• Title/Summary/Keyword: cervical root resorption

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Invasive cervical resorption: treatment challenges

  • Kim, Yookyung;Lee, Chan-Young;Kim, Euiseong;Roh, Byoung-Duck
    • Restorative Dentistry and Endodontics
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    • v.37 no.4
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    • pp.228-231
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    • 2012
  • Invasive cervical resorption is a relatively uncommon form of external root resorption. It is characterized by invasion of cervical region of the root by fibrovascular tissue derived from the periodontal ligament. This case presents an invasive cervical resorption occurring in maxillary lateral incisor, following damage in cervical cementum from avulsion and intracoronal bleaching procedure. Flap reflection, debridement and restoration with glass ionomer cement were performed in an attempt to repair the defect. But after 2 mon, more resorption extended apically. Considering root stability and recurrence potential, we decided to extract the tooth. Invasive cervical resorption in advanced stages may present great challenges for clinicians. Therefore, prevention and early detection must be stressed when dealing with patients presenting history of potential predisposing factors.

The prevalence and characteristics of external cervical resorption based on cone-beam computed tomographic imaging: a cross-sectional study

  • Matheus Diniz Ferreira;Matheus Barros-Costa;Felipe Ferreira Costa;Deborah Queiroz Freitas
    • Restorative Dentistry and Endodontics
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    • v.47 no.4
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    • pp.39.1-39.12
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    • 2022
  • Objectives: This study investigated the prevalence and characteristics of external cervical resorption (ECR) regarding sex, age, tooth, stages of progression, and portal of entry, using cone-beam computed tomography (CBCT) scans. Materials and Methods: CBCT scans of 1,313 patients from a Brazilian subpopulation comprising 883 female and 430 male patients (mean age, 55.2 years), acquired using a PreXion 3D CBCT unit, were evaluated. All permanent teeth included in the scans were evaluated for the presence of ECR according to the 3-dimensional classification and the portal of entry. The association between the presence of ECR and the factors studied was assessed using the χ2 test. Intra-observer agreement was analyzed with the kappa test (α = 0.05). Results: In total, 6,240 teeth were analyzed, of which 84 (1.35%) were affected by ECR. A significant association was found between the presence of ECR and sex, with a higher prevalence in male patients (p = 0.002). The most frequently affected teeth were the mandibular and maxillary central incisors. The most common height was the mid-third of the root. For the portal of entry, 44% of cases were on the proximal surfaces, 40.5% on the lingual/palatal surface and 15.5% on the buccal surface. Intra-observer agreement was excellent. Conclusions: The prevalence of ECR was 1.35%, with a higher prevalence in male patients and a wide age distribution. The mandibular and maxillary central incisors were the most commonly affected teeth, and cases of ECR most frequently showed a height into the mid-third of the root and proximal entry.

ONE VISIT CANAL FILLING BY USING MINERAL TRIOXIDE IN A MENTALLY RETARDED CHILD : A CASE REPORT (정신지체장애아의 Mineral trioxide aggregate를 이용한 즉일 근관 충전)

  • Kang, Ji-Ye;Kim, Jong-Soo;Kim, Seung-Oh
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.7 no.2
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    • pp.99-102
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    • 2011
  • A-12year-old boy visited the clinic with chief complaint of anterior maxillary trauma. He was diagnosed with first degree mental retardation and cerebral disorders. By clinical and radiographic examination, intrusion of maxillary central incisors were found. The intrusion was not severe, teeth were luxated with a slight force and the prognosis was followed. After the first year, external root resorption was seen radiographically. Due to difficult behavior management, one visit root canal filling with OrthoMTA(BioMTA, Korea) which is known to generate of cementum and periodontal ligament was planned along with general anesthesia. OrthoMTA was filled from the apex to 1-2mm below cervical area and composite resin used for crown restoration. 6 months after, further resorption, discoloration and mobility was not found. This case is currently checked yearly and further research is needed for inflammatory root resorption and ankylosis.

IN VITRO DETERMINATION & QUANTIFICATION OF HYDROGEN PEROXIDE PENETRATION DURING NONVITLAL BLEACHING (무수치 표백시술시 치경부를 통한 표백제 누출량의 정량적 측정)

  • Park, Soo-Kyeong;Lee, Chung-Sik;Choi, Han-Seuk
    • Restorative Dentistry and Endodontics
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    • v.21 no.1
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    • pp.19-34
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    • 1996
  • It has been demonstrated that intracoronal bleaching of pulpless teeth may result in cervical root resorption. Several authors postulated that bleaching agents such as hydrogen peroxide penetrated through the dentinal tubules to damage the surrounding tissues that cause cervical root resorption. The purpose of this study was to suggest on in vitro model for direct determination of hydrogen peroxide penetration through CEJ during nonvital bleaching. In addition, this model permit the quantification of the amount of hydrogen peroxide penetrated during the procedure. Freshly extracted intact premolars, removed for orthodontic reasons were used. Root canal treatment was performed in each tooth. And then the outer surface and crown portion of the teeth was sealed with wax leaving the CEJ. The prepared teeth mounted on the wax laminates were placed in plastic assay tubes containing 1.5ml bidistilled water with their entire root, including the CEJ, submerged in the solution. The teeth were dividied into four groups. Thermo group : thermocatalytic bleaching with superoxol Walk group: walking bleaching with sodium perborate & superoxol Combi group : combination of thermocatalytic & walking bleaching Dw group : walking bleaching with sodium perborate & water The bleaching procedure was performed three times. The bleaching intervals were at 3 days. The hydrogen peroxide present in the assay system was added to ferrous ammonium sulfate resulting in ferric ion release. Upon the addition of potassium thiocyanate a ferrithiocyanate complex results, which absorbs light at the wavelength of 467nm. The radicular penetration of hydrogen peroxide in the four groups was assessed directly using spectrophotometer. The amount of hydrogen peroxide in the samples tested is determined by comparing them with a standard curve generated by known amounts of hydrogen peroxide. The results were obtained as follows : 1. In all experimental groups except the Dw group showed lower penetration amount in day 4 than day 1, there was statistical importance in the difference (P<0.05). 2. After 3rd treatment, Thermo group showed slightly increased value and narrow distribution. Walk group showed much more penetration amount and widely dispersed value. Value of Combi group showed wide distribution without regard to treatment time, but value of Dw group evenly distributed. 3. Thermo group, Walk group and Dw group showed a tendency of increasing penetration amount with increasing treatment times(P<0.01), but Combi group revealed no statistically important differences. 4. Combi group showed the highest degree of penetration. Walk group showed lower penetration than Combi group. Thermo group & Dw group showed lower than Walk group. 5. Cervical root permeability to hydrogen peroxide varied from 0 to 35 %.

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Management of horizontal root fractures by fabrication of canine protected occlusion using composite resin

  • Shin, Joo-Hee;Kim, Ryan Jin-Young
    • Restorative Dentistry and Endodontics
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    • v.37 no.3
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    • pp.180-184
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    • 2012
  • Traumatic injuries of the face often involve root fractures especially in anterior teeth. The prognosis and the treatment of the root fracture depend on the extent of the fracture line, general health and patient compliance. This case report outlines a new conservative trial treatment modality to stabilize the maxillary central incisors with horizontal root fracture on the cervical to middle third by fabricating canine guidance to remove loading on the traumatized maxillary central incisors during eccentric movements and thus inducing spontaneous healing of the fractured line between the fragments. Radiographs after thirty months showed adequate healing with no signs of pathological changes including root resorption, ankylosis or displacement. Long term follow-up revealed that vitality, stability and aesthetics were maintained and the patient was satisfied with the outcome.

EFFECT OF MAXILLARY EXPANSION APPLIANCE USING MAGNETIC ATTRACTION FORCE (자석의 견인력을 이용한 상악골 확대 장치의 효과)

  • Lee, Won You;Jang, Ji Cheul;Kim, Hyoung Don;Han, Bu Seuk
    • The korean journal of orthodontics
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    • v.21 no.3
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    • pp.603-614
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    • 1991
  • To study the possibility of attraction magnetic forces to expand maxillary arch, we used 2 big adult dogs, 2 small puppies, 1 small adult dog as experiments, and 1 small adult dog as a control. We measured the intercanine width and intermolar width and histologically observed in the suture and cervical and apex region of teeth and took occlusal X-rays to observe separation of suture line in the maxilla. The results were as follows: 1. Expansion velocities of intercanine (0.25mm/day) and intermolar widths (0.23mm/day) in puppies were faster than those (0.135mm/day, 0.09mm/day) in adults. 2. In all experiments in adults (0.135mm/day) and puppies (0.25mm/day), expansion velocity of intercanine widths were faster than those (0.09mm/day, 0.23mm/day) of intermolar width. 3. In all experiments ectatic changes were observed and cellularities of fibroblast increased in the suture line. Only in adults dogs the separations of palatal suture were observed in the occlusal X-ray view. 4. In the puppies bony deposition was particularly observed in the suture line and micro-bony fragments were often observed. 5. In the all experiments no root resorption was observed in the cervical and root area, but normal root resorption due to eruption of permanent teeth was observed in the puppies.

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A QUANTITATIVE STUDY ON THE DEGRADING EFFECT OF THE VARIOUS IRRIGATING AGENTS IN THE ELIMINATION OF RESIDUAL HYDROGEN PEROXIDE FOLLOWING WALKING BLEACHING (무수치 표백술 후 잔존 과산화수소수 제거를 위한 수종의 치수강 세척제의 효과에 관한 정량적 연구)

  • Kum, Kee-Yeon;Han, Won-Sup;Jung, Il-Young;Lee, Seung-Jong;Lee, Chan-Young;Oh, Byung-Hoon
    • Restorative Dentistry and Endodontics
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    • v.23 no.2
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    • pp.656-669
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    • 1998
  • Hydrogen peroxide at high concentration during walking bleaching may cause damage to the tooth structure and to the surrounding periodontal tissues and may develop external root resorption. Clinically, It is so important to find a method of prevention or minimization of these complications. The efficacy of various chamber-irrigating agents to eliminate residual hydrogen peroxide after walking bleaching was examined and compared with water rinse in this study. Extracted human 46 premolars without any cementoenamel junction defects were treated endodontically and based with IRM to 1 mm below CEJ and totally bleached 3 times for each tooth with 30% hydrogen peroxide and sodium perborate. Upon completion of the 3rd walking bleaching procedure, the cervical portion and pulp chamber of each group of teeth were irrigated with catalase, 70% ethylalcohol, acetone, and distilled water. And then, a radicular hydrogen peroxide penetration was measured with spectrophotometer immediately after each bleaching and following treatment with each chamber-irrigating agents, and the significance of their eliminating efficacy of residual hydrogen peroxide was analyzed by Kruskal-Wallis test. The results were obtained as follows. 1. Cervical root penetration of hydrogen peroxide was increased as the bleaching procedure was repeated(P<.01). 2. The most effective irrigant that removed residual hydrogen peroxide was the catalase, and the least effective one was water rinsing (P<.01).; there was no significant difference between the acetone and ethanol group. 3. The Irrigation with antioxidant enzyme or water-displacement solutions can eliminate residual oxygen radicals from the pulp chamber effectively after walking bleaching. So, these agents can reduce adverse effects such as cervical external resorption and periapical inflammation and prevent residual $O_2$ from impeding composite resin polymerization, thus increase the bonding strength of composite resin. This, in turn reduces microleakage and discoloration of the esthetic restoration, extending its service-life.

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THE STUDY ON THE LEAKAGE OF BLEACHING AGENTS THROUGH CERVICAL AREA ACCORDING TO THE BASING METHOD (이장재 도포 방법에 따른 표백제의 치경부 누출에 대한 연구)

  • Kim, Sung-Chul;Yoon, Tae-Chull;Park, Dong-Soo
    • Restorative Dentistry and Endodontics
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    • v.20 no.1
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    • pp.250-260
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    • 1995
  • Bases have been used in order to prevent the leakage of bleachingagents through dentinal tubules in bleached teeth. But the proximal surfaces where the actual resorption takes place havenot been protected. The purpose of this study was to compare the conventional basing method with the basing of the labial and two proximal surfaces to the cementoenamel junction. The bases were placed after conventional root canal treatment. Group I: 2mm thickness bases were placed to the level of labial cementoenamel junction line. Group II : 2mm thickness bases were placed to the level of all c-e J lines including cervical area. Control : No bases were placed. After placement of sodium perborate and 30% hydrogen peroxide mixtureinto the teeth, the changes of pH were measured. The results were as follows. 1. Group II showed smaller leakage of bleaching agents and was statistically significant difference compared to Group I.(p<0.05) 2. Group I showed no statistically significant difference compared to the control group. (p>0.05) 3. There were no significant among the upper and lower teeth groups in each group and between the groups.(p>0.05). According to the above results, it was considered that basing of the labial and proximal surfaces to the cementoenamel junction can reduce the leakage of bleaching agents during bleaching procedure of pulplessteeth.

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THE EFFECT OF INTRACANAL BASE ON PREVENTION OF APICAL LEAKAGE OF BLEACHING AGENTS (무수치 표백술에서 근관내 Base가 표백약제의 누출 방지에 미치는 영향)

  • Choi, Seung-Ho;Ro, Byeng-Duck;Park, Sung-Ho;Lee, Seung-Jong
    • Restorative Dentistry and Endodontics
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    • v.24 no.3
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    • pp.453-464
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    • 1999
  • The non-vital bleaching technique has been used widely as a very effective treatment method on discolored non-vital teeth. But periodontal tissue deterioration and cervical external root resorption have been reported because of the high toxicity of hydrogen peroxide in bleaching agents. So in previous studies, placement of base over the root canal obturation prior to bleaching has been suggested in order to prevent microleakage of bleaching agents, however, the effectiveness of base is still controversial. The purpose of this study was to evaluate the effects of base and root canal sealer on prevention of leakage of bleaching agents in non-vital bleaching. Fifty-two extracted sound teeth with single root were used. For root canal obturation, Tubuli seal$^{(R)}$(Kerr Co., USA) was used in 39 teeth and in others, AH-26$^{(R)}$(De Trey Dentsply, Inc., Switzerland) was used as a root canal sealer. 26 teeth among the teeth obturated with Tubuli seal$^{(R)}$ were divided into two groups, and Dentin cement$^{(R)}$(GC corp., Japan) and JRM$^{(R)}$(De Trey Dentsply, Inc. Germany) were used in each group as a intracanal base. In all teeth, non-vital bleaching using bleaching agent mixed with methylene blue dye was performed and all specimens were stored in $37^{\circ}C$ water bath for 72 hours. After sectioning longitudinally, the depth of dye leakage was measured with digital vernier calipers under the stereobinocular microscope using ${\times}40$ magnification. It can be concluded as follows: 1. The microleakage of bleaching agent was observed ill all groups regardless of type of the base and the sealer. 2. The microleakage in the groups using AH-26$^{(R)}$ as a sealer was significantly reduced (p<0.05). 3. In the groups with intracanal base, micro leakage was observed through almost the whole depth of the base and there was no significant difference between Dentin cement$^{(R)}$ and IRM$^{(R)}$ group(p>0.05). In conclusion, all the basing materials and the sealers in this study did not prevent the microleakage of bleaching agent. Therefore further studies and attempts to seal off the pulp chamber will be necessary.

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