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PubMed1998

Tooth replantation in germ-free and conventional rats.

The purpose of the present study was to evaluate the influence of bacterial infection on the pulpal and periodontal tissues in replanted teeth using germ-free and conventional rats. Forty maxillary and mandibular first molars from ten 6-week-old germ-free male Wistar rats were used. The animals and all materials were maintained in a germ-free environment inside vinyl isolators throughout the experimental periods. Twenty conventional male Wistar rats served as controls. The first molars were intentionally replanted immediately after extraction. At 3 days, and 1, 2, 4 and 8 weeks after replantation, animals were sacrificed and the replanted teeth were histopathologically evaluated. Diversity of pulp tissue response was notable in conventional rats, which initially showed various degrees of neutrophil infiltration and then displayed different types of response, including revascularization with reparative dentin formation and complete necrosis. Pulpal responses of germ-free rats were less variable, being characterized by an almost complete lack of neutrophil infiltration and a high frequency of bone-like tissue ingrowth. Typical inflammatory resorption was detected only in conventional rats, whereas a higher incidence of ankylosis was notable in germ-free rats. The present results may corroborate the concept that bacterial infection is a major cause of serious healing complications following tooth replantation, such as pulp necrosis and inflammatory root resorption. The difficulty in optimally controlling bacterial infection seems to be highly relevant to the complexity and unpredictability of the outcome of this procedure. It should also be emphasized that extensive mechanical damage to the periodontal tissues may trigger the development of unfavorable healing complications as ankylosis, even under strictly aseptic conditions.

Animals↗

PubMed1987

Traumatically intruded teeth.

Various combinations of orthodontic force, luxation, and observation are applied to 12 teeth traumatically intruded in 3 large dogs. All showed root resorption to some degree. Early orthodontic repositioning, with luxation if immobile, produced the best recovery.

Animals↗

PubMed2004

Management of unerupted maxillary canines where no orthodontic treatment is planned; a survey of UK consultant opinion.

OBJECTIVE: To assess current consultant opinion on the management of impacted maxillary canines in patients for whom no orthodontic treatment is planned. DESIGN: Questionnaire survey. METHOD: Questionnaires were sent to all UK consultant orthodontists identified from the Consultant Orthodontists Group database. Follow-up questionnaires were sent to those who had not replied within 6 weeks. An overall response rate of 76% was achieved. RESULTS: Most consultants were in favor of intervention, with removal of the unerupted canine, although a significant minority suggested a conservative approach. Of the latter group, nearly all recommended radiographic monitoring, but there was little agreement regarding the frequency and duration of this. The risk of root resorption was stated to be the most important factor justifying monitoring. CONCLUSIONS: Significant variation was found amongst UK consultant orthodontists with regard to the management of impacted canines, where orthodontic treatment was not planned. The clinical and radiographic features, which the respondents stated would influence their decision to remove or leave the canine, were not those that existing research suggests as being the primary risk factors. It is suggested that, once the patient has passed the peak age for initiation of resorption, a more conservative approach may be appropriate.

Attitude of Health Personnel↗

PubMed1991

[Alveolar bone remodelling following orthodontic tooth movement in aged rats. An animal experimental study].

Orthodontic tooth movement of upper first molars was performed in twelve aged (500 days old) rats. It was demonstrated by histomorphologic findings as well as by vital polychrome staining that the remodelling process of the periodontal tissues in the aged animals was qualitatively similar to that in younger ones. The first molar in all animals was tipped mesially, while its mesial root was intruded. According to the vital polychrome staining the bone formation rate at the mesio-apical bone surface of the mesial root was determined as 7-8 microns per day. After 14 days comprehensive root resorption in the pressure zone distal of the bifurcation was found.

Aging↗

PubMedDate not supplied

Permanent molar impactions and an odontogenic keratocyst: report of case.

A case of permanent molar impactions involving maxillary and mandibular second and third molars is reported. An odontogenic keratocyst was present in conjunction with root resorption of adjacent teeth. Treatment involved surgical removal of the impacted teeth and enucleation of the cystic lesion.

Adolescent↗

PubMed2004

Considerations in intracoronal bleaching.

Intracoronal bleaching is a simple, useful procedure for restoring the colour of discoloured root-filled teeth that are not extensively restored. It is important to minimise the extraradicular diffusion of hydrogen peroxide, as excessive levels of hydrogen peroxide in conjunction with existing inflammatory changes in the periodontium predispose the tooth to external root resorption. To keep the levels of extraradicular diffusion of hydrogen peroxide below the safety limit, it is imperative that an effective intermediate base cement of at least 2 mm be placed at the level of the buccal cemento-enamel junction over the root-filling prior to bleaching. The use of 35% carbamide peroxide as the intracoronal bleaching agent seems to combine the safety of sodium perborate together with the efficacy of 35% hydrogen peroxide. As bleaching agents may reduce the composite-tooth bond of some adhesive systems, the post-bleaching composite restoration should be delayed for at least three weeks.

Borates↗

PubMed1992

The radiographic characteristics of histiocytosis X. A study of 29 cases that involve the jaws.

The purpose of this study was to provide an objective analysis of the radiographic characteristics of histiocytosis X as it affects the jaws. The original radiographs of 29 cases were reviewed independently and objectively by three observers. The results suggest that seven characteristics, either alone or in combination, are useful in the identification of histiocytosis X. These include the appearance of solitary "intraosseous" lesions, the multiplicity of "alveolar bone" lesions, the "scooped-out" effect in the alveolar process, the well-defined periphery, sclerosis in the alveolar bone lesions, periosteal new bone formation, and slight root resorption.

Adolescent↗

PubMed1996

Early tooth movement pattern after application of a controlled continuous orthodontic force. A human experimental model.

This clinical study was designed to investigate early orthodontic movement of human premolars subjected to a controlled, continuous, horizontally directed force. The maxillary right, first or second premolar in 56 children, 18 boys and 38 girls (mean age 13.8 years), was moved buccally with a fixed orthodontic appliance with a frontal bite-block disengaging the occlusion. The contralateral premolar served as control. A weekly controlled and reactivated force of 50 cN (approximately 50 gm) was applied. The force declined on average about 24% per week. The patient material was subgrouped to comprise eight patients in each of seven groups, for which the experimental periods varied from 1 to 7 weeks. Tooth displacement was studied on dental casts, with a coordinate measuring machine (Validator 100, TESA SA, Renens, Switzerland), which made it possible to measure the displacement in three dimensions. The movement pattern of the test teeth was found to be a combination of horizontal and vertical displacements, including tipping. The horizontal movement of the tooth crown was on average 0.8 mm during the first week and 3.7 mm after 7 weeks. The vertical movements were intrusive in 45% and extrusive in 55% of the teeth. In some tipping movements, the crown was "intruded" at the same time as the apex was "extruded." The individual variations in tooth displacements were considerable. The clinical experimental model used permits detailed study of orthodontic tooth movement under controlled force conditions, as well as detailed histologic analysis of related root resorption.

Adolescent↗

PubMed2002

Odontogenic myxomas in the Hong Kong Chinese: clinico-radiological presentation and systematic review.

AIM: The aim of this study was to determine the clinical and radiological presentation on plain films of central odontogenic myxomas (OM) in the Hong Kong Chinese and compare them to other reported series by a systematic review (SR). METHODS: The study had two elements, that of a complete series of all OMs presenting at a major Chinese maxillofacial surgical unit and a SR. The files of the Department of Oral and Maxillofacial Surgery of the University of Hong Kong between 1989 and 2000 were reviewed for OM cases. The relevant literature was identified by electronic databases, review of citation lists and handsearching of key journals. The principal selection criterion was that the study should represent a complete collection of cases. RESULTS: The SR revealed that only a quarter of the reports provided any quantitative radiological details. Just under half of the included reports provided the relative period prevalence of OMs compared to other odontogenic tumours, but these reports almost completely excluded consideration not only of the radiology but also specific clinical details. Furthermore, they did not report of recurrence data, an important feature of the OM. Most of the most recent reports were concerned with relative period prevalence. The relative period prevalence and 'number of OMs per hospital per year' of studies separated by two or more decades in Hong Kong and Nigeria indicate an increase in the number of lesions diagnosed as OMs. The 10 Hong Kong cases were broadly consistent with the predilections for females and the mandible of other reports. The mean age at first presentation in the present report is 36.9, older than the other reports. Most lesions are large, affecting both posterior and anterior quadrants. They appear to be larger than those in many other reports. Two of the OMs are accompanied by histories of recent rapid growth. Tooth displacement and root resorption are more frequently observed in OMs in the present study. Although all OMs in the present study are still being followed up after surgery, none have recurred. CONCLUSION: Although the presentation of larger lesions in the older Chinese could in part be explained by attitudes rooted in traditional medicine in spite of the widespread availability of modern medical care in Hong Kong, there is a history of recent rapid growth in at least two cases. An emphasis by recent reports on the OMs' relative period prevalence of concurrent odontogenic lesions, has omitted recording the radiology and the specific clinical details usually required for diagnosis.,

Adolescent↗

PubMed1987

Allotransplantation of human teeth. A retrospective study of 73 transplantations over a period of 28 years.

An assessment was made of the postoperative fate of 73 allotransplanted human teeth carried out by 3 surgeons between 1956 and 1980 to determine the clinical and radiographical course of immunogenetically unmatched allotransplanted human teeth. The mean ages of recipients and donors were 34.1 and 15.2 years, respectively; 47 of the grafts had incomplete root-formation at time of transplantation. Mean observation period was 7.8 years with a maximum of 28 years. The study was terminated December 1985. The mean functional time of the grafts (function of graft without symptoms) was 6.8 years (max. 28.5 years). No signs of pulpal survival were found in any graft. Root resorption was found in 91.6% of grafts within a mean of 8.8 months after transplantation, causing a high frequency of graft loss within the first 2 years (34.1%). Recipients older than 45 years of age retained the grafts significantly longer than young patients. The major causes of graft loss were replacement (60.3%) and inflammatory resorption (24.4%). Graft loss due to marginal periodontitis was minor (2.7%). Inflammatory resorption, which was found more frequent in young recipients (P = 0.02), usually caused rapid rejection, whereas the survival time after ankylosis was significantly longer. In conclusion, no clinical or radiographical evidence of long-term survival of the pulpal or periodontal tissues of the unmatched allografts were found. However, despite a progressing replacement resorption frequently present, the allografts seem to function clinically sufficient, symptomless and often with clinically normal gingival condition for many years. Increasing age of the recipient at time of transplantation significantly increased the function time of the graft. Younger recipients showed more inflammatory resorption of the grafts.

Adolescent↗

PubMed1994

Periodontal conditions of teeth autogenously transplanted by a two-stage technique.

Inflammatory reactions of the marginal periodontal tissues and loss of attachment could partly account for the often occurring rejection of autogenously transplanted mature teeth. The periodontal conditions of transplanted teeth were investigated from 1 month up to 5 years postoperatively. The parameters plaque, bleeding on probing to the bottom of the pocket, probing pocket depth (PPD), gingival recession and probing attachment loss were analysed by multiple regression analysis. No significant difference was found between transplanted and control teeth in bleeding on probing the bottom of the pockets up to 5 years postoperatively with the exception of increased bleeding on probing of the transplanted teeth at the 1-month postsurgery examination. No significant difference of the mean probing depth between transplanted teeth and control teeth was found at the mesio- and distobuccal surfaces. The transplanted teeth at the buccal surface showed increase of the mean pocket depth during the observation period. Increased mean probing depth without progression over time was found at the transplanted teeth compared to the controls at the distolingual, lingual and mesiolingual surfaces. A small mean gingival recession at the transplants was observed. Loss of attachment was recorded at 13% of the surfaces. Totally 50% of the transplants showed loss of attachment and 5% were removed because of extensive attachment loss. On 13% of the transplanted teeth with loss of attachment, root resorption was also found.

Adolescent↗

PubMed2004

[Use of osteoconductive materials in pediatric dental medicine].

Osteoconductive materials are well known to have the ability to form a characteristic scaffold for bone replacement. The use of these agents is mostly described in periodontal procedures. The present study deals with the use of two different osteoconductive materials used for repairing bone defects following traumatic injuries. The materials used were Bio-Oss (Geistlich) an allogenic demineralised bone and Fisiograft (Ghimas) a synthetic co-polymer of polyglicolic and polylactic acid. These materials were used in five different clinical cases with the objective to compare their typical properties during application and to evaluate radiographically and clinically their healing ability. In three cases filling of the alveolus was performed after extraction of traumatised incisors as a consequence of root resorption or fracture; two patients suffered from periodontal defects. All cases were followed every three months for at least two years and maximum 6 years. Regarding the handling of the materials all products were well accepted. From our clinical experience all modalities are found to be suitable. After clinical and radiographical evaluation normal bone formation was found in all cases without any complaints nor clinical symptoms. These clinical findings support the use of osteoconductive agents in the field of Paediatric Dentistry in well-defined indications.

Adolescent↗

PubMed2005

Complications associated with segmentation of the maxilla: a retrospective radiographic follow up of 82 patients.

The aim of the present study was to retrospectively examine the clinical and radiographic incidence and frequency of injuries to teeth and their surrounding tissues adjacent to interdental osteotomies in conjunction with segmentation of the maxilla. Vertical interdental osteotomies have been performed in combination with Le Fort I osteotomy for correction of various dento-facial deformities. All our orthognathic patients are followed prospectively in a standardized manner. Eighty-two consecutive patients who underwent dento-facial correction by segmented maxillary osteotomy alone or in combination with simultaneous mandibular surgery between 1992 and 1998 were included in the study. They were followed for up to 30 months postoperatively. A total of 158 interdental osteotomies were performed, involving a total of 316 teeth. Only a small number of complications such as osteolytic processes, marginal bone destruction, root resorption or mechanical injuries to the teeth were seen.

Adult↗

PubMed1998

Alveolar bone grafting: a review of 115 patients.

The results of alveolar bone grafting carried out at The Hospital for Sick Children, Great Ormond Street, London, UK, between January 1982 and January 1989 were assessed. Cancellous bone from the iliac crest was grafted to alveolar cleft defects in 115 patients (63 male and 52 female). Eighty-seven unilateral (58 left and 29 right) and 28 bilateral clefts were operated on. The mean age at the time of operation was 11.5 years, with a range of 8.08-18.75 years. The cleft canine had erupted prior to bone grafting in 58.4 per cent. At the time of this study the cleft had erupted in 96.35 per cent and was unerupted in 3.65 per cent of sites. Radiographs were taken at regular intervals and assessed according to previously reported criteria. Eighty-six per cent were clinically successful (Type I and II). In Type III 10.95 per cent had less than three-quarters of the normal interdental septal height and 2.18 per cent failed (Type IV). In addition, 3.6 per cent of sites showed cervical root resorption affecting the adjacent incisor and 1.4 per cent internal resorption of the cleft canine.

Adolescent↗

PubMed2000

Cementoenamel junction: microscopic analysis and external cervical resorption.

There is a lack of data regarding the shapes and distribution of the mineralized tissue that composes the cementoenamel junction. A sample of 198 permanent human teeth was analyzed by optical microscopy and scanning electron microscopy. Scanning electron microscopy showed three types of tissue interrelations: enamel overlapped by cementum; enamel and cementum edge-to-edge; and a gap, revealing a strip of exposed dentin. Using optical microscopy, a fourth type of cementoenamel junction was observed: cementum overlapped by enamel. The distribution of the hard tissues found at the cementoenamel junction is unpredictable and irregular both for any tooth type (e.g. on cuspids) and on any one individual tooth. Based on these results and on analysis of the mechanisms involved in cervical root resorption, it is possible to consider the cervical region as prone to external resorption.

Dental Cementum↗

PubMed2005

Orthodontic treatment of a traumatically intruded tooth with ankylosis by traction after surgical luxation.

This report presents the treatment of a patient with anterior crossbite and displacement of ankylosed maxillary and mandibular right lateral incisors. The maxillary lateral incisor, which was traumatically intruded, was successfully treated with 2 surgical luxations followed by orthodontic traction. The mandibular lateral incisor, which was avulsed and replanted, experienced replacement root resorption during orthodontic treatment and was ultimately extracted. Two years after active orthodontic treatment, the occlusal results were considered satisfactory.

Cephalometry↗

PubMed1996

Interleukin-1 beta and tumor necrosis factor-alpha production by human monocytes cultured with L-thyroxine and thyrocalcitonin: relation to severe root shortening.

The objectives of this study were to determine whether L-thyroxine (T4) and thyrocalcitonin (TCA) influence monocyte production of interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) and to examine IL-1 beta and TNF-alpha production in monocytes from a group of orthodontic patients with severe root shortening. Human monocytes were incubated with varying concentrations of T4 and TCA for 24 hours, and IL-1 beta and TNF-alpha levels were measured by ELISA. At a concentration of 0.1 microgram/ml, T4 and TCA induced significantly more IL-1 beta than untreated controls, and T4 induced more IL-1 beta than TCA. Neither hormone induced significant TNF-alpha release, conversely, TCA had an inhibitory effect on unstimulated monocyte release of TNF-alpha. TCA was also shown to inhibit, but not reverse, the activational effect of lipopolysaccharide on monocyte TNF-alpha release. T4 and TCA concentrations as low as 0.1 pg/ml caused monocytes to release significant amounts of IL-1 beta. The highest concentration of T4 tested (1.0 microgram/ml) induced significantly less IL-1 beta production than lower concentrations. T4- and TCA-treated monocytes bound more labeled IL-1 beta than untreated controls, which suggests that these hormones increase IL-1 receptor expression. There was a wide range of unstimulated and stimulated IL-1 beta and TNF-alpha production by root resorption subject monocytes with no significant differences between resorption and nonresorption group means. This data suggest that patient monocytes did not differ from control monocytes in regard to these cytokine parameters, and therefore in vitro IL-1 beta and TNF-alpha levels could not distinguish resorption subjects.

Adult↗

PubMed1992

Complications of orthodontic treatment.

Orthodontic treatment may in some cases initiate damage to teeth and supporting tissues (decalcification and gingivitis) or root resorption, pulp damage, allergic reactions, or craniomandibular dysfunction. This review updates some interesting findings regarding these problems.

Craniomandibular Disorders↗