Cases reported "Tooth Discoloration"

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1/49. A scanning electron and confocal laser microscope investigation of tetracycline-affected human dentine.

    Because of the well reported dental side-effects of tetracycline administration, the drug should not be administered to children. However, it and its derivatives are often administered over a prolonged period for treatment of acne in young adults. Dental side effects are also noticed in these patients. The aim of this study was to examine with scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) the root dentine of a tooth from a young adult affected by tetracycline therapy. The palatal root of an upper third molar, demonstrating distinct areas of tetracycline staining, was removed from the crown and sectioned longitudinally to produce two samples. The pulp tissue was peeled off the dentine and any remaining non-mineralized tissues were removed with sodium hypochlorite. One sample was prepared for SEM and the other as a ground section which was examined with a CLSM. It was demonstrated by SEM that the mineralizing front of unaffected dentine was of a normal calcospherite appearance; in contrast, the mineralizing front of the tetracycline-affected dentine was devoid of calcospherite formation and many surface defects were apparent. In addition, the number of dentinal tubules associated with the defects was reduced. It was shown by CLSM that tetracycline bands were made up of numerous smaller bands and that peritubular dentine not associated with fluorescent bands had incorporated tetracycline. The CLSM examination of the mineralization front of the affected dentine revealed that fluorescence of dentine was restricted to the peritubular dentine. The results confirm that dentine mineralization is affected by systemic tetracycline therapy and that tetracycline can be incorporated into peritubular dentine after mineralization of the primary dentine matrix.
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2/49. Enamel staining and hypoplasia due to multiple causes in a Nigerian adolescent: report of a case.

    The aim of this report is to discuss the effects of childhood drug ingestion and metabolic disturbances of ill health in childhood on the coloration, structure and therefore the aesthetics of permanent dentition. To illustrate this, the report presents a case of a 15 year old Nigerian girl with combined tetracycline staining and chronological enamel hypoplastic defects on her teeth. The relationship between the clinical appearance of her teeth and her childhood medical and drug history are analysed. The various treatment modalities available for the management of the dental anomalies are discussed along with the rationale for the treatment given. Strategies for the prevention of these conditions are emphasised.
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3/49. Nightguard vital bleaching beneath existing porcelain veneers: a case report.

    Dentist-prescribed, at-home bleaching with 10% carbamide peroxide was used to lighten the apparent color of teeth with preexisting porcelain veneers. Veneers had been placed over unprepared, tetracycline-stained teeth; the translucency of the veneers over the discolored teeth resulted in a graying of the veneers. A custom-fitted tray with no reservoirs and no gingival scalloping was fabricated. A 10% carbamide peroxide material was applied nightly for 9 months to achieve the maximum change in the underlying tooth color. The patient was pleased with the apparent color change. tooth sensitivity during treatment was minimal (lasting 4 days total); the patient treated sensitivity by brushing with a potassium nitrate-containing toothpaste or applying fluoride in the tray.
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keywords = gingival
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4/49. Secondary caries: a literature review with case reports.

    The clinical diagnosis of secondary caries is by far the most common reason for replacement of restorations, but the scientific basis for the diagnosis is meager. The purpose of this article is to review the literature on secondary (recurrent) caries and present case reports to document the problems encountered in the clinical diagnosis of secondary caries. The literature on secondary caries was critically reviewed and subdivided into clinical diagnosis, location of secondary lesions, histopathology, microleakage, and microbiology. The case reports included restorations that were scheduled to be replaced because of secondary caries or stained margins of composite restorations. The lesions were photographed preoperatively and postoperatively. Based on the limited literature available, secondary caries appears to be a localized lesion similar or identical to primary caries. It is most often localized gingivally on restorations. Narrow gaps, crevices, ditches, and "microleakage" do not lead to secondary caries, but wide voids may. Secondary caries is difficult to diagnose clinically. Consistency or hardness and discoloration of dentin and enamel are the best parameters. Secondary caries is the same as primary caries located at the margin of a restoration.
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keywords = gingival
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5/49. Dental findings in Morquio syndrome (mucopolysaccharidoses type IVa).

    Morquio syndrome is a disorder of mucopolysaccharide metabolism with specific skeletal features. The clinical and radiographic appearance of the teeth resembles hypoplastic amelogenesis imperfecta with thin enamel of normal radiodensity. The dental practitioner has a part to play in collaboration with medical colleagues in the recognition and diagnosis of this condition.
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6/49. A newly recognized syndrome of skeletal dysplasia with opalescent and rootless teeth.

    A Thai girl with skeletal dysplasia and dental anomalies was seen. Her anomalies consisted of disproportionately short stature, short neck, broad and depressed nasal bridge, broad chest in the anteroposterior dimension, kyphosis, widely spaced nipples, and protruded abdomen. Radiographic testing indicated that she had a large sella turcica, platyspondyly, hypoplastic acetabulum, and a small body of mandible. Both her deciduous and permanent teeth were equally opalescent, and most were rootless, with root development of the mandibular teeth more severely affected. Some maxillary roots were extremely short and tapered. Hypodontia was also observed. These findings represent a unique and hitherto undescribed syndrome of skeletal dysplasia with concomitant dental anomalies.
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7/49. Treatment planning for porcelain veneer restoration of crowded teeth by modifying stone models.

    The three-dimensional result attainable through porcelain veneer restoration of crowded teeth can be preoperatively determined by diagnostically altering stone study models of the patient's dentition. Techniques for diagnostically preparing and waxing the stone dental models are described in this article, along with the corresponding postoperative restorative results of representative cases. CLINICAL SIGNIFICANCE: patients with malaligned teeth who are not willing or able to undergo straightening of their teeth with orthodontics, nonetheless may be able to attain straight teeth concomitant with the restoration of their teeth with modified porcelain veneer restorations. This article describes a straight forward treatment planning technique for altering study casts preoperatively, to accurately predict and guide the postoperative outcome.
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8/49. Clinical and radiographic features of a family with autosomal dominant amelogenesis imperfecta with taurodontism.

    This paper describes the clinical features of a family of four generations with autosomal dominant amelogenesis imperfecta with taurodontism (ADAIT). Considerable variation in phenotype was seen, both between individuals and within the dentition of some individuals. Many of the adults had received extensive dental restorative work. These findings re-enforce previous observations of variable phenotype in this and other forms of the condition and add to the argument for a revision of methods of classification. This history of this large family draws further attention to the restorative demands of this group of dental anomalies and, by their generous co-operation, will prove an invaluable help in the investigation by molecular genetic techniques of this disfiguring condition.
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9/49. Esthetic improvement following enamel microabrasion on fluorotic teeth: a case report.

    enamel microabrasion is a proven method of removing intrinsic and superficial defects from teeth, establishing esthetics with minimal loss of dental enamel. This article reports one case in which two different microabrasion techniques were used to remove fluorotic stains from teeth.
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10/49. Effectiveness of dentist-prescribed, home-applied tooth whitening. A meta analysis.

    INTRODUCTION: Common clinical experience suggests that tooth whitening agents are 100% effective. This study uses meta-analysis of data from published randomized controlled clinical trials to determine the efficacy of tooth whitening agents. methods: A medline search strategy was developed and implemented to systematically identify clinical trials on dentist-prescribed, home-applied tooth whitening agents, using 10% carbamide peroxide, published between 1989-1999. Inclusion criteria (e.g., in English, human clinical trials) and exclusion criteria (e.g., not placebo controlled) were established and clinical trials that met these criteria were critically appraised for validity and clinical applicability. meta-analysis was then used to quantitatively integrate the findings. RESULTS: Seven studies were identified that met the inclusion and validity criteria. These studies indicated that: Whitening results in a significant mean change of 6 4 shade guide units (p < 0.01), while the placebo control group exhibited little change (0.7 0.6, p > 0.05). 93% of the bleached patients exhibited 2 shade guide unit change, while 20% of the placebo control group exhibited this change. The brand of bleaching agent had a significant effect on tooth whitening, but the daily application time and duration of treatment did not. Whitening is maintained for 6 months for 1/2 of the people treated. Neither gingival indices nor plaque indices were adversely or favorably affected by bleaching. CLINICAL APPLICABILITY: The data from the reviewed studies indicate that rather than being 100% effective, on average: 73% (93% for bleached group minus 20% placebo group) of people who whiten their teeth will exhibit a whitening that is 2 shade guide units greater than the placebo. 20% of the people who use dentist-prescribed, home-applied bleaching will achieve a mean whitening effect of 5 shade guide units. Re-treatment for 50% of people may be necessary to maintain this effect longer than 6 months. The methods used here are internet applicable for other clinical topics.
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ranking = 0.42895510573371
keywords = gingival
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