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Expression of cathepsin K mRNA and protein in odontoclasts after experimental tooth movement in the mouse maxilla by in situ hybridization and immunoelectron microscopy.

This study demonstrated the simultaneous expression of cathepsin K (CK) mRNA by in situ hybridization and CK protein by immunoelectron microscopy in odontoclasts in mouse maxillae after experimental tooth movement. On the pressure side (the area under pressure during tooth movement), CK mRNA was detected in odontoclasts in resorption lacunae in the tooth root, in osteoclasts in bone resorption lacuane, and in fibroblasts in the periodontal ligament. Using electron microscopy, CK protein was detected at the apex of odontoclasts, intracellularly in vesicles and granules, and extracellularly in irregularly shaped vacuoles (extracellular spaces), on the plasma membrane of the ruffled border, and on and between typical striated type I collagen fibrils in the lacunae. These vesicles and granules appeared to fuse with irregular vacuoles containing CK-positive fragmented fibril-like structures close to the ruffled border. In the basolateral portion of odontoclasts, small amounts of CK-positive rough endoplasmic reticulum (ER) were found. CK-positive intracellular vacuoles (not extracellular spaces) also appeared to fuse with the vesicles and granules. However, these fused organelles rarely contained fragmented fibril-like structures. They are probably endolysosomes. The distribution of CK in odontoclasts was similar to that previously seen in osteoclasts. Furthermore, CK-positive fibril-like structures were found in the vacuoles of fibroblasts. These results indicated that during tooth movement CK is synthesized in odontoclasts on the pressure side and secreted into the tooth resorption lacunae. Therefore, CK may take part in the degradation of the dentin matrix (type I collagen fibrils and non-collagenous protein) of the tooth root, and in the subsequent intracellular degradation of endocytosed fragmented fibril-like structures in endolysosomes.

Animals↗

Raising the root. A look at orthodontic extrusion.

A simple technique using bonded wires to establish anchorage and an attachment to a tooth requires a minimum of special materials or advanced skills in orthodontics. The bonded wire stabilizes the anchor unit and avoids any adverse tooth movement.

Humans↗

A biological conservative approach to complex traumatic dento-alveolar lesions.

Of all the kinds of traumatic dental injury, luxation injuries associated with crown-root fractures deserve special attention due to the particular need for complex multidisciplinary treatment. Clinical experience has demonstrated the need for repositioning of luxated teeth and treatment of crown-root fractures by orthodontic or surgical extrusion and completed with periodontal plastic surgery (gingivoplasty). In many cases the outcome is good conservation and excellent esthetic results. This approach cannot however, always be recommended, for example because of the age of the patient. For this reason, a different protocol is proposed that involves, in addition to orthodontic repositioning of the luxated teeth, (as is required to return teeth to the physiological position), the extrusion, restoration and subsequent re-intrusion to the natural position (without the need for further surgery) of those teeth involved with associated crown-root fractures. Two cases illustrate the use of this proposed technique.

Adolescent↗

[Surgical exposure with an apically repositioned flap and orthodontic management of an upper impacted canine].

The combination of surgical exposure and orthodontic traction is usually the treatment of choice in cases with unerupted upper anterior teeth. Different methods of surgical exposure have been described with specific indications for each one. In this paper we present a case with an unerupted upper right canine and describe its management, after surgical exposure with an apically repositioned flap and orthodontic traction. Contemporary aspects of this technique are referred with regard to its advantage of maintaining a good tooth-gingiva relationship.

Child↗

[Intra-alveolar transplantation of tooth root].

In this article the technique and results of intra-alveolar transplantation are presented. The surgical technique consisted of extrusion of the root, lying under the gingival margins, within its own socket. By this technique the root was placed into the appropriate position required for the prosthodontic restoration.

Adult↗

Molar uprighting with the piggyback buccal sectional arch wire technique.

This article describes an orthodontic mechanical variation to unlock and upright mandibular impacted second permanent molars. This is accomplished with a small sectional arch wire that is ligated in a piggyback fashion to the existing arch wire and first molar band attachment. The piggyback buccal sectional arch wire (PBBSAW) technique provides a simple, expedient, and effective mechanical approach to the impacted second molar problem.

Humans↗

Lingual forced eruption orthodontic technique: clinical considerations for patient selection and clinical report.

Lingual forced eruption is a treatment modality that minimizes esthetic impairment during orthodontic treatment. Use of this technique can enhance the acceptance of orthodontic treatment by adult patients and minimize unnecessary compromises in the treatment planning of submerged roots. In this clinical report, a treatment modality for forced eruption therapy is described, clinical considerations for patient selection are identified, and the advantages and limits of the lingual orthodontic technique are discussed.

Crown Lengthening↗

[Clinical and roentgenologic evaluation of the outcome of therapeutic tooth movement for occlusal adjustment].

The indication of therapeutic tooth luxation in partly impacted teeth as the only method of occlusal adjustment has up to the present been rare. It was therefore the aim of this retrospective, long-term study to include clinical and X-ray results following therapeutic molar luxation (OK 6, UK 7). After an average observation period of 5.3 years, all teeth (7) with incomplete root formation at the time of luxation were rated "successful" following molar luxation. On the other hand, only 2 out of 4 teeth were hand, only classified as "successful" following molar luxation with complete root formation. The results have shown that therapeutic tooth luxation for occlusal adjustment of partly retained molars has a high rate of success when the indication is correctly handled. Because the prognosis is determined according to the stage of root formation, the surgical approach of tooth luxation should be used solely in teeth whose root development has the 1/2 to 3/4 of the expected definitive root length and whose Foramen apicale is open at the time of operation. When an atraumatic operation technique is used, further root formation and a maintained sensibility of the pulp can be reckoned with.

Adolescent↗

Use of the apically repositioned flap in the management of labially impacted maxillary central incisors.

Management of labially impacted maxillary central incisors often requires a coordinated surgical and orthodontic approach. In such cases, the treatment objective is surgical exposure of the unerupted incisor, preferably with a functional width of keratinized gingiva on the labial surface. Tooth exposure is then followed by orthodontic intervention to move the tooth to the line of occlusion. This paper describes three cases where the apically repositioned flap technique was used to manage labially impacted maxillary central incisors.

Child↗

Forced eruption in the treatment of transverse root fractures.

A relatively new method for treating transverse root fractures near the gingival crevice is reviewed. Two cases are described in which the fractured teeth are orthodontically erupted to facilitate restoration. A periodontal pocket was reduced in the first case, and the technique was modified to accommodate a patient wearing a partial denture in the second case. The technique appears to be a favorable alternative to extraction or periodontal surgery.

Adolescent↗

The palatally impacted canine: a new approach to treatment.

A method for the application of traction to misplaced maxillary canines in the palate is described. The treatment approach is from the palatal side, with initial traction applied in a lingually downward direction to prevent interference with the neighboring teeth. Emphasis is placed on the suitability of the method as an adjunct to almost any of the established techniques. In this way improving their efficiency in treating the over-all orthodontic problem.

Child↗

Management of the nonerupted maxillary anterior tooth.

The noneruption of maxillary anterior teeth, particularly the canine, is a common problem. The cause of the noneruption is multifactorial but almost always involves a lack of space. The literature presents an active and a passive form of orthodontic treatment and has recently stressed the periodontal management of these teeth. Two cases are presented. In both cases the orthodontic techniques of regaining space and providing traction on the unerupted tooth are described. A free gingival graft is used in one case and an apically repositioned flap in the other to achieve a healthy periodontium. The advantages and disadvantages of the techniques used as well as their rationale are discussed.

Adolescent↗

[Impacted upper central incisor. Surgical-orthodontic treatment].

This study goes through the aetio-pathogenetic factors which cause the upper central incisor's inclusion and then it analyses the various clinical pictures to which odontologist's attention may be called. It is in this context that the study describes afterwards several problems pertinent to disinclusion's surgical techniques and to scientific methods about included teeth's hooking and about their odontological settling in the dental arch.

Child↗