Three-dimensional observations of the incisive foramen on cone-beam computed tomography image analysis

PURPOSE: The purpose of this study was to utilize cone-beam computed tomography (CBCT) image analysis to obtain anatomical information related to the morphology of the incisive foramen to provide useful data regarding implant placement and clinical procedures such as anesthesia.METHODS: The study included 167 patients who underwent CBCT scans over 20 years. Three components were measured: 1) the anteroposterior and mediolateral diameter of the incisive foramen, 2) the horizontal bone thickness anterior to the incisive foramen, and 3) the vertical bone height coronal to the incisive foramen. All measurements were expressed as mean±standard deviation and were analyzed by a single examiner.RESULTS: The anteroposterior diameter of the incisive foramen was wider than the mediolateral diameter (P<0.001). The diameter of the incisive foramen in patients in whom the central incisors were present was smaller than that in those in whom at least one central incisor was absent, but no statistically significant difference between the groups was observed. The horizontal bone thickness in the patients with central incisors was statistically significantly larger than that in the patients without at least one central incisor (P<0.001). The same pattern was observed with regard to vertical height, but that difference was not statistically significant.CONCLUSIONS: The buccal bone thickness anterior to the incisive foramen was significantly decreased after central incisor loss. It is necessary to identify the morphology of the bone and the location of the incisive foramen via CBCT to avoid invasion of the incisive foramen and nasopalatine canal.

Management of peri-implantitis associated with tear-like implant fracture: case reports

Implant fracture is rare, but one of the most serious problem in implantation. Treatment of implant fracture can be different according to the extent of the fracture and on the state of the surrounding prosthetic restoration. Maintaining or submerging implant after treatment of peri-implantitis can be useful options for cases of tear-like fracture on the coronal area of an implant.

Association between health status and tooth loss in Korean adults: longitudinal results from the National Health Insurance Service-Health Examinee Cohort, 2002–2015

PURPOSE: This study investigated the association between health status and tooth loss based on data from the National Health Insurance Service-Health Examinee Cohort in 2002–2015. METHODS: Multivariate Cox proportional hazards regression analyses were applied to a longitudinal retrospective database, which was updated and newly released in 2018, to assess the association between health status and tooth loss while adjusting for potential confounders among sociodemographic and economic factors (sex, age, household income, insurance, and presence of disability), general and oral health status (body mass index [BMI], smoking and drinking status, periodic dental visits and scaling, and brushing before sleep), and comorbid disease (hypertension, diabetes mellitus [DM], and Charlson comorbidity index [CCI]). RESULTS: Among 514,866 participants from a South Korean population, 234,247 (45.5%) participants satisfying the inclusion criteria were analyzed. In the adjusted multivariate analysis, sex, age, household income, insurance, presence of disability, BMI, smoking and drinking status, periodic scaling, tooth brushing before sleep, DM, and CCI showed statistically significant associations with the loss of at least 1 tooth. The risk of experiencing a loss of ≥4 teeth was associated with an increase in age (in those 50–59 years of age: hazard ratio [HR], 1.98; 95% confidence interval [CI], 1.93–2.03; in those 60–69 years of age: HR, 2.93; 95% CI, 2.85–3.02; and in those 70–79 years of age: HR, 2.93; 95%, CI 2.81–3.05), smoking (HR, 1.69; 95% CI, 1.65–1.73), and DM (HR, 1.43; 95% CI, 1.38–1.48). CONCLUSIONS: The results of this study showed that the risk of experiencing tooth loss was related to multiple determinants. DM and smoking were especially significantly associated with tooth loss.

Stability of periodontally compromised teeth after splint and non-surgical therapy: two cases followed-up for 1 to 3 years

This article describes cases of applying non-surgical treatment including scaling and root planing, occlusal adjustment and tooth splinting of periodontally compromised lower anterior incisors Clinical and radiographic evaluations were performed over a 1–3-year period. All clinical parameters and radiographic bone levels improved in both cases. Dramatic regeneration of alveolar bone and lamina dura were observed on radiographic images, and no specific complications occurred during the follow-up period. Within the limitations of this study, these cases demonstrated the possibility of tooth rescue through non-surgical treatment and splinting of periodontally compromised teeth typically considered for extraction.

Trends in the incidence of tooth extraction due to periodontal disease: results of a 12-year longitudinal cohort study in South Korea

PURPOSE: This study evaluated trends in tooth extraction due to acute and chronic periodontal disease (PD) using data from the National Health Insurance Service-National Sample Cohort for 2002–2013. METHODS: A random sample of 1,025,340 individuals was selected as a representative sample of the population, and a database (DB) of diagnostic and prescription codes was followed up for 12 years. We used multivariate logistic regression analysis to assess the incidence of total extraction (TE), extraction due to periodontal disease (EPD), and immediate extraction due to periodontal disease (IEPD) according to sociodemographic factors (sex, age, household income, health status, and area of residence). RESULTS: The incidence of tooth extraction was found to be increasing, and at a higher rate for TE in PD patients. In 2002, 50.6% of cases of TE were caused by PD, and this increased to 70.8% in 2013, while the number of cases of IEPD increased from 42.8% to 54.9% over the same period. The incidence rates of extraction due to acute and chronic PD increased monotonically. We found that the incidence rates of TE, EPD, and IEPD were all 2-fold higher among patients with high income levels and those who were not beneficiaries of health insurance. CONCLUSIONS: The rates of TE, EPD, and IEPD have been steadily increasing despite dental healthcare policies to expand public health insurance coverage, increasing the accessibility of dental clinics. Moreover, the effects of these policies were found to vary with both income and education levels. Consistent patient follow-up is required to observe changes in trends regarding tooth extraction according to changes in dental healthcare policies, and meticulous studies of such changes will ensure optimal policy reviews and revisions.

Marginal bone level changes in association with different vertical implant positions: a 3-year retrospective study

PURPOSE: To retrospectively evaluate the relationship between the vertical position of the implant-abutment interface and marginal bone loss over 3 years using radiological analysis. METHODS: In total, 286 implant surfaces of 143 implants from 61 patients were analyzed. Panoramic radiographic images were taken immediately after implant installation and at 6, 12, and 36 months after loading. The implants were classified into 3 groups based on the vertical position of the implant-abutment interface: group A (above bone level), group B (at bone level), and group C (below bone level). The radiographs were analyzed by a single examiner. RESULTS: Changes in marginal bone levels of 0.99±1.45, 1.13±0.91, and 1.76±0.78 mm were observed at 36 months after loading in groups A, B, and C, respectively, and bone loss was significantly greater in group C than in groups A and B. CONCLUSIONS: The vertical position of the implant-abutment interface may affect marginal bone level change. Marginal bone loss was significantly greater in cases where the implant-abutment interface was positioned below the marginal bone. Further long-term study is required to validate our results.