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PubMed2005

Transmigration of a maxillary canine. A case report.

In the oral cavity, transmigration is defined as a tooth that crosses the mid-line by more than half its length. Following extensive literature review, it was found that, although well documented with respect to mandibular canines, there were only two publications detailing maxillary cuspid transmigration. This report presents a case of transmigration where the left maxillary canine gradually crossed the mid-line and migrated to the right side in a patient with hemifacial microsomia and cleft palate. The Mupparapu classification of the migratory pattern of the mandibular canines is discussed. Various clinical considerations, as well as guidelines for general practitioners to diagnose and manage such a condition, are also discussed.

Child↗
PubMed1993

A survey of natural tooth abutment intrusion with implant-connected fixed partial dentures.

To elicit information about the phenomenon of intrusion of natural tooth abutments in implant-connected prostheses, a survey was distributed to clinicians with varied experience. Although practitioners with more experience in fabricating implant-supported dentures connected to natural teeth reported fewer instances of intrusion, it cannot be concluded that this observation is significant. The cause of intrusion is probably multifactorial, and respondents suggested several possible causative factors: disuse atrophy, debris impaction, impaired rebound memory, and mechanical binding. Because apical migration of abutment teeth affects occlusion and oral hygiene, the authors make several recommendations for treatment planning for patients who have natural dentition adjacent to proposed implant sites.

Clinical Competence↗
PubMed2005

Structure, attachment, replacement and growth of teeth in bluefish, Pomatomus saltatrix (Linnaeus, 1776), a teleost with deeply socketed teeth.

Tooth replacement poses many questions about development, pattern formation, tooth attachment mechanisms, functional morphology and the evolution of vertebrate dentitions. Although most vertebrate species have polyphyodont dentitions, detailed knowledge of tooth structure and replacement is poor for most groups, particularly actinopterygians. We examined the oral dentition of the bluefish, Pomatomus saltatrix, a pelagic and coastal marine predator, using a sample of 50 individuals. The oral teeth are located on the dentary and premaxillary bones, and we scored each tooth locus in the dentary and premaxillary bones using a four-part functional classification: absent (A), incoming (I), functional (F=fully ankylosed) or eroding (E). The homodont oral teeth of Pomatomus are sharp, deeply socketed and firmly ankylosed to the bone of attachment. Replacement is intraosseus and occurs in alternate tooth loci with long waves of replacement passing from rear to front. The much higher percentage of functional as opposed to eroding teeth suggests that replacement rates are low but that individual teeth are quickly lost once erosion begins. Tooth number increases ontogenetically, ranging from 15-31 dentary teeth and 15-39 premaxillary teeth in the sample studied. Teeth increase in size with every replacement cycle. Remodeling of the attachment bone occurs continuously to accommodate growth. New tooth germs originate from a discontinuous dental lamina and migrate from the lingual (dentary) or labial (premaxillary) epithelium through pores in the bone of attachment into the resorption spaces beneath the existing teeth. Pomatomus shares unique aspects of tooth replacement with barracudas and other scombroids and this supports the interpretation that Pomatomus is more closely related to scombroids than to carangoids.

Animals↗
PubMed2006

Swallowed foreign bodies in children: report of four unusual cases.

INTRODUCTION: Although a majority of ingested foreign bodies (FBs) pass down the gastrointestinal tract spontaneously, those that are sharp, pointed or large in size need removal to avert serious complications. We highlight the urgent need and utility of endoscopic accessories and technical artistry in safe retrieval of FBs in children. CLINICAL PICTURE: Four children had accidentally swallowed a nail, metallic dumbbell, open safety pin and a cushion pin respectively. They were symptom-free and the abdominal plain radiographs revealed foreign body in the stomach in all the cases. TREATMENT: Oesophago-gastro-duodenoscopy (OGD) was done in all the patients and could retrieve the nail, metallic dumbbell and open safety pin successfully using a Dormia basket, a polypectomy snare and a pair of rat-tooth forceps respectively. The cushion pin had migrated to the duodeno-jejunal junction within 4 hours of ingestion and necessitated open duodenotomy and retrieval. OUTCOME: All patients did well after the procedure with no complications. CONCLUSIONS: Swallowed FBs with pointed or sharp ends or large enough to cross the pylorus and duodenal sweep need removal and in the majority of the cases they can be retrieved by OGD. Sharp or pointed FBs that have crossed the second part of the duodenum necessitate urgent laparotomy for retrieval to prevent complications.

Adolescent↗
PubMed1976

The biosynthesis and secretion of precursor enamel protein by ameloblasts as visualized by autoradiography after tryptophan administration.

The incorporation of 3H-tryptophan into the inner enamel epithelium of newborn mouse incisor tooth organs has been studied in situ by light and electron microscopic autoradiography to determine the sites and kinetics of biosynthesis, migration, and secretion of precursor enamel protein during newborn mouse incisor tooth formation maxillary and mandibular incisor tooth amelogenesis was studied 5, 30, 60, 120, 240 minutes and 24 hours following the intraperitoneal injection of 3H-tryptophan. By 5 minutes, 40% of the total silver grains associated with the secretory ameloblasts were localized over the rough endoplasmic reticulum and 50% of the silver grains were localized over the Golgi apparatus. By 30 minutes, silver grains were observed predominately over condensing vacuoles and secretory granules within the forming Tomes' processes, and were also localized over the extracellular "granular" pre-enamel matrix. The enamel proteins were synthesized on membrane-bound polysomes, transferred within the cisternae of the rough endoplasmic reticulum and then accumulated in the inner saccules of the Golgi apparatus. The enamel proteins were than packaged in condensing vacuoles which subsequently became secretory granules which migrated to the lateral and apical secretory regions of the forming Tomes' processes. It was concluded from these in vivo studies that enamel protein were synthesized and subsequently secreted within 30 minutes. The initially secreted precursor enamel protein was localized over a material which demonstrated a granular or stippled ultrastructure. The labeled protein then was localized over the amorphous enamel matrix per se which contained the forming calcium hydroxyapatite crystals. We assumed, therefore, that there are two different ultrastructural forms of 3H-tryptophan containing extracellular enamel proteins and suggest that the granular or "stippled" form represents newly secreted precursor enamel protein.

Ameloblasts↗
PubMed1982

Progressive replacement of epithelial attachment by a connective tissue junction after experimental periodontal surgery in rats.

The purpose of this study was to test the hypothesis that the long junctional epithelium formed during the early stages of periodontal wound healing can become replaced, at least in part, by a connective tissue attachment. A surgical wound was created on the mesial surface of the left maxillary first molar of 4-month-old rats and the mesial root surface curetted free of soft tissue and cementum. The contralateral molar served as an unoperated control. Groups of five to eight animals were killed at intervals of 10 days, 3 and 6 weeks, and 3, 6 and 12 months after surgery. The histometric data demonstrated a progressive apical recession of the entire gingival unit on the unoperated control side during the experimental period. On the operated side, the junctional epithelium became reestablished by migration of epithelium from the wound edge along the cut gingival surface facing the tooth, until contact was established near the apical border of the instrumented root surface. Coronal migration of the epithelium from that level accounted for most of the lengthening of the junctional epithelium observed in 3 weeks. During the balance of the experimental period the junctional epithelium did not change in length significantly. However, the entire epithelial attachment was displaced coronally, primarily at the expense of sulcus depth which decreased with time, and by replacement of the apical portion of the junctional epithelium by a connective tissue junction of increasing dimension. These findings challenge the widely held belief that, once established, the dentoepithelial junction cannot be replaced by a connective tissue attachment.

Animals↗
PubMed1999

Chemokines are upregulated during orthodontic tooth movement.

In the early stage of orthodontic tooth movement, an acute inflammatory response characterized by the migration of leukocytes occurs. This response suggests the presence of specific chemotactic signals that may play a role in the mechanism of bone remodeling, in particular in resorption. The aim of the present study was to explore the induction of potential chemokines at the resorption side during orthodontic tooth movement. Monocyte chemoattractant protein-1 (MCP-1), regulated on activation normal T cell expressed and secreted (RANTES), and macrophage inflammatory protein-2 (MIP-2) were examined by in situ hybridization using radioactive synthetic oligoneucleotide probes. Mesial movement of the upper first molars was performed with a fixed appliance for 3, 7, and 10 days. The results demonstrated that MCP-1, RANTES, and MIP-2 were highly expressed during orthodontic movement. On day 3, MCP-1 showed maximum induction in the pressure zone, followed in intensity by RANTES and MIP-2, although not in the contralateral control side. The induction of these chemokines had declined on day 7 and reached low levels on day 10. Our data suggest that chemokines are induced early in the application of force, and such induction may contribute to the early inflammatory response that may be responsible in part for the ensuing bone remodeling.

Animals↗
PubMed2000

Clinical application of laser-induced breakdown spectroscopy to the analysis of teeth and dental materials.

OBJECTIVES: The luminous plasma generated during laser ablation of dental tissue and dental materials has been analyzed to determine qualitative and quantitative elemental composition. BACKGROUND DATA: The use of pulsed lasers for controlled material ablation now is frequently suggested as an alternative to mechanical drilling for the removal of caries and in tooth modification. Spectral analysis of the ablated plasma can be exploited to monitor precisely the laser drilling process in vivo and in real time. METHODS: Teeth samples and dental materials were ablated using pulses from a Nd:YAG laser. The line positions and intensities in the spectra, recorded in real time, were used to identify elements and to determine their relative concentrations. RESULTS: From the spectra of horizontally and vertically cut tooth slices, profiles of elemental distribution were determined; these were used in a range of monitoring applications. We showed that the transition from caries to healthy tooth material could be identified through the decrease in calcium (Ca) and phosphorus (P) concentrations, whereas nonmineralizing elements and organic materials increased in concentration. We also could relate the spatial distribution of elements to their migration or accumulation over time, for example, the migration of aluminium (Al) from dental restorative materials to the tooth matrix. CONCLUSIONS: The plasma existing during laser ablation (in vitro/in vivo) can be analyzed spectrally in real time. From the spectra, one can pinpoint high/low levels of element concentrations within the tooth matrix. Thus, this analysis could be used to monitor the ablation of material during laser dental treatment.

Adult↗
PubMed2000

Inhibition of Wnt signaling by exogenous Mfrzb1 protein affects molar tooth size.

Wnt extracellular signaling molecules have essential roles as regulators of cell proliferation, migration, differentiation, and in epithelial-mesenchymal interactions involved in tissue morphogenesis. Frizzled integral membrane proteins have been shown to function as receptors for Wnt signaling molecules. Vertebrates also produce secreted proteins related to Frizzled receptors, Frizzled-related proteins (FRPs), which contain the cysteine-rich domain of Frizzleds and appear to function as Wnt antagonists. Tooth development is regulated by a reciprocal series of epithelial-mesenchymal interactions, and many Wnt signaling pathway genes are expressed in the developing tooth at these sites. Here we report the expression of one FRP gene, Mfrzb1, in the rostral mesenchyme of the mandibular primordium. Using explant cultures, we show that expression of Mfrzb1 in the mandibular mesenchyme is under the control of signals derived from the overlying epithelium. Bead implantation experiments in vitro show that FGF8 induces Mfrzb1 expression, whereas BMP4 and SHH proteins have no effect. We studied the effect of ectopic MFrzb1 protein on the developing tooth germs by transplanting explants treated with Mfrzb1 protein into renal capsules, and found it to retard tooth development. This suggests that Wnt signaling is required early in tooth germ formation and that interference with signaling via addition of an antagonist results in retarded development and formation of smaller teeth.

Animals↗
PubMed2000

Intra-alveolar granulocytic sarcoma developing after tooth extraction.

Granulocytic sarcoma (GS) is a malignant tumour composed of poorly differentiated myeloid cells forming in an extramedullary site. It is generally associated with acute leukaemia, particularly the myelocytic type. Its appearance in patients with chronic myeloid leukaemia is exceptional. GS can appear in multiple locations with the oral cavity being rarely involved. A mandibular GS detected in a patient with chronic myeloid leukaemia 10 days after a tooth extraction is reported. The pathogenesis (by metastatic cells or migration through the Haversian canals) of the tumour is discussed.

Diagnosis, Differential↗
PubMed2005

Zebrafish acvr2a and acvr2b exhibit distinct roles in craniofacial development.

To examine the roles of activin type II receptor signaling in craniofacial development, full-length zebrafish acvr2a and acvr2b clones were isolated. Although ubiquitously expressed as maternal mRNAs and in early embryogenesis, by 24 hr postfertilization (hpf), acvr2a and acvr2b exhibit restricted expression in neural, hindbrain, and neural crest cells (NCCs). A morpholino-based targeted protein depletion approach was used to reveal discrete functions for each acvr2 gene product. The acvr2a morphants exhibited defects in the development of most cranial NCC-derived cartilage, bone, and pharyngeal tooth structures, whereas acvr2b morphant defects were largely restricted to posterior arch structures and included the absence and/or aberrant migration of posterior NCC streams, defects in NCC-derived posterior arch cartilages, and dysmorphic pharyngeal tooth development. These studies revealed previously uncharacterized roles for acvr2a and acvr2b in hindbrain and NCC patterning, in NCC derived pharyngeal arch cartilage and joint formation, and in tooth development.

Activin Receptors, Type II↗
PubMed2000

Proliferative response of cells of the dentogingival junction to mechanical stimulation.

The aim of this research was to study the proliferative response of junctional epithelium (JE) and gingival connective tissue (GCT) to mechanical stimulation in vivo with regard to the potential occurrence of apical migration of JE and loss of GCT attachment during orthodontic tooth movement. Elastic bands were inserted between the maxillary first and second molars of male rats aged 8 weeks, which were pulse-labelled with 3H-thymidine and subsequently killed in groups, together with labelled control animals (a total of 98 rats) after periods of 1-168 hours. Autoradiographs were prepared from plastic mesiodistal sections, and parameters of cell proliferation for JE and GCT of the papilla between the second and third molars were determined. Although the distance between the apical limit of JE and the most coronal periodontal ligament (PDL) fibres decreased on the pressure and increased on the tension sides of mechanically stimulated animals, the total cross-sectional area of JE remained unchanged compared with controls. In the basal and suprabasal layers of JE, cell proliferation was reduced on the pressure side and showed no change on the tension side. In the apical JE compartments on both sides, mechanical stressing resulted in lower proliferative activity. Cell proliferation in GCT adjacent to JE in stimulated animals did not differ from the corresponding controls. JE rapidly adapted to mechanical stimulation by means of differential local adjustments of cell proliferation without an occurrence of apical migration or hyperplasia. GCT cells in the vicinity of JE maintained their steady-state proliferative activity. These results do not support the concept that orthodontic tooth movement might per se have detrimental effects on the stability of the dentogingival junction.

Analysis of Variance↗
PubMed2005

Rat enamel contains RP59: a new context for a protein from osteogenic and haematopoietic precursor cells.

We have recently identified a protein, RP59, in bone marrow cells and young osteoblasts, in cells involved in bone repair and in young erythroblasts and megakaryocytes. Here, we report immunohistochemical data at the light- and electron-microscope level indicating that RP59 is also present in newly secreted tooth enamel of the rat and in ameloblasts, the formative cells. In enamel matrix, RP59 was located proximal to secretory ameloblasts only, i.e. in newly secreted material. Distal enamel and enamel in association with maturation stage ameloblasts were unlabelled. Secretory ameloblasts contained RP59 in the matrix-proximal region including Tomes' processes, post-secretory ameloblasts in the cell-matrix interface. Western blotting of proteins from tooth germs identified RP59 as a band at 90 kD, co-migrating with RP59 from bone marrow and spleen. Antisera versus a chemically synthesised RP59 peptide and versus a bacteria-synthesised protein fragment reacted in the same manner. In situ hybridisation of tooth tissue revealed RP59 RNA specifically in ameloblasts. The reverse transcription/polymerase chain reaction method identified tooth RNA coding for RP59. Sequence analysis indicated that RP59 RNA from tooth and marrow had the same sequence. An internal sequence motif was found in rat RP59 resembling a signal implicated in secretion of the chicken "engrailed" gene product. The findings indicate that RP59 is a genuine product of ameloblasts and that it is secreted in the course of enamel formation together with other matrix components.

Ameloblasts↗
PubMed1988

Spatial organization of the epithelium and the role of neural crest cells in the initiation of the mammalian tooth germ.

Teeth develop from composite organ rudiments that are formed through the interaction of oral epithelium and mesenchyme of the first branchial arch; cells of the former differentiate into enamel-secreting ameloblasts whereas those of the latter differentiate into dentine-secreting odontoblasts. Experimental analysis of odontogenic tissue interactions in mammalian embryos has focused on the late developmental stages of morphogenesis and cytodifferentiation; little is known about initial pattern-forming events, during which presumptive tooth-forming cells are specified and the sites of tooth initiation become established. It requires to be shown, for example, whether the mesenchymal cells of mammalian teeth are derived, like those of amphibians, from the cranial neural crest, and if so, whether these form a specified subpopulation in the neural folds. Alternatively, are they specified after migration into the mandibular arch, possibly by interaction with the oral epithelium? The developmental potentials of mouse embryo premigratory cranial neural crest cells (CNC - explanted from the caudal mesencephalic and rostral metencephalic neural folds) have been studied in intraocular homograft recombinations with various regions of embryonic surface ectoderm. Cartilage, bone and neural tissue developed in all combinations of CNC and epithelium. Teeth formed in combinations of CNC with mandibular arch epithelium but not in combinations of CNC with limb bud epithelium. Teeth also formed in combinations of mandibular arch epithelium with neural crest explanted from the trunk level. These results indicate that mammalian neural crest has an odontogenic potential but that this is not restricted to the crest of presumptive tooth-forming levels. Normal migration appears not to be a prerequisite for expression of odontogenic potential but this does require an interaction with region-specific epithelium. It is reasonable to infer that during normal development the neural crest that enters the mandibular arch is odontogenically unspecified before or during migration and that the oral epithelium is the earliest known site of tooth pattern.

Amelogenesis↗
PubMed1988

Ameloblastic fibroma--a case report.

An unusual case of ameloblastic fibroma involving two supernumerary teeth in the anterior part of maxilla has been presented here. The radiographic picture mimics a dentigerous cyst where there is a gross migration of one of the involved super-numerary tooth. After the histopathological diagnosis, the lesion was treated with enucleation and curettage.

Humans↗
PubMed2005

Cell transplantation in wounded mixed connective tissues.

Direct transplantation of multipotent precursor cells into the periodontium could provide a therapeutic approach for restoring periodontal tissues destroyed by periodontitis or trauma. To improve the understanding of cell migration, proliferation, and differentiation, we used a rodent model combining orthodontic tooth movement and transplantation of Lac-Z-positive murine-cultured periodontal ligament (PL) or femur-derived bone marrow precursor cells into a defined mandibular wound site, thus promoting tissue regeneration in wounded periodontium. Our results show that in orthodontically traumatized tissues, transplanted PL and bone marrow cells migrated systemically, contributing to the repopulation of sites with reduced cell/matrix density. The transplanted PL cells proliferated in adjacent alveolar bone marrow spaces, thus migrating to vascular tissues in the PL. The capillary walls in the PL serve as delivery sites for these cells and other marrow-derived hematopoietic cells, including monocytes. The transplanted marrow cells, extracted from femur of transgenic (TgR) mice exhibited similar behavior to those of transplanted PL cells, showing high proliferative activity in alveolar marrow as well as intensive repopulating capacity in wounded periodontium. On the other hand, the buccal skin fibroblasts failed to migrate and home effectively and thus the transplantation of these cells had no effect on periodontium regeneration. Based on these results, we conclude that the transplanted PL and bone marrow cells migrate systemically and following a cyclical process of growth and development and differentiate into PL fibroblasts, osteoblasts, and cementoblasts, thereby contributing to periodontal regeneration.

Alveolar Bone Loss↗
PubMed1995

Use of the carbon dioxide laser in retarding epithelial migration: a pilot histological human study utilizing case reports.

Predictable regeneration of tooth-supporting tissues lost to periodontal disease is the aim of periodontal therapy. Often the result of conventional treatment is healing with a long junctional epithelium along the root surface and little regeneration of the complete attachment apparatus. The purpose of this pilot study was to evaluate whether de-epithelialization with a CO2 laser at the time of flap surgery and at 10-day intervals over the first 30 days of healing has the potential to enhance the formation of a connective tissue attachment. Six mandibular incisors in two patients were selected for the study. Each patient received oral hygiene instruction and initial therapy prior to surgery. The teeth were splinted together, open flap debridement was performed on all teeth, a notch was placed on the roots at the height of the crest of the alveolar bone, and the flaps were sutured in place. The test side received controlled de-epithelialization of the outer (oral) gingiva with the carbon dioxide laser, and the inner gingival flap. The de-epithelialization was repeated on the test side at 10, 20, and 30 days postsurgically. Controls received open debridement only. Block sections were taken at 90 days and processed for histologic analysis. The results showed that for both patients, junctional epithelium (JE) was formed on both test and control teeth. In all control teeth, the JE extended the entire length of the root to the base of the reference notch.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1980

The pathway of enamel rods at the base of cusps of human teeth.

Enamel increases in volume and surface area with distance from the dentin-enamel junction, particularly at cusps, while the number of rods remains constant. Our results indicate that the increase in volume may be due to the increased rod diameter near the tooth surface, a circumferential winding of rods in the parazone orientation of Hunter-Schreger bands, and the migration of rods from a mid-coronal origin at the dentin surface to a cuspal terminaton at the tooth surface. Increased surface area can be explained by the increased rod diameter and the oblique approach of rods to the tooth surface.

Acid Etching, Dental↗