Database: MEDLINE <: biomedical, nursing & dental literature, 1966 - Oct 2000.> Search Strategy (You Saved Citations 1-235 From Set 58): ----------------------------------------------------------------------------- 1 ("94349329" or "85231665" or "88266637" or "89091841" or 5 "90316397").ui. 2 "Root caries"/ 297 3 ("root" adj3 (carie: or lesion:)).mp. 1180 4 exp Tooth root/ 7047 5 ((tooth or teeth or enamel or dentin) adj5 ("root" or apex 3443 or apices)).mp. 6 ((amelocemental or cemental or cementum) adj5 (carie: or 74 lesion:)).mp. 7 Dental cementum/ 1911 8 or/2-7 11043 9 exp Tooth demineralization/ 22628 10 demineralization.mp. 1620 11 caries.mp. 15295 12 caires.mp. 1 13 craies.mp. 0 14 careis.mp. 4 15 carise.mp. 0 16 (teeth adj3 cavit:).mp. 422 17 (tooth adj3 cavit:).mp. 217 18 (dental adj3 cavit:).mp. 276 19 (dentin adj3 cavit:).mp. 254 20 (enamel adj3 cavit:).mp. 182 21 (teeth adj3 decay:).mp. 374 22 (tooth adj3 decay:).mp. 321 23 (dental adj3 decay:).mp. 250 24 (dentin adj3 decay:).mp. 12 25 (enamel adj3 decay:).mp. 20 26 (active adj decay).mp. 9 27 (rampant adj3 decay:).mp. 14 28 (recurrent adj3 decay:).mp. 30 29 (white adj spot:).mp. 509 30 carious.mp. 2077 31 cariology.ti,ab. 56 32 (non-cavitated adj3 lesion:).mp. 15 33 (noncavitated adj3 lesion:).mp. 2 34 Tooth remineralization/ 478 35 (dental adj3 fissure:).mp. 99 36 (tooth adj3 fissure:).mp. 50 37 (teeth adj3 fissure:).mp. 98 38 caries-free.mp. 603 39 cariesfree.mp. 17 40 Cariogenic agents/ 728 41 precavit:.mp. 8 42 (filled adj3 teeth).mp. 510 43 (filled adj3 tooth).mp. 117 44 (oral adj fissure:).mp. 6 45 (tooth adj3 remineraliz:).mp. 28 46 (teeth adj3 remineraliz:).mp. 24 47 dft.mp. 413 48 dfs.mp. 1258 49 dmf:.mp. 6397 50 cariogeni:.mp. 1787 51 or/9-50 32256 52 8 and 51 1410 53 limit 52 to (human and english language) 1069 54 limit 53 to yr=1980-2000 1006 55 limit 54 to (adult < 19 to 44 years > or middle age < 45 to 523 64 years > or "aged < 65 and over >" or "aged, < 80 and over >") 56 ("gerodontics" or "gerodontology" or "geron" or "gerontion" 6114 or "gerontologia" or "gerontologia clinica" or "gerontologie" or "gerontologist" or "gerontology" or "gerontology & geriatrics education").jn. 57 54 and 56 45 58 55 or 57 535 59 from 58 keep 1-300 300 60 from 58 keep 301-535 235 *************************** <1> UI - 92276606 AU - Wefel JS AU - Jensen ME IN - Dows Institute for Dental Research, University of Iowa, College of Dentistry, Iowa City 55242. TI - An intra-oral single-section demineralization/remineralization model. SO - Journal of Dental Research 1992 Apr;71 Spec No:860-3 AB - This paper reviews the use of our intra-oral crown single-section model for the evaluation of in situ demineralization and remineralization. The model uses normal, healthy adults who are in need of a gold crown. A slot is placed in the working crown which can hold 3-4 single sections. A typical experiment would use an enamel lesion, root lesion, and sound root section which are characterized with polarized light microscopy and/or microradiography prior to insertion in the crown. After the experimental regimen, the sections are removed and re-characterized for any changes. The model has been used to evaluate mineral changes from the use of fluoride dentifrices and rinses, chewing gum, and food sequencing. The advantages of the model system are the before-and-after measurements on the same section, a natural plaque formation, interaction with saliva, episodic demineralization and remineralization, no bulky appliances, and the use of reasonable time frames. This model, therefore, reduces the artificiality of the in situ study to a great extent and appears to be a useful predictor of demineralization/remineralization interactions. <2> UI - 92276599 AU - Corpron RE AU - More FG AU - Mount G IN - School of Dentistry, University of Michigan, Ann Arbor 48109-1078. TI - Comparison of fluoride profiles by SIMS with mineral density of subsurface enamel lesions treated intra-orally with a fluoride-releasing device. SO - Journal of Dental Research 1992 Apr;71 Spec No:828-31 AB - A variety of intra-oral model systems has evolved which allows for the study of remineralization of coronal and/or root-surface lesions following application of topical fluoride (F) agents. The problem of interpretation of the results has led to a variety of analytical methods (i.e., microhardness, F biopsy, microradiography, and polarizing light microscopy), each of which provides important but limited information related to the overall understanding of remineralization. Microhardness measures change in mineral content which is more precisely localized by microradiography and polarized light microscopy. F biopsy allows for assessment of the F uptake of lesions, but does not suggest the chemical state of the F. Previous work has demonstrated that patterns of mineral deposition during remineralization do not necessarily parallel the F uptake profiles, and fluoridated apatites cannot be distinguished from non-specifically-adsorbed F (Clark et al., 1988). Because artificial lesions demonstrate variations in depth and mineral content, complementary analytical methods that demonstrate profiles of both F content and mineral density curves on the same section are needed so that the process of remineralization can be more clearly understood. This study used secondary ion mass spectrometry (SIMS) for F profiles and quantitative microradiography for assessment of mineral deposition on the same section. These state-of-the-art methods demonstrate the precision with which information about remineralization can be obtained. Subsurface lesions in human enamel specimens were developed by immersion in 0.1 M lactate buffer with 1% CMC at a pH of 4.5 for 48 h.(ABSTRACT TRUNCATED AT 250 WORDS) <3> UI - 92203178 AU - Morrison SL AU - Cobb CM AU - Kazakos GM AU - Killoy WJ IN - Department of Periodontics, School of Dentistry, University of Missouri-Kansas City. TI - Root surface characteristics associated with subgingival placement of monolithic tetracycline-impregnated fibers. SO - Journal of Periodontology 1992 Feb;63(2):137-43 AB - The purpose of this investigation was to inspect and characterize the subgingival root surface after a 10-day exposure in vivo to 25% tetracycline hydrochloride by weight in an ethylene vinyl acetate copolymer fiber matrix with and without root planing therapy. The root surfaces were examined by fluorescent-light microscopy (FLM), scanning electron microscopy (SEM), and energy dispersive spectroscopy (EDS). Thirty-two teeth were selected for study, 4 from each of 8 patients. The teeth of each patient were randomly assigned to one of four treatment groups: non-treated control (C), scaling and root planing only (RP), tetracycline-impregnated fiber only (F), and scaling and root planing with tetracycline-impregnated fiber application (RP/F). SEM revealed a visible reduction in the subgingival microbial flora in both the F and RP/F treatment groups in comparison with the C group specimens. Many of the residual bacteria observed in F and RP/F specimens appeared non-viable, exhibiting obvious loss of membrane integrity. In contrast, the RP specimens exhibited randomly distributed areas of residual subgingival plaque and calculus with newly developing plaque fronts; the plaque fronts undoubtedly having formed during the 10 days post-therapy. All RP/F specimens exhibited an incomplete removal of adsorbed root surface pellicle and demineralization of the subsequently exposed root surface. EDS analysis of large crystals adhering to root surfaces of F and RP/F specimens revealed high chloride peaks, suggesting the presence of residual tetracycline. FLM examination of F and RP/F treated specimens showed a superficial penetration of tetracycline into the root surface of about 10 microns. Areas of demineralized root showed slight tetracycline penetration into exposed dentinal tubules. <4> UI - 92227034 AU - Graves RC AU - Beck JD AU - Disney JA AU - Drake CW IN - Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill 27599-7450. TI - Root caries prevalence in black and white North Carolina adults over age 65. SO - Journal of Public Health Dentistry 1992 Winter;52(2):94-101 AB - The baseline root caries prevalence of 809 dentate black and white home-dwelling North Carolinians over age 65 was determined along with the collection of a large number of demographic and behavioral, clinical, and microbiological variables in the longitudinal Piedmont over-age-65 Dental Study. In comparison to other studies of older adults, the prevalence of decayed-filled root surfaces (DFRS) was low, fewer than 2.0 DFRS in whites, and significantly fewer than that in blacks (1.3 DFRS). Although tooth loss was a substantial problem, nearly half of the white population and almost two-thirds of the black participants exhibited no evidence of root caries history. Even though DFRS prevalence was much lower in blacks, their treatment need for decayed root surfaces (DRS) was significantly higher than for white participants. Correlates with DRS within both race groups appeared to be those that reflect lack of access to dental services or neglect of oral health--decayed coronal surfaces, higher rates of tooth extraction, high CPITN scores and worst loss of attachment greater than or equal to 7 mm, and more than a year since the last dental visit. Some variables were associated significantly with one racial group, but not the other, while others, particularly root surfaces at risk and age, were not associated significantly with DRS. We concluded that although there was considerable neglect of root caries, particularly among blacks, it was not a serious problem among older North Carolinians. <5> UI - 92191525 AU - Scheinin A AU - Pienihakkinen K AU - Tiekso J AU - Holmberg S IN - Department of Cariology, University of Turku, Finland. TI - Multifactorial modeling for root caries prediction. SO - Community Dentistry & Oral Epidemiology 1992 Feb;20(1):35-7 AB - The study was part of a series of investigations aiming at the development of diagnostic caries tests for screening of risk subjects. The material consisted of 100 adult subjects (mean 62 yr, range 47-79 yr), 50 of these under chronic medication. The series of tests included two chairside registrations, i.e. incipient demineralization of exposed root surfaces without cavitation (RD 1) and quantitation of visible plaque (VPT%), three microbiological tests for mutans streptococci, lactobacilli, and candida/yeasts and three tests on stimulated saliva, i.e. secretion rate, buffering capacity and sucrase activity. A thorough clinical examination was conducted at the baseline and 1-yr registration phases, caries being registered at a tooth surface level according to WHO recommendations separately for coronal and root caries. Considerably more root caries than coronal caries developed during the observation period. For coronal caries increment, the predictive value of any of the tests was not significant. For root caries, however, the association between several tests and prospective caries increment was significant. Subsequent multifactorial modeling yielded the highest predictive value to the combination of Past Root Caries Experience (OR 25.0, Visible Plaque (OR 4.2), Candida (OR 8.0) and Lactobacilli (OR 5.8). A positive finding of Past Root Caries (RDFS) or the combination of the other three tests (Can, LB, VPT%) as criteria for selection in screening for root caries produced good accuracy (84.0) and a relative risk of 5.5. <6> UI - 93182998 AU - Mount GJ TI - The aged in dentistry. SO - Annals of the Royal Australasian College of Dental Surgeons 1991 Oct;11:75-81 AB - Statistics show clearly the greying of our population and the profession must face the inevitable modifications to the delivery of dental care which will follow. We have spent many years fighting the high caries rate of youngsters and teenagers but, quite suddenly, that battle seems to be virtually won. Now we are faced with an ageing population who, with our help, have retained their teeth to an advanced age and they do not want to part with them. In fact, changing a patient to full dentures after the age of forty years is a very traumatic occurrence to both patient and operator. The profession now has two major problems to deal with in the area of restorative dentistry for the ageing patient. Firstly, teeth which have been retained but are heavily restored because of ongoing caries and bulk loss of tooth structure as a result of splitting or the application of careless restorative techniques. Secondly, the onset of root surface caries following migration of the epithelial attachment and exposure of root surfaces combined with a reduction in the efficacy of oral hygiene measures. Both problems are likely to appear after the age of sixty years and the patient may live for another twenty or thirty years in a gentle medical and physical decline. Maintenance of dental health presents a series of unique problems under these circumstances. <7> UI - 92317854 AU - Imfeld TN IN - Dental Institute, University of Zurich, Switzerland. TI - Prevalence and quality of endodontic treatment in an elderly urban population of Switzerland. SO - Journal of Endodontics 1991 Dec;17(12):604-7 AB - Little oral health data on the elderly are available in Switzerland. This study assessed endodontic findings in 66-yr-old residents of the city of Zurich using intraoral radiographs. Of the 143 volunteers having a total of 2004 natural teeth, 78% had at least one endodontically treated tooth. Twenty percent of all teeth were root filled, two thirds of them being in the upper jaw. Sixty-four percent of the root fillings were judged insufficient and 8.5% of all teeth showed periapical radiolucencies, most of the latter (73%) being associated with insufficient root canal treatments. Ninety-eight percent of the root-filled teeth had intracanal retentive devices. Fifty-two percent of the teeth with insufficient root fillings were judged not to need revision, 37% needed revision, 9% needed apicectomy, and 2% were ready for extraction. The considerable endodontic treatment needs of the elderly can only be reduced by an improvement of quality of initial endodontic treatment. <8> UI - 92316682 AU - Figures KH AU - Douglas CW IN - University of Sheffield, UK. TI - Actinomycosis associated with a root-treated tooth: report of a case. SO - International Endodontic Journal 1991 Nov;24(6):326-9 AB - An unusual case of a persistent infection related to a root-filled tooth is reported. Microscopical evaluation revealed the cause to be a large mass of Actinomyces-like filaments, and microbiological culture yielded a low level of Actinomyces israelii. The significance of such a presentation is discussed. <9> UI - 92314195 AU - Sikri V AU - Sikri P IN - Govt. Dental College and Hospital, Amritsar. TI - Clinical and radiological examination of root surface caries. An in vitro study. SO - Indian Journal of Dental Research 1991 Jan-Jun;2(1-2):1-6 AB - The better knowledge of prevention and treatment of periodontal diseases is expected to give rise to retention of more number of teeth in future. However, the periodontal surgery and also the intensive mechanical oral hygiene may expose the root surfaces to cariogenic environment. The present study was intended to evaluate and compare the clinical and radiological examination of root surface caries on extracted teeth. One hundred and twenty extracted teeth, both anteriors and posteriors, collected from the Department of Oral Surgery, Pb. Govt. Dental College & Hospital, Amritsar, were examined clinically as well as radiographically from all the four surfaces. Mesial surfaces were found to be more susceptible to caries and the lingual surfaces the least. Approximately eighty percent agreement was observed in clinical and radiological examination. Thorough probing is suggested especially on buccal and lingual surfaces since radiographs of these surfaces may be difficult in vivo. It was concluded from the study that early detection of root caries is of paramount importance; and the preventive technique should be considered for elderly patients even if there is not detectable root caries. <10> UI - 92304425 AU - Meyerowitz C IN - University of Rochester. TI - Geriatric dentistry and prevention: research and public policy (reaction paper). [Review] [40 refs] SO - Advances in Dental Research 1991 Dec;5:74-7 AB - The population of older adults is heterogeneous and can be divided into many subgroups: the young-old, the old-old, the healthy, the sick, the frail, the mentally and physically handicapped, the ambulatory, the chair-bound, house-bound or institution-bound, and the economically advantaged and disadvantaged. This diversity is extremely important to the discussion of the oral health needs, preventive health strategies, and research agenda for the elderly. As life expectancy increases, more attention is being paid to disease prevention so that the quality of life in old age can be improved. However, the link among oral health, systemic disease, and quality of life in the elderly needs to be better-defined. There is some evidence in the literature that indicates that coronal and root caries appear to be major health problems for the elderly. This needs to be corroborated in longitudinal studies. Although periodontal disease prevalence and severity are high in some subgroups of the elderly, these appear to be in decline in the general population. Dental health-care workers must be cognizant of the oral conditions associated with systemic disease and the use of medication, a major concern in older adults. Prevention of oral disease in the elderly requires early intervention, education of the dental health team, and innovative uses of well-established preventive agents such as fluoride. An extensive research effort is needed to answer basic and applied questions regarding the oral health needs of the elderly. Federal and private funding will be necessary. The dental profession will have to demonstrate and be persuasive that money spent on research and care for the elderly is money well spent. [References: 40] <11> UI - 92304424 AU - Gershen JA IN - School of Dentistry, University of California-Los Angeles. TI - Geriatric dentistry and prevention: research and public policy. [Review] [31 refs] SO - Advances in Dental Research 1991 Dec;5:69-73 AB - Changing demographics, including the increase in life expectancy and the growing numbers of elderly, has focused attention on the need for dental research activities to be expanded for geriatric dentistry. The elderly are at greater risk for oral disease, since gains in longevity result in more medically compromising conditions or systemic disease with oral manifestations. Also, as edentulism decreases and as more teeth are retained by the elderly, the pattern of oral diseases and the treatment of dental conditions will be altered. Barriers to self-care and professional care must be removed, and prevention and early intervention strategies must be formulated to reduce the risk of oral disease. Risk factors for oral diseases in the elderly can be reduced by personal home-care regimens, professionally provided preventive, diagnostic, and therapeutic care, changes in high-risk behavior, and a supportive environment. Generating new information about the prevention of oral diseases and conditions that have an impact on the elderly requires a substantial research effort. A research agenda for the elderly should include: epidemiologic studies of relevant oral diseases and related risk factors; investigations of patient and provider attitudes and behavior related to oral health; studies of the relationship between general health and oral health; development and testing of preventive and treatment strategies for conditions such as xerostomia, root caries, secondary caries, and gingival recession; and studies for the evaluation of the impact of the aging population on the dental delivery system. Public policy options to support geriatric oral health care and research are limited by the Government's pre-occupation with cost containment and the lack of visibility for dental programs.(ABSTRACT TRUNCATED AT 250 WORDS) [References: 31] <12> UI - 92287617 AU - Odlum O IN - Faculty of Dentistry, University of Manitoba, Winnipeg. TI - Preventive resins in the management of radiation-induced xerostomia complications. SO - Journal of Esthetic Dentistry 1991 Nov-Dec;3(6):227-9 AB - The article focuses on caries problems that can arise in oncology patients following radiation of the salivary glands. Preventive restoration techniques are described that utilize fluoride-releasing resins. The particular difficulties associated with the management of areas of exposed incisal and gingival dentine in older patients are given special attention. Positive results are described for a 14-month period that appear to indicate that the technique leads to prevention of recurrent decay and retention of restorations in dehydrated areas of the mouth. <13> UI - 92287616 AU - Galan D IN - Faculty of Dentistry, University of Manitoba, Winnipeg. TI - Clinical application of Geristore glass-ionomer restorative in older dentitions. SO - Journal of Esthetic Dentistry 1991 Nov-Dec;3(6):221-6 AB - Geristore is a new multi-use dual-cure glass-ionomer restorative that has been introduced recently. There are many clinical applications for this material, some of which are presented in this article. <14> UI - 92249721 AU - Kaurich M AU - Kawakami K AU - Perez P AU - Munn T AU - Hasse AL AU - Garrett NR IN - Veterans Administration Medical Center, Sepulveda, California. TI - A clinical comparison of a glass ionomer cement and a microfilled composite resin in restoring root caries: two-year results. SO - General Dentistry 1991 Sep-Oct;39(5):346-9 <15> UI - 92253675 AU - Duke ES AU - Robbins JW AU - Snyder DS IN - Department of General Practice, University of Texas, Health Science Center at San Antonio, Dental School 78284. TI - Clinical evaluation of a dentinal adhesive system: three-year results. SO - Quintessence International 1991 Nov;22(11):889-95 AB - The dentinal adhesive Scotchbond 2 was evaluated with the microfilled composite resin Silux in cervical and root caries lesions for up to 3 years. Clinical criteria evaluated included retention, marginal integrity, marginal discoloration, color match, anatomic form, recurrent caries, gingival response, and postoperative sensitivity. Overall, the adhesive demonstrated improved performance over earlier dentinal adhesive systems. Retention was greatest at 3 years when available enamel margins had been etched (93%) and when root caries lesions (97%) had been restored. Other criteria were reported as generally favorable. Early findings suggest that the level of development of sclerotic dentin may influence behavior of the adhesive. The greatest difficulty was noted in lesions presenting with heavy sclerotic dentin. <16> UI - 92260303 AU - Myers TD AU - McDaniel JD TI - The pulsed Nd:YAG dental laser: review of clinical applications. [Review] [21 refs] SO - Journal of the California Dental Association 1991 Nov;19(11):25-30 AB - Since the first demonstration of a laser in 1960, numerous applications of this unique form of energy have been developed for the manufacturing, electronic, consumer and medical industries. Recent technological innovations have permitted development of lasers appropriate for use in the dental operatory. The carbon dioxide laser has been used for soft tissue surgery; the Nd:YAG laser has both soft and hard tissue applications. Advantages of laser treatment over conventional methods include minimal cellular destruction and tissue swelling, hemostasis, increased visualization of surgical sites and reduced post-operative pain. Additionally, it is possible to perform many procedures without needing anesthesia. Soft tissue clinical applications of the Nd:YAG laser include gingivectomies, gingivoplasties, operculectomies, biopsies, incising and draining procedures, frenectomies and treatment of aphthous ulcers; hard tissue clinical applications include vaporizing decay, etching enamel and dentin, desensitizing exposed root structure and creating temporary analgesia. As both clinical experiences and scientific investigations expand, possible future applications of the dental laser may well include development of new dental adhesives and composite systems, new methods for managing caries and new endodontic treatments. With its numerous benefits, the laser is having a positive impact on patients and the dental team. [References: 21] <17> UI - 92256340 AU - Nunn JH AU - Welbury RR AU - Gordon PH AU - Kernahan J AU - Craft AW IN - Department of Child Dental Health, University of Newcastle upon Tyne. TI - Dental caries and dental anomalies in children treated by chemotherapy for malignant disease: a study in the north of England. SO - International Journal of Paediatric Dentistry 1991 Dec;1(3):131-5 AB - Fifty-two children in remission from childhood cancer and 41 siblings underwent a full clinical and radiographic dental examination. All the children had received chemotherapy. The leukaemic patients had received radiotherapy also, but not involving the jaws. There was no significant difference in dental caries experience between the treated children and the siblings, but significantly more dental anomalies were detected radiographically in the treated group. <18> UI - 92199196 AU - Holloway PJ IN - University Dental Hospital of Manchester. TI - International dental public health. SO - Current Opinion in Dentistry 1991 Jun;1(3):348-56 AB - Dental public health workers around the world are considering the service implications of changing patterns of dental health. In industrialized countries, with few exceptions, caries levels are declining among adolescents and young adults, but there are signs that this may not now be the case in the very young. The situation in developing countries is equivocal. In an effort to target resources more efficiently, efforts to detect those at high risk to caries continue. However, there still seems no better predictor than the caries experience of the individual or group. With reducing levels of dental caries, greater interest is being shown in the epidemiology of periodontal disease. Despite the acceptance by Federation Dentaire Internationale of the Community Periodontal Index of Treatment Needs as a suitable measure of community periodontal health, some workers still have reservations of its value. With increasing numbers of elderly people retaining greater numbers of teeth, investigations into patterns of adult caries, particularly root caries, are increasing. Collaboration among health workers on an international basis would enhance knowledge in these disciplines. <19> UI - 92143708 AU - Varrela TM IN - Institute of Dentistry, University of Turku, Finland. TI - Prevalence and distribution of dental caries in a late medieval population in Finland. SO - Archives of Oral Biology 1991;36(8):553-9 AB - The aim was to document the late medieval material and to compare the results with findings in other medieval populations and present-day Finns. The sample consisted of the remains of 410 individuals and included 4581 permanent and 600 deciduous teeth. Age determination was based on the stage of dental development and on the attrition pattern in the molar region. Scoring the presence and location of caries was done visually with the aid of a dental probe. In the younger age groups, caries was most prevalent in the occlusal fissures, but the proportion of cavities at these sites declined with age, possibly because occlusal attrition progressed more rapidly than did caries. In the permanent dentition, carious lesions were most frequently observed at the cementum-enamel junction, particularly on the approximal surfaces. The prevalence of caries was lower than among modern populations of similar ages. In addition, the relative distribution of caries was strikingly different, with root caries being the most common type. <20> UI - 92140739 AU - Thomson WM AU - Brown RH AU - Williams SM IN - Public Health Unit, Manawatu-Wanganui Area Health Board, Palmerston North. TI - Dental status and treatment needs of a New Zealand institutionalised elderly population. SO - New Zealand Dental Journal 1991 Oct;87(390):119-23 AB - A survey of 359 elderly residents of rest homes and geriatric hospitals in the Manawatu and Horowhenua districts showed that approximately two-thirds were aged 80 or over, and 19.5 percent were dentate, with a mean 13.3 teeth per dentate subject. A mean of 4.6 teeth per dentate subject had caries of either the crown or root, or both. Older males had substantially higher extraction requirements than other subjects. The periodontal needs of the sample were generally low and dominated by the need for calculus removal. <21> UI - 92131808 AU - Banoczy J AU - Nemes J IN - Department of Conservative Dentistry, Semmelweis University of Medicine, Budapest, Hungary. TI - Effect of amine fluoride (AmF)/stannous fluoride (SnF2) toothpaste and mouthwashes on dental plaque accumulation, gingivitis and root-surface caries. SO - Proceedings of the Finnish Dental Society 1991;87(4):555-9 AB - The aim of the study was to assess the effect of a toothpaste and mouthwashes containing amine fluoride (AmF) and stannous fluoride (SnF2) on dental plaque, gingivitis and root-surface caries. Forty-four adults participated in a five-month double-blind study. The following combinations of toothpastes and mouthwashes were used: (1) AmF/SnF2 toothpaste and AmF/SnF2 (Meridol) mouthwash (20 patients, mean age 45.7 years), (2) sodium fluoride (NaF) toothpaste and NaF mouthwash (24 patients, mean age 48.8 years). The mean values for dental plaque (Silness-Loe index) were clinically and statistically significantly reduced in both groups, the difference being greater in the AmF/SnF2 group. Sulcus-bleeding index values were clinically and statistically significantly decreased in both groups. There was no marked difference between the groups. The root caries index (RCl, Katz) had decreased by the end of the experiment by 10% in the NaF group and by 47.4% in the AmF/SnF2 group. <22> UI - 92161977 AU - Bergman JD AU - Wright FA AU - Hammond RH IN - School of Dental Science, University of Melbourne. TI - The oral health of the elderly in Melbourne. SO - Australian Dental Journal 1991 Aug;36(4):280-5 AB - A survey of 303 subjects over the age of 60 years collected demographic and oral health status data for analysis. The majority of the sample (64.2 per cent) were edentulous. Over 90 per cent of the dentate subjects required scaling and the removal of plaque (CPITN score of TN2); however, just less than half of the sextants examined were excluded because they contained fewer than two functional teeth. About one-third of the dentate subjects required no treatment for dental caries. Of those who required treatment, most needed only one restoration of any particular type. Total tooth loss was associated with gender, level of education, previous occupation, and birthplace. The need for complex periodontal treatment (TN3) was not high, nor was there a high prevalence of root or cervical dental caries. <23> UI - 92124119 AU - Ekstrand KR AU - Westergaard J AU - Thylstrup A IN - Department of Cariology and Endodontics, Royal Dental College, Copenhagen, Denmark. TI - Organic content in occlusal groove-fossa-system in unerupted 3rd mandibular molars: a light and electron microscopic study. SO - Scandinavian Journal of Dental Research 1991 Aug;99(4):270-80 AB - A method is described by means of which organic content in fissure areas of 12 unerupted 3rd mandibular molars can be prepared for studies in the light microscope (LM) and in the transmission electron microscope (TEM). Thus, LM and TEM examinations revealed that the organic content throughout the fissure in bone-covered and in mucosa-covered 3rd molars with uncompleted root formation consists of cells belonging to the enamel organ in late or in postmaturative stages. In mucosa-covered teeth with completed root formation it was only possible to identify enamel organ cells at the entrance of the fissure. Deeper parts were occupied by degenerative cells, polymorphonuclear cells and unidentified material. The results indicate that ameloblasts in fissures do not transform to stratified squamous epithelium but gradually degenerate towards terminal stages and remain as such, as the tooth emerges into the oral cavity. <24> UI - 92086264 AU - Serman N IN - Division of Diagnostic Sciences, Columbia University School of Dental and Oral Surgery. TI - Restorative needs and pathological findings in northern Manhattan dentate community. SO - New York State Dental Journal 1991 Nov;57(9):67-71 AB - When determining the dental health of the population, radiographic findings cannot be omitted. Nor should large groups of people be left out as this affects the results significantly. <25> UI - 92083571 AU - Fejerskov O AU - Luan WM AU - Nyvad B AU - Budtz-Jorgensen E AU - Holm-Pedersen P IN - Department of Dental Pathology and Operative Dentistry, Royal Dental College, Aarhus, Denmark. TI - Active and inactive root surface caries lesions in a selected group of 60- to 80-year-old Danes. SO - Caries Research 1991;25(5):385-91 AB - In 90, 60- to 80-year-old patients with teeth retained in both jaws (mean 20.4 +/- 4.3), a total of 1,092 root surface lesions were recorded. Of these 156 were diagnosed as active caries lesions, whereas 509 were considered inactive, and 427 were filled. About 60% of the elderly had one or more active lesions and 79% had fillings. Seventy percent had more than 8 filled or carious (active or inactive) surfaces. The percentage of carious and filled root surfaces in relation to surfaces at risk demonstrated that the buccal surfaces of lower molars and premolars and upper canines were the most severely affected (RCI = 70%) with fillings predominating on easily accessible surfaces. A constant relationship between active and inactive lesions was found on all other surfaces but third molars and upper incisors. The data suggest that active and inactive root caries lesions must be diagnosed as separate entities if the dynamic nature of root surface caries is to be explored in epidemiological studies and clinical trials. <26> UI - 92083570 AU - Ravald N AU - Birkhed D IN - Department of Periodontology, Public Dental Service, Linkoping, Sweden. TI - Factors associated with active and inactive root caries in patients with periodontal disease. SO - Caries Research 1991;25(5):377-84 AB - The aim of this study was to analyze a number of microbial, salivary, and dietary factors in patients with clinically active and inactive root caries. 147 patients, aged 30-78 years, referred for specialist treatment of periodontal disease, were randomly selected. 645 decayed and 539 filled root surfaces were found. Out of the carious lesions, 372 (58%) were recorded as clinically active and 273 (42%) as inactive. 30 patients showed no lesions (group 1), 46 had only fillings or inactive lesions (group 2), and 35 showed 1-2 (group 3) and 36 greater than or equal to 3 active lesions (group 4). The lactobacillus count differed significantly between all groups, except group 1 vs. 2, and the mutans streptococcus count between groups 1 vs. 4 and 2 vs. 3 and 4. Group 4 differed in plaque score from the other groups, and the salivary buffer effect differed between the inactive groups 1 and 2 and the active group 4. By stepwise multiple regression analysis, it was shown that lactobacillus count, plaque index, salivary buffer effect, dietary habit index, and number of exposed root surfaces contributed significantly to the coefficient of determination. <27> UI - 92066313 AU - Saunders RH AU - Handelman SL IN - Eastman Dental Center, Rochester. TI - Coronal and root decay in institutionalized older adults. SO - New York State Dental Journal 1991 Oct;57(8):25-8 <28> UI - 92074440 AU - Vardimon AD AU - Graber TM AU - Drescher D AU - Bourauel C IN - University of Bonn, Department of Orthodontics, Germany. TI - Rare earth magnets and impaction. SO - American Journal of Orthodontics & Dentofacial Orthopedics 1991 Dec;100(6):494-512 AB - Aberration in the eruption process was found to be a prime etiologic factor in inducing impaction. Thus an ideal treatment approach should attempt to mimic the normal eruption modus. However, conventional traction methods have been found to be associated with gingiva inflammation, bone recession, reduced attached gingiva, periodontal pockets, exposed cementoenamel junction, and root resorption of the impacted and adjacent teeth. These side effects are the result of premature exposure of the impacted tooth to the oral cavity through a nonself-cleansing pathway and an uncontrolled force system. The present study introduces a new, magnetic attraction system, with a magnetic bracket bonded to an impacted tooth and an intraoral magnet linked to a Hawley type retainer. Vertical and horizontal magnetic brackets were designed, with the magnetic axis magnetized parallel and perpendicular to the base of the bracket, respectively. The vertical type is used for impacted incisors and canines, and the horizontal magnetic bracket is applied for impacted premolars and molars. A three-dimensional analysis of the magnetic force system, by means of the OMSS apparatus, found the small magnetic bracket combined with a large pole surface area of the intraoral magnet to exhibit the most efficient convergent guidance. For this report the magnetic eruption device was examined on one animal subject and four patients. The Nd2Fe14B magnets were coated with parylene and/or encapsulated in stainless steel housings. In deep impaction, the magnetic bracket was cold-sterilized before surgery, and the surgical mucoperiosteal flap was then sutured over the bonded magnetic bracket. Attraction was initiated 1 to 2 weeks after healing. Thus tooth emergence into the oral cavity replicated normal eruption conditioning. The system operated at an attractive force level of 0.2 to 0.5 N. Adjustment was accomplished by temporarily interposing a magnetic spacer between the two magnetic units. No side effects were observed in this restricted number of treated cases, and treatment time was reduced. The study recommends the application of magnets in the treatment of impaction on the grounds of less invasive surgical procedure, effective attractive forces at short distances, and controlled spatial guidance. <29> UI - 92076759 AU - Powell LV AU - Mancl LA AU - Senft GD IN - Department of Restorative Dentistry, University of Washington, Seattle 98195. TI - Exploration of prediction models for caries risk assessment of the geriatric population. SO - Community Dentistry & Oral Epidemiology 1991 Oct;19(5):291-5 AB - The purpose of this study was to demonstrate a method for establishing a model designed to predict the caries risk of elderly individuals. Twenty-three patients over the age of 65 and living in a semi-independent retirement center were examined; several variables were collected and analyzed for their ability to predict the development of new carious lesions. The analysis was performed using logistic regression where the proportion of new decay was used as the dependent variable. The model for prediction of combined coronal and root caries included the variables flow rate, gender, and root caries index. The proposed method has the advantages of easily collected data, individualized criteria, and the ability to order patients as to the relative risk of developing decay. <30> UI - 92076761 AU - Beighton D AU - Hellyer PH AU - Lynch EJ AU - Heath MR IN - Hunterian Dental Research Unit, London Hospital Medical College, England. TI - Salivary levels of mutans streptococci, lactobacilli, yeasts, and root caries prevalence in non-institutionalized elderly dental patients. SO - Community Dentistry & Oral Epidemiology 1991 Oct;19(5):302-7 AB - Root caries prevalence was recorded for a consecutive sample of dental patients (n = 146), aged over 55 yr and with at least 12 natural teeth. The mean root DFS score of the males (n = 49) was 6.34 +/- 4.55 and for the females (n = 97) 3.76 +/- 3.31 (P less than 0.001). The salivary levels of mutans streptococci, lactobacilli, and yeasts were determined in addition to salivary flow rate and buffering capacity. Subjects with greater than 1 root DFS had significantly higher salivary levels of mutans streptococci, lactobacilli, and yeasts. They also had fewer teeth and more exposed root surfaces. In step-wise multivariate analyses the factors significantly related to the root DFS score were the number of exposed root surfaces, number of teeth, sex and salivary yeast levels (R2 = 0.41). In the multivariate analyses salivary levels of mutans streptococci were not significantly related to any clinical measurement of root caries experience due to the greater strength of association between the root DFS score and salivary levels of yeasts. Subjects prescribed medicines with a reported xerostomic effect had significantly fewer active root lesions than those not prescribed such medicines and salivary levels of all microorganisms studied were significantly elevated in subjects prescribed medications containing sucrose. <31> UI - 92041785 AU - Stander I AU - Van Wyk CW IN - Institute for Biostatistics South African Medical Research Council, University of Stellenbosch, Tygerberg. TI - Toothbrushing with the root of Euclea natalensis. SO - Journal de Biologie Buccale 1991 Jun;19(2):167-72 AB - The custom of cleaning teeth and the gums with a chewed root of the tree Euclea natalensis, in the belief that it benefits oral health, is practised in South Africa by married women of an African Zanzibari community. The root of E. natalensis contains naphthoquinones which are bactericidal and, as they are also pigments, the mouths of the root users are stained bright orange. Samples of fresh root were tested against Streptococcus mutans and organisms in saliva and from deep periodontal pockets. Aerobic as well as anaerobic bacterial growth was suppressed in all instances. In addition we compared the plaque index (Silness et Loe), the periodontal index (CPITN), the DMFT and the state of the oral mucosa of root users and non-users. No significant differences were recorded in any of the variables. Although the beneficial effects claimed for this custom may have scientific validity, it is concluded that the daily practice is too limited to have a demonstrable beneficial effect. <32> UI - 92045696 AU - Drake CW AU - Beck JD AU - Graves RC IN - Department of Diagnostic Sciences, University of North Carolina, Chapel Hill 27599-7450. TI - Dental treatment needs in an elderly population. SO - Journal of Public Health Dentistry 1991 Fall;51(4):205-11 AB - A random sample of 1,019 adults 65 years of age and older, living in their own homes, consented to a clinical dental examination and an interview. Eight hundred nine subjects were dentate and 210 were edentulous. Each dentate person was examined for caries and periodontal conditions, as well as a separate determination of restorative and extraction treatment needs. Most people in this study lacked restorative treatment needs of any kind. Blacks required restorative treatment and extractions more often than whites. Carious coronal and root surfaces, pocket depths, number of teeth, as well as educational level and time since last visit to the dentist were related to treatment needs. While clinical findings were related to treatment needs, precise determinations of treatment needs of this elderly population generally could not be based solely on clinical findings. Additional behavioral, social, and health factors appear to play a role in dentists' decisions when determining treatment needs of older persons. <33> UI - 92025173 AU - Geddes DA IN - University of Glasgow Dental Hospital and School, Scotland. TI - Teeth for the future. [Review] [31 refs] SO - Acta Paediatrica Scandinavica - Supplement 1991;373:53-7 AB - The main dietary influences on teeth are, with the exception of ingested fluoride, local rather than systemic. The frequent use of carbohydrates which can be rapidly fermented by dental plaque micro-organisms is the major factor in dental decay. Sweetened and/or highly acidic soft drinks or medicines sweetened with sugars may damage the teeth. Similarly infant's comforters also have their dangers if they provide prolonged exposure of the teeth to cariogenic conditions. Although dental caries is primarily a disease of children many adults still develop new lesions and adults who have lost gingival tissue through periodontal disease may develop root surface caries. Pathological conditions of the oral mucosa can arise from nutritional disorders or inappropriate dietary habits. Health education is most effective when it carries a positive message so encouraging patients to eat the right kind of tasty snacks and to round off meals with sugar-free products or a modicum of cheese should in healthier eating without conflicting with general health guidelines. [References: 31] <34> UI - 91361239 AU - Clark DC AU - Morgan J AU - MacEntee MI IN - Department of Clinical Dental Sciences, The University of British Columbia, Vancouver. TI - Effects of a 1% chlorhexidine gel on the cariogenic bacteria in high-risk elders: a pilot study. SO - Special Care in Dentistry 1991 May-Jun;11(3):101-3 AB - Root caries in dentate elderly patients is a problem which may be controlled with chlorhexidine. The purpose of this pilot study was to establish the extent and duration of the antimicrobial effects from an intensive regimen of a 1% chlorhexidine gel in institutionalized elders who had experienced high caries activity in the previous year. Stimulated saliva samples from all subjects before treatment produced more than 105 colony forming units/milliliters of Streptococcus mutans (mean: 2.0 x 10(7); s.d.: 2.0 x 10(7)) when diluted and cultured on Mitus Salivarius-bacitracin agar for 48 hours. Findings suggest that daily treatments for 1 week with a 1% chlorhexidine gel can reduce the number of cariogenic bacteria in elderly people for approximately 3 weeks after treatment. <35> UI - 91364380 AU - Kalsbeek H AU - Truin GJ AU - Burgersdijk R AU - van 't Hof M IN - Department of Community Dental Health and Epidemiology, TNO Institute for Preventive Health Care, Leiden, The Netherlands. TI - Tooth loss and dental caries in Dutch adults. SO - Community Dentistry & Oral Epidemiology 1991 Aug;19(4):201-4 AB - As part of a nationwide dental survey in 1986 a caries study was executed in 3526 adults, aged 15-74 yr, living in 40 residential areas in The Netherlands. Marked differences were found between the social classes distinguished (more edentates in the lower classes) and between the different regions. It is supposed that these differences reflect the lack of dental manpower in the past. <36> UI - 91364386 AU - Heft MW AU - Gilbert GH IN - Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville 32610. TI - Tooth loss and caries prevalence in older Floridians attending senior activity centers. SO - Community Dentistry & Oral Epidemiology 1991 Aug;19(4):228-32 AB - Older adults attending 14 senior activity centers in six countries of Florida cooperated for a questionnaire and an oral examination. The mean age was 76.5 yr, and about one-third were 80 yr or older. One-third of the dentate persons had dental caries. Most of the carious lesions were on the crown, not the root, and most of the decay was primary, not recurrent. Most of the persons with a need for caries treatment were likely to seek dental care; however, the majority of carious surfaces were in persons who reported being infrequent users of care. These results from ambulatory older adults suggest that older adults have significant caries treatment needs, and provide support for the view that the treatment of older U.S. adults may grow in the coming decades. <37> UI - 91316654 AU - McDermott RE AU - Hoover JN AU - Komiyama K IN - Dental Epidemiology Research Unit, College of Dentistry, University of Saskatchewan, Saskatoon. TI - Root surface caries prevalence and associated factors among adult patients in an acute care hospital. SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1991 Jun;57(6):505-8 AB - There have been many studies reporting on the prevalence of root surface caries in elderly populations, but there is little consistency in these reports concerning the associated risk factors. In the present study, intraoral examinations were carried out on adult patients (age range 22 to 91 years, mean age 57.9) on the acute care wards of a teaching hospital. Of the 103 patients examined, 23.3% exhibited carious lesions on root surfaces, these lesions occurring more frequently in males than in females, and more frequently in the 60 years and older age groups. Forty-five per cent of all root lesions recorded were found on the buccal or facial root surfaces of teeth exhibiting root surface caries. Individuals exhibiting root surface caries had more surfaces with gingival recession and loss of attachment greater than or equal to 3mm, more retained roots, higher DMFT values, and less teeth. However, statistically significant relationships were not obtained between root surface caries and a) coronal caries, b) dental plaque, c) calculus, d) bleeding on probing, and e) probing depth greater than or equal to 4mm. Thirty-three strains of Actinomyces viscosus were isolated from plaque samples taken from root surface lesions compared to 21 strains isolated from intact root surfaces. <38> UI - 91324332 AU - Huizinga ED AU - Arends J IN - Laboratory for Materia Technica, University of Groningen, The Netherlands. TI - The effect of an antimicrobial releasing varnish on root demineralisation in situ. The influence of the demineralisation period. SO - Journal de Biologie Buccale 1991 Mar;19(1):29-33 AB - Caries in exposed root surfaces is becoming a significant problem in dentistry. Varnish applications have interesting preventive possibilities against root caries. The effect of such a varnish, containing two antimicrobials, was studied on the demineralisation of roots with a twofold aim. Firstly, the efficacy of the varnish was investigated in situ as a function of the demineralisation period. Ten participants wore sound intact roots treated with the varnish in an intra oral appliance for 2, 4 and 6 weeks. Secondly, the effect of the varnish on root demineralisation after removal of the varnish was measured. The results showed that the reduction, in demineralization of about 80% after 2 weeks, decreased in magnitude with the length of the in situ demineralisation period. After 4 weeks there was no longer statistically significant difference compared with untreated roots. The acid attack by plaque was, however, substantial in this model; after 6 weeks in situ untreated roots were so strongly demineralised that microradiography was no longer possible anymore. In the second experiment in which the varnish was removed 2 days after application there was a trend toward a reduction of about 30% in root demineralisation after 2 weeks. This was not statistically significant when compared with no application. <39> UI - 91310819 AU - Chiew SY AU - Wilson M AU - Davies EH AU - Kieser JB IN - Department of Periodontology, Institute of Dental Surgery, Eastman Dental Hospital, London, UK. TI - Assessment of ultrasonic debridement of calculus-associated periodontally-involved root surfaces by the limulus amoebocyte lysate assay. An in vitro study. SO - Journal of Clinical Periodontology 1991 Apr;18(4):240-4 AB - This investigation assessed the effectiveness of an in vitro ultrasonic debridement regime on periodontally involved teeth with visually-detectable calculus deposits, using the LAL assay for lipopolysaccharides (LPS) as a marker of bacterial products. 34 single rooted teeth with extensive amounts of calcified accretions were selected, of which 10 served as uninstrumented controls for the estimation of existing LPS levels. The periodontally involved roots of the 24 experimental teeth were debrided with a Cavitron TF-10 tip for a limited time using light pressure and overlapping strokes which ensured complete surface instrumentation without reference to the presence of calculus. Marked reductions in root surface area coverage by calculus were nevertheless achieved as assessed planimetrically from photographic records of the teeth before and after debridement. The root surfaces of each tooth were then stripped away and the harvested material subjected to 'Westphal' extraction and LAL assay for LPS. The resulting LPS yields from the experimental teeth ranged from less than 0.08 to 22.387 ng compared to 1,900 to 29,200 ng from the uninstrumented controls. The extremely small residual LPS yields from the experimental teeth not only confirm the efficacy of ultrasonic debridement but, when coupled with the lack of a relationship with the widely varying amounts of the remaining calculus, support the contention that bacterial plaque rather than calculus has the greater pathogenic potential. These results reinforce the growing impression of the superficial location of bacterial toxic products associated with periodontally involved root surfaces. <40> UI - 91284138 AU - Corpron RE AU - More FG AU - Beltran ED AU - Clark JW AU - Kowalski CJ IN - School of Dentistry, University of Michigan, Ann Arbor. TI - In vivo fluoride uptake of human root lesions using a fluoride-releasing device (short communication). SO - Caries Research 1991;25(2):158-60 <41> UI - 91286432 AU - Axelsson P AU - Lindhe J AU - Nystrom B IN - Department of Preventive Dentistry, Public Dental Health Service, Karlstad, Sweden. TI - On the prevention of caries and periodontal disease. Results of a 15-year longitudinal study in adults. SO - Journal of Clinical Periodontology 1991 Mar;18(3):182-9 AB - In 1971-72, a total of 375 adult subjects were recruited for a clinical trial aimed at assessing the effect of a preventive program, based on plaque control and topical application of fluoride, on the incidence of caries and periodontal disease. After a baseline examination, the volunteers were subjected to scaling, root planning and conventional caries therapy. During the course of the subsequent 6 years, they were recalled for preventive measures once every 2-3 months. After the 6-year follow-up examination, however, it was decided to extend the interval between the preventive sessions. Thus, during the next 9-year period, about 95% of the participants returned for preventive measures only 1 to 2 times per year. A small subgroup of about 15 subjects, who, during the initial 6 years had developed new caries lesions or had exhibited additional periodontal attachment loss, however, were also during the following 9 years recalled 3-6 times per year for oral hygiene control and preventive therapy. The re-examination performed in 1987 disclosed that the 317 subjects, who participated during the entire 15-year period, had a low incidence of caries and almost no further loss of periodontal tissue support. It was suggested that improved self performed oral hygiene, daily use of fluoridated dentifrice and regularly repeated professional tooth cleaning effectively prevented recurrence of dental disease. <42> UI - 91303328 AU - Grbic JT AU - Lamster IB AU - Celenti RS AU - Fine JB IN - Division of Periodontics, Columbia University, School of Dental and Oral Surgery, New York, NY. TI - Risk indicators for future clinical attachment loss in adult periodontitis. Patient variables. SO - Journal of Periodontology 1991 May;62(5):322-9 AB - We studied patient-derived variables to identify individuals at risk for future clinical attachment loss (CAL). Seventy-five patients with chronic adult periodontitis were followed for 6 months and clinical and epidemiological parameters collected at baseline were related to CAL. Clinical parameters were obtained from 6 sites per tooth and whole-mouth averages were calculated. Epidemiologic parameters were obtained by questionnaire and interview. After the baseline examination, patients were treated with root planing and scaling. Thirty-one patients (41.3%) demonstrated greater than or equal to 1 site with CAL of greater than or equal to 2.5 mm, while 16 patients (21.3%) demonstrated CAL at greater than or equal to 2 sites. Epidemiological factors such as gender, health status, marital status, education, and occupation were not associated with CAL. In contrast, baseline mean attachment level, age, baseline mean probing depth, baseline mean recession, percentage of sites exhibiting bleeding on probing, and the number of missing teeth were related to CAL. Using logistic modelling, we found that baseline attachment level was the primary risk indicator for post-treatment CAL. Nineteen percent of the patients with baseline attachment levels less than 4.0 mm, 50% of the patients with 4.0 to 4.9 mm, and 85% (P less than .005) of the patients with greater than or equal to 5.0 mm exhibited CAL. The age of the patient was also a major risk indicator for CAL, and was independent of baseline attachment levels. Eighty-nine percent of the 60 to 69 year old patients demonstrated CAL, compared to only 35% of patients between the ages of 30 and 59 (P less than or equal to .005).(ABSTRACT TRUNCATED AT 250 WORDS) <43> UI - 91295024 AU - Burkes EJ Jr AU - Lyles KW AU - Dolan EA AU - Giammara B AU - Hanker J IN - University of North Carolina School of Dentistry, Chapel Hill. TI - Dental lesions in tumoral calcinosis. SO - Journal of Oral Pathology & Medicine 1991 May;20(5):222-7 AB - Tumoral calcinosis (TC) is a rare inherited autosomal dominant metabolic disease manifested by elevated serum phosphorus and 1,25 dihydroxyvitamin D levels and periarticular cystic and solid tumorous calcifications. The dental findings in a large family have been critical in determining the genetic transmission of the condition. Radiographically the teeth have short bulbous roots, pulp stones and partial obliteration of the pulp cavity. Histologically, coronal dentin and a variable amount of radicular dentin appears to be deposited regularly. At nonspecific points the developing radicular dentin appears to encounter a mass of calcified material and proceed to grow around it. This mass has a unique histologic pattern with ovoid spaces surrounded by amorphous calcification. At levels of further root development the radicular dentin has an irregular bending tubule arrangement. The dental lesion of TC appears to be different from that of radicular dentin dysplasia in histologic structure and in the method of initiation of the dentin defect. These data suggest that the specific dental lesion is a new phenotypic marker for TC. <44> UI - 91258682 AU - Tavares M AU - Depaola P AU - Soparkar P AU - Joshipura K IN - Forsyth Dental Center, Boston, Massachusetts 02115. TI - The prevalence of root caries in a diabetic population. SO - Journal of Dental Research 1991 Jun;70(6):979-83 AB - The objective of this study was to assess the level of root caries in a population of diabetic adults. Diabetics are of special interest because they are alleged to be periodontally compromised and have atypical patterns of refined carbohydrate ingestion. Diabetic subjects were patients of the Joslin Diabetic Center in Boston and had significantly elevated blood glucose and glycosylated hemoglobin levels over at least a ten-year period. Eligible subjects had to be between the ages of 45 and 65 and have a minimum of ten teeth and three sites with recession. Data were collected on coronal caries, oral hygiene, gingivitis, pocket depth, recession, and root caries and were compared with data from control subjects from a larger non-diabetic study group. There were 88 diabetics and 185 controls with mean ages of 55.7 and 56.3 years, respectively. The groups were found to be similar with respect to the numbers of buccal surface sites with gingival recession and the numbers of carious root lesions. There was a distinct difference, however, with respect to restored root surfaces: 1.76 mean filled surfaces were observed in the controls, as compared with 0.49 in the diabetics. A Katz Root Caries Index (for which lesions are calculated as a percentage of the numbers of exposed root surfaces) was determined to be 15.2 for the controls and 7.1 for the diabetics. A reasonable inference is that these differences are the result of a restricted ingestion of refined carbohydrates by the diabetic group. This was confirmed by a dietary survey of subsamples from the diabetic and non-diabetic groups. <45> UI - 91266105 AU - Willemsen WL AU - Truin GJ AU - Kalsbeek H AU - Mulder J IN - Department of Cariology and Endodontology, Faculty of Medicine and Dentistry, University of Nijmegen, The Netherlands. TI - Caries prevalence in Dutch elderly people. SO - Community Dental Health 1991 Mar;8(1):39-44 AB - In 1986 a nationwide oral survey was carried out in the Netherlands. One of the aims of this study was to assess the prevalence of oral diseases in adults. The present paper describes the prevalence of coronal and root caries in elderly Dutch subjects (45-74 years). The oldest age group (65-74 years) had, on average, the least number of teeth remaining; the posterior oral segment contained fewer teeth than the anterior segment. The anterior segment had the higher percentage of teeth with coronal caries and the posterior segment a higher percentage of filled teeth. The reverse was the case for root caries; a higher percentage of teeth had root caries in the posterior segment and the anterior segment a higher percentage of filled teeth. <46> UI - 91266131 AU - Packota GV AU - Hoover JN AU - Bell RC IN - Department of Diagnostic and Surgical Sciences, College of Dentistry, University of Saskatchewan, Saskatoon. TI - Radiographic findings in a group of elderly patients at a Canadian dental school. SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1991 May;57(5):407-9 AB - The panoramic and intraoral radiographs of 154 elderly dental patients aged 65 years and older were assessed at the College of Dentistry, University of Saskatchewan, Saskatoon. Thirty-seven per cent of the patients were completely edentulous, and 61% were partially edentulous. In the dentate group, 87% had evidence of at least one carious tooth, and all had radiographic evidence of alveolar bone loss. The incidence of periapical inflammatory lesions and root remnants was relatively high. <47> UI - 91220942 AU - Valderhaug J IN - Department of Prosthetic Dentistry and Stomatognathic Physiology, Dental Faculty, University of Oslo, Norway. TI - A 15-year clinical evaluation of fixed prosthodontics. SO - Acta Odontologica Scandinavica 1991 Feb;49(1):35-40 AB - The purpose of the present study was to examine failures of fixed prosthodontics during a period of 15 years and to evaluate the quality of those bridges remaining after this period of time. The study group consisted of 102 patients who received 108 bridges made by the senior students at the Dental Faculty. University of Oslo, in 1967/68. All bridges were made of type-3 casting gold and heat-cured acrylic veneering. The mean age of the patients at the beginning of the study was 48 years. Of the original group of 102 patients, 88 attended the clinical examination after 5 years, 71 after 10 years, and 55 after 15 years. Of the 343 abutment teeth 25% were root-filled and restored with post and core. During the 15 years' observation period 26 bridges were lost or had to be remade because of failures. The mean time of service for these bridges were 10.5 years. The failure rate was 4% after 5 years, 12% after 10 years and 32% after 15 years. A modification of the CDA rating system was used for evaluation of the clinical quality of the restorations after 15 years. Between 5% and 14% of the units were recorded as 'not acceptable' for the different characteristics evaluated. <48> UI - 91208900 AU - Hand JS AU - Hunt RJ AU - Kohout FJ IN - Department of Preventive and Community Dentistry, University of Iowa, Iowa City. TI - Five-year incidence of tooth loss in Iowans aged 65 and older. SO - Community Dentistry & Oral Epidemiology 1991 Feb;19(1):48-51 AB - The prevalence of missing teeth has been described for US adults, but little is known about the incidence of tooth loss in any segment of the population. This study investigated the 5-yr incidence of tooth loss in a random sample of Iowans aged 65 yr and older residing in two rural counties. These people had an average of 20 teeth at baseline and approximately 40% lost at least one tooth in the subsequent 5 yr. The incidence of tooth loss was highest for mandibular molars and lowest for mandibular canines. Men were more likely than women to lose teeth. Although we were able to identify a number of statistically significant potential risk factors for tooth loss, the multivariate models that incorporated all these factors were not good predictors of which people were at highest risk for tooth loss. <49> UI - 91123519 AU - Schaeken MJ AU - Keltjens HM AU - Van Der Hoeven JS IN - Institute of Preventive and Community Dentistry, University of Nijmegen, The Netherlands. TI - Effects of fluoride and chlorhexidine on the microflora of dental root surfaces and progression of root-surface caries. SO - Journal of Dental Research 1991 Feb;70(2):150-3 AB - The effects of fluoride and chlorhexidine varnishes on the microflora of dental root surfaces and on the progression of root-surface caries were studied. Forty-four patients, surgically treated for advanced periodontal disease, were distributed at random among three groups. All patients received a standardized preventive treatment. Furthermore, the dentition of the patients in the two experimental groups was treated, at three-month intervals, with chlorhexidine and fluoride varnish, respectively. Patients in the control group received no additional treatment. In the experimental groups, plaque samples were collected from selected sound and carious root surfaces at baseline and at three, six, and nine months after the onset of the study. The presence of root-surface caries was scored at baseline and after one year. In addition, the texture, depth, and color of the root-surface lesions were monitored. Mutans streptococci on root surfaces were suppressed significantly (p less than 0.05) during the whole experimental period in the chlorhexidine varnish group, but not in the fluoride varnish group. A non-significant increase in the number of Actinomyces viscosus/naeslundii was noted after treatment with chlorhexidine and fluoride varnish. The increase in the number of decayed and filled root surfaces after one year was significantly lower in the experimental groups than in the control group. After treatment with chlorhexidine varnish, significantly more initial root-surface lesions had hardened than in the other groups. <50> UI - 92181725 AU - Schwimer CW AU - Rosenberg ES AU - Schwimer DH IN - University of Pittsburgh School of Dental Medicine. TI - Rapid extrusion with fiberotomy. SO - Journal of Esthetic Dentistry 1990 May-Jun;2(3):82-8 AB - Rapid extrusion with fiberotomy as an alternative to traditional crown lengthening modalities is described. Given appropriate anatomic conditions, rapid extrusion with fiberotomy may be utilized as a viable and esthetic crown lengthening procedure. <51> UI - 91329794 AU - Wilkins EM IN - Tufts University School of Dental Medicine, Boston, Massachusetts. TI - Root caries: the problem and the protocol. First of two parts. SO - Dentalhygienistnews 1990 Fall;3(4):2-4 <52> UI - 91279251 AU - Bowden GH AU - Ekstrand J AU - McNaughton B AU - Challacombe SJ IN - Faculty of Dentistry, University of Manitoba, Winnipeg, Canada. TI - Association of selected bacteria with the lesions of root surface caries. SO - Oral Microbiology & Immunology 1990 Dec;5(6):346-51 AB - Plaque from the root surfaces of 165 subjects (mean age 65.5 years, 22-26 teeth/subject) was analysed for specific bacteria. Five subject groups were defined: A (DMFS 16.4), B (DMFS 55.9), C1 (DMFS 55.6), C2 (DMFS 57.0) and C3 (DMFS 48.1). Groups C1 and C2 had unrestored root surface lesions; Group A, B and C3 were free of unrestored root caries and differed in their coronal caries experience. Streptococcus mutans was isolated more frequently from the root lesions in Groups C1 and C2 than from intact root surfaces in Group A. Streptococcus oralis, Streptococcus mitis 1 and Streptococcus sanguis were isolated more frequently from Group A. The percentage contribution that S. mutans made to plaque from lesions in Groups C1 and C2 was higher than that from plaque in Group A and Actinomyces viscosus serovar 2 contributed more to plaque in Group C1 than in samples from Group A. The percentage counts of Lactobacillus in plaque from lesions in Groups C1 and C2 were higher than those from intact roots in Groups A, B, and C3. Subjects were also grouped on the presence of Lactobacillus and S. mutans in plaque samples. Samples with both organisms (n = 17) showed significantly higher isolation frequencies of specific strains of S. mitis 1 and also A. viscosus serovar 2 compared with samples of plaque containing S. mutans or Lactobacillus. Actinomyces naeslundii serovar 1 was not isolated from samples containing both S. mutans and Lactobacillus. The results confirm an association of S. mutans and Lactobacillus with root surface lesions and suggest a relationship between lesions and A. viscosus serovar 2. <53> UI - 91245251 AU - Nair PN AU - Sjogren U AU - Krey G AU - Sundqvist G IN - Dental Institute, University of Zurich, Switzerland. TI - Therapy-resistant foreign body giant cell granuloma at the periapex of a root-filled human tooth. SO - Journal of Endodontics 1990 Dec;16(12):589-95 AB - Although the primary etiological factor of periapical lesions is microbial, there are other independent factors that can adversely affect the outcome of endodontic treatment. In this communication, we present morphological evidence in support of the role of a foreign body reaction of periapical tissue to root-filling materials. The specimen consisted of a surgical biopsy of an asymptomatic periapical lesion which persisted after a decade of postendodontic follow-up. The biopsy was processed for correlated light and electron microscopy and was analyzed by various microtechniques. The unique feature of the lesion was the presence of vast numbers of large multinucleated cells and their cytoplasmic inclusion bodies. Morphologically, these multinucleated cells resembled foreign body giant cells. They contained characteristic birefringent cytoplasmic inclusions which on electron-probe X-ray microanalysis consistently revealed the presence of magnesium and silicon. The magnesium and silicon are presumably the remnants of a root-filling excess which protruded into the periapex and had been resorbed during the follow-up period. These observations strongly suggest that in the absence of microbial factors, root-filling materials which contain irritating substances can evoke a foreign body reaction at the periapex, leading to the development of asymptomatic periapical lesions that may remain refractory to endodontic therapy for long periods of time. <54> UI - 91245250 AU - Nair PN AU - Sjogren U AU - Krey G AU - Kahnberg KE AU - Sundqvist G IN - Dental Institute, University of Zurich, Switzerland. TI - Intraradicular bacteria and fungi in root-filled, asymptomatic human teeth with therapy-resistant periapical lesions: a long-term light and electron microscopic follow-up study. SO - Journal of Endodontics 1990 Dec;16(12):580-8 AB - Light and electron microscopy were used to analyze nine therapy-resistant and asymptomatic human periapical lesions, which were removed as block biopsies during surgical treatment of the affected teeth. The cases that required surgery represented about 10% of all of the cases which received endodontic treatment and root fillings during the period 1977 to 1984. These cases revealed periapical lesions when they were examined 4 to 10 yr after treatment. The biopsies were processed for correlated light and electron microscopy. Six of the nine biopsies revealed the presence of microorganisms in the apical root canal. Four contained one or more species of bacteria and two revealed yeasts. Of the four cases in which bacteria were found, only in one biopsy could they be found by light microscope. In the other three specimens, the bacterial presence could be confirmed only after repeated electron microscopic examination of the apical root canal by serial step-cutting technique. Among the three cases in which no microorganisms could be encountered, one showed histopathological features of a foreign body giant cell granuloma. These findings suggest that in the majority of root-filled human teeth with therapy-resistant periapical lesions, microorganisms may persist and may play a significant role in endodontic treatment failures. In certain instances such lesions may also be sustained by foreign body giant cell type of tissue responses at the periapex of root-filled teeth. <55> UI - 91204334 AU - Butler JE AU - Spradling JE AU - Peterman JH AU - Joshi KS AU - Satam M AU - Challacombe SJ IN - Department of Microbiology, University of Iowa, Iowa City. TI - Humoral immunity in root caries in an elderly population. 1. SO - Oral Microbiology & Immunology 1990 Apr;5(2):98-107 AB - IgA, IgG and IgM antibody activity (ELISA Units/ml) to Streptococcus mutans, Actinomyces viscous and Escherichia coli CF8 in serum, parotid saliva and whole saliva was measured using the amplified ELISA (a-ELISA) while the concentration (microgram/ml) of each isotype of immunoglobulin as well as albumin and lactoferrin, was determined using sandwich ELISAs. Selection of suitable reagents from those commercially available was based on specificity tests using purified human immunoglobulin; most polyclonal reagents required further absorption to attain class specificity. Cross-absorption studies indicated the absence of patient antibodies that were cross-reactive among the bacteria studied, except for IgM in some cases. Expression of response in ELISA Units (E.U.) per microgram of immunoglobulin, i.e. specific activity, revealed that IgG specific activity was significantly higher in parotid saliva than in either whole saliva or serum for all bacteria studied; serum and whole saliva did not differ except for the higher specific activity in whole saliva to E. coli. The value of one E.U. was determined using the Comparative Antibody-immunoglobulin Capture Assay (CACA). Using this novel method, we estimated that about 0.05 percent of serum IgA was specific for Streptococcus mutans, 0.008 for Actinomyces viscosus and 0.004 for Escherichia coli CF8. The percentage of specific IgM antibodies was higher than for IgA and IgG. The concentration of IgA anti-Streptococcus mutans, Actinomyces viscosus and Escherichia coli levels are approximately 92 ng/ml, 25 ng/ml and 16 ng/ml in whole saliva and 46 ng/ml, 9.4 ng/ml and 6.3 ng/ml in parotid saliva.(ABSTRACT TRUNCATED AT 250 WORDS) <56> UI - 91191808 AU - Streckfus CF AU - Strahl RC AU - Welsh S TI - Anti-hypertension medications: an epidemiological factor in the prevalence of root decay among geriatric patients suffering from hypertension. SO - Clinical Preventive Dentistry 1990 Aug-Sep;12(3):26-9 AB - Predictions showing age distribution in our population of elderly citizens in our society within the next 30 to 40 years. One of the most destructive oral afflictions of the elderly is root decay. A study was performed to ascertain the prevalence of root caries among inner city geriatric patients taking anti-hypertension medications. One hundred randomly selected patients were studied. Fifty patients taking the anti-hypertension medications for at least two years were compared to a control group of 50 healthy patients of nearly the same age. With oral hygiene factors being equal, the group taking anti-hypertension medications demonstrated a higher prevalence of root decay at the p less than 0.01 level. <57> UI - 91179771 AU - Butler JE AU - Spradling JE AU - Rowat J AU - Ekstrand J AU - Challacombe SJ IN - Department of Microbiology, University of Iowa Medical School, Iowa City 52242. TI - Humoral immunity in root caries in an elderly population. 2. SO - Oral Microbiology & Immunology 1990 Jun;5(3):113-20 AB - Saliva specimens stored for 18 months at -20 degrees C with or without glycerol and the anti-protease benzamidine-HCl, lost all antibody activity for S. mutans. IgA activity in processed whole saliva decreased significantly after one week when stored either at 4 degrees C or -20 degrees C with or without glycerol, although it was stable in parotid saliva for at least 40 days. Loss of activity prior to processing was significant in the first 24 h, and the addition of 50% glycerol and storage at -70 degrees after processing, prevented loss of antibody activity in both whole and parotid saliva. Diurnal variations in IgA, lactoferrin and the IgA secretion rate were insignificant in parotid saliva but showed some fluctuations in whole saliva. Albumin and lactoferrin levels exhibited the greatest fluctuation in whole saliva specimens although IgA and IgA antibody levels were still more characteristic of the patient than the time of sampling. Monthly variations in IgA, IgA antibody activity and other parameters were least in parotid saliva and e.g., values for parameters that were high in patients samples on the first month, remained high during the 4-month study period. Statistical analyses showed a high correlation between values obtained for most of the 15 parameters that were measured in parotid and whole saliva specimens collected from greater than 20 patients during 2 successive visits. Whole saliva values for albumin, lactoferrin and albumin levels in parotid saliva, were most variable but differences were not significant. Hence, patients with very low or very high values, even in whole saliva, can be identified within the population on the basis of specimens collected at a single time. <58> UI - 91193657 AU - Sjogren U AU - Hagglund B AU - Sundqvist G AU - Wing K IN - University of Umea, Sweden. TI - Factors affecting the long-term results of endodontic treatment. SO - Journal of Endodontics 1990 Oct;16(10):498-504 AB - The influence of various factors that may affect the outcome of root canal therapy was evaluated in 356 patients 8 to 10 yr after the treatment. The results of treatment were directly dependent on the preoperative status of the pulp and periapical tissues. The rate of success for cases with vital or nonvital pulps but having no periapical radiolucency exceeded 96%, whereas only 86% of the cases with pulp necrosis and periapical radiolucency showed apical healing. The possibility of instrumenting the root canal to its full length and the level of root filling significantly affected the outcome of treatment. Of all of the periapical lesions present on previously root-filled teeth, only 62% healed after retreatment. The predictability from clinical and radiographic signs of the treatment-outcome in individual cases with preoperative periapical lesions cases was found to be low. Thus, factors which were not measured or identified may be critical to the outcome of endodontic treatment. <59> UI - 91156968 AU - Fure S AU - Zickert I IN - Department of Cariology, Faculty of Odontology, Gothenburg University, Sweden. TI - Root surface caries and associated factors. SO - Scandinavian Journal of Dental Research 1990 Oct;98(5):391-400 AB - The prevalence of root surfaces caries in 208 randomly selected 55, 65, and 75-yr-old Swedes was related to the frequency of coronal caries, the number of remaining teeth and to bacteriologic, salivary, and dietary variables. At least one decayed or filled root surface was found in 89% of the individuals and all of those had also experienced coronal caries. The frequency of root surface caries was positively correlated to the frequency of coronal decay and negatively correlated to the number of remaining teeth and exposed root surfaces. The study shows that the same factors which are associated with enamel caries seem to be of importance in determining the development of root surface caries. The variation in the frequency of root surface caries was best explained by the salivary levels of mutans streptococci and lactobacilli, the percentage of surfaces harboring plaque and the frequency of carbohydrate intake. Other contributory factors were the saliva secretion rate and the buffer capacity. <60> UI - 91166823 AU - Jensen ME AU - Wefel JS IN - Dows Institute for Dental Research, University of Iowa, Iowa City. TI - Effects of processed cheese on human plaque pH and demineralization and remineralization. SO - American Journal of Dentistry 1990 Oct;3(5):217-23 AB - This two-part study was undertaken to examine the effects of processed cheese on human plaque pH and de- and remineralization of enamel and root lesions in a human in situ caries model system. In the first part of the study the selected processed cheese (Kraft American Singles Processed Cheese Food) was eaten alone and followed by a 10% sucrose rinse after the acidogenicity of the plaque was demonstrated. A 10% sucrose rinse alone resulted in a mean minimum pH of 4.26. The cheese alone showed a mean minimum pF of 6.32 and cheese followed by sucrose resulted in a mean minimum pH of 6.48. The plaque pH of cheese eaten alone stayed at pH above 5.7 (the "safe for teeth" level). Cheese consumption also prevented the acid challenge when followed by sucrose. The second part of the study utilized the thin-sections of artificially created caries-like lesions on enamel and root, and sound root sections. One-month periods were used in a cross-over design to examine the effect of eating the cheese q.i.d. Polarized light microscopy was used to determine changes in the size of lesion areas. The addition of the processed cheese to the diet resulted in statistically significant reductions in enamel lesion size as well as a reduction in progression of root lesions. Lesions created on the sound root surfaces were approximately one-third the size of those created during the control period. This study indicates that processed cheese is hypoacidogenic, anti-acidogenic, and prevents demineralization as well as enhances remineralization. <61> UI - 91064952 AU - Klock B AU - Svanberg M AU - Petersson LG IN - Department of Public Dental Health, Bohusian-County Council, Sweden. TI - Dental caries, mutans streptococci, lactobacilli, and saliva secretion rate in adults. SO - Community Dentistry & Oral Epidemiology 1990 Oct;18(5):249-52 AB - In 718 Swedish patients, equally divided into four age groups (19-25, 26-45, 46-60, greater than 60 yr), salivary levels of mutans streptococci and lactobacilli, saliva secretion rate, and DMFS were registered. No significant differences were found between the various age groups either in salivary factors or in caries (D). Number of missing (M) and filled (F) surfaces increased with age. Prevalence of root caries, which increased with age, was significantly correlated to number of exposed root surfaces independent of age. Of the total study group, 50% had greater than or equal to 10(6) mutans streptococci and 40% had greater than or equal to 10(5) lactobacilli per mL saliva. Three percent had a saliva secretion rate of less than or equal to 0.5 mL/min. Correlation analyses showed that both mutans streptococci and lactobacilli significantly correlated to the caries prevalence but the r-value never exceeded 0.34. <62> UI - 91026400 AU - Hellyer PH AU - Beighton D AU - Heath MR AU - Lynch EJ IN - Hunterian Dental Research Unit, London Hospital Medical College. TI - Root caries in older people attending a general dental practice in East Sussex. SO - British Dental Journal 1990 Oct 6;169(7):201-6 AB - With increasing numbers of older people retaining their natural dentitions, dentists are becoming increasingly aware of the problem of dental caries occurring on exposed root surfaces--root caries. This study reports the prevalence of root caries in a selected older population, living in the community and attending a general dental practice in Bexhill, East Sussex. A total of 146 non-institutionalised people, aged at least 55 years with at least 12 teeth, were examined. Most of the subjects (88.4%) had evidence of root caries, males and denture wearers having more lesions than females and non-denture wearers, respectively. Active coronal caries was present in only 11.6% of the subjects, whereas active (soft or leathery) root caries lesions were present in 31.5% of the subjects. The teeth and surfaces most commonly affected by root caries were found to be similar to those seen in previous epidemiological surveys. The majority of active root caries lesions were within 1 mm of the gingival margin, while inactive lesions tended to be greater than or equal to 1 mm from the gingival margin. Colour of root caries lesions was not diagnostic of caries activity. A more detailed method of recording root caries lesions is also described. <63> UI - 91034217 AU - Konig KG IN - Medical Faculty, University of Nijmegen, The Netherlands. TI - Root lesions. [Review] [13 refs] SO - International Dental Journal 1990 Oct;40(5):283-8 AB - In the elderly, but increasingly also in middle-aged patients, root lesions are a major problem in everyday practice. Formerly, the cause of these root destructions was usually caries attack due to a failure of patients to practise adequate oral hygiene measures. However, with increasing dental motivation and health consciousness, patients--for example in the USA, Scandinavian countries and Switzerland--cause such lesions by vigorous, badly controlled brushing, often in combination with the consumption of 'healthy' vegetarian, erosive diets. The former problem of carious root destruction due to neglect thus seems to be gradually being replaced by the problem that self-care is not yet thoroughly understood, is exaggerated and is technically inadequate. Faulty brushing may result in severe damage to those gingival sites that require attention cariologically as well as periodontologically. To exploit all possibilities of (secondary) preventive management of patients, careful investigation and analysis of the clinical signs is required to identify the aetiology of the lesions in each case. Fortunately, therapeutic management of root lesions, regardless of their aetiology, is facilitated by modern restorative techniques and materials. [References: 13] <64> UI - 90360960 AU - Andersson L AU - Bodin I IN - Department of Oral and Maxillofacial Surgery, Central Hospital, Sweden. TI - Avulsed human teeth replanted within 15 minutes--a long-term clinical follow-up study. SO - Endodontics & Dental Traumatology 1990 Feb;6(1):37-42 AB - Twenty-one avulsed human permanent teeth replanted within 15 min after trauma were followed radiographically for an average of 5 years. Seven teeth did not show any root resorption during the observation period. In 8 teeth shallow resorption cavities were observed, but no signs of progression were observed with increased observation time. In 6 teeth some progressive root resorption was observed with increased observation time. The depth of root resorption cavities was assessed using a radiographic index, and the rate of root resorption was defined as the index change over time. The rate of root resorption was determined. It was concluded that teeth replanted within 15 min after the avulsion have a favourable long-term prognosis. <65> UI - 90360956 AU - Tachibana H AU - Matsumoto K IN - Department of Endodontics, School of Dentistry, Showa University, Tokyo, Japan. TI - Applicability of X-ray computerized tomography in endodontics. SO - Endodontics & Dental Traumatology 1990 Feb;6(1):16-20 AB - This study was carried out to observe the teeth of the maxillary and mandibular bones in computerized tomographic (CT) scans. In addition to using CT images, a 3-dimensional analysis was conducted for further visualization. The anatomical configurations of the teeth were clearly observed in the CT scans, as was the relation of the teeth to the periodontal tissues. Further, using CT scans made it possible to determine buccolingual and mesiodistal widths of teeth, and the presence or absence of root canal filling materials and metal posts. In addition, carious lesions of a certain size and expansions of the maxillary sinus and proximity to the roots were observed. The 3-dimensional image analysis was interesting, but detailed observations could not be made with this technique. <66> UI - 90347109 AU - Van Houte J AU - Jordan HV AU - Laraway R AU - Kent R AU - Soparkar PM AU - DePaola PF IN - Department of Oral Microbiology, Forsyth Dental Center, Boston, Massachusetts 02115. TI - Association of the microbial flora of dental plaque and saliva with human root-surface caries. SO - Journal of Dental Research 1990 Aug;69(8):1463-8 AB - Dental plaque was obtained from one or two sound root surfaces of subjects with different degrees of root-surface caries experience. From subjects with root-surface caries, plaque samples were also obtained from either one incipient or one more advanced lesion. Proportions of the total flora were determined for total streptococci and different streptococcal species, total and different Actinomyces species, and lactobacilli. A sample of saliva was obtained from about one-third of the subjects for determination of the concentrations of mutans streptococci and lactobacilli. The main observations were: (1) Subjects without root-surface caries or restorations (group I), as compared with subjects with root-surface caries with or without restorations (group II), were characterized by having a lower prevalence and proportion of mutans streptococci and a higher prevalence and proportion of A. naeslundii in plaque on sound root surfaces; (2) subjects in group I also tended to have a lower salivary concentration of mutans streptococci and lactobacilli than subjects in group II; (3) dental plaque on sound surfaces in group II subjects contained a lower proportion of mutans streptococci than plaque associated with incipient or advanced lesions; and (4) the prevalence and proportion of lactobacilli in plaque associated with sound as well as carious root surfaces were very low. The data reinforce findings from other studies and indicate that, as for coronal caries, the plaque and saliva populations of mutans streptococci specifically are correlated positively with the presence of root-surface caries. <67> UI - 90352954 AU - Angelillo IF AU - Sagliocco G AU - Hendricks SJ AU - Villari P IN - Institute of Hygiene, Medical School, University of Reggio Calabria, Catanzaro, Italy. TI - Tooth loss and dental caries in institutionalized elderly in Italy. SO - Community Dentistry & Oral Epidemiology 1990 Aug;18(4):216-8 AB - An epidemiological survey of dental health status and needs was conducted in a group of 234 randomly selected institutionalized elderly people in Naples, Italy. The mean age of the patients was 81.4 yr, 71.4% were women and 28.6% men. A total of 140 (59.8%) people were totally edentulous; an additional 13.7% were edentulous in one jaw. A significant increase in prevalence of edentulousness with increasing age was recorded. 44.3% of the edentulous in both jaws wore complete dentures. The mean number of remaining sound teeth, decayed teeth and root remnants in the elderly with maxillary and mandibular natural teeth decreased with increasing age. Of the 94 dentate elderly, 29.8% had no need of dental treatment. Of all dentate patients 68.1% needed one or more dental extractions with a mean need of 3.9 per patient; 37.2% needed restorative treatment for one or more teeth with a mean need per patient of 2.9. Analysis of the results showed poor dental health in this target group and the necessity of improving the dental health services programs for the elderly living in institutions. <68> UI - 90318742 AU - Gutierrez JH AU - Herrera VR AU - Berg EH AU - Villena F AU - Jofre A IN - Division of Endodontics, Faculty of Dentistry, University of Concepcion, Chile. TI - The risk of intentional dissolution of the smear layer after mechanical preparation of root canals. SO - Oral Surgery, Oral Medicine, Oral Pathology 1990 Jul;70(1):96-108 AB - The root canals of 27 caries-free human cuspids were divided into 3 groups of 9 teeth each. Group I was mechanically prepared with reamers and files. Alternate irrigation with 5.25% NaOCl and 3% hydrogen peroxide was used between each instrument. The group II root canals were prepared with the use of alternate irrigation with the same concentrations of NaOCl and hydrogen peroxide and finally flushed with 17% EDTA and NaOCl solution. Group III was prepared mechanically with the use of sterile distilled water as an irrigant followed by a final flush with 17% EDTA solution. The root canals of all specimens were obturated with gutta-percha points and Tubliseal by means of the lateral condensation technique. After the root canals were obturated, samples of each of the three groups were immersed in separate flasks containing Streptococcus mutans, Staphylococcus epidermidis, and Corynebacterium hofmannii. All the microorganisms tested invaded the coronal dentin--where the access cavity had been sealed with Fynal--and/or the main foramen. <69> UI - 90304827 AU - Zuidgeest TG AU - Herkstroter FM AU - Arends J IN - Laboratory for Materia Technica, University of Groningen, The Netherlands. TI - Mineral density and mineral loss after demineralization at various locations in human root dentine. A longitudinal microradiographic study. SO - Caries Research 1990;24(3):159-63 AB - From intact roots of human cuspids 83 dentine specimens were cut. The specimens with known location and thickness were embedded in a holder of polymethyl methacrylate and microradiographic images were made. From the longitudinal microradiography (LMR) measurements the average mineral density (kg/m3) of the sound human dentine specimens was calculated. All specimens were subsequently demineralized using a constant composition method in a solution containing 3 mM CaCl2.2H2O, 3 mM KH2PO4, 50 mM CH3COOH and 0.2 ppm fluoride as NaF at pH = 5 for 24 h. After demineralization the LMR measurements were repeated to calculate the amount of mineral lost. The data show that there is no correlation between: (1) the location of a dentine specimen in the root and the mineral density of sound human dentine, (2) the location of a dentine specimen in the root and the degree of demineralization after 24 h and (3) the mineral density of sound human dentine and the demineralization degree. This information is useful for future in vitro and in vivo studies on human roots. <70> UI - 90304826 AU - Schupbach P AU - Guggenheim B AU - Lutz F IN - Department of Oral Microbiology and General Immunology, University of Zurich, Switzerland. TI - Human root caries: histopathology of advanced lesions. SO - Caries Research 1990;24(3):145-58 AB - The histopathology of human root caries was examined in extracted teeth. The present study details several stages of advanced carious lesions in root dentin. Lesions of different severities were assessed by different optical methods. Four major root caries patterns were defined and significant differences between coronal and root caries elucidated. The patterns were distinguishable by (1) their location at the exposed root surface, (2) their mode of spreading towards the root canal and over the root surface, (3) their mode of bacterial spreading in dentin and (4) the role of dentinal defense mechanisms. In addition, a comparison of clinical and histological classification of lesions revealed that the carious process extended much deeper towards the root canal and had a higher degree of both bacterial infection and dentin demineralization than could be predicted by clinical examination. <71> UI - 90274555 AU - Slomiany BL AU - Murty VL AU - Mandel ID AU - Sengupta S AU - Slomiany A IN - Research Center, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, Newark 07103-2425. TI - Effect of lipids on the lactic acid retardation capacity of tooth enamel and cementum pellicles formed in vitro from saliva of caries-resistant and caries-susceptible human adults. SO - Archives of Oral Biology 1990;35(3):175-80 AB - The lipid content and composition of these pellicles and the effect of lipids on their ability to retard the diffusion of lactic acid were investigated. Lipids accounted for 22.4% of the dry weight of caries-resistant enamel pellicle and 19.2% of caries-resistant cementum pellicle; the pellicle of caries-susceptible enamel contained 24.6% lipids and that of caries-susceptible cementum, 23.4%. Enamel and cementum pellicles from caries-resistant saliva had a significantly lower content of neutral lipids and phospholipids, whereas the glycolipid content was lower, although not significantly, in caries-susceptible pellicles. Pellicles from caries-resistant saliva had a considerably greater capacity to retard lactic acid diffusion than those from caries-susceptible saliva. In all cases, the retardation capacity was clearly dependent upon the lipid constituents, removal of which caused a 50-52% drop in lactic acid impedance by caries-resistant enamel and cementum pellicles, and 32-35% drop by caries-susceptible pellicles. On reacting the delipidated pellicles with their lipids, it was found that, in all cases, the highest quantitative effect on the restoration of the retardation capacity occurred when phospholipids were added. The findings suggest that the events controlling the interaction of salivary phospholipids with enamel and cementum may determine the susceptibility of the tooth surface to demineralization by acids produced by cariogenic micro-organisms. <72> UI - 90275965 AU - MacEntee MI AU - Wyatt CC AU - McBride BC IN - University of British Columbia, Vancouver, Canada. TI - Longitudinal study of caries and cariogenic bacteria in an elderly disabled population. SO - Community Dentistry & Oral Epidemiology 1990 Jun;18(3):149-52 AB - A 2-yr longitudinal study was conducted among elderly disabled residents of a longterm care facility. Each of the 50 subjects examined at the beginning of the study had a mean of 14 teeth, with a mean of 6 carious and 6 restored teeth, per person. Most of the subjects had very poor oral hygiene, and 26 of them had dental plaque that produced cultures of mutans streptococci and lactobacilli in excess of 10(5) CFU/ml. At the end of the first year, 40 subjects were examined again and, apart from a decrease in the mean number of carious root lesions per person, there was very little change in their dental or microbial status. Although only 18 subjects were available at the end of the second year, they presented with fewer carious lesions after 2 yr. The reduction in caries appeared to result from the remineralization of tooth structure, but new lesions did appear in 33% of the 1-yr group, and in 78% of the 2-yr group. This dynamic environment around the teeth produced a mean net incidence of one lesion in the first year, and three lesions over 2 yr. There was a significant (P less than 0.05) association between large (greater than 10(5) CFU/ml) numbers of mutans streptococci and the development of new lesions, but there was no association between the dental status of the subjects and the dental treatment they received. Overall, the results indicate that caries is not rampant in this population. <73> UI - 90254734 AU - Huizinga ED AU - Ruben J AU - Arends J IN - Materia Technica, University of Groningen, The Netherlands. TI - Effect of an antimicrobial-containing varnish on root demineralisation in situ. SO - Caries Research 1990;24(2):130-2 AB - The effect of an antimicrobial-containing varnish on root demineralisation was investigated. The in situ demineralisation effect on the varnish, with or without the active ingredients chlorhexidine and thymol, was measured by means of microradiography in comparison with no application after a 2-week period in vivo. Furthermore, the effect of one or two applications was investigated by the 10 participants who carried sound intact roots in an appliance for four consecutive 2-week periods. In each period, different roots were mounted in the buccal flanges of a lower prosthesis, the experiment being of a randomized cross-over design. The results show that: (1) A single varnish treatment with active ingredients reduced lesion depth and mineral loss by about 77 and 82%, respectively. (2) The control varnish had no effect, and it can be concluded that antimicrobial-releasing varnishes are promising materials for root caries prevention. <74> UI - 90236514 AU - Silness J AU - Berge M IN - Department of Prosthodontics, University of Bergen, Norway. TI - Changes over time in the clientele and restoration pattern in a dental school prosthodontic department. SO - International Dental Journal 1990 Apr;40(2):109-16 AB - The clientele and the production of single artificial crowns and fixed partial dentures in the Department of Prosthodontics were compared from 1964/68-1982/87. In the first period 65 per cent of the single crowns were made for women versus 55 per cent in the second. In the first period 69 per cent of the crowns were placed in the upper jaw as against 60 per cent in the second period. On average 1.6 crowns were made per female patient in the first period versus 1.4 per male patient. In the second period both sexes averaged 1.8 units. In both jaws the percentage of root-filled crowned teeth had increased in the second period to 60 per cent from 48 per cent in the upper jaw and 46 per cent in the lower jaw. In both sexes maxillary and mandibular teeth were crowned on average 13 years later in the second period than in the first. Sixty per cent of the fixed partial dentures were made for women in the first period versus 55 per cent in the second. In the first period 74 per cent of the bridges were made for the upper jaw as against 70 per cent in the second period. The mean pontic to abutment ratio was 0.7 in both periods. The maximum number of bridges in the first period were made for patients 40-59 years of age versus 50-69 years in the second period.(ABSTRACT TRUNCATED AT 250 WORDS) <75> UI - 90241704 AU - Hutchison IL AU - Hopper C AU - Coonar HS IN - Department of Oral and Maxillofacial Surgery, St Bartholomew's Hospital, West Smithfield, London. TI - Neoplasia masquerading as periapical infection [see comments]. [Review] [32 refs] CM - Comment in: Br Dent J 1990 Jun 9;168(11):429 SO - British Dental Journal 1990 Apr 7;168(7):288-94 AB - Seven examples of neoplasia which presented as periapical radiolucencies are described. These were all initially treated for presumed periapical infection. The atypical features that should alert dentists to the possibility of a tumour presenting in this manner are: a vital tooth with minimal caries, root resorption and an irregular radiolucent outline, tooth mobility in the absence of generalised periodontal disease, regional nerve anaesthesia, and failure to respond to good endodontic therapy. All material removed at the time of apical surgery must be examined histologically to prevent neoplasia being overlooked. [References: 32] <76> UI - 90256235 AU - Nyvad B AU - Kilian M IN - Department of Oral Anatomy, Royal Dental College, Arhus, Denmark. TI - Microflora associated with experimental root surface caries in humans. SO - Infection & Immunity 1990 Jun;58(6):1628-33 AB - This study describes the microflora from actively progressing root surface caries lesions, in which mineral loss had been determined by quantitative microradiography. The caries lesions were produced experimentally in root surface specimens from human molars inserted in lower partial dentures carried for 3 months by six elderly individuals. A total of 780 bacterial isolates were identified from 13 plaque samples, collected with a punch technique, and six dentin samples. The composition of the microflora showed distinct individual differences. The microflora from plaque samples associated with the highest mineral loss was dominated by either Actinomyces viscosus or a combination of mutans streptococci (serotypes c, d, and f) and Lactobacillus species (L. casei and L. brevis). Plaque from root surfaces with less pronounced mineral loss harbored a more complex microflora comprising gram-positive rods, mutans streptococci, Streptococcus mitis biovar 1, Veillonella spp., gram-negative rods, and low numbers of lactobacilli. In the latter samples, individual variations in the proportions of mutans streptococci (serotypes c, d, and g), Actinomyces species (A. viscosus and A. naeslundii), and Veillonella parvula biotypes were observed. These findings suggest that certain species or combinations of species are more cariogenic than others and that dominance of single acidogenic species in particular is conducive to high caries activity. <77> UI - 90242625 AU - Fure S AU - Zickert I IN - Department of Cariology, Faculty of Odontology, University of Gothenburg, Sweden. TI - Prevalence of root surface caries in 55, 65, and 75-year-old Swedish individuals. SO - Community Dentistry & Oral Epidemiology 1990 Apr;18(2):100-5 AB - The prevalence and intraoral distribution of decayed and filled root surfaces were evaluated in 55, 65, and 75-yr-old inhabitants of Gothenburg. From randomly selected groups, 88, 72, and 48 dentate persons in the respective age groups participated and as many as 85, 93, and 90% respectively had one or more decayed or filled root surfaces. In the two oldest age groups 32-35% were free from root carious lesions, while 20% had five or more decayed root surfaces. The corresponding figures for the youngest group were 63% and 8%. The prevalence of root surface caries was evaluated using the Root Caries Index (RCI), excluding prosthetic crowns. The mean RCI value increased with age (P less than 0.05, ANOVA on age groups) from 14% to 16% and 22% in the 55, 65, and 75-yr-olds, respectively. The root surfaces of the molars were most frequently affected by caries and fillings, the incisors least frequently. In the maxilla the proximal surfaces were most affected, in the mandible this applied to the buccal surfaces, while the lingual surfaces had the lowest proportion of carious lesions and fillings in both jaws. <78> UI - 90243945 AU - Nyvad B AU - Fejerskov O IN - Department of Oral Anatomy, Royal Dental College, Arhus, Denmark. TI - An ultrastructural study of bacterial invasion and tissue breakdown in human experimental root-surface caries. SO - Journal of Dental Research 1990 May;69(5):1118-25 AB - This study describes the structural features of the interface between microbial deposits and root cementum in actively progressing root-surface caries lesions developed experimentally in six elderly individuals. A total of 18 specimens was examined by microradiography, and a further 18 by light and transmission electron microscopy after intra-oral periods of one, two, and three months. All specimens showed various degrees of subsurface dissolution of mineral and bacterial invasion of the cementum. Although the microradiographic pattern of mineral loss was subsurface in nature, transmission electron microscopy showed dissolution of crystals in the outermost layers of the cementum, with a distinct gradient inward. Bacterial invasion occurred along the borders between bundles of relatively well-mineralized extrinsic collagen fibers in which the characteristic cross-banding remained intact. The pattern of bacterial invasion was influenced by the incremental lines and the cemento-dentinal junction. The invading bacteria were almost exclusively Gram-positive, of various shapes, and possessed thick, moderately electron-dense cell walls and electron-lucent "vacuoles" in the cytoplasm. It is concluded that because of pronounced mineral loss of the outermost cementum, accompanied by bacterial invasion, the surface of an active cementum caries lesion, as observed by transmission electron microscopy, is not identical to that seen in microradiograms. <79> UI - 90217224 AU - Kerr NW IN - Department of Dental Surgery, Aberdeen Royal Infirmary, Scotland. TI - The prevalence and pattern of distribution of root caries in a Scottish medieval population. SO - Journal of Dental Research 1990 Mar;69(3):857-60 AB - The prevalence and pattern of distribution of root caries were determined in a Scottish Medieval population. The principal finding was a lower root caries prevalence, compared with that of modern times, with respect to surfaces at risk; this was particularly marked with respect to buccal root caries. A lower intake of refined sugars and the presence of heavy deposits of supragingival calculus are suggested as factors that may be responsible for the observed differences. The common site for the early root caries lesion was just apical to the enamel-cementum junction. Initially, it extended laterally in the form of an elliptical erosion; however, the greater the depth of the lesion, the more circular the outline became. <80> UI - 90222928 AU - Ericson G AU - Nilson H AU - Bergman B IN - Department of Prosthetic Dentistry, Faculty of Odontology, University of Umea, Sweden. TI - Cross-sectional study of patients fitted with fixed partial dentures with special reference to the caries situation. SO - Scandinavian Journal of Dental Research 1990 Feb;98(1):8-16 AB - The caries situation among 30 patients with fixed partial dentures was examined 3 yr after cementation of the constructions. The fit of the crowns on the abutment teeth, the size of the interproximal areas and the relation between the crown margin and the gingival margin were registered. Risk factors for caries development, such as salivary factors, microbiologic factors, oral hygiene and diet were evaluated for each patient. During the 3-yr period 54 caries lesions occurred in 25 patients. Eleven lesions were found on abutment teeth. Two were located on the root surfaces unconnected with the crown margin (greater than 2mm from the gingival margin), three were recurrent lesions, where the crown margin was located above the gingival margin but closer than 2 mm and six were recurrent lesions where the crown margin was located under the gingival margin. No single caries risk factor seemed to be so closely correlated to the number of caries lesions developed that it could be used alone to select of patients at risk. When the sum of the assumed negative factors was used, more caries was found among the patients with three or more factors with negative values in the group as a whole. However, predicting the development of caries in an individual case with a high degree of probability seems to be complicated. Generally speaking there was no indication that caries disease development was caused by the presence of the fixed partial denture per se. <81> UI - 90131451 AU - Stamm JW AU - Banting DW AU - Imrey PB IN - University of North Carolina, School of Denistry, Chapel Hill 27599-7455. TI - Adult root caries survey of two similar communities with contrasting natural water fluoride levels. SO - Journal of the American Dental Association 1990 Feb;120(2):143-9 AB - For a comparative study of root caries, 502 adult lifelong residents of a naturally fluoridated community (1.6 ppm F) and 465 such residents of a nearby, comparable nonfluoridated community (0.2 ppm F) were examined. Substantially fewer carious lesions were found among adults in the fluoridated community relative to the nonfluoridated community. This was observed in virtually all age- and gender-specific groups. Given a cross-sectional design and considering only exposed root surfaces, root caries was related to age. In addition, the data from this study show that the number of root caries lesions is underestimated but that root caries prevalence is overestimated by the standard Root Caries Index (RCI). A less restrictive form of the RCI may lead to more valid estimation of root caries prevalence. <82> UI - 91209872 AU - Mersel A IN - Faculty of Dental Medicine, and Municipality of Jerusalem, Israel. TI - Oral health status and dental needs in a geriatric institutionalized population in Paris. SO - Gerodontology 1989 Summer;8(2):47-51 AB - One hundred and forty-two residents of a geriatric hospital in France were given an oral exam and interviewed by questionnaire regarding their backgrounds, physical health and oral hygiene habits. The residents suffered from many systemic diseases and drug intake was relatively high. Over fifty percent reported mouth dryness, especially at waking. Twenty-three percent stated that they never brushed their teeth and the demand for dental services was low. Edentulousness was similar to those rates reported in Israel and the U.S. The majority of prostheses were rated by examiners as unacceptable and there were significant amounts of root and cervical caries in spite of the relatively high level of oral health care provided by the staff. <83> UI - 90330311 AU - DePaola PF AU - Soparkar PM AU - Tavares M AU - Kent RL Jr TI - Clinical profiles of individuals with and without root surface caries. SO - Gerodontology 1989 Spring;8(1):9-15 AB - As part of a collaborative multidisciplinary investigation of root surface caries (RSC), 273 subjects (median age = 57) were clinically evaluated for coronal caries, debris, calculus, gingivitis, periodontal pocketing, recession, abrasion, as well as RSC. The entire study group was divided into three subgroups: (1) subjects whose exposed root surface were without lesions or restorations (non-diseased individuals, n = 43); (2) subjects whose exposed root surfaces had one or more lesions and may or may not have had restorations (diseased individuals, n = 110); (3) subjects with one or more restorations but no lesions, since it was not known whether these restorations were preceded by RSC or abrasion the disease status of these individuals was unclear (n = 120). A comparison of Subgroup 1 (unequivocally non-diseased) and Subgroup 2 (unequivocally diseased) revealed that subjects without RSC had more teeth, less coronal caries, less recession, less debris, less calculus, less gingivitis, and more abrasion. We infer that the common factor underlying most if not all of the subgroup differences is oral hygiene which must therefore be a major disease determinant. <84> UI - 90330310 AU - DePaola PF AU - Soparkar PM AU - Kent RL Jr TI - Methodological issues relative to the quantification of root surface caries. SO - Gerodontology 1989 Spring;8(1):3-8 AB - The purpose of this study was to assess the effect upon the quantification of root surface caries (RSC) of (1) the separation of the disease into its discrete clinical phases, (2) the confounding caused by the presence of restored abraded surfaces, and (3) the decision rule formulated for dealing with lesions and restorations which involve both crown and root. It was found that the apparent prevalence of RSC varied widely depending upon arbitrary decisions as to what stages of the disease were included in the measurement scheme. The addition of restorations (confined to the root) greatly enlarged the various disease measures, but probably also introduced some degree of error since there are several indications from the data and the clinical patterns of affected surfaces which suggest that some of the restored surfaces were formerly abraded rather than carious. The inclusion of lesions and restorations involving both root and crown produced another conspicuous increment in all disease measures, which is a cause for concern given that these components are included in some studies and ignored in others. These findings serve as the basis for several recommendations for future prevalence and incidence studies of RSC. <85