Preservation Of Teeth Research Articles

Fibro-odontome améloblastique mandibulaire chez une patiente de 3 ans

The ameloblastic fibro-odontoma (FOA) is a rare benign tumor representing 1-3% of odontogenic tumors. The FOA affects young patients before the age of 20. Surgical treatment allows usually for recovery. Recurrence and malignant transformation are possible. A 3-year-old patient, with no medical and surgical history, was referred for a painless swelling of the right cheek progressing for several months. Radiographic examination showed a large mixed lesion. Buccal and lingual cortices were blown out. Surgical resection was performed under general anesthesia. Microscopically, the lesion consisted of dental tissue composed of mature dentin and enamel and of an epithelial component. These elements allowed for the diagnosis of ameloblastic fibro-odontoma. The postoperative course was uneventful. The management of this 3-year-old patient was delayed due to late consultation. The size of the lesion, that included all dental structures of sector 4, was big considering the very young age of the patient. The primary conservative surgical treatment allowed for preservation of teeth and of the inferior alveolar nerve, the only sequelae being the removal of the germ of the tooth no44 directly involved in the tumor.

Kieferorthopädische Extrusion von frakturierten bleibenden Zähnen — ein Fallbericht

IntroductionTraumatic dental injuries (TDIs) of permanent teeth are challenging for interdisciplinary dental treatments. Emergency treatment determines long-term success. According to current guidelines the preservation of teeth and minimally invasive procedures are of major importance to keep all options open for later treatment. Restorative treatments are part of follow-up. However, they play an important role for long-term success of tooth structure and hard as well as soft tissues. There is special focus on adjunctive orthodontic or surgical therapy that improve the prognosis of prosthodontic rehabilitation.MethodThe case presentation describes the forced extrusion technique using mini screws and the restorative treatment of a fractured central incisor in the maxilla step by step.ConclusionOrthodontic extrusion is tissue friendly and in combination with skeletal anchorage a predictable and reliable treatment option.

Evaluation of Dental Caries Awareness among the Parents of School Going Children

AIM: The purpose of this study is to evaluate the awareness of parents about the dental caries among the school going children in chennai. OBJECTIVES: The objective of this study is to investigate the dental caries awareness in the different medium school children by questionnaire method. BACKGROUND: The dental caries is one of the most common infectious diseases all over the world. Overall dental caries is more severe in the baby teeth of 4-11 years children than the permanent tooth. However, an active effort of the school authority and dental health care team can make a awareness program more effective and also make a parents more aware about the dental caries prevention and milk tooth preservation. MATERIALS AND METHODS: Total 80 parents from different socioeconomic groups participated in the study. Data were collected using a self-administered questionnaire addressing various aspects of knowledge and attitude of parents toward oral health and treatment modalities Awareness among parents was significantly lower in low socioeconomic group. Their attitude toward dental treatment differed significantly in high socioeconomic group preferred going to the pediatric dentist. CONCLUSION: The level of awareness among parents is relatively low and there is need for the implementation of oral health awareness programs for parents to change their attitude toward dental treatment of their children

Preservation of the Fractured Natural Tooth by Reattachment with Fiber Post: Two Case Reports

Preservation of the Fractured Natural Tooth by Reattachment with Fiber Post: Two Case Reports

Endodontie im Kindes- und Jugendalter — Grenzen der Zahnerhaltung

BackgroundThe limitations of endodontic procedures in childhood and adolescence arise from general and special aspects at this age. The preservation of primary teeth during the pre-school age could be challenging due to the facts that these procedures are usually compliance related procedures and due to the dental physiological changes happening during the early mixed dentition phase, in the late mixed dentition stage and after the full development of dentition some technical (local) problems start to manifest especially in nonvital permanent teeth with incompletely formed roots.RecommendationIn particular cases the clinical indications along with individual tooth situations should be balanced, whether or not the endodontic procedure is reasonable in terms of cost-effect and associated risks for the patient. Some considerations should be taken during treatment planning; primary teeth should have a transitional character type of treatment, as for permanent teeth a long term prognosis should be taken in account. At selected clinical examples such limitations should be identified.

Patients' Values Related to Treatment Options for Teeth with Apical Periodontitis

IntroductionThis study aimed to explore patients' values when selecting treatment for a tooth with apical periodontitis (AP), namely retention via root canal treatment (RCT) and extraction without replacement or replacement with implant-supported crowns or fixed or removable partial prostheses. MethodsThrough 2 surveys of patients (800 university patients and 200 community patients, response rate = 43%) and dentists (498 Ontario endodontists, periodontists, prosthodontists, oral and maxillofacial surgeons, response rate = 40% and 1983 Ontario general dentists, response rate = 15%), the importance of values that might be considered important to patients when selecting treatment options for a tooth with AP were recorded. Chi-square and Kendall's tau tests were used to respectively compare the importance rating frequency by each surveyed group and its correlation to their demographic variables (P ≤ .05). ResultsPatients considered communication and trust (94%), tooth retention (90%), esthetic outcome (84% regardless of location), cost (83%), longevity (83%), and preoperative pain (81%) as the most important decision values. Dentists overrated the importance of patients' previous experience with the treatment options (94% vs 72%), dental insurance (90% vs 70%), and intraoperative pain (79% vs 60%) while underestimating the importance of maintenance cost (60% vs 79%). ConclusionsDentists should respect patients' views about esthetic outcome, longevity, and cost associated with treatment options for a tooth with AP. In particular, this survey highlights the value of communication and trust between patient and dentist and preservation of the natural tooth through RCT over implant-supported crown replacement when planning treatment for a tooth with AP.

Gorlin-Goltz Syndrome: Conservative Treatment of Keratocystic Odontogenic Tumors, Frequent First Clinical Manifestation in Pediatric Age

Objective: Gorlin-Goltz Syndrome, also known as Nevoid Basal Cell Carcinoma Syndrome, is a rare genetic condition resulting from mutations of the PTCH1 (9q22.3) gene. It involves multiple organs, such as the skin, skeleton and jaws. Aim of this study was to describe Keratocystic Odontogenic Tumors as frequent first clinical manifestation of NBCCS during pediatric age, and theirs conservative treatment, that is really important, especially among young patients. Methods: We report on 20 pediatric patients affected by Gorlin-Goltz Syndrome, presenting totally 60 Keratocystic Odontogenic Tumors. Patients underwent conservative lesion enucleation with maximal permanent teeth preservation. The ostectomy and osteoplasty were made with both conventional rotative instruments and piezoelectric tools, in order to remove damaged bone, epithelial remnants and satellite cysts, and to possibly minimize the recurrence risk. All surgical samples were subjected to histopathological examination and the patients were followed-up for a minimum of 18 months. Results: Overall, 60 Keratocystic Odontogenic Tumors were removed (8 patients with single and the remaining with multiple cysts) with healing of all the surgical wounds without complications. Nevertheless, recurrence of 5 lesions (8.3%) from 3 patients occurred: all of them were >5 cm in maximum diameter and associated with permanent teeth. Conclusion: Keratocystic Odontogenic Tumors in pediatric patients require conservative approaches for permanent teeth preservation. While conventional enucleation leads up to 60% recurrence rates, cavity ostectomy with piezoelectric tools significantly reduced the recurrence risk and allowed preservation of permanent teeth.

Antimicrobial Efficacy of Contemporary Obturating Materials used in Primary Teeth- An In-vitro Study.

Preservation of primary tooth with non-vital pulp has been a major problem for pediatric dentist. In such cases, the preferred treatment modality is pulpectomy. The objective of pulpectomy is complete removal of necrotic and irreversibly infected pulp of an affected tooth but, in spite of chemomechanical preparation and copious irrigation of canal, there are chances of failure of pulp therapy due to the entrapped micro organisms in the canal space owing to the tortuous and complex nature of the root canal system and change in their morphology with root resorption. Thus, for optimal success of endodontic treatment, obturating material with antimicrobial properties is advocated in deciduous teeth. The aim of the study was to assess the antimicrobial efficacy of different obturating materials used in pediatric dentistry. In the present study, antimicrobial efficacy of endoflas, Zinc Oxide Eugenol (ZOE), calcium hydroxide with chlorhexidine, calcium hydroxide with iodoform and distilled water, metapex and saline as control were assessed and compared with each other. The antimicrobial efficacy of obturating materials was evaluated against E. faecalis (ATCC 29212) by agar diffusion method. The statistical analysis was done using SPSS Version 15.0. The Analysis of Variance (ANOVA) and Post-Hoc Tests (Tukey-HSD) were performed to reveal the statistical significance. Intergroup comparison at 24 hours (Tukey's test) revealed significant difference amongst all the groups. Endoflas had significantly higher zone of inhibition as compared to all the other groups except group treated with ZOE (p-value <0.001). The antimicrobial activity of obturating materials according to results obtained from the present study can be summarized as follows: Endoflas > ZOE >Calcium hydroxide + Chlorhexidine > Calcium hydroxide + Iodoform +Distilled water ~ Metapex > Saline.

Oral Health Determinants and Demographic Factors of Permanent Tooth Extraction in Iranian Adults

Preservation of teeth until old ages indicates oral health status. Improving life expectancy in developing countries makes teeth care an important topic. This study assessed reasons of tooth extraction (TE), oral health determinants and demographic factors of permanent TE in Iranian adults. Adult people who referred to dental clinic of Mashhad Medical University in 2012 for dental extraction and lived in Mashhad city, participated in this study by convenient sampling method after obtaining informed consent. Demographic characteristics, oral health status, health habit and reasons of TE of participants were assessed. Data were analyzed by SPSS11.5 by Chi-Square, T-Test, ANOVA, Mann-Whitney and Kruskall-Wallis tests. Totally 254 people participated (383 extracted teeth) that 55% were female. Mean age of participants was 39.3 years; females were 6.1 years younger than males. The main reason of TE was dental caries (55.1%), following by impaction. There was significant difference between average times of tooth brushing in both sexes, but difference was not shown in sugar intake. Except in people with college degrees that dental caries is the main cause of TE. With increase in life expectancy to more than 70 years old in Iranian, the age of TE especially in women is younger than expected. The most common cause of TE is dental caries that seem in spite of improving health indexes in Iran, poor oral hygiene remains as a problem. There is no significant difference between frequency of sugar intake and level of education that indicates unhealthy dietary habits related to tooth decay.

Hemisection: A conservative approach of tooth preservation

Progressive inflammatory periodontal disease, if left untreated, it will ultimately result in attachment loss. This can affect the bifurcation or trifurcation of multirooted teeth. Dentists are challenged to save those teeth that earlier would have been extracted without a second thought to save it. Hence, resective therapy has been utilized in the treatment of furcation defects. Hemisection is a removal of compromised root and the associated crown portion. It is one of the treatment options for preserving remaining part of molar having sound periodontium. This case report presents a patient in whom distal half of the carious and periodontally compromised tooth was resected, and after healing, fixed dental prosthesis was given to restore proper form and function.

An alternate method for extracting DNA from environmentally challenged teeth for improved DNA analysis.

A grinding-free method to extract DNA from teeth via a direct minimal-invasive retrograde approach to the pulp cavity and dentine was compared to a standard grinding/pulverisation method. This alternate method uses endodontic dental files to access the root canals and pulp cavity for tissue and dentine harvest via the apical end of the roots and avoids mechanical damage to the crown and root morphology. In contrast, other methods require pulverisation of the whole root or tooth, transection or destruction of the occlusal surface to gain access to the DNA in the root canals and pulp chamber. This study compared two methods for preparing dentine powder from the roots of environmentally challenged teeth for forensic DNA analysis. We found that although the filing method was more laborious, and produced less dentine powder, the amount of amplifiable DNA per milligram of powder was substantially higher with the filing method compared to grinding the entire root. In addition, the number of short tandem repeat (STR) alleles detected and the peak height ratios of the STR profiles were notably higher. Although several other methods of extracting DNA-rich tissue from the pulp chamber of teeth have previously been reported, the method presented in this study is minimally invasive, thereby allowing the preservation of tooth and crown morphology.

Occlusal rehabilitation in patients with congenitally missing teeth-dental implants, conventional prosthetics, tooth autotransplants, and preservation of deciduous teeth-a systematic review.

BackgroundImplant patients with congenitally missing teeth share some common charateristics and deserve special attention.MethodsThe PICO question was “In patients with congenitally missing teeth, does an early occlusal rehabilitation with dental implants in comparison to tooth autotransplants, conventional prosthetics on teeth or preservation of deciduous teeth have better general outcomes in terms of survival, success and better patient centered outcomes in terms of quality of life, self-esteem, satisfaction, chewing function?”After electronic database search, a total of 63 relevant studies were eligible, of which 42 qualified for numerical data synthesis, 26 being retrospective studies. A data synthesis was performed by weighted means for survival/success/annual failure rates.ResultsThe mean survival of implants was 95.3 % (prosthesis survival 97.8 %), autotransplants 94.4 %, deciduous teeth 89.6 %, and conventional prostheses 60.2 %. The implant survival in children, adolescents, and adults was 72.4, 93.0, and 97.4 %. Annual failure rates of implants 3.317 %, autotransplants 1.061 %, deciduous teeth 0.908 %, and conventional prostheses 5.144 % indicated better results for natural teeth and more maintenance needs for the both prosthetic treatments. The mean OHIP score was 27.8 at baseline and a mean improvement of 14.9 score points was reported after implant prosthetics. The mean satisfaction rates were 93.4 (implants), 76.6 (conventional prostheses), 72.0 (autotransplants), and 65.5 % (orthodontic space closure).ConclusionsIn synopsis of general and patient-centered outcomes, implants yielded the best results, however, not in children <13 years. Autotransplants and deciduous teeth had low annual failure rates and are appropriate treatments in children and adolescents at low costs. Conventional prosthetics had lower survival/success rates than the other options. Due to heterogeneity and low number of studies, patient-reported outcomes in this review have to be interpreted with caution.

Crown Preservation of the Mandibular First Molar Tooth Impacts the Strength and Stiffness of Three Non-Invasive Jaw Fracture Repair Constructs in Dogs.

Repairing mandibular body fractures presents unique challenges not encountered when repairing long bones. Large tooth roots and the presence of the inferior alveolar neurovascular bundle limit safe placement for many types of orthopedic implants. Use of non-invasive fracture repair methods have increasingly become popular and have proven safe and effective at achieving bone healing. Non-invasive fixation constructs have not been tested in dogs using cantilevered bending. Furthermore, non-invasive fracture repair constructs have not been tested at the location of a common fracture location – the mandibular first molar tooth (M1). The objectives of this study were to test the strength and stiffness of three non-invasive mandibular fracture repair constructs and to characterize the impact that tooth crown preservation has on fixation strength for fractures occurring at the M1 location. Specimens were assigned to three treatment groups: (1) composite only, (2) interdental wiring and composite (IWC), and (3) transmucosal fixation screw and composite. For each pair of mandibles, one mandible received crown amputation at the alveolar margin to simulate the effect of crown loss on fixation strength and stiffness. Regardless of the status of crown presence, IWC demonstrated the greatest bending stiffness and load to failure. With the crown removed, IWC was significantly stronger compared to other treatments. All fixation constructs were stiffer when the tooth crown was preserved. In fractures at this location, retaining the tooth crown of M1 significantly increases stiffness of interdental wiring with composite and transmucosal screw with composite constructs. If the crown of M1 was removed, IWC was significantly stronger than the other two forms of fixation.

Antimicrobial Activity of Two Root Canal Filling Pastes in Deciduous Teeth: an in Vitro Study

&lt;p&gt;Endodontic treatment in deciduous teeth is very important so that we can preserve the primary dentition and thus promote appropriate craniofacial development. However, the use of filling pastes that have some important biological properties for the preservation of the tooth is required. The objective this study was to evaluate the in vitro antimicrobial activity of two root canal filling pastes in deciduous teeth, Vitapex® and Calcipex®, on microbial species commonly found in endodontic infections (Candida albicans, Enterococcus faecalis, Streptococcus mutans, Streptococcus sanguinis, Escherichia coli and Staphylococcus aureus), using the agar diffusion test. The experiment was carried out on BHI (Brain Heart Infusion) plates in four equidistant points, which were immediately filled with the sealers Vitapex® and Calcipex®. The&lt;br /&gt;chlorhexidine gluconate 1% (CHX) and distilled water were used as positive and negative controls, respectively. After incubation of plates at 37 °C for 24 h, the diameter of the growth inhibition zones around the wells was measured (in millimeters) with a digital caliper with reflected light. The test was performed in triplicate and data were submitted to ANOVA and Tukey’s test (α = 0.05). Both pastes had antimicrobial activity, but Calcipex® was more efficient for most strains. The halo formed in the experiments with S. mutans and S. sanguinis was similar for both pastes. This study suggests that Calcipex® had the highest antimicrobial property with respect to the microorganisms studied.&lt;/p&gt;

Retrospective Study of the Characteristics and Treatment of Odontomas

This study was aimed to retrospectively evaluate the clinical findings and treatments of odontomas in the Korean demographic group. The subject of the present study included 75 odontomas in 74 patients who received treatment from Chonbuk National University Dental Hospital between April 2005 and March 2014. The average age of the subjects were 10.3 years old (range 3 - 23 years old). 42 (56.8%) males and 32 (43.2%) females were in the present study. It was found that compound odontomas were about 4 times more common than complex odontomas. Odontomas equally occurred in both maxillary and mandible. The impaction of permanent teeth (73.3%) was the most common complication of odontomas on adjacent teeth. Most odontomas (96.0%) were surgically removed either to induce spontaneous eruption or to guide orthodontically to occlusion. When the impacted tooth could not be naturally or forcefully erupted to occlusion, it was extracted. Early detection and treatment of odontomas would increase the possible preservation of the impacted tooth by eliminating the source of disturbance. Therefore, this study recommends that periodic radiographic examination from birth until the eruption of the permanent third molar to prevent possible hindrance to the teeth eruption.

BRIEF OVERVIEW OF XEROSTOMIA PROBLEM

The saliva is indispensable for preservation of healthy mouth and teeth, due to its composition and physical and chemical properties. Saliva preserves the teeth and favors their remineralization for account of afflux of irreplaceable minerals: calcium and phosphor. Due to contents of such epidermal growth factor it participates in tissue repair. The saliva contains the antibacterial, antiviral and antifungal drug resistance factors, suppressing the bacterial colonization of teeth and mucosa. Dry mouth (xerostomia) results in development of stomatitis, periodontitis effects, increases a risk of infectious lesions of oral mucosa. The severest forms of such pathology (Degrees II–III) are observed in the patients administered of X-ray therapy on head and neck area and in case of Sjogren’s syndrome, when the irreversible degenerative changes develop in эпителии salivary glands epithelium. Etiology and pathogenesis of xerostomia are not exhaustively studied yet, and treatment of such complex pathology is still symptomatic.

The fight against malnutrition in older adults: new aproaches in dentistry

A minimal oral treatment aiming a clean and comfortable mouth could be very helpful in malnutrition control of dependent elderly persons. In such a case, it is necessary and generally it is enough to perform dental scaling and/or extractions with anxiolytic premedication (oral or rectal diazepam). Most of times, such minimal dental care can be performed at bedside, avoiding patient's stress and displacement to a dental surgery. The nursing staff can reassure the residents and their families on the absence of dentures, because saliva would be even more important than teeth. Actually, there is a tight relation between oral health, saliva, drugs, food texture and nutritional state of person. The notion of saliva includes two important criteria: 1) saliva-bacteria in the saliva, 2) fluid saliva-oral biofilm covering mucous membranes. All factors which change saliva secretion or inhibit oral bacteria community may lead to malnutrition. Several studies performed in hospital geriatric wards and in retirement homes allowed us to identify the following iatrogenic causes for malnutrition: 1) inappropriate preservation of teeth or dentures which may lead to oral reservoir (Candida albicans yeast-hyphal transition, antibiotic resistance genes transfer); 2) excessive uses of antiseptic mouthwashes for oral hygiene (leading to oral biofilm inhibition which is a cause of xerostomia); 3) drugs crushed in food (alteration of food taste and alteration of the oral biofilm); 4) exclusive recourse to a soft or mixed texture of food (alternative solutions exist, such as texture-adapted protein rich cookies). All these iatrogenic practices raise the possibility of formation of thick microbial communities in the mouth. This would explain why, despite attentive oral care, most of nurses and nurse's aides feel that in retirement homes the oral hygiene of the many residents is insufficient.

Caries Management – Science and Clinical Practice

A comprehensive approach to modern caries management This systematic approach to modern caries management combines new, evidence-based treatment techniques with the scientific underpinnings of caries formation, providing an in-depth review for both clinicians in daily practice and students advancing in the field. Beginning with patho-anatomic changes in the dental hard tissues, Dental Caries: Science and Clinical Practice goes on to cover non-invasive, minimally invasive, and more aggressive interventions based on each stage of the disease. From microbiology and histology to visual, tactile and radiographic diagnosis, risk assessment, preventive measures, and tooth preservation and treatment strategies, the book is packed with valuable clinical information for all dental practitioners. Key Features: * Succinctly covers the science behind the disease, with recommendations for treatments based on assessment starting at the microscopic level * Written by a team of leading worldwide authorities on caries treatment and management-and utilizing the International Caries Detection and Assessment System (ICDAS) standard throughout* Covers the newest treatment techniques, including adhesion technology, fissure sealing and infiltration, caries removal, tooth-colored restorations, and more * Demonstrates step-by-step caries procedures in striking, full-color illustrations of adult and pediatric cases * Offers the newest thinking on early prevention and behavioral changes in oral health promotion, including the role of diet and nutrition, biofilm management, fluoride use, population-based approaches, and more Shifting to the new paradigm of heal and seal rather than the more invasive drill and fill, this beautifully illustrated text puts scientific principles into clinical action for the best results. It is an essential resource for a complete, proactive approach to caries detection, assessment, treatment, management, and prevention in contemporary dental practice.

Dental Avulsion: Are the Dentist Prepared to the Correct Management?

Purpose: This study evaluated the knowledge of dentists from the health units (HU) of Porto Alegre - Brazil, regarding the management of avulsion of permanent teeth. Methods: A questionnaire regarding treatment and preservation of avulsed teeth was utilized. Professional data were also collected. Results: The response rate was 56.41%. The mean performance rate of the dentists regarding the clinical questions was 69.3%, but 37.4% had poor performance (less than 70% correct). The greatest number of hits was where the patient comes with the already replanted teeth (89.2%); 87.3% agreed in situations where the injured child reaches two hours of trauma with the tooth in a liquid medium, however in cases that period of trauma was more than two hours and tooth was dehydrated, the professionals performance was reduced (64.9%). There was a lack of knowledge about the use of intracanal medication (error rate of 56.9%); 41% are mistaken about the period to start endodontics procedures; 32.8% did the wrong about contention of avulsed teeth and clinical and radiographs follow-up. Dentists with postgraduate performed better than those without (p = 0.011). Professionals with longer time elapsed since graduation had lower performance, as well as those who reported not being satisfied with their knowledge of dental trauma (p<0.05). Conclusions: A limited knowledge of dentists from HUs of Brazil regarding the management of avulsed teeth was found. The lack in knowledge suggests the need for implementation of continuing education programs and simulation programs on approaches to dental traumas to improve dental care offered for the population.

Management of root resorption in maxillary first molar-radectomy

Preservation of tooth is one of the major goals of an Endodontist. This goal can be acquired either by non surgical or surgical approach. Root resection is one of the surgical approaches for preservation of molars with furcation involvement. This procedure results in a unique environment which is dictated by the contours of the remaining roots and the residual furcation between them. Root resorption is a viable treatment option to salvage and retain a part of multirootedteeth. This case report illustrates prognosis of root resection after completion of endodontic therapy for managing a case of root resorption. This case shows external root resorption of the distobuccal root of right maxillary first molar. Due to strategic value of maxillary first molar, it was decided to employ root resection. After completion of endodontic therapy root resection was carried out. After 6 months, the absence of periradicular radiolucent lesions, periodontal pocket, pain, and swelling indicated a successful outcome of root resection. Keywords: Endodontist, Multirooted teeth, Periradicular, Distobuccal, Resorption