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European Journal of Dentistry May 2024Osteoporosis is a disease characterized by disruption of the bone microarchitecture. It is observed in both sexes, but to a greater extent in women. It affects the whole...
Osteoporosis is a disease characterized by disruption of the bone microarchitecture. It is observed in both sexes, but to a greater extent in women. It affects the whole body, including the jaws. The main indicator of the presence of osteoporosis accepted by the World Health Organization is bone mineral density. The aim of this article is to find data on the influence of osteoporosis on apical periodontitis, to investigate how the intake of osteoporosis drugs affects apical periodontitis, and to establish various data that may be of benefit to the dental practitioner when treating patients with osteoporosis and apical periodontitis. Open-access publications are included. The presence of osteoporosis is important to the dentist. Apical periodontitis in these patients has a faster progression. They are characterized by inflammation and destruction of the tissues located around the tooth root. Osteoporosis has a destructive effect on bone tissue through different mechanisms: nuclear factor-κβ ligand and NLRP3/Caspase-1/IL-1β cascade. It is also associated with low estrogen levels. Various medications such as corticosteroids, bisphosphonates (alendronate, zoledronate (Zoledronic acid), calcitonin, raloxifene, and strontium used to treat osteoporosis can affect the course of apical periodontitis. When treating patients with periapical lesions, the dentist must take a proper medical history and general medical history. In cases of osteoporosis or taking bisphosphonates and other medications, consideration should be given to whether consultation with a specialist is necessary, what treatment approach would be most appropriate, and what the prognosis will be. Chronic diseases affect both the general state of the body and dental health. It has been found that in patients with osteoporosis, inflammation of the apical periodontium develops with faster bone resorption. Before starting dental treatment, it is important to specify the etiology of osteoporosis, the bone density of each patient, as well as the medications they are taking.
PubMed: 38759999
DOI: 10.1055/s-0044-1785533 -
Brazilian Oral Research 2024The aim of this systematic review was to answer the following question: "Does alendronate, a nitrogen-containing bisphosphonate, improve or impair alveolar socket...
The aim of this systematic review was to answer the following question: "Does alendronate, a nitrogen-containing bisphosphonate, improve or impair alveolar socket healing after tooth extraction in animal models"? To this end, a systematic review of the literature was carried out in PubMed, Scopus, LILACS, Web of Science, as well as in the gray literature up to May 2023. Preclinical studies that evaluated alveolar healing after tooth extraction and the intake of sodium alendronate compared with placebo were included. Two investigators were responsible for screening the articles independently, extracting the data, and assessing their quality through the SYRCLE's RoB tool for randomized trials in animal studies. The study selection process, study characteristics, risk of bias in studies, impact of alendronate on bone healing, and certainty of evidence were described in text and table formats. Methodological differences among the studies were restricted to the synthesis methods. The synthesis of qualitative results followed the Synthesis Without Meta-analysis (SWiM) reporting guideline. From the 19 included studies, five were considered to have low risk, three were of unclear risk, and eleven presented a high risk of bias. The studies were considered heterogeneous regarding alendronate posology, including its dosage and route of administration. Furthermore, a variety of animal species, different age ranges, diverse teeth extracted, and exposure or not to ovariectomy contributed to the lack of parity of the selected studies. Our results indicated that alendronate monotherapy negatively affects the early phase of wound healing after tooth extraction in preclinical studies, suggesting that the bone resorption process after tooth extraction in animals treated with alendronate might impair the bone healing process of the extraction socket. In conclusion, alendronate administration restrains bone resorption, thereby delaying alveolar socket healing . Future studies should be conducted to validate these findings and to better understand the effects of alendronate therapy on oral tissues.
Topics: Alendronate; Tooth Extraction; Animals; Wound Healing; Tooth Socket; Bone Density Conservation Agents
PubMed: 38747825
DOI: 10.1590/1807-3107bor-2024.vol38.0038 -
Frontiers in Dentistry 2024In an ideal pulpotomy, the radicular pulp remains vital, healthy, and fully encased within an odontoblastic layer. Mineral trioxide aggregate (MTA) and bone...
In an ideal pulpotomy, the radicular pulp remains vital, healthy, and fully encased within an odontoblastic layer. Mineral trioxide aggregate (MTA) and bone morphogenetic proteins (BMPs) have been suggested to facilitate this outcome. We aimed to compare the clinical and radiographic failure and success rates of MTA and rhBMP2 as pulpotomy medicaments. Sixty-eight teeth from 3-6-year-old children were randomly assigned to two groups using a split-mouth design. Cervical pulpotomy was performed using MTA in one group and rhBMP2 in the other. Subsequently, the teeth were restored with stainless-steel crowns. Clinical and radiographic assessments were performed at 3, 6, 9, and 12-month follow-up intervals to evaluate success and failure rates. Data were analyzed using Chi-square test and Kaplan-Meier survival analysis (P<0.05) At six and nine months, one tooth in the BMP2 group and one tooth in the MTA group showed internal resorption, respectively. After 12 months, one tooth in the BMP2 group exhibited PDL widening. The radiographic success rate was 100% for the MTA- and 97.1% for the BMP2-group at six months, 96.7% for both groups at nine months, and 96.7% and 93.3%, respectively, at 12 months. No clinical failure criteria were observed in any of the teeth. Survival analysis revealed no significant difference between the two groups. The study reveals comparable outcomes between rhBMP2 and MTA, suggesting rhBMP2 as a viable alternative for pulpotomy in primary teeth. With minimal incidences of complications and no significant differences noted, rhBMP2 demonstrates potential for clinical use.
PubMed: 38742221
DOI: 10.18502/fid.v21i12.15224 -
Veterinary Journal (London, England :... May 2024Tooth resorption (TR) is one of the most common dental diseases of cats. It is a painful condition leading to tooth loss. The etiology of TR remains unclear, but old...
Tooth resorption (TR) is one of the most common dental diseases of cats. It is a painful condition leading to tooth loss. The etiology of TR remains unclear, but old age, breed, other oral and dental diseases, and environmental factors are suspected predisposing factors. In our study, we used part of the data from the extensive feline health online survey of 8115 Finnish cats. As TR is difficult to detect and as the feline health survey included diagnoses defined by both veterinarians and the owners, we limited our study to a subpopulation of cats diagnosed with oral or dental disease by a veterinarian and had dental examination or surgery under sedation (n=944). We utilized case-control study analysed by multivariable logistic regression to determine the risk factors and breed variation of feline TR. The 202 cats diagnosed with TR were defined as TR cases and the remaining 742 cats as controls. The frequency of veterinarian-diagnosed TR was 3.9% in the health survey data (316/8115) and 21% in the subpopulation (202/944). The risk of TR increased with age (14.7% in youngest and 25.3% in oldest age group). Our finding that TR was significantly associated with gingivitis or periodontitis in cats that had also calculus (OR: 2.49 and 3.70, respectively) suggests that inflammatory changes caused by calculus increase the risk of TR. We found that Cornish Rex, European, and Ragdoll are at higher risk for TR (OR: 2.44, 2.98 and 2.90, respectively). Exotic-Persians breed group had lower risk (OR: 0.28). TR was not observed in Turkish van or Devon Rex. The differences between breeds highlight a genetic contribution. In addition, female cats that had food available constantly had significantly less TR than female cats that had feeding times (OR: 0.44). The underlying reasons for this remain unexplained in our study.
PubMed: 38740176
DOI: 10.1016/j.tvjl.2024.106133 -
Cureus Apr 2024Alveolar bone resorption is a natural occurrence following tooth extraction, complicating the process of prosthetic rehabilitation with implants. Techniques such as...
Alveolar bone resorption is a natural occurrence following tooth extraction, complicating the process of prosthetic rehabilitation with implants. Techniques such as socket preservation, atraumatic extraction, and immediate implant placement are employed to reduce the dimensional changes associated with extraction. The socket shield technique (SST) is effective in preserving the alveolar ridge's contour, enhancing the aesthetic results of rehabilitation by maintaining the integrity of the bundle bone complex even when the buccal bone is less than 1mm. This case report presents a 23-year-old female patient with a fractured upper central incisor. The socket shield technique was chosen based on the clinical findings from the cone beam computed tomography (CBCT) scan. Immediate temporization was provided to preserve soft tissue integration. A comparison of the initial and subsequent cone beam computed tomography (CBCT) scans, along with clinical observations, suggests that the socket shield technique is a viable method for preserving both hard and soft tissue structures in the anterior dental region, thereby improving aesthetic outcomes.
PubMed: 38738015
DOI: 10.7759/cureus.57940 -
Journal of Clinical and Experimental... Apr 2024Estimating the age of majority is a challenging task in forensic odontology, especially because the third molars are usually the only developing teeth between the ages...
BACKGROUND
Estimating the age of majority is a challenging task in forensic odontology, especially because the third molars are usually the only developing teeth between the ages of 16 and 21 years. The London Atlas emerged as an alternative to estimate age using dental development, eruption and deciduous root resorption as parameters. The method has performed well in young age categories, while its performance for age estimation via third molars has been disputed. The present study tested the performance of the London Atlas to estimate the age of legal majority in a sample of individuals from the Amazon Region.
MATERIAL AND METHODS
The sample consisted of 1.256 panoramic radiographs of women (n = 694) and men (n = 562) between 16 and 22.9 years. The method was applied to the maxillary (#28) and mandibular (#38) left third molars. For comparative purposes, the sample was divided into seven age groups: 16├ 16.99; 17├ 17.99; 18├ 18.99; 19├ 19.99; 20├ 20.99; 21├ 21.99; and 22├ 22.99 years. Chronological and estimated ages were compared descriptively by means of mean absolute errors (MAE) and root mean squared errors (RMSE), as well as through Receiver Operating Characteristic (ROC) curves and their area under the curve (AUC).
RESULTS
The MAE of the age estimates using tooth #28 was 1.76 years for females and 1.52 years for males. When the tooth #38 was used, the MAE for the females and males were 1.68 and 1.51 years, respectively. The MAE and RMSE increased in ascending order between age categories. Tooth #28 led to 74% of correct classifications around the age of legal majority, while tooth #38 reached 77%. The area under the curve was 0.75 for tooth #28 and 0.73 for tooth #38.
CONCLUSIONS
The London Atlas should be used carefully to estimate the age of legal majority and not as a single method when the age threshold is 18 years. Age determination by teeth, forensic dentistry, forensic science, third molar.
PubMed: 38725811
DOI: 10.4317/jced.61263 -
Cureus Apr 2024Crown-root fractures are often challenging to treat and have a poor prognosis. The present case explains the successful management of a vertically fractured tooth...
Crown-root fractures are often challenging to treat and have a poor prognosis. The present case explains the successful management of a vertically fractured tooth treated by intentional replantation in a 12-year-old child. The patient underwent a successful 12-month follow-up, which included a mobility test and measurement of the gingival sulcus depth. Additionally, a radiological assessment was performed to evaluate the root resorption, the integrity of the alveolar cortex, and the periodontal space. We suggest that intentional replantation may be an effective therapeutic approach for the treatment of cases of vertical crown-root fractures.
PubMed: 38716028
DOI: 10.7759/cureus.57737 -
BMC Oral Health May 2024Low impacted third molars are usually asymptomatic and are often found by X-ray examination. The removal of asymptomatic low impacted third molars is one of the most...
OBJECTIVE
Low impacted third molars are usually asymptomatic and are often found by X-ray examination. The removal of asymptomatic low impacted third molars is one of the most controversial clinical issues in oral and maxillofacial surgery.
METHODS
In this study, 806 patients with low impacted mandibular third molars (LIMTMs) (full bony impaction) were analyzed to determine the prevalence and risk factors for cystic lesions and adjacent tooth root resorption throughout the patients' entire life cycle.
RESULTS
The results showed that the prevalence of adjacent tooth root resorption and cystic lesions was age-related, exhibiting a trend of first increasing and then decreasing; prevalence peaked at the age of 41 to 45 years old, the prevalence rates were 12.50% and 11.11% respectively. And the lowest prevalence rate was 2.86% and 2.44% in ≥ 61 group and 56- to 60-year age group respectively. Age was an independent risk factor for adjacent tooth root resorption of LIMTMs, whereas age and impaction type (especially inverted impaction) were independent risk factors for cystic lesions.
CONCLUSIONS
The full life cycle management strategy for LIMTMs may need to be individualized. Surgical removal is recommended for LIMTMs in patients younger than 41 to 45 years, especially for inverted, mesioangular, and horizontally impacted LIMTMs. LIMTMs in patients older than 41 to 45 years may be treated conservatively with regular follow-up, but surgical removal of inverted impacted LIMTMs is still recommended to avoid cyst formation.
Topics: Humans; Molar, Third; Tooth, Impacted; Root Resorption; Female; Retrospective Studies; Male; Adult; Middle Aged; Risk Factors; Mandible; Prevalence; Young Adult; Adolescent; Age Factors; Aged
PubMed: 38698359
DOI: 10.1186/s12903-024-04248-z -
Frontiers in Bioengineering and... 2024Low-intensity pulsed ultrasound (LIPUS) can accelerate tooth movement and preserve tooth and bone integrity during orthodontic treatment. However, the mechanisms by...
BACKGROUND
Low-intensity pulsed ultrasound (LIPUS) can accelerate tooth movement and preserve tooth and bone integrity during orthodontic treatment. However, the mechanisms by which LIPUS affects tissue remodeling during orthodontic tooth movement (OTM) remain unclear. Periodontal ligament cells (PDLCs) are pivotal in maintaining periodontal tissue equilibrium when subjected to mechanical stimuli. One notable mechano-sensitive ion channel, Piezo1, can modulate cellular function in response to mechanical cues. This study aimed to elucidate the involvement of Piezo1 in the osteogenic response of force-treated PDLCs when stimulated by LIPUS.
METHOD
After establishing rat OTM models, LIPUS was used to stimulate rats locally. OTM distance and alveolar bone density were assessed using micro-computed tomography, and histological analyses included hematoxylin and eosin staining, tartrate-resistant acid phosphatase staining and immunohistochemical staining. GsMTx4 and Yoda1 were respectively utilized for Piezo1 functional inhibition and activation experiments in rats. We isolated human PDLCs (hPDLCs) and evaluated the effects of LIPUS on the osteogenic differentiation of force-treated hPDLCs using real-time quantitative PCR, Western blot, alkaline phosphatase and alizarin red staining. Small interfering RNA and Yoda1 were employed to validate the role of Piezo1 in this process.
RESULTS
LIPUS promoted osteoclast differentiation and accelerated OTM in rats. Furthermore, LIPUS alleviated alveolar bone resorption under pressure and enhanced osteogenesis of force-treated PDLCs both and by downregulating Piezo1 expression. Subsequent administration of GsMTx4 in rats and siPIEZO1 transfection in hPDLCs attenuated the inhibitory effect on osteogenic differentiation under pressure, whereas LIPUS efficacy was partially mitigated. Yoda1 treatment inhibited osteogenic differentiation of hPDLCs, resulting in reduced expression of Collagen Ⅰα1 and osteocalcin in the periodontal ligament. However, LIPUS administration was able to counteract these effects.
CONCLUSION
This research unveils that LIPUS promotes the osteogenesis of force-treated PDLCs via downregulating Piezo1.
PubMed: 38694622
DOI: 10.3389/fbioe.2024.1347406 -
International Dental Journal Apr 2024The aim of this study was to evaluate the amount of external apical root resorption in patients who had undergone orthodontic treatment with clear aligners evaluated...
OBJECTIVE
The aim of this study was to evaluate the amount of external apical root resorption in patients who had undergone orthodontic treatment with clear aligners evaluated using cone beam computed tomography.
METHODS
Studies that evaluated external apical root resorption before and after comprehensive orthodontic treatment with clear aligners were assessed by performing an electronic search from 5 databases comprising PubMed, SCOPUS, EBSCO, Cochrane Library, and LILACS and manual searches in the relevant journals and the reference lists of the included studies. Database search, elimination of duplicate studies, and data extraction were performed independently by 2 authors. The quality of the included studies was assessed using the Risk of Bias in Non-randomised Studies-of Interventions and the Cochrane Collaboration's Risk of Bias Tool. Studies that reported the tooth length or volume were used for quantitative analyses.
RESULTS
Nine studies were included in the meta-analysis. The overall root length after clear aligner treatment was significantly decreased compared with the pre-treatment length using cone beam computed tomography (mean differences = -0.56 mm, 95% confidence interval [-0.73, -0.38], P < .00001). However, only the maxillary central incisors, maxillary lateral incisors, and mandibular central incisors had significant reduction in root length. The meta-analysis from 3 studies also indicated that the root volume of the upper incisors also significantly decreased (mean differences = -13.34 mm, 95% confidence interval [-16.57, -10.10], P < .00001).
CONCLUSIONS
Current evidence suggests that clear aligners can cause minimal root resorption. The highest amount of root resorption was observed in the maxillary central incisors.
PubMed: 38692962
DOI: 10.1016/j.identj.2024.04.008