Dentition In Patients Research Articles

Short-term treatment effects produced by the Herbst appliance in the mixed dentition.

This prospective clinical investigation evaluates the dentoalveolar and skeletal cephalometric changes produced by the Herbst appliance during treatment of mixed dentition patients with Class II division 1 malocclusion. Thirty individuals (15 male and 15 female individuals; initial mean age nine years 10 months) were treated with the Herbst appliance for a period of 12 months. For comparison, the records of 30 untreated Class II children (15 boys, 15 girls; initial mean age nine years eight months) were followed without treatment for a period of 12 months. The results indicated that the treatment effects produced in the mixed dentition patients were primarily dentoalveolar in nature. The mandibular incisors were tipped labially, and the maxillary incisors were retruded; a significant increase in mandibular posterior dentoalveolar height occurred, and there was a restriction in the vertical development of the maxillary molars. There was no difference in the forward growth of the maxilla between the two groups. In comparison with the controls, however, the Herbst treatment produced a modest but statistically significant increase in total mandibular length. This increase in total mandibular length, however, was less than that observed in adolescent Herbst patients in other studies.

Trends in Indirect Dentistry: 1. Case Selection

Indirect restorations can provide a conservative, functional and aesthetic method for managing a patient's dentition. These restorations, however, are only as good as the environment in which they are placed. Many restorations, though technically satisfactory, may fail because assessment and subsequent treatment planning has been unsatisfactory. This article presents a philosophy of case selection mindful of factors related to the patient, operator and oral environment. The wrong treatment, however skilfully executed, may invite failure.

A clinical report of 85 fractured metallic post-retained crowns.

To determine any patient, technique or material factors that were significantly associated with post fracture in metallic post systems. Eighty-five fractured metal posts were retrieved over a 5-year period from a total of 84 patients who attended a dental hospital for treatment. A record was kept of the patient's dentition to identify the tooth with the fractured post, the number of teeth present, the excursive guidance scheme and the likely post design and material. Radiographs of 67 of these teeth were available. The presence or absence of a periapical lesion was noted as was the quality of the root filling. Maxillary lateral incisors, followed by maxillary centrals were associated with most of the fractured posts. The median survival to fracture was 36 months. The number of teeth in the dentition had a mode of 28. The most commonly fractured post design was a serrated and parallel design with an average diameter of 1.2 mm at the site of fracture. Apical lesions were found in 67% of the teeth with radiographs. Only 12% of teeth with a 'good' apical filling as opposed to 55% with a 'poor' apical filling had apical lesions. . Maxillary lateral incisors, followed by maxillary central incisors are at greatest risk of having a fractured metallic post. . Having a large number of teeth in the dentition or an adequate length of post was not protective against metallic post fracture. . Teeth with fractured post-retained crowns had a high incidence of apical lesions.

Prediction of mesio–distal crown diameter of the unerupted lower premolars

The purpose of this study was to det-ermine the more accurate method for pre-dicting the width of unerupted mandibular premolar of mixed dentition patients, whe-ther by the multiple regression analysis method or by radiographic measurements of deciduous molars width method. Multiple regression analysis method was performed on data derived from 108 children (62 females and 46 males) aged 9–12 years old. These children were selec-ted from primary schools located in differ-ent areas of Mosul City. All subjects had normal Class I molar relationship with mixed dentition (the right and left perman-ent centrals, laterals and first molars, and right and left primary canines and first and second molars). The data were statistically analysed using Statistical Package for Soc-ial Statistics. The results revealed that there were no significant differences in mesio–distal crown diameter between right and left sides of both unerupted premolars and deciduous molars. All the teeth in males were larger in mesio–distal crown dia-meter than females. Also, the results of the present study indicated that there was a positive correlation between most of the teeth, individual teeth and groups of teeth. There was a difference in the means bet-ween the mesio–distal crown diameter of deciduous molars and unerupted premo-lars. The present results used to generate a formula “linear regression equation” that can be used clinically to affect prediction depending on the mesio–distal width of individual deciduous molars.

Computer-assisted treatment planning and analysis.

The Invisalign orthodontic system (Align Technology, Inc, Santa Clara, CA) is a series of clear removable appliances that is worn by a patient to correct malocclusions. Introduced in 1999, it has been applied to successfully correct an increasingly wide variety of malocclusions. Part of the success of the system is because of the innovative technologies inherent in the design of the appliances. During the development of the system, many challenges and issues needed to be overcome to realize the product. Many of these issues were not specific to Invisalign, and represented general problems in the area of computer-aided orthodontics. The general problems of developing a virtual model of a patient's dentition appropriate for use in orthodontics, performing a treatment plan on a virtual dentition model, and analyzing how accurately the virtual treatment plan executed in the patient's mouth are presented.

Early intervention in the transverse dimension: Is it worth the effort?

Am J Orthod Dentofacial Orthop 2002;121:572-4

Denture satisfaction and clinical performance in a paediatric population.

The objectives of this study were to investigate the clinical performance of partial upper dentures in children and to assess reported denture satisfaction in this young population. This was a retrospective study using patients' dental records in conjunction with a postal questionnaire. The Paediatric Dentistry Clinic, School of Clinical Dentistry, Sheffield. Fifty-eight children (aged 7-17 years) who had been provided with a partial upper denture to replace one or more missing permanent incisors were included in the study. The patients' dental records were examined for the following details: tooth type missing, presence of retained incisor roots, aetiology of tooth absence, age at which the denture was first provided, total time period dentures had been worn, and frequency and type of any denture repairs or replacements. Next a short questionnaire was sent to each child, which sought an evaluation of several parameters of denture satisfaction including: overall attitude towards wearing a denture, denture appearance, ease of eating, comfort and perceived degree of teasing from peers. Visual analogue scales (VAS) were employed to provide a graded response. 70.7% of subjects had a single missing incisor and trauma was the most common cause of tooth loss (77.3%). The mean age at which patients started wearing a denture was 11.6 years and the mean length of time dentures had been worn, at the time of the investigation, was 2.1 years. A 'T-shaped' denture was most commonly employed (77.5% of dentures). Overall, 36.2% of subjects had required at least one denture repair, 28.2% presenting within a year of denture provision. One or more denture replacements had been received by 60.3% of the patients, and 43.6% had required this within a year. Component failure was highest for the denture tooth (40% of repairs) and a change in the patient's dentition necessitated a denture remake in 66% of cases. VAS scores for parameters of denture satisfaction indicated an overall positive evaluation of the dentures, with the most positive response relating to ease of eating. However, the reported degree of teasing was high and increased with time. The only significant difference for denture satisfaction according to gender was for mastication: girls reportedly found eating easier than did boys. Children are generally accepting of upper partial dentures, but their poor clinical performance is of concern and there is need for improvement.

Three-dimensional diagnosis andorthodontic treatment of complex malocclusions with the invisalign appliance

Recent developments in software technology have made it possible to create a virtual three-dimensional (3D) model of the dental arches from digitally scanned impressions of a patient's dentition. This model may then be manipulated with software to produce stages of tooth movement from the initial malocclusion to the final desired occlusion. A stereolithographic model is made for each stage of tooth movement which is the basis for construction of a series of clear, thin, overlay appliances. These appliances are worn full time by the patient to move the teeth according to the programmed stages of movement. Malocclusions involving mild to moderate crowding and space closure have been proven to be successfully treated with this appliance. The present study shows orthodontic treatment of patients with more complex orthodontic problems, requiring dental expansion, Class II and Class III correction, extraction treatment and correction of overbite. Experience with this appliance, thus far, has demonstrated excellent patient compliance with less discomfort, and improved esthetics and oral hygiene, when compared with fixed orthodontic appliances. Orthodontic treatment with this appliance is a potentially useful alternative approach to fixed appliances for treatment of a variety of malocclusions in patients with fully erupted permanent teeth.

A Standardized, Uniform and Universal Dental Chart for Documenting State of Dentition before Anaesthesia

It is vital to have adequate and precise documentation of the condition of a patient's dentition before commencing an anaesthetic. The incidence of dental damage during anaesthesia is not low. To the authors' knowledge, there is no standardized method used by anaesthetists to document the state of a patient's dentition. We propose the introduction of a standardized uniform dental chart to enable anaesthetists to accurately document the condition of their patients' teeth. This vital information can be easily obtained during the preanaesthetic assessment. With the increase in medical litigation and demands for adequate documentation, we believe this chart can become an invaluable part of every hospital's preanaesthetic assessment form. The dental chart is to be offered as a service to anaesthetists in the form of a copyright-free "Freeware" computer diskette or adhesive sticker and will be downloadable from the internet.

The use of the lingual arch in the mixed dentition to resolve incisor crowding

In the mixed dentition, arch length preservation, maintaining the leeway space, can often provide adequate space to resolve lower incisor crowding. Yet the frequency of this occurrence is not known. To obtain this information, lingual arches were placed in the mandibular arches of 107 consecutive mixed dentition patients with incisor crowding to preserve arch length and make the leeway space available to resolve the crowding. Arch length decreased only 0.44 mm whereas the intercanine, interpremolar, and intermolar dimensions increased between 0.72 and 2.27 mm. There was adequate space to resolve the crowding in 65 (60%) of the 107 patients. If perfect arch length preservation had occurred, there would have been adequate space to resolve the crowding in 73 (68%) of the 107 patients. The correlation between leeway space and tooth size-arch size discrepancy was only 0.44. (Am J Orthod Dentofacial Orthop 2000;117:81-5)

A procedure for restoring proximal contact surfaces of cast gold restorations with solder

Faulty contacts on restorations can be very damaging to the patient's dentition. Occasionally they are not corrected on a new restoration because of the length of time required for the procedure. The method described here is fast, simple, and protects the occlusal surfaces and margins of the restorations from damage while adding to the contacts with solder.

Incidence and indications for surgical management of phenytoin-induced gingival overgrowth in a cerebral palsy population

Phenytoin-induced gingival overgrowth (PIGO) is a recognized side effect in many cerebral palsy patients using diphenylhydantoin (Dph) for the control of seizures. Severe degrees of gingival overgrowth can affect the patient's dentition by: 1) interference with normal masticatory function to the point of documented weight loss, 2) producing an ectopically erupting dentition to the point of poor occlusal development, and 3) producing an unattractive appearance, in those patients who appreciate their esthetics, to the point of lessened self-concept. 1 The purpose of this investigation was to evaluate the management of a group of 142 patients, with various cerebral palsy diagnoses, as to the use of diphenylhydantoin for the control of seizures. If diphenylhydantoin was used, the presence, degree, and surgical management of PIGO was documented. Additionally, if surgical treatment was employed for removal of hyperplastic gingiva, the indications for outpatient treatment (no use of general anesthetic) or inpatient (hospital admission and use of a general anesthetic) were identified. A discussion of major indications of surgery and postoperative complications of all surgical procedures is provided.

Dental Care for Patients with Renal Failure and Renal Transplants

Patients with renal failure have characteristic systemic and oral conditions that require special precautions during dental treatment. Drugs must be administered with caution and patients undergoing hemodialysis must receive special consideration. Both hemodialysis and transplant patients must be protected against infection. This is achieved by early, aggressive, and thorough dental treatment. Use of antibiotics during dental treatment is essential in transplant patients and is often necessary in hemodialysis patients to protect them against bacteremia. Bacterial endocarditis is a concern in patients with renal failure and with heart disease and, in these patients, antibiotic prophylaxis is essential. Hepatitis is often present in patients with renal failure, and precautions should be taken against its spread. Before dental treatment of patients with renal failure is begun, the dentist should consult the patient's physician regarding specific precautions. A treatment plan should be constructed which best restores the patient's dentition and protects from potentially severe infection of dental origin.

The anorexia nervosa syndrome

This article reviews the medical and dental literature on the anorexia nervosa syndrome and presents the oral and systemic manifestations of this serious disease process. A case is reported which demonstrates the generalized destruction of tooth structure, primarily as a result of the direct effect of gastric acid on this patient's dentition during a 5-year period of self-induced vomiting. The systemic, psychological, and social aspects of this syndrome are classically illustrated in this case history.

Space Control in the Primary and Mixed Dentitions

Space control has been distinguished from space maintenance. The difference is not a semantic one. Space control calls upon the dentist to apply his knowledge of occlusal development to the patient's condition. It infers assessment and re-evaluation. Space maintenance, unfortunately, sometimes becomes a routine or mechanical placement of appliances. This article has reviewed some of the variables to be considered when effecting space control: the factors that dictate appliance selection and some of the more common appliances used for space control today. No formula has been recommended for the application of appliances. Rather, the dentist has been urged to review the variables and re-evaluate his decisions according to the dynamic development of the patient's dentition.

Relative abilities of natural and artificial dentition patients for judging the sweetness of solid foods

A solid food for psychophysic tests on detection of differences in sweetness was prepared by modification of a standard batch of sugar cookies. A group of 15 natural dentition patients and 15 artificial dentition patients, with approximately matched ages, were compared as to differential threshold using a special adaptation of standard psychologic procedures. The natural dentition persons averaged six seconds in order to reach a decision when concerned with sweetness of the test foods, and their threshold was not affected by a limitation of the time of judgment. The threshold was 15 per cent of the average sugar concentration of the batches. The denture patients averaged fifteen seconds for reaching the judgment, and had a threshold of 30 per cent. When they were limited to ten seconds reaching the judgment, the threshold was over 100 per cent. These results indicate that artificial dentition patients as a group apparently cannot perceive and enjoy subtle differences in the sweetness of solid food that can be appreciated by persons with natural dentitions.

Masticatory function of partial denture patients among navy personnel

<h2>Abstract</h2> Masticatory function has been studied among 103 partial denture patients before and up to one month after completion of the prosthetic restorations. Their average masticatory efficiency and food pulverization were compared with the average for 42 full upper and lower denture patients one month after insertion, with 68 standard dentition patients, and with 27 partial and full denture patients who had had nine plus month's use of the restorations. Function measurements were made before surgery, before insertion, after insertion, ten days later, and thirty days later. At each period tests on masticatory performance were made for each half of the dentition, strokes required to prepare this food for swallowing were counted, and the degree of pulverization of the food was measured. Patients selected for partial dentures had definite need of restorations, since their efficiencies averaged from 16 to 18 per cent of a standard dentition before surgery was performed. The average efficiencies for all groups rose immediately after the restoration was placed in the mouth, and more gradually thereafter, reaching the maximum efficiency in approximately one month. At this time the most efficient group was small partial dentures in the first molar region (adding 6, 46, or 56) which occluded against the natural dentition. Their efficiency was 63 per cent of standard dentitions tested at the same location. All other partial dentures occluding against a natural dentition average 39 per cent in efficiency at this time. Partial dentures occluding against an artificial dentition averaged 24 per cent in efficiency and were practically the same as full dentures one month after insertion. Tooth-borne partial dentures and free-end saddles had the same efficiency on the average. The increase in efficiency caused by the partial dentures allowed the patients to obtain finer pulverization of food on the average before swallowing, with the more efficient groups showing better pulverization. The better preparation of the food was achieved with less effort by the patient as indicated by use of fewer masticatory strokes.