The purpose of this study was to identify and compare preferences and perceptions of orthodontists and general dentists when restoring peg-shaped lateral incisors. The investigation sought to summarize these preferences with regard to treatment planning, tooth preparation and interdisciplinary communication. A pair of mailed and electronic surveys was distributed to 1,500 general dentists and orthodontists, respectively. The results indicated that general dentists perceived that general dentists held the primary decision-making responsibility, while orthodontists disagreed (P<0.0001). Orthodontists prioritized the treatment goals of Class I canine relationship and overbite/overjet more significantly than general dentists, whom valued tooth proportions more highly (P<0.0001). General dentists reported receiving significantly less input than orthodontists report seeking (P<0.0001).The consensus of both groups showed that the tooth should be positioned centered mesiodistally and guided by the gingival margins incisogingivally. Both groups agree that orthodontists must improve communication to improve treatment results.

The purpose of this prospective clinical study was to investigate differences in outcomes from two common treatment modalities used to reduce deep overbite: maxillary incisor intrusion using an intrusion arch and posterior tooth eruption using an anterior bite plate and to assess their influence on smile esthetics. Pre-treatment and post-overbite correction records were gathered from 40 patients with deep overbite malocclusions at the Virginia Commonwealth University orthodontic clinic. Intrusion arch patients displayed significant reductions in maxillary incisor display accompanying documented incisor intrusion. Bite plate patients showed significant lower incisor intrusion and increases in the mandibular plane angle. When compared to the bite plate group, there was a greater tendency for flattening of the smile arc seen in the intrusion arch group. Changes in the smile arc were likely partially a result of the mechanics used but may also have been due to other factors involved in orthodontic tooth alignment.

The purpose of this study was to help predict the enamel thickness of mandibular incisors. At least two direct digital periapical radiographs were made for each of the 80 subjects. Radiographs were scaled to control for magnification errors using dental study models and computer software. Mesiodistal incisor width and mesial and distal enamel thicknesses were measured. Lateral incisors were determined to be wider than central incisors and distal enamel thicknesses were larger than mesial enamel thicknesses on average. The African American group demonstrated wider incisors and enamel thicknesses than the Caucasian group on average. Enamel thickness positively correlated with tooth width for all incisors. No statistically significant differences were detected between male and female groups. Some conclusions relating to enamel thickness can be made based on race, incisor position, and incisor width, but correlations were not considered strong enough to accurately determine enamel width, without the aid of radiographs.

A co-exposição ao chumbo e ao flúor pode alterar o grau de fluorose dental, uma vez que ambos se depositam nos tecidos dentais. Ratos Wistar foram separados em 4 grupos: controle e 3 grupos que recebiam água contendo 100ppm de flúor (F), 30ppm de chumbo (Pb), ou 100ppm de F mais 30ppm de Pb desde a gestação. Análise do esmalte e determinação das dosagens de F no esmalte, dentina e osso foram realizadas nos animais com 81 dias. Defeitos nos incisivos dos ratos foram usados como escores em um índice que discriminou lesões na superfície como bandas, ilhas e cavidades. Não houve diferenças nas concentrações de F nos tecidos calcificados entre os grupos F e F+Pb. Os grupos controle e chumbo apresentaram esmalte normal. O grupo F+Pb apresentou defeitos de esmalte mais severos quando comparados com o grupo F (P<0.001). Este estudo mostrou que o Pb exacerbou a fluorose dental em roedores, sugerindo que a co-exposição ao PB pode explicar as diferenças na prevalência de fluorose. / Co-exposure to lead and fluoride may alter the degree of dental fluorosis, since both accumulate in calcified tissues. Wistar rats were allocated in four groups: control, and 3 groups that received water containing 100 ppm of fluoride (F), 30 ppm of lead (Pb), or 100 ppm of F and 30 ppm of Pb (F+Pb) since gestational age. Enamel analysis and F determinations in enamel, dentine, and bone were performed in 81-day-old animals. Incisor defects were scored using an index that discriminated surface lesions as bands, islets, and pits. There were no differences in the F concentration in calcified tissues between the F and F+Pb groups. The control and the Pb groups presented normal enamel. The F+Pb group presented more severe enamel defects compared with the F group (P<0.001). This study shows that Pb exacerbates dental fluorosis in rodents, suggesting that co-exposure to Pb may explain differences in fluorosis prevalence.

Objetivo: Registrar a prevalência, a localização e as características dos defeitos no esmalte nos incisivos em ambas dentições de pacientes com fissura labiopalatina e avaliar sua possível recorrência. Modelo: Estudo Longitudinal. Local de Execução: Setor de Odontopediatria do Hospital de Reabilitação de Anomalias Craniofaciais - Universidade de São Paulo (HRAC-USP), Bauru - Brasil. Participantes: 48 pacientes, regularmente matriculados no HRAC-USP, com fissura transforame incisivo unilateral (FTIU) e bilateral (FTIB), de ambos os sexos, de 7 a 13 anos que participaram de uma avaliação prévia da dentição decídua em 2000/2002. Metodologia: A freqüência, a extensão e a localização das alterações do esmalte na face vestibular dos dentes em ambas dentições foram avaliadas clinicamente, segundo o índice DDE, após testes intra e inter examinador. Resultados: As alterações do esmalte foram encontradas em ambas dentições em 24 pacientes (50%). Em indivíduos com FTIU a recorrência foi de 53,8% com maior severidade em 50% dos dentes e 89,5% em pacientes com FTIB apresentando-se em 94% igual ou mais severa na dentição permanente. Conclusões: As alterações no esmalte apresentaram recorrência em ambos os tipos de fissuras, com maior ocorrência e gravidade nas bilaterais. Estes aspectos associados aos fatores secundários que envolvem as fissuras, como tensão cicatricial do lábio e maior acúmulo de placa, podem favorecer o aparecimento de doenças bucais, sendo o seu conhecimento essencial para que o cirurgião-dentista realize procedimentos mais adequados. / Objective: To record the prevalence, location and characteristics of enamel defects on incisors in both deciduous and permanent teeth of patients with cleft lip and palate, investigating their possible recurrence.Design: Longitudinal study.Setting: Pediatric Dentistry sector, HRAC-USP. Participants: 48 patients registered at HRAC/USP, with complete unilateral or bilateral cleft lip and palate, of both genders, aged 7 to 13 years; the patients had been previously submitted to evaluation of their deciduous teeth in 2000 to 2002. Methods: The frequency, extent and location of enamel alterations on the buccal aspect of deciduous and permanent teeth were evaluated by the DDE index, after evaluation of intra- and inter-examiner agreement. Results: Enamel alterations were observed in both deciduous and permanent teeth in 24 patients (50%). Recurrence was observed in 53.8% of individuals with complete unilateral cleft lip and palate, with greater severity in 50% of permanent teeth; and in 89.5% of patients with complete bilateral cleft lip and palate, with greater severity in the permanent dentition in 94% of cases. Conclusions: Recurrence of enamel alterations was observed in both types of clefts, with greater occurrence and severity in bilateral clefts. These aspects, associated to secondary factors related to cleft lip and palate, such as lip scar and greater plaque accumulation, may increase the appearance of oral diseases; knowledge on these disturbances is fundamental to allow the dental professional to adopt more adequate procedures.

Objetivo: Determinar la distribución entre el diente en forma de pala y la presencia de lesiones cariosas. Materiales y métodos: El presente estudio es de tipo transversal analítico. Se determinó un tamaño de muestra de 335 niños de 7 a 14 años de edad (1340 incisivos anterosuperiores) utilizando el Software EPIDAT, versión 4.2. Se consideró la clasificación de Hrdlička que se divide en no pala, trazo pala, semi pala y pala. Asimismo, se utilizó como instrumento el Sistema Internacional de Detección y Diagnóstico de Caries II (ICDAS II) para codificar la caries dental desde su estadio más temprano. En una ficha de recolección de datos se registró iniciales del participante, edad, sexo, índice de O’Leary, dieta cariogénica, diente en pala y clasificación de caries. Para el análisis bivariado y determinar la asociación estadística se utilizó la prueba de Chi Cuadrado. Resultados: La prevalencia de incisivos en forma de pala fue de 56.42%. El género con mayor prevalencia fue el masculino con 406(51.64%) dientes que presentaban dicha alteración de forma. Se observó 1229 piezas dentarias que no presentaban caries dental. De las cuales, 583(47.44%) eran forma de no pala y 646(52.56%) forma de pala. Por otro lado, sólo 111 piezas tenían morfología de pala con presencia de caries dental. Se encontró distribución mas no asociación debido a la poca frecuencia de piezas que tienen forma de pala y caries dental. Conclusiones: Se encontró distribución entre los incisivos en forma de pala y caries dental. Esto se debe a la morfología del incisivo en pala, la cual se caracteriza por tener rebordes marginales prominentes, fosa lingual profunda a nivel del cíngulo por la superficie palatina produciéndose un mayor acúmulo de placa. Asimismo, se determinó que el género no es considerado una predisposición. / Objective: To determine the distribution between shovel shaped teeth and the presence of dental caries injuries. Materials and methods: The determined sample was of 335 infants between 7 and 14 years old (1340 incisor at the front of the mouth) using the EPIDAT software 4.2 version. The Hrdlička classification that is divided in no shovel, part shovel, semi shovel and shovel was considered. Likewise, the International Caries Detection and Assessment System II (ICDAS II) was used to code the dental caries since its early stages. The data collection form registries contained the initials of the participant, age, sex, O’ Leary index, cariogenic diet, shovel-shaped teeth and caries classification. The chi-square test was utilized to determine the statistical association and the bi-variate analysis. Results: The remain of the shovel-shaped incisors was 56.42%. the gender that prevailed was the male with 406 (51.64%) teeth that presented such a shape alteration. 1229 incisors of the observed did not present any dental caries. Form this incisor 583 (47.44%) were non-shovel-shaped and 646 (52.56%) were shovel-shaped. On the other hand, just 11 examples had shovel-shaped morphology and the presents of dental caries. Distribution was found but not association due to the infrequency of pieces that have the shape of a shovel and dental caries. Conclusions: A distribution was found between the shovel-shaped incisors and dental caries. This is due to the morphology of the shovel-shaped incisor, which is characterized by having prominent marginal borders, the deep lingual fossa at the level of the palatal surface angle producing a greater accumulation of the plaque. Likewise, it was determined that the gender is not considered a predisposition. / Tesis

Objetivo: Registrar a prevalência, a localização e as características dos defeitos no esmalte nos incisivos em ambas dentições de pacientes com fissura labiopalatina e avaliar sua possível recorrência. Modelo: Estudo Longitudinal. Local de Execução: Setor de Odontopediatria do Hospital de Reabilitação de Anomalias Craniofaciais - Universidade de São Paulo (HRAC-USP), Bauru - Brasil. Participantes: 48 pacientes, regularmente matriculados no HRAC-USP, com fissura transforame incisivo unilateral (FTIU) e bilateral (FTIB), de ambos os sexos, de 7 a 13 anos que participaram de uma avaliação prévia da dentição decídua em 2000/2002. Metodologia: A freqüência, a extensão e a localização das alterações do esmalte na face vestibular dos dentes em ambas dentições foram avaliadas clinicamente, segundo o índice DDE, após testes intra e inter examinador. Resultados: As alterações do esmalte foram encontradas em ambas dentições em 24 pacientes (50%). Em indivíduos com FTIU a recorrência foi de 53,8% com maior severidade em 50% dos dentes e 89,5% em pacientes com FTIB apresentando-se em 94% igual ou mais severa na dentição permanente. Conclusões: As alterações no esmalte apresentaram recorrência em ambos os tipos de fissuras, com maior ocorrência e gravidade nas bilaterais. Estes aspectos associados aos fatores secundários que envolvem as fissuras, como tensão cicatricial do lábio e maior acúmulo de placa, podem favorecer o aparecimento de doenças bucais, sendo o seu conhecimento essencial para que o cirurgião-dentista realize procedimentos mais adequados. / Objective: To record the prevalence, location and characteristics of enamel defects on incisors in both deciduous and permanent teeth of patients with cleft lip and palate, investigating their possible recurrence.Design: Longitudinal study.Setting: Pediatric Dentistry sector, HRAC-USP. Participants: 48 patients registered at HRAC/USP, with complete unilateral or bilateral cleft lip and palate, of both genders, aged 7 to 13 years; the patients had been previously submitted to evaluation of their deciduous teeth in 2000 to 2002. Methods: The frequency, extent and location of enamel alterations on the buccal aspect of deciduous and permanent teeth were evaluated by the DDE index, after evaluation of intra- and inter-examiner agreement. Results: Enamel alterations were observed in both deciduous and permanent teeth in 24 patients (50%). Recurrence was observed in 53.8% of individuals with complete unilateral cleft lip and palate, with greater severity in 50% of permanent teeth; and in 89.5% of patients with complete bilateral cleft lip and palate, with greater severity in the permanent dentition in 94% of cases. Conclusions: Recurrence of enamel alterations was observed in both types of clefts, with greater occurrence and severity in bilateral clefts. These aspects, associated to secondary factors related to cleft lip and palate, such as lip scar and greater plaque accumulation, may increase the appearance of oral diseases; knowledge on these disturbances is fundamental to allow the dental professional to adopt more adequate procedures.

A co-exposição ao chumbo e ao flúor pode alterar o grau de fluorose dental, uma vez que ambos se depositam nos tecidos dentais. Ratos Wistar foram separados em 4 grupos: controle e 3 grupos que recebiam água contendo 100ppm de flúor (F), 30ppm de chumbo (Pb), ou 100ppm de F mais 30ppm de Pb desde a gestação. Análise do esmalte e determinação das dosagens de F no esmalte, dentina e osso foram realizadas nos animais com 81 dias. Defeitos nos incisivos dos ratos foram usados como escores em um índice que discriminou lesões na superfície como bandas, ilhas e cavidades. Não houve diferenças nas concentrações de F nos tecidos calcificados entre os grupos F e F+Pb. Os grupos controle e chumbo apresentaram esmalte normal. O grupo F+Pb apresentou defeitos de esmalte mais severos quando comparados com o grupo F (P<0.001). Este estudo mostrou que o Pb exacerbou a fluorose dental em roedores, sugerindo que a co-exposição ao PB pode explicar as diferenças na prevalência de fluorose. / Co-exposure to lead and fluoride may alter the degree of dental fluorosis, since both accumulate in calcified tissues. Wistar rats were allocated in four groups: control, and 3 groups that received water containing 100 ppm of fluoride (F), 30 ppm of lead (Pb), or 100 ppm of F and 30 ppm of Pb (F+Pb) since gestational age. Enamel analysis and F determinations in enamel, dentine, and bone were performed in 81-day-old animals. Incisor defects were scored using an index that discriminated surface lesions as bands, islets, and pits. There were no differences in the F concentration in calcified tissues between the F and F+Pb groups. The control and the Pb groups presented normal enamel. The F+Pb group presented more severe enamel defects compared with the F group (P<0.001). This study shows that Pb exacerbates dental fluorosis in rodents, suggesting that co-exposure to Pb may explain differences in fluorosis prevalence.

no / This was to study an archaeological population of subadult teeth in 17th and 18th century skeletal material from a London (England) cemetery for enamel defects including molar-incisor-hypomineralisation (MIH).Methods: Dentitions of 45 sub-adults were examined using standard macroscopic methods and systematically recorded. A total of 557 teeth were examined with a *5 lens and photographed. Ages of the individuals were estimated from their dental crown and root development stages and not from charts that combine tooth eruption with development stages. The dental age of the individual and the approximate age of onset of enamel defects was then calculated on the basis of the chronological sequence of incremental deposition and calcification of the enamel matrix. Affected enamel was graded macroscopically as: - Mild: <30% of the tooth¿s enamel surface area visibly disrupted (this encompasses the entire range reported in most other studies), Moderate: 31-49% of the tooth's enamel surface area visibly disrupted and Severe: >50% of the tooth's enamel surface area visibly disrupted. Results: Of the total number of individuals 41 (93.2%) showed signs of enamel developmental dysplasia or MIH, 28 of them showing moderate or severe lesions of molars, primary or permanent (63.6% of the sample). Incisors and canines, though surviving much less often, showed episodes of linear hypoplasia. Conclusion:The extensive lesions seen on many of the molars displayed cuspal enamel hypoplasia (CEH). Many of these teeth also exhibited Molar Incisal Hypomineralisation (MIH).

Molar Incisor Hypomineralization definieras som ett specifikt tillstånd orsakat av störningar i den tidiga fasen av emaljbildning av en eller flera permanenta första molarer med eller utan involvering av permanenta incisiver. Tidigare studier har visat att standardiserad intraoral fotograferingsteknik kan vara användbar för epidemiologiska studier av emaljdefekter. Denna studies syfte var att utveckla och utvärdera en fotografisk klassificering av allvarlighetsgraden av Molar Incisor Hypomineralization genom att studera metodens validitet och reliabilitet. 164, 10-12 åriga svenska barn granskades fotografiskt avseende prevalensen av Molar Incisor Hypomineralization. Först granskades endast första molarens ocklusalyta, därefter ocklusal- och buckalyta. Granskningarna jämfördes sedan med en tidigare utförd klinisk registrering, baserad på etablerade kriterier. Den fotografiska metodens validitet och reliabilitet beräknades. Vid beräkning av validiteten framgick att överensstämmelsen mellan den fotografiska och kliniska registreringen låg mellan 82-84 % på individnivå. Sensitiviteten för den fotografiska diagnostiken av ocklusalytorna var 48 % och specificiteten 95 %. Motsvarande siffror då buckalytorna inkluderades var 73 % och 88 %. Metodens reliabilitet resulterade i Cohens Kappa koefficienter som motsvarade ”moderat” och ”good” inom Kappa statistiken. Fotografisk klassificering bedöms användbar för diagnostisering av molar incisor hypomineralization, förutsatt att registreringen föregås av noggrann diagnostisk träning och kalibrering. / Molar Incisor Hypomineralization is defined as a specific condition caused by disturbance in the early phase of enamel formation in one or more of the permanent first molars, with or without the involvement of permanent incisors. Previous studies have shown that standardized intraoral photographic technique can be useful in epidemiological studies of enamel defects. The aim of this study was to develop and evaluate a photographic classification of the severity of Molar Incisor Hypomineralization by studying the validity and reliability of the methods. 164, 10 – 12 year old Swedish children were examined photographically for Molar Incisor Hypomineralization prevalence. The first examination only included the occlusal surface of the first molars, thereafter the occlusal and the buccal surfaces were examined. The findings from the photographical examinations were compared to a previously performed clinical registration, based on recognized criteria. The photographical method´s validity and reliability was calculated. The agreement between the photographic and the clinical examinations varied between 82-84 % on individual level. The sensitivity for the photographic examination of the occlusal surface only, was 48% and the specificity 95%. Corresponding results for occlusal and buccal surface were 73% and 88%. The reliability of the method, calculated using the Cohens Kappa coefficient, was judged as “moderate” to “good”. The photographic diagnostic method seems to be useful for diagnosis of Molar Incisor Hypomineralization. However, careful diagnostic training and calibration prior to registration is necessary.