How much reduction of the dental arch is functionally acceptable for the ageing patient?

Dental care should be aimed at the preservation of a natural functioning dentition for life, within the available resources. In general, preference should be given to dentitions comprising complete dental arches or 14 occluding pairs of teeth. However, in many subjects--such as the elderly--this goal might be neither attainable nor necessary. In these cases, dental care should be aimed at preserving the strategic parts of the dental arch, which are the front and premolar regions (the so-called ultimate occlusal preservation target). Clinical observation as well as research findings indicate that elderly people can function at an acceptable level with a reduced dentition consisting of 10 or even fewer occluding pairs. The minimum size of a functional dental arch differs between individuals and depends on local and systemic factors. Important indicators are the age, the (periodontal) quality of the remaining dentition, the spatial relationship between the lower and upper teeth, the occlusal activity and the adaptive capacity. Dental health care systems should implement guidelines to concentrate the available resources primarily on the strategic regions of the dental arch, especially in high-risk groups. These guidelines should be based on research results. The main objective of this paper is to contribute to defining an acceptable oral status for elderly subjects.     

The research and analysis on the fused primary teeth regarding to the permantent dental dentition-10 years follow up]

36 cases with unilateral mandibular fused primary teeth have been followed up and analysed for 10 years.The result showed that the fused primary teeth obviously affect the secondary permanent teeth and permanent dental dentition.In this series,there was one secondary permanent tooth lost in all of 19 cases.The secondary permanent tooth was also fused tooth in 3 cases.The length of permanent dental dentition and the width of dentition in front of the second cuspids in the cases with one secondary permanent tooth lost were extremely shorter than that in the cases with secondary permanent teeth.In addition,the mandibular dental dentitions were towards the fused teeth side.Comparing to the synonymic teeth,the mesial and distal steps and the height of secondary permanent teeth of fused primary teeth were no difference from normal side.     

Incisor Trauma and the Planning of Orthodontic Treatment

Because of the frequency of dental injuries during infancy and adolescence, traumatized teeth with variable long-term prognoses present a problem for orthodontic treatment planning. Orthodontic therapy can remain unaffected, or be complicated, by traumatized teeth. In some cases, following dental injury, orthodontics can also be used to enhance (prosthetic and) restorative treatment results. The orthodontic challenges involved in treating patients with a history of dental trauma are complicated by the consequences of trauma on dentition development and the different treatment options that must be considered. In this paper, we provide actual examples of the effects dental trauma can have on orthodontic treatment planning.     

Restoring erosion associated with gastroesophageal reflux using direct resins: case report

Gastroesophageal reflux disease (GERD) is a condition where stomach acids are chronically regurgitated into the esophagus and oral cavity, resulting in pathology, such as esophagitis, varices or ulcers. Continual exposure of the teeth to these acids can also cause severe dental erosion. This condition frequently is asymptomatic, and the only evident sign may be the irreversible erosion of tooth structure. The dentist often is the first health care professional to identify the affected dentition. Knowledge of this cause and effect relationship between GERD and dental erosion will better prepare the practitioner to refer patients for appropriate diagnosis and treatment of the underlying medical condition and provide treatment for the affected teeth. This article presents a case report where dental erosion was present due to GERD. After management of the disease with medication, dental treatment of the eroded dentition is described, including diagnosis, treatment planning and restorative reconstruction.     

种植修复在头颈部肿瘤放疗后的应用及研究进展

目前头颈部肿瘤的常规治疗主要是手术结合放疗,而术后颌骨及相应的牙列缺损严重影响患者的生活质量。近年来,随着种植牙的普及,更多患者选择种植牙修复头颈部手术后牙列缺损或牙列缺失。手术后放疗不仅增加颌骨骨髓炎及黏膜炎的发病率,甚至导致颌骨骨坏死（osteoradionecrosis, ORN）,影响种植体的存活。因此,尽可能减小放疗对颌骨的影响并选择合适的种植时机、种植体修复方式及干预手段,对种植体在颌骨内的存留起着关键作用。本文就种植体在颌骨放疗区的应用及研究进展作一综述。     

A critique of age estimation using attrition as the sole indicator

The age determination of skeletal remains has been carried out using anthropological examination of the remaining bones and dentition. The aging of the dentition is based on attrition which, if physiological will correlate with age. Occasionally the only material available is a single tooth or a few teeth, or in the case of a living person, teeth in situ. In certain cases microscopic examination of the teeth may not be possible and the age estimation is then often determined by the degree of attrition associated with the tooth. In more recent times the causes of attrition have involved other factors such as bruxism, diet, environment and medication. The weaknesses and limitations of age estimation by examination of dental attrition as the sole indicator of age are highlighted.     

A proposal for classification of tooth fractures based on treatment need

Accuracy in defining a disease makes it easier to study and understand. Similarly, with injuries to the teeth, a comprehensive classification is an aid to correct diagnosis and treatment planning. A thorough review of various classifications of tooth fractures shows that, despite an emphasis on traumatic dental injuries, a consensus needs to be arrived at, especially among clinicians and general/family dentists. The ideal classification would be applicable to both primary and permanent dentition, based on tooth fractures in both the horizontal and vertical planes, encompassing all possible sites, easy to comprehend, communicable amongst health professionals and clinically relevant. With recent improvements in conservative techniques, it is now clinically possible to preserve natural teeth even if they have been horizontally or vertically fractured, and thus an in-depth understanding and knowledge of tooth fractures, together with a simplified classification, is now more than ever essential.     

A cohort study on prevalence of dental caries concerning primary schoolchildren in one village of Niigata Prefecture

To review the previous preventive measures against the incidence of dental caries in children, we started to examine the state of dental health in children at the age of 18 months. The annual dental examination continued up to 12 years of age (sixgraders). Enrolled in this study were a total of 225 children living in a Town T and born between 1980 and 1982. Meanwhile, we made surveys in order to gauge the degree to which the subjects and their parents have concern for oral health. The findings and their relationships to the caries incidence were analyzed using an epidemiological technique. The annual dental examinations revealed that in primary dentition the incidence of caries tends to increase in 3-year-olds while in permanent dentition the carious process extends in 4–6 graders. By kind of teeth, primary molars accounted for 52% of the affected deciduous teeth. First molars made up 72% of all the decayed permanent teeth. Using the two caries cumulative indexes developed by our department for recording the prevalence and severity of tooth decay in the deciduous dentition and in the permanent dentition, respectively, we found that there is a correlation between the incidence of caries in the deciduous dentition and that in the permanent teeth. The two formulae are based on the cumulative number of decayed teeth that appeared in the deciduous dentition and permanent dentition for a given period of time. In order to find whether there is any correlation between caries attack and attention paid to the risk factors, we divided the subjects into two groups by the number of decayed teeth per person. In the group made up of those with many carious teeth, it was noted that between-meal snacks are most likely to produce caries in deciduous teeth, while lifestyle affects permanentteth.

     

Dental findings in an adult with Lowe's syndrome

This paper describes the dental findings and care of a Chinese adult affected with oculo-cerebrorenal syndrome—Lowe's syndrome—a rare, X-linked recessive disorder, whose clinical manifestations include cataracts, mental retardation, and renal tubular dysfunction. Approximately 150 cases have been reported in the last 45 years. Little has been reported in the dental literature. This patient is described with particular reference to the dental findings, which include gross periodontal disease with severe bone loss, impaction of teeth In the permanent dentition, taurodontism, and underdevelopment of the maxilla and mandible. Dental treatment was aimed at arresting the periodontal disease and preseiving the remaining dentition.     

A possible association between early apical resorption of primary teeth and ectodermal characteristics of the permanent dentition

The hypothesis of this study is that children with unexpected early apical resorption of the primary teeth are also predisposed to resorption in the permanent dentition. Accordingly, the aim was to perform a longitudinal study focussing on the permanent teeth in children with unexpected early apical resorption in the primary dentition. Panoramic radiographs of 12 children (7 boys and 5 girls) aged 6 years 4 months to 8 years 9 months with unexpected early apical resorption of primary teeth were identified from a dental archive of 588 patients. After written request, follow-up radiographs were obtained (2-15 year interval between early and follow-up radiographs). The radiographs were examined in order to verify the abnormal resorption pattern of the primary teeth and dental deviations in the permanent teeth, known to predispose for root resorption (i.e. invaginations, narrow crowns, abrupt root deflections, slender roots, short roots, taurodontia, agenesis, deviant pattern of eruption). Primary dentition: Two phenotypically different resorption groups were identified: group I, eight patients (resorption of the roots only), and group II, four patients (resorption of root and crown). Permanent dentition: In all 12 children, dental deviations in the permanent dentition were observed. Additionally, idiopathic external apical resorption of the permanent teeth was seen in three children, two of whom had received orthodontic treatment.     

Guidelines for the management of traumatic dental injuries. III. Primary teeth

Abstract –  Trauma to the primary dentition present special problems and the management is often different as compared with permanent teeth. An appropriate emergency treatment plan is important for a good prognosis. Guidelines are useful for delivering the best care possible in an efficient manner. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the group. In cases in which the data did not appear conclusive, recommendations were based on the consensus opinion of the IADT board members. The guidelines represent the current best evidence based on literature research and professional opinion. In this third article out of three, the IADT Guidelines for the management of traumatic injuries in the primary dentition, are presented.     

Dental crowding: the restorative approach

Crowded dentition is commonly found in the esthetic zone. Many forms of therapy can be used to treat the overlap of teeth caused by insufficient space within the dental arch. A careful analysis of patients with dental crowding is necessary to determine the most appropriate treatment of each individual case. Clinical considerations, advantages, disadvantages, and alternative treatment modalities for crowding dentition are discussed in this article and a clinical case is presented to illustrate the application of these techniques.     

正畸结合种植义齿治疗牙列稀疏的临床研究

目的 :探讨正畸开辟间隙法与种植义齿结合治疗个别牙缺失和牙列稀疏错牙合畸形的临床效果。方法 :利用正畸开辟间隙法结合种植义齿修复对 2 0例牙缺失或先天牙列稀疏的病例进行矫治。结果 :2 0例经治疗后均达到理想的临床效果。结论 ;对个别牙缺失和牙列稀疏病例 ,利用正畸开辟间隙法结合种植义齿修复能实现最大限度的美观、功能及稳定。     

A clinical study of patients with hypersensitive teeth

Hypersensitive teeth have been a nemesis to patients in every dental practice. This clinical study was done to find a causal relationship of hypersensitive teeth and other organs of special senses, namely, sight, hearing, taste, smell, and touch. The analysis of the findings offers a basis for conclusion that dentition hypersensitivity and hypersensitivity of the special senses have a causal relationship. The dental clinician can provide the patient with an understanding and explanation of the cause(s) of hypersensitivity that will assist in a cooperative analysis of the symptoms and aid in the treatment to alleviate the pain.     

Pre-prosthetic orthodontics

For some patients, pre-prosthetic orthodontic intervention is necessary to optimize both esthetic and functional aspects of dental treatment. This review will focus on the following topics: orthodontics treatment with multiple missing teeth, correction of anterior deep vertical overlap, anterior worn dentition, up-righting of tilted teeth, and orthodontic crown lengthening. This review will aid restorative dentists in identifying which patients could benefit from orthodontic intervention, and in understanding how orthodontic treatment can be utilized to improve patient prognosis in restorative treatment.     

Supernumerary teeth diagnosis and treatment approach. Six case reports

Supernumerary teeth are relatively common in the general population, affecting the primary and the permanent dentition and have been reported in many genetic syndromes. They are classified according to form and shape. Seven different examples of hyperodontia are presented to highlight the numerical and morphological variation in dental abnormalities manifestations, empathising the importance of thorough clinical and radiological examination and of a correct therapeutic approach. The patients presented single or multiple hyperodontia, with particular interest for a 12 supernumerary teeth case. The clinical problems linked to supernumerary teeth were: impaction or ectopic eruption, crowding, possible root resorption of adjacent teeth. The therapeutical approach of supernumerary teeth varied on the position of the element in excess and on the complexity of the clinical case. In some cases the single extraction of the supernumerary tooth was indicated, while in other cases the extraction of the tooth was needed in addition to orthodontic treatment to gain sufficient space for the tooth with delayed eruption.     

Consequences of dental restorative treatment (and of the dental materials used in its execution) on pulp tissue

Pulp tissue may suffer from carious invasion, direct or indirect trauma and last but not least from dental treatment. As the general population grows older and retains longer its dentition, teeth will inevitably experience a complex history of multiple episodes of aggressions. It is therefore not surprising that the dental practitioner is confronted more and more with teeth reacting acutely or chronically (in other words, painfully or not) after proper dental treatment. This paper describes the common pathologic and iatrogenic events that may have an effect on the pulpal health status. Preventive endodontic treatment is to be considered in cases of extensive dental treatment.     

The unresolved problem of the third molar: would people be better off without it?

BACKGROUND: Third molars are teeth that have little functional value and a relatively high rate of associated pain and disease. Their value as part of the dentition of modern people is dubious. TYPES OF STUDIES REVIEWED: The authors review the evolution, development, morbidity and treatment of third molars. They assess the value of third molars in the 21st century and describe the risks these teeth pose when they develop in the dentition. CONCLUSIONS: There is a mandate for the dental profession to improve health outcomes and quality of life. The prevention of third molar-related morbidity should be included in dental research efforts. The authors suggest that novel preventive methodologies be developed to alleviate the problems third molars pose. One potential methodology suggested is intentional therapeutic agenesis of this tooth. CLINICAL IMPLICATIONS: Prevention of third molar development early in life, even before tooth bud initiation, could dramatically improve health care outcomes for millions of people.     

The role of orthodontics in implant dentistry

Orthodontic treatment of partially edentulous patients is difficult, especially if a significant number of teeth are missing. With loss of teeth, adjacent or opposing teeth usually tip, drift or over-erupt leaving spaces that are not optimal for replacement of missing teeth. Orthodontic correction of these spatial relationships will aid prosthetic replacement of the missing teeth, function, hygiene and aesthetics. Orthodontists rely on teeth to provide the anchorage to correct malocclusions. With patients with an intact dentition dental anchorage is usually adequate to facilitate tooth movement. In some partially edentulous patients however, insufficient anchorage may present to correct the malocclusion. In these patients implants can provide additional anchorage. At times, osseointegrated implants can also be used to support restorations after completion of orthodontic therapy if treatment planning is precise. The use of implants for orthodontic anchorage requires an interdisciplinary approach and precise planning to achieve optimal results.