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PubMed1994

Changes in vertical tooth position and face height related to long term anterior repositioning splint therapy.

This study evaluates whether extended full-time wear of a partial coverage mandibular anterior repositioning splint (MORA) causes intrusion of posterior teeth and determines the effect on jaw position. Sixty-four patients from two private orthodontic practices were studied using cephalometric radiographs to measure vertical change in position of the anterior and posterior teeth and the mandible. The splint wear time ranged from a minimum of one half year to a maximum of 4.8 years, with a mean of 1.33 years. No significant change was recorded in the distance from the mandibular molar to the mandibular plane. On average, the maxillary incisor and maxillary molar extruded about 1 mm, while the mandibular molar was unchanged and the mandibular incisor intruded about 0.6 mm. Posterior face height increased an average of 1.6 mm, and anterior face height increased an average of 2.7 mms. In 20% of the patients, intrusion of the mandibular molars of 1 mm or more occurred. In 41%, extrusion of the maxillary incisors of 1 mm or more was noted. Intrusion of the upper molars or extrusion of the lower incisors occurred in only 5% of the patients. The data indicates that only a very small proportion of patients having long term splint therapy using the MORA have clinically significant molar intrusion. Change in mandibular position was expressed in a vertical increase in posterior and anterior face height. Only very small changes occurred in antero-posterior position.

Adolescent↗
PubMed2000

Denture satisfaction and clinical performance in a paediatric population.

OBJECTIVES: The objectives of this study were to investigate the clinical performance of partial upper dentures in children and to assess reported denture satisfaction in this young population. DESIGN: This was a retrospective study using patients' dental records in conjunction with a postal questionnaire. SETTING: The Paediatric Dentistry Clinic, School of Clinical Dentistry, Sheffield. SAMPLE AND METHODS: Fifty-eight children (aged 7-17 years) who had been provided with a partial upper denture to replace one or more missing permanent incisors were included in the study. The patients' dental records were examined for the following details: tooth type missing, presence of retained incisor roots, aetiology of tooth absence, age at which the denture was first provided, total time period dentures had been worn, and frequency and type of any denture repairs or replacements. Next a short questionnaire was sent to each child, which sought an evaluation of several parameters of denture satisfaction including: overall attitude towards wearing a denture, denture appearance, ease of eating, comfort and perceived degree of teasing from peers. Visual analogue scales (VAS) were employed to provide a graded response. RESULTS: 70.7% of subjects had a single missing incisor and trauma was the most common cause of tooth loss (77.3%). The mean age at which patients started wearing a denture was 11.6 years and the mean length of time dentures had been worn, at the time of the investigation, was 2.1 years. A 'T-shaped' denture was most commonly employed (77.5% of dentures). Overall, 36.2% of subjects had required at least one denture repair, 28.2% presenting within a year of denture provision. One or more denture replacements had been received by 60.3% of the patients, and 43.6% had required this within a year. Component failure was highest for the denture tooth (40% of repairs) and a change in the patient's dentition necessitated a denture remake in 66% of cases. VAS scores for parameters of denture satisfaction indicated an overall positive evaluation of the dentures, with the most positive response relating to ease of eating. However, the reported degree of teasing was high and increased with time. The only significant difference for denture satisfaction according to gender was for mastication: girls reportedly found eating easier than did boys. CONCLUSION: Children are generally accepting of upper partial dentures, but their poor clinical performance is of concern and there is need for improvement.

Adaptation, Psychological↗
PubMed2000

The long-term management of patients with tooth surface loss treated using removable appliances.

The causes of tooth surface loss are multi-factorial and hence can be difficult to eradicate. This paper identifies the problems that may be anticipated during the long-term management of patients where tooth surface loss has been treated using removable appliances, where the number of teeth is often reduced. Wear and tear are inevitable and patients should therefore be made fully aware of the possibility of the gradual deterioration and failure of restorative work. Treatments should be planned, which would enable the dentist to recover the situation, with minimal inconvenience to the patient.

Dental Restoration, Permanent↗
PubMedDate not supplied

Tooth-supported telescopic crown-retained dentures: an up to 9-year retrospective clinical follow-up study.

PURPOSE: This study evaluated outcome and quality of treatments with telescopic crown-retained dentures. MATERIALS AND METHODS: A total of 72 subjects (27 men and 45 women; mean age 67 years) wearing 75 telescopic crown-retained dentures (18 in the mandible and 57 in the maxilla) participated in the study. There were a total of 368 abutment teeth, 272 in the maxilla and 96 in the mandible. Each patient was clinically examined. Using the CDA evaluation system, four calibrated evaluators also examined, independently, the inner crowns for margin integrity and the superstructure for retention, occlusion, stability, wear, and esthetic appearance. Observer consistency was measured with Cohen's kappa. RESULTS: The observation period varied from 9 months to 9.3 years (mean 3.8 years). One telescopic crown-retained denture was lost, and 24 abutment teeth (7%) were extracted during the observation period. In 49 abutment teeth (13%), technical complications had occurred, and a total of four framework fractures (5%) were observed. Based on the CDA criteria, most of the characteristics were evaluated as satisfactory. The characteristics "condition of denture-supporting soft tissue" and "superstructure wear" showed the highest frequencies of not acceptable ratings, 44% and 45%, respectively. CONCLUSION: In this retrospective follow-up study, satisfactory outcome was found for tooth-supported telescopic crown-retained dentures over a mean observation period of 3.8 years.

Adult↗
PubMed1995

Traumatic crown fractures in permanent incisors with immature roots: a follow-up study.

A follow-up study of crown fractured permanent incisors with incomplete root formation was carried out in a group of patients, aged 6-12 years, over a 5-year period in the Dental Clinic of the University of Verona, Italy. The number of injured patients was 55, representing 84 injured incisors. All patients were followed clinically and radiographically using a standardized follow-up protocol. The most common type of trauma was fracture of enamel and dentine without pulpal exposure (80%) and the most common type of treatment was restoration with the acid-etch composite resin technique (46%). Bonding of the crown fragment was performed in 10 instances (12%). At the 5-year-control all teeth with fracture of the enamel had no pulp complications. Four of 67 teeth (6%) with fracture of the enamel and dentine without pulpal involvement showed pulp necrosis and 1 tooth showed pulp obliteration (1.5%). Eight of 14 teeth (57%) with fractures of the enamel and dentine with pulp involvement showed pulp necrosis. Aesthetically 36 of the restored teeth were deemed satisfactory (43%). In 9 teeth the bonded fragment had to be rebonded. 14 teeth were considered unsatisfactorily restored due to wear of the composite (17%). 34 restored teeth had to be retreated because of a new trauma (40%). In one tooth a previous bonded fragment had to be rebonded. These results confirmed that crown fractures without pulp involvement in permanent incisors with incomplete root formation hav a low percentage of pulp complications, while 60% of the teeth with crown fractures with pulp involvement had pulp complications.

Chi-Square Distribution↗
PubMedDate not supplied

In vitro investigation of the wear of resin composite materials and cast direct retainers during removable partial denture placement and removal.

The purpose of this study was to determine whether wear of two resin composite materials and contacting I-bar clasp tips would occur within a simulated RPD placement and removal period of 2 years. The data were compared to enamel with contacting I-bars. Cast I-bar clasps were passed over each specimen in the resin composite and tooth experimental groups (n = 10). Computer digitized image analysis of SEM photomicrographs of the specimens provided data for analysis of wear. Results indicated a statistical difference in the amount of mean wear between the two resin composites and between the I-bar groups. The results from this study suggest that the selection of a resin composite for use as a RPD retentive undercut must be carefully undertaken to avoid excessive wear and loss of retention.

Analysis of Variance↗
PubMed2005

Evaluation of resin composite materials. Part II: in vivo investigations.

PURPOSE: To clinically evaluate two different resin-based composites (Solitaire I and Ariston pHc) in order to determine the minimum clinical evaluation time needed to detect critical signs of failure. METHODS: In a controlled prospective clinical study, 99 cavities (30 Class I, 69 Class II) in 31 patients were restored (50 Ariston pHc without enamel etching and rubber dam, 49 Solitaire I restorations with total etching and rubber dam) and clinically investigated at baseline, after 6, 12, and 24 months. RESULTS: After 2 years of clinical service, 49 restorations (Ariston pHc: n = 38, Solitaire: n = 11) had to be replaced. The majority of failures occurred after more than 1.5 years. The reasons for replacement were differently distributed in both groups (Ariston pHc: 28 tooth fractures, 3 gap formations, 5 hypersensitivities, 1 bulk fracture, 1 marginal fracture. Solitaire: 5 gap formations, 1 hypersensitivity, 3 bulk fractures, 1 wear of the restorative material, 1 void in the restoration). Forty-four restorations were still in function after 2 years (overall failure rate after 2 years: 14%; Ariston pHc: 17%; Solitaire: 7%; survival analysis algorithm according to Kaplan/Meier). Comparing the materials, no statistical differences were evident except for the criteria "integrity tooth" (= tooth fracture or cracks) and "hypersensitivity" (from the 12-month recall; Mann-Whitney U-test; P< 0.05). In both cases of significant difference, Ariston pHc exhibited inferior results. After 2 years, only three teeth restored with Ariston pHc did not show considerably cracked enamel. The additional marginal analysis showed statistically significant differences for both materials regarding the criteria "perfect margin" (decrease), "gap formation" (increase), and "negative step formation" (increase; P< 0.05; Friedman 2-way ANOVA) between the four recalls. Therefore, a 2-year in vivo evaluation should be recommended prior to marketing a dental restorative material.

Acid Etching, Dental↗
PubMed2001

A review of taurodontism with new data on indigenous southern African populations.

The prevalence and degree of taurodontism (enlargement of the pulp cavity) in the mandibular permanent molars of two recent population samples from southern Africa were investigated quantitatively from lateral radiographs. The degree of occlusal wear was scored and two measures of relative pulp cavity size were recorded for each tooth. There was a significant association between increased attrition and a reduction in the size of the pulp cavity when all of the teeth were considered together, but no correlation among individual molar types within each sample. In both the Zulu (n=68 individuals) and Khoisan (n=28 individuals) samples, third molars had the highest prevalence of taurodontism and first molars the lowest. The data for Zulus are similar to those recorded for other modern populations (e.g. white and black Americans, and Israelis), whereas the Khoisan data exhibit significantly higher frequencies. An increased appreciation of the distribution of this variant in modern human populations would contribute to an understanding of its possible evolutionary significance in the human fossil record.

Africa, Southern↗
PubMed2001

[A comparative study of friction behaviour matching of natural tooth and new type dental prosthetic materials--titanium].

New type dental prosthetic materials Titanium not only have excellent biocompatibility, better corrosion resistance, appropriate hardness, light density approaching to human skeleton, but also good mechanical properties as those of type II, IV gold alloy recommended by ADAS, and their strength to weight ratio is 1.3 times that of aluminum, 1.5 times that of steel. Friction wear comparative tests of natural living teeth and dental Titanium materials have been carried out against Gr15 steel ball. A reciprocating movement was realized at the modified machine of fretting to simulate the pair of real tooth. The main test parameters were: slip amplitude 500 microns, normal load 20 N, frequency 2 Hz, and number of cycles 5000. The wear behavior results show that titanium is comparatively a prospective dental materials for restoration.

Child↗
PubMed1996

The influence of dft index on sealant success: a 48-month survival analysis.

Early loss of pit and fissure sealants is considered to be primarily dependent on inadequate isolation of the tooth from salivary contamination during application. Gradual additional loss is considered to be caused by occlusal wear, shearing forces, and marginal failure. Our hypothesis is that the caries risk of the child may be an additional factor in sealant loss. The objective of this study was to analyze the influence of caries history in primary teeth (dft index) on the success of sealants. Delton light-polymerized sealant was applied in 104 six- to eight-year-old children, followed for four years on a six-month-visit basis. All sound permanent first molars were sealed during the study. A survival analysis was used to describe sealant success over time. A Cox proportional hazards regression model was built to test the influence on sealant success of the dft index and site of sealant application (mandibular occlusal surface, maxillary fossae, and maxillary distolingual fissure), controlling for some potential confounders. Sealant half-life was 46 months. Site and dft index were related to sealant survival. The maxillary fossae showed the best retention, followed by the mandibular occlusal site and the maxillary disto-lingual fissure. The higher the dft, the higher the risk of sealant failure. This study has implications for sealant study designs and public sealant programs.

Bisphenol A-Glycidyl Methacrylate↗
PubMedDate not supplied

[The effect of toothbrushes on human dental enamel and dentin wear].

The authors compare the effects of natural (porcine) and synthetic (Toinex, USA, and Eschalon, France) bristle and rough toothbrushes on the tooth enamel and dentin in the course of toothbrushing. No abrasive effects were detected when brushing normal teeth in clear water. The rate of enamel and dentin abrasion in tooth powder or tooth paste suspension depended on the shape of bristle cut and particularly on the toothbrush roughness.

Adult↗
PubMed1997

A new optical 3-D device for the detection of wear.

For the clinical performance of new dental restorative materials to be accurately assessed, the three-dimensional anatomical changes of the functional surfaces of the restoration must be elucidated over time. To this end, a highly accurate 3-D optical scanner has been developed that utilizes the principles of triangulation and a reference-free automated 3-D superimposition software. The aim of this study was to assess the accuracy and the precision of the new system with and without referenced positioning. Additionally, the ability of the system to determine wear of posterior fillings three-dimensionally has been shown. Gypsum replicas of restored teeth were evaluated. The tooth surfaces were scanned with a resolution of 250,000 surface points within a measuring time of 20 to 40 sec. The results show that the precision and accuracy of 3-D data acquisition depend on the surface inclination. Up to an angle of 60 degrees, the precision is better than 3 microns, and the accuracy is better than 6 microns. If exact repositioning of the object before and after occlusal loading is possible, e.g., with in vitro studies, differences on the surface can be determined with a precision of 2.2 microns. In reference-free measurements, which are a necessity in clinical studies, the 3-D data acquisition in combination with the automatic matching program can detect wear with an accuracy of 10 microns. The application of this measuring device for the detection of wear of a composite filling functioning in the mouth has been shown. Since this measuring technique is automated, and measurements of high accuracy can be attained in a short period of time, this system offers the possibility for complex analyses of three-dimensional wear to be conducted on a large number of samples in clinical studies.

Algorithms↗
PubMed1987

Relationship of cheek tooth abrasion to fluoride-induced permanent incisor lesions in livestock.

Teeth from cattle, sheep, and horses that ingested various fluoride intakes and teeth from field studies of these species plus deer, elk, and bison were examined for abnormalities. Approximately 99,000 animals in 322 herds were examined for fluorosis. From field studies, 988 cattle of various ages and with different degrees of dental fluorosis were slaughtered and necropsied. The severity of fluoride-induced mottling, hypoplasia, and abnormal abrasion of paired permanent incisor teeth was correlated with abrasion of premolar and molar (cheek) teeth that form and mineralize at approximately the same age. Severe irregular wear of cheek teeth impaired mastication and resulted in poor utilization of feed and unthriftiness. Excessive amounts of fluoride during tooth formation and mineralization induce characteristic dental changes. Offspring from the fluoride-affected animals did not have discernible fluoride-induced lesions in the deciduous teeth.

Animals↗
PubMed2000

Shifting paradigms in whitening: introduction of a novel system for vital tooth bleaching.

The advent of whitening strips (Crest Whitestrips) affords a novel system for peroxide delivery without custom tray fabrication. In addition to generalized bleaching indications, clinical applications may leverage the low overall dose and short wearing regimen with the easy-to-use strips. The impact of these strips on the dental practice may be direct, as a result of increased accessibility via professional or personal use, or indirect, because of advertising and research in the area of tooth whitening.

Drug Delivery Systems↗
PubMed1989

Enlarged occlusal surfaces on first molars due to severe attrition and hypercementosis: examples from prehistoric coastal populations of Texas.

During an examination of prehistoric samples from the Texas coast, individuals consistently exhibited a suite of traits on the first molars that included severe wear, hypercementosis, and resorption of the buccal margin of the alveolus. The occlusal surface of the tooth was worn below the cervical margin, with the subsequent incorporation of the buccal surface of the buccal roots into the occlusal plane. This expanded occlusal surface, which extends the buccal surface beyond the normal edge of the tooth, is composed of a combination of original enamel, secondary dentin, and cementum. There is a marked rounding of the buccal aspect of the occlusal surface. These conditions were noted in both maxillary and mandibular first molars. The resorption of alveolar bone surrounding the buccal roots resembles resorption associated with periodontal infection and is thought to be the result of severe levels of stress being applied to this portion of the dentition.

Dental Occlusion↗