• Title/Summary/Keyword: Alveolar bone necrosis

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AN ELECTRON MICROSCOPIC STUDY ON THE TISSUE CHANGES IN THE PRESSURE ZONES OF RAT MOLAR PERIODONTIUM INCIDENT TO ORTHODONTIC TOOTH MOVEMENT (백서구치의 교정적 치아이동중 압박측 치주조직의 초기변화에 관한 연구)

  • Koo, Jung-Hoe;Lee, Ki Soo
    • The korean journal of orthodontics
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    • v.19 no.1 s.27
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    • pp.21-44
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    • 1989
  • Incipient changes of the periodontal tissue in the pressure zones of rat molar subjected to the experimental force were studied by the transmission electron microscope. Experimental animals were consisted in 3 control and 21 experimental rats, of which one maxillary first molar was moved buccally with a fixed appliance which were exerting the force of 15 gm. After experimental period of 1 hour, 3 hours, 6 hours, 24 hours, 2 days, 3 days and 7 days, the animal were sacrificed with cardiac perfusion of $2.5\%$ glutaraldehyde in the sodium cacodylate buffer and the experimental teeth with surrounding periodontal structures were processed for electron microscope. At the beginning of the tooth movement, periodontal ligaments of the pressure were compressed and collagenous fibers were arranged parallel to the root of the teeth and cell free zones in company with cell necrosis were followed. Cell free zones at the periodontal ligaments appeared in the 3 hour survival group, and getting severe with time lapse it became widespread in 2-3 day survival group and undermining bone resorption as a healing process was observed in 7 day survival group. Dilatation of mitochondria and swelling of the rER in the fibroblast and other connective tissue cells in the periodontal ligament were observed in the 3 hour survival group, which were characteristics of the incipient changes in the compressed periodontal ligament. Dilatation of nuclear membrane and pyknosis were followed by the destruction of the nucleus and cell membrane. There were no evidence in cell damage or necrosis of the alveolar bone adjacent to the hyalinized area of periodontal ligaments.

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Unicortical Bone Necrosis of the Fibula Free Flap Associated to the Fixation with a Nonlocking 2.0-mm Reconstruction Plate and Screws

  • Pereira, Gustavo N.;Ribeiro, Diogo;Saraiva, Luis;Freitas, Hugo;Santos, Ana R.
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.413-417
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    • 2022
  • The authors present a unique case of osteonecrosis of a cortical half of a fibula free flap that has not been reported in the literature yet. This complication was associated with the impairment of the vascularization of periosteum in the cortical half of fibula that was fixated with a nonlocking reconstructive 2.0-mm plate and screws but other factors could have been involved. The patient was submitted to excision of a cemento-ossifying fibroma that resulted in a left hemimaxilectomy mesoinfrastructure defect classified as the Cordeiro type 2B. The 42-year-old female patient was submitted to reconstruction with an osteomusculocutaneous fibula free flap plus a segment of fibula graft. The two bone segments of the free flap used to reconstruct the anterior and left alveolar crest were fixated with a reconstructive 2.0-mm plate of matrixMANDIBLE system. The only reported complication was an oronasal fistula that healed with conservative treatment and the referred osteonecrosis of the external cortical half of the fibula free flap with plate exposure at 2.5 years postoperatively. Surgical excision of the osteonecrosed cortical half of the fibula with the plate and screws was performed, while the other cortical underwent bone union as corroborated by computed tomography scans.

Sequential anti-inflammatory and osteogenic effects of a dual drug delivery scaffold loaded with parthenolide and naringin in periodontitis

  • Rui Chen;Mengting Wang;Qiaoling Qi;Yanli Tang;Zhenzhao Guo;Shuai Wu;Qiyan Li
    • Journal of Periodontal and Implant Science
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    • v.53 no.1
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    • pp.20-37
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    • 2023
  • Purpose: Our pilot study showed that a 3-dimensional dual drug delivery scaffold (DDDS) loaded with Chinese herbs significantly increased the regenerated bone volume fraction. This study aimed to confirm the synergistic anti-inflammatory and osteogenic preclinical effects of this system. Methods: The targets and pathways of parthenolide and naringin were predicted. Three cell models were used to assess the anti-inflammatory effects of parthenolide and the osteogenic effects of naringin. First, the distance between the cementoenamel junction and alveolar bone crest (CEJ-ABC) and the bone mineral density (BMD) of surgical defects were measured in a rat model of periodontitis with periodontal fenestration defects. Additionally, the mRNA expression levels of matrix metallopeptidase 9 (MMP9) and alkaline phosphatase (ALP) were measured. Furthermore, the number of inflammatory cells and osteoclasts, as well as the protein expression levels of tumor necrosis factor-alpha (TNF-α) and levels of ALP were determined. Results: Target prediction suggested prostaglandin peroxidase synthase (PTGS2) as a potential target of parthenolide, while cytochrome P450 family 19 subfamily A1 (CYP19A1) and taste 2 receptor member 31 (TAS2R31) were potential targets of naringin. Parthenolide mainly targeted inflammation-related pathways, while naringin participated in steroid hormone synthesis and taste transduction. In vitro experiments revealed significant antiinflammatory effects of parthenolide on RAW264.7 cells, and significant osteogenic effects of naringin on bone marrow mesenchymal stem cells and MC3T3-E1 cells. DDDS loaded with parthenolide and naringin decreased the CEJ-ABC distance and increased BMD and ALP levels in a time-dependent manner. Inflammation was significantly alleviated after 14 days of DDDS treatment. Additionally, after 56 days, the DDDS group exhibited the highest BMD and ALP levels. Conclusions: DDDS loaded with parthenolide and naringin in a rat model achieved significant synergistic anti-inflammatory and osteogenic effects, providing powerful preclinical evidence.

PROGNOSIS OF THE SURGICALLY REPOSITIONED MAXILLARY CENTRAL INCISOR IN INTRUSIVE INJURY (함입된 상악 중절치의 외과적 재위치 후 예후)

  • Min, Sung-Jin;Ryu, Jung-Ah;Kim, Seong-Oh;Lee, Jae-Ho;Choi, Byung-Jai;Son, Heung-Kyu;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.3
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    • pp.522-528
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    • 2006
  • When tooth is displaced within the alveolar bone, it could apply pressure and rupture the apical vessels. Pulpal reaction in such case is affected by the stage of root formation, amount of intrusion and pulpal infection. Determining the need of pulp treatment depends on the pulp vitality. Therefore, periodic vitality tests, coronal color changes and radiographic root resorption signs should be observed through periodic post-trauma follow-up. Pulp necrosis, pulp canal obliteration, external root resorption, root ankylosis and marginal bone loss could result from periodontal injuries. Negative sign changes from positive signs of vitality tests suggest pulp necrosis. In this case, pulp treatment should be held before root resorption occurs. By comparing the following two cases, complications of intrusion and factors producing them could be confirmed, thus we propose to report these two cases.

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Alveolar bone necrosis and spontaneous tooth exfoliation associated with trigeminal herpes zoster: a report of three cases

  • Kim, Nam-Kyoo;Kim, Bong-Chul;Nam, Jung-Woo;Kim, Hyung-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.3
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    • pp.177-183
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    • 2012
  • Herpes zoster is a viral infection caused by the reactivation of the varicella zoster virus, an infection most commonly affecting the thoracolumbar trunk. Herpes Zoster Infection (HZI) may affect the cranial nerves, most frequently the trigeminal. HZI of the trigeminal nerve distribution network manifests as multiple, painful vesicular eruptions of the skin and mucosa which are innervated by the infected nerves. Oral vesicles usually appear after the skin manifestations. The vesicles rupture and coalesce, leaving mucosal erosions without subsequent scarring in most cases. The worst complication of HZI is post-herpetic neuralgia; other complications include facial scarring, motor nerve palsy and optic neuropathy. Osteonecrosis with spontaneous exfoliation of the teeth is an uncommon complication associated with HZI of the trigeminal nerve. We report several cases of osteomyelitis appearing on the mandible, caused by HZI, and triggering osteonecrosis or spontaneous tooth exfoliation.

Outcome of Regenerative Endodontic Treatment for an Avulsed Immature Permanent Tooth: A Case Report (완전 탈구된 미성숙 영구치의 치수재생치료 증례 보고)

  • Park, Nakyoung;Song, Jihyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.2
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    • pp.250-256
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    • 2018
  • Dental avulsion, defined as the complete displacement of a tooth from the alveolar bone with consequent loss of the blood and nerve supply, was reported as one of the most severe dental injuries. Avulsion can cause tissue ischemia, which leads to pulp necrosis. Apexification is a conventional treatment method that induces an apical calcified barrier in immature roots with pulp necrosis. However, root development characterized by an increase in the root thickness and length cannot be achieved by apexification. The purpose of this case report was to describe the radiographic and clinical outcomes of regenerative endodontic treatment for the avulsed and necrosed permanent tooth with an immature root after replantation in a 5-year-old girl; the treatment was performed using a mixture of ciprofloxacin, metronidazole and cefaclor, CollaTape and Biodentine.

A CASE REPORT OF PRIMARY INTRA-OSSEOUS CARCINOMA OF THE MAXILLA (상악골에 발생한 원발성 골내암종)

  • Park In-Woo;Choi Soon-Chul;Lee Young-Ho;Park Tae-Won;You Dong-Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.27 no.2
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    • pp.135-144
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    • 1997
  • The primary intra-osseous carcinoma (PIOC) is a very rare lesion. PIOC is an odontogenic carcinoma defined as a squamous cell carcinoma arisinig within a jaw having no initial connection with the oral mucosa, and presumably developing from residues of the odontogenic epithelium. The authors diagnosed a 51-year-old female as primary intra-osseous carcinoma after undergoing clinical, radiological and histological examinations. The characteristics were as followed : 1. The patient complained of gingival bleeding on the premolar area in the left maxilla 2. The conventional radiograms showed a relatively well-defined unilocular radiolucent lesion from the mesial aspect of the upper left canine to the mesial aspect of the upper left 1st molar. The 2nd premolar was separated from the 1st molar and the floor of the maxillary sinus was elevated by the lesion. There was a external root resorption of the upper left canine, the 1st premolar, and the 2nd premolar. 3. On the computed tomograms, the osteolytic bony lesion expanded the cortical plate of the left maxilla and displaced the margin of the left maxillary sinus upwards. But the bony lesion was separated from the maxillary sinus by a bony septum. 4. Bone scintigram with /sup 99m/Tc demonstrated the increased uptake in the left maxilla. Sonograms in the neck area and chest P-A radiogram didn't show any abnormalities. 5. Histologically, the tumor islands infiltrating into the surrounding bone increased in alveolar pattern, composed of the malignant cells, and there was a necrosis in the center of the tumor islands.

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Effect of irradiation on the healing of extraction sockets in diabetic rats (방사선조사가 당뇨 백서의 발치와 치유에 미치는 영향)

  • Kim Il-Joong;Hwang Eui-Hwan;Lee Sang-Rae
    • Imaging Science in Dentistry
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    • v.33 no.1
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    • pp.5-14
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    • 2003
  • Purpose: To observe the histologic pattern of healing in molar tooth extraction sockets of streptozotocin-induced diabetic rats following irradiation. Materials and Methods: Mature Sprague-Dawley rats were divided into three groups: control, diabetic, and diabetic-irradiated groups. Diabetes mellitus was induced by injecting streptozotocin. Control rats were injected with a citrate buffer only. After 5 days, the right maxillary first molar was extracted under general anesthesia from each of the rats. After the extraction, rats in the diabetic-irradiated group were irradiated with a single absorbed dose of 10 Gy to the head and neck region. The rats were killed at 1, 3, 7, 14, 21, and 28 days after treatment. Tissue sections were stained with hematoxylin-eosin and Masson's trichrome. Results: In the diabetic and diabetic-irradiated groups, the early healing process of the socket extraction was similar to the control group, but bone formation was delayed at 7 days after the treatment. In the diabetic-irradiated group, alveolar bone surrounding the extraction socket showed signs of necrosis at 3 days after treatment, and hemorrhage was observed in connective tissue within the extraction socket at 14 days after treatment. Conclusion: This experiment revealed that the healing process of the extraction socket was severely delayed and retarded by irradiation in the diabetic state.

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Baicalein Treatment Promotes Osteoblast Proliferation and Osteogenic Differentiation through Activation of Immediate Early Response 3

  • Lee, Sang-Im
    • Journal of dental hygiene science
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    • v.19 no.4
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    • pp.254-260
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    • 2019
  • Background: The primary aims of periodontal disease treatment is to remove dental plaque and calculus, the main causes of tooth loss, and restore periodontal tissue destroyed by inflammation. Periodontal disease treatment should also help maintain the alveolar bone, alleviate inflammation, and promote periodontal ligament cell proliferation, which is essential for tissue regeneration. Conventional antibiotics and anti-inflammatories have adverse side effects, especially during long-term use, so there is a need for adjunct treatment agents derived from natural products. The purpose of this study was to investigate whether the herbal flavone baicalein has the osteogenic activity under inflammatory conditions, and assess the involvement of osteoblast immediate early response 3 (IER3) expression. Methods: Human osteoblastic MG-63 cells were cultured with the pro-inflammatory cytokines tumor necrosis factor α and interleukin 1β in the presence and absence of baicalein. Proliferation was assessed using the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay, and expression of IER3 mRNA was assessed using real-time polymerase chain reaction. The expression of IER3 protein levels and activation of associated signal transduction pathways were assessed using western blotting. Results: Baicalein increased IER3 mRNA and protein expression synergistically. In addition, baicalein reversed the suppression of cell proliferation, and the downregulation of osteogenic transcription factor runt-related transcription factor 2 and osterix induced by pro-inflammatory cytokines. Baicalein also upregulated the phosphorylation of c-Jun N-terminal kinase (JNK) and extracellular signal-regulated kinase (ERK 1/2). The upregulation of IER3 by pro-inflammatory cytokines was blocked by pretreatment with inhibitors of AKT, p38, JNK, and ERK 1/2. Conclusion: Baicalein mitigates the deleterious responses of osteoblasts to pro-inflammatory cytokines. Further, IER3 enhanced the effect of baicalein via activation of AKT, p38, JNK, and ERK pathways.

Induction of osteoclastogenesis-inducing cytokines and invasion by alive Aggregatibacter actinomycetemcomitans in osteoblasts (조골세포에서 Aggregatibacter actinomycetemcomitans 생균의 파골세포분화유도 cytokine 발현 유도능 및 침투능)

  • Choi, Ho-Kil;Lee, Yang-Sin;Kim, Min-Young;Kim, Kyoung-Dae;Cha, Jeong-Heon;Yoo, Yun-Jung
    • Journal of Periodontal and Implant Science
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    • v.37 no.3
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    • pp.553-562
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    • 2007
  • Osteoblasts regulate osteoclastogenesis by production of various cytokines. Aggregatibacter(A) ac-tinomycetemcomitans is one of periodontopathogens which invades gingival tissue. Therefore, clarifying the effect of alive A. actinomycetemcomitans on osteoblasts is important to understand the mechanism of alveolar bone resorption in periodontitis. We investigated induction of osteoclastogenesis-inducing cytokines, adherence, and invasion by A. actinomycetemcomitans in osteoblasts. Osteoblasts were isolated from mouse calvaria and expression of cytokines was determined by RT-PCR. When the ratio of the number of A. actinomycetemcomtians to the number of osteoblasts was 10:1, 50:1 and 100:1, RANKL mRNA expression was increased. A. actinomycetemcomitans also increased expression of macrophage inflammatory protein (MIP) -1${\alpha}$, interleukin (IL)-1${\beta}$, and tumor necrosis factor (TNF)-${\alpha}$. A. actinomycetemcomitans attached to and invaded osteoblasts at ratio of 1000:1. These results suggest that A. actinomycetemcomitans increases osteoclastogenesis-inducing ability of osteoblasts by stimulating the expression of RANKL, MIP-1${\alpha}$,IL-1${\beta}$, and TNF-${\alpha}$ and that invasion of A. actinomycetemcomitans provides a means by which the bacteria escape from immune system and antibiotic therapy.