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Clinical observations of odontomas in Japanese children: 39 cases including one recurrent case.

Retrospective investigations of odontomas in Japanese children and one recurrent case were carried out. Thirty-nine cases of odontoma in 38 children were treated in the Paediatric Dentistry Clinic of Niigata University Dental Hospital between September 1979 and December 2002. The patients consisted of 23 males and 15 females and their ages ranged from 1 year 2 months to 14 years old. The chief complaints were delayed tooth eruption in 19 cases (five: primary teeth, 14: permanent teeth), retention of primary teeth in 11, incidentally found on the radiographic examination in eight cases, and swelling of the jaw in one case. Thirty-four cases (87%) were associated with tooth eruption disturbances. The most frequently affected region was the maxillary anterior region. Treatment consisted of surgical removal of odontomas in all cases, after which if the impacted teeth did not erupt, exposure of the crown and/or orthodontic traction was performed. Pathological diagnoses were compound odontoma in 30 cases, complex odontoma (n = 7), and compound and complex odontoma (n = 2). A retrospective study of the radiographs revealed the developing process of odontomas in four cases and odontoma disturbed tooth eruption since the early uncalcified developing stage. A recurrent case was a boy aged 6 years 5 months in whom the first surgical removal of odontoma was performed at the age of 1 year 8 months. Recurrence of an odontoma is very rare, but in very young children odontomas are in the early developing stages, containing uncalcified portions, so it is important to perform periodical observations until the succedaneous teeth erupt.

Adolescent↗

Regulation and localization of colony-stimulating factor-1 mRNA in cultured rat dental follicle cells.

Cultured dental follicle cells from rat mandibular molars transcribe colony-stimulating factor-1 (CSF-1) mRNA as determined by reverse-transcription polymerase chain reaction. In turn, the CSF-1 mRNA appears to be translated, as seen by immunoperoxidase staining. Interleukin 1 alpha (IL-1 alpha) stimulates increased transcription of the CSF-1 gene in a concentration- and time-dependent manner. Moreover, CSF-1 itself has an autocrine effect on transcription of the CSF-1 gene. Because others have shown that in vivo injection of CSF-1 accelerates tooth eruption and because the dental follicle is required for eruption to occur, this study demonstrates the possible relation between CSF-1 and the follicle; namely, the source of CSF-1 for tooth eruption might be the dental follicle. In turn, regulation of gene expression for CSF-1 by IL-1 alpha and CSF-1 may play a part in signalling the onset of tooth eruption.

Animals↗

Secondary bone grafting in cleft lip and palate with eruption of tooth into the graft: a case report.

Secondary bone grafting in cleft lip and palate patients is performed preferably before the eruption of permanent canine in order to provide adequate periodontal support for eruption and preservation of the teeth adjacent to the cleft. Presented here with is a case of unilateral cleft lip and palate, which was followed up from birth to 15 years of age. The role of an orthodontist in the team approach for management of such anomalies is described. Also discussed in detail is the entire range of treatment procedures the child underwent, especially the role of secondary bone grafting.

Alveoloplasty↗

Symptoms associated with infant teething: a prospective study.

CONTEXT: Studies of infant teething have been retrospective, small, or conducted on institutionalized infants. OBJECTIVES: To conduct a large, prospective study of healthy infants to determine which symptoms may be attributed to teething and to attempt to predict tooth emergence from an infant's symptoms. DESIGN: Prospective cohort. Setting. Clinic-based pediatric group practice. PATIENTS: One hundred twenty-five consecutive well children of consenting Cleveland Clinic employees. OUTCOME MEASURES: Parents daily recorded 2 tympanic temperatures, presence or absence of 18 symptoms, and all tooth eruptions in their infants, from the 4-month well-child visit until the child turned 1 year old. RESULTS: Daily symptom data were available for 19 422 child-days and 475 tooth eruptions. Symptoms were only significantly more frequent in the 4 days before a tooth emergence, the day of the emergence, and 3 days after it, so this 8-day window was defined as the teething period. Increased biting, drooling, gum-rubbing, sucking, irritability, wakefulness, ear-rubbing, facial rash, decreased appetite for solid foods, and mild temperature elevation were all statistically associated with teething. Congestion, sleep disturbance, stool looseness, increased stool number, decreased appetite for liquids, cough, rashes other than facial rashes, fever over 102 degrees F, and vomiting were not significantly associated with tooth emergence. Although many symptoms were associated with teething, no symptom occurred in >35% of teething infants, and no symptom occurred >20% more often in teething than in nonteething infants. No teething child had a fever of 104 degrees F and none had a life-threatening illness. CONCLUSIONS: Many mild symptoms previously thought to be associated with teething were found in this study to be temporally associated with teething. However, no symptom cluster could reliably predict the imminent emergence of a tooth. Before caregivers attribute any infants' signs or symptoms of a potentially serious illness to teething, other possible causes must be ruled out.teething, tooth eruption, teeth, deciduous dentition.

Body Temperature↗

[The eruption times of permanent teeth in boys and girls in the Stormarn District, Schleswig-Holstein (Germany)].

UNLABELLED: In a longitudinal study in two small towns in southern Schleswig-Holstein (Ammersbek and Ahrensburg, District Stormarn; 9155 inhabitants) we investigated 2832 oral findings of 1396 patients (711 males, 685 females). The minimum age was 1.51 years, and the maximum age was 25.50 years. The dental findings were collected over a period of about 20 years (1982-2002). The oral findings per child were assessed between one and eight times. The eruption times of teeth in females are earlier than those for the same teeth in males. Further, the permanent dentition in females is completed earlier than in males. In both sexes the tooth eruption occurs symmetrically in both jaws. The comparison of both jaws revealed a slightly advanced eruption of the lower jaw teeth in both sexes. There is a noteworthy change in the eruption sequence of the teeth. In contrast to other reports we observed that the eruption of the canine proceeds the eruption of the second molar. We found no acceleration of the dentition when compared with other reports and could confirm the rules of tooth eruption in man. CONCLUSION: Oral examination of teeth is a simple tool to calculate tooth eruption intervals. This first investigation on a population of Schleswig-Holstein revealed a change in the eruption sequence of permanent teeth. These findings are relevant for dental treatment planning and should be reconfirmed at certain intervals.

Adolescent↗

Eruption of the primary dentition in human infants: a prospective descriptive study.

PURPOSE: This study investigated the clinical process of the emergence phase of eruption of the primary dentition including length of time taken to erupt and the association between soft tissue changes and stages of eruption. METHODS: Twenty-one children aged 6-24 months at commencement of the study were recruited from three suburban daycare centers in Melbourne, Australia. Daily oral examinations of each child were conducted for seven months. RESULTS: One hundred twenty-eight teeth were observed during eruption. Swelling very infrequently accompanied tooth eruption and in all cases was mild. Forty-nine percent of observed teeth demonstrated gingival redness during the emergence stages of eruption, but there was no significant relationship between redness and specific stages of eruption. Mean duration of eruption, from palpable enlargement of the gingival tissue to full eruption, was 2.0 months (range 0.9-4.6 months). The average rate of eruption was 0.7 mm per month. Many of the deciduous teeth appeared to demonstrate an "oscillating" pattern of eruption, (emerging and then retreating before emerging again). Timing of oscillation was not specific to stage of eruption or tooth type. This was defined as a "transitional" phase of eruption which appears to be common. CONCLUSION: The results suggest that eruption of the primary dentition is often accompanied by redness, but not swelling, of the gingival tissues. For some children, there also appears to be a "transitional" eruption phase for primary teeth.

Child, Preschool↗

Tumor necrosis factor modulates apoptosis of monocytes in areas of developmentally regulated bone remodeling.

Tooth eruption is characterized by spatially segregated bone resorption along the path of eruption and bone formation in the opposite direction. Monocyte recruitment occurs in two distinct peaks in both areas of resorption and formation. Without such recruitment tooth eruption does not occur. The signals that regulate this recruitment are thought to involve the expression of cytokines and chemokines. One such cytokine is tumor necrosis factor (TNF), which can affect monocyte recruitment through the induction of chemokines and adhesion molecules and increase their lifespan by acting as antiapoptotic cell survival signals. We examined the latter by studying mice with targeted deletions of TNF receptors p55 and p75 (TNFRp55/p75). The results indicate that mice that lack functional TNF receptors have a significantly reduced number of monocytes in the apical area associated with bone formation. The reduced number of monocytes in this area can be accounted for by an increase in apoptosis in TNFRp55-/-/p75-/-. In contrast, the number of monocytes, the rate of monocyte apoptosis, and the formation of osteoclasts in the occlusal area associated with bone resorption occurred independently of TNF activity. These results suggest that TNF receptor signaling can affect tooth eruption by acting as a monocyte survival signal in some but not all areas of bone undergoing developmentally regulated remodeling.

Animals↗

[An embryological analysis of the variation in the lipid content of the dental pulp at different developmental stages].

The authors have considered the per cent differences of lipidic content in Bos taurus dental pulp taken from differently aged animals. The studies have been carried out on 6-7 months fetus, on 1-2 years old animals (deciduous erupted tooth and developing non erupted permanent teeth) and on 8-10 years old animals. Moreover the percentages of free and esterified cholesterol, fatty free acids, triglycerides as well as different phospholipids have been calculated.

Aging↗

Effects of bone marrow transplantation on impacted dental germs in osteopetrotic op/op rats.

The osteopetrotic op/op rats suffered from a complete failure of tooth eruption in association with a reduced bone resorption. An unresorbed occlusal bone overlaid the germs which remained embedded in bone. The process of prefunctional eruption in limited growing teeth depends on the resorption of the alveolar bone covering the germs. The aim of this study was to investigate the effects of hematopoïetic grafts in newborn op/op rats on the process of prefunctional eruption. Fifteen op/op treated rats were used for radiographic, microradiographic and histologic examinations. After transfusion of bone marrow cells, we observed the restoration of bone resorption and a delayed eruption of the molars. The incisors never erupted. They developed odontome-like tumors near their apices. These results confirm the dependence of tooth eruption on bone resorption.

Animals↗

Recognition and management of teething diarrhea among Florida pediatricians.

According to current medical opinion, teething diarrhea (TD) is a myth; yet cross-cultural data document a worldwide distribution of popular belief in the association of frequent, loose stools with tooth eruption. A mail survey in 1990 of 215 pediatricians practicing in Florida investigated beliefs and practices related to TD. Thirty-five percent of respondents believed there is a real association between diarrhea and tooth eruption. When compared with pediatricians who do not believe in TD, these respondents were more likely to be more recent graduates of medical school, to be in general pediatric practice, to be female, to see more patients per week, and to practice in metropolitan areas. The most common explanations for the link between dentition and diarrhea were changes in eating habits, increased salivation, and stress. Respondents reported that both they and the parents of their patients tended to view TD as less serious than other types of diarrhea, and both managed it accordingly. When compared with earlier studies, our findings indicate that belief in TD among pediatricians may have increased since the 1970s. The results suggest a need for more empirical research on the effects of tooth eruption on bowel function.

Diagnosis, Differential↗

Pericoronal hamartomatous lesions in the opercula of teeth delayed in eruption: an immunohistochemical study of the extracellular matrix.

Opercula of teeth delayed in eruption were examined histopathologically and immunohistochemically to determine the possible causes for tooth eruption failure. Specimens were obtained from 58 patients with non-erupted teeth by surgical removal of their gingival opercula. Among the 61 specimens, 31 (50.8%) were diagnosed as pericoronal myxofibrous hyperplasia (PMH), 8 (13.1%) as infantile ameloblastic fibromatosis (IAF), and 19 (31.2%) as odontomas. Histopathologically, PMH is characterized by hyperplasia of odontogenic mesenchymal tissues with a myxoid appearance in which odontogenic epithelial islands and mesenchymal multinucleated giant cells are scattered randomly. Between the mucosal epithelium and the PMH, there is a layer of fibrosis, whose matrix is strongly immunopositive for tenascin. The PMH seems to induce its overlying gingival mucosa to remodel the connective tissue, which obstructs tooth eruption. IAF is usually located adjacent to the PMH and shows an ameloblastic fibroma-like histology with atrophic ameloblastic components and poor encapsulation. The findings suggest that IAF associated with PMH is not a true neoplasm and should be distinguished from ameloblastic fibromas by the name of IAF, and that both lesions are included in the range of hamartomas formed only in the pericoronal tissue of teeth in eruption. We propose to categorize these lesions into a new disease entity of pericoronal hamartomas of odontogenic origin.

Adolescent↗

Craniofacial morphology and dental age in children with Silver-Russell syndrome.

OBJECTIVES: This investigation is a part of a multidisciplinary descriptive evaluation of the Silver-Russell syndrome (SRS). The aim of this study was to describe the craniofacial morphology, occlusion and dental age in children with the SRS. DESIGN: A descriptive literature-controlled study. SETTING AND SAMPLE POPULATION: Sixteen children diagnosed as having SRS, 10 boys and six girls, aged 4.4-14.5 years, were referred from different parts of Sweden to the Queen Silvia Children's Hospital, Göteborg University. EXPERIMENTAL VARIABLE: Facial morphology was measured on lateral and postero-anterior radiographs. Occlusion, tooth eruption and palatal height were measured on casts, and dental maturity was evaluated on orthopantomograms. OUTCOME MEASURE: Linear and angular measurements were obtained from lateral radiographs and the ratios of the linear measurements from the postero-anterior radiographs. The degree of tooth calcification shown on orthopantomograms was taken as a measure of dental maturity. Biometric measurements were taken and the degree of tooth eruption was recorded from the dental casts. The SRS children were compared with reference groups with t-test and z-scores. RESULTS: Overall, SRS children were found to have smaller linear facial dimensions and deviations in the facial proportions, such as a small retropositioned, and steeply inclined maxilla and mandible, and a proportionally larger anterior facial height in relation to the posterior facial height. In 40% of them a smaller facial height or length on one side (facial asymmetry) was correlated to the smaller side of the body. The frequency of malocclusions was higher, and the palatal height showed a tendency towards an increase. Dental maturity was within normal limits, while the time of tooth eruption was slightly delayed. CONCLUSIONS: The deviating facial morphology described above is a part of the syndrome, which is characterized by short stature, growth hormone deficiency and asymmetries of the body. The higher percentage of malocclusions in the SRS children might lead to a greater need of orthodontic treatment.

Abnormalities, Multiple↗

The Ruffini ending as the primary mechanoreceptor in the periodontal ligament: its morphology, cytochemical features, regeneration, and development.

The periodontal ligament receives a rich sensory nerve supply and contains many nociceptors and mechanoreceptors. Although its various kinds of mechanoreceptors have been reported in the past, only recently have studies revealed that the Ruffini endings--categorized as low-threshold, slowly adapting, type II mechanoreceptors--are the primary mechanoreceptors in the periodontal ligament. The periodontal Ruffini endings display dendritic ramifications with expanded terminal buttons and, furthermore, are ultrastructurally characterized by expanded axon terminals filled with many mitochondria and by an association with terminal or lamellar Schwann cells. The axon terminals of the periodontal Ruffini endings have finger-like projections called axonal spines or microspikes, which extend into the surrounding tissue to detect the deformation of collagen fibers. The functional basis of the periodontal Ruffini endings has been analyzed by histochemical techniques. Histochemically, the axon terminals are reactive for cytochrome oxidase activity, and the terminal Schwann cells have both non-specific cholinesterase and acid phosphatase activity. On the other hand, many investigations have suggested that the Ruffini endings have a high potential for neuroplasticity. For example, immunoreactivity for p75-NGFR (low-affinity nerve growth factor receptor) and GAP-43 (growth-associated protein-43), both of which play important roles in nerve regeneration/development processes, have been reported in the periodontal Ruffini endings, even in adult animals (though these proteins are usually repressed or down-regulated in mature neurons). Furthermore, in experimental studies on nerve injury to the inferior alveolar nerve, the degeneration of Ruffini endings takes place immediately after nerve injury, with regeneration beginning from 3 to 5 days later, and the distribution and terminal morphology returning to almost normal at around 14 days. During regeneration, some regenerating Ruffini endings expressed neuropeptide Y, which is rarely observed in normal animals. On the other hand, the periodontal Ruffini endings show stage-specific configurations which are closely related to tooth eruption and the addition of occlusal forces to the tooth during postnatal development, suggesting that mechanical stimuli due to tooth eruption and occlusion are a prerequisite for the differentiation and maturation of the periodontal Ruffini endings. Further investigations are needed to clarify the involvement of growth factors in the molecular mechanisms of the development and regeneration processes of the Ruffini endings.

Acid Phosphatase↗

The role of magnesium in the aetiology and prevention of caries: some new findings and implications.

While some epidemiological studies seem to indicate that a high intake of magnesium should be associated with a low prevalence of dental caries, the results of experimental studies are mainly equivocal. Magnesium is probably not bound to the apatite lattice of dental enamel or dentine, or it is bound to a small degree only. It is mainly located in the hydration layer of the apatite crystallites. In the dental caries process it is preferentially dissolved together with the carbonate of the mineral phase. It is not known to what extent feasible dietary changes can modify tooth magnesium content during pre-eruptive tooth development. Animal experiments indicate that the elevation of dietary magnesium alone after tooth eruption has no definite capacity to modify the occurrence of dental caries. When fed in combination with small fluoride supplements in the diet magnesium and fluoride may support each other in preventing various calcium salt imbalances such as dental caries, arteriosclerosis and nephrocalcinosis. Although some recent in vitro findings indicate that extra magnesium in the fluid environment of cariogenic streptococci may protect them against the inhibitory action of fluoride, such magnesium changes do not seem possible in the human mouth under present or envisaged dietary conditions.

Bacteria↗

Osteoclast diseases and dental abnormalities.

Tooth eruption depends on the presence of osteoclasts to create an eruption pathway through the alveolar bone. In diseases where osteoclast formation, or function is reduced, such as the various types of osteopetrosis, tooth eruption is affected. Diseases in which osteoclast formation or activity is increased, such as familiar expansile osteolysis and Paget's disease, are associated with dental abnormalities such as root resorption and premature tooth loss. Less is known about the origin of the dental problems in these conditions as there are no rodent models of these diseases as yet. In this short review, the genes currently known to be mutated in human osteoclast diseases will be reviewed and, where known, the effect of osteoclast dysfunction on dental development described. It will focus on human conditions and only mention rodent disease where no clear data in the human are available.

Alveolar Process↗

Effect of loading on the migration of periodontal fibroblasts in the rat incisor.

The influence of occlusal loading on periodontal fibroblasts was investigated in hypoloaded (shortened out of occlusion), functionally loaded and hyperloaded (constant linguointrusive mechanical loads of 9.4 +/- 0.06 g) lower left rat incisors. One hour following injection of 3H-thymidine, half of the animals in each group were killed, while the remaining rats were killed 2 weeks later. The decalcified incisors were embedded in glycolmethacrylate and sectioned (2 microns) serially, perpendicularly to the long tooth axis. Labeled and unlabeled fibroblasts in the tooth-related periodontal ligament were counted in 8 x 80 microns consecutive layers. Cell density (CD) and labeling index (LI) were plotted according to their location on the apico-incisal and cementum-bone axes. Loading caused a decrease in CD and a shift of cells from the cementum towards the middle of the ligament, proportionally to load intensity and duration. The average tooth-to-bone movement of the cells was 2 microns/day in the hypoloaded and 4 microns/day in the two loaded groups. The mean daily tooth eruption rate was 975 +/- 60 microns, 499 +/- 18 microns and 103 +/- 27 microns in the hypo-, functionally- and hyperloaded teeth, respectively. The respective concomitant average daily cell migration rates in the incisal direction were 786 microns, 500 microns, and 500 microns, i.e. 80%, 100% and 485% of the tooth eruption rates. The gross disparity between cell velocity and tooth movement under conditions of restrained eruption indicates active motility of the fibroblasts, rather than their passive tooth-eruption dependent translation.

Analysis of Variance↗

Effects of colchicine and hydrocortisone on unimpeded eruption rates of root-resected mandibular incisors of rats.

A single injection of colchicine and daily injections of hydrocortisone have opposite effects on tooth eruption, respectively causing marked reduction and marked increase in unimpeded eruption rates in the root-resected incisors of rats. Unimpeded eruption rates of both root-resected and normal, non-resected, incisors responded identically to these two drugs, providing support for the view that the eruptive process following root resection is physiological. It was not possible to obtain direct evidence relating to either the hydrostatic pressure or the periodontal fibroblast hypotheses of tooth eruption; the drugs used to affect the eruption rates of resected rat incisors could also affect either the tissue hydrostatic pressure or the motility or contractibility of periodontal fibroblasts or both.

Animals↗

Experimental study in the dog of the non-active role of the tooth in the eruptive process.

The role of the tooth in eruption was studied radiographically and histologically after experimental manipulations of the crowns of permanent mandibular premolars in dogs. Crowns were removed and dead crown shells or metal or silicone replicas were substituted into dental follicles just prior to scheduled eruption. These replacements erupted on schedule after formation of the usual eruption pathways and formation of trabecular bone from the base of the bony crypt. Removal of crowns, but without adding replacements, also exhibited these same hallmarks of eruption. We conclude that tooth eruption is a series of metabolic events in alveolar bone characterized by bone resorption and formation on opposite sides of the dental follicle and the tooth does not contribute to this process.

Alveolar Process↗