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Labial root torque: effect on the maxilla and incisor root apex.

This study was designed to determine the effectiveness of labial root torque on anterior nasomaxillary development. Quantification was made of the angular and linear changes in Downs' point A (representing midsagittal basal bone) and incisor point A (representing the dentoalveolar bone) and any concomitant incisor root resorption. The study was divided into two parts: part 1--to determine the anatomic configuration of the premaxillary region by use of laminagraphy on skulls, and part 2--to use the morphologic landmarks found in part 1 to assess the development of the nasomaxillary complex in maxillary retrusive patients. The clinical study involved 17 maxillary retrusive patients, aged 8.0 to 15.7 years, who had been treated for a period between 0.31 and 3.70 years with edgewise advancing mechanics. Clinical results indicate that during the first phase of orthodontic treatment with labial root torque, encompassing a 0.63-year mean treatment period, a greater rate of advancement of Downs' point A was produced when compared with normal growth. The skeletal convexity increased, whereas normal growth straightened the profile. Incisor point A advanced at a greater rate than Downs' point A, suggesting that treatment caused a larger dentoalveolar effect than the effect on midsagittal basal bone. When treatment was extended to 1.57 years, similar changes were found but at a reduced rate. Overall apical root resorption was 12.7%/year. Sex and age were not found to have any correlation to the amount of apical root loss.

Cephalometry↗

Orthodontic treatment for an adolescent with a history of acute lymphoblastic leukemia.

This case report describes the treatment of a Class I malocclusion that involved ectopic position of the maxillary permanent left canine and the mandibular permanent right second molar. The patient was an adolescent who presented with a medical history that was remarkable for diagnosis and treatment of acute lymphoblastic leukemia (ALL). Dental history was remarkable for significant, generalized shortened roots that were more severe in the mandibular arch. The treatment included fixed appliance therapy in the maxillary arch only and surgical luxation of the mandibular second molar. Successful integration of the maxillary permanent left canine was accomplished without excessive flaring of the maxillary permanent incisors or disruption of the buccal segment occlusion. The risk of external root resorption on teeth with abnormal root morphology, as a result of fixed appliance therapy, should be weighed against the relative benefits that are expected from treatment.

Adolescent↗

Orthodontic tooth movement in the mixed dentition. Histological study of a human specimen.

MATERIAL AND METHOD: We present a retrospective analysis of periodontal tissue reactions and clinically relevant phases of permanent tooth eruption and deciduous tooth resorption after half a year of orthodontic tooth movement in the upper and lower jaw of a deceased male (age 9 years 3 months). Specimens of the horizontal plane (lower jaw) and sagittal plane (upper jaw) were prepared by the ground microsection technique without prior decalcification. RESULTS: Histologically, reactions in the periodontal ligament presented as characteristic appositional/resorptive metaplastic processes in the areas of tension and pressure, with side effects such as root resorption and periodontal necrosis being only minor. In the upper jaw, an erupting permanent canine was closely associated with the tooth germ of the first premolar. Resorptive follicle activity had resulted in extensive erosion of the interradicular bone and root resorption in the area of the first premolars. CONCLUSION: These findings suggest that it might prove useful to take critical topographic findings as parameters for differential therapeutic decisions. Follicle-driven deciduous tooth resorption presenting partly as resorption lacunae and partly with linear characteristics was accompanied by resorptive/appositional remodeling of the alveolar socket as well as regressive changes in the supracrestal fibers of the marginal gingiva.

Child↗

Immunohistochemical characteristics of epithelial cell rests of Malassez during cementum repair.

To clarify the roles of epithelial cell rests of Malassez (ECRM) during periodontal repair, experimental root resorption was induced in rats and then the ECRM that existed in periodontal ligament during cementum repair was investigated using morphological and immunohistochemical approaches. At day 7, after mechanical injury, root resorption was observed and ECRM were present adjacent to the site of resorption lacunae. They were observed in periodontal ligament adjacent to site of the resorption lacunae. These ECRM were immunoreactive for bone morphogenetic protein-2. During the stage of early cementum repair, the ECRM were immunoreactive for osteopontin and ameloblastin. They strongly reacted to proliferating cell nuclear antigen. In uninjured control sections, ECRM located in the periodontal ligament adjacent to cementum were not immunoreactive for any antibodies. These findings suggested that ECRM may be related to cementum repair by activating their potential to secrete matrix proteins which have been expressed in tooth development.

Amelogenin↗

Effect of endodontic smear layer and various solvents on the calcium ion diffusion through radicular dentin--an in vitro study.

External root resorption and ankylosis remains the major cause of failure of replanted teeth. This study was conducted to explore the different ways to increase the pH of periradicular area in order to overcome the problem of root resorption and ankylosis. 60 freshly extracted permanent anteriors were used after removing the crown at CEJ. After biomechanical preparation Ca (OH)2 was injected and assays were done using EDTA, Citric and tannic acid Assays were repeated. Calcium diffusion and pH in the root exterior was measured using spectrophotometer. Results showed that dentin is permeable to calcium & hydroxyl ions and placement of Ca (OH)2 in the canal resulted in its increased recovery and alkaline pH periradicularly. Smear layer removal did not result in significant increase in Ca++ recovery or alkaline pH however combination of EDTA & NaOCl was found best than the other two.

Calcium↗

Periodontal conditions after facial root tipping and palatal root torque of incisors.

UNLABELLED: The maxilla of a deceased 19-year-old young woman who had been treated with a fixed appliance was removed during autopsy. The sagittal movements of the incisors could be reconstructed by using the treatment records, which were also at our disposal. The anterior segment of the specimen was prepared histologically in the sagittal plane and stained with toluidine blue. RESULTS: The tooth movements were executed in two phases: an uncontrolled tipping (root movement to vestibular) was followed by palatinal root torque. The histologic changes, induced by the palatinal root torque were (1) root resorption with apical slope from facioapical to orocoronal, and (2) pronounced subperiosteal bone apposition (palatinal) with partial protrusion of the cortical plate thinning toward coronal. No osseous perforations occurred. The extent and the localization of root resorptions were not verified in the orthoradial x-ray film of the specimen.

Adult↗

Anterior open bite malocclusion: a follow-up study of orthodontic treatment effects.

Treatment response and stability of the anterior open bite malocclusion were evaluated in 20 open bite patients (17 females, 3 males), who were treated with the Edgewise appliance. The overbite, the number of teeth in occlusion, the functional occlusal contacts of the incisors and the cephalometric characteristics were studied before treatment (T1), at the end of retention (T2), and at least 1 year out of retention (T3). The apical root resorption of the upper incisors was analysed before and after treatment. The mean age at the follow-up control was 17 years 10 months. In 15 patients at least two occlusal contacts of the incisors were possible at the end of the retention period as well as at the follow-up control. The number of teeth in occlusion mesial to the second molars, expressed in percentage of the maximum possible, increased from 40 to 70 per cent during treatment with a positive tendency from T2 to T3. Apical root resorption of the upper incisors exceeded 10 per cent of the original root length in 4 out of 19 measurable cases. One of these patients had a history of trauma and the three others displayed atypical root form. Cases with an increased facial convexity, in which the uprighting of the incisors was possible, seemed to have a favourable treatment prognosis.

Adolescent↗

[A new technique for the treatment of ectopically erupting permanent first molars].

The problem and treatment of the ectopically erupting permanent first molars have been addressed by many authors since they were first mentioned in the literature by Chapman in 1923. Many treatments involve techniques using the primary second molar. It is better for correcting the eruption of the permanent first molar into normal occlusion to maintain the primary second molar in its normal position. However severe mobility and root resorption are often present when an ectopic eruption is found. An 8-year-old male with ectopic eruption of the maxillary right permanent first molar was examined and treated. The right primary second molar demonstrated severe mobility and root resorption, and therefore a new appliance using the primary first molar was designed. After 4 months from the beginning of the treatment the mobility of the primary second molar decreased, and after 6 months the permanent first molar almost erupted in its normal position.

Child↗

Multiple idiopathic resorption in the primary dentition: review of the literature and case report.

Resorption of primary teeth is a normal physiologic process, except when it occurs prematurely. Resorption of permanent teeth is considered abnormal, and multiple etiologic factors have been implicated. A significant number of cases are represented by idiopathic resorption. Multiple idiopathic root resorption stands as a separate physiologic entity that has been described as affecting the entire permanent dentition. Multiple idiopathic resorption of primary teeth has not been previously reported. A case is described and a differential diagnosis is provided. The specific radiographic diagnostic criteria for this condition affecting the primary dentition are outlined.

Child↗