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Free Full Text ArticleDental trauma: restorative procedures using composite resin and mouthguards f...
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Dental trauma: restorative procedures using composite resin and mouthguards for prevention.

J Contemp Dent Pract. 2007;8(6):89-95

Authors: Santos Filho PC, Quagliatto PS, Simamoto PC, Soares CJ

AIM: The aim of this article is to describe a step-by-step protocol for emergency care of a patient with a dentoalveolar injury in the anterior region of the mouth as well as the fabrication of a mouthguard to prevent future trauma. BACKGROUND: Dental trauma is one of the most serious oral health problems in active children and adolescents. Care of traumatized patients requires immediate initial emergency treatment followed by integrated procedures to restore damaged oral structures along with a subsequent trauma prevention strategy. Dentoalveolar injuries in the anterior region of the mouth are often characterized by tooth avulsion and coronal fracture. They are managed using procedures such as dental splinting, endodontic therapy with its unique characteristics, and restorative techniques to re-establish function and esthetics as well as protective mouthguards. REPORT: A 16-year-old male presented with avulsion of his maxillary central incisors as a result of a direct, unintentional impact with an opponent during a basketball game. The teeth had been stored in physiological serum immediately following the injury and the patient received immediate care. On clinical examination, the right central incisor was fractured at the incisal third of the crown but no bone fractures were found. The teeth were reimplanted and splinted. The fractured right central incisor was restored following endodontic treatment and a mouthguard was fabricated for the patient. SUMMARY: The dentist must be knowledgeable about the most efficient and suitable treatment for each traumatic scenario in order to provide appropriate care for dental injuries. Coordinated multi-disciplinary action is fundamental in the successful treatment of these injuries. The dental mouthguard is an effective device for protecting the teeth and supportive structures during physical activities and must be part of the protective equipment used by athletes. It is the responsibility of the dental professional to make parents, trainers, and athletic associations aware of the risks associated with physical activities without orofacial protection; this should encourage the proper use of all protective devices to prevent dentoalveolar injuries that compromise oral functions, esthetics, and increase the cost of healthcare.

PMID: 17846676 [PubMed - indexed for MEDLINE]

Free Full Text ArticleManagement of periodontitis associated with endodontically involved teeth: a ...
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Management of periodontitis associated with endodontically involved teeth: a case series.

J Contemp Dent Pract. 2005 May 15;6(2):118-29

Authors: Anand PS, Nandakumar K

The pulp and the periodontal attachment are the two components that enable a tooth to function in the oral cavity. Lesions of the periodontal ligament and adjacent alveolar bone may originate from infections of the periodontium or tissues of the dental pulp. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. The function of the tooth is severely compromised when either one of these is involved in the disease process. Treatment of disease conditions involving both of these structures can be challenging and frequently requires combining both endodontic and periodontal treatment procedures. This article presents cases of periodontitis associated with endodontic lesions managed by both endodontic and periodontal therapy.

PMID: 15915211 [PubMed - indexed for MEDLINE]

Free Full Text ArticleImmediate loading of dental implants in the edentulous mandible.
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Immediate loading of dental implants in the edentulous mandible.

J Am Dent Assoc. 2004 Nov;135(11):1543-9; quiz 1621-2

Authors: Castellon P, Blatz MB, Block MS, Finger IM, Rogers B

BACKGROUND: The authors review the literature regarding immediate implant loading in the anterior edentulous mandible, demonstrate the technique they currently use, review preliminary results and present an illustrative case. MATERIALS AND METHODS: The authors conducted a literature search using PUBMED and Ovid databases. They considered for review 31 articles in English from 1969 to 2003 that pertained to immediate loading of the anterior mandible. The authors developed a technique to provide a bar-supported prosthesis on the day of surgery. They treated five patients and followed them up for at least six months. The preliminary results are presented. RESULTS: This literature review demonstrated that immediate loading of anterior mandibular implants is an acceptable method, with predictable results. This case series demonstrates the potential for delivering a final bar on the day of surgery, based on the current evidence and clinical application. CONCLUSIONS AND PRACTICE IMPLICATIONS: The method described provides patients with immediate prosthetic restorations and a decreased treatment time compared with that for the traditional two-stage implant approach.

PMID: 15622658 [PubMed - indexed for MEDLINE]

Free Full Text ArticleMultiple dentoalveolar traumatic lesions: report of a case and proposition of...
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Multiple dentoalveolar traumatic lesions: report of a case and proposition of dental polytrauma as a new term.

J Contemp Dent Pract. 2004 Nov 15;5(4):139-47

Authors: Martins WD, Westphalen FH, Westphalen VP, Souza PH

Traumatic injuries to permanent teeth are common, and dramatic episodes can occur during childhood. The aim of this paper is to present a report of severe trauma to the orofacial complex of an 8-year old girl that resulted in multiple injuries. The use of the term "dental polytrauma" (concomitant different dental traumatic injuries) is advocated in this case presentation.

PMID: 15558099 [PubMed - indexed for MEDLINE]

Free Full Text ArticleAssessing revascularization of avulsed permanent maxillary incisors by laser ...
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Assessing revascularization of avulsed permanent maxillary incisors by laser Doppler flowmetry.

J Am Dent Assoc. 2003 Dec;134(12):1597-603

Authors: Strobl H, Gojer G, Norer B, Emshoff R

BACKGROUND: Laser Doppler flowmetry, or LDF, is a noninvasive method used to assess pulpal blood flow, or PBF. Dental avulsion is associated with loss of pulpal sensitivity. The authors conducted this study to assess whether LDF could be used to detect revascularization of replanted teeth. METHODS: The authors used LDF to assess the PBF values of avulsed permanent maxillary incisors treated using replantation and splinting in 17 subjects. They took measurements at four sessions: on the day of splint removal and at 12 weeks, 24 weeks and 36 weeks after splint removal. Five vital control teeth and five nonvital control teeth were used to assess the background signal. At 36 weeks, the authors determined clinically and radiographically whether revascularization had occurred. RESULTS: LDF readings correctly predicted the pulp status in 88.2 percent of the readings. Of the readings for vital teeth, 100 percent were correct, and of the readings for nonvital teeth, 80 percent were correct. Univariate analysis of variance demonstrated that in revascularized teeth, the PBF value increased significantly from splint removal to week 12 after splint removal and from week 24 to week 36 after splint removal. In the teeth that failed to revascularize, the PBF value dropped significantly from week 24 to week 36 after splint removal. CONCLUSIONS: The results of this study suggest that LDF accurately diagnoses revascularization of avulsed maxillary incisors after replantation and splinting. CLINICAL IMPLICATIONS: LDF may become useful in detecting revascularization much earlier than standard sensitivity tests.

PMID: 14719756 [PubMed - indexed for MEDLINE]

Free Full Text ArticleA review of the clinical management of mobile teeth.
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A review of the clinical management of mobile teeth.

J Contemp Dent Pract. 2002 Nov 15;3(4):10-22

Authors: Bernal G, Carvajal JC, Muñoz-Viveros CA

The clinical management of mobile teeth can be a perplexing problem, especially if the underlying causes for that mobility have not been properly diagnosed. In some cases, mobile teeth are retained because patients decline multidisciplinary treatment that might otherwise include strategic extractions. This article discusses the relationship between occlusion and tooth mobility with an emphasis on identifying differences between increased mobility and increasing mobility. The indications, contraindications, and basic principles of tooth splinting are also reviewed. Provisional and definitive splints are defined and described with their respective occlusal considerations. Some mobile teeth can be treated through occlusal equilibration alone (primary occlusal trauma). Whereas mobile teeth with a compromised periodontium can be stabilized with the aid of provisional and/or definitive splinting (secondary occlusal trauma). It is important to consider splint therapy, because it may not only improve the prognosis of teeth, but may actually enhance the stability of the final prosthodontic treatment. The ultimate goal of successful management of mobile teeth is to restore function and comfort by establishing a stable occlusion that promotes tooth retention and the maintenance of periodontal health.

PMID: 12444399 [PubMed - indexed for MEDLINE]

Free Full Text ArticleOcclusal considerations in periodontics.
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Occlusal considerations in periodontics.

Br Dent J. 2001 Dec 8;191(11):597-604

Authors: Davies SJ, Gray RJ, Linden GJ, James JA

Periodontal disease does not directly affect the occluding surfaces of teeth, consequently some may find a section on periodontics a surprising inclusion. Trauma from the occlusion, however, has been linked with periodontal disease for many years. Karolyi published his pioneering paper, in 1901 'Beobachtungen uber Pyorrhoea alveolaris' (occlusal stress and 'alveolar pyorrhoea'). (1) However, despite extensive research over many decades, the role of occlusion in the aetiology and pathogenesis of inflammatory periodontitis is still not completely understood.

PMID: 11770945 [PubMed - indexed for MEDLINE]

Free Full Text ArticleMinimizing excessive composite resin when fabricating fiber-reinforced splints.
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Minimizing excessive composite resin when fabricating fiber-reinforced splints.

J Am Dent Assoc. 2000 Jul;131(7):977-9

Authors: Hughes TE, Strassler HE

PMID: 10916335 [PubMed - indexed for MEDLINE]

Free Full Text ArticleBackscattering from dental restorations and splint materials during therapeut...
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Backscattering from dental restorations and splint materials during therapeutic radiation.

Radiology. 1985 Aug;156(2):523-6

Authors: Farman AG, Sharma S, George DI, Wilson D, Dodd D, Figa R, Haskell B

Models were constructed to simulate as closely as possible the human oral cavity. Radiation absorbed doses were determined for controls and various test situations involving the presence of dental restorative and splint materials during cobalt-60 irradiation of the models. Adjacent gold full crowns and adjacent solid dental silver amalgam cores both increased the dose to the interproximal gingivae by 20%. Use of orthodontic full bands for splinting the jaws increased the dose to the buccal tissues by an average of 10%. Augmentation of dose through backscatter radiation was determined to be only slight for intracoronal amalgam fillings and stainless steel or plastic bracket splints.

PMID: 4011918 [PubMed - indexed for MEDLINE]

Free Full Text ArticleEffect of splint placement on black-pigmented Bacteroides and spirochetes in ...
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Effect of splint placement on black-pigmented Bacteroides and spirochetes in the dental plaque of beagle dogs.

J Dent Res. 1984 Nov;63(11):1284-8

Authors: Mikx FH, Ngassapa DN, Reijntjens FM, Maltha JC

The gingival microbiota in beagle dogs was investigated during a period of 42 days after the placement of continuous wire and arch bar splints. The splints were found to induce an increase in helicoidal-shaped micro-organisms and black-pigmented Bacteroides. Two different asaccharolytic Bacteroides types were isolated and tentatively identified as B. gingivalis and B. asaccharolyticus. In addition, B. intermedius-like organisms were isolated. The last two species were observed only after splint placement. The local accumulation of helicoidal-shaped micro-organisms in the epithelial tissue rather than in the micro-ulcerations was regarded as an indication of an active role for these spirochetes in the disease process. The observed shift toward tissue-invading and potentially pathogenic micro-organisms after splinting stresses the need for antimicrobial measures during splint placement in order to minimize periodontal destruction.

PMID: 6594370 [PubMed - indexed for MEDLINE]

Free Full Text ArticleDiseases of the alimentary system. Obesity.
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Diseases of the alimentary system. Obesity.

Br Med J. 1976 Oct 30;2(6043):1052-5

Authors: Bennett JR, Baddeley M

PMID: 990759 [PubMed - indexed for MEDLINE]

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