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Objectives The aim of this study was to compare the reliability of cone-beam computerized tomography (CBCT) with that of other radiographic methods in preoperative radiographic determination of the number of roots of lower third molars and their relationship to the inferior alveolar canal (IAC). Study design Forty-two teeth were clinically studied and imaged using CBCT and other imaging methods—panoramic radiography, multiprojection narrow-beam radiography (MNBR), and cross-sectional tomography. Statistical analysis (kappa values) was used to compare the diagnoses of 2 trained oral radiologists and the radiologic diagnoses with the findings at operation. Results Cone-beam CT revealed the number of roots of teeth more reliably than panoramic radiographs. CBCT examination was highly reliable in locating the IAC, whereas MNBR was unreliable and cross-sectional tomography fell between the two. With cross-sectional tomography, the IAC was noninterpretable in one-third of the cases. Conclusions We recommend CBCT examination for preoperative radiographic evaluation of complicated impacted lower third molars.

This study is part of a larger research program, at the Finnish Student Health Service in Helsinki, in which changes in the dental and oral health of first-year university students (born in Helsinki) in the years 1982 and 2002 were compared.Panoramic radiographs were taken of 176 students in 1982, mean age 19.8 years (SD+/-0.7), and of 231 in 2002, mean age 20.2 (SD+/-0.7). DMFT index, caries and periapical changes, alveolar bone resorption, wisdom teeth, supernumerary, missing, and persisting deciduous teeth were evaluated from the radiographs. The chi-squared test and non-parametric tests were used to analyze the statistical significance of differences between the study groups and between genders.The DMFT index diminished from 11.0 (SD +/- 4.2) to 2.9 (SD +/- 3.3) (p0.0001). In 2002, 27.9% of the students had a DMFT index of zero (in 1982, 0%, p0.000). The mean number of endodontically treated teeth diminished from 0.1 to 0.03 (p0.05). The number of impacted wisdom teeth increased in males from mean 0.41 to 0.69 (p0.05).An improvement in dental health was obvious in the year 2002. The favorable change in DMFT index is a trend that has been going on for several decades in Finland, probably as a result of the use of fluorides and better education in dental hygiene. The change might also be connected with improved general health.

Purpose The aim of the present study was to follow the clinical changes in third molar status during an 18-year period in patients aged 20 to 38 years. Patients and methods The series consisted of 118 subjects (37 men and 81 women). In the beginning of the study, the mean age was 20.2 years (SD, ±0.6 year), and at the end, it was 38.6 years (SD, ±0.6 year). Panoramic radiographs were taken at baseline and at age 38. All of the subjects were clinically examined at baseline and at the end of the study. A portion of the subjects (n = 69) were also examined at age 32. Results Most of the initially unerupted third molars were removed during the follow-up period (73%, maxilla and mandible together). More than half of the initially partially erupted third molars were removed during the follow-up period (64%, maxilla and mandible together). The percentage of erupted third molars found in the mouth at age 38 increased significantly depending on the initial status. Of the initially unerupted, partially erupted, or erupted third molars, 10%, 33%, and 50%, respectively, were erupted at age 38 (maxilla and mandible together). Changes in the status of third molars continued from age 32 to age 38, although to a lesser extent (8%). The 3 third molars with advanced eruption were all maxillary teeth in men. Conclusion Third molars undergo continuous clinical change on a reduced scale at least up to the age of 38 years.

Short-root anomaly (SRA), occurring mostly in maxillary incisors, is defined as developmentally very short, blunt dental roots. The condition has a genetic background and is related to hypodontia. Earlier population studies have been based on schoolchildren with developing dentitions and have indicated prevalence figures between 1% and 10%. We studied a random sample of existing panoramic radiographs of 2000 university students for SRA. Roots as long as or shorter than the crowns in the incisors and visually evaluated as very short, blunt roots bilaterally in the posterior teeth were classified as SRA. The prevalence was 1.3%. According to anamnestic information, half the SRA patients had undergone orthodontic therapy, but pre-treatment radiographs were unavailable. In 70% of the SRA patients the short-rooted tooth pairs were upper incisors, but also involved were maxillary premolars, lateral incisors, and lower second premolars. Women were significantly more often affected. We discuss other factors known to cause short-rooted teeth and conclude that the population prevalence for genetic SRA in fully developed dentitions is close to our 1.3%.

The purpose of this study was to assess how the eruptive status of third molars relates to gingival and dental health and, in particular, to the status of the adjacent second molar. One hundred and twenty-three young adults were followed up over a 6-year period, from age 20 to age 26. The status of the second and third molars, and DMF, DMFS, DS, MS, and FS indices, periodontal condition, and salivary acidogenic bacterial counts were assessed. The 6-year DFS increase in relation to second molars was greatest in sextants with unerupted third molars. The percentage of erupting third molars that became carious or had been filled during the study period was 30%. Most new caries lesions or filled surfaces were on mesial surfaces of second molars and occlusal surfaces of third molars. The periodontal condition was best in mandibular sextants in which the third molar was missing. It is concluded that the most favourable situation for upper second molars is if the neighbouring third molar is missing by age 20.

The development of 412 upper and lower third molars was clinically followed up for 6 years in 120 students, starting at the age of 20 years. Clinical and radiographic examinations carried out at baseline and 6 years later showed that during the follow-up period almost half the third molars originally recorded as partially erupted had erupted. When the lower third molars were initially invisible, only 9% of them had erupted by age 26 years whereas 29% remained invisible. When third molars had been already erupted at baseline, only a few were extracted during the 6-year follow-up period. It was concluded that a certain proportion of third molars erupt relatively late, and therefore the need for surgical interventions may decrease with age during early adulthood.

The aim of the study was to examine oral piercings among first-year university students.First-year university students in 2002 were invited to a dental examination (n = 234; 49 men and 185 women). Students with piercings formed the study group and the rest served as controls. The methods included decayed, missing, and filled teeth (DMF) index, stimulated salivary flow rates, panoramic tomograms, and questionnaires including the Depression Inventory of Beck. Fisher's 2-sided exact test was used for statistical analysis.The prevalence of oral piercings was 3.4%. In the DMF indices, no statistically significant differences existed between the groups. Increased salivary flow rates were noted among students with piercings (63% vs 26%, P.05). Use of tobacco and illicit drugs, and also depression, were more prevalent in the study group than in the controls.Because of the possibility of oral implications, follow-up of oral piercings is essential.

Nineteen patients (13 male, six female) with 34 impacted third molars, 21 in the mandible and 13 in the maxilla were radiographically followed from age 20 to 32. All were examined clinically and panoramic radiographs were taken at baseline and at the end of the study. Radiographic analysis included resorption of teeth, enlargement of the follicle, development of the root, change in inclination of the third molar, state of impaction, relative depth of the third molar in bone and relation to the ramus of the mandible and to the second molar tooth. In the mandible, the mean change in inclination was 19 degrees and the percentage of teeth with changed angulation was 76%. In the maxilla, only 23% of the teeth changed their inclination. The state of impaction (soft tissue, partially in bone, completely in bone) had changed for 44% of the teeth. According to the questionnaire, no pain or symptoms in the region of the third molars were reported by 74% of the students during the 12-year period. It is concluded that considerable radiographic changes, without notable symptoms, may occur involving inclination of the tooth and state of impaction in impacted third molars after the usual age of eruption.

Purpose: The aim of this study was to evaluate the estimates on need for third molar removals made at age 20 after 12 years. Patients and Methods: The series consisted of 81 university students followed from age 20 to 32 years. At baseline and at study end, these students were clinically examined, and panoramic radiographs were taken. At baseline in 1982, a qualified oral surgeon had made estimates on need for removal of third molars within 5 years; 75% of students needed removals. Actual treatment performed was evaluated after 12 years. A questionnaire served to determine symptoms related to third molars during the 12-year period. Results: During the follow-up, one or more third molars had been removed from 67% of the former students. A total of 155 third molar removals had been estimated, but by age 32 years the percentage actually removed was only 59%. Of the 79 third molars taken out at the Finnish Student Health Service, 77% were initially estimated to need a surgical procedure, but actually 66% were simply extracted. Most were removed at around age 27 years. According to the questionnaire, 67% of the students were asymptomatic in the third molar region during 12 years. Conclusion: Because need for surgical removal decreases during early adulthood, routine prophylactic extraction of asymptomatic third molars in young adults cannot be recommended. Well-defined indications for prophylactic removals are needed.

Purpose: The aim of the study was to follow the clinical changes in third molar status during a 12-year period in patients aged 20 to 32 years. Patients and Methods: The study was based on a follow-up of 81 university students (32 men, 49 women). They were clinically examined and panoramic radiographs were taken at baseline (mean age, 20.7 ± 0.5 years) and at the end of the study (mean age, 32.6 ± 0.6 years). Results: The students had 285 unerupted, partially erupted, or fully erupted third molars at the beginning of the study, and 150 at the end. On final examination, 115 teeth were erupted. During the first 6 years from age 20 to 26, various clinical changes took place in the status of the third molars. In the second 6 years, until age 32, the two main changes were either removal or eruption. During the 12-year follow-up, 22% of third molars erupted, a few even after 26 years of age; the percentage of third molars removed was 42%. Conclusion: Third molars undergo continuous clinical change at least up to the age of 32 years.

A questionnaire dealing with the incidence of traumatic injuries was sent to 1,000 randomly selected 3rd-year university students in Finland; 617 students responded adequately. Of those, 177 (28.7%) reported a combined total of 281 accidents and 323 separate injuries requiring medical or dental treatment during the preceding 3 years. The accidents resulted in 1,061 days of official sick leave, and one third of the accidents caused permanent sequelae to the affected students. Almost half of all accidents had been sustained during sports activities and 14% in traffic. Only 0.5% of the accidents were classified as having occurred in the university environment or during activities directly related to studies. Alcohol was involved in 10.1% of the accidents; 45% of the injuries affected the lower extremities, and 22% the upper extremities. Most of the injuries were related to the students' active lifestyles and keen interest in sports.

To determine radiographic features by which one could estimate whether lower third molars are likely to erupt after the age of 20 years, university students with a total of 84 unerupted or partially erupted lower third molars were followed up. Five radiographic features of each third molar were measured from the panoramic tomogram taken at age 20 years, and the status of third molars was examined for a second time at age 26 years. The results showed that the lower third molars that did erupt after the age of 20 years were initially: 1) root formation complete; 2) impacted in soft tissue; 3) vertical; 4) placed at the same occlusal level as the neighbouring second molar; 5) showed sufficient space between the ramus and the second molar. In contrast, the teeth that remained impacted at the age of 26 years showed such initial features as: 1) incomplete root formation; 2) embedding in bone; 3) mesioangularity; 4) situated at the cervical level of the neighbouring second molar. It was concluded that a panoramic tomogram taken at age 20 years revealed radiographic features on which an estimation of future eruption of mandibular third molars could be based.

Samples were collected from the stimulated saliva of 113 students enrolled in institutions of higher education. The students were divided into three "carries-diagnostic groups" on the basis of indications given by the Dentocult saliva test, which shows the frequency of lactobacilli and other aciduric microorganisms in saliva. The frequency of such microorganisms in 1 ml saliva in Group A was less than or equal to 103, in Group B greater than 10(3), less than 10(4) and in Group C greater than or equal to 10(4). The rate of secretion of saliva in Group A was significantly higher than in Group C (P less than 0.05). On the average, a rise was noted in the fluoride and calcium concentrations with increasing "caries activity". In the material as a whole, there was a negative and highly significant correlation between the secretion rate of saliva and the concentrations of fluoride and calcium. In the examination by groups, significant correlations were observed between fluoride concentration and rate of saliva secretion in Group A, and with respect to fluoride and calcium only in Group C. The results suggest that the extra salivary fluoride is likely to be derived from the enamel.

The periodontal status of 217 5th-year students (aged 25-26 years and born in Helsinki) at the University of Helsinki was assessed. The students had been eligible for community-based dental care free of charge until the age of 18 years, after which they could obtain low-cost dental care from the Helsinki Student Health Service. Their periodontal status was determined according the community periodontal index of treatment needs; gingival retraction was recorded when 1 mm or more of the cementum was exposed. Code 0 sextant was found for 67% of the women and 57% of the men. 20% of the students examined had sextant scoring of code 3; no-one had code 4 sextants. 69% of the women and 49% of the men had gingival retraction, in average 1.5 ± 0.5 mm. No correlation was found between the frequency of tooth brushing or the hand used for brushing and the number of retractions, nor did the number of healthy sextants correlate with the frequency of retractions. The findings emphasize the importance of better guidance regarding qualitative aspects of oral hygiene at home.

Washed cells of Streptococcus sanguis were used to form artificial plaque on the surface of bovine enamel and incubated underneath buffer solutions, initial pH 6, for 36 h at 37 degrees C. The decrease in the microhardness of the enamel surface under fermenting "plaque" could be prevented with fluoride. Enamel under a fermenting "plaque" took up significantly more (P less than 0.0u) fluoride than enamel under a non-fermenting "plaque" (initial F- in buffer: 10 parts/10(6)). The artificial plaque did not accumulate fluoride. Within fermenting "plaques/, the pH decreased significantly more without flouride (P less than 0.01) than with fluoride. Fluoride combined with sucrose more than negated the softening of the enamel caused by sucrose fermentation, i.e. it increased the hardness above the original values. The diffusion of fluoride through the fermenting artificial plaque was more rapid than through a non-fermenting plaque. These findings suggest that caries-conducive circumstances may promote fluoride uptake by enamel compared with non-caries-conducive circumstances.

Four per cent of the sucrose component of a cariogenic diet of the 580 type was replaced by a combination of Na2HPO4 + NaH2PO4 + KH2PO4

The average pH change from the control value 6.72 for 19 subjects was -0.59 during ingestion of experimental sucrose tablets and -0.84 after ingestion. There was a significant positive correlation between the magnitude of the pH decreases and the amount of plaque. There was no correlation between the magnitude of the pH changes and the DMFS index.

In order to shed light on the problem of the retention of wisdom teeth, the status of third molars in the 20- to 21-year-old university population was evaluated both clinically and radiographically. A total of all 248 first-year students at the University of Helsinki who had been born and were living in the city of Helsinki were invited to participate in the study. The response rate was 73%. The rate of full eruption, as determined clinically with 95% confidence limits, was 36% for the upper and 19% for the lower third molars. According to the radiographical examination, 42% of the upper third molars and 58% of the lower third molars were classified unerupted. The clinical and radiographical information was combined to determine the rates of impacted third molars. The rate for impacted maxillary third molars was 29% among the female and 35% among the male students. The respective rates for impacted mandibular third molars were 28% and 21%. The average number of impacted third molars was 1.8 for w...

— The salivary lactobacilli and Streptococcus mutans county in 217 university students of 25.4-yr-old were studied with regard to the state of eruption of their third molar teeth. Statistically significantly higher counts of both bacterial species were found in students who had one or more third molars partly erupted, compared with those whose third molars were lacking or fully erupted. No other parameters studied such as salivary flow rate or buffering capacity of the saliva were found to explain the high bacteria1 counts. These findings should be taken into consideration when interpreting salivary microbial counts in young adults. Also, special interest should be focused into these aspects at oral hygiene and dietary counseling of young patients.

The purpose of this study was to determine the quality of amalgam fillings among 20-yr-old Helsinki University students. The quality of the fillings was evaluated for the teeth 16 and 46. The marginal adaptation, anatomical form and surface texture of the fillings were evaluated and the filled surfaces were classified as being good, or requiring refinishing or replacement. The age of the fillings and how often they had been replaced were also evaluated from previous records. 47% of the filled surfaces were classified as good, 43% needed to be refinished and 10% needed replacement. The reasons for refinishing a filling were faults in surface texture (61 %), anatomical form (23 %) or marginal adaptation (16%). The reasons for replacing a filling were fractured filling (38%), secondary caries or incorrect marginal adaptation (23%), inadequate anatomical form (13 %) or poor surface texture (26%) which could not be refinished. The mean age of all fillings was 6.6 yr. The mean age of fillings which needed replacement was 7.3 yr. The maxillary first molar had been filled an average of 2.0 times and the mandibular first molar 2.2 times by the age of 20 yr.

Dental health practices among Finnish university students were studied in 1980. In order to obtain more information about the factors associated with different health status this problem was studied using linear discriminant analyses. 360 students were separately classified into fifths according to increasing individual VPI, GBI and DMFS index scores. According to the classification, the students of the two first fifths with lowest mean index scores were combined in the positively health oriented group. The students with low VPI and GBI index scores reported that they brushed their teeth most frequently. Also the good results of the dip-slide method for counting salivary lactobacilli correlated well with the low VPI and DMFS index scores. In the discriminant analysis toothbrushing frequency was the most important single variable related to a good VPI score. By a computer method, 64% of the students were found to be correctly placed in the group of the positively health oriented. The corresponding percentage for the negatively oriented was 69%. The most important single variable related to good GBI and DMFS scores was subjective estimation of condition of dentition. According to GBI score the method correctly placed 57% of the students in the group of the positively and 69% in the group of the negatively health oriented. The respective percentages for DMFS-index were 65% and 68%. The predictor variables failed to make an important contribution toward explaining the great variations in the oral health status indicators.

“Recurrent Vaginal and Cervical Ulcers Associated With Tampon Use,” Steven M. Weissberg, Melvin G. Dodson. Three cases of recurrent vaginal and cervical ulcers were associated with tampon use. We review the diagnosis, treatment, and management and discuss the possible etiologic mechanisms. Prevention of recurrent ulceration may be best approached by discontinuation of tampon use. (Journal of the American Medical Association 1983;250:1430–1431)

Students ingested tablets daily during a period of 3 d growth of dental plaque and in connection with the collection of plaque specimens. The tablets varied in composition: sucrose (C), sucrose containing sodium bicarbonate-monopotassium orthophosphate and fluoride (BPF), and sucrose modified with fluoride (F). The daily fluoride dose in conjunction with the growth of plaque and the collection of specimens was 0.5 mg of total fluoride and 0.2 mg in the determination of ionized fluoride. The fluoride taken during the growth period did not significantly affect the total and ionized fluoride contents of the plaque. During the consumption of all the tablets, the total fluoride content of the plaque increased temporarily, after which a drop took place to close to the original value. In the case of the C- and the BPF-tablets, the increase was statistically significant (P-values less than 0.02 and less than 0.001, respectively). During the consumption of the BPF- and F-tablets, the ionized fluoride content dropped significantly (P-values less than 0.001 and less than 0.01, respectively). The investigation showed that a binding of the free fluoride ions in dental plaque takes place in connection with fermentation.

A total of 49 rats was littermate-distributed into three dietary groups when 21 days old. The control group (C) was fed a cariogenic nutritionally adequate high- sucrose diet for 40 days. The second group (BP) received the same diet as group C except that 4% of the sucrose component of the diet was replaced by a combination Phosphate, dietary NaHCO3 + KH2PO4 (mole ratio 9.82/1). The third group (BPF) was fed the same diet as group BP except that NaF was also added to the sucrose to give 10 ppm F addition to the whole of diet. The mean gain of body weight in the BPF group was 55% higher than in group C (p

– Plaques were grown for 3 d by 16 caries-active and 17 caries-inactive subjects. During the growth, the subjects consumed tablets containing sucrose (C), sucrose with a 3% supplement of NaHCO3+ KH2PO4 combination (BP, mole ratio 9 82/1), sucrose with the NaHCO3+ KH2PO4+10 parts/106 fluoride as NaF (BPF) or 10 parts/106 F as NaF alone in the sucrose (F). Ten tablets of the respective qualities were consumed within 30 min in the experimental sessions. Plaque samples were taken before, during and after ingestion of the tablets and suspended in a small volume of distilled water. The pH dropped immediately after the start of ingestion of the sucrose, remained practically at the decreased level during ingestion, and after ingestion dropped even more in the caries-active plaques. Throughout the experiment, these plaques showed a lower average pH than the caries-inactive. The BPF additive elevated significantly the pH of the caries-active plaques from the respective sucrose values and the BP values, both during and after ingestion. The BP additive elevated the plaque pH only during ingestion and the F additive had no significant influence.