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Reis-Prado AHD, Toledo PTA, Nunes GP, Ferreira PAV, Rahimnejad M, Dal-Fabbro R, Abreu LG, Bottino MC, Benetti F. Citric Acid Conditioning as an Alternative to EDTA for Growth Factors Release and Stem Cell Response in Regenerative Endodontics: A Systematic Review of In Vitro Studies. J Endod 2024; 50:129-143. [PMID: 37984798 DOI: 10.1016/j.joen.2023.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/11/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Citric acid (CA) conditioning may be a promising alternative to ethylenediaminetetraacetic acid (EDTA) in regenerative endodontic procedures, as reported to improve growth factors' release from dentin. This review systematically investigated the effect of CA conditioning on the growth factors release from dentin and cell behavior compared to EDTA conditioning. METHODS Searches were conducted (PubMed/MEDLINE, Scopus, Web of Science, Embase, SciELO, Cochrane Library, and grey literature) until May-2023. Only in vitro studies that evaluated the effects of CA on growth factors' release from dentin and cell behavior outcomes compared to EDTA were included. The studies were critically appraised using a modified Joanna Briggs Institute's checklist. Meta-analysis was unfeasible. RESULTS Out of the 335 articles screened, nine were included. Among these, three studies used dentin discs/roots from permanent human teeth; the rest combined them with stem cells. 10% CA for 5 or 10 minute was the most used protocol. Meanwhile, EDTA concentrations ranged from 10% to 17%. In eight studies examining the release of growth factors, five reported a significant release of transforming growth factor-β after dentin conditioning with 10% CA compared to 17% EDTA. Regarding cell behavior (6 studies), three studies assessed cell viability. The findings revealed that 10% CA conditioning showed cell viability similar to those of 17% EDTA. Additionally, in two out of three studies, it was observed that 10% CA conditioning did not affect cell morphology. The studies had a low risk of bias. CONCLUSIONS The use of 10% CA to condition dentin for 5-10 minutes resulted in a notable transforming growth factor -β1 release, but its cell responses were similar to those of EDTA.
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Affiliation(s)
- A H Dos Reis-Prado
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, Minas Gerais, Brazil; Cariology, Restorative Sciences and Endodontics, University of Michigan, School of Dentistry, Ann Arbor, Michigan
| | - P T A Toledo
- Cariology, Restorative Sciences and Endodontics, University of Michigan, School of Dentistry, Ann Arbor, Michigan; Preventive and Restorative Dentistry, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - G P Nunes
- Laboratory for Bone Metabolism and Regeneration, University of Porto, Faculty of Dental Medicine, Porto, Portugal
| | - P A V Ferreira
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, Minas Gerais, Brazil
| | - M Rahimnejad
- Cariology, Restorative Sciences and Endodontics, University of Michigan, School of Dentistry, Ann Arbor, Michigan
| | - R Dal-Fabbro
- Cariology, Restorative Sciences and Endodontics, University of Michigan, School of Dentistry, Ann Arbor, Michigan
| | - L G Abreu
- Child's and Adolescent's Oral Health, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, Minas Gerais, Brazil
| | - M C Bottino
- Cariology, Restorative Sciences and Endodontics, University of Michigan, School of Dentistry, Ann Arbor, Michigan
| | - F Benetti
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, Minas Gerais, Brazil.
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Batista LAS, dos Reis-Prado AH, Chaves HGDS, de Arantes LC, Morgan LFSA, André CB, Suzuki TY, Benetti F. Can different agents reduce the damage caused by bleaching gel to pulp tissue? A systematic review of basic research. Restor Dent Endod 2023; 48:e39. [PMID: 38053785 PMCID: PMC10695728 DOI: 10.5395/rde.2023.48.e39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 12/07/2023] Open
Abstract
Objectives This study aimed to investigate the effectiveness of different topical/systemic agents in reducing the damage caused by bleaching gel to pulp tissue or cells. Materials and Methods Electronic searches were performed in July 2023. In vivo and in vitro studies evaluating the effects of different topical or systemic agents on pulp inflammation or cytotoxicity after exposure to bleaching agents were included. The risk of bias was assessed. Results Out of 1,112 articles, 27 were included. Nine animal studies evaluated remineralizing/anti-inflammatories agents in rat molars subjected to bleaching with 35%-38% hydrogen peroxide (HP). Five of these studies demonstrated a significant reduction in inflammation caused by HP when combined with bioglass or MI Paste Plus (GC America), or following KF-desensitizing or Otosporin treatment (n = 3). However, orally administered drugs did not reduce pulp inflammation (n = 4). Cytotoxicity (n = 17) was primarily assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay on human dental pulp cells and mouse dental papilla Cell-23 cells. Certain substances, including sodium ascorbate, butein, manganese chloride, and peroxidase, were found to reduce cytotoxicity, particularly when applied prior to bleaching. The risk of bias was high in animal studies and low in laboratory studies. Conclusions Few in vivo studies have evaluated agents to reduce the damage caused by bleaching gel to pulp tissue. Within the limitations of these studies, it was found that topical agents were effective in reducing pulp inflammation in animals and cytotoxicity. Further analyses with human pulp are required to substantiate these findings. Trial Registration PROSPERO Identifier: CRD42022337192.
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Affiliation(s)
- Letícia Aparecida Silva Batista
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | | | | | - Lara Cancella de Arantes
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | | | - Carolina Bosso André
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - Thaís Yumi Suzuki
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
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Dos Reis-Prado AH, Abreu LG, de Arantes LC, Dos Santos de Paula K, de Castro Oliveira S, Goto J, Viana ACD, Benetti F. Influence of sodium hypochlorite on cyclic fatigue resistance of nickel-titanium instruments: A systematic review and meta-analysis of in vitro studies. Clin Oral Investig 2023; 27:6291-6319. [PMID: 37704917 DOI: 10.1007/s00784-023-05243-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE This systematic review/meta-analysis investigated the influence of NaOCl on cyclic fatigue resistance of endodontic NiTi instruments. MATERIALS AND METHODS A systematic search until July 2022 in PubMed/MEDLINE, Embase, Scopus, Web of Science, SciELO, Cochrane Library, and grey literature was conducted. According to the PECOS strategy, only in vitro studies evaluating the effects of NaOCl on the cyclic fatigue resistance of NiTi instruments were eligible. Cyclic fatigue resistance was the primary outcome. A modified Joanna Briggs Institute's Checklist was used for risk of bias assessment. RESULTS Of the 2,445 records screened, 37 studies were included. Most studies used simulated canals made of stainless-steel block with severe to moderate curvatures. NaOCl concentration varied from 1-6%, mainly at 37 °C. Regarding fatigue resistance, 23 studies using 1.2% to 6% NaOCl showed a reduction in the resistance compared to the control groups, especially when pre-heated. Four meta-analyses were performed according to the tested NiTi systems. The meta-analyses indicated that the PTU F2 files had higher reduction of fatigue resistance after exposure to 5.25% NaOCl; no differences between NaOCl and no immersion were observed for Reciproc R25, WaveOne 25.08, and WaveOne Gold Primary files. Included studies had low risk of bias. CONCLUSION NaOCl appears to reduce cyclic fatigue resistance of certain NiTi files, especially when they are pre-heated, particularly in conventional NiTi files compared to some heat-treated instruments. It is possible that the temperature of the solution may have a greater influence on resistance than NaOCl itself. Important to note that an overall tendency toward no significant influence was observed among various systems. CLINICAL RELEVANCE Precautions are necessary when a pre-heated high-concentration NaOCl is used to enhance its properties during root canal preparation, mainly using conventional wire.
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Affiliation(s)
| | - Lucas Guimarães Abreu
- Department of Child's and Adolescent's Oral Health, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Lara Cancella de Arantes
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Kiani Dos Santos de Paula
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Sabrina de Castro Oliveira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Juliana Goto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - Ana Cecília Diniz Viana
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Mahmoudi S, Iranmanesh P, Khazaei S, Jahromi MZ. Immediate and Delayed Post Space Preparations in Endodontically Treated Teeth: A Scoping Review. BMC Oral Health 2022; 22:625. [PMID: 36544179 PMCID: PMC9773456 DOI: 10.1186/s12903-022-02564-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/04/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The aim of the present review was to identify the effect of the post-space preparation (PSP) timing (immediate or delayed) on endodontically treated teeth. METHODS All studies in any language that compared the effect of immediate versus delayed PSP on the outcomes of an endodontically treated tooth were searched in PubMed, Scopus, Web of Science, Cochrane, ProQuest, WorldCat, and Google Scholar databases by two independent researchers until February 12, 2022. Studies assessing merely the immediate or delayed PSP were excluded. A descriptive analysis was performed to evaluate the study design and the characteristics of the included studies. RESULTS The initial search yielded 2612 records, of which 68 were included. Except for one randomized controlled trial, all were in vitro. The evaluated variables were apical/coronal microleakage (n = 48/n = 1), post-bond strength (n = 8), bacterial infiltration (n = 7), presence of voids (n = 3), apical extrusion and residual of filling material (n = 1), and post-operative pain (n = 1). The number of publications had steady growth per year and fast growth per decade. "Post-space preparation" was the most popular keywords. CONCLUSIONS The present review highlights the need for further investigations due to the various design of studies, controversial results, and an inadequate number of randomized controlled trials. TRIAL REGISTRATION Retrospectively registered. Open Science ( https://doi.org/10.17605/OSF.IO/2YTM6 ).
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Affiliation(s)
- Sadaf Mahmoudi
- grid.411757.10000 0004 1755 5416Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Pedram Iranmanesh
- grid.411036.10000 0001 1498 685XDental Research Center and Department of Endodontics, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saber Khazaei
- grid.412112.50000 0001 2012 5829Department of Endodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Zare Jahromi
- grid.411757.10000 0004 1755 5416Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
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Hajihassani N, Mohammadi N, Karimi Kelayeh A, Aalaei S. Comparison of the effect of post space preparation time on the apical seal of two different sealers. BMC Oral Health 2022; 22:356. [PMID: 35978297 PMCID: PMC9387075 DOI: 10.1186/s12903-022-02367-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/02/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The present study compared the effect of post space preparation time on the apical seal of two different sealers. METHODS In the in vitro study, 94 central incisors were used. After the samples' root canal preparation, they were randomly assigned to four experimental groups (n = 21). The samples in groups 1 and 2 were obturated with AH Plus sealer, gutta-percha, and in groups 3 and 4 with Endoseal MTA bioceramic sealer and single cone technique. The post spaces in groups 1 and 3 were prepared immediately and in groups 2 and 4 with a delay. The samples were evaluated at 7-, 30-, and 90-day intervals for apical microleakage using the fluid filtration technique. The data were analyzed with SPSS 25, using three-way ANOVA and independent t-test. RESULTS The apical microleakage in groups 3 and 4, obturated with Endoseal MTA bioceramic sealer and prepared immediately and after a delay, respectively, was not significantly different between the interval times. In group 2, obturated with AH Plus sealer and prepared for post space with a delay, the apical microleakage was significantly less than all the other groups. Group 1, obturated with AH Plus sealer and prepared for post space immediately, exhibited the least microleakage after seven days, but its microleakage increased over time to reach the level of groups 3 and 4. CONCLUSION According to the results, the apical microleakage in the AH + sealer group and the delayed post-space preparation method, was significantly less than all the other groups over time.
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Affiliation(s)
- Neda Hajihassani
- grid.412606.70000 0004 0405 433XDepartment of Endodontics, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Navid Mohammadi
- grid.412606.70000 0004 0405 433XChildren Growth Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran ,Canada Optimax Access Consulting, Conquitlam, BC Canada
| | - Ahmad Karimi Kelayeh
- grid.412606.70000 0004 0405 433XStudent Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Shima Aalaei
- grid.412606.70000 0004 0405 433XDepartment of Prosthodontics, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Bahonar Blvd., Qazvin, Iran
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Simões LP, Dos Reis-Prado AH, Bueno CRE, Viana ACD, Duarte MAH, Cintra LTA, Lemos CAA, Benetti F. Effectiveness and safety of rotary and reciprocating kinematics for retreatment of curved root canals: a systematic review of in vitro studies. Restor Dent Endod 2022; 47:e22. [PMID: 35692221 PMCID: PMC9160764 DOI: 10.5395/rde.2022.47.e22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/07/2021] [Accepted: 10/17/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives This systematic review (register-osf.io/wg7ba) compared the efficacy and safety of rotary and reciprocating kinematics in the removal of filling material from curved root canals. Materials and Methods Only in vitro studies evaluating both kinematics during retreatment were included. A systematic search (PubMed/MEDLINE, Scopus, and other databases, until January 2021), data extraction, and risk of bias analysis (Joanna Briggs Institute checklist) were performed. Efficacy in filling removal was the primary outcome. Results The search resulted in 2,795 studies, of which 15 were included. Efficacy was measured in terms of the remaining filling material and the time required for this. Nine studies evaluated filling material removal, of which 7 found no significant differences between rotary and reciprocating kinematics. Regarding the time for filling removal, 5 studies showed no difference between both kinematics, 2 studies showed faster results with rotary systems, and other 2 showed the opposite. No significant differences were found in apical transportation, centering ability, instrument failure, dentin removed and extruded debris. A low risk of bias was observed. Conclusions This review suggests that the choice of rotary or reciprocating kinematics does not influence the efficacy of filling removal from curved root canals. Further studies are needed to compare the kinematics safety in curved root canals.
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Affiliation(s)
- Lucas Pinho Simões
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | | | | | - Ana Cecília Diniz Viana
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - Marco Antônio Húngaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, University of São Paulo (USP), School of Dentistry, Bauru, SP, Brazil
| | | | - Cleidiel Aparecido Araújo Lemos
- Department of Dentistry, Federal University of Juiz de Fora, Campus GV (UFJF-GV), School of Dentistry, Governador Valadares, MG, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
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Dos Reis-Prado AH, Abreu LG, Fagundes RR, Oliveira SC, Bottino MC, Ribeiro-Sobrinho AP, Benetti F. Influence of ethylenediaminetetraacetic acid on regenerative endodontics: a systematic review. Int Endod J 2022; 55:579-612. [PMID: 35305029 DOI: 10.1111/iej.13728] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The effects of ethylenediaminetetraacetic acid (EDTA) on regenerative endodontic procedures (REPs) are controversial, because, despite releasing growth factors from dentine, some studies show negative effects on cell behaviour. OBJECTIVES To investigate the influence of the use of EDTA in REP on the growth factors' release, cell behaviour, and tissue regeneration. METHODS A systematic search was conducted (PubMed/Medline, Scopus, Cochrane Library, Web of Science, Embase, OpenGrey, and reference lists) up to February 2021. Only in vivo and in vitro studies evaluating the effects of EDTA on the biological factors of dentine, pulp/periapical tissues, and cell behaviour were eligible. Studies without a control group or available full text were excluded. The growth factors' release was the primary outcome. Risk of bias in the in vitro and in vivo studies was performed according to Joanna Briggs Institute's Checklist and SYRCLE's RoB tool, respectively. RESULTS Of the 1848 articles retrieved, 36 were selected. Among these, 32 were in vitro, three animal studies, and one with both models. The EDTA concentrations ranged from 3%-15%, at different times. Regarding growth factors' release (17 studies), 15 studies found significant transforming growth factor (TGF)-β release after dentine conditioning with EDTA, and most found no influence on vascular endothelial growth factor (VEGF) release. Regarding cell behaviour (26 studies), eight studies showed no influence of EDTA-treated dentine on cell viability; whereas, five, nine, and six studies showed higher cell migration, adhesion, and differentiation, respectively. No influence of EDTA conditioning was observed in animal studies. In vitro studies had a low risk of bias, whereas animal studies had high risk of bias. Meta-analysis was unfeasible. DISCUSSION This review found that EDTA increased TGF-β release and improved cell activity. However, well-designed histological analyses using immature teeth models are needed. CONCLUSIONS High quality in vitro evidence suggests that EDTA-treated dentine positively influences TGF-β release, cell migration, attachment, and differentiation; further research to evaluate its influence on tissue regeneration is necessary due to low methodological quality of the animal studies.
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Affiliation(s)
- A H Dos Reis-Prado
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - L G Abreu
- Child's and Adolescent's Oral Health, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - R R Fagundes
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - S C Oliveira
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - M C Bottino
- Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, 48109, USA
| | - A P Ribeiro-Sobrinho
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - F Benetti
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
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Porciuncula M, Teixeira AP, Duque TM, Prado MC, Simão RA, Prado M. Age and experience with dental operating microscope: Do these factors influence on the post space preparation and adhesion of glass fiber posts? Microsc Res Tech 2022; 85:2206-2211. [DOI: 10.1002/jemt.24077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/14/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Mariana Porciuncula
- Metallurgical and Materials Engineering, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering Federal University of Rio de Janeiro (COPPE‐UFRJ) Rio de Janeiro RJ Brazil
| | - Adriana P. Teixeira
- Department of Dental Clinic, Faculty of Dentistry Federal University of Rio de Janeiro (FO‐UFRJ) Rio de Janeiro RJ Brazil
| | - Thais M. Duque
- Department of Dental Clinic Federal University of Santa Catarina (UFSC) Florianópolis SC Brazil
| | - Marina C. Prado
- Metallurgical and Materials Engineering, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering Federal University of Rio de Janeiro (COPPE‐UFRJ) Rio de Janeiro RJ Brazil
| | - Renata A. Simão
- Metallurgical and Materials Engineering, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering Federal University of Rio de Janeiro (COPPE‐UFRJ) Rio de Janeiro RJ Brazil
| | - Maíra Prado
- Post Graduate Program in Dentistry Veiga de Almeida University (UVA) Rio de Janeiro RJ Brazil
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Soveral M, Machado V, Botelho J, Mendes JJ, Manso C. Effect of Resin Infiltration on Enamel: A Systematic Review and Meta-Analysis. J Funct Biomater 2021; 12:jfb12030048. [PMID: 34449679 PMCID: PMC8395859 DOI: 10.3390/jfb12030048] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/28/2021] [Accepted: 08/12/2021] [Indexed: 12/30/2022] Open
Abstract
Subsurface enamel demineralization beneath an intact surface layer or white spots lesions (WSL) can and should be treated with non-invasive procedures to impede the development of a cavitated lesion. We aim to analyze if infiltrative resin improves enamel roughness, microhardness, shear bond strength, and penetration depth. MEDLINE [via Pubmed], Cochrane Central Register of Controlled Trials, Embase, Web of Science, Scholar, and LILACS were searched until May 2021. Methodological quality was assessed using the Joanna Briggs Institute Clinical Appraisal Checklist for Experimental Studies. Pairwise ratio of means (ROM) meta-analyses were carried out to compare the enamel properties after treatment with infiltrative resin on sound enamel and WSLs. From a total of 1604 articles, 48 studies were included. Enamel surface roughness decreased 35% in sound enamel (95%CI: 0.49–0.85, I2 = 98.2%) and 54% in WSLs (95%CI: 0.29–0.74, I2 = 98.5%). Microhardness reduced 24% in sound enamel (95%CI: 0.73–0.80, I2 = 99.1%) and increased by 68% in WSLs (95%CI: 1.51; 1.86, I2 = 99.8%). Shear bond strength reduced of 25% in sound enamel (95%CI: 0.60; 0.95, I2 = 96.9%) and increased by 89% in WSLs (95%CI: 1.28–2.79, I2 = 99.8%). Penetration depth was 65.39% of the WSLs (95%CI: 56.11–74.66, I2 = 100%). Infiltrative resins effectively promote evident changes in enamel properties in sound and WSLs. Future studies with long-term follow-ups are necessary to corroborate these results from experimental studies.
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Affiliation(s)
- Madalena Soveral
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal; (M.S.); (J.B.); (J.J.M.); (C.M.)
| | - Vanessa Machado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal; (M.S.); (J.B.); (J.J.M.); (C.M.)
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal
- Correspondence:
| | - João Botelho
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal; (M.S.); (J.B.); (J.J.M.); (C.M.)
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal; (M.S.); (J.B.); (J.J.M.); (C.M.)
| | - Cristina Manso
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal; (M.S.); (J.B.); (J.J.M.); (C.M.)
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Reis-Prado AHD, Grossi IR, Chaves HGDS, André CB, Morgan LFDSA, Briso ALF, Cintra LTA, Benetti F. Influence of Hydrogen Peroxide on Mineralization in Dental Pulp Cells: A Systematic Review. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.689537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Dental bleaching agents show the ability to permeate through dental hard tissues, which may lead to pulp tissue changes. This systematic review (PROSPERO register: CRD42020213767) is aimed at understanding the effects of bleaching agents on the process of mineralization of the pulp tissue.Methods: Only in vitro studies evaluating the influence of hydrogen peroxide (HP) on mineralization in dental pulp cells were included. Studies without a non-bleached control group or cells after co-treatment with a bleaching agent other than HP and/or carbamide peroxide were excluded. The primary outcomes evaluated were alkaline phosphatase (ALP) activity and mineralized nodule deposition. The mineralization markers analysis in dental pulp cells and the cell viability were considered secondary outcomes. Two independent authors conducted a systematic search (PubMed/MEDLINE, Scopus, Embase, Cochrane Library, and OpenGrey until January 2021) with no language restrictions and performed data extraction. The quality assessment was appraised according to a modified Joanna Briggs Institute critical appraisal checklist.Results: The search resulted in 473 studies, and 11 were considered eligible. Overall, a reduction in the process of mineralization was observed among pulp cells after bleaching. A reduction in the ALP activity was reported in the mostly bleached groups using different protocols and analysis periods of nine studies. Regarding mineralized nodule deposition, 6 studies reported a significant reduction from 7 to 21 days among bleached groups. Of those three studies that investigated other mineralization markers, two found a reduction in the expression of dentin matrix acidic phosphoprotein (DMP)-1, dentin sialophosphoprotein (DSPP), and matrix extracellular phosphoglycoprotein (MEPE) among some bleaching gel concentrations. In contrast, one study showed a greater expression of osteopontin (OPN) and osteocalcin (OCN) in 100 μmol/L HP after 5 or 10 min of exposure, and another study showed significant induction of DSPP in concentrations of up to 0.5 mmol/L HP.Conclusion: Especially, high concentrations of bleaching gel reduce the potential of mineralization in pulp cells in in vitro studies; however, different HP concentrations, bleaching protocols, and analysis periods can influence this outcome.
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