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Detection of simulated internal tooth resorption using conventional radiography and subtraction imaging.

OBJECTIVES: To compare the diagnostic accuracy of conventional radiography with digital subtraction imaging in the detection of simulated internal resorption. METHODS: Simulated resorption cavities were created by the sequential use of progressively larger round burs (ISO size range 006-016) in the labial wall of the coronal or apical thirds of the pulp chamber of the maxillary incisors of two cadavers. Five viewers examined 120 pairs of radiographs, one of each pair being baseline (no lesion) and the other with or without a lesion. The process was then repeated with subtraction images of the pairs of radiographs. Receiver Operating Characteristic (ROC) analysis was used to compare the diagnostic accuracy of the two imaging modalities. RESULTS: Using conventional radiography, the minimum lesion size detectable coronally was in the 'medium' range (ISO size 010 and 012 round burs), but only 'large' lesions (ISO size 014 and 016) could be detected in the apical region. The overall diagnostic accuracy of subtraction imaging was superior to conventional radiography but only significant (P<0.05) for coronal lesions. CONCLUSION: Subtraction radiography may be a useful tool for detecting and monitoring the progress of internal root resorption.

Cadaver↗

Aneurysmal bone cyst of the maxilla--an association with tooth resorption.

The aneurysmal bone cyst is an uncommon lesion of the jaws. Cases involving the maxilla have been reported infrequently. Despite uncertainty as to the aetiology of the aneurysmal bone cyst, it is regarded as a benign lesion. Conservative surgical treatment with regular postoperative follow-up is recommended. The case described here presented with tooth mobility resulting from extensive root resorption. A review of the literature reveals that significant root resorption is not a commonly reported feature of aneurysmal bone cysts. For the present case we interpret the evidence as supporting a diagnosis of idiopathic root resorption complicated by the formation of a aneurysmal bone cyst.

Adult↗

[Morphological and functional properties of odontoclasts on dentine resorption].

Tooth root resorption in tooth movement is the principal unsolved problem in orthodontics. In order to study this mechanism, odontoclasts in bovine deciduous tooth root-resorbing tissues (RRT) were cultured and characterized for their biological properties in comparison with those of osteoclasts. Multinucleated cells isolated from the RRT had tartrate-resistant acid phosphatase activity and responded to calcitonin and also formed the resorption lacunae on the dentine. These results are consistent with the notion that odontoclasts resemble osteoclasts with respect to enzyme-cytochemical and morphological properties. However, odontoclasts cultured on dentine in the presence of 1 alpha,25-dihydroxyvitamin D3 demonstrated a higher activity in forming resorption lacunae than did osteoclasts. Immunohistochemical examinations revealed that interleukin-1 (IL-1) was detected in mononuclear cells and occasionally in odontoclasts that were present adjacent to the site where active root resorption occurred. The IL-1 stimulated the formation of resorption lacunae on dentine to a higher extent in odontoclasts than in osteoclasts, suggesting functional differences between odontoclasts and osteoclasts. In conclusion, the present study demonstrates that 1) odontoclasts present in the RRT possess similar biological properties to those of osteoclasts. However, under certain circumstances odontoclasts may behave differently from osteoclasts; 2) IL-1 produced in the RRT might play a role in controlling the function of odontoclasts in a paracrine and autocrine fashion.

Animals↗

[Frequency of the external resorptions of tooth roots].

Root resorptions present a significant problem in endodontic therapy of the affected teeth and in dentistry in general. The objective of this study was to analyze, based on epidemiological and statistical research, the frequency of clinical incidence of pathological root resorptions in everyday practice related to localization, type of tooth, age and sex of patients. Radiographic documentation of patients treated from 1997 till 2002 at the Department of Conservative Dentistry and Endodontics, Faculty of Stomatology in Belgrade, was used as baseline for this study. Retroalveolar radiographs of teeth with visible signs of resorptions were singled out from 15654 patients' clinical records used for this study. The external resorptions were shown as radiolucent areas localized on various outer root surfaces, followed by significant or less significant resorption of lamina dura and alveolar bone. Out of all teeth analyzed in this study, 594 (3.79%) showed some kind of resorption. The external resorptions were found to be more present in the upper jaw (55.10%) and molars (50.30%) than in the lower jaw (44.90%) and single root teeth (49.70%), but in both cases without significant statistical differences. The most frequent localization of resorptions was root apex (82.44%). In regard to age, the most frequent resorptions were recorded in patients aged between 21 and 30 years (28.40%), and the lowest incidence was found in the youngest population (5.51%). The results also showed that resorptions were more frequent among the female population (59.04%) than among the male population (40.96%). Based on these results, we may conclude that the external root resorptions are not a frequent clinical phenomenon. Proper and early diagnostics of such tissue pathology is one of the basic prerequisites for successful endodontic therapy of the affected root.

Adolescent↗