Delayed eruption of premolars with periodontitis of primary predecessors and a cystic lesion: a case report.

Apical periodontitis after pulp therapy in a primary tooth can cause delayed eruption of the permanent successor. A case of bilateral delayed eruption of mandibular premolars is presented. The patient. a 13-year-old girl, was referred by her dentist. Oral findings showed that the right first and left second primary molars were retained. Other premolars had erupted. An orthopantomogram revealed apical periodontitis, affecting both retained primary molars. The right first mandibular premolar was impacted against the alveolar bone and root of the second premolar, and there was a large cystic lesion in close association with the left second mandibular premolar. Both primary molars were extracted, and the cystic lesion was treated by marsupialization. Fenestration and traction were performed on the right first premolar. Correct tooth alignment was achieved with orthodontic appliances. If the problem had been detected earlier, treatment of the premolars might have been easier. Clinical and radiological follow-up, therefore, of primary teeth that have undergone pulp therapy procedures should be performed until eruption of succedaneous teeth.

Low calcium environment effects osteoprotegerin ligand/osteoclast differentiation factor.

In coculture with osteoblastic cell line MC3T3-E1 (E1) and mouse bone marrow cells, we reported that numbers of osteoclasts rose significantly on exposure to a low-calcium environment. Here we examined how osteoblasts influence osteoclastogenesis under a low-calcium environment. Comparing low extracellular calcium with a regular calcium environment, osteoprotegerin ligand (OPGL)/osteoclast differentiation factor (ODF) mRNA expression show more increase in the culture of low-calcium environment than in that of a regular calcium environment. Calcium-sensing receptor (CaSR), which was supposed as one of the mechanisms of recognizing extracellular calcium, existedon the surface of E1 cells. When E1 cells stimulated with agonists of CaSR, gadolinium, and neomycin, OPGL/ODF mRNA expression decreased. Moreover, these agonists reduced osteoclast formation in coculture. Taken together, it is possible that osteoblasts may recognize extracellular calcium via CaSR and regulate osteoclastogenesis.

Ultrastructural study of the root dentine surface resuming resorption on human deciduous teeth.

Resorption of deciduous teeth is not continuous, but alternates with periods of repair or rest. Dentine surfaces in periods of rest or repair resume resorption by odontoclasts during physiological root resorption of the deciduous teeth. However, no observations of such dentine surfaces have been shown. The characteristic feature of the dentine surfaces resuming resorption remains unknown. Tartrate-resistant acid phosphatase activity (TRAP) was detected on human deciduous teeth. The root resorbing surfaces on these teeth were photographed with a whole-mount light microscope, and the photographed areas were serially sectioned into 0.5 micron semithin sections. Preodontoclasts and odontoclasts were three-dimensionally reconstructed. On root resorbing surfaces, areas with small scattered TRAP-positive cells were observed among areas with many TRAP-positive resorbing odontoclasts and TRAP-negative areas. The sections showed that areas with small scattered TRAP-positive cells have features similar to those of TRAP-negative areas, but there were three kinds of characteristic TRAP-positive cells: preodontoclasts, odontoclasts forming small lacunae, and preodontoclasts, and odontoclasts with cytoplasmic processes extending to the dentine surface, which is covered with cells. These results suggest that the areas with small scattered TRAP-positive cells could be at the stage of resuming resorption, and show that the presence of preodontoclasts and odontoclasts with cytoplasmic processes extending to the covered dentine surface is a characteristic feature of the dentine surface at this stage.

Effect of extracellular calcium concentrations on osteoclast differentiation in vitro.

We have been researching with the purpose of understanding the hard organization mineralization-suppression mechanism under a low calcium environment. So far, we have discerned clearly that the femur of an incubated newborn rat under a low calcium environment will develop bone formation dyscrasia such as hypertrophy of the caput. In this experiment, MC3T3-E1 (E1) cells, which are osteoblast-like cells, and mouse bone marrow were incubated in a coculture system under a low calcium environment and manifestation of osteoblast cells and their ability to resorb were examined. The results suggested that as the calcium concentration in the medium decreased manifestation of osteoclast cells increased, and as the degree of mineralization of E1 cells advanced, the number of manifestation of osteoblast cells decreased. We, therefore, report that there is a possibility that extracellular calcium concentrations involve the process of differentiation of bone marrow cells into osteoblast cells.

Electron microscopic and histochemical studies of the mononuclear odontoclast of the human.

BACKGROUND: Osteoclasts and odontoclasts are multinucleated giant cells which resorb hard tissue by the ruffled borders. Recently, the authors reported the presence of a mononuclear osteoclast with a ruffled border in vitro. However, its presence in vivo has not been shown. To demonstrate the presence of a mononuclear odontoclast in humans, the present study used human deciduous teeth. METHODS: After fixation and decalcification, tartrate-resistant acid phosphatase (TRACPase) activity was detected with the azo dye method, and then TRACPase-positive cells were observed on resorbing areas of teeth. TRACPase-positive cells could be distinguished from other cells by light microscopy, and the cells for investigation were serially sectioned by alternating semithin and ultrathin sections to observe their ultrastructure and three-dimensional organization. RESULTS: TRACPase activity was detected in both multinucleated odontoclasts and a mononuclear cell from serial sections. By electron microscopy, most of the multinucleated odontoclasts had ruffled borders and clear zones. A mononuclear TRACPase-positive cell with a ruffled border and clear zone was reconstructed three-dimensionally by NIKON COSMO-ZONE 2SA. The reconstruction showed that this cell had one irregularly shaped nucleus and a wide ring-shaped clear zone and a small ruffled border. Under the ruffled border, this cell formed a small lacuna on the dentin surface. The results suggested that this cell was a mononuclear odontoclast. CONCLUSIONS: The present study concludes that cells with ruffled borders and clear zones observed by transmission electron microscopy can be identified as odontoclasts or osteoclasts irrespective of the number of nuclei.

[Biochemical studies of three cases of a compound odontoma].

This study was conducted to investigate some biochemical characteristics of compound odontoma obtained from three cases, all found in the mandible. The results were compared with data obtained from deciduous teeth (3) and permanent teeth (3). The mole ratios of calcium to inorganic phosphorus (Ca/P) among three groups were deviated between 1.67 and 1.68 in the enamel extracts and between 1.65 and 1.69 in the dentine extracts. No significant differences were found in each case. Amino acid analysis of dentine showed apparent differences among these groups in the degrees of hydroxylation of proline (Hyp/Pro + Hyp) and of lysine (Hyl/Lys + Hyl). Hydroxylation rates of proline were 43.1 +/- 0.98% for the permanent teeth, 44.4 +/- 0.47% for the deciduous teeth and 40.9 +/- 0.44% for the odontoma. Hydroxylation rates of lysine were 32.0 +/- 0.67% for the permanent teeth, 27.3 +/- 0.0% for the deciduous teeth and 26.5 +/- 0.46% for the odontoma. T-test confirmed the significance of the differences between the permanent teeth and odontoma in the case of lysine (p less than 0.5%) and between the deciduous teeth and odontoma in the case of proline (p less than 0.5%). These results suggest the differential organization of dentine matrix between human permanent teeth, deciduous teeth and compound odontoma.

[A new technique for the treatment of ectopically erupting permanent first molars].

The problem and treatment of the ectopically erupting permanent first molars have been addressed by many authors since they were first mentioned in the literature by Chapman in 1923. Many treatments involve techniques using the primary second molar. It is better for correcting the eruption of the permanent first molar into normal occlusion to maintain the primary second molar in its normal position. However severe mobility and root resorption are often present when an ectopic eruption is found. An 8-year-old male with ectopic eruption of the maxillary right permanent first molar was examined and treated. The right primary second molar demonstrated severe mobility and root resorption, and therefore a new appliance using the primary first molar was designed. After 4 months from the beginning of the treatment the mobility of the primary second molar decreased, and after 6 months the permanent first molar almost erupted in its normal position.