Faculty Bibliography

This clinical report describes the fabrication of a mandibular denture for an elderly woman who presented with bilateral Stafne's bone cavities. A review of this anatomical entity is presented together with the prosthodontic management of the patient

STATEMENT OF PROBLEM: There is limited scientific information on the relationship between tooth shade and skin color. This lack of knowledge may impact the ability of the prosthodontist to select artificial teeth that complement the facial complexion of the patient. PURPOSE: This observational study explored the possibility of a relationship between tooth shade and skin color. MATERIALS AND METHODS:A total of 119 individuals aged 18 to 80 years participated in this observational study. Two investigators calibrated for examining tooth shade performed all examinations. A Vita-Lumin shade guide was used to examine either the maxillary right or left central incisor, one of which had to be restoration- and caries-free for study inclusion. Tooth shades were divided into 4 categories according to value, and skin tones were divided into 4 categories (fair, fair/medium, medium, and dark) with the use of L'Oreal True Illusion compact makeup shades as a guide. Categorical modeling with chi-square analysis and Fisher's exact tests was used to analyze the data (alpha=.05). RESULTS: No interaction among age, skin color, and tooth shade or gender, skin color, and tooth shade was found; however, age was associated with tooth shade (P<.001). Older persons were more likely to have teeth with lower values (darker). Among those aged 60 and older, 85% had teeth in the medium and low range values compared with 17% of those younger than 31. Significant tooth shade differences were discovered among patients with different skin colors (P<.05). Among those with low values (darker teeth), 50% were of fair complexion and 17% were of dark complexion (P<.001). CONCLUSION: Within the limitations of this study, tooth shade value and skin color were inversely related. Older adults were more likely to have darker teeth (lower value)

Clinical treatments that require restoration of occlusal vertical dimension pose a challenge to prosthodontists. This article describes the modification of existing removable partial dentures into onlay interim prostheses. This process allowed the patient's tolerance to the restored occlusal vertical dimension, esthetics, and phonetics to be evaluated before irreversible changes were made to the dentition

PURPOSE: This article reviews the current understanding of the biology of tooth extraction wound healing and residual ridge remodeling. METHODS: The review of the biology of tooth extraction wound healing involves a discussion of the different cells populating the tooth extraction wound, the matrix formation, and the control of the repair process in the short-term. Defects in socket matrix formation or cellular activity will lead to stalled healing. The review of residual ridge remodeling describes the long-term result of tooth extraction and formation of residual ridges, in which the quantity of bone tissue continuously decreases. This may suggest that any potential regulatory factors of residual ridge resorption should have an adverse effect either on the increased catabolic activity by osteoclasts or on the decreased anabolic activity by osteoblasts. Both short-term tooth extraction healing and long-term residual ridge remodeling processes are interdependent. Furthermore, any potential genetic and environmental regulatory factors can affect the quality and quantity of bone by altering the gene expression events taking place in bone cells. RESULTS: The intent of this article was to review the current progresses of biologic research on residual ridge remodeling and to relate the changes at molecular, cellular, and tissue levels. The understanding of residual ridge remodeling may provide a sound scientific basis for improved restorative and therapeutic treatments of the edentulous population

STATEMENT OF PROBLEM: Osteoporosis and edentulism are two disease processes that affect a large group of elderly people in the United States (24 and 25 million, respectively). These two diseases are independent of each other; however, they have several pathologic symptoms in common, such as reduction in bone mass. PURPOSE: The purpose of this study was to determine whether estrogen deficiency or its replacement therapy have any effect on the phenomenon of residual ridge remodeling. MATERIAL AND METHODS: Three animal groups were formed that consisted of six female Sprague-Dawley rats each. The two groups had ovariectomy and received either a vehicle solution or a daily dose (1.5 micrograms/day) of 17 beta-estradiol delivered through osmotic pumps. The control group underwent sham surgery and received a vehicle solution. Animals were pair fed throughout the experiment. Unilateral molar extraction was performed in the maxilla, which produced a suitable site for examination of histologic characteristics and molecular biologic analyses. At the 4-week postextraction period the bone remodeling activity was noted at the surface of the residual ridge in the control group. RESULTS: The ovariectomized group showed increased bone resorption activity, whereas the surface of the residual ridge alveolar bone of the ovariectomized and estrogen-treated group was covered by a layer of hyaline tissue. Poly(A)+ ribonucleic acid samples were isolated from the remodeling residual ridge tissues. Expression of alpha 2(I), alpha 1(II), alpha 1(IX), and alpha 2(X) collagens were examined by ribonucleic acid transfer dot blots. Compared with the control group, ovariectomized animals showed a reduction in bone formation with decreased expressions of type I and II collagens. In contrast, the estrogen-treatment group showed decreased formation of type I collagen with a much increased expression of type II collagen. Further examination of type II collagen formation on the ovariectomized and estrogen-treated group by means of in situ hybridization revealed the notable labeling by the type IIA collagen probe, which was associated with the surface tissue of the residual ridge alveolar bone. CONCLUSION: These findings suggest that estrogen deficiency and its replacement therapy seem to affect the activity of residual ridge bone remodeling at the molecular level