Influence of contact points on the performance of caries detection methods in approximal surfaces of primary molars: an in vivo study.

This in vivo study aimed to evaluate the influence of contact points on the approximal caries detection in primary molars, by comparing the performance of the DIAGNOdent pen and visual-tactile examination after tooth separation to bitewing radiography (BW). A total of 112 children were examined and 33 children were selected. In three periods (a, b, and c), 209 approximal surfaces were examined: (a) examiner 1 performed visual-tactile examination using the Nyvad criteria (EX1); examiner 2 used DIAGNOdent pen (LF1) and took BW; (b) 1 week later, after tooth separation, examiner 1 performed the second visual-tactile examination (EX2) and examiner 2 used DIAGNOdent again (LF2); (c) after tooth exfoliation, surfaces were directly examined using DIAGNOdent (LF3). Teeth were examined by computed microtomography as a reference standard. Analyses were based on diagnostic thresholds: D1: D 0 = health, D 1 ­D 4 = disease; D2: D 0 , D 1 = health, D 2 ­D 4 = disease; D3: D 0 ­D 2 = health, D 3 , D 4 = disease. At D1, the highest sensitivity/specificity were observed for EX1 (1.00)/LF3 (0.68), respectively. At D2, the highest sensitivity/ specificity were observed for LF3 (0.69)/BW (1.00), respectively. At D3, the highest sensitivity/specificity were observed for LF3 (0.78)/EX1, EX2 and BW (1.00). EX1 showed higher accuracy values than LF1, and EX2 showed similar values to LF2. We concluded that the visual-tactile examination showed better results in detecting sound surfaces and approximal caries lesions without tooth separation. However, the effectiveness of approximal caries lesion detection of both methods was increased by the absence of contact points. Therefore, regardless of the method of detection, orthodontic separating elastics should be used as a complementary tool for the diagnosis of approximal noncavitated lesions in primary molars.

The alveolar bone height of the primary and first permanent molars in healthy 6- to 9-year-old Jordanian children.

AIM: To establish a threshold cemantoenamel junction (CEJ)-alveolar bone crest (ABC) distance in healthy 6- to 9-year-old Jordanian children and determine the effect of pathological changes, physiological changes, gender, and age on the CEJ-ABC distance. DESIGN: Bitewing radiographs were made for 539 6- to 9-year-old children. Plaque index (PI), gingival index (GI), calculus index (CI), DMFS score, and pocket depth were all assessed through clinical examination. CEJ-ABC distance was measured from radiographs at the mesial surface of permanent first molars (PFM), and the mesial and distal surfaces of primary molars. RESULTS: The CEJ-ABC distance ranged from 0.00 to 4.49 mm, the mean for all surfaces was 0.84 ± 0.44 mm, no gender or age group differences were found. The mesial surface of the PFMs had the smallest mean CEJ-ABC distance. The CEJ-ABC distances were greater in the maxilla than in the mandible. No significant effect of PI, GI or CI on CEJ-ABC distance was found. Caries, faulty restorations, exfoliation, and partial eruption adjacent to measured surfaces had significant effect on the CEJ-ABC distance. CONCLUSION: The mean CEJ-ABC distance was <1 mm. Threshold CEJ-ABC distances of 1.0 and 1.5 mm for PFMs and primary molars, respectively, are suggested to be used in 6- to 9-year-old children.

Can persistence of primary molars be predicted in subjects with multiple tooth agenesis?

The purpose of this research was to create a method for predicting the persistence of primary molars in patients with multiple agenesis. Dental pantomographs (DPTs) from 51 males with agenesis of 5-17 teeth and 54 females with agenesis of 5-21 teeth were investigated. All patients (6 years 9 months to 16 years 7 months) had agenesis of one or both lower second premolars. Patients with ectodermal dysplasia and craniofacial anomalies were not included. The DPTs were classified into two groups according to tooth morphology and agenesis pattern. Group--I-ectodermal symptoms: screwdriver-shaped maxillary central incisors, invaginations in incisors or narrow incisors, taurodontic molar roots, and atypical agenesis. At least two of these ectodermal symptoms had to be present for classification into group I. Group II: one or none of the criteria for group I. Each group was subdivided according to the number of missing teeth. The degree of root resorption of the lower second primary molar was analysed and converted to a metric scale for statistical analysis. Ectodermal status (group I versus group II) was analysed as a binary outcome with agenesis and gender as covariates (logistic regression), whereas ordinary multiple regression was performed in order to study the dependency of root resorption score on gender, ectodermal status, and age. The study showed that subjects with agenesis of more than seven teeth belonged more often to group I than group II, also when correcting for age differences. Root resorption of the primary molars was more severe in group I than in group II.

Agenesis of mandibular second premolars with retained primary molars: a longitudinal radiographic study of 99 subjects from 12 years of age to adulthood.

In subjects with agenesis of the second mandibular premolar teeth, the primary molar may be left in situ. The long-term prognosis of a retained primary molar has not been established in any study that included large number of patients. The aim of this investigation was to monitor the survival of retained mandibular second primary molars, from 12-13 years of age to adulthood. The material comprised the radiographs of 99 subjects, 37 males and 62 females, with retained primary molars and agenesis of 149 mandibular second premolars. In subjects with bilateral agenesis, only one randomly selected primary molar was included to ensure that all primary molars were statistically independent units. Three variables were recorded on intraoral radiographs at 11 registration stages starting at 12-13 years of age: the distance between the permanent molar and the premolar abutting the retained primary molar, infraocclusion of the primary molar, and resorption of the primary molar roots. The mean age at the final registration was 24 years 7 months, [standard deviation (SD) 5.3 3 years, range 18.25-45.44 years]. Paired t-tests were used to analyse changes in the variables and intraclass correlation coefficient (ICC) to determine whether all primary molars could be included in the analyses. During the observation period, only seven of the 99 primary molars were lost due to extensive root resorption, infraocclusion, or caries. Long-term survival may be expected in more than 90 per cent of patients with retained primary molars with agenesis of mandibular second premolars.

The role of dental pulp cells in resorption of deciduous teeth.

OBJECTIVE: To address the question whether dental pulp cells of exfoliating human deciduous teeth have some roles for controlling or regulating the root resorption via secreting key molecules (OPG, RANKL, CSF-1, TGFbeta, MCP-1 and Cbfa-1) in osteoclastogenesis, we used a sensitive reverse transcriptase polymerase chain reaction (RT-PCR) method for detection of mRNA expressions for the cytokines listed. STUDY DESIGN: The dental pulps were retrieved from incisor and molar teeth in the late stage of shedding (n = 30) and from sound premolar teeth extracted for orthodontic reasons (control group; n = 30). The RT-PCR assays were used to identify targeted gene expression. RESULTS: Of the cytokines examined, RANKL and CSF-1 expressions showed significantly higher occurrence in deciduous dental pulps than in permanent teeth pulpal tissues (P < .040). CONCLUSIONS: The findings may suggest an interactive role for pulp tissue cells in the physiologic root resorption process. The cells of dental pulp may have some cytokine-producing cells which mediate monocyte-macrophage lineage to form osteo/odontoclasts, and the RANKL/RANK system might be involved in human deciduous teeth resorption.

Studies of a family manifesting premature exfoliation of deciduous teeth.

We report observations made on a family in which the children manifested premature exfoliation of the deciduous incisors and canines beginning as early as 1.5 years of age. We observed gingival recession, alveolar bone resorption, tooth loosening and exfoliation without apical root resorption in the absence of clinical signs of inflammation. The children's mother, age 26, had a normal periodontium, but the father, age 30, had periodontitis of moderate severity. Exfoliated deciduous teeth from one of the children were examined histologically and features characteristic for hypophosphatasia were seen. However, localized prepubertal periodontitis could not be ruled out from these data alone. The differential diagnoses for this type of condition are discussed.

[Autotransplantation of teeth: indication, technic and prognosis]. / Autotransplantasjon av tenner: indikasjon, teknikk og prognose.

An account is given of the most important indications for tooth transplantation. The developmental stage of the tooth most suitable for transplantation and the special demands to the recipient site, are considered. Each main group of indication is illustrated with case reports. Finally, factors influencing the prognosis of the transplant are discussed.