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PubMed2004

Immunocompetent cells in the pulp of human deciduous teeth.

This immunohistological study sought to determine how the distribution and density of various immunocompetent cells change in the pulp of human deciduous teeth during the process of physiological root resorption. Forty-three extracted deciduous teeth at various stages of resorption were subjected to immunoperoxidase staining with the use of antibodies directed to HLA-DR, CD68, factor XIIIa and lymphocyte subsets. In intact deciduous teeth (group 0), all types of cells examined, except for CD20+ B lymphocytes, were detected. In teeth in which resorption was less than 1/3 of the root length (group 1), all types of cells showed a statistically significant increase compared with group 0 (P<0.05; Mann-Whitney's U-test). HLA-DR+, CD68+, and factor XIIIa+ cells with a dendritic profile kept their distribution in the periphery of the pulp, and oval and round, newly recruited macrophages accumulated in the central portion of the pulp and near the resorption sites. In teeth where resorption was 1/2 to 2/3 (group 2), all the cell types increased further. Aggregations of HLA-DR+, CD68+, and factor XIIIa+ cells were frequently seen in the central portion of the pulp, and T and B lymphocytes occasionally formed some clusters. Comparisons with group 1 revealed that the density of these cells, except for CD20+ cells, showed significant increases (P<0.05; Mann-Whitney's U-test). These results provided evidence showing that immunocompetent cells of deciduous tooth pulp increase with the progress of physiological root resorption, suggesting that immunocompetency of deciduous teeth is altered by this process.

Analysis of Variance↗
PubMed2000

The long-term survival of lower second primary molars in subjects with agenesis of the premolars.

This study investigated 41 subjects, 13 male and 28 female, with agenesis of one or both lower second premolars, and with retained lower second primary molars. Intra-oral radiographs of 59 primary teeth were examined to judge the resorption of the mesial and distal roots, and were measured to record infra-occlusion of the primary teeth and tipping of the adjacent permanent teeth. The study commenced at 11-12 years of age. The mean age at the last measurement was 20 years 6 months (SD 3.62, range 13.6-31.8 years). During the observation period, only two of the 59 primary teeth were exfoliated. Five were extracted, two of which were replaced by upper third molar transplants. Beyond the age of 20 years no teeth were lost. Root resorption varied widely between individuals, but was slow. There was no typical pattern for development of infra-occlusion. Mean infra-occlusion was 0.47 mm (SD 1.13) at 11-12 years, increasing by less than 1.0 to 1.43 mm (SD 1.13) at age 17-18 years. At age 19-20 years, 55 per cent of teeth showed infra-occlusion between 0.5 and 4.5 mm, but 45 per cent showed no infra-occlusion. The space between the first molar and first premolar was a mean of 10.35 mm (SD 0.76) at age 10-12 years compared with the mean width of the second primary molar of 10.53 mm (SD 0.51). The space reduced by less than 0.5 mm to 9.95 mm (SD 1.50) at age 17-18 years. If primary molars are present at 20 years of age they appear to have a good prognosis for long-term survival.

Adolescent↗
PubMed1996

Radiographic evaluation of the effect of orthodontic retraction on the root of the maxillary canine.

OBJECTIVES: To evaluate possible apical root resorption following orthodontic retraction of the maxillary canine quantitatively and qualitatively. METHODS: Twenty maxillary canines in 12 patients were retracted using a prefabricated orthodontic spring. Twenty non-treated mandibular canines from the same patients served as controls. Standardized radiographs were taken of all upper and lower canines before (T0) and after (T2) retraction. Root length and tooth length were measured on the radiographs at T0 and T2, and the root length/tooth length ratio was calculated. Ten orthodontists assessed blind the root apex of the pairs of radiographs taken at T0 and T2 for resorption. Digital subtraction was performed between the pairs of radiographs taken at T0 and T2 and the mean density and the standard deviation of the grey shades of the root apex calculated. RESULTS: There were no significant differences between root length/tooth length ratio at T0 and T2 for either the maxillary (p = 0.45) or the mandibular canines (p = 0.79). There was considerable variation between observers judgements of root resorption: nine out of ten observers agreed that a resorption had taken place in only one tooth. There were no significant differences between the mean density values in the subtraction images of the upper and lower canines (p = 0.3). CONCLUSIONS: Quantitative assessment with conventional and subtraction radiography failed to demonstrate root resorption in the maxillary canines. Root resorption could be shown qualitatively in only one tooth. The standardized orthodontic force system used for canine retraction appeared to cause no resorption, or only a small degree of resorption of no clinical relevance.

Adult↗
PubMed1981

Periodontal healing of exarticulated monkey teeth stored in milk or saliva.

Saliva has usually been recommended as a storage medium for exarticulated teeth. Recent tissue culture studies have, however, shown that milk has a more suitable osmolality than saliva and that milk is a better storage medium for human periodontal ligament cells. In the present investigation periodontal healing of replanted monkey teeth has been studied after storage of teeth in milk or saliva before replantation. There was much less root resorption, especially inflammatory resorption, after storage in milk than in saliva. Storage of teeth in milk for 3 h before replantation resulted in the same low frequency of root resorptions as was seen after immediate replantation. There was hardly any replacement resorption (ankylosis) seen in the replanted teeth.

Animals↗
PubMed2006

Expression of MT1-MMP during deciduous tooth resorption in odontoclasts.

Membrane type 1-matrix metalloproteinase (MT1-MMP) is a membrane-bound matrix metalloproteinase capable of mediating pericellular proteolysis of extracellular matrix components. In osteoclasts, the localization of MT1-MMP has been reported at the tips of specialized membrane protrusions (podosomes and lamellipodia) so that osteoclasts might use MT1-MMP to perform focal proteolysis and move through the extracellular matrix to the bone surface. The objectives of this study were to investigate an association of MT1-MMP in physiological root resorption of the deciduous tooth by reverse transcriptase-polymerase chain reaction (RT-PCR) and Northern blot analysis, and to identify MT1-MMP-producing cell during deciduous tooth resorption by in situ hybridization and immunohistochemistry. RT-PCR and Northern blot analysis revealed the exclusively high expression of MT1-MMP mRNA in bovine root-resorbing tissue, which lies between the root of the deciduous tooth and its permanent successor. Expression of MT1-MMP mRNA was seen in odontoclasts aligning in the surface layer of the root-resorbing tissue at sites of root resorption. Furthermore, immmunohistochemistry also confirmed the localization of MT1-MMP protein to the odontoclasts. The present identification of MT1-MMP in odontoclasts during deciduous tooth resorption might be relevant to the migration activity that these cells have to gain access to the root surface.

Animals↗
PubMed2006

[Tooth movement in tissue-engineered bone].

OBJECTIVE: To explore the effect and practical value of repairing the alveolar defects with tissue engineering technique and investigate the influence of the generated new bone on the orthodontic tooth movement. METHODS: The marrow stromal cells of rats were separated, cultured in vitro and induced to osteoblast-like cells. The osteoblast-like cells were implanted onto the ceramic bovine bone. Then the complex was implanted into the alveolar defect in one side of the rat's mandible. The other side of the mandible served as control. Eight weeks later, the orthodontic appliances were placed between the first molar and incisors of SD rats to move the first molar forward. The tooth movement and root resorption of the molar were observed. RESULTS: We found that the tooth movement in the experimental area was faster than that in the normal alveolar bone (P < 0.05). The root resorption and the alveolar bone height loss were less than that in the control area (P < 0.05). CONCLUSIONS: The tissue-engineered bone did not have negative influences on tooth movement. The repair of alveolar bone defect by tissue engineering approach may be used in craniofacial surgery and orthodontics.

Animals↗
PubMed2005

Observations on healing following endodontic surgery in nonhuman primates (Macaca fascicularis): effects of rhBMP-2.

OBJECTIVES: The potential of recombinant human bone morphogenetic protein-2 (rhBMP-2) to enhance bone healing following endodontic surgery was tested. The pattern and timing of de novo bone formation and cementum regeneration, and the potential for root resorption and ankylosis to accompany bone formation were evaluated. STUDY DESIGN: Pulpal infections were induced in maxillary and mandibular incisor teeth in young adult Cynomolgus monkeys. The teeth received conventional endodontic treatment immediately followed by surgical root resection. In a randomized split-mouth design, contralateral apical bone defects received rhBMP-2 in absorbable collagen sponge (ACS) carrier or served as sham-surgery controls to provide histological and radiographic evaluations following 1 (mandibular incisors) and 4.5 (maxillary incisors) month(s) postsurgery. RESULTS: At 1 month postsurgery trabecular bone filled the apical bone defects. The newly formed bone appeared considerably more mature and had assumed characteristics of the contiguous resident bone at 4.5 months postsurgery. The resected root tips were almost completely covered by new cementum with a maturing functionally oriented periodontal ligament. Localized inflammatory infiltrates were associated with the filled root canals and extruded root-filling material. Root resorption and ankylosis were not observed. There were no apparent differences in healing patterns between sites implanted with rhBMP-2/ACS and those serving as sham-surgery controls. CONCLUSIONS: Under conditions where the influence of infectious elements and irritation caused by root filling material are minimized, bone formation and cementum regeneration appears rapid following endodontic surgery. rhBMP-2/ACS did not offer an obvious benefit above and beyond that of the native osteogenic potential in this animal model.

Alveolar Bone Loss↗
PubMed2002

Feline odontoclastic resorptive lesions: unveiling the early lesion.

The purpose of this study was to increase understanding of the factors initiating feline odontoclastic resorptive lesions (FORLs). Fifty-six teeth (clinically and radiographically unaffected by ORLs) were harvested. Of these, 43 were from cats that had ORLs in other teeth (group A) and 13 were from cats with no clinical or radiographic evidence of ORLs in any teeth (group B). Twenty-six teeth in group A and one tooth in group B showed histological evidence of external root resorption (surface resorption and replacement resorption resulting in ankylosis). Some teeth in group B showed healed cementum resorption. It has previously been assumed that FORLs were similar to lesions associated with peripheral inflammatory root resorption, and were associated with periodontal disease. These histological findings suggest instead that a FORL is a non-inflammatory replacement resorption, resulting in ankylosis. The periodontal ligament of resorbing teeth lacked normal fibrous architecture, but was not inflamed. Resorption was not identified in cervical cementum. However, the histological appearance of the cervical cementum differed between the two groups. Several aetiopathogenetic explanatory models which arise from these observations are discussed.

Animals↗
PubMed1997

Premolar child-to-parent grafting within the framework of orthodontic serial extraction.

While allografting of human teeth holds all the risks and problems of immunological reactions or host-versus-graft reactions encountered in any organ transplantation, root resorption and thus the loss of the grafted tooth may be delayed by several decades if the transfer is between close relatives and minimum histocompatibility is 50%. In 2 cases premolars with incomplete root growth, which had to be extracted because of considerable crowding, were transplanted from child to mother and child to father, respectively. The grafts healed without complications and after a retention time of several weeks the teeth were attached. Three years after transplantation the teeth show only minor signs of root resorption and are fully functional.

Adult↗
PubMed1992

[Intrusion of the anterior teeth with the segmented-arch technic of Burstone--a clinical study].

The purpose of this study was to examine the efficiency of intrusion mechanics as described by Burstone. Thirty-one cases of deep bite with an overbite equal to or more than 4 mm were analysed by means of cast models, lateral cephalometric views and dental films of the front teeth prior to and after intrusion. The following parameters were considered: 1. Extent of the intrusion relative to a selective point of force application, 2. duration of the intrusion, and 3. amount of root resorption. The average extent of the intrusion in the case of the upper front teeth was 2.3 mm, and in the case of the mandible 3 mm. The rate of intrusion per month was 0.53 mm in the maxilla, and 0.54 mm in the mandible. Analysis of the point of force application showed that the centre of resistance must be presumed to be more distal than previously assumed. For an average treatment time of 4.3 months in the maxilla, and 5.5 months in the mandible, the apical root resorption was minimized by applying dosed force using a calculable force system. A buccal root torque arch employed in three cases permitted, in class II/1 cases, a combined movement comprising lingual tipping of the crown and intrusion, the intrusion component being clearly delayed in comparison with tipping. The segmented arch technique allows an objective intrusion of anterior teeth. This depends on choosing the appropriate point of force attachment and the correct amount of force.

Adolescent↗
PubMed1997

Case report: non-extraction treatment with functional and mechanical therapy of a Class II division 1 malocclusion.

Non-extraction treatment was carried out for a growing Angle Class II division 1 patient. Because the patient demonstrated potential growth and all the third molars were congenitally missing, the extraction of the four premolars was ruled out. A functional appliance (MGA) and cervical headgear were employed simultaneously in the first phase of treatment. The second phase was carried out by mechanotherapy. As a result, adequate forward growth of the mandible was attained and all 28 teeth were kept in good relation with no root resorption and healthy periodontal tissue. A better improvement of the profile may have been attained had extraction treatment been performed; with non-extraction treatment, however, the amount of tooth movement could be minimized, and root resorption was not observed. The role of the functional appliance is also important for the success of non-extraction treatment in Class II patients.

Cephalometry↗
PubMed2002

Immunohistochemical localization of receptor activator of nuclear factor kappaB (RANK) and its ligand (RANKL) in human deciduous teeth.

Osteoblasts and osteoclasts are involved in bone formation and resorption. RANK and RANKL [receptor activator of nuclear factor kappaB (ligand)], two cytokine-like proteins of the tumor necrosis factor superfamily, are localized on these bone cells and are crucial for the regulation of osteoclastic cell differentiation from hematopoietic precursors and also for the upregulation of mature osteoclasts mediated by cell-to-cell contact and a subsequent cascade of diverse intracellular signaling processes in the osteoclasts. It was the aim of this study to examine the sites of expression of RANKL and RANK in the corresponding cells of human dental hard and periodontal tissues using immunohistochemical light microscopical methods on tissue sections of 15 paraffin-embedded human deciduous teeth undergoing root resorption. We detected granular cytoplasmic RANKL-immunoreactivity in odontoblasts, pulp fibroblasts, periodontal ligament fibroblasts, and in single odontoclasts, the latter finding suggesting an autocrine/paracrine role. RANK-positive cells were identified as multinucleated odontoclasts localized near the dentine surface in resorption lacunae or as mononucleated precursors. These findings indicate that human dental cells express key mediators of hard tissue resorption and, though the RANK/RANKL-system may not be the sole regulator of tooth root resorption, these factors could at least contribute to this complex process under both physiological and pathological conditions.

Adsorption↗
PubMed1981

Developmental growth and degeneration of pulpal axons in feline primary incisors.

The life history of pulpal axons in primary mandibular incisors was examined by light and electron microscopy in 56 kittens aged from 25 days postconception to 120 days after birth. Cells resembling Schwann cells preceded the first arrival of pulpal axons, 1 week postnatally. myelination was initiated during the second week. Two months after birth the incisors were fully grown and each pulp contained about 100 axons. Between 10 and 20% of these were myelinated and ranged in size from 1 to 5 micrometer. The relation between number of myelin lamellae and axon size appeared nonlinear and differed markedly from that in similarly sized inferior alveolar nerve axons. During the third month many unmyelinated axons showed signs of degeneration. With progress of root resorption an increasing proportion of both unmyelinated and myelinated axons degenerated. In highly resorbed incisors necrotic Schwann cells were associated with degenerating axons and there was a generalized pulpal tissue reaction. In some teeth with advanced root resorption pulpal axons were lacking. A progressive derangement of all pulpal tissue elements continued until shedding during the second half of the fourth month. In incisor nerve branches below the incisor teeth axon degeneration was very limited.

Aging↗
PubMed1989

[Studies on factors causing tooth resorption. 1. Role of prostaglandins as a chemical mediator on resorption of deciduous teeth in rabbits].

The aim of this study was to investigate the effects in the administration of indomethacin which is a specific inhibitor of prostaglandins (PGs) in order to understand the role of PGs in physiologic root resorption. For this study, 24 young rabbits aged 7 days which had been in utero for 31-32 days were used. The experimental group (N = 12) was injected with 5.0 mg/kg indomethacin every 12 h, and the control group (N = 12) was injected with normal saline solution every 12 h. 4 animals of each group were sacrificed at the 9th, 11th and 13th day, respectively. Their maxillary deciduous incisors embedded in paraffin were sectioned serially 7 mus in thickness. From each sample was counted the number of odontoclasts appearing on the root surface and measured the volume of the root in the maxillary deciduous incisor. The results were as follows: 1. The appearance of odontoclasts increased in a day-related manner from 9 days to 13 days on the resorption of maxillary deciduous teeth in the control and experimental rabbits. 2. The number of odontoclasts was significantly decreased by the administration of indomethacin (9 days P less than 0.05, 11 and 13 days P less than 0.01). 3. The amount of the root resorption was significantly inhibited by the administration of indomethacin at 9 days which was the initial stage of root resorption in the maxillary deciduous incisors, and then the effect of inhibition rapidly disappeared. These results strongly suggest that PGs can possibly act as a chemical mediator of odontoclastic root resorption occurred during tooth exchange.

Animals↗
PubMed1986

Periodontal attachment responses to surgical injury in the cat. Removal of buccal bone with and without placement of foreign body at ligament periphery.

Recently, PDL progenitor cells were claimed essential for the establishment of new connective tissue attachment to root surface. To further test new periodontal attachment after surgical injury, portions of the buccal alveolar plate were removed from the canines of 4 cats. Removal of bone was carried out with or without removal of the underlying PDL, and in half of the experimental sites, dental amalgam was placed at ligament periphery. Tissue blocks were prepared for routine histologic evaluation (H & E) and specific collagen stains (Mallory Trichrome and Mallory PATH). Exfoliation of amalgam was noted in 6 experimental sites during the healing period. At all sites, plaque accumulation and marginal gingivitis were observed before sacrifice. Histologic observation demonstrated limited new connective tissue attachment to root surfaces at PDL periphery where bone, PDL and cementum had been removed. Where PDL was retained, connective tissue attachment was present which appeared to be the result of fiber interdigitation between root-inserted fiber ends and gingival wound edge fibers. "Blockage" of PDL cell migration by amalgam could not be well controlled. However, the placement of amalgam seems to have interfered with new connective tissue attachment and/or cementogenesis. In 5 specimens, root resorption had progressed into dentin. At these sites, collagen tufts appeared to arise from dentin. These tufts were in intimate contact with zones of dense inflammatory cellular infiltrate and connective tissue elements. We suggest that this observation may be a further tissue response to injury, namely: root resorption with the unmasking of dentinal collagen, which may finally lead to fiber interdigitation.

Alveolar Process↗
PubMed2002

Application of enamel matrix derivative in autotransplantation of an impacted maxillary premolar: a case report.

BACKGROUND: The success of tooth transplantation or replantation depends on the viability of periodontal ligament in the planted tooth. Mechanical injury to periodontal tissues frequently results in dental root resorption and dental ankylosis, which leads to the failure of transplantation or replantation. Enamel matrix derivative (EMD) has been recently used to induce periodontal regeneration. In this report, we show a clinical case of EMD application in the transplantation of an inversely impacted and immature tooth. METHODS: An impacted second premolar was found in the right maxilla of a 16 year-old girl. The tooth was inversely impacted and the dental root was incomplete. When transplantation was carried out, EMD was applied to the periodontal tissues of the extracted premolar. The tooth was fixed at the correct position and the clinical condition was followed for evaluation for 6 months. RESULTS: Radiographs after 3 months exhibited new bone formation surrounding the transplanted tooth. After 6 months, considerable growth of dental root was evident, periodontal ligament-like radiolucency appeared, the vital reaction of the planted tooth was detected, and there were no signs of root resorption or ankylosis. CONCLUSION: Short-term results from this case indicate that EMD application was effective in the transplantation of an inversely impacted and immature tooth and that EMD might contribute to the growth of dental root and to the prevention of ankylosis.

Adolescent↗
PubMed1990

Effect of topical application of doxycycline on pulp revascularization and periodontal healing in reimplanted monkey incisors.

Maxillary incisors in 47 monkeys, 54 in the experimental group (I) and 117 in the control group (II), were extracted and reimplanted, either immediately or after 30 or 60 min wet or dry storage. Incisors in the experimental group I were additionally kept 5 min in a suspension of 1 mg doxycycline in 20 ml physiologic saline, freshly prepared for each of the 15 animals before reimplantation. The observation time varied from 6 to 8 weeks. The teeth were removed in tissue blocks, histologically processed and evaluated for occurrence of complete pulp revascularization (CPR), presence of the micro-organisms in the pulpal lumen and ankylosis or inflammatory root resorption. Then the results were statistically evaluated, using log-linear analyses and chi-square tests (SAS, 1985) for the comparisons between group I and group II. These analyses revealed that topical application of doxycycline increased the frequency of complete pulp revascularization (P less than 0.002) and decreased the frequency of micro-organisms in the pulpal lumen (P less than 0.001). Furthermore, the frequencies of ankylosis (P less than 0.05) and inflammatory root resorption (P less than 0.001) were also decreased compared with the control group of teeth. It was concluded that the effect of topical treatment with doxycycline was most probably exerted on the micro-organisms that contaminated root surface during the extra-alveolar time; contamination of necrotic pulp tissue from the mechanical damage in the cervical part of the root surface was not affected.

Animals↗