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PubMedDate not supplied

Prepubertal periodontitis: a report of 2 cases.

PURPOSE: Prepubertal periodontitis is a term suggested for a form of periodontitis that starts soon after the eruption of primary teeth. There is increased awareness that the disease entity known as "periodontitis" is in all probability a family of related but reasonably discrete diseases. The purpose of this report is to describe the clinical, radiographic, and laboratory findings in 2 patients, as well as treatment of prepubertal periodontitis. METHODS: This study presents 2 cases of generalized prepubertal periodontitis: a 5-year-old girl and a 13-year-old girl. RESULTS: Case 1 presented to the clinic because of parental concern for the early exfoliation of her teeth. All of her teeth with Grade III mobility, ie, 8.5, were extracted and the rest were scaled and root planed with subgingival irrigation of 0.2% chlorhexidine. She received a program of 3-month maintenance scaling and 6 months later, there was no further progression of periodontal lesions. Case 2 demonstrated the destruction of tooth roots along with extensive loss of tooth roots and alveolar bone. Since all the permanent teeth were Grade II mobile, the patient was advised to have total extraction with replacement of teeth by complete denture prosthesis at a later date. CONCLUSIONS: In case 2 premature root resorption was occurring concurrently with unexplained extensive alveolar bone loss. In Case 1, the elimination of the pathogenic microflora during primary dentition by early extraction of the teeth involved, plus daily local, mechanical and chemical control of the irritant factors may have prevented subsequent damage to remaining teeth in prepubertal periodontitis.

Adolescent↗

PubMed1975

Histological study on the postnatal development and sequence of eruption of the maxillary cheek-teeth of rabbits (Oryctolagus cuniculus).

The development and sequence of eruption of the maxillary cheek-teeth of rabbits were studied by histological methods. The presence of three deciduous molars which were replaced by correspondent premolars and of three permanent molars without predecessors was confirmed. The eruption of the maxillary deciduous molars was shown to begin at 4 days postnatally and that of the permanent molar at 9 days, while the eruption of the premolars occurs from 24 days on, replacing the deciduous molars which are exfoliated. The last tooth to erupt is the M3. At 32 days all the permanent cheek-teeth are erupted. The deciduous molars are completely developed at birth, root resorption starting at 4 days. On the first day the premolars are in the bell stage and in the M1 and M2 amelogenesis is taking place. After 27 days the development of the permanent maxillary cheek-teeth is completed. Dentinogenesis, amelogenesis and cementogenesis were observed in all of them.

Age Factors↗

PubMedDate not supplied

Evaluation of the carbon dioxide laser on vital human primary pulp tissue.

PURPOSE: The purpose of this study was to evaluate the response of the human primary pulp to the carbon dioxide laser and formocresol for vital pulp therapy. METHODS: Fifteen healthy children with intact, caries-and-restoration-free, contralateral primary cuspids with at least two-thirds of the roots remaining who were scheduled for orthodontic extraction were randomly assigned to pulpotomy treatment with a carbon dioxide laser or formocresol. The treated teeth were clinically and radiographically evaluated at 28 and 90 days post-treatment prior to extraction. The extracted teeth were evaluated histologically for pulpal response. RESULTS: All teeth were asymptomatic and clinically normal at both observation periods. Internal root resorption was observed in one formocresol and two laser treated teeth. There was a significant inverse correlation between the laser energy applied to the pulp and the degree of inflammation at 28 days (P = .01) but not at 90 days (P = .27). CONCLUSION: Carbon dioxide laser treatment compared favorably to formocresol for pulpotomy in primary teeth.

Child↗

PubMed2003

Recombinant human basic fibroblast growth factor (bFGF) stimulates periodontal regeneration in class II furcation defects created in beagle dogs.

Several growth factors (or cytokines) have been recently investigated for their use as potential therapeutics for periodontal tissue regeneration. The objective of this study was to evaluate periodontal tissue regeneration, including new bone and cementum formation, following topical application of recombinant basic fibroblast growth factor (bFGF, FGF-2) to furcation class II defects. Twelve furcation class II bone defects were surgically created in six beagle dogs, then recombinant bFGF (30 micro g/site) + gelatinous carrier was topically applied to the bony defects. Six weeks after application, periodontal regeneration was analyzed. In all sites where bFGF was applied, periodontal ligament formation with new cementum deposits and new bone formation was observed histomorphometrically, in amounts greater than in the control sites. Basic FGF-applied sites exhibited significant regeneration as represented by the new bone formation rate (NBR) (83.6 +/- 14.3%), new trabecular bone formation rate (NTBR) (44.1 +/- 9.5%), and new cementum formation rate (NCR) (97.0 +/- 7.5%). In contrast, in the carrier-only sites, the NBR, NTBR, and NCR were 35.4 +/- 8.9%, 16.6 +/- 6.2%, and 37.2 +/- 15.1%, respectively. Moreover, no instances of epithelial down growth, ankylosis, or root resorption were observed in the bFGF-applied sites examined. The present results indicate that topical application of bFGF can enhance considerable periodontal regeneration in artificially created furcation class II bone defects of beagle dogs.

Alveolar Process↗

PubMed2002

Tooth replantation after traumatic avulsion: a report of ten cases.

This report compares the manner in which the avulsed tooth was handled at home versus at school, and presents the different outcomes of the replanted teeth in both groups. Eighteen of 32 avulsed teeth were not replanted, and four replanted teeth could not be followed. Thus, the material comprised 10 avulsed permanent incisors of 10 traumatized children, aged between 8 and 13 years, who were treated at the Pediatric Dental Clinic of Niigata University Dental Hospital. Half of the patients avulsed the tooth at school and the other half at or near home. Of the five teeth avulsed at school, three were kept under wet conditions. The time until their replantation ranged between 0.5 and 3.5h. Their outcomes were fairly good, except for one incisor that was extracted about 3 years later owing to the undesirable replantation procedures by the dentist. Of the avulsed teeth at or near home, three were left under dry conditions. Their time until replantation ranged scattered between 0.5 and 12h. Of these, two incisors preserved under wet conditions survived without significant root resorption. These results suggested that information about the way to keep the avulsed tooth was relatively well known to school nurse-teachers compared with parents. Depending on the kind of lay people, it appears that it is necessary to select the best way to convey information about the management of avulsed permanent teeth.

Accidental Falls↗

PubMed2003

Use of third molar transplantation for closure of the oroantral communication after tooth extraction: a report of 2 cases.

OBJECTIVE: This clinical report introduces a promising and unique method for the immediate closure of the oroantral communication (OAC) after tooth extraction: the use of the transplanted third molar with closed apices. STUDY DESIGN: In 2 adult patients, OAC caused by the extraction of an upper molar was immediately closed by using a transplanted third molar with complete root formation. After tooth extraction at the recipient site, OAC with perforated mucosa of the sinus floor was confirmed and the donor third molar was transferred to the prepared recipient socket. Endodontic therapy of the transplanted third molar began at 3 weeks after surgery, and prosthetic treatment was completed at 5 months after the operation. These 2 patients were carefully observed both clinically and radiographically. RESULTS: Closure of the OAC was successfully performed, and the transplanted teeth became fixed with the passage of time in these 2 patients. Root resorption did not occur, and good functional results were obtained without any complications. CONCLUSIONS: Tooth transplantation of a mature third molar for closure of the OAC is a simple and excellent method because the transplanted tooth not only closes the communication to the maxillary sinus, but it also satisfactorily functions at the recipient site during mastication, even in adult patients.

Adult↗

PubMed1998

Ectopic eruption of the first permanent molars: prevalence and etiologic factors.

The purpose of this research was to study the prevalence of ectopic eruption of the first permanent molars and possible etiologic factors. A group of 4,232 Thai students, from 6 to 9 years old, was examined. The prevalence of ectopic eruption of the first permanent molars in the subjects was 0.75%. Both the severity of the ectopic eruption and the amount of root resorption on the second primary molars were more pronounced in the maxilla than in the mandible. The important etiologic factors were the eruption path of the first permanent molars relative to reference lines and the size of the mandibular second primary molars. The amount of proximal caries did not seem to affect the prevalence of ectopic eruption.

Analysis of Variance↗

PubMed2004

The use of glass ionomer cements in both conventional and surgical endodontics.

The capacity to bond to dental tissues, especially to dentine, their long-term fluoride release and their biocompatibility make glass ionomer cements (GICs) advantageous for use in endodontics, as well as in restorative dentistry. This review provides information on the basic properties of GICs, such as adhesion, antimicrobial effects and biocompatibility, particularly as they relate to use in endodontics. Indications for the use of GICs in endodontics are orthograde root canal sealing, root-end filling, repair of perforations and root resorption defects, treatment of vertical fractures and maintenance of the coronal seal. The paper includes a review on each of these indications. It is concluded that in spite of the critical handling characteristics and the inconclusive findings regarding sealing ability and antimicrobial activity, there is substantial evidence to confirm their satisfactory clinical performance. Both soft tissue and bone compatibility make them suitable for use during endodontic surgery.

Anti-Infective Agents, Local↗

PubMedDate not supplied

Oral restoration with fixed partial dentures on transplanted abutment teeth.

Thirty-five fully developed teeth were autogenously transplanted for 24 partially edentulous adult patients to enable the placement of fixed partial dentures. Restoration was successfully carried out on 22 patients during the follow-up period up to 13 years after surgery. Two restorations failed, one because of root fracture and another as a result of ankylosis of the transplanted tooth. Six transplanted abutment teeth showed root resorption and/or loss of attachment without consequence for the dental restoration. The proportion of successful tooth transplantations was 97% after 1 year, 94% after 2 years, and 88% from 6 to 13 years. Transplantation of teeth using a two-stage surgical technique could provide the necessary dental support for fixed partial dentures even for patients with atrophic alveolar bone.

Adult↗

PubMed1994

Dental complications associated with repeated orotracheal intubation in infancy: a case report.

Various oral and dental problems have been attributed to orotracheal intubation in the neonatal period. A case is described of a child whose dental anomalies are ascribed to multiple orotracheal intubations for the management of a complex cardiac abnormality. Six intubations were required between the ages of 9 days and 4 years for investigation and surgery. His maxillary right primary central incisor did not erupt until 3 years of age and the maxillary left was still unerupted at 6 years and 10 months and was rotated in its crypt. At this time, the mandibular primary incisors were physiologically mobile but the maxillary right primary central incisor remained firm. Both maxillary primary central incisors were extracted and examined histologically and showed abnormal morphology, enamel hypoplasia, and disordered dentine formation and root resorption. Subsequent eruption of the left permanent central incisor revealed hypoplasia of its incisal edge. It is suggested that the delayed eruption and abnormal morphology of the primary incisors were due to pressure effects on the overlying mucosa, follicular displacement and localized trauma caused by intubation. This case highlights the importance of monitoring the developing dentition of patients with a history of orotracheal intubation, so that interceptive treatment may be instituted when appropriate.

Dental Enamel Hypoplasia↗

PubMed1996

Biologic responses of autogenous bone and beta-tricalcium phosphate ceramics transplanted into bone defects to orthodontic forces.

This study was conducted to evaluate biologic responses of autogenous bone (particulate marrow and cancellous bone; PMCB) and beta-tricalcium phosphate ceramics (TCPC) to orthodontic stimuli. Nine dogs served as the experimental animals; three dogs underwent orthodontic tooth movement after grafting, three dogs received PMCB grafting without tooth movement, and three dogs received TCPC grafting without tooth movement. Immediately after extraction of the upper second and/or third incisors, the maxillary alveolar bone was resected bilaterally. Autogenous PMCB obtained from the iliac bone and TCPC were transplanted into each bone defect. Experimental tooth movement was initiated 2 to 4 weeks after the grafting and continued for 9 to 15 weeks. Sectional archwires with open-coll springs were used for distal movement of the upper first incisors into the extraction sites. Oxytetracycline and calcein were employed as bone markers. Sections of grafted areas including the teeth were prepared for light and fluorescence microscopy. The results revealed that both autogenous bone and TCPC presented similar adaptive changes to the original alveolar bone without any external stimuli. TCPC exhibited more prominent biodegradative responses to orthodontic force in association with new cementum formation. Root resorption was also less in the TCPC area than in the PMCB region. It is shown that TCPC is biodegradative in nature and adaptive for remodeling during orthodontic tooth movement. This finding indicates that TCPC may be a better biocompatible alternative to autogenous bone transplanted into bone defects subjected to orthodontic tooth movement.

Adaptation, Physiological↗

PubMedDate not supplied

Primary hyperoxaluria in a pediatric dental patient: case report.

A case is presented in which primary hyperoxaluria and oxalosis in a 14-year-old Caucasian female were diagnosed. Generalized root resorption resulted in a remarkable mobility of her maxillary central and lateral incisors, although no bone loss was noted. The management of the patient's dental concerns in this rare heritable metabolic disorder consisted of removing the maxillary incisor teeth and placing two sequential prostheses, which the patient tolerated well. A history of trauma to the maxillary incisors was ruled out, so this case adds previously unreported information to our knowledge about the effect of oxaluria on teeth and oral tissues.

Adolescent↗

PubMed1998

The nature and extent of jaw involvement in Gaucher disease: observations in a series of 28 patients.

A wide variety of osteoarticular pathoses plague the clinical course of many patients with Gaucher disease. Osseous lesions involving the jaws have been described, usually as isolated case reports. The purpose of this study was to ascertain the nature and extent of mandibulo-maxillofacial pathosis in 28 patients with documented Gaucher disease by means of panoramic radiography. Twenty-five of the 28 patients displayed radiographic evidence of jaw involvement. The most prevalent finding was gross widening of marrow spaces; frank radiolucencies, endosteal scalloping, cortical thinning, root resorption, and inferior displacement of the mandibular canal or effacement of its cortices were also seen. A previously unreported finding was delayed eruption of permanent teeth, which was seen in more than one half of the patients who were under 20 years of age. Osseous changes throughout the jaws may be more common than previously suspected and may alert the dentist to the presence of the disease.

Adolescent↗

PubMed2000

Ehlers-Danlos type VIII. Review of the literature.

Ehlers-Danlos type VIII is a rare disorder characterized by soft, hyperextensible skin, abnormal scarring, easy bruising, and generalized periodontitis with early loss of teeth. To illustrate the clinical dermatological and dental features, we present the case history of a 20-year-old patient who has suffered from poor healing of wounds at the shins and knees since childhood, which have developed into hyperpigmented atrophic scars. In the course of orthodontic treatment during the last 3 years, severe apical root resorption, gingival recession, and loss of alveolar bone were observed. Family history was noncontributory for any skin or tooth disorders. The typical clinical signs confirmed the diagnosis of Ehlers-Danlos syndrome type VIII. As there is no specific treatment for the disorder, management is limited to the symptomatic treatment of the dental disease. It seems advisable to consider carefully the indications for orthodontic treatment in patients with Ehlers-Danlos type VIII syndrome.

Adult↗

PubMed2002

A histological study on experimental tooth movement into bone induced by recombinant human bone morphogenetic protein-2 in beagle dogs.

OBJECTIVE: The purpose of this preliminary study was to examine experimental tooth movement into newly generated bone induced by recombinant human bone morphogenetic protein-2 (rhBMP-2). METHOD: After extraction of the maxillary first premolars, bone defects were surgically created in eight adult beagle dogs using a 5-mm-diameter trepan bar. According to which material was grafted into the bone defects, animals were divided into the following four groups: (1) the rhBMP-2 group in which rhBMP-2 with a poly[ D,L-(lactide-co-glycolide)]/gelatin sponge complex was implanted; (2) the spongiosa group in which spongiosa from the tibia was grafted; (3) the nongrafted group in which no material was embedded; and (4) the control group in which only tooth extraction was performed. The osteoinductive activity of rhBMP-2 and tooth movement into the newly generated bone were examined by histological and morphometric comparisons of each group. RESULTS: Considerable new bone formation was observed at the grafted site both in the rhBMP-2 and in the spongiosa groups. The area of generated bone in the rhBMP-2 group was significantly greater than that in the spongiosa group. Newly generated bone, in both the rhBMP-2 and spongisosa groups, showed a similar histological response to orthodontic force as in normal alveolar bone in the control group. However, root resorption occurred on the pressure side in the rhBMP-2 group. CONCLUSION: These results indicated that rhBMP-2 might constitute an alternative material to autogeneous bone grafting for alveolar cleft defects. Further studies regarding tooth movement into generated bone induced by rhBMP-2 are suggested.

Absorbable Implants↗

PubMed1995

Retention of teeth with reduced root length through use of a resin-bonded splint: a case report.

Orthodontic relapse and tooth migration are commonly observed in patients with severe postorthodontic root resorption. If conventional removable retention is not adequate, fixed splint retention is necessary. Proponents of flexible splints suggest that the difference in mobility between natural teeth and the rigid systems is responsible for the loss of cement seal in the rigid systems. Proponents of rigid splints suggest that the flexibility that allows physiologic movement of the teeth also contributes to fatigue and subsequent failure of the material in the flexible splint systems. A clinical technique for increasing retention, consequently improving the prognosis of a resin-bonded fixed splint, is described.

Adolescent↗

PubMedDate not supplied

Pulp response to ferric sulfate, diluted formocresol and IRM in pulpotomized primary baboon teeth.

This study investigated the pulp response to a 15.5 percent ferric sulfate solution (FS) and a 20 percent dilution of formocresol (DFC) in pulpotomized primary teeth of baboons, after four and eight weeks. Pulpotomies were performed in seventy-nine primary teeth of 4 baboons. After coronal pulp resection, the pulp stumps were painted with ferric sulfate for fifteen seconds, in thirty-two teeth (group 1); in another thirty-two teeth, a cotton pellet moistened with dilution of formocresol was placed over the pulp stumps for five minutes, and removed (group 2). In fifteen teeth, IRM was placed directly over the pulp stumps after hemostasis (group 3--control). The teeth of all groups were sealed with IRM, and examined for inflammatory changes under a microscope by two blinded examiners. Seventy-seven teeth were assessed. Mild or no inflammation was found in 58 percent (18/31) of the teeth of group 1, in 48 percent (15/31) of those of group 2, and in 73 percent (11/15) of those of group 3. Severe inflammation was found in 35 percent (11/31) of group 1, 29 percent (9/31) of group 2, and in 7 percent (1/15) of group 3. No statistically significant difference between the three groups was observed for degree of inflammation, periradicular or interradicular abscess or inflammatory root resorption (chi-square p > 0.05). Dentin bridges were observed in 52 percent (16/31) of the teeth in group 1, 52 percent (16/31) of those of group 2, and in 73 percent (11/15) of those of group 3. No difference was found between the experimental and control groups for the presence of dentin bridge, (p > 0.05). Ferric sulfate produced pulp responses that compared favorably to those of diluted formocresol.

Animals↗

PubMed1996

Mandibular incisors, alveolar bone, and symphysis after orthodontic treatment. A retrospective study.

The mandible of a deceased 19-year-old young woman who had been treated with an edgewise appliance was removed during autopsy. The overall tooth movements during the 19 months of treatment were reconstructed (treatment documents) and compared with the macroscopic, radiologic, and micromorphologic findings of the incisor/alveolar bone/symphysis complex of the dry mandible. The initial lateral cephalogram revealed an extremely narrow and high symphysis, with an incisor position straight above the thin bone. During treatment, the incisors had been moved to lingual (lingual root torque) and derotated. Morphologic evaluation of the dry mandible revealed lingual (oral) aspects of the roots reaching some millimeters out of the lingual alveolar bone and largely without cortical plate covering. Lateral dental contact radiographs of any bone/incisor segment showed the sagittal alveolar bone width to be smaller than the labiolingual (orobuccal) diameter of the incisor roots. A comparison of the approximate pretherapeutic alveolar bone height, which was assessed by measuring the distance from the cementoenamel junction to the most coronal margin of any root resorption in scanning electron microscopy, with that of the specimen showed a calculated bone loss on the lingual aspect extending from 2.3 to 6.9 mm. On the labial (buccal) aspect, bone loss was far less pronounced. These results suggest that in the case of a narrow and high symphysis, pronounced sagittal incisor movements and derotation during routine orthodontic treatment with a fixed appliance may be critical and lead to progressive bone loss of lingual and labial cortical plates.

Adult↗