Tooth Loss Research Articles

Advances of Oxidative Stress Impact in Periodontitis: Biomarkers and Effective Targeting Options.

Periodontitis is the most common inflammatory oral disease that affects around 15% of adults and contributes to severe periodontal tissue destruction with subsequent tooth loosening and loss. Among the main pathogenic mechanisms underlying periodontitis, excessive reactive oxygen species production and oxidative stress play a predominant role in inducing both local and systemic damage. Current therapeutic approaches have expanded the conventional methods combined with herbal antioxidant compounds to free radical-scavenging nanomaterials and infrared laser therapy, offering promising pre-clinical evidence in periodontitis management. Herein, we review the pathogenic mechanisms of reactive oxygen species tissue damage, along with recent advances in oxidative stress biomarkers and novel targeting options.

Inequalities in prevalence rate of edentulism in the European Union between 1990 and 2019

Abstract Background Edentulism, characterized by tooth loss, serves as a global indicator of oral health burden, particularly affecting older and economically disadvantaged populations. We aimed to assess health inequalities in age-standardized prevalence rate (ASPR) of edentulism across 28 EU member states and EU as a whole between 1990 and 2019. Methods We retrieved ASPR, annual rate of change (ARC) and 95% uncertainty interval from the Global Burden of Disease (GBD) 2019 study. We calculated the ASPR ratio between 1990 and 2019 and country-paired ASPR for 2019. To estimate the inequalities between countries between 1990 and 2019, we used the Gini Coefficient (GC) and Slope Index of Inequality (SII). Results The EU ASPR for edentulism was 5912 (95% UI: 4751-7473) in 1990 while in 2019 it was 5048 (95% UI: 3970-6485). Sweden had the lowest ASPR in 1990, while Spain held this position in 2019. The highest rates in 1990 were observed in Poland and the Netherlands, with the Netherlands maintaining the highest ASPR in 2019. Spain exhibited the lowest ARC at -0.325 (95% UI: -0.477--0.193), while Sweden was the sole country with a positive value, at 0.034 (95% UI: -0.009-0.075). The ASPR ratio across all EU member states exhibited a range of values for males, from 1.00-2.16, and for females, from 1.00 to 1.87. The ASPR ratios ranged between 1.81 and 2.16 from 1990 to 2000. The GC was 0.097 (95% UI: 0.076-0.117) in 1990 and subsequently decreased-0.084 (95% UI: 0.063-0.105) by 2019. The SII exhibited a range from 0.062 (95% UI: 0.051-0.072) in 1990-0.046 (95% UI: 0.038-0.054) in 2019. Conclusions Inequalities in edentulism in the EU were similarly low when comparing 1990 and 2019. However, there was an alarming increase in inequalities between 2005 and 2010. This underscores the need for targeted interventions and policy measures-address oral health inequalities, considering socio-economic factors, healthcare policies, sex disparities, and public awareness initiatives. Key messages • Edentulism is a significant public health concern within the EU for approximately 30 years. • It has demonstrated comparable disparities in prevalence at both the beginning and end of the period, with a noticeable intensification in the interim.

Periodontal disease and cardiovascular disease: umbrella review

BackgroundPeriodontal disease (PD) is an infectious and inflammatory condition that affects the tissues surrounding and supporting the teeth. It has been suggested that PD may be associated with cardiovascular disease (CVD), one of the leading causes of mortality worldwide. Our study aimed to investigate the association between PD and CVD through an umbrella review.MethodsA comprehensive search was conducted until April 2024 across various electronic databases, including PubMed, Cochrane Library, Scopus, SciELO, Web of Science, Google Scholar, ProQuest Dissertations and Theses, and OpenGrey. Systematic reviews with or without meta-analysis were considered for inclusion, without any limitations on time or language, provided they examined primary studies linking PD with CVD. The AMSTAR-2 tool was employed to assess the quality and overall confidence of the included studies.ResultsAfter the initial search, a total of 516 articles were identified. Following the application of selection criteria, 41 articles remained for further consideration. All these studies indicated an association between PD and CVD, with odds ratios and risk ratios ranging from 1.22 to 4.42 and 1.14 to 2.88, respectively.ConclusionsSystematic reviews with high overall confidence support the association between PD, tooth loss, and cardiovascular diseases. However, it is crucial to interpret these results with caution due to methodological limitations. The potential public health relevance justifies preventive and corrective oral health strategies. Additionally, the need for rigorous future research is highlighted to strengthen the evidence and guide effective public health strategies.

The association between low serum vitamin D level & periodontal diseases in Bangladeshi population- An observational study

Aims: Bangladeshi population (20-45 age) presents early loss of tooth without any history of systemic disease. Low serum vitamin D level is one of the factors of early tooth loss. The aim of the study is to assess the significance of low or insufficient serum vitamin D level as a factor of early tooth loss in Bangladesh perspective. Materials and Methods: An observational study was performed in dental unit of TMSS Medical College from January 2021 to December 2022 after ethical clearance of IRB of this institute. Total number of patients was 70 selected by non-random sampling (judgment sampling) who fulfilled the inclusion and exclusion criteria. We assessed the variable like gingivitis, periodontal pocket & tooth mobility clinically. The depth of the periodontal pocket & gingivitis was assessed by the periodontal probe & the mobility by using a blunt instrument & feel with the fingers before & after Vit D supplementation. Data were processed and analyzed using computer software SPSS version 26.0. Results: Deficiency of low serum vit D level has significant effect on periodontal bone resorption and after correction of serum vit D level resulted clinical improvement on periodontal health. Conclusion: Vitamin D deficiency may place subject at risk of developing chronic periodontitis. J Bangladesh Coll Phys Surg 2024; 42: 363-367

The Treatment Alliance and the Provision of Removable Dentures: Exploring the Emotional Work of the Dental Team

Background: Research has demonstrated that the loss of one or more natural teeth can be an emotionally traumatic experience that mirrors processes associated with bereavement. There remains scant literature examining the role of emotions in dental encounters. One such exception is the literature on the idea of the ‘treatment alliance’ in dental encounters. The aim of this paper is to explore the role of the ‘treatment alliance’ in dentist–patient encounters. Methods: Data were collected from clinical observations, semi-structured interviews and focus groups exploring the experience of tooth loss and how the treatment alliance shaped the patient journey. Data analysis was conducted using the grounded theory method influenced by phenomenology. Coding was conducted using NVIVO and the unit of analysis was the treatment alliance. Results: Twenty participants took part in the interviews (eleven male; nine female; 22–86 years; mean age = 58.9 years). Observations were carried out with a further fourteen participants (seven male; seven female; 50–101 years; mean age = 62.2 years). The paper draws on four cases taken from the observational data to illustrate important dynamics underpinning how the treatment alliance varied. These case studies are then used as the basis for a critical discussion of the importance of the treatment alliance in dentistry. Conclusions: The treatment alliance acted as an important moderator in the clinical encounter, helping to influence successful outcomes. An important foundational component of the treatment alliance was the degree of emotional work the dental team conducted when ‘getting to know’ unfamiliar patients. Whilst emotions were an important factor in dental encounters, their acknowledgement and management were not essential to all successful outcomes. Much more research is therefore needed into the role of emotional labour in dental encounters.

Acidic/abrasive challenges on simulated non-carious cervical lesions development and morphology

This in vitro investigation assessed how frequency of erosive challenges and duration of toothbrushing abrasion influenced non-carious cervical lesions (NCCLs) development and morphology. Experimental units were prepared using extracted human premolars assigned to four erosive-abrasive frequency protocols (n=16): F0. No acid exposure (negative control), F2.5 K. Acid exposure (1 % citric acid at natural pH) every 2500, F5K. 5000 and F15K. 15000 brushing-strokes. All groups were brushed for 55000 total brushing-strokes. Three-dimension images of the teeth were captured at baseline, after 15000, 35000 and 55000 brushing-strokes, using an intraoral scanner (TRIOS4, 3Shape). WearCompare software (Leeds Digital Dentistry) was used to analyze volumetric tooth loss (mm3) by superimposition followed by subtraction analysis. Lesion angle was measured (ImageJ, NIH) and morphology visually classified. Data were analyzed using ANOVA and Fisher's Exact tests adopting two-sided 5 % significance level. Tooth loss increased with brushing-strokes overall (p<0.001) and for each erosive-abrasive protocol (p<0.001). Acid exposure significantly increased tooth loss (p<0.001), regardless of brushing interval (p<0.001), however by 35000 strokes no tooth loss difference was observed among acid-exposed groups (p>0.05). Control had significantly sharper mean lesion angle (59°) than all acid-exposed groups (∼145°) (p<0.001), and significantly different lesion shape with 94 % wedge-shaped lesions versus 0 %, respectively (p<0.001). In contrast to the control, acid exposure was associated to more striated lesions. Simulated NCCLs developed and progressed differently and more rapidly in the presence of acidic challenges, regardless of their frequency. Exposure to acid impacted the morphology of lesions.

RESTAURAÇÃO BIOMIMÉTICA EM DENTE TRATADO ENDODONTICAMENTE: RELATO DE CASO CLÍNICO

Biomimetic dentistry is constantly evolving evolution, seeking inspiration from nature to develop technologies and biocompatible materials that mimic the structure and function of natural dental tissues. tissues. This innovative approach aims to improve the effectiveness of dental treatments by preserving tooth structure, improving the adhesion of restorative restorative materials, restoring structural integrity and replicating natural biomechanics. With a focus on regenerating and replacing lost dental tissues, biomimetic dentistry promises to revolutionise clinical practice, offering practice, offering more effective and safer solutions to patients through biomimetic products with improved properties. This study aims to aim of this study is to report a clinical case of restoration of a tooth treated tooth, using the principles of biomimetic dentistry to preserve tooth structure the tooth structure. Research was carried out in the following electronic databases databases: National Library of Medicine (PUBMED), Virtual Health Library (BVS), Brazil (BVS), Brazil Scientific Electronic Library Online (SciELO) from 2019 to 2024. Following the Biomimetic Dentistry approach, the use of intracanal pins was avoided in the restoration was avoided, prioritising methods that improve adhesion and reduce resin shrinkage and reduce the shrinkage of the composite resin. These techniques were considered sufficient to carry out the restoration, even in cases of extensive tooth loss after root canal treatment after root canal treatment.

Reasons for Patients Preferring Extraction over Root Canal Treatment in a Tertiary Care Hospital

Introduction: Dental caries is a major global oral health issue, potentially progressing to irreversible pulpitis and causing substantial discomfort. Although advancements in materials, instruments and knowledge have improved the success rates of root canal procedures, some patients opt for tooth extraction instead of root canal treatment. This choice can result in tooth loss, necessitating costly prosthetic replacements. Objective: The objective of this study was to determine the reasons for patients choosing extraction over root canal treatment. Methods: A descriptive cross-sectional study was conducted among 205 patients visiting the Department of Conservative Dentistry and Endodontics at Kathmandu Medical College for the treatment of irreversible pulpitis, who ultimately opted for extraction. A structured questionnaire was utilized, and responses were recorded and analyzed using the Statistical Package for the Social Sciences. Mean, standard deviation, frequency and percentage were calculated depending upon the nature of data. Results: The study found that the primary reason for patients not undergoing root canal treatment (RCT) was the high cost of RCT and crown, accounting for 42.9% (88 patients), followed by the need for more appointments with pain, at 31.2% (64 patients). Conclusions: This study revealed the cost of RCT and crown to be the major factor for patients opting out from RCT. The study provides valuable insights into the psychology of patients regarding RCT, highlighting reasons for its rejection. Such understanding assists dentists and specialists in tailoring treatment plans that align with patient preferences and needs.

Knowledge, Attitudes Regarding Dental and Oral Health With The Number of Funtioning Teeth: A Cross-Sectional Study

Background: Elderly people are expected to have a minimum of 20 functioning teeth so that mastication, speech, and aesthetic functions are assumed to be normal. However, in reality, tooth loss still occurs in some elderly people, so they only have less than 20 functioning teeth. Problem: Low percentage of functioning teeth in the elderly. Research Objective: To determine the relationship between knowledge and attitudes about dental and oral health with the number of functioning teeth in the elderly at Integrated Service Post Melati VI, Karanglo Village, Mojowarno District, Jombang Regency. Method: This type of research is cross-sectional analytical research. The sample of respondents was 52 elderly people. The research instrument to measure knowledge and attitudes about dental and oral health in the elderly uses a questionnaire sheet and a dental examination sheet to identify the number of functioning teeth. The data obtained were analyzed using non-parametric tests with chi square. Results: There was no relationship between knowledge about dental and oral health and the number of functioning teeth. There is a relationship between attitudes about dental and oral health and the number of functioning teeth (study at the Melati VI Integrated Service Post for the Elderly, Karanglo Village, Mojowarno District, Jombang Regency, 2024)

The 2018 Classification of Periodontal Diseases: An Observational Study on Inter-examiner Agreement among Undergraduate Students.

The objective of the present observational study was to assess the inter-examiner agreement for the diagnosis of periodontitis using the 2018 CPD among fourth and fifth year undergraduate students. It is hypothesised that there is no difference in the inter-examiner relaibility between fourth- and fifth-year undergraduate students regarding staging and grading periodontal disease using the 2018 Classification of Periodontal Diseases (CPD). All participants received training on the 2018 CPD scheme through a mandatory periodontics course conducted by a periodontist. Documentation for seven deidentified periodontitis patients, comprising medical history, dental history including tooth loss, intra-oral photographs and radiographs, periodontal charts reporting probing depth, plaque and bleeding on probing scores, furcation involvement and clinical attachment loss, was sent via e-mail to undergraduate students. The cases consisted of one sextant, and the participants were instructed to assume the sextant to be a true representation of the entire dentition. Power analysis was done on pilot data, and the level of significance was set at p0.05. The percentage of undergraduate students in the fourth and fifth year that correctly identified the stage of periodontitis according to the 2018 CPD ranged between 28% and 72% and 18.5% and 77.8%, respectively. The percentage of undergraduate students in the fourth and fifth year that correctly identified the grade of periodontitis ranged between 40% and 88% and 51.8% and 92.5%, respectively. The overall staging and grading ranged between 22.8% and 74.1%, and 45.66% and 87.4%, respectively. There was no statistically significant difference between fourth- and fifth-year undergraduate students with regards to assigning the correct diagnoses to case documentation in terms of either stage or grade. Fourth- and fifth-year undergraduate students demonstrated high inter-examiner agreement using the 2018 CPD.

Tooth loss during long-term periodontal therapy in specialized practices – a retrospective cohort study from a periodontal practice-based research network (Perio-PBRN)

ObjectivesTo investigate tooth-specific, clinical tooth-, and patient-related factors associated with tooth loss (TL) in patients with mild to severe periodontitis treated in a periodontal practice-based research network (Perio-PBRN) over at least 5 years.Materials and methodsThe Perio-PBRN consists of five German periodontal practices where clinical data were collected regarding patient age, tooth type, bleeding on probing (BOP), pocket probing depth (PPD), furcation involvement (FI), number of attended appointments, and other variables of interest. The data were evaluated regarding factors influencing TL.ResultsData from 687 patients (aged 54.5 ± 11.1 years) with mild (N = 23, 3.35%), moderate (N = 247, 35.95%) or severe (N = 417, 60.70%) periodontitis and 15,931 teeth over a mean observation period of 6.83 ± 1.40 years per patient were gathered via the Perio-PBRN. In this period, a total of 657 teeth were lost (4.12%, overall TL: 0.14 ± 0.22 teeth/patient/y). The risk of TL was significantly increased for teeth with persistent PPD ≥ 6 mm (hazard ratio: 6.81 [95% confidence interval: 5.07–9.15] in comparison to PPD < 4 mm. Additionally, BOP (3.90 [2.46–6.19]), furcation involvement, jaw, age and tooth type showed a significant influence on TL, while number of visits were not significantly associated with TL.ConclusionsPeriodontal care of patients with moderate to severe disease in specialized practices was associated with a low rate of TL. Known tooth-related prognostic factors were confirmed. However, the results must be interpreted cautiously without knowledge of risk factors such as smoking and diabetes.Clinical relevancePBRNs can help gather large amounts of periodontal practice-level data.Trial registrationThe study was registered in the German Clinical Trials Register (DRKS 00011448).

Social Relationships and Tooth Loss in Adults Aged 60 Years and Older: A Systematic Review and Meta-Analysis.

To systematically assess current evidence on the extent to which social relationships are associated with tooth loss in adults aged 60 years and older. A systematic literature search was conducted on PubMed, Embase, Web of Science, CINAHL and The Cochrane Library databases to identify relevant studies published from 1966 up to March 2024. Cross-sectional or cohort studies investigating the association between structural, functional and/or combined (structural and functional) components of social relationships and the number of remaining teeth or edentulism among community-dwelling or institutionalised older adults were included. Data were extracted on participants' and study characteristics, including study design, the type of measures used to assess social relationships (structural, functional, and combined), outcome measures and association estimates. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies and the adapted NOS for cross-sectional studies. The reported association between social relationships and the number of remaining teeth or edentulism was summarised using meta-analysis with robust variance estimation. Twenty studies were included in the review and 12 studies (125 553 participants) in the meta-analysis. Across the 12 studies, the average odds ratio (95% confidence interval) was 1.15 (1.01-1.32), indicating a 15% higher likelihood of having a lower number of teeth or edentulism for those with weaker social relationships. The GRADE certainty of the body of evidence was low. Weak social relationships were associated with a lower number of teeth or edentulism in older adults. Our findings may inform potential public health approaches that target and modify social relationships to prevent and address older adults' oral diseases. Still, the directionality and the underlying mechanisms connecting social relationships and tooth loss need to be further explored by longitudinal studies with follow-up long enough for oral health outcomes or changes in social relationships to occur. Protocol Registration: PROSPERO (CRD42023417845).

Oral Health-Related Quality of Life in Dutch Adults With Osteogenesis Imperfecta.

To explore the oral health-related quality of life and its possible risk factors among adults with Osteogenesis Imperfecta using the Oral Health Impact Profile (OHIP)-49 questionnaire. Secondary objectives were to investigate the impact of self-reported Osteogenesis Imperfecta, Dentinogenesis Imperfecta, and age on various dental parameters. A cross-sectional questionnaire was distributed online to 417 Dutch adults with Osteogenesis Imperfecta at three national referral centers. Multivariate linear regression was performed to identify indicators for OHIP-49 Scores. The effect of Osteogenesis Imperfecta, Dentinogenesis Imperfecta, and age on various dental parameters was investigated using logistic regressions (p < 0.05). One hundred and fifty-five questionnaires (37.2%) were suitable for analysis. Osteogenesis Imperfecta type III was significantly associated with higher OHIP-49 scores as compared to type I. Symptoms of temporomandibular disorders, missing teeth or dentures also increased the OHIP-49 scores significantly. Osteogenesis Imperfecta type IV and increasing age were associated with missing teeth. There was a 31.94 times (95% CI: 8.56-119.13) higher odds of tooth fracture with self-reported Dentinogenesis Imperfecta. Adults with Osteogenesis Imperfecta type III report a lower oral health-related quality of life compared to Osteogenesis Imperfecta type I adults.

Teeth, Health, and Mind: Understanding the Interplay of Social Determinants and Cognitive Decline in Older Adults.

The study examines the association between social determinants of health, tooth loss, and cognitive decline. Using regression models, the 2020 Behavioral Risk Factor Surveillance data examined the study objective; it included 32,663 older adults who reported on cognitive status. Results suggested that older adults missing more than five teeth or unable to work are 1.61 times and 6.84 times more likely to report cognitive decline, respectively. Older adults with higher education and higher household incomes are less likely to report cognitive decline. Results suggested that older adults with no diabetes or who never smoked are 31% and 39% less likely to report a cognitive decline. The results suggested a significant association between tooth loss and cognitive decline among social determinants of health. A comprehensive approach to affect cognitive decline should include oral and social health strategies.

An Animal Ex Vivo Model Comparing Two Different Methods of Sinus Floor Elevation with Great Elevation Heights: Macroscopic, Microscopic and Radiological Analysis

Introduction: Maxillary sinus pneumatization increases with age and tooth loss, leading to a reduction in the maxillary alveolar ridge, which often results in insufficient bone height for the proper placement of dental implants. This study focused on performing maxillary sinus elevations in ex vivo bisected pig heads using novel access and elevation devices, comparing these with the osteotome sinus floor elevation (OSFE) technique. Materials and Methods:An experimental study was conducted using 20 ex vivo adult pig heads. The sinus elevations were divided into two groups: 10 heads were treated using the osteotome technique, and 10 heads were treated using a new device, which consists of a syringe with latex and saline solution, as well as a burr system for membrane access and control. Results: In the osteotome technique, perforations of the Schneiderian membrane were observed, whereas the inflatable balloon device did not cause any lacerations. Conclusions: OSFE resulted in sinus membrane perforations at greater elevation heights, while the new balloon device successfully elevated the membrane without tearing it. Within the limitations of this study, maxillary sinus lifts using the new balloon technique proved to be minimally invasive procedures.

CONHECIMENTO DOS CUIDADORES DE IDOSOS DE INSTITUIÇÕES DE LONGA PERMANÊNCIA SOBRE AS ALTERAÇÕES DE MASTIGAÇÃO E DEGLUTIÇÃO

Physiological changes in old age significantly impact biopsychosocial life, especially in the areas of communication and eating, with eating being not only a source of pleasure but also a crucial facilitator of social interaction. The integrity of chewing and swallowing functions is essential to ensure safety. Elderly people who are unable to perform activities of daily living independently require the attention of caregivers, whether family members or professionals, to ensure their well-being and quality of life. Thus, this study aims to understand the perception of caregivers of elderly people regarding changes in chewing and swallowing of elderly people in Long-Term Care Facilities (LTCFs). This study is quantitative and analytical, carried out with caregivers of elderly people in LTCFs in Alagoas, using a form, with a random and non-probabilistic sample. Thirty-four questionnaires were collected. The average time working with elderly people was 3 years and 9 months, and they remained for an average of 1 year and 10 months. 94.1% of caregivers identified the presence of chewing disorders, correlating these with missing teeth and/or use of dentures (41.2%). Dietary adaptations to deal with these disorders are carried out individually by each caregiver, although they believe they know what is important for good chewing, they do not associate missing teeth with chewing impairment. It is clear that caregivers are unable to prevent choking, as 70.5% have had to perform the Heimlich maneuver while serving meals.

Circular DNA enhanced amplification-free CRISPR/Cas12a assays for end-user friendly ultra-sensitive Porphyromonas gingivalis diagnosis

Periodontitis not only leads to tooth loss but is also associated with various systemic symptoms. Porphyromonas gingivalis (Pg) is the microorganism most closely linked to periodontitis. A rapid and accurate Pg detection method holds significant potential health benefits for patients. While several nucleic acid amplification-based diagnostic methods have been developed, there is a current lack of rapid diagnostic tools for Pg, particularly at chair-side level. Here, two detection methods for the Pg 16S gene based on the CRISPR/Cas12a system have been developed. To achieve ultra-high sensitivity in the developed CRISPR/Cas12a assays without pre-amplification, we designed a circular DNA molecule (termed as Cir-amplifier) which amplifies the signal output of the Cas12a reactions in a cascade response manner. The Cir-amplifier enhanced Fluorescence-Cas12a reaction achieved a minimum detectable limit of 0.39 CFU of Pg within 80-minute under room-temperature. In addition, the Cir-amplifier enhanced Lateral Flow Detection (LFD)-Cas12a reaction has demonstrated the ability to detect a minimum of 3.9 CFU of Pg in 90 min, with results observable by the naked eye. The potential of the two methods for Pg detection in clinical samples has been demonstrated, showing 100 % sensitivity compared to the traditional real-time PCR method. In summary, we have established two efficient detection methods for Pg that eliminate the need for pre-amplification, hence no amplicon contaminations, making them promising candidates for chair-side Pg diagnosis. Furthermore, the Cir-amplifier has been demonstrated to be adaptable to CRISPR/Cas systems producing various signal formats. The Cir-amplifier is expected to become a universal CRISPR/Cas enhancer.

Rehabilitation of a Severe Anterior Ridge Defect with a Fixed-Removable Prosthesis

Significant anterior ridge abnormalities might be difficult to restore with prosthesis. To attain good speech and aesthetics necessitate not only the restoration of the missing teeth but also the closure of the problematic region. One recommended treatment option for individuals with substantial ridge abnormalities is the Andrews bridge which is a fixed-removable prosthesis. The prosthesis correctly replaces the missing teeth and corrects the ridge defect area and restore speech and appearance. A 35-year-old female patient reported with the principal complaint of spacing in her lower front teeth and difficulty in phonetics and poor appearance. On clinical examination spacing was seen in the maxillary central incisors along with pro-clination and 31,32,33,41,42,43 teeth were missing and the edentulous defect area was coming under Seibert's Class III category. Rehabilitation of such defect with an Andrews bridge described in this case report, which used natural teeth as abutments for its permanent component and a detachable superstructure.

Analysis of factors associated with tooth loss in older adults from 1995 to 2015: a population-based cross-sectional survey in Guangdong, China.

The aim of this study was to detect trends and related factors in the functional dentition (FD) in 65- to 74-year-olds in Guangdong, China, while also assessing trends in education and income inequality factors. Three large-scale cross-sectional National Oral Health Surveys (NOHS), specifically NOHS II in 1995, NOHS III in 2005, and NOHS IV in 2015, were included. Post hoc stratification was weighted for 1038 participants aged 65 to 74years. Retaining teeth ≥ 20 teeth and retaining < 20 teeth was defined as functional dentition (FD) and nonfunctional dentition (NFD), respectively. Logistic regression models were established to assess related factors. Slope index of inequality (SII) and relative index of inequality (RII) were used to analyze inequality. From NOHS II to IV, the FD proportion increased from 42.8 to 71.9%. Years of NOH, with caries, with periodontal pocket, high educational level, high income level, female, and those who had dental visits were associated with FD preservation. The education-related SII decreased from 0.44 to 0.20, and the income-related SII increased from 0.13 to 0.16. The FD proportion among 65- to 74-year-olds improved from 1995 to 2015. Years of NOHS, with caries, with periodontal pocket, high education level, and high income level were associated with higher FD proportion. Female and those who had dental visits were associated lower FD proportion. Social inequalities in FD persisted, especially economic-related inequalities. Public health policy support and respective interventions should be applied to increase FD retention.

Morphometric Tomographic Analysis of the Head of the Tridactyl Humanoid Specimen from Nasca-Peru

Objective: To report the tomographic and morphometric analysis of the head of the tridactyl humanoid specimen from Nazca, Peru. Method: A qualitative case study approach. RadiAnt DICOM Viewer software version 4.2.1 was used to analyze lengths, diameters, and volume in tomographic images of the head. The morphological biometric analysis applied anthropometric methods using some craniometric points and cephalometric angles. Results and Discussion: As a result, it is reported that there are atypical, strange, and exceptional morphometric imaging features in the cephalic segment of specimen M01. The cephalometric analysis based on the ANB angle revealed a class II skeletal pattern, and according to the Bjorl-Jarabak analysis, it has a convex facial profile with hypodivergent growth (brachyfacial). The patient also has maxillary biprotrusion, severe protrusion of upper and lower incisors, loss of teeth, presence of root remnants, severe dental abrasion, non-assessable canine class, absence of three third molars and ocular protrusion. Based on craniometric points, the SNA angle (Sella, Nasion and Point A) and the SNB angle (Sella, Nasion and Point B) maxillary protrusion and mandibular protrusion were diagnosed. Implications of the research: It is concluded that the combination of uncommon morpho-anatomical features in the maxillofacial and cranial massif do not correspond to a human craniofacial biotype, but could be considered as suggestive findings of morpho-anatomical features typical of a hominid species similar to humans. Originality/Value: The expansion of biometric and morphoanatomical data of the head reinforces the hypothesis that morphologically it would be a non-human hybrid species.