Tooth Resorption - Part 1: The evolvement, rationales and controversies of tooth resorption.

In 1966, Andreasen and Hjørting-Hansen were the first to describe a relationship between tooth resorption and dental trauma. However, Andreasen's original classification did not include other resorptive processes which have since been identified. Numerous articles have been published suggesting new terminology and definitions for tooth resorption. A uniform language with universally accepted terminology is crucial to eliminate the multiplicity of terms and definitions which only cause confusion within the profession. An electronic literature search was carried out in the PubMed database using the following keywords for articles published in English: "root resorption," "inflammatory root resorption," "replacement resorption," "cervical resorption," "trauma," "ankylosis," "surface resorption," and "internal resorption." The search also included textbooks and glossaries that may not have surfaced in the online search. This was done to identify articles related to tooth resorption and its etiology in dentistry. The aim of this review was to present the history that has led to the variety of terms and definitions for resorption. This review emphasizes the need for a clearer, simpler, and more comprehensive nomenclature for the various types of tooth resorption which are presented in Part 2 of this series.

Alveolar Fracture Caused by Tooth Extraction at Home.

Injuries to the teeth and surrounding structures are relatively common. Although traumatic injuries caused by falls or activities related to sports are widely discussed, the same cannot be said regarding accidents arising from non-professional extraction of primary teeth. The present study reports a 6-year-old male child who underwent mandibular alveolar bone fracture during non-professional extraction of his central lower left incisor at home, performed by his 30-year-old aunt. The root of the tooth was with an irregular physiological resorption, which acted as a lever component for the mechanical force applied, leading to bone fracture. Although not common, the possibility that dental roots with irregular resorption can act as a possible risk factor for accidents if the parents or guardians of children during the period of transitional dentition try to perform intentional extraction of primary teeth should be highlighted. Parents should always consult a professional, preferably a pediatric dentist, for monitoring this period of transitional dentition.

A case report of gingival enlargement associated with invasive cervical resorption.

Invasive cervical resorption (ICR) is a rare external dental resorption with unknown etiology; it progresses asymptomatically in the cervical area of the permanent teeth. Lesions are mostly misdiagnosed as internal resorption or caries, which leads to erroneous treatments. This case report presents the clinical and radiological diagnosis, as well as the results of treatment and 3-year follow-up in a 50-year-old female patient with gingival enlargement associated with ICR in tooth No. 25. Granulation tissue was removed by accessing the cervical resorption area through a flap operation. Following the endodontic treatment, the tooth was restored using composite resin and the hyperplastic lesion was excised. In conclusion, it should be kept in mind that clinical, radiological, and pathological evaluation in the differential diagnosis of localized hyperplastic lesions in the gingiva is of importance and that ICR could play a role in the etiology of these lesions.

Efeito do LED infravermelho sobre a movimentação dentária induzida em ratos / Infrared LED phototherapy effects on induced tooth movement in rats

O LED infravermelho tem sido considerado uma alternativa efetiva para o laser na bioestimulação. Entretanto, o efeito na remodelação óssea durante o movimento ortodôntico ainda deve ser esclarecido. Oitenta ratos machos com 10 semanas de idade, foram divididos em dois grupos de 40 animais cada: grupo LED (GLED) e grupo controle (GCON), e tiveram seu 1ºmolar superior esquerdo submetido a força de 10 g com uma mola helicoidal fixada entre o 1ºmolar superior esquerdo e incisivo superior esquerdo. Durante os primeiros cinco dias de movimentação dentária foi aplicada a luz infravermelha LED (850nm, 30mW) durante 5 minutos no GLED. O GCON não foi irradiado. Em 0, 7, 14 e 21 dias, 5 animais de cada grupo foram submetidos a microtomografia computadorizada. Para a avaliação histológica, todos os ratos foram subdivididos em subgrupos de 20 animais cada de acordo com a o dia da eutanásia 4, 7, 14 e 21 dias e as maxilas foram dissecadas e processadas para a microscopia de luz (HE e TRAP). A quantidade de movimento, segundo as microtomografias computadorizadas, foi maior no grupo LED em T1 (intervalo entre os dias 0 e 7) e em T3 (intervalo entre os dias 14 e 21). No dia 4 foi observada hialinização na área de pressão em ambos os grupos; nos períodos posteriores, 7, 14, a área hialina foi vista apenas no grupo controle. A reabsorção radicular ocorreu em ambos os grupos após o dia 7. A fototerapia LED melhora a movimentação dentária e minimiza a hialinização durante o movimento ortodôntico. Entretanto, não reduz o risco de reabsorção da superfície radicular.

Infrared LED has been considered an effective alternative to infrared LASER for biostimulation purposes. However, its effect on bone remodeling during orthodontic tooth movement (OTM) is unknown. Eighty 10 week-old male Wistar rats were divided into two groups of forty animals each: LED group (GLED) and control group (GCON) and had a coiled spring bonded to the first upper molar and upper incisor exerting 10g force to mesially move the molar. During the first five days of OTM the maxillae were daily irradiated with infrared LED (850nm, 30mW) during 5 minutes (LED group). The controls were not irradiated (GCON). At 0, 7, 14 and 21 days, 5 LED group and 5 CON group rats were submitted to ?CT. For the histological study, all rats were subvided into subgroups of 20 animal each according to the euthanasia day 4, 7, 14 e 21 days. The rats were euthanized after 4, 7, 14 and 21 days and the maxillae were processed to light microscopy and TRAP histochemistry. The amount of tooth movement was greater in the GLED on days 7 and 14. At 4 day, hyalinization was seen at the pressure areas in both groups; on the subsequent days it was seen only in the GCON. Root resorption occurred in both groups after 7 days. LED phototherapy enhances early tooth movement and minimizes periodontal hyalinization during OTM. However, it does not reduce the risk of tooth resorption.

Oral pain due to severe pre-eruptive intracoronal resorption in permanent tooth.

BACKGROUND: Pre-eruptive intracoronal resorption is a dental lesion located within the dentin. This defect is usually discovered incidentally on routine dental radiographs. Occasionally this process may be associated with oral pain in advanced lesions. CASE REPORT: This case report describes a 12-year-old boy whose chief complaint was a diffuse oral pain due to a severe pre-eruptive intracoronal resorption in a permanent second molar. The previous radiographs, taken at the age of nine years, showed no evidence of the lesion. After surgical exposure, a pulp-like tissue under the crown was removed and analyzed; subsequently the tooth was extracted due to extensive resorption. A follow-up of the unerupted third molar, still in formation process, allowed to see that it was favourably positioned for replacing the extracted molar.

Anquilose alveolodentária e subsequente reabsorção por substituição: a colocação de implantes osseointegráveis no mesmo local pode ser feita? / Alveolodental ankylosis and subsequent replacement resorption:can osseointegrated implants be placed in the same location?

os dentes com anquilose alveolodentária naturalmente evoluirão para reabsorção por substituição e, desde que sem contaminação microbiana, devem ser considerados no contexto ósseo como mais uma das estruturas a serem remodeladas continuadamente. A remodelação constante representa uma das características mais marcantes da biologia óssea, haja vista que serve para manter estável o nível sanguíneo de cálcio e outros minerais essenciais à vida. Outra consequência da anquilose alveolodentária é a gradativa infraoclusão do dente envolvido. As áreas ósseas com raízes ou fragmentos radiculares em reabsorção por substituição, desde que livres de contaminação microbiana, podem ser incluídas nas áreas onde se farão alvéolos cirúrgicos para receber implantes osseointegráveis que não atrapalharão o processo de reparo ósseo peri-implantar mais conhecido como osseointegração. Quando contaminada por bactérias e seus produtos, a estrutura radicular deve ser eliminada para depois se avaliar o local para se indicar futuras correções de volume e forma.

Teeth with alveolodental ankylosis naturally evolve to replacement resorption. Provided that they remain free of microbial contamination, these teeth should be considered in the bone context as one more structure that should undergo continuous remodeling. Continuous remodeling is one of the most remarkable characteristics of bone biology, given that it is responsible for keeping blood calcium, as well as other minerals essential to life, levels stable. Another consequence of alveolodental ankylosis is the gradual infraocclusion of the affected tooth. Provided that free of microbial contamination, the areas of bone with root or root fragments under going replacement resorption can remain in the sites where surgical sockets are prepared to receive osseointegrated implants which shall not hinder the process of peri-implant bone repair also known as osseointegration. In the event of being contaminated by bacteria and their byproducts, the root structure should be eliminated. The remaining site should be further assessed to indicate potential corrections of volume and shape.

Pre-eruptive coronal resorption of a maxillary canine: a case report.

This paper is the first to highlight a case of pre-eruptive coronal resorption of a maxillary canine in a patient undergoing extraction-based fixed appliance therapy. The etiology, clinical implications, and management of pre-eruptive coronal resorption are discussed.

Uprighting and distalisation of first permanent maxillary molars in patients with undermining resorption: a case report.

AIM: This case report describes a treatment method for distalisation and uprighting of first permanent maxillary molars with the aim of preventing complications in the presence of undermining resorption of the second deciduous molar. We present a fixed appliance, which is a compliance-independent and effective alternative to the methods used thus far such as removable plates with distal screws or separating ligatures.

Unexpected early apical resorption of primary molars and canines.

AIM: This was to examine the resorption pattern of primary molars and canines in dentitions with advanced apical resorption even though the permanent successor had barely begun root formation and to verify the resorption process histologically. STUDY DESIGN: Panoramic or bite-wing radiographs were selected from a dentition archive of radiographs from 142 children with deviant resorption patterns. METHODS: There were 14 patients (10 boys, 4 girls) aged 6 years 2 months to 8 years 1 month selected. In 11 patients abnormal resorption occurred only in the roots (group I). In 3 patients resorption occurred in the roots as well as in the crown (group II). The degree of resorption was evaluated using Haavikko's five resorption stages, and the degree of development of the permanent successor was evaluated using Haavikko's ten formation stages [Haavikko, 1973]. For histologic study 7 teeth were decalcified, paraffin-embedded, sectioned and stained with hematoxylin and eosin and examined microscopically. RESULTS: Group I: in 5 patients severe root resorption occurred before crown formation of the permanent successor was completed. In 6 children the abnormal resorption pattern was less severe. Group II: in 3 subjects full resorption of the root complex was observed as well as partial resorption of the crown. A histological analysis confirmed the resorption process. CONCLUSION: This is the first study focussing on unexpected early resorption of primary molars and canines in 14 patients without agenesis. The study showed an abnormal resorption pattern of roots and crown of primary teeth before the permanent successor had barely begun root formation. This indicates that resorption of primary molars and canines may occur independently from eruptional processes in the succeeding permanent tooth.

Adenomatoid odontogenic tumor - a rare cause of jaw swelling

O tumor odontogênico adenomatóide (TOA) é um tumor incomum de origem odontogênica, caracterizado histologicamente pela formação de estruturas tubulares com depósitos do tipo amilóide. A histogênese do TOA ainda é indeterminada e este tumor é frequentemente considerado mais como uma lesão hamartomatosa do que propriamente um neoplasma. O TOA tem comportamento benigno, sendo suficiente a enucleação cirúrgica conservadora ou curetagem. Neste artigo, é descrito um caso de TOA em paciente de 15 anos do sexo feminino, que exibia um edema no lado esquerdo da mandíbula com reabsorção dental. A histopatologia revelou uma variante folicular intra-óssea do tumor odontogênico adenomatóide. Uma breve revisão da literatura é também apresentada.

Treatment of severe pre-eruptive intracoronal resorption of a permanent second molar.

Pre-eruptive intracoronal resorption is a lesion often located within the dentin, adjacent to the dentin-enamel junction, in the occlusal aspect of the crown. As the lesions resemble caries, they are often referred as "pre-eruptive caries." The purpose of this case report was to describe the diagnosis and treatment of a permanent molar with pre-eruptive intracoronal resorption and to elaborate on possible associated clinical problems. After surgical exposure of the unerupted tooth, the tooth structure in the resorbed area was removed and the tooth was restored with glass-ionomer material. Three months after the treatment, partial pulpotomy had been performed and the restoration was replaced by amalgam. Elaboration on possible associated clinical problems is provided.

Radiolucent lesion of an unerupted mandibular molar.

A coronal radiolucent lesion of an unerupted and partially developed mandibular second molar was coincidentally found during a routine radiographic orthodontic examination of a generally healthy 9-year old girl. The size of the lesion increased continuously during a 2-year observation period. Histologic examination after extracting the tooth proved the lesion to be an idiopathic external coronal resorption. In a review of the literature, we found no original research on the subject. However, the number of case reports suggests that idiopathic external coronal resorptions are quite common in young patients. Their etiology, however, remains unclear. The case history, histologic findings, differential diagnoses, and possible treatment approaches suggested in the literature are described.

Lesiones cervicales no cariosas y su tratamiento / Non-carious cervical lesions and their treatment

El objetivo de este trabajo consiste en describir las distintas lesiones cervicales no cariosas, la abrasión, la erosión y la abfracción. Se desarrollarán en detalle: su etiología, localización y características clínicas. Siendo la abfracción considerada la más asociada a la hipersensibilidad, se plantearán diferentes formas de tratamiento de la misma. Se mencionarán los diferentes procedimientos a realizar para su prevención y los materiales a utilizar para su restauración

Lesiones cervicales no cariosas y su tratamiento / Non-carious cervical lesions and their treatment

El objetivo de este trabajo consiste en describir las distintas lesiones cervicales no cariosas, la abrasión, la erosión y la abfracción. Se desarrollarán en detalle: su etiología, localización y características clínicas. Siendo la abfracción considerada la más asociada a la hipersensibilidad, se plantearán diferentes formas de tratamiento de la misma. Se mencionarán los diferentes procedimientos a realizar para su prevención y los materiales a utilizar para su restauración (AU)

Dental anomalies associated with amelogenesis imperfecta: a radiographic assessment.

Amelogenesis imperfecta, a group of hereditary conditions primarily affecting the enamel, has been associated with dental anomalies, including taurodontism, congenitally missing teeth, delayed eruption, crown resorption, and abnormal enamel density. The purpose of this study was to assess the prevalence of these anomalies in an amelogenesis imperfecta population. The study group consisted of members of 9 unrelated families--22 family members with amelogenesis imperfecta and 13 unaffected family members. Panoramic radiographs were evaluated for taurodontism, congenitally missing teeth, delayed tooth eruption, pathologic dental resorption, pulp calcification, and radiographic enamel density. The prevalence of taurodontism was similar in people with amelogenesis imperfecta and normal people; all of the remaining parameters were more commonly observed in people with amelogenesis imperfecta. The radiographic enamel density was quantitatively reduced in teeth affected by amelogenesis imperfecta in comparison with teeth with normal enamel. These findings suggest that some of the features associated with amelogenesis imperfecta result from abnormal enamel formation (eg, decreased enamel density, crown resorption) whereas others may occur as a result of expression of the genetic mutation in cells other than ameloblasts (eg, abnormal eruption, pulp calcification).

A case report of pre-eruptive coronal resorption in a mandibular canine.

A case of intracoronal resorption in a recently erupted mandibular canine in an 11-year-old girl is presented. Possible aetiology and approaches to treatment of such lesions are discussed.