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PubMed2006

[The reliability of digital periapical films in diagnosis of root resorption].

OBJECTIVE: To investigate the difference between digital periapical film and conventional film in the evaluation of tooth length and root resorption. METHODS: A standard for root resorption in vitro was developed based on 20 extracted upper central incisors. Digital periapical films and conventional periapical films were taken before and after the process of simulating root resorption at six different projection angles respectively. The tooth length and root resorption were measured on these films. The results were analyzed by paired-samples rank sum test. RESULTS: Significant difference on tooth length measurement was found between two types of films on the same projection angle. No significant difference on the length of root resorption calculated on digital and conventional films was found. CONCLUSIONS: The accuracy of the digital periapical film was greater than that of conventional periapical films. The conventional periapical film can still be used in the evaluation of root resorption.

Humans↗
PubMed2005

Primary teeth in adults--a pilot study.

Remaining primary teeth are occasionally found in adults. The cause and the long-term survival may vary. The aim of this investigation was to study the occurrence and condition of primary teeth in adults in a county in Sweden. All dentists in general practice were asked to send in radiographs showing remaining primary teeth in patients aged 18 years and more. The following variables were registered: 1) age, 2) gender, 3) year of exposure of the radiograph, 4) location of the primary tooth, 5) impaction of the permanent successor, 6) fillings or caries in the primary tooth, 7) amount of root resorption and 8) infraocclusion of the primary tooth. 35 dentists contributed with radiographs from 65 subjects showing 89 retained primary teeth. The most commonly found tooth was the second primary molar in the mandible, followed by the primary canine in the maxilla. Except for maxillary molars, most of the primary teeth showed a moderate degree of root resorption. No relationship was found between the degree of root resorption and gender, fillings/caries or infraocclusion. For the mandibular primary molars, there was a statistically significant correlation between root resorption and age. The mesial root of the molar in the mandible was more affected by root resorption than the distal, and the degree of root resorption of the mesial and distal roots was found to be closely correlated. Also, the results indicated a symmetrical pattern of root resorption in bilateral cases of remaining mandibular second primary molars.

Adult↗
PubMed1995

Nuclear matrix-intermediate filament proteins of the dental follicle/enamel epithelium and their changes during tooth eruption in dogs.

Tooth eruption activates a localized resorption and formation of alveolar bone and these activities depend upon the adjacent parts, coronal and basal, respectively, of the dental follicle-enamel epithelium. In this study the nuclear matrix-intermediate filament (NM-IF) proteins of these tissues were isolated in order to continue investigations into the molecular mechanisms underlying eruption. Dental follicles were removed from the third and fourth premolar of dogs at 13, 16 and 20 weeks (pre-, early, and mid-to-late eruption of these teeth) and NM-IF proteins were extracted from the coronal and basal halves. Most of the NM-IF protein profiles of these coronal and basal parts on one-dimensional, sodium dodecyl sulphate-polyacrylamide gel electrophoresis were remarkably constant, indicating an essentially uniform cellular composition. However, differences between these tissues were observed and some of these changed during eruption. Based on recent observations that nuclear matrix changes reflect and may even mediate cell-specific changes in gene expression, these findings suggest that changes in nuclear matrix proteins may be related to the molecular basis for some aspects of differential gene expression in the coronal and basal regions of the dental follicle and account for the ability of these tissues to activate bone resorption and formation during tooth eruption.

Alveolar Process↗
PubMed2000

Avoiding "the space" by the treatment of compromised teeth.

The advent of implant therapy has given new a dimension to dentistry particularly where teeth have been irretrievably damaged or pathologically involved. There are many situations however, where endodontic or combined therapy may effectively retain compromised teeth and clinicians should carefully evaluate evidence-based treatment. The main areas discussed are: transverse and crown root fractures and invasive cervical resorption. Transverse root fractures have an excellent natural healing capacity and will also respond favourably to treatment if pulp necrosis occurs in the coronal segment. Studies have shown that crown root fractures can be effectively treated by combined endodontic-orthodontic-periodontic and prosthodontic therapy. Invasive cervical resorption has been classified into four classes depending on the degree of infiltration of resorptive tissue into the tooth structure. A study of treatment results following the topical application of 90% aqueous trichloracetic acid, curettage and restoration indicated that this regimen could be successfully applied to Classes 1, 2 and 3 resorption.

Aluminum Compounds↗
PubMed1991

Radiographic observations on root resorption in the primary dentition.

In order to construct standardized charts for root resorption in the primary dentition of Japanese children, we investigated the stages of resorption (1/4, 1/2 and 3/4 of the root) based on the criterion of Fanning, et al. using 11,167 panoramic radiographs (5,759 of boys and 5,408 of girls). The following information was obtained. 1) The root resorption for a tooth on one side was the same as for its counterpart on the other side regardless of differences in sex or arch. 2) The average age for each root resorption stage was lower in girls than in boys regardless of differences in sex or arch. 3) The average age for each root resorption stage was lower in the mandible than in the maxilla for every tooth. 4) In the maxilla, the period between 1/4 to 3/4 resorption of the root was greater in the primary molars than in the primary anterior teeth. However, the opposite was true in the mandible. 5) Although no difference was observed between the maxilla and the mandible in the resorption period for the primary incisors and canines, the resorption time for the primary molars was greater in the maxilla than in the mandible. 6) When the relationship was observed between the resorption stages for each tooth and the calcification stages for the corresponding successional permanent tooth. a) With the exception of the maxillary and mandibular canines, the average age for 1/4 resorption of the primary root corresponded to the period between completion of the permanent crown and initial root formation of the successional permanent tooth. b) With the exception of the maxillary and mandibular canines, and the mandibular second premolars, the average age for 3/4 resorption of the primary root corresponded to the period between 1/4 and 1/2 formation of the root of the successional permanent tooth. From these results, standardized charts were constructed for the resorption of the roots of primary teeth in Japanese children. These standardized charts are useful in daily clinical practice in such areas as endodontic treatment of primary teeth and orthodontics.

Adolescent↗
PubMed1989

Periodontal manifestations of hyperoxaluria and oxalosis.

Dental and periodontal findings associated with primary hyperoxaluria in a 29-year old male patient are described. This is a rare, inherited, metabolic disease which results in excessive calcium oxalate synthesis. The predominant and early manifestation of hyperoxaluria is nephrocalcinosis which results in chronic renal failure. Widespread extrarenal deposits of calcium oxalate crystals, however, is a consistent finding. Extensive infiltration of crystals was noted in the pulps of the teeth, in the marrow spaces of the alveolar bone, in the gingival corium, and in the periodontal ligament. Crystalline calcium oxalate deposits in the periodontal ligament provoked a granulomatous foreign-body reaction. This resulted in aggressive external root resorption leading to pulp exposure and tooth mobility.

Adult↗
PubMed2006

Titanium membranes in prevention of alveolar collapse after tooth extraction.

BACKGROUND AND PURPOSE: The resorption of alveolar bone following tooth extraction results in a narrowing and shortening of the residual ridge, which leads to esthetic and restorative problems, and reduces the bone volume available for implant therapy. The aim of this study was to evaluate the prevention of alveolar collapse after tooth extraction, using titanium membrane (Frios Boneshield; DENTSPLY Friadent, Mannheim, Germany), associated (or not) with autologous bone graft. MATERIALS AND METHODS: A total of 10 nonsmoking healthy subjects, ranging from 35 to 60 years old, were selected for this study. Each patient had a minimum of 2 uni-radicular periodontally hopeless teeth, which were scheduled for extraction. After the procedure, 2 titanium pins were fixed on the vestibular bone surfaces that were used as references for the initial measures (depth, width, and height) of the socket. Of the sockets,1 was randomly chosen to be filled with autologous bone graft (test) removed from superior maxillary tuber, and the other one did not receive the graft (control). A titanium membrane was adapted and fixed, covering the sockets, which remained for at least 10 weeks. After a 6-month healing, the final measures were performed. RESULTS: There was exposure of the membrane in 5 of the 10 treated subjects. Average bone filling (+/-standard deviation) among the 10 subjects was 8.80 +/- 2.93 mm (range 4-13) in the control group and 8.40 +/- 3.35 mm (range 4-13) in the test group. Average bone loss in width in both group was 1.40 +/- 1.97 mm (range -4-1) in the control group and 1.40 +/- 0.98 mm (range -4-0) in the test group. There was no significant statistical difference between groups considering the evaluated standards. CONCLUSION: The use of titanium membrane, alone or in association with autogenous bone, favored the prevention of alveolar ridge after tooth extraction. This membrane seems to be a possible and safe alternative to other nonresorbable membranes when the prevention of alveolar ridge resorption is the objective.

Adult↗
PubMed1999

Dental anomalies associated with amelogenesis imperfecta: a radiographic assessment.

Amelogenesis imperfecta, a group of hereditary conditions primarily affecting the enamel, has been associated with dental anomalies, including taurodontism, congenitally missing teeth, delayed eruption, crown resorption, and abnormal enamel density. The purpose of this study was to assess the prevalence of these anomalies in an amelogenesis imperfecta population. The study group consisted of members of 9 unrelated families--22 family members with amelogenesis imperfecta and 13 unaffected family members. Panoramic radiographs were evaluated for taurodontism, congenitally missing teeth, delayed tooth eruption, pathologic dental resorption, pulp calcification, and radiographic enamel density. The prevalence of taurodontism was similar in people with amelogenesis imperfecta and normal people; all of the remaining parameters were more commonly observed in people with amelogenesis imperfecta. The radiographic enamel density was quantitatively reduced in teeth affected by amelogenesis imperfecta in comparison with teeth with normal enamel. These findings suggest that some of the features associated with amelogenesis imperfecta result from abnormal enamel formation (eg, decreased enamel density, crown resorption) whereas others may occur as a result of expression of the genetic mutation in cells other than ameloblasts (eg, abnormal eruption, pulp calcification).

Adolescent↗
PubMed1997

Periapical replacement resorption of permanent, vital, endodontically treated incisors after orthodontic movement: report of two cases.

Radiographic observations show that periapical replacement resorption (PARR) is a frequent and unpredictable sequella of orthodontic movement of permanent maxillary incisors. Only the apical root portion undergoes resorption, and it is subsequently replaced with normal bone. PARR also occurs without orthodontic tooth movement, but these resorptions differ as to type and location. PARR clearly occurs in teeth with vital pulps after orthodontic movement; however, our two cases and a review of 43 other cases indicate that endodontically treated incisors show a statistically significant lesser frequency and severity of apical resorption than untreated teeth. The role the vital pulp plays in this apical resorption is yet to be determined. A hypothetical explanation is offered suggesting that pulpal neuropeptides may be involved in PARR in both vital and endodontically treated incisors. The role calcium hydroxide plays in endodontically treated teeth is also considered.

Adolescent↗
PubMed1977

Endodontic perforations: their prognosis and treatment.

Causes of tooth perforation include resorption, caries, and operator performance. The prognosis for a tooth with a perforation is related to the location of the perforation, negotiability of the canal, contamination, and treatment. Alternative treatment approaches include routine endodontic treatment, correction via the chamber, surgical correction, and stimulation of calcification. In most instances, a perforation can be treated so that satisfactory healing will occur.

Apicoectomy↗
PubMed1990

Endocytosis in odontoclasts and osteoclasts using microperoxidase as a tracer.

Microperoxidase (MP, a peptide tracer) was intravenously injected into rats after six days of tooth movement by the Waldo method. Bone resorption was seen along the distal bone surface of the inter-radicular septum of the upper first molar, and tooth root resorption occurred along the mesial and distal surfaces of the distal root of the same molar. Odontoclasts were smaller in size and numbers than osteoclasts, but had the same organelles [multiple nuclei, ruffled borders (RB), clear zones, vacuoles, mitochondria, and specific granules] as osteoclasts. MP was deposited on the resorbed area through the clear zone and was transported into the vacuoles along the channels of the RB. The uptake of MP by odontoclasts was small, compared with that by osteoclasts. Collagen fibrils were found in the channels of the RB but were not detected in the vacuoles. Instead, filament-like structures were seen in the vacuoles and were located very near the collagen fibrils in the channels. Fibroblasts outside the resorbed lacunae had endocytosed collagen. In contrast, some cells close to odontoclasts (osteoclasts) in the dentin (bone)-resorbed lacunae had not endocytosed any collagen fibrils. These findings suggest (1) that odontoclasts resorb the dentin or cementum just as osteoclasts do in bone resorption, (2) that the resorbed area connects with the extracellular spaces of the odontoclasts or osteoclasts, and (3) that the organic components (e.g., collagen fibrils) of dentin or cementum are endocytosed through the channels of the RB in the same manner as that for MP. However, the endocytotic ability of odontoclasts appears inferior to that of osteoclasts.

Animals↗
PubMed2002

Effect of artificial tooth material on mandibular residual ridge resorption.

PURPOSE: In this 10-year longitudinal study we evaluated the amount of mandibular residual ridge resorption for 2 groups of subjects with complete dentures, one group with porcelain artificial teeth and the other with acrylic resin teeth. METHODS: One hundred and nine patients who had undergone ridge extension procedures with skin graft and prosthetic rehabilitation with porcelain or acrylic resin teeth were investigated for mandibular bone loss. Measurements were made on serial cephalograms. RESULTS: There were no significant differences between the groups in terms of their baseline characteristics (age, period of edentulousness, period of observation, vertical facial morphology, sex, severity of atrophy or presence of bruxism). Similarly, there were no statistically significant differences in amount of bone loss in relation to baseline characteristics. CONCLUSION: The view that acrylic resin teeth should be preferred to prevent bone resorption of the mandibular residual ridge is not supported by these data. Further research concerning soft denture-lining material should be undertaken to elucidate the potential role of denture pressure in ridge resorption.

Acrylic Resins↗
PubMed2000

Invasive cervical resorption--a periodontist's perspective.

Invasive cervical resorption (ICR) is a relatively uncommon, insidious, resorptive lesion starting subgingivally at the cervical root surface of a tooth. ICR is of uncertain aetiology, although damage to the cervical periodontal attachment to the tooth appears to be a prerequisite. For the most part the lesion is asymptomatic so early detection can be difficult. Nevertheless, if less than a third of the root of the tooth is affected by an ICR lesion treatment of the resorptive tissue using the chemical escharotic agent trichloracetic acid, with or without surgical access, followed by curettage of the lesion and restoration of the defect with glass ionomer cement, is generally successful.

Caustics↗
PubMed1999

Endodontic disease of the mandibular first molar tooth secondary to caudal crossbite in a young Shetland sheepdog.

A six month-old intact female Shetland sheepdog was referred to the University of Illinois Veterinary Dental Clinic with a left-sided mandibular deviation and a thickened left ventral mandible in the region of the first molar tooth. On oral examination, left caudal crossbite was diagnosed. Dental radiographs revealed endodontic disease of the mandibular first molar tooth involved in the crossbite. Because of the difficulty of treating caudal crossbite and the potential of a pathological mandibular fracture, the endodontically affected tooth was extracted. Ten months following the extraction, mandibular deviation and alveolar bone lysis were resolved, but alveolar ridge resorption was present. The abnormal occlusal relationship caused by the caudal crossbite may have led to movement of the tooth, resorption of the tooth alveolus, and irreversible pulpal damage. Although not employed in this case, use of alveolar ridge preservation techniques can prevent mandibular bone loss after extractions.

Alveolar Bone Loss↗
PubMed1998

Ultrastructural features of odontoclasts that resorb enamel in human deciduous teeth prior to shedding.

Three dental hard tissues, i.e., cementum, dentin, and enamel, are resorbed by multinucleated cells referred to as "odontoclasts." These cells have morphological and functional characteristics similar to those of bone-resorbing osteoclasts. However, concerning enamel resorption, which is a process that may occur during tooth eruption, satisfactory ultrastructural data on odontoclastic resorption are still lacking. Ultrastructural and histochemical characteristics of odontoclasts resorbing enamel of human deciduous teeth prior to shedding were examined by means of light microscopy and transmission and scanning electron microscopy. Odontoclasts that that resorbed enamel were tartrate-resistant acid phosphatase (TRAP)-positive multinucleated giant cells that were essentially the same as those that resorbed dentin and cementum. Ultrastructurally, they had numerous mitochondria, lysosomes, and free polysomes in their cytoplasm. In addition, they were characteristically rich in large cytoplasmic vacuoles containing enamel crystals in the cytoplasm opposite the ruffled border. Although they extended a well-developed, ruffled border against enamel surface, a clear zone--an area typically devoid of organelles--was rarely seen in these cells. In many cases, the cells were in very close contact with the enamel surface by the peripheral part of their cytoplasm. The enamel prisms at the resorption surface contained more loosely packed and electron-lucent enamel crystals compared with those of unresorbed, intact enamel. Furthermore, numerous thin needle- or plate-like enamel crystals that were liberated from the enamel matrix were found in the extracellular channels of the ruffled border and in various-sized cytoplasmic vacuoles in their cytoplasm. The superficial layer of the enamel matrix undergoing odontoclastic resorption stained positively with toluidine blue and for TRAP activity. The results of the present study suggest that odontoclasts resorbing enamel secrete acids as well as organic components, including hydrolytic enzymes, into the resorption zone underlying their ruffled border and that they phagocytose crystals that have been liberated from the partially demineralized enamel matrix by acids, subsequently dissolving them intracellularly.

Acid Phosphatase↗
PubMed1982

The effect of force magnitude on extractable bone resorptive activity and cemental cratering in orthodontic tooth movement.

The delay period in the orthodontic tooth movement cycle was studied with respect to the stimulation of an extractable bone resorptive activity and the degree of tissue damage at sites of greatest pressure. Total area of cemental cratering was used as a measure of tissue damage. Both bone resorptive activity and tissue damage were found to be significantly increased with moderate and high forces, a fact which supports the suggestion that bone resorptive activity is related to tissue damage.

Alveolar Process↗
PubMed2004

Root resorption: the possible role of extracellular matrix proteins.

During maxillary permanent canine eruption, the deciduous canine root is selectively resorbed while the adjacent permanent lateral incisor root is left intact. An understanding of this selective resorption could provide insights into the cause of moderate to severe iatrogenic root resorption during orthodontic tooth movement. This study investigated the possible role of extracellular matrix (ECM) proteins in the selective resorption process. The spatial expression patterns of 2 ECM proteins, osteopontin (OPN) and bone sialoprotein (BSP), were assessed within the periodontal ligament (PDL) surrounding root surface areas of deciduous and permanent teeth. Intact and resorbed root surface areas from 14 deciduous roots and intact root surface areas from 12 permanent tooth roots were examined. In the deciduous roots, BSP and OPN were locally expressed in the cell layer adjacent to the root surface and most intensely concentrated in areas surrounding and within odontoclasts proximal to the resorptive lacunae. In contrast, BSP and OPN were expressed in a generalized pattern throughout the PDL of permanent roots. These preliminary findings suggest a differential expression of ECM proteins on deciduous versus permanent tooth roots, which could act as a signal for selective odontoclast adhesion to, and subsequent resorption of, deciduous root surfaces.

Extracellular Matrix Proteins↗
PubMed1999

Production of matrix-degrading enzymes and inhibition of osteoclast-like cell differentiation by fibroblast-like cells from the periodontal ligament of human primary teeth.

Clinically, the most apparent difference between the primary and permanent dentitions is the physiologic loss of the primary tooth by root resorption. Root resorption is associated with loss of integrity of the periodontal ligament (PDL), followed by recruitment of resorptive cells that remove root structure. We therefore cultured primary dentition PDL fibroblasts (PPDL cells) to investigate in vitro their production of matrix metalloproteinases (MMPs) and tissue inhibitors of MMP (TIMPs), and the effects of soluble factors produced by these cells on osteoclast-like cell differentiation. These studies demonstrate that PPDL cells in vitro have a heterogeneous morphology, and they constitutively synthesize 92-kDa gelatinase, 72-kDa gelatinase, and 53/57-kDa procollagenase as well as TIMP-1, -2, and a third inhibitor of matrix metalloproteinase, as determined by substrate gel zymography and immunoblot analysis. Compared with PDL cells from the permanent dentition, PPDL cells generally produced a greater amount of collagenase but similar amounts of the gelatinases and inhibitors. PPDL cells were treated with pro-inflammatory cytokines to determine their effect on the expression of matrix-degrading enzymes and inhibitors. Interleukin-1alpha and tumor necrosis factor-alpha enhanced the constitutive expression of proteinases but not that of inhibitors in PPDL cells. Conditioned media from PPDL cell lines inhibited the differentiation of osteoclast-like cells in mouse bone marrow cultures. These findings indicate that PPDL cells may modulate the cascade of root resorption both by their regulated production of proteinases and inhibitors and by synthesis of unknown soluble factor(s) that may regulate osteoclast development.

Adult↗