Uncommon disturbance of root development after tooth replantation: five-year follow-up period case report / Trastorno del desarrollo radicular poco frecuente posterior a reimplante dentario: reporte de caso con 5 años de seguimiento

To present an uncommon disturbance of root development with ingrowth of bone and periodontal tissue into the pulp space in a delayed replanted immature permanent incisor at five years of follow-up. Severe arrest of root formation with uncommon healing of an immature permanent maxillary incisor after delayed replantation is reported. Continued development of a tooth root separate from the body of the tooth was not observed. A 6-year-old girl sustained an avulsion injury to her upper left central permanent incisor. The tooth was replanted and splinted 2 hours after the accident. Patient has been monitored clinically and with radiography for 5 years. The periodontal tissues presented good healing without replacement resorption. However, severe arrest of root formation with development of hard-like tissue and internal periodontal ligament inside the pulp canal have been observed. Despite being a delayed tooth replantation, the patient has been asymptomatic, and has maintained alveolar bone volume. Clinicians must be vigilant and monitor traumatized immature teeth closely.

El objetivo de este trabajo fue presentar una alteración poco frecuente del desarrollo de la raíz con el crecimiento del tejido óseo y periodontal en el espacio pulpar en un incisivo permanente inmaduro reimplantado de manera tardía, a los cinco años de seguimiento.Se observó una suspensión severa de la formación de raíces con cicatrización poco común, de un incisivo maxilar permanente inmaduro después de una reimplantación tardía. No se observó el desarrollo continuo de la raíz dentaria separada del diente. Una niña de 6 años de edad sufrió una lesión por avulsión en su incisivo central superior izquierdo. El diente fue replantado dos horas después del accidente. La paciente ha sido monitoreada clínicamente y con exámenes radiológicos durante 5 años. Los tejidos periodontales presentaron buena cicatrización sin reabsorción de reemplazo. Sin embargo, se ha observado una detención severa de la formación de las raíces, con desarrollo de tejido duro y ligamento periodontal interno dentro del canal pulpar. A pesar de ser una reimplantación tardía del diente, la paciente presenta asintomática, y ha mantenido el volumen del hueso alveolar. Los médicos deben estar atentos y mantener en observación los dientes inmaduros traumatizados.

Evaluación in vitro de la resistencia a la fractura en dientes con desarrollo radicular incompleto reforzados intraconducto con diferentes materiales / In vitro evaluation of fracture resistance of teeth with incomplete root development and intracanal reinforcement with different materials

El objetivo de este trabajo fue evaluar la resistencia a la fractura de dientes con desarrollo radicular incompleto y refuerzo intrarradicular con materiales adhesivos. 50 dientes incisivos centrales y laterales maxilares humanos fueron instrumentados y preparados intraconducto para simular un diente inmaduro y obturado apicalmente con MTA. Las muestras fueron divididas en cuatro grupos experimentales y un grupo control. Grupo 1: Resina compuesta Filtek™ P90; Grupo 2: Ionómero de vidrio Vitremer™; Grupo 3: Resina compuesta Filtek™ Z350 XT; Grupo 4: Ionómero de vidrio Ketac™ N 100; Grupo 5: Control negativo (Instrumentado pero no se reforzó intraconducto). Luego se realizó la prueba de fractura utilizando una maquina de ensayo universal (Instron™). Los valores máximos de resistencia antes de la fractura catastrófica fueron recolectados y analizados mediante la prueba Anova (p = 0,05). Como resultado se encontró diferencia significativa entre los grupos comparados (p = 0,02). Fue encontrada diferencia significativa entre los grupos 1 (847,73N) y el grupo 5 (474,77N) (p = 0,02) aplicando el test de Bonferroni. Pese a las limitaciones del estudio se puede concluir que las resinas compuestas microhíbridas se muestran como un material óptimo para reforzar intrarradicularmente dientes con desarrollo radicular incompleto tratados endodónticamente.

The aim of this study was to evaluate the fracture resistance of teeth with incomplete root development and intracanal reinforcement with adhesives materials. 50 human central and lateral incisors were instrumented and prepared to simulate an immature tooth and filled apically with MTA. The samples were divided into four experimental groups and one control group. Group 1: resin composite Filtek™ P90; Group 2: glass Ionomer Vitremer™; Group 3: resin composite Filtek™ Z350 XT; Group 4: glass Ionomer Ketac™ N 100; Group 5: negative control (instrumented but not reinforced). After, the fracture test was performed using a fracture universal testing machine (Instron™). The maximum values of resistance before catastrophic fracture were collected and analyzed by Anova (p = 0.05). The results show a significant difference between the groups compared (p = 0.02). A significant difference was found between group 1 (847.73 N) and group 5 (474.77 N) (p = 0.02) applying the Bonferroni test. Despite the limitations of the study, the conclusion is that micro-hybrid composite resins are ideal materials to strengthen teeth with incomplete root development endodontically treated.

Dilaceración de diente primario asociado a un mesiodens en niño de 4 años / Dilaceration temporary tooth associated with a mesidens in 4 year old

Dilaceración es un término utilizado para describir la distorsión que ocurre en la raíz durante el desarrollo dentario, el cual se manifiesta alterando la normal relación axial entre la corona y la raíz dentaria. La dilaceración radicular es una angulación o curvatura de la raíz dentaria. Esta alteración es frecuentemente observada en dientes permanentes como consecuencia de un traumatismo de su correspondiente temporario, con una incidencia de 3 %. En la literatura hay solamente cinco casos de dilaceración que involucran a incisivos temporarios. El propósito de este artículo fue hacer una revisión y presentar un caso clínico que fue un hallazgo radiográfico

Dilaceration is a term used to describe the distortion that occurs in the root during tooth development, which manifests itself by altering the normal axial relationship between the crown and the dental root. The root is dilaceration, angulation or curvature of the tooth root. This alteration is frequently observed in permanent teeth as a result of trauma to the corresponding temporary, with an incidence of 3%. In the literature there are only five cases involving dilaceration temporary incisors. The purpose of this article was to review and present a clinical case was a radiographic finding

Root growth and revascularization in an immature necrotic permanent tooth: a case report

Successful continued growth of infected pulpless immature roots may occur with normal procedure of CaOH placement and minimal disinfection. This case report demonstrates the evidence of continued root growth by the process of revascularization after going through a period of Ca[OH][2] apexification

Root development of permanent lateral incisor in cleft lip and palate children: a radiographic study.

OBJECTIVE: The objective of this study was to compare the root development of lateral incisor on the cleft side with the root development of its contralateral tooth in cleft lip and palate children. SETTING: Cleft lip and palate wing, Meenakshi Ammal Dental College and Hospital, Chennai, South India. MATERIALS AND METHODS: A sample of 96 orthopantamograms of patients with unilateral orbilateral cleft lip and/or cleft palate was selected, regardless of sex and race. MAIN OUTCOME MEASURE: Orthopantamograms were analyzed for root development of lateral incisor on the cleft and non cleft side. Associated anomalies like hypodontia, supernumerary teeth, malformed lateral incisors and root development of canine, if present, were recorded. FINDINGS AND CONCLUSIONS: Root development of permanent lateral incisor was delayed on the cleft side compared to the non cleft side. There was a statistically significant relationship between levels of root development of lateral incisors on the cleft side within the different study groups(P < 0.05). Incidence of hypodontia increased in proportion to cleft severity. Frequency of missing second premolars, supernumerary teeth and malformed lateral incisors increased in cleft lip and palate patients. Root development of canine showed a slight delay on the cleft side when compared to the canine on the noncleft side.

Lactate dehydrogenase isoenzymes in dental pulp of rats according to stage of root development

The objective of this study was to present a classification of the root development stage of female rat molar teeth and to evaluate the variation in the lactate dehydrogenase (LDH) activity and electrophoretic isoenzyme profile according to the stage of root development of the molar teeth. We also studied the LDH activity and isoenzymes of the pulp of incisor teeth. The stage of development of the rat first molar at the age of 15 days and that of the second molar at the age of 18 days was classified as the beginning of root formation. At the age of 15 days, the electrophoretic profile of the isoenzymes for the first molar showed a prevalence of LDH-1 followed by LDH-2. However, for the maxillary second molar there was a prevalence of LDH-4 followed by LDH-1, while for the mandibular second molar LDH-1 predominated followed by LDH-2 and LDH-4. From 18 days of age, the prevalence was always of LDH-1. The electrophoretic profile of LDH isoenzymes from the pulp of the incisor teeth at the ages studied (25 and 60 days) showed the following order of prevalence: LDH-1 > LDH-2 > LDH-3 > LDH-4 > LDH-5. These results suggest that there are variations in the prevalence of the various forms of LDH isoenzymes in the dental pulp of rats according to the developmental stage of the root

Apecificação em adulto: relato de um caso / Apexification in adult: case report

Neste trabalho o autor relata o fechamento apical de um incisivo lateral superior de uma paciente adulta através dos procedimentos de apecificação com pasta de hidróxido de cálcio

Root development in relation to impacted mesiodens.

Presented here is a case of 7 years 6 month old child with an apically impacted mesiodens in relation to the developing root of right upper central incisor. The removal of mesiodens was deferred in order to avoid disturbance in the natural development of the upper central incisor. Serial X-rays are presented and case is discussed.

Morfologia radicular de dentes decíduos na fase de rizólise, implicaçöes clínicas e terapia endodôntica / Dental root morfhology of primary teeth during root resorption, clinical implications and endodontic treatment

Neste trabalho de revisäo de literatura buscou-se demonstrar a importância do acompanhamento e monitoramento da fase de rizólise de dentes decíduos e dos aspectos clínicos envolvidos durante este período de desenvolvimento

Evaluación clínica y radiográfica de autotrasplantes y reposiciones dentales / Clinical and radiographic evaluation of autotransplantations and dental repositions

Se realizó un estudio prospectivo de 8 autotrasplantes y 2 reposiciones dentales en 8 pacientes que consultaron entre agosto de 1994 y abril de 1996, los que se controlaron en el período de un año. Se evaluaron parámetros clínicos como dolor, cambio de color, sangrado, movilidad e índice de Russell, también se evaluaron parámetros radiográficos como espacio del ligamento periodontal, reabsorción radicular interna y externa, obliteración de la cámara pulpar y estadio de desarrollo radicular. Todos los casos se realizaron de diferentes dientes donantes a diferentes sitios receptores, notándose que los autotrasplantes más frecuentemente realizados son del tercer molar al primer molar y las reposiciones en zona de premolares. La tasa de supervivencia fue del 100 por ciento a los seis meses y del 75 por ciento a los 12 meses, teniendo en cuenta que no todos los casos han completado los períodos de control. Uno de los autotrasplantes no sobrevivió aunque se le intentó realizar tratamiento pulpar con hidróxido de calcio. Los resultados iniciales de este estudio piloto demuestran que los autotrasplantes y las reposiciones dentales son alternativas de tratamiento con altos porcentajes de éxito en caso de pérdida dentaria o alteración en la erupción por malposición

Dentes permanentes jovens com rizogênese incompleta e necrose pulpar / Nonvital young permanent teeth with incomplete root formation

Os autores fazem uma revisäo da literatura e relatam tratamentos endodônticos em incisivos centrais superiores com necrose pulpar e rizogênese incompleta, através da introduçäo de pasta de hidróxido de cálcio nos canais radiculares, como curativo expectante. Obtendo-se fechamento apical, os dentes obturados convencionalmente

Diferenciación de las fibras nerviosas pulpares en relación al grado de desarrollo radicular / Pulpal nerve differentiation in relation to the degree of radicular developement

Se realizó un estudio histológico y morfométrico de la inervación pulpar en piezas dentarias con distinto grado de desarrollo radicular. Se utilizaron premolares jóvenes, sanos, extraídos por indicación ortodóncica y con examen radiográfico previo para determinar su grado de desarrollo radicular, clasificándose en 5 niveles. Las piezas dentarias se fijaron en formol al 10 por ciento, se descalcificaron en Ana Morse y se incluyeron en parafina. Cortes seriados de 6 um se tiñeron con hematoxilina-eosina y con las técnicas de Bielschowsky y de Cajal para axones y fibras nerviosas. El recuento de las fibras nerviosas del plexo subodontoblástico de Raschkow, mostró que en los niveles iniciales está escasamente desarrollado, aumentando progresivamente junto con el desarrollo radicular, existiendo un aumento peak entre los niveles 3 y 4. En un mismo nivel se observó mayor desarrollo nervioso en la zona coronaria disminuyendo gradualmente hacia la zona radicular. Los resultados obtenidos se correlacionaron con tests de vitalidad pulpar

Avaliação da vitalidade pulpar em dentes permanentes jovens com rizogênese incompleta / Pulp vitality evaluation of young permanent teeth with incomplete root formation

No intuito de avaliar a confiabilidade dos testes de vitalidade pulpar em dentes permanentes jovens com rizogênese incompleta, os autores compararam a aplicação do gelo, teste elétrico e DDM (gás refrigerante) - diclorofluorometano em 86 incisivos centrais superiores de crianças com idade variável entre 7 e 8 anos. Pôde-se verificar que o DDM proporcionou maior porcentagem de respostas positivas que o teste elétrico e o gelo nesta ordem, observadno ademais, uma maior rapidez na obtenção da resposta com gás refrigerante, devendo porém ser utilizado como recurso adicional somente quando os métodos usuais não se mostrarem eficazes na avaliação da vitalidade pulpar

Evaluation of decalcified allogenic bone matrix grafts in and around root apices. A histological study.

Decalcified Allogenic Bone grafts were implanted in and around eighteen root apices after apicoectomy. The procedure was carried out on eighteen rabbits, dividing them into three groups of six rabbits each. The animals were sacrificed after 48-72 hours, 8-10 days & 8-10 weeks period of interval. Result of the present investigation reveal that DABM grafts stimulate osteogenesis and cementogenesis after the initial phase of inflammation. Tissues simulating bone and cementum appear at the apical end, speculating that the grafts would certainly result in physiological sealing of root apices. The possibility of saving the life of non vital teeth with or without wide apical foramen will enhance in future.

Apexification: follow-up after 6-12 years.

Thirty 'apexified' immature permanent anterior teeth treated utilising Ca(OH)2 as root canal dressing assessed clinically and radiographically after greater than 6 less than or equal to 12 years revealed that in 15 teeth bridge remained the same; in 10 consolidated, while in 3 it decreased. Periapical radiolucency reappeared in one case, while in two it was questionable but clinically the teeth were comfortable; these cases were ones showing decrease in bridge consolidation: two teeth had been extracted during this observation period by some dentists because of complaint of discolouration.