Levels of B-ALP and TRAP-5b in a patient with short root anomaly: a case report

The purpose of this study was to observe the changes in bone-specific alkaline phosphatase (B-ALP) and tartrate-resistant acid phosphatase-5b (TRAP-5b) in a patient diagnosed with short root anomaly (SRA). The detailed clinical data and history of related clinical symptoms of the SRA patient were retrieved. Oral examination showed that the shape and color of the tooth crown were normal. Tooth 11 and 12 were missing, and the mobility degree of other teeth was II–III. Panoramic radiograph examination showed that the root length only reached the neck of the tooth. Laboratory results showed that blood spectrum, chromosome and trace elements were normal. Endocrinological evaluation indicated that hormone levels were within normal limits; however, both B-ALP and TRAP-5b were higher than the normal range. The present case shows that SRA may be related to an imbalance in osteoblast/osteoclast metabolism, which provides a new direction for the etiological research of this disease.

Short root anomaly; Clinical examination; Laboratory test; Osteoclast; Osteoblast

[1] Michelogiannakis D, Vastardis H, Melakopoulos I, Papathanasopoulou C, Tosios K. The challenge of managing patients with generalized short root anomaly: a case report. Quintessence International. 2018; 49: 673–679.

[2] Yu MJ, Jiang ZW, Wang Y, Xi Y, Yang GL. Molecular mechanisms for short root anomaly. Oral Diseases. 2021; 27: 142–150.

[3] Rohof ECM, Kerdijk W, Jansma J, Livas C, Ren Y. Autotransplantation of teeth with incomplete root formation: a systematic review and meta-analysis. Clinical Oral Investigations. 2018; 22: 1613–1624.

[4] Vishwanath M, Chen P, Upadhyay M, Yadav S. Orthodontic management of a patient with short root anomaly and impacted teeth. American Journal of Orthodontics and Dentofacial Orthopedics. 2019; 155: 421–431.

[5] Kalahasthi R, Tapu B, Bhavani SB. Assessment of bone turnover biomarkers in lead-battery workers with long-term exposure to lead. The International Journal of Occupational and Environmental Medicine. 2020; 11: 140–147.

[6] Katyal S, Yadav V. Diagnostic and treatment approach in the management of dental anomalies associated with Stevens-Johnson syndrome: a case report. International Journal of Clinical Pediatric Dentistry. 2021; 14: 569–574.

[7] Liu J, Wang XE, Lv D, Qiao M, Zhang L, Meng HX, et al. Association between root abnormalities and related pathogenic genes in patients with generalized aggressive periodontitis. Beijing Da Xue Xue Bao Yi Xue Ban. 2021; 53: 16–23. (In Chinese)

[8] Flores MT, Onetto JE. How does orofacial trauma in children affect the developing dentition? Long-term treatment and associated complications. Dental Traumatology. 2019; 35: 312–323.

[9] Revathy V, Abirami R, Abharna R. Aberrant root formation—an unreported complication of dental trauma. Journal of the Indian Society of Pedodontics and Preventive Dentistry. 2018; 36: 216–219.

[10] Zhu XF, Yuan H, Ouyang NJ, Carroll AT, Thomas EVD, Jake J, et al. 6-Shogaol promotes bone resorption and accelerates orthodontic tooth movement through the JNK-NFATc1 signaling axis. Journal of Bone and Mineral Metabolism. 2021; 39: 962–973.

[11] Lee KE, Mo S, Lee HS, Jeon M, Song JS, Choi HJ, et al. Deferoxamine reduces inflammation and osteoclastogenesis in avulsed teeth. International Journal of Molecular Sciences. 2021; 22: 8225.

[12] Yang JY, Li WZ, Feng RJ, Li D. Intercalary frozen autografts for reconstruction of bone defects following meta-/diaphyseal tumor resection at the extremities. BMC Musculoskeletal Disorders. 2022; 23: 890.

[13] Laurian LJ, Decaudaveine S, Caillot A, Walter P, Benichou L. Case report of a zygomatic bone hemangioma surgery with reconstruction by a custom-made implant. Journal of Stomatology, Oral and Maxillofacial Surgery. 2022; 123: 660–662.

[14] Qi JW, Kitaura H, Shen WR, Ogawa S, Ohori F, Noguchi T, et al. Effect of a DPP-4 inhibitor on orthodontic tooth movement and associated root resorption. BioMed Research International. 2020; 2020: 7189084.

[15] Charles JF, Aliprantis AO. Osteoclasts: more than ‘bone eaters’. Trends in Molecular Medicine. 2014; 20: 449–459.

[16] Nagata MJH, Messora MR, Antoniali C, Fucini SE, de Campos N, Pola NM, et al. Long-term therapy with intravenous zoledronate increases the number of nonattached osteoclasts. Journal of Cranio-Maxillofacial Surgery. 2017; 45: 1860–1867.

[17] de Andrade VW, Souza-Silva BN, de Macedo BÍ, Santana ES, de MFR, Vieira BMA, et al. Maxillary incisor root morphology in patients with nonsyndromic tooth agenesis: a controlled cross-sectional pilot study. American Journal of Orthodontics and Dentofacial Orthopedics. 2020; 157: 212–217.

[18] Piekoszewska-Ziętek P, Olczak-Kowalczyk D, Pańczyk-Tomaszewska M, Gozdowski D. Developmental abnormalities of teeth in children with nephrotic syndrome. International Dental Journal. 2022; 72: 572–577.

[19] Zhao L, Matsumoto Y, Ono T, Iseki S. Effects of mechanical force application on the developing root apex in rat maxillary molars. Archives of Oral Biology. 2019; 101: 64–76.

[20] Sinha P, Gabor R, Haupt-Harrington R, Deering L, Steiner RD. Dental manifestations in adult hypophosphatasia and their correlation with biomarkers. JIMD Reports. 2022; 63: 434–445.

[21] Okawa R, Nakano K. Dental manifestation and management of hypophosphatasia. Japanese Dental Science Review. 2022; 58: 208–216.

[22] Li J, Parada C, Chai Y. Cellular and molecular mechanisms of tooth root development. Development. 2017; 144: 374–384.

[23] Mohamed FF, Ge C, Binrayes A, Franceschi1 RT. The role of discoidin domain receptor 2 in tooth development. Journal of Dental Research. 2020; 99: 214–222.

[24] Ponraj RR, Sarah SR, Nayak VS, Mathew M. Unilateral short root anomaly: an incidental finding on routine radiographic examination. BMJ Case Reports. 2021; 14: 1–10.

[25] Zong C, Van DJ, Vande VG, Willems G, Cadenas de LlPM. Dynamic changes in tooth displacement and bone morphometry induced by orthodontic force. Scientific Reports. 2022; 12: 13672.

[26] Nanda A, Chen PJ, Mehta S, Kalajzic Z, Dutra EH, Allareddy V, et al. The effect of differential force system and minimal surgical intervention on orthodontic tooth movement and root resorption. European Journal of Orthodontics. 2021; 43: 607–613.

[27] Lerner UH. Osteoclasts in health and disease. Pediatric Endocrinology Reviews. 2019; 17: 84–99.