Natal teeth: Case report

The natal teeth are defined as the presence of teeth at birth and the etiology is rather obscure. Clinically, the teeth show normal size and shape, although they reveal an immature appearance. The histological aspect show enamel with the possibility of presenting normal mineralization or being hypoplastic. The dentin may show alterations. The incidence of natal teeth varies greatly, with a predisposition for the female sex. This paper relates a case report of two partially erupted natal teeth in a female baby 9 days-old. The presence of teeth made the parents anxious. In their mind, that meant the child was abnormal. On the radiograph the erupted teeth showed little radioopacity, without a radicular formation. The therapy utilized was the keeping of the teeth and a periodic monitoring, cleaning and daily topical applications sodium fluoride. The case was monitored by monthly consultations. At 9 months of age the primary central lower did not present mobility. On the radiograph examination incomplete radicular formation was observed.

Natal maxillary primary molars: Case report

An unusual case of a newborn with two immature natal maxillary molars is presented. Clinical and histological examination showed that the teeth were rootless and incompletely mineralized. The patient was followed up during one year and we confirmed that the natal teeth were from normal primary series.

Restoration of severely decayed primary incisors using indirect composite resin restoration technique

Caries of primary incisors is a common problem in paediatric dentistry in some countries. The restoration of primary incisors which have been severely damaged by early childhood caries or trauma is also a difficult challenge for clinicians. This case report describes an indirect technique for the restoration of primary anterior teeth using composite resin reinforced with a fibreglass post. Over a one-year period, the crowns have demonstrated good retention and aesthetic results. The restorations were provided in two short chair-side sections, with satisfactory patient cooperation. © 2005 BSPD and IAPD.

Dentigerous cysts in primary dentition: Report of 2 cases

Dentigerous cysts are benign odontogenic cysts associated with the crowns of permanent teeth. They are usually single in occurrence and located in the mandible. The purpose of this case report was to describe the management of 2 dentigerous cysts in children. The treatments instituted were the extraction of the deciduous tooth involved followed by marsupialization in the first case and enucleation in the second one. Both treatments allowed rapid healing of the lesion and eruption of the permanent teeth without the need for orthodontic treatment.

CCL3 and CXCL12 production in vitro by dental pulp fibroblasts from permanent and deciduous teeth stimulated by Porphyromonas gingivalis LPS

Objective: The aim of this study was to compare the production of the chemokines CCL3 and CXCL12 by cultured dental pulp fibroblasts from permanent (PDPF) and deciduous (DDPF) teeth under stimulation by Porphyromonas gingivalis LPS (PgLPS). Material and Methods: Primary culture of fibroblasts from permanent (n=3) and deciduous (n=2) teeth were established using an explant technique. After the fourth passage, fibroblasts were stimulated by increasing concentrations of PgLPS (0 - 10 pg/mL) at 1, 6 and 24 h. The cells were tested for viability through MTT assay, and production of the chemokines CCL3 and CXCL12 was determined through ELISA. Comparisons among samples were performed using One-way ANOVA for MTT assay and Two-way ANOVA for ELISA results. Results: Cell viability was not affected by the antigen after 24 h of stimulation. PgLPS induced the production of CCL3 by dental pulp fibroblasts at similar levels for both permanent and deciduous pulp fibroblasts. Production of CXCL12, however, was significantly higher for PDPF than DDPF at 1 and 6 h. PgLPS, in turn, downregulated the production of CXCL12 by PDPF but not by DDPF. Conclusion: These data suggest that dental pulp fibroblasts from permanent and deciduous teeth may present a differential behavior under PgLPS stimulation.

Expanding the spectrum of PTH1R mutations in patients with primary failure of tooth eruption

Objectives: Primary failure of tooth eruption (PFE) is a rare autosomal-dominant disease characterized by severe lateral open bite as a consequence of incomplete eruption of posterior teeth. Heterozygous mutations in the parathyroid hormone 1 receptor (PTH1R) gene have been shown to cause PFE likely due to protein haploinsufficiency. To further expand on the mutational spectrum of PFE-associated mutations, we report here on the sequencing results of the PTH1R gene in 70 index PFE cases. Materials and methods: Sanger sequencing of the PTH1R coding exons and their immediate flanking intronic sequences was performed with DNA samples from 70 index PFE cases. Results: We identified a total of 30 unique variants, of which 12 were classified as pathogenic based on their deleterious consequences on PTH1R protein while 16 changes were characterized as unclassified variants with as yet unknown effects on disease pathology. The remaining two variants represent common polymorphisms. Conclusions: Our data significantly increase the number of presently known unique PFE-causing PTH1R mutations and provide a series of variants with unclear pathogenicity which will require further in vitro assaying to determine their effects on protein structure and function. Clinical relevance: Management of PTH1R-associated PFE is problematic, in particular when teeth are exposed to orthodontic force. Therefore, upon clinical suspicion of PFE, molecular DNA testing is indicated to support decision making for further treatment options. © 2013 Springer-Verlag Berlin Heidelberg.

Histopathology of the pulp of primary molars with active and arrested dentinal caries

The purpose of this study was to compare the histological appearance of the pulp of human primary molars with active and arrested lesions. The sample consisted of 36 primary molars (18 with active lesions and 18 with arrested lesions) extracted from 35 children between 5 to 9 years of age. The histological diagnosis was classified in normal pulp, transitional stage, partial pulpitis, total pulpitis and total necrosis, and then subdivided in three subgroups: treatable, untreatable and questionable. Results showed that normal pulp or transitional stage (treatable category) was diagnosed in 50% of teeth with arrested lesions, compared to 11.1% of teeth with active lesions. Partial pulpitis (questionable category) was present in 38.8% with arrested lesions compared to 22.2% with active lesions. Total pulpitis and total necrosis (untreatable category) was diagnosed in 11.2% with arrested lesions compared to 66.7% with active lesions. The observed frequencies of histological categories between both groups were statistically significant (P < 0.05). Histologically, pulp reaction under active and arrested lesions in primary molars revealed the formation of a basophilic calcio-traumatic line at the junction of the primary and reparative dentin, formation of reparative dentin and a regular odontoblastic layer in 60% of the cases. Results indicated that the type of lesion (active or arrested) is a good indicator of the histological status of the pulp.

Thermal alteration and morphological changes of sound and demineralized primary dentin after Er:YAG laser ablation

The purpose of this study was to assess the influence of Er:YAG laser pulse repetition rate on the thermal alterations occurring during laser ablation of sound and demineralized primary dentin. The morphological changes at the lased areas were examined by scanning electronic microscopy (SEM). To this end, 60 fragments of 30 sound primary molars were selected and randomly assigned to two groups (n = 30); namely A sound dentin (control) and B demineralized dentin. Each group was divided into three subgroups (n = 10) according to the employed laser frequencies: I4 Hz; II6 Hz, and III10 Hz. Specimens in group B were submitted to a pH-cycling regimen for 21 consecutive days. The irradiation was performed with a 250 mJ pulse energy in the noncontact and focused mode, in the presence of a fine water mist at 1.5 mL/min, for 15 s. The measured temperature was recorded by type K thermocouples adapted to the dentin wall relative to the pulp chamber. Three samples of each group were analyzed by SEM. The data were submitted to the nonparametric Kruskal-Wallis test and to qualitative SEM analysis. The results revealed that the temperature increase did not promote any damage to the dental structure. Data analysis demonstrated that in group A, there was a statistically significant difference among all the subgroups and the temperature rise was directly proportional to the increase in frequency. In group B, there was no difference between subgroup I and II in terms of temperature. The superficial dentin observed by SEM displayed irregularities that augmented with rising frequency, both in sound and demineralized tissues. In conclusion, temperature rise and morphological alterations are directly related to frequency increment in both demineralized and sound dentin. Microsc. Res. Tech., 2011. (c) 2011 Wiley Periodicals, Inc.

CCL3 and CXCL12 production in vitro by dental pulp fibroblasts from permanent and deciduous teeth stimulated by Porphyromonas gingivalis LPS

Objective: The aim of this study was to compare the production of the chemokines CCL3 and CXCL12 by cultured dental pulp fibroblasts from permanent (PDPF) and deciduous (DDPF) teeth under stimulation by Porphyromonas gingivalis LPS (PgLPS). Material and Methods: Primary culture of fibroblasts from permanent (n=3) and deciduous (n=2) teeth were established using an explant technique. After the fourth passage, fibroblasts were stimulated by increasing concentrations of PgLPS (0 – 10 µg/mL) at 1, 6 and 24 h. The cells were tested for viability through MTT assay, and production of the chemokines CCL3 and CXCL12 was determined through ELISA. Comparisons among samples were performed using One-way ANOVA for MTT assay and Two-way ANOVA for ELISA results. Results: Cell viability was not affected by the antigen after 24 h of stimulation. PgLPS induced the production of CCL3 by dental pulp fibroblasts at similar levels for both permanent and deciduous pulp fibroblasts. Production of CXCL12, however, was significantly higher for PDPF than DDPF at 1 and 6 h. PgLPS, in turn, downregulated the production of CXCL12 by PDPF but not by DDPF. Conclusion: These data suggest that dental pulp fibroblasts from permanent and deciduous teeth may present a differential behavior under PgLPS stimulation.

Image analysis in the morphological and morphometric study of teeth

The subject of this doctoral dissertation concerns the definition of a new methodology for the morphological and morphometric study of fossilized human teeth, and therefore strives to provide a contribution to the reconstruction of human evolutionary history that proposes to extend to the different species of hominid fossils. Standardized investigative methodologies are lacking both regarding the orientation of teeth subject to study and in the analysis that can be carried out on these teeth once they are oriented. The opportunity to standardize a primary analysis methodology is furnished by the study of certain early Neanderthal and preneanderthal molars recovered in two caves in southern Italy [Grotta Taddeo (Taddeo Cave) and Grotta del Poggio (Poggio Cave), near Marina di Camerata, Campania]. To these we can add other molars of Neanderthal and modern man of the upper Paleolithic era, specifically scanned in the paleoanthropology laboratory of the University of Arkansas (Fayetteville, Arkansas, USA), in order to increase the paleoanthropological sample data and thereby make the final results of the analyses more significant. The new analysis methodology is rendered as follows: 1. Standardization of an orientation system for primary molars (superior and inferior), starting from a scan of a sample of 30 molars belonging to modern man (15 M1 inferior and 15 M1 superior), the definition of landmarks, the comparison of various systems and the choice of a system of orientation for each of the two dental typologies. 2. The definition of an analysis procedure that considers only the first 4 millimeters of the dental crown starting from the collar: 5 sections parallel to the plane according to which the tooth has been oriented are carried out, spaced 1 millimeter between them. The intention is to determine a method that allows for the differentiation of fossilized species even in the presence of worn teeth. 3. Results and Conclusions. The new approach to the study of teeth provides a considerable quantity of information that can better be evaluated by increasing the fossil sample data. It has been demonstrated to be a valid tool in evolutionary classification that has allowed (us) to differentiate the Neanderthal sample from that of modern man. In a particular sense the molars of Grotta Taddeo, which up until this point it has not been possible to determine with exactness their species of origin, through the present research they are classified as Neanderthal.

Changes in retention force with electroplated copings on conical crowns: a comparison of gold and zirconia primary crowns

The aim of this study was to examine the wear behavior of conical crowns with electroplated gold copings that are used to connect implants and teeth to a removable denture. Gold alloy and zirconium dioxide ceramic crowns were compared.

In vitro comparison of laser fluorescence performance with visual examination for detection of occlusal caries in permanent and primary molars

The aim of this study was to compare the performance of the DIAGNOdent 2095 with visual examination for occlusal caries detection in permanent and primary molars. The sample comprised 148 permanent human molars and 179 primary human molars. The samples were measured and visually examined three times by two examiners. After measurement, the teeth were histologically prepared and assessed for caries extension. Sensitivity, specificity, accuracy and area under the receiver operating characteristics (ROC) curve were calculated. Intra-class correlation (ICC), unweighted kappa and the Bland and Altman method were used to assess inter- and intra-examiner reproducibility. DIAGNOdent showed higher specificity and lower sensitivity than did visual examination. The ICC values indicated an excellent agreement between the examinations. Kappa values varied from good to excellent for DIAGNOdent but from poor to good for visual examination. In conclusion, the DIAGNOdent may be a useful adjunct to conventional methods for occlusal caries detection.

The bonding of glass ionomer cements to caries-affected primary tooth dentin

PURPOSE The purpose of this study was to evaluate the bonding of glass ionomer cements (GICs) to sound and caries-affected dentin by microtensile bond strength (μTBS) and nanoleakage (NL) tests. METHODS Occlusal cavity preparations were made in 36 sound primary molars. Half of the specimens were submitted to a pH-cycling model to create simulated caries-affected dentin. Teeth were randomly restored with one of the three materials: (1) resin-modified GIC with nanoparticles (Ketac N100; KN); (2) resin-modified GIC (Vitremer; VI); and (3) high-viscosity GIC (Ketac Molar Easy Mix; KM). Specimens were tested using a microtensile test (1 mm/minute). One specimen from each tooth was immersed in ammoniacal silver nitrate for 24 hours and revealed after eight hours to assess interfacial NL. The μTBS means were analyzed by 2-way analysis of variance and Tukey's post hoc test. For NL, Kruskal-Wallis and Mann-Whitney tests were used (P<.05). RESULTS No difference was found between sound and caries-affected dentin (P>.05). KM showed the lowest GIC-dentin μTBS values, while VI and KN showed higher values. Infiltration of ammoniacal silver nitrate into the adhesive interface was not affected by sound or caries-affected dentin. CONCLUSION Caries-affected dentin does not jeopardize the bonding of glass ionomer cements to primary tooth dentin.

Influence of contact points on the performance of caries detection methods in approximal surfaces of primary molars: an in vivo study

This in vivo study aimed to evaluate the influence of contact points on the approximal caries detection in primary molars, by comparing the performance of the DIAGNOdent pen and visual-tactile examination after tooth separation to bitewing radiography (BW). A total of 112 children were examined and 33 children were selected. In three periods (a, b, and c), 209 approximal surfaces were examined: (a) examiner 1 performed visual-tactile examination using the Nyvad criteria (EX1); examiner 2 used DIAGNOdent pen (LF1) and took BW; (b) 1 week later, after tooth separation, examiner 1 performed the second visual-tactile examination (EX2) and examiner 2 used DIAGNOdent again (LF2); (c) after tooth exfoliation, surfaces were directly examined using DIAGNOdent (LF3). Teeth were examined by computed microtomography as a reference standard. Analyses were based on diagnostic thresholds: D1: D 0 = health, D 1 –D 4 = disease; D2: D 0 , D 1 = health, D 2 –D 4 = disease; D3: D 0 –D 2 = health, D 3 , D 4 = disease. At D1, the highest sensitivity/specificity were observed for EX1 (1.00)/LF3 (0.68), respectively. At D2, the highest sensitivity/ specificity were observed for LF3 (0.69)/BW (1.00), respectively. At D3, the highest sensitivity/specificity were observed for LF3 (0.78)/EX1, EX2 and BW (1.00). EX1 showed higher accuracy values than LF1, and EX2 showed similar values to LF2. We concluded that the visual-tactile examination showed better results in detecting sound surfaces and approximal caries lesions without tooth separation. However, the effectiveness of approximal caries lesion detection of both methods was increased by the absence of contact points. Therefore, regardless of the method of detection, orthodontic separating elastics should be used as a complementary tool for the diagnosis of approximal noncavitated lesions in primary molars.

Bacteriologic investigation of the effects of sodium hypochlorite and chlorhexidine during the endodontic treatment of teeth with apical periodontitis

SIQUEIRA JR. et al. Bacteriologic investigation of the effects of sodium hypochlorite and chlorhexidine during the endodontic treatment of teeth with apical periodontitis. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod., v. 104, n. 1, p. 122-130, 2007.