A radiographic assessment of the prevalence of pulp stones.
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The traumatisms of the temporary teeth are very frequent. They are bound to the acquirement of the march, to the games, to the sport and to the accidents of the public way. Favoured by the presence one improved proalveoly, they constitute a dental emergency of makes some important risks of complications. Indeed, these traumatisms, in case of belated conference and/or of maladjusted treatment or conducted pain, could induce some complications and have some aesthetic and functional after effects on the dental germ underlying. Some of these complications observed in some patients are stakes in evidence by some iconographic illustrations.
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A longitudinal clinical and radiographic follow-up study was made of all permanent teeth with root fractures referred to the Oslo University Department of Pedodontics between 1953 and 1972 (n = 66). The material included 51 patients aged 6-21 years. The mean observation period was 5.2 years, ranging from 1 to 19 years. The present report documents background data and the long-term results. Two teeth with exarticulation of the coronal fragments (3%) were immediately extracted. Repair of the fracture area occurred in 51 teeth (77%). Pulp necrosis was found in 13 teeth (20%), nine of which were successfully treated endodontically; only four teeth had to be extracted. Several factors were found to influence the prognosis, most notably the degree of dislocation of the coronal fragment. The localization of the fracture influenced repair only slightly. Despite somewhat increased mobility in some cases, the longevity of teeth with fractures even in the coronal third of the root was not significantly shortened. It is concluded that when optimally treated by repositioning, fixation and relief of occlusion, anterior teeth with root fracture have a favorable prognosis. Even when pulp necrosis occurs, the long-term prognosis is good.
The dentin dysplasias (DD), which may be classified as type 1 (DD1) or type 2 (DD2), form a group of rare, inherited dentin abnormalities that are clinically distinct from dentinogenesis imperfecta. Studies of affected families may help to distinguish different types of DD and provide further insight into their etiology and clinical management. This report describes a family that showed characteristic dental features of DD1, including clinically normal crowns in both primary and permanent dentitions, and mobile teeth that may be associated with premature exfoliation. Radiographic features included calcification of the pulp with crescent-shaped, radiolucent pulp remnants, short, tapering, taurodontic roots, and many periapical pathoses that may be cysts or granulomas. A spectrum of dentin dysplasia was noted within the family. Strategies to prevent pulp and periapical infections and early exfoliation of the teeth include meticulous oral hygiene and effective caries-preventive measures.
By energy-dispersive X-ray microanalysis (EDX) in scanning electron microscopy, we studied the calcification of the inner-basic lamellas of a cow bone and the coronal cementum of a horse tooth treated with sodium hypochlorite (NaOCl). These tissues were divided into 4 groups with a combination of NaOCl treatment and polyester-resin embedding including, [A]: non-NaOCl + Resin, [B]: non-NaOCl + non-resin, [C]: NaOCl + Resin, and [D]: NaOCl + non-Resin. From the Ca and P values by EDX analysis, it was suggested that the natural porous spaces of [B] were higher than those of [A], and both the natural and NaOCl-soluble porous spaces were highest in [D]. However, [A] had the lowest porous spaces in both the tissues because the micropores formed 3-dimensionally by NaOCl treatment might be incompletely filled with the resin. The backscattered electron microscopy and the difference of the Ca/P ratios indicated that the NaOCl treatment of the calcified tissues caused some minerals besides organic materials to dissolve. Thus, the sample preparation of [B] is suitable for the quantitative EDX of calcified tissues, whereas the data of [C] except for the Ca/P ratio may be used to approximate the Ca and P contents.
Calcification process in membranous ossification was examined histologically by light and electron microscopies in comparison with that in enchondral ossification. The following results were obtained: 1) In the rat tibial articular cartilage, the extracellular matrix proceeding from the transitional to the hypertrophic zone consisted of the following three layers from the proximal: the first layer in which ruthenium red positive granules were densely populated and thin collagen fibrils diffusely arranged but few matrix vesicles were observed; the second one containing numerous matrix vesicles and slightly thick collagen fibrils; and the last one in which the thick collagen fibrils were observed while matrix vesicles and ruthenium red positive granules were few. 2) In the calcified regions in the extracellular matrix of MC3T3-E1 cells, the regions of alveolar new bone formation due to orthodontic tooth movement and the calcified regions in the interparietal suture expanded mechanically in vitro, the number of matrix vesicles was less than those in the regions of enchondral ossification. 3) Ruthenium red positive granules were fewer in the regions of alveolar new bone formation after the orthodontic tooth movement than in the calcified regions of cartilage. 4) The observation on MC3T3-E1 cells revealed the two different possibilities of the processes of calcification: the calcification induced by matrix vesicles as an initiator and that directly related to mineral deposit on the collagen fibrils.
The reactions of the dental pulp to traumatic injuries can be extremely varied. They range from almost immediate pulp death to long-term slow pulp canal calcification. In this study the pulpal reactions were divided into three types: pulps with a very poor prognosis that required endodontic therapy soon after the tooth was traumatized. Seventy-nine teeth were studied in this category, and all 79 teeth required endodontic therapy; pulps with a moderate prognosis that required endodontic intervention some 18 to 24 months after the traumatic episode. Forty-eight teeth were studied in this category, and 27 of them required endodontic therapy: pulps with a very good prognosis that rarely required endodontic therapy. Fifty-two teeth were studied in this category, and only 2 required endodontic therapy. The prognosis of a particular pulp depends on the degree and type of trauma.
Endodontic therapy can be challenging at the diagnostic and technical levels. The more one can advance one's accomplishments, the more that would-be barriers cease to be so. Difficult aspects of tooth isolation and assessment of root integrity can be rendered less problematic by some relatively simple methods. Gaining a clear awareness of the internal layout of a coronal chamber and any possible inclusions can be assisted by use of a modified endodontic explorer. It can be usefully employed to resolve with certainty the common dilemma of whether openings at the base of a molar or maxillary premolar coronal access cavity are exposures in the pulp chamber roof or orifices in the chamber floor. Locating and then gaining full working length entry into partly calcified canals, even when they are not radiographically discernible, remains one of the difficult tasks in endodontic therapy, but methods can be implemented that maximize their successful negotiation and management. The use of fine engine-driven reamers, but absolutely restricted to a reciprocating action handpiece, is described.
The terminal differentiation of odontoblasts is controlled by the inner dental epithelium (IDE) and occurs according to a tooth-specific pattern. It requires temporospatially regulated epigenetic signaling and the expression of specific competence. The patterning of cusp formation was compared with that of odontoblast differentiation in the first lower molar in mice. Histology, immunostaining, and three dimensional reconstructions were completed by experimental approaches in vitro. The mesenchyme controls the pattern of cusp formation. During the cap-bell transition in the molar, a subpopulation of nondividing IDE cells from the enamel knot (EK) undergo a tooth-specific segregation in as many subpopulations as cusps will form. Epithelial cell-basement membrane interactions seem to be involved in the segregation of EK cells. The timing and spatial pattern of the segregation of EK cells correlate with cusps formation. However, the temporal pattern of odontoblast terminal differentiation is different. This discrepancy might result from cusp-specific differences either in the timing of the initiation of odontoblast terminal differentiation and/or in cell proliferation kinetics.
Achieving access and finding canals are the key first steps in the endodontic procedure. This has always been a time-consuming, qualitative procedure that relies on the dentist's experience and feel. Recent basic research has been published that shows that the anatomic morphological measurements concerning the pulp chamber are very consistent in every tooth. This research points the way to a quantitative, predictable and quick technique for making endodontic access preparations without risk. The research and clinical technique are described in this article.
gamma-Carboxyglutamic acid, previously identified in the vertebrate mineralized tissues of bone and dentin, is not detectable in the calcified skeletons of six invertebrate species representing five phyla. Its absence in all analyzed invertebrate tissues (including calcitic, aragonitic, and apatitic mineral phases) indicates that matrix protein-bound gamma-carboxyglutamic acid is not obligatory for the calcification process in the invertebrates. Further, these data raise the possibility that invertebrates as a group may lack the enzymatic capability for biosynthesizing gamma-carboxyglutamic acid. In contrast, the distribution of gamma-carboxyglutamic acid in the vertebrates has been further extended by this study to include an apatitic shark tooth and an aragonitic fish otolith. No gamma-carboxyglutamic acid was detected, however, in the organic matrix of the calcitic hen egg shell.
OBJECTIVES: To assess the prevalence of taurodontism in a group of Jordanian adult dental patients. METHODS: Posterior periapical radiographs of 875 unselected dental patients were examined for the presence of taurodontism defined as the presence of an apically displaced pulp chamber without the usual constriction at the cemento-enamel junction. RESULTS: Taurodontism was detected in 8% of subjects and 4.4% of the teeth examined. The maxillary second molar was the most commonly affected tooth. It was equally distributed between males and females (7.9% compared with 8.1% respectively, P > 0.05). 26.7% of the taurodont teeth also had pulp stones or calcifications. CONCLUSION: Taurodontism is not uncommon in Jordan but further larger scale studies are required to assess its prevalence in the general population to compare it with other ethnic groups.
In recent years, ultrasonic waves have been an interesting subject for studies due to their wide range of applications in medical diagnoses. In this study, the acoustic properties of the structure of human teeth was determined with the ultrasonic imaging technique. This study may offer some fundamental findings related to the clinical application of the ultrasonic imaging technique in the further development of a virtual system for dental education and research. Twenty freshly-extracted permanent human teeth (10 molars and 10 premolars) were used to investigate their acoustic velocity and impedance by the ultrasonic image analyzing system with a high-resolution focusing probe. Additionally, the relationship between the acoustic properties and the hardness of the teeth was evaluated. It was found that the acoustic properties of the human teeth were influenced by factors related to their structure, such as degree of calcification, distribution of dentinal tubules, and volume of the dentin matrix. The acoustic velocity and impedance showed an apparent correspondence to the hardness of tooth. This analyzing system provides visual information related to tooth structure that can easily quantitatively evaluate their acoustic properties. It is expected that this system will have a wide range of applications and be further developed for clinical uses.
Connective tissue growth factor (CTGF/CCN2), one of the most recently described growth factors, is produced by chondrocytes, vascular endothelial cells, and transforming growth factor (TGF)-beta-stimulated fibroblasts. CTGF was isolated from a chondrosarcoma-derived chondrocytic cell line, HCS-2/8, and found to be normally expressed in cartilage tissues, especially in hypertrophic chondrocytes, and also to stimulate both the proliferation and the differentiation of chondrocytes in vitro. Therefore, CTGF is thought to be one of the most important regulators of endochondral ossification in vivo. Herein we describe the expression pattern of the ctgf gene in the calcifying tissues of normal developing mouse embryos in comparison with that in core binding factor a1 (Cbfa1)-targeted mutant (cbfa1-null) mouse embryos, in which impaired development and growth were characteristically observed in the skeletal system. After 15 days of development (E15), the expression of ctgf was detected in the zone of hypertrophy and provisional calcification, in which ossification proceeds toward the epiphysis during the skeletal development of the mouse embryo. Furthermore, ctgf was expressed in developing molar and incisal tooth germs around the perinatal stage. However, no expression of the gene was found in the cbfa1-null mouse embryos. These results indicate that CTGF may have certain important roles in the development of the calcifying tissues in the mouse embryo.