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Comparison of oral radiographic findings among 35-year-old Oslo citizens in 1973 and 1984.

The purpose of the present study was to evaluate a variety of radiographically detectable conditions found on orthopantomograms of 141 individuals as a part of an oral health survey of 35-year-old Oslo citizens, born 1949. Radiographic findings were recorded and compared with those of a similar study made in 1973. The findings revealed a statistically significant reduction in the prevalence of marginal bone loss. The frequencies of endodontically treated teeth and teeth with apical radiolucencies were unchanged.

Adult↗

Reasons for extraction of permanent teeth in Japan.

Eight hundred forty-nine Japanese dentists were asked to record the reason for every tooth extraction of permanent teeth during 1 week in each of four seasons. The reasons were assigned to six groups: dental caries, periodontal disease, eruption problems, trauma, orthodontics and other reasons. Thirty-eight to 40% of the dentists returned the forms in each season, relating to a total of 11,175 extracted teeth. Overall, caries was the most frequent reason for tooth extraction (55.4%), followed by periodontal disease (38.0%). The females lost more teeth due to caries than did the males. In the > or = 16 age groups, caries was the main reason for tooth extraction. However, periodontal disease became principal only in the males aged 46-65 yr. Anterior teeth, especially in the mandible, represented the highest percentage of periodontal extractions. A considerable difference in the major reason for maxillary tooth loss was observed between both sexes. Maxillary premolars and molars in the males were extracted for periodontal disease as much as for caries, whereas caries was the predominant reason for loss of all maxillary teeth in the females.

Adolescent↗

A re-examination of the pre-eruptive and post-eruptive mechanism of the anti-caries effects of fluoride: is there any anti-caries benefit from swallowing fluoride?

The belief that fluoridated water reduces caries incidence by half stems from years of fluoridation studies where the caries rates of people in various fluoridated and non-fluoridated communities were compared. By their nature, the water fluoridation trials were not able to distinguish between the topical effects of the fluoride in the water and the systemic effects of the fluoride that is inevitably swallowed and incorporated into developing teeth. Some attempts have been made to estimate the contribution of systemic fluoride to the control of dental caries but researchers are discovering that the topical effects of fluoride are likely to mask any benefits that ingesting fluoride might have. In this updated review of the pre-eruptive vs. post-eruptive benefits of fluoride in the prevention of dental caries, a re-examination of the literature, which is often cited to support the notion that swallowing fluoride, either in water or in pill form, was done in recognition of the mounting evidence for the topical mechanism as being the primary mechanism for the prevention of dental caries. Maximum benefits from exposing newly erupted teeth to topical fluoride in the oral cavity may have been seriously under-estimated. This has obvious implications for the use of systemic fluorides to prevent dental caries and forces everyone working in the field to examine more closely the risks and benefits of fluoride in all its delivery forms.

Administration, Oral↗

Granular cells associated with the enamel organ of a developing tooth.

An accumulation of granular cells associated with the enamel organ of a developing deciduous, incisor tooth was noted during light microscopy (LM) of serial sections from the right half of a mandible from a stillborn, female infant of 37 weeks gestations. There was a break in continuity of the enamel matrix associated with the focus of granular cells, which appeared to be continuous with, and arise directly from, the cells of the stratum intermedium. The granular cells were very similar histologically to those of a congenital epulis but it is impossible to say whether the lesion would have developed sufficiently to present clinically as an epulis. Less probably, the granular cells might eventually have been associated with the subsequent development of a granular cell ameloblastoma or ameloblastic fibroma. If the lesion does represent an early stage in the formation of a congenital epulis, it would support the odontogenic theory of origin of the granular cells.

Cytoplasmic Granules↗

The unicystic ameloblastoma: a clinicopathological study of 57 cases.

A clinicopathological study of 57 unicystic ameloblastomas has been undertaken, which represents 15% of all cases of ameloblastoma accessioned in our department over a 30-yr period. Of the cases where gender was recorded: 30 were male and 23 female. The majority of patients were black (51 cases) and most occurred in the mandible (52). This distribution conforms to that of solid and multicystic ameloblastomas. The mean age at diagnosis was 23.8 years (S.D. 14.9) which is significantly younger than for the conventional counterpart (p less than 0.1%). The lesions were classified histologically into 3 groups: Group 1 (42%) cyst lined by a variable often non-descript epithelium; Group 2 (9%) cyst showing intraluminal plexiform proliferation of epithelium; Group 3 (49%) cyst with invasion of epithelium into the cyst wall in either follicular or plexiform patterns. While Group 1 and 2 lesions may be treated by enucleation, Group 3 lesions should be treated aggressively as for conventional ameloblastomas. The objectives of correct histological diagnosis, subclassification and appropriate therapy are best achieved by enucleation biopsy. There is little evidence to support origin from pre-existing odontogenic cysts.

Adolescent↗

Eruption disturbances of permanent molars: a review.

Eruption disturbances of permanent molars may become clinically and radiographically manifest as impaction, primary retention or secondary retention. This may result in clinical problems such as malocclusion and loss of neighboring teeth due to caries and periodontal disease. Which of these disorders will develop, depends primarily on the eruptive stage. Factors that may interfere with the eruptive stages (i.e. follicular growth, pre-emergent eruptive spurt, postemergent eruptive spurt, juvenile occlusal equilibrium, circumpubertal occlusal eruptive spurt, adult occlusal equilibrium) and the clinical consequences of that interference are reviewed. Treatment recommendations are given.

Humans↗

Compound odontoma erupting in the mouth: 4-year follow-up of a clinical case.

A case of a compound odontoma erupting in the oral cavity is presented: a follow-up study of 4 yr has been performed evaluating the possible relationship with a previous dental trauma. A discussion is presented concerning the etiologic aspects, clinical signs, diagnostic aids and therapeutic approaches to this type of lesion.

Child↗

Effect of non-erupted third molars on roots of approximal teeth. A radiographic, clinical and histologic study.

This study was undertaken to evaluate clinically and histologically root resorption in extracted human second molars in close proximity to non-erupted third molars. The control group consisted of extracted second molars that were proximal to fully erupted third molars. Eight out of the 11 teeth in the study group presented different degrees of radiographic root resorption, nine presented clinical resorption, and all 11 had histologic evidence of root resorption. In the control group, no signs of root resorption were seen radiographically or clinically. Histologically, limited sites of resorption were identified in all teeth, which were partially repaired by cellular cementum. Histologic observation of study specimens revealed root surface resorption in 10 out of the 11 teeth, one showing replacement resorption as well. Inflammatory resorption was observed in the three most advanced cases in the study group. Reparative cementum partially lining resorbed areas was evident in all teeth with surface resorption. Within the limits of this study, radiographic identification of distal root resorption of second molars in close proximity to non-erupted third molars appears reliable. The findings may support the hypothesis that the presence of a non-erupted third molar in close proximity to the distal root of the second results in root resorption.

Adult↗

Multiple supernumerary teeth in two brothers: a case report.

Supernumerary teeth (hyperdontia) are relatively common in the general population and occur more frequently in patients with a family history of such teeth. Supernumerary teeth have been reported in many genetic syndromes, but multiple supernumerary teeth occurring as an isolated non-syndromic trait are rare. This article describes a rare non-syndromic variety of multiple impacted supernumerary teeth in two brothers.

Adult↗

Pericoronal hamartomatous lesions in the opercula of teeth delayed in eruption: an immunohistochemical study of the extracellular matrix.

Opercula of teeth delayed in eruption were examined histopathologically and immunohistochemically to determine the possible causes for tooth eruption failure. Specimens were obtained from 58 patients with non-erupted teeth by surgical removal of their gingival opercula. Among the 61 specimens, 31 (50.8%) were diagnosed as pericoronal myxofibrous hyperplasia (PMH), 8 (13.1%) as infantile ameloblastic fibromatosis (IAF), and 19 (31.2%) as odontomas. Histopathologically, PMH is characterized by hyperplasia of odontogenic mesenchymal tissues with a myxoid appearance in which odontogenic epithelial islands and mesenchymal multinucleated giant cells are scattered randomly. Between the mucosal epithelium and the PMH, there is a layer of fibrosis, whose matrix is strongly immunopositive for tenascin. The PMH seems to induce its overlying gingival mucosa to remodel the connective tissue, which obstructs tooth eruption. IAF is usually located adjacent to the PMH and shows an ameloblastic fibroma-like histology with atrophic ameloblastic components and poor encapsulation. The findings suggest that IAF associated with PMH is not a true neoplasm and should be distinguished from ameloblastic fibromas by the name of IAF, and that both lesions are included in the range of hamartomas formed only in the pericoronal tissue of teeth in eruption. We propose to categorize these lesions into a new disease entity of pericoronal hamartomas of odontogenic origin.

Adolescent↗

Quantitative histological features and ultrastructure of opercula of human teeth showing normal and delayed eruption.

BACKGROUND: Failure of eruption of human permanent molars has been attributed to opercular lesions, although comparisons with specimens from normally erupting teeth are scarce. The aim of this study was to quantitatively analyse opercula associated with normal and delayed tooth eruption. METHOD: Twenty opercula covering permanent molars delayed in eruption were obtained from 13 patients aged 7.3-18.1 years. Six opercula from normally erupting molars of five 7.3-17.5-year-old subjects served as controls. Specimens were analysed light and electron microscopically and morphometrically. RESULTS: In addition to features recognized previously, prominent numbers of nerves, high endothelial-like venules and mast cells were observed. Ultrastructurally, large multinucleated cells did not reveal cell boundaries running between the nuclei, and mast cells seemed belonging to the MC(TC)-type. None of the features differed significantly between opercula from cases of delayed and normal tooth eruption. CONCLUSIONS: Disturbances of tooth eruption that are attributed to opercular lesions may represent retentions resulting from the failure of the eruption mechanism, rather than impactions because of a physical barrier.

Adolescent↗

Eruption of maxillary canines.

In 79 of 124 children with bilaterally located widened follicles around non-erupted canines one of the maxillary canines was chosen by lot for surgical exposure of the tooth crown. In seven cases both maxillary canines were exposed. The remaining 38 children were radiographically controlled at certain time intervals as were the 86 cases where surgery was performed. The follicles removed from 52 cases were histologically examined. The result showed that surgical exposure did not enhance the eruption of the tooth. The histological examination showed that the histologic appearance of the extirpated follicle did not correspond to the radiographically verified width of the pericoronal space. The specimens were composed of a loosely arranged fibrous connective tissue with an epithelial lining occurring in 77% of the cases. The epithelial lining consisted of reduced enamel epithelium and showed in none of the cases squamous metaplasia or keratinization. Nor was there any clinical or histologic sign of a neoplastic or cystic change of the follicle.

Adolescent↗

Anterior esthetics achieved with orthodontic therapy: a report of three cases.

The adult dental patient today, as a discerning consumer, is seeking the highest quality care in the realm of esthetic dentistry, and frequently these expectations can be met through the modalities of bonded composites, porcelain laminates, porcelain bonded to etched metal support structures or modified conventional crown and bridge prosthodontics. However, there are occasions where the individual tooth, teeth, or the arches are so aligned that the pulpal, gingival, or osseous tissues would be jeopardized by the conventional restorative intercession. The incorporation of accepted and routine procedures of acid etching and direct bonding of orthodontic appliances to the surfaces of the adult dentition to reposition malposed teeth offers the clinician a magnificent alternative or adjunct to the conventional dental material forms of treatment. This article will present several patient treatments that incorporated the use of acid etching and direct bonding of orthodontic appliances to the surfaces of the patient's teeth for the purposes of repositioning the teeth with or without the need for restorative interventions.

Acid Etching, Dental↗