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A scanning electron microscopic study of external root resorption in replanted dog teeth.

Root resorption after replantation of mature permanent dog incisors was examined by scanning electron microscopy. Three groups consisting of three extracted teeth each were kept in a saline solution for 5, 30, and 120 min before replantation. The first group was replanted with the pulp intact. The second and third groups were replanted after root canal filling by Calciobiotic Root Canal Sealer. After 90 days, the teeth were extracted and the apical root surfaces were examined. Severe inflammatory root resorption was observed in the first (intact pulp) group. For the root canal filled teeth, the degree of root resorption was observed to be much less in those kept in saline for 30 min than in those kept for 120 min.

Animals↗

Two approaches to the treatment of true combined periodontal-endodontal lesions.

Periodontal endodontal lesions present a difficult diagnostic and treatment challenge to the clinician and treatment often requires a combined therapeutic effort. Both endodontal and periodontal surgical procedures may be indicated for access and treatment of these lesions. This case report presents an early onset periodontitis patient with bilateral periodontal-endodontal lesions on mandibular first molars. Treatment included apical surgery followed by repeated scaling and root planing on one tooth and root canal obturation followed by a periodontal bone grafting procedure on the other. Both procedures resulted in clinical attachment gain as well as radiographic evidence of alveolar bone gain. This case report once again demonstrates that proper diagnosis followed by removal of etiologic factors and nonsurgical therapy or periodontal regenerative procedures can restore health and function in cases of severe attachment loss.

Adult↗

Spontaneous apical closure of an avulsed immature incisor.

Apical closure of nonvital teeth can be achieved by appropriate endodontic intervention. A case is reported in which apical maturation appears to have occurred without treatment and in the presence of sporadic drainage from a sinus tract stoma.

Child↗

Ultrasonic root-end preparation: clinical and radiographic evaluation of results.

PURPOSE: This study evaluated the results of periradicular surgery performed using ultrasonic root-end preparation. PATIENTS AND METHODS: The course of healing during observation periods ranging from 6 months to 3 years was examined in 157 teeth. RESULTS: One hundred forty-five teeth were successfully treated, for a success rate of 92.4%. CONCLUSION: It was concluded that the ultrasonic root-end preparation technique for periradicular surgery is a simple procedure that provides excellent results.

Adolescent↗

Histologic analysis of pulpal revascularization of autotransplanted immature teeth after removal of the original pulp tissue.

The survival rate of replanted and autotransplanted teeth is mainly affected by the reaction of the pulp. Pulpal necrosis can cause periapical inflammation and inflammatory root resorption. The purpose of this study is to learn more about the pulpal changes in autotransplanted immature teeth whose pulp tissue was removed before transplantation. The experimental material consisted of 16 single-rooted teeth with open apices, from a beagle dog (3 months of age). At day 0, 4 teeth were extracted, the pulpal tissues were removed, and the teeth were then transplanted to their contralateral side. The same procedure was carried out on days 9, 16, and 23, each time for 4 single-rooted teeth. Longitudinal paraffin sections were made for histologic investigation. The results showed that, after 7 days, 2 of the 4 teeth had an ingrowth of new tissue over one fourth of their length. After 14 days, all 4 teeth had ingrowth (> or =one fourth of the pulp chamber). At the 21-day observation, more than half of the pulp chambers of all teeth were filled, and, after 30 days, there was total ingrowth in 3 of the 4 teeth. This new tissue consisted of well-organized and well-vascularized connective tissue.

Animals↗

Surgically assisted rapid palatal expansion: orthodontic preparation for clinical success.

Close root proximity between the maxillary central incisors presents a problem in the surgical management of a maxillary palatal expansion. During the surgical fracture of this interdental area, the possibility exists for a separation to occur between the root surface and the bone. If this does occur, it is paramount that the gingival attachment remain intact. Asymmetric separation places more stress on the mesial gingival attachment because of the anatomy of the gingival fiber apparatus. Gingival detachment results in epithelial downgrowth in an apical direction, which in turn prevents bone apposition in a coronal direction. The resulting osseous defect is difficult to treat with an osseous graft procedure, as there are few if any intrabony walls. Treatment planning should include analysis of a recent periapical radiograph of the incisor roots to determine the need for orthodontic root separation before surgery. A postsurgical periapical radiograph should be taken to determine where the interdental separation has occurred. The expansion schedule should be adjusted depending on the symmetry of the separation and the health of the gingival attachment.

Adult↗

Long-term clinical and radiologic evaluation of autotransplanted teeth.

The purpose of the present study was to investigate the radiologic results of 40 autotransplantations (20 molars and 20 premolars) performed in the orthodontic department of the University of Geneva between 1979 and 1990. The sample demonstrated persistence of pulp vitality and continuous root development, followed, however, in most cases by replacement root resorption. The data were in accordance with previously published studies and point to an ideal developmental stage for molar and premolar transplantation to ensure pulpal and periodontal survival.

Adolescent↗

Dental root resorption.

This article presents a review of physiologic mechanisms involved in various types of root resorption that may be encountered clinically. Included is a brief overview of suggested homeostatic mechanisms of the periodontal ligament and the role of the intermediate cementum in inhibiting root resorption. Root resorption (surface, inflammatory, and replacement) associated with traumatic injuries is discussed, with emphasis on etiology and the ability to provide treatment. The final discussion relates to other types of resorption, based on a classification of internal, cervical, and external resorption associated with periradicular pathosis and resulting from pressure in the periodontal ligament.

Humans↗

Intentional replantation for periodontally involved hopeless teeth.

The aim of this study was to evaluate the clinical and radiographic results of intentional replantation of periodontally involved teeth after conditioning of root surfaces with tetracycline-HCl. Thirteen patients (seven female, six male; age range: 35-52 years) with 15 periodontally involved hopeless teeth were included in this study. During the replantation procedure, the affected teeth were gently extracted, then the granulation tissues, calculus, remaining periodontal ligament and necrotic cementum on the root surfaces were removed. Tetracycline-HCl, at a concentration of 100 mg ml(-1), was applied for 5 min to the root surfaces. The teeth were then replaced into the socket and splinted. Patients were clinically and radiographically evaluated at baseline (time of surgery) and 6 months after the surgery. The following measurements were recorded: probing depth (PD), gingival recession (R), the amount of bone loss (BL) and bone gain (BG). Results indicated a reduction in PD and in the amount of bone loss and healthy gingiva. Mean PD was decreased from 5.25 to 2.36 mm, gingival recession was increased from 3.73 to 4.0 mm, and BL was reduced from 73.20 to 56.86%. At the end of 6 months, no root resorption or ankylosis was observed radiographically. Even during the short period of evaluation, it may be suggested that intentional replantation can be an alternative approach to extraction in cases where advanced periodontal destruction is present and no other treatments could be considered.

Adult↗

Effect of minocycline on healing of replanted dog teeth after extended dry times.

Minocycline is available as a locally administered tetracycline derivative antibiotic (Arestin, OraPharma, Inc., Warminster, PA, USA) which demonstrated antibacterial activity and anti-inflammatory action that may slow down resorptive processes after severe traumatic injuries to the dentition. A total of 48 premolar roots of six mongrel dogs were instrumented in an aseptic fashion with rotary nickel-titanium files and obturated with vertically condensed warm gutta percha. All accesses were sealed with glass ionomer, the roots extracted and then allowed to bench dry for 60 min. Group 1 consisted of 15 roots that were coated with minocycline and replanted and nine roots that were replanted without minocycline. Group 2 consisted of 24 roots, all of which were prepared with a uniform cemental defect down to sound dentin along the lateral aspect of the root, with a high-speed bur following the 60-min dry time. Half of the roots (12) were then coated with minocycline and replanted, and the other 12 roots were replanted without minocycline. After 4 months, the dogs were killed and the roots prepared for histological evaluation. About 5- microm thick cross-sections of the root and surrounding tissue taken every 90 microm were evaluated for healing. In addition, residual root mass was also measured in the roots of group 1 to determine the extent of root structure loss for each treatment method. The roots with and without minocycline treatment showed no significant differences between the remaining root mass or the percentage of favorably healed root surfaces. The use of minocycline is not currently recommended for prevention or attenuation of external root resorption following avulsion in a dog trauma model.

Animals↗