Dental Root Research Articles

RETRIEVAL OF DISPLACED ROOT FRAGMENT ASSOCIATED WITH FUNGAL BALL IN THE MAXILLARY SINUS USING FUNCTIONAL ENDOSCOPIC SINUS SURGERY- A CASE REPORT

Introduction: Fungal ball is a non-invasive sinus disease and the incidence of this disease has increased in recent years and also several case reports and case series have suggested a relationship with the accidental displacement of root into maxillary sinus. We report a case where fungal ball was removed along with the dental root fragment which was accidentally displaced into the maxillary sinus following traumatic dental extraction. A 32-years-o Case Report: ld female patient presented to Maxillofacial Surgery Department with complaint of pain in the left orofacial region for one month. The patient had a history of traumatic extraction of posterior maxillary teeth 4 years back. On examination, no dental cause of pain was detected. On further evaluation, a foreign body within the left maxillary sinus was seen in the panoramic radiograph. Computed tomography images revealed displaced root in the left maxillary sinus with surrounding heterogenous soft tissue opacity. Following the detection of foreign body, patient underwent Functional Endoscopic Sinus Surgery (FESS) and the root was retrieved and the adjacent soft tissue specimen was sent for histopathological examination. The presence of fungus consistent with the Aspergillus species was confirmed. Conclusion: This article emphasizes the importance of atraumatic dental extraction, the association of fungal ball with displaced root and the utility of FESS in clearing the same.

Comparative evaluation of a patient-specific customised plate designs and screws for partial mandibular reconstruction.

Mandibles with odontogenic tumors are often partially reconstructed with a metallic bone graft analogue with dental roots, crowns, along with a customized plate fixed with monocortical or bicortical screws, following resection of the tumor. In this study, two different designs of patient specific customized Ti reconstruction plates, solid and plate with holes, were considered. Fixation through both bicortical and monocortical screw types were investigated. FE models of the reconstructed mandibles were developed to analyse the influence of the plate-screw type combination on the load transfer across the mandibles under a mastication cycle. The effective homogenized orthotropic material properties of the lattice structures with 0.6mm fibre diameter with 0.5mm inter-fibre space were assigned to material properties for the bone graft analogue. The study shows that the combination of plate and screw types influences the state of stresses in the reconstructed mandible. Based on the results of this patient specific study, following resection of the tumor, either solid Ti plate with bicortical screws or Ti plate with holes along with monocortical screws may be used for partial mandibulectomy. It should also be noted that stresses in none of the plates or screws exceeded the yield limit for Ti under the mastication cycle indicating that the components are safe for mandibular reconstruction. However, the choice of this combination of reconstruction plates and screws is dependant on the condition and severity of the tumor in the diseased mandible.

History of dental implantology

A dental implant is an artificial dental root inserted into the maxilla or the mandible to replace a missing tooth. Many materials have been used throughout history for this type of tooth replacement. Today, it is one of the most advanced subspecialties of dentistry.

Прикладная анатомия канала нижней челюсти

The mandibular canal (canalis mandibulae) runs in the thickness of the mandible from the mandibular foramen (foramen mandibulae) to the mental foramen (foramen mentale). The knowledge of its topography and relations with the dental root apices is of great practical importance for the prevention of iatrogenic injuries of the inferior alveolar neurovascular bundle during endodontic and orthodontic treatment and during a number of surgical procedures, such as extraction, resection of the apices of the roots of the teeth, cystectomy, removal of intraosseous neoplasms, as well as during conduction anesthesia. The purpose of this work is to summarize information about the variants of the structure and topography of the mandibular canal. The article considers variants of the structure, course, and topography of the mandibular canal, including in cases of adentia, revealed on the basis of various methods of research. In addition to the use of natural preparations (cuts of the lower jaws), modern radiation research methods, such as radiography, computed tomography and cone-beam computed tomography, are widely used to study the topography of the mandibular canal. The mandibular canal is characterized by significant variability in its course and complex relationships with surrounding structures. The most common variation in the structure of the canal is its bifurcation, which is associated with the peculiarities of embryonic development and is of great clinical importance. Up to date, there are several classifications of variants of its structure that can be used in clinical practice. Further accumulation and systematization of data on its anatomical and topographic features are important for the diagnosis and implementation of therapeutic manipulations in this area.

Molekularno ispitivanje gena enterokoknog površinskog proteina (esp) Enterococcus faecalis izolovanog kod endodontskih pacijenata

Objective. Enterococci are generally considered transient components of oral bacteria that may be a reason for several oral and systemic infections, particularly those related to dental root canal infections. The current study aims to examine the occurrence of Enterococcus surface protein, esp in Enterococcus faecalis, which is isolated from infected root canals. Methods. Forty samples were collected from endodontic patients who attended the Conservative Treatment Department in the College of Dentistry/Mosul University/Dental Teaching Hospital. Materials and Methods: All samples were traditionally examined using HiCrom TM Enterococcus faecium Agar base medium and biochemical tests. 16srRNA sequencing was performed using the polymerase chain reaction technique to confirm their identity. Then, all Enterococcus faecalis isolates were examined for the existence of esp gene coding for enterococcal surface protein using PCR assay. Results. From 40 clinical samples obtained, 31 isolates were recognized as E. faecalis by traditional methods; unexpectedly, other non-enterococci genera were also grown on HiCromTM Enterococcus faecium Agar base medium. The PCR products for the sequence-specific primers obtained from the full-length of 16S rRNA gene sequence, which belongs to E. faecalis, and the PCR products for specific primer of esp genes created bands at the position of 138bp and 932 bp on the agarose gel, respectively. The gene correlating with the aggregation of this bacteria on the canal walls was detected in a high proportion (91%) of the isolates. Conclusions. PCR assay provides an accurate, rapid, and more sensitive detection of E. faecalis. A positive correlation between esp gene and enterococcal infections in root canals has been found.

Photoacoustic tomography versus cone-beam computed tomography versus micro-computed tomography: Accuracy of 3D reconstructions of human teeth.

In this in-vitro study, teeth were imaged using photoacoustic tomography (PAT), cone-beam computed tomography (CBCT), and micro-computed tomography (μ-CT). The study had aim: to identify the best wavelength for PAT images to determine the accuracy of the three imaging methods, and to determine whether PAT images of teeth can achieve acceptable reconstruction quality. Nineteen human mandibular single-rooted incisors were extracted from patients with trauma or periodontitis. To determine the best wavelength for acquiring photoacoustic images, all 19 teeth were scanned in vitro with PAT, using different laser wavelengths between 680 and 960 nm. The images were analyzed using image analysis software. To assess the accuracy of PAT and compare it with the accuracy of CBCT, each tooth was also scanned in vitro using CBCT and the reference standard technique of μ-CT. Subsequently, three different three-dimensional models, one for each imaging technique, were created for each tooth. Finally, the three different three-dimensional models acquired for the same tooth were matched and analyzed regarding volume and surface. The highest quality tooth images were achieved using the 680 nm wavelength, which showed the best contrast ratio. The full geometry of the dental root (μ-CT compared with PAT) could be visualized with relative standard deviations of 0.12 mm for the surface and -7.33 mm3 for the volume (n = 19). The full geometry of the dental root (μ-CT compared with CBCT) could be visualized with relative standard deviations of 0.06 mm for the surface and -14.56 mm3 for the volume (n = 19). The difference between the PAT-μ-CT group and CBCT-μ-CT group regarding the total average of the root surface area was not significant (p>0.06). Images, which were acquired using PAT at 680nm showed the best contrast ration, enabling the identification of dentin, cementum and the dental pulp. No significant differences were found between the PAT-μ-CT group and CBCT-μ-CT group regarding the total average of the RSA and the total volume. Thus, three-dimensional reconstructions based on in-vitro PAT are already of acceptable reconstruction quality.

Conservative preparation of curved root canals using novel nickel-titanium instruments: influence of operator experience

BackgroundNickel-titanium (NiTi) instrumentation systems allow predictable dental root canal treatment. Novel systems promoting conservative preparation are constantly introduced into the market. Therefore, this study aimed to explore how operator experience would influence the performance using a new system – Race Evo- in preparation of curved root canals. MethodsThree groups of participants, with no previous experience with Race Evo, were compared: Third-year dental students, general dental practitioners (GPs), and endodontists. Each participant was asked to prepare 3 simulated resin blocks. Preparation time, the occurrence of procedural errors, and canal deviation were measured. ResultsEndodontists prepared the canals with significantly fewer procedural errors (p = 0.027), and in less time than students (p < 0.001) and GPs (p = 0.019). However, there was no significant difference in performance between undergraduate students and GPs. In fact, endodontists and students alike prepared the canal with less deviation compared to GPs (p = 0.006 and p = 0.002). ConclusionProficiency in instrumenting curved canals with a new conservative NiTi system was not influenced by experience related to that of the general dental practitioner, but required more specialized experience in root canal treatment. Regardless of experience level, a learning period was still necessary.

Cryopreservation of human dental roots using vitrification for autologous human tooth tissue banking

This study aims to preliminarily evaluate the feasibility of autologous transplantation of tooth tissues cryopreserved with vitrification, by investigating the influence of cryopreservation with vitrification on human dental root, regarding the morphology, microhardness, cell apoptosis, proliferation and differentiation. Freshly extracted human permanent premolars were collected with crown removed. Dental roots were cryopreserved using a commercial vitrification medium (Kitazatousa). After six-month storage in liquid nitrogen, cryopreserved roots were thawed, and then evaluated using histological and immunohistochemical methods. Microhardness of dentine was measured with a Vickers indenter. Cells in periodontal ligament and dental pulp tissues were isolated and characterized. The proliferation, immunophenotype, apoptosis and differentiation ability of cells isolated from cryopreserved roots were evaluated. The data was analyzed using one-way analysis of variance (ANOVA) and Student's t-test. The gross and histological morphology of dental roots was not significantly changed after vitrification and thawing. A few tiny cracks were found in 3 of all 10 cryopreserved samples. No obvious changes were found in microstructure of dentine under SEM observation. Dental pulp cells and periodontal ligament cells were successfully isolated from tissues of cryopreserved human dental roots. There were also no significant differences of those periodontal ligament cells in the two groups regarding morphology, immunophenotype, viability, proliferation and apoptosis. The osteogenic and adipogenic differentiation capability of periodontal ligament cells was maintained by cryopreservation with vitrification. In the conditions of this study, cryopreservation with vitrification preserves cell survival, hardness and structural integrity of dental roots. Vitrification can be a potential way to preserve tooth tissue for future auto-transplantation and autologous cell therapy.

Transcriptome Analysis Reveals Modulation of Human Stem Cells from the Apical Papilla by Species Associated with Dental Root Canal Infection.

Interaction of oral bacteria with stem cells from the apical papilla (SCAP) can negatively affect the success of regenerative endodontic treatment (RET). Through RNA-seq transcriptomic analysis, we studied the effect of the oral bacteria Fusobacterium nucleatum and Enterococcus faecalis, as well as their supernatants enriched by bacterial metabolites, on the osteo- and dentinogenic potential of SCAPs in vitro. We performed bulk RNA-seq, on the basis of which differential expression analysis (DEG) and gene ontology enrichment analysis (GO) were performed. DEG analysis showed that E. faecalis supernatant had the greatest effect on SCAPs, whereas F. nucleatum supernatant had the least effect (Tanimoto coefficient = 0.05). GO term enrichment analysis indicated that F. nucleatum upregulates the immune and inflammatory response of SCAPs, and E. faecalis suppresses cell proliferation and cell division processes. SCAP transcriptome profiles showed that under the influence of E. faecalis the upregulation of VEGFA, Runx2, and TBX3 genes occurred, which may negatively affect the SCAP's osteo- and odontogenic differentiation. F. nucleatum downregulates the expression of WDR5 and TBX2 and upregulates the expression of TBX3 and NFIL3 in SCAPs, the upregulation of which may be detrimental for SCAPs' differentiation potential. In conclusion, the present study shows that in vitro, F. nucleatum, E. faecalis, and their metabolites are capable of up- or downregulating the expression of genes that are necessary for dentinogenic and osteogenic processes to varying degrees, which eventually may result in unsuccessful RET outcomes. Transposition to the clinical context merits some reservations, which should be approached with caution.

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.

Dental tissue proportions and linear dimensions of Sima de los Huesos lower incisors

AbstractObjectivesTo assess the phenotypic affinities of the Sima de los Huesos (SH) mandibular incisors dental tissue proportions, and radicular dimensions, relative to Neandertals, recent modern humans (RMH), and a large comparative sample of Pleistocene hominins.Materials and MethodsTwo dimensional (2D) and three dimensional (3D) data were extracted from SH (n = 22) incisors, and compared with specimens from Krapina (n = 6) and Ehringsdorf (n = 2), RMH (n = 42), as well as a comparative sample of hominins from the literature (n = 244). We calculated average enamel thickness (AET), relative enamel thickness (RET) and radicular variables (cervical area [CA] and root surface area [RSA], root linear dimensions [RL], dentine and pulp volume [RDV, RPV, TRV]).ResultsWe found that SH incisor crown variables were generally undiagnostic for 2D and 3D AET and 2D RET. Trends indicated thicker 3D RET in RMH relative to SH hominins, Tighenif hominins, and Neandertals. The SH and Neandertal mandibular incisors share similar RL, RSA, and root tissue volumes when compared to other extinct members of Homo. Relative to all other extinct hominins examined here, SH incisors display a relatively narrow cervical labio‐lingual diameter. Finally, we found a weak correlations in SH and RMH between the crown and root variables.DiscussionThis study confirms that SH mandibular incisors' dental tissue proportions and root dimensions align more closely to Neandertals. However, the complete set of Neandertal apomorphies is not present within SH mandibular incisors. SH incisors concur with traits reported in SH canines, and contrasting patterns in the molars, revealing a dichotomy between the anterior and posterior teeth for dental tissue proportions.

Chemical Gastroenterocolitis After the Root Canal Therapy - A Case Report

A 46-year-old patient with history of treated previously for colitis, was reported with severe abdominal discomfort, pain or uneasiness in colon area after the dental re root canal therapy was initiated.His physician started treatment with Xifan (Rifaxin 200mg), Proflora (intense Probiotic high potency), Divigest ADS digestive enzymes, Gasdep (lactobacillus acidophilus) ever since the reroot canal therapy started two months ago. When he developed his abdominal pain rectal discomfort, he was prescribed mesalazine rectal suppositories for his colitis. He was advised further investigations to perform gastroscopy, colonoscopy, to check for any edematous mucosa, any polyps like change in the whole mucosa of the stomach, duodenum, first part of jejunum, distal ileum, complete colon and rectum. With the history from the dentist, Formacresol was given as the intra canal medication after removing the gutta-percha. And his previous endodontic sealer was endomethasone. The diagnosis would be complicated without any of to achieve in synopsis with use of any dental materials like Formacresol, Endomethasone. Intracanal medication was changed to calcium hydroxide paste, his colitis symptoms decreased, calcium hydroxide paste was continued as intracanal medicament during the retreatment. Keywords: Chemical Gastroenterocolitis, Gastroenteritis, Root canal therapy, RCT

AN ASSOCIATIVE CLASSIFICATION BASED APPROACH TOWARDS ANALYSIS OF DENTAL CARIES X-RAY IMAGES

The most common disease on the planet is dental caries, also known as cavities. Almost everyone has had this condition at some point in their lives. Early identication of dental caries can considerably reduce the risk of serious damage to teeth in people who have dental disease. As medical imaging becomes more efcient and faster to use, clinical applications are having a greater impact on patient care. Recently, there has been a lot of interest in machine learning approaches for categorizing and analyzing image data. In this study, we describe a new strategy for locating and identifying dental caries from X-ray photos as a dataset and using associative classication as a classication method. This technique incorporates both classication and correlation. The numerical discrimination approach is also used in the strategy. This is the rst study to employ association-based classications to determine dental cavities and root canal treatment positions. This method was tested on real data from hundreds of patients and found to be very good at nding unexpected damage to teeth.

Detailed study on basic methodology of dental implant and surface modification techniques

Dental implant can be defined as the process of inserting an artificial tooth in the place of natural tooth. This artificial tooth consists of: a) abutment b) Custom made crown and c) an implant. Since it is replacing the natural tooth, it should resemble and work in the same manner. It should not break under the chewing load. Dental implant shows great success rate but over the years. They are regarded as a significant contribution to dentistry since they have changed the process of replacing lost teeth. The capacity of the implant material to integrate with the surrounding tissue is critical to its success. Dental implants are artificial dental roots that are used to replace missing teeth. Dental implant is slightly expensive and patient has to go through plenty of processes like surgery. Moreover, even after taking all the preventive measures there are still chances of failing the implant and hence material selection and surface modification techniques used in Dental implant plays a crucial role. In this review paper we will see the different material used in dental implant and different surface modification techniques.

Cone-beam computed tomography evaluation of the possibility of fabrication of screw-retained implant crowns on maxillary central incisors

BACKGROUND: Immediate implant placement to the fresh socket of the extracted tooth, with immediate loading, is well documented. Dental roots in proximity to the vestibular plate require thorough attention from clinicians. Implants placed close to the vestibular plate often lead to its resorption and gingival recession. Therefore, dental surgeons place implants 23 mm away from the vestibular plate. In turn, prosthodontists plan implant placement so that the screw channel is not on the vestibular surface, which is most significant in the aesthetic area. However, this is not always possible, and there is a conflict between implant placement with proper primary stability and its simultaneous loading with a screw-retained crown.&#x0D; AIM: To conduct radiological assessment of the ideal implant placement for a screw-retained crown.&#x0D; MATERIALS AND METHODS: A total of 120 cone-beam computed tomography (CBCT; 3 groups of 40 people with different root positions) were analyzed. In each group, the possibility of extracting tooth 1.1 and inserting an implant was evaluated in compliance with the protocol for immediate implantation and the possibility to have the screw shaft of the artificial crown on the palatal surface.&#x0D; RESULTS: Group C was defined as the most favorable for immediate implant placement with a screw-retained crown. The least favorable was group N. In total, the screw channel in 40% of the cases was located palatally, 26.6% to the incisal edge, and 33.3% on the vestibular surface.&#x0D; CONCLUSIONS: Careful analysis of CBCT when planning implant-supported restoration in the aesthetic area is an integral part of the treatment. A team approach is required from surgeons and prosthodontists when planning. In a larger percentage of cases, implant-supported prosthetics in the maxillary central incisors involve the use of alternative solutions for the restoration of screw-retained crowns.

Comparison of the methods of disinfection/sterilization of extracted human roots for research purposes.

Extracted human teeth are used to simulate dental procedures and are essential for practical education and research studies. The aim of this study was to evaluate the efficacy of different sterilization methods for extracted human roots and to assess the effects of these methods on dentin microhardness. The crowns of 40 mandibular incisors were removed. The roots were sectioned at 10 mm and divided into 4 groups (n = 10 per group): G1 - no sterilization (control); G2 - microwave radiation (650 W, 5 min); G3 - ethylene oxide (288°C, 3 h); and G4 - autoclave (121°C, 15 min). The roots were immersed in brain heart infusion (BHI) and incubated at 37°C in variable oxygen atmospheres. After 14 days, the samples were assessed for turbidity. Three slices were obtained from each root, and indentations were made at 30, 60 and 120 μm from the root canal lumen. The microbiological data was analyzed with the Kruskal-Wallis test and Dunn's post-hoc test. Microhardness was evaluated by means of the twoway analysis of variance (ANOVA) and Tukey's test (p < 0.05). The roots submitted to autoclaving were 100% sterile, which differed from the other methods (p < 0.05); the control specimens had 0% sterility. For microhardness, significant differences were found between the methods, particularly for the apical third (68.06 ±12.50) (p < 0.05). Although all the evaluated techniques reduced dentin microhardness, autoclaving should be used as the most reliable method of sterilization of extracted dental roots.

Transition metals and Enterococcus faecalis: Homeostasis, virulence and perspectives.

Enterococcus faecalis, a Gram-positive bacterium, is known to be a key player in several chronic infections as well as nosocomial, heart valve, urinary tract, surgical wound, and dental root canal infections. The capability to sense different transition metal levels and tune its response accordingly endows it with the potential to thrive and cause infections in several host niches. Over the past decade, our knowledge of how transition metals play a critical role in maintaining homeostasis of E. faecalis has improved significantly. The aim of this review is to elucidate the roles of metals such as iron, manganese, zinc, and copper in the physiology, metabolism, and pathogenicity of E. faecalis. These essential micronutrients contribute to energy production, redox stress response, expression of virulence determinants, and cooperation in polymicrobial communities. The review also highlights metal homeostasis systems in E. faecalis, which respond to fluctuations in extracellular metal levels, and regulate the intracellular metal content. Regulation of intracellular metallome secures the tolerance of E. faecalis to oxidative stress and host-mediated metal sequestration strategies. Therapeutic interventions which deprive E. faecalis of its essential metal requirements or disrupt its homeostatic control have been proposed to combat E. faecalis infections.

A Multi-Criteria Approach for Comparison of Ginger Extract and Conventional Irrigants in Root Canal Treatment.

BackgroundConsidering the importance of irrigation in dental root canal treatment, there is an urgent need to find a risk-free bioactive and antibacterial endodontic solution. Enterococcus faecalis, an anaerobic gram-positive coccus, has been identified as the main reason for endodontic infections. Several studies have been conducted on E. faecalis and periapical infection. Nowadays, plants used in traditional medicine play a role that is widely appreciated by researchers. One of these herbs is ginger which shows an acceptable antimicrobial effect on E. faecalis. Due to the highly crucial role that irrigation plays in the success of endodontic treatment, a comprehensive survey based on several criteria, namely, scientific, technical, and empirical, is required to address the goal of determining the best endodontic solution.MethodologyThe most important criteria are antibacterial activity, risks and hazards, cost, and availability. In this study, the analytical network process (ANP), which is a multi-criteria decision-making method, was applied to determine the best endodontic irrigant.ResultsSeveral alternatives were investigated using the ANP. In this study, 5.25% sodium hypochlorite (NaOCl) and 2% chlorhexidine were at the top of the list. According to the sensitivity analysis, 10% ethanolic ginger extract showed comparable results to 2.5% NaOCl.ConclusionsTo carefully prioritize endodontic irrigants a wide range of standards and criteria should be considered. Considering the low risk, great wettability, and active compounds of ginger extract, it can be a promising viable risk-free solution for root canal treatments.

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.

Asymmetric dental-alveolar transversal corrections with skeletal anchorage

Transversal asymmetries of the dental arches are common orthodontic problems. Significant asymmetries needed a surgical approach for their correction before the introduction of skeletal anchorage. This paper presents two different approaches to correct dental transversal asymmetries, using skeletal anchorage both directly and indirectly. The direct use of skeletal anchorage requires careful planning of the desired dental movement and the estimation of the line of action of the needed force to achieve it. This information can be used to orientate the orthodontist in the screw placement, since it should be inserted, if possible, along the line of action of this force. In this way, it is possible to design appliances that do not deliver to the screw moments, which can compromise their stability. In the direct approach, the screw can be placed in the palatal vault or between the dental roots. The indirect use of skeletal anchorage implies the connection of the screw with one or some of the teeth which are required to maintain their position. Since the connecting wire should be rather short, it is recommendable to place the screw in the interradicular bone, rather than in the palate. This approach can be used with both fixed appliances, and with aligners. Four clinical cases illustrate these modalities of asymmetric expansion or contraction.