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Progress in Orthodontics Nov 2023To systematically assess the efficacy of the various interventions used to intrude maxillary molars. Furthermore, to evaluate associated root resorption, stability of... (Review)
Review
AIMS
To systematically assess the efficacy of the various interventions used to intrude maxillary molars. Furthermore, to evaluate associated root resorption, stability of intrusion, subsequent vertical movement of mandibular molars, cost effectiveness, compliance, patient reported outcomes and adverse events.
METHODS
A pre-registered and comprehensive literature search of published and unpublished trials until March 22nd 2023 with no language restriction applied in PubMed/Medline, Embase, Scopus, DOSS, CENTRAL, CINAHL Plus with Full Text, Web of Science, Global Index Medicus, Dissertation and Theses Global, ClinicalTrials.gov, and Trip (PROSPERO: CRD42022310562). Randomized controlled trials involving a comparative assessment of treatment modalities used to intrude maxillary molars were included. Pre-piloted data extraction forms were used. The Cochrane Risk of Bias tool was used for risk of bias assessment, and The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used for certainty of evidence appraisal.
RESULTS
A total of 3986 records were identified through the electronic data search, of which 24 reports were sought for retrieval. Of these, 7 trials were included. One trial was judged at high risk of bias, while the others had some concerns. Based on individual small sample studies, maxillary molar intrusion was achieved using temporary anchorage devices (TADs) and rapid molar intruder appliance (RMI). It was also observed to a lesser extent with the use of open bite bionator (OBB) and posterior bite blocks. The molar intruder appliance and the posterior bite blocks (spring-loaded or magnetic) also intruded the lower molars. Root resorption was reported in two studies involving TADs. None of the identified studies involved a comparison of conventional and TAD-based treatments for intrusion of molars. No studies reported outcomes concerning stability, cost-effectiveness, compliance and patient-reported outcomes. Insufficient homogeneity between the included trials precluded quantitative synthesis. The level of evidence was very low.
CONCLUSIONS
Maxillary molar intrusion can be attained with different appliances (removable and fixed) and with the use of temporary anchorage devices. Posterior bite blocks (spring-loaded or magnetic) and the RMI offer the additional advantage of intruding the mandibular molars. However, stability of the achieved maxillary molar intrusion long term is unclear. Further high-quality randomized controlled trials are needed.
Topics: Humans; Maxilla; Root Resorption; Tooth Movement Techniques; Orthodontic Anchorage Procedures; Malocclusion; Open Bite; Molar
PubMed: 37953383
DOI: 10.1186/s40510-023-00490-3 -
In Vivo (Athens, Greece) 2020Internal root resorption is an endodontic disease characterized by progressive resorption of dentin from the inside of the pulp chamber. It is a comparatively rare...
BACKGROUND
Internal root resorption is an endodontic disease characterized by progressive resorption of dentin from the inside of the pulp chamber. It is a comparatively rare finding in the permanent dentition, and the underlying pathology is not fully understood.
CASE REPORT
A 45-year-old patient was referred to our Department for the evaluation of the lower right canine and the upper left wisdom tooth. Pulp sensitivity tests, cone-beam tomography, and magnetic resonance imaging were used to determine the extent of lesions of the affected teeth. The teeth were subsequently extracted due the extent of the lesions. The same was the case for the upper right canine, which developed a severe internal resorption 10 months later. Micro-computed tomography of the extracted teeth revealed that all lesions had a well-defined border with no evidence of sclerosis or hypomineralization. Pulp stones were evident inside the pulp chamber. Ground sectioning of the upper right canine revealed pulp necrosis and an acute infection that had gradually moved in the apical direction. Large multi-nucleated resorbing cells were found on the dentin surface. Importantly, the apical half of the pulp exhibited comparatively normal tissue without substantial inflammatory changes. Decalcified histology of the upper left wisdom tooth demonstrated a completely different histopathological appearance characterized by chronically inflamed granulation tissue with pseudoepitheliomatous hyperplasia and massive bacterial colonization.
CONCLUSION
Our analyses demonstrate that internal root resorption is a multifaceted dental disease with considerable variability in the rate of the underlying inflammatory changes. Oral surgeons should take this into consideration when evaluating the need for extraction of teeth with internal root resorption.
Topics: Cone-Beam Computed Tomography; Humans; Middle Aged; Radiology; Root Resorption; Tooth; X-Ray Microtomography
PubMed: 32606158
DOI: 10.21873/invivo.11983 -
Root resorption during maxillary molar intrusion with clear aligners: a randomized controlled trial.The Angle Orthodontist Nov 2023To compare changes in maxillary molar root resorption, intrusion amount, dentoskeletal measures, and maximum bite force (MBF) between clear aligners (CA) and fixed... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To compare changes in maxillary molar root resorption, intrusion amount, dentoskeletal measures, and maximum bite force (MBF) between clear aligners (CA) and fixed appliances with miniscrew (FM) during molar intrusion.
MATERIALS AND METHODS
Forty adults with anterior open bite were randomized into either CA or FM groups. Lateral cephalograms, cone-beam computed tomography (CBCT), and MBF were collected at pretreatment (T0) and 6 months of treatment (T1). Maxillary molar intrusion in FM were intruded by nickel-titanium (NiTi) closed-coil spring delivered force (150 grams/side) while clear aligners combined with squeezing exercise were performed in CA. Parametric tests were used for statistical analysis.
RESULTS
After 6 months of treatment, significant root resorption of 0.21-0.24 mm in CA and 0.38-0.47 mm in FM were found while maxillary molars were intruded 0.68 and 1.49 mm in CA and FM, respectively. CA showed significant less root resorption and intrusion than FM. Overbite, bite closing, and MBF increased significantly. CA showed significantly less overbite and SN-MP changes but more MBF increase than FM. MBF in CA was correlated with the amount of maxillary molar intrusion (r = 0.736, P < .05).
CONCLUSIONS
Maxillary molar intrusion and root resorption in CA were half the amount in FM in 6 months. The amount of maxillary molar root resorption was one-third of the intrusion distance. CA displayed less overbite increase and bite closing but more MBF increase than FM. MBF in CA was positively correlated with the molar intrusion amount.
Topics: Adult; Humans; Root Resorption; Overbite; Open Bite; Malocclusion, Angle Class II; Molar; Tooth Movement Techniques; Orthodontic Anchorage Procedures; Orthodontic Appliances, Removable; Maxilla
PubMed: 37922387
DOI: 10.2319/010723-14.1 -
Progress in Orthodontics Dec 2022The study aimed to compare external root resorption (ERR) three-dimensionally in subjects treated with tooth-borne (TB) versus bone-borne (BB) rapid maxillary expansion...
BACKGROUND
The study aimed to compare external root resorption (ERR) three-dimensionally in subjects treated with tooth-borne (TB) versus bone-borne (BB) rapid maxillary expansion (RME). Forty subjects who received tooth-borne RME (TB group, average age 13.3 years ± 1.10 years) or bone-borne RME (BB group, average age 14.7 ± 1.15 years) were assessed using CBCT imaging before treatment (T0) and after a 6-month retention period (T1). 3D reconstructions of the radicular anatomy of maxillary first molars (M1), first and second premolars (P1 and P2) were generated to calculate volumetric (mean and percentage values) and shape changes (deviation analysis of the radicular models) obtained at each time point. 2D assessment of radicular length changes was also performed for each tooth. Data were statistically analyzed to perform intra-group (different teeth) and inter-group comparisons.
RESULTS
In both groups, all the investigated teeth showed a significant reduction in radicular volume and length (p < 0.05), with the first molars being the teeth most affected by the resorption process (volume and palatal root length). When volumetric radicular changes were calculated as a percentage of the pre-treatment volumes, no differences were found among the investigated teeth (p > 0.05). Based on the deviation analysis from radicular models superimposition, the areas most affected by shape change were the apex and bucco-medial root surface. Overall, the amount of ERR was significantly greater in the TB group (mm: M1 = 17.03, P1 = 6.42, P2 = 5.26) compared to the BB group (mm: M1 = 3.11, P1 = 1.04, P2 = 1.24).
CONCLUSIONS
Despite the statistical significance, the difference in the amount of ERR of the posterior maxillary dentition between TB-RME and BB-RME remains clinically questionable.
Topics: Humans; Adolescent; Root Resorption; Palatal Expansion Technique; Molar; Tooth Root
PubMed: 36464753
DOI: 10.1186/s40510-022-00439-y -
Australian Dental Journal Dec 2017The purpose of the study is to document a rare case of a peripheral odontogenic fibroma with associated cervical and coronal tooth resorption in a 38 year old woman.... (Review)
Review
The purpose of the study is to document a rare case of a peripheral odontogenic fibroma with associated cervical and coronal tooth resorption in a 38 year old woman. Histopathological features are described, the clinical management outlined and follow-up observations over 27 years detailed. The exophytic firm lesion, coral pink in appearance, located on the labial aspect of a maxillary right lateral incisor was excised, fixed in formalin and prepared for histological evaluation. The resorption cavity and adjacent soft tissue were treated by the topical application of trichloroacetic acid prior to restoration with a glass-ionomer cement and subsequent root canal treatment. Histologically, the body of the lesion was characterized by the presence of odontogenic epithelium embedded in a mature fibrous stroma. Areas of dystrophic calcification could also be identified. The features were consistent with a diagnosis of a peripheral odontogenic fibroma. The clinical result of treatment assessed 27 years postoperatively showed no evidence of recurrence of the peripheral odontogenic fibroma. External cervical and coronal tooth resorption can, on rare occasions, prove to be a clinical feature associated with peripheral odontogenic fibroma. Treatment of the tumour mass and the resorptive lesion can provide a successful outcome.
Topics: Adult; Female; Fibroma; Gingival Neoplasms; Glass Ionomer Cements; Humans; Incisor; Neoplasm Recurrence, Local; Odontogenic Tumors; Root Canal Therapy; Tooth Resorption
PubMed: 28665047
DOI: 10.1111/adj.12544 -
Scientific Reports Dec 2022Tooth roots embedded in the alveolar bone do not typically undergo resorption while the bone continues remodeling in its physiological state. In this study, we analyzed...
Tooth roots embedded in the alveolar bone do not typically undergo resorption while the bone continues remodeling in its physiological state. In this study, we analyzed genetically modified mice with the functional inactivation of nucleotide pyrophosphatase 1 (Npp1), encoded by ectonucleotide pyrophosphatase/phosphodiesterase 1 (Enpp1). This mutation leads to the formation of ectopic cervical cementum vulnerable to external tooth root resorption. Cementoblasts with the inactivation of Enpp1 extensively expressed non-collagenous matrix proteins enriched with bone sialoprotein (Bsp), dentin matrix protein 1 (Dmp1), and osteopontin (Opn), which have roles in mineralization through nucleation and in cell adhesion through the Arg-Gly-Asp (RGD) motif. In cementoblasts with the inactivation of Enpp1, β-catenin was significantly activated and induced the expression of these non-collagenous matrix proteins. In addition, adenosine triphosphate (ATP), which is the most preferred substrate of Npp1, accumulated extracellularly and autocrinally induced the expression of the receptor activator of nuclear factor κB ligand (Rankl) in cementoblasts with inactivated Npp1. Consequently, these results strongly suggest that functional Npp1 preserves cervical cementum integrity and supports the anti-resorptive properties of tooth roots through ATP homeostasis in the physiological state of cervical cementum.
Topics: Animals; Mice; Root Resorption
PubMed: 36477209
DOI: 10.1038/s41598-022-25846-3 -
Scientific Reports Mar 2023Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) is a common, painful and poorly understood disease. Enamel, dentin and cementum accumulate both...
Equine odontoclastic tooth resorption and hypercementosis (EOTRH): microspatial distribution of trace elements in hypercementosis-affected and unaffected hard dental tissues.
Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) is a common, painful and poorly understood disease. Enamel, dentin and cementum accumulate both essential and toxic trace elements during mineralization. Characterization of the spatial accumulation pattern of trace elements may provide insight into the role that toxic elements play and inform biological processes affecting these hard dental tissues for future research. Laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) was used to map the distribution of multiple trace elements and heavy metals across equine healthy and diseased (hypercementosis-affected) hard dental tissues among four teeth extracted from horses with EOTRH. Results showed banding patterns of some trace elements (lead, strontium, barium), reflecting the temporal component of accumulation of trace elements during dentin mineralization. Essential elements zinc and magnesium did not show banding patterns. Comparison to the unaffected cementum and dentin adjacent to the hypercementosis region showed that there is an underlying incremental pattern in the uptake of some metals with spatial irregularities. This supports a possible metabolic change involved in hypercementosis lesion development. This represents the first use of LA-ICP-MS to study the microspatial distribution of trace elements in equine teeth, establishing a baseline for elemental distribution in normal and EOTRH impacted dental hard tissue.
Topics: Animals; Horses; Trace Elements; Hypercementosis; Horse Diseases; Magnesium; Tooth Resorption
PubMed: 36977746
DOI: 10.1038/s41598-023-32016-6 -
European Journal of Orthodontics Sep 2023The application of orthodontic forces causes root resorption of variable severity with potentially severe clinical ramifications.
BACKGROUND
The application of orthodontic forces causes root resorption of variable severity with potentially severe clinical ramifications.
OBJECTIVE
To systematically review reports on the pathophysiological mechanisms of orthodontically induced inflammatory root resorption (OIIRR) and the associated risk factors based on in vitro, experimental, and in vivo studies.
SEARCH METHODS
We undertook an electronic search of four databases and a separate hand-search.
SELECTION CRITERIA
Studies reporting on the effect of orthodontic forces with/without the addition of potential risk factors on OIIRR, including (1) gene expression in in-vitro studies, the incidence root resorption in (2) animal studies, and (3) human studies.
DATA COLLECTION AND ANALYSIS
Potential hits underwent a two-step selection, data extraction, quality assessment, and systematic appraisal performed by duplicate examiners.
RESULTS
One hundred and eighteen articles met the eligibility criteria. Studies varied considerably in methodology, reporting of results, and variable risk of bias judgements.In summary, the variable evidence identified supports the notion that the application of orthodontic forces leads to (1) characteristic alterations of molecular expression profiles in vitro, (2) an increased rate of OIIRR in animal models, as well as (3) in human studies. Importantly, the additional presence of risk factors such as malocclusion, previous trauma, and medications like corticosteroids increased the severity of OIIRR, whilst other factors decreased its severity, including oral contraceptives, baicalin, and high caffeine.
CONCLUSIONS
Based on the systematically reviewed evidence, OIIRR seems to be an inevitable consequence of the application of orthodontic forces-with different risk factors modifying its severity. Our review has identified several molecular mechanisms that can help explain this link between orthodontic forces and OIIRR. Nevertheless, it must be noted that the available eligible literature was in part significantly confounded by bias and was characterized by substantial methodological heterogeneity, suggesting that the results of this systematic review should be interpreted with caution.
REGISTRATION
PROSPERO (CRD42021243431).
Topics: Animals; Humans; Root Resorption; Risk Factors; Malocclusion; Tooth Movement Techniques
PubMed: 37366151
DOI: 10.1093/ejo/cjad011 -
Indian Journal of Dental Research :... 2021The number of adult patients seeking orthodontics treatment has increased drastically. There is increased need for faster tooth movement and good esthetics. Piezocision... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
The number of adult patients seeking orthodontics treatment has increased drastically. There is increased need for faster tooth movement and good esthetics. Piezocision is one of the methods used for accelerating the rate of tooth movement.
AIMS AND OBJECTIVES
To assess the amount of root resorption after retraction of canine through piezocision site and compare it with that of recently extracted site using cone-beam computed tomography (CBCT) and assessment of dentin sialoprotein (DSP) levels in gingival crevicular fluid (GCF).
MATERIALS AND METHODS
A split mouth design was used in 15 patients who were undergoing first orthodontic treatment with premolar extractions. Randomly one of the sides was chosen as control (Group I) and the other side underwent piezocision procedure (Group II). 0.022 × 0.028'' MBT system was used with 0.017 × 0.025 SS wire for canine retraction using 150 grams of force. GCF samples were collected from mesio-buccal and disto-buccal of the canine with micropipette at baseline (T) and day 90(T) to detect the levels of DSP and the root resorption was measured using CBCT.
RESULTS
Statistically significant amount of root resorption was observed after retraction in both the groups. DSP levels were increased in both the groups, though little higher in Group II when compared to group I.
CONCLUSION
DSP level was increased on the piezocision side but it was statistically insignificant which suggests the amount of root resorption on both the sides is similar.
Topics: Bicuspid; Dental Care; Gingival Crevicular Fluid; Humans; Root Resorption; Tooth Movement Techniques
PubMed: 35645070
DOI: 10.4103/ijdr.IJDR_654_19 -
The Angle Orthodontist Jul 2017The aim of this systematic review was to evaluate the effect of piezocision as an adjunctive procedure to accelerate orthodontic tooth movement. (Review)
Review
OBJECTIVES
The aim of this systematic review was to evaluate the effect of piezocision as an adjunctive procedure to accelerate orthodontic tooth movement.
MATERIALS AND METHODS
Randomized controlled trials and controlled clinical trials that investigated the effectiveness of piezocision on accelerating orthodontic tooth movement were identified through electronic and manual searches. The literature search, study inclusion, risk of bias assessment, and data extraction were performed by two reviewers independently.
RESULTS
Four eligible studies were included in this review. All studies reported accelerated tooth movement after piezocision, and three reported a significant reduction of treatment duration in the piezocision group. No deleterious effects on periodontal status, pain perception, satisfaction, root resorption, or anchorage control were reported in any studies.
CONCLUSION
Based on currently available information, weak evidence supports that piezocision is a safe adjunct to accelerate orthodontic tooth movement, at least in the short term. More high-quality clinical trials to determine the long-term effects and optimal protocol for piezocision are needed to draw more reliable conclusions.
Topics: Humans; Patient Satisfaction; Piezosurgery; Root Resorption; Tooth Movement Techniques; Visual Analog Scale
PubMed: 28429956
DOI: 10.2319/01191-751.1