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Helal MB. Histological and Radiographical Evaluation of Deciduous Teeth during Shedding (Human and Experimental Study). Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: The aim of this study was to evaluate the process of deciduous teeth shedding histologically and radiographically.
METHODS: The design of the present study included both human and experimental animals. A total number of twenty human primary teeth, aged 8–10 years, were collected for light microscope and scanning electron microscopy (SEM). Furthermore, ten nameless copies of dental/occlusal X-rays of children aged 9–10 years were used to measure the radicular dentin radiodensity. For the experimental part, 4-month-old beagles were used for histological examination of the process of shedding in situ.
RESULTS: Histologically, the decalcified beagles deciduous teeth specimens showed deep resorption fossae occupied with many odontoclasts together with periodontal ligaments disorganization. Furthermore, SEM examination of human exfoliated teeth revealed variable-sized plentiful resorption lacunae with irregular edges. Interestingly, radiographic examination of the human deciduous teeth at late resorption stage revealed significant decrease in radicular dentin radiodensity.
CONCLUSION: Shedding is a complex physiological process that involves intermittent resorption of deciduous teeth supporting tissues together with significant decrease in root dentin radiodensity at late root resorption stage in comparison to other various stages of root resorption.
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Xiao M, Qian H, Lv J, Wang P. Advances in the Study of the Mechanisms of Physiological Root Resorption in Deciduous Teeth. Front Pediatr 2022; 10:850826. [PMID: 35433548 PMCID: PMC9005890 DOI: 10.3389/fped.2022.850826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 02/23/2022] [Indexed: 11/15/2022] Open
Abstract
Physiological root resorption of deciduous teeth is a complex physiological process that is essential for the normal replacement of deciduous teeth and permanent teeth in clinical practice, but its importance is often overlooked due to the presence of permanent teeth. This physiological process includes not only the resorption of hard tissues of deciduous teeth, such as dentin and cementum, but also the elimination of soft tissues, such as pulp and periodontal ligament (PDL). However, the mechanisms of physiological root resorption are not yet clear. In this article, the advances of research on the mechanisms related to physiological root resorption will be reviewed in two main aspects: hard tissues and soft tissues of deciduous teeth, specifically in relation to the effects of inflammatory microenvironment and mechanical stress on the resorption of hard tissues, the repair of hard tissues, and the elimination and the histological events of soft tissues.
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Affiliation(s)
- Manxue Xiao
- Department of Pediatric Dentistry, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Hong Qian
- Department of Pediatric Dentistry, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Jingwen Lv
- Department of Pediatric Dentistry, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Peixuan Wang
- Department of Pediatric Dentistry, Stomatological Hospital, Southern Medical University, Guangzhou, China
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Selvakumar H, Kavitha S, Vijayakumar R, Eapen T, Bharathan R. Study of pulp chamber morphology of primary mandibular molars using spiral computed tomography. J Contemp Dent Pract 2014; 15:726-729. [PMID: 25825097 DOI: 10.5005/jp-journals-10024-1606] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM The purpose of this study was to evaluate the pulp chamber morphology in primary mandibular molars using spiral computed tomography (SCT). MATERIALS AND METHODS Sixty extracted primary mandibular molars were scanned using SCT for the (i) distance between the central fissure to furcation, (ii) distance between the central fissure to the floor of the pulp chamber, (iii) height of the pulp chamber (roof-floor), (iv) distance between the floor of the pulp chamber to the furcation. The mean and standard deviation was analyzed using statistical package for the social sciences (SPSS) program. RESULTS The results of this study show that the average mean distance from the central fissure to the floor of the pulp chamber is 5.07 mm in first mandibular primary molar and 5.54 mm in second mandibular primary molar. CONCLUSION It can be concluded that the greatest depth to which a bur can go during access opening without perforating the furcation in first primary mandibular molar is 5.07 mm and 5.54 mm in second primary mandibular molar.
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Affiliation(s)
- Haridoss Selvakumar
- Senior Lecturer, Department of Pedodontics, AG1 Guru Royal Palace Rayala Nagar 1st Main Road, Ramapuram, Chennai-600089, Tamil Nadu, India, Phone: 98402 75503, e-mail:
| | - Swaminathan Kavitha
- Reader, Department of Pedodontics, Faculty of Dental Sciences, Sri Ramachandra University, Chennai, Tamil Nadu, India
| | - Rajendran Vijayakumar
- Reader, Department of Pedodontics, SRM Dental College, SRM University, Chennai, Tamil Nadu, India
| | - Thomas Eapen
- Professor, Department of Pedodontia, Dr Sunny Medical Centre Sharjah United Arab Emirates
| | - Rajendran Bharathan
- Senior Lecturer, Department of Pedodontics, Sri Ramakrishna Dental College and Hospital, Coimbatore, Tamil Nadu, India
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Rajan S, Day PF, Christmas C, Munyombwe T, Duggal M, Rodd HD. Pulpal status of human primary molars with coexisting caries and physiological root resorption. Int J Paediatr Dent 2014; 24:268-76. [PMID: 24131387 DOI: 10.1111/ipd.12070] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM This study sought to investigate the effect of caries, in association with physiological root resorption, on the pulpal status of human primary molars. DESIGN Fifty-three mandibular primary molars were obtained from children requiring extractions under general anaesthesia. Following extraction, teeth were split longitudinally and placed in Zamboni's fixative. Teeth were categorised according to i) the depth of caries (less than or greater than halfway through dentine thickness) and ii) the degree of physiological root resorption (<33%, 34-66% or >67% of the root length). Ten-micrometre pulp sections were subject to indirect immunofluorescence using a combination of PGP 9.5 (a general neuronal marker), CD45 (a general neuronal marker), and Ulex europaeus agglutinin I (a marker of vascular endothelium). Image analysis was used to determine the percentage area of staining (PAS) for innervation and immune cells. RESULTS Marked differences were seen between different samples, but there were no significant differences in mean PAS for PGP 9.5 or CD45 according to the degree of caries or extent of physiological root resorption (two-way anova, P > 0.05). CONCLUSION Findings suggest that even if primary molars are undergoing exfoliation, they show comparable caries-induced changes to teeth without physiological root resorption, thus retaining potential for healing and repair.
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Affiliation(s)
- Sadna Rajan
- Department of Paediatric Dentistry, Leeds Dental Institute, University of Leeds, Leeds, UK
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Kalender A, Öztan MD, Basmaci F, Aksoy U, Orhan K. CBCT evaluation of multiple idiopathic internal resorptions in permanent molars: case report. BMC Oral Health 2014; 14:39. [PMID: 24739085 PMCID: PMC3999360 DOI: 10.1186/1472-6831-14-39] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 04/09/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Internal inflammatory root resorption is a rare condition in permanent teeth, which requires the presence of necrotic and infected pulp tissue within the coronal portion of the root canal system as well as inflamed pulp tissue apical to the resorptive defect. The aetiology of internal root resorption is not completely understandable, trauma and chronic pulpitis are considered the main risk factors. CASE PRESENTATION We report a rare case of the multiple idiopathic resorption in the permanent maxillary and mandibular molars in a healthy 33-year-old female patient. In addition to clinical examination the patient was imaged using conventional radiography techniques and cone beam computed tomography (CBCT).The patient had recurrent throbbing pain in her # 46. The radiographic examination including "panoramic radiography and CBCT" revealed that radiographic evidence of internal resorption in #37 #36 #35 #34 #33 #47 #46 #45 #44 #43 #16 #15 #14 #13 and also including in unerupted #17, #26, #27, #28 teeth. The definitive diagnosis was made with the histopathological examination of the extracted tooth. CONCLUSIONS Internal root resorption is a rare clinical process that should be examined using different radiographic modalities. CBCT seems to be useful in evaluation of the lesions with superior diagnostic performance.
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Affiliation(s)
- Atakan Kalender
- Department of Endodontics, Faculty of Dentistry, Near East University, 90392, Nicosia Cyprus, Mersin 10, Turkey
| | - Meltem D Öztan
- Department of Endodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Fatma Basmaci
- Department of Endodontics, Faculty of Dentistry, Near East University, 90392, Nicosia Cyprus, Mersin 10, Turkey
| | - Umut Aksoy
- Department of Endodontics, Faculty of Dentistry, Near East University, 90392, Nicosia Cyprus, Mersin 10, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Mersin 10, Turkey
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Qassem A, Goettems M, Torriani DD, Pappen FG. Radicular maturity level of primary teeth and its association with trauma sequelae. Dent Traumatol 2013; 30:227-31. [PMID: 24118894 DOI: 10.1111/edt.12072] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2013] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to investigate the influence of the radicular maturity level of primary teeth on the sequelae of traumatic dental injury (TDI). MATERIALS AND METHODS A longitudinal retrospective study that collected data from dental records and radiographs of patients with TDI in one or both maxillary primary central incisors was conducted. Sequelae such as crown discoloration, pulp canal obliteration (PCO) and inflammatory root resorption (IRR) were evaluated during a 12- to 18-month follow-up period after the trauma. RESULTS Of the 132 patients included in the study, 103 (78%) had luxations and 29 (22%) had dental fractures. At the initial postinjury examination, 12 teeth (9.1%) were found to have immature roots, 107 (81.1%) had closed apexes and 13 (9.8%) had visible root resorption. Inflammatory root resorption occurred mostly in traumatized teeth that presented with physiological root resorption at the moment of trauma (P = 0.004). The frequency of PCO was higher in teeth with a closed apex at the moment of the injury (P = 0.026). There was also an association between the type of injury and the occurrence of crown discoloration (P = 0.008) as well as between the type of injury and the development of PCO (P = 0.001). CONCLUSIONS The occurrence of TDI sequelae can be determined by the type of injury as well as by the radicular maturity level of the primary teeth at the moment of injury.
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Affiliation(s)
- Aya Qassem
- Post-Graduate Program in Pediatric Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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Akbulut N, Altuğ AT, Shahbazi B, Yildirim BT. Supernumerary deciduous molar teeth in the anterior region of the maxilla: Unusual case. J Dent Sci 2013. [DOI: 10.1016/j.jds.2013.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Rodrigues LV, Del Puerto HL, Brant JMC, Leite RC, Vasconcelos AC. Caspase-3/caspase-8, bax and bcl2 in pulps of human primary teeth with physiological root resorption. Int J Paediatr Dent 2012; 22:52-9. [PMID: 21819468 DOI: 10.1111/j.1365-263x.2011.01157.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE. Physiological root resorption is a programmed event that takes place in primary teeth leading to elimination of all root structures. The mechanism behind pulp elimination indicates apoptosis, but its pathway has not been well characterised yet. To better understand this event, we evaluated the gene expression of bax, bcl-2, caspase-3 and caspase-8 through real-time polymerase chain reaction (PCR) and immunohistochemistry expression of Caspase-8 and Bax in pulps. METHODS. Samples were split into two groups: pulps from primary teeth with physiological root resorption (n = 40) and control (n =40), pulps from permanent teeth. Samples of each group were split into PCR (n = 20) and immunohistochemistry (n = 20). RESULTS. Pulps from primary teeth showed a higher caspase-3 mRNA level than pulps from permanent teeth. The expression of bax gene was more intense than caspase-8 but both did not show difference between groups. The bcl-2 mRNA level was incipient and similar between groups. Histopath slides did not show any evidence of inflammatory infiltration, which implies that extrinsic via is not likely to be involved. Immunohistochemistry reaction to Bax and Caspase-8 supported PCR results. CONCLUSIONS. Pulp apoptosis is likely to occur via caspase-3 activation through the mitochondrial pathway.
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Affiliation(s)
- Luciana V Rodrigues
- Laboratory of Apoptosis, Department of General Pathology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Bernardi L, Luisi SB, Fernandes R, Dalberto TP, Valentim L, Bogo Chies JA, Medeiros Fossati AC, Pranke P. The Isolation of Stem Cells from Human Deciduous Teeth Pulp Is Related to the Physiological Process of Resorption. J Endod 2011; 37:973-9. [DOI: 10.1016/j.joen.2011.04.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Revised: 04/08/2011] [Accepted: 04/10/2011] [Indexed: 01/09/2023]
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Rodrigues LV, Vasconcelos AC, Campos PA, Brant JMC. Apoptosis in pulp elimination during physiological root resorption in human primary teeth. Braz Dent J 2009; 20:179-85. [PMID: 19784460 DOI: 10.1590/s0103-64402009000300001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pulp samples of 50 healthy human teeth with indication for extraction were examined to evaluate the role of apoptosis in pulp elimination during physiological root resorption. Two groups were formed: a test group (n=30) composed of pulp samples of primary teeth with physiological root resorption and a control group (n=20) composed of pulp samples of permanent maxillary third molars. Morphological evidence of apoptosis as well as in situ detection of cellular DNA fragmentation by TUNEL assay and detection of internucleosomal pattern of fragmentation of the genomic DNA by electrophoresis were observed. The apoptotic index of the primary tooth group was significantly higher than that of the permanent tooth group (51.01 +/- 0.52 versus 25.32 +/- 0.68) (p<0.001). TUNEL reaction showed intense and diffuse labeling in the pulp samples of primary teeth, which were discrete in the controls. Intense DNA internucleosomal fragmentation, a specific pattern for apoptosis, was observed in primary tooth pulps DNA by electrophoresis, in the permanent tooth pulps this pattern fragmentation of the genomic DNA for apoptosis were not present. These results seem to indicate a role of apoptosis in pulp elimination during the physiological root resorption of human primary teeth.
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Affiliation(s)
- Luciana Villela Rodrigues
- Department of General Pathology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
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Monteiro J, Day P, Duggal M, Morgan C, Rodd H. Pulpal status of human primary teeth with physiological root resorption. Int J Paediatr Dent 2009; 19:16-25. [PMID: 19120506 DOI: 10.1111/j.1365-263x.2008.00963.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The overall aim of this study was to determine whether any changes occur in the pulpal structure of human primary teeth in association with physiological root resorption. METHODS The experimental material comprised 64 sound primary molars, obtained from children requiring routine dental extractions under general anaesthesia. Pulp sections were processed for indirect immunofluorescence using combinations of: (i) protein gene product 9.5 (a general neuronal marker); (ii) leucocyte common antigen CD45 (a general immune cell marker); and (iii) Ulex europaeus I lectin (a marker of vascular endothelium). Image analysis was then used to determine the percentage area of staining for each label within both the pulp horn and mid-coronal region. Following measurement of the greatest degree of root resorption in each sample, teeth were subdivided into three groups: those with physiological resorption involving less than one-third, one-third to two-thirds, and more than two-thirds of their root length. RESULTS Wide variation was evident between different tooth samples with some resorbed teeth showing marked changes in pulpal histology. Decreased innervation density, increased immune cell accumulation, and increased vascularity were evident in some teeth with advanced root resorption. Analysis of pooled data, however, did not reveal any significant differences in mean percentage area of staining for any of these variables according to the three root resorption subgroups (P > 0.05, analysis of variance on transformed data). CONCLUSIONS This investigation has revealed some changes in pulpal status of human primary teeth with physiological root resorption. These were not, however, as profound as one may have anticipated. It is therefore speculated that teeth could retain the potential for sensation, healing, and repair until advanced stages of root resorption.
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Affiliation(s)
- Joana Monteiro
- Department of Paediatric Dentistry, Leeds Dental Institute, Leeds, UK
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Bolan M, Rocha MJDC. Histopathologic study of physiological and pathological resorptions in human primary teeth. ACTA ACUST UNITED AC 2007; 104:680-5. [PMID: 17448706 DOI: 10.1016/j.tripleo.2006.11.047] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2006] [Revised: 11/13/2006] [Accepted: 11/28/2006] [Indexed: 11/30/2022]
Abstract
This study presents a histological analysis through optical microscopy of primary teeth with physiological and pathological resorptions to outline the histological profile of resorptions. Sixty teeth were examined: 19 primary teeth with physiological resorption and 41 primary teeth with pathological resorption. To analyze the histological conditions of the pulp, periradicular tissue, and the resorption areas, and to investigate the presence, intensity, and location of bacteria, slides were prepared using the hematoxylin-eosin and the Brown-Brenn techniques. For the teeth with physiological resorption, normal pulps and no evidence of bacteria were found. For the teeth with pathological resorption, pulpal alterations, atypical resorption, and bacteria were observed.
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Affiliation(s)
- Michele Bolan
- Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
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Harokopakis-Hajishengallis E. Physiologic root resorption in primary teeth: molecular and histological events. J Oral Sci 2007; 49:1-12. [PMID: 17429176 DOI: 10.2334/josnusd.49.1] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Root resorption is a physiologic event for the primary teeth. It is still unclear whether odontoclasts, the cells which resorb the dental hard tissue, are different from the osteoclasts, the cells that resorb bone. Root resorption seems to be initiated and regulated by the stellate reticulum and the dental follicle of the underlying permanent tooth via the secretion of stimulatory molecules, i.e. cytokines and transcription factors. The primary root resorption process is regulated in a manner similar to bone remodeling, involving the same receptor ligand system known as RANK/RANKL (receptor activator of nuclear factor-kappa B/ RANK Ligand). Primary teeth without a permanent successor eventually exfoliate as well, but our current understanding on the underlying mechanism is slim. The literature is also vague on how resorption of the pulp and periodontal ligament of the primary teeth occurs. Knowledge on the mechanisms involved in the physiologic root resorption process may enable us to delay or even inhibit exfoliation of primary teeth in those cases that the permanent successor teeth are not present and thus preservation of the primary teeth is desirable.
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HAAPASALO MARKUS, ENDAL UNNI. Internal inflammatory root resorption: the unknown resorption of the tooth. ACTA ACUST UNITED AC 2006. [DOI: 10.1111/j.1601-1546.2008.00226.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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