[An 18 month evaluation of MM-MTA pulpotomy on primary decayed molars]. / Evaluation sur 18 mois de la pulpotomie au MM-MTA sur des molaires temporaires cariées.

Pulpotomy is the most performed and controversial therapeutic in pediatric dentistry. Formocresol is known to have a toxic effect on living tissues, a mutagenic and carcinogenic potential with a systemic uptake of formocresol via pulpotomized teeth, other alternative products have been investigated. 40 molars were pulpotomized using Micro Mega Mineral Trioxide Aggregate (MM-MTA), which eliminates the need for the use of formocresol. The effects of this material were evaluated both clinically and radiographically. Post-operative control examinations were performed at 1, 6, 12, and 18 months trying to detect spontaneous or stimulated pain, pathological tooth mobility, abscesses or fistulas, internal or external pathological tooth resorption, periapical bone destruction, or canal obliteration. Pain was absent at 18 months post operatively. Thirty six molar treated with the MM-MTA didn't show any mobility or pain, one molar presented a pathological resorption and one molar presented an abscess without a fistula at 12 month. The observations were compared to others related to formocresol, ferric sulfate, MTA, and laser pulpotomies, using the Chi-square test x2. The abundance of positive result strongly demonstrate that the MM-MTA pulpotomy on carious temporary molars is a promising technique.

[Pathogenesis and classification of tooth resorption].

Tooth resorption is an idiopathic destructive disease of dental hard tissues. The etiology and pathogenesis remain obscure. It has various manifestations and can be commonly classified as internal tooth resorption and external root resorption on the basis of the resorptive lesion sites. There have been many attempts to make further classification based upon the pathological manifestations in recent years. Radiographic examination is an effective tool to assist in the diagnosis. There are few systematic researches on tooth resorption worldwide, most of which are case reports. This review elaborates on the research progress of tooth resorption from aspects of pathogenesis and classification.

Radiographic evaluation of the classification of the extent of tooth resorption in dogs.

OBJECTIVE: To determine applicability of the 2007 American Veterinary Dental College (AVDC) classification method for determining extent of tooth resorption in dogs. ANIMALS: 224 dogs > 1 year old admitted for periodontal treatment or other dental procedures in 2007. PROCEDURES: Full-mouth radiographs of all dogs were reviewed for evidence of tooth resorption. Tooth resorption in dogs was classified in accordance with the radiographic criteria described for use in human teeth and, when applicable, the guidelines described in the 2007 AVDC classification method. RESULTS: 851 of 943 (90.2%) affected teeth met the radiographic characteristics of 1 of the 5 stages of tooth resorption described by the AVDC classification method. Among tooth resorption types described for human teeth, the AVDC classification method was totally applicable (100%) in 17 teeth with external surface resorption, 21 teeth with external replacement resorption, and 736 teeth with external cervical root surface resorption, but it was applicable in only 56 of 121 (46.3%) teeth with external inflammatory resorption and none of the teeth with internal resorption. CONCLUSIONS AND CLINICAL RELEVANCE: The AVDC classification method was useful to describe the extent of tooth resorption in dogs, but it did not reflect the radiographic patterns and location of lesions. The AVDC classification method was applicable in some, but not all, of the teeth with various resorption types in dogs. The AVDC classification method could be adapted best to lesions that have radiographic patterns of external replacement resorption and external cervical root surface resorption.

Invasive Cervical Resorption: Clinical Management in the Anterior Zone.

According to the high number of articles published on invasive cervical resorption (ICR), this pathology, as commonly believed, is a more frequent form of cervical resorption. ICR is often misdiagnosed as internal resorption or caries, which leads to inappropriate treatment and even unnecessary tooth loss. Despite a correct diagnosis, the treatment of this type of hyperplastic invasive external resorption poses a challenge for the clinician. The Heithersay classification and the use of cone-beam computed tomographic imaging have increased our knowledge of the pathology and helped improve its prognosis. Nevertheless, there is no standard protocol for the treatment of this type of lesion. This article proposes a treatment protocol for ICR based on the pattern and location of resorption. Three treatment approaches (internal access, external access, and intentional replantation) are presented through 3 clinical cases.

Is the resorption external or internal?

UNLABELLED: Resorption of teeth is reviewed from a diagnostic perspective to clarify the confusion as to whether it is external or internal. The key features of the various types (external surface, transient apical breakdown, external inflammatory, external replacement, external cervical and internal) are described and illustrated by cases. Management and appropriate treatment is dependent on the correct diagnosis. CLINICAL RELEVANCE: Diagnosis of resorption is essential to the appropriate management.

[Impacted teeth and the six incarnations of resorption]. / Les six formes de résorption associées à l'inclusion dentaire.

There are six distinct types of resorption of dental hard tissue that occur in association with unerupted and impacted permanent teeth. These pathologic entities differ markedly from one another in terms of their aetiology, their treatment and their prognosis. In several of them, the continued existence of the affected tooth may be in danger while in others, conservative treatment may halt the resorption process and provide for a successful outcome. The treatment approach is specific for each type and is entirely dependant on the diagnosis. This presentation will discuss prevalence, aetiology, presenting symptoms and clinical signs, radiographic features, histopathology, differential diagnosis, treatment and prognosis in relation to each of the conditions.

Endodontic classification.

Clinical and histopathologic findings are mixed in current endodontic classifications. A new system, based on symptomatology, may be more useful in clincial practice. The classifications are vital asymptomatic, hypersensitive dentin, inflamed-reversible, inflamed/dengenerating without area-irreversible, inflamed/degenerating with area-irreversible, necrotic without area, and necrotic with area.

Feline odontoclastic resorptive lesions an unsolved enigma in veterinary dentistry.

This article presents a comprehensive review of the literature on feline odontoclastic resorptive lesions (FORLs), including etiopathogenesis, prevalence and predisposition, classification, histopathologic appearance, diagnosis, and treatment. Approximately one-third of all domestic cats may develop FORLs during their life span, and the risk of developing FORLs increases with age. Sophisticated dental treatments promise neither cure nor permanent improvement of affected teeth. Extraction is the current treatment of choice. Research on the etiology of FORLs has not been rewarding in recent years, and the causative factors contributing to the development of FORLs are still unknown.

Subgingival odontoclastic resorptive lesions. Classification, treatment, and results in 58 cats.

A commonly recognized dental problem in cats is the resorption of tooth structure and subsequent loss of the tooth. These tooth defects are often very painful, because the sensitive dentin layer is exposed. The destruction of the tooth through odontoclastic resorption is considered a consequence of inflammatory resorption, probably secondary to periodontal inflammation. Because these resorptive lesions are progressive in nature, it is best to stage this progression of resorption in order to address treatment planning. The purpose of this study was to evaluate a group of 58 cats with resorptive lesions to determine the outcome of treatment 6 months or longer after restoration. In 81% of the cats, there was loss of the tooth, evidence of further resorption, or loss of the restoration at one or more resorption sites. Of the 154 teeth restored, only 33% showed no further evidence of loss of tooth structure.

Tooth resorption.

Tooth resorption is a common sequela following injuries to or irritation of the periodontal ligament and/or tooth pulp. The course of tooth resorption involves an elaborate interaction among inflammatory cells, resorbing cells, and hard tissue structures. The key cells involved in resorption are of the classic type, which include osteoblasts and odontoclasts. Types of tooth resorption include internal resorption and external resorption. There are two types of internal resorption: root canal (internal) replacement resorption and internal inflammatory resorption. External resorption can be classified into four categories by its clinical and histologic manifestations: external surface resorption, external inflammatory root resorption, replacement resorption, and ankylosis. External inflammatory root resorption can be further categorized into cervical resorption with or without a vital pulp (invasive cervical root resorption) and external apical root resorption. Other variations of resorption include combined internal and external resorption and transient apical breakdown.

Surgical endodontic management of an invasive cervical resorption class 4 with mineral trioxide aggregate: a 6-year follow-up.

Invasive cervical resorption is a type of external resorption rarely seen as an adverse effect after a guided tissue regeneration procedure for a periodontal condition. This case report summarizes the surgical endodontic management of an invasive cervical resorption class 4 (Heithersay) with mineral trioxide aggregate, in a mandibular incisor of a 67-year-old man. A 6-year clinical follow-up with radiovisiography and cone-beam computerized tomography revealed complete healing. A surgical endodontic management could promote healing and survival of a tooth with advanced root resorption due to a periodontal condition.

Reabsorção interna versus externa: indicadores para um diagnóstico preciso / Internal resorption versus external: indicators for accurate diagnosis

Os diagnóticos equivocados entre absorção interna e externa frequentemente estão presentes nos laudos imaginológicos, em trabalhos publicados e em livros. Objetivo: destacamos, no presente trabalho, os indicadores imaginológicos de diagnóstico preciso para as reabsorções internas e externas, haja vista que são distintas e específicas. Resultados: a preservação dos limites pulpares nos dentes com reabsorção externa se destaca como seu principal indicador diagnóstico. A expansão foco/local balonizante dos limites pulpares com continuidade e a regularidade nas suas margens expandidas, formando uma área pulpar de radiolucidez homogênea, são os principais indicadores do diagnóstico de reabsorção interna. Conclusão: os diagnósticos equivocados geralmente estão associados à falta de conhecimento da etiopatogenia desses processos reabsortivos e/ou de uma experiência prévia em seus diagnósticos.

Dental erosion. Definition, classification and links.

An overview of tooth wear, i.e. of non-carious destructive processes affecting the teeth including abrasion, demastication, attrition, abfraction, resorption and erosion is presented. The nomenclature and classification of dental erosion commonly used in the dental literature are summarized. They are based on etiology (extrinsic, intrinsic, idiopathic), on clinical severity (Classes I to III), on pathogenetic activity (manifest, latent) or on localization (perimolysis). Interactions between erosion and abrasion, demastication, attrition, and abfraction as well as caries and low salivary flow rate are highlighted.

Detection of simulated internal tooth resorption using conventional radiography and subtraction imaging.

OBJECTIVES: To compare the diagnostic accuracy of conventional radiography with digital subtraction imaging in the detection of simulated internal resorption. METHODS: Simulated resorption cavities were created by the sequential use of progressively larger round burs (ISO size range 006-016) in the labial wall of the coronal or apical thirds of the pulp chamber of the maxillary incisors of two cadavers. Five viewers examined 120 pairs of radiographs, one of each pair being baseline (no lesion) and the other with or without a lesion. The process was then repeated with subtraction images of the pairs of radiographs. Receiver Operating Characteristic (ROC) analysis was used to compare the diagnostic accuracy of the two imaging modalities. RESULTS: Using conventional radiography, the minimum lesion size detectable coronally was in the 'medium' range (ISO size 010 and 012 round burs), but only 'large' lesions (ISO size 014 and 016) could be detected in the apical region. The overall diagnostic accuracy of subtraction imaging was superior to conventional radiography but only significant (P<0.05) for coronal lesions. CONCLUSION: Subtraction radiography may be a useful tool for detecting and monitoring the progress of internal root resorption.

Avoiding "the space" by the treatment of compromised teeth.

The advent of implant therapy has given new a dimension to dentistry particularly where teeth have been irretrievably damaged or pathologically involved. There are many situations however, where endodontic or combined therapy may effectively retain compromised teeth and clinicians should carefully evaluate evidence-based treatment. The main areas discussed are: transverse and crown root fractures and invasive cervical resorption. Transverse root fractures have an excellent natural healing capacity and will also respond favourably to treatment if pulp necrosis occurs in the coronal segment. Studies have shown that crown root fractures can be effectively treated by combined endodontic-orthodontic-periodontic and prosthodontic therapy. Invasive cervical resorption has been classified into four classes depending on the degree of infiltration of resorptive tissue into the tooth structure. A study of treatment results following the topical application of 90% aqueous trichloracetic acid, curettage and restoration indicated that this regimen could be successfully applied to Classes 1, 2 and 3 resorption.

Preeruptive intracoronal radiolucencies: review and report of case.

Intracoronal radiolucencies in unerupted teeth are an uncommon radiographic finding; but their early detection and classification allow the most appropriate management protocol to be developed. Early separation of lesions into those that are developmental and remain static and those that are reactive and aggressive is necessary for a controlled outcome. The current paper reviews possible formative mechanisms and describes a case of severe intracoronal resorption resulting in loss of the tooth.

Reabsorção radicular: etiologia, patogênese, classificação e manifestações clínicas / Root resorption: etiology, pathogenesis, classification and clinical manifestations

Este artigo revisa a classificação, os inúmeros agentes etiológicos e a patogênese da reabsorção radicular. A estrutura dentária mineralizada não é normalmente reabsorvida, pois possui células capazes de promover sua manutenção, defesa e reparação. Caso essas células sejam danificadas ou removidas, células multinucleadas colonizarão essa região e o processo reabsortivo se iniciará. Esse tipo de reabsorção foi denominada reabsorção radicular inflamatória. Ocorrendo nas paredes do canal radicular, é dita interna e, na superfície externa da raiz, externa. A reabsorção radicular pode ser transitória ou progressiva

Reabsorciones dentarias: un problema para el diagnóstico, el tratamiento y el pronóstico. Trabajo de divulgación científica. Parte II / Tooth resorptions: a problem for the diagnosis, treatment an prognosis. Scientific divulgation article. Part II

El presente trabajo de divulgación científica tiene por finalidad describir los distintos tipos de reabsorciones que afectan los tejidos duros del diente. Generalmente, estas patologías son difíciles de diagnosticar y de tratar y, en numerosas ocasiones, pueden comprometer la permanencia del elemento dentario en boca. Las reabsorciones se clasifican, según su ubicación, en dentinarias internas y cemento dentinarias externas y, por su etiología, en aquellas que se vinculan a factores físicos como los traumatismos y las presiones que sufren las piezas dentarias, a agentes infecciosos que provienen de la cavidad pulpar o del periodonto, a afeciones sistémicas y a causas idiopáticas. Se pone especial énfasis en la importancia de arribar al diagnóstico clínico-radiográfico a los fines de estabvlecer el pronóstico y el tratamiento adecuado