Widespread prevalence of Equine Odontoclastic Tooth Resorption and Hypercementosis detected in German Icelandic horse population: impact of anamnestic factors on etiology.

OBJECTIVE: To compare anamnestic factors in Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) in affected and nonaffected horses to detect risk factors for horses developing EOTRH. ANIMALS: A total of 154 Icelandic horses, aged 15 years and older, examined at 22 locations in Lower Saxony, Germany. The investigations took place from October 2020 to December 2021. METHODS: Anamnestic data were collected using an owner-completed questionnaire. Horses underwent a thorough physical examination and CBC. The rostral oral cavity was clinically examined, and intraoral radiographs of the incisors were taken. Clinical and radiographic findings were scored. Based on the results, the study population was separated into "EOTRH-affected" and "EOTRH-healthy" horses. Both groups were compared to identify differences within the anamnestic factors. In case of inconclusive findings, some horses were classified as "suspicious". RESULTS: The diagnosis of EOTRH was made in 72.2% (109/151) of horses. The risk of contracting the disease increased with the age of the horse (P = .004). In addition, there was a predisposition for male animals (P = .032). Feeding, keeping, and dental treatments showed no significant influence, while place of birth seemed to influence horses developing EOTRH (P = .017). CLINICAL RELEVANCE: The results highlight how widespread EOTRH is among the German Icelandic horse population and the need for raising awareness of EOTRH, as many horses were not suspected of having EOTRH beforehand. Moreover, numerous etiological propositions exist, but, to date, no studies have investigated their relevance.

Hematologic, Biochemical, and Endocrine Parameters in Horses With Tooth Resorption and Hypercementosis.

BACKGROUND: Equine odontoclastic tooth resorption and hypercementosis (EOTRH) is a frequently diagnosed condition in adult horses. The underlying etiology is still unknown. Hematologic, biochemical, and endocrine values have not been reported in EOTRH-affected horses. OBJECTIVES: The main objective of the study was to describe the hematologic, biochemical, and endocrine parameters in horses with EOTRH. STUDY DESIGN: Descriptive cross-sectional study of client-owned animals with EOTRH. METHODS: A complete blood count, biochemistry panel, and endocrine profile were performed in horses diagnosed with EOTRH. Diagnosis was based on oral and radiographic examination findings and confirmed with histopathology. RESULTS: Eighteen horses with EOTRH aged 10 to 32 years from various regions of the United States were sampled. The only consistent abnormality on the complete blood cell count and chemistry panel was hypoalbuminemia (88%). Endocrine parameters demonstrated no major abnormalities in the functioning of the thyroid and pituitary pars intermedia. The parathyroid hormone concentration was increased in 7 (47%) of 15 horses with an elevated 25-hydroxy vitamin D in 3 (17%) of 17 horses. Main Limitations: The main limitations of this study are the small sample size and lack of age-matched and management-matched control horses. CONCLUSIONS: The relevance of elevated parathyroid hormone in this study cannot be determined due to the lack of age-based controls and large population studies. With the small population evaluated in this study, there are no obvious hematological, biochemical, and endocrine changes evident. Further evaluation with signalment-matched controls will be necessary to evaluate some trends noted in the laboratory values.

Hypercementosis: a rare finding in a patient with systemic lupus erythematosus.

Hypercementosis is excessive deposition of non-neoplastic cementum over normal root cementum, which alters root morphology. This cementum may be either hypocellular or cellular in nature. The aetiopathogenesis of hypercementosis is ambiguous. Although most of the cases are idiopathic, several local and systemic factors are also linked to this condition, such as Paget's disease, acromegaly, vitamin A deficiency, etc. We report two rare cases of hypercementosis associated with systemic lupus erythematosus, not previously described in the literature, and also discuss the possible aetiopathogenesis.

Finite element analysis of equine incisor teeth. Part 2: investigation of stresses and strain energy densities in the periodontal ligament and surrounding bone during tooth movement.

This study investigated the hypothetical contribution of biomechanical loading to the onset of equine odontoclastic tooth resorption and hypercementosis (EOTRH) and to elucidate the physiological age-related positional changes of the equine incisors. Based on high resolution micro-computed tomography (µCT) datasets, 3-dimensional models of entire incisor arcades and the canine teeth were constructed representing a young and an old incisor dentition. Special attention was paid to constructing an anatomically correct model of the periodontal ligament (PDL). Using previously determined Young's moduli for the equine incisor PDL, finite element (FE) analysis was performed. Resulting strains, stresses and strain energy densities (SEDs), as well as the resulting regions of tension and compression within the PDL and the surrounding bone were investigated during occlusion. The results showed a distinct distribution pattern of high stresses and corresponding SEDs in the PDL and bone. Due to the tooth movement, peaks of SEDs were obtained in the PDL as well as in the bone on the labial and palatal/lingual sides of the alveolar crest. At the root, highest SEDs were detected in the PDL on the palatal/lingual side slightly occlusal of the root tip. This distribution pattern of high SEDs within the PDL coincides with the position of initial resorptive lesions in EOTRH affected teeth. The position of high SEDs in the bone can explain the typical age-related alteration of shape and angulation of equine incisors.

Periodontitis with hypercementosis: report of a case and discussion of possible aetiologic factors.

BACKGROUND: Hypercementosis may be idiopathic or secondary to either local factors or systemic disorders. However, periodontitis as an aetiologic factor in the formation of hypercementosis has never been documented in the literature. METHODS: We report a case of periodontitis with hypercementosis, affecting the right mandibular second premolar and first molar teeth. RESULTS: Our patient's maxillary was edentulous and the mandibular teeth #47, #43, #42, #41, #31, #32, #33, #36, #37 were missing. The right mandibular second premolar and first molar had first-degree mobility and second-degree mobility respectively. Periodontal pocket depth in the right mandibular second premolar and first molar were 5 mm and 8 mm at buccal pockets, 6 mm and 9 mm at distal pockets, respectively. The radiograph revealed that the roots of both teeth were grossly thickened and blunted. The right mandibular first molar was extracted and sent for histopathological examination. The definitive diagnoses were periodontitis and hypercementosis. CONCLUSIONS: The concomitant occurrence of periodontitis and hypercementosis in our patient suggests that periodontitis is a predisposing factor for hypercementosis development. This condition may be associated with various local stimuli and possible compensative phenomenon.

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.

Hypercementosis and odontogenic epithelial hyperplasia associated with a tooth root remnant mimicking a neoplasm. A case report.

Hypercementosis presents as painless, single or multiple non-neoplastic cementum formation beyond the physiological limits of the tooth. It often occurs in the apical area of the involved tooth following infection, chemical or mechanical trauma. We report on radiographic and histopathological findings in a single case of late intraosseous hypercementosis and odontogenic epithelial hyperplasia associated with a minute apical tooth root remnant years after its extraction, mimicking a tumour.

Paget's disease of bone and osteonecrosis.

UNLABELLED: Paget's disease of bone, although common in the long bones and pelvis, is less common in the head and neck. A 20-year follow-up is reported of a patient who was diagnosed with Paget's disease following the investigation of her initial oral complaint. Following surgical extraction of two teeth in her maxilla, the sockets have failed to heal, despite numerous attempted interventions. This case highlights both the cranio-maxillofacial and oral manifestations of Paget's disease of bone, its effects on surgical exodontia and the possible effects of bisphosphonate therapy. CLINICAL RELEVANCE: Paget's disease of bone does not manifest in the head and neck commonly but, when it does, there are significant implications for the dentist. Prevention and conservation of the patient's remaining teeth are paramount as the complications of extraction are significant.

Enamel dysplasia with hamartomatous atypical follicular hyperplasia (EDHFH) syndrome: suggested pathogenic mechanisms.

The syndrome of enamel dysplasia with hamartomatous atypical follicular hyperplasia (EDHFH) is an unusual syndrome and is unique to black South Africans. Major criteria for the syndrome are enamel dysplasia with generalized amelogenesis imperfecta-like features and atypical hyperplastic dental follicles with microscopic features of central odontogenic fibroma WHO-type (follicle analogue) attached to the crowns of multiple impacted teeth. Minor features of some cases are anterior open-bite malocclusion, supernumerary teeth, pulpal calcification, aberrant roots with hypercementosis, and hypodontia. The pathogenic mechanisms that lead to the development of EDHFH are unknown. We speculate that faulty synthesis of enamel matrix proteins may interfere with enamel formation and play a role in the generalized enamel hypoplasia described in this syndrome. Alterations in inductive signalling by the odontogenic epithelium mediated by enamel matrix proteins may explain the development of the follicle analogues, the root hypercementosis and the presence of dysplastic cementum deposition juxtaposed to odontogenic epithelium in the gingival overgrowth. Thus, alterations in the function of enamel matrix protein function, may be the common denominator responsible for the development of the EDHFH phenotype.

Histological assessment of pulp condition after apical vital root transection in one root of multirooted teeth in dogs: a preliminary study.

One of the most important aspects in surgery is the healing process after the periapical surgery. Past studies have shown occasional encounters with vital root resection and have noted varying degrees of pulpal response after root resection in periodontal disease. The purpose of this investigation was to observe the pulpal and periapical responses to intentional apical vital root transection in one root of multirooted teeth of German-Canadian dogs over a 6-month postoperative period. This is an experimental study performed on left maxillary and mandibular quadrants of four adult German-Canadian dogs after a 3- and 6-month period. Four teeth were assessed in each interval. One of the roots of multirooted teeth in the left quadrant of both maxillary and mandibular jaws was surgically transected. Tissue blocks were prepared by routine histological methods after 12 and 24 weeks after the surgery. The results showed a disruption of the normal pulpal architecture, with initial pulpal degeneration and subsequent early replacement by the periodontal ligament tissue after 24 weeks. Hypercementosis was seen around the apical portion of the root in all specimens. Pulpal regeneration was seen in the both upper and lower molars (p = 0.03). Resorption took place only in two specimens (p = 0.46). The inflammation in the 12th week was more than the 24th week. The pulp of multirooted teeth remains vital after transection of the apical part of the root in dogs. Longer follow-up periods are recommended because root canal therapy or extraction is indicated if resorption, necrosis, or ankylosis is seen.

Osteomyelitis of the mandible associated with autosomal dominant osteopetrosis: a case report.

Osteopetrosis is a rare hereditary bone disorder presenting with variable clinical features and is characterized by an increase in bone density. The main clinical findings of the benign-type of osteopetrosis (autosomal dominant) are fractures and osteomyelitis of the mandible, leading to the detection of the disease. We report a case of autosomal dominant osteopetrosis with secondary mandibular osteomyelitis. Clinical and radiological patterns and treatment evaluation were assessed. The patient was referred for evaluation and treatment of an acute abscess in the left side of the face and osteomyelitis of the mandible. Several imaging studies were performed to assess the lesion and the adjacent bone and soft tissue structures. Treatment consisted of intravenous antibiotic therapy, debridement of the necrotic bone and sequestrum, and extra-oral drainage of the abscess, with submandibular access. Healing was uneventful.

Anatomic variations of the root canal of the rat according to age

El conducto mesial del primer molar inferior de la rata se ha utilizado como modelo en estudios experimentales de endodoncia. Se plantea un análisis pormenorizado de las variaciones estructurales en función de la edad, que sirve de base para la caracterización y utilización como modelo. Se estudiaron 60 molares de ratas Wistar de diferente peso: grupo 1: 300-399 g n=22, grupo 2: 400-499 g n=16, grupo 3: 600-700 g N=22.). Las piezas se radiografiaron con un sistema estandarizado. Se realizaron proyecciones aumentadas y sobre los perfiles de la proyección se efectuaron mediciones de la longitud total y del volumen del conducto. Se determinaron los diámetros del conducto en tres niveles: coronario, medio y apical. A partir de estos diámetros se estimó el área de la sección transversal como índice de caudal o posibilidad de intercambio metabólico. Se encontró que a partir del segundo grupo se produce una hipercementosos que aumenbta la longitud del conducto y conduce a la formación de un complejo delta apical. El diámetro del conducto disminuye muy significativamente en el tercio apical. La estimulación del caudal, a partir del área de la sección transversal disminuye de 1.2 mm2 (de proyección) en el grupo 1, a 0,05 mm2 en el grupo 2, valor que no cambia significativamente en el grupo 3. Los resultados indican que en los estudios experimentales de endodoncia en la rata, deben tenerse en cuenta las variaciones anatómicas espontáneas producidas por la edad. (AU)

Estudos macro e microscópico da morfologia do terço dentário apical na hipercementose: implicaçöes clínicas e etiopatogênicas / Macro and microscopical studies of apical dental portion morphology in the hypercementosis: clinical and etiopathogenic implications

Cento e sessenta dentes com e sem hipercementose foram analisados macroscopicamente, ao estereomicroscópio sem e com diafanizaçäo e na microscopia óptica de luz, com a finalidade de estudar a anatomia externa e interna do terço apical. Verificou-se que: 1) A hipercementose aumenta consideravelmente o número de canais secundários, canais acessórios e deltas apicais. 2) As modificaçöes na morfologia interna do terço apical dos dentes comprometidos näo säo passíveis de visualizaçäo e identificaçäo radiográfica. 3) O canal principal na grande maioria dos dentes com hipercementose apresenta-se constricto no terço apical associado à mudança da trajetória original ou a canais secundários, acessórios e deltas apicais. 4) O tipo morfológico mais comum de hipercementose dá à raiz a forma de clava. A forma localizada de hipercementose apresenta-se com considerável menor frequência. A forma de boca de manga de camisa encontra-se apenas eventualmente. 5) O padräo morfológico e aposicional do cemento constituinte da hipercementose assemelha-se ao cemento em dentes normais quando observado na microscopia óptica de luz, assim como sua superfície externa. Após estas verificaçöes, concluiu-se que na hipercementose o clínico de várias especialidades, como o cirurgiäo, o ortodontista e especialmente o endodontista, deve considerar a modificaçäo anatômica externa e interna a que foi submetido o dente portador, pois sua forma radicular tende a ser retentiva, o corpo radicular mais espesso e o terço apical mais rico em canalículos e deltas apicais associado à constricçäo e mudança direcional do canal principal

Duplication and dilaceration of a crown with hypercementosis of the root following trauma: a case report.

Trauma to a primary mandibular central incisor resulted in a rare case of dilaceration and duplication of crown with hypercementosis of the root in the permanent successor. This tooth was extracted. This article highlights the consequences of trauma to a primary tooth for a developing permanent successor.

Repair process of external root resorption subsequent to palatal expansion treatment.

The repair process of external root resorption (ERR) and the role of retention mechanics in enhancing ERR repair were studied on eight Macaca fascicularis monkeys that were divided equally into short- and long-term groups. Six monkeys received palatal expansion appliances, and two received sham appliances. The short-term group received active treatment. The long-term group received additional retention (4 months) and relapse (2 months) treatment periods with biweekly injections of individual vital dye per phase, i.e., procion red H-8B and violet H-3R (80 mg/kg B.W.), respectively. Histomorphologic examinations included scanning electron microscopy, light, and ultraviolet microscopy. The short-term group demonstrated penetrated resorption with pulp exposure at sites with initial deficiency of the protecting odontoblastic layer (apical zone, nutrition canal). The long-term group showed two forms of ERR repair: (1) Nonfunctional retarded repair cementum, comprised of overlapped incremental lines and deprived of extrinsic fibers, was delineated in severe pulp exposure. The pulp/dentin complex showed intense incorporation of procion dye in the dentinal tubuli, conceivably related to a defense response in the form of sclerotic dentin. (2) Functional rapid repair cementum, comprised of discriminated incremental lines mainly of mixed cellular cementum, with a consistent pattern of five sequential phases: the lag phase (14 to 28 days), the incipient phase (14 days), the peak phase (14 to 28 days), the steady phase (42 to 56 days) and the retreating phase (70 days). Sharpey's fibers at functional ERR sites were scarce, never emerging from the dentinocemental junction, and not developing into principal fibers. The pulp/dentin complex showed an increase in pulp stones but no formation of tertiary dentin. The apical area responded by hypercementosis in the form of apical occlusion and a displaced pulp canal. The application of a fixed retention device is recommended in light of accelerated apposition of repair cementum during the retention period. However, increased formation of Sharpey's fibers during the relapse period might suggest a restricted duration in splinting therapy.

Determinação da prevalência da hipercementose e suas implicações etiopatogênicas / Prevalence of hypercementosis and its etiopathogeny

Em uma amostragem de 21.573 dentes isolados, a prevalência da hipercementose foi de 1,05//, acentuadamente maior nos dentes posteriores, principalmente nos molares superiores. Os incisivos superiores raramente estavam envolvidos e os incisivos inferiores não foram comprometidos pela hipercementose. A forma difusa ocorreu em 96,92//dos casos, sendo a hipercementose focal um achado ocasional. A hipercementose quase sempre envolvia o terço apical da raiz. Como conseqüência da hipercementose, a concrescência radicular foi encontrada em 22,80//dos casos, principalmente nos molares superiores. Após discussão sobre as causas da hipercementose e as implicações dos dados obtidos na sua etiopatogenia, os autores afirmam que a periodontite apical crônica provavelmente não é uma das principais causas da hipercementose, como comumente é citada na literatura

[Osteitis deformans]. / Ostitis deformans.

Osteitis deformans is a bone disease of still unknown aetiology which shows characteristic symptoms in the maxillofacial region. An increase in size of the entire calvarium and also of single bones of the facial skeleton belongs to these symptoms. A triad may be seen in the jawbone: osteoporosis, foci of densification and cementum hyperplasia. No possibility of treatment was known in the past. Nowadays, the use of cytostatics, calcitonin and diphosphonates seems to be promising.