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PubMedDate not supplied

Immediate loading of single-tooth implants: immediate versus non-immediate implantation. A clinical report.

The hypothesis of the present study was that immediate loading of implant-supported restorations replacing single missing teeth could be a successful procedure. The present study compared the clinical success of immediately loaded single-tooth implants placed in fresh extraction sites to that of immediately loaded single-tooth implants placed in healed sites. From the years 1997 to 1998, 26 patients, ranging in age from 18 to 70 years, presented for the placement of 28 immediately loaded implants intended to support single-tooth ceramometal restorations. Nineteen implants were placed into fresh extraction sites, and 9 implants were placed into healed sites. Temporary prefabricated acrylic resin crowns were prepared and adjusted. At the time of traditional second-stage surgery (3 to 6 months after implantation), the implants were restored with single-tooth ceramometal prostheses. The survival rates were 82.4% and 100% for immediate and non-immediate implants, respectively. Follow-up ranged from 6 to 24 months from the day of implant placement, with a mean of 13 months for the immediate implants and 16.4 months for the non-immediate implants. Radiographic marginal bone loss after 3 to 6 months did not extend beyond the abutment-implant junction. Within the limits of the present investigation, immediate loading of single-tooth implants placed in healed sites is a possible treatment alternative. Immediate loading of single-tooth implants placed in fresh extraction sites carried a risk of failure approximating 20% in this patient population.

Adolescent↗

PubMed2001

Comparative seven-day clinical evaluation of two tooth whitening products.

A 1-week study was conducted to compare the tooth whitening efficacy of two carbamide peroxide-based products (one containing 5% carbamide peroxide and one containing 10% carbamide peroxide). In addition, the perception of transient tooth hypersensitivity associated with the use of these products was subjectively evaluated. Sixty participants took part in a double-blind, randomized, parallel clinical study. Change in tooth color was measured by chroma meter and Vita shade guide at the initiation of the study and after 7 days of product use. Color change (delta E) was calculated using the color-difference equation established by the Commission Internationale de L'Eclairage. Data concerning dental hypersensitivity was assessed by subjective panelist questionnaires administered after the day 7 recall examination. Results of the whitening data showed that there was no significant difference between the two products. After 1 week, the mean delta E for the product containing 5% carbamide peroxide was 4.43 +/- 1.89 and the mean delta E for the product containing 10% carbamide peroxide was 4.05 +/- 1.84. However, the subjective data collected on tooth hypersensitivity showed that the product containing 5% carbamide peroxide was associated with less discomfort. Of the group using the 5% carbamide peroxide product, 20% reported transient sensitivity of their teeth after product use for 1 week compared with 53% of the group using the product with 10% carbamide peroxide. Statistical analysis using a 2-tailed t test showed significant differences between the two groups (P < .05). The data suggest that these products are clinically equivalent for tooth whitening; however, the product containing 5% carbamide peroxide was associated with less tooth hypersensitivity after 1 week of application.

Adult↗

PubMed1998

[The effect of retinoic acid on crown morphogenesis of mouse tooth germs in vitro].

OBJECTIVE: To study the effects of retinoic acid on crown morphogenesis of early tooth germs. METHODS: Mouse tooth organ culture model was used and the functions of different retinoic acid concentration on the first mandibular molar germs of 14-day old mouse embryo were examined. RESULTS: The first mandibular molar germ of 14-day old mouse was at the bud stage. After 6 days culture, tooth germs in culture medium (not containing retinoic acid) developed from bud stage to bell stage and formed normal cusps. The morphogenesis of tooth germs in medium containing 1 x 10(-7) mol/L retinoic acid was similar to molar germs in the medium without retinoic acid. When the concentration of retinoic acid increased to 1 x 10(-6) mol/L, the mouse tooth germs still developed from bud stage to bell stage, but normal cusps was not formed. CONCLUSION: The results suggest that high concentration of retinoic acid alter crown morphogenesis of tooth germs.

Animals↗

PubMed2000

Present and future technologies of tooth whitening.

Dental stains can be broadly classified as intrinsic or extrinsic. Intrinsic stains are a result of defects in tooth development, fluorosis, or acquired through the use of tetracycline. Extrinsic stains are localized mainly in the pellicle and are generated by the reaction between sugars and amino acids or acquired from the retention of exogenous chromophores in the pellicle. Three clinical methods are currently used for measuring stain removal and tooth whitening in the development of new whitening technologies: Lobene Stain Index, Shade Guide Color Change, and Minolta ChromaMeter. Professional tooth whitening products rely on proven technologies--35% hydrogen peroxide for in-office power bleaching or 10% to 15% carbamide peroxide for at-home bleaching--to reduce intrinsic stain and change the inherent tooth color. Over-the-counter tooth whitening products use a combination of surfactants, abrasives, anticalculus agents, and low levels of hydrogen peroxide to reduce extrinsic stain and help maintain tooth whiteness after professional treatment. Future technologies for whitening teeth could involve the use of activating agents to enhance the performance of hydrogen peroxide and natural enzymes.

Color↗

PubMed1992

Tooth surface loss and associated factors among factory workers in Finland and Tanzania.

The relative importance of various factors in the occurrence of tooth surface loss was explored in a, cross-sectional study using blind dental examinations. Two samples were drawn; one from Finland, comprising 186 workers from four factories and another from Tanzania of 180 workers from two factories. Among the 326 dentate individuals who participated, 164 were exposed to acid fumes and 162 were not. In Finland, people with tooth surface loss were older and smoked cigarettes less frequently. In Tanzania, those with tooth surface loss were also older and the proportion of subjects with the condition was significantly higher among people not using a commercial toothbrush and those exposed to acids. Among the Tanzanians, exposure to acids increased the probability of tooth surface loss to a high level of significance, and increasing age increased its probability, both among the Finns and the Tanzanians. Both anterior and posterior teeth were affected. It can be concluded that if the exposure to acids from the air breathed is high, the probability of tooth surface loss will increase. It seems that explanatory factors for tooth surface loss from one society cannot be extrapolated to another.

Adult↗

PubMed1992

Vital tooth bleaching: review and current status.

Vital tooth bleaching refers to the clinical application of a chemical solution to a tooth surface in order to achieve a lightening effect. This article reviews the available literature to address the following questions: What are the methods of vital bleaching? How does vital bleaching work and is it effective? What effects are there on the teeth, dental restorative materials, soft tissues and systemic health? The techniques used in the application of dentist-applied and patient-applied bleaching systems are described. Generally, vital tooth bleaching has been found to be effective, however, relapse does occur. The literature suggests that bleaching agents may have transient effects on the tooth itself, and may affect some dental materials. Soft tissues exposed to hydrogen peroxide for prolonged periods show changes consistent with inflammation or hyperplasia. Hydrogen peroxide may also potentiate the carcinogenic effect of known carcinogens. However, more clinically relevant studies are needed. Until long-term safety data becomes available, the dental practitioner should approach the use of in-home bleaches with caution. The U.S. Food and Drug Administration (FDA) recently classified these products as "new drug." However, dentist-applied bleaching gel systems are a viable alternative and deserve further consideration. They are simple to use, require little armamentarium, and limit the exposure of the bleaching agent to the teeth only. Vital tooth bleaching refers to the clinical application of a chemical solution to a tooth surface in order to achieve a lightening effect. There was a resurgence of interest in vital bleaching with the recent introduction of the in-home bleaching technique.(ABSTRACT TRUNCATED AT 250 WORDS)

Carbamide Peroxide↗

PubMed2004

[Dental tours de force 6. Autotransplantation in case of agenesis or traumatic tooth loss].

Autotransplantation of a tooth is probably the most natural method to replace a missing or lost tooth. This treatment has been performed successfully already for more than twenty years. The prognosis of a transplanted tooth is determined by tooth type, stage of root formation at the time of transplantation, surgical technique used, and duration and way of splinting. Determining the optimal stage of root formation of the tooth is very important in planning the autotransplantation. If the transplantation is carried out successfully, the transplanted tooth behaves at its new location just like before: it erupts, the root formation is continuing, it shows physiological mobility and it can be displaced by orthodontic forces. Most cases of autotransplantation require teamwork between oral surgeon, orthodontist, and dentist.

Anodontia↗

PubMed2004

[Prevalence of dental anxiety in 144 patients with cardiovascular diseases before tooth extraction].

OBJECTIVE: To determine the prevalence of dental anxiety (DA) in patients with cardiovascular diseases before tooth extraction so as to provide psychotherapy. METHODS: 144 patients with cardiovascular diseases were asked to complete a questionnaire modified from Corah Dental Anxiety Scale (DAS) while awaiting for tooth extraction. RESULTS: The incidence rate of DA in these patients was 7.6%. Anxiety level on anesthesia procedure was the highest. DAS score was higher among patients with the following factors: inactive perception, female, below 60 years old, experiences of painful tooth extraction, a documented history of single cardiovascular disease, under ECG monitoring for the first time and complicated tooth extraction. CONCLUSION: DA existed in patients with cardiovascular diseases before tooth extraction and was related to many factors. Medical staff should take necessary measures to provide them with psychotherapy and nursing guidance before tooth extraction.

Adult↗

PubMed1992

Iatrogenic exfoliation of a tooth following abuse of a rubber dam: a case report.

This report presents a case in which tooth exfoliation followed rubber dam abuse. A 40-year-old patient was referred to the prosthodontic clinic with complaints of mobility and discomfort in tooth 44, which had received an amalgam restoration. While this tooth was scaled, a piece of rubber dam appeared in the buccal sulcus. Removal of the rubber piece was followed by thorough scaling and tooth splinting. Tooth deterioration continued, and concern for the adjacent teeth necessitated extraction of tooth 44. To avoid such undesirable consequences, the integrity of the dam should be verified on its removal.

Adult↗

PubMed1989

[Usefulness of the bodily movement of the tooth into the hydroxyapatite-packed extracted cavity].

Early application of bodily movement of teeth at an unfinished stage of the healing of the extracted wound i.e. ossification is presumed to increase the risk of jiggling. Using adult dogs, an experimental study was made on bodily movement in the case of HAp packing into the extracted wound cavity to avoid jiggling. When tooth movement was performed immediately after extraction and HAp packing, no encapsulation of HAp with fibrous connective tissue was noted. Either for a weak force or for a strong force, the moved tooth lacked alveolar septum on its compressed side, its dental root being in direct contact with the HAp mass. Remarkable enlargement of periodontal cavity on the tension side and strong osteoclastic resorption of proper alveolar bone were noted. When tooth movement was clone one week after extraction and HAp packing, Either for a weak force or for a strong force, the extracted wound surface was sealed and the HAp mass in the extracted wound cavity got encapsulated by fibrous connective tissue. Alveolar septum has disappeared completely on the compressed side of the moved tooth. Fibrous connective tissue lay between the dental root and the HAp mass and presented its partial osteogenesis. Vigorous bone apposition was noted in the proper alveolar bone surface on tension side. When tooth movement was done one month after extraction and HAp packing, definite ossification was noted in fibrous connective tissue which encapsulated the HAp mass in the extracted wound cavity. Alveolar septum on the compressed side of the moved bone presented resorption and disappearance. For a weak force, gradual ossification was noted in fibrous connective tissue which lay in the same region, and for a strong force, osseous adhesion to the HAp mass was noted. On the tension side, bone apposition was remarkable in proper alveolar bone surface either for a weak force or for a strong force. The above findings revealed thus most suitable time to begin tooth movement was one week after extraction and HAp packing.

Animals↗

PubMedDate not supplied

[Autotransplantation of human tooth germs].

The Author presents three cases of tooth germ transplantation which were periodically checked by x-rays to show the progressive root development. The clinical result obtained were quite satisfactory. The situations requiring the transplantations in the 3 cases were all rather unusual: in one case the tooth germ was inside a large follicular cyst; in the other two the tooth germs were mesiodistally rotated 90 degrees which made eruption impossible. The cases described differ from cases frequently found in literature in that the transplanted tooth germs were in the initial stage of development; the roots, in fact, had not yet begun to develop. All the tooth germs transplanted, once their growth was completed, presented two types of morphological alternations. A reduction in the volume of the pulpar chamber and a pad of radiopaque tissue around the neck of the tooth. We have attempted to give an explanation for both of these alterations. The cases as well as the surgical procedures are described in detail.

Child↗

PubMed1995

Clinical management of the avulsed tooth.

Treatment outside the dental office: Replant immediately after gentle washing if practical. If replantation is not practical, store the tooth in the best medium available. Storage media in order of preference are Hank's Balanced Salt Solution (HBSS), milk, saline, and saliva (buccal vestibule). Water is the least desirable storage medium. Treatment in the office: Emergency visit; Place tooth in HBSS while exam is conducted and history is taken. Prepare socket for gentle repositioning of the tooth. Prepare the root. Extraoral dry time < 20 minutes: Closed apex--replant immediately after gentle washing. Open apex--soak in 1 mg doxycycline in 20 mg saline for 5 minutes. Extraoral dry time 20 to 60 minutes: Soak in HBSS for 30 minutes and replant. Extraoral dry time > 60 minutes: soak in citric acid, 2% stannous fluoride, and doxycycline and replant. Endodontics can be done extraorally. Semirigid splint for 7 to 10 days. (If alveolar fracture is present, rigid splint for 4 to 8 weeks). Suture soft-tissue lacerations, particularly in the cervical area. Administer systemic antibiotics (penicillin V potassium if possible) Chlorhexidine rinses and stringent oral hygiene while the splint is in place (7 to 10 days). Analgesics as required. Second visit after 7 to 10 days: Endodontic treatment: Tooth with open apex and extraoral dry time of < 60 minutes: No endodontic treatment initially. Recall every 3 to 4 weeks to examine for evidence of pathosis. If pathosis is noted, disinfect the pulp space and start apexification procedure. Tooth with open apex and extraoral dry time > 60 minutes: If endodontics was not completed in the emergency visit, start endodontics and follow apexification procedure. Tooth with closed apex: Endodontics should be initiated after 7 to 10 days. Careful chemomechanical instrumentation under strict asepsis. Splint removed at end of visit. Obturation visit: If endodontics was initiated 7 to 10 days after the avulsion, obturation can take place after short-term calcium hydroxide treatment. If endodontics was initiated more than 14 days after the avulsion or inflammatory resorption, long-term calcium hydroxide for 6 to 24 months, obturated when an intact lamina dura is traced. Restorations: Temporary restorations: Should be 4 mm deep. Reinforced zinc-oxide-eugenol, acid-etch composite resin, glass-ionomer cement. Permanent restoration: Placed immediately after obturation. Acid-etch resin and dentin bonding agents. Follow-up care: Twice per year for 3 years and yearly for as long as possible. Late complications are common.

Dental Restoration, Permanent↗

PubMedDate not supplied

Delayed primary tooth eruption in premature infants: relationship to neonatal factors.

Previous studies suggest that primary tooth eruption (PTE) in preterm infants is related primarily to gestational age, but the impact of other neonatal factors has not been studied. In a prospective longitudinal study, the timing and sequence of PTE were documented by a pictorial PTE record completed by the parents and by frequent oral exams in 14 preterm infants whose first tooth erupted at < or = 10 months chronologic age (normal group) and 21 preterm infants whose first tooth erupted at > 10 months (late group). Initial eruption sequence in both groups was the same as full-term infants, with the two lower central incisors erupting first. PTE occurred significantly later in children with BW < 1000 g (t = 3.4, P < 0.01) or < or = 30 weeks (t = 2.41, P < 0.05). Factors related to nutrition appeared to be important. Age at first tooth correlated significantly with age when full enteral feedings were attained, age when oral vitamin supplementation was started, and with average weight gain per day. Five neonatal factors (duration of oral intubation, birthweight, gestational age, age when full enteral feedings were attained, and apnea of prematurity) explained 44% (R = 0.67, P < 0.05) of the variability in age at which the first tooth erupted. Of that 44%, 77% was explained by a single factor, duration of oral intubation. These results suggest that factors related to severity of neonatal illness and postnatal nutrition as well as degree of prematurity affect timing of primary tooth eruption.

Apnea↗

PubMed2006

Tooth loss in well-maintained patients with chronic periodontitis during long-term supportive therapy in Brazil.

AIM: The objective of this retrospective study was to assess the reasons for tooth loss in a sample of patients who underwent periodontal therapy and supportive periodontal therapy (SPT) in a Brazilian private periodontal practice. MATERIAL AND METHODS: A sample of 120 subjects who had been treated and maintained for 10 years or longer was selected from patients attending a periodontal practice. All patients followed a similar treatment: basic procedures, re-evaluation and periodontal surgery where indicated. Reasons for tooth loss were categorized as periodontal, caries, endodontal, root fractures and extraction of retained or partially erupted third molars. RESULTS: Of the 2927 teeth present at the completion of active periodontal treatment, 53 (1.8%) were lost due to periodontal disease, 16 (0.5%) for root fracture, six (0.2%) to caries, five (0.2%) for endodontic reasons and 31 (1.0%) were lost to extraction of retained or partially erupted third molars. Logistic regression analysis was performed to investigate the association between five independent variables with tooth loss due to periodontitis. Only age (> 60 years) and smoking were statistically significant (p < 0.05). CONCLUSION: The findings of this survey were consistent with previous studies. Older subjects and smokers were more susceptible to periodontal tooth loss. In addition, patients with generalized chronic periodontitis were treated and maintained for long-term periods with low rates of tooth loss.

Adult↗

PubMed1996

Incidence of traumatic tooth injuries in children and adolescents in the county of Västmanland, Sweden.

The study reports the total incidence as well as the incidence of different types of traumatic tooth injuries in a Swedish county in the age interval 0-19 years during 1989/90. The incidence of individuals experiencing tooth injuries was 13 per 1000 per year. Boys were more frequently injured in the age-groups 3-4 years and 7-9 years and girls, in the age-group 5-6 years. A method is presented defining uncomplicated and complicated tooth injuries as a basis for estimating the economic consequences of these injuries in the community. Boys more often suffered uncomplicated injuries to permanent teeth and girls, to primary teeth (p < 0.05). The same distribution was found for uncomplicated multiple tooth injuries. Boys sustained more uncomplicated hard tissue injuries and girls, more uncomplicated luxation injuries (p < 0.01). Using a classification according to the most serious tooth injury in each episode, 33% of the episodes had resulted in complicated injuries in which the pulpal tissue and/or periodontal membrane was severely damaged.

Adolescent↗

PubMed2000

Clinical evaluation of allografts and homografts for restoration of missing tooth structure.

STATEMENT OF PROBLEM: The clinical performance of bonding human tooth fragments to either replace missing teeth or to restore defective teeth is unclear. Prospective studies can help to predict the success of such treatment options. PURPOSE: This study evaluated the feasibility of bonding tooth tissue homografts and allografts either to replace missing teeth or to restore defective teeth, and estimated the success rate of bonded allograft and homograft restorations 3 years after placement. METHOD AND MATERIAL: Twenty clinical cases were treated by bonding tooth fragments or crowns into 6 groups (Gp): Gp1, cervical erosion and abrasion lesions (6); Gp2, incisal edge fractures (4); Gp3, partially destroyed crowns (4); Gp4, teeth placed in a removable prosthesis (2); Gp5, missing tooth with no opposing tooth (2); and Gp6, temporary space maintenance (2). Restorations were examined using USPHS criteria every 2 months and whenever a patient called to report a failure. RESULTS: After a 3-year follow-up, the overall success rate was 80% for the 20 restorations. The 95% confidence interval was 63% to 94%. Four restorations failed by debonding (Gp2 [2]; Gp5 [1]; Gp6 [1]) during the first 4 months. The main cause of failure appeared to be excessive occlusal loading. CONCLUSION: Within the limitations of this clinical study, the results after a 3-year follow-up showed the success rate was not less than 63% for bonded allograft and homograft restorations.

Dental Bonding↗

PubMed1998

Autogenous free tooth transplantation by the two-stage operation technique. An analysis of treatment factors.

Teeth were autogenously transplanted by the 2-stage technique in adult patients and examined up to 5 years after surgery for the prevalence of, and correlation between, tooth graft loss, root resorption, ankylosis, periodontal attachment loss, tooth mobility, and pain. The influence on the dependent variables of independent variables related to the patient, the donor tooth, the recipient site, and the transplantation procedure was examined. Pain was correlated to transplanted teeth, later extracted, and teeth with periodontal attachment loss. The expected correlation of root resorption to periodontal attachment loss was not verified owing to incomplete follow-up. The older the patient was, the less root resorption was found. Variables indicative of infection of the recipient bed and of traumatic injuries to the donor tooth at the transplantation were found to be detrimental to the tooth transplant.

Adolescent↗

PubMed2006

Interaction between attrition,abrasion and erosion in tooth wear.

Tooth wear is the result of three processes: abrasion (wear produced by interaction between teeth and other materials), attrition (wear through tooth-tooth contact) and erosion (dissolution of hard tissue by acidic substances). A further process (abfraction) might potentiate wear by abrasion and/or erosion. Both clinical and experimental observations show that individual wear mechanisms rarely act alone but interact with each other. The most important interaction is the potentiation of abrasion by erosive damage to the dental hard tissues. This interaction seems to be the major factor in occlusal and cervical wear. The available evidence seems insufficient to establish whether abfraction is an important contributor to tooth wear in vivo. Saliva can modulate erosive/abrasive tooth wear through formation of pellicle and by remineralisation but cannot prevent it.

Dental Pellicle↗