Hypohyperdontia: literature review and report of seven cases

Hypodontia in combination with hyperdontia (hypohyperdontia) is a condition of mixed numeric variation in the human dentition. A comprehensive review on the hypohyperdontia literatures reported prevalence ranges from 0.002% to 3.1%. Our seven cases of hypohyperdontia involved both the maxillary and the mandibular arches. A traditional narrative review is included to describe the prevalence, etiology, and previously reported cases on hypohyperdontia. Furthermore, we opine that comprehensive clinical and radiographic examinations are essential for recognizing such rare dental anomalies. Judicious use of radiographs not only enhances the detection of hypohyperdontia, but also leads to changes in the course of management.     

Viscoelastic behavior and fracture toughness of six glass-ionomer cements

STATEMENT OF PROBLEM: Viscoelastic behavior can influence the fracture properties of glass ionomers, which is of clinical relevance. Glass-ionomer cements can display viscoelastic behavior, defined as having displacement rate- or strain rate-dependent mechanical properties. Understanding and describing the viscoelastic behavior of glass ionomers is important to understanding their clinical behavior. PURPOSE: The purpose of this study was to evaluate the viscoelastic behavior of 6 glass-ionomer cements and determine whether there was a correlation to fracture toughness. MATERIAL AND METHODS: Three conventional glass-ionomer cements (alpha-Silver, alpha-Fil, and Ketac-Molar) and 3 resin-modified glass-ionomer cements (Vitremer, Fuji II LC, and Photac-Fil Quick) were evaluated using measurements of compressive strength (CS), flexural strength (FS), and diametral tensile strength (DTS) at displacement rates of 0.5, 1.0, 1.5, and 2.0 mm/min. The CS and DTS specimens were cured in glass tubes and cut to 4 x 6-mm and 4 x 2-mm disk-shaped specimens, respectively. The FS specimens were cured in bar molds (2 x 2 x 15 mm). The fracture toughness (FT) specimens were cured in a minicompact mold to obtain precracked specimens. The mechanical testing results were compared statistically using generalized linear model/analysis of covariance and the Ryan-Einot-Gabriel-Welsch multiple range test at the alpha=.05 level. RESULTS: For all 3 mechanical properties, there was a displacement-rate dependence on the mechanical property. However, there were no differences in the displacement-rate dependence based on the type of material-conventional glass ionomer or resin-modified glass ionomer-for any of the mechanical properties. Only for FS test was there a significant difference based on the brand of material. There was no statistical difference in FT among the glass-ionomer cements tested, although the resin-modified glass ionomers tended to display higher FT. CONCLUSION: A larger sample size and a much wider range of crosshead speeds are necessary to support a correlation between viscoelastic behavior and FT.     

A newly designed resonance frequency analysis device for dental implant stability detection

Resonance frequency (RF) analysis technology was used to design a new dental implant stability detector. To calibrate and test the performance of this novel apparatus, in vitro and in vivo models, respectively, were used. The RF values of the test implants detected using our new device and a commercially available analogous device (Osstell) were compared. Further, implant stability status was also detected clinically using our device at 2, 4, 8, and 12 weeks after surgery. A high correlation was demonstrated between the values measured with the two devices (y = 0.31x-12.45; R2 = 0.98, p < 0.05). In our clinical tests, an initial RF value above 10.0 kHz indicated that the implant was ready to accept functional loading, while values in the 4.0-10.0 kHz range reflected the need for further osseointegration. In conclusion, these results indicated that our new device might be useful in a clinical setting for evaluating the healing status of a placed implant.     

Immunoglobulins in milk from cows immunized with oral strains of Actinomyces, Prevotella, Porphyromonas, and Fusobacterium.

Immunization of pregnant cows with bacteria leads to the presence of high concentrations of specific antibodies in colostrum and milk. A total of 14 cows was immunized with single strains of heat-killed oral bacteria or pools of strains of Actinomyces, Porphyromonas, Prevotella, and Fusobacterium. Two cows were treated with adjuvant alone. The mean percentages of IgG1, IgG2, IgM, and IgA in all of the milks were 83.8, 3.8, 9.3, and 3.1, respectively. ELISA and whole cell agglutination assays demonstrated high titers in the milks from the cows immunized with either individual strains or the bacterial pools. The highest titers determined by ELISA belonged to the IgG1 isotype and in several milks were 64-fold greater than titers in milk from cows treated with adjuvant alone. The concentrations of all antibodies and the titers determined by ELISA and whole cell agglutination assays markedly decreased from the first to the sixth milkings. The functional specificity of the antibodies was demonstrated by agglutination tests against a wide range of bacteria including members of Actinomyces, Fusobacterium, Porphyromonas, Prevotella, Streptococcus, Eubacterium, Propionibacterium, Peptostreptococcus, Bacteroides, Actinobacillus, Haemophilus, Capnocytophaga, and Wolinella. Minimal cross-reactions with bacteria in other genera were observed with all of the milks. High-titer milk preparations have been obtained from immunized cows, and the capacity of the bovine antibodies to agglutinate target bacteria indicates their potential usefulness in oral passive immunization studies.     

Progressive dysphagia in an elderly male

Dysphagia can result from a variety of causes, including central nervous and peripheral nervous system, myogenic, and structural disorders. A 76-year-old man underwent anterior cervical disketomy and fusion 10 years ago, with progressive dysphagia noted 2 years ago. Endoscopy showed an oropharyngeal tumor, and lateral plain film evaluation of the neck revealed a cervical plate extrusion. Removal of the instrumentation and tumor with primary closure of the pharyngeal perforation was performed, and dysphagia was resolved postoperatively. We report the case of an unusual presentation in the pharynx. We should not neglect this rare diagnosis, because it can progress to a life-threatening outcome.     

Changes in response properties of periodontal mechanoreceptors after experimental orthodontic tooth movement in rats

Using an in vitro preparation, we investigated chronological changes in response properties of periodontal mechanoreceptors (PMRs) in the rat right mandibular first molar (M1) after experimental orthodontic tooth movement. Orthodontic force was applied to M1 for 14 days by activating 24.5 mN superelastic titanium-nickel alloy closed coil springs anchored to the mandibular incisors. Experiments were performed on days 3, 7, 10, and 14 during application of orthodontic force and on days 7, 14, 21, and 28 after removal of orthodontic force. The rats without application of orthodontic force were used as control group. In each group, direct mechanical stimulation using von Frey hairs and electrical stimulation was applied to the distal root of M1. Results showed that compared with controls (1) the mechanical thresholds were significantly lower during application of orthodontic force; however, no significant difference was found after removal of force application and (2) conduction velocities were significantly lower from day 7 during application of orthodontic force to day 14 after removal of orthodontic force; however, no significant difference was found on days 21 and 28 after removal of orthodontic force. These results suggest that the PMRs, although having some of their response properties altered during orthodontic force application, were able to recover and adapt to the newly acquired intraoral condition after removal of the orthodontic force.     

Assessing the relationship between children's oral health status and that of their mothers

BackgroundThe authors conducted a study to describe the relationship between the oral health of young children and that of their mothers.MethodsUsing data from the Third National Health and Nutrition Examination Survey and a related birth certificate–linked file, the authors compiled a sample of 1,184 mother/child pairs for children aged 2 through 6 years. The authors performed logistic and cumulative logistic regression analyses by using children's caries experience and untreated caries status as dependent variables. They evaluated the mothers' untreated caries status and tooth loss status along with other covariates, including age, race/ethnicity and poverty status.ResultsChildren of mothers who had high levels of untreated caries were more than three times as likely (odds ratio [OR], 3.5; 95 percent confidence interval [CI], 2.0–6.2) to have higher levels of caries experience (treated or untreated dental caries) compared with children whose mothers had no untreated caries. A similar relationship was observed between mothers' tooth loss and caries experience among their children. The children of mothers with high levels of tooth loss were more than three times as likely (OR, 3.3; 95 percent CI, 1.8–6.4) to have higher levels of caries experience compared with children of mothers with no tooth loss; for mothers with moderate tooth loss, the OR was 2.3 (95 percent CI, 1.5–3.5).ConclusionsMothers' oral health status is a strong predictor of the oral health status of their children.Practice ImplicationsPreventive plans for children should be based on a caries risk assessment. The results of this study demonstrate that basic information obtained from the child's mother regarding her oral health status is valuable in helping the dentist determine the child's caries risk.     

Repeated oral hygiene instructions alone, or in combination with metronidazole dental gel with or without subgingival scaling in adult periodontitis patients: a one-year clinical study

The aims of the present study were to evaluate the clinical efficacy of, and to monitor microbiologically, repeated oral hygiene instructions alone or in combination with metronidazole 25% gel or subgingival scaling with or without metronidazole gel in treatment of new, residual or recurrent periodontal pockets in previously treated adult periodontitis patients. Ten suitable patients were included in this randomized single-blind clinical study with an intra-individual design. Clinical parameters were measured before and at 1, 3, 6, 9 and 12 months after treatment. Subgingival plaque samples were taken at every examination from one selected site in each quadrant. Smears from plaque samples were silver-stained and differential counting was performed under light microscopy at 1000X magnification. Four treatment modalities: (i) oral hygiene instruction (OHI) alone; (ii) OHI and metronidazole dental gel; (iii) OHI and subgingival scaling; (iv) OHI and subgingival scaling plus metronidazole gel, were randomly assigned to one quadrant of each patient. At the 12-month examination, the mean reductions in probing pocket depth were 2.6 mm after OHI alone, 2.8 mm after OHI and metronidazole gel, 3.3 mm after OHI and subgingival scaling and 2.6 mm after oral OHI and subgingival scaling plus metronidazole gel. The mean gains in probing attachment level were 2.2 mm, 1.9 mm, 2.7 mm and 1.6 mm, respectively. Although there were statistically significant differences in treatment responses between some treatment modalities at some time points, these were not considered to be clinically significant. Differential counts showed a shift towards a healthy microflora in response to all treatment modalities. From the 12-month results, it was concluded that the metronidazole 25% gel produced positive effects on the clinical parameters and on the subgingival plaque microbiological composition in new, residual or recurrent pockets in previously treated chronic periodontitis patients. However, the metronidazole gel alone or in combination with scaling does not seem to have any additional clinically significant therapeutic effects over and above those derived from improved oral hygiene resulting from monthly recalls, with or without subgingival scaling.     

Effect of two-step adhesive systems on inhibition of secondary caries around fluoride-releasing resin composite restorations in root dentine

OBJECTIVE: The purpose of this study was to investigate the effect of two-step adhesive systems on secondary caries inhibition around fluoride-releasing materials in vitro. METHODS: Two self-etching primer systems, Clearfil SE Bond (SE) and UniFil Bond (UB), and two one-bottle systems with a total-etch wet-bonding technique, Single Bond (SB) and One-Step (OS), were used prior to placement of resin composites either with (Reactmer) or without (Z100) fluoride release. Class V cavities prepared in extracted human premolars were restored with various combinations of materials: Reactmer/SE, Reactmer/UB, Reactmer/SB, Reactmer/OS, Z100/SE, Z100/UB, Z100/SB and Z100/OS. After storage for 14 days, the restored teeth were incubated in bacterial medium containing sucrose with Streptoccus mutans for 2 weeks. Water sorption and desorption of the adhesives and fluoride release from the resins either coated with adhesive or uncoated were also determined. RESULTS: The one-bottle groups showed higher water sorption and desorption than the self-etching primer groups. Although fluoride release from the Reactmer specimens was suppressed by the adhesive coating, the one-bottle groups allowed significantly higher fluoride release than the self-etching primer groups. On microradiographs, the radio-opaque layers adjacent to the Reactmer restorations were thick and clear, while the layers adjacent to the Z100 restorations were thin and unclear. For the Reactmer restorations, the radio-opaque layers associated with the one-bottle groups were significantly thicker than for the self-etching primer groups. CONCLUSIONS: These results indicated that the use of one-bottle wet-bonding systems for bonding of fluoride-releasing resin composites to dentine may contribute to inhibit secondary caries compared to self-etching primer systems.     

Group distal movement of teeth using microscrew implant anchorage

The purpose of this study was to quantify the treatment effects of distalization of the maxillary and mandibular molars using microscrew implants. The success rate and clinical considerations in the use of the microscrew implants were also evaluated. Thirteen patients who had undergone distalization of the posterior teeth using forces applied against microscrew implants were selected. Among them, 11 patients had mandibular microscrew implants and four patients had maxillary implants, including two patients who had both maxillary and mandibular ones at the same time. The maxillary first premolar and first molars showed significant distal movement, with no significant distal movement of the anterior teeth. The mandibular first premolar and first and second molars showed significant distal movement, but no significant movement of the mandibular incisor was observed. The microscrew implant success rate was 90% over a mean application period of 12.3 +/- 5.7 months. The results might support the use of the microscrew implants as an anchorage for group distal movement of the teeth.