This case presents an unusual transposition of an impacted canine on the central incisor that provides a multidisciplinary approach to its resolution. The patient comes to the consultation for mobility of the central ...This case presents an unusual transposition of an impacted canine on the central incisor that provides a multidisciplinary approach to its resolution. The patient comes to the consultation for mobility of the central incisor. Clinically, tooth mobility was confirmed with tooth crowding and persistence of the temporary canine. Cone beam tomography (CBCT) observed the atypical position of the permanent canine that caused root resorption of the ipsilateral central incisor and the need to extract both teeth. The conservative treatment of the bone structures during the dental enucleation of the impacted canine carried out by odontosection and the immediate bone grafting of the defect projected an acceptable regeneration of the bone volume for the insertion of the implant. The orthodontic treatment managed to correct the bite, position the upper premolar in the place of the canine tooth and maintain the space to place the implant in the central incisor. The three-year follow-up shows maintenance of the peri-implant crestal bone level, the success of orthodontic treatment with recovery of the patient’s function and aesthetics.展开更多
Orthodontic forces have been reported to significantly increase nicotine-induced periodontal bone loss. At present, however, it is unknown, which further (side) effects can be expected during orthodontic treatment a...Orthodontic forces have been reported to significantly increase nicotine-induced periodontal bone loss. At present, however, it is unknown, which further (side) effects can be expected during orthodontic treatment at a nicotine exposure corresponding to that of an average European smoker. 63 male Fischer344 rats were randomized in three consecutive experiments of 21 animals each (A/B/C) to 3 experimental groups (7 rats, 112/3). (A) cone-beam-computed tomography (CBCT); (B) histology/serology; (C) reverse- transcription quantitative real-time polymerase chain reaction (RT-qPCR)/cotinine serology--(1) control; (2) orthodontic tooth movement (OTM) of the first and second upper left molar (NiTi closed coil spring, 0.25 N); (3) OTM with 1.89 mg-kg- 1 per day s.c. of L(- )-nicotine. After 14 days of OTM, serum cotinine and IL-6 concentration as well as orthodontically induced inflammatory root resorption (OIIRR), osteoclast activity (histology), orthodontic tooth movement velocity (CBCT, within 14 and 28 days of OTM) and relative gene expression of known inflammatory and osteoclast markers were quantified in the dental-periodontal tissue (RT-qPCR). Animals exposed to nicotine showed significantly heightened serum cotinine and IL-6 levels corresponding to those of regular European smokers. Both the extent of root resorption, osteoclast activity, orthodontic tooth movement and gene expression of inflammatory and osteoclast markers were significantly increased compared to controls with and without OTM under the influence of nicotine. We conclude that apart from increased periodontal bone loss, a progression of dental root resorption and accelerated orthodontic tooth movement are to be anticipated during orthodontic therapy, if nicotine consumption is present. Thus patients should be informed about these risks and the necessity of nicotine abstinence during treatment.展开更多
This study evaluated,over a 4-month study period,the amount of apical root resorption occurring in maxillary central incisors following their retraction when employing either micro-implant or J-hook headgear anchorage...This study evaluated,over a 4-month study period,the amount of apical root resorption occurring in maxillary central incisors following their retraction when employing either micro-implant or J-hook headgear anchorage.The prospective randomised clinical trial was conducted in Orthodontic Clinic,College of Stomatology,China from 2008-2009.Subjects are patients requiring fixed appliances on waiting list (n=20).In female Han Chinese patients aged from 16-26 years,standardized periapical radiographs from 10 randomly assigned patients with maxillary protrusions comprising the micro-implant group,and from 10 similar patients comprising the J-hook headgear group,were assessed for maxillary central incisor apical root resorption.Measurements before and after orthodontic therapy were also obtained from lateral cephalometric radiographs to calculate incisor horizontal retraction and vertical intrusion distances.Estimated retraction force vectors were calculated in horizontal and vertical directions for both treatment groups.Data analysis employed t-tests and the Pearson correlation test,with α=0.05 for statistical significance.The results showed that when compared with the J-hook group,significantly more apical root resorption shortening of the maxillary central incisors was observed in the micro-implant group (1.27 mm difference,95% CI=0.70-1.84,P<0.001),which was associated with a significantly larger retraction distance (P=0.004) and a smaller vertical force component (P<0.0001).We are led to conclude that continuous activation of the nickel-titanium coil springs used in the micro-implant group resulted in significantly more apical root resorption shortening and maxillary central incisor retraction than when intermittent J-hook retraction was employed.The employment of continuous duration orthodontic forces presents a risk for increased apical root resorption that requires careful radiographic monitoring.展开更多
Summary: The purpose of this study was to develop a new way to localize the impacted canines from three dimensions and to investigate the root resorption of the adjacent teeth by using cone beam computed tomography ...Summary: The purpose of this study was to develop a new way to localize the impacted canines from three dimensions and to investigate the root resorption of the adjacent teeth by using cone beam computed tomography (CBCT). Forty-six patients undergoing orthodontic treatments and having impacted canines in Tongii Hospital were examined. The images of CBCT scans were obtained from KaVo 3D exam vision. Angular and linear measurements of the cusp tip and root apex according to the three planes (mid-sagittal, occlusal and frontal) have been taken using the cephalometric tool of the InVivo Dental Anatomage Version 5.1.10. The measurements of the angular and linear coordinates of the maxillary and mandibular canines were obtained. Using this technique the operators could envision the location of the impacted canine according to the three clinical planes. Adjacent teeth root resorption.of 28.26 % was in the upper lateral incisors while 17.39% in upper central incisors, but no lower root resorption was found in our samples. Accurate and reliable localization of the impacted canines could be obtained from the novel analysis system, which offers a better surgical and orthodontic treatment for the patients with impacted canines.展开更多
Background: The objective of this study was to determine the levels of tumor necrosis factor-alpha (TNF-α) and receptor activator of NF-kB ligand (RANKL) in the gingival crevicular fluid (GCF) in patients with severe...Background: The objective of this study was to determine the levels of tumor necrosis factor-alpha (TNF-α) and receptor activator of NF-kB ligand (RANKL) in the gingival crevicular fluid (GCF) in patients with severe root resorption after orthodontic treatment. Materials and Methods: Ten patients who had been receiving orthodontic treatment (5-control subjects and 5-severe root resorption subjects) participated in this study. GCF was collected from all patients. Subjects with severe root resorption (>1/3 of the original root length) were identified. Control group subjects with no loss of the root structure undergoing orthodontic treatment were also identified. The GCF was collected non-invasively from the mesial and distal sides of each of the upper central and lateral incisors using filter paper strips. The eluted GCF was used for a Western blot analysis with Antibodies against TNF-α and soluble RANKL (sRANKL). Ten male 6-week-old Wistar rats were subjected to orthodontic force of 50 g to induce a mesially tipping movement of the upper first molars for 7 days. The expression levels of TNF-α and RANKL proteins were determined in periodontal ligament (PDL) by immunohistochemical analysis. Results: The Western blot analysis showed that the TNF-α and sRANKL expressions were significantly higher in the severe root resorption group than in the control group. In the experimental tooth movement in vivo, resorption lacunae with multinucleated cells were observed in 50 g group. The immunoreactivity for TNF-α and RANKL was detected in PDL tissue subjected to the orthodontic force on day 7. Conclusion: These results suggest that TNF-α and RANKL play important roles in inducing or facilitating the development of orthodontically-induced inflammatory root resorption (OIIRR).展开更多
Purpose: To establish a new coordinate system using the incisive canal and incisive foramen in cases confirmed to have root resorption in the maxillary incisor region by cone beam computed tomography (CBCT) to investi...Purpose: To establish a new coordinate system using the incisive canal and incisive foramen in cases confirmed to have root resorption in the maxillary incisor region by cone beam computed tomography (CBCT) to investigate the positions of the central and lateral incisor roots and erupting maxillary canine tooth crowns in the horizontal plane. Methods: Nine patients (two males;mean age: 10.5 years old) with suspected incisor root resorption due to erupting maxillary canines on panoramic X-ray images and in whom incisor root resorption was confirmed on CBCT images were evaluated. A control group of 12 patients with a supernumerary tooth on one side (three males;mean age: 8.6 years old) was also examined. X, Y, and Z-axes were defined, and the positions of the centers of the central incisor root (U1) and lateral incisor root (U2) and the canine cusp (U3) were examined, along with alveolar process width and length. Results: In the control group, U1, U2, and U3 were located within a certain range without overlap, while, in the incisor root resorption group, U3 overlapped with U1 and U2 and tended to deviate centrally. U2 tended to be located further posteriorly than U3. The anteroposterior diameter of the alveolar process was 1.2 mm shorter in the incisor root resorption group (p < 0.05). Conclusions: The risk of incisor root resorption accompanying canine eruption can be evaluated early by investigating the canine position on a horizontal plane established on the upper anterior tooth dentition CT images with a coordinate system using the incisive canal and incisive foramen.展开更多
External root resorption can induce the degeneration of dental cementum and dentine and may extend towards the pulp reductive. Digital subtraction radiography can function as a useful tool in diagnosing degenerative c...External root resorption can induce the degeneration of dental cementum and dentine and may extend towards the pulp reductive. Digital subtraction radiography can function as a useful tool in diagnosing degenerative carious lesions. This study investigated the diagnostic value of digital subtraction radiography in detecting external root resorption. This was a descriptive study conducted using the lab trial method. Artificially-induced external root resorption was created in different sizes at the coronal and apical aspects of 20 premolar teeth. Digital radiographs were obtained of each tooth under standard conditions and these radiographs were subtracted by imaging devices. The subtracted images and the digital radiographs were observed by three radiologists. Chi-square, Kappa test, and Z-test were used to analyze the data. The mean of general sensitivity of digital subtraction radiography and direct digital radiography was low in diagnosing 0.05 mm lesions (Sen = 35%), yet, the accuracy index was good for all lesions (Acc ≥ 65%). Other diagnostic parameters were also acceptable. Both types of radiography worked better in diagnosing coronal than apical lesions (P > 0.05). The interpreters (observers) showed a better performance in diagnosing external root resorption using digital subtraction radiography compared to digital radiography. Both modalities were exact and accurate in detecting 0.05 mm lesions as well as other lesions. However, the results of digital subtraction radiography were not significantly different from those of direct digital radiography.展开更多
The aim of this study was to investigate the amount of external apical root resorption (EARR) and the release of interleukin (IL)-6 in the gingival crevicular fluid (GCF) in subjects treated with a low-force low-frict...The aim of this study was to investigate the amount of external apical root resorption (EARR) and the release of interleukin (IL)-6 in the gingival crevicular fluid (GCF) in subjects treated with a low-force low-friction system. Sixty patients were assigned to two groups of thirty patients for each: one group received treatment with self-ligating brackets and the other with conventional ligated edgewise brackets. All patients were treated with extraction of the maxillary first premolars. The EARR of the maxillary central incisors was evaluated on the periapical radiographs and cephalograms, taken before and after orthodontic treatment. The GCF was also collected non-invasively from the mesial and distal sides of central incisors by using filter paper strips before and after orthodontic treatment. Enzyme-linked immunosorbent assay (ELISA) kits were used to determine the IL-6 levels in the GCF samples. A significant difference was found in the amount of EARR between the patients with self-ligating brackets and conventional brackets. The mean amount of EARR was significantly lower for self-ligating brackets than conventional brackets (p < 0.05). The GCF levels of IL-6 for the patients with self-ligating brackets appliance were significantly lower than for those with the conventional brackets (p < 0.05). These results show that the mean amount of EARR and the GCF levels of IL-6 were significantly lower in the patients treated using low-force low-friction appliances than conventional brackets. Therefore, self-ligating brackets may be a useful system for reducing inflammation and EARR.展开更多
A simple overview of daily orthodontic practice involves use of brackets, wires and elastomeric modules. However, investigating the underlying effect of orthodontic forces shows various molecular and cellular changes....A simple overview of daily orthodontic practice involves use of brackets, wires and elastomeric modules. However, investigating the underlying effect of orthodontic forces shows various molecular and cellular changes. Also, orthodontics is in close relation with dentofacial orthopedics which involves bone regeneration. In this review current and future applications of stem cells(SCs) in orthodontics and dentofacial orthopedics have been discussed. For craniofacial anomalies, SCs have been applied to regenerate hard tissue(such as treatment of alveolar cleft) and soft tissue(such as treatment of hemifacial macrosomia). Several attempts have been done to reconstruct impaired temporomandibular joint. Also, SCs with or without bone scaffolds and growth factors have been used to regenerate bone following distraction osteogenesis of mandibular bone or maxillary expansion. Current evidence shows that SCs also have potential to be used to regenerate infrabony alveolar defects and move the teeth into regenerated areas. Future application of SCs in orthodontics could involve accelerating tooth movement, regenerating resorbed roots and expanding tooth movement limitations. However, evidence supporting these roles is weak and further studies are required to evaluate the possibility of these ideas.展开更多
Orthodontic forces can cause stress and strain concentration and microcracks on tooth root surfaces.This study aimed to analyze whether a lingual orthodontic appliance was more likely to cause root stress concentratio...Orthodontic forces can cause stress and strain concentration and microcracks on tooth root surfaces.This study aimed to analyze whether a lingual orthodontic appliance was more likely to cause root stress concentration and root resorption than the traditional buccal appliance.A finite element model of the root of the maxillary central incisor with straight,buccal,and lingual curvatures was established.A load perpendicular to the tooth surface on the buccal and lingual surfaces of the central incisor was applied,and the stress and strain concentration at the root apex was compared.The stress and strain at the root apex of the lingual cingulum group were lesser than those of the buccal group;little difference was observed between the lingual and buccal clinical crown central augmentation groups.The stress and strain at the root apex of the lingual direction movement group were greater than those of the buccal direction movement group.The direction of the root curvature also influenced the amount of stress and strain at the root apex.The difference in the risk of root resorption between lingual and buccal orthodontics is dependent on the height of the bracket placement.The loading direction of the orthodontic force and direction of the root curvature also affect the stress and strain at the root apex.展开更多
Introduction: One of the most common risks of fixed orthodontic therapy is the evidence of root resorption post orthodontic treatment ranging from mild root blunting to severe root resorption of significant portions o...Introduction: One of the most common risks of fixed orthodontic therapy is the evidence of root resorption post orthodontic treatment ranging from mild root blunting to severe root resorption of significant portions of the root structure. The etiology of apical root resorption is multifactorial but largely depends upon the type of orthodontic tooth movement and treatment duration. Study Objective: The primary aim of this study is to examine the association of external apical root resorption and vertical correction in anterior open bite malocclusions using panoramic radiographs for evaluation. Materials and Methods: Pre-treatment and post-treatment panoramic radiographs of 16 patients with anterior open bite malocclusions were scored to assess root resorption of anterior teeth (U/L 3-3). Initial and final root length and total tooth length for U/L 3-3 were measured on panoramic radiographs in Dolphin imaging. Results: Of the 24 pairs of measurements, 7 had a significant p-value (p Conclusions: A statistically significant amount of root resorption was observed, from pre-treatment to post-treatment radiographs. All mandibular anterior teeth except the mandibular right lateral incisors showed evidence of root resorption.展开更多
BACKGROUND The objective of this work is displaying a successful treatment for an internal resorption case under operating microscope using bioceramic material.CASE SUMMARY Periapical radiograph showed radiolucent les...BACKGROUND The objective of this work is displaying a successful treatment for an internal resorption case under operating microscope using bioceramic material.CASE SUMMARY Periapical radiograph showed radiolucent lesion representing large internal resorption of the root.The respective defect was obturated using endoscquence bioceramic material follow up at the month 18 after treatment revealed no abnormal finings clinically and radiographically.CONCLUSION New generations bioceramics have many advantages that internal root resorption cases can benefit from.The use of operating microscope helps to apply obturating materials with precision.However,long term study on a large sample is required in future studies.展开更多
BACKGROUND The bone remodeling during orthodontic treatment for malocclusion often requires a long duration of around two to three years,which also may lead to some complications such as alveolar bone resorption or to...BACKGROUND The bone remodeling during orthodontic treatment for malocclusion often requires a long duration of around two to three years,which also may lead to some complications such as alveolar bone resorption or tooth root resorption.Low-intensity pulsed ultrasound(LIPUS),a noninvasive physical therapy,has been shown to promote bone fracture healing.It is also reported that LIPUS could reduce the duration of orthodontic treatment;however,how LIPUS regulates the bone metabolism during the orthodontic treatment process is still unclear.AIM To investigate the effects of LIPUS on bone remodeling in an orthodontic tooth movement(OTM)model and explore the underlying mechanisms.METHODS A rat model of OTM was established,and alveolar bone remodeling and tooth movement rate were evaluated via micro-computed tomography and staining of tissue sections.In vitro,human bone marrow mesenchymal stem cells(hBMSCs)were isolated to detect their osteogenic differentiation potential under compression and LIPUS stimulation by quantitative reverse transcription-polymerase chain reaction,Western blot,alkaline phosphatase(ALP)staining,and Alizarin red staining.The expression of Yes-associated protein(YAP1),the actin cytoskeleton,and the Lamin A/C nucleoskeleton were detected with or without YAP1 small interfering RNA(siRNA)application via immunofluorescence.RESULTS The force treatment inhibited the osteogenic differentiation potential of hBMSCs;moreover,the expression of osteogenesis markers,such as type 1 collagen(COL1),runt-related transcription factor 2,ALP,and osteocalcin(OCN),decreased.LIPUS could rescue the osteogenic differentiation of hBMSCs with increased expression of osteogenic marker inhibited by force.Mechanically,the expression of LaminA/C,F-actin,and YAP1 was downregulated after force treatment,which could be rescued by LIPUS.Moreover,the osteogenic differentiation of hBMSCs increased by LIPUS could be attenuated by YAP siRNA treatment.Consistently,LIPUS increased alveolar bone density and decreased vertical bone absorption in vivo.The decreased expression of COL1,OCN,and YAP1 on the compression side of the alveolar bone was partially rescued by LIPUS.CONCLUSION LIPUS can accelerate tooth movement and reduce alveolar bone resorption by modulating the cytoskeleton-Lamin A/C-YAP axis,which may be a promising strategy to reduce the orthodontic treatment process.展开更多
A series of changes occur in the remaining alveolar process after whole tooth extraction.The basic question is,why do the bony walls(especially the labial/buccal)get resorbed immediately after the tooth is removed?Thi...A series of changes occur in the remaining alveolar process after whole tooth extraction.The basic question is,why do the bony walls(especially the labial/buccal)get resorbed immediately after the tooth is removed?This could be because,with cementum of the concerned tooth and its periodontal ligament,the supporting bundle bone is dependent on the presence of the tooth.This loss can be compensated using numerous techniques,such as socket grafting using various biomaterials to preserve the alveolar bone and buccal grafting with guided tissue regeneration to increase the thickness of buccal bone or placement of implant immediately.However,none of these techniques prevent the modelling of the alveolar bone post-extraction.Few studies have demonstrated that preservation of the roots in the alveolar process maintains the bone volume and facilitates vertical bone growth.A histological study in animals and humans has shown that the retained root shell does not pose any interference in the osseointegration of the implant(if placed simultaneously).Although various names have been proposed to describe the concept of retaining full or part of the root to prevent the resorption of the ridge,socket-shield and pontic-shield are the two most commonly used terms worldwide.The extraction of the whole tooth might be the choice of therapy when socket-shield or pontic-shield is not possible due to anatomical variations,infections,or lack of clinical expertise.Irrespective of the size,when a whole root or a root fragment(is left in situ),it is the dentist’s ethical duty to advise/inform the patient and ensure repeated clinical and radiographic follow-up.The present study aimed to highlight the current status of these techniques,their benefits,and possible complications and address whether the paradigm of the teeth extraction methods should be altered.展开更多
BACKGROUND Invasive cervical resorption(ICR), a commonly misdiagnosed condition, is an aggressive form of external tooth resorption that contributes to periodontal tissue inflammation and deepening of the periodontal ...BACKGROUND Invasive cervical resorption(ICR), a commonly misdiagnosed condition, is an aggressive form of external tooth resorption that contributes to periodontal tissue inflammation and deepening of the periodontal pockets. Herein we report the case of a patient, exhibiting ICR and elaborate the effects of a non-surgical approach in the amelioration of this condition.CASE SUMMARY A 21-year-old female reporting intermittent pain at the upper left side, multiple restorations, no trauma history, and having received orthodontic treatment was studied. Localized erythematous swelling was noted at the buccal interdental papilla between the left maxillary first molar and second premolar. The diseased pulp and tissue in resorption were removed and the root canal system including the defect were sealed using gutta percha/AH Plus and mineral trioxide aggregate(MTA). At the one-year recall, the tooth showed no symptoms and responded normally to percussion and palpation. The surrounding periodontium exhibited a normal color and the probing depth was normal. Radiographic examination showed a restoration of crestal alveolar bone and good adaption to MTA.CONCLUSION Non-surgical root canal treatment in conjunction with resorption defect orthograde repair with MTA was found to be an effective treatment option in the elimination of ICR. Early diagnoses are recommended in order to employ nonsurgical approaches for management of ICR instead of surgical interventions.展开更多
文摘This case presents an unusual transposition of an impacted canine on the central incisor that provides a multidisciplinary approach to its resolution. The patient comes to the consultation for mobility of the central incisor. Clinically, tooth mobility was confirmed with tooth crowding and persistence of the temporary canine. Cone beam tomography (CBCT) observed the atypical position of the permanent canine that caused root resorption of the ipsilateral central incisor and the need to extract both teeth. The conservative treatment of the bone structures during the dental enucleation of the impacted canine carried out by odontosection and the immediate bone grafting of the defect projected an acceptable regeneration of the bone volume for the insertion of the implant. The orthodontic treatment managed to correct the bite, position the upper premolar in the place of the canine tooth and maintain the space to place the implant in the central incisor. The three-year follow-up shows maintenance of the peri-implant crestal bone level, the success of orthodontic treatment with recovery of the patient’s function and aesthetics.
基金the ReForM-A-research funding programme of the Faculty of Medicine(University of Regensburg)for their financial supportsupported by a ReForM-A grant from the ReForM research funding programme of the Faculty of Medicine of the University of Regensburg,Germany(Kirschneck 31 March 2015)the German Research Foundation(DFG)within the funding programme Open Access Publishing
文摘Orthodontic forces have been reported to significantly increase nicotine-induced periodontal bone loss. At present, however, it is unknown, which further (side) effects can be expected during orthodontic treatment at a nicotine exposure corresponding to that of an average European smoker. 63 male Fischer344 rats were randomized in three consecutive experiments of 21 animals each (A/B/C) to 3 experimental groups (7 rats, 112/3). (A) cone-beam-computed tomography (CBCT); (B) histology/serology; (C) reverse- transcription quantitative real-time polymerase chain reaction (RT-qPCR)/cotinine serology--(1) control; (2) orthodontic tooth movement (OTM) of the first and second upper left molar (NiTi closed coil spring, 0.25 N); (3) OTM with 1.89 mg-kg- 1 per day s.c. of L(- )-nicotine. After 14 days of OTM, serum cotinine and IL-6 concentration as well as orthodontically induced inflammatory root resorption (OIIRR), osteoclast activity (histology), orthodontic tooth movement velocity (CBCT, within 14 and 28 days of OTM) and relative gene expression of known inflammatory and osteoclast markers were quantified in the dental-periodontal tissue (RT-qPCR). Animals exposed to nicotine showed significantly heightened serum cotinine and IL-6 levels corresponding to those of regular European smokers. Both the extent of root resorption, osteoclast activity, orthodontic tooth movement and gene expression of inflammatory and osteoclast markers were significantly increased compared to controls with and without OTM under the influence of nicotine. We conclude that apart from increased periodontal bone loss, a progression of dental root resorption and accelerated orthodontic tooth movement are to be anticipated during orthodontic therapy, if nicotine consumption is present. Thus patients should be informed about these risks and the necessity of nicotine abstinence during treatment.
基金supported by the Priority Academic Program Development of Jiangsu Higher Education Institutions
文摘This study evaluated,over a 4-month study period,the amount of apical root resorption occurring in maxillary central incisors following their retraction when employing either micro-implant or J-hook headgear anchorage.The prospective randomised clinical trial was conducted in Orthodontic Clinic,College of Stomatology,China from 2008-2009.Subjects are patients requiring fixed appliances on waiting list (n=20).In female Han Chinese patients aged from 16-26 years,standardized periapical radiographs from 10 randomly assigned patients with maxillary protrusions comprising the micro-implant group,and from 10 similar patients comprising the J-hook headgear group,were assessed for maxillary central incisor apical root resorption.Measurements before and after orthodontic therapy were also obtained from lateral cephalometric radiographs to calculate incisor horizontal retraction and vertical intrusion distances.Estimated retraction force vectors were calculated in horizontal and vertical directions for both treatment groups.Data analysis employed t-tests and the Pearson correlation test,with α=0.05 for statistical significance.The results showed that when compared with the J-hook group,significantly more apical root resorption shortening of the maxillary central incisors was observed in the micro-implant group (1.27 mm difference,95% CI=0.70-1.84,P<0.001),which was associated with a significantly larger retraction distance (P=0.004) and a smaller vertical force component (P<0.0001).We are led to conclude that continuous activation of the nickel-titanium coil springs used in the micro-implant group resulted in significantly more apical root resorption shortening and maxillary central incisor retraction than when intermittent J-hook retraction was employed.The employment of continuous duration orthodontic forces presents a risk for increased apical root resorption that requires careful radiographic monitoring.
文摘Summary: The purpose of this study was to develop a new way to localize the impacted canines from three dimensions and to investigate the root resorption of the adjacent teeth by using cone beam computed tomography (CBCT). Forty-six patients undergoing orthodontic treatments and having impacted canines in Tongii Hospital were examined. The images of CBCT scans were obtained from KaVo 3D exam vision. Angular and linear measurements of the cusp tip and root apex according to the three planes (mid-sagittal, occlusal and frontal) have been taken using the cephalometric tool of the InVivo Dental Anatomage Version 5.1.10. The measurements of the angular and linear coordinates of the maxillary and mandibular canines were obtained. Using this technique the operators could envision the location of the impacted canine according to the three clinical planes. Adjacent teeth root resorption.of 28.26 % was in the upper lateral incisors while 17.39% in upper central incisors, but no lower root resorption was found in our samples. Accurate and reliable localization of the impacted canines could be obtained from the novel analysis system, which offers a better surgical and orthodontic treatment for the patients with impacted canines.
文摘Background: The objective of this study was to determine the levels of tumor necrosis factor-alpha (TNF-α) and receptor activator of NF-kB ligand (RANKL) in the gingival crevicular fluid (GCF) in patients with severe root resorption after orthodontic treatment. Materials and Methods: Ten patients who had been receiving orthodontic treatment (5-control subjects and 5-severe root resorption subjects) participated in this study. GCF was collected from all patients. Subjects with severe root resorption (>1/3 of the original root length) were identified. Control group subjects with no loss of the root structure undergoing orthodontic treatment were also identified. The GCF was collected non-invasively from the mesial and distal sides of each of the upper central and lateral incisors using filter paper strips. The eluted GCF was used for a Western blot analysis with Antibodies against TNF-α and soluble RANKL (sRANKL). Ten male 6-week-old Wistar rats were subjected to orthodontic force of 50 g to induce a mesially tipping movement of the upper first molars for 7 days. The expression levels of TNF-α and RANKL proteins were determined in periodontal ligament (PDL) by immunohistochemical analysis. Results: The Western blot analysis showed that the TNF-α and sRANKL expressions were significantly higher in the severe root resorption group than in the control group. In the experimental tooth movement in vivo, resorption lacunae with multinucleated cells were observed in 50 g group. The immunoreactivity for TNF-α and RANKL was detected in PDL tissue subjected to the orthodontic force on day 7. Conclusion: These results suggest that TNF-α and RANKL play important roles in inducing or facilitating the development of orthodontically-induced inflammatory root resorption (OIIRR).
文摘Purpose: To establish a new coordinate system using the incisive canal and incisive foramen in cases confirmed to have root resorption in the maxillary incisor region by cone beam computed tomography (CBCT) to investigate the positions of the central and lateral incisor roots and erupting maxillary canine tooth crowns in the horizontal plane. Methods: Nine patients (two males;mean age: 10.5 years old) with suspected incisor root resorption due to erupting maxillary canines on panoramic X-ray images and in whom incisor root resorption was confirmed on CBCT images were evaluated. A control group of 12 patients with a supernumerary tooth on one side (three males;mean age: 8.6 years old) was also examined. X, Y, and Z-axes were defined, and the positions of the centers of the central incisor root (U1) and lateral incisor root (U2) and the canine cusp (U3) were examined, along with alveolar process width and length. Results: In the control group, U1, U2, and U3 were located within a certain range without overlap, while, in the incisor root resorption group, U3 overlapped with U1 and U2 and tended to deviate centrally. U2 tended to be located further posteriorly than U3. The anteroposterior diameter of the alveolar process was 1.2 mm shorter in the incisor root resorption group (p < 0.05). Conclusions: The risk of incisor root resorption accompanying canine eruption can be evaluated early by investigating the canine position on a horizontal plane established on the upper anterior tooth dentition CT images with a coordinate system using the incisive canal and incisive foramen.
文摘External root resorption can induce the degeneration of dental cementum and dentine and may extend towards the pulp reductive. Digital subtraction radiography can function as a useful tool in diagnosing degenerative carious lesions. This study investigated the diagnostic value of digital subtraction radiography in detecting external root resorption. This was a descriptive study conducted using the lab trial method. Artificially-induced external root resorption was created in different sizes at the coronal and apical aspects of 20 premolar teeth. Digital radiographs were obtained of each tooth under standard conditions and these radiographs were subtracted by imaging devices. The subtracted images and the digital radiographs were observed by three radiologists. Chi-square, Kappa test, and Z-test were used to analyze the data. The mean of general sensitivity of digital subtraction radiography and direct digital radiography was low in diagnosing 0.05 mm lesions (Sen = 35%), yet, the accuracy index was good for all lesions (Acc ≥ 65%). Other diagnostic parameters were also acceptable. Both types of radiography worked better in diagnosing coronal than apical lesions (P > 0.05). The interpreters (observers) showed a better performance in diagnosing external root resorption using digital subtraction radiography compared to digital radiography. Both modalities were exact and accurate in detecting 0.05 mm lesions as well as other lesions. However, the results of digital subtraction radiography were not significantly different from those of direct digital radiography.
文摘The aim of this study was to investigate the amount of external apical root resorption (EARR) and the release of interleukin (IL)-6 in the gingival crevicular fluid (GCF) in subjects treated with a low-force low-friction system. Sixty patients were assigned to two groups of thirty patients for each: one group received treatment with self-ligating brackets and the other with conventional ligated edgewise brackets. All patients were treated with extraction of the maxillary first premolars. The EARR of the maxillary central incisors was evaluated on the periapical radiographs and cephalograms, taken before and after orthodontic treatment. The GCF was also collected non-invasively from the mesial and distal sides of central incisors by using filter paper strips before and after orthodontic treatment. Enzyme-linked immunosorbent assay (ELISA) kits were used to determine the IL-6 levels in the GCF samples. A significant difference was found in the amount of EARR between the patients with self-ligating brackets and conventional brackets. The mean amount of EARR was significantly lower for self-ligating brackets than conventional brackets (p < 0.05). The GCF levels of IL-6 for the patients with self-ligating brackets appliance were significantly lower than for those with the conventional brackets (p < 0.05). These results show that the mean amount of EARR and the GCF levels of IL-6 were significantly lower in the patients treated using low-force low-friction appliances than conventional brackets. Therefore, self-ligating brackets may be a useful system for reducing inflammation and EARR.
文摘A simple overview of daily orthodontic practice involves use of brackets, wires and elastomeric modules. However, investigating the underlying effect of orthodontic forces shows various molecular and cellular changes. Also, orthodontics is in close relation with dentofacial orthopedics which involves bone regeneration. In this review current and future applications of stem cells(SCs) in orthodontics and dentofacial orthopedics have been discussed. For craniofacial anomalies, SCs have been applied to regenerate hard tissue(such as treatment of alveolar cleft) and soft tissue(such as treatment of hemifacial macrosomia). Several attempts have been done to reconstruct impaired temporomandibular joint. Also, SCs with or without bone scaffolds and growth factors have been used to regenerate bone following distraction osteogenesis of mandibular bone or maxillary expansion. Current evidence shows that SCs also have potential to be used to regenerate infrabony alveolar defects and move the teeth into regenerated areas. Future application of SCs in orthodontics could involve accelerating tooth movement, regenerating resorbed roots and expanding tooth movement limitations. However, evidence supporting these roles is weak and further studies are required to evaluate the possibility of these ideas.
基金This work was supported by the National Natural Science Foundation of China(No.U20A20390 and 11827803).
文摘Orthodontic forces can cause stress and strain concentration and microcracks on tooth root surfaces.This study aimed to analyze whether a lingual orthodontic appliance was more likely to cause root stress concentration and root resorption than the traditional buccal appliance.A finite element model of the root of the maxillary central incisor with straight,buccal,and lingual curvatures was established.A load perpendicular to the tooth surface on the buccal and lingual surfaces of the central incisor was applied,and the stress and strain concentration at the root apex was compared.The stress and strain at the root apex of the lingual cingulum group were lesser than those of the buccal group;little difference was observed between the lingual and buccal clinical crown central augmentation groups.The stress and strain at the root apex of the lingual direction movement group were greater than those of the buccal direction movement group.The direction of the root curvature also influenced the amount of stress and strain at the root apex.The difference in the risk of root resorption between lingual and buccal orthodontics is dependent on the height of the bracket placement.The loading direction of the orthodontic force and direction of the root curvature also affect the stress and strain at the root apex.
文摘Introduction: One of the most common risks of fixed orthodontic therapy is the evidence of root resorption post orthodontic treatment ranging from mild root blunting to severe root resorption of significant portions of the root structure. The etiology of apical root resorption is multifactorial but largely depends upon the type of orthodontic tooth movement and treatment duration. Study Objective: The primary aim of this study is to examine the association of external apical root resorption and vertical correction in anterior open bite malocclusions using panoramic radiographs for evaluation. Materials and Methods: Pre-treatment and post-treatment panoramic radiographs of 16 patients with anterior open bite malocclusions were scored to assess root resorption of anterior teeth (U/L 3-3). Initial and final root length and total tooth length for U/L 3-3 were measured on panoramic radiographs in Dolphin imaging. Results: Of the 24 pairs of measurements, 7 had a significant p-value (p Conclusions: A statistically significant amount of root resorption was observed, from pre-treatment to post-treatment radiographs. All mandibular anterior teeth except the mandibular right lateral incisors showed evidence of root resorption.
文摘BACKGROUND The objective of this work is displaying a successful treatment for an internal resorption case under operating microscope using bioceramic material.CASE SUMMARY Periapical radiograph showed radiolucent lesion representing large internal resorption of the root.The respective defect was obturated using endoscquence bioceramic material follow up at the month 18 after treatment revealed no abnormal finings clinically and radiographically.CONCLUSION New generations bioceramics have many advantages that internal root resorption cases can benefit from.The use of operating microscope helps to apply obturating materials with precision.However,long term study on a large sample is required in future studies.
基金Supported by the National Science and Technology Major Project of the Ministry of Science and Technology of China,No.2022YFA1105800the National Natural Science Foundation of China,No.81970940.
文摘BACKGROUND The bone remodeling during orthodontic treatment for malocclusion often requires a long duration of around two to three years,which also may lead to some complications such as alveolar bone resorption or tooth root resorption.Low-intensity pulsed ultrasound(LIPUS),a noninvasive physical therapy,has been shown to promote bone fracture healing.It is also reported that LIPUS could reduce the duration of orthodontic treatment;however,how LIPUS regulates the bone metabolism during the orthodontic treatment process is still unclear.AIM To investigate the effects of LIPUS on bone remodeling in an orthodontic tooth movement(OTM)model and explore the underlying mechanisms.METHODS A rat model of OTM was established,and alveolar bone remodeling and tooth movement rate were evaluated via micro-computed tomography and staining of tissue sections.In vitro,human bone marrow mesenchymal stem cells(hBMSCs)were isolated to detect their osteogenic differentiation potential under compression and LIPUS stimulation by quantitative reverse transcription-polymerase chain reaction,Western blot,alkaline phosphatase(ALP)staining,and Alizarin red staining.The expression of Yes-associated protein(YAP1),the actin cytoskeleton,and the Lamin A/C nucleoskeleton were detected with or without YAP1 small interfering RNA(siRNA)application via immunofluorescence.RESULTS The force treatment inhibited the osteogenic differentiation potential of hBMSCs;moreover,the expression of osteogenesis markers,such as type 1 collagen(COL1),runt-related transcription factor 2,ALP,and osteocalcin(OCN),decreased.LIPUS could rescue the osteogenic differentiation of hBMSCs with increased expression of osteogenic marker inhibited by force.Mechanically,the expression of LaminA/C,F-actin,and YAP1 was downregulated after force treatment,which could be rescued by LIPUS.Moreover,the osteogenic differentiation of hBMSCs increased by LIPUS could be attenuated by YAP siRNA treatment.Consistently,LIPUS increased alveolar bone density and decreased vertical bone absorption in vivo.The decreased expression of COL1,OCN,and YAP1 on the compression side of the alveolar bone was partially rescued by LIPUS.CONCLUSION LIPUS can accelerate tooth movement and reduce alveolar bone resorption by modulating the cytoskeleton-Lamin A/C-YAP axis,which may be a promising strategy to reduce the orthodontic treatment process.
文摘A series of changes occur in the remaining alveolar process after whole tooth extraction.The basic question is,why do the bony walls(especially the labial/buccal)get resorbed immediately after the tooth is removed?This could be because,with cementum of the concerned tooth and its periodontal ligament,the supporting bundle bone is dependent on the presence of the tooth.This loss can be compensated using numerous techniques,such as socket grafting using various biomaterials to preserve the alveolar bone and buccal grafting with guided tissue regeneration to increase the thickness of buccal bone or placement of implant immediately.However,none of these techniques prevent the modelling of the alveolar bone post-extraction.Few studies have demonstrated that preservation of the roots in the alveolar process maintains the bone volume and facilitates vertical bone growth.A histological study in animals and humans has shown that the retained root shell does not pose any interference in the osseointegration of the implant(if placed simultaneously).Although various names have been proposed to describe the concept of retaining full or part of the root to prevent the resorption of the ridge,socket-shield and pontic-shield are the two most commonly used terms worldwide.The extraction of the whole tooth might be the choice of therapy when socket-shield or pontic-shield is not possible due to anatomical variations,infections,or lack of clinical expertise.Irrespective of the size,when a whole root or a root fragment(is left in situ),it is the dentist’s ethical duty to advise/inform the patient and ensure repeated clinical and radiographic follow-up.The present study aimed to highlight the current status of these techniques,their benefits,and possible complications and address whether the paradigm of the teeth extraction methods should be altered.
文摘BACKGROUND Invasive cervical resorption(ICR), a commonly misdiagnosed condition, is an aggressive form of external tooth resorption that contributes to periodontal tissue inflammation and deepening of the periodontal pockets. Herein we report the case of a patient, exhibiting ICR and elaborate the effects of a non-surgical approach in the amelioration of this condition.CASE SUMMARY A 21-year-old female reporting intermittent pain at the upper left side, multiple restorations, no trauma history, and having received orthodontic treatment was studied. Localized erythematous swelling was noted at the buccal interdental papilla between the left maxillary first molar and second premolar. The diseased pulp and tissue in resorption were removed and the root canal system including the defect were sealed using gutta percha/AH Plus and mineral trioxide aggregate(MTA). At the one-year recall, the tooth showed no symptoms and responded normally to percussion and palpation. The surrounding periodontium exhibited a normal color and the probing depth was normal. Radiographic examination showed a restoration of crestal alveolar bone and good adaption to MTA.CONCLUSION Non-surgical root canal treatment in conjunction with resorption defect orthograde repair with MTA was found to be an effective treatment option in the elimination of ICR. Early diagnoses are recommended in order to employ nonsurgical approaches for management of ICR instead of surgical interventions.