Susceptibility of Nd:YAG laser-irradiated root surfaces in replanted teeth to external inflammatory resorption

Nd:YAG laser-induced modification of the root surface may inhibit development of external inflammatory resorption in replanted teeth. This study tested this hypothesis in vivo. The pulp chambers of six mandibular premolars in each of two dogs were accessed, inoculated with plaque, and sealed (Groups 1, 2). Two additional premolars in each dog were endodontically treated without inoculation (Groups 3, 4). After 2 weeks, teeth were hemisected and extracted. Each root had a 2 x 3 mm surface area denuded of cementum on the buccal and lingual surface. In Groups 1 (n = 12 roots) and 3 (n = 4), the denuded surfaces were wiped with 15% EDTA, coated with black ink, and irradiated with Nd:YAG laser (0.75 W, 15 pps, 300 microns tip, 20 s). In Groups 2 (n = 12) and 4 (n = 4), the surfaces were wiped with 15% EDTA, and rinsed with sterile saline for 20 s. Roots were replanted within 5 min. The dogs were perfusion-euthanised 10 weeks after replantation. Block specimens were removed, decalcified, embedded and horizontally sectioned (6 microns) at 180-microns intervals, resulting in 10 to 14 cross-sections of each root. From these, the middle five consecutive sections were stained with hematoxylin and eosin, and observed by light microscopy for occurrence of surface, inflammatory and replacement resorption on the denuded surfaces. No obvious differences were noted between the laser-irradiated and non-irradiated surfaces. Inflammatory resorption was frequent in Groups 1 and 2, and absent in Groups 3 and 4. Replacement resorption was minimal in Groups 1 and 2, and frequent in Groups 3 and 4. Differences between Groups 1 and 2, and between Groups 3 and 4 were not significant, whereas the differences between the two pairs of groups were statistically significant (chi-square and two-way ANOVA, P < 0.006). These results did not support the hypothesis, and questioned the clinical validity of the surface modification in Nd:YAG laser-irradiated dentin. Therefore, the clinical application of Nd:YAG laser to the root surfaces of replanted teeth is not warranted.     

Effect of systemic tetracycline and amoxicillin on inflammatory root resorption of replanted dogs'' teeth

Upper motor neuron lesion in adults is usually associated with spasticity and "extensor toe sign" on plantar stimulation (extensor plantar response). There are various methods of eliciting this sign including the classic method by Babinski. Other methods produce this response when the area of reflexogenic zone is increased due to upper motor neuron lesion. There are varying reports of Babinski positivity in spastic cerebral palsy. This study was undertaken to assess the sensitivity of different methods of eliciting "extensor toe sign." An attempt has also been made to correlate the severity of spasticity with the combined "extensor toe sign" positivity by various methods and with the increase in reflexogenic zone. Eighty-one children with spastic cerebral palsy were examined. Twelve had hemiplegia; therefore, a total of 150 limbs were tested. "Extensor toe sign" was elicited by 12 different methods in each patient. The sensitivity of each method was calculated and compared with each other one. The assessment of spasticity was done using the Ashworth Tone Scale. The severity of spasticity was correlated with "extensor toe sign" positivity using various methods. Classic Babinski reflex was positive in 75% of cases, whereas Gonda-Allen sign was positive in 90% of cases followed by Allen-Cleckley (82%), Chaddock (74%), and Cornell (54%). All other signs had sensitivity of less than 30%. There was no increase in sensitivity after combining them. There was significant negative correlation between the spasticity and the combined "extensor toe sign" positivity (by all the methods). This study, therefore, suggests that the majority of patients with spastic cerebral palsy have positive "extensor toe sign." The Gonda-Allen method is more sensitive than the classic Babinski method. A positive "extensor toe sign" is negatively correlated to the degree of spasticity.     

Apical root resorption in orthodontically treated adults

This study analyzed the relationship in orthodontically treated adults between upper central incisor displacement measured on lateral cephalograms and apical root resorption measured on anterior periapical x-ray films. A multiple linear regression examined incisor displacements in four directions (retraction, advancement, intrusion, and extrusion) as independent variables, attempting to account for observed differences in the dependent variable, resorption. Mean apical resorption was 1.36 mm (sd +/- 1.46, n = 73). Mean horizontal displacement of the apex was -0.83 mm (sd +/- 1.74, n = 67); mean vertical displacement was 0.19 mm (sd +/- 1.48, n = 67). The regression coefficients for the intercept and for retraction were highly significant; those for extrusion, intrusion, and advancement were not. At the 95% confidence level, an average of 0.99 mm (se = +/- 0.34) of resorption was implied in the absence of root displacement and an average of 0.49 mm (se = +/- 0.14) of resorption was implied per millimeter of retraction. R2 for all four directional displacement variables (DDVs) taken together was only 0.20, which implied that only a relatively small portion of the observed apical resorption could be accounted for by tooth displacement alone. In a secondary set of univariate analyses, the associations between apical resorption and each of 14 additional treatment-related variables were examined. Only Gender, Elapsed Time, and Total Apical Displacement displayed statistically significant associations with apical resorption. Additional multiple regressions were then performed in which the data for each of these three statistically significant variables were considered separately, with the data for the four directional displacement variables. The addition of information on Elapsed Time or Total Apical Displacement did not explain a significant additional portion of the variability in apical resorption. On the other hand, the addition of information on Gender to the information on the four directional displacement variables yielded an R2 value of 0.35, which indicated that these variables taken together could account for approximately a third of the observed variability in apical resorption in this sample.     

A new approach in restorative treatment of external root resorption. A case report

This case report describes the treatment of an external root resorption with extensive loss of tooth structure and bone at the labial surface of an upper left central incisor. The area of bone loss and root resorption was surgically exposed and an impression was taken using curing silicone. An individual ceramic insert was fabricated, allowing endodontic retreatment through an artificial root canal. The insert was incorporated using a dentin bonding system and a dual curing luting composite. Following endodontic retreatment and internal bleaching, a ceramic veneer was bonded to the tooth to obtain good esthetics and to improve stability. Twenty months after surgical treatment no further root resorption could be detected radiographically. A shallow residual pocket but no bleeding on probing was found.     

Idiopathic dental root replacement resorption in old dogs

The roots of the teeth of 33 large dogs aged 10 years or older were radiographed. These dogs were euthanized for reasons other than oral diseases; dogs with obvious dental or periodontal diseases were excluded. The dogs had shown no clinical signs related to the teeth and the teeth were macroscopically normal. Of the 33 dogs, six had one or more teeth that had abnormally shaped and partially resorbed roots, with replacement of root structure by radiographically normal trabecular bone. Histological examination of radiographically abnormal roots revealed mid-root resorption, without signs of inflammation or hypercementosis. These findings are similar to the condition known as idiopathic dental root replacement resorption in the human dental literature. Possible etiologies of root resorption are discussed.     

Forceps extraction of teeth with severe internal root resorption

Many treatment plans require a dental practitioner to maintain the entire labial cortical plate of bone when removing an anterior maxillary tooth. A tooth with an undermined root secondary to an endodontic perforation or internal (Idiopathic) resorption can present a surgical challenge to the general practitioner. This article describes a new technique for extracting a severely undermined anterior maxillary tooth while maintaining the entire labial cortex of bone.     

Repair of a root resorption lesion. A case report

1. One-day-old turkey poults (n = 14) were randomised into 2 groups (n = 7) and fed diets containing 20 (E20) and 600 (E600) mg all-rac-alpha-tocopheryl acetate/kg food for 21 weeks prior to slaughter. Two batches were formed from E20 meat (E20) and E20 plus 10 g salt/kg (E20S). Two similar batches were formed from E600 meat (E600) and E600 plus 10 g salt/kg (E600S). 2. The effects of alpha-tocopheryl acetate supplementation and salt addition on the oxidative stability of raw turkey patties was investigated during aerobic and vacuum-packaged refrigerated (4 degrees C) storage. 3. Dietary alpha-tocopheryl acetate supplementation reduced TBARS (thiobarbituric acid reacting substances) numbers for raw overwrapped and vacuum-packaged turkey leg and breast patties. 4. Dietary alpha-tocopheryl acetate had the greatest influence on TBARS numbers for raw overwrapped turkey leg patties. 5. The addition of 10 g salt/kg increased TBARS numbers for overwrapped and vacuum-packaged turkey leg and breast patties. 6. Vacuum-packaged patties remained more oxidatively stable than similarly treated overwrapped patties throughout the experimental period.     

A heritable component for external apical root resorption in patients treated orthodontically

Double-stimulation was used to demonstrate that, in a T lymphocytic cell line (CEM), phorbol myristate acetate (PMA) rapidly induced NF-kappa B through a signaling pathway which did not involve reactive oxygen species (ROS) and was different from the activation triggered by either H2O2 or tumor necrosis factor-alpha (TNF-alpha). Since these latter compounds were known to activate NF-kappa B translocation in a redox-sensitive way, we have demonstrated that NF-kappa B activation by PMA was resistant to antioxidant N-acetyl-L-cysteine (NAC) and sensitive to kinase inhibitors staurosporine and H7 while activation by H2O2 or TNF-alpha were not.     

Generalized idiopathic apical root resorption as an incidental finding in an adolescent: a case history

Generalized idiopathic apical root resorption is an unusual finding, especially in adolescents. This report describes a case in which the root resorption was an incidental finding in a patient referred for orthodontic treatment after suffering trauma to a central incisor. It emphasizes the need for adequate clinical and radiological examination before undertaking active orthodontic treatment.     

颅骨锁骨发育不良患者乳牙牙根吸收特点及牙齿结构分析

目的:研究颅骨锁骨发育不良(cleidocranial dysplasia,CCD)患者乳牙牙根的吸收特点以及乳牙结构的异常.方法:收集CCD患者因治疗需要而拔除的滞留乳牙,在扫描电镜下观察CCD患者乳牙牙根吸收面的情况;同时制备牙齿结构的病理磨片,在偏光显微镜下观察CCD患者牙齿结构的特点.结果:CCD患者具有典型的临床表现.扫描电镜的观察结果显示,与正常对照相比,CCD患者乳牙牙根的吸收陷窝表浅,底部平坦、光滑、大小不一,吸收陷窝的数目相对较少.病理磨片显示,CCD患者乳牙的髓腔内有大量不规则的、结构不清晰的钙化团块沉积,钙化团块的形成量与牙根吸收的程度密切相关;患者乳牙牙根尖1/3处的牙骨质由细胞性或无细胞性牙骨质构成.结论:CCD患者乳牙牙根的吸收特点与正常乳牙不一致,患者髓腔内钙化团块的形成可能与牙髓细胞在牙根吸收时的调控功能异常有关,根部牙骨质的类型可能不是乳牙滞留的因为.     

Diagnosis and treatment of extracanal invasive resorption

Extracanal invasive resorption is not a well-defined phenomenon. This article describes its clinical, radiographic, and histological characteristics. Treatment of affected teeth based on the location of the resorptive defect is also described.     

Effect of fluoride on root resorption of autogenous dental replants. Clinical study

One hundred and fifty teeth were replanted using three procedures and it was found that greater success occurred in teeth when the periodontal membrane had been removed prior to treatment with two per cent sodium fluoride solution before replantation. Retention of the periodontal membrane on the root surface of the alveolar bone was not significant in the success of replants and reduced the success of those replants which were treated with fluoride. Endodontic procedures were found to be time consuming without contributing to the success of the end result.     

Oesophageal cancer treatment: studies, strategies and facts

Esophageal cancer is among the ten most frequent cancers in the world. Once diagnosis is established prognosis is poor with five-year survival rates below 10%. Over the last few years, the evidence--base for treatment of oesophageal cancer has changed with the publication of several important articles in this field. This article reviews these and other relevant publications with focus on current evidence which holds potential for an improvement in survival in oesophageal cancer patients. Prevention and early detection represent the mainstay in the ongoing struggle to improve prognosis, which is most stringently linked to tumor stage. Other efforts have been dedicated to optimise surgical treatment, radiotherapy and chemotherapy and to discover the most efficient combinations of these treatment modalities. Strong but not unanimous evidence in favour of a multimodality approach with chemoradiotherapy followed by surgery has accumulated in recent years, and confirmatory trials are presently ongoing. A pathological complete response to chemoradiotherapy has been identified to significantly enhance survival. Among the strategies to achieve higher response rates, variations in the administration of the most commonly used drugs rather than higher drug and radiation dosages seem promising. Occult lymphatic spread has been recognized as a major source of recurrence and has been successfully targeted by three field surgical dissection and extended field radiotherapy. In search of the optimal treatment for patients with oesophageal cancer, a variety of different tracks are being pursued. This review outlines and analyses current treatment approaches and investigates how recent advances may impact on patient management.