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Dental caries, restoration and tooth conditions in U.S. adults, 1988-1991. Selected findings from the Third National Health and Nutrition Examination Survey.

This article provides estimates of dental caries experience and selected restorative and tooth conditions among U.S. adults, obtained from Phase 1 (1988-1991) of the Third National Health and Nutrition Examination Survey. Between 1988 and 1991, 94 percent of adults in the United States showed evidence of past or present coronal caries. Based on the data collected, the authors estimate that about 40.5 percent, or 61.6 million, dentate adults had at least one tooth or tooth space that could potentially benefit from professional treatment. Minimally, it is estimated that 135.6 million tooth or tooth spaces among U.S. adults may benefit from professional treatment. These estimates supplement information available from the DMF index to provide a broader profile of the impact of dental caries on permanent tooth of U.S. adults.

Adolescent↗

Expression and role of Lhx8 in murine tooth development.

We examined the expression and possible functions of Lhx8, a member of the LIM-homeobox gene family, during tooth morphogenesis of the mouse. Lhx8 was expressed in the dental mesenchyme between the bud and early bell stage of the molar tooth germ. Tooth germ explants from embryonic day 12.5 mice treated for 5 to 7 days with antisense-oligodeoxynucleotides (AS-ODN) against Lhx8 showed a marked decrease in the number of mesenchymal cells. The explants treated with AS-ODN for 11 to 14 days were filled with a large number of undifferentiated epithelial cells and a limited number of undifferentiated mesenchymal cells, but did not contain a tooth germ. Treatment of explants with AS-ODN for 7 days suppressed the proliferation of dental mesenchymal cells and induced apoptosis; the latter was confirmed by histochemical and ultrastructural examinations. Moreover, the expression of Lhx6, Msx1, Msx2, Bmp4 and Gsc, which are also known to be involved in tooth morphogenesis, were suppressed after the application of AS-ODN against Lhx8 for 7 days. The present results suggest that Lhx8 plays an important role in the survival of mesenchymal cells of the tooth germ during development.

Animals↗

Possible explanations for the tooth loss and cardiovascular disease relationship.

Several studies have shown relationships between periodontal disease and cardiovascular disease (CVD). A few studies have also shown that tooth loss may be associated with increased risk of coronary heart disease and stroke. We have reviewed the relevant literature to assess possible explanations for the reported associations between tooth loss and CVD. In particular, we considered whether the reported association between tooth loss and CVD could be explained by antecedent periodontal disease, antecedent caries, the extraction process, dietary changes following tooth loss, or confounding or bias from other sources. Since access to care and attitudes to health care may influence the decision to extract teeth, as well as cardiovascular disease risk, one needs to be cautious about confounding from behaviorally related factors. Available evidence suggests that further studies are needed to rule out that confounding is a possible explanation for the tooth loss and CVD relationship, that prior periodontal disease may not completely explain the tooth loss-CVD relationship, and that the role of diet needs to be further explored

Attitude to Health↗

Orthodontic tooth movement enhances bone healing of surgical bony defects in rats.

BACKGROUND: The question of whether the repair of an alveolar bony defect can be enhanced by orthodontic tooth movement was addressed. METHODS: Alveolar bone defects were created in 52 Wistar male rats anterior to both maxillary first molars. After 1 week of healing, orthodontic protraction was applied for 2 weeks on the right side, resulting in mesial tipping and displacement movement. Subsequently, a retention appliance was inserted for 1 week. The left side served as the untreated (control) group. Vital bone staining (procion brilliant red H-8) was administered before and after orthodontic traction. Histomorphometric analysis was performed on 62 hemimaxillae using UV confocal microscopy and an imaging program. The total area of the bony defect was divided into 4 equal quadrants, and the area of bony apposition in each quadrant was measured. RESULTS: The total area of bony apposition was 6.5-fold larger in the treated (26.41 x 10(4) +/- 28.92 x 10(4) microm2) than in the control group (4.07 x 10(4) +/- 2.82 x 10(4) microm2), approaching statistical significance (P = 0.065). The treated occlusal quadrants demonstrated highly significant (P= 0.010), greater bone apposition compared to the control group (13.8-fold) and to the treated apical quadrants (P= 0.04, 5-fold). CONCLUSIONS: This study confirms that orthodontic tooth movement is a stimulating factor of bone apposition. A conversion in the repair pattern of the bony defect from apicoocclusal in the control group (no tooth movement) to occlusoapical in the treated group (with tooth movement) further supports the linkage between tooth movement and enhanced bone deposition. Clinical implication suggests incorporation of orthodontic tooth movement in regenerative therapy.

Alveolar Process↗

Statin use and tooth loss in chronic periodontitis patients.

BACKGROUND: Statins have anti-inflammatory and bone stimulating properties that may positively affect chronic periodontitis. Our objective in this study was to evaluate whether statin use by chronic periodontitis patients had a beneficial impact on tooth loss. METHODS: In a retrospective cohort study (N patients = 1,021; mean follow-up = 7.1 years), dental records were merged with pharmacy data. Any statin use during 3 years, statin use during each of 3 consecutive years (regular use), and any statin use during the first 3 years after the initial periodontal exam were evaluated as predictors of tooth loss using negative binomial regression models with adjustment for potential confounding factors. RESULTS: Any statin use during 3 years was not associated with tooth loss rate in the year subsequent to the 3-year period (rate ratio [RR] = 1.00; 95% confidence interval [CI] = 0.56 to 1.81). Regular statin use during 3 years was associated with a non-significant 37% reduced tooth loss rate in the year subsequent to the 3-year period (RR = 0.63; 95% CI = 0.32 to 1.25). Any statin use during the first 3 years after the initial periodontal exam was associated with a 48% decreased tooth loss rate in year 4 and subsequent years (RR = 0.52; 95% CI = 0.29 to 0.95). CONCLUSIONS: Our findings were mixed for an association of statin use with reduced tooth loss in chronic periodontitis patients. Lack of control for some potential confounders, particularly smoking, and evaluation of different patterns of statin usage hamper the interpretation of the results. Exploration of these findings in additional epidemiological studies may be worthwhile.

Adult↗

Endodontic treatment of a supernumerary tooth fused to a mandibular second molar: a case report.

Since abnormal tooth morphology can predispose to caries and periodontal disease, careful management of fused teeth is essential. In this paper we report a rare case of a fused molar and supernumerary tooth and describe its management. Caries was removed from the tooth complex under local anesthesia. The pulp chamber of the supernumerary tooth was exposed without involvement of second molar pulp chamber. The root canal of the supernumerary tooth was prepared using the step back technique and copious irrigation with 2.6% sodium hypochlorite. Obturation using the lateral condensation technique with gutta-percha and AH26 sealer was subsequently performed and final restoration was accomplished with composite resin. Nine months after the treatment, no clinical or radiographic concern is apparent, and the second molar tooth has remained vital.

Adult↗

Analysis of tooth marks in a homicide case. Observations by means of visual description, stereo-photography, scanning electron microscopy and stereometric graphic plotting.

In 1957 a woman was murdered in Oslo. Her left breast exhibited tooth marks. A man was arrested and sentenced to life imprisonment partly because of the dental evidence. He never admitted guilt and filed a petition for retrial. The present author was appointed as new dental expert. The material consisted of the fixed breast, models of the bite mark and models of the teeth of the convict, and several photographs. By means of visual examination, a magnifying glass, a lens stereoscope and a stereomicroscope characteristic details were noted. Stereoscopic picture pairs were taken, the material was studied by means of scanning electron microscopy and a stereometricgraphic plotting method permitting the outline of the tooth mark or the biting edge of a tooth to be registered in great detail in all three dimensions in the form of a contour map. This method has not previously been applied in the analysis of tooth marks in human skin. These examinations revealed no discrepancies but showed many corresponding characteristic features between the tooth marks and the teeth of the convict, resulting in the conclusion that it is highly probable that the tooth marks in the breast were made by the teeth of the convict.

Bites and Stings↗

Effects of sympathetic nerve activity on acute mobility of the rabbit incisor tooth.

The contribution of local blood flow to the buffering properties of the periodontal ligament was examined in 15 anesthetized rabbits. The position of the tooth was recorded by an ultrasonic transit time technique, and local vascular pressures and volumes were altered by electrical stimulation of the cervical sympathetic nerves. The unloaded tooth was shifted into a slightly intruded position by nerve stimulation, and from this position, intrusion movements evoked by 5- to 10-g loads were found to be 10-15% smaller than before the stimulation. Tooth mobility was unaffected by 20-30 mm Hg reductions in mean arterial pressure, but similar decreases in mobility as evoked by nerve stimulation were observed when the pressure was brought down to 10-25 mm Hg. This procedure also produced about the same intrusive shift of the unloaded tooth. Most likely, the sympathetic nerve activity decreased tooth mobility by causing a fall in periodontal vascular pressures, thereby moving the tooth into a position where it was more resistant to further, load-induced intrusion.

Animals↗

Comparing permanent tooth sizes (mesio-distal) of males and females in a Nigerian population.

Two hundred and fifty school children in Ibadan metropolis, comprising of 125 male and 125 females were chosen by modified random sampling to study their tooth sizes (mesiodistal width) and to establish if there is any appreciable sex-difference in their permanent tooth sizes. The teeth measured were selected based on certain criteria. The mesio-distal width of a tooth was recorded as the maximum distance between the tooth sides (proximal) of a tooth on a line parallel to the occlusal and buccal surfaces. The result showed that the male teeth were consistently larger than the female teeth. The summed total maxillary and mandibular arch width of the males were 3.31 mm and 1.37 mm greater than those of the females respectively. The differences in tooth size between males and females have been established.

Adolescent↗

[Study on prosthodontic procedure in patients with unilateral cleft lip and palate--effects of various extensions of splint on tooth-borne ability of teeth adjacent to the cleft].

It is mandatory that the prosthodontic devices for the cleft palate patients not only prevent the relapse of the corrected arch and teeth by orthodontic and/or surgical intervention but also equilibrate the tooth-borne ability between the upper and the lower jaw. The purpose of this paper is to set up a criterion for the extension of the splint from the point of the tooth-borne ability. Four patients with unilateral cleft lip and palate were examined for the maximal biting force at the tooth adjacent to the cleft in each alveolar segment in the case of various extensions of the splints. The findings were as follows: 1. The maximal biting force increased significantly in every splint, compared with the non-splint. 2. The maximal biting force increased significantly in the splints where the neighbouring tooth in the same segment was involved, compared with that in the splints where only the tooth adjacent to the cleft was involved, even if the tooth in another segment increased in number for splinting. 3. The maximal biting force did not increase significantly in most splints where three teeth in the same segment were involved, compared with that in the splints where two teeth in that segment were involved.

Adult↗

[A newly developed method for taking pictures of tooth crown cracks for clinical records].

It is very important to examine fine cracks on the crown surface of traumatized tooth in the dental clinic because the presence of these cracks may cause discomfort or hypersensitivity of the tooth. By the emission of routinely used light, it is difficult to illuminate cracks, and the usual intraoral photography using strobe light emission is not useful to make records of cracks in most cases. In the present study, a method for taking pictures to record tooth crown cracks was newly developed using LED as a light source, and applied to patients with traumatized teeth in the dental clinic. The results were as follows: 1. Cracks on the tooth surface could be confirmed with the LEDs of all the colors used in this study. However, the blue LED enabled cracks in the incisal edge part to be more easily confirmed, and the white LED enabled cracks in the cervical part to be more easily confirmed. 2. Cracks of multiple modalities on the tooth surface was illuminated more often when the LED light was emitted at 45 degrees to the axis of the tooth than 90 degrees. 3. The light exposure field became wider by the use of the LED of diameter 5 mm than that of diameter 3 mm. However, the LED of diameter 3 mm was more favorable than that of diameter 5 mm for the observation of the cracks because the former could more easily change the direction of light emission.

Child↗

Distraction osteogenesis: the effects of orthodontic tooth movement on distracted mandibular bone.

The application of distraction osteogenesis in craniomaxillofacial surgery has created new treatment methods for patients with craniofacial skeletal dysplasias. Most of the applications in the craniofacial skeleton have been for the correction of severe congenital or acquired conditions. As more understanding is gained with these new approaches, refinements in techniques will enhance treatment planning and outcome. This will expand the application of distraction osteogenesis to more common, less severe types of skeletal dysplasias. One of the important areas in mandibular distraction osteogenesis is the management of the dental gap created when distraction is applied within the tooth-bearing segment of the mandibular body. In this study, the authors investigated the effects of orthodontic tooth movement into new bone created through the process of distraction osteogenesis. Orthodontic tooth movement through newly formed mandibular bone in the canine model was performed and, through histologic studies, was found to create compact bone along the path of the moving tooth. This compact bone replaced the more unstructured woven bone that was originally created by the process of mandibular distraction osteogenesis. These findings indicate that orthodontic tooth movement can be performed in distracted bone and can have significant influence on the stability and long-term structural preservation of the bone created by distraction osteogenesis within the tooth-bearing segment of the mandible.

Animals↗

The effects of tooth preparation on pressure measured in the pulp chamber: a laboratory study.

PURPOSE: The purpose of this study was to determine pressure changes in the pulp space during tooth preparation with either diamond or tungsten carbide burs in a high-speed dental handpiece in the laboratory. MATERIALS AND METHODS: Twenty premolar teeth were collected and randomly assigned to two groups: group 1 received preparation with diamond burs and group 2 with tungsten carbide burs. The teeth were mounted on a pressure transducer and the pulp chambers were filled with saline. A 0.1-mm thickness of tooth tissue was removed from the proximal surface of each tooth, alternating dry and wet cutting, until the pulp chamber was exposed. Pressure and temperature changes were recorded during tooth preparation. RESULTS: At 0 to 1 mm of remaining dentin depth dry cutting with diamond and tungsten carbide burs generated a mean positive pulpal pressure of 12 kPa and 6 kPa, respectively. Wet cutting under the same conditions produced 0.6 kPa and 0.15 kPa, respectively. The difference between wet and dry cutting was highly significant (P < 0.001). Diamond burs produced significantly higher pressure increases than carbide burs at all levels for both wet and dry techniques (P < 0.05). When cutting farther than 2 mm from the pulp, tooth preparation created a mean 0.09-kPa pressure increase, which was not influenced by either coolant use or bur type. The temperature change was minimal during wet cutting and only minor temperature increases were recorded during dry cutting. CONCLUSION: From this laboratory study it is concluded that significant pressure changes occur in the pulp chamber during tooth preparation of extracted teeth when the remaining dentin thickness is less than 2 mm.

Body Temperature↗

A study to assess the tooth whitening efficacy of a new dentifrice formulation variant containing a special grade of silica: a six-week study on adults.

The objective of this double-blind clinical study was to investigate the tooth whitening efficacy of a formulation variant of a commercially available dentifrice (Colgate Total Plus Whitening Toothpaste) obtained by the addition of high cleaning silica, relative to that of its currently marketed formulation (Colgate Total Toothpaste). Following a baseline examination, qualifying adult male and female subjects were randomized into two treatment groups which were balanced for age, gender and level of extrinsic tooth stain. Subjects were instructed to brush their teeth twice daily (morning and evening) for one minute with their assigned dentifrice, using a soft-bristled toothbrush. After one, and again after two weeks' use of the assigned dentifrices, a randomly selected panel of subjects was examined for soft tissue findings. Examinations for extrinsic tooth stain were repeated for all subjects after six weeks' use of the study dentifrices. Ninety-seven (97) subjects complied with the protocol and completed the entire study. At the six-week examination, subjects assigned to the new dentifrice formulation group exhibited statistically significantly (p < 0.05) lower levels of extrinsic tooth stain area and extrinsic tooth stain intensity than did those subjects assigned to the Colgate Total Toothpaste group. Thus, the results of this double-blind clinical study support the conclusion that the new dentifrice formulation variant is efficacious for the removal of extrinsic tooth stain.

Adult↗

Clinical efficacy of a new tooth whitening dentifrice.

The objective of this double-blind clinical study was to investigate the tooth whitening efficacy of a variation in formula of a commercially available dentifrice (Colgate Total Toothpaste). The variation (Colgate Total Plus Whitening Toothpaste) was the addition of high cleaning silica to the existing formulation. Following a baseline examination for extrinsic tooth stain, qualifying adult male and female subjects from the Mississauga, Ontario, Canada area were randomized into two treatment groups which were balanced for gender, age and level of extrinsic tooth stain. Subjects were instructed to brush their teeth twice daily (morning and evening) for one minute with their assigned dentifrice, using a soft-bristled toothbrush. Examinations for extrinsic tooth stain were repeated after six weeks' use of the study dentifrices. Ninety-three (93) subjects complied with the protocol and completed the entire study. At the six-week examination, subjects assigned to the new dentifrice formulation group exhibited statistically significantly lower levels of extrinsic tooth stain area and extrinsic tooth stain intensity than did those subjects assigned to the Colgate Total Toothpaste group.

Adult↗

Pathways and fate of migratory cells during late tooth organogenesis.

Tissue recombination experiments and cell lineage analyses of the developing neural crest have documented the role and central pathways of migratory cells during early craniofacial development. In the present study, regional pathways of cells during late peripheral morphogenesis were investigated using the crown stage tooth organ as a model. Homing targets during tooth integument formation were analyzed to understand the fate of migratory cells involved in late tooth organogenesis and the developmental origin of periodontal tissues. After surgical removal of the oral mucosa, the oral aspect of the dental follicle of lower first mouse molar teeth was labeled using a fluorescent contact dye. Following sacrifice after 0, 2, 4, and 6 days, labeled cells were detected in the dental follicle, in the alveolar bone, and in the periodontal ligament adjacent to the molar root. The distribution of labeled tissues was reconstructed three-dimensionally via confocal microscopy. Using a tooth molar organ culture system, labeled cells within the dental follicle were documented traveling in the apical direction. Our results indicated that cell migration during tooth organogenesis was following specific pathways and that cells within the circumference of the dental follicle were migrating in the apical direction. We speculate that migratory cells passing through the dental follicle connective tissue may contribute to the formation of the periodontium. The present documentation visualizes pathways, role, and dynamics of extensive cell movements during late tooth organogenesis.

Alveolar Process↗

[A study of sensory pathway in central nervous system of experimental tooth movement in rats].

OBJECTIVE: To investigate whether ventral posteromedial thalamus nucleus (VPM) receive the stimulation from experimental tooth movement in rats through the conduction of spinal trigeminal caudal nucleus (Vc), thus to study the central sensory pathway of tooth movement. METHODS: 2% fluorogold (FG) was injected into rat's VPM using microinjector through retrograde tracing technique. After 4-6 days, the experimental tooth movement was conducted in contra-side against FG injection. 2 hours later, animals were sacrificed and FOS protein immunocytochemical reaction was conducted. The sections were observed under Olympus fluorescence microscope. RESULTS: FOS immunocytochemical-positive neurons were densely distributed in epilateral superfacial layer of Vc, being belt-like with more in dorsolateral 2 hours after experimental tooth movement; FG-labeled neurons were found in Vc and principle trigeminal nucleus complex, especially within the whole length of Vc, with more in layer I and the junction of layers I and II. There were both FOS immunocytochemically positive and FG-labeled neurons, approximately 5% of the whole FG-labeled neurons. CONCLUSION: As a special oro-facial stimulation, there are corresponding parts in the central nervous system according to tooth movement. The stimulating message integrated in Vc and Vc has projective neurons to VPM, and VPM might be a relay station of the stimulating message of experimental tooth movement in rats.

Afferent Pathways↗

Diagnosis and treatment planning: cracked tooth.

This article discusses the cracked tooth, one of the five major classifications of longitudinal tooth fractures: 1) craze line; 2) cuspal fracture; 3) cracked tooth; 4) split tooth; and 5) vertical root fracture. The term "longitudinal tooth fracture" was first introduced by Rivera (Personal Communication, Iowa City, IA, 1996) and has two meanings. The first implies distance (length), particularly in the vertical (occlusal-cervical) plane, as illustrated by longitudinal lines on a map. The second indicates that these fractures occur over a period of time. Therefore, the term longitudinal tooth fracture applies to fractures that have both a distance and a time component. Thus, fractures are described that are not related to impact trauma (which occurs primarily in incisors), in which the distance (length) component may be similar, but is immediate instead of over a period of time.

Cracked Tooth Syndrome↗