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PubMed1997

Psychosocial factors and tooth wear with a significant component of attrition.

Pathological tooth wear is often associated with bruxism, which appears in turn to be influenced by psychosocial factors. This study investigated putative relationships between psychosocial factors (total and average perceived stress, state and trait anxiety) and tooth wear, comparing 45 patients exhibiting tooth wear with a significant component of attrition to 45 controls. Groups were matched for gender and age. Subjects completed the Modified and Perceived Stress Scale and the State-Trait Anxiety Inventory. A between-groups multivariate analysis of variance indicated that the two groups did not differ significantly on the combined psychosocial factors, F(4,85) = 1.16, P > 0.05. However, a univariate F-test showed that tooth-wear patients presented significantly more trait anxiety than controls, F(1,88) = 4.15, P < 0.05. Further research is indicated to clarify the importance of trait anxiety and other psychosocial factors in the progression of tooth wear with a significant component of attrition.

Adult↗

PubMed1998

The extracted tooth pontic--provisional replacement during bone graft and implant healing.

When tooth extraction is required, a provisional restoration may be utilized as an interim prosthesis during bone graft and implant healing. The selection of provisional replacement of the anterior teeth following extraction may have a direct influence on the success of the definitive tooth replacement. This article describes a technique for using the extracted tooth or a denture tooth as an interim prosthesis during bone graft and implant healing. This method of provisionalization offers several advantages, including no adjacent tooth preparation, natural appearance, and retention of the papillae.

Adult↗

PubMed2005

Immunolocalization of fibroblast growth factor-2 (FGF-2) in the developing root and supporting structures of the murine tooth.

Epithelio-mesenchymal interactions are active during the development of the root of the tooth and are regulated by a variety of growth factors, such as fibroblast growth factors. FGF-2, 3, 4, and 8 have all been shown to play a role in the development of the crown of the tooth, but less is known about the factors that govern root formation, particularly FGF-2. The aim of this study was thus to elucidate the spatial and temporal expression of FGF-2 in the root of the developing tooth, as this growth factor is believed to be a mediator of epithelio-mesenchymal interactions. Parasagittal sections of the maxillary and mandibular arches of post-natal mice were utilized and the roots of the molar teeth were studied. Immunocytochemistry utilizing an antibody to FGF-2 was performed on sections of teeth at various stages of development. Intense immunostaining for FGF-2 was observed in differentiating odontoblasts at the apical end of the tooth and in the furcation zone of the developing root at all the stages examined. FGF-2 localization was also observed in cementoblasts on post-natal days 16, 20 and 24. The pattern of localization of FGF-2 in the developing root suggests that this growth factor may participate in the signaling network associated with root development.

Ameloblasts↗

PubMed1985

The blood-vessel thrust theory of tooth eruption and migration.

The Blood-Vessel Thrust Theory is a new hypothesis regarding the forces which produce the normal eruption of teeth, and the movement of 'nonerupted' teeth through bone away from their normal position in the jaws. It points out that the flow of blood through the vessels of the dental pulp, and of the tissues surrounding the tooth, must produce hydrodynamic and hydrostatic forces within the blood vessels, and that these forces have a resultant towards the tooth crown, thus causing the tooth to move, crown first, through the bone during normal eruption or abnormal tooth migration.

Humans↗

PubMed1990

Australian aboriginal tooth succession, interproximal attrition, and Begg's theory.

In 1954, P.R. Begg analyzed interproximal attrition as a prehistorically universal mechanism to reduce tooth size. With modern processed diets and the virtual disappearance of constant interproximal attrition, Begg asserted, teeth remain too large for the arches and become crowded. Later investigators have questioned Begg's estimate of attritional tooth-size reduction, as well as aspects of his theory relating the succession sequence of permanent teeth to different malocclusions. The present paper examines the theory using longitudinal casts and records of modern Australian aborigines who are among the first generation lacking notable interproximal attrition thanks to a "modernized" diet. Deciduous and permanent tooth size, arch size, and occlusal relational variables were analyzed with respect to the expected occlusal outcomes in the absence of attritional tooth reduction. Permanent incisor overjet correlated with crowding status, as predicted by Begg. On the other hand, longer teeth did not relate to crowding in general nor to crowding in relevant local areas or during developmental stages. Unfavorable leeway space did not relate clearly to crowding or other malocclusions. Lowered correlations among structures and narrowness of the maxilla related more significantly to malocclusion. These results are in keeping with recent thinking that small jaws rather than large teeth underlie tooth/arch discrepancy.

Australia↗

PubMed2003

A nonlinear finite element analysis of the periodontal ligament under orthodontic tooth loading.

The stressed state of the periodontal ligament (PDL) is understood to play a critical role in the tooth movement initiated by orthodontic treatment. Finite element simulations have been used to describe PDL stresses for orthodontic loading; however, these models have predominantly assumed linear mechanical properties for the PDL. The present study sought to determine the importance of using nonlinear mechanical properties and nonuniform geometric data in computer predictions of periodontal ligament stresses and tooth movements. A 2-dimensional plane-strain finite element model of a mandibular premolar was constructed based on anatomic data of transverse sections of tooth, PDL, and bone from a 24-year-old cadaveric man. A second model was constructed of the same tooth but with a PDL of uniform thickness. Each of these was prescribed linear or nonlinear elastic mechanical properties, as obtained in our own experiments. Predictions of the maximum and minimum principal stresses and von Mises stresses in the PDL were determined for extrusive and tipping forces. The results indicated that biofidelic finite element models predicted substantially different stresses in the PDL for extrusive loading than did the uniform thickness model, suggesting that incorporation of the hourglass shape of the PDL is warranted. In addition, incorporation of nonlinear mechanical properties for the PDL resulted in dramatic increases in the stresses at the apex and cervical margin as compared with the linear models.

Adult↗

PubMed1991

Measuring dental drift and orthodontic tooth movement in response to various initial forces in adult rats.

A method for the quantification of orthodontic tooth movement in the rat is presented. Reliability, sensitivity, and validity were assessed and tooth movement kinetics were determined for initial forces of 20, 40, and 60 gm. The appliance consisted of a 9 mm length of closed coil spring suspended between a cleat and bonded to the occlusal surface of the maxillary first molars and the maxillary incisors. Initial tipping forces were placed by suspending known weights from the anterior end of these coils before fixation to the incisors. Tooth movement was quantified from enlarged cephalograms by measuring the position of a reproducible landmark on the molar cleat with respect to either zygomatic amalgam implants or a barbed broach placed submucosally on the palate. All measurements were made along the molar-incisor vector by projecting at 90 degrees to this line. Validity and sensitivity were assessed by quantifying molar distal drift and comparing these results with reports of bone turnover rates adjacent to distally drifting adult rat molars. Reliability was obtained by estimating the error of a single measurement in a longitudinal study of 12 adult male Sprague-Dawley rats (180 to 200 days) receiving both amalgam and broach implants and a cross-sectional study of 72 animals divided equally into six groups to be killed at 1, 3, 5, 7, 10, and 14 days. No orthodontic forces were used in this portion of the study. Implant stability within the craniofacial complex was assessed by measuring bilateral broaches as a function of time with respect to each other. There were no systematic errors between replicate films for either the amalgam or the broach method. The 95% confidence limit for a single determination of molar position was 62 microns using the amalgams and 47 microns for the broach (p less than 0.001). The latter could be reduced to 23 microns when the average of four independent determinations was used. Homologous implants did not differ with respect to each other in the sagittal plane but did in the transverse plane (p less than 0.01), migrating laterally 9 microns/day. Linear regression analysis of molar distal movement over time predicted 7.7 microns/day distal drift (p less than 0.01), which compared favorably with reports of 6.7 microns/day of alveolar bone turnover during this drifting process. Characteristic three-part cumulative tooth movement kinetics were obtained for the 40 and 60 gm initial force groups. No individual time point at 60 gm differed from its counterpart at 40 gm.(ABSTRACT TRUNCATED AT 400 WORDS)

Analysis of Variance↗

PubMed1995

Etiologic aspects and orthodontic treatment of unilateral localized arrested tooth-development combined with hearing loss.

In this study a case has been presented involving localized, arrested maxillary tooth development, asymmetric maxillary development, and unilateral loss of hearing. No similar case seems to have been described before. The orthodontic treatment comprised extraction of four permanent tooth germs in the maxilla and autotransplantation of mandibular teeth, followed by the use of fixed orthodontic appliances and a one-unit bridge restoration. Etiologic aspects are discussed. It is suggested that a severe attack of mumps that involved massive swelling of the parotid glands immediately after chicken pox and measles at the age of 4 to 5 years, may have resulted in a neurologic reduction of hearing and arrested tooth development. The teeth in which root development in relation to mumps does not appear to have been reported previously, whereas hearing loss after mumps has been reported. In the search for verification of this possible connection, children with arrested tooth development should be examined for reduction of hearing, and children with hearing loss after mumps ought to have their dental development checked.

Bicuspid↗

PubMed2002

Tooth loss and pocket probing depths in compliant periodontally treated patients: a retrospective analysis.

BACKGROUND/AIMS: This retrospective study determined the treatment outcomes of 142 compliant periodontal patients observed for at least 10 years at the University of Kiel. All patients had been treated for moderate to advanced periodontitis and regularly received supportive periodontal therapy (SPT). METHODS: Patient- and tooth-related variables [tooth loss and pocket probing depth (PPD)] were analysed. RESULTS: Of a total of 3353 teeth, 167 were extracted during active treatment and 99 during SPT, mainly for periodontal reasons. Forty-five per cent of the patients did not lose any teeth during 11.7 years of observation. Thirty-seven per cent underwent extractions during active treatment or SPT, 18% both during active periodontal therapy and SPT. Mean tooth loss per patient was 0.07 teeth/year during SPT. Mobility, furcation involvement, smoking, and prescription antibiotics had a negative impact on prognosis. Intraindividual differences in PPD were significant between single- and multirooted teeth with initial PPD > or = 4 mm at baseline, following active treatment and at the end of SPT, and between firm and mobile teeth at baseline. Interindividual differences in mean PPD were only significant between smokers and non-smokers at the end of the observation period. CONCLUSIONS: Long-term maintenance of our patients was effective. Periodontal disease represented the major cause of tooth loss in a minority of the population.

Adult↗

PubMed2005

Tooth wear in the mixed dentition: a comparative study between children born in the 1950s and the 1990s.

The aim of this study was to evaluate the degree of tooth wear in posterior deciduous teeth of 100 subjects in the second phase of mixed dentition who were born in the 1950s (50sG) and 100 subjects born in the 1990s (90sG). The degree of abrasion for each posterior deciduous tooth was scored ranging from 0 to 3. The comparison of the degree of abrasion showed significant differences between the two groups for all examined teeth (upper and lower deciduous canines and first and second primary molars) all of which appeared to be more abraded in the 50sG. The findings of the present study indicate that subjects who were born in the 1950s exhibited a significantly greater degree of tooth wear on the posterior deciduous teeth when compared with contemporary subjects, along with a well-recognized lower prevalence of malocclusions. Changes in dietary habits and a diet based on processed foods may be postulated as factors involved with a decrease of dental attrition in contemporary populations. An increase in the prevalence of mouth breathing (tested in the present study) appears to be associated with a decrease in tooth wear in the contemporary population as well.

Child↗

PubMed2002

Incomplete tooth fracture following root-canal treatment: a case report.

AIM: To demonstrate the need for proper restoration of root-filled teeth. SUMMARY: Tooth fracture can be a sequel to root-canal treatment. It is associated with the removal of excessive amounts of the tooth substance during the instrumentation phase, the use of unnecessary force during obturation, or inadequate planning of the design of the eventual coronal restoration to include appropriate cuspal protection. Rarely, a fracture may be present in a tooth before treatment commences, but remains undetected. A case describing incomplete vertical tooth fracture of a root-filled mandibular first molar is presented.

Adult↗

PubMed2003

The effect of fluorides and caries in primary teeth on permanent tooth emergence.

This study addressed two questions: (i) is there an effect of exposure to fluorides on the timing of emergence of permanent teeth? and (ii) can a difference in timing of tooth emergence be explained by the impact of fluorides on the caries experience of the predecessors? Data were obtained from a long-term follow-up study of the oral health condition in a sample of 4468 Flemish children. Survival analyses with log-logistic distribution were performed to calculate median emergence ages and 95% confidence intervals; four fluoride exposure parameters (fluorosis, use of systemic fluoride supplements, age at which tooth brushing started and frequency of tooth brushing) and caries experience were taken as covariates in the model. The present study indicates that the impact of any of the four fluoride exposure parameters on permanent tooth emergence was relatively minimal. Caries experience in the primary molars had a more pronounced impact on the timing of emergence of the successors than exposure to any of the four fluoride parameters.

Age Factors↗

PubMed2000

Tooth anomalies associated with failure of eruption of first and second permanent molars.

The occurrence of tooth anomalies in association with failure of the first and second molars to erupt was assessed in a sample of 1520 nonsyndromic subjects with uncrowded dental arches (mean age, 14 years 4 months) and compared with the prevalence rate calculated in a matched control group of 1000 subjects. The tooth anomalies examined included infraocclusion of deciduous molars, palatal displacement of maxillary canines, rotation of maxillary lateral incisors, aplasia of second premolars, and small size of maxillary lateral incisors. Associations among arrested eruption of first and second permanent molars and anomalies in tooth eruption and position (infraoccluded deciduous molars, palatally displaced canines, rotated maxillary lateral incisors) were highly significant (P <. 001). No significant association was found among the occurrence of molar eruption disturbances, aplasia of premolars, and small-sized laterals. These findings point to a common biologic cause for the appearance of failure of eruption of molar teeth and other disturbances in tooth eruption and position, most likely under genetic influence.

Adolescent↗

PubMed2004

Deletion of dentin matrix protein-1 leads to a partial failure of maturation of predentin into dentin, hypomineralization, and expanded cavities of pulp and root canal during postnatal tooth development.

The dentin matrix protein-1 (DMP-1) gene is identified in odontoblasts during both embryonic and postnatal development. In vitro study suggests that this noncollagen acidic phosphoprotein plays a role in mineralization. However, deletion of the Dmp-1 gene has little effect on tooth development during embryogenesis. To address the role of DMP-1 in tooth during postnatal development, we analyzed changes of dentinogenesis in Dmp-1 null mice from 3 days after birth to 1 year. Here we show that Dmp-1 null mice postnatally develop a profound tooth phenotype characterized by a partial failure of maturation of predentin into dentin, enlarged pulp chambers, increased width of predentin zone with reduced dentin wall, and hypomineralization. The tooth phenotype of these mice is strikingly similar to that in dentin sialophosphoprotein (Dspp) null mice and shares some features of the human disease dentinogenesis imperfecta III. We have also demonstrated that DSPP levels are reduced in Dmp-1 null mice, suggesting that DSPP is probably regulated by DMP-1 during dentinogenesis. Finally, we show the absence or delayed development of the third molar in Dmp-1 null mice, which is probably secondary to defects in Dmp-1 null bone. Taken together, these studies suggest that DMP-1 is essential for later dentinogenesis during postnatal development.

Animals↗

PubMed1994

The fate of developing teeth in facial trauma: tooth buds in the line of mandibular fractures in children.

Mandibular fractures in children present the surgeon with a unique set of considerations. Tooth buds within the body and ramus of the mandible restrict the type of surgical intervention that may be used. In addition, the fate of nonerupted dentition in the direct line of the fracture remains unclear. Between July 1985 and June 1990, 30 patients in deciduous or mixed dentition presented with a total of 45 mandibular fractures. Of these 45 fractures, 33% (n = 15) involved 16 nonerupted teeth. Age at the time of fracture was 6.0 +/- 2.3 years (mean +/- SD). Thirty-three percent of patients were treated with open reduction and internal fixation of fractures; 67% of patients were treated with closed reduction and either intermaxillary fixation or a lingual splint. Normal eruption was exhibited by 82% (n = 9) of the tooth buds in the line of mandibular fracture. The results of this study indicate the following: (1) Mandibular fractures in children involve unerupted teeth directly in one-third of cases. (2) The majority of tooth buds (82%) in the line of mandibular fractures eventually erupt normally. And (3) a significant percentage of dentition (18%) may exhibit either delayed eruption or noneruption with resorption of the tooth bud if directly involved in the line of fracture.

Child↗

PubMed2004

Development of methods to enhance extrinsic tooth discoloration for comparison of toothpastes. 2. Two-product clinical study.

BACKGROUND: Extrinsic staining of teeth is considered to be unsightly and a number of 'whitening' toothpastes have been formulated to inhibit or remove such tooth discoloration. The aim of this study was to compare the stain prevention of two toothpastes. METHOD: The study was a single-blind, randomised, placebo-controlled, crossover design, balanced for residual effects involving 24 healthy dentate volunteers. The treatments were as follows: (1) a whitening toothpaste product, (2) an experimental toothpaste formulation and (3) water. For each 4-day rinse period, subjects were rendered stain free on the teeth and tongue. Approximately on the hour from 09:00 to 16:00 hours, subjects rinsed with chlorhexidine mouth rinse for 1 min followed by warm black tea for 1 min. The treatment interventions were at 09:00 and 16:00 hours and before the chlorhexidine rinse. The toothpastes were rinsed as 3 g/10 ml water slurries and water as a 10 ml rinse each for 2 min. On day 5, subjects were scored for tooth and tongue stain intensity and area, and the product of these was calculated. The washout period was at least 9 days. RESULTS: Treatment differences for the teeth were highly significant but not for the tongue. Paired contrasts for tooth stain intensity, area and product were mostly all significantly in favour of reduced staining by the experimental formulation compared with water and the whitening product. There were no significant differences between water and the whitening product. CONCLUSIONS: Using a forced dietary staining method, the data support a tooth stain-inhibitory/-removal action for the experimental formulation, but not the whitening product.

Adult↗

PubMed2004

Patient experience of, and satisfaction with, delayed-immediate vs. delayed single-tooth implant placement.

OBJECTIVES: Recent investigations have focused on patients' subjective assessment of implant treatment. The aim of this study was to compare the patients' experience of surgical and prosthetic procedures, as well as satisfaction with function and aesthetics following single-tooth replacements mounted to early vs. delayed placed dental implants. MATERIAL AND METHODS: Forty-six patients were treated with a single-tooth implant in the anterior or premolar region. Twenty-three implants were placed on average 10 days after tooth extraction (Im), while 23 implants were placed approximately 3 months after tooth extraction (De). Forty-one patients completed a questionnaire regarding the treatment using visual analog scales (VAS) and check boxes 16-18 months after delivery of the restoration. RESULTS: In all, 90% of the respondents rated 88 or higher on the VAS regarding satisfaction with the crown. Satisfaction with the restoration in general and the appearance was significantly greater in the Im group than in the De group (96 vs. 93; P<0.02). Assessment of the implant surgery was not significantly different between the delayed-immediate and the delayed group. Approximately 25% of the patients experienced unpleasantness in relation to the prosthetic procedures, and in 8 of 11 cases, impression taking was the cause. When evaluating satisfaction with the overall implant treatment, the VAS scores for the delayed-immediate group were significantly higher than for the delayed group (96 vs. 90; P<0.02). CONCLUSION: The patients in the present study were highly satisfied with the outcome of the treatment and experienced it to be without significant unpleasantness irrespective of the treatment concept.

Adult↗

PubMed2005

Clinical and radiographic performance of delayed-immediate single-tooth implant placement associated with peri-implant bone defects. A 2-year prospective, controlled, randomized follow-up report.

OBJECTIVES: The aim of the present study was to compare the delayed-immediate (Im) and the delayed (De) protocols for placement of single-tooth implants. MATERIAL AND METHODS: After allocation to the Im and De groups by random, 46 patients were treated with a single-tooth implant with acid etched surfaces (Osseotite) in the anterior or pre-molar region of the maxilla or the mandible on average 10 days (Im) or 3 months (De) following tooth extraction, respectively. Forty-one patients attended a follow-up visit 2 years after implant placement corresponding to 1(1/2) years of loading of the implant restorations. Peri-implant and prosthetic parameters were evaluated clinically and marginal bone levels measured on radiographs. RESULTS: Three implants were lost, all before mounting of the crown. None of the implant restorations had failed after 1(1/2) years of function. Probing pocket depths were reduced by up to 1.4 mm on average from the time of loading to the 2-year follow-up and at that time, no significant difference between the Im and De groups was found (4.2 versus 4.1 mm). A statistically significant radiographic marginal bone loss had occurred in the Im group (mean=0.8 mm) as well as in the De group (mean=0.7 mm) in the follow-up period. However, a mean marginal bone level of approx. 1.5 mm in both groups measured from the implant-abutment junction was found to be acceptable. It was demonstrated that probing pocket depths and marginal bone levels after 1(1/2) years of loading of the implant-retained crowns were not influenced by the presence of peri-implant bone defects immediately after implant placement. Furthermore, no severe prosthodontic complications, such as screw loosening or porcelain fractures, arose in this study material. CONCLUSION: High success rates of single-tooth implants after 1(1/2) years of function were achieved using the delayed-immediate and delayed implant placement techniques.

Alveolar Bone Loss↗