[Dental care and sexuality]. / Médecine dentaire esthétique et sexualité.

It must be stressed that a comprehensive evaluation of the general health condition is a pre-requisite in any screening process of a specific sexual activity. In the same way, the oral health examination should include the soft tissues such as the tongue and the lips, and the oral breath as well as the teeth to stress their possible implication in disorders of any kind. A special attention is given to the connexion between a good sexual life and a good aspect of all the dentition. The main purpose is to presume the importance particularly of smile, kisses and a good breath in the sexual life of a couple.

Long-term vertical changes of the anterior maxillary teeth adjacent to single implants in young and mature adults. A retrospective study.

AIM: To evaluate the effects of the tooth eruption process on the position of teeth adjacent to implant-borne restorations in adult patients compared to patients in their late adolescence. SUBJECT AND METHODS: The sample included 28 patients divided into two groups. A "young adult" group consisting of 14 patients, aged from 15.5 to 21 years, and a "mature adult" group consisting of 14 patients, aged from 40 to 55 years. All patients presented missing anterior teeth, requiring insertion of 40 implant fixtures (16 central incisors, 12 lateral incisors, 12 canines). The implants were of the Straumann Dental Implant System, clinically and radiologically re-evaluated 1 year or more after the surgical procedure (mean interval=4.2 years). Assessment of the eruption of the adjacent teeth was performed using the implant as a stable point of reference: measurements of the different reference points were compared after implant placement and at follow-up examination. RESULTS: In the "young adult" group, all patients showed infra-occlusion of the implant-supported crowns: the vertical step measured on radiographs varied between 0.1 and 1.65 mm. In the "mature adult" group, all patients showed a vertical difference between the teeth adjacent to the implant-supported crown and the implant: the measured step ranged from 0.12 to 1.86 mm. No difference was found in the amount of vertical eruption between male and female patients, nor according to localization of the implant. CONCLUSION: Mature adults can exhibit major vertical steps after anterior restorations with osseointegrated fixtures to the same extent as adolescents or "young adult" individuals with residuous growth potential.

Treatment of traumatic injuries in the front teeth: restorative aspects in crown fractures.

Crown fractures are the most common form of traumatic dental injuries encountered in permanent dentition. Restorative treatment modalities incorporate adhesive materials to effectively maintain function and aesthetics. While uncomplicated injuries of the enamel and/or dentin can be treated solely with adhesive procedures, complicated trauma that involves pulp exposure requires the incorporation of a multidisciplinary treatment approach. Fragment reattachment is facilitated by the utilization of bonding agents that enhance retention and aesthetics. This article discusses the application of provisional and permanent restorative options for the treatment of complications following traumatic injuries.

Treatment of luxation traumatic injuries: definition and classification in the literature.

Luxation traumatic injuries affect the hard tissues and may involve periodontal tissues in severe cases. Periodontal healing must be considered during treatment of traumatic injuries that result in total luxation of the teeth. Pulpal healing is essential for the endodontic prognosis of a reimplanted tooth, as well as for its periodontal healing. Luxation injuries can be further classified as intrusive, extrusive, and/or lateral; this categorization further facilitates the mode of splinting and repositioning utilized during treatment. This article reviews various types of dentoalveolar traumatic injuries and discusses commonly incorporated treatment modalities.

Muco-gingival and periodontal health recovery following reimplantation of teeth.

Reimplantation of avulsed permanent teeth following traumatic injuries is a widely accepted therapeutic measure; however, though periodontal healing is considered to be the major determinant of long-term survival of reimplanted teeth, the mucogingival reaction to reimplantation has never been assessed. In the present study, hygiene level and gingival inflammation of 13 reimplanted teeth were assessed according to the plaque index (PI) and the gingival index (GI) around both reimplanted and control teeth. The periodontal condition was evaluated by measuring probing depth and probing attachment level at the same location. The clinical parameters of the reimplanted teeth were compared with those of contralateral teeth with the help of the non-parametric Wilcoxon signed ranks test. There were no statistically significant differences in PI and GI scores at any points of measurements around both reimplanted and control teeth; neither did probing depths and probing attachment levels differ between reimplanted and contralateral teeth. The results of the present study indicated that the muco-gingival reaction following traumatic avulsion did not affect the long-term prognosis of the reimplanted teeth.

Intra-alveolar surgical uprighting of impacted teeth: a case report.

Although orthodontic repositioning of impacted teeth is widely used, the treatment has its limitations. Autotransplantation or intra-alveolar surgical repositioning of teeth is an alternative therapy that may be used in selected cases of desperate impactions, when orthodontic extrusion is unsuccessful or when orthodontic treatment is rejected by the patient. A case report is presented to stress both the indications and limitations of a modified technique of intra-alveolar surgical uprighting of impacted teeth.

Current restorative modalities for young patients with missing anterior teeth.

The early loss of permanent teeth following trauma or congenital aplasia may be corrected by orthodontic or prosthetic means, sometimes combined with implant therapy. The orthodontic solution results usually in different anatomic, functional, and esthetic problems. Prosthetic and implant procedures, on the other hand, are very demanding and require long-term maintenance. Considering these limitations, a comprehensive diagnostic and treatment plan is mandatory to achieve the most satisfactory clinical result. Modern restorative modalities, such as recontouring, bleaching, and resin composite bonding, may improve the final clinical result after orthodontic space closure. In more difficult situations, veneers and crowns may also be indicated.

A retrospective clinical and radiologic study of teeth re-implanted following traumatic avulsion.

Re-implantation is the recommended therapeutic procedure following traumatic exarticulation of teeth though its long-term prognosis remains controversial. The purpose of the following study was to evaluate the periodontal healing of 33 reimplanted incisors lost after trauma. The sample, which included 24 upper and 9 lower incisors, was divided in two groups: 15 teeth were reimplanted within 1 hour (=Group A) and 21 teeth after 3 hours or more (=Group B). The reimplanted teeth were followed for different radiographic evaluation periods up to 5 years (mean=2-9 years). The results showed a high rate of periodontal healing in Group A (66.7%), while Group B demonstrated a high percentage (83.3%) of both inflammatory and replacement resorption. Thus, even if the whole sample was prevented from drying before reimplantation, the teeth were affected by different rates of root resorption. Among the various prognostic factors suggested by the literature, bacterial contamination during extra-alveolar storage seemed the most critical.

A new concept of education and knowledge retrieval through network systems.

Recent epidemiological investigations reveal increasing figures of prevalence of dental traumatology; however, basic and clinical research is rather scarce in the scientific literature. The development of computer technologies and the advent of communication pathways through network systems offer increased opportunities to disseminate theoretical and practical data on dento-facial traumatisms. A new server launched on Internet, the global network system, is described and proposed to allow better recognition and information sharing through both practitioners and institutions in the field of dental traumatology.

Conservative surgical and orthodontic management of a child with central giant cell granuloma.

Differential diagnosis and treatment modalities of giant cell granulomas have been a controversial matter since Jaffe first distinguished true giant cell tumours (TGCG) from central giant cell granulomas (CGCG). CGCG is a slowly growing and painless tumour usually treated by simple curettage but denotes a strong tendency to recurrence. A case report is presented to describe conservative therapy of CGCG in the maxilla of a young child: surgical enucleation of the tumour at the age of 11 years, though successful, was followed by progressive impaction of the maxillary right permanent canine. Orthodontic treatment aligned the maxillary teeth to accommodate autotransplantation of the impacted tooth. Clinical and radiographic evaluation of the patient 5 years after the initial surgical treatment showed good bony and periodontal healing around the transplanted canine and no recurrence of the CGCG. As the literature shows that distinction of the two tumours is difficult even by histological means, various clinico-pathologic factors involved in prognostic evaluation are discussed.

Cephalometric evaluation of surgical-orthodontic treatment of skeletal Class III malocclusion.

The stability of combined surgical-orthodontic correction of Class III malocclusions was evaluated. Changes at surgery and at 1-year postsurgery were observed in a sample of 13 patients undergoing mandibular setback by bilateral sagittal split osteotomy. The average posterior movement of the chin at surgery was 7.27 mm at point B, 6.39 mm at pogonion, and 5.72 mm at menton. Changes from postsurgery to 1-year follow-up revealed statistically significant differences in horizontal measurements, in which a forward movement of the mandible at point B, pogonion, and menton indicated a relapse tendency. Although vertical changes were minimal, soft tissue points followed relapse of the chin to the same extent. Because rigid internal fixation was not able to prevent relapse, technical refinements should be investigated to improve the stability of bilateral sagittal split osteotomy if the absence of maxillary deficiency contraindicates the use of bimaxillary surgical procedures.

Indications of autotransplantation of teeth in orthodontic problem cases.

Autotransplantations of teeth have been widely used in orthodontics, mainly in cases of severe impactions, early loss of permanent teeth, or congenital aplasia. In specific clinical situations, indication of extractions or supernumerary teeth may provide donor teeth for transplantations avoiding prosthetic or implant therapy. Two cases are presented to illustrate the topic, and prognostic factors of autotransplantation are discussed.

A retrospective study of dento-alveolar injuries.

Traumatic injuries to primary and permanent dentition may lead to severe therapeutic problems. The purpose of the investigation was to evaluate epidemiologic data of dento-alveolar injuries collected in a university dental clinic. The sample consisted of 300 patients (198 boys, 102 girls) representing 480 injured teeth, mostly maxillary incisors (94.6%). The results pointed-out a high predominance of traumatized primary teeth. Types of injuries differed between deciduous and permanent dentition: luxation injuries were most often recorded in primary dentition (81%), while a high percentage of crown and crown-root fractures were recorded in permanent dentition (38%). Epidemiological observations concerning location, etiology and distribution of dento-alveolar injuries are briefly discussed.

[Dental and dentoalveolar injuries: their etiology, incidence and distribution in a specialized university service]. / Traumatologie dentaire et dento-alvéolaire: étiologie, fréquence et distribution dans un service universitaire spécialisé.

From 1987 to 1992, 520 patients presenting with traumatic injuries were referred to the Department of Orthodontics and Pedodontics at the University of Geneva. The sample consisted of 949 injuries, involving 556 primary and 393 permanent teeth. They concerned mostly upper primary (56%) or permanent (35%) incisors, and were more frequent in boys (60.6%) than girls (39.4%). Various epidemiological observations concerning etiology, age distribution and seasonal variations are discussed. Given the limits assigned by data derived from a selected sample, they are compared with other studies dealing with traumatic injuries.

A clinical and radiologic study of autotransplanted impacted canines.

The aim of the present study was to evaluate the clinical and radiologic results of 20 autotransplantations of impacted canines performed in the Orthodontic and Pedodontic Department of the University of Geneva between 1979 and 1988. The sample, divided into two different age groups (group A: 13-20 years; group B: 20-48 years), demonstrated persistence of pulp vitality in 80% of the cases in group A, whereas routine endodontic treatment was instituted in all cases of group B. Periodontal healing was noted in 90% of the cases in group A, and in 70% of the cases in group B. The present clinical and radiologic data indicate that impacted canines can be transplanted at any age with good prognosis and are an alternative to orthodontic repositioning in selected cases of canine impaction.

Autotransplantations and loss of anterior teeth by trauma.

The loss of anterior teeth by trauma has usually been corrected by orthodontic or prosthetic means. In some specific cases, however, the skeletal and dental relationship may contraindicate the use of space-closure mechanics. Autotransplantation of teeth, successfully depicted in many clinical studies, can help to reduce the severity of orthodontic cases complicated by traumatized anterior teeth. A case report is presented to stress both the indications and limitations of such treatment.

Long-term clinical and radiologic evaluation of autotransplanted teeth.

The purpose of the present study was to investigate the radiologic results of 40 autotransplantations (20 molars and 20 premolars) performed in the orthodontic department of the University of Geneva between 1979 and 1990. The sample demonstrated persistence of pulp vitality and continuous root development, followed, however, in most cases by replacement root resorption. The data were in accordance with previously published studies and point to an ideal developmental stage for molar and premolar transplantation to ensure pulpal and periodontal survival.