Three-dimensional, non-destructive visualization of vertical root fractures using flat panel volume detector computer tomography: an ex vivo in vitro case report

AIM: To detect and to visualize radiographically vertical root fractures in extracted teeth with a prototype of a novel, high resolution, three-dimensional flat panel volume detector computer tomograph (FD-VCT) system. SUMMARY: Five teeth with root fillings and clinical symptoms such as fistulas and isolated periodontal pockets of 8 mm or more were extracted after dental radiography indicating lateral or periapical lesions. Vertical root fractures or cracks were suspected because of the symptoms and clinical findings were evident after extraction in all cases but fracture lines were not visible on routine dental radiographs acquired before extraction. The extracted teeth were explored with a prototype of a FD-VCT. Using the FD-VCT, in all cases vertical root fractures or crack lines could be detected clearly in different views, depiction-modes and cross-sections at a spatial resolution of 140 microm. The evaluation of the fracture lines and teeth could be performed in three-dimensional views. The FD-VCT findings were confirmed by detailed inspection of the extracted teeth. KEY LEARNING POINTS: The FD-VCT is an innovative diagnostic tool for non-destructive, three-dimensional evaluation of extracted teeth in pre-clinical and experimental studies. The FD-VCT allows precise visualization and evaluation of vertical root fractures or cracks in extracted teeth. Clinical application of the system may be possible if technical modifications reduce the exposure dose: the high resolution detector systems of the FD-VCT should be combined with radiation systems that focus the radiation to the area of interest.     

Global trends in dental fluorosis from 1980 to 2000: a systematic review.

AIM: To determine trends in fluorosis prevalence at water fluoride levels <0.3, >0.3 to <0.7, and >0.7 to 1.4 ppm from 1980 to 2000. METHODS: A systematic review of 55 published articles identified in a Medline search for peer-reviewed articles on fluorosis published from 1 January 1980 to 31 December 2000. The prevalence recorded with any fluorosis index was pooled and the trends over time were determined in the three water concentration categories. RESULTS: The fluorosis prevalence for the three fluoride categories were 16.7, 27.4 and 32.2 percent, respectively. A 16-fold and a 2-fold increase in fluorosis prevalence compared with reported rates in the 1940s was seen in non-fluoridated (= 0.3 ppm F) and fluoridated (>0.7 to = 1.4 ppm F) areas, respectively. There has been an increase in fluorosis prevalence over time in the three fluoride water concentration categories but linear regression analysis showed that none are significantly different from zero. CONCLUSION: This systematic review concurs with recent reports of an increase in fluorosis prevalence in fluoridated and non-fluoridated communities.     

Cultural diversity and its role in reducing oral health disparities

African-American, Hispanic and Native-American/Alaskan Native dental students and professionals are often referred to as underrepresented minorities (URMs) because of their poor representation in the profession compared to their proportion in the U.S. population. Disparities in oral health services may, in part, be attributable to minority and economically disadvantaged patients' lack of confidence in the dental profession's ability to provide care in a culturally sensitive manner. Increasing diversity within the oral health workforce is one way to address this perception. However, an effective remedy will require all oral health professionals to devote additional attention to diversity and cultural competency issues.     

Occlusal alterations in unilateral coronal craniosynostosis

There are few studies on maxillomandibular skeletal alterations. Twenty-one patients with unilateral coronal craniosynostosis were analysed and compared with controls. Landmarks analysed were: sella-nasion-point A and B angles, point A-nasion-point B angle, interincisal angle, angle of superior incisor axis on the sella-nasion plane, lower incisor to mandibular plane angle, Frankfort mandibular plane angle, zygomatic-frontal suture (Z), point on the most concave part of pyramidal apophysis of the upper maxilla (Mx), antegonial incisure (AG), upper (UMT) and lower (LMT) molar teeth. Differences were significant for class II dentoskeletal occlusion (p < 0.0001), mandibular hyperdivergence (p < 0.0001), lingualization of superior incisor (p < 0.005), deviation of inferior interincisal contralateral line to the synostosis (p < 0.0001) in the plagiocephalic population. Compared with contralateral counterpoints, Z (p < 0.05), Mx (p < 0.005) and UMT (p < 0.0005) on the affected side were closer to the midline; AG (p < 0.0005) and LMT (p < 0.05) were further from it. On the frontal plane, Z, Mx, UMT, LMT and AG on the affected side were higher. Vertical and transversal contraction of the jaw of the synostotic side and laterodeviation of the mandibular interincisal line of the contralateral synostotic were clear. The altered position of the glenoid cavity, anteriorized in unilateral coronal craniosynostosis, could be the cause of mandibular dentoskeletal asymmetry.     

Factors of failure of prosthetic restoration of the acquired losses of substance of the jawbone and the mandible in sub-Saharan Africa

The obturating prostheses of the jawbone and the prostheses of rebuilding of the mandible make it possible to restore the losses of substance of the jawbone and of the mandible and to cure the functional and Aesthetic disorders which result from these losses of substance. The success of these prosthetic restorations can be compromised by technical, economic and cultural factors. The principal factors are the importance of the losses of substance, the reduced number of teeth, the poverty of the technical plate, the persistence of certain traditional concepts. The fight against these factors requires the promotion of therapeutic associations in maxillo-facial cancerology, the sensitizing of the populations to the early hospital consultations, the improvement of the technical plate of the prosthesis of the jawbone and the face, the facilitation of the access of the most underprivileged groups to the prosthetic restorations, the promotion of multi-field collaboration, the whole co-operation of the patient throughout the treatment and the follow-up postprothetic.     

Tooth whitening: current status

This article reviews the history of tooth whitening and its rapid evolution and briefly discusses tooth whitening agents and protocols. The active ingredients and mode of action during the whitening process are explained. The factors affecting the speed of whitening and its final results are discussed, as well as adverse effects and safety precautions. Protocols are explained in detail, and the predicted outcomes, including those for tetracycline-stained teeth, are covered.     

Dental practitioners in Israel: past, present and future

Since 1980 various studies have been published in Israel dealing with dental manpower issues, utilizing several methods such as manpower to population ratio. The dental literature pointed out that dentistry in Israel has an over supply of dentists and that manpower to population ratio is one of the highest in the world 1:770. All studies were based on the information provided by the Ministry of Health which showed that Israel has over 9500 dentists. The Israel Central Bureau of Statistics figures showed a much smaller number which was 5700 active dentists. This enormous gap in between two sources of information, following strict examination of the data revealed that the Bureau of Statistics information is reliable and hence, the real manpower to population ratio in Israel in 2008 was 1:1271. Prediction of manpower is extremely important and the base line information is crucial for future evaluations.