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Introduction: During development and regeneration, odontogenesis and osteogenesis are initiated by a cascade of signals driven by several master regulatory genes., Methods: In this study, we investigated the differential expression of 84 stem cell-related genes in dental pulp cells (DPCs) and periodontal ligament cells (PDLCs) undergoing odontogenic/osteogenic differentiation., Results: Our results showed that, although there was considerable overlap, certain genes had more differential expression in PDLCs than in DPCs. CCND2, DLL1, and MME were the major upregulated genes in both PDLCs and DPCs, whereas KRT15 was the only gene significantly downregulated in PDLCs and DPCs in both odontogenic and osteogenic differentiation. Interestingly, a large number of regulatory genes in odontogenic and osteogenic differentiation interact or crosstalk via Notch, Wnt, transforming growth factor beta (TGF-beta)/bone morphogenic protein (BMP), and cadherin signaling pathways, such as the regulation of APC, DLL1, CCND2, BMP2, and CDH1. Using a rat dental pulp and periodontal defect model, the expression and distribution of both BMP2 and CDH1 have been verified for their spatial localization in dental pulp and periodontal tissue regeneration., Conclusions: This study has generated an overview of stem cell-related gene expression in DPCs and PDLCs during odontogenic/osteogenic differentiation and revealed that these genes may interact through the Notch, Wnt, TGF-beta/BMP, and cadherin signaling pathways to play a crucial role in determining the fate of dental derived cell and dental tissue regeneration. These findings provided a new insight into the molecular mechanisms of the dental tissue mineralization and regeneration.

Objective: The purpose of this study was to evaluate the pulp healing process and the dentin-cementum complex in 51 endodontically treated human teeth after long observation periods and to correlate histologic observations with conventional periapical radiographic findings., Study Design: Specimens were obtained from the extraction of 77 treated teeth, which were deemed to be unrestorable, with no evidence of periapical bone lesion at the follow-up. After stringent evaluation of the radiographs, 51 cases that 3 independent evaluators assessed as having normal periapical conditions were selected. The specimens were histologically evaluated using serial sections., Results: In the majority of the cases, complete healing was observed, with no signs of acute or chronic inflammatory processes in the remaining apical tissue or periodontal tissue fragments. Some cases showed moderate inflammation in the root canal tissue. Narrowing of the apical root canal by cementum was a common finding in most cases, but total closure was not observed. Debris intermixed with necrotic tissue and sealer particles was a common finding in the pulp stump. Bacteria were present in the coronal portion of the root in almost all cases, but in only 1 case could bacteria be demonstrated in the coronal and apical portions of the root., Conclusions: Apical tissue of properly treated teeth with no signs of periapical changes is only rarely significantly inflamed. When the tissue is inflamed, microbial causes can always be demonstrated. Despite the presence of microorganisms coronally in nearly all cases, apical tissue is seldom affected.

The purpose of the study was to investigate the relationship between root resorption and repair in human premolars that had been orthodontically intruded. The objective was to examine these processes related to time and root development. Seventy-six premolars were divided into subgroups: 33 teeth were intruded and then extracted (G1); 25 teeth were intruded and then left in situ for varying periods before extraction (G2); 18 teeth served as the controls (G3). All teeth were examined by light microscopy. Using non-parametric statistical analysis, differences between the groups were examined with the Pearson chi-square test. Teeth in G1 and G2 had significantly more resorptive lesions, 55 and 64 per cent, respectively, than the controls of 11 per cent. Resorption was observed over the whole root surface and increased with time. The occurrence increased to 100 per cent in both experimental groups after 36 days of intrusion. The appearance of lesions in relation to root development showed no differences between G1 and G2. In the apical part of the root, total resorption of the dentine was sometimes observed, but no resorptions extended into the predentine. Resorptive lesions undergoing repair were seen in both groups, with significantly more repair in G2 (58 per cent) than in G1 (32 per cent). Active resorption and repair were sometimes seen at the same resorption site. Deposition of cellular and acellular cementum was found to the same extent over the whole root when repair took place. With time, resorption appeared over the whole root surface. In some teeth, resorptive activity continued up to 10 days after removal of forces but on the other hand, repair of the resorbed area sometimes started during active movement. The individual variation in repair was much wider compared with resorption. The predentine layer in the apical area appeared not to be affected by the resorptive process.

Background: Cementogenesis is sensitive to altered local phosphate levels; thus, we hypothesized a cementum phenotype, likely of decreased formation, would be present in the teeth of X-linked hypophosphatemic (Hyp) mice. Mutations in the phosphate-regulating gene with homologies to endopeptidases on the X chromosome (Phex) cause X-linked hypophosphatemia, characterized by rickets, osteomalacia, and hypomineralized dentin formation, a phenotype recapitulated in the Hyp mouse homolog. Here, we report a developmental study of tooth root formation in Hyp mouse molars, focusing on dentin and cementum., Methods: Light and transmission electron microscopy were used to study molar tissues from wild-type (WT) and Hyp mice. Demineralized and hematoxylin and eosin-stained tissues at developmental stages 23 to 96 days postcoital (dpc) were examined by light microscopy. Immunohistochemistry methods were used to detect bone sialoprotein (BSP) distribution in Hyp and WT mouse molar tissues, and transmission electron microscopy was used to study similar molar tissues in the non-demineralized state., Results: Dentin in Hyp mice exhibited mineralization defects by 33 dpc, as expected, but this defect was partially corrected by 96 dpc. In support of our hypothesis, a cementum phenotype was detected using a combination of immunohistochemistry and transmission electron microscopy, which included thinner BSP-positive staining within the cementum, discontinuous mineralization, and a globular appearance compared to WT controls., Conclusion: Mutations in the phosphate-regulating Phex gene of the Hyp mouse resulted in defective cementum development.

Progressive replacement resorption following delayed replantation of avulsed teeth has proved to be an intractable clinical problem. A wide variety of therapeutic approaches have failed to result in the predictable arrest of resorption, with a good long-term prognosis for tooth survival. Bisphosphonates are used in the medical management of a range of bone disorders and topically applied bisphosphonate has been reported to inhibit root resorption in dogs. This study evaluated the effectiveness of a bisphosphonate (etidronate disodium) as an intracanal medicament in the root canals of avulsed monkey teeth, placed before replantation after 1 h of extraoral dry storage. Incisors of six Macaca fascicularis monkeys were extracted and stored dry for 1 h. Teeth were then replanted after canal contamination with dental plaque (negative control) or after root canal debridement and placement of etidronate sealed in the canal space. A positive control of calcium hydroxide placed 8-9 days after replantation was also included. All monkeys were sacrificed 8 weeks later and block sections were prepared for histomorphometric assessment of root resorption and periodontal ligament status. Untreated teeth showed the greatest extent of root resorption (46% of the root surface), which was predominantly inflammatory in nature. Calcium hydroxide treated teeth showed the lowest overall level of resorption (<30% of the root surface), while the bisphosphonate-treated group was intermediate (39%). Ankylosis, defined as the extent of the root surface demonstrating direct bony union to both intact and resorbed root surface, was the lowest in the untreated control group (15% of the root surface), intermediate in the calcium hydroxide group (27%) and the highest in the bisphosphonate group (41%). Bony attachment to the tooth root was divided approximately equally between attachment to intact cementum and to previously resorbed dentin. Overall, bisphosphonate resulted in a worse outcome than calcium hydroxide in terms of both root resorption and ankylosis.

The aim of this study was to investigate the effect of C-Graft particles on formation of new cementum and bone in periodontal bone defects in dog. Healing and tissue change were histologically determined at 2, 4, 8, and 16 weeks. Little bone or cementum formation was observed in the control group. A statistically significant increase in bone and cementum formation was seen in the C-Graft group compared to the control group (75.4% vs. 44.9%, p < 50.01, 80.4% vs. 46.7%, p < 50.05, respectively). These findings suggest that C-Graft particles provide a scaffold for the regeneration of new bone and cementum.

Introduction: In this preliminary study, we investigated early histologic changes of paradental tissues in response to a clear plastic appliance in rats., Methods: Fifteen rats were divided into 3 groups. Group I was the untreated controls; group II received a clear plastic appliance made from a model, with the maxillary left first molar repositioned mesially 0.5 mm from the origin; and group III had a closed-coil spring to move the molar mesially. Specimens were prepared in parasagittal sections, and changes in paradental tissues were evaluated on days 1, 4, and 7 by light microscopy., Results: In group II, the periodontal ligament (PDL) was compressed in the bifurcation and apical areas of the roots of the molar. On day 7, the PDL of the apical and distal aspects of the roots and the bifurcation area showed further compression, with the PDL of the roots stretched along the mesial side. In group III, a disorganized and compressed PDL in the mesial cervical half and interradicular septum was observed, and the stretched fibers were at the distal aspects of the roots after days 4 to 7., Conclusions: Early histologic changes in response to the clear plastic appliance were intrusion and distal tipping despite the intended mesial movement. In this rat model, the observed histologic changes were subject to the direction and magnitude of forces generated by the clear aligner.

Background: Few studies have examined the effect of nutrition on tooth development in subadults., Aim: The study investigates the association between nutritional status, sex and tooth development., Material and Methods: This study was conducted on 390 (195 males, 195 females) impacted mandibular third molars extracted from North Indian healthy patients aged between 17 and 21 years. Buccolingual ground sections were prepared and the distance between the margins of enamel and cementum were measured with a micrometer attached to a light microscope. Individual age was estimated by the BR regression equation. Age estimates were then compared to the chronological age of the individual to assess the accuracy of this procedure., Results: The distance between the cementum and enamel between malnourished and well nourished North Indian subadults was statistically significantly different. No significant difference was found between chronological age and dental age for well nourished subjects while underestimation of the age was observed for malnourished individuals., Conclusions: Thus nutritional status of the individual should be considered when the BR regression equation is applied in age estimation from impacted teeth.

Background: Previous studies reported that bone morphogenetic protein (BMP)-2 induced periodontal regeneration in animals. However, the effects of local host factors on bone formation when using recombinant human (rh)BMP-2 are unknown. The purpose of this study was to evaluate local conditions in recipient sites that affected periodontal regeneration following BMP implantation in experimentally induced horizontal defects in dogs., Methods: Experimental periodontitis was induced in the maxillary and mandibular premolars of six male beagles. The recipient sites were divided into four quadrants (maxillary buccal, maxillary palatal, mandibular buccal, and mandibular lingual sites). A polymer-coated gelatin sponge (PGS; 3 x 3 x 2 mm) was impregnated with 7.2 mul rhBMP-2 solution. The recipient sites in each quadrant were treated with physiologic saline/PGS and rhBMP-2/PGS (rhBMP-2 at 7.2 mug/7.2 mul). The dogs were sacrificed 12 weeks post-surgery, and healing was evaluated histologically., Results: Bone formation and connective tissue attachment were observed following rhBMP-2/PGS implantation. In the four recipient sites of the BMP-treated group, significant positive correlations were found between the width of residual bone and the height and area of regenerated bone (r = 0.791; r = 0.828; P <0.0001). The height of regenerated bone was also significantly correlated to the area (r = 0.891; P <0.0001)., Conclusions: The width of residual bone was one of the clinical host factors that affected bone regeneration following BMP implantation. However, it did not affect connective tissue attachment, cementum regeneration, and downgrowth of junctional epithelium.

The purpose of this study was to perform a three-dimensional observation, via microvascular corrosion casts, of the microcirculation system during deposition of cementum after flap surgery and to investigate the permeable structure of the vascular endothelium. Two stages of wound healing after flap surgery were confirmed based on successive vascular changes. The transition between these stages occurred 3 weeks after surgery, at which time new blood vessels disappeared and an early stage of accumulation of new cementum was apparent. Hence, fibrous repair occurred during the first stage, and repair of hard tissue (ie, formation of cementum) occurred during the second stage. These findings suggest that metabolic activity in cementogenesis is low, based on the condition of the blood vessels, and therefore new cementum is not easily formed.

Objectives: To study the wound healing of acellular dermal matrix (ADM) allografts when used together with coronally advanced flaps (CAF) in the treatment of localized gingival recessions in the mini-pig experimental model., Material and Methods: Dehiscence defects 4 x 5 mm were surgically created in one buccal root surface in each quadrant of PI, II, or III in three mini-pigs. They were then treated with CAF and the interposition of either a connective tissue graft (CTG) or ADM. As the primary outcome, the histological interface between the ADM and the root surface was studied and was compared with CTG. As secondary outcomes, we assessed the amount and quality of the keratinized tissue and clinical outcomes in terms of root coverage and recession reduction., Results: At 3 months, the CTG group attained a mean 76% root coverage, versus 62% in the ADM group. The histological interface with the root surface was similar in both groups. The apical migration of the epithelium was 1.79+/-0.46 mm for the CTG and 1.21+/-0.35 mm for ADM. Newly formed cementum was observed with both treatments. New bone and a newly formed periodontal ligament were shown in five specimens in the ADM group and in three in the CTG group., Conclusion: Both materials showed similar clinical and histological outcomes.

Background and Objectives: The purpose of this study was to assess the potential of polarization-sensitive optical coherence tomography (PS-OCT) to non-destructively measure the depth and severity of artificial demineralization on exposed root surfaces and measure the degree of inhibition by topical fluoride. Although PS-OCT imaging studies have demonstrated the utility of PS-OCT for imaging carious lesions on enamel and dentin surfaces the influence of the cementum layer that is present on intact root surfaces has not been investigated., Materials and Methods: In this study, extracted human tooth roots were partitioned into three sections with one partition treated with topical fluoride, one partition protected from demineralization with acid resistant varnish, and one partition exposed to a demineralization solution, producing artificial lesions approximately 200-mum deep in root dentin. The lesion depth, remaining cementum thickness and the integrated reflectivity for lesion areas were measured with PS-OCT. These measurements were also compared with more established methods of measuring demineralization, namely transverse microradiography (TMR) and polarized light microscopy (PLM)., Results: PS-OCT was able to measure a significant increase in the reflectivity between lesion areas and sound root surfaces. In contrast to dentin, the cementum layer manifests minimal reflectivity in the PS-OCT images allowing non-destructive measurement of the remaining cementum thickness. The reflectivity of the cementum layer did not increase significantly after substantial demineralization, however it did manifest considerable shrinkage in a fashion similar to dentin and that shrinkage could be measured with OCT., Significance: This study demonstrates that PS-OCT can be used to measure demineralization non-destructively on root surfaces and assess inhibition of demineralization by anti-caries agents.

The current study evaluated in-vitro microleakage of indirect composite inlays fixed with flowable composite and resinous cement and cured by LEDs and QTH units, thus modifying the internal conditioning of the inlays. Thirty-two non-carious teeth were selected and 64 cavity preparations were performed in both enamel and cementum. These teeth were divided into four groups: I--Elipar FreeLight appliance and Filtek Flowable composite; II--Ultralux appliance and Filtek Flowable composite; III--Elipar FreeLight appliance and RelyX cement and IV--Ultralux appliance and RelyX cement. The inlays were internally sandblasted with aluminum oxide, etched with 37% phosphoric acid, washed and silanized. The dental etching was carried out with 37% phosphoric acid for 15 seconds in dentin and 30 seconds in enamel. After being washed and dried, Single Bond dentinal adhesive was then applied, and the inlays were fixed with their respective luting agents, cured in close contact with their surfaces for 60 seconds, thermocycled and immersed in 0.5% basic fuchsine solution. The teeth were then washed and sectioned through the center of the restoration in order for the microleakage readings to be performed using the Image Tool Software. Then, ANOVA and Tukey's statistical tests were applied. In enamel, there was no significant difference for both groups with regard to microleakage; in cementum, the significant difference was 5% (p > 0.005). In agreement with the results, the inlays can be fixed with RelyX and Filtek Flowable resins.

Background and Objective: Domestic cats commonly suffer from external osteoclastic tooth resorption, a disease with many similarities to human multiple idiopathic root resorption. In both diseases, it is unclear whether anatomical features of the tooth surface are associated with a predisposition for resorptive lesions. The aim of the present study was to investigate the origin and progression of early feline osteoclastic resorptive lesions in teeth exhibiting no clinical signs of disease., Material and Methods: The entire surfaces of 138 teeth from 13 adult cats were analysed using back-scattered electron microscopy. The distribution of lesions was assessed by tooth type, location and between individuals., Results: Seventy-three (53%) teeth showed at least one resorptive lesion. Eleven (85%) cats had lesions, and there was a significant association between increasing age and incidence of resorptive lesions. The highest frequency occurred in mandibular molars (82%). On average, there were 3.5 lesions per tooth. Fifty-two (38%) teeth featured resorptive lesions at the cemento-enamel junction. Twenty-three per cent of teeth with resorptive lesions showed evidence of repair of lesions that was limited to the root surface. There was no evidence of repair of resorptive lesions at the cemento-enamel junction., Conclusion: Resorption is prevalent without evidence of clinical disease, and occurred at younger ages than previously reported. It can initiate anywhere on the root surface, but lack of repair of lesions at the cemento-enamel junction indicates that mechanisms of replacement are absent or compromised in this region. Whereas resorption of the root may undergo repair, resorption at the cervix may progress to clinically evident lesions.

Odontoameloblastoma (OA) is a very rare mixed odontogenic neoplasm, characterized by the simultaneous occurrence of an ameloblastoma and a compound or complex odontoma in the same tumor mass. To date, less than 50 cases of OA and/or ameloblastic odontoma have been reported in the English dental literature. This neoplasm was called ameloblastic odontoma. The term OA was included in the 1971 WHO classification. In this study, we present two cases of OA, which we hope will contribute to the awareness and knowledge of surgeons regarding the existence of this odontogenic tumor so that patients having it may be treated and followed-up properly.

This study sought to evaluate how the matrix and insertion technique affected microleakage and microhardness of posterior composite restorations. Class II preparations with the gingival margin in cementum were performed in 60 bovine teeth and divided into two groups: transparent matrix and reflective wedge (Group T) (n=20) and metallic matrix and wood wedge (Group M) (n=40). Cavities were restored and specimens were isolated with nail varnish, immersed in 0.2% Rhodamine B, and sectioned. Microleakage was evaluated under magnification (20x) and data were analyzed with one-way ANOVA. Microhardness was assessed at 1, 2, and 3 mm from the gingival wall and data were analyzed with two-way ANOVA. No significant difference was observed in terms of leakage. Significant differences were observed in terms of hardness for both factors, although no interaction was noted. It was concluded that the insertion technique had no influence on microleakage and that using a metallic matrix with oblique increments provided the highest hardness. There was no correlation between these two variables.

Introduction: The purposes of the study were to evaluate the immediate damage to roots and periodontal structures after initial miniscrew implant (MSI) placement and the short- and long-term damage after MSIs were left in situ., Methods: The roots of the maxillary second, third, and fourth premolars of 7 mature beagle dogs were randomly assigned to undergo immediate, short-term (left for 6 weeks), or long-term (left for 12 weeks) damage. Intentional damage was inflicted with self-tapping screws (1.8 x 8 mm) placed with a stent. Alternating tetracycline and calcein labels were administered at 6-week intervals. Undecalcified sections were stained and evaluated histologically to determine the extent of damage; healing was evaluated by using fluorescence labels., Results: Histology showed damage to 73.8% of the teeth, ranging from displacement of bone into the periodontal ligament to invasion of the pulp chamber. Displacement of bone into the periodontal ligament and direct damage to the periodontal ligament occurred in 3 (7.2%) instances. Damage was isolated to the cementum of 8 (19.0%) teeth, whereas damage occurred in the dentin of 11 (26.2%) teeth. Loss of bone in the furcation was evident in 3 (7.2%) teeth, and severe damage into the pulp occurred in 6 (14.2%) teeth. No differences in the amounts of damage were evident between the immediate, short-, and long-term groups. Healing often occurred with cementum around the unloaded MSIs., Conclusions: Extensive damage can be caused by MSIs, with little to no differences evident over time. Unloaded MSIs that remain in contact with roots of teeth can show varying degrees of healing.

The combined effect of beta-tricalcium phosphate and basic fibroblast growth factor was observed in the regeneration of periodontal tissue in dogs. For this purpose, either beta-TCP and FGF-2 (beta-TCP/FGF-2 group) or FGF-2 alone (FGF-2 group) was applied in intrabony defects. The control group received beta-TCP alone. The tissues were histologically examined at 2, 4, or 8 weeks following treatment. The control group was characterized by incomplete, newly formed bone around beta-TCP particles. The beta-TCP/FGF-2 group showed a statistically significant increase in both new bone and cementum formation compared to the FGF-2-alone group (76.3% vs. 65.3%, p < 0.01; 81.0% vs. 68.3%, p < 0.01, respectively). These findings suggested that beta-TCP may be a suitable scaffold for FGF-2 and that the combination of beta-TCP and FGF-2 can enhance bone and cementum formation.

The aim of this study was to compare the effects of orthodontic extrusive and intrusive forces on histological changes of the human dental pulp. In this clinical trial, 52 sound upper first premolars from 26 patients scheduled for extraction for orthodontic reasons were selected. They were divided into 2 groups, based on the time intervals for histological evaluation (3 days and 3 weeks). In each group, 10 teeth received orthodontic extrusive forces, 10 teeth underwent intrusive forces, and 6 teeth served as controls. After each period, teeth were extracted and prepared for histological examination under light microscopy and some histological parameters were evaluated. The data were statistically analyzed by Kruskall-Wallis and Mann Whitney tests. Of the parameters evaluated, just vacuolization and disruption of the odontoblastic layer showed statistically significant differences between the control group and both of the experimental groups in each test period (P < 0.05). Additionally, there was no significant difference between 3-day and 3-week intervals in each experimental group, except for fibrosis in the extrusive group which significantly increased after 3 weeks of force application (P = 0.001). Histological pulp changes following extrusive and intrusive force applications for 3 days and 3 weeks show no difference from each other.

A case of peripheral ossifying fibroma (POF) in the mandibular gingiva of a 30-year-old man is described. The lesion was asymptomatic, firm, pinkish red and pedunculated histologically showing cellular, fibrous connective tissue stroma with calcified osseous and cementum-like calcifications. Lesions histologically similar to peripheral ossifying fibroma (POF) have been given various names in the existing literature. Therefore, the controversial varied nomenclature and possible etiopathogenesis of peripheral ossifying fibroma are discussed.

Objective: To examine the stability of mini-screws that invade a dental root by measuring the retention period/failure rate, and to illustrate their effects on paradental tissues., Materials and Methods: Three adult male beagle dogs received 48 orthodontic mini-screws. Half of the mini-screws were implanted to invade the roots, and the rest were placed in the middle of the alveolar bone. Half of the mini-screws were loaded immediately. The retention period of the mini-screws was documented. The dogs were euthanized after 8 weeks, and tissue samples were examined histologically., Results: The failure rate of the mini-screws that invaded the roots was 79.2%, and that of the mini-screws in the middle of the alveolar bone was 8.3%. The application of force had little effect on the failed mini-screws. Moderately injured roots were repaired with osteoid and/or cementoid tissues with normal periodontal ligaments, followed by recovery of the original configuration., Conclusion: Orthodontic mini-screws had a higher failure rate when placed to invade the dental roots. However, minimally damaged dental roots do not adversely affect the healing process.

Objective: To develop a new cementoblast culture method and to detect bone sialoprotein (BSP) expression in response to high and low mechanical tensile stress in cementoblast in vitro., Materials and Methods: Cementoblasts were collected from the roots of newborn bovine teeth and were identified with cementum-derived attachment protein (CAP) antibody 3G9. Cell proliferation was evaluated by MTT [3-(4,5-dimethylthazol-2-yl)-2,5-diphenyl tetrazolium bromide] assay, and mineralization was confirmed by von Kossa staining. Mechanical tensile stress was applied in vitro to the cementoblast with the use of a uniaxial four-point bending system with 2000 or 4000 microstrains, at a frequency of 0.5 Hz for 3, 6, 12, 24, or 36 hours. BSP mRNA level was quantified by real-time quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR)., Results: A large amount of cementoblast was observed to be expressing CAP. Cementoblasts had a proliferation tendency similar to that of osteoblasts but different from that of periodontal ligament (PDL) cells. Cementoblasts had the ability to become mineralized between osteoblasts and PDL cells. The mechanical tensile stress significantly up-regulated BSP mRNA expression, which reached a peak at 24 hours in both 2000 and 4000 microstrain groups (P < .01) and was tenfold and sixfold higher than that of controls, respectively. BSP expression dropped toward baseline levels at 36 hours in both groups., Conclusions: Mechanical tensile stress up-regulated the expression of BSP. Low mechanical tensile stress induced earlier and more intensive up-regulation of BSP mRNA; this might represent the optimal stimuli for cementoblast activity.

Introduction: In this study, we evaluated the healing potential of the roots and surrounding periodontium (cementum, periodontal ligament [PDL], and bone) after intentional damage during miniscrew implant (MSI) placement., Methods: A randomized split-mouth design was used to evaluate healing 6 and 12 weeks after intentional root damage. Seven skeletally mature male beagle dogs had MSIs placed into the roots of 8 mandibular teeth (6 premolars, 2 first molars). After root contact had been verified by using insertion torques and radiographs, the MSIs were immediately removed, and the sites were allowed to heal for 6 or 12 weeks. Sequential point labeling was performed at 6-week intervals with tetracycline and calcein. Demineralized and undemineralized sections were stained, and healing was histologically evaluated., Results: The placement torque was twice as high with root contact than without contact (23.8 vs 50.7 Ncm). Damage to the roots and periodontium ranged from cementum interruption to pulp invasion. New bone, PDL, and cementum were observed in 64.3% of the teeth, with significant (P <0.05) increases in the percentages of cementum over time. Sequential labeling confirmed healing at both 6 and 12 weeks. Abnormal healing was found in 35.7% of teeth; it included lack of PDL and bone regeneration, bone degeneration in the furcation area, ankylosis, and no healing associated with inflammatory infiltrate or pulpal invasion., Conclusions: Under favorable conditions (no inflammatory infiltrate or pulpal invasion), healing can occur when root damage caused by MSIs is limited to the cementum or the dentin. Increased resistance should be used as an indicator of possible root contact during MSI placement.

Background and Objective: In primates and in primates only, the transforming growth factor-b proteins induce endochondral bone formation. Transforming growth factor-b3 also induces periodontal tissue regeneration. Two regenerative treatments using human recombinant transforming growth factor-b3 were examined after implantation in mandibular furcation defects of the nonhuman primate, Papio ursinus., Material and Methods: Class III furcation defects were surgically created bilaterally in the mandibular first and second molars of two adult Chacma baboons (P. ursinus). Different doses of recombinant transforming growth factor-beta3 reconstituted with Matrigel matrix were implanted in the rectus abdominis muscle to induce heterotopic ossicles for subsequent transplantation to selected furcation defects. Twenty days after heterotopic implantation, periodontal defects were re-exposed, further debrided and implanted with minced fragments of induced heterotopic ossicles. Contralateral class III furcation defects were implanted directly with recombinant transforming growth factor-beta3 in Matrigel matrix with the addition of minced fragments of autogenous rectus abdominis muscle. Treated quadrants were not subjected to oral hygiene procedures so as to study the effect of the direct application of the recombinant morphogen in Matrigel on periodontal healing. Histomorphometric analyses on undecalcified sections cut from specimen blocks harvested on day 60 measured the area of newly formed alveolar bone and the coronal extension of the newly formed cementum along the exposed root surfaces., Results: Morphometric analyses showed greater alveolar bone regeneration and cementogenesis in furcation defects implanted directly with 75 microg of transforming growth factor-beta3 in Matrigel matrix with the addition of minced muscle tissue., Conclusion: Matrigel matrix is an optimal delivery system for the osteogenic proteins of the transforming growth factor-beta superfamily, including the mammalian transforming growth factor-beta3 isoform. The addition of minced fragments of rectus abdominis muscle provides responding stem cells for further tissue induction and morphogenesis by the transforming growth factor-beta3 protein.

Tissue engineering in the head and neck area, presents numerous advantages. One of the most remarkable advantages is that regeneration of only a small amount of tissue can be highly beneficial to the patient, particularly in the field of periodontal tissue regeneration. For decades, successful osseointegration has provided thousands of restorations that maintain normal function. With the increasing need to utilize dental implants for growing patients and enhance their function to simulate normal tooth physiology and proprioception, there appears to be an urgent need for t concept of periodontal tissue regeneration around dental implants. In the present work, 5 goats wer used for immediate implant placement post canine teeth extraction. Each goat received 2 implan fixtures; the control side received a porous hollow root-form poly (DL-Lactide-co-Glycolide) scaf around the titanium fixture, and the experimental side received the same scaffold but seeded with autogenous bone marrow-derived mesenchymal stem cells. One animal was killed 10 days postoperatively, and the others were killed after 1 month. The results showed that on th experimental side, periodontal-like tissue with newly formed bone was demonstrated both at 1 days and after 1 month, while the control specimens showed early signs of connective tissue regeneration around the titanium fixture at 10 days, but was not shown in the 1 month specimens. I can be concluded that undifferentiated mesenchymal stem cells were capable of differentiating t provide the 3 critical tissues required for periodontal tissue regeneration: cementum, bone, a periodontal ligament. This work may provide a new approach for periodontal tissue regeneration.

Florid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. It usually exhibits as multiple radiopaque cemetum-like masses distributed throughout the jaws. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. Computed tomography, because of its ability to give axial, sagittal, and frontal views, is useful in the evaluation of these lesions. This paper presents the case of a patient who was diagnosed with FCOD on the basis of clinical and radiographic findings.

Cemental tears have been described as a fragment of cementum becoming detached from the root surface, which can lead to severe periodontal breakdown. A 50-year-old woman with no history of periodontal attachment loss had an asymptomatic, isolated deep pocket on the mesial aspect of tooth No. 14. The radiographic examination revealed a thin, chip-like radiopacity along the lateral aspect of tooth No. 14. Periodontal flap surgery revealed a cemental tear on the apical part of the tooth. The root fragment was removed and the intrabony lesion was treated with enamel matrix derivative. A clinical examination one year after surgery demonstrated resolution of the pocket. Radiographic examination revealed an apparent bone fill at the bottom and the mesial wall of the original defect. This case illustrates that severe attachment loss associated with a cemental tear can be treated successfully by removing the cemental fragment and applying enamel matrix derivative.

Benign cementoblastoma (BC) is a relatively rare odontogenic neoplasm characterized by the formation of a mass of cementum-like tissue connected to the root of a tooth. Clinically, BC has a slow and constant growth pattern, frequently accompanied by pain, and it promotes volume expansion on both the vestibular and lingual surfaces. Radiographically, it appears attached to the apical or lateral portion of the root of a tooth root as a densely radiopaque, well-circumscribed mass surrounded by a thick and uniform radiolucent halo. Treatment usually consists of surgical tooth extraction along with the attached calcified mass or endodontic treatment of the associated tooth, enucleation of the tumor and osseous curettage. In this article, the clinical, radiographic and histopathological features of one case of BC are presented and the variations of the cases cited in the literature are discussed.

The present study examined the root surfaces of teeth from children with or without periodontal diseases and with or without systemic diseases. Light microscopy revealed that when compared to control teeth: teeth with chronic periodontitis had similar radicular histology; teeth from children with leukocyte adhesion deficiency, Down syndrome and aggressive periodontitis had narrower cementum areas; teeth from children with hypophosphatasia showed cementum aplasia. Cementum anomalies may facilitate the establishment and progress of periodontitis in children.

The major concern in the therapeutics of tooth replantation refers to the occurrence of root resorption and different approaches have been proposed to prevent or treat these complications. The purpose of this study was to evaluate tissue response to delayed replantation of anterior rat teeth treated endodontically using calcium hydroxide, Sealapex, and Endofill without the placement of gutta-percha cones. Thirty rats had their right upper incisor extracted and maintained in dry storage for 60 min. After removal of the dental papilla, enamel organ, pulp tissue, and periodontal ligament remnants, the teeth were immersed in 2% sodium fluoride phosphate acidulated, pH 5.5, for 10 min. The root canals were dried with absorbent paper points and the teeth were assigned to three groups (n = 10) according to the filling material. Group I - calcium hydroxide and propyleneglycol paste, Group II - Sealapex, and Group III - Endofill. The sockets were irrigated with saline and the teeth were replanted. Replacement resorption, inflammatory resorption and ankylosis were observed in all groups. Although the occurrence of inflammatory resorption was less frequent in Group I, there were no statistically significant differences among the groups. It may be concluded that compared to the paste, filling the root canals with Sealapex and Endofill sealers without the placement of gutta-percha cones did not provide better results.

Replantation is an acceptable option for treatment of an avulsed permanent tooth. Nevertheless, an extended extraoral period damages the periodontal ligament and results in external root resorption. The purpose of this study was to assess by histologic and histometric analysis, the influence of propolis 15% (natural resinous substance collected by Apis mellifera bees from various plants) and the fluoride solution used as root surface treatment on the healing process after delayed tooth replantation. Thirty Wistar (Rattus norvegicus albinus) rats were submitted to extraction of their upper right incisor. The teeth were maintained in a dry environment for 60 min. After this, the pulp was extirpated and the papilla, enamel organ and periodontal ligament were removed with scalpel. The teeth were divided into three experimental groups: Group I - teeth immersed in 20 ml of physiologic saline; Group II - teeth immersed in 20 ml of 2% acidulated phosphate sodium fluoride; Group III - teeth immersed in 20 ml of 15% propolis. After 10 min of immersion in the solutions, the root canals were dried and filled with calcium hydroxide paste and the teeth were replanted. The animals were euthanized 60 days after replantation. The results showed that similar external root resorption was seen in the propolis and fluoride groups. Teeth treated with physiologic saline tended to have more inflammatory root resorption compared with those treated with fluoride or propolis. However, the comparative analysis did not reveal statistically significant differences (P > 0.05) between the treatment modalities when used for delayed tooth replantation.

Parathyroid hormone-related protein (PTHrP) is an integral mediator of physiologic and pathologic processes and has demonstrated actions in the periodontium. PTHrP functions via AP-1, and specifically through JunB. This study identified JunB-dependent downstream mediators of PTHrP using OCCM cementoblastic transfectants with JunB over- or reduced expression. Over-expressing cells showed an increase in proliferation, while the opposite was seen in siRNA transfected cells. Microarray analysis of over-expressing cells revealed more than 1000 regulated genes. Three genes were investigated in more detail. The PTH/PTHrP receptor (PTHR1) and ephrin B1 (EfnB1) were down-regulated, and vascular cell adhesion molecule-1 (VCAM-1) was up-regulated with JunB over-expression. JunB siRNA transfectants had increased PTHR1, but reduced ephrin B1 and unaltered VCAM-1 in vitro. To validate these targets, parental OCCM cells and primary osteoblasts were treated with PTHrP, resulting in reduced PTHR1 and ephrin B1, and increased VCAM-1. Cell transfectants were implanted subcutaneously in vivo, and microarray analysis and RT-PCR performed. Over-expression of JunB down-regulated PTHR1 and ephrin B1, and increased VCAM-1. JunB siRNA transfectant implants had increased PTHR1 and ephrin B1, but no altered VCAM-1. These data highlight new gene targets for PTHrP and indicate JunB is a critical mediator of PTHrP actions.

The regeneration of the periodontal attachment apparatus remains clinically challenging because of the involvement of three tissue types and the complexity of their relationship. Human recombinant bone morphogenic protein-2 (rhBMP-2) can accelerate the regeneration of bone and cementum and the insertion of periodontal ligament fibers but may lead to a deranged periodontal relationship, ankylosis and root resorption.This study evaluated a novel approach to regeneration of the periodontal attachment apparatus using a combination of ex vivo autologous bone marrow mesenchymal stem cells (MSCs) engineered by replication-defective adenovirus to express the BMP-2 gene and Pluronic F127 (PF127). Twenty-four periodontal defects were surgically created in 12 New Zealand white rabbits and randomly assigned to three experimental groups with MSCs: the advBMP-2 group; the advbetagal group; the MSC group and one control group: PF127 only. The regenerated periodontal attachment apparatus was assessed histologically and the total regenerated bone volume was calculated from three-dimensional computed tomography analysis.This approach regenerated not only cementum with Sharpey's fiber insertion, but also statistically significant quantities of bone, re-establishing a more normal relationship among the components of the regenerated periodontal attachment apparatus, which is beneficial for the maintenance of periodontal health.Ex vivo gene transfer using stem cells as vectors may provide an advantage of slower BMP-2 release, increasing cementogenesis. There is regeneration of the periodontal attachment apparatus, whereas direct usage of the protein (rhBMP-2) yields unhinged periodontal relationship. Thus, this approach may represent an alternative means for periodontal alveolar bone graft in clinical settings.

Background: The goal of this study was to evaluate clinically and histologically the healing of advanced intrabony defects following regenerative periodontal surgery with an enamel matrix derivative (EMD) combined with a new biphasic calcium phosphate (BCP)., Methods: Ten subjects, each of them displaying advanced combined 1- and 2-wall intrabony defects around teeth scheduled for extraction because of advanced chronic periodontitis and further prosthodontic considerations, were included in the study. The defects were consecutively treated with a combination of EMD + BCP. A notch was placed at the most apical extent of the calculus present on the root surface or at the most apical part of the defect (if no calculus was present) to serve as a reference for the histologic evaluation. At 9 months after regenerative surgery, nine of 10 teeth were extracted with some of their surrounding soft and hard tissues and processed for histologic evaluation., Results: There were no adverse effects related to EMD or the graft material used in any of the treated subjects. One tooth was not extracted because of the excellent clinical outcome. The clinical measurements at the nine biopsied teeth demonstrated a mean probing depth reduction of 3.3 +/- 1.4 mm and a mean clinical attachment level gain of 3.0 +/- 1.6 mm. The histologic findings indicated formation of cementum with inserting collagen fibers to a varying extent. A long junctional epithelium was observed in three of the nine biopsies. Mean new connective tissue attachment (i.e., new cementum with inserting collagen fibers) varied from 0.0 to 2.1 mm. The amount of newly formed bone was limited and varied from 0.0 to 0.7 mm. At 9 months, graft particles were still present and were mostly encapsulated in connective tissue, whereas formation of bone around the graft particles was observed only occasionally. Direct contact between the graft particles and the root surface (cementum or dentin) was not observed in any of the analyzed specimens., Conclusions: The combination of EMD with a BCP bone substitute did not interfere with the regenerative potential reported for EMD and may result in formation of new cementum with an associated periodontal ligament. However, the combination of EMD + BCP resulted in no to minimal new bone formation.

This paper describes a case of a 9-year-old patient who presented a completely intruded primary maxillary incisor because of a traumatic injury sustained at the age of 3 years. After tooth extraction, histological analysis revealed that the dentin-pulp complex was partially replaced by cementum, periodontal ligament and alveolar bone. No signs of ankylosis were noticed. It is suggested that the lack of spontaneous re-eruption of the traumatized primary tooth after 6 years could be due to the development of functional periodontal supporting tissues in the pulp chamber secondary to the traumatism.

Aim: To assess orthodontic intrusion effects on periodontal tissues in dogs' pre-molars with class III furcations treated with open flap debridement (OFD) or with guided tissue regeneration (GTR) associated to bone autograft (BA)., Material and Methods: Class III furcations were created in the pre-molars of seven mongrel dogs. After 75 days, teeth were randomly treated with OFD or GTR/BA. After 1 month, metallic crowns were assembled on pre-molars and connected apically to mini-implants by nickel-titanium springs. Teeth were randomly assigned to orthodontic intrusion (OFD+I and GTR/BA+I) groups or no movement (OFD and GTR/BA) groups. Dogs were sacrificed after 3 months of movement and 1 month retention., Results: All class III furcations were closed or reduced to class II or I in the intrusion groups, while 50% of the lesions in non-moved teeth remained unchanged. Intruded teeth presented higher probing depth and lower gingival marginal level than non-moved teeth (p<0.01). Clinical attachment gain was reduced in the intrusion groups by the end of retention (p<0.05). OFD+I presented smaller soft tissue area and larger bone tissue area than other groups (p<0.05)., Conclusion: Orthodontic intrusion with anchorage via mini-implants improved the healing of class III furcation defects after OFD in dogs. GTR/BA impaired those results.

Aim: Aim of this work was to carry out a comparative evaluation of the structural behaviour of different root canal posts (cylindrical, conical and triple conical) fitted in a second lower bicuspid and subjected to compression and bending test., Materials and Methods: This study has been carried out by numerical method of structural analysis of finite elements (FEM, Finite Element Method). Different tridimensional models were obtained by CAT images of an extracted tooth, endodontically treated, filled with guttapercha and triple conical glass post. Images have been elaborated by a software for images (Mimics and Ansys) and CAD (Rhinoceros 3 D). In the models a II Class restoration has been virtually created. In the numerical simulation dental tissues (enamel, dentine and root cement), guttapercha, root canal cement, different posts, different techniques of cementation and crown restoration (composites and adhesive systems) have been considered., Results: Strain distributions in dental tissues, in root canal cement and in posts have been compared. The equivalent tensions and the single components (traction, compression and cut) have been analysed. In all examined posts, the most strained part is resulted the coronal one, even if the total tension, in the different tooth-post analyzed systems, resulted uniformly distributed. A similar behaviour was shown by the root canal cement., Conclusions: According to the analyzed conditions of bond and load, varying according to the geometry of the considered posts, our results confirm that there is no substantial difference of deformation in posts, root canal cement and treated tooth.

Background: The ability of the periodontal ligament (PDL) to absorb and distribute forces is necessary for periodontal homeostasis. This adaptive response may be determined, in part, by a key molecule, periostin, which maintains the integrity of the PDL during occlusal function and inflammation. Periostin is primarily expressed in the PDL and is highly homologous to betaig-H3 (transforming growth factor-beta [TGF-beta] inducible gene). Cementum, alveolar bone, and the PDL of periostin-null mice dramatically deteriorate following tooth eruption. The purpose of this study was to determine the role of periostin in maintaining the functional integrity of the periodontium., Methods: The periodontia from periostin-null mice were characterized followed by unloading the incisors. The effect of substrate stretching on periostin expression was evaluated using a murine PDL cell line. Real-time reverse transcription-polymerase chain reaction was used to quantify mRNA levels of periostin and TGF-beta. TGF-beta1 neutralizing antibodies were used to determine whether the effects of substrate stretching on periostin expression are mediated through TGF-beta., Results: Severe periodontal defects were observed in the periostin-null mice after tooth eruption. The removal of masticatory forces in periostin-null mice rescue the periodontal defects. Periostin expression was increased in strained PDL cells by 9.2-fold at 48 hours and was preceded by a transient increase in TGF-beta mRNA in vitro. Elevation of periostin in response to mechanical stress was blocked by the addition of 2.5 ng/ml neutralizing antibody to TGF-beta1, suggesting that mechanical strain activates TGF-beta to have potential autocrine effects and to increase periostin expression., Conclusion: Mechanical loading maintains sufficient periostin expression to ensure the integrity of the periodontium in response to occlusal load.

Background: Topical injection of simvastatin in methylcellulose gel was shown to stimulate bone growth and inflammation over mouse calvaria and in rat mandible models. The purpose of these pilot studies was to evaluate the potential of locally injected simvastatin in human-sized periodontal defects., Methods: Chronic periodontal defects were created bilaterally in seven 1-year-old beagle dogs: 3-walled intrabony defects distal of the mandibular second premolar and mesial of the fourth premolar and Class II furcation defects at the buccal furcation of the mandibular first molars. The edentulous space distal to the mandibular canine was left undisturbed. After 16 weeks of healing, defect sites were treated with scaling and root planing, and mandible sides were randomly selected to receive three weekly injections of 0.5 mg simvastatin in 30 microl methylcellulose gel and contralateral gel alone (n=3) or 2.0 mg simvastatin/methylcellulose gel and contralateral gel alone (n=4). Two months following drug application, block sections, including teeth and surrounding tissues, and submandibular lymph nodes were obtained for histomorphometric analysis., Results: Two trends were noted in this pilot study: buccal edentulous ridge thickness was 29% greater with simvastatin, 0.5 mg, compared to gel alone (P=0.0845), and the simvastatin groups had bone-height loss in interproximal intrabony and furcation defects, but the length of new cementum in the interproximal intrabony defects was greater with simvastatin, 0.5 mg (0.35+/-0.14 mm), compared to gel alone (0.06+/-0.15 mm; P=0.069). No new cementum was found in furcations., Conclusions: Multiple injections of simvastatin are not appropriate for the treatment of intrabony or furcation defects. However, this approach shows potential to augment bone thickness in closed alveolar environments.

Objective: Cleidocranial dysostosis (CCD) is a skeletal disorder associated with dental anomalies such as failure or delayed eruption of permanent teeth and multiple impacted supernumerary or permanent teeth. Absence of cellular cementum at the root apex is presumed to be one of the factors for failure or delayed eruption. The aim of this study was to analyze the root cementum of supernumerary(S) and permanent teeth (P) of a CCD patient and to compare the findings with those of normal individuals with special emphasis on delayed eruption., Materials and Methods: Ground sections of 12 extracted teeth (9S + 3P) of a CCD patient and 12 teeth of normal individuals (5S + 7P) were taken for the study. The sections were longitudinal and 50 microm thick. Root characteristics were recorded with the aid of a light microscope., Results: The absence of apical cellular cementum, increased root resorption and increased percentage of the gap type of cemento-enamel (C-E) junctions were significant findings noted both in the supernumerary and permanent teeth of the CCD patient., Conclusion: The presumption of cellular cementum is essential for tooth eruption is not supported by the findings of the present study. Delayed exception could be attributed to various other factors like mechanical obstruction, reduced serum alkaline phosphatase levels etc. Also, the significance of the increased percentage of the gap type of C-E junctions and its role in tooth eruption has to be further evaluated.

Dentin Matrix Protein 1 (DMP1) is highly expressed in alveolar bone and cementum, which are important components of the periodontium. Therefore, we hypothesized that Dmp1 is critical for the integrity of the periodontium, and that deletion may lead to increased susceptibility to disease. An early-onset periodontal defect was observed in the Dmp1 null mouse, a mouse model of hypophosphatemic rickets. The alveolar bone is porous, with increased proteoglycan expression. The cementum is also defective, as characterized by irregular, punctate fluorochrome labeling and elevated proteoglycan. The osteocyte and cementocyte lacuno-canalicular system of both alveolar bone and cementum is abnormal, with irregular lacunar walls and fewer canaliculi. As a consequence, there is significant interproximal alveolar bone loss, combined with detachment between the periodontal ligament (PDL) and cementum. We propose that defective alveolar bone and cementum may account for the periodontal breakdown and increased susceptibility to bacterial infection in Dmp1 null mice.

Abnormal extrusion of canine teeth is often noted in middle-aged and geriatric domestic cats. The same age group of cats also is commonly affected by tooth resorption (TR). This study explored the relationship between these two phenomena of unknown etiology. Using digital radiography, the distance between the alveolar margin (AM) and cementoenamel junction (CEJ), referred to as the AM-CEJ distance, was measured in clinically and radiographically healthy maxillary canine teeth of 24 TR-affected and 29 TR-free cats. The mean AM-CEJ distance of maxillary canine teeth of cats with and cats without TR was 2.68-mm and 2.22-mm, respectively. An analysis of covariance adjusting for age revealed a significant correlation (p = 0.02) between tooth extrusion and TR. Extrusion of the maxillary canine teeth became clinically apparent when an AM-CEJ distance of 2.5-mm or greater was evident in the absence of horizontal or vertical alveolar bone loss. Based on this criterion, 15 of 24 cats with TR (63.0 %) exhibited extrusion of maxillary canine teeth, compared to 9 of 29 cats without TR (31.0 %). Four extruded and five non-extruded maxillary canine teeth were evaluated histologically. Cementum of extruded teeth was significantly thicker compared to that of non-extruded teeth. Four of 4 canine teeth with extrusion (100 %) showed histological evidence of resorption, compared to 1 of 5 canine teeth without extrusion (20.0 %). These results suggest that tooth extrusion is linked to or may be caused by similar factors responsible for the development of TR.

Objective: To investigate whether cirrhosis and cholestasis could influence orthodontic tooth movement., Design: Basic science, animal experimental study., Setting: This study was conducted in the Department of Pharmacology, School of Medicine at Tehran University of Medical Sciences in 2007., Participants: A total of 40 male Sprague-Dawley rats (150-200 g) were divided into five experimental groups: non-operated, cholestatic-sham, cirrhotic-sham, cholestatic and cirrhotic groups., Methods: An orthodontic appliance, consisting of a 5 mm nickel titanium closed coil spring, was ligated between the maxillary right incisor and first molar of each rat to deliver an initial force of 60 g. The cholestatic and cirrhotic groups underwent a bile duct ligation operation and received an orthodontic appliance for 7 days (cholestatic group) and 28 days (cirrhotic group) after surgery. Two other groups underwent a sham operation and had an orthodontic appliance inserted after 7 (cholestatic-sham) and 28 days (cirrhotic-sham). A fifth control group underwent neither bile duct ligation operation nor sham operation., Results: The cirrhotic group showed significantly increased orthodontic tooth movement (OTM), compared to all other study groups (P<0.001). The mean OTM in the cholestatic group was significantly higher than in the other three groups (two sham groups and unoperated one) (P<0.01). Bone density was also significantly decreased in the bile duct ligated (cirrhotic and cholestatic) groups (P<0.01)., Conclusion: Our data demonstrated that biliary cirrhosis could cause a significant increase in the OTM and decrease in the bone density in rats, though there was no significant alteration in bone resorption or osteoclasts detected in such animals.

Objective: To test the hypothesis that there is no difference in the effect of different continuous moderate to very heavy forces on root resorption or amount of tooth movement., Materials and Methods: In the study, 10, 25, 50 and 100 g mesial force were applied to the maxillary first molars of rat using nickel titanium closed-coil springs for 3 days, 14 days, and 28 days. The molars were extracted and the surface areas of the root resorption craters were measured using scanning electron microscope. The depths of the root resorption craters were measured using a three-dimensional laser scanning microscope. Tooth movement of the maxillary first molar was measured in relation to the maxillary second molar on digitized lateral cephalometric radiographs., Results: Three days after force application, the tooth movement was not proportionally related to force magnitude. However, 14 days of force application resulted in significantly more tooth movement in the 10, 25, and 50 g force groups than in the 100 g force group. A force application of 10 g produced significantly more tooth movement at 28 days than all the other three force applications. The largest and deepest resorption craters were observed in the disto-buccal root followed by disto-palatal, middle-buccal, middle-palatal, and mesial root. Root resorption and tooth movement increased over time from 3 to 28 days. As heavier forces were applied, greater root resorption occurred., Conclusion: The hypothesis is rejected. The light mesially oriented forces, as applied in this study, produced more tooth movement and less root resorption compared with heavier forces.

Purpose: Regional odontodysplasia (RO) is a rare developmental odontogenic defect. The affected teeth are described as "ghost teeth," due to malformation of dentin, enamel, and cementum. The purpose of this study was to describe the ultrastructural characteristics of the affected teeth as well as the immunohistochemical features of the soft tissue associated with 2 cases of regional odontodysplasia., Methods: Two cases diagnosed as RO were included on the study. After diagnosis, affected teeth and associated soft tissue were surgically removed from both patients and processed for light and scanning electron microscopy (SEM) analysis. For light microscopy, the specimens were decalcified in 5% nitric acid for 10 to 16 days and stained with hematoxylin and eosin. For SEM studies, specimens were cleaned with diamond paste and, after polishing, treated with 37% phosphoric acid for 5 minutes and covered by a thin layer of metallic gold. Soft tissues covering and surrounding the extracted teeth were routinely processed, and submitted to immunohistochemical reactions against pan-cytokeratins, cytokeratin 19, vimentin, laminin and collagen IV., Results: Both enamel and dentin showed gross alterations, including hypomineralization and discoloration, being more prominent on the coronal structures than the radicular structures. Ultrastructural features included alterations on the prismatic enamel surface, dentinal grooves, interglobular dentin, and hypoplastic and hypocalcified dental hard tissues. The soft gingival and alveolar tissue surrounding and covering the affected teeth showed calcifications and odontogenic remnants, positive for cytokeratin 19, laminin, and collagen IV., Conclusions: Enamel and dentin are grossly altered in regional odontodysplasia, while cementum is less affected, and soft-tissue calcifications are associated with odontogenic cytokeratin-positive epithelial remnants, in addition to mesenchymal components.

Purpose: The aim of this in vitro study was to evaluate the polymerization shrinkage and the microleakage of direct resin-based restorative materials commonly used in pediatric dentistry., Methods: Standardized Class V cavities overlapping the cementoenamel junction were prepared on the buccal and the lingual surfaces of 40 extracted human mandibular third molars (36 specimens, 4 controls). The cavities were restored with 4 different materials: a packable resin composite (Filtek P60), a compomer (Compoglass F), an ormocer (Admira) and their associated bonding agents (Scotchbond 1, Excite, and Admira Bond, respectively), and a resin-modified glass ionomer (Fuji II LC). The teeth were then immersed in methylene blue solution for 48 hours. Dye penetration was evaluated for all materials, which were analyzed using a multivariate model (alpha=0.05): influence of microleakage score, margin location (enamel/cementum), and preparation location (buccal/lingual). Multivariate analysis was performed using a polychotomous logistic regression. Polymerization shrinkage was evaluated by the disk deflective method. The percentage of polymerization shrinkage (N=3) was evaluated by ANOVA and Tukey test., Results: Regarding polymerization shrinkage, the P60 demonstrated the lowest value, followed by ADM and COF, whereas FLC presented the highest shrinkage-strain (P<.0001). The preparation location had no significant effect on dye penetration (P=.86). Margin location (enamel or cementum) had a significant effect on microleakage (odds ratio [OR]=24.61). Significant differences in the microleakage patterns and scores were also observed between the 4 restorative materials. Admira exhibited the lowest overall microleakage. In comparing Filtek P60, Compoglass F, and Fuji II LC to Admira, P60 showed significantly less microleakage (OR=1.30) than Fuji II LC (OR=1.47), whereas Compoglass F demonstrated the greatest significant overall microleakage (OR=3.15)., Conclusion: Within the experimental conditions of this in vitro study, the microleakage was significantly lower at the enamel margins than at the cementum margins for the four restorative materials tested. The ormocer and the packable resin composite exhibited the best sealing ability, as well as the lowest polymerization shrinkage. It could not be demonstrated in this study, however, that the higher the polymerization shrinkage was, the lower the marginal sealing ability was.

The group of odontogenic ectomesenchymal tumors consists of odontogenic fibroma (epithelium-rich and epithelium-poor types), odontogenic myxoma, and cementoblastoma. Whereas odontogenic fibromas and cementoblastomas are very rare lesions, odontogenic myxoma is the fourth common odontogenic tumor, preceded only by keratocystic odontogenic tumor, the odontomas, and ameloblastoma. The diagnosis of cementoblastoma rests on its connection to the root of a tooth. The differentiation of odontogenic fibroma and myxoma from other lesions, especially from normal structures such as dental follicles and papillae, may be challenging if the X-ray appearance (localized osteolysis containing a tooth) is not appreciated and subtle histological clues (remainders of inner enamel epithelium at the surface of the lesion, dentin fragments) are not properly recognized. While odontogenic fibromas have almost no tendency for recurrence and are treated by enucleation or local excision, cementoblastomas and especially odontogenic myxomas have a high percentage of recurrence if intralesional procedures are applied. Hence, complete resection with free margins is recommended--at least for larger odontogenic myxomas and, especially, lesions in the maxilla--to prevent further extension to the orbita or base of the skull.

Benign "mixed"odontogenic tumors consist of an epithelial and ectomesenchymal tumor component, distinguishing them from pure epithelial and pure ectomesenchymal odontogenic tumors. In addition, they may have the ability to produce dentin, enamel or cementum. Therefore, they can sometimes already be differentiated radiologically from epithelial odontogenic tumors. Some of the mixed odontogenic lesions are regarded as true tumors (ameloblastic fibroma, odontoameloblastoma, dentinogenic ghost cell tumor), while others are assumed to represent hamartomatous lesions (complex and compound odontoma, probably also ameloblastic fibrodentinoma and ameloblastic fibroodontoma). Preceded by keratocystic odontogenic tumor, complex and compound odontomas are the second most common odontogenic tumors, while other members of the "mixed" odontogenic tumor group are far less frequently diagnosed. Odontoameloblastoma and dentinogenic ghost cell tumors are locally aggressive lesions that require total resection. All other lesions of this group are treated by local excision. Since ameloblastic fibrosarcoma may evolve from ameloblastic fibroma, patients with ameloblastic fibroma should remain in long-term follow-up.

This study histologically evaluated recombinant human platelet-derived growth factor-BB (rhPDGF-BB) in combination with beta-tricalcium phosphate (beta-TCP) for the treatment of human intraosseous periodontal defects. Eight patients, each with two teeth treatment planned for extraction, were enrolled. Presurgical measurements included probing depth, clinical attachment level, and recession. Initial surgery consisted of flap reflection, debridement, placement of a root notch through the base of calculus, scaling and root planing, root biomodification with 50 mg/mL tetracycline, grafting with rhPDGF-BB + beta-TCP, and complete wound closure. One tooth in each patient was treated with 0.3 mg/mL of rhPDGF-BB + beta-TCP, and the other tooth was treated with 1.0 mg/mL of rhPDGF-BB + beta-TCP. After a minimum of 6 months of healing, postsurgical clinical measurements were made, and teeth were removed en bloc. Soft tissue healing was uneventful. Histologic evaluation demonstrated new bone, cementum, and periodontal ligament coronal to the reference notch in 13 of the 16 teeth. Six of the eight 0.3-mg/mL sites and seven of the eight 1.0-mg/mL sites demonstrated periodontal regeneration. This study provides proof of principle that 0.3 mg/mL and 1.0 mg/mL of rhPDGF-BB and beta-TCP can promote periodontal regeneration in human intraosseous periodontal defects.