Tooth Follicle Research Articles

Protein Activation in Periapical Reaction to Iodoform Containing Root Canal Sealer.

An association between root canal sealers and periapical lesions in primary dentition has been suggested, yet the chemical-protein interactions that may be involved in it have not been studied. The present study explored root sealer components' effect on periapical tissue proteins using bioinformatics tools. For each chemical component of Endoflas F.S. root sealing material we identified the known and predicted target proteins, using STITCH (search tool for interactions of chemicals http://stitch.embl.de/ ). Identified target proteins were grouped into functional categories using the annotation clustering tool from DAVID, the Database for Annotation, Visualization and Integrated Discovery ( http://david.abcc.ncifcrf.gov/ ). STRING Protein-Protein Interaction network database identified associations between the proteins. Sixteen proteins identified with STITCH served as input to DAVID annotation clustering tool. Only ZnO and Eugenol targeted proteins had statistically significant annotations. Gene Ontology terms of ZnO and Eugenol targeted proteins demonstrated that these proteins respond to mechanical stimulus and to oxidative stress. They highlight these proteins' role in the positive regulation of transcription, gene expression, cell proliferation and apoptosis, and their complementary role in the negative regulation of cell death. When stimulated by Zinc Oxide, Eugenol and Calcium hydroxide, chemical-protein and subsequent protein-protein interactions result in cell proliferation in the periapical area. Our findings indicate that certain root sealers components may cause enlargement of the permanent tooth follicle. Dentists should be aware of this phenomenon and radiographically monitor root canal treated teeth until shedding.

Surgical Template to Minimize the Damage of Tooth Buds in Young Children With Mandibular Distraction Osteogenesis.

Mandibular distraction osteogenesis has become one of the most powerful reconstructive techniques for the treatment of mandibular deformities in young children. Damage to the tooth buds is often cited as a complication of it. The purpose of this study was to precisely design the osteotomy line and avoid the damage of tooth buds at the mandibular angle area with the help of surgical template. Six patients aged from 6 to 10 years were selected in this study. Three-dimensional computed tomography data was put into Mimics software for preoperative planning the osteotomy line and the accurate placement of the distractor based on the exact position of tooth follicle. And then the surgical template was manufactured by a three-dimensional printer with rapid prototyping technique. The surgeons were guided to perform the osteotomy aided with the prefabricated template through an intraoral approach. Distraction began 7 days postoperation with a rate of 1 mm/d and the distractor was removed after a 6 to 8 months consolidation period. The tooth buds were observed through radiographs that were performed at 5 time intervals: before distraction, at the end of latency, at the end of distraction, at the end of consolidation and 2 years of the postoperation to remove the distractor. The average follow-up time is 24 months. Facial appearance and occlusal plane of all the young patients were greatly improved without complications. From the radiological observation, the tooth buds was intact after the surgery and the second molar normally erupted after removing the distractor. The surgical template was considered to be helpful in improving the surgical accuracy and avoiding the tooth buds damage during mandibular distraction osteogenesis.

Role of podoplanin expression in deciding the invasive potential of ameloblastoma – A retrospective IHC study

BackgroundThe aim of this study was to investigate the podoplanin expression in epithelial odontogenic tumors both non-aggressive and aggressive, tumors with and without ectomesenchyme and remnants of the odontogenic epithelium from dental follicles (DF) of unerupted teeth and to examine its role in progression and invasion of tumors. MethodThirty paraffin embedded specimens AM (15 were non-aggressive ameloblastomas and 15 ameloblastoma showing aggressive behavior), 15 paraffin embedded specimens of AOT, 15 paraffin embedded specimens of CEOT, 15 paraffin embedded specimens of CCOT were obtained and were analyzed by immunohistochemistry using anti-human podoplanin. Podoplanin expression in odontogenic epithelial cells was evaluated using a scoring method, along with calculation of the percentage of positive odontogenic cells. ResultsPodoplanin was expressed strongly at the invasive front (in the peripheral odontogenic epithelial cells) of most tumors and dental follicles. Membranous expression of podoplanin in ameloblastomas was stronger in cases of ameloblastomas showing aggressive behavior than (NA) non-aggressive ameloblastomas. ConclusionExpression of podoplanin at the invasive front (in peripheral cells) of odontogenic tumors considered to be associated with neoplastic odontogenic tissues. This molecule might play a role in progression and local invasion of odontogenic tumors. The migration and invasion mediated by podoplanin in odontogenic tumors could be related to cytoskeletal reorganization.

An Alternative Method of Intermaxillary Fixation for Simple Pediatric Mandible Fractures

Mandibular fractures represent a substantial portion of facial fractures in the pediatric population. Pediatric mandibles differ from their adult counterparts in the presence of mixed dentition. Avoidance of injury to developing tooth follicles is critical. Simple mandibular fractures can be treated with intermaxillary fixation (IMF) using arch bars or bone screws. This report describes an alternative to these methods using silk sutures and an algorithm to assist in treating simple mandibular fractures in the pediatric population. A retrospective chart review was performed and the records of 1 surgeon were examined. Pediatric patients who underwent treatment for a mandibular fracture in the operating room from 2011 to 2015 were identified using Common Procedural Terminology codes. Data collected included age, gender, type of fracture, type of treatment used, duration of fixation, and presence of complications. Five patients with a mean age of 6.8 years at presentation were identified. Fracture types were unilateral fractures of the condylar neck (n = 3), bilateral fractures of the condylar head (n = 1), and a unilateral fracture of the condylar head with an associated parasymphyseal fracture (n = 1). IMF was performed in 4 patients using silk sutures, and bone screw fixation was performed in the other patient. No post-treatment complications or malocclusion were reported. Average duration of IMF was 18.5 days. An algorithm is presented to assist in the treatment of pediatric mandibular fractures. Silk suture fixation is a viable and safe alternative to arch bars or bone screws for routine mandibular fractures.

Gubernacular Cord and Canal

The gubernacular cord, located within the gubernacular canal, links the tooth follicle to the overlying gingiva and can be identified in the alveolar region of the lingual/palatal surface of deciduous teeth. Some authors believe that the gubernacular canal and cord play a role in the guiding the course of tooth eruption, whereas others claim that these structures can influence the development of an adenomatoid odontogenic tumor (AOT). Here, we present the case of an 11-year-old female who, on a routine panoramic radiograph, presented a well-defined radiolucency around the crown of an impacted tooth associated with a canal in the apical direction, which was diagnosed as hyperplastic dental follicle associated with gubernacular cord. It is likely that most cases presenting gubernaculum dentis are undiagnosed or misdiagnosed. Current data show that there is a histogenetic relationship between the gubernaculum dentis and AOT; hence its importance.

A massive dentigerous cyst of the mandible in a young patient: a case report

Cysts of the jaw present as swellings of jaws and midface. Of the different varieties, the dentigerous cyst is the most common type of noninflammatory odontogenic cyst and the frequent cause of a lytic lesion associated with an impacted tooth. The cyst develops from epithelial remnants of the tooth forming organ. The obstruction of venous flow due to compression of tooth follicle by developing tooth causes fluid accumulation between the follicular epithelium and the crown of the developing or unerupted tooth resulting in a cyst. Most small dentigerous cysts manifest in early age, usually as an incidental discovery in radiographic examinations. However, they can grow extremely large, asymptomatically, and remain undetected until they enlarge enough, causing bony expansion and asymptomatic facial swelling. We present a challenging case of massive dentigerous cyst in a 13-year-old female child involving half of the mandible, which was successfully treated with conservative therapy. This case report illustrates the effectiveness of simplified surgical treatment for a large dentigerous cyst in the mixed dentition period.

Detecting Gram-Positive Anaerobic Cocci Directly From the Clinical Samples by Multiplex Polymerase Chain Reaction in Odontogenic Infections

Gram-positive anaerobic cocci (GPAC) can be isolated as pathogens from odontogenic infections. Culturing GPAC is time consuming and labor intensive. The objectives of the present study were to examine the utility of polymerase chain reaction (PCR) in directly detecting the presence of GPAC in clinical samples obtained from patients with odontogenic infections and to compare the distribution of GPAC in infected and healthy tissue. In the present case-control study, the infected tissue from patients and oral mucosal swabs from healthy control subjects were subjected to anaerobic culture and direct PCR analysis for the presence of GPAC. The McNemar, chi-square, and Fisher exact tests and kappa analysis were used for the statistical analyses. P < .05 was regarded as significant. The patient group included 13 men and 14 women, including 9 patients diagnosed with granulation of tooth extraction, 6 with impacted tooth follicles, 4 with peri-implantitis, 3 with abscesses, 2 with epithelial cysts, 2 with infected cysts, and 1 with an oroantral fistula. The control group included 14 men and 12 women. All the patient and control samples contained at least 1 GPAC. The groups did not differ by method of determining GPAC presence, but more microorganisms were detected when clinical samples were directly used for PCR analysis than when cultured bacteria were used (P= .001). The presence of GPAC in infected tissue cannot be directly related to the development of odontogenic infections. PCR performed directly on clinical material is a sensitive and specific method that can detect GPAC and save time.

Management of an impacted inverted mesiodens associated with a large circumferential type of dentigerous cyst: A rare case report with one-year follow-up

Introduction: A dentigerous cyst is a developmental cyst of odontogenic origin, which apparently develops by accumulation of fluid between the reduced enamel epithelium and the tooth crown of an unerupted tooth, with consequent expansion of tooth follicle. It may be associated with crown of unerupted teeth, odontomas, or supernumerary teeth. Ninety-five percent of dentigerous cysts are associated with permanent dentition whereas only 5% are with supernumerary teeth.

Pericoronal Follicles of Asymptomatic Impacted Teeth: A Radiographic, Histomorphologic, and Immunohistochemical Study

Objective. To associate radiographic and histopathological features of pericoronal follicles (PFs) of asymptomatic impacted teeth and evaluate cell proliferation and apoptosis in the epithelium. Study Design. Epithelium and mesenchyme of radiographically normal (NPF ≤ 2.5 mm) and hyperplastic (HPF 2.6 to 5 mm) PF (n = 140) were studied histologically. Cell proliferation (PI) and epithelial apoptosis were evaluated by Ki-67 and bcl-2 expression in 14 NPFs and 10 dentigerous cysts (DCs). Results. Radiographically, 127 were NPFs and 13 were HPFs; 87.8% of total PFs exhibited epithelium on the surface. Reduced enamel epithelium was observed in 78 (61.4%) NPFs and 6 (46.2%) HPFs, squamous metaplasia in 17 (13.4%) NPFs and 4 (30.8%) HPFs, and cystic epithelium in 15 (11.8%) NPFs and 3 (23%) HPFs. Mean PI was 1.97 ± 1.25 and 7.97 ± 1.74 in the epithelial component of NPF and DC, respectively; bcl-2 positive expression was observed in 9 (64.3%) NPFs and 7 (70%) DCs. Conclusion. The scant epithelial remnant proliferation could imply low risk for development of odontogenic pathologies in the absence of an additional stimulus.

Dentigerous cyst involving an inverted mesiodens—a rare report with unusual findings

Dentigerous cysts are developmental cysts of odontogenic origin, which surround the crown of unerupted teeth, odontomas, or supernumerary teeth. It is formed by the accumulation of fluid between the reduced enamel epithelium and the crown, with consequent expansion of the tooth follicle, and is characteristically attached to the cervical area of the tooth. Dentigerous cysts involving an inverted mesiodens is a rare occurrence with only few cases reported. The aim of this article is to report a case of a dentigerous cyst of the anterior maxilla involving an impacted and inverted mesiodens which is extremely rare and unusual.

Impacted Inverted Teeth with their Possible Treatment Protocols

Inversion of the impacted tooth is a rare condition. The purpose of this article is to review this rare condition in detail on the basis of available literature. In addition, this article also explores the various multidisciplinary approaches varying from space creation to prosthodontic rehabilitation and reimplantation to endodontic treatment for inverted impacted teeth. A very few cases of inverted and impacted third molars have been reported in the literature. We describe few rare cases of inverted impacted teeth which presented to us in the Dept. Of Oral Surgery, K.D. Dental College and Hospital over a period of 2years approx. we report of four cases presented to us with inverted maxillary third molars (Figs. 1, 2), inverted supernumerary tooth in anterior maxilla (Figs. 3, 4). The first and second case of maxillary third molar and third case, of supernumerary tooth, the patients presented were asymptomatic, hence patient opted for conservative management and continued follow up, in the fourth case, the supernumerary tooth was removed for orthodontic reasons. On the basis of literature available, it has been noticed that related complications particularly depend on justification on whether the tooth follicle is with a pathology or is pathology-free. Pathology-free and asymptomatic cases can be treated in a conservative manner. Possible treatment protocol for impacted inversion is entirely dependent on patient's needs, findings and surgeons skills.

Moving an incisor across the midline: A treatment alternative in an adolescent patient

A 13-year-old sought treatment for a severely compromised maxillary left central incisor and an impacted fully developed left canine. Extraction of both teeth became necessary. As the key component of the revised comprehensive treatment plan, the right maxillary central incisor was moved into the position of the left central incisor. All other maxillary teeth were moved mesially to close any gaps. Active orthodontic treatment was completed after 34 months. Frenectomy, minor periodontal surgeries, and bonded lingual retainers were used to improve aesthetics and stabilize the tooth positions. The patient was pleased with the treatment outcome. Cone-beam computed tomography provided evidence that the tooth movement was accompanied by a deviation of the most anterior portion of the median palatine suture. This observation may make relapse more likely if long-term retention cannot be ensured. Root resorption was not observed as a consequence of the major tooth movement.

Odontogenic ameloblast-associated protein nature of the amyloid found in calcifying epithelial odontogenic tumors and unerupted tooth follicles

We have previously reported that the amyloid found in three patients with calcifying epithelial odontogenic tumors (CEOT) was composed of N-terminal fragments of a putative 153-residue protein specified by a gene designated FLJ20513 now known to represent exons 5 through 10 of the odontogenic ameloblast-associated protein (ODAM) locus that encodes a 279-residue polypeptide. Confirmation of the amyloidogenic potential of ODAM has resulted from analyses of four other cases where we found, in addition, a 74-residue segment specified by exon 4. Through preparation of ODAM-related synthetic peptides, it was possible to localize the fibril-forming region of this molecule, as well as generate a monoclonal antibody that reacted specifically with the amyloid associated with CEOT. Notably, we also detected green birefringent congophilic material in unerupted tooth follicles – a precursor of CEOT – and demonstrated through immunologic and chemical analyses the ODAM nature of the deposits. Our studies have provided further evidence for this unique form of odontogenic amyloid that we provisionally designate “AODAM”.

Dentigerous Cyst After Distraction Osteogenesis of the Mandible

Damage to the dentition or tooth follicle is often cited as a potential complication of Distraction Osteogenesis (DO). The authors describe a case of a dentigerous cyst that developed following DO of the mandible. The possible histogenic mechanisms and the management are outlined. Understanding the causes of dentigerous cysts as well as the anatomy of the neonatal mandible may help avoid such a complication in the future.

Effect of mandibular distraction osteogenesis on developing molars

To observe the effect of mandibular distraction osteogenesis (DO) on developing molars. Descriptive clinical study. University hospital setting. Seventeen children (mean age 7.6 years) with various syndromes (hemifacial/craniofacial microsomia, Goldenhar syndrome, Treacher Collins syndrome, Nager syndrome and Pyle-Bakwin-Krida syndrome) participated. experimental variable - Severely retrognathic lower jaws were distracted (mean 30 days) with an extraoral bicortically fixed DO device. Consecutive panoramic tomograms were analysed after a mean follow-up period of 3.6 years, range 1-6.9 years. The mandibular molars were affected by DO in 13 of the 17 patients which included 18 of 63 mandibular molars studied. Structural changes included root malformations, hindered tooth development and the destruction of tooth follicles. Positional changes such as shifted and tilted teeth were also found. Three injured teeth failed to erupt. These changes were because of splitting of the tooth follicle during the osteotomy (22%), piercing of the tooth follicle by the pin (39%) or migration of tooth germ towards the newly created bone (39%). Fifteen per cent of first molars, 43% of second molars and 31% of third molars were affected during the distraction process. Of all dental injuries, 44% were noticed while the appliance was in place. A further 17% of injuries were noted between 3 months and 1 year postoperatively and 33% during the second postoperative year. Although dental injuries are a minor disadvantage compared with the vast benefits offered by DO, focusing on these drawbacks might lead to re-consideration of the type of the device as well as the timing of DO.

Primary failure of tooth eruption associated with secondarily inflamed dental follicle: inflammatory follicular cyst?

Primary failure of eruption represents a cessation of tooth eruption before emergence not due to a physical barrier or abnormal position and has no systemic cause. This failure of tooth eruption is rare phenomenon and it has not been associated with alterations of dental follicle. This case report describes a permanent right first molar with primary failure of eruption at the inferior border of the mandible presenting microscopic, clinical and radiographic findings compatible with follicular cystic lesion. The follicular tissues of this molar showed microscopic aspects of inflammation. Thus, pericoronal tissues surrounding long-term unerupted teeth with primary failure of eruption has potential to develop into odontogenic cysts. The lesion presented herein probably arose in association with a periodontal pocket mesial to the adjacent second molar, representing an atypical inflammatory follicular cyst. This case shares etiological, radiological and microscopic features with the usual form of the inflammatory follicular cyst associated with infected primary teeth, except for the infection pathways reaching the tooth follicle. The controversies regarding the terminology for this cyst are discussed.

Epidermal growth factor receptor distribution in pericoronal follicles: relationship with the origin of odontogenic cysts and tumors

Investigate the distribution of epidermal growth factor receptor (EGFR) in pericoronal follicles as a predictor of progression to odontogenic cysts and tumors. Immunohistochemical EGFR staining patterns (membrane-only, cytoplasm-only, or combined membrane and cytoplasmic staining) in the reduced enamel epithelium and nests of odontogenic epithelium associated with follicles of impacted molar teeth were evaluated. The staining pattern of 20 specimens of pericoronal follicle was compared with that of 16 normal oral mucosa samples and to squamous cell carcinoma samples. Combined membrane and cytoplasmic staining was observed for normal oral mucosa mostly in proliferating layers (basal and suprabasal), decreasing in intensity toward the surface. Seven epithelial nests presented membrane-only staining, and the majority presented either a cytoplasm-only or a combined staining pattern. The staining patterns observed in reduced enamel epithelium were cytoplasm-only and combined. EGFR membrane-only staining may be an indicator of increased potential for epithelial nests to become odontogenic cysts or tumors.

Removal of Mandibular Tooth Follicles Before Distraction Osteogenesis

Removal of Mandibular Tooth Follicles Before Distraction Osteogenesis

Tooth follicle extirpation and uvulectomy

Migration is not only the movement of people, but also of their culture, customs and beliefs. As more people from developing countries in Africa migrate to industrialized countries, the more likely health professionals will find themselves providing care for people of whose customs and practices they have little knowledge. This review of the literature suggests that removal of deciduous canine follicles and uvulectomy are frequently practised in some African and neighbouring countries. Reasons given for deciduous canine extirpation include the prevention of vomiting, fever and diarrhoea. The indications for uvulectomy appear widespread, including treatment for persistent fever, coughing and growth retardation. The practices are usually performed by traditional healers. Risks for children who undergo these procedures are extensive, including septicaemia, potential for HIV transmission, numerous dental complications and death. With improved understanding between Western health teams and local, traditional people, an improved system may develop whereby the two systems can work together in providing improved health outcomes for the people.

MIB-1 expression in odontogenic epithelial rests, epithelium of healthy oral mucosa and epithelium of selected odontogenic cysts: An immunohistochemical study

The aim of this study is to investigate the proliferative potential of rests of odontogenic epithelium found in follicles of unerupted teeth, epithelium of oral mucosa and epithelial linings of various odontogenic cysts. MIB-1 expression was studied in the rests of odontogenic epithelium ( n = 10), healthy oral mucosa ( n = 10), odontogenic keratocysts ( n = 10) and other odontogenic cysts ( n = 10) using an avidin–biotin peroxidase technique on paraffin sections. The number of positively stained cells was counted on 10 representative areas of epithelium using a ×40 objective. The average number of MIB-1 positive cells in each group was calculated. No MIB-1 positive cells were seen in the rests of odontogenic epithelium. The mean numbers of MIB-1 positive cells detected within the epithelium of oral mucosa, and of radicular and dentigerous cysts were similar. The number of MIB-1 positive cells was found to be increased in the presence of marked inflammatory cell infiltration. The highest number of MIB-1 positive cells was seen in the keratocysts. These findings suggest that removal of an unerupted tooth to prevent the possibility of neoplastic transformation of rests of odontogenic epithelium is not a justifiable rationale.