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PubMed1978

Histologic response of replanted teeth pretreated with acidulated sodium fluoride.

Central incisors in the vervet monkey were extracted, endodontically treated, and replanted into their original sockets after immersion in a 2 per cent acidulated sodium fluoride solution (pH 5.5) for 30 minutes. Histologic examination at 1, 2, 4, and 8 weeks postoperatively showed that by the second week resorption had taken place and that ankylosis, first seen by the fourth week, along both the buccal and palatal root surfaces, was well established by the eighth week. Under the conditions of the study, pretreatment of the tooth roots with 2 per cent acidulated sodium fluoride did not reduce root resorption and ankylosis.

Acids↗
PubMed1995

Experimental topical tetracycline-induced neuritis in the rat.

PURPOSE: Recent studies have reported that tetracycline may induce chronic inflammatory responses in the adjacent soft tissues. The purpose of the present study was to determine if dry, powdered tetracycline evoked an inflammatory response in nerve tissue. MATERIALS AND METHODS: Twenty male Sprague-Dawley rats were anesthetized and bilateral mental nerves were exposed. Half of the 40 nerves were intentionally injured by removing the epineurium, and the remaining nerves were uninjured. In a prospective, randomized, double-blind manner, equal volumes of color-matched, precoded tetracycline powder or Gelfoam (Upjohn, Kalamazoo, MI) powder control was placed in intimate contact with the nerves and sealed in polyethylene tubes. Forty-five days later the animals were killed and 5-micron sections of the nerves were prepared for histologic examination. The presence of epineurium, fascicular number, and fascicular area were measured. An inflammatory response in nerve tissue and the intrafascicular and epifascicular inflammatory index was measured by counting darkly stained nuclei with a Jandel Video Analysis System (Jandel Scientific, Corte Madera, CA). RESULTS: Experimental injury (ie, epineurectomy) of nerves resulted in a statistically significant increase in fascicular number (P = .034), but not in fascicular area. For the intrafascicular inflammatory index, there was a significant main effect for drug (P = .002) and injury (P = .002). Experimental injury in both Gelfoam control and tetracycline grouped nerves resulted in an increase in intrafascicular inflammation. There was no significant increase in intrafascicular inflammation in either Gelfoam control or tetracycline grouped nerves when the epineurium was intact. The combination of both tetracycline and epineurectomy resulted in the largest increase in intrafascicular inflammation found among the groups studied. For epifascicular inflammatory index, there was a significant main effect for drug (P = .003) and injury (P = .001) that mirrored the intrafascicular inflammatory pattern. CONCLUSION: The results of the present study suggest that dry, powdered tetracycline accentuates the inflammatory response in intrafascicular and epifascicular nerve tissue following epineurectomy. The maintenance of epineurium inhibited the inflammatory response in intrafascicular and epifascicular nerve tissues. Gel-foam was an inert material when placed against exposed nerve tissue. These findings suggest that tetracycline should not be placed in extraction sockets when injury of the inferior alveolar and/or lingual nerves are present.

Administration, Topical↗
PubMed1998

Topical bupivacaine for pain control following simple dental extractions.

OBJECTIVE: This study was carried out to examine the effectiveness of topically applied bupivacaine 0.25% with adrenaline 1:200,000, for post-operative analgesia in children undergoing dental extractions under general anaesthesia. DESIGN: Randomised double blind study in a single centre. SETTING: An outpatient dental clinic in a district general hospital, in England, in 1997. SUBJECTS AND METHODS: Subjects were selected from children of age 7-15 years having six or less extractions, and randomised using the closed envelope technique. INTERVENTIONS: The local anaesthetic used was bupivacaine 0.25% with adrenaline 1:200,000. MAIN OUTCOME MEASURES: Children were asked on waking from the anaesthetic whether they had pain or not. Pain was reassessed five and ten minutes post application of swabs to determine any changes in pain. RESULTS: Forty-eight children were recruited, of these 18 had no pain post-operatively and 6 were withdrawn due to a lack of cooperation. Twelve children were randomised to each group. There were 6 boys and 6 girls in the bupivacaine group (age 7-15 years), and 4 boys and 8 girls in the saline group. Bupivacaine 0.25% with adrenaline soaked swabs resulted in a significant reduction in pain in 10 children at 10 minutes (P = 0.01). CONCLUSION: Bupivacaine 0.25% with adrenaline 1:200,000, on application to exposed sockets is a simple technique that may provide useful post-operative analgesia.

Administration, Topical↗
PubMed1997

The role of the socket in the periodontal healing of replanted dogs' teeth stored in ViaSpan for extended periods.

In a previous study on the extended storage of extracted dogs' teeth, it was hypothesized that changes in the socket environment might play a role in the periodontal healing of these teeth. The purpose of this study was to evaluate the role of the socket in the periodontal healing of replanted dogs' teeth. Extracted endodontically treated dogs' teeth were stored in ViaSpan for 6 hours and replanted into sockets after 6, 48 or 96 hours. Controls included teeth extracted and replanted immediately, 48-hour stored teeth replanted into 48-hour sockets and 96-hour stored teeth replanted into 96-hour sockets. After 6 months the dogs were killed and the teeth prepared for histologic evaluation according to Andreasen. Overall healing for the groups and healing for teeth within the groups were evaluated and compared. The best results were obtained when the teeth were replanted immediately. For the teeth stored in ViaSpan for 6 hours, complete healing decreased significantly as the age of the socket increased. In addition, the rate of replacement resorption increased significantly with increasing socket age for the 6-hour stored teeth. Forty-eight-hour stored teeth replanted into 48-hour sockets had the lowest healing rate with levels of inflammatory resorption not seen in the other groups. According to the results of this study, the socket environment plays an important role in the healing of replanted teeth in dogs.

Adenosine↗
PubMed1994

A retrospective study of 237 sites treated consecutively with guided tissue regeneration.

A number of controversies have arisen concerning the use of guided tissue regeneration in conjunction with implant fixtures. Three of these are the effect on the regenerative result of material exposure, the type of grafting material used, and whether the fixture is placed in an extraction socket or edentulous ridge. This study examines these issues in 237 consecutive sites treated with guided tissue regeneration.

Alveolar Bone Loss↗
PubMed1997

Histometric analysis of rat alveolar wound healing.

The chronology of alveolar wound healing was analyzed by a standard stereological method (point-counting volumetry) in normal rats. The upper right incisors were extracted and the animals were killed 1, 2, 3 and 6 weeks postoperatively. A light camera was used to determine the volume fraction of histologic components in the apical, middle and cervical thirds of the alveolus. Progressive bone neoformation was quantified, in parallel to a decrease in percent volume of connective tissue. A significantly smaller volume fraction of bone trabeculae in the cervical third of the socket was observed at all periods except the 6th week. The present histometric data show that bone neoformation continued to proceed beyond the 3rd postoperative week.

Alveolar Process↗
PubMed1976

Comparison of a microcrystalline collagen preparation and gelatin foam in extraction wounds.

A microcrystalline collagen preparation and a gelatin foam were compared relative to their effects on hemostasis and healing in molar extraction sockets in cats. The agents were essentially equivalent in both hemostasis and the inflammatory response that accompanied healing. Healing was slightly retarded in comparison to that seen in untreated control sockets in a previous study. It appears likely that the inflammatory response was caused by oral contamination, which is unavoidable in this type of procedure, rather than by the agents themselves.

Alveolar Process↗
PubMed2000

Effect of an antirotation resistance form on screw loosening for single implant-supported crowns.

STATEMENT OF PROBLEM: The gold screw of the single tooth implant-supported restoration has frequently been reported to exhibit the problem of screw loosening. PURPOSE: This in vitro study considered an antirotation resistance form with an increased moment arm length as a strategy to increase the net effect of the retaining screw preload. MATERIAL AND METHODS: Three groups examined included (a) standard abutments (3 mm), (b) modified standard abutments (3 mm) with 4 milled (1 x 1 mm) notches placed equidistant around the periphery, and (c) Estheticone abutments (1 mm). Crown castings of 2% gold-palladium-based alloy were made using plastic and resin patterns molded to fit inside a quarter-inch socket wrench. For testing, each specimen consisted of a 15-mm endosseous threaded implant analog, its abutment (20 N force) and crown casting (10 N force) screwed together and securely clamped in a vise. A clockwise shear (rotational) force was applied using a manual torque driver and the torque recorded to failure of the gold screw or loosening of the abutment screw. RESULTS: Analysis revealed that the dislodging force for groups (b) and (c) was similar (69.6 and 71.0 N.cm, respectively), whereas group (a) (standard implant external hex) demonstrated that the smallest moment arm required a significantly smaller dislodging force (21.3 N.cm). CONCLUSION: These findings suggest that the addition of an antirotation resistance form increased the length of the moment arm, thereby increasing the effect of preload and reducing the problem of screw loosening.

Analysis of Variance↗
PubMed1990

The early effects of surgical sympathectomy on bone resorption in the rat incisor socket.

Earlier studies have shown that one week after sympathectomy in the rat, both bone apposition and resorption are significantly altered. Resorption in the incisor socket was now examined 1, 3 and 5 days after surgical sympathectomy. Morphometric analyses indicated that the total resorbing surface, active resorbing surface and number of osteoclasts per socket were increased one day after sympathectomy; the area and length of the bone surface of the socket were not significantly altered. Sympathetic denervation thus affects bone resorption within the first few hours after surgery.

Alveolar Process↗
PubMed1976

99MTc-diphosphonate bone imaging and uptake in healing rat extraction sockets.

Clinically positive bone scans of the jaws may result from a variety of benign dental conditions. An experimental system for studying radionuclide imaging and uptake in the jaws of rats was developed. Sequential 99mTc-diphosphonate bone scans and radionuclide uptake determinations were performed on rats after standardized extractions of their mandibular left first molars. Positive bone scans were seen 4-16 days after molar extraction, and increased radionuclide uptake was found in the healing extraction wounds 4-42 days after the extraction. Conventional radiography and histology fail to show unusual bony architecture in extraction sockets at such times. These results correlate with clinical findings in patients and suggest that human beings may have positive bone scans for several months after dental extraction.

Animals↗
PubMed2006

Mandibular fracture 2 weeks after third molar extraction.

This case report describes mandibular fracture after the surgical extraction of fully erupted lower third molar of a 53-year-old healthy male patient. The fracture occurred 15 days after the extraction while chewing. The fracture line extended from the apex of the mesiobuccal root socket to the inferior border of the mandible. Follow-up of the patient was agreed as the patient was not willing to carry on further treatment. Bony union was observed radiologically 3 months later.

Fracture Healing↗
PubMedDate not supplied

[Prolong bleeding after extraction from green pit venom].

A case of prolonged socket bleeding after extraction is reported to have been caused by a recent green pit viper snake bite. The snake is a common tropical creature. Several cases bitten are seen in general medical clinic yearly. Pain and local symptoms lead most patient to doctor's attention; while coagulopathy, the other clinical features are usually not being aware of. The 66-year-old patient who had been bitten by the snake a day earlier, of having tooth extraction was referred to Rachaburi Hospital Dental clinic of having post-extraction delayed haemostasis. A routine heamostasis as of gel foam with adrenalin pack and vitamin K injection was unsuccessful. Further laboratory investigations confirmed that he had hypofibrinogenemia as the pathogenic cause. Fresh frozen plasma was administered, haemostatis was satisfactory within 24 hrs.

Afibrinogenemia↗
PubMed2004

Alveolar bone Sharpey fibers of the rat incisor in normal and altered functional conditions examined by scanning electron microscopy.

The morphology and the area density of Sharpey fibers in the socket of the rat incisor under normo-, hyper-, and hypofunctional conditions were evaluated using scanning electron microscopy. Sharpey fibers appeared either as dome-shaped projections, when highly mineralized, or as depressions when less mineralized. Near the alveolar crest, most of the fibers were fully mineralized and arranged in compact longitudinal rows. Toward the basal end of the socket, the rows became interrupted, forming islets of gradually smaller size and number. The density of the Sharpey fibers was higher (P < 0.01) in the mesial and distal faces than in the lingual face in most of the socket length. In normofunctional conditions, in all faces the density decreased 70 to 90 times from the crestal toward the basal region of the socket (P < 0.01). The degree of mineralization of the Sharpey fibers also decreased steadily in the same direction, indicating that, for support, the periodontal ligament matures from basal to incisal and is fully developed only in the crestal region. In hyper- and hypofunctional conditions, the same distribution was observed. The area density of the Sharpey fibers in the hyperfunctional condition showed a slight increase at the basal levels of the socket mesial and distal faces (P < 0.01 or P < 0.05). In hypofunctional incisors, the density decreased significantly (P < 0.01) at the mesial and distal faces in all regions of the socket, and at the lingual face, the decrease (P < 0.05) was restricted to the incisal regions. This may be one of the factors for the weakening of the periodontal ligament in hypofunctional incisors.

Alveolar Process↗
PubMedDate not supplied

Immediate placement of implants into extraction sockets: implant survival.

In 51 patients (21 males and 30 females) aged 16 to 72 years, a total of 109 Nobelpharma implants were placed into extraction sockets immediately following extraction. The follow-up period varied between 1 and 67 months with a mean of 30.5 months. Osseointegration was determined by clinical stability, lack of symptoms, and lack of peri-implant pathology based on radiographic examination. The implant survival rate was 93.6%. Six implants were mobile at the abutment connection stage, and one was lost when function commenced. The success rate was 92.0% for implants replacing teeth extracted because of periodontitis and 95.8% for implants replacing teeth extracted for other reasons. Two other complications occurred: 12 cover screws perforated the gingiva during healing; and infection developed in five cases. The incidence of infection was higher in the periodontitis group. It was found that immediate placement of implants into extraction sockets is a safe and predictable procedure if certain guidelines are followed.

Adolescent↗
PubMed1999

Ischemic osteonecrosis under fixed partial denture pontics: radiographicand microscopic features in 38 patients with chronic pain.

STATEMENT OF PROBLEM: Previous studies have identified focal areas of alveolar tenderness, elevated mucosal temperature, radiographic abnormality, and increased radioisotope uptake or "hot spots" within the quadrant of pain in most patients with chronic, idiopathic facial pain (phantom pain, atypical facial neuralgia, and atypical facial pain). PURPOSE: This retrospective investigation radiographically and microscopically evaluated intramedullary bone in a certain subset of patients with histories of endodontics, extraction, and fixed partial denture placement in an area of "idiopathic" pain. MATERIAL AND METHODS: Patients from 12 of the United States were identified through tissue samples, histories, and radiographs submitted to a national biopsy service. Imaging tests, coagulation tests, and microscopic features were reviewed. Of 38 consecutive idiopathic facial pain patients, 32 were women. RESULTS: Approximately 90% of subpontic bone demonstrated either ischemic osteonecrosis (68%), chronic osteomyelitis (21%), or a combination (11%). More than 84% of the patients had abnormal radiographic changes in subpontic bone, and 5 of 9 (56%) patients who underwent radioisotope bone scan revealed hot spots in the region. Of the 14 patients who had laboratory testing for coagulation disorders, 71% were positive for thrombophilia, hypofibrinolysis, or both (normal: 2% to 7%). Ten pain-free patients with abnormal subpontic bone on radiographs were also reviewed. CONCLUSIONS: Intraosseous ischemia and chronic inflammation were suggested as a pathoetiologic mechanism for at least some patients with atypical facial pain. These conditions were also offered as an explanation for poor healing of extraction sockets and positive radioisotope scans.

Adult↗
PubMed2003

Results of transplanting developing third molars as part of orthodontics space management. Part 2: results following the orthodontic treatment of transplanted developing third molars in cases of aplasia and premature loss of teeth with atrophy of the alveolar process.

MATERIAL AND METHODS: The aim of this study was to assess the effects of atrophy of the alveolar process and subsequent orthodontic treatment on the transplantation results of developing third molars. The material consisted of 35 teeth transplanted to an atrophied alveolar process. 19 of these teeth were treated orthodontically subsequent to transplantation. The control group consisted of 61 developing molars transplanted to a new extraction socket. The transplanted teeth were followed up clinically and radiographically for a mean period of 3.2 years. RESULTS: The success rate was 85% for transplants to new extraction sockets and 84% for transplants to atrophied jaw sections with subsequent orthodontic treatment. In contrast, transplants to atrophied jaw sections without subsequent orthodontic treatment showed a significantly (p < or = 0.001) lower success rate of only 37.5%. These poorer results were due to persistent infraocclusion and ankylosis. CONCLUSIONS: Even in cases with atrophy of the alveolar process, a transplantation with subsequent orthodontic treatment represents a promising treatment concept, whereas teeth without subsequent orthodontic treatment showed a lower success rate. Orthodontic tooth movement had no negative effect on the healing rates of transplanted developing third molars.

Adolescent↗
PubMed2006

Characterization of dentin formed in transplanted rat molars by electron probe microanalysis.

The present study was designed to characterize dentin formed in transplanted rat molars by investigating calcium (Ca), phosphorus (P), and magnesium (Mg) concentrations using electron probe microanalysis (EPMA) as well as examining the rate of dentin matrix formation by vital staining. The unerupted immature lower right second molar in 2-week-old rats was transplanted into the upper right first molar socket. Rats were injected with oxytetracycline, calcein, and alizarin intraperitoneally at 1 day before and 1 and 2 weeks after transplantation, respectively, for vital staining. The maxillae and mandibles were fixed 3 weeks after transplantation, resected, and embedded in resin. Undemineralized sections were cut and examined by fluorescent microscopy and EPMA. The thickness of dentin formed in the first week after transplantation was significantly less than that of dentin formed in any other 1-week period in the transplanted tooth and was about one-fifth the thickness of dentin formed in control teeth. Formation of dentin recovered in the third week after transplantation. In the first week after transplantation, EPMA demonstrated a sharp increase in Mg concentration with a slight decrease in Ca concentration. Thereafter, no significant difference was identified among Ca, P, or Mg concentrations or the Ca/P ratio between transplanted and control teeth. These results suggest that disruption of the circulation and innervation by transplantation cause a temporary change in the matrix formation rate and elemental distribution of dentin, which is subsequently restored within 2 weeks after transplantation.

Animals↗
PubMed1990

Measurement of the force required to extract the mandibular first molar from its socket in the dissected jaw of growing young rats.

Age-related changes in the mechanical strength of the periodontal ligament have been examined by measuring the force required to extract the mandibular first molar from its socket at an extension rate of 5 mm/min in the dissected jaws of growing young rats from 3 to 32 weeks of age. Almost linear increase in the ultimate loads was found from 3 to 8 weeks of age. However the values from 8 to 32 weeks of age did not show any significant differences. Close correlations were found between the ultimate loads and the weights of animals, mandibles and extracted teeth and between the load and length of the tooth from 3 to 8 weeks of age. It is supposed that a mechanical equilibrium has been established within the periodontal ligament in association with various external and internal factors such as root elongation, alveolar bone growth, turnover and maturation of periodontal ligament and occlusal activity, at about 8 weeks of age in the rat mandibular first molar.

Aging↗