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PubMed2000

Early bone healing events following rat molar tooth extraction.

Healing of the rat tooth extraction socket occurs rapidly, indicating a mechanism for cancellous bone formation occurring swiftly throughout the matrix. The residual periodontal ligament is evident at 2 days after extraction and its rich collagen type III fibre content may form a template for future cancellous bone formation. In the remainder of the early tooth extraction socket, fibronectin staining was generalized. The widespread distribution of fibronectin staining has given rise to speculation that the function of fibronectin may be important in granulation tissue formation, by providing a template matrix for fibroblast migration. Osteoprogenitor cells migrated into the socket from the surrounding bone, and produced decorin and proMMP-13 (procollagenase-3). ProMMP-13 was only expressed at sites of new bone formation, e.g. the border of the recently formed trabecular islands or the periphery of the closing socket. Collagen type I fibres were formed later, and were especially evident at 6 days after extraction. The pattern of distribution of both collagen type I and III fibres were similar as they passed from the bone margin towards the centre of the socket - in the same direction as the forming bone trabeculae. Bone formation occurs by rapid movement of the osteoprogenitor cells along these collagen fibres to allow a rapid healing, rather than that of resorption followed by slow bone deposition.

Animals↗

PubMed2003

The use of bovine porous bone mineral in combination with collagen membrane or autologous fibrinogen/fibronectin system for ridge preservation following tooth extraction.

Preservation of the alveolar ridge following tooth extraction is desirable since it facilitates placement of endosseous implants and may improve the adverse esthetics often associated with fixed partial dentures. The purpose of this study was to compare the clinical effectiveness of bovine porous bone mineral (BPBM) used as a graft material combined with either guided tissue regeneration (GTR) or with the autologous fibrinogen/fibronectin system (AFFS) in preserving alveolar ridges following tooth extraction. Twenty-six patients who required extraction of two or more anterior or bicuspid teeth participated in a split-mouth design study. Following tooth extraction and elevation of a buccal full thickness flap, sockets were filled with bovine porous bone mineral which was then covered with either a collagen membrane or mixed and covered with an AFFS system. An acrylic stent served as a reference point for measurements. Primary flap closure was achieved in all surgical sites, and reentry surgery was performed at 6 months. Reentry surgery showed that BPBM/GTR sites presented with [1] significantly more internal socket bone fill (6.04 +/- 0.21 mm vs. 4.98 +/- 0.26 mm), [2] less, although not statistically significant, resorption of alveolar bone height (0.23 +/- 0.28 mm vs. 0.3 +/- 0.21 mm), and [3] significantly less horizontal resorption of the alveolar bony ridge as compared to BPBM/AFFS (1.06 +/- 0.28 mm vs. 2.60 +/- 0.25 mm). This study suggests that treatment of extraction sockets with a combination of bovine porous bone mineral and guided tissue regeneration is of slightly more benefit in preserving alveolar ridge dimensions following tooth extraction than treatment with a combination of bovine porous bone mineral and the autologous fibrinogen/fibronectin system.

Adult↗

PubMed1994

Differentiation of periodontal ligament fibroblasts into osteoblasts during socket healing after tooth extraction in the rat.

BACKGROUND: The entire socket after tooth extraction is filled with new bone formed by osteoblasts (Obs), but the origin of these Obs remains unknown. Thus, the proliferation and migration of paravascular and endosteal fibroblastic cells and periodontal ligament (PDL) fibroblasts (Fbs) and their differentiation into Obs during socket healing after extraction of the first maxillary molars of the rat were investigated. METHODS: The proliferative activity and migration of these cells in the sockets after tooth extraction were studied using radioautography and immunohistochemistry after injection of 3H-thymidine and 5-bromo-2'-deoxyuridine (BrdU), respectively. Their morphological changes during differentiation was investigated by transmission electron microscopy. RESULTS: One day after tooth extraction, PDL Fbs were the major cell type in the PDL remnant of the socket. Proliferation was low (labeling index (LI) = approximately 2%) until 16 h after tooth extraction but dramatically increased to a maximum level 1 day postextraction (LI = 23%). Between 1 and 2 days, numerous PDL Fbs in the PDL remnant actively migrated into the coagulum and continued to proliferate. On the basis of the high proliferative activity and small number of cellular organelles responsible for procollagen synthesis, these cells appear immature. At 3 days, Fbs contained more cellular organelles and deposited more collagen fibers as they replaced the coagulum with dense connective tissue and the LI declined. At 4 and 5 days, some of the Fbs began to differentiate into Obs, and the proliferation of Fbs dramatically decreased to baseline values. The migration of PDL Fbs and their differentiation into Obs were investigated by labeling with 3H-thymidine or BrdU 1 day after tooth extraction. Heavily labeled Fbs were observed in the PDL remnant at 1 day, in the coagulum at 2 days, and in the dense connective tissue at 3 days. Labeled Obs associated with new bone were seen 4 days after injection. Endosteal and paravascular Fbs also proliferated, but at a lower level and at later time periods than the PDL Fbs. Surprisingly, endosteal and paravascular Fbs contributed only a small population of Fbs to socket healing. CONCLUSIONS: These results indicate that PDL Fbs after tooth extraction actively proliferative, migrate into the coagulum, form dense connective tissue, and differentiate into Obs which form new bone during socket healing.

Animals↗

PubMed1997

Reasons for tooth extractions in dental practices in Ontario, Canada according to tooth type.

In a study of tooth extractions in general dental practices in Ontario, Canada, 165 dental practitioners provided information on 6134 patients attending during a reference week. Of these, 11.6 per cent of patients had one or more permanent teeth extracted. Periodontal disease was given as the reason for 35.9 per cent of these extractions and caries for 28.9 per cent. Analysis by tooth type showed that third molars were the most common tooth type extracted. However, there were differences in the types of teeth extracted by age. Posterior teeth were most frequently lost by the younger age groups and anterior teeth by older subjects. There were also differences in the reasons for the loss of different tooth types. A comparison of these results with those of a similar study in Scotland suggests that age and tooth type does not account for the excess of extractions due to periodontal disease in this Canadian population. Differences in practice patterns and attitudes towards the retention of teeth may be contributing factors.

Adolescent↗

PubMed1994

Early alveolar ridge osteogenesis following tooth extraction in the rat.

Following tooth extraction, fluorochrome bone labels were injected intraperitoneally at intervals to identify mineralizing bone surfaces. At 5, 10 and 14 days post-extraction, the rats were killed. The mineral apposition rate, mineralizing surface and mineral formation rate were determined at various locations around the healing tooth socket. Linear trends in mineral apposition rate (p < 0.000001), mineralizing surface (p < 0.000001) and mineral formation rate (p = 0.00008) were seen around the socket, decreasing from gingivopalatal to gingivobuccal regions. These differences may be due to variations in vascularity as the gingivopalatal region is adjacent to the greater palatine artery. The mineral formation rate and mineralizing surface were significantly higher in the rats killed at 14 days after tooth extraction than at the other two post-extraction time points. This may be related to an earlier peak rate of bone resorption.

Alveolar Process↗

PubMedDate not supplied

Multiple atrophies following tooth extraction.

Following a molar tooth extraction, the patient developed a depression and atrophy of the right ear, the right half of the mentum, and the tongue. These atrophy deformities were successfully corrected with dermografts.

Adipose Tissue↗

PubMed2006

Reasons for tooth extraction in Kuwait.

OBJECTIVES: To investigate reasons for tooth extraction and its association with age and gender in Kuwait. SUBJECTS AND METHODS: A record of all tooth extractions performed in 21 general dental practice centers during a 1-month period was logged on specially designed study forms. The patient's age and gender, number of teeth extracted, and the reason(s) for the extraction were recorded. RESULTS: A total of 2,783 teeth were extracted in 1,604 patients (1.73 +/- 0.07 teeth per patient). Caries and periodontal disease were responsible for 43.7 and 37.4% of extractions, respectively. Caries was the principal cause for extraction in patients < or =40 years old (60.7%), while periodontal disease was the main cause of extractions in patients > or =40 years of age (63.0%). Extractions for caries and orthodontic reasons were more common in females, while extractions for periodontal disease were more prevalent in males. Molars and maxillary premolars were more commonly extracted due to caries, while mandibular premolars, and maxillary and mandibular anterior teeth (canines and incisors) were more commonly extracted due to periodontal disease. CONCLUSIONS: The data show that caries is the principal cause for extractions in younger patients, while periodontal disease accounts for the majority of tooth extractions in patients older than 40 years. Furthermore, this study indicates that more teeth per patient are lost to periodontal disease than for any other reason.

Adolescent↗

PubMed2005

Primary reason for tooth extraction in a Brazilian adult population.

PURPOSE: To identify the primary reasons for tooth extraction in a Brazilian adult population. MATERIALS AND METHODS: Interviews and oral examinations were conducted with 466 subjects aged from 18-76 years in the city of Maceió, Brazil. Frequency distributions, means and medians were calculated and the chi-square test was used to determine the level of significance. A logistic regression model was used to evaluate the variables associated with reasons for tooth extraction. RESULTS: Of the 466 extractions, 295 (63.3%) were due to dental caries, 61 (13.1%) due to periodontal disease, 56 (12.0%) for orthodontic reasons, 32 (6.9%) at the patient's request, 15 (3.2%) for pre-prosthetic reasons, four (0.9%) due to pericoronitis, two (0.4%) due to trauma and one (0.2%) for other reasons. Tooth extraction due to caries and other causes (excluding periodontal disease) shows a significant association with family income, toothache, type of health centre (public or private), educational level (P < 0.001) and marital status (P = 0.002). The logistic regression model has shown that patients undergoing treatment at a public health centre, those suffering from toothache or with an incomplete secondary education were more likely to lose their teeth due to caries, with educational level as the strongest indicator. For tooth extraction due to periodontal disease and other causes (excluding dental caries) the variables age, family income, type of health centre, tooth types (anterior or posterior), educational level (P < 0.001) and toothache (P = 0.006) were statistically significant, and age was the only associated variable in the logistic regression model. CONCLUSION: Dental caries was the main cause of tooth extraction in the study group, following tooth extraction due to periodontal disease.

Adolescent↗

PubMed1980

Tooth extractions and sick sinus syndrome.

The experience of tooth extraction in four patients with sick sinus syndrome (SSS) is described, and electrocardiographic features and a guideline for dental extractions are discussed. Patients controlled by medical therapy were safely treated under administration of an effective drug prior to treatment, while patients with a cardiac pacemaker were examined and checked on the apparatus before tooth extraction by their own specialist. After freedom from the cardiac problems, dental extractions were done smoothly. Electrocardiographically, in the cases with pharmacological treatments, either normal sinus rhythm revealed after additional administration of isoproterenol, or more severe bradycardia-tachycardia pattern was shown immediately after tooth extraction. In the patients with a cardiac pacemaker, ECG presented patterns controlled by pacemaker but beats rose from their own sinus node in the anesthesia-extraction procedure with various grades.

Adult↗

PubMed2004

[Prevalence of dental anxiety in 144 patients with cardiovascular diseases before tooth extraction].

OBJECTIVE: To determine the prevalence of dental anxiety (DA) in patients with cardiovascular diseases before tooth extraction so as to provide psychotherapy. METHODS: 144 patients with cardiovascular diseases were asked to complete a questionnaire modified from Corah Dental Anxiety Scale (DAS) while awaiting for tooth extraction. RESULTS: The incidence rate of DA in these patients was 7.6%. Anxiety level on anesthesia procedure was the highest. DAS score was higher among patients with the following factors: inactive perception, female, below 60 years old, experiences of painful tooth extraction, a documented history of single cardiovascular disease, under ECG monitoring for the first time and complicated tooth extraction. CONCLUSION: DA existed in patients with cardiovascular diseases before tooth extraction and was related to many factors. Medical staff should take necessary measures to provide them with psychotherapy and nursing guidance before tooth extraction.

Adult↗

PubMed1997

Changes in lysyl oxidase activity and calcium content during the healing of tooth extraction wounds.

The typical wound healing process after tooth extraction includes several important biological reactions. The collagen fiber, which is the main organic component of connective tissue, plays an important role in the formation of granulation tissue and also bone tissue. Maturation of collagen is controlled by the intermolecular crosslinks in the collagen fibers. Lysyl oxidase, which catalyzes the corresponding aldehyde formation from certain lysyl and hydroxylysyl residues in collagen and elastin in the first step of the linking reaction, is the only known enzyme required in the crosslinking process. This study was designed to analyze changes in the lysyl oxidase activity and calcium content during the healing of rabbit tooth extraction wounds and to survey the relationship between them. Healing tissue in the extraction sockets was removed 1, 2, 3, 4, 5, 7, 10, 14, 21, 28, and 56 days postoperatively. After decalcification, lysyl oxidase was extracted from wound tissue, and activity of this enzyme was examined by tritium-release assay. Radiographs and histologic sections were also obtained in each group. The results show that lysyl oxidase activity can be detected on the first day postoperatively and that it increases sharply from days five to seven, reaching the peak value on the seventh day. After that, enzyme activity decreases gradually and returns to normal range on day 14. Histologically, the healing sockets were filled mainly with young fibrous connective tissue at day seven; osteoid tissue could be found on the lateral wall and fundus of the extraction sockets at the same time. Accompanying the formation of new bone, calcium content increased conspicuously from day 7 to day 14. These results indicate that lysyl oxidase predominantly acts to promote cross-linking of the abundantly synthesized collagen in the early stage of healing of rabbit tooth extraction wounds. When minerals were precipitated at a great rate in the newly-formed bone, lysyl oxidase activity was concurrently decreased.

Animals↗

PubMedDate not supplied