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The detection and prevalence of reactive and physiologic sclerotic dentin, reparative dentin and dead tracts beneath various types of dental lesions according to tooth surface and age.

The pulpo-dentinal complex responds to external injuries with dentin sclerosis (DS), dead tracts (DT), or reparative dentin (RD). This investigation correlates the prevalence of these responses with age, sex, type and surface location of tooth lesions (caries, restorations, attrition, abrasion and erosion) utilizing ground sections, microradiographs and decalcified paraffin-embedded tooth sections treated with the Pollak trichrome stains (270 teeth from 113 patients). The main response to caries, restorations and erosion was DS, followed by RD and DT. DS, RD and DT occurred equally in any tooth, on any tooth surface and even beneath the same lesion. DS did not necessarily prevent RD. Root and furcation DS and RD in the floor of the pulp chamber and root canals were unrelated to particular lesions but did relate to increasing age. Root DS extended from apical to cervical area with increasing age. Beneath caries and restorations DS and RD were more prevalent in males, but DT was more prevalent in females. Pollak staining of decalcified paraffin sections for DS was approximately 80% as accurate as ground sections and microradiography. In pulp studies, where the result is contrary to previous experience, the Pollak stains reveal whether DS has decreased dentin permeability.

Adolescent↗

Developmental arrest of tooth bud after correction of mandibular fracture.

A case of multiple fractures of the mandible following a car accident in a five-year-old patient is reported. The fracture line passed distal to the first molar tooth bud. The fracture was treated by wire osteosynthesis and skeletal fixation. During the ensuing 18 months, a gradual arrest of the development of the first molar tooth bud was radiologically observed. The eruption process had not been disturbed, and the tooth erupted at the age of 6 1/2 years. Since the distal root had completely failed to develop and the mesial roots showed a diminished size, the tooth was extracted. Histopathological examination revealed disturbed dentin apposition, there was almost complete obliteration of the pulp chamber by globular dentin, and evidence of root resorption.

Child, Preschool↗

Prevalence and side preference for tooth grinding in twins.

BACKGROUND: Estimates of the prevalence of tooth grinding in children range considerably, reflecting different methods of recording. The main aims of this study were to determine the prevalence of tooth grinding in monozygotic (MZ) and dizygotic (DZ) twin pairs by assessing wear faceting on the primary canines, and to compare the faceting on the right and left to determine whether children have a side preference for grinding. METHODS: The sample consisted of 116 MZ twin pairs and 124 dizygous DZ twin pairs, all participants in an ongoing study of dento-facial development at the dental schools in Adelaide and Melbourne. Evidence of wear faceting on primary maxillary and mandibular canine tips was recorded from dental casts, and the side with the larger wear facet recorded. Types of occlusal relationship, handedness, zygosity and gender were also recorded, and associations between variables analysed statistically. RESULTS: Canine tip wear facets were found in 100 per cent of the sample, and grinding was lateralized in 59 per cent of children. MZ twin pairs showed a higher discordance for grinding side preference than DZ twin pairs (33.8 per cent compared with 16.8 per cent), providing evidence of a mirror-imaging effect for grinding side preference. There was no strong evidence that individuals had the same preference for grinding side and handedness, although right-handers (RH) showed a preference for a grinding side more often than non-right-handers (NRH) (63.6 per cent compared with 51.2 per cent), consistent with previous findings that RHs display more cerebral lateralization than NRHs. CONCLUSIONS: Tooth grinding appears to be a universal phenomenon in children and is commonly expressed more on one side than the other. The significantly higher discordance for grinding side preference in MZ twin pairs compared with DZ twin pairs may reflect a mirror-imaging effect in the former. However, at present we have no evidence to suggest that handedness and preferred tooth grinding side are associated.

Adolescent↗

Tooth wear: diet analysis and advice.

Diet analysis and advice for patients with tooth wear is potentially the most logical intervention to arrest attrition, erosion and abrasion. It is saliva that protects the teeth against corrosion by the acids which soften enamel and make it susceptible to wear. Thus the lifestyles and diet of patients at risk need to be analysed for sources of acid and reasons for lost salivary protection. Medical conditions which put patients at risk of tooth wear are principally: asthma, bulimia nervosa, caffeine addiction, diabetes mellitus, exercise dehydration, functional depression, gastroesophageal reflux in alcoholism, hypertension and syndromes with salivary hypofunction. The sources of acid are various, but loss of salivary protection is the common theme. In healthy young Australians, soft drinks are the main source of acid, and exercise dehydration the main reason for loss of salivary protection. In the medically compromised, diet acids and gastroesophageal reflux are the sources, but medications are the main reasons for lost salivary protection. Diet advice for patients with tooth wear must: promote a healthy lifestyle and diet strategy that conserves the teeth by natural means of salivary stimulation; and address the specific needs of the patients' oral and medical conditions. Individualised, patient-empowering erosion WATCH strategies; on Water, Acid, Taste, Calcium and Health, are urgently required to combat the emerging epidemic of tooth wear currently being experienced in westernised societies.

Alcoholic Beverages↗

Development of horizontal tooth wear in maxillary anterior teeth from five to 18 years of age.

Sizes of horizontal wear facets of maxillary anterior teeth were studied longitudinally from the primary dentition at age five to the young adult dentition at the age of 18 years. By a planimetric method, we calculated the wear areas on dental casts taken at the ages of five, ten, 14, and 18 years from the dentition of 39 healthy, orthodontically untreated subjects with good morphological occlusion. For young adults, we also studied the association between the amount of wear and reported parafunctions, maximal bite force, salivary buffer capacity, salivary flow rate, and some cephalometric variables. Size of wear facets on all anterior teeth increased with age. Significant correlations were found between the total wear areas of the six anterior primary teeth at five years of age and those of their permanent successors at age 14 (r = 0.44) and 18 (r = 0.39). For an individual, tooth wear at five years of age was, however, of low predictive value for tooth wear in young adulthood, whereas tooth wear at 14 years of age predicted it well (r = 0.89). Highest correlations between tooth wear and background factors at 18 years of age were found for maximal anterior bite force (r = 0.44) and for the size of the gonial angle (r = -0.31). Wear of anterior teeth was not associated with reported parafunctions in young adulthood.

Adolescent↗

Predictable periimplant gingival esthetics: use of the natural tooth as a provisional following implant placement.

UNLABELLED: Maintaining the interdental papilla and bone height following implant placement has been a challenge for the restorative dentist. Bone resorption following anterior tooth extraction is common and often compromises the esthetics of the final restoration. The tissue must be maintained during the surgical and healing phases to achieve an esthetic outcome. Using the patient's natural tooth as a provisional can help maintain the volume and support the papilla. This article describes a technique to achieve maximum esthetics and preservation of tissue following tooth extraction and implant placement. CLINICAL SIGNIFICANCE: By using the patient's extracted natural tooth, the tissue should maintain itself with minimal recession. This will allow for a more esthetic outcome.

Dental Abutments↗

Etiology and diagnosis of tooth wear: a literature review and presentation of selected cases.

PURPOSE: This article presents an overview of etiologies associated with tooth wear. MATERIALS AND METHODS: Specific types of wear based on clinical findings and patient history are described. RESULTS: The occurrence and pattern of tooth wear are related to cultural, dietary, occupational, and geographic factors. Examples of tooth wear related to these factors with regional specificity are presented. CONCLUSION: The dental practitioner should recognize the characteristic signs of tooth wear, as they may be the first to discuss the problem with the patient. Management should be based on accurate diagnosis.

Adolescent↗

A literature review of the techniques to measure tooth wear and erosion.

This paper reviews methods to measure tooth wear especially those more recently introduced as a result of improvements in technology. The review searched methods to measure tooth wear and dental erosion from large epidemiological investigations, in vitro and in vivo studies. There seems to be wide variation in techniques used to measure tooth wear and erosion. In vitro techniques may have little direct clinical relevance but can lead to new and more accurate clinical methods. In vivo studies have problems with reference points and accurate validation of the techniques. There is a need for a simple, reliable technique to quantify tooth wear due to erosion.

Diagnostic Imaging↗

Maintenance of tooth color after prophylaxis: comparison of three dentifrices.

Pellicle rapidly accumulates on tooth surfaces after prophylaxis and may acquire cosmetically unacceptable levels of stain. A three-month clinical trial was conducted to evaluate stain prevention by a new silica-based tartar control whitening dentifrice (Crest Extra Whitening) compared to marketed tartar control baking soda peroxide whitening and regular dentifrice controls. Prior to the trial, a one-month screening exercise was conducted to identify adult subjects who accumulated extrinsic tooth stain after dental prophylaxis. A total of 672 subjects were stratified based on tooth whiteness, gender and tobacco usage, then given a dental prophylaxis and randomized into one of three dentifrice treatment groups. All product use was unsupervised. Change in tooth whiteness (delta L*) was determined by comparing colorimeter measurements collected on the facial surfaces of the four central incisors at months 1 and 3 to baseline. Ninety-six percent of subjects completed the three-month study. At both one and three months, the two whitening dentifrices did not differ from baseline in terms of delta L*. In contrast, the regular control had delta L* values of -0.26 and -0.39 at one and three months, respectively, differing significantly from baseline at both time points. Each of the whitening dentifrices differed statistically from the regular control in stain accumulation (p < or = 0.001) at one and three months, but were not different from each other. In general, all three test dentifrices were well tolerated. These data demonstrate the effectiveness of the new tartar control whitening dentifrice in preventing stain accumulation after dental prophylaxis compared to the marketed regular dentifrice control.

Adult↗

[Tooth wear. Classification and terminology].

Tooth wear rarely occurs as a result of one factor alone. Non-carious loss of tooth tissue can be subdivided into attrition, demastication, abrasion, fractionation, and erosion. Clinically, the tooth tissue loss may result from any combination of these types of wear. The first essential principle in the management of tooth wear is, as far as possible, to remove the cause. Secondly, restoration may be indicated.

Adult↗

Absence of apical resorption during orthodontic treatment on a tooth with a complicated crown fracture and root canal treatment: a case report.

Root resorption often occurs after tooth trauma and may also occur during orthodontic tooth movement. This has been attributed to bacteria and inflammation or a combination of both aetiologies. The literature suggests that root canal treatment performed on a traumatized tooth that will concurrently or subsequently undergo orthodontic tooth movement may forestall the resorptive process. This case report provides evidence for this prevention and discusses the hypothesis for the absence of resorption on root-treated teeth.

Adolescent↗

The role of erosion, abrasion and attrition in tooth wear.

There is increasing clinical awareness of erosion of enamel and dentine by dietary acids and the consequent increased susceptibility to physical wear. Enamel erosion is characterized by acid-mediated surface softening that, if unchecked, will progress to irreversible loss of surface tissue, potentially exposing the underlying dentine. In comparison, dentine erosion is less well understood as the composition and microstructure are more heterogeneous. Factors which affect the erosive potential of a solution include pH, titratable acidity, common ion concentrations, and frequency and method of exposure. Abrasion and attrition are sources of physical wear and are commonly associated with tooth brushing and tooth-to-tooth contact, respectively. A combination of erosion and abrasion or attrition exacerbates wear; however, further research is required to understand the role of fluoride in protecting mineralized tissues from such processes. Abrasive wear may be seen in a wide range of patients, whereas attritive loss is usually seen in individuals with bruxism. Wear processes are implicated in the development of dentine hypersensitivity. Saliva confers the major protective function against wear due to its role in pellicle formation, buffering, acid clearance, and hard tissue remineralization. This review focuses on the physiochemical factors impacting tooth wear.

Dental Enamel↗

Simultaneous bleaching of vital teeth and an open-chamber nonvital tooth with 10% carbamide peroxide.

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of bleaching a nonvital tooth with an open pulp chamber while simultaneously bleaching the other vital teeth with 10% carbamide peroxide. METHOD AND MATERIALS: Ten discolored nonvital teeth were treated. Each nonvital tooth was prepared as in the conventional "walking bleaching" fashion, so that the gutta-percha was sealed from the pulp chamber. The 10% carbamide peroxide was injected into the chamber of the nonvital tooth and loaded into the custom-fitted tray for all teeth. The nonvital teeth were bleached from both the inside and the outside. The patient closed the orifice with a cotton pellet during the day and changed the cotton pellet after meals. The patient applied fresh solution nightly. RESULTS: All teeth were successfully lightened. The time required to lighten the nonvital tooth was related to the duration of the discoloration. CONCLUSION: With proper patient selection and education, this technique can provide an effective way to lighten nonvital and vital teeth simultaneously, especially where extended treatment time may be required for difficult discolorations.

Adult↗

Measurements of tooth wear among Australian aborigines: I. Serial loss of the enamel crown.

The dental casts made from Aboriginal children during the course of a longitudinal growth study in Central Australia provided material for analyzing tooth wear under known environmental conditions. The wear facets produced on the occlusal surfaces were clearly preserved on the dental stone casts and recorded the progress of enamel attrition from ages 6 to 18. These casts were photographed and traced by electronic planimetric methods that automatically recorded the location and size of wear facets on the first and second permanent molars. These areas of worn tooth surface were compared to the total tooth surface. The worn surface was regressed on age to calculate wear rates of each tooth. Discriminant analyses were also performed to determine the significance of dental attrition differences between the sexes at each age group. The total wear on each tooth was highly correlated with age as expected but females wore their teeth at a significantly higher rate than males. The mandibular molars wore more rapidly than maxillary teeth in both sexes. The discriminant analysis successfully grouped 91% of the cases according to age and sex. Pattern of wear, the location, and size of wear facets also differed between age groups and sex. The questions of why there is a difference between male and female wear or why there is greater wear on one arch or arch region have no ready answers. The differing rates and pattern of dental wear do suggest that arch shape and growth rates may be the answer though it has yet to be tested. However, the occlusal surface wear is useful for age estimation in a population and provides a record of shifting masticatory forces during growth.

Aging↗

Dietary and environmental reconstruction with stable isotope analyses of herbivore tooth enamel from the Miocene locality of Fort Ternan, Kenya.

Tooth enamel of nine Middle Miocene mammalian herbivores from Fort Ternan, Kenya, was analyzed for delta 13C and delta 18O. The delta 18O values of the tooth enamel compared with pedogenic and diagenetic carbonate confirm the use of stable isotope analysis of fossil tooth enamel as a paleoenvironmental indicator. Furthermore, the delta 18O of tooth enamel indicates differences in water sources between some of the mammals. The delta 13C values of tooth enamel ranged from -8.6(-)-13.0/1000 which is compatible with a pure C3 diet, though the possibility of a small C4 fraction in the diet of a few of the specimens sampled is not precluded. The carbon isotopic data do not support environmental reconstructions of a Serengeti-typed wooded grassland with a significant proportion of C4 grasses. This study does not preclude the presence of C3 grasses at Fort Ternan; it is possible that C3 grasses could have had a wider geographic range if atmospheric CO2 levels were higher than the present values.

Animals↗

Comparison of Leaf Plastochron Index and Allometric Analyses of Tooth Development in Arabidopsis thaliana.

Two methods of analyses were used to investigate tooth development in serrate (se) mutant and wild-type Columbia-1 (Col-1) Arabidopsis thaliana leaves. There were almost twice as many teeth with deeper sinuses and two orders of toothing on the margins of serrate compared with Columbia-1 leaves. The main objective of this study was to test three hypotheses relative to the source of polymorphism in tooth development: (i) Teeth share similar growth rates and initial sizes, but the deeper teeth are initiated earlier in leaf development. (ii) Teeth share similar timing of initiation and growth rates, but the deeper teeth have a larger initial size. (iii) Teeth share similar timing of initiation and initial sizes, but the deeper teeth have a faster growth rate. Leaf plastochron index (LPI) was used as the time variable for leaf development. Results showed teeth in se were initiated at -27 LPI, 15 plastochrons earlier than those of Col-1. Serrate leaf expansion was biphasic, with the early phase expanding at half the relative plastochron rate of the later phase, which equaled the constant relative expansion rate of Col-1 leaves. Allometric analyses of tooth development obscured the interactions between time of tooth and leaf initiation and the early phase of leaf expansion characteristic of serrate leaves and teeth. Timing of developmental events that allometric analysis obscured can be readily detected with the LPI as a developmental index.

Journal Article↗

Association of developmental regulatory genes with the development of different molar tooth shapes in two species of rodents.

While the evolutionary history of mammalian tooth shapes is well documented in the fossil record, the developmental basis of their tooth shape evolution is unknown. We investigated the expression patterns of eight developmental regulatory genes in two species of rodents with different molar morphologies (mouse, Mus musculus and sibling vole, Microtus rossiaemeridionalis). The genes Bmp-2, Bmp-4, Fgf-4 and Shh encode signal molecules, Lef-1, Msx-1 and Msx-2, are transcription factors and p21CIP1/WAF1 participates in the regulation of cell cycle. These genes are all known to be associated with developmental regulation in mouse molars. In this paper we show that the antisense mRNA probes made from mouse cDNA cross-hybridized with vole tissue. The comparisons of gene expression patterns and morphologies suggest that similar molecular cascades are used in the early budding of tooth germs, in the initiation of tooth crown base formation, and in the initiation of each cusp's development. Furthermore, the co-localization of several genes indicate that epithelial signalling centres function at the three stages of morphogenesis. The earliest signalling centre in the early budding epithelium has not been reported before, but the latter signalling centres, the primary and the secondary enamel knots, have been studied in mouse. The appearance of species-specific tooth shapes was manifested by the regulatory molecules expressed in the secondary enamel knots at the areas of future cusp tips, whilst the mesenchymal gene expression patterns had a buccal bias without similar species-specific associations.

Animals↗

Alteration of nerve growth factor-receptor expression in the periodontal ligament of the rat during experimental tooth movement.

This pilot study deals with the initial responses of neural elements showing nerve growth factor-receptor (NGFR) immunoreactivity in the periodontal ligament of rats to orthodontic forces. The animals were killed at intervals of 1, 2, 6, 12 h and 1, 3, 5, 7 days after the insertion of elastic bands between the maxillary first and second molars. Serial frozen sections, prepared from each animal, were processed immunohistochemically to demonstrate NGFR, after which the periodontal ligament of the mesial root of the maxillary second molar was examined microscopically. In control sections, NGFR-positive neural elements were predominantly distributed at the apex of the bony socket on the distal side of the periodontal ligament. After 1 h of tooth movement, NGFR positively-stained nerve fibres tended to disappear slightly in both the intermediate and coronal regions of the distal periodontal ligament. By the third day of tooth movement, the periodontal ligament nerve fibres showed more intense NGFR-immunoreactivity; thick, positively stained nerve fibres were recognized on the distal side in which active bone remodelling was occurring, and a few of these fibres were densely distributed around blood vessels or near Howship's lacunae. The distribution of NGFR-positive neural elements on the mesial side increased at 5 days of tooth movement. Finally, at 7 days of tooth movement, staining intensity for NGFR appeared to decrease. These findings demonstrate that an alteration in the distribution and the intensity of immunoreactive staining for NGFR in the periodontal ligament is associated with the bone remodelling induced by orthodontic tooth movement.

Animals↗