Effects of clodronate on early alveolar bone remodeling and root resorption related to orthodontic forces: a histomorphometric analysis.

PubMed

Choi, Josefina; Baek, Seung-Hak; Lee, Jae-Il; Chang, Young-Il

2010-11-01

The objective of this study was to evaluate the short-term effects of clodronate, a first-generation bisphosphonate, on early alveolar bone remodeling and root resorption related to orthodontic tooth movement. The samples consisted of 54 sex-matched Wistar rats (weight, 180-230 g) allocated to the 2.5 mmol/L clodronate, 10 mmol/L clodronate, and control groups (n = 18 for each group). After application of a nickel-titanium closed-coil spring (force, 60 g) between the maxillary central incisor and first molar, 2.5 mmol/L of clodronate, 10 mmol/L of clodronate, or saline solution was injected into the subperiosteum adjacent to the maxillary first molar every third day. All animals received tetracycline, calcein, and alizarin red by intraperitoneal injection at 1, 6, and 14 days, respectively. The amounts of tooth movement were measured at 3, 6, 9, 12, and 15 days. The animals were killed at 4, 7, and 17 days. Histomorphometric analyses of bone mineral appositional rate, labeled surface, percentage of root resorption area, and number of root resorption lacunae of the mesiobuccal root of the maxillary first molar at 4, 7, and 17 days were done. One-way analysis of variance (ANOVA) with the post-hoc test were done for statistical analyses. Rats in the 10 mmol/L clodronate group had significant decreases of tooth movement (12 and 15 days, P <0.05) and percentages of root resorption area and numbers of root resorption lacunae (7 day, P <0.05), and increases of labeled surface and mineral appositional rates (17 day, P <0.05) over those of the 2.5 mmol/L clodronate and control groups. Although clodronate might decrease root resorption related to orthodontic tooth movement, patients should be informed about a possible decrease in the amount of tooth movement and a prolonged period of orthodontic treatment. Copyright © 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Effect of interleukin-4 on orthodontic tooth movement and associated root resorption.

PubMed

Hakami, Zaki; Kitaura, Hideki; Kimura, Keisuke; Ishida, Masahiko; Sugisawa, Haruki; Ida, Hiroto; Jafari, Saeed; Takano-Yamamoto, Teruko

2015-02-01

Interleukin-4 (IL-4) is a recognized immunomodulatory cytokine that regulates bone homeostasis. However, the influence of IL-4 on orthodontic tooth movement (OTM) and subsequent root resorption is still unknown. Therefore, the purpose of this study was to investigate the effect of IL-4 on tooth movement and its associated root resorption in a mouse model. The maxillary first molars of four male mice for each experimental group were subjected to mesial force by a nickel titanium coil spring for 12 days. Control mice were not given appliances and injections. Varying doses of IL-4 were injected locally, adjacent to the first molar. Two sets of experiments were designed. The first set was composed of three groups: the control, treatment with phosphate-buffered saline (PBS), or 1.5 µg/day of IL-4. The second set was composed of five groups: the control, treatment with 0 (PBS only), 0.015, 0.15, or 1.5 µg/day of IL-4. The distance of OTM was measured and tartrate-resistant acid phosphatase positive cells along the loaded alveolar bone and root surface were identified. The root resorption associated with OTM was evaluated by a scanning electron microscope. The amount of OTM and the number of osteoclasts were significantly decreased in the IL-4-treated mice. Moreover, IL-4 significantly suppressed force-induced odontoclasts and root resorption. IL-4 inhibits tooth movement and prevents root resorption in the mouse model. These results suggest that IL-4 could be used as a useful adjunct to regulate the extent of OTM and also to control root resorption. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Root resorption after orthodontic treatment: a review.

PubMed

Jatania, Archana; Shivalinga, B M; Kiran, Jyothi

2012-01-01

Root resorption that occurs in permanent teeth is an unwanted process and is considered pathologic. Although apical root resorption occurs in individuals who have never experienced orthodontic tooth movement, the incidence among treated individuals is seen to be significantly higher. Some resorption occurs in most orthodontic patients, but because of repair the changes are difficult to detect with radiographic examination and therefore are clinically insignificant. This article gives a review of the various types of root resorption, the etiological factors, the biology and the identification of root resorption.

Study of external root resorption during orthodontic treatment in root filled teeth compared with their contralateral teeth with vital pulps.

PubMed

Llamas-Carreras, J M; Amarilla, A; Solano, E; Velasco-Ortega, E; Rodríguez-Varo, L; Segura-Egea, J J

2010-08-01

To determine whether root filled teeth and those with vital pulps exhibit a similar degree of external root resorption (ERR) as a consequence of orthodontic treatment. The study sample consisted of 77 patients, with a mean age of 32.7 +/- 10.7 years, who had one root filled tooth before completion of multiband/bracket orthodontic therapy for at least 1 year. For each patient, digital panoramic radiographs taken before and after orthodontic treatment were used to determine the proportion of external root resorption (PRR), defined as the ratio between the root resorption in the root filled tooth and that in its contralateral tooth with a vital pulp. The student's t-test, anova and logistic regression analysis were used to determine statistical significance. The mean PRR was 1.00 +/- 0.13, indicating that, in the total sample, there were no significant differences in root resorption in the root filled teeth and their contralateral teeth with vital pulps. Multivariate logistic regression analysis suggested that PRR was significantly greater in incisors (P = 0.0014; odds ratio = 6.2885, C.I. 95% = 2.0-19.4), compared to other teeth, and in women (P = 0.0255; odds ratio = 4.2, C.I. 95% = 1.2-14.6), compared to men. There was no significant difference in the amount or severity of external root resorption during orthodontic movement between root filled teeth and their contralateral teeth with vital pulps.

[Calcitonin as an alternative treatment for root resorption].

PubMed

Pierce, A; Berg, J O; Lindskog, S

1989-01-01

Inflammatory root resorption is a common finding following trauma and will cause eventual destruction of the tooth root if left untreated. This study examined the effects of intrapulpal application of calcitonin, a hormone known to inhibit osteoclastic bone resorption, on experimental inflammatory root resorption induced in monkeys. Results were histologically evaluated using a morphometric technique and revealed that calcitonin was an effective medicament for the treatment of inflammatory root resorption. It was concluded that this hormone could be a useful therapeutic adjunct in difficult cases of external root resorption.

Three consecutive days of application of LED therapy is necessary to inhibit experimentally induced root resorption in rats: a microtomographic study.

PubMed

Higashi, Dayla Thyeme; Andrello, Avacir Casanova; Tondelli, Pedro Marcelo; de Oliveira Toginho Filho, Dari; de Paula Ramos, Solange

2017-01-01

Previous studies have suggested that phototherapy may modulate orthodontic tooth movement and the incidence of root resorption. We aimed to identify a minimal dose-response relationship to LED therapy with regard to orthodontic tooth movement (OTM) and root resorption in rats. Forty-eight male Wistar rats were divided into six groups with equal and random distribution: control (C) no intervention; three daily LED irradiation (CLED); submitted only to OTM (RR); OTM and LED irradiation on the first day (LED1); OTM and two LED irradiation on the first and second days (LED2); and OTM and three LED irradiation on the first, second, and third days (LED3). Orthodontic appliance was installed in groups RR, LED1, LED2, and LED3 to promote OTM. Animals from groups CLED, LED1, LED2, and LED3 received LED therapy (940 nm, 4 J, 4 J/cm2) according to each group of treatment. After 7 days, all the animals were sacrificed. The jaws were fixed and scanned with microtomography (micro-CT). The micro-CT images were reconstructed on 2D and 3D models. These models were used to identify and measure root resorption number and dimensions (diameter, depth, and volume). The distance between the first and second molars was used to verify tooth displacement. The results showed that LED3 group had significantly lower number of root resorption. The root resorption dimensions (diameter and depth) had no significant differences among the experimental groups. LED3 group had significant tooth displacement in relation to C and CLED groups. In conclusion, three daily LED therapy doses are required to inhibit root resorption after appliance of orthodontic forces.

Apical root resorption of incisors after orthodontic treatment of impacted maxillary canines: a radiographic study.

PubMed

Brusveen, Elin Marie Gravdal; Brudvik, Pongsri; Bøe, Olav Egil; Mavragani, Maria

2012-04-01

The purpose of the study was to evaluate impacted maxillary canines as risk factor for orthodontic apical root resorption. The sample comprised 66 patients treated with fixed appliances. Thirty-two patients with a unilateral impacted maxillary canine, which was distanced from the roots of the incisors at a preliminary phase of treatment before bonding, formed the impaction group, and 34 patients without impactions served as the controls. Root shortening was calculated by using pretreatment and posttreatment intraoral radiographs. Inclination of the eruption path of the impacted canine relative to the midline, axis of the lateral incisor, and nasal line, root development, and the medial and vertical positions of the impacted tooth were recorded on orthopantomograms and lateral cephalometric films. The follicle/tooth ratio was evaluated by using periapical radiographs. No significant difference in apical resorption of the maxillary incisors was detected between the impaction and control groups, or between the incisors of the impacted and contralateral sides in the same subject. Likewise, no difference in the severity of root resorption was found between the incisors of impacted side alone and the incisors of the control group. Mesial and vertical inclinations of the impacted canines were negatively related to a lateral incisor's root resorption. No correlations were found between resorption and medial or vertical position of the crown of the canine. The follicle/tooth ratio was significantly related to the mesial inclination of the impacted canine, but not to root resorption. An impacted maxillary canine, after being distanced from the incisor roots, does not seem to be a risk factor for apical root resorption during orthodontic treatment. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Strontium ranelate improved tooth anchorage and reduced root resorption in orthodontic treatment of rats.

PubMed

Kirschneck, Christian; Wolf, Michael; Reicheneder, Claudia; Wahlmann, Ulrich; Proff, Peter; Roemer, Piero

2014-12-05

The anchorage mechanisms currently used in orthodontic treatment have various disadvantages. The objective of this study was to determine the applicability of the osteoporosis medication strontium ranelate in pharmacologically induced orthodontic tooth anchorage. In 48 male Wistar rats, a constant orthodontic force of 0.25 N was reciprocally applied to the upper first molar and the incisors by means of a Sentalloy(®) closed coil spring for two to four weeks. 50% of the animals received strontium ranelate at a daily oral dosage of 900 mg per kilogramme of body weight. Bioavailability was determined by blood analyses. The extent of tooth movement was measured both optometrically and cephalometrically (CBCT). Relative alveolar gene expression of osteoclastic markers and OPG-RANKL was assessed by qRT-PCR and root resorption area and osteoclastic activity were determined in TRAP-stained histologic sections of the alveolar process. Compared to controls, the animals treated with strontium ranelate showed up to 40% less tooth movement after four weeks of orthodontic treatment. Gene expression and histologic analyses showed significantly less osteoclastic activity and a significantly smaller root resorption area. Blood analyses confirmed sufficient bioavailability of strontium ranelate. Because of its pharmacologic effects on bone metabolism, strontium ranelate significantly reduced tooth movement and root resorption in orthodontic treatment of rats. Strontium ranelate may be a viable agent for inducing tooth anchorage and reducing undesired root resorption in orthodontic treatment. Patients under medication of strontium ranelate have to expect prolonged orthodontic treatment times. Copyright © 2014 Elsevier B.V. All rights reserved.

Effect of bisphosphonates on root resorption after tooth replantation - a systematic review.

PubMed

Najeeb, Shariq; Siddiqui, Fahad; Khurshid, Zohaib; Zohaib, Sana; Zafar, Muhammad Sohail; Ansari, Shazia Akbar

2017-04-01

Replantation of avulsed teeth may lead to root resorption. Bisphosphonates (BPs), a class of drugs of used to treat resorptive diseases of the bone such as osteoporosis and Paget's disease, have been observed to exert an antiresorptive effect on periodontal bone as well. The antiresorptive properties of BPs could prove them useful in preventing root resorption of replanted avulsed teeth. The aim of this systematic review was to analyze and summarize the currently available literature concerning the use of BPs in preventing root resorption of avulsed teeth. PubMed/MEDLINE, Google Scholar, ISI Web of Knowledge, and Embase databases were searched using keywords 'bisphosphonate', 'replantation', and 'tooth'. Quality assessment of each study was carried out. In addition, general characteristics and outcomes of each study were summarized. After exclusion of 116 irrelevant articles, 10 animal studies were included in this review. The majority of the studies suggest that surface application of zoledronate or alendronate reduces root resorption of replanted teeth in animal models. Surface treatment with etidronate had no significant effect on root resorption, and intracanal etidronate accelerated resorption. Surface application of zoledronate and alendronate reduces root resorption of replanted teeth in animal models. However, the efficacy of intracanal usage of BPs is still debatable. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

BoneCeramic graft regenerates alveolar defects but slows orthodontic tooth movement with less root resorption.

PubMed

Ru, Nan; Liu, Sean Shih-Yao; Bai, Yuxing; Li, Song; Liu, Yunfeng; Wei, Xiaoxia

2016-04-01

BoneCeramic (Straumann, Basel, Switzerland) can regenerate bone in alveolar defects after tooth extraction, but it is unknown whether it is feasible to move a tooth through BoneCeramic grafting sites. The objective of this study was to investigate 3-dimensional real-time root resorption and bone responses in grafted sites during orthodontic tooth movement. Sixty 5-week-old rats were randomly assigned to 3 groups to receive BoneCeramic, natural bovine cancellous bone particles (Bio-Oss; Geistlich Pharma, Wolhusen, Switzerland), or no graft, after the extraction of the maxillary left first molar. After 4 weeks, the maxillary left second molar was moved into the extraction site for 28 days. Dynamic bone microstructures and root resorption were evaluated using in-vivo microcomputed tomography. Stress distribution and corresponding tissue responses were examined by the finite element method and histology. Mixed model analysis of variance was performed to compare the differences among time points with Bonferroni post-hoc tests at the significance level of P <0.05. The BoneCeramic group had the least amount of tooth movement and root resorption volumes and craters, and the highest bone volume fraction, trabecular number, and mean trabecular thickness, followed by the Bio-Oss and the control groups. The highest stress accumulated in the cervical region of the mesial roots. BoneCeramic has better osteoconductive potential and induces less root resorption compared with Bio-Oss grafting and naturally recovered extraction sites. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

An evaluation of root resorption after orthodontic treatment.

PubMed

Thomas, E; Evans, W G; Becker, P

2012-08-01

Root resorption is commonly seen, albeit in varying degrees, in cases that have been treated orthodontically. In this retrospective study the objective was to compare the amount of root resorption observed after active orthodontic treatment had been completed with one of three different appliance systems, namely, Tip Edge, Modified Edgewise and Damon. The sample consisted of pre and post-treatment cephalograms of sixty eight orthodontic cases. Root resorption of the maxillary central incisor was assessed from pre- and post- treatment lateral ce phalograms using two methods. In the first, overall tooth length from the incisal edge to the apex was measured on both pre and post-treatment lateral cephalograms and root resorption was recorded as an actual millimetre loss of tooth length. There was a significant upward linear trend (p = 0.052) for root resorption from the Tip Edge Group to the Damon Group. In the second method root resorption was visually evaluated by using the five grade ordinal scale of Levander and Malmgren (1988). It was found that the majorty of cases in the sample came under Grade 1 and Grade 2 category of root resorption. Statistical evaluation tested the extent of agree ment in this study between visual measurements and actual measurements and demonstrated a significant association (p = 0.018) between the methods.

Lithium chloride attenuates root resorption during orthodontic tooth movement in rats.

PubMed

Wang, Yu; Gao, Shang; Jiang, Huan; Lin, Peng; Bao, Xingfu; Zhang, Zhimin; Hu, Min

2014-02-01

Root resorption is a common side effect of orthodontic treatment. In the current study, lithium chloride (LiCl), a Wnt signaling activator, was examined to determine its effect on root resorption. In total, 10 Sprague Dawley rats were randomly allocated into the experimental group (EG) and control group (CG). Each group consisted of five subjects. By using closed nickel-titanium coil springs, a 50-g force was applied between the upper incisors and the maxillary right first molars in order to mimic orthodontic biomechanics in the EG and CG for 14 days. During the 14 days, the EG rats were gavage-fed 200 mg/kg LiCl every 48 h. Next, digital radiographs were captured using a micro-computational tomography scanner. The movement of the maxillary first molars and the root resorption area ratio were measured electronically on the digital radiographs. The outcomes were analyzed using ANOVA. Following 14 days of experimental force application, all rats had spaces of varying sizes between the first and second right maxillary molars. The average distance measured in the CG was slightly higher than in the EG, however, the difference was not found to be statistically significant (P=0.224). Root resorption craters were observed in the groups following the experiment. Rough cementum areas were observed on the mesial surface of the distobuccal and distopalatal roots. The mean root resorption area ratio of CG was significantly greater than EG (P<0.05). Results of the present study indicate that LiCl can attenuate orthodontically induce root resorption during orthodontic tooth movement. The effect of LiCl on tooth movement is insignificant.

Effects of calcitonin on orthodontic tooth movement and associated root resorption in rats.

PubMed

Guan, Ling; Lin, Suai; Yan, Weijun; Chen, Lei; Wang, Xiaofeng

2017-11-01

Our main aim was to evaluate the effects of calcitonin (CT) on orthodontic tooth movement (OTM) and orthodontic root resorption in a rat model. Eighty male Wistar rats were randomly divided into five groups. Rats in the negative control group were not given any appliances or injections. All the remaining rats were used to establish a model of OTM. The positive control group were then injected with normal saline, while rats in the three experimental groups were injected with 0.2 IU, 1 IU or 5 IU/kg/day CT. Nickel-titanium closed-coil springs were used to deliver an initial 50 g mesial force to the left maxillary first molar for 14 days in rats in the positive control group and the experimental groups. Each group was randomly subdivided into two groups, one for analysis of tooth movement, tissue changes and tartrate-resistant acid phosphatase (TRAP)-positive cells in alveolar bone, the other to examine root resorption by scanning electron microscopy. The OTM distance, the number of force-induced osteoclasts and root resorption areas were significantly decreased in CT-injected rats in a dose-dependent manner. Administration of CT reduces the root resorption area and may therefore be effective as a novel adjunctive orthodontic approach to diminish undesired tooth movement via enhancing anchorage or preventing relapse after OTM.

The relationship between apical root resorption and orthodontic tooth movement in growing subjects.

PubMed

Xu, Tianmin; Baumrind, S

2002-07-01

To investigate the relationship between apical root resorption and orthodontic tooth movement in growing subjects. 58 growing subjects were collected randomly into the study sample and another 40 non-treated cases were used as control. The apical resoption of the upper central incisors was measured on periapical film and the incisor displacement was measured on lateral cephalogram. Using multiple linear regression analysis to examine the relationship between root resoption and the displacement of the upper incisor apex in each of four direction (retraction, advancement, intrusion and extrusion). The statistically significant negative association were found between resorption and both intrusion (P < 0.001) and extrusion (P < 0.05), but no significant association was found between resorption and both retraction and advancement. The regression analysis implied an average of 2.29 mm resorption in the absence of apical displacement. The likelihood that the magnitude of displacement of the incisor root is positively associated with root resoption in the population of treated growing subjects is very small.

Effects of corticopuncture (CP) and low-level laser therapy (LLLT) on the rate of tooth movement and root resorption in rats using micro-CT evaluation.

PubMed

Suzuki, Selly Sayuri; Garcez, Aguinaldo Silva; Reese, Patricia Oblitas; Suzuki, Hideo; Ribeiro, Martha Simões; Moon, Won

2018-05-01

The aim of this study was to compare the rate of tooth displacement, quantity of root resorption, and alveolar bone changes in five groups: corticopuncture (CP), low-level laser therapy (LLLT), CP combined with LLLT (CP + LLLT), control (C), and negative control (NC). A total of 60 half-maxilla from 30 male Wistar rats (10 weeks old) were divided randomly into five groups: three (CP, LLLT, and CP + LLLT) test groups with different stimulation for accelerated-tooth-movement (ATM), one control (C) group, and one negative control (NC) group with no tooth movement. Nickel-titanium coil springs with 50 g of force were tied from the upper left and right first molars to micro-implants placed behind the maxillary incisors. For the CP and CP + LLLT groups, two perforations in the palate and one mesially to the molars were performed. For the LLLT and CP + LLLT groups, GaAlAs diode laser was applied every other day for 14 days (810 nm, 100 mW, 15 s). The tooth displacements were measured directly from the rat's mouth and indirectly from microcomputer (micro-CT) tomographic images. Bone responses at the tension and compression sites and root resorption were analyzed from micro-CT images. The resulting alveolar bone responses were evaluated by measuring bone mineral density (BMD), bone volume fraction (BV/TV), and trabecular thickness (TbTh). Root resorption crater volumes were measured on both compression and tension sides of mesial and distal buccal roots. The tooth displacement in the CP + LLLT group was the greatest when measured clinically, followed by the CP, LLLT, and control groups (C and NC), respectively (p <0.05). The tooth movements measured from micro-CT images showed statistically higher displacement in the CP and CP + LLLT groups compared to the LLLT and control groups. The BMD, BV/TV, and TbTh values were lower at the compression side and higher at the tension side for all three test groups compared to the control group. The root resorption crater volume of the distal buccal root was higher in the control group, followed by CP, LLLT, and CP + LLLT, mostly at the compression site. Combining corticopuncture and low-level laser therapy (CP + LLLT) produced more tooth displacement and less root resorption at the compression side. The combined technique also promoted higher alveolar bone formation at the tension side.

A posteriori registration and subtraction of periapical radiographs for the evaluation of external apical root resorption after orthodontic treatment.

PubMed

Kreich, Eliane Maria; Chibinski, Ana Cláudia; Coelho, Ulisses; Wambier, Letícia Stadler; Zedebski, Rosário de Arruda Moura; de Moraes, Mari Eli Leonelli; de Moraes, Luiz Cesar

2016-03-01

This study employed a posteriori registration and subtraction of radiographic images to quantify the apical root resorption in maxillary permanent central incisors after orthodontic treatment, and assessed whether the external apical root resorption (EARR) was related to a range of parameters involved in the treatment. A sample of 79 patients (mean age, 13.5±2.2 years) with no history of trauma or endodontic treatment of the maxillary permanent central incisors was selected. Periapical radiographs taken before and after orthodontic treatment were digitized and imported to the Regeemy software. Based on an analysis of the posttreatment radiographs, the length of the incisors was measured using Image J software. The mean EARR was described in pixels and relative root resorption (%). The patient's age and gender, tooth extraction, use of elastics, and treatment duration were evaluated to identify possible correlations with EARR. The mean EARR observed was 15.44±12.1 pixels (5.1% resorption). No differences in the mean EARR were observed according to patient characteristics (gender, age) or treatment parameters (use of elastics, treatment duration). The only parameter that influenced the mean EARR of a patient was the need for tooth extraction. A posteriori registration and subtraction of periapical radiographs was a suitable method to quantify EARR after orthodontic treatment, and the need for tooth extraction increased the extent of root resorption after orthodontic treatment.

Evaluating the Amount of Tooth Movement and Root Resorption during Canine Retraction with Friction versus Frictionless Mechanics Using Cone Beam Computed Tomography

PubMed Central

Makhlouf, Mohamed; Aboul–Ezz, Amr; Fayed, Mona Salah; Hafez, Hend

2018-01-01

BACKGROUND: The current study was carried out to compare the amount of tooth movement during canine retraction comparing two different retraction mechanics; friction mechanics represented by a NiTi closed coil spring versus frictionless mechanics represented by T - loop, and their effect on root resorption using Cone Beam Computed Tomography (CBCT). METHOD: Ten patients were selected in a split-mouth study design that had a malocclusion that necessitates the extraction of maxillary first premolars and retraction of maxillary canines. The right maxillary canines were retracted using T - loops fabricated from 0.017 X 0.025 TMA wires. The left maxillary canines received NiTi coil spring with 150 gm of retraction force. Pre retraction and post retraction Cone Beam Computed Tomography were taken to evaluate the amount of tooth movement and root resorption using three-dimensional planes. RESULTS: T - loop side showed statistically significant higher mean anteroposterior measurement than NiTi coil spring side, indicating a lower amount of canine movement pre and post a canine retraction. Concerning the root resorption, there was no statistically significant change in the mean measurements of canine root length post retraction. CONCLUSION: The NiTi coil spring side showed more distal movement more than the T-loop side. Both retraction mechanics with controlled retraction force, do not cause root resorption. PMID:29531610

Evaluating the Amount of Tooth Movement and Root Resorption during Canine Retraction with Friction versus Frictionless Mechanics Using Cone Beam Computed Tomography.

PubMed

Makhlouf, Mohamed; Aboul-Ezz, Amr; Fayed, Mona Salah; Hafez, Hend

2018-02-15

The current study was carried out to compare the amount of tooth movement during canine retraction comparing two different retraction mechanics; friction mechanics represented by a NiTi closed coil spring versus frictionless mechanics represented by T - loop, and their effect on root resorption using Cone Beam Computed Tomography (CBCT). Ten patients were selected in a split-mouth study design that had a malocclusion that necessitates the extraction of maxillary first premolars and retraction of maxillary canines. The right maxillary canines were retracted using T - loops fabricated from 0.017 X 0.025 TMA wires. The left maxillary canines received NiTi coil spring with 150 gm of retraction force. Pre retraction and post retraction Cone Beam Computed Tomography were taken to evaluate the amount of tooth movement and root resorption using three-dimensional planes. T - loop side showed statistically significant higher mean anteroposterior measurement than NiTi coil spring side, indicating a lower amount of canine movement pre and post a canine retraction. Concerning the root resorption, there was no statistically significant change in the mean measurements of canine root length post retraction. The NiTi coil spring side showed more distal movement more than the T-loop side. Both retraction mechanics with controlled retraction force, do not cause root resorption.

Effects of pulpectomy on the amount of root resorption during orthodontic tooth movement.

PubMed

Kaku, Masato; Sumi, Hiromi; Shikata, Hanaka; Kojima, Shunichi; Motokawa, Masahide; Fujita, Tadashi; Tanimoto, Kotaro; Tanne, Kazuo

2014-03-01

Previous studies have revealed that orthodontic force affects dental pulp via the rupture of blood vessels and vacuolization of pulp tissues. We hypothesized that pulp tissues express inflammatory cytokines and regulators of odontoclast differentiation after excess orthodontic force. The purpose of this study was to investigate the effects of tensile force in human pulp cells and to measure inflammatory root resorption during tooth movement in pulpless rat teeth. After cyclic tensile force application in human pulp cells, gene expression and protein concentration of macrophage colony-stimulating factor, receptor activator of nuclear factor kappa-B ligand, interleukin-1 beta, and tumor necrosis factor alpha were determined by real-time polymerase chain reaction and enzyme-linked immunoassay. Moreover, the role of the stretch-activated channel was evaluated by gadolinium (Gd(3+)) treatment. The upper right first molars of 7-week Wistar rats were subjected to pulpectomy and root canal filling followed by mesial movement for 6 months. The expression of cytokine messenger RNAs and proteins in the experimental group peaked with loading at 10-kPa tensile force after 48 hours (P < .01). Gd(3+) reduced the expression of these cytokine messenger RNAs and protein concentrations (P < .01). The amount of inflammatory root resorption was significantly larger in the control teeth than the pulpectomized teeth (P < .05). This study shows that tensile forces in the pulp cells enhance the expression of various cytokines via the S-A channel, which may lead to inflammatory root resorption during tooth movement. It also suggests that root canal treatment is effective for progressive severe inflammatory root resorption during tooth movement. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

A posteriori registration and subtraction of periapical radiographs for the evaluation of external apical root resorption after orthodontic treatment

PubMed Central

Chibinski, Ana Cláudia; Coelho, Ulisses; Wambier, Letícia Stadler; Zedebski, Rosário de Arruda Moura; de Moraes, Mari Eli Leonelli; de Moraes, Luiz Cesar

2016-01-01

Purpose This study employed a posteriori registration and subtraction of radiographic images to quantify the apical root resorption in maxillary permanent central incisors after orthodontic treatment, and assessed whether the external apical root resorption (EARR) was related to a range of parameters involved in the treatment. Materials and Methods A sample of 79 patients (mean age, 13.5±2.2 years) with no history of trauma or endodontic treatment of the maxillary permanent central incisors was selected. Periapical radiographs taken before and after orthodontic treatment were digitized and imported to the Regeemy software. Based on an analysis of the posttreatment radiographs, the length of the incisors was measured using Image J software. The mean EARR was described in pixels and relative root resorption (%). The patient's age and gender, tooth extraction, use of elastics, and treatment duration were evaluated to identify possible correlations with EARR. Results The mean EARR observed was 15.44±12.1 pixels (5.1% resorption). No differences in the mean EARR were observed according to patient characteristics (gender, age) or treatment parameters (use of elastics, treatment duration). The only parameter that influenced the mean EARR of a patient was the need for tooth extraction. Conclusion A posteriori registration and subtraction of periapical radiographs was a suitable method to quantify EARR after orthodontic treatment, and the need for tooth extraction increased the extent of root resorption after orthodontic treatment. PMID:27051635

Comprehensive therapy of a fusion between a mandibular lateral incisor and supernumerary tooth: case report.

PubMed

Onçag, Ozant; Candan, Umit; Arikan, Fatih

2005-08-01

The term fusion is used to define a developmental anomaly characterised by the union of two adjacent teeth. In the case reported here, clinical and radiographic examinations suggested a unilateral fusion between the mandibular left permanent incisor and a super-numerary tooth. Radiographs showed that the fused teeth had two distinct pulp chambers and canals. A diagnosis of chronic periapical abscess of the supernumerary tooth was made. Before root canal therapy, a periodontal surgical procedure was performed to section the central incisor and its fused supernumerary. Also, odontoplasty was performed on the roots, to establish an anatomy consistent with a normal central incisor. Later, the chronic apical abscess on the supernumerary tooth was instrumented chemo-mechanically, root canal filling was performed and an anterior composite resin restoration was placed. The patient was evaluated for one year after root canal therapy. The tooth was asymptomatic, not exhibiting any pathological root resorption or alveolar resorption, and the anterior composite restoration was intact. Instead of extracting the supernumerary tooth, the application of endodontic, periodontal, and restorative procedures proved to be an alternative treatment.

The effect of photobiomodulation on root resorption during orthodontic treatment.

PubMed

Nimeri, Ghada; Kau, Chung H; Corona, Rachel; Shelly, Jeffery

2014-01-01

Photobiomodulation is used to accelerate tooth movement during orthodontic treatments. The changes in root morphology in a group of orthodontic patients who received photobiomodulation were evaluated using the cone beam computed tomography technique. The device used is called OrthoPulse, which produces low levels of light with a near infrared wavelength of 850 nm and an intensity of 60 mW/cm(2) continuous wave. Twenty orthodontic patients were recruited for these experiments, all with class 1 malocclusion and with Little's Irregularity Index (>2 mm) in either of the arches. Root resorption was detected by measuring changes in tooth length using cone beam computed tomography. These changes were measured before the orthodontic treatment and use of low-level laser therapy and after finishing the alignment level. Little's Irregularity Index for all the patients was calculated in both the maxilla and mandible and patients were divided into three groups for further analysis, which were then compared to the root resorption measurements. Our results showed that photobiomodulation did not cause root resorption greater than the normal range that is commonly detected in orthodontic treatments. Furthermore, no correlation between Little's Irregularity Index and root resorption was detected.

The effect of photobiomodulation on root resorption during orthodontic treatment

PubMed Central

Nimeri, Ghada; Kau, Chung H; Corona, Rachel; Shelly, Jeffery

2014-01-01

Photobiomodulation is used to accelerate tooth movement during orthodontic treatments. The changes in root morphology in a group of orthodontic patients who received photobiomodulation were evaluated using the cone beam computed tomography technique. The device used is called OrthoPulse, which produces low levels of light with a near infrared wavelength of 850 nm and an intensity of 60 mW/cm2 continuous wave. Twenty orthodontic patients were recruited for these experiments, all with class 1 malocclusion and with Little’s Irregularity Index (>2 mm) in either of the arches. Root resorption was detected by measuring changes in tooth length using cone beam computed tomography. These changes were measured before the orthodontic treatment and use of low-level laser therapy and after finishing the alignment level. Little’s Irregularity Index for all the patients was calculated in both the maxilla and mandible and patients were divided into three groups for further analysis, which were then compared to the root resorption measurements. Our results showed that photobiomodulation did not cause root resorption greater than the normal range that is commonly detected in orthodontic treatments. Furthermore, no correlation between Little’s Irregularity Index and root resorption was detected. PMID:24470774

In vivo microcomputed tomography evaluation of rat alveolar bone and root resorption during orthodontic tooth movement.

PubMed

Ru, Nan; Liu, Sean Shih-Yao; Zhuang, Li; Li, Song; Bai, Yuxing

2013-05-01

To observe the real-time microarchitecture changes of the alveolar bone and root resorption during orthodontic treatment. A 10 g force was delivered to move the maxillary left first molars mesially in twenty 10-week-old rats for 14 days. The first molar and adjacent alveolar bone were scanned using in vivo microcomputed tomography at the following time points: days 0, 3, 7, and 14. Microarchitecture parameters, including bone volume fraction, structure model index, trabecular thickness, trabecular number, and trabecular separation of alveolar bone, were measured on the compression and tension side. The total root volume was measured, and the resorption crater volume at each time point was calculated. Univariate repeated measures analysis of variance with Bonferroni corrections were performed to compare the differences in each parameter between time points with significance level at P < .05. From day 3 to day 7, bone volume fraction, structure model index, trabecular thickness, and trabecular separation decreased significantly on the compression side, but the same parameters increased significantly on the tension side from day 7 to day 14. Root resorption volume of the mesial root increased significantly on day 7 of orthodontic loading. Real-time root and bone resorption during orthodontic movement can be observed in 3 dimensions using in vivo micro-CT. Alveolar bone resorption and root resorption were observed mostly in the apical third on day 7 on the compression side; bone formation was observed on day 14 on the tension side during orthodontic tooth movement.

Interrupted orthodontic force results in less root resorption than continuous force in human premolars as measured by microcomputed tomography.

PubMed

Sawicka, Monika; Bedini, Rossella; Wierzbicki, Piotr M; Pameijer, Cornelis H

2014-01-01

Root resorption is an undesirable but very frequently occurring sequel of orthodontic treatment. The aim of this study was to compare root resorption caused by either continuous (CF) or interrupted (IF) orthodontic force. The study was performed on human subjects on 30 first upper and lower premolars scheduled for extraction for orthodontic reasons. During four weeks before extraction 12 teeth were subjected to either CF or IF. The force was generated by a segmental titanium-molybdenum alloy cantilever spring that was activated in buccal direction. Initially a force of 60 CentiNewton was used in both CF and IF groups, the force in the former, however, was reactivated every week for 4 weeks. There was no reactivation of force in the IF group after initial application. A morphometric analysis of root resorption was performed by microcomputed tomography and the extent of tooth movement was measured on stone casts. Furthermore, a Tartarate-Resistant Acidic Phosphatase activity (TRAP), the marker enzyme of osteoclasts and cementoclasts, was determined by histochemical method. The Mann-Whitney U test was used to compare the difference in measured parameters between treatment and control tooth groups. The number of resorption craters was significantly higher and their average volume almost twice as large in the CF compared to the IF group (p < 0.05). However, the distance of tooth displacement was similar for both groups. Cementoclasts were detected with the TRAP technique on the surface of two teeth only; both were subjected to continuous force. The use of IF leads to less destruction of root structure as opposed to continuous force while the same tooth movement was achieved.

Determination of orthodontic tooth movement and tissue reaction following demineralized freeze-dried bone allograft grafting intervention

PubMed Central

Seifi, Massoud; Ghoraishian, Seyed Ahmad

2012-01-01

Background: Socket preservation after tooth extraction is one of the indications of bone grafting to enhance preorthodontic condition. The aim of this study is to determine the effects of socket preservation on the immediate tooth movement, alveolar ridge height preservation and orthodontic root resorption. Materials and Methods: In a split-mouth technique, twelve sites in three dogs were investigated as an experimental study. Crushed demineralized freeze-dried bone allograft (DFDBA) (CenoBone®) was used as the graft material. The defects were made by the extraction of 3rd premolar. On one side of each jaw, the defects were preserved by DFDBA and defects of the other side left opened as the control group. Simultaneously the teeth adjacent to the defects were pulled together by a NiTi coil spring. After eight weeks, the amount of (OTM), alveolar height, and root resorption were measured. Analysis of variance was used for purpose of comparison. Results: There was a slight increase in OTM at grafted sites as they were compared to the control sites (P<0.05). Also a significant bone resorption in control site and successful socket preservation in experimental site were observed. Reduction of root resorption at the augmented site was significant compared to the normal healing site (P<0.05). Conclusion: Using socket preservation, tooth movement can be immediately started without waiting for the healing of the recipient site. This can provide some advantages like enhanced rate of OTM, its approved effects on ridge preservation that reduces the chance of dehiscence and the reduction of root resorption. PMID:22623939

Single tooth torque correction in the lower frontal area by a completely customized lingual appliance.

PubMed

Jacobs, Collin; Katzorke, Milena; Wiechmann, Dirk; Wehrbein, Heiner; Schwestka-Polly, Rainer

2017-10-10

Aim of this study was to analyze the efficacy and precision of the completely customized lingual appliance (CCLA) regarding the single tooth torque correction. The study also examined external apical root resorptions as possible side effects of torque correction and the changings of the periodontal situation. A case series of three patients were included. The patients showed a single tooth torque problem with a gingival recession and were treated with the CCLA. Plaster casts before and after treatment and plaster casts of the set up were scanned and superimposed. Deviations between the two plaster casts were analyzed at different points of interest. Changes of the gingival recession were compared before and after treatment. Relative root resorptions were measured by the orthopantomograms. Treatment times were assessed by the records of the patients. Results were presented descriptively. The mean change of the most apical part of the root reached by the orthodontic treatment was 1.8 ± 0.3 mm. The largest deviation between set up and final model was measured on the occlusal surface of the tooth 36 with 0.8 mm. Most measurement points showed a deviation of 0.5 mm or less. The depths of the gingival recession showed a significant reduction of 4.7 mm. The widths of the gingival recession were reduced by 1.1 mm. The average relative root resorption of the corrected teeth was 2.7 ± 1.5%. The average treatment time was 13.8 ± 4.5 months. This is the first study showing that the CCLA with its high precision is very effective in correcting single tooth torque problems. Orthodontic torque correction resulted in a significant reduction of gingival recessions and caused only negligible root resorptions.

Three-year follow-up results for non-surgical root canal therapy of idiopathic external root resorption on a maxillary canine with MTA: a case report

PubMed Central

Huang, Zheng; Chen, Li-Li; Wang, Cong-Yi; Dai, Lin; Cheng, Bo; Sun, Jun; Sun, Jun

2014-01-01

External root resorption (ERR) is an uncommon and intractable disease. Treatment alternatives are case-dependant and aim for the repair of the resorptive lesion and long-term retention of the tooth. A forty-year-old Asian female was diagnosed with idiopathic ERR on tooth #11 (the left maxillary canine) by CBCT. Non-surgical root canal therapy was completed with the aid of an operating microscope. The apical third of the root canal was filled with warm gutta-percha and the resorption defect was filled with mineral trioxide aggregate (MTA). The periapical radiographs were taken immediately after operation, one-month follow-up, six-month follow-up and three-year follow-up, respectively. Clinically, the canine was asymptomatic, and no evidence of any further resorption was found. The six-month follow-up radiograph showed initial healing of the bony lesion, while the three-year follow-up radiograph manifested almost complete healing. MTA can be a superior material to be successfully used in the non-surgical treatment of ERR. CBCT is very useful for evaluating the true nature and severity of absorption lesions in root resorption. It is the first complete case report from China about non-surgical treatment of severe ERR along with a relatively long term follow-up. PMID:25031758

Intracanal bisphosphonate does not inhibit replacement resorption associated with delayed replantation of monkey incisors.

PubMed

Thong, Yo Len; Messer, Harold H; Zain, Rosnah Binti; Saw, Lip Hean; Yoong, Lai Thong

2009-08-01

Progressive replacement resorption following delayed replantation of avulsed teeth has proved to be an intractable clinical problem. A wide variety of therapeutic approaches have failed to result in the predictable arrest of resorption, with a good long-term prognosis for tooth survival. Bisphosphonates are used in the medical management of a range of bone disorders and topically applied bisphosphonate has been reported to inhibit root resorption in dogs. This study evaluated the effectiveness of a bisphosphonate (etidronate disodium) as an intracanal medicament in the root canals of avulsed monkey teeth, placed before replantation after 1 h of extraoral dry storage. Incisors of six Macaca fascicularis monkeys were extracted and stored dry for 1 h. Teeth were then replanted after canal contamination with dental plaque (negative control) or after root canal debridement and placement of etidronate sealed in the canal space. A positive control of calcium hydroxide placed 8-9 days after replantation was also included. All monkeys were sacrificed 8 weeks later and block sections were prepared for histomorphometric assessment of root resorption and periodontal ligament status. Untreated teeth showed the greatest extent of root resorption (46% of the root surface), which was predominantly inflammatory in nature. Calcium hydroxide treated teeth showed the lowest overall level of resorption (<30% of the root surface), while the bisphosphonate-treated group was intermediate (39%). Ankylosis, defined as the extent of the root surface demonstrating direct bony union to both intact and resorbed root surface, was the lowest in the untreated control group (15% of the root surface), intermediate in the calcium hydroxide group (27%) and the highest in the bisphosphonate group (41%). Bony attachment to the tooth root was divided approximately equally between attachment to intact cementum and to previously resorbed dentin. Overall, bisphosphonate resulted in a worse outcome than calcium hydroxide in terms of both root resorption and ankylosis.

Comparisons of orthodontic root resorption under heavy and jiggling reciprocating forces during experimental tooth movement in a rat model.

PubMed

Hikida, Takuji; Yamaguchi, Masaru; Shimizu, Mami; Kikuta, Jun; Yoshino, Tomokazu; Kasai, Kazutaka

2016-07-01

Root mobility due to reciprocating movement of the tooth (jiggling) may exacerbate orthodontic root resorption (ORR). "Jiggling" describes mesiodistal or buccolingual movement of the roots of the teeth during orthodontic treatment. In the present study, buccolingual movement is described as "jiggling." We aimed to investigate the relationship between ORR and jiggling and to test for positive cell expression in odontoclasts in resorbed roots during experimental tooth movement (jiggling) in vivo. Male Wistar rats were divided into control, heavy force (HF), optimal force (OF), and jiggling force (JF) groups. The expression levels of cathepsin K, matrix metalloproteinase (MMP)-9 protein, interleukin (IL)-6, cytokine-induced neutrophil chemoattractant 1 (CINC-1; an IL-8-related protein in rodents), receptor activator of nuclear factor κB ligand (RANKL), and osteoprotegerin protein in the dental root were determined using immunohistochemistry. On day 21, a greater number of root resorption lacunae, which contained multinucleated odontoclasts, were observed in the palatal roots of rats in the JF group than in rats from other groups. Furthermore, there was a significant increase in the numbers of cathepsin K-positive and MMP-9-positive odontoclasts in the JF group on day 21. Immunoreactivities for IL-6, CINC-1, and RANKL were stronger in resorbed roots exposed to jiggling than in the other groups on day 21. Negative reactivity was observed in the controls. These results suggest that jiggling may induce ORR via inflammatory cytokine production during orthodontic tooth movement, and that jiggling may be a risk factor for ORR.

Comparisons of orthodontic root resorption under heavy and jiggling reciprocating forces during experimental tooth movement in a rat model

PubMed Central

Hikida, Takuji; Shimizu, Mami; Kikuta, Jun; Yoshino, Tomokazu; Kasai, Kazutaka

2016-01-01

Objective Root mobility due to reciprocating movement of the tooth (jiggling) may exacerbate orthodontic root resorption (ORR). "Jiggling" describes mesiodistal or buccolingual movement of the roots of the teeth during orthodontic treatment. In the present study, buccolingual movement is described as "jiggling." We aimed to investigate the relationship between ORR and jiggling and to test for positive cell expression in odontoclasts in resorbed roots during experimental tooth movement (jiggling) in vivo. Methods Male Wistar rats were divided into control, heavy force (HF), optimal force (OF), and jiggling force (JF) groups. The expression levels of cathepsin K, matrix metalloproteinase (MMP)-9 protein, interleukin (IL)-6, cytokine-induced neutrophil chemoattractant 1 (CINC-1; an IL-8-related protein in rodents), receptor activator of nuclear factor κB ligand (RANKL), and osteoprotegerin protein in the dental root were determined using immunohistochemistry. Results On day 21, a greater number of root resorption lacunae, which contained multinucleated odontoclasts, were observed in the palatal roots of rats in the JF group than in rats from other groups. Furthermore, there was a significant increase in the numbers of cathepsin K-positive and MMP-9-positive odontoclasts in the JF group on day 21. Immunoreactivities for IL-6, CINC-1, and RANKL were stronger in resorbed roots exposed to jiggling than in the other groups on day 21. Negative reactivity was observed in the controls. Conclusions These results suggest that jiggling may induce ORR via inflammatory cytokine production during orthodontic tooth movement, and that jiggling may be a risk factor for ORR. PMID:27478800

Effect of gingival fibroblasts and ultrasound on dogs' root resorption during orthodontic treatment.

PubMed

Crossman, Jacqueline; Hassan, Ali H; Saleem, Ali; Felemban, Nayef; Aldaghreer, Saleh; Fawzi, Elham; Farid, Mamdouh; Abdel-Ghaffar, Khaled; Gargoum, Ausama; El-Bialy, Tarek

2017-01-01

To investigate the effect of using osteogenic induced gingival fibroblasts (OIGFs) and low intensity pulsed ultrasound (LIPUS) on root resorption lacunae volume and cementum thickness in beagle dogs that received orthodontic tooth movement. Seven beagle dogs were used, from which gingival cells (GCs) were obtained and were induced osteogenically to produce OIGFs. Each third and fourth premolar was randomly assigned to one of the five groups, namely, LIPUS, OIGFs, bone morphogenetic protein-2 (BMP-2), OIGFs + LIPUS, and control. All groups received 4 weeks of bodily tooth movement, then LIPUS-treated groups received LIPUS for 20 min/day for 4 weeks, and OIGFs groups received an injection of OIGFs near the root apex. Microcomputed tomography analysis was used to calculate root resorption lacunae volume and histomorphometric analysis was performed to measure the cementum thickness of each root at 3 root levels on compression and tension sides. There was no significant difference in resorption volume between the treatment groups. OIGFs + LIPUS increased cementum thickness ( P > 0.05) in third premolars near the apex, and LIPUS increased cementum thickness ( P > 0.05) in fourth premolars near the apex. Furthermore, BMP2 increased cementum thickness at the coronal third at the compression side. OIGFs, LIPUS, and BMP-2 can be potential treatments for orthodontically induced root resorption, however, improvements in experimental design and treatment parameters are required to further investigate these repair modalities.

The Effect of Thyroid Hormone, Prostaglandin E2, and Calcium Gluconate on Orthodontic Tooth Movement and Root Resorption in Rats.

PubMed

Seifi, Massoud; Hamedi, Roya; Khavandegar, Zohre

2015-03-01

A major objective of investigators is to clarify the role of metabolites in achievement of maximum tooth movement with minimal root damage during orthodontic tooth movement (OTM). The aim of this study was to determine the effect of administration of thyroid hormone, prostaglandin E2, and calcium on orthodontic tooth movement and root resorption in rats. Sixty four male Wistar rats were randomly divided into 8 groups of eight rats each: 1- 20µg/kg thyroxine was injected in traperitoneally after installation of the orthodontic appliance.  2- 0.1 ml of 1 mg/ml prostaglandin E2 was injected submucosally.  3- 10% (200 mg/kg) calcium gluconate was injected.  4- Prostaglandin E2 was injected submucosally and 10% calcium was injected intraperitoneally.  5- Thyroxine was injected intraperitoneally and prostaglandin E2 was injected submucosally.  6- 20µg/kg thyroxine with calcium was injected. 7- Prostaglandin E2 was injected submucosally with calcium and thyroxine.  8- Distilled water was used in control group. The orthodontic appliances comprised of a NiTi closed coil were posteriorly connected to the right first molar and anteriorly to the upper right incisor. OTM was measured with a feeler gauge. The mid-mesial root of the first molar and the adjacent tissues were histologically evaluated. The Data were analyzed by one-way ANOVA and Student-Newman-Keuls test. The highest mean OTM was observed in the thyroxine and prostaglandin E2 group (Mean±SD = 0.7375±0.1359 mm) that was significantly different (p< 0.05). A significant difference (p< 0.05) in root resorption was observed between the prostaglandin E2 (0.0192±0.0198 mm(2)) and the other groups. It seems that the combination of thyroxine and prostaglandin E2, with a synergistic effect, would decrease the root resorption and increase the rate of orthodontic tooth movement in rats.

Regular nicotine intake increased tooth movement velocity, osteoclastogenesis and orthodontically induced dental root resorptions in a rat model

PubMed Central

Kirschneck, Christian; Maurer, Michael; Wolf, Michael; Reicheneder, Claudia; Proff, Peter

2017-01-01

Orthodontic forces have been reported to significantly increase nicotine-induced periodontal bone loss. At present, however, it is unknown, which further (side) effects can be expected during orthodontic treatment at a nicotine exposure corresponding to that of an average European smoker. 63 male Fischer344 rats were randomized in three consecutive experiments of 21 animals each (A/B/C) to 3 experimental groups (7 rats, 1/2/3): (A) cone-beam-computed tomography (CBCT); (B) histology/serology; (C) reverse-transcription quantitative real-time polymerase chain reaction (RT-qPCR)/cotinine serology—(1) control; (2) orthodontic tooth movement (OTM) of the first and second upper left molar (NiTi closed coil spring, 0.25 N); (3) OTM with 1.89 mg·kg−1 per day s.c. of L(−)-nicotine. After 14 days of OTM, serum cotinine and IL-6 concentration as well as orthodontically induced inflammatory root resorption (OIIRR), osteoclast activity (histology), orthodontic tooth movement velocity (CBCT, within 14 and 28 days of OTM) and relative gene expression of known inflammatory and osteoclast markers were quantified in the dental-periodontal tissue (RT–qPCR). Animals exposed to nicotine showed significantly heightened serum cotinine and IL-6 levels corresponding to those of regular European smokers. Both the extent of root resorption, osteoclast activity, orthodontic tooth movement and gene expression of inflammatory and osteoclast markers were significantly increased compared to controls with and without OTM under the influence of nicotine. We conclude that apart from increased periodontal bone loss, a progression of dental root resorption and accelerated orthodontic tooth movement are to be anticipated during orthodontic therapy, if nicotine consumption is present. Thus patients should be informed about these risks and the necessity of nicotine abstinence during treatment. PMID:28960194

The relationships between the arrangement of teeth, root resorption, and dental maturity in bovine mandibular incisors

PubMed Central

An, Jin-kyu; Ono, Takashi

2017-01-01

Objective The objective of this study is to investigate the eruption pattern and root resorption of the bovine anterior dentition in relation to growth-related parameters based on dental maturity. Methods A cross-sectional study was conducted on 110 bovine anterior mandibles by using standard radiography, cone-beam computed tomography (CBCT), and actual measurements. We determined the relationships between the stages of dental maturity by using a modification of Demirjian's method and various growth-related parameters, such as the activity of the root-resorbing tissue and mobility of the deciduous teeth. The correlation of growth-related parameters with interdental spacing and distal unusual root resorption (DRR) of the deciduous fourth incisor was assessed. The cause of mesial unusual root resorption (MRR) of the deciduous fourth incisor was determined on the basis of the arrangement of the permanent third incisor. Results An independent t-test and chi-square test indicated significant differences in growth-related parameters associated with dental arch length discrepancy and factors related to the shedding of deciduous teeth between the low and high dental maturity groups. The samples with interdental spacing and DRR showed a larger sum of mesiodistal permanent crown widths and higher dental maturity than did the respective controls. Samples with MRR tended to show a lingually rotated distal tip of the adjacent tooth crown. Conclusions Dental maturity has relevance to the interdental spaces and unusual root resorption of mixed dentition. The position of the adjacent tooth crown on CBCT may be correlated with the occurrence of unusual root resorption of the incisor. PMID:29090124

Effects of low-level laser therapy on orthodontic tooth movement and root resorption after artificial socket preservation.

PubMed

Seifi, Massoud; Atri, Faezeh; Yazdani, Mohammad Masoud

2014-01-01

Low- level laser therapy has been used to stimulate the orthodontic tooth movements (OTM) previously. Furthermore, in the orthodontic treatments accompanying tooth extractions, the adjacent teeth move towards the extraction sites and close the space in some cases. Then, the adjacent tooth movements must be prevented in the treatments requiring space. Laser stimulates and at some doses decelerates tooth movement; it also improves healing process and enhances osteogenesis. Hence, it can prevent movement by osteogenesis adjacent to the tooth. The present study investigated the effects of low-level laser therapy on the OTM and root resorption following artificial socket preservation. In this experimental animal trial, 16 male albino rabbits were selected with similar characteristics and randomly divided in two groups. Under general anesthesia, an artificial socket, 8 mm in height, was created in the mesial aspect of the first premolars of the rabbits and filled with demineralized freeze dried bone allograft (DFDBA). The first premolars were connected to the incisors using nickel titanium coil springs. In experimental group, gallium-aluminum-arsenide (GaAlAs) laser was irritated mesial to first premolar where artificial socket was created continuously (808 nm). The cycle was 10 days irritation, 14 days rest, 10 days irritation, 14 days rest (Biostimulation mode). Control group was not laser irradiated. All animals were sacrificed after 48 days and the distance between the distal aspect of the first premolars, and the mesial surface of the second premolars was measured with leaf gauge. The specimens underwent histological assessments. Integrity of root and its resorption was observed under microscope calibration. The size of resorption lacunae was calculated in mm(2). Normality of data was proved according to Kolmogorov-Smirnov analysis, and Student's t-test was done. P value less than 0.05 was considered as significant. The mean OTM were 5.68 ± 1.21 mm in the control group and 6.0 ± 0.99 mm in the laser irradiated teeth with no statistically significant differences(P > 0.75). The mean root resorption was 1.61 ± 0.43 mm(2) and 0.18 ± 0.07 mm(2) in the control and experimental groups respectively being significantly lower in the laser irradiated teeth (P < 0.0001). The findings of the present study show that GaAlAs irradiation together with the application of DFDBA led to limited amount of the stimulated OTM. The laser beam irradiation in combination with alloplastic materials used for socket preservation could reduce the degree of root resorption significantly.

Effect of gingival fibroblasts and ultrasound on dogs' root resorption during orthodontic treatment

PubMed Central

Crossman, Jacqueline; Hassan, Ali H; Saleem, Ali; Felemban, Nayef; Aldaghreer, Saleh; Fawzi, Elham; Farid, Mamdouh; Abdel-Ghaffar, Khaled; Gargoum, Ausama; El-Bialy, Tarek

2017-01-01

Objectives: To investigate the effect of using osteogenic induced gingival fibroblasts (OIGFs) and low intensity pulsed ultrasound (LIPUS) on root resorption lacunae volume and cementum thickness in beagle dogs that received orthodontic tooth movement. Materials and Methods: Seven beagle dogs were used, from which gingival cells (GCs) were obtained and were induced osteogenically to produce OIGFs. Each third and fourth premolar was randomly assigned to one of the five groups, namely, LIPUS, OIGFs, bone morphogenetic protein-2 (BMP-2), OIGFs + LIPUS, and control. All groups received 4 weeks of bodily tooth movement, then LIPUS-treated groups received LIPUS for 20 min/day for 4 weeks, and OIGFs groups received an injection of OIGFs near the root apex. Microcomputed tomography analysis was used to calculate root resorption lacunae volume and histomorphometric analysis was performed to measure the cementum thickness of each root at 3 root levels on compression and tension sides. Results: There was no significant difference in resorption volume between the treatment groups. OIGFs + LIPUS increased cementum thickness (P > 0.05) in third premolars near the apex, and LIPUS increased cementum thickness (P > 0.05) in fourth premolars near the apex. Furthermore, BMP2 increased cementum thickness at the coronal third at the compression side. Conclusion: OIGFs, LIPUS, and BMP-2 can be potential treatments for orthodontically induced root resorption, however, improvements in experimental design and treatment parameters are required to further investigate these repair modalities. PMID:28197400

Genetic and clinical risk factors of root resorption associated with orthodontic treatment.

PubMed

Guo, Yujiao; He, Shushu; Gu, Tian; Liu, Yi; Chen, Song

2016-08-01

External apical root resorption (EARR) is a common complication in orthodontic treatment. Despite many studies on EARR, great controversies remain with regard to its risk factors. The objective of this study was to explore the relationship among sex, root movement, IL-1RN single nucleotide polymorphism (SNP) rs419598, IL-6 SNP rs1800796, and EARR associated with orthodontic treatment. Altogether 174 patients (with 174 maxillary left central incisors) were selected for this study. Cone-beam computed tomography was performed before the start of the treatment and at the end of the treatment. Cone-beam computed tomography data were used to reconstruct a 3-dimensional image of each tooth; the volume and the root resorption volume of each tooth were calculated. Three-dimensional matching was used to measure the amount of movement of each root. Genomic DNA was extracted from buccal swabs, and genotypes of SNP rs419598 and SNP rs1800796 of each subject were determined using TaqMan polymerase chain reaction genotyping (Applied Biosystems, Foster City, Calif). The data were analyzed with multiple linear regression analysis. The statistical analysis indicated no relationship between sex, tooth movement amount, and IL-1RN SNP rs419598 with EARR. The IL-6 SNP rs1800796 GC was associated with EARR, and root resorption differed significantly between SNP rs1800796 GC and CC. IL-6 SNP rs1800796 GC is a risk factor for EARR. The amount of root movement, IL-1RN SNP rs419598, and sex as risk factors for EARR need further study. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

The Effect of Thyroid Hormone, Prostaglandin E2, and Calcium Gluconate on Orthodontic Tooth Movement and Root Resorption in Rats

PubMed Central

Seifi, Massoud; Hamedi, Roya; Khavandegar, Zohre

2015-01-01

Statement of the Problem A major objective of investigators is to clarify the role of metabolites in achievement of maximum tooth movement with minimal root damage during orthodontic tooth movement (OTM). Purpose The aim of this study was to determine the effect of administration of thyroid hormone, prostaglandin E2, and calcium on orthodontic tooth movement and root resorption in rats. Materials and Method Sixty four male Wistar rats were randomly divided into 8 groups of eight rats each: 1- 20µg/kg thyroxine was injected in traperitoneally after installation of the orthodontic appliance.  2- 0.1 ml of 1 mg/ml prostaglandin E2 was injected submucosally.  3- 10% (200 mg/kg) calcium gluconate was injected.  4- Prostaglandin E2 was injected submucosally and 10% calcium was injected intraperitoneally.  5- Thyroxine was injected intraperitoneally and prostaglandin E2 was injected submucosally.  6- 20µg/kg thyroxine with calcium was injected. 7- Prostaglandin E2 was injected submucosally with calcium and thyroxine.  8- Distilled water was used in control group. The orthodontic appliances comprised of a NiTi closed coil were posteriorly connected to the right first molar and anteriorly to the upper right incisor. OTM was measured with a feeler gauge. The mid-mesial root of the first molar and the adjacent tissues were histologically evaluated. The Data were analyzed by one-way ANOVA and Student-Newman-Keuls test. Results The highest mean OTM was observed in the thyroxine and prostaglandin E2 group (Mean±SD = 0.7375±0.1359 mm) that was significantly different (p< 0.05). A significant difference (p< 0.05) in root resorption was observed between the prostaglandin E2 (0.0192±0.0198 mm2) and the other groups. Conclusion It seems that the combination of thyroxine and prostaglandin E2, with a synergistic effect, would decrease the root resorption and increase the rate of orthodontic tooth movement in rats. PMID:26106633

Molecular and structural assessment of alveolar bone during tooth eruption and function in the miniature pig, Sus scrofa

PubMed Central

Yeh, Kuang-Dah; Popowics, Tracy

2011-01-01

Summary The development of alveolar bone adjacent to the tooth root during tooth eruption is not well understood. This study tested the hypothesis that predominantly woven bone forms adjacent to tooth roots during tooth eruption, but that this immature structure transitions to lamellar bone when the tooth comes into function. Additionally, bone resorption was predicted to play a key role in transitioning immature bone to more mature, load-bearing tissue. Miniature pigs were compared at two occlusal stages, 13 weeks (n=3), corresponding with the mucosal penetration stage of M1 tooth eruption, and 23 weeks (n=3), corresponding with early occlusion of M1/M1. Bone samples for RNA extraction and qRT-PCR analysis were harvested from the diastema and adjacent to M1 roots on one side. Following euthanasia, bone samples for hematoxylin and eosin and TRAP staining were harvested from these regions on the other side. In contrast to expectations, both erupting and functioning molars had reticular fibrolamellar structure in alveolar bone adjacent to M1. However, the woven bone matrix in older pigs was thicker and had denser primary osteons. Gene expression data and osteoclast cell counts showed a tendency for more bone resorptive activity near the molars than at distant sites, but no differences between eruptive stages. Thus, although resorption does occur, it is not a primary mechanism in the transition in alveolar bone from eruption to function. Incremental growth of existing woven bone and filling in of primary osteons within the mineralized scaffold generated the fortification necessary to support an erupted and functioning tooth. PMID:21434979

Ability of mini-implant-facilitated micro-osteoperforations to accelerate tooth movement in rats.

PubMed

Cheung, Tracy; Park, Juyoung; Lee, Deborah; Kim, Catherine; Olson, Jeffrey; Javadi, Shadi; Lawson, Gregory; McCabe, James; Moon, Won; Ting, Kang; Hong, Christine

2016-12-01

Although current techniques for accelerated tooth movement often involve invasive surgical procedures, micro-osteoperforations (MOPs) using mini-implants may facilitate orthodontic tooth movement without raising flaps, reduce surgical risks, and increase patient acceptance. In this study, we evaluated the effectiveness of mini-implant-facilitated MOPs in inducing accelerated tooth movement and investigated the potential risks for root resorption. Five MOPs were placed on the left side around the maxillary first molars in 6 rats using an automated mini-implant driver, whereas the right side received no MOPs as the control. Closed-coiled springs were secured from incisors to first molars for orthodontic tooth movement. Tooth movement was measured, and samples underwent radiologic and histologic analyses. The MOP side exhibited a 1.86-fold increase in the rate of tooth movement with decreased bone density and bone volume around the first molars compared with the control side. Hematoxylin and eosin and tartrate-resistant acid phosphatase analyses showed increased numbers of osteoclasts as well as new bone formation. Three-dimensional volumetric analysis of all 5 roots of the maxillary first molars demonstrated no statistically significant difference in root volumes. Mini-implant-facilitated MOPs accelerated tooth movement without increased risk for root resorption and therefore may become a readily available and efficient treatment option to shorten orthodontic treatment time with improved patient acceptance. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Cementocyte cell death occurs in rat cellular cementum during orthodontic tooth movement.

PubMed

Matsuzawa, Humihiro; Toriya, Naoko; Nakao, Yuya; Konno-Nagasaka, Moe; Arakawa, Toshiya; Okayama, Miki; Mizoguchi, Itaru

2017-05-01

To clarify the mechanism of root resorption during orthodontic treatment, we examined cementocyte cell death and root resorption in the cellular cementum on the pressure side during experimental tooth movement. Using 8-week-old male Wistar rats, the right first molar was pushed mesiobuccally with a force of 40 g by a Ni-Ti alloy wire while the contralateral first molar was used as a control. Localization and number of cleaved caspase-3-positive and single-stranded DNA (ssDNA) - positive cells were evaluated using dual-label immunohistochemistry with anticleaved caspase-3 and anti-ssDNA antibodies. In addition, tartrate-resistant acid phosphatase (TRAP)-positive cells in the cellular cementum were evaluated using TRAP histochemical staining. Caspase-3- and ssDNA-positive cells appeared at 12 hours, but were restricted to the compressed periodontal ligament (PDL) and not the cellular cementum. Cleaved caspase-3-positive cementocytes were observed in the cellular cementum adjacent to the compressed PDL on day 1. From days 2 to 4, the number of caspase-3- and ssDNA-positive cementocytes increased. TRAP-positive cells appeared on the cellular cementum at the periphery of the hyalinized tissue on day 7, and resorption progressed into the broad surface of the cementum by day 14. Cementocytes adjacent to the hyalinized tissue underwent apoptotic cell death during orthodontic tooth movement, which might have been associated with subsequent root resorption.

Immediate, non-submerged, root-analogue zirconia implant in single tooth replacement.

PubMed

Pirker, W; Kocher, A

2008-03-01

This report demonstrates the successful clinical use of a modified root-analogue zirconia implant for immediate single tooth replacement. A right maxillary premolar was removed and a custom-made, root-analogue, roughened zirconia implant with macro-retentions in the interdental space was fabricated and placed into the extraction socket 4 days later. Four months after root implantation a composite crown was cemented. No complications occurred during the healing period. An excellent esthetic and functional result was achieved with the composite crown. No clinically noticeable bone resorption or soft-tissue recession was observed at 26 months follow up. Significant modifications such as macro-retentions seem to indicate that primary stability and excellent osseointegration of immediate root-analogue zirconia implants can be achieved, while preventing unesthetic bone resorption. The macro-retentions must be limited to the interdental space to avoid fracture of the thin buccal cortex. This successful case warrants further clinical research in well controlled trials.

Apical root resorption during orthodontic treatment. A prospective study using cone beam CT.

PubMed

Lund, Henrik; Gröndahl, Kerstin; Hansen, Ken; Gröndahl, Hans-Göran

2012-05-01

To investigate the incidence and severity of root resorption during orthodontic treatment by means of cone beam computed tomography (CBCT) and to explore factors affecting orthodontically induced inflammatory root resorption (OIIRR). CBCT examinations were performed on 152 patients with Class I malocclusion. All roots from incisors to first molars were assessed on two or three occasions. At treatment end, 94% of patients had ≥1 root with shortening >1 mm, and 6.6% had ≥1 tooth where it exceeded 4 mm. Among teeth, 56.3% of upper lateral incisors had root shortening >1 mm. Of upper incisors and the palatal root of upper premolars, 2.6% showed root shortenings >4 mm. Slanted surface resorptions of buccal and palatal surfaces were found in 15.1% of upper central and 11.5% of lateral incisors. Monthly root shortening was greater after 6-month control than before. Upper jaw teeth and anterior teeth were significantly associated with the degree of root shortening. Gender, root length at baseline, and treatment duration were not. Practically all patients and up to 91% of all teeth showed some degree of root shortening, but few patients and teeth had root shortenings >4 mm. Slanted root resorption was found on root surfaces that could be evaluated only by a tomographic technique. A CBCT technique can provide more valid and accurate information about root resorption.

Effect of nanocrystalline hydroxyapatite socket preservation on orthodontically induced inflammatory root resorption.

PubMed

Seifi, Massoud; Arayesh, Ali; Shamloo, Nafise; Hamedi, Roya

2015-01-01

Orthodontically induced inflammatory root resorption (OIIRR) is considered to be an important sequel associated with orthodontic tooth movement (OTM). OTM after Socket preservation enhances the periodontal condition before orthodontic space closure. The purpose of this study is to investigate the histologic effects of NanoBone®, a new highly nonsintered porous nano-crystalline hydroxyapatite bone on root resorption following OTM. This experimental study was conducted on four male dogs. In each dog, four defects were created at the mesial aspects of the maxillary and mandibular first premolars. The defects were filled with NanoBone®. We used the NiTi closed coil for mesial movement of the first premolar tooth. When the experimental teeth moved approximately halfway into the defects, after two months, the animals were sacrificed and we harvested the area of interest. The first premolar root and adjacent tissues were histologically evaluated. The three-way ANOVA statistical test was used for comparison. The mean root resorption in the synthetic bone substitute group was 22.87 ± 11.25×10(-4)mm(2) in the maxilla and 21.41 ± 11.25×10(-4)mm(2) in the mandible. Statistically, there was no significant difference compared to the control group (p>0.05). The use of a substitution graft in the nano particle has some positive effects in accessing healthy periodontal tissue following orthodontic procedures without significant influence on root resorption (RR). Histological evaluation in the present study showed osteoblastic activity and remodeling environment of nanoparticles in NanoBone®.

Effect of Nanocrystalline Hydroxyapatite Socket Preservation on Orthodontically Induced Inflammatory Root Resorption

PubMed Central

Seifi, Massoud; Arayesh, Ali; Shamloo, Nafise; Hamedi, Roya

2015-01-01

Objective Orthodontically induced inflammatory root resorption (OIIRR) is considered to be an important sequel associated with orthodontic tooth movement (OTM). OTM after Socket preservation enhances the periodontal condition before orthodontic space closure. The purpose of this study is to investigate the histologic effects of NanoBone®, a new highly nonsintered porous nano-crystalline hydroxyapatite bone on root resorption following OTM. Materials and Methods This experimental study was conducted on four male dogs. In each dog, four defects were created at the mesial aspects of the maxillary and mandibular first premolars. The defects were filled with NanoBone®. We used the NiTi closed coil for mesial movement of the first premolar tooth. When the experimental teeth moved approximately halfway into the defects, after two months, the animals were sacrificed and we harvested the area of interest. The first premolar root and adjacent tissues were histologically evaluated. The three-way ANOVA statistical test was used for comparison. Results The mean root resorption in the synthetic bone substitute group was 22.87 ± 11.25×10-4mm2 in the maxilla and 21.41 ± 11.25×10-4mm2 in the mandible. Statistically, there was no significant difference compared to the control group (p>0.05). Conclusion The use of a substitution graft in the nano particle has some positive effects in accessing healthy periodontal tissue following orthodontic procedures without significant influence on root resorption (RR). Histological evaluation in the present study showed osteoblastic activity and remodeling environment of nanoparticles in NanoBone®. PMID:25685742

Effect of LED-mediated-photobiomodulation therapy on orthodontic tooth movement and root resorption in rats.

PubMed

Ekizer, Abdullah; Uysal, Tancan; Güray, Enis; Akkuş, Derya

2015-02-01

The aim of this experimental study was to evaluate the effects of light-emitting diode-mediated-photobiomodulation therapy (LPT), on the rate of orthodontic tooth movement (TM) and orthodontically induced root resorption, in rats. Twenty male 12-week-old Wistar rats were separated into two groups (control and LPT) and 50 cN of force was applied between maxillary left molar and incisor with a coil spring. In the treatment group, LPT was applied with an energy density of 20 mW/cm(2) over a period of 10 consecutive days directly over the movement of the first molar teeth area. The distance between the teeth was measured with a digital caliper on days 0 (T0), 10 (T1), and 21 (T2) on dental cast models. The surface area of root resorption lacunae was measured histomorphometrically using digital photomicrographs. Mann-Whitney U and Wilcoxon tests were used for statistical evaluation at p < 0.05 level. TM during two different time intervals (T1-T0 and T2-T1) were compared for both groups and a statistically significant difference was found in the LPT group (p = 0.016). The TM amount at the first time period (1.31 ± 0.36 mm) was significantly higher than the second time period (0.24 ± 0.23 mm) in the LPT group. Statistical analysis showed significant differences between two groups after treatment/observation period (p = 0.017). The magnitude of movement in the treatment group was higher (1.55 ± 0.33 mm) compared to the control group (1.06 ± 0.35 mm). Histomorphometric analysis of root resorption, expressed as a percentage, showed that the average relative root resorption affecting the maxillary molars on the TM side was 0.098 ± 0.066 in the LPT group and 0.494 ± 0.224 in the control group. Statistically significant inhibition of root resorption with LPT was determined (p < 0.001) on the TM side. The LPT method has the potential of accelerating orthodontic tooth movement and inhibitory effects on orthodontically induced resorptive activity.

Root Resorption with Orthodontic Mechanics: Pertinent Areas Revisited.

PubMed

Krishnan, V

2017-03-01

Root resorption can occur at any time during orthodontic treatment and lead to a compromise in the prognosis of the tooth and the stability of the treatment results. Recent research has focused more on the cause and effect relationship as well as preventive or treatment options to combat this unwelcome event. Investigations have highlighted the genetic as well as molecular aspects of the process and enabled clinicians to determine which patients might be susceptible. A proper medical history, an assessment of predisposing factors, a radiographic evaluation for alterations in root morphology and careful planning and execution of orthodontic mechanics may reduce the incidence of root resorption. The current review is aimed at providing clinicians and academics with an insight into the process of root resorption, the methods of identification during its early stages and intervention at the right time to reduce its severity. © 2017 Australian Dental Association.

Evaluation of laser photobiomodulation (λ 780 nm) on repair of dental replantation in rats

NASA Astrophysics Data System (ADS)

Bastos de Carvalho, Fabíola; Vasconcelos, Rebeca M.; Santos, Laila; dos Santos Barbosa, Artur F.; Aguiar, Marcio C.; Cangussu, Maria Cristina T.; Pinheiro, Antônio Luiz B.; Pedreira Ramalho, Luciana M.

2014-02-01

Up to date the success of tooth replantation is still limited. The majority of the teeth is lost due to progressive external root resorption. The aim of this study was to assess, histologically, the effect of laser photobiomodulation on repair after tooth replantation. Sixty Wistar Albinus rats had the right upper incisor extracted and then divided into 4 groups: G1 - absence of storage medium; G2 - milk u s e d as storage medium; G3 - milk used as storage medium a n d followed by GaAlAs laser irradiation on dental surfaces and at the entrance of alveolus; G4 - milk used as storage medium associated with laser irradiation as in G3 before and after replantation on the buccal and palatal mucosa every 48 hours for 15 days. The animals were sacrificed at 15, 30 and 60 days after replantation. The results showed that after 15 days G4 exhibit more intense chronic inflammation, with presence of clastic cells and moderate inflammatory root resorption (p<0.05) when compared to G3, which presented absence of those parameters. At day 30 in G1, G2 and G4 mild to moderate chronic inflammation and severe external root resorption were observed. G3 remained with no inflammation and inflammatory root resorption with 30 and 60 days of healing experimental times. The results suggest that laser irradiation on the dental entrance of the dental alveolus prior to tooth replantation has a positive biomodulative effect on the healing process in rats.

Effect of local injection of Zolena, zoledronic acid made in Iran, on orthodontic tooth movement and root and bone resorption in rats.

PubMed

Seifi, Massoud; Asefi, Sohrab; Hatamifard, Ghazal; Lotfi, Ali

2017-01-01

Background. Anchorage control is an essential part of orthodontic treatment planning, especially in adult patients who demand a more convenient treatment. Zoledronic acid (ZA) is an effective choice to address this problem. It is the most potent member of the bisphosphonates family that has an inhibitory effect on bone resorption by suppressing osteoclast function. Therefore, ZA might be a good option for orthodontic anchorage control. The current study evaluated the effect of local administration of Zolena (ZA made in Iran) on orthodontic tooth movement (OTM) and root and bone resorption. Methods. The experimental group consisted of 30 rats in 3 subgroups (n=10). Anesthesia was induced, and one closed NiTi coil spring was installed between the first molar and central incisor unilaterally, except for the negative control group. The positive control group received vestibular injection of 0.01 mL of saline next to the maxillary first molar, and 0.01 mL of the solution was injected at the same site in the ZA group. After 21 days, the rats were sacrificed and the distance between the first and second molars was measured with a leaf gauge. Histological analysis was conducted by a blind pathologist for the number of Howship's lacunae, blood vessels, osteoclast-like cells and root resorption lacunae. Data were analyzed with ANOVA, Tukey test and t-test. Results. There were no significant differences in OTM between the force-applied groups. ZA significantly inhibited bone/root resorption and angiogenesis compared to the positive control group. Conclusion. Zolena did not decrease OTM but significantly inhibited bone and root resorption. Zolena might be less potent than its foreign counterparts.

Immediate autotransplantation of mandibular third molar in China.

PubMed

Yan, Quanmei; Li, Bo; Long, Xing

2010-10-01

Tooth autotransplantation is a useful surgical method to replace a nonrestorable tooth. We reported our experiences in the replacement of mandibular nonrestorable molars by immediate autotransplantation in a Chinese population. Thirty-five mandibular third molars with open or closed apices from 34 patients were autotransplanted into the same or contralateral fresh recipient sites immediately after the extraction of the nonrestorable mandibular molars. Root canal treatment was routinely performed in the closed-apical molars within 1 month after surgery. Clinical and radiographic examination of the transplanted donor molars was done after surgery. Two teeth were been extracted for progressive root resorption. The remaining 33 autotransplanted teeth were asymptomatic and functioning after a mean follow-up period of 5.2 years. No infection, ankylosis, loss of the transplants, or root resorption was noted in the remaining autotransplanted teeth. Immediate autotransplantation of the mandibular third molar is a reasonable and alternative treatment to replace a nonrestorable tooth in China. Copyright © 2010 Mosby, Inc. All rights reserved.

[Multiple tooth resorption in an Italian greyhound].

PubMed

Roux, P; Stich, H; Schawalder, P

2011-06-01

An Italian greyhound was presented three times during a two-year period for dental prophylaxis due to periodontal disease. Clinical examination revealed lesions on several teeth. Radiographs revealed extensive resorptive root lesions. On histological examination, the presence of odontoclasts and signs of boney remodeling of the roots confirmed the resorptive nature of the lesions. Given the extent of the lesions, and poor prognosis with conservative treatment alone, teeth affected by the most severe resorption were extracted at each visit using a flap technique combined with alveolar vestibular osteotomy. Dental resorptive lesions are rarely detected in the dog but may be more frequent than previously thought. The routine use of dental radiographs can be used to reveal these lesions in the dog.

Periodontal ligament hydrostatic pressure with areas of root resorption after application of a continuous torque moment.

PubMed

Hohmann, Ansgar; Wolfram, Uwe; Geiger, Martin; Boryor, Andrew; Sander, Christian; Faltin, Rolf; Faltin, Kurt; Sander, Franz Guenter

2007-07-01

To evaluate the risk of root resorption, individual finite element models (FEMs) of extracted human maxillary first premolars were created, and the distribution of the hydrostatic pressure in the periodontal ligament (PDL) of these models was simulated. A continuous lingual torque of 3 Nmm and 6 Nmm respectively was applied in vivo to the aforementioned teeth. After extraction, FEMs of these double-rooted teeth were created based on high-resolution microcomputed tomographics (micro CT, voxel size: 35 microns). This high volumetric resolution made the recognition of very small resorption lacunae possible. Scanning electron micrographs of the root surfaces were created as well. This enabled the investigation of advantages and disadvantages of the different imaging techniques from the viewpoint of the examination of root resorption. Using the FEMs, the same loading conditions as applied in vivo were simulated. The results of clinical examination and simulations were compared using the identical roots of the teeth. The regions that showed increased hydrostatic pressure (>0.0047 MPa) correlated well with the locations of root resorption for each tooth. Increased torque resulted in increased high-pressure areas and increased magnitudes of hydrostatic pressure, correlating with the experiments. If hydrostatic pressure exceeds typical human capillary blood pressure in the PDL, the risk of root resorption increases.

Rapidly progressive internal root resorption: a case report.

PubMed

Keinan, David; Heling, Ilana; Stabholtz, Adam; Moshonov, Joshua

2008-10-01

The etiology of internal root resorption is not fully understandable, trauma and chronic pulpitis are considered the main risk factors. Usually the process is asymptomatic and diagnosed upon routine radiographic examination. This case report presents a rapid progression of internal resorption related directly to traumatic injury. A 16-year-old female arrived at the emergency room after a mild extrusion of the mandibular incisors. The initial treatment included repositioning and splinting of the teeth. Radiographs performed at repositioning and splinting demonstrated normal configuration of the incisor's roots. Ten months later progressive internal resorption of the left mandibular first incisor was diagnosed. While treating this tooth similar process was detected in the right mandibular second incisor and in the mandibular left second incisor. The lower right first incisor reacted inconsistently to vitality test. As a result of the severe and rapidly progressive nature of the process, root canal treatments were performed in all lower incisors. The follow-up radiographs demonstrate arrest of the internal resorption process.

Taking advantage of an unerupted third molar: a case report.

PubMed

Pereira, Igor Figueiredo; Santiago, Fernando Zander Mucci; Sette-Dias, Augusto Cesar; Noronha, Vladimir Reimar Augusto de Souza

2017-01-01

Treatments with dental surgery seek to displace tooth to the correct position within the dental arch. To report a clinical case that took advantage of an unerupted third molar. A male patient, 18 years of age, was referred by his dentist to evaluate the third molars. The clinical exam revealed no visible lower third molars. The computed tomography (CT) exam showed the presence of a supernumerary tooth in the region of the mandibular ramus, on the left side, and impaction of the third molar, which was causing root resorption on the second molar, thus making it impossible to remain in the buccal cavity. The preferred option, therefore, was to remove both second molar and the supernumerary tooth, in addition to attaching a device to the third molar during surgery for further traction. After 12 months, the third molar reached the proper position. When a mandibular second permanent molar shows an atypical root resorption, an impacted third molar can effectively substitute the tooth by using an appropriate orthodontic-surgical approach.

A Comprehensive Mixture of Tobacco Smoke Components Retards Orthodontic Tooth Movement via the Inhibition of Osteoclastogenesis in a Rat Model

PubMed Central

Nagaie, Maya; Nishiura, Aki; Honda, Yoshitomo; Fujiwara, Shin-Ichi; Matsumoto, Naoyuki

2014-01-01

Tobacco smoke is a complex mixture of numerous components. Nevertheless, most experiments have examined the effects of individual chemicals in tobacco smoke. The comprehensive effects of components on tooth movement and bone resorption remain unexplored. Here, we have shown that a comprehensive mixture of tobacco smoke components (TSCs) attenuated bone resorption through osteoclastogenesis inhibition, thereby retarding experimental tooth movement in a rat model. An elastic power chain (PC) inserted between the first and second maxillary molars robustly yielded experimental tooth movement within 10 days. TSC administration effectively retarded tooth movement since day 4. Histological evaluation disclosed that tooth movement induced bone resorption at two sites: in the bone marrow and the peripheral bone near the root. TSC administration significantly reduced the number of tartrate-resistant acid phosphatase (TRAP)-positive osteoclastic cells in the bone marrow cavity of the PC-treated dentition. An in vitro study indicated that the inhibitory effects of TSCs on osteoclastogenesis seemed directed more toward preosteoclasts than osteoblasts. These results indicate that the comprehensive mixture of TSCs might be a useful tool for detailed verification of the adverse effects of tobacco smoke, possibly contributing to the development of reliable treatments in various fields associated with bone resorption. PMID:25322153

Enhanced M1/M2 macrophage ratio promotes orthodontic root resorption.

PubMed

He, D; Kou, X; Luo, Q; Yang, R; Liu, D; Wang, X; Song, Y; Cao, H; Zeng, M; Gan, Y; Zhou, Y

2015-01-01

Mechanical force-induced orthodontic root resorption is a major clinical challenge in orthodontic treatment. Macrophages play an important role in orthodontic root resorption, but the underlying mechanism remains unclear. In this study, we examined the mechanism by which the ratio of M1 to M2 macrophage polarization affects root resorption during orthodontic tooth movement. Root resorption occurred when nickel-titanium coil springs were applied on the upper first molars of rats for 3 to 14 d. Positively stained odontoclasts or osteoclasts with tartrate-resistant acid phosphatase were found in resorption areas. Meanwhile, M1-like macrophages positive for CD68 and inducible nitric oxide synthase (iNOS) persistently accumulated on the compression side of periodontal tissues. In addition, the expressions of the M1 activator interferon-γ and the M1-associated pro-inflammatory cytokine tumor necrosis factor (TNF)-α were upregulated on the compression side of periodontal tissues. When the coil springs were removed at the 14th day after orthodontic force application, root resorption was partially rescued. The number of CD68(+)CD163(+) M2-like macrophages gradually increased on the compression side of periodontal tissues. The levels of M2 activator interleukin (IL)-4 and the M2-associated anti-inflammatory cytokine IL-10 also increased. Systemic injection of the TNF-α inhibitor etanercept or IL-4 attenuated the severity of root resorption and decreased the ratio of M1 to M2 macrophages. These data imply that the balance between M1 and M2 macrophages affects orthodontic root resorption. Root resorption was aggravated by an enhanced M1/M2 ratio but was partially rescued by a reduced M1/M2 ratio. © International & American Associations for Dental Research 2014.

The use of a single-step regenerative approach for the treatment of a replanted mandibular central incisor with severe resorption.

PubMed

Chaniotis, A

2016-08-01

To report the clinical and radiographic treatment outcome of an immature replanted mandibular incisor with severe inflammatory external root resorption following a single-step regenerative approach. A 7-year-old female patient was referred 1 week following an extrusion injury to her mandibular central incisor (tooth 31). There was a history of a 6 months previous avulsion injury to the same tooth, which had been replanted after 20 min of extra-oral time. On clinical examination, all teeth were asymptomatic and there was an arch wire splint placed on the mandibular incisors. Radiographic examination revealed severe inflammatory external root resorption of tooth 31. A diagnosis of necrotic pulp and asymptomatic apical periodontitis was made. Under local anaesthesia and rubber dam isolation, an access cavity was prepared. The canal was irrigated using 6% NaOCl solution delivered through the EndoVac negative pressure irrigation system (Endo Vac, Axis/SybronEndo, Coppell, TX, USA). A 17% EDTA solution was used for 5 min followed by a final rinse of sterile water. The periapical tissues were probed using a K-file, and bleeding was induced. A blood clot was allowed to form filling the entire canal. A thick plug of MTA was placed in direct contact with the blood clot. The tooth was restored with composite resin. All procedures were performed in a single visit. The splint was removed 2 weeks later. Recall examination after 24 months revealed healthy soft tissues with normal periodontal probing and mobility. The 24 months radiographic evaluation revealed healing of the severe inflammatory external root resorption and continuous root development/dentine wall thickening of the apical third. No signs of ankylosis or significant discoloration was present. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Degenerative alterations of the cementum-periodontal ligament complex and early tooth loss in a young patient with periodontal disease.

PubMed

Petruţiu, S A; Buiga, Petronela; Roman, Alexandra; Danciu, Theodora; Mihu, Carmen Mihaela; Mihu, D

2012-01-01

Premature exfoliation of primary or permanent teeth in children or adolescents is extremely rare and it can be a manifestation of an underlying systemic disease. This study aims to present the histological aspects associated with early tooth loss in a case of periodontal disease developed without local inflammation and with minimal periodontal pockets and attachment loss. The maxillary left second premolar was extracted together with a gingival collar attached to the root surface. The histological analysis recorded the resorption of the cementum in multiple areas of the entire root surface with the connective tissue of the desmodontium invading the lacunae defects. The connective tissue rich in cells occupied the periodontal ligamentar space and the resorptive areas. No inflammation was obvious in the periodontal ligament connective tissue. This report may warn clinicians about the possibility of the association of cemental abnormalities with early tooth loss.

Quantitative digital subtraction radiography in the assessment of external apical root resorption induced by orthodontic therapy: a retrospective study.

PubMed

Sunku, Raghavendra; Roopesh, R; Kancherla, Pavan; Perumalla, Kiran Kumar; Yudhistar, Palla Venkata; Reddy, V Sridhar

2011-11-01

The objective of this study was to evaluate density changes around the apices of teeth during orthodontic treatment by using digital subtraction radiography to measure the densities around six teeth (maxilla central incisors, lateral incisors, and canines) before and after orthodontic treatment in 36 patients and also assess treatment variables and their coorelation with root resorption. A total of 36 consecutive patient files were selected initially. The selected patients presented with a class I or II relationship and were treated with or without premolar extractions and fixed appliances. Some class II patients were treated additionally with extraoral forces or functional appliances. External apical root resorption (EARR) per tooth in millimeters was calculated and was also expressed as a percentage of the original root length. Image reconstruction and subtraction were performed using the software Regeemy Image Registration and Mosaicing (version 0.2.43-RCB, DPI-INPE, Sao Jose dos Campos, Sao Paulo, Brazil) by a single operator. A region of interest (ROI) was defined in the apical third of the root and density calibration was made in Image J® using enamel (gray value = 255) as reference in the same image. The mean gray values in the ROIs were reflective of the change in the density values between the two images. The root resorption of the tooth and the factors of malocclusion were analyzed with a one-way ANOVA. An independent t-test was performed to compare the mean amount of resorption between male and female, between extraction and nonextraction cases. The density changes after orthodontic treatment were analyzed using the Wilcoxon signedrank test. In addition, the density changes in different teeth were analyzed using the Kruskal-Wallis test. The cut-off for statistical significance was a p-value of 0.05. All the statistical analyses were carried out using SPSS (version 13.0 for Windows, Chicago, IL, USA). Gender, the age at which treatment was started and Angle's classification was not statistically related with observed root resorption. The mean percentage density reduction as assessed by DSR was greatest in both central incisor: by 27.2 and 25.2% in the upper-right and upper-left central incisors, respectively, followed by the upper-right and upper-left canine teeth (23.5 and 21.0%) and then the upper-right and upper-left lateral incisors (19.1 and 17.4%). Tooth extraction prior to treatment initiation and the duration of orthodontic treatment was positively correlated with the amount of root resorption. DSR is useful for evaluating density changes around teeth during orthodontic treatment. The density around the apices of teeth reduced significantly after the application of orthodontic forces during treatment. Assessment of density changes on treatment radiographs of patients undergoing orthodontic therapy may help in the monitoring of external apical root resorption during course of treatment.

External apical root resorption in maxillary root-filled incisors after orthodontic treatment: A split-mouth design study

PubMed Central

Amarilla, Almudena; Espinar-Escalona, Eduardo; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Sánchez-Domínguez, Benito; López-Frías, Francisco J.

2012-01-01

Introduction: The purpose of this study was to compare, in a split mouth design, the external apical root resorption (EARR) associated with orthodontic treatment in root-filled maxillary incisors and their contralateral teeth with vital pulps. Methodology: The study sample consisted of 38 patients (14 males and 24 females), who had one root-filled incisor before completion of multiband/bracket orthodontic therapy for at least 1 year. For each patient, digital panoramic radiographs taken before and after orthodontic treatment were used to determine the root resortion and the proportion of external root resorption (PRR), defined as the ratio between the root resorption in the endodontically treated incisor and that in its contralateral incisor with a vital pulp. The student’s t-test, chi-square test and logistic regression analysis were used to determine statistical significance. Results: There was no statistically significant difference (p > 0.05) between EARR in vital teeth (1.1 ± 1.0 mm) and endodontically treated incisors (1.1 ± 0.8 mm). Twenty-six patients (68.4%) showed greater resorption of the endodontically treated incisor than its homolog vital tooth (p > 0.05). The mean and standard deviation of PPR were 1.0 ± 0.2. Multivariate logistic regression suggested that PRR does not correlate with any of the variables analyzed. Conclusions: There was no significant difference in the amount or severity of external root resorption during orthodontic movement between root-filled incisors and their contralateral teeth with vital pulps. Key words:Endodontics, orthodontics, root canal treatment, root resorption. PMID:22143731

CBCT evaluation of multiple idiopathic internal resorptions in permanent molars: case report.

PubMed

Kalender, Atakan; Oztan, Meltem D; Basmaci, Fatma; Aksoy, Umut; Orhan, Kaan

2014-04-16

Internal inflammatory root resorption is a rare condition in permanent teeth, which requires the presence of necrotic and infected pulp tissue within the coronal portion of the root canal system as well as inflamed pulp tissue apical to the resorptive defect. The aetiology of internal root resorption is not completely understandable, trauma and chronic pulpitis are considered the main risk factors. We report a rare case of the multiple idiopathic resorption in the permanent maxillary and mandibular molars in a healthy 33-year-old female patient. In addition to clinical examination the patient was imaged using conventional radiography techniques and cone beam computed tomography (CBCT).The patient had recurrent throbbing pain in her # 46. The radiographic examination including "panoramic radiography and CBCT" revealed that radiographic evidence of internal resorption in #37 #36 #35 #34 #33 #47 #46 #45 #44 #43 #16 #15 #14 #13 and also including in unerupted #17, #26, #27, #28 teeth. The definitive diagnosis was made with the histopathological examination of the extracted tooth. Internal root resorption is a rare clinical process that should be examined using different radiographic modalities. CBCT seems to be useful in evaluation of the lesions with superior diagnostic performance.

Accuracy of volumetric measurement of simulated root resorption lacunas based on cone beam computed tomography.

PubMed

Wang, Y; He, S; Guo, Y; Wang, S; Chen, S

2013-08-01

To evaluate the accuracy of volumetric measurement of simulated root resorption cavities based on cone beam computed tomography (CBCT), in comparison with that of Micro-computed tomography (Micro-CT) which served as the reference. The State Key Laboratory of Oral Diseases at Sichuan University. Thirty-two bovine teeth were included for standardized CBCT scanning and Micro-CT scanning before and after the simulation of different degrees of root resorption. The teeth were divided into three groups according to the depths of the root resorption cavity (group 1: 0.15, 0.2, 0.3 mm; group 2: 0.6, 1.0 mm; group 3: 1.5, 2.0, 3.0 mm). Each depth included four specimens. Differences in tooth volume before and after simulated root resorption were then calculated from CBCT and Micro-CT scans, respectively. The overall between-method agreement of the measurements was evaluated using the concordance correlation coefficient (CCC). For the first group, the average volume of resorption cavity was 1.07 mm(3) , and the between-method agreement of measurement for the volume changes was low (CCC = 0.098). For the second and third groups, the average volumes of resorption cavities were 3.47 and 6.73 mm(3) respectively, and the between-method agreements were good (CCC = 0.828 and 0.895, respectively). The accuracy of 3-D quantitative volumetric measurement of simulated root resorption based on CBCT was fairly good in detecting simulated resorption cavities larger than 3.47 mm(3), while it was not sufficient for measuring resorption cavities smaller than 1.07 mm(3) . This method could be applied in future studies of root resorption although further studies are required to improve its accuracy. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Retrospective Radiographic Survey of Pathology Associated with Impacted Third Molars among Patients Seen in Oral & Maxillofacial Surgery Clinic of College of Dentistry, Riyadh.

PubMed

Khawaja, Naveed Ahmad; Khalil, Hesham; Parveen, Kauser; Al-Mutiri, Abdulmajeed; Al-Mutiri, Saif; Al-Saawi, Abdullah

2015-04-01

The purpose of this study is to determine the type and frequency of pathological conditions around third molar teeth among randomly selected patient's records in Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh. Totally, 281 patient panoramic radiographs were selected with detectable pathology among 570 files of patients seen in oral and maxillofacial surgery clinics 2 years retrospectively. Almost 17-55 years age (mean age 25.43) was selected. The following radiographs were analyzed for all pathology associated impacted teeth; dental caries, bone resorption, periodontitis, and apical pathology. The study found caries, external bone resorption and periodontitis are highly frequent to mesioangular and horizontal in mandibular impacted third molar compared to maxillary impacted third molar. Overall result evaluated that tooth #28 related periodontitis is significant (P = 0.021), and tooth #38 related bone resorption, tooth #48 related root caries, bone resorption and apical pathology are highly significant (P = 0.000) comparing to others. This study also concluded the high frequency of root caries, bone resorption and apical pathology reported in relation to mandibular impacted third teeth. Significant results were also achieved with periodontitis in relation to mesiangular and vertical angulation of left impacted maxillary third molars. Prophylactic removal of impacted third molars is recommended in many studies to avoid future risk of associated pathology. Retained asymptomatic impacted third molars imply pathology that could be difficult in later ages as less morbidity in younger ages.

Autogenous transplantation of mandibular third molar to replace tooth with vertical root fracture

PubMed Central

Asgary, Saeed

2009-01-01

Autogenous tooth transplantation (ATT) can be considered when there is a hopeless molar tooth and suitable donor present. This report presents an unconventional case of successful ATT of a third molar replacing the adjacent fractured second molar in a 33 year old woman. This wisdom tooth had completely developed roots. Root-end filling with Calcium Enriched Mixture (CEM) cement was performed in the third molar. The second molar was extracted non-traumatically without any bone removal; the wisdom tooth was immediately transplanted into the recipient socket. No endodontic treatment was carried out either during or after the ATT. At six-month and 2-year clinical examination the patient was asymptomatic; the transplanted tooth was still functional, with no evidence of marginal periodontal pathosis. At the same follow ups, radiographic evaluation illustrated bone regeneration, normal PDL, and absence of external root resorption. Transplantation of mature third molar seems to be a promising method for replacing a lost permanent molar tooth and restoring aesthetics and function. PMID:24003333

Analysis of Transforming Growth Factor- β1 Expression in Resorptive Lacunae following Orthodontic Tooth Movement in An Animal Model.

PubMed

Seifi, Massoud; Kazemi, Bahram; Kabiri, Sattar; Badiee, Mohammadreza

2017-01-01

Root resorption is a complication of orthodontic treatment and till date, there is a dearth of information regarding this issue. The aim of this study was to determine whether the expression of transforming growth factor-β1 (TGF-β1, an inflammatory cytokine) is related to orthodontic force. Moreover, if associated, the expression level may be helpful in differential diagnosis, control and ultimate treatment of the disease. In this experimental study, a total of 24 eight-week-old male Wistar rats were selected randomly. On day 0, an orthodontic appliance, which consisted of a closed coil spring, was ligated to the upper right first molar and incisor. The upper left first molar in these animals was not placed under orthodontic force, thus serving as the control group. On day 21, after anesthesia, the animals were sacrificed. The rats were then divided into two equal groups where the first group was subjected to histological evaluation and the second group to reverse transcriptase-polymerase chain reaction (RT-PCR). Orthodontic tooth movement was measured in both groups to determine the influence of the applied force. Statistical analysis of data showed a significant root resorption between the experimental group and control group (P<0.05), however, there was no significant difference in the expression level of the inflammatory cytokine, TGF-β1 . Based on the findings of this study, we suggest that there is a direct relationship between orthodontic force and orthodontic induced inflammatory root resorption. In addition, no relationship is likely to exist between root resorption and TGF-β1 expression in the resorptive lacunae.

Analysis of Transforming Growth Factor- β1 Expression in Resorptive Lacunae following Orthodontic Tooth Movement in An Animal Model

PubMed Central

Seifi, Massoud; Kazemi, Bahram; Kabiri, Sattar; Badiee, Mohammadreza

2017-01-01

Objective Root resorption is a complication of orthodontic treatment and till date, there is a dearth of information regarding this issue. The aim of this study was to determine whether the expression of transforming growth factor-β1 (TGF-β1, an inflammatory cytokine) is related to orthodontic force. Moreover, if associated, the expression level may be helpful in differential diagnosis, control and ultimate treatment of the disease. Materials and Methods In this experimental study, a total of 24 eight-week-old male Wistar rats were selected randomly. On day 0, an orthodontic appliance, which consisted of a closed coil spring, was ligated to the upper right first molar and incisor. The upper left first molar in these animals was not placed under orthodontic force, thus serving as the control group. On day 21, after anesthesia, the animals were sacrificed. The rats were then divided into two equal groups where the first group was subjected to histological evaluation and the second group to reverse transcriptase-polymerase chain reaction (RT-PCR). Orthodontic tooth movement was measured in both groups to determine the influence of the applied force. Results Statistical analysis of data showed a significant root resorption between the experimental group and control group (P<0.05), however, there was no significant difference in the expression level of the inflammatory cytokine, TGF-β1. Conclusion Based on the findings of this study, we suggest that there is a direct relationship between orthodontic force and orthodontic induced inflammatory root resorption. In addition, no relationship is likely to exist between root resorption and TGF-β1 expression in the resorptive lacunae. PMID:28670520

The effects of topical application of bisphosphonates on replanted rat molars.

PubMed

Choi, Sung Chul; Kwon, Yong-Dae; Kim, Kwang Chul; Kim, Gue-Tae

2010-12-01

The purpose of this study was to evaluate the potential usefulness of two bisphosphonates (BPs) (etidronate and zoledronate), compared with that of alendronate, which is a well-known drug for delayed replantation, in decreasing or preventing inflammatory root resorption and replacement root resorption in replanted teeth. Eighty-four Sprague Dawley rat maxillary first molars were extracted, dried for 60 min and then replanted after root treatment. The rats were divided into four groups (control, alendronate, etidronate, zoledronate) as following treatments of avulsed root before replantation. At 7, 14, and 28 days postreplantation, the animals were sacrificed and the samples obtained and process for microscopic analysis. The data were statistically analyzed with the SPSS procedure, anova test and each test was complemented by the Tukey's post hoc test. The result indicated that topical application of alendronate and zoledronate, both nitrogen containing BPs, prevented inflammatory root resorption and inflammatory cell response in the delayed replantation model. Both drugs were demonstrated similar effects in the delayed tooth replantation model (P = 0.9). Etidronate did not prevent inflammatory root resorption and inflammation in the delayed replantation (P < 0.05). No significant differences in replacement root resorption were observed among all drugs. These results suggest that when teeth are dried and not replanted immediately, zoledronate, like alendronate, may prevent root resorption and facilitates the regeneration of periodontal tissues after replantation. © 2010 John Wiley & Sons A/S.

Transient apical breakdown and its relationship with orthodontic forces: a case report.

PubMed

González, Oscar Lozano; Vera, Jorge; Orozco, Marco Salas; Mancera, Jaime Trigueros; González, Karla Vidal; Malagón, Genaro Vega

2014-08-01

Transient apical breakdown (TAB) caused by orthodontic treatment is a reversible resorptive process in which the apex of a tooth shows some radiographic evidence of resorption and the crown may display some discoloration. It usually requires no treatment other than monitoring and elimination of the orthodontic forces applied to the tooth. This report describes the case of a 48-year-old man patient who was referred to the department of endodontics for evaluation of some discoloration of his upper right central incisor, which was undergoing orthodontic treatment. The tooth was nonresponsive to sensitivity tests, it was sensitive to percussion, and, radiographically, there was some evidence of root resorption and apical radiolucency. Because TAB was the suspected cause of the signs and symptoms, no treatment was performed on the tooth except for periodic recalls, and lightening and eventual removal of the orthodontic appliances was indicated. Ten weeks after the initial appointment and removal of the applied orthodontic forces, color improvement was observed, accompanied by a return of tooth sensitivity to cold tests. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

External apical root resorption in maxillary root-filled incisors after orthodontic treatment: a split-mouth design study.

PubMed

Llamas-Carreras, José María; Amarilla, Almudena; Espinar-Escalona, Eduardo; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Sánchez-Domínguez, Benito; López-Frías, Francisco Javier

2012-05-01

The purpose of this study was to compare, in a split mouth design, the external apical root resorption (EARR) associated with orthodontic treatment in root-filled maxillary incisors and their contralateral teeth with vital pulps. The study sample consisted of 38 patients (14 males and 24 females), who had one root-filled incisor before completion of multiband/bracket orthodontic therapy for at least 1 year. For each patient, digital panoramic radiographs taken before and after orthodontic treatment were used to determine the root resortion and the proportion of external root resorption (PRR), defined as the ratio between the root resorption in the endodontically treated incisor and that in its contralateral incisor with a vital pulp. The student's t-test, chi-square test and logistic regression analysis were used to determine statistical significance. There was no statistically significant difference (p > 0.05) between EARR in vital teeth (1.1 ± 1.0 mm) and endodontically treated incisors (1.1 ± 0.8 mm). Twenty-six patients (68.4%) showed greater resorption of the endodontically treated incisor than its homolog vital tooth (p > 0.05). The mean and standard deviation of PPR were 1.0 ± 0.2. Multivariate logistic regression suggested that PRR does not correlate with any of the variables analyzed. There was no significant difference in the amount or severity of external root resorption during orthodontic movement between root-filled incisors and their contralateral teeth with vital pulps.

Vital Pulp Therapy of a Mature Molar with Concurrent Hyperplastic Pulpitis, Internal Root Resorption and Periradicular Periodontitis: A Case Report.

PubMed

Asgary, Saeed; Kemal Çalışkan, Mehmet

2015-01-01

Vital pulp therapy (VPT) of permanent mature teeth is continuously ascertaining to be a more reliable endodontic treatment. The purpose of this case report was to describe successful VPT of a mature mandibular left first molar with concurrent hyperplastic pulpitis, internal root resorption and periradicular periodontitis in a 35-year-old male patient. After complete caries removal and access cavity preparation, the dental pulp was removed from the coronal third of the roots. To protect the remaining pulp, calcium-enriched mixture (CEM) cement was placed and adapted into the cavities; the tooth was then restored with amalgam. Six months after VPT, radiographic examination showed evidence of periradicular healing. Clinically, the tooth was functional without signs and symptoms of infection/inflammation. The successful outcome of this case suggests that diseased dental pulp (i.e. irreversible pulpitis) has the potential to heal after pulp protection with CEM biocement.

Endodontic treatment of a maxillary lateral incisor with a perforating internal resorption by using cone beam computed tomography as a diagnostic aid: a case report.

PubMed

Takita, Toshiya; Tsurumachi, Tamotsu; Ogiso, Bunnai

2011-10-01

This case report presents the endodontic treatment of a maxillary right lateral incisor with a perforating internal resorption in a 50-year-old woman. Radiographically, internal resorption appears as a fairly uniform, radiolucent enlargement of the pulp canal and distortion of the original root canal outline. The use of cone beam computed tomography can help the clinician in making a confirmatory diagnosis and determining the treatment plan before undertaking the actual treatment. After cleaning the root canal space and the resorptive defect by mechanic instrumentation, irrigation, and interim calcium hydroxide dressing, the apical third canal was filled with a gutta-percha point by lateral condensation. The resorptive defect was filled with mineral trioxide aggregate. Follow-up radiographs at 3 years showed adequate repair of the resorption, and the tooth remained asymptomatic.

Autotransplantation of mandibular third molar: a case report.

PubMed

Ravi Kumar, Pabbati; Jyothi, Mandava; Sirisha, Kantheti; Racca, Khushboo; Uma, Chalasani

2012-01-01

Autogenous transplantation is a feasible, fast, and economical option for the treatment of nonsalvageable teeth when a suitable donor tooth is available. This paper presents successful autotransplantation of a mature mandibular left third molar (38) without anatomical variances is used to replace a mandibular left second molar (37). The mandibular second molar was nonrestorable due to extensive root caries and resorption of distal root. After extraction of mandibular second and third molars, root canal therapy was done for the third molar extraorally, and the tooth was reimplanted into the extracted socket of second molar site. After one year, clinical and radiographic examination revealed satisfactory outcome with no signs or symptoms suggestive of pathology. In selected cases, autogenous tooth transplantation, even after complete root formation of the donor tooth, may be considered as a practical treatment alternative to conventional prosthetic rehabilitation or implant treatment.

Autogenous Transplantation for Replacing a Hopeless Tooth.

PubMed

Zakershahrak, Mehrsa; Moshari, Amirabbas; Vatanpour, Mehdi; Khalilak, Zohreh; Jalali Ara, Afsoon

2017-01-01

Autogenous tooth transplantation (ATT) is a simple and reasonable choice for replacing the missing teeth when a proper donor tooth is available. This report presents a case of successful ATT of a maxillary right third molar for replacement of mandibular right second molar with a concomitant endodontic-periodontal disease. The mandibular second molar was believed to be hopeless due to a severe damage to coronal tooth structure, inappropriate root canal treatment and apical radiolucency. After extraction of mandibular second molar and maxillary third molar (the donor), the tooth was re-implanted into the extracted socket of second molar site. Root canal therapy was then performed. After 3 years, clinical and radiographic examinations revealed satisfying results, with no signs and symptoms. The patient is asymptomatic and the transplanted tooth is still functional with no signs of marginal periodontal pathosis. Radiographies showed bone regeneration in the site of previous extensive periapical lesion, normal periodontal ligament with no signs of root resorption.

Cone-beam computed tomography-based diagnosis and treatment simulation for a patient with a protrusive profile and a gummy smile

PubMed Central

Imamura, Toshihiro; Kokai, Satoshi; Ono, Takashi

2018-01-01

For patients with bimaxillary protrusion, significant retraction and intrusion of the anterior teeth are sometimes essential to improve the facial profile. However, severe root resorption of the maxillary incisors occasionally occurs after treatment because of various factors. For instance, it has been reported that approximation or invasion of the incisive canal by the anterior tooth roots during retraction may cause apical root damage. Thus, determination of the position of the maxillary incisors is key for orthodontic diagnosis and treatment planning in such cases. Cone-beam computed tomography (CBCT) may be useful for simulating the post-treatment position of the maxillary incisors and surrounding structures in order to ensure safe teeth movement. Here, we present a case of Class II malocclusion with bimaxillary protrusion, wherein apical root damage due to treatment was minimized by pretreatment evaluation of the anatomical structures and simulation of the maxillary central incisor movement using CBCT. Considerable retraction and intrusion of the maxillary incisors, which resulted in a significant improvement in the facial profile and smile, were achieved without severe root resorption. Our findings suggest that CBCT-based diagnosis and treatment simulation may facilitate safe and dynamic orthodontic tooth movement, particularly in patients requiring maximum anterior tooth retraction. PMID:29732305

Autotransplantation of a maxillary third molar to replace a maxillary premolar with vertical root fracture.

PubMed

Tsurumachi, T; Kakehashi, Y

2007-12-01

To report the successful autotransplantation of a fully developed third molar that required nonsurgical and surgical interventions for tooth adaptation. This case report describes the autotransplantation of a third molar with complete root development after the loss of a fractured premolar in a 47-year-old male. To allow better adaptation of the donor tooth, the buccal roots of the third molar were removed using a diamond bur and the canal entrances were filled. Recall examination 6 years after completion of root-canal treatment showed normal periodontal healing with absence of infection, ankylosis or progressive resorption. The transplantation of a third molar is seen as a promising method to replace a lost permanent tooth, and to restore aesthetics and function. *Autotransplantation is a viable option for the treatment of a missing tooth or for replacement of traumatized tooth when there is a donor tooth available. *Fully developed third molars are potentially reliable candidates in the absence of other suitable donor teeth.

Association of orthodontic force system and root resorption: A systematic review.

PubMed

Roscoe, Marina G; Meira, Josete B C; Cattaneo, Paolo M

2015-05-01

In this systematic review, we assessed the literature to determine which evidence level supports the association of orthodontic force system and root resorption. PubMed, Cochrane, and Embase databases were searched with no restrictions on year, publication status, or language. Selection criteria included human studies conducted with fixed orthodontic appliances or aligners, with at least 10 patients and the force system well described. A total of 259 articles were retrieved in the initial search. After the review process, 21 full-text articles met the inclusion criteria. Sample sizes ranged from 10 to 73 patients. Most articles were classified as having high evidence levels and low risks of bias. Although a meta-analysis was not performed, from the available literature, it seems that positive correlations exist between increased force levels and increased root resorption, as well as between increased treatment time and increased root resorption. Moreover, a pause in tooth movement seems to be beneficial in reducing root resorption because it allows the resorbed cementum to heal. The absence of a control group, selection criteria of patients, and adequate examinations before and after treatment are the most common methodology flaws. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Physical properties of root cementum: Part 16. Comparisons of root resorption and resorption craters after the application of light and heavy continuous and controlled orthodontic forces for 4, 8, and 12 weeks.

PubMed

Paetyangkul, Anchalee; Türk, Tamer; Elekdağ-Türk, Selma; Jones, Allan S; Petocz, Peter; Cheng, Lam L; Darendeliler, M Ali

2011-03-01

Orthodontic force duration can affect the severity of root resorption. The aim of this clinical study was to investigate the amounts of root resorption volumetrically after the application of controlled light and heavy forces in the buccal direction for 4, 8, and 12 weeks. The sample consisted of 54 maxillary first premolars in 36 patients (mean age, 14.9 years; 21 girls, 15 boys) who required first premolar extractions as part of their orthodontic treatment. The teeth were allocated into 3 groups that varied in the duration of force application: 4, 8, or 12 weeks. The right or left first premolars were randomly selected to receive 2 levels of forces. A light buccally directed orthodontic force of 25 g was applied to the experimental tooth on 1 side, while a heavy orthodontic force of 225 g was applied on the contralateral premolar. At the end of the experimental period, the teeth were extracted and scanned with the microcomputed-tomography x-ray system. Resorption crater analysis was performed with specially designed software for direct volumetric measurements. Significant differences in the extent of root resorption were found between 4, 8, and 12 weeks of force application (P <0.001), with substantially more severe resorption in the longer force duration groups. The light force produced significantly less root resorption than did the heavy force. After 4, 8, or 12 weeks of buccally directed orthodontic forces applied on the maxillary first premolars, the volumes of root resorption craters were found to be related to the duration and the magnitude of the forces. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

External apical root resorption diagnosis by using FII human dentine fraction and salivary IGg.

PubMed

Da-Costa, Tânia Maris Pedrini Soares; Hidalgo, Mirian Marubayashi; Consolaro, Alberto; Lima, Carlos Eduardo de Oliveira; Tanaka, Evelise Ono; Itano, Eiko Nakagawa

2018-06-01

External apical root resorption as a consequence of orthodontic treatment is an inflammatory pathological process that results in permanent loss of tooth structure from the root apex. This study aimed to investigate the diagnostic potential of human dentine fractions and salivary IgG in external apical root resorption. Saliva samples were collected from 10 patients before (T0) and after 3 (T3), 6 (T6) and 12 (T12) months of orthodontic treatment. The total dentinal extract, obtained from human third molars, was fractioned by gel filtration chromatography in three fractions denominated FI, FII and FIII. The root resorption analysis of the upper central incisors was performed by digital image subtraction method. Reactivity of salivary IgG to antigenic fractions of dentine was determined by enzyme-linked immunosorbent assay (Elisa). Regardless of treatment, FI dentin fraction with high MM (<300kDa) was the one that presented highest reactivity with salivary IgG. However, it was found higher salivary IgG reactivity for FII (69 to 45 kilodalton [kDa]) as compared to FIII (<45kDa) at (T6) and (T12), (P<0.05), the same periods in that the root resorptions were detected. Our results suggest that FII human dentine fraction and salivary IgG have potential to be used in diagnosis and monitoring of external apical root resorption. The development of a practical and accessible biochemical test using saliva and FII dentine fraction may help in the prevention of severe root resorption. Copyright © 2018. Published by Elsevier Masson SAS.

Pulpal status of human primary teeth with physiological root resorption.

PubMed

Monteiro, Joana; Day, Peter; Duggal, Monty; Morgan, Claire; Rodd, Helen

2009-01-01

The overall aim of this study was to determine whether any changes occur in the pulpal structure of human primary teeth in association with physiological root resorption. The experimental material comprised 64 sound primary molars, obtained from children requiring routine dental extractions under general anaesthesia. Pulp sections were processed for indirect immunofluorescence using combinations of: (i) protein gene product 9.5 (a general neuronal marker); (ii) leucocyte common antigen CD45 (a general immune cell marker); and (iii) Ulex europaeus I lectin (a marker of vascular endothelium). Image analysis was then used to determine the percentage area of staining for each label within both the pulp horn and mid-coronal region. Following measurement of the greatest degree of root resorption in each sample, teeth were subdivided into three groups: those with physiological resorption involving less than one-third, one-third to two-thirds, and more than two-thirds of their root length. Wide variation was evident between different tooth samples with some resorbed teeth showing marked changes in pulpal histology. Decreased innervation density, increased immune cell accumulation, and increased vascularity were evident in some teeth with advanced root resorption. Analysis of pooled data, however, did not reveal any significant differences in mean percentage area of staining for any of these variables according to the three root resorption subgroups (P > 0.05, analysis of variance on transformed data). This investigation has revealed some changes in pulpal status of human primary teeth with physiological root resorption. These were not, however, as profound as one may have anticipated. It is therefore speculated that teeth could retain the potential for sensation, healing, and repair until advanced stages of root resorption.

Cellular and Molecular Changes in Orthodontic Tooth Movement

PubMed Central

Zainal Ariffin, Shahrul Hisham; Yamamoto, Zulham; Zainol Abidin, lntan Zarina; Megat Abdul Wahab, Rohaya; Zainal Ariffin, Zaidah

2011-01-01

Tooth movement induced by orthodontic treatment can cause sequential reactions involving the periodontal tissue and alveolar bone, resulting in the release of numerous substances from the dental tissues and surrounding structures. To better understand the biological processes involved in orthodontic treatment, improve treatment, and reduce adverse side effects, several of these substances have been proposed as biomarkers. Potential biological markers can be collected from different tissue samples, and suitable sampling is important to accurately reflect biological processes. This paper covers the tissue changes that are involved during orthodontic tooth movement such as at compression region (involving osteoblasts), tension region (involving osteoclasts), dental root, and pulp tissues. Besides, the involvement of stem cells and their development towards osteoblasts and osteoclasts during orthodontic treatment have also been explained. Several possible biomarkers representing these biological changes during specific phenomenon, that is, bone remodelling (formation and resorption), inflammation, and root resorption have also been proposed. The knowledge of these biomarkers could be used in accelerating orthodontic treatment. PMID:22125437

Effect of a static magnetic field on orthodontic tooth movement in the rat.

PubMed

Tengku, B S; Joseph, B K; Harbrow, D; Taverne, A A; Symons, A L

2000-10-01

Orthodontic tooth movement may be enhanced by the application of a magnetic field. Bone remodelling necessary for orthodontic tooth movement involves clastic cells, which are tartrate-resistant acid phosphatase (TRAP) positive and which may also be regulated by growth hormone (GH) via its receptor (GHR). The aim of this study was to determine the effect of a static magnetic field (SMF) on orthodontic tooth movement in the rat. Thirty-two male Wistar rats, 9 weeks old, were fitted with an orthodontic appliance directing a mesial force of 30 g on the left maxillary first molar. The appliance incorporated a weight (NM) or a magnet (M). The animals were killed at 1, 3, 7, or 14 days post-appliance insertion, and the maxillae processed to paraffin. Sagittal sections of the first molar were stained with haematoxylin and eosin (H&E), for TRAP activity or immunohistochemically for GHR. The percentage body weight loss/gain, magnetic flux density, tooth movement, width of the periodontal ligament (PDL), length of root resorption lacunae, and hyalinized zone were measured. TRAP and GHR-positive cells along the alveolar bone, root surface, and in the PDL space were counted. The incorporation of a SMF (100-170 Gauss) into an orthodontic appliance did not enhance tooth movement, nor greatly alter the histological appearance of the PDL during tooth movement. However significantly greater root resorption (P = 0.016), increased width of the PDL (P = 0.017) and greater TRAP activity (P = 0.001) were observed for group M at day 7 on the compression side. At day 14 no differences were observed between the appliance groups.

Orthodontic Forces Induce the Cytoprotective Enzyme Heme Oxygenase-1 in Rats.

PubMed

Suttorp, Christiaan M; Xie, Rui; Lundvig, Ditte M S; Kuijpers-Jagtman, Anne Marie; Uijttenboogaart, Jasper Tom; Van Rheden, René; Maltha, Jaap C; Wagener, Frank A D T G

2016-01-01

Orthodontic forces disturb the microenvironment of the periodontal ligament (PDL), and induce craniofacial bone remodeling which is necessary for tooth movement. Unfortunately, orthodontic tooth movement is often hampered by ischemic injury and cell death within the PDL (hyalinization) and root resorption. Large inter-individual differences in hyalinization and root resorption have been observed, and may be explained by differential protection against hyalinization. Heme oxygenase-1 (HO-1) forms an important protective mechanism by breaking down heme into the strong anti-oxidants biliverdin/bilirubin and the signaling molecule carbon monoxide. These versatile HO-1 products protect against ischemic and inflammatory injury. We postulate that orthodontic forces induce HO-1 expression in the PDL during experimental tooth movement. Twenty-five 6-week-old male Wistar rats were used in this study. The upper three molars at one side were moved mesially using a Nickel-Titanium coil spring, providing a continuous orthodontic force of 10 cN. The contralateral side served as control. After 6, 12, 72, 96, and 120 h groups of rats were killed. On parasagittal sections immunohistochemical staining was performed for analysis of HO-1 expression and quantification of osteoclasts. Orthodontic force induced a significant time-dependent HO-1 expression in mononuclear cells within the PDL at both the apposition- and resorption side. Shortly after placement of the orthodontic appliance HO-1 expression was highly induced in PDL cells but dropped to control levels within 72 h. Some osteoclasts were also HO-1 positive but this induction was shown to be independent of time- and mechanical stress. It is tempting to speculate that differential induction of tissue protecting- and osteoclast activating genes in the PDL determine the level of bone resorption and hyalinization and, subsequently, "fast" and "slow" tooth movers during orthodontic treatment.

Orthodontic Forces Induce the Cytoprotective Enzyme Heme Oxygenase-1 in Rats

PubMed Central

Suttorp, Christiaan M.; Xie, Rui; Lundvig, Ditte M. S.; Kuijpers-Jagtman, Anne Marie; Uijttenboogaart, Jasper Tom; Van Rheden, René; Maltha, Jaap C.; Wagener, Frank A. D. T. G.

2016-01-01

Orthodontic forces disturb the microenvironment of the periodontal ligament (PDL), and induce craniofacial bone remodeling which is necessary for tooth movement. Unfortunately, orthodontic tooth movement is often hampered by ischemic injury and cell death within the PDL (hyalinization) and root resorption. Large inter-individual differences in hyalinization and root resorption have been observed, and may be explained by differential protection against hyalinization. Heme oxygenase-1 (HO-1) forms an important protective mechanism by breaking down heme into the strong anti-oxidants biliverdin/bilirubin and the signaling molecule carbon monoxide. These versatile HO-1 products protect against ischemic and inflammatory injury. We postulate that orthodontic forces induce HO-1 expression in the PDL during experimental tooth movement. Twenty-five 6-week-old male Wistar rats were used in this study. The upper three molars at one side were moved mesially using a Nickel-Titanium coil spring, providing a continuous orthodontic force of 10 cN. The contralateral side served as control. After 6, 12, 72, 96, and 120 h groups of rats were killed. On parasagittal sections immunohistochemical staining was performed for analysis of HO-1 expression and quantification of osteoclasts. Orthodontic force induced a significant time-dependent HO-1 expression in mononuclear cells within the PDL at both the apposition- and resorption side. Shortly after placement of the orthodontic appliance HO-1 expression was highly induced in PDL cells but dropped to control levels within 72 h. Some osteoclasts were also HO-1 positive but this induction was shown to be independent of time- and mechanical stress. It is tempting to speculate that differential induction of tissue protecting- and osteoclast activating genes in the PDL determine the level of bone resorption and hyalinization and, subsequently, “fast” and “slow” tooth movers during orthodontic treatment. PMID:27486402

Vital Pulp Therapy of a Mature Molar with Concurrent Hyperplastic Pulpitis, Internal Root Resorption and Periradicular Periodontitis: A Case Report

PubMed Central

Asgary, Saeed; Kemal Çalışkan, Mehmet

2015-01-01

Vital pulp therapy (VPT) of permanent mature teeth is continuously ascertaining to be a more reliable endodontic treatment. The purpose of this case report was to describe successful VPT of a mature mandibular left first molar with concurrent hyperplastic pulpitis, internal root resorption and periradicular periodontitis in a 35-year-old male patient. After complete caries removal and access cavity preparation, the dental pulp was removed from the coronal third of the roots. To protect the remaining pulp, calcium-enriched mixture (CEM) cement was placed and adapted into the cavities; the tooth was then restored with amalgam. Six months after VPT, radiographic examination showed evidence of periradicular healing. Clinically, the tooth was functional without signs and symptoms of infection/inflammation. The successful outcome of this case suggests that diseased dental pulp (i.e. irreversible pulpitis) has the potential to heal after pulp protection with CEM biocement. PMID:26523145

Effects of Low-Intensity Pulsed Ultrasound on Orthodontic Tooth Movement and Orthodontically Induced Inflammatory Root Resorption in Ovariectomized Osteoporotic Rats.

PubMed

Dahhas, Feras Y; El-Bialy, Tarek; Afify, Ahmed R; Hassan, Ali H

2016-03-01

This study investigated the effects of low-intensity pulsed ultrasound (LIPUS) on orthodontic tooth movement (OTM) and orthodontically induced inflammatory root resorption (OIRR) in ovariectomized osteoporotic rats. Forty-eight 28-d-old female Wistar rats were divided into ovariectomized and intact groups. In both groups, animals were left untreated; treated with 50 g mesially directed orthodontic force on the maxillary first molars using nickel-titanium closed-coil springs for 28 d; or treated with the same orthodontic protocol along with a 20-min LIPUS application on alternate days for 28 d. Extent of OTM and amount of OIRR of mesial roots were measured on three-dimensionally reconstructed micro-computed tomography images. Ovariectomy increased OIRR (p < 0.05). LIPUS reduced root volumetric loss regardless of ovariectomy status (p < 0.05); only ovariectomized animals had decreased OTM (p < 0.05). LIPUS normalizes OTM and attenuates OIRR in ovariectomized osteoporotic rats. It may therefore be beneficial in women with postmenopausal osteoporosis. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Perforating internal root resorption repaired with mineral trioxide aggregate caused complete resolution of odontogenic sinus mucositis: a case report.

PubMed

Bendyk-Szeffer, Maja; Łagocka, Ryta; Trusewicz, Matylda; Lipski, Mariusz; Buczkowska-Radlińska, Jadwiga

2015-02-01

An extensive perforating internal root resorption accompanied by apical periodontitis and odontogenic sinus mucositis was detected on preoperative cone-beam computed tomographic scans in a first maxillary molar. After the chemomechanical debridement of the root canals, calcium hydroxide was placed as a temporary dressing for 7 days. Mineral trioxide aggregate was used to fill the perforation site with the aid of a surgical microscope. At the next visit, the root with the resorption defect was filled with warm vertical compaction of gutta-percha. A control cone-beam computed tomographic scan acquired 6 months after the endodontic treatment revealed complete resolution of the sinus retention cyst. Moreover, the patient's frequent otolaryngologic disturbances ceased. The tooth was functional with satisfactory clinical and radiographic results after 12 months. Based on the results of this case, successful repair of an extensive, perforating internal resorption with mineral trioxide aggregate may lead to complete resolution of apical periodontitis and maxillary sinus retention cyst. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Could zoledronic acid prevent root resorption in replanted rat molar?

PubMed

Yoo, Jung Eun; Kim, Mi Sun; Kwon, Yong-Dae; Kim, Eun-Cheol; Kim, Kwang Chul; Choi, Sung Chul

2015-12-01

In this study, we evaluated whether zoledronate could suppress the progression of external root resorption in rat due to delayed replantation by inhibiting osteoclastic activity. Also, we estimated the optimal dosage of zoledronate in root treatment of the rat model for a maximum effect of zoledronate. Maxillary first molars in Sprague Dawley rats (N = 84) were extracted, dried for 60 min, and then replanted. The rats were divided into 6 groups (1 mM alendronate, and 1, 5, 10, 20, 40 μM zoledronate). At 4 and 8 weeks postreplantation, the animals were sacrificed and evaluated by radiographic and histological analysis. There were no significant differences at 4 weeks. However, at 8 weeks, 10, 20, and 40 μM ZOL showed more increased radiopaque and smaller periapical lesion in radiographic analysis. In histological analysis, all groups showed similar inflammatory root resorption rate at 4 weeks. However, at 8 weeks, 20 and 40 μM ZOL showed lower rate than those of other groups (P < 0.05). In concerning of replacement resorption, there were no significant differences statistically. In this animal experiment, zoledronate was capable of limiting the occurrence of root resorption in delayed replantation model. In particular, 20 μM dosage of zoledronate solution showed the most effective dose in long-term follow up and might be suitable for inhibition of root resorption in delayed tooth replantation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Histologic evaluation of the effect of mineral trioxide aggregate-Fillapex as a root canal sealer in rat teeth submitted to late replantation

PubMed Central

Ferreira, Manuel Marques; Botelho, Maria Filomena; Abrantes, Margarida; Carvalho, Lina; Carrilho, Eunice

2017-01-01

Objective: This study aims to analyze the effect of new root canal based silicate cement, in rat teeth after late replantation, comparing with calcium hydroxide (CH) in preventing tooth root resorption. Materials and Methods: The study group included 16 Wistar rats in which the upper right central incisors were extracted and were left on a worktable for 60 min, simulating a case of tooth avulsion, after had been anesthetized. One group, (Group I), the canals were filled with CH past, before replantation. The second groups of teeth, (Group II), the canals were filled with mineral trioxide aggregate-Fillapex (MTAF). After removal, the blood clot of the socket, with saline solution irrigation, the teeth were replanted into their original socket, and splinted with silk 3/0. The rats were sacrificed 8 weeks after replantation and the specimens were prepared for histologic and histomorphometric analyses. The areas of inflammatory and replacement resorptions were selected and quantified. These data for each group of teeth were evaluated and analyzed using the Mann–Whitney test (P = 0.05). Result and Conclusion: All the replanted teeth in both groups survived. Although root canal filled with MTAF provide better results than with CH past concerning inflammatory and replacement resorption, there was no statistical difference (P = 0.527). PMID:28435372

Physical properties of root cementum: Part 26. Effects of micro-osteoperforations on orthodontic root resorption: A microcomputed tomography study.

PubMed

Chan, Emmanuel; Dalci, Oyku; Petocz, Peter; Papadopoulou, Alexandra K; Darendeliler, M Ali

2018-02-01

Studies have demonstrated the potential efficacy of micro-osteoperforations in accelerating tooth movement by amplifying the expression of inflammatory markers. The aim of this investigation was to examine the effects of micro-osteoperforations on orthodontic root resorption with microcomputed tomography. This prospective controlled clinical trial involved 20 subjects requiring extraction of the maxillary first premolars as part of their orthodontic treatment. A buccal tipping force of 150 g was applied to both premolars. Using the Propel appliance (Propel Orthodontics, San Jose, Calif), micro-osteoperforations were applied at a depth of 5 mm on the mesial and distal aspects in the midroot region of the experimental side of the first premolar root; the contralateral side served as the control. After 28 days, both premolars were extracted. The teeth were scanned under microcomputed tomography, and the volumes of root resorption craters were calculated and compared. Premolars treated with micro-osteoperforation exhibited significantly greater average total amounts of root resorption than did the control teeth (0.576 vs 0.406 mm 3 ). The total average volumetric root loss of premolars treated with micro-osteoperforation was 42% greater than that of the control teeth. This 28-day trial showed that micro-osteoperforations resulted in greater orthodontic root resorption. However, these results should be verified in patients who are undergoing full-length orthodontic treatment. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

DELAYED TOOTH REPLANTATION AFTER ROOT SURFACE TREATMENT WITH SODIUM HYPOCHLORITE AND SODIUM FLUORIDE: HISTOMORPHOMETRIC ANALYSIS IN RATS

PubMed Central

Sottovia, André Dotto; Sonoda, Celso Koogi; Poi, Wilson Roberto; Panzarini, Sônia Regina; Lauris, José Roberto Pereira

2006-01-01

In cases of delayed tooth replantation, non-vital periodontal ligament remnants have been removed with sodium hypochlorite in an attempt to control root resorption. Nevertheless, reports of its irritating potential in contact with the alveolar connective tissue have been described. Therefore, this study evaluated the healing process on delayed replantation of rat teeth, after periodontal ligament removal by different treatment modalities. Twenty-four rats, assigned to 3 groups (n=8), had their upper right incisor extracted and left on the workbench for desiccation during 60 min. Afterwards, the teeth in group I were immersed in saline for 2 min. In group II, root surfaces were scrubbed with gauze soaked in saline for 2 min; and in group III, scrubbing was done with gauze soaked in 1% sodium hypochlorite solution. Thereafter, root surfaces were etched with 37% phosphoric acid and immersed in 2% acidulate-phosphate sodium fluoride solution, at pH 5.5. Root canals were filled with a calcium hydroxide-based paste and the teeth were replanted. The animals were sacrificed 60 days postoperatively and the pieces containing the replanted teeth were processed and paraffin-embedded. Semi-serial transversally sections were obtained from the middle third of the root and stained with hematoxylin and eosin for histomorphometric analysis. Data were analyzed statistically using Kruskal-Wallis and Dunn's tests. The results showed that root structure and cementum extension were more affected by resorption in group III (p<0.05). All groups were affected by root resorption but the treatment performed in group III was the least effective for its control. The treatment accomplished in groups I and II yielded similar results to each other. PMID:19089038

Delayed tooth replantation after root surface treatment with sodium hypochlorite and sodium fluoride: histomorphometric analysis in rats.

PubMed

Sottovia, André Dotto; Sonoda, Celso Koogi; Poi, Wilson Roberto; Panzarini, Sônia Regina; Lauris, José Roberto Pereira

2006-04-01

In cases of delayed tooth replantation, non-vital periodontal ligament remnants have been removed with sodium hypochlorite in an attempt to control root resorption. Nevertheless, reports of its irritating potential in contact with the alveolar connective tissue have been described. Therefore, this study evaluated the healing process on delayed replantation of rat teeth, after periodontal ligament removal by different treatment modalities. Twenty-four rats, assigned to 3 groups (n=8), had their upper right incisor extracted and left on the workbench for desiccation during 60 min. Afterwards, the teeth in group I were immersed in saline for 2 min. In group II, root surfaces were scrubbed with gauze soaked in saline for 2 min; and in group III, scrubbing was done with gauze soaked in 1% sodium hypochlorite solution. Thereafter, root surfaces were etched with 37% phosphoric acid and immersed in 2% acidulate-phosphate sodium fluoride solution, at pH 5.5. Root canals were filled with a calcium hydroxide-based paste and the teeth were replanted. The animals were sacrificed 60 days postoperatively and the pieces containing the replanted teeth were processed and paraffin- embedded. Semi-serial transversally sections were obtained from the middle third of the root and stained with hematoxylin and eosin for histomorphometric analysis. Data were analyzed statistically using Kruskal-Wallis and Dunn's tests. The results showed that root structure and cementum extension were more affected by resorption in group III (p<0.05). All groups were affected by root resorption but the treatment performed in group III was the least effective for its control. The treatment accomplished in groups I and II yielded similar results to each other.

Differences of protein profile before and after orthodontic treatment

NASA Astrophysics Data System (ADS)

Nasri, Farah Amirah Mohd; Wahab, Rohaya Megat Abdul; Karsani, Saiful Anuar; Ariffin, Shahrul Hisham Zainal

2016-11-01

Mechanical forces in orthodontic treatment used to treat malocclusion can cause inflamed gingival tissue and the process of tooth movement may resorb dental root. Root resorption is an iatrogenic effect of orthodontic treatment but it can be monitored using protein biomarker. This study aims to investigate the differences of protein profile before and after orthodontic treatment using different staining methods. Human gingival crevicular fluid and saliva were collected from orthodontic patients before and after treatment. Protein profile were observed using SDS-PAGE. Our study shows down regulation of proteins after 3 months of treatment. Hence, there are potential values from this study to aid in investigation for specific biomarkers for root resorption.

Fifteen-year Clinical Follow-up of Restoration of Extensive Cervical Resorption in a Maxillary Central Incisor.

PubMed

Reston, E G; Bueno, Rpr; Closs, L Q; Zettermann, J

Internal bleaching in endodontically treated teeth requires care and protection to prevent harm to the periodontal ligament due to peroxide and may result in external root resorption. There is a myriad of treatment options when this occurs, such as monitoring, extraction, and subsequent rehabilitation with implants or fixed prosthodontics. In some cases, such as the one described here, a conservative attempt to maintain the tooth as a single structure can be made by sealing the resorptive defect. In the present case, we show a multidisciplinary approach where orthodontics, periodontics, and restorative dentistry were involved in treating the maxillary right central incisor (#8) of a 65-year-old patient with extensive cervical resorption, whose chief complaint was esthetics. The proposed treatment was extrusion of the tooth followed by curettage and restoration of the defect with glass ionomer cement. The patient has been followed for 15 years with no signs of recurrence, maintenance of periodontal health, and patient satisfaction with the esthetic outcome.

Effect of supplementary zinc on orthodontic tooth movement in a rat model

PubMed Central

Sadegh, Ahmad Akhoundi Mohammad; Rezvaneh, Ghazanfari; Shahroo, Etemad-Moghadam; Mojgan, Alaeddini; Azam, Khorshidian; Shahram, Rabbani; Reza, Shamshiri Ahmad; Nafiseh, Momeni

2016-01-01

ABSTRACT Introduction: Osteoclasts and osteoblasts are responsible for regulating bone homeostasis during which the trace element zinc has been shown to exert a cumulative effect on bone mass by stimulating osteoblastic bone formation and inhibiting osteoclastic bone resorption. Objective: The aim of the present study was to investigate the effects of zinc (Zn) on orthodontic tooth movement (OTM) in a rat model. Material and Methods: A total of 44 male Wistar rats were divided into four groups of 11 animals each and received 0, 1.5, 20 and 50 ppm Zn in distilled water for 60 days. In the last 21 days of the study, nickel-titanium closed coil springs were ligated between maxillary right incisors and first molars of all rats, and tooth movement was measured at the end of this period. Histological analysis of hematoxylin/eosin slides was performed to assess root resorption lacunae, osteoclast number and periodontal ligament (PDL) width. Results: Mean OTM was calculated as 51.8, 49.1, 35.5 and 45 µm in the 0, 1.5, 20 and 50 ppm zinc-receiving groups, respectively. There were no significant differences in neither OTM nor histological parameters among the study groups (p > 0.05). Conclusion: According to the results obtained in the current investigation, increase in supplementary zinc up to 50 ppm does not affect the rate of OTM neither bone and root resorption in rats. PMID:27275614

Volumetric measurement of root resorption following molar mini-screw implant intrusion using cone beam computed tomography.

PubMed

Li, Wen; Chen, Fei; Zhang, Feng; Ding, Wanghui; Ye, Qingsong; Shi, Jiejun; Fu, Baiping

2013-01-01

Molar intrusion by mini-screw implantation can cause different degrees of root resorption. However, most methods (2-D and 3-D) used for evaluating root resorption have focused on the root length without considering 3-D resorption. The purpose of this study was to volumetrically evaluate root resorption using cone beam computed tomography(CBCT) after mini-screw implant intrusion. 1. The volumes of 32 teeth were measured using CBCT and laser scanning to verify the accuracy of CBCT. 2. Twelve overerupted molars from adult patients were investigated in this study. After mini-screw implants were inserted into the buccal and palatal alveolar bones, 150 g of force was applied to the mini-screw implants on each side to intrude the molars. CBCT images of all patients were taken immediately prior to intrusion and after intrusion. The volumes of the roots were calculated using the Mimics software program. The differences between the pre-intrusion and post-intrusion root volumes were statistically evaluated with a paired-samples t-test. In addition, the losses of the roots were statistically compared with each other using one-way analysis of variance at the P<0.05 level. No statistically significant volume differences were observed between the physical (laser scanning) and CBCT measurements (P>0.05). The overerupted molars were significantly intruded (P<0.05), and the average intrusion was 3.30±1.60 mm. The differences between the pre-intrusion and post-intrusion root volumes were statistically significant for all of the roots investigated (P<0.05). The roots were sorted by volume loss in descending order as follows: mesiobuccal, palatal, and distobuccal. Statistical significance was achieved among the three roots. The average total resorption for each tooth was 58.39±1.54 mm(3). Volume measurement using CBCT was able to effectively evaluate root resorption caused by mini-screw intrusion. The highest volume loss was observed in the mesiobuccal root among the three roots of the investigated first molar teeth.

Volumetric Measurement of Root Resorption following Molar Mini-Screw Implant Intrusion Using Cone Beam Computed Tomography

PubMed Central

Li, Wen; Chen, Fei; Zhang, Feng; Ding, Wanghui; Ye, Qingsong; Shi, Jiejun; Fu, Baiping

2013-01-01

Objective Molar intrusion by mini-screw implantation can cause different degrees of root resorption. However, most methods (2-D and 3-D) used for evaluating root resorption have focused on the root length without considering 3-D resorption. The purpose of this study was to volumetrically evaluate root resorption using cone beam computed tomography(CBCT) after mini-screw implant intrusion. Materials and Methods 1. The volumes of 32 teeth were measured using CBCT and laser scanning to verify the accuracy of CBCT. 2. Twelve overerupted molars from adult patients were investigated in this study. After mini-screw implants were inserted into the buccal and palatal alveolar bones, 150 g of force was applied to the mini-screw implants on each side to intrude the molars. CBCT images of all patients were taken immediately prior to intrusion and after intrusion. The volumes of the roots were calculated using the Mimics software program. The differences between the pre-intrusion and post-intrusion root volumes were statistically evaluated with a paired-samples t-test. In addition, the losses of the roots were statistically compared with each other using one-way analysis of variance at the P<0.05 level. Results No statistically significant volume differences were observed between the physical (laser scanning) and CBCT measurements (P>0.05). The overerupted molars were significantly intruded (P<0.05), and the average intrusion was 3.30±1.60 mm. The differences between the pre-intrusion and post-intrusion root volumes were statistically significant for all of the roots investigated (P<0.05). The roots were sorted by volume loss in descending order as follows: mesiobuccal, palatal, and distobuccal. Statistical significance was achieved among the three roots. The average total resorption for each tooth was 58.39±1.54 mm3. Conclusion Volume measurement using CBCT was able to effectively evaluate root resorption caused by mini-screw intrusion. The highest volume loss was observed in the mesiobuccal root among the three roots of the investigated first molar teeth. PMID:23585866

Florid cemento-osseous dysplasia mimicking apical periodontitis: A case report.

PubMed

Rekabi, Ali Reza; Ashouri, Rezvan; Torabi, Molok; Parirokh, Masoud; Abbott, Paul V

2013-12-01

Cemento-osseous dysplasia may present as a focal, periapical or florid lesion in the mandible or maxilla. The lesion may sometimes appear similar to peri-radicular lesions on a periapical radiograph. This report presents a case with irreversible pulpitis and root resorption as well as a mixed radiolucent/radiopaque lesion around a mandibular molar tooth root. Root canal treatment was performed and because of the radiographic signs of root resorption and the patient's fear of having a malignant disease, periapical surgery was also performed. The histopathology report confirmed the presence of florid cement-osseous dysplasia which was mimicking apical periodontitis. Follow-up radiography 12 months after the surgery illustrated complete healing of the radiolucent area. © 2011 The Authors. Australian Endodontic Journal © 2011 Australian Society of Endodontology.

Use of the piezosurgery technique for cutting bones in the autotransplantation of unerupted third molars.

PubMed

Koszowski, Rafał; Morawiec, Tadeusz; Bubiłek-Bogacz, Anna

2013-01-01

Autotransplantation is a well-known method used in oral surgery. However, risk of failure, most commonly resulting from root resorption of the transplanted tooth or ankylosis, is quite high. Piezosurgery with specific device tip vibration frequencies enables selective tissue cutting, and therefore, tooth buds or teeth can easily be removed from bones with little injury to periodontal fibers or bud follicles.

Severe periodontitis in a patient with hyperoxaluria and oxalosis: a case report and review of the literature.

PubMed

Panis, Vassilios; Tosios, Konstantinos I; Gagari, Eleni; Griffin, Terrence J; Damoulis, Petros D

2010-10-01

Hyperoxaluria is a metabolic disease with excessive urinary oxalate excretion that can be primary or secondary. Hyperoxaluria can result in chronic renal disease and renal failure. Calcium oxalate crystals can be deposited in oral tissues, and the disease can be associated with severe periodontitis and tooth loss. The periodontal condition of a 38-year-old patient with a diagnosis of hyperoxaluria and end-stage renal disease is presented. The patient's periodontal status was monitored over a period of several weeks, and extracted teeth were submitted for histopathologic evaluation. The patient was diagnosed with generalized severe periodontitis and external root resorption. Initial periodontal treatment consisting of oral-hygiene instructions and scaling and root planing was performed. However, despite an initial decrease of soft tissue inflammation, the patient's periodontal condition deteriorated, and eventually, all teeth had to be extracted. The deposition of calcium oxalate crystals in the periodontal tissues was confirmed histologically. Long-standing hyperoxaluria can be associated with severe periodontitis and external root resorption resulting in tooth loss. The pathogenetic mechanisms of hard tissue destruction are still unclear.

Root resection under the surgical field employed for extraction of impacted tooth and management of external resorption.

PubMed

Pai, Ar Vivekananda; Khosla, Manak

2012-07-01

This case report illustrates determination of prognosis and immediate resection carried out, before completing the endodontic therapy, during the surgery employed for managing a nonperiodontal problem. This case showed external pressure resorption in the distobuccal root of maxillary second molar caused by the impingement of impacted third molar. Extraction of third molar was decided when healing was not seen, despite initiating endodontic therapy in second molar. Following elevation of flap and extraction of third molar, the poor prognosis due to severe bone loss around the resorbed root was evident. But due to strategic value of second molar, it was found beneficial to employ resection. Therefore, immediate resection was carried out in the same surgical field before the completion of endodontic therapy. This prevented the need for another surgical entry with its associated trauma to carry out resection separately later. Resection followed by the completion of endodontic therapy and full crown assisted in salvaging the remaining functional portion of the tooth and prevented the occurrence of distal extension with its potential drawbacks.

The Effect of An Angiogenic Cytokine on Orthodontically Induced Inflammatory Root Resorption

PubMed Central

Seifi, Massoud; Lotfi, Ali; Badiee, Mohammad Reza; Abdolazimi, Zahra; Amdjadi, Parisa; Bargrizan, Majid

2016-01-01

Objective Orthodontically induced inflammatory root resorption (OIIRR) is an undesirable sequel of tooth movement after sterile necrosis that takes place in periodontal ligament due to blockage of blood vessels following exertion of orthodontic force. This study sought to assess the effect of an angiogenic cytokine on OIIRR in rat model. Materials and Methods In this experimental animal study, 50 rats were randomly divided into 5 groups of 10 each: E10, E100 and E1000 receiving an injection of 10, 100 and 1000 ng of basic fibroblast growth factor (bFGF), respectively, positive control group (CP) receiving an orthodontic appliance and injection of phosphate buffered saline (PBS) and the negative control group (CN) receiving only the anesthetic agent. A nickel titanium coil spring was placed between the first molar and the incisor on the right side of maxilla. Twenty-one days later, the rats were sacrificed. Histopathological sections were made to assess the number and area of resorption lacunae, number of blood vessels, osteoclasts and Howship’s lacunae. Data were statistically analyzed using ANOVA and Tukey’s honest significant difference (HSD) test. Results Number of resorption lacunae and area of resorption lacunae in E1000 (0.97 ± 0.80 and 1. 27 ± 0.01×10-3, respectively) were significantly lower than in CP (4.17 ± 0.90 and 2.77 ± 0.01×10-3, respectively, P=0.000). Number of blood vessels, osteoclasts and Howship’s lacunae were significantly higher in E1000 compared to CP (P<0.05). Conclusion Tooth movement as the outcome of bone remodeling is concomitant with the formation of sterile necrosis in the periodontal ligament following blocked blood supply. Thus, bFGF can significantly decrease the risk of root resorption by providing more oxygen and angiogenesis. PMID:27551674

Association between root resorption incident to orthodontic treatment and treatment factors.

PubMed

Motokawa, Masahide; Sasamoto, Tomoko; Kaku, Masato; Kawata, Toshitsugu; Matsuda, Yayoi; Terao, Akiko; Tanne, Kazuo

2012-06-01

The purpose of this study was to clarify the prevalence and degree of root resorption induced by orthodontic treatment in association with treatment factors. The files of 243 patients (72 males and 171 females) aged 9-51 years were randomly selected from subjects treated with multi-bracket appliances. The severity of root resorption was classified into five categories on radiographs taken before and after treatment. The subjects were divided into extraction (n = 113 patients, 2805 teeth) and non-extraction (n = 130 patients, 3616 teeth) groups and surgical (n = 56 patients, 1503 teeth) and non-surgical treatment (n = 187 patients, 4918 teeth) groups. These subjects were also divided into two or three groups based on the duration of multiloop edgewise archwire (MEAW) treatment, elastic use, and total treatment time: 0 month (T1; n = 184 patients, 4831 teeth), range 1-6 months (T2; n = 37 patients, 994 teeth), more than 6 months (T3; n = 22 patients, 596 teeth); range 0-6 months (n = 114 patients, 3016 teeth) more than 6 months (n = 129 patients, 3405 teeth); range 1-30 months (n = 148 patients, 3913 teeth) and more than 30 months (n = 95 patients, 2508 teeth). The prevalence of overall and severe root resorption evaluated by the number of subjects and teeth was compared with a chi-square test. A Student's t-test for unpaired data was used to determine any statistically significant differences. The prevalence of severe root resorption based on the number of teeth was significantly higher in the group with extractions (P < 0.01). Longer use of a MEAW appliance and elastics also produced a significantly higher prevalence of root resorption (P < 0.05). On the other hand, the prevalence of severe root resorption was not significantly different between the subjects treated with or without surgery, but there was a significant increase when treatment time was prolonged (P < 0.05). A significant difference was found in the amount of root movement of the upper central incisors and the distance from their root apices to the cortical bone surface (P < 0.05). These are regarded as essential factors in the onset of root resorption. These results indicate that orthodontic treatment with extractions, long-term use of a MEAW appliance and elastics, treatment time, and distance of tooth movement are risk factors for severe root resorption.

The effect of mechanical vibration on orthodontically induced root resorption.

PubMed

Yadav, Sumit; Dobie, Thomas; Assefnia, Amir; Kalajzic, Zana; Nanda, Ravindra

2016-09-01

To investigate the effect of low-frequency mechanical vibration (LFMV) on orthodontically induced root resorption. Forty male CD1, 12-week-old mice were used for the study. The mice were randomly divided into five groups: group 1 (baseline)-no spring and no mechanical vibration, group 2-orthodontic spring but no vibration, group 3-orthodontic spring and 5 Hz of vibration applied to the maxillary first molar, group 4-orthodontic spring and 10 Hz of vibration applied to maxillary first molar, and group 5-orthodontic spring and 20 Hz of vibration applied to maxillary first molar. In the different experimental groups, the first molar was moved mesially for 2 weeks using a nickel-titanium coil spring delivering 10 g of force. LFMVs were applied at 5 Hz, 10 Hz, and 20 Hz. Microfocus X-ray computed tomography imaging was used to analyze root resorption. Additionally, to understand the mechanism, we applied LFMV to MC3T3 cells, and gene expression analyses were done for receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG). Orthodontic tooth movement leads to decreased root volume (increased root resorption craters). Our in vivo experiments showed a trend toward increase in root volume with different frequencies of mechanical vibration. In vitro gene expression analyses showed that with 20 Hz of mechanical vibration, there was a significant decrease in RANKL and a significant increase in OPG expression. There was a trend toward decreased root resorption with different LFMVs (5 Hz, 10 Hz, and 20 Hz); however, it was not more statistically significant than the orthodontic-spring-only group.

Innovative evaluation of local injective gel of curcumin on the orthodontic tooth movement in rats.

PubMed

Asefi, Sohrab; Seifi, Massoud; Fard, Ghazal Hatami; Lotfi, Ali

2018-01-01

Curcumin is the most active compound in turmeric. It can suppress the nuclear factor kappa-light-chain-enhancer of activated B cells pathway and prevent the osteoclastogenesis procedure. This study aimed to be the first to evaluate the effect of curcumin on the rate of orthodontic tooth movement (OTM). Forty rats were used as follows in each group: (1) negative control: Did not receive any appliance or injection; (2) positive control: received 0.03 cc normal saline and appliance; (3) gelatin plus curcumin (G): Received 0.03 cc hydrogel and appliance; and (4) chitosan plus curcumin (Ch): Received 0.03 cc hydrogel and appliance. They were anesthetized and closed nickel-titanium coil springs were installed between the first molars and central incisors unilaterally as the orthodontic appliance. After 21 days, the rats were decapitated, and the distance between the first and second molars was measured by a leaf gauge. Howship's lacunae, blood vessels, osteoclast-like cells, and root resorption lacunae were evaluated in the histological analysis. Data were analyzed by one-way ANOVA, Tukey's test, and t -test ( P < 0.05 consider significant). No significant difference was found in OTM between groups delivered orthodontic forces. Curcumin inhibited root and bone resorption, osteoclastic recruitment, and angiogenesis significantly. Curcumin had no significant inhibitory effect on OTM. While it had a significant role on decreasing bone or root resorption ( P > 0.05).

Apical root resorption during orthodontic treatment with aligners? A retrospective radiometric study.

PubMed

Krieger, Elena; Drechsler, Thomas; Schmidtmann, Irene; Jacobs, Collin; Haag, Simeon; Wehrbein, Heinrich

2013-08-14

Objective of this study was to investigate the incidence and severity of apical root resorptions (ARR) during orthodontic treatment with aligners. The sample comprised 100 patients (17-75 years of age) with a class I occlusion and anterior crowding before treatment, treated exclusively with aligners (Invisalign®, Align Technologies, Santa Clara, CA, USA). The following teeth were assessed: upper and lower anterior teeth and first molars. Root and crown lengths of a total of 1600 teeth were measured twice in pre- and post-treatment panoramic radiographs. Afterwards, relative changes of the root length during treatment were calculated by a root-crown-ratio taking pre- and post-treatment root and crown lengths into consideration. A reduction of this ratio was considered as a shortening of the initial root length. Additionally, tooth movements of the front teeth were assessed by lateral cephalograms and the 3-dimensonal set up of each patient. All patients had a reduction of the pre-treatment root length with a minimum of two teeth. On average 7.36 teeth per patient were affected. 54% of 1600 measured teeth showed no measurable root reduction. A reduction of >0%-10% of the pre-treatment root length was found in 27.75%, a distinct reduction of >10%-20% in 11.94%. 6.31% of all teeth were affected with a considerable reduction of >20%. We found no statistically significant correlation between relative root length changes and the individual tooth, gender, age or sagittal and vertical orthodontic tooth movement; except for extrusion of upper front teeth, which was considered as not clinical relevant due to the small amount of mean 4% ARR. The present study is the first analyzing ARR in patients with a fully implemented orthodontic treatment with aligners (i.e. resolving anterior crowding). The variety was high and no clinical relevant influence factor could be detected. A minimum of two teeth with a root length reduction was found in every patient. On average, 7.36 teeth per patient were affected.

Root resorption during orthodontic treatment.

PubMed

Walker, Sally

2010-01-01

Medline, Embase, LILACS, The Cochrane Library (Cochrane Database of Systematic Reviews, CENTRAL, and Cochrane Oral Health Group Trials Register) Web of Science, EBM Reviews, Computer Retrieval of Information on Scientific Project (CRISP, www.crisp.cit.nih.gov), On-Line Computer Library Center (www.oclc.org), Google Index to Scientific and Technical Proceedings, PAHO (www.paho.org), WHOLis (www.who.int/library/databases/en), BBO (Brazilian Bibliography of Dentistry), CEPS (Chinese Electronic Periodical Services), Conference materials (www.bl.uk/services/bsds/dsc/conference.html), ProQuest Dissertation Abstracts and Thesis database, TrialCentral (www.trialscentral.org), National Research Register (www.controlled-trials.com), www.Clinicaltrials.gov and SIGLE (System for Information on Grey Literature in Europe). Randomised controlled trials including split mouth design, recording the presence or absence of external apical root resorption (EARR) by treatment group at the end of the treatment period. Data were extracted independently by two reviewers using specially designed and piloted forms. Quality was also assessed independently by the same reviewers. After evaluating titles and abstracts, 144 full articles were obtained of which 13 articles, describing 11 trials, fulfilled the criteria for inclusion. Differences in the methodological approaches and reporting results made quantitative statistical comparisons impossible. Evidence suggests that comprehensive orthodontic treatment causes increased incidence and severity of root resorption, and heavy forces might be particularly harmful. Orthodontically induced inflammatory root resorption is unaffected by archwire sequencing, bracket prescription, and self-ligation. Previous trauma and tooth morphology are unlikely causative factors. There is some evidence that a two- to three-month pause in treatment decreases total root resorption. The results were inconclusive in the clinical management of root resorption, but there is evidence to support the use of light forces, especially with incisor intrusion.

Internal and external resorption in a lower molar with an associated endodontic-periodontic lesion: a case report.

PubMed

Komabayashi, Takashi; Zhu, Qiang

2012-08-01

This article describes a unique case in which both internal and external inflammatory resorption and endodontic-periodontic lesions were present at the same time in the patient's left mandibular first molar. Based on clinical and radiographic findings, it was determined that the nature of this case was a pulpal infection-induced inflammatory resorption and furcation lesion. After root canal therapy, the furcation lesion and external inflammatory resorption were completely resolved. This case indicates that the correct diagnosis of the stimulating factor for tooth resorption and determination of the primary origin of endodontic-periodontic lesions are critical for clinical management and success. Published 2011. This article is a U.S. Government work and is in the public domain in the USA.

IL-8 and MCP-1 induced by excessive orthodontic force mediates odontoclastogenesis in periodontal tissues.

PubMed

Asano, M; Yamaguchi, M; Nakajima, R; Fujita, S; Utsunomiya, T; Yamamoto, H; Kasai, K

2011-07-01

The aim of this study was to investigate how interleukin (IL)-8 (cytokine-induced neutrophil chemoattractant; CINC-1) and monocyte chemotactic protein (MCP)-1/CCL2 contribute to root resorption during orthodontic tooth movement. Forty 6-week-old male Wistar rats were subjected to orthodontic force of 10 or 50 g to induce a mesially tipping movement of the upper first molars for 7 days. We determined the expressions of CINC-1, CXCR2, and MCP-1 proteins in root resorption area using immunohistochemistry. Furthermore, we investigated the effects of compression forces (CF) on IL-8 and MCP-1 production by human periodontal ligament (hPDL) cells. We observed an effect of chemokine treatment on rat odonto/osteoclasts in dentin slices that recapitulated root resorption. The immunoreactivity for CINC-1/CXCR2 and MCP-1 was detected in odontoclasts and PDL fibroblasts by the orthodontic force of 50 g on day 7. CF increased the secretion and the expression of mRNA of IL-8 and MCP-1 from PDL cells in a magnitude-dependent manner. Moreover, CINC-1 and MCP-1 stimulated osteoclastogenesis from rat osteoclast precursor cells. IL-8 (CINC-1) and MCP-1 may therefore facilitate the process of root resorption because of excessive orthodontic force. © 2010 John Wiley & Sons A/S.

Effect of odanacatib on root resorption and alveolar bone metabolism during orthodontic tooth movement.

PubMed

Wei, X X; Chu, J P; Zou, Y Z; Ru, N; Cui, S X; Bai, Y X

2015-12-22

The aim of this study was to investigate the effect of local administration of odanacatib (ODN) on orthodontic root resorption and the status of alveolar bone metabolism in rat molars. All specimens were scanned using microcomputed tomography and then the raw images were reconstructed. The total volume of the root resorption craters of the 60 g-NS (normal saline) group was higher than in the 60 g-ODN group and the control group. In the 60 g-NS group, the bone volume fraction values of alveolar bone were significantly decreased compared with the other 2 groups. There were no significant differences in the bone volume fraction values of the tibiae among the 3 groups. The results of tartrate-resistant acid phosphatase-positive (TRAP+) numbers showed that there was no difference between the 60 g-NS group and the 60 g-ODN group. The expression of cathepsin K was decreased significantly in the 60 g-ODN group. These results indicate that ODN reduces orthodontics-induced external root resorption and increases alveolar bone metabolism. This may be because ODN inhibits the activity of odontoclasts, but maintains the quantity of odontoclasts and enhances bone formation. ODN promotes local alveolar bone metabolism, but does not affect systemic bone metabolism.

Apical stress distribution on maxillary central incisor during various orthodontic tooth movements by varying cemental and two different periodontal ligament thicknesses: a FEM study.

PubMed

Vikram, N Raj; Senthil Kumar, K S; Nagachandran, K S; Hashir, Y Mohamed

2012-01-01

During fixed orthodontic therapy, when the stress levels in the periodontal ligament (PDL) exceedsan optimum level, it could lead to root resorption. To determine an apical stress incident on the maxillary central incisor during tooth movement with varying cemental and periodontal ligament thickness by Finite Element Method (FEM) modeling. A three dimensional finite element model of a maxillary central incisor along with enamel, dentin, cementum, PDL and alveolar bone was recreated using EZIDCOM and AUTOCAD software. ALTAIR Hyper mesh 7.0 version was used to create the Finite Element meshwork of the tooth. This virtual model was transferred to Finite Element Analysis software, ANSYS where different tooth movements were performed. Cemental thickness at the root apex was varied from 200 μm to 1000 μm in increments of 200 μm. PDL thickness was varied as 0.24 mm and 0.15 mm. Intrusive, Extrusive, Rotation and Tipping forces were delivered to determine an apical stress for each set of parameters. Results indicated that an apical stress induced in the cementum and PDL, increased with an increase in cementum and PDL thickness respectively. Apical stress induced in the cementum remained the same or decreased with an increase in the PDL thickness. Apical stress induced in the PDL decreased with an increase in the cementum thickness. The study concluded that the clinical delivery of an orthodontic forces will cause stress in the cementum and PDL. Hence, it is necessary to limit the orthodontic force to prevent root resorption.

Interactive effects of periodontitis and orthodontic tooth movement on dental root resorption, tooth movement velocity and alveolar bone loss in a rat model.

PubMed

Kirschneck, Christian; Fanghänel, Jochen; Wahlmann, Ulrich; Wolf, Michael; Roldán, J Camilo; Proff, Peter

2017-03-01

Many adult orthodontic patients suffer from chronic periodontitis with recurrent episodes of active periodontal inflammation. As their number is steadily increasing, orthodontists are more and more frequently challenged by respective treatment considerations. However, little is currently known regarding interactive effects on undesired dental root resorption (DRR), tooth movement velocity, periodontal bone loss and the underlying cellular and tissue reactions. A total of 63 male Fischer344 rats were used in three consecutive experiments employing 21 animals each (A/B/C), randomly assigned to 3 experimental groups (n=7, 1/2/3), respectively: (A) CBCT; (B) histology/serology; (C) RT-qPCR-(1) control; (2) orthodontic tooth movement (OTM) of the first/second upper left molars (NiTi coil spring, 0.25N); (3) OTM with experimentally induced periodontitis (cervical silk ligature). After 14days of OTM, we quantified blood leukocyte level, DRR, osteoclast activity and relative gene expression of inflammatory and osteoclast marker genes within the dental-periodontal tissue as well as tooth movement velocity and periodontal bone loss after 14 and 28 days. The experimentally induced periodontal bone loss was significantly increased by concurrent orthodontic force application. Periodontal inflammation during OTM on the other hand significantly augmented the extent of DRR, relative expression of inflammatory/osteoclast marker genes, blood leukocyte level and periodontal osteoclast activity. In addition, contrary to previous studies, we observed a significant increase in tooth movement velocity. Although accelerated tooth movement would be favourable for orthodontic treatment, our results suggest that orthodontic interventions should only be performed after successful systematic periodontal therapy and paused in case of recurrent active inflammation. Copyright © 2016 Elsevier GmbH. All rights reserved.

Innovative evaluation of local injective gel of curcumin on the orthodontic tooth movement in rats

PubMed Central

Asefi, Sohrab; Seifi, Massoud; Fard, Ghazal Hatami; Lotfi, Ali

2018-01-01

Background: Curcumin is the most active compound in turmeric. It can suppress the nuclear factor kappa-light-chain-enhancer of activated B cells pathway and prevent the osteoclastogenesis procedure. This study aimed to be the first to evaluate the effect of curcumin on the rate of orthodontic tooth movement (OTM). Materials and Methods: Forty rats were used as follows in each group: (1) negative control: Did not receive any appliance or injection; (2) positive control: received 0.03 cc normal saline and appliance; (3) gelatin plus curcumin (G): Received 0.03 cc hydrogel and appliance; and (4) chitosan plus curcumin (Ch): Received 0.03 cc hydrogel and appliance. They were anesthetized and closed nickel-titanium coil springs were installed between the first molars and central incisors unilaterally as the orthodontic appliance. After 21 days, the rats were decapitated, and the distance between the first and second molars was measured by a leaf gauge. Howship's lacunae, blood vessels, osteoclast-like cells, and root resorption lacunae were evaluated in the histological analysis. Data were analyzed by one-way ANOVA, Tukey's test, and t-test (P < 0.05 consider significant). Results: No significant difference was found in OTM between groups delivered orthodontic forces. Curcumin inhibited root and bone resorption, osteoclastic recruitment, and angiogenesis significantly. Conclusion: Curcumin had no significant inhibitory effect on OTM. While it had a significant role on decreasing bone or root resorption (P > 0.05). PMID:29497446

External root resorption during orthodontic treatment in root-filled teeth and contralateral teeth with vital pulp: A clinical study of contributing factors.

PubMed

Lee, Yun Ju; Lee, Tae Yeon

2016-01-01

There is a lack of research to support the belief that root canal treatment can be considered for stopping or decreasing external apical root resorption (EARR). There is conflicting evidence as to whether root-filled teeth are more or less likely to experience EARR after orthodontic treatment. The purpose of this study was to compare the degree of EARR of root-filled teeth with that of contralateral teeth with vital pulp after fixed orthodontic treatment. The study sample consisted of 35 patients aged 25.23 ± 4.92 years who had at least 1 root-filled tooth before orthodontic treatment. Digital panoramic radiographs of each patient taken before and after orthodontic treatment were used to measure the EARR. The Student t test for matched pairs and the Pearson correlation analysis were applied. The mean EARR values were 0.22 (0.14, 0.35) for root-filled teeth and 0.87 (0.59, 1.31) for contralateral teeth with vital pulp, indicating significantly less EARR for root-filled teeth compared with the contralateral teeth with vital pulp after orthodontic treatment. EARR was influenced by the patient's age, treatment duration, treatment type, and periapical pathosis, but not by tooth type and sex. Root-filled teeth appear to be associated with significantly less EARR than are contralateral teeth with vital pulp. This study suggests that the possible complication of EARR in root-filled teeth may not be an important consideration in orthodontic treatment planning, and root canal treatment can be considered for stopping or decreasing EARR when severe EARR occurs during orthodontic treatment. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Tooth-bone morphogenesis during postnatal stages of mouse first molar development

PubMed Central

Lungová, Vlasta; Radlanski, Ralf J; Tucker, Abigail S; Renz, Herbert; Míšek, Ivan; Matalová, Eva

2011-01-01

The first mouse molar (M1) is the most common model for odontogenesis, with research particularly focused on prenatal development. However, the functional dentition forms postnatally, when the histogenesis and morphogenesis of the tooth is completed, the roots form and the tooth physically anchors into the jaw. In this work, M1 was studied from birth to eruption, assessing morphogenesis, proliferation and apoptosis, and correlating these with remodeling of the surrounding bony tissue. The M1 completed crown formation between postnatal (P) days 0–2, and the development of the tooth root was initiated at P4. From P2 until P12, cell proliferation in the dental epithelium reduced and shifted downward to the apical region of the forming root. In contrast, proliferation was maintained or increased in the mesenchymal cells of the dental follicle. At later stages, before tooth eruption (P20), cell proliferation suddenly ceased. This withdrawal from the cell cycle correlated with tooth mineralization and mesenchymal differentiation. Apoptosis was observed during all stages of M1 postnatal morphogenesis, playing a role in the removal of cells such as osteoblasts in the mandibular region and working together with osteoclasts to remodel the bone around the developing tooth. At more advanced developmental stages, apoptotic cells and bodies accumulated in the cell layers above the tooth cusps, in the path of eruption. Three-dimensional reconstruction of the developing postnatal tooth and bone indicates that the alveolar crypts form by resorption underneath the primordia, whereas the ridges form by active bone growth between the teeth and roots to form a functional complex. PMID:21418206

Resorptive tooth root lesions in the Malayan tapir (Tapirus indicus).

PubMed

Da Silva, Mari-Ann O; Kortegaard, Hanne E; Choong, Siew Shean; Arnbjerg, Jens; Bertelsen, Mads F

2011-03-01

Facial abscessation and osteomyelitis due to dental disease is commonly seen in the Malayan tapir (Tapirus indicus), but little is known about the prevalence or etiology of these lesions. To determine the prevalence of dental ailments, 56 skulls and mandibles of deceased Malayan tapirs were visually and radiographically evaluated. Dental lesions were scored according to severity, and individuals were classified according to their age (juvenile/ young adult/adult) and origin (captive/free ranging). All of the lesions identified were of a resorptive nature. seemingly originating at the cementoenamel junction and burrowing towards the center of the tooth. Overall, 27% of the investigated skulls presented radiolucent dental lesions. The prevalence among captive animals was 52% (13/25), while only 6% (2/31) of the free-ranging tapirs had dental lesions. The second, third, and fourth premolars and first molar were the teeth most commonly affected, and the mandibular teeth were more often involved than the maxillary dentition. This study demonstrates a high prevalence of resorptive dental lesions in captive Malayan tapirs and provides a strong indication that age and captivity are significant risk factors in the development of these lesions. Dental disease, Malayan tapir, radiology, resorptive lesions, Tapirus indicus.

Influence of a parafunctional oral habit on root fracture development after trauma to an immature tooth.

PubMed

dos Santos, Cláudia Letícia Vendrame; Saito, Célia Tomiko Matida Hamata; Luvizzuto, Eloá Rodrigues; Poi, Wilson Roberto; Panzarini, Sônia Regina; Sonoda, Celso Koogi

2011-07-01

Root fractures in immature teeth are rare because the resilience of the alveolar bone is more favorable to the occurrence of luxation. This article reports a case of traumatic injury in an immature permanent tooth that progressed to root fracture, having a parafunctional oral habit as the possible modifying factor of case evolution. A 12-year-old boy presented for treatment complaining of a defective restoration and mild pain on the maxillary right central incisor. The patient had a history of crown fracture in this tooth due to trauma 2 years before. The clinical examination showed healthy gingival tissues and no abnormal tooth mobility, whereas radiographic projections revealed healthy periradicular tissues, incomplete root formation, and no visible root fracture. As pulp necrosis was diagnosed, calcium hydroxide therapy was started for canal disinfection and subsequent obturation. However, after 4 weeks of treatment, a horizontal fracture line was observed radiographically in the root's middle third. The patient denied a new traumatic injury, but revealed the habit of chewing on a pencil. Refraining from the deleterious oral habit was strongly advised, and root canal filling with mineral trioxide aggregate was performed to treat the root fracture. After 4 years of follow-up, the tooth has normal function and no abnormal mobility. Images suggestive of remodeling at the apical end of the coronal segment and replacement resorption of the apical segment are seen radiographically. This case demonstrates the need of following cases of dental trauma and the possible influence of parafunctional oral habits as modifying factors of case progression.

Apical root resorption in orthodontically treated adults.

PubMed

Baumrind, S; Korn, E L; Boyd, R L

1996-09-01

This study analyzed the relationship in orthodontically treated adults between upper central incisor displacement measured on lateral cephalograms and apical root resorption measured on anterior periapical x-ray films. A multiple linear regression examined incisor displacements in four directions (retraction, advancement, intrusion, and extrusion) as independent variables, attempting to account for observed differences in the dependent variable, resorption. Mean apical resorption was 1.36 mm (sd +/- 1.46, n = 73). Mean horizontal displacement of the apex was -0.83 mm (sd +/- 1.74, n = 67); mean vertical displacement was 0.19 mm (sd +/- 1.48, n = 67). The regression coefficients for the intercept and for retraction were highly significant; those for extrusion, intrusion, and advancement were not. At the 95% confidence level, an average of 0.99 mm (se = +/- 0.34) of resorption was implied in the absence of root displacement and an average of 0.49 mm (se = +/- 0.14) of resorption was implied per millimeter of retraction. R2 for all four directional displacement variables (DDVs) taken together was only 0.20, which implied that only a relatively small portion of the observed apical resorption could be accounted for by tooth displacement alone. In a secondary set of univariate analyses, the associations between apical resorption and each of 14 additional treatment-related variables were examined. Only Gender, Elapsed Time, and Total Apical Displacement displayed statistically significant associations with apical resorption. Additional multiple regressions were then performed in which the data for each of these three statistically significant variables were considered separately, with the data for the four directional displacement variables. The addition of information on Elapsed Time or Total Apical Displacement did not explain a significant additional portion of the variability in apical resorption. On the other hand, the addition of information on Gender to the information on the four directional displacement variables yielded an R2 value of 0.35, which indicated that these variables taken together could account for approximately a third of the observed variability in apical resorption in this sample.

Th17-cells in atopic dermatitis stimulate orthodontic root resorption.

PubMed

Yamada, K; Yamaguchi, M; Asano, M; Fujita, S; Kobayashi, R; Kasai, K

2013-10-01

The aim of this study was to investigate how atopic dermatitis (AD) contributes to root resorption during orthodontic tooth movement. Atopic dermatitis model mice and wild-type mice were subjected to an excessive orthodontic force (OF) to induce movement of the upper first molars. The expression levels of the tartrate-resistant acid phosphatase (TRAP), IL-17, IL-6, and RANKL proteins were determined in the periodontal ligament (PDL) by an immunohistochemical analysis. Furthermore, the effects of the compression force on co-cultures of CD4(+) cells from AD patients or healthy individuals and human PDL cells were investigated with regard to the levels of secretion and mRNA expression of IL-17, IL-6, RANKL, and osteoprotegerin. The immunoreactivities for TRAP, IL-17, IL-6, and RANKL in the AD group were found to be significantly increased. The double immunofluorescence analysis for IL-17/CD4 detected immunoreaction. The secretion of IL-17, IL-6, and RANKL, and the mRNA levels of IL-6 and RANKL in the AD patients were increased compared with those in healthy individuals. Th17 cells may therefore be associated with the deterioration of root resorption of AD mice, and may explain why AD patients are more susceptible to root resorption than healthy individuals when an excessive OF is applied. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Root resorption during orthodontic treatment with Invisalign®: a radiometric study.

PubMed

Gay, Giulia; Ravera, Serena; Castroflorio, Tommaso; Garino, Francesco; Rossini, Gabriele; Parrini, Simone; Cugliari, Giovanni; Deregibus, Andrea

2017-12-01

Root resorption (RR) is described as a permanent loss of tooth structure from the root apex. Many reports in the literature indicate that orthodontically treated patients are more likely to have severe apical root shortening, interesting mostly maxillary, followed by mandibular incisors. The aim of the study was to investigate the incidence and severity of RR in adult patients treated with aligners. The study group consisted of 71 class I adult healthy patients (mean age 32.8 ± 12.7) treated with aligners (Invisalign®, Align Technologies, Santa Clara, CA, USA). All incisors, canines, upper first premolars, and first molars were assessed. Root and crown lengths of 1083 teeth were measured in panoramic radiographs at the beginning (T0) and at the end (T1) of clear aligner therapy. Individual root-crown ratio (RCR) of each tooth and therefore the relative changes of RCR (rRCR) were determined. A decrease of rRCR was assessed as a reduction of the root length during treatment. All patients had a minimum of one teeth affected with a reduction of root length, on average 6.38 ± 2.28 teeth per patient. Forty one, 81% of the 1083, measured teeth presented a reduction of the pre-treatment root length. A reduction in percentage of >0% up to 10% was found in 25.94% (n = 281), a distinct reduction of >10% up to 20% in 12.18% (n = 132) of the sample. 3.69% (n = 40) of the teeth were affected with a considerable reduction (>20%). Orthodontic treatment with Invisalign® aligners could lead to RR. However, its incidence resulted to be very similar to that described for orthodontic light forces, with an average percentage of RR < 10% of the original root length.

Knowledge of orthodontic tooth movement through the maxillary sinus: a systematic review.

PubMed

Sun, Wentian; Xia, Kai; Huang, Xinqi; Cen, Xiao; Liu, Qing; Liu, Jun

2018-05-23

To investigate the feasibility, safety and stability of current interventions for moving teeth through the maxillary sinus (MTTMS) by performing a systematic review of the literature. The electronic databases PubMed, Embase, CENTRAL, Web of Science, CBM, CNKI and SIGLE were searched without a language restriction. The primary outcomes were parameters related to orthodontic treatment, including orthodontic protocols, magnitude of forces, type of tooth movement, duration and rate of tooth movement, and remolding of alveolar bone and the maxillary sinus floor. The secondary outcomes were safety and stability, including root resorption, perforation of the sinus floor, loss of pulp vitality and periodontal health and relapse. Nine case reports with 25 teeth were included and systematically analyzed. Fifty to two hundred g of force was applied to move teeth through the maxillary sinus. Bodily movement was accomplished, but initial tipping was observed in 7 cases. The rate was 0.6-0.7 mm/month for molar intrusion and 0.16-1.17 and 0.05-0.16 mm/month for mesial-distal movement of premolars and molars, respectively. Bone formation and remolding of the sinus floor occurred in 7 cases. Root resorption within 6 to 30 months was observed in 3 cases, while no cases of perforation of the sinus floor, loss of pulp vitality, periodontal health impairment or relapse were reported. At the present stage, no evidence-based protocol could be recommended to guide MTTMS. The empirical application of constant and light to moderate forces (by TAD, segment and multibrackets) to slowly move teeth through or into the maxillary sinus in adults appears to be practical and secure. Bodily movement was accomplished, but teeth appear to be easily tipped initially, potentially resulting in root resorption. However, this conclusion should be interpreted with caution as the currently available evidence is based on only a few case reports or case series and longitudinal or controlled studies are lacking in this area.

Design and implementation of therapeutic ultrasound generating circuit for dental tissue formation and tooth-root healing.

PubMed

Woon Tiong Ang; Scurtescu, C; Wing Hoy; El-Bialy, T; Ying Yin Tsui; Jie Chen

2010-02-01

Biological tissue healing has recently attracted a great deal of research interest in various medical fields. Trauma to teeth, deep and root caries, and orthodontic treatment can all lead to various degrees of root resorption. In our previous study, we showed that low-intensity pulsed ultrasound (LIPUS) enhances the growth of lower incisor apices and accelerates their rate of eruption in rabbits by inducing dental tissue growth. We also performed clinical studies and demonstrated that LIPUS facilitates the healing of orthodontically induced teeth-root resorption in humans. However, the available LIPUS devices are too large to be used comfortably inside the mouth. In this paper, the design and implementation of a low-power LIPUS generator is presented. The generator is the core of the final intraoral device for preventing tooth root loss and enhancing tooth root tissue healing. The generator consists of a power-supply subsystem, an ultrasonic transducer, an impedance-matching circuit, and an integrated circuit composed of a digital controller circuitry and the associated driver circuit. Most of our efforts focus on the design of the impedance-matching circuit and the integrated system-on-chip circuit. The chip was designed and fabricated using 0.8- ¿m high-voltage technology from Dalsa Semiconductor, Inc. The power supply subsystem and its impedance-matching network are implemented using discrete components. The LIPUS generator was tested and verified to function as designed and is capable of producing ultrasound power up to 100 mW in the vicinity of the transducer's resonance frequency at 1.5 MHz. The power efficiency of the circuitry, excluding the power supply subsystem, is estimated at 70%. The final products will be tailored to the exact size of teeth or biological tissue, which is needed to be used for stimulating dental tissue (dentine and cementum) healing.

Endodontic Treatment of an Autogenous Transplanted Tooth Using an Er,Cr:YSGG Laser and Radial Firing Tips: Case Report.

PubMed

Martins, Miguel Rodrigues; Lima, Rita C; Pina-Vaz, Irene; Carvalho, Manuel Fontes; Gutknecht, Norbert

2016-10-01

Although several surgical techniques have been reported, no study has yet reported alternative strategies for endodontic treatment of autogenous transplanted teeth. Therefore, the aim of this clinical report is to present the long-term endodontic outcome of a nonvital autogenously transplanted third molar treated with an Er,Cr:YSGG laser and radial firing tips (RFTs). Autogenous tooth transplantation can be considered an alternative to restore edentulous areas and, in donor's teeth with complete root formation, root canal treatment should be performed up to 14 days following transplantation. In the present case report, the patient returned only after 6 months, with clinical and radiological signs of apical periodontitis (AP) associated with the transplanted tooth. Instead of traditional endodontic chemical irrigants or medications, the protocol for smear-layer removal and root canal disinfection was based on intracanal irradiation with an Er,Cr:YSGG laser and RFTs. After 3-years' follow-up, the complete reestablishment of the periodontal ligament and the arrest of the resorptive process could be noticed. This protocol has shown to be effective for the endodontic treatment of a transplanted multi-rooted tooth with AP. Further randomized clinical trials should be conducted to clearly demonstrate the effectiveness of this laser-assisted endodontic protocol.

An overview of removable partial overdentures.

PubMed

McDermott, I G; Samant, A

1990-02-01

As an alternative to complete dentures, overdentures are well established as a sound therapeutic modality for patients with terminal dentition. By utilizing natural tooth roots and their periodontal structures to aid in support, overdentures maintain proprioceptive mediation and a mechanism for masticatory force vectors that favor bone retention over bond resorption. The degree of stability enhancement and denture retention from retained roots varies with the design and environment of the prosthesis. This article reviews various aspects of removable partial over-denture use.

Endodontic management of horizontally placed molars after gunshot injury to mandible: a case report.

PubMed

Nawal, Ruchika Roongta; Sehgal, Ritu; Ansari, Irfan; Talwar, Sangeeta; Sood, Abhinav; Verma, Mahesh

2009-11-01

A 37-year-old man reported to our department with the history of gunshot injury to the mandible 15 years before. His anterior mandible had been resected earlier and bone graft was seen. Intraoral examination of lower jaw revealed 4 remaining mandibular molars. These teeth were severely rotated such that they lay horizontal with respect to the mandibular base. Preoperative Dentascan spiral computerized tomography (CT) of the patient revealed obliteration of the mesial canals of the mandibular right first molar and pear-shaped internal resorption defect in the distal canal of the same tooth. This paper reports the challenging endodontic management of a rare case of severely angulated teeth also exhibiting traumatic sequelae in both roots of the impact tooth. It also highlights the usefulness of spiral CT scan in diagnosis of traumatic sequelae such as pulp canal obliteration and internal resorption.

An automatic early stage alveolar-bone-resorption evaluation method on digital dental panoramic radiographs

NASA Astrophysics Data System (ADS)

Zhang, Min; Katsumata, Akitoshi; Muramatsu, Chisako; Hara, Takeshi; Suzuki, Hiroki; Fujita, Hiroshi

2014-03-01

Periodontal disease is a kind of typical dental diseases, which affects many adults. The presence of alveolar bone resorption, which can be observed from dental panoramic radiographs, is one of the most important signs of the progression of periodontal disease. Automatically evaluating alveolar-bone resorption is of important clinic meaning in dental radiology. The purpose of this study was to propose a novel system for automated alveolar-bone-resorption evaluation from digital dental panoramic radiographs for the first time. The proposed system enables visualization and quantitative evaluation of alveolar bone resorption degree surrounding the teeth. It has the following procedures: (1) pre-processing for a test image; (2) detection of tooth root apices with Gabor filter and curve fitting for the root apex line; (3) detection of features related with alveolar bone by using image phase congruency map and template matching and curving fitting for the alveolar line; (4) detection of occlusion line with selected Gabor filter; (5) finally, evaluation of the quantitative alveolar-bone-resorption degree in the area surrounding teeth by simply computing the average ratio of the height of the alveolar bone and the height of the teeth. The proposed scheme was applied to 30 patient cases of digital panoramic radiographs, with alveolar bone resorption of different stages. Our initial trial on these test cases indicates that the quantitative evaluation results are correlated with the alveolar-boneresorption degree, although the performance still needs further improvement. Therefore it has potential clinical practicability.

Effect of corticosteroids on orthodontic tooth movement in a rabbit model.

PubMed

Abtahi, M; Shafaee, H; Saghravania, N; Peel, S; Giddon, D; Sohrabi, K

2014-01-01

While there are a growing number of studies on the effects of medications on orthodontic tooth movement (OTM), only few studies have investigated the role of corticosteroids, despite their widespread use. The aim of the current study was to evaluate the effects of triamcinolone acetonide injection on OTM in a rabbit model. Sixteen one-month old rabbits were randomly divided into two groups: Eight rabbits had triamcinolone acetonide (1 mg/kg/day) administered IM daily for 21 days (test group) while the remaining eight rabbits received no drug (control group). The rabbits in both groups had a tube bonded to the upper central incisors and a stainless steel helical spring was inserted in tube slot to apply 50 cN distal force. After 3 weeks, the rabbits were sacrificed and the distance between mesial corners of incisors was measured The incisors are associated tissue was processed for histology and the apical and cervical area of the roots evaluated. An observer who was blind to the study groups evaluated the specimens. All appliance-treated incisors in test and control groups showed evidence of tooth movement. The distance between the incisors was significantly greater in the triamcinolone acetonide treated group compared to the control group (P < 0.001). Histological examination revealed an increased number of resorption lacunae and decreased number of cuboidal osteoblastic cells around the apical and cervical area of the Incisor roots in the test compared to the control group (P < 0.01). Treatment with triamcinolone acetonide is associated with increased tooth movement in rabbits via increased resorptive activity in the alveolar bone.

Incisal Apical Root Resorption Evaluation after Low-Friction Orthodontic Treatment Using Two-Dimensional Radiographic Imaging and Trigonometric Correction.

PubMed

Savoldi, Fabio; Bonetti, Stefano; Dalessandri, Domenico; Mandelli, Gualtiero; Paganelli, Corrado

2015-11-01

Root resorption shall be taken into consideration during every orthodontic treatment, and it can be effected by the use of different techniques, such as the application of low friction mechanics. However, its routinely assessment on orthopantomography has limitations related to distortions and changes in dental inclination. The aim of this investigation was to evaluate the severity of apical root resorption of maxillary and mandibular incisors after low-friction orthodontic treatment, using the combination of panoramic and lateral radiographs, and applying a trigonometric correction. A hospital based Retrospective study at the orthodontic Department (Dental School, University of Brescia, Spedali Civili di Brescia, Brescia, Italy). Ninety-three subjects (53 females and 40 males; mean age, 14 years) with mild teeth crowding were treated without extractions by the same operator using a low-friction fixed appliance following an integrated straight wire (ISW) protocol. The pre- and post-treatment tooth lengths of the maxillary and mandibular incisors were measured on panoramic radiographs. A trigonometric factor of correction for the pre-treatment length was calculated based on the difference between the pre and post-treatment incisal inclination on lateral cephalograms. The changes in lengths were investigated using the Student's t-test for paired values (p<0.05). Maxillary central incisors showed no changes (0.3%, 0.6%), maxillary lateral incisors showed a small increase (1.4%, 1.8%) that was attributed to the completion of root development in younger patients, mandibular central and lateral incisors underwent slight resorption (-3.1%, -3.4%). A statistically significant difference was found for the mandibular incisors but not for the maxillary ones. In patients with mild crowding and consequent low amount of root movement, a low-friction orthodontic treatment can lead to slight apical root resorption, mainly involving lower incisors. The use of a trigonometric correction in the panoramic radiograph analysis may reduce the limitations of this 2D evaluation.

The effect of caffeine on orthodontic tooth movement in rats

PubMed Central

Shirazi, Mohsen; Vaziri, Hamed; Salari, Behzad; Motahhari, Pouria; Etemad-Moghadam, Shahroo; Dehpour, Ahmad Reza

2017-01-01

Objective(s): to determine the effect of different doses of caffeine on orthodontic tooth movement (OTM) in rats. Materials and Methods: Forty male 250-300 g Sprague-Dawley rats were randomly divided into four groups of ten animals each and received 0 (control), 1 g/l, 2 g/l and 3 g/l caffeine in tap water for 3 days. Orthodontic appliances were ligated between the maxillary first molars and incisors on the 4th day of the study period. All rats were sacrificed after 2 weeks of treatment after which OTM was measured. Hematoxylin/eosin-stained sections of the molars were prepared and the mesial roots were examined for resorption-lacunae depth and osteoclast number. ANOVA was used for statistical analysis (P<0.05). Results: A significant decrease in OTM was observed only in the 2 g/l (P=0.043) and 3 g/l (P<0.01) caffeine-receiving rats compared to the control animals. Osteoclast counts and resorption-lacunae depths demonstrated significant differences between each of the caffeine groups and control rats (P<0.05). None of the variables showed significant differences between the caffeine groups (P>0.05). Conclusion: According to our findings, one of the effects of caffeine consumption during orthodontic treatment in rats was decreased root resorption. Additionally, concentrations of 2 g/l and 3 g/l inhibited OTM which seems to be due to its influence on osteoclast numbers. PMID:28392897

Failure of tooth eruption in two patients with cerebral palsy and bruxism-a 10-year follow-up: a case report.

PubMed

Staufer, Kirsten; Hamadeh, Sinan; Gesch, Dietmar

2009-01-01

The aim of this paper was to analyze delayed tooth eruption in two children with cerebral palsy who had severe bruxism and to determine whether treatment could influence tooth eruption and alignment. Extraction of primary teeth was carried out and orthodontic treatment was considered due to severe tooth wear of primary teeth, lack of space, and development of a class III malocclusion. Analysis was based on clinical examination, photographs, radiographs, and dental casts. In both patients, early mixed dentition was delayed for more than 5 years. Calcification and root development of posterior permanent teeth corresponded with the chronological age. Root resorption of the severely abraded primary teeth and eruption of their successors were delayed or failed. Eruption of permanent teeth occurred slowly after primary teeth were extracted. Orthodontic treatment succeeded in one patient, achieving a normal overjet in combination with a successful orofacial therapy. The disturbed exfoliation of abraded primary teeth and failure of tooth eruption of the posterior teeth could be linked to the systemic pathology and to bruxism. At age 20, eruption of the canines and premolars remained questionable.

The importance of cone-beam computed tomography in the management of endodontic problems: a review of the literature.

PubMed

Venskutonis, Tadas; Plotino, Gianluca; Juodzbalys, Gintaras; Mickevičienė, Lina

2014-12-01

To obtain essential information in clinical endodontics, cone-beam computed tomographic (CBCT) imaging can be used in all phases of treatment including diagnosis, treatment planning, during the treatment phase, and through post-treatment assessment and follow-up. The purpose of this article was to review the use of CBCT imaging in the diagnosis, treatment planning, and assessing the outcome of endodontic complications. Literature was selected through a search of PubMed electronic databases for the following keywords: tooth root injuries, tooth root radiography, tooth root perforation, tomography, cone-beam computed tomography, endodontic complications, tooth root internal/external resorption, root fractures, and broken instruments. The research was restricted to articles published in English. One hundred twelve articles met the inclusion criteria and were included in this review. Currently, intraoral radiography is the imaging technique of choice for the management of endodontic disease, but CBCT imaging appears to have a superior validity and reliability in the management of endodontic diagnosis and complications. Endodontic cases should be judged individually, and CBCT imaging should be considered in situations in which information from conventional imaging systems may not yield an adequate amount of information to allow the appropriate management of endodontic problems. CBCT imaging has the potential to become the first choice for endodontic treatment planning and outcome assessment, especially when new scanners with lower radiation doses will be available. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Development of cyclic shedding teeth from semi-shedding teeth: the inner dental arcade of the stem osteichthyan Lophosteus

NASA Astrophysics Data System (ADS)

Chen, Donglei; Blom, Henning; Sanchez, Sophie; Tafforeau, Paul; Märss, Tiiu; Ahlberg, Per E.

2017-05-01

The numerous cushion-shaped tooth-bearing plates attributed to the stem group osteichthyan Lophosteus superbus, which are argued here to represent an early form of the osteichthyan inner dental arcade, display a previously unknown and presumably primitive mode of tooth shedding by basal hard tissue resorption. They carry regularly spaced, recumbent, gently recurved teeth arranged in transverse tooth files that diverge towards the lingual margin of the cushion. Three-dimensional reconstruction from propagation phase-contrast synchrotron microtomography (PPC-SRµCT) reveals remnants of the first-generation teeth embedded in the basal plate, a feature never previously observed in any taxon. These teeth were shed by semi-basal resorption with the periphery of their bases retained as dentine rings. The rings are highly overlapped, which evidences tooth shedding prior to adding the next first-generation tooth at the growing edge of the plate. The first generation of teeth is thus diachronous. Successor teeth at the same sites underwent cyclical replacing and shedding through basal resorption, producing stacks of buried resorption surfaces separated by bone of attachment. The number and spatial arrangement of resorption surfaces elucidates that basal resorption of replacement teeth had taken place at the older tooth sites before the addition of the youngest first-generation teeth at the lingual margin. Thus, the replacement tooth buds cannot have been generated by a single permanent dental lamina at the lingual edge of the tooth cushion, but must have arisen either from successional dental laminae associated with the individual predecessor teeth, or directly from the dental epithelium of these teeth. The virtual histological dissection of these Late Silurian microfossils broadens our understanding of the development of the gnathostome dental systems and the acquisition of the osteichthyan-type of tooth replacement.

Contribution of cone beam computed tomography to the detection of apical root resorption after orthodontic treatment in root-filled and vital teeth.

PubMed

Castro, Iury; Valladares-Neto, José; Estrela, Carlos

2015-09-01

To investigate whether root-filled teeth are similar to vital pulp teeth in terms of apical root resorption (ARR) after orthodontic treatment. An original sample of cone beam computed tomography (CBCT) images of 1256 roots from 30 orthodontic patients were analyzed. The inclusion criteria demanded root-filled teeth and their contralateral vital teeth, while teeth with history of trauma had to be excluded to comply with exclusion criteria. CBCT images of root-filled teeth were compared before and after orthodontic treatment in a split-mouth design study. Tooth measurements were made with multiplanar reconstruction using axial-guided navigation. The statistical difference between the treatment effects was compared using the paired t-test. Twenty posterior root-filled teeth and their contralaterals with vital pulp were selected before orthodontic treatment from six adolescents (two boys and four girls; mean [SD] age 12.8 [1.8] years). No differences were detected between filled and vital root lengths before treatment (P  =  .4364). The mean differences in root length between preorthodontic and postorthodontic treatment in filled- and vital roots were -0.30 mm and -0.16 mm, respectively, without any statistical difference (P  =  .4197) between them. There appears to be no increase in ARR after orthodontic treatment in root-filled teeth with no earlier ARR.

External apical root resorption concurrent with orthodontic forces: the genetic influence.

PubMed

Nieto-Nieto, Nuria; Solano, Jose Enrique; Yañez-Vico, Rosa

2017-05-01

Root resorption is a pathological process of multifactorial origin related to the permanent loss of dental root structure in response to a mechanical, inflammatory, autoimmune or infectious stimulus. External apical root resorption (EARR) is a frequent clinical complication secondary to orthodontic tooth movement; apart from variables related to treatment, environmental factors and/or interindividual genetic variations can confer susceptibility or resistance to its occurrence. In this context, genetic predisposition has been described as an etiological factor, together with mechanical factors derived from orthodontic treatment. In recent years, international research groups have determined the degree of influence of some genetic biomarkers in defining increased/reduced susceptibility to postorthodontic EARR. The influences of the IL1 gene cluster (IL1B, IL1A, IL1RN, IL6), P2RX7, CASP1, OPG (TNFRSF11B), RANK (TNFRSF11A), Osteopontin (OPN), TNFα, the vitamin D receptor (TaqI), TNSALP and IRAK1 have been analyzed. The objective of the present review study was to compile and analyze the latest information about the genetic background predisposing to EARR during orthodontic treatment. Genetics-based studies along with other basic science research in the field might help to clarify the exact nature of EARR, the influence of genetic inheritance and possibly lead to the prevention or even eradication of this phenomenon during orthodontic treatment.

Life cycles of traumatized teeth: long-term observations from a cohort of dental trauma victims.

PubMed

Heithersay, G S

2016-03-01

Life cycles of dental trauma victims can provide important clinical information, especially when viewed over many years. In this first series of life cycles, the pulp and periodontal responses to traumatic injuries of four patients are documented over periods varying from 26 to 51 years. The dynamics of pulp survival following an intrusive luxation and two avulsions are followed, with particular reference to pulp canal calcification to which a new term, root canal stenosis, has been proposed. The life cycles include the successful management of inflammatory root resorption in a replanted tooth with an open apex contrasting with the early prophylactic endodontic treatment of two replanted teeth in a patient with mature apices. The long-term development of invasive cervical resorption in one of the patient's life cycle highlights the importance of ongoing follow-up examinations for dental trauma victims. © 2016 Australian Dental Association.

Bone Density and Dental External Apical Root Resorption

PubMed Central

Iglesias-Linares, Alejandro; Morford, Lorri Ann

2016-01-01

When orthodontic patients desire shorter treatment times with aesthetic results and long-term stability, it is important for the orthodontist to understand the potential limitations and problems that may arise during standard and/or technology-assisted accelerated treatment. Bone density plays an important role in facilitating orthodontic tooth movement (OTM), such that reductions in bone density can significantly increase movement velocity. Lifestyle, genetic background, environmental factors and disease status all can influence a patients’ overall health and bone density. In some individuals, these factors may create specific conditions that influence systemic-wide bone metabolism. Both genetic variation and the onset of a bone-related disease can influence systemic bone density and local bone density, such as is observed in the mandible and maxilla. These types of localized density changes can affect the rate of OTM and may also influence the risk of unwanted outcomes, i.e., the occurrence of dental external apical root resorption (EARR). PMID:27766484

[Retrospective study about periodontal ligament healing of replanted permanent teeth in children].

PubMed

Bai, J; Zhao, Y M; Qin, M

2015-04-18

To analyze the prognosis about periodontal ligament healing of replanted permanent teeth in children and to examine the associated factors. The sample consisted of 49 children with 61 avulsed permanent teeth, whose injuries had been managed in the period from 2000 to 2012. The clinical data of replanted teeth were collected, and the follow-up period was no less than 12 months. The factors were analyzed in relation to postoperative outcomes, classified as functional periodontal healing (FH), infection-related (inflammatory) resorption (IRR) and replacement resorption (RR). The functional healing rate was 23.0%, while replacement resorption rate was 72.1%. The replacement resorption (ankylosis) was usually observed earlier by clinical examination than by radiographic examination. 86.0% (40/47) resorptive processes were diagnosed within the first year. Physiological storages, such as milk, saline and saliva were significantly better to periodontal ligament healing than nonphysiological storages, such as tap water and sterilizing solutions (chloramine and alcohol). Functional healing was found significantly more frequent in canines and premolars. The factor significantly affecting periodontal ligament healing is storage medium. Replacement resorption is the most common type of root resorption. The replacement resorption diagnosis must combine the radiographic examination with the clinical examination. It is better to follow up more than 1 year after tooth replantation.

Synergistic Effects of a Calcium Phosphate/Fibronectin Coating on the Adhesion of Periodontal Ligament Stem Cells Onto Decellularized Dental Root Surfaces.

PubMed

Lee, Jung-Seok; Kim, Hyun-Suk; Park, So-Yon; Kim, Tae-Wan; Jung, Jae-Suk; Lee, Jong-Bin; Kim, Chang-Sung

2015-01-01

This study aimed to enhance the attachment of periodontal ligament stem cells (PDLSCs) onto the decellularized dental root surface using surface coating with fibronectin and/or calcium phosphate (CaP) and to evaluate the activity of PDLSCs attached to a coated dental root surface following tooth replantation. PDLSCs were isolated from five dogs, and the other dental roots were used as a scaffold for carrying PDLSCs and then assigned to one of four groups according to whether their surface was coated with CaP, fibronectin, CaP/fibronectin, or left uncoated (control). Fibronectin increased the adhesion of PDLSCs onto dental root surfaces compared to both the control and CaP-coated groups, and simultaneous surface coating with CaP and fibronectin significantly accelerated and increased PDLSC adhesion compared to the fibronectin-only group. On in vivo tooth replantation, functionally oriented periodontal new attachment was observed on the CaP/fibronectin-coated dental roots to which autologous PDLSCs had adhered, while in the control condition, dental root replantation was associated only with root resorption and ankylosis along the entire root length. CaP and fibronectin synergistically enhanced the attachment of PDLSCs onto dental root surfaces, and autologous PDLSCs could produce de novo periodontal new attachment in an experimental in vivo model.

Evaluation of the topical effect of alendronate on the root surface of extracted and replanted teeth. Microscopic analysis on rats' teeth.

PubMed

Lustosa-Pereira, Adriana; Garcia, Roberto Brandão; de Moraes, Ivaldo Gomes; Bernardineli, Norberti; Bramante, Clovis Monteiro; Bortoluzzi, Eduardo Antunes

2006-02-01

The treatment of choice for tooth avulsion is replantation. The ideal replantation should be realized as quickly as possible, or at least, the avulsed tooth should be kept in an adequate solution to preserve the periodontal ligament attached to the root. If that is not possible, treatment of the radicular surface should be done in order to prevent radicular resorption. The purpose of this study was to test sodium alendronate as a substance for topical treatment of the radicular surface of avulsed teeth in an attempt to prevent the occurrence of dental resorptions. Fifty-four rat maxillary right central incisors were extracted and replanted. Group I--extra-alveolar dry period of 15 min, intracanal dressing with calcium hydroxide (CALEN, S.S. White, Artigos Dentários LTDA, Rio de Janeiro, Brazil) and replantation; Groups II and III - extra-alveolar dry periods of 30 and 60 min, respectively, immersion in 1% sodium hypochlorite for 30 min for removal of the periodontal ligament, washing in saline solution for 5 min, and treatment of the radicular surface with 3.2 mg/l sodium alendronate solution for 10 min. Intracanal dressing with calcium hydroxide and replantation followed. At 15, 60, and 90 days post-reimplantation, the animals were killed and the samples obtained and processed for microscopic analysis. The results indicated that sodium alendronate was able to reduce the incidence of radicular resorption, but not of dental ankylosis. No significant differences were observed regarding variations in the extra-alveolar periods among the groups.

Marsupialization of a large dentigerous cyst in the mandible with orthodontic extrusion of three impacted teeth. A case report.

PubMed

Abu-Mostafa, Nedal; Abbasi, Arshad

2017-09-01

The dentigerous cyst (DC) is the most common type of developmental odontogenic cyst. It is usually asymptomatic and associated with the crown of an unerupted or impacted tooth. However, after a long duration, it is likely to cause significant bone resorption, cortical expansion, and tooth displacement. This report presents a large infected DC in the mandible of a 12-year-old female patient. The DC was located inferior to badly decayed primary molars and surrounded three impacted permanent teeth: canine, first premolar, which had a dilacerated root, and second premolar. The DC was treated successfully by marsupialization and extrusion of the impacted teeth. In conclusion, the combination of marsupialization with orthodontic extrusion is a conservative, efficient protocol that stimulates bone healing and promotes the eruption of cyst-associated teeth even if they are deeply impacted, crowded, or have a dilacerated root. Key words: Dentigerous cyst, marsupialization, impacted teeth, orthodontic extrusion, dilacerated root.

[Alveolar bone thickness and root length changes in the treatment of skeletal Class III patients facilitated by improved corticotomy: a cone-beam CT analysis].

PubMed

Wu, Jiaqi; Jiang, Jiuhui; Xu, Li; Liang, Cheng; Li, Cuiying; Xu, Xiao

2015-04-01

To evaluate the alveolar bone thickness and root length changes of anterior teeth with cone-beam computed tomography (CBCT). CBCT scans were taken for 12 skeletal Class III patients who accepted the improved corticotomy (IC) procedures during pre-surgical orthodontics. The CBCT data in T1 (the maxillary dental arch was aligned and leveled) and T2 (extraction space closure) were superimposed and the alveolar bone thickness at root apex level and root length measurements were done. From T1 to T2, the buccal alveolar bone thickness for the upper lateral incisors increased from (1.89±0.83) to (2.47±1.02) mm (P<0.05), and for central incisors and for canines from (2.32±0.71) to (2.68±1.48) mm and from (2.28±1.08) to (2.41±1.40) mm, respectively. According to Sharpe Grading System, the root resorption grade for 69 teeth of 72 was located in Grade 1, two teeth in Grade 2, one tooth in Grade 3. The improved corticotomy had the potential to increase the buccal alveolar bone thickness and the root resorption in most teeth was in Grade 1 according to Sharpe grading system.

[Effect of pamidronate and ibandronate on orthodontic root resorption in rats].

PubMed

Zhao, Shu-ya; Wang, Xu-xia; Liu, Wan-xin; Dong, Rui; Li, Jing; Zhang, Jun

2013-09-01

To compare the effects of pamidronate and ibandronate on orthodontic root resorption. Seventy-two 6-week-old female specific pathogen free (SPF) Wistar rats were selected to establish models for orthodontic tooth movement. The rats were randomly divided into three groups: the control group (C group), pamidronate group (Pm group) and ibandronate group (Ib group). 0.9% normal saline,0.5 mmol/L pamidronate and 0.5 mmol/L ibandronate were injected every 3 days. The rats were executed in batch on the 3rd, 7th and 14th day to make tissue sections. All statistical analysis was performed using the PASW Statistics 18 software package. On the 7th and 14th day, the amount of cementoclast, the expression of osteoclast differentiation factor (ODF) and root resorption index were significantly lower in Pm group [the 7th day: (2.675 ± 0.002), (0.1683 ± 0.0007), (0.103 ± 0.003); the 14th day: (3.886 ± 0.048), (0.1873 ± 0.0014), (0.283 ± 0.001)] and Ib groups[the 7th day: (2.601 ± 0.001), (0.1634 ± 0.0010), (0.099 ± 0.002); the 14th day: (3.754 ± 0.019), (0.1818 ± 0.0016), (0.281 ± 0.001)] than in C group[the 7th day: (2.810 ± 0.001), (0.1792 ± 0.0008), (0.120 ± 0.001); the 14th day: (4.800 ± 0.001), (0.2060 ± 0.0007), (0.401 ± 0.001)] (P < 0.05). However, no significant difference was found between Pm and Ib groups on the 3rd, 7th and 14th day (P > 0.05). Both pamidronate and ibandronate could inhibit orthodontic root resorption.

Invasive cervical resorption and the oro-facial cleft patient: a review and case series.

PubMed

O'Mahony, A; McNamara, C; Ireland, A; Sandy, J; Puryer, J

2017-05-12

Introduction Invasive cervical resorption (ICR) has an unknown aetiology, yet it exhibits very aggressive behaviour compared with typical external root resorption, posing a high risk of tooth loss.Aim To investigate the number of patients at the Dublin Cleft Prosthodontic Department with an oro-facial cleft who experienced ICR and to identify any possible aetiological factors.Materials and method A retrospective investigation of all oro-facial cleft patients treated at the Dublin Cleft Prosthodontic Department, St James's Hospital, Dublin. All patients' clinical and radiological records were reviewed. Patients where tooth loss became inevitable due to Class 4 ICR were analysed.Results From 588 oro-facial cleft patients, 14 (2.38%) patients with ICR were identified. Of these eight (57%) were female and six (43%) were male. Mean age at diagnosis was 28 years (range = 16-49 years). Cleft type: six (42.1%) unilateral cleft lip and palate, eight (57.9%) bilateral cleft lip and palate. Seventeen ICR affected teeth in total, with eleven (65%) maxillary central incisors, two (12%) maxillary lateral incisors, four (23%) maxillary canines, and one (7%) central, lateral and canine affected. Some, (N = 10, 71.4%) presented with ICR resulting in immediate tooth loss. Other patients (N = 4, 28.6%) developed ICR during or following prosthodontic treatment at the Cleft Centre. Tooth loss for this cohort, though not immediate, was inevitable. All had undergone fixed orthodontic appliance treatment and twelve had received dento-alveolar bone grafts. A number (N = 7, 50%) had undergone osteotomy, two (14%) had received night guard vital dental whitening and one had a history of trauma.Conclusions ICR, given its aggressive nature and ill-understood aetiology, poses significant treatment challenges. The most severe form of ICR (Class 4) leads inevitably to tooth loss. The slow-moderate progression of ICR may explain the late presentation found in this study, reinforcing the importance of long-term follow-up of this special dental care group.

Use of third molar transplantation for closure of the oroantral communication after tooth extraction: a report of 2 cases.

PubMed

Kitagawa, Yoshimasa; Sano, Kazuo; Nakamura, Mikiko; Ogasawara, Toshiyuki

2003-04-01

This clinical report introduces a promising and unique method for the immediate closure of the oroantral communication (OAC) after tooth extraction: the use of the transplanted third molar with closed apices. In 2 adult patients, OAC caused by the extraction of an upper molar was immediately closed by using a transplanted third molar with complete root formation. After tooth extraction at the recipient site, OAC with perforated mucosa of the sinus floor was confirmed and the donor third molar was transferred to the prepared recipient socket. Endodontic therapy of the transplanted third molar began at 3 weeks after surgery, and prosthetic treatment was completed at 5 months after the operation. These 2 patients were carefully observed both clinically and radiographically. Closure of the OAC was successfully performed, and the transplanted teeth became fixed with the passage of time in these 2 patients. Root resorption did not occur, and good functional results were obtained without any complications. Tooth transplantation of a mature third molar for closure of the OAC is a simple and excellent method because the transplanted tooth not only closes the communication to the maxillary sinus, but it also satisfactorily functions at the recipient site during mastication, even in adult patients.

Orthodontic treatment in cherubism: an overview and a case report.

PubMed

Abela, Stefan; Cameron, Malcolm; Bister, Dirk

2014-11-01

Cherubism is a rare hereditary disease that frequently manifests as a painless enlargement of the mandible and/or maxilla. The disease usually progresses rapidly during the first and second decades of life but it is self-limiting and often regresses. Although few orthodontic case reports describing cherubic patients exist, the timing and extent of surgical intervention is controversial. This present paper aims to review the treatment literature and provide a case report of a patient who underwent orthodontic/surgical management. The patient presented with severe cherubism in her late teenage years; her main complaint was poor facial and dental appearance. Multiple teeth were missing and those present demonstrated significant preoperative root resorption. Treatment consisted of orthodontic alignment of the upper anterior teeth and a recontouring osteotomy. Confirmed by the patient, the combination approach led to a significant improvement in facial aesthetics and better self-esteem. Tooth movement through the osseous lesions was uneventful and no further root resoption was observed. Orthodontic treatment may be undertaken in those affected by Cherubism even with pre-existing idiopathic root resorption, but patients need to be appropriately informed and consented.

Polymorphisms of genes encoding P2X7R, IL-1B, OPG and RANK in orthodontic-induced apical root resorption.

PubMed

Pereira, S; Lavado, N; Nogueira, L; Lopez, M; Abreu, J; Silva, H

2014-10-01

Orthodontic-induced external apical root resorption (EARR) is a complex phenotype determined by poorly defined mechanical and patient intrinsic factors. The aim of this work was to construct a multifactorial integrative model, including clinical and genetic susceptibility factors, to analyze the risk of developing this common orthodontic complication. This retrospective study included 195 orthodontic patients. Using a multiple-linear regression model, where the dependent variable was the maximum% of root resorption (%EARRmax) for each patient, we assessed the contribution of nine clinical variables and four polymorphisms of genes involved in bone and tooth root remodeling (rs1718119 from P2RX7, rs1143634 from IL1B, rs3102735 from TNFRSF11B, encoding OPG, and rs1805034 from TNFRSF11A, encoding RANK). Clinical and genetic variables explained 30% of%EARRmax variability. The variables with the most significant unique contribution to the model were: gender (P < 0.05), treatment duration (P < 0.001), premolar extractions (P < 0.01), Hyrax appliance (P < 0.001) and GG genotype of rs1718119 from P2RX7 gene (P < 0.01). Age, overjet, tongue thrust, skeletal class II and the other polymorphisms made minor contributions. This study highlights the P2RX7 gene as a possible factor of susceptibility to EARR. A more extensive genetic profile may improve this model. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effect of high-frequency near-infrared diode laser irradiation on periodontal tissues during experimental tooth movement in rats.

PubMed

Gunji, Hidemi; Kunimatsu, Ryo; Tsuka, Yuji; Yoshimi, Yuki; Sumi, Keisuke; Awada, Tetsuya; Nakajima, Kengo; Kimura, Aya; Hiraki, Tomoka; Hirose, Naoto; Yanoshita, Makoto; Tanimoto, Kotaro

2018-02-05

Tooth movement during orthodontic treatment is associated with bone neoplasticity and bone resorption on the tension and pressure sides. Previous clinical studies have suggested that low-power laser irradiation can accelerate tooth movement during orthodontic treatment, although the underlying mechanism remains unclear. In this study, we used a high-frequency near-infrared diode laser that generates less heat and examined the histologic changes in periodontal tissue during experimental tooth movement with laser irradiation. A nickel-titanium closed coil was mounted between the maxillary left side first molar and incisor of rats to model experimental tooth movement. The laser-irradiation and the control groups were set, and the amount of movement of the first molar on 7th and 14th days after the start of pulling of the first molar tooth on the maxillary left was measured by three-dimensional analysis of µCT. After tooth movement, tissue samples from the mesial and tension sides were collected, and successive horizontal sections were prepared and examined using hematoxylin-eosin and TRAP staining and immunohistochemical staining for RANKL, OPG, ALP, and proliferating cell nuclear antigen (PCNA). Changes in tissue temperature following laser irradiation were also examined. Laser irradiation significantly increased tooth movement compared with non-irradiated controls. Histologic staining of the pressure-side mesial root in laser-irradiated rats revealed enhanced RANKL expression and increased numbers of TRAP-positive cells compared with controls. By contrast, on the tension side, laser irradiation led to increased expression of ALP and PCNA. These data indicate that high-frequency near-infrared diode laser irradiation on the pressure side upregulates RANKL expression and accelerates osteoclast differentiation, facilitating bone resorption, whereas bone formation is induced on the tension side. This study demonstrates that high-frequency near-infrared diode laser irradiation of periodontal tissue leads to metabolic activation, which ultimately increases the rate of tooth movement. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

The decade of overdentures: 1970-1980.

PubMed

Fenton, A H

1998-01-01

Jaw bones resorb when teeth are lost. People cannot function as well with complete dentures compared with their natural teeth. As more people are living longer and these cumulative effects become increasingly documented, dentists in the 1970s attached more importance to keeping teeth. The concept of overdentures developed as a simple and economic alternative to prolong the retention and function of the last few teeth in a compromised dentition. The previous option was extensive fixed prosthodontics. An overdenture is a complete or removable partial denture that has one or more tooth roots to provide support. Rather than extracting all compromised teeth, the crowns, and pulpal tissue of selected teeth (usually two anterior teeth) are removed. The remaining root projecting through the mucosa is restored and/or contoured. With the crown removed, there is space to cover the area with a denture. The root has less mobility, and its retention retards bone resorption. Overdentures with roots are more stable, and patients can chew better than with dentures supported on residual alveolar bone and mucosal tissue alone. Keeping even a few teeth has a strong psychological value for some patients. Patients who have lost teeth, adjacent tissue, and bone need replacement of more oral structures than tooth crowns alone can provide. A complete denture with flange contours can restore tissue and appearance. The conventional tooth-supported overdenture concept continues to be an accepted treatment modality and has now been adapted to implants.

Effects of zinc oxide-eugenol and calcium hydroxide/ iodoform on delaying root resorption in primary molars without successors.

PubMed

Lin, Bichen; Zhao, Yuming; Yang, Jie; Wang, Wenjun; Ge, Li-hong

2014-01-01

The purpose of this study was to compare the effects of zinc oxide-eugenol (ZOE) and calcium hydroxide/iodoform paste (Vitapex), as root canal filling materials in pulpectomy, on delaying the root resorption of primary molars without permanent successors. Animal models without permanent successors were surgically established in beagle dogs. Root resorption was observed via periapical radiographs. The onset of root resorption of primary mandibular molars without successors occurred later (p<0.05) than physiologic resorption. ZOE pulpectomy clearly delayed the root resorption of primary molars without permanent successors (p<0.05), whereas resorption of primary molars with Vitapex pulpectomy started at almost the same time as physiologic resorption. Compared with Vitapex, ZOE was a more effective root canal filling material in delaying the root resorption of primary molars.

[Orthodontic effects of tooth injury to the permanent and temporary incisors of children and the adolescent [corrected].

PubMed

Bassigny, F

1990-01-01

Traumatisms on the deciduous upper incisors could induce orthodontic indirect consequences on the permanent germ, dependent on his growth level and his malleability, dependent on connection between the root of deciduous incisor and the crown of permanent germ and according to the type of traumatism. According to those various data, it should be observed on the permanent incisor: germination of two germs, multiple odontoma, crown dilaceration, severe tipping of the crown with facial angulation, retention of the permanent germ with lack of root resorption of the deciduous teeth or simple cross-bite, without speaking of enamel defect.

Clinical impact of bisphosphonates in root canal therapy

PubMed Central

AlRahabi, Mothanna K.; Ghabbani, Hani M.

2018-01-01

Bisphosphonates are stable structural analogs of pyrophosphate, which suppress the activity of osteoclasts, leading to decreased bone resorption. They are essential medications in the treatment of osteoporosis. Osteonecrosis of the jaw is a serious adverse effect of bisphosphonate therapy. The prevalence of bisphosphonate-related osteonecrosis of the jaw varies from 0% to 28%, and it can be triggered by dental extraction and trauma. Root canal therapy can delay, or even eliminate, the need for tooth extraction, and therefore, may reduce the risk of bisphosphonate-related osteonecrosis of the jaw. We suggest that this might be the best treatment for teeth with pulpal and/or periapical disease. PMID:29543299

[Root resorption and orthodontic treatment].

PubMed

Sebbar, M; Bourzgui, F

2011-09-01

The aim of our study was to investigate the prevalence of root resorption during and at the end of orthodontic treatment and to assess its relationship with age, sex and treatment with or without extractions. Our study included 82 patients (51 women and 31 men) aged between 6 and 38 years, who received orthodontic treatment. Evaluation of root resorption was performed on panoramics at the beginning and at the end of orthodontic treatment. All the teeth were observed. The degree of root resorption was increased respectively by the standards in four ordinal levels (4). Data analysis was performed by Epi Info 6.0. Root resorption was present in all the teeth and maxillary incisors are the most affected. The correlation between age and root resorption was significant (p = 0.008). Women were more affected by resorption (P = 0.002). Patients treated with extraction showed more root resorption (p = 0.12). Our results suggest that orthodontic treatment is involved in the development of root resorption. The most often teeth resorbed are maxillary incisors. Age, sex and orthodontic extractions can be considered as risk factors for root resorption.

Root resorption diagnosed with cone beam computed tomography after 6 months and at the end of orthodontic treatment with fixed appliances.

PubMed

Makedonas, Dimitrios; Lund, Henrik; Hansen, Ken

2013-05-01

To investigate the prevalence of orthodontically induced root resorption after treatment and the correlation with resorption found after 6 months of treatment. One hundred fifty-six patients (11-18 years) treated with fixed appliances and extraction of four premolars were examined with cone beam computed tomography before treatment, after 6 months of treatment (n  =  97), and at the end of active treatment. The Malmgren Index was used to describe the degree of root resorption. Severe root resorption (>2 mm, score 3) was found in 25.6% of the patients at the end of treatment. Extreme root resorption was found in one patient. Root resorption was seen more frequently in the maxillary incisor region. There was no correlation between the severity of root resorption after 6 months and the amount observed at the end of treatment. Furthermore, no correlation was seen between treatment duration and the severity of root resorption. Clinically significant resorption was diagnosed in 25.6% of the patients, but no correlations, either with the resorption seen after 6 months or with the length of treatment, were found. Radiographic examination after 3 to 6 months of orthodontic treatment is too early and will not reduce the number of patients who will have teeth with severe root resorption.

[Root resorption after orthodontic treatment: a study of age factor and prevalence in anterior teeth].

PubMed

Tian, Yu-lou; Wang, Kun; Wang, Jing; Liu, Fang; Piao, Mei-ling

2013-04-01

To investigate the impact of age factor on root resorption and the prevalence in anterior teeth during orthodontic treatment. Sixty extraction cases treated with straight wire appliance were divided into adult group and child group, with 30 cases in each group.The panoramic radiographs pre-treatment and post-treatment were examined to measure the degrees of root resorption. A total of 360 anterior teeth in each group were evaluated. SPSS 13.0 software package was applied to perform statistical analysis. There was significant difference in root resorption index before and after treatment(P<0.01). The incidence of root resorption increased remarkably after orthodontic treatment. There was significant difference in the degree of root resorption in two groups (P<0.01). The prevalence of root resorption in anterior teeth was: upper central incisors, upper lateral incisors, lower central incisors, lower lateral incisors, upper canines and lower canines. The root resorption in adult patients are more obvious than child patients. The prevalence of root resorption in anterior teeth is different. Moderate or severe root resorption is prone to happen in upper central incisors or lateral incisors in adult patients.

Treatment of alveolar cleft with distraction osteogenesis using anchorage with a tooth-microimplant joint in a dog model.

PubMed

Huang, Dai-Ying; Zhang, Ji-Bing; Li, Xiang; Chen, Song-Ling

2012-10-01

Our aim was to investigate the efficacy of correction of an alveolar cleft with distraction osteogenesis using anchorage with a tooth-microimplant joint in a canine model, which was established in 12 adult mongrel dogs that were subsequently randomised into two groups (n=6 in each). The first group comprised dogs that had osteogenesis using anchorage with a tooth (tooth group), while in the second, anchorage with tooth-microimplant joint (microimplant group) was used. All animals were killed one month after completion of distraction. Samples were collected for gross observation and histological examination. There was a significant difference in the degree of movement of the anchorage teeth in the transport discs between the 2 groups (p<0.01). There was less prominent inclination and shift of the natural teeth in the transport disc and less bony resorption around the root in the microimplant group than in the tooth group. These changes were less remarkable in the microimplant group. Treatment of alveolar cleft by distraction osteogenesis using anchorage with a tooth-microimplant joint is practical, and yields better results. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Intrusive luxation in primary teeth – Review of literature and report of a case

PubMed Central

Gupta, Megha

2011-01-01

Luxation injuries such as intrusion are commonly seen in the primary dentition. Intrusion drives the tooth deeper into the alveolar socket, which results in damage to the pulp and peridontium. Difficulty in gaining compliance from a very young child and the risk of damaging the permanent tooth germ makes the management of these injuries challenging. Careful clinical and radiographic examination along with regular follow-up is essential. A case of intrusive luxation to the maxillary central incisor in a 3-year-old patient is reported. Spontaneous reeruption was noted 4 months after injury, but the tooth had developed an abscess and external root resorption. Hence, extraction of the tooth was done and an anterior esthetic fixed space maintainer was placed. Traumatic injuries to the primary dentition should not be ignored by the parents or by the dentist. The paper also includes a literature review of intrusive luxation in the primary dentition. PMID:23960512

[Comparison of root resorption between self-ligating and conventional brackets using cone-beam CT].

PubMed

Liu, Yun; Guo, Hong-ming

2016-04-01

To analyze the differences of root resorption between passive self-ligating and conventional brackets, and to determine the relationship between passive self-ligating brackets and root resorption. Fifty patients were randomly divided into 2 groups using passive self-ligating brackets or conventional straight wire brackets (0.022 system), respectively. Cone-beam CT was taken before and after treatment. The amount of external apical root resorption of maxillary incisors was measured on CBCT images. Student's t test was performed to analyze the differences of root apical resorption between the 2 groups with SPSS17.0 software package. No significant difference(P> 0.05) in root resorption of maxillary incisors was found between passive self-ligating brackets and conventional brackets. Passive self-ligating brackets and conventional brackets can cause root resorption, but the difference was not significant. Passive self-ligating brackets do not induce more root resorption.

Immediate, single stage, truly anatomic zirconia implant in lower molar replacement: a case report with 2.5 years follow-up.

PubMed

Pirker, W; Wiedemann, D; Lidauer, A; Kocher, A A

2011-02-01

This report demonstrates the clinical use of a modified, truly anatomic, root-analogue zirconia implant for immediate replacement of a two-rooted, left first mandibular molar. A 50-year-old female patient with chronic apical periodontitis of the left mandibulary first molar was referred and the tooth was extracted. The mesial root had to be removed surgically due to a root fracture. A truly anatomical, root identical, roughened zirconia implant modified by macro-retentions was manufactured and placed into the extraction socket by tapping 7 days later. After 4 months a composite crown was cemented in place. No complications occurred during the healing period. A good functional and aesthetic result was achieved with minimal bone resorption and soft tissue recession at 30 months follow-up. This report describes the successful clinical use of an immediate, single stage, truly anatomical root-analogue zirconia implant for replacement of a two-rooted tooth. Significant modifications such as macro-retentions yielded primary stability and excellent osseointegration. This novel approach is minimally invasive, respects the underlying anatomy, aids socket prevention, is time- and cost-saving with good patient acceptance as there is no need for bone drilling, sinus lift, bone augmentation or other traumatic procedures. Copyright © 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

The potential of mangosteen (Garcinia mangostana) peel extract, combined with demineralized freeze-dried bovine bone xenograft, to reduce ridge resorption and alveolar bone regeneration in preserving the tooth extraction socket.

PubMed

Kresnoadi, Utari; Ariani, Maretaningtias Dwi; Djulaeha, Eha; Hendrijantini, Nike

2017-01-01

Following the extraction of a tooth, bone resorption can cause significant problems for a subsequent denture implant and restorative dentistry. Thus, the tooth extraction socket needs to be maintained to reduce the chance of any alveolar ridge bone resorption. The objective of this study is to determine whether the administration of mangosteen peel extracts (MPEs), combined with demineralized freeze-dried bovine bone xenograft (DFBBX) materials for tooth extraction socket preservation, could potentially reduce inflammation by decreased the expression of nuclear factor κβ (NfKb) and receptor activator of nuclear factor-κβ ligand (RANKL), to inhibit alveolar bone resorption, and increased of bone morphogenetic protein-2 (BMP2) expressions to accelerate alveolar bone regeneration. This study consists of several stages. First, a dosage of MPE combined with graft materials was applied to a preserved tooth extraction socket of a Cavia cobaya . Second, the C. cobaya was examined using immune histochemical expression of NfKb, RANKL, BMP2, as well as histology of osteoblasts and osteoclasts. The research was statistically analyzed, using an analysis of variance test and Tukey honest significant difference test. The results of this research were that it was determined that MPEs combined with graft materials on a preserved tooth extraction socket can reduce NfKb, RANK, and osteoclasts also increase of BMP2 and osteoblast. The induction of MPEs and DFBBX is effective in reducing inflammation, lowering osteoclasts, decreasing alveolar bone resorption, and also increasing BMP2 expression and alveolar bone regeneration.

Cone-beam computed tomography evaluation of the association of cortical plate proximity and apical root resorption after orthodontic treatment.

PubMed

Nakada, Tomoo; Motoyoshi, Mitsuru; Horinuki, Eri; Shimizu, Noriyoshi

2016-01-01

We investigated the effects of proximity of the root apex to the maxillary labial cortical plate, palatal cortical plate, and incisive canal cortical plate on apical root resorption. Cone-beam computed tomography was used to measure the amount of root resorption and root apex movement around maxillary right and left central incisors in 30 adults who underwent four-bicuspid extraction followed by treatment with multibracket appliances. The patients were divided into three groups on the basis of the direction of root apex movement, after which the correlation between the amount of root resorption and root apex movement was determined. Mean apical root resorption was 1.80 ± 0.82 mm (range, 0.18-3.96 mm). The amount of root apex movement was positively correlated with the amount of root resorption on the side of pressure. Root apex proximity to the maxillary labial cortical plate, palatal cortical plate, and incisive canal cortical plate was associated with apical root resorption. Orthodontic treatment plans should carefully consider root proximity to the maxillary cortical plate. (J Oral Sci 58, 231-236, 2016).

Varanoid Tooth Eruption and Implantation Modes in a Late Cretaceous Mosasaur.

PubMed

Liu, Min; Reed, David A; Cecchini, Giancarlo M; Lu, Xuanyu; Ganjawalla, Karan; Gonzales, Carol S; Monahan, Richard; Luan, Xianghong; Diekwisch, Thomas G H

2016-01-01

Erupting teeth are some of the oldest witnesses of developmental processes in the vertebrate fossil record and provide an important resource for vertebrate cladistics. Here, we have examined a mosasaur jaw fragment from central Texas using ultrathin ground section histology and 3D tomographic imaging to assess features critical for the cladistic placement of mosasaurs among varanoids vs. snakes: (i) the orientation of replacement teeth compared to the major tooth axis, (ii) the occurrence of resorption pits, and (iii) the mode of tooth implantation/attachment to the tooth bearing element (TBE). The replacement tooth studied here developed in an inclined position slightly distal of the deciduous parent tooth, similar to another varanoid squamate, the Gila monster Heloderma suspectum. Ground sections and tomographs also demonstrated that the replacement tooth attachment apparatus was entirely intact and that there was no evidence of mechanical deformation. Sections and tomographs further illustrated that the replacement tooth was located within a bony crypt and the inclination of the crypt matched the inclination of the replacement tooth. These preparations also revealed the presence of a resorption pit within the boundaries of the deciduous tooth that surrounded the developing replacement tooth. This finding suggests that developing mosasaur teeth developed within the walls of resorption pits similar to varanoid tooth germs and unlike developing snake teeth which are surrounded by fibrous connective tissue integuments. Finally, mosasaurs featured pseudo-thecodont tooth implantation with teeth anchored within a socket of mineralized tissue by means of a mineralized periodontal ligament. Together, these data indicate that the moderate inclination of the erupting mosasaur tooth studied here is neither a result of postmortem displacement nor a character representative of snakes, but rather a shared character between Mosasaurs and other varanoids such as Heloderma. In conjunction with the presence of resorption pits and the evidence for pseudothecodont tooth implantation, the tooth eruption and implantation characters described in the present study either place mosasaurs among the varanoids or suggest convergent evolution mechanisms between both clades, with mosasaurs evolving somewhat independently from a common varanoid ancestor.

Varanoid Tooth Eruption and Implantation Modes in a Late Cretaceous Mosasaur

PubMed Central

Liu, Min; Reed, David A.; Cecchini, Giancarlo M.; Lu, Xuanyu; Ganjawalla, Karan; Gonzales, Carol S.; Monahan, Richard; Luan, Xianghong

2016-01-01

Erupting teeth are some of the oldest witnesses of developmental processes in the vertebrate fossil record and provide an important resource for vertebrate cladistics. Here, we have examined a mosasaur jaw fragment from central Texas using ultrathin ground section histology and 3D tomographic imaging to assess features critical for the cladistic placement of mosasaurs among varanoids vs. snakes: (i) the orientation of replacement teeth compared to the major tooth axis, (ii) the occurrence of resorption pits, and (iii) the mode of tooth implantation/attachment to the tooth bearing element (TBE). The replacement tooth studied here developed in an inclined position slightly distal of the deciduous parent tooth, similar to another varanoid squamate, the Gila monster Heloderma suspectum. Ground sections and tomographs also demonstrated that the replacement tooth attachment apparatus was entirely intact and that there was no evidence of mechanical deformation. Sections and tomographs further illustrated that the replacement tooth was located within a bony crypt and the inclination of the crypt matched the inclination of the replacement tooth. These preparations also revealed the presence of a resorption pit within the boundaries of the deciduous tooth that surrounded the developing replacement tooth. This finding suggests that developing mosasaur teeth developed within the walls of resorption pits similar to varanoid tooth germs and unlike developing snake teeth which are surrounded by fibrous connective tissue integuments. Finally, mosasaurs featured pseudo-thecodont tooth implantation with teeth anchored within a socket of mineralized tissue by means of a mineralized periodontal ligament. Together, these data indicate that the moderate inclination of the erupting mosasaur tooth studied here is neither a result of postmortem displacement nor a character representative of snakes, but rather a shared character between Mosasaurs and other varanoids such as Heloderma. In conjunction with the presence of resorption pits and the evidence for pseudothecodont tooth implantation, the tooth eruption and implantation characters described in the present study either place mosasaurs among the varanoids or suggest convergent evolution mechanisms between both clades, with mosasaurs evolving somewhat independently from a common varanoid ancestor. PMID:27242535

Elastic band causing exfoliation of the upper permanent central incisors.

PubMed

Alves, Monica Ghislaine Oliveira; Kitakawa, Dárcio; Becker, Joao Batista Macedo; Brandão, Adriana Aigotti Haberbeck; Cabral, Luiz Antonio Guimarães; Almeida, Janete Dias

2015-01-01

Objective. This study reports a case in which elastic band use culminated in the loss of the incisors. Case Report. An 11-year-old white girl was seen complaining of pain, with purulent discharge and severe tooth mobility. The bone destruction detected radiographically in the region, despite its single location and absence in posterior quadrants of the maxilla and/or mandible, was similar to that observed in Langerhans cell disease. To our surprise, an elastic band involving the midportion of the roots of the two upper central incisors was found during biopsy. The debris was removed and a metal wire was placed in permanent maxillary right and left incisors. The patient was followed up, but no improvement in tooth mobility was observed. Bone loss increased, and internal resorption and root exposure occurred, which culminated in the extraction of permanent maxillary right and left incisors. Conclusion. The present case highlights the fact that professionals sometimes are confronted by anamnestic reports never seen before.

Nonsurgical Clinical Management of Periapical Lesions Using Calcium Hydroxide-Iodoform-Silicon-Oil Paste

PubMed Central

Al Khasawnah, Qusai; Hassan, Fathi; Malhan, Deeksha; Engelhardt, Markus; Daghma, Diaa Eldin S.; Obidat, Dima; Lips, Katrin S.; Heiss, Christian

2018-01-01

Background The study aim is to avoid tooth extraction by nonsurgical treatment of periapical lesion. It assesses healing progress in response to calcium hydroxide-iodoform-silicon oil paste (CHISP). Numeric Pain Rating Scale was used to validate the approach. Furthermore, CHISP was used to treat cystic lesions secondary to posttraumatic avulsion of permanent teeth. Materials and Methods Over 200 patients with radicular cysts were treated with CHISP through the root canal. Radiographs were used to verify lesion size and position, ensure correct delivery to the site, and monitor the progress of bone healing in the lesion area. Ten males and 10 females were randomly selected for statistical assessment. Results No severe pain, complications, or failure in cyst healing was reported. Complete healing was achieved in an average of 75 days. Furthermore, healing of radicular cyst secondary to posttraumatic tooth avulsion was successful. Conclusion CHISP indicated an antiseptic effect, which enhanced and shortened healing time of periapical lesions. The less invasive procedure avoids tooth extraction and reduces bone resorption. Cyst management with CHISP can remedy failed root canal treatments. The results show a bone regenerative capacity of CHISP suggested in first rapid phase and a second slow phase. PMID:29619378

Treatment of Severe Chronic Periodontitis with Surgical and Prosthetic Intervention: A 9-year Follow-up Case Report.

PubMed

Makino-Oi, Asako; Ishii, Yoshihito; Makino, Kenshi; Kondo, Asako; Uekusa, Tomomi; Ishizuka, Yoichi; Tomita, Sachiyo; Saito, Atsushi

2017-01-01

A 60-year-old woman presented with the chief complaint of mobility of tooth #16. Gingival swelling and calculus were observed. Clinical examination revealed that 49.4% of sites had a probing depth (PD) of ≥4 mm and 72% of sites bleeding on probing. Radiographic examination revealed vertical bone resorption in #35 and horizontal resorption in other regions. Periapical region radiolucency on #16 and 27 suggested a perio-endo lesion. The clinical diagnosis was severe chronic periodontitis. Initial periodontal therapy mainly comprised the following: oral hygiene instruction; quadrant scaling and root planing (SRP); extraction of #16, 27, and 31; and placement of provisional restorations. Open flap debridement was performed for teeth with a PD ≥4 mm. Bone defects exceeding the root apex were found in #17, 41, 42, and 45 intraoperatively. Teeth #41, 42, and 45 were extracted. After confirming the stability of the periodontal tissue, final prostheses were placed on #14-17, 13-22, 35-37, 33-43, 44-46, and 47. Following reevaluation, the patient was placed on supportive periodontal therapy (SPT). After 6 years, the patient experienced dull pain in and pus discharge from #17. Repeated SRP yielded no improvement, so the tooth was extracted and a removable partial denture placed on #16 and 17. Nine years have passed since the start of SPT and the level of plaque control has remained adequate and periodontal condition stable.

Conservative Socket Regeneration with Buccal Wall Defect Using Guided Tissue.

PubMed

Al-Juboori, Mohammed Jasim

2016-01-01

Progressive alveolar bone resorption after tooth extraction may lead to surgical and prosthetic-driven difficulties, especially when deciding to use a dental implant to replace the extracted tooth. This case report discusses an irreparable lower left second premolar tooth with a periodontal lesion on the buccal side. A preservative tooth extraction was performed. Then, the socket was grafted with bovine bone, a collagen membrane was placed between the buccal bone and the attached gingiva, covering the bone dehiscence buccally, and the socket without a flap was raised. After a 6-month healing period, there was minimal socket width resorption and a shallow buccal vestibule. The implant was placed with high primary stability and sufficient buccal plate thickness. In conclusion, this guided tissue regeneration technique can minimize alveolar bone resorption in a socket with buccal dehiscence, but technical difficulties and shallowing of the buccal vestibule still exist.

Open bite as a risk factor for orthodontic root resorption.

PubMed

Motokawa, Masahide; Terao, Akiko; Kaku, Masato; Kawata, Toshitsugu; Gonzales, Carmen; Darendeliler, M Ali; Tanne, Kazuo

2013-12-01

The purpose of the present study was to clarify the prevalence and degree of root resorption induced by orthodontic treatment in patients with and without open bite. One hundred and eleven patients treated with multibracket appliances were retrospectively selected from the patients and divided into non-open bite (NOB) and open bite (OB) groups. The severity of root resorption and the root shape were classified into five groups on periapical radiographs before and after treatment. Moreover, only in the OB group, all teeth were sub-divided into functional and hypofunctional ones that are occluding and non-occluding. As the results of multiple linear regression analysis of patient characteristics and clinical variables with the number of overall root resorption, the independent variables that were found to contribute significantly to root resorption were bite and abnormal root shape. The prevalences of root resorption evaluated in the number of patients were significantly higher in OB group than in NOB group, and those in the number of teeth were significantly higher in OB group than in NOB group, in particular anterior and premolar teeth. The prevalence of resorbed teeth with abnormal root shapes was also significantly higher in OB group than in NOB group. On the other hand, in OB group, the prevalences of root resorption and teeth with abnormal root shape were significantly greater in hypofunctional teeth than in normal functional teeth. There are more teeth with root resorption and abnormal root shape in open bite cases than in normal bite cases, and more teeth with abnormal root shapes and root resorption in hypofunctional teeth than in functional teeth.

Root resorption diagnosed with cone beam computed tomography after 6 months of orthodontic treatment with fixed appliance and the relation to risk factors.

PubMed

Makedonas, Dimitrios; Lund, Henrik; Gröndahl, Kerstin; Hansen, Ken

2012-03-01

To investigate root resorption after 6 months of active orthodontic treatment and its relation to possible risk factors. Ninety-seven patients (10-18 years) with a Class I malocclusion and crowding treated with fixed appliance and premolar extractions were examined with cone beam computed tomography before and after 6 months of active treatment. The exposure covered all teeth from first molar to first molar in both jaws. The Malmgren index was used to evaluate the degree of root resorption. Irregular root contour (score 1) was seen in most teeth already before active treatment, and therefore resorptions were registered only as score 2 (<2 mm, minor resorption) or higher. Minor root resorption was noted in 10% of the patients and severe root resorption, >2 mm (score 3) was found in four patients. Root resorption was more frequently seen in the upper jaw, especially the incisors. There was no statistically significant correlation of root resorption with any of the selected risk factors. After 6 months of treatment, clinically significant resorption was diagnosed in 4% of the patients, ie, in 96% of the patients the radiographic examination did not reveal any significant information. The selected risk factors did not have any impact on the amount of resorption after 6 months of active treatment.

Orthodontic treatment in patient with idiopathic root resorption: a case report.

PubMed

Rey, Diego; Smit, Rosana Martínez; Gamboa, Liliana

2015-01-01

Multiple idiopathic external root resorption is a rare pathological condition usually detected as an incidental radiographic finding. External root resorption of permanent teeth is a multifactorial process related to several local and systemic factors. If an etiological factor cannot be identified for root resorption, the term "idiopathic" is applied. This report presents a case of multiple idiopathic apical root resorption. The condition was found in a young female patient seeking orthodontic treatment due to malocclusion. This kind of resorption starts apically and progresses coronally, causing a gradual shortening and rounding of the remaining root. Patients with this condition are not the ideal candidates for orthodontic treatment; however, the aim of this report is to describe an unusual case of idiopathic root resorption involving the entire dentition, and to present the orthodontic treatment of this patient. It describes the progress and completion of orthodontic therapy with satisfactory end results.

Tooth replantation after use of Euro-Collins solution or bovine milk as storage medium: a histomorphometric analysis in dogs.

PubMed

Sottovia, André Dotto; Sottovia Filho, Dagoberto; Poi, Wilson Roberto; Panzarini, Sônia Regina; Luize, Danielle Shima; Sonoda, Celso Koogi

2010-01-01

Euro-Collins solution was developed for the preservation of organs for transplantation, whose characteristics have raised interest for its use as a storage medium for avulsed teeth before replantation. This study evaluated histologically and morphometrically the healing process of dog teeth replanted after storage in Euro-Collins solution or bovine milk. Eighty roots of 4 young adult mongrel dogs were randomly assigned to 4 groups (n = 20) and the root canals were instrumented and obturated with gutta-percha and a calcium hydroxide-based sealer. After 2 weeks, the teeth were extracted and subjected to the following protocols: GI (negative control), replantation immediately after extraction; GII (positive control), bench-drying for 2 hours before replantation; GIII and GIV, immersion in 10 mL of whole bovine milk and Euro-Collins solution at 4 degrees C, respectively, for 8 hours before replantation. The animals were sacrificed 90 days postoperatively. The pieces containing the replanted teeth were subjected to routine processing for histologic and histometric analyses under light microscopy and polarized light microscopy. Root resorption was observed in all groups. GII exhibited the greatest loss of dental structure (P < .01), and inflammatory resorption was predominant in this group. Storage in milk showed poorer results than immediate replantation and storage in Euro-Collins solution (P < .01). The teeth stored in Euro-Collins solution presented similar extension of root resorption and periodontal ligament reorganization to those of immediately replanted teeth. The findings of this study suggest that the Euro-Collins solution is an adequate storage medium for keeping avulsed teeth for up to 8 hours before replantation.

Clinical attachment level gain and bone regeneration around a glass ionomer restoration on root surface wall of periodontal pocket

PubMed Central

Biniraj, K. R.; Sagir, Mohammed; Sunil, M. M.; Janardhanan, Mahija

2012-01-01

A case describing perio-restorative management of an accidental trauma in the mid portion of root on an upper left canine tooth following an ostectomy surgery is presented here. The traumatized root area was undergoing fast resorption and a chronic periodontal abscess had developed in relation to the lesion. The article illustrates the clinical and radiographic photo series of a periodontal flap surgery done to gain access into a subgingival region for the placement of Glass ionomer restoration on the root and its periodic follow up. The clinical condition of the area suggests 8 mm clinical attachment gain over the restoration and the review radiographs at definite intervals up to 18 months revealed evidence of consistent bone regeneration around the restoration. The article also highlights the various other possibilities, where this restorative material can be effectively used in conjunction with periodontal surgical procedures. PMID:23162344

Physical properties of root cementum: part 20. Effect of fluoride on orthodontically induced root resorption with light and heavy orthodontic forces for 4 weeks: a microcomputed tomography study.

PubMed

Karadeniz, Ersan Ilsay; Gonzales, Carmen; Nebioglu-Dalci, Oyku; Dwarte, Dennis; Turk, Tamer; Isci, Devrim; Sahin-Saglam, Aynur M; Alkis, Huseyin; Elekdag-Turk, Selma; Darendeliler, M Ali

2011-11-01

The major side effect of orthodontic treatment is orthodontically induced inflammatory root resorption. Fluoride was previously shown to reduce the volume of the root resorption craters in rats. However, the effect of fluoride on orthodontically induced inflammatory root resorption in humans has not yet been investigated. The aim of this study was to investigate the effect of high and low amounts of fluoride intake from birth on orthodontically induced inflammatory root resorption under light (25 g) and heavy (225 g) force applications. Forty-eight patients who required maxillary premolar extractions as part of their orthodontic treatment were selected from 2 cities in Turkey with high and low fluoride concentrations in the public water of ≥ 2 and ≤ 0.05 ppm, respectively. The patients were randomly separated into 4 groups of 12 each: group 1, high fluoride intake and heavy force; group 2, low fluoride intake and heavy force; group 3, high fluoride intake and light force; and group 4, low fluoride intake and light force. Light or heavy buccal tipping orthodontic forces were applied on the maxillary first premolars for 28 days. At day 28, the teeth were extracted, and the samples were analyzed with microcomputed tomography. Fluoride reduced the volume of root resorption craters in all groups; however, this effect was significantly different with high force application (P = 0.015). It was also found that light forces caused less root resorption than heavy forces. There was no statistical difference in the amount of root resorption observed on root surfaces (buccal, lingual, mesial, and distal) in all groups. However, the middle third of the roots showed the least root resorption. With high fluoride intake and heavy force application, less root resorption was found in all root surfaces and root thirds. Fluoride may reduce the volume of root resorption craters. This effect is significant with heavy force applications (P <0.05). The cervical and apical thirds of the root showed significantly greater root resorption after the application of buccal tipping force for 4 weeks. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT

PubMed Central

Bilge Gülsüm, NUR; Evren, OK; ALTUNSOY, Mustafa; AĞLARCI, Osman Sami; ÇOLAK, Mehmet; GÜNGÖR, Enes

2014-01-01

Objective This study aimed to assess the quality of root fillings, coronal restorations, complications of all root-filled teeth and their association with apical periodontitis (AP) detected by cone-beam computed tomography (CBCT) images from an adult Turkish subpopulation. Material and Methods The sample for this study consisted of 242 patients (aging from 15 to 72 years) with 522 endodontically treated teeth that were assessed for technical quality of the root canal filling and periapical status of the teeth. Additionally, the apical status of each root-filled tooth was assessed according to the gender, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion and type and quality of the coronal structure. Statistical analysis was performed using percentages and chi-square test. Results The success rate of the root canal treatment was of 54.4%. The success rates of adequate and inadequate root canal treatment were not significantly different (p>0.05). Apical periodontitis was found in 228 (45.6%) teeth treated for root canals. Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth]. Conclusions The technical quality of root canal filling performed by dental practitioners in a Turkish subpopulation was consistent with a high prevalence of AP. The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics. PMID:25591019

OCT investigation of dental lesions

NASA Astrophysics Data System (ADS)

Osiac, Eugen; Popescu, Sanda Mihaela; Scrieciu, Monica; Mercuţ, Rǎzvan; Mercuţ, Veronica; Vǎtu, Mihaela

2018-03-01

There are several important non carious lesions affecting the tooth structure, lesions which may be classified into four clinical forms of dental wear: abfraction, erosion, attrition and abrasion, and different types of root resorption. Search for new, non-invasive and fast methods able to detect and describe such injuries is of utmost importance. Optical coherence tomography (OCT) proved itself as an appropriate investigation method for several medical fields including ophthalmology, dermatology, cardiology etc. Our study reveals OCT preliminary investigations as a promising tool for detecting and evaluating of the mentioned lesions.

Root resorption of maxillary incisors retracted with and without skeletal anchorage.

PubMed

Barros, Sérgio Estelita; Janson, Guilherme; Chiqueto, Kelly; Baldo, Vitor Oliveira; Baldo, Taiana Oliveira

2017-02-01

Our objective was to compare root resorption degree of the maxillary central incisors retracted with and without skeletal anchorage. This nonrandomized historical control study included 37 patients requiring maximum anterior retraction and treated with extraction of 2 maxillary premolars. Group 1 consisted of 22 patients (11 male, 11 female) in whom anterior retraction was performed without skeletal anchorage, and group 2 included 15 patients (3 male, 12 female) treated with skeletally anchored anterior retraction. Periapical radiographs were used to evaluate root resorption degree by a scoring system. The groups were compared regarding the resorption score and resorption degree distribution with the Mann-Whitney U test, chi-square test, and Z test on proportions. There was no statistically significant intergroup difference regarding root resorption, but the number of patients with severe and extreme root resorption degrees was significantly greater in group 2. Although the root resorption degree of the skeletal anchorage group was not significantly different from the group without skeletal anchorage, the number of patients with severe to extreme resorption in the first group was significantly greater. Therefore, careful clinical monitoring of skeletally anchored anterior retraction is needed, especially when there are known root resorption predisposing factors. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Effect of Calcium Hydroxide, Chlorhexidine Digluconate and Camphorated Monochlorophenol on the Sealing Ability of Biodentine Apical Plug.

PubMed

Srivastava, Aastha Arora; Srivastava, Harshit; Prasad, Ashwini B; Raisingani, Deepak; Soni, Dileep

2016-06-01

Teeth with immature apex are managed by establishing an apical plug using various materials and techniques. However, the use of previously placed intracanal medicament may affect the sealing ability of permanent filling material used as an apical plug. To evaluate the effect of removal of previously placed Calcium Hydroxide, Chlorhexidine Digluconate and Camphorated Monochlorophenol as an intracanal medicament on the sealing ability of the Biodentine as an apical plug. A total of 72 recently extracted human permanent teeth with single root were selected and stored in saline at room temperature. The crown portion of each tooth was removed at the level of cemento enamel junction; 14mm root length was taken as standard length. All the roots were submerged in 20% sulphuric acid up to 3 mm from the apex, for four days for root resorption. One sample was cut longitudinally to look for root resorption under stereo microscope. The canal preparation was done; the roots were kept in moist gauze after instrumentation. A total of 71 roots were randomly divided into three groups. GROUP 1:Calcium hydroxide paste, GROUP 2: Chlorhexidine digluconate, GROUP 3: Camphorated Monochlorophenol (CMCP). The medicaments were removed with stainless steel hand files and 0.5% sodium hypochlorite irrigation. After removal of medicament Biodentine was placed in apical third of resorbed roots and the remaining portion of the canals was filled with gutta-percha. All the 71 roots were analysed with fluid filtration method for evaluating microleakage. Comparing all the three groups statistically there was no significant difference. The mean values were found more for group 1 followed by group 2 & 3. All the groups showed microleakage. Calcium hydroxide showed the maximum microleakage followed by Chlorhexidine digluconate and least with CMCP.

Association analysis of clinical aspects and vitamin D receptor gene polymorphism with external apical root resorption in orthodontic patients.

PubMed

Fontana, Maria Luiza S Simas Netta; de Souza, Cleber Machado; Bernardino, José Fabio; Hoette, Felix; Hoette, Maura Levi; Thum, Lotario; Ozawa, Terumi O; Capelozza Filho, Leopoldino; Olandoski, Marcia; Trevilatto, Paula Cristina

2012-09-01

Vitamin D is responsible for the regulation of certain genes at the transcription level, via interaction with the vitamin D receptor, and influences host immune responses and aspects of bone development, growth, and homeostasis. Our aim was to investigate the association of TaqI vitamin D receptor gene polymorphism with external apical root resorption during orthodontic treatment. Our subjects were 377 patients with Class II Division 1 malocclusion, divided into 3 groups: (1) 160 with external apical root resorption ≤1.43 mm, (2) 179 with external apical root resorption >1.43 mm), and (3) 38 untreated subjects. External apical root resorption of the maxillary incisors was evaluated on periapical radiographs taken before and after 6 months of treatment. After DNA collection and purification, vitamin D receptor TaqI polymorphism analysis was performed by polymerase chain reaction-restriction fragment length polymorphism. Univariate and multivariate analyses were performed to verify the association of clinical and genetic variables with external apical root resorption (P <0.05). There was a higher proportion of external apical root resorption in orthodontically treated patients compared with the untreated subjects. In patients orthodontically treated, age higher than 14 years old, initial size of the maxillary incisor root superior to 30 mm, and premolar extraction were associated with increased external apical root resorption. Genotypes containing the C allele were weakly associated with protection against external apical root resorption (CC + CT × TT [odds ratio, 0.29; 95% confidence interval, 0.07-1.23; P = 0.091]) when treated orthodontic patients were compared to untreated individuals. Clinical factors and vitamin D receptor TaqI polymorphism were associated with external apical root resorption in orthodontic patients. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Effect of indomethacin on surface treatment and intracanal dressing of replanted teeth in dogs.

PubMed

Zanetta-Barbosa, Darceny; Moura, Camilla Christian Gomes; Machado, Juliana Reis; Crema, Virginia Oliveira; Lima, Cirilo Antônio de Paula; de Carvalho, Antônio Cesar Perry

2014-01-01

This study evaluated the healing process of teeth replanted after root treatment and intracanal dressing with indomethacin alone or indomethacin with calcium hydroxide (Ca[OH]2). Through a case-control study, 24 teeth of 6 adult dogs were extracted, dried, and divided into 4 groups according to the root surface treatment protocols performed before replantation and the intracanal medication used after replantation. In group 1 (negative control), root surfaces were treated by immersion in a 0.9% saline solution and then replanted. In the other groups, the roots were immersed for 10 minutes in Ca(OH)2 (group 2), indomethacin (group 3), or a solution of indomethacin and Ca(OH)2 (group 4). After 2 weeks, group 1 teeth were subjected to single-visit root canal treatment and obturation with gutta-percha and sealer consisting of zinc oxide and eugenol. The teeth in the other groups were subjected to intracanal dressing with the same material used for immersion. After an additional period of 28 weeks, the animals were euthanized and the jaws containing the replanted teeth were processed for histologic analysis. Histometric values were statistically analyzed, with significance set at a P value less than or equal to .05. Group 1 exhibited significantly more normal periodontium than group 4 (P = .02). Total resorption was greater in group 4 than in group 1 (P = .02). No statistically significant difference in the percentage of surface resorption or in total inactive resorption was observed between the groups. The findings of this study suggest that intracanal dressing and topical root treatment with Ca(OH)2 with or without indomethacin is not recommended for teeth dried for 50 minutes, but the use of indomethacin alone as root surface treatment for delayed tooth replantation deserves further study using longer drying periods. In addition, the present results suggest that a single-visit root canal, performed up to 2 weeks after replantation, might be indicated for teeth dried for up to 50 minutes. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Short-term vs long-term calcium hydroxide therapy after immediate tooth replantation: a histomorphometric study in monkey's teeth.

PubMed

Panzarini, Sônia Regina; Gulinelli, Jéssica Lemos; Saito, Célia T M H; Poi, Wilson Roberto; Sonoda, Celso Koogi; Américo de Oliveira, José; Melo, Moriel Evangelista; de Souza Gomes, Weglis Dyanne

2012-06-01

Endodontic treatment is an important step of tooth replantation protocols, but the ideal moment for definitive obturation of replanted teeth has not yet been established. In this study, a histomorphometric analysis was undertaken to evaluate the repair process on immediate replantation of monkey's teeth after calcium hydroxide (CH) therapy for 1 and 6 months followed by root canal filling with a CH-based sealer (Sealapex(®) ). The maxillary and mandibular lateral incisors of five female Cebus apella monkeys were extracted, kept in sterile saline for 15 min, replanted and splinted with stainless steel orthodontic wire and composite resin for 10 days. In Group I (control), definitive root canal filling was performed before tooth extraction. In Groups II and III, CH therapy started after removal of splint, and definitive root canal filling was performed 1 and 6 months later, respectively. The animals were euthanized 9 months after replantation, and specimens were processed for histomorphometric analysis. In all groups, epithelial attachment occurred at the cementoenamel junction or very close to this region; the areas of resorption on root surface had small extension and depth and were repaired by newly formed cementum; and the periodontal ligament was organized. Statistical analysis of the scores obtained for the histomorphometric parameters did not show any statistically significant difference (P = 0.1221) among the groups. The results suggests that when endodontic treatment is initiated 10 days after immediate replantation and an antibiotic regimen is associated, definitive root canal filling can be performed after a short-term CH therapy. © 2011 John Wiley & Sons A/S.

Periodontal tissue repair after sealing of the gap in vertical root fracture.

PubMed

Sugaya, Tsutomu; Tomita, Mahito; Motoki, Youji; Zaman, Khurshiduz; Miyaji, Hirofumi; Kawanami, Masamitsu

2017-04-01

The aim of this study was to determine whether sealing of fracture gap using adhesive resin through the root canal can prevent inflammation of periodontal tissue, and resealing the incompletely sealed fracture gap from outside can resolve such inflammation in experimentally created vertical root fractures. Vertical root fractures were created in incisor of beagles. In the experimental group, the fracture gap was sealed through the root canal with adhesive resin. After 5 weeks, sites with the clinical attachment level ≥4 mm were further divided randomly into the poor-replanting group and the poor-untreated group. In the poor-replanting group, the tooth was extracted and replanted after resealing the fracture gap with adhesive resin from the outer surface. Sites with clinical attachment level ≤3 mm after 5 weeks were considered as the satisfactory group. The poor-untreated group and the satisfactory group were subjected to no further treatment. The clinical attachment level was evaluated at baseline and after 2, 5, and 9 weeks. After 9 weeks, histological measurements were made to determine the length of the epithelial downgrowth and the area of alveolar bone resorption. The clinical attachment level and the area of bone resorption were significantly smaller in the poor-replanting group and the satisfactory group than in the poor-untreated group (p < 0.05). The results indicate the possibility that periodontal inflammation along the fracture line can be prevented and improved if the fracture gap is sealed.

Predisposing factors to severe external root resorption associated to orthodontic treatment.

PubMed

Picanço, Gracemia Vasconcelos; de Freitas, Karina Maria Salvatore; Cançado, Rodrigo Hermont; Valarelli, Fabricio Pinelli; Picanço, Paulo Roberto Barroso; Feijão, Camila Pontes

2013-01-01

The aim of this study was to evaluate predisposing factors among patients who developed moderate or severe external root resorption (Malmgren's grades 3 and 4), on the maxillary incisors, during fixed orthodontic treatment in the permanent dentition. Ninety-nine patients who underwent orthodontic treatment with fixed edgewise appliances were selected. Patients were divided into two groups: G1 - 50 patients with no root resorption or presenting only apical irregularities (Malmgren's grades 0 and 1) at the end of the treatment, with mean initial age of 16.79 years and mean treatment time of 3.21 years; G2 - 49 patients presenting moderate or severe root resorption (Malmgren's grades 3 and 4) at the end of treatment on the maxillary incisors, with mean initial age of 19.92 years and mean treatment time of 3.98 years. Periapical radiographs and lateral cephalograms were evaluated. Factors that could influence the occurrence of severe root resorption were also recorded. Statistical analysis included chi-square tests, Fisher's exact test and independent t tests. The results demonstrated significant difference between the groups for the variables: Extractions, initial degree of root resorption, root length and crown/root ratio at the beginning, and cortical thickness of the alveolar bone. It can be concluded that: Presence of root resorption before the beginning of treatment, extractions, reduced root length, decreased crown/root ratio and thin alveolar bone represent risk factors for severe root resorption in maxillary incisors during orthodontic treatment.

A Rare Case of Apical Root Resorption during Orthodontic Treatment of Patient with Multiple Aplasia.

PubMed

Agrawal, Chintan M; Mahida, Khyati; Agrawal, Charu C; Bothra, Jitendrakumar; Mashru, Ketan

2015-07-01

External apical root resorption is an adverse effect of orthodontic treatment. It reduces the length of root and breaks the integrity of teeth and dental arch. Orthodontics is the only dental specialty that clinically uses the inflammatory process to correct the mal-aligned teeth. Hence, it is necessary to know the risk factors of root resorption and do everything to reduce the rate of root resorption. Hence, all predisposing factors which are systemic as well as local should be considered before treatment begins. This case report describes the incidence of root resorption following orthodontic treatment and the teeth affected in the patient with multiple aplasia.

Clinical Management of Two Root Resorption Cases in Endodontic Practice

PubMed Central

2016-01-01

Root resorption is a pathological process involving loss of hard dental tissues. It may occur as a consequence of dental trauma, orthodontic treatment, and bleaching, and occasionally it accompanies periodontal disease. Although the mechanism of resorption process is examined in detail, its etiology is not fully understood. Wide open apical foramen is more difficult to manage and the root canal may often overfill. In this report we present two cases of root resorption and describe means for its clinical management. We conclude that useful measure of a success or failure in managing root resorption is the persistence of the resorption process. It is a clear sign of an active ongoing inflammatory process and shows the clinical need for retreatment. PMID:27648314

Odontogenic keratocyst in a cat.

PubMed

LaDouceur, E E B; Walker, K S; Mohr, F C; Murphy, B

2014-01-01

Odontogenic cysts are derived from odontogenic epithelium, can be locally invasive and destructive and have been reported rarely in cats. A 16-year-old, male domestic shorthair cat had a 3-year history of a slowly progressive, right mandibular swelling. Intraoral dental radiographs revealed a multilocular, radiolucent, cystic mass within the right mandible that extended from the distal aspect of the canine tooth to the mesial aspect of the fourth premolar tooth. Radiographically, the mass was associated with distortion and regional destruction of the right mandibular bone and resorption of regional tooth roots. Histological examination of an incisional biopsy sample revealed multiple ruptured cysts lined by stratified squamous epithelium of odontogenic origin with luminal parakeratinization and a prominent palisading basal cell layer. The cyst contained abundant orthokeratotic and parakeratotic keratin. The clinical, radiographical and histological features were consistent with a diagnosis of odontogenic keratocyst, as seen in man. This is the first report of an odontogenic keratocyst in a cat. Copyright © 2014 Elsevier Ltd. All rights reserved.

External apical root resorption in maxillary incisors in orthodontic patients: associated factors and radiographic evaluation.

PubMed

Nanekrungsan, Kamonporn; Patanaporn, Virush; Janhom, Apirum; Korwanich, Narumanus

2012-09-01

This study was performed to evaluate the incidence and degree of external apical root resorption of maxillary incisors after orthodontic treatment and to evaluate particular associated factors related to external apical root resorption. The records and maxillary incisor periapical radiographs of 181 patients were investigated. Crown and root lengths were measured and compared on the pre- and post-treatment periapical radiographs. Crown length was measured from the center of the incisal edge to the midpoint of the cemento-enamel junction (CEJ). Root length was measured from the CEJ midpoint to the root apex. A correction factor for the enlargement difference was used to calculate root resorption. The periapical radiographs of 564 teeth showed that the average root resorption was 1.39±1.27 (8.24±7.22%) and 1.69±1.14 mm (10.16±6.78%) for the maxillary central and lateral incisors, respectively. The results showed that the dilacerated or pointed roots, maxillary premolar extraction cases, and treatment duration were highly significant factors for root resorption (p<0.001). Allergic condition was a significant factor at p<0.01. Age at the start of treatment, large overjet, and history of facial trauma were also factors significantly associated with root resorption (p<0.05). There was no statistically significant difference in root resorption among the factors of gender, overbite, tongue-thrusting habit, types of malocclusion, and types of bracket. These results suggested that orthodontic treatment should be carefully performed in pre-treatment extraction patients who have pointed or dilacerated roots and need long treatment duration.

Clinical technique for invasive cervical root resorption

PubMed Central

Silveira, Luiz Fernando Machado; Silveira, Carina Folgearini; Martos, Josué; Piovesan, Edno Moacir; César Neto, João Batista

2011-01-01

This clinical case report describes the diagnosis and treatment of an external invasive cervical resorption. A 17-year-old female patient had a confirmed diagnosis of invasive cervical resorption class 4 by cone beam computerized tomography. Although, there was no communication with the root canal, the invasive resorption process was extending into the cervical and middle third of the root. The treatment of the cervical resorption of the lateral incisor interrupted the resorptive process and restored the damaged root surface and the dental functions without any esthetic sequelae. Both the radiographic examination and computed tomography are imperative to reveal the extent of the defect in the differential diagnosis. PMID:22144822

Maxillary premolar resorption by canines: three case reports.

PubMed

Cooke, M E; Nute, S J

2005-05-01

Three unusual cases of maxillary premolar root resorption are reported. Three teenage patients were referred to the orthodontic department for management of ectopic maxillary canines. Radiographic examination revealed unilateral premolar root resorption in all three patients. This represents an unusual finding. Whereas the prevalence of maxillary lateral incisor root resorption secondary to palatally ectopic canines has been reported, the prevalence of premolar root resorption is unknown. This report discusses the findings in the context of the available literature. The postulated aetiology and the need for early diagnosis are highlighted.

A Comparison of pical Root Resorption in Incisors after Fixed Orthodontic Treatment with Standard Edgewise and Straight Wire (MBT) Method

PubMed Central

Zahed Zahedani, SM; Oshagh, M; Momeni Danaei, Sh; Roeinpeikar, SMM

2013-01-01

Statement of Problem: One of the major outcomes of orthodontic treatment is the apical root resorption of teeth moved during the treatment. Identifying the possible risk factors, are necessary for every orthodontist. Purpose: The aim of this study was to compare the rate of apical root resorption after fixed orthodontic treatment with standard edgewise and straight wire (MBT) method, and also to evaluate other factors effecting the rate of root resorption in orthodontic treatments. Materials and Method: In this study, parallel periapical radiographs of 127 patients imaging a total of 737 individual teeth, were collected. A total of 76 patients were treated by standard edgewise and 51 patients by straight wire method. The periapical radiographs were scanned and then the percentage of root resorption was calculated by Photoshop software. The data were analyzed by Paired-Samples t-test and the Generalized Linear Model adopting the SPSS 15.0. Results: In patients treated with straight wire method (MBT), mean root resorption was 18.26% compared to 14.82% in patients treated with standard edgewise technique (p< .05). Male patients had higher rate of root resorption,statistically significant (p< .05). Age at onset of treatment, duration of treatment, type of dental occlusion, premolar extractions and the use of intermaxillary elastics had no significant effect on the root resorption in this study. Conclusion: Having more root resorption in the straight wire method and less in the standard edgewise technique can be attributed to more root movement in pre-adjusted MBT technique due to the brackets employed in this method. PMID:24724131

A Comparison of pical Root Resorption in Incisors after Fixed Orthodontic Treatment with Standard Edgewise and Straight Wire (MBT) Method.

PubMed

Zahed Zahedani, Sm; Oshagh, M; Momeni Danaei, Sh; Roeinpeikar, Smm

2013-09-01

One of the major outcomes of orthodontic treatment is the apical root resorption of teeth moved during the treatment. Identifying the possible risk factors, are necessary for every orthodontist. The aim of this study was to compare the rate of apical root resorption after fixed orthodontic treatment with standard edgewise and straight wire (MBT) method, and also to evaluate other factors effecting the rate of root resorption in orthodontic treatments. In this study, parallel periapical radiographs of 127 patients imaging a total of 737 individual teeth, were collected. A total of 76 patients were treated by standard edgewise and 51 patients by straight wire method. The periapical radiographs were scanned and then the percentage of root resorption was calculated by Photoshop software. The data were analyzed by Paired-Samples t-test and the Generalized Linear Model adopting the SPSS 15.0. In patients treated with straight wire method (MBT), mean root resorption was 18.26% compared to 14.82% in patients treated with standard edgewise technique (p< .05). Male patients had higher rate of root resorption,statistically significant (p< .05). Age at onset of treatment, duration of treatment, type of dental occlusion, premolar extractions and the use of intermaxillary elastics had no significant effect on the root resorption in this study. Having more root resorption in the straight wire method and less in the standard edgewise technique can be attributed to more root movement in pre-adjusted MBT technique due to the brackets employed in this method.

Bone augmentation of the osteo-odonto alveolar lamina in MOOKP--will it delay laminar resorption?

PubMed

Iyer, Geetha; Srinivasan, Bhaskar; Agarwal, Shweta; Rishi, Ekta; Rishi, Pukhraj; Rajan, Gunaseelan; Shanmugasundaram, Shanmugasundaram

2015-07-01

We aimed to describe a new technique and analyse the early outcomes of augmenting the canine tooth using a mandibular bone graft in an attempt to delay or retard the process of laminar resorption following the modified osteo odonto keratoprosthesis (MOOKP) procedure. This was a retrospective case series. Eyes that underwent the bone augmentation procedure between December 2012 and February 2014 were retrospectively analysed. The procedure, performed by the oromaxillofacial surgeon, involved securing a mandibular bone graft beneath the periosteum on the labial aspect of the canine tooth chosen to be harvested for the MOOKP procedure. This procedure was performed simultaneously with the Stage 1 A of the MOOKP. Three months later, the tooth was harvested and fashioned into the osteo-odonto alveolar lamina similar to the method described in the Rome-Vienna Protocol. The bone augmentation procedure was performed in 11 eyes (five SJS/ six chemical injuries). The mean follow-up after Stage 2 of MOOKP procedure in these eyes was 7.45 months (2 to 20 months). Complications noted were peripheral laminar exposure (three eyes-SJS) and bone graft exposure and necrosis in the mouth (nine-SJS). No evidence of clinical laminar resorption was noted in any of the eyes. Laminar resorption in MOOKP can lead to vision and globe threatening complications due to the consequent cylinder instability and chances of extrusion. Augmenting the bone on the labial aspect of the canine tooth might have a role to play in delaying or preventing laminar resorption.

Paleobiology: A Tooth for a Tooth.

PubMed

Johanson, Zerina

2017-02-06

Many vertebrates replace teeth through shedding of the functional tooth. New analyses of a fossil fish demonstrate that shedding involved tooth resorption, a primitive feature in bony fishes, but absent in sharks and their relatives. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Orthodontic extrusion of Ellis Class VIII fracture of maxillary lateral incisor - The sling shot method.

PubMed

Felicita, A Sumathi

2018-07-01

The aim of this paper is to evaluate the efficacy of forced extrusion using the sling shot elastic. A 21 year adult patient reported with an Ellis Class VIII fracture of the maxillary right lateral incisor. Root canal treatment followed by a fiber reinforced composite post was placed and core build up was done. A metal button was bonded to the tooth. Begg brackets were placed from the second premolar on one side to the second premolar on the opposite side. 0.016″ × 0.025″ stainless steel was placed in ribbon mode. The ligature wire was placed as a sling shot from the button on the fractured tooth to the two adjacent teeth. 4 mm of extrusion was achieved and there was no evidence of root resorption. Forced extrusion was achieved in four months. The sling shot method is a very effective method of ligation. Light forces are delivered over a long duration with definitive results as compared to the inconsistent force delivery with conventional extrusion mechanics.

Synchrotron imaging of dentition provides insights into the biology of Hesperornis and Ichthyornis, the "last" toothed birds.

PubMed

Dumont, Maïtena; Tafforeau, Paul; Bertin, Thomas; Bhullar, Bhart-Anjan; Field, Daniel; Schulp, Anne; Strilisky, Brandon; Thivichon-Prince, Béatrice; Viriot, Laurent; Louchart, Antoine

2016-09-23

The dentitions of extinct organisms can provide pivotal information regarding their phylogenetic position, as well as paleobiology, diet, development, and growth. Extant birds are edentulous (toothless), but their closest relatives among stem birds, the Cretaceous Hesperornithiformes and Ichthyornithiformes, retained teeth. Despite their significant phylogenetic position immediately outside the avian crown group, the dentitions of these taxa have never been studied in detail. To obtain new insight into the biology of these 'last' toothed birds, we use cutting-edge visualisation techniques to describe their dentitions at unprecedented levels of detail, in particular propagation phase contrast x-ray synchrotron microtomography at high-resolution. Among other characteristics of tooth shape, growth, attachment, implantation, replacement, and dental tissue microstructures, revealed by these analyses, we find that tooth morphology and ornamentation differ greatly between the Hesperornithiformes and Ichthyornithiformes. We also highlight the first Old World, and youngest record of the major Mesozoic clade Ichthyornithiformes. Both taxa exhibit extremely thin and simple enamel. The extension rate of Hesperornis tooth dentine appears relatively high compared to non-avian dinosaurs. Root attachment is found for the first time to be fully thecodont via gomphosis in both taxa, but in Hesperornis secondary evolution led to teeth implantation in a groove, at least locally without a periodontal ligament. Dental replacement is shown to be lingual via a resorption pit in the root, in both taxa. Our results allow comparison with other archosaurs and also mammals, with implications regarding dental character evolution across amniotes. Some dental features of the 'last' toothed birds can be interpreted as functional adaptations related to diet and mode of predation, while others appear to be products of their peculiar phylogenetic heritage. The autapomorphic Hesperornis groove might have favoured firmer root attachment. These observations highlight complexity in the evolutionary history of tooth reduction in the avian lineage and also clarify alleged avian dental characteristics in the frame of a long-standing debate on bird origins. Finally, new hypotheses emerge that will possibly be tested by further analyses of avian teeth, for instance regarding dental replacement rates, or simplification and thinning of enamel throughout the course of early avian evolution.

External apical root resorption in maxillary incisors in orthodontic patients: associated factors and radiographic evaluation

PubMed Central

Patanaporn, Virush; Janhom, Apirum; Korwanich, Narumanus

2012-01-01

Purpose This study was performed to evaluate the incidence and degree of external apical root resorption of maxillary incisors after orthodontic treatment and to evaluate particular associated factors related to external apical root resorption. Materials and Methods The records and maxillary incisor periapical radiographs of 181 patients were investigated. Crown and root lengths were measured and compared on the pre- and post-treatment periapical radiographs. Crown length was measured from the center of the incisal edge to the midpoint of the cemento-enamel junction (CEJ). Root length was measured from the CEJ midpoint to the root apex. A correction factor for the enlargement difference was used to calculate root resorption. Results The periapical radiographs of 564 teeth showed that the average root resorption was 1.39±1.27 (8.24±7.22%) and 1.69±1.14 mm (10.16±6.78%) for the maxillary central and lateral incisors, respectively. The results showed that the dilacerated or pointed roots, maxillary premolar extraction cases, and treatment duration were highly significant factors for root resorption (p<0.001). Allergic condition was a significant factor at p<0.01. Age at the start of treatment, large overjet, and history of facial trauma were also factors significantly associated with root resorption (p<0.05). There was no statistically significant difference in root resorption among the factors of gender, overbite, tongue-thrusting habit, types of malocclusion, and types of bracket. Conclusion These results suggested that orthodontic treatment should be carefully performed in pre-treatment extraction patients who have pointed or dilacerated roots and need long treatment duration. PMID:23071964

The effect of budesonide on orthodontic induced root resorption.

PubMed

Aghili, Hosseinagha; Meybodi, Seyed Amir Reza Fatahi; Ardekani, Mohammed Danesh; Bemanianashkezari, Mohammad Hassan; Modaresi, Jalil; Masomi, Yousef; Moghadam, Mahdjoube Goldani

2015-01-01

The aim of this study was to evaluate the hypothesis that budesonide increases the susceptibility of teeth to root resorption during the course of orthodontic treatment. A randomized controlled trial design (animal study) was employed. Budesonide was administered in test group for 14 days during which orthodontic force was applied to upper right molar. Afterwards, root resorption was measured on mesio-cervical and disto-apical parts of the mesial root on transverse histological sections. ANOVA and Bonfferoni tests were used. Statistical significance was considered to be P ≤ 0.05. In general, the subgroups in which the force was applied showed significantly greater root resorption. Where force was applied there was no significant difference, whether budesonide was administered or not. While where there was no force, a group who received budesonide showed significantly greater root resorption than the other, unless at the coronal level where the difference was not significant. Within the limitations of this study, it seems budesonide could increase root resorption, but in the presence of orthodontic force this effect is negligible.

Technological advances in endodontics: treatment of a mandibular molar with internal root resorption using a reciprocating single-file system.

PubMed

de Souza, Samir Noronha; Marques, André Augusto Franco; Sponchiado-Júnior, EmÍlio Carlos; Roberti Garcia, Lucas da Fonseca; da Frota, Matheus Franco; de Carvalho, Fredson Márcio Acris

2017-01-01

The field of endodontics has become increasingly successful due to technological advances that allow clinicians to solve clinical cases that would have been problematic a few years ago. Despite such advances, endodontic treatment of teeth with internal root resorption remains challenging. This article presents a clinical case in which a reciprocating single-file system was used for endodontic treatment of a mandibular molar with internal root resorption. Radiographic examination revealed the presence of internal root resorption in the distobuccal root canal of the mandibular right first molar. A reciprocating single-file system was used for root canal instrumentation and final preparation, and filling was obtained through a thermal compaction technique. No painful symptoms or periapical lesions were observed in 12 months of follow-up. The results indicate that a reciprocating single-file system is an adequate alternative for root canal instrumentation, particularly in teeth with internal root resorption.

Correlation of Periodontal Disease With Inflammatory Arthritis in the Time Before Modern Medical Intervention.

PubMed

Rothschild, Bruce

2017-03-01

Controversy exists regarding possible correlation of periodontal disease with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Confounding factors may relate to stringency of inflammatory disease diagnosis and the effect of therapeutic intervention for RA on periodontal disease. These factors are investigated in this study. Forty-five individuals with documented RA (n = 15), spondyloarthropathy (n = 15), and calcium pyrophosphate deposition disease (CPPD) (n = 15), from the Hamann-Todd collection of human skeletons compiled from 1912 to 1938, and 15 individuals contemporarily incorporated in the collection were examined for tooth loss, cavity occurrence, average and maximum lingual and buccal depth of space between tooth and bone, periosteal reaction, serpentine bone resorption, abscess formation, and root penetration of the bone surface and analyzed by analysis of variance. Tooth loss was common, but actual number of teeth lost, cavity occurrence, average and maximum lingual and buccal depth of space between tooth and bone, periosteal reaction, serpentine grooving surrounding teeth (considered a sign of inflammation), abscess formation, and root exposure (penetration of bone surface) were indistinguishable among controls and individuals with RA, spondyloarthropathy, and CPPD. Although many factors can affect periodontal disease, presence of inflammatory arthritis does not appear to be one of them. The implication is that dental disease was common in the general population and not necessarily associated with arthritis, at least before the advent of modern rheumatologic medications. As specific diagnosis did not affect prevalence, perhaps current prevalence controversy may relate to current intervention, a subject for further study.

Injectable bone substitute to preserve alveolar ridge resorption after tooth extraction: a study in dog.

PubMed

Boix, D; Weiss, P; Gauthier, O; Guicheux, J; Bouler, J-M; Pilet, P; Daculsi, G; Grimandi, G

2006-11-01

The aim of the present study was to assess the efficacy of a ready-to-use injectable bone substitute on the prevention of alveolar ridge resorption after tooth extraction. Maxillary and mandibular premolars were extracted from 3 Beagle dogs with preservation of alveolar bone. Thereafter, distal sockets were filled with an injectable bone substitute (IBS), obtained by combining a polymer solution and granules of a biphasic calcium phosphate (BCP) ceramic. As a control, the mesial sockets were left unfilled. After a 3 months healing period, specimens were removed and prepared for histomorphometric evaluation with image analysis. Histomorphometric study allowed to measure the mean and the maximal heights of alveolar crest modifications. Results always showed an alveolar bone resorption in unfilled sockets. Resorption in filled maxillary sites was significantly lower than in control sites. Interestingly, an alveolar ridge augmentation was measured in mandibular filled sockets including 30% of newly-formed bone. It was concluded that an injectable bone substitute composed of a polymeric carrier and calcium phosphate can significantly increase alveolar ridge preservation after tooth extraction.

Computed tomography as a diagnostic aid for extracanal invasive resorption.

PubMed

Kim, Euiseong; Kim, Kee-Deog; Roh, Byoung-Duck; Cho, Yong-Sik; Lee, Seung-Jong

2003-07-01

A case of multiple extracanal invasive resorption is reported. The patient had a history of hypothyroidism for approximately 1 yr before the dental visit. Utilization of computed tomography and a rapid prototyping tooth model in diagnosing the exact location and the size of the resorption area are discussed.

Severe root resorption resulting from orthodontic treatment: Prevalence and risk factors

PubMed Central

Maués, Caroline Pelagio Raick; do Nascimento, Rizomar Ramos; Vilella, Oswaldo de Vasconcellos

2015-01-01

OBJECTIVE: To assess the prevalence of severe external root resorption and its potential risk factors resulting from orthodontic treatment. METHODS: A randomly selected sample was used. It comprised conventional periapical radiographs taken in the same radiology center for maxillary and mandibular incisors before and after active orthodontic treatment of 129 patients, males and females, treated by means of the Standard Edgewise technique. Two examiners measured and defined root resorption according to the index proposed by Levander et al. The degree of external apical root resorption was registered defining resorption in four degrees of severity. To assess intra and inter-rater reproducibility, kappa coefficient was used. Chi-square test was used to assess the relationship between the amount of root resorption and patient's sex, dental arch (maxillary or mandibular), treatment with or without extractions, treatment duration, root apex stage (open or closed), root shape, as well as overjet and overbite at treatment onset. RESULTS: Maxillary central incisors had the highest percentage of severe root resorption, followed by maxillary lateral incisors and mandibular lateral incisors. Out of 959 teeth, 28 (2.9%) presented severe root resorption. The following risk factors were observed: anterior maxillary teeth, overjet greater than or equal to 5 mm at treatment onset, treatment with extractions, prolonged therapy, and degree of apex formation at treatment onset. CONCLUSION: This study showed that care must be taken in orthodontic treatment involving extractions, great retraction of maxillary incisors, prolonged therapy, and/or completely formed apex at orthodontic treatment onset. PMID:25741825

Severe root resorption resulting from orthodontic treatment: prevalence and risk factors.

PubMed

Maués, Caroline Pelagio Raick; do Nascimento, Rizomar Ramos; Vilella, Oswaldo de Vasconcellos

2015-01-01

To assess the prevalence of severe external root resorption and its potential risk factors resulting from orthodontic treatment. A randomly selected sample was used. It comprised conventional periapical radiographs taken in the same radiology center for maxillary and mandibular incisors before and after active orthodontic treatment of 129 patients, males and females, treated by means of the Standard Edgewise technique. Two examiners measured and defined root resorption according to the index proposed by Levander et al. The degree of external apical root resorption was registered defining resorption in four degrees of severity. To assess intra and inter-rater reproducibility, kappa coefficient was used. Chi-square test was used to assess the relationship between the amount of root resorption and patient's sex, dental arch (maxillary or mandibular), treatment with or without extractions, treatment duration, root apex stage (open or closed), root shape, as well as overjet and overbite at treatment onset. Maxillary central incisors had the highest percentage of severe root resorption, followed by maxillary lateral incisors and mandibular lateral incisors. Out of 959 teeth, 28 (2.9%) presented severe root resorption. The following risk factors were observed: anterior maxillary teeth, overjet greater than or equal to 5 mm at treatment onset, treatment with extractions, prolonged therapy, and degree of apex formation at treatment onset. This study showed that care must be taken in orthodontic treatment involving extractions, great retraction of maxillary incisors, prolonged therapy, and/or completely formed apex at orthodontic treatment onset.

Radiographic comparison of apical root resorption after orthodontic treatment between bidimensional and Roth straight-wire techniques

PubMed Central

Zawawi, Khalid H; Malki, Ghadah A

2014-01-01

Objective: The aim of this study was to compare the amount of root resorption after orthodontic treatment between the bidimensional and the Roth straight-wire techniques. Another objective was to compare the amount of root resorption in the whole sample studied and record the prevalence of root resorption. Materials and Methods: The sample consisted of 40 patients (age ranged between 11 and 18 years) with Angle Class II division 1 malocclusions, treated nonextraction. Twenty patients were treated with bidimensional technique and 20 with a 0.018-inch Roth straight-wire technique. Root lengths of the maxillary incisors were measured on pre- and post-treatment periapical radiographs. Results: The results demonstrated that the bidimensional and Roth straight-wire groups showed significant root resorption after treatment, 1.11 (0.17) and 0.86 (0.05), respectively, P < 0.001. When comparing the amount of root shortening between the bidimensional and Roth straight-wire groups, there was no significant difference between the mean change from pre- to post-treatment between bidimensional group (mean = 1.00 ± 1.34) and Roth straight-wire group (mean = 0.88 ± 0.86), P = 0.63. Considering the whole sample, there was no root resoprtion in 32.5% of the analysed teeth. There was only mild resorption in 56.2%, moderate in 8.8% and severe in only 2.5% of the teeth. Conclusions: Treatment with the bidimensional technique did not produce an increase in the amount of root resorption. The prevalence and amount of root resorption was similar between bidimensional and Roth straight-wire techniques. PMID:25426453

Radiographic comparison of apical root resorption after orthodontic treatment between bidimensional and Roth straight-wire techniques.

PubMed

Zawawi, Khalid H; Malki, Ghadah A

2014-10-01

The aim of this study was to compare the amount of root resorption after orthodontic treatment between the bidimensional and the Roth straight-wire techniques. Another objective was to compare the amount of root resorption in the whole sample studied and record the prevalence of root resorption. The sample consisted of 40 patients (age ranged between 11 and 18 years) with Angle Class II division 1 malocclusions, treated nonextraction. Twenty patients were treated with bidimensional technique and 20 with a 0.018-inch Roth straight-wire technique. Root lengths of the maxillary incisors were measured on pre- and post-treatment periapical radiographs. The results demonstrated that the bidimensional and Roth straight-wire groups showed significant root resorption after treatment, 1.11 (0.17) and 0.86 (0.05), respectively, P < 0.001. When comparing the amount of root shortening between the bidimensional and Roth straight-wire groups, there was no significant difference between the mean change from pre- to post-treatment between bidimensional group (mean = 1.00 ± 1.34) and Roth straight-wire group (mean = 0.88 ± 0.86), P = 0.63. Considering the whole sample, there was no root resoprtion in 32.5% of the analysed teeth. There was only mild resorption in 56.2%, moderate in 8.8% and severe in only 2.5% of the teeth. Treatment with the bidimensional technique did not produce an increase in the amount of root resorption. The prevalence and amount of root resorption was similar between bidimensional and Roth straight-wire techniques.

A Simple Technique for Accurate Transfer of Secondary Copings in a Tooth-Supported Telescopic Prosthesis.

PubMed

Shankargouda, Swapnil B; Sidhu, Preena; Kardalkar, Swetha; Desai, Pooja M

2017-02-01

Residual ridge resorption is a rapid, progressive, irreversible, and inevitable process of bone resorption. Long-standing teeth and implants have been shown to have maintained the bone around them without resorption. Thus, overdenture therapy has been proven to be beneficial in situations where few remaining teeth are present. In addition to the various advantages seen with tooth-supported telescopic overdentures, a few shortcomings can also be expected, including unseating of the overdenture, increased bulk of the prosthesis, secondary caries, etc. The precise transfer of the secondary telescopic copings to maintain the spatial relationship, without any micromovement, remains the most critical step in ensuring the success of the tooth-supported telescopic prosthesis. Thus, a simple and innovative technique of splinting the secondary copings was devised to prevent distortion and micromovement and maintain its spatial relationship. © 2015 by the American College of Prosthodontists.

Prevalence of different periapical lesions associated with human teeth and their correlation with the presence and extension of apical external root resorption.

PubMed

Vier, F V; Figueiredo, J A P

2002-08-01

The aim of this study was to determine the prevalence of various periapical pathologies and their association with the presence and extent of apical external inflammatory root resorption in human teeth. One hundred and four root apices from extracted teeth with periapical lesions were examined. Semi-serial sections of soft tissue lesions were stained with HE. The lesions were classified as noncystic or cystic, each with different degrees of acute inflammation: 0, 1, 2 and 3, increasing in severity. The root apices were analysed by SEM. External root resorption was classified according to site, as periforaminal or foraminal, and the extension of the resorbed area graded in increasing area as 0, 1, 2 or 3. Cysts accounted for 24.5% of the samples, 84% of which were associated with marked inflammation. The most prevalent diagnosis was noncystic periapical abscess with varying degrees of severity (63.7%). Periapical granuloma was not a frequent finding. SEM analysis showed that 42.2% of the root apices had periforaminal resorption extending over 50% of their circumference. When the foraminal resorption was evaluated, 28.7% had resorption affecting >50% of the periphery. Only 8.9% of the samples showed no periforaminal or foraminal resorption. In the sample of extracted teeth investigated, 24.5% of the periapical lesions were cysts. Most periapical lesions (84.3%) displayed acute inflammation, whether cystic or not. Periforaminal resorption was present in 87.3% of the cases, and foraminal resorption in 83.2%. Periforaminal and foraminal resorptions were independent entities. There was no association between external root resorption and the nature of the periapical lesions.

Autotransplantation of teeth in humans: a systematic review and meta-analysis.

PubMed

Almpani, Konstantinia; Papageorgiou, Spyridon N; Papadopoulos, Moschos A

2015-07-01

The aim of this investigation was to assess the currently available evidence concerning the complications and risk factors influencing the outcome of autotransplantation of teeth in humans. Electronic searches were conducted to identify randomized controlled and prospective clinical trials. Risk of bias within studies was assessed with the Downs and Black tool. Random-effects meta-analyses were conducted to pool the adverse event rates and relative risks with their 95% confidence intervals. Risk of bias across studies was assessed with the GRADE framework followed by sensitivity analyses. Thirty-eight studies were included in the analysis. Reported complications included the need for extraction, failure, hypermobility, pulp necrosis, pulp obliteration, and root resorption. Pooled complication event rates varied considerably, with small studies (<100 teeth) reporting greater complication rates. The analysis of risk factors was associated with both the primary outcome (extraction need) and secondary outcomes (failure, hypermobility, pulp necrosis, pulp obliteration, root resorption). The stage of root development seems to influence both the future survival, as well as the success of the transplanted teeth. Teeth with open apex were less likely to be extracted in comparison to teeth with closed apex (3 studies; 413 teeth; relative risk 0.3; 95% confidence interval 0.2-0.6). Due to the small number of the contributing studies, their methodological limitations, and the heterogeneous results reported, no firm conclusions can be drawn. Root development of the donor teeth has been established as one the most important factor related to the success of tooth autotransplantation.

[Orthodontic Management of the Impacted Mandibular Second Molar Tooth].

PubMed

Mah, Michael; Takada, Kenji

2016-09-01

When the mandibular permanent second molar becomes impacted, it is identified as a malocclusion that needs treatment as it often leads to unwanted complications such as caries and periodontitis of the adjacent permanent first molar. Other less common complications include root resorption of the adjacent first molar root or continued root development to be in close proximity to the inferior dental alveolar nerve. This paper seeks to differentiate various levels of severity of impaction and review treatment options that are considered clinically available for the proper management of the impacted mandibular permanent second molar. Treatment options that will be discussed in this article include timing of second molar removal for replacement by the third molar, relief of impaction via second premolar removal, surgical repositioning and the combination of third molar removal, surgical exposure and orthodontic uprighting of the impacted tooth. Depending on the severity of the impaction, most impactions can be easily and predictably corrected with nickel titanium archwires or auxillary open coil springs or uprighting springs. Uncommonly, the mandibular permanent second molar can become severely impacted and in close proximity to the inferior dentoalveolar nerve. In these instances, the use of temporary anchorage devices such as microimplants has shown to be successful in uprighting the severely impacted mandibular permanent second molars. © EDP Sciences, SFODF, 2016.

Properties of the "Orgamax" osteoplastic material made of a demineralized allograft bone

NASA Astrophysics Data System (ADS)

Podorognaya, V. T.; Kirilova, I. A.; Sharkeev, Yu. P.; Uvarkin, P. V.; Zhelezny, P. A.; Zheleznaya, A. P.; Akimova, S. E.; Novoselov, V. P.; Tupikova, L. N.

2016-08-01

We investigated properties of the "Orgamax" osteoplastic material, which was produced from a demineralized bone, in the treatment of extensive caries, in particular chronic pulpitis of the permanent teeth with unformed roots in children. The "Orgamax" osteoplastic material consists of demineralized bone chips, a collagen additive, and antibiotics. The surface morphology of the "Orgamax" osteoplastic material is macroporous, with the maximum pore size of 250 µm, whereas the surface morphology of the major component of "Orgamax", demineralized bone chips, is microporous, with a pore size of 10-20 µm. Material "Orgamax" is used in the treatment of complicated caries, particularly chronic pulpitis of permanent teeth with unformed roots in children. "Orgamax" filling a formed cavity exhibits antimicrobial properties, eliminates inflammation in the dental pulp, and, due to its osteoconductive and osteoinductive properties, undergoes gradual resorption, stimulates regeneration, and provides replacement of the defect with newly formed tissue. The dental pulp viability is completely restored, which ensures the complete formation of tooth roots with root apex closure in the long-term period.

Effect of piezocision on root resorption associated with orthodontic force: A microcomputed tomography study.

PubMed

Patterson, Braydon M; Dalci, Oyku; Papadopoulou, Alexandra K; Madukuri, Suman; Mahon, Jonathan; Petocz, Peter; Spahr, Axel; Darendeliler, M Ali

2017-01-01

The purpose of this study was to investigate the effect of piezocision on orthodontically induced inflammatory root resorption. Fourteen patients were included in this split-mouth study; 1 side was assigned to piezocision, and the other side served as the control. Vertical corticotomy cuts of 4 to 5 mm in length were performed on either side of each piezocision premolar, and 150-g buccal tipping forces were applied to the premolars. After 4 weeks, the maxillary first premolars were extracted and scanned with microcomputed tomography. There was a significantly greater total amount of root resorption seen on the piezocision sides when compared with the control sides (P = 0.029). The piezocision procedure resulted in a 44% average increase in root resorption. In 5 patients, there was noticeable piezocision-related iatrogenic root damage. When that was combined with the orthodontic root resorption found on the piezocision-treated teeth, there was a statistically significant 110% average increase in volumetric root loss when compared with the control side (P = 0.005). The piezocision procedure that initiates the regional acceleratory phenomenon may increase the iatrogenic root resorption when used in conjunction with orthodontic forces. Piezocision applied close to the roots may cause iatrogenic damage to the neighboring roots and should be used carefully. Copyright © 2017.

Nonsyndromic Bilateral Multiple Impacted Supernumerary Mandibular Third Molars: A Rare and Unusual Case Report

PubMed Central

Reddy, G. Siva Prasad; Reddy, G. V.; Krishna, I. Venkata; Regonda, Shravan Kumar

2013-01-01

A supernumerary tooth is that which is present additionally to the normal series and can be found in any region of the dental arch. An impacted tooth is defined as the one which is embedded in the alveolus, so that its eruption is prevented, or the tooth is locked in position by bone or the adjacent teeth. The occurrence of multiple supernumerary teeth in only one patient in the absence of an associated systemic condition or syndrome is considered as a rare phenomenon. The occurrence of supernumerary teeth in the lower molar region is rare. A prevalence of less than 2% of cases occurring in this region has been estimated. Their occurrence presents a clinical problem for orthodontists and oral surgeons. The cause, frequency, complications, and surgical operation of impacted teeth are always interesting subjects for study and research. An impacted tooth can result in caries, pulp disease, periapical and periodontal disease, temporomandibular joint disorder, infection of the fascial space, root resorption of the adjacent tooth, and even oral and maxillofacial tumours. The management of impacted wisdom teeth has changed over the past 20 years from removal of nonsymptomatic third molars to simple observation. The aim of this paper is to present a rare case of bilateral multiple impacted supernumerary mandibular third molars. PMID:23476818

A rare case report and appraisal of the literature on spontaneous tooth exfoliation associated with trigeminal herpes zoster.

PubMed

Kaur, Rupinder; Rani, Pooja; Malhotra, Divye; Kaur, Rajwant; Dass, Praveen Kumar

2016-09-01

Reports of post herpetic maxillofacial complications have been very rarely documented in the literature that includes periapical lesions, calcified and devitalized pulps, resorption of roots, osteonecrosis, and spontaneous exfoliation of teeth. The atypical feature of the case of concern to the dental surgeon is the rare complication of spontaneous tooth exfoliation following herpes zoster. This case reports a male patient of age 47 years who reported to the Department of Periodontology with the chief complaint of mobility in the left upper central incisor. Patient history revealed herpes zoster infection that began 11 days earlier along with underlying diabetes mellitus condition. We hereby report a known diabetic patient with history of herpes zoster infection who presented with rare complication of spontaneous tooth exfoliation involving the maxillary division of the trigeminal nerve. Limited number of cases has been reported in the literature regarding spontaneous teeth exfoliation secondary to herpes zoster. The exact pathogenesis regarding the spontaneous exfoliation of teeth in herpes zoster patient is still controversial. Thus, an oral health care provider should be aware of this rare complication while managing a case of tooth mobility with the previous history of herpes zoster of trigeminal nerve.

Three-dimensional quantification of orthodontic root resorption with time-lapsed imaging of micro-computed tomography in a rodent model.

PubMed

Yang, Chongshi; Zhang, Yuanyuan; Zhang, Yan; Fan, Yubo; Deng, Feng

2015-01-01

Despite various X-ray approaches have been widely used to monitor root resorption after orthodontic treatment, a non-invasive and accurate method is highly desirable for long-term follow up. The aim of this study was to build a non-invasive method to quantify longitudinal orthodontic root resorption with time-lapsed images of micro-computed tomography (micro-CT) in a rodent model. Twenty male Sprague Dawley (SD) rats (aged 6-8 weeks, weighing 180-220 g) were used in this study. A 25 g orthodontic force generated by nickel-titanium coil spring was applied to the right maxillary first molar for each rat, while contralateral first molar was severed as a control. Micro-CT scan was performed at day 0 (before orthodontic load) and days 3, 7, 14, and 28 after orthodontic load. Resorption of mesial root of maxillary first molars at bilateral sides was calculated from micro-CT images with registration algorithm via reconstruction, superimposition and partition operations. Obvious resorption of mesial root of maxillary first molar can be detected at day 14 and day 28 at orthodontic side. Most of the resorption occurred in the apical region at distal side and cervical region at mesiolingual side. Desirable development of molar root of rats was identified from day 0 to day 28 at control side. The development of root concentrated on apical region. This non-invasive 3D quantification method with registration algorithm can be used in longitudinal study of root resorption. Obvious root resorption in rat molar can be observed three-dimensionally at day 14 and day 28 after orthodontic load. This indicates that registration algorithm combined with time-lapsed images provides clinic potential application in detection and quantification of root contour.

A comparison of apical root resorption after orthodontic treatment with surgical exposure and traction of maxillary impacted canines versus that without impactions.

PubMed

Lempesi, Evangelia; Pandis, Nikolaos; Fleming, Padhraig S; Mavragani, Maria

2014-12-01

Orthodontic management of maxillary canine impaction (MCI), including forced eruption, may result in significant root resorption; however, the association between MCI and orthodontically induced root resorption (OIRR) is not yet sufficiently established. The purpose of this retrospective cohort study was to comparatively evaluate the severity of OIRR of maxillary incisors in orthodontically treated patients with MCI. Additionally, impaction characteristics were associated with OIRR severity. The sample comprised 48 patients undergoing fixed-appliance treatment-24 with unilateral/bilateral MCI and 24 matched controls without impaction. OIRR was calculated using pre- and post-operative panoramic tomograms. The orientation of eruption path, height, sector location, and follicle/tooth ratio of the impacted canine were also recorded. Mann-Whitney U-test and univariate and multivariate linear mixed models were used to test for the associations of interest. Maxillary central left incisor underwent more OIRR in the impaction group (mean difference = 0.58mm, P = 0.04). Overall, the impaction group had 0.38mm more OIRR compared to the control (95% confidence interval, CI: 0.03, 0.74; P = 0.04). However, multivariate analysis demonstrated no difference in the amount of OIRR between impaction and non-impaction groups overall. A positive association between OIRR and initial root length was observed (95% CI: 0.08, 0.27; P < 0.001). The severity of canine impaction was not found to be a significant predictor of OIRR. This study was a retrospective study and used panoramic tomograms for OIRR measurements. This study indicates that MCI is a weak OIRR predictor. Interpretation of the results needs caution due to the observational nature of the present study. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Orthodontic aligners and root resorption: A systematic review.

PubMed

Elhaddaoui, Rajae; Qoraich, Halima Saadia; Bahije, Loubna; Zaoui, Fatima

2017-03-01

Root resorption is one of the leading problems in orthodontic treatment. Most earlier studies have assessed the incidence and severity of root resorption following orthodontic treatment using fixed appliances as well as associated factors. However, few studies have assessed these parameters in the context of orthodontic treatment using thermoplastic splints or aligners. The aim of this systematic review was to assess the incidence and severity of root resorption following orthodontic treatment using aligners and associated factors. A comparative analysis was also made with fixed multi-bracket treatments. The data bases consulted were: Medline, Embase, EBSCO Host, Cochrane Library and Science Direct. Our search included meta-analyses, randomized and non-randomized controled trials, cohort studies and descriptive studies published before December 2015 and evidencing a connection with the incidence and severity of root resorption following orthodontic treatment using aligners alone or compared with fixed multi-bracket treatments. Among the 93 selected references, only 3 studies met our selection criteria. The incidence of root resorption ranged between 0 and 46%, of which 6% were severe cases. Relative to fixed multi-bracket non-extraction treatments to correct the same malocclusions, the incidence of resorption ranged between 2% and 50%, of which 22% were severe cases. In both techniques, the incidence of resorption was higher for the maxillary incisors and was not influenced by either age or sex. In malocclusion cases not requiring extractions, orthodontic aligner treatment is possibly associated with a lower incidence of resorption than fixed multi-bracket treatment. Further research encompassing extraction cases is needed to better assess the incidence and severity of root resorption following the use of these removable appliances. Copyright © 2016 CEO. Published by Elsevier Masson SAS. All rights reserved.

Cellular and Molecular Pathways Leading to External Root Resorption

PubMed Central

Iglesias-Linares, A.; Hartsfield, J.K.

2016-01-01

External apical root resorption during orthodontic treatment implicates specific molecular pathways that orchestrate nonphysiologic cellular activation. To date, a substantial number of in vitro and in vivo molecular, genomic, and proteomic studies have supplied data that provide new insights into root resorption. Recent mechanisms and developments reviewed here include the role of the cellular component—specifically, the balance of CD68+, iNOS+ M1- and CD68+, CD163+ M2-like macrophages associated with root resorption and root surface repair processes linked to the expression of the M1-associated proinflammatory cytokine tumor necrosis factor, inducible nitric oxide synthase, the M1 activator interferon γ, the M2 activator interleukin 4, and M2-associated anti-inflammatory interleukin 10 and arginase I. Insights into the role of mesenchymal dental pulp cells in attenuating dentin resorption in homeostasis are also reviewed. Data on recently deciphered molecular pathways are reviewed at the level of (1) clastic cell adhesion in the external apical root resorption process and the specific role of α/β integrins, osteopontin, and related extracellular matrix proteins; (2) clastic cell fusion and activation by the RANKL/RANK/OPG and ATP-P2RX7-IL1 pathways; and (3) regulatory mechanisms of root resorption repair by cementum at the proteomic and transcriptomic levels. PMID:27811065

Restoration of Long Standing Traumatized Teeth: A Case Report

PubMed Central

Kadkol, Prasanna Kumar; Reddy, K. Veera Kishore Kumar; Ainapur, Raghavendra

2015-01-01

Children are uniquely susceptible to craniofacial trauma. Injuries to the teeth occur often as a result of falls and sport activities. The pulp often gets infected after dental trauma resulting in to numerous complications. The authors present a case report of successful restoration of traumatized teeth with open apex which were weakened due to long standing infection and internal resorption. Initially antibiotic combination of 3- mix was used to disinfect the root canals. One tooth is treated with conventional endodontic treatment and the other tooth with open apex and perforation is managed by MTA apexification followed by canal reinforcement using glass ionomer cement and fiber reinforced composite post. Core build up is done using light cure composite resin followed by aesthetic crowns. The patient also presented with the peg shaped lateral incisors, which were built to an aesthetic appearance using light cure composite resins. PMID:26436062

Root resorption of permanent incisors during three months of active orthodontic treatment.

PubMed

Batool, Iffat; Abbas, Hasnain; Abbas, Assad; Abbas, Iram

2010-01-01

Root resorption is one of the most common and undesirable sequelea of orthodontic treatment. The aim of this study was to evaluate the amount of root resorption in permanent incisors during 3 month active period of fixed orthodontic appliance therapy using periapical radiographs. Periapical radiographs of a total of 138 permanent teeth (n = 138, mandibular n1 = 52, maxillary n2 = 86) were evaluated for root resorption. All patients were treated with 3M MBT multi-bonded, pre-adjusted appliances with 0.022 inch slots. Initial levelling and alignment was achieved with 0.0175 inch co-axial wires. All four incisors (maxillary and mandibular) were measured for any change in root length. The change in root length between T0 (pre-treatment) and T1 (post-treatment) was measured in millimetres and expressed in terms of percentage of original root length. The mean pre treatment (T0) root length for the maxillary teeth (n1 = 62) was 19.27 +/- 2.86 mm and 20.01 +/- 2.57 mm for the mandibular teeth (n2 = 31). The post-treatment (T1) root length for the maxillary teeth was 18.96 +/- 2.85 mm and 19.49 +/- 2.4 mm for the mandibular teeth showing a mean resorption of 0.31 mm and 0.52 mm for the maxillary and mandibular teeth respectively. Root resorption was strongly correlated with active orthodontic appliance therapy with maxillary and mandibular incisors being most susceptible. It was found that root resorption can be detected even in the early levelling and alignment stages of orthodontic treatment.

Treatment of root fracture with accompanying resorption using cermet cement.

PubMed

Lui, J L

1992-02-01

A method of treating an apical root fracture with accompanying resorption at the junction of the fracture fragments using glass-cermet cement is described. Endodontically, the material had previously been used for repair of lateral resorptive root defects and retrograde root fillings. Complete bone regeneration was observed three years post-operatively following treatment of the root fracture in the conventional manner. The various advantages of glass-cermet cement as a root filling material used in the technique described are discussed.

Multiple idiopathic external apical root resorption: report of four cases.

PubMed

Cholia, S S; Wilson, P H R; Makdissi, J

2005-07-01

Multiple idiopathic external root resorption is an unusual condition that may present in a cervical or an apical form. In this article, we review the published literature relating to multiple idiopathic external apical root resorption and present four clinical cases. We consider the aetiology of this condition and discuss the various treatment options.

Stress distributions in internal resorption cavities restored with different materials at different root levels: A finite element analysis study.

PubMed

Aslan, Tuğrul; Üstün, Yakup; Esim, Emir

2018-04-15

The aim of this study was to evaluate the stresses within simulated roots with internal resorption cavities at the apical, middle and coronal root levels, after obturation with gutta-percha and/or MTA utilising finite element analysis (FEA). Mandibular premolar teeth with internal resorption cavities at different root levels were modelled. Models were restored with gutta-percha and/or MTA. An oblique force of 300 N was applied and stress evaluations were carried out. In the MTA-filled resorption models, the stresses were distributed more homogeneously than the gutta-percha filled models, and the stress concentrations were lower in the remaining dentinal tissues. If the whole root is considered, the fully gutta-percha-filled models generated the highest stress values. Differences between the fully MTA-filled models and hybrid techniques were present only in the apical resorption models. Both the MTA and combination of MTA and gutta-percha can be suggested for use in clinical practice, in cases of internal root resorption cavity obturation. © 2018 Australian Society of Endodontology Inc.

Anti-dentine antibodies with root resorption during orthodontic treatment.

PubMed

Ramos, Solange de Paula; Ortolan, Geórgia Oliveira; Dos Santos, Lívia Marques; Tobouti, Priscila Lie; Hidalgo, Miriam Marubayashi; Consolaro, Alberto; Itano, Eiko Nakagawa

2011-10-01

The aim of this study was to analyse serum IgG levels and salivary secretory IgA (sIgA) levels in human dentine extract (HDE) before (T0) and 6 months after (T6) orthodontic treatment and to correlate anti-HDE autoantibodies to root resorption. Fifty orthodontic patients were selected, 19 males (15.6 ± 8.5 years) and 31 females (21.4 ± 11.2 years), 19 in the mixed dentition (10.3 ± 1.9 years) and 31 in the permanent dentition (24.6 ± 9.9 years). Fifty individuals not undergoing orthodontic treatment matched by gender and age were selected as the controls. Periapical radiographs of the upper central incisors and saliva sampling were obtained of all patients at T0 and T6. Serum samples were collected from the permanent dentition patients (n = 31). Antibody levels were determined by means of immunoenzyme assay. At T6, root resorption was classified as grade 0 (no resorption), grade 1 (slight resorption), and grade 2 (moderate to severe resorption). Differences between antibody levels at T0 and T6 and among different grades of resorption were determined by paired t- and Kruskal-Wallis tests, respectively. Spearman's rank correlation coefficient was applied to detect correlation between sIgA and IgG levels, and logistic regression to determine the association of root resorption grade and the studied variables. Differences were considered significant at P < 0.05. Serum anti-HDE IgG levels decreased (P < 0.01) in grade 2 root resorption patients during treatment and was not correlated to salivary sIgA levels or other variables. Patients who had grade 2 root resorption at T6 showed higher levels of anti-HDE sIgA (P < 0.001). Anti-HDE sIgA levels at T0 and root shape were the main factors associated with the degree of root resorption. The results suggest that variations to systemic and local humoural immune response to dentine antigens may occur during orthodontic treatment. High levels of salivary sIgA before treatment were associated with more advanced lesions after 6 months of treatment.

Iatrogenic Damage to the Periodontium Caused by Orthodontic Treatment Procedures: An Overview

PubMed Central

Rafiuddin, Syed; YG, Pradeep Kumar; Biswas, Shriparna; Prabhu, Sandeep S; BM, Chandrashekar; MP, Rakesh

2015-01-01

In orthodontic treatment, teeth are moved in to new positions and relationships and the soft tissue and underlying bone are altered to accommodate changes in esthetics and function. Function is more important than esthetics. The speciality of orthodontics has in addition to its benefits, complications as well as risks associated with its procedures. However the benefits outweigh the risks & complications in most of the treatment cases. Few of the unwanted side effects associated with treatment are tooth discolorations, enamel decalcification, periodontal complications like open gingival embrasures, root resorption, allergic reactions to nickel & chromium as well as treatment failure in the form of relapse. PMID:26312093

A radiographic study of external apical root resorption in patients treated with single-phase fixed orthodontic therapy.

PubMed

Agarwal, S S; Chopra, S S; Kumar, Prasanna; Jayan, B; Nehra, K; Sharma, Mohit

2016-12-01

External apical root resorption (EARR) is one of the most common iatrogenic consequences of orthodontic tooth movement. Many factors like gender, duration, orthodontic force and duration of orthodontic treatment have been implicated to cause EARR. Pre- and post-treatment OPGs of 60 orthodontic patients (30 males and 30 females) who had undergone treatment with a single phase of fixed orthodontic therapy were randomly selected from institutional archives. The root apices were evaluated for EARR by a single operator on an radiograph viewing box at a standardized source of light using a four-grade ordinal scale. Anterior EARR was measured on the maxillary and mandibular canines. Posterior EARR was measured on premolars, mesiobuccal and distobuccal roots of maxillary first molars and mesial and distal roots of mandibular first molars. The results were compiled and subjected to statistical analysis. The cases in which the patients underwent therapeutic extraction had a relatively higher amount of EARR compared to the cases in which the patients were treated by non-extraction therapy ( P  < 0.001). Odds ratio indicated that extraction cases had two-fold increased risk of EARR than non-extraction cases ( P  < 0.001). No statistically significant difference was observed in the distribution of EARR based on gender or duration of orthodontic treatment ( P  > 0.05). Therapeutic extraction is an important determinant of post-treatment EARR. Gender and duration of orthodontic treatment may not be important variables in the causation of EARR according to the findings of this study. However, longitudinal studies with larger sample size are required to validate the results of this study.

Orthodontic management of a dilacerated central incisor and partially impacted canine with unilateral extraction - A case report.

PubMed

Felicita, A Sumathi

2017-10-01

To align a dilacerated maxillary central incisor and partially impacted canine with unilateral extraction in a young patient with skeletal deep bite. A 14 year old male patient reported to the hospital with skeletal deep bite (basal plane angle-17°), severe horizontal pattern of growth (Go-Gn to Sn -22°), upright maxillary incisors (U1 to NA -26°) and retroclined lower incisors (L1 to NB -11°). The maxillary left central incisor was dilacerated, and the maxillary left canine was partially impacted. Unilateral extraction of the left maxillary premolar and left mandibular central incisor was done. A canine disimpaction spring was used to align the impacted canine. An anterior bite plane was given to open the bite. Superimposition of lateral cephalogram (T1, T2) revealed bite opening, normal overjet and overbite. There was backward rotation of the mandible and increase in lower anterior facial height. There was no evidence of root resorption or loss of vitality in the dilacerated tooth. Clinically the canine was well aligned in the arch. Orthodontic management of a dilacerated incisor can be done without root resorption or loss of vitality. The partially impacted canine was well aligned in the arch. Unilateral extraction can produce good treatment results.

Evaluating success of autotransplantation of embedded/impacted third molars harvested using piezosurgery: a pilot study.

PubMed

Nagori, Shakil Ahmed; Jose, Anson; Bhutia, Ongkila; Roychoudhury, Ajoy

2014-11-01

To evaluate the success of autogenous transplantation of embedded/impacted third molars harvested using piezosurgery. This prospective pilot study enrolled 20 healthy patients with non-restorable first/second molars and a caries-free retrievable embedded/impacted third molar. Piezosurgery was used for removing inter-radicular bone at the recipient socket as well as for bone removal around the donor teeth. After an average follow-up of 16.4 months (SD = 1.9), 18 cases were successful with formation of periodontal ligament around the teeth. One tooth was lost due to infection at 1 month. One patient was lost to follow-up. There was no root resorption or ankylosis in any of the cases. In six donor teeth with complete root formation, root canal treatment was carried out. All the remaining teeth responded positively with vitality testing. Piezosurgery is an effective device if embedded/impacted third molars are to be harvested for successful autogenous transplantation.

Effect of Atorvastatin on Orthodontic Tooth Movement in Male Wistar Rats

PubMed Central

MirHashemi, Amir Hossein; Afshari, Maryam; Alaeddini, Mojgan; Etemad-Moghadam, Shahroo; Dehpour, Ahmadreza; Sheikhzade, Sedigheh; Akhoundi, Mohammad Sadegh Ahmad

2013-01-01

Objectives: Statins are used as cholesterol-lowering drugs by many patients and have been recently shown to affect bone metabolism. The aim of this study was to determine the effect of atorvastatinon on orthodontic tooth movement (OTM) in rats. Materials and Methods: Thirty-six adult male Sprague-Dawley rats were randomly divided into three groups of 12 samples each. Group A, served as control with no medication while groups B and C received a daily gavage of carboxymethyl cellulose (CMC) as vehicle and atorvastatin (5 mg/kg) as test substance, respectively. In all three groups, 6mm nickel-titanium closed-coil springs were ligated between the maxillary incisors and first left molars to deliver an initial force of 60g. Tooth movement was measured following sacrifice, 21 days after appliance insertion. Root resorption, PDL width and osteoclast number were histologically evaluated and compared between the groups. Results: The mean amount of tooth movement was 0.62 mm in group A, 0.59 mm in group B and 0.38 mm in group C. OTM reduction following administration of atorvastatin was statistically significant (p<0.05), but there was no significant difference in the studied histologic variables among the three groups (p>0.05). Conclusion: According to the results obtained in the current study, atorvastatin appears to reduce tooth movement in rats; however its effect on osteoclasts, especially osteoclastic function, requires further investigation. PMID:24910664

Physical properties of root cementum: Part 18. The extent of root resorption after the application of light and heavy controlled rotational orthodontic forces for 4 weeks: a microcomputed tomography study.

PubMed

Wu, Andy T J; Turk, Tamer; Colak, Canan; Elekdağ-Turk, Selma; Jones, Allan S; Petocz, Peter; Darendeliler, M Ali

2011-05-01

The aim of this prospective randomized clinical trial was to quantitatively measure and compare the locations, dimensions, and volume of root resorption craters in human premolars after the application of controlled light and heavy rotational orthodontic forces over a 28-day (4-week) period. Fifteen patients requiring bilateral extraction of maxillary first premolars as part of their orthodontic treatment were recruited for this study. Each patient received a heavy (225 g) rotational force on 1 premolar and a light (25 g) rotational force on the contralateral premolar. Orthodontic rotational forces were applied over 28 days with buccal and palatal cantilever springs; 0.016-inch beta-titanium molybdenum alloys were used to apply the light force and 0.018-inch stainless steel was used for the heavy force. After the 28-day experimental period, the upper first premolars were extracted under stringent protocols to prevent root surface damage. The samples were then scanned using a microcomputed tomography (micro-CT) scan x-ray system (SkyScan 1072, Skyscan, Aartselaar, Belgium), and analyzed using convex hull algorithm (CHULL2D; University of Sydney, Sydney, Australia) software to obtain direct volumetric measurements. The mean volume of resorption craters was 0.42 in the light force group and 0.51 in the heavy force group (P = 0.013). When separated at the root level, the difference in volume of root resorption craters between the 2 groups was significantly different only at the midlevel (P = 0.001). Root resorption craters were consistently detected at the boundaries between the buccal and distal surfaces and the mesial and lingual surfaces. The result supports our hypothesis that positive areas develop significantly more root resorption craters at all 3 levels, as compared with minimal areas (paired t test <0.001). Heavy rotational forces caused more root resorption than light rotational forces and compression areas (buccal-distal and lingual-mesial surfaces in this study) showed significantly higher root resorption than other areas at all levels of the root. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Dental pulp neurophysiology: part 2. Current diagnostic tests to assess pulp vitality.

PubMed

Abd-Elmeguid, Ashraf; Yu, Donald C

2009-03-01

In this second part of our 2-part review, we discuss recent research about pulp tests that determine the vitality of the tooth and clinically accepted pulp testers. A pain response to hot, cold or an electric pulp tester indicates the vitality of only a tooth's pulpal sensory supply; the response does not give any idea about the state of the pulp. Although the sensitivity of these tests is high, when false-positive and false-negative results occur, they may affect the treatment of the tooth. A tooth falsely diagnosed as nonvital with an electric pulp tester may undergo an unnecessary root canal, whereas one falsely diagnosed as vital may be left untreated, causing the necrotic tissue to destroy the supporting tissues (resorption). The vascular supply is more important to the determination of the health of the pulp than the sensory supply. Pulp death is caused by cessation of blood flow and may result in a necrotic pulp, even though the pulpal sensory supply may still be viable. The pulp can be healed only if the circulating blood flow is healthy. Although still under investigation, diagnostic devices that examine pulpal blood flow, such as the pulse oximeter and laser Doppler flowmetry, show promising results for the assessment of pulp vitality.

Autogenous transplantation of maxillary and mandibular molars.

PubMed

Reich, Peter P

2008-11-01

Autogenous tooth transplantation has been used as a predictable surgical approach to correct malocclusion and replace edentulous areas. This article focuses on the surgical approach and technique for molar transplantation. Thirty-two patients aged between 11 and 25 years underwent 44 autogenous molar transplantations. The procedure involved transplantation of impacted or newly erupted third molars into the extraction sockets of nonrestorable molars and surgical removal and replacement of horizontally impacted molars into their proper vertical alignment. Five basic procedural concepts were applied: 1) atraumatic extraction, avoiding disruption of the root sheath and root buds; 2) apical contouring of bone at the transplantation site and maxillary sinus lift via the Summers osteotome technique, when indicated, for maxillary molars; 3) preparation of a 4-wall bony socket; 4) avoidance of premature occlusal interferences; and 5) stabilization of the tooth with placement of a basket suture. All 32 patients successfully underwent the planned procedure. To date, 2 patients have had localized infection that resulted in loss of the transplant. The remaining 42 transplants remain asymptomatic and functioning, with a mean follow-up period of 19 months. No infection, ankylosis, loss of the transplant, or root resorption has been noted. In addition, endodontic therapy has not been necessary on any transplanted teeth. Autogenous tooth transplantation has been discussed and described in the literature previously, with a primary focus on cuspid and bicuspid transplantation. The molar transplant is infrequently discussed in today's literature, possibly because of the preponderance of titanium dental implants. Autogenous molar transplantation is a viable procedure with low morbidity and excellent functional and esthetic outcomes. This report shows the successful transplantation of 42 of 44 molars in 32 patients with a mean follow-up period of 19 months.

[Root resorption associated to orthodontic treatment: a clinical case].

PubMed

Houb-Dine, Afaf; Rerhrhaye, Mariam; Ismaili, Zouheir; Rerhrhaye, Wiam

2011-12-01

Root resorption associated to orthodontic treatment is of multiple etiologies and a non intentional iatrogenic side effect which exists in almost all the orthodontic treatment. This clinical case of an apparently healthy patient illustrates the occurrence during the orthodontic treatment of a root resorption interesting the left central incisor, victims of previous traumatism and presenting a moderate periodontal attachment loss. The orthodontic treatment was carried out with light and continuous forces and a per-orthodontic periodontal maintenance in respect of periodontal requirements. As soon as the root resorption on the left central incisive was diagnosed, the active orthodontic treatment was interrupted in order to stabilize the lesion and a regular clinical and radiological monitoring was established.

Extruded upper first molar intrusion: Comparison between unilateral and bilateral miniscrew anchorage.

PubMed

Sugii, Mari Miura; Barreto, Bruno de Castro Ferreira; Francisco Vieira-Júnior, Waldemir; Simone, Katia Regina Izola; Bacchi, Ataís; Caldas, Ricardo Armini

2018-01-01

The aim of his study was to evaluate the stress on tooth and alveolar bone caused by orthodontic intrusion forces in a supraerupted upper molar, by using a three-dimensional Finite Element Method (FEM). A superior maxillary segment was modeled in the software SolidWorks 2010 (SolidWorks Corporation, Waltham, MA, USA) containing: cortical and cancellous bone, supraerupted first molar, periodontal tissue and orthodontic components. A finite element model has simulated intrusion forces of 4N onto a tooth, directed to different mini-screw locations. Three different intrusion mechanics vectors were simulated: anchoring on a buccal mini-implant; anchoring on a palatal mini-implant and the association of both anchorage systems. All analyses were performed considering the minimum principal stress and total deformation. Qualitative analyses exhibited stress distribution by color maps. Quantitative analysis was performed with a specific software for reading and solving numerical equations (ANSYS Workbench 14, Ansys, Canonsburg, Pennsylvania, USA). Intrusion forces applied from both sides (buccal and palatal) resulted in a more homogeneous stress distribution; no high peak of stress was detected and it has allowed a vertical resultant movement. Buccal or palatal single-sided forces resulted in concentrated stress zones with higher values and tooth tipping to respective force side. Unilateral forces promoted higher stress in root apex and higher dental tipping. The bilateral forces promoted better distribution without evidence of dental tipping. Bilateral intrusion technique suggested lower probability of root apex resorption.

The cell biology and role of resorptive cells in diseases: A review.

PubMed

Babaji, Prashant; Devanna, Raghu; Jagtap, Kiran; Chaurasia, Vishwajit Rampratap; Jerry, Jeethu John; Choudhury, Basanta Kumar; Duhan, Dinesh

2017-01-01

Resorptive cells are responsible for the resorption of mineralized matrix of hard tissues. Bone-resorbing cells are called osteoclasts; however, they can resorb mineralized dental tissues or calcified cartilage and then they are called odontoclasts and chondroclasts, respectively. Resorptive cells form when mononuclear precursors derived from a monocyte-macrophage cell lineage are attracted to certain mineralized surfaces and subsequently fuse and adhere onto them for exerting their resorbing activity. These cells are responsible for degradation of calcified extracellular matrix composed of organic molecules and hydroxyapatite. The activity of these cells can be observed in both physiological and pathological processes throughout life and their activity is mainly required in bone turnover and growth, spontaneous and induced (orthodontic) tooth movement, tooth eruption, and bone fracture healing, as well as in pathological conditions such as osteoporosis, osteoarthritis, and bone metastasis. In addition, they are responsible for daily control of calcium homeostasis. Clastic cells also resorb the primary teeth for shedding before the permanent teeth erupt into the oral cavity.

Comparison of Australian and American orthodontic clinical approaches towards root resorption.

PubMed

Lim, Elaine; Sameshima, Glenn; Petocz, Peter; Darendeliler, Ali

2012-11-01

As part of The Rocky Mountain Travelling Fellowship, a pilot survey was conducted to assess current diagnostic and clinical approaches to the management of orthodontic patients in relation to root resorption. Groups comprising Australians (Sydney, New South Wales) and North Americans (Los Angeles, California), in two stages of their orthodontic careers (post-graduate orthodontic students from the University of Sydney and University of Southern California and qualified practising orthodontists) were asked to complete a questionnaire. The questions examined diagnosis and management approaches related to root resorption used in their clinical practice. Replies demonstrated that there were differences in management depending on operator experience and the country of clinical practice. However, a summarised common approach to orthodontic root resorption comprised (1) the use of an orthopantomogram as a screening diagnostic tool, followed by periapical radiographs for those perceived as 'higher risk' patients, particularly individuals with a history of root resorption; (2) a six monthly radiographic review during treatment; (3) the use of light forces and/or rest periods (discontinuous forces) every two to three months; (4) the extraction of deciduous teeth if permanent successors were erupting ectopically and causing damage to adjacent root structures; and (5) the use of fixed retention after treatment. This project was intended to initiate discussion and form a basis for further investigation into the clinical management of orthodontic root resorption.

Comparison between anterior segmental osteotomy versus conventional orthodontic treatment in root resorption: a radiographic study using cone-beam computed tomography.

PubMed

Hwang, Bo-Yeon; Choi, Byung-Joon; Lee, Baek-Soo; Kwon, Yong-Dae; Lee, Jung-Woo; Jung, Junho; Ohe, Joo-Young

2017-12-01

Patients who received orthodontic treatment are likely to have apical root shortening. It appears that external apical root resorption results from a combination of patient-related risk factors such as genetic influences, systemic factors, and orthodontic treatment-related factors. Regarding the fact that the anterior segmental osteotomy (ASO) has been known for its possibility of complementing external apical root resorption and of buffering periodontal problems, it has been the preferred treatment. However, the studies on the efficacy of ASO in preserving the root are not sufficient. In this study, we compared the amount of root resorption between the patients who only received orthodontic treatment and the patients who received orthodontic treatment with ASO. This study included 28 patients (the number of incisor = 198) who received orthodontic treatment with or without ASO. We categorize them into groups A and B by the type of orthodontic treatment (group A: conventional orthodontic treatment; group B: orthodontic treatment with ASO). Cone-beam computed tomographic and cephalometric evaluations were retrospectively performed on the radiographs taken for the diagnosis of the treatment before treatment and at the end of active treatment. In group B, root resorption itself and its rate both turned out to have significantly lower than those in group A. Also, the change of incisal angle is significantly smaller in group B than in group A. On the other hand, in group A, the change of incisal angle was positively correlated with the change of AP (anteroposterior) position. In group B, the change of incisal angle was negatively correlated with the duration of the orthodontic treatment. In group B, amount of root resorption (mm) was positively correlated with the duration of the orthodontic treatment. The results show lesser root resorption and shorter treatment duration with ASO than with conventional orthodontic treatment. Therefore, if the indications are accurately determined, ASO can be an effective treatment option when the amount of root resorption is expected to be high, especially in late adults.

Tooth eruption in a patient with craniometaphyseal dysplasia: case report.

PubMed

Hayashibara, T; Komura, T; Sobue, S; Ooshima, T

2000-10-01

Craniometaphyseal dysplasia (CMD) is a very rare genetic disorder of bone remodeling caused by osteoclast dysfunction. The clinical and radiographical features of oral findings are presented in a sporadic case of CMD in a child (age 10 years, 7 months). An intraoral examination showed severe malocclusions, including anterior crossbite and deep bite. Furthermore, a radiographic examination showed increased radiopacity of the maxilla and mandibular bones due to hyperostosis and sclerosis of the jaw. There was no root resorption of the canines or molars in the primary dentition, although root formation of the permanent teeth was proceeding. Dental age was calculated to be approximately 1 year, 4 months younger than his chronological age. The eruption speed of the permanent lateral incisors after the gingival emergence was shown to be within normal values, and we discuss whether the canines and premolars in the permanent dentition could erupt or not.

External root resorption with the self-ligating Damon system-a retrospective study.

PubMed

Handem, Roberta Heiffig; Janson, Guilherme; Matias, Murilo; de Freitas, Karina Maria Salvatore; de Lima, Darwin Vaz; Garib, Daniela Gamba; de Freitas, Marcos Roberto

2016-12-01

The aim of this study was to compare the degree of external apical root resorption (EARR) in patients treated with self-ligating Damon appliances and with conventional preadjusted appliances. The sample comprised 52 patients, divided into two groups. Group 1 consisted of 25 patients treated with self-ligating Damon appliances, with an initial age of 16.04 years, final age of 18.06 years, and treatment time of 2.02 years. Group 2 consisted of 27 patients, treated with conventional preadjusted appliances, with an initial age of 16.77 years, final age of 18.47 years and treatment time of 1.70 years. The groups were matched regarding the initial and final ages, treatment time, type of malocclusion, and treatment protocol without extractions. Root resorption was evaluated on periapical radiographs of the maxillary and mandibular incisors at the end of orthodontic treatment with the scores of Levander and Malmgren. Intergroup comparisons of root resorption were performed with Mann-Whitney tests. No significant difference in the degree of root resorption between the two groups was found. Similar degrees of resorption can be expected after non-extraction treatment with Damon self-ligating or conventional preadjusted appliances.

An Evaluation of GuttaFlow2 in Filling Artificial Internal Resorption Cavities: An in vitro Study.

PubMed

Mohammad, Yara; Alafif, Hisham; Hajeer, Mohammad; Yassin, Oula

2016-06-01

Obturation of root canal with internal resorption represents a major challenge in Endodontics. In spite of that, usual obturation techniques are often employed without considering the best technique to solve this problem. The goal of this study was to investigate the ability of GuttaFlow2 in filling artificial internal resorption cavities. The study sample included 36 human upper central incisors that were prepared using Protaper system (F4). Internal resorption cavities were prepared by cutting each tooth at 7 mm from the apex and preparing hemispherical cavities on both the sides and then re-attaching them. The sample was randomly separated into three groups (n = 12 in each group). In the first group, thermal injection technique (Obtura II) was employed and served as the control group. In the second group, injection of cold free-flow obturation technique with a master cone (GF2-C) was employed, whereas in the third group injection of cold free-flow obturation without a master cone (GF2) was followed. The teeth were re-cut at the same level as before and examined under a stereomicroscope. Subsequently, the captured images were transferred to AutoCAD program to measure the percentage of total filling "TF," gutta-percha "G," sealer "S," and voids "V" out of the total surface of the cross sections. All materials showed high filling properties in terms of "total filling," ranging from 99.17% (for Obtura II) to 99.72% (for GF2-C). Regarding gutta-percha percentages of filling, they ranged from 83.15 to 83.93%, whereas those for the sealer ranged from 5.71 to 15.24%. GuttaFlow2 group with a master cone appeared to give the best results despite the insignificant differences among the three groups. The GuttaFlow2 with a master cone technique seemed to be a promising filling material and gave results similar to those observed with Obtura II. It is recommended for use to obturate internal resorption cavities in clinical practice due to its good adaptability to root canal walls, ease of handling, and application. Internal resorption defects can be successfully filled with GuttaFlow2 material when supplemented with a master cone, and the results are comparable with those obtained with the Obtura II technique.

Pre-existing Periapical Inflammatory Condition Exacerbates Tooth Extraction–induced BRONJ Lesions in Mice

PubMed Central

Song, Minju; Alshaikh, Abdullah; Kim, Terresa; Kim, Sol; Dang, Michelle; Mehrazarin, Shebli; Shin, Ki-Hyuk; Kang, Mo; Park, No-Hee; Kim, Reuben H.

2016-01-01

Introduction Surgical interventions such as tooth extraction increase a chance of developing osteonecrosis of the jaw (ONJ) in patients receiving bisphosphonates (BPs) for treatment of bone-related diseases. Tooth extraction is often performed to eliminate pre-existing pathological inflammatory conditions that make the tooth unsalvageable; however, the role of such conditions on bisphosphonate-related ONJ (BRONJ) development following tooth extraction is not clearly defined. Here, we examined the effects of periapical periodontitis on tooth extraction-induced BRONJ development in mice. Methods Periapical periodontitis was induced by exposing the pulp of the maxillary first molar for 3 weeks in C57/BL6 mice that were intravenously administered with BP. The same tooth was extracted, and after 3 additional weeks, the mice were harvested for histological, histomorphometric, and histochemical staining analyses. Results Pulp exposure induced periapical radiolucency as demonstrated by increased inflammatory cells, TRAP+ osteoclasts, and bone resorption. When BP was administered, pulp exposure did not induce apical bone resorption despite the presence of inflammatory cells and TRAP+ osteoclasts. While tooth extraction alone induced BRONJ lesions, pulp exposure further increased tooth extraction-induced BRONJ development as demonstrated by the presence of more bone necrosis. Conclusion Our study demonstrates that pre-existing pathological inflammatory condition such as periapical periodontitis is a predisposing factor that may exacerbate BRONJ development following tooth extraction. Our study further provides a clinical implication whereby periapical periodontitis should be controlled before performing tooth extraction in BP-users in order to reduce the risk of developing BRONJ. PMID:27637460

The effect of ovalbumin on orthodontic induced root resorption.

PubMed

Aghili, Hosseinagha; Ardekani, Mohammad Danesh; Meybodi, Seyed Amir Reza Fatahi; Toodehzaeim, Mohammad Hossein; Modaresi, Jalil; Mansouri, Reza; Momeni, Ehsan

2013-09-01

This randomized trial was undertaken to investigate the effect of experimentally induced allergy on orthodontic induced root resorption. A total of 30 Wistar rats were divided randomly into test and control groups. Starting from the first 3 days, the rats in the test group were injected intra-peritoneally by 2 mg ovalbumin as allergen and 0.5 mg Alume as adjuvant. Afterward only allergen was injected once a week. The control group was injected by normal saline. After 21 days, Wistar immunoglobulin E was measured and peripheral matured eosinophil was counted. A total of 50 g nickel-titanium closed coil spring was ligated between right incisor and first molar. All animals were sacrificed after 14 days. The mesial root of the right and left first molar was dissected in a horizontal plane. The specimens were divided into four groups considering whether force and/or ovalbumin was applied or not. Root resorption was measured and compared among these groups. Repeated measures analysis of variance (ANOVA), and Bonferoni tests were used to analyze the data. The level of significance was determined at 0.05. In general, the differences were insignificant (P < 0.05). As the only exception, the group in which both ovalbumin and force were applied had significantly more root resorption than the group in which neither force nor ovalbumin was applied (P > 0.001). Allergy may increase the susceptibility to root resorption. Application of light force, periodical monitoring of root resorption and control of allergy are advisable.

Etiopathogenesis of Mandibulofacial and Maxillofacial Abscesses in Mice

PubMed Central

2010-01-01

The etiologic agent of mandibulofacial and maxillofacial abscesses in mice is reportedly coagulase-positive Staphylococcus aureus. Although suggested to be through the oral cavity, the exact route of entry has not been documented. Among the clinical cases of mandibulofacial and maxillofacial abscess we report here, each case that was cultured yielded coagulase-positive S. aureus. Histologically, all of the abscesses examined were directly associated with intralesional hair shafts, both vibrissae and pelage, that were introduced into the submucosa via the maxillary or mandibular molar gingival sulci. Grossly, a variable amount of hair was imbedded in the lingual, buccal, or mesial gingival sulci of the maxillary or mandibular molars or both. Computed tomography revealed that the presence of the hair resulted in inflammation and resorption of alveolar bone. With these findings, we propose that mandibulofacial and maxillofacial abscesses are induced by the mastication and fragmentation of hair ingested during the barbering process. From the resulting foreign body periodontitis, abscess formation originates at the maxillary lingual, buccal, or mesial gingival sulci, resulting in infection of the maxillary molar tooth roots with swelling or rupture through the skin inferior to the eye, or at the mandibular lingual, buccal, and or mesial gingival sulci, resulting in infection of the mandibular molar tooth roots and osteomyelitis with drainage through the skin of the ventral mandible. PMID:20579435

Mineral trioxide aggregate repair of a perforating internal resorption in a mandibular molar.

PubMed

Meire, Maarten; De Moor, Roeland

2008-02-01

Internal resorption is a rare condition in permanent teeth that poses difficulties for treatment. The challenge is complicated further if the resorption extends beyond the confines of the root. This article describes treatment of a perforating internal resorption in the mesial root of a second lower molar, with adjacent destruction of the alveolar bone. After cleaning the root canal space and the resorption lacuna by mechanical instrumentation, irrigation, and interim calcium hydroxide dressing, the defect was filled with mineral trioxide aggregate, and the canals were obturated conventionally with gutta percha and epoxy resin sealer. At a 2-year follow-up examination, no clinical abnormalities were found, and complete resolution of the alveolar bone lesion and establishment of a new periodontal ligament were observed.

Orthodontic Treatment of Maxillary Incisors with Severe Root Resorption Caused by Bilateral Canine Impaction in a Class II Division 1 Patient.

PubMed

Chang, Na-Young; Park, Jae Hyun; Lee, Mi-Young; Cho, Jin-Woo; Cho, Jin-Hyoung; An, Ki-Yong; Chae, Jong-Moon

2016-01-01

This case report shows the successful alignment of bilateral impacted maxillary canines. A 12-year-old male with the chief complaint of the protrusion of his maxillary anterior teeth happened to have bilateral maxillary canine impaction on the labial side of his maxillary incisors. Four maxillary incisors showed severe root resorption because of the impacted canines. The patient was diagnosed as skeletal Class II malocclusion with proclined maxillary incisors. The impacted canine was carefully retracted using sectional buccal arch wires to avoid further root resorption of the maxillary incisors. To distalize the maxillary dentition, two palatal miniscrews were used. After 25 months of treatment, the maxillary canines were well aligned without any additional root resorption of the maxillary incisors.

Resorption of maxillary incisors after orthodontic treatment--clinical study of risk factors.

PubMed

Elhaddaoui, Rajae; Benyahia, Hicham; Azeroual, Mohamed-Faouzi; Zaoui, Fatima; Razine, Rachid; Bahije, Loubna

2016-03-01

External apical root resorption (EARR) is one of the major problems associated with orthodontic treatment. Such lesions represent an iatrogenic risk that must be detected as early as possible, with regular radiological follow-up and appropriate therapeutic precautions. The causes and mechanisms leading to susceptibility to root resorption following the application of an orthodontic force are often not clear and are generally said to be of multifactorial origin. The aim of this clinical study was to analyze the factors linked to the occurrence of moderate to severe resorption (MSR) of upper incisors during orthodontic treatment in a group of Moroccan patients treated in the Dento-Facial Orthopedic Department of the Dental Consultation and Treatment Center (Centre de consultation et de traitements dentaires [CCTD]) in Rabat. A total of 82 patients (28% males, 72% females) aged between 12 and 27, with various malocclusions, who had been treated with fixed appliances for at least 1 year and for whom panoramic X-rays at the start, during and at the end of treatment were available, were selected randomly. The reduction in maxillary incisor root length was evaluated using resorption scores. The factors studied in relation to the risk of occurrence of MSR were: age, sex, treatment duration, extraction or non-extraction, type of malocclusion (Class I arch-length discrepancy, Class II, Class III), the vertical diagnosis (normal, supraocclusion, open bite), presence of dysfunction, impacted canines and root morphology. Statistical analysis was performed using SPSS software, version 18.0. Statistical tests used were: Kaplan-Meier analysis and the univariate and multivariate Cox models for the study of factors associated with MSR. The threshold of significance adopted was 0.05. The factors that were significantly associated with the occurrence of MSR at the level of the upper incisors were: tooth type, with a greater risk for the lateral incisor (HR=3.2 95% CI [2.3-4.5] P<0.001), treatments with extraction (HR=1.64 95% CI [1.16-2.33] P<0.05), the presence of supraocclusion (HR=2.17 95% CI [1.33-3.53] P<0.05) or open bite (HR=3.12 95% CI [1.66-5.86] P<0.001) and root malformation (HR=1.5 95% CI [1.09-2.07] P<0.05). Age, sex, type of malocclusion, dysfunction and impaction of canines were not associated at a statistically significant level with the risk of occurrence of MSR of the upper incisors. EARR is difficult to avoid; the orthodontist's role remains crucial in identifying risk factors so as to adopt a treatment strategy taking these factors into account. In our population, the risk of MSR in the upper incisors appeared to increase in treatments with extraction, situations of supraocclusion or open bite, and in the presence of root abnormalities. Finally, clinical recommendations for the prevention of the occurrence of MSR of the maxillary incisors are proposed, taking into account all the risk factors identified. Copyright © 2015 CEO. Published by Elsevier Masson SAS. All rights reserved.

Effect of zoledronic acid used in the root surface treatment of late replanted teeth: a study in rats.

PubMed

Mori, Graziela Garrido; Janjacomo, Daniela Maria de Mendonça; Nunes, Daniele Clapes; Castilho, Lithiene Ribeiro

2010-01-01

This study evaluated the use of zoledronic acid, a resorption inhibitor, as a medication for root resorption treatment of late replanted teeth. Twenty-four maxillary right central incisors of rats were avulsed and kept dry for 30 min. Then, the teeth were divided into 2 groups. In group I, root surface was treated with 2% sodium fluoride for 20 min; in group II, 10-6M zoledronic acid solution was used for 20 min. All root canals were filled with calcium hydroxide. Next, teeth were replanted in their respective sockets. After 15 and 60 days post-replantation, the animals were killed and the anatomic pieces were obtained and prepared for microscopic and morphometric analyses. The results showed that zoledronic acid was capable of limiting the occurrence of root resorption and preserving cementum resorption. Further research must be performed to confirm the use of zoledronic acid in root surface treatment of late replanted teeth.

Small-Scale Fabrication of Biomimetic Structures for Periodontal Regeneration

PubMed Central

Green, David W.; Lee, Jung-Seok; Jung, Han-Sung

2016-01-01

The periodontium is the supporting tissues for the tooth organ and is vulnerable to destruction, arising from overpopulating pathogenic bacteria and spirochaetes. The presence of microbes together with host responses can destroy large parts of the periodontium sometimes leading tooth loss. Permanent tissue replacements are made possible with tissue engineering techniques. However, existing periodontal biomaterials cannot promote proper tissue architectures, necessary tissue volumes within the periodontal pocket and a “water-tight” barrier, to become clinically acceptable. New kinds of small-scale engineered biomaterials, with increasing biological complexity are needed to guide proper biomimetic regeneration of periodontal tissues. So the ability to make compound structures with small modules, filled with tissue components, is a promising design strategy for simulating the anatomical complexity of the periodotium attachment complexes along the tooth root and the abutment with the tooth collar. Anatomical structures such as, intima, adventitia, and special compartments such as the epithelial cell rests of Malassez or a stellate reticulum niche need to be engineered from the start of regeneration to produce proper periodontium replacement. It is our contention that the positioning of tissue components at the origin is also necessary to promote self-organizing cell–cell connections, cell–matrix connections. This leads to accelerated, synchronized and well-formed tissue architectures and anatomies. This strategy is a highly effective preparation for tackling periodontitis, periodontium tissue resorption, and to ultimately prevent tooth loss. Furthermore, such biomimetic tissue replacements will tackle problems associated with dental implant support and perimimplantitis. PMID:26903872

Maxillary incisors changes during space closure with conventional and skeletal anchorage methods: a systematic review.

PubMed

Jayaratne, Yasas Shri Nalaka; Uribe, Flavio; Janakiraman, Nandakumar

2017-01-01

The objective of this systematic review was to compare the antero-posterior, vertical and angular changes of maxillary incisors with conventional anchorage control techniques and mini-implant based space closure methods. The electronic databases Pubmed, Scopus, ISI Web of knowledge, Cochrane Library and Open Grey were searched for potentially eligible studies using a set of predetermined keywords. Full texts meeting the inclusion criteria as well as their references were manually searched. The primary outcome data (linear, angular, and vertical maxillary incisor changes) and secondary outcome data (overbite changes, soft tissue changes, biomechanical factors, root resorption and treatment duration) were extracted from the selected articles and entered into spreadsheets based on the type of anchorage used. The methodological quality of each study was assessed. Six studies met the inclusion criteria. The amount of incisor retraction was greater with buccally placed mini-implants than conventional anchorage techniques. The incisor retraction with indirect anchorage from palatal mini-implants was less when compared with buccally placed mini-implants. Incisor intrusion occurred with buccal mini-implants, whereas extrusion was seen with conventional anchorage. Limited data on the biomechanical variables or adverse effects such as root resorption were reported in these studies. More RCT's that take in to account relevant biomechanical variables and employ three-dimensional quantification of tooth movements are required to provide information on incisor changes during space closure.

Age-Related Adaptation of Bone-PDL-Tooth Complex: Rattus-Norvegicus as a Model System

PubMed Central

Leong, Narita L.; Hurng, Jonathan M.; Djomehri, Sabra I.; Gansky, Stuart A.; Ryder, Mark I.; Ho, Sunita P.

2012-01-01

Functional loads on an organ induce tissue adaptations by converting mechanical energy into chemical energy at a cell-level. The transducing capacity of cells alters physico-chemical properties of tissues, developing a positive feedback commonly recognized as the form-function relationship. In this study, organ and tissue adaptations were mapped in the bone-tooth complex by identifying and correlating biomolecular expressions to physico-chemical properties in rats from 1.5 to 15 months. However, future research using hard and soft chow over relevant age groups would decouple the function related effects from aging affects. Progressive curvature in the distal root with increased root resorption was observed using micro X-ray computed tomography. Resorption was correlated to the increased activity of multinucleated osteoclasts on the distal side of the molars until 6 months using tartrate resistant acid phosphatase (TRAP). Interestingly, mononucleated TRAP positive cells within PDL vasculature were observed in older rats. Higher levels of glycosaminoglycans were identified at PDL-bone and PDL-cementum entheses using alcian blue stain. Decreasing biochemical gradients from coronal to apical zones, specifically biomolecules that can induce osteogenic (biglycan) and fibrogenic (fibromodulin, decorin) phenotypes, and PDL-specific negative regulator of mineralization (asporin) were observed using immunohistochemistry. Heterogeneous distribution of Ca and P in alveolar bone, and relatively lower contents at the entheses, were observed using energy dispersive X-ray analysis. No correlation between age and microhardness of alveolar bone (0.7±0.1 to 0.9±0.2 GPa) and cementum (0.6±0.1 to 0.8±0.3 GPa) was observed using a microindenter. However, hardness of cementum and alveolar bone at any given age were significantly different (P<0.05). These observations should be taken into account as baseline parameters, during development (1.5 to 4 months), growth (4 to 10 months), followed by a senescent phase (10 to 15 months), from which deviations due to experimentally induced perturbations can be effectively investigated. PMID:22558292

Role of the epithelial cell rests of Malassez in the development, maintenance and regeneration of periodontal ligament tissues.

PubMed

Xiong, Jimin; Gronthos, Stan; Bartold, P Mark

2013-10-01

Periodontitis is a highly prevalent inflammatory disease that results in damage to the tooth-supporting tissues, potentially leading to tooth loss. Periodontal tissue regeneration is a complex process that involves the collaboration of two hard tissues (cementum and alveolar bone) and two soft tissues (gingiva and periodontal ligament). To date, no periodontal-regenerative procedures provide predictable clinical outcomes. To understand the rational basis of regenerative procedures, a better understanding of the events associated with the formation of periodontal components will help to establish reliable strategies for clinical practice. An important aspect of this is the role of the Hertwig's epithelial root sheath in periodontal development and that of its descendants, the epithelial cell rests of Malassez, in the maintenance of the periodontium. An important structure during tooth root development, the Hertwig's epithelial root sheath is not only a barrier between the dental follicle and dental papilla cells but is also involved in determining the shape, size and number of roots and in the development of dentin and cementum, and may act as a source of mesenchymal progenitor cells for cementoblasts. In adulthood, the epithelial cell rests of Malassez are the only odontogenic epithelial population in the periodontal ligament. Although there is no general agreement on the functions of the epithelial cell rests of Malassez, accumulating evidence suggests that the putative roles of the epithelial cell rests of Malassez in adult periodontal ligament include maintaining periodontal ligament homeostasis to prevent ankylosis and maintain periodontal ligament space, to prevent root resorption, to serve as a target during periodontal ligament innervation and to contribute to cementum repair. Recently, ovine epithelial cell rests of Malassez cells have been shown to harbor clonogenic epithelial stem-cell populations that demonstrate similar properties to mesenchymal stromal/stem cells, both functionally and phenotypically. Therefore, the epithelial cell rests of Malassez, rather than being 'cell rests', as indicated by their name, are an important source of stem cells that might play a pivotal role in periodontal regeneration. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Initial arch wires for tooth alignment during orthodontic treatment with fixed appliances.

PubMed

Jian, Fan; Lai, Wenli; Furness, Susan; McIntyre, Grant T; Millett, Declan T; Hickman, Joy; Wang, Yan

2013-04-30

Initial arch wires are the first arch wires to be inserted into the fixed appliance at the beginning of orthodontic treatment and are used mainly for the alignment of teeth by correcting crowding and rotations. With a number of different types of orthodontic arch wires available for initial tooth alignment, it is important to understand which wire is most efficient, as well as which wires cause the least amount of root resorption and pain during the initial aligning stage of treatment. This is an update of the review 'Initial arch wires for alignment of crooked teeth with fixed orthodontic braces' first published in the Cochrane Database of Systematic Reviews 2010, Issue 4. To assess the effects of initial arch wires for alignment of teeth with fixed orthodontic braces in relation to alignment speed, root resorption and pain intensity. We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 2 August 2012), CENTRAL (The Cochrane Library 2012, Issue 7), MEDLINE via OVID (1950 to 2 August 2012) and EMBASE via OVID (1980 to 2 August 2012). We also searched the reference lists of relevant articles. There was no restriction with regard to publication status or language of publication. We contacted all authors of included studies to identify additional studies. We included randomised controlled trials (RCTs) of initial arch wires to align teeth with fixed orthodontic braces. Only studies involving participants with upper and/or lower full arch fixed orthodontic appliances were included. Two review authors were responsible for study selection, validity assessment and data extraction. All disagreements were resolved by discussion amongst the review team. Corresponding authors of included studies were contacted to obtain missing information. Nine RCTs with 571 participants were included in this review. All trials were at high risk of bias and a number of methodological limitations were identified. All trials had at least one potentially confounding factor (such as bracket type, slot size, ligation method, extraction of teeth) which is likely to have influenced the outcome and was not controlled in the trial. None of the trials reported the important adverse outcome of root resorption.Three groups of comparisons were made.(1) Multistrand stainless steel initial arch wires compared to superelastic nickel titanium (NiTi) initial arch wires. There were four trials in this group, with different comparisons and outcomes reported at different times. No meta-analysis was possible. There is insufficient evidence from these trials to determine whether or not there is a difference in either rate of alignment or pain between stainless steel and NiTi initial arch wires.(2) Conventional (stabilised) NiTi initial arch wires compared to superelastic NiTi initial arch wires. There were two trials in this group, one reporting the outcome of alignment over 6 months and the other reporting pain over 1 week. There is insufficient evidence from these trials to determine whether or not there is any difference between conventional (stabilised) and superelastic NiTi initial arch wires with regard to either alignment or pain.(3) Single-strand superelastic NiTi initial arch wires compared to other NiTi (coaxial, copper NiTi (CuNiTi) or thermoelastic) initial arch wires. The three trials in this comparison each compared a different product against single-strand superelastic NiTi. There is very weak unreliable evidence, based on one very small study (n = 24) at high risk of bias, that coaxial superelastic NiTi may produce greater tooth movement over 12 weeks, but no information on associated pain or root resorption. This result should be interpreted with caution until further research evidence is available. There is insufficient evidence to determine whether or not there is a difference between either thermoelastic or CuNiTi and superelastic NiTi initial arch wires. There is no reliable evidence from the trials included in this review that any specific initial arch wire material is better or worse than another with regard to speed of alignment or pain. There is no evidence at all about the effect of initial arch wire materials on the important adverse effect of root resorption. Further well-designed and conducted, adequately-powered, RCTs are required to determine whether the performance of initial arch wire materials as demonstrated in the laboratory, makes a clinically important difference to the alignment of teeth in the initial stage of orthodontic treatment in patients.

Conservative treatment of an ankylosed tooth after delayed replantation: a case report.

PubMed

Díaz, Jaime Andrés; Sandoval, Hector Paulo; Pineda, Patricia Irene; Junod, Pablo Antonio

2007-10-01

An 8-year-old boy sustained avulsion of his upper right maxillary central incisor and lateral luxation of his upper left maxillary incisors. Subsequently, the upper right maxillary central incisor developed replacement resorption, and both upper left maxillary incisors developed pulpal canal obliteration. In the ankylosed tooth, decoronation procedure was performed, and in the 44-month follow-up period the involved alveolar site showed vertical apposition of bone and continuing replacement resorption. Decoronation is a surgical procedure that allows preservation of the bone volume for the future, avoiding aesthetic disturbances and more aggressive treatments in cases where other therapeutic alternatives are not feasible.

Root Resorption: Simplifying Diagnosis and Improving Outcomes.

PubMed

Darcey, James; Qualtrough, Alison

2016-05-01

Root resorption is a condition resulting in the progressive loss of dental hard tissue. It may occur both within the root and upon the external aspect of the root. Diagnosis can be difficult and management challenging. Understanding the pathology is critical to understanding why and when this disease occurs and what the best management techniques involve. With such knowledge practitioners can confidently diagnose resorption, discuss prognoses and management strategies with the patient and either refer or begin treatment. Early intervention is paramount in improving outcomes. As such, if practitioners choose to refer patients they must be aware of what can be done immediately to mitigate risks until consultation and specialist treatment begins.

Tooth Eruption without Roots

PubMed Central

2013-01-01

Root development and tooth eruption are very important topics in dentistry. However, they remain among the less-studied and -understood subjects. Root development accompanies rapid tooth eruption, but roots are required for the movement of teeth into the oral cavity. It has been shown that the dental follicle and bone remodeling are essential for tooth eruption. So far, only limited genes have been associated with root formation and tooth eruption. This may be due to the difficulties in studying late stages of tooth development and tooth movement and the lack of good model systems. Transgenic mice with eruption problems and short or no roots can be used as a powerful model for further deciphering of the cellular, molecular, and genetic mechanisms underlying root formation and tooth eruption. Better understanding of these processes can provide hints on delivering more efficient dental therapies in the future. PMID:23345536

Bis-enoxacin Inhibits Bone Resorption and Orthodontic Tooth Movement

PubMed Central

Toro, E.J.; Zuo, J.; Guiterrez, A.; La Rosa, R.L.; Gawron, A.J.; Bradaschia-Correa, V.; Arana-Chavez, V.; Dolce, C.; Rivera, M.F.; Kesavalu, L.; Bhattacharyya, I.; Neubert, J.K.; Holliday, L.S.

2013-01-01

Enoxacin inhibits binding between the B-subunit of vacuolar H+-ATPase (V-ATPase) and microfilaments, and also between osteoclast formation and bone resorption in vitro. We hypothesized that a bisphosphonate derivative of enoxacin, bis-enoxacin (BE), which was previously studied as a bone-directed antibiotic, might have similar activities. BE shared a number of characteristics with enoxacin: It blocked binding between the recombinant B-subunit and microfilaments and inhibited osteoclastogenesis in cell culture with IC50s of about 10 µM in each case. BE did not alter the relative expression levels of various osteoclast-specific proteins. Even though tartrate-resistant acid phosphatase 5b was expressed, proteolytic activation of the latent pro-enzyme was inhibited. However, unlike enoxacin, BE stimulated caspase-3 activity. BE bound to bone slices and inhibited bone resorption by osteoclasts on BE-coated bone slices in cell culture. BE reduced the amount of orthodontic tooth movement achieved in rats after 28 days. Analysis of these data suggests that BE is a novel anti-resorptive molecule that is active both in vitro and in vivo and may have clinical uses. Abbreviations: BE, bis-enoxacin; V-ATPase, vacuolar H+-ATPase; TRAP, tartrate-resistant acid phosphatase; αMEM D10, minimal essential media, alpha modification with 10% fetal bovine serum; SDS-PAGE, sodium dodecyl sulfate-polyacrylamide gel electrophoresis; RANKL, receptor activator of nuclear factor kappa B-ligand; NFATc1, nuclear factor of activated T-cells; ADAM, a disintegrin and metalloprotease domain; OTM, orthodontic tooth movement. PMID:23958763

Physical properties of root cementum: part 24. Root resorption of the first premolars after 4 weeks of occlusal trauma.

PubMed

Cakmak, Fethiye; Turk, Tamer; Karadeniz, Ersan Ilsay; Elekdag-Turk, Selma; Darendeliler, M Ali

2014-05-01

In orthodontics, adding restorative materials on occlusal or lingual surfaces is a common method to create a mini-biteplane to increase patients' vertical dimension temporarily to facilitate several treatment procedures. However, this method transmits excessive occlusal forces through the periodontal ligament and causes trauma. In this prospective randomized clinical trial, we measured and compared quantitatively the volumes of root resorption after 4 weeks of occlusal trauma. Forty-eight maxillary and mandibular first premolars of 12 patients (6 girls, 6 boys) comprised the sample for this study. One side of each patient was randomly selected as the control. On the contralateral side, a light-cured glass ionomer cement (Transbond Plus Light Cure Band Adhesive; 3M Unitek, Monrovia, Calif) was bonded onto the occlusal surface of the mandibular first premolar so that the cement was in contact with the maxillary first premolar. After 4 weeks, both first premolars were extracted. Each sample was imaged using a microcomputed tomography system (1172; SkyScan, Aartselaar, Belgium) and analyzed with specially designed software for volumetric measurements of resorption craters. Furthermore, pain was evaluated with a visual analog scale for 7 days. There were significant differences in the amounts of root resorption between the control and the experimentally traumatized teeth. No significant difference among the buccal, lingual, mesial, and distal surfaces was found in either jaw. Furthermore, no significant difference existed in the amount of root resorption among the cervical, middle, and apical thirds of both jaws. There was no correlation between age, sex, volume of the root resorption craters, and pain. Restorative buildups, used to increase the vertical dimension by 2 mm for 4 weeks, caused root resorption along the sides of the teeth during the active bite-increase period. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

A preliminary investigation of short-term cytokine  expression in gingival crevicular fluid secondary to high-level orthodontic forces and the associated root resorption: case series analytical study.

PubMed

Ahuja, Rajiv; Almuzian, Moahmmed; Khan, Alamgir; Pascovici, Dana; Dalci, Oyku; Darendeliler, M Ali

2017-12-01

Orthodontically induced iatrogenic root resorption (OIIRR) is an unavoidable inflammatory process. Several factors claimed to be related to the severity of OIIRR. Orthodontic forces cause micro-trauma to the periodontal ligament and activate a cascade of cellular events associated with local periodontal inflammation. The purpose of this split-mouth study were (1) to investigate the changes in cytokine profile in the gingival crevicular fluid (GCF) secondary to heavy orthodontic forces and (2) to compare the cytokine expression between participants showing high and low root resorption. Eight participants requiring maxillary first premolar extractions involved in this study. The teeth on the tested side (TS) received 225 g of controlled buccal tipping force for 28 days, while the contralateral teeth act as a control (CS). GCF was collected from both TS and CS teeth at 0 h (prior to application of force) and 3 h, 1 day, 3 days, 7 days and 28 days after the application of force, and analysed with multiplex bead immunoassay to determine the cytokine levels. Statistically significant temporal increase was found in the TS teeth for tumour necrosis factor alpha (TNF-α) at 3 h and 28 days (p = 0.01). Interleukin 7 (IL-7) significantly peaked at the 28th day. Comparing cytokine profile for participants with high and low root resorption (>0.35 and <0.15 mm 3 , respectively), the levels of GM-CSF was significantly greater in low root resorption cases (p < 0.05). The amounts of root resorption which craters on mesial, distal surfaces and middle third region were significant in the TS teeth (p < 0.05). IL-7 and TNF-α (pro-resorptive cytokine) increased significantly secondary to a high-level of orthodontic force application. Significantly high levels of granulocyte macrophage colony-stimulating factor (anti-resorptive cytokine) were detected in mild root resorption cases secondary to high-level orthodontic force application. A future long-term randomised clinical trial with larger sample taking in consideration gender, age and growth pattern distribution would be recommended.

Apical root resorption comparison between Fränkel and eruption guidance appliances.

PubMed

Janson, Guilherme; Nakamura, Alexandre; de Freitas, Marcos Roberto; Henriques, José Fernando Castanha; Pinzan, Arnaldo

2007-06-01

The objectives of this study were to compare the amounts of apical root resorption that occur after treatment with 2 removable appliances-the Fränkel function regulator and the eruption guidance appliance (EGA)-in an untreated control group, and to determine the prevalence of root resorption in the maxillary and mandibular incisors and the dental arches. After treatment, periapical radiographs were obtained of the maxillary and mandibular incisors with the long-cone paralleling technique from 72 patients divided into 3 groups. Group 1 included 24 patients treated with the Fränkel appliance, group 2 consisted of 24 patients treated with the EGA, and group 3 comprised 24 untreated subjects. Some patients in groups 1 and 2 were also treated with fixed appliances. Subgroups of patients who had used exclusively 1 functional appliance were also formed and evaluated. Root resorption was scored according to the method of Levander and Malmgren. Results of the Kruskal-Wallis tests showed significantly greater resorption in the Fränkel group, the EGA group, and the EGA subgroup in relation to the control group. However, there were no statistically significant differences between the Fränkel and the EGA groups and the subgroups. The amounts of resorption were predominantly small and similar in the experimental groups and the subgroups. The prevalence of resorption for the incisors was greatest for the maxillary central, followed by the maxillary lateral, mandibular central, and mandibular lateral. It was concluded that the Fränkel group, the EGA group, and the EGA subgroup had significantly greater resorption than the control group. There was no difference in the amount of resorption between the Fränkel and the EGA groups.

Correlation of Vitamin D status and orthodontic-induced external apical root resorption.

PubMed

Tehranchi, Azita; Sadighnia, Azin; Younessian, Farnaz; Abdi, Amir H; Shirvani, Armin

2017-01-01

Adequate Vitamin D is essential for dental and skeletal health in children and adult. The purpose of this study was to assess the correlation of serum Vitamin D level with external-induced apical root resorption (EARR) following fixed orthodontic treatment. In this cross-sectional study, the prevalence of Vitamin D deficiency (defined by25-hydroxyvitamin-D) was determined in 34 patients (23.5% male; age range 12-23 years; mean age 16.63 ± 2.84) treated with fixed orthodontic treatment. Root resorption of four maxillary incisors was measured using before and after periapical radiographs (136 measured teeth) by means of a design-to-purpose software to optimize data collection. Teeth with a maximum percentage of root resorption (%EARR) were indicated as representative root resorption for each patient. A multiple linear regression model and Pearson correlation coefficient were used to assess the association of Vitamin D status and observed EARR. P < 0.05 was considered statistically significant. The Pearson coefficient between these two variables was determined about 0.15 ( P = 0.38). Regression analysis revealed that Vitamin D status of the patients demonstrated no significant statistical correlation with EARR, after adjustment of confounding variables using linear regression model ( P > 0.05). This study suggests that Vitamin D level is not among the clinical variables that are potential contributors for EARR. The prevalence of Vitamin D deficiency does not differ in patients with higher EARR. These data suggest the possibility that Vitamin D insufficiency may not contribute to the development of more apical root resorption although this remains to be confirmed by further longitudinal cohort studies.

[Apical resorption in pre-surgical orthodontics].

PubMed

Piasente, M; Merlini, C; Amelotti, C; Antonioli, M; Roghi, M

1991-07-15

Apical root resorption is a frequent phenomenon observed in pre-surgical orthodontic; the reason is double: we deal with adult patients and we often move the teeth in the opposite direction compared to the position obtained in previous inefficacious orthodontic treatments. Notwithstanding the amount of apical root resorption we couldn't record an hyper-mobility of the teeth and a long term evaluation of occlusal stability didn't show any significant change.

Radiologically determined orthodontically induced external apical root resorption in incisors after non-surgical orthodontic treatment of class II division 1 malocclusion: a systematic review.

PubMed

Tieu, Long D; Saltaji, Humam; Normando, David; Flores-Mir, Carlos

2014-07-23

This study aims to critically evaluate orthodontically induced external apical root resorption (OIEARR) in incisors of patients undergoing non-surgical orthodontic treatment of class II division 1 malocclusion by a systematic review of the published data. An electronic search of two databases was performed; the bibliographies of relevant articles were also reviewed. Studies were included if they examined the amount of OIEARR in incisors produced during non-surgical orthodontic treatment of individuals with class II division I malocclusion in the permanent dentition. Individuals had no previous history of OIEARR, syndromes, pathologies, or general diseases. Study selections, risk of bias assessment, and data extraction were performed in duplicate. Eight studies of moderate methodological quality were finally included. An increased prevalence (65.6% to 98.1%) and mild to moderate severity of OIEARR (<4 mm and <1/3 original root) were reported. No sex difference in root resorption was found. For the maxillary incisors, there was no evidence that either the central or lateral incisor was more susceptible to OIEARR. A weak to moderate positive correlation between treatment duration and root resorption, and anteroposterior apical displacement and root resorption was found. Current limited evidence suggests that non-surgical comprehensive orthodontic treatment to correct class II division 1 malocclusions causes increased prevalence and severity of OIEARR the more the incisor roots are displaced and the longer this movement takes.

Single-Tooth Osteotomy Combined Wide Linear Corticotomy Under Local Anesthesia for Correcting Anterior Protrusion With Ectopically Erupted Canine.

PubMed

Iskenderoglu, Nur Serife; Choi, Byung-Joon; Seo, Kyung Won; Lee, Yeon-Ji; Lee, Baek-Soo; Kim, Seong-Hun

2017-01-01

This article presents the alternative surgical treatments of both anterior protrusion by carrying out retraction on mandibular anterior fragment, meanwhile applying retraction force on maxilla anterior teeth and ectopically erupted canine with using platelet-rich fibrin (PRF). Anterior segmental osteotomy was combined with linear corticotomy under local anesthesia. The correction of right ectopic canine was achieved through 2 stages. First, dento-osseous osteotomy on palatal side was performed. Then second osteotomy with immediate manual repositioning of the canine with concomitant first premolar extraction was enhanced with PRF, which was prepared by centrifuging patient's blood, applied into buccal side of high canine during osteotomy. Mandibular retraction was accomplished by anterior segmental osteotomy. Single-tooth osteotomy is a more effective surgical method for ankylosed or ectopically erupted tooth in orthodontic treatment. It can reduce the total orthodontic treatment time and root resorption, 1 common complication. Significant improved bone formation was seen with the addition of PRF on noncritical size defects in the animal model. It is reasonable to think that PRF can promote bone regeneration. So early bone formation also can reduce the complication such as postoperative infection. As an alternative to anterior protrusion and ectopically erupted canine treatment, segmental osteotomy and corticotomy combined platelet-rich plasma can enhance orthodontic treatment outcome.

Adverse effects of orthodontic treatment: A clinical perspective

PubMed Central

Talic, Nabeel F.

2011-01-01

Orthodontic treatment is associated with a number of adverse effects, such as root resorption, pain, pulpal changes, periodontal disease, and temporomandibular dysfunction (TMD). Orthodontists should be aware of these effects and associated risk factors. Risk factors linked to root resorption include the duration of treatment, length, and shape of the root, trauma history, habits, and genetic predisposition. PMID:24151415

Three-dimensional anatomy of equine incisors: tooth length, enamel cover and age related changes

PubMed Central

2013-01-01

Background Equine incisors are subjected to continuous occlusal wear causing multiple, age related changes of the extragingival crown. It is assumed that the occlusal wear is compensated by continued tooth elongation at the apical ends of the teeth. In this study, μCT-datasets offered the opportunity to analyze the three-dimensional appearance of the extra- and intraalveolar parts of the enamel containing dental crown as well as of the enamel-free dental root. Multiple morphometric measurements elucidated age related, morphological changes within the intraalveolar part of the incisors. Results Equine incisors possess a unique enamel cover displaying large indentations on the mesial and distal sides. After eruption tooth elongation at the apical end outbalances occlusal wear for two to four years resulting in increasing incisor length in this period of time. Remarkably, this maximum length is maintained for about ten years, up to a tooth age of 13 to 15 years post eruption. Variances in the total length of individual teeth are related to different Triadan positions (central-, middle- and corner incisors) as well as to the upper and lower arcades. Conclusion Equine incisors are able to fully compensate occlusal wear for a limited period of time. However, after this ability ceases, it is expected that a diminished intraalveolar tooth length will cause massive changes in periodontal biomechanics. The time point of these morphodynamic and biomechanical changes (13 to 15 years post eruption) occurs in coincidence with the onset of a recently described destructive disease of equine incisor (equine odontoclastic tooth resorption and hypercementosis) in aged horses. However, further biomechanical, cell biological and microbiological investigations are needed to elucidate a correlation between age related changes of incisor morphology and this disease. PMID:24321365

Three-dimensional anatomy of equine incisors: tooth length, enamel cover and age related changes.

PubMed

Schrock, Patricia; Lüpke, Matthias; Seifert, Hermann; Staszyk, Carsten

2013-12-09

Equine incisors are subjected to continuous occlusal wear causing multiple, age related changes of the extragingival crown. It is assumed that the occlusal wear is compensated by continued tooth elongation at the apical ends of the teeth. In this study, μCT-datasets offered the opportunity to analyze the three-dimensional appearance of the extra- and intraalveolar parts of the enamel containing dental crown as well as of the enamel-free dental root. Multiple morphometric measurements elucidated age related, morphological changes within the intraalveolar part of the incisors. Equine incisors possess a unique enamel cover displaying large indentations on the mesial and distal sides. After eruption tooth elongation at the apical end outbalances occlusal wear for two to four years resulting in increasing incisor length in this period of time. Remarkably, this maximum length is maintained for about ten years, up to a tooth age of 13 to 15 years post eruption. Variances in the total length of individual teeth are related to different Triadan positions (central-, middle- and corner incisors) as well as to the upper and lower arcades. Equine incisors are able to fully compensate occlusal wear for a limited period of time. However, after this ability ceases, it is expected that a diminished intraalveolar tooth length will cause massive changes in periodontal biomechanics. The time point of these morphodynamic and biomechanical changes (13 to 15 years post eruption) occurs in coincidence with the onset of a recently described destructive disease of equine incisor (equine odontoclastic tooth resorption and hypercementosis) in aged horses. However, further biomechanical, cell biological and microbiological investigations are needed to elucidate a correlation between age related changes of incisor morphology and this disease.

The effects of systemic stress on orthodontic tooth movement.

PubMed

Gameiro, Gustavo Hauber; Nouer, Darcy Flávio; Pereira-Neto, Joáo Sarmento; Urtado, Marília Bertoldo; Novaes, Pedro Duarte; de Castro, Margaret; Veiga, Maria Cecília Ferraz Arruda

2008-11-01

To determine if systemic stress affects the biological reactions occurring during orthodontic tooth movement. Four groups of male 10 week-old Wistar rats were used. Group A animals (N=10) were restrained for one hour per day for 40 days; Group B animals (N=10) were restrained for one hour per day for three days; Group C (N=10) and Group D (N=8) animals were unrestrained. The upper left first molars in the rats in Groups A (long-term stress), B (short-term stress) and C (control) were moved mesially during the last 14 days of the experiment. The animals in Group D (N=8) were used for body weight and hormonal dosage comparisons only. They were not subjected to any stress and did not have appliances fitted. All animals were killed at 18 weeks of age and blood collected for measurement of plasma corticosterone. Tooth movement was measured with an electronic caliper. The right and left hemi-maxillae of five rats from each group were removed and the number of tartrate-resistant acid phosphatase (TRAP) positive cells, defined as osteoclasts, adjacent to the mesial roots of the upper first molars counted. The contralateral side in each animal served as the control (split-mouth design). Corticosterone levels were significantly higher in the stressed groups (Groups A and B) than in the control group (Group C). Tooth movement was significantly greater in Group A (long-term stress) compared with Group B (short-term stress) and Group C (control), which did not differ from each other. There were significantly more osteoclasts in the long-term stress group than in the short-term stress and control groups. Persistent systemic stress increases bone resorption during orthodontic tooth movement. Systemic stress may affect the rate of tooth movement during orthodontic treatment.

An Analysis of the Stress Induced in the Periodontal Ligament during Extrusion and Rotation Movements: A Finite Element Method Linear Study Part I.

PubMed

Hemanth, M; Raghuveer, H P; Rani, M S; Hegde, Chathura; Kabbur, Karthik J; Vedavathi, B; Chaithra, D

2015-09-01

Orthodontic tooth movement occurs due to various biomechanical changes in the periodontium. Forces within the optimal range yield maximum tooth movement with minimum deleterious effects. Among various types of tooth movements, extrusion and rotational movements are seen to be associated with the least amount of root resorption and have not been studied in detail. Therefore in this study, the stress patterns in the periodontal ligament (PDL) were evaluated with extrusion and rotational movements using the finite element method FEM. A three-dimensional (3D) FEM model of the maxillary incisors was generated using SOLIDWORKS modeling software. Stresses in the PDL were evaluated with extrusive and rotational movements by a 3D FEM using ANSYS software with linear material properties. It was observed that with the application of extrusive load, the tensile stresses were seen at the apex, whereas the compressive stress was distributed at the cervical margin. With the application of rotational movements, maximum compressive stress was distributed at the apex and cervical third, whereas the tensile stress was distributed on cervical third of the PDL on the lingual surface. For extrusive movements, stress values over the periodontal ligament was within the range of optimal stress value as proposed by Lee, with a given force system by Profitt as optimum forces for orthodontic tooth movement using linear properties. During rotation there are stresses concentrated at the apex, hence due to the concentration of the compressive forces at the apex a clinician must avoid placing heavy stresses during tooth movement.

An evaluation of clinical, radiological and three-dimensional dental tomography findings in ectodermal dysplasia cases.

PubMed

Doğan, Mehmet-Sinan; Callea, Michele; Yavuz, Ìzzet; Aksoy, Orhan; Clarich, Gabriella; Günay, Ayse; Günay, Ahmet; Güven, Sedat; Maglione, Michele; Akkuş, Zeki

2015-05-01

This study aimed to review the results related to head and jaw disorders in cases of ectodermal dysplasia. The evaluation of ectodermal dysplasia cases was made by clinical examination and examination of the jaw and facial areas radiologically and on cone-beam 3-dimensional dental tomography (CBCT) images. In the 36 cases evaluated in the study, typical clinical findings of pure hypohidrotic ectodermal displasia (HED) were seen, such as missing teeth, dry skin, hair and nail disorders. CBCT images were obtained from 12 of the 36 cases, aged 1.5- 45 years, and orthodontic analyses were made on these images. The clinical and radiological evaluations determined, hypodontia or oligodontia, breathing problems, sweating problems, a history of fever, sparse hair, saddle nose, skin peeling, hypopigmentation, hyperpigmentation, finger and nail deformities, conical teeth anomalies, abnormal tooth root formation, tooth resorption in the root, gingivitis, history of epilepsy, absent lachrymal canals and vision problems in the cases which included to the study. Ectodermal dysplasia cases have a particular place in dentistry and require a professional, multi-disciplinary approach in respect of the chewing function, orthognathic problems, growth, oral and dental health. It has been understood that with data obtained from modern technologies such as three-dimensional dental tomography and the treatments applied, the quality of life of these cases can be improved.

Role of basic biological sciences in clinical orthodontics: a case series.

PubMed

Davidovitch, Ze'ev; Krishnan, Vinod

2009-02-01

Orthodontic therapy is based on interaction between mechanics and biology. Basic biologic research aims at developing a better understanding of the mechanism of transformation of mechanical energy into biologic reactions, and exposing the reasons for iatrogenic tissue damage in orthodontics. Previous research has shown that inflammation is a major part of the biologic response to orthodontic forces. In inflammation, signal molecules that originate in remote diseased organs can reach strained paradental tissues and exacerbate the inflammatory process, leading to tissue damage. Our case series includes 3 patients, each having had systemic diseases and malocclusion. One had diabetes mellitus, Hashimoto's thyroiditis, and depression. Concern about the possible effect of these conditions on the well-being of the teeth and their surrounding tissues compelled the orthodontist to choose not to treat this patient. The other 2 patients had allergies, and 1 also had bronchial asthma and bruises. Although these conditions are thought to be risk factors for root resorption, these patients received orthodontic treatment for 2 and 3.5 years, respectively. At the end of treatment, both had excessive root resorption of many teeth. In 1 patient, this damage led to the loss of most maxillary teeth. Basic research should continue to address questions related to the biologic mechanisms of tooth movement on tissue, cellular, and molecular levels. Moreover, this research should continue to identify risk factors that might jeopardize the longevity of treated teeth. Such basic research should promote the development of new tissue-friendly and patient-friendly therapeutic methods.

Understanding External Cervical Resorption in Vital Teeth.

PubMed

Mavridou, Athina M; Hauben, Esther; Wevers, Martine; Schepers, Evert; Bergmans, Lars; Lambrechts, Paul

2016-12-01

The aim of this study was to investigate the 3-dimensional (3D) structure and the cellular and tissue characteristics of external cervical resorption (ECR) in vital teeth and to understand the phenomenon of ECR by combining histomorphological and radiographic findings. Twenty-seven cases of vital permanent teeth displaying ECR were investigated. ECR diagnosis was based on clinical and radiographic examination with cone-beam computed tomographic imaging. The extracted teeth were further analyzed by using nanofocus computed tomographic imaging, hard tissue histology, and scanning electron microscopy. All examined teeth showed some common characteristics. Based on the clinical and experimental findings, a 3-stage mechanism of ECR was proposed. At the first stage (ie, the initiation stage), ECR was initiated at the cementum below the gingival epithelial attachment. At the second stage (ie, the resorption stage), the resorption invaded the tooth structure 3-dimensionally toward the pulp space. However, it did not penetrate the pulp space because of the presence of a pericanalar resorption-resistant sheet. This layer was observed to consist of predentin, dentin, and occasionally reparative mineralized (bonelike) tissue, having a fluctuating thickness averaging 210 μm. At the last advanced stage (ie, the repair stage), repair took place by an ingrowth and apposition of bonelike tissue into the resorption cavity. During the reparative stage, repair and remodeling phenomena evolve simultaneously, whereas both resorption and reparative stages progress in parallel at different areas of the tooth. ECR is a dynamic and complex condition that involves periodontal and endodontic tissues. Using clinical, histologic, radiographic, and scanning microscopic analysis, a better understanding of the evolution of ECR is possible. Based on the experimental findings, a 3-stage mechanism for the initiation and growth of ECR is proposed. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Apical root resorption in maxillary incisors when employing micro-implant and J-hook headgear anchorage: a 4-month radiographic study.

PubMed

Wang, Qingzhu; Chen, Wenjing; Smales, Roger J; Peng, Hui; Hu, Xiaokun; Yin, Lu

2012-10-01

This study evaluated, over a 4-month study period, the amount of apical root resorption occurring in maxillary central incisors following their retraction when employing either micro-implant or J-hook headgear anchorage. The prospective randomised clinical trial was conducted in Orthodontic Clinic, College of Stomatology, China from 2008-2009. Subjects are patients requiring fixed appliances on waiting list (n=20). In female Han Chinese patients aged from 16-26 years, standardized periapical radiographs from 10 randomly assigned patients with maxillary protrusions comprising the micro-implant group, and from 10 similar patients comprising the J-hook headgear group, were assessed for maxillary central incisor apical root resorption. Measurements before and after orthodontic therapy were also obtained from lateral cephalometric radiographs to calculate incisor horizontal retraction and vertical intrusion distances. Estimated retraction force vectors were calculated in horizontal and vertical directions for both treatment groups. Data analysis employed t-tests and the Pearson correlation test, with α=0.05 for statistical significance. The results showed that when compared with the J-hook group, significantly more apical root resorption shortening of the maxillary central incisors was observed in the micro-implant group (1.27 mm difference, 95% CI=0.70-1.84, P<0.001), which was associated with a significantly larger retraction distance (P=0.004) and a smaller vertical force component (P<0.0001). We are led to conclude that continuous activation of the nickel-titanium coil springs used in the micro-implant group resulted in significantly more apical root resorption shortening and maxillary central incisor retraction than when intermittent J-hook retraction was employed. The employment of continuous duration orthodontic forces presents a risk for increased apical root resorption that requires careful radiographic monitoring.

Effect of fluoride on root resorption following heavy and light orthodontic force application for 4 weeks and 12 weeks of retention.

PubMed

Karadeniz, Ersan I; Gonzales, Carmen; Turk, Tamer; Isci, Devrim; Sahin-Saglam, Aynur M; Alkis, Huseyin; Elekdag-Turk, Selma; Darendeliler, M Ali

2013-05-01

To evaluate the null hypothesis that fluoride intake via drinking water has no effect on orthodontic root resorption in humans after orthodontic force application for 4 weeks and 12 weeks of retention. Forty-eight patients who required maxillary premolar extractions as part of their orthodontic treatment were selected from two cities in Turkey. These cities had a high and low fluoride concentration in public water of ≥2 pm and ≤0.05 pm, respectively. The patients were randomly separated into four groups of 12 each: group 1HH, high fluoride (≥2 ppm) and heavy force (225 g); group 2LH, low fluoride (≤0.05 ppm) and heavy force; group 3HL, high fluoride and light force (25 g); and group 4LL, low fluoride and light force. Light or heavy buccal tipping force was applied on the upper first premolars for 28 days. At day 28, the left premolars were extracted (positive control side); the right premolars (experimental side) were extracted after 12 weeks of retention. The samples were analyzed with microcomputed tomography. On the positive control side, under heavy force application, the high fluoride groups exhibited less root resorption (P  =  .015). On the experimental side, it was found that fluoride reduced the total volume of root resorption craters; however, this effect was not statistically significant (P  =  .237). Moreover, the results revealed that under heavy force application experimental teeth exhibited more root resorption than positive control groups. The null hypothesis could not be rejected. High fluoride intake from public water did not have a beneficial effect on the severity of root resorption after a 4-week orthodontic force application and 12 weeks of passive retention.

Correlation of Vitamin D status and orthodontic-induced external apical root resorption

PubMed Central

Tehranchi, Azita; Sadighnia, Azin; Younessian, Farnaz; Abdi, Amir H.; Shirvani, Armin

2017-01-01

Background: Adequate Vitamin D is essential for dental and skeletal health in children and adult. The purpose of this study was to assess the correlation of serum Vitamin D level with external-induced apical root resorption (EARR) following fixed orthodontic treatment. Materials and Methods: In this cross-sectional study, the prevalence of Vitamin D deficiency (defined by25-hydroxyvitamin-D) was determined in 34 patients (23.5% male; age range 12–23 years; mean age 16.63 ± 2.84) treated with fixed orthodontic treatment. Root resorption of four maxillary incisors was measured using before and after periapical radiographs (136 measured teeth) by means of a design-to-purpose software to optimize data collection. Teeth with a maximum percentage of root resorption (%EARR) were indicated as representative root resorption for each patient. A multiple linear regression model and Pearson correlation coefficient were used to assess the association of Vitamin D status and observed EARR. P < 0.05 was considered statistically significant. Results: The Pearson coefficient between these two variables was determined about 0.15 (P = 0.38). Regression analysis revealed that Vitamin D status of the patients demonstrated no significant statistical correlation with EARR, after adjustment of confounding variables using linear regression model (P > 0.05). Conclusion: This study suggests that Vitamin D level is not among the clinical variables that are potential contributors for EARR. The prevalence of Vitamin D deficiency does not differ in patients with higher EARR. These data suggest the possibility that Vitamin D insufficiency may not contribute to the development of more apical root resorption although this remains to be confirmed by further longitudinal cohort studies. PMID:29238379

Health of periodontal tissues and resorption status after orthodontic treatment of impacted maxillary canines.

PubMed

Oz, A Z; Ciger, S

2018-03-01

The aim of the present study was to evaluate the changes of incisor root resorption associated with impacted maxillary canines and health of periodontal tissues around maxillary canines erupted with orthodontic treatment. Twenty patients with a unilateral palatally impacted maxillary canine were included in the study. Cone-beam computed tomography images taken before and after orthodontic treatment were compared with the contralateral canines serving as control teeth. Root resorption was present in 10% of central and 40% of lateral incisors before treatment. After treatment, the incidence of resorption decreased. The thickness of the buccal bone surrounding the impacted canines was similar to that surrounding the contralateral canines, except in the apical area. Periodontal pocket depth and alveolar bone loss were greater for the impacted canine teeth than for the contralateral canines. Incisor root resorption associated with impacted canine teeth showed signs of repair after orthodontic treatment. Slight differences related to periodontal health were found between the previously impacted teeth and contralateral canine teeth.

Dental and Cranial Pathologies in Mice Lacking the Cl−/H+-Exchanger ClC-7

PubMed Central

WEN, Xin; LACRUZ, Rodrigo S.; PAINE, Michael L.

2015-01-01

ClC-7 is a 2Cl−/1H+-exchanger expressed at late endosomes and lysosomes, as well as the ruffled border of osteoclasts. ClC-7 deficiencies in mice and humans lead to impaired osteoclast function and therefore osteopetrosis. Failure of tooth eruption is also apparent in ClC-7 mutant animals, and this has been attributed to the osteoclast dysfunction and the subsequent defect in alveolar bone resorptive activity surrounding tooth roots. Ameloblasts also express ClC-7, and this study aims to determine the significance of ClC-7 in enamel formation by examining the dentitions of ClC-7 mutant mice. Micro-CT analysis revealed that the molar teeth of 3-week old ClC-7 mutant mice had no roots, and the incisors were smaller than their age-matched controls. Despite these notable developmental differences, the enamel and dentin densities of the mutant mice were comparable to those of the wild type littermates. Scanning electron microscopy (SEM) showed normal enamel crystallite and prismatic organization in the ClC-7 mutant mice, although the enamel was thinner (hypoplastic) than in controls. These results suggested that ClC-7 was not critical to enamel and dentin formation, and the observed tooth defects may be related more to a resulting alveolar bone phenotype. Micro-CT analysis also revealed abnormal features in the calvarial bones of the mutant mice. The cranial sutures in ClC-7 mutant mice remained open compared to the closed sutures seen in the control mice at 3 weeks. These data demonstrate that ClC-7 deficiency impacts the development of the dentition and calvaria, but does not significantly disrupt amelogenesis. PMID:25663454

Substance P increases production of proinflammatory cytokines and formation of osteoclasts in dental pulp fibroblasts in patients with severe orthodontic root resorption.

PubMed

Yamaguchi, Masaru; Ozawa, Yasuhito; Mishima, Hiroyuki; Aihara, Norihito; Kojima, Tadashi; Kasai, Kazutaka

2008-05-01

The objective of this study was to determine the extent to which substance P (SP) increases proinflammatory cytokine production and osteoclast formation of human dental pulp fibroblasts (HDPF) in patients with severe orthodontically induced inflammatory root resorption (OIIRR). HDPF were obtained from 5 patients with severe apical root resorption after orthodontic treatment. The levels of interleukin (IL)-1beta, IL-6, and tumor necrosis factor (TNF)-alpha were determined after 24 hours by using ELISA kits. Furthermore, culture supernatants were added to cultured human osteoclasts, and osteoclast formation was observed after tartrate-resistant acid phosphatase (TRAP) staining and the formation of resorption cavities. Stimulation with SP increased the levels of IL-1beta, IL-6, and TNF-alpha, in a time- and concentration-dependent manner, although the increase was greater in the severe root resorption (SRR) group than in the nonresorption (NR) group (P < 0.001, 3-way repeated measures ANOVA). As for osteoclast formation, the numbers of TRAP-positive multinucleate cells and resorptive pits were significantly increased in the SRR group compared with the NR group (P < 0.001, 2-way repeated measures ANOVA). These results suggest that HDPF stimulated with SP might be deeply involved in the progress of inflammation in pulp tissue and the incidence of SRR during orthodontic treatment.

Human Life History Evolution Explains Dissociation between the Timing of Tooth Eruption and Peak Rates of Root Growth

PubMed Central

Dean, M. Christopher; Cole, Tim J.

2013-01-01

We explored the relationship between growth in tooth root length and the modern human extended period of childhood. Tooth roots provide support to counter chewing forces and so it is advantageous to grow roots quickly to allow teeth to erupt into function as early as possible. Growth in tooth root length occurs with a characteristic spurt or peak in rate sometime between tooth crown completion and root apex closure. Here we show that in Pan troglodytes the peak in root growth rate coincides with the period of time teeth are erupting into function. However, the timing of peak root velocity in modern humans occurs earlier than expected and coincides better with estimates for tooth eruption times in Homo erectus. With more time to grow longer roots prior to eruption and smaller teeth that now require less support at the time they come into function, the root growth spurt no longer confers any advantage in modern humans. We suggest that a prolonged life history schedule eventually neutralised this adaptation some time after the appearance of Homo erectus. The root spurt persists in modern humans as an intrinsic marker event that shows selection operated, not primarily on tooth tissue growth, but on the process of tooth eruption. This demonstrates the overarching influence of life history evolution on several aspects of dental development. These new insights into tooth root growth now provide an additional line of enquiry that may contribute to future studies of more recent life history and dietary adaptations within the genus Homo. PMID:23342167

Apical root resorption due to orthodontic treatment detected by cone beam computed tomography.

PubMed

Castro, Iury O; Alencar, Ana H G; Valladares-Neto, José; Estrela, Carlos

2013-03-01

To determine the frequency of apical root resorption (ARR) due to orthodontic treatment using cone beam computed tomography (CBCT) in a sample of 1256 roots from 30 patients. All patients had Class I malocclusion with crowding. Of the 30 patients evaluated, 11 were boys and 19 were girls; their mean age was 13 years (11 to 16 years). Orthodontic treatment followed the nonextraction treatment. CBCT images were obtained before and after orthodontic treatment, and ARR was determined using Axial Guided Navigation of CBCT images. All patients had ARR. No statistically significant association was found between resorption frequency, gender, and age. ARR was detected using CBCT in 46% of all roots that underwent orthodontic treatment. CBCT was effective for detecting in vivo even minimal degrees of ARR due to orthodontic treatment and allowed three-dimensional evaluation of dental roots and visualization of palatine roots of maxillary molars. The highest frequencies and the most significant ARR occurred in incisors and distal roots of first maxillary and mandibular molars.

Anti-resorptive effect of pamidronate on extraction socket wall in dogs.

PubMed

Cha, Jae-Kook; Sun, Yoo-Kyung; Kim, Myong Ji; Sanz, Mariano; Jung, Ui-Won

2018-05-12

The aim of this experimental in vivo investigation was to assess the anti-resorptive effect of low concentration pamidronate on the buccal plate in fresh extraction sockets. The distal roots of the third premolars were extracted bilaterally in six dogs. A collagen matrix loaded with either pamidronate (test group) or saline (control group) was positioned on the outer surface of buccal bone immediately after tooth extraction and subsequently covered with a coronally advanced flap. Histological and histomorphometric outcomes were evaluated 12 weeks later. The mean vertical distance between the buccal and lingual bone crest differed significantly between the test and control groups (0.52 ± 0.43 and 2.21 ± 1.15 mm, respectively; p = .037). The width of the buccal bone 1 mm below the crest was significantly wider in the test group than the control group (4.68 ± 0.68 vs. 3.44 ± 0.60 mm, p < .001). Local application of pamidronate onto a collagen matrix may reduce the dimensional changes of the buccal bone plate both vertically and horizontally. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Long-term effects of local pretreatment with alendronate on healing of replanted rat teeth.

PubMed

Komatsu, K; Shimada, A; Shibata, T; Shimoda, S; Oida, S; Kawasaki, K; Nifuji, A

2008-04-01

Our previous study showed that topical alendronate, an inhibitor of bone resorption, reduces root resorption and ankylosis for 21 d after replantation of rat teeth. The aim of the present study was to evaluate the long-term inhibitory effects of topical alendronate in the replanted teeth. The rat maxillary first molars were extracted, placed in saline containing 1 mm alendronate (alendronate group) or saline (saline group) for 5 min and then replanted. The maxillae were dissected at 60 and 120 d. Microcomputed tomography horizontal sections at three root levels were analyzed for root and bone resorption, ankylosis and pulp mineralization. In the alendronate group at 60 and 120 d, the frequencies of resorption of roots and bone were lower than those in the saline group. The p values show statistical significances of lower frequencies in the alendronate group than in the saline group by chi-square test (see Table 1). Ankylosis and pulp mineralization occurred in the alendronate and saline groups. Bone marrow spaces were narrowed in conjunction with bone tissue expansion around the replanted teeth in the alendronate group. The inhibitory effects of topical alendronate were retained on root and bone resorption, but not on ankylosis and pulp mineralization, in the replanted teeth for 4 mo. Alendronate might also stimulate bone formation around the rat replanted teeth.

Invasive cervical resorption following orthodontic treatment: Two cases involving the same patient.

PubMed

Yoshpe, Margarita; Kaufman, Arieh; Lin, Shaul; Gabay, Eran; Einy, Shmuel

2016-01-01

Invasive cervical resorption (ICR), a destructive form of external root resorption, is characterized by invasion of the fibrovascular tissue. This phenomenon is very rare and appears in 0.02% of the general population where the leading factors are orthodontics in addition to trauma, restorations, and bleaching. Heavy orthodontic force may increase the incidence to 1%. One of the main concerns regarding ICR is that it is often misdiagnosed with conventional diagnostic tools. In recent decades, a cone beam computed tomography (CBCT) imaging technique has become more common and can lead to a more accurate diagnosis and treatment plan. This case report describes a possible association between orthodontic treatment and ICR of a 14-year-old male, 18 months post orthodontic treatment. ICR in the mandibular right canine was diagnosed and verified by CBCT, and underwent combined endodontic-periodontal treatment. However, after orthodontic forced eruption was performed on this tooth to improve the bone defect, ICR was diagnosed on the mandibular right second premolar. The possible association between orthodontic treatment and ICR is discussed, as ICR was noted following orthodontic treatment on both occasions. This case report stresses the importance of ICR early detection by close attention to periodic radiographic checkups during orthodontic treatment. The use of modern diagnostic tools is highly recommended in suspicious cases. A case is described in which the patient underwent two types of orthodontic treatment in the mandible at different time periods and developed ICR in two different teeth.

Effect of root canal obturation with calcium silicate materials on pH change in simulated root resorption defects.

PubMed

Aggarwal, Vivek; Singla, Mamta; Miglani, Sanjay; Sharma, Ritu

2018-01-01

This study evaluated the effect of 3 commercially available calcium silicate materials (CSMs) on pH changes in simulated root resorption defects. Simulated root resorption defects were prepared on the facial root surface of 40 mandibular premolars. The depth of each defect was individually calculated to standardize the remaining dentin thickness to 1 mm. Prepared canals were obturated with the 3 CSMs. Ten specimens were kept as controls, filled with unbuffered normal saline. The pH measurements were taken at 1 hour, 6 hours, 1 day, 1 week, 2 weeks, 3 weeks, 1 month, and 2 months. All CSM groups exhibited an initial alkaline pH of 9.0-9.7. The pH decreased to 8.0-8.5 after 2 months of storage. There were no significant differences between pH measurements at other time intervals. The CSM groups exhibited higher pH levels than the control group. The results showed that intracanal placement of the CSMs maintained initial pH levels of 9.0-9.7 inside the simulated resorption defects; these measurements gradually decreased to 8.0-8.5 over the span of 2 months.

Fabrication and anti-microbial evaluation of drug loaded polylactide space filler intended for ridge preservation following tooth extraction

PubMed Central

Thomas, Nebu George; Sanil, George P.; Rajmohan, Gopimohan; Prabhakaran, Jayachandran V.; Panda, Amulya K.

2011-01-01

Background: The preservation or reduction of alveolar ridge resorption following tooth extraction is important in patients especially for those intended for implants at a later stage. One way to achieve this is by using membranes, graft materials, and biodegradable space fillers to prevent alveolar bone resorption and promote regeneration. A major attraction for using biodegradable and biocompatible polymers as space fillers for ridge preservation is their safety profile in comparison to xenograft materials like lyophilized bone and collagen. Materials and Methods: Biocompatible polylactide space fillers were fabricated by fusing porous polylactide particles. The sponges were loaded with drugs by placing them in the respective solutions. Pseudomonas aeruginosa was isolated from a chronic periodontitis patient and in vitro anti-microbial evaluation was done with the drug loaded sponges. Results: Chlorhexidine loaded space filler showed significant anti microbial effect against multiple drug resistant Pseudomonas aeruginosa isolated from a patient with chronic periodontitis. Conclusion: The results of this study indicate that biodegradable drug releasing polylactide space fillers has the potential to be used for ridge preservation following tooth extraction. Release of drugs in the socket may prove useful in preventing development of alveolar osteitis post extraction which can interfere with normal healing of the socket. Synthetic biodegradable polymers also exhibit a controlled degradation rate to achieve complete resorption within the intended time. PMID:22028514

Evaluation of orthodontically induced external root resorption following orthodontic treatment using cone beam computed tomography (CBCT): a systematic review and meta-analysis.

PubMed

Samandara, Aikaterini; Papageorgiou, Spyridon N; Ioannidou-Marathiotou, Ioulia; Kavvadia-Tsatala, Smaragda; Papadopoulos, Moschos A

2018-05-15

Orthodontically induced external root resorption (OIRR) is a pathologic consequence of orthodontic tooth movement. However, the limitations of two-dimensional radiography suggest that cone beam computed tomography (CBCT) with its three-dimensional capabilities might be more suitable to assess OIRR. The aim of this study was to assess in an evidence-based manner data on linear or volumetric OIRR measurements of permanent teeth by means of CBCT, during and/or after the end of orthodontic treatment. Unrestricted electronic and hand searches were performed up to January 2017 in 15 databases. Randomized clinical trials, prospective, and retrospective non-randomized studies assessing OIRR during and/or after orthodontic treatment using CBCT in human patients were included. After duplicate study selection, data extraction, and risk-of-bias assessment according to the Cochrane guidelines, random-effects meta-analyses, followed by subgroup, meta-regression, and sensitivity analyses were also performed in order to evaluate factors that affect OIRR. A total of 33 studies (30 datasets) were included in the qualitative analysis while data from 27 of them were included in the quantitative analysis. Direct comparisons from randomized trials found little to no influence of appliance-related factors on OIRR. Explorative analyses including non-randomized studies found a pooled OIRR of 0.79 mm based on all included studies and 0.86 mm when OIRR was assessed at the end of orthodontic treatment. Statistically significant differences in OIRR were found according to tooth type or jaw, inclusion of extractions, treatment duration, and diagnostic accuracy of the CBCT. Based on the results of this study, CBCT seems to be a reliable tool to examine OIRR during or at the end of orthodontic treatment. Although the average OIRR measured with CBCT seems to lack clinical relevance, there are certain factors that may affect OIRR following orthodontic treatment. Nevertheless, due to data heterogeneity and low quality of the included studies, the corresponding results should be interpreted with some caution. PROSPERO (CRD42016030131).

Physical properties of root cementum: Part I. A new method for 3-dimensional evaluation.

PubMed

Malek, S; Darendeliler, M A; Swain, M V

2001-08-01

Cementum is a nonuniform connective tissue that covers the roots of human teeth. Investigation of the physical properties of cementum may help in understanding or evaluating any possible connection to root resorption. A variety of engineering tests are available to investigate these properties. However, the thickness of the cementum layer varies, and this limits the applicability of these techniques in determining the physical properties of cementum. Hardness testing with Knoop and Vickers indentations overcame some of these limitations, but they prohibited the retrieval and retesting of the sample and therefore the testing was restricted to one area or section of the tooth. Another limiting factor with the existing techniques was the risk of artifacts related to the embedding material such as acrylic. A new method to investigate the physical properties of human premolar cementum was developed to obtain a 3-dimensional map of these properties with the Ultra Micro Indentation System (UMIS-2000; Commonwealth Scientific and Industrial Research Organization, Campbell, Australia). UMIS-2000 is a nano-indentation instrument for investigation of the properties of the near-surface region of materials. Premolars were harvested from orthodontic patients requiring extractions and then mounted on a newly designed surveyor that allowed sample retrieval and 3-dimensional rotation. This novel method enabled the quantitative testing of root surface cementum, on all 4 root surfaces, extending from the apex to the cementoenamel junction at 60 different sites.

An Analysis of the Stress induced in the Periodontal Ligament during Extrusion and Rotation Movements- Part II: A Comparison of Linear vs Nonlinear FEM Study.

PubMed

Hemanth, M; Raghuveer, H P; Rani, M S; Hegde, Chathura; Kabbur, Karthik J; Chaithra, D; Vedavathi, B

2015-10-01

Optimal orthodontic forces are those which stimulate tooth movement with minimal biological trauma to the tooth, periodontal ligament (PDL) during and alveolar bone. Among various types of tooth movements, extrusion and rotational movements are seen to be associated with the least amount of root resorption and have not been studied in detail. The mechanical behavior of the PDL is known to be nonlinear elastic and thus a nonlinear simulation of the PDL provides precision to the calculated stress values. Therefore in this study, the stress patterns in the PDL were evaluated with extrusion and rotational movements using the nonlinear finite element method (FEM). A three-dimensional (3D) FEM model of the maxillary incisors was generated using SOLIDWORKS modelling software. Stresses in the PDL were evaluated with extrusive and rotational movements by a 3D FEM using ANSYS software with nonlinear material properties. It was observed that with the application of extrusive load, the tensile stresses were seen at the apex whereas the compressive stress was distributed at the cervical margin. With the application of rotational movements, maximum compressive stress was distributed at the apex and cervical third whereas the tensile stress was distributed on cervical third of the PDL on the lingual surface. For rotational and extrusion movements, stress values over the periodontal ligament was within the range of optimal stress value as proposed by Lee, with a given force system by Proffit as optimum forces for orthodontic tooth movement using nonlinear properties. During rotation there are stresses concentrated at the apex, hence due to the concentration of the compressive forces at the apex a clinician must avoid placing heavy stresses during tooth movement.

Efficiency of different storage media for avulsed teeth in animal models: a systematic review.

PubMed

Longo, Daniele L; Fumes, Ana C; Küchler, Erika C; Paula-Silva, Francisco W G; Nelson-Filho, Paulo; Silva, Léa A B

2018-02-01

Tooth avulsion consists of the complete displacement of a tooth from the alveolar socket. When immediate replantation is not possible, the avulsed tooth should be kept in a storage medium capable of maintaining the viability of periodontal ligament (PDL) cells on the root surface. However, there is no consensus on the best storage medium able to prevent sequels such as ankylosis and tooth resorption. The aim of this study was to perform a systematic review to evaluate the in vivo effectiveness of different storage media for avulsed teeth. Two reviewers performed a database search for studies published between January 1950 and December 2015 which were indexed in the PubMed, Scopus, Web of Science, and Bireme databases. An additional manual search was performed. Studies with animal models that evaluated tooth avulsion, storage media, and replantation were included. After full-text analysis of the potentially relevant studies, the selected studies were included in the systematic review. The database search found 157 distinct studies evaluating avulsed teeth storage media. However, only six studies met the selection criteria and were included in the review. There was a high variability in the study estimates for the parameters analyzed. When assessing the quality and level of evidence of each study, one study was rated as having a very low level of evidence, four studies had low levels of evidence, and one had a moderate level of evidence. As a result of data heterogeneity and limitations of the studies, there was insufficient evidence to determine the most effective storage medium for avulsed teeth. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Does the Use of a "Walking Bleaching" Technique Increase Bone Resorption Markers?

PubMed

Bersezio, C; Vildósola, P; Sáez, M; Sánchez, F; Vernal, R; Oliveira, O B; Jorquera, G; Basualdo, J; Loguercio, A; Fernández, E

This randomized clinical trial evaluated the effect of 35% hydrogen peroxide in comparison with 37% carbamide peroxide in a nonvital bleaching technique of "walking bleaching" (four sessions of treatment) on periodontal markers: nuclear factor kappa B-ligand (RANK-L-process of root resorption marker) and interleukin 1β (IL-1β-inflammatory response marker). Fifty volunteers presenting with discoloration of nonvital teeth and endodontic treatment in good condition participated. Fifty teeth were randomly divided into two study groups according to bleaching gel: HP = 35% hydrogen peroxide (n=25) and 37% carbamide peroxide (n=25). Nonvital bleaching was performed with a walking bleaching technique consisting of four sessions of bleach application. Gingival crevicular fluid samples were taken in order to quantify the RANK-L and IL-1β levels by enzyme-linked immunosorbent assay. Samples were obtained from six periodontal sites for each bleached tooth: three vestibular and three palatine (mesial, middle, and distal) at seven time periods: baseline, after each of the four sessions of nonvital bleaching, at one week, and at one month after nonvital bleaching. Tooth color variations were analyzed in each session by VITA Bleachedguide 3D-MASTER (ΔSGU). Significant increments in the RANK-L and IL-1β levels were detected in each evaluated time compared with baseline ( p<0.05); however, no differences were detected between hydrogen peroxide and carbamide peroxide on increments of the biomarkers studied. The change of color was effective for both nonvital bleaching therapies ( p<0.05). Nonvital bleaching induced a significant increment in the RANK-L and IL-1β levels in periodontal tissues around bleached, nonvital teeth.

Microscopic morphological changes of the tooth surface in relation to fixed orthodontic treatment.

PubMed

Preoteasa, Cristina Teodora; NiŢoi, Dan Florin; Preoteasa, Elena

2015-01-01

Orthodontic treatment has, as any other medical intervention, in addition to its benefits, side effects, some of them being perceived as unavoidable. The aim of this case series was to microscopically evaluate the changes of the tooth surface in relation to fixed orthodontic treatment. A case series study was implemented by the usage of four extracted first maxillary premolars, from patients with previous orthodontic treatment, of 12 and 23 months. Analysis was performed using the high precision stereomicroscope (Axiovert, Carl Zeiss, Germany), at magnifications from 10× to 50×. The tooth surface corresponding to the bracket bonding area registered numerous disorderly grooves and cracks, with various directions and depths, and was flattened, having lower convexity compared to teeth surfaces where brackets were not bonded. Root resorption lacunae were more frequently observed in teeth under orthodontic treatment, these having various depths, and sizes considerably larger than those observed in teeth without orthodontic treatment. Following orthodontic treatment, teeth exhibit changes that can be perceived as being directly linked to this medical intervention. These teeth changes usually have low or moderate severity, which can be influenced at some degree by the clinical conduct of the orthodontic treatment. The stereomicroscope proved to be a high sensitivity tool for the analysis of morphological changes of teeth in relation to the fixed orthodontic treatment.

[Orthodontic treatment of patients medicated with bisphosphonates-a clinical case report].

PubMed

Krieger, Elena; d'Hoedt, Bernd; Scheller, Herbert; Jacobs, Collin; Walter, Christian; Wehrbein, Heinrich

2013-01-01

Bisphosphonates (BP) are an established medication, e.g., for the prevention/therapy of osteoporosis. The effects of the changed bone metabolism for orthodontic treatments are unknown. A 66-year-old woman underwent a total oral rehabilitation. The therapy included (1) tooth extractions, (2) periodontal treatment, (3) insertion of dental implants, (4) provisional implant restorations, (5) orthodontic treatment, and (6) definite implant restorations. The orthodontic tooth movements were in- and retrusion of the upper frontal teeth, intrusion of the lower front teeth, using the dental implants as skeletal anchorage. After implant insertion and one month before beginning the orthodontic treatment, osteoporosis was diagnosed in this patient and, without notification to our facility, BP treatment was initiated by her general practitioner (alendronate oral, 70 mg/week), with an overall duration of intake of 7 months. After 13 months, the orthodontic treatment was successfully accomplished; however enlarged periodontal gaps, sclerotic bone areas, and mild apical root resorptions of the upper frontal teeth were found in this patient. Currently, there are no recommendations for orthodontic patients undergoing BP therapy. Orthodontic tooth movement in this low-risk patient with a short duration of intake and a low-dose BP medication was possible. Because of the reduced bone metabolism and the higher amount of side effects, the treatment should be performed with extremely light forces and frequent monitoring.

Root resorption of endodontically treated teeth following orthodontic treatment: a meta-analysis.

PubMed

Ioannidou-Marathiotou, Ioulia; Zafeiriadis, Anastasios A; Papadopoulos, Moschos A

2013-09-01

The aim of this meta-analysis was to investigate the effect of orthodontic treatment on root resorption of endodontically treated teeth compared to vital teeth. A literature search was conducted in 18 electronic databases. Review articles and relevant articles were searched for cross-references. Two independent reviewers screened all articles according to predefined inclusion and exclusion criteria and extracted the corresponding data. The pooled estimate of mean difference of root resorption weighted by the fixed-effect model and the corresponding 95 % confidence intervals (CIs) were used to construct a forest plot by implementing the "RevMan 5.1" software. Quality and heterogeneity assessments as well as publication bias evaluation and sensitivity analyses were performed. Inter-reviewer agreement for data selection, data extraction and quality analysis was evaluated by Cohen's kappa. Six out of 1,942 original papers met the inclusion criteria. Four out of six studies were included in the quantitative analysis. Root resorption was less in endodontically treated teeth than in vital teeth (MD = -0.48 mm; 95 % CI = -0.81 to -0.14 mm). The funnel plot indicated no evidence of publication bias, while no data heterogeneity was present (I(2) = 0 %). However, the overall quality of the included studies was considered as "low." Following orthodontic treatment, endodontically treated teeth exhibit relatively less root resorption than teeth with vital pulps. Clinicians should consider orthodontic movement of endodontically treated teeth as a relatively safe clinical procedure.

An evaluation of clinical, radiological and three-dimensional dental tomography findings in ectodermal dysplasia cases

PubMed Central

Doğan, Mehmet-Sinan; Callea, Michele; Aksoy, Orhan; Clarich, Gabriella; Günay, Ayşe; Günay, Ahmet; Güven, Sedat; Maglione, Michele; Akkuş, Zeki

2015-01-01

Background This study aimed to review the results related to head and jaw disorders in cases of ectodermal dysplasia. The evaluation of ectodermal dysplasia cases was made by clincal examination and examination of the jaw and facial areas radiologically and on cone-beam 3-dimensional dental tomography (CBCT) images. Material and Methods In the 36 cases evaluated in the study, typical clinical findings of pure hypohidrotic ectodermal displasia (HED) were seen, such as missing teeth, dry skin, hair and nail disorders. CBCT images were obtained from 12 of the 36 cases, aged 1.5- 45 years, and orthodontic analyses were made on these images. Results The clinical and radiological evaluations determined, hypodontia or oligodontia, breathing problems, sweating problems, a history of fever, sparse hair, saddle nose, skin peeling, hypopigmentation, hyperpigmentation, finger and nail deformities, conical teeth anomalies, abnormal tooth root formation, tooth resorption in the root, gingivitis, history of epilepsy, absent lachrymal canals and vision problems in the cases which included to the study. Conclusions Ectodermal dysplasia cases have a particular place in dentistry and require a professional, multi-disciplinary approach in respect of the chewing function, orthognathic problems, growth, oral and dental health. It has been understood that with data obtained from modern technologies such as three-dimensional dental tomography and the treatments applied, the quality of life of these cases can be improved. Key words: Ectodermal dysplasia, three-dimensional dental tomography. PMID:25662550

Endodontic Treatment of an Anomalous Anterior Tooth with the Aid of a 3-dimensional Printed Physical Tooth Model.

PubMed

Byun, Chanhee; Kim, Changhwan; Cho, Seungryong; Baek, Seung Hoon; Kim, Gyutae; Kim, Sahng G; Kim, Sun-Young

2015-06-01

Endodontic treatment of tooth formation anomalies is a challenge to clinicians and as such requires a complete understanding of the aberrant root canal anatomy followed by careful root canal disinfection and obturation. Here, we report the use of a 3-dimensional (3D) printed physical tooth model including internal root canal structures for the endodontic treatment of a challenging tooth anomaly. A 12-year-old boy was referred for endodontic treatment of tooth #8. The tooth showed class II mobility with swelling and a sinus tract in the buccal mucosa and periapical radiolucency. The tooth presented a very narrow structure between the crown and root by distal concavity and a severely dilacerated root. Moreover, a perforation site with bleeding and another ditching site were identified around the cervical area in the access cavity. A translucent physical tooth model carrying the information on internal root canal structures was built through a 3-step process: data acquisition by cone-beam computed tomographic scanning, virtual modeling by image processing, and manufacturing by 3D printing. A custom-made guide jig was then fabricated to achieve a safe and precise working path to the root canal. Endodontic procedures including access cavity preparation were performed using the physical tooth model and the guide jig. At the 7-month follow-up, the endodontically treated tooth showed complete periapical healing with no clinical signs and symptoms. This case report describes a novel method of endodontic treatment of an anomalous maxillary central incisor with the aid of a physical tooth model and a custom-made guide jig via 3D printing technique. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

External cervical resorption: an analysis using cone beam and microfocus computed tomography and scanning electron microscopy.

PubMed

Gunst, V; Mavridou, A; Huybrechts, B; Van Gorp, G; Bergmans, L; Lambrechts, P

2013-09-01

To provide a three-dimensional representation of external cervical resorption (ECR) with microscopy, stereo microscopy, cone beam computed tomography (CT), microfocus CT and scanning electron microscopy (SEM). External cervical resorption is an aggressive form of root resorption, leading to a loss of dental hard tissues. This is due to clastic action, activated by a damage of the covering cementum and stimulated probably by infection. Clinically, it is a challenging situation as it is characterized by a late symptomatology. This is due to the pericanalar protection from a resorption-resistant sheet, composed of pre-dentine and surrounding dentine. The clastic activity is often associated with an attempt to repair, seen by the formation of osteoid tissue. Cone beam CT is extremely useful in the diagnoses and treatment planning of ECR. SEM analyses provide a better insight into the activity of osteoclasts. The root canal is surrounded by a layer of dentine that is resistant to resorption. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Functional Tooth Restoration by Allogeneic Mesenchymal Stem Cell-Based Bio-Root Regeneration in Swine

PubMed Central

Wei, Fulan; Song, Tieli; Ding, Gang; Xu, Junji; Liu, Yi; Liu, Dayong; Fan, Zhipeng; Zhang, Chunmei

2013-01-01

Our previous proof-of-concept study showed the feasibility of regenerating the dental stem cell-based bioengineered tooth root (bio-root) structure in a large animal model. Here, we used allogeneic dental mesenchymal stem cells to regenerate bio-root, and then installed a crown on the bio-root to restore tooth function. A root shape hydroxyapatite tricalcium phosphate scaffold containing dental pulp stem cells was covered by a Vc-induced periodontal ligament stem cell sheet and implanted into a newly generated jaw bone implant socket. Six months after implantation, a prefabricated porcelain crown was cemented to the implant and subjected to tooth function. Clinical, radiological, histological, ultrastructural, systemic immunological evaluations and mechanical properties were analyzed for dynamic changes in the bio-root structure. The regenerated bio-root exhibited characteristics of a normal tooth after 6 months of use, including dentinal tubule-like and functional periodontal ligament-like structures. No immunological response to the bio-roots was observed. We developed a standard stem cell procedure for bio-root regeneration to restore adult tooth function. This study is the first to successfully regenerate a functional bio-root structure for artificial crown restoration by using allogeneic dental stem cells and Vc-induced cell sheet, and assess the recipient immune response in a preclinical model. PMID:23363023

Six-year follow-up in skeletal Class III patient aged over 40 receiving orthognathic surgery and autotransplantation: a case report.

PubMed

Motegi, Etsuko; Takane, Yumi; Tokunaga, Eri; Sueishi, Kenji; Takano, Nobuo; Shibahara, Takahiko; Saito, Chikara

2009-08-01

This paper describes the post-operative course of care in a patient requiring orthognathic surgery for skeletal mandibular protrusion in whom autotransplantation of a third molar was performed. A lower third molar that had to be removed for sagittal split ramus osteotomy (SSRO) was transplanted to replace the missing right second molar during pre-surgical orthodontic treatment, contributing to post-treatment occlusal stability. A 44-year-old woman presented with mandibular protrusion. The upper left second molar was congenitally missing and the lower right second molar had been extracted. She was diagnosed as having skeletal mandibular protrusion with excess vertical growth of the mandible and anterior open bite. Correction of the skeletal problem required orthognathic surgery by SSRO and Le Fort I osteotomy without orthodontic tooth extraction. At month 5 during 18 months of pre-surgical orthodontic treatment, the lower left third molar was transplanted to the lower right second molar site. Active treatment was completed after 7 months of post-surgical orthodontic treatment. The patient wore upper and lower Begg-type removable retainers for approximately 2 years. She returned for a recall checkup at 6 years post-treatment. Although radiographic examination revealed root resorption and ankylosis of the autotransplanted tooth at 8 years after transplantation, occlusion has remained stable with no clinically significant complications. The autotransplanted tooth helped stabilize her occlusion and acted as a kind of temporary tooth prior to the final decision on treatment to be given such a dental implant.

Labial soft tissue volume evaluation of different techniques for ridge preservation after tooth extraction: a randomized controlled clinical trial.

PubMed

Schneider, David; Schmidlin, Patrick R; Philipp, Alexander; Annen, Beat M; Ronay, Valerie; Hämmerle, Christoph H F; Attin, Thomas; Jung, Ronald E

2014-06-01

To volumetrically evaluate soft tissue changes of different ridge preservation techniques compared to spontaneous healing 6 months after tooth extraction. In each of 40 patients, one single-rooted tooth was extracted and four treatment modalities were randomly assigned to the following groups (n = 10 each): A) ß-tricalcium-phosphate-particles with a polylactid coating (ß-TCP), B) demineralized bovine bone mineral with 10% collagen covered with a collagen matrix (DBBM-C/CM), C) DBBM with 10% collagen covered with an autogenous soft tissue punch graft (DBBM-C/PG), D) spontaneous healing (control). Impressions were obtained before extraction and 6 months later, casts were digitized and volumetric changes at the buccal soft tissues were determined. One-way anova was performed and pair-wise Wilcoxon rank sum test with Bonferroni-Holm method was applied for comparison of differences between two groups. After 6 months, horizontal contour changes accounted for -1.7 ± 0.7 mm (A), -1.2 ± 0.5 mm (B), -1.2 ± 0.7 mm (C) and -1.8 ± 0.8 mm (D). None of the group comparisons reached statistical significance. Six months after tooth extraction all groups revealed a horizontal volume change in the buccal soft tissue contour. Application of DBBM-C/CM or DBBM-C/PG reduced the amount of volume resorption compared to ß-TCP or spontaneous healing without reaching statistically significant difference. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Management of failed periodontal surgical intervention for a furcal lesion with a nonsurgical endodontic approach

PubMed Central

Asgary, Saeed

2014-01-01

As long as the prognosis of teeth remains a matter of concern, the endodontic-periodontal relationship will be considered a challenge for the clinician. Many etiologic factors, including bacteria, fungi, and viruses, plus other contributing factors, such as trauma, root resorptions/perforations, and dental malformations, play a role in the co-occurrence of endodontic and periodontal lesions. Whatever the cause, a correct diagnosis on which to base the treatment plan is the key to successful maintenance of the tooth. This article reports the successful endodontic management of a furcation lesion in a mandibular molar that was nonresponsive to a previous periodontal surgical graft. The case had presented a diagnostic challenge for the clinicians, and this article reviews the key points that can lead to a correct diagnosis and treatment planning. PMID:24790924

Delayed orthodontic extrusion of a traumatically intruded immature upper permanent incisor - a case report.

PubMed

Umesan, Uday Kumar; Chua, Kui Lay; Kok, Ei Chuen

2014-10-01

Dental injuries are probably the most common orofacial injuries sustained during sports and play. Intrusion or intrusive luxations occur when the teeth are driven into the alveolus by an axially directed impact. This article describes the clinical case of an 8-year-old patient who suffered complete intrusive luxation of an immature permanent central incisor following an accident. An attempt at spontaneous re-eruption failed to facilitate re-emergence of the tooth beyond 2 mm. The recommended wait-and-see strategy in anticipation of spontaneous re-eruption should cease to be an option when no further elongation can be observed. Orthodontic extrusion or surgical re-positioning is a valid treatment alternative when the former fails. In this case, although the recommended time period for effecting orthodontic extrusion had elapsed, this procedure was undertaken successfully presumably owing to the application of controlled, biologically optimal forces. A review of the extruded tooth a year later revealed no clinical or radiographic signs of loss of vitality. This was confirmed radiographically by the completion of root development, an intact lamina dura and no evident signs of resorption. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Effectiveness of selective alveolar decortication in accelerating orthodontic treatment: a systematic review].

PubMed

Fau, Victor; Diep, Dany; Bader, Gérard; Brézulier, Damien; Sorel, Olivier

2017-06-01

The number of scientific publications on accelerating orthodontic treatment, and especially surgical alveolar corticotomies techniques, has grown exponentially over the years. The objective of this systematic literature review was to assess the effectiveness of these corticotomies basing on human studies. The review was conducted from Medline and Web of Science Core Collection to identify prospective controlled clinical trials with duration of orthodontic treatment or the tooth movement rate for primary endpoint. Eleven studies respected all inclusion criteria. Six investigated the duration of treatment and found shorter values in experimental group than in control group, with a gain of 8 to 34 weeks. Five investigated the tooth movement rate and found 2.3 times higher values on average during the first month in experimental groups, 1.9 times during the second and third months, and 1.3 times during the fourth month. The technique also seemed to decrease the risk of root resorption and improve molar anchorage. Moreover, it exhibited good periodontal tolerance. Current literature highlights the effectiveness of surgical decortications during the first three to four months after surgery. Longer prospective studies are needed to assess their long term effects. © EDP Sciences, SFODF, 2017.

Abnormalities of tooth development in pituitary dwarfism.

PubMed

Kosowicz, J; Rzymski, K

1977-12-01

Roentgenographic studies of the jaws and teeth in a group of forty-eight pituitary dwarfs showed the following abnormalities in the development of the teeth: 1. Delayed shedding of the deciduous teeth. 2. Absence of resorption of the roots of the deciduous teeth at the usual time. 3. Marked delay in eruption of the permanent teeth. 4. Retention of permanent teeth in the maxillary and mandibular shafts. 5. Development of the apical parts of roots of the retained permanent teeth and their growth toward the lower mandibular edge. 6. Displacement of the first molars from the mandibular shaft to rami. 7. Tilting of some of the retained teeth. 8. Small size of the maxilla and mandible with overcrowding of the teeth in these bones. 9. Complete absence of buds of the wisdom teeth, even in patients in the fourth decade of life. 10. Stimulation of development and eruption of the teeth after administration of anabolic drugs. These abnormalities when present in combination depend on growth hormone deficiency since they do not occur in other types of dwarfism.

Dentine sialoprotein expression in gingival crevicular fluid during trauma-induced root resorption.

PubMed

Kumar, V; Logani, A; Shah, N

2013-04-01

To detect and quantify dentine sialoprotein (DSP) in the gingival crevicular fluid (GCF) of luxated teeth. Eighteen subjects were enroled and distributed as follows. Group I (n = 6, positive control): subjects with primary second molar teeth undergoing physiological root resorption. Group II (n = 6, negative control): subjects with permanent mature maxillary central incisors. Subjects with a recent history (<1 week) of luxation injury were included in group III (n = 6, test group) and standardized digital radiographs with a superimposed mesh gauge were exposed at various time intervals. Percentage of radiographic root resorption (%RRR) was calculated. GCF was collected using microcapillary pipettes. DSP in the GCF was quantified using enzyme-linked immunosorbant assay. Group III was subjected to Spearman's rank test to establish the correlation between the concentration of DSP and %RRR at 6 weeks, 3 and 6 months. Quantifiable amounts of DSP were released in the GCF of subjects in Group I and III. However, the protein was not detected in Group II. Detectable quantities of DSP were observed in the GCF of luxated teeth before any radiographic evidence of root resorption (base line radiograph). A positive correlation was established at 6 weeks (r = 0.795), 3 (r = 0.755) and 6 month (r = 0.837) between the release of DSP and %RRR (P < 0.05). Dentine sialoprotein was released in the GCF of luxated teeth and its concentration correlated with the active and remission phases of this pathological process. Further investigation is required to establish a potentially noninvasive aid for diagnosing and monitoring root resorption. © 2012 International Endodontic Journal.

The effects of binge-pattern alcohol consumption on orthodontic tooth movement

PubMed Central

de Araujo, Cristiano Miranda; Johann, Aline Cristina Batista Rodrigues; Camargo, Elisa Souza; Tanaka, Orlando Motohiro

2014-01-01

OBJECTIVE: This study aimed to assess tissue changes during orthodontic movement after binge-pattern ethanol 20% exposure. METHODS: Male Wistar rats (n = 54) were divided into two groups. The control group (CG) received 0.9% saline solution, while the experimental group (EG) received 20% ethanol in 0.9% saline solution (3 g/kg/day). On the 30th day, a force of 25 cN was applied with a nickel-titanium closed coil spring to move the maxillary right first molar mesially. The groups were further divided into three subgroups (2, 14 and 28 days). Tartrate-resistant acid phosphatase and picrosirius were used to assess bone resorption and neoformation, respectively. Data were compared by two-way ANOVA, Tukey's HSD, Games-Howell and chi-square test. Significance level was set at 5%. RESULTS: There was a decrease in the number of osteoclasts in EG at day 28. The percentage of collagen showed no interaction between group and time. CONCLUSION: Binge-pattern 20% ethanol promoted less bone resorption at the end of tooth movement, thereby suggesting delay in tooth movement. PMID:25628085

Treatment of Necrotic Teeth by Apical Revascularization: Meta-analysis.

PubMed

He, Ling; Zhong, Juan; Gong, Qimei; Kim, Sahng G; Zeichner, Samuel J; Xiang, Lusai; Ye, Ling; Zhou, Xuedong; Zheng, Jinxuan; Liu, Yongxing; Guan, Chenyu; Cheng, Bin; Ling, Junqi; Mao, Jeremy J

2017-10-24

Each year ~5.4 million children and adolescents in the United States suffer from dental infections, leading to pulp necrosis, arrested tooth-root development and tooth loss. Apical revascularization, adopted by the American Dental Association for its perceived ability to enable postoperative tooth-root growth, is being accepted worldwide. The objective of the present study is to perform a meta-analysis on apical revascularization. Literature search yielded 22 studies following PRISMA with pre-defined inclusion and exclusion criteria. Intraclass correlation coefficient was calculated to account for inter-examiner variation. Following apical revascularization with 6- to 66-month recalls, root apices remained open in 13.9% cases (types I), whereas apical calcification bridge formed in 47.2% (type II) and apical closure (type III) in 38.9% cases. Tooth-root lengths lacked significant postoperative gain among all subjects (p = 0.3472) or in subgroups. Root-dentin area showed significant increases in type III, but not in types I or II cases. Root apices narrowed significantly in types II and III, but not in type I patients. Thus, apical revascularization facilitates tooth-root development but lacks consistency in promoting root lengthening, widening or apical closure. Post-operative tooth-root development in immature permanent teeth represents a generalized challenge to regenerate diseased pediatric tissues that must grow to avoid organ defects.

Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

PubMed

Guarnieri, R; Cavallini, C; Vernucci, R; Vichi, M; Leonardi, R; Barbato, E

2016-11-01

The prevalence of impacted maxillary canine is reported to be between 1% and 3%. The lack of monitoring and the delay in the treatment of the impacted canine can cause different complications such as: displacement of adjacent teeth, loss of vitality of neighbouring teeth, shortening of the dental arch, follicular cysts, canine ankylosis, recurrent infections, recurrent pain, internal resorption of the canine and the adjacent teeth, external resorption of the canine and the adjacent teeth, combination of these factors. An appropriate diagnosis, accurate predictive analysis and early intervention are likely to prevent such undesirable effects. The objective is to evaluate, by means of a retrospective observational study, the possibility of carrying out a predictive analysis of root resorption adjacent to the impacted canines by means of orthopantomographs, so as to limit the prescription of additional 3D radiography. 120 subjects with unilateral or bilateral maxillary impacted canine were examined and 50 patients with 69 impacted maxillary canine (22 male, 28 female; mean age: 11.7 years) satisfied the inclusion criteria of the study. These patients were subjected to a basic clinical and radiographic investigation (orthopantomographs and computerized tomography). All panoramic films were viewed under standardized conditions for the evaluation of two main variables: maxillary canine angulations (a, b, g angles) and the overlapping between the impacted teeth and the lateral incisor (Analysis of Lindauer). Binary logistic regression was used to estimate the likelihood of resorbed lateral incisors depending on sector location and angle measurements. Results indicated that b angle has the greatest influence on the prediction of root resorption (predictive value of b angle = 76%). If β angle <18° and Lindauer = I, the probability of resorption is 0.06. Evaluation of b angle and superimposition lateral incisor/impacted canine analysed on orthopantomographs could be one of the evaluation criteria for prescribing second level examination (CT and CTCB) and for detecting root resorption of impacted maxillary canine adjacent teeth.

The effect of the heights and thicknesses of the remaining root segments on buccal bone resorption in the socket-shield technique: An experimental study in dogs.

PubMed

Tan, Zhen; Kang, Jian; Liu, Wenjia; Wang, Hang

2018-06-01

To date only a few studies have been done on the use of the socket-shield technique for preserving the resorption of the buccal bone in aesthetically sensitive sites. Besides, there have been no further studies on the effect of the heights and thicknesses of the remaining root segments on buccal bone resorption when using this method. The aim of this study was to evaluate the effect of different heights and thicknesses of the remaining root segments on bone resorption in the socket-shield technique. Four healthy female beagle dogs were used in this study. The third premolar (P3) and the fourth premolar (P4) on both sides of the mandible were hemisected in the buccal-lingual direction, and the clinical crown of the distal root was beheaded. In the experimental groups, the roots were worn down in the apical direction until they were located at the buccal crestal level (Group A) or 1 mm higher than that level (Group B). In the control group, the distal root segments were extracted. Then, implant placement was performed into the distal root. After 3 months of healing, the specimens were prepared for histological diagnosis. There was no difference between Group A and Group B when using the socket-shield technique, but the results of both groups were better than those of the control group. The height of the root segments has little effect on the bone absorption of alveolar bone, while the bone absorption was strongly influenced by the thickness of the root segments. More precisely, the absorption may decrease if the thickness of the root fragment increases, when the thickness of the root plate is in the 0.5-1.5 mm range. © 2018 Wiley Periodicals, Inc.

Etiology and sequelae of root resorption.

PubMed

Vlaskalic, V; Boyd, R L; Baumrind, S

1998-06-01

This article reviews the current status of investigation into apical root resorption within the context of orthodontic treatment. Treatment and patient factors that have traditionally been investigated are discussed, along with the results of current research in this area. The need for rethinking traditional research strategies in the quest for identifying both control and causative mechanisms is explored. Finally, proposals for key areas of future interest are highlighted.

Root resorption, treatment time and extraction rate during orthodontic treatment with self-ligating and conventional brackets

PubMed Central

2014-01-01

Introduction This study determined the amount and severity of EARR (external apical root resorption) after orthodontic treatment with self-ligating (SL) and conventional (Non-SL) brackets. Differences regarding rate of extraction cases, appointments and treatment time were evaluated. Material and methods 213 patients with a mean age of 12.4 ± 2.2 years were evaluated retrospectively. The treatments were performed with SL brackets (n = 139, Smartclip, 3 M Unitek, USA) or Non-SL brackets (n = 74, Victory Series, 3 M Unitek, USA). Measurements of the crown and root length of the incisors were taken using panoramic radiographs. Three-factor analysis of variance (ANOVA) was performed for an appliance effect. Results There was no difference between patients treated with Non-SL or SL brackets regarding the amount (in percentage) of EARR (Non-SL: 4.5 ± 6.6 vs. SL: 3.0 ± 5.6). Occurrence of severe EARR (sEARR) did also not differ between the two groups (Non-SL 0.5 vs. SL: 0.3). The percentage of patients with need of tooth extraction for treatment (Non SL: 8.1 vs. SL: 6.9) and the number of appointments (Non-SL: 12.4 ± 3.4 vs. SL: 13.9 ± 3.3) did not show any differences. The treatment time was shorter with Non-SL brackets (Non-SL: 18.1 ± 5.3 vs. SL: 20.7 ± 4.9 months). Conclusions This is the largest study showing that there is no difference in the amount of EARR, number of appointments and extraction rate between conventional and self-ligating brackets. For the first time we could demonstrate that occurrence of sEARR does not differ between the two types of brackets. PMID:24456620

Biomaterial Selection for Tooth Regeneration

PubMed Central

Yuan, Zhenglin; Nie, Hemin; Wang, Shuang; Lee, Chang Hun; Li, Ang; Fu, Susan Y.; Zhou, Hong

2011-01-01

Biomaterials are native or synthetic polymers that act as carriers for drug delivery or scaffolds for tissue regeneration. When implanted in vivo, biomaterials should be nontoxic and exert intended functions. For tooth regeneration, biomaterials have primarily served as a scaffold for (1) transplanted stem cells and/or (2) recruitment of endogenous stem cells. This article critically synthesizes our knowledge of biomaterial use in tooth regeneration, including the selection of native and/or synthetic polymers, three-dimensional scaffold fabrication, stem cell transplantation, and stem cell homing. A tooth is a complex biological organ. Tooth loss represents the most common organ failure. Tooth regeneration encompasses not only regrowth of an entire tooth as an organ, but also biological restoration of individual components of the tooth including enamel, dentin, cementum, or dental pulp. Regeneration of tooth root represents perhaps more near-term opportunities than the regeneration of the whole tooth. In the adult, a tooth owes its biological vitality, arguably more, to the root than the crown. Biomaterials are indispensible for the regeneration of tooth root, tooth crown, dental pulp, or an entire tooth. PMID:21699433

Eight-year follow-up of autogenous tooth transplantation involving multidisciplinary treatment.

PubMed

Candeiro, George T M; Alencar-Júnior, Emmanuel A; Scarparo, Henrique C; Furtado-Júnior, João H C; Gavini, Giulio; Caldeira, Celso L

2015-09-01

Although autogenous tooth transplantation is a widely reported procedure, its success is dependent on a number of factors. Here we describe the surgical technique, endodontic treatment and rehabilitation employed for a patient in whom a lower right third molar was transplanted to substitute an adjacent second molar with extensive caries. During an 8-year follow-up period, normal periodontal healing was observed and no infection, ankylosis or progressive resorption occurred. It may be concluded that transplantation of a third molar is a practicable approach for replacement of a lost permanent tooth, with restoration of esthetics and function.

Towards a synthetic osteo-odonto-keratoprosthesis.

PubMed

Viitala, Reeta; Franklin, Valerie; Green, David; Liu, Christopher; Lloyd, Andrew; Tighe, Brian

2009-01-01

Osteo-odonto-keratoprostheses (OOKP) is a unique form of keratoprosthesis involving surgical removal of a tooth root and surrounding bone from the patient which are then used to construct an osteo-odonto lamina into which an optical cylinder is cemented. The OOKP procedure is successful and capable of withstanding the very hostile ocular environments found in severe Stevens-Johnson syndrome, pemphigoid, chemical burns, trachoma and multiple corneal graft failure. The existing procedure is complex and time consuming in terms of operative time, and additionally involves sacrifice of the oral structures. This paper discusses the rational search for a "synthetic" analogue of the dental lamina, capable of mimicking those features of the natural system that are responsible for the success of OOKP. In this study the degradation of selected commercial and natural bioceramics was tested in vitro using a purpose-designed resorption assay. Degradation rate was compared with tooth and bone, which are currently used in OOKP lamina. At normal physiological pH the degradation of bioceramics was equivalent to tooth and bone; however, at pH 6.5-5.0, associated with infectious and inflamed tissues, the bioceramics degrade more rapidly. At lower pH the degradation rate decreased in the following order: calcium carbonate corals>biphasic calcium phosphates>hydroxyapatite. Porosity did not significantly influence these degradation rates. Such degradation is likely to compromise the stability and viability of the synthetic OOKP. Consequently more chemically stable materials are required that are optimized for the surrounding ocular environment.

Unusual complication after genioplasty.

PubMed

Avelar, Rafael Linard; Sá, Carlos Diego Lopes; Esses, Diego Felipe Silveira; Becker, Otávio Emmel; Soares, Eduardo Costa Studart; de Oliveira, Rogerio Belle

2014-01-01

Facial beauty depends on shape, proportion, and harmony between the facial thirds. The chin is one of the most important components of the inferior third and has an important role on the definition of facial aesthetic and harmony in both frontal and lateral views. There are 2 principal therapeutic approaches that one can choose to treat mental deformities, alloplastic implants, and mental basilar ostectomy, also known as genioplasty. The latest is more commonly used because of great versatility in the correction of three-dimensional deformities of the chin and smaller taxes of postoperative complications. Possible transoperative and postoperative complications of genioplasty include mental nerve lesion, bleeding, damage to tooth roots, bone resorption of the mobilized segment, mandibular fracture, ptosis of the lower lip, and failure to stabilize the ostectomized segment. The study presents 2 cases of displacement of the osteotomized segment after genioplasty associated with facial trauma during postoperative orthognathic surgery followed by rare complications with no reports in the literature.

Pre-eruptive intracoronal resorption in a third upper molar: clinical, tomographic and histological analysis.

PubMed

Lenzi, R; Marceliano-Alves, M F; Alves, Frf; Pires, F R; Fidel, S

2017-06-01

Radiolucent or hypodense lesions in the crown of unerupted teeth may be due to pre-eruptive intracoronal resorption. Clinicians must be aware of this risk so that they can diagnose and appropriately treat this condition. The purpose of this study is to present a well-documented clinical case of pre-eruptive intracoronal resorption in an impacted third upper left molar of a 63 year old female patient. This was an unexpected finding, which occurred after cone-beam computed tomography was used to investigate the first upper left molar, which had an acute periradicular abscess. A multidisciplinary team followed up the case to describe clinical, radiographic and histological findings. The available treatment options were discussed, and the tooth extraction was the option chosen. Previous case studies describing such resorption in third upper molars have not been reported. This case shows that all permanent teeth in a pre-eruptive stage must be analysed radiographically to detect early pre-eruptive intracoronal resorption. © 2016 Australian Dental Association.

Delayed replantation of rat teeth after use of reconstituted powdered milk as a storage medium.

PubMed

dos Santos, Cláudia Letícia Vendrame; Sonoda, Celso Koogi; Poi, Wilson Roberto; Panzarini, Sônia Regina; Sundefeld, Maria Lúcia Marçal Mazza; Negri, Márcia Regina

2009-02-01

Minimal extraoral dry storage period and moist storage for the avulsed tooth are identified as key steps for the treatment protocol of tooth replantation. Among the possible moist storage media, bovine milk has stood out because of its capacity of preserving the integrity of the periodontal ligament (PDL) fibers. This condition has attracted the attention to investigate the use of powdered milk, which is one of the presentation forms of bovine milk, as a feasible storage medium in cases of delayed tooth replantation. The aim of this study was to evaluate the healing process after delayed replantation of rat teeth stored in reconstituted powdered milk and long shelf-life (ultra high temperature) whole milk. Forty maxillary right rat incisors were assigned to four groups (n = 10): group I--the teeth were extracted and immediately replanted into theirs sockets; group II--the teeth were stored for 60 min in 200 ml of freshly reconstituted powdered milk; group III--the teeth were stored for 60 min in 200 ml of long shelf-life whole milk; group IV--the teeth were kept dry for the same time. All procedures were performed at room temperature. Next, the root canals of teeth in groups II, III, and IV were instrumented, filled with a calcium hydroxide-based paste, and replanted into their sockets. All animals received systemic antibiotic therapy and were killed by anesthetic overdose 60 days after replantation. The pieces containing the replanted teeth were removed, fixed, decalcified, and paraffin-embedded. Semi-serial 6-microm-thick sections were obtained and stained with hematoxylin and eosin for histomorphological analysis. There was statistically significant difference (P < 0.05) between groups I and IV regarding the presence of replacement resorption and PDL remnants on root surface. The powdered milk and long shelf-life whole milk presented similar results to each other and may be indicated as storage media for avulsed teeth.

Resorption behavior of a nanostructured bone substitute: in vitro investigation and clinical application.

PubMed

Reichert, Christoph; Götz, Werner; Reimann, Susanne; Keilig, Ludger; Hagner, Martin; Bourauel, Christoph; Jäger, Andreas

2013-03-01

To develop an in vitro assay for quantitative analysis of the degradation to which a bone substitute is exposed by osteoclasts. The aim of establishing this method was to improve the predictability of carrying out tooth movements via bone substitutes and to provide a basis for verification in exemplary clinical cases. After populating a bone substitute (NanoBone®; ArtOss, Germany) with osteoclastic cells, inductively-coupled mass spectrometry was used to evaluate changing calcium levels in the culture medium as a marker of resorption activity. It was observed that calcium levels increased substantially in the culture medium with the cells populating the bone substitute. This in vitro assay is a valid method that can assist clinicians in selecting the appropriate materials for certain patients. While tooth movements occurring through this material were successful, uncertainty about the approach will remain as long-term results are not available.

SEM observations of resected root canal ends following apicoectomy.

PubMed

Furusawa, Masahiro; Asai, Yasuhiro

2002-02-01

The purpose of this study was to examine the apical foramen of root apices extracted during apicotomies. A total of 25 teeth extracted from 25 patients admitted to the Department of Conservative Dentistry at Tokyo Dental College's Chiba Hospital were used for the study. All patients were between 22 to 56 years of age at the time of the study, and each of the 25 cases was determined clinically on radiographs to be chronic apical suppurative periodontitis. Microsurgery was performed on all cases, and the extracted root apices were then observed using SEM. The results demonstrated a wide opening, greater than 350 microns as measured along the major axis, of the apical foramen in 80% of the cases. Various characteristics indicative of resorption were observed around the apical foramen. These features included those believed to have been caused by overinstrumentation during root canal treatment as well as irregularly shaped areas presumed to be apical lesions that had enlarged and eroded. We observed a high frequency of manifestations of cementum resorption surrounding the root apices of teeth with apical lesions. Furthermore, we concluded that in the majority of cases in the present study, due to the fact that the apical foramen exceeded normal opening dimensions as a result of overinstrumentation during root canal treatment or resorption around the root apex, prolongation of the lesions had occurred in response to direct contact of microbial infectious matter and tissues surrounding the root apex over a large area. The above finding suggested that, in cases in which the apical foramen is destroyed through overinstrumentation larger than #35 or in which the apical foramen opens up to dimensions greater than 350 microns due to pathologic resorption, surgical intervention may be indicated. On the other hand, in 64% of the cases, an accessory canal was observed in the root apical lesion. Based on this observation, the presence of an accessory canal in the root apex may contribute to some degree to the prolongation of the lesion.

Pulpal and Periodontal Tissues Changes Associated with Le Fort I and Sagittal Split Ramus Osteotomies: A review

PubMed Central

Lazaridis, Konstantinos; Athanasiou, Athanasios E.

2018-01-01

Introduction: Le Fort I and sagittal split ramus osteotomies are the most commonly performed orthognathic surgery procedures on the maxilla and mandible, respectively. Techniques: Despite progress in the techniques, these procedures may still be associated with morbidity, expressed as inflammation, inadequate bony union, periodontal damages or in extreme cases even total bone loss. Discussion: Through a comprehensive review of the literature, the influences of maxillary and mandibular surgery on Pulpal Blood Flow (PBF), pulp sensitivity and pulp vitality are examined. Moreover, adverse effects of maxillary surgery on tooth color and periodontal tissues are also reported. The effects had a variety of expression. Concerning maxillary surgery, some studies showed an initial increase in PBF followed by a decrease to the baseline or even lower levels after 1-3 months. Other studies found an initial decrease in PBF followed by an increase soon after. There were also studies that showed no significant PBF changes, in contrast. Conclusion: Concerning mandibular surgery, a recent study showed a decrease in PBF immediately after sagittal split ramus osteotomy. Some authors detected tooth discoloration of maxillary teeth after Le Fort I osteotomy. Root resorption and root injury were also detected, but were of minor significance. Usually, these adverse effects derive from injury of the vessels of the palatal pedicle. This pedicle should be maintained intact for the avoidance of blood flow impairments. In addition, the descending palatine artery should be protected during maxillary surgery procedures in order to maintain the highest possible blood flow on the maxillary teeth. PMID:29456771

Cryopreservation induces macrophage colony stimulating factor from human periodontal ligament cells in vitro.

PubMed

Rhim, E-M; Ahn, S-J; Kim, J-Y; Chang, Y-R; Kim, K-H; Lee, H-W; Jung, S-H; Kim, E-C; Park, S-H

2013-10-01

Cryopreservation is used to protect vital periodontal ligaments during the transplantation of teeth. We investigated which gene products implicated in root resorption are upregulated in human periodontal ligament cells by cryopreservation, and whether cryopreservation affects the expression of macrophage-colony stimulating factor (M-CSF) in human periodontal ligament cells. We used customized microarrays to compare gene expression in human periodontal ligament cells cultured from teeth immediately after extraction and from cryopreserved teeth. Based on the result of these assays, we examined M-CSF expression in periodontal ligament cells from the immediately extracted tooth and cryopreserved teeth by real-time PCR, enzyme-linked immunosorbent assay (ELISA), Western blot analysis, and immunofluorescence. We also investigated whether human bone marrow cells differentiate into tartrate-resistant acid phosphatase (TRAP) positive osteoclasts when stimulated with RANKL (Receptor Activator for Nuclear Factor κ B Ligand) together with any secreted M-CSF present in the supernatants of the periodontal ligament cells cultured from the various groups of teeth. M-CSF was twofold higher in the periodontal ligament cells from the rapid freezing teeth than in those from the immediately extracted group (p < 0.05). Cryopreservation increased M-CSF expression in the periodontal ligament cells when analyzed by real time PCR, ELISA, Western blotting, and immunofluorescence (p < 0.05). TRAP positive osteoclasts were formed in response to RANKL and the secreted M-CSF present in the supernatants of all the experimental groups except negative control. These results demonstrate that cryopreservation promotes the production of M-CSF, which plays an important role in root resorption by periodontal ligament cells. Copyright © 2013 Elsevier Inc. All rights reserved.

Long-term observation of endodontic surgical intervention to treat root perforation and apical periodontitis: a case report of an amalgam-restored tooth.

PubMed

Tsurumachi, Tamotsu; Hayashi, Makoto

2003-10-01

A case of crestal root perforation and periapical lesion in a maxillary left lateral incisor is reported. Teeth with root perforation present technical difficulties in their clinical management because of their complex defects. In the present case, surgical endodontic treatment was chosen. The apical and lateral pathology was curetted, the tooth root was resected, and a retrograde root restoration of amalgam was placed in a root-end cavity and perforation site. A 10-year follow-up clinical and radiographic examination showed an asymptomatic tooth with osseous healing proceeding.

Ex vivo accuracy of an apex locator using digital signal processing in primary teeth.

PubMed

Leonardo, Mário Roberto; da Silva, Lea Assed Bezerra; Nelson-Filho, Paulo; da Silva, Raquel Assed Bezerra; Lucisano, Marília Pacífico

2009-01-01

The purpose of this study was to evaluate ex vivo the accuracy an electronic apex locator during root canal length determination in primary molars. One calibrated examiner determined the root canal length in 15 primary molars (total=34 root canals) with different stages of root resorption. Root canal length was measured both visually with the placement of a K-file 1 mm short of the apical foramen or the apical resorption bevel, and electronically using an electronic apex locator (Digital Signal Processing). Data were analyzed statistically using the intraclass correlation (ICC) test. Comparing the actual and electronic root canal length measurements in the primary teeth showed a high correlation (ICC=0.95). The Digital Signal Processing apex locator is useful and accurate for apex foramen location during root canal length measurement in primary molars.

Alveolar process fractures in the permanent dentition. Part 2. The risk of healing complications in teeth involved in an alveolar process fracture.

PubMed

Lauridsen, Eva; Gerds, Thomas; Andreasen, Jens Ove

2016-04-01

To analyze the risk of pulp canal obliteration (PCO), pulp necrosis (PN), repair-related resorption (RRR), infection-related resorption (IRR), ankylosis-related resorption (ARR), marginal bone loss (MBL), and tooth loss (TL) for teeth involved in an alveolar process fracture and to identify possible risk factors. A total of 91 patients with 223 traumatized teeth. The risks of PCO, PN, RRR, IRR, ARR, MBL, and TL were analyzed separately for teeth with immature and mature root development using Kaplan-Meier and Aalen-Johansen methods. Possible risk factors for PN (age, fracture in relation to apex, displacement, gingival injury, degree of repositioning, type of splint, duration of splinting, treatment delay, and antibiotics) were analyzed for mature teeth using Cox regression. The level of significance was 5%. Immature: No severe complications (PN, IRR, ARR, MBL, or TL) were diagnosed during follow up. Mature: Estimated risk after a 10-year follow up: PN: 56% (95% confidence interval (CI): 48.1-63.9), IRR: 2.5% (95% CI: 0-5.1), ARR: 2.1% (95% CI: 0.1-4.1), MBL: 2.4% (95% CI: 0.3-4.4), and TL: 7.8% (95% CI: 0-15.7). The following factors significantly increased the risk of PN in teeth with mature root development: fracture in relation to apex (hazard ratio (HR): 2.6 (95% CI: 0.2 - 5.7), P = 0.01), displacement in the horizontal part of the fracture >2 mm (HR: 1.8; 95% CI: 1.1-3.2, P = 0.03), incomplete repositioning (HR: 2.1 (95% CI: 1.3-3.5), P = 0.003), and age >30 years (HR: 2.3 (95% CI: 1.1-4.6), P = 0.02). The type of splint (rigid or flexible), the duration of splinting (more or less than 4 weeks), and the administration of antibiotics did not affect the risk of PN. Teeth involved in alveolar process fractures appear, apart from PN, to have a good prognosis. A conservative treatment approach is recommended. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Analysis of correlation between initial alveolar bone density and apical root resorption after 12 months of orthodontic treatment without extraction

PubMed Central

Scheibel, Paula Cabrini; Ramos, Adilson Luiz; Iwaki, Lilian Cristina Vessoni; Micheletti, Kelly Regina

2014-01-01

OBJECTIVE: The aim of the present study was to investigate the correlation between initial alveolar bone density of upper central incisors (ABD-UI) and external apical root resorption (EARR) after 12 months of orthodontic movement in cases without extraction. METHODS: A total of 47 orthodontic patients 11 years old or older were submitted to periapical radiography of upper incisors prior to treatment (T1) and after 12 months of treatment (T2). ABD-UI and EARR were measured by means of densitometry. RESULTS: No statistically significant correlation was found between initial ABD-UI and EARR at T2 (r = 0.149; p = 0.157). CONCLUSION: Based on the present findings, alveolar density assessed through periapical radiography is not predictive of root resorption after 12 months of orthodontic treatment in cases without extraction. PMID:25715722

In vitro performance of DIAGNOdent laser fluorescence device for dental calculus detection on human tooth root surfaces.

PubMed

Rams, Thomas E; Alwaqyan, Abdulaziz Y

2017-10-01

This study assessed the reproducibility of a red diode laser device, and its capability to detect dental calculus in vitro on human tooth root surfaces. On each of 50 extracted teeth, a calculus-positive and calculus-free root surface was evaluated by two independent examiners with a low-power indium gallium arsenide phosphide diode laser (DIAGNOdent) fitted with a periodontal probe-like sapphire tip and emitting visible red light at 655 nm wavelength. Laser autofluorescence intensity readings of examined root surfaces were scored on a 0-99 scale, with duplicate assessments performed using the laser probe tip directed both perpendicular and parallel to evaluated tooth root surfaces. Pearson correlation coefficients of untransformed measurements, and kappa analysis of data dichotomized with a >40 autofluorescence intensity threshold, were calculated to assess intra- and inter-examiner reproducibility of the laser device. Mean autofluorescence intensity scores of calculus-positive and calculus-free root surfaces were evaluated with the Student's t -test. Excellent intra- and inter-examiner reproducibility was found for DIAGNOdent laser autofluorescence intensity measurements, with Pearson correlation coefficients above 94%, and kappa values ranging between 0.96 and 1.0, for duplicate readings taken with both laser probe tip orientations. Significantly higher autofluorescence intensity values were measured when the laser probe tip was directed perpendicular, rather than parallel, to tooth root surfaces. However, calculus-positive roots, particularly with calculus in markedly-raised ledges, yielded significantly greater mean DIAGNOdent laser autofluorescence intensity scores than calculus-free surfaces, regardless of probe tip orientation. DIAGNOdent autofluorescence intensity values >40 exhibited a stronger association with calculus (36.6 odds ratio) then measurements of ≥5 (20.1 odds ratio) when the laser probe tip was advanced parallel to root surfaces. Excellent intra- and inter-examiner reproducibility of autofluorescence intensity measurements was obtained with the DIAGNOdent laser fluorescence device on human tooth roots. Calculus-positive root surfaces exhibited significantly greater DIAGNOdent laser autofluorescence than calculus-free tooth roots, even with the laser probe tip directed parallel to root surfaces. These findings provide further in vitro validation of the potential utility of a DIAGNOdent laser fluorescence device for identifying dental calculus on human tooth root surfaces.

Biological Effects of Orthodontic Tooth Movement Into the Grafted Alveolar Cleft.

PubMed

Sun, Jian; Zhang, Xiaoyue; Li, Renmei; Chen, Zhengxi; Huang, Yuanliang; Chen, Zhenqi

2018-03-01

Functional stimulus during orthodontic tooth movement into the grafted bone can lead to better alveolar bone grafting outcomes. The aim of this study was to analyze the biological effects of orthodontic tooth movement into the grafted alveolar cleft area with histologic staining, fluorescence staining, and real-time polymerase chain reaction (PCR). An animal model of orthodontic tooth movement into the grafted alveolar cleft area was established in 8-week-old Sprague-Dawley rats. The animals were divided into the experimental group and the control group. Four checkpoints were observed: before orthodontic stimuli, day 1 after orthodontic stimuli, day 3 after orthodontic stimuli, and day 5 after orthodontic stimuli. The cleft bone formation conditions, including the collagen fibers and the activities of the osteoclasts and osteoblasts, were evaluated by histologic staining. The expression of tartrate-resistant acid phosphatase (TRAP), receptor activator nuclear factor κB ligand, and Runt-related transcription factor 2 was detected by real-time PCR in both groups. Hematoxylin-eosin staining showed that the remodeling process of iliac autografts was completed when the orthodontic stress was applied, whereas the bone tissues first showed osteoclastogenesis and then osteogenesis. On the basis of TRAP staining, the osteoclasts increased to the maximal amount on day 3 and decreased thereafter. Evidence from tetracycline fluorescence staining indicated that no obvious changes in osteoblast activity were detected at the early stage; however, it gradually increased, especially in the region close to the root surface. According to real-time PCR, the expression of TRAP increased in both the early and middle stages, that of receptor activator nuclear factor κB ligand increased in the early stage, and that of Runt-related transcription factor 2 increased in the late stage. Moreover, the results showed significant differences between the experimental and control groups. Orthodontic tooth movement into the alveolar cleft bone graft area promoted bone remodeling of embedded bone, thus inducing bone resorption and subsequent deposition. Copyright © 2017. Published by Elsevier Inc.

Analysis of the dentin-pulp complex in teeth submitted to orthodontic movement in rats

PubMed Central

MASSARO, Camila da Siveira; CONSOLARO, Renata Bianco; SANTAMARIA, Milton; CONSOLARO, Maria Fernanda Martins-Ortiz; CONSOLARO, Alberto

2009-01-01

ABSTRACT In order to microscopically analyze the pulpal effects of orthodontic movement, 49 maxillary first molars of rats were submitted to orthodontic appliance composed of a closed coil spring anchored to the maxillary incisors, placed for the achievement of mesial movement. Material and Methods: Ten animals were used as the control group and were not submitted to orthodontic force; the other animals were divided into groups according to the study period of tooth movement, namely 1, 2, 3, 4, 5, 6 and 7 days. The investigation of pulp and periodontal changes included hyalinization, fibrosis, reactive dentin and vascular congestion. Statistical evaluation was performed between control and experimental groups and between periods of observation using non-parametric chi-square, Kruskal-Wallis and Dunn tests. Results: There was no statistically significant difference concerning pulpal changes between control and experimental groups nor between periods of observation. The control group, at 3 and 5 days, revealed greater hyalinization of the periodontal ligament (p<0.05), whereas root resorption was significantly greater at 5 and 7 days (p<0.05). Conclusion: No morphological change from the effect of induced tooth movement could be found in the dentin-pulp complex. In addition, no inflammatory or pulp degeneration, detectable in optical microscopy, was found in experimental groups. PMID:21499653

Effects of mangosteen peel extract combined with demineralized freeze-dried bovine bone xenograft on osteocalcin, collagen 1, and osteoblast as alveolar bone regeneration in socket preservation.

PubMed

Kresnoadi, Utari; Raharjo, Tika; Rostiny, Rostiny

2018-01-01

Tooth extraction will provoke changes in alveolar bone morphology and dimensions. Postextraction bone resorption can lead to significant problems for restorative dentistry. Therefore, the extracted tooth socket needs to be preserved to reduce alveolar ridge bone resorption. This research aimed to analyze the expression and levels of osteocalcin, collagen 1, and osteoblasts in extracted tooth sockets filled with a combination of mangosteen peel extract and demineralized freeze-dried bovine bone xenograft (DFDBBX). Fifty-six Cavia cobaya , whose lower left incisors had been extracted, were divided into eight groups according to the substance used to fill their sockets on days 7 and 30, Poly ethylene glycol, DFDBBX, mangosteen peel extract, or a combination of mangosteen peel extract and DFDBBX. This research was conducted in several stages; the application of mangosteen peel extract combined with graft material was performed as the form of tooth extraction socket preservation. The C. cobaya rats were subsequently examined by immunohistochemical methods to measure osteocalcin and collagen 1 expressions, whereas histological examination was conducted to calculate the number of osteoblasts in accordance with the duration of the research. On days 7 and 30, the group treated with a combination of DFDBBX and mangosteen peel extract which had the highest expression and levels of osteocalcin, collagen 1, and osteoblasts. The administration of mangosteen peel extract combined with DFDBBX as a means of tooth extraction socket preservation can increase osteocalcin and collagen 1 expression. Consequently, osteoblasts as a means of alveolar bone regeneration will increase in number.

The use of different analgesics in orthodontic tooth movements.

PubMed

Hammad, Shaza M; El-Hawary, Yousry M; El-Hawary, Amira K

2012-09-01

To provide a semi-quantitative assessment of the effect of different analgesics (celecoxib, ketorolac, and paracetamol) on tooth movement and bone resorption using immunohistochemical staining of matrix metalloproteinase-13 (MMP-13). Forty white male rats (12-weeks old; body weight: 230-250 g) were divided into four groups (10 rats each) and were given the treatment once a day for 2 consecutive months. Group A (control group) rats were given the reverse osmosis water; group B rats were given 10 mg/kg celecoxib; group C rats were given 3 mg/kg ketorolac; and group D rats were given 150 mg/kg paracetamol. A precalibrated closed Sentalloy coil spring was placed inside each rat mouth to deliver a constant force of 50 cN. The magnitude of tooth movement was measured intraorally. After 2 months, the rats were sacrificed, and the sections were mounted on L-polylysine-coated glass slides. Slides from each specimen were stained with hematoxylin and eosin, and others were stained with MMP-13. Data were analyzed with the one-way analysis of variance (ANOVA). Celecoxib, ketorolac, and paracetamol groups showed tooth movement of 1.81 ± 0.43 mm, 1.13 ± 0.28 mm, and 1.08 ± 0.27 mm, respectively. The mean number of MMP-13-positive osteoclasts was highest in celecoxib-treated group followed by the control group and was decreased in the ketorolac and paracetamol groups. Comparing all groups to the control revealed significant differences (P < .05). Administration of celecoxib did not reduce bone resorption or interfere with tooth movement in rats compared to other analgesics tested (ketorolac and paracetamol).

Do Autotransplanted Teeth Require Elective Root Canal Therapy? A Long-Term Follow-Up Case Series.

PubMed

Murtadha, Linda; Kwok, Jerry

2017-09-01

To determine the long-term survival and outcomes of 252 autotransplanted teeth with a novel root canal therapy (RCT) and follow-up protocol and to establish whether elective RCT after autotransplantation is routinely required for teeth with complete root formation. A retrospective analysis of 209 patients 10 to 58 years old, with a total of 252 autotransplants was carried out with a minimum observational period of 1 year and a maximum period of 29 years. Patients were reviewed at specified intervals. Only the teeth showing any radiographic or clinical signs of internal resorption (IR), external resorption (ER), or pulpal necrosis underwent RCT. A failure was considered the loss or extraction of the autotransplanted tooth. Ten of the 252 autotransplants constituted failures, with 249, 190, 155, 97, 70, and 35 teeth surviving at 1, 2, 3, 5, 7, and 10 years, respectively; the remainder were lost to follow-up. Eighteen percent of teeth (n = 46) showed radiographic signs of IR, ER, and apical pathology (AP). Most cases of ER were observed by 3 years (18 of 28 teeth) and then at 5 to -8 years. Only 3 teeth showed signs of IR, which were observed within 5 years. Most cases of AP were observed within the first year (8 of 15 teeth) and then at 3 to 6 years. Five teeth showed signs of pulp obliteration or sclerosis and did not require RCT, with a maximum period of 16 years after identification of sclerosis. Retrospective analysis of the data showed that 184 autotransplanted teeth had complete root formation and 68 had incomplete root formation at the time of autotransplantation. Of the teeth that were followed for at least 5 years, 59.3% had complete root formation with no signs of pathology and required no RCT. Despite the limitation of this long-term study of patients lost to follow-up, the results suggest that, with close monitoring, some autotransplanted teeth with complete root formation that do not undergo RCT could have the potential for revascularization. Hence, one could reconsider the protocol of routinely providing RCT after autotransplantation. Future long-term studies will be beneficial to assess the vascularity of autotransplanted teeth using Doppler flowmetry with a larger cohort of patients. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. All rights reserved.

Endodontic Management of a Maxillary Lateral Incisor with 4 Root Canals and a Dens Invaginatus Tract.

PubMed

Nosrat, Ali; Schneider, S Craig

2015-07-01

Dens invaginatus (DI) is associated with complex internal anatomy. This article represents a maxillary lateral incisor with 5 root canals including DI. The treatment was planned and performed using cone-beam computed tomographic (CBCT) imaging. After clinical and radiographic evaluations, tooth #7 was diagnosed with DI and pulp necrosis with symptomatic apical periodontitis. Periapical radiographs of the tooth showed 2 roots and complex internal anatomy. CBCT evaluation revealed tooth #7 had 5 separate canals (4 root canals and 1 DI canal extending through the root to the periodontal ligament), communication between DI and the root canal system, and severe and multiple curvatures of the palatal canals. Root canal treatment was completed in 2 visits. Modified access openings were required to safely treat the dilacerated palatal canals. At the 6-month re-evaluation, the patient reported he had remained asymptomatic and his tooth had remained functional since the treatment was completed. Clinical examination showed tooth #7 had no sensitivity to percussion or palpation, probe depths within normal limits (≤3 mm), and no mobility. Radiographic assessment of the tooth showed significant osseous healing of the preoperative lesion. Three-dimensional imaging is a valuable tool for endodontic management of teeth with complex internal anatomy. Three-dimensional imaging is recommended for evaluating and treatment planning cases with DI. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Tooth fracture risk analysis based on a new finite element dental structure models using micro-CT data.

PubMed

Chen, G; Fan, W; Mishra, S; El-Atem, A; Schuetz, M A; Xiao, Y

2012-10-01

The finite element (FE) analysis is an effective method to study the strength and predict the fracture risk of endodontically-treated teeth. This paper presents a rapid method developed to generate a comprehensive tooth FE model using data retrieved from micro-computed tomography (μCT). With this method, the inhomogeneity of material properties of teeth was included into the model without dividing the tooth model into different regions. The material properties of the tooth were assumed to be related to the mineral density. The fracture risk at different tooth portions was assessed for root canal treatments. The micro-CT images of a tooth were processed by a Matlab software programme and the CT numbers were retrieved. The tooth contours were obtained with thresholding segmentation using Amira. The inner and outer surfaces of the tooth were imported into Solidworks and a three-dimensional (3D) tooth model was constructed. An assembly of the tooth model with the periodontal ligament (PDL) layer and surrounding bone was imported into ABAQUS. The material properties of the tooth were calculated from the retrieved CT numbers via ABAQUS user's subroutines. Three root canal geometries (original and two enlargements) were investigated. The proposed method in this study can generate detailed 3D finite element models of a tooth with different root canal enlargements and filling materials, and would be very useful for the assessment of the fracture risk at different tooth portions after root canal treatments. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

External Cervical Resorption: A Comparison of the Diagnostic Efficacy Using 2 Different Cone-beam Computed Tomographic Units and Periapical Radiographs.

PubMed

Vaz de Souza, Daniel; Schirru, Elia; Mannocci, Francesco; Foschi, Federico; Patel, Shanon

2017-01-01

The aim of this study was to compare the diagnostic efficacy of 2 cone-beam computed tomographic (CBCT) units with parallax periapical (PA) radiographs for the detection and classification of simulated external cervical resorption (ECR) lesions. Simulated ECR lesions were created on 13 mandibular teeth from 3 human dry mandibles. PA and CBCT scans were taken using 2 different units, Kodak CS9300 (Carestream Health Inc, Rochester, NY) and Morita 3D Accuitomo 80 (J Morita, Kyoto, Japan), before and after the creation of the ECR lesions. The lesions were then classified according to Heithersay's classification and their position on the root surface. Sensitivity, specificity, positive predictive values, negative predictive values, and receiver operator characteristic curves as well as the reproducibility of each technique were determined for diagnostic accuracy. The area under the receiver operating characteristic value for diagnostic accuracy for PA radiography and Kodak and Morita CBCT scanners was 0.872, 0.99, and 0.994, respectively. The sensitivity and specificity for both CBCT scanners were significantly better than PA radiography (P < .001). There was no statistical difference between the sensitivity and specificity of the 2 scanners. The percentage of correct diagnoses according to the tooth type was 87.4% for the Kodak scanner, 88.3% for the Morita scanner, and 48.5% for PA radiography.The ECR lesions were correctly identified according to the tooth surface in 87.8% Kodak, 89.1% Morita and 49.4% PA cases. The ECR lesions were correctly classified according to Heithersay classification in 70.5% of Kodak, 69.2% of Morita, and 39.7% of PA cases. This study revealed that both CBCT scanners tested were equally accurate in diagnosing ECR and significantly better than PA radiography. CBCT scans were more likely to correctly categorize ECR according to the Heithersay classification compared with parallax PA radiographs. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Electronic working length determination in primary teeth by ProPex and Digital Signal Processing.

PubMed

Nelson-Filho, Paulo; Lucisano, Marcela Pacífico; Leonardo, Mário Roberto; da Silva, Raquel Assed Bezerra; da Silva, Léa Assed Bezerra

2010-12-01

The purpose of this study was to evaluate the accuracy of electronic apex locators Digital Signal Processing (DSP) and ProPex, for root canal length determination in primary teeth. Fifteen primary molars (a total of 34 root canals) were divided into two groups: Group I - without physiological resorption (n = 16); and Group II - with physiological resorption (n = 18). The length of each canal was measured by introducing a file until its tip was visible and then it was retracted 1 mm. For electronic measurement, the devices were set to 1 mm short of the apical resorption. The data were analysed statistically using the intraclass correlation coefficient (ICC). Results showed that the ICC was high for both electronic apex locators in all situations - with (ICC: DSP = 0.82 and Propex = 0.89) or without resorption (ICC: DSP = 0.92 and Propex = 0.90). Both apex locators were extremely accurate in determining the working length in primary teeth, both with or without physiological resorption. © 2010 The Authors. Australian Endodontic Journal © 2010 Australian Society of Endodontology.

The use of cone beam computed tomography in the diagnosis and management of internal root resorption associated with chronic apical periodontitis: a case report.

PubMed

Perlea, Paula; Nistor, Cristina Coralia; Iliescu, Mihaela Georgiana; Iliescu, Alexandru Andrei

2015-01-01

Internal root resorption is a consequence of chronic pulp inflammation. Later on, the pulp necrosis followed by a chronic apical periodontitis is installed. Hence, usually, in clinical practice, both lesions have to be simultaneously managed. Conventional periapical radiograph is mandatory in diagnosis. Improving the diagnosis and management of both lesions, cone beam computed tomography proves to be more reliable than conventional radiography.

Pressure Bearing Device Affects Extraction Socket Remodeling of Maxillary Anterior Tooth. A Prospective Clinical Trial.

PubMed

Jiang, Xi; Zhang, Yu; Chen, Bo; Lin, Ye

2017-04-01

Extraction socket remodeling and ridge preservation strategies have been extensively explored. To evaluate the efficacy of applying a micro-titanium stent as a pressure bearing device on extraction socket remodeling of maxillary anterior tooth. Twenty-four patients with a extraction socket of maxillary incisor were treated with spontaneous healing (control group) or by applying a micro-titanium stent as a facial pressure bearing device over the facial bone wall (test group). Two virtual models obtained from cone beam computed tomography data before extraction and 4 months after healing were 3-dimenionally superimposed. Facial bone wall resorption, extraction socket remodeling features and ridge width preservation rate were determined and compared between the groups. Thin facial bone wall resulted in marked resorption in both groups. The greatest palatal shifting distance of facial bone located at the coronal level in the control group, but middle level in the test group. Compared with the original extraction socket, 87.61 ± 5.88% ridge width was preserved in the test group and 55.09 ± 14.46% in the control group. Due to the facial pressure bearing property, the rigid micro-titanium stent might preserve the ridge width and alter the resorption features of extraction socket. © 2016 Wiley Periodicals, Inc.

Decoronation followed by dental implants placement: fundamentals, applications and explanations

PubMed Central

Consolaro, Alberto; Ribeiro, Paulo Domingos; Cardoso, Maurício A.; Miranda, Dario A. Oliveira; Salfatis, Monica

2018-01-01

ABSTRACT Dental arches areas with teeth presenting dentoalveolar ankylosis and replacement root resorption can be considered as presenting normal bone, in full physiological remodeling process; and osseointegrated implants can be successfully placed. Bone remodeling will promote osseointegration, regardless of presenting ankylosis and/or replacement root resorption. After 1 to 10 years, all dental tissues will have been replaced by bone. The site, angulation and ideal positioning in the space to place the implant should be dictated exclusively by the clinical convenience, associated with previous planning. One of the advantages of decoronation followed by dental implants placement in ankylosed teeth with replacement resorption is the maintenance of bone volume in the region, both vertical and horizontal. If possible, the buccal part of the root, even if thin, should be preserved in the preparation of the cavity for the implant, as this will maintain gingival tissues looking fully normal for long periods. In the selection of cases for decoronation, the absence of microbial contamination in the region - represented by chronic periapical lesions, presence of fistula, old unconsolidated root fractures and active advanced periodontal disease - is important. Such situations are contraindications to decoronation. However, the occurrence of dentoalveolar ankylosis and replacement resorption without contamination should neither change the planning for implant installation, nor the criteria for choosing the type and brand of dental implant to be used. Failure to decoronate and use dental implants has never been reported. PMID:29791693

[Effect of orthodontic force on periodontal healing after autotransplantation: an experimental study].

PubMed

Yang, Yun; Bai, Yu-xing; Li, Song; Gao, Wei-min; Ru, Nan; Li, Li-xuan

2012-10-01

To investigate the effect of the continuous light force to the donor teeth on the periodontal healing after transplantation. Thirty-two maxillary and mandibular incisors in four 10-month-old male Beagle dogs were autotransplanted. The pulps were removed in all teeth. The teeth were divided into four groups, one control and three experimental groups. In control group (group 1), the teeth were unloaded. In the other three experimental groups, continuous force (0.49 N) was applied in the 1st (group 2), 2nd (group 3) and 4th (group 4) week, respectively. The dogs were sacrificed in the 8th week. The tissue blocks were demineralized and sectioned perpendicular to the long axis of the teeth. The histological analysis was made. Histomophometric analysis revealed a significantly lower occurrence of replacement root resorption in the group 3 (2.1%) than in the control group (12.5%, P < 0.05). The significant lower incidence of replacement root resorption, and a higher surface and inflammatory root resorption were found in group 2 (6.3% and 68.8%) than in the control group (12.5% and 41.7%, P < 0.05). No significant difference was found between group 4 and control group (P > 0.05). The orthodontic force promoted the regeneration of the periodontal ligament and prevented dentoalveolar ankylosis, whereas excessive initial force might cause root and bone resorption.

Periodontist-Dental Hygienist Collaboration in Periodontal Care for Chronic Periodontitis: An 11-year Case Report.

PubMed

Tomita, Sachiyo; Uekusa, Tomomi; Hosono, Meiko; Kigure, Takashi; Sugito, Hiroki; Saito, Atsushi

2016-01-01

We report a case of severe chronic periodontitis treated and longitudinally maintained by a periodontist and dental hygienists. The patient was a 45-year-old woman who presented with the chief complaint of gingival bleeding and tooth mobility. An initial examination revealed generalized gingival inflammation and subgingival calculus in the premolar and molar regions. Premature contact was observed in #14 and 45. Clinical examination revealed 42% of sites with a probing depth (PD) of ≥4 mm and 44% of sites with bleeding on probing. Radiographic examination revealed vertical bone resorption in #35, 36, and 45, and horizontal bone resorption in other regions. Based on a clinical diagnosis of severe chronic periodontitis, initial periodontal therapy consisting of plaque control, scaling and root planing, and removal of an ill-fitting prosthesis was performed. Following suppression of inflammation, occlusal adjustment of premature contact sites was performed. Open flap debridement was performed for teeth with a PD of ≥5 mm. After confirming the stability of the periodontal tissue, final prostheses were placed on #16, 35-37, and 46. Following re-evaluation, the patient was placed on supportive periodontal therapy. It has been 11 years since the patient's first visit, and the periodontal conditions have remained stable. Meticulous periodontal care maintained over a number of years by a periodontist and dental hygienist have yielded a clinically favorable outcome.

Effect of topical alendronate on root resorption of dried replanted dog teeth.

PubMed

Levin, L; Bryson, E C; Caplan, D; Trope, M

2001-06-01

Alendronate (ALN) is a third generation bisphosphonate with demonstrated osteoclast inhibitory activity that may slow down the resorptive process after severe traumatic injuries. Eighty-two premolar roots of five mongrel dogs were endodontically treated and restored, extracted and treated as follows: 70 roots were bench dried for either 40 or 60 min. Thirty-eight of these roots were then soaked for 5 min in a 1 mM solution of ALN in Hanks' Balanced Salt Solution (HBSS) and replanted. Thirty-two roots were soaked for 5 min in HBSS and replanted. In the remaining 12 roots which were not exposed to the bench drying procedure, a 0.5 mM deep lingual mid-root cemental defect was made. Six of these roots were soaked in a 1 mM solution of ALN in HBSS for 5 min and replanted. The other six roots were soaked for 5 min in HBSS and replanted. Historical negative and positive controls were used from similarly treated teeth in our previous studies. After 4 months the dogs were killed and the roots prepared for histological evaluation. Five-microm-thick cross-sections of the root and surrounding tissue taken every 70 microm were evaluated for healing according to the criteria of Andreasen. In the 12 roots with cemental defects, healing with cementum of the damaged root surface was evaluated. In addition, residual root mass was also measured to determine the extent of root structure loss for each soaking method. Cemental healing took place in all 12 artificially damaged roots, indicating that these soaking media did not inhibit cementogenesis. The alendronate-soaked roots had statistically significantly more healing than the roots soaked in HBSS without alendronate. This improvement in healing was seen in all dogs except one and in all teeth except the first premolar. Soaking in alendronate also resulted in significantly less loss in root mass due to resorption compared to those teeth soaked in HBSS without alendronate.

Study of the effectiveness of propolis extract as a storage medium for avulsed teeth.

PubMed

Casaroto, Ana Regina; Hidalgo, Mirian Marubayashi; Sell, Ana Maria; Franco, Selma Lucy; Cuman, Roberto Kenji Nakamura; Moreschi, Eduardo; Victorino, Fausto Rodrigo; Steffens, Vânia Antunes; Bersani-Amado, Ciomar Aparecida

2010-08-01

The purpose of the present study was to evaluate the efficacy of propolis extract in maintaining the viability of human periodontal ligament (PDL) cells, and to radiographically analyze tooth replantation and the adjacent periodontium in dogs after storage in this extract. Human PDL cells were incubated with the experimental media propolis, milk, saliva, Hank's balanced salt solution (HBSS), and Dulbecco's modified Eagles medium (DMEM, positive controls), and distilled water (negative control). Cell viability was determined 0, 1, 3, 6, 12, and 24 h later by colorimetric MTT assay. Thirty incisors from dogs were divided into two storage time blocks (1 and 3 h) and were maintained in the experimental media. HBSS served as a positive control, and dry teeth (on gauze) as a negative control. The replanted teeth were radiographed once per month for 6 months. The radiographic images were standardized by the shortening/lengthening factor, and were both qualitatively and quantitatively analyzed. The in vitro results showed that the efficacy of propolis in maintaining functional viability of PDL cells was similar to that of milk. Propolis and milk were significantly better than controls from the 6-h time period. The in vivo results showed that teeth maintained in propolis medium exhibited replacement resorption with significant reduction in tooth length, similar to teeth maintained in saliva and dried teeth. This resorption was less intense with the 3-h storage time than the 1-h storage time. Conditions close to normal were found in teeth maintained in milk, similar to the HBSS control. Therefore, although propolis was effective in maintaining the viability of human PDL cells, resorption of the tooth replantation in dogs occurred under these experimental conditions.

Morphologic changes of the nasopalatine canal related to dental implantation: a radiologic study in different degrees of absorbed maxillae.

PubMed

Mardinger, Ofer; Namani-Sadan, Noa; Chaushu, Gavriel; Schwartz-Arad, Devorah

2008-09-01

Implant rehabilitation of the edentulous anterior maxilla remains a complex restorative challenge. Intricate preexisting anatomy dictates meticulous and accurate osteotomy planning. With progressive bone loss, the alveolar crest may approach anatomic structures. The nasopalatine nerve and vessels may ultimately emerge from the ridge crest. The radiologic changes of the nasopalatine canal were evaluated in different resorption phases of the premaxilla alveolus with regard to dental implantation. The study consisted of 207 subjects who had maxillary computed tomography scans before dental implantation. The Lekholm and Zarb classification was used to divide images according to the residual bony ridge: Class A (control group) and classes B to E (study group). Anatomic mapping of the nasopalatine canal structure was carried out in both groups. The canal diameter was wider along the degree of ridge resorption from classes A to E in all dimensions, mainly in the palatal opening (P <0.01), middle area (P <0.001), and nasal area. The mean diameter of the enlargement was 1.8 mm, which reached 5.5 +/- 1.08 mm (P <0.01) in type E bone. In the severely resorbed ridges (classes C through E), when the palatal opening was situated on the ridge, it occupied a mean of 35.6% (13% to 58%) of the area devoted to implant placement. Tooth loss was the main reason for ridge resorption (P <0.01). Canal diameter enlargement was greater anteriorly to the ridge and posteriorly to the palatal bone, mainly because of tooth extraction. The atrophy of disuse may influence surrounding structures, similar to the maxillary sinus tendency to expand into surrounding bone mainly after tooth loss.

Efficacy of enamel matrix protein applied to spontaneous periodontal disease in two dogs.

PubMed

Watanabe, Kazuhiro; Kikuchi, Masahiro; Okumura, Masahiro; Kadosawa, Tsuyoshi; Fujinaga, Toru

2003-09-01

Enamel matrix protein (EMP) was applied for regeneration of periodontal tissue in 2 dogs with spontaneous periodontal disease. Case 1 had bony resorption around the root and root apex of the maxillary fourth premolars. Case 2 had vertical resorption of bone between the mandibular first and second molars. A flap was formed in the buccal gingiva, and EMP was applied onto the surface of the exposed root. One or 4 months postoperatively, increased bone level and clinical attachment were recognized. EMP was therefore suggested to be effective to induce regeneration of periodontal tissues in the cases with periodontal disease.

Replantation of 45 avulsed permanent teeth: a 1-year follow-up study.

PubMed

Chappuis, Vivianne; von Arx, Thomas

2005-10-01

Thirty-four patients with 45 avulsed and replanted permanent teeth were followed for 1 year. All teeth were soaked in tetracycline before replantation. In addition, enamel matrix derivative was used in teeth with dry storage times exceeding 30 min. Splinting was carried out with a non-rigid titanium splint and was limited to 7-10 days. Within that period, root canal treatment was begun in all teeth with a closed apex, whereas teeth with an open apex and ideal post-traumatic storage were not instrumented. All patients were given tetracycline systematically for 10 days. The survival rate of replanted avulsed permanent teeth was 95.6% at the 1-year follow-up. In 82.2%, root canal treatment was performed. Pulp survival was never observed, but three teeth had pulp canal obliteration. Normal periodontal healing was observed in 57.7% of teeth; 42.3% of teeth showed external root resorption (28.9% replacement resorption, 6.7% infection-related resorption, 6.7% surface resorption). The occurrence of replacement resorption correlated with the period of extraoral dry storage. Compared with other clinical studies on avulsed and replanted teeth, the present study reports a higher percentage of periodontal healing. The favorable treatment outcome may be associated with a strict protocol to enforce endodontic treatment, the use of topical and systemic tetracycline, and the relatively high number of ideally stored teeth following avulsion. In contrast, the present study has a follow-up period limited to 1 year.

Alveolar ridge reduction after tooth extraction in adolescents: an animal study

PubMed Central

Sun, Zongyang; Herring, Susan W.; Tee, Boon Ching; Gales, Jordan

2013-01-01

Objective The mechanism for tooth extraction induced residual alveolar ridge reduction (RRR) during adolescence is poorly understood. This study investigated the alveolar bone morphology, growth, resorption and functional loading at normal and extraction sites using an adolescent pig model. Design Sixteen 3-month-old pigs were divided into two groups – immediate post-extraction (IE) and 6-week post-extraction (SE). The IE group received an extraction of one deciduous mandibular molar, immediately followed by a final experiment to record masseter muscle EMGs and strains from the buccal surface of the extraction and contralateral non-extraction sites during function (mastication). The SE group was given the same tooth extraction, then kept for 6 weeks before the same final functional recording as the IE group. Both groups also received baseline (pre-extraction) EMGs and fluorescent vital stains 10 and 3 days before the final functional recording. Immediately after the final functional recording, animals were euthanized and alveolar bone specimens from extraction and contralateral non-extraction sites were collected and used to analyze alveolar bone morphology, apposition and resorption based on fluorescent and hematoxylin and eosin stained histological sections. Results At control sites (IE-extraction, IE-non-extraction and SE-non-extraction), the alveolar ridges grew gingivally and buccally. Bone formation characterized the buccal surface and lingual bundle bone, whereas resorption characterized the lingual surface and buccal bundle bone. The SE-extraction sites showed three major alterations: convergence of the buccal and lingual gingival crests, loss of apposition on the lingual bundle bone, and decelerated growth at the entire buccal surface. These alterations likely resulted from redirected crestal growth as part of the socket healing process, loss of tongue pressure to the lingual side of the teeth which normally provides mechanical stimulation for dental arch expansion, and masticatory underloading during the initial post-extraction period, respectively. Conclusions These data indicate that the initial phase of RRR in adolescents is a product of modified growth, not resorption, possibly because of decreased mechanical stimulation at the extraction site. PMID:23380583

Complications of misdiagnosis of maxillary canine ectopic eruption.

PubMed

Garib, Daniela Gamba; Janson, Guilherme; Baldo, Taiana de Oliveira; dos Santos, Patrícia Bittencourt Dutra

2012-08-01

Ectopic eruption of maxillary canines can be associated with root resorption of adjacent teeth. This case report describes and discusses an interesting case of a 15-year-old girl with a Class III malocclusion and an impacted maxillary canine. Because of the unfavorable position of the ectopic canine and the severe root resorption of the maxillary left central and lateral incisors, the treatment options included extraction of the maxillary permanent canines. The mandibular first premolars were extracted to compensate for the Class III malocclusion. A panoramic radiograph taken earlier in the mixed dentition already indicated a possible eruption disturbance of the maxillary left permanent canine. The importance of early diagnosis of maxillary canine ectopic eruption is highlighted in this case report. The early identification of radiographic signs of an ectopic pathway of eruption should be followed by deciduous canine extraction to prevent canine retention and maxillary incisor root resorption. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Minimizing the extra-oral time in autogeneous tooth transplantation: use of computer-aided rapid prototyping (CARP) as a duplicate model tooth.

PubMed

Lee, Seung-Jong; Kim, Euiseong

2012-08-01

The maintenance of the healthy periodontal ligament cells of the root surface of donor tooth and intimate surface contact between the donor tooth and the recipient bone are the key factors for successful tooth transplantation. In order to achieve these purposes, a duplicated donor tooth model can be utilized to reduce the extra-oral time using the computer-aided rapid prototyping (CARP) technique. Briefly, a three-dimensional digital imaging and communication in medicine (DICOM) image with the real dimensions of the donor tooth was obtained from a computed tomography (CT), and a life-sized resin tooth model was fabricated. Dimensional errors between real tooth, 3D CT image model and CARP model were calculated. And extra-oral time was recorded during the autotransplantation of the teeth. The average extra-oral time was 7 min 25 sec with the range of immediate to 25 min in cases which extra-oral root canal treatments were not performed while it was 9 min 15 sec when extra-oral root canal treatments were performed. The average radiographic distance between the root surface and the alveolar bone was 1.17 mm and 1.35 mm at mesial cervix and apex; they were 0.98 mm and 1.26 mm at the distal cervix and apex. When the dimensional errors between real tooth, 3D CT image model and CARP model were measured in cadavers, the average of absolute error was 0.291 mm between real teeth and CARP model. These data indicate that CARP may be of value in minimizing the extra-oral time and the gap between the donor tooth and the recipient alveolar bone in tooth transplantation.

Cellular and molecular mechanisms of tooth root development

PubMed Central

Li, Jingyuan; Parada, Carolina

2017-01-01

ABSTRACT The tooth root is an integral, functionally important part of our dentition. The formation of a functional root depends on epithelial-mesenchymal interactions and integration of the root with the jaw bone, blood supply and nerve innervations. The root development process therefore offers an attractive model for investigating organogenesis. Understanding how roots develop and how they can be bioengineered is also of great interest in the field of regenerative medicine. Here, we discuss recent advances in understanding the cellular and molecular mechanisms underlying tooth root formation. We review the function of cellular structure and components such as Hertwig's epithelial root sheath, cranial neural crest cells and stem cells residing in developing and adult teeth. We also highlight how complex signaling networks together with multiple transcription factors mediate tissue-tissue interactions that guide root development. Finally, we discuss the possible role of stem cells in establishing the crown-to-root transition, and provide an overview of root malformations and diseases in humans. PMID:28143844

Endodontic-periodontal management of two rooted maxillary lateral incisor associated with complex radicular lingual groove by using spiral computed tomography as a diagnostic aid: a case report.

PubMed

Gandhi, A; Kathuria, A; Gandhi, T

2011-06-01

To present the successful endodontic and periodontal management of a two rooted maxillary lateral incisor tooth with a complex radicular lingual groove and severe periodontal destruction using spiral computed tomography as a diagnostic aid. A 30-year-old male patient presented with a chief complaint of mobility and discharge of pus in an upper front tooth. Clinical examination revealed a sinus tract on the labial gingival surface and a 10-mm-deep periodontal pocket associated with maxillary left lateral incisor tooth. On the lingual side, a groove emerging from cingulum, continuing mesioapically down the lingual aspect of tooth was found. Intraoral periapical radiographs demonstrated a lateral periodontal defect around the mesial aspect and a diffuse radiolucency at the apex of maxillary left lateral incisor tooth. The sinus tract was traced with gutta-percha to the maxillary left lateral incisor that showed an accessory root surrounded by a large radiolucent area. A spiral computed tomographic scan for better understanding of the complicated root canal morphology of the tooth was performed. Based on the clinical, radiographic and spiral computed tomographic findings, a diagnosis of an endo-perio lesion in tooth 22 was made. Management consisted of conventional root canal treatment, radiculoplasty, root resection of accessory root and surgical curettage of the periodontal defect. Follow-up with radiographic examination at 3 months and 1 year was performed. At 1-year recall, the patient was asymptomatic, there was no evidence of the sinus tract and a 3-mm nonbleeding pocket was present in relation to tooth 22. Progression of hard tissue healing was observed in the periapical radiograph taken 1 year postoperatively. The key to achieving favourable results in this particular type of developmental anomaly is accurate diagnosis and treatment planning. The health of the periapical osseous tissues appears to be the provital factor for tooth retention. A favourable outcome can only be achieved with a comprehensive treatment approach that effectively manages all local factors that are contributing to the disease process. © 2011 International Endodontic Journal.

Hypercementosis and odontogenic epithelial hyperplasia associated with a tooth root remnant mimicking a neoplasm. A case report.

PubMed

Zustin, J; Friedrich, R E

2010-01-01

Hypercementosis presents as painless, single or multiple non-neoplastic cementum formation beyond the physiological limits of the tooth. It often occurs in the apical area of the involved tooth following infection, chemical or mechanical trauma. We report on radiographic and histopathological findings in a single case of late intraosseous hypercementosis and odontogenic epithelial hyperplasia associated with a minute apical tooth root remnant years after its extraction, mimicking a tumour.

Intraosseous mucoepidermoid carcinoma: a review of the diagnostic imaging features of four jaw cases.

PubMed

Chan, K C; Pharoah, M; Lee, L; Weinreb, I; Perez-Ordonez, B

2013-01-01

The purpose of this case series is to present the common features of intraosseous mucoepidermoid carcinoma (IMC) of the jaws in plain film and CT imaging. Two oral and maxillofacial radiologists reviewed and characterized the common features of four biopsy-proven cases of IMC in the jaws in plain film and CT imaging obtained from the files of the Department of Oral Radiology, Faculty of Dentistry, University of Toronto, Toronto, Canada. The common features are a well-defined sclerotic periphery, the presence of internal amorphous sclerotic bone and numerous small loculations, lack of septae bordering many of the loculations, and expansion and perforation of the outer cortical plate with extension into surrounding soft tissue. Other characteristics include tooth displacement and root resorption. The four cases of IMC reviewed have common imaging characteristics. All cases share some diagnostic imaging features with other multilocular-appearing entities of the jaws. However, the presence of amorphous sclerotic bone and malignant characteristics can be useful in the differential diagnosis.

Apical root resorption caused by orthodontic forces: A brief review and a long-term observation.

PubMed

Topkara, Ahu; Karaman, Ali I; Kau, Chung H

2012-10-01

External apical root resorption (ARR) is a common iatrogenic consequence of orthodontic treatment. One of the aims of this article is to present a brief overview of the literature, including; diagnosis and etiology, with emphasis on orthodontic forces to facilitate an understand of the prevention or management of ARR in orthodontic patients. We also present a long-term follow-up observation of severe ARR, including the last obtained cone beam computed tomography (CBCT) records, to demonstrate the effect of orthodontic forces on ARR.

Contamination of tooth-colored mineral trioxide aggregate used as a root-end filling material: a bacterial leakage study.

PubMed

Montellano, Angela M; Schwartz, Scott A; Beeson, Thomas J

2006-05-01

This experiment investigated the ability of tooth-colored mineral trioxide aggregate (MTA) to maintain an apical seal in the presence of bacteria when contaminated with blood, saline or saliva. Ninety extracted human teeth with single canals were randomly placed into six groups of 15. Canals were prepared to size 50. The apical 3 mm of each root was removed and 3 mm root-end preparations were made with a #329 bur. Root-end preparations in groups 1 through 3 were filled with MTA after contamination with blood, saline, or saliva, respectively. In group 4, uncontaminated root-end preparations were filled with MTA. Groups 5 and 6 served as negative and positive controls. A tube/tooth assembly was utilized to suspend each root end in Trypticase Soy Broth (TSB). The access chambers were filled with Staphylococcus epidermidis. Positive growth over thirty days was demonstrated by turbidity of the TSB. Vitek analysis was used to confirm the presence of S. epidermidis in the positive samples. Data evaluation consisted of a chi(2) analysis (p < 0.05). Although all experimental groups demonstrated leakage, tooth-colored MTA contaminated with saliva (group 3) leaked significantly more than the uncontaminated tooth-colored MTA (group 4) (p = 0.028).

Clinical feline dental radiography.

PubMed

Lemmons, Matthew

2013-05-01

Dental radiography is a necessary diagnostic modality in small animal practice. It is not possible to accurately assess and diagnose tooth resorption, periodontal disease, endodontic disease, neoplasia and injury without it. Dental radiography is also necessary for treatment and assessment of the patient postoperatively. Copyright © 2013 Elsevier Inc. All rights reserved.

Effect of education intervention on the quality and long-term outcomes of root canal treatment in general practice.

PubMed

Koch, M; Wolf, E; Tegelberg, Å; Petersson, K

2015-07-01

To compare the technical quality and long-term outcomes of root canal treatment by general practitioners of a Swedish Public Dental Service, before and after an endodontic education including Ni-Ti rotary technique (NiTiR). A random sample was compiled, comprising one root filled tooth from each of 830 patients, treated by 69 general practitioners participating in the education: 414 teeth root filled in 2002, pre-education, using primarily stainless steel instrumentation and filling by lateral compaction, and 416 teeth root filled post-education (2005), using mainly NiTiR and single-cone obturation. Follow-up radiographs taken in 2009 were evaluated alongside immediate post-filling radiographs from 2002 to 2005. The density and length of the root fillings were registered. Periapical status was assessed by the Periapical Index (PAI), using two definitions of disease: apical periodontitis (AP) (PAI 3 + 4 + 5) and definite AP (PAI 4 + 5). Tooth survival was registered. Root fillings pre- and post-education were compared using chi-square and Fisher's exact tests. Crude extraction rates per 100 years were calculated for comparison of tooth survival. Explanatory variables (type of tooth, root filling quality, periapical status, marginal bone loss, type and quality of coronal restoration) in relation to the dependent variable (AP at follow-up) were analysed by multivariable logistic regression. Follow-up data were available for 229 (55%) of teeth treated pre- and 288 (69%) treated post-education: both tooth survival (P < 0.001) and root filling quality were significantly higher (P < 0.001) in the latter. However, there was no corresponding improvement in periapical status. Both pre- and post-education, root fillings with definite AP on completion of treatment had significantly higher odds of AP or definite AP at follow-up. For teeth treated post-education, inadequate root filling quality was significantly associated with AP at follow-up. Despite a higher tooth survival rate and a significant improvement in technical quality of root fillings after the education, there was no corresponding improvement in periapical status. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Corticotomy-assisted orthodontic treatment

PubMed Central

Hassan, Ali H.; Al-Saeed, Samar H.; Al-Maghlouth, Basma A.; Bahammam, Maha A.; Linjawi, Amal I.; El-Bialy, Tarek H.

2015-01-01

Objectives: To systematically review the literature to assess the quality of evidence related to corticotomy-assisted orthodontic treatment (CAOT) as adjunctive treatment in orthodontics. Methods: The study was conducted in the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia between 2013 and 2014. Various electronic databases were searched and abstracts were retrieved. Defined inclusion criteria were then applied to the obtained original articles for further evaluation by 2 examiners independently. The criteria of selection included human, or animal studies, which assessed some aspects of CAOT and/or the biological principles behind it. Case reports and series were excluded. The quality of the studies was evaluated by the methodological score for clinical trials developed. Results: Fourteen articles were retrieved initially, but only 12 articles were finally selected for the study. The CAOT was found to accelerate tooth movement by 2-2.5 folds when compared with conventional orthodontic tooth movement. The CAOT was found safe on periodontal health and exhibits no or little risk of root resorption. A localized turnover of alveolar spongiosa and the absence of a hyalinized zone was the acceptable biological explanation of CAOT. There is no evidence to support that CAOT enhances the movement of ankylosed teeth, closing old extraction sites, post-orthodontic stability, or transverse expansion. Conclusions: Corticotomy-assisted orthodontic treatment should be considered with caution. Long term randomized clinical trials are still needed. PMID:26108582

Effectiveness of decoronation technique in the treatment of ankylosis: A systematic review.

PubMed

Mohadeb, Jhassu Varsha Naveena; Somar, Mirinal; He, Hong

2016-08-01

Dentoalveolar ankylosis in growing patients is complex leading to continuing root replacement resorption, tooth infra-position, or may even affect the development of alveolar ridge and adjacent teeth. While extraction of ankylosed teeth might be associated with bone loss, decoronation of the offending tooth (removal of crown portion and instrumentation of pulp canal to stimulate bleeding) has been suggested as a more conservative approach of bone preservation until definitive implant placement is planned. To primarily assess the efficacy of bone width and height preservation around ankylosed permanent teeth following decoronation. Pubmed, Embase, Ovid Medline, Thomson's ISI Web of Science and Cochrane library were searched from the year 1984 up to May 2015. Two authors conducted the data extraction. To eliminate publication bias, Open Grey literature and Pro-quest Dissertation Abstracts and Thesis database was also consulted. Through our strict selection criteria, only 12 articles were considered for eligibility. No randomized controlled trials were identified. Only one retrospective cohort study, four case series and seven case reports, were analyzed. Following decoronation, preservation of ridge height and ridge width were both noted. To maximize the benefits of decoronation, a timely and wellmonitored intervention is required. Treatment in patients, who have surpassed pubertal growth peaks, may not yield maximum effective treatment outcomes. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparison of gray mineral trioxide aggregate and diluted formocresol in pulpotomized primary molars: a 6- to 24-month observation.

PubMed

Sushynski, John M; Zealand, Cameron M; Botero, Tatiana M; Boynton, James R; Majewski, Robert F; Shelburne, Charles E; Hu, Jan Chingchun

2012-01-01

The purpose of this multisite, multioperator, prospective, randomized, controlled clinical trial was to evaluate 2-year outcomes of diluted formocresol (DFC) compared to gray mineral trioxide aggregate (GMTA) as pulpotomy medicaments. Following the standard pulpotomy procedure, the pulp stumps of 252 primary molars in 168 healthy children were randomly covered with GMTA or DFC. Pulp chambers were filled with Intermediate Restorative Material (IRM(®)) and teeth were restored with stainless steel crowns. At each follow-up appointment, the clinical status of the treated tooth was assessed and radiographs were taken. A total of 694 clinical and radiographic evaluations were analyzed. Gender, study site, arch type, and tooth type did not influence treatment outcome. At the combined 6- to 24-month follow-up, clinical success in the DFC group was no different than for the GMTA group. Radiographically, a significantly lower success rate was found in the DFC group vs the MTA group at all time points (P<.01). Dentin bridge formation was observed at a significantly higher frequency among the GMTA group (P<.01), while internal root resorption was observed at a higher frequency in the DFC group (P<.01). At the combined 6- to 24-month follow-up, gray mineral trioxide aggregate demonstrated significantly better radiographic outcomes vs diluted formocresol as pulpotomy medicaments.

[Three-dimensional data fusion method for tooth crown and root based on curvature continuity algorithm].

PubMed

Zhao, Y J; Liu, Y; Sun, Y C; Wang, Y

2017-08-18

To explore a three-dimensional (3D) data fusion and integration method of optical scanning tooth crowns and cone beam CT (CBCT) reconstructing tooth roots for their natural transition in the 3D profile. One mild dental crowding case was chosen from orthodontics clinics with full denture. The CBCT data were acquired to reconstruct the dental model with tooth roots by Mimics 17.0 medical imaging software, and the optical impression was taken to obtain the dentition model with high precision physiological contour of crowns by Smart Optics dental scanner. The two models were doing 3D registration based on their common part of the crowns' shape in Geomagic Studio 2012 reverse engineering software. The model coordinate system was established by defining the occlusal plane. crown-gingiva boundary was extracted from optical scanning model manually, then crown-root boundary was generated by offsetting and projecting crown-gingiva boundary to the root model. After trimming the crown and root models, the 3D fusion model with physiological contour crown and nature root was formed by curvature continuity filling algorithm finally. In the study, 10 patients with dentition mild crowded from the oral clinics were followed up with this method to obtain 3D crown and root fusion models, and 10 high qualification doctors were invited to do subjective evaluation of these fusion models. This study based on commercial software platform, preliminarily realized the 3D data fusion and integration method of optical scanning tooth crowns and CBCT tooth roots with a curvature continuous shape transition. The 10 patients' 3D crown and root fusion models were constructed successfully by the method, and the average score of the doctors' subjective evaluation for these 10 models was 8.6 points (0-10 points). which meant that all the fusion models could basically meet the need of the oral clinics, and also showed the method in our study was feasible and efficient in orthodontics study and clinics. The method of this study for 3D crown and root data fusion could obtain an integrate tooth or dental model more close to the nature shape. CBCT model calibration may probably improve the precision of the fusion model. The adaptation of this method for severe dentition crowding and micromaxillary deformity needs further research.

Comparison of intracanal EndoSequence Root Repair Material and ProRoot MTA to induce pH changes in simulated root resorption defects over 4 weeks in matched pairs of human teeth.

PubMed

Hansen, Stephen W; Marshall, J Gordon; Sedgley, Christine M

2011-04-01

Intracanal mineral trioxide aggregate (MTA) may provide an alternative to calcium hydroxide in the treatment of external inflammatory root resorption. This in vitro study using human matched pairs of teeth compared white ProRoot MTA (WMTA; (Dentsply Tulsa Dental Specialties, Tulsa, OK) and an alternative material with purportedly improved handling properties, EndoSequence Root Repair Material (ES; Brasseler USA, Savannah, GA), by measuring pH in simulated root surface resorptive defects after intracanal placement. The null hypothesis tested was that there is no difference between WMTA and ES. Bilaterally matched pairs (n = 24) of extracted, human, single-rooted teeth were instrumented to apical size 50/.06, and root surface cavities were prepared at 5 mm and 2 mm from the apex. Root canals of experimental matched pairs (n = 20) were filled with WMTA or ES; control pairs (n = 4) were filled with calcium hydroxide (positive control [POS]) or saline (negative control [NEG]). Teeth were sealed coronally and apically and immersed in saline. The pH in root surface cavities was measured at 20 minutes, 3 hours, 24 hours, 1 week, 2 weeks, 3 weeks, and 4 weeks. The pH at 5 mm when compared with the 2-mm level was significantly higher for the WMTA, ES, and POS groups (P < .05, paired t tests); therefore, each level was analyzed separately. At both the 2-mm and 5-mm levels, significant pH changes occurred over time in the WMTA, ES (both P < .0001, repeated-measures analysis of variance), and POS (P < .0001, Friedman test) groups and not in the NEG group (mean pH = 7.32 ± 0.04, P > .05). There were no differences between WMTA and ES at 20 minutes and 3 hours at both levels or at 24 hours at 5mm. The pH of WMTA was higher than ES by 24 hours at the 2-mm level (8.79 vs 8.56, P < .05, paired t test) and after 1 week at the 5-mm level (8.91 vs 8.05, P < .0001) and was thereafter always significantly higher in WMTA compared with ES (P < .0001). The null hypothesis was rejected. In matched pairs of teeth, intracanal placement of WMTA compared with ES resulted in a higher pH in simulated root resorption defects that was time and root level dependent. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

[Theory and practice of minimally invasive endodontics].

PubMed

Jiang, H W

2016-08-01

The primary goal of modern endodontic therapy is to achieve the long-term retention of a functional tooth by preventing or treating pulpitis or apical periodontitis is. The long-term retention of endodontically treated tooth is correlated with the remaining amount of tooth tissue and the quality of the restoration after root canal filling. In recent years, there has been rapid progress and development in the basic research of endodontic biology, instrument and applied materials, making treatment procedures safer, more accurate, and more efficient. Thus, minimally invasive endodontics(MIE)has received increasing attention at present. MIE aims to preserve the maximum of tooth structure during root canal therapy, and the concept covers the whole process of diagnosis and treatment of teeth. This review article focuses on describing the minimally invasive concepts and operating essentials in endodontics, from diagnosis and treatment planning to the access opening, pulp cavity finishing, root canal cleaning and shaping, 3-dimensional root canal filling and restoration after root canal treatment.

First record of plicidentine in Synapsida and patterns of tooth root shape change in Early Permian sphenacodontians.

PubMed

Brink, Kirstin S; LeBlanc, Aaron R H; Reisz, Robert R

2014-11-01

Recent histological studies have revealed a diversity of dental features in Permo-Carboniferous tetrapods. Here, we report on the occurrence of plicidentine (infolded dentine around the base of the tooth root) in Sphenacodontia, the first such documentation in Synapsida, the clade that includes mammals. Five taxa were examined histologically, Ianthodon schultzei, Sphenacodon ferocior, Dimetrodon limbatus, Dimetrodon grandis, and Secodontosaurus obtusidens. The tooth roots of Ianthodon possess multiple folds, which is generally viewed as the primitive condition for amniotes. Sphenacodon and D. limbatus have distinctive "four-leaf clover"-shaped roots in cross section, whereas Secodontosaurus has an elongate square shape with only subtle folding. The most derived and largest taxon examined in this study, D. grandis, has rounded roots in cross section and therefore no plicidentine. This pattern of a loss of plicidentine in sphenacodontids supports previous functional hypotheses of plicidentine, where teeth with shallow roots require folds to increase the area of attachment to the tooth-bearing element, whereas teeth with long roots do not. This pattern may also reflect differences in diet between co-occurring sphenacodontids as well as changes in feeding niche through time, specifically in the apex predator Dimetrodon.

Endoscopically assisted tunnel approach for minimally invasive corticotomies: a preliminary report.

PubMed

Hernández-Alfaro, Federico; Guijarro-Martínez, Raquel

2012-05-01

The dental community has expressed low acceptance of traditional corticotomy techniques for corticotomy-facilitated orthodontics. These procedures are time consuming, entail substantial postoperative morbidity and periodontal risks, and are often perceived as highly invasive. A total of 114 interdental sites were treated in nine consecutive patients. Under local anesthesia, a tunnel approach requiring one to three vertical incisions per arch (depending on the targeted teeth) was used. Piezosurgical corticotomies and elective bone augmentation procedures were performed under endoscopic assistance. Postoperative cone-beam computerized tomography evaluation was used to confirm adequate corticotomy depth. Procedures were completed in a mean time of 26 minutes. Follow-up evaluations revealed no loss of tooth vitality, no changes in periodontal probing depth, good preservation of the papillae, and no gingival recession. No evidence of crestal bone height reduction or apical root resorption was detected. The tunnel approach minimizes soft-tissue debridement and permits effective cortical cuts. The combination of piezosurgery technique with endoscopic assistance provides a quick, reliable means to design and perform these corticotomies while maximizing root integrity preservation. Moreover, the sites needing bone augmentation are selected under direct vision. Compared to traditional corticotomies, this procedure has manifest advantages in surgical time, technical complexity, patient morbidity, and periodontium preservation.

Dental Space Deficiency Syndrome: An Anthropological Perspective.

PubMed

Richman, Colin S

2017-03-01

A new syndrome in dentistry, the dental space deficiency syndrome is proposed in this article. Signs and symptoms of this entity may include one or more of the following clinical dental features: tooth crowding, gingival recession, tooth impactions, rapid resorption of facial alveolar bony plates following premature tooth loss, dentally oriented sleep disorders, extended orthodontic treatment time, and malocclusion relapse following orthodontic therapy. These oral conditions, individually or collectively, seem to be associated with both genetic and functional factors. From an anthropological-functional perspective, the human jaws (basal bone and/or alveolar bone) have been shrinking. This results in a three-dimensional discrepancy between jawbone and tooth volumes, which are genetically determined. Consequently, the reduced volume of alveolar bone is not adequately able to accommodate the associated genetically determined dentition in functional and esthetic harmony. This paper describes the common etiology for the conditions listed above, namely the discrepancy between alveolar bone volume (essentially determined by functionality), and associated tooth volume (essentially determined by genetics), when considered in a three-dimensional perspective.

Functional fixation of autotransplanted tooth germs by using bioresorbable membranes.

PubMed

Gérard, Eric; Membre, Hervé; Gaudy, Jean-François; Mahler, Patrick; Bravetti, Pierre

2002-12-01

The purpose of this study was to evaluate the contribution of a bioresorbable membrane placement to the healing of immature teeth after autotransplantation of tooth buds. Six cases were selected: 2 transplantations of wisdom teeth, 2 for premolar agenesis, 1 for ectopia, and 1 premolar in an incisor position. The crown of each tooth germ and the marginal alveolar bone were covered with a resorbable membrane. The radicular edification was nearly complete, neither ankylosis nor inflammatory resorption was observable, the pulp vitality was preserved, and the periodontal integration was identical to that of other teeth. The membrane ensured contention and stabilization of the transplant, allowed functional stimulation, permitted protection of the coagulum and periodontal cells, and kept the epithelium at a distance. The transplantations of immature teeth were improved by the use of a resorbable membrane, which caused an optimal functional fixation of the transplanted tooth.

Effects of near-infrared LED therapy on experimental tooth replantation in rats.

PubMed

Pigatto Mitihiro, Débora; de Paula Ramos, Solange; Corazza Montero, Janaína; Alves Campos, Aline; de Oliveira Toginho Filho, Dari; Dezan Garbelini, Cassia Cilene

2017-02-01

Dental avulsion damages periodontal tissues and may induce dentoalveolar ankylosis and root resorption after replantation. The aim of this work was to evaluate the effects of light-emitting diode (LED) therapy after tooth replantation. The upper right incisors of 36 male Wistar rats were extracted and replanted after 15 min. The control group (Co, n = 18) was submitted to replantation and the LED group (n = 18) was submitted to replantation and LED therapy (940 nm, 4 J cm -2 ) for three consecutive days (0, 24, and 48 h). Six animals from each group were euthanized at 7, 14, and 21 days for histological analysis. The upper left incisors were used as a negative control. Data were compared using the Fisher exact test, considering P < 0.05. After 7 days, the Co (73.3%) and LED (72.2%) groups presented areas of periodontal ligament necrosis. However, periodontal ligament necrosis was more frequent in the LED group at 14 (70%, P < 0.05) and 21 days (43.2%, P < 0.05) in relation to the Co group (33 and 21.6%). Inflammatory cell infiltration was more frequent in the Co group at 7 days (100%) than the LED group (24.4%, P < 0.05), but increased in the LED group after 21 days (83.3%, P < 0.05). Bone necrosis was more frequent in the LED group after 14 (79%, P < 0.05) and 21 days (60%, P < 0.005) than in the Co group (45% and 20%). Bone repair was evident in the Co group at 14 days. All of the replanted teeth had pulp necrosis. The results suggest that the application of LED therapy up to 48 h after tooth replantation may delay periodontal ligament repair. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Morphometric and microscopic evaluation of the effect of a solution of alendronate as an intracanal therapeutic agent in rat teeth submitted to late reimplantation.

PubMed

Mori, Graziela Garrido; Garcia, Roberto Brandão; Gomes de Moraes, Ivaldo; Bramante, Clóvis Monteiro; Bernardineli, Norberti

2007-08-01

The use of substances that inhibit root resorption may be an alternative for cases of unsuccessful reimplants. Hence, the purpose of this study was to test a solution of alendronate, a resorption inhibitor, as an intracanal therapeutic agent for teeth submitted to late reimplantation. Thirty rat maxillary right central incisors were avulsed and kept dry for 30 min. The teeth were instrumented, and the root surfaces treated with 1% hypochlorite solution followed by application of 2% sodium fluoride. Thereafter, the teeth were divided in two groups according to the intracanal dressing: (i) group I, solution of alendronate and (ii) group II, calcium hydroxide paste. Teeth were then reimplanted in their respective sockets. The animals were killed at 15, 30 and 60 days after reimplantation and the samples processed for morphometric and microscopic analysis. The results demonstrated that the solution of alendronate and the calcium hydroxide paste limited the root resorption, yet did not impair its occurrence. It may be concluded that alendronate and calcium hydroxide paste demonstrated similar behavior.

Histogenesis and disappearance of the teeth of the Mekong giant catfish, Pangasianodon gigas (Teleostei).

PubMed

Kakizawa, Yoshiko; Meenakarn, Wanpen

2003-12-01

Juveniles of the Mekong giant catfish, Pangasianodon gigas (Teleostei), have 3 sorts of tooth-upper and lower jaw teeth, palatal teeth, and pharyngeal teeth--but adults are toothless. To investigate the histogenesis and disappearance of the teeth, we made serial sections of the mouth and teeth of juvenile fish at 10 developmental stages (from ca. 8.5 to ca. 30 cm in total length) and examined them under scanning electron microscope and light microscope. Observations of teeth and surrounding tissues in the serial sections revealed the process of tooth resorption by active odontoclast-like cells. Numbers of jaw and palatal teeth decreased with age. When the fish reached ca. 14 cm in total length, the numbers of functional upper jaw teeth and successional tooth germs decreased rapidly, and the developmental rate of successional tooth germs slowed. When the fish reached ca. 24 cm, no teeth existed in the upper jaw. It is clear that tooth disappearance results from the shedding of functional teeth and the lack of replacement tooth germs.

[Root canal treatment of mandibular second premolar tooth with taurodontism].

PubMed

Vujasković, Mirjana; Karadzić, Branislav; Miletić, Vesna

2008-01-01

Taurodontism is a morphoanatomical change in the shape of a tooth. An enlarged body of a tooth with smaller than usual roots is a characteristic feature. Internal tooth anatomy correlates with this appearance, which means that a taurodontal tooth has a large pulp chamber and apically positioned furcations. This dental anomaly may be associated with different syndromes and congenital discoders. The case report presents the patient of a rare case of taurodontism in the mandibular second premolar with chronic periodontitis. Endodontic treatment was performed after dental history and clinical examination. Special care is required in all segments of endodontic treatment of a taurodontal tooth from the identification orifice, canal exploration, determining working length, cleaning and shaping and obturation of the root canal. Precurved K-file was used for canal exploration and location of the furcation. One mesial and one distal canal with the buccal position were identified in the apical third of the root canal. The working lengths of two canals were determined by radiographic interpretation with two K-files in each canal and verified with the apex locator. During canal instrumentation, the third canal was located in the disto-lingual position. The working length of the third canal was established using the apex locator. Thorough knowledge of tooth anatomy and its variations can lead to lower percentage of endodontic failure. Each clinical case involving these teeth should be investigated carefully, clinically and radiographically to detect additional root canals. High quality radiographs from different angles and proper instrumentarium improve the quality of endodontic procedure.

Root canal treatment of a periradicular lesion caused by unintentional root damage after orthodontic miniscrew placement: a case report.

PubMed

Er, K; Bayram, M; Taşdemir, T

2011-12-01

To present the successful endodontic management of a maxillary lateral incisor tooth with a periradicular lesion caused by unintentional root damage after orthodontic miniscrew placement. A 22-year-old female was diagnosed with a skeletal Class II, Division 2 malocclusion with Class II molar and canine relationships on both sides. The treatment plan included distalization of the maxillary first molars bilaterally followed by full fixed appliance therapy. For the maxillary molar distalization, an appliance in conjunction with a miniscrew anchorage system was designed. Two months later, the patient came to the clinic with complaints of pain in the maxillary right lateral incisor region. On intraoral examination, intraoral sinus tracts were detected in the maxillary right buccal sulcus and palate. A large radiolucent lesion with a well-defined margin around the root of the maxillary right lateral incisor was seen. Root canal treatment was performed on the maxillary right lateral incisor tooth. The root canal was filled with gutta-percha and AH Plus sealer, using a lateral compaction technique. The final restoration of the tooth was completed using composite, and the tooth was reviewed after 10 months. The tooth was asymptomatic and radiographically showed repair of the lesion. Healing was achieved without any need for further endodontic or surgical intervention. Key learning points • This case illustrates the need to take care with miniscrews when performing orthodontic treatment, especially when the miniscrews are in close proximity to root apices. • The periradicular lesion as a result of miniscrew damage was successfully treated with root canal treatment. © 2011 International Endodontic Journal.

Two-rooted maxillary first molars with two canals: a case series.

PubMed

Shakouie, Sahar; Mokhtari, Hadi; Ghasemi, Negin; Gholizadeh, Seddigheh

2013-01-01

Thorough understanding of the anatomic and internal morphology of a root canal system is absolutely essential for the success of endodontic treatment. Since permanent maxillary first molars have shown variation in internal anatomy, morphology, this tooth has been reviewed extensively. Presence of two canals in a two-rooted maxillary first molar has rarely been reported in studies describing tooth and root canal anatomies. In this report, three cases are presented, which involve the root canal treatment of maxillary first molars with fusion of the two buccal roots.

Extracellular Matrix-mediated Tissue Remodeling Following Axial Movement of Teeth

PubMed Central

Luan, Xianghong; Ito, Yoshihiro; Holliday, Sean; Walker, Cameron; Daniel, Jon; Galang, Therese M.; Fukui, Tadayoshi; Yamane, Akira; Begole, Ellen; Evans, Carla; Diekwisch, Thomas G.H.

2007-01-01

SUMMARY Tooth eruption is a multifactorial process involving movement of existing tissues and formation of new tissues coordinated by a complex set of genetic events. We have used the model of the unopposed rodent molar to study morphological and genetic mechanisms involved in axial movement of teeth. Following extraction of opposing upper molars, lower molars supererupted by 0.13 mm. Labeled tissue sections revealed significant amounts of new bone and cementum apposition at the root apex of the unopposed side following supereruption for 12 days. Newly apposited cementum and alveolar bone layers were approximately 3-fold thicker in the experimental vs the control group, whereas periodontal ligament width was maintained. Tartrate-resistant acid phosphatase staining indicated bone resorption at the mesial alveolar walls of unopposed molars and provided in tandem with new bone formation at the distal alveolar walls an explanation for the distal drift of molars in this model. Microarray analysis and semiquantitative RT-PCR demonstrated a significant increase in collagen I, integrin β5, and SPARC gene expression as revealed by comparison between the unopposed molar group and the control group. Immunohistochemical verification revealed increased levels of integrin β5 and SPARC labeling in the periodontal ligament of the unopposed molar. Together our findings suggest that posteruptive axial movement of teeth was accomplished by significant formation of new root cementum and alveolar bone at the root apex in tandem with upregulation of collagen I, integrin β5, and SPARC gene expression. PMID:17015623

Endodontic treatment of a mandibular second premolar with three root canals.

PubMed

Aguiar, Carlos; Mendes, Daniela; Câmara, Andréa; Figueiredo, Jose

2010-03-01

The purpose of this case report is to describe a nonsurgical endodontic treatment of a mandibular left second premolar with two separate roots and three distinct root canals. In endodontics, the possible existence of extra canals must be considered before endodontic treatment is instituted. A wide morphological variation of the root canal system is known to exist. A 36-year-old male patient was referred for endodontic treatment on the left mandibular second premolar. Radiographic examination of the involved tooth revealed an unusual, complex root canal anatomy. There was an irregular root morphology consisting of two distinct roots and three canals. This case report describes the successful nonsurgical endodontic treatment of a mandibular left second premolar with two separate roots and three distinct root canals filled using size 35 Thermafil gutta-percha carriers and AH Plus sealer. On the one-year follow-up radiograph, the tooth was asymptomatic, confirming adequate healing with no complications. Even in a tooth with an extremely complex root canal morphology, conventional endodontic treatment without surgical intervention can result in adequate healing without any complications.

[A method for rapid extracting three-dimensional root model of vivo tooth from cone beam computed tomography data based on the anatomical characteristics of periodontal ligament].

PubMed

Zhao, Y J; Wang, S W; Liu, Y; Wang, Y

2017-02-18

To explore a new method for rapid extracting and rebuilding three-dimensional (3D) digital root model of vivo tooth from cone beam computed tomography (CBCT) data based on the anatomical characteristics of periodontal ligament, and to evaluate the extraction accuracy of the method. In the study, 15 extracted teeth (11 with single root, 4 with double roots) were collected from oral clinic and 3D digital root models of each tooth were obtained by 3D dental scanner with a high accuracy 0.02 mm in STL format. CBCT data for each patient were acquired before tooth extraction, DICOM data with a voxel size 0.3 mm were input to Mimics 18.0 software. Segmentation, Morphology operations, Boolean operations and Smart expanded function in Mimics software were used to edit teeth, bone and periodontal ligament threshold mask, and root threshold mask were automatically acquired after a series of mask operations. 3D digital root models were extracted in STL format finally. 3D morphology deviation between the extracted root models and corresponding vivo root models were compared in Geomagic Studio 2012 software. The 3D size errors in long axis, bucco-lingual direction and mesio-distal direction were also calculated. The average value of the 3D morphology deviation for 15 roots by calculating Root Mean Square (RMS) value was 0.22 mm, the average size errors in the mesio-distal direction, the bucco-lingual direction and the long axis were 0.46 mm, 0.36 mm and -0.68 mm separately. The average time of this new method for extracting single root was about 2-3 min. It could meet the accuracy requirement of the root 3D reconstruction fororal clinical use. This study established a new method for rapid extracting 3D root model of vivo tooth from CBCT data. It could simplify the traditional manual operation and improve the efficiency and automation of single root extraction. The strategy of this method for complete dentition extraction needs further research.

Periodontal soft tissue root coverage procedures: a consensus report from the AAP Regeneration Workshop.

PubMed

Tatakis, Dimitris N; Chambrone, Leandro; Allen, Edward P; Langer, Burton; McGuire, Michael K; Richardson, Christopher R; Zabalegui, Ion; Zadeh, Homayoun H

2015-02-01

Management of gingival recession defects, a common periodontal condition, using root coverage procedures is an important aspect of periodontal regenerative therapy. The goal of the periodontal soft tissue root coverage procedures group was to develop a consensus report based on the accompanying systematic review of root coverage procedures, including priorities for future research and identification of the best evidence available to manage different clinical scenarios. The group reviewed and discussed the accompanying systematic review, which covered treatment of single-tooth recession defects, multiple-tooth recession defects, and additional focused questions on relevant clinical topics. The consensus group members submitted additional material for consideration by the group in advance and at the time of the meeting. The group also identified priorities for future research. All reviewed root coverage procedures provide significant reduction in recession depth, especially for Miller Class I and II recession defects. Subepithelial connective tissue graft (SCTG) procedures provide the best root coverage outcomes. Acellular dermal matrix graft (ADMG) or enamel matrix derivative (EMD) in conjunction with a coronally advanced flap (CAF) can serve as alternatives to autogenous donor tissue. Additional research is needed to do the following: 1) assess the treatment outcomes for multiple-tooth recession defects, oral sites other than maxillary canine and premolar teeth, and Miller Class III and IV defects; 2) assess the role of patient- and site-specific factors on procedure outcomes; and 3) obtain evidence on patient-reported outcomes. Predictable root coverage is possible for single-tooth and multiple-tooth recession defects, with SCTG procedures providing the best root coverage outcomes. Alternatives to SCTG are supported by evidence of varying strength. Additional research is needed on treatment outcomes for specific oral sites. Clinical Recommendation: For Miller Class I and II single-tooth recession defects, SCTG procedures provide the best outcomes, whereas ADMG or EMD in conjunction with CAF may be used as an alternative.

Effects of tooth root contact on the stability of orthodontic anchor screws in the maxilla: Comparison between self-drilling and self-tapping methods.

PubMed

Iwai, Hiroaki; Motoyoshi, Mitsuru; Uchida, Yasuki; Matsuoka, Miho; Shimizu, Noriyoshi

2015-04-01

We evaluated the effects of screw placement angle on the frequency of root contact and the effects of root contact on screw stability, comparing self-drilling and self-tapping methods. In total, 80 patients with 142 screws (diameter, 1.6 mm; length, 8.0 mm) were included. Cone-beam computed tomography images were taken. Cortical bone thickness, interroot distance, shortest distance between the screw and adjacent tooth root, and screw placement angle were measured. The success rates of the screws were 91.5% for the self-drilling method and 94.4% for the self-tapping method (P >0.05). The self-drilling screws tended to contact the distal tooth roots in the right maxilla. In the self-drilling method, the failure rate was significantly higher in the root contact group than in the no-contact group (P <0.05). The success rate was not significantly different between the self-drilling and the self-tapping methods in the maxilla. Avoidance of tooth root contact may improve the success rate more in the self-drilling method than in the self-tapping method. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

2-Dimensional changes of the soft tissue profile of augmented and non-augmented human extraction sockets: a randomized pilot study.

PubMed

Flügge, Tabea; Nelson, Katja; Nack, Claudia; Stricker, Andres; Nahles, Susanne

2015-04-01

This study identified the soft tissue changes of the alveolar ridge at different time points within 12 weeks after tooth extraction with and without socket augmentation. In 38 patients with single tooth extractions, 40 sockets were augmented and 39 extraction sockets were not augmented. At 2, 4, 6, 8 and 12 weeks impressions were taken and casts digitized with a laser scanner. The horizontal and vertical changes were compared between augmented and non-augmented sites. A p-value <0.05 was considered statistically significant. The mean changes of augmented sockets were between 0.4 mm (2 weeks) and 0.8 mm (12 weeks). In non-augmented sockets changes of 0.7 mm (2 weeks) and of 1.0 mm (12 weeks) were demonstrated. The mean values differed significantly between the buccal and oral region (p < 0.01). Overall, there were significant differences of the mean dimensional changes regarding time (p < 0.01) and augmentation (p < 0.01). Augmented sockets showed less resorption within 4 weeks after extraction compared to non-augmented sockets. Non-augmented sockets showed a continuous dimensional loss with a great variation over 12 weeks whereas augmented sockets had the highest degree of resorption between 4 and 6 weeks. At 12 weeks a comparable resorption in augmented and non-augmented sockets was observed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Human tooth and root canal morphology reconstruction using magnetic resonance imaging.

PubMed

Drăgan, Oana Carmen; Fărcăşanu, Alexandru Ştefan; Câmpian, Radu Septimiu; Turcu, Romulus Valeriu Flaviu

2016-01-01

Visualization of the internal and external root canal morphology is very important for a successful endodontic treatment; however, it seems to be difficult considering the small size of the tooth and the complexity of the root canal system. Film-based or digital conventional radiographic techniques as well as cone beam computed tomography provide limited information on the dental pulp anatomy or have harmful effects. A new non-invasive diagnosis tool is magnetic resonance imaging, due to its ability of imaging both hard and soft tissues. The aim of this study was to demonstrate magnetic resonance imaging to be a useful tool for imaging the anatomic conditions of the external and internal root canal morphology for endodontic purposes. The endodontic system of one freshly extracted wisdom tooth, chosen for its well-known anatomical variations, was mechanically shaped using a hybrid technique. After its preparation, the tooth was immersed into a recipient with saline solution and magnetic resonance imaged immediately. A Bruker Biospec magnetic resonance imaging scanner operated at 7.04 Tesla and based on Avance III radio frequency technology was used. InVesalius software was employed for the 3D reconstruction of the tooth scanned volume. The current ex-vivo experiment shows the accurate 3D volume rendered reconstruction of the internal and external morphology of a human extracted and endodontically treated tooth using a dataset of images acquired by magnetic resonance imaging. The external lingual and vestibular views of the tooth as well as the occlusal view of the pulp chamber, the access cavity, the distal canal opening on the pulp chamber floor, the coronal third of the root canals, the degree of root separation and the apical fusion of the two mesial roots, details of the apical region, root canal curvatures, furcal region and interradicular root grooves could be clearly bordered. Magnetic resonance imaging offers 3D image datasets with more information than the conventional radiographic techniques. Due to its ability of imaging both hard and soft dental tissues, magnetic resonance imaging can be successfully used as a 3D diagnostic imaging technique in dentistry. When choosing the imaging method, dental clinicians should weight the benefit-risk ratio, taking into account the costs associated to magnetic resonance imaging and the harmful effects of ionizing radiations when cone beam computed tomography or conventional x-ray are used.

Inactivation of Tgfbr2 in Osterix-Cre expressing Dental Mesenchyme Disrupts Molar Root Formation

PubMed Central

Coricor, George; MacDougall, Mary; Serra, Rosa

2013-01-01

It has been difficult to examine the role of TGF-ß in post-natal tooth development due to perinatal lethality in many of the signaling deficient mouse models. To address the role of Tgfbr2 in postnatal tooth development, we generated a mouse in which Tgfbr2 was deleted in odontoblast-and bone-producing mesenchyme. Osx-Cre;Tgfbr2fl/fl mice were generated (Tgfbr2cko) and postnatal tooth development was compared in Tgfbr2cko and control littermates. X-ray and μCT analysis showed that in Tgfbr2cko mice radicular dentin matrix density was reduced in the molars. Molar shape was abnormal and molar eruption was delayed in the mutant mice. Most significantly, defects in root formation, including failure of the root to elongate, were observed by postnatal day 10. Immunostaining for Keratin-14 (K14) was used to delineate Hertwig's epithelial root sheath (HERS). The results showed a delay in elongation and disorganization of the HERS in Tgfbr2cko mice. In addition, the HERS was maintained and the break up into epithelial rests was attenuated suggesting that Tgfbr2 acts on dental mesenchyme to indirectly regulate the formation and maintenance of the HERS. Altered odontoblast organization and reduced Dspp expression indicated that odontoblast differentiation was disrupted in the mutant mice likely contributing to the defect in root formation. Nevertheless, expression of Nfic, a key mesenchymal regulator of root development, was similar in Tgfbr2cko mice and controls. The number of osteoclasts in the bone surrounding the tooth was reduced and osteoblast differentiation was disrupted likely contributing to both root and eruption defects. We conclude that Tgfbr2 in dental mesenchyme and bone is required for tooth development particularly root formation. PMID:23933490

Adaptation of BAp crystal orientation to stress distribution in rat mandible during bone growth

NASA Astrophysics Data System (ADS)

Nakano, T.; Fujitani, W.; Ishimoto, T.; Umakoshi, Y.

2009-05-01

Biological apatite (BAp) c-axis orientation strongly depends on stress distribution in vivo and tends to align along the principal stress direction in bones. Dentulous mandible is subjected to a complicated stress condition in vivo during chewing but few studies have been carried out on the BAp c-axis orientation; so the adaptation of BAp crystal orientation to stress distribution was examined in rat dentulous mandible during bone growth and mastication. Female SD rats 4 to 14 weeks old were prepared, and the bone mineral density (BMD) and BAp crystal orientation were analyzed in a cross-section of mandible across the first molar focusing on two positions: separated from and just under the tooth root on the same cross-section perpendicular to the mesiodistal axis. The degree of BAp orientation was analyzed by a microbeam X-ray diffractometer using Cu-Kα radiation equipped with a detector of curved one-dimensional PSPC and two-dimensional PSPC in the reflection and transmission optics, respectively. BMD quickly increased during bone growth up to 14 weeks, although it was independent of the position from the tooth root. In contrast, BAp crystal orientation strongly depended on the age and the position from the tooth root, even in the same cross-section and direction, especially along the mesiodistal and the biting axes. With increased biting stress during bone growth, the degree of BAp orientation increased along the mesiodistal axis in a position separated from the tooth root more than that near the tooth root. In contrast, BAp preferential alignment clearly appeared along the biting axis near the tooth root. We conclude that BAp orientation rather than BMD sensitively adapts to local stress distribution, especially from the chewing stress in vivo in the mandible.

Comparison of the intrusion effects on the maxillary incisors between implant anchorage and J-hook headgear.

PubMed

Deguchi, Toru; Murakami, Takashi; Kuroda, Shingo; Yabuuchi, Toshinori; Kamioka, Hiroshi; Takano-Yamamoto, Teruko

2008-05-01

Recently, miniscrews have been used to provide anchorage during orthodontic treatment, especially for incisor intrusion. Miniscrews during incisor intrusion are commonly used in implant orthodontics. Traditionally, effective incisor intrusion has been accomplished with J-hook headgear. In this study, we compared the effect of incisor intrusion, force vector, and amount of root resorption between implant orthodontics and J-hook headgear. Lateral cephalometric radiographs from 8 patients in the implant group and 10 patients in the J-hook headgear group were analyzed for incisor retraction. The estimated force vector was analyzed in the horizontal and vertical directions in both groups. Root resorption was also measured on periapical radiographs. In the implant group, significant reductions in overjet, overbite, maxillary incisor to palatal plane, and maxillary incisor to upper lip were observed after intrusion of the incisors. In the J-hook headgear group, significant reductions in overjet, overbite, maxillary incisor to upper lip, and maxillary incisor to SN plane were observed after intrusion of the incisors. There were significantly greater reductions in overbite, maxillary incisor to palatal plane, and maxillary incisor to upper lip in the implant group than in the J-hook headgear group. Estimated force analysis resulted in significantly more force in the vertical direction and less in the horizontal direction in the implant group. Furthermore, significantly less root resorption was observed in the implant group compared with the J-hook headgear group. The maxillary incisors were effectively intruded by using miniscrews as orthodontic anchorage without patient cooperation. The amount of root resorption was not affected by activating the ligature wire from the miniscrew during incisor intrusion.

Trial shows partial caries removal is an effective technique in primary molars.

PubMed

Santamaria, Ruth; Innes, Nicola

2014-09-01

Randomised controlled trial in a university setting. Children aged three to eight years, with at least one molar with an acute, deep carious lesion into the dentine were recruited. Treatment took place under rubber dam with decayed dentine being removed completely from the lateral walls of cavities in both groups using round burs operated at low speed. TCR or PCR was then performed in the pulpal wall of each tooth. After caries removal teeth were restored with calcium hydroxide cement and composite resin. Teeth with pulpal exposure were pulpotomised using ferric sulphate. The presence of a fistula, swelling, spontaneous pain and mobility not compatible with root resorption were considered to be clinical signs of failure. Radiolucency at the furcation or in the periapical region and internal or external pathological resorption were considered to be radiographic signs of failure. One hundred and twenty-four teeth in 51 patients were randomised. In the TCR group there were 57 teeth and 38 patients, with 41 patients and 67 teeth in the PCR group. Three patients (four teeth; one PCR and three TCR) dropped out leaving 120 teeth (PCR: n = 66; TCR: n = 54) for analysis. In the TCR group 27.5% (15) teeth in 13 children had pulp exposure compared with one tooth in one child in the PCR group (2%). The mean operative time was significantly higher for TCR (28.1 min; 95% CI: 23.6-32.6 min) than for PCR (17.9 min; 95% CI: 16.3-19.5 min). There was no statistical difference in success rates at 24 months between the groups. The success rate in the TCR group was 96%; (95% CI: 85-99%) compared with 92%; (95% CI: 81-96%) in the PCR group. The clinical and radiographic success rates of PCR and TCR in primary teeth with deep carious lesions were high and did not differ significantly, indicating that PCR is a reliable minimally invasive approach in primary teeth and that the retention of carious dentine does not interfere with pulp vitality. Moreover, PCR provided other clinically relevant advantages over TCR, especially lower incidence of pulp exposure and lower operative time.

Taurodontism, variations in tooth number, and misshapened crowns in Wnt10a null mice and human kindreds

PubMed Central

Yang, Jie; Wang, Shih-Kai; Choi, Murim; Reid, Bryan M; Hu, Yuanyuan; Lee, Yuan-Ling; Herzog, Curtis R; Kim-Berman, Hera; Lee, Moses; Benke, Paul J; Kent Lloyd, K C; Simmer, James P; Hu, Jan C-C

2015-01-01

WNT10A is a signaling molecule involved in tooth development, and WNT10A defects are associated with tooth agenesis. We characterized Wnt10a null mice generated by the knockout mouse project (KOMP) and six families with WNT10A mutations, including a novel p.Arg104Cys defect, in the absence of EDA,EDAR, or EDARADD variations. Wnt10a null mice exhibited supernumerary mandibular fourth molars, and smaller molars with abnormal cusp patterning and root taurodontism. Wnt10a−/− incisors showed distinctive apical–lingual wedge-shaped defects. These findings spurred us to closely examine the dental phenotypes of our WNT10A families. WNT10A heterozygotes exhibited molar root taurodontism and mild tooth agenesis (with incomplete penetrance) in their permanent dentitions. Individuals with two defective WNT10A alleles showed severe tooth agenesis and had fewer cusps on their molars. The misshapened molar crowns and roots were consistent with the Wnt10a null phenotype and were not previously associated with WNT10A defects. The missing teeth contrasted with the presence of supplemental teeth in the Wnt10a null mice and demonstrated mammalian species differences in the roles of Wnt signaling in early tooth development. We conclude that molar crown and root dysmorphologies are caused by WNT10A defects and that the severity of the tooth agenesis correlates with the number of defective WNT10A alleles. PMID:25629078

Expression of bone morphogenetic proteins and Msx genes during root formation.

PubMed

Yamashiro, T; Tummers, M; Thesleff, I

2003-03-01

Like crown development, root formation is also regulated by interactions between epithelial and mesenchymml tissues. Bone morphogenetic proteins (BMPs), together with the transcription factors Msx1 and Msx2, play important roles in these interactions during early tooth morphogenesis. To investigate the involvement of this signaling pathway in root development, we analyzed the expression patterns of Bmp2, Bmp3, Bmp4, and Bmp7 as well as Msx1 and Msx2 in the roots of mouse molars. Bmp4 was expressed in the apical mesenchyme and Msx2 in the root sheath. However, Bmps were not detected in the root sheath epithelium, and Msx transcripts were absent from the underlying mesenchyme. These findings indicate that this Bmp signaling pathway, required for tooth initiation, does not regulate root development, but we suggest that root shape may be regulated by a mechanism similar to that regulating crown shape in cap-stage tooth germs. Msx2 expression continued in the epithelial cell rests of Malassez, and the nearby cementoblasts intensely expressed Bmp3, which may regulate some functions of the fragmented epithelium.

Multiple essential MT1-MMP functions in tooth root formation, dentinogenesis, and tooth eruption

PubMed Central

Wimer, H.F.; Yamada, S.S.; Yang, T.; Holmbeck, K.; Foster, B.L.

2016-01-01

Membrane-type matrix metalloproteinase 1 (MT1-MMP) is a transmembrane zinc-endopeptidase that breaks down extracellular matrix components, including several collagens, during tissue development and physiological remodeling. MT1-MMP-deficient mice (MT1-MMP−/−) feature severe defects in connective tissues, such as impaired growth, osteopenia, fibrosis, and conspicuous loss of molar tooth eruption and root formation. In order to define the functions of MT1-MMP during root formation and tooth eruption, we analyzed the development of teeth and surrounding tissues in the absence of MT1-MMP. In situ hybridization showed that MT1-MMP was widely expressed in cells associated with teeth and surrounding connective tissues during development. Multiple defects in dentoalveolar tissues were associated with loss of MT1-MMP. Root formation was inhibited by defective structure and function of Hertwig's epithelial root sheath (HERS). However, no defect was found in creation of the eruption pathway, suggesting that tooth eruption was hampered by lack of alveolar bone modeling/remodeling coincident with reduced periodontal ligament (PDL) formation and integration with the alveolar bone. Additionally, we identified a significant defect in dentin formation and mineralization associated with the loss of MT1-MMP. To segregate these multiple defects and trace their cellular origin, conditional ablation of MT1-MMP was performed in epithelia and mesenchyme. Mice featuring selective loss of MT1-MMP activity in the epithelium were indistinguishable from wild type mice, and importantly, featured a normal HERS structure and molar eruption. In contrast, selective knock-out of MT1-MMP in Osterix-expressing mesenchymal cells, including osteoblasts and odontoblasts, recapitulated major defects from the global knock-out including altered HERS structure, short roots, defective dentin formation and mineralization, and reduced alveolar bone formation, although molars were able to erupt. These data indicate that MT1-MMP activity in the dental mesenchyme, and not in epithelial-derived HERS, is essential for proper tooth root formation and eruption. In summary, our studies point to an indispensable role for MT1-MMP-mediated matrix remodeling in tooth eruption through effects on bone formation, soft tissue remodeling and organization of the follicle/PDL region. PMID:26780723

Occult caries or pre-eruptive intracoronal resorption? A chance finding on a radiograph.

PubMed

Wong, Lilia; Khan, Sadaf

2014-01-01

The purpose of this paper was to describe a rare case of idiopathic coronal resorption of an unerupted permanent mandibular second molar, which was detected as a chance finding on an orthopantomogram taken to assess dental eruption on a young patient about to start orthodontic treatment. The affected tooth was removed and underwent histopathological investigation. This case report provides a discussion of the possible etiologies for this radiographic appearance, as well as the diagnosis and management of such lesions. Failure to identify such lesions can potentiate a guarded prognosis. Further research is required in this field to investigate the etiology and pathological process, albeit this is limited by the rarity if these lesions.

A clinical correlation between stature and posterior tooth length.

PubMed

Reddy, Smitha; Shome, Bhuvan; Patil, Jayaprakash; Koppolu, Pradeep

2017-01-01

Exploration and determination of the relationship between stature and length of tooth is essential in Paleontology, Forensic Odontology and Endodontology. This study aimed to determine any association between stature and posterior tooth length in a group of patients who required root canal treatment. Age, sex and standing height of adults were considered for posterior tooth length measurement. Molars and Premolars of apparently normal males (n=115 for molars, n= 75 for premolars) and females (n=124 for molars, n=80 for premolars), aged 20-50 years with intact cuspal morphology, which required RCT were selected for this study. Females and males were divided into 2 groups each based on their heights females > 155 cm and ≤ 155 cm, males > 165.10 and ≤ 165.10cm. The tooth length of permanent molars and premolars in both groups were measured using RVG and Electronic apex locator. Measurements obtained were compared separately for males and females using descriptive statistics and Pearson correlation coefficient. In females MB, ML, D roots of molar showed significant association (P=0.021), (P=0.027), (P=0.010) and roots of premolars showed significant association (P=0.002), (P=0.006) between both the groups respectively In males MB, ML, D roots of molar showed significant association (P=0.009), (P=0.004), (P=0.015) and roots of premolars showed significant association (P=0.006), (P=0.020) between both the groups respectively. The present clinical study reveals that there is a positive association between stature and posterior tooth length in both males and females.

Film and digital periapical radiographs for the measurement of apical root shortening.

PubMed

El-Angbawi, Ahmed M F; McIntyre, Grant T; Bearn, David R; Thomson, Donald J

2012-12-01

The aim of this study was to compare the accuracy and agreement of scanned film and digital periapical radiographs for the measurement of apical root shortening. Twenty-four film and digital [phosphor plate sensor (PPS)] periapical radiographs were taken using the long-cone paralleling technique for six extracted teeth before and after 1mm of apical root trimming. All teeth were mounted using a typodont and the radiographs were recorded using a film holder and polysiloxane occlusal index for each tooth to ensure standardization during the different radiographic exposures. The film radiographs were scanned and the tooth length measurements for the scanned film and digital (PPS) images were calculated using Image-J-Link 1.4 software (http://rebweb.nih.gov/ij/index.html) for the two groups. The accuracy and agreement among the tooth length measurements from each group and the true tooth length measurements were calculated using intra-class correlation (ICC) tests and Bland and Altman plots. A high level of agreement was found between the true tooth length measurements and the scanned film measurements (ICC=0.979, limit of agreement 0.579 to -0.565) and the digital (PPS) radiograph measurements (ICC= 0.979, limit of agreement 0.596 to -0.763). Moreover, a high level of agreement was found between the scanned film and digital (PPS) radiographs for the measurement of tooth length ICC=0.991, limit of agreement 0.411-0.231. Film and digital (PPS) periapical radiographs are accurate methods for measuring apical root shortening with a high level of agreement. Key words:Root shortening, measurement, periapical radiographs, film, digital.

Orthodontic movement of a horizontally fractured tooth: a case report.

PubMed

Erdemir, Ali; Ungor, Mete; Erdemir, Ebru Olgun

2005-06-01

Intra-alveolar root fractures are relatively uncommon, and sometimes may be healed without treatment. Diagnosis of intra-alveolar root fracture is frequently made by exclusion of clinical signs of other traumatic injury, and by radiographic examination with films taken at different tube angulations. This case report presents a horizontal root fractured tooth that was healed satisfactory without treatment and moved orthodontically after prolonged time from trauma.

Diagnosis and Management of Hidden Caries in a Primary Molar Tooth.

PubMed

Gera, Arwa; Zilberman, Uri

2017-01-01

Hidden caries is a dentinal lesion beneath the dentinoenamel junction, visible on radiographs. A single report described this lesion in primary dentition. This case report describes a case of hidden caries in a mandibular second primary molar, misdiagnosed as malignant swelling. A 3-year-old white girl was referred to the Department of Pediatric Dentistry with a chief complaint of pain and extraoral swelling on the right side of the mandible for the last 3 months. She was earlier referred to the surgical department for biopsy of the lesion. Radiographic and computed tomography scan examination showed a periapical lesion with buccal plate resorption and radiolucency beneath the enamel on the mesial part of tooth 85. The tooth was extracted, and follow-up of 2 years showed normal development of tooth 45. The main problem is early detection and treatment, since the outer surface of enamel may appear intact on tactile examination. Gera A, Zilberman U. Diagnosis and Management of Hidden Caries in a Primary Molar Tooth. Int J Clin Pediatr Dent 2017;10(1):99-102.

A prospective study on transplantation of third molars with complete root formation.

PubMed

Mejàre, Bertil; Wannfors, Karin; Jansson, Leif

2004-02-01

The study objective was to evaluate the prognosis for autotransplantation of third molar teeth with fully developed roots followed by endodontic treatment on the basis of a time-table analysis. A total of 50 third molars with completely developed roots were autotransplanted to replace a lost first or second molar in the same number of admitted patients. Root canal treatment was started 3 to 4 weeks later. Clinical and radiographic checkup of the transplanted and root-filled third molars was done annually according to a predesigned record form. Descriptive statistics including a life table and statistical analysis were performed. The cumulative survival rate during 4 years' follow-up was 81.4%. In all, 7 transplants were lost during the follow-up time, 4 of them due to marginal periodontal pathosis and the other 3 due to root resorption. None of the root resorptions was observed before the second postoperative year. The radiographic periapical status was considered normal in 96% of the transplants at the latest follow-up visit. Autotransplantation of mature third molar teeth is a reasonable treatment alternative to conventional prosthetic rehabilitation or implant treatment in cases of partial edentualism from both a therapeutic and an economic point of view.

Evaluation of the diagnostic yield of dental radiography and cone-beam computed tomography for the identification of dental disorders in small to medium-sized brachycephalic dogs.

PubMed

Döring, Sophie; Arzi, Boaz; Hatcher, David C; Kass, Philip H; Verstraete, Frank J M

2018-01-01

OBJECTIVE To evaluate the diagnostic yield of dental radiography (Rad method) and cone-beam CT (CBCT) methods for the identification of 31 predefined dental disorders in brachycephalic dogs. ANIMALS 19 client-owned brachycephalic dogs admitted for evaluation and treatment of dental disease. PROCEDURES 31 predefined dental disorders were evaluated separately and scored by use of dental radiography and 3 CBCT software modules (serial CBCT slices and custom cross sections, tridimensional rendering, and reconstructed panoramic views). A qualitative scoring system was used. Dental disorders were grouped into 10 categories for statistical analysis. Point of reference for presence or absence of a dental disorder was determined as the method that could be used to clearly identify the disorder as being present. Accuracy, sensitivity, specificity, and positive and negative predictive values were calculated with the McNemar χ 2 test of marginal homogeneity of paired data. RESULTS When all 3 CBCT methods were used in combination, the diagnostic yield of CBCT was significantly higher than that of dental radiography for 4 of 10 categories (abnormal eruption, abnormally shaped roots, periodontitis, and tooth resorption) and higher, although not significantly so, for all categories, except for 1 (loss of tooth integrity). CONCLUSIONS AND CLINICAL RELEVANCE CBCT provided more detailed information than did dental radiography. Therefore, CBCT would be better suited for use in diagnosing dental disorders in brachycephalic dogs.

Nerve Damage From Bone Allografts and Xenografts-A Case Series.

PubMed

Pogrel, M Anthony

2017-07-01

The concept of socket preservation by placing a particulate bone allograft or xenograft into a tooth socket or on the alveolar ridge after tooth removal remains a somewhat controversial topic. The concept is that it will preserve the ridge from resorption and such that subsequent implant insertion will be easier, with fewer complications. However, one particular issue is that these materials, although not directly neurotoxic, appear to be an irritant to the nerves if they come in contact with them. We present a case series demonstrating this complication. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Effect of local administration of simvastatin on postorthodontic relapse in a rabbit model.

PubMed

AlSwafeeri, Hani; ElKenany, Walid; Mowafy, Mohamed; Karam, Sahar

2018-06-01

Posttreatment relapse is a major challenging clinical issue. The objective of this study was to evaluate the effect of local administration of simvastatin on posttreatment relapse. Orthodontic tooth movement was induced in 10 white New Zealand rabbits. After 21 days of active tooth movement, the orthodontic appliances were removed, and the experimental teeth were allowed to relapse for 21 days. During the relapse phase, 1 mandibular quadrant received local simvastatin administration, and the other received the control vehicle solution on a weekly basis. Three-dimensional models of the experimental teeth were created to allow the measurement of experimental tooth movement and posttreatment relapse. The animals were killed at the end of the relapse phase for histomorphometric analysis of alveolar bone remodeling. The mean relapse percentages were 75.83% in the quadrant receiving the control vehicle solution and 62.01% in the quadrant receiving simvastatin. Neither the relapse magnitude nor the relapse percentage showed a significant difference between the 2 quadrants. Histomorphometric analyses showed that local simvastatin administration yielded a significant reduction in the area of active bone-resorptive lacunae and a significant increase in newly formed bone area. Although local administration of simvastatin aids in bone remodeling associated with posttreatment relapse by reducing the area of active bone resorption and upregulating bone formation, it did not significantly minimize posttreatment relapse. Copyright © 2018 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Synergistic acceleration of experimental tooth movement by supplementary high-frequency vibration applied with a static force in rats.

PubMed

Takano-Yamamoto, Teruko; Sasaki, Kiyo; Fatemeh, Goudarzi; Fukunaga, Tomohiro; Seiryu, Masahiro; Daimaruya, Takayoshi; Takeshita, Nobuo; Kamioka, Hiroshi; Adachi, Taiji; Ida, Hiroto; Mayama, Atsushi

2017-10-25

Several recent prospective clinical trials have investigated the effect of supplementary vibration applied with fixed appliances in an attempt to accelerate tooth movement and shorten the duration of orthodontic treatment. Among them, some studies reported an increase in the rate of tooth movement, but others did not. This technique is still controversial, and the underlying cellular and molecular mechanisms remain unclear. In the present study, we developed a new vibration device for a tooth movement model in rats, and investigated the efficacy and safety of the device when used with fixed appliances. The most effective level of supplementary vibration to accelerate tooth movement stimulated by a continuous static force was 3 gf at 70 Hz for 3 minutes once a week. Furthermore, at this optimum-magnitude, high-frequency vibration could synergistically enhance osteoclastogenesis and osteoclast function via NF-κB activation, leading to alveolar bone resorption and finally, accelerated tooth movement, but only when a static force was continuously applied to the teeth. These findings contribute to a better understanding of the mechanism by which optimum-magnitude high-frequency vibration accelerates tooth movement, and may lead to novel approaches for the safe and effective treatment of malocclusion.

Vertical root fractures and their management

PubMed Central

Khasnis, Sandhya Anand; Kidiyoor, Krishnamurthy Haridas; Patil, Anand Basavaraj; Kenganal, Smita Basavaraj

2014-01-01

Vertical root fractures associated with endodontically treated teeth and less commonly in vital teeth represent one of the most difficult clinical problems to diagnose and treat. In as much as there are no specific symptoms, diagnosis can be difficult. Clinical detection of this condition by endodontists is becoming more frequent, where as it is rather underestimated by the general practitioners. Since, vertical root fractures almost exclusively involve endodontically treated teeth; it often becomes difficult to differentiate a tooth with this condition from an endodontically failed one or one with concomitant periodontal involvement. Also, a tooth diagnosed for vertical root fracture is usually extracted, though attempts to reunite fractured root have been done in various studies with varying success rates. Early detection of a fractured root and extraction of the tooth maintain the integrity of alveolar bone for placement of an implant. Cone beam computed tomography has been shown to be very accurate in this regard. This article focuses on the diagnostic and treatment strategies, and discusses about predisposing factors which can be useful in the prevention of vertical root fractures. PMID:24778502

Root canal

MedlinePlus

... top part of your tooth to expose the pulp. This is typically called access. Pulp is made up of nerves, blood vessels, and ... the tooth and runs to the jaw bone. Pulp supplies blood to a tooth and allows you ...

Oral rehabilitation of patients with Chediak-Higashi syndrome using zygoma and root form implant-supported fixed prostheses: A report of two patients.

PubMed

Alzoubi, Fawaz; Bedrossian, Edmond; Wong, Allen

2016-12-01

Chediak-Higashi syndrome (CH-S) is a rare genetic immunodeficiency disorder. Fewer than 500 individuals with CH-S have been reported worldwide in the past 20 years. The dental management of patients in whom CH-S has been diagnosed has been rarely reported and only in the form of a case report. All reports addressed the severe periodontal disease found in those patients, and most studies concluded that periodontal treatment had an unfavorable prognosis. As a result, complete edentulism at an early age because of severe periodontal disease is expected. The purpose of this report was to present 2 patients with CH-S seeking oral rehabilitation after early tooth loss and severe bone resorption as a manifestation of severe periodontal disease. The treatment used bilateral zygoma implants and an all-on-4 concept. The complications encountered and management with a 5-year post-surgery follow-up are also presented. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

[An 18 month evaluation of MM-MTA pulpotomy on primary decayed molars].

PubMed

Abou Chedid, J C; Mchayleh, N; Khalil, I; Melki, B; Hardan, L S

2015-12-01

Pulpotomy is the most performed and controversial therapeutic in pediatric dentistry. Formocresol is known to have a toxic effect on living tissues, a mutagenic and carcinogenic potential with a systemic uptake of formocresol via pulpotomized teeth, other alternative products have been investigated. 40 molars were pulpotomized using Micro Mega Mineral Trioxide Aggregate (MM-MTA), which eliminates the need for the use of formocresol. The effects of this material were evaluated both clinically and radiographically. Post-operative control examinations were performed at 1, 6, 12, and 18 months trying to detect spontaneous or stimulated pain, pathological tooth mobility, abscesses or fistulas, internal or external pathological tooth resorption, periapical bone destruction, or canal obliteration. Pain was absent at 18 months post operatively. Thirty six molar treated with the MM-MTA didn't show any mobility or pain, one molar presented a pathological resorption and one molar presented an abscess without a fistula at 12 month. The observations were compared to others related to formocresol, ferric sulfate, MTA, and laser pulpotomies, using the Chi-square test x2. The abundance of positive result strongly demonstrate that the MM-MTA pulpotomy on carious temporary molars is a promising technique.

Cost-effectiveness of root caries preventive treatments.

PubMed

Schwendicke, Falk; Göstemeyer, Gerd

2017-01-01

With a growing number of individuals retaining their teeth lifelong, often with periodontitis-induced root surface exposure, there is the need for cost-effective management strategies for root caries lesions. The present study aimed to assess the cost-effectiveness of root caries preventive treatments. Patients were simulated over 10 years using a Markov model. Four treatments were compared: No treatment, daily 225-800ppm fluoride rinses, chlorhexidine (CHX) varnish (2×/year), silver diamine fluoride (SDF) varnish (2×/year). Data from a systematic review were submitted to network meta-analysis for inferring relative efficacies of treatments. The health outcome was years of teeth being free of root caries. A mixed public-private payer perspective within 2016 German healthcare was taken, with costs being estimated from fee item catalogues or based on market prices. Populations with different numbers of teeth and tooth-level risks were modelled. Monte-Carlo microsimulations, univariate- and probabilistic sensitivity analyses were performed. In populations with 16 teeth at risk and low tooth-level risk for root caries, providing no preventive treatment was least costly, but also least effective (130 Euro, 144 years). SDF ranked next, being more costly (180 Euro), but also more effective (151 years). Payers willing to invest 8.30 Euro per root caries-free tooth-year found SDF most cost-effective. CHX varnish and fluoride rinse were not cost-effective. In populations with more teeth and high tooth-level risk, SDF was the most effective and least costly option. Root caries preventive treatments (like SDF) are effective and might even be cost-saving in high risk populations. Application of SDF can be recommended as a cost-saving treatment for prevention of root caries in patients with high risk of root caries. Copyright © 2016 Elsevier Ltd. All rights reserved.

Canine and Premolar Root Dimensions in Chinese. A Reference for Osteoodontokeratoprosthesis Surgery.

PubMed

Sun, Stella Yue; Yeo, Woon Chee; Tay, Andrew Ban Guan; Tan, Donald Tiang Hwee; Tan, Danny Ben Poon

2018-01-01

Osteoodontokeratoprosthesis (OOKP) surgery is used to restore vision in end-stage corneal disorders, where an autogenous tooth supporting an optical cylinder is implanted through the cornea under a buccal mucosal graft. The ideal tooth for OOKP is a healthy single-rooted permanent tooth with sufficient buccolingual/palatal root diameter to accommodate an optical cylinder. The aim of this study was to determine the buccolingual/palatal diameters of canine and premolar roots in Chinese, for selection of teeth for OOKP surgery. This was an anatomical study on root dimensions of extracted intact teeth. Extracted canine and premolar teeth (excluding maxillary first premolars) were collected and the buccolingual/palatal and mesiodistal diameters of the root at the cervical line and at 2-mm intervals below the cervical line were measured with Vernier calipers. Other measurements included total tooth length, crown buccolingual/palatal diameter, and root length. Mean and minimum buccolingual/palatal root diameters were compiled for each 2-mm interval. A total of 415 extracted teeth (198 male, 217 female) were collected and measured. Recorded dimensions of keratoprostheses in 55 previous OOKP surgeries were used to establish acceptable lamina dimensions to ascertain root size adequacy. Premolars in Chinese female patients were undersized in a small minority. Minimal dimensions of teeth were insufficient if at 6 mm root level, the buccolingual/palatal width was less than 5 mm, or the mesiodistal width was less than 3 mm. This was noted in female mandibular first premolars (5.6%), maxillary second premolars (4.5%), and mandibular second premolars (1.5%). Canines have adequate dimensions for OOKP surgery. However, premolars in Chinese females may be undersized in a small minority. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

The effect of Emdogain and 24% EDTA root conditioning on periodontal healing of replanted dog's teeth.

PubMed

Guzmán-Martínez, Nayelli; Silva-Herzog, Flores Daniel; Méndez, González Verónica; Martín-Pérez, Silvia; Cerda-Cristerna, Bernardino Isaac; Cohenca, Nestor

2009-02-01

Controversies still exist as for the regenerative role of enamel matrix derivatives and the need for removal of the periodontal ligament in replanted teeth. The purpose of this study was to evaluate the effect of Emdogain and 24% ethylenediamine tetraacetic acid (EDTA) root conditioning on periodontal healing of replanted dog's teeth. Teeth were extracted, endodontically treated and preconditioned as follows: group 1, Emdogain; group 2, Emdogain + EDTA and group 3, EDTA. Teeth were replanted after 30 min extraoral time, splinted for 15 days and animals sacrificed after 8 weeks of observation. Histological evaluation was performed using hematoxylin/eosin and Masson trichrome and results scored based on previously reported criteria for histological evaluation. Replacement root resorption was histologically diagnosed in all groups except in the negative control. A parametric analysis showed no statistically significant differences between experimental groups. Root preconditioning with Emdogain alone or in combination with 24% EDTA showed no evidence of regeneration of collagen fibers and consequently did not prevent the development of replacement root resorption on replanted dog's teeth.

Autologus Platelet Rich Fibrin aided Revascularization of an immature, non-vital permanent tooth with apical periodontitis: A case report.

PubMed

Jadhav, Ganesh Ranganath; Shah, Dipali; Raghvendra, Srinidhi Surya

2015-01-01

Caries or trauma induced non-vital immature permanent tooth with blunderbuss, thin root which are very common among childrens are corrected using regenerative endodontic (revascularization) procedures. In the presented case, a 16-year-old boy reported with chief complaint of pain in maxillary left central incisor (Tooth #21). Tooth #21 showed grade III mobility, draining labial sinus, and short blunderbuss root with diffuse periapical radiolucency. Patient was explained the treatment plan and written informed consent was taken. Platelet rich fibrin (PRF) was prepared according to standard protocol. Autologous PRF was carried to the apical portion of the root canal after inducing revascularization. Access opening was double sealed with MTA and resin modified glass ionomer cement (RMGI). Baseline, 12 month and 18 month follow-up intraoral radiographs were taken. Clinically case was asymptomatic with complete resolution of intraoral sinus. Periapical healing, apical closure, root lengthening and dentinal wall thickening were uneventful. Thus PRF supplementation hastens the predictability and rate of revascularization in non-vital immature permanent teeth.

The combination use of platelet-rich fibrin and treated dentin matrix for tooth root regeneration by cell homing.

PubMed

Ji, Baohui; Sheng, Lei; Chen, Gang; Guo, Shujuan; Xie, Li; Yang, Bo; Guo, Weihua; Tian, Weidong

2015-01-01

Endogenous regeneration through cell homing provides an alternative approach for tissue regeneration, except cell transplantation, especially considering clinical translation. However, tooth root regeneration through cell homing remains a provocative approach in need of intensive study. Both platelet-rich fibrin (PRF) and treated dentin matrix (TDM) are warehouses of various growth factors, which can promote cell homing. We hypothesized that endogenous stem cells are able to sense biological cues from PRF membrane and TDM, and contribute to the regeneration of tooth root, including soft and hard periodontal tissues. Therefore, the biological effects of canine PRF and TDM on periodontal ligament stem cells (PDLSCs) and bone marrow mesenchymal stem cells (BMSCs) were evaluated respectively in vitro. Beagle dogs were used as orthotopic transplantation model. It was found that PRF significantly recruited and stimulated the proliferation of PDLSCs and BMSCs in vitro. Together, PRF and TDM induced cell differentiation by upregulating the mineralization-related gene expression of bone sialoprotein (BSP) and osteopotin (OPN) after 7 days coculture. In vivo, transplantation of autologous PRF and allogeneic TDM into fresh tooth extraction socket achieved successful root regeneration 3 months postsurgery, characterized by the regeneration of cementum and periodontal ligament (PDL)-like tissues with orientated fibers, indicative of functional restoration. The results suggest that tooth root connected to the alveolar bone by cementum-PDL complex can be regenerated through the implantation of PRF and TDM in a tooth socket microenvironment, probably by homing of BMSCs and PDLSCs. Furthermore, bioactive cues and inductive microenvironment are key factors for endogenous regeneration. This approach provides a tangible pathway toward clinical translation.

Effectiveness of bovine-derived xenograft versus bioactive glass with periodontally accelerated osteogenic orthodontics in adults: a randomized, controlled clinical trial.

PubMed

Bahammam, Maha A

2016-11-30

Periodontally accelerated osteogenic orthodontics (PAOO) combines periodontal therapy with orthodontic therapy, which minimises treatment time. This study compared the effectiveness of a bovine-derived xenograft with that of bioactive glass when combined with PAOO for the treatment of adult patients with moderate crowding of the teeth. In this prospective, single-masked clinical trial, 33 orthodontic patients (20 women, 13 men; mean age 21.2 ± 1.43 [18 - 27] years), were randomly allocated to one of three groups. Group 1 underwent a modified corticotomy technique on the labial side only, whereas group 2 was treated with the same technique combined with PAOO using a bovine-derived xenograft and group 3 was treated in the same way but combining PAOO with bioactive glass. The total treatment duration was recorded from the start of active orthodontic treatment, immediately after corticotomy, and at the time of debonding. Probing depth was evaluated clinically and bone density and root length were evaluated radiographically on the day of surgery (baseline, T1), post-treatment at debonding (T2), and 9 months post-treatment (T3). The duration of orthodontic treatment was markedly reduced to an average of 11.4 ± 0.14 weeks in all groups. All probing depths were < 3 mm, the interdental papillae were well preserved, there was no loss of tooth vitality, and there was no evidence of significant apical root resorption at any time interval. All groups showed a decrease in mean bone density at T2 followed by an increase at T3. The net percentage change that occurred between baseline and 9 months post-treatment was significantly different between the three groups. Groups 2 and 3, where grafts were incorporated, demonstrated a statistically significant greater increase in bone density than group 1 at T3. Combination of orthodontic treatment and periodontal surgery is an effective treatment for adult patients that decreases the duration of active treatment and reduces the risk of root resorption. Use of a bovine-derived xenograft with modified corticotomy provided superior benefits in terms of increased bone density than did the use of bioactive glass. The study was retrospectively registered at ClinicalTrials.gov under Clinical Trial Registration Number: NCT02796911 .

Pose estimation of teeth through crown-shape matching

NASA Astrophysics Data System (ADS)

Mok, Vevin; Ong, Sim Heng; Foong, Kelvin W. C.; Kondo, Toshiaki

2002-05-01

This paper presents a technique for determining a tooth's pose given a dental plaster cast and a set of generic tooth models. The ultimate goal of pose estimation is to obtain information about the sizes and positions of the roots, which lie hidden within the gums, without the use of X-rays, CT or MRI. In our approach, the tooth of interest is first extracted from the 3D dental cast image through segmentation. 2D views are then generated from the extracted tooth and are matched against a target view generated from the generic model with known pose. Additional views are generated in the vicinity of the best view and the entire process is repeated until convergence. Upon convergence, the generic tooth is superimposed onto the dental cast to show the position of the root. The results of applying the technique to canines demonstrate the excellent potential of the algorithm for generic tooth fitting.

Stress Induced in the Periodontal Ligament under Orthodontic Loading (Part I): A Finite Element Method Study Using Linear Analysis.

PubMed

Hemanth, M; Deoli, Shilpi; Raghuveer, H P; Rani, M S; Hegde, Chatura; Vedavathi, B

2015-08-01

Orthodontic tooth movement is a complex procedure that occurs due to various biomechanical changes in the periodontium. Optimal orthodontic forces yield maximum tooth movement whereas if the forces fall beyond the optimal threshold it can cause deleterious effects. Among various types of tooth movements intrusion and lingual root torque are associated with causing root resoprtion, especially with the incisors. Therefore in this study, the stress patterns in the periodontal ligament (PDL) were evaluated with intrusion and lingual root torque using finite element method (FEM). A three-dimensional (3D) FEM model of the maxillary incisors was generated using SOLIDWORKS modeling software. Stresses in the PDL were evaluated with intrusive and lingual root torque movements by a 3D FEM using ANSYS software using linear stress analysis. It was observed that with the application of intrusive load compressive stresses were distributed at the apex whereas tensile stress was seen at the cervical margin. With the application of lingual root torque maximum compressive stress was distributed at the apex and tensile stress was distributed throughout the PDL. For intrusive and lingual root torque movements stress values over the PDL was within the range of optimal stress value as proposed by Lee, with a given force system by Proffit as optimum forces for orthodontic tooth movement using linear properties.

Stress Induced in the Periodontal Ligament under Orthodontic Loading (Part I): A Finite Element Method Study Using Linear Analysis

PubMed Central

Hemanth, M; deoli, Shilpi; Raghuveer, H P; Rani, M S; Hegde, Chatura; Vedavathi, B

2015-01-01

Background: Orthodontic tooth movement is a complex procedure that occurs due to various biomechanical changes in the periodontium. Optimal orthodontic forces yield maximum tooth movement whereas if the forces fall beyond the optimal threshold it can cause deleterious effects. Among various types of tooth movements intrusion and lingual root torque are associated with causing root resoprtion, especially with the incisors. Therefore in this study, the stress patterns in the periodontal ligament (PDL) were evaluated with intrusion and lingual root torque using finite element method (FEM). Materials and Methods: A three-dimensional (3D) FEM model of the maxillary incisors was generated using SOLIDWORKS modeling software. Stresses in the PDL were evaluated with intrusive and lingual root torque movements by a 3D FEM using ANSYS software using linear stress analysis. Results: It was observed that with the application of intrusive load compressive stresses were distributed at the apex whereas tensile stress was seen at the cervical margin. With the application of lingual root torque maximum compressive stress was distributed at the apex and tensile stress was distributed throughout the PDL. Conclusion: For intrusive and lingual root torque movements stress values over the PDL was within the range of optimal stress value as proposed by Lee, with a given force system by Proffit as optimum forces for orthodontic tooth movement using linear properties. PMID:26464555

Daughters of the Enamel Organ: Development, Fate, and Function of the Stratum Intermedium, Stellate Reticulum, and Outer Enamel Epithelium

PubMed Central

Liu, Hui; Yan, Xiulin; Pandya, Mirali; Luan, Xianghong

2016-01-01

The tooth enamel organ (EO) is a complex epithelial cell assembly involved in multiple aspects of tooth development, including amelogenesis. The present study focuses on the role of the nonameloblast layers of the EO, the stratum intermedium, the stellate reticulum, and the outer enamel epithelium (OEE). The secretory stage stratum intermedium was distinguished by p63-positive epithelial stem cell marks, highly specific alkaline phosphatase labeling, as well as multiple desmosomes and gap junctions. At the location of the presecretory stage stellate reticulum, the pre-eruption EO prominently featured the papillary layer (PL) as a keratin immunopositive network of epithelial strands between tooth crowns and oral epithelium. PL cell strands contained numerous p63-positive epithelial stem cells, while BrdU proliferative cells were detected at the outer boundaries of the PL, suggesting that the stellate reticulum/PL epithelial cell sheath proliferated to facilitate an epithelial seal during tooth eruption. Comparative histology studies demonstrated continuity between the OEE and the general lamina of continuous tooth replacement in reptiles, and the outer layer of Hertwig's epithelial root sheath in humans, implicating the OEE as the formative layer for continuous tooth replacement and tooth root extension. Cell fate studies in organ culture verified that the cervical portion of the mouse molar EO gave rise to Malassez rest-like cell islands. Together, these studies indicate that the nonameloblast layers of the EO play multiple roles during odontogenesis, including the maintenance of several p63-positive stem cell reservoirs, a role during tooth root morphogenesis and tooth succession, a stabilizing function for the ameloblast layer, the facilitation of ion transport from the EO capillaries to the enamel layer, as well as safe and seamless tooth eruption. PMID:27611344

Daughters of the Enamel Organ: Development, Fate, and Function of the Stratum Intermedium, Stellate Reticulum, and Outer Enamel Epithelium.

PubMed

Liu, Hui; Yan, Xiulin; Pandya, Mirali; Luan, Xianghong; Diekwisch, Thomas G H

2016-09-09

The tooth enamel organ (EO) is a complex epithelial cell assembly involved in multiple aspects of tooth development, including amelogenesis. The present study focuses on the role of the nonameloblast layers of the EO, the stratum intermedium, the stellate reticulum, and the outer enamel epithelium (OEE). The secretory stage stratum intermedium was distinguished by p63-positive epithelial stem cell marks, highly specific alkaline phosphatase labeling, as well as multiple desmosomes and gap junctions. At the location of the presecretory stage stellate reticulum, the pre-eruption EO prominently featured the papillary layer (PL) as a keratin immunopositive network of epithelial strands between tooth crowns and oral epithelium. PL cell strands contained numerous p63-positive epithelial stem cells, while BrdU proliferative cells were detected at the outer boundaries of the PL, suggesting that the stellate reticulum/PL epithelial cell sheath proliferated to facilitate an epithelial seal during tooth eruption. Comparative histology studies demonstrated continuity between the OEE and the general lamina of continuous tooth replacement in reptiles, and the outer layer of Hertwig's epithelial root sheath in humans, implicating the OEE as the formative layer for continuous tooth replacement and tooth root extension. Cell fate studies in organ culture verified that the cervical portion of the mouse molar EO gave rise to Malassez rest-like cell islands. Together, these studies indicate that the nonameloblast layers of the EO play multiple roles during odontogenesis, including the maintenance of several p63-positive stem cell reservoirs, a role during tooth root morphogenesis and tooth succession, a stabilizing function for the ameloblast layer, the facilitation of ion transport from the EO capillaries to the enamel layer, as well as safe and seamless tooth eruption.

Developmental Disturbances of a Maxillary Central Incisor due to Trauma to Its Predecessor: A Case Report

PubMed Central

Karataş, Merve Safa; Sönmez, Işıl Şaroğlu

2013-01-01

Objective To report the effects of a primary tooth trauma on the underlying permanent tooth germ. Clinical Presentation and Intervention A 12-year-old girl was referred to our clinic with a complaint of poor aesthetic appearance. The crown of the permanent maxillary left central tooth exhibited an increased clinical crown height with an ‘enamel hyperplasia’ in the cervical third and had hypoplastic enamel with yellowish-brown discoloration extending from the middle third to the incisal edge. Radiographic examination revealed that the permanent maxillary left central tooth had abnormal root morphology with root dilaceration. The patient revealed a history of trauma at the age of 4 years. An aesthetic restoration with light-curing resin composite was performed on the vestibular surface of the maxillary left permanent central tooth. Conclusion Sequelae of a primary tooth trauma on the permanent tooth were restored. We recommend that parents should be aware of the consequences of untreated trauma to a primary tooth. Educational and preventive programmes on dental trauma are required to educate parents about emergency knowledge and sequelae of dental trauma. PMID:23689528

Human pulpal blood flow in different root formation stages measured with transmitted-light plethysmography.

PubMed

Ganbold, Khongorzul; Kakino, Satoko; Ikeda, Hideharu; Miyashin, Michiyo

2017-11-01

To determine the pulp vitality after traumatic injury, dentists often use pulp sensitivity tests, which can be ambiguous in young permanent teeth with incomplete root formation. Transmitted-light plethysmography (TLP) is a non-invasive objective method that uses a 525-nm LED to detect blood volume change in the pulp. The present study aimed (1) to investigate pulpal blood flow with TLP and optical characteristics in healthy permanent maxillary incisors in different root formation stages, and (2) to assess the influences of body growth of the children and tooth color on the TLP amplitude. Seventy-eight fully erupted maxillary central incisors were divided into four groups, according to the root formation stages. Group 1: root with wide-open apex, Group 2: root completed in length with open apex, Group 3: root with half-closed apex, Group 4: root with complete formation. The TLP amplitude, optical density, electric pulp testing, and cervical tooth color measurements of each group were compared using a one-way analysis of variance followed by the Bonferroni method. The correlation between the weights/heights of children and TLP amplitudes was analyzed using Pearson coefficient. The TLP amplitude was significantly higher in Group 3 than in the other groups. The amplitude was correlated with the weights/heights of children, but not with the tooth color. Optical density and electric sensitivity increased with tooth maturation. The amplitude of TLP and optical density may be affected by growth and development in children and indicate changes in the vascular dynamics of the pulp and hard tissue maturation during root formation stages. Copyright © 2017 Elsevier Ltd. All rights reserved.

SCAPs Regulate Differentiation of DFSCs During Tooth Root Development in Swine

PubMed Central

Wu, Xiaoshan; Hu, Lei; Li, Yan; Li, Yang; Wang, Fu; Ma, Ping; Wang, Jinsong; Zhang, Chunmei; Jiang, Canhua; Wang, Songlin

2018-01-01

The tooth root transmits and balances occlusal forces through the periodontium to the alveolar bone. The periodontium, including the gingiva, the periodontal ligament, the cementum and the partial alveolar bone, derives from the dental follicle (DF), except for the gingiva. In the early developmental stages, the DF surrounds the tooth germ as a sphere and functions to promote tooth eruption. However, the morphological dynamics and factors regulating the differentiation of the DF during root elongation remain largely unknown. Miniature pigs are regarded as a useful experimental animal for modeling in craniofacial research because they are similar to humans with respect to dentition and mandible anatomy. In the present study, we used the third deciduous incisor of miniature pig as the model to investigate the factors influencing DF differentiation during root development. We found that the DF was shaped like a crescent and was located between the root apical and the alveolar bone. The expression levels of WNT5a, β-Catenin, and COL-I gradually increased from the center of the DF (beneath the apical foramen) to the lateral coronal corner, where the DF differentiates into the periodontium. To determine the potential regulatory role of the apical papilla on DF cell differentiation, we co-cultured dental follicle stem cells (DFSCs) with stem cells of the apical papilla (SCAPs). The osteogenesis and fibrogenesis abilities of DFSCs were inhibited when being co-cultured with SCAPs, suggesting that the fate of the DF can be regulated by signals from the apical papilla. The apical papilla may sustain the undifferentiated status of DFSCs before root development finishes. These data yield insight into the interaction between the root apex and surrounding DF tissues in root and periodontium development and shed light on the future study of root regeneration in large mammals. PMID:29511365

Effect of cementum defects on radicular penetration of 30% H2O2 during intracoronal bleaching.

PubMed

Rotstein, I; Torek, Y; Misgav, R

1991-05-01

Bleaching pulpless teeth with 30% hydrogen peroxide has been reported to cause external cervical root resorption. It has been hypothesized that H2O2 penetrating through open dentin tubules can initiate an inflammatory reaction which could result in root resorption. Extracted human premolars were treated endodontically and bleached intracoronally using the thermocatalytic technique. The teeth were divided into three groups; one group with no cementum defects at the cementoenamel junction, one group with artificial cementum defects at the cementoenamel junction, and another group with artificial cementum defects at the middle third of the root. The radicular penetration of 30% hydrogen peroxide in the three groups was assessed directly and compared using an in vitro model. Radicular penetration of hydrogen peroxide was found in all of the groups tested. The penetration of hydrogen peroxide was significantly higher in teeth with cementum defects at the cementoenamel junction than in those without defects.

Human permanent teeth are divided into two parts at the cemento-enamel junction in the divine golden ratio.

PubMed

Anand, Rahul; Sarode, Sachin C; Sarode, Gargi S; Patil, Shankargouda

2017-01-01

The aim of this study is to find out whether tooth length (crown length + root length) follows the rule of most divine and mysterious phi (ϕ) or the golden ratio. A total of 140 teeth were included in the study. The crown-root ratio was manually calculated using vernier caliper and its approximation to golden ratio or the divine number phi (ϕ) was examined. The average root-crown ratio (R/C) for maxillary central incisor was 1.627 ± 0.04, and of its antagonist, mandibular central incisor was 1.628 ± 0.02. The tooth-root ratio (T/R) for the same was 1.609 ± 0.016 and 1.61 ± 0.008, respectively. Similar values were appreciated for lateral incisors where the R/C ratio in the maxillary and mandibular teeth was 1.632 ± 0.015 and 1.641 ± 0.012 and the T/R ratio was 1.606 ± 0.005 and 1.605 ± 0.005, respectively. On measuring the tooth length in linear fashion from the cusp tip to the root apex, we found that the tooth was divided into two parts at the cemento-enamel junction in the golden ratio. This information can be exploited in restorative and implant dentistry in future.

Orthodontic-surgical retreatment of facial asymmetry with occlusal cant and severe root resorption: A 3-year follow-up.

PubMed

Lisboa, Cinthia de Oliveira; Borges, Marlon Sampaio; Medeiros, Paulo José D'Albuquerque; Motta, Alexandre Trindade; Mucha, José Nelson

2017-08-01

Our objective was to report the orthodontic and surgical retreatment of a patient who had undergone a prolonged orthodontic treatment with extractions, but who had unsatisfactory results and persistent side effects. The man, aged 25 years 3 months, sought treatment with major complaints of facial and smile asymmetries. The clinical examination showed a mandibular deviation to the right and a maxillary occlusal cant. A Class II Division 1 subdivision right was observed. Radiographic examination showed extensive root resorptions in the maxillary second premolars and absence of the 4 first premolars. The maxillary midline was deflected 2 mm to the left, and the mandibular midline was shifted 5 mm to the right. Aligning and leveling were performed with orthodontic fixed appliances, with a standard edgewise system (0.022 × 0.028 in), followed by LeFort I maxillary impaction and bilateral sagittal split osteotomy with asymmetrical advancement. Retreatment showed outstanding results that remained stable after 3 years of follow-up. Root resorption in the second premolars did not seem to increase. Orthodontic-surgical intervention is the main choice for correcting esthetic and functional problems in facial asymmetry, particularly in cases of retreatment. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Model assessing thermal changes during high temperature root canal irrigation

PubMed Central

Bartolo, Analise; Koyess, Edmond; Micallef, Christopher

2016-01-01

The main aim of root canal irrigation is to eliminate micro-organisms. Sodium hypochlorite (NaOCl) is considered to be the ideal material and raising its temperature potentiates the antimicrobial activity. NaOCl may lead to localised tissue necrosis when extruded past the root apex. This study analyses the use of high temperature root canal irrigation as an alternative process for the elimination of microorganisms from the root canal system. An experimental set-up was designed where a constant supply of heat was passed from a heat source through a copper wire inside the root canal. The data acquired together with known constants pertaining to enamel and dentine was used to numerically model the thermal changes in a tooth using a finite element method. Results obtained from the finite element thermal model of the tooth were repeatable and were validated with the experimental results. The thermo-physical properties of the tooth were varied and convergence criteria met. The temperatures reached were below what has been reported to cause irreversible damage to the bone. This was further confirmed from a series of simulations that were undertaken. The temperatures achieved were suitable for the elimination of microorganisms during root canal therapy. PMID:27733934

Orthodontic-periodontal interactions: Orthodontic extrusion in interdisciplinary regenerative treatments.

PubMed

Paolone, Maria Giacinta; Kaitsas, Roberto

2018-06-01

Orthodontics is a periodontal treatment. "Guided orthodontic regeneration" (GOR) procedures use orthodontic movements in perio-restorative patients. The GOR technique includes a guided orthodontic "soft tissue" regeneration (GOTR) and a guided orthodontic "bone" regeneration (GOBR) with a plastic soft tissue approach and a regenerating reality. The increased amount of soft tissue gained with orthodontic movement can be used for subsequent periodontal regenerative techniques. The increased amount of bone can as well improve primary implant stability and, eventually, simplify a GTR technique to regenerate soft tissues, to restore tooth with external resorption in aesthetic zone or to extract a tooth to create new hard-soft tissue for adjacent teeth. Copyright © 2018. Published by Elsevier Masson SAS.

[Injuries to permanent teeth. Part 2: Therapy of avulsion].

PubMed

von Arx, Thomas; Chappuis, Vivianne; Hänni, Stefan

2005-01-01

The present paper describes the current treatment philosophy of dislocated or avulsed permanent teeth at our school. Splinting and medication (root canal treatment, systemic antibiotics, etc.) are targeted to minimize the initial inflammatory reaction and to reduce post-traumatic complications such as pulp necrosis and/ or external root resorption.

PTH intermittent administration may be a useful therapeutic agent to avoid premature eruption of the tooth.

PubMed

Vasconcelos, Daniel Fernando Pereira; Vasconcelos, Any Carolina Cardoso Guimarães

2016-03-01

Parathyroid hormone (PTH) acts as a controller of bone remodeling and has influence on periodontal tissues. In addition to the well-established catabolic effects (activation of bone resorption) of PTH, it is recognized that the PTH intermittent administration has anabolic effects (promotion of bone formation). However, there is no information regarding the effects of the PTH intermittent administration on the eruption tooth rate. Studies have shown that tooth eruption depends on the presence of osteoclasts to create an eruption pathway through the alveolar bone. It may also be controlled by osteoblast, precursor of osteoclast, and cells of periodontal ligament. Our hypothesis is based on previous studies showing that the PTH intermittent administration can promote bone formation, particularly in the areas around which the tooth erupts. Furthermore, the PTH intermittent administration influenced periodontal ligament fiber, what may be seen as greater organization, and isomerization, as well as higher birefringence of the periodontal ligament fiber, which then offers increased resistance to the process, delaying tooth eruption. Thus, this article opens new perspectives for the treatment and maintenance of teeth that can erupt early. Published by Elsevier Ltd.

Clinical use of the resorbable bioscaffold poly lactic co-glycolic acid (PLGA) in post-extraction socket for maintaining the alveolar height: A prospective study.

PubMed

Hoda, Nadeemul; Saifi, Aamir Malick; Giraddi, Girish B

2016-01-01

A common sequel of tooth extraction is alveolar bone resorption. It makes the placement of dental implants difficult and creates an esthetic problem for the fabrication of conventional prostheses. Therefore, alveolar bone following tooth extraction should be preserved. The present prospective study was conducted to evaluate the efficacy of the resorbable bioscaffold poly lactic co-glycolic acid (PLGA) in maintaining the alveolar height in post-extraction socket. 20 patients were selected based on inclusion and exclusion criteria and were randomly divided into two groups: cases and control comprising of 10 patients each. Atraumatic tooth extraction was done in all patients. PLGA bioscaffold was placed in cases and socket was closed with 3-0 vicryl. In control group, socket was directly closed with 3-0 vicryl. The patients were kept on follow-up and complications such as dry socket, pain, and swelling were recorded. IOPA were taken at 1st, 4th, 12th, and 24th week to record changes in the height of alveolar bone. The radiographic measurements were compared and the differences were statistically analyzed. Reduction in alveolar bone height after placement of PLGA bioscaffold was significantly less in cases as compared to controls at 4th, 12th, and 24th week following extraction. No complications were observed throughout the follow-up period. PLGA scaffold significantly reduces bone resorption. Application is very simple and can be easily performed in a dental setup. However, PLGA scaffold adds significantly to the cost of treatment.

Monocyte recruitment and expression of monocyte chemoattractant protein-1 are developmentally regulated in remodeling bone in the mouse.

PubMed Central

Volejnikova, S.; Laskari, M.; Marks, S. C.; Graves, D. T.

1997-01-01

Tooth eruption is defined as the movement of a tooth from its site of development within the alveolar bone to its position of function in the oral cavity. It represents an excellent model to examine osseous metabolism as bone resorption and bone formation occur simultaneously and are spatially separated. Bone resorption occurs in the coronal (occlusal) area, whereas bone formation occurs in the basal area. Monocytes are thought to have a significant role in the regulation of osseous metabolism. The goal of this study was to examine the recruitment of monocytes to bone in C57BL/6J mice that are undergoing developmentally regulated bone remodeling. Monocytes were detected by immunohistochemistry and osteoclasts were counted as bone-associated multi-nucleated, tartrate-resistant acid phosphatase (TRAP)-positive cells. Cell numbers were obtained from histological sections of animals sacrificed daily for 14 days after birth; an image analysis system was used for quantification. The results demonstrated that, immediately after birth, there were relatively few monocytic cells. In the area of bone resorption, the number of monocytes increased with time, reaching peaks at 5 and 9 days, and decreased thereafter. A similar pattern was observed for osteoclasts. In the area of bone formation, there was a time-dependent increase in the number of monocytes. In contrast, the number of osteoclasts in this area was highest at the earliest time points and decreased after day 3. To investigate potential mechanisms for the recruitment of monocytes, expression of monocyte chemoattractant protein (MCP)-1 was assessed. The number of MCP-1-positive cells increased with time and was generally proportional to the recruitment of mononuclear phagocytes. Osteoblasts were the principal bone cell type expressing MCP-1. The results demonstrate that the recruitment of mononuclear cells in the occlusal area is associated with bone resorption. In contrast, recruitment of monocytes in the basal area is associated with bone formation and a decrease in the number of osteoclasts. These results suggest that monocytes have different functional roles in areas of bone formation compared with bone resorption. Furthermore, the expression of MCP-1 is developmentally regulated and may provide a mechanistic basis to explain the recruitment of monocytic cells. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:9137095

A three-dimensional topology optimization model for tooth-root morphology.

PubMed

Seitz, K-F; Grabe, J; Köhne, T

2018-02-01

To obtain the root of a lower incisor through structural optimization, we used two methods: optimization with Solid Isotropic Material with Penalization (SIMP) and Soft-Kill Option (SKO). The optimization was carried out in combination with a finite element analysis in Abaqus/Standard. The model geometry was based on cone-beam tomography scans of 10 adult males with healthy bone-tooth interface. Our results demonstrate that the optimization method using SIMP for minimum compliance could not adequately predict the actual root shape. The SKO method, however, provided optimization results that were comparable to the natural root form and is therefore suitable to set up the basic topology of a dental root.

Root resorption due to orthodontic treatment using self-ligating and conventional brackets : A cone-beam computed tomography study.

PubMed

Aras, Isil; Unal, Idil; Huniler, Gencer; Aras, Aynur

2018-05-01

Purpose of the present study was to compare external root resorption (ERR) volumetrically in maxillary incisors induced by orthodontic treatment using self-ligating brackets (Damon Q, DQ) or conventional brackets (Titanium Orthos, TO) with the help of cone-beam computed tomography (CBCT). A sample of 32 subjects, with Angle Class I malocclusion and anterior crowding of 4-10 mm, was divided randomly into two groups: a DQ group, in which self-ligating DQ brackets with Damon archwires were used; and a TO group, in which conventional TO brackets with large Orthos archwires were applied. The study was conducted using CBCT scans taken before (T1), and near the end (9 months after the initiation of treatment; T2) of the orthodontic treatment. The extent of ERR was determined volumetrically using Mimics software. Changes in root volume were evaluated by repeated-measures analysis of variance as well as by paired and independent t-tests. While significant differences were found between T1 and T2 for root volume in both groups (p < 0.05), there was no difference between the groups regarding the amount (mm 3 or relative change) of ERR (p > 0.05). Maxillary central and lateral incisors showed similar volume loss (p > 0.05). Furthermore, the TO group showed a higher prevalence of palatinal and proximal slanted RR compared with the DQ group (p < 0.05). It is not possible to suggest superiority of one bracket system over the other only considering root resorption pattern or amount. Higher incidence of slanted RR found in patients treated with the TO system warrants further research to identify possible specific causes.

[Maxillary cementoblastoma. A case report].

PubMed

Slimani, F; Elbouihi, M; Oukerroum, A; Lazreqh, H; Mahtar, M; Karkouri, M; Abdelouafi, A; Benjelloun, A; Chekkoury-Idrissi, A

2009-01-01

Cementoblastoma is a rare benign odontogenic neoplasm. Its cause is unknown. It represents less 6 % of all odontogenic tumors. The aim of our work is to present a rare case of maxillary cementoblastoma involving an included central incisor. A 32-year old man consulted for a left maxillary swelling to projection under nostril. A panoramic radiographic examination revealed an included tooth 21 with a radiopaque lesion around its root. The computed tomography revealed the included tooth 21 with a process around its root. This process is well-defined, high-dense and is surrounded by a radiolucent halo. The treatment should consist of complete removal of the lesion with the tooth 21. Histological examination concluded to the diagnosis of a cementoblastoma. The cementoblastoma occurs most frequently in young persons and predominantly among men. The mandibular premolar and molar are the more frequently reached. The maxillary localization remains rare. This tumor occurs around the roots of the posterior and lower teeth. Radiographically, the lesion is well-defined and attached to the root of the tooth, radiopaque dense and surrounded by a radiolucent halo. The cementoblastoma evolves slowly and has the tendency to blow the cortical. The prognosis is good.

Playing wind instruments as a potential aetiologic cofactor in external cervical resorption: two case reports.

PubMed

Gunst, V; Huybrechts, B; De Almeida Neves, A; Bergmans, L; Van Meerbeek, B; Lambrechts, P

2011-03-01

To present two cases of external cervical resorption (ECR) on maxillary incisors, in which the primary aetiologic factor is suggested to be pressure trauma by frequently playing wind instruments. The exact aetiological spectrum of ECR is still poorly understood. For resorption to occur, a defect in the cementum layer (trigger) is a likely prerequisite. Whilst the mechanism for continuation (stimulus) is still unclear, knowledge of potential predisposing factors is important in assessing patients at risk. Pressure generated by playing wind instruments could present an aetiological factor in ECR because it affects the cervical region of the root surface. The cases that are presented may confirm this hypothesis and the extent of resorption defects is shown by cone-beam computer tomography (CT) and micro-focus CT imaging techniques. © 2010 International Endodontic Journal.

Concept and clinical application of the resin-coating technique for indirect restorations.

PubMed

Nikaido, Toru; Tagami, Junji; Yatani, Hirofumi; Ohkubo, Chikahiro; Nihei, Tomotaro; Koizumi, Hiroyasu; Maseki, Toshio; Nishiyama, Yuichiro; Takigawa, Tomoyoshi; Tsubota, Yuji

2018-03-30

The resin-coating technique is one of the successful bonding techniques used for the indirect restorations. The dentin surfaces exposed after cavity preparation are coated with a thin film of a coating material or a dentin bonding system combined with a flowable composite resin. Resin coating can minimize pulp irritation and improve the bond strength between a resin cement and tooth structures. The technique can also be applied to endodontically treated teeth, resulting in prevention of coronal leakage of the restorations. Application of a resin coating to root surface provides the additional benefit of preventing root caries in elderly patients. Therefore, the coating materials have the potential to reinforce sound tooth ("Super Tooth" formation), leading to preservation of maximum tooth structures.

[Torque control evaluated by lateral cephalometric radiography and cone-beam CT after retraction of the upper anterior teeth].

PubMed

Yang, Xue; Qian, Yu-Fen

2016-08-01

To investigate the relationship between torque control and movement type of the teeth and to investigate the correlation between reconstruction of the alveolar bone and retraction of the upper anterior teeth. Cephalograms of pre-treatment and post-treatment of 111 cases and cone-beam computed tomography of pre-retraction and post-retraction of 7 cases were collected. The inclination degree of the upper anterior teeth, the horizontal and vertical displacement of edge and apex,and the thickness of the alveolar bone at the apex level were measured. Student's t test and Pearson χ2 test were performed for statistical analysis with SAS 8.02 software package. Cases who received torque control during the period of retraction displayed less change of inclination degree of the upper anterior teeth, less lingual displacement of the edge, more lingual displacement of the apex. The total thickness of the alveolar bone at the apex level and the length of the teeth significantly decreased after retraction(P<0.05). The amount of the alveolar bone rebuilt after retraction was less than that of the tooth movement, and there was no significant difference between teenagers and adults. During retraction of the upper anterior teeth, cases who received torque control showed less inclination degree change of the upper anterior teeth, less lingual displacement of the edge, more lingual displacement of the apex. More bodily movement and partially controlled tipping movement as well as higher incident rate of severe root resorption would also arise. There was correlation between reconstruction of the alveolar bone and the tooth movement. Since the amount of adaptive reconstruction of the lingual alveolar bone was limited, and there was no difference between teenagers and adults, excessive lingual displacement would surpass its adaption ability, and gave rise to alveolar bone and tooth damage.

Gear Tooth Root Stresses of a Very Heavily Loaded Gear Pair-Case Study: Orbiter Body Flap Actuator Pinion and Ring Gear

NASA Technical Reports Server (NTRS)

Krantz, Timothy L.; Handschuh, Robert F.

2015-01-01

The space shuttle orbiter's body flap actuator gearing was assessed as a case study of the stresses for very heavily loaded external-internal gear pairs (meshing pinion and ring gear). For many applications, using the high point of single tooth contact (HPSTC) to locate the position of the tooth force is adequate for assessing the maximum tooth root stress condition. But for aerospace gearing such an approach may be inadequate for assessing the stress condition while also simultaneously minimizing mass. In this work specialized contact analyses and finite element methods were used to study gear tooth stresses of body flap actuator gears. The analytical solutions considered the elastic deformations as an inherent part of the solutions. The ratio for the maximum tooth stresses using the HPSTC approach solutions relative to the contact analysis and finite element solutions were 1.40 for the ring gear and 1.28 for the pinion gear.

Regeneration and Repair in Endodontics—A Special Issue of the Regenerative Endodontics—A New Era in Clinical Endodontics

PubMed Central

Saoud, Tarek Mohamed A.; Ricucci, Domenico; Lin, Louis M.; Gaengler, Peter

2016-01-01

Caries is the most common cause of pulp-periapical disease. When the pulp tissue involved in caries becomes irreversibly inflamed and progresses to necrosis, the treatment option is root canal therapy because the infected or non-infected necrotic pulp tissue in the root canal system is not accessible to the host's innate and adaptive immune defense mechanisms and antimicrobial agents. Therefore, the infected or non-infected necrotic pulp tissue must be removed from the canal space by pulpectomy. As our knowledge in pulp biology advances, the concept of treatment of pulpal and periapical disease also changes. Endodontists have been looking for biologically based treatment procedures, which could promote regeneration or repair of the dentin-pulp complex destroyed by infection or trauma for several decades. After a long, extensive search in in vitro laboratory and in vivo preclinical animal experiments, the dental stem cells capable of regenerating the dentin-pulp complex were discovered. Consequently, the biological concept of ‘regenerative endodontics’ emerged and has highlighted the paradigm shift in the treatment of immature permanent teeth with necrotic pulps in clinical endodontics. Regenerative endodontics is defined as biologically based procedures designed to physiologically replace damaged tooth structures, including dentin and root structures, as well as the pulp-dentin complex. According to the American Association of Endodontists’ Clinical Considerations for a Regenerative Procedure, the primary goal of the regenerative procedure is the elimination of clinical symptoms and the resolution of apical periodontitis. Thickening of canal walls and continued root maturation is the secondary goal. Therefore, the primary goal of regenerative endodontics and traditional non-surgical root canal therapy is the same. The difference between non-surgical root canal therapy and regenerative endodontic therapy is that the disinfected root canals in the former therapy are filled with biocompatible foreign materials and the root canals in the latter therapy are filled with the host's own vital tissue. The purpose of this article is to review the potential of using regenerative endodontic therapy for human immature and mature permanent teeth with necrotic pulps and/or apical periodontitis, teeth with persistent apical periodontitis after root canal therapy, traumatized teeth with external inflammatory root resorption, and avulsed teeth in terms of elimination of clinical symptoms and resolution of apical periodontitis. PMID:29563445

Regeneration and Repair in Endodontics-A Special Issue of the Regenerative Endodontics-A New Era in Clinical Endodontics.

PubMed

Saoud, Tarek Mohamed A; Ricucci, Domenico; Lin, Louis M; Gaengler, Peter

2016-02-27

Caries is the most common cause of pulp-periapical disease. When the pulp tissue involved in caries becomes irreversibly inflamed and progresses to necrosis, the treatment option is root canal therapy because the infected or non-infected necrotic pulp tissue in the root canal system is not accessible to the host's innate and adaptive immune defense mechanisms and antimicrobial agents. Therefore, the infected or non-infected necrotic pulp tissue must be removed from the canal space by pulpectomy. As our knowledge in pulp biology advances, the concept of treatment of pulpal and periapical disease also changes. Endodontists have been looking for biologically based treatment procedures, which could promote regeneration or repair of the dentin-pulp complex destroyed by infection or trauma for several decades. After a long, extensive search in in vitro laboratory and in vivo preclinical animal experiments, the dental stem cells capable of regenerating the dentin-pulp complex were discovered. Consequently, the biological concept of 'regenerative endodontics' emerged and has highlighted the paradigm shift in the treatment of immature permanent teeth with necrotic pulps in clinical endodontics. Regenerative endodontics is defined as biologically based procedures designed to physiologically replace damaged tooth structures, including dentin and root structures, as well as the pulp-dentin complex. According to the American Association of Endodontists' Clinical Considerations for a Regenerative Procedure, the primary goal of the regenerative procedure is the elimination of clinical symptoms and the resolution of apical periodontitis. Thickening of canal walls and continued root maturation is the secondary goal. Therefore, the primary goal of regenerative endodontics and traditional non-surgical root canal therapy is the same. The difference between non-surgical root canal therapy and regenerative endodontic therapy is that the disinfected root canals in the former therapy are filled with biocompatible foreign materials and the root canals in the latter therapy are filled with the host's own vital tissue. The purpose of this article is to review the potential of using regenerative endodontic therapy for human immature and mature permanent teeth with necrotic pulps and/or apical periodontitis, teeth with persistent apical periodontitis after root canal therapy, traumatized teeth with external inflammatory root resorption, and avulsed teeth in terms of elimination of clinical symptoms and resolution of apical periodontitis.

Regenerative treatment of an immature, traumatized tooth with apical periodontitis: report of a case.

PubMed

Cotti, Elisabetta; Mereu, Manuela; Lusso, Daniela

2008-05-01

This case report describes the treatment of a necrotic immature permanent central incisor with complete crown fracture, suspected root fracture, and sinus tract, which was not treated with conventional apexification techniques. Instead, a regenerative approach based on the trauma literature's methods for revascularization was provided. The root canal was gently debrided of necrotic tissue with a sharp spoon excavator and irrigated for only one third of its length with NaOCl and then medicated with calcium hydroxide. After 15 days the sinus tract had healed, and the tooth was asymptomatic. The tooth was accessed, calcium hydroxide was removed, bleeding was stimulated to form an intracanal blood clot, and mineral trioxide aggregate was placed coronally to the blood clot. After 8 months, a coronal calcified barrier was radiographically evident and accompanied with progressive thickening of the root wall and apical closure. Two and a half years after treatment was initiated, the tooth remained asymptomatic, and the sinus tract had not reappeared. The progressive increase in the thickness of the dentinal walls and subsequent apical development suggest that appropriate biologic responses can occur with this type of treatment of the necrotic immature permanent tooth with sinus tract.

Partitioning the components of maxillary tooth displacement by the comparison of data from three cephalometric superimpositions.

PubMed

Baumrind, S; Ben-Bassat, Y; Bravo, L A; Curry, S; Korn, E L

1996-01-01

Using roentgenographic cephalograms from a sample of subjects with metallic implants, appropriately superimposed tracings were used to distinguish developmental and treatment-associated displacements of the maxillary central incisor and first molar associated "local" changes within the periodontium from "secondary" changes which reflect sutural and appositional growth at more distant osseous loci. Tracings were superimposed on anterior cranial base (ACB), on the maxillary implants only (IMP_MAX), and according to the best fit of maxillary anatomic structures without reference to the implants (A_MAX). Using the IMP_MAX superimposition, one could measure total local displacement at any landmark taking into consideration the effects of all appositional and resorptive changes on the superior and anterior surfaces of the palate, whereas using the A_MAX superimposition one could measure local displacement without consideration of surface appositional and resorptive changes. If the second of these measurements were subtracted from the first, the result would be a direct measurement of the effects of surface appositional and resorptive changes as they are expressed at that particular landmark. This strategy has enabled us to quantify and report the amount of accommodation which occurs at the location of each dental landmark in association with the resorptive and appositional changes which occur through time on the superior and anterior surfaces of the hard palate.

Comparison of elastic properties of nickel-titanium orthodontic archwires.

PubMed

Sarul, Michał; Kowala, Beata; Antoszewska, Joanna

2013-01-01

Cognizance of the mechanical properties of nickel-titanium archwires is necessary for the management of orthodontic therapy with fixed appliances. Acting on the periodontium with forces that are too heavy may lead to such complications as: pain, tooth root resorption and destruction of the alveolar bone and may also lead to retardation in tooth movement. The aim of the study was to assess the activation and deactivation forces of nickel-titanium archwires: Titanol Superelastic, Copper NiTi 35oC and NeoSentalloy. The examined material was 90 samples of Titanol Superelastic, Copper NiTi 35oC and NeoSentalloy with diameters of 0.016 and 0.016 x 0.022. All tests were carried out on the Zwick mechanical tests machine at a temperature of 30o C. In the group of archwires with diameters 0.016, the levels of deactivation forces were, respectively, from highest to lowest: Titanol Supertelastic, NeoSentalloy, Copper NiTi 35oC. In the group of rectangular archwires 0.016 x 0.022, the highest deactivation forces were released in Titanol Superelastic. With the high levels of deflection, 0.016 x 0.022 NeoSentalloy archwires released statistically significantly higher levels of force than 0.016 x 0.022 Copper NiTi 35o C, but this force diminished rapidly with lower deflection and below 3 mm of deflection, the highest forces were released by Copper NiTi 35o C. Testing the mechanical properties of the nickel-titanium wires of various diameters, it was found that round section wires release forces which fall within the range of optimal forces.

Parathyroid hormone related to bone regeneration in grafted and nongrafted tooth extraction sockets in rats.

PubMed

Kuroshima, Shinichiro; Al-Salihi, Zeina; Yamashita, Junro

2013-02-01

The quality and quantity of bone formed in tooth extraction sockets impact implant therapy. Therefore, the establishment of a new approach to enhance bone formation and to minimize bone resorption is important for the success of implant therapy. In this study, we investigated whether intermittent parathyroid hormone (PTH) therapy enhanced bone formation in grafted sockets. Tooth extractions of the maxillary first molars were performed in rats, and the sockets were grafted with xenograft. Intermittent PTH was administered either for 7 days before extractions, for 14 days after extractions, or both. The effect of PTH therapy on bone formation in the grafted sockets was assessed using microcomputed tomography at 14 days after extractions. PTH therapy for 7 days before extractions was not effective to augment bone fill, whereas PTH therapy for 14 days after operation significantly augmented bone formation in the grafted sockets. Intermittent PTH therapy starting right after tooth extractions significantly enhanced bone fill in the grafted sockets, suggesting that PTH therapy can be a strong asset for the success of the ridge preservation procedure.

Cytotoxicity analysis of alendronate on cultured endothelial cells and subcutaneous tissue. a pilot study.

PubMed

Moreira, Maria Stella; Katayama, Emilio; Bombana, Antonio Carlos; Marques, Márcia Martins

2005-12-01

The use of alendronate, a bisphosphonate which is able to inhibit bone resorption, in order to prevent dental root resorption after tooth replantation would be of clinical relevance. However, this drug must be biocompatible to the periapical tissues. The aim of this study was to analyze the effect of an alendronate paste in polyethyleneglycol (2 g ml(-1)) on endothelial cells in culture (in vitro) and on rat subcutaneous tissue (in vivo). For the in vitro study the paste was applied on round glass coverslips that were immersed into confluent cell cultures (clone Cips). The cell viability percentages of these cultures were obtained 0, 6 and 12 h after contact with the substance. As control, cultures that received plain coverslips were used. This analysis was carried out in triplicate using the Trypan blue dye exclusion assay. For the in vivo study the paste was introduced into polyethylene tubes that were placed into the rat subcutaneous tissue. The rats were killed 7 and 14 days later; then, the tissue sections stained with hematoxylin-eosin were analyzed. In vitro, the alendronate caused a significant decrease in the cell viability in 6 h (P < 0.05) and 12 h (P < 0.01), when compared with the control cultures. In vivo the tissue response was exuberant and similar at the two experimental times. There was a necrosis in a comprehensive area in contact with the open end of the tube. Presence of micro-abscesses and intense inflammatory infiltrate in the hypoderm permeating the muscle fibers and fat lobules were observed. In conclusion, the alendronate paste in polyethylene glycol as used showed to be highly cytotoxic in vitro as well as in vivo.

Damping ratio analysis of tooth stability under various simulated degrees of vertical alveolar bone loss and different root types.

PubMed

Ho, Kuo-Ning; Lee, Sheng-Yang; Huang, Haw-Ming

2017-08-03

The purpose of this study was to evaluate the feasibility of using damping ratio (DR) analysis combined with resonance frequency (RF) and periotest (PTV) analyses to provide additional information about natural tooth stability under various simulated degrees of alveolar vertical bone loss and various root types. Three experimental tooth models, including upper central incisor, upper first premolar, and upper first molar were fabricated using Ti6Al4V alloy. In the tooth models, the periodontal ligament and alveolar bone were simulated using a soft lining material and gypsum, respectively. Various degrees of vertical bone loss were simulated by decreasing the surrounding bone level apically from the cementoenamel junction in 2-mm steps incrementally downward for 10 mm. A commercially available RF analyzer was used to measure the RF and DR of impulse-forced vibrations on the tooth models. The results showed that DRs increased as alveolar vertical bone height decreased and had high coefficients of determination in the linear regression analysis. The damping ratio of the central incisor model without a simulated periodontal ligament were 11.95 ± 1.92 and 27.50 ± 0.67% respectively when their bone levels were set at 2 and 10 mm apically from the cementoenamel junction. These values significantly changed to 28.85 ± 2.54% (p = 0.000) and 51.25 ± 4.78% (p = 0.003) when the tooth model was covered with simulated periodontal ligament. Moreover, teeth with different root types showed different DR and RF patterns. Teeth with multiple roots had lower DRs than teeth with single roots. Damping ratio analysis combined with PTV and RF analysis provides more useful information on the assessment of changes in vertical alveolar bone loss than PTV or RF analysis alone.

Healing process of incisor teeth of diabetic rats replanted after storage in milk.

PubMed

Ricieri, Camila Benez; Sonoda, Celso Koogi; Aranega, Alessandra Marcondes; Panzarini, Sônia Regina; Poi, Wilson Roberto; Sundefeld, Maria Lúcia Marçal Mazza; Okamoto, Tetuo

2009-06-01

Several local factors that influence the healing process of replanted teeth have been investigated. However, it remains unclear how systemic alterations, such as diabetes mellitus, affect the prognosis of these cases. The purpose of this study was to evaluate the healing process of incisors of non-controlled diabetic rats replanted after storage in bovine long shelf-life (UHT) whole milk. Thirty-two rats were randomly assigned to receive an endovenous injection of either citrate buffer solution (group I - control; n = 16) or streptozotocin dissolved in citrate buffer solution to induce diabetes (group II; n = 16). After confirmation of the diabetic status by analysis of the glycemic levels, the maxillary right incisor of each animal was extracted and immersed in milk for 60 min. The root canals of teeth were then instrumented, and were filled with a calcium hydroxide-based dressing and replanted into their sockets. All animals received systemic antibiotic and were killed by anesthetic overdose 10 and 60 days after replantation. The specimens containing the replanted teeth were removed, fixed, decalcified, and embedded in paraffin. Semi-serial 6-microm-thick sections were obtained and stained with hematoxylin and eosin for histologic and histometric analyses. The results showed that the connective tissue adjacent to the root surface was less organized in the diabetic animals than in the control animals in both periods; the root dentin was less severely affected by root resorption in the diabetic rats; there were no significant differences between the control and diabetic groups regarding the occurrence of replacement resorption and inflammatory resorption.

Does systemic administration of casein phosphopeptides affect orthodontic movement and root resorption in rats?

PubMed

Crowther, Lachlan; Shen, Gang; Almuzian, Mohammed; Jones, Allan; Walsh, William; Oliver, Rema; Petocz, Peter; Tarraf, Nour E; Darendeliler, M Ali

2017-10-01

To assess the potential effects of casein phosphopeptides (CPPs) on orthodontically induced iatrogenic root resorption (OIIRR) and orthodontic teeth movement. Forty Wistar rats (aged 11 weeks) were randomly divided into experimental group (EG; n = 20) that received a diet supplemented with CPP and control group (CG; n = 20) devoid of diet supplement. A 150 g force was applied using nickel titanium (NiTi) coil that was bonded on maxillary incisors and extended unilaterally to a maxillary first molar. At Day 28, animals in both groups were euthanized. Volumetric assessment of root resorption craters and linear measurement of maxillary first molars movement were blindly examined using a micro-computed tomography scan. Nine rats were excluded from the experiment due to loss during general anesthesia or appliances' failure. Intra-operator reproducibility was high in both volumetric and linear measurements, 92.8 per cent and 98.5-97.6 per cent, respectively. The results reveal that dietary CPP has statistically insignificant effect on the overall OIIRR and orthodontic movement. CPP seems to have statistically insignificant effect on the volume of OIIRR and orthodontic movement in rats. A long-term study with larger sample size using a different concentration of CPP is required to clarify the dentoalveolar effect of CPP. © The Author 2017. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com

Treatment Options: Biological Basis of Regenerative Endodontic Procedures

PubMed Central

Hargreaves, Kenneth M.; Diogenes, Anibal; Teixeira, Fabricio B.

2013-01-01

Dental trauma occurs frequently in children and often can lead to pulpal necrosis. The occurrence of pulpal necrosis in the permanent but immature tooth represents a challenging clinical situation since the thin and often short roots increase the risk of subsequent fracture. Current approaches for treating the traumatized immature tooth with pulpal necrosis do not reliably achieve the desired clinical outcomes, consisting of healing of apical periodontitis, promotion of continued root development and restoration of the functional competence of pulpal tissue. An optimal approach for treating the immature permanent tooth with a necrotic pulp would be to regenerate functional pulpal tissue. This review summarizes the current literature supporting a biological rationale for considering regenerative endodontic treatment procedures in treating the immature permanent tooth with pulp necrosis. PMID:23439043

Clinical, radiographic, and histological observation of a human immature permanent tooth with chronic apical abscess after revitalization treatment.

PubMed

Shimizu, Emi; Ricucci, Domenico; Albert, Jeffrey; Alobaid, Adel S; Gibbs, Jennifer L; Huang, George T-J; Lin, Louis M

2013-08-01

Revitalization procedures have been widely used for the treatment of immature permanent teeth with apical periodontitis. The treatment procedures appear to be capable of encouraging continued root development and thickening of the canal walls. The nature of tissues formed in the canal space and at the root apex after revitalization has been shown histologically in several animal studies; similar studies in humans were recently reported. A 9-year-old boy had a traumatic injury to his upper anterior teeth. Tooth #9 suffered a complicated crown fracture with a pulp exposure, which was restored with a composite resin. The tooth developed a chronic apical abscess. Revitalization procedures were performed on tooth #9 because it was an immature permanent tooth with an open apex and thin canal walls. Twenty-six months after revitalization, the tooth had a horizontal crown fracture at the cervical level and could not be restored. The tooth was extracted and processed for routine histological and immunohistochemical examination to identify the nature of tissues formed in the canal space. Clinically and radiographically, the revitalization of the present case was successful because of the absence of signs and symptoms and the resolution of periapical lesion as well as thickening of the canal walls and continued root development. The tissue formed in the canal was well-mineralized cementum- or bone-like tissue identified by routine histology and immunohistochemistry. No pulp-like tissue characterized by the presence of polarized odontoblast-like cells aligning dentin-like hard tissue was observed. The tissues formed in the canal of revitalized human tooth are similar to cementum- or bone-like tissue and fibrous connective tissue. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Treatment of paraesthesia following root canal treatment by intentional tooth replantation: a review of the literature and a case report.

PubMed

Tsesis, Igor; Taschieri, Silvio; Rosen, Eyal; Corbella, Stefano; Del Fabbro, Massimo

2014-01-01

Some endodontic procedures may cause damage to the inferior alveolar nerve, leading to paraesthesia. When such complication is due to extrusion of obturation material beyond the apex, it can be managed by intentional replantation (IR). IR consists of the removal of a tooth and its re-insertion into the socket after performing a proper root end manipulation. It is a relatively conservative procedure aimed at preserving the tooth and, with correct case selection, can provide a predictable outcome. The aim of the present paper is to report a case of paraesthesia following endodontic treatment of second mandibular molar successfully treated by intentional replantation. In our opinion this treatment modality may be considered when the extrusion of root canal filling material causes irritation to the periapical tissues and endodontic retreatment is unfeasible.

A comparison of root surface instrumentation using manual, ultrasonic and rotary instruments: an in vitro study using scanning electron microscopy.

PubMed

Marda, Preeti; Prakash, Shobha; Devaraj, C G; Vastardis, S

2012-01-01

The commonly accepted idea concerning root planing is that excessive removal of cementum is not necessary for removal of endotoxins. The ideal instrument should enable the removal of all extraneous substances from the root surfaces, without causing any iatrogenic effects. To compare the remaining calculus, loss of tooth substance, and roughness of root surface after root planing with Gracey curette, ultrasonic instrument (Slimline insert FSI-SLI-10S), and DesmoClean rotary bur. The efficiency of calculus removal, the amount of lost tooth substance, and root surface roughness resulting from the use of hand curette, ultrasonic instrument, and rotary bur on 36 extracted mandibular incisors were examined by SEM. We used three indices to measure the changes: Remaining calculus index (RCI), Loss of tooth substance index (LTSI), and Roughness loss of tooth substance index (RLTSI). Twelve samples were treated with each instrument. The time required for instrumentation was also noted. Kruskal-Wallis ANOVA was used for multiple group comparisons and the Mann-Whitney test for group-wise comparisons. Analysis was carried out with SPSS software (version 13). The RCI and LTSI showed nonsignificant differences between the three groups. RLTSI showed a significant difference between Slimline and hand curette as well as Slimline and Desmo-Clean. Slimline showed the least mean scores for RCI, LTSI, and RLTSI. Thus, even though the difference was not statistically significant, Slimline insert was shown to be better than the other methods as assessed by the indices scores and the instrumentation time.

A comparative scanning electron microscopy study between hand instrument, ultrasonic scaling and erbium doped:Yttirum aluminum garnet laser on root surface: A morphological and thermal analysis

PubMed Central

Mishra, Mitul Kumar; Prakash, Shobha

2013-01-01

Background and Objectives: Scaling and root planing is one of the most commonly used procedures for the treatment of periodontal diseases. Removal of calculus using conventional hand instruments is incomplete and rather time consuming. In search of more efficient and less difficult instrumentation, investigators have proposed lasers as an alternative or as adjuncts to scaling and root planing. Hence, the purpose of the present study was to evaluate the effectiveness of erbium doped: Yttirum aluminum garnet (Er:YAG) laser scaling and root planing alone or as an adjunct to hand and ultrasonic instrumentation. Subjects and Methods: A total of 75 freshly extracted periodontally involved single rooted teeth were collected. Teeth were randomly divided into five treatment groups having 15 teeth each: Hand scaling only, ultrasonic scaling only, Er:YAG laser scaling only, hand scaling + Er:YAG laser scaling and ultrasonic scaling + Er:YAG laser scaling. Specimens were subjected to scanning electron microscopy and photographs were evaluated by three examiners who were blinded to the study. Parameters included were remaining calculus index, loss of tooth substance index, roughness loss of tooth substance index, presence or absence of smear layer, thermal damage and any other morphological damage. Results: Er:YAG laser treated specimens showed similar effectiveness in calculus removal to the other test groups whereas tooth substance loss and tooth surface roughness was more on comparison with other groups. Ultrasonic treated specimens showed better results as compared to other groups with different parameters. However, smear layer presence was seen more with hand and ultrasonic groups. Very few laser treated specimens showed thermal damage and morphological change. Interpretation and Conclusion: In our study, ultrasonic scaling specimen have shown root surface clean and practically unaltered. On the other hand, hand instrument have produced a plane surface, but removed more tooth structure. The laser treated specimens showed rough surfaces without much residual deposit or any other sign of morphological change. PMID:24015009

Mesenchymal Stem Cell-Mediated Functional Tooth Regeneration in Swine

PubMed Central

Fang, Dianji; Yamaza, Takayoshi; Seo, Byoung-Moo; Zhang, Chunmei; Liu, He; Gronthos, Stan; Wang, Cun-Yu; Shi, Songtao; Wang, Songlin

2006-01-01

Mesenchymal stem cell-mediated tissue regeneration is a promising approach for regenerative medicine for a wide range of applications. Here we report a new population of stem cells isolated from the root apical papilla of human teeth (SCAP, stem cells from apical papilla). Using a minipig model, we transplanted both human SCAP and periodontal ligament stem cells (PDLSCs) to generate a root/periodontal complex capable of supporting a porcelain crown, resulting in normal tooth function. This work integrates a stem cell-mediated tissue regeneration strategy, engineered materials for structure, and current dental crown technologies. This hybridized tissue engineering approach led to recovery of tooth strength and appearance. PMID:17183711

Comparison of analysis and experiment for dynamics of low-contact-ratio spur gears

NASA Technical Reports Server (NTRS)

Oswald, Fred B.; Rebbechi, Brian; Zakrajsek, James J.; Townsend, Dennis P.; Lin, Hsiang Hsi

1991-01-01

Low-contact-ratio spur gears were tested in NASA gear-noise-rig to study gear dynamics including dynamic load, tooth bending stress, vibration, and noise. The experimental results were compared with a NASA gear dynamics code to validate the code as a design tool for predicting transmission vibration and noise. Analytical predictions and experimental data for gear-tooth dynamic loads and tooth-root bending stress were compared at 28 operating conditions. Strain gage data were used to compute the normal load between meshing teeth and the bending stress at the tooth root for direct comparison with the analysis. The computed and measured waveforms for dynamic load and stress were compared for several test conditions. These are very similar in shape, which means the analysis successfully simulates the physical behavior of the test gears. The predicted peak value of the dynamic load agrees with the measurement results within an average error of 4.9 percent except at low-torque, high-speed conditions. Predictions of peak dynamic root stress are generally within 10 to 15 percent of the measured values.

Successful Ultra-Conservative Management of a Mandibular Premolar with Dens Invaginatus.

PubMed

Abazarpour, Ramin; Parirokh, Masoud; Farhadi, Aida; Jalali, Zahra; Kheirabadi, Nasir

2017-01-01

Dens invaginatus is one of the most common anomalies of tooth structure. It is caused by the invagination of the crown surface during odontogenesis that enters the pulp chamber of the affected tooth. Depending on the complexity of invagination, the tooth might present with pulp necrosis, open apex and a complicated root canal system. This case report presents an Oehlers' type 2 dens-invaginatus in a mandibular premolar with chronic apical abscess. In most cases, dens invaginatus is removed during treatment. However, in this case report, based on cone-beam computed tomography (CBCT) evaluation, non-surgical treatment and maintenance of the invaginated segment was chosen in order to prevent compromising the tooth structure and its susceptibility to future root fracture. This is a new treatment approach and has not been performed in previous reports. Calcium-enriched mixture (CEM) cement was used as an apical plug followed by gutta-percha in warm vertical compaction for root canal obturation. The case was followed up for 36 months after treatment. This report highlights the importance of selecting the appropriate treatment approach based on CBCT evaluation.

Successful Ultra-Conservative Management of a Mandibular Premolar with Dens Invaginatus

PubMed Central

Abazarpour, Ramin; Parirokh, Masoud; Farhadi, Aida; Jalali, Zahra; Kheirabadi, Nasir

2017-01-01

Dens invaginatus is one of the most common anomalies of tooth structure. It is caused by the invagination of the crown surface during odontogenesis that enters the pulp chamber of the affected tooth. Depending on the complexity of invagination, the tooth might present with pulp necrosis, open apex and a complicated root canal system. This case report presents an Oehlers’ type 2 dens-invaginatus in a mandibular premolar with chronic apical abscess. In most cases, dens invaginatus is removed during treatment. However, in this case report, based on cone-beam computed tomography (CBCT) evaluation, non-surgical treatment and maintenance of the invaginated segment was chosen in order to prevent compromising the tooth structure and its susceptibility to future root fracture. This is a new treatment approach and has not been performed in previous reports. Calcium-enriched mixture (CEM) cement was used as an apical plug followed by gutta-percha in warm vertical compaction for root canal obturation. The case was followed up for 36 months after treatment. This report highlights the importance of selecting the appropriate treatment approach based on CBCT evaluation. PMID:28808472

Quasi-automatic 3D finite element model generation for individual single-rooted teeth and periodontal ligament.

PubMed

Clement, R; Schneider, J; Brambs, H-J; Wunderlich, A; Geiger, M; Sander, F G

2004-02-01

The paper demonstrates how to generate an individual 3D volume model of a human single-rooted tooth using an automatic workflow. It can be implemented into finite element simulation. In several computational steps, computed tomography data of patients are used to obtain the global coordinates of the tooth's surface. First, the large number of geometric data is processed with several self-developed algorithms for a significant reduction. The most important task is to keep geometrical information of the real tooth. The second main part includes the creation of the volume model for tooth and periodontal ligament (PDL). This is realized with a continuous free form surface of the tooth based on the remaining points. Generating such irregular objects for numerical use in biomechanical research normally requires enormous manual effort and time. The finite element mesh of the tooth, consisting of hexahedral elements, is composed of different materials: dentin, PDL and surrounding alveolar bone. It is capable of simulating tooth movement in a finite element analysis and may give valuable information for a clinical approach without the restrictions of tetrahedral elements. The mesh generator of FE software ANSYS executed the mesh process for hexahedral elements successfully.

Bone-level implants placed in the anterior maxilla: an open-label, single-arm observational study

PubMed Central

2017-01-01

Purpose This study assessed marginal bone remodeling and soft tissue esthetics after the loading of single bone-level implants in the anterior maxilla. Methods An open, single-arm observational clinical trial with 3 years of follow-up was performed, including 22 implants. The patients presented with a single tooth gap in the anterior maxilla (tooth positions 14–24), with natural or restored adjacent teeth. An implant was placed at least 8 weeks post-extraction and healed submerged for 6 weeks. After the second-stage operation, a fixed provisional prosthesis was provided. The final restoration was placed 6 months after the provisional restoration. The time of the provisional crown connection was considered to be the baseline in this study. Esthetic parameters and the marginal bone level were assessed at 6, 12, 24, and 36 months. Results All implants were well integrated in the bone. A statistically significant increase was found in the mean implant stability quotient between the time of the provisional prosthesis and the time of the final prosthesis. Most implants (95.5%) revealed marginal bone resorption (<0.5 mm), and just 1 implant (4.5%) showed a change of 2.12 mm from baseline to 36 months (mean 0.07±0.48 mm), while the crestal bone level decreased significantly, from 2.34±0.93 mm at baseline to 1.70±1.10 mm at 36 months. The facial gingival margin and papilla were stable and the esthetic scores indicated high patient and dentist satisfaction. Conclusions Platform-switching bone-level implants placed in maxillary single-tooth gaps resulted in successful osseointegration with minimal marginal bone resorption. The peri-implant soft tissue was also esthetically satisfying and stable. PMID:29093988

Orthodontics at a Pivotal Point of Transformation

PubMed Central

Mao, Jeremy J.

2014-01-01

The profession of orthodontics is projected to face a multitude of challenges. Do cyclic forces accelerate the rate of tooth movement and hence the speed of orthodontic treatment? Would bioengineered cementum and dentine be a solution to root resorption? What would orthodontics be like when bioengineered periodontal ligament and alveolar bone become clinical practice, or one day, entire teeth are bioengineered? Would it be possible to selectively differentiate stem cells into osteoblasts or osteoclasts by either static or cyclic forces? What is the new demand on orthodontic expertise with increasingly automated appliances? What will be the impact of the next generation of dental implants or rapid prototyped crowns on orthodontics? A century ago, Edward Angle’s practice of fixed appliances, along with other seminal contributions, such as functional appliances, established the profession of orthodontics. Today, the biophysical principles of orthodontics remain largely unchanged from Angle’s era, despite incremental refinements of brackets and wires. The paucity of fundamental innovations in orthodontics for decades presents intrinsic risks for the profession. This review will identify challenges for contemporary orthodontics and delineate strategies for the profession to evolve in an era of unprecedented scientific and technological advances, and serve as a call to action for the orthodontic profession. PMID:25018618

Evaluation of a Computer-Assisted Dental Diagnostic System by Navy Hospital Corpsmen

DTIC Science & Technology

1989-06-23

hypersensitivity 1 Defective restoration Displace/mobility of tooth, favorable prognosis Displace/mobility of tooth, guarded prognosis 2 Endo / perio ... injury Osseous sequestrum 2 Occlusal trauma _1 Periodontal abscess 3 Periocoronitis/erupting tooth 2 Reversible pulpitis Root fracture Total...Trauma Related Injury 1 1 0 *Tooth, Specific 18 26 17 *Teeth, Generalized 1 1 0 *Gingiva, Specific Area 6 1 1 *Gingiva, Generalized Area 2 2 2 *Oral

Bacterial analysis of combined periodontal-endodontic lesions by polymerase chain reaction-denaturing gradient gel electrophoresis.

PubMed

Xia, Minghui; Qi, Qingguo

2013-01-01

We used denaturing gradient gel electrophoresis (DGGE) to compare bacterial profiles in periodontium and root canals of teeth with combined periodontal-endodontic lesions. Samples of dental plaque and necrotic pulp were collected from thirteen extracted teeth with advanced periodontitis. Genomic DNA was extracted for polymerase chain reaction (PCR) analysis using universal bacterial primers. The PCR products were then loaded onto DGGE gels to obtain fractionated bands. Characteristic DGGE bands were excised and DNA was cloned and sequenced. The number of bands, which indicates the number of bacterial species, was compared between dental plaques and necrotic pulp tissues from the same tooth. Although the difference was statistically significant (P < 0.01), there was no positive correlation; similarity (Dice coefficient) was 13.1% to 62.5%. Some bacteria species were present in both the periodontal pockets and root canals of the same tooth; however, periodontal bacteria did not always invade the root canals, and some bacteria in root canals were not present in periodontal pockets of the same tooth. In some teeth, unique bacteria in root canals had not passed from periodontal pockets. A basic local alignment search tool (BLAST) sequence search in Genbank indicated that new bacteria species were present in periodontal pockets and root canals. Their characteristics must thus be further analyzed.

Maxillary canine morphology: comparative and descriptive analysis from periapical radiographs and cone beam computed tomography.

PubMed

Torres, Hianne Miranda de; Arruda, Julyanna Jacinto de; Silva-Filho, João Manoel da; Faria, Danielle Lago Bruno de; Nascimento, Monikelly Carmo Chagas; Torres, Érica Miranda de

2017-01-01

The anatomical characteristics of permanent maxillary canines were evaluated through visual examination, periapical radiography, and cone beam computed tomography (CBCT), and measurements obtained from the images and directly on the teeth were compared. Fifty extracted human maxillary canines were classified according to the side of the mouth. The direction of root curvature and location of the apical foramen were also verified. Periapical radiographs and CBCTs of the specimens were obtained. The number of root canals was verified. Tooth length and the mesiodistal and buccopalatal widths of the root were measured directly on the specimens as well as on the radiographs and CBCTs. Data were analyzed by chi-square testing and analysis of variance (α = 0.05). All teeth-26 (52%) from the right side of the dental arch and 24 (48%) from the left-had only 1 main canal each. The apical foramen was located exactly in the root apex in 34 teeth (68%). Root curvature toward the distal side was observed in the apical third in 23 teeth (46%). There were no statistically significant differences between the canines' arch side and either the foramen location (P = 0.104) or the root curvature (P = 0.215). No statistically significant differences were found in measurements of tooth length (P = 0.669), mesiodistal root width (P = 0.517), or buccopalatal root width (P = 0.672) obtained from specimens and images. Both CBCTs and periapical radiographs were reliable for determining the tooth length, mesiodistal root width, and buccopalatal root width of maxillary canines and produced statistically similar measurements.

[Maintenance and the clinical evaluation of periodontal patients in Konus-Telescope denture].

PubMed

Shin, K; Araki, H; Maeda, S; Miyata, T; Ikeda, K

1989-12-01

In order to assess by periodontal evaluation the changes that might occur with time in the abutment teeth and periodontal tissues when Konus-Telescope dentures are used as that final treatment of periodontal disease, the dentures (15 units) were placed in 13 patients with missing tooth and periodontal disease and findings at the time of denture placement and 30 months after the placement were compared. The number of cases that exhibited significant changes in hygiene level, tissue inflammation and periodontal pocket depth of the abutment teeth after 30 months was very small, while as many as 85.2% of the abutment teeth showed decrease in tooth mobility. Increase in tooth mobility was not detected in any of the cases. In addition, X-ray examination revealed tendencies toward improvement of the periodontal ligament and remission of alveolar bone resorption in many of the cases. These results suggest that Konus-Telescope denture is highly offers protection of the residual periodontal tissues through its secondary splint action.

Persistent apical periodontitis associated with a calcifying odontogenic cyst.

PubMed

Estrela, C; Decurcio, D A; Silva, J A; Mendonça, E F; Estrela, C R A

2009-06-01

To report a case of calcifying odontogenic cyst (COC) that was suggestive of apical periodontitis adjacent to the roots of the maxillary incisor teeth. Tooth 21 presented with clinical and radiographic signs of secondary infection, a post within the root canal and substantial internal tooth destruction; it was scheduled for endodontic surgery. Teeth 12 and 22 were root filled following the placement of a calcium hydroxide intracanal dressing for 21 days. Three attempts at root canal disinfection in tooth 11 were unsuccessful, and a persistent purulent drainage precluded completion of root canal treatment. Surgical enucleation of the periapical lesion was undertaken and the tissues submitted for histopathological examination. A diagnosis of COC was established based on the microscopic analysis. COC is an unusual benign lesion that represents 2% of all odontogenic lesions. Depending on the stage of development, it can mimic a large lesion associated with apical periodontitis and should therefore be considered in the differential diagnosis. In the case of COC, the definitive diagnosis can only be made with histopathological analysis. Persistent apical periodontitis may be of nonendodontic origin. * Histological examination is essential to establish the cause of persistent apical periodontitis. * Calcifying odontogenic cyst can mimic apical periodontitis.

Autotransplantation of a mandibular third molar: a case report with 5 years of follow-up.

PubMed

Chagas e Silva, Mauro Henrique; Lacerda, Mariane Floriano Lopes Santos; Chaves, Maria das Graças Afonso Miranda; Campos, Celso Neiva

2013-01-01

This paper describes the autologous transplantation of a mandibular right third molar to replace the residual roots of the second molar in the same quadrant, preserving function and aesthetics. A 5-year clinical and radiographic follow-up was undertaken. After transplantation, the donor tooth received endodontic treatment and placement of calcium hydroxide, which was periodically replaced every 3 months until the filling of the root canals, totalizing a period of 1-year, when apical closure was confirmed. The tooth was in perfect functional and aesthetic conditions 5 years after beginning of treatment. Autotransplantation is a feasible option for replacing missing teeth when a donor tooth is available. The autotransplantation of a right mandibular third molar with compromised function and aesthetics to replace the residual roots resulting from coronal destruction due to extensive carious lesion of the second molar in the same quadrant was a viable treatment alternative.

Management of a maxillary first molar having atypical anatomy of two roots diagnosed using cone beam computed tomography.

PubMed

Sharma, Sarang; Mittal, Meenu; Passi, Deepak; Grover, Shibani

2015-01-01

Most often, a clinician working on maxillary first molar when anticipates an aberration thinks of an extra canal but rarely does he preempt fewer canals. Maxillary first molar is a tooth, which has been extensively reviewed with respect to its external and internal morphology. Abundant literature related to its anatomy is available, but reports on incidence of two roots and two root canals in maxillary first molar are very limited. Here, a case of maxillary first molar is presented that had two roots: one palatal root with Type I canal configuration and one bulbous fused buccal root with Type V canal configuration; a unique root and canal configuration not seen in any of the earlier reported cases. Diagnosis of root canal aberrancy and subsequently, accurate management of the tooth was greatly facilitated by cone beam computed tomography (CBCT) scan. The relevance of CBCT in improving treatment prognosis is greatly emphasized in this report.

Interleukin-1β induces human cementoblasts to support osteoclastogenesis

PubMed Central

Huynh, Nam C-N; Everts, Vincent; Pavasant, Prasit; Ampornaramveth, Ruchanee S

2017-01-01

Injury of the periodontium followed by inflammatory response often leads to root resorption. Resorption is accomplished by osteoclasts and their generation may depend on an interaction with the cells in direct contact with the root, the cementoblasts. Our study aimed to investigate the role of human cementoblasts in the formation of osteoclasts and the effect of interleukin (IL)-1β hereupon. Extracted teeth from healthy volunteers were subjected to sequential digestion by type I collagenase and trypsin. The effect of enzymatic digestion on the presence of cells on the root surface was analyzed by histology. Gene expression of primary human cementoblasts (pHCB) was compared with a human cementoblast cell line (HCEM). The pHCBs were analyzed for their expression of IL-1 receptors as well as of receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG). In a co-culture system consisting of osteoclast precursors (blood monocytes) and pHCBs, the formation of osteoclasts and their resorptive activity was assessed by osteo-assay and ivory slices. The cells obtained after a 120 min enzyme digestion expressed the highest level of bone sialoprotein, similar to that of HCEM. This fraction of isolated cells also shared a similar expression pattern of IL-1 receptors (IL1-R1 and IL1-R2). Treatment with IL-1β potently upregulated RANKL expression but not of OPG. pHCBs were shown to induce the formation of functional osteoclasts. This capacity was significantly stimulated by pretreating the pHCBs with IL-1β prior to their co-culture with human blood monocytes. Our study demonstrated that cementoblasts have the capacity to induce osteoclastogenesis, a capacity strongly promoted by IL-1β. These results may explain why osteoclasts can be formed next to the root of teeth. PMID:29235551

Regenerative Endodontic Treatment with Orthodontic Treatment in a Tooth with Dens Evaginatus: A Case Report with a 4-year Follow-up.

PubMed

Natera, Marianella; Mukherjee, Padma M

2018-06-01

Dens evaginatus is a developmental tooth anomaly in which an extra cusp or tubercle protrudes on the occlusal surface of the tooth along with some pulpal tissue. Because of the fragile nature of the protrusion, these teeth are often at risk of pulpal exposure. When this occurs in an immature tooth, regenerative endodontic treatment may be a good treatment approach to promote root formation. There is limited literature that documents the occurrence of orthodontic treatment in teeth that have undergone regenerative endodontic therapy using triple antibiotic paste. Here we present a case of an immature premolar tooth with dens evaginatus that was diagnosed with pulp necrosis and chronic apical abscess. The tooth was treated with regenerative endodontic treatment; after which, the patient received orthodontic treatment with fixed appliances for 2 years. The tooth responded favorably to the regenerative endodontic treatment and orthodontic tooth movement. Clinically and radiographically, all the follow-up examinations revealed an asymptomatic tooth with evidence of periapical healing with stunted root development. The tooth remained asymptomatic even after 4 years. The regenerative endodontic procedure (REP) was successful in treating an immature permanent premolar with pulp necrosis and apical periodontitis with dens evaginatus. In this case, the tooth treated with an REP responded to orthodontic treatment similar to the nonendodontically treated teeth. Further studies are recommended to clarify the precise effects of orthodontic treatment on teeth treated with an REP. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Comparison of alternative image reformatting techniques in micro-computed tomography and tooth clearing for detailed canal morphology.

PubMed

Lee, Ki-Wook; Kim, Yeun; Perinpanayagam, Hiran; Lee, Jong-Ki; Yoo, Yeon-Jee; Lim, Sang-Min; Chang, Seok Woo; Ha, Byung-Hyun; Zhu, Qiang; Kum, Kee-Yeon

2014-03-01

Micro-computed tomography (MCT) shows detailed root canal morphology that is not seen with traditional tooth clearing. However, alternative image reformatting techniques in MCT involving 2-dimensional (2D) minimum intensity projection (MinIP) and 3-dimensional (3D) volume-rendering reconstruction have not been directly compared with clearing. The aim was to compare alternative image reformatting techniques in MCT with tooth clearing on the mesiobuccal (MB) root of maxillary first molars. Eighteen maxillary first molar MB roots were scanned, and 2D MinIP and 3D volume-rendered images were reconstructed. Subsequently, the same MB roots were processed by traditional tooth clearing. Images from 2D, 3D, 2D + 3D, and clearing techniques were assessed by 4 endodontists to classify canal configuration and to identify fine anatomic structures such as accessory canals, intercanal communications, and loops. All image reformatting techniques in MCT showed detailed configurations and numerous fine structures, such that none were classified as simple type I or II canals; several were classified as types III and IV according to Weine classification or types IV, V, and VI according to Vertucci; and most were nonclassifiable because of their complexity. The clearing images showed less detail, few fine structures, and numerous type I canals. Classification of canal configuration was in 100% intraobserver agreement for all 18 roots visualized by any of the image reformatting techniques in MCT but for only 4 roots (22.2%) classified according to Weine and 6 (33.3%) classified according to Vertucci, when using the clearing technique. The combination of 2D MinIP and 3D volume-rendered images showed the most detailed canal morphology and fine anatomic structures. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Surgical management of vertical root fractures for posterior teeth: report of four cases.

PubMed

Floratos, Spyros G; Kratchman, Samuel I

2012-04-01

The objective of this article was to present a surgical treatment option for teeth with incomplete vertical root fracture in maxillary and mandibular posterior teeth. Four cases are presented in which 1 endodontically treated maxillary or mandibular molar had an incomplete vertical root fracture involving 1 of the roots. The tooth underwent a flap elevation procedure to visualize the pattern of bone loss and assess the extent of root fracture. The fracture line was eliminated by resecting the root in a beveled manner, after which root-end preparation and root-end filling were performed by using mineral trioxide aggregate. The osteotomy was covered with an absorbable collagen membrane. Cases were followed up for 8-24 months after surgery. The procedure was shown to be predictable and successful in this series. Root length was preserved, and tooth extraction was avoided. The microsurgical treatment option for multirooted teeth with incomplete vertical root fracture resulted in long-term clinical success. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Immediate Implants: Clinical Guidelines for Esthetic Outcomes

PubMed Central

Javaid, Mohammad A.; Khurshid, Zohaib; Zafar, Muhammad S.; Najeeb, Shariq

2016-01-01

Research has shown that tooth loss results in morphological changes in alveolar ridge that may influence the subsequent implant placement. Immediate implant placement was introduced as a possible means to limit bone resorption and reduce the number of surgical procedures following tooth extraction. Histological and clinical evidence from human clinical studies showing efficacy of immediate implants has come to light over the last decade or so. However, immediate implant placement is a challenging surgical procedure and requires proper case selection and surgical technique. Furthermore, there appears to be a lack of clinical guidelines for immediate implant placement case selection. Therefore, the aim of this mini-review is to analyze critical evidence from human studies in order to establish clinical guidelines which may help clinicians in case selection when considering immediate implant placement protocol. PMID:29563463

Fractographic Analysis of a Split Tooth Presenting Radiographically as a Horizontal Root Fracture in an Unrestored Mandibular Second Molar.

PubMed

Krishnan, Unni; Moule, Alex; Michael, Shaji; Swain, Michael

2018-02-01

Spontaneously catastrophic fracture of intact unrestored molar teeth is not common. Nevertheless, cracks do occur that progress apically, resulting in the complete splitting of the tooth and root. This report describes a catastrophic fracture that occurred in an unrestored mandibular second molar resulting in a previously unreported combination of a longitudinal and horizontal root fracture, appearing radiographically as a single horizontal root fracture. Tooth fragments were examined clinically, stereoscopically, and by scanning electron microscopy. Fractographic analysis was used to investigate the dynamics involved in fracture initiation, structural resistances encountered during progression of the fracture, and reasons for direction changes culminating in the unusual radiographic appearance. The uniqueness of this report is that it describes fractographic evidence of factors contributing to the initiation and progression of an in vivo crack. It shows fracture markings that are evidence of the energy dissipation mechanisms. The topographic location of these markings confirmed that cracks occur in vivo in stages with different rates of progression. This analysis helps to explain why split teeth are uncommon and highlights some of the multitude of factors that have to coincide for a tooth to catastrophically fracture. The report describes the mechanism of fracture and should stimulate clinicians and researchers to investigate cracking of teeth by undertaking fractographic analysis of extracted cracked teeth. Copyright © 2017 American Association of Endodontists. All rights reserved.

Revascularization Induced Maturogenesis of Non-Vital Immature Permanent Tooth Using Platelet-Rich-Fibrin: A Case Report.

PubMed

Nagaveni, N B; Pathak, Sidhant; Poornima, P; Joshi, Jooie S

2016-01-01

The aim of this report is to describe a novel method of revascularization therapy done in a non-vital, immature permanent tooth using Platelet-rich fibrin (PRF),in a recently developed scaffold material to overcome limitations associated with the traditional method of revascularization using natural blood clot. PRF prepared from autologous blood was placed in the root canal and patient was followed up regularly at one, three, six, nine and 12 months for detailed clinical and radiographic evaluation. At 12 months, radiographic examination revealed root elongation, root end closure, continued thickening of the root dentinal walls, obliteration of root canal space, and normal periradicular anatomy. However, more long term prospective trials and histological studies are highly needed before to testify PRF a panacea for the regenerative endodontic therapy in children.

ClC-7 Deficiency Impairs Tooth Development and Eruption

PubMed Central

Wang, He; Pan, Meng; Ni, Jinwen; Zhang, Yanli; Zhang, Yutao; Gao, Shan; Liu, Jin; Wang, Zhe; Zhang, Rong; He, Huiming; Wu, Buling; Duan, Xiaohong

2016-01-01

CLCN7 gene encodes the voltage gated chloride channel 7 (ClC-7) in humans. The mutations in CLCN7 have been associated with osteopetrosis in connection to the abnormal osteoclasts functions. Previously, we found that some osteopetrosis patients with CLCN7 mutations suffered from impacted teeth and root dysplasia. Here we set up two in vivo models under a normal or an osteoclast-poor environment to investigate how ClC-7 affects tooth development and tooth eruption. Firstly, chitosan-Clcn7-siRNA nanoparticles were injected around the first maxillary molar germ of newborn mice and caused the delay of tooth eruption and deformed tooth with root dysplasia. Secondly, E13.5 molar germs infected with Clcn7 shRNA lentivirus were transplanted under the kidney capsule and presented the abnormal changes in dentin structure, periodontal tissue and cementum. All these teeth changes have been reported in the patients with CLCN7 mutation. In vitro studies of ameloblasts, odontoblasts and dental follicle cells (DFCs) were conducted to explore the involved mechanism. We found that Clcn7 deficiency affect the differentiation of these cells, as well as the interaction between DFCs and osteoclasts through RANKL/OPG pathway. We conclude that ClC-7 may affect tooth development by directly targeting tooth cells, and regulate tooth eruption through DFC mediated osteoclast pathway. PMID:26829236

Assessment of the amount of remaining coronal dentine in root-treated teeth.

PubMed

Bandlish, R B; McDonald, A V; Setchell, D J

2006-10-01

There is currently no standardised technique to measure the amount of coronal dentine remaining in a root-treated tooth after crown preparation. The aim of this study was to develop a method of measuring remaining coronal dentine in root-treated teeth and to propose an index for grading tooth restorability. The study recruited 20 patients who had completed molar endodontic treatment at the Eastman Dental Hospital and had been prescribed an amalgam coronal-radicular core with a full coverage cast restoration. Using a series of interlocking special trays and impressions, a method was devised to produce a cast of the amount of remaining dentine coronal to the finish line after crown preparation. This cast was scanned using a laser profilometer and the volume of remaining dentine was calculated. A tooth restorability index (TRI) was developed to assess the strategic value of the remaining dentine. The TRI allowed scores of 0-3 in each sextant with a maximum score of 18 per tooth. Twenty teeth were scored by three examiners and the TRI scores varied from 2 to 13. The volume of coronal dentine varied from 61.73 to 232.22 mm(3). A tooth restorability index has been devised to assess the strategic value of remaining dentine. A Kappa statistic was calculated to produce values of 0.584, 0.688 and 0.720, giving moderate-good agreement between the examiners.

Permanent tooth mineralization in bonobos (Pan paniscus) and chimpanzees (P. troglodytes).

PubMed

Boughner, Julia C; Dean, M Christopher; Wilgenbusch, Chelsea S

2012-12-01

The timing of tooth mineralization in bonobos (Pan paniscus) is virtually uncharacterized. Analysis of these developmental features in bonobos and the possible differences with its sister species, the chimpanzee (P. troglodytes), is important to properly quantify the normal ranges of dental growth variation in closely related primate species. Understanding this variation among bonobo, chimpanzee and modern human dental development is necessary to better contextualize the life histories of extinct hominins. This study tests whether bonobos and chimpanzees are distinguished from each other by covariance among the relative timing and sequences of tooth crown initiation, mineralization, root extension, and completion. Using multivariate statistical analyses, we compared the relative timing of permanent tooth crypt formation, crown mineralization, and root extension between 34 P. paniscus and 80 P. troglodytes mandibles radiographed in lateral and occlusal views. Covariance among our 12 assigned dental scores failed to statistically distinguish between bonobos and chimpanzees. Rather than clustering by species, individuals clustered by age group (infant, younger or older juvenile, and adult). Dental scores covaried similarly between the incisors, as well as between both premolars. Conversely, covariance among dental scores distinguished the canine and each of the three molars not only from each other, but also from the rest of the anterior teeth. Our study showed no significant differences in the relative timing of permanent tooth crown and root formation between bonobos and chimpanzees. Copyright © 2012 Wiley Periodicals, Inc.

Periodontal healing in one-wall intra-bony defects in dogs following implantation of autogenous bone or a coral-derived biomaterial.

PubMed

Kim, Chang-Sung; Choi, Seong-Ho; Cho, Kyoo-Sung; Chai, Jung-Kiu; Wikesjö, Ulf M E; Kim, Chong-Kwan

2005-06-01

Autogenous bone grafts and bone biomaterials are being used as part of protocols aiming at reconstruction of periodontal defects. There is a limited biologic information on the effect of such materials on periodontal healing, in particular aberrant healing events that may prevent their general use. The objective of this study was, using histological techniques, to evaluate periodontal healing with focus on root resorption and ankylosis following implantation of autogenous bone and a coral-derived biomaterial into intra-bony defects in dogs. One-wall intra-bony periodontal defects were surgically created at the distal aspect of the second and the mesial aspect of the fourth mandibular premolars in either right or left jaw quadrants in four Beagle dogs. Each animal received particulated autogenous bone and the resorbable calcium carbonate biomaterial into discrete one-wall intra-bony defects. The mucoperiosteal flaps were positioned and sutured to their pre-surgery position. The animals were euthanized 8 weeks post-surgery when block sections of the defect sites were collected and prepared for qualitative histological analysis. There were no significant differences in periodontal healing between sites receiving autograft bone and the coral-derived biomaterial. A well-organized periodontal ligament bridging new bone and cementum regeneration was observed extending coronal to a notch prepared to delineate the apical extent of the defect. Osteoid and bone with enclosed osteocytes were formed onto the surface of both autograft and coral particles. Although small resorption pits were evident in most teeth, importantly none of the biomaterials provoked marked root resorption. Ankylosis was not observed. Particulated autogenous bone and the coral-derived biomaterial may be implanted into periodontal defects without significant healing aberrations such as root resorption and ankylosis. The histopathological evaluation suggests that the autogenous bone graft has a limited osteogenic potential as demonstrated in this study model.

Osteoblast and osteoclast behaviors in the turnover of attachment bones during medaka tooth replacement.

PubMed

Mantoku, Akiko; Chatani, Masahiro; Aono, Kazushi; Inohaya, Keiji; Kudo, Akira

2016-01-15

Tooth replacement in polyphyodont is a well-organized system for maintenance of homeostasis of teeth, containing the dynamic structural change in skeletal tissues such as the attachment bone, which is the supporting element of teeth. Histological analyses have revealed the character of tooth replacement, however, the cellular mechanism of how skeletal tissues are modified during tooth replacement is largely unknown. Here, we showed the important role of osteoblasts for controlling osteoclasts to modify the attachment bone during tooth replacement in medaka pharyngeal teeth, coupled with an osterix-DsRed/TRAP-GFP transgenic line to visualize osteoblasts and osteoclasts. In the turnover of the row of attachment bones, these bones were resorbed at the posterior side where most developed functional teeth were located, and generated at the anterior side where teeth were newly erupted, which caused continuous tooth replacement. In the cellular analysis, osteoclasts and osteoblasts were located at attachment bones separately, since mature osteoclasts were localized at the resorbing side and osteoblasts gathered at the generating side. To demonstrate the role of osteoclasts in tooth replacement, we established medaka made deficient in c-fms-a by TALEN. c-fms-a deficient medaka showed hyperplasia of attachment bones along with reduced bone resorption accompanied by a low number of TRAP-positive osteoclasts, indicating an important role of osteoclasts in the turnover of attachment bones. Furthermore, nitroreductase-mediated osteoblast-specific ablation induced disappearance of osteoclasts, indicating that osteoblasts were essential for maintenance of osteoclasts for the proper turnover. Taken together, our results suggested that the medaka attachment bone provides the model to understand the cellular mechanism for tooth replacement, and that osteoblasts act in the coordination of bone morphology by supporting osteoclasts. Copyright © 2015 Elsevier Inc. All rights reserved.

Structure, attachment, replacement and growth of teeth in bluefish, Pomatomus saltatrix (Linnaeus, 1776), a teleost with deeply socketed teeth.

PubMed

Bemis, William E; Giuliano, Anne; McGuire, Betty

2005-01-01

Tooth replacement poses many questions about development, pattern formation, tooth attachment mechanisms, functional morphology and the evolution of vertebrate dentitions. Although most vertebrate species have polyphyodont dentitions, detailed knowledge of tooth structure and replacement is poor for most groups, particularly actinopterygians. We examined the oral dentition of the bluefish, Pomatomus saltatrix, a pelagic and coastal marine predator, using a sample of 50 individuals. The oral teeth are located on the dentary and premaxillary bones, and we scored each tooth locus in the dentary and premaxillary bones using a four-part functional classification: absent (A), incoming (I), functional (F=fully ankylosed) or eroding (E). The homodont oral teeth of Pomatomus are sharp, deeply socketed and firmly ankylosed to the bone of attachment. Replacement is intraosseus and occurs in alternate tooth loci with long waves of replacement passing from rear to front. The much higher percentage of functional as opposed to eroding teeth suggests that replacement rates are low but that individual teeth are quickly lost once erosion begins. Tooth number increases ontogenetically, ranging from 15-31 dentary teeth and 15-39 premaxillary teeth in the sample studied. Teeth increase in size with every replacement cycle. Remodeling of the attachment bone occurs continuously to accommodate growth. New tooth germs originate from a discontinuous dental lamina and migrate from the lingual (dentary) or labial (premaxillary) epithelium through pores in the bone of attachment into the resorption spaces beneath the existing teeth. Pomatomus shares unique aspects of tooth replacement with barracudas and other scombroids and this supports the interpretation that Pomatomus is more closely related to scombroids than to carangoids.

Effects of the incorporation of ε-aminocaproic acid/chitosan particles to fibrin on cementoblast differentiation and cementum regeneration.

PubMed

Park, Chan Ho; Oh, Joung-Hwan; Jung, Hong-Moon; Choi, Yoonnyoung; Rahman, Saeed Ur; Kim, Sungtae; Kim, Tae-Il; Shin, Hong-In; Lee, Yun-Sil; Yu, Frank H; Baek, Jeong-Hwa; Ryoo, Hyun-Mo; Woo, Kyung Mi

2017-10-01

Cementum formation on the exposed tooth-root surface is a critical process in periodontal regeneration. Although various therapeutic approaches have been developed, regeneration of integrated and functional periodontal complexes is still wanting. Here, we found that the OCCM30 cementoblasts cultured on fibrin matrix express substantial levels of matrix proteinases, leading to the degradation of fibrin and the apoptosis of OCCM30 cells, which was reversed upon treatment with a proteinase inhibitor, ε-aminocaproic acid (ACA). Based on these findings, ACA-releasing chitosan particles (ACP) were fabricated and ACP-incorporated fibrin (fibrin-ACP) promoted the differentiation of cementoblasts in vitro, as confirmed by bio-mineralization and expressions of molecules associated with mineralization. In a periodontal defect model of beagle dogs, fibrin-ACP resulted in substantial cementum formation on the exposed root dentin in vivo, compared to fibrin-only and enamel matrix derivative (EMD) which is used clinically for periodontal regeneration. Remarkably, the fibrin-ACP developed structural integrations of the cementum-periodontal ligament-bone complex by the Sharpey's fiber insertion. In addition, fibrin-ACP promoted alveolar bone regeneration through increased bone volume of tooth roof-of-furcation defects and root coverage. Therefore, fibrin-ACP can promote cementogenesis and osteogenesis by controlling biodegradability of fibrin, implicating the feasibility of its therapeutic use to improve periodontal regeneration. Cementum, the mineralized layer on root dentin surfaces, functions to anchor fibrous connective tissues on tooth-root surfaces with the collagenous Sharpey's fibers integration, of which are essential for periodontal functioning restoration in the complex. Through the cementum-responsible fiber insertions on tooth-root surfaces, PDLs transmit various mechanical responses to periodontal complexes against masticatory/occlusal stimulations to support teeth. In this study, periodontal tissue regeneration was enhanced by use of modified fibrin biomaterial which significantly promoted cementogenesis within the periodontal complex with structural integration by collagenous Sharpey's fiber insertions in vivo by controlling fibrin degradation and consequent cementoblast apoptosis. Furthermore, the modified fibrin could improve repair and regeneration of tooth roof-of-furcation defects, which has spatial curvatures and geometrical difficulties and hardly regenerates periodontal tissues. Copyright © 2017 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

FEM analysis of different dental root canal-post systems in young permanent teeth.

PubMed

Vitale, M C; Chiesa, M; Coltellaro, F; Bignardi, C; Celozzi, M; Poggio, C

2008-09-01

Aim of this work was to carry out a comparative evaluation of the structural behaviour of different root canal posts (cylindrical, conical and triple conical) fitted in a second lower bicuspid and subjected to compression and bending test. This study has been carried out by numerical method of structural analysis of finite elements (FEM, Finite Element Method). Different tridimensional models were obtained by CAT images of an extracted tooth, endodontically treated, filled with guttapercha and triple conical glass post. Images have been elaborated by a software for images (Mimics and Ansys) and CAD (Rhinoceros 3 D). In the models a II Class restoration has been virtually created. In the numerical simulation dental tissues (enamel, dentine and root cement), guttapercha, root canal cement, different posts, different techniques of cementation and crown restoration (composites and adhesive systems) have been considered. Strain distributions in dental tissues, in root canal cement and in posts have been compared. The equivalent tensions and the single components (traction, compression and cut) have been analysed. In all examined posts, the most strained part is resulted the coronal one, even if the total tension, in the different tooth-post analyzed systems, resulted uniformly distributed. A similar behaviour was shown by the root canal cement. According to the analyzed conditions of bond and load, varying according to the geometry of the considered posts, our results confirm that there is no substantial difference of deformation in posts, root canal cement and treated tooth.

Endodontic treatment of a fused tooth. Report of a case.

PubMed

Gallottini, L; Barbato Bellatini, R C; Migliau, G

2007-01-01

Dental fusion, a rare developmental anomaly present in 0.2% of the general population, consists of the union of two teeth originating from two different tooth germs. The irregular coronal morphology and the complex endodontic anatomy, characterized by the partial or total union of the pulp chambers, together with the peculiarity of the root canal systems, make diagnosis, therapy and rehabilitation difficult. The authors describe the endodontic treatment of a permanent lower second molar fused with a third molar and having four root canals.

Endodontic management of an unusual maxillary first molar with a single buccal root.

PubMed

Nayak, Gurudutt; Dahiya, Surya; Singh, Inderpreet; Mohammad, Faiz Hasan

2014-05-01

The aim of this clinical article is to describe the unusual anatomy that was detected in a maxillary first molar during routine endodontic treatment. Variation in Root and Root canal morphology especially in multirooted teeth presents a constant challenge for a clinician in their detection and management. The literature is replete with cases that have extra canal or Root but cases with fused Root and fewer numbers of canals are sparse. This case report describes the endodontic management of one such unusual case of maxillary first molar presenting with a single fused buccal and a palatal Root. The confirmatory diagnosis of this morphologic aberration was done with the help of spiral computerized tomography, which revealed that the contralateral tooth also had a similar morphology. Dental practitioners should always be aware of the fact that abnormalities need not be in form of extra Roots or Root canals; anomalies can also be in form of fewer number of Roots or Root canals. A thorough knowledge of the complexities and variations of the Root canal system would help in avoiding some of the common iatrogenic access opening errors like perforations and excessive tooth removal caused during the search for the missing or extracanal.

Apical root resorption in patients treated with comprehensive orthodontics.

PubMed

Harris, E F; Boggan, B W; Wheeler, D A

2001-01-01

External apical root resorption (EARR) is a common--but seldom extreme--consequence of orthodontic treatment. Incisors are most at risk, perhaps because of their single roots and because they typically are moved farther than other teeth. We followed a cohort of patients (n = 153) treated with comprehensive orthodontics. EARR was scored on the upper incisors with a qualitative five-grade ordinal scale. There was no EARR at the start of treatment, but most (> 80%) exhibited slight-to-moderate EARR by the end of treatment (i.e., a loss of 1-2 mm). Cases treated with premolar extractions experienced more EARR because their incisors were retracted farther; however, the sum of the effects of patients' sex and age, and severity of the malocclusion, and the kind of mechanics used accounts for little of the overall variation in EARR. Instead, it appears that genetically-based inter-individual variation in susceptibility to EARR is the most influential factor. Research should be directed at understanding the biochemical nature of susceptibility so prospective patients can be screened to identify those at particular risk.

Hounsfield unit change in root and alveolar bone during canine retraction.

PubMed

Jiang, Feifei; Liu, Sean S-Y; Xia, Zeyang; Li, Shuning; Chen, Jie; Kula, Katherine S; Eckert, George

2015-04-01

The objective of this study was to determine the Hounsfield unit (HU) changes in the alveolar bone and root surfaces during controlled canine retractions. Eighteen maxillary canine retraction patients were selected for this split-mouth design clinical trial. The canines in each patient were randomly assigned to receive either translation or controlled tipping treatment. Pretreatment and posttreatment cone-beam computed tomography scans of each patient were used to determine tooth movement direction and HU changes. The alveolar bone and root surface were divided into 108 divisions, respectively. The HUs in each division were measured. Mixed-model analysis of variance was applied to test the HU change distribution at the P <0.05 significance level. The HU changes varied with the directions relative to the canine movement. The HU reductions occurred at the root surfaces. Larger reductions occurred in the divisions that were perpendicular to the moving direction. However, HUs decreased in the alveolar bone in the moving direction. The highest HU reduction was at the coronal level. HU reduction occurs on the root surface in the direction perpendicular to tooth movement and in the alveolar bone in the direction of tooth movement when a canine is retracted. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Hounsfield Unit Change in Root and Alveolar Bone during Canine Retraction

PubMed Central

Jiang, Feifei; Liu, Sean Y.; Xia, Zeyang; Li, Shuning; Chen, Jie; Kula, Katherine S.; Eckert, George

2014-01-01

Objectives The objective of this study was to determine the Hounsfield unit (HU) changes in the alveolar bone and root surface during controlled canine retractions. Methods Eighteen maxillary canine retraction patients were selected for this split mouth design clinical trial. The canines in each patient were randomly assigned to receive either translation or controlled tipping treatment strategy. Pre- and post-treatment cone beam computed tomography scans of each patient were used to determine tooth movement direction and HU changes. The alveolar bone and root surface were divided into 108 divisions, respectively. The HU in each division was measured. The Mixed-model ANOVA was applied to test the HU change distribution at the p<0.05 significant level. Results The HU changes varied with the directions relative to the canine movement. The HU reduction occurred at the root surface. Larger reductions occurred in the divisions that were perpendicular to the moving direction. However, HU decreased in the alveolar bone in the moving direction. The highest HU reduction was at the coronal level. Conclusions HU reduction occurs on the root surface in the direction perpendicular to the tooth movement and in the alveolar bone in the direction of tooth movement when a canine is retracted. PMID:25836004

Effect of restoration technique on stress distribution in roots with flared canals: an FEA study.

PubMed

Belli, Sema; Eraslan, Öznur; Eraslan, Oğuz; Eskitaşcıoğlu, Gürcan

2014-04-01

The aim of this finite element analysis (FEA) study was to test the effect of different restorative techniques on stress distribution in roots with flared canals. Five three-dimensional (3D) FEA models that simulated a maxillary incisor with excessive structure loss and flared root canals were created and restored with the following techniques/materials: 1) a prefabricated post: 2) one main and two accessory posts; 3) i-TFC post-core (Sun Medical); 4) the thickness of the root was increased by using composite resin and the root was then restored using a prefabricated post; 5) an anatomic post was created by using composite resin and a prefabricated glass-fiber post. Composite cores and ceramic crowns were created. A 300-N static load was applied at the center of the palatal surface of the tooth to calculate stress distributions. SolidWorks/Cosmosworks structural analysis programs were used for FEA analysis. The analysis of the von Mises and tensile stress values revealed that prefabricated post, accessory post, and i-TFC post systems showed similar stress distributions. They all showed high stress areas at the buccal side of the root (3.67 MPa) and in the cervical region of the root (> 3.67 MPa) as well as low stress accumulation within the post space (0 to 1 MPa). The anatomic post kept the stress within its body and directed less stress towards the remaining tooth structure. The creation of an anatomic post may save the remaining tooth structure in roots with flared canals by reducing the stress levels.

The Relationship between Dental Follicle Width and Maxillary Impacted Canines' Descriptive and Resorptive Features Using Cone-Beam Computed Tomography.

PubMed

Dağsuyu, İlhan Metin; Okşayan, Rıdvan; Kahraman, Fatih; Aydın, Mehmet; Bayrakdar, İbrahim Şevki; Uğurlu, Mehmet

2017-01-01

To assess the relationship between dental follicle width and maxillary impacted canines' descriptive and resorptive features with three-dimensional (3D) cone-beam computed tomography (CBCT). The study comprised 102 patients with cone-beam computed tomography 3D images and a total of 140 impacted canines. The association between maxillary impacted canine dental follicle width and the variables of gender, impaction side (right and left), localization of impacted canine (buccal, central, and palatal), and resorption of the adjacent laterals was compared. Measurements were analyzed with Student's t -test, Kruskal-Wallis test, and Mann-Whitney U statistical test. According to gender, no statistically significant differences were found in the follicle size of the maxillary impacted canine between males and females ( p > 0.05). Widths of the follicles were determined for the right and left impaction sides, and no statistically significant relation was found ( p > 0.05). There were statistically significant differences between root resorption degrees of lateral incisors and maxillary impacted canine follicle width ( p < 0.05). Statistically significant higher follicle width values were present in degree 2 (mild) resorption than in degree 1 (no) and degree 3 (moderate) resorption samples ( p < 0.05). No significant correlation was found between follicle width and the variables of gender, impaction side, and localization of maxillary impacted canines. Our study could not confirm that increased dental follicle width of the maxillary impacted canines exhibited more resorption risk for the adjacent lateral incisors.

Treatment options following single-rooted tooth removal: a literature review and proposed hierarchy of treatment selection.

PubMed

Fugazzotto, Paul A

2005-05-01

Alveolar bone changes following tooth extraction have been well documented and have given rise to a number of treatment approaches. Included in these approaches are placement of various grafting materials, immediate implant placement, and a combination of both. A review of all pertinent literature discussing regenerative therapy at the time of tooth extraction or immediate implant placement with or without concomitant regenerative therapy was carried out. A clinically-based hierarchy of treatment selection following extraction of single rooted teeth is proposed, based upon the available literature and clinical experience. The role of patient phenotype is considered. Utilization of the proposed hierarchy of treatment selection affords a logical framework within which to predictably treat a variety of patients.

Age estimation by pulp-to-tooth area ratio using cone-beam computed tomography: A preliminary analysis.

PubMed

Rai, Arpita; Acharya, Ashith B; Naikmasur, Venkatesh G

2016-01-01

Age estimation of living or deceased individuals is an important aspect of forensic sciences. Conventionally, pulp-to-tooth area ratio (PTR) measured from periapical radiographs have been utilized as a nondestructive method of age estimation. Cone-beam computed tomography (CBCT) is a new method to acquire three-dimensional images of the teeth in living individuals. The present study investigated age estimation based on PTR of the maxillary canines measured in three planes obtained from CBCT image data. Sixty subjects aged 20-85 years were included in the study. For each tooth, mid-sagittal, mid-coronal, and three axial sections-cementoenamel junction (CEJ), one-fourth root level from CEJ, and mid-root-were assessed. PTR was calculated using AutoCAD software after outlining the pulp and tooth. All statistical analyses were performed using an SPSS 17.0 software program. Linear regression analysis showed that only PTR in axial plane at CEJ had significant age correlation ( r = 0.32; P < 0.05). This is probably because of clearer demarcation of pulp and tooth outline at this level.

Endodontic management of middle mesial canal of the mandibular molar

PubMed Central

Sundaresh, K J; Srinivasan, Raghu; Mallikarjuna, Rachappa; Rajalbandi, Sandeep

2013-01-01

Thorough knowledge of root canal morphology and unusual anatomy of the tooth is critical for successful endodontic treatment. Although the most common configuration is two roots and three root canals, mandibular molars might have many different combinations. In the literature, it is less described about three mesial canals and two distal canals in mandibular second molars, indicating a rare anatomical configuration. A case of unusual root canal morphology is presented to demonstrate anatomical variations in mandibular molars. Endodontic therapy was performed in a mandibular second molar with five separate canals, three mesial and two distal. This report points out the importance of looking for additional canals and unusual canal morphology, because knowledge of their existence might occasionally enable clinicians to treat a case successfully that otherwise might have ended in failure. In conclusion, every attempt should be made to find and treat all root canals of a tooth. PMID:23349182

Nasolacrimal obstruction caused by root abscess of the upper canine in a cat.

PubMed

Anthony, James M G; Sandmeyer, Lynne S; Laycock, Amanda R

2010-03-01

A 10-year-old, castrated male domestic short hair cat was presented to the Small Animal Clinic at the Western College of Veterinary Medicine with a presenting complaint of chronic, ocular discharge from the left eye. Ocular examination confirmed epiphora and mucopurulent discharge but there were no apparent reasons for the ocular discharge, and nasolacrimal obstruction was suspected. The cat had swelling of the left side of the face, severe periodontal disease and a fractured upper left canine tooth with pulpal exposure. Dacryocystorhinography revealed narrowing of the nasolacrimal duct above the root of the fractured upper left canine and dental radiographs showed a severe periapical lucency at the apex of the upper left canine tooth. The fractured canine tooth was removed. Subsequently, the ocular discharge and facial swelling resolved. After 2 years, the epiphora has never reoccurred. This is a noteworthy case because a suspected root abscess resulted in extralumenal compression of the nasolacrimal duct, which shows the importance of a thorough oral examination when nasolacrimal obstruction is evident.