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PubMed1983

Periodontal healing of replanted monkey teeth prevented from drying.

Root resorption of replanted teeth is dependent on the duration of the extra-alveolar period and on the storage environment. In the present investigation the significance of preserving the humidity of the periodontal ligament (PDL) during the extra-alveolar period was tested on isolated PDL cells and on replanted monkey teeth. The isolated PDL cells were tested with respect to cell viability (trypan blue exclusion test) and to cell recovery (number of cells after additional cultivation). About 70% of the cells were viable and 44% recovered after 1 h in a humid atmosphere. Practically no cells were viable or recovered after 1 h of drying. Replanted teeth that had been wrapped in plastic foil for 1 h before replantation showed no more resorption than immediately replanted teeth. This is in contrast to teeth dried in air for 1 h before replantation. They showed extensive root resorption on almost all root surfaces. Thus, prevention of evaporation of tissue fluid from the PDL must be considered a primary goal if the tooth cannot be replanted immediately.

Animals↗
PubMed1997

An assessment of treatment outcome in American Board of Orthodontics cases.

In a retrospective study, 90 American Board of Orthodontic (ABO) cases were evaluated for treatment outcome. Changes in occlusion, cephalometric skeletal and dental variables, soft tissue variables, and root resorption were evaluated. The occlusions of completed ABO cases were compared with 147 naturally occurring good-to-excellent occlusions from the Andrews Foundation for Education and Research, using the Ideal Tooth Relationship Index (ITRI). Cephalometric variables were evaluated in relation to an "acceptable range" based on established standards. Photographs were evaluated for lip posture at rest and at closure, and the incidence and the severity of root resorption of maxillary and mandibular teeth excluding second molars were evaluated from panoramic radiographs. After treatment, occlusions of ABO cases scored significantly higher overall and for all ITRI segments except the anterior interarch segment when compared with Andrew's sample. In all the ABO cases, ideal overjet and overbite were attained. Cephalometrically, the mandibular plane and the Y-axis angle showed no significant change as a result of treatment. However, skeletal dysplasia (ANB) and skeletal convexity (Na-A-Po) showed improvement. Dentally, the maxillary incisor position and inclination, the interincisal angle, and the lower incisor position ended within the acceptable range, whereas the lower incisors were proclined. Soft tissue variables also improved, lip balance and harmony, closure at rest, and closure without strain all improved. The nasolabial angle showed little change. Most of the root resorption was minor in nature and involved the maxillary and mandibular central and lateral incisors. In conclusion, the ABO cases were well treated and showed marked improvement in occlusion, cephalometric, and soft tissue changes, although experiencing minor iatrogenic effects.

Adolescent↗
PubMed1992

Periodontal healing of replanted dog teeth stored in Viaspan, milk and Hank's balanced salt solution.

This study examined, histologically, periodontal healing and root resorption of replanted dogs teeth stored in Viaspan for different time periods and compared these healing patterns to those after storage in milk or Hank's balanced salt solution (HBSS). Seventy-two beagle incisors were endodontically treated, extracted, randomly divided and placed in Viaspan or milk for 6, 12, 24 and 36 h, and Viaspan or HBSS for 36, 48, 72 and 96 h, after which they were replanted. Four negative control teeth were immediately replanted while four positive controls were allowed to dry for one hour before replantation. All replanted teeth were splinted for 14 days. Two months after replantation the dogs were killed and the teeth histologically examined for healing of the supporting tissues. For Viaspan neither replacement nor inflammatory root resorption was seen after 6 and 12 h storage. A statistically significant rise in the incidence of replacement resorption was seen at 24, 36 and 48 h which decreased again at 72 and 96 h to levels equal to storage for 6 and 12 h. The occurrence of inflammatory root resorption was low and significantly increased only at 48 h after which it decreased significantly again. Viaspan proved superior to milk as a storage medium. Teeth stored in HBSS showed healing results similar to those stored in Viaspan.

Adenosine↗
PubMed2005

Light microscopic and SEM findings after orthodontic treatment--analysis of a human specimen.

AIM: The hard and soft tissue damage caused by orthodontic forces has so far, for obvious ethical reasons, been investigated in animal models primarily. However, the validity of these results as applied to humans remains controversial. The particular value of this study is that the maxilla of a young adult could be analyzed histologically. Thus it was possible to retrospectively study the effects of a routine orthodontic therapy using light microscopy. MATERIAL AND METHODS: The upper jaw of a 24-year-old patient was investigated. He had been in orthodontic treatment with a straight-wire-appliance using superelastic materials for 18 months. Both posterior segments were analyzed in the horizontal plane using the microsection method according to Donath (toluidine blue staining). Both central incisors were analyzed using a scanning electron microscope (SEM). The examination was performed qualitatively and histomorphometrically. RESULTS: 170 lateral root resorptions were found in the nine posterior teeth, while pressure sites and interference areas with the buccal and sinus cortical bone were predominantly affected. However, the extent of root resorption was minimal: mean length 979 +/- 766 microm, mean depth 208 +/- 133 microm. The lateral root erosions presented high repair potential: 55.6% of resorption length, and 28% of the depth were repaired in 76% of all lesions. CONCLUSION: The incidence of detected root resorptions seems high at first. However, the prognosis of the affected teeth is not critically impaired, due to the lesions' minor extent (length, depth) and their high repair capacity.

Adult↗
PubMed1990

Light and ultrastructural studies of human chronic periapical lesions.

Forty clinically chronic periapical granulomas and cysts and their corresponding teeth were removed. Diagnosis was by light and transmission electron microscopy. Ultrastructural features of the root surfaces concerned and the corresponding soft tissue were detected by scanning electron microscopy. Chronic periapical inflammation had caused root resorption which affected the cementum and/or the dentin. There were no ultrastructural differences between granuloma- and cyst-induced root resorption. Resorption lacunae were devoid of epithelial and connective tissue attachment. However, root surface exposed to granulomas and cysts also indicated spontaneous cementum repair. Moreover, at their periphery, cellular debris, cells defined as fibroblasts, and cell projections and fibrils could be seen which were continuations of the periodontal ligament.

Adolescent↗
PubMed1978

[Histological examinations of persisting milk teeth (author's transl)].

In twelve patients aged 13 to 24, histological examinations of twenty persistent milk teeth (with persistency having been due to aplasia of permanent teeth) showed that root resorptions are possible in such cases too. Cellular resorption results in the root being decomposed lacunally or linerly, respectively. The formation of osteodentin, which is a result of the phase of apposition and which is taking place in the pulp and along the surface of resorption, respectively, is considered a characteristic concomitant phenomenon. However, this tissue does not cause "true ankylosis". Accordingly, use of the term "ankylosis" to describe such cases is questionable. The author, on the strength of the results obtained in these studies, believes that root resorption of persistent milk teeth is a pathological process in the case of congenital absence of permanent teeth.

Adolescent↗
PubMedDate not supplied

A novel multidisciplinary approach for the treatment of an intruded immature permanent incisor.

The optimal treatment for intruded permanent teeth has not yet been determined. The ideal treatment option is the one with the lowest probability of developing complications such as external root resorption and marginal bone loss. Each case should be considered individually, bearing in mind the severity of the intrusion, the stage of root development, and tooth mobility. Management of an intruded permanent tooth may consist of: (1) observation for spontaneous eruption; (2) surgical crown uncovering; (3) orthodontic extrusion (with or without prior luxation of the intruded tooth); (4) and partial surgical extrusion, immediately followed by orthodontic extrusion and surgical repositioning. The purpose of this article was to review the treatment options for intruded immature permanent incisors, and to present a new modality of an elective internal strengthening of the immature root weakened by external root resorption. A case of an intrusive luxation injury in a 7 1/2-year-old child and the resulting complications utilizing this technique is described. This is the first known report in the pediatric dentistry literature of performing an elective (preventive) internal strengthening of an immature root weakened by severe external inflammatory resorption. The child was followed for 5 years with an excellent clinical outcome. This technique should be considered for treatment of immature permanent teeth with thin cervical root dentin and external or internal root resorption due to trauma or caries.

Child↗
PubMed2002

Effect of recombinant human bone morphogenetic protein-2/absorbable collagen sponge (rhBMP-2/ACS) on healing in 3-wall intrabony defects in dogs.

BACKGROUND: Recombinant human bone morphogenetic protein-2 (rhBMP-2) in an absorbable collagen sponge (ACS) carrier is being evaluated as a candidate therapy for periodontal regeneration. The objective of this study was to evaluate regeneration of alveolar bone and cementum, and associated root resorption and ankylosis following surgical implantation of rhBMP-2/ACS in a canine clinical model. METHODS: Bilateral 3-wall intrabony periodontal defects were surgically induced in the premolar region in the maxilla and mandible in 8 young adult Korean mongrel dogs. The defects in each animal received rhBMP-2/ACS (rhBMP-2 at 0.2 mg/ml, total implant volume/defect approximately 0.1 ml) or buffer/ACS, or served as sham-operated controls. Surgeries were sequenced for each animal to provide postmortem observations following 8- and 24-week healing intervals. Treatment outcomes were evaluated using clinical, radiographic, and histometric parameters. RESULTS: Surgical implantation of rhBMP-2/ACS resulted in accelerated enhanced bone formation in the 3-wall intrabony periodontal defects but in no apparent enhancement of cementum regeneration. rhBMP-2/ACS did not appear to be associated with aberrant healing events such as root resorption and ankylosis under these simulated clinical conditions. CONCLUSIONS: Surgical implantation of rhBMP-2/ACS may be used safely to support regeneration of alveolar bone in intrabony periodontal defects in dogs without aberrant events such as root resorption or ankylosis complicating the regenerative procedure. rhBMP-2/ACS does not appear to have a significant effect on cementum regeneration and formation of a functional periodontal ligament in this model.

Alveolar Bone Loss↗
PubMed1996

The use of a resin-ionomer in varying restorative procedures: case reports.

UNLABELLED: The purpose of this paper is to describe the subgingival placement of a resin-ionomer for several restorative procedures, namely, root resorption, endodontic perforation, and root fracture. After endodontic therapy, a combination scallop flap (in attached gingiva)-full thickness flap (at affected tooth only) was raised to gain access to the lesion and root defect. The root defects were prepared with ultra-sonic instruments under an operating microscope and the preparations treated with Tenure Dentin Conditioner (DenMat Corporation, Santa Maria, CA). The preparations were washed and lightly air-dried, and the Tenure All-Purpose Bonding System (Den Mat Corporation, Santa Maria, CA) was placed in the prepared areas. Geristore resin-ionomer (DenMat Corporation, Santa Maria, CA) was then syringed into the preparations and either light-activated or allowed to undergo a chemical set. Once set, the material was finished with fine diamonds under water spray. The flap was then sutured to place with Gore-Tex sutures when a non-resorbable Gore-Tex membrane (Gore Corporation, Flagstaff, AZ) was used or 4-0 nylon sutures when resorbable Guidor membranes (Butler Company, Bensenville, IL) were used. The sutures were removed after two days. The patients were observed weekly for the first month and then monthly until released. No untoward effects have been observed during the time frame of this project. All of the cases have been responding satisfactorily. CLINICAL SIGNIFICANCE: The cases presented indicate that a resin ionomer, Geristore, may be used as a subgingival restorative, and may be placed in lesions thought to be unrestorable. Thus, teeth may be saved that were previously designated to be extracted.

Drug Evaluation↗
PubMed1990

Clinical and histological findings in ligature-induced experimental periodontitis in dogs. A pilot study.

Prior to experimental periodontal regenerative procedures in animals, the process of destruction due to periodontitis is often simulated by placing ligatures around the necks of teeth. 2 models, one using cotton floss ligatures and the other elastic rubber ligatures, have been widely used. The aim of this study was to compare these 2 methods using clinical and histometric criteria. Premolars on both sides of the mandibular jaw were used in 2 beagle dogs. Periodontal tissue breakdown was induced during a 48-day period using cotton floss ligatures on one side of the mandible and contra-laterally by elastic rubber ligatures. At weekly intervals, the ligatures were changed and pocket depth and loss of probing attachment were recorded. All the ligatures were removed after 7 weeks. The animals were fed a soft, plaque-promoting diet during the experimental period. 20 days after ligature removal, the teeth were hemisected and the 2 roots extracted. From each tooth, 1 root was prepared for scanning electron microscopy and one for light microscopy. At the time of extraction, no differences regarding pocket depth or probing attachment level were found between the 2 groups. Root resorption was observed in all elastic ligature teeth, whereas only minor alterations at the root surface were observed on cotton ligature teeth. This finding may be of particular interest to investigators designing studies evaluating the healing sequalae of regenerative surgery in animals. As was observed in this study, root resorption can already be present in the pre-experimental phase of periodontal tissue breakdown, particularly if elastic ligatures are used.

Animals↗
PubMed1991

Surface resorption following two forms of rapid maxillary expansion.

Rapid maxillary expansion (RME) is a useful orthodontic technique for correction of posterior cross-bite of skeletal origin. The aim of the present study was to compare the frequency and nature of root resorption in premolars subjected to RME by means of either a tissue-borne, fixed split acrylic (Haas) palatal expansion applicance, or an all-wire framework appliance. Another factor examined was the relationship between the pattern of resorption and the duration of the retention period. RME was performed on five patients using the fixed split acrylic appliance and on four patients with the all-wire framework appliance. Following the transverse expansion, two upper and two lower premolars were extracted and processed for histological examination. Root resorption was found mainly on the buccal surfaces of all maxillary premolars. The resorption lacunae covered more of the root surface in premolars treated with an all-wire framework appliance compared to premolars treated with the acrylic expansion plate. The largest resorption areas were found on teeth extracted shortly after the expansion period and the smallest on premolars retained for a relatively longer period. Mandibular premolars showed neither buccal nor lingual resorptions. It was concluded that maximum anchorage of the expansion device, using the tissue-borne acrylic appliance, seems preferable in order to minimize the incidence of buccal surface root resorption. A longer post-treatment observation time is needed in order to draw more specific conclusions regarding the healing process of the damaged root surface.

Acrylic Resins↗
PubMed2006

Changes in the physical properties of human premolar cementum after application of 4 weeks of controlled orthodontic forces.

This study was performed to assess the relationship between the magnitude of orthodontic force and physical properties of individual human cementum, and to identify the sites that may be predisposed to root resorption. The findings may assist in relating physical properties of dental root cementum and its susceptibility to root resorption. Sixteen maxillary first premolar teeth were selected in eight orthodontic patients (three males and five females), mean age 14.8 years (range 11.2-17.5 years), requiring first premolar extractions. In each patient, a light orthodontic force of 25 cN was applied buccally using a sectional archwire on the first premolar on one side, while a heavy force of 225 cN was applied to the contralateral side. The teeth were extracted 4 weeks after initial force application. Hardness and elastic modulus were measured on the buccal and the lingual surfaces of the cementum at the cervical, middle, and apical third of the root. The results showed that the mean hardness and elastic modulus of cementum in the light force group were greater than in the heavy force group at all positions. There were highly significant differences in both hardness and elastic modulus between the heavy and light force groups (P < 0.01). The mean hardness and elastic modulus of cementum gradually decreased from the cervical to the apical regions for buccal as well as lingual surfaces in both groups. There was, however, an insignificant difference between hardness and elastic modulus on the buccal surface compared with the lingual surface (P < 0.05). It was concluded that the hardness and elastic modulus of cementum were affected by the application of orthodontics forces.

Adolescent↗
PubMed1978

Some considerations on the role of cementum in periodontal disease.

The protective role of cementum against root resorption is discussed in relation to buried teeth, orthodontic treatment, replantation and periodontal disease. The essential feature seems to be a layer of partially calcified precementum or vital cementoblasts. Root resorption close to the epithelial attachment, although not common, is probably the result of death of cementoblasts caused by irritants from bacterial plaque, and the presence of severe of prolonged inflammation. Cementum exposed in the pocket can be affected in different ways by these irritants, and rendered unacceptable for re-attachment to periodontal tissue. Successful re-attachment procedures involve either the removal of the affected cementum or its treatment with agents partially to decalcify such as acids, or detoxify by phenol for example. Examples of treatment embodying some of these principles are illustrated by two case histories of localised gingival recession and one of intra-bony pocketing associated with an acute lateral periodontal abscess. In this case a follow-up radiograph taken 16 years later is presented as evidence of the permanence of repair which can be achieved. Root resorption which often follows the use of fresh autogenous bone from the ilium is then discussed and the conclusion reached that the vital cells in the transplant discourage the migration of cementoblasts from the adjacent periodontium. The cementum and dentine thus remain unprotected and susceptible to resorption.

Dental Cementum↗
PubMed1990

Replantation: an analysis of 29 teeth.

The results of replantation of 29 teeth are described. Maxillary incisors constituted 85% of 27 permanent teeth. The period between avulsion and replantation ranged from within an hour to 86 days, but the actual extraoral period was within 5 hours in all but one case. Nineteen of the 27 permanent teeth were functioning for 7 months to 6 years and 7 months postoperatively. Root resorption was the cause of tooth loss in five cases. The incidence of root resorption seemed to increase with the increase of the extraoral period, but it was not affected by the period between avulsion and replantation, the condition of supporting tissues, the degree of root formation, and the type and period of splinting, indicating multiple factors involved in determining the prognosis of replanted teeth. In conclusion, every effort should be made to preserve avulsed teeth even in unfavorable conditions.

Adolescent↗
PubMed2004

Periodontal regeneration of transplanted rat molars after cryopreservation.

The effects of cryopreservation on periodontal regeneration of transplanted rat molars were investigated histologically and histochemically in rats. Bilateral first and second maxillary molars of 4-week-old Wistar rats were gently extracted and transplanted into the abdominal subcutaneous connective tissue immediately or after cryopreservation in liquid nitrogen overnight. Donor teeth were slowly frozen by a rate-controlling freezer (program freezer) using 5% dimethylsulfoxide (DMSO) and 6% hydroxyethyl starch (HES) as cryoprotectants. One-four weeks after transplantation, they were carefully excised with the surrounding tissues. Regeneration of acellular cementum, periodontal ligament, and alveolar bone were observed 2 weeks after immediate transplantation. The pulp was repaired by the ingrowth of granulation tissue from the root apex followed by the formation of calcified tissue. The regenerated periodontal ligament was positive for alkaline phosphatase (ALP). Small or mononuclear tartrate resistant acid phosphatase (TRAP) positive cells were scattered on the newly formed alveolar bone and on the hard tissue in the pulp, but there was no external or internal progressive root resorption at 4 weeks. Cryopreserved teeth had acellular cementum with a rough surface at 1 week, but with the increase of cementoblasts and the appearance of periodontal ligament and alveolar bone, the surface became smooth at 3 weeks. Epithelial rests of Malassez (ERM) also revived. After regeneration of the periodontal tissues at 4 weeks, there was no evidence of root resorption. Although the process proceeded slowly, the cryopreserved teeth showed the periodontal regeneration substantially similar to that of the immediately transplanted teeth without progressive root resorption, indicating that they could be applicable for clinical use.

Alkaline Phosphatase↗
PubMed1988

[Root reactions during treatment with indomethacin in the rat].

During the course of a study on the effect of indomethacin, an inhibitor of PG-synthesis, on the alveolar bone remodeling associated with the drift of the rat molar, the root profile appeared altered. The perimeter of the buccal root of the lower first molar had increased during the 7-day experimental period (+9%; p less than 0.02) in the treated group. This was due to an increase in the extent of root resorption lacunae (+99%; p less than 0.05). They were located in the disto-buccal aspect of the root, i.e., facing the alveolar wall remodeling area. The periodontal ligament width was also increased (p less than 0.001). This might be an adaptative process to maintain the periodontal ligament width as the drift of the teeth had not ceased while the remodeling had markedly slowed down. These results show that the osteoclastic population responsible for root resorption was not PG-dependent, unlike that active on alveolar wall. In addition, dentin deposition was accelerated in the pulp area underlying the resorption lacunae in the treated group as shown by measuring the distance between two fluorescent labels incorporated in a 6-day interval (p less than 0.05).

Alveolar Process↗
PubMed1998

The effect of systemic tetracycline on resorption of dried replanted dogs' teeth.

The use of systemic penicillin after an avulsion injury has been recommended to decrease the occurrence of resorption complications. Tetracycline antibiotics have been reported to possess anti-resorptive properties in addition to their anti-microbial actions. The purpose of this study was to evaluate histologically the effect of systemically administered tetracycline and amoxicillin on the inhibition of resorption due to attachment damage after replantation of dogs' teeth. Thirty-one roots from the teeth of four beagle dogs were endodontically treated to inhibit subsequent inflammatory root resorption of pulpal origin. They were then extracted and left to bench dry for 1 h to ensure severe periodontal ligament damage before replantation. For the teeth in the experimental groups, two dogs were given tetracycline hydrochloride and the other two dogs were given amoxicillin, administered orally, on the day of extraction/replantation and for the following 6 days. The control group were teeth in these animals treated in the same manner but where no antibiotics had been given. After 12-16 weeks, the dogs were sacrificed and histological sections were prepared and evaluated for complete healing, inflammatory and replacement root resorption, and the groups were compared. It was shown that healing in the amoxicillin and the control groups was poor (10.90% and 11.28%, respectively), while for the tetracycline group, 35.45% showed complete healing. Individual teeth with over 50% complete healing sites were considered as having good healing, and significantly more of these teeth were found in the tetracycline group (5 of 11 teeth) compared to the amoxicillin (1 of 11 teeth) or control group (1 of 8 teeth).

Amoxicillin↗