Diagnostic imaging in veterinary dental practice. Unerupted tooth resulting in a dentigerous cyst causing resorption of bone.
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Orthodontists are often concerned about the prognosis of root-filled teeth, particularly when extractions are required for orthodontic treatment. This review provides guidance on assessing the quality of root fillings, as well as the factors which affect the prognosis of root-filled teeth. The implications of previous traumatic injuries and the likelihood of root resorption during orthodontic tooth movement are discussed.
This case report describes an unusual phenomenon where resorption occurred in the crown of an unerupted permanent molar. It was an incidental radiological finding. After eruption the tooth was extracted. Histological examination revealed resorption of enamel and dentine, and partial replacement by calcific material. The possible aetiology of the condition is discussed.
Radiographs were taken of both the right and left sets of maxillary teeth in 23 Friesian cattle of known age. The stage of development of each permanent tooth was ascertained and the degree of root resorption in the deciduous premolars was noted. All stages in individuals were later than for those of the mandibular cheek teeth except in the case of the first permanent premolar. As with mandibular cheek tooth development stages of formation occurred within certain age limits.
The objective of this paper is to clarify the literature's findings and provide guidelines for decision-making during the long-term treatment planning of infraoccluded primary molars. This paper presents a synopsis of findings concerning prevalence, aetiology, diagnostic methods, diagnostic criteria and treatment options. Treatment decisions are mainly guided by the clinical assessment of the presence or absence of succedaneous tooth, evaluation of onset, time of diagnosis, resorption rate, rate of progression of infraocclusion, risk of adverse effects over time, and predictive clinical patterns of infraoccluded primary molars. These models are a result of a comprehensive review of the literature and presents a compilation of findings in a format that is of practical use to the clinician.
The aim of the present publication is to provide a broad survey of the current concepts on the regulation of tooth eruption. There is increasing evidence that tooth eruption is a multifactorial process. The bone resorption occlusal to an erupting tooth is probably induced by the occlusal part of the follicle, and allows the tooth to erupt. The occlusal movement it self is likely to be regulated by a localized increase in tissue fluid pressure in the apical area. The bone deposition which is often observed apical to an erupting tooth is more likely to be a reaction to the eruption than a source of eruptive forces.
The purpose of this study was to evaluate prevalence and severity of apical root resorption of maxillary anterior teeth in a large sample of adult orthodontic patients, to analyse any difference between subgroups of patients with and without a history of earlier orthodontic treatment, and to test the hypothesis that endodontically treated teeth are less likely to experience apical root resorption. Differences in tooth length measurements of standardized periapical radiographs made before and after treatment of 343 adults, representing groups of consecutively treated patients from four orthodontic practices, were calculated. Sample means of averaged root resorption of all six anterior teeth and of the most severely resorbed tooth per patient were 0.94 mm (SD 0.88) and 2.39 mm (SD 1.43), respectively. Forty per cent of the adults had one or more teeth with 2.5 mm resorption or greater. The subsample of 31 patients with a history of earlier orthodontic treatment had less root resorption than the remaining patients (P < 0.001). Evaluation of the 39 contralateral pairs of teeth with and without endodontic treatment in 36 of the patients revealed less resorption of the endodontically treated teeth (P < 0.05).
Although prognosis for the avulsed tooth is guarded, replantation, followed by a brief period of splinting and endodontic therapy, is suggested. Minimal extraoral period, minimal manipulation of the root surface and alveolus, and moist storage for the tooth are identified as factors that minimize resorption. Education of coaches, teachers, and all dentists in the technique of replantation is encouraged.
This study was designed to evaluate the 3-D relation of epithelial rests of Malassez (ERM) to orthodontically induced resorption lacunae in human tooth roots. First premolars were extracted following rapid maxillary expansion, then they were prepared for transmission electron microscopy and sectioned. Serial 1 micron sections were used for the 3-D reconstructions and ultra thin sections were utilized to verify the identification of epithelial cells and blood vessel types. Each serial section was photographed and profiles of the resorption bays, epithelial cells and blood vessels were digitized and computer reconstructions performed with an IBM-based software programme. The reconstructions supported the view that epithelial cell and blood vessel relation to the resorption lacunae appeared to be related to the level of activity of the bay. Possible functional roles for epithelial cells in the resorptive process are discussed.
A functioning dental follicle and bone resorption are necessary for tooth eruption. In the microphthalmic (mi) mouse, bone resorption is defective and teeth fail to erupt. Local bone metabolism involves the production of cytokines such as interleukin-1 alpha (IL-1 alpha) and transforming growth factor-beta (TGF-beta). The production of these cytokines by dental tissues during eruption may be fundamental to tooth movement. Molars from mi mice were cultured and supernatants tested for the presence of these cytokines using bio-dot blotting and ELISA. A thymocyte bioassay was used to test supernatants for IL-1 bioactivity and IL-1 inhibition bioactivity. IL-1 alpha and TGF-beta were detected in all supernatants. Supernatants demonstrated no IL-1 bioactivity but inhibited IL-1 bioactivity which varied with concentration of supernatant, age and animal. This study demonstrated that cultured developing teeth secrete IL-1 alpha and TGF-beta however, concentrations varied in normal and pathological states. While IL-1 alpha was present in the supernatants, all demonstrated a variable ability to inhibit IL-1 bioactivity. This ability may influence local bone metabolism and hence tooth eruption.
The purpose of the present study was to identify factors which might influence the success of autotransplantation, such as root development, root resorption, pulp condition and tooth eruption. The material consisted of 100 human premolars transplanted in 87 patients. The observation period ranged from 3-18 years, with a mean value 6.3 years. Clinical and radiographic examinations were performed. The transplanted premolars were divided into 7 stages of root development. At the final control, 93 teeth remained and 7 teeth were extracted. Periodontal healing without root resorption was related to stage of root development. It decreased from 93% in teeth with 3/4 root development to 37% in teeth with fully developed roots. Inflammatory root resorption was seen in 7 cases and replacement root resorption in 12 cases. Pulp revascularization was observed in 100% in stages with initial root development to 1/2 root development and decreased to 0% for teeth with fully developed roots. Pulp obliteration was observed in all cases with revascularized pulp tissue. The gingival condition was similar to contralateral, not transplanted premolars or adjacent teeth. Root growth increased with the stage of root development at the time of transplantation. It is concluded that transplantation of premolars with 1/2-3/4 root development provides a good chance of pulp survival, limited risk of root resorption and ensures sufficient final root length, and is thus recommended.
The movement of teeth during orthodontic treatment occasionally induces undesirable root resorption. Although high collagenolytic activity has been detected in resorbing tissue of deciduous teeth, the cellular origin of collagenolytic enzymes in root-resorbing tissue caused by tooth movement has not been identified. Here, rats were subject to 7 days of experimental tooth movement to induce root resorption. In situ hybridization with digoxigenin-labelled RNA probes was performed on sections of the maxillary bone to detect the mRNAs that encode matrix metalloproteinase-1 (MMP-1) and cathepsin K in root-resorbing tissue. MMP-1 mRNA was detected in fibroblastic cells, cementoblasts and osteoblasts, but not in odontoclasts nor osteoclasts. Moreover, MMP-1 mRNA was highly expressed in some cementocytes located near odontoclasts and in many osteocytes. In contrast, cathepsin K mRNA was expressed only in odontoclasts and osteoclasts. These results suggest that MMP-1 and cathepsin K are important in root resorption during tooth movement in a mode similar to bone resorption.
Intracoronal bleaching is a simple, useful procedure for restoring the colour of discoloured root-filled teeth that are not extensively restored. It is important to minimise the extraradicular diffusion of hydrogen peroxide, as excessive levels of hydrogen peroxide in conjunction with existing inflammatory changes in the periodontium predispose the tooth to external root resorption. To keep the levels of extraradicular diffusion of hydrogen peroxide below the safety limit, it is imperative that an effective intermediate base cement of at least 2 mm be placed at the level of the buccal cemento-enamel junction over the root-filling prior to bleaching. The use of 35% carbamide peroxide as the intracoronal bleaching agent seems to combine the safety of sodium perborate together with the efficacy of 35% hydrogen peroxide. As bleaching agents may reduce the composite-tooth bond of some adhesive systems, the post-bleaching composite restoration should be delayed for at least three weeks.
The purpose of this study was to investigate the occurrence of orthodontic root resorption in connection with local injection of prostaglandin E2 (PGE2). The material consisted of 25 male Wistar rats. The control group comprised six animals where no force was applied. In five animals 0.1 ml of 0.1 micrograms/microliter PGE2 was injected in the gingival area of the upper right first molar. In one animal no PGE2 was injected. The animals were killed after 3 days. The experimental tooth movement groups consisted of 19 animals. Duration of experiments was 3 days, 7 days, and 10 days. The maxillary first molars on both sides were each moved mesially by means of a coil spring. On the right side 0.1 ml of PGE2 0.1 micrograms/microliters was injected in the gingiva on the buccal side of the upper first molar on days 0, 3, 5, and 7. On the left side no injection of PGE2 was performed. In three animals in the 7-day group the vehicle (Waymouth medium) was injected. There was no significant difference in root resorption between the experimentally moved teeth with and without local injection of PGE2, but a trend towards more root resorption was registered on the teeth where such injections had been performed.
Root resorption is an adverse outcome of orthodontic tooth movement. In addition to the iatrogenic response and compromising the crown-root ratio, root resorption has led to increased malpractice litigation against orthodontists. A clinically acceptable method of treating root resorption has not been validated in the literature to date. Previous research has shown that low-intensity pulsed ultrasound (LIPUS) can enhance healing of various types of traumatized connective tissues and stimulate dental tissue formation. The purpose of this study was to evaluate the effect of LIPUS on the healing process of orthodontically induced tooth-root resorption in humans. Twelve orthodontic patients who were seeking orthodontic treatment that necessitated extracting the first premolars before mechanotherapy participated in this study. For each patient, buccally activated springs were used to tip the maxillary first premolars buccally, with an initial force level of 50 g; the springs were checked weekly to ensure continuous force levels. A short period of LIPUS was applied to 1 side of each patient's mouth, with the other side used as a control. After 4 weeks, the experimental premolars of all patients were extracted, and the premolars of 6 patients were studied by scanning electron microscopy (SEM); the premolars of the other 6 patients were studied histologically. The number and total area of resorption lacunae as examined by SEM were compared between the LIPUS-treated and the control premolars with a t test. The SEM study showed a statistically significant decrease in the areas of resorption and the number of resorption lacunae in the LIPUS-exposed premolars. Histologic examination showed healing of the resorbed root surface by hypercementosis. The results of this study provide a noninvasive method for reducing root resorption in humans.
The effect of growth hormone (GH) on the dentition has been described in children with pituitary dwarfism where teeth fail to form; those that do form tend to be reduced in size and the eruption potential is diminished. The aim here was to examine the effect of GH on odontogenesis via molar development in Lewis (control), dwarf (Dw) and Dw GH-treated (Dw+GH) rats aged 3, 6, 9, 12 and 15 days. Dw+GH animals received a twice-daily dose (65 microg/kg) of GH which commenced at 2 days of age. Animals were killed, mandibles removed, processed to embedding in paraffin, sectioned and stained for histological examination of molar morphology during development. Variations in enamel mineralization and root development were observed. In 6-day-old animals, enamel mineralization was delayed in Dw and Dw+GH animals. Root initiation was evident at 6 days of age in controls but was not observed until 9 days of age in Dw and Dw+GH animals. At 12 days of age, maturation of enamel in Dw and Dw+GH animals remained delayed. By 15 days of age no variation in tooth development was evident. These data indicate that enamel mineralization is affected by the level of circulating GH in the rat. A specific deficiency of GH did not appear to delay bone resorption prior to tooth emergence.
1. The anterior portion of the palate does not appear to move lingually as orthodontic forces move incisor teeth lingually. Although the alveolar bone directly supporting the teeth can be moved distally (and elongated), it does not appear possible to move the apex of the root more distally than the pretreatment position of the palatal plate. Thus, there appears to be an anatomic limitation to the distal movement of maxillary incisor teeth. 2. When incisor teeth are moved distally within the boundaries of the present alveolar process, the supporting bone does not remodel to the roots' new position; when a root which was initially positioned nearer the labial alveolar plate is moved distally against the palatal plate, there was observed no adaptation in the bone to have the root once again located near the labial alveolar plate, the root remained stable against the palatal plate. 3. When great distal movement of incisor teeth results in an alteration in position of the supporting alveolar bone, remodeling of the bone maintains a relatively constant labiolingual width of this alveolar bone. The new position of the tooth and supporting bone appears to be stable. 4. The scanty metallic implant evidence would seem to support histologic observations that alveolar processes are remodeled by apposition of bone on the cortical plate toward which the tooth is moving and resorption of the cortical plate away from which the tooth is moving. 5. There does not appear to be a statistically significant correlation between posterior facial measurements (SNMP) and the labiolingual width of the anterior palate.
UNLABELLED: Maintaining the interdental papilla and bone height following implant placement has been a challenge for the restorative dentist. Bone resorption following anterior tooth extraction is common and often compromises the esthetics of the final restoration. The tissue must be maintained during the surgical and healing phases to achieve an esthetic outcome. Using the patient's natural tooth as a provisional can help maintain the volume and support the papilla. This article describes a technique to achieve maximum esthetics and preservation of tissue following tooth extraction and implant placement. CLINICAL SIGNIFICANCE: By using the patient's extracted natural tooth, the tissue should maintain itself with minimal recession. This will allow for a more esthetic outcome.