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Abstract
Non-surgical periodontal treatment has traditionally been based on the notion that bacterial plaque (dental biofilm) penetrates and infects dental cementum. Removal of this infected cementum via scaling and root planing (SRP) was considered essential for re-establishing periodontal health. In the 1980s the concept of SRP was questioned because several in vitro studies showed that the biofilm was superficially located on the root surface and its disruption and removal could be relatively easily achieved by ultrasonic instrumentation of the root surface (known as root surface debridement (RSD). Subsequent in vivo studies corroborated the in vitro findings. There is now sufficient clinical evidence to substantiate the concept that the deliberate removal of cementum by SRP is no longer warranted or justified, and that the more gentle and conservative approach of RSD should be implemented in daily periodontal practice.
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2
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Satheesh K, MacNeill SR, Rapley JW, Cobb CM. The CEJ: a biofilm and calculus trap. Compend Contin Educ Dent 2011; 32:30-40. [PMID: 21473298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
There is a direct correlation between increasing periodontal probing depth and increasing presence of residual biofilms and calculus. One of the more common areas to find postscaling and root-planing residual biofilm and calculus is the cemento-enamel junction (CEJ)--an area that in most cases is easily accessible. Yet few studies have addressed the question of why the CEJ is a potential biofilm and calculus trap. This article discusses the various anatomical relationships of enamel, dentin, and cementum at the CEJ, the role of CEJ anatomy in the retention of biofilm (with SEM photographs as supporting evidence), and the biological and clinical implications of subgingival residual biofilm and calculus.
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Affiliation(s)
- Keerthana Satheesh
- Department of Periodontics, School of Dentistry, University of Missouri-Kansas City, Missouri, USA
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3
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Yip HK, Guo JH, Wong WHS. Incipient caries lesions on cementum by mono- and co-culture oral bacteria. J Dent 2007; 35:377-82. [PMID: 17174463 DOI: 10.1016/j.jdent.2006.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2006] [Revised: 10/27/2006] [Accepted: 11/09/2006] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES There is increasing prevalence of root caries. We hypothesized different biofilms will cause varying demineralization in cementum. This study investigated the extent of demineralization of cementum by oral biofilm formed from three major cariogenic microorganisms: Streptococcus mutans, Lactobacillus acidophilus, and Actinomyces israelii. Sound cementum tooth blocks were incubated with mono-, bi-, and tri-species combinations of the bacteria under investigation. MATERIALS AND METHODS The matrix (amide I) and phosphate content of the lesions was analyzed by Fourier-transform infrared spectroscopy (FTIR), and calcium and phosphorus levels were analyzed by scanning electron microscopy and energy-dispersive spectroscopy (SEM-EDX). RESULTS The log[amide I:HPO(4)(2-) absorbance] values showed that A. israelii mono-culture caused significantly more demineralization than the other bacterial cultures. log[Ca:P] showed that all carious lesions were confined to the cementum. CONCLUSIONS Oral biofilm arising from bacterial species A. israelii alone was the most cariogenic of those tested and produced the most demineralization in incipient carious lesions in cementum.
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Affiliation(s)
- H K Yip
- Family Dentistry and Endodontics, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong, China.
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4
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Araki AT, Ibraki Y, Kawakami T, Lage-Marques JL. Er:Yag laser irradiation of the microbiological apical biofilm. Braz Dent J 2007; 17:296-9. [PMID: 17262142 DOI: 10.1590/s0103-64402006000400006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2006] [Accepted: 08/30/2006] [Indexed: 11/22/2022] Open
Abstract
One problem in cases of healing-resistant periapical lesions is to eradicate the contamination at the periapical area. This contamination is due to the microbiological biofilm formed by microorganisms and their subproducts lodged in apical third of the root, on both cementum and dentin surface. Paraendodontic surgery consists of the mechanical removal of harmful agents to promote healing and periapical health. The purpose of this study was to assess the results of Er:YAG laser irradiation on the apical root third of newly extracted teeth to eliminate microbial contamination on root apex surface. Apical irradiation was performed with an Er:YAG laser device using an experimental contact tip, at 100 mJ, 10 Hz, 1 W, 39 J/cm(2), 3 times on the target area. SEM analysis showed the elimination of part of the irradiated cementum and the formation of small roughened without exposing the subjacent dentin. Vaporization of the remaining periodontal tissue and removal of microbiological apical biofilm (MAB) were also observed on the irradiated areas. Under the tested conditions and based on the findings of this study, Er:YAG laser may be considered effective for removal of microbiological apical biofilm.
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Affiliation(s)
- Angela Toshie Araki
- Department of Endodontics, School of Dentistry, University of São Paulo, Avenida Professor Lineu Prestes 2227, 05508-000 São Paulo, SP, Brazil
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5
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Gonçalves PF, Gurgel BCV, Pimentel SP, Sallum EA, Sallum AW, Casati MZ, Nociti FH. Effect of two different approaches for root decontamination on new cementum formation following guided tissue regeneration: a histomorphometric study in dogs. J Periodontal Res 2007; 41:535-40. [PMID: 17076778 DOI: 10.1111/j.1600-0765.2006.00902.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim of the present study was to evaluate comparatively the effect of two different approaches for root decontamination on new cementum formation following guided tissue regeneration (GTR). MATERIAL AND METHODS Nine mongrel dogs were used to obtain bilateral chronic class III furcation defects by placing cotton ligatures around both third mandibular premolars. The teeth were randomly assigned to receive one of the following treatments: scaling and root planing, by means of hand and rotatory instruments, in order to remove soft and hard deposits as well as all root cementum (group A); or removal of only soft microbial deposits, by polishing the root surface with rubber cups and polishing paste, aiming for maximum root cementum preservation (group B). Both groups were treated with GTR, with the use of resorbable polyglycolic-lactic acid membranes (RESOLUT XT). RESULTS Four months later, data analysis showed that a superior length (mm) (3.59 +/- 1.67 and 6.20 +/- 2.26 for groups A and B, respectively; p = 0.004) and a thicker layer (microm) (18.89 +/- 9.47 and 52.29 +/- 22.48 for groups A and B, respectively; p = 0.001) of new cementum was achieved by keeping the root cementum in place during root decontamination (group B). Regardless of the treatment modality, the new cementum was predominantly of a reparative, cellular extrinsic and intrinsic fiber type. CONCLUSION Within the limits of the present study, it may be concluded that root cementum preservation may affect the new cementum formation following GTR in class III furcation defects, and the treatment modality did not influence the type of newly formed cementum.
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Affiliation(s)
- P F Gonçalves
- Division of Periodontics, School of Dentistry at Piracicaba, UNICAMP, São Paulo, Brazil
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6
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Abstract
Fimbriae, which are involved in adherence, constitute an important pathogenic factor of Porphyromonas gingivalis. In vivo, however, the distribution of P. gingivalis-carrying fimbriae is unknown. The localization of P. gingivalis-carrying fimbriae was examined in situ. From 19 patients with severe periodontitis and P. gingivalis, we obtained 20 teeth with periodontal tissue attached, with and without immunolocalized fimbriae. Eleven teeth were subjected to light microscopy, 9 to electron microscopy. In 6 of the 11 samples examined, we detected positive reactions with an anti-P. gingivalis-fimbriae serum, located in the cementum-attached plaque area in the deep pocket zones. In the so-called 'plaque-free zones', P. gingivalis-carrying fimbriae were immunocytochemically observed to reside in contact with the dental cuticle in 6 of the 9 samples examined. These findings suggest that P. gingivalis-carrying fimbriae are strongly related to adherence to the root surface at the bottoms of human periodontal pockets.
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Affiliation(s)
- Y Noiri
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
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7
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Abstract
The aim of this study was to evaluate the presence of bacterial biofilm on the external surface of the root apex in teeth with pulp necrosis, with and without radiographically visible periapical lesions, and in teeth with a vital pulp. Twenty-one teeth were extracted, eight with pulp necrosis and periapical lesions, eight with pulp necrosis without radiographically visible periapical lesions, and five with a vital pulp. The roots were sectioned, and the root apexes (+/- 3 mm) were processed for scanning electron microscope evaluation. The surface of the apical root was evaluated for the presence of microorganisms, root resorption, and biofilm. There were no microorganisms on the apical root surface of either teeth with pulp vitality or with pulp necrosis with no radiographically visible periapical lesions. Microorganisms were always present in teeth with pulp necrosis and radiographically visible periapical lesions. These included cocci, bacilli, and filaments and the presence of an apical biofilm. Apical biofilm is clinically important because microbial biofilms are inherently resistant to antimicrobial agents and cannot be removed by biomechanical preparation alone. This may cause failure of endodontic treatment as a consequence of persistent infection.
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Affiliation(s)
- Mário R Leonardo
- Department of Restorative Dentistry, School of Dentistry of Araraquara, Faculdade de Odontologia de Araraquara, UNESP, SP, Brazil
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8
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Liu CM, Shyu YC, Pei SC, Lan WH, Hou LT. In vitro effect of laser irradiation on cementum-bound endotoxin isolated from periodontally diseased roots. J Periodontol 2002; 73:1260-6. [PMID: 12479628 DOI: 10.1902/jop.2002.73.11.1260] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND In a previous study, we evaluated the in vivo effects of an Nd:YAG laser on periodontal disease by measuring crevicular interleukin (IL)-1beta levels before and after laser application. It was found that laser therapy was less effective than traditional scaling and root planing. These results might be due to incomplete removal of microbial residues and cementum-bound endotoxin on root surfaces by the laser. In this study, we explored the in vitro effectiveness of an Nd:YAG laser for the elimination of cementum-bound endotoxin by measuring IL-1beta changes in stimulated monocytes. METHODS Fresh human monocytes were harvested from adults without periodontitis and grown in RPMI 1640 medium. Diseased cementum particles were collected and prepared from teeth with untreated periodontitis and were irradiated with 5 levels of laser energy. Cementum particles were subjected to endotoxin testing by a limulus amebocyte lysate (LAL) assay and then were incubated with cultured monocytes. Production of IL-1beta in stimulated monocytes was measured by enzyme-linked immunosorbent assay and quantified by spectrophotometry. RESULTS The endotoxin unit (EU) of diseased cementum was 18.4 EU/mg, which seemed to be remarkably lower than that of common periodontal pathogens including Porphyromonas gingivalis (381) at 15,300 EU/mg/ml, Prevotella intermedia (ATCC 25611) at 227 EU/mg/ml, and Fusobacterium nucleatum (ATCC 25586) at 1,987 EU/mg/ml. Monocytes subjected to stimulation by diseased cementum particles without laser irradiation produced 124 to 145 pg/ml IL-1beta, 9- to 18-fold higher than that of unstimulated monocytes (7.07 to 15.95 pg/ml). Diseased cementum particles after irradiation with various energy levels of the Nd:YAG laser could still stimulate monocytes to secrete 89 to 129 pg/ml IL-1beta. No statistically significant difference was found in the production of IL-1beta induced by diseased-bound cementum with or without laser irradiation. CONCLUSIONS The Nd:YAG laser varying from 50 mJ, 10 pps to 150 mJ, 20 pps, for 2 minutes, did not seem to be effective in destroying diseased cementum endotoxin.
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Affiliation(s)
- Cheing-Meei Liu
- Department of Periodontology, School of Dentistry, College of Medicine, National Taiwan University and Hospital, Taipei, Taiwan
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9
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Abstract
The aim of this study was to examine morphologically the participation of extraradicular biofilm in refractory periapical periodontitis. Six teeth and five extruded root filling gutta-percha points associated with refractory periapical periodontitis were investigated by scanning electron microscope. In nine of 11 samples examined, bacterial biofilms were seen at the extraradicular area. The gutta-percha surface was covered with glycocalyx-like structures, and filaments, long rods, and spirochete-shaped bacteria were predominant in the extraradicular sites. Planktonic cells, which were filaments and spirochete-shaped bacteria, emigrated from the glycocalyx structures in some spots. In the extracted teeth, biofilm consisting of both bacteria and glycocalyx-like structures were observed on the periapical root surfaces. Next to the residual periodontal ligament, a few filaments, rods, and fusiforms were attached on the healthy cementum surface. The present findings suggested that bacterial biofilms formed in the extraradicular areas were related to refractory periapical periodontitis.
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Affiliation(s)
- Yuichiro Noiri
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate, School of Dentistry, Suita, Japan
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10
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Balto K, White R, Mueller R, Stashenko P. A mouse model of inflammatory root resorption induced by pulpal infection. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002; 93:461-8. [PMID: 12029286 DOI: 10.1067/moe.2002.122641] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The present study was undertaken to determine the frequency and extent of apical root resorption associated with induced periradicular lesions in mice. STUDY DESIGN Bone and root resorption was quantified by using two- and three-dimensional micro-computed tomography (mu-CT) in the lower first molars of mice subjected to pulp exposure and infection. RESULTS mu-CT measurements showed significant apical resorption in exposed and infected teeth, resulting in an average distal root shortening of 12.7% (P <.001 vs unexposed). These findings were confirmed with three-dimensional reconstituted images that showed thinning and shortening of the distal root. Tartrate-resistant acid phosphatase clastic cells were associated with resorption lacunae on the cementum of root apices, as well as on bone at the periphery of the periradicular lesions. Brown and Brenn staining showed the presence of bacteria in dentinal tubules adjacent to resorbed cementum. CONCLUSIONS Apical root resorption is a prominent and consistent finding associated with periradicular infection in the mouse. This species represents a convenient model for studying the pathogenesis of inflammatory root resorption in vivo.
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Affiliation(s)
- Khaled Balto
- Department of Cytokine Biology, Forsyth Institute, Boston, Mass 02115, USA
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11
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Abstract
Two sets of teeth with apical periodontitis were collected at different geographic locations to study the identity of bacteria left in the root dentinal tubules. Root dentin of 20 of these teeth was cultured from three locations between pulp and cementum (A, B, and C). In addition dentin from eight teeth was examined histologically. Using the culturing technique bacteria were found in 77% of the dentin samples from set 1 (Amsterdam) and in 87.5% of the dentin samples from set 2 (Glasgow). At greater distance, in layer C, from the pulp bacteria were found in 62% (13 of 21) of the dentin samples. Twenty-three percent (3 of 13) of set 1 and 25% (2 of 8) of set 2 contained >50,000 colony-forming units/mg of dentin in layer C. In layers closer to the pulp higher numbers of anaerobic bacteria and gram-positive rods were found, as well as a larger number of bacterial species. Histological sections showed bacterial penetration in dentinal tubules in 5 of 8 teeth. In the other three teeth where the colony-forming units/mg recovered was <10,000, no histological signs of tubule penetration was seen. It seems clear that, in more than half of the infected roots, bacteria are present in the deep dentin close to the cementum and that anaerobic culturing of dentin is more sensitive than histology to detect these bacteria.
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Affiliation(s)
- L B Peters
- Department of Cariology, Endodontology, and Pedodontology, Academic Center for Dentistry Amsterdam, The Netherlands
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12
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Okte E, Bal B. Topography of periodontally involved human root surfaces after different chemical treatment modalities: an in vitro scanning electron microscopic study. J Oral Sci 2000; 42:139-46. [PMID: 11111324 DOI: 10.2334/josnusd.42.139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The significance of chemical and conservative treatments of cemental tissue proximal to periodontal pockets has been pointed out in recent years. This in vitro scanning electron microscopy (SEM) study aimed to investigate the surface effects of topical applications of 0.1% cetylpyridinium chloride (CPC) and 2% sodium lauryl sulfate (SLS) and polishing on the periodontally involved root surfaces of human teeth. Ten single-rooted teeth from 8 patients with advanced adult periodontitis were included. Following extraction, any calculus was removed with extreme care to preserve as much cementum as possible. Eighty root specimens were prepared. Fresh solutions of CPC and SLS were applied for 1, 3 and 5 minutes each to 10 segments of root cementum. A total of 20 segments formed the polished (P) and control (C) groups, respectively. The results showed that the surfaces treated with CPC or SLS differed considerably from polished and control specimens. Depending on time, the surface coating was partly or wholly removed, leaving a nodular cementum structure, uncovering a fibrillar collagen substrate and the openings of dentinal tubules. Scarce debris was present on both control and polished surfaces, whereas bacteria were observed only on the control specimens. In view of these results, further definitive in vitro and in vivo research must be done to determine the advantages of chemical treatment and its effect on periodontal regeneration.
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Affiliation(s)
- E Okte
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey.
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13
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Abstract
The persistent presence of bacteria in the root canal system often leads to the failure of treatment. The purpose of this study was to determine in vitro penetration of Streptococcus sanguis and Prevotella intermedia into dentinal tubules. Samples obtained from human teeth were inoculated with a strain of S. sanguis (NCTC 7853) and P. intermedia (NCTC 93336) for 20 days. Bacterial penetration into tubules was investigated at scanning electron microscopy and light microscopic level. The results showed that S. sanguis could penetrate into dentinal tubules 382.3 microns, whereas P. intermedia could penetrate 25.9 microns. It was observed that P. intermedia had not penetrated into all dentinal tubules. If penetration occurred the depth was quite limited.
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Affiliation(s)
- M Berkiten
- Department of Microbiology and Clinical Microbiology, Istanbul University, Istanbul Faculty of Medicine, 34390, Capa, Istanbul, Turkey
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14
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Sandhu HS, Salloum IA, Stakiw JE. Scaling and root planing: hand versus power-driven instruments. J Can Dent Assoc 1998; 64:269-75. [PMID: 9594465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Scaling and root planing (S&RP) are regarded as the main modalities for treating periodontal disease. The goal of these treatments is to arrest the disease process, maintain a healthy periodontium and preserve the dentition. As prevention becomes a larger component of everyday dental practice, dentists are performing S&RP more often as part of their periodontal maintenance programs. Therefore, it is essential for dentists to know the latest S&RP techniques and methods. This paper reviews the current knowledge and experiences related to mechanical non-surgical periodontal therapy and focuses on the types of S&RP instruments that are available, their advantages and disadvantages, their efficacy in debridement, and their effects on the hard tissues of the oral cavity.
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Affiliation(s)
- H S Sandhu
- Division of Periodontics, Faculty of Dentistry, University of Western Ontario, London
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15
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Micheletti Cremasco M. Dental histology: study of aging processes in root dentine. Boll Soc Ital Biol Sper 1998; 74:19-28. [PMID: 10965360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The amount of sclerotic root dentine increases with age, proceeding from the apex towards the crown. There are obvious optical changes in the tissue, which becomes translucent (dentine is normally opaque). Therefore, the sclerosis of root dentine could be a reliable indicator of age in anthropological studies of human remains. We studied the histological aspects of sclerotic dentine in longitudinal thin sections (70-140 microns) of undecalcified premolars, cut in the bucco-lingual plane. To quantify the sclerosis and to construct a reference standard, we sectioned 85 premolars from subjects of known age (70 from odontological extractions and 15 from a university collection). Another 10 teeth from medieval subjects were studied to assess the applicability of the method to ancient skeletal collections. The technique consists of embedding the tooth in a polyester resin (cold method), sectioning it with a diamond blade microtome. Qualitative analysis was performed with polarized light microscopy and measurements were made with a quote 2D x,y viewer and on digital images. The sclerotic root dentine was quantified with both linear and surface area parameters in order to assess the correlation with age. The quality of the sections was sufficient for the clear discernment and quantification of the sclerotic dentine. Indeed, the technique allowed us to obtain good results with a considerable saving of time and money compared with other dental histological techniques. The best correlation with age was obtained from the surface area parameter, particularly after exclusion of the cementum and pulp chamber. To produce comparable data from similar studies, we advise the use of cold resins, as used here, and digital computerized analyzers because of their accuracy, precision and quickness. The qualitative analysis of the ancient teeth indications that this dental aging techniques can be applied to both recent and ancient dental tissues.
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Abstract
This study describes the histologic characteristics of root surfaces of primary teeth from children with prepubertal periodontitis (PP). Fifteen primary teeth from 4 children with PP, and 2 control primary teeth from 2 healthy children were examined. Light microscopy revealed normal root surfaces in the control teeth. In contrast, the PP specimens revealed bacteria inside dentin tubules or covering cementum, a cuticle, or resorbed dentin; normal, wider than normal, or hypoplastic cementum; resorption lacunae with various depths; aplastic root resorption; alternate resorption and repair; and active repair. No cementoclasts were found in the resorption lacunae. Scanning electron microscopy revealed intrabony and suprabony root areas, and a "plaque free zone" (PFZ). Colonies of filaments were evident at the cemento-enamel junction (CEJ). The suprabony root surfaces had resorption lacunae, isolated short rods, calculus, colonies of filaments, or colonies composed by an heterogeneous bacterial population. The coronal boundary of the PFZ was the border of a sheet-like structure, which included isolated rods or filaments. At the PFZ, isolated filaments and rods, and a fibril matrix were evident. The apical boundary of the PFZ consisted of bundles of soft tissue remnants or the insertion of the periodontal fibers. The intrabony surfaces were mostly covered by soft tissue, which included isolated filaments and short rods. Resorption lacunae with or without soft tissue were also evident in this area. Crystals of calcium oxalate dihydrate and erythrocytes in distinct forms were found at various root areas. The present findings are different from those previously reported for hypophosphatasia specimens.
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Affiliation(s)
- E Bimstein
- Department of Pediatric Dentistry, The Hebrew University-Hadassah School of Dental Medicine Jerusalem, Israel.
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17
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Williams JC, Gharbia SE, Gulabivala K, Rajendram D, Mehta N, Huttson R, Collins MD, Shah HN. Noncultivable microbial communities in dentine and cementum: a molecular analytical approach. Clin Infect Dis 1997; 25 Suppl 2:S233-4. [PMID: 9310689 DOI: 10.1086/516203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- J C Williams
- Eastman Dental Institute, University of London, United Kingdom
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18
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Abstract
Candida albicans is a fungus that commonly infects oral mucosal surfaces. Limited data exist on biofilm formation by C. albicans on dental surfaces. Human premolar teeth were infected with C. albicans for 10 days and hard-tissue surfaces were examined with a scanning electron microscope. Enamel, cementum and dentine, in the absence or presence of a smear layer, were readily colonized by this micro-organism. Hyphae penetrated into cracks, followed the ridges of the cavities and migrated into dentinal tubules. Blastospores and hyphae were embedded in an extracellular material. These findings suggest that dental hard tissues may be invaded by C. albicans and thus can potentially present a reservoir for disseminating candidal infections.
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Affiliation(s)
- B H Sen
- Department of Restorative Dentistry and Endodontology, School of Dentistry, Ege University, Izmir, Turkey
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19
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Crespi R, Covani U, Margarone JE, Andreana S. Topographic distribution of subgingival plaque along root surfaces of human periodontally diseased teeth. A descriptive study. J Clin Periodontol 1996; 23:698-703. [PMID: 8841904 DOI: 10.1111/j.1600-051x.1996.tb00596.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The purpose of this study was to characterize the topographical distribution and organization of subgingival plaque in periodontally diseased teeth. 26 extracted teeth were fixed and processed for undecalcified histological evaluation. The sections were cut perpendicular to the long axis of the tooth and analyzed by phase-contrast microscopy. The coronal portion of the analyzed roots showed a dense accumulation of filamentous forms, fusiform rods, coccoid forms and loosely aggregated spirochetes. The middle and apical portions showed a non-uniform distribution of the microflora, with microorganisms representing all the known morphotypes. Furthermore, plaque was detected below undisturbed periodontal fibers, indicating that plaque not only forms apically, but also in a lateral direction, penetrating and colonizing below areas where periodontal fibers are inserted into the root surface.
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Affiliation(s)
- R Crespi
- Department of Oral and Maxillo-facial Surgery, School of Dental Medicine, State University of New York at Buffalo, USA
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20
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Abstract
This study concerns the apical border (AB) plaque in relation to severe forms of periodontitis (SP), including juvenile, post-juvenile, and rapidly progressing periodontitis. Twenty-four (24) teeth from 16 patients with SP were examined by transmission electron microscopy (TEM). The AB was not discrete, with islands of bacteria in the so-called plaque-free zone (PFZ). Coronal to the AB the established plaque consisted of a layer of Gram-positive cocci and ghost cells and a superficial layer mainly of Gram-negative morphotypes, including cocci, rods, filaments, fusiforms, and spirochetes. The most apical apparently intact organisms in the PFZ were in bacterial islands or in isolation and were predominantly Gram-negative cocci and rods, with ghost cells in abundance. Ruthenium red, alcian blue-lanthanum nitrate, and safranin O were used to label matrix polyanionic macromolecules, and periodic acid (thiosemicarbazide) silver proteinate for intracellular polysaccharide (IPS). The matrix components were mainly fibrillar. Many intact bacteria exhibited extracellular polysaccharides or glycocalyces associated with their cell wall, and cytoplasmic IPS granules. The latter varied in distribution and were evident even in the most apically advanced intact microorganisms. The results indicate that IPS and some matrix features of the apical border plaque in severe periodontitis in certain aspects resemble those of sub-contact area plaque on children's teeth, in health or associated with early chronic gingivitis, and with those in chronic adult periodontitis. They also suggest the establishment of acidic regions in the microniche at the bottom of the periodontal pocket in the various forms of periodontitis differing in rate of progression. It was concluded that there was a limited range of intact bacterial morphotypes in the apical border plaque in severe periodontitis, similar to those in chronic adult periodontitis.
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Affiliation(s)
- T P Vrahopoulos
- Department of Periodontology, Eastman Dental Institute, University of London, UK
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21
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Schüpbach P, Osterwalder V, Guggenheim B. Human root caries: microbiota in plaque covering sound, carious and arrested carious root surfaces. Caries Res 1995; 29:382-95. [PMID: 8521441 DOI: 10.1159/000262097] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The plaque microbiota covering sound or carious root surfaces were studied and compared with that covering arrested root caries lesions. From each of these categories five extracted teeth were examined. The experimental design of the study allowed us to relate the qualitative and quantitative microbial composition to the degree of integrity of the root surface. Plaque was sampled by a newly developed 'mowing' technique. Plaque samples were cultured anaerobically on nonselective Columbia blood agar plates supplemented with 5% hemolyzed human blood and on media selective for Lactobacillus spp. and streptococci of the mutans group. The cultivable microbiota were quantitatively speciated using Rapid ID 32A, Rapid ID 32 Strep, API 20 Strep, API ZYM, and API 50 CH tests and SDS-PAG electrophoresis. Regardless of the state of mineralization, the microbiota on all surfaces resembled marginal plaque associated with gingivitis. In addition to the gram-positive predominant facultative anaerobic genera Streptococcus, Staphylococcus, Lactobacillus and Actinomyces, gram-negative anaerobes, predominantly Bacteroides, Prevotella, Selenomonas, Fusobacterium, Leptotrichia, and Capnocytophaga, showed the highest isolation frequencies. On all surfaces Actinomyces spp. predominated, with streptococci and lactobacilli forming a minor part of the microbiota. With respect to the detected proportions of anaerobes, microaerophiles, Actinomyces naeslundii, Prevotella buccae and Selenomonas dianae, significant differences were observed between the three categories of root surfaces. The total CFU's on both caries-free and caries-active surfaces were significantly higher than on arrested lesions. In general, the results support a polymicrobial etiology for caries initiation on root surfaces, with A. naeslundii, Capnocytophaga spp., and Prevotella spp. making specific contributions to the processes of cementum and dentin breakdown.
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Affiliation(s)
- P Schüpbach
- Institut für Orale Mikrobiologie und Allgemeine Immunologie, Universität Zürich, Schweiz
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Leonardo MR, Almeida WA, Ito IY, da Silva LA. Radiographic and microbiologic evaluation of posttreatment apical and periapical repair of root canals of dogs' teeth with experimentally induced chronic lesion. Oral Surg Oral Med Oral Pathol 1994; 78:232-8. [PMID: 7936595 DOI: 10.1016/0030-4220(94)90153-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The objective of the present study was to evaluate radiographically and bacteriologically apical and periapical repair in dogs' teeth with induced chronic periapical lesions with the use of two different operative techniques (techniques 1 and 2). The study was conducted on 40 root canals of upper and lower premolars from two dogs aged approximately 12 months. Periapical lesions were induced by leaving the root canals exposed to the oral environment for 5 days and then sealing them with zinc oxide-eugenol for 45 days. After this period, radiographic examination revealed the occurrence of a radiolucent lesion and endodontic treatment was started. The two techniques did not differ in terms of chemomechanical preparation, final filling, or type of cement, but differed in terms of irrigating solution and the presence of an antibacterial dressing. Thus 4% to 6% hypochlorite and hydrogen peroxide (10 volumes) were used in technique 1 during chemomechanical preparation and an antibacterial dressing based on calcium hydroxide was applied between sessions, whereas Dakin's fluid (0.5% sodium hypochlorite solution) and a final filling with no antibacterial dressing were used in technique 2. After chemomechanical preparation, the root canals were filled with gutta-percha cones and Sealapex (Sealapex-Sybron, Kerr, Sao Paulo, Brazil), and the animals were killed 270 days after the final filling. Blocks were cut into 6-microns sections and stained by the Brown and Brenn method.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M R Leonardo
- School of Dentistry of Araraquara and School of Dentistry of Barretos, UNESP, Araraquara, Brazil
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Abstract
The aim of this study was to determine whether microorganisms invade periapical cementum of human teeth from the adjacent periapical lesions. We therefore attempted to isolate microorganisms from periapical cementum through the adoption of standard anaerobic procedures for obligate anaerobes. Samples of cementum were taken from 10 amputated tooth roots at the time of apicoectomy. From two of these samples, bacteria were recovered after anaerobic incubation, but no bacteria were recovered after aerobic incubation of the same samples. Of a total of eight isolates from the cementum, seven were obligate anaerobes and one was aerotolerant. The obligate anaerobes isolated were assigned to the genera Prevotella, Peptostreptococcus, Eubacterium, and Fusobacterium. The aerotolerant anaerobe was Campylobacter. From this, we conclude that bacteria can successfully invade cementum via periapical periodontal tissue, and that such bacteria may play a significant role in chronic periapical pathosis.
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Affiliation(s)
- T Kiryu
- Department of Operative Dentistry and Endodontics, Niigata University School of Dentistry, Japan
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Abstract
This study examined the dental cuticle (DC) at the interface with cementum surface, as well as its relationship to the overlying subgingival plaque (SP), the so-called plaque-free zone (PFZ), the junctional epithelium (JE), and the coronal fibers of the residual periodontal ligament (PL) by transmission electron microscopy (TEM) and histochemistry. Material comprised of 41 extracted, adult periodontitis-affected teeth (AP). Following extraction, 20 teeth were fixed in 3% glutaraldehyde in 0.1M sodium cacodylate, post-fixed in 1% osmium tetroxide, embedded in araldite, decalcified in EDTA, re-embedded in araldite, and sectioned. En bloc histochemistry was undertaken on the remaining 21 teeth, using ruthenium red, alcian blue-lanthanum nitrate, or safranin-O, and processed as above. Results show that the DC covered the cementum surface from the SP to the JE, and formed an interface with these structures. No DC was observed at the interface with PL. Morphological variations in DC surface were observed at the interface with the SP and at the so-called PFZ where bacteria were always in close contact with or surrounded by the DC. At the interface with JE, the DC appeared homogeneous, although layers varying in electron density were distinguishable. Teeth treated histochemically revealed a positive reaction of DC and bacteria to the three methods, suggesting the presence of anionic polymers including glycoproteins in the DC. It was concluded that on adult periodontitis affected teeth, the DC always covers exposed cementum and may mediate bacterial adhesion, and adsorb components from the periodontal pocket.
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Affiliation(s)
- M T Friedman
- Electron Microscopy Unit, Institute of Dental Surgery, London, UK
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O'Hehir T. Studies question extensive root planing to remove cementum. RDH 1992; 12:46. [PMID: 1410642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Schroeder HE. [The effects of furcation morphology on periodontal disease]. Dtsch Zahnarztl Z 1991; 46:324-7. [PMID: 1817045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Enamel spurs projecting from the cemento-enamel junction into the furcation as well as small islands and droplets of enamel deposited on furcational root surfaces are characteristic morphological features of human maxillary and mandibular molars. The furrows and recesses created by these structures form pathways for bacterial invasion and predispose for local periodontitis. Furthermore, the furcations are often covered by thick central cementum ridges, with steplike or tongue-like deepenings around enamel droplets. In the cementum, there is a variable number of small and large openings, representing either cementum-inherent channels or large open connections between pulp chamber and furcation. These structures offer ample opportunities for uncontrollable bacterial retention and colonisation, and the possibility for pulpal infections to spread into the furcation. The literature covering these issues is summarized.
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Abstract
This study describes the structural features of the interface between microbial deposits and root cementum in actively progressing root-surface caries lesions developed experimentally in six elderly individuals. A total of 18 specimens was examined by microradiography, and a further 18 by light and transmission electron microscopy after intra-oral periods of one, two, and three months. All specimens showed various degrees of subsurface dissolution of mineral and bacterial invasion of the cementum. Although the microradiographic pattern of mineral loss was subsurface in nature, transmission electron microscopy showed dissolution of crystals in the outermost layers of the cementum, with a distinct gradient inward. Bacterial invasion occurred along the borders between bundles of relatively well-mineralized extrinsic collagen fibers in which the characteristic cross-banding remained intact. The pattern of bacterial invasion was influenced by the incremental lines and the cemento-dentinal junction. The invading bacteria were almost exclusively Gram-positive, of various shapes, and possessed thick, moderately electron-dense cell walls and electron-lucent "vacuoles" in the cytoplasm. It is concluded that because of pronounced mineral loss of the outermost cementum, accompanied by bacterial invasion, the surface of an active cementum caries lesion, as observed by transmission electron microscopy, is not identical to that seen in microradiograms.
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Affiliation(s)
- B Nyvad
- Department of Oral Anatomy, Royal Dental College, Arhus, Denmark
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Abstract
Thirty-nine permanent teeth from three siblings aged 11 to 14 years were extracted because of generalized prepubertal periodontitis (PP) and studied histologically with light microscopy. Twenty healthy teeth (HT) removed for orthodontic procedures from 10 children of similar ages and 22 teeth affected by adult periodontitis (AP) extracted from patients over 50 years old were used as controls. The cementum of the PP teeth was much thicker than that of the healthy teeth. A high percentage of resorption, unrelated to inflammation, was found in all the teeth studied. In 24 PP teeth the cementum was infiltrated by microorganisms and bacterial substances. All PP teeth showed a cuticle ranging from 10 to 80 microns in thickness on the diseased cementum. No similar structure was noted on the diseased cementum of the AP teeth. The PP teeth did not show any structural changes which could account for the severity of the periodontal lesions.
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Affiliation(s)
- N J López
- Section of Periodontology, Dental School, University of Chile, Santiago
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Abstract
We have described the morphology of developing plaque on cementum in an in vivo human model. Slabs of cementum obtained from sound teeth, rendered anorganic with 5% sodium hypochlorite, were glued to orthodontic brackets and positioned on the upper canines, premolars and molars in 8 volunteers. The brackets were removed after 2, 4, 8, 24 h and processed for scanning electron microscopy (SEM). Within 2 h, a thin pellicle covered the cementum surface, with few micro-organisms detectable. At 4 and 8 h, coccoid plaques were present. Filaments inserted perpendicularly to the plaque surface were seen at 24 h. The results indicate that early bacterial colonization of human cementum is a selective process, mediated by an organic pellicle and mainly involves cocci.
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Affiliation(s)
- A Carrassi
- Department of Dentistry and Stomatology, Medical School, University of Milan, Italy
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Abstract
Superficial root caries lesions of incisors and premolars of 24 patients aged 52-60 years were studied by scanning electron microscopy and transmission electron microscopy. In the predominantly gram-positive bacteria of the root dental plaque, a great number of corncob configurations were observed. Bacterial infiltration into cementum occurred without any gradient of demineralization and mainly followed the borders between calcified cementum bundles as well as incremental lines. The narrow channels which were filled initially by a single row of gram-positive bacteria broadened progressively with simultaneous destruction of the apatite minerals and the collagenous matrix. Root dentin invasion showed great similarities to coronal dentin with an important gradient of demineralization. In the deep layers, sclerosed tubules contained sometimes rhombohedral crystals. In more superficial layers, bacterial invasion occurred initially in still partially sclerosed tubules. Tubular lumens as well as lateral side branches which had lost their peritubular dentin were filled with gram-positive microorganisms. An important diffuse destruction of the apatite minerals was observed at this stage in the intertubular dentin which still presented typical cross-banded collagen fibrils. The confluence of enlarged dentinal tubules filled by numerous microorganisms led to large bacterial zones with complete destruction of root dentin.
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Affiliation(s)
- R M Frank
- Centre de Recherches, Unité INSERM U 157, Faculté de Chirurgie Dentaire, Strasbourg, France
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Adriaens PA, Edwards CA, De Boever JA, Loesche WJ. Ultrastructural observations on bacterial invasion in cementum and radicular dentin of periodontally diseased human teeth. J Periodontol 1988; 59:493-503. [PMID: 3171862 DOI: 10.1902/jop.1988.59.8.493] [Citation(s) in RCA: 203] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In this study the bacterial invasion in root cementum and radicular dentin of periodontally diseased, caries-free human teeth was examined. In addition, structural changes in these tissues, which could be related to the bacterial invasion, were reported. Twenty-one caries-free human teeth with extensive periodontal attachment loss were studied by light and scanning electron microscopy. At the base of the gingival pocket, bacteria were found in the spaces between remnants of Sharpey's fibers and their point of insertion in the cementum. In teeth that had been scaled and root planed, most of the root cementum had been removed. Bacterial invasion was found in the remaining root cementum. The invasion seemed to start as a localized process, often involving only one bacterium. In other areas bacteria were present in lacunar defects in the cementum. These lacunae extended into the radicular dentin. In 11 teeth bacteria had invaded the dentinal tubules. Most bacteria were located in the outer 300 microns of the dentinal tubules, although occasionally they were found in deeper parts. In two of the nontreated teeth, bacteria were detected on the pulpal wall. No correlation was found between the presence of bacterial invasion and the absence of radicular cementum. No bacteria were found in the portion of the root located apically to the epithelial attachment. These data are in agreement with our results from cultural studies of the bacterial flora in these structures. It was also demonstrated that in spite of meticulous scaling and root planning and personal oral hygiene, bacterial plaque remained present on radicular surfaces. Both the invaded dentinal tubules and the lacunae could act as bacterial reservoirs from which recolonization of treated root surfaces occurs. From these reservoirs bacteria could also induce pulpal pathoses. Since these bacterial reservoirs are not eliminated by conventional mechanical periodontal treatment, it seems appropriate to combine mechanical periodontal therapy with the use of chemotherapeutic agents.
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Affiliation(s)
- P A Adriaens
- State University of Ghent, School of Dentistry, Department of Fixed Prosthetics and Periodontology, University Hospital, Belgium
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Adriaens PA, De Boever JA, Loesche WJ. Bacterial invasion in root cementum and radicular dentin of periodontally diseased teeth in humans. A reservoir of periodontopathic bacteria. J Periodontol 1988; 59:222-30. [PMID: 3164373 DOI: 10.1902/jop.1988.59.4.222] [Citation(s) in RCA: 225] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In this study the viability and the distribution of bacteria within the radicular dentin and pulp of periodontally diseased caries-free teeth were studied. Healthy teeth served as controls. Samples were obtained from the pulp tissue and from the radicular dentin. Dentin samples were taken from the interdental surfaces in the subgingival area. Starting from the pulpal side, three to five successive dentin layers of approximately 1 mm thickness were sampled. The samples were processed and cultured using an anaerobic technique. Bacterial growth was detected in 87% of the periodontally diseased teeth. In 83% of the teeth, bacteria were present in at least one of the dentin layers. Fifty-nine percent of the diseased teeth, from which the pulp tissue was cultured, contained bacteria in the pulp samples. The mean bacterial concentrations in the pulp and dentin layers ranged from 1,399 to 16,537 colony-forming units (CFU) per mg of tissue. These concentrations were 259 to 7,190 times greater than concentrations found in healthy teeth. It is suggested that the roots of periodontally diseased teeth could act as bacterial reservoirs from which recolonization of mechanically treated root surfaces can occur, as well as infection of the dental pulp. These findings might change current concepts concerning root surface debridement in periodontal therapy.
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Affiliation(s)
- P A Adriaens
- University of Michigan, School of Dentistry, Department of Oral Biology, Ann Arbor 48109
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Topoll HH, Crenshaw M, Simpson DM. [Indirect immunohistochemical test of the endotoxin of Veillonella alcalescens and of peptidoglycans in the root cementum of periodontally diseased teeth]. Dtsch Zahnarztl Z 1986; 41:325-9. [PMID: 3461943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Abstract
Subsurface enamel lesions and root surface caries-like lesions were consistently produced in vitro using Streptococcus mutans FA1 cultured in thioglycollate broth containing 3.5% w/v dextrose and 2% w/v gelatin. When viewed in polarized light and after imbibition in water, the enamel lesions had a negatively birefringent surface zone and positively birefringent body of the lesion. Those lesions produced after six weeks, after imbibition in quinoline, exhibited a dark zone. The root surface caries-like lesions exhibited a less-radiolucent surface zone above a heavily demineralized body of the lesion. However, no reactionary dentin was seen in the in vitro lesions.
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Abstract
Contamination of periodontally involved cementum by bacterial substances such as lipopolysaccharide (LPS) is considered a major reason for root planing. The purpose of the present study was to investigate the presence and location of lipid and polysaccharide within involved cementum as compared with uninvolved cementum. Frozen sections were prepared from the decalcified roots of 36 periodontally diseased and two control teeth. Serial sections were stained for either lipid (Oil-Red-O) or polysaccharide (Alcian Blue - PAS) and also with haematoxylin & eosin (H & E) or Huberstone's gram stain. Specimens of involved and uninvolved cementum were then examined under the light microscope for assessment of differences. Involved cementum from 12 of the periodontally diseased teeth exhibited strongly PAS-positive stained processes penetrating 3-7 mum into the surface of cementum from overlying plaque. Such processes were not observed in uninvolved cementum, suggesting a possible bacterial origin. Lipid granules were noted in only one involved specimen where they were situated up to 10 mum beneath the cemental surface. Similar granules were observed within plaque deposits but never in uninvolved cementum, again suggesting a possible bacterial origin. H & E and gram-stained specimens revealed the presence of microbial deposits in surface defects and within defects at the cemento-dentinal junction (CDJ), as well as penetration of micro-organisms into cementum in the absence of any surface defects. The results indicate that although lipid and polysaccharide of possible bacterial origin may be present within the 10 mum surface zone of involved cementum, the finding of microbial deposits down to the level of the CDJ suggests that all periodontally involved cementum should be removed during root planing, in order to achieve a root surface free of bacterial contamination.
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Patters MR, Landesberg RL, Johansson LA, Trummel CL, Robertson PB. Bacteroides gingivalis antigens and bone resorbing activity in root surface fractions of periodontally involved teeth. J Periodontal Res 1982; 17:122-30. [PMID: 6212659 DOI: 10.1111/j.1600-0765.1982.tb01138.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Kawanami M. [An experimental study of bacterial plaque formation on surgically denuded root surface in monkeys (author's transl)]. Nihon Shishubyo Gakkai Kaishi 1980; 22:187-203. [PMID: 6780638 DOI: 10.2329/perio.22.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Abstract
By using in vitro assays, a group of related, filamentous gram-negative bacteria isolated from subgingival plaque deposits of patients with periodontal disease were found to colonize intact teeth. Tentatively identified as members of the genus Cytophaga, these isolates exhibited a preference for colonizing the cementum surface of the root. Examination of intact teeth after several weeks of colonization revealed that the root substructure had been extensively demineralized.
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Abstract
This study was undertaken in order to provide current information relative to the modes of calculus attachment to tooth surfaces. A total of 63 freshly extracted teeth were fixed, sectioned, and conventionally prepared for light, transmission electron, and scanning electron microscopic examination. Previously reported histologic findings of cuticular attachment, mechanical locking into undercuts, and direct attachment of calculus matrix to the tooth surface were affirmed. The claim of bacterial penetration as a mode of attachment has been rejected. Ultrastructural evidence of cuticular attachment has been presented for the first time via a series of scanning electron micrographs. The most frequently encountered method of attachment was found to be the apparent melding of calculus matrix to the surface of cementum. In many instances, these two substances were virtually indistinguishable.
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