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PubMed1999

Diagnosis and management of teeth with vertical root fractures.

Vertical fractures in teeth can present difficulties in diagnosis. There are, however, many specific clinical and radiographical signs which, when present, can alert clinicians to the existence of a fracture. In this review, the diagnosis of vertical root fractures is discussed in detail, and examples are presented of clinical and radiographic signs associated with these fractured teeth. Treatment alternatives are discussed for both posterior and anterior teeth.

Alveolar Bone Loss↗
PubMed1993

A histological study of the exfoliation of human deciduous teeth.

For clarification of the histological details of the shedding of human deciduous teeth, exfoliated and extracted deciduous teeth were examined by light and electron microscopy. After the roots were completely resorbed, the dentogingival junction migrated along the inner resorbing surface and finally reached the pulpal surface of the crown. At the same time, the gingival epithelium also proliferated and migrated under the crown of the deciduous tooth in such a way that part of it lined the residue of the pulp and another part lined the surface overlying the erupting successional tooth. This phenomenon took place from various sides of the tooth surface. Therefore, just before exfoliation, the migrated gingival epithelium formed narrow necks of tissue, and the crown was only superficially attached to the gingiva by them. The final shedding of the tooth appeared to occur by a tearing of these narrow tissue regions. The results of the present study suggest that the dento-gingival junction as well as gingival epithelium play important roles in the process of exfoliation of human deciduous teeth.

Cell Division↗
PubMed1997

Specialty endodontics: diagnostic challenges, Part 2.

Endodontic diagnosis and treatment can range from simple to extremely complex. But no matter how simple a case may seem, a thorough examination by the treating endodontist is imperative before any treatment is done. Taking the time to perform an examination in a consistent and methodical approach can rescue the patient from unnecessary treatment, and the treating dentist from potential liability. The patient may be frustrated from repeating many of the same tests performed by the referring dentist, but this situation can be resolved with clear communication from the general dentist and the endodontist as to the benefits of the endodontist's exam. With proper communication, patients will recognize that their general dentist and endodontist are concerned that they receive the best of care.

Acute Disease↗
PubMed1999

Changes in root length from early to mid-adulthood: resorption or apposition?

A significant number of adults are seeking orthodontic treatment, therefore, it is important to determine the normal changes in root length (resorption or apposition) that occur at this stage of maturation, specifically between early and mid-adulthood. The purpose of the study was to determine on a longitudinal basis the changes in root length between 25 and 45 years of age in a normative untreated population. Two sets of complete mouth surveys were available at early and mid-adulthood, on a total of 26 subjects (12 males and 14 females). Each set consisted of at least 18 periapical radiographs. On each set of radiographs, the roots of 28 teeth were measured including incisors, canines, premolars, and first and second molars, in both the maxillary and mandibular arches. Root length was measured as the perpendicular from the root apex to a line connecting the mesial and distal points of the cementoenamel junction of each tooth. A total of 1456 teeth (1664 roots) were measured; 672 teeth in males and 784 teeth in females. Allowable intraexaminer and interexaminer measurement variability was predetermined at 0.5 mm. Paired and Student t tests were used to determine: (1) whether significant changes occurred with age; (2) whether there were differences between males and females for the incisors, canines, premolars, and molars; and (3) whether there were differences between the right and left sides. Statistical significance was predetermined at P </=.05. The present findings indicated that there were no significant changes in root length for all tooth types evaluated between 25 and 45 years of age, in both males and females. These findings are important for the orthodontist to recognize because they provide some assurance that there is no systematic shortening of root length between early and mid-adulthood.

Adolescent↗
PubMed1986

Resorption of the unmineralized proximal part of Meckel's cartilage in the rat. A light and electron microscopic study.

The resorption of the unmineralized proximal part of Meckel's cartilage in the rat has been investigated by light microscopy and transmission electron microscopy. In the new-born animal an independent resorption area differentiates at the level of the open end of the incisor root and resorption progresses towards the proximal end of Meckel's cartilage. The process of remodelling differs from the usual process of endochondral ossification taking place in the distal part of the cartilage rod. First the perichondrium is affected, where macrophage- and fibroblast-like cells appear to degrade the unmineralized cartilage matrix. The chondrocytes in the center of the cartilage are undergoing degeneration. Finally, giant cells resembling macrophages attack the degenerating chondrocytes. Such giant cells seem to contribute to the digestion of cellular components of the cartilage rod. Thus, Meckel's cartilage provides a suitable model for studying cartilage breakdown under non-ossifying conditions.

Animals↗