Equine Odontoclastic Tooth Resorption and Hypercementosis.

Equine odontoclastic tooth resorption and hypercementosis (EOTRH) is a recently described painful and progressive condition of unknown etiology that occurs in middle-aged and geriatric equines. It predominantly affects the permanent incisor and canine teeth and, less commonly, the premolar and molar dentition. EOTRH was first reported in peer-reviewed literature in 2008, with subsequent publications of case reports, histological studies and retrospective case series. There have been few significant research developments related to this disease. The existing studies have primarily involved single case studies or small sample sizes, without control groups. This review aimed to report current information about EOTRH in terms of clinical, histopathological, diagnostic, radiological, and therapeutic aspects, by searching the available peer-reviewed scientific literature.

Clinical, Diagnostic and Histological Findings Involving Cheek Teeth Hypercementosis in Nine Horses.

Hypercementosis is infrequently reported to affect the cheek teeth of horses and presents as mineral deposits either attached (peripheral) or solitary ovoid (nodular) structures in the tooth bearing region. There is overlap between radiological and histological appearance of hypercementosis, cementoma, and equine odontoclastic tooth resorption and hypercementosis (EOTRH). The clinical presentation, imaging features, surgical management, and histological findings of nine horses that presented for dental lesions and associated hypercementosis of cheek teeth are reported. Horses were 4-15 years old and presented for either nasal discharge or facial swelling. Peripheral and nodular mineral structures were identified using radiographs or computed tomography in six and three horses, respectively. Eight of nine cases involved maxillary cheek teeth. Of six cases with peripheral hypercementosis, three had enlargement of the apical cross-sectional area that was greater than the coronal cross-sectional area thus preventing extraction along the normal eruption pathway and necessitating sectioning (two cases) and repulsion. Nodular hypercementosis lesions were extracted in three of the four cases. Post-extraction complications occurred in five cases; four cases required additional procedures. All horses returned to their intended use, ie riding or pasture. Histology of extracted dental and proliferative mineral material revealed hypercementosis characterized by large sheets of eosinophilic matrix with lacunae (usually empty; presumed artifact) and frequent, irregular, basophilic cement lines. All cases had evidence of chronic inflammation, such as caries, chronic fractures and/or pulpitis. The findings of this case series share many features with previous published descriptions of cementoma and with histological findings of hypercementosis lesions of EOTRH. Further investigation into differentiation of these entities is warranted.

Hipercementose e aumento da espessura do cemento com a idade: implicações clínicas e significados / Hypercementosis and cementum thickness increasing over age: clinical implications and its meanings

Uma alteração muito comum, que suscita muitas dúvidas sobre sua etiopatogenia e significado, é a hipercementose. A literatura pertinente é reduzida e o cemento representa o tecido dentário menos estudado, ignorando-se até qual o seu grau de reatividade frente a estímulos e agressões. A espessura e a estrutura do cemento mudam com a idade. Deve-se fazer uma diferença precisa entre o aumento da espessura do cemento e a hipercementose. Na hipercementose se tem uma formação excessiva do cemento, além do limite necessário para cumprir suas funções normais, com alteração da forma macroscópica da raiz, especialmente em seu diâmetro. Cada forma de hipercementose tem significados diferentes: como interpretá-los no planejamento e/ou no acompanhamento do tratamento? Deve-se tomar algum cuidado especial, do ponto de vista biológico, ao se colocar um implante vizinho a um dente com hipercementose? Para colaborar com as respostas a esses questionamentos — e ao mesmo tempo colaborar para diagnósticos mais seguros da hipercementose, valorizando-se o seu significado clínico e biológico —, nos propusemos a reanalisar a literatura e uma amostra estudada ao longo dos anos em trabalhos, dissertações e teses.

A very common alteration that raises many questions about its etiopathogenesis and meaning is the hypercementosis. The pertinent literature is reduced and cementum represents the less studied dental tissue, and even its reactivity level under stimulation and aggression is ignored. Cementum thickness and structure change overtime. One should make an accurate differentiation between cementum thickness increase and hypercementosis. In hypercementosis there is an excessive formation of cementum beyond the limit necessary to allow its regular functions, with macroscopic root shape alteration, specially regarding to its diameter. Each hypercementosis type has different meanings: How to understand them when planning and/or on treatment follow-up? One must take special care, from a biological point of view, while setting an implant in the neighborhood of a tooth with hypercementosis? To help answering these questions and at once collaborate to more secure hypercementosis diagnoses, appreciating its clinical and biological meaning, we have set ourselves out to reanalyze the literature and a sample studied over the years in papers, dissertations and thesis.

Concrescence of teeth: cemental union between the crown of an impacted tooth and the roots of an erupted tooth.

Concrescence of teeth is a condition showing a union of adjacent teeth by only cementum. In all the previously reported cases, the union has been observed between the roots of the affected teeth. Here, we describe the first case that showed a concrescence of the crown of an impacted tooth and the roots of the erupted tooth. In addition, we discuss how this condition, especially the deposition of acellular cementum on the crown, occurred.

Progressive, generalized, apical idiopathic root resorption and hypercementosis.

BACKGROUND: Root resorption is a multifactorial process that results in loss of tooth structure. The causes of root resorption may vary, leading to several types of resorptions. Some factors have been identified and may be categorized into physiological resorption, local factors, systemic conditions, and idiopathic resorptions. The objective of this report was to present a case of a 17-year-old white female with progressive, generalized, apical idiopathic root resorption followed up for 34 months. METHODS: Two panoramic radiographs, 14 and 34 months after initial clinical and radiological examinations, showed the rapid progression of apical root resorption. Two molars, teeth #15 and #16, which had to be extracted, and a bone sample from the distal aspect of tooth #15 were processed for histologic analysis. RESULTS: Two millimeters apical to the cemento-enamel junction, an abrupt increase in the cementum thickness was noted, amounting to 300 and 800 microm in teeth #15 and #16, respectively. The thickening of the cementum layer was due to an accelerated deposition of cellular intrinsic fiber cementum. An unusually high number of mineralization foci were observed in association with acellular extrinsic fiber cementum, and both free and fused cementicles were seen. In contrast to tooth #16, tooth #15 revealed extensive dentin replacement by a bone-like and a cementum-like tissue. Furthermore, ankylosis was demonstrated in tooth #15 and confirmed in the bone sample. CONCLUSIONS: At present, there is no preventive or therapeutic regimen for the type of root resorption seen in this case report. Treatment usually consists of the extraction of teeth with advanced lesions.

Atypical hypercementosis versus cementoblastoma.

Hypercementosis is a non-neoplastic condition in which excessive cementum is deposited in continuation with the normal radicular cementum. Apart from the idiopathic nature of hypercementosis, this condition is associated with several local and systemic factors. Cementoblastoma is an odontogenic tumour characterized by the proliferation of functional cementoblasts that form a large mass of cementum or cementum-like tissue on the tooth root. Although hypercementosis and cementoblastoma are typical conditions with distinct clinical evolution, atypical cases may challenge their diagnosis. Because cementoblastoma is a neoplasm with unlimited growth potential, the usual treatment is complete surgical resection, whilst conservative treatment is recommended for hypercementosis. An atypical case of hypercementosis with similarities to cementoblastoma is reported and its differential diagnosis is discussed.

Valoración clínica de proliferaciones de tejido duro en la cavidad bucal / Clínical evaluafion of hard tissue proliferations in the mouth

Objetivos: En este trabajo se ha realizado un estudio de las proliferaciones de tejido duro presentes en la cavidad bucal. Diseño del estudio: Se realizó en una muestra de 530 individuos centroamericanos, 179 hombres y 154 mujeres, determinando la frecuencia de estas formaciones en función de laedad, el sexo y la raza, así como de su localización en el maxilar. Resultados: Se observó que el 38 por ciento de la muestra total presentaba proliferación de tejido duro en la cavidad bucal. De estos 206 casos, 158 (el 80 por ciento) se sitúan en el maxilar superior y 48 (el 20 por ciento) de los casos en el maxilar inferior o mandíbula. De ellos, 52 fueron hombres (25 por ciento) y 154 mujeres (75 por ciento). Esta proliferación tiene la mayor incidencia en la raza negra, en personas universitarias y con profesiones liberales. Predominan el torus palatino y el torus mandibular bilateral. Conclusiones: Existe una alta incidencia en la población centroamericana de proliferación de tejido duro en la cavidad oral, siendo suficiente para su detección un estudio clínico-radiológico (AU)

Lesiones radiopacas periapicales de los maxilares: diagnóstico diferencial y plan de tratamiento / Radiopaque periapical jaw lesions: differential diagnosis and treatment planning

Se describen las patologías periapicales de los maxilares, para lo cual se expone una clasificación con fines didácticos tomando en cuenta el origen y comportamiento de dichas entidades patológicas. Se exponen la clínica, radiología e histopatología de las mismas con el fin de conocerlas y así poder llegar a realizar un diagnóstico diferencial correcto de ellas. Por último, se sugiere el enfoque terapéutico para cada una de ellas

Lesiones radiopacas periapicales de los maxilares: diagnóstico diferencial y plan de tratamiento / Radiopaque periapical jaw lesions: differential diagnosis and treatment planning

Se describen las patologías periapicales de los maxilares, para lo cual se expone una clasificación con fines didácticos tomando en cuenta el origen y comportamiento de dichas entidades patológicas. Se exponen la clínica, radiología e histopatología de las mismas con el fin de conocerlas y así poder llegar a realizar un diagnóstico diferencial correcto de ellas. Por último, se sugiere el enfoque terapéutico para cada una de ellas (AU)