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PubMed2004

Conventional and digital radiographic methods in the detection of simulated external root resorptions: a comparative study.

OBJECTIVES: The purpose of this study was to evaluate and to compare the efficacy of a conventional and a digital radiographic method in diagnosing simulated external root resorption cavities. METHODS: Human dry mandibles containing teeth were covered with bovine muscle slices in order to simulate the soft tissues. Nine teeth from each dental group were investigated. Three periapical radiographs of each tooth were taken in an orthoradial, mesioradial and distoradial aspect using conventional film (Insight Kodak F-speed; Eastman Kodak, Rochester, NY) and a digital sensor (DRS Gnatus System; Gnatus, Ribeirao Preto, Brasil). The teeth were extracted using a forceps and had 0.7 mm and 1.0 mm deep cavities prepared on their vestibular, mesial and distal surfaces at the cervical, middle and apical thirds. Following preparation, each tooth was replaced in its alveolus and new radiographs were taken. Three dental professionals, an endodontist, a radiologist and a general practioner, evaluated the images. RESULTS: A larger number of cavities (P<0.05) were detected by the digital method when compared with the conventional method, for all depths of lesions. CONCLUSIONS: The results of this study suggest that the digital radiographic method is more sensitive than conventional radiography to detect simulated external root resorption cavities.

Animals↗
PubMed1994

Apical root resorption in orthodontically treated subjects: analysis of edgewise and light wire mechanics.

Of the several modes of tooth movement, pressure from intrusive forces seems the most likely to cause external apical root resorption (EARR). This has been demonstrated for incisors in human beings and molars in laboratory animals. The present study examined full-banded adolescent patients and scored the degrees of in-treatment root resorption throughout the dentition. Just Class I cases with four first premolar extractions were used. Equal samples of conventional Begg and Tweed treated cases were examined with 1:1 sex ratios (total n = 83). No difference between the Begg and Tweed techniques and no sex difference was found in any of the 30 univariate tests, even though power analysis indicated a strong likelihood of finding a difference if one existed. By using multiple linear regression, significant decreases in length (EARR) were found for those roots systematically intruded in this Class I malocclusion, notably the mesial root of the maxillary first molar and the distal root of the mandibular first molar. Even though some of the present cases had been in "active" treatment up to 6 years, we found no significant association between duration of treatment and degree or amount of EARR.

Adolescent↗
PubMed1989

Adenine nucleotide contents and ATPases activities in porcine deciduous dental pulp during the root formation, in fully formed root and during root resorption phases.

Nucleotide content and activity of certain enzymes were compared in pigs of various ages in order to study the energetic metabolism of deciduous dental pulps in the three phases of the cycle of tooth ontogeny, namely, root formation, fully formed root and root resorption phases. The frozen pulps were removed with the help of a screw vise and analysed for ATP, ADP and AMP contents and Ca2+ and Mg2+-ATPases activities. The highest ATP content in the first deciduous molar pulp was found when the tooth was still in an intrabony position. The calculated energy charge, although low for all groups, at this stage of development, indicated an activation of the consuming processes. In the root resorption phase, lowest ATP content and higher Ca2+ and Mg2+-ATPases activities were observed.

Adenine Nucleotides↗
PubMed1998

Management of apical inflammatory root resorption: report of a case.

This article describes the diagnosis and treatment of a case of extensive apical external root resorption in the presence of a large periradicular lesion. The diagnosis was made in retrospect because the result of the resorption mimicked an immature root. The treatment consisted of the use of calcium hydroxide to induce apexification. Healing was obtained after 24 months.

Adult↗
PubMed1982

Root resorption in bicuspid intrusion. A scanning electron microscope study.

Apical root surfaces covered by cellular cementum are rapidly subjected to resorption under orthodontic loads of varying magnitude and duration. Within the experimental parameters employed, the intrusive forces applied to the teeth produced a striking increase in root resorption compared with the control teeth. The amount of resorption increased markedly with the duration of the force, and to a lesser extent with the magnitude of the appliance activation. After 70 days, cellular cementum repair accompanied the continuing resorption. Little variation was detected in the susceptibility of different patients to root resorption in the experimental teeth. The same intrusive load applied for the same duration to similar teeth produced a corresponding degree of root resorption in various individuals. On the other hand, there were individual differences in the amount of resorption on untreated control teeth. There is a need to extent our understanding of the periodontal ligament and its associated tissues which provide the basis for our professional services. Clearly, root resorption and the capacity for repair are orthodontic facts of life. In the current climate of technological innovation great emphasis has been given to cephalometrics and appliance mechanics, which provide the orthodontist with the clinical stimulus of visual and tactile involvement. This paper is presented as a contribution to our knowledge of the unseen biological consequences which accompany that orthodontic treatment.

Adolescent↗
PubMed2003

Sympathectomy causes increased root resorption after orthodontic tooth movement in rats: immunohistochemical study.

Accumulating evidence suggests that the sympathetic nervous system modulates inflammatory responses and bone remodeling. We have studied the effects of sympathectomy and orthodontic tooth movement (OTM) on root resorption, immunocompetent cell recruitment, neuropeptide, neurokinin-1 receptor (NK1-R), and interleukin 6 (IL-6) expression. Experimental rats (n=8) had the right superior cervical ganglion surgically removed, whereas control rats (n=6) underwent sham surgery. Three days later, all rats had the right maxillary first molar moved mesially by an orthodontic appliance. The rats were perfused 13 days later, and the right maxillae were processed for immunohistochemistry by using primary antibodies directed against ED1 antigen, CD43, substance P (SP), NK1-R, neuropeptide Y (NPY), and IL-6. Following OTM, sympathectomized (SCGx) rats had significantly more root resorption (P<0.01) and SP-immunoreactive (IR) fibers (P=0.01) in the compressed periodontal ligament (PDL) compared with control rats. There was a significant decrease in recruitment of CD43+ cells in the pulp after OTM in SCGx rats compared with control rats (P=0.02). An upregulation of NK1-R immunoreactivity was observed surrounding the hyalinized tissue, and an increase in the number of NK1-R IR cells and density of SP-IR fibers was present in first molar pulp of all rats. NPY-IR fibers were absent in the compressed PDL of SCGx and control rats. Thus, OTM induces remodeling not only around the periodontal tissues, but also in the dental pulp. The sympathetic nerves have an inhibitory effect on hard tissue resorption and a stimulatory effect on CD43+ cell recruitment after OTM.

Animals↗
PubMed1985

Root resorption: the aggressive, unerupted second premolar.

Three cases of first molar root resorption, due to impacted maxillary and mandibular second premolars, presented over a period of 5 months. It is suggested that this may not be such an uncommon occurrence as is generally believed. The clinical situations in which the unerupted second premolar may start resorbing first molar roots are described and methods of identifying and treating this problem suggested.

Adolescent↗
PubMed1998

Root resorptions in upper first premolars after application of continuous intrusive forces. Intra-individual study.

A scanning electron microscopy study of possible root resorptions and their localization after application of continuous forces of different magnitudes was conducted. Twelve upper first premolars, indicated for extraction, were previously intruded with constant forces. The teeth were divided into 3 groups: 1. non-moved control teeth, 2. continuous force application of 50 cN for 4 weeks, 3. continuous force application of 100 cN for 4 weeks. Specially designed NiTi-SE-stainless steel springs were utilized to exert the actual forces. After experimental tooth movement, the extracted teeth were dehydrated, metal-coated and examined by scanning electron microscopy. The intruded teeth showed resorptive areas consisting of lacunae (concavities) in the mineralized root surface. The teeth moved with 50 cN showed in the apical third several, in the medial third few, and in the cervical third no resorptive areas. In the case of the teeth moved with 100 cN, we observed resorptive areas in most of the apical third--including the apex contour-, several in the medial third, and none in the cervical third. In the control group no resorptions were observed. Thus, our results suggest that intrusion of human teeth with continuous forces induces root resorption, depending on the magnitude of force applied.

Adolescent↗
PubMed1998

Etiology and sequelae of root resorption.

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.

Animals↗
PubMed2003

Effect of dexamethasone on root resorption after delayed replantation of rat tooth.

The purpose of this study was to evaluate the effect of dexamethasone after delayed tooth replantation with specific regard to root resorption and ankylosis. In addition, the study was planned to elucidate further the usefulness of the model. Fifty-two maxillary first molar teeth were extracted from 26 Sprague-Dawley white female rats fed 0.4% beta-aminoproprionitrile for 3 days to facilitate the extraction. After extraction, the mesiobuccal root canals were endodontically treated under a microscope to prevent subsequent inflammatory resorption of pulpal origin and were assigned to three groups. Teeth in group 1, the dexamethasone group (n = 22), were demineralized in citric acid (1 min), washed, soaked in 1000 nM dexamethasone solution (3 min), air-dried, and replanted in the original sockets. Total extraoral treatment time for each tooth was controlled to 30 min. Teeth in group 2, the dried-only group (n = 22), were air-dried for 30 min after obturation without any surface treatment and replanted. Teeth in group 3, the immediate group (n = 8), were extracted, not root-filled and replanted immediately into their sockets. All experimental animals were killed at 3 weeks after replantation and evaluated histologically. Forty-three of the 52 teeth were available for histological interpretation. They consisted of six immediate, 18 dried-only, and 19 dexamethasone-treated teeth. The degree of progressive root resorption was significantly less in the dexamethasone-treated group than in the dried-only group (p < 0.05). The dexamethasone-treated group exhibited significantly more bone ankylosis than the dried-only group (p < 0.05). These results indicate that the topical use of dexamethasone may be of value in reducing the degree or rate of progressive root resorption secondary to traumatic avulsion and that the rat is a reasonable model for tooth replantation.

Administration, Topical↗
PubMed2003

Genetic predisposition to external apical root resorption in orthodontic patients: linkage of chromosome-18 marker.

External apical root resorption (EARR) is a common orthodontic treatment sequela. Previous studies implicate a substantial genetic component for EARR. Using a candidate gene approach, we investigated possible linkage of EARR associated with orthodontic treatment with the TNSALP, TNFalpha, and TNFRSF11A gene loci. The sample was comprised of 38 American Caucasian families with a total of 79 siblings who completed comprehensive orthodontic treatment. EARR was assessed by means of pre- and post-treatment radiographs. Buccal swab cells were collected for extraction and analysis of DNA. No evidence of linkage was found with EARR and the TNFalpha and TNSALP genes. Non-parametric sibling pair linkage analysis identified evidence of linkage (LOD = 2.5; p = 0.02) of EARR affecting the maxillary central incisor with the microsatellite marker D18S64 (tightly linked to TNFRSF11A). This indicates that the TNFRSF11A locus, or another tightly linked gene, is associated with EARR.

Child↗
PubMed1993

Repair process of external root resorption subsequent to palatal expansion treatment.

The repair process of external root resorption (ERR) and the role of retention mechanics in enhancing ERR repair were studied on eight Macaca fascicularis monkeys that were divided equally into short- and long-term groups. Six monkeys received palatal expansion appliances, and two received sham appliances. The short-term group received active treatment. The long-term group received additional retention (4 months) and relapse (2 months) treatment periods with biweekly injections of individual vital dye per phase, i.e., procion red H-8B and violet H-3R (80 mg/kg B.W.), respectively. Histomorphologic examinations included scanning electron microscopy, light, and ultraviolet microscopy. The short-term group demonstrated penetrated resorption with pulp exposure at sites with initial deficiency of the protecting odontoblastic layer (apical zone, nutrition canal). The long-term group showed two forms of ERR repair: (1) Nonfunctional retarded repair cementum, comprised of overlapped incremental lines and deprived of extrinsic fibers, was delineated in severe pulp exposure. The pulp/dentin complex showed intense incorporation of procion dye in the dentinal tubuli, conceivably related to a defense response in the form of sclerotic dentin. (2) Functional rapid repair cementum, comprised of discriminated incremental lines mainly of mixed cellular cementum, with a consistent pattern of five sequential phases: the lag phase (14 to 28 days), the incipient phase (14 days), the peak phase (14 to 28 days), the steady phase (42 to 56 days) and the retreating phase (70 days). Sharpey's fibers at functional ERR sites were scarce, never emerging from the dentinocemental junction, and not developing into principal fibers. The pulp/dentin complex showed an increase in pulp stones but no formation of tertiary dentin. The apical area responded by hypercementosis in the form of apical occlusion and a displaced pulp canal. The application of a fixed retention device is recommended in light of accelerated apposition of repair cementum during the retention period. However, increased formation of Sharpey's fibers during the relapse period might suggest a restricted duration in splinting therapy.

Animals↗
PubMed1986

Apical root resorption of upper incisors caused by intrusive tooth movement: a radiographic study.

The purpose of the study was to investigate whether root resorption of the upper incisors occurs during intrusion of maxillary incisors. It examines the possibility of a relationship between the amount of root shortening and duration of the intrusive force. The ratio of root length before and after intrusion was compared in 20 patients. In 66 incisors with an intrusion period of 29 weeks, an intrusion of 3.6 mm was performed. The control group consisted of 15 patients who underwent no orthodontic treatment. Consequently, 58 incisors had no intrusion. The follow-up time between 2 measurements was +/- 28 weeks. The findings clearly showed root shortening after intrusion. A mean resorption of 18% of the original root length was found. In comparison, none of the control patients showed root shortening. No correlation has been found between the amount of resorption and the amount and duration of intrusion. In combination with the apical deflection of the root, the nasal floor was occasionally a limiting factor for intrusion and this may have caused root resorption.

Adolescent↗
PubMed1999

The effect of physiological root resorption on repair potential of primary tooth pulp.

The aim of this study was to determine, the effects of root resorption on repair potential of healthy deciduous tooth pulps. Fourteen canine teeth which needed to be extracted for orthodontic purposes and in which resorption had just begun (1st group, resorption did not exceed 1/3 of root length) or was in advanced resorption stage (2nd group, resorption was between 1/3 and 2/3 of root length) were used for this study. Direct pulp capping treatment was implemented in vivo, to 7 teeth in each group. Reparative dentin formation was determined three months later following extraction. The teeth were examined histopathologically under light microscope. As a result, in the teeth with different resorption levels, dentin bridge formation in the capping area was observed. Although maturation of the thin dentin bridges was completed in all teeth, maturation of the thick dentin bridges was still continuing at the 90th day.

Adolescent↗
PubMed2002

External root resorption following partial-thickness connective tissue graft placement: a case report.

We report an unusual case of external root resorption (ERR) that developed in a 37-year-old black male approximately 1 year following routine partial thickness connective tissue graft surgery. The lesion was accessed via flap surgery, thoroughly root planed, and the mucoperiosteal flap replaced. The site healed uneventfully and the patient has been closely observed for over 1 year without symptoms or recurrence of the resorptive lesion and the affected tooth remained vital. Clinicians performing partial-thickness connective tissue grafts should be alert to the possible occurrence of root resorption over extended periods of time. The authors speculate that retention of the donor periosteum with placement on the recipient dentin and root biomodification may limit the resorptive response following connective tissue graft procedures to treat tooth root recession.

Adult↗
PubMed1981

Upper molar root resorption because of distal movement. Report of a case.

A case of a patient whose upper first molars suffered severe root resorption as a result of distal tooth movement is presented. Complete destruction of one root was found to have occurred. The initial objective in treatment was to regain arch length and improve the molar relationships with headgear. Subsequently, full-bonded orthodontic therapy was initiated after extraction of all first molars, as loss of root length could be observed radiographically. Examination of the extracted upper first molar roots in a scanning electron microscope revealed extensive areas of superficial root surface resorption which were not detectable on radiographs of these teeth. Care should be taken to avoid impingement of roots on adjacent unerupted teeth, which may result in extensive root damage.

Child↗
PubMed2002

Internal root resorption studied by radiography, stereomicroscope, scanning electron microscope and computerized 3D reconstructive method.

AIM AND METHODOLOGY: Two cases of internal tooth resorption were examined. A mandibular premolar and a mandibular canine were studied after they were extracted using radiographs, a stereomicroscope (SM) and a scanning electron microscope (SEM). Lastly, 3D images of the sectioned teeth were obtained(3D). RESULTS: Radiographically, internal root resorption was shown as a uniform radiolucency. By SM examination, an extensive destruction of dentin was seen, while, by SEM examination, a disappearance of dentinal tubules was clear. The 3D reconstructive method revealed a circumscribed, oval-shaped defect that did not perforate the cemental layer. CONCLUSIONS: Internal root resorption is a rare remodeling process that can be studied using different experimental methods.

Bicuspid↗