Estrogen deficiency-induced postmenopausal osteoporosis has become a worldwide problem, inducing low bone mass and microarchitectural deterioration of the bone scaffolding in the vertebrae and long bones. With the prevalence of such osteoporosis on the increase, the influence of this estrogen deficiency on the jaw bones has drawn the attention of researchers and clinicians in the field of dentistry. The aim of this article is therefore to review the microstructural changes occurring after ovariectomy in the jaw bones of animal subjects. Induced estrogen deficiency clearly led to structural changes in the jaw bones and alveolar bone of animal subjects (rats and monkeys). Severe bone loss in the rat alveolar bone was principally caused by high bone resorptive activity. This activity accelerated greatly immediately after ovariectomy, and was then followed by more moderate resorptive activity, which continued over an extended period. Additionally, occlusal hypofunction further greatly accelerated the fragility of the alveolar bone structure in ovariectomized rats. Microstructural damage also seen in the alveolar bone of ovariectomized monkeys was found to be directly connected to their systemic osteoporosis. Recent investigations of the relationship in humans between systemic osteoporosis and jaw bone loss have also suggested that a connection may exist between these two. However, more research is required to confirm this connection in humans as well.
Epidemiological studies have shown that post-menopausal women who do not use an estrogen supplement have fewer teeth than those who do. We hypothesized that changes in the dentition of post-menopausal women might be due to alveolar bone alterations by estrogen deficiency. To clarify this, we analyzed the microstructural alveolar bone changes in ovariectomized monkeys and compared these with their lumbar bone mineral density. The % of baseline bone mineral density showed a significant decrease in the ovariectomized group as compared with the controls. The second-molar interradicular septa in ovariectomized monkeys showed a significantly decreased nodes number, cortices number, and an increased structural model index value. More pores were seen in the ovariectomized group at the top of the septa. This study demonstrated that, in such monkeys, estrogen deficiency led to fragility of the trabecular structure of the molar alveolar bone, and such fragility was inversely correlated with lumbar bone mineral density.
Inadequate oral health knowledge and awareness is more likely to cause oral diseases among all age groups, including children. Reports about the oral health awareness and oral hygiene practices of children in Bangladesh are insufficient. Therefore, the objective of this study was to evaluate the oral health awareness and practices of junior school children in Mathbaria upazila of Pirojpur District, Bangladesh. The study covered 150 children aged 5 to 12 years of age from three primary schools. The study reveals that the students have limited awareness about oral health and poor knowledge of oral hygiene habits. Oral health awareness and hygiene practices amongst the school going children was found to be very poor and create a much-needed niche for implementing school-based oral health awareness and education projects/programs.
Mandibular defects may occur from maxillofacial injury, inflammatory disease, benign or malignant tumour resections and osteoradionecrosis. Mastication, speech and facial disfigurement are often severely compromised without reconstruction leading to poor quality of life. The goal of mandibular reconstruction is to restore facial form and function, repair of mandibular continuity and soft tissue reanimation. Implant insertion should be feasible to allow occlusal rehabilitation and if possible the inferior alveolar nerve function should be restored. Mandibular reconstruction principles and techniques have evolved dramatically over the years. Refinements in techniques continue to improve patient quality of life. This paper reviews short history, current techniques and few promising future endevours related to mandibular reconstruction.
Update Dent. Coll. j: 2019; 9 (2): 50-54
Tooth wear is caused by a variety of reasons, many of which are unknown. Tooth wear management is difficult and complex. For effective treatment, accurate measurement of occlusal vertical dimension (OVD), interocclusal rest space, and centric relation records are required. The analysis of facial soft tissue contours is very crucial. A clinician must remember two things before treating a case with full mouth rehabilitation; severe wear does not always cause loss of OVD and it also does not eliminate all defective occlusal interferences.
A systematic method may be beneficial in achieving a predictable and desirable result. This paper describes the step-by-step treatment of a 63-year-old patient who had lost occlusal vertical dimension due to parafunctional habits. Making occlusal overlay bilateral splints in acrylic resin and provisional restorations in mandibular teeth for the healing of the intermaxillary distance was the first strategy for oral rehabilitation. The ultimate rehabilitative therapy evolved into direct composite resin restorations associated with all-ceramic crowns fortified by lithium disilicate after the patient's adaption and muscle stability to the new occlusal situation. We established that all teeth had solid connections with similar intensity in centric relation, as well as anterior guiding in line with functional jaw movement.
Update Dent. Coll. j: 2022; 12(1): 40-44
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