1/12. Complete replacement resorption after replantation of maxillary incisors: report of case.This article describes the treatment of a 17-year-old patient with complete root resorption of the maxillary permanent central and lateral incisors following avulsion and replantation seven years ago. The most important factor influencing the prognosis of replanted teeth is the status of the periodontal ligament (PDL). As a result of replantation, the PDL cells necrosed and tooth replacement resorption occurred. The main factors, which affected the resorption after replantation and survival of PDL cells, could be summarize as; dry extraoral time greater than 30 minutes, the kept tooth in a dry environment, touching the cementum surface, and splint treatment for a prolonged time. Since complete root resorption was found in our case, these factors probably also occurred.- - - - - - - - - - ranking = 1keywords = periodontal ligament, ligament (Clic here for more details about this article) |
2/12. Different treatment outcomes of two intruded permanent incisors--a case report.Intrusive luxation involves the displacement of the tooth apically into the alveolar socket. This type of injury represents a very complex wound, involving disruption of the marginal gingival seal, alveolar bone, periodontal ligament fibers, cementum and the neuro-vascular supply to the pulp, which results in severely compromised healing and possible complications. The case presented is a report of a 60-year-old lady who fell and intruded her two maxillary central incisors. The healing outcomes of the two central incisors were markedly different from each other even though they sustained similar injuries.- - - - - - - - - - ranking = 1keywords = periodontal ligament, ligament (Clic here for more details about this article) |
3/12. Extracanal invasive root resorption: a perplexing oddity.Extracanal invasive resorption originates in the periodontal ligament, making it difficult to determine during treatment whether all resorption cells have been eliminated. Consequently, periodontal defects and recurrence of the process are quite common. This process can occur supraosseously or subosseously and treatment may or may not include endodontic therapy. The pathogenesis, diagnosis, and treatment modalities are presented along with a clinical case with an 18-month follow-up as an example of the challenges associated with treatment of this lesion.- - - - - - - - - - ranking = 1keywords = periodontal ligament, ligament (Clic here for more details about this article) |
4/12. Evaluation of human recession defects treated with coronally advanced flaps and either enamel matrix derivative or connective tissue. Part 2: Histological evaluation.BACKGROUND: A number of surgical procedures are effective in covering denuded root surfaces. The first paper in this series evaluated the subepithelial connective tissue graft and the coronally advanced flap with enamel matrix derivative (EMD). That paper revealed no significant difference in the percent of root coverage between the two treatments (P = 0.82). There is limited human histological evidence of the type of attachment achieved with these types of procedures. This paper presents a human case report detailing the histological nature of the attachment of these two treatments to the root surfaces previously exposed by recession. methods: One patient presented with two hopeless teeth that were randomized to receive either a subepithelial connective tissue graft or a coronally advanced flap plus EMD. The surgery was accomplished in accordance to the protocol previously described. The teeth and a small collar of tissue were removed at 6 months and underwent histological analysis. RESULTS: Histological evaluation of the subepithelial connective tissue graft revealed a connective tissue attachment between the tooth and graft, and no histological evidence of cementum, bone, or periodontal ligament (PDL) and, therefore, regeneration. In addition, there appeared to be some resorption of the dentin adjacent to the graft. Histological evaluation of the coronally advanced flap with EMD revealed new cementum, organizing PDL fibers and islands of condensing bone at a constant distance from the root surface. CONCLUSIONS: The subepithelial connective tissue graft in this study was found to have adhered to the root surface primarily by a connective tissue attachment with some evidence of root resorption. The coronally advanced flap with EMD was found histologically to have all the tissues necessary for regeneration: new cementum, organizing PDL fibers, and islands of condensing bone. These histologic sections strongly suggest that enamel matrix derivative works in a biomimetic fashion by mimicking the natural process of tooth development.- - - - - - - - - - ranking = 1keywords = periodontal ligament, ligament (Clic here for more details about this article) |
5/12. Interdisciplinary treatment including forced extrusion and reintrusion of a traumatized mandibular incisor for a patient with Class II Division 1 skeletal open bite.A woman with Class II Division 1 long-face syndrome characteristics had a history of facial trauma, dentoalveolar fracture of her mandibular anterior teeth, and temporomandibular joint pain. The pretreatment apical radiograph showed a large area of external root resorption of the mesial surface of the mandibular left central incisor. To arrest the external root resorption, the mandibular left central incisor was extruded. During extrusion, sequential apical radiographs were taken. As the tooth moved away from the site of osteoclastic activity, resorption ceased, and repair took place on the root surface. At this time, the mandibular left central incisor was intruded, the mesial defect self-repaired, the tooth remained vital, and the periodontial ligament was intact. The biologic bases for this cessation of resorption and the repair of the tooth's surface are presented.- - - - - - - - - - ranking = 0.0025982615497124keywords = ligament (Clic here for more details about this article) |
6/12. The fate of a mid-root fracture: a case report.The present report describes a case of a mid-root fracture in a maxillary central incisor of a 19-year-old patient. The fractured tooth was splinted with composite that was removed only 3 years later, as the patient did not appear for follow-up examinations. At this time, the radiographs revealed a normal periodontal ligament, rounding of the borders of the fragments and pulp obliteration of both fragments. Eight years later, the tooth was clinically normal and blurred calcification of the root canal was disclosed radiographically. After 13.5 years the patient complained of tooth mobility and radiographic examination revealed an advanced cervical root resorption. As no conservative approach was possible at this stage, the patient was referred to a prosthodontist for esthetic rehabilitation.- - - - - - - - - - ranking = 1keywords = periodontal ligament, ligament (Clic here for more details about this article) |
7/12. Multiple teeth showing invasive cervical resorption--an entity with little known histologic features.Invasive cervical resorption is a relatively uncommon form of external root resorption, characterized by resorption of the cervical region of the root. There is progressive loss of cementum and dentine with replacement by fibrovascular tissue derived from the periodontal ligament, with deposition of cementum-like hard tissue. In most cases, a single tooth is involved. We report a case of invasive cervical resorption that resulted in loss of multiple teeth from two different quadrants. The case highlights the diagnostic difficulty that may arise in this uncommon lesion, the pathologic features of which may be mistaken for a fibro-osseous lesion or a low-grade sarcoma.- - - - - - - - - - ranking = 1keywords = periodontal ligament, ligament (Clic here for more details about this article) |
8/12. Inflammatory external root resorption following surgical treatment for intra-bony defects: a report of two cases involving Emdogain and a review of the literature.BACKGROUND: Enamel matrix-derived proteins have been shown to regenerate periodontal tissues lost as a result of disease in humans. Emdogain, a commercial preparation of porcine enamel matrix derivative (EMD), has been shown to induce new cementum, periodontal ligament and bone formation in human periodontal defects. Although a number of studies have reported successful outcomes, local adverse effects have so far not been reported in the literature. This case report describes two examples of external inflammatory resorption following surgical root surface debridement and the use of Emdogain. TREATMENT: The treatment in both cases involved raising a full-thickness flap following completion of non-surgical therapy. The granulation tissue from the defect was removed and the root surfaces debrided. Emdogain was applied following the manufacturers' instructions and involved conditioning the root surfaces with Pref-Gel and applying the Emdogain to the defect. The flaps were sutured and the site reviewed regularly. Radiographs were taken before the treatment was undertaken and also at 6 months to assess the healing of the defect. RESULTS: External inflammatory root resorption was observed on the treated teeth 6-24 months after therapy. CONCLUSION: External inflammatory root resorption may be an unusual adverse event following Emdogain treatment.- - - - - - - - - - ranking = 1keywords = periodontal ligament, ligament (Clic here for more details about this article) |
9/12. Periodontal manifestations of hyperoxaluria and oxalosis.Dental and periodontal findings associated with primary hyperoxaluria in a 29-year old male patient are described. This is a rare, inherited, metabolic disease which results in excessive calcium oxalate synthesis. The predominant and early manifestation of hyperoxaluria is nephrocalcinosis which results in chronic renal failure. Widespread extrarenal deposits of calcium oxalate crystals, however, is a consistent finding. Extensive infiltration of crystals was noted in the pulps of the teeth, in the marrow spaces of the alveolar bone, in the gingival corium, and in the periodontal ligament. Crystalline calcium oxalate deposits in the periodontal ligament provoked a granulomatous foreign-body reaction. This resulted in aggressive external root resorption leading to pulp exposure and tooth mobility.- - - - - - - - - - ranking = 2keywords = periodontal ligament, ligament (Clic here for more details about this article) |
10/12. root resorption: a complication following traumatic avulsion.The viability of the periodontal ligament depends on the extraoral period; this viability decreases as the extraoral period of traumatically avulsed teeth increases. This case report describes the management of avulsed teeth replanted four hours after the initial trauma. Progressive root resorption was a problem.- - - - - - - - - - ranking = 1keywords = periodontal ligament, ligament (Clic here for more details about this article) |
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