Fibrous dysplasia and asymmetry of facial bones caused by traumatic dental occlusion.
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Fluorescent microspheres (FM) were used to visualize and semi-quantify flood flow in the periodontal ligament (PDL) and dental pulp during experimental traumatic occlusion of the maxillary and mandibular molar teeth in young rats. At different observation points FM were injected systemically, and the number of FM was counted in serial sections from the jaws in the PDL and pulp of the molar teeth in a fluorescent microscope. Blood flow was related to the number of FM in the tissues and in a reference blood sample. In the early stages an increase in blood flow in the PDL and dental pulp was found on the experimental side compared with the contralateral side. Furthermore, there was an increase in blood flow on both sides of the jaws compared with an unoperated control material. The study thus indicates that a local unilateral occlusal trauma initiates blood flow responses in the total molar dentition in rats.
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The talon cusp is a relatively uncommon dental anomaly manifested as an accessory cusp-like structure on the crown of anterior teeth. The presence of a talon cusp can cause clinical problems. This article reports the case of a patient presenting a talon cusp affecting the permanent maxillary right central incisor causing clinical problems related to caries, displacement of the tooth, occlusal position and tendency to dental traumatism. The management of this tooth included caries removal and reduction of the cusp. Pulp-capping with calcium hydroxide was required because of the presence of pulp horn extensions in the talon cusp.
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In the first of these two articles, occlusal terminology, techniques for examining the occlusion, articulators and interocclusal records were discussed. Here the authors consider some of the practical applications.
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Tooth wear leads to alterations in both static and functional occlusal contacts and may contribute to temporomandibular joint disorders and dysfunction. Treatment of tooth wear may be time consuming, expensive and destructive of remaining tooth tissues. Bruxism has been associated with the recording of abnormally high clenching forces. This paper describes a technique for the provision of the canine riser restoration, which deliberately alters the cuspal incline in canine teeth to provide a canine guided occlusion. These restorations may help to control excessive loading of teeth, limit further tooth wear and assist in the management of temporomandibular disorders and dysfunction.
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Excessive loss of dental hard tissues caused by mechanical, chemical or traumatic influences--or a combination of these factors--poses difficulties for subsequent prosthetic tooth restorations. Traditionally reconstructive treatment to restore affected teeth has been provided using rather invasive methods like porcelain-fused-to-metal crowns or ceramic overlays. For patients with a tooth substance loss caused by an acidic diet, where a payment of the costs by the social insurance cannot be expected, a less expensive treatment modality would be of interest. The presented case report describes an alternative treatment modality of vertical tooth substance loss by using direct adhesive composite restorations. To establish a simple and controlled build-up, a mini-plast splint based on an ideal wax-up was used.
The prevalence of tooth surface loss has increased in recent years. The essence of management is an effective preventive regime; however, in many instances restoration may also be necessary. A number of strategies is available for creating sufficient space to enable restoration and several techniques for restoration known. This article reviews the significance of the vertical dimension of occlusion and describes the restorative management of a patient affected by severe tooth wear.
The purpose of this article is to review the clinical features, diagnosis and management of the cracked tooth syndrome (CTS). The condition refers to an incomplete fracture of a vital posterior tooth that occasionally extends into the pulp. A lack of awareness of the condition coupled with its varied clinical features can make diagnosis of CTS difficult. Common symptoms include an uncomfortable sensation or pain from a tooth that occurs while chewing hard foods and which ceases when the pressure is withdrawn. The patient is often unable to identify the offending tooth or quadrant involved, and may report a history of numerous dental procedures with unsatisfactory results. Successful diagnosis and management requires an awareness of the existence of CTS and the appropriate diagnostic tests. Management options depend on the nature of the symptoms and extent of the lesion. These options include routine monitoring, occlusal adjustments, placement of a cast restoration and endodontic treatment. A decision flowchart indicating the treatment options available to the dental practitioner is presented.
AIM: The deep periodontal disease often leads to dental mobility with further aggravation of the symptomatology. The aim of the paper is to verify the importance of splinting of teeth in the therapy of periodontitis on the basis of parameters commonly studied [probing depth (PD), bleeding on probing (BOP), plaque index], and the role of the occlusal trauma as primary factor or second leading factor in periodontal diseases. METHODS: Thirty patients suffering from periodontitis have been treated with the splinting of teeth, neither preceded nor followed from topical and systemic pharmacological therapy, nor from surgical or non surgical treatment of the periodontal tissues involved. During the 4 visits provided by the study, T0 (0 days), T1 (30 days), T2 (90 days) and T3 (180 days), PD, BOP and plaque index have been estimated. RESULTS: From the comparison of the T0 PD and BOP with the T3 PD and BOP, a significant improvement of these parameters is observed (P<0.05). CONCLUSION: On the basis of the clinical data obtained in this research, the authors suggest that the therapy by means of splinting improves the prognosis of teeth affected by periodontal disease; occlusal trauma and dental mobility cause the aggravation of periodontal lesions.