Morphological and clinical picture of the morphea in the oral cavity

Thera are several types of morphea with different levels of connective tissue involvement and morphological manifestations. In this mini review, it was pointed out the most important morphological and clinical aspects of localized scleroderma in the oral cavity. The own case supports the scientific information and is described with details. The morphea of mucous membrane which was clinically suspected, was proved by histopathological examination of the sample. The unusual location of the local findings posed a diagnostic challenge. The case history should be significant due to the low number of studies. The special attention should be taken to match the clinical with pathomorphological picture in localized scleroderma diagnosis and treatment when the involvement of skin and oral mucosa is.

An odontometric study of tooth dimension in diastematic dentition

BACKGROUND

One of the causes of the maxillary midline diastema (MMD) may be discrepancy between teeth and maxilla dimension. That can relate to two situations: when teeth have correct size but maxilla is too large or maxilla bone is in the proper size but teeth have reduced dimensions (microdontia). The present study has been conducted to investigate the differences in the linear dimensions of upper central and lateral incisors and canines in diastematic dentition and to compare them with the control group without diastema.

MATERIALS AND METHODS

The study was conducted on Caucasian individuals (n = 102) divided into two groups: study group with MMD (n = 50) and control group without MMD (n = 52). The following measurements were done by digital calliper on their plaster models: 1. Width in the widest mesiodistal portion for upper right and left central incisors, lateral incisors and canines. 2. Length in the longest apico-coronal portion for the same teeth.

RESULTS

Statistical analysis showed that comparisons of widths of left canines were significant. In the study group widths of left canines were lower than in the control group. Statistically significant differences in the length were observed for central incisors and canines in both sides. All measurements were lower in the diastema group of patients.

CONCLUSIONS

Patients with diastema were characterised by incorrect tooth dimensions. The central incisors and upper canines were shorter in this group. Aesthetic closing of the diastema requires not only widening the crowns of the front teeth but also their elongation.

Observations of mineralised tissues of teeth in X-ray micro-computed tomography

BACKGROUND

The one of the most recent imaging technology is X-ray microtomography which allows non-invasive three-dimensional visualisation of structures. It also offers the opportunity to conduct a comprehensive quantitative analysis of the tested objects such as measuring the shares of the various phases, determining the material density and distribution of the size of pores and particles. The aim of the paper was to present an overview on the applicability and relevance of X-ray microtomography in the study of mineralised tissues of the teeth.

MATERIALS AND METHODS

The article is based on the most recent and significant literature and own observations.

RESULTS

The use of X-ray microtomography in dentistry has recently increased and includes, inter alia, the assessment of the density of minerals in enamel and dentin, the detection of demineralisation in an artificially and a naturally induced caries, the automatic measurement of the depth of cavities in dentin, the measurement of the amount of removed dentin in preparation of carious lesions by various methods, the assessment of microleakage around fillings and fissure sealants, cortical bone density measurement, evaluation of root canal morphology, comparison of the accuracy of root canal working and filling by various methods.

CONCLUSIONS

X-ray microtomography offers within the analysis of mineralised tissues - complex structures of bone, teeth and biomedical materials, turn out to be indispensable since it opens new opportunities for cognitive and implementation research.

Endodontium - together or separately?

Endodontium, otherwise referred to as pulp-dentin complex or endodont. This term includes two tooth tissues: dentin and pulp, which constitute a structural and functional unity. These tissues have a huge, inseparable influence on each other - the pulp (inter alia) nourishes the dentine, while the dentin forms a protective barrier for the pulp. They develop from the papillary tissue (Latin: papilladentis) from mesenchymal tissue. Nevertheless, in clinical practice this structural-functional complex is often treated as two separate tissues, and not as a whole. Adequate knowledge of the structure, function and protective mechanisms of the endodontium produces successful results in the treatment. The appropriate choice and application of the therapeutic methods and materials to the dentin secures vitality of both tissues of this complex.

Width of dental arches in patients with maxillary midline diastema

BACKGROUND

The aims of the study were as follows: (1) to examine the width of the dental arches of patients with maxillary midline diastema and compare it with control group; (2) to investigate the impact of the width of upper dental arch on the width of diastema.

MATERIALS AND METHODS

Diagnostic orthodontic plaster models of 102 patients with permanent dentition were studied. Patients were divided into two groups: study group with diastema and control group without diastema. Patients with severe malocclusion, craniofacial diseases, hypodontia and microdontia and pa-tients with periodontal disease were excluded. The transpalatal width of palate, premolar and molar arch widths in Pont's points of upper and lower jaw were measured using digital calliper. The results were statistically analysed.

RESULTS

Analysis showed a significant correlation between presence of diastema and premolar and molar width of the dental arches for both upper and lower jaw. Studied widths were larger in patients with diastema compared to the group without diastema. Analysis of the transpalatal width showed statistically significant differences between the study group and the control group. Analysis of widths of diastema and transpalatal widths showed that there was not statistically sig-nificant correlation.

CONCLUSIONS

Patients with diastema had increased in size in both the premolar and molar width of the dental arches. Increase the width affect to both upper and lower dental arch. Patients with diastema also were characterised by often occurrence of normal or increased of the transpalatal width but the width of the diastema did not correlate with the width of the palate. (Folia Morphol 2018; 77, 2: 340-344).

Diastema size and type of upper lip midline frenulum attachment

BACKGROUND

Diastema is a space between teeth. The most often is maxillary midline diastema between upper central incisors. One of the main causes of diastema is enlarged upper lip frenulum attachment. The aim of the study was to assess frenulum attachment in patients with diastema and investigate if type of upper lip frenulum attachment has an impact on the width of diastema.

MATERIALS AND METHODS

Upper lip frenulum attachment was assessed clinically in two groups of adult patients: study group with diastema and control group without diastema. Moreover the width of diastema was measured on plaster models of dentition. The results were statistically analysed.

RESULTS

In study material the most often was diastema in range more than 2 mm. There were statistically significant differences between study and control group in upper lip frenulum attachment (p < 0.05). Normal frenulum attachment (mucosal or gingival) was typical for group without diastema, but enlarged frenulum (papillary or papilla penetrating) was characteristic for diastema group. Type of frenulum had significant (p < 0.05) impact to the width of diastema. Small diastema (≤ 2 mm) more often coexisted with normal frenulum. Oversized frenulum was observed in the big diastema (> 2 mm).

CONCLUSIONS

Patients with diastema have more often oversized upper lip frenulum attachment then patients without diastema. The most often type of frenulum in patients with diastema is papillary and papilla penetrating type. Type of upper lip frenulum attachment has an impact to the size of diastema.

The impact of type 1 diabetes on the development of the craniofacial mineralised tissues (bones and teeth): literature review

BACKGROUND

There are many reports on the impact of diabetes on periodontium as well as the state of organs in diabetics; however, there is little research on the impact of the disease on morphological and anatomical changes in the mineralised tissues like teeth and craniofacial bones. The aim of this study was to present a review of literature on morphological and anatomical changes of mineralised tissues in the course of type 1 diabetes.

MATERIALS AND METHODS

A review of PubMed database was made using the keywords: morphological changes, anatomical changes, enamel hypoplasia, type 1 diabetes, induced diabetes and the names of individual anatomical and morphological structures of the teeth.

RESULTS

The analysis of experimental studies have shown that in induced type 1 diabetes in rats there is a substantial reduction in the thickness of the enamel and dentin, compared with the control group. The changes in the content of indivi-dual minerals in the tissues of the tooth have been shown - a decrease in the concentration of calcium and fluoride ions and an increase in the concentration of magnesium. In a study conducted on embryos of rats born of diabetic dams, defects were observed in enamel organ, which can cause delayed enamel hypo-plasia. Literature analysis revealed morphological disorders also in some clinical cases of patients with type 1 diabetes.

CONCLUSIONS

Type 1 diabetes mellitus as a metabolic disorder may affect changes in the structure of mineralised tissues, thereby increasing their susceptibility to caries development and orthognathic disorders.

The size of anterior teeth in patients with gaps in the upper dental arch

BACKGROUND

The aim of this study was to assess the size of upper incisors and canines in patients with gaps in the upper dental arch, especially medium gap between upper central incisors.

MATERIALS AND METHODS

Diagnostic orthodontic models of 30 adult patients with full permanent dentition with diastema in the upper arch were studied. Patients with severe malocclusion, missing teeth and periodontal disease were excluded. Width-to-length (W/L) ratio of the clinical crown of the central, lateral incisors and canines for both sides was measured. Together 180 teeth were tested. The results were compared with the values indicated by Sterrett et al.

RESULTS

In all patients, the clinical crowns of central incisors were symmetrical. In most cases, a higher W/L ratio was found, which indicates that the clinical crowns of medial incisors were too broad in relation to the length. Lateral incisors: In most cases, the ratio was the same for the right and the left side; however, a few patients had asymmetry of lateral incisors. Most of the lateral incisors had higher W/L ratios, which means that the teeth were wider than they were long; some had reduced ratios and only in one case the ratio was proper. Canines were also asymmetrical, and none of the canine exhibited perfect proportions. The vast majority showed increased W/L ratio of the clinical crown. In several cases, the W/L ratio was decreased.

CONCLUSIONS

Patients with gaps between the teeth have abnormal W/L ratio of the clinical crowns of the upper front teeth. The values were increased in the majority of cases, which indicates that the front teeth were wider than they were long in patients with gaps. Moreover, despite the disturbed W/L proportions, central incisors remained symmetrical. In contrast, lateral incisors and canines more often exhibited asymmetries.