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British Dental Journal Mar 2023In the next part of this series on tooth wear management, we discuss the indications and clinical stages for the provision of removable prostheses for the treatment of...
In the next part of this series on tooth wear management, we discuss the indications and clinical stages for the provision of removable prostheses for the treatment of severely worn and depleted dentitions. The general design features of a complex prosthesis are described for reorganised occlusal schemes and maintenance guidelines are explained. In addition, the clinical stages for three different situations are described: removable-only approaches, and combined fixed and removable in the same arch and separate arches. The value of providing removable prostheses in worn dentitions allows the immediate rehabilitation of severely worn teeth taking a non-invasive and retrievable approach when the remaining dentition is of poor quality or structure and/or there are missing teeth.
Topics: Humans; Dentition; Prosthodontics; Dental Implants; Tooth Wear; Tooth Attrition; Denture, Partial, Removable
PubMed: 36964363
DOI: 10.1038/s41415-023-5583-5 -
Forensic Science International May 2023Reliability, or repeatability, of permanent tooth staging techniques is usually expressed as Cohen's Kappa. This single value obscures information about the quantity and...
Reliability, or repeatability, of permanent tooth staging techniques is usually expressed as Cohen's Kappa. This single value obscures information about the quantity and allocation of disagreements. In this study we assess and compare intra-observer reliability of permanent tooth staging techniques described by Nolla, Moorrees et al. and Demirjian et al. The sample was panoramic radiographs of healthy dental patients made up of 100 males and 100 females aged 6-15 years. All permanent teeth on the left side (excluding third molars) were scored twice. Weighted Kappa and percentage agreement were calculated. Results show Kappa values for all teeth combined as 0.918, 0.922 and 0.938 for Demirjian (number of teeth N = 2682), Nolla (N = 2698) and Moorrees (N = 2674) respectively. A comparison of Kappa values between upper and lower teeth showed marginally higher values for upper incisors and lower molar for all three scoring methods. Small differences in Kappa values were noted between tooth types with the upper first molar having smaller values than other teeth. Percentage agreement ranged from 81 % (Moorrees), 86 % (Nolla) to 87 % (Demirjian). Tooth stage differences between first and second assessments were not more than one stage. Our findings show that Demirjian scoring is marginally more reliable than Nolla or Moorrees. We suggest that (1) data for reliability are tabulated in full to show the quantity and allocation of disagreement between first and second readings, and (2) that the reliability sample is sufficiently large with a wide age range to include multiple different tooth stages.
Topics: Male; Female; Humans; Reproducibility of Results; Age Determination by Teeth; Dentition, Permanent; Tooth; Molar, Third; Molar; Radiography, Panoramic
PubMed: 37011430
DOI: 10.1016/j.forsciint.2023.111654 -
Journal of Dental Research Sep 2017Although children with oral clefts have a higher risk for dental anomalies when compared with the general population, prior studies have shown conflicting results...
Although children with oral clefts have a higher risk for dental anomalies when compared with the general population, prior studies have shown conflicting results regarding their dental decay risk. Also, few studies have assessed dental decay risk in unaffected relatives of children with clefts. Thus, the question of increased risk of dental decay in individuals with oral clefts or their unaffected relatives is still open for empirical investigation. This study characterizes dental decay in the largest international cohort to date of children with nonsyndromic clefts and their relatives, as compared with controls, and it addresses whether families with oral clefts have a significantly increased risk for dental decay versus the general population. A total of 3,326 subjects were included: 639 case probands, 1,549 unaffected relatives, and 1,138 controls. Decay was identified from in-person dental examinations or intraoral photographs. Case-control differences were tested with regression analysis. No significant differences were shown in percentage decayed and filled teeth and decayed teeth in the primary dentition (dft, dt) and permanent dentition (DFT, DT) in cases versus controls. In the cleft region, no significant differences were seen in primary or permanent decay (dt, DT) when compared with controls. No difference was found with regard to cleft type and percentage dft, dt, DFT, and DT in case probands. Nonsignificant differences were found in unaffected siblings and parents versus controls (primary and permanent dentitions). Collectively, these findings indicate that individuals with nonsyndromic oral clefts and their families do not have a higher dental decay risk as compared with the general population. These results suggest that either genetic or environmental factors underlying a higher susceptibility for dental anomalies do not increase caries risk or that the seemingly higher risk for dental decay associated with increased dental anomalies in case probands may be superseded by possible greater access to dental care.
Topics: Case-Control Studies; Child; Cleft Lip; Cleft Palate; DMF Index; Dental Caries; Dentition, Permanent; Disease Susceptibility; Female; Humans; Male; Phenotype; Risk Factors; Surveys and Questionnaires; Tooth, Deciduous
PubMed: 28535364
DOI: 10.1177/0022034517709961 -
PloS One 2018Using salivary microbiota as an accurate proxy for monitoring supragingival microbiota remains controversial because their relationship remains unclear. The eruption of...
BACKGROUND
Using salivary microbiota as an accurate proxy for monitoring supragingival microbiota remains controversial because their relationship remains unclear. The eruption of permanent teeth and the exfoliation of primary teeth in mixed dentition greatly alter microbial habitats, which may cause compositional shifts of oral microbiota from childhood to adults.
OBJECTIVE
This study's purpose was to assess whether saliva represents a suitable sample for monitoring supragingival microbiota in healthy people, and to explore how the replacement process of deciduous teeth with permanent teeth in mixed dentition influences microbiota within the oral cavity.
DESIGN
Samples of saliva and of supragingival plaque from permanent and deciduous teeth were collected separately from 20 healthy children with mixed dentition. To characterize their microbial communities, we used the V3-V4 hypervariable region of the bacterial 16S rRNA gene sequence.
RESULTS
Saliva harbored a less even and less diverse community than did the plaque. Discriminating genera, namely Rothia and Streptococcus, contributed to the saliva and plaque differentiation. About half of predicted KEGG pathways varied between the plaque and saliva communities. Oral bacteria showed significantly associations between their supragingival and salivary states. We identified 20 supragingival plaque-related genera in saliva, such as Corynebacterium, Capnocytophaga, Fusobacterium, and Neisseria. Additionally, the relative abundance of Actinobacteria peaked in the permanent teeth plaque but subsided in deciduous teeth plaque and saliva. The exfoliation of deciduous teeth and eruption of permanent teeth might be related to the reported fluctuation in the relative abundance of Actinobacteria from primary dentition to permanent dentition within the oral cavity. The variation between PT and DT was due mainly to permanent teeth being enriched in Actinomyces and deciduous teeth in Treponema.
CONCLUSION
These results suggested that the supragingival plaque-related bacteria could be suitable candidates when sampling saliva for monitoring supragingival microbiota. The replacement process of deciduous teeth with permanent teeth in mixed dentition might be related to the reported age-maturation of phylum Actinobacteria in the oral cavity.
Topics: Actinobacteria; Child; Dental Caries; Dental Plaque; Dentition, Mixed; Female; Humans; Male; Saliva; Streptococcus; Tooth; Tooth Eruption; Tooth, Deciduous
PubMed: 29979786
DOI: 10.1371/journal.pone.0200337 -
The Journal of Clinical Pediatric... May 2023This systematic review aimed to assess bite force measurements in children and adolescents and to study the various devices that measure Maximum Voluntary Bite Force... (Meta-Analysis)
Meta-Analysis
This systematic review aimed to assess bite force measurements in children and adolescents and to study the various devices that measure Maximum Voluntary Bite Force (MVBF). This systematic review included observational studies and experimental studies in children and adolescents (upto 19 years of age) which evaluated MVBF using a bite force measuring device. Studies on participants with systemic conditions were excluded. Databases such as PubMed, Embase, LILACS, and the Cochrane library were searched until September 2022, for which screening and quality assessment were performed. Newcastle-Ottawa, modified Newcastle-Ottawa and ROBINS-I tools were used to assess the Risk-of-bias. All observational studies reporting overall bite force values of participants were included for meta-analyses. A total of 8864 participants (3491 males and 3623 females) were included from 61 studies. Meta-analyses were conducted to evaluate mean average bite force value for each included dentition using R software v2.4-0. Estimation was done to derive an average BF value for variables such as age (dentition), gender, side, site, device and ethnicity. MVBF values were reported as mean average in the form of MLN with 95% CI (Confidence Interval). Using a random-effects model, 29 forest plots were generated. I values varied between 90% and 100%. Bite force ranged from 246.22 N (220.47; 274.98) to 311.72 N (255.99; 379.59) and 489.35 N (399.86; 598.87) in primary, mixed, and permanent dentitions, respectively. Six different sites for recording bite force and 11 different types of devices were reported with portable occlusal bite force gauge being the most common device. Outcomes of this review provide useful baseline reference values of bite force for clinicians and researchers.
Topics: Male; Female; Humans; Child; Adolescent; Bite Force; Dental Occlusion; Dentition, Permanent
PubMed: 37143420
DOI: 10.22514/jocpd.2023.022 -
Acta Odontologica Scandinavica Aug 2020Dental anomalies occurring in deciduous teeth can affect the eruption of the permanent dentition and the occlusion stability. The occurrence of dental anomalies such as...
Dental anomalies occurring in deciduous teeth can affect the eruption of the permanent dentition and the occlusion stability. The occurrence of dental anomalies such as double teeth during the primary dentition in the daily practice might be frequent. The study aimed to qualitatively summarize the therapeutic management of double teeth in primary incisors. A systematic review regarding the therapy of primary fused incisors in the mandible was performed and the obtained data were assessed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following electronic databases were screened from 1st January, 1996 until 30th July, 2019: PubMed, Scopus, EBSCO and the archives of paediatric dental journals. The search terms were grouped in anatomic entity: ( OR OR ), pathological condition: ( OR OR OR ), intervention: ( OR OR OR OR OR OR ), observed parameters: ( OR OR ). Ten articles met all inclusion criteria. The data disclosed the occurrence of double teeth in mandibular incisors. The main management of this clinical condition is either preventive or surgical involving the extraction of fused teeth, based on the deciduous nature of the teeth, the degree of caries and malocclusion development risk. An early diagnosis of dental anomalies is fundamental for the application of proper preventive strategies to avoid a potential malocclusion in permanent dentition and to maintain these teeth sound and caries-free until the eruption of the permanent dentition.
Topics: Anodontia; Child; Fused Teeth; Humans; Incisor; Mandible; Tooth, Deciduous
PubMed: 32125202
DOI: 10.1080/00016357.2020.1734233 -
Dento Maxillo Facial Radiology 2015Radiation toxicity of the dentition may present significant treatment-related morbidity in the paediatric head and neck cancer population. However, clear dose-effect...
OBJECTIVES
Radiation toxicity of the dentition may present significant treatment-related morbidity in the paediatric head and neck cancer population. However, clear dose-effect relationships remain undetermined and must be predicated upon accurate structure delineation and dosimetry at the individual tooth level. Radiation oncologists generally have limited familiarity or experience with relevant dental anatomy.
METHODS
We therefore developed a detailed CT atlas of permanent and primary dentition. After studying this atlas, five radiation oncology clinicians delineated all teeth for each of eight different cases (selected for breadth of dental maturity and anatomical variability). They were asked to record confidence in their contours on a per-tooth basis as well as the duration of time required per case. Contour accuracy and interclinician variability were assessed by Hausdorff distance and Dice similarity coefficient. All analyses were performed using R v. 3.1.1 and the RadOnc v. 1.0.9 package.
RESULTS
Participating clinicians delineated teeth with varying degrees of completeness and accuracy, stratified primarily by the age of the subject. On a per-tooth basis, delineation of permanent dentition was feasible for incisors, canines, premolars and first molars among all subjects, even at the youngest ages. However, delineation of second and third molars was less consistent, commensurate with approximate timing of tooth development. Within each tooth contour, uncertainty was the greatest at the level of the dental roots.
CONCLUSIONS
Delineation of individual teeth is feasible and serves as a necessary precursor for dental dose assessment and avoidance. Among the paediatric radiation oncology community in particular, this atlas may serve as a useful tool and reference.
Topics: Atlases as Topic; Dentition, Permanent; Humans; Radiation Dosage; Radiation Protection; Radiometry; Tomography, X-Ray Computed; Tooth, Deciduous
PubMed: 25812046
DOI: 10.1259/dmfr.20150034 -
Journal of Oral Science Sep 2020The upper and lower tooth-bearing jaws of the filefish (Stephanolepis cirrhifer) were scanned using a micro-CT system in order to address the existing gaps between the...
The upper and lower tooth-bearing jaws of the filefish (Stephanolepis cirrhifer) were scanned using a micro-CT system in order to address the existing gaps between the traditional pictures of the morphology and histology. 2D tomograms, reconstructed 3D models and virtual dissection were employed to examine and evaluate the in situ geometry of tooth implantation and the mode of tooth attachment both separately and collectively. No distinct sockets comparable to those in mammals were evident, but shallow depressions were observed in the premaxillary and the dentary. The opening of the tooth pulp cavity was not simply oriented towards the apparent tooth base in a direction opposite to the tooth apex. The opening was distorted basoposteriorly or basoanteriorly depending on the position of the tooth, and the edge of the pulp cavity opening was barely ankylosed; i.e. the sites of pleurodont ankylosis along the basoposterior or basoanterior edge of the opening appeared to closely match the contour of the shallow depression in the bone. These 3D findings appear to be very informative when considering the phylogeny of tooth attachment, suggesting that micro-CT would be a useful modality concurrent with or in advance of histological investigations.
Topics: Animals; Dentition; Jaw; Periodontal Ligament; Tooth; Tooth Ankylosis
PubMed: 32788503
DOI: 10.2334/josnusd.19-0457 -
European Archives of Paediatric... Dec 2016This was primarily to examine the effect of premature extraction of primary teeth (PEPT) on subsequent malocclusion and need for orthodontic treatment in the permanent... (Review)
Review
AIM
This was primarily to examine the effect of premature extraction of primary teeth (PEPT) on subsequent malocclusion and need for orthodontic treatment in the permanent dentition. The secondary aim was to correlate the effect of PEPT with loss of space in the primary and mixed dentitions.
METHODS
A predefined protocol was developed and registered prospectively with PROSPERO database. The electronic databases, searched, were MEDLINE, EMBASE, PubMed, and Cochrane Central Register of Controlled Trials. The study designs considered for inclusion were controlled trials, cohort, and case-control studies. Risk of bias was assessed using a validated quality assessment tool.
RESULTS
513 studies were identified. Sixteen studies were included in the systematic review, one study reported on malocclusion, and 15 studies reported on space changes. Narrative synthesis was undertaken owing to the heterogeneity of the included studies. No study examined the effect of PEPT on orthodontic need. Most studies reported on space dimensions used a split-mouth design and were at a high risk of bias.
CONCLUSIONS
The included literature identified that PEPT led to various features of malocclusion and space loss in the mixed and permanent dentitions. No studies, that met the inclusion criteria, described the effect of PEPT on the subsequent need for orthodontic treatment.
Topics: Humans; Malocclusion; Orthodontics, Corrective; Tooth Extraction; Tooth, Deciduous
PubMed: 27812892
DOI: 10.1007/s40368-016-0247-7 -
The Angle Orthodontist Jan 2023To compare the efficacy and efficiency between clear aligners and 2 × 4 fixed appliances for correcting maxillary incisor position irregularities in the mixed dentition. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To compare the efficacy and efficiency between clear aligners and 2 × 4 fixed appliances for correcting maxillary incisor position irregularities in the mixed dentition.
MATERIALS AND METHODS
The sample comprised 32 patients from 7 to 11 years of age randomly allocated into two parallel treatment groups: the clear aligners group, 14 patients (6 girls, 8 boys) with a mean initial age of 9.33 years (standard deviation [SD] = 1.01) treated with clear aligners; and the fixed appliances group, 13 patients (9 girls, 4 boys) with a mean initial age of 9.65 years (SD = 0.80) treated with partial (2 × 4) fixed appliances. Digital models were acquired before treatment and after appliance removal. Primary outcomes were incisor irregularity index and treatment time. Secondary outcomes were arch width, perimeter, length, size and shape, incisor leveling, incisor mesiodistal angulation, plaque index, and white spot lesion formation (International Caries Detection and Assessment System index). Intergroup comparisons were evaluated using t-tests or Mann-Whitney U-tests with Holm-Bonferroni correction (P < .05).
RESULTS
Treatment time was approximately 8 months in both groups. No intergroup differences were observed for changes in any of the variables. Similar posttreatment arch shapes were observed in both groups.
CONCLUSIONS
Clear aligners and 2 × 4 mechanics displayed similar efficacy and efficiency for maxillary incisor position corrections in the mixed dentition. The choice of appliance should be guided by clinician and family preference.
Topics: Male; Female; Humans; Child; Dentition, Mixed; Orthodontic Appliances, Fixed; Incisor; Maxilla; Orthodontic Appliances, Removable
PubMed: 36066265
DOI: 10.2319/032322-237.1