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Calcium hydroxide: a review.

Calcium hydroxide is a multipurpose agent, and there have been an increasing number of indications for its use. Some of its indications include direct and indirect pulp capping, apexogenesis, apexification, treatment of; root resorption, iatrogenic root perforations, root fractures, replanted teeth and interappointment intracanal dressing. The purpose of this paper is to review the properties and various indications for the use of calcium hydroxide.

Anti-Bacterial Agents↗

In vivo killing of Porphyromonas gingivalis by toluidine blue-mediated photosensitization in an animal model.

Porphyromonas gingivalis is one of the major causative organisms of periodontitis and has been shown to be susceptible to toluidine blue-mediated photosensitization in vitro. The aims of the present study were to determine whether this technique could be used to kill the organism in the oral cavities of rats and whether this would result in a reduction in the alveolar bone loss characteristic of periodontitis. The maxillary molars of rats were inoculated with P. gingivalis and exposed to up to 48 J of 630-nm laser light in the presence of toluidine blue. The number of surviving bacteria was then determined, and the periodontal structures were examined for evidence of any damage. When toluidine blue was used together with laser light there was a significant reduction in the number of viable P. gingivalis organisms. No viable bacteria could be detected when 1 mg of toluidine blue per ml was used in conjunction with all light doses used. On histological examination, no adverse effect of photosensitization on the adjacent tissues was observed. In a further group of animals, after time was allowed for the disease to develop in controls, the rats were killed and the level of maxillary molar alveolar bone was assessed. The bone loss in the animals treated with light and toluidine blue was found to be significantly less than that in the control groups. The results of this study show that toluidine blue-mediated lethal photosensitization of P. gingivalis is possible in vivo and that this results in decreased bone loss. These findings suggest that photodynamic therapy may be useful as an alternative approach for the antimicrobial treatment of periodontitis.

Alveolar Bone Loss↗

How repair cementum becomes attached to the resorbed roots of human permanent teeth.

Human premolars extracted for orthodontic reasons were fixed with a mixture of formaldehyde and glutaraldehyde and processed for light and transmission electron microscopy. About 15% of all available teeth showed signs of superficial root resorption. Quantitatively, the resorption lacunae were more frequent at the apical third of the root, when compared to the mid-root and the cervical levels. Qualitatively, the resorption areas appeared as shallow irregular concavities. The degree of resorption and/or repair varied considerably both within and between sites, ranging from arrested resorption to advanced repair. An about 1- to 2-microns-thick seam of exposed collagen fibrils of the residual dentinal matrix lined the resorbed root surfaces in the arrested stage of resorption. A particular class of mononuclear cells repopulated these surfaces and commenced to attach newly produced collagenous matrix fibrils to the exposed dentinal matrix. Increasing fibril formation and bundling resulted in a collagenous fiber fringe oriented perpendicular to the bottom of Howship's lacunae. Following the implantation and establishment of this initial fiber fringe, the junctional zone between the two matrices and further portions of the repair matrix became progressively obscured by a fine granular and electron-dense material, indicating the advancing front of mineralization. In addition, the junctional zone later attained a high degree of electron density and basophilia. Subsequently formed matrix derived from cementoblasts was structurally heterogeneous and resembled cellular intrinsic fiber cementum (CIFC). It is suggested that the initially produced matrix along resorbed root surfaces closely resembles that seen during initial formation of acellular extrinsic fiber cementum (AEFC), whereas further apposition results in a tissue with the characteristics of CIFC.

Adolescent↗

Dentinoenamel junction area of a resorbing permanent incisor studied by means of scanning electron microscopy.

The surfaces of enamel and dentin that had become separated from each other presumably in the region of the dentinoenamel junction were examined. The enamel surface at the junction was scalloped; the scallops were made of enamel rods. The dentinal surface showed a mirror image picture, tubular in nature. Both surfaces were granulated, which may indicate that apatite crystals from the two tissues intermingle there.

Child↗

Cellular roles in physiological root resorption of deciduous teeth in the cat.

This study has attempted to assess the importance of mesenchymal cells, fibroblasts, cementoblasts, and mononuclear phagocytes (i.e., macrophages) in physiological root resorption of feline deciduous teeth. Deciduous incisors of three- to six-month-old kittens undergoing root resorption were investigated by means of electron microscopy. In an early phase of root resorption, the resorption organ consisted of many fibroblasts and relatively few macrophages and odontoclasts, the last with a wide, clear zone and narrow, immature, ruffled border. In the active phase of root resorption, the resorption organ contained many odontoclasts with a well-developed ruffled border and a reduced clear zone, cementoblasts, fibroblasts, macrophages, neutrophils, and many blood vessels. Cementoblasts were present usually on the resorbing dentin surface adjacent to odontoclasts and, in many cases, these cells communicated with each other via gap junctions. Cementoblasts frequently extended broad cell processes with secretion granules and with phagosomes containing collagen fibrils into the dentinal tubules exposed to resorption lacunae. Some macrophages exhibiting a clear zone-like structure also appeared on resorbing dentin surfaces. In the resting phase of root resorption, the dentin surface was covered mostly with cementoblasts resembling bone lining cells. There was an occasional macrophage, but no odontoclasts were observed during this phase. During removal of the periodontal ligament concomitant with root resorption, many fibroblasts phagocytosed mature collagen fibrils, as well as amorphous fluffy material. These results suggest that these mesenchymal cells, as well as odontoclasts, are essential for the cellular removal of dental hard and soft tissues during shedding of feline deciduous teeth.

Animals↗

Clarification.

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Animals↗

Feline "odontolysis" in the 1920's: the forgotten histopathological study of feline odontoclastic resorptive lesions (FORL).

This article reviews an historic description of feline odontoclastic resorptive lesions (FORL) from the 1920's. Hopewell-Smith describes the complete resorption process of feline permanent premolar teeth in remarkable detail, using 14 excellent photomicrographs. Resorptive lesions in cats were seen in the early part of this century, however the prevalence of this condition in domestic cats appears to have increased concurrently with certain aspects of domestication since the 1960's.

Animals↗