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At least 217 records · Page 12Linked to original sources
PubMed2001

Periodontal response to two intracanal medicaments in replanted monkey incisors.

Intracanal medicaments are recommended for use in replanted teeth to inhibit inflammatory root resorption. This study compared the effect of calcium hydroxide (Pulpdent) and a corticosteroid-antibiotic paste (Ledermix) on periodontal healing and root resorption following replantation. Incisors of eight Macaca fascicularis monkeys were extracted, stored dry for 15 min and replanted. After 11 days, root canals in two adjacent maxillary incisors were treated with one medicament and contralateral incisors with the other medicament, or left as untreated controls. Animals were sacrificed 8 weeks later and the teeth prepared for histomorphometric evaluation of periodontal ligament inflammation and root resorption. Periodontal ligament inflammation and inflammatory root resorption were markedly inhibited by both calcium hydroxide and corticosteroid-antibiotic relative to untreated controls. Replacement resorption was lowest in the corticosteroid-antibiotic group, and significantly (P<0.05) more normal periodontal ligament was present in this group (79.6%) than in calcium hydroxide and control groups (64.6% and 62.7%, respectively). Treatment with the corticosteroid-antibiotic inhibited inflammatory resorption and was slightly more effective than calcium hydroxide in producing a periodontal healing response.

Animals↗
PubMed2001

Different treatment outcomes of two intruded permanent incisors--a case report.

Intrusive luxation involves the displacement of the tooth apically into the alveolar socket. This type of injury represents a very complex wound, involving disruption of the marginal gingival seal, alveolar bone, periodontal ligament fibers, cementum and the neuro-vascular supply to the pulp, which results in severely compromised healing and possible complications. The case presented is a report of a 60-year-old lady who fell and intruded her two maxillary central incisors. The healing outcomes of the two central incisors were markedly different from each other even though they sustained similar injuries.

Alveolar Process↗
PubMed2002

Traumatized primary teeth in children assisted at the Federal University of Santa Catarina, Brazil.

The goal of the present study was to identify the factors related to the occurrence of dental trauma in deciduous teeth. Over a period of 25 months, 85 children between 10 months and 6 years of age were assisted by the staff of the Pediatric Dentistry Clinic of the Federal University of Santa Catarina (UFSC) Florianópolis, Brazil. The children, all assisted by only one professional, a dentist working as a trainee in the Pediatric Dentistry Clinic, had 157 traumatized teeth treated. The occurrence of trauma was higher in male patients (51.8%) and in children between 1 and 3 years old. The average age was about =2.7 years. The 54.1% of the assisted children had more than one traumatized tooth and the repeat trauma occurred 16.7% of the time. Anterior teeth represented 98.7% of the cases and 76.4% of the trauma were on the maxillary central incisor teeth. Both sides of the mouth had approximately the same number of traumatic injuries. Luxations were more frequent (85.4%) than fractures (14.6%). Subluxations represented 38.8% of the luxated teeth. Falls were the main cause of trauma (78%). A percentage of 41.9 children were assisted by a dental professional during the first 24h after the incident. The study concluded that the deciduous dentition is mostly affected by luxations (subluxations) that occur specially on the maxillary central incisor teeth, in patients between 1 and 3 years of age. Falls are the most common etiological factor and more than one traumatized tooth is common. Some of the cases were repeat traumatic injuries.

Accidental Falls↗
PubMed2002

PCNA-expression of cementoblasts and fibroblasts on the root surface after extraoral rinsing for decontamination.

Periodontal cells capable of proliferation were studied immunohistochemically on extracted human teeth after 2-min irrigation with saline or ozonized water and marking of Proliferating Cell Nuclear Antigen (PCNA). All specimens expressed PCNA. The labelling index (LI), i.e. the number of positive cells compared to the total number of cells, was 6.6% after irrigation with saline and 7.8% after irrigation with ozone. There was no difference in number and distribution of PCNA-positive cells from the coronal to the apical thirds of the roots. Irrigation with ozonized water showed higher labelling indices in comparison with saline, but this could not be statistically substantiated (P = 0.24). Ozonized water, not being isotonic, had no negative effect on periodontal cells remaining on the tooth surface after irrigation for 2 min.

Cell Division↗
PubMed2002

Traumatic injuries in the primary dentition.

As a support for the guidelines published in 2001, a review of the literature was carried out using the evidence-based approach in order to update the state of the art regarding epidemiology and treatment of traumatic dental injuries in the primary dentition. An online search in Medline, and a review of expert literature, lead to the conclusion that most luxation injuries heal spontaneously, and unless more conclusive evidence is available, conservative treatment of acute dental trauma for preschool children is suggested. Pain control, the dentist's ability to cope with the child's anxiety, and follow-up instructions in oral hygiene techniques will allow many primary teeth that are currently lost at the time of injury to be saved.

Adolescent↗
PubMed2002

Combined apexification and orthodontic intrusion of a traumatically extruded immature permanent incisor.

A patient with a traumatic extrusion of the maxillary right central incisor was referred to the Pedodontic Clinic of Gazi University Faculty of Dentistry after 15 days. Orthodontic repositioning of the tooth was planned in 6 months. At the beginning of orthodontic therapy it was observed that the tooth was necrotic and needed an apexification procedure. The apexification procedure and orthodontic intrusion were successfully performed at the same time. In addition, a "walking bleach" was performed after the orthodontic and endodontic procedures were completed. At the 3-year recall, the tooth appeared normal in all respects.

Child↗
PubMed2002

Healing and prognosis of teeth with intra-alveolar fractures involving the cervical part of the root.

Healing and long-term prognosis of 94 cervical root fractures were evaluated. The teeth were divided into two groups according to type of fracture: transverse fractures limited to the cervical third of the root (51 incisors) and oblique fractures involving both the cervical and middle parts of the root (43 incisors). Neither the frequency nor the type of fracture healing differed significantly between the two groups. In the material as a whole, healing of the fracture with hard tissue formation was observed in 17 teeth (18%), and healing with interposition of periodontal ligament (PDL) and, in some cases, hard tissue between the fragments in 62 teeth (66%). Fifteen teeth (16%) showed no healing and a radiolucency adjacent to the fracture. Statistical analyses revealed that incomplete root formation and a positive sensibility test at the time of injury were significantly related to both healing and hard tissue repair. The same applied to concussion or subluxation compared with dislocation of coronal fragment, as well as optimal compared with suboptimal reposition of displaced coronal fragments. The type and duration of splinting (or no splinting) appeared to be of no significance for frequency or type of healing of cervical root fractures. During the observation time (mean = 75 months), 19 (44%) of the teeth with transverse fractures and 3 (8%) of those with oblique fractures were lost after healing. In conclusion, fractures in the cervical part of the root had a healing potential and the predictive parameters identified for fractures in other parts of the root seemed to be valid for the healing of cervical root fractures. Transverse fractures appeared to have a significantly poorer long-term prognosis compared to oblique fractures, apparently due to a marked post-treatment mobility, which often led to new luxation caused by even minor impacts.

Adolescent↗
PubMed2002

Factors affecting resorption in traumatically intruded permanent incisors in children.

There is a lack of consensus concerning the management of intruded permanent teeth. The objectives of the present study were to determine the prevalence of resorption for intruded permanent teeth and to establish the effect of factors on the timing, prevalence and rate of resorption and to examine the relationship between the timing of onset and the subsequent rate of resorption. Sixty-one intruded permanent incisors treated at the Paediatric Dentistry units in Belfast and Newcastle upon Tyne, during the period 1990-99 with a minimum follow-up period of 1.5 years, were studied. The timing and presence of resorption and its rate of occurrence over time were set as the principal outcomes. There was a significantly earlier onset and higher prevalence of resorption in more severely intruded teeth (P< 0.05). There was also a significant relationship between the degree of apical development and resorption with an increased prevalence in the more fully developed roots (P< 0.001). Resorption was detected significantly earlier in teeth with higher rates of resorption (P< 0.05). However, the treatment method did not significantly affect the prevalence or rate of resorption. In conclusion, the occurrence of root resorption after intrusive trauma appears to be related to the severity of the original injury and the stage of root development rather than the repositioning procedure.

Adolescent↗
PubMed2002

Use of a removable splint in the treatment of subluxated, luxated and root fractured anterior permanent teeth in children.

AIM: The aim of this study was to evaluate the prognosis of subluxated, luxated and root fractured teeth in children treated by removable splints, designed to stabilize mobile anterior teeth and eliminate occlusal trauma due to malocclusion. MATERIAL AND METHODS: A total of 227 traumatized anterior teeth (91 subluxated, 105 luxated and 31 root fractured teeth) treated with a removable splint were observed for 3 years. The traumatized teeth were from 79 children aged between 6-12 years (mean 8 years 5 months). If a traumatized tooth was extremely mobile, a fixed splint was first made before the impression was taken for the removable splint. Two weeks after completion of the removable splint treatment, an impression was taken again to evaluate the occlusal relationship of pre- versus post-treatment of removable splint. RESULTS: The treatment period with a removable splint averaged 3 weeks in subluxated teeth, 3-5 weeks in luxated teeth, 4-6 weeks in apical third root fracture injuries, and more than 5 weeks in middle third root fracture injuries. All the subluxated teeth and 74.1% of the luxated teeth maintained their pulp vitality during the 3-year follow-up period. Two of 21 (9.5%) apical third root fracture teeth and three of five (60%) middle third root fracture teeth had pulp necrosis in the coronal fragments. Internal resorption was not found in any of the traumatized teeth. External replacement resorption was not found in subluxated and luxated teeth. All the root fractured teeth displayed transient external resorption around the fracture lines. The surface resorption appeared to be self-limiting and not to threaten the retention of the tooth. Inflammatory resorption was observed in teeth with pulp necrosis, but in all cases this was reversed with endodontic treatment. Eight of 23 (39%) apical third root fractured teeth displayed replacement resorption in their apical fragments, but the resorption was not serious enough to extract the tooth. No obvious alteration in the occlusal relationship was found comparing pre- and post-treatment casts. The removable splints appeared to positively affect healing after traumatic injuries, as evidenced by the low number of complications at the 3-year follow-up period.

Child↗
PubMed2002

A two-probe laser Doppler flowmetry assessment as an exclusive diagnostic device in a long-term follow-up of traumatised teeth: a case report.

The reliability of laser Doppler flowmetry in a two-probe assessment of pulpal blood flow is well known. The purpose of this case report was to determine its use as an exclusive and reliable tool for tooth vitality diagnosis in a long-term follow-up. As a result of a traumatic injury to a 24-year-old Caucasian female, tooth pulp vitality was studied in six maxillary front teeth over 30 weeks using two-probe laser Doppler flowmetry and current sensitivity tests. A similar assessment was repeated after 228 weeks. Confronted with an alveolar bone fracture with a tooth in the fracture line, one intrusion and several luxated teeth, current sensitivity tests are found not to be as reliable indicators of revascularisation, as significant results are obtained later (7 weeks) than using laser Doppler flowmetry tests (1 week). A pathway with ischaemia (3 weeks), hyperaemia (7 weeks) and restored blood supply in the pulp measured by laser Doppler flowmetry tests was found and avoided endodontic treatment. Teeth vascularisation evolved normally (228 weeks). Despite a strong indication in all sensitivity tests for endodontic treatment, the use of laser Doppler flowmetry tests was clear, more reliable than sensitivity tests and exclusive, as denervation was postponed and pulp vascularisation evident.

Adult↗
PubMed2003

The effect of age of refrigerated conditioned medium on cell survivability in vitro.

Samples of a conditioned medium (CM), obtained from human ginvigal fibroblasts culture, were kept at 4 degrees C each for 2 weeks, 1, 2, 3 and 6 months. Their effectiveness in maintaining cell survival for their contact with L929 cells in 96 well tissue culture plates for 6 and 10 h at 4 degrees C was compared with Hank's Balanced Salt Solution (HBSS). Surviving cells were stained with neutral red dye and the dye intensity was measured spectrophotometrically at 540 nm. The target cells responded to all the above mentioned CM and the HBSS in the same manner at 6-h contact time. However, by 10-h contact time, the percentage of the target cells' survival was higher in the 2-week, 1- and 2-month CM than in HBSS, 3- and 6-month CM.

Animals↗
PubMed2003

Preservation of ridge dimensions following grafting with coral granules of 48 post-traumatic and post-extraction dento-alveolar defects.

This prospective clinical analysis reports on the use of coral granules in alveolar ridge preservation procedures in a population of young, growing patients. The sample consisted of 21 patients, 12 females and 9 males, with a mean age of 13.6 years. These 21 patients had 48 dento-alveolar defects suitable for augmentation with coral granules, and were followed clinically and radiographically for 3-7 years after augmentation. There were two areas of augmentation: 17 defects in the anterior maxilla resulted from traumatic tooth loss, and 31 defects in the posterior maxilla and mandible resulted from the extraction of ankylosed retained primary molars with no permanent succedaneous teeth. Between 1-2 ml of coral granules were implanted into the alveolar bone defects left by the extraction of teeth in both the areas. This was in order to preserve the remaining edentulous ridge from further alveolar ridge resorption. The goal of the procedure was to preserve the alveolus so that in the future, a dental implant could be placed to replace the missing tooth, after jaw growth had stopped, without the need for a bone graft. The coral granules appeared to be totally replaced by the host bone on follow-up clinical and radiographic examinations. The two areas of the jaws behaved quite differently. In the anterior maxilla, where tooth loss was secondary to trauma, the coral granules restored the alveolar ridges temporarily. However, over the years of follow-up in this study, the coral granules failed to provide sufficient bone to support the placement of a dental implant without using a bone graft in 14 of the 17 defects or 82.4% of sites. In the posterior maxilla and mandible, where tooth loss was due to the elective removal of ankylosed primary molars, 29 of the 31 defects or 93.5% of sites were successful as they were able to support the placement of an osseo-integrated dental implant without the use of a bone graft. The alveolar sparing technique was more successful in maintaining an alveolar ridge sufficient for the placement of a dental implant without bone grafting in the posterior maxilla and mandible, where tooth loss was secondary to the elective removal of ankylosed deciduous molars than in the anterior maxilla, where tooth loss was secondary to trauma. Coral granules seem to be more suitable in the posterior maxilla and mandible where there were ankylosed deciduous teeth and congenitally absent permanent teeth than in the traumatized anterior maxilla. In successful sites, coral granules can spare the alveolus from residual ridge atrophy or resorption, obviating the need for a bone graft. This reduces patient morbidity, as a second surgical donor site is avoided because bone graft harvesting is made unnecessary.

Adolescent↗
PubMed2003

Orthodontic movement in traumatically intruded teeth: a case report.

Intrusive luxation of permanent mature teeth is one of the most serious injuries to the periodontal ligament in dental traumatology. Various treatment approaches are currently practised. The treatment of choice for traumatically intruded teeth was to combine orthodontic repositioning and endodontic treatment. This case report describes the treatment of a 50-year-old male patient, with four completely intruded mature permanent maxillary incisors. Orthodontic extrusion was initiated 1 week after the trauma. After 10 days, the crowns of the teeth were exposed to start endodontic therapy. Nine weeks after the injury and 8 weeks after the beginning of orthodontic extrusion, the intruded incisors were back about to their original position before the displacement occurred. All treatment management as well as a follow-up 8 years after the trauma are described.

Humans↗
PubMed2003

Clinical outcomes for permanent incisor luxations in a pediatric population. I. Intrusions.

A longitudinal outcome study was undertaken to identify variables that significantly influenced tooth survival as well as pulpal and periodontal outcomes for intruded permanent maxillary incisors of children and adolescents. All cases were treated between June 1988 and June 1998 in a teaching hospital clinic. Clinical and radiographic data were collected for 26 patients (19 males, 7 females) that represented 31 permanent maxillary incisors. Mean age at the time of injury was 9.3 years (range = 5.5-17.8 years). Mean time elapsed to follow up was 1380 days (range = 65-3394 days). Survival analysis was used to identify variables significantly related to the survival and pulp necrosis (PN) for these incisors. Proportional hazards regression yielded significant prognostic models for tooth survival and the diagnosis of PN (P < 0.05). Incisors intruded > 6 mm had significantly decreased survival compared with incisors intruded < 3 mm (5-year survival, 0.45 and 1.0, respectively, (P < 0.05)). Complex crown fractures were significantly related to the development of PN (P < 0.05). Logistic regression analysis showed that treatment method and severity of intrusion were related to the presence of replacement root resorption (P < 0.05). This study represents the largest sample of intruded permanent incisors examined in an outcome study of children and adolescents exclusively.

Adolescent↗
PubMed2000

Variations in the presenting and treatment features in reimplanted permanent incisors in children and their effect on the prevalence of root resorption.

OBJECTIVE: To examine variations in the presentation and treatment of reimplanted incisors in children and to determine the effect of these on the prevalence of external root resorption. SETTING: Departments of Paediatric Dentistry, Belfast and Newcastle upon Tyne. DESIGN: Recording of the timing of the injury and the storage mediums (including air) and of reimplantation, the stage of root development, the degree of contamination and the time of commencement of root treatment. Cases were reviewed clinically and radiographically at intervals of 3 months. Root resorption was classified as present or absent. Logistic regression and cross-tabulations were produced with the presence of resorption set as the outcome. RESULTS: 128 reimplanted permanent incisor teeth, their median dry time prior to reimplantation being 15 minutes (range 4-52 mins), the median time in a liquid medium being 45 minutes (range 0-650 mins), with a median splinting time of 15 days (range 4-52 days) and a median pulp extirpation time of 15 days (range 0-612 days). There was a lower prevalence of resorption when the period of dryness was less than or equal to 5 minutes (p = 0.025). The prevalence of resorption in teeth with no visible contamination was 57.1%, for those with contamination which were washed clean it was 75%, in those rubbed clean it was 87.5%, and it was 100% for those reimplanted with visible contamination still present (p = 0.014). The corrected odds ratio for contamination was 2.99 and for an extension of 10 minutes of dryness it was 1.29. CONCLUSION: The degree of contamination and the period of dryness were the major risk factors for resorption in this study of reimplanted teeth in children.

Adolescent↗
PubMed2001

Good occlusal practice in children's dentistry.

The difference between paediatric dentistry and most other branches of dentistry is that in the child the occlusion is changing. Consequently 'Good Occlusal Practice' in children is a matter of making the right clinical decisions for the future occlusion. The clinician needs to be able to predict the influence that different treatment options will have on the occlusion when the child's development is complete.

Anodontia↗