Tooth Resorption

Dental trauma can lead to injuries in teeth and their supporting structures, which occurs most commonly in young patients and varies in severity from enamel fractures to avulsions. Root fractures are relatively uncommon among dental traumas, mostly affecting the permanent dentition. It has been reported that root fractures can undergo healing, whereas pulp necrosis can also occur.In this report, we present a case of the utilization of cone-beam computed tomography (CBCT) in the detection of possible cervical or internal resorption secondary to a mid-horizontal fracture in a 36-year-old male patient. The fractured teeth spontaneously healed and were diagnosed radiographically after 28 years. Initially, conventional radiographs showed fractured fragments with radiolucent lines. Because of possible invasive cervical resorption and doubt over internal resorption in the conventional images, it was decided to examine the teeth with cone-beam computed tomography with three-dimensional reconstructions.The images clearly showed the displaced fragments of the root fracture. Despite the appearance in the conventional radiograph, no evidence of cervical or internal resorption was detected in the teeth other than the healed root fracture.It was concluded that CBCT images should be obtained for root fractures, especially those in which cervical or internal resorption is suspected from routine conventional radiographs.

Intentional replantation consists of purposefully extracting a tooth, correcting the defect and replanting it into its original socket. This case report describes how this technique was used to successfully restore an external cervical resorptive (ECR) lesion. A 22-year-old man was diagnosed with ECR of the mandibular right canine following clinical and radiographic examination. CBCT showed the lesion had been initiated distally and extended circumferentially around the root canal. The nature of the resorptive lesion meant that it was inaccessible to repair conventionally in a predictable manner. This report describes how intentional replantation was used to access and restore the lesion with minimal patient cooperation and postoperative discomfort. At an 18-month recall the tooth was clinically sound with no radiographic evidence of inflammatory or replacement root resorption. Intentional replantation should be considered a viable treatment option when ECR is inaccessible and canno...

To assess associations between epidemiologic and laboratory variables and calciotropic hormones in cats with odontoclastic resorptive lesions (ORLs). 182 client-owned cats older than 1 year of age with oral disease. Information on medical history, behavior, living environment, and feeding management was assessed by use of a questionnaire. After induction of general anesthesia, oral examination was performed following standardized protocols and included dental probing and full-mouth radiography. Laboratory analyses included evaluation of FeLV-FIV status, serum biochemical analyses, CBC, urinalysis, and serum concentrations of intact parathyroid hormone (iPTH), parathyroid hormone-related peptide (PTHrP), 25-hydroxyvitamin D (25-OHD), free thyroxine (fT4), and ionized calcium (iCa). ORLs were identified in 72.5% of cats. Mandibular third premolars were the most commonly affected teeth. Cats with ORLs were significantly older (mean, 9.2 years) than cats without ORLs (mean, 6.6 years). ...

The aim of this case report was to analyze clinical and histological features of a central odontogenic fibroma followed up for 6 years after surgical excision. A 26-year old Caucasian female was referred, reporting a painless gingival swelling in the buccal area of the maxillary right canine. There were no other symptoms and no recent history of pain. Her medical history was non-contributory. Radiographic evaluation showed the presence of a radiolucent area with well-defined margins. The lesion was surgically removed and histologically analysed. Histologic analysis showed a cellular fibroblastic tissue characterized by interwoven bundles of collagen densely packed and absence of odontogenic epithelium. The surgical site was monitored for 6 years after surgery with no signs of recurrence. The central odontogenic fibroma here reported displayed a prominent quantity of collagen and absence of odontogenic epithelium. The surgically removed lesion had a favourable prognosis and no recurr...

Tooth resorption (TR) is one of the most common dental diseases in cats. Determination of risk factors has not yet been fully assessed and, to the best knowledge of the authors, this disease has never been studied in Portuguese cats. The objective of this case-control study was to determine type and distribution of TR lesions, evaluate risk factors, and establish relationships between variables in this disease. The study included data from 71 cats admitted for general anesthesia for various reasons. The cats were randomly selected. The inclusion criteria were availability of clinical history and owner permission. Cats with known oral disease were not excluded from the study. All cats received ultrasonic scaling and polishing of the teeth, a thorough oral examination, and full-mouth radiographs. A strong statistical relation was found between age and TR. The age group of 10 to 15-years showed an increased risk of 6.56 times for TR occurrence compared with the group 0 to 4-years of ag...

Feline tooth resorption has been widely reported in domestic cats and sporadically described in other felidae. The goal of the present study was to determine the prevalence of tooth resorption and to report other dental problems in a population of wild felidae. Observations of dental disorders and anomalies were made in skulls from 73 wild felidae (cheetahs, leopards, caracals, African wildcats, and lions) originating from Namibia. In addition, radiographs were taken in 43 cases to determine signs of bone and root pathology. Radiographs showed varying stages of tooth resorption in 16.0 % of the specimens. Other dental anomalies found included fused teeth, supernumerary roots, or missing teeth. The prevalence of dental resorption in wild felidae was lower than reported in the domestic cat.

Pathological external root resorption is a process by which the hard tooth substance is lost because of action of different local irritative or systemic factors. Six forms of external root resorption are described: surface external root resorption, inflammatory external root resorption, replacement external root resorption, invasive external cervical root resorption, ankylosis and transient apical breakdown. The objective of the study was to establish the prevalence of the pathological root resorption in a retrospective radiological study, to highlight radiological aspects of external root resorption and to describe optical coherence tomography (OCT) aspects in pathological root resorption. External root resorption prevalence in our study was 17%. Radiological exam was very useful to detect the form of root resorption but also to establish possible etiological factors. The study presents the radiological aspects of some forms of pathological external root resorption highlighted on r...

A method was devised, from a pilot study, for transplanting a root-treated tooth with an intact periodontium into a newly prepared socket to assess whether the prognosis for transplantation procedures could be improved. Five male vervet monkeys were used for the definitive study. The mandibular central incisors were extracted from each monkey and the sockets were allowed to heal for 5 weeks. Thereafter a window of gingiva overlying each of these healed receptor sites was removed and the sockets were prepared with tapered burs. The distal root of the mandibular second molar was used as the transplant tooth and the distal root of the first molar as the control tooth. The transplant tooth was removed, together with surrounding alveolar bone which was then trimmed to a thickness of approximately 1 mm. The control tooth was extracted with root forceps. After transplantation, the teeth were splinted to the adjacent incisors for 3 weeks. After 8 weeks the healing process was examined histo...

The purpose of this study was to investigate histopathological changes in primary teeth following trauma, and to look for possible correlations between the morphology of pulpal calcification and clinical findings. The material consisted of 123 primary teeth from 98 Danish children aged 9-108 months (mean age 33.5 +/- 19.7 months) at the time of injury. The specimens were analyzed by means of light and scanning and transmission electron microscopy. Data from the clinical investigation and from predetermined ranked parameters from the histological analysis were processed in a computerized inductive analysis program. The results, describing patterns of co-variation, are presented as a decision tree. The most common diagnosis was intrusion luxation (54%). In 41% of all teeth, the degree of obliteration was less than 1/4 of the pulpal lumen. In most cases (79%), no denticles were visible. When present, 80% of the denticles had a bone-like appearance. Tissues occluding the pulpal lumen we...

The cellular activity and changes in mineral composition of dental tissues involved in feline odontoclastic resorptive lesions were investigated. Teeth with at least 1 lesion (n = 10) were extracted from 10 different cats that were presented primarily for chronic gingivostomatitis and/or severe periodontal disease. Scanning electron microscopic methods were used to determine the presence of resorptive cells in 8 teeth while 2 teeth were evaluated for pathologic changes in dental mineral composition. Observations were complicated by the presence of organic wear on the dental surfaces, however resorptive cells could be clearly identified in feline odontoclastic resorptive lesions. Resorptive cells had morphologic features indicative of "osteoclast-like" cells or odontoclasts. Resorptive cell activity created a resorption area of darker dentin continuous with physiologic dentin. The darker dentin area seemed poorly mineralized and showed a significantly lower calcium/phosphor...

A 10-year-old DSH cat was referred for a dental evaluation and extraction procedure. Subsequently, the animal developed an acute onset of ocular discharge. Ophthalmologic examination revealed presence of unilateral ocular mucoid discharge leading to a diagnosis of epiphora secondary to nasolacrimal duct obstruction. Dacryocystorhinography was performed and confirmed the presence of a nasolacrimal duct obstruction, presumably acquired after an invasive dental procedure. Additionally, a vinyl cast in situ study of the nasolacrymal apparatus was performed to demonstrate the route of the nasolacrimal duct in the cat and its relationship to oral dental structures. This report documents an unusual case in which excessive inflammation/edema following tooth extraction caused acute epiphora secondary to extraluminal compression of the distal nasolacrimal duct.

To evaluate the long-term clinical and radiographical results of using gray mineral trioxide aggregate (MTA) in pulpotomy treatments in primary molars. A total of 69 primary molars were treated with pulpotomy procedures using MTA and follow-up every 6 months up to 42 months. Clinical success was 100% as none of the molars showed clinical pathologic signs; radiographical success was 98.5% as one case of internal resorption was recorded. Reparative dentin deposition was found as stenosis of the pulp canals in 84% of the cases 42 months after treatment and as dentin bridge formation in 83% of the cases 42 months after treatment. Moreover, 11 permanent successors erupted at their normal exfoliation time without pathology after pulpotomy treatment with gray MTA of the primary molars.

The etiology of feline dental resorptive lesions is unknown, but some evidence suggests that interactions between components of the periodontium may be initiating factors in the development of these lesions. In the present study, 22 clinically normal teeth were harvested from 7 cats. The teeth and periodontium were radiographed and examined histologically. In addition, 14 of the 22 teeth were examined histometrically. Two teeth were histologically normal with an open apical foramen and two were normal with a closed apical foramen. Histological evidence of periodontal ligament degeneration without cementum resorption was observed in 8 teeth, and varying degrees of cementum resorption were observed in 10 teeth. Mandibular molar and premolar teeth had distal drift, and mandibular canine teeth had mesial drift. Alterations in the periodontal ligament may represent a preclinical stage of dental resorption.

Pathological external root resorption is a process by which the hard tooth substance is lost because of action of different local irritative or systemic factors. Six forms of external root resorption are described: surface external root resorption, inflammatory external root resorption, replacement external root resorption, invasive external cervical root resorption, ankylosis and transient apical breakdown. The objective of the study was to establish the prevalence of the pathological root resorption in a retrospective radiological study, to highlight radiological aspects of external root resorption and to describe optical coherence tomography (OCT) aspects in pathological root resorption. External root resorption prevalence in our study was 17%. Radiological exam was very useful to detect the form of root resorption but also to establish possible etiological factors. The study presents the radiological aspects of some forms of pathological external root resorption highlighted on r...