Occasionally, the extraction of an impacted tooth provides a clinical challenge for an oral surgeon. Any tooth may be impacted, but third molars and maxillary cuspids are most frequently encountered followed by premolars and supernumerary teeth. Various s...

We evaluated whether long-term tooth loss induces functional and morphologic changes in the hippocampus in senescence-accelerated mice (SAMP8) maintained until old age after tooth extraction shortly after tooth eruption. First, to examine whether early tooth loss acts as a stressor, plasma concentration was measured as an index of stress. Plasma corticosterone concentration was significantly higher in old or mature mice with tooth extraction than in the age-matched controls. Plasma corticosterone concentration did not differ between the young tooth extraction and their age-matched control groups. Next, hippocampal function was assessed by evaluating spatial memory performance in the Morris water maze. In the Morris water maze learning and memory trials was significantly slower in the mature or old tooth extraction groups compared with the age-matched controls. There was no significant difference, however, between the young tooth extraction and control groups. Finally, hippocampal neuronal morphology was assessed by counting Nissl-stained cells. The number of hippocampal neurons was significantly reduced in the CA3 region in the mature and old tooth extraction groups compared with their age-matched controls, but there was no significant difference in the CA1-region or dentate gyrus between the mature or old tooth extraction groups and their age-matched controls. In young mice, there was no significant difference in the number of neurons in CA1, CA3, or dentate gyrus region between the tooth extraction and control groups. The findings indicated that tooth extraction after tooth eruption enhances the effects of aging on the hippocampus in mice.   

Aqueous extracts from 8 plants used for tooth-cleaning in Nigeria were tested for their ability to inhibit the growth of five periodontopathic bacteria, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Eikenella corrodens and Campylobacter rectus. Extracts of all the plants ...

This prospective study has been designed to evaluate the correlation between the presence/absence of the interproximal papilla and the mesio-distal and corono-apical position single-tooth replacement implants inserted immediately following tooth extraction. These distances have been evaluated measur...

This report presents a therapeutic approach to orthodontic tooth extraction in a patient at high risk for the development of osteoradionecrosis with conventional techniques. The rationale for this procedure is discussed in detail, combining principles of radiation biology, clinical radiation therapy, and biomechanics of tooth movement.

Numerous epidemiological studies have shown that caries is the main reason for tooth loss. More recent epidemiological data seem to show an increasing trend of tooth loss due to periodontal reasons rather than caries. In considering the issue of periodontal disease and tooth loss the following observations were made. The presence of initial attachment loss, bone height and the habit of smoking significantly increase the risk of tooth mortality. There is a strong correlation between smoking, the severity of periodontal disease and tooth mortality. Cross-sectional population surveys of tooth loss reported lower anterior teeth to be the most frequently extracted due to periodontal reasons, followed by upper anteriors and upper second molars. However, in long term maintenance studies, molars were lost most frequently. Periodontal reasons for tooth loss were mainly mobility followed by furcation involvement. Periodontal surgery did not significantly enhance tooth retention in high risk groups. Ethnic differences observed were not significant and would need further investigations to address variables such as cultural differences, health habits, diet and socio-economic status. In conclusion, periodontal tooth mortality was found to be associated with the loss of periodontal attachment and risk groups with advanced periodontitis contributing to major tooth loss in a minority of the population. PMID:9779103

Paragraph. Title. Sockets. Handles and Attacbents for Nand Socket Wrenches ..... . 9. Pliers. ..... drawers shall be vieible and easily extracted. The capability ... sional moment for each tooth of gear) shall be not greatar than. 15 inch-ounces.

... slow down the production of saliva, which allows bacteria to grow inside the mouth and bad breath to develop. More Monitor Infant's Fluoride Intake Check Menstrual Calendar for Tooth Extraction Keep ...

Exploration of the relationship between tooth dimensions, body size, and age is important in paleontology, forensic odontology and aesthetic dentistry. It is reasonable to speculate that tooth length is associated with stature since teeth contribute to facial height. This study aimed to determine whether there was an association between tooth length and stature and age in a sample of Sri Lankan Sinhalese. Extracted teeth of adults, whose age, sex and standing height were known, were used for measurements. The total tooth length (TTL), crown length (CL) and root length (RL) of permanent maxillary central (68) and lateral (67) incisors were measured using a caliper. Statistical analyses were performed with the software MINITAB version 14.0 (Minitab Inc, USA). Mean age and standing height were 47.81 yr and 152.15 cm, respectively. There was no significant correlation between stature and tooth lengths of incisors. However, age was found to have a significant correlation with RL, (r = 0.26, P < 0.05) and CL (r = -0.28, P < 0.05). Absence of an association between tooth length and stature indicated that the genetic linkage between tooth size and stature was weak, suggesting that determination of stature from tooth lengths is unwarranted. The association between tooth length and age indicates the importance of root length in age determination. (J Oral Sci 51, 587-592, 2009)   

Objective This study aimed to evaluate the effect of an intentionally created socket on bone remodeling with orthodontic tooth movement in rabbits. Methods Eighteen male rabbits weighing 3.8 - 4.25 kg were used. An 8-mm deep and 2-mm wide socket was drilled in the bone 1 mm mesial to the right mandibular first premolar. The left first premolar was extracted to serve as an extraction socket. A traction force of 100 cN was applied to the right first premolar and left second premolar. Sections were obtained at the middle third of the moving tooth for both the drilled and extraction sockets and evaluated with hematoxylin and eosin staining and immunohistochemical analyses. The amount of tooth movement and tartrate-resistant acid phosphatase (TRAP)-positive cell count were compared between the 2 groups using the Mann-Whitney U test. Results At week 2, the distance of tooth movement was significantly higher in the intentional socket group (p extraction socket group. The number of TRAP-positive cells decreased in week 2 but increased in week 3 (p socket group showed greater distance of tooth movement than did the extraction socket group at week 2. Osteoclast counts and results of immunohistochemical analyses suggested elevated bone remodeling in both the groups. Thus, osteotomy may be an effective modality for enhancing tooth movement in orthodontic treatment. PMID:9710828

Intracoronal resorption in an unerupted developing tooth is rare and most lesions of this type are incidentally found in radiographs taken for other purposes. A 5Y10M-old girl was referred to our clinic by a general practitioner for detailed examination of radiolucency identified in the unerupted mandibular left first permanent molar. Intraoral examination revealed that the affected tooth was unerupted, while the radiographic findings demonstrated a wide radiolucent area in the coronal part of the affected molar, which extended close to the pulp. There were no signs or symptoms associated with the tooth at the first examination. At 6Y4M of age, the affected tooth had emerged into the oral cavity, though the patient reported no symptoms. We performed surgical removal of the gingival tissue corresponding to the occlusal surface of the tooth under infiltration anesthesia and macroscopic appearance showed the affected tooth to be intact. However, when the enamel of the affected tooth was removed, a hollow portion approximately 2 mm into the tooth with no pulp exposure was revealed. Calcium hydroxide was applied to the bottom of the cavity and restoration with cement was performed. Three months after treatment, the patient had no abnormal signs or symptoms. A literature search found 15 similar cases, in which mandibular dentition was more frequently affected than maxillary dentition. As for treatment modalities in those cases, conservative restoration was preferably selected, though extraction was inevitable in approximately half.   

Prosthodontists face the difficult task of judging the influence and significance of multiple risk factors of periodontal, endodontic, or prosthetic origin that can affect the prognosis of an abutment tooth. The purpose of this review is to summarize the critical factors involved in deciding whether a questionable tooth should be treated and maintained, or extracted and possibly replaced by dental implants. A MEDLINE (PubMed) search of the English, peer-reviewed literature published from 1966 to August 2009 was conducted using different keyword combinations including treatment planning, in addition to decision making, periodontics, endodontics, dental implants, or prosthodontics. Further, bibliographies of all relevant papers and previous review articles were hand searched. Tooth maintenan...

We retrospectively reviewed and discussed hematostatic managements for tooth extraction in patients maintained on oral anticoagulant. From 2001 to 2007, 109 patients maintained with oral anticoagulant treatment underwent a total of 143 occasions of tooth extraction in our department. At the time of tooth extraction, oral anticoaglant medication was maintained on 76 occasions (53%), and had been discontinued on 55 occasions (38%). Postoperative bleeding happened in 5 cases (9.1%) in patients without interruption of oral anticoagulant, and in 3 cases (3.9%) in patients with interruption. There was no significant difference in the Prothrombin Time International Normalized Ratio (PT-INR) and in postoperative hemostatic procedures between them. The results of this study suggest that dental extraction can be performed without modification of oral anticoagulant treatment in cases where the PT-INR is less than 3.0. Strict local hemostatic procedures are necessary to prevent postoperative bleeding.   

Abstract: Background: Recent studies showed that qPCR could detect bacteria related to periodontitis and peri-implantitis in a low concentration after full-mouth tooth extraction. This study monitored the microbiota from tooth extraction, over 9 months of full edentulism, up to 1 year after abutment connection. Material and methods: Ten patients with severe periodontitis were recruited. Six months after tooth extraction, implants were inserted. Three to 6 months later, they were connected to abutments. Plaque samples were collected from the tongue dorsum, saliva, and subgingival area (teeth/implants) before extraction up to 1 year after abutment connection, and analysed via culture, qPCR, and checkerboard technology. Results: A reduction in the total amount of aerobic and anaerobic CFU/ml ...

The wound of the upper jaw 3 days after the first molar tooth extraction in female rats was exposed to 1,500 rads (Group 2) and 2,000 rads (Group 3) of the 10 MeV electron beams, and its pathohistological changes were compared with those of rats with the tooth extraction alone (control group). In the control group, the tooth extraction wound was covered with epithelium 10 days later and new bones were formed 17 days later. Wound healing with the epithelium was seen in all irradiated rats 24 days later. The formation of the new teeth was seen 24 days later in the Group 2 and 38 days later in Group 3. Cell infiltration under the epithelial layers was still observed in some of the Group 3, although the wound was covered with epithelium, and the new bone covering the extraction wound was formed 38 days later. Healing was prolonged in Group 3, as compared with that in Group 2.

We examined effects of local and whole body irradiation before tooth extraction on appearance and differentiation of osteoclasts in the alveolar bone of rat maxillary first molars. Wistar rats weighting 100 g were divided into three groups: non-irradiation group, local irradiation group, and whole body irradiation group. In the local irradiation group, a field made with lead blocks was placed over the maxillary left first molar tooth. In the whole body irradiation group, the animals were irradiated in cages. Both groups were irradiated at 8 Gy. The number of osteoclasts around the interradicular alveolar bone showed chronological changes common to non-irradiated and irradiated animals. Several osteoclasts appeared one day after tooth extraction, and the maximal peak was observed 3 days after extraction. Local irradiation had no difference from non-irradiated controls. In animals receiving whole body irradiation, tooth extraction one day after irradiation caused smaller number of osteoclasts than that 7 day after irradiation during the experimental period. Whole body-irradiated rats had small osteoclasts with only a few nuclei and narrow resorption lacunae, indicating deficiency of redioresistant osteoclast precursor cells. Injection of intact bone marrow cells to whole body-irradiated animals immediately after tooth extraction recovered to some content the number of osteoclasts. These findings suggest that bone resorption in the wound healing of alveolar socket requires radioresistant, postmitotic osteoclast precursor cells from hematopoietic organs, but not from local sources around the alveolar socket, at the initial phase of wound healing.   

Background: Animal and human researches have shown that immediate implant placement into extraction sockets failed to prevent socket dimensional changes following tooth extraction. It has been suggested that a minimal width of 1-2 mm of buccal bone is necessary to maintain a stable vertical dimensio...

A 5Y7M-old girl was referred to our clinic by a general dentist for detailed examination of a recurrent gingival abscess in the maxillary left primary central incisor region. An intraoral examination revealed a diffuse swelling in the palatal gingiva area of the affected tooth. A periapical radiograph showed that the affected tooth was actually the primary central incisor and a supernumerary tooth, which had fused and been filled with composite resin at the juncture of the 2 tooth crowns. Removal of the filling induced severe bleeding and root canal treatment was performed. Radiographic examinations revealed 2 independent root canals, thus an additional access cavity to the mesial pulp cavity was produced for further root canal treatment. After the lesion had disappeared, root canal filling was performed using iodoform-calcium hydroxide paste and the affected tooth was restored with composite resin to fashion a single crown. However, the canal filling paste was later observed to be resorbed in the cervical area of the root. At 6Y0M, the patient received a traumatic injury in the anterior teeth region and the fused tooth was drastically displaced in a palatal direction, thus we extracted it under infiltration anesthesia. The root was observed to be wide in the mediodistal direction, and a histopathological examination revealed only dentin between 2 independent root canals. Our findings showed that the fused tooth was composed of 2 crowns and 1 root with 2 independent canals, and indicate that each crown and canal should have been treated separately.   

Abstract Objective. To clarify the healing-promoting effects of carbon dioxide laser irradiation in high and low reactive-level laser therapies (HLLT and LLLT, respectively) on extraction sockets after tooth extraction. Material and methods. Forty-two 5-week-old male Wistar rats were divided into laser irradiation and non-irradiation (control) groups and compared. The laser-irradiation group underwent HLLT immediately after tooth extraction and then LLLT 1 day post-extraction. Tissue was excised 6 h and 3, 7, or 21 days after extraction and histopathologically investigated. The alveolar crest height was measured osteomorphometrically 21 days post-extraction, and granulation tissue in the extraction socket surface layer was immunohistologically investigated using anti-a-smooth muscle actin ...

Irradiation before tooth extraction delays wound healing in the alveolar socket. This study examined the influences of local and whole body irradiation before tooth extraction on appearance of osteoblasts in the alveolar bone of rat maxillary first molars because bone formation is observed at the initial phase of wound healing. Several osteoblasts were generated 3 days after tooth extraction, and the number of cells increased day by day. Morphological studies showed there were little differences between local irradiation and non-irradiated controls. In contrast, the extraction wound in the whole body irradiation group showed delayed healing, and there was poor granulation tissue and very few osteoblasts at the bottom of the socket. An ultrastructural study showed that the osteoblasts in the extraction socket of whole body irradiation rats were smaller, and had poorly developed organelles. Injection of bone marrow cells to whole body-irradiated animals immediately after tooth extraction partially restored the number of osteoblasts. New periosteal bone formations outside of sockets showed little delay in the whole body irradiation group. These findings suggest that bone formation in the wound healing of extraction socket requires bone marrow cells from hematopoietic organs such as the bone marrow as well as local sources around the alveolar socket, during the initial phase of wound healing.   

Dens invaginatus or ‘dens in dente’ is a developmental malformation of the tooth resulting from infolding of the dental papilla before calcification. This article presents a case of dens invaginatus occurring in maxillary right lateral incisor of a 45-year-old male patient. The patient presented with pain and clinically missing maxillary right canine. The tooth was found to be non-vital. Radiographic examination revealed the tooth-in-tooth appearance of lateral incisor with a dilated pulp chamber. The crown of impacted canine was found within the pulp chamber of lateral incisor. Owing to this unique clinical presentation, both the lateral incisor and the impacted canine were extracted. Histopathologic examination confirmed the diagnosis of Dens invaginatus Type III B. A brief review on etiopathogenesis, radiographic features and treatment of dens invaginatus has also been included. PMID:10023236

Objectives: The aim of the present in vitro study was the evaluation of a CPP-ACP paste (Tooth Mousse) on preventing dental erosion produced by a soft drink (Coca Cola), using Atomic Force Microscopy (AFM). Methods: Thirty extracted human central incisors free of caries were selected and divided in a treatment and a control half. The treatment halves were divided in three groups-group 1: demineralization with soft drink (4 intervals of 2min); group 2: demineralization with soft drink (4 intervals of 2min) plus Tooth Mousse; group 3: intact enamel plus Tooth Mousse. In groups 2 and 3 Tooth Mousse was applied for 3min at 0, 8, 24 and 36h. The surface of each specimen was imaged by AFM and Rrms values were registered. Results: Among treatment specimens of groups 1 and 2, a statistically signi...

Introduction A triple antibiotic mixture of ciprofloxacin, metronidazole, and minocycline was used as an intracanal medicament in an attempt to disinfect the root canal system for revascularization of a tooth with a necrotic pulp. However, discoloration developed after applying the triple antibiotic mixture. Methods Six weeks after a triple antibiotic paste had been applied to the root canal of tooth #8 of a 7-year-old girl, the tooth showed a dark discoloration. An in vitro experiment with human extracted teeth was performed to determine which of the 3 antibiotics caused the tooth discoloration. Another experiment was then carried out to examine whether a currently used dentin bonding agent would prevent or reduce such discoloration. The degree of discoloration was assessed by using a col...

Nitrogen-containing bisphosphonates such as zoledronic acid (ZOL) and pamidronate have been widely and successfully used for the treatment of cancer patients with bone metastases and/or hypercalcemia. Accumulating recent reports have shown that cancer patients who have received these bisphosphonates occasionally manifest bisphosphonate-related osteonecrosis of the jaw (BRONJ) following dental treatments, including tooth extraction. However, little is known about the pathogenesis of BRONJ to date. Here, to understand the underlying pathogenesis of BRONJ, we examined the effects of ZOL on wound healing of the tooth extraction socket using a mouse tooth extraction model. Histomorphometrical analysis revealed that the amount of new bone and the numbers of blood vessels in the socket were signi...

One way to estimate biological age is to use the aspartic acid (Asp) racemization method. Although this method has been performed mostly using enamel and dentin, we investigated whether an entire tooth can be used for age estimation. This study used 12 pairs of canines extracted from both sides of the mandible of 12 individuals of known age. From each pair, one tooth was used as a dentin sample and the other as a whole-tooth sample. Amino acids were extracted from each sample, and the integrated peak areas of d-Asp and l-Asp were determined using a gas chromatograph/mass spectrometer. Statistical analysis was performed using the d/l-Asp ratio. Furthermore, teeth from two unidentified bodies, later identified as Japanese and Brazilian, were examined in the same manner. Results showed that the d/l ratios of whole-tooth samples were higher overall than those of dentin samples. The correlation coefficient between the d/l ratios of dentin samples and their age was r=0.98, and that of the whole-tooth samples was r=0.93. The difference between estimated age and actual chronological age was -0.116 and -6.86years in the Japanese and Brazilian cases, respectively. The use of whole teeth makes the racemization technique easier and can standardize the sampling site. Additionally, using only a few tooth samples per analysis made it possible to reanalyze known-age samples. Although the difficulty in obtaining a proper control sample has prevented racemization from being widely used, the method described here not only ensures the availability of a control tooth, but also enables the teeth to be used for other purposes such as DNA analysis. The use of a whole tooth will increase the application of the racemization technique for age determination. PMID:22989598

Oral Diseases (2010) 16, 674-685 Objectives: Tooth extraction has been identified as an important risk factor for bisphosphonate-induced osteonecrosis of the jaw. Therefore, the main goal of this study was to determine the effects of alendronate on healing of the extraction socket and on interdental alveolar bone after tooth extraction in rats. Materials and methods: Animals were injected subcutaneously with vehicle or alendronate for 3-4 weeks before the first mandibular molar was extracted and these treatments were continued during post-extraction periods of 10, 21, 35 and 70 days. Mandibles were processed to evaluate healing of the extraction socket and adjacent alveolar bone by assessing bone formation, bone resorption and vascularity by histomorphometric techniques. Results: Alendrona...

Epidemiological evidence regarding dental status and its relationship to diet and nutritional status has been limited. The present cross-sectional study examined the relationship between intake of vegetables, fruit, grains, antioxidants, and fiber and the prevalence of tooth loss. Study subjects were 1,002 pregnant Japanese women. Tooth loss was defined as the previous extraction of 1 or more teeth. Adjustment was made for age, gestation, parity, cigarette smoking, passive smoking at home and at work, family income, education, changes in diet in the previous 1 mo, season when data were collected, and body mass index. Of the 1,002 subjects, 256 women had lost 1 or more teeth. Compared with intake of vegetables other than green and yellow vegetables in the lowest quartile, consumption of the other vegetables in the highest quartile was independently associated with a decreased prevalence of tooth loss, showing a clear inverse dose-response relationship. There was a marginally significant inverse dose-response relationship between the intake of insoluble fiber and tooth loss. No association was observed between intake of green and yellow vegetables, soluble fiber, or antioxidant nutrients and tooth loss. These findings suggested that consumption of vegetables other than green and yellow vegetables and insoluble fiber may be related to a decreased prevalence of tooth loss among young Japanese women.   

Abstract in english The aim of this study was to evaluate the effect of brushing with a Colgate 360º or Oral B Indicator 35 toothbrush on the shear bond strength of orthodontic brackets bonded to extracted human teeth. The bristle wear and bristle tip morphology were also examined after simulated tooth-brushing. Orthodontic brackets (Roth-P/1st and 2nd premolar S/D- Slot 0.18") were bonded (Transbond XT®) to the smoothest surface of each of 45 extracted human molar and premolar teeth. Test (more) specimens were randomly divided into three groups: Group 1, control group with no brushing; Group 2, brushing with the Oral B Indicator 35; Group 3, brushing with the Colgate 360º. Samples were adapted to a machine that simulated tooth-brushing. The bond strength of each bracket to each tooth was assessed with a mechanical testing machine. The bristle wear and bristle tip morphology indices were also assessed. Statistically significant differences were defined for p

Dentistry has entered an era in which patients no longer need to accept an edentulous or partially edentulous condition, or one in which their candidacy for tooth structure replacement (ie, implants with subsequent restoration) must be dismissed because of insufficient alveolar bone volume, height, or width. The supporting bone can be preserved at the time of tooth extraction, or augmented at the time of case presentation, using a variety of available regenerative materials. Among them are mineralized human allograft bone and collagen membranes that can be placed in combination with specific growth factor complexes and implant designs. This article reviews the challenges associated with adequately preserving or augmenting the alveolar bone after tooth extraction or loss and before implant placement. The research and benefits to support using allogenic bone graft and membrane materials for such procedures are detailed, and 3 clinical cases are presented to demonstrate the clinically successful incorporation of these materials with the host tissues. PMID:18064786

Cartilage does not form in the tooth extraction socket of the normal rat. The aim of the study was to determine if adding BMP-6 to the extraction socket would cause chondrogenic differentiation in the diabetic rat. A group of 8-week-old rats were injected intraperitoneally with a diabetogenic agent, streptozotocin, and a control group received citrate buffer only. Three weeks later, the maxillary molar teeth were extracted and either BMP-6 or saline applied to the extraction sockets. Rats from each group were killed on days 3, 5, 7, and 9 after tooth extraction. In the diabetic rats treated with BMP-6, there was a cellular subperiosteal reaction at day 3 in the extra-alveolar tissues, which by day 7 had formed a large mass of cartilage. Cartilage was induced in the subperiosteal region of ...

allow the astronauts to monitor the socket engine and attitude control system and ..... venient method is to rotate a gear tooth wheel and use a magnetic pickup to ..... cold gas and after the engine startup begins the hot gas is extracted from the ...

... pills. It occurs after 3% to 5% of tooth extractions. It is more common after the removal of premolar or molar teeth, especially impacted wisdom teeth (third molars) in the lower jaw. Symptoms Dry socket causes pain in and around the site where ...

AIM: To study the influence on the healing of soft and hard peri-implant tissues when implants of different sizes and configurations were installed into sockets immediately after tooth extraction. MATERIAL AND METHODS: Transmucosal cylindrical implants, 3.3 mm in diameter in the control sites, and c...

The authors demonstrate, with a 66 patients research, that also when laboratory tests on hemostasis indicate pathology like XII factor penia, disfibrinogenemy, lupus (Lac), pyastrinopenia, we manage pseudopathology. In these cases haemostasis is completely normal, even after surgery, like tooth extraction. PMID:2639799

Abstract Aim: The objective of this experiment was to analyze processes involved in the incorporation of Bio-Oss Collagen in host tissue during healing following tooth extraction and grafting. Methods: Five beagle dogs were used. Four premolars in the mandible (3P3, 4P4) were hemi-sected, the distal roots were removed and the fresh extraction socket filled with Bio-Oss Collagen. The mucosa was mobilized and the extraction site was closed with interrupted sutures. The tooth extraction and grafting procedures were scheduled in such a way that biopsies representing 1 and 3 days, as well as 1, 2 and 4 weeks of healing could be obtained. The dogs were euthanized and perfused with a fixative. Each experimental site, including the distal socket area, was dissected. The sites were decalcified in E...

Alveolar healing following tooth extraction is a complex repair process involving different tissues, including epithelium and bone. This research aimed to study the effect of laser therapy on alveolar healing process in patients waiting for liver transplantation, evaluating some inflammation, osteogenesis, and clinical parameters. Twelve patients with hepatic failure waiting for liver transplantation, with indications to bilateral extraction, entered the split-mouth study. One post-extractive defect was treated with laser while the other was left without treatment. Specimens of soft tissues were removed from around the tooth before extraction and after 7 days. Superpulsed laser irradiation prevented IL-1? increase and induced IL-6, IL-10, and collagen III increase at 7 days in compariso...

The authors report a case of natal primary molar in a healthy 14-day-old child. The diagnosis of the case and the treatment plan are discussed, as well as histological analyses of the natal tooth. The tooth presented an immature appearance, with high mobility and insertion only in soft tissue, and therefore the clinical option adopted was dental extraction. Histological analyses revealed enamel hypoplasia and dentin showing a typical tubular pattern without alterations. The soft tissue had young and richly vascularized pulp with areas of chronic inflammatory infiltration. (J Oral Sci 52, 313-317, 2010)   

Better understanding of the furcation anatomy may serve to decrease the risk of pulpal injury during rotary odontoplasty, a procedure often used in conjunction with guided tissue regeneration. The purpose of this study was to determine (i) the tooth thickness about the furcation entrance of lower molars, and (ii) whether there is a relationship between tooth thickness and patient age. 40 mandibular 1st molars (M1) (mean age = 36.2; range 10-65 years) and 40 mandibular 2nd molars (M2) (mean age = 37.9; range 14-70 years) were collected. Age, gender and furcation involvement (if any) were noted for each tooth at the time of extraction. Teeth were sectioned in half, buccal-lingual, at the furcation entrance with a rotary diamond blade. A standardized linear reference scale was placed on each experimental section and an 8 x 10 in. photograph generated. The distance from the floor of the pulp chamber to 5 predetermined sites on the root surface was calculated. The data were expressed as (a) the mean of each site and (b) the mean of each tooth (the average of the 5 points of each tooth). Analysis of covariance failed to show a relationship between thickness measurements and gender or furcation involvement. Thus, the data was subjected to simple regression analysis to determine the relationship of age with tooth and cementum thickness. This study revealed that by site, the mean measurements ranged from 2.7-3.0 mm for both M1 and M2. The single least/greatest measurements of the 5 sites were for M1: 1.6/4.7 mm and for M2: 1.8/4.2 mm. By tooth, the average distance from the pulp to the root surface was 2.83 mm (+/- 0.49) for M1 and 2.88 mm (+/- 0.44) for M2. Regression analysis of tooth thickness with age was significant for M1 only. The maximum slope of the 5 sites was approximately 0.3 mm/10 years. No relationship was found between cementum thickness and age for either tooth group. The results of this study indicate that the majority of times the pulp is 1.6-4.2 mm from the root surface in the vicinity of the furcation entrance of lower 1st and 2nd molars. Although tooth thickness in this area may increase with age, the amount is not enough to forego judicious odontoplasty on older patients. PMID:8841893

To observe the histopathological changes following irradiation on the wound healing after tooth extraction in the rachitic rats. In order to carry out this study, the rats were divided into four groups: Group 1 (normal diet/non-irradiation group), Group 2 (normal diet/irradiation group), Group 3 (rachitogenic diet/non-irradiation group), and Group 4 (rachitogenic diet/irradiation group). Rachitic changes were induced with rachitogenic diet No. 2 (high calcium, low phosphorus, and Vitamin D deficient diet) for 5 weeks. After the extraction of both maxillary first molars of the rats in Group 2 and 4, the head and neck of the rats were irradiated with single absorbed dose of 10 Gy. The rats were sacrificed at the 1st, 5th, 10th, and 15th day after tooth extraction. The specimens including the extraction wound were sectioned, stained with the hematoxylin-eosin and Masson's trichrome method and examined under the light microscope. In the Group 2, the amount of newly formed bone trabeculae on the periphery of extraction socket and osteoblastic activity were reduced. In the Group 3, epithelial fusion was not revealed on the 5th day after toothe extraction and growth rate of osteoid formation was reduced. In the Group 4, necrotized tissue at the outer surface of extraction socket and destructive changes on the alveolar bones were noted on the 10th day. Epithelial fusion was not revealed and large amounts of osteoclast were noted on alveolar bone on the 15th day. The healing process of wound after tooth extraction was retarded by irradiation and especially in the rachitic rats.

A six-year-old male neutered Dachshund dog presented with generalized moderate gingivitis and calculus formation. A comprehensive oral examination performed under general anesthesia revealed infrabony pockets and horizontal bone loss associated with the left mandibular first and second molar teeth. The left mandibular second molar tooth was extracted, while the left mandibular first molar tooth was treated by staged periodontal therapy, including a modified distal wedge excision for open root planning and bone augmentation. Preoperative probing depths of 9-mm associated with the distal root of the left mandibular first molar tooth were reduced to 2-mm following treatment. The patient continued to maintain normal periodontal probing depths, with no gingival recession at 3, 6, 16, and 33-months following periodontal treatment. PMID:20469791

In this study, several in vivo and in vitro comparisons were performed to test the possibility of using adipose-derived stem cells (ADSCs), a more convenient cell source than dental pulp stem cells (DPSCs), in tooth regeneration. Using an efficient, non-engineering implantation method, we first demonstrated that both implants of ADSCs and DPSCs were able to grow self-assembled new teeth in adult rabbit extraction sockets with high success rate. The stem cells were necessary because the implants grew no tooth without them. A stepwise comparison showed that the regenerated teeth from these two types of adult stem cells were living with nerves and vascular system and remarkably similar to a normal tooth in many details. Further strictly controlled, side-by-side comparisons between the two typ...

IntroductionHistological studies of immature human permanent necrotic teeth with or without apical periodontitis after revascularization have not been reported. This case report describes the histological findings of tissue formed in the canal space of an immature permanent tooth #9 with irreversible pulpitis without apical periodontitis after revascularization. MethodsAn immature human permanent tooth #9 was fractured 3.5 weeks after revascularization and could not be retained. The tooth was extracted and prepared for routine histological and immunohistochemical evaluation in order to examine the nature of tissue formed in the root canal following the revascularization procedure. ResultsAt 3.5 weeks after revascularization, more than one half of the canal was filled with loose connective ...

This report presents a case of eruption guidance for an upper right central incisor with a dentigerous cyst associated with an impacted supernumerary tooth in a 5-year-9-month-old boy. A swelling was seen in the region of an upper right central incisor. Radiographic examinations showed that a well-defined cystic lesion, containing an impacted supernumerary tooth crown in it, was located between the root of the primary upper right central incisor and a permanent upper central incisor germ. Under general anesthesia, the dentigerous cyst was removed at extraction of the upper impacted supernumerary tooth. And then, a socket was kept open wound. A histopathological examination confirmed the diagnosis of a dentigerous cyst associated with a supernumerary tooth. By using an obturator, we guided eruption of an upper right central incisor with malposition that was caused by the dentigerous cyst, and observed the way of the tooth eruption for two years and seven months. The obturator was inserted in the socket directly for three months until it was closed. After that, the obturator was used as only a removable space maintainer. Eight months after the operation, the obturator was removed because the upper left central incisor began to erupt. Two years and seven months after the operation, both upper central and lateral incisors had erupted completely. In this case, the obturator was used for expectation of natural eruption of permanent incisors, space maintenance and aesthetic recovery. The permanent incisors had been able to be guided to almost correct position without traction.   

We used the Isolite system for treatment of dental caries identified in a submerged mandibular right primary second molar. A 5-year-6-month-old girl was referred to our clinic for close examination of an impacted mandibular right second primary molar. An intraoral examination showed a slight pit extending inside the gingiva and on the occlusal surface of the tooth. X-ray photographic examination revealed that the affected tooth was severely submerged and had a radiolucent area on the occlusal surface, which extended close to the pulp cavity. Most of the periodontal ligament space could not be clearly identified except for the distal side of the distal root. We considered that the area of the tooth was partially ankylosed and consulted with oral surgeons, who decided to postpone extraction, due to the presence of the permanent successor close to the affected tooth. Thus, we treated the dental caries, which appeared to be technically difficult because of the deep location of the tooth. The Isolite system was utilized in this case, as we considered that adjacent soft tissue and saliva could be excluded with its use. Under infiltration anesthesia, gingival tissue covering the occlusal surface was removed with an electric knife, and the carious lesion was removed, which resulted in pulp exposure. Severe inflammation of the pulp was revealed and pulpectomy was performed. There were no signs and symptoms after the treatment. At 1 year after treatment, the occlusal surface remained exposed and no inflammatory findings were observed in adjacent gingival tissue.   

BACKGROUND: A 16-years old female patient was referred to our observation in July 2006, 14 days after an accident, with traumatic intrusive luxation of the right upper central incisor that caused the nasal floor and buccal cortical bone fracture. While the extraoral examination showed the traumatic lesions of the upper lip, the intraoral examination revealed intrusive luxation, pain and high mobility of the tooth, and bleeding of the adjacent oral tissue. The treatment protocol consisted in surgical buccal bone removal, tooth extraction, retrograde root-canal filling, and tooth repositioning in occlusion with a resilient splinting. After 8 weeks the splinting was removed, and clinical and radiological examinations were taken 3, 6, 9, 12, and 24 months after surgery. At the 24 months follow-up the root showed no radiographic signs of inflammation, resorption or ankylosis, and the function of the replanted tooth was fully maintained. Tooth replantation can be considered an effective alternative to dental implant, when the latter is contraindicated in young patient with incomplete skeletal development. The long-term success of the procedure will likely require a multidisciplinary approach. PMID:21250776

This case report describes extraction of a fractured left maxillary lateral incisor tooth, followed by immediate placement of a dental implant in the prepared socket and temporization by a bonded restoration. The tooth was atraumatically extracted, the socket was prepared to the required depth and a Biohorizon Implant was inserted followed a week later by temporization by a bonded restoration. An impression was made 4 months after implant insertion, and a definitive restoration was placed. The atraumatic operating technique and the immediate insertion of the Implant resulted in the preservation of the hard and soft tissues at the extraction site. The patient exhibited no clinical or radiologic complications through 5 years of clinical monitoring. The dental implant and provisional restorat...

Particle embolization for epistaxis and intra-oral hemorrhage are performed on an as needed basis by neurointerventionalists. A case is presented of massive oral hemorrhage associated with end stage liver disease coagulopathy after tooth extraction of bilateral maxillary and mandibular molars. A man in his fifties with end stage liver disease who presented for evaluation of a syncopal episode was determined to be in hemorrhagic shock from 2 days of persistent oral bleeding after elective tooth extractions. Conservative management with multiple blood transfusion products, packing and vasoconstrictive spray was ineffective. Microcatheter angiograms of the alveolar arteries demonstrated blood and contrast pooling within the sockets of the extracted teeth. Selection of the bilateral supplying alveolar and inferior alveolar artery branches was achieved followed by polyvinyl alcohol particle embolization (250-355 ?m). Polyvinyl alcohol particle embolization of dental socket hemorrhages is technically feasible and effective. PMID:21990507

Objective. This preclinical pilot study evaluated the systemic, radiographic, and histological responses to bone putty containing lidocaine in a canine tooth extraction model. Methods. In five beagle dogs the right mandibular premolars were extracted and sockets grafted with (1) xenograft particulate bone and a collagen sponge plug (control), (2) bone putty alone, (3) bone putty mixed with xenograft (3?:?1), or (4) xenograft sandwiched between bone putty. At 6 weeks post-op, the systemic and local responses were evaluated using a blood chemistry panel, micro-CT, and histological analyses. Results. No significant differences in blood chemistries were noted at 6 weeks postgrafting compared to baseline. Sockets grafted with either bone putty formulation demonstrated comparable radiographic and histologic evidence of bone healing compared to control sockets. Conclusions. Our preclinical results indicate that this bone putty appears to be a safe biocompatible device that may be useful in the postoperative management of tooth extractions. PMID:11268363

Van der Weijden F, Dell'Acqua F, Slot DE. Alveolar bone dimensional changes of post-extraction sockets in humans :a systematic review. J Clin Periodontol 2009; 36: 1048-1058. doi: 10.1111/j.1600-051X.2009.01482.x. Abstract Objective: To review the literature to assess the amount of change in height and width of the residual ridge after tooth extraction. Material and Methods: MEDLINE-PubMed and the Cochrane Central register of controlled trials (CENTRAL) were searched through up to March 2009. Appropriate studies which data reported concerning the dimensional changes in alveolar height and width after tooth extraction were included. Approximal height change, mid-buccal change, mid-crestal change, mid-lingual change, Alveolar width change and socket fill were selected as outcome variables. M...

IntroductionThe present study was conducted with the aim to assess the extraction and retention incidence of endodontically treated teeth with an uncertain prognosis after endodontic referral and to evaluate the factors related to the decision-making process. MethodsTwo hundred seventy-five permanent teeth were clinically and radiographically evaluated by 3 experienced endodontists. The type of tooth, age and sex of the patients, the motive of referral, and the main chief complaint were the initial recorded data. The associations between extraction reasons and the patients' age and sex or tooth type were analyzed using the chi-square test. ResultsOf the 275 teeth examined, 217 (79%) were finally extracted. The remaining 58 (21%) teeth were endodontically retreated and restored. A questiona...

In certain clinical conditions when endodontic treatment is either impractical or unlikely to improve the previous results, tooth extraction and replacement with a dental implant becomes a viable alternative. Although the presence of active infection has long been considered a major contraindication to the insertion of implants immediately following tooth extraction, several articles assessing this treatment modality reported excellent and promising results. The aim of this literature review is to evaluate and discuss the clinical outcome of implants placed immediately following extraction in endodontically infected sockets. A Medline and EMBASE search was performed to identify articles published from 1966 to 2010 using the keywords "dental implants", "immediate implant", "extraction socket", "infected teeth", "infected site", "infected socket". No restrictions were placed regarding the study design. Only clinical articles with at least 6 months of follow-up were included. The available relevant literature concerning this topic was limited, and based on relatively low level of evidence study designs with limited follow-up periods. However, the data analysis of the selected articles showed that an immediate implant insertion in endodontically infected sites following tooth extraction and careful debridement of the socket, could be a predictable viable technique. Additional large scaled, well-designed studies are required in order to further assess the clinical applications of this treatment alternative. PMID:22471158

A case of supernumerary primary and permanent canines is presented. A 9Y4M-old boy was referred to our clinic for consultation regarding a maxillary supernumerary primary canine. An oral examination showed 2 primary canines with a similar morphology between the maxillary left lateral incisor and first primary molar. The primary canine in the opposite quadrant had the appearance of a fused-tooth, with composite resin restoration seen in the border. Orthopantomography revealed that permanent successors were present for each primary tooth in the maxillary left region, whereas only a single permanent canine was developing in the opposite quadrant. The 2 primary canines in the maxillary left region were extracted at 9Y4M. The mesially located permanent canine emerged into the oral cavity at 10Y1M and was extracted at 10Y9M. At 12Y2M, the other permanent canine located in the distal position had nearly reached the occlusal plane and the maxillary right permanent canine had arrived at the occlusal plane. Dental age was evaluated by assessing the tooth formation stages in 4 orthopantomographs taken between 8Y5M and 12Y2M, and found to be nearly the same as chronological age. However, the dental ages of the maxillary left permanent canine that had erupted earlier than the one located distally and of the left permanent canine were approximately 1 year behind chronological age. In addition, the dental age of the left permanent canine located distally was 2.5 years behind until the patient reached the age of 10Y9M, after which tooth development was accelerated following extraction of the mesially located permanent tooth.   

This study evaluated buccal bone maintenance after implantation with a surgical flap approach immediately following tooth extraction in a dog model. Mandibular premolars of six dogs were extracted, and threaded implants of 4-mm diameter and 8-mm length with as-machined and dual acid-etched surfaces were placed through balanced procedures in the distal root extraction sockets with a full-thickness flap design. Submerged healing was allowed for 4 weeks, and following euthanization, bone-to-implant contact and buccal and lingual bone loss were evaluated. None of the parameters evaluated were indicative of an effect of implant surface in hindering bone loss around immediately placed implants. PMID:22140672

Background and Purpose. Dry socket syndrome is one of the most irritating complications after tooth extraction. This study aims to investigate the efficacy of pastille GECB compared to ZOE. Materials and Methods. 30 patients with dry socket syndrome were selected and divided into two groups. GECB pastille was produced with 3% Guaiacol, 3% Eugenol 1.6% Chlorobutanol, sized 3 × 7 × 10?mm. GECB was applied in one group, and ZOE was used for the other group. Duration of pain after treatment and painkiller intake values were recorded within 20 days. The data were analyzed with independent samples t-test, Mann-Whitney, and Chi-Square tests. Results. Pain persisted for 45.53 ± 33.34 minutes in patients treated with ZOE and 19.87 ± 21.80 minutes in those treated with GECB (P = 0.19). Patients in the ZOE group reported more painkiller intake within 20 days (P = 0.031). Conclusion. GECB showed more significant efficacy in reducing complications after tooth extraction. PMID:11829653

Abstract Objective: The aim of this study was a radiographic mesiodistal analysis of the shape of the bone crest 3 months after tooth removal. Material and methods: One hundred single tooth extractions were performed on 100 patients because of orthodontic or prosthetic causes. Bite blocks were used for two radiographs: one on the day of extraction and the other after healing of the socket, 3 months later. These X-rays were used to determine: (1) the most apical distance of alveolar ridge resorption, with baseline as the line between bone-to-teeth contact (the greatest distance in bone resorption height) and (2) the mesiodistal distance (MDD) and mesial and distal angles arising after bone tissue modeling. Results: Significant differences (P<0.05) emerged between the MDDs of multiple- [8 mm...

This study evaluated non-submerged, root-analogue zirconia implants with two different surfaces for immediate single-rooted tooth replacement in 18 patients. After tooth extraction the root was laser scanned and one-piece root analogue zirconia dental implants with one of two different surfaces were manufactured. In group A (n=6) the implant surface was roughened by sandblasting only, in group B (n=12) additional macroretentions limited to the interdental space, to avoid fracture of the thin buccal cortex, were designed prior to laser scanning. Implants were placed in the socket 1-8 days after extraction by tapping and restored with a composite crown 3-5 months later. Implant survival, level of marginal bone and adverse soft tissue changes were recorded. No complications occurred during th...

Removal of an impacted superior third molar is usually a simple and uncomplicated procedure for an Oral and Maxillofacial Surgeon. Nevertheless, complications are possible and include infection, facial swallowing, trismus, wound dehiscence, root fracture or even orosinusal fistula. Iatrogenic displacement into the infratemporal fossa is frequently mentioned but rarely reported. This anatomical fossa includes several important structures such as the internal maxillary artery, the venous pterygoid plexus, the sphenopalatine nerve, the coronoid process of the mandible and the pterygoid muscles. Recommended treatment includes immediate surgical removal if possible or initial observation and secondary removal, as necessary, because of infection, limited mandibular movement, inability to extract the tooth, or the patient's psychological unease. Sometimes, the displaced tooth may spontaneously migrate inferiorly and becomes accessible intraorally. This report describes the location and secondary surgical removal of a left maxillary third molar displaced into the infratemporal fossa, two weeks after first attempt at extraction. PMID:20038889

Abstract Objectives: The aim of this randomized, controlled clinical trial was to compare the potential of a synthetic bone substitute or a bovine-derived xenograft combined with a collagen membrane to preserve the alveolar ridge dimensions following tooth extraction. Methods: Twenty-seven patients were randomized into two treatment groups following single tooth extraction in the incisor, canine and premolar area. In the test group, the alveolar socket was grafted with Straumann Bone Ceramic (SBC), while in the control group, Bio-Oss deproteinized bovine bone mineral (DBBM) was applied. In both groups, a collagen barrier was used to cover the grafting material. Complete soft tissue coverage of the barriers was not achieved. After 8 months, during re-entry procedures and before implant plac...

Procedures are reviewed of therapeutic and preventive care in patients with malignant tumours in the area of the head and neck during radiotherapy and during the subsequent follow-up of patients. As compared with previous views, the care is now more conservative, indications for tooth extractions are now limited, careful oral hygiene is emphasized and, in particular, the long-term use of fluorine gel is recommended. Surgery is only recommended where conservative treatment fails.

Non-carious cervical tooth lesions for many decades were attributed to the effects of abrasion and erosion mainly through toothbrush trauma, abrasive toothpaste, and erosive acids. However, though the above may be involved, more recently a biomechanical theory for the formation of these lesions has arisen, and the term abfraction was coined. The aim of this study was to investigate the biomechanics of abfraction lesions in upper canine teeth under axial and lateral loading conditions using a three-dimensional finite element analysis. An extracted human upper canine tooth was scanned by ?CT machine (Skyscan, Belgium). These ?CT scans were segmented, reconstructed, and meshed using ScanIP (Simpleware, Exeter, UK) to create a three-dimensional finite element model. A 100?N load was applied axially at the incisal edge and laterally at 45° midpalatally to the long axis of the canine tooth. Separately, 200?N axial and non-axial loads were applied simultaneously to the tooth. It was found that stresses were concentrated at the CEJ in all scenarios. Lateral loading produced maximum stresses greater than axial loading, and pulp tissues, however, experienced minimum levels of stresses. This study has contributed towards the understanding of the aetiology of non-carious cervical lesions which is a key in their clinical management. PMID:22919387

This study was undertaken to assess the effect of splint type on stresses occurring around traumatized tooth by photoelastic stress analysis. Three semi-rigid splint types--a wire-composite splint, fiberglass splint and titanium trauma splint--were utilized for comparisons. Extracted left upper central and lateral incisors and the canine tooth of an otherwise healthy patient were embedded equidistantly in photoelastic resin. For all cases studied, a static axial and 20 degrees oblique force of 100 N was applied on the lateral incisor in separate sessions. The experiments were undertaken without any splint application (unsplinted, control) after which the splints, adhesively bonded to the labial aspects of teeth, were consecutively tested. During each loading sequence, generation of isochromatic fringes was observed in the field of a polariscope, and photographed by a digital camera. Quantification of fringes was performed on magnified images, transferred to a PC. Under vertical loading, the highest stresses in the apical regions were observed for the unsplinted and ribbond-splint groups, whereas the lowest fringes occurred with the use of orthodontic wire as a splinting medium. Titanium trauma splint had absolutely no effect on reduction of stresses, as the fringe orders were slightly higher than the unsplinted lateral tooth. The use of orthodontic wire resulted in lowest fringe orders around the traumatized tooth. PMID:16643288

Electron paramagnetic resonance (EPR) dosimetry of human tooth enamel has been widely used in measuring radiation doses in various scenarios. However, there are situations that do not involve a human victim (e.g. tests for suspected environmental overexposures, measurements of doses to experimental animals in radiation biology research, or chronology of archaeological deposits). For such cases we have developed an EPR dosimetry technique making use of enamel of teeth extracted from mice. Tooth enamel from both previously irradiated and unirradiated mice was extracted and cleaned by processing in supersaturated KOH aqueous solution. Teeth from mice with no previous irradiation history exhibited a linear EPR response to the dose in the range from 0.8 to 5.5 Gy. The EPR dose reconstruction for a preliminarily irradiated batch resulted in the radiation dose of (1.4{+-}0.2) Gy, which was in a good agreement with the estimated exposure of the teeth. The sensitivity of the EPR response of mouse enamel to gamma radiation was found to be half of that of human tooth enamel. The dosimetric EPR signal of mouse enamel is stable up at least to 42 days after exposure to radiation. Dose reconstruction was only possible with the enamel extracted from molars and premolars and could not be performed with incisors. Electron micrographs showed structural variations in the incisor enamel, possibly explaining the large interfering signal in the non-molar teeth.

Context The question that clinicians face is whether the use of bone replacement grafts and/or barrier membranes enhance their ability to provide for the future placement of a dental implant or to maximize ridge dimensions following the extraction of a tooth versus no additional treatments. Evidence Acquisition The evidence was obtained by search of Entrez PubMed and manual search of The International Journal of Oral and Maxillofacial Implants, The International Journal of Periodontics & Restorative Dentistry, Clinical Oral Implant Research, The Journal of Periodontology, The Journal of Clinical Periodontology, and The Compendium of Continuing Education in Dentistry. Key search words included Guided Bone Regeneration, Dental Extraction, Tooth Extraction, Bone Replacement Graft, Alveolar Ridge. The years of search included from January 2011 through February 2012. Evidence Synthesis The recurring theme was that there was considerable heterogeneity to study designs, time periods, and methods of evaluation. This created great difficulty in trying to answer with good high-quality evidence questions about the techniques and materials to be used for maximizing regeneration at the time of tooth extraction or in which situations this ought to be used. Conclusions There appears to be consensus from the reviewed literature supporting ridge preservation techniques as a whole. Multiple studies demonstrated less ridge resorption occurring when alveolar ridge preservation procedures were used versus the placement of no graft material in fresh alveolar sockets. The analysis did not show any grafting materials demonstrating a clear benefit over any others or that a barrier membrane is necessary. The evidence is also too premature about whether socket preservation efforts require primary closure. In the emerging area of growth factors, there is no high-quality evidence to either support or refute their use. Background Tooth extraction is one of the most widely performed procedures in dentistry today and it has been historically well documented that this procedure may induce significant dimensional changes of the alveolar ridge. The dilemma that clinicians face is how to manage tooth extractions to provide for the future placement of a dental implant or to maximize ridge dimensions for the fabrication of a fixed or removable prosthesis. If performed inadequately, the resulting deformity can be a considerable obstacle to the esthetic, phonetic, and functional results that both our patients and we clinicians expect at this current time. PMID:23040345

In an attempt to make the in vitro electron spin resonance (ESR) retrospective dosimetry of the tooth enamel a lesser invasive method, experiments using X-Band and K-Band were performed, aiming to determine conditions that could be used in cases of accidental exposures. First, a small prism from the enamel was removed and ground with an agate mortar and pestle until particles reach a diameter of approximately less than 0.5 mm. This enamel extraction process resulted in lower signal artifact compared with the direct enamel extraction performed with a diamond burr abrasion. The manual grinding of the enamel does not lead to any induced ESR signal artifact, whereas the use of a diamond burr at low speed produces a signal artifact equivalent to the dosimetric signal induced by a dose of 500 mGy of gamma irradiation. A mass of 25 mg of enamel was removed from a sound molar tooth previously irradiated in vitro with a dose of 100 mGy. This amount of enamel was enough to detect the dosimetric signal in a standard X-Band spectrometer. However using a K-Band spectrometer, samples mass between 5 and 10 mg were sufficient to obtain the same sensitivity. An overall evaluation of the uncertainties involved in the process in this and other dosimetric assessments performed at our laboratory indicates that it is possible at K-Band to estimate a 100 mGy dose with 25% accuracy. In addition, the use of K-Band also presented higher sensitivity and allowed the use of smaller sample mass in comparison with X-Band. Finally, the restoration process performed on a tooth after extraction of the 25 mg of enamel is described. This was conducted by dental treatment using photopolymerizable resin which enabled complete recovery of the tooth from the functional and aesthetic viewpoint showing that this procedure can be minimally invasive.

Purpose: The objective of this review was to systematically screen the literature for data related to the survival and complication rates observed with dental or implant double crown abutments and removable prostheses under functional loading for at least 3 years. Materials and Methods: A systematic review of the dental literature from January 1966 to December 2009 was performed in electronic databases (PubMed and Embase) as well as by an extensive hand search to investigate the clinical outcomes of double crown reconstructions. Results: From the total of 2412 titles retrieved from the search, 65 were selected for full-text review. Subsequently, 17 papers were included for data extraction. An estimation of the cumulative survival and complication rates was not feasible due to the lack of detailed information. Tooth survival rates for telescopic abutment teeth ranged from 82.5% to 96.5% after an observation period of 3.4 to 6 years, and for tooth-supported double crown retained dentures from 66.7% to 98.6% after an observation period of 6 to 10 years. The survival rates of implants were between 97.9% and 100% and for telescopic-retained removable dental prostheses with two mandibular implants, 100% after 3.0 and 10.4 years. The major biological complications affecting the tooth abutments were gingival inflammation, periodontal disease, and caries. The most frequent technical complications were loss of cementation and loss of facings. Conclusions: The main findings of this review are: (I) double crown tooth abutments and dentures demonstrated a wide range of survival rates. (II) Implant-supported mandibular overdentures demonstrated a favorable long-term prognosis. (III) A greater need for prosthetic maintenance is required for both tooth-supported and implant-supported reconstructions. (IV) Future areas of research would involve designing appropriate longitudinal studies for comparisons of survival and complication rates of different reconstruction designs. PMID:22947104

PURPOSE Many dentists use desensitizing agents to prevent hypersensitivity. This study compared and evaluated the effect of two desensitizing agents on the retention of cast crowns when cemented with various luting agents. MATERIALS AND METHODS Ninety freshly extracted human molars were prepared with flat occlusal surface, 6 degree taper and approximately 4 mm axial length. The prepared specimens were divided into 3 groups and each group is further divided into 3 subgroups. Desensitizing agents used were GC Tooth Mousse and GLUMA® desensitizer. Cementing agents used were zinc phosphate, glass ionomer and resin modified glass ionomer cement. Individual crowns with loop were made from base metal alloy. Desensitizing agents were applied before cementation of crowns except for control group. Under tensional force the crowns were removed using an automated universal testing machine. Statistical analysis included one-way ANOVA followed by Turkey-Kramer post hoc test at a preset alpha of 0.05. RESULTS Resin modified glass ionomer cement exhibited the highest retentive strength and all dentin treatments resulted in significantly different retentive values (In Kg.): GLUMA (49.02 ± 3.32) > Control (48.61 ± 3.54) > Tooth mousse (48.34 ± 2.94). Retentive strength for glass ionomer cement were GLUMA (41.14 ± 2.42) > Tooth mousse (40.32 ± 3.89) > Control (39.09 ± 2.80). For zinc phosphate cement the retentive strength were lowest GLUMA (27.92 ± 3.20) > Control (27.69 ± 3.39) > Tooth mousse (25.27 ± 4.60). CONCLUSION The use of GLUMA® desensitizer has no effect on crown retention. GC Tooth Mousse does not affect the retentive ability of glass ionomer and resin modified glass ionomer cement, but it decreases the retentive ability of zinc phosphate cement. PMID:17589454

In experiments on pigs, bone regeneration was studied after implantation of implants with four cylindrical roots and support cone and laminar crest-shaped implants with shape memory effect. The implants were placed to the extraction socket (mandibular canine) and through the socket immediately after tooth extraction using osteoplastic material or without using collapan-L. The use of collapan-L accelerated regeneration of peri-implant tissue and provided stable fixation of dental construct in the bone over 3?months after surgery, which can be relevant for determining timing of prosthodontic therapy and constructional features of prosthesis.

Abstract Immediate implant placement into extraction sockets has been widely reported in the dental literature, but few studies have evaluated the immediate loading of such implants. In this retrospective study, we evaluated 235 implants placed into fresh extraction sites utilizing a flapless technique, followed by immediate provisionalization with non-functional single-tooth restorations, and definitive restoration within 2 weeks. Cumulative survival and success rates were 98.8% (mean follow-up = 23.1 months). Periodontitis did not adversely influence the outcome. Within the limitations of this study, immediate implant placement and restoration followed by definitive loading within 2 weeks achieved outcomes comparable to those historically reported for delayed implants. PMID:21905899

Purpose To assess risk factors for alveolar osteitis. Materials and Methods A prospective nested case-control study was conducted in an urban community dental clinic in Valdivia, Chile. A cohort of 1,355 patients who underwent dental extractions was included. Eight predictor variables (risk factors), namely patient gender, hygiene, tooth location, previous surgical site infection, traumatic extraction, systemic diseases, alcohol consumption, and tobacco use, were considered in a risk factor model. A binary regression logistic analysis was performed to determine significant associations. Results In total 1,302 participants completed the follow-up. Eighty incident case patients with alveolar osteitis and 80 matched control patients were included. A statistically significant association was f...

This study evaluated the early hemostatic effects of a novel hemostatic agent (Ankaferd blood stopper [ABS]) during dental extractions in patients on antithrombotic therapy, without interruption or diminution of the medication. In total, 25 patients, who are on antithrombotic therapy and in need of simple dental extractions, were randomized into 2 groups. In group I (control group), which consisted of 10 patients, local hemostasis was achieved with direct packing with gauze. In group II, which consisted of 15 patients, local hemostasis was achieved by the local application of ABS on the extraction sockets. The bleeding time was compared between 2 groups following the tooth extraction. The bleeding time in the dental sockets treated with ABS was statistically lower compared to the sockets of the control group (p = 0.0001). It is concluded that the dental extractions could be performed without interruption of the medication in patients on antithrombotic therapy. The ABS appears to be sufficient as an alternative hemostatic agent. PMID:22327817

Objective: To compare the shapes of roots of impacted teeth shown in three-dimensional computed tomographic images (3D Dental-computed tomography (CT) images) and plain radiographs and to determine whether 3D Dental-CT images are useful for examination before performing an operation for extraction of a maxillary impacted tooth. Methods and patients: Images obtained from patients who had impacted teeth in the maxilla, including impacted mesial supernumerary teeth in 13 patients, impacted incisors in two patients, impacted canines in 11 patients, impacted premolars in four patients and impacted molars in three patients, were used in this study. In all patients, plain radiographs and 3D Dental-CT images were retrospectively reviewed by an oral radiologist for evidence of root dilaceration before operations to extract the impacted teeth were performed. The findings in the images were compared with intraoperative findings in all cases. Results: The mean specificity and sensitivity of plain radiographs were 95 and 8%, respectively, while those of 3D Dental-CT images were 100 and 77%, respectively. There was a statistically significant (P<0.01) difference between the depiction capabilities of plain radiographs and 3D Dental-CT images with regard to dilacerations of roots of impacted teeth. Discussion and conclusion: CT may enable radiologists to make a quick and accurate diagnosis of tooth impaction. 3D Dental-CT images are useful for determining the root shape of an impacted tooth in the maxilla.

AIM: To evaluate the influence of the presence or absence of adjacent teeth on the level of the mesial and distal alveolar bony crest following healing at sites where implants were installed immediately into extraction sockets. MATERIAL AND METHODS: Six Labrador dogs were used. In the right side of the mandible, full-thickness flaps were elevated, and the second, third, and fourth premolars and first molars were extracted. In the left side of the mandible, endodontic treatments of the mesial roots of the third and fourth premolars as well as of the first molars were performed. Full-thickness flaps were elevated, the teeth were hemi-sected, and the distal roots were removed. The second premolars were extracted as well. Subsequently, implants were bilaterally installed with the implant shoulder flush with the buccal bony crest. Implants were placed in the center of the alveoli, but at the fourth premolars, they were placed toward the lingual bony plate of the alveoli. After 3 months of healing, the animals were euthanized and histological sections of the sites prepared. RESULTS: Larger bony crest resorption was observed at the test compared with the control sites, both at the bucco-lingual and mesio-distal aspects. The differences between test and controls for the coronal level of osseointegration were smaller than those for resorption. When data from all mesial and distal sites facing an adjacent tooth were collapsed and compared with those opposing an edentulous zone, lower bony crest resorption and deeper residual marginal defects were found at the sites with neighboring teeth. CONCLUSION: The extraction of teeth adjacent to a socket into which implants were installed immediately after tooth extraction caused more alveolar bone resorption both for the bucco-lingual and at the mesio-distal aspects compared with sites adjacent to a maintained tooth. PMID:22909080

The potential for EPR dosimetry using walrus tooth cementum was examined. Using standard peak to peak methods, individual measurement errors of the dosimetric signal (g = 2.0018) were approximately 350 mGy (1 SD). Linearity of the dose response extended up to 6 kGy for large intact specimens. The dentin was found to have a larger g = 2.005 signal than the cementum and so was not investigated for linearity or sensitivity due to its expected higher organic content. A complex native signal was seen in all samples. A heat induced signal similar to that occurring in human tooth enamel was also observed. The signal was detectable at temperatures as low as 70 deg. C. Deorganification with diethylenetriamine using the Soxhlet extraction procedure decreased the initial dosimetric signal by a factor of 10. (author)

Abstract - In cases of an immediate insertion and loading of implants after a traumatic loss of the patient's own dentition or due to an inevitable extraction of an anterior tooth, it is essential to provide the patient with an adequate provisional crown. A soft-tissue recession must be avoided, whether it is due to a compression of the peri-implant soft-tissue caused by an over-dimensioned restoration in the cervical collar of the provisional crown or to a too small dimensioned sulcus former. A simulation of the exact dimension of the lost tooth - especially on the cervical part of the new provisional restoration - is expected to preserve all relevant information and allows the design of a naturally looking emergence profile. Based on theoretical considerations and a case report, the auth...

The aim of this study was to develop a three-dimensional (3D) finite element (FE) model of a sound extracted human second premolar from micro-CT data using commercially available software tools. A detailed 3D FE model of the tooth could be constructed and was experimentally validated by comparing strains calculated in the FE model with strain gauge measurement of the tooth under loading. The regression coefficient and its standard error in the regression analysis between strains calculated by the FE model and measured with strain gauge measurement were 0.82 and 0.06, respectively, and the correlation coefficient was found to be highly significant. These results suggested that an FE model reconstructed from micro-CT data could be used as a valid model to estimate the actual strains with acceptable accuracy.   

Objective: Transient receptor potential (TRP) channels, a family of structurally related proteins have been implicated in the sensation of pain and hyperalgesia caused by exogenous and endogenous agonists, as well as touch, pH, and temperature. The objective of this study was to determine the effects of tooth injury on the expression of the cold sensitive channel TRPA1, in the trigeminal ganglion, the primary source of sensory and nociceptive innervation of teeth. Design: We analyzed TRPA1 expression in a rodent model of tooth injury, by Western blot analyses of proteins extracted from trigeminal ganglia. Results: We found that TRPA1 was selectively increased in trigeminal ganglia innervating injured teeth when compared to TRPA1 expression in trigeminal ganglia innervating healthy teeth. C...

Abstract Background:- This study aimed to investigate the effect of silver and fluoride ions on demineralization of enamel. Methods:- The coronal parts of 40 extracted sound premolars were prepared into tooth blocks. An unvarnished occlusal surface window (OW) and a flat buccal/lingual surface window (FW) were created for each tooth by covering all other surfaces with an acid-resistant varnish. These blocks were randomly allocated into four groups of 10 blocks each and immersed in respective solutions for 5-minutes: Group 1 - 2.36-M silver fluoride; Group 2 - 2.36-M potassium fluoride; Group 3 - 2.36-M silver nitrate; and Group 4 - deionized water. After 7-day immersion in a buffered demineralization solution at pH 4.4, micro-CT scans were taken. Results:- Mean lesion depth in the FW area ...

Abstract Background and Aim: Various methods have been used to remove self expandable stents (SES) because of either malposition or migration. The main difficulties encountered in such situations are the anatomic obstacle of the lower and upper esophageal sphincters as well as risk of mucosal injury during removal. Methods: We describe a modified approach using an esophagogastroduodenoscope (EGD) in combination with a foreign body hood protector, rat tooth forceps and snare allowing for successful SES removal from the upper gastrointestinal tract in four cases. Results: In all cases, the SES were successfully removed from upper gastrointestinal tract using this technique. No complications were noted after extraction. Conclusion: The foreign body hood protector combined with rat tooth force...

IntroductionOur objective was to analyze patterns of tooth movement and changes of arch dimension by superimposing 3-dimensional (3D) virtual models. MethodsThe sample consisted of 24 Korean adults with Class I malocclusion and minimal crowding, treated by first premolar extractions, sliding mechanics (0.022-in MBT brackets [3M Unitek, Monrovia, Calif] with 0.019 x 0.025-in stainless steel wire) and moderate anchorage. The 3D virtual maxillary casts at pretreatment and posttreatment were superimposed with the best-fit method. Linear and angular variables were measured with 3Txer program (Orapix, Seoul, Korea). Wilcoxon signed rank and Mann-Whitney tests were used for statistical analysis. ResultsThere was no significant difference in the individual tooth movement between the right and left...

Accurate assessments of doses received by individuals exposed to radiation from nuclear accidents and incidents such as those at Hiroshima and Nagasaki, the Nevada test site, Cheliabinsk and Mayak are required for epidemiological studies seeking to establish relationships between radiation dose and health effects. One method of retrospective dosimetry which allows for measurement of cumulative gamma ray doses received by exposed individuals is electron paramagnetic resonance spectroscopy (EPR) of tooth enamel. Tooth enamel stores and retains, indefinitely, information on absorbed radiation dose. And teeth are available in every population as a result of dental extraction for medical reasons including periodontal disease and impacted wisdom teeth. In the case of children, deciduous teeth, which are shed between the ages of 7 and 13, can be a very important dosimetric source if documented collection is implemented shortly following an accident.

A dentigerous cyst is the most common developmental odontogenic cyst. It is a benign and asymptomatic intraosseous lesion that affects the bones of the maxillofacial complex, interfering with tooth eruption. This article reports the spontaneous eruption of a canine after marsupialization of an infected dentigerous cyst and extraction of the deciduous teeth. A radiograph showed a large cyst with a radiolucent area involving the mandibular left deciduous canine and first molar, and the permanent canine and first premolar. Although enucleation is the treatment of choice, marsupialization is the best option for large cysts involving an unerupted permanent tooth, as in this case. The patient was followed for 1 year, and eruption of the permanent canine and first premolar and gradual reduction o...

Abstract Objective: The aim of this study was to investigate the effect of Nd:YAG and argon laser irradiations on enamel demineralization after two different models to induce artificial caries. Background data: It is believed that the use of the high-intensity laser on the dental structure can lead to a more acid-resistant surface. Materials and methods: Twenty-one extracted human third molars were sectioned into tooth quarters. The quarters were distributed in three groups: Group I (control), untreated; Group II, Nd:YAG laser (60?mJ, 15?pps, 47.77?J/cm2, 30?sec); and Group III, argon laser (250?mW, 12?J/cm2, 48?sec). Tooth quarters from each group were subjected to two different demineralization models: cycle 1, a 14 day demineralization (pH 4.5; 6?h) and remineralization (pH 7.0; 18?h) s...

OBJECTIVES: To evaluate, using meta-analysis methodology, mesiodistal tooth dimensions in non-syndromic unilateral cleft lip and palate (CLP) patients. MATERIALS AND METHODS: A literature search was conducted using PubMed, Medline, Google Scholar Beta, EMBASE Excerpta Medica, CINAHL, Web of Science, and the Cochrane Collaboration, identifying English and non-English articles reporting on mesiodistal tooth dimensions on the cleft and non-cleft side of non-syndromic unilateral CLP patients. Additional studies were identified by searching reference lists of articles consulted. Only studies with a suitable control group were included. Two examiners independently performed the literature search and data extraction. Using meta-analysis software, data extracted from each selected study were statistically combined using the fixed-effects model. Weighted mean differences, 95 % confidence intervals, and heterogeneity were calculated for each measurement. RESULTS: Four articles fulfilling the inclusion criteria were located and included in the meta-analysis. Maxillary incisors and first molars were found to be significantly larger on the non-cleft side while mandibular incisors and premolars were larger on the cleft side, in non-syndromic unilateral CLP patients. On the cleft side, maxillary premolars and second molars were larger in cleft than control patients while incisors were smaller, whereas all mandibular teeth were larger in cleft patients. On the non-cleft side, all maxillary teeth except for the central incisors were larger in the cleft than control patients, while all mandibular teeth were larger in the cleft patients except for lateral incisors. CONCLUSIONS: Non-syndromic unilateral CLP patients tend to have larger posterior but smaller anterior teeth compared with the general population. Comparing sides, unilateral CLP patients tend to have smaller maxillary but larger mandibular teeth on the cleft than on the non-cleft side. CLINICAL RELEVANCE: Given that obtaining a stable, functional, and esthetic occlusion requires a thorough evaluation of tooth size, knowledge about trends in tooth size variations in CLP patients can help with dental and orthodontic treatment planning. PMID:23011523

...recovery purposes to collect flower buds for chromosome counts from Arizona...spider (Neoleptoneta microps), Tooth Cave spider (Neoleptoneta myopica), Tooth Cave pseudoscorpion (Tartarocreagris...beetle (Texamaurops reddelli), Tooth Cave ground beetle...

Abstract Background: Animal and human researches have shown that immediate implant placement into extraction sockets failed to prevent socket dimensional changes following tooth extraction. It has been suggested that a minimal width of 1-2 mm of buccal bone is necessary to maintain a stable vertical dimension of the alveolar crest. Aim: To determine the dimensions of the bony wall at extraction sites in the esthetic zone (anterior teeth and premolars in the maxilla) and relate it to immediate implant placement. Methods: As part of an ongoing prospective randomized-controlled multicenter clinical study on immediate implant placement, the width of the buccal and palatal bony walls was recorded at 93 extraction sites. Results: The mean width of the buccal and palatal bony walls was 1 and 1.2 ...

Chlorhexidine is broadly prescribed by clinicians for treating extraction socket wounds; however, studies have reported adverse effects for chlorhexidine. Persica, a herbal antibacterial agent, could be an alternative for chlorhexidine. The aim of this randomised controlled trial was to investigate the effects of persica and chlorhexidine on alveolar bone healing following tooth extraction in rats. Eighteen Wistar rats were randomly allocated to three study groups: 0.2% chlorhexidine, 10% persica and controls (tap water). The rats were mouth-rinsed for 14?days. On day?8, the mandibular right first molars of all the rats were extracted. On day?21, the rats were euthanized and histological slides of their extraction sockets were prepared. The amount of new bone formation and the number of in...

Because clinicians are placing more dental implants, it is becoming more important to maintain bone volume after tooth extraction. This article discusses the various bone-augmentation materials available to the clinician and illustrates a case report of particulate mineralized bone allograft (Puros) placement after extraction. Exposure of the grafted site after 5 months revealed a hard bony structure. Human histologic analysis at the light microscopic level revealed nonvital spicules of mature calcified bone having a highly organized matrix surrounded by viable noncalcified immature bone matrix, or osteoid. It was concluded that mineralized human allograft demonstrated the formation or remodeling of bone histologically and was clinically useful to maintain bone volume for implant placement after extraction. To the authors' knowledge, this is the first publication to demonstrate human histology of particulate mineralized bone allograft (Puros) after placement into an extraction site. PMID:15119456

Aims and objectives: To compare the success rate of implant placed immediately in extraction socket vs implant placed delayed in extraction socket. Materials and Methods: The study comprised of 8 patients (6 male and 2 female, aged from 14 to 58 year) for evaluation of implant placement immediately (i.e. Group – A) or delayed (i.e. Group – B) into extraction site, in which at 12 sites implants were placed. Results: The inclusion criteria for implantation was tooth/teeth with one or two degree mobility, root stumps, tooth with failure root canal treatment and extraction sockets. HI-TEC TRX-OP (Life Care) with abutment, non-submerged, tapered at apical 5 mm, sand-blasted & acid etched surfaced implants were used. These are one stage single implants made of commercially pure titanium. The length of implants used was 10 mm and 13 mm and diameter was 3.70 mm and 4.50 mm. The vertical bone dimension was determined by palpation and radiograph (intra-oral periapical, orthopantomograph and dentascan in some patients). Gingival condition, bone condition was examined clinically and radiographically. Discussion: Post-operative evaluation was done under clinical parameters (i.e. Pain (VAS), Swelling, Stability (By Glickman method), Gingival status, Probing depth (By Williams Periodontal probe), Patient's compliance / satisfaction, Complications (If any) and Radiological parameters was (Intra-oral periapical radiograph, orthopantomograph, Dentascan). Conclusion: Overall conclusion drawn from this study was that both the groups are showing similar results but Group-A is slightly better than Group-B PMID:19157915

Proteolytic activity of viscera extract from hybrid catfish (Clarias macrocephalus×Clarias gariepinus) was studied. The optimal pH and temperature were 9.0 and 50°C, respectively, when toothed ponyfish (Gazza minuta) muscle was used as a substrate. When viscera extract from hybrid catfish was used for the production of protein hydrolysate from toothed ponyfish muscle, extract concentration, reaction time, and fish muscle/buffer ratio affected the hydrolysis and nitrogen recovery (NR) (pmuscle hydrolysis were 3.5% hybrid catfish viscera extract, 15min reaction time and fish muscle/buffer ratio of 1:3 (w/v). High correlation between the degree of hydrolysis (DH) and NR (R(2)=0.974) was observed. Freeze-dried hydrolysate had a high protein content (89.02%, dry weight basis) and it was brownish yellow in colour (L(?)=63.67, a(?)=6.33, b(?)=22.41). The protein hydrolysate contained a high amount of essential amino acids (48.22%) and had arginine and lysine as the dominant amino acids. PMID:23122156

Phantom Tooth Pain (Atypical Odontalgia) PDF Version: ( English / Spanish / Japanese ) Atypical odontalgia, also known as atypical facial pain or phantom tooth pain, is characterized by chronic pain in ...

The aim of the present study was to examine the prevalence rate and treatment outcome of maxillary canine transposition in Japanese children according to the conventional standard and our new additional consideration of the classification. From 140 cases with ectopic canines diagnosed in the Pediatric Dental Clinic of Niigata University Medical and Dental Hospital, we selected 10 transposition cases as the present subjects. Out of 10 cases, 4 were males and 6 females. Six were classified into type A: the mesio-distal positional interchange of the canine and the first premolar, 2 cases into type B: the mesio-distal transposition of the canine and the lateral incisor, and the other 2 cases into type C: the present new classification that showed the vertical transposition of the canine and the first premolar within the developmental bone. The prevalence rate of types A and B resembled the previous papers regarding the ratio of sex and bilateral occurrence. Although 3 cases in type A, one case in type B and one case in type C could finally be aligned in the normal tooth order, every one of the types A and B cases were aligned in the reverse order. For every one case in types A and C, the transposed canines were extracted. It is recommended that pediatric dentists take an orthopantomogram during early mixed dentition as a routine practice in order to detect anomalies of tooth eruption, such as tooth transposition, as early as possible.   

Abstract in portuguese Este artigo descreve dois casos clínicos de reconstrução de molares decíduos com extensa destruição coronária por meio de restaurações biológicas, em crianças de 4 e 5 anos. Após avaliação clínica e radiográfica, os fragmentos dentais heterógenos foram submetidos à colagem ao remanescente dental preparado usando sistema adesivo (Caso 1) ou cimento resinoso de presa dual (Caso 2) sobre uma camada de hidróxido de cálcio e uma base de ionômero de vidro. (more) Foi realizado ajuste oclusal e aplicação tópica de flúor sobre a superfície dentária. Controles clínico e radiográfico foram realizados periodicamente e os dentes restaurados foram acompanhados por 4 e 3 anos respectivamente, até a exfoliação. Por meio destes dois relatos, os autores discutem os aspectos técnicos, além das vantagens e desvantagens das restaurações biológicas como tratamento alternativo para restauração de molares decíduos. Abstract in english This article reports the cases of two young children aged 4 and 5 years, in whom biological restorations using tooth fragments were placed in primary molars with severely damaged crowns due to extensive carious lesions. After radiographic and clinical evaluation, tooth fragments obtained from extracted teeth in stock were autoclaved, adjusted to the prepared cavity and bonded to the remaining tooth structure with either adhesive system (Case 1) or dual-cure resin-based ce (more) ment (Case 2) over a calcium hydroxide layer and a glass ionomer cement base. Occlusal adjustment was performed and topical sodium fluoride was applied to tooth surface. Periodical clinical and radiographic controls were carried out and the restored teeth were followed up for 4 and 3 years, respectively, until exfoliation. In these two reports, the technical aspects are described and the benefits and disadvantages of biological restorations as an alternative treatment for rehabilitation of severely destroyed primary molars are discussed.

Transplantation experiments are a common method in tooth developmental research. Many organs have been previously selected as hosts ; however, there is little information comparing developmental differences in the transplanted tooth among these host organs. In the present study, the authors examined the effect of transplantation into the subcutaneous tissue and the kidney capsule for 4 weeks using E13.5 mandibular first molar tooth germs from mice. The shape and size of the tooth crown of the tooth transplanted into the subcutaneous tissue are smaller than those of the tooth transplanted into the kidney capsule and a normal tooth in vivo. However, the number and arrangement of cusps of the transplanted tooth were similar to those of a normal tooth. Compared with those of the tooth transplanted into the kidney capsule, development and calcification of the transplanted tooth progressed slowly in the subcutaneous tissue. These differences may cause movement of the transplanted tooth ; the subcutaneous tissue is composed of loose connective tissue and the transplanted tooth moves easily in the subcutaneous tissue, although the tooth transplanted into the kidney capsule is maintained tightly between the kidney capsule and kidney cortex. However, cell differentiation and cell function were not affected by movement of the tooth germ ; enamel and dentin were formed in the transplanted tooth in both the subcutaneous tissue and the kidney capsule. These findings suggest that development of the transplanted tooth may be affected by the host organ.   

Dental cementum is a vital tissue that demonstrates continuous apposition throughout the life of a tooth. This study was conducted on 130 impacted mandibular third molars extracted from healthy patients, aged between 18 and 38 years. The buccolingual ground sections were prepared and the distance between the edges of enamel and cementum were measured with micrometer attached to a light microscope. A significant correlation (r=0.56) between age and coronal displacement of cementum in impacted teeth was calculated and a regression equation was derived for age determination.

Data sourcesA Medline search and handsearching of the following journals were carried out: International Journal of Periodontics and Restorative Dentistry, Journal of Clinical Periodontology, Journal of Periodontal Research and Journal of Periodontology as well as reference lists of publications selected.Study selectionTo be eligible for inclusion in this review, studies had to be longitudinal in nature. Prospective and retrospective cohort studies were considered. Studies were screened and quality assessed independently by two reviewers. Review articles, case reports and studies of fewer than 5-years' duration were excluded, as were those not providing information on tooth survival or furcation involvement.Data extraction and synthesisData was abstracted independently by two reviewers. Ow...

An integrated arrayed-waveguide grating fabricated in silicon-oxynitride technology is applied to Raman spectroscopy. After its validation by reproducing the well-known spectrum of cyclohexane, polarized Raman spectra are measured of extracted human teeth containing localized initial carious lesions. Excellent agreement is obtained between the spectra of healthy and carious tooth enamel measured with our integrated device and spectra recorded using a conventional Raman spectrometer. Our results represent a step toward the realization of compact, hand-held, integrated spectrometers, e.g. for the detection of dental caries at an early stage. PMID:22139265

Following tooth extraction, the alveolar ridge undergoes an inevitable remodeling process that influences implant therapy of the edentulous area. Socket grafting is a commonly adopted therapy for the preservation of alveolar bone structures in combination or not with immediate implant placement although the biological bases lying behind this treatment modality are not fully understood and often misinterpreted. This review is intended to clarify the literature support to socket grafting in order to provide practitioners with valid tools to make a conscious decision of when and why to recommend this therapy. PMID:17260521

Displacement of a root into the maxillary sinus is an infrequent consequence of extraction of upper molar teeth. Conventional treatment is centred around surgical access through the tooth socket or via the Caldwell-Luc technique. This case illustrates the use of a minimally invasive method for retrieval of a dislodged root fragment with Functional Endoscopic Sinus Surgery (FESS). This technique is normally reserved for treatment of chronic sinusitis and is shown in this case report to be successful and less traumatic for the patient. It also emphasises the necessity to treat each case on its own merit and base treatment options around the clinical scenario

Summary This paper reports the management of two clinical cases, in which the upper right central incisor was fused with a supernumerary tooth and the upper left central incisor was macrodontic. A radiographic examination revealed that the fused teeth had two separate roots. Hemisectioning of the fused teeth was performed, the supernumerary portion was extracted and the remaining part was reshaped to remove any sharp margins and to achieve a normal morphology. The macrodontic central incisors were not treated. At 12-months post-surgery there were no periodontal problems and no hypersensitivity. Orthodontic treatment was performed to appropriately align the maxillary teeth and to correct the malocclusion. PMID:22351919

Dentigerous cysts are benign odontogenic cysts that develop from the reduced enamel epithelium related to the crown of an unerupted and/or impacted tooth. Inflammatory dentigerous cyst is a variety of dentigerous cyst that is mostly found in the mixed dentition, and the treatment modalities range from enucleation to marsupialization. By extracting the infected primary teeth, opening the cyst, and ensuring continuous drainage, spontaneous eruption of the involved permanent teeth occurs into the dental arch even if they are severely dislocated. The purpose of this report is to describe the successful treatment of a large dentigerous cyst by conservative surgical management. PMID:22919949

The adhesion of early settlers of dental plaque to the tooth surface has a role in the initiation of the development of dental plaque. The hydrophobic surface properties of the bacteria cell wall are indirectly responsible for the adhesion of the bacteria cell to the acquired pellicle on the tooth surfaces. In this study, the effect of aqueous extract of two plants (Psidium guajava and Piper betle) on the cell-surface hydro-phobicity of early settlers of dental plaque was determined in vitro. Hexadecane, a hydrocarbon was used to represent the hydrophobic surface of the teeth in the oral cavity. It was found that treatment of the early plaque settlers with 1 mg/ml extract of Psidium guajava reduced the cell-surface hydrophobicity of Strep. sanguinis, Strep. mitis and Actinomyces sp. by 54.1%, 49.9% and 40.6%, respectively. Treatment of these bacteria with the same concentration of Piper betle however, showed a comparatively lesser effect (< 10%). It was also observed that the anti-adhesive effect of the two extracts on the binding of the early plaque settlers to hexadecane is concentration dependent. (J. Oral Sci. 48, 71-75, 2006)   

Background: The preservation or reduction of alveolar ridge resorption following tooth extraction is important in patients especially for those intended for implants at a later stage. One way to achieve this is by using membranes, graft materials, and biodegradable space fillers to prevent alveolar bone resorption and promote regeneration. A major attraction for using biodegradable and biocompatible polymers as space fillers for ridge preservation is their safety profile in comparison to xenograft materials like lyophilized bone and collagen. Materials and Methods: Biocompatible polylactide space fillers were fabricated by fusing porous polylactide particles. The sponges were loaded with drugs by placing them in the respective solutions. Pseudomonas aeruginosa was isolated from a chronic periodontitis patient and in vitro anti-microbial evaluation was done with the drug loaded sponges. Results: Chlorhexidine loaded space filler showed significant anti microbial effect against multiple drug resistant Pseudomonas aeruginosa isolated from a patient with chronic periodontitis. Conclusion: The results of this study indicate that biodegradable drug releasing polylactide space fillers has the potential to be used for ridge preservation following tooth extraction. Release of drugs in the socket may prove useful in preventing development of alveolar osteitis post extraction which can interfere with normal healing of the socket. Synthetic biodegradable polymers also exhibit a controlled degradation rate to achieve complete resorption within the intended time. PMID:12748650

This paper reports a case treated by a serial extraction program at the mixed dentition stage followed by a corrective orthodontic treatment, with a long-term follow-up period. Twenty years after the interceptive treatment, a harmonious face was observed along with treatment stability in the anterior posterior direction, deep overbite (which has been mentioned as a disadvantage of the serial extraction program), and a small relapse of anterior tooth crowding. All these conditions have been regarded as normal occurrences for most orthodontic treatments with a long-term follow-up period. This case report demonstrated that the establishment of a serial extraction protocol determined relevant esthetic changes that afforded an improvement of the patient's self-esteem, with a positive social impact. Furthermore, the low cost of this protocol permits the use of this therapy with underprivileged populations. It is important to emphasize that an early correction of tooth crowding by this protocol does not guarantee stability, but small relapses do not invalidate its accomplishment. PMID:23032213

Despite being considered noncritical size defects, extraction sockets often require the use of bone grafts or bone graft substitutes in order to facilitate a stable implant site with an aesthetically pleasing mucosal architecture and prosthetic reconstruction. In the present study, the effect of novel TiO2 scaffolds on dimensional ridge preservation was evaluated following their placement into surgically modified extraction sockets in the premolar region of minipig mandibles. After six weeks of healing, the scaffolds were wellintegrated in the alveolar bone, and the convex shape of the alveolar crest was preserved. The scaffolds were found to partially preserve the dimensions of the native buccal and lingual bone walls adjacent to the defect site. A tendency towards more pronounced vertical ridge resorption, particularly in the buccal bone wall of the nongrafted alveoli, indicates that the TiO2 scaffold may be used for suppressing the loss of bone that normally follows tooth extraction. PMID:2094653

Abstract Aim: The aim of this study was to compare the clinical outcome of submerged vs. non-submerged tapered implants placed into fresh extraction sockets. Materials and methods: A prospective, controlled, multicenter, randomized, clinical trial has been performed in two centers in Rome and Torino (Italy). Thirty healthy patients were recruited according to the following inclusion criteria: need for an immediate post extraction implant, ages between 18 and 70, horizontal defect depth <2 mm, smokers <10 cigarettes/day and absence of any circumstance or condition that could represent contraindications to implant surgery. The patients were randomly allocated to submerged or non-submerged treatment groups immediately after flap elevation and tooth extraction. Submerged implants were exposed ...

The aim of this systematic review was to assess if the use of autologous platelet concentrates may be beneficial to the healing of extraction sockets. Medline, Embase and Cochrane Central Register of Controlled Trials were searched using a combination of specific search terms. Hand searching of the relevant journals and of the bibliographies of reviews was also performed. Prospective comparative studies evaluating the effect of a platelet concentrate on fresh extraction sockets were included. Outcome variables related to hard and soft tissue healing, aesthetics and postoperative discomfort were considered. A methodological study quality assessment was made. The initial search yielded 425 articles, eight were finally included. 207 tooth extractions (104 tests and 103 controls) in 115 patien...

BACKGROUND: There has been no nationwide study in Japan on reasons for extraction of permanent teeth. This survey was aimed to determine the reasons for extraction of permanent teeth in Japan.METHODS: Five thousand, one hudred and thirty-one dentists were selected by systematic selection from the 2004 membership directory of the Japan Dental Association. The dentists selected were asked to record the reason for each extraction of permanent teeth during a period of one week from February 1 through 7, 2005. Reasons for tooth extraction were assigned to five groups: caries, fracture of teeth weakened by caries or endodontics, periodontal diseases, orthodontics, and other reasons.RESULTS: A total of 2,001 dentists (response rate of 39.1%) returned the questionnaires, and information on 9,115 extracted teeth from 7,499 patients was obtained. The results showed that caries and its sequela (totally 43.3%, 32.7% and 10.6%, respectively) and periodontal disease (41.8%) were the main reasons for teeth extraction. Extraction due to caries or fracture was commonly observed in all age groups over 15 years of age, whereas periodontal disease was predominant in the groups over 45 years of age.CONCLUSIONS: Most of the permanent teeth were extracted due to caries and its sequela and periodontal disease. Prevention and care for dental caries for all age groups and periodontal disease for over middle age groups are required.J Epidemiol 2006; 16: 214-219.   

This study investigates the checks of cavity margin after enamel and dentin ablation. The Er:YAG laser enamel and dentin ablation can be directly connected with the danger of cracks originating in the enamel near the cavity. This study evaluates the quality of the enamel edges after Er:YAG laser preparation. The enamel and dentin of buccal surfaces were ablated by the Er:YAG laser radiation. An Erbium:YAG laser system with the energy of 200 mJ was used to generate 200 microsecond(s) long pulses of mid-infrared 2.94 micrometers light in multimode configuration. The laser was operating in a free running mode, the repetition rate being 0.5 Hz with average laser power of 100 mW. Laser radiation was focused on the tooth tissue. Water cooling was used during the procedure in order to prevent tooth tissue destruction. The time of laser preparation was 5 minutes. A cavity of class V was prepared. The teeth were immersed into 0.5% basic fuchsin and then centrifuged at 6000 rev/min for 20 minutes. The microphotographs of the margins stained with 0.5% basic fuchsin were made and then the longitudinal section of the teeth were evaluated. The micrographs of the longitudinal section were checked and measured afterwards. The effect of the investigated laser irradiation on the origin of cracks was analyzed in the scanning electron microscope. Micrographs of each tooth before and after the laser ablation were compared. Micrographs of the intact teeth after extraction present the cracks of the enamel. They depend on the pressure exerted during extraction. The influence of the laser ablation proper is it bears no signs of new cracks. The conclusions of this study demonstrate the non-invasive nature of the Er:YAG laser ablation of the hard dental tissues.

This paper describes early findings of evaluations of the International Caries Detection and Assessment System (ICDAS) conducted by the Detroit Center for Research on Oral Health Disparities (DCR-OHD). The lack of consistency among the contemporary criteria systems limits the comparability of outcomes measured in epidemiological and clinical studies. The ICDAS criteria were developed by an international team of caries researchers to integrate several new criteria systems into one standard system for caries detection and assessment. Using ICDAS in the DCR-OHD cohort study, dental examiners first determined whether a clean and dry tooth surface is sound, sealed, restored, crowned, or missing. Afterwards, the examiners classified the carious status of each tooth surface using a seven-point ordinal scale ranging from sound to extensive cavitation. Histological examination of extracted teeth found increased likelihood of carious demineralization in dentin as the ICDAS codes increased in severity. The criteria were also found to have discriminatory validity in analyses of social, behavioral and dietary factors associated with dental caries. The reliability of six examiners to classify tooth surfaces by their ICDAS carious status ranged between good to excellent (kappa coefficients ranged between 0.59 and 0.82). While further work is still needed to define caries activity, validate the criteria and their reliability in assessing dental caries on smooth surfaces, and develop a classification system for assessing preventive and restorative treatment needs, this early evaluation of the ICDAS platform has found that the system is practical; has content validity, correlational validity with histological examination of pits and fissures in extracted teeth; and discriminatory validity. PMID:17518963

Chlorhexidine is broadly prescribed by clinicians for treating extraction socket wounds; however, studies have reported adverse effects for chlorhexidine. Persica, a herbal antibacterial agent, could be an alternative for chlorhexidine. The aim of this randomised controlled trial was to investigate the effects of persica and chlorhexidine on alveolar bone healing following tooth extraction in rats. Eighteen Wistar rats were randomly allocated to three study groups: 0.2% chlorhexidine, 10% persica and controls (tap water). The rats were mouth-rinsed for 14 days. On day 8, the mandibular right first molars of all the rats were extracted. On day 21, the rats were euthanized and histological slides of their extraction sockets were prepared. The amount of new bone formation and the number of inflammatory cells in the extraction socket for each rat were recorded. Data were analysed using linear regression and Mann-Whitney tests. There was no significant difference between the control group and the intervention groups in terms of new bone formation and inflammatory cell count. The mean new bone formation was significantly higher in the persica group than in the chlorhexidine group. There was a significant association between new bone formation and inflammatory cell count in the entire sample. In conclusion, there were no significant differences between rinsing with tap water and rinsing with 0.2% chlorhexidine and 10% persica in enhancing extraction socket wound healing in rats. Extraction socket wound healing in rats was better enhanced with 10% persica than 0.2% chlorhexidine. PMID:20938794

BACKGROUND: Dental implants, indicated for re-establishing both mastigatory and aesthetic functions, can be placed in the sockets immediately after tooth extraction. Most studies investigate the anterior and upper regions of the dental arch, whereas few examine longitudinal appraisal of immediate implant installation in the mandibular molar region. OBJECTIVE: The aim of this retrospective study was to evaluate the success rate of immediate dental implants placement in mandibular molars within a follow-up period as long as 8 years. MATERIALS AND METHODS: Seventy-four mandibular molar implants after non-traumatic tooth extraction between 2002 and 2008 were examined in the study. All implants were evaluated radiographically immediately after prosthesis placement, 1 year after implantation, and by the end of the experimental period, in 2010. Clinical evaluation was done according to [Albrektsson et al. (1986) The International Journal of Oral & Maxillofacial Implants, 1, 11-25] success criteria for marginal bone loss. The mean bone losses, calculated as the difference between the final evaluation measures and those taken by the end of the first year of implant, were compared using Kruskal-Wallis test with a significance level of 5%. RESULTS: All implants presented clinical and radiographic stable conditions, that is, 100% success rate. Significant bone loss was not found between final evaluation and that of the first functional year (P > 0.05). CONCLUSION: Immediate implant placement of mandibular molars proved to be a viable surgical treatment given the high success rate up to 8 years after implantation. PMID:22462471

Endodontic treatment is an important step of tooth replantation protocols, but the ideal moment for definitive obturation of replanted teeth has not yet been established. In this study, a histomorphometric analysis was undertaken to evaluate the repair process on immediate replantation of monkey's teeth after calcium hydroxide (CH) therapy for 1 and 6?months followed by root canal filling with a CH-based sealer (Sealapex(®) ). The maxillary and mandibular lateral incisors of five female Cebus apella monkeys were extracted, kept in sterile saline for 15?min, replanted and splinted with stainless steel orthodontic wire and composite resin for 10?days. In Group I (control), definitive root canal filling was performed before tooth extraction. In Groups II and III, CH therapy started after removal of splint, and definitive root canal filling was performed 1 and 6?months later, respectively. The animals were euthanized 9?months after replantation, and specimens were processed for histomorphometric analysis. In all groups, epithelial attachment occurred at the cementoenamel junction or very close to this region; the areas of resorption on root surface had small extension and depth and were repaired by newly formed cementum; and the periodontal ligament was organized. Statistical analysis of the scores obtained for the histomorphometric parameters did not show any statistically significant difference (P?=?0.1221) among the groups. The results suggests that when endodontic treatment is initiated 10?days after immediate replantation and an antibiotic regimen is associated, definitive root canal filling can be performed after a short-term CH therapy. PMID:22051142

For the purpose of preventing osteonecrosis following interstitial irradiation for tongue cancer, a Radiolucent Spacer was prepared with the intention of reducing bone dose by keeping the mandible at a distance from the source. Because of its radiolucency, the Spacer made of silicone enables to perform X-P while inserted, and more exact dose calculation. For 6 cases in which 8 mm-spacer was used, dose reduction rate for surface of lower gingiva corresponded to 42.3%, average of tumor dose for TDF. For 51 cases in which the observation of course was practicable for 2 years--9 years and 4 months, averaging 5 years and 7 months, the incidence of osteonecrosis was 0%, and therefore, Spacer of not less than 8 mm-thickness is thought useful as prosthesis. Extraction of the tooth was done at the start of irradiation, but the healing course was always favorable. The most aseptic possible alveolectomy and complete closure of the wound are necessary for tooth extraction. (author).

Indication to extract deep impacted teeth as well as the surgical approaches is controversally discussed in the litterature. Based on a clinical case report we describe two atypical approaches, one is extraoral the other lingual for removing tow deeply impacted teeth. The revue of the litterature shows that atypical surgical approaches are only indicated in particular clinical situations. The indication to remove the teeth and the approach depends on the patient's compliance as well as the experience of the operator. In the reported case the extraoral approach is justified by the chronical dentogene infection with fistulisation and cutaneus changes in the submandibular region. Based on the much easier access to the tooth and the only minimal cutaneus modifications in this case, we recommand the extraoral approach for extraction of deep impacted teeth in some special cases like the one we present. PMID:15587600

Abstract - This study employed novel topographic and histological techniques to assess remaining periodontal ligament (PDL) in a convenience sample of avulsed and intruded human permanent incisors and extracted premolars. Seventeen human teeth (eight avulsed, five severely intruded and four uninjured extracted) were evaluated for the distribution and physical characteristics of adherent root surface PDL. The topographic distribution of PDL was assessed by staining roots with malachite green and determining the proportion of remaining PDL within selected regions on four aspects of each tooth. In order to characterize mechanical damage to PDL, serial transverse sections of roots were stained with hematoxylin and eosin and examined at magnifications of 40x to 800x. The sections were photograp...

Abstract Aim: The primary objective of this study was to determine the association between the size of the void established by using two different implant configurations and the amount of buccal/palatal bone loss that occurred during 16 weeks of healing following their installation into extraction sockets. Material and methods: The clinical trial was designed as a prospective, randomized-controlled parallel-group multicenter study. Adults in need of one or more implants replacing teeth to be removed in the maxilla within the region 15-25 were recruited. Following tooth extraction, the site was randomly allocated to receive either a cylindrical (group A) or a tapered implant (group B). After implant installation, a series of measurements were made to determine the dimension of the ridge and...

Abstract Aim: To compare the influence of autologous or deproteinized bovine bone mineral as grafting material on healing of buccal dehiscence defects at implants installed immediately into the maxillary second incisor extraction socket in dogs. Material and methods: In the maxillary second incisor sockets of 12 Labrador dogs, implants were installed immediately following tooth extraction. A standardized buccal defect was created and autologous bone particles or deproteinized bovine bone mineral were used to fill the defects. A collagen membrane was placed to cover the graft material, and the flaps were sutured to fully submerge the experimental areas. Six animals were sacrificed after 2 months, and six after 4 months of healing. Ground sections were obtained for histological evaluation. R...

Abstract Objectives: The aim of this randomized controlled trial was to evaluate radiographical bone changes following alveolar ridge preservation with a synthetic bone substitute or a bovine xenograft. Methods: Alveolar ridge preservation was performed in 27 patients randomized in two groups. In the test group (n=14), the extraction socket was treated with Straumann bone ceramic (SBC) and a collagen barrier membrane (Bio-Gide), whereas in the control group (n=13) with deproteinized bovine bone mineral and the same barrier. Standardized periapical X-rays were taken at 4 time points, BL: after tooth extraction, GR: immediately after socket grafting, 4M: 16 weeks, 8M: 32 weeks post-operatively. The levels of the alveolar bone crest at the mesial (Mh), and distal (Dh) and central aspects of t...

A 58-year-old woman presented to the Oral and Maxillofacial Surgery Clinic experiencing severe limited mouth opening and exposed bone in the socket of the right mandibular third molar 8 months following the extraction of the tooth. The patient had been treated during the year before her presentation with sunitinib, an antiangiogenic drug, for renal cell carcinoma. The clinical, radiographic, and histologic picture of a chronic nonhealing extraction socket was consistent with osteonecrosis of the jaw (ONJ), although she had never been treated with bisphosphonates or corticosteroids. The treatment with sunitinib was discontinued and the patient was treated with antibiotics and physiotherapy for 12 weeks with complete recovery. Sunitinib may cause osteonecrosis of the jaw after oral surgical ...

Alveolar ridge resorption occurs after tooth extraction and has the potential to either complicate implant placement or impair the final esthetic result. Techniques to preserve natural bone and soft tissue contours are of great interest to clinicians and patients because even subtle postextraction buccal plate resorption may have significant clinical effects, particularly in the esthetic zone. Buccal plate augmentation (BPA) is a novel approach for ridge preservation aiming to avoid recession of the facial wall of the socket without interfering with the natural healing mechanism of the extraction socket. It consists of placement of bone graft material over an intact buccal plate, underneath the soft tissues in a surgically created pouch with an aim to maintain or augment the soft tissue es...

Purpose This study radiographically evaluated the performance of autologous platelet-rich plasma (PRP) applied in tooth sockets. Patients and Methods Thirty extractions of bilateral impacted mandibular third molars were performed in 15 volunteers (7 men, 8 women; 18 to 22 years old). After extraction of right and left mandibular third molars, the socket at 1 side received the autologous PRP (PRP group) and the other was filled with blood clot (control group). Millimeter periapical radiographs were obtained 7 days, 1 month, and 2, 3, and 6 months postoperatively. Radiographic bone density was quantified 3 times by the same examiner at different moments using HLImage 97 software, and data were statistically analyzed by Statgraf 7.0 software (analysis of variance and Tukey test). Results In g...

Endodontic restorations often fail due to inadequate disinfection of the root canal even though the antimicrobial irrigants used have been shown to be capable of killing the bacterium frequently implicated in this complication, Enterococcus faecalis (Ef). Extracted human teeth were root-prepared and filled with a liquid culture of Ef. Following incubation, the root canals were irrigated with 1% sodium hypochlorite (NaOCl), electrochemically activated water or saline control. Irrigation was modelled using an electronic pipette to deliver the solutions at a reproducible flow velocity. A series of parallel experiments employed a membrane biofilm model that was directly immersed into irrigant. Experimental conditions where contiguous between the extracted tooth model and biofilm model wherever...

Abstract Introduction: After a tooth extraction, the height of the buccal wall tends to decrease. The literature indicates that regenerative techniques (guided bone regenerative [GBR] techniques) have succeeded in improving the bone levels. Therefore, this experiment set out to compare the physiological bone remodelling in Beagle dog models after implant placement in a fresh extraction socket, with and without the application of regenerative procedure. Materials and methods: Five dogs were used in this study. Test and control sites were randomly selected. The experimental teeth (fourth pre-molar and first molar) were hemi-sected removing the distal roots and placing implants. Porcine bone was placed to fill the gap around the implant on the test sites and a reabsorbable membrane was used t...

Epulis, a discrete sessile or pedunculated mass of fibrous tissue on the gingiva caused by chronic inflammation, is a common lesion. However, other lesions may occasionally exhibit exophytic growth and they must be differentiated from epulis. A 38-year-old Japanese female noticed a pedunculated soft mass on the alveolar ridge of the right maxillary third molar shortly after extraction of the tooth. The mass, which had periods of exacerbation and quiescence, was excised under a tentative diagnosis of epulis. Because histopathology revealed edematous, inflamed antral mucosa with a covering of ciliated columnar epithelium, a final diagnosis of herniation of antral polyp through an oro-antral fistula was established. Although a rare occurrence, herniation of antral polyp should be included in the differential diagnosis of exophytic lesions on the maxillary molar alveolar ridge if there is a history of dental extraction at the concerned area.   

Alveolar ridge resorption has long been considered an unavoidable consequence of tooth extraction and can be a significant problem in implant and restorative dentistry. Postextraction maintenance of the alveolar ridge minimizes residual ridge resorption and allows placement of an implant that satisfies both esthetic and functional criteria. Guided bone-regeneration techniques and the use of bone-replacement materials have been shown to enhance socket healing and potentially modify the resorption process. The prime indication for socket preservation is the prevention of alveolar-bone and soft-tissue collapse, which would cause unacceptable prosthesis esthetics. This review describes the rationale behind socket preservation, and the various techniques and materials used for extraction site grafting. PMID:22616214

Summary Feline chronic gingivitis/stomatitis (FCGS) is a painful inflammatory disease in cats. Extraction of teeth, including all premolars and molars, has been shown to be the therapy of choice in cats not responding sufficiently to home care (e.g. tooth brushing) and/or medical treatment (corticosteroids and/or antibiotics). In this study, we hypothesize that a cat food with an omega-6 polyunsaturated fatty acid (6 PUFA) to 3 PUFA ratio of 10:1 reduces inflammation of the FCGS and accelerates soft tissue wound healing of the gingiva after dental extractions, compared to a cat food with a 6:3 PUFA ratio of 40:1. The cats were fed diets with chicken fat and fish oil as sources of fatty acids. In one diet, part of the fish oil was replaced by safflower oil, resulting in two diets with 6:3 P...

Objective: This case report was aimed at primary clinical experience concerning surgical extraction of a displaced tooth with the help of the Er:YAG laser based on refined computer-assisted presurgical planning. Methods: The case refers to the extraction of a displaced maxillary canine in a female patient. For the osteotomy, a pulsed Er:YAG laser was applied with pulse energy of 500 mJ, pulse duration of 250 sec and pulse frequency of 12 Hz. The fiber tip (1000 m) was kept with a 1-2 mm distance to the bone surface. Refined presurgical computer-assisted planning was performed with regard to minimization of bone loss, especially for the sake of preservation of the alveolar ridge. Based on a detailed three-dimensional (3D) reconstruction of the patient's anatomy, dynamical simulations of a b...

SUMMARY Purpose : Although damage to the structural integrity of the tooth is not usually considered a significant problem associated with tooth bleaching, there have been some reported negative effects of bleaching on dental hard tissues in vitro. More studies are needed to determine whether the observed in vitro effects have practical clinical implications regarding tooth structural durability. Objectives : This in situ study evaluated the effect of 10% and 15% carbamide peroxide (CP) dental bleach, applied using conventional whitening trays by participants at home, on the fracture toughness of dentin. Methods : Ninety-one adult volunteers were recruited (n ? 30/group). Compact fracture toughness specimens (approximately 4.5 × 4.6 × 1.7 mm) were prepared from the coronal dentin of recently extracted human molars and gamma-radiated. One specimen was fitted into a prepared slot, adjacent to a maxillary premolar, within a custom-made bleaching tray that was made for each adult participant. The participants were instructed to wear the tray containing the dentin specimen with placebo, 10% CP, or 15% CP treatment gel overnight for 14 nights and to store it in artificial saliva when not in use. Pre-bleach and post-bleach tooth color and tooth sensitivity were also evaluated using ranked shade tab values and visual analogue scales (VASs), respectively. Within 24-48 hours after the last bleach session, the dentin specimens were tested for fracture toughness using tensile loading at 10 mm/min. Analysis of variance, Kruskal-Wallis, ?(2), Tukey's, and Mann-Whitney U tests were used for statistical analysis. The level of significance was set at p<0.05 for all tests, except for the Mann-Whitney U tests, which used a Bonferroni correction for post hoc analyses of the nonparametric data (p<0.017). Results : The placebo, 10% CP, and 15% CP groups contained 30, 31, and 30 participants, respectively. Mean fracture toughness (+ standard deviation) for the placebo, 10% CP, and 15% CP groups were 2.3 ± 0.9, 2.2 ± 0.7, and 2.0 ± 0.5 MPa*m(1/2) respectively. There were no significant differences in mean fracture toughness results among the groups (p=0.241). The tooth sensitivity VAS scores indicated a significantly greater incidence (p=0.000) and degree of tooth sensitivity (p=0.049 for VAS change and p=0.003 for max VAS) in the bleach groups than in the placebo group. The color change results showed generally greater color change in the bleach groups than in the placebo group (p=0.008 for shade guide determination and p=0.000 for colorimeter determination). Conclusions : There were no significant differences in in situ dentin fracture toughness results among the groups. The results of this study provide some reassurance that dentin is not overtly weakened by the bleaching protocol used in this study. However, the lack of a statistically significant difference cannot be used to state that there is no effect of bleach on dentin fracture toughness. PMID:22934528

Purpose The healing process following tooth extraction apparently results in a pronounced resorption of the alveolar ridge. As a result, the width of alveolar ridge is reduced and severe alveolar bone resorption occurs. The purpose of this experiment is to clinically and histologically evaluate the results of using horse-derived bone mineral for socket preservation. Methods The study comprised 4 patients who were scheduled for extraction as a consequence of severe chronic periodontitis or apical lesion. The extraction was followed by socket preservation using horse-derived bone minerals. Clinical parameters included buccal-palatal width, mid-buccal crest height, and mid-palatal crest height. A histologic examination was conducted. Results The surgical sites healed uneventfully. The mean ridge width was 7.75 ± 2.75 mm at baseline and 7.00 ± 2.45 mm at 6 months. The ridge width exhibited no significant difference between baseline and 6 months. The mean buccal crest height at baseline was 7.5 ± 5.20 mm, and at 6 months, 3.50 ± 0.58 mm. The mean palatal crest height at baseline was 7.75 ± 3.10 mm, and at 6 months, 5.00 ± 0.82 mm. There were no significant differences between baseline and 6 months regarding buccal and palatal crest heights. The amount of newly formed bone was 9.88 ± 2.90%, the amount of graft particles was 42.62 ± 6.57%, and the amount of soft tissue was 47.50 ± 9.28%. Conclusions Socket preservation using horse-derived bone mineral can effectively maintain ridge dimensions following tooth extraction and can promote new bone formation through osteoconductive activities. PMID:11895288

Purpose: Clinical guidelines suggest that a minimal buccal alveolar bone thickness of 1 to 2 mm is required to maintain the tissue architecture following tooth extraction and implant placement. The aim of this study was to evaluate the thickness of buccal alveolar bone at the maxillary first premolars and anterior teeth using cone beam computed tomography (CBCT). Materials and Methods: CBCT images of the maxillae of 43 implant patients were obtained. Two examiners manually measured the distance from the cementoenamel junction (CEJ) to the buccal alveolar bone crest and the thickness of the buccal alveolar bone at the crest, midroot, and apex of the maxillary first premolars and anterior teeth. The absence of bone and presence of radiographic artifacts were recorded. Average bone thicknesses were calculated and compared. Both parametric and nonparametric statistics were used to analyze the findings. Results: The median distance from the CEJ to the buccal alveolar bone crest was 2.79 mm, and measurements were similar among tooth positions. The median buccal alveolar bone thickness 1 mm apical to the alveolar bone was 1.13 mm in the premolar area and 0.83 mm for the anterior maxillary teeth. The median buccal alveolar bone thickness at the midroot was 1.03 mm in the premolar area and 0.70 mm for the other anterior maxillary teeth. Measurements of the buccal plate at 1 mm from the tooth apex were similar in all teeth positions, with a median thickness of 0.88 mm. Conclusions: The presence or absence of buccal alveolar bone can be discerned by CBCT evaluation. Few maxillary anterior teeth displayed buccal alveolar bone thickness greater than 1 mm. The implications for implant therapy must be fully discerned regarding tissue biotypes and dental implant outcomes. PMID:23189304

Day PF, Lewis BRK, Spencer RJ, Barber SK, Duggal M. The design and development of surgical templates for premolar transplants in adolescents. International Endodontic Journal., 45, 1042-1052, 2012. ABSTRACT: The aim of designing and fabricating the surgical templates was to assist the surgical component of premolar transplantation, by establishing and replicating the root dimensions of the donor premolar tooth. The correct template could be used to assess the socket preparation (width and depth) prior to placement of the transplant in the recipient site, obviating the need to repeatedly try the donor tooth for fit at the recipient site, thereby minimising trauma to the periodontal ligament of the donor tooth. Seventy-five mandibular premolars and 50 maxillary second premolars were selected with varying stages of root development. All teeth had been extracted for orthodontic reasons. The root was measured for its length (maxL) and maximum (maxW) and minimum width (minW) with digital callipers from standardised reference points. These measurements were then used in the design of premolar transplant templates. The mean measurements for second maxillary premolars were maxL 14.6?mm (±1.7), maxW 8.3?mm (±0.5) and minW 4.9 (±0.3). The mean measurements for mandibular premolars were maxL 14.8 (±1.6), maxW 7.4 (±0.6) and minW 5.3 (±0.5). From these measurements, a range of maxillary second premolar and mandibular premolar templates have been fabricated. These figures also inform the multidisciplinary planning process for the space requirements at the donor site prior to transplantation. PMID:23039120

Abstract in english OBJECTIVE: The purpose of this study was to provide information regarding the marginal adaptation of composite resin onlays in primary teeth previously treated with 1% sodium hypochlorite (NaOCl) (pulp irrigant) using two different resin luting agents. MATERIAL AND METHODS: Forty extracted sound primary molars had their crowns prepared in a standardized machine and were randomly divided into 4 groups (n=10): G1 (1% NaOCl irrigation+EnForce); G2 (EnForce); G3 (1% NaOCl irr (more) igation+Rely X); G4 (Rely X). The onlays were made with Z250 composite resin on plaster models. After luting, the tooth/restoration set was stored in 100% relative humidity at 37ºC for 24 h and finished with Soflex discs. Caries Detector solution was applied at the tooth/restoration interface for 5 s. The specimens were washed and four digital photos of each tooth were then taken. The extents of the gaps were measured with Image Tool 3.0 software. The percentage data were submitted to a Kruskal-Wallis test (?=0.05). The Relative Risk test analyzed the chance of a gap presence correlated to each group. RESULTS: There were no statistically significant differences (p>0.05) among the groups. The relative risk test revealed that some groups were more apt to have a presence of gaps than others. CONCLUSION: Neither the 1% NaOCl treatment nor the resin luting agents caused any alterations in the dental substrate that could have influenced the marginal adaptation of composite onlays in primary teeth.

With clinicians placing more dental implants, it is becoming increasingly important to maintain bone volume after tooth extraction. This article reports the results of implants placed into extraction sites grafted with particulate mineralized bone allograft (Puros). A total of 313 extraction sites were grafted with mineralized bone graft during a 36-month period. A total of 252 Tapered Screw-Vent dental implants were placed into the grafted extraction sites after a 4- to 7-month healing period. All reentries revealed a bony hard structure acceptable for osteotomy preparation. A total of 244 of these implants have been restored with fixed prosthesis and 6 with removable overdentures for a total of 250 loaded implants. A total of 6 implants failed, which required their removal (2 implants before load and 4 after loading), resulting in a 97.6% implant success rate. We conclude that mineralized human allograft placed into extraction sites is clinically useful to maintain bone volume. This material provided a bony hard structure acceptable for implant placement with good success rates. PMID:16447901

This study evaluated the influence of different light sources on the efficiency of an office bleaching agent containing visible-light activating titanium dioxide photocatalyst (VL-TiO2) using an artificial discoloration tooth model. Extracted bovine teeth were stained by black tea. The CIE L*a*b* values were measured before and after nine consecutive treatments by the VL-TiO2-containing bleaching agent (TiON in Office, GC, Tokyo, Japan). A halogen light unit (CB; CoBee, GC) or an LED unit (G-light, GC) with two modes (blue and violet: GL-BV, blue: GL-B) were used to activate the bleaching agent in three groups (n=8). Brightness (?L) and color difference (?E) increased as bleaching repeated in all groups. Two-way ANOVA showed that both number of treatments and light sources significantly affected ?E (p<0.05). GL-BV showed better bleaching effect than GL-B. In measurement of irradiation spectra, CB showed a wide spectrum (380–530 nm), GL-B had a sharp peak at 470 nm and GL-BV showed an additional peak at 405 nm. It was concluded that the light source influenced the efficiency of the tooth bleaching with VL-TiO2.   

Abstract in spanish La fusión dental es la unión de dos gérmenes dentales normalmente separados, mientras que la geminación se define como el intento de división de un único germen dental. La fusión y geminación de molares es poco frecuente en la dentición permanente. Describimos un caso clínico de un tercer molar inferior derecho fusionado a un cuarto molar supernumerario en un paciente varón de 36 años que ha presentado repetidos episodios de pericoronaritis. Tras el estudio ra (more) diológico se realiza la exodoncia del cordal semiincluido bajo anestesia local. Llevamos a cabo una revisión bibliográfica al respecto. Abstract in english Dental fusion is the union of two tooth buds that normally are separated, while gemination is defined as an attempt by a single tooth bud to divide. The fusion and gemination of molars is uncommon in permanent teeth. We report a clinical case of a right lower third molar fused to a supernumerary fourth molar in a 36-year-old male patient with repeated episodes of inflammation. After the radiologic study, the semi-impacted third molar was extracted under local anesthesia. The literature was reviewed.

The retention in root canals of Flexi-Posts, Para-Posts and Brasseler/Vlock-Posts was measured using tensile and compressive/shear forces. Forty-two extracted maxillary anterior teeth were embedded in self-curing acrylic resin and treated endodontically. Each root canal was prepared with the appropriate matching drills for the post-core system chosen. Each post-core was cemented in the canal with zinc phosphate cement. A tensile force was applied along the long axis of each tooth and the force needed to dislodge the post-core was recorded. There was no difference in retention between the small diameter posts, but the difference between the medium and the large diameter posts, however, was significant. In the medium diameter post group, the Flexi-Post was approximately twice as retentive as the other two post-core systems evaluated. In the second series of tests compressive/shear force was applied at an angle of 130 degrees to the long axis of the tooth. The retention difference between the small diameter posts was found to be statistically significant, Flexi-Posts being more retentive than Para-Posts and B/V-Posts. PMID:8185535

Objective: To investigate the views and experiences of parents whose children have rampant tooth decay. Methods: In-depth, semi-structured interviews were carried out with 19 parents of varied age and social background whose children had been referred to Dundee Dental Hospital for assessment for dental extractions. Participants were encouraged to discuss their own and their child's dental experiences and their views on how the child developed rampant caries. The interview data was systematically coded using key theme headings, and summary charts were constructed to facilitate analysis. Results: The parents found it difficult to avoid sweets and giving their children sweet treats. They had limited knowledge of oral health maintenance which was poorly applied. These factors, combined with the difficulties of family life--in particular illness and life events--created circumstances in which their children experienced tooth decay. Conclusions: Parents find it difficult to restrict their children's sugar intake in an environment where sugary snacks are so readily available. More societal support in restricting children's sugar intake is of central importance. Parents would benefit from more sympathetic and explicit diet and toothbrushing messages tailored to their individual circumstances from those involved in the care of children's oral health. (Contains 1 table.)

The aim of this study was to compare the diagnostic accuracy of a high resolution charge-coupled device (CCD) sensor and a medium resolution photostimulable phosphor (PSP) plate for detecting experimentally induced root fractures and further, to evaluate differences between images taken with various horizontal and vertical angles. Forty-seven extracted single-rooted human teeth mounted in a dry human skull were used in the experiment. The teeth were radiographed, before and after root fractures were induced, with two digital receptors: the Digora PSP system (approx. 8 lp mm(-1)) and the RVG-ui(TM), a CCD sensor with a high-resolution mode (15-20 lp mm(-1)). Four images were taken with each of the receptors of each tooth: one orthogonal exposure (O-images), one exposure with a vertical angle of 15 degrees by which the root was imaged elongated (L-images), and two eccentric exposures with a horizontal angle of 15 degrees mesially and distally. Three observers marked a fracture line if detected, in each image. Three sessions were held, one assessing the O-images, one the L-images, and one in which all four images of the same tooth were displayed simultaneously (X-images). The RVG-ui images obtained higher sensitivities than the Digora PSP images (P 0.05). It may be speculated that the difference in spatial resolution between the two digital systems accounts for the differences in their sensitivity. PMID:15660754

Bone atrophy occurs after tooth extraction in the posterior mandible, placing the mandibular canal and its neural, arterial, and venous contents closer to the osseous facial aspect and the coronal crest. This proximity places the structure in danger of damage when dental implants are surgically placed to support fixed or removable prostheses. Several options are available to treat these areas for implant-supported fixed and removable complete or partial dentures. Osseous grafting and ridge expansion are surgical options that enable acceptance of standard sized dental implants but have serious morbidities. Additionally, vertical osseous augmentation is not predictable at this time. Narrow diameter dental implants can be placed to avoid the mandibular canal, but some bone volume situations preclude this. Very wide and very short (6.5 × 5 mm) dental implants may be placed at an angle in atrophic sites to successfully support fixed partial dentures. An anterior guidance occlusal scheme may be used in maxillary dentate patients or group function in maxillary complete denture patients. A 100 micron occlusal relief in fixed partial dentures in dentate patients may be required to account for natural tooth intrusion and to prevent occlusal overload of the implant-supported partial denture. PMID:20925498

A low-energy Nd:YAG laser was used to irradiate extracted human teeth coated with a black energy-absorbent laser initiator in a study to determine the extent of the morphologic changes produced in the enamel surface. The laser initiator was applied to a cleaned enamel surface and irradiated at an energy output of 30 mJ or 75 mJ. Both energy levels produced morphologic changes of the surface. There was a sharp line of demarcation between the coated, irradiated area and the surrounding noncoated enamel surface. The scanning electron microscope view at the lower energy level showed that the surface had melted and reformed with numerous small, bubble-like inclusions. The 75 mJ energy level showed individual impact craters with shallow centers and raised edges containing numerous pores and large, bubble-like inclusions. Etching is a dental procedure in which an acid is normally used to remove a thin outer layer of the tooth structure. This is necessary to create a roughened, irregular surface in order to provide mechanical retention for dental restorative materials. The changes produced by the laser in this study suggest a simple, effective, and controlled method of etching the enamel surface of a tooth by altering its surface characteristics.

Using cone beam computed tomography (CBCT) we investigated the distance between the cemento-enamel junction (CEJ) and the marginal bone crest (MBC) at buccal, lingual, mesial, and distal surfaces of incisors to first molars in adolescents before (baseline) and after extractive orthodontic treatment (study end point). Patients with Class I malocclusion, crowding and an overjet of ? 5 mm were examined with a CBCT unit using a 60 × 60-mm field of view and a 0.125-mm voxel size. Large differences in marginal bone height were found at baseline, particularly between tooth surfaces. There was a slight correlation between age and CEJ-MBC distance. From baseline to the study end point, large bone-height changes among teeth and tooth surfaces could be seen. Lingual surfaces, followed by buccal surfaces, showed the largest changes. Eighty-four per cent of lingual surfaces of mandibular central incisors exhibited a bone-height decrease of > 2 mm. The bone-height decrease was larger at lingual surfaces in the mandible than in the maxilla, and larger in girls (mean=1.8 mm) than in boys (mean=1.5 mm). Fewer than 1% of proximal surfaces exhibited changes of > 2 mm. It is unknown whether the changes in marginal bone height are transitory. A high-quality CBCT technique may help to determine this by providing a deeper insight into the long-term side effects of orthodontic treatment. PMID:22607336

Tooth morphogenesis requires sequential and reciprocal interactions between the cranial neural crest–derived mesenchymal cells and the stomadial epithelium, which regulate tooth morphogenesis and differentiation. We show how mesenchyme-derived single stem cell populations can be induced to transdiff...

nutating plate type drive system for a 3500 horse- power" helicopter ... tooth width at working depth line, in. I moment of ... input shaft, the nutating plate makes one nutation and advances .... The tooth bending stress can be calculated using the ...

... caries) Trauma — a broken or cracked tooth Poor development, so that a tooth may be too small or improperly shaped Endodontic therapy (pulpotomy or root canal therapy ) Change in color Restoring Children's Primary ...

Abstract in spanish El propósito del presente trabajo es dar a conocer una alternativa quirúrgica en el tratamiento de las fusiones dentarias mediante la colocación de matriz de hueso humano desmineralizado (MHHD) (Grafton® Putty, New Jersey Eatotown, Osteotech), luego de la separación y exodoncia del diente fusionado al permanente. La fusión de los dientes es una anomalía dentaria de unión, que consiste en la unión de dos gérmenes dentarios en desarrollo, pudiendo suceder en cualq (more) uiera de los estadios de evolución del germen dental a partir de la lámina dentaria o en períodos más avanzados del proceso de diferenciación. Para el tratamiento, se utilizó un aloinjerto de MHHD con propiedades osteoinductivas y osteoconductivas, que además posee varios factores de crecimiento óseo, lo cual permitió el crecimiento gradual de nuevo hueso, que corrigió los defectos óseos acarreados post exodoncia y cubrió la pared distal expuesta del diente permanente remanente. Para el control clínico se realizaron radiografías periapicales y panorámicas. Se concluyó que la separación quirúrgica y exodoncia del diente con menor similitud anatómica al contralateral y posterior colocación de MHHD, representa una alternativa en el tratamiento quirúrgico de las fusiones dentarias. Abstract in english The purpose of this work is to present a surgical alternative in the treatment of the dental fusions through the placement of demineralized human bone matrix (DHBM) (Grafton Putty)*, immediately after the separation and extraction of the fused tooth to the permanent one. The dental fusion is a dental anomaly of union, that consists in the union of two dental germs during development. It could happen at any of the dental germ evolution stages from the dental sheet or from (more) more advanced processes of differentiation. For the clinical treatment, an allograft of DHBM with osteoinductive and osteoconductive properties was used. This had several factors of bone growth, it allowed the gradual growth of a new bone that helped to correct the bone defects post-extraction and to cover the exposed distal wall of the remaining permanent tooth. The clinic evaluation and the periapical and panoramic radiographies images were used for the clinical control. It can be concluded that the surgical separation and the extraction of the tooth with less anatomical likeness to the contralateral and the placement of the DHBM, represent a surgical treatment alternative of the dental fusion.

The earliest steps in tooth development depend on signaling interactions that result in the condensation of mandibular mesenchyme into the tooth bud. Reporting in this issue of Developmental Cell, Mammoto et al. (2011) find that chemotactic signals coordinate condensation and that the compressive force generated is sufficient to induce tooth bud gene expression.

Case report of an accidentally diagnosed supernumerary tooth in the superior orbital fissure. Computed tomography (CT) contributed with a more precise localization of the tooth being situated between the orbit and the brain. CT also showed that there was no cyst or other pathological process around the supernumerary tooth, which is plausible and frequently reported in the literature.

Mutations in the transcription factors PAX9 and MSX1 cause selective tooth agenesis in humans. In tooth bud mesenchyme of mice, both proteins are required for the expression of Bmp4, which is the key signaling factor for progression to the next step of tooth development. We have previously shown tha...

Background: Bisphosphonate-induced osteonecrosis of the jaw (BONJ) is a frequently reported complication. The aim of this study was to investigate the clinical and histopathological presentation of BONJ with the Hounsfield score and to evaluate the reliability of the score for determining necrosis in an animal model. Material/Methods: Eighty rats were prospectively and randomly divided into two groups of 40 each: a control group and an experimental group. Half of the animals from each group underwent extraction of the left mandibular molars, and the other half underwent extraction of the left maxillary molars under pentobarbital-induced general anesthesia. All animals were euthanized 28 days after tooth extraction. Maxillae and mandibles were extracted, cone beam computed tomography (CBCT) was performed, and Hounsfield scores were evaluated. Results: The Hounsfield scores of the experimental group were found to be compatible with chronic osteomyelitis and periosteal reactions. The Hounsfield scores of the control group were compatible with a healthy healing period. Conclusion: In light of these results, both cone beam computed tomography (CBCT) and the Hounsfield Units (HU) evaluations together are thought to be efficient in the diagnosis of BONJ. PMID:12666717

The aim of this clinical study was to evaluate the 24-month clinical outcomes of immediate provisionalization of dental implants placed in fresh extraction sockets using a flapless technique. Fifteen patients were included under strict inclusion and exclusion criteria. All patients required one or two teeth to be extracted for lesions with a hopeless prognosis in the maxillary monoradicular or first premolar region. Twenty implants were placed immediately after tooth extraction, and immediate provisionalization was performed. Sixteen implants had a diameter of 5 mm, and four implants had a diameter of 3.80 mm, all with a 13-mm length. After 24 months of follow-up, a cumulative survival rate of 100% was reported for all implants. Modified Bleeding Index (mBI), modified Plaque Index (mPI), probing depth (PD), marginal gingiva level (MGL), and keratinized mucosa (KM) remained stable for up to 24 months. Mean MGL at 24 months was 0.22 ± 0.15 mm; no significant changes occurred in MGL between baseline and 24 months. Mean KM remained stable from baseline to 24 months. At 24 months, a mean bone loss of 0.83 ± 0.52 mm was measured. The results of this study indicate that flapless surgery for immediately provisionalized implants placed in fresh extraction sockets provides soft tissue and marginal bone maintenance for up to 24 months of follow-up. PMID:22254223

BACKGROUND: Loss of teeth results in marked qualitative and quantitative alterations of the alveolar process at the edentulous site. It was observed that a graft comprised of bovine bone mineral placed in the fresh extraction socket delayed tissue modeling, but preserved the dimension of the ridge at edentulous sites. OBJECTIVE: To analyze the influence of a biphasic synthetic graft on tissue modeling and remodeling during healing of extraction wounds. MATERIAL AND METHODS: Five beagle dogs were used. Two premolars in the maxilla and two in the mandible were included. Full thickness flaps were elevated and the distal roots were removed. An alloplastic graft (BPCAP; ?-TCP core coated with nanocrystalline biomimetic hydroxyapatite) embedded in porcine collagen was placed to fill the fresh extraction socket of the premolar sites. Flaps were replaced to cover the entrance of the extraction sockets during early healing. The extraction and grafting procedures were scheduled to allow for the study of 1, 2, and 3 months socket healing. The biopsies from the maxillary sites were decalcified, embedded in paraffin, and stained to allow the study of various aspects of hard tissue formation. The biopsies from the mandibular sites were processed for ground sectioning and used to evaluate alterations of ridge dimensions after 3 months of socket healing. RESULTS AND CONCLUSION: It was documented that the biphasic alloplastic graft did not undergo marked resorption during tissue modeling and remodeling, but allowed large amounts of bone to form within the post-extraction site. Grafting the experimental sites with this biomaterial furthermore counteracted ridge resorption that otherwise occurs following tooth extraction. PMID:22804845

Periodontitis is a chronic-, infectious-disease of the human periodontium that is characterized by the loss of supporting tissues surrounding the tooth such as the periodontal ligament (PDL), cementum and alveolar bone. Regeneration of the periodontium is dependent on the participation of mesenchymal stem/stromal cells (MSC) resident in the PDL. Enamel matrix derivative (EMD), an extract from immature porcine enamel rich in amelogenin protein but that also contain bone morphogenetic protein (BMP), is used to treat periodontal defects. The effects of EMD on MSC cells of the PDL are not well characterized. In this in vitro study, we identify PDL progenitor cells from multiple individuals and demonstrate that EMD stimulates them. We show that the effect of EMD on cell proliferation and migrat...

Objective Can we correct dental midline discrepancies by systematic torque bends on all canines and premolars without extraction and mesiodistal tooth movement? Patients and methods Eight orthodontic patients (4 males, 4 females, mean age 31 years) presented a dental midline discrepancy of 2â??4 mm, moderate deviation of the chin, no skeletal asymmetry, and a horizontal orientation of the occlusal plane in the frontal aspect. On the side where the mandible was shifted medially, asymmetric torque bends moved the antagonist canine and both premolar crowns buccally, while palatal crown torque was used on the maxillary canine and premolars on the other side. Lingual crown torque corrected the medially shifted canine and premolars in the mandibular dental arch, and buccal crown torque the l...

IntroductionIrrigation dynamics and antibacterial activity determine the efficacy of root canal disinfection. Sonic or ultrasonic agitation of irrigants is expected to improve irrigation dynamics. This study examined the effects of microbubble emulsion (ME) combined with sonic or ultrasonic agitation on irrigation dynamics and reduction of biofilm bacteria within root canal models. MethodsTwo experiments were conducted. First, high-speed imaging was used to characterize the bubble dynamics generated in ME by sonic or ultrasonic agitation within canals of polymer tooth models. Second, 5.25% NaOCl irrigation or ME was sonically or ultrasonically agitated in canals of extracted teeth with 7-day-grown Enterococcus faecalis biofilms. Dentinal shavings from canal walls were sampled at 1 mm and 3...

Using modified USPHS criteria, we evaluated annually for ten years 91 cases restored with visible light cured posterior composite resin LFP (Base resin: UDMA; filler: micro crushed type, alumino-silicate, barium glass and silica, 85 wt%, 74 vol%). The 91 cases restored with LFP decreased to 68 in ten years. Of the 23 cases that were lost, one resulted from a pulpal reaction immediately following restoration, four were extracted owing to periodontal disease or extrusion of third molars, two became abutments owing to loss of an adjacent tooth, eight had recurrent caries, and eight were lost owing to caries on a surface having no relationship to the composite resin restoration. Because we observed comparatively little wear, good marginal adaptability, and no discoloration, we concluded that the ten-year clinical success of LFP was on the whole very good, and that this resin has adequate clinical merit as a restorative material for posterior teeth when restricted to restorations covering comparatively small areas. PMID:8940551

Lymphomatoid granulomatosis (LYG) represents a B cell lymphoproliferative disorder that appears to be driven by infection of the lesional cells by Epstein???Barr virus (EBV). Although not a common condition, the overwhelming majority of cases affect the lungs and mediastinal lymph nodes. Oral mucosal involvement has been documented in only one other report. We describe an 82-year-old man who developed a chronic oral ulcer following extraction of a mandibular molar tooth. Biopsy of the ulcer identified large atypical mononuclear cells that had a B cell immunophenotype and were associated with the walls of several arterioles in the sample. In situ probes for EBV-encoded small RNA showed prominent labeling of these large cells, suggesting the possibility of LYG. Imaging studies identified med...

IntroductionThe purpose of this study was to determine whether ultrashort echo time magnetic resonance imaging technology could be used to image teeth with orthodontic appliances in place. MethodsHigh-resolution 3-T ultrashort echo time magnetic resonance imaging was performed on 60 extracted premolars with fixed ceramic orthodontic appliances (Clarity, 3M Unitek, Monrovia, Calif; Radiance, American Orthodontics, Sheboygan, Wis; and Ice, Ormco, Glendora, Calif). The teeth were collected from the orthodontic clinic at the University of Alabama at Birmingham, and the institutional review board of the University of Alabama at Birmingham approved the study. Linear measurements of tooth morphology and orthodontic bracket dimensions were acquired with calipers and compared with virtual digital m...

In order for a dental implant to be restored optimally, it must be placed in an ideal anatomic position. However, this is not always possible, since physiological wound healing after tooth removal, often results in hard and soft tissue changes which ultimately compromises ideal implant placement. With the aim of minimising the need for tissue augmentation, several alveolar ridge preservation (ARP) techniques have been developed. These often require the use of grafting material and therefore increase the risk of disease transmission. Leukocyte and platelet-rich fibrin (L-PRF) is a newly developed platelet concentrate that is prepared from the patient's own blood. Clinical research has indicated that it improves wound healing and stimulates bone formation. We present a case where L-PRF was successfully used in an ARP procedure to facilitate implant placement in a compromised extraction socket. PMID:16783734

Abstract Though dental implant placement is now a well accepted surgical procedure, practitioners of dental implantology will often be faced with more and more complex problems to overcome as patients' demands increase: there may be hard and soft tissue factors that will hinder the stabilisation of the peri implant mucogingival complex following such surgery. This is a step by step description of the comprehensive application of a number of surgical procedures illustrated by a case report with its 30 month follow up: The extraction and immediate insertion of a dental implant into the modified vacated tooth socket. The insertion of a dental implant into what is considered an infected apical area. The use of the mineral portion of bovine bone (Bio Oss, Geistlich, Wolhusen, Switzerland) to fi...

Polyvinylpyrrolidone-iodine (PVP-I) is a well-known antiseptic, widely used in various preparations and concentrations in all surgical fields. It is also used as an irrigant for open wounds and in some centres for irrigating sockets after tooth extraction. One of the authors (GA) incidentally discovered an anti-oedematous effect of PVP-I after using it in low concentration as an irrigant/coolant during the surgical removal of lower third molars. A prospective randomized clinical trial was subsequently performed on 50 patients (25 control, 25 treatment group) undergoing removal of impacted lower third molars. In the treatment group a 0.5% PVP-I solution at a concentration of 0.5 mg/ml (we call it as "Arakeri's iodine solution") resulted in a significant reduction in postoperative swelling c...

Hurzeler MB, Zuhr O, Schupbach P, Rebele SF, Emmanouilidis N, Fickl S. The socket-shield technique: a proof-of-principle report. J Clin Periodontol 2010; 37: 855-862. doi: 10.1111/j.1600-051X.2010.01595.x. Abstract Aim: Clinical studies have suggested that retaining roots of hopeless teeth may avoid tissue alterations after tooth extraction. Therefore, the objective of this proof-of-principle experiment was to histologically assess a partial root retention (socket-shield technique) in combination with immediate implant placement. Material and Methods: In one beagle dog, the third and fourth mandibular pre-molar were hemisected and the buccal fragment of the distal root was retained approximately 1 mm coronal to the buccal bone plate. Following application of enamel matrix derivate, a titan...

We recently presented the case of a first century AD young woman, found in the archaeological site of Cosa, showing clinical signs of malnutrition, such as short height, osteoporosis, dental enamel hypoplasia and cribra orbitalia, indirect sign of anemia, all strongly suggestive for celiac disease (CD). However, whether these findings were actually associated to CD was not shown based on genetic parameters. To investigate her human leukocyte antigen (HLA) class II polymorphism, we extracted DNA from a bone sample and a tooth and genotyped HLA using three HLA-tagging single nucleotide polymorphisms for DQ8, DQ2.2 and DQ2.5, specifically associated to CD. She displayed HLA DQ 2.5, the haplotype associated to the highest risk of CD. This is the first report showing the presence of a HLA haplotype compatible for CD in archaeological specimens. PMID:23066327

Twenty-five extracted human maxillary central incisors were randomly divided into five equal groups. Crowns were removed 1 mm incisal to the cementoenamel junction. Endodontic treatment was carried out and each tooth was affixed with two strain gauges. The strain gauge wires were connected to a Wheatstone Bridge circuit. Each group of five teeth was restored with either a Para-Post Plus (the control post), Flexi-Post, Vlock post, Kurer Fin Lock Anchor, or a Radix Anchor. Strains generated during post placement were recorded and compared for the five groups using a one-way analysis of variance. The maximum strains accompanying placement of the Kurer Fin Lock Anchor and the Radix Anchor were significantly higher than those induced by placement of the other posts. Also, when the threaded posts were allowed to contact the bottom of the prepared channel, high strains resulted. PMID:1811040

Abstract Objective: The purpose of this study was to evaluate the effects of antimicrobial pretreatments [chlorhexidine gluconate (CHX), Clearfil Protect Bond (CPB), and potassium-titanyl-phosphate (KTP) laser] on microleakage under metal orthodontic brackets. Materials and Methods: Sixty freshly-extracted human premolars were randomly assigned to four equal groups: group 1, 37% phosphoric acid; group 2, 37% phosphoric acid?+?2% CHX; group 3, 37% phosphoric acid?+?KTP laser; and group 4, CPB. The teeth were kept in distilled water for 24?h, and thereafter subjected to 500 thermal cycles. Then specimens were sealed with nail varnish, stained with 0.5% basic fuchsin for 24?h, sectioned, and evaluated under a stereomicroscope. Microleakage was scored with regard to the adhesive?tooth interfac...

Abstract Tissue engineering has emerged as a novel treatment for replacement of lost bone tissue. This study evaluated the effects of a chitosan-gelatin scaffold seeded with bone marrow mesenchymal stem cells (BMMSCs) in the healing process of tooth sockets in rats. BMMSCs isolated from transgenic rats expressing enhanced green fluorescent protein (eGFP) were expanded and seeded on a chitosan-gelatin scaffold. These constructs were cultured for three days and characterized by scanning electronic microscopy (SEM) and energy dispersion spectroscopy (EDS). Receptor rats received the implant in the left sockets, after upper first-molar extraction. Right alveoli served as control. Animals were sacrificed at days 5, 21, and 35 post-graft for examination. Morphometry demonstrated increased bone m...

In the present paper, the influence of tubule orientation on surface texture development was studied. Specimens of dentin with a wide range of tubule orientations were extracted from caries-free human teeth, processed using KrF laser radiation, and analyzed by scanning electron microscopy. When a transverse cross section of dentin cut perpendicularly to the tooth axis is processed with KrF laser radiation, a cone-like topography develops in the inner dentin where tubules are parallel to the laser beam. When laser processing is carried out in the outer dentin, because tubules are significantly tilted with respect to the laser beam, flat surfaces are achieved. The surface texture after laser processing depends effectively on the angle between the tubules and the laser beam. The dependency of cone growth on tubule orientation was confirmed using a simple differential ablation model. PMID:16897108

Background. Ludwig's angina is a rapidly spreading cellulitis that may produce upper airway obstruction often leading to death. There is very little published information regarding this condition in the pregnant patient. Case. A 24-year old black female was admitted at 26 weeks gestation with tooth pain, submandibular swelling, severe trismus, and dysphagea, consistent with Ludwig's angina. Her treatment included emergent tracheostomy, incision and drainage of associated spaces, teeth extraction, and antibiotic therapy. Conclusions. During a life threatening infectious situation such as the one described, risks of maternal and fetal morbidity include both septicemia and asphyxia. Furthermore, the healthcare provider must consider the risks that the condition and the possible treatments may cause the mother and her unborn child. PMID:8450077

Introduction: Bisphosphonates are important and effective drugs in oncology and osteoporosis therapy. They accumulate in the bone matrix becoming released and active by bone resorption. This leads to effective inhibition of tumor cells and bone degradation. A side effect of bisphosphonates similar to other drugs like denosumab is osteonecrosis of the jaws (ONJ). This problem mostly occurs after tooth extraction. We studied the cytoprotectant dexrazoxane known from anthracycline chemotherapy for cytoprotection in nitrogen-containing bisphosphonate treated cells and in the rabbit tibia model to evaluate a possible value in ONJ management. Materials & methods: Human osteoblasts (HOB) P2 cells and Human ginigiva fibroblasts (HGF) P2 cells were treated with zoledronic acid (50@mmol/L) and the c...

Lymphomatoid granulomatosis (LYG) represents a B cell lymphoproliferative disorder that appears to be driven by infection of the lesional cells by Epsteinâ??Barr virus (EBV). Although not a common condition, the overwhelming majority of cases affect the lungs and mediastinal lymph nodes. Oral mucosal involvement has been documented in only one other report. We describe an 82-year-old man who developed a chronic oral ulcer following extraction of a mandibular molar tooth. Biopsy of the ulcer identified large atypical mononuclear cells that had a B cell immunophenotype and were associated with the walls of several arterioles in the sample. In situ probes for EBV-encoded small RNA showed prominent labeling of these large cells, suggesting the possibility of LYG. Imaging studies identified med...

Abstract--- Clinical experience has shown that most avulsed teeth are replanted after a long extra-alveolar time and dry or inadequate wet storage, causing necrosis of periodontal ligament cells. This condition invariably leads to development of external root resorption, leaving the filling material in contact with the periapical connective tissues. In this study, the periapical tissue reactions to calcium hydroxide (CH) and mineral trioxide aggregate (MTA) were evaluated after occurrence of external root resorption as an expected sequela of delayed tooth replantation. Twenty male Wistar rats (Rattus norvegicus, albinus) had their right upper incisor extracted and maintained in dry storage for 60-min. Then, the dental papilla, enamel organ, pulp tissue, and periodontal ligament were remove...

Failures in the sealing of the tooth apex have been considered to be responsible for most of the failures of apical surgeries. The Er:YAG laser has been proposed as an alternative for the use of rotator instruments in surgical endodontics due to its precision, lack of vibration, less post-operative discomfort, bacterial reduction, and less stress for patients and professionals. Following approval by the ethics committee, 12 extracted human canines without previous endodontic treatment with anatomically normal roots and free from apical lesions were washed in running tap water and disinfected. The teeth were sectioned axially at the crown-root junction and submitted to routine endodontic treatment. The apical limit was set at 1 mm before the apical foramen. The root canals were routinely f...

The purpose of this study is to evaluate the effect of resinifying therapy to the hard tissue of tooth by using measurement of the tensile strength. The fresh extracted maxillary anterior teeth having been cleaned and sterilized were divided into two groups. The control group was placed into 9% N-saline solution of 37 +/- 1 degrees C. The experimental group was treated with resinifying therapy. The tensile specimens were shaped by turning in a lathe until it satisfied the tensile test requirement of Mechanics of Materials except that they were hollow. A set of special split jig was made for this test. Instron Universal Testing Machine was used for measuring the load on the specimens. The loading speed was 0.05 mm/min. The straining meter was used to measure the tensile strain. The result revealed that tensile strength of resinifying dentin was little lower than that of unresinified dentin. The resinified dentin didn't increases stiffness or brittleness. PMID:2517091

Synopsis Enamel and dentin are susceptible to extrinsic and intrinsic stains. The purposes of this study were to determine the penetration pattern of Rhodamine B and dextran-conjugated Rhodamine B into the enamel and dentin as observed by confocal laser microscopy and to relate it to the penetration pattern of hydrogen peroxide commonly used as an active ingredient in tooth-whitening agents and high-molecular-weight staining molecules. Eighteen recently extracted human maxillary anterior teeth were used. Teeth were cleaned and painted with nail varnish except for the crown area above the cemento-enamel junction (CEJ). The painted teeth were then immersed in Rhodamine B and dextran-conjugated Rhodamine B (70-000-MW) for 4, 7, 10 and 15-days. Teeth were sliced to 3-mm thickness in transverse...