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PubMed1996

Therapeutic delivery of calcitonin to inhibit external inflammatory root resorption. II. Influence of calcitonin binding to root mineral.

Experimentally-induced external inflammatory tooth-root resorption can be inhibited by therapeutic doses of calcitonin. Such doses can be delivered by an intrinsically slow diffusion pathway, from a reservoir in endodontically-debrided root canals, via the dentinal tubules. While the kinetics of this journey have been followed in an earlier report, the binding characteristics of calcitonin to the tooth mineral, which will be responsible, in part, for these kinetics, have not been reported before. The current study examines the binding potential of calcitonin to root mineral and addresses the potential role of non-specific binding proteins. A modified Scatchard plot indicated that a simple non-reactive type of ligand binding exists between calcitonin and root mineral, represented by a small number of identical binding sites. This interaction is both strong and reversible. Furthermore, it appears to be time-dependent with more time being required for the residual ligands to interact with the diminishing numbers of free calcitonin-binding sites. While preloaded [125I]-calcitonin could be incompletely (75-91%) displaced from dental-root material by non-radioactive calcitonin, its release was slow over 23 h. Calcitonin was four times as effective as bovine-serum albumin in competing for common "calcitonin binding sites" on macerated dental-root material. Thus, even in the presence of extraneous protein, calcitonin will bind tightly but reversibly to tooth-root material, making it a good candidate for therapeutically protracted delivery to external root surfaces from root canals.

Adolescent↗
PubMed2003

Root resorption associated with a subepithelial connective tissue graft for root coverage: clinical and histologic report of a case.

This article reports on a case of root resorption following a clinically successful root coverage procedure with a subepithelial connective tissue graft on a maxillary lateral incisor. Two years after the graft procedure was performed, the tooth was extracted in conjunction with the buccal attachment apparatus. Histologic examination of the specimen revealed signs of active resorption of the dentinal surface and bone formation in the deepest portion of the resorption cavity. Possible causative factors of the root resorption process are discussed.

Connective Tissue↗
PubMed2005

Root resorption and ankylosis associated with guided tissue regeneration.

BACKGROUND: Root resorption and ankylosis have been reported rarely as sequelae to guided tissue regeneration (GTR). The authors describe a clinical case of root resorption following GTR that involved the use of a bioabsorbable membrane. CASE DESCRIPTION: Two years after GTR was performed on a Class II furcation defect, the clinical examination revealed root resorption reaching the pulp chamber. The furcation defect was filled with epithelium and connective tissue, which contained inflammatory infiltrate and fragments of the membrane. The authors also observed areas of the tooth that exhibited points of ankylosis and root resorption. CLINICAL IMPLICATIONS: Clinical trials have reported favorable clinical and histologic results with GTR. However, this case report, along with other case reports and studies in animals, suggests a high risk of root resorption and ankylosis after GTR, which could limit the indications for this technique.

Absorbable Implants↗
PubMed1998

Root resorption of dental and traumatic origin: classification based on etiology.

While root resorption is a relatively common complication of dental trauma, classifications of root resorption are inconsistent and confusing. All pathological root resorption of dental origin is inflammatory in nature. For root resorption to occur, the protective superficial layer must be (internally or externally) damaged or changed and an inflammatory stimulator must be present. This article attempts to classify root resorption on the basis of etiology, i.e., the cause of the protective layer loss and the cause of the inflammatory response, to facilitate more efficient treatment.

Bacterial Infections↗
PubMed1990

Possible role of cementoblasts in the resorbant organ of human deciduous teeth during root resorption.

Human deciduous teeth undergoing physiologic root resorption were extracted and fixed with a mixture of formaldehyde and glutaraldehyde and processed for scanning (SEM) and transmission (TEM) electron microscopy, and for acid (ACPase) and alkaline phosphatase (ALPase) cytochemistry. The resorbant organ, rich in odontoclasts, cementoblasts, fibroblasts, and macrophages, formed prominent resorption lacunae in root dentin. SEM observations of resorption lacunae treated with trypsin solution showed islands of newly-formed cementum matrix in part of the resorbing dentin surfaces. Such cementum consisted of bundles of densely-arranged collagen fibrils and, in part, contained forming cementocytic lacunae and canaliculi. Active cementoblasts adjacent to odontoclasts on resorbing dentin surfaces showed cuboidal outlines and were characterized by the presence of numerous cisterns of rough endoplasmic reticulum, well-developed Golgi complexes, secretion granules, and many mitochondria. They sometimes formed a thin layer of cementoid and/or cementum matrix upon the resorbing dentin surface. These cementoblasts had ACPase-positive lysosomes in the cell bodies and exhibited intense ALPase activity along the plasma membranes of whole cell surfaces. These results suggest that, during root resorption, 1) active cementoblasts are present adjacent to active odontoclasts and 2) these cementoblasts are involved in remodeling the resorbing dentin surfaces.

Acid Phosphatase↗
PubMed2006

Surgical root restoration after external inflammatory root resorption: A case report.

External inflammatory root resorption after a jaw fracture is rare. This report describes a case of extensive external root resorption in the middle third of the root of a mandibular right canine after a mandibular fracture involving the tooth socket. Because of delayed treatment and damage to the root caused by a surgical screw, root canal treatment was performed followed by surgical intervention. The resorptive defect was debrided and part of the root was rebuilt with conventionally setting restorative glass ionomer cement. Postoperative follow-up revealed complete healing.

Adult↗
PubMed1998

External root resorption in orthodontics: avoiding high risk teeth. A case report.

External root resorption is one of the most exasperating and least understood clinical problems in orthodontics. Numerous studies have been conducted, attempting to establish the factors causing root resorption of permanent teeth. Considerable variation exists however, in the extent and distribution of root resorption, seen in the orthodontic treatment of apparently similar cases. After an excellent review of the literature, Brezniak and Wassertein (1993) concluded that the most significant disgnostic aid in predicting whether root resorption would occur during orthodontic treatment, is the radiographic evidence of root resorption before treatment. A case is reported, describing the dilemma of orthodontically treating a patient, who had previously experienced trauma to the upper right central incisor, leading to external root resorption.

Cephalometry↗
PubMed1990

Humoral immune response to active root resorption with a murine model.

A depression in autoantibody titers to tooth root antigens has been shown to coincide with active root resorption in the dog. Since a murine model would facilitate immunologic studies of root resorption because of the availability of syngeneic and immunodeficient strains, the objectives of this study were to develop a quantitative mouse model for root resorption and to determine if a similar drop in tooth root autoantibodies coincides with active root resorption in this species. Uniform areas of necrosis were created in the periodontal ligaments of lower incisors of 36 male Swiss albino mice by inserting a cryoprobe through a skin incision (-80 degrees C; 5 minutes). Contralateral incisors served as controls. At 0, 3, 5, 7, 10, 14, and 21 days; six mice were killed, and blood and incisors were collected. Relative surface areas of root resorption were quantified with micrographs taken at a standardized position, tilt, and magnification with a scanning electron microscope. Serum autoantibody titers were determined with an enzyme-linked immune sorbent assay with antigen prepared from a 5 mol/L guanidine-HCl-EDTA (pH 5.0) extract of incisor roots that were harvested from syngeneic mice. ANOVA and the paired Student t test were used to compare data at the various time points. No root resorption was evident on control teeth. Localized lesions on treated teeth were found to be of significant size between 7 and 14 days (p less than 0.05), but most of these erupted into the mouth by 21 days.(ABSTRACT TRUNCATED AT 250 WORDS)

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↗
PubMed1993

An analysis of causes of apical root resorption in patients not treated orthodontically.

With few exceptions, most cases of external apical root resorption have no evident etiology, particularly when root blunting from orthodontic treatment has been ruled out. This study determined the frequency of apical root resorption in the permanent dentition of patients who had not been treated orthodontically. Associations between the occurrence of external apical root resorption and three measures of oral health--number of missing teeth, periodontal probing depths, and alveolar crestal bone heights--were also examined. Between 7% and 10% of the 306 patients exhibited obvious apical resorption. Strong statistical associations were found between the occurrence of external apical root resorption and loss of teeth, increased periodontal probing depths, and reduced crestal bone heights; ie, root resorption was significantly more common in teeth with compromised support. Loss of stability from adjacent teeth, increased use of fewer remaining teeth, and loss of the root's anchorage in the bone are significant predictors of external apical root resorption.

Adolescent↗
PubMed1999

Dental root resorption.

This article presents a review of physiologic mechanisms involved in various types of root resorption that may be encountered clinically. Included is a brief overview of suggested homeostatic mechanisms of the periodontal ligament and the role of the intermediate cementum in inhibiting root resorption. Root resorption (surface, inflammatory, and replacement) associated with traumatic injuries is discussed, with emphasis on etiology and the ability to provide treatment. The final discussion relates to other types of resorption, based on a classification of internal, cervical, and external resorption associated with periradicular pathosis and resulting from pressure in the periodontal ligament.

Humans↗
PubMedDate not supplied

An unusual case of cervical root resorption.

Supraosseous extracanal invasive root resorption was diagnosed based on a radiographic survey, clinical examination, and microscopic examination of pulpal and exophytic soft-tissue specimens. Microscopic pulpal examination showed little or no evidence of significant inflammation. This resorptive process demonstrates extensive noncarious destruction of dentin without affecting pulpal health.

Adult↗
PubMed1991

Radiographic observations on root resorption in the primary dentition.

In order to construct standardized charts for root resorption in the primary dentition of Japanese children, we investigated the stages of resorption (1/4, 1/2 and 3/4 of the root) based on the criterion of Fanning, et al. using 11,167 panoramic radiographs (5,759 of boys and 5,408 of girls). The following information was obtained. 1) The root resorption for a tooth on one side was the same as for its counterpart on the other side regardless of differences in sex or arch. 2) The average age for each root resorption stage was lower in girls than in boys regardless of differences in sex or arch. 3) The average age for each root resorption stage was lower in the mandible than in the maxilla for every tooth. 4) In the maxilla, the period between 1/4 to 3/4 resorption of the root was greater in the primary molars than in the primary anterior teeth. However, the opposite was true in the mandible. 5) Although no difference was observed between the maxilla and the mandible in the resorption period for the primary incisors and canines, the resorption time for the primary molars was greater in the maxilla than in the mandible. 6) When the relationship was observed between the resorption stages for each tooth and the calcification stages for the corresponding successional permanent tooth. a) With the exception of the maxillary and mandibular canines, the average age for 1/4 resorption of the primary root corresponded to the period between completion of the permanent crown and initial root formation of the successional permanent tooth. b) With the exception of the maxillary and mandibular canines, and the mandibular second premolars, the average age for 3/4 resorption of the primary root corresponded to the period between 1/4 and 1/2 formation of the root of the successional permanent tooth. From these results, standardized charts were constructed for the resorption of the roots of primary teeth in Japanese children. These standardized charts are useful in daily clinical practice in such areas as endodontic treatment of primary teeth and orthodontics.

Adolescent↗
PubMed1995

A radiographic comparison of apical root resorption after orthodontic treatment with the edgewise and Speed appliances.

Apical root resorption is a serious iatrogenic problem sometimes associated with orthodontic treatment. The Speed appliance (Strite Industries, Ltd., Ontario, Canada) provides a continuous rotatory and torque action through its spring clip mechanism, in contrast with the edgewise appliance that may provide an interrupted force. The effect of continuous action on root resorption compared with the interrupted action of the edgewise system has not been investigated previously. The purpose of the present investigation is to test the null hypothesis that there is no difference in the apical root resorption seen after orthodontic treatment with the edgewise straight wire and the Speed appliance systems. Pretreatment and posttreatment periapical radiographs of 63 patients, (30 treated with the Speed 0.018 bracket and 33 with the 0.018 edgewise bracket) were studied. The long cone paralleling technique was used for all the radiographs. Any image distortion between the pretreatment and posttreatment radiograph was calculated and compensated for by using the crown length measurements, on the assumption that the crown length remains unaltered during the treatment period. Quantitative measurements of crown and root lengths for the maxillary and the mandibular central and lateral incisors were compared. Means and standard deviations for the percentage root resorption per tooth group were calculated. A three-factor analysis for variance (ANOVA test) was performed to determine whether there was an appliance, treatment, or gender effect on the amount of root resorption seen after treatment. No statistically significant difference in root resorption between the two appliance systems was found.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2006

Orthodontically induced inflammatory root resorptions: a case report.

Orthodontically induced inflammatory root resorption is an unfortunate consequence of orthodontic movement. It is an adverse effect of an otherwise predictable force application. The degree of the inflammatory process depends on various factors such as amount of force, bone quality, aggressiveness of the resorbing cells and individual variation. Orthodontists should keep track of tooth movement both clinically and radiographically in order to detect any root resorptions and reevaluate the case. This case report presents the treatment outcome (4-year follow up) of five teeth with different and extensive inflammatory root resorptions following orthodontic treatment.

Adult↗
PubMed2006

Factors related to apical root resorption of maxillary incisors in orthodontic patients.

UNLABELLED: THE MAIN OBJECTIVE of the study was to determine the extent of external apical root resorption at the end of orthodontic treatment and to identify the possible pre-treatment and treatment factors that would allow to predict the possible incidence of root resorption before the start of treatment. PATIENTS AND METHODS: Panoramic radiographs of 75 patients that had been treated with full fixed appliances were used to assess apical root resorption in maxillary incisors. The degree of root resorption was measured in millimetres and the scale of Shape was used. RESULTS: The results showed that the resorption in the maxillary incisors is on the average 1.5 mm, the severe resorption was seen in 2.6% of patients. The worst resorption was seen in teeth with abnormal root shape. There were no differences in the severity of root resorption when comparing males and females as well as children and adults. Increased overjet, overbite and extraction therapy were not associated with greater root resorption. Duration of treatment and length of treatment time with rectangular wires were associated with greater root resorption. Patients wearing composite brackets with a metal slot had more resorption than patients wearing metal brackets. CONCLUSION: Pre-treatment risk indicator for root resorption was abnormal root shape. Risk indicators for root resorption that were related to treatment procedures included length of treatment time with rectangular wires, duration of treatment and treatment with composite brackets with a metal slot.

Adolescent↗
PubMed1982

Root resorption after orthodontic treatment of traumatized teeth.

This study concerns the frequency and degree of root resorption in traumatized incisors that have been treated orthodontically. The subjects were twenty-seven patients (fifteen boys and twelve girls) with fifty-five traumatized incisors; fifty-five consecutive patients without traumatized teeth served as controls. All the control patients were treated with extraction of four first premolars and a fixed appliance (thirty-three with an edgewise and twenty-two with a Begg appliance). Signs of root resorption were registered with index scores from 0 to 4 (Fig. 1). The degree of root resorption in traumatized teeth was compared to that in the uninjured control teeth in the same patient and in the patients without trauma. Neither the intraindividual nor the interindividual comparisons support the hypothesis that traumatized teeth have a greater tendency toward root resorption than uninjured teeth. Root resorption (scores 2 to 4) was found in 51 percent of the traumatized incisors, in 43 percent of the incisors treated with edgewise appliances, and in 48 percent of those treated with Begg appliances. Traumatized teeth with signs of root resorption prior to orthodontic treatment may be more prone to root resorption during treatment.

Adolescent↗
PubMed2005

Root resorption after orthodontic intrusion and extrusion: an intraindividual study.

The aim of this investigation was to compare root resorption in the same individual after application of continuous intrusive and extrusive forces. In nine patients (mean age 15.3 years), the maxillary first premolars were randomly intruded or extruded with a continuous force of 100 cN for eight weeks. Eleven maxillary first premolars from six randomly selected orthodontic patients served as controls. Root resorption was determined using scanning electron microscopy. Quantitative assessment of the percentage of resorbed area of the total root surface was performed on composite micrographs. The severity of root resorption was also assessed by visual scoring of the roots. Root resorption mainly occurred at the apical part of the roots in both experimental groups. A significant difference in root resorption was found between the intruded and the control teeth (P = .006) but not between the extruded and the control teeth. However, the mesial and distal root surfaces showed resorption on 5.78 +/- 3.86% of the root surface of the intruded teeth and 1.28 +/- 1.24% of the root surface of the extruded teeth, and this difference was significant (P = .004). In addition, a large individual variation was found. From this study, it can be concluded that intrusion of teeth causes about four times more root resorption than extrusion. Because the amount of root resorption due to intrusion or extrusion in the same patient is correlated, every clinician should be aware that the extrusion of teeth might also cause root resorption in susceptible patients.

Adolescent↗