1/24. Unusual horizontal and vertical root fractures of maxillary molars: an 11-year follow-up.Intra-alveolar root fractures of posterior teeth are rare when compared with other dental injuries. This case report describes one vertical and two horizontal root fractures of teeth 3, 14, and 15. The teeth all tested normal to cold and electric pulp tests. The patient reported no history of accidental trauma, and no signs of scarring were found. These fractures were discovered during a routine full-mouth radiographic survey. All teeth were asymptomatic and in good function. During the 11 yr that followed, there was no dental treatment, except for routine periodontal maintenance. The patient had one abscess that occurred after 9 yr on tooth 3, which had to be extracted. The upper left molars are surprisingly still in function and asymptomatic. Either occlusal or lateral trauma may be the cause of these fractures. This would strongly suggest night guard appliances for patients who clench or grind. A psychological evaluation of the patient might reveal neurosis, anxiety, or stress situations affecting teeth.- - - - - - - - - - ranking = 1keywords = tooth (Clic here for more details about this article) |
2/24. Treating severe bruxism with botulinum toxin.BACKGROUND: Locally administered botulinum toxin, or BTX, is an effective treatment for various movement disorders. Its usefulness in treating bruxism, however, has not been systematically evaluated. SUBJECTS AND methods: The authors studied 18 subjects with severe bruxism and whose mean duration of symptoms was 14.8 /- 10.0 years (range three-40 years). These subjects audibly ground their teeth and experienced tooth wear and difficulty speaking, swallowing or chewing. Medical or dental procedures had failed to alleviate their symptoms. The authors administered a total of 241 injections of BTX type A, or BTX A, in the subjects' masseter muscles during 123 treatment visits. The mean dose of the BTX A was 61.7 /- 11.1 mouse units, or MU (range 25-100 MU), per side for the masseter muscles. RESULTS: The mean total duration of response was 19.1 /- 17.0 weeks (range six-78 weeks), and the mean peak effect on a scale of 0 to 4, in which 4 is equal to total abolishment of grinding, was 3.4 /- 0.9. Only one subject (5.6 percent) reported having experienced dysphagia with BTX A. CONCLUSION: The results of this study suggest that BTX administered by skilled practitioners is a safe and effective treatment for people with severe bruxism, particularly those with associated movement disorders. It should be considered only for those patients refractory to conventional therapy. Future placebo-controlled studies may be useful in further evaluating the potential of BTX in the treatment of bruxism.- - - - - - - - - - ranking = 1keywords = tooth (Clic here for more details about this article) |
3/24. Restoring esthetics and anterior guidance in worn anterior teeth. A conservative multidisciplinary approach.BACKGROUND: Developments in adhesive dentistry have given the dental profession new restorative materials and technology to restore esthetics and function to the worn anterior dentition. This article illustrates, through a clinical case study, the clinical requirements for restoring esthetic harmony and functional stability to the worn anterior dentition. CASE DESCRIPTION: The author presents the case of a 24-year-old man who sought esthetic dental treatment because he was unhappy with the appearance of his maxillary anterior teeth. The review of his dental history revealed that he ground his teeth at night. The author performed a complete evaluation of the causes of the patient's bruxism and created a diagnostic preview to, among other things, develop the relationship between the condylar and anterior guidance and to establish the esthetic requirements for the final restorations. Treatment included periodontal recontouring, tooth preparation and placement of temporary and then permanent restorations; the patient also was given an occlusal guard to protect the restorations against future bruxing. CLINICAL IMPLICATIONS: Whatever the cause of occlusal instability, it is important that the restorative dentist be able to recognize its signs--such as tooth hypermobility, tooth wear, periodontal breakdown, occlusal dimpling, stress fractures, exostosis, muscle enlargement and loss of posterior disclusion. When restoring the worn dentition, the clinician should bear in mind the five P's: proper planning prevents poor performance.- - - - - - - - - - ranking = 3keywords = tooth (Clic here for more details about this article) |
4/24. Dental erosion: diagnostic-based noninvasive treatment.Lesions that result from dental erosion can be difficult to recognize--particularly when abrasion and attrition are also present. Consequently, dental erosion is often misdiagnosed and mistreated by radical restorative modalities that compromise the vitality of the pulp. This article provides clinicians with knowledge concerning the diagnosis of the complex lesions of dental wear and demonstrates the conservative treatment of this condition. Two cases that exhibit marked tooth wear in anterior teeth and their subsequent restoration utilizing occlusal principles and composite resin are presented.- - - - - - - - - - ranking = 1keywords = tooth (Clic here for more details about this article) |
5/24. Syndromes with salivary dysfunction predispose to tooth wear: case reports of congenital dysfunction of major salivary glands, Prader-Willi, congenital rubella, and Sjogren's syndromes.Four cases-of congenital dysfunction of the major salivary glands as well as of Prader-Willi, congenital rubella, and Sjogren's syndromes-were identified in a series of 500 patients referred for excessive tooth wear. Although there was evidence of consumption of highly acidic drinks, some occlusal parafunction, and unacceptable toothbrushing habits, salivary dysfunction was the salient factor predisposing a patient to tooth wear in these syndromal cases. The 500 subjects have been characterized either as having medical conditions and medications that predispose them to xerostomia or lifestyles in which workplace- and sports-related dehydration lead to reduced salivary flow. Normal salivation, by buffering capacity, clearance by swallowing, pellicle formation, and capacity for remineralization of demineralized enamel, protects the teeth from extrinsic and intrinsic acids that initiate dental erosion. Thus, the syndromes, unrelated in many respects, underline the importance of normal salivation in the protection of teeth against tooth wear by erosion, attrition, and abrasion.- - - - - - - - - - ranking = 8keywords = tooth (Clic here for more details about this article) |
6/24. Diagnosis and dental treatment of a young adult patient with gastroesophageal reflux: a case report with 2-year follow-up.A young adult who complained of extreme dentin sensitivity to tactile and thermal stimuli exhibited severe, generalized tooth erosion and an associated parafunctional habit. The diagnosis of the underlying general disease and treatment of its dental sequelae are presented, together with a 2-year follow up. patients who are suspected of having gastroesophageal reflux should be referred to a gastroenterologist or other health professionals to ensure early diagnosis and treatment of the underlying disorder, thus minimizing the destruction of the patient's dentition and improving the patient's general health. Dental treatment should be adjusted to fit the characteristics of each case.- - - - - - - - - - ranking = 1keywords = tooth (Clic here for more details about this article) |
7/24. Vectored upper cervical manipulation for chronic sleep bruxism, headache, and cervical spine pain in a child.OBJECTIVE: To discuss the management of chronic sleep bruxism in a 6-year old girl. Clinical features The patient had morning headaches and cervical spine pain. Due to abnormal tooth wear, bruxism had been previously diagnosed and was verified by observation during sleep. She also had abnormal postural and palpatory findings, indicating upper cervical joint dysfunction. Intervention and outcome Bilateral rotary cervical stretching/mobilization and a vectored high-velocity, low-amplitude adjustment were performed in the upper cervical spine, using the atlas transverse process as the contact point. There was complete relief of the chronic subjective symptoms concomitant with remission of the objective signs of joint dysfunction. CONCLUSIONS: Cervical, particularly upper cervical, spine muscle-joint dysfunction should be considered as a potential etiology in chronic childhood sleep bruxism.- - - - - - - - - - ranking = 1keywords = tooth (Clic here for more details about this article) |
8/24. Permanent bruxism as a manifestation of the oculo-facial syndrome related to systemic Whipple's disease.We report here a new case of oculomasticatory syndrome related to systemic Whipple's disease. The patient presented typical ophthalmoparesis associated with ocular myorhythmia consisting of 1 Hz convergent oscillations of both eyes. The masticatory involvement was remarkable and consisted of a permanent bruxism leading to severe tooth abrasions. Possible pathophysiology of such a disorder is discussed.- - - - - - - - - - ranking = 1keywords = tooth (Clic here for more details about this article) |
9/24. Severe bruxism following basal ganglia infarcts: insights into pathophysiology.Bruxism characterized by clenching and grinding of teeth can lead to toothwear, headaches and depression. While bruxism has been associated with a number of neurological diseases, it has not been highlighted following cerebral infarction.An elderly man presented with an acute onset of tooth grinding and jaw clenching associated with dysarthria. His bruxism was worse during the day and resolved during sleep. He had frequent jaw aches, headaches and swallowing difficulty. Examination demonstrated the presence of dysarthria with jaw clenching and tooth grinding, producing persistent high pitch and loud squeaky sounds. A magnetic resonance imaging and angiography examination revealed a recent infarct in the right thalamus. In addition, chronic lacunar infarcts were present in the bilateral caudate nuclei with severe basilar artery stenosis. He was successfully treated with botulinum toxin.We discuss the pathophysiologic mechanisms of bruxism associated with basal ganglia infarcts. Dysfunction of the efferent and/or afferent thalamic or striatopallidal tracts may play a role in bruxism. Early recognition of bruxism following stroke could reduce unnecessary suffering since the condition can be effectively treated.- - - - - - - - - - ranking = 3keywords = tooth (Clic here for more details about this article) |
10/24. Rehabilitating a patient with bruxism-associated tooth tissue loss: a literature review and case report.Tooth tissue loss from bruxism has been demonstrated to be associated with various dental problems such as tooth sensitivity, excessive reduction of clinical crown height, and possible changes of occlusal relationship. A literature search revealed a number of treatment modalities, with an emphasis on prevention and rehabilitation with adhesive techniques. Rehabilitating a patient with bruxism-associated tooth tissue loss to an acceptable standard of oral health is clinically demanding and requires careful diagnosis and proper treatment planning. This article describes the management of excessive tooth tissue loss in a 43-year-old woman with a history of bruxism. The occlusal vertical dimension of the patient was re-established with the use of an acrylic maxillary occlusal splint, followed by resin composite build-up. Full-mouth oral rehabilitation ultimately involved constructing multiple porcelain veneers, adhesive gold onlays, ceramo-metal crowns, and fixed partial dentures.- - - - - - - - - - ranking = 7keywords = tooth (Clic here for more details about this article) |
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