Histopathological evaluation of root canal filling materials for primary teeth

This study aimed to assess the response of apical and periapical tissues of dogs¿ teeth after root canal filling with different materials. Forty roots from dogs¿ premolars were prepared biomechanically and assigned to 4 groups filled with: Group I: commercial calcium hydroxide and polyethylene glycol-based paste (Calen®) thickened with zinc oxide; Group II: paste composed of iodoform, Rifocort® and camphorated amonochlorophenol; Group III: zinc oxide-eugenol cement; Group IV: sterile saline. After 30 days, the samples were subjected to histological processing. The histopathological findings revealed that in Groups I and IV the apical and periapical regions exhibited normal appearance, with large number of fibers and cells and no resorption of mineralized tissues. In Group II, mild inflammatory infiltrate and mild edema were observed, with discrete fibrogenesis and bone resorption. Group III showed altered periapical region and thickened periodontal ligament with presence of inflammatory cells and edema. It may be concluded that the Calen paste thickened with zinc oxide yielded the best tissue response, being the most indicated material for root canal filling of primary teeth with pulp vitality

Idiopathic radiographic apical root resorption in wind instrument players

Root resorption of the permanent teeth involves an elaborate interaction among inflammatory cells resulting in loss of dental hard tissues. This report describes three clinical cases where idiopathic root resorption occurred in wind instrument playing patients. These patients produce adequate non-orthodontic forces, while playing their instruments, to expose their teeth to root resorbing force. Careful clinical monitoring of patients' teeth should be undertaken, as the additive effects of orthodontic treatment and musical habits are unknown

The comparison of different rapid maxillary expansion devices from periodontal tissue health and root resorption perspectives

INTRODUCTION: Utilization of rapid maxillary expansion (RME) is common for the correction of sagittal discrepancies in orthodontic treatment. RME appliances will transmit a compressive force to the periodontal support structures. This resultant force can lead to resorption of the dento-alveolar structures leading to unwanted dental movements. The purpose of this retrospective study was to compare changes from a periodontal and root resorption perspective by means of computer tomography with tooth-borne and bonded expanders. METHODS: The sample comprised of cone beam computed tomography and spiral CT images of 41 subjects, 12 to 17 years old, with unilateral or bilateral posterior crossbites. 20 subjects treated previously with a bonded expander and 21 with a banded expander. Pre and post-treatment images were digitized and landmarks were identified to measure buccal and lingual cortex thickness, alveolar height, root length and angulation by means of a computerized method. RESULTS: RME with banded and bonded expanders have similar effects from periodontal and root resorption perspectives. Changes include increasing thickness of lingual alveolar bone 0.2 to 0.7 mm, decreases in buccal bone width 0.1 to 0.5 mm; and decreases in alveolar height 0.1 to 0.9 mm and root length 0.3 to 1.0mm of each support teeth. CONCLUSIONS: RME with banded and bonded expanders exhibited similar changes post-expansion and these variables should not play a role in selection of the type of device

External cervical root resorption involving multiple maxillary teeth in a patient with hereditary hemorrhagic telangiectasia

Hereditary hemorrhagic telangiectasia (HHT) is an inherited syndrome characterized by mucocutaneous telangiectases that commonly involve the tongue, lips, fingers, and conjunctiva. While root resorption has been reported in association with central hemangiomas of bone, the association of HHT with external cervical root resorption has not been described to date. We report a case of a 57-year-old female with HTT who presented with advanced cervical root resorption involving multiple maxillary anterior teeth. Histologic examination of the gingival tissue adjacent to the area of root resorption demonstrated multiple thin-walled vascular elements as well as larger vascular channels surrounded by a thickened muscular layer. We hypothesize that the external root resorption seen in this case is the result of the HHT-related vascular process in the adjacent gingival tissue

Moving an incisor across the midline: A treatment alternative in an adolescent patient

A 13-year-old sought treatment for a severely compromised maxillary left central incisor and an impacted fully developed left canine. Extraction of both teeth became necessary. As the key component of the revised comprehensive treatment plan, the right maxillary central incisor was moved into the position of the left central incisor. All other maxillary teeth were moved mesially to close any gaps. Active orthodontic treatment was completed after 34 months. Frenectomy, minor periodontal surgeries, and bonded lingual retainers were used to improve aesthetics and stabilize the tooth positions. The patient was pleased with the treatment outcome. Cone-beam computed tomography provided evidence that the tooth movement was accompanied by a deviation of the most anterior portion of the median palatine suture. This observation may make relapse more likely if long-term retention cannot be ensured. Root resorption was not observed as a consequence of the major tooth movement. (Am J Orthod Dentofacial Orthop 2011;139:533-43

Morphologic characteristics, location, and associated complications of maxillary and mandibular supernumerary teeth as evaluated using cone beam computed tomography

SUMMARYOBJECTIVES: To evaluate the location and morphologic characteristics of supernumerary teeth and to assess the frequency and extent of root resorption of adjacent teeth using cone beam computed tomography (CBCT). MATERIALS AND METHODS: CBCT scans of 82 patients with supernumerary teeth in the maxilla and mandible were evaluated by two orthodontists independently. Data regarding the type, shape, and three-dimensional (3D) location of the supernumeraries including the frequency and extent of root resorption of adjacent teeth were recorded and evaluated for possible associations. RESULTS: The study comprised a total of 101 supernumerary teeth. Most of the patients (80.5 per cent) exhibited one single supernumerary tooth, while 15.8 per cent had two and 3.7 per cent had three supernumeraries. Males were affected more than females with a ratio of 1.65:1. Mesiodentes were the most frequently diagnosed type of supernumerary teeth (48.52 per cent), followed by supernumerary premolars (23.76 per cent) and lateral incisors (18.81 per cent). Supernumeraries were most commonly conical in shape (42.6 per cent) with a normal or inclined vertical position (61.4 per cent). Root resorption of adjacent teeth was detected for 22.8 per cent of the supernumerary teeth, most frequently for supernumerary premolars. There was a significant association between root resorption of adjacent teeth and type and shape of tooth. Interrater agreement for the measurements performed showed kappa values ranging from 0.55 to 1 with a kappa value of 1 for type and shape of the supernumerary teeth. CONCLUSIONS: CBCT provides 3D information about location and shape of supernumerary teeth as well as prevalence and degree of root resorption of neighbouring teeth with moderate to high interrater correlatio

The window approach for extraction of tooth root fragments: a different soft tissue management

Different techniques have been proposed for the removal of the apical portion of fractured teeth. The window approach was proposed in the past to remove a tooth root fragment through a buccal bone opening at the level of fragment. In the classical approach, a marginal triangular flap is elevated, only the bone overlying the fractured apex is removed and then the apex is pushed out by an elevator toward the alveolar crest. In this technique, the bone removal is minimal, and it does not involve the marginal bone so that patient’s post-surgical discomfort is reduced, and bone resorption is less. A different kind of soft tissue management for bone exposure is proposed here with a simple linear incision at the level of the root apex without any vertical incision. This kind of incision is simple and versatile, leads to a lesser discomfort to the patient and avoids un-aesthetic scar

Multidimensional scaling for orthodontic root resorption

The paper investigates the risk factors for the severity of orthodontic root resorption. The multidimensional scaling (MDS) visualization method is used to investigate the experimental data from patients who received orthodontic treatment at the Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, during a period of 4 years. The clusters emerging in the MDS plots reveal features and properties not easily captured by classical statistical tools. The results support the adoption of MDS for tackling the dentistry information and overcoming noise embedded into the data. The method introduced in this paper is rapid, efficient, and very useful for treating the risk factors for the severity of orthodontic root resorption

Retrospective analysis of the correlation between the facial biotype and the inclination of the upper canine cusp axis to the occlusal plane

Permanent maxillary canines are the second most frequently impacted teeth and the prevalence of this clinical condition is estimated to be 1-2% in the general population. The diagnosis of maxillary canine impaction should be based on both clinical and radiographic examinations. The aim of this study was to evaluate the presence of a correlation between the facial biotype and the inclination of the upper cusp axis. A correlation between the total radicular length of the lateral incisors was also evaluated, by comparing the side of impaction with the healthy side. Twenty three patients with a diagnosis of unilateral upper cusp impaction were recruited. For each patient, dental casts and radiographic material (panoramic radiographs and lateral cephalograms) were examined. Statistical analyses were done with Spearman's rank correlation coefficient or Spearman's rho (V). X-ray examinations demonstrated that canine impaction was associated to other dental anomalies (32% of the sample). The mean S angle measurements were 22.9° ± 4.1°, and mean values of the T angle were 34.7°± 4.0°. The mean distance “d” value was 14.6 mm ± 1.2 mm. The mean values of the angle between the upper cusp axis and the perpendicular-to-Fh plane were 20.8 °± 2.6°. Among the 23 subjects recruited, 5 showed values included in the range 25°-45° and 1 an inclination > 45°. The results obtained in the present study demonstrate a significant inverse correlation between the MM angle and the inclination of the upper cusp axis to the perpendicular-to-Fh plan