Evaluation of the anti‐resorptive ability of an experimental acetazolamide paste for the treatment of late replanted teeth: a study in rats

Abstract – When late replantation is performed, the root surface and root canal should be treated. Notwithstanding failures still occur, because of the high rates of root resorption, evidencing the need to search for substances that may inhibit root resorption. The acetazolamide is a known anti‐resorptive agent, and its use as root canal dressing may increase the success rates in the treatment of root resorption. Therefore, this study evaluated the effect of an acetazolamide paste used as root canal dressing in late replanted teeth. The study was conducted on 24 maxillary right incisors of rats, which were avulsed and divided in two groups. In group I, the teeth were kept dry for 30 min, had their root surfaces rubbed with a blade, and were treated with 2% sodium fluoride at pH 5.5 for 20 min; the root canals were instrumented and filled with acetazolamide paste; and then the teeth were replanted. In group II, the treatment was similar to group I, except for the root canal dressing, with utilization of calcium hydroxide in group II. At 15 and 60 days after replantation, the animals were killed and the specimens were processed in a histotechnical laboratory for microscopic and morphometric analysis. The results demonstrated the ability of both intracanal substances to limit root resorption, yet they were unable to completely inhibit the root resorption. Replacement resorption lacunae were present in greater proportion in group II, at 60 days. It was concluded that the acetazolamide paste was effective to limit the root resorption, being more effective in limiting the replacement resorption compared with calcium hydroxide.     

Effect of polylactic acid on replanted teeth in dogs

An attempt to inhibit root resorption and ankylosis of replanted roots in the mandibles of dogs was made by coating the root segments with a biodegradable compound. Resorption was not inhibited, but ankylosis response was apparently averted until the compound began to degrade.     

脱位再植牙牙髓不同处理方法对比研究

目的 探讨脱位再植牙牙髓治疗的最佳方法。方法 61例67颗再植牙随机分为四组，A组：术前不做牙髓治疗直接再植，出现牙髓病变时常规根充，B组：术前去髓，根充碘仿氢氧化钙，（Metapaste)半年后常规根充，C组；术前去髓，根充氢氧化钙，半年后常规根充，D组；术前去髓常规根充，结果 当牙脱位时间超过30分钟后，术前牙髓治疗组的疗效显著优于术后牙髓治疗组。术前去髓充入根管过渡性药物氢氧化钙或碘仿氢氧化钙组的疗效显著优于即刻常规根管治疗组，单纯使用氢氧化钙与使用Metapaste做根管过渡性药物，二者间疗效无显著性差异。结论 牙脱位时间大于30分钟后，术前去髓，先充入氢氧化钙类根管过渡性药物，半年后行根充糊剂加牙胶尖永久充填为较理想的牙髓治疗方法。     

Effect of topical alendronate on root resorption of dried replanted dog teeth

Abstract – Alendronate (ALN) is a third generation bisphosphonate with demonstrated osteoclast inhibitory activity that may slow down the resorptive process after severe traumatic injuries. Eighty-two premolar roots of five mongrel dogs were endodontically treated and restored, extracted and treated as follows: 70 roots were bench dried for either 40 or 60 min. Thirty-eight of these roots were then soaked for 5 min in a 1 mM solution of ALN in Hanks' Balanced Salt Solution (HBSS) and replanted. Thirty-two roots were soaked for 5 min in HBSS and replanted. In the remaining 12 roots which were not exposed to the bench drying procedure, a 0.5 mM deep lingual mid-root cemental defect was made. Six of these roots were soaked in a 1 mM solution of ALN in HBSS for 5 min and replanted. The other six roots were soaked for 5 min in HBSS and replanted. Historical negative and positive controls were used from similarly treated teeth in our previous studies. After 4 months the dogs were killed and the roots prepared for histological evaluation. Five-μm-thick cross-sections of the root and surrounding tissue taken every 70 μm were evaluated for healing according to the criteria of Andreasen. In the 12 roots with cemental defects, healing with cementum of the damaged root surface was evaluated. In addition, residual root mass was also measured to determine the extent of root structure loss for each soaking method. Cemental healing took place in all 12 artificially damaged roots, indicating that these soaking media did not inhibit cementogenesis. The alendronate-soaked roots had statistically significantly more healing than the roots soaked in HBSS without alendronate. This improvement in healing was seen in all dogs except one and in all teeth except the first premolar. Soaking in alendronate also resulted in significantly less loss in root mass due to resorption compared to those teeth soaked in HBSS without alendronate.     

Timing of calcium hydroxide therapy in the treatment of root resorption in replanted teeth in dogs

Abstract The effect of time of the onset of calcium hydroxide (CH) pulpectomy on root resorption of 31 permanent dog incisors was investigated. CH pulpectomy was delayed 4, 9, 14 and 18 days after the teeth were extracted and replanted. Control teeth were replanted 1) without pulpectomy, 2) with a pulpectomy only or 31. with a pulpectomy and CH filling. All teeth were prepared for histologic evaluation 8 weeks after the teeth were replanted. Cross section were examined using a computer microscope and linear (jam) and/or square areas (μm²) of surface (SRR), inflammatory (IRR), and replacement (RRR) root resorption were calculated. From this data the percentage of linear and area resorption was averaged for each group. Duncan multiple range t-test (P<0.05) revealed that teeth in which a pulpectomy with CH filling was done extraorally had significantly greater SRR than the rest of the groups; teeth in which a pulpectomy without CH filling was done extra orally had significantly greater RRR than teeth in which CH pulpectomy was delayed for 18 days; there was no significant difference in SRR. IRR or RRR when CH placement was delayed 4, 9, 14 or 18 days after replantation. Although it was not significant the overall resorption was least when CH pulpectomy was delayed 18 days.     

Effect of different endodontic treatment protocols on periodontal repair and root resorption of replanted dog teeth.

This study examined, histologically, the healing of intentionally damaged root surfaces of replanted teeth with either uninfected or infected root canals treated with short- and long-term calcium hydroxide. Thirty beagle dog incisors were randomly divided into four groups. In group 1, uninfected obturated incisors were extracted, the roots were longitudinally grooved and the teeth were replanted within 2 min. In group 2 the root canals were artificially infected followed by extraction, longitudinal grooving, and replantation as described in group 1. Fourteen days after replantation, the root canals were fully instrumented and medicated with intracanal calcium hydroxide. One week later the root canals were permanently obturated with gutta-percha and sealer. The teeth in group 3 were treated as described in group 2 but after 1 wk the calcium hydroxide dressing was repacked for the duration of the study. In group 4 (positive control) the teeth were treated as described in groups 2 and 3 but no endodontic treatment was performed. After 8 wk, sacrifice and histological preparation were carried out. In group 1 complete cemental repair was seen in all teeth. In groups 2 and 3, complete and incomplete cemental repair was seen in seven and two teeth, respectively. An ankylotic area was present in one tooth in group 3. None of the teeth in group 4 showed cemental repair. It was concluded that short- and long-term calcium hydroxide treatment resulted in similar healing patterns when endodontic treatment is initiated 14 days after replantation of teeth.     

A histopathologic study of replanted teeth with superficially demineralized root surfaces in Java monkeys

abstract — Since unmineralized tissues are supposed to possess a resistance to resorption, and demineralized dentin implants induce bone formation and may be remineralized, it was thought worthwhile to study the effect of superficial demineralization of the root surface prior to replantation of the maxillary incisors in 14 Java monkeys. The investigation showed that this treatment caused an accentuated resorption and ankylosis of the tooth as well as other pathologic changes in the periodontium. The technique neither improves the healing of the replanted tooth nor prolongs the survival time.     

Effect of fibronectin on healing of replanted teeth in monkeys: a histologic and autoradiographic study

The purpose of this study was to evaluate the effect of fibronectin application on healing of replanted teeth. Three rhesus monkeys were used. Maxillary and mandibular incisors and premolars were extracted and replanted. Teeth were extracted with forceps and placed in saline solution. After 5 minutes, each tooth was returned to its socket and immobilized by interproximal acid-etch splints, which were removed after 1 week. Of the forty-eight teeth replanted, twenty-four control teeth were replanted as described. On each of the remaining teeth, the root surface and the inner walls of the socket were bathed with 1 ml of fibronectin in saline solution (400 micrograms/ml) during the 5-minute interval between tooth extraction and its replantation. Replanted teeth and animal killings were scheduled to provide observations 1, 3, 7, 14, 28, and 45 days after replantation. Each monkey received an intravenous injection of tritiated thymidine, 1 microCi/g body weight, 1 hour before it was killed. Tissue specimens were processed for histologic and autoradiographic evaluation following standard procedures. For each of the six points of time, four pairs of contralateral teeth were available for evaluation; four teeth were treated with fibronectin and four without it. The findings of this study indicate that fibronectin use resulted in enhanced healing by early replacement of the fibrin clot, increased connective tissue cell proliferation, reduction of the inflammatory response, and inhibition of both cementum resorption and dentoalveolar ankylosis.     

The effects of three modified Hank's balanced salt solutions on root resorption of late replanted teeth: A pilot study

Purpose

The purpose of this study was to evaluate the effects of replanted rats' teeth that had been soaked in one of three modified Hank's balanced salt solutions (HBSSs) before replantation and after extended extra-oral dry time.

Effect of systemic tetracycline and amoxicillin on inflammatory root resorption of replanted dogs' teeth

Abstract— The use of systemic penicillin after an avulsion injury has been recommended as a way to decrease the occurrence of resorption complications. Our previous study has shown systemic tetracycline to possess anti-resorptive properties independent of potential anti-bacterial actions. The purpose of this study was to compare histologically the effectiveness of tetracycline and amoxicillin in limiting inflammatory root resorption (IR) secondary to pulpal infection, in replanted dogs' teeth. Thirty root canals in five dogs were infected with plaque. The roots were extracted, the lingual mid-roots were shaved with a fissure bur ensuring cemental damage and immediately replanted. Dogs were given either tetracycline hydro-chloride or amoxicillin, administered orally, on the day of extraction and replantation and for the following 6 days. The control group was teeth in these animals treated in the same manner but where no antibiotics were given. After approximately 6 months, the dogs were sacrificed and the teeth prepared for histologic evaluation. The shaved root surface was identified in cross-sections and eight equidistant points along the cut root surface were evaluated for healing (H) or IR in eight sections per tooth. For the tetracycline group, H averaged 67.22% and IR 32.!8%, which was not statistically different from the amoxicillin group with H averaging 56.88% and IR 43.12%. The tetracycline group was superior to the control group with H= 27.86% and IR=72.14%. Since tetracycline has been shown to have anti-resorptive properties in addition to the antibacterial properties demonstrated here, it could be considered as an alternative to amoxicillin after avulsion injuries.     

Root resorption of replanted teeth: an SEM study

Abstract— Two replanted and subsequently expelled upper central incisors were observed under a scanning electron microscope to study the changes brought about by root resorption The severity of resorption and the distribution of the affected areas were different in the two specimens. In the first case, large, deep excavations were found along a continuous bone defect which exposed the opposite root canal wall. Bacteria-like elements were found on the bottom of the eroded areas both on the outer and on the inner root surfaces. In the second case, resorption denuded the apical portion of the metal post. Erosive lacunae were visible in some areas while tubiform excavations were present close to the apical margin exposing the collagen network. The roots in the first case likely underwent inflammatory resorption while replacement resorption was thought to have occurred in the second case.     

Secondary dentin in replanted teeth — a histometric study

Abstract To quantify the secondary dentin formation in replanted teeth, 16 human premolars with a postoperative observation period of 6, 12 and 24 weeks were studied histometrically. In spite of marked intra- and interindividual variations, a regression analysis revealed a significant correlation (r=0.70) between observation time and the quantity of secondary dentin in the coronal pulp registered by histometry. A comparison with a previous semiquantitative interpretation of the same material showed that the histometric method was more accurate.     

Evaluation of the topical effect of alendronate on the root surface of extracted and replanted teeth. Microscopic analysis on rats' teeth

Abstract –  The treatment of choice for tooth avulsion is replantation. The ideal replantation should be realized as quickly as possible, or at least, the avulsed tooth should be kept in an adequate solution to preserve the periodontal ligament attached to the root. If that is not possible, treatment of the radicular surface should be done in order to prevent radicular resorption. The purpose of this study was to test sodium alendronate as a substance for topical treatment of the radicular surface of avulsed teeth in an attempt to prevent the occurrence of dental resorptions. Fifty-four rat maxillary right central incisors were extracted and replanted. Group I – extra-alveolar dry period of 15 min, intracanal dressing with calcium hydroxide (CALEN^®, S.S. White, Artigos Dentários LTDA, Rio de Janeiro, Brazil) and replantation; Groups II and III – extra-alveolar dry periods of 30 and 60 min, respectively, immersion in 1% sodium hypochlorite for 30 min for removal of the periodontal ligament, washing in saline solution for 5 min, and treatment of the radicular surface with 3.2 mg/l sodium alendronate solution for 10 min. Intracanal dressing with calcium hydroxide and replantation followed. At 15, 60, and 90 days post-reimplantation, the animals were killed and the samples obtained and processed for microscopic analysis. The results indicated that sodium alendronate was able to reduce the incidence of radicular resorption, but not of dental ankylosis. No significant differences were observed regarding variations in the extra-alveolar periods among the groups.     

Short vs. long-term calcium hydroxide treatment of established inflammatory root resorption in replanted dog teeth

Abstract This study examined, histologically, the healing of intentionally produced inflammatory root resorption of replanted teeth in beagle dogs, treated with short- or long-term placement of calcium hydroxide. Thirty beagle dog incisors were randomly divided into four groups. In group 1 (negative control), uninfected incisors were extracted, the roots were longitudinally grooved and the teeth were replanted within 2 min. In group 2 the root canals were artificially infected followed by extraction, longitudinal grooving, and replantation as in group 1. Radiographs were taken biweekly and at the first signs of inflammatory root resorption or at 4 weeks, the root canals were fully instrumented and medicated with calcium hydroxide. In group 2, the root canals were permanently obturated with gutta-percha and sealer after 1 week of calcium hydroxide. The teeth in group 3 were treated as described in group 2 but after 1 wk the calcium hydroxide dressing was repacked for the duration of the study. In group 4 (positive control) the teeth were treated as described in groups 2 and 3 but no endodontic treatment was performed. Twrelve weeks after the initiation of the endodontic treatment, sacrifice and histological preparation were carried out. In group 1, complete cemental repair was seen in all teeth. In group 2, five often teeth showed complete cemental repair whereas in group 3 complete cemental repair was seen in nine of ten teeth. None of the teeth in group 4 showed cemental repair. It was concluded that long-term may be more effective than short-term calcium hydroxide treatment of established inflammatory root resorption.     

Effect of delayed calcium hydroxide treatment on periodontal healing in contaminated replanted teeth

Abstract – The effect of delayed intracanal calcium hydroxide treatment on experimentally induced extensive inflammatory root resorption in monkeys was studied. A significant shift from inflammatory resorption to ankylosis was noted following calcium hydroxide treatment. Furthermore, calcium hydroxide treatment appeared to change the pattern of ankylosis over time, although the total ankylotic area remained the same. Ankylosis preceded by root resorption (replacement resorption) increased, while ankylosis not associated with root resorption decreased. It was concluded that intracanal calcium hydroxide treatment of teeth with compromised PDM may cause unnecessary replacement resorption if left in the root canal for a long time or changed repeatedly.     

全瓷高嵌体用于后牙根管治疗后牙体修复的临床回顾性研究

目的:本研究的目的是观察铸瓷高嵌体在根管治疗后牙中的长期临床效果.方法:对2010年-2015年间于青岛市立医院口腔科就诊、并选择瓷高嵌体进行牙体修复的患者按照纳入及排除标准进行筛选,最终对296例患者的308颗修复体进行回访,并按照修复方式分为部分覆盖组和全覆盖组,根据改良USPHS评价标准对患牙和修复体进行评价,根...     

Effect of delayed calcium hydroxide treatment on periodontal healing in contaminated replanted teeth

The effect of delayed intracanal calcium hydroxide treatment on experimentally induced extensive inflammatory root resorption in monkeys was studied. A significant shift from inflammatory resorption to ankylosis was noted following calcium hydroxide treatment. Furthermore, calcium hydroxide treatment appeared to change the pattern of ankylosis over time, although the total ankylotic area remained the same. Ankylosis preceded by root resorption (replacement resorption) increased, while ankylosis not associated with root resorption decreased. It was concluded that intracanal calcium hydroxide treatment of teeth with compromised PDM may cause unnecessary replacement resorption if left in the root canal for a long time or changed repeatedly.