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PubMed1998

Changes in peri-implant tissues subjected to orthodontic forces and ligature breakdown in monkeys.

The aims of this investigation were to histologically evaluate in monkeys the effect of a repetitive mechanical trauma alone on the peri-implant tissues, and the effect of a repetitive mechanical trauma in combination with ligature-induced peri-implantitis on the peri-implant tissues. The study used 5 male cynomolgus monkeys. Prior to the start of the study, all premolars and the first and second molars in the mandible were extracted. After a healing period of 12 weeks, following tooth extraction, split/full thickness flaps were elevated on both sides of the mandible in order to expose the bony ridge. Four implants, of 3.75 mm in diameter and 7 mm in length, were then inserted on each side and the flaps were readapted and sutured in place. Following a healing period of 16 weeks, the second stage procedure was performed, impressions were taken, and custom-made crowns using a non-precious metal alloy were fabricated and inserted on all implants 4 weeks after abutment connection. At the same time peri-implantitis was induced on one side of the mandible by placing plaque-retentive ligatures around the implants. On the other side, an oral hygiene program consisting of thrice weekly brushing with a toothbrush and flour of pumice mixed with 2% chlorhexidine was initiated. Four months later, a repetitive mechanical trauma was initiated on implants 1 and 2 on both sides in the mandible. Consequently, a split mouth design was obtained: 1) test 1=ligature-induced peri-implantitis alone (LPNO); 2) test 2=ligature-induced peri-implantitits with a repetitive mechanical trauma (LPMT); 3) test 3=healthy peri-implant tissues with a repetitive mechanical trauma (MT); and 4) control (NO)=healthy peri-implant tissues with no repetitive mechanical trauma. Following 16 weeks of repetitive mechanical trauma the animals were sacrificed. Histologic observations and computed-assisted histometric and histomorphometric analyses were performed to determine the amount of peri-implant bone loss and the percentage of direct mineralized bone-to-implant contact around each endosseous oral implant. Histologically, all implants yielded osseointegration at the light microscopic level. There was a significant difference regarding the mean direct mineralized bone-to-implant contact length as a fraction of the total implant length between the healthy (i.e., MT and NO) and diseased sites (i.e., LPNO and LPMT) (P < 0.05). When comparing the percent of direct mineralized bone-to-implant contact for the 2 best threads of each implant and group, no significant difference (P=0.675) could be detected. Under the conditions of this study, the repetitive mechanical trauma showed no histologic effect on the peri-implant bone loss neither in healthy nor in diseased implant sites. The effects of excessive loading on osseointegration are presently not clearly understood. The key problem seems to be the determination when loading on implants exceeds the physiological range of bone adaptation which may then cause implant failure. Further research to elucidate this problem is essential.

Adaptation, Physiological↗
PubMed2006

[Problems and possibility of resin abutment construction with a combined use of fiber posts: at the beginning of discussion].

When using post materials that are more rigid than teeth for abutment construction, tooth root fracture may be caused by stress concentration in the remaining part of the tooth root. Most of the tooth root fractures clinically observed in metal post abutment cases are longitudinal fractures, resulting in tooth extraction in many cases. In cases with sufficient coronal tooth substance, post-less abutment construction has recently been considered. Fiber posts have recently attracted attention as a post material for resin abutment construction due to their flexibility with elastic modulus similar to that of dentine. In Japan, although approval by the Ministry of Health, Labour and Welfare has recently been obtained, there have been few experimental studies and clinical reports on fiber posts. In this study, we performed a break-down test and finite element analysis of fiber posts as in vitro studies, and reviewed overseas references on clinical results. Experimental results show that, the effects on preventing stress concentration are high in all abutment construction methods when sufficient ferrule in the remaining teeth is present, and stress may be concentrated in the cervical area in fiber post abutment cases. Clinical results obtained from references showed that, fiber posts are superior to cast posts and commercially available metal posts, in terms of fracture and dislodgment. However, since issues were revealed in previous clinical studies, further comparison studies are necessary to evaluate the superiority of fiber posts compared with metal posts.

Dental Abutments↗
PubMed1996

[Characterization of rat periodontal ligament cells in culture].

It has been reported that periodontal ligament cells (PDLC) show osteoblastic phenotypes in culture. In most previous studies, PDLC have been obtained from the tooth root surface, however, a new method in which PDLC are obtained from the coagulum after tooth extraction has been proposed recently. To compare PDLC from tooth surface with these from coagulum, PDLC from both sources were cultured and examined. PDLC from both sources responded to PTH or PGE2 increasing cAMP and showed high alkaline phosphatase (ALP) activity. Some PDLC cultures produced mineralized tissues and these mineralizing cultures showed high ALP activity with high gene expression level of type I collagen, bone sialoprotein, and osteopontin in comparison with non-mineralizing cultures. PDLC from both sources expressed various osteoblastic or cementoblastic phenotypes and seemed to contain heterogenous mesenchymal cell population with various differentiation potentials. However, the frequency of cellular transmigration, rate of mineralized tissue formation, increased level of cAMP that responded to PTH or PGE2, and osteopontin expression pattern were different between PDLC from both sources. These differences indicate that PDLC cultures from coagulum contain more immature cells than PDLC from tooth surface.

Animals↗
PubMed1980

Effect of extraction in the late mixed dentition on the eruption of the first premolar in Macaca nemestrina.

The effect of deciduous tooth extraction in the late mixed dentition on the eruption of succedaneous teeth was studied in ten Macaca nemestrina. Nineteen deciduous teeth were extracted: nine maxillary and ten mandibular left deciduous first molars. Regardless of sex, arch, chronologic or dental age, all first premolars on the experimental side erupted before those on the control side and this pattern was statistically significant. Extraction of deciduous molars in the late mixed dentition is seen to accelerate eruption of first premolars in Macaca nemestrina. This could be the result of eliminating the need for deciduous tooth root resorption during the normal process of eruption.

Age Factors↗
PubMed2000

The effect of local delivery of PDGF-BB on attachment of human periodontal ligament fibroblasts to periodontitis-affected root surfaces--in vitro.

BACKGROUND/AIMS: The purpose of this study was to determine at what concentration does platelet-derived growth factor-BB (PDGF-BB) provide for optimal stimulation of human periodontal ligament fibroblasts (PDL) to adhere to periodontitis affected root surfaces. METHOD: 80 root dentine specimens were prepared from extracted periodontally diseased teeth obtained from patients ranging in age between 35 to 60 years. The root dentine specimens were associated with the subgingival area opposing the periodontal pocket for each extracted tooth. 10 healthy root dentine specimens were obtained from teeth extracted for orthodontic reasons and served as controls. The specimens were distributed into 9 groups (10 specimens in each). In group 1, PDL fibroblasts were cultured on the specimen surface of a diseased treated control. In group 2, PDL fibroblasts were cultured on the specimen surface of a healthy control. In groups 3 to 9, PDL fibroblasts were cultured on a pre-treated specimen surface with concentrations ranging from 5, 10, 20, 50, 100, 200 and 300 ng/ml PDGF-BB, respectively. After 24 h incubation, the media were removed, specimens were fixed, processed for SEM viewing and photographed at 750x. Fibroblast adherence was measured by counting number of cells within a standard test area and cell morphology was scored. RESULTS: Findings suggest dentine specimens pretreated with 5, 10 and 20 ng/ml PDGF-BB were not significantly different in number of adherent cells from the diseased treated control. However, at concentrations of 50, 100, 200 and 300 ng/ml, a highly significant increase in number of adherent fibroblasts was detected when compared to the diseased treated control. At these concentrations, the cell morphology was comparable to that of the healthy control. CONCLUSIONS: PDGF-BB in concentrations equal to or greater than 50 ng/ml demonstrates a significant stimulation of PDL cells adherence to periodontal diseased root surfaces. Since the higher concentrations resulted in similar effects as obtained by 50 ng/ml, it may therefore be considered that this concentration provides for optimal stimulation of human periodontal ligament fibroblasts (PDL) to adhere to periodontitis-affected root surfaces.

Adult↗
PubMed1995

Root resorption of a partially erupted tooth: a case report.

This article reports a case of a maxillary second premolar which on presentation was partially erupted, and which resisted attempts at orthodontic extrusion. The crown of the tooth was eventually restored using an adhesive composite onlay technique. The patient subsequently complained of pain and the root of the tooth showed radiographic evidence of resorption. The root of the extracted tooth had a vital pulp but massive external resorption was evident, with repair with bone-like material.

Adolescent↗
PubMed1998

The novel use of extracted teeth as a dental restorative material--the 'Natural Inlay'.

OBJECTIVE: This preliminary study aimed to find out whether it is possible to produce a well fitting Class II inlay from an extracted tooth using a copy-milling technique. METHODS: Two pairs of matching sound extracted permanent molar teeth were used. The molars were matched for mesio-distal size of the tooth crown and the convexity of the approximal surfaces. One tooth of each pair was assigned to be the 'donor' tooth, the other tooth being the 'host'. MO inlay preparations were made in the host teeth. These were restored with the milled 'Natural Inlays' produced from the donor teeth using the CELAY system. The restored host teeth were sliced and examined using light-microscopy. RESULTS: The specimens showed the desired location of enamel and dentine, and a clinically acceptable fit. CONCLUSION: This study has shown that by using the CELAY milling machine it is possible to 'recycle' extracted teeth for the production of dental restorations.

Cementation↗
PubMed2004

The presurgical workup before third molar surgery: how much is enough?

PURPOSE: We sought to assess the indications for patient referral for computed tomography (CT) scan before third molar extraction. The influence of the data obtained from the CT scans on the surgical outcome and morbidity was also evaluated. PATIENTS AND METHODS: There were 189 patients in the study (120 females and 69 males). Sixty-five patients were referred to receive CT and formed the study group. The remaining patients were included in the control group. RESULTS: There were no statistically significant differences between the groups with regard to demographic data and tooth and root angulations. Indications for tooth extraction such as pain, swelling, pericoronitis, caries, endodontic problems, pathology, and prosthetic considerations were similar. The proximity of the tooth root to the inferior alveolar canal was the only statistically significant difference between the 2 groups (P <.001). The treatment plan outcomes for extraction, surgical extraction, and follow-up were comparable. The surgeon changed the initial decision from "surgical extraction" to "follow-up" in only 1 case after CT scan. CONCLUSIONS: Within the limits of the present study, it can be concluded that the main reason for CT scan referral is the proximity of the third molar root to the inferior alveolar canal (<1 mm). The data obtained from the CT scan had minimal effect on the final surgical outcome. The routine use of CT scan in cases of third molar extractions cannot be recommended.

Adolescent↗
PubMed1976

Long-term effects of activator (Andresen appliance) treatment. A clinical, biometric, cephalometric roentgenographic and functional analysis.

The purpose of this investigation was to analyse the long-term effects of activator treatment on the dental arches and arch relationships, the dento-facial skeleton and the function of the masticatory system. A follow-up study was performed on 112 patients treated 10-20 years previously with activators as the sole orthodontic appliance. In connection with activator treatment extractions of permanent teeth were performed on 66 patients while 46 patients were treated without tooth extractions. The investigation consisted of four separate portions (Parts I-IV).

Activator Appliances↗
PubMed1987

Effect of fibronectin on healing of replanted teeth in monkeys: a histologic and autoradiographic study.

The purpose of this study was to evaluate the effect of fibronectin application on healing of replanted teeth. Three rhesus monkeys were used. Maxillary and mandibular incisors and premolars were extracted and replanted. Teeth were extracted with forceps and placed in saline solution. After 5 minutes, each tooth was returned to its socket and immobilized by interproximal acid-etch splints, which were removed after 1 week. Of the forty-eight teeth replanted, twenty-four control teeth were replanted as described. On each of the remaining teeth, the root surface and the inner walls of the socket were bathed with 1 ml of fibronectin in saline solution (400 micrograms/ml) during the 5-minute interval between tooth extraction and its replantation. Replanted teeth and animal killings were scheduled to provide observations 1, 3, 7, 14, 28, and 45 days after replantation. Each monkey received an intravenous injection of tritiated thymidine, 1 microCi/g body weight, 1 hour before it was killed. Tissue specimens were processed for histologic and autoradiographic evaluation following standard procedures. For each of the six points of time, four pairs of contralateral teeth were available for evaluation; four teeth were treated with fibronectin and four without it. The findings of this study indicate that fibronectin use resulted in enhanced healing by early replacement of the fibrin clot, increased connective tissue cell proliferation, reduction of the inflammatory response, and inhibition of both cementum resorption and dentoalveolar ankylosis.

Animals↗
PubMed1999

Rotated split palatal flap for soft tissue primary coverage over extraction sites with immediate implant placement. Description of the surgical procedure and clinical results.

Immediate implant placement after tooth extraction is becoming a common procedure in implant-supported oral rehabilitation. However, lack of primary full flap closure can jeopardize final results. A surgical approach that would enable predictable primary soft tissue closure over implants placed into fresh extraction sockets is described and evaluated. This technique is based on a rotated deep split thickness palatal flap (RSPF) containing periosteum and connective tissue, covering the implant and/or a barrier membrane. In 29 patients, 33 consecutive implants were placed immediately post extraction of 1 or 2 anterior or premolar maxillary teeth. Patients were divided in 2 groups: Group A (15 patients; n = 18 sites) where no barrier membrane was used and Group B (14 patients, n = 15 sites) where an occlusive resorbable collagen membrane was used. Distance between the alveolar crestal bone and the coronal aspect of the implant was measured at time of implant placement (Group A: mean 1.9 mm, SD 1.16; Group B: mean 4.6 mm, SD 1.18) and at second stage surgery (Group A: mean 0.3 mm, SD 0.46; Group B: mean 0. 7 mm, SD 0. 7). The difference between both records (crestal bone formation) was calculated (Group A: 1.7 mm, SD 1.03; Group B: 3.9 mm, SD 1.12) and found to be statistically significant (P <0.0001). Crestal bone formation, relative to the initial bone crest-implant distance at time of implant placement was approximately 85% in both groups. In 4 sites (2 in each group), where the cover screws were exposed before second stage surgery, complete crestal bone regeneration did not occur. Use of a barrier membrane may be obviated in appropriate cases while placing implants into fresh extraction sites. This procedure offers a predictable treatment approach in achieving complete soft tissue coverage, while allowing for healing of bony defects in immediate implantation procedures.

Adult↗
PubMed1986

Effect of lyophilized autologous plasma on periodontal healing of replanted teeth.

The purpose of this histologic and autoradiographic study of replanted teeth was to evaluate the beneficial effect, if any, of lyophilized autologous plasma (LAP) application on periodontal healing and to re-examine rates of repair in different areas of the associated periodontium following replantation. Maxillary and mandibular incisors and premolars of three rhesus monkeys were used. Teeth were extracted with forceps and placed in sterile physiologic saline. After 5 minutes each tooth was returned to its socket and immobilized by interproximal acid-etch splints. Splints were removed after 1 week. Of the 48 replants performed, 24 (controls) were replanted as described. Of the 24 experimental teeth, during the 5 minute interval between tooth extraction and replantation, the root surface and the inner socket walls were bathed with 1 ml of the reconstituted LAP-saline solution (800 mg/ml). Replants and animal sacrifice were scheduled to provide observations at 1, 3, 7, 14, 28 and 45 days following replantation. One hour prior to sacrifice, each monkey received an intravenous injection of tritiated thymidine, 1 microCi/gm body weight. Tissue specimens were processed for evaluation following standard procedures. Eight replanted teeth were available for evaluation for each of the six time-points. Four teeth were treated with LAP and four without it. Histologically, tissue sections were examined for epithelial proliferation and attachment, periodontal fibers organization and maturation, inflammatory cell types, presence or absence of cementum resorption and dentoalveolar ankylosis and degree of vascularity of the tissues. For autoradiographic evaluation, the periodontium associated with the replanted tooth was divided into nine spatial cell compartments. In each compartment, labeled tissue cells, epithelial or connective, were counted and recorded. Differences between the control (untreated) replanted teeth and the LAP-treated teeth, at each time-point and within each compartment, were analyzed for significance using the paired t-test. The findings of this study indicate that LAP use enhanced healing by early replacement of the fibrin clot, increased connective tissue cell proliferation, reduction of the inflammatory response and inhibition of root cementum resorption. Periodontal healing and repair occurred more rapidly in the supracrestal or transseptal connective tissue region than within the periodontal membrane space.

Alveolar Process↗
PubMed1995

Crown amputation with intentional root retention for advanced feline resorptive lesions--a clinical study.

Whole tooth extraction is generally considered to be the treatment of choice for teeth with advanced feline external odontoclastic resorptive lesions. These teeth often have both a weakened, brittle crown and radicular ankylosis. These two factors cause frustration and sometimes complications during attempts at extraction. This study investigated the alternative of intentionally leaving part or all of non-pathologic tooth roots in situ to prevent iatrogenic trauma to the patient, loss of alveolar bone, and prolonged healing of surgical defects. Fifty one roots from 23 teeth were radiographed 5-36 months following elective root retention; continued resorption without surrounding bony reaction was seen in almost all cases. In one cat, the roots retained normal periodontal ligament one year later, and in another cat that developed severe stomatitis, the intentionally retained roots were extracted at the same time that the remaining molar teeth were extracted.

Alveolar Bone Loss↗
PubMed2004

Dental health of elderly confederate veterans: evidence from the Texas State Cemetery.

Analysis of the skeletal remains of 50 Confederate veterans provided a unique opportunity to explore the dental health of a geriatric sample. These men, who died between 1907-1932, had an average age at death of 76.7 years. Ninety percent were institutionalized at the Confederate Home for Men (Austin, TX) prior to their deaths. This elderly sample was assessed in terms of caries, antemortem tooth loss (AMTL), abscesses, and linear enamel hypoplasias. On a per tooth basis, the AMTL rate was 57.2%. Of 39 dentate men, 33 (84.6%) had dental caries, and 24.4% (121 of 496) of teeth were carious. Ten (25.0%) of the dentate men had hypoplastic teeth. At least one abscess was seen in 14 (28%) of 50 individuals. Results from this geriatric institutionalized sample are compared to contemporaneous historical samples. Disparities in dental health among these groups may be due to differences in average age at death, and these comparisons allow a better understanding of dental changes that occur with age. The sample is also compared to modern elderly samples: modern groups have higher caries rates, possibly because they retained more teeth. This finding may be due in part to diets in the United States becoming increasingly cariogenic over time. In addition, dental care has moved from the reactive practices seen in the nineteenth and early twentieth centuries (such as tooth extractions) to modern proactive solutions dedicated to preserving and restoring teeth (such as tooth brushing, fluoride treatments, and dental fillings).

Aged↗
PubMed2004

In vivo caries formation in enamel following argon laser irradiation and combined fluoride and argon laser treatment: a clinical pilot study.

OBJECTIVE: This in vivo pilot study investigated the role of argon laser irradiation and combined fluoride and argon laser treatment in accelerated natural caries development in sound enamel surfaces beneath plaque-retentive orthodontic bands. METHOD AND MATERIALS: Five patients (3 female, 2 male, ages 19 to 28 years) requiring tooth extraction prior to orthodontic treatment, participated in the study. Buccal surfaces were treated with either: (1) argon laser (250 mW for 10 seconds, ARGO-MOD); (2) topical fluoride (0.5% fluoride ion, Thera-Flur-N) followed by argon lasing; or (3) no treatment (control). Orthodontic bands with plaque-retentive slots on buccal surfaces were placed on the teeth slated for extraction (n = 14). Following a minimum of 5 weeks of intraoral exposure, the teeth were extracted for laboratory analysis. The teeth underwent serial longitudinal sectioning (12 sections per tooth). The sections were imbibed in water, and lesion depths were determined with each section, using polarized light microscopy. Comparisons were made among treatment groups (analysis of variance, Duncan's multiple range test for paired samples). RESULTS: Mean lesion depths were: 261 +/- 24 microm for the no treatment control group (n = 84 sections); 147 +/- 18 microm for the argon laser group (n = 24 sections); and 99 +/- 12 microm for the fluoride and argon laser group (n = 60 sections). Both the argon laser (44%) and the fluoride and argon laser groups (62%) had significant lesion depth reductions compared to controls. The addition of fluoride treatment prior to argon lasing resulted in a 32% reduction in lesion depth compared to argon laser treatment alone. CONCLUSIONS: Within this clinical pilot study, in vivo natural caries formation was affected significantly by a single exposure to low fluence argon laser irradiation. Topical fluoride treatment in combination with argon lasing provided an even greater degree of resistance against in vivo enamel caries development. A simple technique for reducing the caries susceptibility of enamel may be a clinical reality.

Adult↗