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Treatment of root fracture with accompanying resorption using cermet cement.

A method of treating an apical root fracture with accompanying resorption at the junction of the fracture fragments using glass-cermet cement is described. Endodontically, the material had previously been used for repair of lateral resorptive root defects and retrograde root fillings. Complete bone regeneration was observed three years post-operatively following treatment of the root fracture in the conventional manner. The various advantages of glass-cermet cement as a root filling material used in the technique described are discussed.

Adult↗

Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha. A retrospective clinical study.

A material of 885 luxated, non-vital incisors was evaluated radiographically with respect to healing of periodontal tissues including inflammatory root resorption and occurrence of ankylosis and cervical root fractures. The results were assessed after completion of calcium hydroxide treatment and 4 years after filling of the root canal with gutta-percha. After treatment with calcium hydroxide, periapical healing occurred in 95% of the teeth. Four years after filling with gutta-percha, periapical healing was present in 91% of the teeth. In the remaining teeth, recurrent or persistent periapical radiolucency was more frequent in overfilled than adequately filled teeth (P = 0.0001). There was no difference between immature and mature teeth. Inflammatory root resorption healed in 192 of 197 teeth (97%); in 5 teeth it developed into ankylosis. Ankylosis occurred in 13 teeth, all of which were intruded into the alveolar bone at the time of injury. The frequency of cervical root fractures was markedly higher in immature than mature teeth (P greater than 0.0001). Among immature teeth, the frequency of fractures was dependent on the stage of root development (chi 2 = 31.6) and ranged from 77% in teeth with the least to 28% in teeth with the most developed roots. The frequency of fractures was also related to the defects after healing of inflammatory root resorption in the cervical area of the root, significant at P less than 0.0001.

Calcium Hydroxide↗

Pulpal and radicular changes following maxillary subapical corticotomy.

Pulpal and radicular changes after subapical corticotomy in combination with posterior transfer of the maxilla were studied histopathologically using monkey jaws. When the surgical procedures were successful, the pulp tissues were kept alive, even though some slight atrophy and degeneration appeared. In some cases, however, severe reticular atrophy occurred which might be due to anaemia during operations.

Animals↗

Radiographic assessment of simulated external root resorption cavities in maxillary incisors.

Upper central and lateral incisors of three human skulls were used to assess radiographically the possibility of detecting cavities of different sizes and locations, drilled to simulate external root resorptions. The sequence of radiographs was evaluated by three endodontists, who were unaware of the experiment being done, using a 2 x magnifier. The first observation was done without comparing the radiographic images of the different cavities with the preoperative radiograph. For the second round of observation, each sequence was compared with the preoperative X-ray. The results showed that small cavities were more difficult to detect than the medium and large ones. Moreover, cavities located on the proximal surfaces were more easily detected than those located on the buccal surfaces. Finally, when the observers could compare with the preoperative radiographs (second round of observation), the rate of detection was considerably higher.

Chi-Square Distribution↗

Root resorption of replanted teeth: an SEM study.

Two replanted and subsequently expelled upper central incisors were observed under a scanning electron microscope to study the changes brought about by root resorption. The severity of resorption and the distribution of the affected areas were different in the two specimens. In the first case, large, deep excavations were found along a continuous bone defect which exposed the opposite root canal wall. Bacteria-like elements were found on the bottom of the eroded areas both on the outer and on the inner root surfaces. In the second case, resorption denuded the apical portion of the metal post. Erosive lacunae were visible in some areas while tubiform excavations were present close to the apical margin exposing the collagen network. The roots in the first case likely underwent inflammatory resorption while replacement resorption was thought to have occurred in the second case.

Adolescent↗

Periosteal connective tissue grafting or root coverage with enamel matrix derivative: a case report.

A 24-year-old female patient presented for the resolution of esthetic concerns associated with wide gingival recession facial to the maxillary left central incisor before orthodontic treatment. A periosteal connective tissue graft in conjunction with an enamel matrix derivative was used to achieve root coverage. This technique achieved healthy thick keratinized tissue coverage of the root surfaces and effectively improved the esthetics. These satisfactory clinical results have been maintained for 18 months, even through active orthodontic treatment.

Adult↗

Trauma quiz. Terribly troublesome, trauma teeth.

Unfortunately, we come across many traumatised teeth during our practising career. Some of these traumatic injuries are rather simple to treat whereas others provide us with a real challenge. It is absolutely essential that the diagnosis of the injury be known before any treatment is attempted. When it comes to trauma, however, defining the exact form of treatment can often be very difficult. In this paper I will discuss some of the cases that I have managed and leave it up to YOU to decide whether my treatment has been correct, incorrect or whether there is some other form of treatment that we have at our disposal that could have been attempted.

Adolescent↗

Use of dental implants in patients with Down syndrome: a case report.

Down syndrome is caused by trisomy of the 21st chromosome and is associated with well-described physical and systemic problems. Most people with Down syndrome have some degree of mental retardation as well as malformation of head and neck. Oral structures that are commonly affected include the tongue (macroglossia), abnormalities in the number and shape of teeth, and poor quality (osteoporotic-like) of alveolar bone and jaw. These oral malformations as well as a tendency toward poor cooperation in the dental office contribute to the belief among dentists that people with Down syndrome are not good candidates for oral rehabilitation with dental implants. This article describes the use of dental implants in the oral rehabilitation of a 16-year-old boy with Down syndrome. Although more experience is needed before dental implants can be considered a suitable option during oral rehabilitation in people with Down syndrome, this case report shows a promising beginning.

Adolescent↗

How repair cementum becomes attached to the resorbed roots of human permanent teeth.

Human premolars extracted for orthodontic reasons were fixed with a mixture of formaldehyde and glutaraldehyde and processed for light and transmission electron microscopy. About 15% of all available teeth showed signs of superficial root resorption. Quantitatively, the resorption lacunae were more frequent at the apical third of the root, when compared to the mid-root and the cervical levels. Qualitatively, the resorption areas appeared as shallow irregular concavities. The degree of resorption and/or repair varied considerably both within and between sites, ranging from arrested resorption to advanced repair. An about 1- to 2-microns-thick seam of exposed collagen fibrils of the residual dentinal matrix lined the resorbed root surfaces in the arrested stage of resorption. A particular class of mononuclear cells repopulated these surfaces and commenced to attach newly produced collagenous matrix fibrils to the exposed dentinal matrix. Increasing fibril formation and bundling resulted in a collagenous fiber fringe oriented perpendicular to the bottom of Howship's lacunae. Following the implantation and establishment of this initial fiber fringe, the junctional zone between the two matrices and further portions of the repair matrix became progressively obscured by a fine granular and electron-dense material, indicating the advancing front of mineralization. In addition, the junctional zone later attained a high degree of electron density and basophilia. Subsequently formed matrix derived from cementoblasts was structurally heterogeneous and resembled cellular intrinsic fiber cementum (CIFC). It is suggested that the initially produced matrix along resorbed root surfaces closely resembles that seen during initial formation of acellular extrinsic fiber cementum (AEFC), whereas further apposition results in a tissue with the characteristics of CIFC.

Adolescent↗

Five-year incidence rates and intraoral distribution of root caries among community-dwelling older adults.

The 5-year incidence and intraoral distribution of decayed and filled root surfaces were evaluated in 379 black and 323 white residents of North Carolina aged 65 and older. During the period of study, approximately 39% of blacks developed at least one root DFS compared with 52% for whites (Wald X(2) test, p = 0.062). When the results were calculated using the net root DFS increment, blacks did not have significantly higher rates than whites over the 5-year study period (0.52 surfaces/person versus 0.42 surfaces/person, Survey Regression, n = 363, p = 0.708). However, for blacks, the 5-year incidence density rate of root DFS was 0.26 per 60 surface-months at risk, and for whites the rate was 0.19 new root DFS per 60 surface-months (incidence density ratio = 1.33, 95% CI = 1.01-1.76, p = 0.047). Intraoral distribution patterns for root caries incidence revealed that the approximal surfaces of the anterior teeth were involved most frequently, particularly in the mandible and maxilla in whites, followed in decreasing order by the buccal surfaces of the lower anteriors and the mesial surfaces of the upper anteriors in blacks. Although root caries incidence rates were obviously low, there were significant differences in the occurrence of caries between blacks and whites. The pattern of occurrence was similar for both races with root surface disease being concentrated in the approximal surfaces of the anterior teeth in a small proportion of affected individuals, with whites presenting more filled root increments than blacks. These findings suggest a need for more caries treatment in blacks and increased monitoring of this population since they are at a higher risk for root caries.

Black or African American↗

The influence of the organic matrix on demineralization of bovine root dentin in vitro.

The effect of matrix degradation on the rate of demineralization of dentin lesions was investigated. It was hypothesized that the demineralized matrix would inhibit the demineralization of the underlying mineralized dentin. Bovine root dentin specimens were alternately demineralized and incubated with either a bacterial collagenase or buffer (control). The demineralization was carried out under various conditions: Acetic acid solutions were used to form incipient and advanced erosive lesions, and lactic acid solutions containing a bisphosphonate were used to form incipient subsurface lesions. Under all conditions, the demineralization was found to be accelerated when the matrix was degraded by collagenase. This increase was more pronounced in advanced erosive lesions than in incipient lesions. Microscopic examination of collagenase-treated specimens revealed that the matrix of erosive lesions contained several layers of differently affected matrices, whereas the matrix of subsurface lesions appeared to be equally affected throughout the lesion. In conclusion, the matrix degradation was different in erosive and subsurface lesions but promoted the demineralization in both types of lesions.

Acetates↗

Laser-fluoride effect on root demineralization.

Although the individual cariostatic effects of laser and fluoride have been shown, the combined effect of CO(2) laser and fluoride on root demineralization remains uncertain and was the main aim of this study. By using a pH-cycling system and Polarized Light Microscopy, we demonstrated the synergistic effect of fluoride combined with CO(2) laser treatment on reducing root demineralization. The mean lesion depths (in microm) for each group were 160 +/- 14 (Control), 113 +/- 8 (Laser treatment alone), 111 +/- 6 (Fluoride treatment alone), and 25 +/- 7 (Fluoride followed by laser treatment). A significant laser-enhanced fluoride uptake, characterized by the ToF-SIMS analysis, was revealed by the 37% and 400% increments in loosely and firmly bound fluorides (both p < 0.002) in laser-irradiated areas, compared with the non-irradiated controls. In conclusion, there is a significant synergistic effect of combined CO(2) laser and fluoride treatment on the inhibition of root demineralization, possibly due to laser-enhanced fluoride uptake in the root.

Carbon Dioxide↗

The insane root.

Explore the source record for details and available documents.

Pharmaceutical Preparations↗

Scanning electron microscopy of root resorption of feline teeth.

Scanning electron microscopy was carried out on 10 feline extracted permanent teeth from 3 cases with root resorption. Various-sized resorption lacunae were well defined, showing an etched pattern and configuration as shown in human deciduous teeth. In cats, regardless of the shape and depth of lacunae, the resorption lacunae showed opening dentinal tubules in the wall with or without cement matrix apperring only in the deep and round lacunae of human cases. Some specific process of mineralization for repairing dental root resorption was suggested in cats.

Animals↗