to the patient's files: trauma group, caries group and caries and trauma group. The inflammatory infiltration was diminished from the pulp chamber towards the apical third of the root canal in all of the examined teeth. Teeth in the trauma group presented fewer inflammatory cells in the root canal in comparison with other groups. It was concluded that the teeth with traumatic pulp exposure were considered as more likely to respond positively to pulpotomy technique. Pulpectomy or extraction seemed to be indicated for the decayed or decayed and traumatically injured teeth.

Child, Preschool↗
PubMed2006

The role for 'reminders' in dental traumatology: 3. The minimum data set that should be recorded for each type of dento-alveolar trauma - a review of existing evidence.

The aim of this study was to establish the prognostic factors recorded at the time of diagnosis or initial treatment that affect pulp and periodontal healing and tooth survival. A search strategy and quality assessment method was established to review the literature. The significant factors identified are listed for each type of dento-alveolar injury. These factors identified are the gold standard against which quality assessments of dento-alveolar trauma records can be compared and all new computer or paper-based methods for recording any type of dento-alveolar trauma should aim to record this minimum information.

Humans↗
PubMed2002

Preservation of esthetics with implant dentistry: a clinical report.

BACKGROUND: The replacement of single teeth with implants in the anterior maxilla poses a significant challenge to the clinician because of its esthetic implications. PURPOSE: The purpose of this article is to report a protocol in which single teeth are replaced by implants and temporarily restored without load, immediately after extraction. MATERIALS AND METHODS: Between June 2001 and July 2002, 16 cases were followed up in which this protocol was used. Briefly, the teeth are extracted with a Periotome (Friadent, Mannheim, Germany), using a flapless technique, the sockets are evaluated and débrided, an osteotomy is performed following the direction of the socket, and a tapered implant is placed using the alveolar crest as the landmark. A temporary abutment is immediately custom made, and a temporary crown is placed without loading. The 16 cases are summarized, and 4 of them are presented to illustrate this approach. RESULTS: All four cases have provided excellent esthetic results maintaining an ideal implant-to-supporting-tissue relationship. Furthermore, the overall time needed to restore the cases was considerably reduced when compared with time needed for the conventional approach. CONCLUSION: The four cases presented support the use of the described protocol in the placement of single implants in areas of the maxillary anterior region where esthetics is a high priority.

Adult↗
PubMed2003

Immediate replacement of single upper posterior teeth: a report of cases.

BACKGROUND: The immediate replacement of upper molar teeth with implants poses a significant challenge to the clinician because of its sinus involvement. PURPOSE: The purpose of this article is to report a protocol in which single molar teeth are replaced immediately with implants, minimizing the need for other surgical procedures. MATERIALS AND METHODS: This protocol has been employed in eight cases. Briefly, the teeth are extracted atraumatically, the sockets evaluated, an osteotomy performed following the direction of the socket, and a wide diameter implant placed using the socket walls and sinus floor to anchor it. A grafting material is placed when the space between implant and socket wall is considerably large. Three cases are reviewed here, and all eight are summarized. RESULTS: All cases have excellent soft and hard tissue healing after 6 months. Furthermore, the overall time needed to restore the cases has been considerably reduced and the need for sinus management eliminated. CONCLUSION: The cases presented support the use of the described protocol in the placement of implants in maxillary molar areas without any other sinus procedures.

Adult↗
PubMedDate not supplied

Rapid extrusion with fiberotomy.

Rapid extrusion with fiberotomy as an alternative to traditional crown lengthening modalities is described. Given appropriate anatomic conditions, rapid extrusion with fiberotomy may be utilized as a viable and esthetic crown lengthening procedure.

Crown Lengthening↗
PubMed2004

Selection defines design.

The era of "extension for prevention" used restorative materials and cavity preparation designs in an attempt to arrest the caries process. In the new era of "prevention to eliminate extension," many of the old limitations are no longer applicable because of advances in research and technology. The advances in restorative materials and adhesive technology require the use of an adhesive design concept when considering restorative material selection, preparation designs, and adhesive protocol and placement procedures and techniques. This adhesive design concept has been instrumental in the paradigm shift from the principles of extension for prevention to an ultraconservative principle of prevention to eliminate extension. From the early onset of the disease to initial placement of the restoration, this modern philosophy has three clinical objectives: prevention, preservation, and conservation. The clinician should strive to preserve the maximum integrity of the natural dentition by preventing the placement of the initial restoration, preserving and conserving tooth structure during the preparation of restoration, and conserving the tooth and restoration by increasing the longevity of the restoration between replacements. This article describes an incremental layering technique that uses a conservative restorative adhesive design concept (adhesive preparation design and protocol) for preparing, restoring, and finishing a Class IV restoration, and it demonstrates how the selection of a small-particle hybrid composite influences the preparation design. CLINICAL SIGNIFICANCE Selection of improved restorative materials that simulate the physical properties and other characteristics of natural teeth in combination with an adhesive design concept and preoperative considerations during the diagnostic and treatment planning phases of the restorative procedures provide the framework that ensures the optimal development of an esthetic restoration while preserving, conserving, and reinforcing the tooth-restoration complex.

Color↗
PubMed1998

Trauma quiz. Terribly troublesome, trauma teeth.

Unfortunately, we come across many traumatised teeth during our practising career. Some of these traumatic injuries are rather simple to treat whereas others provide us with a real challenge. It is absolutely essential that the diagnosis of the injury be known before any treatment is attempted. When it comes to trauma, however, defining the exact form of treatment can often be very difficult. In this paper I will discuss some of the cases that I have managed and leave it up to YOU to decide whether my treatment has been correct, incorrect or whether there is some other form of treatment that we have at our disposal that could have been attempted.

Adolescent↗
PubMed1999

Investigations on a cell culture medium for storage and transportation of avulsed teeth.

Non-physiologic storage of avulsed teeth leads to a high incidence of root resorption, resulting in poor prognosis. This study investigated the suitability of specially composed cell culture media for storage of extracted teeth for up to 48 hours. Autoradiographic investigations revealed that the proliferative activity of periodontal ligament (PDL) cells of teeth stored in cell culture medium for up to 48 hours increased with storage time. Studies on proliferation of PDL cells after storage of teeth in different media for up to 24 hours demonstrated that the proliferative activity is dependent on the composition of the medium. Immunohistochemical investigations with markers for cell proliferation revealed that pulp cells of extracted immature teeth show numerous proliferations after storage for up to 24 hours in a special cell culture medium but few proliferations after storage in Hanks Balanced Salt Solution (HBSS). The investigations indicate that a special cell culture medium can preserve cell viability of PDL cells adhering to extracted teeth for at least 48 hours. The in vitro results are confirmed by a case presented: After storage of two upper central incisors for 36 hours in the cell culture medium the teeth could be successfully reimplanted after extraoral insertion of titanium posts into the root canal (auto-alloplastic reimplantation). Clinical and radiological follow-up examinations for 12 months revealed normal periodontal healing.

Autoradiography↗
PubMed1975

Causes of accidental injuries to the teeth and jaws.

Almost one half of all the dental accidents recorded during this study occurred when the victim was moving and struck a stationary object. Falls and vehicles were about equally responsible for half of the accidents. Accident proneness seemed to be affected by age and sex with the teenage group reporting the most dental accidents (35.76%) and males reported dental accidents three times as often as females. Of orthodontic patients, 16.43 percent had a history of dental accidents in contrast to about five percent of the general population. From the limited data available, approximately three fourths of the persons reporting said no seat belts were available in their automobiles. The remaining one fourth had belts but they were not being used at the time of the dental injury. Right-handed victims tended to be injured on the right side of the mouth and jaw and left-handed victims exhibited more injuries on the left side. As was anticipated, a high percentage (23 percent) of the residents of a hospital for the mentally retarded exhibited dental injuries.

Accident Prevention↗
PubMedDate not supplied

Facial attractiveness and the aged.

This study examined the relationship between dentofacial appearance and judgments of facial attractiveness in a sample of 60 subjects between ages 65 and 75. Subjects completed questionnaires regarding their current dental appearance and level of satisfaction with their facial attractiveness. Subjects then viewed and ranked four sets of five photographs that had been digitally manipulated to simulate common dental defects. Regardless of background facial attractiveness or gender of stimulus photographs, a specific ranking order for dental defects emerged with rank-order correlations in the 90% range. Findings suggest that dental appearance affects judgments of facial attractiveness regardless of gender or background facial attractiveness.

Aged↗