Tom Bergendal

Prevalence and severity of incisal and occlusal tooth wear in an adult Swedish population

The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal or occlusal wear was evaluated for each single tooth in accordance with the following criteria: 0 = no wear or negligible wear of enamel; 1 = obvious wear of enamel or wear through the enamel to dentin in single spots; 2 = wear of dentin up to one-third of the crown height; 3 = wear of dentin more than one-third of the crown height and/or excessive wear of tooth restorative material. Among the 20-year-olds 35% of the subjects had no or slight incisal or occlusal wear. The corresponding figures for the 30- to 80-year age groups were 20%, 32%, 18%, 14%, 26%, and 23%, respectively. For the age groups 20-80 years, the percentage of teeth with incisal or occlusal wear in accordance with criteria 1-3 was 13%, 20%, 16%, 24%, 23%, 23%, and 23%, respectively. Men presented more teeth with wear than women, the difference being significant for all age groups except the 20- and 60-year-olds. Among the 20-year-olds 6% had one or more teeth with wear scored 2. Among subjects aged 30 and 70 years 10% and 31%, respectively, showed tooth wear with score 2. Wear with score 3 was only found in 2% of the total population. There was an increase in the number of teeth with incisal or occlusal wear with age. With increasing age, there was also a change in distribution of wear within the dentition.

An individual tooth wear index and an analysis of factors correlated to incisal and occlusal wear in an adult Swedish population

The aim of the study was to introduce an individual tooth wear index and to use this index to investigate factors correlated to occlusal wear. The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal and occlusal wear was evaluated for each single tooth in accordance with criteria presented earlier. An individual tooth wear index, which made it possible to rank individuals in accordance with incisal and occlusal wear, was used as dependent variable to investigate factors related to incisal and occlusal wear. Of all factors analyzed, the following were found to correlate significantly with increased incisal and occlusal wear: number of existing teeth, age, sex, occurrence of bruxism, use of snuff, and saliva buffer capacity. Stepwise multiple regression analysis gave a total explanation factor of R2 = 0.41. It was also possible to distinguish well between groups of individuals with and without tooth wear by means of these factors.

A Combined Clinical, Mycological and Histological Study of Denture Stomatitis

The clinical and histological appearance of the different types of denture stomatitis are in many respects very similar and confluent. In order to study the correlation between clinical and histological appearance and amount of yeasts, 48 patients with denture stomatitis and 24 with a healthy palatal mucosa were examined. The terms atrophic and hyperplastic denture stomatitis were introduced. The intensity of the palatal erythema and the growth of yeasts were most prominent among patients with hyperplastic lesions. Dryness and soreness of the mouth, angular cheilitis, spontaneous hemorrhage, glossitis and leukoplakias were found to a varying extent. No statistical evidence of correlation between the intensity of clinical erythema, amount of yeasts and grade of subepithelial inflammation could be found. The disease has most certainly a background other than solely increased growth of yeasts.

Yeast colonization in the oral cavity and feces in patients with denture stomatitis

An investigation was undertaken of 77 denture wearers to study the incidence of yeasts in the angles of the mouth, denturebearing mucosa, denture base, the throat and the gastrointestinal tract. Fifty-one denture wearers exhibited denture stomatitis and 26 showed no clinical signs of inflammation of the palatal mucosa (controls). In addition the influence of oral local treatment with an antifungal agent (Mycostatin®) on the yeast flora in the same sites was studied in denture wearers with denture stomatitis. The findings suggest a higher rate of yeast colonization in the mouth (100% compared to 40%) and feces (71% compared to 35%) in denture wearers with denture stomatitis than in denture wearers without stomatitis. Similar species of yeasts, predominantly Candida albicans, C. tropicalis and Torulopsis glabrata were identified among the isolates from the oral sites, throat and feces in denture wearers with stomatitis. In denture wearers without stomatitis the yeast species isolated from the oral sites and...

In situ characterization of the inflammatory cell infiltrates of hyperplastic denture stomatitis

Cryostat sections from 14 surgical specimens were examined to determine whether selected factors of the immune response related to histopathological reactions are present in the palatal mucosa affected by hyperplastic denture stomatitis. By means of various immunological techniques the presence of IgG, IgA, IgM, complement factor C3c, receptors for the Fc region of IgG (FcR) and for complement factor C3b (C3bR), T lymphocytes, and macrophages were studied. The inflammatory infiltrate was mainly located in the papillary part of the lamina propria. IgG, IgA, and IgM appeared both in plasma cells and intercellularly. FcR, C3bR, and T lymphocytes were present in the areas with inflammatory cell infiltrate. Macrophages were found in the papillary part of the lamina propria and within the epithelium. The immunological response in the mucosa affected by denture stomatitis was in many respects similar to that of marginal and apical periodontitis. We conclude that hyperplastic denture stomatitis is a complex inflammatory lesion showing elements of both humoral and cellular immune responses.

Dental Implant Therapy for a Child with X-linked Hypohidrotic Ectodermal Dysplasia— Three Decades of Managed Care

PURPOSE The aim was to report on oral rehabilitation of a boy with X-linked hypohidrotic ectodermal dysplasia (XLHED) and anodontia of the mandible between ages 3 and 33 years where treatment involved dental implants and oral care management by a multidisciplinary team of specialists. MATERIALS AND METHODS This case history report describes the clinical management of a boy born in 1979 with XLHED and anodontia of the mandible. Two implants were successfully placed in the anterior region of the mandible in 1985. Genetic analysis later verified the diagnosis by confirming a mutation in the EDA gene. The case description was based on review of the patient records and assessment of orofacial function. RESULTS The patient had satisfactory orofacial appearance and function throughout his youth. He is still caries-free at age 33 and has experienced only minor oral complications. Dental management began at age 3, when he received a maxillary removable dental prosthesis. At age 7, he received a mandibular implant-supported overdenture. After two more implants in the mandible and orthodontic treatment in the maxilla, his oral rehabilitation was completed at age 22 with maxillary tooth-supported and mandibular implant-supported fixed dental prostheses. Regular follow-ups provided supervision of oral hygiene, caries prevention, and prosthetic maintenance. CONCLUSION This long-term follow-up of a child with XLHED and anodontia in the mandible supports the use of dental implants, with consideration given to the dense bone quality associated with the diagnosis, to establish good orofacial function and appearance from childhood onward.