scholarly journals General Factors of Anatomical Variation on the Size and Number of Dental Roots Influencing the Choice of Immediate Implants

2021 ◽  
Vol 6 (7) ◽  

Bone metabolism is gaining more prominence due to osseointegrated implants. Even after a minimally traumatic tooth extraction, there are natural reductions and losses in the proportions of the alveolar bone and other periodontal tissues. Maintaining these dimensions has become a challenge for researchers. Immediate implants are set in the same surgical act as tooth extraction. Implants are recommended aiming at reducing the waiting time for bone repair and thus offering the necessary stimuli to the bone for its dimensional, functional, and esthetic maintenance. Planning prior to immediate setting should take into account anatomical variations and even anomalies mainly related to the dimensions and number of tooth roots. Among the general factors of anatomical variation, those related to Gender, Age, Biotype, and Ethnicity stand out. These data were provided in studies carried out by several authors in several countries, correlating them with the dimensions and number of tooth roots. A selection of works using measurement methods as Cone Beam Computed Tomography or direct measurements in extracted teeth was carried out. Studies confirm that Panoramic Radiography presents greater distortions and does not provide sharpness for dimensional boundary markings. Significant data were obtained and confirm the correlation of these general factors of anatomical variation with the length and number of tooth roots. Further studies need to be carried out, in order to provide clinicians with details of these variants, important in the planning and prior choice of the best shape and size of the dental implant to be installed.

2019 ◽  
Vol 24 (3) ◽  
Author(s):  
Piotr Grad ◽  
Aleksandra Paruzel-Pliskowska ◽  
Andrzej Żegleń ◽  
Jolanta Pytko-Polończyk

Tooth extraction is one of the most common dental surgical procedures. Its success depends on the operator’s knowledge, skills and experience. Proper choice of tools is also important. Incorrect tooth extraction using excessive force may cause local complications, such as damage to the soft tissue or to the extracted or neighbouring tooth with potential translocation, bone fracture, formation of an oral sinus communication or even mandibular dislocation. Currently, efforts are being made to develop methods that will allow for the preservation of intact surrounding periodontal tissues to facilitate subsequent prosthetic rehabilitation. Surgical tools used in atraumatic tooth extraction include, among other things, Physics Forceps, periotomes, luxators, and the Benex extractor system. These tools reduce the risk of damage to the vestibular lamina of the alveolar bone, allow for avoiding the need for a mucoperiosteal flap and reduce the incidence of postoperative pain. This helps create optimal conditions for subsequent implant prosthetic reconstruction. The paper presents the characteristics and application of selected tools used in atraumatic tooth extraction.


1995 ◽  
Vol 12 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Gregg DuPont

Whole tooth extraction is generally considered to be the treatment of choice for teeth with advanced feline external odontoclastic resorptive lesions. These teeth often have both a weakened, brittle crown and radicular ankylosis. These two factors cause frustration and sometimes complications during attempts at extraction. This study investigated the alternative of intentionally leaving part or all of non-pathologic tooth roots in situ to prevent iatrogenic trauma to the patient, loss of alveolar bone, and prolonged healing of surgical defects. Fifty one roots from 23 teeth were radiographed 5–36 months following elective root retention; continued resorption without surrounding bony reaction was seen in almost all cases. In one cat, the roots retained normal periodontal ligament one year later, and in another cat that developed severe stomatitis, the intentionally retained roots were extracted at the same time that the remaining molar teeth were extracted.


2019 ◽  
Vol 98 (4) ◽  
pp. 450-458 ◽  
Author(s):  
M. Arioka ◽  
X. Zhang ◽  
Z. Li ◽  
U.S. Tulu ◽  
Y. Liu ◽  
...  

Osteoporosis is associated with decreased bone density and increased bone fragility, but how this disease affects alveolar bone healing is not clear. The objective of this study was to determine the extent to which osteoporosis affects the jaw skeleton and then to evaluate possible mechanisms whereby an osteoporotic phenotype might affect the rate of alveolar bone healing following tooth extraction. Using an ovariectomized mouse model coupled with micro–computed tomographic imaging, histologic, molecular, and cellular assays, we first demonstrated that the appendicular and jaw skeletons both develop osteoporotic phenotypes. Next, we demonstrated that osteoporotic mice exhibit atrophy of the periodontal ligament (PDL) and that this atrophy was accompanied by a reduction in the pool of osteoprogenitor cells in the PDL. The paucity of PDL-derived osteoprogenitor cells in osteoporotic mice was associated with significantly slower extraction socket healing. Collectively, these analyses demonstrate that the jaw skeleton is susceptible to the untoward effects of osteoporosis that manifest as thinner, more porous alveolar bone, PDL thinning, and slower bone repair. These findings have potential clinical significance for older osteopenic patients undergoing reconstructive procedures.


2021 ◽  
pp. 105054
Author(s):  
Bruna Barcelos Só ◽  
Felipe Martins Silveira ◽  
Gabriela Sauer Llantada ◽  
Luisa Comerlato Jardim ◽  
Thiago Calcagnotto ◽  
...  

2015 ◽  
Vol 26 (2) ◽  
pp. 175-180 ◽  
Author(s):  
Rander Moreira Macedo ◽  
Luiz Guilherme Brentegani ◽  
Suzie Aparecida de Lacerda

Studies have suggested that caffeine acts on bone promoting an increase of calcium excretion, inhibition of osteoblast proliferation and delay in tissue repair process, raising the risk of fractures, osteoporosis, periodontal disease and affecting the success of bone reconstructive procedures. The aim of this study was to analyze histomorphometrically the process of alveolar bone healing after tooth extraction in rats subjected to daily intake of boiled coffee or intraperitoneal administration of caffeine. Forty-five male rats were divided according to the treatment in Control group (C); Coffee group (CO) - treated with coffee since birth; and Caffeine (CAF) - intraperitoneal injection of aqueous solution of caffeine 1.5% (0.2 mL/100g body weight) for 30 days. When weighing between 250-300 g they were anesthetized, subjected to extraction of the maxillary right incisor, and euthanized 7, 21 and 42 days after surgery for histological assessments of bone volume and the quality of formed bone in the dental socket. The qualitative results demonstrated larger amounts of blood clot and immature bone in animals under treatment of pure caffeine compared to coffee and control. Histometric analysis revealed that coffee treatment led to a 40% drop in bone formation, and caffeine a 60% drop in comparison to control animals (ANOVA p≤0.01). It was concluded that both the daily ingestion of coffee and the intraperitoneal administration of caffeine in rats delayed the alveolar bone reparative process after tooth extraction, and this effect was more aggressive when pure caffeine was used.


VASA ◽  
2011 ◽  
Vol 40 (5) ◽  
pp. 404-407
Author(s):  
Maras ◽  
Tzormpatzoglou ◽  
Papas ◽  
Papanas ◽  
Kotsikoris ◽  
...  

Foetal-type posterior circle of Willis is a common anatomical variation with a variable degree of vessel asymmetry. In patients with this abnormality, carotid endarterectomy (CEA) may create cerebral hypo-perfusion intraoperatively, and this may be underestimated under general anaesthesia. There is currently no evidence that anatomical variations in the circle of Willis represent an independent risk factor for stroke. Moreover, there is a paucity of data on treating patients with such anatomical variations and co-existing ICA stenosis. We present a case of CEA under local anaesthesia (LA) in a 52-year-old female patient with symptomatic stenosis of the right ICA and coexistent foetal-type posterior circle of Willis. There were no post-operative complications and she was discharged free from symptoms. She was seen again 3 months later and was free from complications. This case higlights that LA should be strongly considered to enable better intra-operative neurological monitoring in the event of foetal-type posterior circle of Willis.


2021 ◽  
pp. 002203452110199
Author(s):  
Y. Xie ◽  
Q. Tang ◽  
S. Yu ◽  
W. Zheng ◽  
G. Chen ◽  
...  

Orthodontic tooth movement (OTM) depends on periodontal ligament cells (PDLCs) sensing biomechanical stimuli and subsequently releasing signals to initiate alveolar bone remodeling. However, the mechanisms by which PDLCs sense biomechanical stimuli and affect osteoclastic activities are still unclear. This study demonstrates that the core circadian protein aryl hydrocarbon receptor nuclear translocator–like protein 1 (BMAL1) in PDLCs is highly involved in sensing and delivering biomechanical signals. Orthodontic force upregulates BMAL1 expression in periodontal tissues and cultured PDLCs in manners dependent on ERK (extracellular signal–regulated kinase) and AP1 (activator protein 1). Increased BMAL1 expression can enhance secretion of CCL2 (C-C motif chemokine 2) and RANKL (receptor activator of nuclear factor–κB ligand) in PDLCs, which subsequently promotes the recruitment of monocytes that differentiate into osteoclasts. The mechanistic delineation clarifies that AP1 induced by orthodontic force can directly interact with the BMAL1 promoter and activate gene transcription in PDLCs. Localized administration of the ERK phosphorylation inhibitor U0126 or the BMAL1 inhibitor GSK4112 suppressed ERK/AP1/BMAL1 signaling. These treatments dramatically reduced osteoclastic activity in the compression side of a rat orthodontic model, and the OTM rate was almost nonexistent. In summary, our results suggest that force-induced expression of BMAL1 in PDLCs is closely involved in controlling osteoclastic activities during OTM and plays a vital role in alveolar bone remodeling. It could be a useful therapeutic target for accelerating the OTM rate and controlling pathologic bone-remodeling activities.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui Yu ◽  
Tianyi Zhang ◽  
Haibin Lu ◽  
Qi Ma ◽  
Dong Zhao ◽  
...  

Abstract Background Granulocyte colony-stimulating factor (G-CSF) is an important immune factor that mediates bone metabolism by regulating the functions of osteoclasts and osteoblasts. Bone loss is a serious and progressive result of periodontitis. However, the mechanisms underlying the effects of G-CSF on periodontal inflammation have yet not been completely elucidated. Here, we examined whether an anti-G-CSF antibody could inhibit bone resorption in a model of experimental periodontitis and investigated the local expression of G-CSF in periodontal tissues. Methods Experimental periodontitis was induced in mice using ligatures. The levels of G-CSF in serum and bone marrow were measured; immunofluorescence was then performed to analyze the localization and expression of G-CSF in periodontal tissues. Mice with periodontitis were administered anti-G-CSF antibody by tail vein injection to assess the inhibition of bone resorption. Three-dimensional reconstruction was performed to measure bone destruction‐related parameters via micro-computed tomography analysis. Immunofluorescence staining was used to investigate the presence of osteocalcin-positive osteoblasts; tartrate-resistant acid phosphatase (TRAP) staining was used to observe osteoclast activity in alveolar bone. Results The level of G-CSF in serum was significantly elevated in mice with periodontitis. Immunofluorescence analyses showed that G-CSF was mostly expressed in the cell membrane of gingival epithelial cells; this expression was enhanced in the periodontitis group. Additionally, systemic administration of anti-G-CSF antibody significantly inhibited alveolar bone resorption, as evidenced by improvements in bone volume/total volume, bone surface area/bone volume, trabecular thickness, trabecular spacing, and trabecular pattern factor values. Immunofluorescence analysis revealed an enhanced number of osteocalcin-positive osteoblasts, while TRAP staining revealed reduction of osteoclast activity. Conclusions G-CSF expression levels were significantly up-regulated in the serum and gingival epithelial cells. Together, anti-G-CSF antibody administration could alleviates alveolar bone resorption, suggesting that G-CSF may be one of the essential immune factors that mediate the bone loss in periodontitis.


2021 ◽  
Vol 22 (2) ◽  
pp. 539
Author(s):  
Yüksel Korkmaz ◽  
Behrus Puladi ◽  
Kerstin Galler ◽  
Peer W. Kämmerer ◽  
Agnes Schröder ◽  
...  

Nitric oxide (NO) binds to soluble guanylyl cyclase (sGC), activates it in a reduced oxidized heme iron state, and generates cyclic Guanosine Monophosphate (cGMP), which results in vasodilatation and inhibition of osteoclast activity. In inflammation, sGC is oxidized and becomes insensitive to NO. NO- and heme-independent activation of sGC requires protein expression of the α1- and β1-subunits. Inflammation of the periodontium induces the resorption of cementum by cementoclasts and the resorption of the alveolar bone by osteoclasts, which can lead to tooth loss. As the presence of sGC in cementoclasts is unknown, we investigated the α1- and β1-subunits of sGC in cementoclasts of healthy and inflamed human periodontium using double immunostaining for CD68 and cathepsin K and compared the findings with those of osteoclasts from the same sections. In comparison to cementoclasts in the healthy periodontium, cementoclasts under inflammatory conditions showed a decreased staining intensity for both α1- and β1-subunits of sGC, indicating reduced protein expression of these subunits. Therefore, pharmacological activation of sGC in inflamed periodontal tissues in an NO- and heme-independent manner could be considered as a new treatment strategy to inhibit cementum resorption.


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