Treatment of Class III malocclusion in a young adult patient: a case report.

PubMed

Kiran, B H Jyothi; Kumar, Prashanth; Ravi, S; Shivalinga, B M; Bhagyalaxmi; Pradeep; Kudagi, Vishal

2012-01-01

This article describes the treatment of a young adult male with a concave profile, skeletal class III malocclusion because of a prognathic mandible and proclined upper incisors. The therapy included stages: 1. Pre-surgical orthodontics involving leveling and aligning of upper and lower arches, protraction of lower molars and retraction of upper incisors; 2. Surgical phase involving BSSO with mandibular setback and 3. Post-surgical orthodontics for finishing and detailing. The treatment lasted 23 months and improved facial esthetics significantly The treatment resulted in a functional occlusion with a lack of lateral cuspid guidance that could be accepted considering the difficulty of the case. Over jet and overbite are within norms.

Morphological features of the maxillary incisors roots and relationship with neighbouring anatomical structures: possible implications in endodontic surgery.

PubMed

Taschieri, S; Weinstein, T; Rosano, G; Del Fabbro, M

2012-05-01

The purpose of this study was to investigate the relationship between the root apex of the upper incisors and neighbouring anatomical structures as well as the morphology of the root-end foramen after apicoectomy. Fifty-seven patients requiring endodontic surgical treatment for a maxillary anterior root were enrolled. A preoperative diagnostic computed tomography (CT) scan was analysed to determine: the distance between the anterior wall of the nasopalatine duct and the central (CI-ND) incisor root 4mm from the apex; and the distance between the floor of the nasal cavity and the tip of either the central (CI-NF) or the lateral (LI-NF) incisor root. After apicoectomy, root-end foramen endoscopic pictures were taken in order to characterize their morphology. Fifty-nine central and 26 lateral incisors were evaluated. The average CI-ND was 4.71 ± 1.26 (SD) mm. The average CI-NF was 10.62 ± 2.25 mm. The average LI-NF was 13.05 ± 2.43 mm. The foramen shape after apicoectomy was ovoid to circular in about 90% of cases in both central and lateral incisors. A sound knowledge of the anatomical relationships at the surgical site is essential for the clinician to perform a safe endodontic surgical procedure. Copyright © 2011 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

The relationship between apical root resorption and orthodontic tooth movement in growing subjects.

PubMed

Xu, Tianmin; Baumrind, S

2002-07-01

To investigate the relationship between apical root resorption and orthodontic tooth movement in growing subjects. 58 growing subjects were collected randomly into the study sample and another 40 non-treated cases were used as control. The apical resoption of the upper central incisors was measured on periapical film and the incisor displacement was measured on lateral cephalogram. Using multiple linear regression analysis to examine the relationship between root resoption and the displacement of the upper incisor apex in each of four direction (retraction, advancement, intrusion and extrusion). The statistically significant negative association were found between resorption and both intrusion (P < 0.001) and extrusion (P < 0.05), but no significant association was found between resorption and both retraction and advancement. The regression analysis implied an average of 2.29 mm resorption in the absence of apical displacement. The likelihood that the magnitude of displacement of the incisor root is positively associated with root resoption in the population of treated growing subjects is very small.

[Developmental radicular groove as a cause of endodontic failure].

PubMed

Fabra Campos, H; Millet Part, J

1989-01-01

A clinical case of apical injury on an upper lateral incisor with endodontical and surgical failures in its treatment is presented. Extraction of the incisor and its study at the stereoscopic microscope showed the existence of a developmental groove running from the cingulum to the end of the root, establishing a communication between the crevice and the apical part of the tooth. Bacterial infection through the groove could provide an explanation for treatment failure.

Maxillary canine impactions related to impacted central incisors: two case reports.

PubMed

Bayram, Mehmet; Ozer, Mete; Sener, Ismail

2007-09-01

The purpose of this case report is to describe the combined surgical and orthodontic treatment of two cases with an impacted maxillary central incisor and canine in the same quadrant and to discuss the causal relationship between them. The most common causes of canine impactions are usually the result of one or more factors such as a long path of eruption, tooth size-arch length discrepancies, abnormal position of the tooth bud, prolonged retention or early loss of the deciduous canine, trauma, the presence of an alveolar cleft, ankylosis, cystic or neoplastic formation, dilaceration of the root, supernumerary teeth, and odontomas. Although impaction of the maxillary central incisor is almost as prevalent as impacted canines its etiology is different. The principal factors involved in causing the anomaly are supernumerary teeth, odontomas, and trauma. Case #1: A 10.5-year-old girl in the early mixed dentition stage presented with a chief complaint of the appearance of her anterior teeth. She had a Class I skeletal pattern and a history of trauma to the maxillary central incisors at age five with premature exfoliation. Radiographs revealed an impacted upper right central incisor in the region of the nasal floor, delayed eruption of the maxillary permanent central incisor, and the adjacent lateral incisor was inclined toward the edentulous space. Treatment was done in two stages consisting of surgical exposure and traction of the impacted central incisor and fixed orthodontic treatment. Case #2: An 11.5-year-old girl presented for orthodontic treatment with the chief complaint of an unerupted tooth and the appearance of her upper anterior teeth. She was in the late mixed dentition period with a Class III skeletal pattern along with an anterior cross-bite with some maxillary transverse deficiency. The maxillary right canine and central incisor were absent, but the maxillary right deciduous canine was still present. Treatment included arch expansion followed by surgical exposure and traction of the impacted teeth and fixed orthodontic treatment. This case report provides some evidence of a significant environmental influence of an impacted maxillary central incisor on the path of eruption of the ipsilateral maxillary canine. When an impacted maxillary central incisor exists, the maxillary lateral incisor's root might be positioned distally into the path of eruption of the maxillary canine preventing its normal eruption. Ongoing assessment and early intervention might help to prevent such adverse situations from occurring.

Camouflage treatment of skeletal Class III malocclusion with multiloop edgewise arch wire and modified Class III elastics by maxillary mini-implant anchorage.

PubMed

He, Shushu; Gao, Jinhui; Wamalwa, Peter; Wang, Yunji; Zou, Shujuan; Chen, Song

2013-07-01

To evaluate the effect of the multiloop edgewise arch wire (MEAW) technique with maxillary mini-implants in the camouflage treatment of skeletal Class III malocclusion. Twenty patients were treated with the MEAW technique and modified Class III elastics from the maxillary mini-implants. Twenty-four patients were treated with MEAW and long Class III elastics from the upper second molars as control. Lateral cephalometric radiographs were obtained and analyzed before and after treatment, and 1 year after retention. Satisfactory occlusion was established in both groups. Through principal component analysis, it could be concluded the anterior-posterior dental position, skeletal sagittal and vertical position, and upper molar vertical position changed within groups and between groups; vertical lower teeth position and Wits distance changed in the experimental group and between groups. In the experimental group, the lower incisors tipped lingually 2.7 mm and extruded 2.4 mm. The lingual inclination of the lower incisors increased 3.5°. The mandibular first molars tipped distally 9.1° and intruded 0.4 mm. Their cusps moved 3.4 mm distally. In the control group, the upper incisors proclined 3°, and the upper first molar extruded 2 mm. SN-MP increased 1.6° and S-Go/N-ME decreased 1. The MEAW technique combined with modified Class III elastics by maxillary mini-implants can effectively tip the mandibular molars distally without any extrusion and tip the lower incisors lingually with extrusion to camouflage skeletal Class III malocclusions. Clockwise rotation of the mandible and further proclination of upper incisors can be avoided. The MEAW technique and modified Class III elastics provided an appropriate treatment strategy especially for patients with high angle and open bite tendency.

Nonextraction Treatment of Severe Crowding with the Aid of Corticotomy-Assisted Orthodontics

PubMed Central

Aljhani, Ali S.; Zawawi, Khalid H.

2012-01-01

This paper illustrates the combined nonextraction orthodontic treatment with the corticotomy technique in an adult patient (age: 25 years and 3 months) with severely crowded arches to accelerate tooth movement and shorten the treatment time. Both her upper lateral incisors were congenitally absent and both upper central incisors' roots were short. Initial fixed orthodontic appliances (bidimensional) were bonded and one week later buccal and lingual corticotomy with alveolar augmentation procedure in the maxilla and mandible was performed. Orthodontic activation to level and align and unravel the crowding was performed every two weeks. The total treatment time was 8 months with no adverse effects observed at the end of active treatment. The addition of the decortication procedure to the conventional orthodontic therapy decreased the duration of treatment significantly. Successful alignment of both arches with ideal overbite and overjet as well as adequate occlusion was achieved. PMID:22848854

Skeletal and dental stability after maxillary distraction with a rigid external device in adult cleft lip and palate patients.

PubMed

Aksu, Muge; Saglam-Aydinatay, Banu; Akcan, Cenk Ahmet; El, Hakan; Taner, Tulin; Kocadereli, Ilken; Tuncbilek, Gokhan; Mavili, Mehmet Emin

2010-02-01

To evaluate skeletal and dental stability in adult cleft lip and palate patients treated with a rigid external distraction system at the end of distraction and during the postdistraction period. Lateral cephalograms of 7 patients were obtained before distraction, at the end of distraction, and during the postdistraction period. The mean age before distraction was 21.56 +/- 4.73 years. The mean follow-up was 37.3 +/- 12.4 months. The assessment of findings showed that skeletal maxillary sagittal movement was achieved in a superoanterior direction. The maxillary depth angle and effective maxillary length increased significantly (2 degrees and 9 mm, respectively) after distraction, whereas the palatal plane angle increased by 8 degrees , resulting in an anterior movement of the maxilla with a counterclockwise rotation. The lower facial height showed no significant changes after distraction. The sagittal movement of the upper incisors and the angulation of the upper first molars increased significantly (4.5 mm and 5.5 degrees , respectively). During the postdistraction period, the maxilla showed a slight relapse (22%). The effective maxillary length decreased by 2 mm. The palatal plane angle almost returned to its original position, showing 7 degrees of clockwise rotation. The lower facial height remained stable. The upper incisors moved anteriorly and the upper first molars showed a significant mesioangular change during follow-up. After distraction, significant maxillary advancement was achieved with a counterclockwise rotation. The upper incisors moved labially, and the upper first molars angulated mesially. After 3 years, a 22% relapse rate was seen in the maxilla. The counterclockwise rotation of the maxilla was returned to its original position. The upper incisors moved more anteriorly. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Analysis of the golden proportion and width/height ratios of maxillary anterior dentition in patients with lateral incisor agenesis.

PubMed

Pini, Núbia Pavesi; de-Marchi, Luciana Manzotti; Gribel, Bruno Frazão; Ubaldini, Adriana Lemos Mori; Pascotto, Renata Corrêa

2012-12-01

  The purpose of this study was to assess the presence of the golden proportion (GP) in the facial view tooth-to-tooth width proportion of the six maxillary anterior teeth and to evaluate the width/height (W/H) ratios of the incisors of patients with maxillary lateral incisor (LI) agenesis treated either with implants or orthodontically (by moving canines into the position of the laterals, recontouring them, and placing composite restorations over the repositioned teeth).   Forty-eight patients with LI agenesis were divided into four experimental groups: unilateral recontouring group (N = 10), bilateral recontouring group (BRG, N = 18), unilateral implant group (UIG, N = 10), bilateral implant group (N = 10), and a control group (CG, N = 25) of patients without agenesis. GP ratios were determined on patients' dental casts placed over Levin's grids, whereas W/H ratios were measured directly on the casts and a millimeter ruler to determine these distances. Statistical analysis was performed with Shapiro-Wilk, Kruskal-Wallis, Mann-Whitney, Friedman, and Wilcoxon tests (p < 0.05).   The incidence of GP in the tooth-to-tooth width proportions was significantly different between groups and more commonly found between centrals and laterals than between laterals and canines. The GP was more likely to be observed in the BRG, UIG, and CG. The results demonstrated that the GP was not found to be present in the majority of the cases treated with maxillary agenesis, regardless of the method of treatment. The mean W/H ratios of the laterals ranged between 0.75 and 0.90.   Although the GP may be a useful diagnostic guide, it was not observed in the majority of esthetic outcomes of patients treated with maxillary LI agenesis in this study. The assessment of the golden proportion and width/height ratio of upper anterior teeth in patients with upper lateral incisor agenesis treated with either implants or tooth re-contouring may assist dentists and patients in deciding the best treatment option based on the peculiarities of each case. © 2012 Wiley Periodicals, Inc.

A study of Class III treatment: orthodontic camouflage vs orthognathic surgery.

PubMed

Georgalis, Katherine; Woods, Michael G

2015-11-01

To evaluate the differences in pretreatment and post-treatment characteristics of Class III patients treated with orthodontic camouflage or orthognathic surgery, and to compare the range of skeletal, dental and soft tissue changes that are likely to occur with treatment, with particular reference to the influence of extractions on the resultant incisor angulations. Pretreatment and post-treatment cephalograms of 31 Class III orthodontically-camouflaged patients and 36 Class III surgical patients (without genioplasty) were obtained from one specialist practice. From the surgical group, 26 pre-surgical lateral cephalograms were also obtained. Inclusion criteria for the two groups were at least three of the following: (1) an ANB angle of 1 degree or less, (2) a Wits appraisal less than -4 mm, (3) an incisal overjet ≤ 0 mm, and (14) a Class III molar relationship. All lateral cephalograms were traced and digitised and a number of skeletal, dental and soft tissue variables were measured. The camouflage and surgical groups were also divided into premolar extraction and non-extraction subgroups to allow for a specific analysis of extraction effects. Before treatment, the surgical group demonstrated, on average, a more severe skeletal discrepancy and increased dental compensations, compared with the orthodontically camouflaged group. After treatment, the mean SNA angle was greater, the ANB angle was more positive, the Wits appraisal was closer to ideal and the lower incisors were less retroclined in the surgery group. There was a small mean reduction in horizontal chin projection in the surgery group compared with a small increase in the camouflage group. The mentolabial fold and the lower lip curve were deeper, on average, and the lips less retrusive after surgery. There was a mean increase in upper incisor proclination during treatment in both the surgical and camouflage groups with a greater increase in the camouflage group. There was a significant reduction in upper incisor proclination and a subsequent greater increase in the ANB angle associated with upper premolar extractions in the surgical group compared with the non-extraction group. Lower premolar extractions in the camouflage group resulted only in a deeper mentolabial fold compared with those treated without lower extractions. Class III patients selected for surgical treatment are likely to have more severe pretreatment dental and skeletal discrepancies than those selected for camouflage treatment. Surgical treatment is associated with significant decompensation of the lower incisors but, ultimately, not the upper incisors. Class III patients treated with either camouflage or surgery treatment are likely to finish with slightly proclined upper incisors. Generally, surgical treatment results in greater skeletal change, involving normalisation of the skeletal base relationship, a reduction in chin prominence, fuller lips, and a more favourable lip and chin contour.

Orthodontic movement of a maxillary incisor through the midpalatal suture: a case report.

PubMed

Garib, Daniela Gamba; Janson, Guilherme; dos Santos, Patrícia Bittencourt Dutra; de Oliveira Baldo, Taiana; de Oliveira, Gabriela Ulian; Ishikiriama, Sérgio Kiyoshi

2012-03-01

Orthodontic space closure is a treatment alternative when a maxillary central incisor is missing. The objective of this report was to present an unusual treatment in which a right maxillary central incisor was moved through the midpalatal suture to replace the absent contralateral tooth. The biologic aspects and clinical appearance of the recontoured lateral and central incisors were analyzed. The position of the examined teeth and the appearance of the surrounding soft tissues were satisfactory; however, the upper midline frenulum deviated to the left. The incisor was successfully moved with no obvious detrimental effects as observed on the final radiographs. In the radiographic and tomographic examinations, the midline suture seemed to have followed the tooth movement. The patient expressed satisfaction with the results. It was concluded that orthodontic movement of the central incisor to replace a missing contralateral tooth is a valid treatment option, and the achievement of an esthetic result requires an interdisciplinary approach, including restorative dentistry and periodontics.

Assisted eruption of impacted teeth into an alveolar bone graft in a patient with cleft lip and palate.

PubMed

Peamkaroonrath, Chonthicha; Manosudprasit, Montien; Godfrey, Keith

2008-11-01

To assist the eruption of impacted upper teeth into an alveolar bone graft in a patient with a unilateral cleft lip and palate. An 8-year-old Thai boy with left unilateral complete cleft lip and palate had the chief complaint of anterior crossbite. He presented with a mild skeletal 3, dental Class III subdivision malocclusion, anterior crossbite, left unilateral posterior crossbite, moderate crowding in the upper arch with impaction of upper the left lateral incisor (tooth 22) and canine (tooth 23). In the first phase of treatment the posterior crossbite was corrected with a removable appliance with a 3-way screw. In the second phase the impacted teeth were surgically exposed, moved into the alveolar bone graft and the teeth aligned with fixed appliances. The upper left lateral incisor was extracted because of its questionable longevity. The orthodontic treatment resulted in normal overjet, overbite and an acceptable facial profile. A prosthesis replaced tooth 22. Forced eruption of impacted teeth can be carried out successfully in the cleft patients after an appropriate treatment plan has been formulated and following preparation of alveolar bone graft in the cleft site.

[Nonsurgical retreatment of lateral radiopacity after surgical treatment].

PubMed

Arias de Luxan, A

1990-01-01

A case report is presented of an upper central incisor with incomplete endodontic procedure evidencing a radiolucent image that was treated by apicoectomy and retroamalgam. A year later the periapical lesion had healed completely but a new lateral radiolucency is observed. A reentry of the canal is performed eliminating the old obturating material, biomechanical preparation and obturation with sealer and thermo gutta-percha. The lesion was cured in nine months.

Differences in lightness, chroma, and hue in the anterior teeth of quinquagenarians and septuagenarians.

PubMed

Eiffler, Constantin; Cevirgen, Engin; Helling, Stephan; Zornek, Juanita; Pritsch, Maria; Hassel, Alexander Jochen

2010-10-01

The purpose of this study was to evaluate, for both genders and two elderly age groups, differences in lightness, chroma, and hue of pairs of natural anterior teeth, so that more accurate information on color would be available for the production of dentures with a natural appearance. The subjects in the younger group (YG) were 54 to 56 years of age, those in the older group 73 to 75 (N = 195, 48% women). Tooth color was measured using a spectrophotometer. Mixed models were calculated for each pair of teeth, with gender as a fixed factor. Gender did not have a significant effect in either age group. In both groups, differences in chroma between upper canines and lateral incisors and in lightness and hue between upper and lower canines were observed. In the YG, additional differences were found, with the only exception of the comparison between upper central and lateral incisors. The nongender-specific color differences observed should be considered when producing denture teeth for these groups of patients, in order to come as close as possible to the natural color ideal.

[Effect of soft tissue thickness of upper lip on lip retraction in orthodontical-treated Class II, Division 1 females].

PubMed

Zou, Lanyi; Chen, Yunjia; Liu, Henglang; Na, Bi; He, Jinlong; Fan, Xiaoping

2016-04-01

To establish the Chinese Han national criteria for the thickness of upper lip in Chongqing and to investigate the effect of lip thickness on lip retraction in orthodontic treatment.
 A total of 240 adult patients (male=120, female=120) of Chinese Han nationality aged 18-35 years in Chongqing were treated with cephalograms and measured the thickness of upper lip. We established the Chinese Han national criteria for the thickness of upper lip in Chongqing according to the results. Sixty-eight female patients with Angle II 1 from Department of Orthodontics Stomatological Hospital of Chongqing Medical University were treated with maxillary premolars extraction, and pre- and post-treated with lateral cephalograms, then divided into 3 groups according to our criteria: a thin lips group, a normal lips group and a thick lips group. The ratio of the incisors retraction and the upper lip retraction were measured and calculated. The correlation between incisors retraction and the upper lip retraction was analyzed by the Pearson correlation method.
 There was statistical significance in the thickness of upper lip between males and females (P<0.01). The ratio of maxillary inscior retraction to the upper lip soft tissue retraction was 1.6:1, 2.2:1 and 2.9:1 in the thin lips group, the normal lips group and the thick lips group, respectively.
 Gender differences exist in the thickness of upper lip. Upper lip retraction with the incisors was negatively correlated with the soft tissue thickness of the upper lip in females with Angle II 1.

The influence of varying maxillary lateral incisor dimensions on perceived smile aesthetics.

PubMed

Bukhary, S M N; Gill, D S; Tredwin, C J; Moles, D R

2007-12-22

The aim of this study was to determine the influence of varying the dimensions of the maxillary lateral incisors on perceived smile aesthetics. Clinical study. Postgraduate dental teaching hospital. A photograph of a female smile displaying only the lips and teeth was digitally altered. First, the width of the maxillary lateral incisors, in proportion to the central incisor, was altered at 5% intervals to produce six images (52%, 57%, 62% [the 'golden proportion'], 67%, 72% and 77%). In a second group, the length of the lateral incisor was altered at 0.5 mm increments to produce five images with the lateral incisor 0.5 mm, 1 mm, 1.5 mm, 2 mm and 2.5 mm shorter than the adjacent central incisor. The photos were ranked from 'most attractive' to 'least attractive' by 41 hypodontia patients, 46 non-hypodontia 'control' patients and 30 dentists. The 67% followed by the 72% lateral-to-central width proportions were the 'most preferred' by all groups. A maxillary lateral incisor that is 1-1.5 mm shorter than the central incisor was the 'most popular' maxillary lateral incisor length. The very short and very long maxillary lateral incisor was consistently perceived as 'least attractive'. There is no evidence to suggest that the golden proportion should be considered the ideal aesthetic standard when creating space for the replacement of missing lateral incisors.

Torque Control During Intrusion on Upper Central Incisor in Labial and Lingual bracket System - A 3D Finite Element Study.

PubMed

Pol, Tejas R; Vandekar, Meghna; Patil, Anuradha; Desai, Sanjana; Shetty, Vikram; Hazarika, Saptarshi

2018-01-01

The aim of present study was to investigate the difference of torque control during intrusive force on upper central incisors with normal, under and high torque in lingual and labial orthodontic systems through 3D finite element analysis. Six 3D models of an upper right central incisor with different torque were designed in Solid Works 2006. Software ANSYS Version 16.0 was used to evaluate intrusive force on upper central incisor model . An intrusive force of 0.15 N was applied to the bracket slot in different torque models and the displacements along a path of nodes in the upper central incisor was assessed. On application of Intrusive force on under torqued upper central incisor in Labial system produce labial crown movement but in Lingual system caused lingual movement in the apical and incisal parts. The same intrusive force in normal-torqued central incisor led to a palatal movement in apical and labial displacement of incisal edge in Lingual system and a palatal displacement in apical area and a labial movement in the incisal edge in Labial systemin. In overtorqued upper central incisor, the labial crown displacement in Labial system is more than Lingual system. In labial and lingual system on application of the same forces in upper central incisor with different inclinations showed different responses. The magnitudes of torque Loss during intrusive loads in incisors with normal, under and over-torque were higher in Labial system than Lingual orthodontic appliances. Key words: FEM, lingual orthodontics, intrusion, torque control, labial bracket systems.

The Dance of Tusks: Rediscovery of Lower Incisors in the Pan-American Proboscidean Cuvieronius hyodon Revises Incisor Evolution in Elephantimorpha

PubMed Central

2016-01-01

The incisors of proboscideans (tusks and tushes) are one of the most important feature in conservation, ecology and evolutionary history of these mammals. Although the absence of upper incisors is rare in proboscideans (occurring only in deinotheres), the independent losses of lower incisors are recognized for most of its lineages (dibelodont condition). The presence of lower incisors in the Pan-American gomphothere Cuvieronius hyodon was reported a few times in literature, but it was neglected in systematic studies. We analyzed several specimens of Cuvieronius hyodon from the Americas and recognized that immature individuals had lower incisors during very early post-natal developmental stages. Subsequently, these are lost and lower incisors alveoli close during later developmental stages, before maturity. Moreover, for the first time in a formal cladistic analysis of non-amebelodontine trilophodont gomphotheres, Rhynchotherium and Cuvieronius were recovered as sister-taxa. Among several non-ambiguous synapomorphies, the presence of lower incisors diagnoses this clade. We recognize that the presence of lower incisors in Cuvieronius and Rhynchotherium is an unique case of taxic atavism among the Elephantimorpha, since these structures are lost at the origin of the ingroup. The rediscovery of the lower incisors in Cuvieronius hyodon, their ontogenetic interpretation and the inclusion of this feature in a revised phylogenetic analysis of trilophodont gomphotheres brought a better understanding for the evolutionary history of these proboscideans. PMID:26756209

The Dance of Tusks: Rediscovery of Lower Incisors in the Pan-American Proboscidean Cuvieronius hyodon Revises Incisor Evolution in Elephantimorpha.

PubMed

Mothé, Dimila; Ferretti, Marco P; Avilla, Leonardo S

2016-01-01

The incisors of proboscideans (tusks and tushes) are one of the most important feature in conservation, ecology and evolutionary history of these mammals. Although the absence of upper incisors is rare in proboscideans (occurring only in deinotheres), the independent losses of lower incisors are recognized for most of its lineages (dibelodont condition). The presence of lower incisors in the Pan-American gomphothere Cuvieronius hyodon was reported a few times in literature, but it was neglected in systematic studies. We analyzed several specimens of Cuvieronius hyodon from the Americas and recognized that immature individuals had lower incisors during very early post-natal developmental stages. Subsequently, these are lost and lower incisors alveoli close during later developmental stages, before maturity. Moreover, for the first time in a formal cladistic analysis of non-amebelodontine trilophodont gomphotheres, Rhynchotherium and Cuvieronius were recovered as sister-taxa. Among several non-ambiguous synapomorphies, the presence of lower incisors diagnoses this clade. We recognize that the presence of lower incisors in Cuvieronius and Rhynchotherium is an unique case of taxic atavism among the Elephantimorpha, since these structures are lost at the origin of the ingroup. The rediscovery of the lower incisors in Cuvieronius hyodon, their ontogenetic interpretation and the inclusion of this feature in a revised phylogenetic analysis of trilophodont gomphotheres brought a better understanding for the evolutionary history of these proboscideans.

The Occurrence Rate and Diameter of Arteries Traveling Near the Mandible and an Assessment of the Relative Hemorrhage Risk in Implant Surgery.

PubMed

Katsumi, Yuji; Takagi, Ritsuo; Ohshima, Hayato

2016-10-01

Bleeding in the floor of the mouth during implant surgery is attributed to arterial injuries in the sublingual space. This study aimed to assess the relative hemorrhage risk during implant surgery. We investigated the occurrence rate and diameter of submental and sublingual arteries with special reference to their relationship with the course patterns of these arteries using 26 human cadavers. Three types of arteries were distinguished: main duct (MD), mucoperiosteal branches (MB), and cortical branches (CB). The occurrence rate of MB and CB was significantly high at the central incisor region in the upper part of the mylohyoid muscle, whereas the diameter of the MB and CB was significantly smaller than the occurrence rate of MD at the incisor regions. The occurrence rate of MD in the submental artery was significantly higher at the lateral incisor, canine, and premolar regions in the lower parts, whereas the occurrence rate of MD was significantly lower at the second and third molars in the upper parts. The susceptibility of the submental artery to injury is suggested at the incisors, canine, premolars, and first molar regions during implant surgery. © 2015 Wiley Periodicals, Inc.

Unpredictability of soft tissue changes after camouflage treatment of Class II division 1 malocclusion with maximum anterior retraction using miniscrews.

PubMed

Kim, Kayoung; Choi, Sung-Hwan; Choi, Eun-Hee; Choi, Yoon-Jeong; Hwang, Chung-Ju; Cha, Jung-Yul

2017-03-01

To compare soft and hard tissue responses based on the degree of maxillary incisor retraction using maximum anchorage in patients with Class II division 1 malocclusion. This retrospective study sample was divided into moderate retraction (<8.0 mm; n = 28) and maximum retraction (≥8.0 mm; n = 29) groups based on the amount of maxillary incisor retraction after extraction of the maxillary and mandibular first premolars for camouflage treatment. Pre- and posttreatment lateral cephalograms were analyzed. There were 2.3 mm and 3.0 mm of upper and lower lip retraction, respectively, in the moderate group; and 4.0 mm and 5.3 mm, respectively, in the maximum group. In the moderate group, the upper lip was most influenced by posterior movement of the cervical point of the maxillary incisor (β = 0.94). The lower lip was most influenced by posterior movement of B-point (β = 0.84) and the cervical point of the mandibular incisor (β = 0.83). Prediction was difficult in the maximum group; no variable showed a significant influence on upper lip changes. The lower lip was highly influenced by posterior movement of the cervical point of the maxillary incisor (β = 0.50), but this correlation was weak in the maximum group. Posterior movement of the cervical point of the anterior teeth is necessary for increased lip retraction. However, periodic evaluation of the lip profile is needed during maximum retraction of the anterior teeth because of limitations in predicting soft tissue responses.

Orthodontic treatment of a patient with unerupted maxillary central and lateral incisors and canine: a case report.

PubMed

Sabuncuoğlu, Fidan Alakuş; Olmez, Hüseyin

2012-05-01

The aim of this case report was to describe the orthodontic and periodontal management of a patient with three impacted anterior teeth. An 18-year-old female with Class I crowding on a Class I skeletal base presented with the chief complaint of an unaesthetic smile. Clinical examination revealed an impacted upper right permanent canine (13), lateral (12) and central incisor (11), a retained deciduous incisor and moderate crowding in the lower arch. The impacted teeth were surgically exposed (closed exposure) and aligned with fixed appliances. The 12 was extracted due to root resorption and 44 extracted to resolve the lower arch crowding. A fraenectomy and gingival recontouring were required. Orthodontic treatment resulted in improved overjet, overbite and an acceptable facial profile. The patient reported improved self esteem. While impacted anterior teeth are a clinical challenge, their surgical exposure, in combination with fixed appliances, is a conservative treatment plan which is not without complications.

Heritability estimates of dental arch parameters in Lithuanian twins.

PubMed

Švalkauskienė, Vilma; Šmigelskas, Kastytis; Šalomskienė, Loreta; Andriuškevičiūtė, Irena; Šalomskienė, Aurelija; Vasiliauskas, Arūnas; Šidlauskas, Antanas

2015-01-01

The genetic influence on dental arch morphology may be country-specific, thus it is reasonable to check the estimates of genetics across different populations. The purpose of this study was to evaluate the heredity of dental arch morphology in the sample of Lithuanian twins with accurate zygosity determination. The study sample consisted of digital dental models of 40 monozygotic (MZ) and 32 dizygotic (DZ) twin pairs. The estimates of heritability (h(2)) for dental arch breadth and length were calculated. All dental arch breadths and lengths were statistically significantly larger in men than in women. Arch length differences between genders were less expressed than largest breadth differences. In the upper jaw the largest genetic effect was found on the arch breadth between lateral incisors. The heritability of dental arch length demonstrated similar differences between upper and lower jaw with mandible dental arch length being more genetically determined. The largest genetic impact was found on the upper dental arch breadth between lateral incisors. Similar, but lower heritability is inherent for canines and first premolars of the upper jaw and first premolars of the lower jaw. It also can be noted, that arch breadths between posterior teeth show lower heritability estimates than between anterior teeth on both jaws. The dental arch in the upper jaw has more expressed genetic component than in the lower jaw.

Dental implants placement in paranoid squizofrenic patient with obsessive-compulsive disorder: A case report

PubMed Central

Castellanos-Cosano, Lizett; Corcuera-Flores, José-Ramón; Mesa-Cabrera, María; Cabrera-Domínguez, José; Torres-Lagares, Daniel; Machuca-Portillo, Guillermo

2017-01-01

Background Paranoid schizophrenia is a mental illness that involves no observable anatomical alteration. Main characteristic affects the personality of the individual, as well as areas of his own psychology. Case Report A 33-year-old man with paranoid schizophrenia and obsessive-compulsive disorder in treatment with Haloperidol, Oxcarbazepine, Olanzapine and Seroquel is presented. Dental exploration showed widespread decay mostly cervical with numerous root fragments, agenesis of lateral incisors, impacted wisdom teeth, missing teeth and malocclusion. Treatment plan included restoration of teeth decay, extractions of root fragments and implant-supported prostheses in bilateral upper lateral incisors for aesthetics reason. A previous consultation with a psychiatric specialist was performed and no contraindication were observed. A preliminary radiological examination was performed previous dental treatment and implant placement. Due to patient refusal to replace dental abscenses with implants, inform consent was signed up from his parents. After local anesthesia, first implant was placed at upper right lateral positions (Straumann Bone Level Ø 3.3 mm, length 10 mm). Two weeks later a second implant was placed at upper left lateral position (Straumann Bone Level Ø 3.3 mm, length 12 mm). The patient showed no postoperative complications. After implant placement, the patient attended scheduled review appointments. The prosthesis was placed after a 3-month period of osseointegration. Conclusions Implant placement can be considered a suitable option for people with mental disorders. A previous consultation with psychiatric specialists for conducting a good patient management is necessaire. Key words:Paranoid schizophrenia, obsessive-compulsive disorder, dental implants. PMID:29302292

Space closing versus space opening for bilateral missing upper laterals - aesthetic judgments of laypeople: a web-based survey.

PubMed

Qadri, Salim; Parkin, Nicola A; Benson, Philip E

2016-06-01

To investigate the opinions of laypeople regarding the aesthetic outcome of treating patients with developmental absence of both maxillary lateral incisors using either orthodontic space closure (OSC) or space opening and prosthetic replacement (PR). Cross sectional, web-based survey. A panel of five orthodontists and five restorative dentists examined post-treatment intra-oral images of 21 patients with developmental absence of both upper lateral incisors. A consensus view was obtained about the 10 most attractive images (5 OSC; 5 PR). The 10 selected images were used in a web-based survey involving staff and students at the University of Sheffield. In the first section, the participants were asked to evaluate the attractiveness of the 10 randomly arranged single images using a 5-point Likert scale. In the second section, an image of OSC was paired with an image of PR according to their attractiveness ranking by the clinician panel, and the participants were asked to indicate which of the two images they preferred. The survey received 959 completed responses with 9590 judgements. The images of OSC were perceived to be more attractive (mean rating 3·34 out of 5; SD 0·56) compared with the images of PR (mean rating 3·14 out of 5; SD 0·58) (mean diff 0·21; P < 0·001). Female and staff judges tended to give higher attractiveness ratings. Both females and males preferred the OSC images closing in 3 out of 4 paired images. Space closing was perceived to be more attractive than space opening by lay people. The findings have implications for advising patients about the best aesthetic outcome when both maxillary lateral incisors are missing.

Dental Number Anomalies and Their Prevalence According To Gender and Jaw in School Children 7 To 14 Years.

PubMed

Sejdini, Milaim; Çerkezi, Sabetim

2018-05-20

This study aimed to find the prevalence of Hypodontia and Hyperdontia in different ethnicities in patients from 7 to 14 years old. A group of 520 children were included aged 7 to 14 years, only the children who went to primary schools. Controls were performed by professional people to preserve the criteria of orthodontic abnormalities evaluation. The data were recorded in the individual card specially formulated for this research and all the patients suspected for hypodontia and hyperdontia the orthopantomography for confirmation was made. The data were analysed using descriptive statistical analysis using χ 2 test for the significant difference for p ˂ 0.05 and Fisher test for p < 0.05. Hypodontia, not counting the patients with missing third molars was found in 18 patients researched or 3.46%. The most commonly missing teeth were the second lower premolars, the second upper premolars, second upper lateral incisors followed by the lower incisors. Hyperdontia not including the third molars was found in 4 cases of the participants or 0.76% from which the most frequent atypical tooth mesiodens and one case of bilateral hypodontia of a lateral upper incisor with typical shape and size. But there were no significant differences when tested between genders and jaws. The prevalence we found is similar to the prevalence in the region. Our findings indicate that there is a difference between the genders in the prevalence of hypodontia, but without statistical significance, while for hyperdontia we can't see such a difference between the sexes.

[Effect of incisor retraction on three-dimensional morphology of upper airway and fluid dynamics in adult class Ⅰ patients with bimaxillary protrusion].

PubMed

Sun, F C; Yang, W Z; Ma, Y K

2018-06-09

Objective: To investigate the effect of incisor retraction on three-dimensional morphology of upper airway and fluid dynamics in class Ⅰ adult patients with bimaxillary protrusion. Methods: Thirty class Ⅰ patients with bimaxillary protrusion that received fixed orthodontic treatment in Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University from January 2011 to September 2014 were selected using random number table. All the patients were treated with extraction of four first premolars and retraction of anterior teeth using implant anchorage. Cone-beam CT (CBCT) scans were performed before and after incisor retraction for all patients. The CBCT data of the upper airway were constructed using Mimics 16.0, and the flow field characteristics inside the upper airway were simulated using Ansys 14.0. The changes of volume (V), mean cross-sectional area (mCSA), maximum lateral diameters/maximum anteroposterior diameters (LP/AP) of cross section, the maximum pressure of airflow (P(max)), the minimum pressure of airflow (P(min)) and pressure drop (△P) of nasopharynx, oropharynx and hypopharynx before and after incisor retraction were measured and compared using paired t test. The correlation between the variation of △P in the most significant pharyngeal part and the morphological variables after incisor retraction was analyzed using Pearson correlation test. Results: No statistical differences were observed in the morphology and flow field in nasopharynx before and after incisor retraction ( P> 0.05). Before incisor retraction, the oropharyngeal volume and mCSA were (7 580±622) mm(3) and (217±40) mm(2), respectively, and the hypopharyngeal volume and mCSA were (2 564±162) mm(3), and (239±43) mm(2), respectively. After incisor retraction, the volumes of oropharynx and hypopharynx were (6 885±601) mm(3) and (2 535±156) mm(3), respectively, and mCSA of oropharynx and hypopharynx were (197±37) mm(2) and (236±42) mm(2), respectively. The volume and mCSA of oropharynx and hypopharynx were significantly decreased after incisor retraction ( P< 0.05). The greatest changes in pharyngeal volume and mCSA occurred in the oropharynx. In addition, the LP/AP of oropharynx after incisor retraction was changed from 1.9±0.6 to 2.1±0.7, which was significantly increased compared with the levels before incisor retraction ( P< 0.05). After simulation of pharyngeal airflow, the oropharyngeal P(min), hypopharyngeal P(max) and P(min) were (-13.7±4.3), (-8.3±3.8) and (-42.8±9.5) Pa, respectively, whereas the values turned to (-16.4±6.5), (-11.9±3.6) and (-46.0±11.0) Pa, respectively after incisor retraction, which was significantly reduced ( P< 0.05). △P of oropharynx was significantly increased from (42.7±10.1) Pa to (45.2±13.0) Pa after incisor retraction ( P< 0.05) and the variation of oropharyngeal △P was negatively correlated with the variation of V and mCSA in oropharynx before and after incisor retraction ( r= -0.681, P= 0.001; r= -0.844, P= 0.000). Conclusions: The oropharynx was constricted and the pharyngeal resistance was increased after incisor retraction in adult class Ⅰ patients with bimaxillary protrusion. A comprehensive and systematic evaluation of the pharyngeal morphology and ventilatory function were very important for making a scientific and rational clinical treatment plan.

The gold nun: a case of a gold ligature from the 15th century and the origins of restorative dentistry in Europe.

PubMed

Cunha, Eugénia; Leal, Catarina; Munhós, Miguel; Baptista, Isabel Poiares

2017-12-01

We here report the discovery of a gold dental ligature from the late 15 th century, at the Convent of Santa Clara-a-Velha, in the city of Coimbra, Portugal. A medieval Clare's nun presented the left upper lateral incisor splinted to the canine, since the others three incisors were lost, most probably due to an aggressive periodontal disease. The convent is associated with the medieval upper class, which was well known for its consumption of high levels of sugar. There is a higher prevalence of caries in comparison to other Portuguese skeletal samples of the same time period, as well as a high prevalence of periodontal disease. Thus far, this is one of the earliest findings of dental treatment in Europe.

Endodontic-periodontal management of two rooted maxillary lateral incisor associated with complex radicular lingual groove by using spiral computed tomography as a diagnostic aid: a case report.

PubMed

Gandhi, A; Kathuria, A; Gandhi, T

2011-06-01

To present the successful endodontic and periodontal management of a two rooted maxillary lateral incisor tooth with a complex radicular lingual groove and severe periodontal destruction using spiral computed tomography as a diagnostic aid. A 30-year-old male patient presented with a chief complaint of mobility and discharge of pus in an upper front tooth. Clinical examination revealed a sinus tract on the labial gingival surface and a 10-mm-deep periodontal pocket associated with maxillary left lateral incisor tooth. On the lingual side, a groove emerging from cingulum, continuing mesioapically down the lingual aspect of tooth was found. Intraoral periapical radiographs demonstrated a lateral periodontal defect around the mesial aspect and a diffuse radiolucency at the apex of maxillary left lateral incisor tooth. The sinus tract was traced with gutta-percha to the maxillary left lateral incisor that showed an accessory root surrounded by a large radiolucent area. A spiral computed tomographic scan for better understanding of the complicated root canal morphology of the tooth was performed. Based on the clinical, radiographic and spiral computed tomographic findings, a diagnosis of an endo-perio lesion in tooth 22 was made. Management consisted of conventional root canal treatment, radiculoplasty, root resection of accessory root and surgical curettage of the periodontal defect. Follow-up with radiographic examination at 3 months and 1 year was performed. At 1-year recall, the patient was asymptomatic, there was no evidence of the sinus tract and a 3-mm nonbleeding pocket was present in relation to tooth 22. Progression of hard tissue healing was observed in the periapical radiograph taken 1 year postoperatively. The key to achieving favourable results in this particular type of developmental anomaly is accurate diagnosis and treatment planning. The health of the periapical osseous tissues appears to be the provital factor for tooth retention. A favourable outcome can only be achieved with a comprehensive treatment approach that effectively manages all local factors that are contributing to the disease process. © 2011 International Endodontic Journal.

Orthodontic-periodontic intervention of pathological migration of maxillary anterior teeth in advanced periodontal disease.

PubMed

Panchal, Anita H; Patel, Vasumati G; Bhavsar, Neeta V; Mehta, Hardik V

2013-05-01

This case report presents a female patient whose chief complaint was of mobile and palatally drifted upper left central incisor which led to malalignment of upper anterior teeth. Orthodontic treatment of upper left central incisor was done with the help of 'Z' spring for the alignment of the upper anterior teeth. It was followed by splinting of upper anterior teeth to improve the stability and masticatory comfort. Regenerative periodontal surgery with Decalcified freeze dried bone allograft was done in relation to upper left central incisor.

Prevalence of shovel-shaped incisors in Saudi Arabian dental patients.

PubMed

Saini, T S; Kharat, D U; Mokeem, S

1990-10-01

The prevalence of maxillary incisor shoveling was studied radiographically in 990 Saudi patients. According to the radiomorphologic characteristics, a new classification was developed and shovel teeth were categorized. The findings of this study showed 9% shovel-shaped incisors; among those, 4% were central incisors and 5% were lateral incisors. Frequency of dens invaginatus occurrence with the shovel-shaped incisors was also investigated. Eight percent of shovel-shaped incisors showed presence of dens invaginatus. Prevalence was found to be 4% in central shovel-shaped incisors, whereas that in lateral shovel-shaped incisors was 11%.

[Relationship between crown form of upper central incisors and papilla filling in Chinese Han-nationality youth].

PubMed

Yang, X; Le, D; Zhang, Y L; Liang, L Z; Yang, G; Hu, W J

2016-10-18

To explore a crown form classification method for upper central incisor which is more objective and scientific than traditional classification method based on the standardized photography technique. To analyze the relationship between crown form of upper central incisors and papilla filling in periodontally healthy Chinese Han-nationality youth. In the study, 180 periodontally healthy Chinese youth ( 75 males, and 105 females ) aged 20-30 (24.3±4.5) years were included. With the standardized upper central incisor photography technique, pictures of 360 upper central incisors were obtained. Each tooth was classified as triangular, ovoid or square by 13 experienced specialist majors in prothodontics independently and the final classification result was decided by most evaluators in order to ensure objectivity. The standardized digital photo was also used to evaluate the gingival papilla filling situation. The papilla filling result was recorded as present or absent according to naked eye observation. The papilla filling rates of different crown forms were analyzed. Statistical analyses were performed with SPSS 19.0. The proportions of triangle, ovoid and square forms of upper central incisor in Chinese Han-nationality youth were 31.4% (113/360), 37.2% (134/360) and 31.4% (113/360 ), respectively, and no statistical difference was found between the males and females. Average κ value between each two evaluators was 0.381. Average κ value was raised up to 0.563 when compared with the final classification result. In the study, 24 upper central incisors without contact were excluded, and the papilla filling rates of triangle, ovoid and square crown were 56.4% (62/110), 69.6% (87/125), 76.2% (77/101) separately. The papilla filling rate of square form was higher (P=0.007). The proportion of clinical crown form of upper central incisor in Chinese Han-nationality youth is obtained. Compared with triangle form, square form is found to favor a gingival papilla that fills the interproximal embrasure space. The consistency of the present classification method for upper central incisor is not satisfying, which indicates that a new classification method, more scientific and objective than the present one, is to be found.

The chronology and sequence of eruption of human permanent teeth in Northern Ireland.

PubMed

Kochhar, R; Richardson, A

1998-12-01

To ascertain the average and range of ages and sequence of eruption of human permanent teeth, taking into account the effect of premature loss of primary antecedents. Longitudinal study. Caucasian subjects in Northern Ireland. Study casts at 6-monthly intervals from age 5 to 15 years of 276 children (146 males and 130 females) enrolled in the Belfast Growth Study. The mean and range of ages of eruption of each individual tooth were computed. Comparisons were made between the mean ages of eruption with and without premature loss of primary antecedents, between upper and lower arches, between right and left sides and between males and females. The sequence of eruption was also investigated. The means and ranges of eruption ages are reported. Premature loss of primary antecedents delayed eruption of permanent successors except for the upper premolars which were accelerated. The differences relating to the upper first premolar and lower canine were not statistically significant. Each lower tooth erupted before its upper counterpart except for the premolars. There was no significant difference in age of eruption between right and left sides. Females tended to erupt teeth before males with the exception of the second molars in both arches; however, the only differences to reach statistical significance related to upper and lower canines and upper lateral incisors. The most frequent orders of eruption were unique to the subject. These occurred in 22% of upper and 33% of lower arches. The classic sequences: first molar-central incisor-lateral incisor-first premolar-canine-second premolar-second molar (M1-I1-I2-PM1-C-PM2-M2) in the upper arch and I1-M1-I2-C-PM1-PM2-M2 in the lower arch occurred in only 16% of upper arches and 13% of lower arches. Males adhered to the textbook sequence (20% upper, 17% lower) more than females (12% upper, 8% lower). In the upper arch of females, the order M1-I1-I2-PM1-PM2-C-M2 in 10% of subjects was almost as frequent as the classic sequence. The ages, ranges and orders of eruption found in this study are more reliable than many which are frequently quoted on account of its longitudinal nature and the fact that the effect of premature loss of primary antecedents is taken into account. The exclusively Caucasian sample makes the data quite precise but limits applicability to patients of this ethnic origin.

Morphologic evaluation of dentoalveolar structures of mandibular anterior teeth during augmented corticotomy-assisted decompensation.

PubMed

Ahn, Hyo-Won; Seo, Dong-Hwi; Kim, Seong-Hun; Park, Young-Guk; Chung, Kyu-Rhim; Nelson, Gerald

2016-10-01

Our aim in this study was to evaluate the effect of augmented corticotomy on the decompensation pattern of mandibular anterior teeth, alveolar bone, and surrounding periodontal tissues during presurgical orthodontic treatment. Thirty skeletal Class III adult patients were divided into 2 groups according to the application of augmented corticotomy labial to the anterior mandibular roots: experimental group (with augmented corticotomy, n = 15) and control group (without augmented corticotomy, n = 15). Lateral cephalograms and cone-beam computed tomography images were taken before orthodontic treatment and before surgery. The measurements included the inclination and position of the mandibular incisors, labial alveolar bone area, vertical alveolar bone height, root length, and alveolar bone thickness at 3 levels surrounding the mandibular central incisors, lateral incisors, and canines. The mandibular incisors were significantly proclined in both groups (P <0.001); however, the labial movement of the incisor tip was greater in the experimental group (P <0.05). Significant vertical alveolar bone loss was observed only in the control group (P <0.001). The middle and lower alveolar thicknesses and labial alveolar bone area increased in the experimental group. In the control group, the upper and middle alveolar thicknesses and labial alveolar bone area decreased significantly. There were no significant differences in dentoalveolar changes between the 3 kinds of anterior teeth in each group, except for root length in the experimental group (P <0.05). Augmented corticotomy provided a favorable decompensation pattern of the mandibular incisors, preserving the periodontal structures surrounding the mandibular anterior teeth for skeletal Class III patients. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Reversed palatal perforation by upper incisors in ageing blind mole-rats (Spalax ehrenbergi)

PubMed Central

ZURI, I.; TERKEL, J.

2001-01-01

Blind mole-rats (Spalax ehrenbergi) are fossorial solitary rodents that present striking morphological, physiological and behavioural adaptations to the subterranean environment in which they live. Previous studies have shown that mole-rats are specialised in tooth-digging. The rapid eruption-rate of their incisors has evolved to compensate for their excessive wear by excavation. Males use their incisors more than females for digging and fighting, and their rate of incisor eruption is significantly more rapid than in females. Since mole-rats use their incisors for digging throughout the year, we suggest that continuous mechanical pressure on their oral tissues concentrated at the apical sites of the upper incisors leads to cell and tissue fatigue. We provide evidence for 5 stages of palatal perforation by the upper incisors at their apical sites, with maximum perforation characterising aged males. Interspecies comparisons with 7 other fossorial and semi-fossorial rodent species, and with beavers, which expose their incisors to enormous mechanical pressure, revealed that this palatal perforation is unique to the male mole-rat. We suggest that while the fast eruption rate of incisors in the mole-rat compensates for the rapid wear resulting from digging, evolutionary adaptation to continuous tooth-digging is still ongoing, since the physical pressure of digging at the apical sites of the upper incisors leads to tissue destruction, breakage of the palatal bone and possibly to death, as a result of maxillary inflammation. PMID:11760890

Quantitative digital subtraction radiography in the assessment of external apical root resorption induced by orthodontic therapy: a retrospective study.

PubMed

Sunku, Raghavendra; Roopesh, R; Kancherla, Pavan; Perumalla, Kiran Kumar; Yudhistar, Palla Venkata; Reddy, V Sridhar

2011-11-01

The objective of this study was to evaluate density changes around the apices of teeth during orthodontic treatment by using digital subtraction radiography to measure the densities around six teeth (maxilla central incisors, lateral incisors, and canines) before and after orthodontic treatment in 36 patients and also assess treatment variables and their coorelation with root resorption. A total of 36 consecutive patient files were selected initially. The selected patients presented with a class I or II relationship and were treated with or without premolar extractions and fixed appliances. Some class II patients were treated additionally with extraoral forces or functional appliances. External apical root resorption (EARR) per tooth in millimeters was calculated and was also expressed as a percentage of the original root length. Image reconstruction and subtraction were performed using the software Regeemy Image Registration and Mosaicing (version 0.2.43-RCB, DPI-INPE, Sao Jose dos Campos, Sao Paulo, Brazil) by a single operator. A region of interest (ROI) was defined in the apical third of the root and density calibration was made in Image J® using enamel (gray value = 255) as reference in the same image. The mean gray values in the ROIs were reflective of the change in the density values between the two images. The root resorption of the tooth and the factors of malocclusion were analyzed with a one-way ANOVA. An independent t-test was performed to compare the mean amount of resorption between male and female, between extraction and nonextraction cases. The density changes after orthodontic treatment were analyzed using the Wilcoxon signedrank test. In addition, the density changes in different teeth were analyzed using the Kruskal-Wallis test. The cut-off for statistical significance was a p-value of 0.05. All the statistical analyses were carried out using SPSS (version 13.0 for Windows, Chicago, IL, USA). Gender, the age at which treatment was started and Angle's classification was not statistically related with observed root resorption. The mean percentage density reduction as assessed by DSR was greatest in both central incisor: by 27.2 and 25.2% in the upper-right and upper-left central incisors, respectively, followed by the upper-right and upper-left canine teeth (23.5 and 21.0%) and then the upper-right and upper-left lateral incisors (19.1 and 17.4%). Tooth extraction prior to treatment initiation and the duration of orthodontic treatment was positively correlated with the amount of root resorption. DSR is useful for evaluating density changes around teeth during orthodontic treatment. The density around the apices of teeth reduced significantly after the application of orthodontic forces during treatment. Assessment of density changes on treatment radiographs of patients undergoing orthodontic therapy may help in the monitoring of external apical root resorption during course of treatment.

Orthodontic intrusion of maxillary incisors: a 3D finite element method study

PubMed Central

Saga, Armando Yukio; Maruo, Hiroshi; Argenta, Marco André; Maruo, Ivan Toshio; Tanaka, Orlando Motohiro

2016-01-01

Objective: In orthodontic treatment, intrusion movement of maxillary incisors is often necessary. Therefore, the objective of this investigation is to evaluate the initial distribution patterns and magnitude of compressive stress in the periodontal ligament (PDL) in a simulation of orthodontic intrusion of maxillary incisors, considering the points of force application. Methods: Anatomic 3D models reconstructed from cone-beam computed tomography scans were used to simulate maxillary incisors intrusion loading. The points of force application selected were: centered between central incisors brackets (LOAD 1); bilaterally between the brackets of central and lateral incisors (LOAD 2); bilaterally distal to the brackets of lateral incisors (LOAD 3); bilaterally 7 mm distal to the center of brackets of lateral incisors (LOAD 4). Results and Conclusions: Stress concentrated at the PDL apex region, irrespective of the point of orthodontic force application. The four load models showed distinct contour plots and compressive stress values over the midsagittal reference line. The contour plots of central and lateral incisors were not similar in the same load model. LOAD 3 resulted in more balanced compressive stress distribution. PMID:27007765

A revision of hominin fossil teeth from Fontana Ranuccio (Middle Pleistocene, Anagni, Frosinone, Italy).

PubMed

Rubini, Mauro; Cerroni, Vittorio; Festa, Giulia; Sardella, Raffaele; Zaio, Paola

2014-12-01

The Fontana Ranuccio hominin teeth (FR, Latium, Italy) are dated to the Middle Pleistocene. In previous studies these teeth were classified as two lower (left and right) second molars, one lower left central incisor and a badly worn incisor crown, the exact position of which could not be determined. In 2012 these remains were acquired by the Anthropological Service of S.B.A.L. (Italian Ministry of Culture) and for this reason re-analysed. In a thorough revision we have reassessed them both morphologically and dimensionally as two lower (left and right) first molars, one lower left lateral incisor and a possible upper left canine. The comparison with penecontemporaneous and diachronic samples shows that the Fontana Ranuccio teeth are morphologically similar to Atapuerca-Sima de los Huesos, Arago XIII and Neanderthal samples. Copyright © 2014 Elsevier Ltd. All rights reserved.

Anatomoradiographic description of the teeth of pacas bred in captivity (Agouti paca, Linnaeus, 1766).

PubMed

Oliveira, F S; Canola, J C; Oliveira, P T; Pécora, J D; Capelli, A

2006-10-01

Two newborn males, two adult males 9 and 72 months old, one newborn female and two adult females of 30 and 54 months old pacas were used. Animals were radiographed on lateral recumbency, teeth were extracted and the vestibulolingual and mesiodistal lengths were achieved at the occlusal surface, besides the longitudinal length. The lower incisors presented greater length in relation to the other ones and sinuous shape; the upper incisors, relatively smaller, are practically straight. There is no canine tooth, and after a great diastema there is one premolar and three molars in each hemiarcade. In adult pacas, the enamel of incisors presents yellowish colour, mainly in the labial surface; in the premolars and molars, the enamel is present as internal sheets disposed nearly in a parallel way and in vestibulolingual direction, through practically all the dental length, which provides several joined teeth aspect.

Comparison of ropivacaine and lidocaine with epinephrine for infiltration anesthesia in dentistry. A randomized study.

PubMed

Krzemiński, Tadeusz Faustyn; Gilowski, Łukasz; Wiench, Rafał; Płocica, Iwona; Kondzielnik, Piotr; Sielańczyk, Andrzej

2011-10-01

To compare the efficacy of maxillary infiltration anesthesia with 0.5% plain ropivacaine or 2% lidocaine with epinephrine 1:100,000. 60 volunteers received 1.8 ml of the anesthetic for infiltration anesthesia of maxillary central and lateral incisors and canine teeth. The onset time and duration of pulp anesthesia were assessed with an electric pulp tester. The duration time of numbness of the upper lip was also monitored. Blood pressure and heart rate were measured before and after administration of the solution. The efficacy of anesthesia of the lateral and central incisors was 100% for both anesthetics. There were small insignificant differences in effectiveness of canine pulp anesthesia. The mean onset time was significantly shorter for ropivacaine--2.2 minutes vs. 5.1 for lidocaine. Ropivacaine also had a significantly longer duration of action--mean time 79.2 minutes. Ropivacaine caused statistically significant increases in blood pressure and heart rate.

Perception of altered smile esthetics among Moroccan professionals and lay people.

PubMed

Ousehal, L; Aghoutan, H; Chemlali, S; Anssari, I Filali; Talic, N

2016-10-01

To evaluate and compare the impact of altered smile characteristics on the perception of smile esthetics between Moroccan dentists and lay people. Thirty-four digital smile photographs displaying alterations in crown length and width, lateral incisor gingival margin position, gingival exposition, midline diastema, and upper midline deviation were presented to a sample of 30 dentists and 30 lay people. The ratings were assessed with a visual analog scale. Compared to that of lay people, Moroccan dentists' evaluation of the gingival smile was more critical when the decrease in central incisor crown length was 2.5 mm ( p  < 0.001) or greater and when the increase in gingival exposition was 4 mm or greater ( p  < 0.01). Moroccan dentists were also critical in their evaluation of maxillary lateral incisor crown width alterations ( p  < 0.05) and incisal midline deviations ( p  < 0.05). However, the professionals and lay people similarly evaluated irregularities in the incisor gingival margin position. Increases in the midline diastema were judged critically by both Moroccan dentists and lay people. In this sample, Moroccan dentists evaluate smile esthetic alterations more critically than Moroccan lay people. This difference in perception of smile discrepancies must be taken into account during the finishing phases of orthodontic treatment and restoration of the anterior teeth in Moroccan patients.

Gingival Zenith Positions and Levels of Maxillary Anterior Dentition in Cases of Bimaxillary Protrusion: A Morphometric Analysis.

PubMed

Gowd, Snigdha; Shankar, T; Chatterjee, Suravi; Mohanty, Pritam; Sahoo, Nivedita; Baratam, Srinivas

2017-08-01

To investigate the two clinical parameters, such as gingival zenith positions (GZPs) and gingival zenith levels (GZLs), of maxillary anterior dentition in bimaxillary protrusion cases and collate it with severiety of crown inclination. Gingival zenith position and GZL in 40 healthy patients (29 females and 11 males) with an average age of 21.5 years were assessed. Inclusion criteria involved absence of periodontal diseases, Angle's class I molar relationship, and upper anterior proclination within 25 to 45° based on Steiner's analysis; exclusion criteria included spacing, crowding, anterior restoration and teeth with incisor attrition or rotation. The GZP was evaluated using digital calipers from voxel-based morphometry (VBM), and GZL was assessed from the tangent drawn from GZP of central incisor and canines to the linear vertical distance of GZP of lateral incisor. All the central incisors showed a GZP distal to VBM with a mean average of 1 mm. Severe proclination between 40 and 45° showed a statistically significant variation. Lateral incisors displayed a mean of 0.5 mm deviation of GZP from the vertically bisected midline. In 80% of canine population, GZP was centralized. We conclude that the degree of proclination of maxillary anterior dentition was correlated to the gingival contour in bimaxillary cases. The investigation revealed that there is a variation in the location of GZP as the severity of proclination increases. This study highlights the importance of microesthetics in fixed orthodontic treatment. The gingival contour should be unaltered while retraction during management of bimaxillary protrusion.

Orthodontic management of congenitally missing maxillary lateral incisors: a case report.

PubMed

Paduano, Sergio; Cioffi, Iacopo; Rongo, Roberto; Cupo, Antonello; Bucci, Rosaria; Valletta, Rosa

2014-01-01

This case report describes the orthodontic treatment of a woman, aged 15 years, with permanent dentition, brachyfacial typology, with congenitally missing maxillary lateral incisors. Multibracket straightwire fixed appliance was used to open the space for dental implant placement, and treat the impaired occlusion. The missing lateral incisors were substituted with oral implants.

Management of 2 teeth diagnosed with dens invaginatus with regenerative endodontics and apexification in the same patient: a case report and review.

PubMed

Kumar, Harleen; Al-Ali, Muna; Parashos, Peter; Manton, David J

2014-05-01

This review and case report present the treatment of a 10-year-old boy with both permanent maxillary lateral incisors demonstrating Oehlers type II dens invaginatus and pulpal involvement. Treatment was complicated by dental anxiety, supraventricular tachycardia, immature tooth development, and facial cellulitis. An infected necrotic pulp of the permanent maxillary left lateral incisor was treated by apexification and endodontic treatment with mineral trioxide aggregate. The necrotic pulp of the permanent maxillary right lateral incisor was treated with canal debridement and dressing under general anesthesia. Periapical healing of both teeth occurred, with the right lateral incisor showing continued root growth, thickening of the dentinal root walls, and completed apex formation. This tooth responded normally to pulp testing. Twenty-eight months after initial treatment, the right lateral incisor displayed progressive sclerosis of the canal. This case demonstrates possible pulpal regeneration of an infected maxillary right lateral incisor with dens invaginatus and an immature apex after minimal canal debridement. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

[Simultaneous intrusion and retraction of the anterior teeth using a three-piece base arch].

PubMed

Liu, D; Bai, D; Wang, C; Sun, W; Guo, J; Xi, R

2000-06-01

To evaluate the effects of the three-piece base arch on overbite correction of Class II malocclusion. 20 patients with high angle, flared incisors were treated using a three-piece base arch appliance. The intrusion force of four upper incisors was adjusted to approximately 50 g. The line of force action was 2 mm distally to the resistant center(RC) and the retraction force was 20 g, the right and left posterior segments were joined by a palatal bar. Cephalograms were taken before treatment (T1) and six months after treatment (T2). The upper molars moved mesially 0.60 +/- 0.35 mm and the distance of the vertical extrusion was 0.80 +/- 0.52 mm. The distances of the upper central incisor retraction and intrusion were -4.20 +/- 2.12 mm and 3.10 +/- 0.54 mm respectively. The RC of the central incisor retracted -4.12 +/- 1.96 mm and intruded 3.20 +/- 0.66 mm. The axial inclination of the upper incisor-palatal plane changed from 123.21 degrees +/- 4.26 degrees to 116.00 degrees +/- 3.96 degrees. The three-piece segmented approach can effectively intrude and retract the upper anterior teeth for flared incisors and deep overbite.

Vertical force and torque analysis during mechanical preparation of extracted teeth using hand ProTaper instruments.

PubMed

Glavičić, Snježana; Anić, Ivica; Braut, Alen; Miletić, Ivana; Borčić, Josipa

2011-08-01

The purpose was to measure and analyse the vertical force and torque developed in the wider and narrower root canals during hand ProTaper instrumentation. Twenty human incisors were divided in two groups. Upper incisors were experimental model for the wide, while the lower incisors for the narrow root canals. Measurements of the force and torque were done by a device constructed for this purpose. Differences between the groups were statistically analysed by Mann-Whitney U-test with the significance level set to P<0.05. Vertical force in the upper incisors ranged 0.25-2.58 N, while in the lower incisors 0.38-6.94 N. Measured torque in the upper incisors ranged 0.53-12.03 Nmm, while in the lower incisor ranged 0.94-10.0 Nmm. Vertical force and torque were higher in the root canals of smaller diameter. The increase in the contact surface results in increase of the vertical force and torque as well in both narrower and wider root canals. © 2010 The Authors. Australian Endodontic Journal © 2010 Australian Society of Endodontology.

Effect of retraction of anterior teeth on pharyngeal airway and hyoid bone position in Class I bimaxillary dentoalveolar protrusion.

PubMed

Bhatia, S; Jayan, B; Chopra, S S

2016-12-01

To test the hypothesis that the retraction of anterior teeth has no effect on the dimensions of pharyngeal airway and to evaluate the retraction of anterior teeth on each parameter of pharyngeal airway. Twenty-two adult patients of Class I bimaxillary protrusion requiring first premolar extractions with maximum anchorage requirements were selected. The pharyngeal airway and dentofacial parameters of the patients were compared using pre- and post-treatment lateral cephalograms with the help of Student's paired t -test ( P  < 0.05). The relationship between airway size and dentofacial parameters was also evaluated using Pearson correlation coefficient. The upper and lower lips were retracted by 2.25 and 5.4 mm after retraction of the incisors. The tips of upper and lower incisors were retracted by 7.75 and 7.15 mm, respectively. There was a statistically significant decrease in SPP-SPPW ( P  < 0.05), U-MPW ( P  < 0.001), TB-TPPW ( P  < 0.001), and change in HRGN ( P  < 0.01). A significant correlation was observed between the amount of retraction of lower incisor and decrease in the pharyngeal airway posterior to soft palate ( r  = 0.102), tongue ( r  = 0.322), and change in HRGN ( r  = 0.265). The size of the pharyngeal (velopharyngeal and glossopharyngeal) airway reduced and hyoid bone position changed after retraction of the incisors in extraction space in bimaxillary protrusive adult patients.

Orthodontic camouflage versus orthognathic surgery for class III deformity: comparative cephalometric analysis.

PubMed

Martinez, P; Bellot-Arcís, C; Llamas, J M; Cibrian, R; Gandia, J L; Paredes-Gallardo, V

2017-04-01

The objective of this study was to compare different cephalometric variables in adult patients with class III malocclusions before and after treatment, in order to determine which variables are indicative of orthodontic camouflage or orthognathic surgery. The cases of 156 adult patients were assessed: 77 treated with orthodontic camouflage and 79 treated with orthodontics and orthognathic surgery. The following cephalometric variables were measured on pre-treatment (T1) and post-treatment (T2) lateral cephalograms: sella-nasion-A-point (SNA), sella-nasion-B-point (SNB), and A-point-nasion-B-point (ANB) angles, Wits appraisal, facial axis angle, mandibular plane angle, upper and lower incisor inclination, and inter-incisal angle. There were statistically significant differences in cephalometric variables before and after treatment between the two groups. The percentage of normal pre-treatment measurements in the camouflage orthodontics group was 30.7%, which worsened slightly to 28.4% post-treatment. However in the group receiving surgery, this was 24.5% pre-treatment, improving to 33.5% after surgery. SNA, SNB, Wits appraisal, lower incisor inclination, and inter-incisal angle showed differences between the two groups before and after treatment. Wits appraisal, lower incisor inclination, and inter-incisal angle were indicative of one or other treatment. Upper and lower incisor decompensation in both groups did not reach ideal values, which impeded complete skeletal correction in 52% of surgical cases. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

To evaluate the validity of Recurring Esthetic Dental proportion in natural dentition

PubMed Central

Shetty, Shilpa; Pitti, Varun; Satish Babu, CL; Surendra Kumar, GP; Jnanadev, KR

2011-01-01

Background: Different proportions are described in the literature for smile designing, such as Golden proportion, Golden percentage, Preston's proportion, and recently, Recurring Esthetic Dental (RED) proportion. Aims and Objectives: To evaluate the existence of RED proportion in natural dentition. To determine the relative height of maxillary lateral incisor and canine occurring in natural dentition so that it can be used in any of the above proportions. Materials and Methods: Fifteen male subjects and 15 female subjects in each of the different age groups of 18–23 years, 24–29 years and 30–35 years were selected for this study (total 90). Photographs of the subjects were taken using Nikon D200 camera with 135 mm lens and analyzed using Adobe Photoshop CS4 extended software. The height and width of maxillary central incisors, lateral incisors and canines were found out using the measuring tool provided in the software. Results: Average width ratio and height ratio of maxillary lateral incisor to central incisor and maxillary canine to lateral incisor were calculated to check the existence of RED proportion in natural dentition. Average lateral incisor to central incisor height ratio for “small”- and “medium”-sized teeth was found to be 88% and for “tall”-sized teeth was found to be 84%. Average canine to lateral incisor height ratio for “small”- and “medium”-sized teeth was found to be 106% and for “tall”-sized teeth was found to be 105%. Conclusions: Within the limitations of the study, RED proportion was not seen in natural dentition. PMID:22025841

Orthodontic Management of Congenitally Missing Maxillary Lateral Incisors: A Case Report

PubMed Central

Rongo, Roberto; Cupo, Antonello; Valletta, Rosa

2014-01-01

This case report describes the orthodontic treatment of a woman, aged 15 years, with permanent dentition, brachyfacial typology, with congenitally missing maxillary lateral incisors. Multibracket straightwire fixed appliance was used to open the space for dental implant placement, and treat the impaired occlusion. The missing lateral incisors were substituted with oral implants. PMID:24711929

Mandibular Symmetrical Bilateral Canine-Lateral Incisors Transposition: Its Early Diagnosis and Treatment Considerations.

PubMed

Shapira, Yehoshua; Finkelstein, Tamar; Kadry, Rana; Schonberger, Shirley; Shpack, Nir

2016-01-01

Bilateral mandibular tooth transposition is a relatively rare dental anomaly caused by distal migration of the mandibular lateral incisors and can be detected in the early mixed dentition by radiographic examination. Early diagnosis and interceptive intervention may reduce the risk of possible transposition between the mandibular canine and lateral incisor. This report illustrates the orthodontic management of bilateral mandibular canine-lateral incisor transposition. Correct positioning of the affected teeth was achieved on the left side while teeth on the right side were aligned in their transposed position. It demonstrates the outcome of good alignment of the teeth in the dental arch.

The effect of canine characteristics and symmetry on perceived smile attractiveness when canine teeth are substituted for lateral incisors.

PubMed

Rayner, Wendy Jane; Barber, Sophy K; Spencer, Richard James

2015-03-01

To determine the effect of canine tooth characteristics and symmetry on perceived smile attractiveness when maxillary canine teeth are substituted for missing lateral incisors. Prospective, cross-sectional study. Non-clinical study undertaken from Leeds Dental Institute, UK. A composite full-face image of a smiling female was used to display various dentitions; a control image with an 'ideal' smile, plus six further images substituting the maxillary lateral incisors with canine teeth either unilaterally or bilaterally with varying size, shape, colour and gingival margin level. The seven images were shown to orthodontists (n = 30), dentists (n = 30) and lay people (n = 30) who were asked to rate smile attractiveness using a visual analogue scale. Dental professionals rated smiles with canine substitution for lateral incisor agenesis to be significantly less attractive than an ideal smile unless the substituted canine teeth approximated the lateral incisor in terms of size, shape, colour and gingival margin. Lay people did not find smiles where canine teeth were substituted for lateral incisors significantly more or less attractive than an ideal smile regardless of the canine tooth characteristics. Dental professionals were significantly more perceptive than lay people to the deviation from ideal smile aesthetics due to canine substitution. Smiles with unilateral canine substitution were not found to be significantly less attractive than bilateral canine substitution by all groups. Canine characteristics and observer status will affect how canine substitution for lateral incisor agenesis is viewed in terms of aesthetic outcome.

[The supportive outcome of periodontal non-surgical therapy to severe chronic periodontitis accompanied with malformed lingual groove in lateral incisor for 6 years: a case report].

PubMed

Li, Zheng; Kang, Jun

2011-06-01

To track the initiating and developing process of one case diagnosed as chronic periodontitis accompanied with malformed lingual groove in maxillary lateral incisor and report the long-term prognosis to the periodontal conservative and supportive therapy. The patient was diagnosed with mild chronic periodontitis 6 years ago and accepted routine periodontal scaling and root planning (SRP) plus supportive periodontal therapy (SPT) one time. Two years later the periodontal condition deteriorated by deep pockets in molars and severe bone destruction around the maxillary lateral incisor with malformed lingual groove. After SRP in sites which pocket depth more than 4mm plus root canal therapy and lingual groove plasty of maxillary right lateral incisor, the SPT regularly proceeded at 3rd, 6th and 12th month. At present the whole periodontal tissue was healthy, the bone lesion around maxillary lateral incisor recovered well, the tooth had no mobile, the cosmetic effect andtooth function was in good state, and the patient was very satisfied.

[The effect of pre-surgical orthodontics on secondary alveolar bone grafting in the patients with complete cleft lip and palate].

PubMed

Jia, Yi-lin; Fu, Min-kui; Ma, Lian

2004-05-01

To examine the effect of pre-surgical orthodontics on the outcome of the secondary alveolar bone grafting in the patients with complete cleft lip and palate. Sixteen complete cleft lip and palate patients (9 males and 7 females) with collapsed upper arch or severe mal-positioned upper incisors were selected. The cleft was not easily grafted because of the poor access. The total cleft sites were 22 (10 patients with UCLP and 6 patients with BCLP). The age range of the patients was from 8 to 22 years. Pre-surgical orthodontic treatment was mainly to expand the collapsed upper arch and correct the mal-positioned upper incisors. After the secondary alveolar bone grafting, the patients were followed up and anterior occlusal radiograph/intraoral panograph were taken regularly. The observation period was from 6 months to 4 years. Bergland criteria were used to evaluate the interdental septal height. Upper arch expansion and the correction of the mal-positioned upper incisors done by the orthodontic treatment made the bone grafting procedure easier. The clinically successful rate reached 86%. The severe upper arch collapse and mal-positioned upper incisors in the patients with complete cleft lip and palate should be corrected orthodontically before the secondary alveolar bone grafting.

Multiple tooth anomalies in a nonsyndromic patient with class II division 2 malocclusions: A case report and a literature review.

PubMed

Isman, E; Isman, O; Aktan, A M; Ciftci, E; Topcuoglu, T

2015-01-01

Reports in the literature about the craniofacial characteristics of patients with class II division 2 malocclusions show a lot of different patterns accompanied by palatally displaced upper incisors, congenital missing teeth, polydiastema, fusion, germination, tooth impaction, peg-shaped lateral incisors, persistent teeth, hypodontia, persistent deciduous teeth, transpositions, and supernumerary teeth. The following case report focuses on the description of the clinical characteristics observed on a patient with a very unusual conjunction of dental and skeletal anomalies mentioned above, as well as a literature review on the related issues. Extra-intra-oral examinations, radiographic evaluations, orthodontic consultation, and reviewing the literature concluded that this nonsyndromic patient that refused to receive all dental treatment approaches is special with its uniqueness.

Biometric analysis of the clinical crown and the width/length ratio in the maxillary anterior region.

PubMed

Orozco-Varo, Ana; Arroyo-Cruz, Gema; Martínez-de-Fuentes, Rafael; Jiménez-Castellanos, Emilio

2015-06-01

Restorative dentistry often involves correcting tooth size discrepancies. Therefore, dental biometrics should play an important role in the planning of an esthetic restoration. The purpose of this study was to analyze the clinical crown width, length, and width/length ratio of maxillary central incisors, lateral incisors, and canines in an adult population. The study also aimed to determine whether a correlation exists between natural tooth dimensions and the optimal tooth dimension guidelines suggested for planning esthetic restorations. Stone casts were poured from irreversible hydrocolloid impressions of 412 healthy adult participants. These casts were used to measure the maximum mesiodistal width and maximum crown-root length of the maxillary central incisors, lateral incisors, and canines with a digital precision caliper (0.01 mm). The width/length ratio was calculated for each tooth, and 40 casts were selected to test the reliability of the measuring method. The mean age of the participants in the sample was 33.94 years; 60.7% were women and 39.3% were men. The mean width value was 8.71 mm for central incisors, 6.75 mm for lateral incisors, and 7.81 mm for canines. The mean length was 10.23 mm for central incisors, 8.59 mm for lateral incisors, and 9.93 mm for canines. The average width/length ratio was 85% for central incisors and 79% for lateral incisors and canines. The data obtained from the population studied are similar to those from previous research studies with similar methodology. However, great discrepancies in the absolute values were found when compared with other studies of ideal tooth dimension guidelines on the personal preferences and the esthetic perception of dentists. The perception of what is considered natural seems to differ from what is considered esthetically perfect. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Gingival zenith positions and levels of the maxillary anterior dentition.

PubMed

Chu, Stephen J; Tan, Jocelyn H-P; Stappert, Christian F J; Tarnow, Dennis P

2009-01-01

The location of the gingival zenith in a medial-lateral position relative to the vertical tooth axis of the maxillary anterior teeth remains to be clearly defined. In addition, the apex of the free gingival margin of the lateral incisor teeth relative to the gingival zeniths of the adjacent proximal teeth remains undetermined. Therefore, this investigation evaluated two clinical parameters: (1) the gingival zenith position (GZP) from the vertical bisected midline (VBM) along the long axis of each individual maxillary anterior tooth; and (2) the gingival zenith level (GZL) of the lateral incisors in an apical-coronal direction relative to the gingival line joining the tangents of the GZP of the adjacent central incisor and canine teeth under healthy conditions. A total of 240 sites in 20 healthy patients (13 females, 7 males) with an average age of 27.7 years were evaluated. The inclusion patient criteria were absence of periodontal disease, gingival recession, or gingival hypertrophy as well as teeth without loss of interdental papillae, spacing, crowding, existing restorations, and incisal attrition. GZP dimensions were measured with calibrated digital calipers for each individual tooth and within each tooth group in a medial-lateral direction from the VBM. GZLs were measured in an apical-coronal direction from a tangent line drawn on the diagnostic casts from the GZPs of the adjacent teeth. This study demonstrated that all central incisors displayed a distal GZP from the VBM, with a mean average of 1 mm. Lateral incisors showed a deviation of the gingival zenith by a mean of 0.4 mm. In 97.5% of the canine population, the GZP was centralized along the long axis of the canine. The mean distance of the contour of the gingival margin in an apical-coronal direction of the lateral incisors (GZL) relative to gingival line joining the tangent of the adjacent central and canine GZPs was approximately 1 mm. This investigation revealed a GZP mean value of 1 mm distal from the VBM for the central incisor tooth group. The lateral incisors showed a mean average of 0.4 mm. The canine tooth group demonstrated almost no deviations of the GZP from the VBM. The GZL of the lateral incisors relative to the adjacent central incisor and canine teeth were more coronal by approximately 1 mm. These data could be used as reference points during esthetic anterior oral rehabilitation. The information presented in this article can be clinically applied to reestablish the proper intratooth GZPs of the maxillary anterior teeth during periodontal crown lengthening or root coverage procedures. In addition, the intra-arch gingival level of the lateral incisor gingival zenith relative to the adjacent central and canine teeth can be appropriately established.

Multi-disciplinary approach for enhancing orthodontic esthetics - case report.

PubMed

Kalia, Ajit; Mirdehghan, Nasim; Khandekar, Sonali; Patil, Wasu

2015-01-01

In contemporary dental care, an increasing number of adult patients are now seeking orthodontic treatment with the primary motive of improvement in appearance and achievement of esthetic smile. Proper recognition of the dental and facial defects at the outset of treatment is the most important key to esthetic success and is essential in satisfying the patient's needs. By following the rules of Golden proportion smiles can be made attractive, harmonious, symmetrical, and proportionate. Consisted of 22-year-old girl who came for treatment of crowding in maxillary and mandibular arches, abnormal overjet and overbite and had unesthetic peg lateral. Non-extraction therapy was carried out since the patient had good soft tissue drape, alignment was achieved by expanding the arches and moving teeth in ideal axial inclination. Esthetic smile was attained using composite buildup of upper right peg lateral and minor adjunctive surgery (full thickness periodontal graft) on lower right central incisor. The present case report orchestrates interrelationship between various branches of dentistry and orthodontics. It exhibits how multidisciplinary approach can be used to achieve ideal dental esthetics in a 22-year-old girl who was successfully treated for peg shaped lateral incisor, gingival recession, and unesthetic smile.

Multi-disciplinary approach for enhancing orthodontic esthetics – case report

PubMed Central

Kalia, Ajit; Mirdehghan, Nasim; Khandekar, Sonali; Patil, Wasu

2015-01-01

Background In contemporary dental care, an increasing number of adult patients are now seeking orthodontic treatment with the primary motive of improvement in appearance and achievement of esthetic smile. Proper recognition of the dental and facial defects at the outset of treatment is the most important key to esthetic success and is essential in satisfying the patient’s needs. By following the rules of Golden proportion smiles can be made attractive, harmonious, symmetrical, and proportionate. Methodology Consisted of 22-year-old girl who came for treatment of crowding in maxillary and mandibular arches, abnormal overjet and overbite and had unesthetic peg lateral. Results Non-extraction therapy was carried out since the patient had good soft tissue drape, alignment was achieved by expanding the arches and moving teeth in ideal axial inclination. Esthetic smile was attained using composite buildup of upper right peg lateral and minor adjunctive surgery (full thickness periodontal graft) on lower right central incisor. Conclusion The present case report orchestrates interrelationship between various branches of dentistry and orthodontics. It exhibits how multidisciplinary approach can be used to achieve ideal dental esthetics in a 22-year-old girl who was successfully treated for peg shaped lateral incisor, gingival recession, and unesthetic smile. PMID:26316821

Evaluation of treatment modality for skeletal Class III malocclusion with labioversed upper incisors and/or protrusive maxilla: surgical movement and stability of rotational maxillary setback procedure.

PubMed

Baek, Seung-Hak; Kim, Keunwoo; Choi, Jin-Young

2009-11-01

The purpose of this study was to evaluate the range of surgical movement and stability of rotational maxillary setback (MXS) procedure as treatment modality for skeletal class III malocclusion with labioversed upper incisors and/or protrusive maxilla (CIII/LUI-PM). The samples consisted of 20 adult patients (mean [SD] age, 23.55 [4.30] y) who had CIII/LUI-PM and were treated with rotational MXS and mandibular setback using LeFort I osteotomy and bilateral sagittal split ramus osteotomy. The lateral cephalograms were obtained 1 week before (T0), 1 week after (T1), and 1 year after surgery (T2). The amounts of surgical movement, relapse, and stability rate of the upper central incisor (UIE), upper first molar (U6MBC), point A (A), incisive canal point, and posterior nasal spine (PNS) in relation to the reference planes were statistically analyzed. During T1 - T0, there were backward and downward movements of UIE and A, backward and upward movements of U6MBC, and upward and slight forward movements of PNS due to rotational MXS. The center of rotation of the maxilla was placed between A and the upper premolar area. During T2 - T1, skeletal landmarks showed clinically insignificant counterclockwise rotational relapse (<0.5 mm). The anteroposterior (AP) and vertical positions of skeletal landmarks were more stable than dental landmarks. The U6MBC was more stable in the vertical aspect than UIE (P < 0.01). Posterior nasal spine showed significantly higher stability rate in both vertical and AP aspects (P < 0.01, respectively), whereas UIE showed a lower value in the vertical aspect (P < 0.05). Rotational MXS procedure in cases with CIII/LUI-PM can be regarded as a stable one, especially in the vertical and AP positions of PNS. Vertical relapse in UIE should be managed with postoperative orthodontic treatment.

Resorption of maxillary incisors after orthodontic treatment--clinical study of risk factors.

PubMed

Elhaddaoui, Rajae; Benyahia, Hicham; Azeroual, Mohamed-Faouzi; Zaoui, Fatima; Razine, Rachid; Bahije, Loubna

2016-03-01

External apical root resorption (EARR) is one of the major problems associated with orthodontic treatment. Such lesions represent an iatrogenic risk that must be detected as early as possible, with regular radiological follow-up and appropriate therapeutic precautions. The causes and mechanisms leading to susceptibility to root resorption following the application of an orthodontic force are often not clear and are generally said to be of multifactorial origin. The aim of this clinical study was to analyze the factors linked to the occurrence of moderate to severe resorption (MSR) of upper incisors during orthodontic treatment in a group of Moroccan patients treated in the Dento-Facial Orthopedic Department of the Dental Consultation and Treatment Center (Centre de consultation et de traitements dentaires [CCTD]) in Rabat. A total of 82 patients (28% males, 72% females) aged between 12 and 27, with various malocclusions, who had been treated with fixed appliances for at least 1 year and for whom panoramic X-rays at the start, during and at the end of treatment were available, were selected randomly. The reduction in maxillary incisor root length was evaluated using resorption scores. The factors studied in relation to the risk of occurrence of MSR were: age, sex, treatment duration, extraction or non-extraction, type of malocclusion (Class I arch-length discrepancy, Class II, Class III), the vertical diagnosis (normal, supraocclusion, open bite), presence of dysfunction, impacted canines and root morphology. Statistical analysis was performed using SPSS software, version 18.0. Statistical tests used were: Kaplan-Meier analysis and the univariate and multivariate Cox models for the study of factors associated with MSR. The threshold of significance adopted was 0.05. The factors that were significantly associated with the occurrence of MSR at the level of the upper incisors were: tooth type, with a greater risk for the lateral incisor (HR=3.2 95% CI [2.3-4.5] P<0.001), treatments with extraction (HR=1.64 95% CI [1.16-2.33] P<0.05), the presence of supraocclusion (HR=2.17 95% CI [1.33-3.53] P<0.05) or open bite (HR=3.12 95% CI [1.66-5.86] P<0.001) and root malformation (HR=1.5 95% CI [1.09-2.07] P<0.05). Age, sex, type of malocclusion, dysfunction and impaction of canines were not associated at a statistically significant level with the risk of occurrence of MSR of the upper incisors. EARR is difficult to avoid; the orthodontist's role remains crucial in identifying risk factors so as to adopt a treatment strategy taking these factors into account. In our population, the risk of MSR in the upper incisors appeared to increase in treatments with extraction, situations of supraocclusion or open bite, and in the presence of root abnormalities. Finally, clinical recommendations for the prevention of the occurrence of MSR of the maxillary incisors are proposed, taking into account all the risk factors identified. Copyright © 2015 CEO. Published by Elsevier Masson SAS. All rights reserved.

New method of assessing the relationship between buccal bone thickness and gingival thickness

PubMed Central

2016-01-01

Purpose The aim of this study was to determine the relationship between buccal bone thickness and gingival thickness by means of a noninvasive and relatively accurate digital registration method. Methods In 20 periodontally healthy subjects, cone-beam computed tomographic images and intraoral scanned files were obtained. Measurements of buccal bone thickness and gingival thickness at the central incisors, lateral incisors, and canines were performed at points 0–5 mm from the alveolar crest on the superimposed images. The Friedman test was used to compare buccal bone and gingival thickness for each depth between the 3 tooth types. Spearman's correlation coefficient was calculated to assess the correlation between buccal bone thickness and gingival thickness. Results Of the central incisors, 77% of all sites had a buccal thickness of 0.5–1.0 mm, and 23% had a thickness of 1.0–1.5 mm. Of the lateral incisors, 71% of sites demonstrated a buccal bone thickness <1.0 mm, as did 63% of the canine sites. For gingival thickness, the proportion of sites <1.0 mm was 88%, 82%, and 91% for the central incisors, lateral incisors, and canines, respectively. Significant differences were observed in gingival thickness at the alveolar crest level (G0) between the central incisors and canines (P=0.032) and between the central incisors and lateral incisors (P=0.013). At 1 mm inferior to the alveolar crest, a difference was found between the central incisors and canines (P=0.025). The lateral incisors and canines showed a significant difference for buccal bone thickness 5 mm under the alveolar crest (P=0.025). Conclusions The gingiva and buccal bone of the anterior maxillary teeth were found to be relatively thin (<1 mm) overall. A tendency was found for gingival thickness to increase and bone thickness to decrease toward the root apex. Differences were found between teeth at some positions, although the correlation between buccal bone thickness and soft tissue thickness was generally not significant. PMID:28050315

Perception of Saudi dentists and lay people to altered smile esthetics.

PubMed

Talic, Nabeel; Alomar, Samar; Almaidhan, Asma

2013-01-01

To evaluate and compare the perceptions of Saudi dentists and lay people to altered smile features. Thirty-six digital smile photographs with altered features were used. Altered features included the following: crown length, width, gingival level of the lateral incisors, gingival display, midline diastema, and upper midline shift. The photographs were presented to a sample of 30 dentists and 30 lay people with equal gender distribution. Each participant rated each picture with a visual analogue scale, which ranged from 0 (very unattractive) to 100 (very attractive). Dentists were more critical than lay people when evaluating symmetrical crown length discrepancies. Compared to lay people, Saudi dentists gave lower ratings to a crown length discrepancy of >2 mm (P < 0.001), crown width discrepancy of ⩾2 mm (P < 0.05), change in gingiva to lip distance of ⩾2 mm (P < 0.01), and midline deviation of >1 mm (P < 0.01). There was no significant difference between dentists and lay people towards alterations in the gingival level of the lateral incisors or towards a space between the central incisors. No significant sex difference was seen across the groups. In this sample, Saudi dentists gave significantly lower attractiveness scores to crown length and crown width discrepancies, midline deviations, and changes in gingiva to lip distance compared to Saudi lay people.

Cephalometric norms for orthognathic surgery for North India (Eastern Uttar Pradesh).

PubMed

Gulati, Rajeev; Jain, Shikha

2011-01-01

The present study was aimed at development of the cephalometric norms for orthognathic surgery for the population of eastern Uttar Pradesh in North India. This study was conducted at a dental college. The study sample consisted of 50 males and 50 females. Each lateral cephalogram was taken in occlusion and subsequently traced. All reference points, landmarks, and measurements were made according to cephalometrics for orthognathic surgery (COGS) system. The statistical analysis involved calculation of mean and standard deviation for each of the 23 parameters assessed for each subject. The data was subsequently compared with COGS study by using Normal (Z) test. The norms were derived for the purvanchal population of North India and these were found to be quite distinct compared to those obtained from COGS study with respect to specific parameters. Male subjects indicated greater prominence of chin relative to the face, decreased posterior divergence, infraeruption of upper and lower molar as well as lower incisors, decreased total effective length of the maxilla, tendency towards Class III occlusion, and procumbent lower incisors. Female subjects, however, indicated increased anterior cranial base length, greater prominence of chin relative to the face, prognathic maxilla and mandible, increased middle third facial height, infraerupted lower incisors, increased mandibular body length, and procumbent lower incisors.

[Alveolar bone thickness in A point area : how to avoid periodontal failures in front of upper incisors].

PubMed

Chevalier, Émilie; Philip-Alliez, Camille; Le Gall, Michel

2016-03-01

Studies on orthodontic-periodontics relationships are numerous but few have benefited from the contribution of new 3D imaging techniques that emphasize iatrogenic effects that orthodontics may have on the periodontium. Periodontal risk in terms of fenestration, bone dehiscences next maxillary incisors are real during or after orthodontic treatment. The accurate assessment of the initial situation in terms of bone quantity in this dental arch anterior segment is thus very important. Our study aimed to evaluate the reliability of conventional lateral cephalograms to quantify alveolar bone thickness in relation to the maxillary incisors by comparing it with data from CT scans. The second objective was to identify an at risk patient profile by assessing possible correlations between this thickness and dysmorphia components. The results revealed a half of assessment error in the estimation of bone thickness and increased risk in case of hyperdivergence typology, Class III skeletal relationships and dento-alveolar protrusion. Finally, in view of these data, we discussed the clinical procedures to avoid such periodontal failures in this anterior segment of the dental arch. © EDP Sciences, SFODF, 2016.

Surgical orthodontic treatment of an impacted canine in the presence of dens invaginatus and follicular cyst.

PubMed

Spallarossa, Marialuce; Canevello, Carola; Silvestrini Biavati, Francesca; Laffi, Nicola

2014-01-01

Introduction. "Dens invaginatus" is a dental anomaly which originates from the invagination of the ameloblastic epithelium into the lingual surface of the dental crown during the odontogenesis. It can cause early pulpal necrosis, abscesses, retention or dislocation of contiguous elements, cysts, and internal resorptions. It normally affects the upper lateral incisors. In the following study the authors will discuss the etiology, the physiopathology, and the surgical-orthodontic management of a rare case of impacted canine associated with dens invaginatus and follicular cyst, with the aim of highlighting the importance of taking any therapeutic decision based on the data available in the literature. Case Report. The present study describes a combined surgical-orthodontic treatment of an impacted canine associated with a lateral incisor (2.2) suffering from type III dens invaginatus with radicular cyst, in a 15-year-old patient. Discussion. When treating a dens invaginatus there are different therapeutic solutions: they depend on the gravity of the anomaly and on the association with the retention of a permanent tooth. The aesthetic and functional restoration becomes extremely important when performing a surgical-orthodontic repositioning.

Comparison of mesiodistal tooth widths in Caucasian, African and Japanese individuals with Brazilian ancestry and normal occlusion.

PubMed

Fernandes, Thais Maria Freire; Sathler, Renata; Natalício, Gabriela Letícia; Henriques, José Fernando Castanha; Pinzan, Arnaldo

2013-01-01

To observe the presence of sexual dimorphism and compare the mesiodistal width of the teeth in Caucasian, African and Japanese individuals with Brazilian ancestry not orthodontically treated and with normal occlusion. One hundred pairs of dental casts were used. It was measured, from first molar to first molar in both arches, the teeth's mesiodistal widths, using a digital caliper. For the statistical analysis of results Kolmogorov-Smirnov, t test, ANOVA and Tukey's test (p < 0.05) were used. Sexual dimorphism occurred on the three evaluated groups, and the highest mesiodistal widths were found in males. There was statistically significant difference between racial groups in all evaluated teeth in males. However, in females, this same difference was found only on upper lateral incisor and first molar; and lower lateral incisor, canine, first premolar and first molar. Most of mesiodistal measures present particular characteristics in relation to gender, with higher values for males, and to race, with a tendency for African to present greater mesiodistal distance of the teeth, followed by Japanese and Caucasians, respectively, important for the correct diagnosis and orthodontic planning.

Do different vertical positions of maxillary central incisors influence smile esthetics perception?

PubMed

Menezes, Erica Bretas Cabral; Bittencourt, Marcos Alan Vieira; Machado, Andre Wilson

2017-01-01

The purpose of this study was to determine the perception of smile esthetics among orthodontists and layperson, with respect to different maxillary central incisors vertical positions in full-face and close-up smile analyses. Frontal photographs of the smiles of two adult women were used. Images were altered to create a symmetrical image with the gingival margin levels of the maxillary canines matching the central incisors and a 1.0-mm central-to-lateral incisal step. Later, the images were altered in order to create six different central incisor vertical positions in 0.5-mm increments. The images were randomly assembled in an album, which was given to 114 judges, 57 orthodontists and 57 laypersons, who were asked to evaluate the attractiveness of the images using the visual analog scale. The data collected were statistically analyzed by means of 1-way analysis of variance with the Tukey post-hoc test and the Student t test. The highest rated smiles showed two notable characteristics: a) the central incisor gingival margins matched or were 0.5 mm below the line of the canine gingival margins and; b) the central-to-lateral incisal step was 1.0 to 1.5 mm. The worst smiles showed two notable characteristics: a) the central incisor gingival margins were 1.0 mm above or 1.5 mm below the canine gingival margins and; b) no step between the centrals and laterals or a 2.5-mm step. The vertical position of the maxillary central incisors significantly affected the perception of the smile esthetics, whereas slightly extruded central incisors were more esthetically preferred than intruded.

An Analysis of Maxillary Anterior Teeth Dimensions for the Existence of Golden Proportion: Clinical Study.

PubMed

Sandeep, Nalla; Satwalekar, Parth; Srinivas, Siva; Reddy, Chandra Sekhar; Reddy, G Ramaswamy; Reddy, B Anantha

2015-09-01

Appearance of the face is a great concern to everyone, as it is a significant part of self-image. The study analyzed the clinical crown dimensions of the maxillary anterior teeth with respect to their apparent mesiodistal widths, width-to-height ratio to determine whether golden proportion existed among the South Indian population. A total of 240 dentulous subjects were chosen for the study (120 males and 120 females) age ranging between 18 and 28 years. Full face and anterior teeth images of the subjects were made on specially designed device resembling a face-bow, mounted onto the wall under a standard light source. The width and height of the maxillary central incisors were measured on the stone casts using a digital caliper. The mean perceived maxillary lateral incisor to central incisor width ratio was 0.67 in males and 0.703 in females. The mean perceived maxillary canine to lateral incisor width ratio was 0.744 in males and 0.714 in females. The mean width-to-height ratio of the maxillary central incisor was 79.49% in males and 79.197% in females. The golden proportion was not found between perceived mesiodistal widths of maxillary central and lateral incisors and nor between perceived mesiodistal widths of maxillary lateral incisors and canines. In the majority of subjects, the width-to-height ratio of maxillary central incisor was within 75-80%. There are no statistically significant differences in maxillary anterior teeth proportions between males and females. The results may serve as guidelines for treatment planning in restorative dentistry and periodontal surgery.

A rare occurrence of supplementary maxillary lateral incisors and a detailed review on supernumerary teeth

PubMed Central

Chalakkal, Paul; Krishnan, Ramesh; De Souza, Neil; Da Costa, Godwin Clovis

2018-01-01

This article highlights a rare occurrence of nonsyndromic supplemental maxillary lateral incisors in a 11-year-old boy. It also includes a detailed literature review of supernumerary teeth. PMID:29731581

Dental anomalies in an orthodontic patient population with maxillary lateral incisor agenesis.

PubMed

Citak, Mehmet; Cakici, Elif Bahar; Benkli, Yasin Atakan; Cakici, Fatih; Bektas, Bircan; Buyuk, Suleyman Kutalmış

2016-01-01

The purpose of this study was to evaluate the prevalence of dental anomalies in a subpopulation of orthodontic patients with agenesis of maxillary lateral incisors (MLI). The material of the present study included the records of the 1964 orthodontic patients. Panoramic radiographs and dental casts were used to analyze other associated eight dental anomalies, including agenesis of other teeth, dens invaginatus, dens evaginatus, peg shaped MLI, taurodontism, pulp stone, root dilaceration and maxillary canine impaction. Out of the 1964 patients examined, 90 were found to have agenesis of MLI, representing a prevalence of 4.6%. The most commonly found associated-anomalies were agenesis of other teeth (23.3%), peg-shaped MLIs (15.6%), taurodontism (42.2%), and dilacerated teeth (18.9%). Permanent tooth agenesis, taurodontism, peg-shaped maxillary lateral incisor, and root dilacerations are frequently associated with maxillary lateral incisor agenesis.

Dens invaginatus with necrotic pulp in a right maxillary lateral incisor with preserved vitality.

PubMed

Alessandro, Lanza; Fabrizio, Di Francesco; Gennaro, De Marco; Dario, Di Stasio; Eugenio, Guidetti; Letizia, Perillo; Luigi, Femiano; Felice, Femiano

2018-01-01

Dens invaginatus (DI) is a dental malformation occurring in several morphologic types. Consequently, treatment of teeth affected by DI can get complicated because of the complex root canal anatomy. The aim is to describe how to manage a rare report of a DI with necrotic pulp held within the vital pulp of a maxillary lateral incisor. Oral fistula was found on the buccal mucosa of the apex of the vital maxillary lateral incisor with a DI having necrotic pulp. Endodontic treatment of the maxillary lateral incisor and of the tract canal of DI was realized. Clinical disappearance of oral sinus tract was observed after 10 days. On the contrary, the disappearance of radiolucent area occurred after 6 months. A proper and prompt diagnosis is necessary to carry out effective prevention protocols or prevent consequences generating nonrecoverable endo-perio diseases.

Premaxillary-maxillary suture asymmetry in a juvenile Gorilla. Implications for understanding dentofacial growth and development.

PubMed

Schwartz, J H

1983-01-01

A specimen of juvenile gorilla was found that had the premaxillary-maxillary suture coursing between the lateral deciduous incisor and deciduous canine on one side of the jaw, but between the central and lateral deciduous incisors on the other; in the latter, the suture also separates the alveolus of the lateral deciduous incisor from the crypt of the growing successional lateral incisor. Rather than dismiss this exception to the traditional dictum of tooth identification--which is based on the position to teeth relative to this suture--as some inconsequential anomaly, an attempt is made to understand how this can occur within the confines of present understanding of dentofacial growth and development and developmental theory. An hypothesis relating tooth and tooth class identification is presented in the context of ectomesenchymally predifferentiated stem progenitors and subsequent tooth class proliferation.

Relationship between degree of malocclusion and occlusal interference in mice that spontaneously develop anterior transverse crossbite.

PubMed

Tsukamoto, Yuri; Kajii, Takashi S; Sugawara-Kato, Yuki; Hirabayashi, Yoshifumi; Fujimori, Osamu; Iida, Junichiro

2010-12-01

Mice with brachymorphism (bm) have defective chondrogenesis, including abnormal growth of the spheno-occipital synchondrosis. Malocclusion (anterior transverse crossbite) sometimes spontaneously occurs in inbred BALB/c-bm/bm mice, before the mandibular incisors erupt and make contact with the maxillary incisors. The aim of this study was to determine whether functional lateral loads to incisors promote anterior transverse crossbites in BALB/c-bm/bm mice. BALB/c-bm/bm mice with normal occlusion (normal group), BALB/c-bm/bm mice with malocclusion in which the incisors were not cut (mal group), and BALB/c-bm/bm mice in which the incisors had been cut to eliminate the functional lateral load during continued growth (mal-cut group) were used. We examined the amounts of shift of the maxillary and mandibular incisors in each group using radiographic images. The amount of shift of the maxillary incisors in the mal group was significantly greater than that in normal group. The total amount of shift from the maxilla to the mandible in the mal group was significantly greater than in the normal and mal-cut groups. The results suggest that a continuous functional lateral load to the incisors is strongly related to promoting and worsening anterior transverse crossbite in BALB/c-bm/bm mice. Copyright © 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

The impact of digging on craniodental morphology and integration.

PubMed

McIntosh, A F; Cox, P G

2016-12-01

The relationship between the form and function of the skull has been the subject of a great deal of research, much of which has concentrated on the impact of feeding on skull shape. However, there are a number of other behaviours that can influence craniodental morphology. Previous work has shown that subterranean rodents that use their incisors to dig (chisel-tooth digging) have a constrained cranial shape, which is probably driven by a necessity to create high bite forces at wide gapes. Chisel-tooth-digging rodents also have an upper incisor root that is displaced further back into the cranium compared with other rodents. This study quantified cranial shape and upper incisors of a phylogenetically diverse sample of rodents to determine if chisel-tooth-digging rodents differ in craniodental morphology. The study showed that the crania of chisel-tooth-digging rodents shared a similar place in morphospace, but a strong phylogenetic signal within the sample meant that this grouping was nonsignificant. It was also found that the curvature of the upper incisor in chisel-tooth diggers was significantly larger than in other rodents. Interestingly, most subterranean rodents in the sample (both chisel-tooth and scratch diggers) had upper incisors that were better able to resist bending than those of terrestrial rodents, presumably due to their similar diets of tough plant materials. Finally, the incisor variables and cranial shape were not found to covary consistently in this sample, highlighting the complex relationship between a species' evolutionary history and functional morphology. © 2016 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2016 European Society For Evolutionary Biology.

Cone Beam Computed Tomography-based Evaluation of the Anterior Teeth Position Changes obtained by Passive Self-ligating Brackets.

PubMed

Rhoden, Fernando K; Maltagliati, Liliana Á; de Castro Ferreira Conti, Ana C; Almeida-Pedrin, Renata R; Filho, Leopoldino C; de Almeida Cardoso, Maurício

2016-08-01

The objective of this study was to evaluate the anterior teeth position changes obtained by passive self-ligating brackets using cone beam computed tomography (CBCT). Twenty patients with a mean age of 16.5 years, class I malocclusion, constricted maxillary arch, and teeth crowding above 5 mm were enrolled in this study, and treated by passive orthodontic self-ligating brackets. A sequence of stainless steel thermoset wire was implemented with ending wire of 0.019" × 0.025". The CBCT and dental casts were obtained prior to the installation of orthodontic appliances (T1), and 30 days after rectangular steel wire 0.019" × 0.025" installation (T2). The measurements in CBCT were performed with the Anatomage software, and the dental casts were evaluated with a digital caliper rule with an accuracy of 0.01 mm. The CBCT data demonstrated mean buccal inclination of the upper and lower central incisors ranging from 6.55° to 7.24° respectively. The upper and lower lateral incisors ranged from 4.90° to 8.72° respectively. The lower canines showed an average increase of 3.88° in the buccal inclination and 1.96 mm in the transverse intercuspal distance. The upper canines showed a negative inclination with mean average of -0.36°, and an average increase of 0.82 mm in the transverse distance, with negative correlation with the initial crowding. Treatment with passive self-ligating brackets without obtaining spaces increases buccal inclination of the upper and lower incisors with no correlation with the amount of initial teeth crowding. The intercanine distance tends to a small increase showing different inclinations between the arches. When taking into account the self-ligating brackets, the amount of initial dental crowding is not a limitation factor that could increase the buccal inclination of the anterior teeth.

[A case of restoration using IPS empress (staining technique) for upper central incisors].

PubMed

Hata, Utako

2007-07-01

The patient had esthetically unacceptable upper left central incisor crowns. The case was restored using Empress (staining technique) for the upper central incisors on both sides. In making all-ceramic crowns, it is necessary to reproduce the shape and color near to those of the natural tooth. We should not overlook the importance of diagnostic waxing-up, provisional restoration, tooth preparation, gingival retraction and others, to achieve excellent appearance, function and biocompatibility. It is effective to use the staining technique for an anterior tooth crown in order to obtain esthetically satisfactory results by the papilla being present in such cases as the distance from the base of the contact point to the crest of the bone is 5 mm or less.

Incisors’ proportions in smile esthetics

PubMed Central

Alsulaimani, Fahad F; Batwa, Waeil

2013-01-01

Aims: To determine whether alteration of the maxillary central and lateral incisors’ length and width, respectively, would affect perceived smile esthetics and to validate the most esthetic length and width, respectively, for the central and lateral incisors. Materials and Methods: Photographic manipulation was undertaken to produce two sets of photographs, each set of four photographs showing the altered width of the lateral incisor and length of the central length. The eight produced photographs were assessed by laypeople, dentists and orthodontists. Results: Alteration in the incisors’ proportion affected the relative smile attractiveness for laypeople (n=124), dentists (n=115) and orthodontists (n=68); dentists and orthodontists did not accept lateral width reduction of more than 0.5 mm (P<0.01), which suggests that the lateral to central incisor width ratio ranges from 54% to 62%. However, laypeople did not accept lateral width reduction of more than 1 mm (P<0.01), widening the range to be from 48% to 62%. All groups had zero tolerance for changes in central crown length (P<0.01). Conclusion: All participants recognized that the central incisors’ length changes. For lateral incisors, laypeople were more tolerant than dentists and orthodontists. This suggests that changing incisors’ proportions affects the relative smile attractiveness. PMID:24987650

Do different vertical positions of maxillary central incisors influence smile esthetics perception?

PubMed Central

Menezes, Erica Bretas Cabral; Bittencourt, Marcos Alan Vieira; Machado, Andre Wilson

2017-01-01

ABSTRACT INTRODUCTION: The purpose of this study was to determine the perception of smile esthetics among orthodontists and layperson, with respect to different maxillary central incisors vertical positions in full-face and close-up smile analyses. METHODS: Frontal photographs of the smiles of two adult women were used. Images were altered to create a symmetrical image with the gingival margin levels of the maxillary canines matching the central incisors and a 1.0-mm central-to-lateral incisal step. Later, the images were altered in order to create six different central incisor vertical positions in 0.5-mm increments. The images were randomly assembled in an album, which was given to 114 judges, 57 orthodontists and 57 laypersons, who were asked to evaluate the attractiveness of the images using the visual analog scale. The data collected were statistically analyzed by means of 1-way analysis of variance with the Tukey post-hoc test and the Student t test. RESULTS: The highest rated smiles showed two notable characteristics: a) the central incisor gingival margins matched or were 0.5 mm below the line of the canine gingival margins and; b) the central-to-lateral incisal step was 1.0 to 1.5 mm. The worst smiles showed two notable characteristics: a) the central incisor gingival margins were 1.0 mm above or 1.5 mm below the canine gingival margins and; b) no step between the centrals and laterals or a 2.5-mm step. CONCLUSION: The vertical position of the maxillary central incisors significantly affected the perception of the smile esthetics, whereas slightly extruded central incisors were more esthetically preferred than intruded. PMID:28658361

"Maxillary lateral incisor partial anodontia sequence": a clinical entity with epigenetic origin.

PubMed

Consolaro, Alberto; Cardoso, Maurício Almeida; Consolaro, Renata Bianco

2017-01-01

The relationship between maxillary lateral incisor anodontia and the palatal displacement of unerupted maxillary canines cannot be considered as a multiple tooth abnormality with defined genetic etiology in order to be regarded as a "syndrome". Neither were the involved genes identified and located in the human genome, nor was it presumed on which chromosome the responsible gene would be located. The palatal maxillary canine displacement in cases of partial anodontia of the maxillary lateral incisor is potentially associated with environmental changes caused by its absence in its place of formation and eruption, which would characterize an epigenetic etiology. The lack of the maxillary lateral incisor in the canine region means removing one of the reference guides for the eruptive trajectory of the maxillary canine, which would therefore, not erupt and /or impact on the palate. Consequently, and in sequence, it would lead to malocclusion, maxillary atresia, transposition, prolonged retention of the deciduous canine and resorption in the neighboring teeth. Thus, we can say that we are dealing with a set of anomalies and multiple sequential changes known as sequential development anomalies or, simply, sequence. Once the epigenetics and sequential condition is accepted for this clinical picture, it could be called "Maxillary Lateral Incisor Partial Anodontia Sequence."

“Maxillary lateral incisor partial anodontia sequence”: a clinical entity with epigenetic origin

PubMed Central

Consolaro, Alberto; Cardoso, Maurício Almeida; Consolaro, Renata Bianco

2017-01-01

ABSTRACT The relationship between maxillary lateral incisor anodontia and the palatal displacement of unerupted maxillary canines cannot be considered as a multiple tooth abnormality with defined genetic etiology in order to be regarded as a “syndrome”. Neither were the involved genes identified and located in the human genome, nor was it presumed on which chromosome the responsible gene would be located. The palatal maxillary canine displacement in cases of partial anodontia of the maxillary lateral incisor is potentially associated with environmental changes caused by its absence in its place of formation and eruption, which would characterize an epigenetic etiology. The lack of the maxillary lateral incisor in the canine region means removing one of the reference guides for the eruptive trajectory of the maxillary canine, which would therefore, not erupt and /or impact on the palate. Consequently, and in sequence, it would lead to malocclusion, maxillary atresia, transposition, prolonged retention of the deciduous canine and resorption in the neighboring teeth. Thus, we can say that we are dealing with a set of anomalies and multiple sequential changes known as sequential development anomalies or, simply, sequence. Once the epigenetics and sequential condition is accepted for this clinical picture, it could be called “Maxillary Lateral Incisor Partial Anodontia Sequence.” PMID:29364376

Predictors of favorable soft tissue profile outcomes following Class II Twin-block treatment.

PubMed

Kim, Ji-Eun; Mah, Su-Jung; Kim, Tae-Woo; Kim, Su-Jung; Park, Ki-Ho; Kang, Yoon-Goo

2018-01-01

The aim of this study was to determine cephalometric factors that help predict favorable soft-tissue profile outcomes following treatment with the Class II Twin-block appliance. Pre- and post-treatment lateral cephalograms of 45 patients treated with the Class II Twin-block appliance were retrospectively analyzed. Profile silhouettes were drawn from the cephalograms and evaluated by three orthodontists in order to determine the extent of improvement. Samples were divided into a favorable group (upper 30% of visual analogue scale [VAS] scores, n = 14) and an unfavorable group (lower 30% of VAS scores, n = 14). Skeletal and soft-tissue measurements were performed on the cephalograms and an intergroup comparison was conducted. An independent t -test revealed that the following pre-treatment values were lower in the favorable group compared to the unfavorable group: lower incisor to mandibular plane angle, lower incisor to pogonion distance, point A-nasion-point B angle, sella-nasion line (SN) to maxillary plane angle, SN to mandibular plane angle, gonial angle, and symphysis inclination. The favorable group had a larger incisor inclination to occlusal plane. Moreover, the favorable group showed larger post-treatment changes in gonial angle, B point projection, and pogonion projection than did the unfavorable group. Class II malocclusion patients with a low divergent skeletal pattern and reduced lower incisor protrusions are likely to show more improvement in soft-tissue profile outcomes following Class II Twin-block treatment.

Elastic band causing exfoliation of the upper permanent central incisors.

PubMed

Alves, Monica Ghislaine Oliveira; Kitakawa, Dárcio; Becker, Joao Batista Macedo; Brandão, Adriana Aigotti Haberbeck; Cabral, Luiz Antonio Guimarães; Almeida, Janete Dias

2015-01-01

Objective. This study reports a case in which elastic band use culminated in the loss of the incisors. Case Report. An 11-year-old white girl was seen complaining of pain, with purulent discharge and severe tooth mobility. The bone destruction detected radiographically in the region, despite its single location and absence in posterior quadrants of the maxilla and/or mandible, was similar to that observed in Langerhans cell disease. To our surprise, an elastic band involving the midportion of the roots of the two upper central incisors was found during biopsy. The debris was removed and a metal wire was placed in permanent maxillary right and left incisors. The patient was followed up, but no improvement in tooth mobility was observed. Bone loss increased, and internal resorption and root exposure occurred, which culminated in the extraction of permanent maxillary right and left incisors. Conclusion. The present case highlights the fact that professionals sometimes are confronted by anamnestic reports never seen before.

Presurgical Unilateral Cleft Lip Anthropometrics and the Presence of Dental Anomalies.

PubMed

Antonarakis, Gregory S; Fisher, David M

2015-07-01

To investigate associations between cleft lip anthropometrics and dental anomalies in the permanent dentition in unilateral cleft lip patients. Retrospective cross-sectional study. Children with unilateral clefts of the lip, with or without cleft palate. Anthropometric lip measurements, made immediately prior to lip repair, were available for each patient. The presence of dental anomalies in the permanent dentition was assessed radiographically. The presence of associations between anthropometric lip measurements and prevalence rates of different dental anomalies were determined using logistic regression analyses. In the 122 included patients, the cleft lateral lip element was deficient in height in 80% and in transverse length in 84% of patients. Patients with more deficient cleft side lateral lip height and less deficient cleft side lateral lip transverse length were more likely to present with cleft side maxillary lateral incisor agenesis. On the other hand, patients with a less deficient cleft side lateral lip height and more deficient cleft side lateral lip transverse length were more likely to present with a cleft side supernumerary maxillary lateral incisor. When looking only at incomplete clefts, the cleft side lateral lip transverse length deficiency was more predictive of the presence of supernumerary maxillary lateral incisors (P = .030), while for complete clefts, the cleft side lateral lip height deficiency was more predictive of the presence of maxillary lateral incisor agenesis (P = .035). In patients with unilateral clefts, cleft lip anthropometrics have a predictive role in determining the occurrence of dental anomalies.

Periodontal probing of an impacted tooth recovered through a surgical-orthodontic approach: a case report.

PubMed

Dinoi, Maria Teresa; Lacarbonara, Mariano; Dimartino, Salvatore; Monaco, Annalisa; Marzo, Giuseppe

2014-01-27

The aim of this work was to assess the periodontal support of a central upper incisor recovered through a surgical-orthodontic approach compared to the spontaneously erupted contralateral incisor. This case study describes an 8-year-old Caucasian female with an impacted upper right central incisor. Surgical-orthodontic treatment was performed to reset the impacted dental element in the arch. Periodontal probing was performed of all sites (mesio-buccal, central-buccal, disto-buccal, mesio-palatal, central-palatal and disto-palatal) of the recovered impacted tooth and the contralateral tooth. The results were compared to determine whether the treated element showed signs of periodontal injury. Most of the probing results on both her right and left incisors gave values of approximately 3mm, which were not considered pathological. Both dental elements had adequate and physiological osseous attachments.

Apical root resorption of incisors after orthodontic treatment of impacted maxillary canines: a radiographic study.

PubMed

Brusveen, Elin Marie Gravdal; Brudvik, Pongsri; Bøe, Olav Egil; Mavragani, Maria

2012-04-01

The purpose of the study was to evaluate impacted maxillary canines as risk factor for orthodontic apical root resorption. The sample comprised 66 patients treated with fixed appliances. Thirty-two patients with a unilateral impacted maxillary canine, which was distanced from the roots of the incisors at a preliminary phase of treatment before bonding, formed the impaction group, and 34 patients without impactions served as the controls. Root shortening was calculated by using pretreatment and posttreatment intraoral radiographs. Inclination of the eruption path of the impacted canine relative to the midline, axis of the lateral incisor, and nasal line, root development, and the medial and vertical positions of the impacted tooth were recorded on orthopantomograms and lateral cephalometric films. The follicle/tooth ratio was evaluated by using periapical radiographs. No significant difference in apical resorption of the maxillary incisors was detected between the impaction and control groups, or between the incisors of the impacted and contralateral sides in the same subject. Likewise, no difference in the severity of root resorption was found between the incisors of impacted side alone and the incisors of the control group. Mesial and vertical inclinations of the impacted canines were negatively related to a lateral incisor's root resorption. No correlations were found between resorption and medial or vertical position of the crown of the canine. The follicle/tooth ratio was significantly related to the mesial inclination of the impacted canine, but not to root resorption. An impacted maxillary canine, after being distanced from the incisor roots, does not seem to be a risk factor for apical root resorption during orthodontic treatment. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Surgical Orthodontic Treatment of an Impacted Canine in the Presence of Dens Invaginatus and Follicular Cyst

PubMed Central

Canevello, Carola; Laffi, Nicola

2014-01-01

Introduction. “Dens invaginatus” is a dental anomaly which originates from the invagination of the ameloblastic epithelium into the lingual surface of the dental crown during the odontogenesis. It can cause early pulpal necrosis, abscesses, retention or dislocation of contiguous elements, cysts, and internal resorptions. It normally affects the upper lateral incisors. In the following study the authors will discuss the etiology, the physiopathology, and the surgical-orthodontic management of a rare case of impacted canine associated with dens invaginatus and follicular cyst, with the aim of highlighting the importance of taking any therapeutic decision based on the data available in the literature. Case Report. The present study describes a combined surgical-orthodontic treatment of an impacted canine associated with a lateral incisor (2.2) suffering from type III dens invaginatus with radicular cyst, in a 15-year-old patient. Discussion. When treating a dens invaginatus there are different therapeutic solutions: they depend on the gravity of the anomaly and on the association with the retention of a permanent tooth. The aesthetic and functional restoration becomes extremely important when performing a surgical-orthodontic repositioning. PMID:24963421

Using Composite Resin Inclined Plane for the Repositioning of a Laterally Luxated Primary Incisor: A Case Report

PubMed Central

Arikan, Volkan; Sari, Saziye

2011-01-01

This case report describes the repositioning of a laterally luxated primary central incisor with occlusal interference, using a composite inclined plane. The patient was a 4-year-old girl who applied to our clinic three days after the injury. Because of the time delay between injury and presentation, it was not possible to reposition the tooth with pressure. Following a root-canal treatment, an inclined plane was prepared on the lower primary incisors, using composite resin. The tooth was repositioned in two weeks, and the inclined plane was then removed. After 1 year of follow-up, the treatment was found to be successful, both clinically and radiographically. The use of a composite inclined plane, accompanied by careful follow-up, is an effective alternative to extraction for laterally luxated primary incisors with occlusal interference. PMID:21228962

A nonsurgical endodontic treatment in open-apex and immature teeth affected by dens invaginatus: using a collagen membrane as an apical barrier.

PubMed

Gharechahi, Maryam; Ghoddusi, Jamileh

2012-02-01

The authors' objective in this case report is to demonstrate an effective nonsurgical endodontic treatment in open-apex teeth affected by dens invaginatus (DI) by using a collagen membrane as an apical barrier and using a mineral trioxide aggregate (MTA) apical plug. . The authors present two cases of DI with open apexes in maxillary lateral incisors. In the first case, an adolescent had bilateral Oehlers type II DI and extensive periradicular radiolucency, internal root resorption and a vestibular fistula in the left maxillary lateral incisor. In the second case, an adult had Oehlers type II DI and an incomplete apex in the left maxillary lateral incisor. For both patients, the clinician placed a collagen membrane through the apexes of the left maxillary incisors to provide a resorbable extraradicular barrier against which MTA cement could be packed. The clinician obturated the adolescent's right lateral incisor. In the adolescent, the vestibular sinus tract was closed after one week. At subsequent follow-up examinations, the periradicular regions were completely healed, and postoperative radiographs revealed good bone healing in the lateral incisors. The teeth were asymptomatic and healing was achieved without any need for further endodontic surgical intervention. In the adult patient, the tooth was symptom free after one week, and radiography performed six months after the procedure showed complete healing. and Despite complex anatomy and diagnoses of DI and open apexes, both patients successfully underwent nonsurgical endodontic treatment involving the use of a collagen membrane and an MTA apical plug. Using an extraradicular barrier clinically can help improve the adaptation of MTA in the apexes of open-apex teeth to achieve a complete seal.

Orthodontic decompensation in class III patients by means of distalization of upper molars.

PubMed

Carlos, Villegas B; Giovanni, Oberti; Diego, Rey; Angela, Sierra; Baccetti, Tiziano

2009-01-01

Pre-surgical orthodontic treatments have the objective of establishing harmony between the dental arches by moving the teeth to ideal positions in relation to their bony bases, in order to achieve adequate antero-posterior occlusal and transverse relationships at the moment of surgery. Among the typical requirements in terms of dental compensations presented by Class III patients that require surgery, the inclination of anterior teeth must be changed in most cases by proclination of the lower incisors and retroclination of upper incisors. To achieve the inclination of the upper incisors, many different alternatives have been proposed, such as inter-proximal reduction, extractions, or distalization of upper molars, which has not been widely reported in the literature as a means to decompensate Class III malocclusion prior to surgery. This article describes the Bone Supported Pendulum (BSP) as an efficient therapeutic option to distalize molars through the use of an appliance stabilized to the palate by mini-implants, thus avoiding extractions and providing good interdigitation and coordination of the dental arches.

A Rare Occurrence of Geminated-Taloned Maxillary Lateral Incisor

PubMed Central

Kayal, Vizhi G

2012-01-01

ABSTRACT The talon cusp is a developmental anomaly characterized by the presence of an accessory cusp like structure projecting from the cingulum area of the anterior teeth. Gemination is an anomaly caused by a single tooth germ that attempted to divide during its development. These developmental anomalies may cause clinical problems including esthetic impairment, pain, caries and tooth crowding. Co-occurrence of two anomalies in a teeth is rare. This paper presents an unusual case of talon cusp on geminated permanent lateral incisor. How to cite this article: Neeraja R, Kayal VG. A Rare Occurrence of Geminated-Taloned Maxillary Lateral Incisor. Int J Clin Pediatr Dent 2012;5(2):136-138. PMID:25206153

Dental hyponatraemia.

PubMed

Simpson, R M

2011-08-01

A 14-year-old girl developed dental pain and was treated for acute infected pulpitis of her right upper lateral incisor with drilling and filling. The pain continued and was helped by analgesia, sucking ice cubes and drinking cold water. Forty-eight hours later, she became confused and disoriented. She started to vomit and complained of headache. Investigations revealed hyponatraemia with normal serum potassium levels and initially normal urinary sodium excretion. Over the next 24 hours, she passed 5.45 L of urine and her serum sodium rose from 125 to 143 mmol/L. Self-induced water intoxication has been described during drinking games and initiation ceremonies, but this would appear to an unusual cause. Conservative management proved successful in allowing this girl to recover without sequelae.

The characteristics and distribution of dental anomalies in patients with cleft.

PubMed

Wu, Ting-Ting; Chen, Philip K T; Lo, Lun-Jou; Cheng, Min-Chi; Ko, Ellen Wen-Ching

2011-01-01

Dental anomalies associated with different severities of cleft lip and palate have been rarely reported. This retrospective study investigates the characteristics of dental anomalies associated with different types of cleft, and compares the dental anomaly traits based on sex and severity of cleft. Cleft patients born in 1995 with qualified diagnostic records from 7 to 11 years were included for evaluation. Records were retrieved from database of Chang Gung Craniofacial Center, including panoramic radiographs and intraoral photographs. In total, 196 patients with complete records were included in the evaluation. This study compares the dental anomalies associated with each type of cleft. The frequency of dental anomalies in the maxillary incisor area in the cleft palate (CP) group (20%) was significantly lower than that in other groups. The frequency of missing maxillary lateral incisors (MLIs) increased as the cleft severity increased. Supernumerary teeth and missing lower incisors exhibited the opposite trend. No sexual dimorphism appeared in terms of the frequencies of peg laterals and missing MLIs. The distribution patterns of missing MLIs and peg laterals in males, but not in females, were consistent for the three types of unilateral clefts. Regarding the characteristics of dental anomalies among the three unilateral clefts, missing MLIs, supernumerary teeth, and missing lower incisors were found to be related to cleft severity. The maxillary lateral incisor was the most affected tooth in the cleft area. The frequency of missing MLIs and peg laterals was not sexual dimorphic, but the distribution pattern was different between the sexes.

Frequency and variability of dental morphology in deciduous and permanent dentition of a Nasa indigenous group in the municipality of Morales, Cauca, Colombia.

PubMed

Díaz, Eider; García, Lorena; Hernández, Michelle; Palacio, Lesly; Ruiz, Diana; Velandia, Nataly; Villavicencio, Judy; Moreno, Freddy

2014-01-01

To determine the frequency, variability, sexual dimorphism and bilateral symmetry of fourteen dental crown traits in the deciduous and permanent dentition of 60 dental models (35 women and 25 men) obtained from a native, indigenous group of Nasa school children of the Musse Ukue group in the municipality of Morales, Department of Cauca, Colombia. This is a quantitative, descriptive, cross-sectional study that characterizes dental morphology by means of the systems for temporary dentition from Dahlberg (winging), and ASUDAS (crowding, reduction of hypocone, metaconule and cusp 6), Hanihara (central and lateral incisors in shovel-shape and cusp 7), Sciulli (double bit, layered fold protostylid, cusp pattern and cusp number) and Grine (Carabelli trait); and in permanent dentition from ASUDAS (Winging, crowding, central and lateral incisors in shovel-shape and double shovel-shape, Carabelli trait, hypocone reduction, metaconule, cusp pattern, cusp number, layered fold protostylid, cusp 6 and cusp 7). The most frequent dental crown features were the shovel-shaped form, grooved and fossa forms of the Carabelli trait, metaconule, cusp pattern Y6, layered fold, protostylid (point P) and cusp 6. Sexual dimorphism was not observed and there was bilateral symmetry in the expression of these features. The sample studied presented a great affinity with ethnic groups belonging to the Mongoloid Dental Complex due to the frequency (expression) and variability (gradation) of the tooth crown traits, upper incisors, the Carabelli trait, the protostylid, cusp 6 and cusp 7. The influence of the Caucasoide Dental Complex associated with ethno-historical processes cannot be ruled out.

European college of orthodontics: commission of affiliation and titularisation.

PubMed

Muller, Christine

2012-06-01

Date of birth: 28/4/1977; sex: female. A. (4/2006; 29 years). Tooth-arch discrepancy with bi-maxillary protrusion. Correction of bi-maxillary protrusion; avulsion of 15, 25, 35 and 45; fixed multi-bracket Incognito bi-maxillary appliance; mini-screw anchorage. B. POST-TREATMENT RECORDS DOCUMENTS: (9/2009; 32 years and 6 months). Permanent retainers using fixed upper and lower bonded wires. C. POST-RETENTION RECORDS: (7/2010; 33 years and 3 months). D. Reason for consultation: correction of crooked and "jutting" teeth. Extraoral examination: balanced facial levels; lateral view: predominant lower third; closed nasolabial angle; labial asymmetry with predominant lower lips. Endooral examination: young adult dentition; average dental status; large number of fillings; panorex confirms four devitalized teeth; good periodontal status; V-shaped upper arch with lingually ectopic 12 and 22; lower arch with slight incisor crowding; bi-lateral molar and canine Class I; crossbite of 12 and 22; 2-mm deepbite and 1-mm overjet. Copyright © 2012. Published by Elsevier Masson SAS.

Predictors of favorable soft tissue profile outcomes following Class II Twin-block treatment

PubMed Central

Kim, Ji-Eun; Mah, Su-Jung; Kim, Tae-Woo; Kim, Su-Jung; Park, Ki-Ho

2018-01-01

Objective The aim of this study was to determine cephalometric factors that help predict favorable soft-tissue profile outcomes following treatment with the Class II Twin-block appliance. Methods Pre- and post-treatment lateral cephalograms of 45 patients treated with the Class II Twin-block appliance were retrospectively analyzed. Profile silhouettes were drawn from the cephalograms and evaluated by three orthodontists in order to determine the extent of improvement. Samples were divided into a favorable group (upper 30% of visual analogue scale [VAS] scores, n = 14) and an unfavorable group (lower 30% of VAS scores, n = 14). Skeletal and soft-tissue measurements were performed on the cephalograms and an intergroup comparison was conducted. Results An independent t-test revealed that the following pre-treatment values were lower in the favorable group compared to the unfavorable group: lower incisor to mandibular plane angle, lower incisor to pogonion distance, point A-nasion-point B angle, sella-nasion line (SN) to maxillary plane angle, SN to mandibular plane angle, gonial angle, and symphysis inclination. The favorable group had a larger incisor inclination to occlusal plane. Moreover, the favorable group showed larger post-treatment changes in gonial angle, B point projection, and pogonion projection than did the unfavorable group. Conclusions Class II malocclusion patients with a low divergent skeletal pattern and reduced lower incisor protrusions are likely to show more improvement in soft-tissue profile outcomes following Class II Twin-block treatment. PMID:29291184

How much incisor decompensation is achieved prior to orthognathic surgery?

PubMed

McNeil, Calum; McIntyre, Grant T; Laverick, Sean

2014-07-01

To quantify incisor decompensation in preparation for orthognathic surgery. Pre-treatment and pre-surgery lateral cephalograms for 86 patients who had combined orthodontic and orthognathic treatment were digitised using OPAL 2.1 [http://www.opalimage.co.uk]. To assess intra-observer reproducibility, 25 images were re-digitised one month later. Random and systematic error were assessed using the Dahlberg formula and a two-sample t-test, respectively. Differences in the proportions of cases where the maxillary (1100 +/- 60) or mandibular (900 +/- 60) incisors were fully decomensated were assessed using a Chi-square test (p<0.05). Mann-Whitney U tests were used to identify if there were any differences in the amount of net decompensation for maxillary and mandibular incisors between the Class II combined and Class III groups (p<0.05). Random and systematic error were less than 0.5 degrees and p<0.05, respectively. A greater proportion of cases had decompensated mandibular incisors (80%) than maxillary incisors (62%) and this difference was statistically significant (p=0.029). The amount of maxillary incisor decompensation in the Class II and Class III groups did not statistically differ (p=0.45) whereas the mandibular incisors in the Class III group underwent statistically significantly greater decompensation (p=0.02). Mandibular incisors were decompensated for a greater proportion of cases than maxillary incisors in preparation for orthognathic surgery. There was no difference in the amount of maxillary incisor decompensation between Class II and Class III cases. There was a greater net decompensation for mandibular incisors in Class III cases when compared to Class II cases. Key words:Decompensation, orthognathic, pre-surgical orthodontics, surgical-orthodontic.

The effectiveness of pendulum, K-loop, and distal jet distalization techniques in growing children and its effects on anchor unit: A comparative study.

PubMed

Marure, Pravinkumar S; Patil, Raju Umaji; Reddy, Sumitra; Prakash, Amit; Kshetrimayum, Nillachandra; Shukla, Rajeevkumar

2016-01-01

A common strategy to correct Class II malocclusions using a nonextraction protocol in children is to move the maxillary molars distally using molar distalization appliances, which usually derive their anchorage from maxillary premolars, causing mesialization of premolars and protrusion of incisors. To evaluate the skeletal, dental and soft tissue changes produced by three different distalizing appliances, namely, pendulum, K-loop, and distal jet appliances. Sixty-six children of mean age 14.13 years requiring molar distalization were divided into three groups: Group I (pendulum appliance), Group II (K-loop), and Group III (distal jet). Lateral cephalometric films were taken before and after 5 months of molar distalization and following cephalometric parameters were used to assess the effects of maxillary molar distalization, namely, anteroposterior skeletal (SNA/SNB/ANB), vertical skeletal (face height ratio/Frankfort-mandibular plane [FMA]/angle formed between Maxillary plane & Mandibular plane (MM)), interdental (overjet/overbite), maxillary dentoalveolar, and soft tissue parameters. There was no significant age difference between the three groups. In overall treatment changes among the three groups, the Anteroposterior skeletal changes were not statistically significant, vertically FMA angle increased by 1.79° ± 2.25° and overbite reduced by 2.38 ± 1.83 mm. The maxillary first molars were distalized by an average of 4.70 ± 3.01 mm (Upper 6 [U6] to pterygoid vertical [PTV]). The maxillary central incisor labial tipping increased to an average of 1.61 ± 2.73 mm and cant of upper lip increased by 3.40° ± 5.88° are statistically significant (P < 0.05). All three distalization techniques in growing children produced significant effects on anchor unit. There was an increase in FMA angle, significant bite opening, proclination of the maxillary incisors and increase in the cant of the upper lip.

Applicability of Berry's index in bite mark analysis

PubMed Central

Antony, Palathottungal Joseph; Pillai, Karthigakannan Subramanian; George, Giju Baby; Varghese, Thomas; Puthalath, Mohammed Shibin; Arakkal, Leena Johnson

2015-01-01

Objectives: This study attempts to highlight the usefulness of applying Berry's Index as an adjuvant to support and aid in bite analysis. Materials and Methods: This study was conducted among 100 students between the ages of 18–30 from Mar Baselios Dental Collage, Kothamangalam. Out of the 100 subjects, there were 50 males and 50 females. The data obtained was tabulated and analyzed using Statistical Package for Social Sciences, Version 16 (SPSS). Results: The mean value of the width of the upper central incisor for male and female was 0.7602 cm and 0.7765 cm respectively. The mean value of the bizygomatic width for male and female was 12.54 cm and 12.42 cm respectively. The correlation between the upper central incisor width and the bizygomatic width was inferred to have a good positive correlation with a value 0f 0.613. Pearson correlation coefficient with greater correlation between the upper central incisor width and the bizygomatic width in female patient (r = 0.678) compared with male patient (r = 0. 525). Conclusion: Berry's Index can be a useful adjuvant to bite analysis by providing a means of determining the facial proportions of an individual from the width of the central incisors. PMID:25709316

Differences between dentitions with palatally and labially located maxillary canines observed in incisor width, dental morphology and space conditions.

PubMed

Artmann, L; Larsen, H J; Sørensen, H B; Christensen, I J; Kjaer, I

2010-06-01

To analyze the interrelationship between incisor width, deviations in the dentition and available space in the dental arch in palatally and labially located maxillary ectopic canine cases. Size: On dental casts from 69 patients (mean age 13 years 6 months) the mesiodistal widths of each premolar, canine and incisor were measured and compared with normal standards. Dental deviations: Based on panoramic radiographs from the same patients the dentitions were grouped accordingly: Group I: normal morphology; Group IIa: deviations in the dentition within the maxillary incisors only; Group IIb: deviations in the dentition in general. Descriptive statistics for the tooth sizes and dental deviations were presented by the mean and 95% confidence limits for the mean and the p-value for the T-statistic. Space: Space was expresses by subtracting the total tooth sizes of incisors, canines and premolars from the length of the arch segments. Size of lateral maxillary incisor: The widths of the lateral incisors were significantly different in groups I, IIa and IIb (p=0.016) and in cases with labially located ectopic canines on average 0.65 (95% CI:0.25-1.05, p=0.0019) broader than lateral incisors in cases with palatally located ectopic canines. Space: Least available space was observed in cases with labially located canines. The linear model did show a difference between palatally and labially located ectopic canines (p=0.03). Space related to deviations in the dentition: When space in the dental arch was related to dental deviations (groups I, IIa and IIb), the cases in group IIb with palatally located canines had significantly more space compared with I and IIa. Two subgroups of palatally located ectopic maxillary canine cases based on registration of space, incisor width and deviations in the morphology of the dentition were identified.

Orthodontic treatment of an anterior openbite with the aid of corticotomy procedure: Case report

PubMed Central

Aljhani, Ali S.; Aldrees, Abdullah M.

2010-01-01

This case report illustrates the orthodontic treatment combined with the corticotomy technique in an adult patient to accelerate tooth movement and shorten the treatment time. The patient was a 22-year-old woman with an anterior open bite and flared and spaced upper and lower incisors. First, fixed orthodontic appliances (bidimensional edgewise brackets) were bonded, and a week later buccal and lingual corticotomy with alveolar augmentation procedure in the maxillary arch from the first molar to the contralateral first molar, and from canine to canine in the mandibular arch was performed. Orthodontic therapy proceeded with frequent activation of the appliances to retract the incisors every 2 weeks. The total treatment time was 5 months and no adverse effects were observed at the end of active treatment. The addition of the decortication procedure to the conventional orthodontic therapy decreased the duration of treatment significantly. Successful closure of the anterior open bite with adequate overbite and interdigitation of the teeth were achieved. PMID:24151417

Transparent aligners: An invisible approach to correct mild skeletal class III malocclusion

PubMed Central

Yezdani, A. Arif

2015-01-01

This case report highlights the treatment of a mild skeletal class III malocclusion with an invisible thermoplastic retainer. A 15-year-old female patient presented with a mild skeletal class III malocclusion with a retrognathic maxilla, orthognathic mandible, a low mandibular plane angle with Angle's class III malocclusion with maxillary lateral incisors in anterior cross-bite with crowding of maxillary anteriors, imbricated and rotated mandibular incisors and deep bite. Accurate upper and lower impressions and a bite registration were taken with polyvinyl siloxane rubber base impression material. This was then sent to the lab for the processing of a series of ClearPath aligners. The ClearPath virtual set-up sent from the lab provided the treatment plan and interproximal reduction estimation complete with posttreatment results. This enabled the clinician to actively participate in the treatment plan and provide the necessary suggestions. The ClearPath three-dimensional aligner was found to have effectively corrected the anterior cross-bite and crowding of the maxillary anteriors. PMID:26015738

Orthodontic treatment of an anterior openbite with the aid of corticotomy procedure: Case report.

PubMed

Aljhani, Ali S; Aldrees, Abdullah M

2011-04-01

This case report illustrates the orthodontic treatment combined with the corticotomy technique in an adult patient to accelerate tooth movement and shorten the treatment time. The patient was a 22-year-old woman with an anterior open bite and flared and spaced upper and lower incisors. First, fixed orthodontic appliances (bidimensional edgewise brackets) were bonded, and a week later buccal and lingual corticotomy with alveolar augmentation procedure in the maxillary arch from the first molar to the contralateral first molar, and from canine to canine in the mandibular arch was performed. Orthodontic therapy proceeded with frequent activation of the appliances to retract the incisors every 2 weeks. The total treatment time was 5 months and no adverse effects were observed at the end of active treatment. The addition of the decortication procedure to the conventional orthodontic therapy decreased the duration of treatment significantly. Successful closure of the anterior open bite with adequate overbite and interdigitation of the teeth were achieved.

Lip line preference for variant face types.

PubMed

Anwar, Nabila; Fida, Mubassar

2012-06-01

To determine the effect of altered lip line on attractiveness and to find preferred lip line for vertical face types in both genders. Cross-sectional analytical study. The Aga Khan University Hospital, Karachi, from May to July 2009. Photographs of two selected subjects were altered to produce three face types for the same individual with the aim of keeping the frame of the smile constant. Lip line was then altered for both the subjects as: both dentitions visible, upper incisors visible, upper incisors and 2 mm gum and 4 mm gum visible. The pictures were rated by different professionals for attractiveness. Descriptive statistics for the raters and multiple factor ANOVA was used to find the most attractive lip line. The total number of raters was 100 with the mean age of 30.3 ± 8 years. The alterations in the smile parameters produced statistically significant difference in the attractiveness of faces, whereas the perception difference was found to be insignificant amongst raters of different professions. Preferred lip line was the one showing only the upper incisors in dolico and mesofacial male and female genders whereas 2 mm gum show was preferred in brachyfacial subjects. The variability in lip line showed significant difference in the perceived attractiveness. Preferred lip lines as the one showing only the upper incisors in dolico and mesofacial male and female genders whereas 2 mm gum show was preferred in brachyfacial subjects.

Dental Anomalies in Different Types of Cleft Lip and Palate: Is There Any Relation?

PubMed

Germec Cakan, Derya; Nur Yilmaz, Rahime Burcu; Bulut, Feyza Nur; Aksoy, Ayca

2018-02-26

The aims of this study were to evaluate the prevalence of dental anomalies in Turkish patients with different types of cleft lip and palate (CLP) and investigate the relationship between the type of cleft and the dental anomaly. Eighty-eight patients with cleft lip and/or palate (mean age: 14.1 ± 6.4 years) were enrolled in this retrospective study. Dental models, panoramic radiographs, and intraoral photographs of these patients were evaluated to detect any maxillary dental anomaly (number and size anomalies). Two hundred fifty unaffected subjects (mean age: 15.2 ± 7.2 years) composed the control group. Data were evaluated using the independent t test, χ, Fischer exact test, and the odds ratio. Dental anomaly frequency was significantly higher in the cleft group compared with the control group. Tooth agenesis was the most common dental anomaly, followed by microdontia and supernumerary tooth. Lateral incisor agenesis was seen in 69% of the unilateral CLP, in 78% of the bilateral CLP, and in 18% of the cleft palate patients. A significant association was revealed between the right unilateral CLP and the right lateral incisor agenesis (P = 0.0001), the left unilateral CLP and the left lateral incisor agenesis (P = 0.002), and the bilateral CLP and the bilateral lateral incisor agenesis (P = 0.0001). Dental anomalies are more frequently seen in patients with CLP compared with the general population. There is a relationship between the cleft type and the ipsilateral lateral incisor agenesis.

Prevalence of abnormalities in dental structure, position, and eruption pattern in a population of unilateral and bilateral cleft lip and palate patients.

PubMed

Tortora, Chiara; Meazzini, Maria C; Garattini, Giovanna; Brusati, Roberto

2008-03-01

To evaluate the dental characteristics of patients subjected to a protocol that included early secondary gingivoalveoloplasty (ESGAP). Panoramic radiographs of 87 patients with unilateral cleft lip and palate (UCLP) and 29 with bilateral cleft lip and palate (BCLP) were evaluated. Missing and supernumerary teeth were also quantified on the cleft and noncleft side and in the maxilla and mandible. Crown and root malformations and tooth rotations were quantified. A subsample in permanent dentition was extrapolated to analyze canine eruption patterns. A total of 48.8% of the UCLP patients presented with missing permanent lateral incisors in the cleft area and 6.1% contralaterally. A total of 4.9% presented with missing second maxillary premolars on the cleft site and 1.2% contralaterally. A total of 7.3% presented with supernumerary lateral incisors, and 45% of the BCLP cleft sites presented with missing lateral incisors, while 25% of the cleft sites presented second maxillary premolars agenesis. Five percent of the cleft sites presented with supernumerary lateral incisors. Evaluation of the subsample in permanent dentition showed that 15.5% had a canine retention and 4.4% of the canines had to be surgically exposed. A significant association was observed between canine inclination and retention but not with absence of the lateral incisor. The frequency of dental anomalies in this sample was similar to other cleft populations. As surgical trauma has been suggested to damage forming teeth, the results of this study indicated that ESGAP has no detrimental influence on subsequent dental development.

Panoramic radiographic survey of hypodontia in Australian Defence Force recruits.

PubMed

Lynham, A

1990-02-01

Comprehensive dental examinations and panoramic radiographs were used to determine the prevalence of hypodontia in 662 Australian Defence Force recruits. Of the sampled population, 6.3 per cent exhibited some degree of hypodontia (third molar agenesis excluded). Previous studies produced similar results. Third molar agenesis occurred in 22.7 per cent of the sample which again is in agreement with other studies. There was no statistical difference between the sexes in third molar agenesis; however, there was a significant difference with upper second premolars. Females exhibited an extremely low incidence of absence of maxillary lateral incisors.

Incisal Apical Root Resorption Evaluation after Low-Friction Orthodontic Treatment Using Two-Dimensional Radiographic Imaging and Trigonometric Correction.

PubMed

Savoldi, Fabio; Bonetti, Stefano; Dalessandri, Domenico; Mandelli, Gualtiero; Paganelli, Corrado

2015-11-01

Root resorption shall be taken into consideration during every orthodontic treatment, and it can be effected by the use of different techniques, such as the application of low friction mechanics. However, its routinely assessment on orthopantomography has limitations related to distortions and changes in dental inclination. The aim of this investigation was to evaluate the severity of apical root resorption of maxillary and mandibular incisors after low-friction orthodontic treatment, using the combination of panoramic and lateral radiographs, and applying a trigonometric correction. A hospital based Retrospective study at the orthodontic Department (Dental School, University of Brescia, Spedali Civili di Brescia, Brescia, Italy). Ninety-three subjects (53 females and 40 males; mean age, 14 years) with mild teeth crowding were treated without extractions by the same operator using a low-friction fixed appliance following an integrated straight wire (ISW) protocol. The pre- and post-treatment tooth lengths of the maxillary and mandibular incisors were measured on panoramic radiographs. A trigonometric factor of correction for the pre-treatment length was calculated based on the difference between the pre and post-treatment incisal inclination on lateral cephalograms. The changes in lengths were investigated using the Student's t-test for paired values (p<0.05). Maxillary central incisors showed no changes (0.3%, 0.6%), maxillary lateral incisors showed a small increase (1.4%, 1.8%) that was attributed to the completion of root development in younger patients, mandibular central and lateral incisors underwent slight resorption (-3.1%, -3.4%). A statistically significant difference was found for the mandibular incisors but not for the maxillary ones. In patients with mild crowding and consequent low amount of root movement, a low-friction orthodontic treatment can lead to slight apical root resorption, mainly involving lower incisors. The use of a trigonometric correction in the panoramic radiograph analysis may reduce the limitations of this 2D evaluation.

Assessment of dynamic smile and gingival contour in young Chinese people.

PubMed

Zhang, Yan-Ling; Le, Di; Hu, Wen-Jie; Zhang, Hao; Liang, Ling-Zhi; Chung, Kwok-Hung; Cao, Zhan-Qiang

2015-08-01

This study aimed to classify the dynamic smile and to quantify the gingival line (GL), as well as apico-coronal displacement of the gingival zenith (GZ), in the maxillary anterior dentition in a young Chinese population. Two-hundred young Chinese subjects (100 men and 100 women; 20-35 years of age) with healthy dentogingival tissue were recruited. The dynamic smile process was captured using a digital camera. The smile type, GL type, the vertical distance of the GZ between the canine and the central incisor on the same side and the GZ of the lateral incisor-GL relationship were measured using a self-developed smile-analysis method. The kappa statistics was used to examine the reliability of the data recorded by the rater. The Pearson chi-square test was used to analyse the differences between subjects regarding the frequencies of smile type and GL type at α = 0.05. Data revealed that 45.5% of subjects had a high smile and 45.5% had an average smile; 58.2% of the subjects presented an upwards GL. The GZ of canine teeth was 0.33 mm apical to the corresponding central incisor and no significant difference between both sides of the GZ was observed. The GZ of the lateral incisor was located coronal to the GL in 87.9% of samples. The vertical distance between the GZ of the lateral incisor and the GL was 0.59 mm and no statistically significant difference was detected. The most common findings were a high or average smile type, combined with an upward GL. In the majority of subjects, the GZ of the lateral incisor is coronal to the GL. The apico-coronal displacement of the GZ showed bilateral symmetry. © 2015 FDI World Dental Federation.

Skeletal, dental and soft tissue changes in Class III patients treated with fixed appliances and lower premolar extractions.

PubMed

Abu Alhaija, Elham S J; Al-Khateeb, Susan N

2011-05-01

Mild Class III malocciusions can be treated by upper incisor proclination and lower incisor retroclination following extraction of the lower first premolars. To compare the skeletal, dental and soft tissue changes in Class III patients treated with fixed appliances, Class III traction and lower first premolar extractions with the changes in a group of untreated Class III patients. The Treatment group consisted of 30 Class III patients (Mean age 13.69 +/- 1.48 years) who were treated by upper and lower fixed appliances, Class III intermaxillary traction and lower first premolar extractions for 2.88 +/- 1.12 years. The Control group consisted of 20 untreated Class III patients (Mean age 13.51 +/- 0.95) matched for age and gender. The T1 to T2 changes in the treated and untreated groups were compared using a paired t-test while differences between the two groups were compared with an independent t-test. During treatment, the upper incisors were proclined about 1 degree and the lower incisors were retroclined 8 degrees. Small, but statistically significant changes in SNB, Wits and the overlying soft tissues accompanied the changes in incisor inclination. At the end of treatment a positive overbite and overjet were achieved. The increase in lower facial height in the Treatment group was comparable with the change in the Control group. A range of mild to moderate Class III malocclusions can be treated by dentoalveolar compensation.

Bilateral cross-bite treated by repeated rapid maxillary expansions: a 17-year follow-up case.

PubMed

Cozzani, M; Mazzotta, L; Caprioglio, A

2014-07-01

The objective of this paper is to show the clinical results after the repeated application of a Haas expander for rapid maxillary expansion (RME) anchored onto deciduous teeth in a 7-year-old patient that presented bilateral cross-bite, superior crowding and no space for permanent lateral incisors eruption. A first Haas expander was applied to the patient. She was told to activate it once a day, each activation was equal to 0.20 mm. After the first RME, the bilateral cross-bite was solved but still there was not enough space for lateral incisor eruption. A second and then a third Haas expander were applied, with the same activation protocol as the first one, in order to gain space in the anterior region and to achieve proper eruption of the lateral incisors. The patient was then treated with fixed appliances. At debonding the patient presented well aligned arch-forms: space for lateral incisor eruption was gained and superior crowding was solved. Bilateral cross-bite was also corrected. She was seen again 10 years and 17 years after expansions: she showed no relapse and presented a good functional occlusion that had remained stable, and an aesthetically pleasant smile, however she exhibited gingival recessions. Repeated rapid maxillary expansion, anchored onto deciduous teeth, performed in early mixed dentition represents a safe and successful treatment to correct severe bilateral cross- bites and to create space for maxillary incisor eruption.

Frequency and variability of dental morphology in deciduous and permanent dentition of a Nasa indigenous group in the municipality of Morales, Cauca, Colombia

PubMed Central

Díaz, Eider; García, Lorena; Hernández, Michelle; Palacio, Lesly; Ruiz, Diana; Velandia, Nataly; Villavicencio, Judy

2014-01-01

Objectives: To determine the frequency, variability, sexual dimorphism and bilateral symmetry of fourteen dental crown traits in the deciduous and permanent dentition of 60 dental models (35 women and 25 men) obtained from a native, indigenous group of Nasa school children of the Musse Ukue group in the municipality of Morales, Department of Cauca, Colombia. Methods: This is a quantitative, descriptive, cross-sectional study that characterizes dental morphology by means of the systems for temporary dentition from Dahlberg (winging), and ASUDAS (crowding, reduction of hypocone, metaconule and cusp 6), Hanihara (central and lateral incisors in shovel-shape and cusp 7), Sciulli (double bit, layered fold protostylid, cusp pattern and cusp number) and Grine (Carabelli trait); and in permanent dentition from ASUDAS (Winging, crowding, central and lateral incisors in shovel-shape and double shovel-shape, Carabelli trait, hypocone reduction, metaconule, cusp pattern, cusp number, layered fold protostylid, cusp 6 and cusp 7). Results: The most frequent dental crown features were the shovel-shaped form, grooved and fossa forms of the Carabelli trait, metaconule, cusp pattern Y6, layered fold, protostylid (point P) and cusp 6. Sexual dimorphism was not observed and there was bilateral symmetry in the expression of these features. Conclusions: The sample studied presented a great affinity with ethnic groups belonging to the Mongoloid Dental Complex due to the frequency (expression) and variability (gradation) of the tooth crown traits, upper incisors, the Carabelli trait, the protostylid, cusp 6 and cusp 7. The influence of the Caucasoide Dental Complex associated with ethno-historical processes cannot be ruled out. PMID:24970955

Molar incisor hypomineralization: proportion and severity in primary public school children in Graz, Austria.

PubMed

Buchgraber, Barbara; Kqiku, Lumnije; Ebeleseder, Kurt A

2018-03-01

The aim of this study was to determine the proportion and severity of molar incisor hypomineralization (MIH) in primary school children in Graz (southeast of Austria). In 1111 children aged 6 to 12 years (mean age 9.0 ± 1.2), a wet examination of all teeth was performed by three trained examiners using a dental chair, optimal illumination, a dental mirror, and a dental explorer. All teeth with MIH lesions were registered so that different definitions of MIH were applicable. According to the European Academy of Pediatric Dentistry criteria that were considered valid at the time of the investigation, MIH was diagnosed when at least one first primary molar (FPM) was affected. MIH was present in 78 children (7.0%). In 64 children (5.8%), at least one molar and one incisor were affected (so-called M + IH). Additionally, in 9 children, only incisors were affected. In 7 affected children, teeth other than FPMs and incisors had MIH lesions. Almost an equal number of males (38) and females (40) were affected. The upper and lower molars were equally affected. The upper incisors were more frequently affected than the lower ones. Demarcated enamel opacities were the predominant types of defects. The proportion of MIH was 7.0% in Graz, which is similar to other comparable trials. This study has proven that MIH is an existing dental problem in Graz.

A Prospective, Randomized, Double-Blind Comparison of 2% Lidocaine With 1 : 100,000 Epinephrine, 4% Prilocaine With 1 : 200,000 Epinephrine, and 4% Prilocaine for Maxillary Infiltrations

PubMed Central

Katz, Steven; Drum, Melissa; Reader, Al; Nusstein, John; Beck, Mike

2010-01-01

Abstract The purpose of this prospective, randomized, double-blind crossover study was to evaluate the anesthetic efficacy of 2% lidocaine with 1 : 100,000 epinephrine, 4% prilocaine with 1 : 200,000 epinephrine, and 4% prilocaine in maxillary lateral incisors and first molars. Sixty subjects randomly received, in a double-blind manner, maxillary lateral incisor and first molar infiltrations of 1.8 mL of 2% lidocaine with 1 : 100,000 epinephrine, 1.8 mL of 4% prilocaine with 1 : 200,000 epinephrine, and 1.8 mL of 4% prilocaine, at 3 separate appointments spaced at least 1 week apart. The teeth were pulp-tested in 3-minute cycles for a total of 60 minutes. Anesthetic success (ie, obtaining 2 consecutive 80 readings with the electric pulp tester) and onset of pulpal anesthesia were not significantly different between 2% lidocaine with 1 : 100,000 epinephrine, 4% prilocaine with 1 : 200,000 epinephrine, and 4% prilocaine for the lateral incisor and first molar. For both lateral incisor and first molar, 4% prilocaine with 1 : 200,000 epinephrine and 2% lidocaine with 1 : 100,000 epinephrine were equivalent for incidence of pulpal anesthesia. However, neither anesthetic agent provided an hour of pulpal anesthesia. For both lateral incisor and first molar, 4% prilocaine provided a significantly shorter duration of pulpal anesthesia compared with 2% lidocaine with 1 : 100,000 epinephrine and 4% prilocaine with 1 : 200,000 epinephrine. PMID:20553134

Prevalence of an unusual hypoplastic defect of the permanent maxillary lateral incisor in great apes.

PubMed

Hannibal, Darcy L

2017-02-01

In this article, I describe a previously unreported maxillary lateral incisor defect (MLID) of the enamel in great apes and evaluate potential general causes (genetic, systemic stress, or localized disturbance), as well as examine differences in prevalence among the represented taxa. This defect occurred only on the labial surface of the maxillary lateral incisor and extended from the cervical-mesial quarter of the crown to the mesial edge of the cementoenamel junction (CEJ). The study sample consisted of 136 great ape specimens, including 41 gorillas, 25 chimpanzees, and 70 orangutans from the Smithsonian's National Museum of Natural History great ape collection. I used logistic regression to assess the prevalence of this defect in the sample and a binomial probability test for bilaterality. This defect of the maxillary lateral incisor is the second most common defect I observed in the study sample (30.1% of individuals affected), and was more likely to occur in individuals with linear enamel hypoplasia (LEH) and pit defects than those without these defects. Among specimens with both maxillary lateral incisors present, the defect was mostly bilateral. Pan and Pongo were significantly more likely to exhibit the defect than Gorilla. Between Pongo species, Pongo pygmaeus was significantly more likely to exhibit the defect than Pongo abelii. Between subspecies of Gorilla, although Gorilla gorilla gorilla exhibited the defect and Gorilla gorilla beringei did not, the difference was not significant. No sex differences were evident in this sample. The prevalence of this defect indicates it is not hereditary. The bilateral trend indicates a systemic cause, although the high inter-tooth specificity suggests a local disturbance and a combination of both is possible. © 2016 Wiley Periodicals, Inc.

[Combination of periodontal, orthodontic and endodontic therapy in upper anterior teeth with hopeless prognosis and long-time follow-up: a case report].

PubMed

Li, Y; Xu, L; Zhou, Y H; Ouyang, X Y; Cao, T

2017-08-18

It is complicated to decide the treatment plan of hopeless anterior teeth in esthetic zone due to severe periodontitis, periodontal-endodontic combined lesion or teeth trauma. The optional treatment plan for this kind of teeth includes retention after periodontal treatment, extraction and implant treatment, extraction and prosthodontic treatment and so on. To make an appropriate treatment plan, patients' periodontal conditions, periodontal biotype, local anatomy, esthetic demand, economic condition and social psychological status should be comprehensively considered. A combine of periodontal, endodontic and orthodontic therapy may achieve a good treatment effect in hopeless anterior teeth with severe periodontal destruction, tooth extrusion and occlusal trauma. In this case, a 20-year-old female who presented with symptoms of bleeding on brushing and upper incisors loosening for 1 month came to the Department of Periodontology, Peking University School and Hospital of Stomatology. The clinical examinations revealed that the patient's right upper incisor had signs of mobility (III°), intrusion of 1-2 mm, and probing depth (PD) of 9-10 mm. The periapical radiograph showed that the alveolar bone of right upper incisor absorbed horizontally to the apex. And the patients showed Angle II° malocclusion with II° overbite in anterior teeth and maxillary protrusion. A diagnosis of aggressive periodontitis and Angle II° malocclusion was made. The treatment of this patient lasts for 5 years which include periodontal initial therapy, orthodontic therapy, guided tissue regeneration (GTR) of right upper incisor and supportive periodontal therapy and the clinical result is fine. A hopeless upper incisor was successfully retained and the longtime clinical condition was stable. The strategy of retention of hopeless upper anterior teeth, the relationship of periodontal treatment and orthodontic treatment, and the indications of periodontal and orthodontic combined therapy were also discussed on the basis of this case. Generally, the positive factors in retention of hopeless teeth includes young age, absence of systemic conditions, strong motivation for maintaining the tooth, single root anatomy, integrated dentition, good response to cause-related therapy, intrabony alveolar bone defect, thick periodontal biotype, and regular supportive periodontal therapy. And in the progress of orthodontic therapy, regular supportive periodontal therapy and good plaque control is extremely important.

[Orthodontic effects of tooth injury to the permanent and temporary incisors of children and the adolescent [corrected].

PubMed

Bassigny, F

1990-01-01

Traumatisms on the deciduous upper incisors could induce orthodontic indirect consequences on the permanent germ, dependent on his growth level and his malleability, dependent on connection between the root of deciduous incisor and the crown of permanent germ and according to the type of traumatism. According to those various data, it should be observed on the permanent incisor: germination of two germs, multiple odontoma, crown dilaceration, severe tipping of the crown with facial angulation, retention of the permanent germ with lack of root resorption of the deciduous teeth or simple cross-bite, without speaking of enamel defect.

Analysis of mechanical behavior of implant-supported prostheses in the anterior maxilla: analysis by speckle pattern interferometry

NASA Astrophysics Data System (ADS)

Corrêa, Cássia B.; Ramos, Nuno V.; Monteiro, Jaime; Vaz, Luis G.; Vaz, Mario A. P.

2012-10-01

The use of implants to rehabilitation of total edentulous, partial edentulous or single tooth is increasing, it is due to the high rate of success that this type of treatment present. The objective of this study was to analyze the mechanical behavior of different positions of two dental implants in a rehabilitation of 4 teeth in the region of maxilla anterior. The groups studied were divided according the positioning of the implants. The Group 1: Internal Hexagonal implant in position of lateral incisors and pontic in region of central incisors; Group 2: Internal Hexagonal implant in position of central incisors and cantilever of the lateral incisors and Group3 - : Internal Hexagonal implants alternate with suspended elements. The Electronic Speckle Pattern Interferometry (ESPI) technique was selected for the mechanical evaluation of the 3 groups performance. The results are shown in interferometric phase maps representing the displacement field of the prosthetic structure.

Rapid Palatal Expansion in the absence of posterior cross-bite to intercept maxillary incisor crowding in the mixed dentition: a CBCT evaluation of spontaneous changes of untouched permanent molars.

PubMed

Rosa, M; Lucchi, P; Manti, G; Caprioglio, A

2016-12-01

The aim of this study was to investigate the reaction of untouched permanent molars following RPE, anchored on deciduous teeth in the early mixed dentition, aimed to solve maxillary anterior crowding in the absence of posterior cross-bite. A prospective clinical trial comprised 35 consecutive patients (20 males and 15 females) treated by the same orthodontist (MR). All patients showed crowding of the upper permanent incisors in the early mixed dentition in the absence of posterior cross-bite. RPE was anchored on second deciduous molars and on the deciduous canines. CBCT was taken before and after the removal of the RPE appliance. The transverse linear changes in width and the variation in the torque of the permanent molars were measured in the coronal plane. Relief of incisor crowding was found in all patients. The transverse width between permanent molars increased significantly. The apices of the upper permanent molars spontaneously expanded more than the crowns, while the opposite happened on the lower permanent molars. Moreover, the untouched upper permanent molars spontaneously uprighted palatally, while the lower permanent molars spontaneously uprighted buccally. The variation in the torque of the permanent molars mirrored transverse normal growth. In the early mixed dentition and in the absence of posterior cross-bite, it is possible to expand transversally the palate while uprighting the upper permanent molars in the opposite direction. RPE anchored on the deciduous teeth in the early mixed dentition, in the absence of posterior cross-bite, provides an "anticipation of transverse growth" and could be indicated to expand the anterior portion of the maxillary arch perimeter to solve upper incisor crowding.

Nasopalatine duct cyst mimicking an endodontic periapical lesion: a case report.

PubMed

Bains, Rhythm; Verma, Promila; Chandra, Anil; Tikku, A P; Singh, Nimisha

2016-01-01

Lesions of nonendodontic origin, such as nasopalatine or globulomaxillary cysts, may mimic periapical radiolucencies associated with pulpal pathosis, and incorrect diagnosis may lead to unnecessary endodontic treatment. Horizontal root fractures most commonly affect the maxillary central and lateral incisors. Prognosis depends largely on the level of fracture; fractures in the apical third have the best prognosis, and those in the cervical third have the worst. This case report discusses surgical and restorative management of a patient who had a nasopalatine cyst that had been misdiagnosed and treated as an endodontic lesion of the maxillary right central incisor as well as a midroot horizontal fracture of the adjacent lateral incisor.

Width/Length Ratio in Maxillary Anterior Teeth. Comparative Study of Esthetic Preferences among Professionals and Laypersons.

PubMed

Álvarez-Álvarez, Lorena; Orozco-Varo, Ana; Arroyo-Cruz, Gema; Jiménez-Castellanos, Emilio

2017-05-17

Many studies have examined the esthetic preferences of professionals in the maxillary anterior region; however, only a few have taken into account the ratios that are more frequent within the population or other ratios suggested in the literature as ideal. Previous studies also failed to compare them with the esthetic preferences of the lay population with regards to the smile. The purpose of this study is to highlight the differences when perceiving the esthetics of smiles between general dentists and laypersons, and linking them with the width/length of the maxillary anterior teeth. Photographs of the full face of a female subject were modified with Photoshop CS regarding the length/width relationships of the 6 maxillary anterior teeth. The three modifications made were: (a) 80% length/width, (b) 85%, length/width, and (c) 85% length/width in central incisors, 80% length/width in lateral incisors and canines. Three sequences of photograph pairs were created with different ratios and presented in PowerPoint to a sample of 100 general dentists and 100 laypersons. The ratio considered as the most esthetic by the majority of the judges was 85% for central incisors and 80% for lateral incisors and canines, with a statistically significant difference (p < 0.01). There was no statistically significant difference in the esthetic preferences of the studied populations either due to gender or professional experience of the dentists (p > 0.01). According to the results obtained in this study, professionals and laypersons considered a width/length ratio of 85% for maxillary central incisors and 80% for lateral incisors and canines as the most esthetic for maxillary anterior teeth. These results do not support findings from other studies previously published with similar ratios in central incisors, lateral incisors, and canines. Today clinicians practice in a treatment environment where not only function and utility but also esthetics is demanded in almost every procedure. Restoring/maintaining function is considered essential in any restorative dentistry treatment, but the esthetic aspects of any treatment should never be forgotten. This study was motivated by the increasing importance of obtaining a better appreciation of the perception of smile beauty, and of the role of maxillary teeth width/length ratio on the perception of dental esthetics. © 2017 by the American College of Prosthodontists.

[Thumbsucking and malocclusion--presentation of a clinical case].

PubMed

Estripeaut, L E; Henriques, J F; de Almeida, R R

1989-01-01

The digital sucking habit have been significantly related with the malocclusions. These problems can be observed as in the deciduous and mixed as in the permanent dentition. Frequency, length, and intensity of the habit generate as a consequence: anterior open bite, retrusion of the mandible, protrusion of the maxilla, excessive overjet, labial version of the upper incisors, uprighting of the lower incisors, posterior cross bites, sometimes associated to a ogival palate, diastema between the upper incisors, and any others facial characteristics. According to various authors, when the habit persist for an extended period after the age of four years, is considered how malocclusion cause. In this case is requered the professional interference. The presentation of this study has the objective to show the clinic conduct for preventive orthodontics in face to cases who exhib harmful habits.

The CHARGE association: report of two cases.

PubMed

Venetikidou, A

1993-01-01

Although many reports of the CHARGE association appear in the literature, the dental findings were never discussed before. In this report of two cases, both patients present with delayed eruption of the permanent teeth and a remarkable similarity of the eruption pattern of the mandibular teeth. One lower permanent central incisor is congenitally missing, while the other is malformed. The lower permanent laterals of JM have erupted lingually and interfere with his speech and function of the tongue. Mandibular retrognathism is present. TM had a V-shaped constricted upper arch, which was expanded in a first phase of orthodontic intervention. Fixed appliances are the future considerations for the correction of the malocclusion.

Ligature wires and elastomeric rings: two methods of ligation, and their association with microbial colonization of Streptococcus mutans and lactobacilli.

PubMed

Forsberg, C M; Brattström, V; Malmberg, E; Nord, C E

1991-10-01

Twelve orthodontic patients undergoing treatment with fixed appliances took part in the present study. In all patients elastomeric rings were used for ligation on one side of the dental arch midline, whereas steel wires were used on the opposite side. The number of micro-organisms in samples of plaque, taken from the labial surface of the upper lateral incisors, was recorded on five occasions during treatment. In samples of saliva, the numbers of Streptococcus mutans and lactobacilli were recorded on the same occasions. This registration was also made on two occasions before insertion of the fixed appliance, and 6 weeks after the period of active treatment. The results showed that, in the majority of patients, the incisor which was attached to the arch-wire with an elastomeric ring, exhibited a greater number of micro-organisms in the plaque than the incisor ligated with steel wire. Following insertion of fixed appliances the number of S. mutans and lactobacilli in saliva increased significantly. Variations in the number of micro-organisms in the saliva during active treatment were not reflected in any relative increase or decrease in microbial colonization on either steel ligatures or elastomeric rings. The use of retainers after active treatment was not associated with increased numbers of micro-organisms in the saliva.

Management of geminated maxillary lateral incisor using cone beam computed tomography as a diagnostic tool.

PubMed

James, Elizabeth Prabha; Johns, Dexton Antony; Johnson, Ki; Maroli, Ramesh Kumar

2014-05-01

Geminated teeth are consequences of developmental anomalies leading to joined elements, due to incomplete attempt of one tooth germ to divide into two. This case report describes successful endodontic treatment of an unaesthetic geminated permanent maxillary lateral incisor tooth and its esthetic rehabilitation using all ceramic crowns. Newer imaging technique like cone beam computed tomography was taken for the better understanding of the complicated root canal morphology.

Root canal treatment of a periradicular lesion caused by unintentional root damage after orthodontic miniscrew placement: a case report.

PubMed

Er, K; Bayram, M; Taşdemir, T

2011-12-01

To present the successful endodontic management of a maxillary lateral incisor tooth with a periradicular lesion caused by unintentional root damage after orthodontic miniscrew placement. A 22-year-old female was diagnosed with a skeletal Class II, Division 2 malocclusion with Class II molar and canine relationships on both sides. The treatment plan included distalization of the maxillary first molars bilaterally followed by full fixed appliance therapy. For the maxillary molar distalization, an appliance in conjunction with a miniscrew anchorage system was designed. Two months later, the patient came to the clinic with complaints of pain in the maxillary right lateral incisor region. On intraoral examination, intraoral sinus tracts were detected in the maxillary right buccal sulcus and palate. A large radiolucent lesion with a well-defined margin around the root of the maxillary right lateral incisor was seen. Root canal treatment was performed on the maxillary right lateral incisor tooth. The root canal was filled with gutta-percha and AH Plus sealer, using a lateral compaction technique. The final restoration of the tooth was completed using composite, and the tooth was reviewed after 10 months. The tooth was asymptomatic and radiographically showed repair of the lesion. Healing was achieved without any need for further endodontic or surgical intervention. Key learning points • This case illustrates the need to take care with miniscrews when performing orthodontic treatment, especially when the miniscrews are in close proximity to root apices. • The periradicular lesion as a result of miniscrew damage was successfully treated with root canal treatment. © 2011 International Endodontic Journal.

Long-term maxillomandibular skeletal and dental changes in children with cleft lip and palate after maxillary distraction.

PubMed

Harada, Kiyoshi; Sato, Masaru; Omura, Ken

2006-09-01

Long-term skeletal and dental changes were examined in 8 children with cleft lip and palate who underwent maxillary distraction to allow the maxilla to catch up to their mandibular growth at the treatment point. Changes in the overjet (OJ), overbite (OB), and positions of the anterior nasal spine (ANS), upper incisors (U1), pogonion (Pog), and lower incisors (L1) were measured on preoperative to 36 months postoperative lateral-cephalograms. In most of the children, the long-term changes after the maxillary distraction resulted in an inferior growth of the maxilla and anteroinferior growth of the mandible. This seems to suggest that maxillary distraction performed during childhood needs considerable overcorrection. However, if the maxilla is distracted to an adult position during childhood, the masticatory functions of the children will markedly deteriorate until their jaws grow. Therefore, we believe that one goal of maxillary distraction during childhood can be to allow the maxilla to catch up to the mandibular growth of the children at the treatment point.

Comparison of ropivacaine and articaine with epinephrine for infiltration anaesthesia in dentistry - a randomized study.

PubMed

Krzemiński, T F; Gilowski, L; Wiench, R; Płocica, I; Kondzielnik, P; Sielańczyk, A

2011-08-01

To compare the efficacy, onset time and duration of maxillary infiltration anaesthesia with 0.5% plain ropivacaine or 4% articaine with epinephrine 1 : 100 000 and to determine their possible influence on cardiovascular parameters. Sixty volunteers received 1.8 mL of the anaesthetic for buccal infiltration anaesthesia of maxillary central and lateral incisors and canine teeth without caries, restorations or signs of pulpitis. The efficacy, onset time and duration of pulp anaesthesia were assessed with an electric pulp tester. The duration of numbness of the upper lip was also monitored. Blood pressure and heart rate were measured before and after administration of the solutions. The efficacy of anaesthesia of lateral and central incisors was 100% for both anaesthetics. There were insignificant differences in effectiveness of canine pulp anaesthesia. The mean onset time was significantly (P < 0.05) shorter for ropivacaine (2.22 min) when compared with articaine (4.08 min). The duration of action and soft tissue anaesthesia were also significantly (P < 0.05) longer for ropivacaine (79.2 and 264 min) when compared with articaine (63.7 and 195.2 min, respectively). Ropivacaine caused significant (P < 0.05) increases in blood pressure and heart rate. Ropivacaine (0.5%) achieved effective and long duration of uninflamed pulp and soft tissue anaesthesia. Ropivacaine could be useful for long-lasting operative procedures without the need for a vasoconstrictor. © 2011 International Endodontic Journal.

Oxygen saturation in the dental pulp of permanent teeth: a critical review.

PubMed

Bruno, Kely Firmino; Barletta, Fernando Branco; Felippe, Wilson Tadeu; Silva, Júlio Almeida; Gonçalves de Alencar, Ana Helena; Estrela, Carlos

2014-08-01

Pulse oximetry is a noninvasive method for assessing vascular health based on oxygen saturation level. The method has recently also been used to assess dental pulp vitality, but a median oxygen saturation level suggestive of normal pulp physiology has not been determined. The objective of this study was to make a critical analysis of the published research to establish the median oxygen saturation for the diagnosis of normal dental pulps in maxillary anterior permanent teeth using pulse oximetry. Studies reporting on the use of pulse oximeters to determine oxygen saturation in dental pulps were retrieved using the MEDLINE, Scientific Electronic Library Online, and Cochrane Central Register of Controlled Trials databases plus a manual search of relevant references cited by selected articles. Different combinations of the terms "oximetry," "oximeter," "pulp," "dental," and "dentistry" were used in the search. Statistical analysis was performed for each group of teeth (central incisors, lateral incisors, and canines) using R statistical software (US EPA ORD NHEERL, Corvallis, OR) and a random effects model (P < .0001) with an I(2) of 99%. Of the 295 articles found, only 6 met the inclusion criteria (472 teeth). Of these, the number of articles included in each analysis (according to tooth group) was as follows: all 6 studies (288 teeth) for central incisors at a median oxygen saturation of 87.73%, 3 studies (90 teeth) for lateral incisors at a median oxygen saturation of 87.24%, and 4 studies (94 teeth) for canines at a median oxygen saturation of 87.26%. The median oxygen saturation in normal dental pulps of permanent central incisors, lateral incisors, and canines was higher than 87%. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Wildlife of southern forests habitat & management (Chapter 15): Rabbits

Treesearch

James G. Dickson

2003-01-01

Rabbits, or lagomorphs, resemble rodents. But unlike rodents they have relatively large hind legs, large ears, a short fluffy tail, and 2 sets of upper incisors. Like rodents their incisors grow continually. They can either walk or hop, and are fleet and elusive when evading predators. They normally are silent but are capable of several different vocalizations. Rabbits...

A rare case of canine anomaly - a possible algorithm for treating it.

PubMed

Vaida, Ligia; Todor, Bianca Ioana; Corega, Claudia; Băciuţ, Mihaela; Băciuţ, Grigore

2014-01-01

Canine transmigration is a very rare dental anomaly in which an unerupted mandibular canine migrates, crossing the mandibular midline. This unusual condition is most often diagnosed by chance during a routine X-ray examination. The most common clinical signs announcing the presence of this anomaly are over-retention of the deciduous canine and the absence of permanent canine from the dental arch after its physiological period of eruption. In this paper, we present a clinical case, 10-year-old boy, who was diagnosed with mandibular right canine transmigration at three years after the start of orthodontic treatment, during which we were expecting the eruption of mandibular canines. The orthopantomograph revealed the mandibular right canine to be in a horizontal position under the apices of the incisors - type 2 transmigration pattern classified by Mupparapu (2002). Based on cone-beam computer tomography examination, we recommended a surgical exposure of the canine and orthodontic alignment. Due to the risk of root resorption of the mandibular right lateral incisor during orthodontic movement phase of canine transmigrated to the dental arch, we decided to align the mandibular right canine in a transposition, between the two mandibular right incisors. Then we resorted to adapting the mandibular right lateral incisor coronary morphology to simulate a canine and also to reshaping the canine coronary morphology to resemble a lateral incisor. This therapeutic approach allowed us to restore morphologically and functionally the mandibular dento-alveolar arch, preserving the entire dental system.

Root resorption during orthodontic treatment with self-ligating or conventional brackets: a systematic review and meta-analysis.

PubMed

Yi, Jianru; Li, Meile; Li, Yu; Li, Xiaobing; Zhao, Zhihe

2016-11-21

The aim of this study was to compare the external apical root resorption (EARR) in patients receiving fixed orthodontic treatment with self-ligating or conventional brackets. Studies comparing the EARR between orthodontic patients using self-ligating or conventional brackets were identified through electronic search in databases including CENTRAL, PubMed, EMBASE, China National Knowledge Infrastructure (CNKI) and SIGLE, and manual search in relevant journals and reference lists of the included studies until Apr 2016. The extraction of data and risk of bias evaluation were conducted by two investigators independently. The original outcome underwent statistical pooling by using Review Manager 5. Seven studies were included in the systematic review, out of which, five studies were statistically pooled in meta-analysis. The value of EARR of maxillary central incisors in the self-ligating bracket group was significantly lower than that in the conventional bracket group (SMD -0.31; 95% CI: -0.60--0.01). No significant differences in other incisors were observed between self-ligating and conventional brackets. Current evidences suggest self-ligating brackets do not outperform conventional brackets in reducing the EARR in maxillary lateral incisors, mandible central incisors and mandible lateral incisors. However, self-ligating brackets appear to have an advantage in protecting maxillary central incisor from EARR, which still needs to be confirmed by more high-quality studies.

Rapidly progressive internal root resorption: a case report.

PubMed

Keinan, David; Heling, Ilana; Stabholtz, Adam; Moshonov, Joshua

2008-10-01

The etiology of internal root resorption is not fully understandable, trauma and chronic pulpitis are considered the main risk factors. Usually the process is asymptomatic and diagnosed upon routine radiographic examination. This case report presents a rapid progression of internal resorption related directly to traumatic injury. A 16-year-old female arrived at the emergency room after a mild extrusion of the mandibular incisors. The initial treatment included repositioning and splinting of the teeth. Radiographs performed at repositioning and splinting demonstrated normal configuration of the incisor's roots. Ten months later progressive internal resorption of the left mandibular first incisor was diagnosed. While treating this tooth similar process was detected in the right mandibular second incisor and in the mandibular left second incisor. The lower right first incisor reacted inconsistently to vitality test. As a result of the severe and rapidly progressive nature of the process, root canal treatments were performed in all lower incisors. The follow-up radiographs demonstrate arrest of the internal resorption process.

[Combined surgical-orthodontic therapy for compound odontoma].

PubMed

Dukić, Walter; Kuna, Tihomir; Lapter-Varga, Marina; Jurić, Hrvoje; Lulić-Dukić, Olga

2007-09-01

Odontogenic tumor is a rare condition in dental medicine that mostly proceeds unrecognized until the occurrence of clinical symptoms such as delayed eruption, or is incidentally detected on routine x-ray examination. The exact cause is not known, however, previous dental trauma and infection have been postulated as the potential factors in the development of odontogenic tumor. The earliest possible operative extirpation of the tumorous growth is recommended to eliminate permanent tooth impaction and to enable normal growth of the teeth. In some cases, corticotomy, including complete removal of the bony coat of the tooth, may be needed to additionally facilitate and precipitate its eruption. Orthodontic therapy is also of great importance in correct alignment of the teeth 'n the dental arch as well as in the management of other anomalies that may be associated with odontogenic tumor. A patient with compound odontoma is presented, along with the course of combined surgical-orthodontic therapy. The patient reported previous intrusion trauma that had occurred at the age of 4 years, which may have been the potential factor in the development of odontoma. In this case, there was a massive odontogenic tumor which had compromised the growth of permanent teeth, and the growth impulse was almost at the end since the patient was 11 years old and the apexes of the upper incisors were partially closed. The first operation included complete removal of the tumorous mass that had interrupted spontaneous eruption of the upper permanent incisors. It did not result in immediate spontaneous tooth eruption, so an additional operation was needed. The objective of the second operative procedure was complete removal of the covering bone over the unerupted upper permanent incisors in order to eliminate the physical barrier to tooth growth and eruption. The objective of fixed orthodontic therapy was full eruption of the partially erupted upper incisors. After 16 months, the upper incisors were regularly located in the dental arch. In this case, orthodontic therapy had another objective, i.e. to ensure rotation of the first upper premolar, to provide space for the upper permanent canine eruption and to establish regular intercuspidation after upper second premolar hypodontia. In colclusion, combined operative and orthodontic therapy can be recommended irrespective of the stage of the impacted tooth development because any treatment to precipitate tooth eruption has favorable effects. Impacted teeth should always be provided all treatment options for faster eruption, as demonstrated in our case where a good clinical result was achieved within 2.5 years. The role of regular clinical and x-ray controls for assessment of the impacted tooth eruption should also be emphasized.

Soft tissue effects of three different Class II/1-camouflage treatment strategies.

PubMed

Atik, Ezgi; Akarsu-Guven, Bengisu; Kocadereli, Ilken

2017-03-01

Aim of this retrospective study was to compare soft tissue effects of Class II treatments with the forsus fatigue resistant device (FRD), the pendulum appliance, and the extraction of two maxillary premolars, all of which were combined with pre-adjusted fixed appliances. The sample of 54 patients with Class II malocclusions was divided in three groups: group I patients (mean age = 15.91 years) were treated with the FRD concurrently used with fixed appliances; group II patients (mean age = 16.08 years) were treated with the pendulum appliance combined with a Nance and headgear followed by fixed appliances; and group III patients (mean age = 19.04 years) were treated with the extraction of two maxillary premolars with miniscrew anchorage. Soft tissue and dentoskeletal parameters were measured on pretreatment (T1) and posttreatment (T2) lateral cephalograms. The changes from T1 to T2 were compared between the groups using Kruskal-Wallis test, and treatment differences were evaluated with the Wilcoxon test at p < 0.05. Soft tissue measurement changes related to the upper and lower lips were significantly greater in group II than in group III (p < 0.05). Upper incisor measurement changes were significantly different between groups II and III. Lower incisor measurement changes were significantly different between groups I and III and groups II and III (p < 0.05). Pendulum and extraction treatment groups showed significant differences in relation with the upper and lower lip positional changes, which were significantly greater in the pendulum group. Treatment time with the extraction treatment was statistically shorter than with the nonextraction protocols.

Clinical measurement of the height of the interproximal contact area in maxillary anterior teeth.

PubMed

Sghaireen, Mohd G; Al-Zarea, Bader K; Al-Shorman, Hisham M; Al-Omiri, Mahmoud K

2013-11-01

To clinically quantify the apicoincisal height of interproximal areas directly in patients' mouths. Thirty participants (11 females and 9 males, mean age=26±1.5 years) were recruited into this study. Measurement of interproximal contact areas was carried out directly in patients' mouths using digital caliper (TERENSA, USA) with measuring accuracy of 0.01 mm. The interproximal contact areas that were measured are: central incisor to central incisor, central incisor to lateral incisor, lateral incisor to canine, and canine to first premolar on both sides of the jaw. Statistical significance was based on probability values less than 0.05 (p<0.05). The largest contact point was the one present between central incisors and it ranged from 2.9 to 6.5 mm. On the other hand, the contact point between canine and first premolar was the smallest on both sides of the arch and ranged from 0.6 to 2.5 mm. The dimensions of the contact points declined as we move from anterior area backwards. Statistical analysis using t-test showed that there were significant differences between the measurements of interproximal points of each tooth (P<0.05). the apicogingival dimension of the contact point decreased as we moved from anterior to posterior teeth. The contact area between the central incisors was largest and the one between canine and premolar was the smallest. This study is the first to report direct intra-oral clinical measurement of contact points. Clinical evaluation of contact point dimensions using digital caliber is a viable, quick and accurate method to use.

Ultrasonic irrigation of a maxillary lateral incisor with perforation of the apical third of the root.

PubMed

Tsurumachi, Tamotsu; Takita, Toshiya; Hashimoto, Kazuhiro; Katoh, Takeshi; Ogiso, Bunnai

2010-12-01

We describe the successful use of a combination of nonsurgical root canal treatment and ultrasonic irrigation for collaborative management of a maxillary left lateral incisor with perforation of the apical third of the root. During the endodontic treatment procedure, the ultrasonically activated tip was used for intracanal irrigation. The area of perforation in the apical third of the root and the main root canal space were obturated with gutta-percha and root canal sealer, using a lateral condensation method. A follow-up clinical and radiographic examination at 5 years after treatment showed an asymptomatic tooth with excellent osseous healing.

Camouflage treatment for class III malocclusion combined with traction of an impacted maxillary central incisor.

PubMed

Closs, Luciane Quadrado; Mundstock, Karina Santos; Ribeiro, Darlene Santos; Reston, Eduardo Galia; Silva, Aurelício Novaes

2010-01-01

This case report describes the treatment of a patient with an unerupted maxillary left central incisor, class III malocclusion with crossbite of the maxillary posterior teeth and lateral open bite. Treatment consisted of rapid maxillary expansion followed by anterior space opening, maxillary protraction and traction of the unerupted teeth with a light force system. Favorable results were obtained in terms of correcting incisor position and class III malocclusion. The results achieved remained stable throughout a 4-year retention period.

Association between third molar agenesis patterns and agenesis of other teeth in a Japanese orthodontic population.

PubMed

Endo, Saori; Sanpei, Sugako; Ishida, Rieko; Sanpei, Shinya; Abe, Ryota; Endo, Toshiya

2015-01-01

The purpose of this study was to investigate the patterns of third molar agenesis and incidence of agenesis of other permanent teeth in a Japanese orthodontic patient group. A total of 417 Japanese subjects (134 males and 283 females) with agenesis of one or more third molars were divided into four groups according to the agenesis pattern, and 874 other Japanese subjects (302 males and 572 females) without third molar agenesis were assigned to a control group. Panoramic radiographs and medical and dental records were used to examine for tooth agenesis. The Chi-square test and odds ratio were used to make statistical comparisons. The prevalence of third molar agenesis worked out at 32.3% with no statistically significant gender difference. A high prevalence rate of agenesis of third molars, unilateral or bilateral, could be considered characteristic of the Japanese orthodontic population. Significant increases in occurrence of oligodontia, and unilateral or bilateral agenesis of other teeth, including maxillary lateral incisors and maxillary and mandibular second premolars, were observed in all or almost all of the third molar agenesis groups, compared with the controls. A significantly increased prevalence rate of mandibular lateral incisor agenesis was observed in almost all of the third molar agenesis groups. The Japanese patients with third molar agenesis had a significantly increased occurrence of oligodontia, and unilateral or bilateral agenesis of maxillary and mandibular lateral incisors and second premolars, except for bilateral agenesis of mandibular lateral incisors.

External root resorption after orthodontic treatment: a study of contributing factors

PubMed Central

Jung, Yun-Hoa

2011-01-01

Purpose The purpose of this study was to examine the patient- and treatment-related etiologic factors of external root resorption. Materials and Methods This study consisted of 163 patients who had completed orthodontic treatments and taken the pre- and post-treatment panoramic and lateral cephalometric radiographs. The length of tooth was measured from the tooth apex to the incisal edge or cusp tip on the panoramic radiograph. Overbite and overjet were measured from the pre- and post-treatment lateral cephalometric radiographs. The root resorption of each tooth and the factors of malocclusion were analyzed with an analysis of variance. A paired t test was performed to compare the mean amount of root resorption between male and female, between extraction and non-extraction cases, and between surgery and non-surgery groups. Correlation coefficients were measured to assess the relationship between the amount of root resorption and the age in which the orthodontic treatment started, the degree of changes in overbite and overjet, and the duration of treatment. Results Maxillary central incisor was the most resorbed tooth, followed by the maxillary lateral incisor, the mandibular central incisor, and the mandibular lateral incisor. The history of tooth extraction was significantly associated with the root resorption. The duration of orthodontic treatment was positively correlated with the amount of root resorption. Conclusion These findings show that orthodontic treatment should be carefully performed in patients who need the treatment for a long period and with a pre-treatment extraction of teeth. PMID:21977469

External root resorption after orthodontic treatment: a study of contributing factors.

PubMed

Jung, Yun-Hoa; Cho, Bong-Hae

2011-03-01

The purpose of this study was to examine the patient- and treatment-related etiologic factors of external root resorption. This study consisted of 163 patients who had completed orthodontic treatments and taken the pre- and post-treatment panoramic and lateral cephalometric radiographs. The length of tooth was measured from the tooth apex to the incisal edge or cusp tip on the panoramic radiograph. Overbite and overjet were measured from the pre- and post-treatment lateral cephalometric radiographs. The root resorption of each tooth and the factors of malocclusion were analyzed with an analysis of variance. A paired t test was performed to compare the mean amount of root resorption between male and female, between extraction and non-extraction cases, and between surgery and non-surgery groups. Correlation coefficients were measured to assess the relationship between the amount of root resorption and the age in which the orthodontic treatment started, the degree of changes in overbite and overjet, and the duration of treatment. Maxillary central incisor was the most resorbed tooth, followed by the maxillary lateral incisor, the mandibular central incisor, and the mandibular lateral incisor. The history of tooth extraction was significantly associated with the root resorption. The duration of orthodontic treatment was positively correlated with the amount of root resorption. These findings show that orthodontic treatment should be carefully performed in patients who need the treatment for a long period and with a pre-treatment extraction of teeth.

Influence of bimaxillary protrusion on the perception of smile esthetics.

PubMed

Almutairi, Terki K; Albarakati, Sahar F; Aldrees, Abdullah M

2015-01-01

To evaluate the impact of bimaxillary protrusion on smile esthetics as perceived by dental professionals and laypersons. One hundred and fifty evaluators, equally distributed into their respective panels (orthodontists, general dentists, and laypersons), participated in this cross-sectional study conducted in April to December 2012 in Riyadh, Saudi Arabia. The patient sample consisted of 14 female patients divided equally into 2 groups: bimaxillary protrusion patients, and patients who have had 4-premolar extraction treatment. Two standardized photographs (frontal and three-quarter close-up smile views), and a lateral cephalogram were taken for each patient. The evaluators were asked to rate the attractiveness of each photo according to a 100-mm visual analog scale. These esthetic ratings were correlated with the patients' cephalometric measurements. The bimaxillary protrusion group was rated significantly as less attractive than the treatment group by each evaluator panel. Panel comparison showed that laypeople were less receptive of bimaxillary protrusion than dental professionals. Frontal and three-quarter views of the same smiles were not similarly rated for esthetic perceptions. Correlational analysis revealed that the dentoalveolar measurement with the highest significant negative correlation to the smile esthetics was the upper incisors to palatal plane (U1-PP) angle. Patients with bimaxillary protrusion were found to be less attractive than patients who were treated for the condition. This was especially evident among the laypersons. An increase in the upper incisor inclination, as well as a decrease in the interincisal angle compounds the bimaxillary effect. 

Influence of bimaxillary protrusion on the perception of smile esthetics

PubMed Central

Almutairi, Terki K.; Albarakati, Sahar F.; Aldrees, Abdullah M.

2015-01-01

Objectives: To evaluate the impact of bimaxillary protrusion on smile esthetics as perceived by dental professionals and laypersons. Methods: One hundred and fifty evaluators, equally distributed into their respective panels (orthodontists, general dentists, and laypersons), participated in this cross-sectional study conducted in April to December 2012 in Riyadh, Saudi Arabia. The patient sample consisted of 14 female patients divided equally into 2 groups: bimaxillary protrusion patients, and patients who have had 4-premolar extraction treatment. Two standardized photographs (frontal and three-quarter close-up smile views), and a lateral cephalogram were taken for each patient. The evaluators were asked to rate the attractiveness of each photo according to a 100-mm visual analog scale. These esthetic ratings were correlated with the patients’ cephalometric measurements. Results: The bimaxillary protrusion group was rated significantly as less attractive than the treatment group by each evaluator panel. Panel comparison showed that laypeople were less receptive of bimaxillary protrusion than dental professionals. Frontal and three-quarter views of the same smiles were not similarly rated for esthetic perceptions. Correlational analysis revealed that the dentoalveolar measurement with the highest significant negative correlation to the smile esthetics was the upper incisors to palatal plane (U1-PP) angle. Conclusion: Patients with bimaxillary protrusion were found to be less attractive than patients who were treated for the condition. This was especially evident among the laypersons. An increase in the upper incisor inclination, as well as a decrease in the interincisal angle compounds the bimaxillary effect. PMID:25630010

Facial and occlusal esthetic improvements of an adult skeletal Class III malocclusion using surgical, orthodontic, and implant treatment

PubMed Central

de Almeida Cardoso, Mauricio; de Avila, Erica Dorigatti; Guedes, Fabio Pinto; Battilani Filho, Valter Antonio Ban; Capelozza Filho, Leopoldino; Correa, Marcio Aurelio; Nary Filho, Hugo

2016-01-01

The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects. PMID:26877982

A Retrospective Study of Association between Peg-shaped Maxillary Lateral Incisors and Dental Anomalies.

PubMed

Kim, Jae-Hwan; Choi, Nam-Ki; Kim, Seon-Mi

The purpose of this study was to investigate the prevalence of peg-shaped maxillary lateral incisors and the incidence of associated dental anomalies in children. We investigated the prevalence of peg-laterals and incidence of associated dental anomalies in 3,834 children aged 7-15 who visited the Department of Pediatric Dentistry from January 2010 to December 2015 and underwent panoramic radiographs. The prevalence of peg-laterals was 1.69% in boys, 1.75% in girls, and 1.72% overall. Among children with peg-laterals, the frequencies of associated dental anomalies were as follows: congenitally missing teeth, 31.8%; dens invaginatus, 19.7%; palatally displaced canines, 12.1%; supernumerary teeth, 7.6%; and transposition, 7.6%. As children with peg-laterals have a higher incidence of other dental anomalies, careful consideration is needed when planning diagnosis and treatment.

Orthodontic management of bilateral maxillary canine-first premolar transposition and bilateral agenesis of maxillary lateral incisors: a case report.

PubMed

Di Palma, Elena; Di Giuseppe, Biagio; Tepedino, Michele; Chimenti, Claudio

2015-01-01

Maxillary canine-first premolar transposition (Mx.C.P1) is an uncommon dental positional anomaly that may create many orthodontic problems from both esthetic and functional points of view. In this report we show the orthodontic management of a case of Mx.C.P1 associated with bilateral maxillary lateral incisor agenesis and unilateral mandibular second premolar agenesis The patient was treated with a multibracket appliance and the extraction of the lower premolar. treatment was completed without the need for any prosthetic replacement.

Comprehensive therapy of a fusion between a mandibular lateral incisor and supernumerary tooth: case report.

PubMed

Onçag, Ozant; Candan, Umit; Arikan, Fatih

2005-08-01

The term fusion is used to define a developmental anomaly characterised by the union of two adjacent teeth. In the case reported here, clinical and radiographic examinations suggested a unilateral fusion between the mandibular left permanent incisor and a super-numerary tooth. Radiographs showed that the fused teeth had two distinct pulp chambers and canals. A diagnosis of chronic periapical abscess of the supernumerary tooth was made. Before root canal therapy, a periodontal surgical procedure was performed to section the central incisor and its fused supernumerary. Also, odontoplasty was performed on the roots, to establish an anatomy consistent with a normal central incisor. Later, the chronic apical abscess on the supernumerary tooth was instrumented chemo-mechanically, root canal filling was performed and an anterior composite resin restoration was placed. The patient was evaluated for one year after root canal therapy. The tooth was asymptomatic, not exhibiting any pathological root resorption or alveolar resorption, and the anterior composite restoration was intact. Instead of extracting the supernumerary tooth, the application of endodontic, periodontal, and restorative procedures proved to be an alternative treatment.

Modeling and characterization of the CEJ for optimization of esthetic implant design.

PubMed

Gallucci, German O; Belser, Urs C; Bernard, Jean-Pierre; Magne, Pascal

2004-02-01

This study evaluated the dimensions and characteristics of the cementoenamel junction (CEJ) of maxillary anterior teeth; the natural CEJ was compared to current implant design and used for design optimization. Standardized digital images of 137 extracted human teeth (45 central incisors, 46 lateral incisors, and 46 canines) were used to measure cervical dimensions, CEJ curvature, and distance from zenith of CEJ to interdental contact on proximal views. The x- and y-coordinates of the CEJ contour were digitized before mathematic processing to allow the representation of a single average curve for buccal, palatal, mesial, and distal surfaces for each tooth type. These measurements were combined to existing data related to dentogingival and "implantomucosal" junction to extrapolate specific biologic landmarks around teeth and implants. Mean cervical dimensions, distance from zenith of CEJ to interdental contact, and CEJ curvature were compared. Cervical dimensions significantly differed, with a more symmetric cervical cross-section for central incisors, slightly more rectangular shape for lateral incisors, and distinctly rectangular shape for canines. CEJ curvature was statistically different between all tooth groups (centrals > laterals > canines); within groups, curvature value was always superior at the mesial aspect compared to distally (3.46 mm vs 3.13 mm for centrals, 2.97 mm vs 2.38 mm for laterals, and 2.55 mm vs 1.60 mm for canines). Tooth-implant biologic width discrepancies ranged from 4.10 to 5.96 mm and were different between all groups of teeth (centrals > laterals > canines); within groups, the discrepancy was always superior at the mesial aspect compared to distally. Current implant design featuring a flat, rotation-symmetric shoulder should be reconsidered in view of natural CEJ contour to improve biologic considerations and related esthetics.

Position and Eruption of Permanent Maxillary Canines in Cases of Maxillary Lateral Incisor Agenesis in Mixed Dentition.

PubMed

Lamas, Cátia; Lavall, Asela; Pinho, Teresa

2018-01-01

Assess whether the permanent maxillary canine (MC) has a natural tendency to erupt mesially in children with maxillary lateral incisors agenesis (MLIA), compared to children without agenesis. This retrospective, observational, cross-sectional study consisted of children between 5 and 12 years old divided into three groups: the first group with unilateral MLIA, in which an intraindividual analysis was performed, the second group presented bilateral MLIA, and the third group with patients without agenesis. These last two groups were matched for comparison interindividual, being pared by sex and maturation of the MC. The canine position in the horizontal sector showed a clear mesial positioning of the MC on the agenesis side in individuals with unilateral MLIA (group 1) when compared with the counter lateral side; and in individuals with bilateral MLIA (Group 2) compared with control Individuals without agenesis (group 3). Even with the maintenance of this deciduous tooth in the dental arch, the MC keeps its tendency to mesial eruption. There is a greater tendency for mesial angulation of the maxillary canine in patients with MLIA, regardless of the presence or absence of deciduous lateral incisor.

Where to position osteotomies in genioglossal advancement surgery based on locations of the mental foramen, canine, lateral incisor, central incisor, and genial tubercle.

PubMed

Park, Joshua S; Lee, Christopher; Rogers, Jason M; Sun, Ho-Hyun; Liu, Yuan F; Elo, Jeffrey A; Inman, Jared C

2017-09-01

The study aimed to provide precise measurements of anterior mandibular structural anatomy and to explore potential osteotomies for genioglossal advancement. Cone beam computed tomography was used to analyze 33 randomly selected patients undergoing surgery for obstructive sleep apnea (OSA) between 2014 and 2016 at an academic surgical hospital. The locations of relevant mandibular structures were measured and statistical modeling was performed. Mean horizontal distances from midline to the mental foramina and the roots of the canine, lateral incisor, and central incisor were 22.11 ± 1.92, 13.56 ± 3.01, 6.19 ± 1.58, and 2.04 ± 0.87 mm, respectively. Mean vertical distances from the inferior border of the mandible were 15.15 ± 1.77, 17.11 ± 3.28, 20.48 ± 3.10, and 21.81 ± 3.49 mm, respectively. The superior border of the genial tubercle was 15.63 ± 2.75 mm, and the inferior border was 6.87 ± 3.29, from the inferior border of the mandible. The angle of decline of the best-fit line through the important structures was about 18° from the occlusion plane at the midline. A straight line estimating the mental foramen, canine, lateral incisor, and central incisor tooth roots crosses at a mean of 22.3-22.6 mm above the inferior border of the mandible at the midline and has an angle of decline of about 18°. Potential osteotomies made parallel to and below this line result in tradeoffs between maximizing capture of the genioglossus muscle attachment and risk of dental/neurovascular injury.

Perception of smile esthetics by laypeople of different ages.

PubMed

Sriphadungporn, Chompunuch; Chamnannidiadha, Niramol

2017-12-01

Age is a factor affecting smile esthetics. Three variables of smile esthetics associated with the maxillary anterior teeth and age-related changes have recently received considerable attention: (i) the incisal edge position of the maxillary central incisors, (ii) the maxillary gingival display, and (iii) the presence of a black triangle between the maxillary central incisors. The aim of this study was to evaluate the influence of age on smile esthetic perception based on these three variables in a group of Thai laypeople. The smiles were constructed from a photograph of a female smile. Smile photographs were altered in various increments using three variables: the incisal edge position of the maxillary incisors, gingival display, and a black triangle between the maxillary central incisors. The photographs were shown to a group of 240 Thai laypeople. The subjects were divided into two groups: a younger group, 15-29 years old (n = 120) and an older group, 36-52 years old (n = 120). Each subject was asked to score the attractiveness of each smile separately using a visual analog scale. Smile attractiveness scores concerning the incisal edge positions of the maxillary central incisors were similar between the two groups. However, upper lip coverage was rated as unattractive by the younger group. A gingival display of 0 and 2 mm was rated as most attractive by the younger group. Upper lip coverage and gingival display of 0 and 2 mm were considered attractive by the older group. Excessive gingival display (6 mm) was scored as unattractive by both groups. A black triangle ranging from 1 to 2.5 mm between the maxillary central incisors was scored differently between the two groups. The older group was more tolerant of the black triangle size. Age impacts smile perception based on maxillary gingival display and the presence of a black triangle between the maxillary central incisors, but not of the incisal edge position of the maxillary central incisors. Due to the variation in esthetic perception of each individual, participation between orthodontists and patients for decision-making and treatment planning is a crucial process to provide successful results.

A Novel Procedure for the Immediate Reconstruction of Severely Resorbed Alveolar Sockets for Advanced Periodontal Disease.

PubMed

Aimetti, Mario; Manavella, Valeria; Cricenti, Luca; Romano, Federica

2017-01-01

Background. Several clinical techniques and a variety of biomaterials have been introduced over the years in an effort to overcome bone remodeling and resorption after tooth extraction. However, the predictability of these procedures in sockets with severely resorbed buccal/lingual plate due to periodontal disease is still unknown. Case Description. A patient with advanced periodontitis underwent extraction of upper right lateral and central incisors. The central incisor exhibited complete buccal bone plate loss and a 9 mm vertical bone deficiency on its palatal side. The alveolar sockets were filled with collagen sponge and covered with a nonresorbable high-density PTFE membrane. Primary closure was not attained and any rigid scaffold material was not used. Histologic analysis provided evidence of new bone formation. At 12 months a cone-beam computed tomographic scan revealed enough bone volume to insert two conventional dental implants in conjunction with minor horizontal bone augmentation procedures. Clinical Implications. This case report would seem to support the potential of the proposed reconstructive approach in changing the morphology of severely resorbed alveolar sockets, minimizing the need for advanced bone regeneration procedures during implant placement.

A Novel Procedure for the Immediate Reconstruction of Severely Resorbed Alveolar Sockets for Advanced Periodontal Disease

PubMed Central

2017-01-01

Background. Several clinical techniques and a variety of biomaterials have been introduced over the years in an effort to overcome bone remodeling and resorption after tooth extraction. However, the predictability of these procedures in sockets with severely resorbed buccal/lingual plate due to periodontal disease is still unknown. Case Description. A patient with advanced periodontitis underwent extraction of upper right lateral and central incisors. The central incisor exhibited complete buccal bone plate loss and a 9 mm vertical bone deficiency on its palatal side. The alveolar sockets were filled with collagen sponge and covered with a nonresorbable high-density PTFE membrane. Primary closure was not attained and any rigid scaffold material was not used. Histologic analysis provided evidence of new bone formation. At 12 months a cone-beam computed tomographic scan revealed enough bone volume to insert two conventional dental implants in conjunction with minor horizontal bone augmentation procedures. Clinical Implications. This case report would seem to support the potential of the proposed reconstructive approach in changing the morphology of severely resorbed alveolar sockets, minimizing the need for advanced bone regeneration procedures during implant placement. PMID:28250998

Delayed orthodontic extrusion of a traumatically intruded immature upper permanent incisor - a case report.

PubMed

Umesan, Uday Kumar; Chua, Kui Lay; Kok, Ei Chuen

2014-10-01

Dental injuries are probably the most common orofacial injuries sustained during sports and play. Intrusion or intrusive luxations occur when the teeth are driven into the alveolus by an axially directed impact. This article describes the clinical case of an 8-year-old patient who suffered complete intrusive luxation of an immature permanent central incisor following an accident. An attempt at spontaneous re-eruption failed to facilitate re-emergence of the tooth beyond 2 mm. The recommended wait-and-see strategy in anticipation of spontaneous re-eruption should cease to be an option when no further elongation can be observed. Orthodontic extrusion or surgical re-positioning is a valid treatment alternative when the former fails. In this case, although the recommended time period for effecting orthodontic extrusion had elapsed, this procedure was undertaken successfully presumably owing to the application of controlled, biologically optimal forces. A review of the extruded tooth a year later revealed no clinical or radiographic signs of loss of vitality. This was confirmed radiographically by the completion of root development, an intact lamina dura and no evident signs of resorption. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Long-term skeletal and dental changes in patients with cleft lip and palate after maxillary distraction: a report of three cases treated with a rigid external distraction device.

PubMed

Harada, Kiyoshi; Sato, Masaru; Omura, Ken

2005-04-01

We examined long-term skeletal and dental changes in three patients with cleft lip and palate who underwent maxillary distraction using a rigid external distraction device. Two were children, and one was an adult. Changes in the overjet (OJ), overbite (OB), and positions of the anterior nasal spine (ANS), upper incisors (U1), pogonion (Pog), and lower incisors (L1) were measured on preoperative to 36 months postoperative lateral-cephalograms. In the adult, the positions of all examination points were relatively stable from 6 to 36 months postoperatively, and the OJ and OB were maintained at over 2 mm at 36 months. In the children, the positions of ANS and U1 changed inferiorly, Pog and L1 changed anteroinferiorly, and OJ and OB tended to decrease from 6 to 36 months postoperatively. Long-term skeletal and dental stability following maxillary distraction was relatively well maintained in the adult patient. In the children, the maxillomandibular growth was observed after maxillary distraction, but the mandibular overgrowth might have been inhibited by the correction of class III dentoskeletal deformity resulting from the maxillary distraction.

Canine substitution for missing maxillary lateral incisors: the influence of canine morphology, size, and shade on perceptions of smile attractiveness.

PubMed

Brough, Elaine; Donaldson, Ana Nora; Naini, Farhad B

2010-12-01

This study was conducted to determine whether variations in the morphology, size, or shade of maxillary canines would influence perceptions of smile attractiveness in patients with canines substituted for missing maxillary lateral incisors. A smiling photograph of a hypodontia patient who had had orthodontic space closure with maxillary canines replacing the lateral incisors was digitally modified to create a bilaterally symmetrical image. Four groups of images were created, digitally altering canine gingival height, crown tip height, canine width, and canine shade. Three groups of judges (40 orthodontists, 40 dentists, and 40 laypeople) ranked the images for smile attractiveness, also scoring the most and the least attractive of each of the 4 groups, and the most and least attractive of all images. Canine gingival height was the most attractive 0.5 mm below the gingival margin of the maxillary central incisor and progressively less attractive with increasing gingival height. Increasing canine width, increased canine tip height, and pointed canines were perceived to be unattractive. Brighter than normal shades of canines were preferred to darker shades. Narrow canine crowns were most frequently ranked as the most attractive overall, 1.5 mm narrower was preferred by the orthodontists and dentists, and 3.0 mm narrower was preferred by the laypeople. All 3 groups ranked the darkest image, 20 times darker than the original, most frequently as the least attractive image overall. There was good general agreement between orthodontists, dentists, and laypeople for all 4 parameters of smile attractiveness, although laypeople demonstrated greater intragroup variations. The morphology, size, and shade of the maxillary canine in patients having orthodontic space closure and lateral incisor substitution can have a marked effect on perceived smile attractiveness. Copyright © 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

[Three-dimensional finite element analysis of the upper cervical-defected incisor with labial access or lingual access].

PubMed

Su, Fan; Zhao, Ying; Su, Qin

2013-08-01

To evaluate the stress distribution of the cervical-defected incisor with labial or lingual endodontic access with finite element analysis (FEA), and to explore the advantage of resistance in labial endodontic access. 3-D finite element models of upper cervical-defected incisor were established using cone-beam CT (CBCT), Mimics Catia, and Ansys software. The subjects were categorized according to the two endodontic accesses and three restorative ways, which were composite resin, glass fiber-reinforced composite resin and glass fiber-reinforced post-crown. All the models were loaded.The von Mises stress values and distribution were recorded and analyzed with Ansys 10.0 software. In this study, direct composite resin restoration showed no significant difference between the labial and lingual access. In glass fiber-reinforced composite resin, labial access could transfer the stress concentration area. It could reduce the incidence of fracture of the cervical lesion but increase the incidence of root fracture. Post-crown restoration could obviously reduce the incidence of fracture of the cervical lesion. When the cervical-defected incisor is restored with composite resin, labial and lingual accesses can be considered. Labial access with glass fiber-reinforced composite resin or post-crown restoration is a good choice.

Enhanced BMP signaling results in supernumerary tooth formation in USAG-1 deficient mouse

DOE Office of Scientific and Technical Information (OSTI.GOV)

Murashima-Suginami, Akiko; Takahashi, Katsu; Sakata, Tomoko

2008-05-16

Uterine sensitization associated gene-1 (USAG-1) is a BMP antagonist, and also modulates Wnt signaling. We previously reported that USAG-1 deficient mice have supernumerary teeth. The supernumerary maxillary incisor appears to form as a result of the successive development of the rudimentary upper incisor. USAG-1 abrogation rescued apoptotic elimination of odontogenic mesenchymal cells. We confirmed that BMPs were expressed in both the epithelium and mesenchyme of the rudimentary incisor at E14 and E15. BMP signaling in the rudimentary maxillary incisor, assessed by expressions of Msx1 and Dlx2 and the phosphorylation of Smad protein, was significantly enhanced. Wnt signaling as demonstrated bymore » the nuclear localization of {beta}-catenin was also up-regulated. Inhibition of BMP signaling rescues supernumerary tooth formation in E15 incisor explant culture. Based upon these results, we conclude that enhanced BMP signaling results in supernumerary teeth and BMP signaling was modulated by Wnt signaling in the USAG-1 deficient mouse model.« less

A novel biomechanical model assessing continuous orthodontic archwire activation

PubMed Central

Canales, Christopher; Larson, Matthew; Grauer, Dan; Sheats, Rose; Stevens, Clarke; Ko, Ching-Chang

2013-01-01

Objective The biomechanics of a continuous archwire inserted into multiple orthodontic brackets is poorly understood. The purpose of this research was to apply the birth-death technique to simulate insertion of an orthodontic wire and consequent transfer of forces to the dentition in an anatomically accurate model. Methods A digital model containing the maxillary dentition, periodontal ligament (PDL), and surrounding bone was constructed from human computerized tomography data. Virtual brackets were placed on four teeth (central and lateral incisors, canine and first premolar), and a steel archwire (0.019″ × 0.025″) with a 0.5 mm step bend to intrude the lateral incisor was virtually inserted into the bracket slots. Forces applied to the dentition and surrounding structures were simulated utilizing the birth-death technique. Results The goal of simulating a complete bracket-wire system on accurate anatomy including multiple teeth was achieved. Orthodontic force delivered by the wire-bracket interaction was: central incisor 19.1 N, lateral incisor 21.9 N, and canine 19.9 N. Loading the model with equivalent point forces showed a different stress distribution in the PDL. Conclusions The birth-death technique proved to be a useful biomechanical simulation method for placement of a continuous archwire in orthodontic brackets. The ability to view the stress distribution throughout proper anatomy and appliances advances understanding of orthodontic biomechanics. PMID:23374936

Correlation Between Dental and Cervical Vertebral Maturation in Iranian Females

PubMed Central

Valizadeh, Solmaz; Eil, Nakissa; Ehsani, Sara; Bakhshandeh, Hooman

2012-01-01

Background Considerable variations in the development stage among patients of the same chronological age have led to introduce the concept of the developmental age based on the maturation of different organs such as cervical vertebrae or teeth. Objectives The purpose of this study was to investigate the correlation between the stages of tooth calcification and the cervical vertebral maturation in Iranian females. Patients and Methods Four hundred females (age range, 8 to 14 years) participated in the study. To determine the dental maturational stage, calcification of the mandibular teeth except for third molars were rated according to the method suggested by Demirjian et al. To evaluate the stage of skeletal maturation, cervical vertebral morphologic changes were assessed on lateral cephalometric radiographs according to the method explained by Baccetti et al. Correlations between bone maturation and teeth calcification were showed by Spearman's correlation and Kendall’s tau-b coefficients. The relevant associations were investigated by ordinal logistic regression models. Results Correlations between the two stages were observed in the first and second premolars, canine and central incisors. All these correlations were significant. The association between cervical vertebral maturation and tooth calcification was greatest in the lateral incisor (odds ratio (OR) = 11, 95% confidence interval (CI): 6.6-18.3). However, considering the 95% CI for OR, no significant difference was detected among the second molar, first molar and lateral incisor. Conclusion The relationship between calcification of teeth and maturation of cervical bones was significant. Bone maturation can be predicted by using teeth calcification stages, especially in the second molar, first molar and lateral incisor. PMID:23599706

Correlation between dental and cervical vertebral maturation in Iranian females.

PubMed

Valizadeh, Solmaz; Eil, Nakissa; Ehsani, Sara; Bakhshandeh, Hooman

2012-12-01

Considerable variations in the development stage among patients of the same chronological age have led to introduce the concept of the developmental age based on the maturation of different organs such as cervical vertebrae or teeth. The purpose of this study was to investigate the correlation between the stages of tooth calcification and the cervical vertebral maturation in Iranian females. Four hundred females (age range, 8 to 14 years) participated in the study. To determine the dental maturational stage, calcification of the mandibular teeth except for third molars were rated according to the method suggested by Demirjian et al. To evaluate the stage of skeletal maturation, cervical vertebral morphologic changes were assessed on lateral cephalometric radiographs according to the method explained by Baccetti et al. Correlations between bone maturation and teeth calcification were showed by Spearman's correlation and Kendall's tau-b coefficients. The relevant associations were investigated by ordinal logistic regression models. Correlations between the two stages were observed in the first and second premolars, canine and central incisors. All these correlations were significant. The association between cervical vertebral maturation and tooth calcification was greatest in the lateral incisor (odds ratio (OR) = 11, 95% confidence interval (CI): 6.6-18.3). However, considering the 95% CI for OR, no significant difference was detected among the second molar, first molar and lateral incisor. The relationship between calcification of teeth and maturation of cervical bones was significant. Bone maturation can be predicted by using teeth calcification stages, especially in the second molar, first molar and lateral incisor.

Prevalence of dental anomalies in patients with cleft lip and palate.

PubMed

Eslami, Neda; Majidi, Mohammad Reza; Aliakbarian, Majid; Hasanzadeh, Nadia

2013-09-01

The aim of the present study was to investigate the prevalence of dental anomalies in a group of patients with cleft lip and palate (CL/P) in the northeast of Iran. Ninety-one patients referring to the Cleft Lip and Palate Clinic of Mashhad Dental School were enrolled and classified into right CL/P, left CL/P, and bilateral CL/P groups. Photographs, dental casts, and panoramic and periapical radiographs were retrieved, and dental anomalies were recorded. χ test was used to analyze the frequency of dental anomalies according to type of cleft and sex. Missing maxillary lateral incisors was the most frequent dental anomaly, which was slightly higher in the bilateral group (61.1%). There were significantly more cases of missing lateral incisors outside the cleft area in right CL/P (P = 0.015). Peg lateral incisors were observed in 33.3% of bilateral CL/P compared with 28% of right and 23.3% of left unilateral cases. The sample presented rotations of central incisors in the cleft area in 33.3% of bilateral clefts. In unilateral clefts, it occurred more frequently in the right side (48%). Sexual dimorphism appeared only for maxillary central incisor rotation in the cleft area, which showed significantly greater frequency in females (P = 0.025). Transposition of maxillary canine and first premolars was found in 5.5% of bilateral, 8% of right, and 3.3% of left unilateral clefts. The prevalence of dental anomalies in the studied sample seems to be higher than that reported in the normal population. More anomalies were observed at the cleft side. The frequency of most anomalies was not significantly different between the 2 sexes.

Two-Step Extraction of the Lower First Molar for Class III Treatment in Adult Patient.

PubMed

Almeida, Kélei Cristina de Mathias; Paulin, Ricardo Fabris; Raveli, Taísa Barnabé; Raveli, Dirceu Barnabé; Santos-Pinto, Ary

2016-01-01

The aim of this article is to describe a case report of Class III malocclusion treatment with lower first molar extraction. The 27-year-old Caucasian male patient presented a symmetric face with a straight profile, hyperdivergent growth pattern, molar and cuspid Class III relation, and an anterior crossbite as well as a mild crowding on cuspids area, in both upper and lower arches and a tendency to posterior crossbite. The treatment was performed by the use of Haas expansion appliance followed by an initial alignment and leveling of the upper and lower arches with a fixed edgewise appliance, extraction of lower teeth aiming the correction of the incisors proclination and end the treatment with a Class I molar relationship. It resulted in a significant change in the patient's profile, dentoalveolar Class III correction, upper arch expansion, leveling and alignment of the upper and lower arches, and improvement of tipping of the upper and lowers incisors. In cases of a dentoalveolar compensation in well positioned bone bases the treatment with fixed appliances is an alternative and extraction of lower teeth is considered.

Assessment of gingival symmetry with digital measuring tools and its reproducibility.

PubMed

Wilson, David; Soileau, Kristi; Esquivel, Jonathan; Cordero, Adriana; Buchman, Wes; Maney, Pooja; Archontia Palaiologou, A

The aim of this study was to investigate the accuracy of digital measuring tools to measure the position of gingival zeniths and to assess its reproducibility between different examiners. A total of 108 subjects were photographed at the Louisiana State University School of Dentistry. The settings, positioning of the digital camera, and subjects' Frankfurt levels were standardized. A photograph was taken of the six anterior maxillary teeth of each subject, and their corresponding free gingival margins. Digital caliper measurements were taken intraorally from the zenith to the incisal edge of the right maxillary central incisor. A reference line was drawn across the screen on each image at the level of the zenith of tooth 8. Three calibrated examiners then measured the distance from the reference line to the zeniths of the other five anterior maxillary teeth. There was no statistically significant difference between the examiners regarding any of the measurements. Central incisors were at the same level in 84.24% of the subjects, and lateral incisors were within 0.5 mm of central incisors in only 58% of the subjects. Canine zeniths were within 0.5 mm of each other in 43% of the subjects. Only 28% of the subjects presented with zeniths of tooth 6 to tooth 11 within 0.5 mm of each other. Lateral incisors were at or beneath the line drawn from central incisors to cuspids in 90.8% of the subjects. Standardized digital photography taken with the aid of a stadiometer and used to evaluate esthetic parameters allowed for reproducible measurements.

Revascularization for a necrotic immature permanent lateral incisor: a case report and literature review.

PubMed

Kottoor, Jojo; Velmurugan, Natanasabapathy

2013-07-01

Revascularization is a valuable treatment in immature necrotic teeth that allows the continuation of root development. This article describes the successful revascularization treatment of an immature maxillary lateral incisor that was initially diagnosed with apical periodontitis. The tooth was asymptomatic and functional clinically and radiographically during the follow-up period of 5 years. The follow-up showed evidence of progressive thickening of the dentinal walls, development of root length and apical closure. The article also discusses the currently available literature regarding revascularization of immature permanent teeth. © 2012 John Wiley & Sons Ltd, BSPD and IAPD.

Conservative Management of Dens Evaginatus: Report of Two Unusual Cases

PubMed Central

Vijaykumar, S; Tenny, J; Ravi, GR

2010-01-01

ABSTRACT Dens evaginatus (DE) is a rare developmental anomaly characterized by presence of an extra cusp arising from occlusal or lingual surfaces. Isolated occurrence or concomitant presence of DE with other dental anomalies has been reported. DE commonly affects permanent teeth and is rarely seen in primary dentition. Treatment may be conservative or radical. This article presents two unusual cases of concomitant occurrence of a supernumerary tooth and DE affecting maxillary deciduous lateral incisor and conservative management of DE occurring concurrently with a possible Oehler’s type I invagination in maxillary permanent lateral incisor. PMID:27507925

[Stress change of periodontal ligament of the anterior teeth at the stage of space closure in lingual appliances: a 3-dimensional finite element analysis].

PubMed

Liu, D W; Li, J; Guo, L; Rong, Q G; Zhou, Y H

2018-02-18

To analyze the stress distribution in the periodontal ligament (PDL) under different loading conditions at the stage of space closure by 3D finite element model of customized lingual appliances. The 3D finite element model was used in ANSYS 11.0 to analyze the stress distribution in the PDL under the following loading conditions: (1) buccal sliding mechanics (0.75 N,1.00 N,1.50 N), (2) palatal sliding mechanics (0.75 N,1.00 N,1.50 N), (3) palatal-buccal combined sliding mechanics (buccal 1.00 N + palatal 0.50 N, buccal 0.75 N + palatal 0.75 N, buccal 0.50 N+ palatal 1.00 N). The maximum principal stress, minimum principal stress and von Mises stress were evaluated. (1) buccal sliding mechanics(0.75 N,1.00 N,1.50 N): maximum principal stress: at the initial of loading, maximum principal stress, which was the compressed stress, distributed in labial PDL of cervix of lateral incisor, and palatal distal PDL of cervix of canine. With increasing loa-ding, the magnitude and range of the stress was increased. Minimum principal stress: at the initial of loading, minimum principal stress which was tonsil stress, distributed in palatal PDL of cervix of lateral incisor and mesial PDL of cervix of canine. With increasing loading, the magnitude and range of minimum principal stress was increased. The area of minimum principal stress appeared in distal and mesial PDL of cervix of central incisor. von Mises stress:it distributed in labial and palatal PDL of cervix of lateral incisor and distal PDL of cervix of canine initially. With increasing loading, the magnitude and range of stress was increased towards the direction of root. Finally, there was stress concentration area at mesial PDL of cervix of canine. (2) palatal sliding mechanics(0.75 N,1.00 N,1.50 N): maximum principal stress: at the initial of loading, maximum principal stress which was the compressed stress, distributed in palatal and distal PDL of cervix of canine, and distal-buccal and palatal PDL of cervix of lateral incisor. With increasing loading, the magnitude and range of the stress was increased. Minimum principal stress: at the initial of loading, minimum principal stress which was tonsil stress, distributed in distal-interproximal PDL of cervix of lateral incisor and mesial-interproximal PDL of cervix of canine. With increasing loading, the magnitude and range of the stress was increased.von Mises stress: von Mises stress distributed in palatal and interproximal PDL of cervix of canine. With increasing loading, the magnitude and range of stress was increased. Finally, von Mises stress distributing area appeared at distal-palatal PDL of cervix of canine. (3) palatal-buccal combined sliding mechanics: maximum principal stress: maximum principal stress still distributed in distal-palatal PDL of cervix of canine. Minimum principal stress: minimum principal stress distributed in palatal PDL of cervix of lateral incisor when buccal force was more than palatal force. As palatal force increased, the stress concentrating area transferred to mesial PDL of cervix of canine.von Mises stress: it was lower and more well-distributed in palatal-buccal combined sliding mechanics than palatal or buccal sliding mechanics. Using buccal sliding mechanics,stress majorly distributed in PDL of lateral incisor and canine, and magnitude and range of stress increased with the increase of loading; Using palatal sliding mechanics, stress majorly distributed in PDL of canine, and magnitude and range of stress increased with the increase of loading; With palatal-buccal combined sliding mechanics, the maximum principal stress distributed in the distal PDL of canine. Minimum principal stress distributed in palatal PDL of cervix of lateral incisor when buccal force was more than palatal force. As palatal force was increasing, the minimum principal stress distributing area shifted to mesial PDL of cervix of canine. When using 1.00 N buccal force and 0.50 N palatal force, the von Mises stress distributed uniformly in PDL and minimal stress appeared.

A comparison of the treatment effects of the Forsus Fatigue Resistance Device and the Twin Block appliance in patients with class II malocclusions

PubMed Central

Hanoun, Abdulfatah; Al-Jewair, Thikriat S; Tabbaa, Sawsan; Allaymouni, Mhd Amer; Preston, Charles B

2014-01-01

Objectives We evaluated the skeletal and dentoalveolar effects of the Forsus Fatigue Resistance Device (FRD) and the Twin Block appliance (TB) in comparison with nontreated controls in the treatment of patients with class II division 1 malocclusion. Materials and methods This retrospective study included three groups: TB (n=37; mean age, 11.2 years), FRD (n=30; mean age, 12.9 years), and controls (n=25; mean age, 12.6 years). Lateral cephalograms were evaluated at T1 (pretreatment) and at T2 (postappliance removal/equivalent time frame in controls). Cephalometric changes were evaluated using the Clark analysis, including 27 measurements. Results Sagittal correction of class II malocclusion appeared to be mainly achieved by dentoalveolar changes in the FRD group. The TB was able to induce both skeletal and dentoalveolar changes. A favorable influence on facial convexity was achieved by both groups. Significant upper incisor retroclination occurred with the TB (−12.42°), whereas only −4° was observed in the FRD group. The lower incisors proclined more in the FRD group than the TB group. Incisor overjet reduction was 62% in the TB group versus 56% in the FRD group. Molar relation was corrected in both functional groups, resulting in a class I relation, although no change appeared in the control sample. Conclusion Both appliances were effective in correcting the class II malocclusion. Both the FRD and the TB induced significant maxillary and mandibular dentoalveolar changes; skeletal changes were induced by TB but not FRD therapy. PMID:25114591

A comparison of the treatment effects of the Forsus Fatigue Resistance Device and the Twin Block appliance in patients with class II malocclusions.

PubMed

Hanoun, Abdulfatah; Al-Jewair, Thikriat S; Tabbaa, Sawsan; Allaymouni, Mhd Amer; Preston, Charles B

2014-01-01

We evaluated the skeletal and dentoalveolar effects of the Forsus Fatigue Resistance Device (FRD) and the Twin Block appliance (TB) in comparison with nontreated controls in the treatment of patients with class II division 1 malocclusion. THIS RETROSPECTIVE STUDY INCLUDED THREE GROUPS: TB (n=37; mean age, 11.2 years), FRD (n=30; mean age, 12.9 years), and controls (n=25; mean age, 12.6 years). Lateral cephalograms were evaluated at T1 (pretreatment) and at T2 (postappliance removal/equivalent time frame in controls). Cephalometric changes were evaluated using the Clark analysis, including 27 measurements. Sagittal correction of class II malocclusion appeared to be mainly achieved by dentoalveolar changes in the FRD group. The TB was able to induce both skeletal and dentoalveolar changes. A favorable influence on facial convexity was achieved by both groups. Significant upper incisor retroclination occurred with the TB (-12.42°), whereas only -4° was observed in the FRD group. The lower incisors proclined more in the FRD group than the TB group. Incisor overjet reduction was 62% in the TB group versus 56% in the FRD group. Molar relation was corrected in both functional groups, resulting in a class I relation, although no change appeared in the control sample. Both appliances were effective in correcting the class II malocclusion. Both the FRD and the TB induced significant maxillary and mandibular dentoalveolar changes; skeletal changes were induced by TB but not FRD therapy.

Upper lip changes and gingival exposure on smiling: vertical dimension analysis.

PubMed

Miron, Hagai; Calderon, Shlomo; Allon, Dror

2012-01-01

Our objectives were to evaluate and quantify upper lip soft-tissue changes in the vertical dimensions both at rest and at maximum smile, and to examine the correlation between upper labial vestibular attachment height and maxillary gingival exposure on smiling. Seventy-two volunteers (36 men, 36 women) aged 20 to 40 (mean, 30.49 years) were recruited for this study. For each subject, 9 measurements of upper lip position and maxillary incisor crown height at rest and in maximum smile were recorded. A statistically significant sexual dimorphism was apparent in most of the measured variables. Relaxed external upper lip length was 3.1 mm shorter in the women than in the men. The mean maxillary central incisor display at rest was 1.78 mm greater in the women than in the men. A high smile line was 2.5 times more prevalent in the women. The upper lip was shortened by 30% in subjects with a high smile line compared with 23% in subjects with a low smile line. The following findings were observed in subjects with a high smile pattern: (1) short upper lip length, (2) low smiling/resting upper lip length ratio, (3) inferior attachment of the upper labial vestibule, and (4) prominent upper lip vermilion. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Comparative study of the craniofacial growth depending on the type of lactation received.

PubMed

Sánchez-Molins, M; Grau Carbó, J; Lischeid Gaig, C; Ustrell Torrent, J M

2010-06-01

Several organizations consider mother's milk the optimal nutrition source for newborns [AAP, 1998; Gartner et al., 1997; Mohrbacher and Stock, 2002; WHO, 1989]. However, there is little scientific evidence supporting the idea that breastfeeding has a positive influence on the development of the orofacial structures. The study of cases and controls (observational, analytical and retrospective) and lateral teleradiographs of the cranium of 197 patients (106 breast-fed and 91 bottle-fed) were compared. Ricketts, Steiner and McNamara values were used for the cephalometric analysis. Differences between the two groups were analysed by applying the T-test and ANOVA. Statistical significance levels were set at p<0.05. Non-nutritive infantile sucking habits have been compared; differences between the two groups were analysed by applying the Chi-square test. First, the upper incisors were found to be protruded in the bottle-fed group. Second, subjects belonging to the breast-fed group displayed a brachycephalic mandible arch, while those fed with bottle had a dolichocephalic Steiner mandibular plane. Third, both facial depth and distance of the pogonion to the perpendicular nasion presented a certain tendency to a retruded mandibular bone in the bottle-fed group. And fourth, the frequency of use of dummy and thumb suction were greater in the bottle feed group, without statistical significance. In addition to the multiple advantages that mother's milk offers to newborns, breastfeeding also helps correct orofacial development (not only for the incisors position, but also for the vertical and sagittal relations of the mandible with upper maxillary and cranial basis).

[Treatment of adult bimaxillary arch protrusion with micro-implant anchorage].

PubMed

Chen, Cheng; Zhang, Xiao-Rong

2015-02-01

In this study, micro-implants were used in 15 adult patients with mild and moderate bimaxillary arch protrusion or crowding. Cephalometric analysis was used to analyze hard and soft-tissues change before and after treatment, with the aim to investigate the effects of treatment on adult bimaxillary arch protrusion with micro-implant anchorage. Fifteen adult patients with mild and moderate bimaxillary arch protrusion were selected in this study. Micro-implants were inserted into the zygomaticoalveolar ridge of maxilla and the external oblique line of mandible. A NiTi coil spring was attached to the micro-implant to drag the whole upper and lower dentition for distal movement. Cephalometrics were taken before and after treatment, and the changes of soft and hard-tissue profile were studied. SPSS13.0 software package was used to analyze the data. (1)Sixty micro-implants remained stable.(2)SNA, SNB had no significant changes (P>0.05), and the relationship between the maxilla and the mandible did not change significantly. U1/NA, U1-NA, L1/NB, L1-NB and U1/L1 changes in hard tissue had significant difference in cephalometric measurement (P<0.05). The upper and lower anterior teeth were more retrusive, and the tipping of incisor decreased significantly.(3)Cephalometric analysis showed that lateral appearance improved and soft tissue cephalometric-related measurements such as Cm-Sn-UL,LL-B'-Pos increased significantly (P<0.01). (4)Molars and incisors acquired distal movement. Micro-implant can provide not only excellent skeletal anchorage but also a novel way to distalize the whole dentition efficiently.

Influence of transmucosal height in abutments of single and multiple implant-supported prostheses: a non-linear three-dimensional finite element analysis.

PubMed

Borie, Eduardo; Leal, Eduardo; Orsi, Iara Augusta; Salamanca, Carlos; Dias, Fernando José; Weber, Benjamin

2018-01-01

The aim of this study was to analyze the influence of three different transmucosal heights of the abutments in single and multiple implant-supported prostheses through the finite element method. External hexagon implants, MicroUnit, and EsthetiCone abutments were scanned and placed in an edentulous maxillary model obtained from a tomography database. The simulations were divided into two groups: (1) one implant with 3.75 × 10 mm placed in the upper central incisor, simulating a single implant-supported fixed prosthesis with an EsthetiCone abutment; and (2) two implants with 3.75 × 10 mm placed in the upper lateral incisors with MicroUnit abutments, simulating a multiple implant-supported prosthesis. Subsequently, each group was subdivided into three models according to the transmucosal height (1, 2, and 3 mm). A static oblique load at an angle of 45 degrees to the long axis of the implant in palatal-buccal direction of 150 and 75 N was applied for multiple and single implant-supported prosthesis, respectively. The implants and abutments were assessed according to the equivalent Von Mises stress analyses while the bone and ceramics were analyzed through maximum and minimum principal stresses. The total deformation values increased in all models, while the transmucosal height was augmented. The transmucosal height of the abutments influences the stress values at the bone, ceramics, implants, and abutments of both the single and multiple implant-supported prostheses, with the transmucosal height of 1 mm showing the lowest stress values.

Evaluation of the mineralization degree of the vestibular surface of the upper central incisors with a 655-nm diode laser in mouth breathers: preliminary results

NASA Astrophysics Data System (ADS)

Pinheiro Ladalardo, Thereza C. C. G.; Cappellette, Mario, Jr.; Zanin, Fatima A. A.; Brugnera, Aldo, Jr.; Anthero de Azevedo, Ramiro; Pignatari, Shirley; Weckx, Luc L. M.

2003-06-01

Mouth breathing unbalances the physiological mechanisms of the dental surface hydration by compromising lip closure, and, very often, causing the vestibular positioning of upper incisors. That variance leads to the interruption of the dental demineralization and remineralization feedback, prevailing a demineralized condition of the dental surface which increases caries risk. The laser fluorescence examination allows an early demineralization diagnosis, thus it makes possible through preventive measures to minimize the risk factor - dental mineral structure loss - in the bacterial infection of the demineralized area, and hence, preventing invasive therapeutical procedures. A DIAGNOdent apparatus was used to evaluate the mineralization degree of the upper central incisors in 40 patients - twenty of them with a mouth breathing diagnosis; the remaining twenty were nasal breathers (control group). Age ranging from 6 to 12 years, both male and female. To measure the vestibular surface of the incisors, it was divided into 3 segments: cervical, medial and incisal. The average of the results pertaining to the mouth breathing patients was as follows: tooth 11 cervical third - 5.45, medial third - 7.15, incisal third - 7.95, and tooth 21 - cervical third - 5.95, medial third - 7.25, incisal third - 8.15. The control patients, nasal breathers, presented the following results: tooth 11 cervical third - 1.75, medial third - 2.30, incisal third - 1.85, and tooth 21 - cervical third - 1.80, medial third - 2.20, incisal third - 2.15. The mouth breathing patients showed demineralization in the teeth examined at the initial stage, subclinical, comparing with the control patients, nasal breathers, who did not present any mineral deficit in these teeth.

Comparative study of dental anomalies assessed with panoramic radiographs of Down syndrome and non-Down syndrome patients.

PubMed

Mayoral-Trias, M A; Llopis-Perez, J; Puigdollers Pérez, A

2016-03-01

The aim of this study was to compare the prevalence of dental anomalies from panoramic radiographs of age-matched individuals with and without Down Syndrome (DS). This is a retrospective cross-sectional study. A group of 41 patients (19 female and 22 male) with Down Syndrome (DS), mean age 10.6 ± 1.4 and a control group of 42 non- DS patients (26 female and 16 male), mean age 11.1 ± 1.3 were studied. This study examined the medical history and a panoramic radiograph of each patient. The dental anomalies studied were agenesis of permanent teeth (except third molars), size and shape maxillary lateral anomalies and maxillary canine eruption path anomalies. The groups were compared using Mann-Whitney and Wilcoxon non-parametric tests (p<0.05). Rho Spearman correlation coefficient was applied for associations. Results Agenesis of one permanent tooth was found in 73.17% of DS subjects and two or more permanent teeth in more than 50% (p<0.001). Maxillary lateral incisor was the most frequently absent tooth followed by mandibular second premolar, mandibular lateral incisor, maxillary second premolar and mandibular central incisor. No significant differences were detected between maxilla and mandible on either side. No differences in gender were observed. Significant differences were found for size and shape anomalies of maxillary lateral incisors, as well as for canine eruption anomalies (p<0.05). No gender differences were observed for either variable. No association was found between these two variables in the DS group. More dental anomalies were present in the DS group than in the control group, which implied that DS patients need periodical dental and orthodontic supervision so as to prevent or control subsequent oral problems.

Prevalence of dental anomalies in children with cleft lip and unilateral and bilateral cleft lip and palate.

PubMed

Rullo, R; Festa, V M; Rullo, R; Addabbo, F; Chiodini, P; Vitale, M; Perillo, L

2015-09-01

To examine the prevalence of different types of dental anomalies in children with nonsyndromic cleft lip, unilateral cleft lip-palate, and bilateral cleft lip-palate. A sample of 90 patients (aged 4-20 years) affected by isolated cleft lip, unilateral and bilateral cleft lip and palate was examined. Cleft patients were classified into one of three groups according to cleft type: (1) Unilateral Cleft Lip-Palate, (2) Bilateral Cleft Lip-Palate, and (3) Cleft Lip. Intraoral exams, panoramic radiographs and dental casts, were used to analyse the prevalence of the various dental anomalies included in this study. There were no statistically significant differences between patients with cleft lip, unilateral cleft lip and palate and bilateral cleft lip and palate. The congenital absence of the cleft-side lateral incisor was observed in 40% of the sample, and a total of 30% patients showed supernumerary teeth at the incisors region. Second premolar agenesis was found in 4.4% of patients, whereas in 18.9% of the sample there was an ectopic dental eruption. Lateral or central incisors rotation was noted in 31.1% of the sample, while shape anomaly, lateral incisor microdontia, and enamel hypoplasia were detected respectively in 25.6%, 5.6% and 18.9% of cleft patients. High prevalence of different dental anomalies in children with cleft lip and unilateral and bilateral cleft lip and palate has been confirmed. This study, in particular, shows the presence of ectopic and rotated teeth in the cleft area.

Quantitative detection of Streptococcus mutans in the dental plaque of Japanese preschool children by real-time PCR.

PubMed

Hata, S; Hata, H; Miyasawa-Hori, H; Kudo, A; Mayanagi, H

2006-02-01

To detect quantitatively the total bacteria and Streptococcus mutans in dental plaque by real-time PCR with prbac, Sm and GTF-B primers, and to compare their presence with the prevalence of dental caries in Japanese preschool children. Human dental plaque samples were collected from the labial surfaces of the upper primary central incisors of 107 children. The dental status was recorded as dft by WHO caries diagnostic criteria. Positive dt and dft scores by the Sm or GTF-B primer were significantly higher than negative scores (P < 0.01). The proportions of Strep. mutans to the total bacteria from sound, and sound and/or filled upper primary incisors were significantly lower than those from decayed or filled, and decayed incisors, respectively (P < 0.01). The ratios of Strep. mutans to total bacteria in plaque detected by real-time PCR with Sm and GTF-B primers were closely associated with the prevalence of dental caries in Japanese preschool children. These assays may be useful for the assessment of an individual's risk of dental caries.

Comparison of incisor inclination in patients with Class III malocclusion treated with orthognathic surgery or orthodontic camouflage.

PubMed

Troy, Beth A; Shanker, Shiva; Fields, Henry W; Vig, Katherine; Johnston, William

2009-02-01

Reports comparing Class III patients treated by camouflage and those treated by orthognathic surgery are not numerous. The purpose of this study was to compare the dental and skeletal values of Class III patients treated with these methods against normative data and over the course of treatment. Thirty-three surgical and 39 camouflage Class III patients were selected from a graduate orthodontic clinic and regional private practices, and lateral cephalograms were digitized. Skeletal and dental values were obtained, and mean and efficacy evaluations referenced to ethnic norms were calculated. At pretreatment, the surgery patients had more severe skeletal discrepancies and more compensated incisors. During presurgical orthodontic treatment, most of the surgery group's mandibular incisors were significantly decompensated, although half of the maxillary incisors remained compensated. The surgical move improved 90% of these patients but to only 60% to 65% of the norm. The camouflage group was compensated at pretreatment, and they became more compensated in the end. After treatment, there were no differences between the incisor positions of the 2 groups. There was no statistical difference in incisor inclination and position between the Class III surgical and camouflage groups after treatment; there was a significant difference in the pretreatment and posttreatment incisor inclination and position compared with normative values for both the surgical and the camouflage groups; the maxillary and mandibular incisors were not adequately decompensated in the surgical group, but significant improvement in mandibular incisor position and axial inclination was achieved presurgically. The outcome of the surgical correction was limited by the inadequate presurgical orthodontic incisor decompensation, and orthodontic compensation of incisors occurred postsurgically to achieve an optimal occlusal result.

Severe root resorption resulting from orthodontic treatment: Prevalence and risk factors

PubMed Central

Maués, Caroline Pelagio Raick; do Nascimento, Rizomar Ramos; Vilella, Oswaldo de Vasconcellos

2015-01-01

OBJECTIVE: To assess the prevalence of severe external root resorption and its potential risk factors resulting from orthodontic treatment. METHODS: A randomly selected sample was used. It comprised conventional periapical radiographs taken in the same radiology center for maxillary and mandibular incisors before and after active orthodontic treatment of 129 patients, males and females, treated by means of the Standard Edgewise technique. Two examiners measured and defined root resorption according to the index proposed by Levander et al. The degree of external apical root resorption was registered defining resorption in four degrees of severity. To assess intra and inter-rater reproducibility, kappa coefficient was used. Chi-square test was used to assess the relationship between the amount of root resorption and patient's sex, dental arch (maxillary or mandibular), treatment with or without extractions, treatment duration, root apex stage (open or closed), root shape, as well as overjet and overbite at treatment onset. RESULTS: Maxillary central incisors had the highest percentage of severe root resorption, followed by maxillary lateral incisors and mandibular lateral incisors. Out of 959 teeth, 28 (2.9%) presented severe root resorption. The following risk factors were observed: anterior maxillary teeth, overjet greater than or equal to 5 mm at treatment onset, treatment with extractions, prolonged therapy, and degree of apex formation at treatment onset. CONCLUSION: This study showed that care must be taken in orthodontic treatment involving extractions, great retraction of maxillary incisors, prolonged therapy, and/or completely formed apex at orthodontic treatment onset. PMID:25741825

Severe root resorption resulting from orthodontic treatment: prevalence and risk factors.

PubMed

Maués, Caroline Pelagio Raick; do Nascimento, Rizomar Ramos; Vilella, Oswaldo de Vasconcellos

2015-01-01

To assess the prevalence of severe external root resorption and its potential risk factors resulting from orthodontic treatment. A randomly selected sample was used. It comprised conventional periapical radiographs taken in the same radiology center for maxillary and mandibular incisors before and after active orthodontic treatment of 129 patients, males and females, treated by means of the Standard Edgewise technique. Two examiners measured and defined root resorption according to the index proposed by Levander et al. The degree of external apical root resorption was registered defining resorption in four degrees of severity. To assess intra and inter-rater reproducibility, kappa coefficient was used. Chi-square test was used to assess the relationship between the amount of root resorption and patient's sex, dental arch (maxillary or mandibular), treatment with or without extractions, treatment duration, root apex stage (open or closed), root shape, as well as overjet and overbite at treatment onset. Maxillary central incisors had the highest percentage of severe root resorption, followed by maxillary lateral incisors and mandibular lateral incisors. Out of 959 teeth, 28 (2.9%) presented severe root resorption. The following risk factors were observed: anterior maxillary teeth, overjet greater than or equal to 5 mm at treatment onset, treatment with extractions, prolonged therapy, and degree of apex formation at treatment onset. This study showed that care must be taken in orthodontic treatment involving extractions, great retraction of maxillary incisors, prolonged therapy, and/or completely formed apex at orthodontic treatment onset.

Surgical management of lateral incisor with type II dens invaginatus and a periapical pathosis: A case report with 1-year follow-up.

PubMed

Lakshmi, V Naga; Varma, K Madhu; Sajjan, Girija S; Rambabu, Tanikonda

2017-01-01

Dens invaginatus is a relatively common dental malformation resulting from an infolding of enamel organ into the dental papilla varying in depth into the tooth tissues. Complex morphological anatomy associated with the pulpal pathology presents inaccessibility to completely remove the necrotic pulp tissues and hence poses challenges in rendering endodontic treatment. A combination of nonsurgical and surgical management in treating such cases is advisable depending on the presented variations. The present case reports the surgical endodontic treatment of an immature maxillary lateral incisor with type II dens invaginatus and periapical pathology.

Surgical management of lateral incisor with type II dens invaginatus and a periapical pathosis: A case report with 1-year follow-up

PubMed Central

Lakshmi, V. Naga; Varma, K. Madhu; Sajjan, Girija S.; Rambabu, Tanikonda

2017-01-01

Dens invaginatus is a relatively common dental malformation resulting from an infolding of enamel organ into the dental papilla varying in depth into the tooth tissues. Complex morphological anatomy associated with the pulpal pathology presents inaccessibility to completely remove the necrotic pulp tissues and hence poses challenges in rendering endodontic treatment. A combination of nonsurgical and surgical management in treating such cases is advisable depending on the presented variations. The present case reports the surgical endodontic treatment of an immature maxillary lateral incisor with type II dens invaginatus and periapical pathology. PMID:28761255

Congenitally Missing Maxillary Lateral Incisors: Functional and Periodontal Aspects in Patients Treated with Implants or Space Closure and Tooth Re-Contouring

PubMed Central

Marchi, Luciana Manzotti De; Pini, Núbia Inocencya Pavesi; Hayacibara, Roberto Massayuki; Silva, Rafael Santos; Pascotto, Renata Corrêa

2012-01-01

To evaluate functional and periodontal aspects in patients with unilateral or bilateral congenitally missing maxillary lateral incisors, treated with either implants or space closure and tooth re-contouring. The sample consisted of 68 volunteers, divided into 3 groups: SCR - space closure and tooth re-contouring with composite resin (n = 26); SOI – implants placed in the area of agenesis (n = 20); and CG - control group (n = 22). A modified Helkimo questionnaire and the Research Diagnostic Criteria for Temporomandibular Disorders were used by a single, previously calibrated evaluator to assess signs and symptoms of temporomandibular joint disorder. The periodontal assessment involved the following aspects: plaque index, bleeding upon probing, pocket depth greater than 3 mm, gingival recession, abfraction, periodontal biotype and papilla index. The data were analyzed using Fisher's exact test and the nonparametric Mann-Whitney and Kruskal-Wallis tests (α=.05). No differences in periodontal status were found between treatments. None of the groups were associated with signs and symptoms of temporomandibular joint disorder. Both treatment alternatives for patients with congenitally missing maxillary lateral incisors were satisfactory and achieved functional and periodontal results similar to those of the control group. PMID:23346262

Alternative method for predicting optimal insertion depth of the laryngeal tube in children.

PubMed

Kim, J T; Jeon, S Y; Kim, C S; Kim, S D; Kim, H S

2007-11-01

Little information is available about the accuracy of the teeth mark on the laryngeal tube (LT) as a guide to correct placement in children. The aim of this crossover study was to evaluate three methods for optimal insertion depth of the size (#) 2 tube in children weighing 12-25 kg. In 24 children, the LT #2 was consecutively inserted by three different methods: (A) until the thick teeth mark on the tube was aligned with the upper incisors, (B) until resistance was felt, and (C) by inserting to a depth, previously measured, of the curved distance between the cricoid cartilage and the upper incisor. In each case, the depth of insertion, the degree of effective ventilation, the presence of leakage, and the fibreoptic view were assessed. Insertion based on the teeth mark led to a shorter insertion depth and a greater incidence of inadequate ventilation compared with the other two methods. There was no difference in the adequacy of ventilation between methods B and C. The vocal cords were more easily identified with methods B (62.5%) and C (75%) than with method A (12.5%). Insertion of the LT #2 aligned with the teeth mark can result in a shallow insertion depth and inadequate ventilation. The measured distance from the cricoid cartilage to the upper incisor offers alternative guidance for correct LT insertion.

Characteristics of Teeth: A Review of Size, Shape, Composition, and Appearance of Maxillary Anterior Teeth.

PubMed

McGowan, Steve

2016-03-01

Although digital technologies play an increasingly integral role in dentistry, there remains a need for dental professionals to understand the fundamentals of tooth anatomy, form, occlusion, and color science. In this article, the size, shape, composition, and appearance of maxillary anterior teeth will be discussed from esthetic and functional perspectives. A total of 600 extracted maxillary incisors were studied: 200 each of central incisors, lateral incisors, and cuspids. The purpose of the article is to exhibit and discuss factors that make teeth unique and diverse. Understanding these aspects of teeth aids dental professionals in more effectively creating realistic and highly esthetic restorations for patients.

Transdisciplinary treatment of Class III malocclusion using conventional implant-supported anchorage: 10-year posttreatment follow-up

PubMed Central

Rinaldi, Mariana Roennau Lemos; Rizzatto, Susana Maria Deon; de Menezes, Luciane Macedo; Polido, Waldemar Daudt; de Lima, Eduardo Martinelli Santayanna

2015-01-01

INTRODUCTION: Combined treatment offers advantages for partially edentulous patients. Conventional implants, used as orthodontic anchorage, enable previous orthodontic movement, which provides appropriate space gain for crown insertion. OBJECTIVE: This case report describes the treatment of a 61-year and 10-month-old patient with negative overjet which made ideal prosthetic rehabilitation impossible, thereby hindering dental and facial esthetics. CASE REPORT: After a diagnostic setup, conventional implants were placed in the upper arch to anchor intrusion and retract anterior teeth. Space gain for lateral incisors was achieved in the lower arch by means of an orthodontic appliance. CONCLUSIONS: Integrated planning combining Orthodontics and Implantology provided successful treatment by means of conventional implant-supported anchorage. The resulting occlusal relationship proved stable after 10 years. PMID:26154459

Three-dimensional anatomy of equine incisors: tooth length, enamel cover and age related changes

PubMed Central

2013-01-01

Background Equine incisors are subjected to continuous occlusal wear causing multiple, age related changes of the extragingival crown. It is assumed that the occlusal wear is compensated by continued tooth elongation at the apical ends of the teeth. In this study, μCT-datasets offered the opportunity to analyze the three-dimensional appearance of the extra- and intraalveolar parts of the enamel containing dental crown as well as of the enamel-free dental root. Multiple morphometric measurements elucidated age related, morphological changes within the intraalveolar part of the incisors. Results Equine incisors possess a unique enamel cover displaying large indentations on the mesial and distal sides. After eruption tooth elongation at the apical end outbalances occlusal wear for two to four years resulting in increasing incisor length in this period of time. Remarkably, this maximum length is maintained for about ten years, up to a tooth age of 13 to 15 years post eruption. Variances in the total length of individual teeth are related to different Triadan positions (central-, middle- and corner incisors) as well as to the upper and lower arcades. Conclusion Equine incisors are able to fully compensate occlusal wear for a limited period of time. However, after this ability ceases, it is expected that a diminished intraalveolar tooth length will cause massive changes in periodontal biomechanics. The time point of these morphodynamic and biomechanical changes (13 to 15 years post eruption) occurs in coincidence with the onset of a recently described destructive disease of equine incisor (equine odontoclastic tooth resorption and hypercementosis) in aged horses. However, further biomechanical, cell biological and microbiological investigations are needed to elucidate a correlation between age related changes of incisor morphology and this disease. PMID:24321365

Three-dimensional anatomy of equine incisors: tooth length, enamel cover and age related changes.

PubMed

Schrock, Patricia; Lüpke, Matthias; Seifert, Hermann; Staszyk, Carsten

2013-12-09

Equine incisors are subjected to continuous occlusal wear causing multiple, age related changes of the extragingival crown. It is assumed that the occlusal wear is compensated by continued tooth elongation at the apical ends of the teeth. In this study, μCT-datasets offered the opportunity to analyze the three-dimensional appearance of the extra- and intraalveolar parts of the enamel containing dental crown as well as of the enamel-free dental root. Multiple morphometric measurements elucidated age related, morphological changes within the intraalveolar part of the incisors. Equine incisors possess a unique enamel cover displaying large indentations on the mesial and distal sides. After eruption tooth elongation at the apical end outbalances occlusal wear for two to four years resulting in increasing incisor length in this period of time. Remarkably, this maximum length is maintained for about ten years, up to a tooth age of 13 to 15 years post eruption. Variances in the total length of individual teeth are related to different Triadan positions (central-, middle- and corner incisors) as well as to the upper and lower arcades. Equine incisors are able to fully compensate occlusal wear for a limited period of time. However, after this ability ceases, it is expected that a diminished intraalveolar tooth length will cause massive changes in periodontal biomechanics. The time point of these morphodynamic and biomechanical changes (13 to 15 years post eruption) occurs in coincidence with the onset of a recently described destructive disease of equine incisor (equine odontoclastic tooth resorption and hypercementosis) in aged horses. However, further biomechanical, cell biological and microbiological investigations are needed to elucidate a correlation between age related changes of incisor morphology and this disease.

Orthodontic management of a dilacerated central incisor and partially impacted canine with unilateral extraction - A case report.

PubMed

Felicita, A Sumathi

2017-10-01

To align a dilacerated maxillary central incisor and partially impacted canine with unilateral extraction in a young patient with skeletal deep bite. A 14 year old male patient reported to the hospital with skeletal deep bite (basal plane angle-17°), severe horizontal pattern of growth (Go-Gn to Sn -22°), upright maxillary incisors (U1 to NA -26°) and retroclined lower incisors (L1 to NB -11°). The maxillary left central incisor was dilacerated, and the maxillary left canine was partially impacted. Unilateral extraction of the left maxillary premolar and left mandibular central incisor was done. A canine disimpaction spring was used to align the impacted canine. An anterior bite plane was given to open the bite. Superimposition of lateral cephalogram (T1, T2) revealed bite opening, normal overjet and overbite. There was backward rotation of the mandible and increase in lower anterior facial height. There was no evidence of root resorption or loss of vitality in the dilacerated tooth. Clinically the canine was well aligned in the arch. Orthodontic management of a dilacerated incisor can be done without root resorption or loss of vitality. The partially impacted canine was well aligned in the arch. Unilateral extraction can produce good treatment results.

Dual odontogenic origins develop at the early stage of rat maxillary incisor development.

PubMed

Kriangkrai, Rungarun; Iseki, Sachiko; Eto, Kazuhiro; Chareonvit, Suconta

2006-03-01

Developmental process of rat maxillary incisor has been studied through histological analysis and investigation of tooth-related gene expression patterns at initial tooth development. The tooth-related genes studied here are fibroblast growth factor-8 (Fgf-8), pituitary homeobox gene-2 (Pitx-2), sonic hedgehog (Shh), muscle segment homeobox-1 (Msx-1), paired box-9 (Pax-9) and bone morphogenetic protein-4 (Bmp-4). The genes are expressed in oral epithelium and/or ectomesenchyme at the stage of epithelial thickening to the early bud stage of tooth development. Both the histological observation and tooth-related gene expression patterns during early stage of maxillary incisor development demonstrate that dual odontogenic origins aligned medio-laterally in the medial nasal process develop, subsequently only single functional maxillary incisor dental placode forms. The cascade of tooth-related gene expression patterns in rat maxillary incisor studied here is quite similar to those of the previous studies in mouse mandibular molar, even though the origins of oral epithelium and ectomesenchyme involved in development of maxillary incisor and mandibular molar are different. Thus, we conclude that maxillary incisor and mandibular molar share a similar signaling control of Fgf-8, Pitx-2, Shh, Msx-1, Pax-9 and Bmp-4 genes at the stage of oral epithelial thickening to the early bud stage of tooth development.

[Alveolar bone thickness and root length changes in the treatment of skeletal Class III patients facilitated by improved corticotomy: a cone-beam CT analysis].

PubMed

Wu, Jiaqi; Jiang, Jiuhui; Xu, Li; Liang, Cheng; Li, Cuiying; Xu, Xiao

2015-04-01

To evaluate the alveolar bone thickness and root length changes of anterior teeth with cone-beam computed tomography (CBCT). CBCT scans were taken for 12 skeletal Class III patients who accepted the improved corticotomy (IC) procedures during pre-surgical orthodontics. The CBCT data in T1 (the maxillary dental arch was aligned and leveled) and T2 (extraction space closure) were superimposed and the alveolar bone thickness at root apex level and root length measurements were done. From T1 to T2, the buccal alveolar bone thickness for the upper lateral incisors increased from (1.89±0.83) to (2.47±1.02) mm (P<0.05), and for central incisors and for canines from (2.32±0.71) to (2.68±1.48) mm and from (2.28±1.08) to (2.41±1.40) mm, respectively. According to Sharpe Grading System, the root resorption grade for 69 teeth of 72 was located in Grade 1, two teeth in Grade 2, one tooth in Grade 3. The improved corticotomy had the potential to increase the buccal alveolar bone thickness and the root resorption in most teeth was in Grade 1 according to Sharpe grading system.

Effects of fixed functional therapy on tongue and hyoid positions and posterior airway.

PubMed

Ozdemir, Fulya; Ulkur, Feyza; Nalbantgil, Didem

2014-03-01

To evaluate how therapy with a fixed functional appliance affects airway dimensions, dentoalveolar changes, and tongue and hyoid positions. A retrospective study was carried out on 46 pre- and posttreatment lateral cephalometric radiographs of 23 post-peak Class II patients (12 girls, 11 boys) treated with a Forsus Fatigue Resistant Device (FRD) appliance. The radiographies were taken at the start and at the end of Forsus FRD appliance therapy when a Class I or overcorrected Class I canine and molar relationship was achieved. The process took an average of 5 months 13 days ± 1 month 4 days. Skeletal and dental parameters were measured using Dolphin software, and the sagittal airway area was measured by AutoCAD software. Analyses of the pre- and posttreatment means revealed that there was no statistically significant skeletal correction of the sagittal malocclusion; increase of lower incisor inclination, decrease of upper incisor inclination, decrease of interincisal angle, and rotation of occlusal plane all contributed to the reduction of overjet. The tongue area and intermaxillary space area increased in response to these dentoalveolar changes; however, there was no statistically significant change in the hyoid position or the oropharyngeal area between the two time points. The dentoalveolar changes produced by Forsus FRD appliance did not cause any significant posterior airway changes in young adult patients.

Conservative treatment of a cervical horizontal root fracture and a complicated crown fracture: a case report.

PubMed

Belobrov, I; Weis, M V; Parashos, P

2008-09-01

Abstract This case report describes successful long-term conservative management of a cervical root fracture and a complicated crown fracture of the maxillary central incisors in a 12-year-old patient. A mineral trioxide aggregate partial pulpotomy was performed on the maxillary right central incisor, while the maxillary left central incisor was splinted to the neighbouring lateral incisor using an acid-etch technique. Both teeth remained asymptomatic throughout the 3.5 years of a review period, with the cervical root fracture having mostly healed with the formation of a calcified tissue between the fragments. Two different treatment methods were used for two different injuries that resulted in pulp preservation in both cases. This in turn has provided for normal root development to occur while also allowing for preservation of bone.

Evaluation of efficacy of a pulse oximeter to assess pulp vitality.

PubMed

Sadique, Mohammed; Ravi, S V; Thomas, Kunjamma; Dhanapal, Prasanth; Simon, Elsy P; Shaheen, Mohammed

2014-06-01

To evaluate the efficacy of pulse oximeter as a pulp vitality tester. The sample group consisted of 60 patients of age 15 to 30 years with normal maxillary anterior teeth. Thirty nonvital teeth with complete endodontic fillings were tested as control group. Systemic oxygen saturation values from the patient's fingers served as the control sample for comparison of pulp oxygen saturation values. Readings were recorded on index fingers first; teeth were then evaluated by placing sensor onto the tooth. Nonvital teeth recorded oxygen saturation values of 0%. The mean value for central incisor was 85.11 (SD ± 2.07), for lateral incisors 80.21 (SD ± 2.03) and for canines 89.55 (SD ± 1.09). Their control values (patient's index fingers) averaged 95.88% (SD ± 0.66). Pearson's correlation analysis showed a correlation of 0.11 for central incisors, 0.19 for lateral incisors and 0.12 for canines. This study confirms that pulse oximeter is effective equipment for pulp vitality testing. Pulse oximeter evidences the actual method of evaluating the pulp vitality compared to contemporary methods. How to cite the article: Sadique M, Ravi SV, Thomas K, Dhanapal P, Simon EP, Shaheen M. Evaluation of efficacy of a pulse oximeter to assess pulp vitality. J Int Oral Health 2014;6(3):70-2.

[Dental anomalies in Chinese children with complete unilateral cleft lip and palate].

PubMed

Fan, Xin-xin; Li, Jing; Ge, Li-hong; Ma, Lian

2011-05-01

To investigate the prevalence of dental anomalies in Chinese children with complete unilateral cleft lip and palate (UCLP). Dental histories and radiographs of 244 Chinese children with UCLP were collected. The diagnosis of dental anomalies was based on panoramic radiographs before alveolar bone grafting. All patients were over 8 years old. In the UCLP group, 66.8% of the patients was presented with hypodontia. The maxillary lateral incisors were the most common teeth affected, followed by maxillary second premolars, mandibular incisors and mandibular second premolars. A total of 33.6% the patients was presented with dental malformation, most were microdontic laterel incisors. A total of 4.9% the patients was presented with hyperdontia. The supernumerary teeth were more frequently found in the cleft region. The prevalence of missing maxillary lateral incisor in the noncleft side was statistically different between genders, which was higher in male (P < 0.050). This group of Chinese children with UCLP demonstrated significantly higher prevalence of hypodontia, hyperdontia, and malformation on the cleft side than on the noncleft side (P < 0.01). Hypodontia is the most common type of dental anomalies. The prevalence of dental anomalies is higher in the UCLP patients than in the normal population. Dental anomalies occur more frequently on the cleft side than on the noncleft side.

The effects of alveolar bone loss and miniscrew position on initial tooth displacement during intrusion of the maxillary anterior teeth: Finite element analysis

PubMed Central

Cho, Sun-Mi; Choi, Sung-Hwan; Sung, Sang-Jin; Yu, Hyung-Seog

2016-01-01

Objective The aim of this study was to determine the optimal loading conditions for pure intrusion of the six maxillary anterior teeth with miniscrews according to alveolar bone loss. Methods A three-dimensional finite element model was created for a segment of the six anterior teeth, and the positions of the miniscrews and hooks were varied after setting the alveolar bone loss to 0, 2, or 4 mm. Under 100 g of intrusive force, initial displacement of the individual teeth in three directions and the degree of labial tilting were measured. Results The degree of labial tilting increased with reduced alveolar bone height under the same load. When a miniscrew was inserted between the two central incisors, the amounts of medial-lateral and anterior-posterior displacement of the central incisor were significantly greater than in the other conditions. When the miniscrews were inserted distally to the canines and an intrusion force was applied distal to the lateral incisors, the degree of labial tilting and the amounts of displacement of the six anterior teeth were the lowest, and the maximum von Mises stress was distributed evenly across all the teeth, regardless of the bone loss. Conclusions Initial tooth displacement similar to pure intrusion of the six maxillary anterior teeth was induced when miniscrews were inserted distal to the maxillary canines and an intrusion force was applied distal to the lateral incisors. In this condition, the maximum von Mises stresses were relatively evenly distributed across all the teeth, regardless of the bone loss. PMID:27668194

Eruption of first permanent incisors and live weight gain in grazing yearling Angora goats.

PubMed

McGregor, B A; Butler, K L

2013-05-01

To investigate the effects of the timing and duration of eruption of the first permanent incisors, live weight, sex and other factors on contemporaneous live weight gain in Angora goats. Goats were previously part of a pen study on the effects of energy intake of Angora does during pregnancy and lactation on kid development. The design was 3 levels of nutrition in mid-pregnancy by 2 levels of postnatal nutrition in 17 randomised blocks. Artificial insemination, ultrasound examination and feeding does in pens enabled accurate conduct of the study. After weaning, goats were grazed in sex groups. Live weight change between 14 and 20 months of age was related to deciduous first incisor loss and permanent first incisor development and other attributes assessed before the study. Live weight change was related to the elapsed time for first permanent incisors to commence eruption and to the length of time for first permanent incisors to erupt. This response was affected by sex. Over summer and autumn, entire males with short eruption intervals gained 2-3 kg more than entire males with long eruption intervals. Females that reached first permanent incisor eruption by mid-summer had a live weight gain of 3 kg more than those that reached the same development 3 months later. Live weight change in yearling Angora goats was associated with the process of first permanent incisor eruption. In females, live weight gain was greater when first permanent incisor eruption was earlier. In males, live weight gain was greater when first permanent incisor eruption was faster. © 2013 The Authors. Australian Veterinary Journal © 2013 Australian Veterinary Association.

A randomized clinical trial comparing mandibular incisor proclination produced by fixed labial appliances and clear aligners.

PubMed

Hennessy, Joe; Garvey, Thérèse; Al-Awadhi, Ebrahim A

2016-09-01

To compare the mandibular incisor proclination produced by fixed labial appliances and third generation clear aligners. Patients underwent a course of orthodontic treatment using either fixed labial appliances or clear aligners (Invisalign). Mandibular incisor proclination was measured by comparing pretreatment and near-end treatment lateral cephalograms. Eligibility criteria included adult patients with mild mandibular incisor crowding (<4 mm) and Class I skeletal bases (ANB, 1-4°). The main outcome was the cephalometric change in mandibular incisor inclination to the mandibular plane at the end of treatment. Eligible patients picking a sealed opaque envelope, which indicated their group allocation, was used to achieve randomization. Data was analyzed using a Welch two-sample t-test. Forty-four patients (mean age, 26.4 ± 7.7 years) were randomized in a 1:1 ratio to either the fixed labial appliance or the clear aligner group. Baseline characteristics were similar for both groups: Fixed appliance mean crowding was 2.1 ± 1.3 mm vs clear aligner mean crowding, 2.5 ± 1.3 mm; pretreatment mean mandibular incisor inclination for the fixed appliance group was 90.8 ± 5.4° vs 91.6 ± 6.4° for the clear aligner group. Fixed appliances produced 5.3 ± 4.3° of mandibular incisor proclination. Clear aligners proclined the mandibular incisors by 3.4 ± 3.2°. The difference between the two groups was not statistically significant (P > .05). There was no difference in the amount of mandibular incisor proclination produced by clear aligners and fixed labial appliances in mild crowding cases.

Spectral analysis of /s/ sound with changing angulation of the maxillary central incisors.

PubMed

Runte, Christoph; Tawana, Djafar; Dirksen, Dieter; Runte, Bettina; Lamprecht-Dinnesen, Antoinette; Bollmann, Friedhelm; Seifert, Eberhard; Danesh, Gholamreza

2002-01-01

The aim of the study was to measure the influence of the maxillary central incisors free from adaptation phenomena using spectral analysis. The maxillary dentures of 18 subjects were duplicated. The central incisors were fixed in a pivoting appliance so that their position could be changed from labial to palatal direction. A mechanical push/pull cable enabled the incisor section to be handled extraorally. Connected to the control was a sound generator producing a sinus wave whose frequency was related to the central incisor angulation. This acoustic signal was recorded on one channel of a digital tape recorder. After calibration of the unit, the denture duplicate was inserted into the subject's mouth, and the signal of the /s/ sounds subsequently produced by the subject was recorded on the second channel during alteration of the inclination angle simultaneously with the generator signal. Spectral analysis was performed using a Kay Speech-Lab 4300B. Labial displacement in particular produced significant changes in spectral characteristics, with the lower boundary frequency of the /s/ sound being raised and the upper boundary frequency being reduced. Maxillary incisor position influences /s/ sound production. Displacement of the maxillary incisors must be considered a cause of immediate changes in /s/ sound distortion. Therefore, denture teeth should be placed in the original tooth position as accurately as possible. Our results also indicate that neuromuscular reactions are more important for initial speech sound distortions than are aerodynamic changes in the anterior speech sound-producing areas.

[Comparison between one-step and two-step space closing methods of sliding mechanics using three-dimensional finite element].

PubMed

Han, Yaohui; Mou, Lan; Xu, Gengchi; Yang, Yiqiang; Ge, Zhenlin

2015-03-01

To construct a three-dimensional finite element model comparing between one-step and two-step methods in torque control of anterior teeth during space closure. Dicom image data including maxilla and upper teeth were obtained though cone-beam CT. A three-dimensional model was set up and the maxilla, upper teeth and periodontium were separated using Mimics software. The models were instantiated using Pro/Engineer software, and Abaqus finite element analysis software was used to simulate the sliding mechanics by loading 1.47 Nforce on traction hooks with different heights (2, 4, 6, 8, 10, 12 and 14 mm, respectively) in order to compare the initial displacement between six maxillary anterior teeth (one-step method) and four maxillary anterior teeth (two-step method). When moving anterior teeth bodily, initial displacements of central incisors in two-step method and in one-step method were 29.26 × 10⁻⁶ mm and 15.75 × 10⁻⁶ mm, respectively. The initial displacements of lateral incisors in two-step method and in one-step method were 46.76 × 10(-6) mm and 23.18 × 10(-6) mm, respectively. Under the same amount of light force, the initial displacement of anterior teeth in two-step method was doubled compared with that in one-step method. The root and crown of the canine couldn't obtain the same amount of displacement in one-step method. Two-step method could produce more initial displacement than one-step method. Therefore, two-step method was easier to achieve torque control of the anterior teeth during space closure.

Surgical management of impacted incisors in associate with supernumerary teeth: a combine case report of spontaneous eruption and orthodontic extrusion.

PubMed

Das, D; Misra, J

2012-01-01

Maxillary permanent incisors impaction is not a frequent case in dental practice, but its treatment is challenging because of its importance to facial esthetics. Supernumerary teeth are the main cause of impaction of upper incisors. Supernumerary teeth when present can cause both esthetic and pathologic problems. Early detection of such teeth is most important if complications are to be avoided. In this reported case, the orthopantamogram of a 9-year-old boy revealed two impacted supernumerary teeth in the maxillary anterior region, which was interfering with the eruption of the permanent central incisors. The impacted supernumerary teeth were surgically removed, 11 was repositioned in the arch as it was situated very high in the arch, close to the nasal floor. Twenty-one erupted spontaneously but orthodontic force was applied over 11 to bring it into the occlusion and alignment was achieved with 0.014 mm NiTi wire.

[Three-dimensional analysis of the early correction of anterior crossbite using eruption guidance appliance].

PubMed

Wang, X; Zhang, J J; Yuan, F S; Wang, Y; Li, C H; Varrela, J E; Yue, J; Ge, L H

2018-06-18

To investigate the clinical effect of eruption guidance appliance in the treatment of anterior cross bite in mixed-dentition children. In the study,10 mixed-dentition children with anterior cross bite, totally 12 incisors, were selected. Alginate was used to take upper and lower dentition impression and make a hard plaster model,which served as the eruption guidance appliance for treatment. The pre- and post-operative dental casts were digitized with SmartOptics Activity 880 scanner,and the three-dimensional overlapping models were obtained by reverse engineering software,Geomagic Studio 2012,then the three-dimensional movements of the upper and lower incisors were analyzed using Imageware 13.2 software. The overbite and overjet were analyzed using the same methods. Measurement with copper wire was used to analyze the upper and lower arch length. Space analysis was the result by the sum of crown width minus the arch length. The crown width of unerupted permanent teeth was according to X-ray method to predict. The SPSS 17.0 software was used to analyze the pre- and post-operative measurements of the same child. The normality test of the measured data showed that it conformed to the normal distribution. Therefore,the t test and double side test were used,and the significance level was 0.05. The course of treatment was (5.6±2.7) months. During orthodontic treatment, the upper incisors moved mainly labially (P<0.001) in three-dimensional displacement, and the lower incisors moved mainly the same direction (P=0.025). During the treatment of eruption guidance appliance,the average overbite decreased (1.01±0.9) mm (t=-3.531, P=0.006), and the difference was statistically significant. There was no statistically significant difference between the pre- and post-operative average overjet (t=0.771, P=0.460). The severity of crowding in upper arch decreased (1.9±0.99) mm (t=-6.042, P<0.001),and that in lower arch decreased (1.9±0.74) mm (t=-8.143, P<0.001), both of the differences were statistically significant. The anterior cross bite in mixed dentition could be corrected by eruption guidance appliance, and at the same time, the normal overjet and overbite were established, and the teeth were aligned.

Relationship between dental erosion and respiratory symptoms in patients with gastro-oesophageal reflux disease.

PubMed

Wang, Geng-Ru; Zhang, Hui; Wang, Zhong-Gao; Jiang, Guang-Shui; Guo, Cheng-Hao

2010-11-01

Both dental erosion and respiratory symptoms are extra-oesophageal manifestations of gastro-oesophageal reflux disease (GERD). The aim of this study was to determine whether dental erosion was correlated with respiratory symptoms in GERD patients. 88 GERD patients were recruited and assigned to three groups mainly according to the frequency of respiratory symptoms: Group I: never; Group II: occasional (1-2 days a week or less); Group III: frequent (3-5 days a week or more). All patients underwent medical evaluations, including medical history, questionnaire answering and alimentary tract examinations. Dental examinations were carried out on these patients and 36 healthy controls. Dental erosions were measured by modified method of Smith and Knight Tooth Wear Index (TWI). Location and severity of dental erosion were recorded. The prevalence of dental erosion in Group III (64.52%) was higher (p<0.05) than that in Groups I (36.67%) and II (44.44%). GERD patients were presented with dental erosion with TWI scores ranging from 1 to 4. Though proportion of dental erosion with Score 2 (7/20) in Group III was higher than that in Group I (2/11) and Group II (3/12), there was no statistical significance in the proportions of erosion scores among three patient groups. Correlation coefficient between airway symptoms and scores of dental erosion was 0.231 (p<0.05). Palatal erosion of upper incisor was seen in 8 persons (72.7%) in Group I, 9 persons (75%) in Group II and 16 persons (80%) in Group III (p>0.05). Labial erosion of upper incisors was found in 1 person in Groups I and II respectively and 4 persons in Group III. All patients with labial erosion on upper incisors had palatal erosion, except 1 patient in Group III. In GERD patients, dental erosions are more prevalent in patients with frequent respiratory symptoms than those in patients with occasional and without respiratory symptoms. Palatal erosion of upper incisor is the main manifestation in patients. Acid reflux is the main causative factor of dental erosion in GERD patients with airway symptoms. Copyright © 2010 Elsevier Ltd. All rights reserved.

Multiple compound odontomas in mandible: A rarity

PubMed Central

Vaid, Sanjeev; Ram, Rangeela; Bhardwaj, Vinay Kumar; Chandel, Mohinder; Jhingta, Pravesh; Negi, Nishant; Sharma, Deepak

2012-01-01

Odontomas are benign odontogenic tumors composed of enamel, dentine, and cementum and pulp tissue. They are usually clinically asymptomatic, but often associated with tooth eruption disturbances. The present study reports an unusual case of eleven odontomas in the left lateral incisor-canine region of lower jaw. A 26 years old female presented to the department of orthodontics and dentofacial orthopedics in H.P. Govt. Dental College and Hospital Shimla for the treatment of misaligned teeth. Clinical examination revealed that the lower left lateral incisor was missing. Patient was advised for radiographs, which revealed a mixed radiopaque lesion associated to impacted lower left canine. The histological report in this case indicated a compound odontoma. PMID:23293496

Endodontic, surgical and periodontal treatment of dens invaginatus. Case report.

PubMed

Castellarin, M; Demitri, V; Politi, M

2001-01-01

The aim of this paper is to propose a single stage global treatment of endodontic, periapical and periodontal lesions in a lateral maxillary incisor with dens invaginatus. A 24 year-old woman presenting a lateral maxillary incisor with dens invaginatus in association with periapica1 and periodontal lesions underwent simultaneous surgical, endodontic and periodontal regenerative procedures. At 2, 6, 12, 18 months follow-up the radiographic healing appeared to be improved and the periapical lesion healed completely 1 year after surgical intervention. Surgery in association with endodontic and periodontal procedures represents the treatment of choice to maximize long term prognosis in cases of dens invaginatus with chronic periapical and periodontal lesions.

Disturbances of dental development distinguish patients with oligodontia-ectodermal dysplasia from isolated oligodontia.

PubMed

Dhamo, B; Kuijpers, M A R; Balk-Leurs, I; Boxum, C; Wolvius, E B; Ongkosuwito, E M

2018-02-01

To investigate phenotypic differences in dental development between isolated oligodontia and oligodontia-ectodermal dysplasia (ED). A total of 129 patients diagnosed with isolated oligodontia and 22 patients with oligodontia as part of ED were eligible. The phenotype of dental development was assessed for the frequency of missing a certain tooth, dental age, development of each tooth present, abnormal size and abnormal shape of teeth. The data were analysed building linear, ordinal and logistic regression models. Compared to patients with isolated oligodontia, patients with oligodontia-ED missed more frequently central incisors and second molars in both jaws, and lateral incisors in the mandible (P < .05). Oligodontia-ED was associated with delayed development of the permanent dentition (β = -0.10; 95% CI: -0.17, -0.03). Specifically, the maxillary teeth: right central incisor, right lateral incisor, right second premolar and left second premolar were delayed approximately from 2 to 4 developmental stages. In addition, the left mandibular second premolar was 3 developmental stages delayed. Abnormal shape of teeth was 7 times more evident in patients with oligodontia-ED compared to patients with isolated oligodontia (OR = 6.54; 95% CI: 2.34, 18.28). The abnormal size of teeth was not a distinctive characteristic for oligodontia-ED. Oligodontia-ED distinguishes from isolated oligodontia by more disturbances in dental development. The abnormal shape of incisors and canines in a patient with oligodontia can raise suspicions for accompanying ectodermal abnormalities. © 2017 The Authors. Orthodontics & Craniofacial Research Published by John Wiley & Sons Ltd.

Endodontic treatment of a maxillary central incisor with two roots.

PubMed

Maghsoudlou, Amir; Jafarzadeh, Hamid; Forghani, Maryam

2013-03-01

This clinical report presents a rare case of maxillary central incisor with two separate roots. Unusual morphology of the roots and root canals may exist in any tooth. Recognition of the dental anatomy and its variations is necessary for successful endodontic therapy. It is well known that maxillary incisors are usually single-rooted teeth. The root canals were instrumented with conventional hand files and Gates Glidden and obturated by using the lateral technique. Recall radiograph after 1 year shows the healing process of the preoperative apical periodontitis. Clinicians should be aware of unexpected root canal morphology when performing root canal therapy. The present case demonstrated the importance of accurate preoperative radiograph and adequate access preparation.

Management of a congenitally missing maxillary central incisor. A case study.

PubMed

Tichler, Howard M; Abraham, Jenny E

2007-03-01

When a maxillary lateral incisor is missing, often the treatment options can be clearly defined, that is, substitute an adjacent tooth for the missing one; open the space for an implant, a bonded bridge or fixed bridge. When a maxillary central incisor is missing and the space for the tooth is absent, the treatment choices become complicated, especially in a growing child. There must be multi-disciplinary coordination among the restorative dentist, the oral surgeon or periodontist, and the orthodontist to obtain the optimum result. At the initiation of treatment, this information must be relayed and the treatment plan agreed upon by the patient or the parents of the patient.

Congenitally Missing Maxillary Lateral Incisors: Update on the Functional and Esthetic Parameters of Patients Treated with Implants or Space Closure and Teeth Recontouring

PubMed Central

Pini, Núbia Inocencya Pavesi; Marchi, Luciana Manzotti De; Pascotto, Renata Corrêa

2015-01-01

Maxillary lateral incisor agenesis (MLIA) is a condition that affects both dental esthetics and function in young patients, and represents an important challenge for clinicians. Although several treatment options are available, the mesial repositioning of the canines followed by teeth recontouring into lateral incisors; or space opening/maintenance followed by implant placement have recently emerged as two important treatment approaches. In this article, the current and latest literature has been reviewed in order to summarize the functional and esthetic outcomes obtained with these two forms of treatment of MLIA patients in recent years. Indications, clinical limitations and the most important parameters to achieve the best possible results with each treatment modality are also discussed. Within the limitations of this review, it is not possible to assert at this point in time that one treatment approach is more advantageous than the other. Long-term followup studies comparing the existing treatment options are still lacking in the literature, and they are necessary to shed some light on the issue. It is possible, however, to state that adequate multidisciplinary diagnosis and planning are imperative to define the treatment option that will provide the best individual results for patients with MLIA. PMID:25646137

Assessment of the golden ratio in pleasing smiles.

PubMed

Nikgoo, Arash; Alavi, Kamiar; Alavi, Kavah; Mirfazaelian, Ali

2009-01-01

The golden ratio is a guideline to help harmoniously restore or replace missing teeth. However, this concept is controversial. This study assesses the validity of the golden ratio between the widths of the maxillary anterior teeth in individuals presenting with an attractive/nonattractive smile. A double-stage random cluster sample cross-sectional study included 903 students whose ages ranged from 18 to 30 years and met the inclusion criteria. Image-measurement software was used to assess the perceived mesiodistal widths of the maxillary anterior teeth on scanned photographs. A jury of two dental professionals, a portrait photographer, and a painter, along with the respective subject as the fifth judge, determined the attractiveness of each smile on a visual analog scale. The mean value determined whether an individual was allocated to the attractive or nonattractive smile group. Finally, the prevalence of the golden ratio was investigated in these two groups. Intraobserver correlation coefficient was 0.966. Cochran's chi-square test was used for data analysis. According to the jury, 143 individuals had an attractive smile and 289 had a nonattractive smile. Maxillary central to lateral incisor ratio showed the golden proportion in 50.3% of the students with an attractive smile as compared to 38.1% in the nonattractive smile group (P =.014). However, the golden ratio between the maxillary lateral incisors and the canines existed in only 16.8% of the individuals with an attractive smile as compared to 12.1% in the nonattractive smile group (P =.223). The golden ratio can be useful to achieve esthetic restorations of the maxillary central and lateral incisors. However, the golden ratio between the perceived widths of the maxillary lateral incisors to the canines does not seem to be decisive for an attractive smile and other factors should be considered. © 2009 BY QUINTESSENCE PUBLISHING CO, INC.

Endodontic treatment of a maxillary lateral incisor with a perforating internal resorption by using cone beam computed tomography as a diagnostic aid: a case report.

PubMed

Takita, Toshiya; Tsurumachi, Tamotsu; Ogiso, Bunnai

2011-10-01

This case report presents the endodontic treatment of a maxillary right lateral incisor with a perforating internal resorption in a 50-year-old woman. Radiographically, internal resorption appears as a fairly uniform, radiolucent enlargement of the pulp canal and distortion of the original root canal outline. The use of cone beam computed tomography can help the clinician in making a confirmatory diagnosis and determining the treatment plan before undertaking the actual treatment. After cleaning the root canal space and the resorptive defect by mechanic instrumentation, irrigation, and interim calcium hydroxide dressing, the apical third canal was filled with a gutta-percha point by lateral condensation. The resorptive defect was filled with mineral trioxide aggregate. Follow-up radiographs at 3 years showed adequate repair of the resorption, and the tooth remained asymptomatic.

Predicting improvement of postorthodontic white spot lesions.

PubMed

Kim, Susan; Katchooi, Mina; Bayiri, Burcu; Sarikaya, Mehmet; Korpak, Anna M; Huang, Greg J

2016-05-01

Patients undergoing orthodontic treatment are at greater risk for developing white spot lesions (WSLs). Although prevention is always the goal, WSLs continue to be a common sequela. For this reason, understanding the patterns of WSL improvement, if any, has great importance. Previous studies have shown that some lesions exhibit significant improvement, whereas others have limited or no improvement. Our aim was to identify specific patient-related and tooth-related factors that are most predictive of improvement with treatment. Patients aged 12 to 20 years with at least 1 WSL that developed during orthodontic treatment were recruited from private dental and orthodontic offices. They had their fixed appliances removed 2 months or less before enrollment. Photographs were taken at enrollment and 8 weeks later. Paired photographs of the maxillary incisors, taken at each time point, were blindly assessed for changes in surface area and appearance at the individual tooth level using visual inspection. One hundred one subjects were included in this study. Patient age, brushing frequency, and greater percentage of surface area affected were associated with increased improvement. Central incisors exhibited greater improvements than lateral incisors. Longer time since appliance removal and longer length of orthodontic treatment were associated with decreased levels of improvement. Sex, oral hygiene status, retainer type, location of the lesion (gingival, middle, incisal), staining, and lesion diffuseness were not found to be predictive of improvement. Of the various patient-related and tooth-related factors examined, age, time since appliance removal, length of orthodontic treatment, tooth type (central or lateral incisor), WSL surface area, and brushing frequency had significant associations with WSL improvement. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

[Three-dimensional finite element analysis of maxillary anterior teeth retraction force system in light wire technique].

PubMed

Zhang, Xiangfeng; Wang, Chao; Xia, Xi; Deng, Feng; Zhang, Yi

2015-06-01

This study aims to construct a three-dimensional finite element model of a maxillary anterior teeth retraction force system in light wire technique and to investigate the difference of hydrostatic pressure and initial displacement of upper anterior teeth under different torque values of tip back bend. A geometric three-dimensional model of the maxillary bone, including all the upper teeth, was achieved via CT scan. To construct the force model system, lingual brackets and wire were constructed by using the Solidworks. Brackets software, and wire were assembled to the teeth. ANASYS was used to calculate the hydrostatic pressure and the initial displacement of maxillary anterior teeth under different tip-back bend moments of 15, 30, 45, 60, and 75 Nmm when the class II elastic force was 0.556 N. Hydrostatic pressure was concentrated in the root apices and cervical margin of upper anterior teeth. Distal tipping and relative intrusive displacement were observed. The hydrostatic pressure and initial displacement of upper canine were greater than in the central and lateral incisors. This hydrostatic pressure and initial intrusive displacement increased with an increase in tip-back bend moment. Lingual retraction force system of maxillary anterior teeth in light wire technique can be applied safely and controllably. The type and quantity of teeth movement can be controlled by the alteration of tip-back bend moment.

Functional anatomy of incisal biting in Aplodontia rufa and sciuromorph rodents - part 2: sciuromorphy is efficacious for production of force at the incisors.

PubMed

Druzinsky, Robert E

2010-01-01

The protrogomorph condition of the rodent masticatory apparatus is thought to be present in only one living species, the mountain beaver Aplodontia rufa. The major anatomical difference between protrogomorphs and sciuromorphs is that the relative size of one part of the masseter muscle, the anterior lateral masseter, is much greater in sciuromorphs than in protrogomorphs. The mechanics of force production at the incisors were compared in A. rufa and six sciuromorph rodents. Is the sciuroid masticatory apparatus more effective for production of forces at the incisors during biting than the primitive, protrogomorph condition? To answer this question, three measures of mechanical ability were employed and three hypotheses were tested: (1) the mechanical advantage of the adductor musculature is greater in sciuromorphs than in A. rufa; (2) the relative force produced at the incisors is greater in sciuromorphs than in A. rufa, and (3) the relative amount of force produced that can be used to drive the incisors into an object, is greater in sciuromorphs than in A. rufa. The results demonstrated that the protrogomorph, A. rufa, is not as efficient at generating bite forces at the incisors as the sciuromorphs. Copyright 2010 S. Karger AG, Basel.

Combined periodontic-orthodonticendodontic interdisciplinary approach in the treatment of periodontally compromised tooth.

PubMed

Deepa, D; Mehta, D S; Puri, Viren K; Shetty, Sadashiva

2010-04-01

Orthodontic treatment in adult patients is one of the most frequently encountered components involving multidisciplinary approaches. In the present report, a 28-year-old male patient was treated for localized chronic periodontitis with pocket formation, mobility, pathologic migration and malalignment of maxillary left lateral incisor tooth #22. The periodontal therapy included motivation, education and oral-hygiene instructions (O.H.I.), scaling and root planing and periodontal flap surgery. Subsequently on resolution of periodontal inflammation, orthodontic therapy was carried out using the orthodontic aligner for a period of 6 months. Post-treatment (3 years) results showed complete resolution of infrabony pocket with significant bone fill, reduced tooth mobility and complete alignment of the affected maxillary left lateral incisor, thus restoring the esthetics and function.

Association between dental erosion and diet in Brazilian adolescents aged from 15 to 19: a population-based study.

PubMed

Aguiar, Yêska Paola Costa; dos Santos, Fábio Gomes; Moura, Eline Freitas de Farias; da Costa, Fernanda Clotilde Mariz; Auad, Sheyla Marcia; de Paiva, Saul Martins; Cavalcanti, Alessandro Leite

2014-01-01

Dental erosion is a pathological condition resulting from the irreversible dissolution of the mineralized portion of the teeth, being recognized in modern society as an important cause of loss of tooth structure. The aim of this study was to assess the prevalence and its association with diet in Brazilian adolescents of Campina Grande, PB, Brazil. A population-based study was conducted on a stratified sample of 675 adolescents aged from 15 to 19 of both sexes using the index proposed by O'Sullivan. Dental examinations were performed by two calibrated dentists (kappa = 0.82). The significance level adopted was 5%. The prevalence of dental erosion was 21%, and the upper central incisors and lateral incisors were the most affected elements, with 50.5% and 40.2%, respectively. The buccal surface showed greater impairment (51.4%) and 67.8% of teeth with dental erosion had more than half of the surface of affected area. Most damage was on the enamel (93.5%). There were no statistically significant differences between the occurrence of dental erosion and gender, age, socioeconomic status, self-reported ethnicity, and diet. There was high prevalence of dental erosion in its early stages among adolescents and there were no significant differences in the frequency of the consumption of foods and beverages and the presence of dental erosion.

Analysis of correlation between initial alveolar bone density and apical root resorption after 12 months of orthodontic treatment without extraction

PubMed Central

Scheibel, Paula Cabrini; Ramos, Adilson Luiz; Iwaki, Lilian Cristina Vessoni; Micheletti, Kelly Regina

2014-01-01

OBJECTIVE: The aim of the present study was to investigate the correlation between initial alveolar bone density of upper central incisors (ABD-UI) and external apical root resorption (EARR) after 12 months of orthodontic movement in cases without extraction. METHODS: A total of 47 orthodontic patients 11 years old or older were submitted to periapical radiography of upper incisors prior to treatment (T1) and after 12 months of treatment (T2). ABD-UI and EARR were measured by means of densitometry. RESULTS: No statistically significant correlation was found between initial ABD-UI and EARR at T2 (r = 0.149; p = 0.157). CONCLUSION: Based on the present findings, alveolar density assessed through periapical radiography is not predictive of root resorption after 12 months of orthodontic treatment in cases without extraction. PMID:25715722

Smile esthetics: Impact of variations in the vertical and horizontal dimensions of the maxillary lateral incisors

PubMed Central

Al Taki, Amjad; Hamdan, Ahmad Mohammad; Mustafa, Ziad; Hassan, Mawada; Abu-Alhuda, Sami

2017-01-01

Objective: The purpose of this study was to determine the perception of trained dental professionals and laypersons toward the esthetic impact of variations in the vertical position, width, and gingival height of the maxillary lateral incisor. Materials and Methods: The present study analyzed the perspective of smile photographs by dental professionals such as “fifty orthodontics and fifty general dental practitioners (GDPs)” as well as fifty laypersons, consisting of an equal number of male and female participants. Photographs edited to depict alteration of golden proportion, incisal length, and gingival height of lateral incisor. SPSS software was used to analyze the data and determine the significant difference within all the participants, at 0.05% level (95% confidence interval). Results: There was no significant difference in ranking between the genders. Golden proportion of 62%–67% were ranked the highest by orthodontists, whereas GDPs and laypersons preferred 67%. Regarding gingival display, corrected height of −0.5 and −1 mm received highest ranking from all the three groups. In case of lateral incisal length, −0.5 mm was ranked highest by laypersons, in contrast to −1 mm by orthodontists and GDPs. Conclusion: Specific differences were observed in the ranking of smile esthetics by health-care professionals and laypersons. Golden proportion of 62% and 67% were ranked the highest by orthodontists, whereas GDPs and laypersons preferred 67%. Corrected gingival height of −0.5 and −1 mm received highest ranking from all the three groups. In case of lateral incisal length, −0.5 mm was ranked highest by laypersons, in contrast to −1 mm by orthodontists and GDPs. PMID:29279680

Anesthetic efficacy of the intraosseous injection in maxillary and mandibular teeth.

PubMed

Coggins, R; Reader, A; Nist, R; Beck, M; Meyers, W J

1996-06-01

The objective of this study was to determine the anesthetic efficacy of the intraosseous injection as a primary technique in human maxillary and mandibular teeth. Forty subjects received two sets of intraosseous injections with 1.8 ml of 2% lidocaine with 1:100,000 epinephrine at two successive appointments. The experimental teeth consisted of 40 groups of maxillary and mandibular first molars and lateral incisors. Each experimental tooth and adjacent teeth were tested with an electric pulp tester at 4-minute cycles for 60 minutes. Anesthetic success was defined as no subject response to the maximum output of the pulp tester (80 reading) for two consecutive readings. Anesthetic success occurred in 75% of mandibular first molars, in 93% of maxillary first molars, in 78% of mandibular lateral incisors, and in 90% of maxillary lateral incisors. Overall, for the intraosseous injection onset was immediate, the duration of pulpal anesthesia steadily declined over the 60 minutes, there was a 78% incidence of subjective increase in heart rate, the majority of the subjects had no pain or mild pain with perforation and solution deposition, and 3% of the subjects had slow healing perforation sites. The results of this study indicate that the intraosseous injection may provide pulpal anesthesia in 75% to 93% of noninflamed teeth as a primary technique. However, the duration of pulpal anesthesia declines steadily over an hour.

Combined periodontic-orthodonticendodontic interdisciplinary approach in the treatment of periodontally compromised tooth

PubMed Central

Deepa, D; Mehta, D. S.; Puri, Viren K.; Shetty, Sadashiva

2010-01-01

Orthodontic treatment in adult patients is one of the most frequently encountered components involving multidisciplinary approaches. In the present report, a 28-year-old male patient was treated for localized chronic periodontitis with pocket formation, mobility, pathologic migration and malalignment of maxillary left lateral incisor tooth #22. The periodontal therapy included motivation, education and oral-hygiene instructions (O.H.I.), scaling and root planing and periodontal flap surgery. Subsequently on resolution of periodontal inflammation, orthodontic therapy was carried out using the orthodontic aligner for a period of 6 months. Post-treatment (3 years) results showed complete resolution of infrabony pocket with significant bone fill, reduced tooth mobility and complete alignment of the affected maxillary left lateral incisor, thus restoring the esthetics and function. PMID:21691554

Glenoid fossa responses to mandibular lateral shift in growing rats.

PubMed

Liu, Chang; Kaneko, Sawa; Soma, Kunimichi

2007-07-01

To evaluate the morphological and histological responses of the glenoid fossa to mandibular lateral shift in growing rats. A resin plate was placed on the upper incisors of 4-week-old rats in the experimental groups to displace the mandible to the left during closure. The rats were killed after 2, 4, 8, and 12 weeks. The morphometric measurements were performed on dry skulls, and tissue blocks were processed for periodic acid and Schiff's reagent (PAS) staining to examine the new bone formation. Gross measurements showed asymmetry in both the position and size of the fossae between the two sides after 4 weeks of lateral shift. The glenoid fossa on the ipsilateral side was repositioned relatively backward, outward and upward compared with the contralateral side and control group, whereas the fossa on the contralateral side was relocated relatively forward and downward compared with the control group. The length of the fossa was smaller on the ipsilateral side than on contralateral side and control group. At 2 weeks, the amount of newly formed bone in the posterior region of the fossa was higher in the experimental group than the control group. It is suggested that the mandibular lateral shift causes asymmetry in the position and size of the glenoid fossa and that this phenomenon can be related to different bilateral directional new bone formation in the posterior region.

Hand to Mouth in a Neandertal: Right-Handedness in Regourdou 1

PubMed Central

Volpato, Virginie; Macchiarelli, Roberto; Guatelli-Steinberg, Debbie; Fiore, Ivana; Bondioli, Luca; Frayer, David W.

2012-01-01

We describe and analyze a Neandertal postcranial skeleton and dentition, which together show unambiguous signs of right-handedness. Asymmetries between the left and right upper arm in Regourdou 1 were identified nearly 20 years ago, then confirmed by more detailed analyses of the inner bone structure for the clavicle, humerus, radius and ulna. The total pattern of all bones in the shoulder and arm reveals that Regourdou 1 was a right-hander. Confirmatory evidence comes from the mandibular incisors, which display a distinct pattern of right oblique scratches, typical of right-handed manipulations performed at the front of the mouth. Regourdou's right handedness is consistent with the strong pattern of manual lateralization in Neandertals and further confirms a modern pattern of left brain dominance, presumably signally linguistic competence. These observations along with cultural, genetic and morphological evidence indicate language competence in Neandertals and their European precursors. PMID:22937134

Esthetic Rehabilitation of the Smile with No-Prep Porcelain Laminates and Partial Veneers

PubMed Central

Farias-Neto, Arcelino; Gomes, Edna Maria da Cunha Ferreira; Sánchez-Ayala, Alfonso; Sánchez-Ayala, Alejandro; Vilanova, Larissa Soares Reis

2015-01-01

Rehabilitation of patients with anterior conoid teeth may present a challenge for the clinician, especially when trying to mimic the nature with composite resins. This clinical report exemplifies how a patient with conoid upper lateral incisors was rehabilitated with minimally invasive adhesive restorations. Following diagnostic wax-up and cosmetic mock-up, no-prep veneers and ceramic fragments (partial veneers) were constructed with feldspathic porcelain. This restorative material presents excellent reproduction of the optical properties of the dental structure, especially at minimal thicknesses. In this paper, the details about the treatment are described. A very pleasing outcome was achieved, confirming that minimally invasive adhesive restorations are an excellent option for situations in which the dental elements are healthy, and can be modified exclusively by adding material and the patient does not want to suffer any wear on the teeth. PMID:26568893

Effect of corticosteroids on orthodontic tooth movement in a rabbit model.

PubMed

Abtahi, M; Shafaee, H; Saghravania, N; Peel, S; Giddon, D; Sohrabi, K

2014-01-01

While there are a growing number of studies on the effects of medications on orthodontic tooth movement (OTM), only few studies have investigated the role of corticosteroids, despite their widespread use. The aim of the current study was to evaluate the effects of triamcinolone acetonide injection on OTM in a rabbit model. Sixteen one-month old rabbits were randomly divided into two groups: Eight rabbits had triamcinolone acetonide (1 mg/kg/day) administered IM daily for 21 days (test group) while the remaining eight rabbits received no drug (control group). The rabbits in both groups had a tube bonded to the upper central incisors and a stainless steel helical spring was inserted in tube slot to apply 50 cN distal force. After 3 weeks, the rabbits were sacrificed and the distance between mesial corners of incisors was measured The incisors are associated tissue was processed for histology and the apical and cervical area of the roots evaluated. An observer who was blind to the study groups evaluated the specimens. All appliance-treated incisors in test and control groups showed evidence of tooth movement. The distance between the incisors was significantly greater in the triamcinolone acetonide treated group compared to the control group (P < 0.001). Histological examination revealed an increased number of resorption lacunae and decreased number of cuboidal osteoblastic cells around the apical and cervical area of the Incisor roots in the test compared to the control group (P < 0.01). Treatment with triamcinolone acetonide is associated with increased tooth movement in rabbits via increased resorptive activity in the alveolar bone.

First records of talon cusps on baboon maxillary incisors argue for standardizing terminology and prompt a hypothesis of their formation.

PubMed

Heaton, Jason L; Pickering, Travis Rayne

2013-12-01

Dental characters can provide vital clues for understanding intra- and intertaxonomic morphological variation and its underlying genetic and environmental components. However, the unambiguous identification of particular traits and their comparative study is often confounded by lack of consistent terminology in the relevant literature. This difficulty is exacerbated when the etiologies are not completely understood, as is the case with talon cusps. To date, research on talon cusps has focused on modern humans. In many instances, descriptions of talon cusps appear in clinical case studies focusing on their treatment and removal. What is lacking in those discussions, though, is a comparative framework, in which the occurrence of talon cusps in nonhuman primates, and possibly other mammals, is established and understood. Here, we report on a taloned upper central incisor of a wild baboon (Papio hamadryas ursinus) from South Africa. The anomalous incisor of this individual includes an exaggerated accessory cusp diagnosed as a Type II talon. Microcomputed tomographic and radiographic analyses show that the taloned cusp possesses enamel, dentin, and pulp. In addition, we identified an unclassifiable talon cusp on a central maxillary incisor of a baboon skull housed in the Smithsonian Institution's Natural History Museum collection. Our observations of talon cusps on baboon incisors demonstrate that, with regard to this phenomenon, systematic study of nonhuman primates is much needed, along with a consistent use of terminology in the anatomical and anthropological literature. Finally, we present a hypothesis of the formation of talon cusps on mammalian incisors. Copyright © 2013 Wiley Periodicals, Inc.

The effect of epidermal growth factor on neonatal incisor differentiation in the mouse.

PubMed

Topham, R T; Chiego, D J; Gattone, V H; Hinton, D A; Klein, R M

1987-12-01

The effect of epidermal growth factor (EGF) on cellular differentiation of the neonatal mouse mandibular incisor was examined autoradiographically using tritiated thymidine ([3H]TDR) and tritiated proline ([3H]PRO). On days 0 (day of birth), 1, and 2, EGF was administered (3 micrograms/g body wt) sc to neonates. Mice were killed on Days 1, 4, 7, 10, and 13 after birth and were injected with either [3H]TDR or [3H]PRO 1 hr before death. [3H]TDR was used to analyze cell proliferation in eight cell types in the developing mouse incisor including upper (lingual) and lower (buccal) pulpal fibroblasts, preodontoblasts, inner and outer enamel epithelial cells (IEE and OEE), stratum intermedium (SI), stellate reticulum (SR), and periodontal ligament (PDL) fibroblasts. [3H]PRO was used to analyze protein synthesis in ameloblasts, and their secretion products (enamel and dentin), as well as PDL fibroblasts. The selected EGF injection scheme elicited acceleration of incisor eruption with minimal growth retardation. At Day 1, the upper and lower pulp, preodontoblasts, SI, and SR showed a significant decrease in labeling index (LI) 24 hr after a single EGF injection. After multiple injections (Days 0, 1, 2), two LI patterns were observed. In lower pulp, preodontoblasts, IEE, SI, SR, and OEE, a posteruptive change in LI was observed. In contrast, the upper pulp and PDL regions demonstrated a direct temporal relationship with eruption. Autoradiographic analysis with [3H]PRO indicated that EGF treatment caused significant increases in grain counts per unit area in ameloblast, odontoblast, and PDL regions studied. Significant differences were found in all four regions studied (ameloblasts, enamel, odontoblasts, dentin) at the 45-microns-tall ameloblast level as well as ameloblasts and odontoblasts at the 30-microns level at 13 days of age. The PDL demonstrated significant differences at all locations studied (base, 30 microns, 45 microns,) in 4-, 7-, and 13-day-old mice. Morphologically, EGF-treated groups demonstrated premature differentiation of ameloblasts and odontoblasts at the light microscopic level. The data indicate that EGF alters DNA and protein synthesis as well as differentiation patterns during the eruption process. While EGF affects both DNA and protein synthesis, the alteration of differentiation may be secondary to mitogenic effects on proliferative compartments. In order to determine the cellular target for EGF within the newborn mouse incisor, in vivo 125I-EGF binding was analyzed autoradiographically.(ABSTRACT TRUNCATED AT 400 WORDS)

En-masse protraction of mandibular posterior teeth into missing mandibular lateral incisor spaces using a fixed functional appliance.

PubMed

Chhibber, Aditya; Upadhyay, Madhur

2016-11-01

Protraction of mandibular posterior teeth requiring absolute anchorage has always been a challenge, especially when the space is located in the anterior region, since more teeth must be protracted. Traditionally, skeletal anchorage devices have been used for anchorage reinforcement during protraction. However, drawbacks such as requirement of a surgical step, inability to tolerate heavy forces, and patient willingness to undergo such surgical procedures can be limiting factors. Additionally, the mechanics involved can sometimes create undesirable side effects, thereby limiting their application in such situations. This report describes the use of a fixed functional appliance as an anchorage-reinforcement device for en-masse protraction of mandibular posterior teeth into a missing lateral incisor space. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Medication-related osteonecrosis of the jaw. Introduction of a new modified experimental model.

PubMed

Curra, Cláudia; Cardoso, Camila Lopes; Ferreira, Osny; Curi, Marcos Martins; Matsumoto, Mariza Akemi; Cavenago, Bruno Cavalini; Santos, Pâmela Letícia Dos; Santiago, Joel Ferreira

2016-05-01

To evaluate a modified experimental model for medication-related osteonecrosis of the jaw (MRONJ) through the upper right central incisor extraction followed by intravenous bisphosphonate administration. Forty five rats underwent the upper right central incisor tooth extraction were divided in 2 groups: Group I - experimental group, 30 rats received an intravenous administration protocol of zoledronic acid 35μg/kg into the tail vein every two weeks, totalizing four administrations, during eight weeks of administration, previously the extraction, and Group II - control group, 15 rats didn't received any medication before extraction. The groups were subdivided in postoperative periods: 14/28/42 days. Clinical analysis and microtomography were performed to verify the presence of osteonecrosis. In addition, descritive histological analysis of hematoxylin-eosin stained sections was performed to evaluate the presence of osteonecrosis or necrotic foci. Twelve (40%) rats, from experimental group, showed clinical signs of MRONJ (p=0.005), however, all samples showed imaginologic findings like osteolysis and loss of integrity of the cellular walls (p≤0.001). Microscopic evaluation revealed osteonecrosis areas with microbial colonies and inflammatory infiltrate (p≤0.001). In the control group, all animals presented the chronology of a normal wound healing. The presence of medication-related osteonecrosis of the jaw after maxillary central incisor extraction in rats. This new experimental model may be considered an option for the study of MRONJ.

Orthodontic treatment for oral rehabilitation after multiple maxillofacial bone fractures.

PubMed

Nakamura, Yoshiki; Ogino, Tomoko Kuroiwa; Hirashita, Ayao

2008-09-01

We present the orthodontic treatment of a patient with occlusal dysfunction after plastic surgery for multiple maxillofacial bone fractures caused by a traffic accident. The patient had mandibular deviation to the right because of inappropriate repositioning and fixation of the fractured bone and complete avulsion of both mandibular central incisors. The bilateral mandibular incisors, canines, and premolars were also suspected of partial avulsion or alveolar bone fracture. Several tests, including percussion and dental computed tomography, were performed on these teeth to rule out ankylosis and confirm tooth movement. Camouflage orthodontic treatment was carried out with expansion of the maxillary arch, alignment of both arches, and space closure between the mandibular lateral incisors to improve the occlusion. Good occlusion and interdigitation were obtained. Orthodontic treatment is useful for the rehabilitation of occlusal dysfunction caused by multiple maxillofacial bone fractures.

Radiologically determined orthodontically induced external apical root resorption in incisors after non-surgical orthodontic treatment of class II division 1 malocclusion: a systematic review.

PubMed

Tieu, Long D; Saltaji, Humam; Normando, David; Flores-Mir, Carlos

2014-07-23

This study aims to critically evaluate orthodontically induced external apical root resorption (OIEARR) in incisors of patients undergoing non-surgical orthodontic treatment of class II division 1 malocclusion by a systematic review of the published data. An electronic search of two databases was performed; the bibliographies of relevant articles were also reviewed. Studies were included if they examined the amount of OIEARR in incisors produced during non-surgical orthodontic treatment of individuals with class II division I malocclusion in the permanent dentition. Individuals had no previous history of OIEARR, syndromes, pathologies, or general diseases. Study selections, risk of bias assessment, and data extraction were performed in duplicate. Eight studies of moderate methodological quality were finally included. An increased prevalence (65.6% to 98.1%) and mild to moderate severity of OIEARR (<4 mm and <1/3 original root) were reported. No sex difference in root resorption was found. For the maxillary incisors, there was no evidence that either the central or lateral incisor was more susceptible to OIEARR. A weak to moderate positive correlation between treatment duration and root resorption, and anteroposterior apical displacement and root resorption was found. Current limited evidence suggests that non-surgical comprehensive orthodontic treatment to correct class II division 1 malocclusions causes increased prevalence and severity of OIEARR the more the incisor roots are displaced and the longer this movement takes.

Effect of implant number and distribution on load transfer in implant-supported partial fixed dental prostheses for the anterior maxilla: A photoelastic stress analysis study.

PubMed

Lee, Jae-In; Lee, Yoon; Kim, Yu-Lee; Cho, Hye-Won

2016-02-01

The 4-, 3- or even 2-implant-supported partial fixed dental prosthesis (PFDP) designs have been used to rehabilitate the anterior edentulous maxilla. The purpose of this in vitro study was to compare the stress distribution in the supporting tissues surrounding implants placed in the anterior maxilla with 5 PFDP designs. A photoelastic model of the human maxilla with an anterior edentulous region was made with photoelastic resin (PL-2; Vishay Micro-Measurements), and 6 straight implants (OsseoSpeed; Astra Tech AB) were placed in the 6 anterior tooth positions. The 5 design concepts based on implant location were as follows: model 6I: 6 implants; model 2C2CI: 4 implants (2 canines and 2 central incisors); model 2C2LI: 4 implants (2 canines and 2 lateral incisors); model 2C1CI: 3 implants (2 canines and 1 central incisor); and model 2C: 2 canines. A load of 127.4 N was applied on the cingulum of 3 teeth at a 30-degree angle to the long axis of the implant. Stresses that developed in the supporting structure were recorded photographically. The 6-implant-supported PFDP exhibited the most even and lowest distribution of stresses in all loading conditions. When the canine was loaded, the 2- or 3-implant-supported PFDP showed higher stresses around the implant at the canine position than did the 4- or 6-implant-supported PFDP. When the central incisor or lateral incisor was loaded, the two 4-implant-supported PFDPs exhibited similar levels of stresses around the implants and showed lower stresses than did the 2- or 3-implant-supported PFDP. Implant number and distribution influenced stress distribution around the implants in the anterior maxilla. With a decrease in implant number, the stresses around the implants increased. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Evaluation of maxillary anterior teeth and their relation to the golden proportion in Malaysian population.

PubMed

Al-Marzok, Maan Ibrahim; Majeed, Kais Raad Abdul; Ibrahim, Ibrahim Khalil

2013-01-24

The maxillary anterior teeth are important in achieving pleasing dental aesthetics. Various methods are used to measure the size and form of them, including the golden proportion between their perceived widths, and the width-to-height ratio, referred to as the golden standard. The purpose of this study was conducted to evaluate whether consistent relationships exist between tooth width and height of the clinical crown dimensions; and to investigate the occurrence of the golden proportion of the maxillary anterior teeth. Dental casts of the maxillary arches were made in this cross-sectional study from MAHSA University College students who met the inclusion criteria. The 49 participants represented the Malaysian population main ethnics. The dimensions of the anterior teeth and the perceived width of anterior teeth viewed from front were measured using a digital caliper. Comparison of the perceived width ratio of lateral to central incisor and canine to lateral incisor with the golden proportion of 0.618 revealed there were a significant statistical difference (p < 0.05). The statistical difference was significant for the width-to-height ratio of central incisors to the golden standard of 80%. There was no significant difference in the comparison among ethnic groups for the golden proportion and the golden standard. The golden proportion was not found to exist between the perceived widths of maxillary anterior teeth. No golden standard were detected for the width-to-height proportions of maxillary incisors. Specific population characteristics and perception of beauty must be considered. However, ethnicity has no association with the proportions of maxillary anterior teeth.

The Evaluation of Root Fracture with Cone Beam Computed Tomography (CBCT): An Epidemiological Study.

PubMed

Doğan, Mehmet-Sinan; Callea, Michele; Kusdhany, Lindawati S; Aras, Ahmet; Maharani, Diah-Ayu; Mandasari, Masita; Adiatman, Melissa; Yavuz, Izzet

2018-01-01

The aim of this study was evaluation of the cone-beam computed tomography (CBCT) image of 50 patients at the ages of 8-15 suspecting root fracture and root fracture occurred, exposed to dental traumatic. In additionally, this study was showed effect of crown fracture on root fracture healing. All of the individuals included in the study were obtained images with the cone-beam computed tomography range of 0,3 voxel and 8.9 seconds.(i-CAT®, Model 17-19, Imaging SciencesInternational, Hatfield, Pa USA).The information obtained from the history and CBCT images of patients were evaluated using chi-square test statistical method the mean and the distribution of the independent variables. 50 children, have been exposed to trauma, was detected root fracture injury in 97 teeth. Horizontal root fracture 63.9% of the 97 tooth, the oblique in 31.9%, both the horizontal and oblique in 1.03%, partial fracture in 2.06% ,and both horizontally and vertical in 1.03% was observed.The most affected teeth, respectively of, are the maxillary central incisor (41.23% left, right, 37.11%), maxillary left lateral incisor (9.27%), maxillary right lateral incisor (11.34%), and mandibular central incisor (1.03%). Crown fractures have negative effects on spontaneous healing of root fractures. CBCT are used selected as an alternative to with conventional radiography for diagnosis of root fractures. In particular, ıt's cross-sectional image is quite useful and has been provided more conveniences seeing the results of diagnosis and treatment for clinician. Key words: Root fracture, CBCT, Epidemiolog.

Dental fragment embedded in the lower lip after facial trauma: Brief review literature and report of a case

PubMed Central

Lauritano, Dorina; Petruzzi, Massimo; Sacco, Gerardo; Campus, Guglielmo; Carinci, Francesco; Milillo, Lucio

2012-01-01

Upper incisors are the most frequently involved teeth in traumatic dental injuries. Soft tissues (lips and/or oral mucosa) adjacent to incisal edge can receive direct and/or indirect traumas. Laceration of the lower lip is a not rare eventuality and teeth fragments could be embedded in labial soft tissue. The reattachment of these fragments, if possible, is the elective treatment choice, thanks to the modern adhesive and restorative techniques. The authors present a case of a white Caucasian 10-year-old child, who attended the dental clinic for the treatment of both upper central incisors’ crown fractures. The fragment of the left incisor was retrieved embedded in the lower lip. It was successfully surgically removed and reattached using a composite adhesive technique. A careful clinical and radiographic examination with the surgical removal of tooth fragments could prevent undesirable foreign body reaction, infection and scarring. The authors also reviewed the most relevant literature concerning tooth fragment reattachment after removal from oral soft tissues. PMID:23814592

Class II treatment in adults: comparing camouflage orthodontics, dentofacial orthopedics and orthognathic surgery--a cephalometric study to evaluate various therapeutic effects.

PubMed

Kinzinger, Gero; Frye, Linda; Diedrich, Peter

2009-01-01

It was the aim of this clinical study to compare the skeletal and dentoalveolar effects as well as those on the profile of three different treatment approaches in Class II patients (camouflage orthodontics, dentofacial orthopedics, and combined orthodontic and surgical treatment). Our study cohort consisted of 60 young adults presenting a skeletal Class II, Division 1 malocclusion: 20 patients whose overjet was reduced by camouflage following premolar extraction, 20 patients whose occlusions were corrected by placement of a fixed functional orthopedic appliance, and 20 who underwent orthognathic surgery (bilateral sagittal split osteotomy of the mandible without genioplasty). We documented the therapeutic progress using cephalometry. Each patient group achieved a reduction in overjet via their respective treatment. While no treatment-related changes in the maxillary area were assessable, the effects on the mandible differed. We observed advancement of the bony chin and an increase in mandibular length in the sagittal-diagonal dimension in the surgical and functional orthopedic groups. However, the extent of the treatment-related changes was significant only in the group of patients that had undergone orthognathic surgery. Only the surgical group presented changes in vertical relationships. Incisor repositioning as an outcome of the respective treatments differed fundamentally, with those in the surgical group revealing significant protrusion of the upper incisors. The maxillary incisors were retruded and mandibular incisors proclined in the functional orthopedic group, whereas the upper and lower incisors both retruded significantly in the extraction group. Soft-tissue remodeling bore no linear relationship to treatment-induced skeletal and dental effects. Still, orthognathic surgery led to the most marked profile changes. Treatment using fixed functional orthopedic appliances reduced the convexity of the soft-tissue profile at least moderately. Camouflage orthodontics, on the other hand, resulted in an increase in the nasolabial angle. In young adults fixed functional appliances are a treatment alternative to extraction therapy but to a lesser extent to orthognathic surgery. Because of their limited skeletal effects and minor changes in the profile they are indicated only in patients with a moderately severe Class II malocclusion. Pre-treatment proclined mandibular incisors limit the scope of indications for fixed functional appliances, as they can cause an increase in lower incisor proclination. Significant reductions in profile convexity are achievable only by combined orthodontic and surgical treatment of the malocclusion. When performing camouflage orthodontics in conjunction with maxillary premolar extractions in adults, an increase in the nasolabial angle, which is often esthetically undesirable, has to be discussed as a potential side effect and has to be taken into account when considering the different therapeutic approaches.

Multiple extraction patterns in severe discrepancy cases.

PubMed

Anderson, B D

1975-10-01

Thirty-five cases have been collected from colleagues which illustrate that removal of additional maxillary teeth, following first bicuspid extractions, can allow the successful resolution of difficult discrepancy and anchorage cases. Charts 1 and 2 describe the amounts of space that might be expected by removal of additional upper bicuspids, upper first molars, and upper second molars. The findings on upper second molars are admittedly limited. Anchorage values as expressed by an efficiency percentage were approximately what would be expected from a study of anchorage values of the roots of teeth. The removal of upper second bicuspids has a better anchorage efficiency potential than the upper first molar, but this may be overcome somewhat by the greater size of the molar. Clear guidance cannot be given as to which teeth to remove in a specific case, but it is the observation of the author that for cases that are still in full Class II following four bicuspid space closure, upper second bicuspid removal would be more helpful from an anchorage perspective, whereas for cases that are in end-to-end molar relationship or require only a few millimeters to move into Class I, the upper first molar might be the tooth of choice. Also, the supper first molar removal allows for a more "normal" appearing arch assuming normal alignment and size of the upper second and third molars. The comparison with the nonextraction control group showed an enormous difference in the amount of incisor retraction that extractions provide when related to the maxilla. The nonextraction control group, though experiencing dramatic correction of Class II relationships, showed no incisor movement within the maxilla. Some problems which appeared in the sample were described. Removal of upper teeth in addition to the four first bicuspids can be a solution to an occasional anchorage, skeletal, growth or cooperation problem.

Periapical cemento-osseous dysplasia: a case report with twelve-year follow-up and review of literature.

PubMed

Senia, E S; Sarao, M S

2015-11-01

To present a case report describing the long-term behaviour of periapical cemento-osseous dysplasia by observing the radiographic changes that took place over a period of 12 years. A review of the pertinent literature is also presented. A healthy 26-year-old white female was referred to the Wilford Hall USAF Medical Center Endodontic Department for evaluation of an asymptomatic radiolucency at the apex of the right mandibular lateral incisor. Following a clinical evaluation that included pulp testing, a diagnosis of periapical cemento-osseous dysplasia (PCOD) was made. No treatment was rendered but follow-up visits were recommended. The patient was subsequently re-evaluated 8 times over a period of 12 years. During that time the lesion changed in appearance, displaying the various phases of PCOD. At the same time, lesions affecting the three adjoining incisors appeared and behaved in a similar manner. At the 12-year recall, the right lateral and both central incisors revealed no evidence of PCOD and an almost normal trabecular pattern of bone could be seen. Misdiagnosis and unnecessary treatment of PCOD may be avoided with careful pulp testing and knowledge of its most common locations of occurrence, radiographic appearances (phases) and benign behaviour. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Prevalence of mesiodens in orthodontic patients with deciduous and mixed dentition and its association with other dental anomalies.

PubMed

Lara, Tulio Silva; Lancia, Melissa; da Silva Filho, Omar Gabriel; Garib, Daniela Gamba; Ozawa, Terumi Okada

2013-01-01

To determine the prevalence of mesiodens in deciduous and mixed dentitions and its association with other dental anomalies. Panoramic radiographs of 1,995 orthodontic patients were analyzed retrospectively, obtaining a final sample of 30 patients with mesiodens. The following aspects were analyzed: gender; number of mesiodens; proportion between erupted and non-erupted mesiodens; initial position of the supernumerary tooth; related complications; treatment plan accomplished; and associated dental anomalies. The frequency of dental anomalies in the sample was compared to reference values for the general population using the chi-square test, with a significance level set at 5%. The prevalence of mesiodens was 1.5% more common among males (1.5:1). Most of the mesiodens were non-erupted (75%) and in a vertical position, facing the oral cavity. Extraction of the mesiodens was the most common treatment. The main complications associated with mesiodens were: delayed eruption of permanent incisors (34.28%) and midline diastema (28.57%). From all the dental anomalies analyzed, only the prevalence of maxillary lateral incisor agenesis was higher in comparison to the general population. There was a low prevalence of mesiodens (1.5%) in deciduous and mixed dentition and the condition was not associated with other dental anomalies, except for the maxillary lateral incisor agenesis.

Jaw motion during gum-chewing in children with primary dentition.

PubMed

Kubota, Naoko; Hayasaki, Haruaki; Saitoh, Issei; Iwase, Yoko; Maruyama, Tomoaki; Inada, Emi; Hasegawa, Hiroko; Yamada, Chiaki; Takemoto, Yoshihiko; Matsumoto, Yuko; Yamasaki, Youichi

2010-01-01

This study was undertaken to characterize jaw motion during mastication in children with primary dentition and to compare jaw motion with that in adults. The means and the variances of the traditional parameters for the chewing cycle, i.e., duration, excursive ranges and 3-D distances of travel at the lower incisor, molars and condyles were analyzed and compared in 23 children and 25 female adults. The duration of opening in children was significantly shorter than that of adults. Significant differences between children and adults were observed in lateral and vertical excursion of the incisor, lateral excursion at the molars, and vertical excursion at the condyles. Many of these measurements had larger between-subject and between-cycle variances in children than adults, suggesting that chewing motion in children has not yet matured. The results of this study indicate that chewing motion in children is different from that of adults.

Comparison of intrusion effects on maxillary incisors among mini implant anchorage, j-hook headgear and utility arch.

PubMed

Jain, Ravindra Kumar; Kumar, Sridhar Prem; Manjula, W S

2014-07-01

Intrusion of maxillary incisors is one of the most important and difficult tooth movements to achieve as a part of orthodontic therapy. A variety of techniques were used in the past to intrude the maxillary incisors before the emergence of mini implants in Orthodontics. Mini implants are temporary anchorage devices used to produce various tooth movements. The research was carried out to evaluate and compare the efficiency of producing intrusion of maxillary incisors using mini implants, utility arch and j- hook headgear. The study was conducted on 30 subjects divided into 3 Groups equally. Group 1- mini implant anchorage, Group 2 - j- hooks headgear and Group 3- utility arch were used for intrusion of the maxillary incisors. Conventional lateral cephalograms were taken before treatment and at the end of intrusion. Five cephalometric parameters were used to measure the amount of intrusion attained in each Group. Intra Group comparisons were done using student t-test and inter Group comparisons were done using ANOVA The duration of intrusion was four months in all the three Groups. In Group 1 the mean average intrusion attained was 2.1 mm, the mean average intrusion attained in Group 2 was 0.7 mm, and the mean average intrusion achieved in Group 3 was 1.4 mm with a side effect of 0.75 mm of molar extrusion. Although, both mini implants and utility arch can be used to attain significant amounts of incisor intrusion but using mini implants will produce true intrusion without any other side effects.

Does Andrews facial analysis predict esthetic sagittal maxillary position?

PubMed

Resnick, Cory M; Daniels, Kimberly M; Vlahos, Maryann

2018-04-01

Cephalometric analyses have limited utility in planning maxillary sagittal position for orthognathic surgery. In Six Elements of Orofacial Harmony, Andrews quantified maxillary position relative to forehead projection and angulation and proposed an ideal relationship. The purpose of this study was to investigate the ability of this technique to predict esthetic sagittal maxillary position. Survey study including a male and female with straight facial profiles, normal maxillary incisor angulations, and Angle's Class I. Maxillary position was modified on lateral photographs to create 5 images for each participant with incisor-goal anterior limit line (GALL) distances of -4, -2, 0, +2, and +4 mm. A series of health care professionals and laypeople were asked to rate each photo in order of attractiveness. A total of 100 complete responses were received. Incisor-GALL distances of +4 mm (41%) and +2 mm (40%) were most commonly considered "most esthetic" for the female volunteer (P < .001). For the male volunteer, there were 2 peak "most esthetic" responses: incisor-GALL distances of 0 mm (37%) and -4 mm (32%) (P < .001). Respondents considered maxillary incisor position 2 to 4 mm anterior to GALL most attractive in a woman and 0 to 4 mm posterior to GALL most esthetic in a man. Using these modified target distances, this analysis may be useful for orthognathic surgery planning. Copyright © 2018 Elsevier Inc. All rights reserved.

Investigation of tooth transposition in a non-syndromic Turkish anatolian population: characteristic features and associated dental anomalies.

PubMed

Celikoglu, Mevlut; Miloglu, Ozkan; Oztek, Ozkan

2010-09-01

The aims of this study were to investigate the frequency and characteristics of dental transpositions and to evaluate associated dental anomalies in a large sample of Turkish Anatolian population. A retrospective study was performed using panoramic radiographs of 6983 patients (4092 females and 2891 males) ranging in age from 12 to 27 subjected to Faculty of Dentistry at the University of Ataturk (Erzurum, Turkey) between 2005 and 2008. For each patient with tooth transposition we recorded the demographic variables (including age, sex), history of trauma, type, classification, and location of tooth transpositions, and associated dental anomalies. The Pearson chi-squared test was used to determine potential differences in the distribution of tooth transposition when stratified by gender. Tooth transposition was detected in 19 subjects (0.27%), with a 2.2:1 female male ratio (P=0.38). The most commonly observed transposition was maxillary canine-lateral incisor (60%). The frequencies of complete and incomplete transpositions were equal (10/10) and it was more common in the left side than in the right side (11/9). Of the 19 subjects, 10.5% had a peg shaped lateral incisor, 21.1% one congenitally missing tooth excluding third molar. Supernumerary tooth, impacted teeth excluding third molars, transmigrated tooth, and dilacerations were also observed. The frequency of tooth transposition was 0.27% in a Turkish Anatolian population and maxillary canine-lateral incisor was the most frequently observed transposition. Retained primary teeth were the most frequently observed dental anomaly in all types of tooth transposition.

Variations in tooth size and arch dimensions in Malay schoolchildren.

PubMed

Hussein, Khalid W; Rajion, Zainul A; Hassan, Rozita; Noor, Siti Noor Fazliah Mohd

2009-11-01

To compare the mesio-distal tooth sizes and dental arch dimensions in Malay boys and girls with Class I, Class II and Class III malocclusions. The dental casts of 150 subjects (78 boys, 72 girls), between 12 and 16 years of age, with Class I, Class II and Class III malocclusions were used. Each group consisted of 50 subjects. An electronic digital caliper was used to measure the mesio-distal tooth sizes of the upper and lower permanent teeth (first molar to first molar), the intercanine and intermolar widths. The arch lengths and arch perimeters were measured with AutoCAD software (Autodesk Inc., San Rafael, CA, U.S.A.). The mesio-distal dimensions of the upper lateral incisors and canines in the Class I malocclusion group were significantly smaller than the corresponding teeth in the Class III and Class II groups, respectively. The lower canines and first molars were significantly smaller in the Class I group than the corresponding teeth in the Class II group. The lower intercanine width was significantly smaller in the Class II group as compared with the Class I group, and the upper intermolar width was significantly larger in Class III group as compared with the Class II group. There were no significant differences in the arch perimeters or arch lengths. The boys had significantly wider teeth than the girls, except for the left lower second premolar. The boys also had larger upper and lower intermolar widths and lower intercanine width than the girls. Small, but statistically significant, differences in tooth sizes are not necessarily accompanied by significant arch width, arch length or arch perimeter differences. Generally, boys have wider teeth, larger lower intercanine width and upper and lower intermolar widths than girls.

The Evaluation of Root Fracture with Cone Beam Computed Tomography (CBCT): An Epidemiological Study

PubMed Central

Doğan, Mehmet-Sinan; Callea, Michele; Kusdhany, Lindawati S.; Aras, Ahmet; Maharani, Diah-Ayu; Mandasari, Masita; Adiatman, Melissa

2018-01-01

Background The aim of this study was evaluation of the cone-beam computed tomography (CBCT) image of 50 patients at the ages of 8-15 suspecting root fracture and root fracture occurred, exposed to dental traumatic. In additionally, this study was showed effect of crown fracture on root fracture healing. Material and Methods All of the individuals included in the study were obtained images with the cone-beam computed tomography range of 0,3 voxel and 8.9 seconds.(i-CAT®, Model 17-19, Imaging SciencesInternational, Hatfield, Pa USA).The information obtained from the history and CBCT images of patients were evaluated using chi-square test statistical method the mean and the distribution of the independent variables. Results 50 children, have been exposed to trauma, was detected root fracture injury in 97 teeth. Horizontal root fracture 63.9% of the 97 tooth, the oblique in 31.9%, both the horizontal and oblique in 1.03%, partial fracture in 2.06% ,and both horizontally and vertical in 1.03% was observed.The most affected teeth, respectively of, are the maxillary central incisor (41.23% left, right, 37.11%), maxillary left lateral incisor (9.27%), maxillary right lateral incisor (11.34%), and mandibular central incisor (1.03%). Conclusions Crown fractures have negative effects on spontaneous healing of root fractures. CBCT are used selected as an alternative to with conventional radiography for diagnosis of root fractures. In particular, ıt’s cross-sectional image is quite useful and has been provided more conveniences seeing the results of diagnosis and treatment for clinician. Key words:Root fracture, CBCT, Epidemiolog. PMID:29670714

Spontaneous correction of anterior crossbite by RPE anchored on deciduous teeth in the early mixed dentition.

PubMed

Rosa, M; Lucchi, P; Mariani, L; Caprioglio, A

2012-09-01

The purpose of this study was to evaluate the effectiveness of Haas RPE anchored on deciduous teeth in the early mixed dentition, for inducing the spontaneous correction of permanent incisor's crossbite, without compliance, without post bite-plane and no involvement of the permanent teeth. The sample group comprised 50 consecutive patients (mean age 8y 5m, SD 2y 1m), 31 males, 19 females. They showed a cross-bite affecting one or more permanent incisors, for a total of 70 teeth. The patients were treated with Haas RPE appliance anchored on second deciduous molars and bonded on deciduous canines. No direct forces were applied on the permanent teeth. Anterior crossbite self-corrected 'spontaneously' in 84% of the cases. Lateral incisors had a higher rate of self-correction than central incisors. All hyper-divergent subjects showed a spontaneous crossbite self-correction. The early maxillary expansion by Haas RPE anchored on deciduous teeth is an efficient and effective procedure to induce the anterior crossbite self-correction in the early mixed dentition without the need of a bite-plane, no involvement of the permanent teeth and without compliance.

Molar-incisor-hypomineralisation (MIH). Retrospective clinical study in Greek children. I. Prevalence and defect characteristics.

PubMed

Lygidakis, N A; Dimou, G; Briseniou, E

2008-12-01

This was to evaluate the prevalence and the clinical characteristics of MIH in a group of Greek children. During the years 2003--2005, all MIH cases diagnosed according to the recently set criteria were selected from the new patients clinic of a Community Dental Centre for Children (Athens). Age, gender and teeth involved were recorded. The severity of MIH was determined collectively by dividing the affected teeth in two groups; a) mild defect (demarcated opacities) and b) moderate/severe defect (enamel breakdown and atypical restorations). Evaluation of the distribution of the affected teeth within MIH cases was performed in a separate group of 225 affected children aged 8-12 years with their entire 12 'index' teeth erupted. From the 3,518, 5.5 to 12 year old children that were examined, there were 360 (10.2%) children with MIH, 211 (58.6%) females and 149 (41.4%) males, with 1,926 affected teeth, 1,231 molars and 695 incisors. In the molars group, maxillary molars were more frequently affected (87.8/90.3%) than mandibular (81.7/82.2%). In the central incisor group, maxillary teeth were also more frequently affected (50/55%) than mandibular (24.4/25%), while laterals were the least affected. In all there were 37.9% molars with moderate/severe defects as compared with 4.9% incisors, the remaining 62.1% and 95.1% respectively being mild. The various associations between the affected teeth were evaluated in the sub-group of 225 MIH children with all 'index' teeth erupted (1,286 affected teeth, 776 molars and 510 incisors), with mean number of affected teeth per child being 5.7; separately for molars 3.4 and for incisors 2.2. In these cases 28.4% of the children had only molars affected and 71.6% had both molars and incisors. In descending order the associations of affected teeth more frequently found were: 4 molars/2 incisors (23.5%), 4 molars/4 incisors (16.8%), 4 molars alone (15.1%) and 2 molars alone (9.7%), the remaining being much less. As age increased the clinical severity of the affected teeth became more prevalent (p=0.0001), and when the total number of affected teeth was assessed the likelihood of having severe defect was also increased (p=0.001). The prevalence of the defect in the present study was 10.2% with maxillary teeth being more frequently affected. Severity increased with age. Mild defects were much more frequent, particularly in incisors. The total number of teeth affected and the most frequently found associations were, 4 molars/2 incisors, 4 molars/4 incisors, 4 molars alone and 2 molars alone.

[Comparison of treatment results between implant anchorage and traditional intraoral anchorage in patients with maxillary protrusion].

PubMed

Ma, Ning; Li, Wei-Ran; Chen, Xiao-Hong; Zheng, Xu

2016-08-01

To compare the treatment effects in patients with maxillary protrusion between implant anchorage and traditional intraoral anchorage. Thirty patients with maxillary protrusion treated with bilateral maxillary first premolars extractions and high anchorage were selected. They were randomly divided into implant anchorage group and traditional intraoral anchorage group. Each group had 15 cases. The casts and the cephalograms were obtained before treatment (T1) and after treatment (T2). Three-dimensional model analysis was used to compare the teeth movements between the two groups and cephalometric analysis was used to compare the changes of skeletal and soft tissues. The differences were analyzed with SPSS 17.0 software package. In the implant anchorage group, the upper central incisors were retracted by (6.661±1.328) mm and intruded by (0.129±1.815) mm. In the traditional intraoral anchorage group, the upper central incisors were retracted by (5.788±2.009) mm and extruded by (2.623±1.776) mm. There was no significant difference between the two groups in sagittal movement (P>0.05), but there was significant difference in vertical movement (P<0.05). In the implant anchorage group, the upper first molars were protracted by (0.608±1.045) mm, intruded by (0.608±1.045) mm and moved palatally by (0.477±0.904) mm. In the traditional intraoral anchorage group, the upper first molars were protracted by (1.503±0.945) mm, extruded by (0.072±0.690) mm and moved palatally by (0.883±0.752)mm. There was significant difference between the two groups in sagittal movement and vertical movement (P<0.05), but there was no significant difference in horizontal movement(P>0.05). There was no significant difference between the two groups in the changes of cephalometric measurements of skeletal and soft tissues (P>0.05). Implant anchorage may be superior in vertical control of the maxillary incisors and also superior in sagittal and vertical control of the maxillary molars to traditional intraoral anchorage during management of maxillary protrusion.

Recovery of multiple impacted maxillary teeth in a hyperdivergent Class I patient using Temporary Skeletal Anchorage Devices and augmented corticotomy.

PubMed

Kim, Kyung A; Hwang, Hyeon-Shik; Chung, Kyu-Rhim; Kim, Seong-Hun; Nelson, Gerald

2018-01-01

Treatment of multiple impacted teeth is challenging. Three-dimensional treatment planning can help in delivering a better outcome. This case report presents a patient with an incomplete dental transposition between the canine and lateral incisor of the maxillary right side associated with the impaction of a dilacerated right central incisor. Using a two-stage surgical exposure and augmented corticotomy, the patient's occlusion and smile esthetics were significantly improved, and Class I occlusal relationships with optimal overjet and overbite were achieved after 50 months of orthodontic treatment. Thirty-month posttreatment records revealed a stable result.

Three-dimensional analysis of the change in the curvature of the smiling line following orthodontic treatment in incisor class II division 1 malocclusion.

PubMed

Mah, Michael; Tan, Wei Chuan; Ong, Sim Heng; Chan, Yiong Huak; Foong, Kelvin

2014-12-01

To investigate the different effects of changes in the occlusal plane, incisors inclination, and maxillary intercanine width on the curvature of the smiling line. Records of 46 subjects (28 females and 18 males, mean age 16.6 ± 4.2 years) with incisor class II division 1 malocclusions were selected. All subjects had four premolar extractions and were treated with preadjusted edgewise appliances. Pre- and post-treatment maxillary dental digital models were virtually aligned via corresponding landmarks to the respective lateral cephalograms. Subsequent two-dimensional superimposition of the aligned cephalograms facilitated the three-dimensional superimposition of the pre- and post-treatment models. This process allowed the quantification of the curvature from a frontal perspective of the models. The change in curvature was then correlated with changes in the cephalometric inclination of the anterior occlusal plane (AOP), functional occlusal plane (FOP), maxillary central incisor (U1), and the intercanine width. Orthodontic correction in this sample resulted in the clockwise rotation of the anterior occlusal plane (5.84 degrees), reduction in proclination of the incisors (-14.39 degrees), increase in intercanine width (2.48mm), and a corresponding increase in the curvature of the smiling line (6.83 degrees). The change in curvature of the smiling line in these subjects was found to be related more significantly to the magnitude of difference in the inclination between the pre-treatment AOP and FOP than to the change in the inclination of the maxillary incisors. With orthodontic treatment, the smiling line can be correlated with cephalometric data to improve or maintain the curvature. © The Author 2013. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Apical root resorption in maxillary incisors when employing micro-implant and J-hook headgear anchorage: a 4-month radiographic study.

PubMed

Wang, Qingzhu; Chen, Wenjing; Smales, Roger J; Peng, Hui; Hu, Xiaokun; Yin, Lu

2012-10-01

This study evaluated, over a 4-month study period, the amount of apical root resorption occurring in maxillary central incisors following their retraction when employing either micro-implant or J-hook headgear anchorage. The prospective randomised clinical trial was conducted in Orthodontic Clinic, College of Stomatology, China from 2008-2009. Subjects are patients requiring fixed appliances on waiting list (n=20). In female Han Chinese patients aged from 16-26 years, standardized periapical radiographs from 10 randomly assigned patients with maxillary protrusions comprising the micro-implant group, and from 10 similar patients comprising the J-hook headgear group, were assessed for maxillary central incisor apical root resorption. Measurements before and after orthodontic therapy were also obtained from lateral cephalometric radiographs to calculate incisor horizontal retraction and vertical intrusion distances. Estimated retraction force vectors were calculated in horizontal and vertical directions for both treatment groups. Data analysis employed t-tests and the Pearson correlation test, with α=0.05 for statistical significance. The results showed that when compared with the J-hook group, significantly more apical root resorption shortening of the maxillary central incisors was observed in the micro-implant group (1.27 mm difference, 95% CI=0.70-1.84, P<0.001), which was associated with a significantly larger retraction distance (P=0.004) and a smaller vertical force component (P<0.0001). We are led to conclude that continuous activation of the nickel-titanium coil springs used in the micro-implant group resulted in significantly more apical root resorption shortening and maxillary central incisor retraction than when intermittent J-hook retraction was employed. The employment of continuous duration orthodontic forces presents a risk for increased apical root resorption that requires careful radiographic monitoring.

The efficacy of infiltration anaesthesia for adult mandibular incisors: a randomised double-blind cross-over trial comparing articaine and lidocaine buccal and buccal plus lingual infiltrations.

PubMed

Jaber, A; Whitworth, J M; Corbett, I P; Al-Baqshi, B; Kanaa, M D; Meechan, J G

2010-11-01

To compare the efficacy of 2% lidocaine and 4% articaine both with 1:100,000 adrenaline in anaesthetising the pulps of mandibular incisors. Thirty-one healthy adult volunteers received the following local anaesthetic regimens adjacent to a mandibular central incisor: 1) buccal infiltration of 1.8 mL lidocaine plus dummy lingual injection (LB), 2) buccal plus lingual infiltrations of 0.9 mL lidocaine (LBL), 3) buccal infiltration of 1.8 mL articaine plus dummy lingual injection (AB), 4) buccal plus lingual infiltrations of 0.9 mL articaine (ABL). Pulp sensitivities of the central incisor and contralateral lateral incisor were assessed electronically. Anaesthetic efficacy was determined by two methods: 1) Recording the number of episodes with no responses to maximal electronic pulp tester stimulation during the course of the study period, 2) recording the number of volunteers with no response to maximal pulp tester stimulation within 15 min and maintained for 45 min (defined as sustained anaesthesia). Data were analysed by McNemar, chi-square, Mann-Whitney and paired t-tests. For both test teeth, the number of episodes of no sensation on maximal stimulation was significantly greater after articaine than lidocaine for both techniques. The split buccal plus lingual dose was more effective than the buccal injection alone for both solutions (p <0.001). 4% articaine was more effective than 2% lidocaine when comparing sustained anaesthesia in both teeth for each technique (p <0.001), however, there was no difference in sustained anaesthesia between techniques for either tooth or solution. 4% articaine was more effective than 2% lidocaine (both with 1:100,000 adrenaline) in anaesthetising the pulps of lower incisor teeth after buccal or buccal plus lingual infiltrations.

Lower incisor dentoalveolar compensation and symphysis dimensions among Class I and III malocclusion patients with different facial vertical skeletal patterns.

PubMed

Molina-Berlanga, Núria; Llopis-Perez, Jaume; Flores-Mir, Carlos; Puigdollers, Andreu

2013-11-01

To compare lower incisor dentoalveolar compensation and mandible symphysis morphology among Class I and Class III malocclusion patients with different facial vertical skeletal patterns. Lower incisor extrusion and inclination, as well as buccal (LA) and lingual (LP) cortex depth, and mandibular symphysis height (LH) were measured in 107 lateral cephalometric x-rays of adult patients without prior orthodontic treatment. In addition, malocclusion type (Class I or III) and facial vertical skeletal pattern were considered. Through a principal component analysis (PCA) related variables were reduced. Simple regression equation and multivariate analyses of variance were also used. Incisor mandibular plane angle (P < .001) and extrusion (P  =  .03) values showed significant differences between the sagittal malocclusion groups. Variations in the mandibular plane have a negative correlation with LA (Class I P  =  .03 and Class III P  =  .01) and a positive correlation with LH (Class I P  =  .01 and Class III P  =  .02) in both groups. Within the Class III group, there was a negative correlation between the mandibular plane and LP (P  =  .02). PCA showed that the tendency toward a long face causes the symphysis to elongate and narrow. In Class III, alveolar narrowing is also found in normal faces. Vertical facial pattern is a significant factor in mandibular symphysis alveolar morphology and lower incisor positioning, both for Class I and Class III patients. Short-faced Class III patients have a widened alveolar bone. However, for long-faced and normal-faced Class III, natural compensation elongates the symphysis and influences lower incisor position.

Relationship between crown-root angulation (collum angle) of maxillary central incisors in Class II, division 2 malocclusion and lower lip line.

PubMed

Srinivasan, Bhadrinath; Kailasam, Vignesh; Chitharanjan, Arun; Ramalingam, Arthi

2013-01-01

The present study aimed to measure the magnitude of the collum angle (crown-root angulation) of maxillary central incisors present in Class II, division 2 malocclusion and to relate the changes in its magnitude with variations in the lower lip line. A set of 120 conventional lateral cephalograms were selected and divided into three groups of 40 each based on the type of malocclusion presented: Class II, division 2 (group 1); Class II, division 1 (group 2); and Class I (group 3). The collum angle of the maxillary central incisor was measured, and the lower lip line was recorded. Analysis of variance (ANOVA) revealed that the mean collum angle was statistically significantly different in the three groups. The mean collum angle was greatest in Class II, division 2 malocclusion (group 1). The mean collum angles were 3.24 ± 4.69 degrees, 0.95 ± 1.06 degrees, and 1.05 ± 1.50 degrees in groups 1, 2, and 3 respectively. In χ ² test comparison of the location of the lower lip line (incisal, middle, or apical third of the central incisor) among the three groups, the lower lip line was found to contact the middle third of the central incisor most frequently in Class II, division 2 malocclusion. ANOVA followed by Tukey honestly significant difference (HSD) test showed that the mean collum angle is significantly increased when the lower lip is in the middle third (P < .05) of the central incisor. Variations in magnitude of the collum angle with the change in the lower lip line suggest a probable etiologic role of the lower lip line in the development of the collum angle.

Mean values of Arnett's soft tissue analysis in Maratha ethnic (Indian) population - A cephalometric study.

PubMed

Singh, Shikha; Deshmukh, Sonali; Merani, Varsha; Rejintal, Neeta

2016-01-01

The aim of this article is to evaluate the mean cephalometric values for Arnett's soft tissue analysis in the Maratha ethnic (Indian) population. Lateral cephalograms of 60 patients (30 males and 30 females) aged 18-26 years were obtained with the patients in the Natural Head Position (NHP), with teeth in maximum intercuspation and lips in the rest position. Moreover, hand tracings were also done. The statistical analysis was performed with the help of a statistical software, the Statistical Package for the Social Sciences version 16, and Microsoft word and Excel (Microsoft office 2007) were used to generate the analytical data. Statistical significance was tested atP level (1% and 5% level of significance). Statistical analysis using student's unpaired t-test were performed. Various cephalometric values for the Maratha ethnic (Indian) population differed from Caucasian cephalometric values such as nasolabial inclination, incisor proclination, and exposure, which may affect the outcome of the orthodontic and orthognathic treatment. Marathas have more proclined maxillary incisors, less prominent chin, less facial length, acute nasolabial angle, and all soft tissue thickness are greater in Marathas except lower lip thickness (in Maratha males and females) and upper lip angle (in Maratha males) than those of the Caucasian population. It is a fact that all different ethnic races have different facial characters. The variability of the soft tissue integument in people with different ethnic origin makes it necessary to study the soft tissue standards of a particular community and consider those norms when planning an orthodontic and orthognathic treatment for particular racial and ethnic patients.

Relationship between the maxillary transverse dimension and palatally displaced canines: A cone-beam computed tomographic study.

PubMed

Hong, Wei-Hsin; Radfar, Rebecca; Chung, Chun-Hsi

2015-05-01

To examine the relationship between palatally displaced maxillary canines (PDC) and the maxillary transverse dimension using cone-beam computed tomography (CBCT). Thirty-three patients (11 males and 22 females, mean age 18.2 years) with PDC were matched to 66 patients (22 males and 44 females, mean age 18.1 years) without PDC (control) by gender, age, and posterior occlusion. A CBCT image was taken on all the patients prior to any orthodontic treatment. For each patient the maxillary basal bone widths and interdental widths at the maxillary first molars and first and second premolars were measured on axial and coronal sections of CBCT images. In addition, the presence of permanent tooth agenesis and the widths of maxillary incisors were recorded. Similar maxillary transverse dimensions, both skeletally and dentally, were found between the PDC and control groups. In the PDC group, the number of patients with permanent tooth agenesis was six times higher than in the control group. In addition, the maxillary lateral incisors on PDC-affected sides were smaller than those of control group (P < .05). The maxillary transverse dimension, both skeletally and dentally, had no effect on the occurrence of PDC. The higher prevalence of permanent tooth agenesis was found in the PDC group. Moreover, the mean mesiodistal width of maxillary lateral incisors in the PDC group was significantly smaller than in the control group (P < .05).

Biologic restoration of a traumatized maxillary central incisor in a toddler: a case report.

PubMed

John, Sheen Ann; Anandaraj, S; George, Sageena

2014-01-01

Trauma to the anterior teeth is relatively common in young children and teenagers. Traumatized anterior teeth require quick functional and aesthetic repair, and poses a challenge to the dental practitioner owing to the lack of co-operation ceded and the longer time invested. Reattachment of tooth fragment should be the first choice to restoring teeth when a usable fragment is available, since it gives a psychological and aesthetic advantage over the conventional technique. With the vast improvement in adhesive technology, reattachment is definitely a predictable treatment option for very young children. This paper describes the treatment of a 2½ year old female child who sustained crown-root fracture, extending subgingivally, in primary upper central incisor.

Effect of implant position, angulation, and attachment height on peri-implant bone stress associated with mandibular two-implant overdentures: a finite element analysis.

PubMed

Hong, Hae Ryong; Pae, Ahran; Kim, Yooseok; Paek, Janghyun; Kim, Hyeong-Seob; Kwon, Kung-Rock

2012-01-01

The aim of this study was to analyze and compare the level and distribution of peri-implant bone stresses associated with mandibular two-implant overdentures with different implant positions. Mathematical models of mandibles and overdentures were designed using finite element analysis software. Two intraosseous implants and ball attachment systems were placed in the interforaminal region. The overdenture, which was supported by the two implants, was designed to withstand bilateral and unilateral vertical masticatory loads (total 100 N). In all, eight types of models, which differed according to assigned implant positions, height of attachments, and angulation, were tested: MI (model with implants positioned in the lateral incisor sites), MC (implants in canine sites), MP (implants in premolar sites), MI-Hi (greater height of attachments), MC-M (canine implants placed with mesial inclination), MC-D (canine implants placed with distal inclination), MC-B (canine implants placed with buccal inclination), and MC-L (canine implants placed with lingual inclination). Peri-implant bone stress levels associated with overdentures retained by lateral incisor implants resulted in the lowest stress levels and the highest efficiency in distributing peri-implant stress. MI-Hi showed increased stress levels and decreased efficiency in stress distribution. As the implants were inclined, stress levels increased and the efficiency of stress distribution decreased. Among the inclined models, MC-B showed the lowest stress level and best efficiency in stress distribution. The lowest stress and the best stability of implants in mandibular two-implant overdentures were obtained when implants were inserted in lateral incisor areas with shorter attachments and were placed parallel to the long axes of the teeth.

Apical root resorption in patients treated with comprehensive orthodontics.

PubMed

Harris, E F; Boggan, B W; Wheeler, D A

2001-01-01

External apical root resorption (EARR) is a common--but seldom extreme--consequence of orthodontic treatment. Incisors are most at risk, perhaps because of their single roots and because they typically are moved farther than other teeth. We followed a cohort of patients (n = 153) treated with comprehensive orthodontics. EARR was scored on the upper incisors with a qualitative five-grade ordinal scale. There was no EARR at the start of treatment, but most (> 80%) exhibited slight-to-moderate EARR by the end of treatment (i.e., a loss of 1-2 mm). Cases treated with premolar extractions experienced more EARR because their incisors were retracted farther; however, the sum of the effects of patients' sex and age, and severity of the malocclusion, and the kind of mechanics used accounts for little of the overall variation in EARR. Instead, it appears that genetically-based inter-individual variation in susceptibility to EARR is the most influential factor. Research should be directed at understanding the biochemical nature of susceptibility so prospective patients can be screened to identify those at particular risk.

Health of periodontal tissues and resorption status after orthodontic treatment of impacted maxillary canines.

PubMed

Oz, A Z; Ciger, S

2018-03-01

The aim of the present study was to evaluate the changes of incisor root resorption associated with impacted maxillary canines and health of periodontal tissues around maxillary canines erupted with orthodontic treatment. Twenty patients with a unilateral palatally impacted maxillary canine were included in the study. Cone-beam computed tomography images taken before and after orthodontic treatment were compared with the contralateral canines serving as control teeth. Root resorption was present in 10% of central and 40% of lateral incisors before treatment. After treatment, the incidence of resorption decreased. The thickness of the buccal bone surrounding the impacted canines was similar to that surrounding the contralateral canines, except in the apical area. Periodontal pocket depth and alveolar bone loss were greater for the impacted canine teeth than for the contralateral canines. Incisor root resorption associated with impacted canine teeth showed signs of repair after orthodontic treatment. Slight differences related to periodontal health were found between the previously impacted teeth and contralateral canine teeth.

The Use of a Novel Approach for the Instrumentation of a Cone-beam Computed Tomography-discernible Lateral Canal in an Unusual Maxillary Incisor: Case Report.

PubMed

Chaniotis, Antonis; Filippatos, Christos G

2017-06-01

Lateral and apical ramifications of the main root canal create potential pathways through which bacteria can spread and remain unaffected by treatment procedures. It is a challenge for the specialty to find techniques that can predictably reach, disinfect, and obturate these ramifications. Here, we report the use of a novel instrumentation approach to aid in the negotiation and management of a lateral canal discernible on cone-beam computed tomography (CBCT) in an unusual maxillary central incisor. A 23-year-old female patient was referred for evaluation and possible treatment of tooth 9. The periapical radiographic examination revealed pulp chamber obliteration, existence of a lateral lesion, and a possible complex internal root canal anatomy. The CBCT evaluation revealed the existence of a lateral lesion, a periapical lesion, an additional distopalatal canal, and a lateral canal exiting at the lateral lesion. The diagnosis of asymptomatic apical and lateral periodontitis of tooth 9 was reached. CBCT-aided access cavity preparation and scouting resulted in the successful negotiation of all canals, main and lateral. A novel instrumentation technique with precurved controlled memory files was used for the mechanical preparation of the lateral canal to a 25/04 enlargement. Obturaton of the lateral canal was achieved with a single gutta-percha cone and AH Plus Root Canal Sealer. At the 2-year follow-up, the patient was asymptomatic, and the 2-dimensional radiographic examinations revealed resolution of both the periapical and the lateral lesions. This case report describes the application of a novel instrumentation technique for the mechanical debridement of an infected lateral canal discernible on CBCT and reinforces the importance of treating the root canals as systems that possesses anatomic intricacies that need to be addressed. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Angle Class I malocclusion treated with lower incisor extraction.

PubMed

Barbosa, Vanessa Leal Tavares

2013-01-01

In planning orthodontic cases that include extractions as an alternative to solve the problem of negative space discrepancy, the critical decision is to determine which teeth will be extracted. Several aspects must be considered, such as periodontal health, orthodontic mechanics, functional and esthetic alterations, and treatment stability. Despite controversies, extraction of teeth to solve dental crowding is a therapy that has been used for decades. Premolar extractions are the most common, but there are situations in which atypical extractions facilitate mechanics, preserve periodontal health and favor maintenance of the facial profile, which tends to unfavorably change due to facial changes with age. The extraction of a lower incisor, in selected cases, is an effective approach, and literature describes greater post-treatment stability when compared with premolar extractions. This article reports the clinical case of a patient with Angle Class I malocclusion and upper and lower anterior crowding, a balanced face and harmonious facial profile. The presence of gingival and bone recession limited large orthodontic movements. The molars and premolars were well occluded, and the discrepancy was mainly concentrated in the anterior region of the lower dental arch. The extraction of a lower incisor in the most ectopic position and with compromised periodontium, associated with interproximal stripping in the upper and lower arches, was the alternative of choice for this treatment, which restored function, providing improved periodontal health, maintained facial esthetics and allowed finishing with a stable and balanced occlusion. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO), as part of the requirements for obtaining the BBO Diplomate title.

Four-year follow-up of a polymethyl methacrylate-based bone cement graft for optimizing esthetics in maxillary anterior implants: a case report.

PubMed

Torres, Érica Miranda De; Naldi, Luis Fernando; Bernades, Karina Oliveira; Carvalho, Alexandre Leite

2017-01-01

Tooth loss promotes bone and gingival tissue remodeling, thus breaking the harmony between the residual ridge and natural teeth. This is critical in the anterior region of the mouth, and the integration of several dental specialties is often essential to successful rehabilitation with implants. This article describes a multidisciplinary approach to implant-supported oral rehabilitation in the maxillary anterior region, presenting a new technique for optimizing esthetics in implants. A 19-year-old woman was missing her central and lateral incisors and had 2 dental implants in the lateral incisor sites. The patient exhibited deficient thickness of the alveolar edge, loss of lip support, and absence of gingival architecture, and the implants were improperly placed. A multidisciplinary team created a correct emergence profile through a polymethyl methacrylate-based bone cement graft along with connective tissue grafts. This technique may be a useful therapeutic adjunct in dental implantology, showing good predictability and regular healing procedures.

Changes in anteroposterior position and inclination of the maxillary incisors after surgical-orthodontic treatment of skeletal class III malocclusions.

PubMed

Zou, Bingshuang; Zhou, Yang; Lowe, Alan A; Li, Huiqi; Pliska, Benjamin

2015-12-01

The purpose of this study was to evaluate and compare the anteroposterior (AP) position and inclination of the maxillary incisors in subjects with class I normal occlusion and a harmonious profile with patients with skeletal class III malocclusions, and to investigate the changes in maxillary incisor inclination and AP position after surgical-orthodontic treatment in class III patients. Sixty-five subjects (35 female and 30 male; mean age: 21.8 ± 3.89 years) with normal profiles and class I skeletal and dental patterns were selected as a control sample. Sixty-seven patients (38 female and 29 male; mean age: 21.3 ± 3.31 years) with skeletal and dental class III malocclusions who sought surgical-orthodontic treatment were used as the study sample. Subjects were asked to smile and profile photographs were taken with the head in a natural position and the maxillary central incisors and the forehead in full view; cephalograms were taken and superimposed on the profile pictures according to the outline of the forehead and nose. Forehead inclination, maxillary incisor facial inclination and the AP position of the maxillary central incisor relative to the forehead (FAFFA) were measured on the integrated images and statistical analyses were performed. In both groups, there were no significant male/female differences in either the maxillary central incisor inclination or AP position. Female subjects had a significantly steeper forehead inclination compared with males (P < 0.001) in both groups. After combined surgical-orthodontic treatment, the significant labial inclination (P < 0.001) and posterior positioning (P < 0.001) of the maxillary central incisors had been corrected to close to normal range (P > 0.05). In the control group, 84.6% had the facial axial point (FA) of their maxillary central incisors positioned between lines through the forehead facial axis (FFA) point and the glabella. In the study group, however, 79.1% had the maxillary central incisors positioned posterior to the line through the FFA point and the difference with the control group was statistically significant (P < 0.001). The position of the maxillary central incisors was strongly correlated with forehead inclination in the control sample (r(2) = 0.456; P < 0.01), but only a poor correlation was detected in the class III group (r(2) = 0.177; P > 0.05). With the integrated radiograph-photograph method, the lateral cephalogram was reoriented, which makes it possible to accurately measure the variables on profile photographs. The AP position and inclination of the maxillary central incisors relative to the forehead plays an important role in the esthetics of the profile during smiling and could be an important variable to be considered during diagnosis and treatment planning. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

[Effect of GABA, sodium glutamate and glycine on evoked potentials in the dental zones of the cerebral cortex].

PubMed

Degtiarev, V P

1979-01-01

Intraventricular administration of gamma-aminobutyric acid (GABA) and glycine decreased, whereas sodium glutamate increased the amplitude of primary responses of dental zones of the somatosensory cortex, which arose during electric stimulation of the pulp of the rabbit upper incisors. No changes in the latent periods were recorded.

Alveolar Bone Housing- A Modified Wilkodontics Approach- A Case Report

PubMed Central

Sanjay, Kothamachu; Bhongade, ML; Shrivastav, Sunita

2016-01-01

Accelerated orthodontic treatment is the need of the hour in current scenario as the conventional orthodontics is time taking. Corticotomy assisted orthodontics have been used for years to reduce the treatment duration by reducing the resistance provided by alveolar bone housing. This case report describes the orthodontic treatment combined with the modification in conventional wilkodontic technique in a patient to accelerate tooth movement and shorten the treatment time with an anterior open bite and flared and spaced upper and lower incisors. Firstly plaque control was achieved with supra and subgingival scaling. A modified approach using periodontal access flap followed by vertical bone cuts in the cortical bone from the crest of the alveolar bone margin to 2mm-3mm below the apices of all the anterior teeth extending from upper left canine to upper right canine were performed. These vertical cuts were joined by horizontal cuts apically and flap repositioned. An MBT 0.018 inch appliance was bonded. Orthodontic therapy proceeded with frequent activation of the appliances to retract the incisors every two weeks. The total treatment time was four and half months with active period of two months and no adverse effects were observed at the end of active treatment. The modified decortication technique reduced the treatment time to a considerable extent. The interdental spacing closed and optimum overjet and overbite was achieved. PMID:27656577

Effect of low-level laser therapy (λ780 nm) on the mechanically damaged dentin-pulp complex in a model of extrusive luxation in rat incisors.

PubMed

de Santana, Dandara Andrade; Fonseca, Gabriela Ferraz; Ramalho, Luciana Maria Pedreira; Rodriguez, Tânia Tavares; Aguiar, Marcio Cajazeira

2017-12-01

In order to regenerate the dental pulp, many strategies have been developed as phototherapy. In the pulp repair, we do not know if gallium-aluminum-arsenide (GaAlAs) laser preserves the primary odontoblasts or stimulates the formation of more dentin matrix when dental pulp is damaged. The aim of the present study was to examine the effect of laser phototherapy (λ780 nm) on vascularization, inflammation, density of the primary odontoblast layer, and formation of reactionary and reparative dentin in the dental pulp by provoking extrusion of the rat incisor. The upper incisors were extruded 3 mm and then repositioned into their original sockets followed by a laser irradiation of the palatal mucosa (λ = 780 nm; p = 70 mW; CW; 4.2 J/cm 2 ; 60 s) every 48 h. Non-traumatized and/or non-irradiated incisors were used as the controls. At 8 and 30 days after surgery, incisors were processed for histological and histomorphometric analysis. Morphological analysis revealed no differences in vascularization between groups, but showed discrete inflammation in some non-irradiated and injured specimens, which correlated with a more irregular reparative dentin. The density of primary odontoblasts in the groups treated with lasers was higher when compared to non-irradiated groups, but no statistically significant difference between groups (p > 0.05). The thickness of the tertiary dentin was increased in both traumatized groups with no statistically significant difference between non-irradiated and irradiated groups (p > 0.05).The present findings revealed that the GaAlAs laser induced small changes on dentin-pulp complex, with more regular dentin matrix in the irradiated dental pulps.

[Exploring a new method for superimposition of pre-treatment and post-treatment mandibular digital dental casts in adults].

PubMed

Dai, F F; Liu, Y; Xu, T M; Chen, G

2018-04-18

To explore a cone beam computed tomography (CBCT)-independent method for mandibular digital dental cast superimposition to evaluate three-dimensional (3D) mandibular tooth movement after orthodontic treatment in adults, and to evaluate the accuracy of this method. Fifteen post-extraction orthodontic treatment adults from the Department of Orthodontics, Peking University School and Hospital of Stomatology were included. All the patients had four first premolars extracted, and were treated with straight wire appliance. The pre- and post-treatment plaster dental casts and craniofacial CBCT scans were obtained. The plaster dental casts were transferred to digital dental casts by 3D laser scanning, and lateral cephalograms were created from the craniofacial CBCT scans by orthogonal projection. The lateral cephalogram-based mandibular digital dental cast superimposition was achieved by sequential maxillary dental cast superimposition registered on the palatal stable region, occlusal transfer, and adjustment of mandibular rotation and translation obtained from lateral cephalogram superimposition. The accuracy of the lateral cephalogram-based mandibular digital dental cast superimposition method was evaluated with the CBCT-based mandibular digital dental cast superimposition method as the standard reference. After mandibular digital dental cast superimposition using both methods, 3D coordinate system was established, and 3D displacements of the lower bilateral first molars, canines and central incisors were measured. Differences between the two superimposition methods in tooth displacement measurements were assessed using the paired t-test with the level of statistical significance set at P<0.05. No significant differences were found between the lateral cephalogram-based and CBCT-based mandibular digital dental cast superimposition methods in 3D displacements of the lower first molars, and sagittal and vertical displacements of the canines and central incisors; transverse displacements of the canines and central incisors differed by (0.3±0.5) mm with statistical significance. The lateral cephalogram-based mandibular digital dental cast superimposition method has the similar accuracy as the CBCT-based mandibular digital dental cast superimposition method in 3D evaluation of mandibular orthodontic tooth displacement, except for minor differences for the transverse displacements of anterior teeth. This method is applicable to adult patients with conventional orthodontic treatment records, especially the previous precious orthodontic data in the absence of CBCT scans.

Mini-implant-borne Pendulum B appliance for maxillary molar distalisation: design and clinical procedure.

PubMed

Wilmes, Benedict; Katyal, Vandana; Drescher, Dieter

2014-11-01

A treatment objective of upper molar distalisation may often be required during the correction of a malocclusion. Distalisation is not only indicated for the management of Class II patients, but also for Class III surgery patients who require decompensation in the upper arch if upper incisor retrusion is needed. Unfortunately, most conventional intra-oral devices for non-compliance maxillary molar distalisation experience anchorage loss. A Pendulum type of appliance and a mini-implant-borne distalisation mechanism have been designed which can be inserted at chair-side, without a prior laboratory procedure and immediately after mini-implant placement. For re-activation purposes, a distal screw may be added to the Pendulum B appliance.

Influence of magnification and superimposition of structures on cephalometric diagnosis.

PubMed

Paula, Leonardo Koerich de; Solon-de-Mello, Priscilla de Almeida; Mattos, Claudia Trindade; Ruellas, Antônio Carlos de Oliveira; Sant'Anna, Eduardo Franzotti

2015-01-01

The purpose of this study was to assess the influence of magnification and superimposition of structures on CBCT-generated lateral cephalometric radiographs (LCR) using different segments of the cranium. CBCT scans of 10 patients were selected. Four LCR were generated using Dolphin Imaging(r) software: full-face, right side, left side and center of the head. A total of 40 images were imported into Radiocef Studio 2(r), and the angles of the most common cephalometric analyses were traced by the same observer twice and within a 10-day interval. Statistical analyses included intraexaminer agreement and comparison between methods by means of intraclass correlation coefficient (ICC) and Bland-Altman agreement tests. Intraexaminer agreement of the angles assessed by ICC was excellent (> 0.90) for 83% of measurements, good (between 0.75 and 0.90) for 15%, and moderate (between 0.50 and 0.75) for 2% of measurements. The comparison between methods by ICC was excellent for 68% of measurements, good for 26%, and moderate for 6%. Variables presenting wider confidence intervals (> 6o) in the Bland-Altman tests, in intraexaminer assessment, were: mandibular incisor angle, maxillary incisor angle, and occlusal plane angle. And in comparison methods the variables with wider confidence interval were: mandibular incisor, maxillary incisor, GoGn, occlusal plane angle, Frankfort horizontal plane (FHP), and CoA. Superimposition of structures seemed to influence the results more than magnification, and neither one of them significantly influenced the measurements. Considerable individual variability may occur, especially for mandibular and maxillary incisors, FHP and occlusal plane.

[Finite element analysis of mechanical characteristics during retracting mandibular incisors through sliding mechanics].

PubMed

Gu, Yong-Jia; Wu, Yan-Ping; Gao, Mei-Qin; Yao, Ning; Chen, Wen-Jing

2008-10-01

To analyze the mechanical characteristic changes of teeth and arch under different loading direction during retracting mandibular incisors through implant, simulating clinical loading system. Three- dimensional finite element model, including brackets, archwire, crampable hooks and implants, was reconstructed. The force direction was determined by connecting the points in crampable hook and the center point of implant, and the force point and force direction were changed with the adjustment of the height of crampable hook and the height of implant. Then three-dimensional movement trend of teeth, stress distribution in periodontal membrane and the largest displacement of archwire nodes in each group were calculated and analyzed. SPSS13.0 software package was used for statistical analysis. It was found that the height of implant and the height of crampable hook were correlated with the movement of teeth and stress distribution in periodontal membrane (P<0.01). The movement trend of teeth in the condition of different height of implant and different height of crampable hook was illustrated as follows:(1)with the height increase of crampable hook, the movement trend of the central and lateral incisors varied from mesial lingual tipping to mesial labial tipping. However, canines tipped distally and lingually; the second premolars tipped mesially and lingually, and the first molar roots tipped distally and buccally with decreasing tipping angle. (2) The largest stress distribution in the whole arch was located in the labial apical one-third area of the lateral incisors, while that of canines and the first molars was located in the alveolar ridges and root bifurcations. These findings indicate that the different movement trend during retracting anterior teeth can be achieved through the adjustment of the height of crampable hook, and implant, anchorage can effectively control anterior movement of the posterior teeth. Supported by Research Fund of Bureau of Science and Technology of Nantong City (Grant No. S40023).

Influence of Preadjusted Bracket Shape and Positioning Reference on Angulation of Upper Central Incisor.

PubMed

Topolski, Francielle; de O Accorsi, Mauricio A; Trevisi, Hugo J; Cuoghi, Osmar A; Moresca, Ricardo

2016-10-01

To verify the influence of different bracket shapes and placement references according to Andrews and MBT systems on the expression of angulation in upper central incisors (UCI). Bracket positioning and mesiodistal dental movement simulations were performed and the angulations produced in the dental crown were evaluated, based on computed tomography scan images of 30 UCI and AutoCAD software analysis. Rectangular (Andrews) and rhomboid (MBT) brackets were placed according to the references recommended by Andrews and MBT systems - long axis of the clinical crown (LACC) and incisal edge (IE) respectively. Data showed that the use of LACC as reference for bracket positioning produced 5° and 4° UCI angulations in Andrews and MBT brackets respectively. The use of IE produced a 1.2° mean angulation in UCI for both brackets. When the LACC was used as reference for bracket positioning, the UCI crown angulation corresponded to the angulation built into the brackets, regardless of shape, while the use of IE resulted in natural crown angulation, regardless of bracket shape. This research contributes to guide the orthodontist in relation to the different treatment techniques based on the use of preadjusted brackets.

Upper airway changes after Xbow appliance therapy evaluated with cone beam computed tomography.

PubMed

Erbas, Banu; Kocadereli, Ilken

2014-07-01

To determine the treatment effects of the Xbow appliance on the upper airway dimensions and volume using cone-beam computed tomography (CBCT); to evaluate the cephalometric changes in the skeletal and dental structures of the skeletal Class II patients. The sample consisted of 25 Class II patients (11 male, 14 female) with a mean age of 11.1 ± 1.1 years. CBCT images were obtained at the beginning of the treatment (T0) and after the debonding of the Xbow (T1). Changes in superior, middle, and inferior parts of the oropharynx in the retroglossal region and changes in the oropharyngeal airway volume were statistically significant (P < .05, P < .01). The differences favoring the Xbow for the changes in the direction of Class II correction included SNA, SNB, ANB, maxillary depth angles, and point A-NPg and Co-B distances. Data of the dental parameters showed palatal tipping and extrusion of the maxillary incisors, labial tipping of the mandibular incisors, and mesial movement and extrusion of the mandibular molars. Treatment with the Xbow appliance in Class II patients resulted in favorable increase in the oropharyngeal airway dimensions and volume. Further studies with larger study samples and with control groups are needed.

The accuracy of image-guided navigation for maxillary positioning in bimaxillary surgery.

PubMed

Sun, Yi; Luebbers, Heinz-Theo; Agbaje, Jimoh Olubanwo; Lambrichts, Ivo; Politis, Constantinus

2014-05-01

The aim of our study was to evaluate the accuracy of image-guided maxillary positioning in sagittal, vertical, and mediolateral direction. Between May 2011 and July 2012, 17 patients (11 males, 6 females) underwent bimaxillary surgery with the use of intraoperative surgical navigation. During Le Fort I osteotomy, the Kolibri navigation system was used to measure movement of the maxilla at the edge of the upper central upper incisor in sagittal (buccal surface), vertical (incisor edge), and mediolateral (dental midline) direction. Six weeks after surgery, a postoperative CBCT scan was taken and registered to the preoperative cone-beam computed tomography scan to identify the actual surgical movement of the maxilla. Student 2-tailed paired t test was used to evaluate differences between the measured result from navigation system and actual surgical movement of the maxilla, which were 0.44 ± 0.35 mm (P = 0.82) in the sagittal, 0.50 ± 0.35 mm (P = 0.85) in the vertical, and 0.56 ± 0.36 mm (P = 0.81) in the mediolateral direction. Our finding demonstrates that intraoperative computer navigation is a promising tool for measuring the surgical change of the maxilla in bimaxillary surgery.

Comparison of short-term effects between face mask and skeletal anchorage therapy with intermaxillary elastics in patients with maxillary retrognathia.

PubMed

Ağlarcı, Cahide; Esenlik, Elçin; Fındık, Yavuz

2016-06-01

The aim of this study was to compare the short-term dental and skeletal effects of a face mask (FM) with those of skeletal anchorage (SA) therapy with intermaxillary elastics in prepubertal patients with skeletal Class III malocclusion. Fifty patients with skeletal Class III malocclusion and maxillary deficiency were divided into two groups. In the FM group, an FM was applied by a bite plate with a force of 400g for each side. In the SA group, mini-plates were placed between mandibular lateral incisors and canines, and mini-implants were inserted between maxillary second premolars and first molars. A bite plate was inserted into the upper arch, and Class III elastics were applied with a force of 200g between each mini-plate and mini-implant. Mean treatment durations were 0.52±0.09 years for FM and 0.76±0.09 years for SA. After the treatment, statistically significant increases in SNA°, ANB°, A-y, 1-NA, SnGoGn°, Co-A, Co-Gn, and A-Nperp, and reductions in SNB° and FH┴N-Pg were observed in both groups, and these changes were similar in both groups. In the FM group, 1-NB decreased significantly, and in the SA group, it increased significantly (P < 0.05). The undesired dentoalveolar effects of the FM treatment were eliminated with SA treatment, except with regard to lower incisor inclination. Favourable skeletal outcomes can be achieved by SA therapies, which could be an alternative to the extraoral appliances frequently applied to treat skeletal Class III patients with maxillary deficiency. © The Author 2015. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Tooth, skin, hair and eye colour interrelationships in Greek young adults.

PubMed

Lagouvardos, Panagiotis E; Tsamali, Ioana; Papadopoulou, Christine; Polyzois, Gregory

2013-01-01

The purpose of this study was to investigate the possible interrelationships of teeth, skin, eye and hair colour. A portable colorimeter (Shade Eye NCC/Shofu) was used to record the colour in the CIELAB system of the upper right incisors in 150 dental school students, along with their skin colour at three different areas. Natural hair and eye colour was classified into several categories by a trained examiner (ICC 0.93-0.99). One-way ANOVA and correlation tests were used to statistically analyse the data. Skin was found to have significantly higher L*, b* but lower a* values than teeth (p < 0.05). A significant correlation (p < 0.05) of teeth to skin L* and a*colour coordinate was found, but not to b* coordinate (p > 0.05). Hair tones were not correlated to teeth L* or b*, but only to a*coordinate. Teeth and eye colour coordinates were not correlated (p > 0.05). Eye and hair tones were found to have the highest significant correlation (ρ = 0.369). In conclusion, teeth of this cohort were found to be lighter, less red and yellow than the skin. Teeth colour was not related to eye colour, but lighter teeth were found to be associated with lighter skins, and redder lateral incisors to lighter hair. Darker facial skins or yellower forehead areas were also associated with darker hair and vice versa. The clinical relevance of the study is that the investigated facial characteristics are inter-correlated weakly to moderately, and for this reason predicting the colour parameters of one facial characteristic by another would not be accurate, but helpful for a rough colour selection as associations show.

Dentoskeletal Effects of the Modified Tandem Appliance vs the Facemask Appliance in the Treatment of Skeletal Class III Malocclusion: A Single-center, Randomized Controlled Trial.

PubMed

Husson, Amro H; Burhan, Ahmad S; Salma, Fadwa B; Nawaya, Fehmieh R

2016-07-01

The aim of this randomized controlled trial was to compare the skeletal and dentoalveolar effects of the modified tandem appliance (MTA) vs the facemask (FM) with rapid maxillary expansion. Thirty-two patients, aged 7 to 9 years were recruited. Eligibility criteria included skeletal class III malocclusion that resulted from the retrusion of the maxilla. Randomization was accomplished to divide the sample into two equal groups to be treated with either MTA or FM. Lateral cephalometric radiographs were obtained before treatment and after 2 mm positive overjet was achieved. Intragroup comparisons were performed using paired-sample t-test, and intergroup comparisons were performed using two-sample t-test at the p ≤ 0.05 level. Thirty-two patients (16 in each group) were available for statistical analysis. The pretreatment variables of both groups were similar. Both treatment therapies showed similar significant increase in the SNA and ANB angles, accompanied by slight decrease in the SNB angle. The increase in the SN:GoMe angle, Bjork's sum, and the overjet were significantly greater in the FM group. The forward movement of upper dentition was similar in both groups. Although the lower incisors retrusion was significantly greater in the FM group than in the MTA group, the uprighting of the lower molars was significantly greater in the MTA group. Both appliances showed similar effects apart from less clockwise rotation of the mandible, less retrusion of the lower incisors, and greater uprighting of the lower molars in the MTA group. Both the MTA and the FM groups are effective in treating class III malocclusion. The MTA group is more efficient in controlling the clockwise rotation and gaining some space in the lower arch.

Tooth angulation and dental arch perimeter-the effect of orthodontic bracket prescription.

PubMed

Pontes, Luana F; Cecim, Rodolpho L; Machado, Sissy M; Normando, David

2015-08-01

The aim of this study was to evaluate the effects of upper incisors and canine angulations introduced by different bracket prescriptions on dental arch perimeter. Cone beam computerized tomography scans collected using I-Cat (Imaging Sciences International, Hatfield, PA, USA) were selected conveniently from a database of routine exams of a clinical radiology center. Crown and radicular measurements of upper incisors and canines were made and exported to the Autocad 2011 software to create a virtual dental model. The virtual teeth were positioned with an angulation of zero; thereafter, a reference value for the perimeter of the arch was measured. Furthermore, teeth angulations were applied according to the standards of the Edgewise bracket system and the Straight-wire systems: MBT, Capelozza, Andrews, and Roth. The largest linear distances for tooth crown (anterior arch perimeter) and root (radicular distance) were obtained for each bracket prescription. The anterior perimeter for well-aligned incisors and canines without angulation was used as reference (crown: 47.34mm; root: 39.13mm). An increase in the arch perimeter was obtained for all bracket prescriptions evaluated, which ranged from 0.28 and 3.19mm in the Edgewise technique, for the crown and root measurements, respectively, to 1.09 and 11.28mm for the Roth prescription. Bracket prescriptions with greater angulation led to an increased use of space within the dental arch, mainly in the radicular region. The consequence of this radicular angular displacement will need to be further investigated. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Coordinating bracket torque and incisor inclination : Part 3: Validity of bracket torque values in achieving norm inclinations.

PubMed

Zimmer, Bernd; Sino, Hiba

2018-03-19

To analyze common values of bracket torque (Andrews, Roth, MBT, Ricketts) for their validity in achieving incisor inclinations that are considered normal by different cephalometric standards. Using the equations developed in part 1 (eU1 (BOP) = 90° - BT (U1) - TCA (U1) + α 1 - α 2 and eL1 (BOP) = 90° - BT (L1) - TCA (L1) + β 1 - β 2 ) (abbreviations see part 1) and the mean values (± SD) obtained as statistical measures in parts 1 and 2 of the study (α 1 and β 1 [1.7° ± 0.7°], α 2 [3.6° ± 0.3°], β 2 [3.2° ± 0.4°], TCA (U1) [24.6° ± 3.6°] and TCA (L1) [22.9° ± 4.3°]) expected (= theoretically anticipated) values were calculated for upper and lower incisors (U1 and L1) and compared to targeted (= cephalometric norm) values. For U1, there was no overlapping between the ranges of expected and targeted values, as the lowest targeted value of (58.3°; Ricketts) was higher than the highest expected value (56.5°; Andrews) relative to the bisected occlusal plane (BOP). Thus all of these torque systems will aim for flatter inclinations than prescribed by any of the norm values. Depending on target values, the various bracket systems fell short by 1.8-5.5° (Andrews), 6.8-10.5° (Roth), 11.8-15.5° (MBT), or 16.8-20.5° (Ricketts). For L1, there was good agreement of the MBT system with the Ricketts and Björk target values (Δ0.1° and Δ-0.8°, respectively), and both the Roth and Ricketts systems came close to the Bergen target value (both Δ2.3°). Depending on target values, the ranges of deviation for L1 were 6.3-13.2° for Andrews (Class II prescription), 2.3°-9.2° for Roth, -3.7 to -3.2° for MBT, and 2.3-9.2° for Ricketts. Common values of upper incisor bracket torque do not have acceptable validity in achieving normal incisor inclinations. A careful selection of lower bracket torque may provide satisfactory matching with some of the targeted norm values.

Hard and soft tissue augmentation in a postorthodontic patient: a case report.

PubMed

Bonacci, Fred J

2011-02-01

A combination of hard and soft tissue grafting is used to augment a thin biotype. A 26-year-old woman with mandibular anterior flaring and Miller Class I and III recessions requested interceptive treatment. Surgery included a full-thickness buccal flap, intramarrow penetrations, bone graft placement, and primary flap closure. Postoperative visits were at 2 and 4 weeks and 2, 3, and 6 months. Stage-two surgery consisted of submerged connective tissue graft placement. Postoperative visits were completed at 2, 4, 6, and 8 weeks and 1 year. Follow-up was completed 3 years after the initial surgery. Interradicular concavities were resolved and gingival biotype was augmented. Soft tissue recession remained at 6 months. Reentry revealed clinical labial plate augmentation; 2 mm was achieved at the lateral incisors and the left central incisor and 3 mm was achieved at the right canine. No bone augmentation was achieved on the left canine and right central incisor. The dehiscence at the right central incisor appeared narrower. Overall, a 2- to 3-mm gain in alveolar bone thickness/height was observed. Two months after stage-two surgery, near complete root coverage was achieved; 1 mm of recession remained on the left central incisor. There was a soft tissue thickness gain of 2 mm without any visual difference in keratinized tissue height. Interradicular concavities were eliminated; the soft tissue was augmented and the gingival biotype was altered. Interdental soft tissue craters remained. One year after connective tissue graft placement, there was near complete root coverage at the left central incisor, which at 2 months experienced residual recession. Interradicular concavities and interdental soft tissue craters were eliminated with soft tissue augmentation, including clinical reestablishment of the mucogingival junction. Clinical stability remained 3 years after the initial surgery, with the patient noting comfort during mastication and routine oral hygiene. A clinical increase in labial plate thickness, in conjunction with soft tissue augmentation, appears to provide for continued stability and decreased potential for future clinical attachment loss.

Regenerative Endodontic Treatment versus Apical Plug in Immature Teeth: Three-Year Follow-Up.

PubMed

Asgary, Saeed; Fazlyab, Mahta; Nosrat, Ali

This report compares and evaluates the treatment outcomes of regenerative endodontic treatment and apical plug as two accepted treatment protocols in a pair of necrotic immature maxillary central incisors of a 12-year old female. The patient was referred complaining of a dull pain and swelling in her upper lip area. She had a history of trauma to the anterior maxilla two years earlier. Both teeth were clinically diagnosed with pulp necrosis and periapical radiographs revealed that separate periapical radiolucent lesions surrounded the immature apices of both teeth. The left and right incisors were treated with apical plug and regenerative endodontic treatment, respectively, using calcium-enriched mixture (CEM) cement. The patient was followed-up for three years. During this period, both teeth were clinically asymptomatic and showed complete radiographic healing of the periapical lesions. The right central incisor showed root development. No tooth discoloration was evident. Apexification by apical plug placement and pulp regeneration are both reliable treatments for immature non-vital teeth. In order to choose the right treatment the advantages of either technique should be weighed against its drawbacks. CEM cement can be successfully applied for both purposes. This biomaterial causes less discoloration of the tooth.

Correction of a Severely Rotated Maxillary Incisor by Elastics in Mixed Dentition Complicated by a Mesiodens.

PubMed

Sidiq, Mohsin; Yousuf, Asif; Bhat, Manohar; Sharma, Rajesh; Bhargava, Neha; Ganta, Shravani

2015-01-01

The aim of this case study was to report a potentially convenient approach instead of a conventional orthodontic procedure for correcting severe rotation of anterior tooth of an 11-year-old Indian boy, with a mixed dentition class I malocclusion. The child reported seeking treatment for severely rotated upper right central incisor with mesiodens and a single tooth crossbite. The supernumerary tooth was first extracted and bondable buttons were placed on the rotated tooth, an appliance composed of a removable plate with Adam's clasp with distal extension and a loop for engagement of elastics was delivered. Circumferential supracrestal fibrotomy was performed on the corrected derotated tooth. Then, Hawley's appliance with a z-spring and posterior bite plane was fabricated and placed for correction of crossbite. Thus, this removable appliance can be a simplified and a cost-effective treatment alternative for derotation of anterior tooth, especially during the mixed dentition period. How to cite this article: Sidiq M, Yousuf A, Bhat M, Sharma R, Bhargava N, Ganta S. Correction of a Severely Rotated Maxillary Incisor by Elastics in Mixed Dentition Complicated by a Mesiodens. Int J Clin Pediatr Dent 2015;8(3):234-238.

[Autotransplantation of a maxillary incisor and orthodontic care: a case study].

PubMed

Charpentier, Valentine; Makaremi, Masrour; Brondeau, François de

2017-12-01

Severely impacted teeth with atypical root anatomy do not respond well to orthodontic traction after surgical exposure. Consequently, they are often removed, but replacing them with dental prostheses can prove difficult in patients who are still growing. Thus, autotransplantation seems to be the only way to preserve a natural tooth and the alveolar bone. An upper central incisor impacted in the region of the nasal cavities with an open apex was diagnosed in an 8.5-year-old female patient. The tooth displayed a curved root pressed against the maxillary cortical bone preventing orthodontic traction treatment. Through this clinical case involving autotransplantation of a maxillary incisor report and a review of the literature, this article explores the indications and exposes the different stages of this orthodontic-surgical protocol. In this case, autotransplantation enabled restoration of maxillary arch continuity. After two years of orthodontic treatment, the bone reconstruction of the extraction site was very satisfactory. The benefits of this technique and the precautions to be taken are discussed as well as the various protocols. The increasing success rate of this surgical procedure makes it possible to consider it as a protocol for the future. © EDP Sciences, SFODF, 2017.

Correction of a Severely Rotated Maxillary Incisor by Elastics in Mixed Dentition Complicated by a Mesiodens

PubMed Central

Sidiq, Mohsin; Bhat, Manohar; Sharma, Rajesh; Bhargava, Neha; Ganta, Shravani

2015-01-01

ABSTRACT The aim of this case study was to report a potentially convenient approach instead of a conventional orthodontic procedure for correcting severe rotation of anterior tooth of an 11-year-old Indian boy, with a mixed dentition class I malocclusion. The child reported seeking treatment for severely rotated upper right central incisor with mesiodens and a single tooth crossbite. The supernumerary tooth was first extracted and bondable buttons were placed on the rotated tooth, an appliance composed of a removable plate with Adam’s clasp with distal extension and a loop for engagement of elastics was delivered. Circumferential supracrestal fibrotomy was performed on the corrected derotated tooth. Then, Hawley’s appliance with a z-spring and posterior bite plane was fabricated and placed for correction of crossbite. Thus, this removable appliance can be a simplified and a cost-effective treatment alternative for derotation of anterior tooth, especially during the mixed dentition period. How to cite this article: Sidiq M, Yousuf A, Bhat M, Sharma R, Bhargava N, Ganta S. Correction of a Severely Rotated Maxillary Incisor by Elastics in Mixed Dentition Complicated by a Mesiodens. Int J Clin Pediatr Dent 2015;8(3):234-238. PMID:26604544

Orthognathic Surgery and Implant-Supported Bridge in a Class III Patient Injured in a Motor Vehicle Accident.

PubMed

Honda, Koji; Hirota, Makoto; Iwai, Toshinori; Fujita, Koichi; Omura, Susumu; Ono, Takashi; Tohnai, Iwai

2018-05-01

Occlusal and esthetic rehabilitation of jaw deformities in patients with partially edentulous maxilla are challenging procedures. This article describes a patient involving a skeletal Class III, 36-year-old male patient with a single bilateral anterior partially edentulous maxilla resulting from injuries sustained in a motor vehicle accident; his anterior teeth had been lost for more than 10 years. His lip protruded from the lateral view due to the proclined upper incisors and mandibular protrusion.Because of the facial deformity and inadequate prosthesis of the maxilla, the prosthesis had dropped out repeatedly. Bone deficiency was prominent in the area of the anterior maxillary region and required augmentation for implant restoration.Consultation among the prosthodontist, orthodontist, and patient led to a decision to perform an orthognathic surgery and bone graft before implant treatment. After orthodontic treatment combined with orthognathic surgery, 3 dental implants were placed with simultaneous iliac bone graft for prosthetic rehabilitation. The treatment restored the maxillary dental arch, which supported the upper lip with appropriate occlusion, both esthetically and functionally. After a 2-year clinical follow-up, the orthoprosthesis of the maxilla remained stable, and the patient was satisfied with the outcome of treatment. The combination of orthodontic, surgical, and dental implant treatment could be an option for skeletal Class III patients with bone-deficient, edentulous jaws.

Effect of the vertical position of the canine on the frictional/orthodontic force ratio of Ni-Ti archwires during the levelling phase of orthodontic treatment.

PubMed

Kato, Moeko; Namura, Yasuhiro; Yoneyama, Takayuki; Shimizu, Noriyoshi

2018-05-31

This study investigated the effect of the vertical position of the canine on changes in the frictional/orthodontic (F/O) force ratio of nickel-titanium (Ni-Ti) archwires during the initial levelling phase of orthodontic treatment. Frictional and orthodontic forces were measured by using low-friction brackets and Ni-Ti archwires with three different cross-sectional sizes and force types. To simulate canine malocclusion (first premolar extraction case), the upper right canine was displaced gingivally by 1 to 3 mm and the inter-bracket distance between the upper right lateral incisor and second premolar was set at 15 mm or 20 mm. A three-point bending test was performed to measure the orthodontic force of each Ni-Ti archwire. Frictional forces were measured with a universal testing machine and dental arch models by pulling parallel to the end of the archwire at a crosshead speed of 0.5 mm/min. F/O force ratio was calculated and analysed statistically. At a displacement of 3 mm, few archwires had F/O force ratios of less than 1.0, at which orthodontic force overcame frictional force, thus ensuring extrusion of the canine. For effective tooth movement, orthodontists should use Ni-Ti archwires with an F/O force ratio of less than 1.0.

A cephalometric comparative study of class II correction with Sabbagh Universal Spring (SUS2) and Forsus FRD appliances

PubMed Central

Oztoprak, Mehmet Oguz; Nalbantgil, Didem; Uyanlar, Ayhan; Arun, Tulin

2012-01-01

Objective The purpose of this clinical prospective study was to compare the dentofacial changes produced by the Sabbagh Universal Spring (SUS2) and Forsus FRD appliances in late adolescent patients with Class II malocclusion, and quantify them in comparison with an untreated group. Method: The study was carried out on 59 patients with skeletal and dental Class II malocclusion due to retrognatic mandible. Among these, 20 were treated with SUS2, 20 were treated with FRD, and no treatment was done to 19 subjects as the control group. 36 cephalometric landmarks were identified on each lateral cephalometric radiograph. Results: The effects of both appliances were dentoalveolar and no significant vertical and sagittal skeletal effect on maxilla and mandible was achieved. The retrusion and extrusion of the maxillary incisors as well as the protrusion and intrusion of mandibular incisors were found to be statistically significant in both treatment groups. Soft tissue profile improvement was limited in both treatment groups. Conclusions: Both appliances corrected Class II discrepancies through dentoalveolar changes; however lower incisor proclination was more prominent with the Forsus FRD. PMID:22904659

A cephalometric comparative study of class II correction with Sabbagh Universal Spring (SUS(2)) and Forsus FRD appliances.

PubMed

Oztoprak, Mehmet Oguz; Nalbantgil, Didem; Uyanlar, Ayhan; Arun, Tulin

2012-07-01

The purpose of this clinical prospective study was to compare the dentofacial changes produced by the Sabbagh Universal Spring (SUS(2)) and Forsus FRD appliances in late adolescent patients with Class II malocclusion, and quantify them in comparison with an untreated group. The study was carried out on 59 patients with skeletal and dental Class II malocclusion due to retrognatic mandible. Among these, 20 were treated with SUS(2), 20 were treated with FRD, and no treatment was done to 19 subjects as the control group. 36 cephalometric landmarks were identified on each lateral cephalometric radiograph. The effects of both appliances were dentoalveolar and no significant vertical and sagittal skeletal effect on maxilla and mandible was achieved. The retrusion and extrusion of the maxillary incisors as well as the protrusion and intrusion of mandibular incisors were found to be statistically significant in both treatment groups. Soft tissue profile improvement was limited in both treatment groups. Both appliances corrected Class II discrepancies through dentoalveolar changes; however lower incisor proclination was more prominent with the Forsus FRD.

Risk factors associated with open gingival embrasures after orthodontic treatment.

PubMed

An, Sang Su; Choi, Yoon Jeong; Kim, Ji Young; Chung, Chooryung J; Kim, Kyung-Ho

2018-05-01

To investigate the incidence of and contributing factors to open gingival embrasures between the central incisors after orthodontic treatment. One hundred posttreatment patients (29 men and 71 women; mean age, 24.7 years) were divided retrospectively into occurrence and nonoccurrence groups based on intraoral photographs. Based on the severity, the occurrence group was further divided into mild, moderate, and severe groups. Parameters from periapical radiographs, superimposed lateral cephalograms, and study models were compared between the occurrence and the nonoccurrence groups by using independent t-tests and were also analyzed on the basis of severity via analysis of variance. Logistic regression analysis was performed to identify the contributing factors to open gingival embrasures. The incidence of open gingival embrasures between the central incisors was 22% and 36% in the maxilla and the mandible, respectively. Lingual movement of the incisors, distance from the contact point to the alveolar crest after treatment, antero-posterior overlap of the two central incisors before treatment in the maxilla, and distance from the contact point to the alveolar crest after treatment in the mandible were significantly associated with the occurrence of open gingival embrasures ( P < .05). In the mandible, the amount of intrusion was significantly related to severity ( P < .05). The incidence of open gingival embrasures following orthodontic tooth movement is high. Therefore, attention should be paid to the contributing factors to prevent or reduce the occurrence of open gingival embrasures.

Orthodontic extrusion of Ellis Class VIII fracture of maxillary lateral incisor - The sling shot method.

PubMed

Felicita, A Sumathi

2018-07-01

The aim of this paper is to evaluate the efficacy of forced extrusion using the sling shot elastic. A 21 year adult patient reported with an Ellis Class VIII fracture of the maxillary right lateral incisor. Root canal treatment followed by a fiber reinforced composite post was placed and core build up was done. A metal button was bonded to the tooth. Begg brackets were placed from the second premolar on one side to the second premolar on the opposite side. 0.016″ × 0.025″ stainless steel was placed in ribbon mode. The ligature wire was placed as a sling shot from the button on the fractured tooth to the two adjacent teeth. 4 mm of extrusion was achieved and there was no evidence of root resorption. Forced extrusion was achieved in four months. The sling shot method is a very effective method of ligation. Light forces are delivered over a long duration with definitive results as compared to the inconsistent force delivery with conventional extrusion mechanics.

Influence of injection speed on the effectiveness of incisive/mental nerve block: a randomized, controlled, double-blind study in adult volunteers.

PubMed

Whitworth, John Martin; Kanaa, Mohammad Dib; Corbett, Ian Porter; Meechan, John Gerald

2007-10-01

This randomized, double-blind trial tested the null hypothesis that speed of deposition has no influence on the injection discomfort, efficacy, distribution, and duration of pulp anesthesia after incisive/mental nerve block in adult volunteers. Thirty-eight subjects received incisive/mental nerve blocks of 2.0 mL lidocaine with 1:80,000 epinephrine slowly over 60 seconds or rapidly over 15 seconds at least 1 week apart. Pulp anesthesia was assessed electronically to 45 minutes after injection. Injection discomfort was self-recorded on visual analogue scales. Overall, 48.7% of volunteers developed pulp anesthesia in first molars, 81.8% in bicuspids, and 38.5% in lateral incisors. The mean duration of pulp anesthesia was 19.1 minutes for first molars, 28.5 minutes for bicuspids, and 19.0 minutes for lateral incisors. Speed of injection had no significant influence on anesthetic success or duration of anesthesia for individual teeth. Slow injection was significantly more comfortable than rapid injection (P < .001). The null hypothesis was supported, although slow injection was more comfortable.

On the relevance of "ideal" occlusion concepts for incisor inclination target definition.

PubMed

Knösel, Michael; Jung, Klaus

2011-11-01

The concept of "ideal" occlusion in harmony with craniofacial structures is often proposed as an ultimate goal of orthodontic treatment. The aim of this study was to assess the impact of slight variations in posterior occlusion and the history of straight-wire orthodontic treatment on the predictability of incisor inclination and third-order angles. Axial incisor inclinations, third-order angles, and craniofacial relationships were assessed on lateral headfilms and corresponding dental casts of 75 healthy white subjects, 16 to 26 years old, selected by the general inclusion criterion of a good interincisal relationship. Four groups were formed: group A (n = 17), Angle Class I occlusion subjects with no orthodontic treatment; group B (n = 20), Angle Class I occlusion subjects treated with standardized straight-wire orthodontics; group C (n = 20), up to a half-cusp distal occlusion after straight-wire treatment; and group D (n = 18), up to a half-cusp distal occlusion and no orthodontic treatment. Regression analysis was used to insert predictor angles into selected regression equations of the subjects with "ideal" occlusion, and the absolute differences between predicted and observed response angles were determined. Small differences in incisor inclination were found between subjects with "ideal" occlusion and those who slightly deviated from "ideal" with a mild occlusion of the Angle Class II category. Posterior occlusion was not relevant to the validity of the vast majority of predictor-response pairs. Straight-wire treatment produced incisor inclination that was slightly protruded compared with subjects who had good natural occlusion. The "ideal" posterior occlusion concepts as a general orthodontic treatment goal should be reconsidered. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Lower incisor inclination regarding different reference planes.

PubMed

Zataráin, Brenda; Avila, Josué; Moyaho, Angeles; Carrasco, Rosendo; Velasco, Carmen

2016-09-01

The purpose of this study was to assess the degree of lower incisor inclination with respect to different reference planes. It was an observational, analytical, longitudinal, prospective study conducted on 100 lateral cephalograms which were corrected according to the photograph in natural head position in order to draw the true vertical plane (TVP). The incisor mandibular plane angle (IMPA) was compensated to eliminate the variation of the mandibular plane growth type with the formula "FMApx.- 25 (FMA) + IMPApx. = compensated IMPA (IMPACOM)". As the data followed normal distribution determined by the KolmogorovSmirnov test, parametric tests were used for the statistical analysis, Ttest, ANOVA and Pearson coefficient correlation test. Statistical analysis was performed using a statistical significance of p <0.05. There is correlation between TVP and NB line (NB) (0.8614), Frankfort mandibular incisor angle (FMIA) (0.8894), IMPA (0.6351), Apo line (Apo) (0.609), IMPACOM (0.8895) and McHorris angle (MH) (0.7769). ANOVA showed statistically significant differences between the means for the 7 variables with 95% confidence level, P=0.0001. The multiple range test showed no significant difference among means: APoNB (0.88), IMPAMH (0.36), IMPANB (0.65), FMIAIMPACOM (0.01), FMIATVP (0.18), TVPIMPACOM (0.17). There was correlation among all reference planes. There were statistically significant differences among the means of the planes measured, except for IMPACOM, FMIA and TVP. The IMPA differed significantly from the IMPACOM. The compensated IMPA and the FMIA did not differ significantly from the TVP. The true horizontal plane was mismatched with Frankfort plane in 84% of the sample with a range of 19°. The true vertical plane is adequate for measuring lower incisor inclination. Sociedad Argentina de Investigación Odontológica.

Endosonographic examination of thyroid gland among patients with nonthyroid cancers.

PubMed

Alkhatib, Amer A; Mahayni, Abdulah A; Chawki, Ghaleb R; Yoder, Leon; Elkhatib, Fateh A; Al-Haddad, Mohammad

2016-01-01

There is limited endosonographic literature regarding thyroid gland pathology, which is frequently visualized during upper endoscopic ultrasound (EUS). Our objective was to assess the prevalence of benign and malignant thyroid lesions encountered during routine upper EUS within a cancer center setting. The data were prospectively collected and retrospectively analyzed. All upper EUS procedures performed between October 2012 and July 2014 were reviewed at a large referral cancer center. Data collected included patient demographics, preexisting thyroid conditions, thyroid gland dimensions, the presence or absence of thyroid lesions, and EUS morphology of lesions if present, and interventions performed to characterize thyroid lesions and pathology results when applicable. Two hundred and forty-five EUS procedures were reviewed. Of these, 100 cases reported a detailed endosonographic examination of the thyroid gland. Most of the thyroid glands were endosonographically visualized when the tip of the scope was at 18 cm from the incisors. Twelve cases showed thyroid lesions, out of which three previously undiagnosed thyroid cancers were visualized during EUS (two primary papillary thyroid cancers and one anaplastic thyroid cancer). Transesophageal EUS-guided fine needle aspiration of thyroid lesions was feasible when the lesion was in the inferior portion of the thyroid gland, and the tip of the scope was at 18 cm or more from the incisors. Routine EUS examination may detect unexpected thyroid lesions including malignant ones. We encourage endosonographers to screen the visualized portions of the thyroid gland during routine withdrawal of the echoendoscope.

Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

PubMed

Guarnieri, R; Cavallini, C; Vernucci, R; Vichi, M; Leonardi, R; Barbato, E

2016-11-01

The prevalence of impacted maxillary canine is reported to be between 1% and 3%. The lack of monitoring and the delay in the treatment of the impacted canine can cause different complications such as: displacement of adjacent teeth, loss of vitality of neighbouring teeth, shortening of the dental arch, follicular cysts, canine ankylosis, recurrent infections, recurrent pain, internal resorption of the canine and the adjacent teeth, external resorption of the canine and the adjacent teeth, combination of these factors. An appropriate diagnosis, accurate predictive analysis and early intervention are likely to prevent such undesirable effects. The objective is to evaluate, by means of a retrospective observational study, the possibility of carrying out a predictive analysis of root resorption adjacent to the impacted canines by means of orthopantomographs, so as to limit the prescription of additional 3D radiography. 120 subjects with unilateral or bilateral maxillary impacted canine were examined and 50 patients with 69 impacted maxillary canine (22 male, 28 female; mean age: 11.7 years) satisfied the inclusion criteria of the study. These patients were subjected to a basic clinical and radiographic investigation (orthopantomographs and computerized tomography). All panoramic films were viewed under standardized conditions for the evaluation of two main variables: maxillary canine angulations (a, b, g angles) and the overlapping between the impacted teeth and the lateral incisor (Analysis of Lindauer). Binary logistic regression was used to estimate the likelihood of resorbed lateral incisors depending on sector location and angle measurements. Results indicated that b angle has the greatest influence on the prediction of root resorption (predictive value of b angle = 76%). If β angle <18° and Lindauer = I, the probability of resorption is 0.06. Evaluation of b angle and superimposition lateral incisor/impacted canine analysed on orthopantomographs could be one of the evaluation criteria for prescribing second level examination (CT and CTCB) and for detecting root resorption of impacted maxillary canine adjacent teeth.

Prevalence and distribution of dental anomalies: a comparison between maxillary and mandibular tooth agenesis.

PubMed

Al-Abdallah, Mariam; AlHadidi, Abeer; Hammad, Mohammad; Al-Ahmad, Hazem; Saleh, Raja'

2015-11-01

The aim of this study was to compare the pattern and prevalence of associated dental anomalies between maxillary and mandibular tooth agenesis (hypodontia). A sample of 3315 dental patients, aged 8.6 to 25.4 years, was surveyed for tooth agenesis (excluding third molars): 106 subjects were diagnosed with maxillary hypodontia (group 1) and 70 with mandibular hypodontia (group 2). Both groups were examined for the following dental anomalies: retained deciduous molars, infraocclusion of deciduous molars, impaction, microdontia of maxillary lateral incisors, supernumerary teeth, transposition, transmigration, and ectopic eruption of the permanent molars. For statistical testing, the chi-square test (P <0.05) was used to compare the occurrences of these anomalies among the groups. We found that 77.5% of the patients in the mandibular hypodontia group had at least 1 dental anomaly compared with 49.5% in the maxillary hypodontia group (P <0.0001). The only dental anomaly with a significantly increased prevalence in the maxillary hypodontia group compared with the mandibular hypodontia group was microdontia of the maxillary lateral incisors (groups 1, 46.7%; group 2, 12.9%; P <0.0001). On the other hand, the prevalences of retained deciduous molars (group 1, 9.4%; group 2, 60.0%), infraoccluded deciduous molars (group 1, 0.9%; group 2, 7.1%), and impacted teeth (group 1, 22.6%; group 2, 38.6%) were significantly higher in the mandibular hypodontia group. The prevalences of supernumerary teeth, transposition, transmigration, and ectopic eruption of permanent molars were low and not significantly different between the groups. Tooth agenesis isolated to the maxilla is frequently associated with microdontia of the maxillary lateral incisors, whereas tooth agenesis isolated to the mandible is frequently associated with retained deciduous molars, infraoccluded deciduous molars, and impacted teeth. The results of this study may provide additional evidence supporting the field-specific genetic control theory for dental development in both jaws. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Apical third enlargement of the root canal and its relationship with the repair of periapical lesions

PubMed Central

Souza, Ronaldo Araújo; Dantas, João Costa Pinto; Brandão, Paula Maciel; Colombo, Suely; Lago, Maurício; Duarte, Marco Antônio Húngaro

2012-01-01

Objective: The purpose of this study was to evaluate if the apical third enlargement of root canal is the determinant factor for the repair of periapical lesions in endodontic treatment. Methods: Eighty upper and lower incisors, canines and premolars with periapical lesions were randomly divided in 2 groups and were treated by undergraduate students. Canals were instrumented with up to 3 files in group I (n = 40) and up to 4 files in group II (n = 40) 1 mm short of the apex and were filled with a calcium hydroxide dressing. After removing calcium hydroxide 14 days later, both groups were filled using the lateral condensation technique. In the 2-year follow-up, a few patients did not return, and some cases did not present conditions for accurate comparisons. Therefore, only 43 patients (24 in group I and 19 in group II) presented conditions for radiographic comparisons. Data were statistically analyzed using Fisher's exact test. Results: Comparison of the initial and follow-up radiographs showed that 22 out of 24 (91.67%) patients in group I and 17 out of 19 patients (89.47%) in group II showed repair. Statistical analysis revealed no significant differences between the groups (P>.05). Conclusion: The results of this study show that the apical third enlargement did not alter the outcome of endodontic treatment of teeth with periapical lesion performed by undergraduate students. PMID:23077417

Lingual orthodontics and forced eruption: a means for osseous and tissue regeneration.

PubMed

Paolone, Maria Giacinta; Kaitsas, Roberto; Paolone, Gaetano; Kaitsas, Vassilios

2008-01-01

An hopeless upper central incisor was subjected to forced eruption in order to improve and develop the implant site by distraction of the periodontal ligament-alveolar bone complex. The orthodontic extrusion was carried out with two aesthetic approaches: lingual orthodontics and a composite resin 2-2 veneer pontic. The first part of the extrusion was realized with lingual orthodontics alone, then, when the crown had been remodelled in its greatest part and the aesthetics was no more acceptable to the patient a composite resin 2-2 veneer pontic was bonded to the vestibular side of the other three incisors to mimetise the extruded tooth and to be anchorage to the lingual mechanics. The orthodontic preparation of the implant site allowed the correction of the periodontal defect due to the fracture, the enhancement of the alveolar bone and the soft tissue remodelling.

Impact of diet on incisor growth and attrition and the development of dental disease in pet rabbits.

PubMed

Meredith, A L; Prebble, J L; Shaw, D J

2015-06-01

To assess the impact of four rabbit diets (hay only; extruded diet with hay; muesli with hay; muesli only) on length and curvature of cheek teeth and eruption and attrition rates of incisors. Thirty-two Dutch rabbits, randomly divided into four diet groups, had length and saggital plane curvature of the first cheek teeth measured radiographically at 1, 9 and 17 months. Eruption/attrition of the left upper incisor was directly measured at weeks 30, 32 and 35. Eruption rates matched attrition rates in all groups, but were higher in the hay only group than in both groups fed muesli. By month 9, a greater degree of tooth curvature was present in rabbits fed muesli only than in those fed hay only and extruded diet with hay. After 17 months, rabbits fed muesli only and muesli with hay had longer lower first cheek teeth and larger interdental spaces between the first two molars than rabbits fed extruded diet and hay and hay only. Three rabbits fed muesli only developed evidence of dental disease. Presence of increased tooth length, curvature and interdental spaces indicated early dental pathology in rabbits fed muesli. Muesli diets cannot be recommended for pet rabbits. © 2015 British Small Animal Veterinary Association.

Uptake of fluoride into developing sheep teeth, following the 1995 volcanic eruption of Mt Ruapehu, New Zealand

NASA Astrophysics Data System (ADS)

Coote, G. E.; Cutress, T. W.; Suckling, G. W.

1997-07-01

In the southern Spring of 1995 (mid-October) the active volcano Mt Ruapehu in the central North Island of New Zealand erupted explosively, spreading up to 40 million m 3 of rhyolite tephra over thousands of km 2 of farmland during the lambing season. This ash contained a high concentration of soluble fluoride, and more than 2000 lactating ewes died of acute fluoride poisoning. To investigate the effects of this brief but acute dose on the teeth of grazing animals we examined the distributions of fluorine and calcium in the permanent incisor teeth of sheep which were one year old at the time. Where part of an incisor had been in the first (secretory) stage of calcification the erupted tooth disclosed surface pitting, a thin layer of enriched mineral across the enamel with as much as 1000 ppm F w/w, and a separate layer with ˜4000 ppm down the dentine. The part of an incisor which had attained the later (maturation) stage showed enriched layers only in the outer enamel and in the dentine. This study has demonstrated some important features of the calcification process, and the risk of fluoride toxicity to grazing animals.

The association between prune belly syndrome and dental anomalies: a case report.

PubMed

Basso, Maria Daniela; Favretto, Carla Oliveira; Cunha, Robson Frederico

2012-12-18

Prune belly syndrome is a rare condition produced by an early mesodermal defect that causes abdominal abnormalities. However, the literature indicates that disturbances related to ectodermal development may also be present. This is the first case report in the literature to suggest that dental abnormalities are part of the broad spectrum of clinical features of prune belly syndrome. Because the syndrome causes many serious medical problems, early diagnosis of abnormalities involving the primary and permanent dentitions are encouraged. The authors report the clinical case of a 4-year-old Caucasian boy with prune belly syndrome. In addition to the triad of abdominal muscle deficiency, abnormalities of the gastrointestinal and urinary tracts, and cryptorchidism, a geminated mandibular right central incisor, agenesis of a mandibular permanent left incisor, and congenitally missing primary teeth (namely, the mandibular right and left lateral incisors) were noted. This original case report about prune belly syndrome highlights the possibility that dental abnormalities are a part of the broad spectrum of clinical features of the syndrome. Therefore, an accurate intra-oral clinical examination and radiographic evaluation are required for patients with this syndrome in order to provide an early diagnosis of abnormalities involving the primary and permanent dentitions.

Malocclusions in a juvenile medieval skull material.

PubMed

Larsson, E

1983-01-01

From a mostly medieval skull material--the "Schreiner collections" in Oslo--juvenile crania were selected as follows: Group A: Crania with complete and intact primary dentition. n = 20. Group B: Crania with early mixed dentition. Incisors only erupted or under eruption. n = 47. Group C: Crania with late mixed dentition. n = 14. The author recorded visually: Sagittal and transversal dental relation, frontal dental contact, anterior cross-bite, rotation and crowding. There was good basal stability. Sagittally 1 moderately postnormal dentition was recorded, transversally there were no anomalies. Slight anterior cross-bite was recorded in 1 case, anterior cross-bite of one and two lateral incisors respectively in 2 others, and tête-à-tête contact in 3 cases. Crowding was recorded in 6 cases, in one of them being general, in the others located solely in the mandibular incisor segment. Broken contact and more or less pronounced rotation occurred in these dentitions. Rotation was also recorded in 2 other cases. The prevalence of malocclusions of the type that can be related to continuing finger-sucking or sucking of dummylike objects was very low in this material. This observation prompted the author to discuss a hypothesis concerning the aetiology of dummy- and finger-sucking habits.

Comparison of mandibular arch changes during alignment and leveling with 2 preadjusted edgewise appliances.

PubMed

Fleming, Padhraig S; DiBiase, Andrew T; Sarri, Grammati; Lee, Robert T

2009-09-01

Our objective was to compare the effects of 2 preadjusted appliances on angular and linear changes of the mandibular incisors, and transverse mandibular arch dimensional changes over a minimum of 30 weeks. This was a prospective, randomized, controlled, clinical trial a the Royal London Hospital, School of Dentistry, in London and the Kent and Canterbury Hospital in Canterbury, United Kingdom. Sixty- six consecutive patients satisfying the inclusion criteria were enrolled and randomly allocated to treatment with a self-ligating bracket system (SmartClip, 3M Unitek, Monrovia, Calif) and conventional preadjusted edgewise brackets (Victory, 3M Unitek). Initial study models and cephalograms were obtained within a month of starting the trial. All subjects received treatment with the following archwire sequence: 0.016-in round, 0.017 x 0.025-in rectangular, 0.019 x 0.025-in rectangular martensitic active nickel-titanium archwires, and 0.019 x 0.025-in stainless steel archwires. Final records, including study models and a lateral cephalogram, were collected a minimum of 30 weeks after initial appliance placement. Lateral cephalograms were assessed for treatment-related changes in mandibular incisor inclination and position. Transverse dimensional changes in intercanine, interpremolar, and intermolar dimensions, and the amount of crowding alleviated during the study period were assessed by comparison of pretreatment and posttreatment models. All measurements were made with a digital caliper (150 mm ISO 9001 electronic caliper, Tesa Technology, Renens, Switzerland). Sixty patients completed the study. After adjustment for pretreatment values, duration of treatment, and amount of crowding alleviated during the study period, bracket type had little effect on incisor inclination (P = 0.437) and positional changes (P = 0.35), and intercanine (P = 0.967), inter-first premolar (P = 0.495), and inter-second premolar (P = 0.905) dimensions. However, the self-ligating appliance produced slightly more expansion in the molar region, a difference that was statistically significant (P = 0.009). Pretreatment values for incisor inclination (P = 0.044) and transverse dimensions (P = 0.000) affected inclination and transverse changes, respectively, with proclination less likely when the labial segment was proclined at the outset and expansion unlikely during leveling and alignment in wider arches. Greater alleviation of crowding during the study period resulted in more incisor proclination (P = 0.000) and advancement (P = 0.000). There was little difference overall in the pattern of arch alignment and leveling related to the 2 preadjusted appliances. However, there was a statistically greater increase in intermolar width in the group treated with the self-ligating appliance, although the difference was only 0.91 mm.

Proportions of maxillary anterior teeth relative to each other and to golden standard in tabriz dental faculty students.

PubMed

Parnia, Fereydoun; Hafezeqoran, Ali; Mahboub, Farhang; Moslehifard, Elnaz; Koodaryan, Rodabeh; Moteyagheni, Rosa; Saleh Saber, Fariba

2010-01-01

Various methods are used to measure the size and form of the teeth, including the golden pro-portion, and the width-to-length ratio of central teeth, referred to as the golden standard. The aim of this study was to eval-uate the occurrence of golden standard values and golden proportion in the anterior teeth. Photographs of 100 dentistry students (50 males and 50 females) were taken under standard conditions. The visible widths and lengths of maxillary right and left incisors were calculated and the ratios were compared with golden standard. Data was analyzed using SPSS 14 software. Review of the results of the means showed statistically significant differences between the width ratio of right lateral teeth to the central teeth width with golden proportion (P<0.001). Likewise, the difference was significant for the left side, too (P<0.001). Test results of mean differences showed that the mean difference between proportion of right laterals to centrals with golden proportion was significant (P<0.001). The difference was significant for the left side, too (P<0.001). As a result, there is no golden proportion among maxillary incisors. The review of results of mean differences for single samples showed that the mean differences between the proportion of width-to-length of left and right central teeth was statistically significant by golden standard (P<0.001). Therefore, considering the width-to-length proportion of maxillary central teeth, no golden standard exists. In the evaluation of the width-to-width and width-to-length proportions of maxillary incisors no golden proportions and standards were detected, respectively.

Apical root resorption comparison between Fränkel and eruption guidance appliances.

PubMed

Janson, Guilherme; Nakamura, Alexandre; de Freitas, Marcos Roberto; Henriques, José Fernando Castanha; Pinzan, Arnaldo

2007-06-01

The objectives of this study were to compare the amounts of apical root resorption that occur after treatment with 2 removable appliances-the Fränkel function regulator and the eruption guidance appliance (EGA)-in an untreated control group, and to determine the prevalence of root resorption in the maxillary and mandibular incisors and the dental arches. After treatment, periapical radiographs were obtained of the maxillary and mandibular incisors with the long-cone paralleling technique from 72 patients divided into 3 groups. Group 1 included 24 patients treated with the Fränkel appliance, group 2 consisted of 24 patients treated with the EGA, and group 3 comprised 24 untreated subjects. Some patients in groups 1 and 2 were also treated with fixed appliances. Subgroups of patients who had used exclusively 1 functional appliance were also formed and evaluated. Root resorption was scored according to the method of Levander and Malmgren. Results of the Kruskal-Wallis tests showed significantly greater resorption in the Fränkel group, the EGA group, and the EGA subgroup in relation to the control group. However, there were no statistically significant differences between the Fränkel and the EGA groups and the subgroups. The amounts of resorption were predominantly small and similar in the experimental groups and the subgroups. The prevalence of resorption for the incisors was greatest for the maxillary central, followed by the maxillary lateral, mandibular central, and mandibular lateral. It was concluded that the Fränkel group, the EGA group, and the EGA subgroup had significantly greater resorption than the control group. There was no difference in the amount of resorption between the Fränkel and the EGA groups.

Pantoprazole, a proton pump inhibitor, increases orthodontic tooth movement in rats.

PubMed

Shirazi, Mohsen; Alimoradi, Houman; Kheirandish, Yasaman; Etemad-Moghadam, Shahroo; Alaeddini, Mojgan; Meysamie, Alipasha; Fatahi Meybodi, Seyed Amir Reza; Dehpour, Ahmad Reza

2014-06-01

Pantoprazole, is a proton pump inhibitor (PPI) prescribed for the treatment of upper gastrointestinal disorders, which in high doses has been suggested to decrease calcium absorption leading to hypocalcaemia and therefore osteoporosis. The aim of this study was to assess whether pantoprazol, could alter the rate of orthodontic tooth movement (OTM) in rats. A time course study was established using 72 rats which were divided into six groups of 12 samples each (four: vehicle; eight: pantoprazole + vehicle). Pantoprazole at a dose of 200 mg/kg suspended in carboxymethyl cellulose (0.25 percent) was administered by a gastric tube. The upper incisors and first molars were ligated by a 5 mm nickel-titanium closed-coil spring to deliver an initial force of 60 g. Animals were euthanized two weeks after orthodontic treatment followed by assessment of tooth movement and histomorphometric evaluation of the detached maxillae. Lateral skull radiographs were obtained once a week, starting from the first day to the 6(th) week of the study. OTM and bone density data were analyzed using independent sample t-test and repeated measures ANOVA. No significant changes in OTM measurements and optical density were observed in vehicle-receiving animals during the study (P=0.994). OTM was significantly increased after six weeks pantoprazole therapy which continued until the 7(th) week of the experiment (P=0.007). Optical density significantly increased in the pantoprazole-treated rats after six weeks. Long term PPI therapy at high doses could lead to osteoporosis and enhanced OTM.

Coexistence of true talon cusp and double dens invaginatus in a single tooth: a rare case report and review of the literature.

PubMed

Nu Nu Lwin, Hnin; Phyo Kyaw, Pyae; Wai Yan Myint Thu, Sai

2017-12-01

Co-occurrence of a talon cusp and double dens invaginatus is an extremely rare developmental dental anomaly. This case report represents a talon cusp with two dens invaginatus on a maxillary right lateral incisor. Early identification is needed for prevention of potential problems on the affected or opposing tooth.

Timing and sequence of primary tooth eruption in children with cleft lip and palate

PubMed Central

KOBAYASHI, Tatiana Yuriko; GOMIDE, Márcia Ribeiro; CARRARA, Cleide Felício de Carvalho

2010-01-01

Objective To determine the timing and sequence of eruption of primary teeth in children with complete bilateral cleft lip and palate. Material and Methods This cross-sectional study was conducted at the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo, Bauru, SP, Brazil, with a sample of 395 children (128 girls and 267 boys) aged 0 to 48 months, with complete bilateral cleft lip and palate Results Children with complete bilateral clefts presented a higher mean age of eruption of all primary teeth for both arches and both genders, compared to children without clefts. This difference was statistically significant for all teeth, except for the maxillary first molar. Mean age of eruption of most teeth was lower for girls compared to boys. The greatest delay was found for the maxillary lateral incisor, which was the eighth tooth of children with clefts of both genders. Analyzing by gender, the maxillary lateral incisor was the eighth tooth to erupt in girls and the last in boys. Conclusion The results suggest an interference of the cleft on the timing and sequence of eruption of primary teeth. PMID:20856997

Masking of Enamel Fluorosis Discolorations and Tooth Misalignment With a Combination of At-Home Whitening, Resin Infiltration, and Direct Composite Restorations.

PubMed

Perdigão, J; Lam, V Q; Burseth, B G; Real, C

This clinical report illustrates a conservative technique to mask enamel discolorations in maxillary anterior teeth caused by hypomineralization associated with enamel fluorosis and subsequent direct resin composite to improve the anterior esthetics. The treatment consisted of at-home whitening with 10% carbamide peroxide gel with potassium nitrate and sodium fluoride in a custom-fitted tray to mask the brown-stained areas, followed by resin infiltration to mask the white spot areas. An existing resin composite restoration in the maxillary right central incisor was subsequently replaced after completion of the whitening and resin infiltration procedures, whereas the two misaligned and rotated maxillary lateral incisors were built up with direct resin composite restorations to provide the illusion of adequate arch alignment, as the patient was unable to use orthodontic therapy.

A comparative study of the effect of the intrusion arch and straight wire mechanics on incisor root resorption: A randomized, controlled trial.

PubMed

de Almeida, Marcio Rodrigues; Marçal, Aline Siqueira Butzke; Fernandes, Thais Maria Freire; Vasconcelos, Juliana Brito; de Almeida, Renato Rodrigues; Nanda, Ravindra

2018-01-01

To analyze and compare external apical root resorption (EARR) of maxillary incisors treated by intrusion arch or continuous archwire mechanics. This cone-beam computed tomography (CBCT) study analyzed 28 deep bite patients in the permanent dentition who were randomly divided into two groups: Group 1, 12 patients with initial mean age of 15.1 ± 1.6 years and mean overbite of 4.6 ± 1.2 mm treated with the Connecticut intrusion arch (CIA) in the upper arch (Ortho Organizers, Carlsbad, Calif) for a mean period of 5.8 ± 1.27 months. Group 2, 16 patients with initial mean age of 22.1 ± 5.7 years and mean overbite of 4.1 ± 1.1 mm treated with conventional leveling and alignment using continuous archwire mechanics for 6.1 ± 0.81 months. The degree of EARR was detected in 112 maxillary incisors by using CBCT scans and a three-dimensional program (Dolphin 11.7, Dolphin Imaging & Management Solutions, Chatsworth, Calif). The CBCT scans were obtained before (T1) and 6 months after initiation of treatment (T2). Differences between and within groups were assessed by nonpaired and paired t-tests, respectively, with a 5% significance level. Significant differences were found for both groups between T1 and T2 ( P < .05) indicating that EARR occurred in both groups. However, there were no significant differences when EARR was compared between group 1 (-0.76 mm) and group 2 (-0.59 mm). The Connecticut intrusion arch did not lead to greater EARR of maxillary incisors when compared with conventional orthodontic mechanics.

Canines are affected in 16-year-olds with molar-incisor hypomineralisation (MIH): an epidemiological study based on the Tromsø study: "Fit Futures".

PubMed

Schmalfuss, A; Stenhagen, K R; Tveit, A B; Crossner, C-G; Espelid, I

2016-04-01

This was to determine the prevalence, distribution of affected teeth and severity of MIH in adolescents from Northern Norway. It was part of a cross-sectional health survey Fit Futures including 16-year-olds from two neighbouring municipalities, Tromsø and Balsfjord. The prevalence of MIH was 13.9% (110 of 794). The maxillary first permanent molars (FPMs) were 1.6 times more frequently affected than in the mandible (P < 0.001). The FPMs on the right side were 1.2 times more often affected than the FPMs on the left side (P = 0.038). The maxillary incisors were 2.5 times more often affected than the incisors in the mandible (P < 0.001). The proportions of participants whose canines and incisors were involved were 22.8 and 41.8%, respectively. Altogether 201 FPMs were affected; 54.0% of these had opacities only, 24.3% had posteruptive breakdown (PEB), 18.8% had atypical restorations, and 3.0% had been extracted due to MIH. The buccal surfaces were most often affected in FPMs. More severe lesions were found in the mandibular FPMs compared with the maxillary FPMs (P = 0.002). In the lower canines, only opacities were recorded, while in the upper jaw 13.0% of the affected canines showed PEBs. The distribution of MIH in the dentition was not symmetrical. The prevalence of MIH (13.9%) in the study population of 16-year-olds from Northern Norway is consistent with previous Scandinavian reports. The distribution pattern shows that one participant in four with MIH had at least one affected canine. Further studies are needed to describe the localisation of defects on the enamel surface and to relate these findings to enamel thickness and the duration of amelogenesis.

External apical root resorption in maxillary incisors in orthodontic patients: associated factors and radiographic evaluation.

PubMed

Nanekrungsan, Kamonporn; Patanaporn, Virush; Janhom, Apirum; Korwanich, Narumanus

2012-09-01

This study was performed to evaluate the incidence and degree of external apical root resorption of maxillary incisors after orthodontic treatment and to evaluate particular associated factors related to external apical root resorption. The records and maxillary incisor periapical radiographs of 181 patients were investigated. Crown and root lengths were measured and compared on the pre- and post-treatment periapical radiographs. Crown length was measured from the center of the incisal edge to the midpoint of the cemento-enamel junction (CEJ). Root length was measured from the CEJ midpoint to the root apex. A correction factor for the enlargement difference was used to calculate root resorption. The periapical radiographs of 564 teeth showed that the average root resorption was 1.39±1.27 (8.24±7.22%) and 1.69±1.14 mm (10.16±6.78%) for the maxillary central and lateral incisors, respectively. The results showed that the dilacerated or pointed roots, maxillary premolar extraction cases, and treatment duration were highly significant factors for root resorption (p<0.001). Allergic condition was a significant factor at p<0.01. Age at the start of treatment, large overjet, and history of facial trauma were also factors significantly associated with root resorption (p<0.05). There was no statistically significant difference in root resorption among the factors of gender, overbite, tongue-thrusting habit, types of malocclusion, and types of bracket. These results suggested that orthodontic treatment should be carefully performed in pre-treatment extraction patients who have pointed or dilacerated roots and need long treatment duration.

[Effect of dental arch length decrease during orthodontic treatment in the upper airway development. A review].

PubMed

Haddad, Stéphanie; Kerbrat, Jean-Baptiste; Schouman, Thomas; Goudot, Patrick

2017-03-01

A possible relation between an upper airway space decrease and the development of obstructive sleep apnea syndrom explains the importance to know the effect of the modification of dental arch length on the upper airway during orthodontic treatment. The aim of this article is to expose recent knowledge about upper airway development and dental arch length decrease factors, to determine the influence of this decrease on upper airway development. A review was done to determine the upper airway normal development, to define dental arch to specify if an ideal position of dental arch on apical base exists. All of the length dental arch decrease factors during orthodontic treatment (dental extraction, dental agenesis and dental malpositions) and their upper airway resounding were searched. Some authors found a diminution of upper airway space after premolars extractions while others didn't found this diminution after extractions premolars when incisor retraction is finished. A decrease of transversal maxillary diameter and nasal cavity may be due to absence of permanent teeth. The effect of dental arch length decrease during orthodontic treatment in the upper airway development was not scientifically proved. However we had to be vigilant and adapt our orthodontic treatment case by case to avoid an upper airway modification. © EDP Sciences, SFODF, 2017.

Long-term observation of endodontic surgical intervention to treat root perforation and apical periodontitis: a case report of an amalgam-restored tooth.

PubMed

Tsurumachi, Tamotsu; Hayashi, Makoto

2003-10-01

A case of crestal root perforation and periapical lesion in a maxillary left lateral incisor is reported. Teeth with root perforation present technical difficulties in their clinical management because of their complex defects. In the present case, surgical endodontic treatment was chosen. The apical and lateral pathology was curetted, the tooth root was resected, and a retrograde root restoration of amalgam was placed in a root-end cavity and perforation site. A 10-year follow-up clinical and radiographic examination showed an asymptomatic tooth with osseous healing proceeding.

Bond strength of stainless steel orthodontic brackets bonded to prefabricated acrylic teeth.

PubMed

Wan Abdul Razak, Wan Salbiah; Sherriff, Martyn; Bister, Dirk; Seehra, Jadbinder

2017-06-01

The purpose of this in-vitro study was to evaluate the force to debond stainless steel orthodontic brackets bonded to acrylic teeth using different combinations of adhesive and surface treatments. One hundred prefabricated upper lateral incisor acrylic teeth were divided into 4 equal groups: Transbond XT® adhesive only (Group 1, control), Transbond XT® adhesive with sandblasting (Group 2), Transbond XT® adhesive with abrasion / + methyl methacrylate (MMA) (Group 3) and Triad® Gel only (Group 4). The force in Newtons (N) to debond the brackets was measured. One-way analysis of variance (ANOVA) and pairwise multi-comparison of means (Šidak's adjustment) were undertaken. The highest force to debond was recorded for Group 2 (275.7 N; SD 89.0) followed by Group 3 (241.9 N; SD 76.0), Group 1 (142.7 N; SD 36.7) and Group 4 (67.9 N; SD 21.1). Significant differences in bond strength measurements between the experimental groups were detected. Mean force values for the groups revealed no significant differences between Group 2 and Group 3 (p>0.05). Both sandblasting and surface abrasion/+ application of methyl methacrylate (MMA) in combination with Transbond XT® adhesive are recommended for bonding stainless orthodontic brackets to acrylic teeth.

Treatment of combined endodontic: periodontic lesion by sealing of palato-radicular groove using biodentine.

PubMed

Naik, Mayuri; de Ataide, Ida de Noronha; Fernandes, Marina; Lambor, Rajan

2014-11-01

Palatoradicular groove is a developmental anomaly which is predominantly found in maxillary lateral incisors. It provides a susceptible alcove for the progression of localised periodontal inflammation which can further cause pulpal involvement. This case report describes the successful treatment of a large periodontic - endodontic lesion usingnon surgical endodontic therapy and biodentine for the sealing of the palatoradicular groove.

Incisor crown bending strength correlates with diet and incisor curvature in anthropoid primates.

PubMed

Deane, Andrew S

2015-02-01

Anthropoid incisors are large relative to the postcanine dentition and function in the preprocessing of food items. Previous analyses of anthropoid incisor allometry and shape demonstrate that incisor morphology is correlated with preferred foods and that more frugivorous anthropoids have larger and more curved incisors. Although the relationship between incisal crown curvature and preferred foods has been well documented in extant and fossil anthropoids, the functional significance of curvature variation has yet to be conclusively established. Given that an increase in crown curvature will increase maximum linear crown dimensions, and bending resistance is a function of linear crown dimensions, it is hypothesized that incisor crown curvature functons to increase incisor crown resistance to bending forces. This study uses beam theory to calculate the mesiodistal and labiolingual bending strengths of the maxillary and mandibular incisors of hominoid and platyrrhine taxa with differing diets and variable degrees of incisal curvature. Results indicate that bending strength correlates with incisal curvature and that frugivores have elevated incisor bending resistance relative to folivores. Maxillary central incisor bending strengths further discriminate platyrrhine and hominoid hard- and soft-object frugivores suggesting this crown is subjected to elevated occlusal loading relative to other incisors. These results are consistent with the hypothesis that incisor crown curvature functions to increase incisor crown resistance to bending forces but does not preclude the possibility that incisor bending strength is a composite function of multiple dentognathic variables including, but not limited to, incisor crown curvature. © 2014 Wiley Periodicals, Inc.

Shear bond strength and enamel fracture behavior of ceramic brackets Fascination® and Fascination®2.

PubMed

Gittner, Robert; Müller-Hartwich, Ralf; Engel, Sylvia; Jost-Brinkmann, Paul-Georg

2012-01-01

The purpose of this study was to compare the shear bond strength and incidence of enamel fractures of the ceramic brackets Fascination® and Fascination®2. A total of 360 teeth (180 first upper bicuspids and 180 lower incisors) were stored in 96% ethanol, while 360 other teeth (180 first upper bicuspids and 180 lower incisors) were stored in 0.1% thymol. All 720 teeth were bonded one-half each with Fascination® and Fascination®2 brackets using three different adhesives and three different light curing units. The teeth were debonded with a debonding-device according to DIN EN ISO 10477 using a universal testing machine with a crosshead speed of 1 mm per minute. The enamel surface was then examined stereomicroscopically (10x and 40x magnification). The non-parametric Mann-Whitney U test was used, since the data were not normally distributed. The Fascination®2 brackets provided significantly lower shear bond strength than Fascination® brackets (p = 0.003). Fascination® brackets demonstrated significantly fewer, smaller enamel fractures than Fascination®2 brackets (p = 0.012). The lower shear bond strength of the Fascination®2 brackets is clinically acceptable, but our study's experimental design did not enable us to prove whether this is clinically associated with a lower risk of enamel fracture.

The Relationship between Dental Follicle Width and Maxillary Impacted Canines' Descriptive and Resorptive Features Using Cone-Beam Computed Tomography.

PubMed

Dağsuyu, İlhan Metin; Okşayan, Rıdvan; Kahraman, Fatih; Aydın, Mehmet; Bayrakdar, İbrahim Şevki; Uğurlu, Mehmet

2017-01-01

To assess the relationship between dental follicle width and maxillary impacted canines' descriptive and resorptive features with three-dimensional (3D) cone-beam computed tomography (CBCT). The study comprised 102 patients with cone-beam computed tomography 3D images and a total of 140 impacted canines. The association between maxillary impacted canine dental follicle width and the variables of gender, impaction side (right and left), localization of impacted canine (buccal, central, and palatal), and resorption of the adjacent laterals was compared. Measurements were analyzed with Student's t -test, Kruskal-Wallis test, and Mann-Whitney U statistical test. According to gender, no statistically significant differences were found in the follicle size of the maxillary impacted canine between males and females ( p > 0.05). Widths of the follicles were determined for the right and left impaction sides, and no statistically significant relation was found ( p > 0.05). There were statistically significant differences between root resorption degrees of lateral incisors and maxillary impacted canine follicle width ( p < 0.05). Statistically significant higher follicle width values were present in degree 2 (mild) resorption than in degree 1 (no) and degree 3 (moderate) resorption samples ( p < 0.05). No significant correlation was found between follicle width and the variables of gender, impaction side, and localization of maxillary impacted canines. Our study could not confirm that increased dental follicle width of the maxillary impacted canines exhibited more resorption risk for the adjacent lateral incisors.

Dental stigmata and enamel thickness in a probable case of congenital syphilis from XVI century Croatia.

PubMed

Lauc, Tomislav; Fornai, Cinzia; Premužić, Zrinka; Vodanović, Marin; Weber, Gerhard W; Mašić, Boris; Rajić Šikanjić, Petra

2015-10-01

To analyse the dental remains of an individual with signs of congenital syphilis by using macroscopic observation, CBCT and micro-CT images, and the analysis of the enamel thickness. Anthropological analysis of human skeletal remains from the 16th century archaeological site Park Grič in Zagreb, Croatia discovered a female, 17-20 years old at the time of death, with dental signs supportive of congenital syphilis: mulberry molars and canine defects, as well as non-specific hypoplastic changes on incisors. The focus of the analysis was on three aspects: gross morphology, hypoplastic defects of the molars, canines and incisors, as well as enamel thickness of the upper first and second molars. The observed morphology of the first molars corresponds to the typical aspect of mulberry molars, while that of the canines is characterised by hypomineralisation. Hypoplastic grooves were observed on the incisal edges of all incisors. The enamel of the first molars is underdeveloped while in the second molars a thick-enamelled condition is observed. Our observations for the dental and skeletal evidence are supportive to a diagnosis of congenital syphilis for this specimen from XVI century Croatia. The use of CT imaging helped documenting the diagnostic features and quantifying the effect of the dental stigmata on first molars. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Class III surgical patients facilitated by accelerated osteogenic orthodontic treatment].

PubMed

Wu, Jia-qi; Xu, Li; Liang, Cheng; Zou, Wei; Bai, Yun-yang; Jiang, Jiu-hui

2013-10-01

To evaluate the treatment time and the anterior and posterior teeth movement pattern as closing extraction space for the Class III surgical patients facilitated by accelerated osteogenic orthodontic treatment. There were 10 skeletal Class III patients in accelerated osteogenic orthodontic group (AOO) and 10 patients in control group. Upper first premolars were extracted in all patients. After leveling and alignment (T2), corticotomy was performed in the area of maxillary anterior teeth to accelerate space closing.Study models of upper dentition were taken before orthodontic treatment (T1) and after space closing (T3). All the casts were laser scanned, and the distances of the movement of incisors and molars were digitally measured. The distances of tooth movement in two groups were recorded and analyzed. The alignment time between two groups was not statistically significant. The treatment time in AOO group from T2 to T3 was less than that in the control group (less than 9.1 ± 4.1 months). The treatment time in AOO group from T1 to T3 was less than that in the control group (less than 6.3 ± 4.8 months), and the differences were significant (P < 0.01). Average distances of upper incisor movement (D1) in AOO group and control group were (2.89 ± 1.48) and (3.10 ± 0.95) mm, respectively. Average distances of upper first molar movement (D2) in AOO group and control group were (2.17 ± 1.13) and (2.45 ± 1.04) mm, respectively.No statistically significant difference was found between the two groups (P > 0.05). Accelerated osteogenic orthodontic treatment could accelerate space closing in Class III surgical patients and shorten preoperative orthodontic time. There were no influence on the movement pattern of anterior and posterior teeth during pre-surgical orthodontic treatment.

Effects of mechanical properties of adhesive resin cements on stress distribution in fiber-reinforced composite adhesive fixed partial dentures.

PubMed

Yokoyama, Daiichiro; Shinya, Akikazu; Gomi, Harunori; Vallittu, Pekka K; Shinya, Akiyoshi

2012-01-01

Using finite element analysis (FEA), this study investigated the effects of the mechanical properties of adhesive resin cements on stress distributions in fiber-reinforced resin composite (FRC) adhesive fixed partial dentures (AFPDs). Two adhesive resin cements were compared: Super-Bond C&B and Panavia Fluoro Cement. The AFPD consisted of a pontic to replace a maxillary right lateral incisor and retainers on a maxillary central incisor and canine. FRC framework was made of isotropic, continuous, unidirectional E-glass fibers. Maximum principal stresses were calculated using finite element method (FEM). Test results revealed that differences in the mechanical properties of adhesive resin cements led to different stress distributions at the cement interfaces between AFPD and abutment teeth. Clinical implication of these findings suggested that the safety and longevity of an AFPD depended on choosing an adhesive resin cement with the appropriate mechanical properties.

A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries

PubMed Central

Zorlu, Sevgi; Cankaya, Abdulkadir Burak; Aktoren, Oya; Gencay, Koray

2015-01-01

The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a fractured crown. CBCT examination revealed a nondisplaced fracture and an oblique greenstick fracture of the mandibular body and unilateral fracture of the condyle. Closed reduction technique was chosen to manage fractures of the mandible. Favorable healing outcomes on multiple fractures of the mandible throughout the 6-year follow-up period proved the success of the conservative treatment. This case report is important since it presents a variety of pathological sequelae to trauma within one case. PMID:26339511

Lightness, chroma, and hue distributions in natural teeth measured by a spectrophotometer.

PubMed

Pustina-Krasniqi, Teuta; Shala, Kujtim; Staka, Gloria; Bicaj, Teuta; Ahmedi, Enis; Dula, Linda

2017-01-01

The aim of the study was to analyze the distribution of color parameters, lightness (L*), chroma (C), hue (H), a* and b*, in the intercanine sector in maxilla. Patients' tooth color measurements were performed using an intraoral spectrophotometer VITA Easyshade ® (VITA Zahnfabrik H. Rauter GmbH and Co. KG, Bad Sackingen, Germany). The measurements were made in 255 subjects in the intercanine sector in maxilla. The mean values for the group of 255 subjects were as follows: L*, a*, b*, C, and H as 81.6, 0.67, 21.6, 21.7, and 92.7, respectively. For F=206.27 and P < 0.001 between L*, a*, b*, C, H, and central incisor/lateral incisor/canines, there were statistically significant differences. With the statistical analysis, it was determined that there are significant color differences between the teeth of the intercanine sector, which differences are clinically significant also.

The association between prune belly syndrome and dental anomalies: a case report

PubMed Central

2012-01-01

Background Prune belly syndrome is a rare condition produced by an early mesodermal defect that causes abdominal abnormalities. However, the literature indicates that disturbances related to ectodermal development may also be present. This is the first case report in the literature to suggest that dental abnormalities are part of the broad spectrum of clinical features of prune belly syndrome. Because the syndrome causes many serious medical problems, early diagnosis of abnormalities involving the primary and permanent dentitions are encouraged. Case presentation The authors report the clinical case of a 4-year-old Caucasian boy with prune belly syndrome. In addition to the triad of abdominal muscle deficiency, abnormalities of the gastrointestinal and urinary tracts, and cryptorchidism, a geminated mandibular right central incisor, agenesis of a mandibular permanent left incisor, and congenitally missing primary teeth (namely, the mandibular right and left lateral incisors) were noted. Conclusion This original case report about prune belly syndrome highlights the possibility that dental abnormalities are a part of the broad spectrum of clinical features of the syndrome. Therefore, an accurate intra-oral clinical examination and radiographic evaluation are required for patients with this syndrome in order to provide an early diagnosis of abnormalities involving the primary and permanent dentitions. PMID:23249412

Predicting bite force and cranial biomechanics in the largest fossil rodent using finite element analysis.

PubMed

Cox, Philip G; Rinderknecht, Andrés; Blanco, R Ernesto

2015-03-01

Josephoartigasia monesi, from the Pliocene of Uruguay, is the largest known fossil rodent, with an estimated body mass of 1000 kg. In this study, finite element analysis was used to estimate the maximum bite force that J. monesi could generate at the incisors and the cheek teeth. Owing to uncertainty in the model inputs, a sensitivity study was conducted in which the muscle forces and orientations were sequentially altered. This enabled conclusions to be drawn on the function of some of the masticatory muscles. It was found that J. monesi had a bite of 1389 N at the incisors, rising to 4165 N at the third molar. Varying muscle forces by 20% and orientations by 10° around the medio-lateral aspect led to an error in bite force of under 35% at each tooth. Predicted stresses across the skull were only minimally affected by changes to muscle forces and orientations, but revealed a reasonable safety factor in the strength of the skull. These results, combined with previous work, lead us to speculate that J. monesi was behaving in an elephant-like manner, using its incisors like tusks, and processing tough vegetation with large bite forces at the cheek teeth. © 2015 Anatomical Society.

Predicting bite force and cranial biomechanics in the largest fossil rodent using finite element analysis

PubMed Central

Cox, Philip G; Rinderknecht, Andrés; Blanco, R Ernesto

2015-01-01

Josephoartigasia monesi, from the Pliocene of Uruguay, is the largest known fossil rodent, with an estimated body mass of 1000 kg. In this study, finite element analysis was used to estimate the maximum bite force that J. monesi could generate at the incisors and the cheek teeth. Owing to uncertainty in the model inputs, a sensitivity study was conducted in which the muscle forces and orientations were sequentially altered. This enabled conclusions to be drawn on the function of some of the masticatory muscles. It was found that J. monesi had a bite of 1389 N at the incisors, rising to 4165 N at the third molar. Varying muscle forces by 20% and orientations by 10° around the medio-lateral aspect led to an error in bite force of under 35% at each tooth. Predicted stresses across the skull were only minimally affected by changes to muscle forces and orientations, but revealed a reasonable safety factor in the strength of the skull. These results, combined with previous work, lead us to speculate that J. monesi was behaving in an elephant-like manner, using its incisors like tusks, and processing tough vegetation with large bite forces at the cheek teeth. PMID:25652795

Validity of palatal superimposition of 3-dimensional digital models in cases treated with rapid maxillary expansion and maxillary protraction headgear

PubMed Central

Choi, Jin-Il; Jost-Brinkmann, Paul-Georg; Choi, Dong-Soon; Jang, In-San

2012-01-01

Objective The purpose of this study was to evaluate the validity of the 3-dimensional (3D) superimposition method of digital models in patients who received treatment with rapid maxillary expansion (RME) and maxillary protraction headgear. Methods The material consisted of pre- and post-treatment maxillary dental casts and lateral cephalograms of 30 patients, who underwent RME and maxillary protraction headgear treatment. Digital models were superimposed using the palate as a reference area. The movement of the maxillary central incisor and the first molar was measured on superimposed cephalograms and 3D digital models. To determine whether any difference existed between the 2 measuring techniques, intra-class correlation (ICC) and Bland-Altman plots were analyzed. Results The measurements on the 3D digital models and cephalograms showed a very high correlation in the antero-posterior direction (ICC, 0.956 for central incisor and 0.941 for first molar) and a moderate correlation in the vertical direction (ICC, 0.748 for central incisor and 0.717 for first molar). Conclusions The 3D model superimposition method using the palate as a reference area is as clinically reliable for assessing antero-posterior tooth movement as cephalometric superimposition, even in cases treated with orthopedic appliances, such as RME and maxillary protraction headgear. PMID:23173116

Human permanent teeth are divided into two parts at the cemento-enamel junction in the divine golden ratio.

PubMed

Anand, Rahul; Sarode, Sachin C; Sarode, Gargi S; Patil, Shankargouda

2017-01-01

The aim of this study is to find out whether tooth length (crown length + root length) follows the rule of most divine and mysterious phi (ϕ) or the golden ratio. A total of 140 teeth were included in the study. The crown-root ratio was manually calculated using vernier caliper and its approximation to golden ratio or the divine number phi (ϕ) was examined. The average root-crown ratio (R/C) for maxillary central incisor was 1.627 ± 0.04, and of its antagonist, mandibular central incisor was 1.628 ± 0.02. The tooth-root ratio (T/R) for the same was 1.609 ± 0.016 and 1.61 ± 0.008, respectively. Similar values were appreciated for lateral incisors where the R/C ratio in the maxillary and mandibular teeth was 1.632 ± 0.015 and 1.641 ± 0.012 and the T/R ratio was 1.606 ± 0.005 and 1.605 ± 0.005, respectively. On measuring the tooth length in linear fashion from the cusp tip to the root apex, we found that the tooth was divided into two parts at the cemento-enamel junction in the golden ratio. This information can be exploited in restorative and implant dentistry in future.

Apical root resorption in orthodontically treated adults.

PubMed

Baumrind, S; Korn, E L; Boyd, R L

1996-09-01

This study analyzed the relationship in orthodontically treated adults between upper central incisor displacement measured on lateral cephalograms and apical root resorption measured on anterior periapical x-ray films. A multiple linear regression examined incisor displacements in four directions (retraction, advancement, intrusion, and extrusion) as independent variables, attempting to account for observed differences in the dependent variable, resorption. Mean apical resorption was 1.36 mm (sd +/- 1.46, n = 73). Mean horizontal displacement of the apex was -0.83 mm (sd +/- 1.74, n = 67); mean vertical displacement was 0.19 mm (sd +/- 1.48, n = 67). The regression coefficients for the intercept and for retraction were highly significant; those for extrusion, intrusion, and advancement were not. At the 95% confidence level, an average of 0.99 mm (se = +/- 0.34) of resorption was implied in the absence of root displacement and an average of 0.49 mm (se = +/- 0.14) of resorption was implied per millimeter of retraction. R2 for all four directional displacement variables (DDVs) taken together was only 0.20, which implied that only a relatively small portion of the observed apical resorption could be accounted for by tooth displacement alone. In a secondary set of univariate analyses, the associations between apical resorption and each of 14 additional treatment-related variables were examined. Only Gender, Elapsed Time, and Total Apical Displacement displayed statistically significant associations with apical resorption. Additional multiple regressions were then performed in which the data for each of these three statistically significant variables were considered separately, with the data for the four directional displacement variables. The addition of information on Elapsed Time or Total Apical Displacement did not explain a significant additional portion of the variability in apical resorption. On the other hand, the addition of information on Gender to the information on the four directional displacement variables yielded an R2 value of 0.35, which indicated that these variables taken together could account for approximately a third of the observed variability in apical resorption in this sample.

A Morphological and Morphometric Study of Bite Marks Caused by Mice (Mus Musculus) on Different Baits for Forensic Purposes.

PubMed

Toledo, Víctor A; Fonseca, Gabriel M; González, Paula A; Ibarra, Luis; Torres, Francisco J; Sáez, Pedro L

2017-03-01

In animal bites, the dental attributes can be fundamental in identifying the marks made by various species on different matrices. Although rodent bite marks have been studied in the context of postmortem interference, little research has used different baits to analyze these marks linking not only specific behavior patterns but also the possibility of structural damage. Twenty mice (Mus musculus) were exposed to different baits to study their bite marks in a controlled model. The known pattern of parallel and multiple grooves has been seen in all baits, but polyvinyl chloride and fiber-optic cable were significantly different between each other and the other baits. Some baits showed patterns of anchorage of the upper incisors and space between the lower incisors when gnawing. This technical note represents a novel model of analysis where veterinarians and/or dentists may be asked to give an opinion on alleged animal bite marks. © 2016 American Academy of Forensic Sciences.

A three-dimensional soft tissue analysis of Class III malocclusion: a case-controlled cross-sectional study.

PubMed

Johal, Ama; Chaggar, Amrit; Zou, Li Fong

2018-03-01

The present study used the optical surface laser scanning technique to compare the facial features of patients aged 8-18 years presenting with Class I and Class III incisor relationship in a case-control design. Subjects with a Class III incisor relationship, aged 8-18 years, were age and gender matched with Class I control and underwent a 3-dimensional (3-D) optical surface scan of the facial soft tissues. Landmark analysis revealed Class III subjects displayed greater mean dimensions compared to the control group most notably between the ages of 8-10 and 17-18 years in both males and females, in respect of antero-posterior (P = 0.01) and vertical (P = 0.006) facial dimensions. Surface-based analysis, revealed the greatest difference in the lower facial region, followed by the mid-face, whilst the upper face remained fairly consistent. Significant detectable differences were found in the surface facial features of developing Class III subjects.

Pedicled fat flap to increase lateral fullness in upper blepharoplasty.

PubMed

Sozer, Sadri O; Agullo, Francisco J; Palladino, Humberto; Payne, Phileemon E; Banerji, Soumo

2010-03-01

The eyelid of a young person can be distinguished by the lateral fullness of the upper eyelid. With aging, lateral fullness decreases. Volume restoration in the periorbital area has been previously addressed by fat draping and grafting. More recently, techniques for regaining lateral fullness of the upper eyelid have focused on fat grafting, although effective graft take, reabsorption, and irregularities have been a concern. To address these issues, the concept of pedicled fat draping in the upper eyelid was explored. In a retrospective study from June 2006 to August 2008, 31 patients underwent upper blepharoplasty with augmentation of the lateral fullness with a pedicled fat flap from the central fat pad. The fat from the central compartment was elevated, dissected, and then transposed to the lateral upper eyelid below the orbicularis muscle. All patients were women ranging in age from 43 to 68 years. Pre- and postoperative picture comparison demonstrated a more youthful appearance with increased lateral fullness of the upper eyelids. There were no cases of fat necrosis encountered. Increased volume remained stable over an average of one-year follow-up. No complications were recorded. Transposing a pedicled fat pad from the central compartment laterally has proven to be an effective technique for achieving predictable upper lateral eyelid fullness and thus achieving a long-lasting, more youthful appearance.

Removable orthodontic appliances: new perspectives on capabilities and efficiency.

PubMed

Hamid Zafarmand, A; Mahdi Zafarmand, M

2013-06-01

Removable appliances are a dependable choice for many patients but like all orthodontic appliances, they have some limitations in use. Patient selection and appropriate appliance design are two key factors for success. Many patients, especially adults, prefer intra-oral appliances to extra-oral devices. Sometimes a removable intra-oral appliance can solve a dental problem in a shorter period of time compared to fixed treatment, and this has also been repeatedly seen in molar distalisation. From the interceptive perspective, the appliance can prevent or alleviate an impending crowding for erupting permanent incisors. This article describes 5 patients with different orthodontic problems: impending crowding for erupting upper canine with 2 approaches, provision of space for upper cuspids, resolution of chronic attrition of anterior teeth, relief of space shortage for upper canines eruption, and reduction of excess overjet. All subjects were treated with removable appliances of various designs.

Treatment of combined endodontic: periodontic lesion by sealing of palato-radicular groove using biodentine

PubMed Central

Naik, Mayuri; de Ataide, Ida de Noronha; Fernandes, Marina; Lambor, Rajan

2014-01-01

Introduction: Palatoradicular groove is a developmental anomaly which is predominantly found in maxillary lateral incisors. It provides a susceptible alcove for the progression of localised periodontal inflammation which can further cause pulpal involvement. This case report describes the successful treatment of a large periodontic – endodontic lesion usingnon surgical endodontic therapy and biodentine for the sealing of the palatoradicular groove. PMID:25506153

Efficacy of "Dimodent" sex predictive equation assessed in an Indian population.

PubMed

Bharti, A; Angadi, P V; Kale, A D; Hallikerimath, S R

2011-07-01

Teeth are considered as a useful adjunct for sex assessment and may play an important role in constructing a post-mortem profile. The Dimodent method is based on the high degree of sex discrimination obtained with the mandibular canine and the high correlation coefficients between mandibular canine and lateral incisor mesiodistal (MD) and buccolingual (BL) dimensions. This has been evaluated in the French and Lebanese, but no study exists on its efficacy in Indians. Here, we have applied the 'Dimodent' equation on an Indian sample (100 males, 100 females; age range of 19-27yrs). Additionally, a population-specific Dimodent equation was derived using logistic regression analysis and applied to our sample. Also, the sex determination potential of MD and BL measurements of mandibular lateral incisors and canines, individually, was assessed. We found a poor sex assessment accuracy using the Dimodent equation of Fronty (34.5%) in our Indian sample, but the populationspecific Dimodent equation gave a better accuracy (72%).Thus, it appears that sexual dimorphism in teeth is population-specific; consequently the Dimodent equation has to be derived individually in different populations for use in sex assessment. The mesiodistal measurement of the mandibular canine alone gave a marginally higher accuracy (72.5%); therefore, we suggest the use of mandibular canines alone rather than the Dimodent method.

Prevalence of hypodontia in a sample of Sudanese orthodontic patients

PubMed Central

Hassan, Duaa Abdulrahman; Abuaffan, Amal H; Hashim, Hayder A

2014-01-01

Objective: The aims of this study were to determine the prevalence of hypodontia in the permanent dentition in a sample of Sudanese patients who sought orthodontic treatment and to compare the results with the reported findings of other populations. Materials and Methods: Orthodontic files including orthopantomographs of 1069 patients (760 females and 309 males - more than 8 years old) were examined and inspected for evidence of hypodontia. Results: The prevalence of hypodontia of the present sample was 5.1%. Hypodontia was found considerably more frequently in the mandible than in the maxilla. The distribution of missing teeth was noticed in the left side more than in the right side. The most frequently missing teeth were the maxillary lateral incisors, followed by the mandibular second premolars, maxillary second premolars and mandibular left lateral incisor. The majority of patients had two or three teeth missing, but rarely more than 5 teeth missing. Conclusions: The prevalence of hypodontia of this study was within the range of that reported in the literature. The incidence of hypodontia in the anterior segment requires great need for orthodontic and prosthodontic treatment. With early detection of hypodontia, alternative treatment modalities can be planned and performed with a multidisciplinary team approach restoring the esthetic and function. PMID:25143929

Clinical effectiveness of combining platelet rich fibrin with alloplastic bone substitute for the management of combined endodontic periodontal lesion

PubMed Central

2014-01-01

The term "endo-perio" lesion has been proposed to describe the destructive lesion resulting from inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. In most of the cases, clinical symptoms disappear following successful endodontic therapy. However failure after conventional root canal treatment calls for surgical intervention. A 35 year old male patient with endo-perio lesion in right maxillary lateral incisor was treated with platelet rich fibrin (PRF) and alloplastic bone substitute after conventional endodontic therapy. At the end of 6 months there was gain in clinical attachment, increased radiographic bone fill and reduction in probing depth which was maintained till 18 month follow-up. Present case report aims to evaluate the efficacy of PRF and alloplastic bone substitute in the management of intrabony defect associated with endo-perio lesion in maxillary lateral incisor because the healing potential of PRF and bone graft has not been widely studied in endodontics. The use of PRF allows the clinician to optimize tissue remodelling, wound healing and angiogenesis by the local delivery of growth factors and proteins. The novel technique described here enables the clinician to be benefited from the full regenerative capacity of this autologous biologic material. PMID:24516830

Clinical effectiveness of combining platelet rich fibrin with alloplastic bone substitute for the management of combined endodontic periodontal lesion.

PubMed

Goyal, Lata

2014-02-01

The term "endo-perio" lesion has been proposed to describe the destructive lesion resulting from inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. In most of the cases, clinical symptoms disappear following successful endodontic therapy. However failure after conventional root canal treatment calls for surgical intervention. A 35 year old male patient with endo-perio lesion in right maxillary lateral incisor was treated with platelet rich fibrin (PRF) and alloplastic bone substitute after conventional endodontic therapy. At the end of 6 months there was gain in clinical attachment, increased radiographic bone fill and reduction in probing depth which was maintained till 18 month follow-up. Present case report aims to evaluate the efficacy of PRF and alloplastic bone substitute in the management of intrabony defect associated with endo-perio lesion in maxillary lateral incisor because the healing potential of PRF and bone graft has not been widely studied in endodontics. The use of PRF allows the clinician to optimize tissue remodelling, wound healing and angiogenesis by the local delivery of growth factors and proteins. The novel technique described here enables the clinician to be benefited from the full regenerative capacity of this autologous biologic material.

Esthetic perception of maxillary lateral incisor agenesis treatment by canine mesialization.

PubMed

Mota, Antonino; Pinho, Teresa

2016-03-01

The objective of this study was to evaluate perception of the smile in maxillary lateral incisor agenesis (MLIA) cases treated by mesialization of a canine. Nine images were digitally modified from the same frontal intraoral photograph to simulate various treatment options for space closure in MLIA. A questionnaire was submitted to laypersons (303), general dentists (215), prosthodontists (55) and orthodontists (81). Statistical tests with a significance level of P<0.05 were used. The views of MLIA treatment judged to be most attractive showed unilateral dental and gingival reshaping. All study groups considered the simple dental reshaping of the mesial edge of the canine to be attractive. In the analysis of the images grouped together for both unilateral and bilateral MLIA, the view showing dental and gingival reshaping was considered the most attractive whereas unmodified mesialization was considered the least attractive. Regarding the space closure treatments, although all groups regarded simple dental reshaping of the canine to be attractive, the dental professionals considered gingival and crown reshaping to be more esthetic. In contrast, laypersons were not significantly responsive to this dental and gingival modification as compared to only slight reshaping of the mesial edge of the cusp of the mesialized canine in MLIA. Copyright © 2015 CEO. Published by Elsevier Masson SAS. All rights reserved.

A Rare Case of Bilateral Agenesis of Central Lower Incisors Associated With Upper Impacted Canine- A Case Report

PubMed Central

PORUMB, Anca; IGNAT ROMANUL, Ioana; DALAI, Camelia; CIAVOI, Gabiela; TIG, Ioan Andrei

2016-01-01

This case of a female patient, 14 yr old with association of the two anomalies, which we came across with in 2014, is rarely met in the specialty practice. The impacted canines are part of the group of dental anomalies of position, while the agenesis is part of the group of dental number anomalies. The orthodontic treatment in the two arches has to be differentiated, the therapeutic objectives being, also different in the two arches. PMID:27141502

A Rare Case of Bilateral Agenesis of Central Lower Incisors Associated With Upper Impacted Canine- A Case Report.

PubMed

Porumb, Anca; Ignat Romanul, Ioana; Dalai, Camelia; Ciavoi, Gabiela; Tig, Ioan Andrei

2016-03-01

This case of a female patient, 14 yr old with association of the two anomalies, which we came across with in 2014, is rarely met in the specialty practice. The impacted canines are part of the group of dental anomalies of position, while the agenesis is part of the group of dental number anomalies. The orthodontic treatment in the two arches has to be differentiated, the therapeutic objectives being, also different in the two arches.

Mandibular dental arch changes with active self-ligating brackets combined with different archwires.

PubMed

Atik, E; Akarsu-Guven, B; Kocadereli, I

2018-05-01

The aim was to compare mandibular arch and incisor inclinational changes by comparing active self-ligating brackets used with different forms of archwires with a control group in nonextraction cases. The sample of 50 patients with Class I malocclusion was divided into three groups: Group I was treated with active self-ligating brackets (Nexus, Ormco/Orange, CA, USA) used with Damon arch form copper nickel-titanium (Cu-NiTi) and stainless steel (SS) wires; Group II was treated with interactive self-ligating bracket system (Empower, American Orthodontics, Sheboygan, Wis, USA) used with standard Cu-NiTi and SS wires; and Group III was treated with Roth prescribed conventional brackets (Forestadent, Pforzheim, Germany) with standard Cu-NiTi and SS wires which was designed as a control group. Changes in dimension of mandibular arch and inclination of incisors were assessed on dental models and lateral cephalometric radiographs at pretreatment (T1) and posttreatment (T2) periods. Paired-t test and one-way analysis of variance were used to perform intragroup and intergroup comparisons, respectively. In all groups, an average increase of transversal distances occurred from pretreatment to the posttreatment period (P < 0.05). However, mandibular arch length increase was significantly different among the Groups I-III (P = 0.008) and I-II (P = 0.006). No significant intergroup difference was found with regard to incisor inclinational changes. Bracket type had no significant effect on the mandibular dimensional or incisor inclination changes. Besides this, archwire type had only little effect on the treatment results as active self-ligating bracket with Damon archwires increased mandibular arch length greater than other groups.

External apical root resorption in maxillary incisors in orthodontic patients: associated factors and radiographic evaluation

PubMed Central

Patanaporn, Virush; Janhom, Apirum; Korwanich, Narumanus

2012-01-01

Purpose This study was performed to evaluate the incidence and degree of external apical root resorption of maxillary incisors after orthodontic treatment and to evaluate particular associated factors related to external apical root resorption. Materials and Methods The records and maxillary incisor periapical radiographs of 181 patients were investigated. Crown and root lengths were measured and compared on the pre- and post-treatment periapical radiographs. Crown length was measured from the center of the incisal edge to the midpoint of the cemento-enamel junction (CEJ). Root length was measured from the CEJ midpoint to the root apex. A correction factor for the enlargement difference was used to calculate root resorption. Results The periapical radiographs of 564 teeth showed that the average root resorption was 1.39±1.27 (8.24±7.22%) and 1.69±1.14 mm (10.16±6.78%) for the maxillary central and lateral incisors, respectively. The results showed that the dilacerated or pointed roots, maxillary premolar extraction cases, and treatment duration were highly significant factors for root resorption (p<0.001). Allergic condition was a significant factor at p<0.01. Age at the start of treatment, large overjet, and history of facial trauma were also factors significantly associated with root resorption (p<0.05). There was no statistically significant difference in root resorption among the factors of gender, overbite, tongue-thrusting habit, types of malocclusion, and types of bracket. Conclusion These results suggested that orthodontic treatment should be carefully performed in pre-treatment extraction patients who have pointed or dilacerated roots and need long treatment duration. PMID:23071964

Radiographic Study of the Prevalence and Distribution of Hypodontia Associated with Unilateral and Bilateral Clef Lip and Palate in a Hungarian Population

PubMed Central

Berniczei-Roykó, Ádám; Tappe, Jan-Hendrik; Krinner, Axel; Gredes, Tomasz; Végh, András; Gábor, Katona; Linkowska-Świdzińska, Kamila; Botzenhart, Ute Ulrike

2016-01-01

Background Cleft defects are one of the most frequent birth-deformities of the orofacial region and they are commonly associated with anomalies of the tooth structure, size, shape, formation, eruption, and tooth number. The aim of our study was to evaluate the prevalence, distribution, and potential association of combined hypodontia in cleft-affected patients with regard to all types of teeth in both jaws in the permanent dentition. Material/Methods This retrospective radiographic analysis included patients with various types of clefts treated orthodontically in the Department of Orofacial Orthopedics and Orthodontics at Heim Pàl Children’s Hospital, Budapest. There were 150 patients (84 males, 66 females) with non-syndromic unilateral (UCLP; n=120 patients) or bilateral (BCLP; n=30 patients) cleft formation (lip, alveolus and palate) who met the inclusion criteria. Statistical analysis was performed using the chi-square test and Fisher’s exact test (significance level p<0.05). Results Hypodontia was significantly more frequent in patients with cleft-sided lateral incisor (104 patients, 69%), with a total of 235 missing teeth, followed by the second premolars of the upper and lower jaw. A significant correlation of congenital missing teeth was observed in left-sided clefts between the upper and lower second premolar in the cleft area. Conclusions Hypodontia inside and outside the cleft area was frequently observed. This should affect the therapy plans, especially if the cleft-sided premolar is also absent. Further comprehensive research including numerous random samples is necessary for better estimating other possible associations. PMID:27767023

Epidemiology of gingivitis in schoolchildren in Bucharest, Romania: a cross-sectional study.

PubMed

Funieru, C; Klinger, A; Băicuș, C; Funieru, E; Dumitriu, H T; Dumitriu, A

2017-04-01

Gingivitis is the most prevalent oral disease in children, being strongly associated to social gradients. Many studies have reported different results concerning the extent and intra-oral distribution of gingivitis in children. The aim of this study was to investigate the epidemiologic parameters and socio-related risk factors of gingivitis in the 10-17-year-old Bucharest schoolchildren population and to analyze its intra-oral distribution. Cross-sectional data were obtained from 1595 schoolchildren, social condition being assigned using a simple questionnaire. Classes of students were used as clusters in a single-stage cluster sampling method. An intra-oral exam was performed for all the children included in this study. Silness and Löe scores, prevalence and the extent of gingivitis were calculated. The gingival scores showed a mild inflammation and the prevalence of gingivitis was 91%. Boys had a higher gingival (0.19 vs. 0.18; p < 0.05) and plaque scores (0.71 vs. 0.59; p < 0.01) than girls. Children who did not live in overcrowded households, whose parents had a better education and those who had direct access to school dental services displayed better gingival conditions (p < 0.05). Gingivitis was more severe on the upper teeth, with the maximum score being reached at the right upper lateral incisor (0.63 on distal surface). Gingival condition in Bucharest schoolchildren population was associated to social gradients. School dental services are also another factor that seems to be related with gingivitis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Applicability of the Moyers' Probability Tables in Adolescents with Different Facial Biotypes

PubMed Central

Carrillo, Jorge J. Pavani; Rubial, Maria C.; Albornoz, Cristina; Villalba, Silvina; Damiani, Patricia; de Cravero, Marta Rugani

2017-01-01

Introduction: The Moyers’ probability tables are used in mixed dentition analysis to estimate the extent of space required for the alignment of canines and premolars, by correlating the mesiodistal size of lower incisors with the size of permanent canines and premolars. Objective: This study intended to evaluate the applicability of the Moyer's probability tables for predicting the mesiodistal space needed for the correct location of premolars and permanent canines non-erupted, in adolescents of the city of Cordoba, Argentina, who show different facial biotypes. Materials and Methods: Models and tele-radiographies of 478 adolescents of both genders from 10 to 15 years of age were analyzed. The tele-radiographies were measured manually in order to determine the facial biotype. The models were scanned with a gauged scanner (HP 3670) and measured by using Image Pro Plus 4.5 software. Results: According to this study, the comparison between the Moyer´s probability table, and the table created at the National University of Córdoba (UNC) (at 95%, 75%, and 50%) shows that, in both tables, a higher value of mesiodistal width of lower incisors corresponds to a bigger difference in the space needed for permanent canines and premolars; being the need for space for permanents canines and premolars bigger in the UNC´s table. On the other hand, when contrasting the values of mesiodistal space for permanent canines and premolars associated with each facial biotype, the discrepancies between groups were not statistically significant (P >0.05). However, we found differences in the size of the space required according to the mesiodistal width range of the lower incisors for each biotype: a) The comparison of lower-range values, with a mesialdistal width of lower incisors less than 22 mm, the space required for permanent canines and premolars resulted smaller in patients with dolichofacial biotype than in patients with mesofacial and braquifacial biotypes. The latter biotypes have meager differences between them. b) The comparison of mid-range values, with a mesialdistal width of lower incisors from 22 to 25 millimeters, shows that the values of required alignment space are similar in the three facial biotypes. c) Finally, the comparison of upper range values, with a mesialdistal width of lower incisors greater than 25 millimeters, indicates that the space required for dolichofacial biotypes tends to be higher than in mesofacial and brachyfacial biotypes. Conclusion: The Moyer´s probability tables should be created to meet the needs of the population under study, with no consideration of patients’ facial biotypes. PMID:28567145

Increased occurrence of dental anomalies associated with infraocclusion of deciduous molars.

PubMed

Shalish, Miriam; Peck, Sheldon; Wasserstein, Atalia; Peck, Leena

2010-05-01

To test the null hypothesis that there is no relationship between infraocclusion and the occurrence of other dental anomalies in subjects selected for clear-cut infraocclusion of one or more deciduous molars. The experimental sample consisted of 99 orthodontic patients (43 from Boston, Mass, United States; 56 from Jerusalem, Israel) with at least one deciduous molar in infraocclusion greater than 1 mm vertical discrepancy, measured from the mesial marginal ridge of the first permanent molar. Panoramic radiographs and dental casts were used to determine the presence of other dental anomalies, including agenesis of permanent teeth, microdontia of maxillary lateral incisors, palatally displaced canines (PDC), and distal angulation of the mandibular second premolars (MnP2-DA). Comparative prevalence reference values were utilized and statistical testing was performed using the chi-square test (P < .05) and odds ratio. The studied dental anomalies showed two to seven times greater prevalence in the infraocclusion samples, compared with reported prevalence in reference samples. In most cases, the infraoccluded deciduous molar exfoliated eventually and the underlying premolar erupted spontaneously. In some severe phenotypes (10%), the infraoccluded deciduous molar was extracted and space was regained to allow uncomplicated eruption of the associated premolar. Statistically significant associations were observed between the presence of infraocclusion and the occurrence of tooth agenesis, microdontia of maxillary lateral incisors, PDC, and MnP2-DA. These associations support a hypothesis favoring shared causal genetic factors. Clinically, infraocclusion may be considered an early marker for the development of later appearing dental anomalies, such as tooth agenesis and PDC.

Combined endodontic-periodontic treatment of a palatal groove: a case report.

PubMed

Schwartz, Scott A; Koch, Michael A; Deas, David E; Powell, Charles A

2006-06-01

The palatal groove is a developmental anomaly that predisposes the tooth involved to a severe periodontal defect. When further complicated by pulp necrosis, these grooves often present a diagnostic and treatment planning challenge that requires an interdisciplinary treatment approach. This case report describes the successful collaborative management of a maxillary lateral incisor with an extensive palatal groove using a combination of nonsurgical endodontic therapy, odontoplasty, and periodontal regenerative techniques.

Spec Rekindled-A Simple Torque Correction Mechanics for Transposed Teeth in Conjunction with Pre-adjusted Edgewise Appliance System.

PubMed

Singh, Harpreet; Maurya, Raj Kumar; Thakkar, Surbhi

2016-12-01

Complete transposition of teeth is a rather rare phenomenon. After correction of transposed and malaligned lateral incisor and canine, attainment of appropriate individual antagonistic tooth torque is indispensable, which many orthodontists consider to be a herculean task. Here, a novel method is proposed which demonstrates the use of Spec reverse torquing auxillary as an effective adjunctive aid in conjunction with pre-adjusted edgewise brackets.

Maxillary unicystic ameloblastoma: a case report.

PubMed

Agani, Zana; Hamiti-Krasniqi, Vjosa; Recica, Jehona; Loxha, Mergime Prekazi; Kurshumliu, Fisnik; Rexhepi, Aida

2016-10-18

Ameloblastoma is a benign epithelial odontogenic tumor. It is often aggressive and destructive, with the capacity to attain great size, erode bone and invade adjacent structures. Unicystic ameloblastoma is a rare odontogenic lesion, with clinical, radiographic and gross features of jaw cysts. The lesion histologically shows typical ameloblastomatous epithelium lining part of the cyst cavity with or without and/or mural tumor growth. Unicystic ameloblastoma usually presents in posterior mandibular ramus region, while it is rare and atypical in posterior maxillary region. . We report a case of 16 year old Kosovar male, Albanian ethnicity, who presented with a swelling located in right maxillary region. Clinical examination revealed a painless swelling extending from the maxillary right central incisor to the maxillary right first molar tooth. Panoramic radiograph disclosed a well corticated unilocular radiolucent lesion approximately 5 × 5 cm in diameter which was in contact with the roots of the teeth present inferiorly and with the maxillary sinus superiorly. Maxillary right canine impaction was noted and unerupted lateral incisor tooth was present inside the radiolucency. Preoperative diagnosis of the lesion was made as dentigerous cyst based on the age of the patient, location of the swelling, clinical and radiographic findings, but the unicystic ameloblastoma was also taken into consideration. The patient was treated by surgical enucleation of the lesion and extraction of lateral incisor tooth which was present inside the lesion. The histopathological examination of the lesion revealed confirmed finding for unicystic ameloblastoma mural form. No recurrence was observed in 1 year follow-up. Maxillary region is considered a rare and atypical location for unicystic ameloblastoma. We emphasize the importance of differential diagnosis of an odontogenic lesion with common clinical and radiological features that will impact the treatment planning and follow up. As oral health providers we should be aware that the unilocular radiolucencies may be unicystic ameloblastoma.

Quantification of facial and smile esthetics.

PubMed

Koidou, Vasiliki P; Chatzopoulos, Georgios S; Rosenstiel, Stephen F

2018-02-01

Whether deviations in alignment discrepancy, width-to-length ratio, application of the golden proportion, or number of teeth revealed in smile affect attractiveness is yet unknown. The purpose of this analytical study was to quantify dental and facial esthetics to determine whether individuals identified as having superior smiles display differences in alignment discrepancies (angulation between interpupillary and commissure line); width-to-length ratios of maxillary anterior teeth; application of the golden proportion (approximately 1.618:1); and number of teeth revealed in an animated smile when compared with an average population. An Internet search for "best smile" and "celebrity" identified 108 celebrities. Photographs showing smiles within 10 degrees of a frontal view were collected, while photographs of dental students were used for the control group. Alignment discrepancies, widths and lengths of the anterior teeth, and number of teeth revealed in an animated smile were measured with photo-editing software, and ratios were calculated. The groups were compared with repeated-measures ANOVA, the Mann-Whitney U test, and the Wilcoxon signed-rank test (α=.05). Usable photographs were obtained for 90 celebrities (58 women, 32 men) and compared with photographs of 97 dental students (54 women, 43 men). Statistically significant differences were found for alignment discrepancies (celebrities 0.97, students 1.25, P=.034) and for the number of teeth displayed (P=.049); 22.2% of the celebrities revealed 12 teeth, versus 6.2% of the students. In both groups, significant differences from the golden ratio (1.618:1) for the width of the central incisor/lateral incisor right and left and for the width of the lateral incisor/canine right and left were observed through 95% confidence intervals. Sex and left-right were nonsignificant factors. Celebrities identified as having a best smile had smaller mean alignment discrepancies and revealed a greater number of teeth in an animated smile than dental students. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Is subcranial Le Fort III plus Le Fort I osteotomy stable?

PubMed

Boos Lima, Fernanda Brasil Daura Jorge; Hochuli Vieira, Eduardo; Juergens, Philipp; Lima Junior, Sergio Monteiro

2017-12-01

The purpose of this study was to test whether associated subcranial Le Fort III (sLF III) and Le Fort I (LF I) osteotomies are stable after large advancements of the middle third of the face and maxilla. The authors designed a retrospective study and enrolled a sample of consecutive patients with midface hypoplasia treated with associated sLF III and LF I osteotomies in this IRB-approved study between September 2013 and February 2015. To test whether the long-term stability was satisfactory, the authors compared cephalometric changes from immediately after surgery to 18 months after surgery taken from multi-slice computed tomography using two different third-party imaging software programs. Statistical significance was set as P ≤ 0.05. The sample comprised 11 patients (mean age 23.84 ± 4.17 yr; 54% men). The mean advancement of the upper incisor immediately after surgery was 10.03 ± 1.6 mm. After 18 months, the position of the upper incisor did not vary significantly (10.18 ± 2.35 mm). All other cephalometric landmarks did not present statistically significant differences between immediately after and 18 months after surgery, with horizontal and vertical variations of less than one millimetre. This study supports that sLF III and LF I osteotomies are effective in maintaining stable horizontal and vertical skeletal positioning after surgery. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Quantitative and qualitative assessment of anchorage loss during en-masse retraction with indirectly loaded miniscrews in patients with bimaxillary protrusion.

PubMed

Monga, Nitika; Kharbanda, Om Prakash; Samrit, Vilas

2016-08-01

This study provides vital insight in assessing anchorage loss when miniscrews are indirectly loaded. The study sample comprised 18 patients with bimaxillary protrusion (14 girls, 4 boys; mean age, 17.3 ± 4.6 years) selected from a database of 89 patients treated with miniscrews. All subjects who were selected required extraction of all first premolars and maximum anchorage. After initial leveling and aligning, miniscrews were placed between the first molar and the second premolar in all 4 quadrants and loaded by the indirect method at 3 weeks after placement with 200-g nickel-titanium alloy closed-coil springs for en-masse retraction. Mean treatment duration was 29.7 ± 6.8 months. Pretreatment and posttreatment lateral cephalograms were analyzed to measure the amount of anchorage loss, incisor retraction, and the incisors' angular change in reference to the pterygoid vertical reference line and were evaluated by the structural superimposition method. The ratio of incisor retraction to molar protraction was 4.2 in the maxilla and 4.7 in the mandible. The first molars showed mean extrusion of 0.20 mm in the maxilla and 0.57 mm in the mandible; these were statistically insignificant. The mean angular change of the first molars was -2.43° in the maxilla and -0.03° in the mandible. The mean anchorage loss in reference to the pterygoid vertical was 1.3 mm in the maxilla and 1.1 mm in the mandible; these were statistically significant. Structural superimpositions showed mean change in molar position of 0.83 mm in the maxilla and 0.87 mm in the mandible, and 5.77 mm in the maxillary incisor and 5.43 mm in the mandibular incisor. These results were compared with the direct anchorage method reported in the literature. Indirect miniscrew anchorage can be a viable alternative to direct anchorage. Copyright © 2016. Published by Elsevier Inc.

Treatment effects of the Forsus Fatigue Resistant Device used with miniscrew anchorage.

PubMed

Aslan, Belma I; Kucukkaraca, Ebru; Turkoz, Cagri; Dincer, Mufide

2014-01-01

To evaluate the dentofacial effects of the Forsus Fatigue Resistant Device (FRD) used with miniscrew anchorage (FRDMS) and compare them with those of conventional FRD and an untreated Class II control group. The sample consisted of 48 Class II subjects. Sixteen patients (13.68 ± 1.09 years of age) were treated with FRDMS, whereas 17 subjects (14.64 ± 1.56 years of age) were treated with only FRD. Also, a control sample of 15 untreated Class II subjects (14.13 ± 1.50 years of age) was constructed. Angular and linear measurements were made on 96 lateral cephalograms. Paired t, one-way analysis of variance, and Tukey tests were used for statistical analysis. Class I molar relationship and overjet correction were achieved in an average period of 6.5 ± 1.97 and 5.5 ± 1.80 months in the FRDMS and FRD groups, respectively. No skeletal effect was determined in both treatment groups. Greater overbite correction was found in the FRD group. Retrusion and extrusion of maxillary incisors, distalization of maxillary molars, and extrusion of mandibular molars were significant in both treatment groups. Labial tipping of mandibular incisors was significantly greater in the FRD group than in the FRDMS group. Overjet and molar correction was totally dentoalveolar. Unfavorable labial tipping of mandibular incisors was effectively minimized with the usage of miniscrews.

Treatment outcomes of Class II malocclusion cases treated with miniscrew-anchored Forsus Fatigue Resistant Device: A randomized controlled trial.

PubMed

Eissa, Osama; El-Shennawy, Mahmoud; Gaballah, Safaa; El-Meehy, Ghada; El Bialy, Tarek

2017-11-01

To evaluate the skeletal, dental, and soft tissue effects of the Forsus Fatigue Resistant Device (FRD) used with miniscrew anchorage and compare them with those of the conventional Forsus FRD. This study was carried out on 38 patients. These patients were randomly allocated into three groups. The 14 patients in group 1 (aged 12.76 ± 1.0 years) were treated with the FRD appliance. In group 2, the 15 patients (aged 12.52 ± 1.12 years) received treatment with FRD using miniscrew anchorage, and the 9 patients in group 3 (aged 12.82 ± 0.9 years) received no treatment as a control group. Linear and angular measurements were made on lateral cephalograms before and immediately after Forsus treatment. Data were analyzed statistically using paired t-, ANOVA, and Tukey tests. Class I molar relationship and overjet correction were achieved in both treatment groups. Although mandibular growth was statistically nonsignificant, there was a significant headgear effect on the maxilla. Mandibular incisor proclination, maxillary incisor retroclination, and distalization of maxillary molars were significant in both treatment groups. However, no significant differences were found between the treatment groups. Class II correction was mainly dentoalveolar in both treatment groups. Use of miniscrews with Forsus did not enhance mandibular forward growth nor prevent labial tipping of the mandibular incisors.

COMPUTED TOMOGRAPHIC FEATURES OF INCISOR PSEUDO-ODONTOMAS IN PRAIRIE DOGS (CYNOMYS LUDOVICIANUS).

PubMed

Pelizzone, Igor; Di Ianni, Francesco; Volta, Antonella; Gnudi, Giacomo; Manfredi, Sabrina; Bertocchi, Mara; Parmigiani, Enrico

2017-05-01

Maxillary incisor pseudo-odontomas are common in pet prairie dogs and can cause progressive respiratory obstruction, while mandibular pseudo-odontomas are rarely clinically significant. The aim of this retrospective cross-sectional study was to describe CT features of maxillary and mandibular incisor pseudo-odontomas vs. normal incisors in a group of pet prairie dogs. All pet prairie dogs with head CT scans acquired during the period of 2013-2015 were included. A veterinary radiologist who was aware of final diagnosis reviewed CT scans and recorded qualitative features of affected and normal incisors. Mean density values for the pulp cavity and palatal and buccal dentin were also recorded. A total of 16 prairie dogs were sampled (12 normal maxillary incisors, 20 confirmed maxillary incisor pseudo-odontomas, 20 normal mandibular incisors, 12 presumed mandibular incisor pseudo-odontomas). Maxillary incisors with confirmed pseudo-odontomas had a significantly hyperattenuating pulp and dentin in the reserve crown and apical zone, when compared to normal maxillary incisors. Pseudo-odontomas appeared as enlargements of the apical zone with a globular/multilobular hyperattenuating mass formation haphazardly arranged, encroaching on midline and growing caudally and ventrally. Presumed mandibular incisor pseudo-odontomas had similar CT characteristics. In 60% of prairie dogs with maxillary incisor pseudo-odontomas, the hard palate was deformed and the mass bulged into the oral cavity causing loss of the palatine bone. The common nasal meatus was partially or totally obliterated in 81.8% of prairie dogs with maxillary pseudo-odontomas. Findings supported the use of CT for characterizing extent of involvement and surgical planning in prairie dogs with pseudo-odontomas. © 2017 American College of Veterinary Radiology.

Evaluation of root and alveolar bone development of unilateral osseous impacted immature maxillary central incisors after the closed-eruption technique.

PubMed

Shi, Xiangru; Xie, Xiaoyan; Quan, Junkang; Wang, Xiaozhe; Sun, Xiangyu; Zhang, Chenying; Zheng, Shuguo

2015-10-01

In this study, we evaluated root and alveolar bone development in unilateral osseous impacted immature maxillary central incisors by cone-beam computed tomography before and after closed-eruption treatment, in comparison with naturally erupted contralateral immature maxillary central incisors. The study included 30 patients, 20 boys and 10 girls, with a mean age of 8.44 ± 1.20 years (range, 6.5-11.2 years). After treatment, the root lengths of both the impacted maxillary central incisors (10.66 ± 2.10 mm) and the contralateral maxillary central incisors (11.04 ± 1.76 mm) were significantly greater than their pretreatment values (6.67 ± 1.94 and 9.02 ± 2.13 mm, respectively). The root canal widths of the incisors decreased significantly after treatment. From the posttreatment cone-beam computed tomography images, the ratio of exposed root length to total root length and the thickness of the alveolar bone at 1 mm under the alveolar crest and at the apex were calculated to evaluate alveolar bone development. Impacted immature maxillary central incisors differed significantly from contralateral immature maxillary central incisors in labial exposed root length, labial ratio to total root length, and lingual alveolar crest. Clinical crown height was higher (statistically but not clinically) for the impacted incisors (9.87 mm) than for the contralateral incisors (9.37 mm). Impacted immature incisors grew to the same stage as did erupted contralateral incisors after closed-eruption treatment. Both incisor types had some alveolar bone loss, and thin alveolar bone surrounded the roots. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

[Aesthetic evaluation of nasolabial angle alteration on the soft tissue profile of skeleton class I].

PubMed

Xu, Anxiu; Deng, Feng; Wang, Fenfen; Zhang, Xiangfeng; Zhang, Yi

2015-10-01

To study the influence of nasolabial angle alteration on facial profile attractiveness and investigate the perception differences in profile attractiveness among laypeople. A young Chinese female with normal hard and soft tissue cephalometric values was chosen as a research object. Profile photograph was taken in a natural head position. Photoshop software was chosen to rotate the nose tip and upper lip, thus changing the degree and direction of nasolabial angle. A total of 33 different profile pictures were achieved. Thirty-three professional orthodontists and 64 non-professionals were chosen to score these 33 pictures. When the upper lip position was fixed, the profile was considerably attractive because the angle of nasal tip was not changed or altered. When the nasal tip rotation angle was fixed, profiles with a retroclined upper lip were considered significantly attractive by the layperson and professional groups. Regardless of the direction of the nasal tip rotation, the respondents considered the profile with a retroclined upper lip highly attractive. The soft tissue profile with a retroclined upper lip looks considerably attractive in Chinese female populations. Therefore, during an orthodontic treatment, appropriate retraction of the incisor is recommended to improve soft tissue profile attractiveness.

Step-wise treatment of two periodontal-endodontic lesions in a heavy smoker.

PubMed

Walter, C; Krastl, G; Weiger, R

2008-11-01

To report a clinical case of two advanced periodontal-endodontic lesions with a focus on treatment issues related to tobacco use. A 53-year-old Caucasian male was referred to the School of Dentistry, Basel, Switzerland, for periodontal treatment. The major diagnoses were chronic (smoker) periodontitis and advanced combined periodontal-endodontic lesions on the mandibular left lateral incisor and right incisor. Conventional root canal treatment was performed, and subsequently led to reduced radiolucencies around the affected roots after 14 months. The remaining osseous defect was augmented by guided tissue regeneration using bovine bone substitute and resorbable membrane. The follow-up revealed a stable situation from clinical (probing depth 2-4 mm) and radiological points of view 32 months after initiation of treatment. Treatment considerations related to tobacco use are discussed. * After conventional root canal treatment, osseous healing should occur before further complementary therapy is taken into account. * Issues related to tobacco use have to be considered before treatment is initiated.

Complications of misdiagnosis of maxillary canine ectopic eruption.

PubMed

Garib, Daniela Gamba; Janson, Guilherme; Baldo, Taiana de Oliveira; dos Santos, Patrícia Bittencourt Dutra

2012-08-01

Ectopic eruption of maxillary canines can be associated with root resorption of adjacent teeth. This case report describes and discusses an interesting case of a 15-year-old girl with a Class III malocclusion and an impacted maxillary canine. Because of the unfavorable position of the ectopic canine and the severe root resorption of the maxillary left central and lateral incisors, the treatment options included extraction of the maxillary permanent canines. The mandibular first premolars were extracted to compensate for the Class III malocclusion. A panoramic radiograph taken earlier in the mixed dentition already indicated a possible eruption disturbance of the maxillary left permanent canine. The importance of early diagnosis of maxillary canine ectopic eruption is highlighted in this case report. The early identification of radiographic signs of an ectopic pathway of eruption should be followed by deciduous canine extraction to prevent canine retention and maxillary incisor root resorption. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Lightness, chroma, and hue distributions in natural teeth measured by a spectrophotometer

PubMed Central

Pustina-Krasniqi, Teuta; Shala, Kujtim; Staka, Gloria; Bicaj, Teuta; Ahmedi, Enis; Dula, Linda

2017-01-01

Objective: The aim of the study was to analyze the distribution of color parameters, lightness (L*), chroma (C), hue (H), a* and b*, in the intercanine sector in maxilla. Material and Methods: Patients' tooth color measurements were performed using an intraoral spectrophotometer VITA Easyshade® (VITA Zahnfabrik H. Rauter GmbH and Co. KG, Bad Sackingen, Germany). The measurements were made in 255 subjects in the intercanine sector in maxilla. Results: The mean values for the group of 255 subjects were as follows: L*, a*, b*, C, and H as 81.6, 0.67, 21.6, 21.7, and 92.7, respectively. For F=206.27 and P < 0.001 between L*, a*, b*, C, H, and central incisor/lateral incisor/canines, there were statistically significant differences. Conclusion: With the statistical analysis, it was determined that there are significant color differences between the teeth of the intercanine sector, which differences are clinically significant also. PMID:28435363

Aesthetic Rehabilitation of a Complicated Crown-Root Fracture of the Maxillary Incisor: Combination of Orthodontic and Implant Treatment

PubMed Central

de Avila, Érica Dorigatti; de Molon, Rafael Scaf; Cardoso, Mauricio de Almeida; Capelozza Filho, Leopoldino; Campos Velo, Marilia Mattar de Amoêdo; Mollo, Francisco de Assis; Borelli Barros, Luiz Antonio

2014-01-01

The aim of this paper is to present a complex rehabilitation, of fractured tooth, with implants in anterior region considering the orthodontics extrusion to clinical success. At 7 years old, the patient fractured the maxillary left central incisor and the dentist did a crown with the fragment. Twenty years later, the patient was referred to a dental clinic for orthodontic treatment, with the chief complaint related to an accentuated deep bite, and a professional started an orthodontic treatment. After sixteen months of orthodontic treatment, tooth 21 fractured. The treatment plan included an orthodontic extrusion of tooth 21 and implant placement. This case has been followed up and the clinical and radiographic examinations show excellence esthetic results and satisfaction of patient. The forced extrusion can be a viable treatment option in the management of crown root fracture of an anterior tooth to gain bone in a vertical direction. This case emphasizes that to achieve the esthetic result a multidisciplinary approach is necessary. PMID:24872900

Comparison of three-dimensional orthodontic load systems of different commercial archwires for space closure.

PubMed

Gajda, Steven; Chen, Jie

2012-03-01

To experimentally quantify the effects of the loop design on three-dimensional orthodontic load systems of two types of commercial closing loop archwires: Teardrop and Keyhole. An orthodontic force tester and custom-made dentoform were used to measure the load systems produced on two teeth during simulated space closure. The system included three force components along and three moment components about three clinically defined axes on two target teeth: the left maxillary canine and the lateral incisor. The archwires were attached to the dentoform and were activated following a standard clinical procedure. The resulting six load components produced by the two archwires were reported and compared. The results were also compared with those of the T-loop archwire published previously. The three designs deliver similar loading patterns; however, the component magnitudes are dependent on the design. All of the designs result in lingual tipping of the teeth, canine lingual-mesial displacement, canine crown-mesial-in rotation, and incisor crown-distal-in rotation.

Relationship between friction force and orthodontic force at the leveling stage using a coated wire.

PubMed

Murayama, Masaki; Namura, Yasuhiro; Tamura, Takahiko; Iwai, Hiroaki; Shimizu, Noriyoshi

2013-01-01

The relationship between orthodontic force and friction produced from an archwire and brackets affects the sliding of the wire in the leveling stage. The purpose of this study was to evaluate the relationship between force and friction in a small esthetic nickel-titanium (Ni-Ti) wire. Five esthetic wires (three coated and two plated) and two small, plain Ni-Ti wires (0.012 and 0.014 inches) were used. We performed a three-point bending test according to ISO 15841 and the drawing test with a dental arch model designed with upper linguoversion of the lateral incisor in the arch (displacements of 0.5, 1.0, 2.0 and 3.0 mm), and evaluated the relationship between them. Unloading bending forces of all wires at displacements of less than 1.0 mm were larger than friction forces, but all friction forces at displacements exceeding 2.0 mm were larger than unloading bending forces. The arch likely expands when displacement from the proximal brackets exceeds 1.0 mm. The friction force of a martensite 0.014-inch Ni-Ti wire was significantly greater than those of the other esthetic and austenitic wires. A wire with the smallest possible friction force should be used in cases with more than 1.0 mm displacement.

Infraorbital nerve transposition to expand the endoscopic transnasal maxillectomy.

PubMed

Salzano, Giovanni; Turri-Zanoni, Mario; Karligkiotis, Apostolos; Zocchi, Jacopo; Dell'Aversana Orabona, Giovanni; Califano, Luigi; Battaglia, Paolo; Castelnuovo, Paolo

2017-02-01

The infraorbital nerve (ION) is a terminal branch of the maxillary nerve (V2) providing sensory innervation to the malar skin. It is sometimes necessary to sacrifice the ION and its branches to obtain adequate maxillary sinus exposure for radical resection of sinonasal tumors. Consequently, patients suffer temporary or permanent paresthesia, hypoestesthia, and neuralgia of the face. We describe an innovative technique used for preservation of the ION while removing the anterior, superior, and lateral walls of the maxillary sinus through a medial endoscopic transnasal maxillectomy. All patients who underwent transnasal endoscopic maxillectomy with ION transposition in our institute were retrospectively reviewed. Two patients were identified who had been treated for sinonasal cancers using this approach. No major complications were observed. Transient loss of ION function was observed with complete recovery of skin sensory perception within 6 months of surgery. One patient referred to a mild permanent anesthesia of the upper incisors. No diplopia or enophthalmos were encountered in any of the patients. The ION transposition is useful for selected cases of benign and malignant sinonasal tumors that do not infiltrate the ION itself but involve the surrounding portion of the maxillary sinus. Anatomic preservation of the ION seems to be beneficial to the postoperative quality of life of such patients. © 2016 ARS-AAOA, LLC.

New evidence for mammaliaform ear evolution and feeding adaptation in a Jurassic ecosystem

NASA Astrophysics Data System (ADS)

Luo, Zhe-Xi; Meng, Qing-Jin; Grossnickle, David M.; Liu, Di; Neander, April I.; Zhang, Yu-Guang; Ji, Qiang

2017-08-01

Stem mammaliaforms are forerunners to modern mammals, and they achieved considerable ecomorphological diversity in their own right. Recent discoveries suggest that eleutherodontids, a subclade of Haramiyida, were more species-rich during the Jurassic period in Asia than previously recognized. Here we report a new Jurassic eleutherodontid mammaliaform with an unusual mosaic of highly specialized characteristics, and the results of phylogenetic analyses that support the hypothesis that haramiyidans are stem mammaliaforms. The new fossil shows fossilized skin membranes that are interpreted to be for gliding and a mandibular middle ear with a unique character combination previously unknown in mammaliaforms. Incisor replacement is prolonged until well after molars are fully erupted, a timing pattern unique to most other mammaliaforms. In situ molar occlusion and a functional analysis reveal a new mode of dental occlusion: dual mortar-pestle occlusion of opposing upper and lower molars, probably for dual crushing and grinding. This suggests that eleutherodontids are herbivorous, and probably specialized for granivory or feeding on soft plant tissues. The inferred dietary adaptation of eleutherodontid gliders represents a remarkable evolutionary convergence with herbivorous gliders in Theria. These Jurassic fossils represent volant, herbivorous stem mammaliaforms associated with pre-angiosperm plants that appear long before the later, iterative associations between angiosperm plants and volant herbivores in various therian clades.

New evidence for mammaliaform ear evolution and feeding adaptation in a Jurassic ecosystem.

PubMed

Luo, Zhe-Xi; Meng, Qing-Jin; Grossnickle, David M; Liu, Di; Neander, April I; Zhang, Yu-Guang; Ji, Qiang

2017-08-17

Stem mammaliaforms are forerunners to modern mammals, and they achieved considerable ecomorphological diversity in their own right. Recent discoveries suggest that eleutherodontids, a subclade of Haramiyida, were more species-rich during the Jurassic period in Asia than previously recognized. Here we report a new Jurassic eleutherodontid mammaliaform with an unusual mosaic of highly specialized characteristics, and the results of phylogenetic analyses that support the hypothesis that haramiyidans are stem mammaliaforms. The new fossil shows fossilized skin membranes that are interpreted to be for gliding and a mandibular middle ear with a unique character combination previously unknown in mammaliaforms. Incisor replacement is prolonged until well after molars are fully erupted, a timing pattern unique to most other mammaliaforms. In situ molar occlusion and a functional analysis reveal a new mode of dental occlusion: dual mortar-pestle occlusion of opposing upper and lower molars, probably for dual crushing and grinding. This suggests that eleutherodontids are herbivorous, and probably specialized for granivory or feeding on soft plant tissues. The inferred dietary adaptation of eleutherodontid gliders represents a remarkable evolutionary convergence with herbivorous gliders in Theria. These Jurassic fossils represent volant, herbivorous stem mammaliaforms associated with pre-angiosperm plants that appear long before the later, iterative associations between angiosperm plants and volant herbivores in various therian clades.

Horizontal root fracture treated with MTA, a case report with a 10-year follow-up.

PubMed

Roig, Miguel; Espona, José; Mercadé, Montse; Duran-Sindreu, Fernando

2011-12-01

Root fractures occur more frequently in fully erupted permanent teeth with closed apices in which the completely formed root is solidly supported in the bone and periodontium. The consequences can be complex because of combined damage to the pulp, dentine, cementum, bone, and periodontium. Management of horizontal root fractures and lateral luxation depends on several factors, with the result that various clinical modalities have been suggested. This case report describes the treatment and 10-year follow-up of two maxillary central incisors, one with horizontal root fracture and the other with lateral luxation, treated with mineral trioxide aggregate and root canal treatment, respectively. © 2011 John Wiley & Sons A/S.

Relapse of incisor crowding: a visit to the Prince of Salina.

PubMed

López-Areal, Luis; Gandía, Jose-Luis

2013-03-01

The management of the retention period after comprehensive orthodontic treatment is of great importance, as a primary goal of clinician. Considerable controversy still surrounds the problem of stability after the retention period. Many studies analyze factors associated to the presence of crowding or incisor irregularity and find predictive features on its relapse. Most studies have reported little o no correlation between the treatment changes in the biological parameters - clinical, biometric (irregularity index, intermolar width, intercanine width, arch length, overjet, overbite), or cephalometric variables- that ocurred and the posttretament and postretention changes that may predict their future development. This article provides a bibliographical overview on the relapse of dental alignment in treated cases. In a brief historical introduction, the first studies on the long-term stability of orthodontic results are analysed. The article then goes on to assess studies that focus attention on anteroinferior alignment before finally studying relapse of upper crowding. It concludes by making some final comments in the light of the bibliography provided and the differents schools regarding retention needs and methods.

Use of a Novel ORMOCER as a Universal Direct Restorative Material.

PubMed

Hakim, Foroud; Vallée, Jessie

2018-01-01

Composite resin is considered the material of choice for direct restoration of teeth when esthetic outcome is a high priority. While material science improvements have mitigated many of the traditional liabilities related to composite resin restorations, shrinkage and related shrinkage stress still play a role in outcomes, placement techniques, and overall success. This case report demonstrates two restorative scenarios using an ORMOCER® composite material. The first features a female patient who, upon completion of preliminary orthodontic treatment, determined in consultation with the orthodontist that her central incisors would present more idealistic display and esthetics if they were lengthened by approximately 1.5 mm. The lengthening of the incisors was to precede the phase II refinement with clear aligners, which would aim to extrude the remaining anterior teeth to develop incisal balance and symmetry. The second case is that of a woman who presented with a newly symptomatic upper right second bicuspid with an existing nearly decade old, large MODL composite resin restoration. This article demonstrates the universal nature of the novel direct restorative material used, making it well-suited for both anterior and posterior applications.

Stainless hooks to bond lower lingual retainer.

PubMed

Durgekar, Sujala G; Nagaraj, K

2011-01-01

We introduced a simple and economical technique for precise placement of lower lingual retainers. Two stainless steel hooks made of 0.6mm wire are placed interdentally in the embrasure area between canine and lateral incisor bilaterally to lock the retainer wire in the correct position. Etch, rinse and dry the enamel surfaces with the retainer passively in place, then bond the retainer with light-cured adhesive. Hooks are simple to fabricate and eliminate the need for a transfer tray.

Spec Rekindled-A Simple Torque Correction Mechanics for Transposed Teeth in Conjunction with Pre-adjusted Edgewise Appliance System

PubMed Central

Singh, Harpreet; Thakkar, Surbhi

2016-01-01

Complete transposition of teeth is a rather rare phenomenon. After correction of transposed and malaligned lateral incisor and canine, attainment of appropriate individual antagonistic tooth torque is indispensable, which many orthodontists consider to be a herculean task. Here, a novel method is proposed which demonstrates the use of Spec reverse torquing auxillary as an effective adjunctive aid in conjunction with pre-adjusted edgewise brackets. PMID:28209017

Endodontic Management of a Maxillary Lateral Incisor with 4 Root Canals and a Dens Invaginatus Tract.

PubMed

Nosrat, Ali; Schneider, S Craig

2015-07-01

Dens invaginatus (DI) is associated with complex internal anatomy. This article represents a maxillary lateral incisor with 5 root canals including DI. The treatment was planned and performed using cone-beam computed tomographic (CBCT) imaging. After clinical and radiographic evaluations, tooth #7 was diagnosed with DI and pulp necrosis with symptomatic apical periodontitis. Periapical radiographs of the tooth showed 2 roots and complex internal anatomy. CBCT evaluation revealed tooth #7 had 5 separate canals (4 root canals and 1 DI canal extending through the root to the periodontal ligament), communication between DI and the root canal system, and severe and multiple curvatures of the palatal canals. Root canal treatment was completed in 2 visits. Modified access openings were required to safely treat the dilacerated palatal canals. At the 6-month re-evaluation, the patient reported he had remained asymptomatic and his tooth had remained functional since the treatment was completed. Clinical examination showed tooth #7 had no sensitivity to percussion or palpation, probe depths within normal limits (≤3 mm), and no mobility. Radiographic assessment of the tooth showed significant osseous healing of the preoperative lesion. Three-dimensional imaging is a valuable tool for endodontic management of teeth with complex internal anatomy. Three-dimensional imaging is recommended for evaluating and treatment planning cases with DI. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Early headgear effects on the eruption pattern of the maxillary canines.

PubMed

Silvola, Anna-Sofia; Arvonen, Päivi; Julku, Johanna; Lähdesmäki, Raija; Kantomaa, Tuomo; Pirttiniemi, Pertti

2009-05-01

To test the null hypothesis that early headgear (HG) treatment has no effect on the eruption pattern of the maxillary canines in the early mixed dentition. Sixty-eight children (40 boys and 28 girls) with a Class II tendency in occlusion and moderate crowding of the dental arches were randomized into two groups. HG treatment was initiated immediately in the first group. In the second group only minor interceptive procedures were performed during the first follow-up period of 2 years. Orthopantomograms were taken at the baseline, three times at 1-year intervals, and after growth at the age of 16. Eruption geometry was performed. The space from the maxillary first molar to the lateral incisor was measured on the dental casts. The inclination of the maxillary canine in relation to the midline appeared to be significantly more vertically oriented on the right side in the HG group 1 and 2 years after starting the HG therapy (P = .0098 and P = .0003, respectively). The inclination in relation to the lateral incisors was smaller in the HG group bilaterally after 1 year and 2 years of HG treatment, and on the right side after 3 years of treatment. The hypothesis is rejected. Early HG treatment significantly affects the inclination of the maxillary canine during eruption. The strongest influence was seen after 2 years of HG use, more prominently in the right-side canine.

Esthetic preferences of laypersons of different cultures and races with regard to smile attractiveness.

PubMed

Sadrhaghighi, Amir Houman; Zarghami, Afsaneh; Sadrhaghighi, Shahrzad; Mohammadi, Amir; Eskandarinezhad, Mahsa

2017-01-01

Culture and ethnicity are among the factors affecting esthetic judgment of individuals. This study aimed to assess the acceptability threshold of variations in four components of an esthetic smile namely vertical lip thickness, dental midline deviation, buccal corridor, and the golden ratio in maxillary lateral incisors display among laypersons of different races and cultures. Raters (n = 35 in each city) among laypersons of nine cities namely Istanbul, Isfahan, Tabriz, Tehran, Doha, Rome, Sydney, Chicago, and Yazd, were given a photo album containing 27 random images of an attractive female smile, digitally altered with regard to the four smile components. They scored each picture from 0 to 100 in terms of smile attractiveness. Data were analyzed using SPSS 13 and the acceptability threshold for each component was calculated in each city using the Spearman and Wilcoxon tests. P< 0.05 was considered statistically significant. No significant differences were noted with regard to the increased vertical lip thickness, and an acceptability threshold could not be determined for it. The acceptability thresholds for midline deviations, buccal corridor, and the golden ratio were different among different cities. One-millimeter increase in the displayed width of maxillary lateral incisors was more desirable than the golden ratio standard width. Culture and race may significantly affect the esthetic preference of individuals with regard to smile attractiveness.

Royal London space analysis: plaster versus digital model assessment.

PubMed

Grewal, Balpreet; Lee, Robert T; Zou, Lifong; Johal, Ama

2017-06-01

With the advent of digital study models, the importance of being able to evaluate space requirements becomes valuable to treatment planning and the justification for any required extraction pattern. This study was undertaken to compare the validity and reliability of the Royal London space analysis (RLSA) undertaken on plaster as compared with digital models. A pilot study (n = 5) was undertaken on plaster and digital models to evaluate the feasibility of digital space planning. This also helped to determine the sample size calculation and as a result, 30 sets of study models with specified inclusion criteria were selected. All five components of the RLSA, namely: crowding; depth of occlusal curve; arch expansion/contraction; incisor antero-posterior advancement and inclination (assessed from the pre-treatment lateral cephalogram) were accounted for in relation to both model types. The plaster models served as the gold standard. Intra-operator measurement error (reliability) was evaluated along with a direct comparison of the measured digital values (validity) with the plaster models. The measurement error or coefficient of repeatability was comparable for plaster and digital space analyses and ranged from 0.66 to 0.95mm. No difference was found between the space analysis performed in either the upper or lower dental arch. Hence, the null hypothesis was accepted. The digital model measurements were consistently larger, albeit by a relatively small amount, than the plaster models (0.35mm upper arch and 0.32mm lower arch). No difference was detected in the RLSA when performed using either plaster or digital models. Thus, digital space analysis provides a valid and reproducible alternative method in the new era of digital records. © The Author 2016. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com

A study of cephalometric soft tissue profile among adolescents from the three West African countries of Nigeria, Ghana and Senegal.

PubMed

Fadeju, A D; Otuyemi, O D; Ngom, P I; Newman-Nartey, M

2013-03-01

Since the introduction of cephalometry, numerous studies have established normal values for Caucasian populations. In Africa, most investigations have established norms and ethnic variations associated with the skeletal pattern. To date, there has been no study comparing soft tissue patterns among adolescents in the West African sub-region. The objective of this investigation was to determine and compare soft tissue patterns among 12- to 16-year-old Nigerian, Ghanaian and Senegalese adolescents, establish any gender dimorphism and compare them with published Caucasian norms. Lateral cephalometric radiographs of adolescents with a normal incisor relationship aged between 12 and 16 years from Nigeria, Ghana, and Senegal were taken under standardized conditions and traced to determine soft tissue patterns. Data obtained were subjected to statistical analysis. The total sample consisted of 165 females and 135 males with a mean age of 13·96 (1·58) years. A number of soft tissue parameters showed significant differences (P<0·05). These included comparison between males and females, and Nigerian, Ghanaian and Senegalese, including lip separation, upper lip length, upper lip exposure, Li-esthetic line, lower lip-NP, nasal tip angle, N-Pr-Pg, Pg-Ls, B-N pogonion and pogonion-mandibular angle. Differences also existed between these West African soft tissue values and published Caucasian norms, including nasolabial angle, mentolabial angle, nasal depth, nose tip, total soft tissue facial convexity and nasal depth angle. The comparative analysis of soft tissue patterns among 12- to 16-year-old adolescents from Nigeria, Ghana and Senegal demonstrated statistically significant differences in soft tissue value between these West African adolescents and published Caucasian soft tissue norms. This study provides useful data in relation to soft tissue parameters for subjects originating from the West African sub-region.

Damping ratio analysis of tooth stability under various simulated degrees of vertical alveolar bone loss and different root types.

PubMed

Ho, Kuo-Ning; Lee, Sheng-Yang; Huang, Haw-Ming

2017-08-03

The purpose of this study was to evaluate the feasibility of using damping ratio (DR) analysis combined with resonance frequency (RF) and periotest (PTV) analyses to provide additional information about natural tooth stability under various simulated degrees of alveolar vertical bone loss and various root types. Three experimental tooth models, including upper central incisor, upper first premolar, and upper first molar were fabricated using Ti6Al4V alloy. In the tooth models, the periodontal ligament and alveolar bone were simulated using a soft lining material and gypsum, respectively. Various degrees of vertical bone loss were simulated by decreasing the surrounding bone level apically from the cementoenamel junction in 2-mm steps incrementally downward for 10 mm. A commercially available RF analyzer was used to measure the RF and DR of impulse-forced vibrations on the tooth models. The results showed that DRs increased as alveolar vertical bone height decreased and had high coefficients of determination in the linear regression analysis. The damping ratio of the central incisor model without a simulated periodontal ligament were 11.95 ± 1.92 and 27.50 ± 0.67% respectively when their bone levels were set at 2 and 10 mm apically from the cementoenamel junction. These values significantly changed to 28.85 ± 2.54% (p = 0.000) and 51.25 ± 4.78% (p = 0.003) when the tooth model was covered with simulated periodontal ligament. Moreover, teeth with different root types showed different DR and RF patterns. Teeth with multiple roots had lower DRs than teeth with single roots. Damping ratio analysis combined with PTV and RF analysis provides more useful information on the assessment of changes in vertical alveolar bone loss than PTV or RF analysis alone.

BCL11B Regulates Epithelial Proliferation and Asymmetric Development of the Mouse Mandibular Incisor

PubMed Central

Kyrylkova, Kateryna; Kyryachenko, Sergiy; Biehs, Brian; Klein, Ophir; Kioussi, Chrissa; Leid, Mark

2012-01-01

Mouse incisors grow continuously throughout life with enamel deposition uniquely on the outer, or labial, side of the tooth. Asymmetric enamel deposition is due to the presence of enamel-secreting ameloblasts exclusively within the labial epithelium of the incisor. We have previously shown that mice lacking the transcription factor BCL11B/CTIP2 (BCL11B hereafter) exhibit severely disrupted ameloblast formation in the developing incisor. We now report that BCL11B is a key factor controlling epithelial proliferation and overall developmental asymmetry of the mouse incisor: BCL11B is necessary for proliferation of the labial epithelium and development of the epithelial stem cell niche, which gives rise to ameloblasts; conversely, BCL11B suppresses epithelial proliferation, and development of stem cells and ameloblasts on the inner, or lingual, side of the incisor. This bidirectional action of BCL11B in the incisor epithelia appears responsible for the asymmetry of ameloblast localization in developing incisor. Underlying these spatio-specific functions of BCL11B in incisor development is the regulation of a large gene network comprised of genes encoding several members of the FGF and TGFβ superfamilies, Sprouty proteins, and Sonic hedgehog. Our data integrate BCL11B into these pathways during incisor development and reveal the molecular mechanisms that underlie phenotypes of both Bcl11b−/− and Sprouty mutant mice. PMID:22629441

Comparison of Ferric Sulfate Combined Mineral Trioxide Aggregate Pulpotomy and Zinc Oxide Eugenol Pulpectomy of Primary Maxillary Incisors: An 18-month Randomized, Controlled Trial.

PubMed

Nguyen, Trang D; Judd, Peter L; Barrett, Edward J; Sidhu, Nicole; Casas, Michael J

2017-01-15

The purpose of this study was to compare outcomes and survival of ferric sulfate with mineral trioxide aggregate (FS+MTA) pulpotomy and root canal therapy (RCT) in carious vital primary maxillary incisors. In this parallel group noninferiority trial, asymptomatic carious vital primary incisors with pulp exposure in healthy 18- to 46-month-olds were allocated randomly to receive FS+MTA pulpotomy or RCT between September 2010 and September 2012. Each incisor was classified into one of the following radiographic outcomes: N (incisor without pathologic change); Po (pathologic change present, follow-up recommended); Px (pathologic change present, extract.) Clinical findings and incisor survival were secondary outcomes. Seventy subjects were enrolled with a total of 172 incisors. Twelve- and 18-month radiographic outcomes demonstrated no statistical difference between FS+MTA pulpotomy and RCT incisors for Px outcomes (P=0.38; odds ratio equals 0.60; 95 percent confidence interval equals 0.19 to 1.89; chi-square test). There was no statistical differences in clinical outcomes for FS+MTA pulpotomy and RCT at 12 and 18 months (P=0.51; Fisher's exact test) or survival for FS+MTA pulpotomy and RCT incisors (P=0.11; log-rank test). Ferric Sulfate with Mineral Trioxide Aggregate (FS+MTA) is an alternative to RCT for vital primary incisors.

Tissue Engineering of Necrotic Dental Pulp of Immature Teeth with Apical Periodontitis in Dogs: Radiographic and Histological Evaluation.

PubMed

El Ashiry, Eman A; Alamoudi, Najlaa M; El Ashiry, Mahmoud K; Bastawy, Hagar A; El Derwi, Douaa A; Atta, Hazem M

2018-05-15

To evaluate tissue engineering technology to regenerate pulp-dentin like tissues in pulp canals of immature necrotic permanent teeth with apical periodontitis in dogs. The study was performed on 36 teeth in 12 dogs. The experiment was carried out using split mouth design. In each dog 3 teeth were selected for implementing the study procedure. Apical periodontitis was induced in Group A and B teeth. Group (A): immature upper left 2 nd permanent incisors that were transplanted with a construct of autologous dental pulp stem cells with growth factors seeded in a chitosn hydrogel scaffold. Group (B): immature upper right 2 nd permanent incisor that received only growth factors with scaffold. A third tooth in each dog was selected randomly for isolation of dental pulp stem cells (DPSCs). Both groups were closed with a double coronal seal of white MTA (Mineral trioxide aggregate) and glass ionomer cement. Both groups were monitored radiographically for 4 months and histologically after sacrificing the animals. There was no statistically significant difference in radiographic findings between group (A) and group (B) for healing of radiolucencies, while there was statistically significant difference between group (A) and group (B) regarding radicular thickening, root lengthening and apical closure. Histologically, group (A) teeth showed regeneration of pulp-dentin like tissue while group (B) teeth did not show any tissue regeneration. Dental pulp stem cells and growth factors incorporated in chitosan hydrogel are able to regenerate pulp-dentine like tissue and help in complete root maturation of non-vital immature permanent teeth with apical periodontitis in dogs.

Dimensional accuracy of ceramic self-ligating brackets and estimates of theoretical torsional play.

PubMed

Lee, Youngran; Lee, Dong-Yul; Kim, Yoon-Ji R

2016-09-01

To ascertain the dimensional accuracies of some commonly used ceramic self-ligation brackets and the amount of torsional play in various bracket-archwire combinations. Four types of 0.022-inch slot ceramic self-ligating brackets (upper right central incisor), three types of 0.018-inch ceramic self-ligating brackets (upper right central incisor), and three types of rectangular archwires (0.016 × 0.022-inch beta-titanium [TMA] (Ormco, Orange, Calif), 0.016 × 0.022-inch stainless steel [SS] (Ortho Technology, Tampa, Fla), and 0.019 × 0.025-inch SS (Ortho Technology)) were measured using a stereomicroscope to determine slot widths and wire cross-sectional dimensions. The mean acquired dimensions of the brackets and wires were applied to an equation devised by Meling to estimate torsional play angle (γ). In all bracket systems, the slot tops were significantly wider than the slot bases (P < .001), yielding a divergent slot profile. Clarity-SLs (3M Unitek, Monrovia, Calif) showed the greatest divergence among the 0.022-inch brackets, and Clippy-Cs (Tomy, Futaba, Fukushima, Japan) among the 0.018-inch brackets. The Damon Clear (Ormco) bracket had the smallest dimensional error (0.542%), whereas the 0.022-inch Empower Clear (American Orthodontics, Sheboygan, Wis) bracket had the largest (3.585%). The largest amount of theoretical play is observed using the Empower Clear (American Orthodontics) 0.022-inch bracket combined with the 0.016 × 0.022-inch TMA wire (Ormco), whereas the least amount occurs using the 0.018 Clippy-C (Tomy) combined with 0.016 × 0.022-inch SS wire (Ortho Technology).

Relationship between dental anomalies and orthodontic root resorption of upper incisors.

PubMed

Van Parys, Katrien; Aartman, Irene H A; Kuitert, Reinder; Zentner, Andrej

2012-10-01

The aim of this study was to examine the potential relationship between the occurrence of orthodontic root resorption and presence of dental anomalies such as tooth agenesis and pipette-shaped roots. Dental anomalies and root resorption were assessed on dental panoramic tomographs (DPT) of 88 subjects, 27 males and 61 females, mean age 28.4 (SD = 11.3 years), selected from orthodontic patients on the basis of the following exclusion criteria: previous fixed appliance treatment, bad quality of the DPTs and no visibility of the periodontal ligament of every tooth, and younger than 15 years of age at the onset of treatment with fixed edgewise appliance lasting at least 18 months. A pipette-shaped root was identified as defined by a drawing. Tooth agenesis was assessed on DPTs and from subjects' dental history. Root resorption was calculated as the difference between the root length before and after treatment, with and without a correction factor (crown length post-treatment/crown length pre-treatment). If one of the four upper incisors showed root resorption of ≥2.3 mm with both formulas, the patient was scored as having root resorption. Chi-square tests indicated that there was no relationship between orthodontic root resorption and agenesis (P = 0.885) nor between orthodontic root resorption and pipette-shaped roots (P = 0.800). There was no relationship between having one of the anomalies and root resorption either (P = 0.750). In the present study, it was not possible to confirm on DPTs a relationship between orthodontic root resorption and dental anomalies, such as agenesis and pipette-shaped roots.

A Comparison of Arch Width with Angle Classification and Wits Appraisal in Class 2 Division 1 and Class 1 Individuals.

DTIC Science & Technology

1983-05-01

longitudinal changes in arch width between lateral incisors, canines and second premolars or deciduous second molars at four stages of dental eruption in 22 male... dental arch or skeletal widths. Also, he made no attempt to divide his sample into normal and malocclusion groups. -J 7 Warren (1959) studying twenty...buccal crossbite of the posterior teeth Many clinicians believe that this problem is highly correlated with tfte type or classification of malocclusion

Flare up rate related to root canal treatment of asymptomatic pulpally necrotic central incisor teeth in patients attending a military hospital.

PubMed

Al-Negrish, Abdul Rohman Salem; Habahbeh, Riyad

2006-10-01

This prospective study was conducted to determine the flare up rate related to root canal treatment of asymptomatic non vital maxillary central incisor teeth performed in one and two appointments and the relationship, if any between pain and number of treatment visits. The frequency of postobturation pain and swelling was recorded and evaluated over an observation period of 1 week in a 120 consecutive patients undergoing root canal treatment. The patients were assigned randomly into one of two groups of 60 patients each. The canals of all teeth were prepared and filled using the step-back preparation and lateral condensation filling techniques. The data were analyzed statistically using Mann-Whitney test. Eight of the 120 patients were excluded from the analysis as they failed to attend for postoperative reviews. Out of the 112 patients involved in the study 90 patients had no pain, 9 patients had slight pain, 8 patients had moderate pain, and 5 patients had severe pain after 2 days. After 7 days 104 patients had no pain, 4 patients had slight pain, 3 patients had moderate pain and 1 patient had severe pain. No statistically significant difference in the incidence and degree of postoperative pain was found between one and two visit Endodontic procedures. The rate of post obturation flare up in asymptomatic Endodontically treated non vital maxillary centarl incisors was 11.6 and 3.6% after 2 and 7 days, respectively.

Predisposing factors to severe external root resorption associated to orthodontic treatment.

PubMed

Picanço, Gracemia Vasconcelos; de Freitas, Karina Maria Salvatore; Cançado, Rodrigo Hermont; Valarelli, Fabricio Pinelli; Picanço, Paulo Roberto Barroso; Feijão, Camila Pontes

2013-01-01

The aim of this study was to evaluate predisposing factors among patients who developed moderate or severe external root resorption (Malmgren's grades 3 and 4), on the maxillary incisors, during fixed orthodontic treatment in the permanent dentition. Ninety-nine patients who underwent orthodontic treatment with fixed edgewise appliances were selected. Patients were divided into two groups: G1 - 50 patients with no root resorption or presenting only apical irregularities (Malmgren's grades 0 and 1) at the end of the treatment, with mean initial age of 16.79 years and mean treatment time of 3.21 years; G2 - 49 patients presenting moderate or severe root resorption (Malmgren's grades 3 and 4) at the end of treatment on the maxillary incisors, with mean initial age of 19.92 years and mean treatment time of 3.98 years. Periapical radiographs and lateral cephalograms were evaluated. Factors that could influence the occurrence of severe root resorption were also recorded. Statistical analysis included chi-square tests, Fisher's exact test and independent t tests. The results demonstrated significant difference between the groups for the variables: Extractions, initial degree of root resorption, root length and crown/root ratio at the beginning, and cortical thickness of the alveolar bone. It can be concluded that: Presence of root resorption before the beginning of treatment, extractions, reduced root length, decreased crown/root ratio and thin alveolar bone represent risk factors for severe root resorption in maxillary incisors during orthodontic treatment.

The use of a single-step regenerative approach for the treatment of a replanted mandibular central incisor with severe resorption.

PubMed

Chaniotis, A

2016-08-01

To report the clinical and radiographic treatment outcome of an immature replanted mandibular incisor with severe inflammatory external root resorption following a single-step regenerative approach. A 7-year-old female patient was referred 1 week following an extrusion injury to her mandibular central incisor (tooth 31). There was a history of a 6 months previous avulsion injury to the same tooth, which had been replanted after 20 min of extra-oral time. On clinical examination, all teeth were asymptomatic and there was an arch wire splint placed on the mandibular incisors. Radiographic examination revealed severe inflammatory external root resorption of tooth 31. A diagnosis of necrotic pulp and asymptomatic apical periodontitis was made. Under local anaesthesia and rubber dam isolation, an access cavity was prepared. The canal was irrigated using 6% NaOCl solution delivered through the EndoVac negative pressure irrigation system (Endo Vac, Axis/SybronEndo, Coppell, TX, USA). A 17% EDTA solution was used for 5 min followed by a final rinse of sterile water. The periapical tissues were probed using a K-file, and bleeding was induced. A blood clot was allowed to form filling the entire canal. A thick plug of MTA was placed in direct contact with the blood clot. The tooth was restored with composite resin. All procedures were performed in a single visit. The splint was removed 2 weeks later. Recall examination after 24 months revealed healthy soft tissues with normal periodontal probing and mobility. The 24 months radiographic evaluation revealed healing of the severe inflammatory external root resorption and continuous root development/dentine wall thickening of the apical third. No signs of ankylosis or significant discoloration was present. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Selecting maxillary anterior tooth width by measuring certain facial dimensions in the Kurdish population.

PubMed

A L-Kaisy, Neda; Garib, Balkees Taha

2016-03-01

One of the most difficult aspects of complete denture fabrication is selecting appropriately sized maxillary anterior teeth that will harmonize with the face. There are no generally accepted or naturally observed principles to guide dentists in this selection. The purpose of this study was to determine whether a relationship exists between various facial measurements and the different single or combined mesiodistal widths of maxillary anterior teeth in a Kurdish population. A total of 65 Kurdish dental students participated in this study. Two standardized digital photographs of the face (relaxed and smiling capture) were recorded. The interpupillary distance (IPD), inner canthal distance (ICD), interalar distance (IAD), and width of the 2 central incisors were determined by Image J software. The mesiodistal width and the combined straight-line width of the centrals, laterals, and canines were measured directly from the casts of the participants with digital calipers. A simple linear regression and the Pearson correlation coefficient were used to investigate the relationship between the particular facial measurement and the widths of the anterior teeth (α=.05). Significant correlations existed between the IPD and different tooth measurements; the highest was with the mean width of the canines (r=0.55). The proposed proportion between the IPD and the central incisor width was 6.93. The golden proportion of the ICD to the width of the central incisors and of the IAD to the straight-line width of the 6 anterior teeth could be used as a dependent parameter in Kurdish men. The IPD can be used to predict the width of anterior teeth in both sexes. In men, the width of the central incisors may be estimated from the ICD and the straight-line width of the 6 anterior teeth from the IAD. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Skeletal anteroposterior discrepancy and vertical type effects on lower incisor preoperative decompensation and postoperative compensation in skeletal Class III patients.

PubMed

Ahn, Hyo-Won; Baek, Seung-Hak

2011-01-01

To determine the initial compensation, preoperative decompensation, and postoperative compensation of the lower incisors according to the skeletal anteroposterior discrepancy and vertical type in skeletal Class III patients. The samples consisted of 68 skeletal Class III patients treated with two-jaw surgery and orthodontic treatment. Lateral cephalograms were taken before preoperative orthodontic treatment (T0) and before surgery (T1) and after debonding (T2). According to skeletal anteroposterior discrepancy/vertical type (ANB, criteria  =  -4°; SN-GoMe, criteria  =  35°) at the T0 stage, the samples were allocated into group 1 (severe anteroposterior discrepancy/hypodivergent vertical type, N  =  17), group 2 (moderate anteroposterior discrepancy/hypodivergent vertical type, N  =  17), group 3 (severe anteroposterior discrepancy/hyperdivergent vertical type, N  =  17), or group 4 (moderate anteroposterior discrepancy/hyperdivergent vertical type, N  =  17). After measurement of variables, one-way analysis of variance with Duncan's multiple comparison test, crosstab analysis, and Pearson correlation analysis were performed. At T0, groups 3 and 2 exhibited the most and least compensated lower incisors. In group 2, good preoperative decompensation and considerable postoperative compensation resulted in different values for T0, T1, and T2 (IMPA, T0 < T2 < T1; P < .001). However, group 3 did not show significant changes in IMPA between stages. Therefore, groups 2 and 3 showed different decompensation achievement ratios (P < .05). Group 3 exhibited the worst ratios of decompensation and stability (24% and 6%, respectively, P < .001). Anteroposterior discrepancy/vertical type (ANB: P < .01 at T0 and T1, P < .001 at T2; SN-GoMe: P < .01, all stages) were strongly correlated with relative percentage ratio of IMPA to norm value. Skeletal anteroposterior discrepancy/vertical type results in differences in the amount and pattern of initial compensation, preoperative decompensation, and postoperative compensation of lower incisors in Class III patients.

Variation in Size and Form between Left and Right Maxillary Central Incisor Teeth.

PubMed

Vadavadagi, Suneel V; Hombesh, M N; Choudhury, Gopal Krishna; Deshpande, Sumith; Anusha, C V; Murthy, D Kiran

2015-02-01

To compare the variation in size of left and right maxillary central incisors for male patients (using digital calipers of 0.01 mm accuracy). To compare the variation in size of left and right maxillary central incisors for female patients (using digital calipers of 0.01 mm accuracy). To find out the difference between the maxillary central incisors of men and women. Its clinical applicability if difference exists. A total of 70 dental students of PMNM Dental College and Hospital were selected. Of 70 dental students, 40 male and 30 female were selected. Impressions were made for all subjects, using irreversible hydrocolloid (Algitex, manufacturer DPI, Batch-T-8804) using perforated stock metal trays. The mesiodistal crown width and cervical width were measured for each incisor and recorded separately for left and right teeth. The length was measured for each incisor and recorded separately for left and right maxillary central incisor using digitec height caliper. The mean value of maximum crown length of maxillary left central incisor of male was greater in length compared with maxillary right central incisor. Mean value of maximum crown length for male patient right and left side was greater compared with maximum crown length of female patient. When compared the dimensions of teeth between two sex, male group shows larger values to female group.

Periodontal health in teenagers treated with removable aligners and fixed orthodontic appliances.

PubMed

Abbate, Gian Marco; Caria, Maria Paola; Montanari, Paola; Mannu, Carla; Orrù, Germano; Caprioglio, Alberto; Levrini, Luca

2015-05-01

The purpose of this study was to explore the microbiological and periodontal changes occurring in adolescents during 12 months of orthodontic therapy with removable aligners and with fixed appliances. During the years 2012-2013, 50 teenagers aged 10-18 years with similar initial orthodontic conditions participated in this trial in a university clinic in northern Italy. After receiving professional oral hygiene and instructions on a standardized oral hygiene protocol, the adolescents were randomly assigned to either orthodontic treatment with traditional fixed brackets (n = 25) or to treatment with Invisalign® aligners (n = 25). Subgingival microbiological samples, probing depth (PD), plaque index (PI), and bleeding on probing (BOP) were obtained and documented from the mesiovestibular subgingival sulcus of the upper right first molar and left central incisor at the beginning of treatment and 3, 6, and 12 months later. Compliance with oral hygiene procedures, full mouth plaque score (FMPS), and full mouth bleeding score (FMBS) were assessed at the beginning of treatment and 12 months later. Two sample independent t-tests and the χ(2) test were used to study whether the indices of periodontal health differed in the teenagers due to the experimental conditions. None of the patients was positive for the periodontal anaerobes analyzed. The PI, PD, BOP, FMPS, and FMBS scores were significantly lower and compliance with oral hygiene was significantly higher in the group treated with Invisalign® than in the group treated with fixed brackets. Teenagers treated with removable appliances display better compliance with oral hygiene, less plaque, and fewer gingival inflammatory reactions than their peers with fixed appliances.

A modified, lingually supported cantilevered Herbst appliance.

PubMed

Snodgrass, D

1996-01-01

This new, fixed-functional appliance/Herbst/Bioprogressive system is designed for patient comfort and mandatory compliance. It also combines the positive clinical effects of four fixed-functional systems. It allows rapid palatal expansion of the upper arch, alveolar uprighting of the lower arch, upper and lower incisor alignment, and sagittal correction of Class II malocclusions to occur simultaneously with one appliance fixed in both arches. It is indicated for use in growing patients with skeletal Class II malocclusions. The ideal timing for treatment is the late mixed dentition. Being able to remove the appliance after one year with the upper second bicuspids erupting slightly Class III so the clinician can immediately begin fixed finishing mechanics would be ideal. This new Herbst design will reduce the frequency of orthognathic surgery and upper bicuspid extraction to camouflage Class II malocclusions. At the same time, it gives total control to the clinician in treating some more difficult, non-compliant patients. Fixed-functional appliances, which improve treatment efficiency and treatment results and provide for patient comfort, while at the same time give the treating clinician almost total control of the three planes of facial growth will open new doors for orthodontic treatment and research in the next century.

Surgical Orthodontic Treatment for Open Bite in Noonan Syndrome Patient: A Case Report.

PubMed

Kawakami, Masayoshi; Yamamoto, Kazuhiko; Shimomura, Tadahiro; Kirita, Tadaaki

2016-03-01

Noonan syndrome, characterized by short stature, facial anomalies, and congenital heart defects, may also be associated with hematopoietic disorders. Craniofacial anomalies in affected patients include hypertelorism and severe open bite associated with masticatory dysfunction. We treated a Noonan syndrome patient with a skeletal open bite. Surgical orthodontic treatment including two-jaw surgery established a good occlusal relationship after correction of severe anemia. Both upper and lower incisors were moved to upright positions, while clockwise rotation of the palatal plane and decreased mandibular plane angle were accomplished. Lower masticatory activity may affect posttreatment occlusion in such cases.

Shade determination using camouflaged visual shade guides and an electronic spectrophotometer.

PubMed

Kvalheim, S F; Øilo, M

2014-03-01

The aim of the present study was to compare a camouflaged visual shade guide to a spectrophotometer designed for restorative dentistry. Two operators performed analyses of 66 subjects. One central upper incisor was measured four times by each operator; twice with a camouflaged visual shade guide and twice with a spectrophotometer Both methods had acceptable repeatability rates, but the electronic shade determination showed higher repeatability. In general, the electronically determined shades were darker than the visually determined shades. The use of a camouflaged visual shade guide seems to be an adequate method to reduce operator bias.

Contour of lingual surface in lower complete denture formed by polished surface impression.

PubMed

Heo, Yu-Ri; Kim, Hee-Jung; Son, Mee-Kyoung; Chung, Chae-Heon

2016-12-01

The aim of this study was to analyze the shapes of lingual polished surfaces in lower complete dentures formed by polished surface impressions and to provide reference data for use when manufacturing edentulous trays and lower complete dentures. Twenty-six patients with mandibular edentulism were studied. After lower wax dentures were fabricated, wax was removed from the lingual side of the wax denture and a lingual polished surface impression was obtained with tissue conditioner. The definitive denture was scanned with a three-dimensional scanner, and scanned images were obtained. At the cross-sections of the lingual frenum, lateral incisors, first premolars, first molars, and anterior border of the retromolar pads, three points were marked and eight measurements were taken. The Kruskal-Wallis test and a post hoc analysis with the Mann-Whitney test were performed. Each patient showed similar values for the same areas on the left and right sides without a statistically significant difference. The height of the contour of the lingual polished surface at the lingual frenum was halfway between the occlusal plane and lingual border, it moved gradually in a downward direction. The angle from the occlusal plane to the height of the contour of the lingual polished surface was increased as it progressed from the lingual frenum towards the retromolar pads. The shape of the mandibular lingual polished surface was convex at the lingual frenum, lateral incisors and gradually flattened towards the first molars and retromolar pads.

Profile Changes and Stability following Distraction Osteogenesis with Rigid External Distraction in Adult Cleft Lip and Palate Deformities

PubMed Central

Painatt, Jaeson M.; Veeraraghavan, Ravi; Puthalath, Ushass; Peter, Sherry; Rao, Latha P.; Kuriakose, Maria

2017-01-01

Objectives: The objective of this study is to analyze the hard and soft-tissue profile changes as well as the upper airway changes after distraction osteogenesis (DO) using rigid external distraction device in adult cleft lip and palate (CLP) patients. The study also evaluates the stability of the surgical result. Materials and Methods: Three lateral cephalometric radiographs were taken: Predistraction (T1), postdistraction (T2), and 1 year after distractor removal (T3). The treatment changes (T1 vs. T2) and the stability (T2 vs. T3) were analyzed. The overall treatment changes after 1 year were also evaluated (T1 vs. T3). The lateral cephalograms were digitally analyzed with the help of software named Dolphin. Statistical Analysis Used: Wilcoxon Signed-Ranks test was used, and the probability value (P value) of 0.05 was considered as statistically significant level. Results: Eleven adult patients with CLP were retrospectively analyzed. After distraction, there was a significant mean maxillary advancement of 14 mm (P < 0.01) from a T1 value of 73.54 ± 10.38 to a T2 value of 88.2 ± 10.49. The lower facial height and the incisor exposure were significantly increased. The nasolabial angle had a significant improvement of 24.5° (P < 0.01) from a T1 value of 56.6 ± 21.03 to a T2 value of 81.18 ± 14.4.The upper airway was significantly improved by 3.7 mm (P < 0.01) with a T1 value of 13.5 ± 3.8 to a T2 value of 17.2 ± 3.66. After 1-year follow-up, there was a significant maxillary relapse of 3.20 mm (P < 0.05) from a T2 value of 8.29 ± 6.84 to a T3 value of 5.09 ± 5.59. However, the soft-tissue profile and upper airway remained stable. Conclusion: The clinician should have an understanding of the related hard and soft tissues as well as airway changes which may assist him when planning for maxillary advancement for CLP patients with DO. There were significant improvements immediately after distraction, but during the 1-year follow-up, some relapse was seen. This stressed on the need for overcorrection of about 35%–40% for adult CLP patients. PMID:28839409

Comparison of intra-oral and study cast measurements in the assessment of malocclusion.

PubMed

Ovsenik, Maja; Farcnik, Franc M; Verdenik, Ivan

2004-06-01

Malocclusion assessment methods are based on registrations and measurements made on study casts, which requires that impressions be taken. In addition to being costly and time-consuming, this process can be unpleasant for very young children. Therefore, the aim of this study was to evaluate the reliability of intra-oral measurements that compute a malocclusion index score to determine malocclusion severity in the mixed dentition. The research was part of a longitudinal study in Slovenia on a sample of 530 3-year-old children. At 8 years of age (mean 8.5 years, standard deviation 0.2), a cohort of 101 children (44 boys, 57 girls) was randomly selected in a cross-sectional study. Quantitative registrations of space and occlusal anomalies were performed intra-orally as well as on study casts. Kappa (kappa) statistics were used to evaluate the agreement between clinical and study cast malocclusion assessments. Systematic bias of measurements was tested using Wilcoxon's signed rank test. The results showed complete agreement between the two measurements for anterior crossbite, anterior open bite and overjet scores (kappa = 1); excellent reliability for the buccal segment relationship (kappa = 0.93), transverse occlusion of posterior teeth (kappa = 0.87); and substantial agreement for overbite (kappa = 0.79) and midline deviation (kappa = 0.71). For the remainder of the traits the agreement was moderate: rotation of incisors (kappa = 0.58), crowding of upper incisors (kappa = 0.51), axial inclination of teeth (kappa = 0.44) and lower incisor crowding (kappa = 0.41). Intra-orally small, but statistically significant scoring of lower incisor rotation and crowding was identified. On the study casts the most favourable axial inclination was found for buccal segment occlusion. Overall classification into severity grades, based on the total malocclusion score, showed excellent agreement between the two methods (kappa = 0.89), without statistically significant bias. Malocclusion assessment, recorded and measured intra-orally, is as reliable as assessment on study casts. The proposed method can be used in screening, in epidemiological studies and in clinical orthodontic assessment.

Orthodontic Treatment of Maxillary Incisors with Severe Root Resorption Caused by Bilateral Canine Impaction in a Class II Division 1 Patient.

PubMed

Chang, Na-Young; Park, Jae Hyun; Lee, Mi-Young; Cho, Jin-Woo; Cho, Jin-Hyoung; An, Ki-Yong; Chae, Jong-Moon

2016-01-01

This case report shows the successful alignment of bilateral impacted maxillary canines. A 12-year-old male with the chief complaint of the protrusion of his maxillary anterior teeth happened to have bilateral maxillary canine impaction on the labial side of his maxillary incisors. Four maxillary incisors showed severe root resorption because of the impacted canines. The patient was diagnosed as skeletal Class II malocclusion with proclined maxillary incisors. The impacted canine was carefully retracted using sectional buccal arch wires to avoid further root resorption of the maxillary incisors. To distalize the maxillary dentition, two palatal miniscrews were used. After 25 months of treatment, the maxillary canines were well aligned without any additional root resorption of the maxillary incisors.

Excessive heat-associated gingival necrosis: a case report.

PubMed

Barnes, P L; Rossi-Fedele, G

2017-09-01

Heat-delivery devices have been associated with relatively high temperatures. Previous basic research studies suggest that the risk for periodontal tissues is negligible, as the presence of the root filling materials, amongst other factors, reduce the risk of overheating. This report describes the case of a 45 year old male, who was undergoing restorative treatment in a multi-specialty dental practice. As part of his overall treatment planning, orthograde root canal retreatment for his maxillary left incisor teeth was deemed necessary, due to chronic apical periodontitis. Following cold lateral compaction, the coronal portion of the core material was severed using a System B Heat Source (Kerr Dental, Orange, CA, USA), with the patient reporting pain as well as a burning sensation. The following day the patient was seen by a periodontist and gingival necrosis in relation to the central incisor was found. The most likely cause of the complication was considered to be excessive heat during the operative procedure. The patient was followed up for a 2-year period and the soft tissues returned to their original condition without the need for periodontal treatment. © 2017 Australian Dental Association.

Comparison of three-dimensional orthodontic load systems of different commercial archwires for space closure

PubMed Central

Gajda, Steven; Chen, Jie

2014-01-01

Objective To experimentally quantify the effects of the loop design on three-dimensional orthodontic load systems of two types of commercial closing loop archwires: Teardrop and Keyhole. Materials and Methods An orthodontic force tester and custom-made dentoform were used to measure the load systems produced on two teeth during simulated space closure. The system included three force components along and three moment components about three clinically defined axes on two target teeth: the left maxillary canine and the lateral incisor. The archwires were attached to the dentoform and were activated following a standard clinical procedure. Results The resulting six load components produced by the two archwires were reported and compared. The results were also compared with those of the T-loop archwire published previously. Conclusions The three designs deliver similar loading patterns; however, the component magnitudes are dependent on the design. All of the designs result in lingual tipping of the teeth, canine lingual-mesial displacement, canine crown-mesial-in rotation, and incisor crown-distal-in rotation. PMID:21879793

Systematics of the Platyrrhinus helleri species complex (Chiroptera: Phyllostomidae), with descriptions of two new species

USGS Publications Warehouse

Velazco, Paúl M.; Gardner, Alfred L.; Patterson, Bruce D.

2010-01-01

Platyrrhinus is a diverse genus of small to large phyllostomid bats characterized by a comparatively narrow uropatagium thickly fringed with hair, a white dorsal stripe, comparatively large inner upper incisors that are convergent at the tips, and three upper and three lower molars. Eighteen species are currently recognized, the majority occurring in the Andes. Molecular, morphological, and morphometric analyses of specimens formerly identified as Platyrrhinus helleri support recognition of Platyrrhinus incarum as a separate species and reveal the presence of two species from western and northern South America that we describe herein as new (Platyrrhinus angustirostris sp. nov. from eastern Colombia and Ecuador, north-eastern Peru, and Venezuela and Platyrrhinus fusciventris sp. nov. from Guyana, Suriname, French Guiana, Trinidad and Tobago, northern Brazil, eastern Ecuador, and southern Venezuela). These two new species are sister taxa and, in turn, sister to Platyrrhinus incarum.

Comparative study of upper lip frenectomy with the CO2 laser versus the Er, Cr: YSGG laser

PubMed Central

Pié-Sánchez, Jordi; España-Tost, Antonio J.; Arnabat-Domínguez, Josep

2012-01-01

Objectives: To compare upper lip frenulum reinsertion, bleeding, surgical time and surgical wound healing in frenectomies performed with the CO2 laser versus the Er, Cr:YSGG laser. Study design: A prospective study was carried out on 50 randomized pediatric patients who underwent rhomboidal resection of the upper lip frenulum with either the CO2 laser or the Er,Cr:YSGG laser. Twenty-five patients were assigned to each laser system. All patients were examined at 7, 14, 21 days and 4 months after the operation in order to assess the surgical wound healing. Results: Insertion of the frenulum, which was preoperatively located between the upper central incisors, migrated to the mucogingival junction as a result of using both laser systems in all patients. Only two patients required a single dose of 650 mg of paracetamol, one of either study group. CO2 laser registered improved intraoperative bleeding control results and shorter surgical times. On the other hand, the Er,Cr:YSGG laser achieved faster healing. Conclusions: Upper lip laser frenectomy is a simple technique that results in minimum or no postoperative swelling or pain, and which involves upper lip frenulum reinsertion at the mucogingival junction. The CO2 laser offers a bloodless field and shorter surgical times compared with the Er,Cr:YSGG laser. On the other hand, the Er,Cr:YSGG laser achieved faster wound healing. Key words:Frenectomy, upper lip frenulum, CO2 laser, Er,Cr:YSGG laser, laser. PMID:22143683

[Finite element analysis of different load mode on tooth movement for space closure in patient with bimaxillary protrusion].

PubMed

Zhang, X B; Yin, Y F; Yao, H M; Han, Y H; Wang, N; Ge, Z L

2016-07-01

To investigate the stress distribution on the maxillary anterior teeth retracted with sliding mechanics and micro-implant anchorage using different retraction hook heights and positions. DICOM image data including maxilla and upper teeth were obtained with cone-beam CT. The three-dimensional finite element model was constructed using Mimics software. Brackets and archwire model were constructed using Creo software. The models were instantiated using Pro/Engineer software. Abaqus software was used to simulate the sliding mechanics by loading 2 N force on 0, 2, 4, 6, 8, 10 mm retraction hooks and three different positions, repectively. Rotation of the occlusal plane, the initial displacement and stress distribution of teeth were analyzed. Lingual rotation of maxillary central incisor(0.021°), gingival movement of the maxillary first molar(0.005 mm), and clockwise rotation of the maxillary occlusal plane(0.012°) were observed when the force application point located at the archwire level (0 mm). In contrast, 0.235° labial rotation of the maxillary central incisor, 0.015 mm occlusal movement of the maxillary first molar, and 0.075° anti-clockwise rotation of the maxillary occlusal plane were observed when the force application point located at the higher level(10 mm retraction hook). The more the force application point was located posteriorly at the archwire level, the less lingual rotation of the maxillary central incisor and the more buccal displacement of maxillary first molar was observed. Maxillary anterior tooth rotation and retraction, vertical displacement of posterior segment, and rotation of the occlusal plane could be controlled by adjusting the height and position of the retraction hook in space closure using miniscrew and sliding mechanics.

Use of photoactivated disinfection and platelet-rich fibrin in regenerative Endodontics

PubMed Central

Johns, Dexton Antony; Shivashankar, Vasundara Yayathi; Krishnamma, Shoba; Johns, Manu

2014-01-01

Aim: Photoactivated disinfection has been used as an adjunct to conventional endodontic treatment. Its use in regenerative endodontics is not reported in literature. The aim of this case report was to describe a new proposal for pulp revascularization with disinfection of pulp canal space using a unique combination of a photosensitizer solution and low-power laser light. Materials and Methods: A 9-year-old boy came with the chief complaint of discolored upper central incisors (#8, #9). A diagnosis of pulp necrosis was made on the basis of clinical and radiographic findings. The canal was irrigated with 5.25% sodium hypochlorite solution and dried with paper points. Photodynamic therapy was used to disinfect the root canal and platelet-rich fibrin was used to revitalize the pulp. Three millimeters of gray mineral trioxide aggregate was placed directly over the platelet-rich plasma clot. Three days later, the tooth was double-sealed with permanent filling materials. Results: Clinical examination revealed no sensitivity to percussion or palpation tests. Radiograph revealed continued thickening of the dentinal walls, root lengthening, regression of the peri-apical lesion and apical closure. Both the roots showed complete apical closure at the 10-month follow-up. However, the teeth were not responsive to electric pulp test. Conclusion: This report of pulp revascularization shows that disinfection with photodynamic therapy combined with platelet-rich fibrin leads to satisfactory root development in necrotic immature teeth. PMID:25298655

Relationship between friction force and orthodontic force at the leveling stage using a coated wire

PubMed Central

MURAYAMA, Masaki; NAMURA, Yasuhiro; TAMURA, Takahiko; IWAI, Hiroaki; SHIMIZU, Noriyoshi

2013-01-01

The relationship between orthodontic force and friction produced from an archwire and brackets affects the sliding of the wire in the leveling stage. Objective The purpose of this study was to evaluate the relationship between force and friction in a small esthetic nickel-titanium (Ni-Ti) wire. Material and Methods Five esthetic wires (three coated and two plated) and two small, plain Ni-Ti wires (0.012 and 0.014 inches) were used. We performed a three-point bending test according to ISO 15841 and the drawing test with a dental arch model designed with upper linguoversion of the lateral incisor in the arch (displacements of 0.5, 1.0, 2.0 and 3.0 mm), and evaluated the relationship between them. Results Unloading bending forces of all wires at displacements of less than 1.0 mm were larger than friction forces, but all friction forces at displacements exceeding 2.0 mm were larger than unloading bending forces. The arch likely expands when displacement from the proximal brackets exceeds 1.0 mm. The friction force of a martensite 0.014-inch Ni-Ti wire was significantly greater than those of the other esthetic and austenitic wires. Conclusions A wire with the smallest possible friction force should be used in cases with more than 1.0 mm displacement. PMID:24473722

A novel surgical procedure for coronally repositioning of the buccal implant mucosa using acellular dermal matrix: a case report.

PubMed

Mareque-Bueno, Santiago

2011-01-01

This case report describes a surgical procedure for coronally advancing the peri-implant mucosa to treat a soft tissue dehiscence in a single-tooth implant-supported restoration in combination with an acellular dermal matrix graft. The patient was a 41-year-old systemically healthy, non-smoking female. Her chief complaint pertained to the unesthetic appearance of her right lateral upper incisor, caused by recession of the mucosal margin. On examination, a 3-mm recession could be observed. The periodontium was classified as thin. A 2-mm band of keratinized peri-implant mucosa was present. Keratinized gingiva was approximately 6 mm at adjacent areas. The surgical technique included a novel incision design to coronally position the flap over an acellular dermal matrix graft. Partial coverage of the recession was achieved. After a 6-month period, tissues appeared thicker than preoperatively, with no bleeding on probing and no probing depth >2 mm. The patient was satisfied with the overall treatment result. This case report shows the possibility of achieving partial soft tissue coverage over an implant-supported restoration with the combined use of an acellular dermal matrix and a coronally positioned flap. A novel technique is presented that allowed advancing the flap over the graft in a single-tooth restoration where enough keratinized tissue was present preoperatively.

Soft chelating irrigation protocol optimizes bonding quality of Resilon/Epiphany root fillings.

PubMed

De-Deus, Gustavo; Namen, Fátima; Galan, João; Zehnder, Matthias

2008-06-01

This study was designed to test the impact of either a strong (MTAD) or a soft (1-hydroxyethylidene-1, 1-bisphosphonate [HEPB]) chelating solution on the bond strength of Resilon/Epiphany root fillings. Both 17% EDTA and the omission of a chelator in the irrigation protocol were used as reference treatments. Forty extracted human upper lateral incisors were prepared using different irrigation protocols (n = 10): G1: NaOCl, G2: NaOCl + 17% EDTA, G3: NaOCl + BioPure MTAD (Dentsply/Tulsa, Tulsa, OK), and G4: NaOCl + 18% HEPB. The teeth were obturated and then prepared for micropush-out assessment using root slices of 1 mm thickness. Loading was performed on a universal testing machine at a speed of 0.5 mm/min. One-way analysis of variance and Tukey multiple comparisons were used to compare the results among the experimental groups. EDTA- and MTAD-treated samples revealed intermediate bond strength (0.3-3.6 MPa). The lowest bond strengths were achieved in NaOCl-treated samples (0.3-1.2 MPa, p < 0.05). The highest bond strength was reached in the HEBP-treated samples (3.1-6.1 MPa, p < 0.05). Under the present in vitro conditions, the soft chelating irrigation protocol (18% HEBP) optimized the bonding quality of Resilon/Epiphany (Resilon Research LLC, Madison, CT) root fillings.

Accelerated eruption of rat lower incisor. Relationship between impeded and unimpeded eruption rates, rate of attrition, tooth length, and production of dentin and enamel.

PubMed

Risnes, S; Septier, D; Goldberg, M

1995-01-01

The present investigation studies the effects of persistently cutting one lower rat incisor out of occlusion. Within four days, the rate of eruption of the cut (unimpeded) incisor increased to 216% and that of the uncut (impeded) contralateral to 136% of the baseline rate. While the former remained high, the latter decreased gradually to about 90% within three weeks. The rate of attrition of the impeded incisor increased to 233% of the baseline rate within two days, then fell abruptly, and remained at a slightly lower level than the rate of eruption. Accordingly, the length of the erupted part of the impeded incisor decreased initially, but increased gradually after about four days. Measurements made on SEM micrographs of the series of transverse tooth segments obtained when cutting the incisor out of occlusion, showed that growth-related increase in mesiodistal tooth width was arrested from the 10th segment, dentin thickness decreased gradually to about 50% in the 12th segment, and enamel thickness, after an initial increase, decreased to about 80% in the 11th segment. The present study provides experimental evidence that accelerated eruption affects morphogenesis and histogenesis of the rat lower incisor. An impeded incisor, especially the contralateral, may not serve as an ideal control.

A retrospective study on traumatic dental and soft-tissue injuries in preschool children in Zagreb, Croatia.

PubMed

Vuletić, Marko; Škaričić, Josip; Batinjan, Goran; Trampuš, Zdenko; Čuković Bagić, Ivana; Jurić, Hrvoje

2014-02-01

The purpose of this study was to analyze data according to gender, age, cause, number of traumatized teeth, time elapsed before treatment and type of tooth from the records of traumatized children. A retrospective study was conducted in the Department of Paediatric Dentistry at the University Dental Clinic in Zagreb, Croatia using the documentation of 128 patients (61 males and 67 females) aged 1 month to 6 years with injuries of primary teeth between February 2009 and January 2013. Trauma was seen in 217 primary teeth, which implies that the number of injured primary teeth was 1.69 per child. The maxillary central incisors were the most frequently affected teeth (81.1%), they were followed by maxillary lateral incisors, while the least affected were mandibular central incisors. Traumatic dental injuries involved periodontal tissue 2.82 times more frequently than hard dental and pulp tissue. The main cause of teeth injury was fall (67.2%) and the majority of injuries occurred at home (51.6%) (p<0.05). Of 128 patients who received treatment 71 (55.5%) also had soft-tissue injuries. The distribution of soft-tissue injuries by gender (35 males, 36 females) was not statistically significant. Comparing children with soft-tissue injuries and those without them, a statistically significant difference was found in the time of arrival (p<0.01). The results of this study showed the need of informing about preventive measures against falls at home and the methods of providing first aid in dental trauma injuries.

A retrospective study on traumatic dental and soft-tissue injuries in preschool children in Zagreb, Croatia

PubMed Central

Vuletić, Marko; Škaričić, Josip; Batinjan, Goran; Trampuš, Zdenko; Bagić, Ivana Čuković; Jurić, Hrvoje

2014-01-01

The purpose of this study was to analyze data according to gender, age, cause, number of traumatized teeth, time elapsed before treatment and type of tooth from the records of traumatized children. A retrospective study was conducted in the Department of Paediatric Dentistry at the University Dental Clinic in Zagreb. Croatia using the documentation of 128 patients (61 males and 67 females) aged 1 month to 6 years with injuries of primary teeth between February 2009 and January 2013. Trauma was seen in 217 primary teeth, which implies that the number of injured primary teeth was 1.69 per child. The maxillary central incisors were the most frequently affected teeth (81.1%), they were followed by maxillary lateral incisors, while the least affected were mandibular central incisors. Traumatic dental injuries involved periodontal tissue 2.82 times more frequently than hard dental and pulp tissue. The main cause of teeth injury was fall (67.2%) and the majority of injuries occurred at home (51.6%) (p<0.05). Of 128 patients who received treatment 71 (55.5%) also had soft-tissue injuries. The distribution of soft-tissue injuries by gender (35 males, 36 females) was not statistically significant. Comparing children with soft-tissue injuries and those without them, a statistically significant difference was found in the time of arrival (p<0.01). The results of this study showed the need of informing about preventive measures against falls at home and the methods of providing first aid in dental trauma injuries. PMID:24579964

Diversity in the later Paleogene proboscidean radiation: a small barytheriid from the Oligocene of Dhofar Governorate, Sultanate of Oman

NASA Astrophysics Data System (ADS)

Seiffert, Erik R.; Nasir, Sobhi; Al-Harthy, Abdulrahman; Groenke, Joseph R.; Kraatz, Brian P.; Stevens, Nancy J.; Al-Sayigh, Abdul Razak

2012-02-01

Despite significant recent improvements to our understanding of the early evolution of the Order Proboscidea (elephants and their extinct relatives), geographic sampling of the group's Paleogene fossil record remains strongly biased, with the first ~30 million years of proboscidean evolution documented solely in near-coastal deposits of northern Africa. The considerable morphological disparity that is observable among the late Eocene and early Oligocene proboscideans of northern Africa suggests that other, as yet unsampled, parts of Afro-Arabia might have served as important centers for the early diversification of major proboscidean clades. Here we describe the oldest taxonomically diagnostic remains of a fossil proboscidean from the Arabian Peninsula, a partial mandible of Omanitherium dhofarensis (new genus and species), from near the base of the early Oligocene Shizar Member of the Ashawq Formation, in the Dhofar Governorate of the Sultanate of Oman. The molars and premolars of Omanitherium are morphologically intermediate between those of Arcanotherium and Barytherium from northern Africa, but its specialized lower incisors are unlike those of other known Paleogene proboscideans in being greatly enlarged, high-crowned, conical, and tusk-like. Omanitherium is consistently placed close to late Eocene Barytherium in our phylogenetic analyses, and we place the new genus in the Family Barytheriidae. Some features of Omanitherium, such as tusk-like lower second incisors, the possible loss of the lower central incisors, an enlarged anterior mental foramen, and inferred elongate mandibular symphysis and diminutive P2, suggest a possible phylogenetic link with Deinotheriidae, an extinct family of proboscideans whose origins have long been mysterious.

Five-minute Apgar score ≤ 5 and Molar Incisor Hypomineralisation (MIH) - a case control study.

PubMed

Sidaly, Rivan; Schmalfuss, Andreas; Skaare, Anne B; Sehic, Amer; Stiris, Tom; Espelid, Ivar

2016-07-22

The aetiology of molar incisor hypomineralisation (MIH) is unclear. The asymmetric distribution of MIH in the dentition may indicate that an insult of short duration that affects ameloblasts at a vulnerable stage could be a causative factor. Apgar ≤ 5 at 5 min may indicate asphyxia (hypoxic-ischemic insult) during birth. It was hypnotised that low Apgar score during birth may cause MIH. The present study aimed to examine a possible association between Apgar ≤ 5 at 5 min and the occurrence of MIH. Two study groups were selected for examination. The cases comprised 67 children aged 8-10 years born with Apgar score equal to or below 5 after 5 min. The control group comprised 157 age-matched healthy children. First permanent molars, second primary molars and all permanent incisors were examined in all children. Clinical examination was undertaken by two calibrated examiners and intraoral close-up photographs of the teeth were later evaluated by three calibrated and blinded clinicians. Demarcated opacities, post-eruptive breakdown, atypical restorations and extractions due to MIH, according to the criteria of the European Association of Paediatric Dentistry, were assessed. The prevalence of MIH did not differ between the two groups. A chi-square test failed to confirm any statistically significant relationship between 5-min Apgar scores and MIH occurrence. In addition, there was no statistically significant relationship between the number of affected first permanent molars in cases and controls. There was no association between Apgar ≤ 5 at 5 min and the occurrence of MIH.

Pattern of maxillary and mandibular proximal enamel thickness at the contact area of the permanent dentition from first molar to first molar.

PubMed

Sarig, Rachel; Vardimon, Alexander D; Sussan, Celine; Benny, Lea; Sarne, Ofer; Hershkovitz, Israel; Shpack, Nir

2015-04-01

Proximal enamel thickness (PET) at the mesial and distal contact areas of the complete permanent dentition has not been previously reported. Anatomic investigation of PET is essential for interproximal reduction treatment. Our objectives were to measure the PETs of the complete maxillary and mandibular dentitions at the contact areas, to compare the PETs of adjacent teeth, and to evaluate the vertical position of each contact area. We evaluated 720 extracted teeth; of these, 109 intact teeth were selected. The mesial and distal contact areas were demarcated, and each tooth was embedded in transparent epoxy resin. Blocks were prepared so that the 2 demarcated contact areas were exposed, and 6 measurements were taken and statistically analyzed. Both jaws showed the same PET pattern characterized by 5 features: PET increased progressively from incisor (0.63 mm) to first molar (1.48 mm). Per tooth, mesial and distal PET did not differ. Total maxillary (26.86 mm) and mandibular (24.52 mm) PETs were similar. Paired PETs at the interproximal interface were similar, with the exception of the lateral incisor-canine interfaces. From incisor to first molar, the contact area becomes located farther gingivally. The existing guideline of maximal 0.5-mm interproximal reduction per 2 adjacent teeth should be kept in the anterior region and could be increased to 1 mm in the posterior region, when an equal amount is removed. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Biomineralization, life-time of odontogenic cells and differential expression of the two homeobox genes MSX-1 and DLX-2 in transgenic mice.

PubMed

Lézot, F; Thomas, B; Hotton, D; Forest, N; Orestes-Cardoso, S; Robert, B; Sharpe, P; Berdal, A

2000-03-01

Msx and Dlx homeobox genes encode for transcription factors that control early morphogenesis. More specifically, Msx-1, Msx-2, and Dlx-2 homeobox genes contribute to the initial patterning of the dentition. The present study is devoted to the potential role of those homeobox genes during the late formation of mineralized tissues, using the rodent incisor as an experimental system. The continuously erupting mandibular incisor allows (1) the coinvestigation of the whole sequences of amelogenesis and dentinogenesis, aligned along the main dental axis in a single sample in situ and (2) the differential characterization of transcripts generated by epithelial and ectomesenchymal odontogenic cells. Northern blot experiments on microdissected cells showed the continuing expression of Msx-2 and Dlx-2 in the later stages of dental biomineralization, differentially in epithelial and ectomesenchymal compartments. Transgenic mice produced with LacZ reporter constructs for Dlx-2 and Msx-1 were used to detect different components of the gene expression patterns with the sensitive beta-galactosidase histoenzymology. The results show a prominent epithelial involvement of Dlx-2, with stage-specific variations in the cells involved in enamel formation. Quantitative analyses identified specific modulations of Dlx-2 expression in ameloblasts depending on the anatomical sites of the incisor, showing more specifically an inverse linear relationship between the Dlx-2 promoter activity level and enamel thickness. This investigation extends the role of homeoproteins to postmitotic stages, which would control secretory cell activity, in a site-specific manner as shown here for Dlx-2.

Prevalence of hypodontia in nine- to fourteen-year-old children who attended the Mashhad School of Dentistry.

PubMed

Ajami, Behgat-al-molok; Shabzendedar, Mahboobeh; Mehrjerdian, Maryam

2010-01-01

Hypodontia is defined as the congenital absence of one or a few teeth, and is also the most common anomaly in dental development. This condition occurs either individually or as part of the symptoms of a syndrome, and it is more common in permanent teeth than in deciduous teeth, reporting a prevalence of between 1.6 and 9.6%. The objective of this study is to investigate the prevalence of hypodontia for permanent teeth in nine- to 14-year-old children who attended the Mashhad School of Dentistry in 2007. We conducted this descriptive, analytical, cross-sectional study, to determine the mentioned aims. In this descriptive, cross-sectional study, panoramic radiographs belonging to 600 children (351 girls and 249 boys), aged nine to 14 years, were available for examination. All related findings were recorded in the respective forms. The data were processed using Exact and Chi-square tests. The prevalence of hypodontia in the girls was 9.2%, in the boys 8.8%, and in both sexes combined 9%. The most and the least frequent cases of absent teeth were the mandibular second premolars and the maxillary central incisor (only one child), respectively. The most commonly absent teeth were the mandibular second premolars, the maxillary lateral incisors, the mandibular central incisor, and the maxillary second premolars, in that order. This study showed a high frequency of hypodontia among the understudied population. Thus, due to the complicated treatment, accurate examination of children for on-time diagnosis of this developmental anomaly is crucial.

An analysis of dental development in Pleistocene Homo using skeletal growth and chronological age.

PubMed

Šešelj, Maja

2017-07-01

This study takes a new approach to interpreting dental development in Pleistocene Homo in comparison with recent modern humans. As rates of dental development and skeletal growth are correlated given age in modern humans, using age and skeletal growth in tandem yields more accurate dental development estimates. Here, I apply these models to fossil Homo to obtain more individualized predictions and interpretations of their dental development relative to recent modern humans. Proportional odds logistic regression models based on three recent modern human samples (N = 181) were used to predict permanent mandibular tooth development scores in five Pleistocene subadults: Homo erectus/ergaster, Neanderthals, and anatomically modern humans (AMHs). Explanatory variables include a skeletal growth indicator (i.e., diaphyseal femoral length), and chronological age. AMHs Lagar Velho 1 and Qafzeh 10 share delayed incisor development, but exhibit considerable idiosyncratic variation within and across tooth types, relative to each other and to the reference samples. Neanderthals Dederiyeh 1 and Le Moustier 1 exhibit delayed incisor coupled with advanced molar development, but differences are reduced when femoral diaphysis length is considered. Dental development in KNM-WT 15,000 Homo erectus/ergaster, while advanced for his age, almost exactly matches the predictions once femoral length is included in the models. This study provides a new interpretation of dental development in KNM-WT 15000 as primarily reflecting his faster rates of skeletal growth. While the two AMH specimens exhibit considerable individual variation, the Neanderthals exhibit delayed incisor development early and advanced molar development later in ontogeny. © 2017 Wiley Periodicals, Inc.

Craniofacial abnormalities in homozygous Small eye (Sey/Sey) embryos and newborn mice.

PubMed

Kaufman, M H; Chang, H H; Shaw, J P

1995-06-01

The Small eye (Sey) gene in the mouse is lethal in the homozygous state. It is located on chromosome 2, is a mutation in the Pax-6 gene, and is genetically homologous with the human aniridia 2 (AN2) gene mutation. Numerous studies over the last few years, using genetic and molecular biological approaches, have investigated both the location of the gene as well as its possible mode of action. In the homozygous state, the primary defect appears to be limited to the failure of differentiation of the presumptive lens and nasal placodes. Such mice therefore display a characteristic phenotype; they possess neither eyes nor any nasal derivatives. Their heterozygous (Sey/+) and normal (+/+) littermates may be distinguished before birth only by a detailed examination of their eyes. Few detailed morphological/histological studies have been undertaken to date in the Sey/Sey embryos and newborn, and in the present study we describe a variety of craniofacial abnormalities that have not previously been reported. We observed, with one exception, delayed closure of the palate, and the presence in 80% of mice of an abnormal complement of upper incisor teeth, so that 35% possessed 1 supernumerary tooth while 45% possessed 2 supernumerary teeth. In these mice, a total of either 3 or 4, rather than the normal complement of 2, upper incisor teeth were present. Possibly the most unexpected finding, however, was the presence of a median cartilaginous rod-like structure which protruded between the 2 maxillae to give the Alizarin red S and Alcian blue-stained 'cleared' skulls of the newborn mice a characteristic 'unicorn-like' appearance. While this structure appeared to be a rostral extension of the chondrocranium, its exact derivation is unclear.

Effects of near-infrared LED therapy on experimental tooth replantation in rats.

PubMed

Pigatto Mitihiro, Débora; de Paula Ramos, Solange; Corazza Montero, Janaína; Alves Campos, Aline; de Oliveira Toginho Filho, Dari; Dezan Garbelini, Cassia Cilene

2017-02-01

Dental avulsion damages periodontal tissues and may induce dentoalveolar ankylosis and root resorption after replantation. The aim of this work was to evaluate the effects of light-emitting diode (LED) therapy after tooth replantation. The upper right incisors of 36 male Wistar rats were extracted and replanted after 15 min. The control group (Co, n = 18) was submitted to replantation and the LED group (n = 18) was submitted to replantation and LED therapy (940 nm, 4 J cm -2 ) for three consecutive days (0, 24, and 48 h). Six animals from each group were euthanized at 7, 14, and 21 days for histological analysis. The upper left incisors were used as a negative control. Data were compared using the Fisher exact test, considering P < 0.05. After 7 days, the Co (73.3%) and LED (72.2%) groups presented areas of periodontal ligament necrosis. However, periodontal ligament necrosis was more frequent in the LED group at 14 (70%, P < 0.05) and 21 days (43.2%, P < 0.05) in relation to the Co group (33 and 21.6%). Inflammatory cell infiltration was more frequent in the Co group at 7 days (100%) than the LED group (24.4%, P < 0.05), but increased in the LED group after 21 days (83.3%, P < 0.05). Bone necrosis was more frequent in the LED group after 14 (79%, P < 0.05) and 21 days (60%, P < 0.005) than in the Co group (45% and 20%). Bone repair was evident in the Co group at 14 days. All of the replanted teeth had pulp necrosis. The results suggest that the application of LED therapy up to 48 h after tooth replantation may delay periodontal ligament repair. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Tooth Whitening And Temperature Rise With Two Bleaching Activation Methods

DOE Office of Scientific and Technical Information (OSTI.GOV)

Abu-ElMagd, D. M.; El-Sayad, I. I.; Abd El-Gawad, L. M.

2009-09-27

To measure the tooth whitening and the surface and Intrapulpal temperature increase in vitro on freshly extracted upper human central incisors after chemical, Zoom AP light and diode laser activated bleaching. Thirty caries-free upper human incisors were selected. Teeth were divided into three equal groups according to the methods of activation of the bleaching agent (n = 10). A whitening gel containing hydrogen peroxide was applied to the buccal surface of all teeth. Group I was bleached using chemically activated hydrogen peroxide gel, for three applications of 15 min each. Group II was bleached with high intensity advanced power Zoommore » activation light (Zoom AP), for three applications of 15 min each. Group III was bleached with diode laser activation technique, where the teeth were irradiated with 2 Watt diode laser for three applications of 30 sec each. The whitening degree was assessed using an image analysis system, while temperature rise was recorded using a thermocouple on the external tooth surface and Intrapulpal. The degree of whitening increased significantly in all groups. However, the percentage of whitening was not statistically significantly different between the three groups. In addition, group II showed statistically significant higher mean rise in both surface and pulp temperatures than group I and group III. Chemical bleaching produces the same whitening effect as Zoom AP light and laser, with no surface or pulpal temperature rise. Laser application is faster and produces less surface and pulp temperature increase than Zoom AP light. Diode laser used to activate bleaching gels is not considered dangerous to the vitality of dental pulp using power settings of 2 W.« less

Maxillary premolar resorption by canines: three case reports.

PubMed

Cooke, M E; Nute, S J

2005-05-01

Three unusual cases of maxillary premolar root resorption are reported. Three teenage patients were referred to the orthodontic department for management of ectopic maxillary canines. Radiographic examination revealed unilateral premolar root resorption in all three patients. This represents an unusual finding. Whereas the prevalence of maxillary lateral incisor root resorption secondary to palatally ectopic canines has been reported, the prevalence of premolar root resorption is unknown. This report discusses the findings in the context of the available literature. The postulated aetiology and the need for early diagnosis are highlighted.

The Role of Epithelial Stat3 in Amelogenesis during Mouse Incisor Renewal.

PubMed

Zhang, Bin; Meng, Bo; Viloria, Edward; Naveau, Adrien; Ganss, Bernhard; Jheon, Andrew H

2018-03-16

The aim of this study was to evaluate the role of epithelial signal transducer and activator of transcription 3 (STAT3) in mouse incisor amelogenesis. Since Stat3 is expressed in the epithelial component of developing and adult mouse teeth, we generated and analyzed Krt14Cre/+;Stat3fl/fl mutant mice in which Stat3 was inactivated in epithelia including ameloblast progenitors and ameloblasts, the cells responsible for enamel formation. Histological analysis showed little enamel matrix in mutant incisors compared to controls. Delayed incisor enamel mineralization was demonstrated using micro-computed X-ray tomography analysis and was supported by an increase in the pre-expression distance of enamel-enriched proteins such as amelogenin, ameloblastin, and kallikrein-4. Lastly, scanning electron microscopy analysis showed little enamel mineralization in mutant incisors underneath the mesial root of the 1st molar; however, the micro-architecture of enamel mineralization was similar in the erupted portion of control and mutant incisors. Taken together, our findings demonstrate for the first time that the absence of epithelial Stat3 in mice leads to delayed incisor amelogenesis. © 2018 S. Karger AG, Basel.

Early Orthodontic Tooth Movement into Regenerative Bony Defects: A Case Report.

PubMed

Tsai, Hui-Chen; Yao, Chung-Chen Jane; Wong, Man-Ying

Early orthodontic tooth movement following regenerative surgery is controversial. In this case, during protraction of the maxillary right first premolar to substitute for the long-term missing maxillary right canine, Bio-Oss and Bio-Gide were used for lateral ridge augmentation at the area of the maxillary right lateral incisor and to cover the denuded surface at the buccal side of the first premolar. Orthodontic tooth movement (OTM) commenced 2 weeks after regenerative surgery. After 8 months, new bone formation was observed on the root surface of the first premolar during implant surgery. A cone beam computed tomography scan taken 1.5 years postsurgery revealed good maintenance of regenerative bone at the same site. This satisfactory outcome of early OTM following regenerative surgery suggests biomechanical stimulation may not jeopardize the regenerative effect.

Comparative morphology and paleobiology of Middle Pleistocene human remains from the Bau de l'Aubesier, Vaucluse, France.

PubMed

Lebel, S; Trinkaus, E; Faure, M; Fernandez, P; Guérin, C; Richter, D; Mercier, N; Valladas, H; Wagner, G A

2001-09-25

The discovery of later Middle Pleistocene human remains from the Bau de l'Aubesier, France reinforces an evolutionary model of the gradual accumulation of Neandertal-derived facial and dental features during the Middle Pleistocene of the northwestern Old World. The pronounced maxillary incisor beveling of Aubesier 4 helps to extend the antiquity of nondietary use of the anterior dentition. The interproximal "toothpick" groove on the Aubesier 10 molar increases the sample for these lesions. The pathological loss of the mandibular dentition of Aubesier 11 indicates advanced antemortem masticatory impairment, at a level previously undocumented before the Late Pleistocene. These remains support a view of later Middle Pleistocene humans able to support debilitated individuals despite the considerable use of their bodies to accomplish routine activities.

Evaluation of postoperative patient satisfaction after covering the nasal dorsum with upper lateral cartilage: "upper lateral closing".

PubMed

Çağıcı, Can Alper

2017-11-16

Following nasal hump removal during septorhinoplasty, the middle vault should be reconstructed to avoid functional and esthetic problems. Middle vault reconstruction, however, may result in widening of the middle vault and may need a camouflage graft to cover dorsal irregularities. To present the results of reconstructing the middle vault with a technique that covers the nasal dorsum with upper lateral cartilage, from the viewpoint of patient satisfaction. Retrospective study of patients who underwent septorhinoplasty that included nasal dorsum closure with upper lateral cartilage from December 1, 2014 to January 31, 2016. Those with postoperative follow-up of less than 3 months were excluded. The final study group included 39 patients. The same surgeon performed all septorhinoplasties. The dorsum was closed using an "upper lateral closing" technique that approximated upper lateral cartilages to each other over the septum. Postoperative patient satisfaction was determined using a visual analog scale and the rhinoplasty outcomes evaluation questionnaire. The questionnaire evaluates patient esthetic and functional satisfaction with the operated nose. High scores indicate improved esthetic results. No dorsal irregularities were seen at postoperative follow-up evaluation of the patients. For esthetic nasal appearance, the median visual analogue scale scores was 86%, and the mean for the questionnaire was 77.03%. The natural dome-shaped anatomy of the nasal dorsum was achieved by approximating the upper lateral cartilages to each other. Closing the dorsum with this technique also covers any dorsal irregularities and results in a smooth dorsum. Patients expressed satisfaction with the esthetic and functional aspects of the smooth, attractive nasal dorsum. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Enamel-free teeth: Tbx1 deletion affects amelogenesis in rodent incisors.

PubMed

Catón, Javier; Luder, Hans-Ulrich; Zoupa, Maria; Bradman, Matthew; Bluteau, Gilles; Tucker, Abigail S; Klein, Ophir; Mitsiadis, Thimios A

2009-04-15

TBX1 is a principal candidate gene for DiGeorge syndrome, a developmental anomaly that affects the heart, thymus, parathyroid, face, and teeth. A mouse model carrying a deletion in a functional region of the Tbx1 gene has been extensively used to study anomalies related to this syndrome. We have used the Tbx1 null mouse to understand the tooth phenotype reported in patients afflicted by DiGeorge syndrome. Because of the early lethality of the Tbx1-/- mice, we used long-term culture techniques that allow the unharmed growth of incisors until their full maturity. All cultured incisors of Tbx1-/- mice were hypoplastic and lacked enamel, while thorough histological examinations demonstrated the complete absence of ameloblasts. The absence of enamel is preceded by a decrease in proliferation of the ameloblast precursor cells and a reduction in amelogenin gene expression. The cervical loop area of the incisor, which contains the niche for the epithelial stem cells, was either severely reduced or completely missing in mutant incisors. In contrast, ectopic expression of Tbx1 was observed in incisors from mice with upregulated Fibroblast Growth Factor signalling and was closely linked to ectopic enamel formation and deposition in these incisors. These results demonstrate that Tbx1 is essential for the maintenance of ameloblast progenitor cells in rodent incisors and that its deletion results in the absence of enamel formation.

Lower incisor intrusion with intraoral transosseous stainless steel wire anchorage in rabbits.

PubMed

Wu, Jian-chao; Huang, Ji-na; Lin, Xin-ping

2010-06-01

The purpose of this research was to investigate the potential use of intraoral transosseous stainless steel wires as anchorage for intrusion of the lower incisors using a rabbit model. Placement of intraoral transosseous stainless steel wires around incisors is similar to that of intraoral transosseous wiring of edentulous mandibular fractures. Ten male New Zealand rabbits, 9 +/- 1.5 months of age, average weight 1.8 +/- 0.3 kg, were used in this study. One lower incisor was intruded with a 50 g bilateral force using a coil spring for 10 weeks, while the other incisor served as the control. Clinical measurements of the distances between the occlusal edges of the incisors (EE) were performed weekly with a calliper. In addition to standard descriptive statistical calculations, a paired Student's t-test was used for comparison of the two groups. All surgical sites healed uneventfully after insertion of the wires. Significant differences were found in the change of EE between the experimental and control sides from 4 weeks onwards. Intrusion of the incisor, 4 +/- 0.58 mm, was seen on the test side, while EE on the control side remained unchanged. Within the limits of this animal study, it is concluded that the intraoral transosseous stainless steel wire anchorage system is a cost-effective method for intrusion of lower incisors when the use of other anchorage system is not possible.

Enamel-free teeth: Tbx1 deletion affects amelogenesis in rodent incisors

PubMed Central

Catón, Javier; Luder, Hans-Ulrich; Zoupa, Maria; Bradman, Matthew; Bluteau, Gilles; Tucker, Abigail S.; Klein, Ophir; Mitsiadis, Thimios A.

2010-01-01

TBX1 is a principal candidate gene for DiGeorge syndrome, a developmental anomaly that affects the heart, thymus, parathyroid, face, and teeth. A mouse model carrying a deletion in a functional region of the Tbx1 gene has been extensively used to study anomalies related to this syndrome. We have used the Tbx1 null mouse to understand the tooth phenotype reported in patients afflicted by DiGeorge syndrome. Because of the early lethality of the Tbx1−/− mice, we used long-term culture techniques that allow the unharmed growth of incisors until their full maturity. All cultured incisors of Tbx1−/− mice were hypoplastic and lacked enamel, while thorough histological examinations demonstrated the complete absence of ameloblasts. The absence of enamel is preceded by a decrease in proliferation of the ameloblast precursor cells and a reduction in amelogenin gene expression. The cervical loop area of the incisor, which contains the niche for the epithelial stem cells, was either severely reduced or completely missing in mutant incisors. In contrast, ectopic expression of Tbx1 was observed in incisors from mice with upregulated Fibroblast Growth Factor signalling and was closely linked to ectopic enamel formation and deposition in these incisors. These results demonstrate that Tbx1 is essential for the maintenance of ameloblast progenitor cells in rodent incisors and that its deletion results in the absence of enamel formation. PMID:19233155

Incisor malalignment and the risk of periodontal disease progression.

PubMed

Alsulaiman, Ahmed A; Kaye, Elizabeth; Jones, Judith; Cabral, Howard; Leone, Cataldo; Will, Leslie; Garcia, Raul

2018-04-01

The objective of this study was to investigate the association between incisor crowding, irregularity, and periodontal disease progression in the anterior teeth. Data collected over 35 years from men enrolled in the Veterans Affairs Dental Longitudinal Study included information concerning pocket depth and alveolar bone loss. Plaster casts of the maxillary (n = 400) and mandibular (n = 408) arches were available for baseline measurements. Periodontal disease in the anterior teeth was defined as per arch sum of pathologic pocket depth and sum of teeth with any alveolar bone loss in the anterior sextants. Incisor malalignment status was defined by the anterior tooth size-arch length discrepancy index and Little's Irregularity Index. Adjusted mixed effects linear models computed the beta (β) estimates and 95% confidence intervals (95% CI) of the amounts of change in periodontal disease outcomes by the level of malalignment. In the anterior maxillary arch, crowding and spacing were significantly associated with an increased per-arch sum of pathologic pocket depth (β, 0.70 mm; 95% CI, 0.20-1.21, and β, 0.49 mm; 95% CI, 0.06-0.91, respectively). In the anterior mandibular arch, incisor crowding and irregularity were significantly associated with an increased per-arch sum of pathologic pocket depth (mild crowding: β, 0.47 mm; 95% CI, 0.01-0.93; severe irregularity: β, 0.94 mm; 95% CI, 0.50-1.38), and the sum number of teeth with alveolar bone loss (mild and moderate-to-severe crowding: β, 0.45 teeth; 95% CI, 0.08-0.82; and β, 0.45 teeth; 95% CI, 0.13-0.83, respectively; moderate irregularity: β, 0.34 teeth; 95% CI, 0.06-0.62). Certain incisor malalignment traits (ie, maxillary incisor crowding, maxillary incisor spacing, mandibular incisor mild crowding, mandibular incisor moderate-to-severe crowding, mandibular incisor moderate irregularity, and mandibular incisor severe irregularity) are associated with significant periodontal disease progression. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Crown-root morphology of lower incisors in patients with class III malocclusion.

PubMed

Wang, Bo; Shen, Guofang; Fang, Bing; Zhang, Li

2012-07-01

The purpose of this study was to investigate the crown-root morphology of lower incisors in patients with class III malocclusion using cone-beam computed tomography. Cone-beam computed tomography images were analyzed from 53 adult class I patients (group 1), 37 preadolescent class III patients (group 2), and 66 adult class III patients (group 3) comprising 3 divisions (divisions 1, 2, and 3 corresponded to mild, moderate, and severe class III malocclusions). The size and crown-root angulations of lower incisors in different groups and divisions were statistically appraised with group 1 used as the control group. No significant differences were found for the size of lower incisors among different groups and divisions (P > 0.05). Compared with group 1, the crown-root angulations of lower incisors in groups 2 and 3 were significantly larger (P < 0.01), and among 3 divisions, the lower incisors of division 3 rather than divisions 2 and 3 exhibited larger crown-root angulations (P < 0.01). Attention should be paid to the enlarged crown-root angulations of lower incisors in class III patients during orthodontic and orthognathic treatment, especially in severe ones.

[Difference of anti-fracture mechanical characteristics between lateral-root branches and adjacent upper straight roots of four plant species in vigorous growth period].

PubMed

Liu, Peng-fei; Liu, Jing; Zhu, Hong-hui; Zhang, Xin; Zhang, Ge; Li, You-fang; Su, Yu; Wang, Chen-jia

2016-01-01

Taking four plant species, Caragana korshinskii, Salix psammophila, Hippophae rhamnides and Artemisia sphaerocephala, which were 3-4 years old and in vigorous growth period, as test materials, the anti-fracture forces of lateral-root branches and adjacent upper straight roots were measured with the self-made fixture and the instrument of TY 8000. The lateral-root branches were vital and the diameters were 1-4 mm. The results showed that the anti-fracture force and anti-fracture strength of lateral-root branches were lesser than those of the adjacent upper straight roots even though the average diameter of lateral-root branches was greater. The ratios of anti-fracture strength of lateral-root branches to the adjacent upper straight roots were 71.5% for C. korshinskii, 62.9% for S. psammophila, 45.4% for H. rhamnides and 35.4% for A. sphaerocephala. For the four plants, the anti-fracture force positively correlated with the diameter in a power function, while the anti-fracture strength negatively correlated with diameter in a power function. The anti-fracture strengths of lateral-root branches and adjacent upper straight roots for the four species followed the sequence of C. korshinskii (33.66 and 47.06 MPa) > S. psammophila (17.31 and 27.54 MPa) > H. rhamnides (3.97 and 8.75 MPa) > A. sphaerphala (2.18 and 6.15 MPa).

Treatment of horizontal root fracture: a case report

PubMed Central

Cantore, Stefania; Ballini, Andrea; Grassi, Felice Roberto

2009-01-01

Radicular fractures in permanent teeth are uncommon injuries among dental traumas, being only 0.5-7% of the cases. Traumatic dental injuries occur more frequently in young patients, and vary in severity from enamel fractures to avulsions. The magnitude of these problems is confirmed by statistical data on the prevalence of dental trauma during childhood and adolescence. Fracture occurs often in the middle-third of the root and rarely at the apical-third. The present paper reports a clinical case of a horizontal radicular fracture located between the middle- and apical-third of a upper left-central incisors followed-up over 4 years. PMID:19830049

To Evaluate the Correlation Between Skeletal and Dental Parameters to the Amount of Crowding in Class II Div. 1 Malocclusions.

PubMed

Singh, Shivani; Shivaprakash, G

2017-09-01

Crowding of teeth is one of the most common problem that motivates the patient to seek orthodontic treatment. Determination of etiology of crowding could have a significant effect on treatment planning and prognosis of Class II malocclusion. Aim of this study was to evaluate the relationship of skeletal and dental parameters to amount of dental crowding in patients with Class II Divison 1 (div.1) malocclusion. Pretreatment lateral cephalograms and dental casts of 60 patients with skeletal Class II malocclusion were collected for the study. The sample was divided into two groups according to severity of pretreatment mandibular crowding. Group I consisted of cases with crowding ≥3 mm and Group II with crowding <3 mm. Lateral cephalograms for each patient was manually traced and skeletal parameters (effective maxillary and mandibular length, mandibular plane angle, Y Axis, lower anterior face height) and dental parameters (axial inclination of lower incisor, inclination of lower incisor to mandibular plane, interincisal angle) were measured. Unpaired t-test was used for intergroup comparison and relationship between different measurements was investigated using Pearson correlation coefficient. Among the skeletal parameters measured, only effective mandibular length exhibited statistically significant difference between the two groups. No statistically significant difference was found between the two groups for any of the dental parameters. Significant inverse correlation was found between mandibular crowding and effective mandibular length. Subjects with Class II div.1 malocclusion and moderate to severe mandibular crowding have significantly smaller effective mandibular base length than subjects with the same malocclusion and slight mandibular crowding.

Unilateral and bilateral dental transpositions in the maxilla-dental and skeletal findings in 63 individuals.

PubMed

Danielsen, J C; Karimian, K; Ciarlantini, R; Melsen, B; Kjær, I

2015-12-01

This was to elucidate dental and skeletal findings in individuals with unilateral and bilateral maxillary dental transpositions. The sample comprised of radiographic materials from 63 individuals with maxillary dental transpositions from the Departments of Odontology at the Universities of Copenhagen and Aarhus and by the Danish municipal orthodontic service. The cases were divided into three groups: unilateral transposition of the canine and first premolar (Type 1U), bilateral transposition of canine and first premolar (Type 1B), and unilateral transposition of canine and lateral incisor (Type 2). The dentitions were analysed regarding agenesis and dental morphological anomalies on panoramic radiographs, and craniofacial aspects were cephalometrically analysed on profile images The results were statistically evaluated. All groups demonstrated increased occurrences of agenesis (Type 1U and Type 1B: 31 agenesis in 15 patients; and Type 2 three agenesis in three patients). Taurodontic root morphology was most dominant in Type 1U. Peg-shaped lateral incisors showed an increased occurrence, though not in Type 1U. Skeletally, Type 1B and Type 1U demonstrated maxillary retrognathia (more pronounced in Type 1B). Type 2 showed a significant posterior inclination of the maxilla. Transpositions of maxillary canines involve dental and skeletal deviations. Dental deviations were predominantly taurodontic root morphology and agenesis. Regarding skeletal deviations, bilateral transpositions of the canines and the first premolars are associated with skeletal changes. Unilateral transpositions are possibly a localised deviation with minor or no skeletal involvements. The results indicate a possible difference in the aetiologies of unilateral and bilateral transpositions.

The relationship between smile attractiveness and esthetic parameters of patients with lateral agenesis treated with tooth recontouring or implants

PubMed Central

De-Marchi, Luciana Manzotti; Pini, Núbia Inocencya Pavesi; Pascotto, Renata Corrêa

2012-01-01

Background The purpose of this study was to associate smile esthetic judgment with dentofacial attributes of patients with unilateral and bilateral agenesis of maxillary lateral incisors treated with recontouring of canines or implants and patients with no agenesis (control). Material and methods Forty-six participants were divided into two groups: those treated with recontouring (N = 26) and those treated with implants (N = 20). The participants in the control group (N = 22) were selected among dentistry students at the State University of Maringá, Brazil. Photographs of posed smiles (17 cm × 10 cm) were evaluated with a 100-mm Visual Analog Scale. Smile attractiveness was judged by two groups: laypersons and dentists (N = 20 in each group). Judgment was classified into Unpleasant and Pleasant. Measurements of 11 smile attributes were done with ImageTool Version 3.0. These measurements were correlated with the type of judgment using the Pearson correlation coefficient. Results The two groups of evaluators showed no rating difference (analysis of variance, P = 0.64), thus they were placed into a single group. No significant correlation was found between esthetic judgment and six smile attributes (incisor exposure, interlabial gap, width 3 to 3, smile index, right buccal corridor, and buccal corridor ratio). The control group showed more correlations with the unpleasant judgment type than the other groups. Conclusion Some correlations between smile attributes and esthetic judgment were found, but other features of smiles not evaluated in this study may interfere in smile attractiveness. PMID:23674925

Implant-supported restoration of congenitally missing teeth using cancellous bone block-allografts.

PubMed

Nissan, Joseph; Mardinger, Ofer; Strauss, Morris; Peleg, Michael; Sacco, Roberto; Chaushu, Gavriel

2011-03-01

Patients with congenitally missing teeth may present with undeveloped alveolar bone morphology, making implant reconstruction a challenge. The aim of the present study was to evaluate the outcome of dental implants after ridge augmentation with cancellous freeze-dried block bone allografts in patients with congenitally missing teeth. Twelve patients with a mean age of 21 ± 4 years, were included. Congenitally missing teeth included maxillary lateral incisors, a maxillary canine, and mandibular central and lateral incisors. A bony deficiency of ≥3 mm horizontally and ≤3 mm vertically according to computerized tomography served as inclusion criteria. Twenty-one implants were inserted after a healing period of 6 months. Five out of 21 implants were immediately restored. Bone measurements were taken before bone augmentation, during implant placement, and at second-stage surgery. Nineteen cancellous allogeneic bone-blocks were used. The mean follow-up time was 30 ± 16 months. Bone block and implant survival rates were 100% and 95.2%, respectively. Mean bone gain was statistically significant (P < .001): 5 ± 0.5 mm horizontally and 2 ± 0.5 mm vertically. All of the patients received a fixed implant-supported prosthesis. Soft tissue complications occurred in 4 patients (30%). Complications after cementation of the crowns were seen in 1 implant (4.8%). All implants remained clinically osseointegrated at the end of the follow-up examination. There was no crestal bone loss around the implants beyond the first implant thread. Cancellous bone block-allografts can be used successfully for implant-supported restorations in patients with congenitally missing teeth. Copyright © 2011 Mosby, Inc. All rights reserved.

Hard and Soft Tissue Changes Following Maxillary Distraction Osteogenesis and Mandibular Setback with Bilateral Sagittal Split Osteotomy.

PubMed

Bawane, Shilpa S; Andrade, Neelam N

2016-12-01

(1) To highlight the role of intraoral submerged device in distraction osteogenesis (DO) of patients requiring two jaw surgeries for the correction of severe developmental maxillary hypoplasia (MH) and mandibular prognathism (MP) (2) To analyse the hard and soft tissue changes following maxillary DO and mandibular setback with bilateral sagittal split osteotomy (BSSO) in patients with severe MH and MP requiring two jaw surgeries. During the period Jan 2004 to Dec 2006, five patients with severe developmental MH along with MP were treated. In 1st stage maxillary distraction was done. Distraction started on 6th postoperative day, 1 mm distraction was carried out for 10-15 days on either side. Serial radiographs were taken immediate postoperative period for baseline comparison, post-distraction and at the end of distraction. After a period of 3-4 months of distraction 2nd stage was done. In 2nd stage, mandibular setback was done with BSSO and distractors were removed under general anesthesia. Radiographs were taken immediately and at 4 months post-operatively. Cephalometric tracings were carried out preoperatively, post DO and finally after mandibular setback with BSSO. The mean horizontal movement of maxilla was 11.4 mm at ANS and 9.6 mm at A point. Upper incisor edge was advanced by 8.8 mms. SNA increased by 8.4° and SNB decreased by 4.6°. Nasal projection advanced by 4°. Nasolabial angle normalized in all patients, mean change achieved was 10.8°. Upper lip moved forward by 5.4 mm. Lower lip moved backward by 5.4 mm. Mandible positioned backward by 4 mm at B point. No vertical change occurred in the position of A, ANS and upper incisor edges. Mean increase in skeletal angle of convexity was 26.4°. Concave profile was significantly changed to convex in all patients. Maxillary DO and mandibular setback with BSSO was associated with improved facial balance and esthetics.

External apical root resorption in maxillary root-filled incisors after orthodontic treatment: a split-mouth design study.

PubMed

Llamas-Carreras, José María; Amarilla, Almudena; Espinar-Escalona, Eduardo; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Sánchez-Domínguez, Benito; López-Frías, Francisco Javier

2012-05-01

The purpose of this study was to compare, in a split mouth design, the external apical root resorption (EARR) associated with orthodontic treatment in root-filled maxillary incisors and their contralateral teeth with vital pulps. The study sample consisted of 38 patients (14 males and 24 females), who had one root-filled incisor before completion of multiband/bracket orthodontic therapy for at least 1 year. For each patient, digital panoramic radiographs taken before and after orthodontic treatment were used to determine the root resortion and the proportion of external root resorption (PRR), defined as the ratio between the root resorption in the endodontically treated incisor and that in its contralateral incisor with a vital pulp. The student's t-test, chi-square test and logistic regression analysis were used to determine statistical significance. There was no statistically significant difference (p > 0.05) between EARR in vital teeth (1.1 ± 1.0 mm) and endodontically treated incisors (1.1 ± 0.8 mm). Twenty-six patients (68.4%) showed greater resorption of the endodontically treated incisor than its homolog vital tooth (p > 0.05). The mean and standard deviation of PPR were 1.0 ± 0.2. Multivariate logistic regression suggested that PRR does not correlate with any of the variables analyzed. There was no significant difference in the amount or severity of external root resorption during orthodontic movement between root-filled incisors and their contralateral teeth with vital pulps.

Atypical Initial Presentation of Painful Muscle Cramps in a Patient with Amyotrophic Lateral Sclerosis: A Case Report and Brief Review of the Literature.

PubMed

Kuzel, Aaron R; Lodhi, Muhammad Uzair; Syed, Intekhab Askari; Rahim, Mustafa

2017-11-10

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized clinically by progressive muscle weakness that can occur proximally or distally in either the upper or lower extremities. It includes both upper motor neuron signs (spasticity, hyperreflexia, clonus, and Babinski sign) and lower motor neuron signs (atrophy, weakness, and muscle fasciculation). Initial presentation of progressively painful muscle cramps should lead the physician to screen for other signs of amyotrophic lateral sclerosis. We report the case of a 51-year-old male, who presented with dull muscle cramps in the right upper shoulder and arm. After a careful history and physical exam, it was found that patient had both upper and lower motor neuron signs; therefore, a diagnosis of amyotrophic lateral sclerosis was made. Amyotrophic lateral sclerosis should strongly be considered in the differential diagnosis of patients presenting with an atypical initial presentation of progressively painful muscle cramps.

Anesthetic Efficacy of Supine and Upright Positions for the Inferior Alveolar Nerve Block: A Prospective, Randomized Study.

PubMed

Crowley, Chase; Drum, Melissa; Reader, Al; Nusstein, John; Fowler, Sara; Beck, Mike

2018-02-01

It has been recommended to place patients in an upright position after administration of an inferior alveolar nerve block (IANB), theoretically allowing the anesthetic to diffuse in an inferior direction and resulting in better pulpal anesthesia. The purpose of this study was to compare an upright versus a supine position on the success of pulpal anesthesia when an IANB was administered in asymptomatic teeth. One hundred ten asymptomatic subjects were randomly given IANBs by using 2% lidocaine with 1:100,000 epinephrine while they were in an upright position and supine position at 2 different appointments spaced at least 2 weeks apart. Pulpal anesthesia was measured in the molars, premolars, and incisors with an electric pulp tester in 4-minute cycles for 60 minutes. Anesthetic success was defined as the subject achieving 2 consecutive 80 readings within 15 minutes of the injection and sustaining the 80 reading for 60 minutes. Success was analyzed by using a mixed model logistic regression. Pulpal anesthesia for the supine position was not statistically more successful than the upright position in the second molars (73% vs 65%), first molars (59% vs 54%), lateral incisors (28% vs 23%), and central incisors (11% vs 8%), respectively. The supine position significantly improved success in the second premolars (63% vs 53%) and first premolars (75% vs 64%). The supine and upright positions were equally successful in the molars and anterior teeth. The supine position was more successful in the premolars. However, clinically, neither position for the IANB administration would provide complete pulpal anesthesia. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Effects of incisor extraction on jaw and tongue motor representations within face sensorimotor cortex of adult rats.

PubMed

Avivi-Arber, Limor; Lee, Jye-Chang; Sessle, Barry J

2010-04-01

Loss of teeth is associated with changes in somatosensory inputs and altered patterns of mastication, but it is unclear whether tooth loss is associated with changes in motor representations within face sensorimotor cortex of rats. We used intracortical microstimulation (ICMS) and recordings of cortically evoked muscle electromyographic (EMG) activities to test whether changes occur in the ICMS-defined motor representations of the left and right jaw muscles [masseter, anterior digastric (LAD, RAD)] and tongue muscle [genioglossus (GG)] within the cytoarchitectonically defined face primary motor cortex (face-M1) and adjacent face primary somatosensory cortex (face-S1) 1 week following extraction of the right mandibular incisor in anesthetized (ketamine-HCl) adult male Sprague-Dawley rats. Under local and general anesthesia, an "extraction" group (n = 8) received mucoalveolar bone surgery and extraction of the mandibular right incisor. A "sham-extraction" group (n = 6) received surgery with no extraction. A "naive" group (n = 6) had neither surgery nor extraction. Data were compared by using mixed-model repeated-measures ANOVA. Dental extraction was associated with a significantly increased number of sites within face-M1 and face-S1 from which ICMS evoked RAD EMG activities, a lateral shift of the RAD and LAD centers of gravity within face-M1, shorter onset latencies of ICMS-evoked GG activities within face-M1 and face-S1, and an increased number of sites within face-M1 from which ICMS simultaneously evoked RAD and GG activities. Our novel findings suggest that dental extraction may be associated with significant neuroplastic changes within the rat's face-M1 and adjacent face-S1 that may be related to the animal's ability to adapt to the altered oral state. (c) 2009 Wiley-Liss, Inc.

Risk factors for incidence and severity of white spot lesions during treatment with fixed orthodontic appliances.

PubMed

Chapman, Joshua A; Roberts, W Eugene; Eckert, George J; Kula, Katherine S; González-Cabezas, Carlos

2010-08-01

The development of incipient caries, or white spot lesions (WSLs), is a significant clinical problem in orthodontics. The purpose of this study was to retrospectively determine the incidence and severity of WSLs by examining pretreatment and posttreatment digital photographs. A total of 332 consecutive finished patients from a university graduate orthodontic clinic were evaluated. Initial and final digital images were compared to assess WSLs. The facial surfaces of the anterior 8 maxillary teeth were analyzed. The percentage area of WSL per total facial tooth surface was calculated to control for magnification differences. Reliability of the method was assessed by comparison with direct clinical examination data. Patient and operator factors, and treatment complexity and outcomes were evaluated as predictors of WSL incidence and severity. Agreement between direct clinical examination and digital photo data was excellent, with an intraclass correlation coefficient 0.88 and a 0.3% average difference between methods. The incidence of at least 1 WSL on the labial surface of the anterior 8 maxillary teeth was 36%. The order of incidence was lateral incisor (34%), canine (31%), premolar (28%), and central incisor (17%). Risk factors for the development of incipient caries during orthodontic treatment were young age (preadolescent) at the start of treatment, number of poor hygiene citations during treatment, unfavorable clinical outcome score, white ethnic group, and inadequate oral hygiene at the initial pretreatment examination. The use of computer software to evaluate digital photos retrospectively is a valid method for assessing the incidence and severity of WSLs on the maxillary anterior incisors, canines, and premolars. Copyright (c) 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Augmented corticotomy-assisted surgical orthodontics decompensates lower incisors in Class III malocclusion patients.

PubMed

Wang, Bo; Shen, Guofang; Fang, Bing; Yu, Hongbo; Wu, Yong; Sun, Liangyan

2014-03-01

To quantitatively evaluate lower incisor decompensation and the surrounding periodontal region after augmented corticotomy-assisted surgical orthodontics in patients with Class III malocclusion. This prospective study enrolled patients with severe Class III malocclusion who underwent augmented corticotomy in the lower anterior region before orthodontic surgery. Cone-beam computed tomograms and lateral cephalograms were obtained before treatment (T0), after presurgical orthodontic treatment (T1), and at removal of the orthodontic surgical appliances (T2). Repeated measures analysis of variance was used to compare variables at each time point: root length (RL), anterior vertical alveolar bone level at the labial side (AVBL), posterior vertical alveolar bone level at the lingual side (PVBL), labial alveolar bone thickness at the apex (LA), lingual alveolar bone thickness at the apex (LP), and angle of the incisor to the mandibular plane (L1-MP). In the 8 subjects studied, RL was maintained from T0 to T2 (P > .05), whereas AVBL and PVBL increased from T0 to T1 (P < .05) and then decreased from T1 to T2 (P < .05). LA and L1-MP increased from T0 to T1 (P < .001) but remained steady from T1 to T2 (P > .05). LP decreased from T0 to T1 (P < .05) but increased from T1 to T2 (P < .05) with no further change. Augmented corticotomy-assisted surgical orthodontics can achieve adequate tooth decompensation with minimal periodontal side-effects in the lower anterior region in patients with Class III malocclusion. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Esophageal cancer diagnosed by high-resolution manometry of the esophagus: A case report

PubMed Central

LIU, RONGBEI; CHU, HUA; XU, FEI; CHEN, SHUJIE

2016-01-01

A 48-year-old female who presented with a history of dysphagia for 5 months and regurgitation for 1 week was referred to the Sir Run Run Shaw Hospital (Hangzhou, China) for further evaluation, since the gastroscopy and endoscopic ultrasound performed in local hospitals did not reveal the presence of cancer. High-resolution manometry (HRM) of the esophagus was performed to determine the patient's condition, and revealed an abnormal high-pressure zone that was located 33 cm from the incisor and did not relax upon swallowing. Synchronous waves were observed, and the pressure of the esophageal lumen was found to increase with secondary synchronous peristaltic waves. The lower esophageal sphincter was 39 cm from the incisor and relaxed upon swallowing. The abnormal high-pressure zone could have been caused by an obstruction, and therefore an upper gastrointestinal series (barium swallow) test and gastroscopy were recommended to further pinpoint the cause. Following the two examinations, mid-esophageal cancer was considered as a possible diagnosis. A biopsy was performed and the final diagnosis was that of basaloid squamous cell carcinoma. The findings of the present study suggest that, for patients with evident symptoms of esophageal motor dysfunction without significant gastroscopy findings, HRM is recommended. PMID:27123076

Evaluation of the Immediate Dentofacial Changes in Late Adolescent Patients Treated with the Forsus™ FRD

PubMed Central

Gunay, Esen Ali; Arun, Tulin; Nalbantgil, Didem

2011-01-01

Objectives: The purpose of this study was to evaluate the short-term dentoalveolar and soft tissue changes in late adolescent patients treated with the Forsus™ FRD. Methods: A prospective study was carried out on 54 lateral cephalometric radiograms that were taken before placement and after removal of the appliance in the treatment group (15 subjects) and at the beginning and six months after in the control group (12 subjects). The patient selection criteria were as follows: skeletal and dental Class II malocclusion due to retrognatic mandible, normal or low-angle growth pattern, post-peak growth period, no extracted or congenitally missing permanent teeth, and minimum crowding in the lower dental arch. Results: The statistical assesment of the data suggested the following results: No sagital and vertical skeletal changes were induced. The mandibular incisors were protruded and intruded, while the maxillary incisors were retruded and extruded. The occlusal plane was rotated in clockwise direction as a result of these dentoalveolar changes. Overbite and overjet were reduced in all patients. Soft tissue profile slightly improved. Conclusions: The results revealed that, in late-adolescent patients Forsus™ FRD corrected Class II discrepancies through maxillary and mandibular dentoalveolar changes. PMID:22589581

Evaluation of the Immediate Dentofacial Changes in Late Adolescent Patients Treated with the Forsus(™) FRD.

PubMed

Gunay, Esen Ali; Arun, Tulin; Nalbantgil, Didem

2011-10-01

The purpose of this study was to evaluate the short-term dentoalveolar and soft tissue changes in late adolescent patients treated with the Forsus™ FRD. A prospective study was carried out on 54 lateral cephalometric radiograms that were taken before placement and after removal of the appliance in the treatment group (15 subjects) and at the beginning and six months after in the control group (12 subjects). The patient selection criteria were as follows: skeletal and dental Class II malocclusion due to retrognatic mandible, normal or low-angle growth pattern, post-peak growth period, no extracted or congenitally missing permanent teeth, and minimum crowding in the lower dental arch. THE STATISTICAL ASSESMENT OF THE DATA SUGGESTED THE FOLLOWING RESULTS: No sagital and vertical skeletal changes were induced. The mandibular incisors were protruded and intruded, while the maxillary incisors were retruded and extruded. The occlusal plane was rotated in clockwise direction as a result of these dentoalveolar changes. Overbite and overjet were reduced in all patients. Soft tissue profile slightly improved. The results revealed that, in late-adolescent patients Forsus™ FRD corrected Class II discrepancies through maxillary and mandibular dentoalveolar changes.

Improvement of an anterior infrabone defect using combined periodontal and orthodontic therapy: A 6-year follow-up case report.

PubMed

de Molon, Rafael Scaf; Kim, Yeon Jung; Dos Santos-Pinto, Ary; Cirelli, Joni Augusto

2014-07-01

Extensive intraosseous lesions represent a clinical challenge for the periodontist. Sites with bone defects have been shown to be at higher risk of periodontitis progression in patients who had not received periodontal therapy. Thus, the aim of this case report was to describe a novel approach for the treatment of 1-walled intraosseous defect by combining nonsurgical periodontal therapy and orthodontic movement toward the bone defect, avoiding regenerative and surgical procedures. A 47-year-old woman underwent the proposed procedures for the treatment of her left central incisor with 9 mm probing depth and 1-walled intraosseous defect in its mesial aspect. Initially, basic periodontal therapy with scaling and root planning was accomplished. Two months later, an orthodontic treatment was planned to eliminate the intraosseous lesion and to improve the interproximal papillary area. Orthodontic root movement toward the osseous defect was performed for 13 months with light forces. After 6 years postoperative it was concluded that combined basic periodontal therapy and orthodontic movement was capable of eliminating the intraosseous defect and improve the esthetics in the interproximal papillary area between the central incisors.

Uneventful upper cervical manipulation in the presence of a damaged vertebral artery.

PubMed

Michaud, Thomas C

2002-09-01

To discuss a case in which a patient with a previously injured vertebral artery underwent manipulation in the upper cervical spine without alteration of her symptom pattern. The literature concerning the relative safety of specific upper cervical manipulative techniques is reviewed. A 42-year-old woman had a 3-week history of unilateral suboccipital pain that she related to a sudden twisting of her head and neck that occurred while she was putting sheets of drywall on top of her car. Subsequent examination by a neurologist 2 weeks later was unremarkable, and a tension-type headache was diagnosed. Approximately 10 days later (3 weeks after injury), a single high-velocity upper-cervical manipulation (incorporating slight rotation and full lateral flexion) was performed with no change in her symptom pattern. Two weeks after that, the patient had development of a lateral medullary syndrome (also known as Wallenberg syndrome) after she briefly extended and rotated her upper cervical spine while painting a ceiling. The patient was treated with anticoagulant therapy, and the lateral medullary infarct healed without incident. The spinocerebellar and subtle motor symptoms also resolved, but the ipsilateral suboccipital headache and the loss of temperature sensation associated with the spinothalamic tract lesion were still present 9 months later. This case report demonstrates that vigorous manipulation of the upper cervical spine is possible without injuring an already damaged vertebral artery. It is suggested that the line of drive used during the single manipulation, almost pure lateral flexion with slight rotation, was responsible for the apparent innocuous response. Guidelines for the evaluation and management of vertebral artery dissection are reviewed. Because it is currently impossible to identify patients at risk of having a dissected vertebral artery with standard in-office examination procedures, rotational manipulation of the upper cervical spine should be abandoned by all practitioners, and schools should remove such techniques from their curriculums.

Determinants of permanent first incisor eruption in grazing Australian Angora goats.

PubMed

McGregor, B A; Butler, K L

2011-12-01

To investigate the effects of live weight, sex and other factors on deciduous (first incisor) loss and permanent first incisor development in Angora goats. Goats were part of a pen study on the effects of energy intake in Angora does during pregnancy and lactation on kid growth and development. The design was three levels of nutrition in mid-pregnancy × two levels of postnatal nutrition in 17 randomised blocks. Conception times were calculated by using artificial insemination, with ultrasound examination 43 days after insemination. Does were fed different amounts of a formulated diet in their pens. After weaning, goats were grazed in sex groups. Deciduous first incisor loss and permanent first incisor development were recorded at 11 time points from 14 to 20 months of age. For each sex, the time for visible eruption and full development of permanent first incisor declined linearly with increased live weight by 5.9 and 5.4 days/kg live weight, respectively. The time to reach similar development stages for first permanent incisors eruption was 3 months longer for the lightest animals compared with the heaviest animals. Date of birth, birth weight, doe age, growth rates, mid-pregnancy and postnatal nutrition, parity, day of weaning and weaning weight had no detectable effect. The results explain much of the substantial range in reported first permanent incisor eruption dates for small ruminants and have application in ageing of goats, marketing of kids for meat, in the selection of animals for breeding flocks and in educational material. © 2011 The Authors. Australian Veterinary Journal © 2011 Australian Veterinary Association.

External apical root resorption in maxillary root-filled incisors after orthodontic treatment: A split-mouth design study

PubMed Central

Amarilla, Almudena; Espinar-Escalona, Eduardo; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Sánchez-Domínguez, Benito; López-Frías, Francisco J.

2012-01-01

Introduction: The purpose of this study was to compare, in a split mouth design, the external apical root resorption (EARR) associated with orthodontic treatment in root-filled maxillary incisors and their contralateral teeth with vital pulps. Methodology: The study sample consisted of 38 patients (14 males and 24 females), who had one root-filled incisor before completion of multiband/bracket orthodontic therapy for at least 1 year. For each patient, digital panoramic radiographs taken before and after orthodontic treatment were used to determine the root resortion and the proportion of external root resorption (PRR), defined as the ratio between the root resorption in the endodontically treated incisor and that in its contralateral incisor with a vital pulp. The student’s t-test, chi-square test and logistic regression analysis were used to determine statistical significance. Results: There was no statistically significant difference (p > 0.05) between EARR in vital teeth (1.1 ± 1.0 mm) and endodontically treated incisors (1.1 ± 0.8 mm). Twenty-six patients (68.4%) showed greater resorption of the endodontically treated incisor than its homolog vital tooth (p > 0.05). The mean and standard deviation of PPR were 1.0 ± 0.2. Multivariate logistic regression suggested that PRR does not correlate with any of the variables analyzed. Conclusions: There was no significant difference in the amount or severity of external root resorption during orthodontic movement between root-filled incisors and their contralateral teeth with vital pulps. Key words:Endodontics, orthodontics, root canal treatment, root resorption. PMID:22143731

[Indirect usage of miniscrew anchorage to intrude overerupted mandibular incisors in a Class II patient with a deep overbite].

PubMed

Ishihara, Yoshihito; Kuroda, Shingo; Sugawara, Yasuyo; Balam, Tarek A; Takano-Yamamoto, Teruko; Yamashiro, Takashi

2016-06-01

Vertical dentoalveolar discrepancies are a common problem in orthodontic patients but are often difficult to treat with traditional mechanics. This case report illustrates the successful treatment of overerupted mandibular incisors via the indirect use of miniscrew anchorage. A woman (age, 22 years 9 months) had chief complaints of maxillary incisor protrusion and crooked teeth. An excessive curve of Spee caused by elongation of the mandibular incisors was also found. The patient was diagnosed with a severe Class II Division 1 malocclusion and a deep overbite. After extraction of the mandibular first premolars and the subsequent leveling phase, the elongated incisors were intruded with a novel method, which involved the combined use of sectional archwires and miniscrews placed in the premolar areas. After the procedure, the mandibular incisors had been intruded by 6.5 mm with no undesirable side effects. The total active treatment period was 42 months. The resultant occlusion and satisfactory facial profile were maintained after 30 months of retention. Our novel intrusion approach shows potential for correcting a deep overbite. © EDP Sciences, SFODF, 2016.

Orthodontic treatment of severe anterior open bite and alveolar bone defect complicated by an ankylosed maxillary central incisor: a case report.

PubMed

Lin, Feiou; Sun, Hao; Yao, Linjie; Chen, Qiushuo; Ni, Zhenyu

2014-11-21

Incisor trauma is common in children, and can cause severe complications during adolescent growth and development. This report describes the treatment of a 16-year-old patient with severe anterior open bite due to ankylosis of the maxillary left incisor after dental trauma as an 8-year-old. No examination or active treatment was undertaken until he was 16 years old. Clinical examination revealed that the maxillary left incisor was severely intruded accompanied by a vertical alveolar bone defect. Orthodontic treatment combined with surgical luxation took 3 years and 7 months. During treatment, the intruded incisor was moved to the occlusal level and the alveolar bone defect was restored, achieving normal occlusion. After two years of retention, the maxillary left incisor was retained in a stable normal position with a slightly reduced overbite. This case demonstrates that surgical luxation with orthodontic traction can be an effective approach, especially when the ankylosed tooth has a single root. Long-term monitoring of orthodontic stability and the maintenance of periodontal health are crucial in the post-treatment period.

Orthodontic space closure without counterbalancing extractions in patients with bilateral aplasia of the lower second premolars.

PubMed

Zimmer, Bernd; Rottwinkel, Yvonne

2002-09-01

Orthodontic space closure in situations with bilateral aplastic lower second premolars without maxillary extractions is a rarely practiced treatment method. Due to the high risk of severe side effects, preference is currently given to the maintenance of deciduous second molars and subsequent prosthodontic solutions. As a combination of Class I push and Class II pull mechanics seemed likely to reduce secondary effects by transferring the anchorage site from the reactive lower anterior teeth to the more resistant upper arch, a clinical study was carried out in order to investigate effects and secondary effects of the mechanics. Casts, panoramic radiographs and lateral headfilms of 13 consecutively treated, non-selected adolescents (seven boys, six girls, mean age at start of treatment 13 years 4 months) were evaluated. In six patients a Jasper Jumper trade mark was inserted in addition for a mean period of 6 months. The treatment outcome after a mean period of 3 years and 1 month showed in almost all cases the desired Class III molar occlusion of one cusp width (+/- 1/4 cw) with overbite and overjet within the normal range. Analyses of static and dynamic occlusion revealed anterior/canine protected articulation and a satisfactory number of centric contact points. A significant space gain (p

Morphea "en coup de sabre": An unusual oral presentation.

PubMed

Niklander, Sven; Marín, Constanza; Martínez, René; Esguep, Alfredo

2017-02-01

Morphea, or localized scleroderma, is an inflammatory disease that leads to sclerosis of the skin and underlying tissues due to excessive collagen deposition. Oral involvement is unusual and it may produce white linear fibrotic areas with a scar-like appearance, atrophy of tongue papillae, gingival recession and alveolar bone resorption. We report a case of a 13-year-old girl who consulted for progressive recession on the attached gingiva of her upper left incisors. She also presented a hypopigmented line on the left side skin of her upper lip, which continued through the vermilion and the lip mucosa, including the gingiva of the affected teeth. Clinical examination, blood tests, computerized axial tomography, echo-Doppler ultrasound and histopathological evaluation confirmed the diagnosis of morphea. Treatment with methotrexate and systemic corticosteroids was conducted. After 24 months, no other lesions appeared. No adverse side effects have been reported so far. Key words: Localized scleroderma, oral morphea, linear scleroderma, oral involvement, intraoral lesions.

New remains of the enigmatic cetartiodactyl Bugtitherium grandincisivum Pilgrim, 1908, from the upper Oligocene of the Bugti Hills (Balochistan, Pakistan).

PubMed

Métais, Grégoire; Antoine, Pierre-Olivier; Baqri, Syed Rafiqul Hassan; Benammi, Mouloud; Crochet, Jean-Yves; de Franceschi, Dario; Marivaux, Laurent; Welcomme, Jean-Loup

2006-07-01

Newly discovered fossil material of the enigmatic cetartiodactyl Bugtitherium grandincisivum from the upper Oligocene of the Bugti Member of the Chitarwata Formation in the Bugti Hills (Balochistan, Pakistan) is reported. These new specimens consist of two fragmentary muzzles (one preserving the first incisors and belonging to a juvenile) and a fragmentary right mandible with m3. The morphologies of the anterior dentition and m3 provided by these new specimens confirm the validity of the genus Bugtitherium and advocate probable anthracotheriid affinity for the genus rather than entelodontid or suoid affinities, but do not definitively close the debate about Bugtitherium's familial affinities within Cetartiodactyla. Although still poorly documented, this large-sized anthracotheriid-like cetartiodactyl is a possible key form for understanding the early evolution of hippos, and, in turn, the ancestry of whales, because of both its morphological similarities with hippos and primitive Paleogene whales and its Tethysian distribution.

New remains of the enigmatic cetartiodactyl Bugtitherium grandincisivum Pilgrim, 1908, from the upper Oligocene of the Bugti Hills (Balochistan, Pakistan)

NASA Astrophysics Data System (ADS)

Métais, Grégoire; Antoine, Pierre-Olivier; Baqri, Syed Rafiqul Hassan; Benammi, Mouloud; Crochet, Jean-Yves; de Franceschi, Dario; Marivaux, Laurent; Welcomme, Jean-Loup

2006-07-01

Newly discovered fossil material of the enigmatic cetartiodactyl Bugtitherium grandincisivum from the upper Oligocene of the Bugti Member of the Chitarwata Formation in the Bugti Hills (Balochistan, Pakistan) is reported. These new specimens consist of two fragmentary muzzles (one preserving the first incisors and belonging to a juvenile) and a fragmentary right mandible with m3. The morphologies of the anterior dentition and m3 provided by these new specimens confirm the validity of the genus Bugtitherium and advocate probable anthracotheriid affinity for the genus rather than entelodontid or suoid affinities, but do not definitively close the debate about Bugtitherium’s familial affinities within Cetartiodactyla. Although still poorly documented, this large-sized anthracotheriid-like cetartiodactyl is a possible key form for understanding the early evolution of hippos, and, in turn, the ancestry of whales, because of both its morphological similarities with hippos and primitive Paleogene whales and its Tethysian distribution.

One year treatment effects of the eruption guidance appliance in 7- to 8-year-old children: a randomized clinical trial.

PubMed

Myrlund, Rita; Dubland, Mari; Keski-Nisula, Katri; Kerosuo, Heidi

2015-04-01

The eruption guidance appliance (EGA) aims to correct sagittal and vertical occlusal relations concomitantly with alignment of the incisors. Few reports have been published on treatment effects with the EGA but no randomized studies have been available. The aim was to find out if 1 year active treatment time with EGA was sufficient for achieving normal occlusal relationships and dental alignment in 7- to 8-year-old children. Eligibility criteria for participants were: fully erupted upper central incisors, and Angle's Class I or Class II molar relationship combined with any of the following traits: deep bite, increased overjet ≥5mm, moderate anterior crowding with overjet ≥4mm. After screening of 148 children, 48 7- to 8-year-old children were recruited in the study. The participants were randomly assigned into a treatment group (N = 25) and a control group (N = 23). Children in the treatment group received treatment with the EGA for 1 year. The controls had no orthodontic treatment. Changes in overjet, overbite, Angle's Class, and crowding were used as primary outcome measures. Occlusal assessments were performed on dental casts obtained from all subjects at start of the study (T1) and after 1 year (T2). Lateral cephalograms were obtained from all subjects at T1 and from the treatment group at T2. All measurements on dental casts and cephalograms were carried out blinded. Forty-six children completed the study. Mean overjet and overbite decreased significantly in the treated subjects during 1 year, in contrast to a slight increase in the controls. Class II molar relationship decreased from 46 to 4 per cent in the treatment group, with no significant change in the control group. Mandibular anterior crowding decreased significantly in the treated subjects, while the controls showed a slight increase. In short term, the EGA seems to be effective in correcting increased overjet and overbite, Class II malocclusion, and lower anterior crowding in the early mixed dentition. Follow-up data are needed to assess long-term effects of this treatment. This study was not registered. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Maxillary incisors changes during space closure with conventional and skeletal anchorage methods: a systematic review.

PubMed

Jayaratne, Yasas Shri Nalaka; Uribe, Flavio; Janakiraman, Nandakumar

2017-01-01

The objective of this systematic review was to compare the antero-posterior, vertical and angular changes of maxillary incisors with conventional anchorage control techniques and mini-implant based space closure methods. The electronic databases Pubmed, Scopus, ISI Web of knowledge, Cochrane Library and Open Grey were searched for potentially eligible studies using a set of predetermined keywords. Full texts meeting the inclusion criteria as well as their references were manually searched. The primary outcome data (linear, angular, and vertical maxillary incisor changes) and secondary outcome data (overbite changes, soft tissue changes, biomechanical factors, root resorption and treatment duration) were extracted from the selected articles and entered into spreadsheets based on the type of anchorage used. The methodological quality of each study was assessed. Six studies met the inclusion criteria. The amount of incisor retraction was greater with buccally placed mini-implants than conventional anchorage techniques. The incisor retraction with indirect anchorage from palatal mini-implants was less when compared with buccally placed mini-implants. Incisor intrusion occurred with buccal mini-implants, whereas extrusion was seen with conventional anchorage. Limited data on the biomechanical variables or adverse effects such as root resorption were reported in these studies. More RCT's that take in to account relevant biomechanical variables and employ three-dimensional quantification of tooth movements are required to provide information on incisor changes during space closure.

Postnatal treatment factors affecting craniofacial morphology of unilateral cleft lip and palate (UCLP) patients in a Japanese population.

PubMed

Alam, M K; Iida, J; Sato, Y; Kajii, Takashi S

2013-12-01

We have evaluated the craniofacial morphology of Japanese patients with unilateral cleft lip and palate (UCLP) and assessed the various postnatal factors that affect it. Lateral cephalograms of 140 subjects (mean (SD) aged 7 (2) years) with UCLP were taken before orthodontic treatment. Surgeons from Hokkaido University Hospital had done the primary operations. The craniofacial morphology was assessed by angular and linear cephalometric measurements. Cheiloplasty, palatoplasty, and preoperative orthopaedic treatment were chosen as postnatal factors. To compare the assessments of the postnatal factors, we made angular and linear cephalometric measurements for each subject and converted them into Z scores in relation to the mean (SD) of the two variables. Subjects treated by the modified Millard cheiloplasty had larger sella-nasion-point A (SNA) and nasion-point A-pogonion (NA-POG) measurements than subjects treated by the modified Millard with a vomer flap cheiloplasty. Two-stage palatoplasty showed consistently better craniofacial morphology than the other palatoplasty. Subjects who had preoperative orthopaedic treatment with a Hotz plate had significantly larger upper incisor/sella-nasion (U1-SN) measurements than who had no preoperative orthopaedic treatment or an active plate. We conclude that in subjects treated by a modified Millard type of cheiloplasty, a two-stage palatoplasty, and a Hotz plate there were fewer adverse effects on craniofacial morphology. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Self-etching adhesive on intact enamel, with and without pre-etching.

PubMed

Devarasa, G M; Subba Reddy, V V; Chaitra, N L; Swarna, Y M

2012-05-01

Bond strengths of composite resin to enamel using self-etch adhesive (SEA) Clearfil SE bond system on intact enamel and enamel pre-etched with phosphoric acid were compared. The objective was to determine if the pre-etching would increase the bond strengths of the SEA systems to intact enamel and to evaluate the effect of pre-etching on bond formation of self-etch adhesives on intact enamel. Labial surfaces of 40 caries free permanent upper central and lateral incisors were cleaned, sectioned of their roots. All specimens were mounted on acrylic block and divided randomly into four groups. In two groups the application of self-etch adhesive, Clearfil SE bond was carried as per manufacturer's instructions, composite cylinders were built, whereas in the other two groups, 37% phosphoric acid etching was done before the application of self-etching adhesives. Then the resin tags were analyzed using scanning electron microscope and shear bond strength was measured using Instron universal testing machine. When phosphoric acid was used, there was significant increase in the depth of penetration of resin tags and in the Shear Bond Strength of composite to enamel. The results indicate that out of both treatment groups, pre-etching the intact enamel with 37% phosphoric acid resulted in formation of longer resin tags and higher depth of penetration of resin tags of the Clearfil SE bond, and attaining higher bond strength of the Clearfil SE bond to intact enamel. Copyright © 2011 Wiley Periodicals, Inc.

Anterior open bite treated with myofunctional therapy and palatal crib.

PubMed

Asiry, Moshabab A

2015-03-01

This case report demonstrates the treatment effects of palatal crib combined with the myofunctional therapy in a child with anterior open bite (AOB) due to thumb sucking and habitual anterior and low tongue position. The patient, an 11-year-old boy, had an anterior open bite and flared and spaced upper and lower incisors. Palatal cribs in conjunction with myofunctional therapy were used to discourage sucking habit and to adapt normal tongue position. Successful correction of the AOB with adequate overjet and overbite were achieved with total treatment time of 7 months. The importance of myofunctional therapy in adopting normal tongue position and in maintaining the stability of open bite correction is emphasized.

Surgical-orthodontic treatment of Class I malocclusion with maxillary vertical excess--a case report.

PubMed

Kiran, Jyothi; Isaac, Anish; Shanthraj, Ravis; Madannagowda, Shivalinga

2012-01-01

This article describes the treatment of an adult male with vertical maxillary excess, excessive gingival display on smiling, a convex profile, proclined upper and lower incisors, and crowded lower anteriors with severe lip incompetence. The therapy included stages: (1) Pre surgical orthodontics- leveling and aligning of the maxillary and mandibular arch with closure of all extraction spaces. (2) Surgical phase-Lefort I osteotomy for superior maxillary impaction, 5 mm of anterior and 3 mm of posterior impaction ofmaxilla was done. (3) Post surgical orthodontics for finishing and detailing. The treatment lasted 16 months; improved facial esthetics significantly; and resulted in a normal occlusion, overjet, and overbite.

Esthetic Rehabilitation of Anterior Teeth with Laminates Composite Veneers

PubMed Central

Riva, Giancarlo

2014-01-01

No- or minimal-preparation veneers associated with enamel preservation offer predictable results in esthetic dentistry; indirect additive anterior composite restorations represent a quick, minimally invasive, inexpensive, and repairable option for a smile enhancement treatment plan. Current laboratory techniques associated with a strict clinical protocol satisfy patients' restorative and esthetic needs. The case report presented describes minimal invasive treatment of four upper incisors with laminate nanohybrid resin composite veneers. A step-by-step protocol is proposed for diagnostic evaluation, mock-up fabrication and trial, teeth preparation and impression, and adhesive cementation. The resolution of initial esthetic issues, patient satisfaction, and nice integration of indirect restorations confirmed the success of this anterior dentition rehabilitation. PMID:25013730

[Veneer computer aided design based on reverse engineering technology].

PubMed

Liu, Ming-li; Chen, Xiao-dong; Wang, Yong

2012-03-01

To explore the computer aided design (CAD) method of veneer restoration, and to assess if the solution can help prosthesis meet morphology esthetics standard. A volunteer's upper right central incisor needed to be restored with veneer. Super hard stone models of patient's dentition (before and after tooth preparation) were scanned with the three-dimensional laser scanner. The veneer margin was designed as butt-to-butt type. The veneer was constructed using reverse engineering (RE) software. The technique guideline of veneers CAD was explore based on RE software, and the veneers was smooth, continuous and symmetrical, which met esthetics construction needs. It was a feasible method to reconstruct veneer restoration based on RE technology.

Esthetic evaluation of incisor inclination in smiling profiles with respect to mandibular position.

PubMed

Zarif Najafi, Hooman; Oshagh, Morteza; Khalili, Mohammad Hassan; Torkan, Sepideh

2015-09-01

The smile is a key facial expression, and a careful assessment of the facial profile in smiling is an essential part of a complete orthodontic diagnosis. The aim of this study was to determine the preferred maxillary incisor inclination in the smile profile with regard to different mandibular positions. A smiling profile photograph of a man with normal facial profile features was altered digitally to obtain 3 different mandibular sagittal positions in 4-mm decrements or increments from -4 to +4 mm. In each mandibular position, the inclination of the maxillary incisors was changed from -10° to +10° in 5° increments. A total of 234 raters (72 senior dental students, 24 orthodontists, 21 maxillofacial surgeons, 25 prosthodontists, and 92 laypeople) were asked to score each photograph using a Likert-type rating scale. Mann-Whitney, Kruskal-Wallis, and intraclass correlation coefficient tests were used to analyze the data. In retruded and protruded mandibles, normal incisor inclination and the most retroclined incisors were selected as the most and the least attractive images, respectively, by almost all groups. With an orthognathic mandible, the image with the most retroclined incisors was selected as the least attractive, but the raters were not unanimous regarding the most attractive image. The intraclass correlation coefficient was 0.82 (high level of agreement). Also, the sex of the raters had no effect on the rating of the photographs. It is crucial to establish a normal incisor inclination, especially in patients with a mandibular deficiency or excess. An excessive maxillary incisor lingual inclination should be avoided regardless of the mandibular position. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Orthodontically induced eruption of a horizontally impacted maxillary central incisor.

PubMed

Rizzatto, Susana Maria Deon; de Menezes, Luciane Macedo; Allgayer, Susiane; Batista, Eraldo Luiz; Freitas, Maria Perpétua Mota; Loro, Raphael Carlos Drumond

2013-07-01

This case report presents the clinical features and periodontal findings in a patient with a horizontally impacted maxillary central incisor that had been exposed and aligned after a closed-eruption surgical technique. By combining 3 treatment stages-maxillary expansion, crown exposure surgery, and induced eruption-the horizontally impacted incisor was successfully moved into proper position. The patient finished treatment with a normal and stable occlusion between the maxillary and mandibular arches, and an adequate width of attached gingiva, even in the area surrounding the crown. The 5-year follow-up of stability and periodontal health demonstrated esthetic and functional outcomes after orthodontically induced tooth eruption. Clinical evaluation showed that the treated central incisor had periodontal clinical variables related to visible plaque, bleeding on probing, width of attached gingiva, and crown length that resembled the contralateral incisor. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Tooth shape preferences in an esthetic smile.

PubMed

Anderson, Kurt M; Behrents, Rolf G; McKinney, Thomas; Buschang, Peter H

2005-10-01

The purpose of this study was to evaluate the contributions of tooth shape to the esthetic smile. Restorative dentists (120), laypeople (102), and orthodontists (113) evaluated a series of color photographs of men's and women's smiles. The photographs were randomly presented to test the effects of 3 different shapes of maxillary incisors and canines on the same patient. For women, orthodontists preferred round and square-round incisors (P < .01), and restorative dentists preferred round incisors (P < or = .03). Laypeople did not discriminate between incisor shapes. For men, all 3 groups preferred square-round incisors (P < or = .042). There was also a tendency for male judges to rate female images more attractive than did female judges. Restorative dentists, orthodontists, and laypeople share similarities and display differences when considering esthetic preferences in tooth shape. Although there was no consensus in preference among the laypeople as a group, their preferences differed from those of the dental professionals.

A Longitudinal Study of the Presence of Dental Anomalies in the Primary and Permanent Dentitions of Cleft Lip and/or Palate Patients.

PubMed

Suzuki, Akira; Nakano, Masayuki; Yoshizaki, Keigo; Yasunaga, Atsushi; Haruyama, Naoto; Takahashi, Ichiro

2017-05-01

  The aim is to survey primary and permanent dental anomalies: hypodontia, microdontia, a supernumerary tooth, and fused teeth in patients with cleft lip and/or palate.   Retrospective longitudinal study Subjects :  The subjects were selected from all 1724 patients with cleft lip and/or palate who were registered at the orthodontic clinic of Kyushu University Hospital, Fukuoka, Japan, from 1970 to 2009. Finally, 994 subjects were evaluated for primary dentition, 1352 for permanent dentition, and 871 for the longitudinal changes from primary to permanent dentition.   The prevalence of dental anomalies was compared for each tooth type, among various cleft types, between males and females, and between the alveolar cleft area and the noncleft area.   The prevalence of hypodontia was 16.2% for primary dentition and 52.7% for permanent dentition in the subjects with cleft lip and/or palate. Hypodontia increased with the severity of the cleft type. Multiple hypodontia was found more frequently in the subjects with bilateral cleft lip and palate and the subjects with unilateral cleft lip and palate. Microformed lateral incisors were found in 22.7% of permanent lateral incisors but not in primary dentition. Supernumerary teeth were found in 17.7% of the subjects with cleft lip and/or palate for primary maxillary dentition and in 5.7% for permanent maxillary dentition.   The prevalence of hypodontia was greater in permanent dentition than in primary dentition; although, it was not much different between males and females or between the right and left sides. The prevalence of dental anomalies was significantly different among four groups by cleft type: cleft lip, cleft lip and alveolus, cleft lip and palate, and cleft palate.

Immediate provisionalization in the esthetic zone: 1-year interim results from a prospective single-cohort multicenter study evaluating 3.0-mm-diameter tapered implants.

PubMed

Kolinski, Martin; Hess, Pablo; Leziy, Sonia; Friberg, Bertil; Bellucci, Gionata; Trisciuoglio, Davide; Wagner, Wilfried; Moergel, Maximilian; Pozzi, Alessandro; Wiltfang, Jörg; Behrens, Eleonore; Zechner, Werner; Vasak, Christoph; Weigl, Paul

2018-07-01

The aim of this interim analysis of a 5-year prospective multicenter study is to evaluate clinical and radiological performance of immediately provisionalized 3.0-mm-diameter tapered implants. Patients needing implant rehabilitation of maxillary lateral incisors or mandibular lateral and central incisors were treated with 3.0-mm-diameter implants placed in extraction or healed sites and immediately provisionalized. Clinical and radiographic examinations were performed at implant insertion, 6 months thereafter, and are ongoing. Marginal bone levels and changes, complications, the papilla, plaque, and bleeding indices, and the pink esthetic score (PES) were evaluated at each follow-up visit. Of 112 enrolled patients, 77 patients (91 implants) met the inclusion criteria. Seventy-one patients with 82 implants completed the 1-year follow-up. Three implants failed yielding a CSR of 96.7%. All failures occurred within the first 3 months after implant insertion. Marginal bone level changes from insertion to 6 months was - 0.57 ± 1.30 mm (n = 75) and from insertion to 12 months - 0.25 ± 1.38 mm (n = 72). Fifteen non-serious complications were recorded. Papilla index score and PES improved at the 1-year follow-up. Plaque formation and bleeding-on-probing showed no statistically significant differences between the 6-month and the 1-year visit. This 1-year analysis demonstrated high survival, stable bone levels, and healthy soft tissue with 3.0-mm-diameter implants. Narrow diameter implants are a safe and predictable treatment option in patients with limited bone volume and/or limited interdental space and eligible for immediate loading protocols.

Patterns of third-molar agenesis and associated dental anomalies in an orthodontic population.

PubMed

Celikoglu, Mevlut; Bayram, Mehmet; Nur, Metin

2011-12-01

The aim of this study was to investigate the frequency of dental anomalies in orthodontic patients with different patterns of third-molar agenesis, comparing them with patients without third-molar agenesis. A sample of 374 patients with agenesis of at least 1 third molar was divided into 4 groups according to the third-molar agenesis pattern, and a control group of 98 patients without third-molar agenesis was randomly selected from the patient archives. Panoramic radiographs and cast models were used to determine the associated dental anomalies, such as hypodontia, hyperdontia, impaction, dilaceration, microdontia, ectopic eruption, transposition, and transmigration. The Pearson chi-square and Fisher exact tests were used to determine the differences in the distribution of the associated dental anomalies among the groups. The prevalence of agenesis of other teeth (11.2%, n = 42) was significantly greater in our study sample (groups 1-4) than in the control group (group 5) (4.1%, n = 4; P <0.05). When we compared the groups according to the various third-molar agenesis patterns, we found that agenesis of other teeth was more common in patients with agenesis of 3 and 4 third molars. In addition, the patients with agenesis of 4 third molars exhibited maxillary lateral-incisor microdontia more frequently. Another important finding was a higher prevalence of total dental anomalies in patients with agenesis of 3 and 4 third molars compared with the control group. Permanent tooth agenesis, microdontia of maxillary lateral incisors, and total dental anomalies are more frequently associated with agenesis of 4 third molars than with the presence of third molars. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

The three-dimensional reconstruction of the jaw with "bone slat technique" in conjunction with third molar removal.

PubMed

Santagata, Mario; Cecere, Atirge; Prisco, Rosario V E; Tartaro, Gianpaolo; D'Amato, Salvatore

2017-01-01

The purpose of this study was to report the outcome of the management of both horizontal and vertical defects of alveolar crest using the bone slat technique approach in conjunction with third molar removal prior to implant placement in the aesthetic area. We present a 20-year-old female patient who lost a maxillary lateral incisor. The objective of treatment was to replace the lateral incisor with an implant-supported crown restoration without interfering with the integrity and topography of the adjacent gingival tissues. Because the future implant site showed horizontal and vertical bone defect the Authors decided to perform bone regeneration. The need for such bone augmentation in the younger patient often coincides with the timing for third molar removal. By combining third molar extraction with bone harvest and alveolar grafting, the patient undergoes only one surgical approach. The bone height (9.5 mm) and width (5.7 mm) were measured at the point of interest (tooth 12) both before and after implant placement in the reconstructed panoramic and parasagittal views by Cone Beam Computed Tomography (CBCT) scan. The final results demonstrated an increase in length of 5 mm after bone slat technique (from 9.5 mm to 13.5 mm) and an increase in width of 1 mm (from 5.7 mm to 6.7 mm). ISQ measurements were recorded at the time of implant placement (the mean was: 68.5) and immediately after individualized screw-retained provisional crown (the mean was: 77). This technique is reliable and aesthetic and functional results appear to be stable and respect this requisite: simple and fast graft harvesting and low risk of morbidity especially in conjunction with third molar removal.

The three-dimensional reconstruction of the jaw with “bone slat technique” in conjunction with third molar removal

PubMed Central

Santagata, Mario; Cecere, Atirge; Prisco, Rosario V.E.; Tartaro, Gianpaolo

2017-01-01

Summary Background The purpose of this study was to report the outcome of the management of both horizontal and vertical defects of alveolar crest using the bone slat technique approach in conjunction with third molar removal prior to implant placement in the aesthetic area. Methods We present a 20-year-old female patient who lost a maxillary lateral incisor. The objective of treatment was to replace the lateral incisor with an implant-supported crown restoration without interfering with the integrity and topography of the adjacent gingival tissues. Because the future implant site showed horizontal and vertical bone defect the Authors decided to perform bone regeneration. The need for such bone augmentation in the younger patient often coincides with the timing for third molar removal. By combining third molar extraction with bone harvest and alveolar grafting, the patient undergoes only one surgical approach. The bone height (9.5 mm) and width (5.7 mm) were measured at the point of interest (tooth 12) both before and after implant placement in the reconstructed panoramic and parasagittal views by Cone Beam Computed Tomography (CBCT) scan. Results The final results demonstrated an increase in length of 5 mm after bone slat technique (from 9.5 mm to 13.5 mm) and an increase in width of 1 mm (from 5.7 mm to 6.7 mm). ISQ measurements were recorded at the time of implant placement (the mean was: 68.5) and immediately after individualized screw-retained provisional crown (the mean was: 77). Conclusions This technique is reliable and aesthetic and functional results appear to be stable and respect this requisite: simple and fast graft harvesting and low risk of morbidity especially in conjunction with third molar removal. PMID:29682225

Combined endodontic therapy and periapical surgery with MTA and bone graft in treating palatogingival groove.

PubMed

Mittal, Mudit; Vashisth, Pallavi; Arora, Rachita; Dwivedi, Swati

2013-04-18

A 37-year-old male patient reported to our department with chief complaint of pain and pus discharge from the labial marginal gingiva in the maxillary right lateral incisor region since last 4 months. Clinically, the tooth was hypersensitive to percussion and palpation but failed to respond to pulp sensitivity testing. After periodontal probing, a palatal groove was observed which started at the cingulum and travelled apically and laterally, associated with a pocket depth of 8 mm. Occlusal radiograph showed circumscribed radiolucency measuring 5 mm×7 mm in diameter at the apex of the tooth. A clinical diagnosis of chronic apical abscess was established. The case was treated with a combination of mineral trioxide aggregate and bone graft. At the 6-month follow-up visit, the tooth showed progressive healing without sinus track and sulcular bleeding.

Dental abnormalities in a mouse model for craniometaphyseal dysplasia.

PubMed

Dutra, E H; Chen, I-P; Reichenberger, E J

2013-02-01

Mice carrying a knock-in mutation (Phe377del) in the Ank gene replicate many skeletal characteristics of human craniometaphyseal dysplasia, including hyperostotic mandibles. Ank (KI/KI) mice have normal morphology of erupted molars and incisors but excessive cementum deposition with increased numbers of Ibsp- and Dmp1-positive cells on root surfaces. The cervical loops of adult Ank (KI/KI) lower incisors are at the level of the third molars, while they are close to the mandibular foramen in Ank (+/+) mice. Furthermore, Ank (KI/KI) incisors show decreased eruption rates, decreased proliferation of odontoblast precursors, and increased cell apoptosis in the stellate reticulum. However, their capability for continuous elongation is not compromised. Quantification of TRAP-positive cells in the apical ends of Ank (KI/KI) incisors revealed decreased osteoclast numbers and osteoclast surfaces. Bisphosphonate injections in Ank (+/+) mice replicate the Ank (KI/KI) incisor phenotype. These results and a comparison with the dental phenotype of Ank loss-of-function mouse models suggest that increased cementum thickness may be caused by decreased extracellular PPi levels and that the incisor phenotype is likely due to hyperostosis of mandibles, which distinguishes Ank (KI/KI) mice from the other Ank mouse models.

Incisor microwear and diet in three species of Colobus.

PubMed

Kelley, J

1990-01-01

Examination of incisor microwear in three species of Colobus revealed that the predominantly folivorous C. badius more closely resembles C. satanas, a seed predator/folivore, than C. guereza, another predominantly folivorous species. This demonstrates that species of the same broad dietary category can have very different patterns of incisor microwear, indicative of differences in food procurement behavior and/or the physical properties of dietary items for some portion of the diet. Conversely, species of different categories can have microwear patterns that, superficially at least, are quite similar. The dissimilarity in incisor microwear between C. badius and C. guereza is mirrored to a certain extent in molar microwear, although the differences are not nearly so great on the molars. The differences between C. badius and C. guereza may involve different food items in the major, folivorous portions of their diets, or they may relate to differences in the very minor fruit and bark components. The similar microwear patterns of C. badius and C. satanas demonstrate that incisor microwear by itself is unreliable for assigning fossil species to broad dietary categories. Incisor microwear can be used to infer finer dietary distinctions in fossil species for which dietary category has been determined by other means.

Lingual eruption of mandibular permanent incisors: a space correlated phenomenon?

PubMed

Aminabadi, Naser Asl; Farahani, Ramin Mostofi Zadeh; Sohrabi, Aydin; Pouralibaba, Firuz

2009-01-01

The aim of the present study was to investigate the prevalence and distribution according to various arch length conditions of lingually erupted mandibular permanent incisors and the effect of space condition on this phenomenon with long-term follow-up of these teeth. A total of 105 children aged 5-7.5 years with one or more permanent mandibular incisors erupting lingual to the corresponding primary incisors were included in the study. A space analysis was performed. The subjects were divided into six groups according to various space conditions. The subjects were followed for 2 years. In this study the prevalence of lingual eruption was 18.4%. Eighty-three point seven percent of the subjects had either equivalent space, mild space excess, or a space deficiency (not more than 3 mm). No relationship was found between groups and clinical outcomes (P>.05). Follow up of the main three groups (according to the space analysis results) revealed in the adequate space group 75% of the children lost their primary incisors without any intervention. Similar outcomes occurred in 85.7% and 57.14% of cases in the mild space excess and space deficiency groups, respectively. Considering the three main groups combined, equivalent space, mild space excess, and mild space deficiency, 70.45% of children lost their primary incisors without any intervention and 14.8% needed primary incisor extraction (17.4%, 14.3%, and 10.7% in each group, respectively). There was no predisposition toward a space deficiency or excess found in these subjects so the wait-and-see policy versus early extraction can be considered for lingually erupting permanent mandibular incisors. Lingual eruption of mandibular incisors is a common clinical problem in the early mixed dentition period that is a source of discomfort for parents of patients with this condition. The present study provides a unique insight into the prevalence of the problem as well as the clinical decisions such as favoring retention of primary incisors as long as possible, the extraction of these primary teeth, placement of lower lingual holding arches, or referral for comprehensive orthodontic treatment. These types of data should not be regarded as standards but as illustrative of several key factors that are still not well-understood or which are still ignored.

Estimating the color of maxillary central incisors based on age and gender

PubMed Central

Gozalo-Diaz, David; Johnston, William M.; Wee, Alvin G.

2008-01-01

Statement of problem There is no scientific information regarding the selection of the color of teeth for edentulous patients. Purpose The purpose of this study was to evaluate linear regression models that may be used to predict color parameters for central incisors of edentulous patients based on some characteristics of dentate subjects. Material and methods A spectroradiometer and an external light source were set in a noncontacting 45/0 degree (45-degree illumination and 0-degree observer) optical configuration to measure the color of subjects’ vital craniofacial structures (maxillary central incisor, attached gingiva, and facial skin). The subjects (n=120) were stratified into 5 age groups with 4 racial groups and balanced for gender. Linear first-order regression was used to determine the significant factors (α=.05) in the prediction model for each color direction of the color of the maxillary central incisor. Age, gender, and color of the other craniofacial structures were studied as potential predictors. Final predictions in each color direction were based only on the statistically significant factors, and then the color differences between observed and predicted CIELAB values for the central incisors were calculated and summarized. Results The statistically significant predictors of age and gender accounted for 36% of the total variability in L*. The statistically significant predictor of age accounted for 16% of the total variability in a*. The statistically significant predictors of age and gender accounted for 21% of the variability in b*. The mean ΔE (SD) between predicted and observed CIELAB values for the central incisor was 5.8 (3.2). Conclusions Age and gender were found to be statistically significant determinants in predicting the natural color of central incisors. Although the precision of these predictions was less than the median color difference found for all pairs of teeth studied, and may be considered an acceptable precision, further study is needed to reduce this precision to the limit of detection. Clinical Implications Age is highly correlated with the natural color of the central incisors. When age increases, the central incisor becomes darker, more reddish, and more yellow. Also, the women subjects in this study had lighter and less yellow central incisors than the men. PMID:18672125

Inner canthal distance and golden proportion as predictors of maxillary central incisor width in south Indian population.

PubMed

George, Shibu; Bhat, Vinaya

2010-01-01

Even though the constant relation of golden proportion and inner canthal distance (ICD) with the width of the maxillary central incisor (CIW) has been found in European population, it may not be applied to Indian population as we differ from Europeans racially and genetically. Hence, this study was carried out with the objectives of determining if these parameters are applicable to our population also. Three hundred south Indian subjects between 18 and 26 years of age, free from facial and dental deformities were examined. Inner canthus of each eye was used as soft tissue landmark. The maxillary central incisors were measured at the contact point area with the help of digital vernier caliper. The CIW was also calculated using golden proportion ratio to obtain the calculated central incisor width. A comparison was made with measured width. Statistical analyses were done to identify any significant difference using "Z" tests. Pearson's Correlation Coefficient test was used to evaluate the measured and the calculated width of the central incisor. ICD and the width of two maxillary incisors were in golden proportion in south Indian population. Also, ICD when multiplied by a decreasing function value of the golden proportion and divided by 2 is a reliable predictor of determining CIW. As in the European population, the ICD and the golden proportion are reliable predictors for determining the width of the maxillary central incisors in the south Indian population also.

Cutaneous and periodontal inputs to the cerebellum of the naked mole-rat (Heterocephalus glaber)

PubMed Central

Sarko, Diana K.; Leitch, Duncan B.; Catania, Kenneth C.

2013-01-01

The naked mole-rat (Heterocephalus glaber) is a small fossorial rodent with specialized dentition that is reflected by the large cortical area dedicated to representation of the prominent incisors. Due to naked mole-rats’ behavioral reliance on the incisors for digging and for manipulating objects, as well as their ability to move the lower incisors independently, we hypothesized that expanded somatosensory representations of the incisors would be present within the cerebellum in order to accommodate a greater degree of proprioceptive, cutaneous, and periodontal input. Multiunit electrophysiological recordings targeting the ansiform lobule were used to investigate tactile inputs from receptive fields on the entire body with a focus on the incisors. Similar to other rodents, a fractured somatotopy appeared to be present with discrete representations of the same receptive fields repeated within each folium of the cerebellum. These findings confirm the presence of somatosensory inputs to a large area of the naked mole-rat cerebellum with particularly extensive representations of the lower incisors and mystacial vibrissae. We speculate that these extensive inputs facilitate processing of tactile cues as part of a sensorimotor integration network that optimizes how sensory stimuli are acquired through active exploration and in turn adjusts motor outputs (such as independent movement of the lower incisors). These results highlight the diverse sensory specializations and corresponding brain organizational schemes that have evolved in different mammals to facilitate exploration of and interaction with their environment. PMID:24302898

[Ultrastructural changes in cells of the inner enamel epithelium, stratum intermedium and reticulum stellatum in the enamel organ of the upper incisor of the Wistar rat at different phases of amelogenesis].

PubMed

Costacurta, L; de Carvalho, C A; König, B; Bilotta, J A

1976-01-01

An electronmicroscopical study of the enamel organ of the upper incisors germs of Wistar rats was performed to analyse the ultrastructural features of the cells of the inner epithelium, the intermediate layer and the stellate reticulum, during preimary, young, transitional and mineralized enamel phases of amelogenesis. So, it was observed that the mitochondria in the ameloblasts are ovoid before the beginning of the enamel matrix formation and in the primary and young enamel phases. However, in the transitional and mineralized phases, these organelles are long and tortuous and some are characterized by a compact structure. In the cells of intermediate layer and stellate reticulum, the mitochondria are ovoid until the beginning of the mineralized phase. At the ending of this phase, these organelles are very long and present irregular form; many of them show also a compact structure. The "zonula adhaerens" could be observed only in the ameloblasts of the primary and young enamel phase. The cytoplasm of ameloblasts, during primary and young enamel phases is characterized by an abundance of free ribosomes and a branular endoplasmic reticulum; but during transitional and mineralized enamel phases, the cytoplasm of these cells shows little granular endoplasmic reticulum and free ribosomes, but ehe agranular endoplasmic reticulum is present. The granular endoplasmic reticulum and free ribosomes are abundant in the cells of the intermediate layer and stellate reticulum at the ending of the young enamel phase, in the transitional enamel phase and in the beginning of the minieralized phase. During different phases of amelogenesis, in the three above referred layers of the enamel organ, were also studied the features of the Golgi apparatus the presence and topographic distribution of the pigment granules, as well as the lysosomes, desmosomes and the tonophibriles.

Side effects of intraoral devices for OSAS treatment.

PubMed

Teixeira, Andressa Otranto de Britto; Andrade, Ana Luiza Ladeia; Almeida, Rhita Cristina da Cunha; Almeida, Marco Antonio de Oliveira

2017-10-14

Intraoral devices have increasingly assumed a key role in the treatment of obstructive sleep apnea syndrome, but there are limitations to their indication and side effects that result from their continuous use, as well as the use of the continuous positive airway pressure device. To evaluate the changes in dental positioning caused by the continuous use of mandibular advancement devices. A prospective longitudinal study with a sample of 15 patients, with evaluation of complete documentation after a mean time of 6.47 months, assessed changes in dental positioning due to the use of the Twin Block oral device for the treatment of patients with apnea. The following variables were evaluated: overjet, overbite, upper and lower intermolar distances, upper and lower intercanine distances, Little's irregularity index and the incisor mandibular plane angle. An intraclass correlation test was performed and a correlation index>0.08 was accepted. After verifying the normal sample distribution (Shapiro-Wilks), a parametric test was used (t test), with a significance level set at 5%. There was a decrease in the values of overjet, overbite and Little's irregularity index, whereas there was an increase in the lower intercanine distance and IMPA values. All these variables are influenced, at different levels, by the forward inclination of the lower incisors, an action that can be expected due to the force applied by the device on the dentition. The other variables did not show statistically significant differences. After a mean time of 6.47 months of use of the mandibular advancement device, there were statistically significant changes in the dental positioning, but they were not clinically relevant. However, it is relevant that this device is commonly in use over long periods of time, making the monitoring of these patients of the utmost importance for the duration of their therapy. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.