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Maxillary Incisors (maxillary + incisor)
Kinds of Maxillary Incisors Selected AbstractsManaging the Challenge of Crowning the Single Central Maxillary IncisorJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 5 2008ARIEL RAIGRODSKI DMD [source] Diagnosis and Management of Maxillary Incisors Affected by Incisal Wear: An Interdisciplinary Case ReportJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 6 2002JUSSARA KARINA BERNARDON ABSTRACT In the attempt to restore anterior teeth affected by erosion and bruxism, many clinicians have been frustrated with the constant restorative failures. Frequently, these failures are attributed to the restorative materials employed, especially in cases in which composite resins are used. However, some flaws of the restorations are related to the oversight of occlusal principles. The purpose of this article is to discuss the etiology, signs, and symptoms of incisal wear, with special attention to that caused by bruxism and chemical erosion. Relatively simple management techniques (e.g., occlusal adjustment, adhesive restorations) are proposed, and the diagnosis and management of a representative clinical case is presented. [source] Dilaceration of maxillary central incisor: a literature reviewDENTAL TRAUMATOLOGY, Issue 5 2010Nikolaos Topouzelis In early developmental stages, the permanent tooth germ of the maxillary incisor is situated palatally and superiorly to the apex of the primary incisor and gradually changes direction in a labial direction with its crown coming closer to the resorbing primary root. For reasons of this close relationship between the permanent tooth germ and the apex of the primary incisor, it is believed that an acute trauma to the primary predecessor can cause dilaceration of the long axis of the permanent successor. Clinically, dilaceration can be revealed by palpation high in the labial sulcus or in the hard palate, while its radiographic view is characteristic. The therapeutic approach to the dilacerated maxillary central incisors has to be carefully planned and needs the cooperation of several specialities to attain the final objective. [source] Replantation of an immature permanent central incisor following pre-eruptive traumatic avulsionDENTAL TRAUMATOLOGY, Issue 5 2008Esti Davidovich Avulsion of a pre-eruptive left permanent maxillary incisor in a 6-year-old boy is presented. The immature tooth was replanted after rinsing with saline following 10 min dry extra-oral time. This case report describes treatment and a 2-year follow-up of the tooth. During the follow-up period, continuation of root development, pulp revascularization, and irregular dentin formation were demonstrated. The tooth is vital, functional, and esthetic. To the best of our knowledge, no such case of replantation of a pre-eruptive tooth has been reported previously. [source] Change in supporting tissue following loss of a permanent maxillary incisor in childrenDENTAL TRAUMATOLOGY, Issue 6 2007Helen D. Rodd Abstract,,, Alveolar bone resorption is an inevitable consequence of tooth loss and may be detrimental to long-term dental aesthetics and function. The aim of the present study was to quantify the degree of tissue resorption following the loss of a permanent incisor in a young population. The study group comprised 11 boys and five girls who all required the extraction of a permanent maxillary central incisor due to trauma-related sequelae. Mean age at tooth loss was 10.8 years. Upper alginate impressions were taken at regular intervals following tooth loss and were cast in yellow dental stone. Study models were sectioned longitudinally through the mid-point of both the maxillary incisor socket and the contra-lateral incisor to provide a thin plaster section. Digital photographs were acquired of the edentulous (A1) and dentate (A2) surfaces of this section and image analysis software was employed to quantify the surface area of both A1 and A2. At 3 months postextraction, mean A1 was 15.7% less than mean A2. By 6 months mean A1 had further reduced and was 25.3% less than that of the corresponding dentate alveolus. However, at subsequent time intervals following tooth extraction (>6 months), tissue loss appeared to stabilise with an overall reduction in tissue area remaining at 22%. This reduction in supporting tissue area was found to be highly statistically significant (P = 0.002, anova). Furthermore, girls appeared to have an overall greater degree of tissue loss than boys (P = 0.015). Further research is indicated to explore factors influencing the degree of tissue loss following incisor extraction and the benefit of therapeutic interventions in limiting this resorption. [source] Apexogenesis after initial root canal treatment of an immature maxillary incisor , a case reportINTERNATIONAL ENDODONTIC JOURNAL, Issue 1 2010S. R. Kvinnsland Abstract Aim, To present a case where a traumatized, immature tooth still showed capacity for continued root development and apexogenesis after root canal treatment was initiated based on an inaccurate pulpal diagnosis. Summary, Traumatic dental injuries may result in endodontic complications. Treatment strategies for traumatized, immature teeth should aim at preserving pulp vitality to ensure further root development and tooth maturation. A 9-year-old boy, who had suffered a concussion injury to the maxillary anterior teeth, was referred after endodontic treatment was initiated in tooth 21 one week earlier. The tooth had incomplete root length, thin dentinal walls and a wide open apex. The pulp chamber had been accessed, and the pulp canal instrumented to size 100. According to the referral, bleeding from the root made it difficult to fill the root canal with calcium hydroxide. No radiographic signs of apical breakdown were recorded. Based on radiographic and clinical findings, a conservative treatment approach was followed to allow continued root development. Follow-up with radiographic examination every 3rd month was performed for 15 months. Continued root formation with apical closure was recorded. In the cervical area, a hard tissue barrier developed, which was sealed with white mineral trioxide aggregate (MTA). Bonded composite was used to seal the access cavity. At the final 2 years follow-up, the tooth showed further root development and was free from symptoms. Key learning points, ,,Endodontic treatment of immature teeth may result in a poor long-term prognosis. ,,The pulp of immature teeth has a significant repair potential as long as infection is prevented. ,,Treatment strategies of traumatized, immature permanent teeth should aim at preserving pulp vitality to secure further root development and tooth maturation. ,,Radiographic interpretation of the periapical area of immature teeth may be confused by the un-mineralized radiolucent zone surrounding the dental papilla. [source] Evaluation of the cost-effectiveness of root canal treatment using conventional approaches versus replacement with an implantINTERNATIONAL ENDODONTIC JOURNAL, Issue 10 2009M. W. Pennington Abstract Aim, To evaluate the cost-effectiveness of root canal treatment for a maxillary incisor tooth with a pulp infection, in comparison with extraction and replacement with a bridge, denture or implant supported restoration. Methodology, A Markov model was built to simulate the lifetime path of restorations placed on the maxillary incisor following the initial treatment decision. It was assumed that the goal of treatment was the preservation of a fixed platform support for a crown without involving the adjacent teeth. Consequently, the model estimates the lifetime costs and the total longevity of tooth and implant supported crowns at the maxillary incisor site. The model considers the initial treatment decisions, and the various subsequent treatment decisions that might be taken if initial restorations fail. Results, Root canal treatment extended the life of the tooth at an additional cost of £5,8 per year of tooth life. Provision of orthograde re-treatment, if the root canal treatment fails returns further extension of the expected life of the tooth at a cost of £12,15 per year. Surgical re-treatment is not cost-effective; it is cheaper, per year, to extend the life of the crown by replacement with a single implant restoration if orthograde endodontic treatment fails. Conclusion, Modelling the available clinical and cost data indicates that, root canal treatment is highly cost-effective as a first line intervention. Orthograde re-treatment is also cost-effective, if a root treatment subsequently fails, but surgical re-treatment is not. Implants may have a role as a third line intervention if re-treatment fails. [source] In vivo determination of root canal length: a preliminary report using the Tri Auto ZX apex-locating handpieceINTERNATIONAL ENDODONTIC JOURNAL, Issue 7 2002F. Grimberg Abstract Aim The aim of this study was to assess the clinical perfomance of a cordless handpiece with a built-in apex locator , the Tri Auto ZX , designed for root canal preparation with nickel-titanium rotary files. Methodology Twenty-five human maxillary incisor and canine teeth scheduled for extraction with mature apices were selected for the study. Informed written consent was obtained from each patient before treatment. After administration of local anaesthesia, the teeth were isolated and the pulp cavities accessed. The Tri Auto ZX along with a size 15 K-file was used in its electronic apex locating function based on the manufacturer's recommendations. A periapical radiograph with the file at the electronically determined constriction was taken, the file removed and the measurement registered as the electronic length (EL). To test the auto reverse function, a size 20 ProFile .04 taper NiTi rotary instrument was mounted in the handpiece. The point for the auto apical reverse function was preset on the panel at the 0.5 mm level. After the file was introduced into the canal and reached the predetermined level, the file automatically stopped and rotated in the opposite direction. A reference point was marked and this measurement was registered as the auto reverse length (ARL). All measurements were made twice by two different investigators. Teeth were then extracted and immersed in a 20% formalin solution for 48 h. After fixation, a size 15 file was inserted into the canal to measure the actual root canal length from the same reference point obtained with the Tri Auto ZX to the apical foramen, as seen in the stereo microscope. When the file tip was visible at the anatomical end of the canal it was withdrawn 0.5 mm and this measurement was registered as the actual length (AL). All measurements were expressed in mm and the measuring accuracy was set to 0.5 mm. The significance of the mean differences between EL and ARL and between EL and AL measurements at the 5% confidence level was evaluated. Results EL measurements were coincident to ARL in all instances. EL and ARL were coincident to AL in 10 (40%) canals, in the remaining 15 canals (60%) the AL measurements were longer than EL and ARL (+0.5 mm) in 14 instances and shorter (,0.5 mm) in one case. Overall, the AL was longer than the EL or ARL, the mean difference being ,0.23 mm ± 0.32 (P < 0.05). Conclusions It was concluded that the Tri Auto ZX was useful and reliable. The Tri Auto ZX measurements protected against overpreparation. [source] Tooth fragments lodged in the lower lip after traumatic dental injury: a case reportDENTAL TRAUMATOLOGY, Issue 4 2008Maria Cristina Munerato The efficient diagnosis and treatment of dental injury are important elements in clinical dentistry. This article describes a case study of trauma in central maxillary incisors with tooth fragments lodged in the lower lip. Radiographs of the soft structures proved themselves as an important tool in the detection and identification of occult tooth fragments, and play an important role in the establishment of the treatment to be adopted. Also, case follow-up is of fundamental significance in the preservation and maintenance of compromised structures. [source] Severe periodontal damage by an ultrasonic endodontic device: a case reportDENTAL TRAUMATOLOGY, Issue 2 2007John D. Walters Abstract,,, Heat produced within a root canal during use of an ultrasonic instrument can be conducted through the dentin into periodontal ligament, bone and soft tissue. If severe in intensity or long in duration, it can induce damage to these tissues. This report describes a case in which an ultrasonic endodontic instrument apparently induced severe damage to alveolar bone, gingiva and nasal mucosa in a 42-year-old female. Overheating of a maxillary central incisor caused necrosis of soft tissue and bone on the facial and mesial aspects and triggered a protracted inflammatory response in the adjacent nasal cavity. To relieve the severe discomfort associated with this damage, the patient chose to have her maxillary incisors extracted and replaced by a removable partial denture. A defect in the soft tissue and bone was present at a follow-up visit 10 months after the extractions. While morbidity of this nature is rare, this case reinforces the need to maintain adequate cooling of ultrasonic instruments. [source] Avulsion of primary teeth and sequelae on the permanent successorsDENTAL TRAUMATOLOGY, Issue 6 2005Pia Christophersen Abstract,,, The purpose of the present study was to determine the frequency of avulsion of primary teeth and the location of the avulsed tooth in a representative population of Danish children. Also, the frequency and the type of developmental disturbances in the permanent successors were assessed and related to age at the time of injury. The material included dental records of 4238 children from three clinics in Municipal Dental Health Services near Copenhagen, Denmark. The children were born between 1 January 1983 and 31 December 2000. Thirty-five children (0.8%) were identified as having avulsed in all 44 primary teeth most frequently the maxillary incisors (89%). Thirty-three fully erupted permanent successors were included in the study, the prevalence of developmental disturbances was 30% (10 teeth). The results showed the risk of developmental disturbances in the permanent successors to be more frequent the younger the age at the time of injury (P = 0.04). Discolouration affected all 10 permanent teeth, but also hypoplasia and horizontal enamel hypoplasia were found. [source] Prevalence of oral trauma in children with bilateral cleftsDENTAL TRAUMATOLOGY, Issue 1 2005Juliana Yassue Barbosa Da Silva Abstract,,, The main object of this study is to analyze the prevalence of oral trauma in subjects with complete bilateral clefts, with anterior projection of the premaxilla. A total of 106 children aging 6 months to 9 years were analyzed. The caretakers answered a specific questionnaire, in order to report the presence or absence of trauma to the soft and/or hard tissues of the child's mouth. Whenever there was a history of trauma, the patients were submitted to clinical examination. The prevalence of oral trauma was 53%, being 91% of soft tissue lesions, 8.9% of avulsion, 7% of luxation and 1.8% of intrusion. For the males, the prevalence was 56% and for the females it was 47%, with no statistical significance. Regarding the following aspects:period of time spent with the parents and at school, and presence or absence of siblings, no statistical difference could be found. Among the traumatized individuals, 80% aged less than 3 years by the moment of the trauma, 89% suffered the trauma at home, 75% presented lesions in the soft tissue at the premaxilla, 16% in the maxillary incisors, and 8.9% presented lesions in both structures. It was noticed that 45% of the permanent incisors that succeeded the traumatized deciduous teeth presented alterations, being 48% of structure and 52% of structure and position. The prevalence of trauma in this sample was superior to that observed in the literature, without any positive associations between the evaluated aspects. These results suggest that the projection of the premaxilla brings about a higher risk of oral trauma around this area. [source] The association between incisor trauma and occlusal characteristics in individuals 8,50 years of ageDENTAL TRAUMATOLOGY, Issue 2 2004Jay D. Shulman Abstract,,, To explore the association between incisal trauma and occlusal characteristics using oral examination and health interview data from the Third National Health and Nutrition Examination Survey 1988,1994 (NHANES III). Incisal trauma examinations were performed on 15 364 individuals 6,50 years of age using an ordinal scale developed by the National Institute of Dental and Craniofacial Research. Occlusal examinations were performed on 13 057 individuals 8,50 years of age. We fitted separate multivariate logistic regression models for maxillary and mandibular incisor trauma adjusting for socio-demographic variables (age, gender, race-ethnicity) and occlusal characteristics (overbite, overjet, open bite). 23.45% of all individuals evidenced trauma on at least one incisor, with trauma more than four times more prevalent on maxillary (22.59%) than on mandibular incisors (4.78%). Males (OR = 1.67) had greater odds of trauma than females; Whites (OR = 1.37) and non-Hispanic Blacks (OR = 1.37) had greater odds of trauma than Mexican,Americans. The odds of trauma increased with age, peaked from age 21 to 30 (OR = 2.92), and declined. As overjet increased, so did the odds of trauma. Compared to individuals with ,0-mm overjet, odds of trauma increased from 1,3 mm (OR = 1.42) to 4,6 mm (OR = 2.42) to 7,8 mm (OR = 3.24) to >8 mm (OR = 12.47). Trauma to incisors is prevalent but mostly limited to enamel. Trauma to maxillary incisors is associated with overjet, gender, race-ethnicity, and age, while trauma to mandibular incisors is associated with gender, age, and overbite. [source] Single-tooth implant treatment in the anterior region of the maxilla for treatment of tooth loss after trauma: a retrospective clinical and interview studyDENTAL TRAUMATOLOGY, Issue 3 2003Lars Andersson Abstract,,, The aim of this study was to evaluate the results of single-tooth implant treatment in patients where teeth have been lost as a result of trauma. Also, the patients' and professionals' opinions regarding the final outcome of treatment were assessed. Thirty-four patients with 42 lost teeth were evaluated by clinical and radiographic examinations and interviews 2,5 years after treatment. A professional who had not taken part in the treatment evaluated the implant crowns. Central maxillary incisors were the most frequently lost and replaced teeth after trauma (75%) followed by lateral incisors (21%). In patients with incomplete growth, implant treatment was generally postponed until completion of growth. Lack of space was treated by presurgical orthodontics (7%) or by selecting an implant with a reduced diameter (5%). Deficiency of bone was seen in 17% and was treated by bone grafting or local augmentation prior to implant surgery. Patients who had lost two or more teeth after trauma were all subjected to bone grafting. Preservation of roots in the alveolar process seemed to maintain the bone volume enabling better conditions for later implant placement. Forty-one implants (97.6%) were integrated successfully. Complications were few and of minor importance (9.5% before and 12% after cementation of crowns) and could all be managed. No or minimal bone loss was seen. In general, the patients felt that they received good care and that they were well informed about their treatment. Some patients reported that the local anesthesia procedure was not pain-free, but 71% of the patients experienced the treatment as pain-free. For each of the variables (color, shape, height, and size of the crowns), the highest degree of satisfaction was noted in 93,98% of the patients and 91,95% of the single evaluating professional. Given that the patients have finished growth and a careful treatment planning and timing are performed, the functional and esthetical outcome of single-tooth implant treatment today is excellent and can be recommended for replacing tooth losses after trauma in the anterior region of the maxilla. [source] The esthetic outcome of autotransplanted premolars replacing maxillary incisorsDENTAL TRAUMATOLOGY, Issue 5 2002Ewa Monika Czochrowska Abstract ,,,Autotransplantation of developing premolars to replace maxillary incisors has been documented to provide physiologically sound results, but comprehensive studies of the esthetic outcome have not been made previously. In order to assess the applicability of this approach and to identify factors important for planning of treatment, 22 autotransplanted premolars reshaped to incisor morphology were compared to their natural, contralateral maxillary incisors by scoring of features considered important for esthetics (color, soft tissue appearance, tooth morphology, and position). The sum of scores for each feature was used to place the reshaped transplant in one of three categories , Match, Deviate, Mismatch. The 22 patients were asked to fill in a questionnaire which addressed the same features that were examined professionally, and the responses were categorized as either Satisfied, Acceptable, or Dissatisfied. Eleven of the 22 patients had received orthodontic treatment with fixed appliances following the transplantation. Most of the transplanted premolars matched the contralateral incisor, and the majority of patients were satisfied with the appearance of the transplant. Fourteen percentage of the transplants were categorized as Mismatch and 18% of patients reported dissatisfaction. The distribution in categories assessed professionally and by the patients was not significantly different. The color and gingival width of the transplanted tooth were scored as different from the natural incisor in about half of the bilateral comparisons. For those teeth categorized professionally as Mismatch and by patients as Dissatisfied, a potential for esthetic improvement could be identified, as allocation to these categories was primarily due to suboptimal positioning and restorative build-up of the transplant. Inter-disciplinary planning is important for successful esthetic results. [source] Periodontal response to two intracanal medicaments in replanted monkey incisorsDENTAL TRAUMATOLOGY, Issue 6 2001Y. L. Thong Abstract , Intracanal medicaments are recommended for use in replanted teeth to inhibit inflammatory root resorption. This study compared the effect of calcium hydroxide (Pulpdent®) and a corticosteroid-antibiotic paste (Ledermix®) on periodontal healing and root resorption following replantation. Incisors of eight Macaca fascicularis monkeys were extracted, stored dry for 15 min and replanted. After 11 days, root canals in two adjacent maxillary incisors were treated with one medicament and contralateral incisors with the other medicament, or left as untreated controls. Animals were sacrificed 8 weeks later and the teeth prepared for histomorphometric evaluation of periodontal ligament inflammation and root resorption. Periodontal ligament inflammation and inflammatory root resorption were markedly inhibited by both calcium hydroxide and corticosteroid-antibiotic relative to untreated controls. Replacement resorption was lowest in the corticosteroid-antibiotic group, and significantly (P<0.05) more normal periodontal ligament was present in this group (79.6%) than in calcium hydroxide and control groups (64.6% and 62.7%, respectively). Treatment with the corticosteroid-antibiotic inhibited inflammatory resorption and was slightly more effective than calcium hydroxide in producing a periodontal healing response. [source] Fracture resistance of incisor teeth restored using fibre-reinforced posts and threaded metal posts: effect of post length, location, pretreatment and cementation of the final restorationINTERNATIONAL ENDODONTIC JOURNAL, Issue 5 2010M. Schmitter Schmitter M, Lippenberger S, Rues S, Gilde H, Rammelsberg P. Fracture resistance of incisor teeth restored using fibre-reinforced posts and threaded metal posts: effect of post length, location, pretreatment and cementation of the final restoration. International Endodontic Journal, 43, 436,442, 2010. Abstract Objective, The hypothesis of this study was that the fracture load of incisor teeth restored using short, threaded, parallel-sided posts (TMP) is, under special conditions, not inferior to that of teeth restored using long TMPs or fibre-reinforced posts (FRP). Methodology, Seventy-two maxillary incisors and 72 mandibular incisors were collected. Sixty-four in each group were root filled; in half of these FRPs were cemented, and in the other half TMPs were used. Half of the FRPs were pretreated; the others were not pretreated. In the TMP-group, half of the teeth received a long post (10 mm), the other half a short post (3 mm). Crowns were fabricated and cemented with Ketac-cem or Panavia. Eight maxillary incisors and eight mandibular incisors with intact natural crowns were used as control groups. All specimens were loaded until fracture. Results, Fracture loads were higher for pretreated FRPs than for untreated FRPs. If the FRPs were not pretreated, fracture loads for maxillary incisors after use of short metal posts were significantly higher (248 N compared with 133 N, P = 0.027). Fracture loads for teeth restored using long TMPs were not higher than for teeth restored using short TMPs (277 N compared with 266 N). Fracture loads for mandibular incisors restored using long (10 mm) pretreated FRP were higher than for mandibular incisors restored using short (3 mm) metal posts (436 N compared with 285 N). Cementation of the crowns using an adhesive resin cement did not increase the fracture load for mandibular incisors, whereas for maxillary incisors, this cementation technique tended to increase fracture loads in teeth restored with FRP, although this increase was not significant at the P < 0.05 level (P = 0.06). In both groups, fracture loads were higher for mandibular incisors. Conclusions, Short, threaded, parallel-sided metal posts might be an alternative to fibre- reinforced posts for maxillary incisors, for teeth with short roots or when FRP cannot be pretreated. [source] Limitations of previously published systematic reviews evaluating the outcome of endodontic treatmentINTERNATIONAL ENDODONTIC JOURNAL, Issue 8 2009M-K. Wu Abstract The aim of this work was to identify the limitations of previously published systematic reviews evaluating the outcome of root canal treatment. Traditionally, periapical radiography has been used to assess the outcome of root canal treatment with the absence of a periapical radiolucency being considered a confirmation of a healthy periapex. However, a high percentage of cases confirmed as healthy by radiographs revealed apical periodontitis on cone beam computed tomography (CBCT) and by histology. In teeth, where reduced size of the existing radiolucency was diagnosed by radiographs and considered to represent periapical healing, enlargement of the lesion was frequently confirmed by CBCT. In clinical studies, two additional factors may have further contributed to the overestimation of successful outcomes after root canal treatment: (i) extractions and re-treatments were rarely recorded as failures; and (ii) the recall rate was often lower than 50%. The periapical index (PAI), frequently used for determination of success, was based on radiographic and histological findings in the periapical region of maxillary incisors. The validity of using PAI for all tooth positions might be questionable, as the thickness of the cortical bone and the position of the root tip in relation with the cortex vary with tooth position. In conclusion, the serious limitations of longitudinal clinical studies restrict the correct interpretation of root canal treatment outcomes. Systematic reviews reporting the success rates of root canal treatment without referring to these limitations may mislead readers. The outcomes of root canal treatment should be re-evaluated in long-term longitudinal studies using CBCT and stricter evaluation criteria. [source] Risk factors for injuries to maxillary permanent incisors and upper lip among schoolchildren in Dar es Salaam, TanzaniaINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2009FEBRONIA KOKULENGYA KAHABUKA Background.,, Dental trauma is common among children, and the maxillary permanent central incisors are the most often affected teeth. Aim.,, This study aimed to investigate the risk factors for injury to maxillary permanent incisors and the upper lip among Tanzanian schoolchildren aged 8,14 years. Design.,, A cross-sectional study involving 1119 children. The risk variables investigated included age, gender, lip competence, and overjet. The corresponding proportions of injuries and the relative risk (with 95% confidence interval) were calculated and tested by Fisher's exact test. Logistic regression was applied to ascertain the strength and direction of the association of the risk variables to injuries, and backward selection was used to test significant risk factors. Results.,, About 24% of the children had trauma to maxillary incisors, 45% had incompetent lip whereas 31% had increased overjet. Age, gender, overjet, and lip competence showed significant association with injuries to upper lip and maxillary incisors. Boys had sustained more injuries than girls, with a higher relative risk for luxation injuries. Enamel fracture was associated with overjet combined with lip competence, whereas enamel dentine fracture without pulp involvement was related to gender. Luxation injuries were associated with gender, tooth avulsion with overjet, and lip competence. Injury to the upper lip was associated with age. Conclusion.,, Male gender, increased overjet, and lip incompetence were the main risk factors of getting trauma to maxillary incisors, whereas age was the risk factor for injury to the upper lip. [source] Prevalence of early childhood caries among First Nations children, District of Manitoulin, OntarioINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2004S. Peressini Summary. Background., Epidemiological studies of Aboriginal communities in Canada and Native American populations in the United States have reported that early childhood caries (ECC) is highly prevalent. The purpose of this study was to determine the prevalence of ECC and dental caries in the First Nations population of 3- and 5-year-old children in the District of Manitoulin, Ontario to assist in developing effective dental health promotion strategies. Methods., All 3- and 5-year-old children in elementary schools and day-care centres in seven First Nation communities were eligible for the survey examination. Three-year-old children at home and 5-year-old children attending school off-reserve in six of the communities were also eligible for epidemiological survey examination of oral health status including caries, gingival and soft tissue conditions. Cases of ECC were defined as children with caries or restorations on two or more primary maxillary incisors or canines or those having a total decayed, missing, filled primary teeth (dmft) score of 4 or greater. Results., A total of 87 children (59% 5 years old, 54% females) were examined. Seventy-four per cent of children had one or more carious lesions. Forty-five cases of ECC were found, a prevalence of 52%. The mean dmft score for cases was 7·5 (95% CI 6·5,8·4) and 0·8 (95% CI 0·5,1·1) for non-cases (P < 0·001). Boys in both age groups were more likely to be affected by ECC than girls. Conclusion., Our results indicate that dental caries and ECC are highly prevalent in this population, with ECC cases having 6.7 more dmft than non-cases. [source] The gingival biotype revisited: transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingivaJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 5 2009Tim De Rouck Abstract Aim: To detect groups of subjects in a sample of 100 periodontally healthy volunteers with different combinations of morphometric data related to central maxillary incisors and surrounding soft tissues. Material and Methods: Four clinical parameters were included in a cluster analysis: crown width/crown length ratio (CW/CL), gingival width (GW), papilla height (PH) and gingival thickness (GT). The latter was based on the transparency of the periodontal probe through the gingival margin while probing the buccal sulcus. Every first volunteer out of 10 was re-examined to evaluate intra-examiner repeatability for all variables. Results: High agreement between duplicate recordings was found for all parameters, in particular for GT, pointing to 85% (,=0.70; p=0.002). The partitioning method identified three clusters with specific features. Cluster A1 (nine males, 28 females) displayed a slender tooth form (CW/CL=0.79), a GW of 4.92 mm, a PH of 4.29 mm and a thin gingiva (probe visible on one or both incisors in 100% of the subjects). Cluster A2 (29 males, five females) presented similar features (CW/CL=0.77; GW=5.2 mm; PH=4.54 mm), except for GT. These subjects showed a clear thick gingiva (probe concealed on both incisors in 97% of the subjects). The third group (cluster B: 12 males, 17 females) differed substantially from the other clusters in many parameters. These subjects showed a more quadratic tooth form (CW/CL=0.88), a broad zone of keratinized tissue (GW=5.84 mm), low papillae (PH=2.84 mm) and a thick gingiva (probe concealed on both incisors in 83% of the subjects). Conclusions: The present analysis, using a simple and reproducible method for GT assessment, confirmed the existence of gingival biotypes. A clear thin gingiva was found in about one-third of the sample in mainly female subjects with slender teeth, a narrow zone of keratinized tissue and a highly scalloped gingival margin corresponding to the features of the previously introduced "thin-scalloped biotype" (cluster A1). A clear thick gingiva was found in about two-thirds of the sample in mainly male subjects. About half of them showed quadratic teeth, a broad zone of keratinized tissue and a flat gingival margin corresponding to the features of the previously introduced "thick-flat biotype" (cluster B). The other half could not be classified as such. These subjects showed a clear thick gingiva with slender teeth, a narrow zone of keratinized tissue and a high gingival scallop (cluster A2). [source] CLINICAL CONSIDERATIONS FOR RESTORING MANDIBULAR INCISORS WITH PORCELAIN LAMINATE VENEERSJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 4 2008Robert D. Walter DDS Authors Porcelain laminate veneers have been proven to be a successful treatment modality for maxillary incisors in clinical practice and in controlled clinical studies. However, the data in clinical studies on the success of veneers for restoring mandibular incisors are limited. Clinically, the successful restoration of mandibular incisors with porcelain laminate veneers is one of the more challenging procedures in all of esthetic restorative dentistry. Limited coronal dimensions, the small amount of enamel available for bonding (particularly in the cervical areas), materials and techniques for the bonding procedures, and the response of the tooth,veneer complex to forces generated during the incisal loading in both functional as well as parafunctional contacts must be considered as potential sources of success or failure. This Critical Appraisal reviews three recent scientific articles to shed some light on these issues and, as in all research endeavors, leads the reader to identify additional areas of concern that might stimulate further scientific inquiry. The first publication studied predictors for enamel thickness for mandibular incisors. The second examined bonding protocols for exposed dentin and suggested immediate dentin sealing. The third paper addressed fracture behavior of mandibular incisors restored with porcelain laminate veneers in vitro. [source] Tooth displacement due to occlusal contacts: a three-dimensional finite element studyJOURNAL OF ORAL REHABILITATION, Issue 12 2006S. GOMES DE OLIVEIRA summary, The use of the Finite Element Method (FE) is an appropriate way to study occlusal forces and tooth movement. The purpose of this study was to evaluate the effects of different occlusal contact patterns on tooth displacement in an adult dentition using a three-dimensional FE model of a human maxilla and mandible. Initially, images of a computerized tomography scan were redrawn in a computer program (CATIA) followed by the FE mesh construction. The MSC/Patran software was used to develop the FE mesh comprising 520 445 elements and 106 633 nodes. The MSC/Nastran program was utilized as pre and post-processor for all mathematical calculations necessary to evaluate dental and mandibular biomechanics. Four occlusal patterns were tested: FEM 1 , standard occlusal contacts; FEM 2 , removal of mesial marginal and mesial tripoidism contacts; FEM 3 , removal of distal marginal and distal tripoidism contacts; FEM 4 , similar to FEM 3 with added contacts between upper and lower incisors. Small changes in the standard distribution of occlusal contacts resulted in an imbalance of occlusal forces and changes in dental positioning. All simulations tested showed mesial displacement of posterior teeth. The most significant changes were registered in the model presenting unstable occlusal contacts when the anterior teeth were in occlusion (FEM 4). These findings may explain mandibular incisors crowding and maxillary incisors flaring as a result of small variations in dental contacts. [source] Dentoalveolar reconstruction of a missing premaxilla using bone graft and endosteal implantsJOURNAL OF ORAL REHABILITATION, Issue 1 2003M. Fukuda summary We report here on a patient with bilateral cleft lip and palate (BCLP) and a missing premaxilla, who underwent dentoalveolar reconstruction of the cleft and premaxillary alveolus using endosteal implants after bone grafting. The patient, whose maxillary incisors and premaxilla were missing, had corticocancellous bone grafting from the iliac crest, followed by excellent bone formation at the anterior alveolus. After the placement of the endosteal implants and the completion of the pre-surgical orthodontic alignment, orthognathic surgery was performed for the restoration of a Class III open bite. After post-operative orthodontic preparation, the final fixed prostheses were completed. This treatment procedure offers an option of dentoalveolar reconstruction for BCLP patients with an excised premaxilla. [source] | ||||||||||