Storage media for avulsed teeth: a literature review

Dental avulsion is the most severe type of traumatic tooth injuries because it causes damageto several structures and results in the complete displacement of the tooth from its socketin the alveolar bone. The ideal situation is to replant an exarticulated tooth immediatelyafter avulsion because the extraoral time is a determinant factor for treatment successand for a good prognosis. However, it is not always possible. The success of replantationdepends on a number of factors that may contribute to accelerate or minimize theoccurrence of root resorption or ankylosis, among which is the type and characteristicsof the medium used for temporary storage during the time elapsed between avulsionand replantation. Maintaining the tooth in an adequate wet medium that can preserve,as longer as possible, the vitality of the periodontal ligament cells that remain on rootsurface is the key to success of replantation. Recent research has led to the developmentof storage media that produce conditions that closely resemble the original socketenvironment, with adequate osmolality (cell pressure), pH, nutritional metabolites andglucose, and thus create the best possible conditions for storage. Although these storagemedia can now be purchased in the form of retail products, the most common scenariois that such a product will not be readily available at the moment of the accident Thispaper reviews the literature on the different storage media that have been investigatedfor avulsed teeth based on full-length papers retrieved from PubMed/Medline, Lilacs, BBOand SciELO electronic databases using the key words storage medium , transportationmedium , avulsion , tooth avulsion , replantation , tooth replantation , milk and propolis .After application of inclusion and exclusion criteria, 39 papers were selected and criticallyreviewed with respect to the characteristics, efficacy and ease of access of the storagemedium. The review of the lite

Surgical-orthodontic tractio for impacted maxillary canines: a critical review and suggested protocol

Maxillary canine impaction is a common occurrence, especially in the palate, despite sufficient space in the arch for tooth alignment. A proper approach requires knowledge of different specialties of dentistry, such as orthodontics, surgery, radiology, and periodontology, which are generally not centered on a single professional. The causes for canine impaction may be either generalized or localized, and the diagnosis should be made through specific clinical and radiographic examination. The prognosis of surgical-orthodontic treatment depends on the position of the canine in relation to the neighboring teeth and height of the alveolar process, in addition to careful surgical technique, considering that there are risks involved, such as ankylosis, loss of tooth vitality, root resorption of the involved tooth and adjacent teeth, and damage to supporting tissues. Given the important role played by impacted maxillary canines, their traction is the treatment of choice in orthodontically treated patients. The present study reviews the literature on important factors to be considered when approaching impacted canines, such as therapeutic possibilities, their advantages and disadvantages.

Treatment of traumatic dental intrusion by surgical repositioning: clinical case report

The prevalence of dental trauma and its consequences are challenging. This article presents a clinical case of a 9-year-old female who was in a bicycling accident and had a dental intrusion of the left maxillary lateral incisor with extensive dislocation. In the emergency department, surgical repositioning of the intruded tooth and a splinting with steel wire and composite resin was performed and the soft-tissue lesions were sutured. Two weeks after the first visit, pulp necrosis was found and endodontic treatment of the intruded tooth was started with a calcium hydroxide dressing. Despite the traumatic nature of the dental injury, the result of treatment was favorable. After 3 years of follow-up, repair of the resorptions and no signs of ankylosis of the teeth involved were evident. Considering the patient's age and the extent of intrusion, it was concluded that surgical repositioning associated with adequate endodontic therapy was an effective alternative treatment for this case.

Estudo histomorfométrico do processo de reparo de dentes reimplantados em ratos pinealectomizados

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência de diferentes tratamentos físico-químicos na adesão e viabilidade de fibroblastos de ligamento periodontal à superfície radicular simulando dentes avulsionados

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeito do filme de carbono DLC aplicado por plasma como recobrimento em Polietileno de Ultra Densidade e Alto Peso Molecular (UHWPE) e planejamento virtual utilizando a técnica de elementos finitos em cirúrgias de próteses totais da ATM

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Osteoarthrosis in a Coyote x Dog Hybrid from Nebraska

Osteoarthrosis is described in a wild, 14-year-old coyote (Canis latrans) x dog (C. familiaris) hybrid shot in southeastern Nebraska. There was ankylosis of five vertebrae, the head of the left femur was absent, and periarticular osteophytes occurred throughout the skeleton. The age is significant because wild coyotes seldom live beyond 6 years and coyote x dog hybrids are considered to be less fit for survival in the wild than coyotes.

Efeito do filme de carbono DLC aplicado por plasma como recobrimento em Polietileno de Ultra Densidade e Alto Peso Molecular (UHWPE) e planejamento virtual utilizando a técnica de elementos finitos em cirúrgias de próteses totais da ATM

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Skeletal abnormalities in humpback whales Megaptera novaeangliae stranded in the Brazilian breeding ground

Skeletal tissues of 49 humpback whales Megaptera novaeangliae that stranded between 2002 and 2011 along the Abrolhos Bank seashore and its adjacent waters in Brazil were studied. Twelve (24.5%) animals presented pathological changes in one or more bones. Degenerative changes and developmental malformations were most frequent (10.2% each), followed by inflammatory/infectious and traumatic lesions (8.2% each). Infectious diseases led to severe lesions of the caudal vertebrae of 2 whales. In one of these individuals, the lesions involved 6 caudal vertebrae, leading to ankylosis of 3 vertebrae. Degenerative changes were observed in the vertebral columns of 3 animals, involving the joints of 13 ribs of 1 individual, and in the humerus of 1 whale. Traumatic lesions, such as osseous callus in the ribs, were observed in 4 animals. In 1 whale, the rib showed severe osteomyelitis, possibly resulting from the infection of multiple fractures. Developmental abnormalities such as spina bifida on 3 cervical vertebrae of 1 whale, fusion of spinal processes on thoracic vertebrae of 1 individual and fusion of the first 2 ribs unilaterally or bilaterally in 4 animals were found. Chronic infectious conditions found in the axial skeleton may have restrained spinal mobility and had detrimental effects on the general health of the animals, contributing to stranding and death. To our knowledge, this is the first systematic study on skeletal lesions in stranded humpback whales.

Conservative Treatment of Comminuted Mandibular Fracture Involving Maxillomandibular Fixation With Miniplates

Bars and steel wires are the most commonly used methods to achieve maxillomandibular fixation, although there are numerous alternatives described for this same purpose. In cases of edentulous candidates for the conservative treatment of facial fractures, none of the conventional methods can be instituted for maxillomandibular fixation. Fixation in such cases is achieved with the aid of the total dentures of the patient or the confection of splints, but these methods lead to eating and oral hygiene problems. This article reports the case of an edentulous patient with a comminuted mandible fracture treated with a rarely described technique in which intermaxillary fixation was achieved with titanium miniplates.

Implant-Supported Prosthesis Misalignment Related to the Dental Arch: A 14-Year Clinical Follow-up

The purpose of this study was to warn the dental community about a possible problem in function with partial implant-supported prostheses used for long periods. The misalignment between natural teeth and the implant-supported prosthesis on teeth 11 and 12, observed in a 14-year clinical follow-up, illustrates the fact. The metal-ceramic crowns were placed in 1995 after a rigorous occlusal adjustment. Evaluations were made at 4, 6, 9, and 14 years, when it was noticed that the restorations were positioned palatally and extruded in comparison with the natural teeth. After 9 years, a greater discrepancy was noticed, with anterior occlusion and esthetic changes. The possible causes have been discussed: occlusal problems, parafunctional habits, and natural movement. The first 2 options were discarded after clinical analysis and diagnosis. Therefore, the natural movement probably deriving from an interaction of mechanical and genetic factors might have been the cause. The implants do not have periodontal ligaments but rather ankylosis, so they do not suffer those movements. This case emphasizes the need to inform patients that implants can last more than 10 years in function, but this is not the case with restorations, which lose function and esthetics and must be replaced.

Atividade muscular da mastigação na anquilose temporomandibular

Purpose: due to the presence of major masticatory dysfunction in patients with temporomandibular joint (TMJ) ankylosis, this study analyzed mouth opening and EMG activity of masticatory muscles in order to detect changes in these parameters after surgical release of mandible ankylosis. Method: in 7 patients with temporomandibular ankylosis, between 7 and 30 years (median = 9 years), the distance was measured as interincisal maximum active (DIMA) and we recorded the electromyographic activity (EMG) of masseter and temporal muscles during voluntary isometric contraction (VIC) and chewing, comparing the data before and after surgery using the Wilcoxon test. Results: higher values were observed for DIMA after surgery (p=0.0277), the asymmetry index showed no difference between the two evaluated periods for both studied muscles, the values of the EMG during VIC decreased after surgery for the right (p=0.0179) and left (p=0.0179) masseter but not for the temporal muscle, there were no changes in EMG values for the studied muscles during mastication. Conclusion: the surgical release of TMJ ankylosis resulted in an increase of mouth opening and decreased amplitude of action potentials generated during maximum isometric voluntary contraction of the masseter muscle on both sides, this did not change the asymmetry index of the masseter and temporal as well as the electromyographic activity of the temporal muscle bilaterally during isometric contraction and masseter and temporal muscles during mastication.

Hypervitaminosis A-induced hepatic fibrosis in a cat

Rationale: The excessive intake of vitamin A in the form of vitamin concentrate, supplement or vitamin-rich liver can result in hypervitaminosis A in man and animals. Although osteopathologies resulting from chronic vitamin A intoxication in cats are well characterized, no information is available concerning feline hypervitaminosis A-induced liver disease. Clinical summary: We report the first case of hepatic stellate cell lipidosis and hepatic fibrosis in a domestic cat that had been fed a diet based on raw beef liver. Radiographic examination revealed exostoses and ankylosis between vertebrae C1 and T7, compatible with deforming cervical spondylosis. Necropsy showed a slightly enlarged and light yellow to bronze liver. Microscopic and ultrastructural analyses of liver tissues revealed diffuse and severe liver fibrosis associated with hepatic stellate cell hyperplasia and hypertrophy. These cells showed immunopositive staining for α-smooth muscle actin and desmin markers. The necropsy findings of chronic liver disease coupled with osteopathology supported the diagnosis of hypervitaminosis A. Practical relevance: As in human hepatology, if there is dietary evidence to support increased intake of vitamin A, then hypervitaminosis A should be considered in the differential diagnosis of chronic liver disease in cats.

Treatment of replacement resorption by intentional replantation, resection of the ankylosed sites, and Emdogain--results of a 6-year survey

The present clinical study investigated the outcome of intentional replantation using resection of the ankylosed sites of the root, extraoral endodontic treatment using titanium posts and Emdogain for periodontal healing following trauma-related ankylosis. During an evaluation period of 6 years, 16 ankylosed teeth affected by replacement resorption were treated as described. Evaluation parameters before treatment and during the follow-up period included Periotest scores, percussion sound and periapical radiographs. All findings were compared to those of the adjacent teeth. In a second accident, one tooth was lost after 7 months and was excluded as a dropout. Ankylosis did not recur in seven replanted teeth, which were observed for an average of 52.3 months (range: 24-68 months). Ankylosis recurred in eight teeth after an average period of 12 months (range: 4-26 months). An infraocclusion, normal or only slightly reduced Periotest scores and normal percussion sound were preoperatively found in six of seven successfully replanted teeth, which corresponded to a relatively small area of ankylosis. The majority of the teeth showing recurrent ankylosis preoperatively presented with normal position, negative Periotest scores and a high percussion sound which corresponded to an extended area of ankylosis. Statistically significant relationship between preoperative findings and the treatment outcome (P = 0.031) have become apparent. The results indicate that the treatment of minor areas of ankylosis by intentional replantation, resection of the ankylosed sites and Emdogain appeared to prevent or delay the recurrence of ankylosis in 7 of 15 teeth.

Morphological and immunocytochemical characterization of feline odontoclastic resorptive lesions

Objective: Feline odontoclastic resorptive lesions (FORL) are common in domestic cats. The disease is painful, and leads to root resorption and replacement by bone, and tooth loss. The cause of this non-curable disease has not been established. The present study focused on the periodontal ligament (PL) in clinically and histologically healthy teeth and in teeth exhibiting various degrees of FORL. Methods: A total of 176 tissue blocks from 29 teeth was available for light and transmission electron microscopy. An antibody against osteopontin (OPN) was used for high-resolution immunocytochemistry, since this protein is involved in bone remodeling, cell adhesion, and inflammation. Results: A partial low cell number and an occasional translucent perivascular zone characterized the PL in healthy looking teeth. In teeth exhibiting small or initial FORL, the perivascular hyalinization was more pronounced, cell number was reduced, and widened channels connected the PL with the alveolar bone. In teeth exhibiting severe forms of FORL, the PL tissue was drastically affected. PL regions with massive tissue destruction were characterized by a lack of both cells and extracellular matrix, while other regions were replaced by bone marrow stroma. OPN labeling was restricted to the PL-facing matrix portions of bone and cementum. Conclusion: PL alterations seem to be a common feature in feline teeth. PL degeneration may initially be associated with vasculitis and appeared to increase with the severity of FORL. Since the PL did not recover and bone marrow stroma occupied the degenerated PL, ankylosis and replacement resorption are regarded as unavoidable sequelae.