TOOTH LOSS

Background: To investigate the role of geography (place of residence) as a moderator in the relationship between dental caries disease and treatment experience and dental fear in 16-year-olds living in Malaysia. Methods: A multi-stage-stratified sampling method was employed. Five hundred and three, 16-year-olds from 6 government secondary schools participated in this study. The questionnaire examined participants' demographic profile and assessed their dental fear using the Dental Fear Survey (DFS). The clinical examination consisted of the DMFT as the outcome measure of dental caries disease and treatment experience by a single examiner (ICC = 0.98). Structural equation modelling inspected the relationship between dental fear and dental caries disease and treatment experience. Results: The mean DMFT was 2.76 (SD 3.25). The DT, MT and FT components were 0.64 (SD 1.25), 0.14 (SD 0.56) and 1.98 (SD 2.43) respectively. Rural compared with urban adolescents had significantly greater mean numbers of decayed and missing teeth. The mean DFS score was 40.8 (SD 12.4). Rural compared with urban adolescents had significantly higher mean scores for physical symptoms of dental fear. The correlation between dental fear (DFS) and dental caries disease and treatment experience (DMFT) was 0.29, p < 0.0001. The structural equation model fitted the raw data well (χ 2 = 9.20, df = 8, p = 0.34). All components of DMFT were closely associated in equal strength to the unidimensional hypothetical latent variable of dental caries disease and treatment experience. The strength of the relationship between dental fear and dental caries disease and treatment experience varied in accordance with place of residence. Conclusion: In conclusion a relationship between dental fear and dental caries disease and treatment experience was shown to exist in 16-year-old adolescents living in Malaysia. This study showed that the rural-urban dichotomy acted as a moderator upon this relationship.

Introduction: There is evidence to suggest that an association exists between oral infections and coronary heart disease (CHD). Subjects presenting lesions of endodontic origin (LEOs) or pulpal inflammation had an increased risk of developing CHD. However, findings concerning systemic manifestations of apical periodontitis (AP) remain controversial. An association between CD14 gene polymorphisms and atherosclerosisassociated diseases has been shown, but there are no data regarding an association between CD14 polymorphism and AP. This study evaluated associations between clinical oral health status, CD14 polymorphisms, and CHD. Methods: A case-controlled clinical trial was designed to compare middle-aged adults with acute myocardial infarction or unstable angina (n = 51) within 12 months of the acute event defined as first manifestation with healthy controls (n = 49). Participants were matched for age, sex, and socioeconomic status. Indicators of oral disease and compliance were evaluated. CD14 polymorphisms were analyzed by restriction fragment length polymorphism-polymerase chain reaction. Results: CHD subjects had a higher prevalence of oral diseases and lower compliance to oral preventive strategies than healthy controls. Multivariate analysis showed a positive association between missing teeth (odds ratio [OR] = 1.37; 95% confidence interval [CI], 1.02-1.85), the number of LEOs (OR = 4.37; 95% CI, 1.69-11.28), chronic periodontitis (OR = 5.87; 95% CI, 1.17-29.4), and CHD. No statistically significant association emerged between the CD14 C(À260)T and the CD14 C(À159)T polymorphism, endodontic or periodontal disease, and CHD. Conclusions: Chronic oral diseases may increase the risk of CHD and may be an unconventional risk factor for CHD. (J Endod 2012;38:1570-1577

To cite this article: Int J Dent Hygiene 5, 2007; 82-86 Airila-Månsson S, Bjurshammar N, Yakob M, Sö der B. Self-reported oral problems, compared with clinical assessment in an epidemiological study. Abstract: Objectives: To study self-reported oral problems in relation to periodontal clinical findings in an epidemiological investigation. Materials and methods: 1676 individuals, 828 men and 848 women, participated. The clinical examination comprised the number of remaining teeth excluding third molars, plaque index (PLI), gingival index (GI), bleeding on probing (BOP%), calculus index (CI) and the number of teeth with pocket depth (PD) ‡5 mm. Participants answered a questionnaire concerning smoking and snuffing habits and described in their own words any oral problems present. Analysis of variance (anova), unpaired t-test and chi-squared test were the statistical methods used. Results: The questionnaire was completed by 99.4% of participants. Problems of the teeth and mouth were reported by 28.9% of respondents comprising 31.8% females and 26.2% males. The

As we age, the dynamic balance between gains and losses has been acknowledged by current portrayals of health. Oral health research has yet to fully incorporate such dynamism in understanding the impact of oral disorders on the life of elders. to explore the existence of alternative views on oral health through values, beliefs and behaviors of older adults. Focus group discussions occurred among 42 men and women between the ages of 64 and 93 years old. Participants were from community and seniors centres and retirement homes. Each discussion lasted for about 90 minutes and was tape-recorded for verbatim transcription. Data were analyzed systematically and comparatively using a thematic approach to explore the depth of opinions and understandings of oral health and disability. Participants shared the acceptance of some oral impairment and disability as an alternative view of a &amp;amp;amp;#39;healthy&amp;amp;amp;#39; mouth as they balanced gains and losses, adjusted expectations, and sought social support. Participants discussed that an edentulous mouth might not always be disruptive to daily functioning for all. As a result, a full set of new dentures may not always be the ultimate goal.

SUMMARY Background Dental health is an important determinant of nutritional status, but has not been investigated as a risk factor for dementia. This study aimed to investigate the association between number of teeth, use of dentures and recent-onset dementia. Methods This was ...

The aim of this study was to compare changes in periodontal status of a Swedish population over a 10-year period expressed as frequency distributions of individuals according to severity of periodontal disease experience. The study involved 600 randomly selected individuals evenly distributed into age groups 20, 30, 40, 50, 60 and 70 years, examined in 1973 and another randomly selected group of 597 individuals similarly age distributed and examined in 1983. Based on clinical data and full mouth intraora! radiographs all individuals were classified into 5 groups according to severity of periodontal disease experience. In 1983, 23% of the individuals were classified as having healthy periodontal tissues, group 1, compared to 8% in 1973. The changes were most pronounced in the age groups 20 and 30 years, among whom 58% and 35%, respectively, were registered as having healthy periodontium in 1983, The prevalence of individuals with gingivitis without signs of lowered periodonta! bone level, group 2, was 22% in 1983 compared to 41% in 1973. in all, 49% ofthe dentate population in 1973 and 45% in 1983 showed no marginal alveolar bone loss. Moderate peridonta! bone loss, group 3, was found in 41% ofthe population in 1983 compared to 47% in 1973, Among 30-. 40-, and 50-year-olds, there were more, and among 60-and 70-yearolds, fewer individuals in this group in 1983 compared to 1973, 96% ofthe dentate population were classified as belonging to groups 1, 2 or 3 in 1973 compared to 86% in 1983. Individuals with severe periodontal bone ioss, group 4, were few in 1973 and not found before the age of 50, In 1983, the prevalence of individuals belonging to group 4 had increased and amounted to 1% ofthe 20year-olds, 9% of the 50-year-olds, 25% of 60-year-olds and 38%i of 70-year-olds. On the average, 11% of the dentate population were found in group 4 in 1983 compared to 2% in 1973. The prevalence of individuals belonging to group 5, i.e., alveolar bone loss around the majority ofthe teeth exceeding Vj ofthe normal bone height and the presence of angular bony defects and/or furcation defects, was 1% in 1973 and 2% in 1983. There were no individuals younger than 40 years in this group. Based on gingivitis and probing pocket scores, 33% of the individuals classified to groups 3 and 4 were considered periodontaliy healthy although with reduced periodontal support. In periodontal disease severity group 5, no individual was considered periodontaliy healthy.

Feline osteoclastic resorptive lesions (FORL) of the teeth are common in cats, and lead to pain, destruction of the periodontal ligament, and tooth loss. The expression of interleukin (IL)-1β and IL-6 mRNA was higher in teeth with FORL than in normal teeth (P<0·01 and P<0·001, respectively), but no such differences were found between pathological and normal gingival tissue samples. There were no differences between teeth affected with FORL and normal teeth in respect of the expression of receptor activator of NFκB ligand (RANKL) mRNA or osteoprotegerin (OPG) mRNA. However, OPG mRNA expression was higher in gingival tissue associated with teeth affected with FORL than in normal gingival tissue (P<0·05), whereas the reverse was true of RANKL mRNA expression (P<0·05). OPG mRNA expression was significantly higher in teeth than in femoral and alveolar bone (P<0·001). RANKL and OPG mRNAs were detected in all tissues examined. The data suggest that the elevated expression of IL-lβ and IL-6 mRNA plays a role in the mediation of osteoclast activity in advanced FORL. In contrast, OPG and RANKL do not appear to regulate osteoclasts in advanced disease. The results also suggest that OPG and RANKL mRNA play a role in mediating inflammatory responses in gingival cells, and that OPG has an inhibiting effect on tooth resorption.

Objectives: This study assessed the geographic distribution of dentists in Kentucky, determined socioeconomic correlates of practice location, estimated the future availability of dental providers, and made policy recommendations that could improve access to oral health care in Kentucky and other rural states.Methods: Dentists' addresses were mapped using a geographic information system. Poisson regression modeling and geospatial analyses were conducted using SAS v9.1 (SAS Institute, Cary, NC, USA) and ArcGIS v9.2 (Environmental Systems Research Institute Inc., Redlands, CA, USA), respectively. Data on the number of dentists (n = 2,391) per county (n = 120) were used for the regression models. Explanatory variables included: per capita income, 2006 intercensal population estimates, percent adults with six or more teeth removed, percent population uninsured, physician-to-population ratios, and region type. A simulation model was used to project dentist-to-population ratios to the year 2016.Results: The dental workforce analysis revealed disparities in the distribution of dentists between rural, urban, and Appalachian Kentucky counties. Dentists were more likely to be found practicing in areas with higher income and higher physician-to-population ratios. Compounding this geographic maldistribution, our projections suggest that the number of dentists per unit population will decrease over time in the near future, likely widening this disparity in rural and underserved areas.Conclusions: These results show present and widening workforce disparities in rural and socioeconomically depressed counties in Kentucky. Understanding the geographic distribution of dentists and the socioeconomic correlates of their practice locations may inform workforce development and reimbursement policies for the goal of improving access to oral health care in these areas.

Background: Generalized aggressive periodontitis is described as a clinical entity affecting both deciduous and permanent dentition with extensive alveolar bone loss, mobility, and exfoliation of all or many teeth. Controversy exists on dental implant use to restore missing dentition in younger patients. Methods: This case report presents a patient diagnosed with aggressive periodontitis who has lost all but 4 of her teeth. Her personal and functional desires led us to include implant therapy in her treatment plan. The hematological data are presented with an analysis of the immunological profile. Results: Dental implants were placed, and following 3 months of osseointegration, an implant-supported prosthesis was completed. The patient was followed up for 36 months. Conclusions: This case report presents an alternative treatment for rehabilitating dentition in a young patient treated for aggressive periodontitis. Similar case studies may help eliminate some of the controversy that exists regarding the use of dental implants in aggressive periodontitis patients.

Objective: To systematically assess the factors influencing tooth loss during longterm periodontal maintenance (PM). Methods: CENTRAL, MEDLINE and EMBASE were searched up to and including September 2009. Studies limited to patients with periodontitis who underwent periodontal therapy and followed a maintenance care programme for the at least 5 years were eligible for inclusion in this review. Studies were considered for inclusion if they reported data on tooth loss during PM. Results: The search strategy identified 527 potentially eligible articles, of which 13 retrospective case series were included in this review. The risk of bias assessment evaluated by the Newcastle-Ottawa scale showed that eight studies were considered of medium methodological quality and five of low methodological quality. Of 41,404 teeth present after active periodontal treatment, 3919 were lost during PM. The percentages of tooth loss due to periodontal reasons and of patients who did not experience tooth loss varied from 1.5% to 9.8% and 36.0% to 88.5%. Studies' individual outcomes showed that different patient-related factors (i.e. age and smoking) and tooth-related factors (tooth type and location, and the initial tooth prognosis) were associated with tooth loss during PM. Conclusions: The considerable heterogeneity found among studies did not allow definitive conclusions. Age, smoking and initial tooth prognosis were found to be associated with tooth loss during PM. Overall, patients must be instructed to follow periodic PM and quit smoking (smokers). Prospective cohort studies are required to confirm the possible predictors of tooth loss due to periodontal reasons. The allocation of patients into subgroups according to the type of periodontitis and smoking frequency will allow more accurate evaluations.

We describe a new familial metabolic bone disease characterized by expanding hyperostotic long bones, early onset deafness, premature tooth loss, and episodic hypercalcemia. The condition affects a mother and daughter studied at the age of 36 years and 11 years, respectively. Both individuals lost all hearing in early childhood and suffered premature shedding of teeth. Skeletal pains began just before puberty. Swelling and aching of most middle phalanges in the hands is an especially troublesome manifestation. The mother also had episodes of symptomatic hypercalcemia first documented in late childhood and subsequently during intercurrent illness and postpartum lactation. Radiographs show hyperostosis and/or osteosclerosis predominantly in the skull and appendicular skeleton. Long bones also are expanded considerably, especially the middle phalanges in the fingers. The mother's skeletal abnormalities are more severe. Biochemical parameters of bone turnover, including serum alkaline phosphatase (ALP) activity, are elevated substantially. In the proposita, dynamic histomorphometry of nondecalcified sections of iliac crest revealed rapid skeletal remodeling. In the mother, who had been treated with bisphosphonates, electron microscopy (EM) showed disorganized collagen bundles as well as necrotic and apoptotic bone cells but no osteocytic osteolysis. Measles virus gene transcripts were not detected in peripheral blood monocytes. Karyotyping was normal, 46,XX. Hyperphosphatasia with bone disease previously has been reported as either a sporadic or autosomal recessive condition. Expansile skeletal hyperphosphatasia (ESH) is probably inherited as an autosomal dominant trait with a high degree of penetrance. (J Bone Miner Res 2000;15:2330 -2344)

Objective. The study investigated the influence of exposure to anti-asthmatic medications and of various factors on the caries prevalence in children in Slovenia. Methods. The study population consisted of children aged 2-to 17 years (n = 220) under treatment for asthma, who had used anti-asthmatic medications for at least 1 year; 220 controls were matched for age. Caries status was determined by the number of decayed, missing, and filled surfaces through clinical examination by two calibrated dentists using the International Caries Detection and Assessment System-II scoring criteria. Questionnaires completed by parents and data from the patients' medical records provided information on various confounding factors. Results. Asthmatic children had significantly higher (P £ 0.01) prevalence of caries on primary and permanent teeth in all age groups, and the proportion of caries-free children was significantly smaller (P £ 0.05). In multivariate regression analysis, asthma diagnosis, child's age, daily use of inhaled glucocorticoids, length and frequency of medicine application, spacer use, mouth rinsing with water after medicine application, parents' education, frequent food and drink consumption, and frequency of toothbrushing were associated with caries experience of asthmatic children. Conclusion. Children with asthma who had used anti-asthmatic medications had higher caries experience in primary and permanent teeth.

To determine the prevalence of permanent tooth loss among children and adults in a suburban area of Chennai. Design: Cross sectional descriptive study. Study setting: The study was conducted in Tiruverkadu, a suburban area of Chennai. Materials and Methods: A house-to-house survey was done in Tiruverkadu. The study population consisted of 6, 12, 15 years children, 35-44 years, and 65-74 years adults. Type III dental examination was carried out. Cross tabulations and Chi-square statistics were computed. The level of significance was chosen as P<0.05. Results: Out of the total 679 subjects, 309 subjects had tooth loss. Females (47.9%) had greater tooth loss compared to males (42.9%). Tooth loss increased as age progressed. Subjects in the lower socio-economic status had greatest tooth loss. The mean tooth loss among the subjects was 2.7. Conclusion: This study indicates that tooth loss increases with age and differs for gender and socio-economic status. The prevalence of tooth loss among the subjects was found to be high in children as well as in adults. Therefore, dental professionals should utilize various measures available in preventive dentistry to minimize tooth loss.

To study the caries prevalence and caries experience of 5, 12 and 15-year-old children in Greece and evaluate how the disease pattern is related to their sociodemographic parameters. A stratified cluster sample of 1209, 1224 and 1257 of five, twelve and fifteen-year-old Greek children were randomly selected according to WHO guidelines for national pathfinder surveys and examined for dental caries, according to the BASCD criteria and standards. d3mft, D3MFT and their components, as well as d3mfs, D3MFS, Care Index (CI) and SiC were recorded and related to the demographic data collected concerning age, gender, counties, urban/rural areas and parents&#39; educational status. Dental caries varied considerably between the different districts, with a mean dmft/DMFT value for each age group being 1.77, 2.05 and 3.19 respectively, while 64%, 37% and 29% of them, were with no obvious dentinal caries. Children living in rural areas demonstrated significantly higher dmft/DMFT values and less d...

Introduction: The aim of this study was to investigate the relationship between smoking and the prevalence of apical periodontitis and root canal treatment in hypertensive patients. Methods: In a cross-sectional study, the records of 100 hypertensive patients, 50 smokers and 50 nonsmokers, were examined. Periapical status of all teeth was assessed by using the periapical index score. Results: Apical periodontitis in 1 or more teeth was found in 92% of smoker patients and in 44% of nonsmoker subjects (P = .000; odds ratio [OR], 16.8; 95% confidence interval [CI], 4.6-61.3). One or more root-filled teeth were found in 58% and 20% of smoker and nonsmoker subjects, respectively (P < .01; OR, 5.5; 95% CI, 2.3-13.5). Among smoker hypertensive patients, 6% of the teeth had apical periodontitis, whereas in the nonsmoker subjects, 2% of teeth were affected (P < .01; OR, 3.3; 95% CI, 2.0-5.4). The percentage of root-filled teeth in the smoker and nonsmoker groups was 3.6% and 1.2%, respectively (P < .01; OR, 2.9; 95% CI, 1.6-5.5). Conclusions: The prevalence of apical periodontitis and root canal treatment was significantly higher in smoker hypertensive patients compared with nonsmoker subjects. (J Endod 2011;37:764-767)

To assess the number of school hours missed for dental reasons per 1,000 grade 5 primary school children in 1 school year and compare dentally related school absences with those related to medical and social reasons. Methods: A longitudinal study using a multistage sampling technique was carried out on a sample of 1,211 children attending schools in Lampang province, Thailand. Data on absence were collected from daily school attendance records for 1 year and from children and parents questionnaires and school dental clinic records. Clinical examinations were done using the World Health Organization criteria. Results: A total of 1,158 children (response rate: 95.7 percent) aged 9 to 13 years were examined and returned completed questionnaires. Their caries level was relatively low (DMFT 1.4 Ϯ 1.7). The children (22.5 percent) reported school absence for any dental reason. The mean number of hours of school absence per year for dental care was 434 hours per 1,000 children (613 hours per 1,000 children when dental screening was included). Among those who actually missed school for dental reasons, the numbers of hours missed were 1,923 hours per 1,000 children. Conclusions: The level of school absence for dental-related conditions and care was low per child but cumulatively was considerable. The time missed because of dental reasons was substantially less than the time missed because of other health and social reasons.

This review, divided into two parts, for the role of occlusion in the aetiology of TMD. evaluates the literature on the relationship be-Experienced clinicians also repudiate the need for occlusal adjustment in the management of TMD, tween dental occlusion and temporomandibular disorders (TMD) and the need for occlusal therapy whereas (less experienced) general dentists adhere in the management of TMD. The first part of the to a concept focusing on the occlusion in diagnosis and treatment of TMD. There is a consensus review focuses on the aetiological importance of that generalized prophylactic occlusal adjustment occlusal interferences and the place of occlusal adis not justified. There is an obvious need for re-justment in the management and prevention of signs and symptoms of TMD. This has long been a search with evidence-based methods, to be able to controversial issue, which has not yet been re-answer the many remaining questions in this field. solved. The literature does not give strong support

Introduction: There is evidence to suggest that an association exists between oral infections and coronary heart disease (CHD). Subjects presenting lesions of endodontic origin (LEOs) or pulpal inflammation had an increased risk of developing CHD. However, findings concerning systemic manifestations of apical periodontitis (AP) remain controversial. An association between CD14 gene polymorphisms and atherosclerosisassociated diseases has been shown, but there are no data regarding an association between CD14 polymorphism and AP. This study evaluated associations between clinical oral health status, CD14 polymorphisms, and CHD. Methods: A case-controlled clinical trial was designed to compare middle-aged adults with acute myocardial infarction or unstable angina (n = 51) within 12 months of the acute event defined as first manifestation with healthy controls (n = 49). Participants were matched for age, sex, and socioeconomic status. Indicators of oral disease and compliance were evaluated. CD14 polymorphisms were analyzed by restriction fragment length polymorphism-polymerase chain reaction. Results: CHD subjects had a higher prevalence of oral diseases and lower compliance to oral preventive strategies than healthy controls. Multivariate analysis showed a positive association between missing teeth (odds ratio [OR] = 1.37; 95% confidence interval [CI], 1.02-1.85), the number of LEOs (OR = 4.37; 95% CI, 1.69-11.28), chronic periodontitis (OR = 5.87; 95% CI, 1.17-29.4), and CHD. No statistically significant association emerged between the CD14 C(À260)T and the CD14 C(À159)T polymorphism, endodontic or periodontal disease, and CHD. Conclusions: Chronic oral diseases may increase the risk of CHD and may be an unconventional risk factor for CHD. (J Endod 2012;38:1570-1577

Unassociated human bones are a particular problem during the exhumation of mass graves and a factor that limits anthropological and paleopathological analyses from archaeological contexts. Extensive anthropological literature has focused on the complex taphonomic factors that influences bone assemblages, but little attention has been paid to postmortem tooth loss and factors affecting this process. The following study focuses upon the influence of different factors on postmortem tooth loss. Three samples were investigated in the study: a medieval church cemetery containing 110 individual skeletal remains, and two samples from a series of mass graves made within the same time period in 1999, containing 402 bodies. The frequency of postmortem tooth loss was analyzed relative to postmortem interval for each sample, excavation methods, age distribution, and presence of bone loss associated with periodontal disease. Our results indicate that the degree of alveolar bone loss significantly affected both antemortem and postmortem tooth loss and that the frequency of postmortem tooth loss has the strongest correlation to time since death. These findings suggest that additional care should be taken when exhuming remains from older contexts.

This issue of Special Care in Dentistry presents protocols that were designed during a conference, Practical Protocols for the Prevention of Dental Disease in Community Settings for People with Special Needs, which was held at the University of the Pacific School of Dentistry on February 1, 2002. After each expert reviewed and reported on one area of the literature, which included risk assessment; chlorhexidine mouth rinses; xylitol chewing gum; topical fluoride and fluoride varnish applications; and methods to control or treat periodontal disease, practical protocols were developed. Next, a strategy of implementation and dissemination will be designed using nurses, case managers, social workers, caregivers, and others to encourage people with special needs to use these protocols. A plan will also be implemented to increase social and health care provider awareness about these interventions through professional publications and educational opportunities. The goal is to reduce dental disease in special needs populations and thereby decrease the need for difficult and costly treatment.

To analyze the dimensions and anatomic characteristics of the nasopalatine canal and the corresponding buccal bone plate of the alveolar process, using limited cone-beam computed tomography (CBCT) imaging. Partially edentulous patients scheduled for CBCT imaging for further radiographic evaluation of a prospective implant recipient site in the anterior maxilla were consecutively enrolled in this study. For all CBCT images, a limited field of view (FOV) of 4 × 4 cm, 6 × 6 cm or 8 × 8 cm was selected. Reformatted sagittal and coronal slices were analyzed with regard to dimensions and anatomic characteristics of the nasopalatine canal as well as the dimensions of the buccal bone wall. Factors influencing these parameters were evaluated using univariate and multivariate linear regression models. The study population comprised 44 men and 56 women with a mean age of 43.09 years. Gender of the included patients had a statistically significant influence on the dimensions of the buccal bone plate, the mean values being generally higher for male subjects. In the multivariate linear regression model, the status of the central maxillary incisors (both present, one missing, and both missing) and the time elapsed since loss of the central incisors (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;1 year vs. &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;1 year) were independently associated with buccal bone wall measurements, adjusted for age and sex. The present study demonstrates decreasing values for the coronal width of the buccal bone wall in patients with missing central incisors and a time span since tooth loss of over 1 year. The age of the patients had a significant influence only on the length of the nasopalatine canal, with the mean values generally decreasing with an increasing age. The limited CBCT scans with FOVs varying between 4 × 4 and 8 × 8 cm are a valid diagnostic alternative to cross-sectional imaging in the anterior maxilla for dental implant treatment planning.

odontal disease, caries, coronal and root fractures, prosthetic complications, and endodontic failures. In a multivariate analysis, Eckerbom et al 10 found that teeth with preoperative periapical pathosis, teeth in which the obturation was greater than 2 mm from the radiographic apex, and teeth with screw-type posts had a greater chance of loss over a 5-to 7-year period than teeth without these attributes. Caplan and Weintraub 9 identified 5 variables predictive of RCT tooth loss. These included the number of proximal contacts at access, patient age, increased levels of plaque, the overall number of missing teeth (excluding third molars), and a history of facial trauma. Teeth with 2 proximal contacts at access were 3 times less likely to be lost than teeth with 1 or no proximal contact. Interestingly, none of the postaccess variables evaluated, including crown status and dowel placement, had a statistically significant bivariate relationship with RCT tooth survival.

The purpose of this paper was to undertake a systematic review about the relationship between obesity in childhood, adolescence and/or adulthood and the prevalence of dental caries. The authors searched Bireme, Medline, ISI, Cochrane Library and the internet for papers from 1984-2004. The main search terms were &#39;obesity&#39; and &#39;dental caries&#39;. The inclusion criteria were studies that defined obesity (body mass index) and dental caries (total number of decayed, and filled teeth - DFT/DFS/dft/dfs) in their subjects. The following were excluded from this paper: articles on reviews, dietary guidelines, policy statements, papers related to oral health and nutrition deficiency--underweight, and with no relation between obesity and dental caries prevalence or dental health problems. No systematic review has focused on correlating obesity and caries and only three stud ies had high levels of evidence. Only one study with high level of evidence showed direct association between...

Objectives: To systematically review the current evidence on the relationship between dentition status and chewing ability in older adults, as the latter was subjectively perceived by questionnaires. Background: Tooth loss is associated with functional impairment regarding chewing ability, depending on the number and the location of the remaining teeth. Methods: A search of the English literature was undertaken using the appropriate electronic databases and keywords in order to answer the question of this review. Independent extraction of the related articles was carried out by two authors using predefined eligibility criteria. Results: Full-text analysis was performed for 51 articles of possible relevance. Finally, data were extracted from 18 studies, published in 20 articles that met the inclusion criteria. Conclusions: Although there was a conflict between the studies relevant to the number of functional tooth units needed to maintain adequate oral function, it was revealed that chewing ability was closely related to the number and distribution of teeth remaining. Treatment plan should focus on the preservation of the strategic parts of the dental arch that are critical for adequate oral function. Long-term prospective studies, comprising well-defined criteria, clinical variables, methods and utilising comprehensive questionnaires, should be preferred to obtain a clearer picture on the association between masticatory ability and functional tooth units.

Background: It is frequently debated whether implant treatment in individuals with previous tooth loss due to periodontitis is characterized by an increased incidence of implant loss and peri-implantitis.Objective: The objective of the present systematic review was to assess whether individuals with previous tooth loss due to periodontitis have an increased risk of loss of suprastructures, loss of implants, peri-implantitis, and peri-implant marginal bone loss as compared with individuals with previous tooth loss due to reasons other than periodontitis.Search strategy: Studies considered for inclusion were searched in MEDLINE (PubMed) and relevant journals were hand searched. Moreover, reference lists of articles selected for full-text screening as well as previously published reviews relevant for the present systematic review were searched. The search was performed by one reviewer and was restricted to human studies published from January 1, 1980 to January 1, 2006. No language restrictions were applied.Selection criteria: Prospective and retrospective cohort studies with at least a 5-year follow-up comparing the outcome of implant treatment in individuals with periodontitis-associated and non-periodontitis-associated tooth loss, respectively, were included. The outcome measures were survival of suprastructures, survival of implants, occurrence of peri-implantitis, and peri-implant marginal bone loss. The 5- and 10-year time points were evaluated.Data collection and analysis: Screening of eligible studies, methodological quality assessment, and data extraction were conducted in duplicate and independently by two of the authors. The authors were contacted for missing information. Results were expressed as random effect models using weighted mean differences for continuous outcomes and relative risk for dichotomous outcomes with 95% confidence intervals (CIs).Main results: Two studies with a 5- and 10-year follow-up, respectively, were identified including a total of 33 patients with tooth loss due to periodontitis and 70 patients with non-periodontitis-associated tooth loss. There was no significant difference in the survival of the suprastructures after 5 years. Furthermore, there were no significant differences in the survival of the implants after 5 and 10 years. However, there were significantly more patients affected by peri-implantitis in the group with periodontitis-associated tooth loss during the 10-year follow-up period, risk ratio (RR) 9 (95% CI 3.94–20.57). Moreover, significantly increased peri-implant marginal bone loss was observed in patients with periodontitis-associated tooth loss after 5 years, mean difference 0.5 mm (95% CI 0.06–0.94).Conclusions: The survival of the suprastructures and the implants was not significantly different in individuals with periodontitis-associated and non-periodontitis-associated tooth loss. However, significantly increased incidence of peri-implantitis and significantly increased peri-implant marginal bone loss were revealed in individuals with periodontitis-associated tooth loss. The small sample size and the methodological quality assessment of the two studies suggest that the results should be interpreted with caution. Consequently, further long-term studies focusing particularly on the outcome of implant treatment in young adults with aggressive periodontitis are needed before final conclusions can be drawn about the outcome of implant treatment in patients with a history of periodontitis.

The principal reason for providing periodontal therapy is to achieve periodontal health and retain the dentition. Patients with a history of periodontitis represent a unique group of individuals who previously succumbed to a bacterial challenge. Therefore, it is important to address the management and survival rate of implants in these patients. Systematic reviews often are cited in this article, because they provide a high level of evidence and facilitate reviewing a vast amount of information in a succinct manner.

The aim of any prosthesis is to restore function and aesthetics by replacing the missing tooth with minimal risks to adjacent tissues. The options presently available to the patient for the replacement of a missing single tooth include the removable partial denture, partial and full coverage bridgework, resin-bonded bridgework and the single-tooth implant prosthesis. The relative merits and guidelines for successful application of these treatment modalities are presented.

The Caries Assessment Spectrum and Treatment (CAST) is a newly developed epidemiological instrument. The aim of this study was to investigate its construct validity. Four calibrated examiners, using CAST codes 0-6, visually examined 109 surfaces of extracted and exfoliated teeth. These teeth were then hemisectioned, photographed, and assessed histologically by two calibrated examiners using the Downer criteria. Twenty-eight of the 109 teeth were scanned using micro-computed tomography (micro-CT) and assessed by the same examiners using the same criteria. Validation was determined through calculation of the sensitivity, specificity, and Youden index for two categories of carious lesions examined visually, with histology and micro-CT as gold standards. Interexaminer consistency was j = 0.76: SE AE 0.05 between visual and histological assessments of teeth and was j = 0.89: SE AE 0.08 between visual and micro-CT assessments. For the category 'healthy' vs. 'diseased' (CAST codes 0-2 vs. CAST codes 3-6), sensitivity, specificity, and Youden index values of 100%, 92.9%, and 93%, respectively, for micro-CT, and 96.6%, 86%, and 83%, respectively, for histology, were obtained. For the category 'dentine' vs. 'non-dentine lesions' (CAST codes 0-3 vs. CAST codes 4-6) sensitivity, specificity, and Youden index values of 90%, 100%, and 90%, respectively, for micro-CT, and 81.4%, 100%, and 81%, respectively, for histology, were obtained. Construct validity of the CAST instrument was obtained.

Significant delay in tooth eruption may be observed in many orthodontic patients. This delay may lead to complications, such as devitalization, ankylosis, external root resorption, injury to the adjacent teeth, and mucogingival problems. These complications may result in prolonged treatment time, esthetic deformities, damage to the periodontal tissues, and tooth loss. This report investigates the special considerations needed in treating such cases. Combined orthodontic and surgical treatment can be used in managing teeth exhibiting significant delay in eruption. A high rate of success can be achieved in terms of esthetics, occlusion, and periodontal health. Nontraumatic surgery, adequate control of gingival inflammation, and use of minimal orthodontic forces may ensure a higher percentage of success and prevention of problems associated with teeth exhibiting significant delay in eruption.

Statement of problem. Although removable partial dentures are a favored option for the restoration of many situations that involve partial tooth loss, some patients are not satisfied with a removable partial denture, especially when it is not stable during mastication. A dental surveyor can be used to prevent countless problems related to the production of removable partial dentures. Many professionals working with oral rehabilitation fail to take advantage of the many uses of a surveyor in planning and designing chromium alloy and other metal removable partial denture frameworks.

Background: It is increasingly recognized that the impact of disease on quality of life should be taken into account when assessing health status. It is likely that tooth loss, in most cases being a consequence of oral diseases, affects Oral Health-Related Quality of Life (OHRQoL). The aim of the present study is to systematically review the literature and to analyse the relationship between the number and location of missing teeth and oral health-related quality of life (OHRQoL). It was hypothesized that tooth loss is associated with an impairment of OHRQoL. Secondly, it was hypothesized that location and distribution of remaining teeth play an important role in this. Methods: Relevant databases were searched for papers in English, published from 1990 to July 2009 following a broad search strategy. Relevant papers were selected by two independent readers using predefined exclusion criteria, firstly on the basis of abstracts, secondly by assessing full-text papers. Selected studies were grouped on the basis of OHRQoL instruments used and assessed for feasibility for quantitative synthesis. Comparable outcomes were subjected to meta-analysis; remaining outcomes were subjected to a qualitative synthesis only. Results: From a total of 924 references, 35 were eligible for synthesis (inter-reader agreement abstracts = 0.84 ± 0.03; full-texts: = 0.68 ± 0.06). Meta-analysis was feasible for 10 studies reporting on 13 different samples, resulting in 6 separate analyses. All studies showed that tooth loss is associated with unfavourable OHRQoL scores, independent of study location and OHRQoL instrument used. Qualitative synthesis showed that all 9 studies investigating a possible relationship between number of occluding pairs of teeth present and OHRQoL reported significant positive correlations. Five studies presented separate data regarding OHRQoL and location of tooth loss (anterior tooth loss vs. posterior tooth loss). Four of these reported highest impact for anterior tooth loss; one study indicated a similar impact for both locations of tooth loss.

The prosthodontic management of a 7-year-old girl with induced dental agenesis is described. The mandibular posterior tooth germs had been removed during surgical excision of a melanotic neuroectodermal tumor of infancy, at the age of 2 months. The ongoing prosthodontic treatment, now in its eighth year, was implemented by regular follow-up of the operation outcome and by targeted orthodontic intervention. The treatment plan included the provision of four successive interim removable partial dentures. Care was taken to preserve the oral structures, adapt to the morphological changes, and satisfy the needs of the child. Due to the unfavorable biomechanical conditions, retention and stability problems were encountered. These were resolved by engaging the mechanism of neuromuscular adaptation through optimization of the shape of the denture base. For children and adolescents with extensive dental agenesis, prosthodontic management with interim removable dentures supports function, restores esthetics, and provides a solid basis for the definitive treatment.

This is a cross-sectional study that aimed to estimate maxillary sinus floor (MSF) pneumatization in single missing tooth of posterior maxilla, by using cone-beam computed tomography (CBCT). CBCT images were analyzed bilaterally and divided into 2 groups: edentulous site (EdS) - edentulous single region of upper second premolar, first or second molars; Tooth site (TS) - contralateral region homologous to the EdS region, with tooth present. Variables evaluated were: sinus height (SH), estimated sinus pneumatization (eSP: ∆ EdS - TS), healed ridge height (HR) and presence of localized sinus pneumatization (LSP) in molars teeth at TS. HR were categorized according to therapeutic option for posterior maxilla. 183 CBCT scans were included and it was observed that EdS presented a higher SH than the TS (p &lt; 0.001) showing an eSP of 0.9 ± 2.93 mm. First molars presented the highest SH for both sides, although significant differences were detected when compared to second molars. First mol...

Osteoporosis and Periodontitis are diseases which affect a large number of women and men, with incidence increasing with advancing age. Osteopenia is a reduction in bone mass due to an imbalance between bone résorption and formation, favoring résorption, resulting in demineralization and leading to osteoporosis. Osteoporosis is a disease characterized by low bone mass and fragility and a consequent increase in fracture risk. Periodontitis is characterized by inflammation of the supporting tissues of the teeth, resulting in résorption of the alveolar bone as well ás loss of the soft tissue attachment to the tooth and is a major cause of tooth loss and edentulousness in adults. The relationship of osteopenia to oral bone loss and periodontal disease has been addressed in a limited number of studies. A review of current knowledge regarding this relationship is presented. Interpretation of the literature is complicated by the variety of methods used to assess osteopenia, oral bone mass, and Periodontitis, as well as varying definitions of outcomes of interest. Results of a previously unpublished study are presented which suggest that severity of osteopenia is related to loss of alveolar crestal height and tooth loss in post-menopausal women. The literature on the relationship among these disorders is limited and points to the need for additional studies which thoroughly evaluate the influence of potential confounding factors to further define the relationship between low bone mineral density and periodontal disease in larger populations. Clearer understanding of this relationship may aid health care providers in their efforts to detect and prevent osteoporosis and periodontal disease. Increased dialogue among medical and dental professionals will be increasingly important in achieving and maintaining patients' optimal health. Osteoporosis and Periodontitis are diseases which affect a large number of men and women, with incidence increasing with advancing age. Osteopenia is a reduction in bone mass due to an imbalance between bone résorption and formation, favoring résorption, resulting in demineralization and leading to osteoporosis. Osteoporosis is a disease characterized by low bone mass and fragility and a consequent increase in fracture risk.1 Fracture risk appears to be influenced by absolute bone mineral density; however, trabecular structure and propensity to fall influence fracture risk as well. Periodontitis is defined as an inflammation of the supporting tissue of the teeth, usually a progressively destructive change leading to a loss of bone and periodontal ligament.2 Periodontitis is characterized by résorption of the alveolar bone as well as loss of the soft tissue attachment to the tooth and is a major cause of tooth loss and edentulousness in adults.3 The relationship of osteopenia to oral bone loss and periodontal disease has been addressed in a limited number of studies. Questions remain about the exact role osteoporosis plays in the establishment of periodontal disease. A review of current knowledge regarding these relationships is presented. BACKGROUND Osteopenia; Osteoporosis Osteoporosis is one of the most important health concerns in the United States. It affects more than 20 million peo-Volume 67 Number 10 WACTAWSKI-WENDE, GROSSI, TREVISAN, ET AL. 1077 pie, most of whom are women, and results in nearly 2 million fractures per year. The treatment of osteoporosis was recently estimated to cost $7 billion to $10 billion per year. Combining all fractures, medical care costs, lost activity, and other indirect factors, the costs of osteoporosis are estimated to reach $18 billion yearly.4