Is there a relationship between the presence of external root resorption in second molars adjacent to impacted mandibular third molars with awake bruxism and masticatory muscle activity?

OBJECTIVES: This study aimed to assess whether awake bruxism and masticatory muscle activity could be related to external root resorption (ERR) in second molars adjacent to impacted mandibular third molars. MATERIALS AND METHODS: Sixty patients, with requests for a cone-beam, computed tomography, were divided into two groups: ERR (patients with ERR in the second molar, n = 30), and control group (n = 30). Awake bruxism was assessed through the Oral Behaviors Checklist (OBC) and an ecological momentary assessment (EMA). Surface electromyography (EMG) was used to assess the masseter and anterior temporal muscle function. Normality and homogeneity of variances were demonstrated. Descriptive analysis was performed, using the T-test and Chi-square test to compare the characteristics of the groups. A multiple regression model was performed. RESULTS: The ERR group presented more non-functional oral activities related to awake bruxism than the control group, according to OBC (p = 0.027) and EMA (p = 0.035). In addition, the ERR group had higher EMG activity than the control group in rest and isotonic protocols (p < 0.05). CONCLUSIONS: Awake bruxism and greater masticatory muscle activity seem to be related to the presence of ERR in second molars adjacent to impacted mandibular third molars. CLINICAL RELEVANCE: The results of the present study can reinforce the theory that triggering ERR in the second molars adjacent to impacted mandibular third molars may be related to mechanical forces coming from the masticatory function.

Aspectos clínicos y forenses del color rosa de los dientes: reporte de un caso / Clinical and forensic aspects of the pink color of teeth: report of a case

La coloración rosa de los dientes puede originarse por diferentes factores. En el ámbito forense se ha descrito al fenómeno denominado post mortem pink teeth como un signo asociado a muertes violentas de etiología diversa. En la práctica clínica también es posible observar pacientes con dientes rosados, fre-cuentemente ocasionados por traumatismos o iatro-genia proveniente de ortodoncia, cuyo mecanismo de producción obedece a distintas etiopatogenias, destacándose las reabsorciones dentinarias inter-nas, cemento-dentinarias externas y calcificaciones dentinarias. El presente artículo expone el caso de un individuo adulto con antecedente de trauma óseo-dentario por accidente vial que, luego de un prolon-gado tiempo, asiste al Servicio de Urgencias Odon-tológicas y Orientación de Pacientes de la Facultad de Odontología de la Universidad de Buenos Aires, en donde se le detecta, a modo de hallazgo exploratorio, una ostensible coloración rosada en el canino infe-rior derecho. La situación motivó un pormenorizado abordaje clínico y radiográfico, indagando respecto a los probables factores que intervinieron en su ge-neración y desarrollo (AU)

The pink coloration of the teeth can be caused by dif-ferent factors. In the forensic field, the phenomenon called post mortem pink teeth has been described as a sign associated with violent deaths of various etiology. In clinical practice, it is also possible to ob-serve patients with pink teeth, frequently caused by trauma or iatrogenesis from orthodontics, whose production mechanism is due to different etiopatho-genesis, highlighting internal dentin resorption, ex-ternal cemento-dentinal resorption and dentin calci-fications. This article presents the case of an adult individual with a history of bone-dental trauma due to a road accident who, after a long time, attends the Dental Emergency and Patient Guidance Service of the Faculty of Dentistry of the University of Bue-nos Aires, where an ostensible pink coloration was detected in the lower right canine as an exploratory finding. The situation motivated a detailed clinical and radiographic approach, inquiring about the probable factors that intervened in its generation and development (AU)

Decoronation followed by dental implants placement: fundamentals, applications and explanations.

Dental arches areas with teeth presenting dentoalveolar ankylosis and replacement root resorption can be considered as presenting normal bone, in full physiological remodeling process; and osseointegrated implants can be successfully placed. Bone remodeling will promote osseointegration, regardless of presenting ankylosis and/or replacement root resorption. After 1 to 10 years, all dental tissues will have been replaced by bone. The site, angulation and ideal positioning in the space to place the implant should be dictated exclusively by the clinical convenience, associated with previous planning. One of the advantages of decoronation followed by dental implants placement in ankylosed teeth with replacement resorption is the maintenance of bone volume in the region, both vertical and horizontal. If possible, the buccal part of the root, even if thin, should be preserved in the preparation of the cavity for the implant, as this will maintain gingival tissues looking fully normal for long periods. In the selection of cases for decoronation, the absence of microbial contamination in the region - represented by chronic periapical lesions, presence of fistula, old unconsolidated root fractures and active advanced periodontal disease - is important. Such situations are contraindications to decoronation. However, the occurrence of dentoalveolar ankylosis and replacement resorption without contamination should neither change the planning for implant installation, nor the criteria for choosing the type and brand of dental implant to be used. Failure to decoronate and use dental implants has never been reported.

Decoronation followed by dental implants placement: fundamentals, applications and explanations

ABSTRACT Dental arches areas with teeth presenting dentoalveolar ankylosis and replacement root resorption can be considered as presenting normal bone, in full physiological remodeling process; and osseointegrated implants can be successfully placed. Bone remodeling will promote osseointegration, regardless of presenting ankylosis and/or replacement root resorption. After 1 to 10 years, all dental tissues will have been replaced by bone. The site, angulation and ideal positioning in the space to place the implant should be dictated exclusively by the clinical convenience, associated with previous planning. One of the advantages of decoronation followed by dental implants placement in ankylosed teeth with replacement resorption is the maintenance of bone volume in the region, both vertical and horizontal. If possible, the buccal part of the root, even if thin, should be preserved in the preparation of the cavity for the implant, as this will maintain gingival tissues looking fully normal for long periods. In the selection of cases for decoronation, the absence of microbial contamination in the region - represented by chronic periapical lesions, presence of fistula, old unconsolidated root fractures and active advanced periodontal disease - is important. Such situations are contraindications to decoronation. However, the occurrence of dentoalveolar ankylosis and replacement resorption without contamination should neither change the planning for implant installation, nor the criteria for choosing the type and brand of dental implant to be used. Failure to decoronate and use dental implants has never been reported.

RESUMO Áreas dos maxilares com dentes em anquilose alveolodentária e reabsorção dentária por substituição podem ser consideradas como portadoras de osso normal, em pleno processo fisiológico contínuo de remodelação; e os implantes osseointegráveis podem ser aplicados com sucesso. A remodelação óssea promoverá sua osseointegração, independentemente de haver raízes em anquilose e/ou em reabsorção por substituição. Após 1 a 10 anos, todos os tecidos dentários terão sido substituídos por osso. O local, a angulação e o posicionamento ideal no espaço para se colocar o implante devem ser ditados pela conveniência clínica associada, exclusivamente, ao planejamento prévio. Uma das vantagens da decoronação com colocação imediata de implantes em dentes anquilosados e com reabsorção por substituição é a manutenção do volume ósseo na região, tanto vertical quanto horizontalmente. Se possível, deve-se preservar, na preparação da cavidade para o implante, a parte vestibular da raiz, mesmo que fina; isso deixará os tecidos gengivais com aspecto de plena normalidade por longos períodos. O importante na seleção de casos para a decoronação é a ausência de contaminação microbiana na região, representada por lesões periapicais crônicas, presença de fístula, fraturas radiculares antigas não consolidadas e doença periodontal avançada ativa. Essas situações são contraindicações para a decoronação. A ocorrência de anquilose alveolodentária e reabsorção por substituição sem contaminação não deve mudar o planejamento para instalação de implantes, nem mesmo os critérios de escolha do tipo e marca de implante dentário a ser utilizado. Nunca foi relatado fracasso na decoronação e uso de implantes dentários.

Should deciduous teeth be preserved in adult patients? How about stem cells? Is it reasonable to preserve them?

When seeking orthodontic treatment, many adolescents and adult patients present with deciduous teeth. Naturally, deciduous teeth will inevitably undergo exfoliation at the expected time or at a later time. Apoptosis is the biological trigger of root resorption. In adult patients, deciduous teeth should not be preserved, as they promote: infraocclusion, traumatic occlusion, occlusal trauma, diastemata and size as well as morphology discrepancy malocclusion. Orthodontic movement speeds root resorption up, and so do restoring or recontouring deciduous teeth in order to establish esthetics and function. Deciduous teeth cells are dying as a result of apoptosis, and their regeneration potential, which allows them to act as stem cells, is limited. On the contrary, adult teeth cells have a greater proliferative potential. All kinds of stem cell therapies are laboratory investigative non authorized trials.

Should deciduous teeth be preserved in adult patients? How about stem cells? Is it reasonable to preserve them?

Abstract When seeking orthodontic treatment, many adolescents and adult patients present with deciduous teeth. Naturally, deciduous teeth will inevitably undergo exfoliation at the expected time or at a later time. Apoptosis is the biological trigger of root resorption. In adult patients, deciduous teeth should not be preserved, as they promote: infraocclusion, traumatic occlusion, occlusal trauma, diastemata and size as well as morphology discrepancy malocclusion. Orthodontic movement speeds root resorption up, and so do restoring or recontouring deciduous teeth in order to establish esthetics and function. Deciduous teeth cells are dying as a result of apoptosis, and their regeneration potential, which allows them to act as stem cells, is limited. On the contrary, adult teeth cells have a greater proliferative potential. All kinds of stem cell therapies are laboratory investigative non authorized trials.

Resumo Muitos adolescentes e adultos, ao procurar pelo tratamento ortodôntico, apresentam dentes decíduos persistentes. Naturalmente, os dentes decíduos ou se esfoliam na época esperada ou mais tardiamente, de forma inevitável. A apoptose é o gatilho biológico da rizólise. Em adultos, os dentes decíduos não devem ser preservados, pois promovem: infraoclusão, oclusão traumática, trauma oclusal, além de diastemas e má oclusão por discrepância de tamanho e morfologia. O movimento ortodôntico acelera o processo de rizólise, assim como restaurar ou reanatomizar dentes decíduos para inseri-los em uma estética e função. As células dos dentes decíduos estão morrendo por apoptose e seu potencial regenerativo para atuarem como células-tronco tem limitações, ao contrário das células de dentes adultos, que têm maior potencial proliferativo. Todas as terapias com células-tronco ainda são laboratoriais e se enquadram como ensaios investigativos não autorizados.

Reabsorção radicular externa cervical invasiva: revisão de literatura / Invasive external cervical root resorrption: literature review

A reabsorção externa cervical (REC) caracteriza-se pela invasão da região cervical da raiz pelo tecido fibrovascular nas fases iniciais e, em seguida, por tecido fibro-ósseo que progressivamente reabsorve o cemento, a dentina e o esmalte. De acordo com Heithersay (2004) podem ser classificadas em 4 estágios de acordo com suas características clinicas e radiográficas. A REC é uma entidade insidiosa e, por isso, seu diagnóstico é eminentemente radiográfico. Uma vez identificada, a TCCB é um exame complementar essencial para o planejamento do melhor plano de tratamento por permitir a localização do ponto de início da reabsorção e da natureza do processo. A etiologia da REC ainda é mal compreendida Sabe-se que seu início depende da lesão ou deficiência da camada de cemento na região cervical da raiz, logo abaixo do epitélio juncional, na região correspondente à junção amelocementária. O tratamento ortodôntico, o traumatismo dentário, o clareamento endógeno e os procedimentos cirúrgicos representam os principais fatores predisponentes por resultarem na quebra de homeostasia desta região. Uma vez instalada a reabsorção, a natureza do estímulo necessário para sustentar a REC também gera discussões. Alguns autores o consideram puramente inflamatório, enquanto outros como reabsorção asséptica que pode ser invadida, secundariamente, por microrganismos oriundos do sulco gengival e, mais raramente dos túbulos dentinários em dentes com polpa necrótica. O tratamento cirúrgico/restaurador está indicado nas REC em estágios iniciais e médios classificação 1,2 e 3 de Heythersay, 1999. Quanto mais precoce o diagnostico maiores os índices de sucesso. As reabsorções classificadas como classe 4 tem baixa taxa de sucesso após o tratament

External cervical resorption (ECR), also called invasive cervical resorption (ICR), is defined as a localized resorptive process that commences on the surface of root below the epithelial attachment and the coronal aspect of the supporting alveolar process, namely the zone of the connective tissue attachment. It is an aggressive type of external resorption characterized by invasion of the cervical region of the root by fibrovascular tissue in the early stages and then by fibro-osseous tissue that progressively reabsorbs cementum, dentin and enamel.The resorptive cavity contains granulomatous fibrovascular tissue separated from the healthy pulp tissue by a thin layer of dentin and predentin, called pericanalar resorption resistant sheet (PRRS). According to Heithersay (2004) they can be classified in 4 stages according to their clinical and radiographic features. Because the majority of cases of REC is an insidious asymptomatic entity, the diagnosis is mostly made during routine radiographic examination. Cone-beam computed tomography (CBCT) is also used as a complementary technique to asses and manage this type of resorption. The onset of REC depends on the presence of gaps in the cement layer in the cervical region of the root, just below the junctional epithelium. Orthodontics, dental trauma, endogenous bleaching and surgical procedures represent the main predisposing factors. Additional factors that continuously stimulate the resorptive cells rendering ERC progressive are not well known. Some authors consider it purely inflammatory while others as aseptic resorption that can be contaminated by microorganisms originating from the gingival sulcus and, more rarely, from the pulp canal trough dentinal tubules. in teeth with necrotic pulp. Surgical/restorative treatment is indicated in the stages 1 to 3 (Heythersay, 1999) achieving higher success rates in earlier diagnosis. Teeth diagnosed with stage 4 of REC have puor prognosis

Axonal Degeneration in Dental Pulp Precedes Human Primary Teeth Exfoliation.

The dental pulp in human primary teeth is densely innervated by a plethora of nerve endings at the coronal pulp-dentin interface. This study analyzed how the physiological root resorption (PRR) process affects dental pulp innervation before exfoliation of primary teeth. Forty-four primary canine teeth, classified into 3 defined PRR stages (early, middle, and advanced) were fixed and demineralized. Longitudinal cryosections of each tooth were stained for immunohistochemical and quantitative analysis of dental pulp nerve fibers and associated components with confocal and electron microscopy. During PRR, axonal degeneration was prominent and progressive in a Wallerian-like scheme, comprising nerve fiber bundles and nerve endings within the coronal and root pulp. Neurofilament fragmentation increased significantly during PRR progression and was accompanied by myelin degradation and a progressive loss of myelinated axons. Myelin sheath degradation involved activation of autophagic activity by Schwann cells to remove myelin debris. These cells expressed a sequence of responses comprising dedifferentiation, proliferative activity, GAP-43 overexpression, and Büngner band formation. During the advanced PRR stage, increased immune cell recruitment within the dental pulp and major histocompatibility complex (MHC) class II upregulation by Schwann cells characterized an inflammatory condition associated with the denervation process in preexfoliative primary teeth. The ensuing loss of dental pulp axons is likely to be responsible for the progressive reduction of sensory function of the dental pulp during preexfoliative stages.

Orthodontic movement in deciduous teeth.

Deciduous teeth exfoliate as a result of apoptosis induced by cementoblasts, a process that reveals the mineralized portion of the root while attracting clasts. Root resorption in deciduous teeth is slow due to lack of mediators necessary to speed it up; however, it accelerates and spreads in one single direction whenever a permanent tooth pericoronal follicle, rich in epithelial growth factor (EGF), or other bone resorption mediators come near. The latter are responsible for bone resorption during eruption, and deciduous teeth root resorption and exfoliation. Should deciduous teeth be subjected to orthodontic movement or anchorage, mediators local levels will increase. Thus, one should be fully aware that root resorption in deciduous teeth will speed up and exfoliation will early occur. Treatment planning involving deciduous teeth orthodontic movement and/or anchorage should consider: Are clinical benefits relevant enough as to be worth the risk of undergoing early inconvenient root resorption?

Orthodontic movement in deciduous teeth

Deciduous teeth exfoliate as a result of apoptosis induced by cementoblasts, a process that reveals the mineralized portion of the root while attracting clasts. Root resorption in deciduous teeth is slow due to lack of mediators necessary to speed it up; however, it accelerates and spreads in one single direction whenever a permanent tooth pericoronal follicle, rich in epithelial growth factor (EGF), or other bone resorption mediators come near. The latter are responsible for bone resorption during eruption, and deciduous teeth root resorption and exfoliation. Should deciduous teeth be subjected to orthodontic movement or anchorage, mediators local levels will increase. Thus, one should be fully aware that root resorption in deciduous teeth will speed up and exfoliation will early occur. Treatment planning involving deciduous teeth orthodontic movement and/or anchorage should consider: Are clinical benefits relevant enough as to be worth the risk of undergoing early inconvenient root resorption?.

O dente decíduo é esfoliado graças à apoptose em seus cementoblastos, que desnuda a parte mineralizada da raiz e atrai os clastos. A rizólise é lenta, pois faltam mediadores em quantidade para acelerar o processo, mas ela se acelera e unidireciona quando se aproxima um folículo pericoronário de dente permanente rico em EGF e outros mediadores da reabsorção óssea - os responsáveis pelas reabsorções óssea na erupção e dentária decídua na rizólise e esfoliação. Se houver movimentação ortodôntica ou ancoragem em dentes decíduos, aumenta-se, também, o nível local desses mesmos mediadores, devendo-se estar bem consciente de que haverá uma aceleração da rizólise e, em decorrência, uma antecipação de sua esfoliação. No planejamento de casos em que dentes decíduos estejam envolvidos na movimentação ortodôntica e/ou ancoragem, deve-se ponderar: o benefício clínico para o paciente será relevante, a ponto de valer o risco de uma rizólise abreviada e inconveniente?.

Serum-containing medium effect on isolation rate of dental pulp cells from cryopreserved intact deciduous teeth.

OBJECTIVES: To isolate cells from pulp of intact cryopreserved deciduous teeth. The null hypothesis raised here is to find no difference in the establishment of cell culture after cryopreservation (1) using culture medium supplemented with different concentrations of fetal bovine serum (FBS); and (2) between teeth with different stages of physiological root resorption. STUDY DESIGN: Intact deciduous teeth with different root resorption stages were cryopreserved using FBS and Dimethyl Sulfoxide (DMSO) medium (9:1) in a progressive freezing process, by placing the samples in the refrigerator (4 degrees C/60 min) and subsequently transferring them to a -80 degrees C freezer (controlled device -1 degrees C/min/24 hours), and finally into liquid nitrogen (-196 degrees C/30 days). After the thawing process, the cell isolation was performed by enzymatic digestion (type I collagenase). The cells were re-suspended into the culture medium with 10% (G1) or 20% (G2) of FBS. Microscopic analysis was performed after 30 days to visualize the cell attachment. RESULTS: The culture establishment rate was higher in G2 (75%) than G1 (12.5%) (p = 0.041). There was no difference between the different stages of root resorption. CONCLUSIONS: It was possible to establish cell cultures from the pulp of intact cryopreserved deciduous teeth. The use of 20% FBS after thawing improved the culture rate.

The four mechanisms of dental resorption initiation.

The aim of this study is to present a classification with a clinical application for root resorption, so that diagnosis will be more objective and immediately linked to the source of the problem, leading the clinician to automatically develop the likely treatment plan with a precise prognosis. With this purpose, we suggest putting together all diagnosed dental resorptions into one of these four criteria: 1) Root resorption caused by cementoblast cell death, with preservation of the Malassez epithelial rests. 2) Root resorption by cementoblasts and Malassez epithelial rests death. 3) Dental resorption by odontoblasts cell death with preservation of pulp vitality. 4) Dental resorption by direct exposure of dentin to gingival connective tissue at the cementoenamel junction gaps.

Immunohistochemical expression of biglycan and decorin in the pulp tissue of human primary teeth during resorption.

Primary teeth are interesting models that can be used to study physiological and pathological processes involving cells and extracellular matrices in hard and soft tissues. This study investigated the expression and distribution of biglycan and decorin-the non-collagenous components of the extracellular matrix-in primary teeth tissue, during physiological root resorption. Thirty healthy human primary teeth were grouped together according to root length: Group I - two-thirds root length, Group II - one-third root length, and Group III - teeth with no root. The streptavidin-biotin-peroxidase immunohistochemical method was used with antibodies against the previously named antigens. The proteoglycans studied were found in the pulp and dentin extracellular matrix in all groups without any differences in the proteins, among the groups. Biglycan was observed mainly in predentin and in pulp connective tissue in the resorption area. In addition, decorin was observed mainly in pulp connective tissue, but near the resorption area. Biglycan and decorin were distributed differentially in the dental tissues. The present immunohistocytochemical data, combined with previously reported data, suggest that these proteoglycans could be involved in regulating the physiological resorption process in healthy primary teeth.

Immunohistochemical expression of biglycan and decorin in the pulp tissue of human primary teeth during resorption

Primary teeth are interesting models that can be used to study physiological and pathological processes involving cells and extracellular matrices in hard and soft tissues. This study investigated the expression and distribution of biglycan and decorin-the non-collagenous components of the extracellular matrix-in primary teeth tissue, during physiological root resorption. Thirty healthy human primary teeth were grouped together according to root length: Group I - two-thirds root length, Group II - one-third root length, and Group III - teeth with no root. The streptavidin-biotin-peroxidase immunohistochemical method was used with antibodies against the previously named antigens. The proteoglycans studied were found in the pulp and dentin extracellular matrix in all groups without any differences in the proteins, among the groups. Biglycan was observed mainly in predentin and in pulp connective tissue in the resorption area. In addition, decorin was observed mainly in pulp connective tissue, but near the resorption area. Biglycan and decorin were distributed differentially in the dental tissues. The present immunohistocytochemical data, combined with previously reported data, suggest that these proteoglycans could be involved in regulating the physiological resorption process in healthy primary teeth.

The four mechanisms of dental resorption initiation

The aim of this study is to present a classification with a clinical application for root resorption, so that diagnosis will be more objective and immediately linked to the source of the problem, leading the clinician to automatically develop the likely treatment plan with a precise prognosis. With this purpose, we suggest putting together all diagnosed dental resorptions into one of these four criteria: 1) Root resorption caused by cementoblast cell death, with preservation of the Malassez epithelial rests. 2) Root resorption by cementoblasts and Malassez epithelial rests death. 3) Dental resorption by odontoblasts cell death with preservation of pulp vitality. 4) Dental resorption by direct exposure of dentin to gingival connective tissue at the cementoenamel junction gaps.

O presente trabalho propõe-se a apresentar uma classificação, com aplicação clínica, para as reabsorções dentárias, para que o diagnóstico seja objetivo e imediatamente ligado à causa do problema, levando automaticamente o clínico ao provável plano de tratamento e a um prognóstico preciso. Com esse objetivo, sugerimos agrupar cada caso clínico de reabsorção dentária em um dos seguintes grupos: 1) Reabsorções radiculares pela morte dos cementoblastos, com manutenção dos restos epiteliais de Malassez. 2) Reabsorções radiculares pela morte dos cementoblastos e dos restos epiteliais de Malassez. 3) Reabsorções dentárias pela morte dos odontoblastos, com manutenção da vitalidade pulpar. 4) Reabsorções dentárias pela exposição direta da dentina ao tecido conjuntivo gengival, nos gaps da junção amelocementária.

Clinical and SEM characterization of prolonged retention of a primary tooth with pulpectomy.

Root canal filling with zinc oxide-eugenol (ZOE) paste following primary tooth pulpectomy is a common practice in pediatric dentistry. This material offers high clinical and radiographic success rates. In some cases, however, it is not resorbed along with the root of the primary tooth. The aim of this study was to describe a case of prolonged retention of a primary maxillary incisor that was subjected to pulpectomy and filled with ZOE paste in order to characterize the aspects of root resorption using scanning electron microscopy.

Minimally invasive intervention of acute trauma in the primary dentition: Successful five-year follow-up.

The main objectives of diagnosis and treatment of traumatic injuries affecting children in the primary dentition are pain management and prevention of damage to the developing tooth germ. Inappropriate approaches to treating dental trauma can cause more damage than the trauma itself; for this reason, minimal intervention presents a low risk of sequelae development in the permanent successor teeth. This case describes a five-year follow-up of acute trauma in the primary dentition. Conservative management with minimal intervention of the traumatized teeth was adopted. The traumatized teeth were followed until eruption of their permanent successors. The permanent teeth erupted in the correct order. The conservative management was a success and resulted in normal eruption of the permanent teeth with no sequelae.

Avaliação da reabsorção radicular externa consecutiva ao uso do Sistema Autoligável Damon / Evaluation od external root resorption consequent to the use of self-ligated damon system

A reabsorção radicular apical constitui um efeito indesejável, porém frequente, do tratamento ortodôntico e por este motivo, várias técnicas e materiais, tal como o aparelho autoligável Damon têm sido desenvolvido visando facilitar a prática clinica e diminuir esse efeito deletério. O propósito deste estudo foi comparar o grau de reabsorção radicular externa em casos tratados com o aparelho autoligável Damon e com o aparelho pré-ajustado convencional. A amostra constitui de 52 casos, sendo 25 do grupo 1, tratados com o aparelho autoligável Damon, com idade média inicial de 16,04 anos e idade média final de 18,06 anos e com tempo de tratamento médio de 2,02 anos; e 27 do grupo 2, tratados com o aparelho pré-ajustado convencional, com idade média inicial de 16,77 anos, idade média final de 18,47 anos e com tempo de tratamento médio de 1,70 anos. Foram avaliadas as radiografias periapicais dos incisivos superiores e inferiores ao final do tratamento ortodôntico. Os dois grupos foram compatibilizados quanto às idades inicial e final, tempo de tratamento, distribuição por gêneros, tipo de má oclusão e protocolo de tratamento sem extrações. A reabsorção radicular foi avaliada pelo escore de Levander e Malmgren. Os dados relacionados à reabsorção radicular foram comparados pelo teste não paramétrico de Mann-Whitney. Os resultados mostraram que não houve diferença significante nos graus de reabsorção radicular entre os dois grupos. Graus de reabsorção radicular semelhantes podem ser esperados ao final do tratamento com o aparelho autoligável Damon e o aparelho pré-ajustado convencional.

The apical root resorption is an undesirable effect, but frequent in orthodontic treatment and for this reason, several techniques and materials, such as self-ligated Damon appliance have been developed to facilitate clinical practice and decrease it. The purpose of this study was to compare the degree of external root resorption in patients treated with the self-ligated Damon appliance and the conventional preadjusted appliance. The sample comprised 52 cases, 25 in group 1, treated with the self-ligated Damon appliance, with mean initial age of 16.04 years, mean final age of 18.06 years, and mean treatment time of 2.02 years; and 27 in group 2, treated with the conventional preadjusted appliance, with a mean initial age of 16.77 years, mean final age of 18.47 years and mean treatment time of 1.70 years. It was evaluated the periapical radiographs of the maxillary and mandibular incisors at the end of orthodontic treatment. The two groups were matched regarding the initial and final ages and treatment time, gender distribution, type of malocclusion and treatment protocol without extractions. The root resorption was assessed by the score of Levander and Malmgren. Data related to root resorption were compared by the nonparametric Mann-Whitney test. The results showed no significant difference in the degree of root resorption between the two groups. Similar degrees of resorption can be expected after the treatment with the Damon self-ligated appliance and the conventional preadjusted appliance.

Successful minimally invasive management of primary maxillary central incisors after lateral luxation: a case report.

Lateral luxation in primary maxillary incisors is a traumatic injury that can lead to darkening of the tooth, pulp necrosis, root resorption, and damage to the permanent teeth. Management of this kind of trauma typically includes pulpectomy or extraction in cases of root resorption. However, in young children, removal of the tooth may be psychological stressing, especially for the parents, while increased mobility can make immediate endodontic treatment difficult to perform. This article outlines a severe palatal luxation on the maxillary right central incisor treated with conservative management in a 2-year-old boy. At the one-year follow-up appointment, the surrounding bone was healthy, the roots displayed physiological resorption, the crowns showed color improvement, and there was no radiographically noticeable damage to the permanent teeth.

Primary teeth show less protecting factors against root resorption.

BACKGROUND: Physiological root resorption differentiates primary from permanent teeth. The understanding of what protects and regulates root resorption might help to develop therapies to its control. AIM: To verify the presence and distribution of ECRM and the expression of CK14, OPG, TRAP and COX-2 in the periodontal ligament (PDL) of human primary and permanent teeth. Design. Eight primary teeth undergoing physiological or pathological root resorption and 4 permanent teeth were immunohistochemically processed for CK14, TRAP, COX-2 and OPG expression. RESULTS: PDL from primary and permanent teeth showed similar morphological features; however, fewer ECRM clusters and higher immunoreactivity to CK14 were found in primary PDL. In permanent teeth, ECRM were distributed along the entire PDL tissue. Howship's lacunae were found only in primary teeth, associated with the presence of TRAP-positive cells and increase in COX-2 expression. OPG expression in primary PDL was detected in nonresorptive cervical areas and in lacunae showing reparative tissue. It was observed higher expression of OPG in all permanent teeth when compared to primary specimens. CONCLUSIONS: It may be concluded that PDL from primary teeth shows less ECRM clusters and lower expression of OPG. These features may be associated with lower protection against root resorption in primary teeth.