Induction of calcification in rat molar pulp with collagen condroitin sulphate complex combination.
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The aim of the present study was to perform a retrospective study of autogeneously transplanted teeth in order to examine the influence of clinical criteria such as the type of the donor tooth, the root length at the time of transplantation, donor eruption stage and others on the overall success rate of the transplantation. The material of this study consisted of 194 patients in whom 273 teeth were transplanted. The mean age at the time of autotransplantation was 18.1 years with a standard deviation of 7.5 years. Transplantations were performed in two hospitals. The follow-up period varied from 15 days to 11 years, and the mean follow-up time was 3.8 years. 58/273 teeth showed one or other form of resorption, 37/273 teeth showed ankylosis, 30/273 showed no important changes in pulp chamber size, 104/273 showed major discoloration after transplantation, 92/273 teeth showed positive results for cold test after transplantation and 26/273 teeth showed clinically unacceptable pocket depth. Clinical and radiological evaluations were performed. An association was found between successful transplantation and donor tooth type (P<0.01), root length at the time of transplantation (P<0.0001) and recipient tooth site (P=0.03). There was a borderline association between successful transplantation and donor eruption stage (P=0.05). In conclusion, autotransplantation of teeth performed with a careful surgical procedure at the stage of 1/2-3/4 of their intended or expected root length can render a very useful service to patients.
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Calcifications found in the coronal pulps of primary teeth extracted in an 8-year-old child were studied by TEM. Different types of relationship were observed between fibroblasts and pulp calcifications: extension of cell processes towards calcifications, modelling of the cells upon calcifications, internalizing process of calcifications. Fibroblasts proved to be able to enclose small pulp calcifications within intracytoplasmic vesicles. There was no evidence of any active role played by fibroblasts in the genesis of pulp calcifications. It was shown that collagen fibres could be involved or not in the mineralizing process. It is suggested that mitochondria might provide an adequate environment for initial mineralization. It is likely that the role played by the cytoskeleton in the internalizing process of calcifications is important.
BACKGROUND: The Ehlers-Danlos syndromes (EDS) comprise a heterogenous group of heritable disorders of connective tissue, characterized by joint hypermobility, skin hyperextensibility and tissue fragility. Most EDS types are caused by mutations in genes encoding different types of collagen or enzymes, essential for normal processing of collagen. METHODS: Oral health was assessed in 31 subjects with EDS (16 with hypermobility EDS, nine with classical EDS and six with vascular EDS), including signs and symptoms of temporomandibular disorders (TMD), alterations of dental hard tissues, oral mucosa and periodontium, and was compared with matched controls. RESULTS: All EDS subjects were symptomatic for TMD and reported recurrent temporomandibular joint (TMJ) dislocations. Abnormal pulp shape (13%) and pulp calcification (78%) were observed in subjects affected with classical EDS. Caries experience was higher in EDS compared with controls and was related to poor oral hygiene, influenced by increased mucosal fragility and restraint of (wrist) joint mobility. The overall periodontal status in EDS was poor, with 62% of EDS subjects presenting high periodontal treatment needs (community periodontal index for treatment need, CPITN = II). CONCLUSION: Oral health may be severely compromised in EDS as a result of specific alterations of collagen in orofacial structures. When considering dental treatment in EDS, a number of tissue responses (mucosa, periodontium, pulp) and precautions (TMJ dislocation) should be anticipated.
The dental pulp was capped indirectly or directly, or partial vital pulpectomy was performed on the 12 functionally most important teeth of 24 beagle dogs. For pulp capping, calcium hydroxide was used, followed by zinc phosphate as a lining, and the preparation was restored with amalgam or composite material. Histological sections were prepared and examined for degree and type of pulp inflammation (hyperaemia, pulpitis, necrosis or gangrene). Degenerative changes of dental pulp (vacuolation, calcification, amyloid or hyaline changes) were also determined. For indirect pulp capping the width of predentine in crown and root dental pulp was measured, and for direct pulp capping and partial pulpectomy (vital pulpotomy) the width and quality of the dentinal bridge were graded. The radical method of partial vital pulpectomy of the coronal part of the dental pulp in dogs produced better quality and continuity of the dentinal bridge than the less radical method of direct pulp capping. This was particularly obvious in small single root teeth such as incisors.
Generalized pulpal calcifications arouse suspicion of diseases or conditions of systemic or hereditary origin. This case report describes a 45-year-old patient with generalized pulpal calcifications and bulging of the roots in areas corresponding to the pulp chambers in otherwise normal teeth. Similar findings were present in the patient's daughters and brother. This pattern of pulpal calcifications is consistent with the hereditary condition of dentinal dysplasia type Id.
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The dentin dysplasias (DD), which may be classified as type 1 (DD1) or type 2 (DD2), form a group of rare, inherited dentin abnormalities that are clinically distinct from dentinogenesis imperfecta. Studies of affected families may help to distinguish different types of DD and provide further insight into their etiology and clinical management. This report describes a family that showed characteristic dental features of DD1, including clinically normal crowns in both primary and permanent dentitions, and mobile teeth that may be associated with premature exfoliation. Radiographic features included calcification of the pulp with crescent-shaped, radiolucent pulp remnants, short, tapering, taurodontic roots, and many periapical pathoses that may be cysts or granulomas. A spectrum of dentin dysplasia was noted within the family. Strategies to prevent pulp and periapical infections and early exfoliation of the teeth include meticulous oral hygiene and effective caries-preventive measures.
We have presented a case in which 3.7-year-old patient exhibited calcific metamorphosis of a maxillary primary central incisor at the initial visit, with subsequently internal resorption developing in the same tooth. This case underscores the need for careful monitoring of traumatized teeth that have undergone calcific metamorphosis.
Access to a tooth with a partial canal calcification was made. The access was possible only with a bur extensor connected to a LN bur. Calcification was bypassed, and the canal was completely prepared.
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Pulpal calcifications are relatively common. However, their occurrence in the entire dentition is relatively infrequent. The presence of such calcification arouses suspicion of systemic or hereditary origin. This case report describes twin sisters with pulpal calcifications in their entire dentitions. No systemic cause was detected. The pattern of calcification was partially consistent with the hereditary condition of dentinal dysplasia.
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References in the endodontic literature specifically warn that orthodontic treatment may initiate the formation of secondary dentin deposition within a tooth to the extent of obstructing the entire root canal. Comparison of forty-six orthodontically treated patients with a control group of age- and sex-matched patients who had not undergone orthodontic treatment revealed two orthodontically treated patients with a total of three teeth that showed evidence of canal calcification. Although this incidence is not statistically significant, the clinical significance of canal calcification in the orthodontic population is discussed.
Pulp fibroblasts were isolated from human deciduous and supernumerary teeth and cultured in vitro. With continued culture in normal tissue-culture medium, six pulp fibroblast strains formed cell nodules after 10-15 days. By electron microscopy the nodules had matrix vesicles, and needle-shaped crystals associated with a dense network of collagen fibrils. The crystalline material exhibited a pattern consistent with hydroxyapatite when nodules were examined by X-ray diffractometry. Furthermore, the cells showed high levels of alkaline phosphatase activity, which could be increased more than seven-fold by the addition of 1,25(OH)2D3 (5 x 10(-9)-5 x 10(-8) M). In addition to the production of type I collagen, these cells also synthesized fibronectin and osteonectin. The formation of mineralized tissue nodules by pulp cells in vitro provides a useful system for study of the pathological calcification of pulp tissues.
Extensive calcification of the pulp is a pathologic condition that occurs as an answer to various factors (trauma, caries, periodontal disease). The increase in the amount of calcification may lead to partial or complete radiographic, but not microscopic, obliteration of the pulp chamber and root canals. Complete calcific degeneration (pulpal obliteration) may be found in two forms, generalized or localized. The generalized form which is presented in the present case report is probably part of the aging process.