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Preventive effect of tooth fracture by pulsed Nd:YAG laser irradiation with diamine silver fluoride solution.

OBJECTIVE: The purpose of the present study was to evaluate the preventive effect of pulsed Nd:YAG laser irradiation with 38% diamine silver fluoride [Ag(NH3)2F] solution for the fracture of endodontically treated teeth in vitro. BACKGROUND DATA: There have been no reports on the preventive effect of tooth fracture using Nd:YAG laser with Ag(NH3)2F solution. MATERIALS AND METHODS: Twenty-eight human extracted teeth were used in this study. The teeth were randomly classified into four groups: control group, where tooth surfaces were not submitted to any treatment; group 1, where tooth surfaces were coated with 38% Ag(NH3)2F solution; group 2, where tooth surfaces were coated with Ag(NH3)2F solution and irradiated by pulsed Nd:YAG laser for 2 sec; and group 3, where tooth surfaces were coated with Ag(NH3)2F solution and irradiated by pulsed Nd:YAG laser for 10 sec. After preparation, shear tests were performed and the maximum load for the fracture was measured. Results were analyzed using the Scheffe test, and difference at p < 0.05 was considered significant. RESULTS: The failure load for group 2 (mean, 182.5 kg) had the highest mean value and differed significantly from those for the control group (mean, 146.3 kg) and group 1 (mean, 147.1 kg; p < 0.05). The failure loads for groups 1 and 3 (mean, 150.0 kg) did not differ significantly from that for the control group (p > 0.05). CONCLUSION: The results show that the application of 38% Ag(NH3)2F solution followed by pulsed Nd:YAG laser irradiation for 2 sec is useful for prevention of tooth fracture at endodontically treated teeth.

Fluorides, Topical↗

Effects on tooth movement of force delivery from nickel-titanium archwires.

The aim of this project was to determine the in vivo effects of tooth movement with nickel-titanium archwires on the periodontium during the early stages of orthodontic treatment. The extent of tooth movement, severity of gingival inflammation, pocket probing depth, gingival crevicular fluid (GCF) flow, and the amount of the chondroitin sulphate (CS) glycosaminoglycan (GAG) component of the GCF of one maxillary canine in each of 33 patients treated with a pre-adjusted appliance were measured before and at four stages during the first 22 weeks of treatment. The methods involved the use of a reflex metrograph to determine the type of tooth movement and electrophoresis to quantitate the CS in the GCF. It was found that GCF flow increased after 4 weeks of tooth movement whereas the increase in the amount of CS in the GCF, which is taken to be indicative of periodontal tissue turnover, occurred at the later stage of 10 weeks. Teeth which showed the greatest amount of tooth movement continued to express large amounts of CS in large volumes of GCF until 22 weeks, whilst the CS levels in those teeth moving to a smaller extent declined. These data suggest that nickel-titanium archwires may produce a super-elastic plateau effect in vivo on canine teeth, which are initially displaced from the arch such that large amounts of tooth movement occur in the first 22 weeks of treatment.

Adolescent↗

Tooth movement and changes in periodontal tissue in response to orthodontic force in rats vary depending on the time of day the force is applied.

The purpose of this study was to investigate whether there are any differences in tooth movement or in the response of periodontal tissue to orthodontic force when the force is applied at different times of the day. One hundred 6-week-old male Wistar rats were divided into one control group without force application and three experimental groups based on the time of day the force was applied to the upper first molars. Animals in the whole-day group received force continuously throughout the experimental period, while animals in the light- and dark-period groups received force only during the light (07:00-19:00) or dark period (19:00-07:00), respectively. Tooth movement was measured using the occlusal view of a precise plaster model with a profile projector. Periodontal tissues were evaluated histologically. The time course of tooth movement varied among the groups. Tooth movement over 21 days in the whole-day and light-period groups was about twice that as in the dark-period group. The formation of new bone on the tension side in the whole-day and light-period groups was more than twice that as in the dark-period group. On the pressure side, more osteoclasts appeared on the alveolar bone in the whole-day and light-period groups than in the dark-period group. The light-period group showed less extensive hyalinization of the periodontal ligament (PDL) than the whole-day group. The area of root resorption on day 21 also varied among the groups. Interference by masticatory forces did not seem to be a principal cause of the decreased tooth movement in the dark-period group. These results indicate that there are considerable variations in tooth movement and in the response of periodontal tissue to orthodontic force when the force is applied at different times of the day in rats. The results suggest that diurnal rhythms in bone metabolism have important implications in orthodontic treatment.

Alveolar Process↗

The rat as a model for orthodontic tooth movement--a critical review and a proposed solution.

The aims of this study were to perform a systematic review of the use of rats as a model for experimental tooth movement, to give a critical evaluation of the use of elastics as a force delivery system, and to describe a newly designed well-defined model for tooth movement in rats. The literature from 1981 to 2002 indicates that in 57 per cent of animal studies on orthodontic tooth movement, rats were used, but in many of these investigations the experimental set-up was poorly documented. Only three of the 159 studies fulfilled the inclusion criteria for a good model: a force magnitude of less than 20 cN; moving molar(s) mesially; an experimental duration longer than 2 weeks; and no extra experimental condition such as drug intervention. As more than one-quarter of the studies on tooth movement in rats used elastics to produce an orthodontic force, and as the forces they produced and their force decay during decompression are unknown, their mechanical characteristics on decompression were tested. Elastics stored under dry conditions or in water showed significant force decay from around 45 N to almost 0 N within the first 0.2 mm of decompression. With regard to the above-mentioned shortcomings of using rats as a model for tooth movement, a newly designed experimental appliance for tooth movement in rats was evaluated. It proved to be stable and simple and able to deliver a continuous and constant force as low as 10 cN on all three molars together during an experimental period of 12 weeks without interference in animal welfare, and was able to compensate for the effects of molar distal drift and continuous incisor eruption.

Animals↗

Tooth counts do not predict bone mineral density in early postmenopausal Caucasian women. EPIC study group.

BACKGROUND: It has been suggested that poor dental status may be a suitable criterion for bone densitometry referral in early postmenopausal women. We evaluated this hypothesis in a cohort of 1365 Caucasian women aged between 45 and 59 years, who were enrolled into an international multi-centre trial. METHODS: Subjects were recruited at four study centres, using population-based techniques. Bone mineral density (BMD) at the lumbar spine and proximal femur was measured by dual energy x-ray absorptiometry (DXA) (Hologic QDR 2000). A full physical examination was performed including a tooth count. RESULTS: Baseline tooth counts ranged from 0 to 32 (median 26): 84 (6%) subjects were edentulous. When classified according to the WHO criteria 445 (33%) of the subjects were osteoporotic at one or more of the skeletal sites analysed; 694 (51%) were osteopenic, and 226 (16%) were normal. Adjusting for confounding variables, there was no significant correlation between tooth count and BMD at any skeletal site. Subjects were divided into tertiles of tooth count, and chi2 tests used to compare the two 'extreme' groups against the WHO criteria for BMD. At each of the six BMD regions the proportion of subjects with normal, osteopenic or osteoporotic BMD was similar for both tertiles. CONCLUSIONS: We found no relationship between tooth count and BMD in early postmenopausal women. This may be because in younger women dental status is a reflection more of dietary habits and past dental surgery than of age-related bone loss. Tooth counts therefore cannot be used to identify individuals at risk of osteoporosis.

Alendronate↗

Relations between tooth enamel dose and organ doses for electron spin resonance dosimetry against external photon exposure.

An analysis of doses to tooth enamel and to organs was carried out to develop a method that can predict the organ doses and the effective dose by electron spin resonance (ESR) dosimetry using tooth samples for external photon exposure. Absorbed dose to tooth enamel and organ doses were obtained by Monte Carlo calculations using the EGS4 code in combination with a mathematical human model with a newly defined teeth part. The calculations gave quantitative relations between tooth enamel dose and organ doses for some cases of external photon exposure. It was also found that tooth enamel dose depends more significantly on energy of incident photons than the other organ dose or the effective dose. The obtained data are to be useful for the assessment of individual dose in past exposure events by the ESR dosimetry using tooth enamel.

Air↗

The effect of mouthguard design on stresses in the tooth-bone complex.

PURPOSE: Mouthguards protect the tooth-bone complex from impact loads that occur during sporting activity. The aim of this study is to investigate the effects of varying mouthguard thickness and stiffness on the magnitude of tensile stresses in the tooth-bone-complex. METHODS: A two-dimensional, plane stress, finite element representation of a central maxillary incisor (CMI) is created. For validation purposes, displacements of the incisal edge of the unprotected tooth model are compared with in vivo displacements under similar loads. A protective mouthguard is then superimposed over the model with varied labial thickness (1-6 mm) and stiffness (9-900MPa) representing a range of designs available. A large horizontal static load of 500N is then applied to the anterior surface of the mouthguard and the resulting stresses in the tooth-bone complex are presented. It is suggested that this loading condition most accurately represent the situation occurring when a guarded tooth collides with a soft object (e.g. boxing glove). RESULTS: It is generally found that mouthguard thickness and stiffness are both desirable in terms of reducing stresses. However, the protection offered by the low-stiffness guards, regardless of thickness, is minimal. Since this low-stiffness (9MPa) is representative of the most common choice of material in mouthguard fabrication, such findings may cast doubt on the ability of popular mouthguards to redistribute stress. CONCLUSION: While few would disagree that these low-stiffness guards absorb shock during hard-object collisions (e.g. baseballs), they may not protect the tooth-bone during soft-object collisions (e.g. boxing gloves). In order to optimize their protective capabilities for a range of loads, the range of materials used in mouthguard construction may have to be reconsidered.

Equipment Design↗

The immunogenicity of tooth allografts in rats.

Orthotopic and heterotopic tooth allografts stimulated the production of alloantibodies in rats incompatible at the major histocompatibility locus. The immunogenicity of whole tooth grafts was slightly diminished but not eliminated by sealing the pulp cavity prior to grafting. Suspensions of dentine in saline elicited alloantibody formation on i.p. injection into allogeneic hosts. Orthotopic tooth allografts, but not heterotopic grafts, were as effective as skin allografts at stimulating second set rejection of challenging skin grafts. Orthotopic tooth allografts were indistinguishable from syngeneic grafts on histological examination over the period 1-6 weeks after grafting. The occurrence of alloantibody formation after tooth grafting was capricious, and this, combined with the histological difficulty of distinguishing syngeneic from allogeneic grafts, and also the differing capacity of orthotopic and heterotopic tooth allografts to provoke accelerated skin grafts rejection, probably accounts for some of the differences of opinion expressed previously on the immunogenicity of grafted teeth.

Animals↗

Charcot-Marie-Tooth disease: an update.

PURPOSE OF REVIEW: The purpose of this review is to assist neurologists, neuroscientists and other interested readers in following the expanding volume of information relating to the inherited peripheral neuropathies collectively referred to as Charcot-Marie-Tooth disease. Currently, mutations in multiple different genes expressed in Schwann cells and neurons cause a variety of overlapping clinical phenotypes. RECENT FINDINGS: Recent articles clarify molecular pathways involved in the pathogenesis of these disorders, and for the first time provide rational treatment strategies for the most common form of Charcot-Marie-Tooth disease. The identification of many new genes associated with neuropathy demonstrate the role of axonal transport and abnormal protein trafficking in causing various forms of Charcot-Marie-Tooth. They also further define the role of axonal signaling and the molecular architecture of both Schwann cells and neurons in maintaining normal peripheral nervous system function. Finally, recent reports have shown that progesterone antagonists and ascorbic acid can successfully treat rodent models of Charcot-Marie-Tooth disease type 1A. SUMMARY: Taken together, results from these articles support the concept that genetic causes of Charcot-Marie-Tooth disease serve as a living microarray system to identify molecules necessary for normal peripheral nervous system function. When we can make sense of these microarrays we are likely to understand the pathogenesis and develop rational therapies for many neurodegenerative diseases including Charcot-Marie-Tooth.

Animals↗

Prevalence of Charcot-Marie-Tooth disease in patients who have bilateral cavovarus feet.

It is not uncommon to see a patient with bilateral cavovarus feet in the outpatient setting. A large percentage of these patients are subsequently diagnosed with an associated condition, such as Charcot-Marie-Tooth disease. The purpose of the present report was to determine the prevalence of Charcot-Marie-Tooth disease in children who have bilateral cavovarus feet. A chart review of children with bilateral cavovarus feet was done. Patients were excluded if they had an existing medical problem known to be associated with bilateral cavovarus feet. Charcot-Marie-Tooth disease was diagnosed after a clinical assessment by an orthopaedic surgeon and a neurologist. The diagnosis was confirmed by either standard nerve conduction velocity studies and/or the CMT DNA Duplication Detection Test (Athena Diagnostics Inc, Worchester, MA). A positive family history was noted only if the diagnosis had been confirmed by a nerve conduction velocity study and/or CMT DNA Duplication Detection Test. One hundred forty-eight patients met the study criteria. The probability of a patient with bilateral cavovarus feet being diagnosed with Charcot-Marie-Tooth disease, regardless of family history, was 78% (116 patients). A family history of Charcot-Marie-Tooth disease increased the probability to 91%. It is recommended that all patients with bilateral cavovarus feet, especially with a known family history, be investigated for Charcot-Marie-Tooth disease.

Adolescent↗

Tooth loss during maintenance following periodontal treatment in a periodontal practice in Norway.

BACKGROUND: Periodontal therapy coupled with careful maintenance has been shown to be effective in maintaining periodontal health; however, a small number of teeth are still lost because of progressive periodontitis. AIM: To investigate factors associated with tooth loss due to periodontal reasons during maintenance following periodontal treatment in patients in a Norwegian specialist periodontal practice. The study also examined how initial prognosis related to actual outcome as measured by periodontal tooth loss. METHODS: Hundred consecutive patients (68 females, 32 males) who had comprehensive periodontal treatment and attended for 9.8 (SD: 0.7), range: 9-11 years of maintenance care, were studied. All teeth classified as being lost due to periodontal disease over the period were identified. RESULTS: Only 36 (1.5%) of the 2436 teeth present at baseline were subsequently lost due to periodontal disease. There were 26 patients who lost at least one tooth. Logistic regression analysis showed that tooth loss was significantly related to male gender (p=0.049; adjusted odds ratio: 2.8; confidence interval (c.i.): 1.0-8.1), older age, i.e.>60 years (p=0.012; adjusted odds ratio: 4.0; c.i.: 1.3-12.0) and smoking (p=0.019; adjusted odds ratio: 4.2; c.i.: 1.4-13.8). The majority 27 (75%) of the teeth lost due to periodontal disease had been assigned an uncertain, poor or hopeless initial prognosis; however, nine teeth (25%) lost had been assigned a good prognosis at baseline. The prognosis for 202 teeth was judged to have worsened over the period of the study. CONCLUSION: Compliance with maintenance following periodontal treatment was associated with very low levels of tooth loss in a referral practice in rural Norway. Male gender, older age (>60 years) and smoking were predictors of tooth loss due to progressive periodontitis.

Adult↗

The natural history of periodontal disease in humans: risk factors for tooth loss in caries-free subjects receiving no oral health care.

AIM: No long-term studies have reported on risk factors for tooth loss in subjects without home or professional dental care. The purpose of this report is to identify potential risk factors for tooth loss among male Sri Lankan tea labourers who participated in a 20-year investigation of the natural history of periodontal disease. MATERIAL AND METHODS: Data for this report were obtained from the 455 subjects who participated in multiple examinations over the 20-year period from 1970 to 1990. Analyses included data from interim examinations in 1971, 1973, 1977, 1982 and 1985. Oral health assessments included the following: (1) attachment levels in millimetres on all mesial and mesio-buccal surfaces, excluding third molars; (2) plaque index; (3) gingival index; (4) calculus index; (5) caries index; and (6) missing teeth. Other variables included age, history of smoking and betel nut use. Statistical analyses included descriptive statistics and multivariate repeated-measures modelling with generalized estimating equations. RESULTS: Tooth loss was significantly dependent upon interactions between the mean attachment loss and betel nut use (Z=3.40; p=0.0007) and history of missing teeth (Z=-3.70; p=0.0002). The effect of attachment loss on tooth loss was increased in the presence of betel nut and diminished when teeth were already missing at baseline. CONCLUSION: History of missing teeth, betel nut use and increasing attachment loss were significant predictors of tooth loss over time. Betel nut use increased the effect of attachment loss on loss of teeth, while history of missing teeth diminished the effect of attachment loss on tooth loss.

Adolescent↗

Experimental odontogenic cysts induced by in vitro 4-nitroquinoline 1-oxide (4NQO) treatment of F344 rat incisor tooth germs.

This study was designed to establish an experimental animal model for elucidating the early stages of odontogenic cysts and tumors. It involves the in vitro treatment of tooth germs with 4-nitroquinoline 1-oxide (4NQO) at the early bell stage and their subsequent transplantation into the kidney subcapsular space. While all tooth germ transplants of the control group not exposed to the carcinogen showed continued tooth development with no pathological lesions, 21 of 23 4NQO-treated tooth germs developed into similar appearing keratinized cysts with or without associated tooth structures. The remaining two transplants failed to develop cysts and formed only a tooth. The present experimental procedure was effective in inducing keratinized cystic lesions that exhibit some similarities to human odontogenic keratocysts or primordial cysts.

4-Nitroquinoline-1-oxide↗

The effect of mechanical trauma on the tooth germ of rat molars at various developmental stages: a histopathological study.

Intrusive trauma was experimentally applied to the tooth germ at different developmental stages in the rat first molar. The tooth germ at the earliest (postnatal day 1, initiating stage of enamel matrix formation) and the latest (postnatal day 10, calcifying stage of preformed enamel matrix) developmental stages studied showed localized enamel hypoplasia as a direct sequela of trauma. The tooth germs in which enamel matrix was rapidly thickening (postnatal days 3, 5, 7) and had not yet started to calcify showed the most intense and extensive injuries to the formation and structural organization of both enamel and dentin. As for indirect effects secondary to trauma, tooth germ dislocation was observed chiefly in tooth germs at the same developmental stages, frequently resulting in ankylosis. The present experimental model may be helpful for clarifying the histogenesis of traumatic changes in the developing tooth germ.

Ameloblasts↗

Biologic and mechanical stability of single-tooth implants: 4- to 7-year follow-up.

BACKGROUND: Single-tooth implants have been reported to achieve a high level of surgical and prosthetic success. However, close inspection of the literature reveals a paucity of data on the follow-up of single-tooth implants in function for 5 years or more. Since unsplinted implants may be considered to be subject to greater functional stresses, there is a need to report on the long-term biologic and mechanical integrity of such implant-supported restorations. PURPOSE: To report on the long-term follow-up of single-tooth implants, restored and in function for 4 to 7 years. MATERIALS AND METHODS: Twenty-seven Astra Tech single-tooth implants were subject to a clinical audit to evaluate implant and prosthetic success as well as response of both hard and soft tissues over a 1- to 4-year follow-up. This current report presents data on the biologic and mechanical integrity of 23 of these single-tooth implants, which have been in function for up to 7 years (mean, 63 mo). Data are provided with respect to implant survival, maintenance of marginal bone levels, soft-tissue health, and the recording of any adverse events, including prosthetic complications. RESULTS: Only 14 implants in 13 patients were available for review, with no failures for this group of implants. One patient from the original group, who was lost to follow-up, was known to have suffered an implant failure. Furthermore, in accordance with established criteria, the remaining 13 implants that are not included in this report must at this time also be considered as potential failures. As such, the best-case scenario would be a 95.6% success rate for the 23 implants included in this review and the worst-case scenario would be a 60.8% success rate. Mean marginal bone loss measured 0.49 mm mesially and 0.76 mm distally, with a frequency of bone loss of 50%. Soft tissues were clinically healthy. There were few adverse events, with only one case of abutment screw loosening, detected at the 6-year review. In addition, crown decementation was recorded three times in two patients. CONCLUSIONS: It can be concluded that the Astra Tech single-tooth implant can achieve long-term biologic and mechanical stability when used to restore single missing teeth, over the long-term.

Adult↗

Minimum color differences for discriminating mismatch between composite and tooth color.

PURPOSE: The purpose of this study was to determine if there are differences between patients and dental professionals in their ability to identify small color differences (deltaE) in composite resin restorative materials in vitro and to determine the deltaE that would indicate acceptability of color match between a restoration and an adjacent tooth. MATERIALS AND METHODS: Subjects were asked to evaluate composite resin disks to distinguish acceptability of deltaE between disk pairs. Color difference discrimination of dental professionals groups D1 (dentists, n = 12) and D2 (dental auxiliaries, n = 12) was compared to that of dental patient groups P1 (patients, n = 12) and P2 (scientists, n = 12). Each group was pretested for normal color vision. Color differences between a standard and restoration disks of composite were measured in Colour Measurement Committee (CMC) (1:1) color units. Data were analyzed by logistic regression, and results were used to calculate a probability level for minimal acceptance or rejection of AE for all observers. Mean 50:50 deltaE replacement points (RP) for each group were obtained and analyzed by analysis of variance, and the Tukey pairwise comparison test was applied (alpha = 0.05 for all statistical analyses). RESULTS: There were significant differences found between the experimental groups (p = .020). Group D2 (mean 50:50 deltaE RP = 1.78) proved to be more discriminating in accepting differences between tooth and composite resin restorative material color than group P1 (mean 50:50 deltaE RP = 2.69). The mean 50:50 deltaE RP for all subjects was 2.29 CMC (1:1) units. CLINICAL SIGNIFICANCE: The ability to generate an excellent color match between a tooth-colored restoration and the tooth is critical to esthetic success. This study demonstrates that patients are not as discriminating in their ability to identify small color differences between composite restorations and the tooth as are dental professionals. Dental auxiliaries proved to be more discriminating in accepting differences between tooth and composite resin restorative material color than were patients.

Analysis of Variance↗

The effect of veratrine and aconitine on the excitability of sensory units in the tooth of the cat.

Intradental sensory nerve impulse activity was recorded by means of electrodes inserted into dentinal cavities in the tooth of the cat. Impulses of different amplitudes was recorded. Local application of aconitine (10(-3) g/ml) and veratrine (10(-3) g/ml) induced nerve impulse activity. A rapid increase in the temperature of the tooth surface to 45-47 degrees C, which is known to induce fluid movements in the dentinal tubuli, did not induce any nerve impulse activity. However, after pretreatment of a tooth cavity with veratrine a rapid increase in the temperature of the tooth surface gave rise to nerve impulse activity. Steady state impulse activity induced by brief local application of aconitine was influenced by a rapid increase in the temperature of the tooth; during the increase in temperature impulses of low amplitude increased in frequency while impulses of high amplitude were blocked. Furthermore, reduced pressure applied to the exposed dentin, which also induces fluid movements in the dentin, gave rise to nerve impulse activity. Thus the sensory units in the tooth are stimulated by dentinal fluid movements and alkaloids known to excite mechanoreceptors increase their excitability. It is therefore suggested that the intradental sensory nerve endings are mechanosensitive structures.

Aconitine↗

The relationship between the number of sound, decayed, and filled permanent tooth surfaces and the number of sealed surfaces in children and adolescents.

OBJECTIVES: The purpose of this investigation was to determine the prevalence of sound, decayed, filled, and sealed permanent tooth surfaces for children and adolescents from three fluoridated communities in British Columbia and to develop a predictive model of sealant use that included the dental caries status of tooth surfaces. METHODS: Children in grades 2 and 3 (n = 2,715) and adolescents in grades 8 and 9 (3,317) were surveyed to determine the prevalence of sound, decayed, filled, and sealed permanent tooth surfaces. The DMFS index, modified to include incipient (D1) and cavitated (D2) lesions, was used to measure the status of all tooth surfaces. The prevalence of D1D2MF and sealed tooth surfaces was estimated by age group and tooth type. Logistic regression models were developed to analyze the association between a number of independent variables and sealant use. RESULTS: About 60 percent of surveyed students had one or more sealants present, with a mean of 3.2 sealants per subject. Of all pit and fissure surfaces on permanent first molars, 23.4 percent and 20.1 percent were sealed for the 11 years and younger and 12 years and older age groups, respectively. For these same two age groups, the percentages of pit and fissure surfaces that were decayed and filled were 6.7 percent and 19.7 percent, respectively. For both age groups combined, 10.8 percent and 23.7 percent of all pit and fissure surfaces on second molars and premolars, respectively, were sealed. The prevalence of decayed and filled pit and fissure surfaces was 5.6 percent and 1.8 percent, respectively, for second molars and premolars. Premolars were being sealed at a rate of 13 to 1 compared to the number of decayed and filled surfaces. Logistic regression failed to identify meaningful predictors of sealant use. CONCLUSIONS: Results from this study found an increase in the prevalence of sealants in the three communities surveyed, yet failed to identify criteria used by dentists or auxiliaries when making decisions about sealant placement. Professional education in the appropriate use of sealants may be necessary.

Adolescent↗