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The mandibular dental arch: Part I, lower incisor position.

The position of the lower incisor with respect to hard tissue references has been evaluated. Two samples were used for this purpose: one containing 78 patients with posttreatment records having a postretention period of at least 4 years, and the other composed of 82 normal occlusions. The results indicated: 1) There was no significant difference in relapse of lower incisor crowding between cases where the lower incisor had been moved lingually, labially, or held in the same relative position during treatment. 2) The position of the maxilla should be considered when placing the lower incisor. The APo plane adequately serves as a guide to this purpose, whereas other reference lines such as mandibular plane or facial plane do not. 3) The positions of the incisors with respect to popular cephalometric reference lines such as APo, NB, or mandibular plane were not correlated with the relapse of mandibular crowding. Therefore, other clinical guides might be more successful for determining stability.

Dental Arch↗

The effect of chronic periodontal disease on human jaw muscles: a pilot study using computed tomography.

Patients with chronic periodontal disease sometimes complain of difficulty in masticating hard foods. Computed tomography (CT) was used to investigate the cross-sectional area (CSA) and density of the masseter and medial pterygoid muscles in a pilot study of 12 healthy female subjects aged 30-39 years. Six subjects (the 'diseased' group) had suffered from chronic periodontal disease and had, on average, 40% bone loss. Their disease had been treated by scaling and root planning and had remained clinically stable for at least 6 months before their inclusion in the study. The six age-matched 'control' subjects had no history of periodontal disease. All bone-loss measurements were evaluated as a percentage of root length. At defined scan planes, sections of both muscles were readily identified. Results from the 'diseased' group as compared with the 'control' group revealed that in the former the CSA of masseter and medial pterygoid was reduced significantly by 25% and 10%, respectively. There were no significant differences in the X-ray density of both muscles between the two groups, which indicated a similar fibro-fatty content. These findings indicate a reduction in the masticatory force that may be utilized by patients with reduced periodontal support and may help explain their masticatory difficulties.

Adult↗

The analysis of frequency of occlusal sounds in patients with periodontal diseases and gnathic dysfunction.

A study is presented of occlusosonograms obtained from healthy subjects and patients with periodontal diseases and gnathic problems. Gnathosonic examinations were carried out by means of a set of equipment whose basic elements were two piezoceramic transducers mounted on a specially made holder and an IBM PC with an ADC card. The evaluation of occlusosonograms was by means of mathematical analysis of the frequency pattern. In pathological stages, the occlusosonograms exhibit more high frequency components. In the case of healthy subjects, the recorded signal took the form of a strong impact of low frequencies and its subsequent exponential decay.

Adolescent↗

Evaluation of pulpal blood flow after tooth splinting of luxated permanent maxillary incisors.

Laser Doppler flowmetry (LDF) is a non-invasive method to assess pulpal blood flow (PBF). Dental injury has been associated with losses of pulpal sensibility. The purpose of this study was to assess whether LDF could be used to detect short- and long-term changes of PBF values of luxated permanent maxillary central incisors after repositioning and splinting. In 18 trauma patients, a single maxillary incisor treated by repositioning and splinting, and the respective contralateral homologous tooth were investigated by LDF to assess local PBF values. Perfusion units (PU) were taken in four sessions: on the day of splint removal, and 12, 24, and 36 weeks after splint removal. Analysis of the luxation type-related PBF measurements revealed intrusion type-related PBF values to be associated with a significant decrease in PBF values (P < 0.05), while lateral luxation and extrusion type-related PBF values showed no significant difference between the session-related values (P > 0.05). PBF measurements did not change over time for the contralateral incisors (P > 0.05). Teeth affected by an intrusion-type luxation injury remained unresponsive to sensitivity testing at follow up, while 3 (60%) developed grey discoloration of the crown. LDF may become useful in the detection of ischemic episodes of luxated maxillary central incisors after repositioning and splinting. Further studies are warranted to assess the validity of post-traumatic 'ischemic episodes' by comparing it to histological tooth pulp changes.

Adolescent↗

Relationship between bleeding time test and postextraction bleeding in a healthy control population.

OBJECTIVE: We sought to determine whether cutaneous bleeding time (BT) is related to bleeding outcome measures after a single tooth extraction. STUDY DESIGN: This was a prospective clinical pilot study of 30 subjects. Cutaneous BT was evaluated before a single tooth extraction. After extraction, an oral BT was determined. Subjects were contacted 3 to 7 hours and 2 days after extraction to assess further postoperative bleeding. RESULTS: The mean cutaneous BT was 5.9 minutes (range 1.5-10.0 minutes). The mean oral BT was 7.5 minutes (range 0-20 minutes). Cutaneous BT did not correlate with oral BT or any of our measures of postoperative bleeding. However, the oral BT correlated with the number of hours of bleeding after surgery (R(s) = 0.54, P =.03). The time necessary to perform the extraction correlated with the extraction site bleeding 3 to 7 hours after surgery (R(s) = 0.67, P =.0006). CONCLUSION: Cutaneous BT did not correlate with measures of postoperative bleeding in the present study, but oral BT immediately after extraction correlated with the duration of subsequent postoperative bleeding.

Adult↗