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At least 631 records · Page 35Linked to original sources
PubMed2003

Endodontic and surgical treatment of a geminated maxillary incisor.

AIM: A geminated maxillary incisor required complex multidisciplinary treatment to preserve health and restore aesthetics. This report describes the coordination of coronal division, root extraction, bone grafting, endodontic treatment and orthodontics in achieving treatment goals. It is the intention of this report to show how a difficult case could be managed by properly coordinated multidisciplinary care. SUMMARY: Pulp testing of the geminated central right maxillary incisor gave a normal response. Radiographic investigation indicated a connection of the pulp chambers. Both the mesial and distal root were filled with gutta-percha. The connection between the two root canals was sealed with a flowable dentine-bonded resin. After dividing the crown with a diamond bur, the mesial part of the tooth was removed and the extraction socket was filled with beta-tricalcium phosphate ceramic (Cerasorb). Radiographs taken immediately after surgery and after 6 months showed no periodontal or periapical lesions. No signs of external resorption were identified. The diastema between the central incisors was closed by orthodontic treatment. KEY LEARNING POINTS: Geminated teeth may present aesthetic and functional problems which require multidisciplinary care. Careful clinical and radiographic examination is essential to decide on the fate of the coronal and root halves involved. A proper coordination between endodontic and surgical treatment may result in maintaining one tooth half, even if a midroot connection between the pulp chambers becomes evident. Orthograde endodontic treatment, hemisection and orthodontics may solve the aesthetic problem of a geminated tooth.

Bone Substitutes↗
PubMed2002

Simplified technique for immediate implant insertion into extraction sockets: report of technique and preliminary results.

A technique is presented for placement of implants at the time of tooth extraction in the precisely desired positions, regardless of extraction socket morphology. To date, 162 implants have been placed utilizing this technique. One was mobile at uncovery and removed. The other implants have been successfully in function, as defined by the Albrektsson Criteria, for up to 7 years, yielding a cumulative success rate of 99.4%.

Bone Regeneration↗
PubMed2006

Development of functional dentin incisors after a partial resection of the odontogenic organ of rat incisors.

The resection of the labial half of the odontogenic organ of rat incisors resulted in the development of teeth without enamel. Ten out of 26 operated rats developed a functional dentin incisor, i.e. a continuously growing and erupting tooth. These teeth were a little shorter and much thinner than normal incisors. The dentin and pulp presented a normal structure. Periodontal ligament and cement started to develop at the lingual face and gradually all tooth faces were invested by these tissues. The original socket space, to accommodate a thinner tooth, was narrowed by newly formed bone around the inner face of the socket. Eleven rats developed defective dentin incisors; these teeth showed signs of growth, however, their eruption was impaired. The operation failed in five rats. The odontogenic organ of the dentin incisor presented islands of epithelial cells at the labial aspect of a dense mass of mesenchyme cells. These islands, formed by densely packed, dark-staining cells encircling a few pale-staining cells, merged gradually, forming a root sheath and a cervical loop limiting a long apical foramen. The bulk of the bulbous part (apical bud) was absent; thus, there was no differentiation of ameloblasts and of the crown-analogue part of the incisor. The growth and eruptive behaviour of the dentin incisor, similar to that of a normal incisor, indicates that it has to bear a stem cell niche to retain its regenerative capacity. As in the apical bud, this niche is apparently located at the stellate reticulum of the cervical loop. The putative molecular mechanisms related to either the maintenance of the stem cell niche or the differentiation of the enamel organ and the root sheath are discussed. These data and our results, showing the development of a functional dentin incisor, suggest that the root-analogue part of the rodent incisor is an anatomic-physiological entity.

Animals↗
PubMed2006

Preliminary study of tissue-engineered odontogenesis in the canine jaw.

PURPOSE: We previously reported a method for the development of tissue-engineered tooth. However, 1 drawback of the procedure was the inability to determine whether the tooth would function when transplanted in the jaw because it was formed in the omentum of the abdomen. Therefore, the present study was designed to evaluate whether transplantation of dissociated odontogenic cells could induce tissue-engineered odontogenesis in the canine jaw. MATERIALS AND METHODS: Cells were harvested from canine first molar tooth buds and the resulting heterogeneous cell population was seeded on a biodegradable polymer. These constructs were then transplanted into the same sockets after extracting the tooth buds. After transplantation, we evaluated the transplanted constructs using dental x-ray, micro-computed tomography, histology, and immunohistochemistry. RESULTS: After 24 weeks, micro-x-ray computed tomography showed regenerated hard tissues in the jaw, and hematoxylin and eosin staining showed tubular dentin and bone. In the regenerated tissue, osteopontin, osteonectin, and osteocalcin antibodies stained the dentinal matrix. However, enamel tissue and dental-root formation were not observed. CONCLUSION: These data show for the first time the formation of dentin and bone from dissociated odontogenic cells in the canine jaw.

Animals↗
PubMed2004

Medical grade calcium sulfate hemihydrate in healing of human extraction sockets: clinical and histological observations at 3 months.

BACKGROUND: Following tooth extraction, remodeling and resorption of the alveolar bone at the extraction site characterize wound healing. This produces a reduction in ridge volume and difficulties in delayed placement of implants in an ideal position. Medical grade calcium sulfate hemihydrate (MGCSH) has been proposed as a graft material in extraction sockets to minimize the reduction in ridge volume. The aim of the present study was to investigate the influence of MGCSH on the histopathologic pattern of intrasocket regenerated bone and to evaluate histologically the healed MGCSH grafted extraction socket site 3 months postextraction METHODS: MGCSH was grafted in 10 fresh human extraction sockets in 10 patients. Five post-extraction sockets were used as controls. At 3 months a cylindrical tissue specimen, 2.5 mm in diameter, was trephined from the previously grafted site followed by implant placement. Non-decalcified specimens were sectioned at a cross-horizontal plane and stained with fast green, toluidine blue, and Van Kossa stains for histological and histomorphometrical examination. RESULTS: Histologically, MGCSH was not observed in most of the specimens. Newly formed bone with lamellar arrangements was identified in all the horizontal sections with no difference between apical, medium, and coronal areas. The mean trabecular area in the coronal sections was 58.6% +/- 9.2%; in the medium sections, 58.1% +/- 6.2%; and in the apical sections, 58.3% +/- 7.8%. The differences were not statistically significant. CONCLUSION: MGCSH seems to be an ideal graft material in extraction socket bone regeneration because it is almost completely resorbable, and it allows a new trabecular bone arrangement at 3 months.

Adult↗
PubMedDate not supplied

[Experiments to determine the time dependent material properties of the periodontal ligament].

The periodontal ligament is a tissue that attaches the tooth (root) to its alveolar socket, and thus plays an important role in the regulation of tooth movements. Detailed knowledge of the material properties of the periodontal ligament is therefore essential to an understanding of tooth reaction to forces applied during orthodontic treatment. A knowledge of material parameters can also be used in simulations of long-term tooth movements with the aim of improving orthodontic treatment. To this end, this study investigated time-dependent material properties, namely the hysteresis behaviour of the periodontal ligament under constant-velocity loading, the influence of loading velocity on the hysteresis, and its failure under constant loading. Specimens obtained from pigs were used for testing purposes, and the experiments were conducted in a special test setup using a material testing device. The material behaviour of the periodontal ligament was shown to be viscoelastic, and the elastic parameters of material behaviour were also determined. Under constant-velocity loading, material behaviour showed a nonlinear course of the stress-strain curve, also known as hysteresis. When loading was repeated several times, the maximum stress of the hysteresis decreased with each cycle. Determination of the deflection of the specimen at different velocities showed maximum stress to be dependent on the loading rate. The measured stress-strain curves were approximated by bilinear behaviour, permitting the use of finite element calculations. Also investigated was the failure behaviour of the periodontal ligament, which revealed tissue rupture to be inconstant.

Animals↗
PubMed2005

Immediately loaded anterior single-tooth implants: two cases.

Immediate loading of implants into fresh extraction sockets has the advantage of decreasing the period of healing, reducing the resorption of the alveolar bone, and achieving optimal esthetic results. These cases reveal the clinical success of immediate loaded single-tooth implants placed in fresh extraction sites.

Adult↗
PubMed1992

An iatrogenic foreign body (dental bur) in the maxillary antrum: a report of two cases.

Two cases of foreign bodies of the antrum are reported. One was a turbine bur which presumably entered through an oro-antral fistula after a tooth extraction. The other was also a turbine bur where the mode of entry was not clear (lack of oro-antral fistula), but it presumably entered through the socket of the extracted tooth. The mucosa of the antrum appeared normal in spite of the lengthy presence of the foreign body.

Adult↗
PubMed2001

Immediate implantation in fresh extraction sockets. A controlled clinical and histological study in man.

BACKGROUND: Early implantation may preserve the alveolar anatomy, and the placement of a fixture in a fresh extraction socket helps to maintain the bony crest. Although a number of clinical studies exist, no histological reports show the outcome of implantation in fresh extraction sockets without the use of membranes in humans compared to implants placed in mature bone. METHODS: Forty-eight healthy patients, receiving at least 4 fixtures in each of 2 symmetrical quadrants, underwent placement of 1 experimental fixture placed in a fresh extraction socket (TI) and 1 contralateral fixture in mature bone (CI). TI were placed after atraumatical tooth extraction, with a surgical site at the apex of the socket and a tight contact between the fixture and the socket's walls, but without the use of filling materials or membranes. The flap was coronally repositioned to obtain primary wound closure. Immediately after surgical intervention, a standardized periapical radiograph was taken. Second-stage surgery was done after 6 months. Six months after the second surgery, a second standardized periapical radiograph was taken and clinical parameters (bleeding and plaque index) recorded. Marginal bone loss (MBL) from the time of implant placement to the time of fixture removal was calculated by comparing periapical radiographs. TI and CI were then removed by a hollow drill to obtain histological specimens. Non-demineralized sections were stained by acid fuchsin and toluidine blue, and by von Kossa to evaluate the degree of bone mineralization. The percentage of direct implant-bone contact (DBC) was calculated by a computerized microscopic digitizer. RESULTS: No significant differences in the clinical and radiographic parameters were observed between the 2 experimental categories. There was no statistically significant difference between TI and CI for DBC either in the maxilla or in the mandible. No connective or fibrous tissues were present around TI or CI. Bone resorption was not present in any of the histological sections. CONCLUSIONS: The present study shows that when a screw-type dental implant is placed without the use of barrier membranes or other regenerative materials into a fresh extraction socket with a bone-to-implant gap of 2 mm or less, the clinical outcome and degree of osteointegration does not differ from implants placed in healed, mature bone.

Adult↗
PubMedDate not supplied

Medial-grade calcium sulfate hemihydrate (surgiplaster) in healing of a human extraction socket--histologic observation at 3 months: a case report.

PURPOSE: Following tooth extraction, wound healing is characterized by remodeling and resorption of the alveolar bone at the extraction site. This produces reduction in ridge volume. Medical-grade calcium sulfate hemihydrate (MGCSH) has been proposed as a graft material for extraction sockets to minimize the reduction in ridge volume. The aim of this study was to investigate the influence of MGCSH on the histopathologic pattern of intrasocket regenerated bone and to evaluate histologically the healed MGCSH-grafted extraction socket site at 3 months postextraction. MATERIALS AND METHODS: MGCSH was grafted in a fresh human extraction socket, and at 3 months a cylindric tissue specimen, 2.5 mm in diameter, was trephined from the previously grafted site and an implant was placed. Non-decalcified specimens were sectioned at a horizontal plane and stained for histologic and histomorphometric evaluation. RESULTS: The mean trabecular area was 58.6% +/- 9.2% in the coronal sections, 58.1% +/- 6.2% in the middle sections, and 58.3% +/- 7.8% in the apical sections. The differences in mean trabecular area between sections were not statistically significant. DISCUSSION: It is significant that the MGCSH underwent complete resorption and replacement by newly formed bone because the most important negative attribute of other graft materials is the resorption time. Moreover, calcium sulfate shows great potential for guided bone regeneration in surgical sites. CONCLUSION: MGCSH seems to be an acceptable graft material for extraction socket bone regeneration because it is completely resorbable and allows new trabecular bone arrangement in a limited 3-month period.

Alveolar Bone Loss↗
PubMed2005

Extraction environment enhancement: critical evaluation of early socket healing in long-term barrier-protected extraction sockets.

Resorption and remodeling of the alveolar bone occurs after periodontal disease, trauma, or tooth extraction. Loss of the functional apparatus can have a deleterious effect on the ability to place endosseous root-form implants into prosthetically ideal locations. As a result, there has been a trend toward socket preservation at the time of extraction. However, there has been limited investigation with histologic verification of results on types of materials used to preserve or augment extraction sockets. Minimizing bone loss after extractions enables an implant to be placed in an ideal orientation surrounded by bone, thereby increasing the longevity of the implant and associated prosthesis. The case reports presented detail clinical and histological results during the 3 to 6 months after a bone maintenance procedure that used a nonexpanded polytetrafluoroethylene barrier placed over an extraction socket with no graft material at the time of tooth extraction.

Alveolar Bone Loss↗
PubMed2004

Early and immediately restored and loaded dental implants for single-tooth and partial-arch applications.

PURPOSE: The objective of this consensus committee report was to review the available literature published predominantly in refereed journals to summarize findings, data, and conclusions as they related to reduced healing times and protocols for single-tooth and partial-arch clinical situations. Early loading of dental implants has been defined as restoration of implants in or out of occlusion at least 48 hours after implant placement, but at a shorter time interval than conventional healing. Immediate loading or restoration has been defined as attachment of a restoration in or out of direct occlusal function within 48 hours of surgical placement. MATERIALS AND METHODS: Six articles addressing early loading, with a mixture of single-tooth and partial-arch clinical conditions and including some controlled cohort studies, were reviewed. Immediate loading or restoration of dental implants in single-tooth and partial-arch applications, was extensively reviewed. An attempt was made to isolate and categorize similar case types to discern trends and relevant factors. Variables that were considered included single- or multiple-tooth conditions, immediate or delayed placement in extraction sockets, effect of implant surface and geometry, bone quality, implant stability, surgical technique, occlusal design, effect of cigarette smoking, and stability of results. RESULTS: Combined data from 6 early loading studies on single-tooth and partial-arch applications revealed 1,046 implants with a survival rate of 98.2%. Long-term data for most of the early loading studies were not yet available. Most of the publications on immediate loading or restoration of dental implants were written as case series rather than scientific studies. DISCUSSION AND CONCLUSIONS: In general, most publications indicated that with attention to appropriate factors, implant survival with immediate restoration was comparable to the results with conventional and early loading protocols. It should be recognized that, with few exceptions, these conclusions may be misleading statistical phenomena of the authors, as most publications were written by exceptionally experienced, highly skilled practitioners working under tightly controlled clinical conditions on a relatively small, statistically inconclusive number of implants and patients.

Crowns↗
PubMed2001

Porous bovine bone mineral in healing of human extraction sockets: 2. Histochemical observations at 9 months.

BACKGROUND: Porous bovine bone mineral (PBBM) has been used in ridge preservation procedures following tooth extractions. The aim of this study was to investigate histochemically tissue sockets grafted with PBBM at 9 months post-extraction. By using different histochemical stainings, characteristics of the newly formed bone; i.e., lamellar/woven ratio at different socket depths, were investigated and the arrangement of bone around the grafted material, as well as the nature of the amorphous organic material found in all specimens, were examined. METHODS: After extraction of 15 single-rooted maxillary teeth from 15 patients, socket sites were grafted with PBBM particles (250 to 1,000 mu). Primary soft tissue closure of the grafted site was established using the rotated split palatal pedicle flap technique. At 9 months, a cylindrical tissue specimen, 2.5 mm in diameter, was trephined from each previously grafted site followed by placement of a screw-shaped implant. Horizontal tissue section cuts, 5 mu wide, were prepared for histological examination. Histochemical staining included alcian blue, periodic-acid Schiff, Mallory trichrome, reticulin, Van Gieson, and picrosirius red (PSR). PSR stained slides were further evaluated morphometrically, using polarized microscopy to determine the amount of lamellar versus woven bone in superficial, mid and deep specimen section cut areas. RESULTS: All staining methods revealed that newly formed bone encircled and adhered to the grafted material in most specimens. Mallory trichrome staining showed osteoblasts present within an osteoid layer, lining the interface zone of PBBM particles and the new osseous tissue. Morphometric evaluation of the PSR stained slides disclosed a constant pattern of increased osseous tissue in a coronal-apical direction. An average of 17.1% osseous tissue with 1:12.9 lamellar/woven bone ratio was calculated in the superficial area. The average bone tissue fraction was 48.3% with a lamellar/woven ratio of 1:3.8 in the mid section area and in the deep area, it increased to 63.9%, with a lamellar/woven ratio average of 1:1.7. Differences between ratios at these sites were statistically significant (P<0.001). An amorphous organic substance was noted in most grafted particles. This material usually attached cell striae and harbored glycoproteins as revealed by periodic-acid Schiff and alcian blue stainings. Mallory trichrome staining showed denatured protein within the decalcified mineral particles; reticulin, Van Gieson stainings, and polarization of PSR stained sections refuted the existence of collagen in the grafted particles. CONCLUSIONS: Cancellous PBBM is a biocompatible filler agent in extraction socket sites and an acceptable graft for edentulous ridge preservation at sites prepared to receive endosseous implants. The osteoconductivity of PBBM was determined based on promoting osseous ingrowth and close integration with the newly generated bone. Grafted particles were not significantly resorbed at 9 months. Further studies are needed to determine the resorbable capability, as well as the nature and significance of the amorphous organic substance of PBBM observed in the grafted particles.

Analysis of Variance↗
PubMed1996

Protocol for treating the avulsed tooth.

Avulsion of a tooth requires decisive action by the dental practitioner. Replantation of the tooth at the earliest possible time, along with the avoidance of further periodontal damage, is paramount to achieving a successful result. The accident site, time the tooth is out of the socket, storage media and endodontic protocol influence the prognosis. Appropriate endodontic management and tooth restoration will ensure long-term success.

Clinical Protocols↗
PubMed1996

Protocol for treating the avulsed tooth.

Avulsion of a tooth requires decisive action by the dental practitioner. Replantation of the tooth at the earliest possible time, along with the avoidance of further periodontal damage, is paramount to achieving a successful result. The accident site, time the tooth is out of the socket, storage media and endodontic protocol influence the prognosis. Appropriate endodontic management and tooth restoration will ensure long-term success.

Clinical Protocols↗
PubMed2006

Clinical and anatomical study of retromolar foramen and canal.

PURPOSE: The retromolar canal is a rare anatomic variation of the mandible. The neurovascular content of the mandibular retromolar canal is very important for surgical procedures involving the retromolar area and there has been a lack of information on this subject. This study consists of anatomic research of the retromolar foramen and canal, planned after an impacted third molar tooth extraction operation in which we encountered a retromolar neurovascular bundle. MATERIALS AND METHODS: Eighty sides of 40 mandibles were evaluated and the presence of the retromolar foramen and its relation to the last teeth, the transverse and sagittal distances of the retromolar trigone, and the distance of the retromolar foramen to the last socket of the arch were measured. RESULTS: The neurovascular bundle includes striated muscle fibers, thin myelinated nerve fibers, numerous venules and a muscular artery. Of the 40 mandibles included in this study, retromolar foramens were found in 10 (25%). The presence of the retromolar foramen is not dependent on the last teeth of the arch. The dimensions of the retromolar trigone were measured and the presence of the retromolar foramen was found to be nonrelevant to the dimensions of the retromolar trigone. Retromolar foramen distance from the distal edge of the last socket of the arch was found to be 11.91 +/- 6.71 mm and 4.23 +/- 2.30 mm, respectively, from the second and third molars. CONCLUSIONS: This study therefore clearly establishes the incidence and importance of the retromolar canal. This study shows that the retromolar foramen and canal can be seen occasionally in routine dental surgery. Due to the neurovascular bundle passing through it, the retromolar canal and foramen must be kept in mind in all anesthetic and surgical approaches regarding the retromolar area and mandible.

Adult↗
PubMed2005

Displacement of avulsed tooth into soft tissue of chin resulting from epileptic attack trauma.

Maxillofacial trauma is the main cause of emergency admittance to dental clinics. Mental retardation and epileptic status are important factors in an increase in the risk of dental injuries. Tooth avulsion, which is the total displacement of a tooth out of its socket, is an infrequently observed entity. Maxillary central incisors are the most commonly affected teeth. The case of a patient with severe dental injury resulting from an epileptic attack is presented. He had several teeth avulsed and displacement of a tooth into the soft tissue of the chin.

Adult↗