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BACKGROUND: Regional odontodysplasia, also described as ghost teeth, has been described on a number of occasions, in some cases generalized odontodysplasia affecting both the primary and the permanent dentition. However, generalised odontodysplasia is a very rare finding, involving large pulps and short roots of the whole dentition and in the cases previously reported the teeth finally erupt. In the case reported on herein this has not happened. CASE REPORT: A female patient, now aged 22-years-old, cared for in the TAKO-centre (Oslo) since she was 5 years old, presented with a continuing problem of absence of permanent teeth due to total lack of eruption. All her permanent teeth were either retained intra-alveolar or had been extracted following previous periods of pain and infections. There was no enamel on any of the permanent teeth and the dentine was softer than normal. In addition, there appeared to be very little potential for eruption. Hence, tooth development was affected in all aspects. Her skeletal height was much shorter than expected taking her tall parents into consideration. After all possible assessments, no specific diagnosis for the condition of this young woman has been determined. TREATMENT: Before the present series of dental care the patient was wearing full dentures in both jaws. In the autumn of 2007, implants were placed in her maxilla and an implant supported fixed prosthesis in porcelain was installed the following spring. Similarly, implants were placed in her mandible, partly in retained teeth, in the autumn of 2008, and an implant supported fixed prosthesis was inserted during the spring of 2009. FOLLOW-UP: after prosthetic treatment a dental hygienist has seen the patient regularly. No problems or signs of infections have occurred to date. CONCLUSION: This case report concerns a rare and apparently un-named syndrome affecting both primary and permanent teeth. This paper has been written with an aim of gathering the views as to the aetiology of her problem, hopefully finally to provide a definitive diagnosis.

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The purpose of this prospective clinical study was to investigate the outcome of 3 different types of endosseous, nonsubmerged implants in the anterior part of the mandible. Fourteen older edentulous patients, 10 females and 4 males, were included. All participants received 3 different types of endosseous implants in the anterior mandible: 1 titanium plasma-sprayed cylindric implant (4 mm in diameter), 1 titanium cylindric implant with hydroxyapatite (HA) coating (4 mm in diameter), and 1 standard threaded titanium implant (3.75 mm in diameter). The 3 types of implants were originally designed to be placed in a 2-step surgical procedure. However, at this stage all implants were simultaneously provided with a temporary abutment that penetrated the mucosa. Three months later the temporary abutments were replaced by ball abutments, which were connected to an overdenture. At 12, 24, and 36 months after surgery, marginal bone resorption and Periotest values were recorded. Two patients died within the 2 first postoperative years. Five of 42 implants (11.9%) failed to osseointegrate. After 3 years, marginal bone resorption around titanium plasma-sprayed implants was significantly greater than that seen around both HA-coated and threaded titanium implants. Threaded titanium implants also had significantly better scores for marginal bone resorption than the HA-coated implants. Periotest values for HA-coated cylinders were significantly lower than test values for the other implants after 3 years (P < .05). The conclusion from this investigation is that nonsubmerged implants showed impaired prognoses compared to implants placed according to the 2-stage concept. Marginal bone resorption around titanium plasma-sprayed cylindric implants was clearly increased compared to the 2 other implant systems. Periotest values for HA-coated cylindric implants were superior to titanium plasma-sprayed and pure titanium implant surfaces.

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An index, called the mucosal-plaque score (MPS), was tested for intra- and inter-examiner agreement at an institution for elderly individuals with mental disabilities. This index was designed to evaluate oral health and oral hygiene in groups of individuals, particularly in hospitals or at other institutions. MPS consists of the sum of a four-point mucosal score (MS) and a four-point plaque score (PS). Intra-examiner agreement was assessed for one dentist (BMH), who examined 24 individuals twice with a one-week interval. Weighted kappa values were 0.60 for MS, 0.62 for PS, and 0.62 for MPS. Inter-examiner agreement between two dentists was conducted by duplicate examinations on 20 persons. Weighted kappa values were 0.47 for MS, 0.71 for PS, and 0.70 for MPS. In a second assessment of inter-examiner-agreement, eight individuals were each examined by a dentist, two dental hygienists, and one medical nurse. Weighted kappa values were 0.79 for MS, 0.80 for PS, and 0.77 for MPS. These results support the conclusion that the MPS can serve as a reliable measure for the assessment of oral health care in groups of older individuals.

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The purpose of this prospective study was to investigate the clinical outcome and marginal bone resorption of three different endosseous implants placed in the anterior mandibles of 15 elderly patients. Eleven women and 4 men (ranging from 65 to 80 years, mean 71 years) had three different endosseous implants placed in the anterior mandible; one titanium plasma-sprayed cylinder implant (4-mm diameter), one titanium cylinder implant with hydroxyapatite coating (4-mm diameter), and one standard threaded titanium implant (3.75-mm diameter). Three months later, at the second-stage surgical procedure, ball abutments were connected and an overdenture was placed. At 12, 24, and 36 months, marginal bone resorption and Periotest values were recorded. None of the implants was lost in this period. An analysis of variance with repeated measurement was performed annually to test the existence of significant differences between the implants. When differences appeared, paired t tests were used to identify which differences were significant. Bonferroni multipliers were used to adjust for multiple testing. When marginal bone resorption was concerned, threaded titanium and hydroxyapatite-coated implants had significantly better scores than titanium plasma-sprayed cylinder implants. Periotest values for hydroxyapatite-coated implants were significantly better than test values for the other implants after 2 years. After 3 years significance was obtained between hydroxyapatite and screw-shaped implants only (P < .05). It was concluded that titanium plasma-sprayed cylinder implants have a less favorable prognosis than the other implants used in this study.

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OBJECTIVES: The purpose of this study was to examine radiographically changes in the periapical status and compare the clinical status of teeth with a vital pulp and root-filled teeth restored with crowns and bridge retainers during 25 years. METHODS: During 1967/68, 114 patients received prosthodontic treatment by senior dental students at the Oslo Dental Faculty. In all, 291 teeth with a vital pulp and 106 root-filled teeth were restored with 158 prostheses. All root-filled teeth were restored with a cast dowel and core. The casts were made in a type-3 gold alloy, and cemented with zinc phosphate cement. Forty-six teeth were restored with crowns and 351 teeth with bridge retainers. Radiographs were taken preoperatively, immediately after cementation, and every fifth year. Two independent observers assessed the periapical status on the radiographs according to the PAI-index. At the 25 years examination, 32 patients (28%) with 101 restored teeth (24%) remained in the study. Survival rates of the prostheses and of the restored teeth were estimated using Kaplan-Meyer non-parametric statistics. RESULTS: The PAI-score of the periapical status deteriorated in 13 vital and four root-filled teeth. The survival rates of the fixed prostheses were not influenced by the pulp vitality of the restored tooth at the baseline. The survival rates of the restored teeth with a vital pulp and of the root-filled teeth were similar. Clinical failures were recorded on approximately one-third of the restored teeth. The main reason for tooth failure was caries (12%), and for the teeth with a vital pulp also pulpal deterioration (10%). Estimates of the proportions of crowned teeth with a vital pulp that will remain free from signs and symptoms of pulpal deterioration were 98% after five years, 92% after 10 years, 87% after 20 years and 83% after 25 years. CONCLUSIONS: The incidence of periapical lesions on radiographs of crowned teeth was low during 25 years observation. Crowned, root-filled teeth with a high quality endodontic treatment and an optimal morphology of the dowel and core have a similar survival rate as crowned teeth with a vital pulp. A high proportion of crowned teeth with a vital pulp will remain free from signs and symptoms of pulpal deterioration over 25 years.

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The dental and periodontal status, oral hygiene, and dental visit habits of 250 residents in long-term care (LTC) facilities for the elderly in a suburban community in Norway were recorded. The findings were compared with the data from an identical examination of the residents in the same LTC facilities in 1980. In 1993 the mean number of remaining teeth per person was 11.7 (CI = 10.3-13.1). The mean number of filled teeth was 5.1 (CI = 4.1-6.0), and the mean number of decayed teeth was 1.8 (CI = 1.4-2.2). The mean number of residual roots per person was 0.8 (CI = 0.5-1.1). Periodontal pockets exceeding 4 mm was recorded on 5% of all teeth. In general, the oral hygiene was poor. Edentulousness had decreased from 80% in 1980 to 54% in 1993, and more remaining and filled teeth and fewer residual roots per person were observed in the 1993 population. The findings show that the objective need for resources to prevent periodontal disease and caries among elderly patients in LTC facilities today is higher than previously.

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OBJECTIVES: The purpose of this investigation was to compare the degree of abrasion in vitro of two acrylic veneers and dental enamel using a dentifrice with and without fluoride. METHODS: Ten specimens of each of the two acrylics and enamel were embedded in resin, and eventually polished to 1 micron with diamond paste. Specimens were brushed in a brushing machine with 10,000 double strokes using a dentifrice (Solidox, A/S Denofa) with and without fluoride. The abrasion was evaluated by the naked eye, by photographs and measured by means of profilometer. RESULTS: One of the polymer materials (Dentacolor, Kulzer) showed a significantly higher resistance to abrasion than the other (Biodent, DeTrey), irrespective of fluoride treatment. Brushing with or without fluoride revealed no significant difference in degree of abrasion between the two acrylic materials. Dentacolor showed significantly higher abrasion resistance than enamel, whereas Biodent did not. There was no significant difference in the degree of abrasion of enamel using dentifrice with or without fluoride. SIGNIFICANCE: Abrasion of acrylic veneering material differed greatly between brands, but did not seem to be influenced by the fluoride in toothpaste.

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There seems to be an increasing need and demand for prosthetic treatment among old-age pensioners in Norway. The demand may be explained by more pensioners with own teeth, more interest in dental care, cosmetics, better information about treatment possibilities, and a better economy among the elderly. This article gives guidelines for various types of prosthetic treatment as respects for barriers such as chronic disease, aging, drugs, social isolation and for some elderly weak economy. Although prosthetic treatment of elderly differs little from that given to younger adults, the requirements of a tooth used as an abutment may be less strict in case of the elderly.

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The purpose of the present study was to describe the dental health status of a dentate elderly population in terms of remaining teeth, periodontal condition and oral hygiene. In a municipality near Oslo, 371 respondents from a random sample of elderly subjects were clinically examined in 1979/80. Of these, 169 were dentate, 39% had 1-9 teeth and 28% had 20 teeth or more. The mean number of teeth present was 13.8. Income, bone loss and oral hygiene explained most of the variance in the number of remaining teeth whereas age seemed to play a minor rôle. Gingivitis was recorded adjacent to 54% of the teeth, and plaque was visible on 63%. The variance in gingivitis was mainly explained by plaque, calculus and number of remaining teeth, while the amount of plaque was associated with differences in cleaning habits, the number of teeth and social class. 38% of the alveolar bone height was on average lost at teeth present at the time of examination. The variance was mainly explained by presence of plaque and gingivitis. However, the majority of remaining teeth displayed a fair periodontal condition.

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The purpose of the present study was to describe and analyze the prevalence of decayed, missing, and filled teeth among dentate non-institutionalized and institutionalized old-age pensioners from the same population. A random sample of 430 persons was drawn from the total population of pensioners in Skedsmo (N = 3072), yielding 159 non-institutionalized with their own teeth as one study group. The second study group consisted of all dentate elderly institutionalized persons (n = 38) from the same municipality. Of the non-institutionalized pensioners 48% had untreated caries lesions (DT = 1.1), and 87% had one or more fillings (FT = 8.8). The mean number of MT was 14.1. The oldest non-institutionalized pensioners (80+ years) had more MT and fewer FT than the younger ones (67-79 years). Only small differences in DT, MT, and FT were seen between the sexes in the youngest age group, whereas in the oldest age group (80+) the men had more DT and fewer FT than the women. Dental visiting habits and age were the most important predictors of DT%. The multivariate models provided best fit for FT% (R2 = 27%), DT% came second (R2 = 15%), and poorest fit was observed for DMFT (R2 = 2%). The institutionalized persons had more DT, MT, and residual roots, higher DMFT, but fewer FT than the non-institutionalized ones. Among the institutionalized pensioners a somewhat different sex-related pattern emerged; women tended to have lower DMFT and fewer residual roots than had men, regardless of age.

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The purpose of the present work was to assess the adequacy and effectiveness of a public dental program for old-age pensioners. The dental care program offered free consultation and treatment at reduced prices to all pensioners (3072) in a municipality near Oslo in 1979. To study treatment need and access to dental care, a random sample of 430 pensioners was drawn from the total population of old-age pensioners; 371 persons were clinically examined. Of the 3072 old-age pensioners 23.7% responded positively and indicated that they were interested in the program, whereas 19.8% accepted, and 14.6% had the treatment carried out. The program adequacy was low and became lower when more restricted criteria for access to dental services were used. The program effectiveness was 18% or 16%, depending on which criteria were used for access. Acceptance of the program was highest among people who were aware of it, had natural teeth, had a dental problem, did not have their own dentist, had limited education, or were among the young pensioners.

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The purpose of the present study was to investigate the effect of two oral hygiene information programs on denture hygiene. The programs were provided individually to healthy elderly denture wearers. Totally, 150 edentulous persons between 67 and 89 years of age were selected and randomly assigned to two experimental groups and one control group. In one test group (INFO) the participants were only given individual verbal information on how to remove denture plaque. The participants of the second test group (DEMO) received individual demonstration of denture cleaning in addition. One hundred and thirty-eight persons completed the study. The percentage plaque covering the maxillary denture base was assessed by a morphometric point-estimator scoring method at the start of the study and after 14 and 180 days. Verbal information resulted only in a short-term effect (14 days), whereas demonstration on how to remove denture plaque gave long-term (180 days) improvement of denture hygiene.

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The purpose of the present study was to compare the reproducibility and reliability of different methods of measuring the distribution of plaque on the fitting surface of maxillary dentures. Data from a clinical trial were used to determine the reproducibility of (1) the original Budtz-Jörgensen index, (2) a proposed morphometric method for facilitating the measurements by this index, and (3) the index of Schubert and Schubert. The recordings from previous tests of reproducibility of an additive index were used to estimate reliability by means of a test-retest procedure and the internal consistency method. The morphometric point-estimator scoring method gave the highest intra- and inter-examiner reproducibility for the three-graded scale (Scott's pi, 0.90 and 0.81) and for the five-graded scale (0.86 and 0.80). Reproducibility was markedly reduced when the distribution of denture plaque was assessed by visual examination (Scott's pi, 0.81 and 0.72), especially when using the five-graded scale (0.73 and 0.51). The PH index exhibited an intra-examiner reliability of 0.83 with the three-graded scale and 0.78 with the five-graded scale. The corresponding inter-examiner figures were 0.76 and 0.70. The test-retest method showed that in the areas M1 and M2 the mean amount of plaque was significantly reduced at the second examination, whereas no significant change occurred in areas T1 and T2. The reliability coefficients obtained by the additive index were greater than 0.88. Error variance was 8% and 12% of the total variance for this index but only 3% with the morphometric test method. The internal consistency reliability gave coefficients that were higher than those obtained by the test-retest method.

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There appears to be a relation between accumulation of plaque on complete maxillary dentures and denture stomatitis. The present index was introduced to assess the location and amount of plaque in some areas of the fitting surfaces of complete maxillary dentures. Scores were recorded in five defined areas on the denture base. Four ranked scores were used: 0 - no visible plaque, 1-plaque visible only by scraping on the denture base with a blunt instrument, 2-moderate accumulation of visible plaque, and 3-abundance of plaque. By summing up the scores from the five areas, the plaque was recorded on a scale from 0 to 15 points. The inter- and intra-reliability were tested for two examiners using the index on 50 complete maxillary dentures. Expressed in terms of Scott's Pi, inter-examiners agreement was 0.83, and intra-examiner 0.83 and 0.82 for examiners A and B, respectively. A simplification of the index was also presented. In this index the scores 0 and 1 were combined to score 0, -no visible plaque, and score 2 and 3 were combined to score 1, -visible plaque. Using this index, Scott's Pi was calculated to 0.91 for inter-examiner reliability. For the intra-examiners reliability Scott's Pi was calculated to 0.91 for examiner A and 0.89 for examiner B.

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Oral conditions were studied clinically and radiographically in a group of people aged 67-94 years. The group comprised 70 persons living in an institution for elderly people and 111 persons living in their homes in the surrounding area. The participants were classified according to sex, age and former occupation. The examination was carried out in a dental office established at the institution. 63% of the participants were dentulous with a mean number of 13 teeth. Almost 50% of the teeth were previously restored and 13% of the teeth were decayed at the examination. 45% had complete maxillary dentures and 39% had complete mandibular dentures. The need for dental treatment according to defined criteria was registered, and treatment-offers were given. Comparisons were made between the treatment suggested and the treatment actually given. Of the total group, 129 persons needed dental treatment. Of these, 65 persons accepted all or part of the treatment suggested. In general, sex was not a good predictor of the need for an acceptance of dental services. However, age was found to be useful as a predictor. Social background was an unreliable predictor of the need for and acceptance of dental services.

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The linear dimensional changes during setting of a reinforced zinc oxide eugenol cement (Alumina EBA Crown and Bridge Cement), a composite resin cement (Epoxylite 9080 Crown and Bridge Adhesive) and a zinc silico phosphate cement (Fluoro-Thin cement), have been studied. The measurements were were performed on specimens placed on a mercury bath. The cements were allowed to set under various environmental humidity. The measurements of specimen length started 3 or 5 min after commencing the mix. The EBA-cement showed a maximum contraction of 0-4 percent after 7 days when setting under dry conditions. Under wet conditions the cement had an initial contraction the first day of setting, and thereafter an expansion. After 21 days specimens setting under 100 percent relative humidity showed 0-3 percent expansion, whereas specimens immersed in water attained the initial length. The composite resin cement showed a contraction of 1-0 percent after 1 day when setting under dry conditions. Under wet conditions the specimens had an initial contraction of 0-8 percent the first day of setting being reduced to 0-4 percent during the next 20 days. The zinc silico phosphate cement showed a maximum contraction of 3-0 percent after 7 days under dry conditions and 0-5 percent after 1 day under wet conditions.

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