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The Journal of Clinical Pediatric... 2019This systematic review and meta-analysis assessed clinical, radiographic and functional retention outcomes in immature necrotic permanent teeth treated either with pulp... (Meta-Analysis)
Meta-Analysis
This systematic review and meta-analysis assessed clinical, radiographic and functional retention outcomes in immature necrotic permanent teeth treated either with pulp revascularization or apexification after a minimum of three months to determine which one provides the best results. The literature was screened via PubMed/MEDLINE and Embase databases up to June 2017 to select observational studies that compared pulp revascularization and apexification treatments assessing clinical, radiographic and functional retention outcomes. Two reviewers independently performed screening and evaluation of articles. A total of 231 articles were retrieved from databases, wherein only four articles were selected for full-text analyses. After exclusion criteria, three studies remained in quantitative and qualitative analyses. Pooled-effect estimates were obtained comparing clinical and radiographic outcomes ('overall outcome') and functional retention rates between apexification and pulp revascularization treatment. The meta-analysis comparing apexification vs. revascularization for 'overall outcome' (Z=0.113, p=0.910, RR=1.009, 95%CI:0.869-1.171) and functional retention rates (Z=1.438, p=0.150, RR=1.069, 95%CI:0.976-1.172) showed no statistically significant differences between the treatments. All studies were classified as high quality. The current literature regarding the clinical, radiographic and functional retention outcomes in immature necrotic permanent teeth treated either with pulp revascularization or apexification is limited. Based on our meta-analysis, the results do not favor one treatment modality over the other.
Topics: Apexification; Dental Pulp; Dental Pulp Necrosis; Dentition, Permanent; Humans; Observational Studies as Topic; Tooth Apex
PubMed: 31560588
DOI: 10.17796/1053-4625-43.5.1 -
PloS One 2023Among mammals, hippopotamids ('hippos') have been described as the species with the lowest chewing efficacy despite elaborate enamel folds on the occlusal surface or...
Among mammals, hippopotamids ('hippos') have been described as the species with the lowest chewing efficacy despite elaborate enamel folds on the occlusal surface or their cheek teeth, which was hypothesized to result from the lack of a grinding chewing motion. We investigated the chewing and dentition of the two extant hippo species, the common hippo (Hippopotamus amphibius) and the pygmy hippo (Choeropsis liberiensis), making (video) observations of live animals and gathering data on museum specimens (n = 86 H. amphibius and 26 C. liberiensis skulls). Hippos have a low degree of anisodonty (differences in width between maxillary and mandibular cheek teeth) and anisognathy (difference in width between the upper and the lower jaw), corresponding to a mainly orthal (up-and-down) chewing motion. The two hippo species differ slightly, but distinctively, in their anterior dental morphology and chewing mode. In both species, the canines do not completely prevent a lateral jaw movement but would, in theory, permit this movement until the mandibular canines get into contact with the maxillary protruding snout. This movement is only realized, to a small extent, in pygmy hippos, leaving distinct wear traces on their incisors and creating relatively wider wear facets on the maxillary canines. In common hippos, the interlocking upper and lower incisors prevent lateral jaw movement. Corresponding contact wear facets are evident on the medial aspect of the upper, and on the lateral aspect of the lower incisors-unless museal reconstructions mispositioned these teeth. If these facets are interpreted as an indication for a relic of a lateral jaw movement that was probably more prominent in hippo ancestors, i.e. if we assume that hippos evolved orthal chewing secondarily, several other characteristics of hippos can be explained, such as a low degree of hypsodonty (in the absence of distinct attrition due to a grinding chewing movement), a secondary loss of complexity in their enamel schmelzmuster, a secondary evolution of a wide mouth gape, a reduction in anisodonty compared to their ancestors, and the evolution of a bilaterally symmetrical ('trifoliate') enamel folding pattern on the molar occlusal surface from an ancestral bunoselenodont condition. As an underlying driving force, selection for intraspecific combat with canines and incisors, necessitating a wide gape and a rigid jaw, has been suggested.
Topics: Animals; Mastication; Dentition; Tooth; Tooth Wear; Artiodactyla; Mammals; Incisor; Maxilla
PubMed: 37792716
DOI: 10.1371/journal.pone.0291825 -
BMC Oral Health Aug 2022Accurate integration of the dentitions with the face is essential in dental clinical practice. Here we introduce a noninvasive and efficient protocol to integrate the...
BACKGROUND
Accurate integration of the dentitions with the face is essential in dental clinical practice. Here we introduce a noninvasive and efficient protocol to integrate the digitized maxillary dentition with the three-dimensional (3D) facial photo using a prefabricated modified computer-aided design/computer-aided manufacture (CAD/CAM) facebow.
METHODS
To integrate the maxillary dentition with the 3D facial photo, the CAD/CAM facebow protocol was applied to 20 patients by taking a series of 3D facial photos in the clinic and integrating them in the laboratory. The integration accuracy of this protocol was compared with that of a valid 3D computed tomography (CT)-aided protocol concerning translational deviations of the landmarks representing maxillary incisors and maxillary first molars as well as the rotational deviation of the maxillary dentition. The intra- and inter-observer reproducibility was assessed, and the time of clinical operation and laboratory integration was recorded.
RESULTS
This facebow-aided protocol generated 3D fused images with colored faces and high-resolution dentitions, and showed high reproducibility. Compared with the well-established CT-aided protocol, the translational deviations ranged from 0 to 1.196 mm, with mean values ranging from 0.134 to 0.444 mm, and a relatively high integration error was found in the vertical dimension (Z) with a mean ± standard deviation (SD) of 0.379 ± 0.282 mm. Meanwhile, the rotational deviations ranged from 0.020 to 0.930°, with mean values less than 1°, and the most evident deviation was seen in pitch rotation with a mean ± SD of 0.445 ± 0.262°. The workflow took 4.34 ± 0.19 min (mins) for clinical operation and 11.23 ± 0.29 min for laboratory integration.
CONCLUSION
The present radiation-free protocol with the modified CAD/CAM facebow provided accurate and reproducible transfer of the digitized maxillary dentition to the 3D facial photo with high efficiency.
Topics: Computer-Aided Design; Dentition; Humans; Imaging, Three-Dimensional; Reproducibility of Results; Tomography, X-Ray Computed
PubMed: 36028874
DOI: 10.1186/s12903-022-02394-w -
International Dental Journal Dec 2013The mouth is in flux from the time the primary teeth begin to erupt, in the first year of life, through to the end of the 'mixed dentition' (i.e. the concurrent eruption... (Review)
Review
The mouth is in flux from the time the primary teeth begin to erupt, in the first year of life, through to the end of the 'mixed dentition' (i.e. the concurrent eruption of the permanent teeth and exfoliation of the primary teeth), at around 12 years of age. Primary teeth facilitate the development of the facial muscles and speech. They act as 'guides' for erupting permanent teeth. If lost prematurely, subsequent misalignment of permanent teeth can make them difficult to clean and possibly more caries-prone. During the mixed dentition phase, teeth are at relatively high risk of caries. Erupting teeth are difficult to clean and cleaning may be avoided because of tender gums and behavioural factors in children. Permanent enamel (and possibly primary enamel) undergoes post-eruptive maturation, accumulating fluoride, becoming harder, less porous and less caries-prone. Overall, primary teeth are more vulnerable to caries than permanent teeth. Widespread use of fluoride toothpaste has effected marked reductions in caries. Some evidence exists that fluoride delivered from toothpastes may be somewhat more effective in reducing caries in primary than in permanent teeth. However, caries remains a public health concern globally. New fluoride toothpaste formulations, optimised using in vivo fluoride delivery and efficacy studies, may improve the caries resistance of mineral deposited during post-eruptive maturation. Behaviour should not be ignored; new formulations will be more effective if used according to professionally endorsed recommendations based on sound science. Establishing good oral hygiene behaviour early in life can lead to lasting anti-caries benefits.
Topics: Cariostatic Agents; Dental Caries; Dental Caries Susceptibility; Dental Enamel; Dentition, Mixed; Fluorides; Humans; Tooth Eruption; Tooth, Deciduous; Toothbrushing; Toothpastes
PubMed: 24283279
DOI: 10.1111/idj.12076 -
Journal of Anatomy Aug 2018In this review, classical data on the early steps in human odontogenesis are summarized and updated with specific insights into the development of the upper and lower... (Review)
Review
In this review, classical data on the early steps in human odontogenesis are summarized and updated with specific insights into the development of the upper and lower embryonic jaws to help in understanding some oral pathologies. The initial step of human odontogenesis is classically characterized by two parallel horseshoe-shaped epithelial laminae. These originate from the oral epithelium and an ingrowth into the jaw mesenchyme: the internal dental lamina gives rise to deciduous tooth primordia, while the external vestibular lamina represents the developmental base of the oral vestibule. However, a more complex situation was revealed by recent studies combining analyses of the dental and adjacent oral epithelia on histological sections and computer-aided three-dimensional (3D) reconstructions during the 2nd month of human embryonic development. The dental epithelium forms a mound, where swellings appear later, corresponding to the individual primordia of deciduous teeth. External to the developing deciduous dentition, the 3D reconstructions do not show any continuous vestibular lamina but instead a complex of discontinuous epithelial bulges and ridges. The patterns of these epithelial structures and their relationship to the dental epithelium differ not only between the upper and lower jaws but also between the lip and cheek segments in each jaw. Knowledge of early odontogenesis may help in understanding some oral pathologies. For example, the human lateral incisor has a dual origin: it arises in the area of fusion between the medial nasal and maxillary facial processes and involves material from these two regions. Such a dual origin at the site of fusion of facial processes represents a predisposition to developmental vulnerability for the upper lateral incisor, resulting in its frequent anomalies (absence, hypoplasia, duplication), especially in patients with a cleft lip and/or jaw. Other pathologies, such as a minute supernumerary tooth, desmoplastic ameloblastoma or extraosseous odontogenic cysts are located external to the upper or lower dentition, and might be derived from structures that transiently appear during early development of the oral vestibule in humans.
Topics: Dentition; Humans; Jaw; Tooth
PubMed: 29745448
DOI: 10.1111/joa.12825 -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Dec 2022This study aimed to investigate the accuracy of model superimposition and automatic analysis for upper and lower dentition widths in iTero Progress Assessment during the...
OBJECTIVES
This study aimed to investigate the accuracy of model superimposition and automatic analysis for upper and lower dentition widths in iTero Progress Assessment during the clear aligner process.
METHODS
Nineteen cases were included in this retrospective case control study. Pretreatment dental cast (T0) and post treatment dental cast after staged treatment (T1) were available for three-dimensional (3D) model superimposition. The movements of maxillary teeth in the horizontal plane (cross section) after staged treatment and the widths of upper and lower dentitions were measured by 3D model superimposition in real world and iTero Progress Assessment. The data collected from the two methods were compared.
RESULTS
The movements [Median (upper and lower quartiles)] of maxillary teeth in the horizontal plane after staged treatment were 2.31 (1.59, 3.22) and 1.79 (1.21, 3.03) mm in iTero Progress Assessment and 3D model analysis, respectively. Significant difference was observed between the two groups (<0.05). In the measurement of upper and lower dentition width, four indicators were measured, including intercanine width upper, intermolar width upper, intercanine width lower, and intermolar width lower. Before treatment, the measurement of iTero Progress Assessment were (35.78±2.49), (56.21±2.51), (27.43±1.38), (52.26±2.91) mm, respectively, and actual measurement were (35.77±2.53), (56.17±2.47), (27.40±1.41), (52.30±2.86) mm, respectively, without significant difference (>0.05). After stage treatment, the measurement of iTero Progress Assessment were (37.37±2.86), (57.76±2.56), (28.89±2.00), (54.16±2.19) mm, respectively, and actual measurement were (37.29±2.94), (57.71±2.63), (28.88±2.05), (54.01±2.15) mm, respectively, and there was no significant difference (>0.05).
CONCLUSIONS
The data from iTero Progress Assessment did not coincide with the model superimposition results with palate as reference. The accuracy of model superimposition in iTero Progress Assessment needs further investigation, whereas the arch width analysis is accurate. Therefore, iTero Progress Assessment results should be interpreted with caution by orthodontists in clinical applications.
Topics: Case-Control Studies; Cuspid; Dental Arch; Orthodontic Appliances, Removable; Retrospective Studies; Humans
PubMed: 36416323
DOI: 10.7518/hxkq.2022.06.011 -
International Journal of Environmental... Dec 2022Traumatic injuries to the permanent dentition are most common in children. In severe dentoalveolar injuries, especially avulsion and intrusion, dentoalveolar ankylosis...
Traumatic injuries to the permanent dentition are most common in children. In severe dentoalveolar injuries, especially avulsion and intrusion, dentoalveolar ankylosis is a common complication, leading to adverse effects on the developing alveolar bone and interfering with the eruption of the adjacent teeth. The decoronation procedure was suggested in 1984 to reduce these side effects related to ankylosis. The objective of the current publication is to describe a minimally invasive, flapless decoronation procedure aimed to minimize and simplify the surgical procedure of decoronation, and ease its clinical acceptance, particularly in young children. The technique is described in a detailed protocol and demonstrated in two cases. Under local anesthesia, the dental crown is removed, and the root is reduced by 1.5-2.0 mm apically to the marginal bone crest. The root canal content is then removed, allowing it to fill with blood. The socket is coronally sealed with a porcine-derived collagen matrix (PDCM) sutured using the "parachute" technique over the resected root, allowing close adaptation to the surrounding soft tissue. In conclusion, the presented technique of flapless decoronation is a modification of the classic decoronation procedure, which can be used as a minimally invasive technique to simplify the surgical procedure and the post-operative process.
Topics: Humans; Tooth Ankylosis; Tooth Crown; Alveolar Process; Tooth; Tooth Avulsion
PubMed: 36612921
DOI: 10.3390/ijerph20010603 -
Seminars in Cell & Developmental Biology 2014Four conserved signaling pathways, including the bone morphogenetic proteins (Bmp), fibroblast growth factors (Fgf), sonic hedgehog (Shh), and wingless-related (Wnt)... (Review)
Review
Four conserved signaling pathways, including the bone morphogenetic proteins (Bmp), fibroblast growth factors (Fgf), sonic hedgehog (Shh), and wingless-related (Wnt) pathways, are each repeatedly used throughout tooth development. Inactivation of any of these resulted in early tooth developmental arrest in mice. The mutations identified thus far in human patients with tooth agenesis also affect these pathways. Recent studies show that these signaling pathways interact through positive and negative feedback loops to regulate not only morphogenesis of individual teeth but also tooth number, shape, and spatial pattern. Increased activity of each of the Fgf, Shh, and canonical Wnt signaling pathways revitalizes development of the physiologically arrested mouse diastemal tooth germs whereas constitutive activation of canonical Wnt signaling in the dental epithelium is able to induce supernumerary tooth formation even in the absence of Msx1 and Pax9, two transcription factors required for normal tooth development beyond the early bud stage. Bmp4 and Msx1 act in a positive feedback loop to drive sequential tooth formation whereas the Osr2 transcription factor restricts Msx1-mediated expansion of the mesenchymal odontogenic field along both the buccolingual and anteroposterior axes to pattern mouse molar teeth in a single row. Moreover, the ectodermal-specific ectodysplasin (EDA) signaling pathway controls tooth number and tooth shape through regulation of Fgf20 expression in the dental epithelium, whereas Shh suppresses Wnt signaling through a negative feedback loop to regulate spatial patterning of teeth. In this article, we attempt to integrate these exciting findings in the understanding of the molecular networks regulating tooth development and patterning.
Topics: Animals; Dentition; Humans; Mice; Morphogenesis; Tooth
PubMed: 24355560
DOI: 10.1016/j.semcdb.2013.12.003 -
TheScientificWorldJournal 2022To evaluate over a six-year period, the prevalence of the dental procedures in primary and mixed dentitions, in males and females.
AIM
To evaluate over a six-year period, the prevalence of the dental procedures in primary and mixed dentitions, in males and females.
MATERIALS AND METHODS
A retrospective descriptive study on dental treatments in primary and mixed dentitions was conducted in the Department of Pediatric Dentistry at the Faculty of Dental Medicine, Lebanese University, from 2015 to 2020. The total number of children was 1291. Data were classified and reviewed according to the dentition type, gender, and type of dental treatment.
RESULTS
The number of children decreased from 741 for the period 2015-2017 to 550 during the period 2018-2020 (279 males and 271 females). No significant association was found between the admission periods and the genders. A significant relationship was found between the number of treatments performed in both genders and the dentition types ( value = 0,015). Males were slightly more likely than females to present for the treatment in mixed dentition (54.58% versus 45.2%, respectively). Results portrayed a significant relationship between surgical treatment and gender ( value = 0.049). However, no significant relationship between gender and other treatment types was noted. The comparison between the 2 time frames and the types of treatments showed a significant association in composite fillings ( value = 0.043), extractions ( value < 0.0001), sealants ( value = 0.039), preventive resin restoration (=0.011), pulp therapies ( value < 0.0001), pediatric crowns ( value < 0.0001), and surgical interventions ( value = 0.013). A nonsignificant relationship was recorded for the appliances and composite crowns ( value = 0.45 and 0.14, respectively).
CONCLUSION
The present study points out the implications of the COVID-19 outbreak and Lebanon's economic collapse on children's dental status, with the number of children receiving dental care dropping remarkably. A decrease in all types of dental procedures was noted in mixed dentition, whereas an increase in dental treatments related to aggravated carious lesions was reported in primary dentition. More medical and financial aids are required to encourage and support parents' attitude towards children dental care during unprecedented crises.
Topics: COVID-19; Child; Crowns; Dental Care; Dental Caries; Female; Humans; Male; Retrospective Studies; Tooth, Deciduous
PubMed: 35615224
DOI: 10.1155/2022/9285893 -
The Chinese Journal of Dental Research Sep 2021Tooth eruption is closely linked to the normal development of dentition and proper establishment of occlusion. Disturbances in tooth eruption may affect oral... (Review)
Review
Tooth eruption is closely linked to the normal development of dentition and proper establishment of occlusion. Disturbances in tooth eruption may affect oral physiological functions, facial contour and aesthetics; it is therefore important to understand the eruption process. This process is a complex biological event involving dynamic changes at the tissue and cellular levels. It is guided by anatomical structures as well as biological and molecular factors that result in the movement of the tooth to its final functional position in the oral cavity. Evidence increasingly suggests that stem cells contribute to tooth development and eruption. Multiple stem cell populations have been discovered in teeth and in their supporting tissues, such as dental follicle precursor cells, orofacial bone-/bone marrow-derived mesenchymal stem cells, periodontal ligament stem cells, stem cells from the apical papilla and dental pulp stem cells. These stem cells exhibit distinct differentiation capacities and are closely linked to alveolar bone remodelling, periodontium development and root formation during the eruption process. The present review summarises the current knowledge of the characteristics and functions of orofacial stem cells in tooth eruption, with a particular focus on recent discoveries concerning their lineage allocation and regulatory mechanisms.
Topics: Cell Differentiation; Periodontal Ligament; Stem Cells; Tooth; Tooth Eruption
PubMed: 34491008
DOI: 10.3290/j.cjdr.b1965049