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Candemil AP, Alves Dos Santos GN, Oliveira ML, Gatti F, Silva-Sousa YTC, Silva-Sousa AC, Mazzi-Chaves JF, Sousa-Neto MD. Accuracy of Magnetic Resonance Imaging in Clinical Endodontic Applications: A Systematic Review. J Endod 2024; 50:434-449. [PMID: 38290691 DOI: 10.1016/j.joen.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
INTRODUCTION The development of dedicated coils and new magnetic resonance imaging (MRI) sequences has led to an increase in image resolution and a reduction in artifacts. Consequently, numerous studies have demonstrated the utility of MRI as a nonionizing alternative to cone-beam computed tomographic imaging. The aim of this systematic review was to evaluate the accuracy of MRI in clinical applications in endodontics. METHODS A literature search was conducted using PubMed, Embase, Scopus, and Web of Science. The inclusion criteria encompassed studies evaluating MRI applications in endodontics, covering tooth and root canal anatomy, root canal working length, pulp vitality and regeneration, the effect of caries on dental pulp, guided endodontics, periapical lesions, and root cracks/fractures. The selected studies examined both ex vivo and in vivo human teeth using clinical MRI units. Two researchers independently screened the studies, applied the eligibility criteria, and assessed the potential risk of bias using the revised QUADAS-2 tool (Bristol Medical School, University of Bristol, UK). RESULTS A total of 18 studies were included in this systematic review, demonstrating that the use of MRI has a high diagnostic value in endodontics. In the evaluation of tooth and root canal anatomy, pulp vitality and regeneration, the effect of caries on dental pulp, periapical lesions, and root cracks/fractures, MRI's accuracy is comparable to or even higher than reference standards such as cone-beam computed tomographic imaging, micro-computed tomographic imaging, and histology. CONCLUSIONS MRI has high potential accuracy for diagnosing various clinical endodontic tasks, except for root canal length, size of caries, and periapical lesion dimensions, which are overestimated in MRI.
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Affiliation(s)
- Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil; CentraleSupélec, Ecole Normale Supérieure Paris-Saclay, Centre national de la recherche scientifique, Laboratoire de Mécanique Paris-Saclay, Université Paris-Saclay, Gif-sur-Yvette, France.
| | | | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Filippo Gatti
- CentraleSupélec, Ecole Normale Supérieure Paris-Saclay, Centre national de la recherche scientifique, Laboratoire de Mécanique Paris-Saclay, Université Paris-Saclay, Gif-sur-Yvette, France
| | | | - Alice C Silva-Sousa
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Kırmızı D, Sehirli AÖ, Sayiner S, Orhan K, Sebai A, Aksoy U. Effects of melatonin against experimentally induced apical periodontitis in rats. AUST ENDOD J 2024. [PMID: 38509787 DOI: 10.1111/aej.12841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/17/2024] [Accepted: 03/10/2024] [Indexed: 03/22/2024]
Abstract
Apical periodontitis is an inflammatory condition resulting from microbial invasion in the root canal system, causing periapical tissue destruction and bone resorption. This study investigated melatonin's effects, known for its antioxidant and anti-inflammatory properties, on experimentally induced apical periodontitis in rats. Three groups of rats were studied: control, apical periodontitis and apical periodontitis with melatonin treatment. Proinflammatory cytokines and enzyme levels in blood serum were measured, and micro-CT analysis assessed bone resorption. Results showed significantly elevated cytokines and enzyme levels in the apical periodontitis group compared to the control. However, in the melatonin-treated group, these levels were significantly reduced (p < 0.01-0.001). Micro-CT analysis indicated decreased periapical resorption cavity volume and surface area with melatonin treatment. This suggests that systemic melatonin administration can mitigate inflammation and reduce bone resorption in experimentally induced apical periodontitis in rats, potentially holding promise for human endodontic disease treatment pending further research.
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Affiliation(s)
- D Kırmızı
- Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, Mersin, Turkey
| | - A Ö Sehirli
- Department of Pharmacology, Faculty of Dentistry, Near East University, Nicosia, Mersin, Turkey
| | - S Sayiner
- Department of Biochemistry, Faculty of Veterinary Medicine, Near East University, Nicosia, Mersin, Turkey
| | - K Orhan
- Department of Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
- Medical Design Application and Research Center (MEDITAM), Ankara University, Ankara, Turkey
| | - A Sebai
- Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, Mersin, Turkey
| | - U Aksoy
- Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, Mersin, Turkey
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Khijmatgar S, Bellucci G, Creminelli L, Tartaglia GM, Tumedei M. Systemic Antibiotic Use in Acute Irreversible Pulpitis: Evaluating Clinical Practices and Molecular Insights. Int J Mol Sci 2024; 25:1357. [PMID: 38279358 PMCID: PMC10816036 DOI: 10.3390/ijms25021357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/28/2024] Open
Abstract
This scoping review systematically evaluates the use of systemic antibiotics in treating acute irreversible pulpitis, integrating clinical practice patterns with recent molecular insights. We analyzed clinical evidence on antibiotic prescription trends among dental professionals and examined molecular research advancements in relation to pulpitis. This review is intended to bridge the gap between clinical practice and molecular research, guiding more evidence-based approaches to treating acute irreversible pulpitis. Electronic databases were searched for relevant articles published in English based on the objective of the review. A second search using all identified keywords and index terms was undertaken across all the included databases. In addition, a reference list of identified articles was searched. Studies including original research, systematic reviews, meta-analyses, clinical trials, and observational and retrospective studies, all written in English and published from 2010 onwards, were included, and an analysis of the text words contained in the titles and abstracts of the retrieved papers and of the index terms used to describe the articles was performed. A total of N = 53 articles were selected. Altogether, N = 43 (76.79%) articles were cross-sectional studies, N = 4 (11.11%) were systematic reviews, and N = 3 (5.36%) were guidelines. The most frequent level of evidence was level VI (N = 43 (76.79%). The mean percentage of dentists who prescribed antibiotics to treat acute irreversible pulpitis was 23.89 ± 23.74% (range: 0.05-75.7). Similarly, for specialists, it was 22.41 ± 15.64 (range 2.2-50.4), and the percentage for undergraduates was 17.52 ± 20.59 (range 0-62.6). The significant developments in research models for pulpitis research and the characterisation of biomarkers have led to better management strategies. Concurrently, significant advancements in molecular research provide new understandings of pulpitis, suggesting alternative therapeutic approaches. Although there are guidelines available, increased rates of antibiotic prescription are still prevalent around the globe.
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Affiliation(s)
- Shahnawaz Khijmatgar
- Complex Structure of Surgical Maxillofacial and Odontostomatology, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.B.); (L.C.)
| | - Gionata Bellucci
- Complex Structure of Surgical Maxillofacial and Odontostomatology, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.B.); (L.C.)
| | - Luca Creminelli
- Complex Structure of Surgical Maxillofacial and Odontostomatology, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.B.); (L.C.)
| | | | - Margherita Tumedei
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy;
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Karataş E, Kul A, Camilleri J, Yonel Z. Association between rheumatoid arthritis and pulpal-periapical pathology: a systematic review. Clin Oral Investig 2023; 27:7019-7028. [PMID: 37828236 PMCID: PMC10713683 DOI: 10.1007/s00784-023-05305-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/03/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVES Rheumatoid arthritis (RA) is a debilitating disease where numerous pro-inflammatory cytokines have a proven role in its pathology. These cytokines are also involved in the pathogenesis of apical periodontitis (AP) where they have a pro-inflammatory role and induce bone resorption. Patients with RA may therefore be more prone to develop pulpal-periapical pathology (PPP). This study systematically reviewed the existing literature evaluating the association between RA and PPP. MATERIALS AND METHODS Studies including human participants with both RA and PPP were included. The search was performed in PubMed, Web of Science, and The Cochrane Library databases using keywords and Medical Subject Headings (MeSH) search terms. The risk of bias was assessed using Newcastle-Ottawa Quality Assessment Scale. The following parameters were extracted and analyzed by the reviewers; author, journal, year, design of the study, diagnostic criteria for periapical pathology, the association between rheumatoid arthritis and periapical pathology, and the evidence level. RESULTS The search identified 142 records. Inclusion criteria were as follows; studies in the English language, including human participants only, including patients with RA and PPP, cohort studies, cross-sectional studies, clinical trials, and case-control studies. According to the inclusion criteria, 5 studies were included in this systematic review. Three of the five studies reported significant association between RA and PPP. CONCLUSIONS Existing evidence suggests there may be an association between RA and PPP. CLINICAL RELEVANCE Clinicians should be aware that RA patients can be more prone to develop PPP which may result in a reduced quality of life.
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Affiliation(s)
- Ertugrul Karataş
- Department of Endodontics, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Ayhan Kul
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Josette Camilleri
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
| | - Zehra Yonel
- Periodontology Research Group, School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Kwak EJ, Choi YJ, Kim HN, Kim KE, Jeon J, Baek YS. Increased dental comorbidities in patients with psoriasis: a nationwide population-based cohort study in Korea. Clin Exp Dermatol 2023; 48:1347-1353. [PMID: 37624999 DOI: 10.1093/ced/llad286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Limited data are available regarding the association between psoriasis and common dental conditions. OBJECTIVES To investigate the risk of potential dental comorbidities in patients with psoriasis. METHODS We conducted a nationwide population-based cohort study to analyse the claims data of patients with psoriasis (n = 15 165) and age- and sex-matched controls (n = 75 825). The incidence risk of the following potential dental conditions was analysed: dental caries, pulp and periapical disease, periodontal disease, gingival changes and tooth loss. RESULTS After adjusting for potential cofactors, the adjusted hazard ratios (aHRs) of dental caries [1.105; 95% confidence interval (CI) 1.078-1.132], pulp and periapical disease (1.07; 95% CI 1.044-1.096) and periodontal disease (1.108; 95% CI 1.088-1.129) were significantly higher than those in the control cohort (P < 0.001). However, among the subset of patients with psoriasis who received systemic antipsoriatic treatment (n = 4275), the aHR risk of all potential dental comorbidities was not significantly higher from that of the control cohort. CONCLUSIONS Patients with psoriasis have an increased risk of dental comorbidities, and systemic antipsoriatic treatment may help mitigate this increased risk.
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Affiliation(s)
- Eun-Jung Kwak
- National Dental Care Center for People with Special Needs, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Yun Jin Choi
- Biomedical Research Institute, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Han-Na Kim
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ko Eun Kim
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jiehyun Jeon
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yoo Sang Baek
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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Arifin FA, Matsuda Y, Kanno T. Development and Validation of Oral Health-Related Quality of Life Scale for Patients Undergoing Endodontic Treatment (OHQE) for Irreversible Pulpitis. Healthcare (Basel) 2023; 11:2859. [PMID: 37958003 PMCID: PMC10648889 DOI: 10.3390/healthcare11212859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
An oral health-related quality of life measure specific to patients undergoing endodontic treatment has not been developed. This study aimed to validate the oral health-related quality of life scale for patients undergoing endodontic treatment (OHQE) for irreversible pulpitis, comprised of 42 questions. Sixty-two patients with irreversible pulpitis, comprising 23 (37.1%) males and 39 (62.9%) females, were enrolled between August 2022 and February 2023. Data were collected at three time points: pretreatment, post-treatment, and at the second week post-treatment. Factor analysis revealed physical, psychological, and expectations as subscales of OHQE. Cronbach's alpha coefficients ranged from 0.87 to 0.95 for each subscale. Each subscale of the General Oral Health Assessment Index (GOHAI) was moderately correlated with the OHQE subscales. Good-poor analysis revealed a significant difference between the high-scoring and low-scoring groups for each OHQE subscale. The intraclass correlation coefficients of the OHQE subscales ranged from 0.89 to 0.95. Multivariate linear regression analysis revealed a significant correlation between the pretreatment and post-treatment psychological factors (p < 0.05). Thus, OHQE will help researchers and policymakers understand the impact of oral health on the quality of life of patients with irreversible pulpitis undergoing endodontic treatment. OHQE could contribute to the appropriate planning, treatment decisions, and management of dental treatment.
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Affiliation(s)
- Fadil Abdillah Arifin
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo 693-8501, Japan; (F.A.A.); (Y.M.)
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Muslim Indonesia, Makassar 90132, Indonesia
| | - Yuhei Matsuda
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo 693-8501, Japan; (F.A.A.); (Y.M.)
| | - Takahiro Kanno
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo 693-8501, Japan; (F.A.A.); (Y.M.)
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Vasconcelos MA, da Silva BR, Andrade AL, de Azevedo Pinheiro A, Evaristo FFV, Arruda FVS, Lorenzón EN, Cilli EM, Teixeira EH. Antimicrobial and Antibiofilm Activity of Synthetic Peptide [W7]KR12-KAEK Against Enterococcus faecalis Strains. Curr Microbiol 2023; 80:325. [PMID: 37606794 DOI: 10.1007/s00284-023-03445-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 08/07/2023] [Indexed: 08/23/2023]
Abstract
The emergence of infections caused by microorganisms in the oral cavity and increasing concerns regarding the use of antibiotics have resulted in the development of novel antimicrobial molecules, such as antimicrobial synthetic peptides. The purpose of this study was to evaluate the antimicrobial and antibiofilm activities of the native peptide KR-12 and its derivative, the synthetic peptide [W7]KR12-KAEK, against planktonic and biofilms Enterococcus faecalis strains. The methods used to evaluate the antimicrobial activity in planktonic cultures include minimum inhibitory concentration and minimum bactericidal concentration assays. The effects of [W7]KR12-KAEK on biofilm formation and mature biofilms were evaluated by quantifying biomass (crystal violet staining) and counting colony-forming units. Structural assessments of the biofilms and cellular morphological changes were performed using scanning electron microscopy. Peptide [W7]KR12-KAEK showed potential antimicrobial activity against planktonic cells. Interestingly, the native peptide KR-12 showed no antimicrobial activity. Moreover, it inhibited biofilm formation and disrupted the mature biofilms of E. faecalis strains. These results suggest that [W7]KR12-KAEK may be a potential molecule for the development of auxiliary antimicrobial therapies against oral infections.
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Affiliation(s)
- Mayron Alves Vasconcelos
- Laboratório Integrado de Biomoléculas, Departamento de Patologia e Medicina Legal, Universidade Federal do Ceará, Fortaleza, CE, Brazil
- Universidade do Estado de Minas Gerais, Unidade de Divinópolis, Divinópolis, MG, Brazil
- Faculdade de Educação de Itapipoca (FACEDI), Universidade Estadual do Ceará, Itapipoca, CE, Brazil
| | - Bruno Rocha da Silva
- Laboratório Integrado de Biomoléculas, Departamento de Patologia e Medicina Legal, Universidade Federal do Ceará, Fortaleza, CE, Brazil
- Universidade de Fortaleza (UNIFOR), Fortaleza, CE, Brazil
| | - Alexandre Lopes Andrade
- Laboratório Integrado de Biomoléculas, Departamento de Patologia e Medicina Legal, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Aryane de Azevedo Pinheiro
- Laboratório Integrado de Biomoléculas, Departamento de Patologia e Medicina Legal, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | | | - Francisco Vassiliepe Sousa Arruda
- Laboratório Integrado de Biomoléculas, Departamento de Patologia e Medicina Legal, Universidade Federal do Ceará, Fortaleza, CE, Brazil
- UNINTA, Sobral, CE, Brazil
| | | | - Eduardo Maffud Cilli
- Instituto de Química, Universidade Estadual Paulista (UNESP), Araraquara, SP, Brazil
| | - Edson Holanda Teixeira
- Laboratório Integrado de Biomoléculas, Departamento de Patologia e Medicina Legal, Universidade Federal do Ceará, Fortaleza, CE, Brazil.
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Fatima A, Khan UN, Nazir A, Akhtar M, Rana SAA, Kashif M. Frequency and Types of Periapical Radiographic Lesions Associated With Pulpitis in a Tertiary Care Hospital. Cureus 2023; 15:e42529. [PMID: 37637624 PMCID: PMC10458404 DOI: 10.7759/cureus.42529] [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] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
Objective This cross-sectional study aimed to determine the frequency and types of periapical radiographic lesions (PARLs) associated with pulpitis in patients visiting a tertiary care hospital. Methodology A sample of patients diagnosed with pulpitis, aged 18 years or older, was recruited following a convenient sampling technique. Clinical examinations were conducted to confirm the diagnosis, and radiographic evaluations, including periapical (PA), occlusal, orthopantomogram (OPG), and cone beam computed tomography (CBCT) radiographs were obtained. The radiographs were evaluated for the presence of PA lesions, and the type, size, and location of the lesions were documented. Data were analyzed using IBM SPSS Statistics for Windows, Version 25.0 (IBM Corp., Armonk, NY, USA). Results A total of 120 patients (equal gender ratio) with a mean age of 32.6 ± 6.39 years participated in the study. PA views were the most frequently performed radiographic view (86.7%), followed by occlusal views (8.3%). The most prevalent radiographic lesion was the widening of the periodontal ligament (PDL) space (34.2%), followed by PA granuloma (17.5%) and PA cyst (10.8%). The most frequently encountered diagnosis was pulpitis (51.7%), followed by irreversible pulpitis with apical periodontitis (25.8%). Education level, swelling, pus discharge, medicine history, and tooth wear showed statistically significant associations (P ≤ 0.05) with the variables under investigation. Conclusions The most common lesions observed were widening of the PDL space, PA granuloma, and PA cyst. The findings contribute to the local epidemiological and clinical data, enriching the existing database. Understanding the prevalence and characteristics of PA lesions associated with pulpitis can aid in accurate diagnosis and treatment planning for patients with pulpal pathologies.
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Affiliation(s)
- Arzoo Fatima
- Operative Dentistry, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Ushwa N Khan
- Operative Dentistry, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Amara Nazir
- Operative Dentistry, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Mobeen Akhtar
- Operative Dentistry, Nishtar Institute of Dentistry (NID), Multan, PAK
| | | | - Muhammad Kashif
- Oral Pathology, Bakhtawar Amin Medical and Dental College, Multan, PAK
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Poggio C, Gallo S. Frontiers in Restorative Dentistry Biomaterials and Endodontic Instruments. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16020475. [PMID: 36676211 PMCID: PMC9867087 DOI: 10.3390/ma16020475] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 12/31/2022] [Indexed: 05/31/2023]
Abstract
Restorative dentistry deals with the prevention, diagnosis, and treatment of pathological conditions affecting the teeth, to restore their function and aesthetics [...].
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Affiliation(s)
- Claudio Poggio
- Unit of Restorative Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, University of Pavia, 27100 Pavia, Italy
| | - Simone Gallo
- Unit of Orthodontics and Pediatric Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, University of Pavia, 27100 Pavia, Italy
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Zhou ZL, Gao L, Sun SK, Li HS, Zhang CD, Kou WW, Xu Z, Wu LA. Spontaneous healing of complicated crown-root fractures in children: Two case reports. World J Clin Cases 2022; 10:6298-6306. [PMID: 35949815 PMCID: PMC9254207 DOI: 10.12998/wjcc.v10.i18.6298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/21/2022] [Accepted: 04/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Complicated crown-root fracture is considered a severe dental trauma and is unlikely to heal without treatment. Usually, dentists have to remove the loose coronal fragment of the fractured tooth and treat the remaining part with multidisciplinary approaches. However, we observed spontaneous healing of fracture in two pediatric cases with a history of complicated crown-root fractures over 4 years ago.
CASE SUMMARY In case 1, a 12-year-old boy complained of pain at tooth 11 following an accidental fall 1 d ago. Clinical examination showed a crack line on the crown of tooth 11. Cone beam computed tomography (CBCT) images of tooth 11 showed signs of hard tissue deposition between the fractured fragments. The patient recalled that tooth 11 had struck the floor 1 year ago without seeking any other treatment. In case 2, a 10-year-old girl fell down 1 d ago and wanted to have her teeth examined. Clinical examination showed a fracture line on the crown of tooth 21. CBCT images of tooth 21 also showed signs of hard tissue deposition between the fractured fragments. She also had a history of dental trauma 1 year ago and her tooth 11 received dental treatment by another dentist. According to her periapical radiograph at that time, tooth 21 was fractured 1 year ago and the fracture was overlooked by her dentist. Both of these two cases showed spontaneous healing of complicated crown-root fractures. After over 4 years of follow-up, both fractured teeth showed no signs of abnormality.
CONCLUSION These findings may provide new insights and perspectives on the management and treatment of crown-root fractures in children.
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Affiliation(s)
- Zi-Ling Zhou
- Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
| | - Lei Gao
- Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
| | - Shu-Kai Sun
- Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
| | - Hong-Shi Li
- Institute of Stomatology, The General Air Force Hospital of PLA, Beijing 110142, China
| | - Cai-Di Zhang
- Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
| | - Wen-Wen Kou
- Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
| | - Zheng Xu
- The Center for Pediatric Dentistry, Department of Pediatric Dentistry, University of Washington, Seaatle, WA 98115, United States
| | - Li-An Wu
- Department of Pediatric Dentistry, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
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Fernandes IB, Ramos-Jorge J, Coelho VS, Pinto ACS, Pordeus IA, Paiva SM, Ramos-Jorge ML. Association between different stages of dental caries in preschoolers and familial socioeconomic factors. Braz Oral Res 2022; 36:e018. [DOI: 10.1590/1807-3107bor-2022.vol36.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 11/03/2021] [Indexed: 11/21/2022] Open
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Monea M, Eşian D, Vlad RE, Bica CI. In vivo effectiveness of visual inspection and laser fluorescence in the diagnosis of early pit-and-fissure carious lesions: A cross-sectional study in a group of Romanian children. Medicine (Baltimore) 2021; 100:e27811. [PMID: 34766591 PMCID: PMC8589235 DOI: 10.1097/md.0000000000027811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/29/2021] [Indexed: 01/05/2023] Open
Abstract
General practitioners are still facing great challenges in the management of occlusal caries. Therefore, the development of better diagnostic protocols and assessment of caries activity might improve the results of nonoperative treatment. This study aimed to evaluate the effectiveness of visual inspection based on ICDAS-II (International Caries Detection and Assessment System) and DiagnoDent pen in the detection of pit-and-fissure early lesions in young permanent molars. The evaluation of 237 occlusal surfaces and caries risk assessment were performed in 96 children aged 7 to 15 years. The presence of pit-and-fissure noncavitated lesions was recorded using ICDAS-II scoring system and laser fluorescence. Statistical analysis was performed using McNemar test, with a level of significance of P < .05. The caries risk was measured for all participants. In 109 occlusal surfaces both methods identified enamel changes (46%) and in 62 cases both methods excluded the carious lesion (26.2%). The statistical analysis showed a significant moderate agreement between ICDAS-II code and DiagnoDent pen measurements (McNemar chi-squared statistic 9.5, P = .002 and Cohen kappa coefficient = 0.427). The majority of children (69.8%) had moderate caries risk and the most frequent risk factors recorded were sugar intake between meals, lack of regular dental control and poor oral hygiene. We concluded that ICDAS-II is a valuable and reliable diagnostic tool for early pit-and-fissure lesions and could be used alone during dental examination in children. The evaluation of caries risk should become clinical routine, as parameters belonging to high risk were frequently recorded in our study group.
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Affiliation(s)
- Monica Monea
- Department of Odontology and Oral Pathology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Romania
| | - Daniela Eşian
- Department of Pedodontics, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Romania
| | - Ramona Elena Vlad
- Department of Odontology and Oral Pathology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Romania
| | - Cristina Ioana Bica
- Department of Pedodontics, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Romania
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Development Strategy of Endodontic Filling Materials Based on Engineering and Medical Approaches. Processes (Basel) 2021. [DOI: 10.3390/pr9112014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
This article is a literature review aimed at presenting the general state of knowledge in manufacturing engineering and materials engineering to develop engineering materials applied for endodontic treatment as filling materials. Particular attention was paid to theoretical analyses concerning the selection of methods for developing and obturating root canals and discussing the results of experimental studies available in the literature. These activities aimed to compare the importance of the most commonly used endodontic filling materials based on gutta-percha or polymeric polyester materials, commonly known as resilon, respectively. The motivation to take up this complex, multi-faceted topic in this paper is the extent of caries, periodontal disease, and other oral diseases in 3 to 5 billion people, often affecting toothlessness and contributing to an increase in the index of disability-adjusted life years (number). Endodontics is an important element of the authors’ concept of Dentistry Sustainable Development (DSD) > 2020. The principles of qualifying patients for endodontic treatment are discussed. The introduction of rotary tools, especially manufactured from Nitinol alloy, to develop root canals and the latest thermohydraulic and condensation techniques for obturation guarantee progress in endodontics. The “Digital Twins” methodology was used, rooted in the idea of Industry 4.0 and the resulting idea of Dentistry 4.0, as well as knowledge management methods, to perform experimental research in virtual space, concerning methods of developing and obturating the root canal and assessing the tightness of fillings. Microscopic visualization methods were also used. Significant factors determining the effectiveness of endodontic obturation are the selection of the filling material and the appropriate obturation method. The generalized dendrological matrix of endodontic filling materials considers the criteria of mechanical strength influencing the potential root fracture and the quality of root canal filling. The results of the SWOT point analysis (strengths and weaknesses, opportunities, threats) were also compared. For both filling materials, the weaknesses are much less than the strengths, while the threats are slightly less than the opportunities for the gutta-percha-based material, while for resilon the opportunities are much smaller than the threats. It requires the application of an appropriate development strategy, i.e., MAXI-MAXI in the case of a filling material based on gutta-percha and MAXI-MINI in the case of resilon. Therefore, the analysis of these experimental data does not indicate the real competitiveness of resilon for the gutta-percha-based material. This material deservedly maintains its strong position as the “Gold Standard of Endodontics”.
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Association between Pulpal-Periapical Pathology and Autoimmune Diseases: A Systematic Review. J Clin Med 2021; 10:jcm10214886. [PMID: 34768405 PMCID: PMC8584450 DOI: 10.3390/jcm10214886] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/09/2021] [Accepted: 10/19/2021] [Indexed: 12/30/2022] Open
Abstract
Several studies have linked apical periodontitis and systemic diseases. The aim of this study is to present a systematic review of the available literature investigating whether there is an association between pulpal-periapical pathology and autoimmune disease. The review was conducted following the PRISMA statement. A literature search was performed in five databases. Studies involving patients with pulpal-periapical pathology and autoimmune diseases were included in the review. Based on the PICO model, the research question aimed to assess whether there is an increased risk of developing pulpal-periapical pathology in patients with autoimmune disease. Article selection, data extraction, and quality assessment were performed using an adapted version of the STROBE guidelines. A total of seven studies were included in our review. The types of articles were five case-control and two cross-sectional studies. Periapical pathologies were associated to three autoimmune diseases (diabetes mellitus I, rheumatoid arthritis, and inflammatory bowel disease). Among the included studies, four show a low risk of bias, while three present a moderate risk. There could be an association between apical periodontitis and autoimmune diseases, although most studies report statistically non-significant associations.
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Verma V, Mathur S, Sachdev V, Singh D. Evaluation of compressive strength, shear bond strength, and microhardness values of glass-ionomer cement Type IX and Cention N. J Conserv Dent 2021; 23:550-553. [PMID: 34083907 PMCID: PMC8095699 DOI: 10.4103/jcd.jcd_109_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/26/2020] [Accepted: 07/10/2020] [Indexed: 12/03/2022] Open
Abstract
Aim: This study aimed to compare the compressive strength, shear bond strength, and microhardness of glass-ionomer cement (GIC) Type IX and Cention N. Materials and Methods: Five samples each of GIC Type IX and Cention N were prepared for testing the shear bond strength, tensile strength, and microhardness. Cylinders of the samples measuring 1 cm diameter and 6 mm height were prepared for compressive strength and shear bond strength. For shear bond strength, these samples were embedded into acrylic blocks of dimensions 2 cm × 2 cm. Testing of shear bond strength and compressive strength was done by mounting the samples in a universal testing machine with a crosshead speed of 1 mm/min. The samples for microhardness were 1 cm diameter and 5 mm height. The samples were mounted on Vickers microhardness testing machine to test the microhardness. Results: The values for shear bond strength of Cention N were statistically highly significant (P < 0.01) as compared to GIC Type IX, whereas the compressive strength and microhardness values of Cention N were statistically significant (P < 0.5) as compared to GIC Type IX. Conclusion: The results suggest significantly higher values for mechanical properties of Cention N as compared to GIC Type IX.
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Affiliation(s)
| | - Shivani Mathur
- Department of Pedodontics and Preventive Dentistry, ITS-CDSR, Ghaziabad, Uttar Pradesh, India
| | - Vinod Sachdev
- Department of Pedodontics and Preventive Dentistry, ITS-CDSR, Ghaziabad, Uttar Pradesh, India
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Couto AMD, Meirelles DP, Valeriano AT, Almeida DSD, Moraes ÊD, Tarquinio SBC, Batista AC, MendonÇa EFD, Costa NDL, Alves PM, Nonaka CFW, Abreu LG, Aguiar MCFD. Chronic inflammatory periapical diseases: a Brazilian multicenter study of 10,381 cases and literature review. Braz Oral Res 2021; 35:e033. [PMID: 33729278 DOI: 10.1590/1807-3107bor-2021.vol35.0033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 10/22/2020] [Indexed: 01/05/2023] Open
Abstract
The aim of this study was to investigate the epidemiological and clinical characteristics of chronic inflammatory periapical diseases in different regions of Brazil and to compare with data from the literature. A multicenter study was carried out in four Brazilian referral centers in oral diagnosis. Histopathological records were reviewed, and all cases diagnosed microscopically as periapical granuloma, radicular cyst, and periapical abscess were included. Demographic and clinical data were collected. Descriptive statistics and Pearson's chi-square test were performed. A total of 10,381 cases of chronic inflammatory periapical diseases were found (13.8% of 74,931 archived specimens) over a period of 65 years. Radicular cysts were the most common lesion (59.9%). Women (56.1%) with a mean age of 37.01 years old (range 13 to 100 ± 14.42) and people of white skin color (59.2%) were the most affected individuals by chronic inflammatory periapical diseases. The lesions were generally asymptomatic (28.1%), located in the maxilla (60.1%), and posterior region (49.8%). The radicular cysts were larger when compared to periapical granulomas (p < 0.001). The disagreement between the clinical and histopathological diagnoses was higher when the final diagnosis was a periapical granuloma (p < 0.001). Chronic inflammatory periapical diseases continue to be common lesions affecting mainly adults. This should be a consequence of the burden of untreated caries in permanent teeth. Women are more affected and radicular cyst was the most common lesion.
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Affiliation(s)
- Aline Maria do Couto
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Daniela Pereira Meirelles
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Alline Teixeira Valeriano
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Douglas Silva de Almeida
- Universidade Federal de Pelotas - UFPel, School of Dentistry, Department of Semiology and Clinics, Pelotas, RS, Brazil
| | - Êmile de Moraes
- Universidade Federal de Pelotas - UFPel, School of Dentistry, Department of Semiology and Clinics, Pelotas, RS, Brazil
| | | | - Aline Carvalho Batista
- Universidade Federal de Goiás - UFGO, School of Dentistry, Department of Stomatology (Oral Pathology), Goiânia GO, Brazil
| | | | - Nádia do Lago Costa
- Universidade Federal de Goiás - UFGO, School of Dentistry, Department of Stomatology (Oral Pathology), Goiânia GO, Brazil
| | - Pollianna Muniz Alves
- Universidade Estadual da Paraíba - UFPB, School of Dentistry, Department of Dentistry, Campina Grande PB, Brazil
| | | | - Lucas Guimarães Abreu
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Belo Horizonte, MG, Brazil
| | - Maria Cássia Ferreira de Aguiar
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, MG, Brazil
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17
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Anti-Inflammatory Effects of Melatonin and 5-Methoxytryptophol on Lipopolysaccharide-Induced Acute Pulpitis in Rats. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8884041. [PMID: 33628825 PMCID: PMC7895566 DOI: 10.1155/2021/8884041] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/26/2020] [Accepted: 02/06/2021] [Indexed: 02/07/2023]
Abstract
Aim The aim of this study was to investigate the possible therapeutic impacts of two pineal hormones, melatonin and 5-methoxytryptophol (5-MTX), in a rat model of acute pulpitis by analyzing biochemical and histopathological parameters. Methods This research was done using 32 male and female Wistar albino rats with weight between 200 and 250 g. The rats were randomly divided into four groups: a control group (rats without any treatment), acute pulpitis (AP) group, AP+melatonin group, and AP+5-MTX group. In the AP-induced groups, the crowns of the upper left incisors were removed horizontally. Lipopolysaccharide solution was applied to the exposed pulp tissue before the canal orifices were sealed with a temporary filling material. Melatonin (10 mg/kg) and 5-MTX (5 mg/kg) were administered intraperitoneally. The rats were sacrificed 24 hours after pulp injury, and trunk blood and pulp samples were collected. The concentrations of TNF-α, IL-1β, MMP-1, and MMP-2 in sera and pulp samples were determined using ELISA assay kits. Results TNF-α, IL-1β, MMP-1, and MMP-2 levels in the serum and pulp tissues were considerably higher in the AP group than the control group (p < 0.01‐0.001). In the AP+melatonin and AP+5-MTX groups, TNF-α, IL-1β, MMP-1, and MMP-2 levels in the serum and pulp tissues were significantly lower than in the AP group (p < 0.05‐0.001). Conclusions Both melatonin and 5-MTX provided protective effects on acute pulpitis, which indicates they may be promising as a therapeutic strategy for oral disease.
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Freire MS, Oliveira NG, Lima SMF, Porto WF, Martins DCM, Silva ON, Chaves SB, Sousa MV, Ricart CAO, Castro MS, Fontes W, Franco OL, Rezende TMB. IL-4 absence triggers distinct pathways in apical periodontitis development. J Proteomics 2020; 233:104080. [PMID: 33338687 DOI: 10.1016/j.jprot.2020.104080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/17/2020] [Accepted: 12/12/2020] [Indexed: 12/18/2022]
Abstract
Dental pulp is a specialized tissue able to respond to infectious processes. Nevertheless, infection progress and root canal colonization trigger an immune-inflammatory response in tooth-surrounding tissues, leading to apical periodontitis and bone tissue destruction, further contributing to tooth loss. In order to shed some light on the effects of IL-4 on periradicular pathology development modulation, microtomographic, histological and proteomic analyses were performed using 60 mice, 30 wild type and 30 IL-4-/-. For that, 5 animals were used for microtomographic and histological analysis, and another 5 for proteomic analysis for 0, 7 and 21 days with/without pulp exposure. The periapical lesions were established in WT and IL-4-/- mice without statistical differences in their volume, and the value of p < 0.05 was adopted as significant in microtomographic and histological analyses. Regarding histological analysis, IL-4-/- mice show aggravation of pulp inflammation compared to WT. By using proteomic analysis, we have identified 32 proteins with increased abundance and 218 proteins with decreased abundance in WT animals after 21 days of pulp exposure, compared to IL-4-/- animals. However, IL-4-/- mice demonstrated faster development of apical periodontitis. These animals developed a compensatory mechanism to overcome IL-4 absence, putatively based on the identification of upregulated proteins related to immune system signaling pathways. Significance: IL-4 might play a protective role in diseases involving bone destruction and its activity may contribute to host protection, mainly due to its antiosteoclastogenic action.
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Affiliation(s)
- Mirna S Freire
- Programa de Pós-Graduação em Biotecnologia e Biodiversidade, Universidade de Brasília, Brasília, DF, Brazil; Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF, Brazil; Curso de Odontologia, Centro Universitário do Planalto Central Apparecido dos Santos, UNICEPLAC, Brasília, DF, Brazil
| | - Nelson G Oliveira
- Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF, Brazil
| | - Stella M F Lima
- Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF, Brazil; Curso de Odontologia, Universidade Católica de Brasília, UCB, Brasília, DF, Brazil
| | - William F Porto
- Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF, Brazil; Porto Reports, Brasília, DF, Brazil
| | - Danilo C M Martins
- Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF, Brazil; Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Ciências da Saúde, Universidade de Brasília, UnB, Brasília, DF, Brazil
| | - Osmar N Silva
- Programa de Pós-graduacao em Ciências Farmacêuticas. Centro Universitário de Anápolis - UniEVANGELICA, Anápolis, GO, Brazil
| | - Sacha B Chaves
- Departamento de nanotecnologia, Universidade de Brasília, Brazil
| | - Marcelo V Sousa
- Laboratório de Bioquímica e Química de Proteínas, Departamento de Biologia Celular, Universidade de Brasília, Brazil
| | - Carlos A O Ricart
- Laboratório de Bioquímica e Química de Proteínas, Departamento de Biologia Celular, Universidade de Brasília, Brazil
| | - Mariana S Castro
- Laboratório de Bioquímica e Química de Proteínas, Departamento de Biologia Celular, Universidade de Brasília, Brazil
| | - Wagner Fontes
- Laboratório de Bioquímica e Química de Proteínas, Departamento de Biologia Celular, Universidade de Brasília, Brazil
| | - Octavio L Franco
- Programa de Pós-Graduação em Biotecnologia e Biodiversidade, Universidade de Brasília, Brasília, DF, Brazil; Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF, Brazil; Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Ciências da Saúde, Universidade de Brasília, UnB, Brasília, DF, Brazil; Programa de Pós-Graduação em Patologia Molecular, Universidade de Brasília, Brasília, DF, Brazil.
| | - Taia M B Rezende
- Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF, Brazil; Curso de Odontologia, Universidade Católica de Brasília, UCB, Brasília, DF, Brazil; Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Ciências da Saúde, Universidade de Brasília, UnB, Brasília, DF, Brazil.
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Abstract
This paper concerns the assessment of the current state of dentistry in the world and the prospects of its sustainable development. A traditional Chinese censer was adopted as the pattern, with a strong and stable support on three legs. The dominant diseases of the oral cavity are caries and periodontal diseases, with the inevitable consequence of toothlessness. From the caries 3.5–5 billion people suffer. Moreover, each of these diseases has a wide influence on the development of systemic complications. The territorial range of these diseases and their significant differentiation in severity in different countries and their impact on disability-adjusted life years index are presented (DALY). Edentulousness has a significant impact on the oral health-related quality of life (OHRQoL). The etiology of these diseases is presented, as well as the preventive and therapeutic strategies undertaken as a result of modifying the Deming circle through the fives’ rules idea. The state of development of Dentistry 4.0 is an element of the current stage of the industrial revolution Industry 4.0 and the great achievements of modern dental engineering. Dental treatment examples from the authors’ own clinical practice are given. The systemic safety of a huge number of dentists in the world is discussed, in place of the passive strategy of using more and more advanced personal protective equipment (PPE), introducing our own strategy for the active prevention of the spread of pathogenic microorganisms, including SARS-CoV-2. The ethical aspects of dentists’ activity towards their own patients and the ethical obligations of the dentist community towards society are discussed in detail. This paper is a polemic arguing against the view presented by a group of eminent specialists in the middle of last year in The Lancet. It is impossible to disagree with these views when it comes to waiting for egalitarianism in dental care, increasing the scope of prevention and eliminating discrimination in this area on the basis of scarcity and poverty. The views on the discrimination of dentistry in relation to other branches of medicine are far more debatable. Therefore, relevant world statistics for other branches of medicine are presented. The authors of this paper do not agree with the thesis that interventional dental treatment can be replaced with properly implemented prophylaxis. The final remarks, therefore, present a discussion of the prospects for the development of dentistry based on three pillars, analogous to the traditional Chinese censer obtaining a stable balance thanks to its three legs. The Dentistry Sustainable Development (DSD) > 2020 model, consisting of Global Dental Prevention (GDP), Advanced Interventionist Dentistry 4.0 (AID 4.0), and Dentistry Safety System (DSS), is presented.
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Association between overweight, obesity and incidence of advanced dental caries in South Korean adults: A 10-year nationwide population-based observational study. PLoS One 2020; 15:e0229572. [PMID: 32107502 PMCID: PMC7046206 DOI: 10.1371/journal.pone.0229572] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 02/10/2020] [Indexed: 12/25/2022] Open
Abstract
The objective of this study was to evaluate the association between overweight, obesity and the incidence of advanced dental caries in South Korean adults, using alternate measures. The participants included 376,077 people aged 20 years and older who had health examination at least one time between 2005 and 2008. This evaluation is based on a change of body mass index (BMI) category, for 10 years, using a nationally representative data resource available from the National Health Insurance System. Instead of using decayed, missing, and filled teeth (DMFT), the diagnostic codes which indicate dental caries, pulpal disease and visiting frequency at dental health professionals were used in this case. A multivariate adjusted Cox regression analysis was performed to examine the association between advanced dental caries and BMI. In addition to the BMI, a multivariate analysis of gender, age, lifestyle behaviors and systemic disease information was included. To this end, the hazard ratio (HR) and 95% confidence interval (CI) were calculated. Chiefly, it is noted that the overweight and obese people were more likely to develop advanced dental caries independent of the noted variables. The positive association between high BMI and incidence of advanced dental caries was more prominent in the population's characteristic of people who were in a classification of the elderly and women. Among the health and lifecycle behaviors, smoking or not was found to be one of the factors affecting the results. The alternate method used in this study showed that being overweight and obesity had a direct association with the incidence of advanced dental caries in Korean adults.
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Pankajakshan D, Voytik-Harbin SL, Nör JE, Bottino MC. Injectable Highly Tunable Oligomeric Collagen Matrices for Dental Tissue Regeneration. ACS APPLIED BIO MATERIALS 2020; 3:859-868. [PMID: 32734173 PMCID: PMC7391263 DOI: 10.1021/acsabm.9b00944] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Current stem cell transplantation approaches lack efficacy, because they limit cell survival and retention and, more importantly, lack a suitable cellular niche to modulate lineage-specific differentiation. Here, we evaluate the intrinsic ability of type I oligomeric collagen matrices to modulate dental pulp stem cells (DPSCs) endothelial and odontogenic differentiation as a potential stem cell-based therapy for regenerative endodontics. DPSCs were encapsulated in low-stiffness (235 Pa) and high-stiffness (800 Pa) oligomeric collagen matrices and then evaluated for long-term cell survival, as well as endothelial and odontogenic differentiation following in vitro cell culture. Moreover, the effect of growth factor incorporation, i.e., vascular endothelial growth factor (VEGF) into 235 Pa oligomeric collagen or bone morphogenetic protein (BMP2) into the 800 Pa oligomeric collagen counterpart on endothelial or odontogenic differentiation of encapsulated DPSCs was investigated. DPSCs-laden oligomeric collagen matrices allowed long-term cell survival. Real time polymerase chain reaction (RT-PCR) data showed that the DPSCs cultured in 235 Pa matrices demonstrated an increased expression of endothelial markers after 28 days, and the effect was enhanced upon VEGF incorporation. There was a significant increase in alkaline phosphatase (ALP) activity at Day 14 in the 800 Pa DPSCs-laden oligomeric collagen matrices, regardless of BMP2 incorporation. However, Alizarin S data demonstrated higher mineralization by Day 21 and the effect was amplified in BMP2-modified matrices. Herein, we present key data that strongly support future research aimed at clinical translation of an injectable oligomeric collagen system for delivery and fate regulation of DPSCs to enable pulp and dentin regeneration at specific locations of the root canal system.
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Affiliation(s)
| | | | - Jacques E Nör
- University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Marco C Bottino
- University of Michigan School of Dentistry, Ann Arbor, Michigan
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22
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Ramezani M, Sanaei‐rad P, Hajihassani N. Revascularization and vital pulp therapy in immature molars with necrotic pulp and irreversible pulpitis: A case report with two-year follow-up. Clin Case Rep 2020; 8:206-210. [PMID: 31998518 PMCID: PMC6982478 DOI: 10.1002/ccr3.2614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/27/2019] [Accepted: 11/21/2019] [Indexed: 01/08/2023] Open
Abstract
Management of teeth with inflamed pulp has been always a challenge. Revascularization and vital pulp therapy are suggested as procedures for successful treatment of immature molars diagnosed with pulp necrosis and irreversible pulpitis, respectively.
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Affiliation(s)
- Masoumeh Ramezani
- Department of EndodonticsSchool of DentistryQazvin University of Medical SciencesQazvinIran
| | - Parisa Sanaei‐rad
- Department of EndodonticsSchool of DentistryQazvin University of Medical SciencesQazvinIran
| | - Neda Hajihassani
- Department of EndodonticsSchool of DentistryQazvin University of Medical SciencesQazvinIran
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Tampi MP, Pilcher L, Urquhart O, Kennedy E, O'Brien KK, Lockhart PB, Abt E, Aminoshariae A, Durkin MJ, Fouad AF, Gopal P, Hatten BW, Lang MS, Patton LL, Paumier T, Suda KJ, Cho H, Carrasco-Labra A. Antibiotics for the urgent management of symptomatic irreversible pulpitis, symptomatic apical periodontitis, and localized acute apical abscess: Systematic review and meta-analysis-a report of the American Dental Association. J Am Dent Assoc 2019; 150:e179-e216. [PMID: 31761029 DOI: 10.1016/j.adaj.2019.09.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Patients with pulpal and periapical conditions often seek treatment for pain, intraoral swelling, or both. Even when definitive, conservative dental treatment (DCDT) is an option, antibiotics are often prescribed. The purpose of this review was to summarize available evidence regarding the effect of antibiotics, either alone or as adjuncts to DCDT, to treat immunocompetent adults with pulpal and periapical conditions, as well as additional population-level harms associated with antibiotic use. TYPE OF STUDIES REVIEWED The authors updated 2 preexisting systematic reviews to identify newly published randomized controlled trials. They also searched for systematic reviews to inform additional harm outcomes. They conducted searches in MEDLINE, Embase, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature. Pairs of reviewers independently conducted study selection, data extraction, and assessment of risk of bias and certainty in the evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. RESULTS The authors found no new trials via the update of the preexisting reviews. Ultimately, 3 trials and 8 additional reports proved eligible for this review. Trial estimates for all outcomes suggested both a benefit and harm over 7 days (very low to low certainty evidence). The magnitude of additional harms related to antibiotic use for any condition were potentially large (very low to moderate certainty evidence). CONCLUSIONS AND PRACTICAL IMPLICATIONS Evidence for antibiotics, either alone or as adjuncts to DCDT, showed both a benefit and a harm for outcomes of pain and intraoral swelling and a large potential magnitude of effect in regard to additional harm outcomes. The impact of dental antibiotic prescribing requires further research.
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Martinho FC, de Rabello DGD, Ferreira LL, Nascimento GG. Participation of endotoxin in root canal infections: A systematic review and meta-analysis. Eur J Dent 2019; 11:398-406. [PMID: 28932155 PMCID: PMC5594974 DOI: 10.4103/ejd.ejd_84_17] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
This systematic review and meta-analysis aimed to evaluate the relationship between endotoxin levels and presence of clinical signs/symptoms and radiographic features in patients with endodontic infection. Electronic searches were performed on Medline/PubMed, Embase, Cochrane Library, Scielo, Science Direct, Web of Knowledge and Scopus databases for identification of relevant studies published up to December 2016. Grey literature was searched in Google Scholar. The selected literature was reviewed independently by two authors. Clinical studies evaluating the levels of endotoxin and the presence of clinical and radiographic features were included in this review. In order to determine the relationship between endotoxin levels and presence of clinical signs/symptoms and radiographic features meta-analyses were performed. Among the 385 articles identified in the initial search, 30 were included for full-text appraisal and only eight studies met the inclusion criteria for this systematic review. Meta-analysis revealed that individuals having teeth with tenderness to percussion (TTP) (P = 0.04; I2 57%) and previous episode of pain (PEP) (P = 0.001; I2 81%) had higher levels of endotoxin than their counterparts. Size of radiographic lesion >2 mm (P = 0.02; I2 68%) and presence of root canal exudation (EX) (P = 0.0007; I2 0%) were associated with higher levels of endotoxin. This systematic review and meta-analyses provided a strong evidence that endotoxin are related with the presence of clinical signs/symptoms and radiographic features in patients with endodontic infection.
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Affiliation(s)
- Frederico Canato Martinho
- Department of Restorative Dentistry, São José dos Campos Dental School, State University of São Paulo, São Paulo
| | | | - Luciana Louzada Ferreira
- Department of Restorative Dentistry, São José dos Campos Dental School, State University of São Paulo, São Paulo
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Cankar K, Vidmar J, Nemeth L, Serša I. T2 Mapping as a Tool for Assessment of Dental Pulp Response to Caries Progression: An in vivo MRI Study. Caries Res 2019; 54:24-35. [PMID: 31509847 DOI: 10.1159/000501901] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 07/03/2019] [Indexed: 11/19/2022] Open
Abstract
Among radiological methods, magnetic resonance imaging (MRI) excels in its ability to image soft tissue at great contrast and without the need of harmful radiation. This study tested whether in vivo MRI based on standard MRI sequences run on a standard clinical MRI system can be used to quantify dental pulp response to caries progression using the T2 mapping method. In the study, 74 teeth were scanned on a 3-T MRI system, and caries was assessed according to the International Caries Detection and Assessment System (ICDAS). The T2 maps were processed to obtain T2 profiles along selected root canals (from crown to apex), and the profiles were sorted according to both tooth type (single-rooted vs. molar) and ICDAS score. In all the examined dental pulps, it was found that T2 values decrease with an increase in the ICDAS score. In the coronal part of dental pulps, average T2 values of 166, 153, and 115 ms were found in ICDAS groups 0, 1-3, and 4-6, respectively. In single-rooted teeth, T2 values were found approximately constant as a function of dental pulp depth, while in multi-rooted teeth, they were found increasing in the coronal part and decreasing towards the root apex. The study confirmed that T2 mapping of dental pulp can be used to reliably quantify its response to caries progression and that it has a potential to become a complementary diagnostic tool to standard radiographic methods in the assessment of dental pulp response to caries.
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Affiliation(s)
- Ksenija Cankar
- Institute of Physiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia,
| | - Jernej Vidmar
- Institute of Physiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Institute of Radiology, University Medical Center Ljubljana, Ljubljana, Slovenia.,Jožef Stefan Institute, Ljubljana, Slovenia
| | - Lidija Nemeth
- Department of Dental Diseases and Normal Dental Morphology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Igor Serša
- Institute of Physiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Jožef Stefan Institute, Ljubljana, Slovenia
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26
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Wells MH. Pit and Fissure Sealants. Pediatr Dent 2019. [DOI: 10.1016/b978-0-323-60826-8.00033-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lew WZ, Feng SW, Lin CT, Huang HM. Use of 0.4-Tesla static magnetic field to promote reparative dentine formation of dental pulp stem cells through activation of p38 MAPK signalling pathway. Int Endod J 2018; 52:28-43. [PMID: 29869795 DOI: 10.1111/iej.12962] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/30/2018] [Indexed: 11/29/2022]
Abstract
AIM To investigate whether static magnetic fields (SMFs) have a positive effect on the migration and dentinogenesis of dental pulp stem cells (DPSCs) to promote reparative dentine formation. METHODOLOGY In vitro scratch assays and a traumatic pulp exposure model were performed to evaluate the effect of 0.4-Tesla (T) SMF on DPSC migration. The cytoskeletons of the DPSCs were identified by fluorescence immunostaining and compared with those of a sham-exposed group. Dentinogenic evaluation was performed by analysing the expressions of DMP-1 and DSPP marker genes using a quantitative real-time polymerase chain reaction (qRT-PCR) process. Furthermore, the formation of calcified deposits was examined by staining the dentinogenic DPSCs with Alizarin Red S dye. Finally, the role played by the p38 MAPK signalling pathway in the migration and dentinogenesis of DPSCs under 0.4-T SMF was investigated by incorporating p38 inhibitor (SB203580) into the in vitro DPSC experiments. The Student's t-test and the Kruskal-Wallis test followed by Dunn's post hoc test with a significance level of P < 0.05 were used for statistical analysis. RESULTS The scratch assay results revealed that the application of 0.4-T SMF enhanced DPSCs migration towards the scratch wound (P < 0.05). The cytoskeletons of the SMF-treated DPSCs were found to be aligned perpendicular to the scratch wound. After 20 days of culture, the SMF-treated group had a greater number of out-grown cells than the sham-exposed group (nonmagnetized control). For the SMF-treated group, the DMP-1 (P < 0.05) and DSPP genes (P < 0.05), analysed by qRT-PCR, exhibited a higher expression. The distribution of calcified nodules was also found to be denser in the SMF-treated group when stained with Alizarin Red S dye (P < 0.05). Given the incorporation of p38 inhibitor SB203580 into the DPSCs, cell migration and dentinogenesis were suppressed. No difference was found between the SMF-treated and sham-exposed cells (P > 0.05). CONCLUSION 0.4-T SMF enhanced DPSC migration and dentinogenesis through the activation of the p38 MAPK-related pathway.
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Affiliation(s)
- W-Z Lew
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - S-W Feng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - C-T Lin
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - H-M Huang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Biomedical Optomechatronics, Taipei Medical University, Taipei, Taiwan
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Ji Y, Choi SK, Sultan AS, Chuncai K, Lin X, Dashtimoghadam E, Melo MA, Weir M, Xu H, Tayebi L, Nie Z, Depireux DA, Masri R. Nanomagnetic-mediated drug delivery for the treatment of dental disease. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2018; 14:919-927. [PMID: 29408655 DOI: 10.1016/j.nano.2018.01.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/05/2018] [Accepted: 01/15/2018] [Indexed: 12/20/2022]
Abstract
Maintaining the vitality of the dental pulp, the highly innervated and highly vascular, innermost layer of the tooth, is a critical goal of any dental procedure. Upon injury, targeting the pulp with specific therapies is challenging because it is encased in hard tissues. This project describes a method that can effectively deliver therapeutic agents to the pulp. This method relies on the use of nanoparticles that can be actively steered using magnetic forces to the pulp, traveling through naturally occurring channels in the dentin (the middle layer of the tooth). This method can reduce the inflammation of injured pulp and improve the penetration of dental adhesives into dentin. Such a delivery method would be less expensive, and both less painful and less traumatic than existing therapeutic options available for treatment of injured dental pulp. This technique would be simple and could be readily translated to clinical use.
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Affiliation(s)
- Yadong Ji
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland Baltimore, Baltimore, MD, USA
| | - Seung K Choi
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland Baltimore, Baltimore, MD, USA
| | - Ahmed S Sultan
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, MD, USA
| | - Kong Chuncai
- Department of Chemistry and Biochemistry, University of Maryland, College Park, MD, USA
| | - Xiaoying Lin
- Department of Chemistry and Biochemistry, University of Maryland, College Park, MD, USA
| | | | - Mary Anne Melo
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland Baltimore, Baltimore, MD, USA
| | - Michael Weir
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland Baltimore, Baltimore, MD, USA
| | - Huakun Xu
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland Baltimore, Baltimore, MD, USA
| | - Lobat Tayebi
- Marquette University School of Dentistry, Milwaukee, WI, USA; Biomaterials and Advanced Drug Delivery Laboratory, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Zhihong Nie
- Department of Chemistry and Biochemistry, University of Maryland, College Park, MD, USA
| | - Didier A Depireux
- Institute for Systems Research, University of Maryland, College Park, MD, USA; Department of Otorhinolaryngology/Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Radi Masri
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland Baltimore, Baltimore, MD, USA.
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Decellularized Swine Dental Pulp as a Bioscaffold for Pulp Regeneration. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9342714. [PMID: 29387727 PMCID: PMC5745671 DOI: 10.1155/2017/9342714] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 10/30/2017] [Accepted: 11/15/2017] [Indexed: 01/09/2023]
Abstract
Endodontic regeneration shows promise in treating dental pulp diseases; however, no suitable scaffolds exist for pulp regeneration. Acellular natural extracellular matrix (ECM) is a favorable scaffold for tissue regeneration since the anatomical structure and ECM of the natural tissues or organs are well-preserved. Xenogeneic ECM is superior to autologous or allogeneic ECM in tissue engineering for its unlimited resources. This study investigated the characteristics of decellularized dental pulp ECM from swine and evaluated whether it could mediate pulp regeneration. Dental pulps were acquired from the mandible anterior teeth of swine 12 months of age and decellularized with 10% sodium dodecyl sulfate (SDS) combined with Triton X-100. Pulp regeneration was conducted by seeding human dental pulp stem cells into decellularized pulp and transplanted subcutaneously into nude mice for 8 weeks. The decellularized pulp demonstrated preserved natural shape and structure without any cellular components. Histological analysis showed excellent ECM preservation and pulp-like tissue, and newly formed mineralized tissues were regenerated after being transplanted in vivo. In conclusion, decellularized swine dental pulp maintains ECM components favoring stem cell proliferation and differentiation, thus representing a suitable scaffold for improving clinical outcomes and functions of teeth with dental pulp diseases.
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30
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Lim SN, Kiang L, Manohara R, Tong HJ, Nair R, Hong C, Hu S. Interim therapeutic restoration approach versus treatment under general anaesthesia approach. Int J Paediatr Dent 2017; 27:551-557. [PMID: 28260237 DOI: 10.1111/ipd.12296] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Although dental treatment under general anaesthesia (GA) remains the long-established approach for treating anxious children, treatment under GA presents with increased risks, costs and parental acceptability issues. Interim therapeutic restoration (ITR) has been proposed as an alternative approach. AIM To compare the incidence and types of failures between children managed with the ITR approach and those managed under GA within 12 months of treatment completion. DESIGN A retrospective cohort study of children who received dental treatment utilizing the ITR approach was compared to children treated under GA. Age, gender and dental disease matching was done. Statistical analyses were carried out with Independent t-test and chi-square analyses. RESULTS A total of 132 children (GA = 66, ITR = 66) were included, and the groups did not differ in terms of initial age, sex, dmft and initial behaviour score. ITR group had a significantly higher rate (P < 0.001; 95% CI: [0.21 to 0.97]) of restorative failure and visits required when compared to the GA group. There were no difference for incidence of pain (P = 0.55; 95% CI: [-0.074 to 0.10]) and behaviour scores (P = 0.46) between the two groups at the 12-month visit. CONCLUSIONS ITR approach may be a viable alternative to the GA approach when treating paediatric dental patients.
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Affiliation(s)
| | - Leroy Kiang
- Ministry of Health Holdings, Singapore, Singapore
| | | | - Huei Jinn Tong
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Rahul Nair
- ARCPOH, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Catherine Hong
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Shijia Hu
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
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Abstract
Odontogenic infections represent a common clinical problem in patients of all ages. The presence of teeth enables the direct spread of inflammatory products from dental caries, trauma, and/or periodontal disease into the maxilla and mandible. The radiographic changes seen depend on the type and duration of the inflammatory process and host body response. Imaging plays a central role in identifying the source of infection and the extent of the disease spread and in detecting any complications. Many different imaging modalities can be used. The radiographic features associated with acute and chronic inflammatory processes are discussed.
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Affiliation(s)
- Shaza Mardini
- BeamReaders, Inc, 7117 West Hood Place, Suite 110, Kennewick, WA 99336, USA.
| | - Anita Gohel
- Oral and Maxillofacial Radiology, Division of Oral and Maxillofacial Pathology and Radiology, The Ohio State University College of Dentistry, 3165 Postle Hall, 305 West 12th Avenue, Columbus, OH 43210-1267, USA
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Xuedong Z, Dingming H, Jianguo L, Zhengwei H, Xin W, Deqin Y, Jin Z, Liming C, Lin Z, Yanhong L, Jiyao L. [Vital pulp therapy of damaged dental pulp]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2017; 35:339-347. [PMID: 28853497 DOI: 10.7518/hxkq.2017.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The development of an expert consensus on vital pulp therapy can provide practical guidance for the improvement of pulp damage care in China. Dental pulp disease is a major type of illness that adversely affects human oral health. Pulp capping and pulpotomy are currently the main methods for vital pulp therapy. Along with the development of minimal invasion cosmetic dentistry, using different treatment technologies and materials reasonably, preserving healthy tooth tissue, and extending tooth save time have become urgent problems that call for immediate solution in dental clinics. This paper summarizes the experiences and knowledge of endodontic experts. We develop a clinical path of vital pulp therapy for clinical work by utilizing the nature, approach, and degree of pulp damage as references, defense and self-repairing ability of pulp as guidance, and modern technologies of diagnosis and treatment as means.
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Affiliation(s)
- Zhou Xuedong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Huang Dingming
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Liu Jianguo
- Dept. of Conservative Dentistry and Endodontics, Stomatological Hospital Affiliated to Zunyi Medical College, Zunyi 563003, China
| | - Huang Zhengwei
- Dept. of Conservative Dentistry and Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Wei Xin
- Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, China
| | - Yang Deqin
- Dept. of Conservative Dentistry and Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing 401147, China
| | - Zhao Jin
- Dept. of Conservative Dentistry and Endodontics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
| | - Chen Liming
- Guiyang Hospital of Stomatology, Guiyang 550002, China
| | - Zhu Lin
- Tibet Branch of West China Hospital of Stomatology, Lasa 850000, China
| | - Li Yanhong
- Hospital of Stomatology, Kunming Medical University, Kunming 650199, China
| | - Li Jiyao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Abogazalah N, Ando M. Alternative methods to visual and radiographic examinations for approximal caries detection. J Oral Sci 2017; 59:315-322. [PMID: 28529280 DOI: 10.2334/josnusd.16-0595] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
A shift in caries prevalence from occlusal surfaces to approximal surfaces has been demonstrated by epidemiological studies. Two recent meta-analyses evaluated the performance of visual examination and radiography for carious lesion detection, and reported low sensitivity but high specificity for early approximal caries detection. This suggests that the conventional methods have a higher risk of failing to detect approximal lesions. Consequently, in caries susceptible populations, there is a risk of progression of non-cavitated lesions to irreversible tooth destruction before the lesions are detected. This paper aims to review the performance of unconventional and novel methods for approximal caries detection. In vitro and in vivo studies identified through a MEDLINE search using keywords such as caries detection, approximal caries detection, light fluorescence and dental caries, and transillumination and dental caries were reviewed. The unconventional methods known to be used for approximal caries detection and included in this review are: cone beam computed tomography, fiber-optic trans-illumination, digital imaging fiber optic trans-illumination, near-infrared digital imaging transillumination, optical coherence tomography, laser fluorescence, ultrasound, and LED reflection and refraction.
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Affiliation(s)
- Naif Abogazalah
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry.,Department of Restorative Dental Sciences, King Khalid University College of Dentistry
| | - Masatoshi Ando
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry
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Novais VR, Soares PBF, Guimarães CM, Schliebe LRSO, Braga SSL, Soares CJ. Effect of Gamma Radiation and Endodontic Treatment on Mechanical Properties of Human and Bovine Root Dentin. Braz Dent J 2016; 27:670-674. [DOI: 10.1590/0103-6440201601267] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 10/21/2016] [Indexed: 11/21/2022] Open
Abstract
Abstract This study evaluated the effect of gamma radiation and endodontic treatment on the microhardness and flexural strength of human and bovine root dentin. Forty single-rooted human teeth and forty bovine incisor teeth were collected, cleaned and stored in distilled water at 4 °C. The human and bovine teeth were divided into 4 groups (n=10) resulting from the combination of two study factors: first, regarding the endodontic treatment in 2 levels: with or without endodontic treatment; and second, radiotherapy in two levels: with or without radiotherapy by 60 Gy of Co-60 gamma radiation fractioned into 2 Gy daily doses five days per week. Each tooth was longitudinally sectioned in two parts; one-half was used for the three-point bending test and the other for the Knoop hardness test (KHN). Data were analyzed by 3-way ANOVA and Tukey HSD test (α=0.05). No significant difference was found for flexural strength values. The human dentin had significantly higher KHN than the bovine. The endodontic treatment and radiotherapy resulted in significantly lower KHN irrespective of tooth origin. The results indicated that the radiotherapy had deleterious effects on the microhardness of human and bovine dentin and this effect is increased by the interaction with endodontic therapy. The endodontic treatment adds additional negative effect on the mechanical properties of radiated tooth dentin; the restorative protocols should be designed taking into account this effect.
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35
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Sabbagh S, Sarraf Shirazi A, Eghbal MJ. Vital Pulp Therapy of a Symptomatic Immature Permanent Molar with Long-Term Success. IRANIAN ENDODONTIC JOURNAL 2016; 11:347-349. [PMID: 27790270 PMCID: PMC5069917 DOI: 10.22037/iej.2016.19] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Vital pulp therapy (VPT) is the preferred conservative treatment for preservation of symptomatic pulps in immature permanent teeth. The present case report summarizes VPT of an immature permanent molar with irreversible pulpitis associated with apical periodontitis in a 9-year-old boy. Cervical pulpotomy was performed and radicular pulp stumps were covered with calcium-enriched mixture (CEM) cement; the tooth was then restored with stainless steel crown. After a 50-month follow-up period, the pulpotomized molar was clinically functional and asymptomatic. Moreover, radiographic evaluation revealed evidence of complete root development as well as normal periodontal ligament around the roots. The successful outcome achieved through VPT using CEM biomaterial in the reported case suggests that this method may produce favorable outcome for vital immature permanent teeth with irreversible pulpitis and periapical disease.
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Affiliation(s)
- Sedigheh Sabbagh
- Student Research Committee, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Sarraf Shirazi
- Dental Material Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Jafar Eghbal
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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36
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Rechenberg DK, Held U, Burgstaller JM, Bosch G, Attin T. Pain levels and typical symptoms of acute endodontic infections: a prospective, observational study. BMC Oral Health 2016; 16:61. [PMID: 27234432 PMCID: PMC4884369 DOI: 10.1186/s12903-016-0222-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 05/24/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND This study aimed to identify key symptoms that could be associated with the diagnosis of acute forms of symptomatic apical periodontitis (SAP) and symptomatic irreversible pulpitis (SIP), and to identify a diagnostic algorithm based on these symptoms. METHODS In this prospective, observational study 173 emergency patients diagnosed with acute pain of endodontic origin and no swelling or fistula were included. Patients were asked 11 specific questions from a checklist with a possible discerning value between acute SAP and acute SIP. Pain levels were recorded using the numeric rating scale (NRS-11). Subsequently, the painful tooth was diagnosed. Logistic regression was used to evaluate the checklist regarding its differentiation between SAP (N = 103) and SIP (N = 70). Moreover, a decision tree was constructed based on recursive partitioning to identify a hierarchy in differentiating symptoms. RESULTS With identical median NRS-11 scores of 8, the teeth diagnosed with acute SAP and SIP were severely painful. The decision tree analysis resulted in a tree with splits according to pain on cold, perceived tooth extrusion, and pain duration. The overall sensitivity of the tree to detect SAP based on key symptoms was 95 %, its specificity was 31 %. CONCLUSIONS The best indicator for SAP was a reported absence of pain to cold stimuli. In teeth that did have a history of pain triggered by cold stimuli, the decision tree correctly identified SAP in 72 % of the teeth that felt too high and had hurt for less than one week.
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Affiliation(s)
- Dan-Krister Rechenberg
- Department of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zürich, Switzerland, Plattenstrasse 11, CH-8032, Zürich, Switzerland.
| | - Ulrike Held
- Department of Internal Medicine, Horten Center for Patient Oriented Research and Knowledge Transfer, University of Zürich, Zürich, Switzerland
| | - Jakob M Burgstaller
- Department of Internal Medicine, Horten Center for Patient Oriented Research and Knowledge Transfer, University of Zürich, Zürich, Switzerland
| | - Gabriel Bosch
- Department of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zürich, Switzerland, Plattenstrasse 11, CH-8032, Zürich, Switzerland
| | - Thomas Attin
- Department of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zürich, Switzerland, Plattenstrasse 11, CH-8032, Zürich, Switzerland
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DeAngelis AF, Barrowman RA, Harrod R, Nastri AL. Review article: Maxillofacial emergencies: oral pain and odontogenic infections. Emerg Med Australas 2015; 26:336-42. [PMID: 25065769 DOI: 10.1111/1742-6723.12266] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2014] [Indexed: 11/30/2022]
Abstract
Oral pain and odontogenic infections are common reasons for patients to present to EDs and general medical practice in Australia. Although most odontogenic infections can be managed on an outpatient basis, because of their proximity to the airway, infections in this region can be life threatening, requiring urgent surgical intervention and ICU management. This article focuses on the emergency assessment, triage and non-specialist management of oral pain and odontogenic infections.
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Affiliation(s)
- Adrian F DeAngelis
- Maxillofacial Surgery Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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Zandona F, Soini HA, Novotny MV, Santiago E, Eckert GJ, Preisser JS, Benecha HK, Arthur RA, Zero DT. A Potential Biofilm Metabolite Signature for Caries Activity - A Pilot Clinical Study. METABOLOMICS : OPEN ACCESS 2015; 5:140. [PMID: 27885354 PMCID: PMC5119531 DOI: 10.4172/2153-0769.1000140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND This study's aim was to compare the dental biofilm metabolite-profile of caries-active (N=11) or caries-free (N=4) children by gas chromatography-mass spectrometry (GC/MS) analyses. METHODS Samples collected after overnight fasting, with or without a previous glucose rinse, were combined for each child based on the caries status of the site, re-suspended in ethanol and analyzed by GC/MS. RESULTS Biofilm from caries-active sites exhibited a different chromatographic profile compared to caries-free sites. Qualitative and quantitative analysis suggested a special cluster of branched alcohols and esters present at substantially higher intensity in biofilms of caries-active sites. CONCLUSIONS This pilot study indicates that there are metabolites present in the biofilm which have the potential to provide a characteristic metabolomics signature for caries activity.
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Affiliation(s)
- F Zandona
- Department of Operative Dentistry, University of North Carolina School of Dentistry at Chapel Hill, Chapel Hill, USA
| | - HA Soini
- Department of Chemistry, Institute for Pheromone Research, Indiana University, Bloomington, Indiana, USA
| | - MV Novotny
- Department of Chemistry, Institute for Pheromone Research, Indiana University, Bloomington, Indiana, USA
| | - E Santiago
- School of Dentistry Research Center, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - GJ Eckert
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - JS Preisser
- Department of Biostatistics, UNC Gillings School of Global Public Health, Chapel Hill, USA
| | - HK Benecha
- Department of Preventive and Community Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - RA Arthur
- Department of Preventive and Community Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - DT Zero
- Department of Preventive and Community Dentistry, Indiana University School of Dentistry, Indianapolis, Indiana, USA
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Ramos-Jorge J, Alencar BM, Pordeus IA, Soares MEDC, Marques LS, Ramos-Jorge ML, Paiva SM. Impact of dental caries on quality of life among preschool children: emphasis on the type of tooth and stages of progression. Eur J Oral Sci 2014; 123:88-95. [PMID: 25557987 DOI: 10.1111/eos.12166] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2014] [Indexed: 11/29/2022]
Abstract
The aim of this cross-sectional study was to evaluate the impact of dental caries on the quality of life of preschool children and their parents/caretakers, with an emphasis on the type of tooth and stage of progression. A randomly selected sample of preschool children, 3-5 yrs of age, underwent an oral examination for the assessment of dental caries using the International Caries Detection and Assessment System II (ICDAS II) criteria. Parents/caretakers answered two questionnaires, one on the oral health-related quality of life (OHRQoL) of the child [the Early Childhood Oral Health Impact Scale (ECOHIS)], and the other on the socio-economic characteristics of the family. Statistical analyses were performed using the chi-square test, Kruskal-Wallis test, Mann-Whitney U-test, and Poisson regression. A total of 451 preschool children participated in the study. The majority of carious lesions exhibited severe decay (60.6%) and were found in both anterior (incisors/canines) and posterior (molars) teeth. The final Poisson model revealed negative impacts on quality of life from more advanced stages of dental caries, both in incisors/canines and molars. Child's age and household income were also associated with impact on quality of life. Carious lesions in more advanced stages of progression in anterior and posterior teeth were associated with a negative impact on the quality of life of preschool children.
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Affiliation(s)
- Joana Ramos-Jorge
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
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Lima SMDF, de Pádua GM, Sousa MGDC, Freire MDS, Franco OL, Rezende TMB. Antimicrobial peptide-based treatment for endodontic infections--biotechnological innovation in endodontics. Biotechnol Adv 2014; 33:203-213. [PMID: 25447423 DOI: 10.1016/j.biotechadv.2014.10.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 10/07/2014] [Accepted: 10/31/2014] [Indexed: 01/30/2023]
Abstract
The presence/persistence of microorganisms in the pulp and periapical area corresponds to the maintenance of an exacerbated immune response that leads to the start of periradicular bone resorption and its perpetuation. In endodontic treatment, the available intracanal medications do not have all the desirable properties in the context of endodontic infection and apical periodontitis; they need to include not only strong antimicrobial performance but also an immunomodulatory and reparative activity, without host damage. In addition, there are various levels of resistance to root canal medications. Thus, antimicrobial agents that effectively eliminate resistant species in root canals could potentially improve endodontic treatment. In the emergence of new therapies, an increasing number of studies on antimicrobial peptides (AMPs) have been seen over the past few years. AMPs are defense biomolecules produced in response to infection, and they have a wide spectrum of action against many oral microorganisms. There are some studies that correlate peptides and oral infections, including oral peptides, neuropeptides, and bacterial, fish, bovine and synthetic peptides. So far, there are around 120 published studies correlating endodontic microbiota with AMPs but, according to our knowledge, there are no registered patents in the American patent database. There are a considerable number of AMPs that exhibit excellent antimicrobial activity against endodontic microbiota at a small inhibitory concentration and modulate an exacerbated immune response, down-regulating bone resorption. All these reasons indicate the antimicrobial peptide-based endodontic treatment as an emerging and promising option.
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Affiliation(s)
- Stella Maris de Freitas Lima
- Centro de Análises Proteômicas e Bioquímicas, Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, SGAN 916N, Av. W5, Campus II, Modulo C, Brasília, DF, Brazil; Curso de Odontologia, Universidade Católica de Brasília, Campus I, QS 07 Lote 01 room S213 EPCT, Águas Claras, Taguatinga, DF, Brazil
| | - Gabriela Martins de Pádua
- Curso de Odontologia, Universidade Católica de Brasília, Campus I, QS 07 Lote 01 room S213 EPCT, Águas Claras, Taguatinga, DF, Brazil
| | - Maurício Gonçalves da Costa Sousa
- Centro de Análises Proteômicas e Bioquímicas, Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, SGAN 916N, Av. W5, Campus II, Modulo C, Brasília, DF, Brazil; Curso de Odontologia, Universidade Católica de Brasília, Campus I, QS 07 Lote 01 room S213 EPCT, Águas Claras, Taguatinga, DF, Brazil
| | - Mirna de Souza Freire
- Centro de Análises Proteômicas e Bioquímicas, Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, SGAN 916N, Av. W5, Campus II, Modulo C, Brasília, DF, Brazil; Programa de Doutorado da Rede Centro-Oeste, Brasília, DF, Brazil
| | - Octávio Luiz Franco
- Centro de Análises Proteômicas e Bioquímicas, Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, SGAN 916N, Av. W5, Campus II, Modulo C, Brasília, DF, Brazil; Programa de Doutorado da Rede Centro-Oeste, Brasília, DF, Brazil; S-Inova, Pós-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande, MS, Brazil
| | - Taia Maria Berto Rezende
- Centro de Análises Proteômicas e Bioquímicas, Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, SGAN 916N, Av. W5, Campus II, Modulo C, Brasília, DF, Brazil; Curso de Odontologia, Universidade Católica de Brasília, Campus I, QS 07 Lote 01 room S213 EPCT, Águas Claras, Taguatinga, DF, Brazil; Programa de Pós-Graduação em Ciências da Saúde, Universidade de Brasília, Faculdade de Ciências da Saúde (FS), Campus Universitário Darcy Ribeiro, Brasília, DF, Brazil.
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Bimix antimicrobial scaffolds for regenerative endodontics. J Endod 2014; 40:1879-84. [PMID: 25201643 DOI: 10.1016/j.joen.2014.07.017] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 07/07/2014] [Accepted: 07/11/2014] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Eliminating and/or inhibiting bacterial growth within the root canal system has been shown to play a key role in the regenerative outcome. The aim of this study was to synthesize and determine in vitro both the antimicrobial effectiveness and cytocompatibility of bimix antibiotic-containing polydioxanone-based polymer scaffolds. METHODS Antibiotic-containing (metronidazole [MET] and ciprofloxacin [CIP]) polymer solutions (distinct antibiotic weight ratios) were spun into fibers as a potential mimic to the double antibiotic paste (DAP, a MET/CIP mixture). Fiber morphology, chemical characteristics, and tensile strength were evaluated by scanning electron microscopy, Fourier transform infrared spectroscopy, and tensile testing, respectively. Antimicrobial efficacy was tested over time (aliquot collection) against Enterococcus faecalis (Ef), Porphyromonas gingivalis (Pg), and Fusobacterium nucleatum (Fn). Similarly, cytotoxicity was evaluated in human dental pulp stem cells. Data were statistically analyzed (P < .05). RESULTS Scanning electron microscopy and Fourier transform infrared spectroscopy confirmed that electrospinning was able to produce antibiotic-containing fibers with a diameter mostly in the nanoscale. The tensile strength of 1:1MET/CIP scaffolds was significantly (P < .05) higher than pure polydioxanone (control). Meanwhile, all other groups presented similar strength as the control. Aliquots obtained from antibiotic-containing scaffolds inhibited the growth of Ef, Pg, and Fn, except pure MET, which did not show an inhibitory action toward Pg or Fn. Antibiotic-containing aliquots promoted slight human dental pulp stem cell viability reduction, but none of them were considered to be cytotoxic. CONCLUSIONS Our data suggest that the incorporation of multiple antibiotics within a nanofibrous scaffold holds great potential toward the development of a drug delivery system for regenerative endodontics.
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Cankar K, Nemeth L, Bajd F, Vidmar J, Serša I. Discrimination between intact and decayed pulp regions in carious teeth by ADC mapping. Caries Res 2014; 48:467-74. [PMID: 24852609 DOI: 10.1159/000358068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 12/17/2013] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to evaluate an advanced magnetic resonance imaging (MRI) method, apparent diffusion coefficient (ADC) mapping, in the functional assessment of carious teeth. 38 extracted human teeth with scores of 0, 3 and 6 according to International Caries Detection and Assessment System (ICDAS) criteria were screened and subsequently analyzed by MRI at 2.35 T. Histology sectioning of teeth was used for the gold standard by analyzing two extreme cases (intact and severely decayed). ADC maps of the same teeth were calculated from corresponding diffusion-weighted images and used to obtain ADC distributions along dental pulp as functions of the relative pulp length measured from the occlusal pulp side. The measured distributions were analyzed for the best fit by a four-parameter three-segment linear regression model for ADC distribution along the pulp. MRI results were in good agreement with findings in histological sections of identical teeth. The best fit model parameters, relative decayed region depth, relative transition region width and ADC values of intact and decayed pulp tissue, showed statistically significant differences between the ADC values of intact and decayed pulp tissue (1.0 × 10(-9) m(2)/s vs. 0.74-0.89 × 10(-9) m(2)/s) and the relative decayed region depth progressing with ICDAS score (3 vs. 46% with ICDAS 3 vs. ICDAS 6). The results of this feasibility study confirmed relevance of ADC mapping for the discrimination and localization of intact and decayed regions in dental pulps of carious teeth.
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Affiliation(s)
- Ksenija Cankar
- Institute of Physiology, University of Ljubljana, Ljubljana, Slovenia
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How the introduction of the acid-etch technique revolutionized dental practice. J Am Dent Assoc 2013; 144 Spec No:47S-51S. [DOI: 10.14219/jada.archive.2013.0249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ferreira Zandoná A, Ando M, Gomez GF, Garcia-Corretjer M, Eckert GJ, Santiago E, Katz BP, Zero DT. Longitudinal analyses of early lesions by fluorescence: an observational study. J Dent Res 2013; 92:84S-9S. [PMID: 23690351 DOI: 10.1177/0022034513490167] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Previous caries experience correlates to future caries risk; thus, early identification of lesions has importance for risk assessment and management. In this study, we aimed to determine if Quantitative Light-induced Fluorescence (QLF) parameters--area (A [mm(2)]), fluorescence loss (F [%]), and Q [% × mm(2)]--obtained by image analyses can predict lesion progression. We secured consent from 565 children (from 5-13 years old) and their parents/guardians and examined them at baseline and regular intervals over 48 months according to the International Caries Detection Assessment System (ICDAS), yearly radiographs, and QLF. QLF images from surfaces with ICDAS 0/1/2/3/4 at baseline that progressed (N = 2,191) to cavitation (ICDAS 5/6) or fillings and surfaces that did not progress to cavitation/fillings (N = 4,141) were analyzed independently for A, F, and Q. Linear mixed-effects models were used to compare means and slopes (changes over time) between surfaces that progressed and those that did not. QLF A, F, and Q increased at a faster rate for surfaces that progressed than for surfaces that did not progress (p = .0001), regardless of type of surface or baseline ICDAS score. AUC for ICDAS ranged from 0.65 to 0.80, but adding QLF information improved AUC (0.82-0.87, p < .0005). We concluded that faster changes in QLF variables can indicate lesion progression toward cavitation and be more clinically relevant than actual QLF values.
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Affiliation(s)
- A Ferreira Zandoná
- Department of Preventive and Community Dentistry, Indiana University School of Dentistry, Indianapolis, Indiana. USA.
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Eba H, Murasawa Y, Iohara K, Isogai Z, Nakamura H, Nakamura H, Nakashima M. The anti-inflammatory effects of matrix metalloproteinase-3 on irreversible pulpitis of mature erupted teeth. PLoS One 2012; 7:e52523. [PMID: 23285075 PMCID: PMC3527558 DOI: 10.1371/journal.pone.0052523] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Accepted: 11/15/2012] [Indexed: 01/29/2023] Open
Abstract
Matrix metalloproteinases (MMPs) are involved in extracellular matrix degradation and the modulation of cell behavior. These proteinases have also been implicated in tissue repair and regeneration. Our previous studies have demonstrated that MMP-3 elicits stimulatory effects on the proliferation and the migration of endothelial cells as well as anti-apoptotic effects on these cells in vitro. In addition, we found that MMP-3 enhanced the regeneration of lost pulp tissue in a rat incisor pulp injury model. However, continuously erupting rodent incisors exhibit significantly different pulp organization compared with mature erupted teeth. Therefore, we have further extended these studies using a canine irreversible pulpitis model to investigate the effects of MMP-3. In this study, the crowns of the canine mature premolars were removed and the pulp tissues were amputated. The amputated pulp tissues remained exposed for 24 or 72 hours to induce mild or severe irreversible pulpitis, respectively, followed by sealing of the cavities. In both models, the whole pulp tissues became necrotic by day 14. In this mild pulpitis model, the regeneration of pulp tissue with vasculature and nerves was observed until 14 days after sealing with MMP-3, followed by extracellular matrix formation in the regenerated pulp tissues until day 28. The treatment with MMP-3 resulted in a decrease in the number of macrophage and antigen-presenting cells and a significant inhibition of IL-6 expression on day 3. The inhibition of MMP-3 activity abolished these anti-inflammatory effects. Immunofluorescence staining demonstrated that MMP-3 was involved in the modification of serum-derived hyaluronan-associated proteins and hyaluronan (SHAP-HA) complexes possibly through the degradation of versican. These results demonstrate that MMP-3 can act as an anti-inflammatory agent and suggest that MMP-3 might represent a useful therapy for the treatment of mild irreversible pulpitis.
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Affiliation(s)
- Hisanori Eba
- Department of Dental Regenerative Medicine, Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
- Department of Endodontics, School of Dentistry, Aichi-gakuin University, Nagoya, Aichi, Japan
| | - Yusuke Murasawa
- Department of Advanced Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Koichiro Iohara
- Department of Dental Regenerative Medicine, Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Zenzo Isogai
- Department of Advanced Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hiroshi Nakamura
- Department of Endodontics, School of Dentistry, Aichi-gakuin University, Nagoya, Aichi, Japan
| | - Hiroyuki Nakamura
- Department of Dental Regenerative Medicine, Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
- * E-mail:
| | - Misako Nakashima
- Department of Dental Regenerative Medicine, Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Sanou M, Jean A, Marjolet M, Pécaud D, Meas Y, Enguehard C, Moret L, Emane A. Conventional medical attitudes to using a traditional medicine vodou-based model of pain management: survey of French dentists and the proposal of a pain model to facilitate integration. JOURNAL OF CHIROPRACTIC HUMANITIES 2012; 19:24-35. [PMID: 23966886 PMCID: PMC3748328 DOI: 10.1016/j.echu.2012.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 09/15/2012] [Accepted: 10/01/2012] [Indexed: 06/02/2023]
Abstract
OBJECTIVES The purposes of this study were to develop a pain management model using traditional medicine (TM) vodou healing methods; to survey a sample of French dentists to rate components of conventional and proposed TM vodou-based pain management model; and to assess the possibility of conventional, allopathic providers to integrate TM or complementary and alternative medicine concepts. METHODS From a set of 30 fact sheets collected from TM African healers (vodou healers), main clinical concepts and terminology were extracted. Twenty vodou-based pain management concepts were collected from an interview with a TM vodou practitioner. From this information, a 7-step vodou-based pain management model was created. A sample of 40 French dentists from Nantes, France, whose practices focused on the clinical treatment of dental pain, was surveyed to assess the importance of both TM (vodou) and conventional biomedical components. RESULTS Seventy percent of the dentists sampled rated the rational components of the TM model as "very important" or "important" for pain treatment, whereas 2 other traditional concepts were considered to be "supernatural" or beyond understanding. CONCLUSION This study showed that traditional healers used conventional concepts and conventional practitioners could use traditional concepts. This suggests that conventional allopathic medical providers have the capacity to integrate biomedical concepts and other therapeutic and explanatory models. This information may be helpful to understand and improve risk management by anticipating and preventing potential reasons for failure in TM integration strategies and to enhance communication between patients, healers, and physicians to optimize TM or complementary and alternative medicine integration.
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Affiliation(s)
- Martin Sanou
- Doctor of Dentistry, ERT 2004-INSERM U791, Nantes, France
| | - Alain Jean
- Professor of Dentistry, PU-PH UFR d'Odontologie, Nantes, France
| | - Michel Marjolet
- Professor of Medicine, UFR Médecine, Laboratoire Pathologie Exotique, Nantes, France
| | - Dominique Pécaud
- Professor, Sociologist and Philosopher, IHT-Polytech'Nantes, France
| | - Yunsan Meas
- Doctor of Medicine, Algologist, Physical Medicine and Rehabilitation Specialist, CETD, CHU de Nantes, France
| | - Chantal Enguehard
- Natural Language Processing Specialist, LINA, UMR CNRS 6241, Nantes, France
| | - Leila Moret
- Doctor of Medicine, Biostatistics and Pharmacoepidemiology Specialist, PIMESP, CHU de Nantes, France
| | - Augustin Emane
- Professor of Social Rights, UFR Droits et sciences politiques, Nantes, France
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Ferreira Zandoná A, Santiago E, Eckert GJ, Katz BP, Pereira de Oliveira S, Capin OR, Mau M, Zero DT. The natural history of dental caries lesions: a 4-year observational study. J Dent Res 2012; 91:841-6. [PMID: 22821238 DOI: 10.1177/0022034512455030] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Dental caries is a ubiquitous disease affecting all age groups and segments of the population. It is known that not all caries lesions progress to cavitation, but little is known regarding the progression pattern of caries lesions. This study's purpose was to evaluate the natural history of dental caries using a standardized, visually based system, the International Caries Detection and Assessment System (ICDAS). The study population consisted of 565 consenting children, who were enrolled and examined at baseline and at regular intervals over 48 months with ICDAS and yearly bitewing radiographs. Of these, 338 children completed all examinations. Not all lesions cavitated at the same rate, differing by surface type and baseline ICDAS severity score and activity status. With increasing severity, the percentage of lesions progressing to cavitation increased: 19%, 32%, 68%, and 66% for ICDAS scores 1, 2, 3, and 4, respectively. Lesions on occlusal surfaces were more likely to cavitate, followed by buccal pits, lingual grooves, proximal surfaces, and buccal and lingual surfaces. Cavitation was more likely on molars, followed by pre-molars and anterior teeth. Predictors of cavitation included age, gender, surfaces and tooth types, and ICDAS severity/activity at baseline. In conclusion, characterization of lesion severity with ICDAS can be a strong predictor of lesion progression to cavitation.
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Affiliation(s)
- A Ferreira Zandoná
- Department of Preventive and Community Dentistry, Indiana University School of Dentistry, 415 Lansing Street, OH-144, Indianapolis, IN 46202, USA.
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Diniz MB, Lima LM, Eckert G, Zandona AGF, Cordeiro RCL, Pinto LS. In Vitro Evaluation of ICDAS and Radiographic Examination of Occlusal Surfaces and Their Association With Treatment Decisions. Oper Dent 2011; 36:133-42. [DOI: 10.2341/10-006-l] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clinical RelevanceIt has been suggested that occlusal caries detection has become more difficult due to the widespread use of fluoride, which slows down lesion progression and delays cavitation. The ability to detect caries lesions at an early stage has a significant impact on treatment decisions, improving the possibility for a successful preventive intervention. In this investigation, the authors found that the International Caries Detection and Assessment System associated with radiographic examination has the potential to support treatment decisions for occlusal surfaces.
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