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At least 613 records · Page 34Linked to original sources
PubMed1992

Effects of destructive periodontitis, induced by diet, on the mechanical properties of the periodontal ligament of the mandibular first molar in golden hamsters.

To examine progressive changes in the mechanical properties of the periodontal ligament in the hamster mandibular first molar with experimental periodontitis--induced by feeding a high-carbohydrate diet--load-deformation curves obtained by extracting the tooth from its socket in the dissected jaw were analyzed. The maximum shear load, elastic stiffness and failure energy in shear in the experimental groups decreased significantly during the experimental period. On the other hand, significant differences in the maximum deformation were not found between the experimental and the relevant control groups. Radiographic and histological observations showed that the alveolar bone loss and destruction of the periodontal tissues occurred at the cervical region of the tooth in the experimental animals at 8 and 12 weeks after the start of the experiment. It is suggested that the reduction of the mechanical strength of the periodontal ligament in the experimental animals may be due to the alveolar bone loss, destruction of the periodontal tissues at the cervical region--particularly on the lingual aspect--followed by a decrease in the surface area of the ligament. It is also suggested that degenerative changes in the remaining periodontal ligament occurred in hamsters with periodontal disease, causing a reduction in the mechanical strength of the ligament.

Alveolar Bone Loss↗
PubMed2002

Proximal contact formation with different restorative materials and techniques.

PURPOSE: To determine, whether different tooth colored materials and application techniques influence the proximal contact strengths (PCS) in vitro. MATERIALS AND METHODS: Standardized MO-cavities for direct restorations were prepared into 360 artificial lower first molars. Eight groups were formed (n = 45) and restored with amalgam (1), low (2, 3), medium (4, 5) and high (6, 7) viscosity hybrid composites and compared to the original contact strengths of the unprepared teeth (8). The restored teeth were mounted into a socket simulating physiological tooth mobility. PCS were quantified by measuring the forces necessary for passing the proximal contact with floss under standardized conditions using a universal testing machine. RESULTS: PCS ranged from 1.32 +/- 0.56 N for the low viscosity composite to 9.90 +/- 1.98 N for the Amalgam restoration. Medium (5.65 +/- 1.08 N) and high viscosity hybrid composites (5.90 +/- 1.45 N) inserted in a multi-layer technique showed no statistically significant differences to the original PCS of the unprepared teeth (5.76 +/- 0.53 N).

Analysis of Variance↗
PubMed2005

Fibrin adhesive implant in wound healing repair of dental sockets with topical application of epsilon aminocaproic acid: histological analysis.

The aim of the study was to evaluate wound healing repair of dental sockets after topical application of 5% epsilon-aminocaproic acid (EACA) and the use of fibrin adhesive implant in rats under anticoagulant therapy with warfarin. Sixty Albinus wistar rats were used, divided into three groups of 20. In Group I, the animals were given 0.1 mL/100 mg of 0.9% saline solution per day, beginning 6 days before dental extraction and continuing throughout the experimental period. In Group II, the animals received 0.03 mL of sodium warfarin daily, beginning 6 days before the surgery and continuing until the day of sacrifice; after tooth extractions, the sockets were filled with fibrin adhesive material. In Group III the animals were treated as in Group II, and after extractions, the sockets were irrigated with 5 mL of 5% EACA and filled with the same fibrin adhesive material. All groups presented biological phases of wound healing repair, the differences being evident only in the chronology. The results obtained in Group III were very similar to those of Group I in the last period of wound repair, whereas Group II presented a late chronology compared to the other groups.

Administration, Topical↗
PubMed1990

[Measurement of supra-eruption of the human first upper molar in the absence of an opposing tooth].

The situation and configuration of the occlusal plane can be modified by the process of supra-eruption, which can be split up into: active eruption (the tooth leaves its socket) and periodontal growth. In order to dissociate and better by understand them, supra eruption of the first upper molar was observed in the absence of the first lower molar. Three groups of subjects were selected, the first group, our reference group (n = 50), consisted of subjects with complete healthy dental arches for which we could determine the extent of the gingival margin and the crown height. The second group of subjects (n = 50) differed from the former by the presence of a supra-erupted first upper molar. This allowed us to evaluate the migration of the gingival margin and the crown height increase in terms of the length of time the antagonist tooth was missing. The analysis of these 2 values shows that in the early years after the tooth loss, supra-eruption is due mainly to periodontal growth. It is only later that tooth movement beyond the occlusal plane is due principally to active eruption. The third group was made up of subjects showing pathological conditions of the periodontium. We observed an apical migration of the gingival margin and in increase in crown height, resulting from a periodontal regression (passive eruption) and a rapid active eruption.

Adult↗
PubMed1990

Dental implant reconstruction after endodontic failure: report of case.

Avulsion of natural teeth caused by trauma may present an unusual problem for the general practitioner. Endodontic therapy and replantation of the tooth into the socket have a relatively low long-term prognosis because of internal or external root resorption. Dental implants can provide proper support and function for missing teeth with excellent esthetic results without preparation of natural dentition. In this case report, an implant system is used to restore an anterior space created by the loss of endodontically treated central and lateral incisors.

Adult↗
PubMed2006

Experimental-numerical analysis of minipig's multi-rooted teeth.

The paper pertains to the analysis of the biomechanical behaviour of the periodontal ligament (PDL) by using a combined experimental and numerical approach. Experimental analysis provides information about a two-rooted pig premolar tooth in its socket with regard to morphological configuration and deformational response. The numerical analysis developed for the present investigation adopts a specific anisotropic hyperelastic formulation, accounting for tissue structural arrangement. The parameters to be adopted for the PDL constitutive model are evaluated with reference to data deducted from experimental in vitro tests on different specimens taken from literature. According to morphometric data relieved, solid models are provided as basis for the development of numerical models that adopt the constitutive formulation proposed. A reciprocal validation of experimental and numerical data allows for the evaluation of reliability of results obtained. The work is intended as preliminary investigation to study the correlation between mechanical status of PDL and induction to cellular activity in orthodontic treatments.

Animals↗
PubMed1989

Effects of lathyrogens on the mechanical strength of the periodontal ligament in the rat mandibular first molar.

Effects of lathyrogens such as aminoacetonitrile (AAN), beta-aminopropionitrile (BAPN) and cysteamine--known inhibitors of cross-linking of collagen--on the mechanical strength of the periodontal ligament of the rat mandibular first molar were examined by measuring the ultimate load required to extract the tooth from its socket in the dissected jaw. Single injections of AAN (40 approximately 100 mg/100 g body weight) or of BAPN (100 mg/100 g body weight) caused significant decreases of the mechanical strength 24 h after administration of the drugs but that of cysteamine (30 mg/100 g body weight) did not. Significant correlations between the dose of AAN or of BAPN and the mechanical strength were found following daily administrations of the drugs for 5 days. The relative potency of AAN to BAPN was estimated to be 4.5 by a slope ratio assay. The rapid appearance and disappearance of the effect of lathyrogens on the mechanical strength of the periodontal ligament of the rat mandibular first molar provide further evidence that the turnover of the collagen in the tissue is fast. The half-time of collagen synthesis was estimated to be approximately 3 d.

Acetonitriles↗
PubMed1998

Rapid canine retraction through distraction of the periodontal ligament.

The process of osteogenesis in the periodontal ligament during orthodontic tooth movement is similar to the osteogenesis in the midpalatal suture during rapid palatal expansion. A new concept of "distracting the periodontal ligament" is proposed to elicit rapid canine retraction in 3 weeks. It is called dental distraction. Fifteen orthodontic patients (26 canines, including 15 uppers and 11 lowers) who needed canine retraction and first premolar extraction were included. At the time of first premolar extraction, the interseptal bone distal to the canine was undermined with a bone bur, grooving vertically inside the extraction socket along the buccal and lingual sides and extending obliquely toward the socket base. Then, a tooth-borne, custom-made, intraoral distraction device was placed to distract the canine distally into the extraction space. It was activated 0.5 to 1.0 mm/day immediately after the extraction. The anchor units were the second premolar and first molar. Cephalometric and periapical x-rays were taken before and after the canine retraction. Both the upper and lower canines were distracted bodily 6.5 mm into the extraction space within 3 weeks. New alveolar bone was generated and remodeled rapidly in the mesial periodontal ligament of the canine during and after the distraction. It became mature and indistinguishable from the native alveolar bone 3 months after distraction. During the distraction, 73% of the first molars did not move mesially and 27% of them moved less than 0.5 mm mesially within 3 weeks. The radiographic examination revealed that apical or lateral surface root resorption of the canine was minimal. No periodontal defect or endodontic lesion was observed throughout and after distraction. We concluded that the periodontal ligament could be rapidly distracted without complications. The rapid orthodontic tooth movement through distracting the periodontal ligament cannot be emulated by current conventional orthodontic concepts and methods.

Activator Appliances↗
PubMed2002

Treatment of replacement resorption with Emdogain--a prospective clinical study.

The present clinical study investigated the outcome of intentional replantation using Emdogain for periodontal healing following trauma-related ankylosis. Sixteen ankylosed teeth affected by replacement resorption were treated as follows: After tooth extraction, the root canal was obturated with a retrograde titanium post. Emdogain was applied to the root surface and into the extraction socket with subsequent replantation of the tooth. Evaluation parameters included horizontal and vertical Periotest scores, percussion sound and periapical radiographs. All findings were compared to those of the adjacent teeth. The mean follow-up period was 15 months (range 4-24 months). Eleven teeth showed no signs of recurrence of ankylosis: they were in full function and exhibited no pathological clinical findings. Four severely traumatized teeth demonstrated a recurrence of ankylosis after a mean period of 6 months, one tooth was lost in a second accident after 7 months. The estimated probability of 1 year without recurrence of ankylosis was P=0.66 (95% confidence interval [0.40; 0.94]). The mean survival time was 10.2 months (SD 1.1). The results indicate that treatment of replacement resorption following light to moderate trauma with replantation and Emdogain appears to prevent or delay recurrence of ankylosis in many cases.

Adolescent↗
PubMed2006

Interventions for replacing missing teeth: dental implants in fresh extraction sockets (immediate, immediate-delayed and delayed implants).

BACKGROUND: Dental implants can be placed in fresh sockets just after tooth extraction. These are called 'immediate' implants. 'Immediate-delayed' implants are those implants inserted after weeks up to about a couple of months to allow for soft tissue healing. 'Delayed' implants are those placed thereafter in partially or completely healed bone. The advantages of immediate implants are that treatment time can be shortened and that bone height might be maintained thus possibly improving the aesthetic results. The potential disadvantages are an increased risk of infection and failures of the immediately placed implants. OBJECTIVES: To evaluate success, function, complications and patient satisfaction between 'immediate', 'immediate-delayed' and 'delayed' implants. SEARCH STRATEGY: The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched. Several dental journals were handsearched. The bibliographies of review articles were checked, and personal references were searched. More than 55 implant manufacturing companies were also contacted. Last electronic search was conducted on 7 August 2006. SELECTION CRITERIA: Randomised controlled trials (RCTs) and preference RCT evaluating immediate, immediate-delayed, and delayed implants, reporting the outcome of the interventions to at least 1 year after functional loading. DATA COLLECTION AND ANALYSIS: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted independently and in duplicate. Authors were contacted for any missing information. Results were expressed as random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals (CIs). The statistical unit of the analysis was the patient. MAIN RESULTS: Two RCTs were included. One RCT compared immediate implants placed in periapical infected sites versus delayed implants in 50 patients and after 1 year found no statistically significant differences. The second RCT compared immediate-delayed versus immediate implants in 46 patients. After 1 year and a half there were no statistically significant differences for prosthesis and implant failures, complications, aesthetics assessed by the patient and the papilla height assessed by the dentist. However, patients in the delayed group perceiving the period between tooth extraction and insertion of the crown significantly longer than patients in the immediate-delayed group, mean difference of VAS -20.30 (95% CI -33.36 to -7.24). There was also statistically significantly higher patient satisfaction in the immediate-delayed group, mean difference (VAS) -6.51 (95% CI -12.63 to -0.39). An independent blinded assessor judged the level of the perimplant marginal mucosa in relation to that of the adjacent teeth as more appropriate in the immediate-delayed group, with risk ratio (RR) 1.68 (95% CI 1.04 to 2.72). AUTHORS' CONCLUSIONS: Despite that the evidence is derived from only two RCTs with a limited number of patients, it is possible to suggest that immediate implants and immediate-delayed implants may offer some advantages over conventional implants in healed sites in terms of patient satisfaction and aesthetics possibly by preserving alveolar bone. Immediate implants can work and are able to shorten treatment periods, however properly designed RCTs are still needed to fully evaluate the potential advantages and risks of this treatment modality since more complications and failures may occur.

Dental Implantation, Endosseous↗
PubMed2001

Different treatment outcomes of two intruded permanent incisors--a case report.

Intrusive luxation involves the displacement of the tooth apically into the alveolar socket. This type of injury represents a very complex wound, involving disruption of the marginal gingival seal, alveolar bone, periodontal ligament fibers, cementum and the neuro-vascular supply to the pulp, which results in severely compromised healing and possible complications. The case presented is a report of a 60-year-old lady who fell and intruded her two maxillary central incisors. The healing outcomes of the two central incisors were markedly different from each other even though they sustained similar injuries.

Alveolar Process↗
PubMed2004

Postextraction tissue management: a soft tissue punch technique.

The aim of this prospective clinical study was to analyze graft-enhanced soft tissue healing during the initial phases after tooth extraction. Twenty patients in need of tooth extraction (incisors, canines, and premolars) and implant replacement were included. In patients with multiple extractions, one tooth was randomly selected for treatment. After administration of antibiotics, the selected tooth was gently removed. The socket was completely filled with deproteinized bovine bone mineral integrated in a 10% collagen matrix to fill out the space of the alveolus and support the soft tissue. A biopsy punch with a diameter corresponding to the socket orifice was chosen to harvest a free gingival graft of 2- to 3-mm thickness from the palate. The punched graft was carefully sutured to the deepithelialized soft tissue margins of the socket. One week after graft insertion, 64.3% of the mean graft area was fully integrated, 35.6% was fibrinoid, and 0.1% showed necrotic parts. Three and 6 weeks postsurgery, the mean integrated graft surface increased to 92.3% and 99.7%, respectively. After 6 weeks, a mean of 0.3% of the surface in four grafts showed incomplete wound closure, and no fibrin or necrosis was present. Colorimetry of the graft and adjacent tissue revealed a mean color match of deltaE = 2.91, lower than the critical threshold of 3.7 for intraoral visibility of different colors. This soft tissue punch technique led to successful biologic and esthetic integration of the transplanted graft into the local host tissues.

Adult↗
PubMed2001

Treatment of replacement resorption with Emdogain--preliminary results after 10 months.

Ankylosis of traumatized teeth in children and adolescents may inhibit further development and growth of the corresponding jawbone. Therefore, ankylosed teeth should be removed. As an alternative treatment option to autotransplantation of a premolar, intentional replantation using Emdogain may be considered, provided the ankylosis is detected at an early stage or has only affected a small area of the root. Eleven ankylosed teeth presenting with replacement resorption were treated as follows: after tooth extraction, the root canal was treated extraorally and obturated by retrograde insertion of a titanium post. Emdogain was applied to the root surface and into the extraction socket with subsequent replantation of the tooth. During a mean follow-up period of 6.3 months, no signs of recurrence of ankylosis were noted. The horizontally and vertically measured Periotest scores were identical to those obtained on the adjacent teeth. These results suggest that intentional replantation using Emdogain may prevent or delay ankylosis of these replanted teeth.

Adolescent↗
PubMed1999

Immediate placement of implants in extraction sites of maxillary impacted canines.

BACKGROUND: Treatment of asymptomatic impacted maxillary canines in adults is inevitable when primary canine becomes lost through extraction or exfoliation or when the impacted tooth becomes symptomatic. Treatment alternatives include an orthodontic procedure to bring the unerupted tooth to the dental arch or prosthetic replacement of the missing tooth. The authors describe an alternative treatment that involves immediate placement of implants into extraction sockets of the teeth. CASE DESCRIPTION: A patient with bilateral palatally impacted upper canines chose to have the unerupted teeth removed and replaced with implants and crowns. Two hydroxyapatite cylindrical implants were inserted through the alveolar ridge into the extraction sites. The unfilled areas in the extraction sites, around the dental implants, were packed and covered with demineralized freeze-dried bone allograft in conjunction with a collagen membrane barrier. Six months after implantation, computed tomography revealed complete osseous fill of the extraction defects and no bone loss around the implants. The implants were uncovered, and porcelain-fused-to-metal restorations were fabricated and placed. CLINICAL IMPLICATIONS: This treatment modality avoids the need for conventional preparation of teeth as part of prosthetic reconstruction or prolonged orthodontic treatment aimed at bringing the impacted canine to the dental arch. Combining the implantation with bone augmentation preserved the alveolar bone and shortened the treatment period.

Bone Transplantation↗
PubMed2004

Extraction sockets and implantation of hydroxyapatites with membrane barriers: a histologic study.

The purpose of this pilot study was to investigate the effect on extraction socket healing when an absorbable hydroxyapatite (AH) and a nonabsorbable anorganic bovine bone mineral (ABB) covered with either an acellular dermal matrix allograft (ADMA) or expanded polytetrafluoroethylene (ePTFE) membrane barrier were left exposed to the oral cavity. Following tooth extraction, a total of 16 sockets in 15 patients with deficient buccal plates of > or =5 mm were randomly divided into 4 treatment groups: 1) AH covered with ADMA, 2) AH covered with an ePTFE membrane, 3) ABB covered with ADMA, and 4) ABB covered with an ePTFE membrane. Primary coverage was not attempted or obtained in any of the 16 treated sockets. Six to 8 months postextraction at the time of implant placement, histologic cores of the treatment sites were obtained. These cores were processed, stained with Stevenel's blue/van Gieson's picro fuchsin, and histomorphometrically analyzed. Vital bone, connective tissue and marrow, and residual graft particles were reported as a percentage of the total core. The mean vital bone was 34.5% (AH with ADMA), 41.7% (ABB with ADMA), 27.6% (ePTFE and AH), and 17.8% (ePTFE and ABB). The average percentage of vital bone in the 8 sockets covered with ADAMA was 38% compared with an average percentage vital bone of 22% in the 8 sockets covered with ePTFE membrane barriers. Because of the small number of specimens in the 4 groups, statistical analysis was not possible. However, in this pilot study, ADMA-covered sites resulted in more vital bone present 6 to 8 months postsocket treatment than obtained in the ePTFE-covered sites regardless of bone replacement materials used. Further research is warranted to see if these results show a similar difference in bone-to-implant contact after implant placement.

Adult↗
PubMed2003

[Dental implants following trauma in young adults].

Various statistics have shown that avulsion (total displacement of tooth out of its socket) following traumatic injuries is relatively infrequent, ranging from 0.5 to 16% of traumatic injuries in the permanent dentition. The maxillary central incisors are the most frequently avulsed teeth. Avulsion of teeth occurs most often in children from 7 to 9 years of age, when the permanent incisors are erupting. Most frequently, avulsion involves a single tooth; but multiple avulsion are occasionally encountered. Fractures of the alveolar socket wall are often associate with avulsion. After the tooth is lost, an almost certain sequelae is the rapid resorption of alveolar bone. In many cases, only a very thin crestal bony lamella remains after healing of the alveolus, with clinically obvious horizontal and vertical depressions. In a young patient missing an anterior tooth, the operator may find implant insertion, in the proper anatomical position, difficult or impossible, because of inadequate bone volume. This situation aggravates with time because of continuous resorption and relative growth of the adjacent alveolar bone around the teeth. New and predictable bone augmentation techniques allow compensation for bone reduction while waiting for completion of growth. In cases of localized ridge augmentation, the amount of initial bone volume and its shape dictate whether implant insertion and bone augmentation will be performed simultaneously. The indications for this approach are: sufficient bone volume to achieve initial implant stability and a predictably high success rate for the augmentation. When bone volume and shape do not allow for initial stability, there is indication for a staged approach, in which the bone is initially augmented, the results are evaluated and the implant is then inserted. The first stage, the bone regeneration phase, may last between 8-10 months. The second, the implant integration period, may take an additional 6-8 months. The effect of growth on the augmented bone is not quite clear and there is only a paucity of information concerning the use of bone regeneration procedures in growing patients. Clinical decision when to start implant treatment after avulsion is dependent not only on the timing of implant insertion, but also on bone regeneration procedures. When most of horizontal and vertical bony walls of the extraction site is lost, augmentation procedure as a measure to reduce the deficiency, may be considered even in preadolescents. Three cases describing different clinical situations following avulsion, tooth replacement, resorption, regeneration treatment and implant insertion are discussed.

Adolescent↗