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Results for “Root Resorption”

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PubMed1980

A time-related study of periodontal healing and root resorption activity after replantation of mature permanent incisors in monkeys.

Periodontal and pulpal healing was registered histometrically at different observation periods after replantation of mature incisors in green Vervet monkeys. Maxillary central incisors and mandibular lateral incisors were extracted and then replanted after either 0- to 18 min. In the 18 min. group, the teeth were stored dry prior to replantation. The animals were sacrificed 1-, 2-, 4-, or 8 weeks after replantation. The mobility of the replanted teeth was determined and histological examination carried out. The following parameters were registered for each tooth: periodontal ligament healing, surface resorption, inflammatory resorption, replacement resorption (ankylosis) and the extent of vital pulp. Periodontal ligament healing, as assessed histologically or via mobility testing, was almost complete 2--4 weeks after replantation. Surface resorption was first recognized after 1 week and became prominent after 2 weeks; the frequency increased slightly after 4- and 8 weeks. Inflammatory resorption was first recognized after 1 week and showed a rapid extension with increasing observation periods. Replacement resorption was first noted afer 2 weeks, where the peak frequency occurred. The frequency decreased in both groups with increased observation periods. The 18 min. group showed significantly more replacement and inflammatory resorption than the immediate replantation group. Finally, an analysis of the systematic error of histometric registration of root resorption showed that the uneven distribution of root resorption upon the root surface could lead to significant errors in the registration of root resorption activity unless a proper sectioning plane was chosen and an adequate number of measuring locations along the root surface was used.

Animals↗

PubMed2005

Multiple idiopathic external apical root resorption: report of four cases.

Multiple idiopathic external root resorption is an unusual condition that may present in a cervical or an apical form. In this article, we review the published literature relating to multiple idiopathic external apical root resorption and present four clinical cases. We consider the aetiology of this condition and discuss the various treatment options.

Adult↗

PubMed1996

Examination of external apical root resorption with scanning electron microscopy.

UNLABELLED: External apical root resorption may be evident histologically but not visible radiographically until it is advanced. If working length is determined without considering this resorption, overinstrumentation or overfilling may occur. OBJECTIVE: This study used scanning electron microscopy to examine the appearance and to compare the incidence of external apical root resorption in 40 teeth with differing pulpal and periapical diagnoses. STUDY DESIGN: After extraction, 46 roots were sectioned horizontally 6 mm from the anatomic apex and prepared for scanning electron microscopy examination. Photomicrographs were scored by two blinded independent examiners. Apical resorption was categorized as: none, partial, or complete. Presence or absence of a funneling appearance of the resorption was also recorded. RESULTS: Kruskal Wallis showed a significant difference in resorption between groups; teeth with irreversible pulpitis/normal periapex had the least resorption. Duncan's multiple range test found radiographic apical lesions to have more resorption than those without lesions; teeth with necrotic pulps had more resorption than those with vital pulps. CONCLUSION: Pulp necrosis with radiolucent apical pathosis is more likely to demonstrate resorption.

Chi-Square Distribution↗

PubMed1989

[Apical root resorption of maxillary central incisors following orthodontic treatment].

This research shows the relationship between orthodontic treatment and apical root resorption. The latest edgewise appliance with a pre-adjusted bracket (Alexander method) was used in the present experimentation. Examination by roentgen cephalometry and intraoral radiography was performed before and after the maxillary central incisors had been moved orthodontically. The conclusion is that there was no significant difference among the grade 0, 1, 2 and 3 of apical root resorption in the change of long axis inclination of the maxillary central incisors. But there was a significant difference among the grade 0, 1, 2 and 3 of root resorption in the distance of the apical root movement. The most apical root resorption was observed when the apical root was moved lingually.

Humans↗

PubMed2006

RANKL increase in compressed periodontal ligament cells from root resorption.

The ligand receptor activator of NFkappaB (RANKL) plays an important role in osteoclast formation. However, very little is known about the relationship between external apical root resorption during orthodontic treatment and RANKL. We hypothesized that compressive force is responsible for RANKL formation and up-regulation of osteoclastogenesis in periodontal ligament (PDL) cells from patients with severe orthodontically induced external apical root resorption. RANKL and osteoprotegerin (OPG) production, TRAP-positive cells, and resorptive pits were determined. The increase of RANKL and the decrease of OPG were greater in the severe root resorption group than in the non-resorption group. The numbers of TRAP-positive cells and resorptive pits were also increased in the severe root resorption group than in the non-resorption group. These results support the hypothesis that the compressed PDL cells obtained from tissues with severe external apical root resorption may produce a large amount of RANKL and up-regulate osteoclastogenesis.

Adolescent↗

PubMed1987

Orthodontic relapse, apical root resorption, and crestal alveolar bone levels.

This investigation examined the relationship of postorthodontic treatment relapse to crestal alveolar bone support and root resorption. Thirty-six persons having completed the retention phase of orthodontics at least 10 years earlier were divided into two groups based on the amount of relapse crowding of the mandibular anterior teeth. Eighteen subjects (relapse group) exhibited 2 mm or more of mandibular anterior relapse crowding and 18 subjects (nonrelapse group) exhibited no mandibular anterior relapse crowding. At time of recall, full-mouth series of periapical and bitewing radiographs were obtained as well as lateral cephalometric films to allow comparison with similar lateral cephalometric films obtained at pretreatment and retention time points. The radiographs were examined to assess three parameters: root resorption, crestal alveolar bone levels, and changes in the position and angulation of the maxillary incisors. The subjects in the relapse group had undergone longer periods of treatment and exhibited a greater prevalence of root resorption; they also displayed significantly greater crestal alveolar bone level distances, indicating greater loss of bone support than that observed in the nonrelapse group. The distances that teeth were translated seemed to affect the extent of root resorption and crestal bone loss with smaller amounts of tooth translation seemingly more prone to demonstrate tissue loss. The findings of this investigation suggest there may be a relationship between orthodontic relapse and the parameters of increased root resorption and decreased crestal alveolar bone levels.

Adult↗

PubMed1998

Subattachment inflammatory root resorption: treatment strategies.

Attempts have been made to classify root resorption according to its etiology in order to develop more efficient strategies for its treatment. This condition has been identified as resulting from damage to the protective attachment layer (predentin or precementum) of the root combined with inflammation adjacent to the root surface. This article demonstrates a series of treatment strategies focused on the reversal of each manifestation of subattachment root resorption, specifically emphasizing defects that extend apically and localized defects.

Humans↗

PubMed2001

Root resorptions in upper first premolars after application of continuous torque moment. Intra-individual study.

MATERIAL AND METHOD: With the purpose of investigating the occurrence, localization and extension of possible root resorptions after fixed appliance treatment with a continuous torque force, 28 upper first premolars orthodontically indicated for extraction from 14 patients were analyzed by scanning electron microscopy. Tooth movement was carried out with continuous moments of different magnitudes (300 cNmm, and 600 cNmm), using a biomechanical model with superelastic wires (stainless steel-NiTi-SE), which was specially designed and individually calibrated. The teeth were divided into one control group with four premolars (non-moved) from two patients, and two experimental groups (300 cNmm and 600 cNmm respectively) with six patients each. Each group was distributed intra-individually as follows: the right first premolar of six patients was extracted after 1 week of movement, the left first premolars were removed after 2, 3 and 4 weeks. After extraction, teeth were fixed, treated with 2% sodium hypochlorite solution for 6 hours in order to remove the organic tissue components, dehydrated, and metal-coated in a Balzers SCD 050 apparatus. RESULTS: The analysis in a scanning electron microscope (Jeol 6100, at 10-15 kV) revealed many resorption lacunae in the root surface, mainly on the lingual side in the apical third of the roots. Resorption processes were also observed on the buccal root surface in the cervical third. All experimental teeth showed resorption areas. Teeth which had been moved for a longer time period and with a higher magnitude of applied moments showed a higher degree of root resorption in width as well as in depth. Higher magnitude of moments produced exposure of root dentine, evidencing pronounced root resorption.

Bicuspid↗

PubMed2005

Longer orthodontic treatment may result in greater external apical root resorption.

DATA SOURCES: Medline was the primary data source, with references of identified papers then being reviewed for additional studies. STUDY SELECTION: Studies were included if they were clinical trials, in English, of samples of greater than 10 subjects who had undergone fixed appliance orthodontic treatment and who had both pre- and postoperative X-rays available. A measurement of external apical root resorption (EARR) in maxillary incisors was essential as was a measure of displacement with the apex of the root as reference. DATA EXTRACTION AND SYNTHESIS: Variables were coded and articles graded by three independent investigators who subsequently negotiated final coding and assessed the methodological soundness of each study. A cumulative 'meta-analysis factor' was computed for each article. Articles were evaluated on study design; population sample; treatment assignment; documentation of statistics; the accuracy of root resorption measurement and apical displacement of incisor roots. A funnel plot analysis did not identify publication bias. RESULTS: Eight articles were included in the statistical analysis. Two did not contain data for mean apical displacement and therefore correlations between mean EARR and mean apical displacement could not be calculated for them. The mean meta-analysis factor was 39 (range, 12-78). Mean root resorption was 1.421+/-0.448 mm (n=8), and mean apical displacement was 2.382+/-0.756 mm. The weighted correlation coefficient between mean root resorption and apical displacement was 0.822 and that between mean root resorption and treatment duration was 0.852. CONCLUSIONS: This analysis suggests that treatment-related root resorption is correlated with the distance the apex moves and the length of time the treatment took.

Comment↗

PubMed2004

Exploring the third dimension in root resorption.

OBJECTIVE: To review and investigate the validity of various 2D quantitative measurement techniques, and to explore the third dimension of root resorption. DESIGN: A review of the literature involving various quantitative evaluation of root resorption. RESULTS: Quantitative evaluation of resorption using radiographs has proven to be highly inaccurate because of magnification errors and their inability to be readily repeated and reproduced. Studies using histology sections of samples have proven to be laborious and technique sensitive. Inherent parallax errors and loss of material in data transfer have denied the true understanding of this 3D event. CONCLUSION: With the evolution in computing technology and digital imaging, the vision of evaluating the extent of root resorption in 3D has materialized. It was demonstrated that 3D volumetric quantitative evaluation of root resorption craters was feasible and its accuracy and repeatability was high.

Humans↗

PubMed1995

The repair of orthodontic root resorption: an ultrastructural study.

It has previously been shown by light (LM) and scanning electron microscopy (SEM), that after force is terminated, repair of the orthodontic root resorption lacunae occur by deposition of new cementum. The ultrastructural details of the process are not well established. Since it has been hypothesized that a new barrier to protect the root surface is formed during the reparative phase, new information on this aspect of orthodontic root resorption may be valuable. The aim of the present investigation was, by using transmission electron microscopy (TEM), to study in more detail the repair of orthodontic root resorption lacunae and the re-establishment of the adjacent periodontal membrane (PM). Three experimental tooth movement groups of rats (age 40-45 days) were used. The maxillary first molar was moved mesially by a closed coil spring for 10, 14, and 21 days. The results indicate that transition of active root resorption into a process of repair which occurs even in the presence of a light force, is associated with invasion of fibroblast-like cells from the circumference into the active root resorption site. After 10 days, formation of new tooth supporting structures was seen in the periphery of the resorption lacunae, while active resorption by multinucleated odontoclast-like cells (OD) took place in the central parts. In the later phases, after termination of force, the repair process is similar to the early cementogenesis occurring during tooth development. New mineralized cementum was observed on the resorbed root surface by 21 days. After deposition of the new cementum, the structures of a new periodontal ligament (PDL) were comparable with the control specimens.

Animals↗

PubMedDate not supplied

Microscopical aspects of root resorption of human deciduous teeth.

In order to obtain detailed information on the tissue changes which occur during physiological root resorption, 52 human deciduous teeth at various stages of resorption were studied under light microscopy. The early stage of root resorption was defined as resorption of not more than one third of the root length; the late stage was defined as resorption of more than one third. A close topographical interrelationship was found among che sites of pressure of the permanent tooth, the extent of root resorption and the types of tissue changes. Linear resorption (which reflects suspension or marked slowing down of resorption) and redeposition of hard tissue were more pronounced at the early stage of resorption, while lacunar resorption was more pronounced at the late stage. There were pronounced haemorrhagic and inflammatory infiltrates within the pulp at the late stage of resorption and the subodontoblastic cells disappeared as the infiltrates took over the tooth. False denticles were found frequently, especially at the early stage of resorption. Unexpectedly, acellular cementum was found to be deposited against secondary dentine at the cuspidal tip of the pulp chamber of seven teeth, independently of any sign of resorption nearby. These data indicate that: 1) the pressure exerted by a permanent tooth is the most important factor in the differentiation of odontoclasts. 2) the extent of lacunar (i.e., active) resorption correlates directly with the resorption rate, which is higher at the late stage of root resorption. 3) inflammation is a consequence, rather than a cause, of resorption; it may lead to the loss of subodontoblastic cells and a consequent decrease in the ability of the pulp cells to replace damaged odontoblasts. 4) the pulp of the deciduous tooth might be cementogenic in some way, given that about 13% of the samples were found to be so.

Adolescent↗

PubMed1989

Progression of root resorption following replantation of human teeth after extended extraoral storage.

Avulsed human permanent teeth subjected to a minimum of 1 h dry extraoral storage before replantation were followed radiographically for an average of 4.8 years. The depth of root resorption cavities was assessed using a radiographic index, and the rate of root resorption was defined as the index change over time. The frequency of inflammatory and replacement resorption was determined at each observation time. Replacement resorption increased in frequency with time in all patients. In teeth endodontically treated within 3 weeks of replantation, minimal inflammatory resorption was found regardless of the age of the patients. In teeth where endodontic treatment was performed more than 3 weeks after replantation, the frequency of inflammatory resorption was significantly higher in young patients but not in older patients, up to more than 3 years after replantation. The rate of root resorption was found to be related to age. In patients 8-16 years old at the time of avulsion the rate of root resorption was significantly higher compared with patients 17-39 years old. Age had a higher impact on the rate of root resorption compared with the delay in endodontic treatment after replantation. It was concluded that a tooth replanted with a necrotic periodontal membrane will become ankylosed and resorbed within 3-7 years in young patients, whereas a tooth replanted under similar conditions in older patients may remain in function for a considerably longer time.

Adolescent↗

PubMed1998

A new approach in restorative treatment of external root resorption. A case report.

This case report describes the treatment of an external root resorption with extensive loss of tooth structure and bone at the labial surface of an upper left central incisor. The area of bone loss and root resorption was surgically exposed and an impression was taken using curing silicone. An individual ceramic insert was fabricated, allowing endodontic retreatment through an artificial root canal. The insert was incorporated using a dentin bonding system and a dual curing luting composite. Following endodontic retreatment and internal bleaching, a ceramic veneer was bonded to the tooth to obtain good esthetics and to improve stability. Twenty months after surgical treatment no further root resorption could be detected radiographically. A shallow residual pocket but no bleeding on probing was found.

Adult↗

PubMed2004

GENETIC FACTORS IN EXTERNAL APICAL ROOT RESORPTION AND ORTHODONTIC TREATMENT.

External apical root resorption (EARR) is a common sequela of orthodontic treatment, although it may also occur in the absence of orthodontic treatment. The degree and severity of EARR associated with orthodontic treatment are multifactorial, involving host and environmental factors. Genetic factors account for at least 50% of the variation in EARR. Variation in the Interleukin 1 beta gene in orthodontically treated individuals accounts for 15% of the variation in EARR. Historical and contemporary evidence implicates injury to the periodontal ligament and supporting structures at the site of root compression following the application of orthodontic force as the earliest event leading to EARR. Decreased IL-1beta production in the case of IL-1B (+3953) allele 1 may result in relatively less catabolic bone modeling (resorption) at the cortical bone interface with the PDL, which may result in prolonged stress concentrated in the root of the tooth, triggering a cascade of fatigue-related events leading to root resorption. One mechanism of action for EARR may be mediated through impairment of alveolar resorption, resulting in prolonged stress and strain of the adjacent tooth root due to dynamic functional loads. Future estimation of susceptibility to EARR will likely require the analysis of a suite of genes, root morphology, skeleto-dental values, and the treatment method to be used-or essentially the amount of tooth movement planned for treatment.

Journal Article↗

PubMed2001

Quantitative analysis of apical root resorption by means of digital subtraction radiography.

OBJECTIVE: This study was performed to assess the diagnostic and quantifying ability of digital subtraction images for simulated apical root resorption, as well as to compare the diagnostic accuracy of conventional intraoral radiographs with digital subtraction images for this condition. STUDY DESIGN: Digital and intraoral radiographs of 10 sound maxillary central incisors and those with simulated apical root resorption were taken with varying horizontal and vertical angulations of the x-ray beam. Paired t tests were used to compare the lengths of the sound teeth on the images with their actual lengths, and the estimated amount of simulated apical root resorption was compared with the actual amount of tooth loss by means of Emago software. The diagnostic accuracy for detecting lesions was also evaluated on conventional intraoral radiographs and digital subtraction images through receiver operating characteristic (ROC) analysis. RESULTS: There were no statistically significant differences between the actual lengths and those measured on the reconstructed images of the sound teeth. The calculated amounts of apical root resorption showed no statistically significant differences in comparison with the actual amounts (P >.05). The diagnostic accuracy of the conventional intraoral radiographs in detecting the lesions was low (ROC area = 0.6446). CONCLUSION: A quantitative analysis of small amounts of apical root resorption can be performed by means of digital subtraction radiography.

Humans↗

PubMed1996

A morphological study of root resorption of the maxillary first deciduous molars.

The aim of this study was to elucidate the relationship between root resorption of the maxillary first deciduous molars and the developmental state of the successive permanent teeth. Twenty-four specimens of the maxilla from 12 dry skulls were classified into four dental eruption stages based upon their deciduous and permanent dentition. Serial sections prepared from the maxilla and embedded in polyester resin were observed with soft X-ray films. The area from the lowest point of the protruded part of the zygomatic process to the alveolar crest of the maxillary first deciduous molar was divided into 6 areas parallel to the Frankfort plane. Specimens from the upper 1/6, 3/6 and 5/6 areas were used. In addition, the shortest distance from the root resorption surface to the bony crypt was measured. The bony crypt containing the successive permanent tooth germ was located closer to the buccal root among the 3 roots of first deciduous molars but grew lingually with the progress of eruption stage. The distance from the root resorption surface to the bony crypt shortened and resorption actively progressed from the deciduous dentition stage to the first molar, and the central incisor reached the occlusal line in the deciduous dentition stage. Three-dimensional reconstruction to reproduce the relationship between the root and bony crypt revealed an increase in the root resorption surface with the eruption phase and growth of the bony crypt in the direction of root furcation.

Alveolar Process↗

PubMed1993

The initial phase of orthodontic root resorption incident to local compression of the periodontal ligament.

The present light microscopic investigation was undertaken in order to study the initial phase of orthodontic root resorption in areas of pressure and, more specifically, to focus on the first cells that penetrate the root surface. Twenty-one upper first molars (rats) and 31 lower first molars (mice) were moved mesially by a fixed orthodontic appliance. The experimental periods were 1, 2, 3, 4, and 5 days in rats, and 1, 2, 3, 4, 5, 6, 7, and 8 days in mice. Tartrate-resistant acid phosphatase (TRAP) and Haematoxylin Eosin (H&E) stains were used. Root resorption related to a hyalinized zone showed a consistent pattern: Root resorption started in the circumference of the necrotic hyalinized tissue. In the central parts of the hyalinized zone frontal root resorption occurred 3-4 days later than in the periphery. Indications that the mechanisms for circumferential and central resorption differed was the reason for presenting only the periphery stage in this paper. The initial penetration of cells into precementum/cementum occurred at the peripheries or at a short distance from the peripheries of the hyalinized zone. These cells were TRAP-negative, indicating that they were not clasts or clast precursors. Before this happened TRAP-negative macrophage-like cells were observed at the borderline between the hyalinized tissue and vital periodontal membrane (PM). TRAP-positive cells were first observed in the bone marrow spaces. During the later stages mono- and multi-nucleated TRAP-positive cells were participating in active removal of the hyalinized tissue toward the root surface, and in resorption of cementum and dentine.

Alveolar Process↗