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PubMed2005

Osteoclast diseases and dental abnormalities.

Tooth eruption depends on the presence of osteoclasts to create an eruption pathway through the alveolar bone. In diseases where osteoclast formation, or function is reduced, such as the various types of osteopetrosis, tooth eruption is affected. Diseases in which osteoclast formation or activity is increased, such as familiar expansile osteolysis and Paget's disease, are associated with dental abnormalities such as root resorption and premature tooth loss. Less is known about the origin of the dental problems in these conditions as there are no rodent models of these diseases as yet. In this short review, the genes currently known to be mutated in human osteoclast diseases will be reviewed and, where known, the effect of osteoclast dysfunction on dental development described. It will focus on human conditions and only mention rodent disease where no clear data in the human are available.

Alveolar Process↗

PubMed2006

DNA analysis of the SH3BP2 gene in patients with aggressive central giant cell granuloma.

A mutation of the SH3BP2 gene is known to cause cherubism. As there are clinical and histopathological similarities between central giant cell granuloma and cherubism, we made a constitutional DNA analysis of the SH3BP2 gene in four patients with aggressive giant cell granuloma (having one or more of the following features pain, paraesthesia, rapid growth, or root resorption). We found no mutations in the SH3BP2 gene, which indicates that cherubism is a separate entity. However, a somatic mutation in a specific group of cells could cause the focal lesions in giant cell granuloma. Further DNA analysis of the tissue of giant cell granulomas therefore seems indicated.

Adaptor Proteins, Signal Transducing↗

PubMed2005

Characterization of epithelial cells derived from periodontal ligament by gene expression patterns of bone-related and enamel proteins.

The cells of epithelial rests of Malassez (ERM) are thought to play a number of roles, such as protection against root resorption and cementoblast differentiation. However, little is known about characteristics of these cells. In the present study, we compared the expression patterns of the bone-related proteins osteopontin (OPN), osteonectin/secreted protein, acidic and rich in cysteine (SPARC), osteoprotegerin (OPG), bone morphogenetic proteins (BMP-2 and BMP-4) and the enamel matrix proteins amelogenin and tuftelin in epithelial cells derived from human periodontal ligament (ECHPL) with those of human gingival epithelial cells (HGEC) and oral mesenchymal cells (human gingival fibroblasts, human periodontal ligament fibroblasts and human pulp cells). The mRNA expression patterns were determined by the reverse-transcription polymerase chain reaction (RT-PCR). Cytokeratin 8 mRNA was expressed by oral epithelial cells but not oral mesenchymal cells. The OPN mRNA levels in ECHPL were by far the highest in the five cell types investigated. ECHPL and oral mesenchymal cells expressed OPG mRNA, whereas HGEC did not. BMP-2, SPARC and tuftelin mRNAs were detected in ECHPL and the other cells examined. The oral mesenchymal cells expressed BMP-4 mRNA much more strongly than did the oral epithelial cells. Amelogenin mRNA expression could not be detected in any of the cells. These findings suggest that cultured ERM cells are characterized by expression of the cytokeratin 8, OPG and OPN genes.

Amelogenin↗

PubMed2004

Computed tomography of odontogenic myxoma.

AIM: The aim of this study was to determine the computed tomography (CT) presentation of odontogenic myxoma (OM) in a Chinese population and to compare them with those observed on the accompanying conventional radiographs (CR). MATERIALS AND METHODS: The files of the Department of Oral and Maxillofacial Surgery of the University of Hong Kong between 1989 and 2000 were reviewed for myxoma cases. RESULTS: Ten cases of OM were found of which eight had been investigated by CT. The formatted hard copy was found in seven cases, four in the maxilla and three in the mandible. Most of the OMs had a round shape but one was fusiform. CT was more likely to display a cortex and its perforation. All OMs had perforated cortices on CT with soft tissue appearing outside the bony contour in two cases. Contrast enhancement was apparent in six cases. Both CR and CT displayed septae, but the latter method revealed that most septae were situated at the periphery, presenting as "sunray" type spicules in one case. Tooth displacement and root resorption were more reliably observed on CR. CONCLUSION: The likelihood of perforation and pattern of septa of OM is better displayed by CT. CR should also allow a better assessment of the degree of definition of the lesion's margins with adjacent normal bone. Therefore, both CT and CR should be used in an investigation of an OM.

Adolescent↗

PubMed2006

Limited regression of central giant cell granuloma by interferon alpha after failed calcitonin therapy: a report of 2 cases.

Central giant cell granuloma (CGCG) is a benign lesion of the jaws with a sometimes locally aggressive behaviour. The most common therapy is surgical curettage which has a high recurrence rate, especially in lesions with aggressive signs and symptoms (i.e. pain, paresthesia, root-resorption and rapid growth). Alternative therapies such as interferon alpha (INFalpha) or calcitonin are described in the literature. In this study 2 patients with an aggressive CGCG are presented who were treated with INF mono-therapy. INF mono-therapy was capable of terminating the rapid growth of the lesion in both patients and induced a partial reduction. Total resolution, however, was not obtained and alternative treatment is still necessary.

Adolescent↗

PubMed2005

Morphological and functional rehabilitation of severely infra-occluded primary molars in the presence of aplasia of the permanent premolar: a clinical report.

This clinical report describes the fixed prosthodontic rehabilitation of an infra-occluded primary molar. Diagnostic considerations included the patient's age, occlusal status, condition of the infra-occluded tooth including the degree of infra-occlusion and root resorption, as well as adjacent alveolar bone levels. Due to the patient's young age, an invasive prosthetic approach was delayed in favor of an onlay restoration, which represented a more rapid and conservative therapeutic choice. The treatment involved the design and fabrication of a composite onlay on the deciduous molar using a ceramic optimized polymer on a fiber-reinforced composite framework. Three years later, intraoral radiography showed satisfactory marginal adaptation. No change was observed in periodontal tissues.

Adolescent↗

PubMed2006

Central giant cell granuloma of the jaws: a clinical, radiologic, and histopathologic study of 26 cases.

The clinical behavior of central giant cell granuloma (CGCG) of the jaws is variable and difficult to predict. Clinical data and follow-up information of 26 patients with CGCG were analyzed. Histologic features were correlated with the clinical course of the disease. In 16 patients the CGCGs were asymptomatic; 10 lesions presented with aggressive growth, pain, massive swelling, root resorption, cortical perforation, and/or recurrence. These patients were younger and the lesions were larger than in the nonaggressive group. The histomorphometric analysis proved a significant increase in large giant cells, fractional surface area, and mitotic activity in aggressive CGCG lesions. Immunohistologic investigation (Ki-67 and p53 stain) revealed no significant differences. After surgical treatment, 3 patients with aggressive lesions developed a recurrence. The data show that clinical and histomorphometric features may be reliable indicators for the differentiation between aggressive and nonaggressive CGCG. This should be accounted for to improve the individual planning of the treatment and follow-up.

Adolescent↗

PubMed1993

Prognosis of intracoronal bleaching with sodium perborate preparation in vitro: 1-year study.

Bleaching materials containing hydrogen peroxide have been used for treating discolored nonvital teeth but their use was occasionally associated with external root resorption. In a previous study it was found that the immediate results of bleaching teeth in vitro were equal for sodium perborate mixed with either water or hydrogen peroxide. The purpose of this study was to compare the bleaching prognosis of sodium perborate mixed with water or hydrogen peroxide over a 1-yr period. Extracted human teeth with intact crowns were discolored with human erythrocytes and bleached by sodium perborate mixed with either 30% hydrogen peroxide (group A), 3% hydrogen peroxide (group B), or water (group C). The bleaching materials were placed in the pulp chambers of the discolored teeth and sealed with IRM. They were replaced with fresh preparations after 3 and 7 days. After 14 days the coronal access cavities were sealed with composite resin and the teeth photographed with a color slide film under standardized conditions. The teeth were stored in artificial saliva for 1 yr and photographed after 3, 6, and 12 months. Two separate evaluators ranked the teeth by comparing them with the shades before and after bleaching. The bleaching success rates of the tested groups at each time interval were compared and analyzed statistically. It was found that after 1 yr all of the teeth in groups A and C maintained their shades. In 20% of the teeth in group B there was color regression. Statistically, these differences were not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Borates↗

PubMed1994

Analysis of a referral-based endodontic practice: Part 1. Demographic data and reasons for referral.

There is little information in the dental literature regarding endodontic practice profiles and the reasons for referral to endodontic specialists. This study was undertaken to analyze various details of 2000 patients referred to an endodontist in Perth, Western Australia. The 2000 patients were comprised of 1295 (64.8%) females and 705 (35.2%) males. They were referred by 405 different dentists, clinics, or hospitals. The main reasons for referral were: management of pain (24.1% of patients), calcified/blocked canals (17.7%), endodontic retreatment (15.0%), trauma (12.9%), surgery (6.5%), and perforations (6.0%). Other reasons for referral included root resorption, fractured instruments, combined endodontic-periodontal lesions, second opinions, nervous patients, and medical complications. There were 312 people that did not require endodontic treatment, resulting in 1688 patients having treatment on 2221 teeth. Review appointments were attended by 50.2% of those patients due for recall examinations. The wide range of treatment procedures required and the high number of cases referred for diagnostic reasons indicate that endodontists must be highly skilled in all aspects of diagnosis, treatment planning, and treatment procedures.

Dental Pulp Diseases↗

PubMed1993

Effect of various types of sodium perborate on the pH of bleaching agents.

Time-dependent changes in the pH value of various types of sodium perborate solutions used as bleaching agents were evaluated. Sodium perborate-monohydrate (MH), sodium perborate-trihydrate (TRH), and sodium perborate-tetrahydrate are available. Each perborate was mixed with 10%, 15%, or 30% fresh hydrogen peroxide or with bidistilled water in a powder to liquid ratio of 2 g:1 ml, respectively. The pH values were recorded at baseline and after 1h, 1 day, 3 days, and 7 days, respectively. At baseline the pH values of MH, TRH, and tetrahydrate in conjunction with 30% H2O2 were 8.7, 7.0, and 7.5, respectively. The pH increased significantly with decreasing concentrations of H2O2. For TRH, MH, and tetrahydrate mixed with bidistilled water more alkaline values were measured at baseline and after 1 h. Due to solidification of the samples, the pH could not be determined for MH starting day 1 and for TRH starting day 3. In conclusion, the pH of bleaching pastes depends on the content of water of crystallization in sodium perborate, H2O2 concentration, and time of measurement. The bulk of the mixtures recorded reached alkaline pH values of 10 to 11. It is recommended that the pH of the mixture being used be checked to avoid potential postbleaching root resorption.

Borates↗

PubMed1999

Results of intentional replantation of molars.

PURPOSE: This study evaluated the treatment outcome of intentional replantation of molars. PATIENTS AND METHODS: Twenty-nine patients were treated with intentional replantation because conventional apicoectomy was not possible. The success rate was judged by clinical and radiographic parameters. RESULTS: One molar (3%) had to be removed because of pain and mobility 4 weeks postsurgery, and three molars (11%) had to be removed during the first year because of periodontal problems. Four molars (14%) showed periodontal problems or root resorption, but are still in function and causing no obvious problems to the patients. Twenty-one molars (72%) were successfully treated. CONCLUSION: Intentional replantation is a reliable and predictable treatment for those cases in which conventional apicoectomy is hampered because of anatomic limitations or patient factors.

Adult↗

PubMed1978

Periodontal and pulpal healing of monkey incisors preserved in tissue culture before replantation.

The effect of delayed replantation and tissue culture as a prevention against root resorption was examined in green Vervet monkeys (Cercopithecus aethiops). Extracted incisors were kept in tissue culture medium (Eagle's medium) for 5--14 days before replantation. The extra-alveolar dry period before tissue culture ranged from to 0 to 60 min. Incisors not subjected to tissue culture served as controls. The animals were sacrificed 8 weeks after replantation. The following histologic parameters were registered for each tooth: surface resorption, inflammatory resorption, replacement resorption (ankylosis), downgrowth of pocket epithelium, and periapical inflammatory changes. The evaluation of the pulp included the extent, recorded in mm, of pulp survival. Histometric evaluation showed that teeth immediately placed in tissue culture medium for 5--14 days showed improved periodontal healing, exhibiting significantly less inflammatory resorption than control teeth immediately replanted. Also the extent of pulp survival was significantly increased in teeth replanted after tissue culture. Teeth bench-dried for 60 min and thereafter placed in tissue culture medium also showed a significant reduction in the amount of inflammatory resorption and increased amount of pulp survival compared with control teeth replanted after the 60-min dry extra-alveolar period. Replacement resorption (ankylosis) was found in all teeth in both groups.

Animals↗

PubMed1978

Central neurilemmoma of the jaws. Review of literature and case report.

Neurilemmomas presenting as primary central bone tumors are extremely rare. Only 21 cases have been reported to have arisen in the jaws; all except for one have occurred in the mandible. The majority of these have been associated with the inferior dental nerve. A case of a central neurilemmoma arising in the anterior mandible is reported. Its probable origin is from one of the alveolar branches of the incisive nerve--an unusual site in the mandible. The radiographic features include expansion of cortical bone, resorption of roots of teeth, the presence of lace-like bony septa and a spotty calcification within the tumor. The treatment and the prognosis are briefly discussed.

Child↗

PubMed1979

Anterior mandibular dentoalveolar advancement utilizing lyophilized bone.

Patients with low angle Class II malocclusions complicated by strong nasal and chin profiles, interarch width discrepancies, and an exaggerated mandibular curve of Spee present several diagnostic and treatment problems. Various treatment possibilities are discussed and anterior mandibular dentoalveolar advancement is suggested as a treatment for these patients. Lyophilized, homologous bone is recommended for placement into the defects created by segmental advancement to avoid root resorption and ankylosis caused by autologous bone grafts. Finally, a modified incision is presented that facilitates watertight closure of the surgical wound.

Adult↗

PubMed1980

Selection of allogenic tooth graft using HLA-A, -B, -C and DR typing and the MLC test.

An allotransplantation of a partly developed premolar from a 12-year-old daughter to her mother is reported. The tooth graft was selected by the use of HLA-A, -B, -C and DR typing and the MLC tests. Follow-up over a 3-year period included periodic identically taken radiographs, electric and galvanic pulp tests and tests for cytotoxic antibodies. Almost complete closure of the apex of the tooth has occurred with no sign of root resorption. The transplant has remained vital, and no production of antibodies against the graft has occurred.

Adult↗

PubMed1986

Cryopreservation as long-term storage of teeth for transplantation or replantation.

A method is presented which for the first time demonstrates the possibility of storing a human tooth over a period of 18 months in a frozen state with the periodontal membrane preserved viable, enabling the thawed tooth to heal with a normal periodontal ligament evaluated 2 years after autotransplantation. The cryopreservation technique included equilibration of the extracted tooth into 10% DMSO (dimethylsulphoxide) at room temperature in tissue culture medium including 10% human serum, freezing with a controlled rate of 1.2 degrees C/min to -40 degrees C and 6 degrees C/min to -100 degrees C, followed by transfer to and storage in liquid nitrogen at -196 degrees C. The tooth was thawed at a fast rate of approximately 100 degrees C/min, and DMSO was removed by slow equilibration at room temperature. A mature human bicuspid was autotransplanted after cryopreservation. Endodontic treatment was initiated 4 weeks after transplantation. 2 years after transplantation, the grafted tooth showed clinically and radiographically normal periodontal healing without signs of root resorption or marginal bone loss.

Adult↗

PubMed1983

Calcifying odontogenic cyst: a survey of 23 cases in the Japanese literature.

The clinical, radiographic and histological characteristics of the calcifying odontogenic cyst were studied in 23 well-documented cases in the Japanese literature. The cysts occurred equally in males and females whose mean age was 21 years. The appeared as a painless swelling with cortical expansion and involved the maxilla three times more often than the mandible. There was no report of the lesion involving the soft tissues. Radiographically, the lesions were unilocular in most cases and contained aggregates or dispersed foci in the radiolucencies which were diagnosed as odontomes in 5 cases. Unerupted teeth and root resorption of the adjacent teeth were noted in approximately half of the cases. Except for one case, they were simply enucleated under a diagnosis of cyst or odontome and recurrence was encountered in no case. The excised specimens consisted of cystic sacs mostly containing calcified materials with or without tooth-like structures which were histologically diagnosed as odontomes in 10 cases. An intimate relationship between the cysts and the unerupted teeth was observed in 4 out of 10 cases. The pathogenesis of the lesion is discussed.

Adolescent↗

PubMed1991

Rare earth magnets and impaction.

Aberration in the eruption process was found to be a prime etiologic factor in inducing impaction. Thus an ideal treatment approach should attempt to mimic the normal eruption modus. However, conventional traction methods have been found to be associated with gingiva inflammation, bone recession, reduced attached gingiva, periodontal pockets, exposed cementoenamel junction, and root resorption of the impacted and adjacent teeth. These side effects are the result of premature exposure of the impacted tooth to the oral cavity through a nonself-cleansing pathway and an uncontrolled force system. The present study introduces a new, magnetic attraction system, with a magnetic bracket bonded to an impacted tooth and an intraoral magnet linked to a Hawley type retainer. Vertical and horizontal magnetic brackets were designed, with the magnetic axis magnetized parallel and perpendicular to the base of the bracket, respectively. The vertical type is used for impacted incisors and canines, and the horizontal magnetic bracket is applied for impacted premolars and molars. A three-dimensional analysis of the magnetic force system, by means of the OMSS apparatus, found the small magnetic bracket combined with a large pole surface area of the intraoral magnet to exhibit the most efficient convergent guidance. For this report the magnetic eruption device was examined on one animal subject and four patients. The Nd2Fe14B magnets were coated with parylene and/or encapsulated in stainless steel housings. In deep impaction, the magnetic bracket was cold-sterilized before surgery, and the surgical mucoperiosteal flap was then sutured over the bonded magnetic bracket. Attraction was initiated 1 to 2 weeks after healing. Thus tooth emergence into the oral cavity replicated normal eruption conditioning. The system operated at an attractive force level of 0.2 to 0.5 N. Adjustment was accomplished by temporarily interposing a magnetic spacer between the two magnetic units. No side effects were observed in this restricted number of treated cases, and treatment time was reduced. The study recommends the application of magnets in the treatment of impaction on the grounds of less invasive surgical procedure, effective attractive forces at short distances, and controlled spatial guidance.

Adolescent↗