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PubMed1993

[Oral complications following a herpes zoster infection of trigeminal nerve].

A case of herpes zoster involving the ophthalmic and maxillary divisions of the trigeminal nerve is reported. It presented as a oral herpes zoster infection with prodromal odontalgia and progressed to spontaneous exfoliation and devitalization of teeth and osteonecrosis of the maxilla. The literature is reviewed and the pathophysiology of tooth exfoliation, tooth devitalization and osteonecrosis by V-Z viruses are discussed in addition to the management of herpes zoster and post-zoster complications.

Adult↗
PubMedDate not supplied

Aspiration of a primary tooth in a patient with a tracheostomy.

Aspiration of a foreign object is uncommon in a patient with a tracheostomy. The following case history describes the consequences of failure to diagnose an aspirated object and how the aspiration of an exfoliated tooth can occur despite the presence of a tracheostomy tube. Dentists play an important role in preventing foreign body aspiration in debilitated patients.

Bronchi↗
PubMedDate not supplied

Clinical and radiographic assessment of Class II esthetic restorations in primary molars.

PURPOSE: The aim of the study was to access the clinical performance of two esthetic materials (Vitremer and Z100 + Scotchbond Multipurpose) when used as Class II restorations in primary molars, and compare them to amalgam controls. METHODS: A total of 102 restorations were placed in primary molars of 29 schoolchildren; 40 were of Vitremer, 38 of Z100 + Scotchbond Multipurpose, and 24 of amalgam (Dispersalloy). The restorations were evaluated clinically at baseline and after 6, 12, 18, 24 months, or until tooth exfoliation or patient drop-out, following the modified Cvar and Ryge criteria. Radiographs were taken at yearly intervals, and the radiograph of the last examination available was assessed and scored. RESULTS: The majority of the restorations examined clinically up to 18 months was good (Alpha according to Cvar and Ryge), and no statistically significant differences between the groups was observed. However, at the 19-24 months evaluation, Z100 rated better than Vitremer for surface appearance and color match. The prevalence of radiolucent defects at the cervical margin for the Z100 (47%) was significantly higher than for amalgam (11%) restorations (P = 0.002) and for Vitremer (13%) restorations (P = 0.008). CONCLUSION: The three materials evaluated (Vitremer, Z100 and Dispersalloy) presented satisfactory clinical performance during the time evaluated (approximately 2 years). Approximately half of the composite resin restorations presented radiographic defects that might require replacement at a later date. In contrast, glass ionomer and amalgam restorations presented significantly less radiographic defects at the time of the final examination. This study suggests that composite resins are indicated for classII restorations in primary molars that are expected to exfoliate within two years.

Analysis of Variance↗
PubMed2000

Delayed eruption of permanent teeth in hyperimmunoglobulinemia E recurrent infection syndrome.

OBJECTIVE: To determine the incidence of abnormal tooth eruption in patients with hyperimmunoglobulinemia E (hyper-IgE) syndrome. STUDY DESIGN: This study evaluated 34 individuals with hyper-IgE syndrome (age range, 2-40 years). A comprehensive dental history and a head and neck evaluation were performed on all patients. Dental age was assessed in patients younger than 17 years by 2 methods: (1) clinical assessment of tooth eruption and (2) a radiographic method. Relationships between the chronologic age, dental developmental age, and age at tooth eruption were determined. Other oral or dental anomalies were recorded. RESULTS: Of patients older than 7 years, 75% reported problems with permanent tooth eruption, as evidenced by retained primary teeth or the need for elective extractions of primary teeth to allow eruption of permanent teeth. None of the patients experienced problems with eruption of primary teeth. Eruption of the first and second permanent molars also occurred on time. Dental maturity scores were established for 14 patients 17 years of age or younger. In each case, the difference between chronologic age and the estimated dental developmental age was less than 12 months; however, we found a significant discrepancy between the chronologic age and the mean age of tooth eruption in 80% of these patients when using a particular set of standardized values. Persistence of Hertwig's epithelial root sheath was observed on histologic examination. Chronic multifocal oral candidiasis was a consistent feature in patients with hyper-IgE recurrent infection syndrome. Other oral anomalies were also noted. CONCLUSION: We confirmed that a disorder of tooth eruption is part of the hyper-IgE syndrome. This problem occurs because of delayed primary tooth exfoliation rather than a developmental delay in the formation of the permanent dentition. The persistence of Hertwig's epithelial root sheath is unusual and may be associated with the lack of resorption of the primary teeth. Dentists should be aware of this feature of hyper-IgE syndrome because timely intervention will allow normal eruption to occur.

Adolescent↗
PubMed1992

Patterns and plasticity of dental afferent inputs to trigeminal (V) brainstem neurons in kittens.

In the young cat, the natural replacement of deciduous teeth with a permanent dentition may be accompanied by extensive peripheral nerve degeneration and reinnervation. Since we have previously reported significant physiological effects of tooth pulp deafferentation on V brainstem neurons, we wished to determine if deafferentation associated with deciduous tooth exfoliation was accompanied by comparable neuroplastic changes in the brainstem of kittens. We have examined the pulpal afferent terminating pattern within the brainstem as well as the electrophysiological properties of V brainstem neurons during this naturally occurring deafferentation phenomenon. The pattern of the HRP-labelled terminals in different parts of V brainstem subnuclei in kittens was similar to that in adult cats. The highest density of labelled terminals was found in the subnucleus oralis. The properties of subnucleus oralis neurons also showed many similarities between kittens at age of 3-4 months old and adult cats, e.g., (1) in the proportions of neurons activated by tactile stimulation of 1-4 teeth (mandibular and maxillary canines and premolars), (2) the ratio of neurons showing fast adapting or slow adapting responses to dental tactile stimulation, (3) the proportions of neurons activated by electrical pulp stimulation of 1-4 teeth, and (4) the minimal latencies of pulp-evoked responses. However, the incidences of pulpal inputs as well as the convergent pattern to oralis neurons of afferent inputs evoked by periodontal stimulation and electrical pulpal stimulation were less common in kittens than adult cats.

Aging↗
PubMed1976

Dental complications of cytotoxic therapy in Hodgkin's disease--a case report.

A case of trigeminal zoster in a patient with disseminated Hodgkin's disease is described. Although one case of maxillary tooth loss in a comparable patient has previously been recorded, this is the first report of mandibular tooth loss. The aetiological significance of Beomycin and I-(2-chloroethyl)-3-cyclohexyl-I-nitrosourea (C.C.N.U.) is discussed and an hypothesis for post-zoster tooth exfoliation is suggested.

Adult↗
PubMed1990

Case report: A.J. Premolar autotransplantation--eight years later.

Congenitally missing premolars often present a diagnostic concern to the orthodontist. Arch crowding, facial profile and the existing malocclusion must be evaluated to diagnose and establish treatment objectives and a treatment plan. When premolars are missing bilaterally in the arches, diagnosis and treatment mechanics can often be straightforward. The choices are (1) to close all spaces so that natural teeth contact each other or (2) to maintain the primary tooth in the missing tooth area with the possibility that a replacement tooth might be needed once the primary tooth exfoliates. The compromises of maintaining the primary tooth can include the periodontal and occlusal concerns due to the size and shape of the crown and root both occlusal-gingivally and mesio-distally.

Adolescent↗
PubMed1991

[Dysostosis cleidocranialis--a case report].

An 18-year female patient with dysostosis cleidocranialis, treated for dental anomalies characteristic of her basic disease since the age of 12, is described. Delayed resorption of deciduous teeth and eruption of permanent teeth were recorded. At the age of 12, the patient had still had all deciduous teeth, with the exception of lower incisors and right upper mesial incisor. The presence of 11 succedaneous teeth, 7 in the maxilla and 4 in the mandible, had been recorded by X-ray. The treatment performed step by step is presented. Firstly, deciduous teeth were extracted, and a prosthesis for both the maxilla and mandible were constructed to stimulate eruption of permanent teeth. All supernumerary teeth from the jaws were also surgically removed. After the permanent tooth eruption had been accomplished, orthodontic treatment of these teeth was required and it has still been successfully performed. Thus, a conclusion is made that the treatment of dental anomalies should start at the time of normally expected deciduous tooth exfoliation.

Adolescent↗
PubMed2004

The effect of partial damage to the enamel-related periodontium combined with root resection on eruption of the rat incisor eruption.

Previous work has indicated that the enamel-related periodontium (ERP) has a role in the eruptive process of the rat lower incisor. By combining partial damage of this tissue with resection of the odontogenic organ, we examined the effect of the damage on subsequent incisor eruption. The connective tissue of the enamel-related periodontium was regenerated in less than 2 weeks, showing morphology close to normal. The injured part of the enamel organ was neither regenerated nor repaired, and a cement-like tissue, continuous with the true acellular cement, was formed on the denuded enamel. Before tooth exfoliation, the operated teeth erupted at a slower rate compared with root-resected and sham-operated incisors, probably because of the absence of a substantial part of the enamel organ due to surgical damage. As with the coronal dental follicle and the enamel organ in rat molars, the enamel-related periodontium and the enamel organ of rat incisors may have some control on their eruptive process.

Aging↗
PubMed2006

Is mild dental invagination a risk factor for apical root resorption in orthodontic patients?

The purpose of this retrospective study was to assess if dental invagination is a risk factor for root resorption during orthodontic treatment. The sample consisted of 91 patients (32 males, 59 females) with a mean age of 13.1 years (range 9.3-32.1 years) with complete orthodontic records, including periapical radiographs of the maxillary incisors before and after treatment. Forty-nine patients had at least one maxillary incisor invaginated, whilst the remaining 42 patients were free of dental invaginations. Variables recorded for each patient included gender, age, Angle classification, extraction or non-extraction therapy, ANB angle, overjet, overbite, trauma, habits, agenesis, tooth exfoliation, treatment duration, Class II elastics, body-build, general factors, impacted canines, and root form deviation. Crown and root length of the maxillary incisors were measured on pre- and post-treatment long cone periapical radiographs corrected for image distortion. The percentage of root shortening and root length loss in millimetres was then calculated. Most of the invaginated teeth were minor type 1. Statistical analysis revealed no significant difference in the severity of apical root resorption between invaginated and non-invaginated incisors in patients without dental invaginations, nor was the extent of dental invagination related to the severity of apical root resorption. However, invaginated teeth had malformed roots more often than non-invaginated teeth. Dental invagination, and particularly type 1, cannot be considered a risk factor for apical root resorption during orthodontic tooth movement.

Adolescent↗
PubMed1993

Durability of restorations in primary molars.

Techniques used to restore carious primary molars have changed over the past decade as new adhesive materials have been developed. The most meaningful way of assessing the efficacy of a technique is by clinical trials. This article reviews the information concerning amalgam, composite and glass polyalkenoate (ionomer) cement as well as extracoronal restorations. Stainless steel/nickel chrome crowns provide the most durable restoration, often surviving until the tooth exfoliates. Class II amalgam restorations, whilst being prone to fracture, have been shown to survive about 3 years, a figure that improves with increasing age of the child and the use of local anaesthesia. Over the shorter term resin-based composites appear to be at least as durable as amalgam, particularly with respect to the maintenance of a good anatomical form. In contrast, when assessed at 6 years the failure rate of composite restorations is high, 62%, whereas the failure rate of amalgam restorations at 5 years is as low as 20%. Glass ionomer cements and cermets are alternative materials for use in the primary dentition. The reported success rate of 33% over 5 years for conventional glass ionomer cements is encouraging, however cermets appear to be less successful but have not been evaluated over the longer term. Glass ionomer cements provide a means of restoring primary molars with minimal amount of destruction of sound tooth tissue and reduced treatment time for the young patient, whilst the local fluoride release is also a potential advantage.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Materials↗
PubMed1999

Changes in the arch length following premature loss of deciduous molars.

When the normal physiological process of deciduous tooth exfoliation and eruption of its successor is disrupted, a series of changes are observed in the dental arches. The aim of the study was to evaluate the amount of changes in arch length after the premature loss of deciduous molars. The sample consisted of 82 children, 53 without premature loss and 29 with premature loss of either deciduous first or second molar or both, unilaterally. A reduction in arch length was observed both in the maxilla and mandible at the molar region and an increase in arch length at the canine region in the mandible. Reduction in arch length was due to mesial migration of the molar and the increase in arch length was due to the distal migration of canine. It was seen that arch length reduction was more in maxilla as compared to the mandible and that distal drifting of canine was observed only in the mandible.

Child↗
PubMed1980

A discussion of dental homology with reference to primates.

The inconsistencies which exist when the traditional tooth-to-bony-landmark/tooth-to-occlusal-relationship criteria of identification of teeth are maintained are discussed. It is pointed out how these (e.g., "the canine is the tooth behind the premaxillary-maxillary suture") can be falsified. It is also suggested that some mammals, including Tarsius and Homo sapiens, develop homologies of three sets of "teeth," and that the "adult" antemolar dentition of a mammal may be composed of retained deciduous teeth as well as permanent teeth. Following a revision of dental homologies in most primates, an approach to reevaluating dental homologies is proposed, and a model of tooth "loss" presented.

Animals↗
PubMed2001

Cellular events at the onset of physiological root resorption in rabbit deciduous teeth.

For elucidation of how physiological root resorption of deciduous teeth is initiated, the cellular events that occur surrounding the root of rabbit deciduous teeth before and at the onset of physiological root resorption were observed by means of light and electron microscopy. In addition, the cytodifferentiation of odontoclasts during the initial phase of this root resorption was evaluated by histochemical staining of tartrate-resistant acid phosphatase (TRAP) activity as a marker odontoclasts and their precursors. The present investigation was focused on the physiological root resorption of the deciduous lower second molar of rabbits from Day 0-5 postnatally. At birth, the deciduous molar had not erupted yet, and no TRAP-positive cell could be found surrounding the tissue adjacent to the root of the deciduous tooth. TRAP-positive mononuclear cells were initially detected in the coronal portion of the dental follicle of the permanent tooth at Day 1 postnatally. Ultrastructurally, these mononuclear cells had moderate numbers of mitochondria and short-strand rough endoplasmic reticulum, as well as scattered free ribosomes throughout their cytoplasm. TRAP-positive mononuclear cells then appeared in the cementoblast layer immediately adjacent to the surface of the deciduous roots. These mononuclear cells projected cytoplasmic extensions between the cementoblasts and made contact with the cementum. At that time, cell-cell contact was frequently observed between these mononuclear cells and cementoblasts. During 3-5 days postnatally, the number of TRAP-positive multinucleate odontoclasts on the root surface gradually increased. They had well-developed ruffled borders and made typical resorption lacunae on the root surface of the deciduous tooth. During this early postnatal period, neither inflammatory cells nor necrotic tissue could be observed surrounding the deciduous root. This study demonstrates that the dental follicle of the permanent tooth as well as the connective tissue adjacent to the deciduous root might play important role in site- and time-specific recruitment, development, and activation of odontoclasts before and at the onset of physiological root resorption.

Acid Phosphatase↗
PubMed2004

Cementum-like tissue deposition on the resorbed enamel surface of human deciduous teeth prior to shedding.

Prior to the shedding of human deciduous teeth, odontoclastic resorption takes place at the pulpal surface of the coronal dentin, and this resorption occasionally extends coronally from the dentinoenamel junction into the enamel. After the end of resorption, however, the resorbed enamel surface is repaired by the deposition of a cementum-like tissue. Using this phenomenon as an observation model, in this study we examined the sequence of cellular and extracellular/matrix events involved in the enamel resorption repair by light and electron microscopy. As the odontoclast terminated its resorption activity, it detached from the resorbed enamel surface; thereafter, numerous mononuclear cells were observed along the resorbed enamel surface. Most of these mononuclear cells made close contact with the resorbed enamel surface, and coated pits or patches were observed on their plasma membrane facing this surface. Furthermore, they frequently contained thin needle- or plate-like enamel crystals in their cytoplasmic vacuoles as well as secondary lysozomes. Following the disappearance of these monononuclear cells, the resorbed enamel surface now displayed a thin coat of organic matrix. Ultrastructurally, this organic layer was composed of a reticular and/or granular organic matrix, but contained no collagen fibrils. Energy-dispersive X-ray microanalysis of this thin organic layer in undecalcified sections revealed small spectral peaks of Ca and P. Cementum-like tissue initially formed along this thin organic layer, increased in width, and appeared to undergo mineralization as time progressed. The results of our observations demonstrate that regardless of type of matrix of dental hard tissues, tooth repair may be coupled to tooth resorption, and suggest that mononuclear cells and an organic thin layer found on the previously resorbed enamel surface may play an important role in the repair process initiated after resorption of the enamel.

Dental Cementum↗
PubMed2006

An approachable human adult stem cell source for hard-tissue engineering.

Stem cells were obtained from deciduous dental pulp of healthy subjects, aged 6-10 years. This stem cell population was cultured, expanded, and specifically selected, detecting using a FACsorter, c-kit, CD34, and STRO-1 antigen expression. Then, c-kit+/CD34+/STRO-1+ cells were replaced in the culture medium added of 20% FBS, leading to osteoblast differentiation. In fact, these cells, after a week, showed a large positivity for CD44, osteocalcin, and RUNX-2 markers. To achieve an adipocytic differentiation, cells, after sorting, were challenged with dexamethason 10(-8) mM in the same culture medium. To obtain myotube fusion, sorted cells were co-cultured in ATCC medium with mouse myogenic C2C12 cells and, after a week, human stem cell nuclei were found to be able to fuse, forming myotubes. Differentiated osteoblasts, as assessed by a large positivity to several specific antibodies, after 30 days of culture and already in vitro, started to secrete an extracellular mineralized matrix, which, 2 weeks later, built a considerable number of 3D woven bone samples, which showed a strong positivity to alkaline phosphatase (ALP), alizarin red, calcein, other than to specific antibodies. These bone samples, after in vivo transplantation into immunosuppressed rats, were remodeled in a lamellar bone containing entrapped osteocytes. Therefore, this study provides strong evidence that human deciduous dental pulp is an approachable "niche" of stromal stem cells, and that it is an ideal source of osteoblasts, as well as of mineralized tissue, ready for bone regeneration, transplantation, and tissue-based clinical therapies.

Alkaline Phosphatase↗