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[The effect of vicasol and pelentan on the biopolymers of the periodontium].

Vitamin K (vikasol) and pelentan were examined for their effects of periodontal tissue levels of collagen, hexosamine-containing biopolymers and sialoglycoproteins. During tooth replantation in dogs, vitamin K was demonstrated to elevate the levels of collagen, hexosamine-containing polymers in periodontal tissue by 25.8, 19.9, and 36.1%, respectively, whereas pelentan lowered the above parameters.

Animals↗

Treatment options of untreatable traumatized anterior maxillary teeth for future use of dental implantation.

The anterior maxilla is the most traumatized region during childhood. Posttraumatic complications occasionally lead to tooth loss as well as the need for future implants. Unfortunately, it is contraindicated to place dental implants during childhood. A waiting period of approximately 8 to 10 years before completion of growth is required. For this patient to become a candidate for future dental implants, it is necessary to ensure the continuous growth and to preserve the dimensions of the alveolar process until growth has ceased from time of injury until joint maturation. To achieve these goals, it is essential to coordinate the treatment sequence at the time of trauma. After loss of a traumatized anterior permanent maxillary incisor in young adults, treatment options are limited: orthodontic closure of the gap and reshaping the adjacent teeth, or tooth extraction and maintaining the gap with a temporary restoration. Orthdontic space closure has limited indications and requires prosthetic restoration of at least 2 teeth. Extraction and temporary restoration will usually lead to bone augmentation before implantation. Other possible treatment options include orthodontic extrusion of the root remnant (in cases of untreatable root fracture or complicated crown-root fracture) and a temporary crown to serve the patient until the completion of growth and development, autogenous tooth transplantation, intentional extraction and immediate tooth replantation, distraction osteogenesis, and decoronation. Because general rules do not apply, individual treatment plans are necessary.

Adolescent↗

[Survival rate of desmodontal cells in relation to their extraoral dehydration].

The success of tooth replantation following traumatic avulsion depends to a large degree on the vitality of periodontal ligament cells which remain on the root surface. Loss of vitality promotes root resorption. In this study 124 freshly extracted teeth, only front teeth and premolars, were stored in dry environment for periods of 10 to 150 min. The vitality of the residual periodontal ligament tissue was tested by means of the fluorescein-diacetate reaction. The root area covered by vital tissue decreased to 90% after 30 min and to 70% after 45 min of dry storage. Between 60 and 90 min after extraction the vital tissue area decreased rapidly to about 10%.

Adolescent↗

Effects of dental trauma on pulpal and periodontal nerve morphology.

Regeneration and morphological changes in sensory peptidergic nerves in pulp and periodontium were studied after general dental trauma by means of immunohistochemistry. In control teeth also the total nerve supply was demonstrated by using antibody to the general neuronal marker, protein gene product (PGP)9.5. Two experimental rat models were used, i.e. tooth replantation and induced traumatic occlusion. Results from these studies are reviewed here. In the controls, the PGP9.5-immunoreactive(IR) nerve supply in pulp and periodontium was generally denser compared to CGRP-IR and SP-IR nerves. In the replanted teeth, regeneration of CGRP-IR nerves closely followed the pulp cell renewal. Density and distribution of the regenerated nerves showed two different patterns which seemed to depend on the capacity of the renewed pulp to form postoperative dentine. The nerve density never reached the same level as the controls. In teeth not able to form irregular dentine, the pulp was sparsely innervated and the pulp cavity was filled with innervated bone. Nerve responses in CGRP-IR and SP-IR nerves after unilateral induced traumatic occlusion in the first maxillary molar were studied at different observation periods up to 30 days. After 5 days, localized morphological nerve changes were found both in the pulp and periodontium within the total rat molar dentition. With increasing observation periods, the pulpal neural changes progressed and were extended to all pulpal areas compared to the periodontium, where the nerve responses remained localized to cervical and apical tissues throughout the experiment.

Animals↗

Treatment of traumatic dental injuries in children.

The major emphasis of this review should rest on articles written within the past 12 months. Many of these papers comprise comprehensive surveys of treatment of various aspects of dental trauma in the primary and permanent dentition, as well as epidemiological studies. There have also been some very good experimental studies which have attempted to standardize luxation injuries as well as tooth replantation in order to study pulpal and periodontal healing in reproducible animal models. However, it can be seen from the reference list that one year's production in dental traumatology would not suffice to cover the scope of the treatment needs nor to adequately orient the reader on the progress made with respect to our present knowledge of wound healing following injury and the most recent developments in the restoration of the traumatized dentition. To present an overall view of the philosophy which has evolved concerning wound healing in the dental pulp and periodontium following injury as well as innovations in the treatment of acute dental trauma, this review must of necessity delve back into the mid-80's and probe forward into publications which are on the way in 1991. In 1984, in Dallas, Texas, the American Association of Endodontists' Endowment and Memorial Foundation convened the first International Conference on Oral Trauma. In 1989, in Stockholm, Sweden, this was followed up with the second International Conference on Dental Trauma. The one-day program summarized the state of the art of dental traumatology with respect to various aspects of epidemiology, diagnosis, treatment and prevention as well as the biological principles which form a basis for our present knowledge about healing and healing complications in the pulp and periodontium after traumatic dental injuries. The proceedings from this conference have been compiled in a newly published volume. Where applicable, these presentations have been cited as current reviews. It could also be mentioned that at the conclusion of the second conference, in recognition of the need to promote research and propagate knowledge in the area of dental traumatology, the International Association of Dental Trauma (IADT) was founded. The third International Conference on Dental Trauma was convened in Copenhagen, Denmark, June 1991. The major theme was restoration of the traumatized dentition. Proceedings from this conference are to be published. However, new information from that program is also cited in the following where applicable. Finally, the second Charlotte Conference on Pathobiology of the Dentin/Pulp Complex was held in Charlotte, North Carolina in May 1991.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Single-tooth osteotomy for intention replantation.

The conventional replantation technique has many drawbacks. The tooth may break during extraction; thus, teeth with diverged or curved roots are not good candidates for such a procedure. The occurrence of root ankylosis after replantation, with subsequent resorption, does not permit the replanted tooth to support any additional load, such as an orthodontic appliance or to be used as a bridge abutment. The procedure described here is designed to eliminate these drawbacks. The technique is based on leaving the delicate periodontal ligament fibers intact and transferring the wound created to the bone tissue. Extraction is achieved by a single-tooth osteotomy with the hope of improving the success rate of replantation.

Alveolar Process↗

Two uncommon uses of Bio-Oss for GTR and ridge augmentation following extractions: two case reports.

Bio-Oss is natural bovine bone mineral, which has the property of bone conduction. It is recommended to be used in two- or three-walled bony defects with an ample supply of pleuripotential cells. Two cases are reported. The first was an intentional replantation, because of previous trauma, of a hopeless tooth affected with severe periodontitis. The tooth was replanted after complete elimination of granulation tissue. Bio-Oss, together with a guided tissue regeneration (GTR) membrane, was used to enhance periodontal regeneration. After 2 years of follow-up, the replanted tooth was quite stable. In the second case, Bio-Oss, together with bone taken from the retromolar area, was used in a sinus lift grafting procedure after the removal of two supernumerary teeth from the floor of the maxillary sinus. Four months after grafting, an orthodontic treatment was applied to move the two adjacent teeth through the grafted site and align them in the proper position. The clinical results of the two cases were satisfactory.

Adolescent↗

Intentional replantation. A viable alternative for selected cases.

When conventional endodontic treatment or retreatment is not possible, the operator may choose to intentionally extract and replant the involved tooth. Intentional replantation consists of extracting the tooth, finding and correcting the defect, and replanting the tooth in its socket. This article discusses the indications, contraindications, and recommended techniques for intentional replantation. Several successful case reports are described in which intentional replantation was used as a last resort.

Aged↗

[Effect of antibiotic administration on the healing of replanted teeth. Experimental investigation in dogs].

Administration of antibiotics is usually recommended when an avulsed tooth is replanted although: a. no immediate acute infection as a consequence of tooth replantation has been known, b. their administration following tooth replantation has been questioned. The purpose of this experimental study was to investigate the effect of antibiotic administration on the healing of replanted teeth. 16 maxillary and mandibular permanent lateral incisors of four dogs aged from 5 to 7 months were immediately replanted without endodontic treatment. Oxytetracycline was administered intramuscularly the day of the experiment and twice daily through the experimental period in two of the dogs (8 teeth). The animals were sacrificed so as to provide observation periods of 15 and 22 days. Results were evaluated histopathologically in haematoxyline eosine stained sections. Results obtained showed shallower resorptine cavities without inflammatory cells in the experimental group (administration of antibiotics) than those found in the control group where inflammatory cells were also present.

Animals↗

Dental neuroplasticity, neuro-pulpal interactions, and nerve regeneration.

This review covers current information about the ability of dental nerves to regenerate and the role of tooth pulp in recruitment of regenerating nerve fibers. In addition, the participation of dental nerves in pulpal injury responses and healing is discussed, especially concerning pulp regeneration and reinnervation after tooth replantation. The complex innervation of teeth is highly asymmetric and guided towards specific microenvironments along blood vessels or in the crown pulp and dentin. Pulpal products such as nerve growth factor are distributed in the same asymmetric gradients as the dentinal sensory innervation, suggesting regulation and recruitment of those nerve fibers by those specific factors. The nerve fibers have important effects on pulpal blood flow and inflammation, while their sprouting and cytochemical changes after tooth injury are in response to altered pulpal cytochemistry. Thus, their pattern and neuropeptide intensity are indicators of pulp status, while their local actions continually affect that status. When denervated teeth are injured, either by pulp exposure on the occlusal surface or by replantation, they have more pulpal necrosis than occurs for innervated teeth. However, small pulp exposures on the side of denervated crowns or larger lesions in germ-free animals can heal well, showing the value of postoperative protection from occlusal trauma or from infection. Current ideas about dental neuroplasticity, neuro-pulpal interactions, and nerve regeneration are related to the overall topics of tooth biomimetics and pulp/dentin regeneration.

Animals↗