Diabetes increases collagenase activity in extracts of rat gingiva and skin

The connective tissues of diabetic humans and experimental animals exhibit abnormalities in collagen metabolism including an increased production of collagenolytic enzymes by gingival explants in tissue culture. In the current study, gingival tissue and skin were obtained from control and diabetic rats, the latter on the 5th, 10th, 15th, and 22nd day after inducing the disease with streptozotocin. Extracts of the tissues were assessed for collagenase activity using either ¹⁴C-labeled collagen fibrils or Peptide-P as substrate and by detecting collagenase digestion products by SDS-polyacrylamide gel electrophoresis. Elastase was measured using the specific substrate, succinyl-(L-Alanyl)₃-p-nitroanilide. Diabetes increased the activity of collagenase in extracts of gingiva and skin; elastase, however, was increased dramatically only in the latter tissue. These findings (1) indicate that diabetes-induced enhanced gingival collagenase activity occurs in vivo as well as in vitro and (2) explain, at least in part, the greater loss of collagen in skin than in gingiva of the diabetic rat and other complications such as unusually severe periodontal breakdown.     

The effects of intraoral splints on the masticatory system of pigs

While evidence exists to support the effectiveness of splints on conditions involving the masticatory musculature, few research projects have examined the results of long-term splint wear. The purpose of this study was to examine the function of the masticatory system over a 2-month time period of splint wear. Young adult female miniature pigs were divided into three groups: a control (C) group that wore no intraoral splint, a control splint (CS) group that wore a splint increasing bite height, and a protrusive splint (PS) group that wore a splint increasing bite height and moving the mandible anteriorly. Splints were worn constantly. Fine-wire needle EMG was performed prior to splint delivery and at 1 and 2 months post-splint delivery. Bilateral superficial masseters and zygomaticomandibularis (ZM, equivalent to deep masseter) muscles were monitored during normal feeding. Absolute EMG output, percentage output, and cycle timing were unaffected by chronic splint wear. However, chewing coordination was significantly changed in the splinted groups in both sessions post-splint delivery relative to baseline readings and to the C group (P < 0.005). Trends indicate that the coordination of the PS group was more greatly altered than that of the CS group.     

Stainless steel bands in endodontics: effects on cuspal flexure and fracture resistance

AIMS: This study investigated the effect of stainless steel bands on cuspal flexure and fracture resistance of extracted maxillary premolars. METHODOLOGY: Twenty extracted maxillary premolars (10 matched pairs) with mesio-occluso-distal (MOD) cavities and endodontic access were subjected to occlusal loading tests (100 N) using a servo-hydraulic testing machine. Cuspal deflections were measured by an extensometer, with and without the band present. Ten teeth (one of each pair) then had the band removed, and all teeth were subjected to loading until fracture. RESULTS: Mean cuspal flexure of teeth with bands was one-half of flexure without bands (P < 0.001). Teeth with bands fractured at higher load than their matched pairs with the band removed (P < 0.001), with mean loads at fracture of 1282 N and 729 N, respectively. CONCLUSIONS: The study showed that stainless steel bands used in endodontics reduce the cuspal flexure of maxillary premolars and increase their fracture resistance.     

Immunolocalization of PTCH protein in odontogenic cysts and tumors

The human patched gene (PTCH) functions in both embryologic development and tumor suppression. PTCH mutations have been found in odontogenic keratocysts. However, the expression and localization of the protein product of the gene have not been determined in odontogenic tumors and cysts. We investigated 68 odontogenic lesions by immunohistochemistry, and compared their PTCH expression with that in basal cell carcinomas. All odontogenic lesions, including two keratocysts with truncating mutations, were positive for PTCH. Different types of lesions had different amounts of staining. Lack of staining was noted in the majority of basal cell carcinomas. Taken together, these data suggest that odontogenic keratocysts arise with heterozygous mutations of the PTCH gene.     

Influence of the size of the microgap on crestal bone levels in non-submerged dental implants: a radiographic study in the canine mandible

BACKGROUND: Accumulating evidence suggests that alveolar crestal bone resorption occurs as a result of the microgap that is present between the implant-abutment interface in dental implants. The objective of this longitudinal radiographic study was to determine whether the size of the interface or the microgap between the implant and abutment influences the amount of crestal bone loss in unloaded non-submerged implants. METHODS: Sixty titanium implants having sandblasted with large grit, acid-etched (SLA) endosseous surfaces were placed in edentulous mandibular areas of 5 American fox hounds. Implant groups A, B, and C had a microgap between the implant-abutment connection of <10 microm, 50 microm, or 100 microm, respectively, as did groups D, E, and F, respectively. Abutments were either welded (1 -piece) in groups A, B, and C or non-welded (2-piece screwed) in D, E, and F. All abutment interfaces were placed 1 mm above the alveolar crest. Radiographic assessment was undertaken to evaluate peri-implant crestal bone levels at baseline and at 1, 2, and 3 months after implant placement whereupon all animals were sacrificed. RESULTS: The size of the microgap at the abutment/implant interface had no significant effect upon crestal bone loss. At 1 month, most implants developed crestal bone loss compared with baseline levels. However, during this early healing period, the non-welded group (D, E, and F) showed significantly greater crestal bone loss from baseline to one month (P <0.04) and 2 months (P < 0.02) compared with the welded group (A, B, and C). No significant differences were observed between these 2 groups at 3 months (P > 0.70). CONCLUSIONS: Crestal bone loss was an early manifestation of wound healing occurring after 1 month of implant placement. However, the size of the microgap at the implant-abutment interface had no significant effect upon crestal bone resorption. Thus, 2-piece non-welded implants showed significantly greater crestal bone loss compared with 1-piece welded implants after 1 and 2 months suggesting that the stability of the implant/abutment interface may have an important early role to play in determining crestal bone levels. At 3 months, this influence followed a similar trend but was not observed to be statistically significant. This finding implies that implant configurations incorporating interfaces will be associated with biological changes regardless of interface size and that mobility between components may have an early influence on wound healing around the implant.     

Crestal bone changes around titanium implants: a methodologic study comparing linear radiographic with histometric measurements

Generally, endosseous implants can be placed according to a nonsubmerged or a submerged technique and in 1-piece or 2-piece configurations. Recently, it has been shown that peri-implant crestal bone reactions differ significantly radiographically as well as histometrically under such conditions and are dependent on a rough/smooth implant border in 1-piece implants and on the location of a microgap (interface) between the implant and the abutment/restoration in 2-piece configurations. The purpose of this study was to evaluate whether standardized radiography as a noninvasive clinical diagnostic method correlates with peri-implant crestal bone levels as determined by histometric analysis. Fifty-nine implants were placed in edentulous mandibular areas of 5 foxhounds in a side-by-side comparison in both submerged and nonsubmerged techniques. Three months after implant placement, abutment connection was performed in the submerged implant sites. At 6 months, all animals were sacrificed, and evaluations of the first bone-to-implant contact (fBIC), determined on standardized periapical radiographs, were compared to similar analyses made from nondecalcified histology. It was shown that both techniques provide the same information (Pearson correlation coefficient = 0.993; P < .001). The precision of the radiographs was within 0.1 mm of the histometry in 73.4% of the evaluations, while the level of agreement fell to between 0.1 and 0.2 mm in 15.9% of the cases. These data demonstrate in an experimental study that standardized periapical radiography can evaluate crestal bone levels around implants clinically accurately (within 0.2 mm) in a high percentage (89%) of cases. These findings are significant because crestal bone levels can be determined using a noninvasive technique, and block sectioning or sacrifice of the animal subject is not required. In addition, longitudinal evaluations can be made accurately such that bone changes over various time periods can be assessed. Such analyses may prove beneficial when trying to distinguish physiologic changes from pathologic changes or when trying to determine causes and effects of bone changes around dental implants.     

Human odontoblast cell numbers after dental injury

OBJECTIVES: The purpose of this study was to measure the changes in odontoblast cell numbers in response to cavity restoration variables and patient factors, and the effect these factors have on dental repair by tertiary dentinogenesis. The number of vital odontoblasts is a critical factor for pulpal repair following restorative surgery, and yet little information is available on these cell numbers. METHODS: Class V non-exposed cavities were prepared in the buccal surface of intact first or second premolar teeth of 27 patients, between 9 and 17 years of age. Following tooth extraction (28-163 days) the area of reactionary dentine and the area of the odontoblasts were measured histomorphometrically. RESULTS: Patient factors, as well as cavity preparation and restoration variables, had little effect on the numbers of odontoblasts per pulpal unit area. However, the age of the patient did appear to have an effect on the reactionary dentine secretory capacity of odontoblasts per unit area, and on the relative number of odontoblasts beneath cut dentinal tubules. CONCLUSIONS: Odontoblast cell numbers were maintained following the preparation of cavities cut into dentine with a 0.5mm residual dentine thickness. The repair capacity of the pulp-dentine complex would appear to be age dependent, this may explain differences in the success of various restorative treatments between patients.     

Treatment of middle-apical level root fracture in necrotic teeth

The purpose of this paper is to present two case reports of dental trauma with middle-apical level root fractures and pulp necrosis. The treatment consisted of programmed applications of calcium hydroxide until a calcified barrier was formed at the fracture level. The technique presented here proved efficient in treating horizontal fractures at the middle and apical thirds of the root.