Overdenture supported by osseointegrated fixtures: a case report

The increasing use of oral endoprostheses has offered new alternatives for fixed and removable prosthesis design. However, the use of implants also requires the complex understanding and use of sound prosthodontic principles. The establishment of proper maxillomandibular relationships (vertical dimension, occlusal plane, curve of Spee, tooth arrangement), esthetics, and function are essential precursors to success. Although the usefulness of rehabilitation with overdentures supported by osseointegrated fixtures is sometimes underestimated, overdentures provide an adequate treatment alternative in indicated cases. A case is presented in which previous preprosthetic surgery had failed and subsequently an overdenture supported by osseointegrated fixtures was constructed.     

The effect of pulp obliteration on pulpal vitality of orthodontically intruded traumatized teeth

Limited information exists on the impact of pulp obliteration on pulpal vitality of orthodontically treated traumatized teeth. Pulpal condition was examined in 269 traumatized maxillary incisors after orthodontic intrusion (OT group) and in 193 traumatized maxillary incisors without subsequent orthodontic treatment (C group). According to the degree of initial pulp obliteration, the teeth were divided into three categories: teeth without, teeth with partial, and teeth with total pulp obliteration. Teeth in the OT group revealed a significantly higher rate of pulp necrosis than teeth in the C group (p < 0.001). In addition, teeth in the OT group with total pulp obliteration showed a significantly higher rate of pulp necrosis than teeth without (p < 0.001) or only partial pulp obliteration (p = 0.025). The results indicate that traumatized teeth with total pulp obliteration have a higher susceptibility to pulpal complications during orthodontic intrusion than traumatized teeth without or only partial pulp obliteration.     

Relationship between kinematic center and TMJ anatomy and function

The kinematic center (KC)-defined by coinciding jaw-opening/-closing and protrusion-retrusion trajectories-has been proposed in the literature as a reference point to represent TMJ movements. In this study, we tested whether the KC lies in a peculiar anatomical point and whether its trajectory reflects intra-articular distance. In 11 asymptomatic individuals (seven females, four males, aged 24-37 yrs), 4 openings/closings and 4 protrusions/retrusions were tracked with dynamic stereometry. In a 3D lattice (0.5 mm grid) constructed solidly around each condyle, the KC was the point with maximal cross-correlation between opening-closing and protrusion-retrusion paths. KC trajectories were more cranial on closing than on opening, consistent with intra-articular distances being smaller on closing than on opening. However, KCs were never located on condylar main axes (distance, 4.5 +/- 2.9 mm), nor did they coincide with points best approximating fossa shapes (distance, 12.5 +/- 6.4 mm). The kinematic center's anatomical and functional significance therefore appears to be questionable.     

No alteration in bone mineral density in patients with periodontitis

Alveolar bone destruction can be magnified in the presence of generalized skeletal disorders. We questioned whether severe generalized periodontitis patients display signs of bone metabolism disturbances. Our objective was to assess skeletal bone mineral density (BMD) and biochemical bone parameters in premenopausal women with periodontitis. Forty-five patients and 40 control individuals were included in the study. We measured BMD by dual-energy x-ray absorptiometry. The results showed no difference in BMD values between the periodontitis and control groups (p > 0.05). A positive relationship between the clinical attachment level and Body Mass Index (BMI) scores was observed (p = 0.03). Increased serum creatinine levels were noted in the periodontitis group (p = 0.04). Analysis of the data suggests that there is no evidence for an association between skeletal BMD and severe periodontitis in premenopausal women. There may be a link between elevated creatinine levels and periodontitis. The persons with high BMI scores seemed to be at risk for periodontitis.     

Effect of nanoporous TiO2 coating and anodized Ca2+ modification of titanium surfaces on early microbial biofilm formation

Background

(i) to describe oral health counselling in Norway to parents with infants and toddlers, ii) to assess existing collaboration and routines in oral health matters between nurses and personnel in the PDS, iii) to evaluate to what extent oral health was integrated in the basic educational curriculum of public health nurses.

Methods

This study was based on two separate surveys: the sample of Study I was 98 randomly selected child health clinics. A questionnaire covering oral health promotion counselling of parents with young children was returned by 259 nurses. Study II was a telephone survey addressing teachers of public health nurses at the eight educational institutions in Norway.

Results

The response rate in Study I was 45%. Nutrition (breast feeding, diet) was the health subject most often prioritized in the counselling targeting parents of young children (by 60% of the nurses). Oral health was not among the first priority counselling subjects. The subject was seldom spontaneously mentioned by parents. Seventy percent of respondents reported (agreed or totally agreed) that they managed to provide information parents needed and 72% believed that the information they gave influenced parents' health behaviours. Seven nurses (5.2%) responded that they agreed with the statement that the information they gave only slightly influenced parents' health behaviour. Lack of time was mentioned as being a problem. Approximately half of the nurses (48%) had regular contact with the PDS for the 0-3 year-old children, but only a quarter of the nurses claimed that children's teeth were routinely examined at the child clinics. Some forms of previously established contact with the PDS enhanced the likelihood of nurses' referrals. Oral health was a minor part of the educational curriculum for public health nurses; at three institutions, the subject was totally absent.

Conclusion

Collaboration between nurses and the PDS in Norway could be improved. Oral health should have a bigger place in the basic educational curriculum.     

Rigid external distraction of the midface with direct wiring of the distraction unit in patients with craniofacial dysplasia

The development of craniofacial distraction techniques represents a significant advancement in the management of craniofacial dysplasias. For distraction of the midface after Le Fort III osteotomy, two levels of anchorage to the moving segments are necessary. In this report, the authors connected the distraction forces directly to the infraorbital rims, using a surgical wire for superior anchorage. They performed this technique in four patients with craniofacial dysplasia for the management of severe maxillary hypoplasia using RED II system. This configuration not only simplified the placement of the system but also made the removal of the device much easier. The authors did not have any problems with the wire traction unit, such as wire breakdown or bony tunnel disruption. It is a cheap, simple, and effective configuration that can be easily performed without any complication.     

Association of the -159 CD14 gene polymorphism and lack of association of the -308 TNFA and Q551R IL-4RA polymorphisms with severe chronic periodontitis in Swedish Caucasians

BACKGROUND: Severe forms of periodontitis are suggested to have a genetic basis. OBJECTIVE: The aim of the present investigation was to study the association of gene polymorphisms related to some immune regulation components (G-308A TNFA, Q551R IL-4RA and C-159T CD14) with severe chronic periodontitis. MATERIALS AND METHODS: Sixty patients (aged 36-74 years; mean 54.5+/-8.5) with severe and generalized chronic periodontitis were included. The patients exhibited bone loss >50% at all teeth. Thirty-nine periodontally healthy subjects between 35 and 78 years of age (mean 51.0+/-10.9) were recruited as controls. DNA was isolated from peripheral blood cells and genotyping was performed by combination of PCR and restriction endonuclease mapping. RESULTS: While gene polymorphisms for TNFA and IL-4RA did not show any association with severe chronic periodontitis, the analysis of the -159 CD14 gene polymorphism revealed significant differences between test and control groups. The proportion of subjects that exhibited the TT genotype was significantly smaller in the group with severe periodontitis than in periodontal healthy group (p=0.028; Fisher's exact test). The C allele carriage was 90% in the periodontitis group and significantly higher than in the healthy control group (72%). CONCLUSION: It is suggested that the -159 CD14 gene polymorphism is associated with chronic periodontitis in Caucasian subjects of a north European origin.     

Outcome of oral implant treatment in partially edentulous jaws followed 20 years in clinical function

Background: Most long‐term follow‐up studies of implants in partially edentulous jaws present their outcomes as mean values of implant survival and follow‐up time, and few address the fate of the remaining teeth. Purpose: The aim of this study was to investigate the results of oral implant treatment in partially edentulous jaws after 20 years, and simultaneously to assess what happens to teeth present at the time of implant placement. Materials and Methods: Seventeen partially edentulous patients, of 27 originally treated individuals, were retrospectively reviewed after receiving implants from 1983 to 1985. The parameters studied were implant survival, prosthesis stability, marginal bone loss at teeth and implants, treatment complications, need for dental treatment, and patient’s satisfaction with the outcome. Results: The cumulative survival rate was 91%, when all 27 patients were assessed, that is, including the 10 dropouts. Of the 69 inserted and followed implants (Brånemark system®; Nobel Biocare AB, Göteborg, Sweden), six failed (8.7%) during the 20‐year period, four during the first decade, and the remaining two during the second. A majority (n=4) of the losses were due to implant fractures, two after 8 years, and two after 17 years. In all, 10 of the original fixed bridges being followed (n=24) remained in function during the entire investigation period, whereas 12 were exchanged for new constructions after an average of 7 years. The mean marginal bone loss at teeth was 0.7 mm, and at implants it was 1.0 mm. The major complication observed during the second decade was veneer material fractures, which occurred 14 times in six patients. Component loosening and abutment‐ and bridge‐locking screw fractures were the second most common problems seen, indicating material/component fatigue. Most patients were satisfied with their treatment and many mentioned that they did not think of the constructions as anything but a part of their own body. Conclusion: Over the decades, treatment of partially edentulous jaws with turned titanium implants seems to function well and to provide patients with good support for fixed short‐span bridge constructions.