Radiographic Assessment of Dental Pathology and Abnormalities in Dolphins.

This study proposes a simple standardized method for the production of analog X-ray images of dolphin teeth, and to explore its potential use as a complementary technique in the evaluation of dental pathology in small cetaceans. We investigated exposure times that produced the best results, and whether radiographs helped in the diagnosis of macroscopic abnormalities. Teeth of six species of dolphins (Delphinidae: Tursiops truncatus, Steno bredanensis, Sotalia guianensis, Delphinus sp., Stenella coeruleoalba, and Stenella frontalis) were X-rayed in an analog dental X-ray machine operating at 70 kVp and 7 mA. Intraoral size 2 standard films were used, and the focus-film distance was standardised at 35 cm. Those species with smaller teeth (total length 12-20 mm) had the best results when exposed for 0.3 seconds, while species with larger teeth (30-45 mm) had to be exposed for 0.4 seconds for their best result. Three independent examiners analysed all the images taken. The average pairwise percent agreement was 73% (Fleiss' Kappa = 0.229), suggesting fair agreement between examiners. Analog X-ray images produced were useful in complementing the diagnosis of dental pathology and abnormalities in dolphins, in addition to allowing the observation of internal details and lesion depths, which would not be possible with conventional macroscopic methods. The use of analog X-ray imaging is easily applicable to the study of dolphin teeth, with low operating costs and simple logistics compared to other non-destructive analytical approaches such as Micro-CT.

The oral health status and the treatment needs in Chad: a pilot study.

AIMS AND OBJECTIVES: This study was designed to evaluate dental conditions, factors contributing to these conditions, and treatment needs among a population from different places in Chad, as part of a general assessment of their oral health. PATIENTS AND METHODS: A cross-sectional nationwide survey was conducted with 1,011 participants. The survey consisted of a brief health interview (conducted by dental students and public health specialists) followed by a 1-2 minutes oral examination (conducted by dental students and dentists). RESULTS: Sixty four per cent of the subjects had experienced dental pain, 66.7% had decayed teeth, and 56.6% had gum diseases. Dental pain was found to be distributed according to age, gender and locations (p<0.001). Only 25% of the participants had ever visited a dentist. Males were show to engage in more tobacco use than females (19.2% vs. 0.3%), while females were more likely to have visited a dentist than males (30.8% vs. 22.8%). Brushing of teeth occurred more often in urban than in rural locations (p<0.001), while date, sugar cane and cola nut intake were statistically significant in the older generation compared to the younger subjects (p<0.001). CONCLUSION: There was a significant need for dental treatment and care in the sample population. In addition, the availability of sugar, combined with poor knowledge, utilisation of preventive and restorative oral health care services have been contributed to have several dental conditions.

Characteristics and cost impact of severe odontogenic infections.

OBJECTIVE: The objective of this study was to retrospectively analyze the clinical presentation, surgical management, and cost implications of inpatients treated for odontogenic infections at a public tertiary care hospital. STUDY DESIGN: Specific analysis from 3 years of chart review included length of stay, cost of hospitalization, site of infection, number of infected spaces, microbiology profile, antibiotics administered, intensive care unit (ICU) stay, number of days intubated, comorbidities, number of operating room visits, imaging studies, and whether the patients received preadmission treatment. RESULTS: Multiple fascial spaces were involved in most of the infections. The average length of stay was 4.57 days and average time in the ICU was 3.1 days. Ninety percent of the patients had a coexisting medical comorbidity. The overall hospital costs totaled $749,382 averaging $17,842 per person. CONCLUSIONS: This study reveals a staggering cost burden on a public health care facility as a result of odontogenic infections.

Quality assessment of dental treatments using en-face optical coherence tomography.

The present study evaluates the potential of en-face optical coherence tomography (OCT) as a possible noninvasive high resolution method for supplying necessary information on the material defects of dental prostheses and microleakage at prosthetic interfaces. Teeth are also imaged after several treatment methods to asses material defects and microleakage at the tooth-filling interface, and the presence or absence of apical microleakage, as well as to evaluate the quality of bracket bonding on dental hard tissue. C-scan and B-scan OCT images as well as confocal images are acquired from a large range of samples. Gaps between the dental interfaces and material defects are clearly exposed.

Histological assessment of root cementum at periodontally healthy and diseased human teeth.

This study aimed to investigate and compare the lipid and polysaccharide content of the cemental surfaces of healthy and periodontally-involved teeth. Thirty periodontally-involved single-rooted teeth from fifteen patients with localized juvenile, adult and rapidly progressive periodontitis were included in the experimental group and 5 healthy teeth were assessed in the control group. Frozen serial sections were obtained and stained with hematoxylin-eosin for morphological assessment. Oil-Red-O and Alcian Blue-Periodic Acid Schiff stains were used to evaluate the presence of lipids, neutral and acidic polysaccharides using light microscopy. It was found that with hematoxylin-eosin staining in the experimental group, both the involved and uninvolved cementum surfaces of teeth, which belong to all periodontitis groups, showed generally irregular surfaces that contain some resorption areas. Alcian Blue-Periodic Acid Schiff positive staining was observed only superficially and at the areas associated with microbial dental plaque. However, Oil-Red-O staining was positive only superficially at 5 teeth that belonged to localized juvenile and rapidly progressive periodontitis groups. Apparent lipopolysaccharide staining into cementum was not seen in any of the diseased teeth. The results presented here suggest that endotoxin was only localized in superficial layers and associated with only microbial colonization.

An assessment of health and disease in the prehistoric inhabitants of the Mariana Islands.

Using a variety of skeletal and dental stress indicators, an assessment of the health and disease of the indigenous inhabitants of the Mariana Islands, the Chamorro, is made. The major hypothesis to be tested is that the Chamorro were relatively healthy and that deviations from the expected, as well as inter-island variation, may reflect environmental, ecological, and cultural differences. The major skeletal series surveyed include sites on Guam (N = 247 individuals), Rota (N = 14), Tinian (N = 20), and Saipan (N = 102). The majority of the specimens are from the transitional pre-Latte (AD 1-1000) and Latte (AD 1000-1521) periods. These data derive primarily from unpublished osteological reports. The indicators of health and disease surveyed include mortality and paleodemographic data, stature, dental paleopathology, cribra orbitalia, limb bone fractures, degenerative osteoarthritis, and infectious disease (including treponemal infection). Where appropriate, tests of significance are calculated to determine the presence of any patterning in the differences observed within and between the skeletal series. Information recorded in prehistoric Hawaiians provides a standard for external comparisons. Several of the larger skeletal series surveyed have paleodemographic features that are consistent with long-term cemetery populations. Females and subadults are typically underrepresented. Most subadult deaths occur in the 2-5 year age interval. Life expectancy at birth ranges from 26.4 to 33.7 years. A healthy fertility rate is indicated for these series. The prehistoric inhabitants of the Mariana Islands were relatively tall, exceeding living Chamorros measured in the early part of the present century. The greater prevalence of developmental defects in the enamel suggests that the Chamorro were exposed to more stress than prehistoric Hawaiians. The low frequency of cribra orbitalia further indicates iron deficiency anemia was not a problem. There are generally low frequencies of dental pathology in the remains from the Mariana Islands. Betel-nut staining is relatively common in all series which may help to explain the relatively low prevalence of dental pathology. Healed limb bone fractures are rare in these skeletal series; the frequency and patterns of fractures suggest accidental injury as the main cause. Greater physical demands involving the lower back region are indicated by a high frequency of spondylolysis, or stress fracture in the lumbar vertebrae in the Chamorro. Likewise, advanced degenerative bone changes, while of low occurrence, are significantly greater in the Chamorro than Hawaiians. The prevalence of skeletal and dental indicators of stress was generally higher in the smaller islands of the Mariansas chain (e.g., Rota), islands with fewer resources to buffer environmental catastrophe. Bony changes suggestive of treponemal (probably yaws) disease are common in most of these Marianas Islands skeletal series.

Factors contributing to dentists' extraction decisions in older adults.

To evaluate which dental and non-dental factors contributed to dentists' extraction decisions in a sample of older adults, an archival study was conducted using community-dwelling and long-term-care older adults receiving dental care at an urban seniors' clinic. Four dentists who provided dental care to older adults reviewed patient records for whom they had extracted at least one tooth over a 21-month period. They identified one or more factors contributing to their extraction decisions. From 105 adults (mean age, 80.6), there were 221 extractions. Frequent contributors to dentists' extraction decisions included non-restorability in 53.8% of all extractions, dental caries (45.6%), prosthetic considerations (45.2%), and periodontal disease (40.3%). The non-dental contributors in 13% to 17% of extractions included patient/family request, inability to care for one's teeth, and financial limitations. When identifying the "most important" (or "primary") factor in their extraction decisions, dentists most frequently indicated non-restorability, followed distantly by patient/family request, periodontal disease, and financial limitations. This investigation demonstrates that non-dental factors are important in dentists' extraction decisions. Of these, patient/family request and financial limitations appear to be most influential.

Secondary retention of permanent molars: an assessment of ankylosis by scanning electron and light microscopy.

Secondary retention refers to the cessation of eruption of a tooth after emergence. This may be the result of pathological changes in the periodontal ligament. The aim of this study was to describe the morphological and histological aspects of the radicular surface of secondarily retained permanent molars. The roots of 12 secondarily retained molars and two control molars, were examined by means of scanning electron microscopy (SEM) and light microscopy (LM) in order to analyse the occurrence and localisation of ankylosis. With SEM it was observed that the root surface of retained molars showed local areas covered with bonelike tissue. LM of these areas showed that this tissue was bone in direct contact with the root surface (ankylosis). In 11 cases, the areas of ankylosis were observed in the bifurcation area and at the interradicular root surface. In the remaining case, ankylosis was located at the outer root surface. The results of this study endorse the assumption that focal ankylosis is an important factor in secondary retention. Treatment recommendations must be based on this fundamental principle, because orthodontic movement of ankylotic molars is not possible.

Validity of the radiographic assessment of ankylosis. Evaluation of long-term reactions in 10 monkey incisors.

The accuracy and sensitivity of radiographic assessments of reactive processes in dental tissues were evaluated by comparison of radiographs and histologic sections. Experimental lesions inflicted on the roots of 10 monkey incisors had been observed by means of serially obtained radiographs over a period of 315 to 370 days. The material was used for evaluation of radiographic assessment of ankylosis. For comparative purposes, assessment of the experimental lesion penetrating to the pulp and periapical radiolucency was added. True and falsely positive or negative recordings formed the basis for calculation of the accuracy and sensitivity of the radiographic assessment. The sensitivity, or the observers' ability to detect the actual changes, was high for pulp penetration, intermediate for inflammation, and low for ankylosis.

Radiographic and visual assessment of alveolar pathology of first molars in dry skulls.

There are many reports in the literature relating to the dental pathology of ancient peoples. In most instances only visual observations of alveolar lesions have been made, precluding assessment of covert dental lesions. The present paper was undertaken to compare the incidence of alveolar dental lesions determined by both visual and radiographic methods in a group of Australian aboriginal skulls. First molars of the right side were used for the comparison: approximately ten percent more lesions were found by the radiographic method. The data demonstrated the limitation of either technique alone. The strong association between pulp exposure and furcal, angular, and apical lesions suggests that pulpal lesions provoke periodontal changes that have traditionally been assigned to a gingival etiology. The location of the lesions within the periodontium would appear to be determined by the location of the pulpal pathology and the pathways through dentin between that location and the periodontal ligament.

Assessment of the status of endodontically treated teeth in patients with cardiovascular abnormality.

The accuracy of conventional methods of assessing the periradicular tissues, especially important in the case of a patient with cardiovascular abnormality, is questioned. The results of histological assessment in 81 teeth are reported. The ideal of a biological obturation of the root canal is emphasized.