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Resorptive lesions in feline teeth are frustrating. Despite a number of studies, there is as yet no satisfactory, clear-cut explanation for the cause, high prevalence, and recent emergence of this lesion, and experience with treatment has identified more problems, rather than indicated a successful management regime.
April 1, 1995. Recent advances and directions in veterinary dentistry are reviewed, to point out that not a lot of progress is being made on some fronts, and none at all on others. The authors conclude that veterinary dentists should brush their own and their pets' teeth at least once during their professional careers.
Yugoslav Mesolithic dentition exhibits maximum mesiodistal reduction compared with contemporary European and North African groups. This reduction is not explained entirely by attrition, and may be seen as a continuation of the European Upper Paleolithic trend. Buccolingual dimension does not reduce as much. In fact, this dimension in premolars and molars is larger than in other groups. This observation also occurs in Natufians, who were grain collectors, hunters, and gatherers. The Yugoslav Mesolithic group was collecting and domesticating Cerelia as well as fishing and hunting. Linear enamel hypoplasias (LEH) indicate childhood stress through the fifth year, which corroborates previously reported incidence of rickets in this group. The central maxillary incisors and canines manifest higher degrees of LEH, but the appearance on the second molars suggest a more severe physiological disruption. Sex differences in distributions of alveolar resorption and calculus suggest differences in diet or nutritional stress. Previous reports indicate that females had higher incidence of osteomalacia. If so, female nutritional stress may explain the extreme mesiodistal reduction and minimal sexual dimorphism in this group.
Since its introduction in 1904, formocresol has become one of the most widely studied dental medicaments. In the United Kingdom, it is the preferred primary tooth pulpotomy medicament of the majority of Specialists in Paediatric Dentistry. Reports of adverse effects resulting from its clinical use are rare. This paper presents a case of premature exfoliation of primary molars that may be related to the use of formocresol in a multivisit pulpotomy technique.
The structure of reparative tertiary dentin in human deciduous teeth has been studied. Reparative dentin is secreted by a new generation of odontoblast-like cells which have been subject to strong stimuli, e.g., trauma or deep active caries lesions with associated pulp inflammation. Ground sections of 25 teeth were prepared, and contact microradiographs were produced. Another 30 teeth were demineralized, embedded in paraffin, sectioned, and stained with hematoxylin and eosin. Some demineralized sections from each tooth were also studied in the scanning electron microscope. Most of the teeth showed some type of tertiary dentin formation. Mineralized tissue with a varied morphology was observed. In teeth which had been subject to trauma, the entire pulp chamber was sometimes obliterated. Mineralization seemed to start in the incisal region, and the central part of the pulp was the last part to be obliterated. Radiolucent voids and canals were seen. The organic matrix was dense and fibrous. In the pulp chamber and especially in the root canals, resorption had often occurred, indicating that signals giving rise to odontoclasts were also present. Resorption was often followed by deposition of various amounts of cementum-like repair tissue. The cells responsible for the formation of reparative dentin are believed to be subodontoblasts or undifferentiated ectomesenchymal cells. The varied morphology of the reparative dentin, observed in the pulp of the teeth examined, indicates that different stimuli lead to induction of hard-tissue-forming cells which produce different types of hard tissue.
The aim of this paper was to describe, with the help of recent research informations, the possible interactions between orthodontics and periodontics. It is well-known that the periodontal structures of a tooth play an important role during its orthodontic movement; this should therefore be considered before, during and after any orthodontic treatment. The theoretical basis of the usual difficulties are explained, as well as their clinical consequences. The particular problem of orthodontic movements in dentitions with reduced periodontal support has been stressed. A synoptic table summarizes the diagnostic steps and the clinical approach with the recommendations which seem, at the present time, to allow the preservation of the periodontal structures during orthodontic movement. Finally, the problem of apical root resorption is addressed in a specific chapter.
A two-year old neuteral/male cougar (Felis concolor) was presented because of abnormal eating habits and an irregularity of the mandibular right first molar that was noted by the caretaker. Oral examination and dental radiographs showed a lesion consistent with odontoclastic resorption of the mandibular right first molar, and a crown fracture and dilacerated root of the maxillary right first incisor. Exodontic therapy was performed on both teeth. The caretaker reported no problems associated with the patient's oral cavity 10-months following treatment.
The present case report describes the reimplantation of avulsed teeth with the treatment of Emdogain. Case was avulsed right maxillary permanent central and lateral incisor in a 9-year-old girl suffering from a traumatic injury. After pretreatment of avulsed teeth, Emdogain was applied to the root surface and into the extraction socket with subsequent replantation of the tooth. Evaluation parameters included horizontal and vertical percussion sound and periapical radiographs. At 1-2-6-12-month follow-up period, the clinical and radiographic appearance of the teeth showed resolution of mobility and no signs of replacement resorbption.
AIM: This is to assess the priority in tooth avulsion: replantation as quickly as possible and deferred endodontic treatment, or replantation and elimination of every irritating stimulus for the periodontal ligament. The objective is to establish a univocal protocol by analysing and comparing the various components of these therapeutic procedures. MATERIALS AND METHODS STUDY DESIGN: 20 patients were selected and divided into 2 groups: in group A we focused our attention on the rapidity of replantation, in group B we focused on the elimination of the necrotic pulp and every possible irritating stimulus that might lead to root resorption of inflammatory nature. RESULTS: Clinically, dental mobility seems to be greater in the first group. However after 15 days teeth have a comparable mobility and after one month they all show a mobility degree 1. Radiographically a greater incidence of resorption can be observed in group A compared to group B as in the first one a higher number of replanted teeth undergo resorption. Such lesions have the tendency to remain constant or even increase. CONCLUSIONS: The results of this study seem to take only one direction: extraoral endodontic therapy.
There are several factors in the etiopathology of feline resorptive lesions. They may be considered as local immune-response mediating cell and humoral factors; release of biochemical components in dental and paradental tissues to attract odontoclasts; mechanical stress, including occlusal mechanism; and local and systemic calcium regulation, including remodeling of mineralized tissue and dietary intake of calcium.
Surveys were carried out in cats presented for dental examination in the Netherlands (432 cats) and in the United States (78 cats). In 62% of the Dutch cats and 67% of the US cats, resorptive lesions were present. In the Dutch study, Asian Short-hair (principally Siamese) cats were most commonly involved, and male cats were more commonly affected than females. The most commonly affected teeth were the fourth maxillary premolar and the mandibular premolar and molar teeth.
The pulpal and periodontal effects of electrosurgery involving teeth restored with Class V cervical amalgams and nonrestored teeth were evaluated in three cynomolgus monkeys. Electrosurgical current was delivered for 1 second with a fully rectified unit at an output intensity consistent with normal clinical usage. Experimental conditions included electrosurgery involving restored teeth, electrosurgery involving unrestored enamel, restored teeth not subjected to electrosurgery, and teeth which were neither restored nor subjected to electrosurgery. No pulpal or periodontal tissue changes were observed in the latter three groups of teeth. Electrosurgery involving cervical restorations consistently resulted in coagulation necrosis of the pulp and extensive resorption of cementum, dentin, and interradicular bone in the furcation area of multirooted teeth. The results suggest that inadvertent contact with cervical restorations during electrosurgical procedures may endanger both the pulp and the periodontal attachment apparatus.
The influence of root development on periodontal and pulpal healing after replantation was examined in 30 green vervet monkeys (Cercopithecus aethiops) in which a total of 50 teeth were replanted. Maxillary central incisors with different stages of root development (immature, young mature and mature root formation) were replanted with untreated pulps or after root canal treatment with gutta percha and Kerr sealer. The extra-alveolar period in all groups was 18 min. The animals were sacrificed 8 weeks after replantation and the teeth examined histologically. The following histologic parameters were registered for each tooth: surface resorption, inflammatory resorption, replacement resorption (ankylosis), downgrowth of pocket epithelium, periapical inflammatory changes and extent of vital pulp. Histologic analysis showed that the extent of vital pulp was significantly related to the stage of root development, being almost complete in teeth with immature roots and almost totally lacking in young mature and mature teeth. Surface resorption was found with the same frequency in the different root development groups while inflammatory resorption was slightly more frequent in young mature teeth than in mature teeth, a finding possibly related to a protective action of a thick cementum layer in the mature teeth. Replacement resorption was found with almost the same frequency in the different root development groups in non-endodontically treated teeth. As ankylosis is the most important factor determining the prognosis of replanted and autotransplanted teeth, the present findings indicate that replantation and autotransplantation of mature teeth could be of clinical use.
Etiology of different types of root resorption requires two phases: mechanical or chemical injury to the protective tissues and stimulation by infection or pressure. Injury can be similar in various types of root resorption. The selection of proper treatment is related to the stimulation factors. Intrapulpal infection is the stimulation factor in internal root resorption and external periradicular inflammatory root resorption. Adequate root canal treatment controls intrapulpal bacteria and arrests the resorption process. In cervical root resorption, infection originates from the periodontal sulcus and stimulates the pathological process. As adequate infection control in the sulcus is unlikely, removal of granulation tissue from the resorption lacuna and sealing are necessary for repair. Removal of the stimulation factor, i.e. pressure, is the treatment of choice in root resorption related to pressure during orthodontic treatment, or an impacted tooth or tumor. In ankylotic root resorption, there is no known stimulation factor; thus, no predictable treatment can be suggested. Therefore, various types of root resorptions can be classified according to the stimulation factors: pulpal infection resorption, periodontal infection resorption, orthodontic pressure resorption, impacted tooth or tumor pressure resorption, and ankylotic resorption.
The radiographs of fifteen Malaysian patients with presenting ameloblastoma aged between 20-55 years (average 35 years) were studied for any peculiar local features. The most common features were cortical plate expansion (80%), corticated scalloped margin (67%), multiloculation (87%), and resorption of tooth roots (47%). The latter two features are constantly found in advanced tumour stage. As pain was not a frequent complaint, many Malaysian patients seek treatment only at a very late stage after the tumours have reached large dimensions. Although ameloblastomas may be diagnosed often through radiographs, it should not be relied upon solely.
The effect of removal of the coagulum in the alveolus before replantation upon periodontal and pulpal healing was studied in green Vervet monkeys (Cercopithecus aethiops). Mandibular lateral incisors were extracted. The extra-alveolar period before replantation was 60 min. The storage medium for the extracted teeth was physiologic saline. On the right side of the mandible, the coagulum was removed before replantation, using syringe with saline assisted by a spoon-shaped excavator. On the left side, the tooth was replanted with the coagulum in situ. The replanted teeth were examined histologically after 8 weeks. The histometric analysis showed no significant difference in periodontal or pulpal healing between the two groups. Based on this finding, it is suggested that replantation of avulsed mature teeth be carried out immediately, without any attempt to remove the coagulum.
For clarification of the histological details of the shedding of human deciduous teeth, exfoliated and extracted deciduous teeth were examined by light and electron microscopy. After the roots were completely resorbed, the dentogingival junction migrated along the inner resorbing surface and finally reached the pulpal surface of the crown. At the same time, the gingival epithelium also proliferated and migrated under the crown of the deciduous tooth in such a way that part of it lined the residue of the pulp and another part lined the surface overlying the erupting successional tooth. This phenomenon took place from various sides of the tooth surface. Therefore, just before exfoliation, the migrated gingival epithelium formed narrow necks of tissue, and the crown was only superficially attached to the gingiva by them. The final shedding of the tooth appeared to occur by a tearing of these narrow tissue regions. The results of the present study suggest that the dento-gingival junction as well as gingival epithelium play important roles in the process of exfoliation of human deciduous teeth.
Connective tissue grafts combined with pedicle grafts (subepithelial grafts) have been shown to be effective in obtaining root coverage. Unfortunately, little is known about the histology of the results in humans. This is a case report of a tooth with a recession defect that was treated with a subepithelial graft. Complete root coverage was obtained. However, at 5 months postoperative the tooth had to be extracted because of a vertical root fracture. With the patient's permission, a small collar of tissue was removed with the tooth. The sample was processed and evaluated histologically. The results revealed areas of regeneration, with new bone, cementum, and connective tissue attachment coronal to the original gingival margin. No bone grafts or guided tissue regeneration membranes were used. This case report confirms that regeneration is possible with subepithelial grafts.