[Spontaneous healing of fractured tooth with resorption of apical root].
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Changes in bone, cartilage and the dentition in animals and man following the administration of anticonvulsant drugs resemble those seen in hypoparathyroidism and pseudohypoparathyroidism. Groups of 21-day-old rats were treated with diphenylhydantoin, parathyroidectomized, or made hypocalcaemic with a calcium-deficient diet. Histological examination revealed extensive resorption of cementum and dentine in the molars of the drug-treated and parathyroidectomized rats, but not in the hypocalcaemic or control groups. Localization of injected tetracycline by fluorescence showed that the resorption affected the distal side of the tooth roots and had occurred after root formation. No changes in cementum formation on the mesial side of the roots had occurred in any of the experimental groups. These results suggest that diphenylhydantoin induces a condition similar to pseudohypoparathyroidism in which the resistance of tooth roots to resorption is reduced.
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The toothless (tl) rat is an osteopetrotic mutation characterized by a generalized skeletal sclerosis, reduced bone resorption, few osteoclasts and a total absence of erupted teeth. This mutation is not cured by bone marrow transplants from normal littermates. It is known that the skeletal defects in tl rats are greatly improved after treatment with colony-stimulating factor-1 (CSF-1). This investigation concerns the effects of CSF-1 on the development and eruption of the dentition of tl rats. Untreated tl rats had no erupted teeth by 56 days after birth, and the roots of incisors and molars were severely distorted by compression against bone. The apex of the mandibular incisor did not extend past the first molar and continued growth of its apical end produced odontoma-like masses consisting of distorted dentine and enamel matrices. In addition, few osteoclasts were seen on alveolar bone surfaces surrounding the developing teeth. Mutants given CSF-1 were characterized by delayed eruption of all molars and sometimes incisors. The incidence of incisor eruption was related inversely to the age at which CSF-1 treatment began. Molars of treated tl rats had well-developed roots similar to those in normal rats. Treated mutants had numerous osteoclasts in alveolar bone and well-developed haemopoietic marrow spaces in the mandible. Histochemical staining for both tartrate-resistant acid phosphatase and tartrate-resistant acid ATPase was reduced or negligible in osteoclasts of untreated tl rats, heavy in normal osteoclasts and of intermediate intensity in CSF-1-treated mutants.(ABSTRACT TRUNCATED AT 250 WORDS)
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Tartrate-resistant acid phosphatase (TRAP) has been used as a cytochemical marker for the cell mediators of bone resorption, osteoclasts and their mononuclear precursors. We have applied a cytochemical method for TRAP to study the dependence of the osteoclast-mediated bone resorption of tooth eruption on the dental follicle, a connective tissue investment of the developing tooth, by analyzing the TRAP activity of mononuclear cells in the dental follicle before and during pre-molar eruption in dogs. The percentage of TRAP-positive monocyte cells increases until mid-eruption, slightly preceding a previously demonstrated rise in numbers of osteoclasts on adjacent bone surfaces. These data suggest an ontogenetic relationship between follicular mononuclear cells and osteoclasts on adjacent alveolar bone surfaces during tooth eruption. However, because TRAP occurs in other tissues and is not an exclusive indicator of pre-osteoclasts, proof of their relationship will have to await application of more definitive techniques.
The behaviour of eruption of lower premolars after pathological resorption of deciduous molar roots was examined on models and X-rays. The molars of the first dentition were shed earlier after pathological resorption of deciduous molar roots. Data of absence are measured in years in the presence of occlusal bone bridges. The middle values are more than three years. Eruption of permanent teeth happens years later or they remain impacted. Eruption dates of premolars after pathological deciduous root resorption and interruption of the lamina dura, and after physiological resorption are significantly earlier than if there is an occlusal bony bridge (p less than 0.01). The therapeutic consequence is the surgical liberation of such premolars and their removal.
The purpose of this study was to determine the role of the pressure generated during the intraligamentary injection technique on the occurrence of root and bone resorptions in dogs. Five beagles were used in the study, and interventions were scheduled to provide observation periods at 7, 25, and 45 days. One hundred five sites on the dogs were divided into three groups: (1) those subjected to needle penetration; (2) those subjected to saline solution injection; and (3) the control sites. Injections were made with a specially designed syringe equipped with a miniaturized force transducer. The dogs were then killed, and block sections of the sites were made and treated in accord with standard histologic procedures. The mean number of osteoclasts and odontoclasts was calculated for each group, and the mean value of bone and tooth resorption angle was measured. Data were then analyzed statistically. Results showed that, at 7 days, needle penetration and saline solution injection caused osteoclastic activity and bone resorption; the number of osteoclasts and the extent bone resorption were greater in the group that received the injection of saline solution. No difference was found for the odontoclastic activity and tooth resorption. A correlation was found between the force developed during injection, the mean number of osteoclasts, and the mean angle of bone and tooth resorption. At 25 and 45 days, healing had occurred. These findings suggest that fluid pressure within the periodontal ligament is sufficient to initiate osteoclastic, reversible bone resorption.
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Autogenous tooth transplantation is an alternative treatment for preserving continuity of the dental arch following early loss of teeth. The prognosis of transplants determines the indication as compared with other methods of space closure. Transplanted buds of upper premolars as well as of lower third molars continue their root growth. The clinical and roentgenological analysis of 81 autogenously transplanted upper canines, following different operative procedures, indicates, that 50% of the transplants remain in situ for five years and only 25% remain in situ longer than six years. The statistical chances of survival of vitally transplanted, apicoectomied teeth are more favourable. Short-term prognosis is determined by inflammatory bone and/or tooth resorption due to odontogenic infection or occlusal trauma. Long-time prognosis is determined by different forms of tooth resorption. Regular radiographic examination as reveal early odontogenic infections which can then be treated endodontically. The doubtful prognosis necessitates strict indications.
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Both physiological and pathological forms of bone and tooth resorption are seen in the dentoalveolar complex, and much of the non-restorative component of a clinician's work is occupied by problems related to loss of bone or dentine. Bone resorption is also a feature of many systemic diseases, some of which can affect the alveolar bone. The aim of this report is to summarize some recent work in which the dentoalveolar complex has been used as a model system to study physiological, pathological and therapeutic aspects of resorption of bone and dentine.
Hydroxyapatite (HAP) tooth root substitute implantation have been applied to extraction sockets in many studies for purpose of preservating alveolar bone. Dimensional changes were measured with sectioned study cast of cephalometric X-ray photo. In this study, dimensional changes were determined by newly developed evaluation system which utilizing image analyzer (Immunomedica Co., Ltd.), in a view of conserving alveolar ridges beneath the denture base. Cone shaped HAP tooth roots (5 or 6 mm in length) were implanted to one subject and disk-like shaped HAP tooth roots (2 mm in length) were also implanted to the other subject. Preservation of alveolar bone was observed in both shaped HAP tooth roots implanted site compared to control site. Bony ankylosis between HAP tooth root and alveolar bone, observed on 1 month after histological specimens, may contribute to this result. Smaller changes of blood flow compared to controls were obtained on implanted site, which were measured with Laser Doppler blood flow meter (Perimed KB; Sweden) on buccal mucosa. We consider that HAP shows good biocompatibility and HAP tooth roots implantation decrease the wound volume consequently.
The author examined 316 teeth, on which total pulpotomy had been performed, for frequency and extent of resorption. Marked resorptions, always associated with chronic apical periodontitis, were radiographically disclosed in 43 teeth. It is pointed out that the clinical radiographic technique permits to visualize only resorptions of greater extent.
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