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[Interaction between orthodontic tooth movement and hydroxyapatite ceramics].

A pilot study examined the clinical and histological effects of orthodontic tooth movement in hydroxyapatite-augmented ridges in animal models. Responses observed at the interface between the clinical root and the ceramo-osseous regeneration were negative: impairment of periodontal function had led to immobility and root resorption. On the basis of this experience one must advice against using this approach in humans at the present time. Further studies will be conducted to elucidate the relevant clinical questions.

Alveolar Ridge Augmentation↗

[A case of horizontal impaction of mandibular left and right deciduous central incisors].

This paper reports on a rare case of horizontal impaction of the mandibular left and right deciduous central incisors. The patient was a 4 year and 7-month-old-girl at the time of first visit to our clinic. She had no previous history, and there was no family history or anomaly in her general physical condition. All the deciduous teeth except the mandibular left and right deciduous central incisors had already erupted. The right deciduous central incisor was impacted completely and the left one erupted with its incisal edge about 2 mm at the lingual gingiva. In the X-ray examination, the horizontal impaction of the mandibular left and right deciduous incisors were noted. There were no cysts, odontoma or tumors. Both of them were extracted to prevent loss of space for the permanent central incisors. Each root of both teeth was curved 90 degrees in the lingual direction at half of length of the root. There was no anomaly of figure and color in their crowns. In the histopathologic examination, there was no anomaly except for the small root resorption at the labial and lingual sides. 3 years and 3 months after extraction of the deciduous central incisors, approximately two thirds of the crowns of the left and right mandibular permanent central incisors have erupted. Both of them incline to the lingual direction and rotate and there is a space of about 5 mm between them. This case is still under observation.

Child, Preschool↗

[A treated case of anterior teeth crowding accompanied with periodontal disease].

On a 23-year-old woman who came to our hospital for anterior teeth crowding accompanied with severe periodontal tissue disease, from which she wanted to be recovered within 2 years, as cc, treatment of the paradental disease was performed for a year, then 55/44 were extracted and length discrepancy was improved in a year according to the edgewise method. Both these treatments removed all of the inflamatory symptoms such as local bleeding, drainage, etc, which had been noted before treatment, leading to normally functional occlusion. X-ray didn't reveale alveolar crest and or root resorption following the orthdontic tooth movement but, there is rather a considerable elevation of the alveolar line of the 2 1 1 2 region.

Adult↗

The unerupted or impacted third molar--a critical appraisal of its pathologic potential.

The prophylactic removal of asymptomatic unerupted or impacted third molars constitutes a major proportion of all oral surgical procedures. Patients are advised to have this preventive surgery on the basis that such teeth, if retained, are likely to cause certain pathologic lesions. The evidence in the scientific literature on the prevalence of dentigerous cysts, mural ameloblastoma, epidermoid carcinoma and root resorption indicates that this concern is exaggerated. The retrospective data on the reasons for extractions of third molars confirm this conclusion. Until there are prospective studies which demonstrate a significant patient benefit from surgery exceeding the risks of retention, the practice should be discontinued. Third molars should be removed only where there is a defined pathologic indication.

Dentigerous Cyst↗

Indications for surgical removal of the mandibular third molar. Study of 2,630 cases.

Indications for surgical removal of 2,630 impacted mandibular third molars were studied. The investigation comprises all operations during a period of 12 months and was carried out at 4 departments of oral surgery within the Stockholm area. The average age of the patients was 27 years. Pathological changes were seen in about 60% with pericoronitis as the most common diagnosis. Root resorption of the adjacent molar was seen in 4.7% and cysts in 4.5%. Orthodontic indications were noted in 10.7%. In about 20% of cases, prophylactic indications (i.e. complications were predicted of tooth remained) were given as the reason for extraction. It was stated that the indications were in some cases uncertain. Further studies of relevant factors are therefore well motivated.

Adolescent↗

Traumatically injured primary incisors: a clinical and histological study.

World-wide epidemiological studies state that from 8 percent to 30 percent of children up to 7 years of age sustain injury to primary incisors, including crown fracture, root fracture, tooth avulsion, and dental displacement, which result in malformation of permanent incisors depending upon their state of development. In this study, traumatized primary incisors were evaluated clinically and radiographically, with the following data recorded: exact or approximate time-interval of traumatic episode(s) and extraction, mobility, color change, sensitivity to percussion/palpation, swelling, sinus tract, caries, crown/root fracture, periodontal/periapical lesions, external/internal root resorption, mineralization, and obturation. Based upon the local damage and developmental age, 138 teeth were extracted, fixed in 10 percent formalin, and processed for histological evaluation according to routine methodology. Histologic findings were: the presence of varying extent of necrosis, bacteria in the area of necrosis--not in all cases--neutrophilic leukocytes, chronic inflammatory cells, pulpal calcifications, resorption/apposition, and circulatory changes. The blood pigment distinguished hemorrhage due to extraction from pathologic circulatory changes. All the described reactions varied in intensity and extent with the time interval and the assumed force of the original trauma. Physical trauma to primary teeth caused pulpal damage, which could involve periapical tissue, depending on the extent of the initial damage.

Child↗

[Corrective movement of a palatal impacted canine tooth: methodology and outcome of a combined oral surgery/orthodontic procedure].

In 24 patients, 31 palatal impacted maxillary canines were brought in position using the same surgical and orthodontic concept. After temporal surgical exposure a little silver chain was attached at the crown of the canine, the mucoperiostal flap was repositioned, and the canine was moved into its position by innovative orthodontic treatment means. The combined method is described intensively. With respect to the applied technique the results indicate that according to the criteria of periodontal status, vitality, bone support, root resorption and occlusion no differences exist to free erupted canines despite a mean orthodontic correction of 36.7 degrees.

Cuspid↗

Anterior tooth trauma in the primary dentition: incidence, classification, treatment methods, and sequelae: a review of the literature.

A review of the literature is presented to discuss anterior tooth trauma in the primary dentition. Studies show that the incidence ranges from 4 percent to 30 percent and varies depending upon the sex and age of the child. Classification of the type of trauma is subdivided into trauma to the tooth and trauma to the periodontium. Treatment modalities depend upon various factors and range from nontreatment to splinting to extraction. Possible sequelae of primary tooth trauma may include tooth discoloration, loss of vitality, root resorption and/or abscess formation. Careful follow-up is recommended following any type of trauma, because the ultimate goal in treatment is to prevent damage to the permanent successor.

Aftercare↗

Effects of fluoride on dental pulp of young rabbits.

Fluoride has been adopting as an anticariogenic agent for many years. Many histologic experiments with the effect of fluoride were made on dental hard tissue, but little is known about its effect on dental pulp. We made histopathological tests on dental pulp of rabbits during administration of fluoride. In this study, 24 young New Zealand rabbits aged 7 days were used. The experimental group (N = 20) was given two intraperitoneal injections of sodium fluoride that contained approximately 7 mg F/kg body mass. The control group (N = 4) was injected with an equivalent volume of normal saline. At the thirteenth day after the final injection, the mandibles were collected and processed according to routine histologic methods. Selected sections were stained with hematoxylin and eosin stain. The mandibular incisor pulp was microscopically examined. The following results were obtained. In the experimental group, histopathologic alterations were observed in the pulp, with loss of palisading of the odontoblastic layer. Slightly elongated swollen odontoblasts were found which showed hydropic alterations. Dilatation and hyperemia of blood vessels were also noted. This dose affected deciduous root resorption and changes in secretory ameloblasts; and also appeared to disturb the dental pulp. The present observations of initial reactions in the pulp following intraperitoneal injection of fluoride are considered suitable as a basis for detailed discussion of histopathologic implications.

Animals↗

Diagnosis and treatment planning for unerupted premolars.

Premolars rank third in frequency after third molars and maxillary canines in impacted or unerupted teeth. Failure to detect and analyze the problem may lead to unnecessary space loss, crowding, or collapse of the dental arch. A diagnostic scheme is presented to facilitate diagnosing and treating unerupted premolars. Important observations include: Diagnosing congenitally missing permanent teeth. Whether the condition is generalized or localized. Whether the succedaneous tooth has a viable form, eruptive potential, and viable orientation Whether the delayed eruption is due to over-retained primary molars such as ankylosis and incomplete root resorption. The amount of space available for the succedaneous tooth to erupt The presence of overlying soft tissue or bone. Space management and proper management of primary molars will frequently facilitate uneventful eruption of premolars. Orthodontic guidance of eruption is rarely indicated if problems can be detected early and managed properly. Four case reports elucidate the recommended treatment methods for these commonly occurring unerupted premolars.

Ankylosis↗

Galactosylceramide lipidosis (Krabbe's disease) and deciduous dental tissues. A case report.

The deciduous teeth of a 5-year-old girl affected by a protracted type of infantile globoid-cell leukodystrophy or Krabbe's disease, a galactosylceramide lipidosis, were examined with the scanning and transmission electron microscopes. The diagnosis was established on the basis of galactosylceramidase activity (0.04 mu katal/kg proteins versus 0.86 +/- 0.49 in the normal situation) and abnormalities in the white matter and trouble in myelinization assessed by magnetic resonance imaging. In spite of the fact that enamel, dentin and pulp are extraneural tissues, they were also affected by the disease. Ultrastructural observations of dental mineralized tissues revealed enamel hypoplasia as well as abnormal proteinaceous lamina and hypomineralized lines or bands. Inside the mantle dentin, dendritic inclusions of amorphous material were seen. Lysosomal storage inclusions were observed in all the cells of the dental pulp. The myelin sheaths of dental peripheral nerves displayed severe degenerative changes. Proliferation of dentinoclasts contributed to stimulate root resorption.

Child↗

Retention of a maxillary primary canine: fifty years above and beyond the call of duty.

A case is reported of a retained maxillary primary canine that functioned effectively over fifty years. At the time of exfoliation the tooth was still of normal length and was lost not because of ankylosis and root resorption, but because of periodontal disease. Excellent histological preservation of the specimen at the time of exfoliation, together with a very complete clinical history, permitted the development of a detailed description of a tooth and its dying pulp while under function over a long period of time.

Cuspid↗

Interobserver variability in radiographic interpretation of pediatric dental diseases: a pilot study.

Interobserver variability in radiographic interpretation of dental disease may be a result of clinical bias, education, training, experience or other factors, and may potentially lead to misdiagnosis of disease. Few studies have investigated variability related to dental specialty. The purpose of this pilot study was to determine interob-server variability in radiographic interpretation of pediatric dental diseases using a small number of observers, consisting of a pedodontist, an orthodontist and an oral radiologist. These specialists interpreted initial radiographic surveys of 200 pediatric patients (4.5 to 15.5 years old). The results showed no differences in interpretations of radiographic signs of dental abnormalities except for caries, abnormal primary root resorption due to the eruptive path of a permanent tooth and presence of a congenital/developmental tooth abnormality. These findings will be used to design future studies which will include a larger number of observers from different dental specialties.

Adolescent↗

Orthodontic retraction into recent and healed extraction sites. A histologic study.

The aim of this experimental study was to assess the advantages of an early or delayed treatment start after tooth extraction on the basis of hard-tissue findings (density, maturity, osteodynamics) and of soft-tissue responses at the extraction site. Following bilateral extraction of the second incisors, reciprocal space closure was initiated in 3 foxhounds (age: 3.5 years): group 1 (6 teeth) 12 weeks after extraction, group 2 (6 teeth) immediately after extraction. After an 8-week bodily tooth movement period and a 2-month retention period, evaluation was undertaken on the basis of clinical/radiologic and histologic criteria (sequential polychromatic bone marking, light microscopy). Histologic analysis yielded the following findings in group 1 (delayed tooth movement): low bone density at the extraction site with more mature lamellar bone, pronounced horizontal atrophy of the alveolar process with periosteal bone apposition in direction of tooth movement, increased tendency towards gingival invagination. The findings in group 2 were characterized by: higher bone density with less maturity (bundle bone) at the extraction site, broader alveolar process, reduced tendency towards gingival invagination. No qualitative difference between the 2 groups was found with respect to root resorption. The histologic findings therefore indicate that orthodontic retraction into extraction sites should be initiated at an early stage.

Animals↗

Endodontic applications of guided tissue regeneration in endodontic surgery.

This paper is intended to provide an overview of different endodontic applications in guided tissue regeneration. It is our expectation that using these techniques, where applicable, will increase endodontic surgical success. We have described six different clinical conditions including external resorption, root perforation, dehiscence, palatal grooves, oblique root fractures, and large periapical lesions. We believe the use of guided tissue regeneration techniques will allow us to predictably treat teeth that otherwise might be extracted.

Combined Modality Therapy↗

Dental transplants: discussion and case report.

A 21-year-old Chinese male patient presented to an urban dental clinic with a transplanted molar, which had been removed from a human cadaver. The tooth was in occlusal function for three years, stable, and without mobility. Radiographs of the tooth showed root resorption and apparent ankylosis. Individual transplantation of human teeth has been considered surgical dental treatment of an empirical nature for centuries. Two types of human tooth transplantation are usually considered in the dental literature. An allotransplantation or allograft is a transplantation of tissue (tooth) between different individuals of identical species. An autotransplantation or autograft is a transplantation of tissue within the same individual (obviously within the same species). Replacement of an avulsed tooth, while technically an autograft is considered a replantation, rather than a transplant. Tooth transplantations in the late 20th century are usually performed in developing third world countries, where patient dental education is minimal, and the cost of more technology based forms of tooth replacement (prosthodontics, synthetic implants) are economically prohibitive. Transplantation of permanent teeth is rarely seen in the United States in the 1990's due to the use of titanium implants, although pediatric, adolescent, and disabled patients, especially those with limited incomes, could benefit from the re-introduction of dental transplants.

Adult↗