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Normal development of dental innervation and nerve/tissue interactions in the colony-stimulating factor-1 deficient osteopetrotic mouse.

Dental innervation occurs concurrently with tooth development, eruption, and root formation and is suggested to interact with developing tissues. The purpose of the present study was to investigate dental innervation in osteopetrotic (op/op) mice, which carry a mutation of colony-stimulating factor-1 (CSF-1) and demonstrate sparse macrophages and osteoclasts, failure of bone resorption, lack of tooth eruption, and poor root formation. Jaw tissues from 21 mice in different age groups (7 days, 18 days, 26 days, 5 weeks, and 3 months) were prepared for immunocytochemistry and light microscopy. Immunocytochemistry with the neuronal marker protein gene product 9.5 (PGP 9.5), macrophage marker F4/80, double-labeling with F4/80 and PGP 9.5, and histochemical analysis using tartarate-resistant acid phosphatase (TRAPase) were carried out in selected sections. Molar and incisor development were arrested in the op/op mouse, and both types of teeth had bony occlusion of the eruptive pathway and failure of root formation. Third molar development in the normal mouse is delayed until after birth; therefore, it encounters different bone barriers and jaw structures than are present when first and second molars and incisors begin to develop after the second embryonic week. All three molars, however, completed crown formation prior to eruption failure. Partial root formation was seen in several homozygous op/op mice, and, in those cases, there was partial development of the periodontal ligament. Innervation of dental tissues that successfully formed was essentially normal in the mutant mice despite phenotypic deficiencies in macrophages and osteoclasts. The periodontal ligament was innervated with PGP 9.5-immunoreactive Ruffini mechanoreceptive endings in those cases in which the ligament formed, and op/op mice had remarkably normal sensory innervation of molar and incisor pulp despite failure of bone resorption, failure of root development, and arrested eruption. This study shows that op/op mice develop normal innervation in dental tissues and that dental nerve development proceeds independently of bone abnormalities and root failure in this animal.

Acid Phosphatase↗

Predictable peri-implant gingival aesthetics: surgical and prosthodontic rationales.

Bone resorption following maxillary anterior tooth extraction is common and often compromises gingival tissue levels for the implant restoration. The creation of predictable peri-implant aesthetics requires proper understanding and preservation of the osseous and gingival tissue surrounding the failing tooth. This article addresses the various factors that affect the predictability of peri-implant gingival aesthetics in anterior single-tooth replacement. The surgical and prosthodontic procedures for maintenance of peri-implant aesthetics are also presented using an ovate pontic tooth on a removable partial denture following immediate extraction and implant placement.

Adult↗

[Long-term follow-up of tooth transplantation from the functional and periodontal viewpoint].

The outcome of 81 of 99 patients being treated from 1980 to 1993 by transplantation of autologous teeth was investigated. The overall transplant survival rate was 91% after 1 year, 81% after 5 years and 70% after 9 years. The early loss of transplanted teeth was due to healing disorders. The long-term losses were due to caries and replacement resorption. Caries in tooth transplants has to be treated very early, because deep caries or deep drilling leads to an infection of the nutrient canals of the osteodentine. If the pulp chamber of a transplant is once obliterated by osteodentine, endodontic treatment can no longer be performed in many cases. The periodontal condition of the transplants did not differ from that of normal teeth. In 23% there was a decreased tooth mobility, caused by ankylosis of the transplant. 51% of the transplants showed occlusal disturbances but none of the patients had signs of occlusal traumatization of the teeth or of the temporomandibular joint. In comparison to success rates taken from the literature it is pointed out that tooth transplantation has a better long-term prognosis than endodontic treatment. Therefore, in young patients requiring root canal treatment, tooth transplantations should be considered.

Adolescent↗

Palatal migration of two mesodens in a prehistoric Tennessee Indian: a case for the blood vessel thrust theory of tooth movement.

The skull of a prehistoric, Middle Mississippian, American Indian shows two mesodens that migrated to the distal margin of the palate. These teeth are positioned in such a way as to avoid the most common intraoral forces affecting tooth movement. The resorption of the palatal bone, distal to the teeth indicates movement caused by forces predicted by the Blood Vessel Thrust Theory.

Adult↗

[External root resorption].

Root resorption may be a physiological (resorption of deciduous teeth) or a pathological process (resorption of permanent teeth). In the latter case an external and an internal form of resorption can be distinguished. Root resorption may occur on one tooth or on several teeth within a dentition and it may be caused by trauma, periodontitis, orthodontic treatment, internal bleaching, cysts, tumors, or by stimuli from a necrotic dental pulp. Current knowledge concerning the pathogenesis of root resorption and therapeutic approaches are presented. For cervical resorption, it is assumed that the stimulus for the resorbing cells originates from the bacteria within the gingival sulcus and along the affected root surface. The case presented here was initially diagnosed as chronic periodontitis of medium severity. Scaling and root planing were performed resulting in a significant improvement of the periodontal status. Two years later, following a period of irregular recall visits, the patient presented with large areas of cervical resorption on teeth 36 and 37 which made it impossible to preserve these teeth. After another six months, teeth 34 and 35 showed deep destruction caused by external root resorption, mandating the extraction of these teeth as well. Fourteen months later, external root resorptions were evident on teeth 32 and 33, and at the same time, a recurrence of the chronic periodontitis was noted. Periodontal therapy was performed under a systemic antibiotic regime. It was possible to preserve teeth 32 and 33 through surgical crown lengthening procedures. No additional resorption has been observed ever since.

Adult↗

Celebrex offers a small protection from root resorption associated with orthodontic movement.

UNLABELLED: Tooth movement results from alveolar bone resorption/deposition following application of orthodontic forces, and root resorption can be an undesirable complication associated with this process. No treatment for external root resorption is available to date. OBJECTIVE: To determine if COX-2 inhibitors like Celebrex are effective in protecting root resorption associated with orthodontic forces. METHODS: A force of 80 grams was applied to the left maxillary first molars of 7-week-old female Wistar rats using nickel titanium closed coil springs attached to the cervical area of the incisors with 0.010 stainless-steel ligature wires. Twenty animals were divided into three experimental groups: one receiving no treatment, the second receiving 25mg/kg, and the third receiving 50 mg/kg of celecoxib (Celebrex) in their drinking water. Rats were maintained on a soft diet and euthanized two weeks after initial placement of the force. Paraffin-embedded sections of the right (control) and left (experimental) maxillae were stained with H&E and the areas of root resorption were examined by counting the number of lacunaes in the roots. RESULTS: No difference in the distance of tooth movement (0.5 mm/two weeks) was seen in all three groups. The rats that received the low dose of Celebrex showed no statistically significant difference in root resorption than that of the rats that received no dose. The rats that received the high dose of Celebrex showed a lower number of lacunaes (mean = 3.5) than that of the control group (mean 10.2; p=0.02). CONCLUSIONS: Administration of Celebrex during the application of orthodontic forces does not interfere with tooth movement and appears to offer some slight protection against root resorption.

Animals↗

Ultrastructural and cytochemical studies of resorptive and digestive functions of secretory ameloblasts in kitten tooth germs.

Ultrastructural and cytochemical studies of kitten secretory ameloblasts were made in order to clarify their functions in the resorption and digestion of extracellular organic materials. The secretory ameloblast had triangular Tomes' processes whose profile was divided into type 1 and type 2 faces. Type 1 face was associated with tubular structures, coated pits, coated vesicles, and irregularly shaped vesicles presumably representing phagosomes. Freeze-fracture replicas clearly showed the presence of large, particle-rich depressions and small depressions on the cell membrane P face in the type 1 face of the Tomes' process. Exocytosis of secretory granules was seldom observed. In both thin sections and replicas, the type 2 face possessed cell membrane microinvaginations. From the supranuclear region to a zone near the Tomes' process, many dense bodies, multivesicular bodies, and vacuoles were present; and many of them showed intense acid phosphatase reactions. Reaction products of acid phosphatase were demonstrated in the Golgi apparatus, GERL, and the lateral cell membrane. These results suggest that kitten secretory ameloblasts resorb and digest extracellular organic materials.

Absorption↗

[Orthodontic treatment and root resorption].

Root resorption after orthodontic treatment occurs frequently. The biologic process of tooth movement and root resorption is described. Furthermore, attention is given to the frequency and severity of root resorption, diagnostics and aspects of the orthodontic treatment which aggravate root resorption. Displacement of teeth with resorptions that already exist or with deviating rootforms is riskfull.

Dental Stress Analysis↗

Recurrent peripheral giant cell granuloma associated with cervical resorption.

A case of recurrent peripheral giant cell granuloma in a 38-year-old man is reported. The lesion was localized on the attached gingiva of the lower left second premolar (tooth #35). The surgical excision of the lesion revealed a superficial resorption of the cervical region of the involved tooth. The resorption was smoothed out, and there was no sign of recurrence or further resorption after 14 months. Root resorption, although extremely rare, may be associated with peripheral giant cell granuloma.

Adult↗

Effect of misoprostol, a prostaglandin E1 analog, on orthodontic tooth movement in rats.

The purpose of this study was to investigate the effects of oral administration of misoprostol, a prostaglandin E1 analog, on orthodontic tooth movement and root resorption in rats. Sixty-four male Sprague-Dawley rats that initially weighed 250 +/- 20 g were used in this study. The animals were randomly assigned to 1 of 6 experimental and 2 control (nonappliance and appliance) groups. The experimental groups received 2.5, 5.0, 10.0, 25.0, 50.0, and 100.0 microg/kg misoprostol by gastric lavage every 24 hours for 2 weeks. A fixed orthodontic appliance consisting of a nickel-titanium closed-coil spring, 5.0 mm long was ligated between the maxillary right incisor and the maxillary right first molar. The initial activating force was 60 g. For analysis of root resorption, 99 maxillary right and left first molars from 61 animals were chosen. Serial histologic sections of the mesial root of the maxillary first molars were made, and histologic analysis of root resorption on the mesial and distal surfaces was performed. The results showed that oral misoprostol did increase the amount of orthodontic tooth movement in all the experimental groups compared with the appliance control group. This increase was statistically significant in doses of 10.0, 25.0, 50.0, and 100.0 microg/kg (P <.001). However, there were no statistically significant differences among these 4 different doses. There were no statistically significant differences in the amount of root resorption among the groups. However, a trend toward more root resorption was registered. On the basis of these findings, oral misoprostol can be used to enhance orthodontic tooth movement with minimal root resorption.

Analysis of Variance↗

Are dental anomalies risk factors for apical root resorption in orthodontic patients?

Regression analyses suggest a weak prediction power of identified risk factors for apical root resorption in orthodontic patients, indicating the presence of etiologic or causative factors that have not yet been disclosed. To investigate the possible significance of dental anomalies as risk factors, pretreatment and posttreatment periapical radiographs of 84 patients with presence of at least one dental anomaly and of 84 patients without such anomalies were compared. The patients in the two groups were matched according to age, gender, Angle Class, extraction therapy, overbite, and treatment time. Apical root resorption was calculated by subtracting posttreatment tooth length measurements from the corresponding pretreatment measurements. Two sample t tests revealed no differences in mean root resorption between the patients in the two groups (P = .88). Stepwise regression analyses did not identify any of the individual anomalies as risk factors. In addition, patients with more than one anomaly did not appear to be at increased risk.

Adolescent↗

Gene expression of potential tooth eruption molecules in the dental follicle of the mouse.

Tooth eruption requires alveolar bone resorption and the presence of the dental follicle, a loose connective tissue sac that surrounds each tooth. This bone resorption involves the follicle in that mononuclear cells enter the follicle to form osteoclasts which resorb bone to form the eruption pathway. In the rat first mandibular molar, probable eruption genes, CSF-1, c-fos, NFkappaB and MCP-1, are expressed maximally in the dental follicle at day 3 postnatally. This correlates with the time of peak influx of mononuclear cells into the follicle. In the mouse, the first peak influx of mononuclear cells into the first mandibular molar is at day 5 postnatally, and this study demonstrates that all four of the above resorption molecules are maximally expressed at this time in the dental follicle. Thus, this work suggests that these molecules may play a role in the cellular events of eruption (mononuclear cell influx and osteoclast formation) in the mouse molar at day 5 postnatally just as they do at day 3 in the rat molar. These results provide a standard for future studies on eruption in the mouse molar and extends the number of species in which putative eruption molecules are expressed at a critical time of eruption.

Animals↗

Autogenous free tooth transplantation with a two-stage operation technique.

If tooth transplantation is to succeed, it is crucial to preserve the vitality of the cells on the root surface of the tooth transplant. Insufficient postoperative nutrition to the cells on the root surface of the tooth transplant was thought to contribute to their devitalization of these cells. Impaired nutrition may be a result of poor contact between the recipient bed and the root surface of the transplanted tooth, and development of an interposed blood clot. To improve postoperative nutrition to the root surface cells, teeth were transplanted to the recipient beds in which the tissues were regenerated during a 14 day period, i.e., using the two-stage transplantation technique. In a clinical study of this technique, a total of 95 autogenous teeth with fully developed roots were transplanted in 84 patients, and examined both clinically and radiographically for up to 13 years after the transplantation. In a dog model, a comparative experimental study was made between teeth transplanted to beds left to heal for 5 days and teeth transplanted to beds prepared immediately before the transplantation. The clinical study showed a low prevalence of tooth graft loss and root resorption even when infection of the root canal occurred. Periodontal attachment loss of less than 3 mm was found in 97% of 6 defined surfaces around the transplanted teeth. Transplanted teeth which were later extracted were often hypermobile, and signalled pain when provoked with heavy loading. Excessive extraction trauma, fixation failure, and excessive plaque accumulation after transplantation were all shown to be detrimental to tooth transplant. Transplanted teeth were used as abutments for fixed partial dentures and provided the necessary dental support for crowns and bridges even in patients with atrophic alveolar bone. The experimental histological study showed no differences between test and control teeth in terms of the prevalence of root resorption, which was suspected to be caused by traumatic injuries to the roots during extraction and non-rigid fixation of the transplanted teeth.

Age Factors↗

Results after replantation of avulsed permanent teeth. I. Endodontic considerations.

Following avulsion and replantation, teeth are at risk for infection and infection related resorption (IRR). Severe discolorations of tooth crowns and cervical root fractures are common. This study presents data on endodontic related complications of avulsed teeth replanted following an extraoral endodontic treatment. Periodontal aspects will be discussed in the second part of the present publication. Twenty-eight permanent teeth in 24 patients aged seven to 17 years were replanted after avulsion. All teeth could be evaluated. In all teeth extraoral endodontic treatment by retrograde insertion of ceramic or titanium posts was performed. Mean observation period was 31.2 months (median: 24.1 months). Nine teeth healed with a functional periodontal ligament (PDL) (functional healing, FH), 19 teeth exhibited replacement resorption (RR), which was succeeded by IRR in three teeth after observation periods of more than 14 months. Diagnosis was set to tunneling resorption (one case) and to cervical resorption preceded by complete RR (two cases). No early IRR was observed. All six teeth rescued in physiologic conditions (cell culture medium of tooth rescue box) exhibited FH. Discolorations of tooth crowns or other complications (cervical root fractures, fractures of posts) were not observed. No differences in the healing results of immature and mature teeth were observed which is in contrast to previous studies. This finding is explained with the different endodontic treatment protocols. Extraoral endodontic treatment by retrograde insertion of posts prevents early IRR and minimizes the overall incidence of IRR. The method does not negatively influence periodontal healing. As there are further advantages (no discoloration, no root fractures, patient not involved, less radiographs, less time consumption, less costs) the method is recommended in isolated teeth before replantation. Especially immature teeth profit from the prevention of complications.

Adolescent↗

Tissue reaction to orthodontic tooth movement--a new paradigm.

Direct or indirect resorption are both perceived as a reaction to an applied force. This is in contrast to orthopaedic surgeons who describe apposition as 'the reaction to loading of bone'. The article reviews the literature on intrusion of teeth with periodontal breakdown, and on the basis of clinical and experimental studies. The conclusion is reached that intrusion can lead to an improved attachment level, and that forces have to be to low and continuous. The tissue reaction to a force system generating translation of premolars and molars in the five Macaca fascicularis monkeys is described. Three force levels, 100, 200, and 300 cN were applied for a period of 11 weeks. Undecalcified serial sections were cut parallel to the occlusal plane and a grid consisting of three concentric outlines of the root intersected by six radii was placed on each section so that areas anticipated to be subject to differing stress/strain distributions were isolated. A posteriori tests were utilized in order to separate areas that differed with regard to parameters reflecting bone turnover. Based on these results and a finite element model simulating the loading, a new hypothesis regarding tissue reaction to change in the stress strain distribution generated by orthodontic forces is suggested. The direct resorption could be perceived as a result of lowering of the normal strain from the functioning periodontal ligament (PDL) and as such as a start of remodelling, in the bone biological sense of the word. Indirect remodelling could be perceived as sterile inflammation attempting to remove ischaemic bone under the hyalinized tissue. At a distance from the alveolus, dense woven bone was observed as a sign of a regional acceleratory phenomena (RAP). The results of the intrusion could, according to the new hypothesis, be perceived as bending of the alveolar wall produced by the pull from Sharpey's fibres.

Alveolar Bone Loss↗

Progressive, generalized, apical idiopathic root resorption and hypercementosis.

BACKGROUND: Root resorption is a multifactorial process that results in loss of tooth structure. The causes of root resorption may vary, leading to several types of resorptions. Some factors have been identified and may be categorized into physiological resorption, local factors, systemic conditions, and idiopathic resorptions. The objective of this report was to present a case of a 17-year-old white female with progressive, generalized, apical idiopathic root resorption followed up for 34 months. METHODS: Two panoramic radiographs, 14 and 34 months after initial clinical and radiological examinations, showed the rapid progression of apical root resorption. Two molars, teeth #15 and #16, which had to be extracted, and a bone sample from the distal aspect of tooth #15 were processed for histologic analysis. RESULTS: Two millimeters apical to the cemento-enamel junction, an abrupt increase in the cementum thickness was noted, amounting to 300 and 800 microm in teeth #15 and #16, respectively. The thickening of the cementum layer was due to an accelerated deposition of cellular intrinsic fiber cementum. An unusually high number of mineralization foci were observed in association with acellular extrinsic fiber cementum, and both free and fused cementicles were seen. In contrast to tooth #16, tooth #15 revealed extensive dentin replacement by a bone-like and a cementum-like tissue. Furthermore, ankylosis was demonstrated in tooth #15 and confirmed in the bone sample. CONCLUSIONS: At present, there is no preventive or therapeutic regimen for the type of root resorption seen in this case report. Treatment usually consists of the extraction of teeth with advanced lesions.

Adolescent↗

Detection of collagenase mRNA in odontoclasts of bovine root-resorbing tissue by in situ hybridization.

The odontoclast, which is morphologically similar to osteoclast, is thought to play a major role in root resorption of deciduous teeth. High collagenolytic activity has been detected in the root resorbing tissue. In order to identify collagenase-producing cells and the role of collagenase in root resorption of deciduous tooth, in situ hybridization of collagenase mRNA in bovine root-resorbing tissue sections was performed using a digoxigenin-labeled, nonradioactive RNA probe. Collagenase mRNA expression was clearly observed in odontoclasts in addition to the macrophages, fibroblasts, odontoblasts, and cementoblasts. Multinuclear odontoclasts showed intense tartrate-resistant acid phosphatase (TRAP) activity. We also examined interleukin-1 (IL-1) mRNA expression in the root-resorbing tissue by in situ hybridization. IL-1 transcripts were found to be expressed in odontoclasts, fibroblasts, and macrophages suggesting that IL-1 might be an important factor for promoting root resorption. These results suggest that the collagenase produced by odontoclasts may play a key role in dentin collagen degradation in root resorption.

Acid Phosphatase↗

Calcific metamorphosis with internal resorption.

We have presented a case in which 3.7-year-old patient exhibited calcific metamorphosis of a maxillary primary central incisor at the initial visit, with subsequently internal resorption developing in the same tooth. This case underscores the need for careful monitoring of traumatized teeth that have undergone calcific metamorphosis.

Child, Preschool↗

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