Dental Root Resorption Research Articles

Vascular Anomalies and Congenital Infiltrating Lipomatosis May Affect Dental Maturation and Development - a Case Control Study.

Vascular anomalies are often associated with hypertrophy and asymmetry of soft tissues and bony structures. The aim of this retrospective cross-sectional radiographic study was to evaluate dental maturation and development in patients with facial vascular anomalies and congenital infiltrating lipomatosis. A sample of 342 patients with different vascular anomalies or congenital infiltrating lipomatosis involving the head and neck area was narrowed down to 31 patients with dental panoramic radiographs taken in the mixed dentition. A control group of 172 age-matched healthy subjects was used. Individual permanent teeth were given a maturation score from 1 to 12 and alveolar eruption stage according to Haavikko et al. 1970. The laterality of the anomaly was noted if applicable. Differences in dental development between affected and unaffected sides were recorded. The study data included both syndromic and non-syndromic vascular anomalies as well as congenital infiltrating lipomatosis and segmental odontomaxillary dysplasia. Teeth on the side of the anomaly were more developed and the eruption of teeth was accelerated with canines, premolars and second molars being most affected. Interestingly all the patients with Sturge-Weber syndrome (n = 4) and infiltrating lipomatosis (n = 2) showed accelerated dental maturation of multiple permanent teeth on the side of the anomaly. Hypodontia, dental root resorption and macrodontia were also found. Accelerated development and eruption of permanent teeth unilaterally in patients with vascular anomalies and congenital infiltrating lipomatosis may have a significant impact on the developing occlusion and should be thus followed by an orthodontist.

Root resorption of primary molars and dental development of premolars in children with Osteogenesis Imperfecta medicated with bisphosphonates, grouped according to age and gender

BackgroundOsteogenesis imperfecta (OI) is an inherited disorder characterized by bone fragility and skeletal alterations. The administration of bisphosphonates (BPs) to patients with OI reduces pain, thereby improving their quality of life. The main mechanism of action of BPs is the inhibition of osteoclast action. In the oral cavity of children with OI during growth and development, physiological processes that require the function of osteoclasts occur. The aim of this investigation was to study the dental development of premolars and the root resorption of primary molars in children with OI medicated with BPs according to age and sex.MethodsAn observational and analytical study was designed. The study sample consisted of 26 6- to 12-year-old children with a confirmed diagnosis of OI treated with BPs with available panoramic radiographs. The control group consisted of 395 children with available panoramic radiographs. Both groups were divided into subgroups according to sex and age. The third quadrant was studied, focusing on the first left temporary molar (7.4), the second left temporary molar (7.5), the first left permanent premolar (3.4) and the second left permanent premolar (3.5). The Demirjian method was used to study the dental development of 3.4 and 3.5, and the Haavikko method was used to study the root resorption of 7.4 and 7.5. The Mann‒Whitney U test was used for comparisons, and p < 0.05 indicated statistical significance.ResultsThe mean chronological age of the 421 patients was 9.21 years (95% CI 9.05–9.37). The sample was reasonably balanced by sex, with 52.5% (221 patients) boys versus 47.5% (200 patients) girls. Delayed exfoliation and tooth development were described in children with OI (p = 0.05). According to sex, the root resorption of primary molars and tooth development were significantly lower in boys in both groups and in girls in the OI group, but the differences between the age groups were not significant.ConclusionsChildren with OI treated with BPs exhibit delayed dental development of the premolars and delayed root resorption of the primary molars. Boys exhibited delays in both variables, but the differences by age subgroup were not significant. These clinical findings support the importance of clinically and radiographically monitoring the dental development and root resorption of primary teeth in children with OI treated with BPs to avoid alterations of the eruptive process.

A newly developed kit for dental apical root resorption detection: efficacy and acceptability

ObjectivesTo determine the efficacy of a newly developed kit in dentine sialophosphoprotein (DSPP) detection and compare it with enzyme-linked immunosorbent assay (ELISA). User acceptance was also determined.Materials and methodsThis cross-sectional study consisted of 45 subjects who were divided into 3 groups based on the severity of root resorption using radiographs: normal (RO), mild (RM), and severe (RS). DSPP in GCF samples was analyzed using both methods. Questionnaires were distributed to 30 orthodontists to evaluate future user acceptance.ResultsThe sensitivity and specificity of the kit were 0.98 and 0.8 respectively. The DSPP concentrations measured using ELISA were the highest in the RS group (6.33 ± 0.85 ng/mL) followed by RM group (3.77 ± 0.36 ng/mL) and the RO group had the lowest concentration (2.23 ± 0.55 ng/mL). The new kit portrayed similar results as the ELISA, the optical density (OD) values were the highest in the RS group (0.62 ± 0.10) followed by RM group (0.33 ± 0.03) and the RO group (0.19 ± 0.06). The differences among all the groups were statistically significant (p < 0.05) for both methods. The Pearson correlation coefficient showed a statistically significant (p < 0.001) strong and positive correlation between DSPP concentrations and OD values.ConclusionsThe new kit was validated to detect the colour intensities of different severity of root resorptions. Most of the responses to the survey were positive towards the new kit for being a safer and simpler method to detect apical root resorption.

The Correlation between the Bone Morphotype and Density and Root Apical Resorption of the Anterior Teeth Due to Orthodontic Forces

The potential side effects of modern orthodontic treatment and its unfavorable impact on dentition and hard tissues have been extensively discussed in professional literature for decades. The presence of uncontrolled forces can result in pulp necrosis, radicular reabsorption, and/or loss of alveolar bone. Dehiscence and fenestration are more commonly found in anterior than posterior teeth, where only the periodontal ligament and the mucosa protect the dental root.&#x0D; Most studies investigating the effect of periodontal phenotype over gingival recession in orthodontic patients have primarily focused on examining the soft tissues. However, due to the vulnerability of thin alveolar bone, the previous evaluation of orthodontic candidate patients may also include the analysis of hard tissues. Bone density plays an important role in facilitating orthodontic tooth movement, such that reductions in bone density can significantly increase movement velocity. These types of localized density changes can affect the rate of orthodontic tooth movement and may also influence the risk of unwanted outcomes, such as the occurrence of dental external apical root resorption.&#x0D; According to the literature, the links of root resorption with the bone morphotype and the density are relevant in clinical dentistry but have not been studied in detail. However, the existing data is not yet conclusive.

The effect of marsupialization of large cystic lesions of the jaws on pulp vitality

AbstractIntroductionThere is a paucity of studies evaluating the preservation and recovery vitality of teeth associated with cystic lesions in the jaws.The purpose of the present study was to evaluate whether the use of the marsupialization treatment method in the large cystic lesions of the jaws associated within involved teeth would save the pulp vitality.Materials and methodsIt was a cohort study of patients treated at the Department of Oral and Maxillofacial Surgery from April 2019 to April 2023. Patients with primary cystic lesions associated teeth, with a cyst diameter of &gt;3.4 cm, along with dental root resorption of less than half the root length, and treated by marsupialization were included. Patient age, gender, location, associated teeth, size, management, dental pulp vitality before and after marsupialization, and the duration of treatment were evaluated. Pulp vitality of involved teeth was assessed with electrical pulp tester.Predictor VariableIt was the treatment method.Main Outcome Variable(s)The primary outcome variable was the recovery or preservation of pulp vitality.CovariatesThe study variables were demographic, clinical features of the cysts, clinical features of associated teeth, and treatment method.AnalysesCategorical data were presented in mean with standard deviation, and set the level of statistical significance at p &lt; 0.05.ResultsThe sample included 73 patients with large cystic lesions; 47 (64.4%) were male and 26 (35.6%) were female. The age range was 9 to 68 years (mean ± standard deviation, 22.4 ± 4). The 73 patients had 305 teeth associated with large cystic lesions. Of these dentitions, 85.9% of teeth had normal pulp vitality and 14.1% were negative before marsupialization. Following marsupialization, preservation of pulp vitality was noted in 61.3% and 18.0% of teeth lost their vitality. Of those without normal dental pulp vitality, 70.9% of teeth recovered their vitality of which 46.5% had recovered their vitality 9 to 12 months following marsupialization.ConclusionMarsupialization followed by second surgery maybe a treatment option for preserving and recovering the pulp vitality of teeth associated with large cystic jaw lesions.

Evaluation of dental manifestations in X-linked hypophosphatemia using orthopantomography.

X-linked hypophosphatemia (XLH) is the most common inherited form of rickets. The presence of sequence variations in the phosphate regulating endopeptidase homolog X-linked (PHEX) gene is associated with increased production of fibroblast growth factor 23 (FGF23). This results in renal phosphate wasting and impaired skeletal mineralization. Spontaneous dental abscesses, caused by endodontic infections resulting from hypomineralization of dentin, are a known dental complication of XLH. There is no objective method to evaluate the severity of dentin dysplasia. The purpose of this study was to develop a quantitative method to evaluate dentin dysplasia using orthopantomography that would allow the values in patients with XLH to be compared with the values in healthy participants of the same age. The severity of dentin dysplasia was analyzed by measuring the pulp cavity area of the tooth using orthopantomographic images. The teeth analyzed were mandibular second primary molars and mandibular first permanent molars with complete root formation. Teeth with dental caries, restorations, or root resorption were excluded. This retrospective observational study included a total of 200 images of healthy participants (aged 2-15 years) divided into five age groups and 42 images of 17 patients with XLH. There was a significant tendency for the pulp cavity area to decrease with increasing age in primary and permanent teeth. The pulp chambers of patients with XLH were larger than those of healthy participants in primary and permanent teeth. We have established a method of using orthopantomography for quantitative assessment of dentin dysplasia in XLH from the primary dentition to the permanent dentition. Evaluating the severity of dentin hypomineralization by this method is useful in the diagnosis of the dental manifestations of XLH. Early diagnosis of XLH enables oral management and leads to prevention of dental abscesses.

Analysis of Primary Tooth Extractions and Associated Factors in 3 to 5-Year-Old Children in Kabul, Afghanistan: A Retrospective Study.

Understanding the patterns and reasons behind the extraction of children's primary teeth is crucial for improving oral health outcomes. This retrospective investigation aimed to discern the patterns and factors contributing to primary tooth extraction among pediatric patients aged 3 to 5 years treated at the Pediatric Surgery Department of the National Curative and Specialized Stomatology Hospital in Kabul, Afghanistan. Between January and May 2023, we conducted an extensive review of dental records, focusing on patients aged 3 to 5 years who had undergone primary tooth extraction. Data were collected on patients' age, gender, specif tooth extracted, and reasons for tooth extraction. Statistical analysis was performed using SPSS Statistics version 25. Among 150 subjects reviewed, 53.3% were male. Primary first molars were the most commonly extracted teeth (29.3%). Dental caries was the leading cause of extraction (50%), followed by periodontitis (31.3%) and root resorption (18.7%). Mandibular extractions (58.6%) were more frequent than maxillary extractions (41.4%). No significant differences were found based on age or tooth type. Weak correlations were observed between specific tooth extractions, age, and etiology. This study reveals a higher frequency of extractions in older children, primarily due to dental caries, periodontitis, and root resorption, with a slight male predominance. While no significant differences were noted in extraction patterns based on age or tooth type, understanding these trends is essential for improving pediatric dental care.

Pulp revascularization procedure for external inflammatory dental root resorption treatment

To assess the effectiveness of pulp revascularization procedure in children with external inflammatory root resorption (EIRR) after constant teeth injury. The study comprised 17 children aged 6-10 years diagnosed with EIRR as a long-term complication of dental trauma in 19 teeth. EIRR was diagnosed with periapical radiographs and CBCT was performed to further assess the pathology extension. Pulp revascularization was carried out in all 19 teeth. There was no resorption progression in all cases. EIRR areas were substituted by bone. In 10 from 19 teeth with early stages of root development bone or cement-like tissue ingrowth into the root canal was observed radiologically. In cases of severe EIRR this ingrowth may partially compensate for lost tissues which is confirmed by a high percentage (94.7%) of functional teeth during mean follow up time of 38±10 months. Pulp revascularization is an effective method for retaining teeth with EIRR for a relatively long period of time and allows maintaining alveolar bone volume both due to functional tooth preservation and healing of bone lesions in periapical and resorption areas.

Metabolomic signatures distinguish extracellular vesicles from osteoclasts and odontoclasts.

Pathological dental root resorption and alveolar bone loss are often detected only after irreversible damage. Biomarkers in the gingival crevicular fluid or saliva could provide a means for early detection; however, such biomarkers have proven elusive. We hypothesize that a multiomic approach might yield reliable diagnostic signatures for root resorption and alveolar bone loss. Previously, we showed that extracellular vesicles (EVs) from osteoclasts and odontoclasts differ in their protein composition. In this study, we investigated the metabolome of EVs from osteoclasts, odontoclasts and clasts (non-resorbing clastic cells). Mouse haematopoietic precursors were cultured on dentine, bone or plastic, in the presence of recombinant RANKL and CSF-1 to trigger differentiation along the clastic line. On Day 7, the cells were fixed and the differentiation state and resorptive status of the clastic cells were confirmed. EVs were isolated from the conditioned media on Day 7 and characterized by nanoparticle tracking and electron microscopy to ensure quality. Global metabolomic profiling was performed using a Thermo Q-Exactive Orbitrap mass spectrometer with a Dionex UHPLC and autosampler. We identified 978 metabolites in clastic EVs. Of those, 79 are potential biomarkers with Variable Interdependent Parameters scores of 2 or greater. Known metabolites cytidine, isocytosine, thymine, succinate and citrulline were found at statistically higher levels in EVs from odontoclasts compared with osteoclasts. We conclude that numerous metabolites found in odontoclast EVs differ from those in osteoclast EVs, and thus represent potential biomarkers for root resorption and periodontal tissue destruction.

A review on accelerated orthodontics.

When the duration of orthodontic treatment is shortened, the patient may have a number of benefits, including an increase in the number of dental cavities, root resorption, and gingival irritation, all of which are associated to a higher degree of decalcification. In addition to drugs, magnets, and other therapies, they include surgical methods (corticotomies, piezosurgery), mechanical/physical stimulation techniques (vibration, lasers), and other forms of therapy. These methods, each of which has been validated by extensive research, have been shown to reduce treatment times.

Correlations between radiological and histological findings of bone remodelling and root resorption in a rodent cleft model

BackgroundThe evaluation of bone remodelling and dental root resorption can be performed by histological techniques or micro-computed tomography (micro-CT). The present study aimed to evaluate the relationship between these two procedures in the context of cleft repair in a rat model.MethodsThe reconstructed maxillae and the orthodontically-moved first molar of 12 rats were analysed for correlations between the histological and radiological findings retrospectively. The alveolar cleft repairs were performed using bone autografts or (human) xenografts. Four weeks after the operation, the intervention of the first molar protraction was initiated and lasted for eight weeks. The newly formed bone and the root resorption lacunae were determined via histology. In the micro-CT analysis, the average change of bone mineral density (BMD), bone volume fraction (BV/TV), trabecular thickness and trabecular separation of the jaw, as well as the volume of the root resorptions were determined. The Pearson correlation coefficient was applied to study the associations between groups.ResultsPositive correlations were found only between the newly formed bone (histology) and BMD changes (micro-CT) in the autograft group (r = 0.812, 95% CI: 0.001 to 0.979, p = 0.05). The relationship of newly formed bone and BV/TV was similar but not statistically significant (r = 0.691, 95% CI: −0.274 to 0.963, p = 0.013). Regarding root resorption, no significant correlations were found.ConclusionsDue to the lack of correlation between histological and radiological findings of bone remodelling and the development of root resorptions, both methods should be combined in this cleft model in rats for a comprehensive analysis.

Analysis of Osteoclasts and Root Resorption in Corticotomy-Facilitated Orthodontics with Ibuprofen Administration-An Animal Study.

Following corticotomy surgery, patients experience moderate to severe post-operative pain that necessitates prescriptions of analgesics. The prostaglandin inhibitory effect of ibuprofen influences the mobility of teeth during orthodontic treatment. This study aimed to determine how ibuprofen affects histological reactions and dental root resorption during orthodontic tooth movement aided by corticotomy. Forty-two male Wistar rats were divided into three groups by random selection: (1) control group, (2) corticotomy group (CO), and (3) corticotomy with 0.6 mL of 15 mg/kg ibuprofen group (CI). On each buccal and palatal alveolar bone, two decortication points were made. Orthodontic tooth movement was induced on the maxillary first molar for 21 days utilizing a NiTi-closed coil spring with 10 g of force. Hematoxylin and eosin were used to prepare and stain the histological sections. The numbers of osteoclasts on days 0, 7, 14, and 21 were determined, and the root resorption area on days 0 and 21 was measured. Compared to the control group, the osteoclast counts in the CO and CI groups were considerably greater (p < 0.002). No significant differences were observed between the CO and CI groups in the numbers of osteoclasts or the percentages of root resorption (p > 0.05). The amounts of osteoclast activity and root resorption were unaffected by the administration of ibuprofen in corticotomy-facilitated tooth movement.

Dietary salt and myeloid NFAT5 (nuclear factor of activated T cells 5) impact on the number of bone-remodelling cells and frequency of root resorption during orthodontic tooth movement

PurposeThe aim of the study was to investigate the impact of dietary salt and the osmoprotective transcription factor nuclear factor of activated T cells 5 (NFAT5) in myeloid cells on bone remodelling cells as osteocytes, osteoblasts and osteoclasts and on force-induced dental root resorptions in a mouse model. MethodsControl mice and mice lacking myeloid NFAT5 (nuclear factor of activated T cells 5) were either kept on low, normal or high salt diets. After one week on the specified diet an elastic band was inserted between the first and second molar to induce orthodontic tooth movement. One week later the mice were euthanised and jaws were fixed for histological analysis. Osteocyte, osteoblast and osteoclast numbers as well as extent of root resorptions were assessed histologically. ResultsOsteocyte number was diminished with high salt diet in wildtype mice. Osteoblast numbers increased with low salt diet in control mice and reduced with high salt diet in mice without NFAT5 in myeloid cells. High salt diet tended to increase osteoclast number in control mice. In mice without myeloid NFAT5, numbers of osteoclasts were reduced under high salt diet. Frequency of force-induced root resorptions tended to be dependent on dietary salt content in control mice. ConclusionDuring orthodontic tooth movement dietary salt impacts on the frequency of root resorptions and the number of osteoclasts and osteoblasts in alveolar bone of mice. This can affect bone remodelling during orthodontic treatment. Myeloid NFAT5 impacts on this salt-dependent reaction.

Immunorthodontics: Role of HIF-1α in the Regulation of (Peptidoglycan-Induced) PD-L1 Expression in Cementoblasts under Compressive Force.

Patients with periodontitis undergoing orthodontic therapy may suffer from undesired dental root resorption. The purpose of this in vitro study was to investigate the molecular mechanisms resulting in PD-L1 expression of cementoblasts in response to infection with Porphyromonas gingivalis (P. gingivalis) peptidoglycan (PGN) and compressive force (CF), and its interaction with hypoxia-inducible factor (HIF)-1α molecule: The cementoblast (OCCM-30) cells were kinetically infected with various concentrations of P. gingivalis PGN in the presence and absence of CF. Western blotting and RT-qPCR were performed to examine the protein expression of PD-L1 and HIF-1α as well as their gene expression. Immunofluorescence was applied to visualize the localization of these proteins within cells. An HIF-1α inhibitor was added for further investigation of necroptosis by flow cytometry analysis. Releases of soluble GAS-6 were measured by ELISA. P. gingivalis PGN dose dependently stimulated PD-L1 upregulation in cementoblasts at protein and mRNA levels. CF combined with P. gingivalis PGN had synergistic effects on the induction of PD-L1. Blockade of HIF-1α inhibited the P. gingivalis PGN-inducible PD-L1 protein expression under compression, indicating an HIF-1α dependent regulation of PD-L1 induction. Concomitantly, an HIF-1α inhibitor decreased the GAS-6 release in the presence of CF and P. gingivalis PGN co-stimulation. The data suggest that PGN of P. gingivalis participates in PD-L1 up-regulation in cementoblasts. Additionally, the influence of compressive force on P. gingivalis PGN-induced PD-L1 expression occurs in HIF-1α dependently. In this regard, HIF-1α may play roles in the immune response of cementoblasts via immune-inhibitory PD-L1. Our results underline the importance of molecular mechanisms involved in bacteria-induced periodontics and root resorption.

Effect of various biological ways on the orthodontic tooth movement

The duration of orthodontic treatment is the primary concern of utmost patients. Unfortunately, long orthodontic treatment time poses several disadvantages like an advanced predilection to dental caries, gingival recession, and root resorption. Thus, there is an increase in the demand to find the best method of faster tooth movement. Orthodontic treatment is formed on the premise that when force is delivered to a tooth and thereby transmitted to the adjacent investing tissues, certain mechanical, chemical, and cellular events take place within these tissues, which allow for the structural difference that contributes to the tooth movement. Conventionally, this process is slow, and orthodontic treatment time can range anywhere from 36-48 months. The body's responses to these forces are the crucial controllers of inflammation and tissue turnover. So, in this article, various pharmacological means are discussed that can enhance the rate of tooth movement.

Considerações sobre reimplantes dentários: condutas clínicas e ortodônticas frente a estas situações

Based on a literature review, the objective of this study is to establish the degree of dental analysis or root resorption that allows replanted teeth to be moved using orthodontic appliance. Some aspects of avulsion and replanted teeth such as etiology, clinical approach and prognosis are considered. It is also presented a literature review of orthodontic tooth movement. According to most authors, the replant is frequently followed by analysis that doesn't allow orthodontic movement. Nevertheless, the lack of resorption signs during a minimum period of one year allows orthodontic treatment when necessary.

Open vs closed surgical exposure of palatally displaced canines: a comparison of clinical and patient-reported outcomes-a multicentre, randomized controlled trial.

To compare treatment time, patients' perceptions during orthodontic treatment, dental fear and side effects, between open and closed surgical exposures in patients with palatally displaced canines (PDCs). Multicentre, randomized controlled trial, with random 1:1 allocation of two parallel groups. One hundred and twenty patients from three different orthodontic centres were randomized into one of the two intervention arms, open or closed surgical exposure. Both techniques had mucoperiosteal flaps raised and bone removed above the PDCs. In open exposure, tissue was removed above the canine, and glass ionomer - reaching above soft tissue - was built on the crown. The canine was then left to erupt spontaneously, prior to orthodontic alignment. At closed exposure, a chain was bonded to the canine and orthodontic traction was applied under the mucosa until eruption. Orthodontic alignment of the canines was undertaken after eruption into the oral cavity, with fixed appliances in both groups. All participants were treated according to intention to treat (ITT). Due to the nature of this trial, only outcome assessors could be blinded to the intervention group. One hundred and seventeen patients completed the trial. All PDCs were successfully aligned. Total treatment time was equal in the two techniques, mean difference -0.1 months (95% CI -3.2 to 2.9, P = 0.93). The closed group experienced more pain and discomfort during the active orthodontic traction. Dental fear, root resorption and periodontal status did not show any clinically significant differences between the groups. Results of this randomized controlled trial (RCT) can be generalized only to a similar population aged 9-16 years, if exclusion criteria are met. The closed exposure group experienced more pain and discomfort mostly during active orthodontic traction. All other studied outcomes were similar between the two exposure groups. ClinicalTrials.gov, ID: NCT02186548 and Researchweb.org, ID: 127201.

Prognostic markers of post-traumatic dental external root resorption in children-a pilot study.

External inflammatory root resorption (EIRR) is a frequent complication of traumatic dental injuries (TDI). The aim of this cohort study was to identify novel non-invasive markers of post-traumatic EIRR by assessing the changes in the pulp's blood flow and the composition of gingival sulcus fluid (GCF) in children after dental trauma. Thirty-two children were enrolled and assessed within 48h of a TDI to their permanent incisors and during an additional three visits over a 6-months follow up period. During each visit, a radiograph and laser Doppler flow (LDF) measurements of the pulp blood flow were performed on the injured tooth, and the GCF was sampled. The permanent first molar tooth of the same subject served as a control for the LDF measurements and the GCF sampling. Concentrations of IL-1α in the GCF were measured using enzyme-linked immunosorbent assays. Radiographs were used to confirm EIRR. EIRR occurred in fourteen (43.8%) teeth in 32 patients. The teeth with EIRR showed diminished LDF readings when compared with controls at all visits. The LDF readings of the injured teeth continued to decrease at follow up visits. In the EIRR group, levels of IL-1α in the GCF of teeth with EIRR were increased and significantly higher than those of the control teeth at the visit when EIRR was diagnosed. The IL-1α levels were significantly higher in the EIRR group when compared to the injured teeth of patients without EIRR at the last follow-up visit. The occurrence of EIRR after mechanical trauma of permanent teeth with complete root development is accompanied by a significant reduction in the blood flow of the tooth's pulp. It is accompanied by an increase in concentrations of IL-1α in the GCF of EIRR affected teeth. The results of this pilot study identified the use of IL-1α in GCF and LDF as non-invasive markers of EIRR.

Novel tier 2 service model for complex NHS endodontics.

Aim The use of tier 2 practitioners has been suggested as an intermediate tier in the NHS workforce completing cases of moderate difficulty previously referred to secondary care. Provision of such services varies depending on speciality and local commissioning priorities. This service evaluation investigated reasons for and outcomes of endodontic referrals to an NHS tier 2 service in Powys, Wales.Methods A sample of endodontic referrals was analysed with reasons for referral, referral outcome, requests for consultant support and patient demographic data recorded producing results with frequencies and percentage distributions.Results Of 401 referrals evaluated, common reasons for referral were management of post-treatment disease (56.4%) followed by inability to locate or negotiate root canals (26.9%). Mandibular molar teeth were the most frequently referred. Additionally, 44.1% of patients referred went on to receive treatment. Consultant advice and/or treatment was required in the management of 3.5% of referrals, most frequently relating to referral of traumatic dental injuries, root resorption and immature apices.Conclusions Results demonstrate tier 2 practitioners can effectively manage and treat the majority of NHS endodontic referrals. Remote consultant advice is effective in supporting tier 2 practitioners in the management of complex presentation, allowing effective treatment delivery.

Influence of the image file format of digital periapical radiographs on the diagnosis of external and internal root resorptions.

To evaluate the influence of different image file formats of digital radiographic images on the diagnosis of external (ERR) and internal root resorption (IRR). Thirty-four human teeth were selected. For ERR, 20 teeth were used (10 control and 10 with simulated ERR), and for IRR, 14 teeth were used (before and after IRR simulation). Digital periapical radiographs were acquired using the Digora Toto system and exported in four different image file formats: TIFF, BMP, PNG, and JPEG, totaling 192 radiographs. Five examiners evaluated the images using the JPEGView software and scored the detection of ERR or IRR on a 5-point scale. Sensitivity, specificity, accuracy, and the area under the ROC curve were obtained for the diagnosis of ERR and IRR in the different image file formats. Two-way ANOVA compared the diagnostic values between the file formats and the Kappa test assessed intra- and inter-examiner agreement. The significance level was set at 5% (α = 0.05). The mean values of intra-examiner agreement were substantial (0.740) for ERR and almost perfect (0.836) for IRR and, inter-examiner was fair (0.263) and moderate (0.421), respectively. No statistically significant differences were found among the different file formats for the diagnostic values of ERR and IRR. The file format of digital radiographs does not influence the diagnosis of ERR and IRR. Digital radiographic images may be susceptible to computational factors; however, they can be stored in multiple file formats without affecting the diagnosis of dental root resorptions.