Functional Teeth Research Articles

Evaluation of the Clinical Efficacy of Orthodontic Retention of Third Molars After Extraction of First or Second Molars

This paper explores the clinical efficacy of orthodontic retention of third molars after extraction of the first or second molars. Studies show that the use of the second molar near the movement to replace the first molar, retain the third molar although need a long treatment time and higher treatment cost, but promote the gap of tissue regeneration, preserve healthy natural teeth, restore occlusal stability, but also can avoid the late repair of the first molar or second molar. In addition, the second molar after moving near the third molar is also conducive to the eruption of the third molar, maximizing the use of the third molar, to form a healthy and complete functional tooth line. Therefore, For patients with severe removal of the first or second molars, poor prognosis, severe periapical disease, and loss of the first or second molars, the treatment method of replacing the second molar for the first molar and the third molar for the second molar can be an effective treatment option.

Association between shortened dental configurations and health outcomes: a scoping review

This study mapped definitions of shortened dental configurations and health outcomes employed in association studies. A scoping review was conducted using the PubMed/Medline, Scopus, Web of Science, SciELO and Cochrane databases. Two trained researchers selected studies and extracted data. Studies that investigated the association between shortened dental configurations (exposure) and person-centered outcomes (general and oral health) related to health behavior (dietary patterns). Clinical outcomes were classified according to the International Classification of Functioning, Disability and Health and the International Classification of Diseases of the World Health Organization (WHO). Shortened dental configurations were defined as at least 20/21 teeth or the position of the teeth, including esthetics, dental occlusion and periodontal status (Eichner Index, Shortened Dental Arches, Functional Dentition Classification System, Posterior Occluding Pairs, Functional Tooth Units). The initial search resulted in 12,525 records in English, Portuguese and Spanish, 432 of which addressed the association of interest. General health (n = 203) and oral health (n = 201) were addressed in a similar number of studies. Most outcomes were related to general health (n = 184), the most frequent of which were endocrine, nutritional or metabolic diseases (n = 57) and mental functions (n = 26). Person-centered measures were addressed in 153 studies, most of which were about oral health and oral health-related quality of life (n = 62). Oral health outcomes were predominantly related to intake functions (n = 44) and diseases or disorders of the orofacial complex (n = 24). Dietary patterns (n = 43) and mortality (n = 38) were also studied. The cross-sectional design (n = 257) and non-probabilistic sampling (n = 218) were more frequent. The shortened dental configurations defined by the WHO were the most frequent in the studies (n = 206). The effects of shortened dental configurations have been investigated mainly in relation to endocrine, nutritional or metabolic diseases and measures of oral health-related quality of life. The findings point to a diversity of health outcomes assessed and substantial methodological variability.

Armadillosuchus arrudai (Sphagesauridae, Crocodyliformes), Adamantina Formation (Turonian – Santonian), Bauru Basin, southeastern Brazil: Dental development aspects

Armadillosuchus arrudai, an extinct crocodyliform, has a complex pattern of tooth replacement. Replacement of functional teeth followed an alternating numerical and directional wave from posterior to anterior. Notably, the presence of an initial fossa in some teeth indicated root resorption and facilitated the development of tooth replacement. These aspects suggest a coordinated tooth replacement process, enabling the animal to maintain functional dentition. This study provides insights into the unique dental dynamics of Armadillosuchus arrudai, highlighting its lifelong polyphyodonty and the meaning of alternating replacement patterns. Microtomography allowed the comprehension of these intricate tooth replacement processes.

Does maintaining the number of present and functional teeth benefit the longevity of life in older people requiring nursing care?: A prospective cohort study.

This prospective cohort study examined the effects of the number of present and functional teeth on mortality among older Japanese adults requiring nursing care in an environment of comprehensive oral hygiene and nutritional management. The study included 174 older adults (mean age: 84.4 ± 8.3 years; male/female: 49/125) in need of support or long-term care, who resided in either a local specialized healthcare facility or their own homes, and received daily oral hygiene and nutritional support at facilities in Okayama, Japan. The initial clinical oral examination along with assessment of general physical condition and nursing environment of the participants were performed in July 2013 and followed up for one year. All-cause mortality occurred in 28 (mean age: 88.7 ±13.4 years; male/female: 6 /22) individuals during the follow-up period. Cox proportional hazard analysis indicated that older age, low performance in activities of daily living (Barthel Index <40), and underweight status (body mass index <18.5) were significant risk factors for mortality. The number of present and functional teeth were not found to be significant risk factors for mortality. During the one-year follow-up period, the number of present and functional teeth did not have a significant impact on mortality among older Japanese adults requiring nursing care in a well-managed environment of oral hygiene and nutritional status.

Pulp revascularization procedure for external inflammatory dental root resorption treatment

To assess the effectiveness of pulp revascularization procedure in children with external inflammatory root resorption (EIRR) after constant teeth injury. The study comprised 17 children aged 6-10 years diagnosed with EIRR as a long-term complication of dental trauma in 19 teeth. EIRR was diagnosed with periapical radiographs and CBCT was performed to further assess the pathology extension. Pulp revascularization was carried out in all 19 teeth. There was no resorption progression in all cases. EIRR areas were substituted by bone. In 10 from 19 teeth with early stages of root development bone or cement-like tissue ingrowth into the root canal was observed radiologically. In cases of severe EIRR this ingrowth may partially compensate for lost tissues which is confirmed by a high percentage (94.7%) of functional teeth during mean follow up time of 38±10 months. Pulp revascularization is an effective method for retaining teeth with EIRR for a relatively long period of time and allows maintaining alveolar bone volume both due to functional tooth preservation and healing of bone lesions in periapical and resorption areas.

Association between oral health and nutritional status among older patients requiring long-term care who received home-visit dental care.

This study examined the association between oral health and nutritional status among older patients receiving home-visit dental care. This study enrolled 110 older patients (age ≥65 years) requiring long-term care who received home-visit dental care. The oral health indicators evaluated included number of teeth, occlusal support, number of functional teeth, tongue pressure, tongue coating index (TCI), and rinsing ability. Nutritional indicators included skeletal muscle mass index (SMI) and the mini-nutritional assessment short-form (MNA-SF). A multivariate modified Poisson regression analysis (adjusted for age, sex, medical history, care level, and housing type) was used to calculate prevalence ratios and 95% confidence intervals (CIs). The prevalence ratio for low SMI was not significantly higher for patients with ≥20 teeth than for those with 1-19 or no teeth. Number of teeth was not significantly associated with MNA-SF score. A high TCI score (2.15, 95% CI: 1.07-4.32) and poor rinsing ability (2.32, 95% CI: 1.25-4.30) were significantly associated with low SMI. High TCI scores were associated with low scores in MNA-SF categories (1.25, 95% CI: 1.01-1.55). TCI and rinsing ability, rather than number of teeth, were associated with nutritional status in older patients requiring long-term care.

Dietary inflammatory index and number of functional teeth in middle-aged and older Japanese adults: A cross-sectional study using national survey data.

To determine whether the number of functional teeth, including the remaining natural teeth and prosthetically restored missing teeth, is associated with the dietary inflammatory index (DII), a quantitative measure of the inflammatory potential of the overall diet, in middle-aged and older Japanese adults. National survey data from a non-institutionalized Japanese population aged ≥45 years was analyzed. Multivariable linear regression analyses were performed to assess the association between the DII score, which was calculated based on dietary records, and the number of functional teeth, which was determined during dental examination. All regression analyses were stratified according to the age groups 45-64, 65-74, and ≥75 years. The association between functional tooth units (FTUs) and the DII was assessed using sensitivity analysis. In total, 2407 individuals (1053 men and 1354 women; mean age = 66.7 years) were included. Multivariable analysis revealed that the number of functional teeth was significantly inversely associated with the DII score among participants aged ≥75 years (regression coefficient per increase of one in the number of functional teeth = -0.050; 95% confidence interval = -0.089 to -0.010). The number of functional teeth was not associated with the DII score in younger age categories (i.e., those aged 45-74 years). As in the primary analysis, the number of FTUs was significantly inversely associated with the DII score only in the group aged ≥75 years. A greater number of functional teeth was associated with a lower DII (i.e., diet with greater anti-inflammatory potential) in Japanese adults aged ≥75 years.

Healing of an Immature Permanent Tooth with Large Periapical Radiolucency, Treated with Autologous Platelet-rich Fibrin Aided Regeneration

Presenting two cases of platelet-rich fibrin (PRF) aided regenerative treatment, performed in immature permanent teeth with large periapical lesions. In contrast to conventional apexification procedures, regenerative procedures can promote root completion and achieve root reinforcement. These case reports evaluated the long-term biological outcome of PRF-aided regeneration in immature permanent teeth with periapical lesions. Three-year and 5-year recalls in these cases revealed functional teeth with complete healing of the large periapical defect. The secondary outcome of regenerative treatment varied in the two reported cases. It was concluded that enhanced repair was achieved by an autologous PRF-aided regenerative procedure, but the secondary outcomes manifest variation.

Recent adavances of functional modules for tooth regeneration.

Dental diseases, such as dental caries and periodontal disorders, constitute a major global health challenge, affecting millions worldwide and often resulting in tooth loss. Traditional dental treatments, though beneficial, typically cannot fully restore the natural functions and structures of teeth. This limitation has prompted growing interest in innovative strategies for tooth regeneration methods. Among these, the use of dental stem cells to generate functional tooth modules represents an emerging and promising approach in dental tissue engineering. These modules aim to closely replicate the intricate morphology and essential physiological functions of dental tissues. Recent advancements in regenerative research have not only enhanced the assembly techniques for these modules but also highlighted their therapeutic potential in addressing various dental diseases. In this review, we discuss the latest progress in the construction of functional tooth modules, especially on regenerating dental pulp, periodontal tissue, and tooth roots.

Metamorphosis of Traumatic teeth- Aesthetic Rehabilitation with Injection Moulding Technique: A Case Report

Dental trauma is unpredictable ranging from minor enamel chipping to complete tooth loss, often accompanied by disruptions to the supporting bone and surrounding soft tissues, potentially compromising aesthetics, function, and overall oral health. Individuals experiencing traumatic injuries to the anterior dentition often report compromised aesthetics, impacting their self-esteem and social interactions. This case report describes the use of injection molding technique, for the rehabilitation of incisor crown fractures. The injectable composite resin technique is a versatile treatment for achieving esthetic and functional tooth restoration. This minimally invasive technique can be precisely adjusted to individual needs to replicate natural tooth structures and functions. Here vacuum-pressed vinyl sheet splint has been used as a stent for the injection moulding technique.

New measure of functional tooth loss for successful Oral ageing: a cross-sectional study

BackgroundThis cross-sectional study evaluated the impacts of functional tooth loss on oral health-related quality of life (OHRQoL) among elderly people compared with the impacts of several common indicators of oral health. Additionally, the cut-off of functional tooth loss needed for a better OHRQoL was investigated to establish a new measure for successful oral ageing.MethodsData from people aged 65–74 were extracted from the Fourth National Oral Health Survey in Sichuan, China. Functional tooth loss was defined as both natural tooth loss and nonfunctional teeth, such as third molars, residual roots, and removable dentures. The cut-offs of tooth loss were first identified as 12, based on the previous definition of functional dentition (≥20 natural teeth except the third molars), and 14, 16, or 18 for further investigation. OHRQoL was evaluated by the standardized Geriatric Oral Health Assessment Index (sGOHAI) score. Logistic regression was performed to estimate the impacts on OHRQoL. Additionally, subgroup analyses were conducted using the stratified chi-square test to explore the effect of functional tooth loss at each position.ResultsThe mean GOHAI score of the 744 participants was 48.25 ± 7.62. Elderly people who had lost ≤12 functional teeth had greater odds of reporting a higher sGOHAI score than those who had lost more functional teeth (odds ratio (OR) 1.49, 95% confidence interval (CI) 1.05–2.11). No significant difference in the sGOHAI score was detected between people who had lost 13–16 functional teeth and those who had lost ≤12 functional teeth (0.61, 0.35–1.07). The loss of second premolars and first and second molars had great impacts on the sGOHAI score when ≤12 or ≤ 16 functional teeth had been lost.ConclusionsCompared with natural tooth loss, functional dentition and occluding pairs, functional tooth loss can be a better indicator of OHRQoL in the elderly population. Sixteen remaining functional teeth seem to be sufficient to maintain good OHRQoL and successful oral ageing despite that number being previously acknowledged as ≥20 teeth.

Over-eruption in marsupial carnivore teeth: compensation for a constraint

Pronounced over-eruption of the canine teeth, causing the cervical enamel margin to extend beyond the alveolar bone and exposing the root, occurs with age and growth in Australian marsupial carnivores, much more than in eco-morphologically equivalent placental carnivores. Suppression of functional tooth replacement is characteristic of marsupials, where most placentals have the primitive diphyodont pattern of two generations of incisor, canine and premolar teeth. Canine and molar tooth dimensions of four species of marsupial carnivores (thylacine Thylacinus cynocephalus , Tasmanian devil Sarcophilus harrisii and two quolls Dasyurus spp . ) and canine dimensions of seven eco-morphologically equivalent placental carnivore species were measured from museum specimens. Canine dimensions were measured in a time series on live wild-living individual devils and quolls. The canine teeth and to a lesser extent the molar teeth of marsupial carnivores continue to erupt through life, resulting in a net increase in tooth height and diameter, a phenomenon not evident in placental carnivores. Potential mechanisms causing over-eruption include tooth wear and gradual release of occlusal pressure as the individual grows. Over-eruption in marsupial carnivores may be a compensatory response for tooth size limits imposed by monophyodont tooth replacement, ensuring that animal's teeth are scaled to jaw size from juvenile to adulthood.

Age-group-specific association of oral health and systemic health on cognitive function: a cross-sectional study of Korean elders

BackgroundAlthough the importance of oral and systemic healthcare for elderly people is increasing owing to the rapid ageing of the population in South Korea, studies on the relationship between oral health, systemic health, and cognitive function, as well as on the prediction of cognitive function by oral and systemic health depending upon age groups are lacking.MethodsWe included 5,975 out of 6,488 participants from the 8th wave of the Korean Longitudinal Study of Aging (KLoSA) panel data, divided the participants into three age groups, and performed a hierarchical multiple linear regression analysis to explain cognitive function with four types of predictors: oral health status, sociodemographic factors, objective health status, and subjective health status.ResultsOral health status was positively correlated with systemic health status and cognitive function. Of all ages over 54, cognitive function was significantly predicted by oral health variables, such as the number of functional teeth, masticatory ability, and Geriatric Oral Health Assessment Index (GOHAI); sociodemographic variables, such as age, sex, education level, and residence; and systemic health variables, such as diagnosis of diabetes mellitus, cancer or malignant tumours, cerebrovascular disease and rheumatoid arthritis, depressive symptom, and self-rated health status. Oral health variables explained cognitive function differently by age group; GOHAI appeared important predictor in the group aged < 75 years, whereas the number of functional teeth did in the group aged ≥ 75 years. Educational level, masticatory ability, depressive symptoms, and self-rated health status were pivotal factors age-independently.ConclusionsThe general and age-group-specific association between oral health, systemic health, and cognitive function were confirmed, suggesting that age-group-specific oral healthcare should be emphasized for the effective management of systemic and cognitive health in the elderly group.

Trajtimi jo-kirurgjikal me mineral treoksid agregat i incizivit lateral maksillar me apeks të hapur në një seancë

Although dental trauma is difficult to manage by general dental practices, it is important to follow the appropriate steps to achieve optimal results. This case report describes the non-surgical management of a tooth with an open apex and necrotic pulp using MTA and CWC (continuous wave compaction) to achieve endodontic success. Although it is a controversial technique, if the right conditions are provided, the creation of an artificial barrier continues to preserve an adequately functional and healthy tooth in the arch while avoiding extensive surgical and prosthet- ic procedures to replace a potentially compressed tooth. This case report highlights the beneficial effects of MTA, which are very good in the field of apexification or even regenerative dentistry as a whole. The 29-year-old man presents post-traumatic necrosis of the maxillary lateral incisor (tooth 12) which has been closed in the apical part with MTA, artificial barriers have been created, achieving the disinfection of the root canal, the remission of apical periodontitis, and where after 7 months of follow-up we have a lot of progress. The importance of using biocompatible materials such as MTA is emphasized, which in this case resulted in satisfactory results. This report reviews the management of a lateral incisor with open apex and necrotic pulp with apical plug with the aid of MTA and CWC achieving a successful apical and canalicular system seal.

Association between oral condition and subjective psychological well-being among older adults attending a university hospital dental clinic: A cross-sectional study.

Positive psychological well-being has a favorable impact on survival rates in both healthy and unhealthy populations. Oral health is also associated with psychological well-being, is multidimensional in nature, and includes physical, psychological, emotional, and social domains that are integral to overall health and well-being. This study aimed to identify the associations between individual and environmental characteristics, oral condition and nutritional status in relation to subjective well-being among older adults using the Wilson and Cleary conceptual model. The participants were older adults (age ≥ 60 years) attending a university hospital. Subjective well-being was assessed using the World Health Organization-5 Well-Being Index, oral condition was assessed based on the number of bacteria in the tongue coating, oral wettability, tongue pressure, occlusal force, oral diadochokinesis, and masticatory ability, and subjective swallowing function was assessed using the Eating Assessment Tool, number of remaining teeth, and number of functional teeth. In addition, factors related to well-being, including social networks, life-space mobility, nutritional status, smoking history, drinking history, and medical history were assessed. In the analysis, structural equation modeling was used to investigate the association between oral condition and subjective well-being. Confirmatory factor analysis revealed oral condition as a latent variable, including tongue pressure, oral diadochokinesis /pa/, /ta/, /ka/, occlusal force, masticatory ability, subjective swallowing function, and number of functional teeth. Structural Equation Modeling revealed that oral condition was positively correlated with nutritional status, and nutritional status was positively correlated with the World Health Organization-5 Well-Being Index. These findings suggest that oral condition may influence subjective well-being via nutritional status or social environmental factors.

Last dental visit and severity of tooth loss: a machine learning approach

The aims of the present study were to investigate last dental visit as a mediator in the relationship between socioeconomic status and lack of functional dentition/severe tooth loss and use a machine learning approach to predict those adults and elderly at higher risk of tooth loss. We analyzed data from a representative sample of 88,531 Brazilian individuals aged 18 and over. Tooth loss was the outcome by; (1) functional dentition and (2) severe tooth loss. Structural Equation models were used to find the time of last dental visit associated with the outcomes. Moreover, machine learning was used to train and test predictions to target individuals at higher risk for tooth loss. For 65,803 adults, more than two years of last dental visit was associated with lack of functional dentition. Age was the main contributor in the machine learning approach, with an AUC of 90%, accuracy of 90%, specificity of 97% and sensitivity of 38%. For elders, the last dental visit was associated with higher severe loss. Conclusions. More than two years of last dental visit appears to be associated with a severe loss and lack of functional dentition. The machine learning approach had a good performance to predict those individuals.

The Complexity of the Root Canal Anatomy and Its Influence on Root Canal Debridement in the Apical Region: A Review.

The main goal of root canal treatment is to eliminate the infection in the complex root canal system for the long-term preservation of a functional tooth. Proper debridement of the root canal system, especially in the apical portion, is essential for successful root canal treatment. The complexity of the canal anatomy in the apical region plays a crucial role in reducing the microbial load. Therefore, clinicians must have a thorough knowledge of the anatomy of the root canal system and its variations, especially in the apical portion. Root canal configurations in cross-section have been classified as round, oval, long oval, flattened, or irregularly shaped. Treating oval, long oval, flattened, or irregularly shaped canals is challenging and should be approached differently than a circular canal. Recognizing the root canal shape and apical anatomy determines the different strategies to be used in cleaning, shaping, and obturation to achieve the best result of root canal treatment. The recent development of the instrumentation system improves the treatment outcome for clinicians and patients. This review aimed to discuss the definition, prevalence, and instrumentation for cleaning and shaping in the apical area with the complexity of root canal systems. Therefore, with the aid of this review, we can better understand the variations in the anatomy of the root canal, especially at the apical portion.

On the dentition, tooth replacement, and taxonomic status of Charruodon tetracuspidatus Abdala & Ribeiro,2000: A bizarre cynodont from the middle upper Triassic of southern Brazil.

Among the living tetrapods, mammals present a unique tooth replacement pattern, diphyodonty. Therefore, studying the dentition of mammalian ancestors is relevant to a better understanding of how this remarkable feature evolved. However, little is known about the postcanine tooth replacement pattern among Triassic cynodonts. Here, we applied the nondestructive method of microcomputed tomography (microCT) to analyze the dentition of the enigmatic Upper Triassic sectorial-toothed cynodont Charruodon tetracuspidatus (MCP 3934 PV, holotype) from the Candelaria Sequence, Santa Maria Supersequence, Brazil. The microCT-scan data allowed visualization of the replacement dentition and roots of the functional teeth, which provided information to inform interpretations of the ontogenetic stage and taxonomy of the species. A combination of dental and mandibular traits, as well as the small size of the specimen MCP 3934 PV, suggest an early ontogenetic stage. Additionally, the specimen could potentially be an ontogenetically immature form of another taxon, or a yet unknown species of probainognathian cynodont. Therefore, Charruodon tetracuspidatus is here designated as a nomen dubium, given the challenges of maintaining the species as valid.

Oral frailty is a risk factor for body weight loss after gastrectomy: a single-center, retrospective study.

Body weight loss (BWL) is a serious complication of gastrectomy in patients with gastric cancer (GC). Nutritional intervention alone is inadequate for preventing BWL, and a new approach is needed. Oral frailty among older adults has recently attracted attention. This study aimed to investigate masticatory ability and BWL after gastrectomy. This was a single-center, retrospective study. Functional tooth units (FTU) were used to measure masticatory ability. Patients with FTU < 4 were defined as low FTU group and FTU ≥ 4 as high FTU group. The BWL was compared between the two groups. Sixty patients who underwent distal gastrectomy for GC from March 2022 to January 2023 were enrolled in this study. The median FTU was 3 (range 0-12). The low-FTU group (FTU < 4) included 29 patients, while the high-FTU group (FTU ≥ 4) included 31 patients. The %BWL in the low FTU group was significantly higher than that in the high-FTU group at 1 and 3months (p = 0.003 and p = 0.017, respectively). The risk factors associated with a %BWL > 5 at 1 and 3months after gastrectomy were analyzed using logistic regression analysis. Only FTU < 4 was an independent risk factor after gastrectomy for GC in univariate and multivariate analyses (p = 0.028 and p = 0.006, respectively). Low FTU in patients with preoperative GC was a risk factor for %BWL 1 and 3months postoperatively. Appropriate oral interventions may be useful in improving the postoperative nutritional status after gastrectomy.

The Association between Oral Health Management and the Functional Independence Measure Scores at the Time of Admission of Inpatients to a Convalescent Hospital.

Many older patients admitted to convalescent hospitals present with impaired oral function, which is an important function of daily life. This study aimed to investigate the actual status of the oral healthcare needs of inpatients in a convalescent hospital and to clarify the relationship between the level of independence at admission and the oral function. The participants were 147 patients (94 males, 53 females, mean age: 74.6 ± 13.1 years) who received dental visits during their stay at a convalescent hospital. Information regarding general and oral health was extracted from medical records. Most patients were found to have low Functional Independence Measure motor scores, and approximately 70% had some form of oral intake, but approximately 80% had nutritional problems. The mean number of present and functional teeth were 16.6 and 20.8, respectively, and 65% of patients lost molar occlusal support. Multiple regression analysis showed significant positive correlations of high functional independence measure with age, eating status, nutritional status, and the number of functional teeth. This implied that oral health management is important for patients in a convalescent hospital and that enhancing oral health may be related to improved eating textures and better nutritional status.