• Title/Summary/Keyword: Apical root resorption

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ROOT SURFACE CHANCES DURING THE INITIAL LEVELING AND ALIGNMENT PHASE IN ORTHODONTICS: A SCANNING ELECTRON MICROSCOPIC STUDY (교정적 치아초기배열단계시 발생하는 치근 변화에 관한 주사전자현미경적 연구)

  • Choi, Jung-Yoon;Chung, Kyu-Rhim
    • The korean journal of orthodontics
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    • v.28 no.4 s.69
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    • pp.591-600
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    • 1998
  • The purpose of this study was to investigate the root resolution and repair pattern of human teeth according to the force magnitude, direction and duration during the initial leveling and alignment phase. 40gms to 500gms of force applied to the 37 experimental teeth with duration of 3 weeks to 7 months. Then, the experimental teeth were extracted. 13 control teeth were extracted without treatment. The results are as follows: 1. $59.5\%$ of 37 teeth exhibited root resorption. The initial resorption site was visible at the apex within 3 weeks with 100 gms samples, and the initial repair site was visible at the apex within 3 months with 400 gms samples. 2. Number of resorbed teeth increased with the duration of the force. 3. The depth of the resorption increased with the magnitude of the force. 4. The areas of resorbed root corresponded with the loading pattern. 5. The areas of resorbed root were highly correlated with the magnitude of the force. The result of this study suggest that root resorption could occur during the initial leveling and alignment phase, These initial injuries are all small and insignificant. It is the extensive type of apical root resolution that must be regarded as deleterious to the function and stability of the tooth moved. During the initial leveling and alignment phase lighter force of the interrupted type and short treatment period would be favorable with regard to avoidance of root resorption and repair of resorbed root surface.

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Orthodontic Traction of the Impacted Mandibular Third Molars to Replace Severely Resorbed Mandibular Second Molars

  • Hwang, Soonshin;Choi, Yoon Jeong
    • Journal of Korean Dental Science
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    • v.9 no.1
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    • pp.42-48
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    • 2016
  • Prophylactic removal of impacted third molars is a common procedure in dentistry, but the necessity of routine extraction is still controversial. When impacted third molars caused severe apical root resorption of the second molars, orthodontic traction of the third molars after extraction of the damaged second molars could minimize alveolar bone defect and preserve the patient's natural teeth. By well-planned orthodontic treatment, functional occlusion was established avoiding extraction of the impacted teeth and eliminating the possibility of a large bone defect after extraction.

Cone-beam computed tomography-based diagnosis and treatment simulation for a patient with a protrusive profile and a gummy smile

  • Uesugi, Shunsuke;Imamura, Toshihiro;Kokai, Satoshi;Ono, Takashi
    • The korean journal of orthodontics
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    • v.48 no.3
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    • pp.189-199
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    • 2018
  • For patients with bimaxillary protrusion, significant retraction and intrusion of the anterior teeth are sometimes essential to improve the facial profile. However, severe root resorption of the maxillary incisors occasionally occurs after treatment because of various factors. For instance, it has been reported that approximation or invasion of the incisive canal by the anterior tooth roots during retraction may cause apical root damage. Thus, determination of the position of the maxillary incisors is key for orthodontic diagnosis and treatment planning in such cases. Cone-beam computed tomography (CBCT) may be useful for simulating the post-treatment position of the maxillary incisors and surrounding structures in order to ensure safe teeth movement. Here, we present a case of Class II malocclusion with bimaxillary protrusion, wherein apical root damage due to treatment was minimized by pretreatment evaluation of the anatomical structures and simulation of the maxillary central incisor movement using CBCT. Considerable retraction and intrusion of the maxillary incisors, which resulted in a significant improvement in the facial profile and smile, were achieved without severe root resorption. Our findings suggest that CBCT-based diagnosis and treatment simulation may facilitate safe and dynamic orthodontic tooth movement, particularly in patients requiring maximum anterior tooth retraction.

COMPARISON OF CANAL FILLING EFFICIENCY ON THE INTERNALLY RESORBED ROOT ACCORDING TO CANAL FILLING TEHNIQUES (근관충전방법에 따른 내흡수 치근의 근관충전 효율성 비교)

  • Ha, Sang-Yoon;Shin, Dong-Hoon;Hong, Chan-Ui
    • Restorative Dentistry and Endodontics
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    • v.20 no.2
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    • pp.789-801
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    • 1995
  • Canals with artificially made internal resorption were filled with 4 techniques(Lateral condensation, Ultrafil, Obtura II, Thermafil) to compare the efficacy of canal filling according to the filling techniques. After canal filling, radiographic examination, dye penetration through the apical portion and percentage of G-P filled area on the internal resorption area were evaluated. To examine the degree of crystal-like structure and the interface between filled G-P and canal wall, SM and SEM images were taken too. The results were as follows : 1. There was no statistically significant difference in apical microleakage among the 4 root canal filling techniques. 2. As a result of radiographic examination, Ultrafil was the best and Obtura II was acceptable but Lateral condensation and Thermafil showed unfavorable canal filling pattern similarly. 3. Ultrafil filled most of artificially made internal resorption area and Obtura II, Lateral condensation, Thermafil in that order filled unfavorably. 4. Degree of crystal like structure was the highest in the group filled with Ultrafil and those of Obtura II and Thermafil were similar and that of gutta percha used in Lateral condensation showed the lowest value. 5. Penetration of gutta percha into the dentinal tubules couldn't be seen in all groups. In the contact surface between the filled G-P and the canal wall, Lateral condensation showed relatively close sealing, Obtura II and Thermafil had irregular contact surface and Ultrafil showed regular filling pattern. 6. Contact surface between the core of Thermafil and the gutta percha showed close relationship without gap formation.

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HISTOPATHOLOGIC STUDY ON THE HEALING PROCESS OF APICAL WOUND IN APPLYING SEVERAL MATERIALS (치근단 손상부의 치유에 영향을 미치는 제재에 관한 병리조직학적 연구)

  • Cho, Young-Gon
    • Restorative Dentistry and Endodontics
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    • v.14 no.2
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    • pp.49-64
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    • 1989
  • The purpose of this study was to evaluate the effect of several materials on the healing process of apical wound. Sixteen mandibular premolars obtained from 4 healthy dogs were used for this study. Under general anesthesia, the pulpal chamber of each tooth was opened and the pulps were extirpated. The root canals were then instrumented with H-file and irrigated with physiologic saline solution ; the apices were purposely perforated and enlarged with the engine K-reamer. In the experimental groups, apical wounds were filled with one of calcium hydroxide, hydroxylapatite, and tricalcium phosphate materials, mixture of each materials and physiologic saline solution, with a lentulo spiral. In the control group, apical wounds were not filled with any material. All the root canals were filled by the lateral condensation technique with gutta-percha cone and ZOE sealer. The access opening of all the teeth were closed with amalgam. On the 10, 20, 40 and 60th day after experiment, experimental animals were sacrificed. Segments of jaws, each containing one tooth, were fixed in 10% formalin solution and decalcified in Plank-Rychlo solution. The specimens were embedded in paraffin and serially sectioned to an average thickness of $6{\mu}m$. The sections were stained by hematoxylin-eosin and Masson's trichrome stain method and examined under light microscope. The results were as follows : 1. In the experimental groups, the new bone formations were observed in apical wounds. 2. Fourty days later, apical wounds were healed by granulation tissue in the experimental groups, but were not healed by granulation tissue in the control group, and the healing process of experimental groups were more rapid than that of control group. 3. Sixty days later, chronic inflammation disappeared in the experimental groups, and the materials used showed biologic affinity to the periapical tissue. 4. In all the groups, the resorption of cementum appeared on the 10th and 20th day after experiment, and the deposition of cementum appeared on the 40th and 60th day after experiment, especially showing narrowness of apical foramen due to newly formed cementum in calcium hydroxide group. 5. Calcum hydroxide and tricalcium phosphate particles were gradually resolved, but hydroxylapatite particles were not resolved through the experimental period.

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The effect of NaF on bone and tooth resorption around an anchor tooth during a rapid maxillary expansion procedure (급속상악확대술 시행 후 지대치와 지지골 표면에 나타나는 치근흡수의 불화나트륨 단독투여를 통한 예방에 대하여)

  • Min, Seungki;Chung, Kyu-Rhim
    • The korean journal of orthodontics
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    • v.34 no.6 s.107
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    • pp.526-536
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    • 2004
  • This study was undertaken to determine the effect of a 2.2mg/Kg/day intraoral administration of NaF on the amount of root resorption and osteoclastic activity during or after a rapid maxillary expansion procedure. Ten puerile female dogs were divided into two groups: a control group and a NaF-treated group. A fixed type maxillary expansion device was delivered to all dogs. The appliance was activated twice daily throughout a 20-day period, causing a 5-mm expansion of maxillary bone. After the expansion procedure, the animals were sacrificed at days 0, 15, 30, 45, and 60 of the retention period. The buccal surface of the root of each maxillary canine was examined by means of a surface electron microscope (SEM). Using SEM, web-like resorption lacunae were observed on the bone or the tooth surface at the site of osteoclastic activity; these observations were verified by histological methods. No peculiar resorption lacunae were found in the apical tip of the roots of either the control group or the NaF-treated group animals. The NaF-treated retention group was found to have less resorption lacunae formation on day 45 and day 60. The preventative effect of NaF on resorption lacunae formation on the surface of the bone covering the anchor tooth was confirmed. Larger areas of resorption lacunae were found on the surface of the bone covering the canines in the control group animals, as compared to those of the NaF-treated group, especially on day 30 and day 60. Using SEM, the present study revealed a difference between the control group and the NaF-treated group in the prevalence and the size of the resorption lacunae formation on the cemental root surface. The preventative effect of NaF on bone resorption was confirmed. Further studies concerned with the optimum concentration of NaF that has an effect in vivo are necessary.

The fate of overfilling in root canal treatments with long-term follow-up: a case series

  • Vito Antonio Malagnino;Alfio Pappalardo;Gianluca Plotino;Teocrito Carlesi
    • Restorative Dentistry and Endodontics
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    • v.46 no.2
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    • pp.27.1-27.10
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    • 2021
  • This study describes 6 cases of endodontic overfilling with successful clinical outcomes during long-term (up to 35 years) radiographic follow-up. Successful endodontic treatment depends on proper shaping, disinfection, and obturation of root canals. Filling materials should completely fill the root canal space without exceeding the anatomical apex. Overfilling may occur when the filling material extrudes into the periapical tissues beyond the apex. The present case series describes 6 root canal treatments in which overfilling of root canal sealer and gutta-percha accidentally occurred. Patients' teeth were periodically checked with periapical radiographs in order to evaluate the outcomes during long-term follow-up. All cases showed healing and progressive resorption of the extruded materials in the periapex. The present cases showed that if a 3-dimensional seal was present at the apical level, overfilling did not negatively affect the long-term outcomes of root canal treatment.

THE PROGNOSIS OF INTENTIONALLY RETAINED ROOT FRAGMENT OF PRIMARY TEETH (의도적으로 남겨진 유치근 파절편의 예후)

  • Lee, Suk-Hee;Kim, Shin;Jeong, Tae-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.1
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    • pp.156-161
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    • 2007
  • Pediatric dentists are frequently encountered with fractured root fragments of primary teeth caused either by the traumatic injuries or by the accidental fractures during the procedure of tooth extractions. In these situations, we often hesitate which method to choose, extract or retain it. In general, it is recommended to retain apical fragments, as the attempts to extract the apical fragments might harm the developing permanent tooth germ. This study was designed to ensure the validity of intentional retention of the root fragments of primary teeth in the situations described above. 6 children with intentionally root fragments who experienced root fracture in primary anterior teeth were available Periodic radiographic assessment was performed at 3 months interval for $7{\sim}37$ months. The results of this study showed that apical fragments had been resorbed through physiologic process in 5 patients. Apical fragment had been gingival emergence along with the erupting permanent tooth in 1 patient. There were no evidence of interference with eruption of permanent successors. In summary we have been ensured the validity of intentionally retention of the root fragments of primary teeth. Children with being remained apical root fragment should be recalled regularly for assessment and parents should be thoroughly informed about the situation with special emphasis on the necessity of periodic check-up.

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Effects of different calcium-silicate based materials on fracture resistance of immature permanent teeth with replacement root resorption and osteoclastogenesis

  • Gabriela Leite de Souza;Gabrielle Alves Nunes Freitas;Maria Tereza Hordones Ribeiro;Nelly Xiomara Alvarado Lemus;Carlos Jose Soares;Camilla Christian Gomes Moura
    • Restorative Dentistry and Endodontics
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    • v.48 no.2
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    • pp.21.1-21.15
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    • 2023
  • Objectives: This study evaluated the effects of Biodentine (BD), Bio-C Repair (BCR), and mineral trioxide aggregate (MTA) plug on the fracture resistance of simulated immature teeth with replacement root resorption (RRR) and in vitro-induced osteoclastogenesis. Materials and Methods: Sixty bovine incisors simulating immature teeth and RRR were divided into 5 groups: BD and BCR groups, with samples completely filled with the respective materials; MTA group, which utilized a 3-mm apical MTA plug; RRR group, which received no root canal filling; and normal periodontal ligament (PL) group, which had no RRR and no root canal filling. All the teeth underwent cycling loading, and compression strength testing was performed using a universal testing machine. RAW 264.7 macrophages were treated with 1:16 extracts of BD, BCR, and MTA containing receptor activator of nuclear factor-kappa B ligand (RANKL) for 5 days. RANKL-induced osteoclast differentiation was assessed by staining with tartrate-resistant acid phosphatase. The fracture load and osteoclast number were analyzed using 1-way ANOVA and Tukey's test (α = 0.05). Results: No significant difference in fracture resistance was observed among the groups (p > 0.05). All materials similarly inhibited osteoclastogenesis (p > 0.05), except for BCR, which led to a lower percentage of osteoclasts than did MTA (p < 0.0001). Conclusions: The treatment options for non-vital immature teeth with RRR did not strengthen the teeth and promoted a similar resistance to fractures in all cases. BD, MTA, and BCR showed inhibitory effects on osteoclast differentiation, with BCR yielding improved results compared to the other materials.

Intentional Replantation of a Root-Fractured Tooth with Pulp Canal Obliteration (근관협착된 치근파절 치아에서 의도적 재식술 치험례)

  • Kim, Mihee;Lee, Sangho;Lee, Nanyoung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.2
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    • pp.200-206
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    • 2016
  • Root fracture is defined as a fracture involving the dentin, cementum, and pulp. Most fractures occur in the maxillary anterior teeth between the ages of 11 and 20 years old. The treatment for root fracture in permanent teeth involves the reduction and fixation of the displaced coronal segment. When signs of pulp necrosis or inflammatory root resorption are present, root canal therapy should be performed. Since most apical fragments maintain pulp vitality, root canal therapy is typically limited to coronal fragments. However, it's too difficult to achieve a proper apical stop on coronal fragment. Intentional replantation involves performing root apex treatment outside the mouth after intentional extraction of the tooth in a controlled environment and then replanting it. The objective is 'perfect' root canal therapy. Intentional replantation may be used in cases of failed typical root canal therapy, problematic endodontic retreatment due to the existing restoration or a calcified root canal, and when apical surgery is contraindicated because of a lack of reasonable approaches. In this case, intentional replantation was carried out to treat a horizontal root fracture in a maxillary central incisor with a calcified root canal due to previous trauma. We achieved a clinically and functionally satisfactory result.