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In vitro studies of bone resorption by the root-resorbing tissue from the bovine deciduous tooth.

Granulation tissue which is responsible for root resorption of deciduous tooth lies between root of the deciduous tooth and its permanent tooth germ. This tissue is called "root-resorbing tissue". Its bone-resorbing activity was investigated in vitro. Bovine root-resorbing tissue was cultured in close contact with 45Ca-labeled dead calvaria of rats. Bone-resorbing activity was determined by measuring 45Ca released from labeled calvaria during culture. It was found that only the root-resorbing tissue which was rich in odontoclasts and had a good blood supply in its surface layer had bone-resorbing ability, and that bone resorption occurred only when it was placed in close contact with calvarium. The root-resorbing tissue which was poor in odontoclasts and blood vessels failed to stimulate by 25-hydroxy-vitaim D3 or heparin, but not by larger amounts of parathyroid hormone, vitamin D3, and dihydrotachysterol when added to the culture.

Alveolar Process↗

Predicting pulpectomy success and its relationship to exfoliation and succedaneous dentition.

This study evaluated factors that affected pulpectomy (PE) success and its effect on the succedaneous tooth's eruption and enamel formation. Sixty-five of 250 patients with PEs met the selection criteria and yielded 81 zinc oxide-eugenol PEs (30 incisors, 51 molars) followed a mean time of 90.8 months. Overall PE success was 77.7% with no difference between molars and incisors (P = 0.53). Enamel defects were observed in 18.7% of succedaneous teeth and were related (P = 0.005) to the pre-existing infection causing excess root resorption (>1 mm preoperative root resorption = 44.4% defects) but were not related to overretention of ZOE filler (P = 1) or length of fill (P = 0.36). The PE procedure was not related to causing succedaneous tooth defects since teeth replacing PEs showed no significant increase in the incidence of defects compared with untreated contralateral controls (P = 0.99). There was a 20% incidence of succedaneous tooth anterior cross-bite or palatal eruption following incisor PEs and 21.6% ectopic eruption of premolars following primary molar PEs. Most PEs (95.9%) were lost at their normal exfoliation time or earlier, but 35.8% needed extraction due to overretention by soft tissue at the time of shedding. Pulpectomy success rates showed that the most important preoperative predictor was the amount of primary tooth root resorption. Greater than 1 mm of root resorption resulted in only a 23.1% success rate, which was significant (P = 0.001). Pulpectomies filled short or to the apex had a significantly greater success (P = 0.011) than long fills. Pulpectomies correctly done do not appear to contribute to adverse effects on succedaneous tooth formation but have a 20% chance of altering the path of permanent tooth eruption.

Amelogenesis↗

Dental abnormalities associated with familial expansile osteolysis: a clinical and radiographic study.

Familial expansile osteolysis is a rare and possibly unique form of hereditary bone dysplasia with dental manifestations that has affected 42 members of a Northern Ireland family for five generations. Twenty-seven family members, aged 3 to 60 years, were examined clinically and radiographically, and it was found that cervical and/or apical root resorption is an early manifestation of the dysplasia. Of the 20 family members with skeletal manifestations of familial expansile osteolysis, 16 showed root resorption. Root resorption may therefore be a good prognosticator for later bone involvement.

Adolescent↗

Federal University of Santa Catarina endodontic treatment of traumatized primary teeth - part 2.

This research sought to evaluate periapical repair in 28 traumatized deciduous teeth that had suffered endodontic intervention due to the presence of internal or external inflammatory resorption or replacement root resorption. After obtaining endodontic access, work length and biomechanical preparation, the root canals were filled with calcium hydroxide and propylene glycol under the form of a dense slurry, during 12 months. Replacement of the intracanal dressing was performed when monthly radiographic examinations showed its absence. After 12 months the teeth were obturated with zinc oxide and eugenol cement. Halting of the inflammatory and replacement root resorption (64.3%; n = 28) occurred 9 months after the use of calcium hydroxide dressings, in a total of 18 successful cases. Fisher's test was applied to relate success with the type of trauma, work length time, child's age and pulpal condition. The test did not present statistical significance (P < 0.05). However, in the qualitative analysis, failure was observed in those cases (35.7%) where replacement resorption was already present at the moment of treatment (up to two-thirds) associated with severe trauma cases. The authors concluded that endodontic treatment must be initiated at an early stage, and must be coincident with the radiographic signs of resorption. Success of the treatment is directly related to the seriousness of the sequelae at the moment of the first examination or the endodontic treatment.

Child, Preschool↗

Infraocclusion of primary molars. An epidemiological, familial, longitudinal clinical and histological study.

The aims of this thesis were to estimate the prevalence and familial tendencies of infraocclusion of primary molars and analyse the effect of extraction on occlusal development, and to characterise histologically the ankylosis in infraoccluded primary molars and recommend guidelines for treatment. The thesis is based on five investigations. In the prevalence and familial studies, 1059 children and 138 first-degree sibs were investigated. The three longitudinal clinical studies comprised 215 primary molars in infraocclusion and the children were subjected to clinical and radiographic examination and analysis of model casts every six months. The histological study comprised 62 teeth in infraocclusion and 40 in normal positions. In addition, bone biopsies were analysed histologically and by enzyme histochemical methods. The prevalence of infraocclusion of primary molars was found to be age-related and was significantly higher in sibs than in the studied population, which indicates a familial tendency. Infraoccluded primary molars with a successor present generally exfoliated normally. The permanent successors usually erupted six months later than on the normal contralateral side. Extraction of primary molars in infraocclusion meant definite space loss in some cases. With aplasia of the successor, the infraoccluded tooth did not exfoliate within the normal time range and the root resorption was found to be very slow, especially after 12-13 years of age. Very few of the previously reported negative effects of non-treatment of primary molars in infraocclusion on exfoliation, eruption and occlusal development could be confirmed in this study. Most infraoccluded primary molars were ankylosed histologically. No differences were found in the bone biopsies from the infraoccluded and control group. The results indicate that ankylosis in infraoccluded primary molars is not a static condition but part of a remodelling process following normal resorption of the roots. The general treatment policy should be to wait for normal exfoliation of infraoccluded primary molars to take place if the permanent successor is present and in cases with aplasia consider the aplasia per se, the degree of primary root resorption and the risk of progression of the infraocclusion.

Adolescent↗

Effect of proliferating tissue on transplanted teeth in dogs.

OBJECTIVE: The objective of this study was to investigate the effect of transplanted proliferating tissue on the regeneration of periodontal ligaments (PDL) in tooth transplantation. STUDY DESIGN: Two weeks after removing the alveolar bone, proliferating tissues were excised and examined for expression of basic fibroblast growth factor (bFGF) and alkaline phosphatase (ALP) using a LightCycler. Next, the teeth to be transplanted (first premolars) were extracted and PDLs were removed by scaling. After that, the first premolar teeth and proliferating tissues for the experimental group were transplanted into bone cavities created at the sites of the third and fourth premolars, while the control sites received teeth only. Finally, 1, 2, and 4 weeks later, the animals were sacrificed and specimens were collected and processed for histopathologic examination. RESULTS: bFGF and ALPmRNA showed a significant increase in the transplanted proliferating tissue. Transplantation of the proliferating tissues positively affected the formation of new cementum and PDL. Moreover, application of the transplanted proliferating tissues decreased the occurrence and extent of ankylosis and root resorption at the root surface. CONCLUSION: These results indicate that transplanted proliferating tissue may promote the regeneration of periodontal tissue and prevent ankylosis and root resorption following the transplantation of teeth.

Alkaline Phosphatase↗

[Results of treatment of milk teeth pulp by modified formocresol method].

The purpose of the study was evaluation of the results of treatment of molar pulp diseases by the formocresol method from the standpoint of the development of inflammatory complications in periapical tissues, disturbances of physiological resorption of roots, disturbances of mineralization of crowns of homologous permanent teeth. For the treatment milk molars were qualified with the diagnosis of grade II pulpopathy in children aged from 3 to 9 years. The treatment was done using formocresol by a modified method of pulp amputation according to Buckley after previous devitalization with parapaste. The status of 143 teeth was examined again 1 to 4 years after completion of treatment. The proportion of positive results after one year was 94%, after two years it was 90%, after three years 87% and after four years 80%. The cause of premature loss of most teeth was root resorption acceleration by 18-24 months. No harmful action of formocresol on the buds of permanent teeth was noted.

Child↗

Anchorage and retentive effects of a bisphosphonate (AHBuBP) on tooth movements in rats.

The purpose of this study was to examine the effect of 4-amino-1-hydroxybutylidene-1,1-bisphosphonate (AHBuBP), a potent blocker of bone resorption, on orthodontic tooth movements in rats. In the first experiment, the right and left upper first molars were moved buccally for 3 weeks with a uniform standardized expansion spring under systemic administration of AHBuBP every other day. The total tooth movement during the 3-week experimental period was 40% of that in the control at a dose of 0.5 mg P/kg. In the second experiment, the right and left upper first molars were first moved buccally for 3 weeks without AHBuBP. The spring was then removed and administration of AHBuBP was initiated. The total relapse movement during the 3-week experimental period was 50% of that in the control at a dose of 0.5 mg P/kg. Results of the first and second experiments were both dose dependent. Histologic examination showed that in the experimental animals fewer osteoclasts appeared on the alveolar bone surface, and both bone resorption and root resorption were inhibited. Inhibition of tooth movement was also observed when AHBuBP was applied topically. These results suggest that AHBuBP could be useful in enhancing anchorage or retaining teeth in orthodontic treatment.

Alendronate↗

Calcium hydroxide: a review.

Calcium hydroxide is a multipurpose agent, and there have been an increasing number of indications for its use. Some of its indications include direct and indirect pulp capping, apexogenesis, apexification, treatment of; root resorption, iatrogenic root perforations, root fractures, replanted teeth and interappointment intracanal dressing. The purpose of this paper is to review the properties and various indications for the use of calcium hydroxide.

Anti-Bacterial Agents↗

A mixture of Ca(OH)2 paste and ZnO powder as a root canal filling material for primary teeth: a preliminary study.

The present pilot study was conducted on five primary mandibular second molars requiring endodontic treatment to evaluate the clinical and radiographic success of root canal filling material which was a mixture of calcium hydroxide paste (1 cm), Zinc oxide powder (15 gms) and distilled water using hand operated lentulo spirals. All the five cases on clinical evaluation after 2,4,6,9, and 12 months were found to be asymptomatic with no history of pain, tenderness or abnormal mobility. Immediate post-operative radiographic evaluation revealed adequate root canal filling in all cases. The obturated material remained upto the apex of root canals till the beginning of physiologic root resorption. The roots of the primary teeth as well as the filling material mentioned above were seen to resorb at the same rate in one case.

Biodegradation, Environmental↗

An endodontic-orthodontic technique for esthetic stabilization of externally resorbed teeth.

Previous studies reveal that external root resorption is often coincident with orthodontic therapy. Some investigators have reported that root resorption ceases when orthodontic therapy is terminated. However, this is not always the case. The purpose of this article is to present an 11-year history of an unusual case in which root-resorptive processes continued for 3 years after orthodontic treatment had been discontinued. The article also describes and discusses a combined endodontic-orthodontic approach to halt external root resorption and stabilize mobile maxillary anterior teeth. Calcium hydroxide therapy was instituted to inhibit inflammatory apical root resorption. A rectangular orthodontic wire was adapted and inserted intracoronally to splint the teeth esthetically. The advantages and disadvantages of this intracoronal splinting technique are compared with other extracoronal splinting methods. Examination of one-year recall radiographs suggested inhibition of the root resorption. Masticatory function was restored for the patient. Considerations for monitoring patients with this problem are discussed.

Adult↗

[Dental injuries due to miniplate osteosynthesis. Classification, treatment management, complications, and prognosis].

BACKGROUND: In spite of a monocortical design, miniplate osteosynthesis can injure dental roots directly as well as damage dental substance indirectly by interrupting the apical blood stream. PURPOSE: The present retrospective study classifies different types of dental root trauma caused by monocortical screws, suggests therapeutic options based on diagnosis, and documents survival probability and prognosis after tooth trauma. PATIENTS AND METHODS: During a period of 11 years, 380 patients with permanent dentition underwent miniplate osteosynthesis for the treatment of mandibular fractures, 29 of whom sustained dental root trauma caused by drilling failure. These patients were clinically and radiographically examined for a follow-up time of not less than 38 months. RESULTS: The 29 patients could be classified into four different types of dental root trauma: 13 pulp injuries above the apical third of the root (type Ia), 6 pulp injuries in the apical third of the root or extradental lesions interrupting the apical blood stream (type Ib), 4 lesions to the central radicular dentin without pulp injury (type II), and 6 lesions to the peripheral radicular dentin and root cementum (type III). Of 13 type Ia injuries, 5 developed apical periodontitis and dilatation of the periodontal space. Therefore one root canal treatment and three apicoectomies were performed. One tooth had to be extracted. Three further type Ia injuries and two type Ib injuries showed root resorptions inducing two root canal treatments. One of six type Ib injuries required root canal treatment because of apical periodontitis. One of four type II injuries caused root resorption not requiring therapy. No relevant, pathological finding could be identified after type III injury. CONCLUSIONS: The type of dental root trauma caused by miniplate osteosynthesis determines therapy, complication rate, and survival of the injured tooth.

Adolescent↗

Primary teeth in adults--a pilot study.

Remaining primary teeth are occasionally found in adults. The cause and the long-term survival may vary. The aim of this investigation was to study the occurrence and condition of primary teeth in adults in a county in Sweden. All dentists in general practice were asked to send in radiographs showing remaining primary teeth in patients aged 18 years and more. The following variables were registered: 1) age, 2) gender, 3) year of exposure of the radiograph, 4) location of the primary tooth, 5) impaction of the permanent successor, 6) fillings or caries in the primary tooth, 7) amount of root resorption and 8) infraocclusion of the primary tooth. 35 dentists contributed with radiographs from 65 subjects showing 89 retained primary teeth. The most commonly found tooth was the second primary molar in the mandible, followed by the primary canine in the maxilla. Except for maxillary molars, most of the primary teeth showed a moderate degree of root resorption. No relationship was found between the degree of root resorption and gender, fillings/caries or infraocclusion. For the mandibular primary molars, there was a statistically significant correlation between root resorption and age. The mesial root of the molar in the mandible was more affected by root resorption than the distal, and the degree of root resorption of the mesial and distal roots was found to be closely correlated. Also, the results indicated a symmetrical pattern of root resorption in bilateral cases of remaining mandibular second primary molars.

Adult↗

Maxillary premolar resorption by canines: three case reports.

Three unusual cases of maxillary premolar root resorption are reported. Three teenage patients were referred to the orthodontic department for management of ectopic maxillary canines. Radiographic examination revealed unilateral premolar root resorption in all three patients. This represents an unusual finding. Whereas the prevalence of maxillary lateral incisor root resorption secondary to palatally ectopic canines has been reported, the prevalence of premolar root resorption is unknown. This report discusses the findings in the context of the available literature. The postulated aetiology and the need for early diagnosis are highlighted.

Adolescent↗

[Radiographic follow up examination on pulpotomy in primary teeth. Treatment with formocresol paste].

We conducted a radiographic follow up and discussion concerning 125 primary teeth (46 boys and 24 girls), which were random samplings from all primary teeth which had been treated by pulpotomy with Formocresol (Pulpac V) during the period from January 1980 to December 1985 at the Pediatric Dentistry Clinic of the School of Dentistry, Hiroshima University. For the follow up examination, we used only the radiograms which were radiographically available. The results obtained were as follows: 1) At the time of final follow up examination for each treated tooth, the number of teeth judged as being successful were 50 (40.0%) and 75 (60.0%) as being unsuccessful. In particular we observed especially many teeth judged as being unsuccessful during the period from 6 to 12 months and from 30 to 36 months after treatment. 2) In this investigation, we observed all the radiograms which had been taken at the recall after treatment, and therefore the number of cases examined was 247. According to the results at the time of each follow up examination, unsuccessful cases were more numerous during the period from 30 to 36 months. 3) According to the location of the treated teeth and the age at the time of treatment, abnormal findings appeared in the majority of the unsuccessful cases within 18 months after treatment. Unsuccessful cases were more numerous for the lower first deciduous molars. Successful cases of patients aged 6 years, when pulpotomy had been performed, were more numerous. 4) Of 75 teeth judged as being unsuccessful, 24 showed internal root resorption, 24 abnormal root resorption, 51 loss of lamina dura integrity and 53 alveolar bone resorption in the periapical and/or furcation areas.

Child↗

Effect of non-erupted third molars on roots of approximal teeth. A radiographic, clinical and histologic study.

This study was undertaken to evaluate clinically and histologically root resorption in extracted human second molars in close proximity to non-erupted third molars. The control group consisted of extracted second molars that were proximal to fully erupted third molars. Eight out of the 11 teeth in the study group presented different degrees of radiographic root resorption, nine presented clinical resorption, and all 11 had histologic evidence of root resorption. In the control group, no signs of root resorption were seen radiographically or clinically. Histologically, limited sites of resorption were identified in all teeth, which were partially repaired by cellular cementum. Histologic observation of study specimens revealed root surface resorption in 10 out of the 11 teeth, one showing replacement resorption as well. Inflammatory resorption was observed in the three most advanced cases in the study group. Reparative cementum partially lining resorbed areas was evident in all teeth with surface resorption. Within the limits of this study, radiographic identification of distal root resorption of second molars in close proximity to non-erupted third molars appears reliable. The findings may support the hypothesis that the presence of a non-erupted third molar in close proximity to the distal root of the second results in root resorption.

Adult↗

A prospective study on transplantation of third molars with complete root formation.

OBJECTIVE: The study objective was to evaluate the prognosis for autotransplantation of third molar teeth with fully developed roots followed by endodontic treatment on the basis of a time-table analysis. STUDY DESIGN: A total of 50 third molars with completely developed roots were autotransplanted to replace a lost first or second molar in the same number of admitted patients. Root canal treatment was started 3 to 4 weeks later. Clinical and radiographic checkup of the transplanted and root-filled third molars was done annually according to a predesigned record form. Descriptive statistics including a life table and statistical analysis were performed. RESULTS: The cumulative survival rate during 4 years' follow-up was 81.4%. In all, 7 transplants were lost during the follow-up time, 4 of them due to marginal periodontal pathosis and the other 3 due to root resorption. None of the root resorptions was observed before the second postoperative year. The radiographic periapical status was considered normal in 96% of the transplants at the latest follow-up visit. CONCLUSIONS: Autotransplantation of mature third molar teeth is a reasonable treatment alternative to conventional prosthetic rehabilitation or implant treatment in cases of partial edentualism from both a therapeutic and an economic point of view.

Adult↗

Autotransplantation of human premolars. A clinical and radiographic study of 100 teeth.

The purpose of the present study was to identify factors which might influence the success of autotransplantation, such as root development, root resorption, pulp condition and tooth eruption. The material consisted of 100 human premolars transplanted in 87 patients. The observation period ranged from 3-18 years, with a mean value 6.3 years. Clinical and radiographic examinations were performed. The transplanted premolars were divided into 7 stages of root development. At the final control, 93 teeth remained and 7 teeth were extracted. Periodontal healing without root resorption was related to stage of root development. It decreased from 93% in teeth with 3/4 root development to 37% in teeth with fully developed roots. Inflammatory root resorption was seen in 7 cases and replacement root resorption in 12 cases. Pulp revascularization was observed in 100% in stages with initial root development to 1/2 root development and decreased to 0% for teeth with fully developed roots. Pulp obliteration was observed in all cases with revascularized pulp tissue. The gingival condition was similar to contralateral, not transplanted premolars or adjacent teeth. Root growth increased with the stage of root development at the time of transplantation. It is concluded that transplantation of premolars with 1/2-3/4 root development provides a good chance of pulp survival, limited risk of root resorption and ensures sufficient final root length, and is thus recommended.

Adolescent↗