OBJECTIVES: Crown-root fracture and cervical caries in maxillary premolars constitute a challenge in cases of subgingival placement of restoration margins. Surgical extrusion has been practiced successfully in permanent anterior teeth. The aim of the present retrospective study was to assess the clinical outcome of surgical extrusion after orthodontic extrusion in maxillary premolars. MATERIALS AND METHODS: Twenty-one single, tapered root maxillary premolars with subgingival crown-root fracture or caries were included. Presurgical orthodontic extrusion was performed on all teeth to prevent root resorption. Extent of extrusion and rotation was determined based on crown/root ratio. The postoperative splinting period was 7 to 14 days. Clinical and radiographic examination was performed at an interval of 1, 2, and 3 months. RESULTS: After the mean follow-up of 41.9±15.2 months, failure was observed as increased mobility in 3 of 21 cases. No significant difference was observed in the outcome of surgical extrusion based on tooth type, age, sex, 180° rotation, or time for extraction. Furthermore, marginal bone loss was not observed. CONCLUSION: Surgical extrusion of maxillary premolars can be a possible therapeutic option in cases of subgingival crown-root fracture.
Bicuspid ; Follow-Up Studies ; Orthodontic Extrusion ; Retrospective Studies ; Root Caries ; Root Resorption ; Splints ; Tooth

PURPOSE: We investigated correlations between the findings of oral examinations and panoramic radiography in order to determine the efficacy of using panoramic radiographs in screening examinations. METHODS: This study included patients who visited dental clinics at National Health Insurance Service (NHIS) Ilsan Hospital for checkups during 2009–2015 and underwent panoramic radiographic examinations within 1 year prior to the oral examinations. Among the 48,006 patients who received checkups, 1,091 were included in this study. The data were evaluated using the Cohen kappa and interrater agreement coefficients. Accuracy, sensitivity, and specificity were calculated using data from the panoramic radiographs as true positive diagnoses. RESULTS: The interrater agreement coefficient for occlusal caries was 28.8%, and the Cohen kappa coefficient was 0.043 between the oral and panoramic radiographic examinations. Root caries and subgingival calculus were only found on the radiographs, while gingival inflammation was found only by the oral examinations. The oral examinations had a specificity for detecting occlusal dental caries of 100%, while their sensitivity for proximal dental caries and supragingival calculus was extremely low (14.0% and 18.3%, respectively) compared to the panoramic radiographic examinations. The oral examinations showed a relatively low sensitivity of 66.2% and a specificity of 43.7% in detecting tooth loss compared with panoramic radiography. CONCLUSIONS: Panoramic radiography can provide information that is difficult to obtain in oral examinations, such as root caries, furcation involvement, and subgingival calculus, which are factors that can directly affect the survival rate of teeth. It therefore seems reasonable and necessary to add panoramic radiography to large-scale health checkup programs such as that provided by the NHIS.
Calculi ; Dental Caries ; Dental Clinics ; Diagnosis ; Diagnosis, Oral ; Humans ; Inflammation ; Mass Screening ; National Health Programs ; Radiography, Dental ; Radiography, Panoramic ; Root Caries ; Sensitivity and Specificity ; Survival Rate ; Tooth ; Tooth Loss

OBJECTIVEThis study aims to evaluate the effects of Pinus massoniana needle extract (PMNE) on inhibiting demineralization of root dentin.

METHODSRoot dentin blocks were randomly divided into distilled deionized water (DDW) group, fluoride sodium (NaF) group, and 4%, 8% and 12% PMNE groups according to the experimental solution used in the process of pH cycling in each group. All specimens in each group experienced pH cycling for 8 d. The dentin mineral density (DMD) of the normal dentin and demineralized dentin and their D-value (ΔDMD) were determined using micro computed tomography. The morphology of dentin surface after pH cycling was also observed using a scanning electron microscope.

RESULTSThe ΔDMD values in all PMNE groups and the NaF group were considerably lower than the ΔDMD in the DDW group (P<0.05). The ΔDMD values of the 8% and 12% PMNE groups had no difference (P>0.05), both of which were lower than the ΔDMD in the 4% PMNE group and higher than that in the NaF group (P<0.05). The dentin tubules were partly opened in the PMNE groups. The opening degrees of the dentin tubule in PMNE groups were significantly less and smaller than the opening degree in the DDW group and were larger than that in the NaF group.

CONCLUSIONSPMNE can inhibit the deminera-lization of root dentin and can slow down the reduction in DMD. PMNE has the potential to prevent caries, and 8% PMNE can effectively inhibit dentin demineralization.

OBJECTIVES: This study aimed to analyze the mineral composition of naturally- and artificially-produced caries-affected root dentin and to determine the elemental incorporation of resin-modified glass ionomer (RMGI) into the demineralized dentin. MATERIALS AND METHODS: Box-formed cavities were prepared on buccal and lingual root surfaces of sound human premolars (n = 15). One cavity was exposed to a microbial caries model using a strain of Streptococcus mutans. The other cavity was subjected to a chemical model under pH cycling. Premolars and molars with root surface caries were used as a natural caries model (n = 15). Outer caries lesion was removed using a carbide bur and a hand excavator under a dyeing technique and restored with RMGI (FujiII LC, GC Corp.). The weight percentages of calcium (Ca), phosphate (P), and strontium (Sr) and the widths of demineralized dentin were determined by electron probe microanalysis and compared among the groups using ANOVA and Tukey test (p < 0.05). RESULTS: There was a pattern of demineralization in all models, as visualized with scanning electron microscopy. Artificial models induced greater losses of Ca and P and larger widths of demineralized dentin than did a natural caries model (p < 0.05). Sr was diffused into the demineralized dentin layer from RMGI. CONCLUSIONS: Both microbial and chemical caries models produced similar patterns of mineral composition on the caries-affected dentin. However, the artificial lesions had a relatively larger extent of demineralization than did the natural lesions. RMGI was incorporated into the superficial layer of the caries-affected dentin.
Bicuspid ; Calcium ; Dentin* ; Electron Probe Microanalysis ; Glass ; Hand ; Humans ; Hydrogen-Ion Concentration ; Microscopy, Electron, Scanning ; Miners ; Models, Chemical ; Molar ; Root Caries ; Streptococcus mutans ; Strontium

When oral cancer is occured, one may experience problems such as lip defect, necrosis of periodontal tissue and cervical caries caused by radiotherapy. According to ADI (Association of dental implantology), recent radiotherapy on jaw bone could be a relative contraindication of implant treatment. Due to this controversy, in most cases, treatment is done with removable dentures rather than implants. Especially, lip defect caused by an oral cancer operation have a serious repercussion on the retention of the denture. In this case report, patient with upper lip cancer had undergone resection primarily and secondary radiotherapy was done periodically. As a result, upper teeth of patient were extracted gradually and lower teeth showed very poor periodontal status. Therefore, Polident(R) denture adhesive cream (GlaxoSmithKline, London, England) was applied on maxillary complete denture to overcome reduced retention due to the lip defect and double crown RPD with friction pin was applied on the mandible successfully for two years.
Adhesives* ; Crowns ; Denture, Complete* ; Denture, Partial, Removable* ; Dentures* ; Friction ; Humans ; Jaw ; Lip ; Lip Neoplasms* ; Mandible ; Mouth Neoplasms ; Necrosis ; Periodontitis* ; Radiotherapy ; Root Caries ; Tooth

The present study aims to evaluate the effect of Galla chinensis compounds on the remineralization of two artificial root lesions morphous in vitro. Sixty bovine dentine blocks were divided into two groups and individually treated with two levels of demineralization solutions to form erosive and subsurface artificial carious lesions in vitro. Each group was then divided into three subgroups, each of which were treated with a remineralization solution (positive control), deionized water (negative control), or 4 000 mg⋅L(-1) aqueous solutions of Galla chinensis extract. The dentine blocks were then subjected to a pH-cycling regime for 7 days. During the first 4 days, the daily cycle included 21-h deal and 3-h demineralization applications. The dentine blocks were dealt with the entire day during the remaining 3 days. Two specimens from each of the treatment groups were selected and observed under a polarized light microscope. Data collected using a laser scanning confocal microscope were computerized and analyzed. Galla chinensis extract clearly enhanced the remineralization of both erosive lesion and subsurface lesion patterns in the specimens (P<0.05). The level of remineralization of the erosive lesion by Galla chinensis extract was lower than that of the subsurface lesion (P<0.05). In addition, the remineralization of the subsurface lesion by Galla chinensis extract was higher than that of the remineralization solution (P<0.05). No significant difference between the remineralization of erosive lesions by Galla chinensis extract and the remineralization solution was observed (P>0.05). So Galla chinensis extract has the potential to improve the remineralization of artificial root lesions under dynamic pH-cyclic conditions, indicating its potential use as a natural remineralization medicine.
Animals ; Cariostatic Agents ; therapeutic use ; Cattle ; Dentin ; pathology ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Gallic Acid ; therapeutic use ; Hydrogen-Ion Concentration ; Hydrolyzable Tannins ; therapeutic use ; Microscopy, Confocal ; Microscopy, Polarization ; Polyphenols ; therapeutic use ; Random Allocation ; Root Caries ; drug therapy ; Tooth Remineralization

OBJECTIVES: The usage of fluoride varnish for a moderate to low caries-risk group has not been well validated. This study aimed to evaluate the preventive and therapeutic efficacies of fluoride varnish on the initiated root caries. MATERIALS AND METHODS: Ten premolars were sectioned into quarters, further divided into two windows, one of which was painted with Fluor Protector (1,000 ppm fluoride, Ivoclar Vivadent). An initial lesion with a well-preserved surface layer was produced by pH cycling. Scanned line analysis using energy dispersive spectrometry determined the weight percentages of Ca and P in the demineralized layer. Scanning Electron microscopy and confocal laser scanning microscopy (CLSM) evaluated the varnish-applied root surfaces. RESULTS: The mean lesion depth (SD) was 12.3 (2.6) microm (single cycling) and 19.6 (3.8) microm (double cycling). Double cycling extended the lesion depth, but induced no more mineral loss than single cycling (p < 0.05). The mean weight percentages of Ca and P between groups with and without varnish were not significantly different (p < 0.05). A CLSM showed varnish remained within 15 microm of the surface layer. CONCLUSIONS: When a mild acid challenge initiated root tissue demineralization, the application of low-concentration fluoride varnish did not influence the lesion depth or the mineral composition of the subsurface lesion.
Bicuspid ; Drug Combinations ; Fluorides ; Fluorides, Topical ; Hydrogen-Ion Concentration ; Microscopy, Confocal ; Microscopy, Electron, Scanning ; Paint ; Polyurethanes ; Root Caries ; Silanes ; Spectrum Analysis ; Waxes

caries, periodontal disease and root resorption of the first molar. Treatment of this problem includes, surgical repositioning and orthodontic forced eruption. Because each procedure have the definite advantages and disadvantages, and influenced by circumferential environment, these have limits for successful recovery as independent treatment. In a case at St. Mary's Hospital, we performed successful correction of a horizontal impacted mandibular second molar using a miniplate skeletal anchorage system. We introduce this treatment as a valid method for an impacted second molar and consider a oromaxillofacial surgeon's role in tooth movement treatment.]]>
Dental Caries ; Dislocations ; Molar ; Odontogenic Tumors ; Orthodontic Extrusion ; Periodontal Diseases ; Periodontal Ligament ; Root Resorption ; Tooth ; Tooth Eruption ; Tooth Germ ; Tooth Movement

OBJECTIVETo investigate the genotypic diversity of Actinomyces naeslundii in aged people and the relationship between the genotypes of Actinomyces naeslundii and root caries.

METHODSAccording to the inclusion criteria, 20 aged people with root caries and 20 without root caries were chosen into two groups for this study. Two sites were chosen in subjects with root caries: One site was the exposed sound root surface, and the other site was the root caries. In subjects without root caries the sampling site of root surface was exposed. Bacteria were cultured and then identified. Repetitive extragenic palindromic sequence-based polymerase chain reaction (REP-PCR) was used to analyze the genotypic diversity of the Actinomyces naeslundii clinic isolates.

RESULTS299 strains were isolated from the groups, 156 strains were chosen to analyze, belonged to 61 different genotypes. At the site of sound root surface in the subjects with root caries, there were 57 strains with 25 different patterns. At the site of root caries and of sound root surface in subjects without caries, there were 34 strains with 25 different patterns and 65 strains with 26 different patterns respectively. There was the genotypic diversity within Actinomyces naeslundii. There was significant difference in the genotypes in every individual site.

CONCLUSIONMany different genotypes of Actinomyces naeslundii concerned with occurrence of root caries.

OBJECTIVETo study the dental caries status of the 65-74 years old people in northeast of China, analyze the distribution of caries in the group of people, and provide scientific basis for establishing the oral health care policies.

METHODSThe representative samples were selected by multi-stage, stratified and random sampling from the three province of northeast of China. Dental caries of 2 364 people aged 65-74 were recorded according to WHO criteria. SPSS 12.0 software was used to analyze the data.

RESULTS1) Among 2,364 elderly people in northeast of China, the prevalence of dental caries was 67.5% and DFT was 2.68, the composition of filling was 10.82%. 2) The prevalence of coronal caries was 66.4% and DFT was 2.55. The composition of filling was 11.37%. 3) The prevalence of root surface caries was 48.4% and DFT was 1.64. The composition of filling was only 1.8%.

CONCLUSIONThe prevalence of dental caries among elderly people in northeast of China is still very high, and the filling rate is low. The community based oral health promotion should be strengthened and preventive-oriented oral health care systems are needed in northeast of China.