Juhani Wolf

Oral status and prosthetic factors related to residual ridge resorption in elderly subjects

Our earlier studies on edentulous elderly subjects have shown associations of severe resorption in the mandibular residual ridge with female gender and systemic diseases. The aim of this study was to examine whether other factors also were related to residual ridge resorption (RRR). Among 177 edentulous elderly subjects effects on RRR were investigated with regard to history of edentulousness and denture-wearing, the condition of the dentures and soft tissues, dental status of the opposing jaw, and oral hygiene habits. No significant association was found between degree of resorption and duration of edentulousness in either the mandible or the maxilla. RRR was related to denture quality (P < 0.05); however, severe resorption was not. In the maxilla previous use of removable partial dentures was a factor contributing to the resorption (odds ratio (OR), 2.4); flabby ridge was related to the severity of the resorption (OR, 2.4). This study showed local factors related to RRR more often in the maxilla than in the mandible, thus suggesting that severe resorption in the mandible is influenced more by systemic factors than by those investigated in this study.

Resorption of mandibular canal wall in the edentulous aged population

STATEMENT OF PROBLEM The mandibular canal wall may be affected by the progress of residual ridge resorption after tooth extraction. Little knowledge is available regarding the relationship of specific systemic factors and the resorption of the mandibular canal wall. PURPOSE The purpose of this study was to assess the status of the mandibular canal in the edentulous mandible and to determine whether there is any relationship between the resorption of the mandibular canal wall and selected health indices in the elderly. MATERIAL AND METHODS The status of the mandibular canal was assessed from panoramic radiographs of 128 edentulous elderly subjects (32 men and 96 women). RESULTS The superior border of the mandibular canal was more frequently resorbed in women (32.6%) than in men (9.8%). Resorption in the mandibular canal wall was significantly more prevalent in subjects with asthma (odds ratio: 6.0), with thyroid disease (odds ratio: 3.04), and with a cortical thickness at the mandibular angle less than 1 mm thick (odds ratio 2.74). CONCLUSION The findings suggest that gender, asthma, and thyroid disease play important roles in resorption of the mandibular canal wall.

Dental diseases and loss of teeth in a group of Finnish alcoholics: a radiological study

A total of 85 Finnish alcohol-dependent subjects and 53 controls were studied with panoramic radiography. The aim was to study the possible associations between prolonged alcohol consumption and dental health. The mean number of teeth, caries lesions, endodontic treatments, periapical lesions, marginal bone loss, and periodontal infrabony pockets was studied. The subjects met the diagnostic criteria of alcohol dependence as set out in DSM-IV and ICD-10. The control group comprised social drinking volunteers with an AUDIT score h 8. For the final results the subjects were divided into groups on the basis of sex and age. The social backgrounds of the subjects were similar, except for employment and smoking. The results show significantly fewer teeth and more caries in the alcoholic group. There was a tendency for the alcoholics <45 years of age to have more endodontically treated teeth than the controls, but no difference in the number of periapical lesions in endodontically treated teeth was found. Horizontal bone loss and the presence of calculus were more frequent in alcoholic men than in alcoholic women. Significantly more horizontal bone loss was observed in the group of alcoholic nonsmokers than in nonalcoholic nonsmokers. In the nonsmoking groups alcoholics had significantly more periodontal destruction than the nonsmoking controls. We conclude that radiological dental health among individuals dependent on alcohol is weakened by more caries, more horizontal bone loss, and more numerous vertical infrabony pockets than social drinkers.A total of 85 Finnish alcohol-dependent subjects and 53 controls were studied with panoramic radiography. The aim was to study the possible associations between prolonged alcohol consumption and dental health. The mean number of teeth, caries lesions, endodontic treatments, periapical lesions, marginal bone loss, and periodontal infrabony pockets was studied. The subjects met the diagnostic criteria of alcohol dependence as set out in DSM-IV and ICD-10. The control group comprised social drinking volunteers with an AUDIT score < or =8. For the final results the subjects were divided into groups on the basis of sex and age. The social backgrounds of the subjects were similar, except for employment and smoking. The results show significantly fewer teeth and more caries in the alcoholic group. There was a tendency for the alcoholics <45 years of age to have more endodontically treated teeth than the controls, but no difference in the number of periapical lesions in endodontically treated teeth was found. Horizontal bone loss and the presence of calculus were more frequent in alcoholic men than in alcoholic women. Significantly more horizontal bone loss was observed in the group of alcoholic nonsmokers than in nonalcoholic nonsmokers. In the nonsmoking groups alcoholics had significantly more periodontal destruction than the nonsmoking controls. We conclude that radiological dental health among individuals dependent on alcohol is weakened by more caries, more horizontal bone loss, and more numerous vertical infrabony pockets than social drinkers.

Quantitative Assessment of Vertical Heights of Maxillary and Mandibular Bones in Panoramic Radiographs of Elderly Dentate and Edentulous Subjects

The clinical applicability of vertical measurements of the mandible and maxilla in panoramic radiographs was studied by assessing the variety of vertical heights among 91 elderly dentate subjects. Measurements in each jaw and calculations of a maxillary ratio were made at five sites. Variations in measurements of the dentate subjects were small: 9-11% for vertical measurements in the mandible, 6-11% for vertical measurements in the maxilla, and 8-10% for the maxillary ratios. These findings suggest that it is possible quantitatively to assess heights of the mandibular and maxillary bones in panoramic radiographs. Reductions in the edentulous jaws were assessed by comparing the heights of jaws of elderly dentate subjects with those measured in 177 elderly edentulous subjects. Significant differences in heights of the mandibular body and maxilla were found between the dentate and the edentulous (P < 0.001). Edentulous women had greater values for percentage reduction in the mandibles than did the men (P < 0.01; P < 0.001 in various locations).

Osteosarcoma of the mandible: Analysis of nine cases

A total of 16 cases of mandibular osteosarcoma were diagnosed histologically in Finland and reported to the Finnish Cancer Registry between 1953 and 1983. Review of the histologic slides confirmed the diagnosis in only nine cases. The overall five-year survival rate was 44%. Three patients who were free of clinical disease at the end of the follow-up period (mean, 9.9 years) either had tumors of low-grade malignancy (two cases) or had undergone prompt radical surgery (one case). The importance of radiography in the diagnosis of mandibular osteosarcoma is stressed, because the widening of the periodontal membrane spaces, the sunray effect, and the widening of the mandibular canal are almost pathognomonic for osteosarcoma.

A stereosialographic study of developmental mandibular bone defects (Stafne's idiopathic bone cavities).

The purpose of the study was to investigate with the aid of stereosialography and orthopantomography, the connection between developmental mandibular bone defects and the submandibular salivary gland. In sialographies on seven patients, there were two cases in which the contrast medium was found, with certainty, to fill the lobe of the submandibular salivary gland in the area of the bone defect. In four cases the contrast medium ended in the immediate vicinity of the defect. In one case no conclusive result was obtained. The results of the study suggest that the developmental mandibular bone defect and the lobe of the submandibular salivary gland being in close contact with the lingual surface of the mandible have a probable etiologic causal connection, at least in a number of cases.

Three main arteries of the face and their tortuosity

The anatomy of the facial, transverse facial and infraorbital arteries and their tortuosity was studied in 69 human cadavers (age range 18-95 years). The types of facial vascularisation were divided into four categories according to the gradually diminishing relative dominance of the facial artery. Type A, in which the facial artery was dominant, comprised 22% of the cases; type B 49%; type C 20%; and the variant of the hypoplastic facial artery, type D, 9% of the cases. The type of vascularisation was not dependent on age or sex. The tortuosity of all three arteries showed a statistically significant increase with age. A weak correlation was found between the relative dominance and the tortuosity of the facial artery.

Development of a Stafne mandibular bone cavity: Report of a case

The present study reports a case in which a clinically asymptomatic radiolucent change surrounded by a sclerotic wall developed below the second molar in the mandible of a middle-aged man. The change was diagnosed as a typical case of Stafne bone cavity. In the earlier literature, development of a mandibular bone cavity has been described in only three patients. The appearance of bone cavities in a mandible that has previously been found normal indicates that these defects are not congenital but developmental processes.

Dental radiographic findings in the elderly in Helsinki, Finland

A total of 169 dentate persons, aged 76, 81, and 86 years, living at home in Helsinki, Finland, were examined by means of panoramic radiography supplemented by intraoral radiographs. The older the age group, the fewer teeth remained. Altogether 75% of the subjects had radiographically detectable caries. A high proportion of the carious teeth (62%) was found in a relatively small number (24%) of subjects. The number of carious teeth and their percentage of the total number of teeth were greater in the older age groups. The proportion of endodontically treated teeth was 19% in the 76-year-olds and 26% in the 86-year-olds. Of the subjects 41% had periapical periodontitis, which was commoner in root-filled teeth (18%) than in other teeth (4%). Caries and periapical radiolucent and radiopaque findings were commoner in men. Vertical bone pockets (3 mm or deeper) were found in 51% and furcation lesions in 28% of the subjects. Compared with earlier Finnish studies, the results indicate an improving oral health status among elderly Finns.

Height of mandibular basal bone in dentate and edentulous subjects

Age-related differences in the height of the mandibular basal bone were compared between young and old dentate subjects and between dentate and old edentulous subjects by means of panoramic radiographs. The distances of the mental foramen and mandibular canal from the lower border of the mandible, when measured, showed the mandibular basal bones in old dentate and in old edentulous men to be higher than those of young dentate men in the molar region (P < 0.05). The height of the basal bone below the mental foramen was smaller in old edentulous women than in young and old dentate women (P < 0.05). A slight bone deposition along the lower border of the mandible in the molar region seems to take place with increasing age. The mental foramina of edentulous women move toward the lower border of the mandible as a result of alveolar bone resorption.