Tooth Root Structure Research Articles

Predentin's influence on clastic cell behavior in human external cervical resorption: Evidence from a case study

External cervical resorption (ECR) is an aggressive disease characterized by resorption of the tooth root structure. While the pericanalar resorption-resistant sheet (PRRS) impedes ECR progression towards the pulp, the underlying mechanisms of its protective role in human teeth remain unclear. This study aimed to elucidate the pathology of ECR in a 31-year-old female patient by employing radiographic, histological, and immunohistochemical analyses of an extracted tooth. Histological examination revealed that the PRRS comprised dentin, predentin, and reparative bone-like tissue. Notably, clastic cells were observed on the surfaces of all three tissues within the same specimens. Immunohistochemical staining for cathepsin K demonstrated diminished resorptive activity of clastic cells on predentin compared to dentin and bone-like tissue. These findings suggest a potential role for predentin in attenuating clastic cell activity, potentially serving as the final barrier safeguarding the pulp tissue.

Histological and histochemical characteristics of the oral, pharyngeal and accessory digestive organs in the water monitor lizard (Varanus salvator) from Thailand.

Srichairat, N., Taksintum, W., & Chumnanpuen, P. (2022). Histological and histochemical characteristics of the oral, pharyngeal and accessory digestive organs in the water monitor lizard (Varanus salvator) from Thailand. Anatomia Histologia Embryologia, 51, https://doi.org/10.1111/ahe.12846. The water monitor lizard (Varanussalvator) is largely distributed in Southeast Asia, especially Thailand, which the microanatomical structure studies on this particular species have been limited. Therefore, the purpose of this study is to examine and describe the oral, pharyngeal and accessory digestive organs' histological and histochemical characteristics. Histological and histochemical examinations were performed on the two specimens (male and female). The majority of V.salvator oral, pharyngeal and accessory digestive organs are similar to those of other vertebrates, according to the results of the histological investigation. However, several unique characteristics have been observed, such as the dentine lamella (plicidentine fold) at the tooth root structure was discovered to be attached to the jaw bone, the absence of lingual papillae and taste buds on the tongue, and the absence of inner surface folding structures in the gallbladder. Regarding mucin histochemical investigation, acid and neutral mucins were discovered in the pharyngeal glands of V.salvator, whereas only acid mucin was found in the mandibular salivary glands. This study reveals the histological and histochemical characteristics of V.salvator oral, pharyngeal and accessory digestive organs, which could be employed to improve digestive tract function, as well as the necessity of understanding animal digestive processes.

DETERMINING THE WORKING LENGTH OF A ROOT CANAL USING INTRAORAL RADIOGRAPHY SEGMENTATION

Apexlocators are devices that determine the working length of the root canal. Measurement with the help of alternating currents of different frequencies in combination with the method of the ratio allows to achieve high accuracy in determining the location of the physiological tip of the root (over 80%). However, such devices cannot accurately visualize where a doctor's tool is. Using image processing algorithms, you can segment tooth root structures with high precision. Therefore, the combination of electronic determination of the root canal length (using apexlocator) with X-ray segmentation is relevant.

External apical root resorption after orthodontic treatment: analysis in different chronological periods.

External apical root resorption (EARR) is characterized by the definitive loss of tooth root structure, with a higher incidence in lateral and central maxillary incisors. To identify, in different chronological periods, the incidence of EARR in the maxillary incisors (MI) of patients orthodontically treated with or without premolars extraction. Periapical radiographs before and after orthodontic treatment of 1,304 MIs from 326 patients (205 women and 121 men) were evaluated for EARR, divided into five groups, according to the chronological period in which treatments were started: G90) from 1990 to 1994, G95) from 1995 to 1999, G00) from 2000 to 2004, G05) from 2005 to 2009, G10) from 2010 to 2015. The evaluation was performed in each group, in patients who underwent maxillary first premolars extraction and those who did not. For statistical analysis, Fisher's exact test was used, with a significance level of p < 0.05. The EARR was measured using the adapted Levander and Malmgren classification. Incidence of EARR was higher in MIs of patients treated with maxillary premolar extraction (p < 0.05) in two chronological periods (G00 and G10), also being influenced by orthodontic treatments with longer duration, and due to possible individual genetic factors. Even with the limitations of a retrospective study, the lack of a defined EARR pattern in the MIs at different chronological periods was larger in the experimental group, due to the sum of factors such as premolars extraction, prolonged orthodontic treatment, possible genetic characteristics, and root shape, without the influence of the sex and age.

Novel root canal sealer with dimethylaminohexadecyl methacrylate, nano-silver and nano-calcium phosphate to kill bacteria inside root dentin and increase dentin hardness

ObjectivesRoot canal re-infection and weakening of roots are two main challenges in endodontics. The objectives of the study were: (1) to develop a novel root canal sealer containing dimethylaminohexadecyl methacrylate (DMAHDM), nanoparticles of silver (NAg), and nanoparticles of amorphous calcium phosphate (NACP), and (2) to investigate the effects on the physical, anti-biofilm, remineralizing ions, and hardness of human dentin for the first time. MethodsMethacrylate-resin dual-cured root canal sealer contained 5% DMAHDM, 0.15% NAg, and NACP at 10%, 20% and 30% mass fractions. The flow, film thickness, and Ca and P ions release were investigated. The effects of NACP on radicular dentin hardness after treatment with sodium hypochlorite (NaOCL) and ethylenediaminetetraacetic acid (EDTA) were assessed. Antibacterial properties were measured against Enterococcus faecalis (E. faecalis)-impregnated dentin blocks; colony-forming units (CFU) and live/dead assays were measured. ResultsIncorporating DMAHDM, NAg and NACP did not adversely influence the flow and film thickness properties. Sealer with 30% NACP neutralized the acid and increased the solution pH (p<0.05). Sealer containing 30% NACP regenerated dentin minerals lost due to NaOCL and EDTA treatment, and increased the dentin hardness to match that of sound dentin (p>0.1). Incorporating 5% DMAHDM and 0.15% NAg reduced biofilm CFU of E. faecalis-impregnated dentin blocks by nearly 3 logs when compared control group (p<0.05). SignificanceThe novel therapeutic root canal sealer with triple bioactive agents of DMAHDM, NAg and NACP neutralized acid, raised the pH, regenerated dentin minerals, increased root dentin hardness, and reduced dentin-block-impregnated biofilm CFU by 3 logs. This new sealer with highly desirable antibacterial and remineralization properties are promising to increase the success rate of endodontic therapy and strengthen the tooth root structures.

Micro-Computed Tomography of Tooth Volume Changes Following Post Removal.

To measure tooth volume change before and after post removal using micro-CT and to compare the difference among various combinations of prefabricated post and cement systems. Forty-eight extracted maxillary anterior teeth and mandibular canines were sectioned 13 mm from the apex. Root canals were properly instrumented. Preparations were filled with gutta percha using lateral condensation. Post space was prepared with a touch and heat device, leaving 5 mm of gutta percha from the apex. Specimens were scanned with micro-CT to establish objective baseline volume and divided into two groups of post systems: stainless steel (SS) ParaPost and glass-fiber reinforced composite (FRC) post. Half the posts for each group were cemented with Ketac Cem radiopaque glass-ionomer cement, and the other half with SpeedCEM dual-curing resin cement. The posts and residual cement were removed by the same operator, using the ultrasonic vibration technique under an endodontic operating microscope. The remaining tooth root structure was scanned again using micro-CT with volume reported (mm3 ). The statistical difference between the combination of posts and cements was measured using the Kruskal-Wallis ANOVA test (α = 0.001). The independent variables were evaluated separately using post hoc Tukey examination to determine which groups resulted in a statistically significant difference. There was a statistical difference of tooth root volume change among the groups. Post hoc exam revealed a statistically significant difference in tooth root volume change between group 1 (SS + GI) and the other groups (α = 0.0002). Compared to other post and cement combinations, serrated parallel-sided SS posts cemented with GI cement had the most tooth root structure loss upon post removal using the ultrasonic vibration technique.

Mineralization defects in cementum and craniofacial bone from loss of bone sialoprotein

Bone sialoprotein (BSP) is a multifunctional extracellular matrix protein found in mineralized tissues, including bone, cartilage, tooth root cementum (both acellular and cellular types), and dentin. In order to define the role BSP plays in the process of biomineralization of these tissues, we analyzed cementogenesis, dentinogenesis, and osteogenesis (intramembranous and endochondral) in craniofacial bone in Bsp null mice and wild-type (WT) controls over a developmental period (1–60days post natal; dpn) by histology, immunohistochemistry, undecalcified histochemistry, microcomputed tomography (microCT), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and quantitative PCR (qPCR). Regions of intramembranous ossification in the alveolus, mandible, and calvaria presented delayed mineralization and osteoid accumulation, assessed by von Kossa and Goldner's trichrome stains at 1 and 14dpn. Moreover, Bsp−/− mice featured increased cranial suture size at the early time point, 1dpn. Immunostaining and PCR demonstrated that osteoblast markers, osterix, alkaline phosphatase, and osteopontin were unchanged in Bsp null mandibles compared to WT. Bsp−/− mouse molars featured a lack of functional acellular cementum formation by histology, SEM, and TEM, and subsequent loss of Sharpey's collagen fiber insertion into the tooth root structure. Bsp−/− mouse alveolar and mandibular bone featured equivalent or fewer osteoclasts at early ages (1 and 14dpn), however, increased RANKL immunostaining and mRNA, and significantly increased number of osteoclast-like cells (2–5 fold) were found at later ages (26 and 60dpn), corresponding to periodontal breakdown and severe alveolar bone resorption observed following molar teeth entering occlusion. Dentin formation was unperturbed in Bsp−/− mouse molars, with no delay in mineralization, no alteration in dentin dimensions, and no differences in odontoblast markers analyzed. No defects were identified in endochondral ossification in the cranial base, and craniofacial morphology was unaffected in Bsp−/− mice. These analyses confirm a critical role for BSP in processes of cementogenesis and intramembranous ossification of craniofacial bone, whereas endochondral ossification in the cranial base was minimally affected and dentinogenesis was normal in Bsp−/− molar teeth. Dissimilar effects of loss of BSP on mineralization of dental and craniofacial tissues suggest local differences in the role of BSP and/or yet to be defined interactions with site-specific factors.

Contribution of Mesenchymal Proliferation in Tooth Root Morphogenesis

In mouse tooth development, the roots of the first lower molar develop after crown formation to form 2 cylindrical roots by post-natal day 5. This study compared the morphogenesis and cellular events of the mesial-root-forming (MRF) and bifurcation-forming (BF) regions, located in the mesial and center of the first lower molar, to better define the developmental mechanisms involved in multi-rooted tooth formation. We found that the mesenchyme in the MRF showed relatively higher proliferation than the bifurcation region. This suggested that spatially regulated mesenchymal proliferation is required for creating cylindrical root structure. The mechanism may involve the mesenchyme forming a physical barrier to epithelial invagination of Hertwig’s epithelial root sheath. To test these ideas, we cultured roots in the presence of pharmacological inhibitors of microtubule and actin polymerization, nocodazole and cytochalasin-D. Cytochalasin D also inhibits proliferation in epithelium and mesenchyme. Both drugs resulted in altered morphological changes in the tooth root structures. In particular, the nocodazole- and cytochalasin-D-treated specimens showed a loss of root diameter and formation of a single-root, respectively. Immunolocalization and three-dimensional reconstruction results confirmed these mesenchymal cellular events, with higher proliferation in MRF in multi-rooted tooth formation.

In VitroDifferentiation and Attachment of Human Embryonic Stem Cells on Periodontal Tooth Root Surfaces

Periodontal tissue engineering based on cell replacement therapies is a promising field for improved regeneration of tooth supporting structures lost as a result of destructive periodontal diseases. Human embryonic stem cells (hESCs) could become adequate cell source for tissue engineering because of their unlimited proliferative potential and ability to differentiate to all somatic cell types. The aim of this study was to analyze the differentiation capacity of hESCs toward periodontal compartment cells and their relationship with tooth root surfaces in vitro. Periodontal ligament fibroblastic cell (PDLF) cultures were established and characterized; hESCs (HUES-9 line) were expanded in undifferentiated state and characterized for pluripotency morphologically and immunohistochemically. Extracted tooth root slices (RS) of 300 microm thickness, prepared with both periodontal and endodontic instrumentation, were used. Three different experimental groups were established: (i) undifferentiated hESC colonies cultured on and around the RS; (ii) undifferentiated hESC colonies cultured on and around RS with PDLF coculture, and (iii) undifferentiated hESC colonies cultured on and around RS with PDLF coculture in osteoinductive medium for 3 weeks. The fibrogenic and osteogenic marker expression was assessed with immunohistochemistry; histological staining and scanning electron microscopy were utilized to determine the relationship between differentiating hESCs and mineralized tooth root structures. Results demonstrate that hESC differentiation is influenced by tooth structures, PDLFs, and osteogenic medium, resulting with increased propensity toward mesenchymal lineage commitment, and formation of soft-hard tissue relationship in close contact areas. The proposed experimental system may facilitate further understanding in development of periodontal structures and contribute to realization of hESCs as a cell source in periodontal tissue engineering applications.

Composite resin root coping with a keeper for magnetic attachment for replacing the missing coronal portion of a removable partial denture abutment

Numerous methods for replacing missing removable partial denture abutments have been introduced, however, most of them are time consuming and require several visits to complete the procedure. Since magnetic attachments can provide support and bracing as well as retention for overdenture abutments, the remaining tooth root structure can be used to support the coping with the keeper. Through the use of composite resin and adhesive material, improved retention of the keeper to the root may be achieved, along with improved esthetics. This article describes a method for replacing the missing abutment of a removable partial denture with a magnetic attachment, and a composite resin coping with a keeper.

Tissue-Engineered Hybrid Tooth and Bone

Tooth loss accompanied by alveolar bone resorption presents a significant clinical problem. We have investigated the utility of a tissue-engineering approach to provide corrective therapies for tooth-bone loss. Hybrid tooth-bone tissues were bioengineered as follows. Tooth implants were generated from pig third molar tooth bud cells seeded onto polyglycolide (PGA) and polyglycolide-colactide (PLGA) scaffolds, and grown for 4 weeks in the omenta of adult rat hosts. Bone implants were generated from osteoblasts induced from bone marrow progenitor cells obtained from the same pig, seeded onto PLGA fused wafer scaffolds, and grown for 10 days in a rotational oxygen-permeable bioreactor system. The tooth and bone implants were harvested, sutured together, reimplanted, and grown in the omenta for an additional 8 weeks. Histological and immunohistochemical analyses of the excised hybrid tooth-bone constructs revealed the presence of tooth tissues, including primary and reparative dentin and enamel in the tooth portion of hybrid tooth-bone implants, and osteocalcin and bone sialoprotein-positive bone in the bone portion of hybrid tooth-bone constructs. Collagen type III-positive connective tissue resembling periodontal ligament and tooth root structures were present at the interface of bioengineered tooth and bone tissues. These results demonstrate the utility of a hybrid tooth-bone tissue-engineering approach for the eventual clinical treatment of tooth loss accompanied by alveolar bone resorption.

The effects of CO2 laser and Nd:YAG with and without water/air surface cooling on tooth root structure: correlation between FTIR spectroscopy and histology.

Morphologic and chemical characterization of root surfaces treated with either the CO2 laser, Nd:YAG, or Nd:YAG with water/air surface cooling (Nd:YAG-C) was completed using scanning electron microscopy (SEM) and FTIR photoacoustic spectroscopy (FTIR/PAS). Specimens for morphologic analysis consisted of 20 extracted single rooted teeth unaffected by periodontal disease. The specimens were exposed at varying energy densities to a single pass of the laser. SEM examination revealed, for all lasers, a direct correlation between increasing energy densities and depth of tissue ablation and width of tissue damage. The Nd:YAG-C required higher energy densities than either the CO2 or Nd:YAG lasers to achieve the same relative depth of tissue ablation. Regardless of energy density, and in contrast with other laser types, areas treated with the Nd:YAG-C did not exhibit collateral zones of heat damage. Specimens for spectroscopic examination consisted of 12 disks, 6 x 2 mm, cut from debrided root surfaces of extracted, unerupted human molars. The spectral results indicate a substantial reduction in the absorption bands attributable to protein and an additional band at 2015 cm-1 in specimens exposed to the Nd:YAG without water. In the presence of water/air coolant, the band at 2015 cm-1 appears only at a substanially higher energy density. The spectra of the CO2 treated specimens, with the char layer present, show a significant reduction in the protein bands and additional bands at 2015 and 2200 cm-1, that are tentatively assigned to the cyanamide and cyanate ions, respectively. These results suggest a reaction of the organic matrix and mineral with laser exposure.