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Dental cervical lesions associated with occlusal erosion and attrition.

Acid demineralization of teeth causes occlusal erosion and attrition, and shallow and wedge-shaped cervical lesions putatively involving abfraction. From 250 patients with tooth wear, 122 with cervical lesions were identified. From epoxy resin replicas of their dentitions, associations of occlusal attrition or erosion or no wear with cervical lesions were recorded at 24 tooth sites (total 2928 sites). Criteria used to discriminate occlusal attrition from erosion, and shallow from grooved, wedge-shaped or restored cervical lesions were delineated by scanning electron microscopy. A 96 per cent association was found between occlusal and cervical pathology. Shallow cervical lesions were more commonly found in association with occlusal erosion. Wedge-shaped lesions were found equally commonly in association with occlusal erosion, as with attrition. Grooved and restored cervical lesions were uncommon. Differences were appreciated in the associations within incisor, canine, premolar and molar tooth sites which related more to the site-specificity of dental erosion than to attrition from occlusal forces. Non-carious lesions on teeth then have multifactorial aetiology and pathogenesis in which erosion and salivary protection play central roles. Dentists should primarily consider erosion in the diagnosis, prevention and treatment of tooth wear.

Adolescent↗

[Histological aspects of tooth bleaching technics].

The chemical principles of tooth bleaching are detailed in order to analyze scanning microscopy data obtained following internal and external bleaching tooth bleaching appears harmless to the enamel structure providing no etching is applied prior to bleaching. Previous enamel undermining appears to increase the porosity along preexisting cracks. Internal bleaching gives way to enamel and dentinal demineralization, which is of particular importance at the dento enamel junction. The biological effects of bleaching on dental hard tissues must be viewed in light of the clinical indications for these procedures.

Adult↗

Characteristics of a fluoride-releasing elastomeric chain.

The physical properties and fluoride releasing capabilities of a recently introduced fluoride-containing elastomeric chain (Fluor-I-Chain) have been evaluated and compared to those of a standard gray elastomeric chain. When stored in solution, there was a progressive loss of the force delivered by both types of chains. In particular, they both required increased displacement to achieve force levels of 150g and 300g but the fluoride chain required significantly more displacement to achieve the same force level. When maintained at a constant distraction of 100%, Fluor-I-Chain was unable to deliver a force within the optimal range for tooth movement after one week. In contrast, the force delivery level of the standard gray chain remained adequate over the entire three-week test period. Fluoride was released by the fluoride-containing chain over a three-week period at a level that could inhibit demineralization and promote remineralization.

Analysis of Variance↗

[The ultrastructure of the circumpulpal dentin of the human tooth].

Ultrastructure of cellular and extracellular constituents of the predentin and adjacent strip of dentin was investigated in both erupted and unerupted but completely shaped third molars of human adults using cautious fixation and demineralization techniques. The odontoblast processes (OP) were slightly bent at their bases to run further straight and parallel to each other across dentin and predentin. The OP cytoplasm contained numerous microfilaments and solitary microtubules. Occasional mitochondria, lysosomes, microvesicles, lipid globules and endoplasmatic reticulum profiles could be found throughout the whole length of the OP under study. Axons and their terminals of apparently efferent type attached to some of the OPs were found in both dentin and predentin. A great bulk of dentin was occupied with the collagen fibers intermingled with the amorphous matrix and occasional dense precipitates next to dentin. Intensive mineralization was found in dentin except the spaces occupied by dentin canaliculi.

Adult↗

Structural changes in the dental and periodontal tissues of the rat incisor following application of orthodontic loads.

The present study deals with the morphometric changes in the loaded rat incisor and its supporting structures 3 months after load removal. The material examined was limited to that part of the tooth that is located between 8 and 20 mm from the tooth apex. Of the ten albino rats in whom laterointrusive loads (19 +/- 0.6 g) were applied to the lower left incisor for a period of 2 weeks, the rate of tooth eruption returned to normal in four animals (group A); in six rats, eruption remained grossly impaired (group B). These two groups were compared with a control group of four rats in whom the incisors were allowed to erupt normally during the 3 months of the experiment. The left mandibles were dissected and fixed; the incisors were demineralized, embedded in paraplast, and cut into transverse serial sections of 6 micron, which were used to produce a three-dimensional reconstruction of all tissue components by means of computerized histomorphometry. The parameters of pulp and dentin, and the total tooth size and shape in group A were similar to those of the control group. In group B, pulp and dentin were changed significantly, tooth size increased, and the oval shape was altered into a more rounded contour, together with a significant enlargement of the socket. Although the total PDL volumes remained similar in all three groups, the tooth/socket relation, as expressed by PDL width and PDL area at the different tooth sides and at varying distances from tooth apex, diverged from normal significantly in all teeth that had been subjected to loading.

Alveolar Process↗

Root and canal morphology of Thai mandibular molars.

AIM: To investigate the root and canal morphology of 351 mandibular permanent molars collected from an indigenous Thai population. METHODOLOGY: The cleaned teeth were accessed, the pulp dissolved by sodium hypochlorite under ultrasonication and the pulp system injected with Indian ink. The teeth were rendered clear by demineralization and immersion in methyl salicylate. The following observations were made: (i) number of roots and their morphology; (ii) number of root canals per tooth; (iii) number of root canals per root; (iv) root canal configuration in each root using Vertucci's classification, with additional modifications; and (v) presence and location of lateral canals and intercanal communications. RESULTS: Of 118 mandibular first molars, 13% had a third disto-lingual root. In three-rooted teeth, 80% of the main distal roots and 100% of the disto-lingual roots had type 1 canal systems. Of 60 mandibular second molars, 10% had C-shaped roots, the majority of which had type 1 (33%) or type IV (33%) canal systems. Of 173 third molars, 68% had two separate roots, 20% had fused roots and 11% had a single C-shaped root; the majority had two canals (61%). CONCLUSIONS: This study suggests that Thai molars exhibit features of both Caucasian and Chinese teeth.

Asian People↗

A two-year comparison of resin-based composite tunnel and Class II restorations in a randomized controlled trial.

PURPOSE: To evaluate the performance of total tunnel restoration with resin-based composites compared to Class II resin-based composite restorations in a randomized controlled clinical study. METHODS: 63 approximal carious lesions were restored in 38 patients by two experienced operators. The carious dentin and approximal demineralized enamel were completely removed for the tunnel restoration leaving the marginal ridge intact. The occlusal opening was enlarged to the center of the tooth to make access easy. Conservative cavity preparation was performed for the Class II restorations. All cavities were restored with Scotchbond Multipurpose Plus and Z250. At baseline, 1- and 2-year recalls, the restorations were evaluated clinically by two examiners using a modified USPHS rating system and radiographically for recurrent, caries. RESULTS: Both types of restorations performed well clinically, and there was no significant difference (P> 0.05) by the chi square test in any category. Recurrent caries was not detected. Only one tunnel restoration had to be replaced with a Class II restoration because of falling of the restoration with the marginal ridge after 2 years. However, no significant difference in the survival rates (P> 0.05) could be demonstrated between the restorations by the log-rank test.

Adult↗

Microporous dentin zone beneath resin-impregnated layer.

The purpose of this study was to investigate marginal microleakage by examining the resin/dentin interface using a cryo-SEM and a silver ion penetration method. Class 5 cervical cavities were restored using an adhesive resin system following treatment with 37% phosphoric acid gel. The cavity wall adaptation was observed using cryo-SEM to avoid specimen damage. This observation showed excellent marginal adaptation of material to cavity walls and no gap formation. However, silver ions had penetrated beneath the resin-impregnated layer when observed with conventional SEM images, which showed the leakage of silver ions between the resin and decalcified tooth structure without gap formation. This study suggests that the bonding monomers of Clearfil Photo Bond were not fully able to penetrate into the demineralized dentin after phosphoric acid etching, thus leaving a porous zone as a microleakage pathway beneath the resin-impregnated layer.

Acid Etching, Dental↗

Sinus augmentation for single-tooth replacement in the posterior maxilla: a 3-year follow-up clinical report.

A technique for single-tooth sinus lift and simultaneous implant placement in the posterior maxilla is presented. Ten hydroxyapatite-coated cylindric implants, 13 to 15 mm in length, were placed together with a composite bone graft of demineralized freeze-dried bone allograft and autogenous bone in 10 adults. Surgical technique and anatomic considerations are discussed. Follow-up of 3 years showed successful function and no cervical bone loss in all patients.

Adult↗

Immunolocalization of gamma-carboxyglutamic acid-containing proteins in developing molar tooth germs of the rat.

The localization of dentin gamma-carboxyglutamic acid containing proteins (DGP's) was examined in rat molar tooth germs at various stages of development by immunostaining with the peroxidase-antiperoxidase method. Odontoblasts and their processes stained positive, whereas all other cells were negative. No staining was found in predentin. Dentin stained only after a mild demineralization. The results support the concept that DGP's are deposited by odontoblasts directly into the mineralizing dentin.

1-Carboxyglutamic Acid↗

Cementum annulation and age determination in Homo sapiens. II. Estimates and accuracy.

The cementum annulation aging technique was evaluated in a sample of 80 clinically extracted premolars (age range 11-70 years). Demineralized thin sections (7 micron) stained with hematoxylin were used. The correlation (r) between age and adjusted count (number of annulations added to age of tooth eruption) was 0.78 for the entire sample (N = 73) and 0.86 for a subsample in which teeth with periodontal disease were excluded (N = 55). Standard error of the estimates ranged from 4.7 to 9.7 years depending on sex and health status of the tooth. The technique provided significantly better estimates for females than for males. The overall inaccuracy (mean absolute error) of the technique was 6.0 years, with a bias (mean error) of 0.26 years. Reduced major axis regression of adjusted count on age produced a slope of 0.797 for the entire sample and 0.889 for the nonperiodontal disease subsample. These slopes are consistent with a hypothesis of annual deposition of cementum rings given a decrease in cementogenesis with increasing age.

Adult↗

Fluoride uptake in situ after the use of dental floss with fluoride.

The possibility of having a commercial product such as waxed floss with an additional agent for controlling and preventing caries is promising. The aim of this research was to determine the uptake of fluoride on tooth enamel in situ after the utilization of a dental floss with fluoride incorporated into the wax. One hundred blocks of bovine enamel were artificially demineralized and randomly separated into a Control Group (C) and a Test Group (T). The dental blocks in group T were mounted two-by-two simulating proximal contacts and were fixed into intra-oral lower arch devices. Eight volunteers with a similar salivary flow and buffer capacity wore devices with the enamel blocks for eight days. During this period of time the subjects applied a 25 cm long portion of a mint waxed floss with fluoride (0.15 mgF/m, Oral-B) between the blocks, 3 times a day for 2 minutes after each meal. At the same time, brushing was carried out with a fluoride-free toothpaste. The alkali-soluble fluoride (CaF2) formed on the enamel was extracted using the Caslavska et al. method and measured with the Orion 96-09 electrode-specific and the EA 720 ion analyzer. The results showed that the group that had the most CaF2 on the enamel (median, minimum and maximum in microF/cm2) was Group T (3.00, 2.11 and 4.00), which differed significantly (p < 0.01) from group C (0.26, 0.10 and 0.69). It was concluded that fluoride uptake on enamel was 11.54 times higher after use of dental floss with fluoride in this study.

Adult↗