[Case report. Direct transmucosal implants (I): the immediate treatment of the individual tooth].
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Gingival recession leading to exposure of crown margins or extensive areas of the tooth root can cause significant aesthetic difficulties. Surgical innovations over the last decade have enabled the periodontist to correct such problems with greater predictability and improved aesthetics. The current surgical procedures for treatment of gingival recession are described and illustrated, and criteria for selection of the appropriate procedure are presented. The learning objective of this article is a review of the surgical procedures and an increased predictability in implementation.
The HA-Ti-Implant is a cylindrical device with titanium as kernel and a HA-coated surface. In the clinical use, a two-stage surgical procedure is recommended. In the past 1.5 years, a total of 98 implants inserted in 63 patients were performed, including 64 immediate and 34 delayed implantation. On 67 implants, dental crowns and bridges were connected. Only one implant failed in osteointegration during the healing phase. 34 implants have been followed-up for more than one year.
The author has succeeded in improving functional results of surgical treatment of the teeth that caused pararadical cysts. This was due to access to the pathologic focus, preservation of the 'causative' tooth root, filling of the residual osseous cavity with formalin-treated allogenic placental transplant. A total of 79 patients were operated on using this method. Late results were followed up for 2 years, no recurrences occurred and functional status of the operated on 'causative' teeth permitted their use as abutment teeth for bridge dentures.
Oral tuberculosis with pulmonary tuberculosis is very rare in Japan. A 45-year old man admitted to our hospital because of spontaneous teeth extraction and pain in oral cavity for the past 3 months. The painful granulation in palate and fistel of 7th tooth root defect in right upper gum were observed. The diagnosis of oral tuberculosis was made by the histological examination of biopsy material and positive smear test for M. tuberculosis in surface of granulation. Chest X-ray showed multicavitary lesions in bilateral upper lobs and spread shadows in bilateral lower lung fields. He was treated with chemotherapy (INH, RFP, SM and EB) and with tube feeding. Five month's chemotherapy was needed to achieve cured granulation and negative smear test for M. tuberculosis in sputum. He was discharged 10 months after admission.
This study confirmed that cervical pulp horns exist in human primary molars as the following results were found: 1. Fifteen cervical pulp horns were observed in the 40 extracted primary molars group (37.5%), 2. Ten cervical pulp horns were observed out of the 26 Indian primary molars group (38.5%), 3. Buccal extension of cervical pulp horns is 0.23 mm in the extracted primary molars group and 0.36 mm in the Indian primary molars group on average, 4. Cervical pulp horns of primary molars tend to be presented bilaterally in the same individual, 5. The percent of occurrence of cervical pulp horns in primary molars (37.6%, 38.5%) was lower than that of the permanent molar (77.1%).
Hemisection as the name implies is the division of a tooth and removal of the unwanted portion thereafter. This technique was performed on a mandibular first permanent molar. An additional advantage of the procedure in the present case was that the impacted second premolar got adequate space to erupt into its occlusion without any further surgical sacrifices of the badly involved carious permanent molar or the impacted premolar itself.
The purposes of the present study were: 1) to assess the microleakage at the cervical margin of Superbond-lined composite restorations with and without a cervical amalgam base and compare the results to cervical margins of composite restorations lined with Scotchbond 2, and 2) to compare the quality of the occlusal margins of Superbond-lined P-50 restorations with those bonded with Scotchbond 2. Forty-eight class 2 cavities were prepared in extracted or exfoliated primary molars. The teeth were randomly divided into three groups and restored as follows: Group A, amalgam + Superbond + P-50 (sandwich); Group B, Superbond + P-50; Group C, Scotchbond 2 + P-50 (control). Marginal leakage was assessed by the degree of dye penetration on sections of the restored teeth. The occlusal margins presented no or minimal leakage (degrees 0 and 1) in 53% of Group A restorations, 60% of Group B, and 44% of Group C. These differences were not statistically significant (P<0.05). The cervical margins showed moderate to severe dye penetration (degrees 2 and 3) in 94% of Group A, 47% of Group B, and 87% of Group C. These differences were statistically significant (P<0.05). The amalgam/Superbond/composite interface exhibited no leakage in 70% of the restorations. Although marginal leakage was not completely eliminated, Superbond exhibited significantly less leakage (P<0.05) at the cervical margins than Scotchbond 2 or amalgam with Superbond.
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.
The reason for a post and core preparation is to provide an anchoring system for a final restoration to the tooth root. This experiment was divided into two groups with the following systems; ExactaCast and Parapost. Casts for these systems were fabricated in photoelastic plastic and cemented with zinc phosphate cement. These photoelastic blocks were placed in a special jig on a universal testing machine. The experiment compared the photoelastic stresses generated for these two systems in two different stress modes; vertically at 30 pounds and obliquely (at a 26 degree angle) at 20 and 30 pounds. Specimens were then photographed after cementation in the unloaded and loaded states. Minimal stresses were observed for the ExactaCast in the unloaded state, while symmetric, even patterns of stresses concentrated coronally were present in the loaded vertical and oblique states. Minimal stresses were observed for the Parapost in the unloaded state, while asymmetric, uneven patterns of stresses concentrated apically were present in the loaded vertical and oblique states. The presence of the multiple tiered system for the Exacta-Cast clearly directs stresses in a symmetric pattern, while the single tiered Parapost system directs stresses in asymmetrical pattern. The symmetric even stresses for the ExactaCast are more favorable than the asymmetric, uneven stresses for the Parapost.
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This study was motivated by the sporadic observation of epiphora in two male rabbits. The epiphora was unilateral and not associated with conjunctivitis or Pasteurella infection. To characterize the cause of epiphora, we studied 15 specific-pathogen-free New Zealand White rabbits. This study group was composed of the two affected males, four unaffected males, and nine unaffected females. Clinical evaluation consisted of bacterial culture of conjunctival specimens, examination of conjunctival scrapings for chlamydial inclusions, culture and cytologic examination of specimens from the nasolacrimal duct, plain and contrast radiography, latex casting, histologic examination, and the Schirmer tear test. Important differences found in the rabbits with epiphora included an opalescent, gritty, nasolacrimal duct flush fluid and marked unilateral dilatation of the duct proximal to a dorsal flexure at the caudal limit of the incisor tooth root. The flush solution from one affected rabbit cleared with ether, suggesting the presence of triglycerides or cholesterol. The organisms most commonly isolated from the conjunctiva were Moraxella sp., Oligella urethralis, Staphylococcus aureus, coagulase-negative Staphylococcus sp., and Streptococcus viridans. The organisms most commonly isolated from the nasolacrimal duct flush fluid were Moraxella sp., S. viridans, and Neisseria sp. Culture of the nasolacrimal duct flush fluid yielded microorganisms more consistently than did culture of the conjunctival specimens. All microorganisms isolated from affected rabbits also were isolated from unaffected rabbits. There was no apparent contribution of microorganisms to the development of epiphora, and Schirmer tear test results for affected animals were within the range seen in unaffected animals. Occlusion of the nasolacrimal duct was presumed to be attributable to fat droplets. This study augments the existing literature and represents the first report of anomalous nasolacrimal duct anatomic features in the rabbit.
The purpose of this study was to evaluate the incidence of accessory canals in the furcation region of human primary second molars. Forty freshly extracted teeth were radectomized and furcations were separated. The severed pulp chamber floors were decalcified and dehydrated. Paraffin embedding followed and cross-cut serial sections were taken from the specimens. Microscopic examination of each section followed. Sixteen out of twenty (80 percent) of the maxillary and fifteen out of twenty (75 percent) of the mandibular primary second molars demonstrated accessory foramina in the furcation area. 17.3 percent of the accessory foramina were found in the pulp chamber floor and 82. 7 percent were observed interradicular, close to the periodontal ligament. Thirty percent of the primary second molars demonstrated accessory canals, running from the pulp chamber to the periodontal ligament. Within the limitations of a microscopic investigation it is assumed that accessory furcation canals might be responsible for interradicular bone pathology in case of pulpal inflammation or necrosis.
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Well-placed implants are a prerequisite to achieving functional as well as aesthetically successful implant-supported restorations. In addition to sufficient bone volume, a precise emergence profile is an important factor in obtaining the optimal result of the final restoration, presenting a natural gingival silhouette. Restorations with a ridge lap design are no longer acceptable. The learning objective of this article is to review implant placement with emphasis on the factors that influence implant position and angulation. Anatomic discrepancies between the natural tooth root and the implant are discussed in context of treatment planning, including the position and direction of the implants, determined by the anticipated prosthetic restorations. The sagittal plane of implant position is reviewed versus horizontal or vertical placement in the anterior as well as posterior region. Function, comfort, access for hygiene, and aesthetics are the four essential requirements for an implant-supported restoration.
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This paper describes delayed development and eruption of the first permanent molars, in most cases only in the upper jaw. The development and eruption of the teeth are chronologically between that of the first and second molars. The anatomy of the aberrant teeth is closest to that of the second molars. The aberrant teeth are often laying at a distance during development from the second primary molars. The clinical implications of the aberrancy are few, because the teeth will normally migrate into close contact with the tooth mesial to them, however, often into a crossbite. Most often the teeth are mistaken to be a first molar with some eruption disturbance and therefore referred for surgical or orthodontic treatment. However, such interception should be avoided because at least in the present cases all teeth are observed to erupt by themselves.