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Dental Traumatology : Official... Aug 2022Tooth resorption is either a physiological or a pathological process resulting in loss of dentin and/or cementum. It may also be associated with bone loss. Currently... (Review)
Review
Tooth resorption is either a physiological or a pathological process resulting in loss of dentin and/or cementum. It may also be associated with bone loss. Currently there is no universal classification for the different types of tooth resorption. This lack of a universal classification leads to both confusion amongst practitioners and poor understanding of the resorptive processes occurring in teeth which can result in incorrect/inappropriate diagnoses and mis-management. When developing a classification of diseases and/or conditions that occur within the body, several criteria should be followed to ensure a useful classification. The classification should not only include pathological conditions but also physiological conditions. Since tooth resorption can be either pathological or physiological, a classification of tooth resorption should include both of these categories. Any classification of diseases should be possible to use clinically, meaningful, useful, clear and universal. It should enable easy storage, retrieval and analysis of health information for evidenced-based decision-making. It should also be possible to share and compare data and information between different institutions, settings and countries. A classification of tooth resorption should be developed by combining anatomical, physiological and pathological approaches. For some types of resorption, the aetiological approach should also be incorporated. A classification of tooth resorption that uses simple, relevant and appropriate terminology based on the nature and location of the resorptive process occurring in teeth is proposed. There are two broad categories of internal and external tooth resorption which are sub-divided into three types of internal tooth resorption (surface, inflammatory, replacement) and eight types of external tooth resorption (surface, inflammatory, replacement, invasive, pressure, orthodontic, physiological, idiopathic). The clinician's understanding, diagnosis and management of tooth resorption can be facilitated by using this simple classification which should ideally be used universally by the entire dental profession to ensure clarity and to avoid confusion.
Topics: Dental Cementum; Humans; Molar; Root Resorption; Tooth Resorption
PubMed: 35605161
DOI: 10.1111/edt.12762 -
Dental Traumatology : Official... Aug 2022In 1966, Andreasen and Hjørting-Hansen were the first to describe a relationship between tooth resorption and dental trauma. However, Andreasen's original... (Review)
Review
In 1966, Andreasen and Hjørting-Hansen were the first to describe a relationship between tooth resorption and dental trauma. However, Andreasen's original classification did not include other resorptive processes which have since been identified. Numerous articles have been published suggesting new terminology and definitions for tooth resorption. A uniform language with universally accepted terminology is crucial to eliminate the multiplicity of terms and definitions which only cause confusion within the profession. An electronic literature search was carried out in the PubMed database using the following keywords for articles published in English: "root resorption," "inflammatory root resorption," "replacement resorption," "cervical resorption," "trauma," "ankylosis," "surface resorption," and "internal resorption." The search also included textbooks and glossaries that may not have surfaced in the online search. This was done to identify articles related to tooth resorption and its etiology in dentistry. The aim of this review was to present the history that has led to the variety of terms and definitions for resorption. This review emphasizes the need for a clearer, simpler, and more comprehensive nomenclature for the various types of tooth resorption which are presented in Part 2 of this series.
Topics: Humans; Root Resorption; Tooth Ankylosis; Tooth Resorption
PubMed: 35559593
DOI: 10.1111/edt.12757 -
Genesis (New York, N.Y. : 2000) Sep 2022Osteoclasts are large multinucleated cells from hematopoietic origin and are responsible for bone resorption. A balance between osteoclastic bone resorption and... (Review)
Review
Osteoclasts are large multinucleated cells from hematopoietic origin and are responsible for bone resorption. A balance between osteoclastic bone resorption and osteoblastic bone formation is critical to maintain bone homeostasis. The alveolar bone, also called the alveolar process, is the part of the jawbone that holds the teeth and supports oral functions. It differs from other skeletal bones in several aspects: its embryonic cellular origin, the form of ossification, and the presence of teeth and periodontal tissues; hence, understanding the unique characteristic of the alveolar bone remodeling is important to maintain oral homeostasis. Excessive osteoclastic bone resorption is one of the prominent features of bone diseases in the jaw such as periodontitis. Therefore, inhibiting osteoclast formation and bone resorptive process has been the target of therapeutic intervention. Understanding the mechanisms of osteoclastic bone resorption is critical for the effective treatment of bone diseases in the jaw. In this review, we discuss basic principles of alveolar bone remodeling with a specific focus on the osteoclastic bone resorptive process and its unique functions in the alveolar bone. Lastly, we provide perspectives on osteoclast-targeted therapies and regenerative approaches associated with bone diseases in the jaw.
Topics: Bone Remodeling; Bone Resorption; Bone and Bones; Humans; Osteoclasts; Osteogenesis
PubMed: 35757898
DOI: 10.1002/dvg.23490 -
Journal of Immunology Research 2015Alveolar bone loss is a hallmark of periodontitis progression and its prevention is a key clinical challenge in periodontal disease treatment. Bone destruction is... (Review)
Review
Alveolar bone loss is a hallmark of periodontitis progression and its prevention is a key clinical challenge in periodontal disease treatment. Bone destruction is mediated by the host immune and inflammatory response to the microbial challenge. However, the mechanisms by which the local immune response against periodontopathic bacteria disturbs the homeostatic balance of bone formation and resorption in favour of bone loss remain to be established. The osteoclast, the principal bone resorptive cell, differentiates from monocyte/macrophage precursors under the regulation of the critical cytokines macrophage colony-stimulating factor, RANK ligand, and osteoprotegerin. TNF-α, IL-1, and PGE2 also promote osteoclast activity, particularly in states of inflammatory osteolysis such as those found in periodontitis. The pathogenic processes of destructive inflammatory periodontal diseases are instigated by subgingival plaque microflora and factors such as lipopolysaccharides derived from specific pathogens. These are propagated by host inflammatory and immune cell influences, and the activation of T and B cells initiates the adaptive immune response via regulation of the Th1-Th2-Th17 regulatory axis. In summary, Th1-type T lymphocytes, B cell macrophages, and neutrophils promote bone loss through upregulated production of proinflammatory mediators and activation of the RANK-L expression pathways.
Topics: Alveolar Bone Loss; Animals; Bone Resorption; Humans; Inflammation; Osteoclasts; Periodontitis; RANK Ligand
PubMed: 26065002
DOI: 10.1155/2015/615486 -
Australian Dental Journal Mar 2016External inflammatory resorption is one of the potential consequences of trauma to the teeth. It occurs when there has been loss of cementum due to damage to the... (Review)
Review
External inflammatory resorption is one of the potential consequences of trauma to the teeth. It occurs when there has been loss of cementum due to damage to the external surface of the tooth root during trauma, plus the root canal system has become infected with bacteria. It is characterized by the radiographic appearance of loss of tooth substance with a radiolucency in the adjacent periodontal ligament and bone. The loss of cementum allows the intracanal bacteria and/or their endotoxins to reach the periodontal ligament more readily and this can lead to the development of the inflammatory resorptive process. External inflammatory resorption can ultimately lead to loss of the tooth if it is not managed in a timely manner. There are some injuries that are very likely to develop this type of resorption and a preventive approach can be adopted by commencing root canal treatment immediately as part of the emergency management of such cases. In cases where the resorptive process is already established, root canal treatment can arrest the resorption and encourage hard tissue repair. The use of a corticosteroid-antibiotic intracanal medicament has been shown to be particularly useful in the prevention and management of external inflammatory resorption. Calcium hydroxide should not be used as an immediate medicament because of its inherent toxicity and irritant properties but it is valuable as a subsequent medicament to encourage hard tissue repair where required. This review outlines the external inflammatory resorptive process and the management strategies that can be employed to prevent it from occurring, and to treat it if already present.
Topics: Calcium Hydroxide; Dental Cementum; Dental Pulp Cavity; Humans; Periodontal Ligament; Root Canal Irrigants; Root Canal Therapy; Root Resorption; Tooth Injuries; Tooth Root
PubMed: 26923450
DOI: 10.1111/adj.12400 -
British Journal of Pharmacology May 2021Efficient therapies are available for the treatment of osteoporosis. Anti-resorptive therapies, including bisphosphonates and denosumab, increase bone mineral density... (Review)
Review
Efficient therapies are available for the treatment of osteoporosis. Anti-resorptive therapies, including bisphosphonates and denosumab, increase bone mineral density (BMD) and reduce the risk of fractures by 20-70%. Bone-forming or dual-action treatments stimulate bone formation and increase BMD more than the anti-resorptive therapies. Two studies have demonstrated that these treatments are superior to anti-resorptives in preventing fractures in patients with severe osteoporosis. Bone-forming or dual-action treatments should be followed by anti-resorptive treatment to maintain the fracture risk reduction. The BMD gains seen with bone-forming and dual-action treatments are greater in treatment-naïve patients compared to patients pretreated with anti-resorptive treatments. However, the antifracture efficacy seems to be preserved. Treatment failure will often lead to switch of treatment from orally to parentally administrated anti-resorptives treatment or from anti-resorptive to bone-forming or dual-action treatment. Osteoporosis is a chronic condition and therefore needs a long-term management plan with a personalized approach to treatment. LINKED ARTICLES: This article is part of a themed issue on The molecular pharmacology of bone and cancer-related bone diseases. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v178.9/issuetoc.
Topics: Bone Density; Bone Density Conservation Agents; Diphosphonates; Humans; Osteogenesis; Osteoporosis
PubMed: 32060897
DOI: 10.1111/bph.15024 -
Current Medicinal Chemistry 2021CDATA[Osteoporosis is a pathological loss of bone mass due to an imbalance in bone remodeling where osteoclast-mediated bone resorption exceeds osteoblast-mediated bone... (Review)
Review
CDATA[Osteoporosis is a pathological loss of bone mass due to an imbalance in bone remodeling where osteoclast-mediated bone resorption exceeds osteoblast-mediated bone formation resulting in skeletal fragility and fractures. Anti-resorptive agents, such as bisphosphonates and SERMs, and anabolic drugs that stimulate bone formation, including PTH analogues and sclerostin inhibitors, are current treatments for osteoporosis. Despite their efficacy, severe side effects and loss of potency may limit the long term usage of a single drug. Sequential and combinational use of current drugs, such as switching from an anabolic to an anti-resorptive agent, may provide an alternative approach. Moreover, there are novel drugs being developed against emerging new targets such as Cathepsin K and 17β-HSD2 that may have less side effects. This review will summarize the molecular mechanisms of osteoporosis, current drugs for osteoporosis treatment, and new drug development strategies.
Topics: Anabolic Agents; Bone Density Conservation Agents; Bone Remodeling; Drug Development; Humans; Osteoclasts; Osteoporosis
PubMed: 32223730
DOI: 10.2174/0929867327666200330142432 -
Schweizer Monatsschrift Fur Zahnmedizin... 2010Today, the bleaching of nonvital, discolored teeth is a low-risk routine treatment for improving esthetics. This review article focuses on the etiology of tooth... (Review)
Review
Today, the bleaching of nonvital, discolored teeth is a low-risk routine treatment for improving esthetics. This review article focuses on the etiology of tooth discolorations, different treatment techniques, and risks of bleaching procedures. Some tooth discolorations in endodontically treated teeth are caused by dental treatments. The three most popular techniques for nonvital tooth bleaching are the walking bleach technique, inside/outside bleaching, and in-office bleaching. The walking bleach technique is a relatively reliable, fairly simple technique for dentists and patients. Inside/outside bleaching can be used additionally when internal and external bleaching must be combined. In-office bleaching seems to be a short-term solution, the effects of which can largely be attributed to dehydration of the teeth. There are still some open questions concerning the bleaching agents. Improved safety seems desirable with regard to adding thiourea as a scavenger of radicals or newer materials such as sodium percarbonate. The thermocatalytic technique, insufficient cervical sealing, and high concentrations of bleaching agents should be avoided, as this can increase the risk of cervical root resorptions. Patients should be informed about the low predictability of bleaching success and the risk of recurrent discoloration. The risk of cervical root resorption should be discussed with the patient. There is a strong correlation between root resorption and dental trauma.
Topics: Humans; Recurrence; Root Resorption; Tooth Bleaching; Tooth Bleaching Agents; Tooth Discoloration; Tooth, Nonvital
PubMed: 20514558
DOI: No ID Found -
Clinical Oral Investigations Sep 2009Root resorption of maxillary lateral incisors caused by erupting canines is well known and a relatively common phenomenon. However, much debate and conflicting evidence... (Review)
Review
Root resorption of maxillary lateral incisors caused by erupting canines is well known and a relatively common phenomenon. However, much debate and conflicting evidence exists with regard to the actual resorption trigger and potential etiological factors involved. Consequently, there are no obvious clinical clues concerning prevention and diagnosis as well as subsequent treatment decisions. The introduction of cone beam computer tomography has recently allowed drawing a new and much more documented light on the diagnostic and therapeutic strategies. However, no investigations have determined that this new information may result in another and better diagnostic approach and an improved treatment outcome. Therefore, the present review will attempt to summarize the existing evidence on two- and three-dimensional images and try to link the radiological observations to any further preventive, diagnostic, and/or therapeutic measures. Detection thresholds, accuracy, and reliability of impacted canine localization and neighboring root resorption risks will also be considered. This review demonstrates how adding a third-dimension to the radiographic information may notably alter the prevalence of root resorptions and descriptions of this prevalence. In any case, further investigation is needed to determine resorption detection thresholds in various two-dimensional and three-dimensional imaging techniques, as well as to determine therapeutic thresholds and criteria for strategic tooth extraction based on radiographic manifest and not manageable resorption lesions.
Topics: Cone-Beam Computed Tomography; Cuspid; Dental Sac; Humans; Imaging, Three-Dimensional; Incisor; Maxilla; Orthodontics, Corrective; Root Resorption; Tooth Eruption, Ectopic; Tooth, Impacted
PubMed: 19277728
DOI: 10.1007/s00784-009-0262-8 -
Theranostics 2019Growing evidence indicates that intracellular reactive oxygen species (ROS) accumulation is a critical factor in the development of osteoporosis by triggering...
Growing evidence indicates that intracellular reactive oxygen species (ROS) accumulation is a critical factor in the development of osteoporosis by triggering osteoclast formation and function. Pseurotin A (Pse) is a secondary metabolite isolated from Aspergillus fumigatus with antioxidant properties, recently shown to exhibit a wide range of potential therapeutic applications. However, its effects on osteoporosis remain unknown. This study aimed to explore whether Pse, by suppressing ROS level, is able to inhibit osteoclastogenesis and prevent the bone loss induced by estrogen-deficiency in ovariectomized (OVX) mice. The effects of Pse on receptor activator of nuclear factor-κB (NF-κB) ligand (RANKL)-induced osteoclastogenesis and bone resorptive function were examined by tartrate resistant acid phosphatase (TRAcP) staining and hydroxyapatite resorption assay. 2',7'-dichlorodihydrofluorescein diacetate (HDCFDA) was used to detect intracellular ROS production . Western blot assay was used to identify proteins associated with ROS generation and scavenging as well as ROS-mediated signaling cascades including mitogen-activated protein kinases (MAPKs), NF-κB pathways, and nuclear factor of activated T cells 1 (NFATc1) signaling. The expression of osteoclast-specific genes was assessed by qPCR. The potential of Pse was determined using an OVX mouse model administered with Pse or vehicle for 6 weeks. ROS production was assessed by intravenous injection of dihydroethidium (DHE) into OVX mice 24h prior to killing. After sacrifice, the bone samples were analyzed using micro-CT and histomorphometry to determine bone volume, osteoclast activity, and ROS level . Pse was demonstrated to inhibit osteoclastogenesis and bone resorptive function , as well as the downregulation of osteoclast-specific genes including (encoding TRAcP), (encoding cathepsin K), and (encoding matrix metalloproteinase 9). Mechanistically, Pse suppressed intracellular ROS level by inhibiting RANKL-induced ROS production and enhancing ROS scavenging enzymes, subsequently suppressing MAPK pathway (ERK, P38, and JNK) and NF-κB pathways, leading to the inhibition of NFATc1 signaling. Micro-CT and histological data indicated that OVX procedure resulted in a significant bone loss, with dramatically increased the number of osteoclasts on the bone surface as well as increased ROS level in the bone marrow microenvironment; whereas Pse supplementation was capable of effectively preventing these OVX-induced changes. Pse was demonstrated for the first time as a novel alternative therapy for osteoclast-related bone diseases such as osteoporosis through suppressing ROS level.
Topics: Animals; Antioxidants; Bone Resorption; Disease Models, Animal; Gene Expression Profiling; Mice; Osteogenesis; Ovariectomy; Pyrrolidinones; Reactive Oxygen Species; Treatment Outcome
PubMed: 31037128
DOI: 10.7150/thno.30206