Dentate Individuals Research Articles

Evaluation of cephalometric parameters in determining the position of anterior teeth

In the study the cephalometric method was used to determine the position of the artificial central upper and lower incisors of edentulous patients class I, and natural central upper and lower incisors of dentulous individuals class I. Cephalometric radiographs of edentulous patients were made with a precisely set position of frontal teeth and marked central incisors. The control group consisted of 30 lateral cephalometric radiographs of dentulous persons class I. Certain of Schwartz and Steiner cephalometric radiograph analysis were used for precise sagittal positioning of upper and lower central incisors. To set precisely the position of these teeth in a sagittal position, the inclination of their axle was analyzed on each cephalometric radiograph, as well as the position of their vestibular surfaces related to the specific craniofacial elements. Statistically significant differences of the value of the angle of inclination of artificial upper and lower incisors of edentulous patients class I, and the angle of inclination of natural upper and lower incisors of dentulous persons, class I, were determined.

Evaluation of cephalometric parameters in determining the position of anterior teeth

In the study the cephalometric method was used to determine the position of the artificial central upper and lower incisors of edentulous patients class I, and natural central upper and lower incisors of dentulous individuals class I. Cephalometric radiographs of edentulous patients were made with a precisely set position of frontal teeth and marked central incisors. The control group consisted of 30 lateral cephalometric radiographs of dentulous persons class I. Certain of Schwartz and Steiner cephalometric radiograph analysis were used for precise sagittal positioning of upper and lower central incisors. To set precisely the position of these teeth in a sagittal position, the inclination of their axle was analyzed on each cephalometric radiograph, as well as the position of their vestibular surfaces related to the specific craniofacial elements. Statistically significant differences of the value of the angle of inclination of artificial upper and lower incisors of edentulous patients class I, and the angle of inclination of natural upper and lower incisors of dentulous persons, class I, were determined.

Influence of smoking on marginal bone loss and tooth loss--a prospective study over 20 years.

The aim was to investigate the influence of smoking on longitudinal marginal bone loss and tooth loss in a prospective study over 20 years. In addition, the effect of cessation of smoking on bone loss and the interaction between smoking, plaque and marginal bone loss were evaluated. A total of 507 dentate individuals from an epidemiological study were examined in 1970 and 1990. The clinical investigation included registration of number of remaining teeth and presence of plaque. The marginal bone level was determined by assessments on the proximal surfaces on the radiographs from 1970 and 1990. The marginal bone loss was defined as the difference in marginal bone level over 20 years. The subjects were interviewed about smoking habits. Stepwise multiple regression analyses were adopted to calculate the influence of the independent variables on longitudinal marginal bone loss and tooth loss. In 1970, 50.7% of the subjects were smokers, while the corresponding relative frequency in 1990 had decreased to 31.0%. Smoking was significantly correlated to an increased marginal bone loss over 20 years. Individuals who stopped smoking between 1970 and 1990 lost significantly less marginal bone during this period than those who declared that they smoked during the 20-year period. Smoking was not found to be significantly correlated to tooth loss over 20 years. The results support the hypothesis that smoking is a significant risk factor of periodontal disease.

The relationship of some negative events and psychological factors to periodontal disease in an adult Swedish population 50 to 80 years of age.

Clinical observations and epidemiological studies suggest that experiences of negative life events, especially those manifested as depression, may contribute to an increased susceptibility to periodontal disease. In the present study, the prevalence of some negative life events and psychological factors and their relation to periodontal disease were investigated. The sample consisted of individuals 50-80 years of age from an extensive cross-sectional epidemiological study performed in 1993 in the city of Jönköping, Sweden. 298 dentate individuals from the Jönköping study were randomly selected. Clinical and radiographic examinations included registration of the number of existing teeth, plaque index, gingival index, pocket depth, and alveolar bone loss. In addition, a questionnaire about socioeconomic status, life events, and psychological and stress-related factors was used. The results revealed that, in addition to the well-documented periodontal disease risk factors such as increased age, oral hygiene status, and smoking, the loss of a spouse (being a widow or widower) and the personality trait of exercising extreme external control were also associated with severe periodontal disease. The findings support recent studies suggesting that traumatic life events such as the loss of a spouse may increase the risk for periodontal disease. Above all, the present results indicate that an individual's ability to cope with stressful stimuli (coping behavior), as measured by the beliefs of locus of control of reinforcements may play a role in the progression of periodontal disease.

The effects of gum chewing, four oral hygiene procedures, and two saliva collection techniques, on the output of bacteria into human whole saliva

Six healthy dentate individuals collected a 5-min sample of unstimulated whole saliva (UWS) and dilutions were plated out on blood agar and grown anaerobically for 48 h. The output of bacteria into saliva (counts/min) was calculated as the product of counts/ml and ml/min. The individuals repeated the collections at intervals of up to 7 h after (1) rinsing with water, (2) eating a meal plus tooth brushing, (3) a thorough dental prophylaxis, or (4) tongue brushing and scraping. They also collected saliva at intervals while chewing gum for 20 min, as did 10 individuals who chewed gum for 2 h. The original six individuals also collected UWS under “drooling” (no oral movements) and “spitting” conditions. Six edentulous individuals not wearing their dentures collected UWS before and after a water rinse. With the four oral hygiene procedures, bacterial outputs fell initially and then rose again, but a repeated-measures ANOVA revealed no significant differences in the effects of the four procedures. Gum chewing caused initial marked increases in the outputs of bacterial and epithelial cells, but these fell with time and reached a plateau after about 10 min at outputs above those in UWS. Samples collected by spitting contained up to 14 times more bacteria than those collected by drooling. Bacterial output by edentulous individuals did not differ from that in those with teeth. It is concluded that bacteria from the teeth and gingival crevices normally make only a small contribution to those in saliva, that various oral hygiene procedures have similar effects on bacterial output into saliva, and that saliva collection conditions should be standardized and specified.

Epidemiological study on improving the QOL and oral conditions of the aged--Part 1: The relationship between the status of tooth preservation and QOL.

In part 1 of this epidemiological study, a survey was conducted for all senior citizens aged 70 and over who resided in a mountainous village in the mid-section of Hyogo Prefecture. It focused on the relationship among the number of existing teeth, life environment, health status, and activities of daily living; and the correlation between oral status and QOL was analyzed. The daily activities of individuals were compared between those having one or more teeth and others who were totally edentulous. Subsequently, it was found that for both males and females, the odds ratio was significantly high for the dentulous individuals, in comparison with edentulous individuals, to exhibit a behavior indicative of a better QOL (such as "opportunity for conversation with family members or others)", "regular physical activities", and "attend meetings or group outings"). The result of this survey indicates that the presence of teeth is very closely related to one's daily activities. It was concluded that preventing tooth loss is vital for maintaining the masticatory function; so to prevent tooth loss, periodontal disease must be averted.

Oral self-care and periodontal health indicators among adults with diabetes in Finland

We assessed the effects of oral self-care on periodontal health indicators among adults with diabetes. The sample consisted of 120 dentate individuals, all of whom were regular patients at the Salo Regional Hospital Diabetes Clinic in southwest Finland. Clinical periodontal examination included identification of visible plaque, the presence of calculus, and use of the Community Periodontal Index of Treatment Needs (CPITN). A questionnaire focused on self-treatment, self-prevention, and self-diagnosis of oral diseases, utilization of dental services, and patients' knowledge and attitudes towards oral health. The New Century model of oral health promotion was used as a theoretical framework for analysis of determinants of oral self-care. Although individuals aged 40 years or older were more frequent interdental cleaners, significantly better oral health indicators were found among younger patients. Women reported brushing their teeth more frequently, and differences in plaque and calculus indices were significantly lower than those of men. Self-reported good oral condition was strongly associated with frequent dental visits and less plaque and calculus. No missing teeth and age less than 40 years were predictors of lower plaque, calculus, and CPITN scores. A significant association was found only between frequent dental visits and reduced amount of calculus. Self-reported frequency of oral health habits among adults with diabetes seemed to have little effect on periodontal health indicators. Adults with diabetes should benefit from comprehensive oral selfcare, and more attention is needed for improving the quality and outcome of these habits.

Dental and other health care visits among U.S. adults with diabetes.

This study compared yearly dental visits of diabetic adults with those of nondiabetic adults. For adults with diabetes, we compared the frequency of past-year dental visits with past-year visits for diabetes care, dilated eye examinations, and foot examinations. We conducted a cross-sectional study using a sample of 105,718 dentate individuals aged > or =25 years, including 4,605 individuals with diabetes who participated in the 1995-1998 Behavioral Risk Factor Surveillance System in 38 states. Dentate adults (i.e., those with at least some natural teeth) with diabetes were less likely than those without diabetes to have seen a dentist within the preceding 12 months (65.8 vs. 73.1%, P = 0.0000). Adults with diabetes were less likely to have seen a dentist than to have seen a health care provider for diabetes care (86.3%); the percentage who saw a dentist was comparable with the percentage who had their feet examined (67.7%) or had a dilated eye examination (62.3%). The disparity in dental visits among racial or ethnic groups and among socioeconomic groups was greater than that for any other type of health care visit for subjects with diabetes. Promotion of oral health among diabetic patients may be necessary, particularly in Hispanic and African-American communities. Information on oral health complications should be included in clinical training programs. Oral and diabetes control programs in state health departments should collaborate to promote preventive dental services, and the oral examination should be listed as a component of continuous care in the American Diabetes Association's standards of medical care for diabetic patients.

Oral Health Profile Of A Group Of Malayasian Drug Addicts

A study was undertaken to identify the oral health status and treatment needs of 403 drug abusers enrolled in a drug rehabilitation center in Perak, Malaysia. The prevalence of dental caries was 97.0%. Calculus was present in 82.1% of the dentate individuals, but only 14.6% had pockets greater than 3mm. The mean DMFT observed was 11.7, with missing teeth (MT=9.6) constituting the major component. Denture needs were high (67.2%), but only 11.4% of individuals had prostheses.

The effect of periradicular endodontic pathosis on the apical region of adjacent implants

Implants have become standard for dentate individuals. A potential problem to consider is implant lesions from microbial contamination; these may occur if there is not careful diagnosis and treatment planning. A factor of concern during treatment planning is the pulpal and periradicular condition of teeth adjacent to the implant site. Periradicular pathosis may jeopardize the implant. Therefore, if endodontic pathosis is identified, root canal treatment or extraction should be initiated before implant placement to prevent microbial contamination of the implant during healing. In reviewing clinical cases, the authors found several that illustrated problems with adjacent teeth that contributed to inflammation surrounding the implant.

Variation in the apparent density of human mandibular bone with age and dental status.

This study examines the variability in the anatomy of mandibles of differing ages and different stages of tooth loss. Mandibles from individuals between 19 and 96 y were sectioned into 2 mm thick vertical plane-parallel slices and cleaned of marrow and periosteum. The apparent density (mass per unit volume in g/ml) from midline (MID) and mental foramen region (MF) sites was determined by weighing the slices and dividing by a volume calculated as the product of section thickness and the mean area of the 2 sides of the section. The cortical thickness of the inferior border and the basal and alveolar bone heights were measured in radiographs of the slices. Mandibular apparent density was negatively correlated with the cross sectional area (midline r=-0.48, mental foramen r=-0.45), and at the midline was significantly greater in edentulous than in dentate individuals (means (+/-S.E.M.) edentulous n=13: 1.43 (+/-0.07) g/ml; dentate n=17: 1.27 (+/-0.04) g/ml, P < 0.05). Where a large enough age range was available, mandibular apparent bone density showed a significant increase with age (midline males: r=0.53, n=18) especially for dentate individuals (r=0.91, n=8). There was a correlation between the apparent densities at the two sites in the same mandible (r=0.64), with the values obtained for the midline being significantly greater than for the mental foramen region (midline 1.34 (+/-0.04) g/ml; mental foramen 1.19 (+/-0.04) g/ml, P < 0.001, paired t test). The mandible shows great interindividual variability, but there may be a considerable reduction in cross sectional girth of the mandible following tooth loss, and, unlike postcranial sites, an increase in apparent density with age.

Periodontal status in the United States, 1988-1991: prevalence, extent, and demographic variation.

This paper reports estimates of the periodontal status of US population derived from data from Phase 1 of the Third National Health and Nutrition Examination Survey conducted by the National Institute of Dental Research from 1988-1991. A total of 7,447 dentate individuals 13 years of age and older, representing approximately 160.3 million civilian non-institutionalized Americans, received a periodontal assessment. Measurements of gingival bleeding, gingival recession level, periodontal pocket depth, and calculus were made by dental examiners. Assessments were made at the mesiobuccal and mid-buccal sites of all fully erupted permanent teeth present in two randomly selected quadrants, one maxillary and one mandibular. All data were weighted and standard errors calculated by special software to adjust for the effect of sample design. Although over 90% of persons 13 years of age or older had experienced some clinical loss of attachment (LA), only 15% exhibited more severe destruction (LA > or = 5 mm). Prevalence of moderate and severe LA and gingival recession increased with age, while prevalence of pockets > or = 4 mm or > or = 6 mm did not. These data suggest that the increasing prevalence of LA with age is more associated with increasing prevalence of recession than with changes in the prevalence of pockets or age. The extent or number of affected sites with advanced conditions for loss of attachment, pocket depth, or recession was not large for any age group. Differences in prevalence of moderate and severe loss of attachment, moderate and deep pockets, and recession were found among gender and race-ethnicity groups. Females exhibited better periodontal health than males, and non-Hispanic whites exhibited better periodontal health than either non-Hispanic blacks or Mexican-Americans.

Prevalence of some oral complaints and their relation to oral health variables in an adult Swedish population.

The aim of the study was to determine, in a randomly selected 20- to 70-year-old Swedish population, the prevalence of oral burning sensations and taste disturbances and their possible correlation to salivary factors, the presence of mandibular dysfunction, the prevalence of teeth, restorative procedures, caries and periodontal disease, and smoking habits. Of a total of 533 dentate individuals, 112 reported a total of 139 symptoms. Eleven of the 40 edentulous individuals reported a total of 14 symptoms. Burning sensations were reported by 18 (3.4%) of the dentate and 1 (2.5%) of the edentulous individuals. The symptoms of pricking and burning were significantly correlated to mandibular dysfunction and negatively correlated to the number of teeth. The symptom of bad taste was correlated to the number of amalgam-filled surfaces and to cigarette smoking. No other statistically significant correlation could be found.

Variation in the masseteric silent period in older dentate humans and in denture wearers

The masseteric silent period was elicited by chin taps at 40% clenching in the masseter muscle of the preferred chewing side in 22 younger dentate individuals, in 22 older dentate individuals, in 22 older experienced denture wearers and in 7 older inexperienced denture wearers. One simple and three combined types of silent period (combination of early and late phases of depression) were recorded in all groups. An early silent period was always elicited, the only exception being in some inexperienced denture wearers. Both the age and the extent of rehabilitation with dentures in the trained denture wearers affected reflex latencies ( p < 0.05), while the variation in duration was not significant ( p>0.05). The duration of the silent period was, however, affected by the type of silent period, thus by the measuring technique ( p < 0.05). Increased variation was observed in the inexperienced denture wearers, who were in a period of adaptation.

A study of the occlusal plane orientation by intra-oral method (retromolar pad).

Reliability of the intra-oral method which orientates the occlusal plane to terminate at the upper level of the retromolar pad was studied. Thirty individuals all with natural teeth and 34 complete denture wearers participated in the study. Stone casts were mounted in the S.A.M. 2 articulator by a quick mount face bow transfer. The angle between the occlusal plane and the articulator horizontal plane was measured in both groups. The angle was 9.42 degrees +/- 4.1 degrees in dentate individuals and 8.53 degrees +/- 2.8 degrees in complete denture wearers. No statistically significant difference was found between the groups (t = 0.72, P > 0.05). Therefore, the method can be advocated for a wide clinical use, as it is a simple method and places the artificial occlusal plane very close to the position of the natural plane of occlusion.

Identification of Candida albicans types related to healthy and pathological oral mucosa.

This study comprised 100 healthy dentate adults and 53 patients with either chronic erythematous oral candidosis or oral leukoplakic lesions. The presence of yeasts was determined by microscopical examination of PAS-stained smears and by culture. Biopsy material was obtained from all lesions. The isolated yeasts were identified to species level. Strain phenotypes of 147 Candida albicans isolates were determined on the basis of the ODDS & ABBOTT procedure (25, 26). Yeasts were found in the mouth of healthy dentate individuals both by culture and by smears. The identification of hyphae in healthy mucosa indicates that the presence of these structures is not an unequivocal sign of candidal infection. The results support the view that tobacco smoking may be a predisposing factor for candidal infection. Also, the results have shown an association between the occurrence of yeasts and the type of leukoplakic lesions. Finally, the strain differentiation has indicated an oral mycoflora in patients with candidal lesions disappearing after antimycotic treatment which was more homogeneous in composition than in patients with irreversible lesions; furthermore, certain strains may possess properties which may be important in the development of pathological conditions and premalignant changes.

Stimulated parotid gland flow rates in healthy, elderly dentulous and edentulous individuals

The use of dentures has been associated with increased stimulated parotid salivary flow rates (SPFR). A comparison of SPFRs was made between dentulous subjects having 20+ teeth (n = 190) and edentulous individuals (n = 67). Two different populations were selected, a white group from the Baltimore Longitudinal Study of Aging and an African-American group from the Washington Village Medical Center in Baltimore. Each group was healthy and unmedicated and had a mean age of 70.2 years. SPFR was determined with a Carlson-Crittenden cup and 2% citrate for stimulation. The edentulous subjects did not wear their dentures during salivary collection. The results indicated a significantly lower SPFR in dentate individuals compared with edentulous subjects ( p < 0.01). Dentulous men also had a lower SPFR than edentulous men ( p < 0.04). In addition, a pre- and postsurgical evaluation of 10 individuals who underwent full mouth tooth extractions revealed no differences in SPFR. These results suggest that edentulism per se does not have a deleterious effect on stimulated parotid salivary flow rates.

An epidemiologic perspective of saliva flow rates as indicators of susceptibility to oral disease.

Catastrophic hyposalivation significantly increases susceptibility to dental caries in dentate individuals and may cause the expression or exacerbation of other oral diseases/disorders as well. The effect of subcatastrophic hyposalivation on susceptibility to caries or other diseases/disorders is less well understood. The aim of this study (part of a larger study on the prevalence of hyposalivation) was to determine the prevalence and to measure the association of oral pathologic conditions with unstimulated and stimulated whole saliva flow rates. Only 6.3% of all study participants had significantly diminished unstimulated (< 0.05 ml/min) and stimulated (< 0.50 ml/min) saliva flow rates. A total of 15 individuals were encountered with oral pathologic lesions and none of these lesions were associated with hyposalivation. Although the prevalence of coronal caries, root surface caries, abrasion, and erosion tended to increase as salivary flow decreased, when the effect of age was considered no significant differences were present. These data suggest that low saliva flow rates alone, at least from an epidemiologic perspective, do not have a clinically relevant effect on susceptibility to oral diseases/disorders.

Oral cavity reconstruction: an objective assessment of function.

The prime objective of oral cavity reconstruction is restoration of function, which must be carefully studied while evaluating the success of any reconstructive endeavour. We devised a unique comprehensive test series for the purpose that is suitable for use in routine follow-ups, and capable of providing objective documentation. Functional assessment included evaluation of general health, food intake, oral competence, mastication, speech, swallowing, tongue mobility, and shoulder-neck function. Fifty patients who had surgery were analyzed and their functional scores compared with those of 10 normal volunteers. The extent of mandibular resection and the magnitude of soft tissue excision significantly affected overall scores of function. Oral competence, as reflected by the water holding test (WHT), was uniformly impaired in the 50 patients, and in dentate individuals, the quality of bolus provided good correlation with all other functional scores. Among reconstructive modalities employed here, the bi-paddled pectoralis major flap produced the best overall scores.

Significance of some variables on interproximal alveolar bone height based on cross-sectional epidemiologic data.

The objective of the study was to analyze the significance of some variables on interproximal alveolar bone height, based on cross-sectional epidemiologic data from a Swedish survey conducted in 1983-1984, in the northern medical care district of Alvsborg county. 723 dentate individuals (92% of the randomly selected dentate individuals) with complete anamnestic, clinical and radiographic documentation were included in the statistical analyses. The computerized method used to measure interproximal alveolar bone height as a % of root length (B/R) provided data at each measurable interproximal surface of the individual teeth. On the population basis, a multivariate linear regression analysis showed that: (i) mean B/R values did not differ significantly between men and women, (ii) B/R value decreased with increasing age at a linear rate of 0.26% (0.04 mm) per year of age, (iii) the higher the calculus index value, the lower the mean B/R value, (iv) the higher the plaque index value, the higher the mean B/R value, (v) level of education, dentist attendance frequency and prevalence of defective margins of dental restorations did not show any statistically significant association with B/R, (vi) individuals attending the dental hygienist less than once every 2 years had higher mean B/R value than individuals attending the dental hygienist at least once every two years, and (vii) current smokers exhibited significantly lower mean B/R value than former and non-smokers. Individuals smoking more than 5 g of tobacco per day had lower mean B/R values than individuals smoking between 1 and 5 g of tobacco per day. There was no statistically significant relationship between snuffing and B/R.