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Incisor root resorptions due to ectopic maxillary canines imaged by computerized tomography: a comparative study in extracted teeth.

The purpose of the study was to analyze the ability of computerized tomography (CT) scanning to discriminate maxillary incisor root resorptions caused by ectopically erupting canines. Seventeen maxillary incisors were radiographed in vivo by CT scanning. Contiguous transverse CT scans with a slice thickness of 2 mm were exposed perpendicular to the long axis of the lateral incisors and through the crown of the adjacent, ectopically positioned maxillary canine. Each scan was analyzed and the resorptions on the roots of the laterals were graded according to the maximum depth of the cavity. After the lateral incisors were extracted they were clinically inspected, photographed in different light settings and views, and probed at the contact area between the laterals and the canines. The assessment of the extent of resorption in 4 stages on the CT images compared with the in vitro observations of the extracted roots showed a high degree of agreement for the extent of loss of root substance for all teeth. We conclude that CT scanning performed with good technique accurately reveals tooth root resorption. The presence and influence of the inherent artifacts of tooth root resorption on CT scans are discussed.

Artifacts↗

An electron microscopic observation on cells found in bone resorption area incident to experimental tooth movement.

For the purpose of investigating many of the cells in the bone resorption area incident to experimental tooth movement and characterizing the role of these cells for the periodontal tissue resorption at the ultrastructural level, orthodontic force was applied to 24 male rats. Orthodontic elastics were inserted into the interproximal space of the upper first and second molars. The mesial side of the interradicular septum of the second molar was observed. The electron micrsocopic findings were as follows: 1. Cell cohorts were found in the undermining bone resorption area. They are mainly composed of fibroblasts, endothelial cells, undifferentiated cells, macrophages and several kinds of osteoclasts. 2. Four different kinds of osteoclasts could be recognized from the morphological features: a) small osteoclasts situated apart from the bone surface, b) large osteoclasts rich in rough ER, c) classic large osteoclasts and d) degenerating osteoclasts. 3. Two different types of undifferentiated cells were observed in these area. One was a spindle-shaped bright cell rich in rough ER and the other was a round-shaped dark cell with numerous mitochondria and free ribosomes. 4. Macrophages showing phagocytosis were also found in the bone resorption area.

Animals↗

Pre-eruptive intracoronal resorption as an entity of occult caries.

"Occult" or "hidden" caries refers to occlusal caries which is not diagnosed clinically because the occlusal surface appears ostensibly intact, and radiographs show radiolucencies in dentin. The prevalence of occult caries has been reported to range from 2.2% to over 50% of permanent molars. In spite of its relatively high prevalence, the etiology and pathogenesis of occult caries remain unclear. The author hypothesizes that occult lesions could have resulted from processes which are pre-eruptive or post-eruptive. Pre-eruptive processes include intracoronal resorption of unerupted teeth, and the post-eruptive process is occlusal fissure caries. Although the prevalence of intracoronal resorption has been shown to be around 3-6% by subject and 0.5-2% by teeth, the percentage contribution of this process to the overall prevalence of occult caries is unclear. When affected teeth are fully erupted, it is difficult to determine if pre-eruptive resorption had been present previously. The prevalence of occult lesions does not appear to be affected by fluoride exposure. Radiographs are useful adjuncts to aid in the diagnosis of occult lesions. Bitewing radiographs are useful for detecting early occlusal fissure caries while panorex radiographs of unerupted developing teeth aid in the diagnosis of pre-eruptive intracoronal lesions. It is suggested that all unerupted, developing teeth on radiographs be examined for pre-eruptive resorptive lesions.

Adolescent↗