Horizontal Root Research Articles

Effectiveness of Two Apex Locators to Determine Simulated Horizontal Root Fractures

Effectiveness of Two Apex Locators to Determine Simulated Horizontal Root Fractures

Fractographic Analysis of a Split Tooth Presenting Radiographically as a Horizontal Root Fracture in an Unrestored Mandibular Second Molar

IntroductionSpontaneously catastrophic fracture of intact unrestored molar teeth is not common. Nevertheless, cracks do occur that progress apically, resulting in the complete splitting of the tooth and root. This report describes a catastrophic fracture that occurred in an unrestored mandibular second molar resulting in a previously unreported combination of a longitudinal and horizontal root fracture, appearing radiographically as a single horizontal root fracture. MethodsTooth fragments were examined clinically, stereoscopically, and by scanning electron microscopy. Fractographic analysis was used to investigate the dynamics involved in fracture initiation, structural resistances encountered during progression of the fracture, and reasons for direction changes culminating in the unusual radiographic appearance. ResultThe uniqueness of this report is that it describes fractographic evidence of factors contributing to the initiation and progression of an in vivo crack. It shows fracture markings that are evidence of the energy dissipation mechanisms. The topographic location of these markings confirmed that cracks occur in vivo in stages with different rates of progression. ConclusionThis analysis helps to explain why split teeth are uncommon and highlights some of the multitude of factors that have to coincide for a tooth to catastrophically fracture. The report describes the mechanism of fracture and should stimulate clinicians and researchers to investigate cracking of teeth by undertaking fractographic analysis of extracted cracked teeth.

Use of MTA in conjunction with an intraradicular endodontic file splint for treatment of horizontal root fracture- A case report.

With the possibility of harnessing the regenerative potential of tissues, clinicians will find greater clinical instances where an old treatment modality used in conjunction with new materials gives greater clinical success in cases with poor clinical prognosis. This case typically illustrates such a situation where we successfully used MTATM in conjunction with an endodontic file used as an intracanal splint for repair of horizontally fractured root with minimal displacement of the fragments. DOI: 10.21276/aohdr.1829

Clinical management of horizontal root fractures aided by the use of cone-beam computed tomography

Aim: To present a a therapeutic approach in a case series of teeth that suffered some root fracture at different thirds with a follow-up period of 24 months. Summary: Dental trauma occurs with great frequency to the maxillary incisors, and, sometimes, horizontal root fractures are caused. The classification and severity of horizontal root fractures are based on the location of the fracture line and on the degree of dislocation of the coronal fragment. Diagnosis of horizontal root fractures is based on clinical findings, sensibility tests, and principally in radiographic and cone-beam computed tomography (CBCT) examination. The following cases report describes the diagnosis and treatment of four maxillary central incisors with horizontal root fractures. In three of the cases described, the healing occurred through the interposition of connective tissue where radiographically was possible to observe a radiolucent at the level of the fracture line and the rounding of the fragment angles. In one case, the healing occurred by calcified tissue, which can be seen radiographically in the fracture line, but the fragments are in close contact. In addition to a proper treatment plan, the International Association of Dental Traumatology (IADT) stresses the importance of patient compliance with follow-up, and daily care visits for better healing after dental trauma. Knowledge of existing protocols for this type of injury and periodic monitoring of cases has shown the success of the treatment so far.

FEATURES OF FORMING CORNER SYSTEM OF SORBUS TORMINALIS (L.) CRANTZ ARE IN FOREST PLANTING OF NATURAL ORIGIN MORE SOUTH OF PODOLSK FOREST-STEPPE OF UKRAINE

The method of excavation has investigated the features of the structure of the root system of the bark of the drug of different age categories and the conditions of location in the plantings of natural seed origin SE "Chechelnytsky forestry" of Vinnytsia region. It was discovered that a large, horizontal root system, which is far from the shoots, is characterized by a significant amount of anchor roots that gives the breed a high wind resistance. Consequent, its root system is plastic, with damage or change of edatic conditions, it is easily regenerated, the appearance of strong lateral horizontal or oblique vertical roots under different soil conditions ensures its adaptation in mixed deciduous forests. As a result a specific feature of the root system of the bark is established in different soil conditions: a) the roots penetrate into the ground horizons to a depth of 57 centimetres, but most of them in the upper 10-15 centimetre layer of soil; b) on the slopes of trees there are no rod roots, a powerful root system of horizontal roots in three directions is formed; c) in porcine species, the horizontal roots of 2 to 3 meters are placed at a depth of 5-8 centimetres from the root neck, occupying position above the parent roots. Paying attention to the distribution of the length of the roots by the branches of branching, found that the largest mass of roots of all orientations falls on the first order of branching. Of these, the largest mass is noted for horizontal roots (71-77 %), somewhat lower – for vertical and oblique vertical (29 %). On the 3-4th order of branching there is only 0.1-0.5 % of the mass of roots. Moreover, the patterns have been revealed that rootstock is formed in the seedlings of the bark of the medicinal plant, but its position is different: vertical, horizontal, oblique vertical, which confirms the differences in the formation of the root system in natural plantings. As a result of this study, the roots of oak, maple, and linden are compatible in the rhizosphere with the birch of the initial period of development of root systems of these species. The dynamics, quantity and quality of root extracts and precipitation in ordinary oak and bunch of medicinal varieties, which can have a significant impact on the consumption of nutrients and the growth of trees in their coexistence.

A five-year follow-up of a root fracture in a ten-year-old boy

The management of horizontal root fracture still presents a challenge to clinicians. The case of a 10-year-old boy with a horizontal root fracture in the left maxillary central incisor (tooth number 21) is described here. The fracture was present at the junction of the apical and the middle thirds. We report both the emergency care and the 5-year follow-up. At the same time, an orthodontic treatment was planned for a retained maxillary cuspid (tooth number 23), first composed of a high-pull headgear and then by a fixed multi-bracket appliance. Today, the tooth number 21 remains vital and symptomless. This report highlights the successful management of a horizontally fractured tooth requiring orthodontic treatment. Our work also underlines the advantages of 3D images [cone-beam computed tomography (CBCT)] in positive and differential diagnosis especially in the event of a suspicion of post-traumatic complication.

Image-Based Analysis to Dissect Vertical Distribution and Horizontal Asymmetry of Conspecific Root System Interactions in Response to Planting Densities, Nutrients and Root Exudates in Arabidopsis thaliana.

Intraspecific competition is an important plant interaction that has been studied extensively aboveground, but less so belowground, due to the difficulties in accessing the root system experimentally. Recent in vivo and in situ automatic imaging advances help understand root system architecture. In this study, a portable imaging platform and a scalable transplant technique were applied to test intraspecific competition in Arabidopsis thaliana. A single green fluorescent protein labeled plant was placed in the center of a grid of different planting densities of neighboring unlabeled plants or empty spaces, into which different treatments were made to the media. The root system of the central plant showed changes in the vertical distribution with increasing neighbor density, becoming more positively kurtotic, and developing an increasing negative skew with time. Horizontal root distribution was initially asymmetric, but became more evenly circular with time, and mean direction was not affected by the presence of adjacent empty spaces as initially hypothesized. To date, this is the first study to analyze the patterns of both vertical and horizontal growth in conspecific root systems. We present a portable imaging platform with simplicity, accessibility, and scalability, to capture the dynamic interactions of plant root systems.

Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications.

Mineral trioxide aggregate (MTA) is a dental material used extensively for vital pulp therapies (VPT), protecting scaffolds during regenerative endodontic procedures, apical barriers in teeth with necrotic pulps and open apices, perforation repairs as well as root canal filling and root-end filling during surgical endodontics. A number of bioactive endodontic cements (BECs) have recently been introduced to the market. Most of these materials have calcium and silicate in their compositions; however, bioactivity is a common property of these cements. These materials include the following: BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA but without the drawbacks. In Part I of this review, the available information on the chemical composition of the materials listed above was reviewed and their applications for VPT was discussed. In this article, the clinical applications of MTA and other BECs will be reviewed for apexification, regenerative endodontics, perforation repair, root canal filling, root-end filling, restorative procedures, periodontal defects and treatment of vertical and horizontal root fractures. In addition, the literature regarding the possible drawbacks of these materials following their clinical applications is reviewed. These drawbacks include their discolouration potential, systemic effects and retreatability following use as a root filling material. Based on selected keywords, all publications were searched regarding the use of MTA as well as BECs for the relevant clinical applications. Numerous publications were found regarding the use of BECs for various endodontic applications. The majority of these investigations compared BECs with MTA. Despite promising results for some materials, the number of publications using BECs for various clinical applications was limited. Furthermore, most studies had several methodological shortcomings and low levels of evidence.

Delayed Repositioning in Teeth with Horizontal Root Fracture: Two Case Reports

Introduction: Horizontal root fracture (HRF) generally has a good prognosis of healing at fracture line after repositioning and flexible splinting. However, various factors such as delayed referral may unfavorably influence close reduction of firmly displaced coronal fragments and the long-term prognosis of healing at fracture line. Case 1: A 25-year-old woman with HRF in her maxillary central incisors was referred 1 week after trauma. Repositioning of the displaced coronal fragment was not successful for the left central incisor. Despite questionable prognosis for this case, reduction and flexible splinting was performed after removing it’s coronal fragment, minor curettage in alveolar socket and immediate replanting. Calcium hydroxide dressing and MTA plug placement for the coronal fragment were carried out after 1 and 3 weeks, respectively. The crown was restored and a minor permanent splint was applied after splint removal. Case 2: The above protocol was applied for a 17-year-old boy with HRF in his left maxillary central incisor. He referred 3 weeks after trauma with a firmed displaced coronal fragment. At four-year follow-up in both patients, the teeth were clinically in function and the patients were asymptomatic. The periapical radiographs revealed complete healing at fracture lines.

Different sets of belowground traits predict the ability of plant species to suppress and tolerate their competitors

Background and aimsFunctional traits may underlie differences in niches, which promote plant species co-existence, but also differences in competitive ability, which drive competitive exclusion. Empirical evidence concerning the contribution of different traits to niche differentiation and the ability to supress and tolerate competitors is very limited, particularly when considering belowground interactions.MethodsWe grew 26 temperate grassland species along a density gradient of interspecific competitors to determine which belowground traits a) explain species’ ability to suppress and tolerate neighbours and b) contribute to niche differentiation, such that species with dissimilar trait values experience reduced competition.ResultsWe found that having larger root systems with extensive horizontal spread and lower root tissue density enabled efficient suppression of neighbours but did not significantly contribute to the ability to tolerate competition. Species with deeper root systems, lower specific root length and less branched roots were better at tolerating competition, but these traits did not significantly affect the ability to suppress neighbours. None of the measured traits contributed significantly to niche differentiation, either individually or in combination.ConclusionsThis study provides little support for belowground traits contributing to species co-existence through niche differentiation. Instead, different sets of weakly correlated traits enable plants to either suppress or tolerate their competitors.

Clinical management of horizontal root fractures aided by the use of cone-beam computed tomography

AimTo present a a therapeutic approach in a case series of teeth that suffered some root fracture at different thirds with a follow-up period of 24 months. SummaryDental trauma occurs with great frequency to the maxillary incisors, and, sometimes, horizontal root fractures are caused. The classification and severity of horizontal root fractures are based on the location of the fracture line and on the degree of dislocation of the coronal fragment. Diagnosis of horizontal root fractures is based on clinical findings, sensibility tests, and principally in radiographic and cone-beam computed tomography (CBCT) examination. The following cases report describes the diagnosis and treatment of four maxillary central incisors with horizontal root fractures. In three of the cases described, the healing occurred through the interposition of connective tissue where radiographically was possible to observe a radiolucent at the level of the fracture line and the rounding of the fragment angles. In one case, the healing occurred by calcified tissue, which can be seen radiographically in the fracture line, but the fragments are in close contact. In addition to a proper treatment plan, the International Association of Dental Traumatology (IADT) stresses the importance of patient compliance with follow-up, and daily care visits for better healing after dental trauma. Knowledge of existing protocols for this type of injury and periodic monitoring of cases has shown the success of the treatment so far.Key-learning points:(1)The diagnosis of root fractures requires a detailed examination, both clinical and radiographic.(2)The IADT developed a guideline in order to propose an effective treatment plan.(3)The CBCT facilitates the visualization of lines fracture.(4)An immediate approach after horizontal root fractures comprises reduction, splints and occlusal adjustment.

Self-repaired Process of a Traumatized Maxillary Central Incisor with Pulp Infarct after Horizontal Root Fracture Monitored by Laser Doppler Flowmetry Combined with Tissue Oxygen Monitor

Achieving a precise diagnosis of the pulp status of traumatized teeth is difficult. The time to interfere through endodontic treatment for these teeth is greatly dependent on the doctor's experience. A 24-year-old male patient suffered a traumatic injury to tooth #9 that resulted in an apical root horizontal fracture 3 days before he came to the hospital. The injured tooth showed no response to pulp sensitivity testing at the first visit and was discolored 1 week later. Tooth #9 was immobilized to its adjacent teeth for 4 weeks by a composite splint. The patient was asked to make regular follow-up appointments for 72 weeks. The changes in the pulp microcirculation of tooth #9 after the injury were recorded using laser Doppler flowmetry (LDF) and a tissue oxygen monitor (OXY). The LDF was used to directly measure the pulpal blood flow, and the OXY was used to detect the tissue oxygen saturation and total hemoglobin at each appointment. Tooth #9 survived a period of pulp infarct that started at week 4 and showed complete revascularization within 10 weeks. The color of the tooth returned to normal after revascularization. The tooth responded to sensitivity testing at week 58, and radiographic examinations confirmed its hard tissue was healing. Without other clinical signs besides tooth discoloration and an absence of response to pulp sensitivity testing, the complete self-repair of pulp can be expected in teeth with pulp infarct after a horizontal root fracture, and more than 1 year of follow-up is recommended. The use of LDF combined with OXY monitoring has great value in the timely and precise reflection of changes in pulp status after dental trauma.

Waterlogged wasteland treatment through agro-forestry: A review

India covers 147.75 mha degraded area, whereas 6.41 mha area confined to waterlogging problem in Bihar, Maharashtra, Gujarat, Uttar Pradesh, Orissa, West Bengal, Punjab, Tamil Nadu, Andhra Pradesh, Haryana, Kerala, Rajasthan and few other states. The transpiration principle of plants is used in bio-drainage treatment to reclaim such problematic areas sustainably. Evergreen broad leaved species recorded high transpiration rate and contribute highly in reclamation of waterlogged saline soils. Short rotation fast growing tree species like Salix, Eucalypt, Acacia, Albizia, Terminalia, Prosopis, Populuswere the suitable species for such areas. Agri-silviculture, agri-horti- silviculture, silvi-pasture, multipurpose woodlots, strip plantation and boundary plantations were widely used for reclamation of saline-waterlogged conditions of India. In agri-silviculture system, Eucalypt based agroforestry systems are widely used for reclamation of waterlogged areas as compared to other woody plant based systems. 0.84–0.86 m total drawdown of ground water in 3 years Eucalypt tree species. The vertical and horizontal root spreading of tree species is one important character for capturing and transpiration of excess water from waterlogged area. From the present investigation, longest root system was recorded from Prosopis cineraria (20-60 m) species.

CBCT or not CBCT: That is the Question

Root fractures comprise approximately 0.5–7% of all traumatic injuries to the permanent dentition and frequently are diagnosed after trauma to the face and mouth. Horizontal fractures are most frequent in the middle third of the root and rare in the apical third, it occurs more often in the maxillary central incisors of male patients. According to Andreasen, the healing process of horizontal root fractures depends on several variables, such as the age of the patient, the mobility of the coronal fragment, the location of the root fracture and the stage of root formation. Traumatic dental injuries prognosis depends on the time elapsed between the traumatic event and the beginning of the treatment. For this reason, the correct diagnosis is decisive in order to influence the therapy and therefore the prognosis.

The Effects of Imaging Enhancement Tools in the Detection of Horizontal Root Fractures.

Detection of root fracture is challenging both clinically and radiographically. Root fractures occur in different planes with unpredictable presentations. The aim of the study was to evaluate the diagnostic accuracy of selected digital image enhancement tools in the detection of horizontal Root Fracture (RF). Fifty three roots, of single and multi-rooted teeth, in eight dentate human cadaver mandibles were selected for this study. Following minimally traumatic extraction of the teeth, horizontal fractures were induced in 23 roots and remounted in the empty sockets of their respective human dry mandibles. The remaining teeth with no fractures were used as the control group. Twenty two periapical radiographs were obtained by using the paralleling technique and using Complementary Metal Oxide Semiconductor (CMOS). Image J software was used to enhance the original images with the Inversion (IN), Histogram-Equalization (EQ) and Polynomial (Poly) tools. A total of 88 periapical images (original and three enhanced images) were reviewed independently by three Oral and Maxillofacial Radiologists and two Endodontists. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the accuracy of fracture detection and the kappa statistic was used to assess agreement among reviewers. The diagnostic accuracy for one of the observers was significantly different in detection of RF with only EQ enhancement tool. Sensitivity and specificity were not significantly different. Interobserver agreement showed no significant difference between imaging methods. Intra-observer agreement was high to moderate. There was no significant difference between the different imaging modalities. No statistical difference for the agreement was found among or between the endodontists and radiologists in this study.

The Evaluation of Root Fracture with Cone Beam Computed Tomography (CBCT): An Epidemiological Study.

BackgroundThe aim of this study was evaluation of the cone-beam computed tomography (CBCT) image of 50 patients at the ages of 8-15 suspecting root fracture and root fracture occurred, exposed to dental traumatic. In additionally, this study was showed effect of crown fracture on root fracture healing.Material and MethodsAll of the individuals included in the study were obtained images with the cone-beam computed tomography range of 0,3 voxel and 8.9 seconds.(i-CAT®, Model 17-19, Imaging SciencesInternational, Hatfield, Pa USA).The information obtained from the history and CBCT images of patients were evaluated using chi-square test statistical method the mean and the distribution of the independent variables.Results50 children, have been exposed to trauma, was detected root fracture injury in 97 teeth. Horizontal root fracture 63.9% of the 97 tooth, the oblique in 31.9%, both the horizontal and oblique in 1.03%, partial fracture in 2.06% ,and both horizontally and vertical in 1.03% was observed.The most affected teeth, respectively of, are the maxillary central incisor (41.23% left, right, 37.11%), maxillary left lateral incisor (9.27%), maxillary right lateral incisor (11.34%), and mandibular central incisor (1.03%).ConclusionsCrown fractures have negative effects on spontaneous healing of root fractures. CBCT are used selected as an alternative to with conventional radiography for diagnosis of root fractures. In particular, ıt’s cross-sectional image is quite useful and has been provided more conveniences seeing the results of diagnosis and treatment for clinician. Key words:Root fracture, CBCT, Epidemiolog.

Healing of transverse root fracture evaluated by using cone beam computed tomography: Case report with 2 years follow-up

A human dental trauma usually occurs in young patients involving an anterior dentition. A horizontal root fracture (HRF) is uncommon, being only 0.5–7.0% of all traumatic dental injuries. A 9-year-old Saudi boy was received trauma on his face causing HRF at both right (#11) and left (#21) maxillary central incisors. The apical third of tooth #11 was fractured, and #21 was lost. Clinical and radiographic examinations investigation were done, and proper management was carried out. The patient was asymptomatic at 2 years follow-up, and the cone beam computed tomography shows good healing of the two fragments that could be done with fibrous tissue.

Comparison of the Diagnostic Accuracy of Digital Intraoral Radiography with PSP and CBCT in the Detection of Horizontal and Vertical Dental Root Fractures

Comparison of the Diagnostic Accuracy of Digital Intraoral Radiography with PSP and CBCT in the Detection of Horizontal and Vertical Dental Root Fractures

Horizontal root fracture in the apical third: case report

ABSTRACT This article presents a clinical case of horizontal root fracture, in an adult patient, male, in the apical third, due to the practice of sports, which, along with other factors, has led to pulp necrosis. Initially, the patient sought emergency care, and then he underwent treatment by endodontics, using calcium hydroxide between sessions. After a monitoring period, root canal obturation was performed and the tooth is clinically and radiographically stable 2 years after the trauma. In this case, monitoring is long-lasting, divided into 12-month periods for 10 years, with clinical and radiographic evaluation. Dental fracture in children and teenagers from 10 to 14 years is very common, especially during the practice of sports and recreation activities. It is expected that young male individuals have greater propensity to damage their teeth than young female individuals. Maxillary central incisor is the tooth most commonly involved, and it often evolves to pulp necrosis after trauma.

Ionospheric error contribution to GNSS single-frequency navigation at the 2014 solar maximum

For single-frequency users of the global satellite navigation system (GNSS), one of the main error contributors is the ionospheric delay, which impacts the received signals. As is well-known, GPS and Galileo transmit global models to correct the ionospheric delay, while the international GNSS service (IGS) computes precise post-process global ionospheric maps (GIM) that are considered reference ionospheres. Moreover, accurate ionospheric maps have been recently introduced, which allow for the fast convergence of the real-time precise point position (PPP) globally. Therefore, testing of the ionospheric models is a key issue for code-based single-frequency users, which constitute the main user segment. Therefore, the testing proposed in this paper is straightforward and uses the PPP modeling applied to single- and dual-frequency code observations worldwide for 2014. The usage of PPP modeling allows us to quantify—for dual-frequency users—the degradation of the navigation solutions caused by noise and multipath with respect to the different ionospheric modeling solutions, and allows us, in turn, to obtain an independent assessment of the ionospheric models. Compared to the dual-frequency solutions, the GPS and Galileo ionospheric models present worse global performance, with horizontal root mean square (RMS) differences of 1.04 and 0.49 m and vertical RMS differences of 0.83 and 0.40 m, respectively. While very precise global ionospheric models can improve the dual-frequency solution globally, resulting in a horizontal RMS difference of 0.60 m and a vertical RMS difference of 0.74 m, they exhibit a strong dependence on the geographical location and ionospheric activity.