Modified cuspal relationships of mandibular molar teeth in children with Down's syndrome.
(1/122)
A total of 50 permanent mandibular 1st molars of 26 children with Down's syndrome (DS) were examined from dental casts and 59 permanent mandibular 1st molars of normal children were examined from 33 individuals. The following measurements were performed on both right and left molars (teeth 46 and 36 respectively): (a) the intercusp distances (mb-db, mb-d, mb-dl, db-ml, db-d, db-dl, db-ml, d-dl, d-ml, dl-ml); (b) the db-mb-ml, mb-db-ml, mb-ml-db, d-mb-dl, mb-d-dl, mb-dl-d angles; (c) the area of the pentagon formed by connecting the cusp tips. All intercusp distances were significantly smaller in the DS group. Stepwise logistic regression, applied to all the intercusp distances, was used to design a multivariate probability model for DS and normals. A model based on 2 distances only, mb-dl and mb-db, proved sufficient to discriminate between the teeth of DS and the normal population. The model for tooth 36 for example was as follows: p(DS) = (e(30.6-5.6(mb-dl)+25(mb-db)))/(1 + e(30.6 5.6(mb-dl)+25(mb db))). A similar model for tooth 46 was also created, as well as a model which incorporated both teeth. With respect to the angles, significant differences between DS and normals were found in 3 out of the 6 angles which were measured: the d-mb-dl angle was smaller than in normals, the mb-d-dl angle was higher, and the mb-dl-d angle was smaller. The dl cusp was located closer to the centre of the tooth. The change in size occurs at an early stage, while the change in shape occurs in a later stage of tooth formation in the DS population. (+info)
Delayed dental age in boys with constitutionally delayed puberty.
(2/122)
It was the purpose of this study to evaluate dental age in boys with delayed puberty and to compare them with a group of normal, healthy boys. The study group consisted of eight boys with constitutional delay of growth and puberty (CDGP), older than 14 years, and with a testis volume smaller than 4 ml. The control group comprised 38 normal, healthy boys, aged between 12.4 and 14.3 years. Dental age was assessed using the Demirjian method and, on the basis of this evaluation, a dental delay score (i.e. dental age minus chronological age) was calculated in the CDGP and the control group. It was found that Demirjian's dental age assessment is a valid method for scoring dental age in Belgian boys between 12 and 14 years of age, and that CDGP boys showed a significant delay in dental development compared with normal boys (P = 0.0085). This study revealed a significant retardation in dental maturation of boys with CDGP. (+info)
Maturation of primary and permanent teeth in preterm infants.
(3/122)
AIMS: To elucidate the development of primary and permanent teeth and to interpret the effect of different calcium, phosphorus, and vitamin D supplementation in the neonatal period on dental maturation in preterm children. METHODS: Preterm infants were randomised to four groups to receive a vitamin D dose of 500 or 1000 IU/day and calcium and phosphorus supplemented or unsupplemented breast milk. The maturity of the primary and permanent teeth was recorded in 30 preterm children. Sixty children aged 2 years and 60 children aged 9-11 years served as controls. Bone mineral content/density was assessed in the preterm infants. RESULTS: The median (range) corrected teething age was 7 (2-16) months in preterm infants and 6 (2-12) months in controls (p = 0.43). The median (range) number of erupted teeth at 2 years of age was 16 (11-19) in preterm infants and 16 (12-20) in controls (p = 0.16). Maturation of the permanent teeth in the preterm infants was not delayed compared with the controls (mean Demirjian SDS 0.16 v 0.49, p = 0.14). Early dietary intake of either mineral or vitamin D did not affect maturation of the primary dentition in preterm children. Children receiving the higher vitamin D dose in the neonatal period had more mature permanent dentition than those receiving the lower dose, but mineral intake did not affect maturation of the permanent teeth. Dental maturation did not correlate with bone mineral status. CONCLUSIONS: This is the first longitudinal study to follow primary and permanent tooth maturation in the same preterm children. Premature birth has no appreciable late sequelae in tooth maturation. (+info)
Tightness of dental contact points in spaced and non-spaced permanent dentitions.
(4/122)
One of the characteristics of normal occlusion is tight dental contact points (CPs). However, the magnitude and distribution of the tightness of a dental contact point (TDCP) in non-spaced versus spaced dentitions are unknown, as well as the mechanism controlling this arrangement. Two hypotheses were examined: the compression theory, i.e. the teeth touch each other in a compressive state; and the resistance theory, i.e. size and number of roots determine TDCP values. For the study, 60 subjects (27 men, 33 women), mean age 25 +/- 4.3 years, with a complete permanent dentition and no missing teeth were divided into spaced (n = 22) and non-spaced dentitions (n = 38). For each CP, four repeated measurements of peak strain were performed with a one-month interval. No significant differences were found between repeated measurements. All CPs demonstrated a continuous decreased TDCP in the postero-anterior direction. Consequently, in non-spaced dentitions TDCPs between molars were 100 per cent higher than incisors. The five anterior CPs of each jaw demonstrated similar TDCP values. Maxillary TDCPs versus mandibular antagonists were not significant. Mandibular TDCPs were significantly higher in men than in women (14 per cent). Anterior TDCPs were less in spaced than in non-spaced dentitions (55 per cent). Posterior TDCPs were also lower in spaced dentitions, however, to a lesser extent (25 per cent). With the exception of TDCPnon-spaced > TDCPspaced, which is partially explained by the compression theory, most of the findings support the resistance theory regulating TDCP characteristics of the permanent dentition. (+info)
Clinical applications and outcomes of using indicators of risk in caries management.
(5/122)
The aim of this review was to systematically assess clinical evidence in the literature to determine the predictive validity of currently available multivariate caries risk-assessment strategies (including environmental, sociodemographic, behavioral, microbiological, dietary/nutritional, and/or salivary risk factors) in: 1) primary teeth; 2) coronal surfaces of permanent teeth; and 3) root surfaces of permanent teeth. We identified 1,249 articles in the search, and selected 169 for full review. Inclusion and exclusion criteria were established prior to commencement of the literature search. Papers that conformed to these criteria were included (n = 15 for primary teeth; n = 22 for permanent teeth; and n = 6 for root surfaces), and 126 papers were excluded. Included articles were grouped by study design as: longitudinal, retrospective, and cross-sectional. The predictive validity of the models reviewed depended strongly on the caries prevalence and characteristics of the population for which they were designed. In many instances, the use of a single predictor gave equally good results as the use of a combination of predictors. Previous caries experience was an important predictor for all tooth types. (+info)
Clinical decision-making for coronal caries management in the permanent dentition.
(6/122)
Optimal conservative treatment decisions to prevent, arrest, and reverse tooth demineralization caused by caries require probability estimates on caries risk and treatment outcomes. This review is focused on the use of the best scientific evidence to recommend treatment strategies for management of coronal caries in permanent teeth as a function of caries risk. Evidence suggests that assigning therapeutic regimens to individuals according to their risk levels should yield a significantly greater probability of success and better cost effectiveness than applying identical treatments to all patients independent of risk. Depending on caries risk levels, treatment decisions based on risk can minimize unnecessary surgical intervention by incorporating the best evidence to prescribe treatment regimens for the use of fluoride-releasing agents, sealants, chlorhexidine, or combinations of these products. (+info)
Systematic review of conservative operative caries management strategies.
(7/122)
The relationship between cavity preparation extension and restoration longevity is examined through a systemic review of the available evidence on specific conservative, operative caries-management strategies. Evidence tables are provided for three specific techniques in the permanent dentition: 1) the proximal "tunnel" restoration, 2) the proximal "box-only" restoration, and 3) the preventive resin restoration. In the primary dentition, the clinical trials involving the proximal box-only restoration, most of which involved glass-ionomer materials, are reviewed. In the permanent dentition, the evidence reveals low effectiveness for "tunnel" restorations, limited but supportive results for proximal-only restorations, and generally favorable outcomes for the occlusal composite resin-sealant restoration. The weak link in the latter is the overlying fissure sealant, which requires adequate ongoing maintenance. Conservative operative strategies in the primary dentition have not been uniformly successful, and deleterious material effects dominate restoration performance. This systematic review concludes that operative conservatism per se does not guarantee increased restoration longevity and that all restorations are vulnerable to caries recurrence, material failures, and technical deficiencies. The more successful conservative strategies are expected to enhance tooth longevity, provided concomitant caries control is effective. (+info)
Radiographic diagnosis of dental caries.
(8/122)
The purpose of this report was to respond to aspects of the RTI/UNC systematic review relating to the radiographic diagnosis of dental caries. The systematic review was commissioned as part of the NIH Consensus Development Conference on Diagnosis and Management of Dental Caries Throughout Life. The systematic review evaluated the dental literature from 1966 to 1999. Well-defined search criteria along with clear inclusion and exclusion criteria were used to perform the review. Some of the inclusion and exclusion criteria used in the systematic review may have limited the evidence supporting the use of radiography, especially for the diagnosis of proximal surface caries. The RTI/UNC review only included studies in which sensitivity and specificity were reported or could be derived from the data presented. Studies that used the receiver operating characteristic as a measure of diagnostic accuracy were not included. Although the strength of evidence is considered poor, this does not mean that the use of radiographic methods is of no diagnostic value. It simply means that, using the criteria established by the systematic review, the evidence is inadequate to validate the method. Guidelines should be developed for assessing diagnostic methods that assist researchers in developing study designs that will hold up to critical review. (+info)