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At least 1,225 records · Page 68Linked to original sources
PubMed2005

Orthodontic extrusion of an extensively broken down anterior tooth: a clinical report.

A predictable esthetic restoration is not limited to the restored teeth; it has to include the gingival unit and its interface with the teeth involved. Failure to deliver restorations that maintain gingival health jeopardizes the success of any restorative procedure and creates potential for periodontal problems. Perforations, fractures, root resorption, or caries in the cervical area of the tooth, especially in the anterior part of the mouth, present many challenges to the clinician. Failure to place the crown margins on sound tooth material may violate the biologic width and should be considered a restorative failure. Orthodontic root extrusion or forced eruption is a well-documented clinical method for altering the relation between a nonrestorable tooth and its attachment apparatus, elevating sound tooth material from within the alveolar socket. It has some advantages over surgical crown lengthening, which is less conservative considering the sacrifice of supporting bone and the negative change in the length of the clinical crowns of both the tooth and its neighbors. This article presents a case of a maxillary right lateral incisor, extensively broken down following trauma, treated with orthodontic extrusion combined with gingival fiberotomy, without a need for a corrective surgical procedure.

Adult↗
PubMed2003

Intentional replantation of a mandibular second molar with long-term follow-up: report of a case.

A case is reported of a mandibular second molar that underwent non-surgical endodontic treatment and intentional replantation in an effort to relieve continued symptoms. A 15.5-year follow-up clinical examination revealed the patient to be asymptomatic, the tooth to be still functional, and a recall film showed no evidence of root resorption. The indications for and limitations of intentional replantation as well as recommended literature on the subject are discussed.

Female↗
PubMed2005

Physical properties of human premolar cementum: hardness and elasticity.

AIMS: To determine if the cementum on the maxillary right and left first premolars has identical physical properties. METHODS: Ten normal maxillary first premolar teeth, extracted from five orthodontic patients with a mean age of 14.0 years, were used. The teeth had not been subjected to an orthodontic force. The hardness and elastic modulus of the cementum were measured on the buccal and lingual surfaces of the roots at three locations: cervical third, middle third and apical third. RESULTS: There were no significant side-to-side differences in cementum hardness (Mean side-to-side difference: 0.0063 GPa; SD: 0.0279; p = 0.525) or elastic modulus (Mean side-to-side difference: -0.027 GPa; SD: 0.111; p = 0.814). The hardness and elastic modulus of the cementum decreased from cervical to apical regions on both root surfaces. CONCLUSIONS: Similar physical properties of the cementum on the maxillary right and left first premolars suggest that intra-arch comparisons can be used to investigate root resorption caused by orthodontic forces.

Adolescent↗
PubMed1989

Histologic evaluation of new attachment apparatus formation in humans. Part II.

There is conflicting evidence regarding the value of graft materials in enhancing the formation of new bone, cementum, and periodontal ligament (new attachment apparatus). Part II of this study compared the healing of intrabony defects with and without the placement of decalcified freeze-dried bone allograft (DFDBA) in a submerged environment. The most apical level of calculus on the root served as a histologic reference point to measure regeneration on root surfaces exposed to the oral environment. Biopsies were obtained at 6-months and evaluated histometrically by two investigators unaware of the treatment performed. Data from 9 patients with 30 grafted defects and 13 nongrafted defects were submitted for statistical analysis. Results indicate that in a submerged environment significantly more new attachment apparatus (P less than .05) and new bone (P less than .05) formed in grafted than nongrafted sites. Significantly greater loss of alveolar crest height occurred in nongrafted than grafted defects (P less than .05); regeneration of new attachment apparatus, new bone, and new cementum occurred more frequently in grafted than nongrafted defects. There was a greater chance for the regeneration of a connective tissue attachment in nongrafted intrabony defects than in grafted defects; new cellular cementum formed equally well on old cementum, dentin, or both old cementum and dentin in the same defect. The periodontal ligament was oriented parallel, perpendicular, or both parallel and perpendicular in the same defect; and, no extensive root resorption, ankylosis, or pulp death was observed in grafted or nongrafted defects.

Alveolar Process↗
PubMed2006

Intentional replantation of a mandibular molar: case report and 14-year follow-up.

This case report describes the nonsurgical endodontic treatment and intentional replantation of a mandibular molar and its nearly 14-year follow-up. A 56-year-old woman sought treatment with complaint of discomfort and sensitivity in the mandibular left area. The radiographic examination showed that the mandibular left first molar was endodontically treated, with over-instrumentation of the distal root and unsatisfactory obturation on the mesial root. A large periapical lesion was observed surrounding the roots. In view of the patient's limited interocclusal space and objection to undergo an apical surgery, intentional replantation was suggested as an alternative. The patient returned for clinical and radiographic follow-up at 15 days, 40 days, 6 months, 12 months, and once yearly thereafter. At the last visit, after 14 years, no painful symptomatology was reported, probing depth was no greater than 3 mm, the periradicular area had normal appearance and no evidence of root resorption or periapical lesion.

Dental Restoration Failure↗
PubMed1989

Histologic evaluation of new attachment apparatus formation in humans. Part III.

There is still controversy as to the role of bone grafting materials in the formation of a new attachment apparatus and component tissues (bone, cementum, and periodontal ligament). The purpose of this study was to compare the healing of intrabony defects with and without the placement of decalcified freeze-dried bone allograft (DFDBA) in a nonsubmerged environment in humans. The most apical level of calculus on the root served as a histologic reference point to delineate root surfaces exposed to the oral environment and to measure new attachment apparatus and new component tissue formation. Free gingival grafts were placed over grafted and nongrafted defects to retard epithelial migration. Biopsies were obtained at 6 months and regeneration was evaluated histometrically. Data from 12 patients with 32 grafted and 25 nongrafted defects were submitted for statistical analysis. Results indicate that in nongrafted defects, a long junctional epithelium formed along the entire length of exposed root surfaces and often extended apical to the calculus reference notch. Free gingival grafts did not enhance regeneration of a new attachment apparatus, new cementum, new connective tissue, or new bone in nongrafted defects. The formation of a new attachment apparatus was observed when intrabony defects were grafted with DFDBA (x1.21 mm); significantly more new attachment apparatus (P less than .005), new cementum (P less than .005), new connective tissue (P less than .05), and new bone (P less than .0001) formed in intrabony defects grafted with DFDBA than in nongrafted defects. There was a greater chance for regeneration of a new attachment apparatus and component tissues in grafted defects than in nongrafted defects. New cellular cementum formed on old cementum and dentin but more often formed over both in the same defect). The periodontal ligament was more frequently oriented perpendicular to the root; there was greater loss in alveolar crest height in nongrafted than grafted defects (P less than .05); and extensive root resorption, ankylosis, and pulp death were not observed in grafted or nongrafted defects.

Analysis of Variance↗
PubMed1997

Follow up after root canal treatment of young permanent molars.

The purpose of the present study was to assess the success of root canal treatment in permanent molars of children and adolescents. Twenty-eight endodontically treated first permanent molars of 18 patients aged 8 to 16 years at the time of treatment were examined. The age of the patient at the time of treatment ranged from 8 to 16 years (mean age 12.4 +/- 2.3). The majority of the treatments were done on the mandibular teeth (67%). Nine patients had one treated molar, eight patients had two treated molars and one patient had three treated teeth. None of the patients had all four molars treated. The time elapsed from the root canal treatment until our examination ranged from 24 months to 77 months (mean time 45.1 +/- 19.1). The examination included clinical and radiological parameters as follows: sensitivity to percussion, mobility, quality of restoration (contact point reproduced, overhang, secondary caries), periapical lesions before and after treatment, external root resorption, furcation involvement and interproximal bone resorption. Treatment was considered completely successful if no pathology was found. Only 10 teeth (36%) demonstrated complete treatment success, less than previously reported. No significant differences between mandibular and maxillary teeth were found with respect to any of the variables. The results suggest that considering a number of multidisciplinary criteria for assessing success of root canal treatments in first permanent molars of children and young adolescents is essential, and provides a realistic success rate.

Adolescent↗
PubMed2006

Premolar root changes following treatment with the banded herbst appliance.

AIM: The aim of this prospective study was to radiographically assess root morphology changes in maxillary and mandibular premolars following Herbst appliance treatment. PATIENTS AND METHODS: Twenty-five consecutive adolescents (19 boys and six girls, mean age 13.08 years) with Class II, Division 1 malocclusion were treated with the banded Herbst appliance for a mean period of 13.16 months. Periapical radiographs of the upper and lower premolars were obtained before appliance insertion and immediately after appliance removal using the parallel technique. All radiographs were scanned, digitized and analyzed using appropriately adjusted cephalometric software. The pre- and post-treatment length and area of the first and second maxillary and mandibular premolar roots were calculated. Statistical analysis included paired t-tests to evaluate pre- and posttreatment changes, and independent t-tests to compare the pre and post-treatment differences between the first and the second premolars, which served as controls. The level of significance was set at p <or= 0.05 for all tests. RESULTS: No statistically significant decrease in premolar root lengths or areas was noted following removal of the Herbst appliance. We observed a statistically-significant decrease in the root area of the first mandibular premolars compared to that of the second mandibular premolars. CONCLUSIONS: Although we observed no statistically-significant root morphology changes in the first and second premolars following Herbst appliance treatment, the mandibular first premolars revealed significantly more root resorption than did the mandibular second premolars.

Adolescent↗
PubMed1997

Attractive magnets for orthodontic extrusion of crown-root fractured teeth.

A subgingival crown-root fracture presents the clinician with a difficult restorative problem, including reaching the fracture line, and is complicated by the need to maintain the periodontal tissues in good health. The treatment options up to now have usually been limited to extrusion of the remaining root with a conventional orthodontic appliance, surgical intraalveolar transplantation of the root or extraction with bridge replacement. In this report, a new method of orthodontic extrusion with attractive magnets is presented. One or two neodymium-iron-boron magnets were attached to the remaining root and a second, larger neodymium-iron-boron magnet was incorporated in a removable appliance. The roots were extruded 2 to 3 mm with a force range from 50 to 240 cN during a treatment period of 9 to 11 weeks. Good force control at short distances, no friction, and no material fatigue of permanent rare earth magnets resulted in successful rapid extrusion. No evidence of soft tissue dehiscences, aberrant tooth mobility, or root resorption was found.

Adolescent↗
PubMed1996

Cytodifferentiation of the odontoclast prior to the shedding of human deciduous teeth: an ultrastructural and cytochemical study.

BACKGROUND: In human deciduous teeth, odontoclastic resorption takes place at the pulpal surface of the coronal dentine prior to shedding, and this resorption shows clear time-related histological changes (Sahara et al., 1992). METHODS: Using this phenomenon as an observation system, we examined the cytodifferentiation of human odontoclasts by light and electron microscopy. For a histochemical marker of odontoclast differentiation and function, tartrate-resistant acid phosphatase (TRAP) activity was determined by light and electron microscopic enzyme histochemistry. RESULTS: As root resorption neared completion, TRAP-positive mononuclear cells were initially detected in the pulp chamber. They had abundant mitochondria, small lysosomes, and moderately developed rough endoplasmic reticulum throughout their cytoplasm. In these mononuclear cells, TRAP activity was localized in compartments of the biosynthetic pathway, i.e., in cisternae of the endoplasmic reticulum and Golgi lamellae, as well as small lysosomes. The TRAP-positive mononuclear cells first made contact with the predentine surface by their elongated cellular processes. After attachment, they spread out along the predentine surface and developed specialized membrane structures, clear zones, and ruffled borders. Next, they fused with each other on the predentine surface and formed typical multinucleate odontoclasts. After termination of their resorption function, the odontoclasts lost their ruffled borders and became detached from the resorbed surface. Most of the detached odontoclasts had numerous large pale vacuoles and secondary lysosomes and appeared to be in the process of degeneration. CONCLUSIONS: The present study demonstrates that: (1) odontoclasts differentiated from TRAP-positive mononuclear cells, which presumably originate from circulating progenitor cells, (2) membrane specialization of odontoclasts, i.e., development of a clear zone and ruffled border, is induced following their contact with the resorption surface, (3) multinucleation of odontoclasts takes place only after their attachment to the resorption surface, (4) mature multinucleate odontoclasts can resorb predentine as well as dentine in the same way as osteoclasts resorb bone, and (5) at the end of the resorption, odontoclasts gradually lose their ruffled borders and become detached from the resorbed surface.

Acid Phosphatase↗
PubMed2005

A study of root canal morphology of human primary molars using computerised tomography: an in vitro study.

Knowledge of the size, morphology and variation of the root canals of primary teeth are useful in visualizing the pulp cavity during treatment. This study was carried out to investigate the applicability of Computed Tomography in studying the root canal morphology of the primary molars. A total of 60 primary molars.without any macroscopic root resorption were collected and divided into four groups. The samples were arranged in wax block and then scanned for evaluation in the CT Scanner both in axial and coronal plane. The results obtained from the scanned images were statistically analyzed to know the frequency, mean and standard deviation for all the groups. The images showed the complexity of the root canals of the primary molars and also several capabilities of the CT Scan in advance Endodontic research in primary teeth were observed.

Dental Pulp Cavity↗
PubMed1984

Focal sclerosing osteomyelitis/focal periapical osteopetrosis: radiographic patterns.

Forty-one histologically documented instances of focal sclerosing osteomyelitis and focal periapical osteopetrosis have been evaluated for radiomorphologic characteristics. These reactive lesions exhibit five distinct patterns that include periapical focal opacifications, target lesions, radiolucencies, multiconfluent configurations, and opacifications with concomitant root resorption. While an irritational origin can usually be detected in chronic sclerosing osteomyelitis, the cause of focal periapical osteopetrosis remains enigmatic.

Chronic Disease↗
PubMed2006

The effect of mineral trioxide aggregate on the apexification and periapical healing of teeth with incomplete root formation.

AIM: To evaluate the influence of mineral trioxide aggregate (MTA) on apexification and periapical healing of teeth in dogs with incomplete root formation and previously contaminated canals and to verify the necessity of employing calcium hydroxide paste before using MTA. METHODOLOGY: Twenty premolars from two 6-month old dogs were used. After access to the root canals and complete removal of the pulp, the canal systems remained exposed to the oral environment for 2 weeks. Canal preparation was then carried out using Hedström files, under irrigation with 1% sodium hypochlorite, 1 mm short of the radiographic apex. After drying, the canals of two premolars in each dog were left empty (control group). The other eight teeth in each animal were divided into two experimental groups. The apical thirds of the canals of group 1 were filled with MTA. In the teeth of group 2, the canals were dressed with a calcium hydroxide-propylene glycol paste. After 1 week, the paste was removed and the apical third was filled with MTA. All teeth were restored with reinforced zinc oxide cement (IRM) and amalgam. The animals were killed 5 months later, and blocks of the teeth and surrounding tissues were submitted to histological processing. The sections were studied to evaluate seven parameters: formation of an apical calcified tissue barrier, level of barrier formation, inflammatory reaction, bone and root resorption, MTA extrusion, and microorganisms. Results of experimental groups were analysed by Wilcoxon's nonparametric tests and by the test of proportions. The critical value of statistical significance was 5%. RESULTS: Significant differences (P < 0.05) were found in relation to the position of barrier formation and MTA extrusion. The barrier was formed in the interior of the canal in 69.2% of roots from MTA group only. In group 2, it was formed beyond the limits of the canal walls in 75% of the roots. MTA extrusion occurred mainly in roots from group 2. There was similarity between the groups for the other parameters. CONCLUSIONS: Mineral trioxide aggregate used after root canal preparation favoured the occurrence of the apexification and periapical healing. The initial use of calcium hydroxide paste was not necessary for apexification to occur, and has shown to be strongly related to the extrusion of MTA and formation of barriers beyond the limits of the root canal walls.

Aluminum Compounds↗
PubMed2005

Effect of electrophoretically activated calcium hydroxide on bacterial viability in dentinal tubules--in vitro.

To evaluate the ability of electrophoretically activated calcium hydroxide (CH) to eliminate bacteria in dentinal tubules. In an in vitro model of dentinal tubule infection, 18 cylindrical root specimens prepared from freshly extracted bovine teeth were used. After removal of the smear layer, intracanal dentinal tubules were infected with Enterococcus faecalis for 21 days. In 12 specimens, CH paste was placed in the root canals for 7 days. In six of these, an electrophoretic current (10 mA per 10 min), using two electrodes, was applied after placing the medicament in the canal. Powder dentin samples obtained from within the canal lumina using ISO 025, 027, 029, 031 and 033 burs were examined for the presence of vital bacteria by inoculating agar plates and counting colony forming units. anova with repeated measures was used to analyze results. A significant difference was found between experimental groups and the positive control group. CH and electrophoretically activated CH significantly (P <0.001) reduced bacterial viabilities in dentinal tubules to a depth of 200 microm. Treatment with electrophoresis was significantly (P <0.001) more effective than pure CH in depths of 200-500 microm. Specimens treated with electrophoretically activated CH showed no viable bacteria in dentinal tubules to a depth of 500 microm from the root canal space within 7 days. The time required for treatment of pulpal infection root resorption may be decreased, thus minimizing the risk of coronal fractures in young patients with traumatized teeth.

Analysis of Variance↗
PubMed1990

[Biomechanical principles of orthodontic movement of teeth with periodontal involvement].

The presence of a reduced periodontal attachment has three fundamental effects on orthodontic tooth movement: the diminished resorptive bone surface necessitates a reduction in the magnitude of force applied; the apical shift of the center of resistance requires an adaptation of the force systems used; (moment/force ratio); the limited anchorage quality of periodontally susceptible teeth has to be considered biomechanically. Orthodontic movement of teeth with reduced attachment therefore requires differented planning and application of force systems in order to avoid root resorption and further bone loss.

Alveolar Bone Loss↗
PubMed2006

Bleaching teeth treated endodontically: long-term evaluation of a case series.

The chromatic stability of nonvital discolored teeth, subjected to the combined intracoronal bleaching technique and to endodontic treatment, was evaluated at a distance of 16 yr (1989-2005). The series comprised 50 patients (age range 7-30 yr) selected from among those attending the Dental Clinic at "Federico II" University, Naples, between 1987 and 1989. After 16 yr, only 35 cases could be evaluated: in 22 of these cases (62.9%) the color had remained stable and was similar to that of adjacent teeth, indicating a successful outcome of the combined bleaching technique. There were 13 cases (37.1%) classified as failures because of marked color relapse. Radiology showed none of the cases re-examined to have undergone internal or external root resorption. These results confirm the validity of the combined intracoronal bleaching technique in terms of efficacy, rapid esthetic result, and safety.

Adolescent↗