Resorption related to orthodontics and some morphological features of the periodontal microvascular bed

Root resorption in the furcation area: a differential diagnostic consideration

BACKGROUND

This report describes the case of a 51-year-old female who was referred to a periodontist with a tentative diagnosis of complicated furcation defect in the facial aspect of the second permanent molar in the mandibular right quadrant.

METHODS

The clinical examination revealed an asymptomatic tooth without evidence of abnormal attrition, caries, or periodontitis. A closer assessment revealed a large concave lesion located close to the furcation entrance without being obviously connected to it. Periapical radiographs confirmed the presence of a lesion in the hard tissues of the root overlapping the furcation area, and radiolucency of the periapical area of the mesial and distal roots was observed.

RESULTS

A tentative diagnosis of tooth fracture with consecutive supraosseous external root resorption was made, and exploratory surgery was performed to disclose the features of the lesion. The direct visual inspection revealed a deep round, conical lesion close to the entrance of the furcation. The base of the lesion was irregular but clean. After removal of a large amalgam restoration, a complete vertical mesio-distal fracture was disclosed.

CONCLUSIONS

External root resorption can be found in the furcation area of mandibular teeth as a result of chronic inflammation. The radiolucent image is poorly delimited and departs from the well-delimited furcation involvement restricted to bone, which is a consequence of periodontitis. The careful interpretation of the clinical and radiographic signs can assist the clinician to differentiate the diagnosis of root resorption in the furcation area from furcation involvements that result from periodontitis.

Dental abnormalities associated with familial expansile osteolysis: a clinical and radiographic study

Familial expansile osteolysis is a rare and possibly unique form of hereditary bone dysplasia with dental manifestations that has affected 42 members of a Northern Ireland family for five generations. Twenty-seven family members, aged 3 to 60 years, were examined clinically and radiographically, and it was found that cervical and/or apical root resorption is an early manifestation of the dysplasia. Of the 20 family members with skeletal manifestations of familial expansile osteolysis, 16 showed root resorption. Root resorption may therefore be a good prognosticator for later bone involvement.

Application of the iodide clearance technique to monitor local changes in periodontal ligament blood flow

The present study was undertaken to validate a newly developed technique for monitoring blood flow changes with local clearance of 125I- in the periodontal ligament (PDL). The tracer substance was allowed to diffuse into the intact PDL via a cavity that was drilled from the root canal out towards the root surface. Electric stimulation of the cervical sympathetic trunk caused a reduction in the clearance rate of the tracer from the cavity in a frequency-dependent manner. Intra-arterial infusions of noradrenaline also induced decreases in clearance rate. Intra-arterial infusions of the vasodilators substance P and vasoactive intestinal peptide induced increases in clearance rate. The present technique makes it possible to monitor local blood flow changes in the intact PDL during both decreases and increases in blood flow.