Dental implants - are they better than natural teeth?

Nowadays, patients find much information on dental treatment from the Internet. There is a vast amount of information on dental implants, in contrast to the limited information available on natural teeth. This review addresses research on survival of natural teeth and dental implants, and discusses factors affecting the survival rate of implants, as well as certain dogmas in implant dentistry. To simplify treatment planning, the article presents a classification system in which teeth are classified as secure, doubtful, or irrational to treat. Secure teeth should last for a long period of time without need for complex treatment. Doubtful teeth are teeth that might need complicated treatment and additional maintenance in order to be maintained. Teeth irrational to treat are teeth that cannot be saved and for which extraction is the only treatment option. Multiple risk factors might decrease the survival probability of teeth. The survival and success rates of dental implants will never succeed the survival rates of healthy, clean teeth. Dental implants and implant-supported restorations are an excellent treatment modality, but it must always be kept in mind that it is associated with a risk of biological and technical complications. Implants are supposed to replace missing teeth - they are not supposed to replace teeth.

Clinical and microbiological findings at sites treated with orthodontic fixed appliances in adolescents.

INTRODUCTION: Fixed orthodontic appliances can alter the subgingival microbiota. Our aim was to compare the subgingival microbiota and clinical parameters in adolescent subjects at sites of teeth treated with orthodontic bands with margins at (OBM) or below the gingival margin (OBSM), or with brackets (OBR). METHODS: Microbial samples were collected from 33 subjects (ages, 12-18 years) in treatment more than 6 months. The microbiota was assessed by the DNA-DNA checkerboard hybridization method. RESULTS: Bacterial samples were taken from 83 OBR,103 OBSM, and 54 OBM sites. Probing pocket depths differed by orthodontic type (P <0.001) with mean values of 2.9 mm (SD, 0.6) at OBSM sites, 2.5 mm (SD, 0.6) at OBM sites, and 2.3 mm (SD, 0.5) at OBR sites. Only Actinomyces israelii (P <0.001) and Actinomyces naeslundii (P <0.001) had higher levels at OBR sites, whereas Neisseria mucosa had higher levels at sites treated with OBSM or OBM (P <0.001). Aggregatibacter actinomycetemcomitans was found in 25% of sites independent of the appliance. CONCLUSIONS: Different types of orthodontic appliances cause minor differences in the subgingival microbiota (A israelii and A naeslundii) and higher levels at sites treated with orthodontic brackets. More sites with bleeding on probing and deeper pockets were found around orthodontic bands.

Can the severity of root resorption be accurately judged by means of radiographs? A case report with histology.

INTRODUCTION: Root resorption of lateral incisors caused by the pressure of erupting canines is a well-known but relatively rare problem in orthodontics and general dentistry. It is usually diagnosed on radiographs. The purpose of this article is to discuss some difficulties associated with evaluating root resorption from radiographs alone. A case report is presented as an example. METHODS: Radiographs showed that an 11-year-old girl had marked root resorption of the maxillary lateral incisors, caused by the impacted permanent canines. The incisors were to be extracted. Several months before the extractions, a canine had been surgically exposed to remove pressure from the incisor root. The lateral incisors were analyzed histologically, and the histologic findings were compared with those of the patient's mandibular first premolars, which had been extracted. RESULTS: The resorption of the lateral incisors was more severe than expected from the radiographs. The resorption extended far into the pulp. Most, although not all, root resorption areas showed histologic evidence of repair, but the amount of repair was far from functional repair levels. The mandibular first premolars had no signs of resorption, thus excluding systemic causes. CONCLUSIONS: The severity of root resorption of lateral incisors cannot be accurately judged from radiographs alone.