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ABSTRACT Management of traumatic dental injuries is often challenging due to the complexity in diagnosis, concomitant injuries, and the interdisciplinary treatment planning. As a result, the clinicians are often confused and not confident over important treatment decisions. The guidelines of International Association of Dental Traumatology have improved the standard of dental trauma care globally and provide a roadmap for predictable prognosis. However, there are unique situations that require additional investigations such as the Cone Beam Computed Tomography and customized treatment and follow up protocol. An essential requisite for prevention of adverse late complications of dental injuries is clear understanding of their etiopathogenesis and the changes that occur after an injury. Additionally, it is prudent to understand the basic physiology behind the healing that is expected after a treatment protocol. This review presents the science behind the development of late complications of dental injuries and their management protocols in a simplified and clinical manner. An attempt has been made to highlight the clinical paradigms and decisions that reduce the chances of failures in traumatized teeth. [ABSTRACT FROM AUTHOR]

In 1966, Andreasen and Hjørting‐Hansen were the first to describe a relationship between tooth resorption and dental trauma. However, Andreasen's original classification did not include other resorptive processes which have since been identified. Numerous articles have been published suggesting new terminology and definitions for tooth resorption. A uniform language with universally accepted terminology is crucial to eliminate the multiplicity of terms and definitions which only cause confusion within the profession. An electronic literature search was carried out in the PubMed database using the following keywords for articles published in English: "root resorption," "inflammatory root resorption," "replacement resorption," "cervical resorption," "trauma," "ankylosis," "surface resorption," and "internal resorption." The search also included textbooks and glossaries that may not have surfaced in the online search. This was done to identify articles related to tooth resorption and its etiology in dentistry. The aim of this review was to present the history that has led to the variety of terms and definitions for resorption. This review emphasizes the need for a clearer, simpler, and more comprehensive nomenclature for the various types of tooth resorption which are presented in Part 2 of this series. [ABSTRACT FROM AUTHOR]

ABSTRACT Justification: Canines represent corners in the dental arch, and are important features in facial esthetics, as they support the upper lip, wing of the nose, and influence the nasolabial fold and the appearance of facial aging. In the laterality movements, the canines guidance coordinate the opening and closing of the teeth, saving the TMJ from sudden movements. Discussion: As a result of the lack of eruption or the inadequate positioning of the maxillary canine, the loss of the laterality guide may occur, which will then occur in the maxillary lateral incisor, inducing lesions of “occlusal trauma”, such as inflammatory root resorption. Likewise, without well positioned canines, there may be premature aging and change in facial esthetics. Conclusion: In order to avoid problems with eruption and positioning of the maxillary canines, early diagnosis is made by analyzing their position and their relationship with the other teeth, and in the three-dimensional context of the maxilla, between 8-10 years of age. Preventive measures can create bone space and direction so that the maxillary canines can occupy their position in the dental arch.

Orthodontically induced inflammatory root resorption (OIIRR) is a complication of dental treatment which consists of the degradation of local tissue due to an inflammatory reaction provoked by inappropriate orthodontic stimulus. The aim of the present systematic review was to assess the effectiveness of low-level laser therapy (LLLT) in reducing orthodontically induced inflammatory root resorption (OIIRR) in animal models. A systematic review was carried out in the MEDLINE, EMBASE and LILACS databases. Studies of interventions in animals were selected which analysed the effect of LLLT on OIIRR repair. The risk of bias was analysed through the 10 domains of the SYRCLE RoB tool for animal studies. Seventy-one studies were found; 27 were eliminated as duplicates and 44 titles/abstracts were analysed. Of these, 38 were excluded, and five studies were included for qualitative analysis. In 66.6% of the studies included, the authors state that LLLT was effective in the inhibition/repair of OIIRR. In histological analysis it was observed that root resorption was significantly less in animals treated with laser as compared to the control. Furthermore, LLLT accelerated cicatrization after OIIRR. Laser proved effective in reducing root resorption lacunae and shortening the inflammatory process induced by the application of orthodontic force. [ABSTRACT FROM AUTHOR]

A patient reported with pain and sinus opening in relation to a previously root canal treated maxillary central incisor. Intraoral radiograph revealed periapical radiolucency with shortening of root indicating external apical inflammatory root resorption associated with failed endodontic treatment. Nonsurgical re-treatment was started and intracanal calcium hydroxide (CaOH) was placed for four weeks. The tooth was obturated with Biodentine. At 6, 12, and 24 months follow-up, the patient was asymptomatic and radiograph revealed satisfactory healing. Inflammatory apical root resorption due to failed root canal treatment could compromise the root length and prognosis. Early arrest of such resorption is indicated by nonsurgical re-treatment using CaOH for root canal disinfection and obturating with bioactive material such as Biodentine, which results in the successful arrest of resorption and periapical healing. [ABSTRACT FROM AUTHOR]

This study investigated the effects of low-intensity pulsed ultrasound (LIPUS) on orthodontic tooth movement (OTM) and orthodontically induced inflammatory root resorption (OIRR) in ovariectomized osteoporotic rats. Forty-eight 28-d-old female Wistar rats were divided into ovariectomized and intact groups. In both groups, animals were left untreated; treated with 50 g mesially directed orthodontic force on the maxillary first molars using nickel-titanium closed-coil springs for 28 d; or treated with the same orthodontic protocol along with a 20-min LIPUS application on alternate days for 28 d. Extent of OTM and amount of OIRR of mesial roots were measured on three-dimensionally reconstructed micro-computed tomography images. Ovariectomy increased OIRR (p < 0.05). LIPUS reduced root volumetric loss regardless of ovariectomy status (p < 0.05); only ovariectomized animals had decreased OTM (p < 0.05). LIPUS normalizes OTM and attenuates OIRR in ovariectomized osteoporotic rats. It may therefore be beneficial in women with postmenopausal osteoporosis. [ABSTRACT FROM AUTHOR]

Introduction: Trauma is one of the primary causes of tooth loss and pulpal injury in adolescents and children. Prior to regenerative endodontics, treatment of necrotic, immature teeth with open apices was limited to long-term calcium hydroxide (Ca(OH)2 ) apexification and subsequent root canal therapy or extraction. Through revascularization, retention of these teeth can be achieved and the elimination of patient symptoms and the radiographic appearance of continued root development were obtained.Case Review: This report illustrates a revascularization protocol through a case where platelet-rich fibrin (PRF) was utilized as an autologous scaffold for traumatized, necrotic, immature teeth with incomplete root development. Through consistent follow-up reports, comprising of both clinical examination and radiographs, marked improvement in the condition of the traumatized tooth was noted.Discussion: This case demonstrates the feasibility of utilizing PRF as an effective treatment protocol for traumatized teeth in lieu of traditional treatment protocols, such as long-term calcium hydroxide (Ca(OH)2 ) apexification or extraction. The choice of utilizing PRF, as opposed to other platelet concentrates, such as platelet-rich plasma (PRP) or a blood clot, lies in PRF's ability to allow for a slow, long-term release of autologous growth factors. [ABSTRACT FROM AUTHOR]

Apical inflammatory root resorptions are frequently the result of long lasting chronical inflammation. Untreated, these situations can lead to loss of hard tissue and even the loss of the tooth. The management of these lesions consists of multi-visit canal treatment, with calcium-hydroxide as interappointment dressing and application of MTA. Single-visit treatment may be also an option. Our clinical cases show the importance of correct diagnosis of the apical inflammatory progressive root resorptions and the evaluation of the outcome of the endodontic treatment due to the use of cone-beam computing tomography (CBCT). The treatments proved to be successful. Although some of the root canal filling seem to be incomplete on radiographs, because of the oblique defect and the roots remained short, the functionality of the teeth could be preserved. Precise information influences the diagnosis and the treatment planning decision. [ABSTRACT FROM AUTHOR]

Copyright of Salud Uninorte is the property of Fundacion Universidad del Norte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Inflammatory root resorption is a serious complication of dental trauma, which leads to progressive loss of the root structure. The purpose of this report was to present a case of perforating inflammatory root resorption in a previously traumatized young incisor tooth with incomplete root development. A 12-year-old girl, who had suffered a traumatic dental injury 4 years earlier, was referred with symptoms of pain and swelling in a permanent maxillary central incisor. The tooth had been root-filled and had thin dentinal walls and a wide open apex. During retreatment, a perforating resorption site was observed on the root's distal aspect. Because the entire root canal filling could not be removed, the resorption site was repaired with white mineral trioxide aggregate in the presence of the remaining gutta-percha. Clinical and radiographic follow-up was conducted for 36 months, demonstrating arrest of the resorptive process, regeneration of the periradicular tissues, and re-establishment of the periodontal space. [ABSTRACT FROM AUTHOR]

Tsesis I, Lin S, Weiss EI, Fuss Z. Dentinal pH changes following electrophoretically activated calcium hydroxide ions in the root canal space of bovine teeth. Dent Traumatol 2005; 21: 146–149.© Blackwell Munksgaard, 2005.The aim of the study was to evaluate pH changes of external root dentin surface at different depths following electrophoretic activation of calcium hydroxide (CH) in the root canals. For the study, 60 cavities were drilled on three external root surfaces of 20 bovine teeth specimens to obtain remaining dentin thickness (RDT) of 0.3, 0.7 and 1.0 mm. CH paste was inserted in the lumens. In the experimental group (10 specimens) CH paste was electrophoretically activated. Microelectrode was used to measure pH changes in the cavities immediately after placement of CH, following electrophoretical activation, and after 30 days storage. A significant (P < 0.05) increase in pH following electrophoresis was found in all specimens in the experimental group. Cavities with 0.4 mm RDT showed a maximal pH increase to the value of 11.3 ± 0.4. In the control group no change in pH was observed after 3 min. A similar increase in pH was observed in both groups after 30 days. The pH changes were significantly depended on the RDT (P < 0.05) in all groups. Electrophoretically activated CH could significantly increase dentinal pH of external root surface within minutes up to 30 days. [ABSTRACT FROM AUTHOR]

Aim and Methodology: Two cases of internal tooth resorption were examined. A mandibular premolar and a mandibular canine were studied after they were extracted using radiographs, a stereomicroscope (SM) and a scanning electron microscope (SEM). Lastly, 3D images of the sectioned teeth were obtained(3D).Results: Radiographically, internal root resorption was shown as a uniform radiolucency. By SM examination, an extensive destruction of dentin was seen, while, by SEM examination, a disappearance of dentinal tubules was clear. The 3D reconstructive method revealed a circumscribed, oval-shaped defect that did not perforate the cemental layer.Conclusions: Internal root resorption is a rare remodeling process that can be studied using different experimental methods. [ABSTRACT FROM AUTHOR]

Experimentally-induced external inflammatory tooth-root resorption can be inhibited by therapeutic doses of calcitonin. Such doses can be delivered by an intrinsically slow diffusion pathway, from a reservoir in endodontically-debrided root canals, via the dentinal tubules. While the kinetics of this journey have been followed in an earlier report, the binding characteristics of calcitonin to the tooth mineral, which will be responsible, in part, for these kinetics, have not been reported before. The current study examines the binding potential of calcitonin to root mineral and addresses the potential role of non-specific binding proteins. A modified Scatchard plot indicated that a simple non-reactive type of ligand binding exists between calcitonin and root mineral, represented by a small number of identical binding sites. This interaction is both strong and reversible. Furthermore, it appears to be time-dependent with more time being required for the residual ligands to interact with the diminishing numbers of free calcitonin-binding sites. While preloaded [125I]-calcitonin could be incompletely (75-91%) displaced from dental-root material by non-radioactive calcitonin, its release was slow over 23 h. Calcitonin was four times as effective as bovine-serum albumin in competing for common "calcitonin binding sites" on macerated dental-root material. Thus, even in the presence of extraneous protein, calcitonin will bind tightly but reversibly to tooth-root material, making it a good candidate for therapeutically protracted delivery to external root surfaces from root canals. [ABSTRACT FROM AUTHOR]

Insertion of calcitonin into root canals of monkey teeth has been shown to inhibit external inflammatory root resorption and suppress inflammation. Regulation of this therapeutic event depends upon the rate of arrival (diffusion) of the hormone at sites of resorptive activity. In the present study, the diffusion characteristics of calcitonin through the dental root in an extracted human-tooth model are described, and the role of cementum in the diffusion process is also addressed. Root-canals were endodontically prepared to form a reservoir for [125I]-calcitonin, and macerated to remove organic material from dentinal tubules. In teeth with intact cementum, an initial period of delay (4-5 h) prior to the detection of calcitonin at the external tooth-root surface was followed by a rapid release of the calcitonin during the first 10.5 h (rate peaks at 6 h). Slower, sustained releases of calcitonin through intact cementum were measured for the following 9 days. Removal of cementum, to expose "smear-free" dentine, resulted in an earlier efflux of calcitonin (2 h) at external tooth surfaces and increased amounts of calcitonin release over 9 days. Biphasic delivery of calcitonin by such internal diffusion mechanisms suggests that loss of cementum will enhance therapeutic availability, while prolonged delivery to intact external dental-root surfaces following early intra-canal placement may also be useful for the therapeutic prevention of external inflammatory root resorption. [ABSTRACT FROM AUTHOR]

In recent years, ultrasonic endodontic instruments have been used for the cleansing and disinfecting of root canals. In the present study, inflammatory root resorption, itself an indication of the presence of bacteria in the dental root, was experimentally induced in monkey teeth. Root canals were subjected to ultrasonic endodon tic preparation in order to investigate the antibacterial effects of this treatment method on the pulpal and periodontal tissues in vivo. Results were histologically evaluated using a morphometric technique, and revealed that ultra- sonication eliminated bacteria and inflammatory root resorption. Furthermore, it had no damaging elects on a healthy periodontal membrane. It is suggested that this mode of treatment may he of value in the elimination of bacteria inside those dentinal tubules otherwise inaccessible to conventional therapy. [ABSTRACT FROM AUTHOR]

Copyright of Revista Odonto Ciencia is the property of EDIPUCRS - Editora Universitaria da PUCRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This case report describes a radiographical, histological and histochemical study of an extracted mandibular tooth with progressive external root resorption. The cells which appeared to be responsible for the hard tissue resorption showed an intense acid phosphatase activity, similar to that of bone-resorbing cells. Some aspects on the etiology and pathogenesis of resorptive process that occurred in the present case are discussed. [ABSTRACT FROM AUTHOR]