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This study investigated the association of ankylosed primary molars with subsequent clinical problems, and found a significant association between the delay in root resorption of the first and second ankylosed primary molars and the delay in root formation of their permanent successors.
A 13-year-old girl was referred for endodontic treatment of a maxillary right lateral incisor with root resorption and apical radiolucency after orthodontic treatment. Radiographically the tooth had an invagination canal (Oehlers' Type III) and responded positively to pulp testing. The invagination canal extending to the lateral resorption was opened. Vital bleeding tissue was found, and the canal was cleaned and obturated. The pulp in the main root canal remained vital. The radiolucent lesion gradually decreased during the 3-year follow-up. The bone resorption seen here, despite vital tissue in the invagination canal, was probably due to osteoclastic activity caused by a low grade chronic infection, influenced by an injury-induced inflammation in the periodontium during orthodontic treatment.
For more than 70 years calcium hydroxide has played a major role in endodontic therapy, although many of its functions are now being taken over by the recently introduced material MTA. Calcium hydroxide may be used to preserve the vital pulp if infection and bleeding are controlled; to repair root fractures, perforations, open apices and root resorptions. Endo-perio lesions are complex and the correct diagnosis is essential if treatment is to be successful. However, root canal treatment will always be the first phase in treating such lesions.
The use of systemic penicillin after an avulsion injury has been recommended as a way to decrease the occurrence of resorption complications. Our previous study has shown systemic tetracycline to possess anti-resorptive properties independent of potential anti-bacterial actions. The purpose of this study was to compare histologically the effectiveness of tetracycline and amoxicillin in limiting inflammatory root resorption (IR) secondary to pulpal infection, in replanted dogs' teeth. Thirty root canals in five dogs were infected with plaque. The roots were extracted, the lingual mid-roots were shaved with a fissure bur ensuring cemental damage and immediately replanted. Dogs were given either tetracycline hydrochloride or amoxicillin, administered orally, on the day of extraction and replantation and for the following 6 days. The control group was teeth in these animals treated in the same manner but where no antibiotics were given. After approximately 6 months, the dogs were sacrificed and the teeth prepared for histologic evaluation. The shaved root surface was identified in cross-sections and eight equidistant points along the cut root surface were evaluated for healing (H) or IR in eight sections per tooth. For the tetracycline group, H averaged 67.22% and IR 32.78%, which was not statistically different from the amoxicillin group with H averaging 56.88% and IR 43.12%. The tetracycline group was superior to the control group with H = 27.86% and IR = 72.14%. Since tetracycline has been shown to have anti-resorptive properties in addition to the antibacterial properties demonstrated here, it could be considered as an alternative to amoxicillin after avulsion injuries.
Periodontal pathology is an unavoidable complication following replantation of avulsed teeth. The present thesis focuses on the etiology, diagnosis, progression and prevention of dentoalveolar ankylosis. The experimental studies were carried out both in vitro and in vivo. Clinical studies were also performed on the progression of ankylosis. Initially, it was determined that the histomorphometrical method used in the animal studies was sufficiently accurate for the estimation of an area of a root surface showing a defined condition. In vivo studies revealed that the periodontal membrane (PDM) of a tooth prevented from drying for one hour before replantation heals without root resorption and ankylosis in a similar manner to an immediately replanted tooth. However, replantation of a tooth with a necrotic PDM results in a rapid destruction of the root by inflammatory resorption. These observations were predicted from the results of the in vitro studies, indicating that data gained from in vitro work may contribute to our understanding of periodontal healing in replanted teeth. Prevention or elimination of inflammatory resorption results in increased dentoalveolar ankylosis. Masticatory stimulation during the healing period will maximize the area of functional PDM and minimize dentoalveolar ankylosis. Antibiotics should be administered as early as possible and endodontic treatment should be performed within the first weeks after replantation to prevent inflammatory resorption. Accurate diagnosis of dentoalveolar ankylosis by assessment of percussion sound and mobility is only possible when more than 20 percent of the root surface is ankylotic. Radiographic diagnosis of ankylosis is of limited value in the early stages of replacement resorption. The rate of replacement resorption was shown to be age related. Even though replacement resorption is present, a tooth in an older individual can remain functional for a long period, possibly throughout life. Furthermore, residual infection and associated periodontal inflammation may be moderating factors in the progression of replacement resorption.
The aim of this investigation was to describe some tooth-related histological features of prepubertal periodontitis. Teeth extracted during treatment of two Papillon-Lefevre syndrome patients were processed by means of the sawing and grinding technique. Light microscopy examination revealed little or no cementum in the coronal parts of the roots. Resorptions of various depths (0.02 to 1.5 mm) and to various extents (affecting up to 1/3 of the root surface) were observed in the 5 investigated teeth. Some resorptive defects on 1 of the examined incisors showed signs of spontaneous repair. Extrinsic fibers were inserted into the new cellular intrinsic fiber cementum which had formed directly on the bottom of the defect. Intact acellular extrinsic fiber cementum was found where fibers were still attached. Here, the characteristic of pristine cementum, a hyaline layer of peripheral dentin, could be identified. If resorption was not present, the cementum did not show any signs of hypoplasia. Thus, histological features of prepubertal periodontitis in the current material were (i) areas of extensive resorption, (ii) signs of spontaneous repair, and (iii) healthy cementum.
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A case is presented here in which mandibular third molars resorbed second molars bilaterally 4 years 9 months after orthodontic treatment was finished. The initial problem was open bite, which was treated by non-extraction followed by a period for observing the third molars. During that period, the mandibular third molars moved mesially to resorb the roots of the second molars. The injured second molars were, therefore, extracted and the third molars were uprighted. During adolescence, third molars are erupting. When the posterior space is not enough for the third molars, they often erupt buccally or lingually, or impact distally toward the second molars and cause root resorption. It is suggested that the third molars should be observed carefully till they erupt or are extracted.
An extensive root surface lesion that presented both supra- and subgingival components was successfully treated with the use of glass ionomer cement to restore the lesion, and facilitate subsequent endodontic therapy and restoration. A coronally-positioned flap covered the repaired/restored lesion, approximately 6 mm x 10 mm in dimension. At 6 months following placement of the restoration, all but 1 mm of the restoration appeared covered, with probing depths <3 mm and no clinical signs of inflammation. Glass ionomer cement appears to be a viable, biocompatible material to restore subgingival root surface lesions.
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This article reviews the clinical behavior, histologic features, differential diagnosis, and treatment of a benign osteoblastoma. Benign osteoblastoma is a rare tumor constituting 1% of all primary bone tumors. Only 15% of osteoblastomas occur in the skull and jaw bones. The most common clinical presentation is a painful or tender swelling. A case is presented of a 21-year-old female who had noted discomfort for approximately 2 years, and the pain was not relieved by any analgesic. The choice of treatment was local excision and curettage. In this case, root resorption of the adjacent tooth, which is not a characteristic behavior of osteoblastoma, is seen.
The aim of this investigation was to study the hyalinization of the periodontal ligament with time and its relationship to root surface resorption after the application of an orthodontic force, reactivated weekly, of 50 cN (approximately 50 g). Fifty-six patients (18 boys and 38 girls, mean age 13.8 years) were divided into 7 groups of 8. In each patient, one premolar was moved buccally 161 with a fixed orthodontic appliance. The contralateral premolar served as a control. The experimental periods ranged from 1 to 7 weeks. Local areas of overcompression in the periodontal ligament were recorded in 33 test teeth (59%) and 2 controls (4%). Hyalinization was seen in all experimental groups, more often after the first 4 weeks of force application. Hyalinized areas were recorded opposite an intact root surface (54%) or close to and just apical or coronal to an area of root resorption (45%), and were usually located buccocervically and linguoapically, corresponding to expected pressure zones of the periodonal ligament.
A brief review of the published results of autotransplanting maxillary canine teeth has been presented together with the results of a prospective study in which 141 maxillary canine teeth were surgically repositioned in 113 patients, but not root-treated unless resorption occurred. Attention was given to assessing factors (age, sex, tooth positions, surgical difficulty, time out of mouth, acute infection, periodontal disease, caries, occlusion, formation of lamina dura) associated with root resorption of the transplanted teeth but no particular factor of significance emerged. It has been speculated that early post-operative root canal treatment and/or a two-stage technique might reduce the incidence of root resorption of autotransplanted teeth.
The purpose of this study was to investigate the in vitro effect of sodium perborate, which is used as a bleaching agent in the treatment of discolored pulpless teeth, on substrate adherence capacity of macrophages. Inflammatory macrophages were obtained from Wistar rats and resuspended in RPMI-1640 medium. As a test of macrophage adhesion, the adherence capacity of macrophages to a plastic surface was determined. Assays were conducted in Eppendorf tubes for 15 min of incubation at 37 degrees C in a humidified atmosphere of 5% CO2. The adherence index was calculated. Results showed that sodium perborate decreased in a dose-dependent manner and decreased significantly (p < 0.05) the adherence index of rat peritoneal macrophages. Sodium perborate was less potent than sodium hypochlorite and eugenol in inhibiting macrophage adhesion. The inhibitory effect of sodium perborate on macrophage adhesion further supports the concept that this agent is not implicated in external cervical root resorption associated with intracoronal bleaching.