The influence of periodontitis on the subgingival flora around implants in partially edentulous patients

The hypothesis that teeth act as reservoirs of micro-organisms for the colonization of oral implants has recently been stated several times. The present study aimed at examining, in partially edentulous patients with severe periodontitis, whether pockets around teeth and implants harbored a comparable micro-flora. In 6 patients (3 with refractory periodontitis and 3 with advanced chronic adult periodontitis), plaque samples were taken from a deep and shallow pocket around both teeth and implants for differential phase contrast microscopy and DNA probe analysis. The results showed important differences in the sub-gingival flora between the 2 disease groups, as well as between deep and shallow pockets, around both implants and teeth. On the other hand, when pockets around teeth and implants with equal depths were compared a striking similarity was observed in the microbial composition. These observations confirm the hypothesis that pockets around teeth act as a reservoir and highlight the importance of periodontal health when oral implants are planned.     

Observation of a child with multiple submerged primary teeth

The authors presented a case report of a seven-year-old male with eight submerged primary molars and a primary lateral incisor. Two major treatment modalities, tooth extraction and observation, were reported. In this case we applied the two alternative modalities and observed the patient for five years. The permanent successors were in the process of almost normal eruption after the extraction of the submerged primary teeth; no eruption and more severe submerging were observed, however, in the permanent successors of the submerged primary teeth that were not extracted. These results suggest that submerged or impacted primary teeth should be extracted immediately when they are moderately or severely submerged.     

Abnormalities of the maxillary incisors in children with cleft lip and palate

Dental anomalies of the maxillary anterior teeth were studied in seventy-seven children affected by unilateral and bilateral clefts of the lip and alveolar process, with or without involvement of the palate. As for the permanent lateral incisor in the cleft area, our results show that its congenital absence is the most frequent abnormality followed by anomalies in size and shape and supernumerary teeth. Enamel hypoplasia was found to affect the permanent central incisor on the cleft side more frequently. Early recognition of tooth abnormalities during the primary dentition phase for an interceptive treatment of potentially severe problems was emphasized.     

Neurohypophysial hormone secretion in hyperprolactinaemic women

We describe a mother and her twin daughters affected with severe hypodontia of the permanent teeth, precocious calcification of the choroid plexus, and minor digital anomalies. The presence of inner telecanthus, broad and flattened nasal bridge, mild ocular proptosis, small nose with anteverted nostrils, and slight microretrognathia gives them an unusual appearance. All three affected persons are of normal intelligence.     

Hallerman-Streiff syndrome: case report and recommendations for dental care

Hallerman-Streiff syndrome is a rare congenital anomaly characterized by a peculiar bird facies, mandibular and maxillary hypoplasia, dyscephaly, cataracts, microphtalmia, hypotrichosis, skin atrophy, and short stature. Dental abnormalities are present in 80 percent of the cases and include malocclusion, crowding, severe caries, supernumerary and neonatal teeth, enamel hypoplasia, hypodontia, premature eruption of primary dentition, agenesis of permanent teeth, and anterior displacement or absence of condyles. Very few cases have been described in the dental literature. The predisposition to severe caries, together with other problems, makes it imperative that young patients be started in a strong prevention program as early as possible. This is a case report of a five-year-eleven-month-old white male who presented for a dental examination at The Children's Hospital in Denver, CO. The findings and recommendations for treatment are discussed.     

Microbiological findings in prepubertal periodontitis. A case report

Generalized pre-pubertal periodontitis (GPP) is a rare entity that usually affects children with severe systemic diseases. We report the case of a 7-year-old male patient diagnosed with GPP, with no apparent systemic condition, who lost all his primary teeth to periodontal disease. Before extractions, while he was still in mixed dentition the subgingival plaque was collected and analyzed using DNA probes to 40 different microorganisms. Putative periodontopathogens such as Prevotella intermedia, Selenomonas noxia, Fusobacterium nucleatum, and Actinobacillus actinomycetemcomitans could be identified throughout the mouth. More intriguing was the colonization of the sulcus of some secondary teeth by potentially harmful microorganisms found in pockets of diseased adjacent primary teeth.     

Fluoride toxicity: a biochemical and scanning electron microscopic study of enamel surface of rabbit teeth

The present study has been carried out to investigate the effect of fluoride toxicity on the morphology as well as inorganic chemical constituents of rabbit teeth. Rabbits were administered sodium fluoride at a dose of 10 mg NaF/kg body weight every 24 h for 18 and 23 months. The incisor and molar teeth (whole tooth) were investigated for fluoride, calcium and phosphorus content in 18- and 23-month treated animals. The enamel surfaces of incisor teeth of 23-month treated animals were examined under scanning electron microscope. A significant increase in fluoride levels and significant decrease in calcium content was found following fluoride administration for 18 and 23 months as compared to control. Ca/P ratio was significantly increased only in 23-month treated animals. The scanning electron micrographs revealed hypoplastic, rough, uneven, pitted and cracked enamel surfaces covered with granular deposits as a result of excessive intake of fluoride. It can be concluded that long term fluoride administration leads to severe structural alterations on the enamel surface, possibly through defective mineralization.     

Oro-dental injuries during intubation anesthesia

Injuries to the oro-dental tissue are still one of the most frequent mishaps during endotracheal intubation and general anaesthesia. However, damage to the soft and hard tissues in most cases involves oral structures already showing advanced pathogenic alterations. Injuries to the teeth are therefore rather more often due to the disease of the teeth than to mistakes during anaesthesia. The risk of injuries to the teeth can be ascertained by means of a presurgical inspection of the oral cavity and evaluation of the individual anatomical conditions in the head and neck region, which may well interfere with the endotracheal intubation. In contrast to anaesthetic pitfalls causing severe disturbance of general health, dental trauma can be treated with quite satisfying functional and aesthetic results. However, in order to maintain conditions for the complete restitution of injured teeth immediate dental therapy is recommended. In preterm infants which need mechanical ventilation during the postnatal period direct laryngoscopy as well as mechanical alterations caused by an oral tube can cause injuries to the tooth germs of the first and second dentition and deformation of the maxillary skeleton. In consequence the patient will need intensive therapy of the resulting disturbances for several years. This review gives information about the causes and types of injuries to the oral and maxillofacial region during general anaesthesia. In addition, the anatomical conditions and pathological changes associated with an increased risk for oro-dental injuries and the facilities for prevention are discussed. Finally, the main aspects of emergency treatment of injuries to the dental hard tissues are presented.     

Epidemiology and risk factors of wedge-shaped defects in a Swiss population

The purpose of this study was to determine the prevalence of wedge-shaped abrasion defects in the teeth of an adult Swiss population. 980 letters explaining the study were sent to randomly selected subjects. 391 persons (40%) belonging to two age groups (26-30 and 46-50 years) were checked for frequency and severity of wedge-shaped lesions on all buccal tooth surfaces. Furthermore patients were asked about dietary and prophylactic habits as well as other factors possibly relevant to this study. The frequency of severe wedge-shaped defects was 19.1% in the younger, and 47.2% in the older age group, with a mean of 3 affected teeth per person (pooled age group). On average, 34.8% of all patients suffered from tooth hypersensitivity. 84.6% of the examinees with wedge-shaped defects complained of hypersensitivity at these sites. It is concluded that wedge-shaped defects cause considerable problems to more than one third of the population, and that such lesions are often combined with hypersensitivity of affected teeth.     

The cervical third of deciduous teeth. An ultrastructural study of the heard tissues by SEM

As information on amelocemental junction of deciduous teeth is limited, this topographical area was investigated by scanning electron microscopy (SEM) to verify differences from that of permanent teeth. Twenty-six carious and non-carious human maxillary and mandibular primary teeth were placed in a fixative immediately after extraction. Pulpal tissue was removed from the pulpal chambers and root. The primary teeth blocked onto stubs and all specimens were platinum coated and examined by SEM. In these specimens an overlapping of cementum onto to enamel and an edge to edge relationship was dominant. No gaps between enamel and cementum were observed. The amelocemental junction of deciduous teeth seem to differ to that described for permanent teeth.     

Dental management of patients irradiated for oral cancer

Management of patients irradiated for oral cancer should include consideration of their oral health prior to, and after, radiation therapy. Data from 130 patients, followed for a period of 1 to 10 years, are presented and evaluated. The philosophy of retention and maintenance of as many teeth as possible is supported by this data. Extraction of teeth with severe periodontal disease after irradiation also proves to be a relatively safe operation. Osteoradionecrosis tends to be limited in extent and is generally well tolerated by the patient when treated conservatively. A treatment regimen is presented that significantly reduces the morbidity from therapeutic irradiation of the jaws. A comprehensive dental evaluation and follow-up plan coupled with patient cooperation are instrumental to the success of this program.     

Late effects of ionizing radiations on head and neck region tissues

Numerous structures are included in the irradiated volume of patients presenting with head and neck cancer: skin, mucosa, bone, teeth, cartilage, muscles, salivary glands, etc. Curative intent treatment of such tumours requires aggressive approach which can lead to severe sequellae. These sequellae are in most cases dose-dependent and volume-dependent. However, an appropriate technique might decrease the severity of such sequellae. Details of these late changes are presented, including their pathophysiology, clinical syndromes, potential treatment, and prevention.     

Idiopathic gingival enlargement--report of two cases

Idiopathic gingival enlargement is a rare condition of undetermined etiology, although some cases have definite hereditary basis. It affects entire gingivae in the form of small to large masses. It causes diastema, displacement and malocclusion of teeth. In severe cases it leads to poor esthetics, restricted movements of tongue, interference with speech, and difficulty in mastication.     

"Carious" and "noncarious" lesions of the hard dental tissues. Ultrastructural (SEM) and microanalytical (EDS) analyses of teeth from the 3rd century B.C

The study was carried out on 80 teeth (70 of permanent dentition and 10 of primary one) of mandibular and maxillary bones. The teeth owned to subjects lived in the III c.b.C. in Sicily, and they were found in Naxos necropolis. The teeth were examined as far as carious and non carious lesions, then they were prepared for instrumental analyses by Scanning Electron Microscopy (SEM) and Energy dispersed X ray spectrometry (EDS). To an objective examination of the sample no caries were detected in the teeth sample apart one tooth, on the other hand there was an extensive occlusal abrasion, from a macroscopic point of view there were no difference as far teeth morphology. SEM examination pointed out all around dentinal tubules a circle of sclerotic dentin as reaction to occlusal wear. The amelocemental junction showed from a ultramicroscopic point of view an overlap of cementum onto enamel. EDS analysis pointed out a higher P concentration on the crown versus the root in all the teeth of the sample.     

Masking severely tetracycline-stained teeth with ceramic laminate veneers

When the primary restorative objective is the reinstatement of vital natural tooth color, dark tetracycline-stained teeth still represent the ultimate challenge for ceramic laminate veneers. Masking severe stain with opaquing composite resins is a significant advancement; however, the procedure requires additional chairtime, is technique sensitive (to avoid excessive opacity), and involves removal of additional tooth structure. The learning objective of this article is to describe and compare two different methods for masking tetracycline-stained teeth. The article illustrates the natural tooth color derived from ceramic laminate veneers when bonded to opaque composite resins in the maxillary arch, and compares it to a new ceramic veneer formulation in the mandibular arch, which masks the stain, eliminates the need for subopaquing with composite resins, and resembles the qualities of natural tooth color.     

Nosocomial hepatitis B virus, hepatitis C virus and HIV infections by infectious medial personnel

Radicular dentin dysplasia (DD-I) is a rare hereditary dental alteration. It is characterized clinically by almost normal looking crowns and severe hypermobility of the teeth. The radiographic analysis, on the other hand, discloses the obliteration of all pulp chambers, the short, malformed roots and plenty of periapical bone radiolucencies on noncarious teeth. A case of radicular dentin dysplasia is presented. In this 43-year-old woman the diagnosis was supported, besides the clinical and radiographic analysis, by the pedigree of the proband, which showed the autosomal dominant pattern of feature transmission. Further-more, the electron microscopic analysis of one extracted molar revealed the atubular structure of the secondary dentin, and its globular organization.     

Split-mouth study of sealant retention with carbon dioxide laser versus acid etch conditioning

A survey was carried out to determine the reasons for tooth extractions of permanent teeth in Singapore. Data were obtained from 52 dentists practising general dentistry over a period of 12 months. At the end of the 12-month period, data were collected from 1276 patients, from whom a total 272 teeth were extracted. In this population group, the results showed that the percentage of teeth extracted due to periodontal reasons and caries were about the same, that is 35.8% and 35.4%, respectively. There was an increase in teeth extracted due to periodontal reasons with age. In patients above 40 yr, an average of 76% of teeth were lost due to periodontal reasons. An average of 26.7% of teeth were lost due to periodontal reasons in patients under 40 yr old. However, the trend for loss of teeth due to caries is reversed. Posterior teeth were more frequently extract compared to anterior teeth. Third molars accounted for 24.7% of all extractions carried out, whilst central incisors were 8.0% of all extractions. Molars were often lost due to caries and lower anterior teeth were most frequently lost due to periodontal reasons. The results of this study did not demonstrate one predominant reason for extraction. Both caries and periodontal reasons were equally common causes of tooth extraction.     

Age-related decline in female fertility is not due to diminished capacity of the uterus to sustain embryo implantation

Rapp-Hodgkin syndrome and AEC syndrome are two disorders in which ectodermal dysplasia and clefting are associated. Rapp-Hodgkin syndrome is an autosomal dominant condition characterized by cleft lip and palate, peculiar craniofacial features, and ectodermal dysplasia, consisting of abnormalities of teeth, hair, nails and sweating. AEC syndrome manifests the same defects plus ankyloblepharon and a higher frequency of scalp dermatitis. A child affected by ectodermal dysplasia associated with clefting, ankyloblepharon, severe scalp dermatitis, and the characteristic Rapp-Hodgkin facies is reported. The overlap between Rapp-Hodgkin syndrome and AEC syndrome is discussed. Critical review of both disorders suggest that AEC syndrome and Rapp-Hodgkin syndrome represent the same entity.     

Eruption of teeth into crowded position, loss of attachment, and downgrowth of subgingival plaque

The role of crowded teeth in the etiology of attachment loss was studied in thirty teeth extracted for orthodontic reasons from eight children 12 to 13 years of age. Following extraction, the teeth were stained in a 1 percent solution of water blue and examined under the stereomicroscope. In one third of the thirty teeth, a 0.9, 2.0, and 3.5 mm. loss of attachment was observed on surfaces adjacent to which another tooth had erupted into an extremely crowded environment. On the same surfaces, subgingival plaque had grown down to the area of the cementoenamel junction. The premature loss of attachment was assumed to be mediated by collagenase derived from the regressing dental organ or from the junctional epithelium surrounding the erupting teeth. The premature downgrowth of subgingival plaque to the area of the cementoenamel junction was facilitated by the development of an irregular contact line within the interdental papilla, rather than a contact point above the papilla.