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PubMed1985

Healing of horizontal circumferential periodontal defects following regenerative surgery in beagle dogs.

Regenerative surgery of dog teeth with reduced periodontal support was undertaken to determine: if new connective tissue attachment could be predictably attained back to the level of the cemento-enamel junction; and to what extent the new attachment would be accompanied by bone regeneration, root resorption, and ankylosis. The alveolar bone around mandibular premolars was surgically reduced up to 6 mm from the cementoenamel junction. The denuded root surfaces were exposed to the oral environment during a period of 3 months without plaque control. Regenerative surgery was then carried out employing citric acid root conditioning and coronally positioned flaps. 6 months later, histologic evaluation of the midbuccal and midlingual areas of mesial and distal roots revealed new attachment over extended portions of the root surfaces. In 91 of 120 available surfaces, there was no epithelial downgrowth apical to the cemento-enamel junction. Bone regeneration varied from negligible amounts to complete reformation. However, root resorption and ankylosis were prevalent features. 2 different types of resorptions could be distinguished: those occurring near the cemento-enamel junction (cervical resorption), and those occurring more apically in areas of newly formed bone (ankylosis-associated resorption). Resorption of either or both types was noted for 92 of the 120 surfaces.

Alveolar Process↗

PubMed1991

In vitro determination and quantification of 30% hydrogen peroxide penetration through dentin and cementum during bleaching.

Bleaching pulpless teeth with 30% hydrogen peroxide was reported to cause external cervical root resorption. It was hypothesized that H2O2 penetrated open dentin tubules to initiate an inflammatory response that could result in root resorption. No direct experimental evidence was provided to support this theory. An in vitro model for determination and quantification of H2O2 penetration during bleaching procedures is suggested. Artificial defects of the cementum covering the cementoenamel junction were performed in 22 extracted human premolars. After 15 minutes of thermocatalytic bleaching, H2O2 could be detected in the medium surrounding all the tested teeth. Cervical root permeability to 30% H2O2 could reach up to 82% of the total amount applied.

Dental Cementum↗

PubMed1986

Secondary bone grafting and orthodontic treatment in patients with bilateral complete clefts of the lip and palate.

The results of secondary bone grafting and orthodontic treatment in 41 patients with bilateral complete clefts of the lip and palate are reported. Good bone formation was found in 98% of the cleft sites grafted before the eruption of the canines, and in 80% of the clefts grafted later. Closure of both cleft spaces by orthodontic means was achieved in 20 of the 21 patients in the first group, and in 14 of the 20 patients in the second group. The bone grafts failed in one cleft site in 4 patients, all of which were regrafted with satisfactory results. In 2 patients one of the canines was later affected by external root resorption, necessitating endodontic treatment. Both the failures and the root resorptions occurred in patients bone grafted at an older age than was considered optimal for bilateral clefts: 10 to 11 years. Seven patients needed a bridge prosthesis, 3 of these over one cleft space only. Even these patients benefited greatly from bone grafting.

Adolescent↗

PubMed1997

Ultrastructural changes on the root surface in "pressure zone" after experimental movement of teeth in young rats fed a low calcium and vitamin D-deficient diet.

Dietary calcium and vitamin D-deficiency, as a potential biological factor in etiopathogenesis of root resorption occurring during orthodontic tooth movement, still remains controversial. The aim of the present investigation was to assess the ultrastructural changes on the surface of the root in "pressure zone" after orthodontic tooth movement in rats fed a low calcium and vitamin D-deficient diet. The studies were carried out on 20 young Wistar rats. The results from the scanning electron microscopic showed the increased root resorption in "pressure zone" after orthodontic tooth movement in rats fed a low calcium and vitamin D-deficient diet.

Animals↗

PubMed1991

Effect of cementum defects on radicular penetration of 30% H2O2 during intracoronal bleaching.

Bleaching pulpless teeth with 30% hydrogen peroxide has been reported to cause external cervical root resorption. It has been hypothesized that H2O2 penetrating through open dentin tubules can initiate an inflammatory reaction which could result in root resorption. Extracted human premolars were treated endodontically and bleached intracoronally using the thermocatalytic technique. The teeth were divided into three groups; one group with no cementum defects at the cementoenamel junction, one group with artificial cementum defects at the cementoenamel junction, and another group with artificial cementum defects at the middle third of the root. The radicular penetration of 30% hydrogen peroxide in the three groups was assessed directly and compared using an in vitro model. Radicular penetration of hydrogen peroxide was found in all of the groups tested. The penetration of hydrogen peroxide was significantly higher in teeth with cementum defects at the cementoenamel junction than in those without defects.

Dental Cementum↗

PubMed1982

Treatment results with light wires studied by panoramic radiography.

The purpose of this investigation is to evaluate "parallelism" and the incidence of root resorption in fifty-three extraction cases treated with light continuous wire therapy, following the principles of minimum force application, minimum tooth movement, avoiding the outward displacement of the roots from the apical bases, and a minimum time of active treatment. Differential tooth movement was performed and active displacement of the full complement of teeth was avoided when possible, according to the needs of the particular case. Panoramic radiographs were taken before and after active treatment and 1 year out of retention. The long axes of upper and lower canines and second premolars were traced and the angulation between them was measured to appraise root "parallelism." Only 1.8 percent root resorption was estimated for those teeth measured. A possible explanation for this low figure may be the mesiodistal movement of the teeth along the apical bone base, without deviations toward the labiobuccal or lingual sides.

Adolescent↗

PubMed1990

Dental developmental status of southern Chinese girls in Hong Kong.

Dental developmental status of the permanent canines, premolars and second molars were studied in one hundred and two twelve-year-old Southern Chinese girls born and brought up in Hong Kong. Eruption of these teeth were defined as gingival emergence during the clinical examination while the root development was assessed from orthopantomographs. Root resorption pattern of the primary canines and molars were also studied with the aid of the orthopantomographs. Two-thirds of girls presented with permanent dentition stage. The root resorption patterns of the primary teeth were different from their order of exfoliation. The mandibular permanent teeth were in advanced in both eruption and root development than the corresponding maxillary teeth, except the first premolars.

Asian People↗

PubMed1990

The effects of periodontal ligament injection on pulpal and periodontal tissues.

This study was designed to investigate histologically the effects of the periodontal ligament injection on the pulp of teeth with or without subsequent amalgam restorations, and the effects of the injection on the periodontium. Eighty-eight injections were made on 55 teeth in dogs in intervals from 10-min to 30-day prefixation, while 18 teeth were not injected and evaluated as controls. After perfusion fixation, block sections were decalcified, sectioned longitudinally, stained, and evaluated microscopically by three independent examiners. The pulps were graded for degree of inflammation and the periodontal ligaments were examined for signs of tissue disruption. The results of the pulp study were evaluated statistically and showed no apparent effect on the pulp from the injection. Several periodontal ligaments showed evidence of the injection, ranging from tissue disruption shortly postinjection to areas of active external root resorption in 30-day specimens. It was concluded that this technique does not have long-term deleterious effects on the pulp, but can induce localized external root resorption.

Anesthesia, Dental↗

PubMed2006

Which orthodontic archwire sequence? A randomized clinical trial.

The aim of this study was to compare three orthodontic archwire sequences. One hundred and fifty-four 10- to 17-year-old patients were treated in three centres and randomly allocated to one of three groups: A = 0.016-inch nickel titanium (NiTi), 0.018 x 0.025-inch NiTi, and 0.019 x 0.025-inch stainless steel (SS); B = 0.016-inch NiTi, 0.016-inch SS, 0.020-inch SS, and 0.019 x 0.025-inch SS; and C = 0.016 x 0.022-inch copper (Cu) NiTi, 0.019 x 0.025-inch CuNiTi, and 0.019 x 0.025-inch SS. At each archwire change and for each arch, the patients completed discomfort scores on a seven-point Likert scale at 4 hours, 24 hours, 3 days, and 1 week. Time in days and the number of visits taken to reach a 0.019 x 0.025-inch SS working archwires were calculated. A periapical radiograph of the upper left central incisor was taken at the start of the treatment and after placement of the 0.019 x 0.025-inch SS wire so root resorption could be assessed. There were no statistically significant differences between archwire sequences A, B, or C for patient discomfort (P > 0.05) or root resorption (P = 0.58). The number of visits required to reach the working archwire was greater for sequence B than for A (P = 0.012) but this could not be explained by the increased number of archwires used in sequence B.

Adolescent↗

PubMed1991

Tissue reactions after experimental luxation injuries in immature rat teeth.

Immature permanent teeth often develop complications after luxation injuries. The pathology and the degenerative processes of the complications, however, are not well understood. In this study, we histologically examined the long-term reactions of immature rat teeth after standardized luxation injuries delivered in our previously developed experimental model. The upper first molars of 3-week-old male Wistar rats weighing 50-60 g were pushed horizontally toward the palate to cause a constant amount of dislocation. The follow-up changes of the luxated molars were studied up to 56 days after the trauma. Soon after the trauma, the periodontium had irregular fibers, degenerated cells, hemorrhage and edema in various places. After 12 h, a cell free area appeared in the palatal periodontium. In the alveolar bone and on the surface of the root, resorption occurred one day and 5-7 days after injury respectively. Although the damage in the periodontium and alveolar bone was gradually repaired, the root resorption, especially in the palatal cervical region, continued throughout the experimental period. In the most cases, the dental pulp did not seem to be damaged immediately after the trauma. By the 3rd day after injury, however, displacement of odontoblasts into the dentinal tubules was observed in many teeth. Moreover, formation of irregular dentin was observed in some teeth after 7 days. These changes of the pulp tended to disappear in the later stages of the experiment.

Alveolar Process↗

PubMed2002

Effects and distribution of the enamel matrix derivative Emdogain in the periodontal tissues of rat molars transplanted to the abdominal wall.

The enamel matrix derivative Emdogain (EMD) has been found to promote regeneration of lost periodontal tissues. We have studied the effects and distribution of EMD in the periodontal tissues of maxillary rat molars transplanted to a subcutaneous position in the abdominal wall. The molars were transplanted with or without EMD either immediately after extraction or after drying for 30 min. After 2 days, 1, 2 or 4 weeks the rats were killed and the teeth were examined by means of light microscopy and immunohistochemistry with anti-amelogenin antibodies. Teeth transplanted immediately after extraction showed formation of alveolar bone separated from the dental roots by a periodontal space, regardless of the use of EMD. Among the teeth that were transplanted with EMD after drying for 30 min, new alveolar bone was formed in five out of eight teeth after 2 and 4 weeks. None of the teeth that were dried for 30 min and transplanted without EMD showed alveolar bone formation. Only one tooth transplanted with EMD showed root resorption after drying, while resorption was noted in all teeth transplanted without EMD. All teeth that were transplanted with EMD and none of the teeth that were transplanted without EMD showed an immunohistochemical reaction for amelogenin. After 2 days, amelogenin was precipitated on all surfaces exposed at the transplantation procedure. Later, the immunoreactive material was redistributed to cells at the root surface, where it was still demonstrable after 4 weeks. In conclusion, EMD is accumulated in cells at the root surface and promotes regeneration of the periodontal tissues of the transplanted teeth. It also seems to promote healing of root resorption.

Abdomen↗

PubMed2004

Endodontic treatment of primary teeth using a combination of antibacterial drugs.

AIM: To evaluate the clinical outcome of 'Lesion Sterilization and Tissue Repair' (LSTR) therapy for endodontic treatment of primary teeth. METHODOLOGY: A mixture of metronidazole, ciprofloxacin, and minocycline (3Mix) in ointment (macrogol mixed with propylene glycol: MP) or in a root canal sealer was used to disinfect infected root canals of 56 patients aged 4-18 years. Out of a total of 87 primary teeth, 81 cases had physiologic root resorption. A total of 54 radiolucent periradicular lesions were present. The root canals were not prepared before or after disinfection. 3Mix medicament (3Mix-MP/3Mix-sealer) was placed at orifices of root canals or on the bottom of pulp chambers, and then sealed with glass-ionomer cement and further reinforced by a composite resin inlay prepared using a direct method and cemented with resin. RESULTS: In all cases, clinical symptoms such as gingival swelling (52 cases), sinus tracts (22 cases), induced dull pain (3 cases), spontaneous dull pain (26 cases), and pain on biting (46 cases) disappeared after treatment, although in four cases clinical signs and symptoms were finally resolved only after retreatment using the same procedures. Thus, gingival abscesses and fistulae, if present, disappeared after a few days. Successor permanent teeth erupted without any disorders, or were found radiographically to be normal and in the process of eruption. All the cases were evaluated as successful. The mean function time of the primary teeth was 680 days (range: 68-2390 days), except for one case in which the successor permanent tooth was congenitally missing. CONCLUSION: Primary teeth with periradicular lesions with or without physiologic root resorption were treated successfully by the LSTR endodontic therapy.

Adolescent↗

PubMed1982

The effects of different splinting times on replantation of teeth in monkeys.

The purpose of the study was to examine histologically the tissue changes affecting the teeth and surrounding structures after using both 7- and 30-day fixation periods on replanted teeth in monkeys. Eight adult male rhesus monkeys were used. The maxillary central and lateral incisors were extracted, treated endodontically, reimplanted, and temporarily immobilized with an interproximal acid-etch splint. The splints were removed at 1 week in half of the teeth and at 30 days in the other half. The monkeys were killed at 7 and 14 days, and at 1, 2, 3, 4, 5, and 6 months postoperatively. The results showed that replanted teeth that were splinted for 7 days recovered uneventfully, whereas the teeth that were splinted for 30 days demonstrated increased areas of root resorption and ankylosis. Thus, it is suggested that after tooth replantation the periodontium will repair rapidly with a shorter time of splinting (7 days). Extended splinting periods (30 days) seem to induce further root resorption and dentoalveolar ankylosis.

Animals↗

PubMed1992

Tissue changes in immature dog teeth autotransplanted to surgically prepared sockets.

Tissue reactions in teeth autotransplanted to surgically prepared sockets were investigated by means of microangiographic, enzyme histochemical, and histologic methods. The experimental material consisted of 28 immature teeth in six mongrel dogs. In each tooth, approximately three fourths of the root was formed at the time of transplantation. Ten days after transplantation, a vascularized, well-stained connective tissue was observed in the apical area of the pulp. An ingrowing tissue had reached the pulp horn in all teeth 90 days after surgery. Odontoblasts were not found in any of the transplanted teeth. External root resorption was seen in all teeth but repair usually occurred approximately parallel to the ingrowth of new tissue into the pulp cavity. In a few teeth, however, advanced inflammatory root resorption was observed in cracks in the cervical area. When compared with the results of a previous study, the ingrowth of tissue occurred at a considerably slower rate than in teeth autotransplanted to natural sockets.

Animals↗

PubMed1991

Periodontal repair in dogs. Healing patterns in large circumferential periodontal defects.

This report describes the healing patterns of large circumferential periodontal defects in the beagle dog. Approximately 5 mm large periodontal defects were created around the mandibular premolars (P2, P3 and P4) in 13 animals. The root surfaces were then instrumented to remove all cementum and the wounds immediately closed by replacing and suturing the flaps just coronal to the cemento-enamel junction. Block biopsies were harvested after 4 weeks. Most of the surgically denuded root surface healed with connective tissue repair. Cementum formation and regeneration of alveolar bone was limited and averaged approximately 30% and 20%, respectively, of the defect height. Almost all teeth exhibited root resorption. Ankylosis was observed in 1/3 of the teeth. There was no difference in the healing response between the 3 premolars or their buccal and lingual surfaces. The range of healing responses indicates that a biological potential exists which makes this model useful for testing the effect of various root and wound conditioners in (1) enhancing cementum formation on the root surface, (2) increasing regeneration of alveolar bone and (3) preventing aberrant healing events such as root resorption and ankylosis. Conversely, whether such agents may compromise wound healing and result in reduced connective tissue repair may concomitantly be tested.

Alveolar Bone Loss↗

PubMed2004

Emergency orthodontic treatment after the traumatic intrusive luxation of maxillary incisors.

Treatment of traumatically intruded teeth is based largely on empirical clinical experience rather than on scientific data. The aim of this qualitative meta-analysis was to provide an evidence base to evaluate the orthodontic repositioning approach. In a MEDLINE search of the literature in English, 14 reported patients involving 22 teeth were found to have been treated by this modality. Additionally, 3 new patients, involving 9 intruded teeth and presented herein, were combined to form a total study sample of 17 subjects (7 girls, 10 boys, aged 8.9 +/- 1.2 years). Orthodontic extrusive forces were applied in the immediate posttrauma period (up to 3 months), with a variety of orthodontic appliances. Repositioning was achieved for 90.3% of the affected teeth but failed in 9.7% because of inflammatory resorption (2 teeth) or a misdiagnosis of root fracture (1 tooth). Early complications included loss of pulp vitality and external root resorption. All intruded teeth with closed root apices lost their vitality regardless of the degree of intrusion, whereas among those with incomplete apices, 45.5% that had been moderately intruded remained vital. External resorption was encountered in 54.8% of the teeth. Loss of marginal bone support was rarely encountered. Late complications included inflammatory root resorption in teeth with closed apices, in which endodontic treatment was not initially performed, and obliteration of the pulp tissue in teeth that remained vital. The results show that this method is superior to other treatment alternatives.

Child↗

PubMed1988

Re- and allotransplantation of teeth--an experimental study in monkeys.

In each of six monkeys one of the permanent lateral incisors with uncompleted root development was replanted. At the same time the contralateral incisors in four of the monkeys were allotransplanted by pairs. The remaining two contralateral incisors served as controls. After 4 weeks and 4 months, respectively, three monkeys were decapitated and the upper lateral incisors with adjacent periodontal tissue were examined histologically. The replanted teeth in five cases had a vital pulp. In the sixth case, however, the replanted incisor exhibited pulpitis and partial necrosis of the pulp. The periodontal membrane had a normal histologic appearance. In two cases a small area of arrested root resorption was observed. With the allotransplanted teeth the histologic appearance was altered. After 4 weeks a pronounced inflammatory reaction was observed in both the pulpal tissue and the periodontal membrane. The pulp was in most cases necrotic, and marked root resorption was observed. Most of the allotransplanted teeth were resorbed and replaced by an irregular hard tissue that resembled osteoid, which in many cases was connected with the tooth remnants by ankylosis. These results indicate that allotransplanted teeth, in contrast to replanted teeth, exhibit the characteristic features of an allograft rejection, including an inflammatory reaction and resorption.

Animals↗

PubMed1991

The influence of orthodontic treatment on previously traumatized permanent incisors.

The reaction of previously traumatized teeth to orthodontic force application was investigated. Four groups of children were examined: group T comprised 56 children who encountered trauma to their maxillary incisors; group O comprised 29 orthodontic patients with intact incisors; group TO comprised 28 previously traumatized orthodontic patients; and group C served as the control group (n = 26). Orthodontic treatment was restricted to tipping movement executed only by means of removable appliances. Groups T, O, and TO were followed up longitudinally by means of clinical and radiographic examinations. In most of the cases the reported trauma occurred to teeth with completed roots and affected the crown only. Group TO presented the highest, though relatively moderate, prevalence of root resorption (27.8 per cent) and was followed by groups O and T (6.7 and 7.8 per cent, respectively) while in the control group no resorption was observed. Electrical pulp testing revealed the highest prevalence of loss of tooth vitality in group TO (7.3 per cent) in which the highest prevalence of pulp obliteration was also found. It can be concluded that the combination of trauma with orthodontic tipping renders the teeth more susceptible to complications, especially to root resorption and loss of vitality.

Adolescent↗