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PubMedDate not supplied

Radiographic assessment of primary molar pulpotomies restored with resin-based materials.

PURPOSE: The aims of this study were to: (1) retrospectively assess the overall performance of formocresol pulpotomies in primary molars when definitively restored with a resin-based material; and (2) compare the results to previously published studies using more traditional restorative techniques (stainless steel crown, amalgam). METHODS: Records of a 2-operator pediatric dental office using this novel restorative technique were reviewed. Pre- and postoperative radiographs of pulpotomized primary molars restored with Z-100 and with a minimum of 6 months of follow-up were compared to the contralateral nonpulpotomized tooth. Radiographic success was determined by the absence of furcation/periapical osseous radiolucency and internal/external pathologic root resorption. Patient's age, gender, tooth type and arch, follow-up time, ZOE base type used (IRM only or IRM with glass ionomer overlay), and number of surfaces involved were the variables analyzed in the study. Statistical analysis was performed using chi-square analysis. RESULTS: Fifty-nine teeth in 52 patients met the selection criteria. Patient's age at treatment ranged between 44 and 118 months, with an average follow-up time of 21 months (range = 7 to 43). Significant failure rate was found in the mandibular arch (P = .035). When only the occlusal surface was restored, 100% success was obtained. With proximal restorations, 83% (15/18) success was obtained when the base was IRM followed by glass ionomer and 69% (22/32) success for IRM only (P = .259). CONCLUSIONS: Overall, restoration of pulpotomized primary molars with resin-based material was inferior to reported success rates using stainless steel crowns. When proximal surfaces were restored, the failure rate (26%) was comparable to amalgam (23%). Prospective studies with larger sample size are necessary for definitive conclusions.

Chi-Square Distribution↗

PubMedDate not supplied

Intralesional corticosteroid injection for central giant cell granuloma: a case report and review of the literature.

Central giant cell granuloma (CGCG) is a benign intraosseous lesion of the jaws that is found predominantly in children and young adults. Although benign, it may be locally aggressive, causing extensive bone destruction, tooth displacement and root resorption. The common therapy is aggressive curettage, peripheral ostectomy or resection, which may be associated with loss of teeth and, in younger patients, loss of dental germs. A number of alternative nonsurgical approaches have been advocated in recent years for the management of CGCGs. These include intralesional corticosteroid injections, calcitonin injections and subcutaneous alpha-interferon injections. In this article, an 1-year-old boy with a CGCG is successfully treated with corticosteroid injections and this treatment is discussed within a review of the literature.

Adrenal Cortex Hormones↗

PubMed2005

Three-dimensional micro-computed tomographic evaluation of periodontal regeneration: a human report of intrabony defects treated with Bio-Oss collagen.

This study utilized three-dimensional micro-computed tomography (micro-CT) to evaluate the regenerative response to Bio-Oss Collagen when used alone or in combination with a Bio-Gide bilayer collagen membrane for the treatment of four intrabony defects (5 to 7 mm) around single-rooted teeth. The micro-CT observations are compared to the clinical, radiographic, and histologic results, which have been previously reported. After reflecting a full-thickness flap, thorough degranulation and root planing were accomplished. Bio-Oss Collagen was then used to fill the defects, and in two cases a Bio-Gide membrane was placed over the filled defect. Radiographs, clinical probing depths, and attachment levels were obtained before treatment and immediately preceding en bloc resection of teeth and surrounding tissues 9 months later. A mean pocket depth reduction of 5.75 mm and mean clinical attachment level gain of 5.25 mm were recorded. The histologic evaluation demonstrated the formation of a complete new attachment apparatus with new cementum, periodontal ligament, and alveolar bone at the level of and coronal to the calculus reference notch. Micro-CT evaluation confirmed the histologic results and demonstrated the absence of ankylosis or root resorption for all specimens. This human histologic study demonstrated that Bio-Oss Collagen has the capacity to facilitate regeneration of the periodontal attachment apparatus when placed in intrabony defects. Micro-CT observations confirmed the histologic results and enhanced the three-dimensional understanding of periodontal wound healing. The results indicate that micro-CT may be useful for three-dimensional evaluation of periodontal regenerative procedures.

Animals↗

PubMed2005

Light-force technique for the early treatment of an ectopic tooth.

Free crown tipping can be useful when teeth do not erupt in their physiologic sequence and a real intraosseous migration and eruption of a single tooth into a distant ectopic position can be observed. This article presents a case of an ectopic mandibular lateral incisor treated early, with the light-force technique and uncontrolled forces, and finished with the bidimensional edgewise appliance. A Caucasian female patient, 10 years 10 months of age, had a mandibular left lateral incisor displacement, with the lateral incisor crown positioned mesial to left second primary molar. An early treatment was planned to correct the mandibular left lateral incisor displacement and to allow proper eruption of the mandibular left canine and first premolar. A second phase of treatment, in permanent dentition, was planned for the dental Class II subdivision on the right and deep bite correction. Phase 1 treatment was completed after 10 months; phase 2 treatment was initiated in the permanent dentition and lasted 18 months. Treatment achieved the following outcomes: (1) mandibular lateral incisor in corrected position; (2) full canine and molar Class I relationship; (3) overjet and overbite within the normal limits; (4) symmetric arches; and (5) a balanced profile. The radiograph evaluation revealed good root parallelism and mandibular left lateral incisor light root resorption. The light-force technique is not only a possible alternative but the ideal appliance for treatment in the mixed dentition, when the permanent teeth should be controlled.

Child↗

PubMed2005

Socket preservation followed by dental implant supported restorative treatment: a case report.

Implant-supported restorative treatment continues to revolutionize all aspects of dentistry. Any clinical procedure(s) with the potential to enhance and improve the success of implant-supported restorative treatment will gain favor with both practitioner and patient. Socket preservation following tooth extraction appears to offer several clinical advantages in preparing the ridge for future implant placement. A case report is presented describing treatment of a patient with evidence of root resorption of the maxillary central incisors, resulting in extraction and socket preservation followed by implant supported restorative treatment.

Adult↗

PubMed2006

Odontogenic myxoma--a case report and clinico-radiographic study of seven tumors.

The primary aim of this paper is to present clinical and radiographic aspects of odontogenic myxomas diagnosed at the Stomatology Clinic of Bauru School of Dentistry, University of São Paulo, Brazil and to compare them with data reported in a series published in the literature. A second objective is to report a clinical case of odontogenic myxoma in a 9-year-old patient in whom the lesion involved the anterior region of the maxilla. Dental records between 1975 and 2000 were reviewed and seven cases diagnosed as odontogenic myxoma were found in individuals aged from nine to 60 years. Of these, four occurred in women and three in men. The mandible was affected in five cases and the maxilla in two. All patients presented with asymptomatic swelling in the affected area. A mixed radiographic result was observed in five patients, while in two patients the lesion was completely radiolucent. The borders of the lesion were well-defined in six patients. In four cases there was dental displacement, although root resorption was not observed in any of these. The treatment of choice was surgical excision. Four cases did not recur during the period of follow-up, which varied from nine months to 19 years. It was concluded the clinico-radiographic study of odontogenic myxomas should be continually refined with the aim of offering the patient an appropriate treatment, since the lesion presents a high potential for recurrence.

Adolescent↗

PubMed2006

[Simple bone cyst in the mandible--a rare occurrence in an elderly patient].

Simple bone cyst (SBC) is an intra-osseous pseudocystic lesion lined by a thin fibrovascular membrane but lacks an epithelial lining. SBC is uncommon and comprises of approximately 1% of all jaw cysts. The lesion is usually discovered incidentally during the first two decades of life. Males are affected slightly more frequently than females. The most common sites of occurrence are the molar and premolar regions of the mandible; maxillary lesions are uncommon. The lesion is usually solitary, radiolucent, well demarcated, and non-expansile. Margins may be scalloped, between vital teeth, and root resorption is rare. A surgical approach to the lesion reveals an empty cavity with serosanguinous fluid. Histologically, the cavity lining consists of a loose connective tissue layer and hemosiderin-laden macrophages. Pathogenesis and etiology of SBC are still not clearly understood. It is assumed that the cyst forms following traumatic intra-osseous hemorrhage with subsequent lysis and resorption of the cellular content. Trauma, as the main cause of SBC, is not always conclusive and the origin of the lesion may be multifactorial. Treatment of SBC is by curettage. Intralesional hemorrhage due to either intentional curettage or during exploratory procedure may induce a reparative process. A rare occurrence of SBC in a 71 year old healthy male, referred to the Oral and Maxillofacial Outpatient Clinic, Sheba Medical Center by his dentist, because of a large radiolucent lesion in the left mandibular body is reported. The patient received a complete lower denture 3 months earlier. He returned to his dentist with a complaint of local pain and an ulcer under the denture. A panoramic radiograph revealed a large unilocular radiolucent lesion with demarcated borders in the left mandibular body and bone erosion in the upper alveolar border of the lesion Clinical examination showed a deep ulcer in the denture-bearing area of the left posterior alveolar ridge. There was no cortical expansion of the mandible. Incisinal biopsy revealed an empty cavity lined by fibrous connective tissue with no epithelial lining. According to the clinico-radiologic and histologic findings, a diagnosis of a simple bone cyst was made. The incidence of SBC is higher in younger age groups (second decade). Occurrence of the lesion in the elderly is rare with only a few reports in the literature. In the present case, the fact that SBC is asymptomatic, may be responsible for the late discovery of the lesion.

Aged↗

PubMed2006

Twenty-year follow-up of an unconventional intentional replantation.

For many years, intentional replantation has been a treatment option for pulpless teeth and an effective strategy for teeth that would be difficult, if not impossible, to treat using traditional root canal therapy. The preservation of cell vitality in the periodontal ligament, the removal of all tissue debris and irritating substances from the root surface, achievement of a good apical seal and reinforcement of the crown structure are critical in ensuring normal function of the reimplanted tooth. In this article, we report on an unconventional intentional replantation of a mandibular second molar to relieve continuing symptoms. Retrograde fillings were placed in the second molar and the coronal pulp chamber was sealed with amalgam. No endodontic therapy was carried out either during or after the procedure. After 20 years, the patient was asymptomatic, the tooth was still functional and a recall intraoral periapical radiograph showed an intact periodontal ligament space and lamina dura with no evidence of gross root resorption or ankylosis.

Follow-Up Studies↗

PubMed2006

Clinical performance of pulpotomized primary molars restored with resin-based materials. 24-month results.

PURPOSE: To evaluate the clinical and radiographic success rates of pulpotomized (formocresol) primary molar teeth restored with a resin-based composite (TPH) or a polyacid-modified resin composite (Dyract AP) over a 2-year period. METHODS: 100 composite and 100 compomer restorations were placed over pulpotomized teeth by two clinicians in 84 patients. Two other calibrated clinicians evaluated the restorations using the modified USPHS/Ryge criteria observing the following characteristics: marginal discoloration, marginal adaptation, wear/anatomic form, enamel loss and caries. Mann Whitney U test, Friedman test and Wilcoxon signed ranks tests were used for statistical analysis (P= 0.05). RESULTS: At 24 months, 80 composite and 72 compomer restorations were available for evaluations. Except for baseline, compomer restorations showed significantly more marginal discoloration (P= 0.001) and marginal disintegrity (P= 0.001) than did the resin composite. Compomer restorations demonstrated a significant increase in minor enamel cracks along restoration margins over time (P= 0.001), but no chipping or loss of enamel was detected. Caries was observed only in 2.8% of compomer restorations and was restricted to restoration margins. 2% of composite and 17% of compomer restoration-treated teeth were extracted due to radiographic evidence of failure. Pathological root resorption patterns observed beneath failed compomer restorations were strongly suggestive of coronal microleakage.

Child↗

PubMed1991

Complications of orthodontic treatment.

Certain complications and limitations have been associated with orthodontic treatment. The current literature obviously has not addressed all complications, but the following review highlights interesting findings and studies that may improve understanding and management of root resorption, ankylosis, implants, periodontal damage, instability, and relapse.

Ankylosis↗

PubMedDate not supplied

[Periodontal new attachment therapy].

The ultimate goal of periodontal therapy includes not only the arrest of progressive periodontal disease, but also the restitution of those parts of the supporting apparatus which were destroyed by the disease. Regeneration of periodontal structures dissolved because of periodontal disease is the goal of reconstructive periodontal treatment procedures. The achievement of this goal requires the formation of new cementum with inserting collagen fibers of previously periodontitis involved root surfaces possibly with a concomitant regeneration of supporting alveolar bone. Healing, after periodontal therapy, leads to the formation of long junctional epithelium, root resorption, ankylosis, etc. These are repair process and not one of regeneration. But guided tissue regeneration seems to lead to regeneration with active periodontal ligament cells.

Guided Tissue Regeneration, Periodontal↗

PubMed1991

New trends in computed tomography of the head and neck.

Pathology in the head and neck region is now often examined using MR imaging. However, CT remains a very valuable tool for staging of tumors and lymph nodes in the pre- and postoperative periods. In cases of sinusitis, CT has completely replaced conventional radiography. Moreover, CT helps in differentiating hypointense spots seen in the paransal sinuses on MR. In dental radiology, CT is superior to pantomography in detecting root resorption due to impacted teeth. Thanks to the development of new scanners, three-dimensional reconstructions are possible and scanning times are reduced.

Head↗

PubMed1991

[Oligodontia with prosthodontic rehabilitation. A case report].

Oligodontia or partial anodontia is the congenital absence of one or more teeth. The inconvenience to patients will vary depending on the specific teeth and the number of teeth that are missing. Permanent teeth are often involved. This report describes an oligodontia case in a 12 years old boy, who had only seven permanent teeth, with root resorption of all remaining deciduous teeth. This boy had problems with esthetics, mastication, and phonation. The prosthesis for him included two splinted porcelain crowns on the upper certral incisors, a conventional maxillary RPD, and a overlayed mandibular RPD. It is necessary for us to monitor this case to achieve better results in the future.

Anodontia↗

PubMedDate not supplied

[Orthodontic effects of tooth injury to the permanent and temporary incisors of children and the adolescent [corrected].

Traumatisms on the deciduous upper incisors could induce orthodontic indirect consequences on the permanent germ, dependent on his growth level and his malleability, dependent on connection between the root of deciduous incisor and the crown of permanent germ and according to the type of traumatism. According to those various data, it should be observed on the permanent incisor: germination of two germs, multiple odontoma, crown dilaceration, severe tipping of the crown with facial angulation, retention of the permanent germ with lack of root resorption of the deciduous teeth or simple cross-bite, without speaking of enamel defect.

Child↗

PubMed1990

[Retrospective evaluation and experimental radiographic study on bone reaction concomitant with orthodontic tooth movement].

Concomitant with orthodontic tooth movement a radiographically dense zone of high mineralisation can be observed on the periodontal tension side. This zone consists of the alveolar cortical bone and mineralized osteoid. This bone reaction has not evoked much interest in orthodontic literature in the past. In a retrospective study, orthopantomograms of children in orthodontic treatment were evaluated, and the discussed reaction was studied in relation with different treatment parameters. Opaque bone layers were found in cases in whom the orthopantomogram was made within 6 months after initiating tooth movement. When using elastics for tooth movement the bone reaction under discussion was comparatively rare. There is no proneness to root resorption in teeth showing the described adjacent bone reaction. Bone reaction was also studied with a densitometric radiological procedure. In all 9 cases the bone reaction was observed.

Adolescent↗

PubMed1990

Supernumerary teeth in the premaxillary region: its effects on the eruption and occlusion of the permanent incisors.

The presence of supernumerary teeth in the premaxillary region may cause a variety of pathological effects. This study was carried out to determine the various aspects of supernumerary teeth in the premaxillary region, particularly the effects of the supernumerary teeth on the permanent incisors and surrounding tissues. Approximately 20 percent of the patients (n = 49) with supernumerary teeth did not present with any abnormality. A high proportion of patients (37.9 percent) had delayed or failure of eruption of permanent teeth and 24.1 percent had rotation or displacement of permanent teeth. Other effects observed were median diastema and cystic changes around the unerupted supernumerary tooth. The high proportion of pathological effects seen showed that early diagnosis of the anomaly is important to intercept damage to the adjacent normal teeth and surrounding tissues. However, no cases of root resorption of the permanent teeth due to the presence of supernumeraries were observed.

Adolescent↗

PubMed1990

[Beagle dogs in periodontal research: a review].

This review intends to focus on the role dogs play in periodontal research. Dogs have given insight in the occurrence, the etiology, the pathogenesis and the treatment of periodontal diseases although some differences with humans exist. The occurrence of root resorption, the better healing capacity and the progression rate of periodontitis are among those differences. Knowledge of the periodontal conditions in dogs is required to be able to evaluate the obtained results and its implications for humans carefully. This seems especially true for the ongoing research in tissue regeneration.

Animals↗

PubMed1990

[Experience with surgical-orthodontic management of impacted and retained upper canines].

On basis of experiences obtained in the course of the surgical orthodontic treatment of 26 upper impacted and retained, respectively, incisors it has been established that, at given conditions, positioning the incisor into occlusion should be tried, even if the axis position approaches 90 degrees. The lesion is discovered relatively lately, many do not risk the treatment and the number of interrupted treatments is high as well. There is possibility to avoid possible complications, interruption of joining to force system, loss of anchorage, pulpa necrosis, root resorption, cysta follicularis.

Child↗