Analysis of the crown fractures and crown-root fractures due to dental trauma assisted by the Integrated Clinic from 1992 to 2002

The purpose of this study was to analyze crown fractures and crown-root fractures due to dentoalveolar trauma, treated in the Integrated Clinic comprehensive dental care at Aracatuba School of Dentistry (UNESP), from January 1992 to July 2002. The data were obtained from files of trauma cases. on the analysis period, 293 patients had crown fractures or crown-root fractures, in 605 teeth. Sixty-nine percent were males and 31% were females. Adolescents between 11 and 18 years old were the most prevalent group (41.6%) and the maxillary arch was the most commonly traumatized (83%). The most commonly affected tooth was the maxillary central incisor (58.3%). The most frequent causes were falls from bicycles (30.8%). It was concluded that the reality of the local service is similar to the published data.

Spectroscopic study of ejected dental tissue after Er : YAG laser ablation

By means of IR spectroscopy, we determined the teeth ablation mechanism by an Er:YAG laser oscillating at 2.94 mum. Ejected dental material, ablated by the laser from human teeth, was deposited on an IR window and the absorption spectra were measured in the range 2500-20,000 nm. Sound teeth were used, and the corresponding film spectra were compared to spectra obtained by traditional methods. The films spectra obtained do not differ appreciably from those obtained by the traditional method for sound teeth, indicating that the material ejected by an Er:YAG represents the tooth condition.The obtained results confirm that a spectroscopic analysis of a tooth treated with an Er:YAG laser can be done measuring the absorbance of a film composed of ejected material without the need to slice it. In addition, we could determine that the laser absorption occurs mainly by the interstitial water, and the temperature elevation of the ejected material does not exceed 60degreesC. (C) 2002 Elsevier B.V. B.V. All rights reserved.

A new locus for autosomal dominant amelogenesis imperfecta on chromosome 8q24.3

Amelogenesis imperfecta (AI) is a collective term used to describe phenotypically diverse forms of defective tooth enamel development. AI has been reported to exhibit a variety of inheritance patterns, and several loci have been identified that are associated with AI. We have performed a genome-wide scan in a large Brazilian family segregating an autosomal dominant form of AI and mapped a novel locus to 8q24.3. A maximum multipoint LOD score of 7.5 was obtained at marker D8S2334 (146,101,309 bp). The disease locus lies in a 1.9 cM (2.1 Mb) region according to the Rutgers Combined Linkage-Physical map, between a VNTR marker (at 143,988,705 bp) and the telomere (146,274,826 bp). Ten candidate genes were identified based on gene ontology and microarray-facilitated gene selection using the expression of murine orthologues in dental tissue, and examined for the presence of a mutation. However, no causative mutation was identified.

Different methods of finishing and polishing enamel

Statement of problem. Highly polished enamel surfaces arc recommended for axial tooth surfaces that will serve as guiding planes and be contacted by component parts of a removable partial denture. There is little evidence to support the assumption that this tooth modification will provide accurate adaptation of the framework and prevent build-up of plaque.Purpose. The aim of this investigation was to evaluate the surface roughness of the tooth enamel, prepared to serve as guiding planes, with different polishing systems.Material and methods. Four different methods (designated A, B, C, and D) for finishing and polishing the prepared enamel surfaces of 20 freshly extracted third molar teeth were studied. Each method involved 3, 4, or 5 different steps. The roughness of each specimen was measured at the start of each method before recontouring, after recontouring, and after each step of the 4 finishing and polishing procedures. The 4 experimental finishing methods were applied after recontouring the axial surfaces (buccal, lingual, and proxinial) of each tooth. Thus the 20 teeth (60 surfaces) were finished and polished by use of 1 of the experimental methods. Surface roughness was measured with a profilometer (mum); the readings of the unpolished enamel Surfaces were recorded as control measurements. Results were statistically analyzed with one-way analysis of variance followed by Tukey's test at the 95% level of confidence.Results. The highest roughness mean values (14.41 mum to 16.44 mum) were found when the diamond bur was used at a high speed for tooth preparation. A significant decrease in roughness values was observed with the diamond bur at a low speed (P<.05). Analysis of the roughness values revealed that all polishing methods produced surface roughness similar to that of the corresponding control teeth.Conclusion. Within the limitations of this study, all finishing procedures tested effectively promoted an enamel surface similar to the original unpolished enamel.

Effect of Cervitec (R) on mutans streptococci in plaque and on caries formation on occlusal fissures of erupting permanent molars

The aim of this study was to evaluate the effect of Cervitec(R) on the abundance of mutans streptococci (MS) in occlusal dental plaque and on 2-year caries increment of partly erupting first permanent molars. Sixteen healthy schoolchildren aged 6-8 years, with at least 2 sound contralateral partly erupted permanent molars, received diet counselling and daily parental supervised toothbrushing with a fluoride dentifrice. Stimulated saliva samples were collected at baseline and after 1 year to evaluate MS levels. In a split-mouth design, Cervitec varnish was applied to one of the teeth at baseline and after 3 and 6 months, while the other tooth in the same jaw was a control. At the 9-month follow-up the teeth were in occlusal contact. At this time, varnish was not applied. At 3 and 6 months after the first application of varnish a significant suppression of MS was observed in plaque. Caries investigations, performed at baseline and every 3 months during the 2 years after the start of the study, showed that all the teeth treated with the varnish were free of caries after 2 years, whereas 8/16 control teeth developed incipient caries. In conclusion, our results suggest that treatment with Cervitec reduces MS in plaque on erupting permanent molars and can lead to a significant decrease in caries incidence. Copyright (C) 2002 S. Karger AG, Basel.

Pulpal temperature increases with Er : YAG laser and high-speed handpieces

Statement of problem. During tooth preparation, both high-speed handpieces and lasers generate heat, which, if not controlled, can cause pulpal necrosis.Purpose. The aim of this study was to compare temperature increases produced by a high-speed dental handpiece with those produced by a relatively new instrument, the Er:YAG (erbium: yttrium-aluminum-garnet) laser.Material and methods. Thirty bovine mandibular incisors were reduced to an enamel/dentin thickness of 2.5 mm. Class V preparations were completed to a depth of 2.0 mm, measured with a caliper or by a mark oil the burs. A thermocouple was placed inside the pulp chamber to determine temperature increases (degreesC). Analysis was performed on the following groups (n = 10): Group 1, high-speed handpiece without water cooling, Group 11, high-speed handpiece with water cooling (30 mL/min), and Group III, the noncontact Er:YAG laser (2.94 mum at 350 mJ/10 Hz) with water cooling (4.5 mL/min). The temperature increases were recorded by a computer linked to the thermocouples. The data were analyzed using the Kruskal-Wallis test. The Dunn multiple comparison test was used as post hoc test (alpha = .05).Results. The average temperature rises were: 11.64degreesC (+/-4.35) for Group 1, 0.96degreesC (+/-0.71) for Group 11, and 2.69degreesC (+/-1.12) for Group III. There were no statistical differences between Groups 11 and III, both 11 and III differed from Group I significantly (P = .000 and P = .002, respectively).Conclusion. The preparations made with the high-speed and the laser instrument generated similar heat increases under water cooling. Water cooling was essential to avoid destructive temperature increases when using both the high-speed handpiece and laser.

Anatomoradiographic description of the teeth of pacas bred in captivity (Agouti paca, Linnaeus, 1766)

Two newborn males, two adult males 9 and 72 months old, one newborn female and two adult females of 30 and 54 months old pacas were used. Animals were radiographed on lateral recumbency, teeth were extracted and the vestibulolingual and mesiodistal lengths were achieved at the occlusal surface, besides the longitudinal length. The lower incisors presented greater length in relation to the other ones and sinuous shape; the upper incisors, relatively smaller, are practically straight. There is no canine tooth, and after a great diastema there is one premolar and three molars in each hemiarcade. In adult pacas, the enamel of incisors presents yellowish colour, mainly in the labial surface; in the premolars and molars, the enamel is present as internal sheets disposed nearly in a parallel way and in vestibulolingual direction, through practically all the dental length, which provides several joined teeth aspect.

Treatment of traumatized primary teeth: A conservative approach

This retrospective study examined some different types of treatment to primary teeth. The aim of this study was to assess the treatment of traumatized primary teeth and the importance of a long-term follow up. Brazilian children in the age group of 1-4 years from a baby clinic took part in the study. Three hundred and fifteen patients suffered some type of traumatic injury, a total of 338 affected teeth. Data were registered in specific records and submitted to statistic analysis. The most prevalent type of treatment was monitor only (85%) followed by tooth extraction and endodontic procedure. Invasive treatments were performed in case of severe traumas, usually 6 months after the injury. We verified that a careful follow up might be the preferential choice to the treatment of traumatic primary teeth even in some severe cases.

Correlation between maxillary central incisor form and face form in 4 racial groups

Objectives: the purpose of this study was to evaluate the correlation between central incisor form and face form in 4 racial groups and to investigate if there was agreement among experts in categorizing the central incisor forms. Method and Materials: A total of 160 subjects (40 whites, 40 mulattos, 40 blacks, and 40 Asians) ranging from 18 to 33 years of age were selected. Digital photographic records were made, 1 full-face and 1 intraoral view of the maxillary right central incisor. The outline tracings of the tooth and face images were obtained using Adobe Photoshop 5.0 software. The outline tracings were printed in distinct transparencies, and 3 prosthodontists determined if there was correspondence between the tooth and the face forms by superimposition of the transparencies. If there was disagreement among the prosthodontists' evaluations, the prevalent decision was considered. The experts also classified the central incisor forms into square, ovoid, tapering, or combination at 2 different sessions. At the first session, no instructions were given. At the second session, the prosthodontists were instructed to follow Williams' method of classification. Results: A correspondence between tooth and face forms was found in 23.75% of all cases. Agreement on the tooth form classifications among the prosthodontists occurred in 30.62% of all cases at the first session and 24.37% at the second session. Conclusion: There is not a highly defined correlation between central incisor form and face form in any racial group studied. In addition, the experts were not in fair agreement in categorizing tooth forms.

Apoptotic bone cells may be engulfed by osteoclasts during alveolar bone resorption in young rats

The alveolar bone is a suitable in vivo physiological model for the study of apoptosis and interactions of bone cells because it undergoes continuous, rapid and intense resorption/remodelling, during a long period of time, to accommodate the growing tooth germs. The intensity of alveolar bone resorption greatly enhances the chances of observing images of the extremely rapid events of apoptosis of bone cells and also of images of interactions between osteoclasts and osteocytes/osteoblasts/bone lining cells. To find such images, we have therefore examined the alveolar bone of young rats using light microscopy, the TUNEL method for apoptosis, and electron microscopy. Fragments of alveolar bone from young rats were fixed in Bouin and formaldehyde for morphology and for the TUNEL method. Glutaraldehyde-formaldehyde fixed specimens were processed for transmission electron microscopy. Results showed TUNEL positive round/ovoid structures on the bone surface and inside osteocytic lacunae. These structures - also stained by hematoxylin - were therefore interpreted, respectively, as osteoblasts/lining cells and osteocytes undergoing apoptosis. Osteoclasts also exhibited TUNEL positive apoptotic bodies inside large vacuoles; the nuclei of osteoclasts, however, were always TUNEL negative. Ultrathin sections revealed typical apoptotic images - round/ovoid bodies with dense crescent-like chromatin - on the bone surface, corresponding therefore to apoptotic osteoblasts/lining cells. Osteocytes also showed images compatible with apoptosis. Large osteoclast vacuoles often contained fragmented cellular material. Our results provide further support for the idea that osteoclasts internalize dying bone cells; we were however, unable to find images of osteoclasts in apoptosis. (C) 2001 Harcourt Publishers Ltd.

Microleakage of hydrophilic adhesive systems in Class V composite restorations

Purpose: To investigate the microleakage of four hydrophilic adhesive systems: one multiple-bottles (Scotchbond Multi-Purpose Plus); two one-bottle (Single Bond, Stae); and one self-etching (Etch & Prime 3.0). Materials and Methods: 120 bovine incisor teeth were divided into four groups (n = 30) and Class V cavities were prepared at the cemento-enamel junction. The cavities were restored with the adhesive systems and with Z100 composite. The teeth were thermocycled 1,000 times between 5 +/- 2 degreesC and 55 +/- 2 degreesC with a dwell time of 1 min, and then placed in a 2% methylene blue dye (pH 7.0) for 4 hrs, washed and sectioned vertically through the center of the restorations. The qualitative evaluation was made by three examiners who distributed pre-established scores (0-4) for each tooth using a stereomicroscope at x30 magnification. Results: In enamel margins little microleakage was observed and the Kruskal-Wallis analysis did not show differences. In dentin margins the KruskaI-Wallis and multiple comparison analyses were applied: microleakage was significantly greater with Stae (median 3) and Scotchbond MP Plus (median 4). Single Bond (median 1) and Etch & Prime 3.0 (median 2) showed the best results in dentin margins, and the statistical analysis did not demonstrate differences in microleakage among these groups.

Stress analysis of an upper central incisor restored with different posts

The effect of different anatomic shapes and materials of posts in the stress distribution on an endodontically treated incisor was evaluated in this work. This study compared three post shapes (tapered, cylindrical and two-stage cylindrical) made of three different materials (stainless steel, titanium and carbon fibre on Bisphenol A-Glycidyl Methacrylate (Bis-GMA) matrix). Two-dimensional stress analysis was performed using the Finite Element Method. A static load of 100N was applied at 45degrees inclination with respect to the incisor's edge. The stress concentrations did not significantly affect the region adjacent to the alveolar bone crest at the palatine portion of the tooth, regardless of the post shape or material. However, stress concentrations on the post/dentin interface on the palatine side of the tooth root presented significant variations for different post shapes and materials. Post shapes had relatively small impact on the stress concentrations while post materials introduced higher variations on them. Stainless steel posts presented the highest level of stress concentration, followed by titanium and carbon/Bis-GMA posts.

Influence of Orthodontic Dental Movement on the Healing Process of Teeth With Periapical Lesions

The purpose of this study was to histomorphologically evaluate (in dog's teeth) the influence of tooth movement in the healing of chronic periapical lesions. Thirty roots of incisors and premolars of two dogs (1-year-old) were used in this research. After pulpectomy, the root canals remained exposed to the oral environment for 6 months for achievement of periapical lesions. Twenty root canals were biomechanically prepared and received a calcium hydroxide dressing for 14 days before being filled with gutta-percha points and Sealapex sealer. After root canal treatment, some incisors were submitted to orthodontic movement, whereas the other roots remained without orthodontic movement. The orthodontic appliance was removed at 5 months and 15 days after treatment, the dogs were killed 15 days later and the specimens were prepared for histomorphological analysis. The results showed that the orthodontic movement delayed, but did not hinder, the periapical healing process. (J Endod 2006;32:115-119)

Topographical, diametral, and quantitative analysis of dentin tubules in the root canals of human and bovine teeth

The aim of this study was to evaluate the number and the diameter of dentin tubules in root canals, in the cervical, middle, and apical thirds, of human and bovine teeth. Twenty-four single-rooted, human premolars were divided into four groups (n = 6): GH1, 10 to 15 years; GH2, 16 to 30 years; GH3, 31 to 45 years; and GH4, 46 to 80 years; and 24 bovine incisors were divided into four groups (n = 6): GB1, central; GB2, lateral first; GB3, lateral second; and GB4, lateral third. The crowns were removed from the specimens, which were then debrided, sectioned longitudinally in the vestibular-lingual direction, and submitted to ultrasonic cleaning. Scanning electron microscopic evaluations were made with 1,000x and 5,000x magnification. According to the root thirds, statistically significant differences were found both for the number and the diameter of dentin tubules, with the cervical third presenting the highest mean values for both specimen types. As regards the number of dentin tubules, it was observed that the bovine specimens presented a significantly higher mean value than the human specimens; this difference was not observed when the diameters of the two types were compared.

Paradental cyst: Report of two cases

Background: the paradentat cyst is an odontogenic lesion of inflammatory origin that has few clinical signs and symptoms apart from recurring acute episodes. A well-defined radiolucency associated with the roots or distal to the crown may be seen radiographically. The purpose of this article is to report on different aspects of two cases involving paradental cysts. In the first case, the patient complained about recurring pericoronitis. A semilunar-shaped radiolucency on the distal aspect of the mandibular third molar was noted on the periapical radiograph. In the second case, the patient's main complaint was chronic trauma of the overlying mucosa. Radiographs revealed an enlarged pericoronal space.Methods: In both cases, the mandibular third molar was extracted due to a lack of space. Lesional samples were sent for histopathologic analysis.Results: In the first case, the drainage of cystic fluid and a regular concavity were found during tooth removal. In the second case, a nodular lesion was found adhering to the disto-buccal surface of the tooth arising from the distal wall of a periodontal pocket. The histopathologic analysis revealed a hyperplastic stratified squamous epithelium with arcading lining a fibrous capsule with inflammatory infiltrate, resulting in a final diagnosis of a paradental cyst.Conclusions: the presence of a paradental cyst should be considered when recurrent inflammatory periodontal processes are associated with partially erupted vital teeth, even when characteristic radiographic findings are absent. Definitive diagnosis requires a clinicopathologic correlation incorporating surgical, radiographic, and histologic findings.