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Oh SL, Tordik PA. Treatment of Retrograde Peri-Implantitis Originating From Apical Periodontitis of an Adjacent Tooth: A Clinical Case Letter. J ORAL IMPLANTOL 2024; 50:402-407. [PMID: 38822658 DOI: 10.1563/aaid-joi-d-24-00020] [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] [Indexed: 06/03/2024]
Abstract
This report aims to present a treatment of retrograde peri-implantitis originating from apical periodontitis of an adjacent tooth in an 84-year-old male. Apical periodontitis of the maxillary left central incisor (#9) extended to the apex of the maxillary left lateral incisor implant (#10), which had been functioning for 16 years. Root canal treatment for #9 was performed, followed by root end surgery to treat the apical periodontitis, which showed a periapical radiolucency measured 1 cm in its greatest dimension. After the root end filling was placed, neither bone substitute materials nor barrier membranes were used to fill and cover the bony defect area. A 2-year postoperative radiograph confirmed the osseous healing around the apices of #9 and #10.
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Affiliation(s)
- Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Patricia A Tordik
- University of Maryland School of Dentistry, Baltimore, Maryland, USA
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Ginjeira A, Neto F, Behdad S, Farinha I, Gonçalves N, Martins JNR, Pires M, Rito Pereira M, Vasconcelos I, Duarte I. Influence of root shape on canal complexity at the mandibular molar apical surgical resection level: A micro-CT study. Arch Oral Biol 2024; 164:105983. [PMID: 38718467 DOI: 10.1016/j.archoralbio.2024.105983] [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: 10/03/2023] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVES This study aimed to investigate the relationship between the aspect ratios of mandibular molar roots at the apical 3-mm level and their root canal complexity. DESIGN This study used micro-CT imaging to analyze 163 two-rooted mandibular molars. The aspect ratios of the roots at the apical 3-mm level were categorized as "< 2.75" or "≥ 2.75" (mesial) and "< 1.75" or "≥ 1.75" (distal). A two-dimensional (2D) analysis focused on four apical axial cross-section levels to determine the presence of main and accessory canals and isthmus. Additionally, a three-dimensional (3D) assessment of the apical 4-mm of both roots examined main and accessory canals, apical foramina, apical deltas, and middle mesial canals. RESULTS Mesial roots with aspect ratios ≥ 2.75 showed a higher number of main canals at all levels compared to those with aspect ratios < 2.75 at the 3-mm level. Additionally, the ≥ 2.75 group exhibited more accessory canals and a higher average number of accessory canals. The 3D assessment confirmed significantly more accessory canals and apical foramina in the ≥ 2.75 group. The prevalence of roots with apical deltas was nearly double in the ≥ 2.75 group, and middle mesial canals were exclusively found in this group. In the distal root, the ≥ 1.75 group showed a significantly higher number of main canals at all axial levels. No significant differences were observed between groups in terms of accessory canals, apical foramina, or deltas. CONCLUSIONS A higher root aspect ratio is related to higher anatomical complexity.
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Affiliation(s)
- António Ginjeira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal; Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal
| | - Filipa Neto
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal
| | - Shirin Behdad
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal
| | - Inês Farinha
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal
| | - Nuno Gonçalves
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal
| | - Jorge N R Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal; Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal; Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal; LIBPhys-FCT UID/FIS/04559/2013 (https://doi.org/10.54499/UIDB/04559/2020), Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal
| | - Mariana Pires
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal.
| | - Mário Rito Pereira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal
| | - Isabel Vasconcelos
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal; Center for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Rua de Portugal, 2430-028 Marinha Grande, Portugal
| | - Isabel Duarte
- TEMA - Centre for Mechanical Technology and Automation, Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal; LASI - Intelligent Systems Associate Laboratory, Guimarães, Portugal
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La Rosa GRM, Peditto M, Venticinque A, Marcianò A, Bianchi A, Pedullà E. Advancements in guided surgical endodontics: A scoping review of case report and case series and research implications. AUST ENDOD J 2024; 50:397-408. [PMID: 38887152 DOI: 10.1111/aej.12865] [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: 02/09/2024] [Revised: 05/15/2024] [Accepted: 06/08/2024] [Indexed: 06/20/2024]
Abstract
This scoping review examined current case series and reports on guided surgical endodontic applications in order to provide a critical platform for future research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews guidelines were followed. A search on PubMed and Scopus yielded 611 articles, with 17 case reports and 1 series meeting inclusion criteria. Overall, guided surgery addressed anatomical complexities, with 15 articles employing static protocols and 3 dynamic. Results showed minimal iatrogenic errors and reduced chair time, with no postoperative issues reported. Within the cases described, guided endodontic surgery exhibited satisfactory results in management of anatomical complex cases. Cost-effectiveness, the need for adequate follow-up, procedure's reproducibility and accuracy, and objective measurement of the reduction in operative times and iatrogenic errors are some of the limitations in the current reports that need to be considered for planning of future experimental and cohort studies.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Matteo Peditto
- Postgraduate School of Oral Surgery, Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Andrea Venticinque
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Antonia Marcianò
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alberto Bianchi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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Ashi T, Kharouf N, Etienne O, Cournault B, Klienkoff P, Gribova V, Haikel Y. Effectiveness of Sectioning Method and Filling Materials on Roughness and Cell Attachments in Root Resection Procedure. Eur J Dent 2024. [PMID: 39029907 DOI: 10.1055/s-0044-1788319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2024] Open
Abstract
OBJECTIVES The purpose of the present study was to investigate the created roughness and cell attachment of intact teeth (C), obturated teeth with bioceramic (BR), or epoxy resin (AH) after root resection using piezoelectric ultrasonic and carbide bur. MATERIALS AND METHODS Three groups of first mandibular premolars were used in the present study: control group (without any preparation or obturation) (C); second group was obturated with an epoxy resin sealer (AH, AH Plus Jet); and finally, the third one was obturated with a bioceramic sealer (BR, BioRoot RCS). All teeth were incubated for 4 months at 37°C. After that, the samples were sectioned using tungsten carbide bur or piezoelectric ultrasonic. Roughness and then cell attachment of periodontal ligament cells on the sectioned surfaces were investigated by profilometer and confocal microscope, respectively. STATISTICAL ANALYSIS Data were statistically analyzed using one-way analysis of variance. RESULTS After root resection, no significant difference was found between the roughness among the three groups sectioned using the piezoelectric technique (p > 0.05). In contrast, concerning the sectioned samples by burs, C demonstrated a rougher surface compared with BR (p < 0.05). There was a significant higher cell attachment in BR compared with AH in the piezoelectric groups (p = 0.047), while no statistically significant difference was found between the groups sectioned with bur (p > 0.05). CONCLUSION Dentists are now focused on the use of calcium silicate-based sealers due to their bioactivity. The present study advises dentists to use bioceramic sealer which could improve the dentin characteristics which ameliorate the cell attachment.
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Affiliation(s)
- Tarek Ashi
- Department of Biomaterials and Bioengineering, University of Strasbourg, INSERM UMR_S 1121, Strasbourg, France
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, University of Strasbourg, INSERM UMR_S 1121, Strasbourg, France
- Department of Endodontics and Conservative Dentistry, Faculty of Dental Medicine, University of Strasbourg, Strasbourg, France
| | - Olivier Etienne
- Department of Biomaterials and Bioengineering, University of Strasbourg, INSERM UMR_S 1121, Strasbourg, France
- Department of Prosthodontics, Faculty of Dental Medicine, University of Strasbourg, Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, Strasbourg, France
| | - Bérangère Cournault
- Department of Biomaterials and Bioengineering, University of Strasbourg, INSERM UMR_S 1121, Strasbourg, France
- Department of Prosthodontics, Faculty of Dental Medicine, University of Strasbourg, Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, Strasbourg, France
| | - Pierre Klienkoff
- Department of Biomaterials and Bioengineering, University of Strasbourg, INSERM UMR_S 1121, Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, Strasbourg, France
| | - Varvara Gribova
- Department of Biomaterials and Bioengineering, University of Strasbourg, INSERM UMR_S 1121, Strasbourg, France
| | - Youssef Haikel
- Department of Biomaterials and Bioengineering, University of Strasbourg, INSERM UMR_S 1121, Strasbourg, France
- Department of Endodontics and Conservative Dentistry, Faculty of Dental Medicine, University of Strasbourg, Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, Strasbourg, France
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Qin L, Chen C, Zhang R, Wang Z, Li F, Meng L. Evaluation of a Novel Drilling Approach for Dynamic Navigation-Aided Endodontic Microsurgery: A Surgical Simulation Comparison Study. J Endod 2024; 50:989-996. [PMID: 38556075 DOI: 10.1016/j.joen.2024.03.010] [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: 01/04/2024] [Revised: 03/20/2024] [Accepted: 03/20/2024] [Indexed: 04/02/2024]
Abstract
INTRODUCTION This study investigated the feasibility of a novel drilling approach that integrates a pilot trephine into dynamic navigation (DN) for guided osteotomy and root-end resection (RER) with unimanual operation in endodontic microsurgery. METHODS Two operators with varying levels of DN experience performed guided osteotomy and RER using 2 unimanual drilling methods with DN-aided operation on 3-dimensional printed jaw models. Method 1 (M1) involved drilling with a conventional trephine. Method 2 (M2) involved drilling with a pilot trephine, followed by drilling with a conventional trephine. Accuracy, time, and safety of M1 and M2 were compared. Accuracy measurements included platform deviation (PD), end deviation (ED), angular deviation (AD), resection length deviation (RLD), and resection bevel angle (RBA). Additional parameters included osteotomy and RER time (OT) and bur slippage number (BSN). Statistical analyses were conducted using a 2-sample t-test or Mann-Whitney U test, with the significance level set at .05. RESULTS The PD, AD, RBA, and BSN in the M2 group were significantly less than in the M1 group (P < .05). For M1, the novice operator (NO) exhibited significantly higher values of PD, ED, OT, and BSN than the experienced operator (EO) (P < .05). For M2, the NO exhibited significantly higher value of ED only (P < .05), and drilling depth >7 mm was significantly associated with a longer OT (P < .05). CONCLUSION In this surgical simulation comparison study, the incorporation of a pilot drill improved the accuracy and safety of DN-aided endodontic microsurgery.
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Affiliation(s)
- Li Qin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chen Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Rui Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zan Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fangzhe Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Liuyan Meng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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Yoo YJ, Cho EB, Perinpanayagam H, Gu Y, Zhu Q, Noblett WC, Kum KY. Endodontic Microsurgery Outcomes over 10 Years and Associated Prognostic Factors: A Retrospective Cohort Study. J Endod 2024; 50:934-943. [PMID: 38642732 DOI: 10.1016/j.joen.2024.04.009] [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: 12/08/2023] [Revised: 03/13/2024] [Accepted: 04/13/2024] [Indexed: 04/22/2024]
Abstract
INTRODUCTION This retrospective cohort study aimed to evaluate long-term healing outcomes (10-17.5 years) after contemporary endodontic microsurgery (EMS) and identify the associated prognostic factors. METHODS Clinical and radiographic data of an EMS cohort (2006-2013) from the electronic database of the dental hospital were reviewed retrospectively by 2 independent examiners to determine their survival and healing outcomes, and potential prognostic factors were analyzed by Cox proportional hazards regression and logistic regression (α = 0.05). RESULTS Through strict inclusion and exclusion criteria and 721 EMS-treated teeth in the cohort, 309 (42.9%) were included (male = 35.0%; female = 65.0%; age = 45.83 ± 15.53 years) with a mean final follow-up of 152.26 ± 26.37 months (range, 120-211 months; median = 148 months). Clinical and radiographic assessments found an 80.5% 10-year survival rate with 63.4% of success. Collectively, tooth type, tooth mobility, preoperative lesion size, clinical crown-to-root ratio, and crown restorations at follow-up were significantly associated with long-term success and survival over 10 years. CONCLUSIONS The preoperative status and condition of the tooth including its alveolar bone support and adequate full-crown restorations may be relevant prognostic determinants of success and survival after EMS over time.
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Affiliation(s)
- Yeon-Jee Yoo
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Eun-Bee Cho
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Hiran Perinpanayagam
- Division of Endodontics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
| | - Yu Gu
- Department of Endodontics, School and Hospital of Stomatology, Shandong University, Jinan, Shandong Province, People's Republic of China
| | - Qiang Zhu
- Division of Endodontology, University of Connecticut School of Dental Medicine, Farmington, Connecticut
| | - W Craig Noblett
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
| | - Kee-Yeon Kum
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea.
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Kim KH, Lévesque C, Malkhassian G, Basrani B. Efficacy of the GentleWave System in the removal of biofilm from the mesial roots of mandibular molars before and after minimal instrumentation: An ex vivo study. Int Endod J 2024; 57:922-932. [PMID: 38374488 DOI: 10.1111/iej.14044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024]
Abstract
AIM To compare the efficacy of Enterococcus faecalis biofilm removal using the GentleWave System (GWS) (Sonendo Inc, CA) on non-instrumented versus minimally instrumented root canal systems. METHODOLOGY Thirty-four mandibular molars were autoclaved and allocated to four groups: Negative control (n = 5); positive control (n = 5); Group 1: non-instrumentation + GWS (NI + GWS) (n = 12); and Group 2: minimal instrumentation + GWS (MI + GWS) (n = 12). Of 34 samples, 24 samples with Vertucci type 2 configuration within the mesial root of each sample were allocated to Groups 1 and 2 and then matched based on the working length and root canal configuration. After inoculation of samples with E. faecalis for 3 weeks, the GWS was used on Group 1 without any instrumentation and Group 2 after instrumentation of mesial canals until size 20/06v. CFU and SEM analysis were used. RESULTS Log10 (CFU/mL) from the positive control, and Group 1 and 2 were 7.41 ± 0.53, 3.41 ± 1.54, and 3.21 ± 1.54, respectively. Both groups showed a statistically significant difference in the reduction of viable E. faecalis cells compared to the positive control (Group 1 [p = .0001] and Group 2 [p < .0001]), whilst showing no significant difference between the two tested groups (p < .05). CONCLUSION The use of GWS on the non-instrumented root canal system could be an effective disinfection protocol in removing the biofilm without dentin debris formation.
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Affiliation(s)
- Kwang Ho Kim
- Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Céline Lévesque
- Microbiology, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Gevik Malkhassian
- Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Bettina Basrani
- Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
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Aslan T, Esim E, Üstün Y. Finite element evaluation of dentin stress changes following different endodontic surgical approaches. Odontology 2024; 112:798-810. [PMID: 38184512 PMCID: PMC11269338 DOI: 10.1007/s10266-023-00882-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/04/2023] [Indexed: 01/08/2024]
Abstract
The aim was to compare the effect of different endodontic surgical treatments on the stress distributions in dentin of a simulated first mandibular molar tooth using the finite element analysis method. Three surgical endodontic procedures (apical resection, root amputation, and hemisection) were simulated in a first mandibular molar. Biodentine or mineral-trioxide-aggregate was used to repair the surgery site in apical resection and root amputation models; the remaining root canal spaces were filled with gutta-percha. Access cavities were restored using resin composite. In hemisection model, root canal was filled with gutta-percha, and coronal restoration was finished with a monolithic zirconia crown. A sound tooth model was created as a control model. An oblique force of 300 N angled at 45° to the occlusal plane was simulated. Maximum von Mises stresses were evaluated in dentin near the surgery regions and the entire tooth. Apical resection/Biodentine and apical resection/mineral-trioxide-aggregate models generated maximum von Mises stresses of 39.001 MPa and 39.106 MPa, respectively. The recorded maximum von Mises stresses in root amputation models were 66.491 MPa for root amputation/Biodentine and 73.063 MPa for root amputation/mineral-trioxide-aggregate models. The highest maximum von Mises stress value among all models was observed in the hemisection model, measuring 138.87 MPa. Hemisection induced the highest von Mises stresses in dentin, followed by root amputation and apical resection. In apical resection, Biodentine and mineral-trioxide-aggregate did not show a significant difference in stress distribution. Biodentine in root amputation may lead to lower stresses compared to mineral-trioxide-aggregate.
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Affiliation(s)
- Tuğrul Aslan
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Turhan Baytop Street, No. 1, Yenidoğan District, Talas, Kayseri, 38280, Turkey.
| | - Emir Esim
- Department of Mechatronics Engineering, Faculty of Engineering, Erciyes University, Kayseri, Turkey
| | - Yakup Üstün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Rodríguez P, Adler I, Cabirta ML, Miklaszewski E, Alfie N, Muiño A, Chulián S, Fresno C, Denninghoff V. Prognosis recovery score of apical surgery Guided Bone Regeneration using cone beam computed tomography and digital bioinformatics. Heliyon 2024; 10:e33033. [PMID: 39022023 PMCID: PMC11252708 DOI: 10.1016/j.heliyon.2024.e33033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 07/20/2024] Open
Abstract
Objective Guided Bone Regeneration (GBR) is a dental surgical procedure that uses barrier membranes to prevent soft tissue invasion and conduct new bone growth. This study aimed to define a Prognosis Recovery score (PR score) to objectively classify post-surgery responders from non-responder patients who underwent GBR using Cone Beam Computed Tomography (CBCT). Methods This prospective-observational-longitudinal-cohort study recruited 250 individuals who were assigned to: Conventional-Apical-Surgery (CAS, n = 39), Apical-Surgery using human fascia lata Membrane placement (ASM, n = 42), and Apical-Surgery using human fascia lata Membrane placement and lyophilized allograft Bone powder (ASMB, n = 39); and Apical-Surgery using collagen membrane Porcine origin and Bovine Bone-matrix (ASPBB, n = 130), an independent external validation cohort. Surgery was performed, and evolution was monitored by CBCTs at 0, 6-, 12-, 18-, and 24 months post-surgery. Results Normalized lesion volumes were calculated, and non-linear time evolution morphology curves were characterized. The three-time evolution bone growth patterns were: a linear tendency (PR0), "S'' shaped log-logistic (PR1), and "C" cellular growth (PR2). The treatment success rates were PR2-46 %, PR2-88 %, and PR2-95 %/PR1-5% for CAS, ASM, and ASMB groups. The xenograft ASPBB counterpart achieved PR2-92 % and PR1-8%. The score PR had a sensitivity, specificity, and accuracy of 100 %. Conclusions Patients' treatment success can be quantitatively, objectively, and precisely predicted with the Prognosis Recovery score (using only two CBCTs), according to their biological response to allograft or xenograft materials (time-evolution bone growth curves), reducing cost and radiation exposure. Clinical significance Through digital imaging and bioinformatic analysis of bone regeneration observed in CBCTs, we defined a Prognosis Recovery (PR) score using only two CBCT volume assessments (0 and 6 months). The PR score allowed us to define three time-evolution curves depending on the biomaterials used and to classify patients in a quantitative, objective, and accurate way.
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Affiliation(s)
- Pablo Rodríguez
- Faculty of Dentistry, University of Buenos Aires (UBA), Argentina
| | - Isabel Adler
- Faculty of Dentistry, University of Buenos Aires (UBA), Argentina
| | | | | | - Nicolás Alfie
- Faculty of Dentistry, University of Buenos Aires (UBA), Argentina
| | - Andrea Muiño
- Faculty of Dentistry, University of Buenos Aires (UBA), Argentina
| | - Sara Chulián
- Andalusian Public Foundation Progress and Health - Andalusian Regional Government (FPS), Sevilla, Spain
| | - Cristóbal Fresno
- Health Sciences Research Center (CICSA), Anáhuac University Mexico, Mexico
| | - Valeria Denninghoff
- Molecular-Clinical Lab–University of Buenos Aires (UBA) - National Council for Scientific and Technical Research (CONICET), Argentina
- Liquid Biopsy and Cancer Interception Group, Centre for Genomics and Oncological Research–Pfizer–University of Granada - Andalusian Regional Government (GENyO), Granada, Spain
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Knapp J, Kirkpatrick T, Ontiveros JC, Jaramillo DE, Kim HC, Jeong JW. Efficacy of root-end filling techniques using premixed putty type bioceramic cements: an ex vivo study. Clin Oral Investig 2024; 28:365. [PMID: 38849637 DOI: 10.1007/s00784-024-05759-3] [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: 03/06/2024] [Accepted: 05/30/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVES Currently, premixed putty-type bioceramic cements (PPBCs) have become popular materials for root-end fillings. This study investigated three root-end filling techniques using PPBCs and calcium silicate-based sealers including EDTA pretreatment. MATERIALS AND METHODS Ninety root segments were prepared and standardized with an artificial fin and lateral canal, and assigned to three groups (n = 30). Root-end fillings were placed using BC-RRM Putty alone (Group PA), injection of BC sealer followed by BC-RRM Putty (Lid Technique: Group LT) or BC-RRM Putty with BC sealer coating (Deep putty packing technique: Group DP). Half of each group was pretreated with 17% EDTA. The radiographic images of the specimens were assessed by five graders and push-out bond strength tests were conducted. The data were analyzed with a general linear model including two-way ANOVA and chi-square test at a significance level of 5%. RESULTS DP approach demonstrated significantly higher bond strength than LT (P < 0.05). However, there was no statistically significant difference in bond strength between PA and either DP or LT. EDTA pretreatment had no significant effect on push-out bond strength. Radiographically, for the main canal, PA and DP scored significantly higher than LT. In the fin, PA scored significantly higher than others (P < 0.05). CONCLUSION Our study highlights variations in root-end filling techniques. Injecting a bulk of bioceramic sealer before the placement of PPBCs may reduce bond strength and radiopacity. The application of PPBCs alone or in the deep putty technique demonstrates potential for favorable outcomes. EDTA pretreatment did not enhance bond-strength. CLINICAL RELEVANCE Careful selection and application of bioceramic materials and techniques in root-end fillings may influence the outcome of endodontic root-end surgery. When PPBCs and calcium silicate-based sealers are used together for root-end fillings, sealer followed by deep putty application may offer improved bond strength and radiographic fill compared to the lid technique.
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Affiliation(s)
- Jason Knapp
- Department of Endodontics, School of Dentistry, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6400, Houston, TX, USA
| | - Timothy Kirkpatrick
- Department of Endodontics, School of Dentistry, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6400, Houston, TX, USA
| | - Joe C Ontiveros
- Department of Restorative Dentistry and Prosthodontics, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - David E Jaramillo
- Department of Endodontics, School of Dentistry, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6400, Houston, TX, USA
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Pusan National University, Geumo-ro 20, Mulgeum, Yangsan, Gyeongsangnam-do, 50612, South Korea.
| | - Ji Wook Jeong
- Department of Endodontics, School of Dentistry, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6400, Houston, TX, USA.
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Chan AS, Chan AJ, Chan A, Armati P. Successful Intentional Replantation of a Severely Compromised Tooth Using 3 Types of Phototherapy: A Case Report. Photobiomodul Photomed Laser Surg 2024; 42:488-492. [PMID: 38700573 DOI: 10.1089/photob.2023.0197] [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] [Indexed: 07/19/2024] Open
Abstract
Background: Intentional replantation (IR) is an emerging and cost-effective last-resort treatment for persistent apical periodontitis. Adjunctive phototherapy for IR aims to improve the management of challenging cases by enhancing disinfection, stimulating healing and promoting regeneration. Objective: We report a novel phototherapy-assisted IR protocol conducted on a compromised lateral incisor with an extensive periapical infection (Ø > 10 mm) in a 68-year-old diabetic male. Methods: The IR protocol involved pre- and postoperative photobiomodulation (660 nm, 0.2 J/cm2, 60 sec/site), antimicrobial photodynamic therapy of the root surface (660 nm, 0.6 J/cm2, 30 sec, methylene blue photosensitizer), and Er:YAG root and socket debridement (2940 nm, 21 J/cm2, 30 sec). The total time from extraction to replantation was 14 min 35 sec. Results: The tooth at 3.5-year follow-up remained clinically functional with radiographic resolution of the infection indicating a successful reimplantation. Conclusions: This case report demonstrated that an adjunctive phototherapy IR protocol can effectively treat a compromised tooth with extensive periapical infection.
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Affiliation(s)
- Alex Simon Chan
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Andrew Jonathan Chan
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Ambrose Chan
- Brain and Mind Centre, Neuroinflammation Group, The University of Sydney, Sydney, Australia
| | - Patricia Armati
- Brain and Mind Centre, Neuroinflammation Group, The University of Sydney, Sydney, Australia
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12
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Manik K, Ikhar A, Patel A, Chandak M, Bhopatkar J, Rathod P, Bhojwani PR. Anatomical Variations in Mandibular Molars: Focus on Midmesial Canals. Cureus 2024; 16:e61711. [PMID: 38975529 PMCID: PMC11226225 DOI: 10.7759/cureus.61711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 06/05/2024] [Indexed: 07/09/2024] Open
Abstract
Endodontic therapy focuses on the root canal system to treat infected or damaged pulp tissue within the tooth, ultimately preserving the tooth and restoring its function. The root canal space should be cleaned with the use of proper instruments and chemical disinfectants to eradicate infected pulpal tissue and its remnants. The failure of endodontic therapy is attributed to a lack of understanding of the differences in anatomy among teeth, as evidenced by research. Canals are identified, and endodontic treatment is facilitated by the use of dental operating microscopes. Therefore, to achieve a favorable endodontic result, it is imperative to use all available methods to identify additional aberrant root canals. Failure to detect and adequately treat the midmesial canal (MMC) can lead to persistent infection, treatment failure, and the need for retreatment. This case underscores the importance of meticulous assessment and advanced techniques in treating complex canal configurations, ultimately leading to favorable outcomes in endodontic therapy. The MMC, a challenging anatomical feature, was located through careful clinical and radiographic examination. Advanced techniques, including ultrasonic activation and meticulous instrumentation, were employed to navigate and clean the canal effectively. Sodium hypochlorite irrigation and passive ultrasonic activation were utilized for thorough disinfection. The MMC was sealed with biocompatible materials, ensuring comprehensive obturation of the root canal system.
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Affiliation(s)
- Khyati Manik
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anuja Ikhar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aditya Patel
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Manoj Chandak
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Jay Bhopatkar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pratik Rathod
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Priyanka R Bhojwani
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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13
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Mansour MM, Moussa SM, Meheissen MA, Aboelseoud MR. Bacterial sealing ability of calcium silicate-based sealer for endodontic surgery: an in-vitro study. BMC Oral Health 2024; 24:584. [PMID: 38773504 PMCID: PMC11107006 DOI: 10.1186/s12903-024-04309-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/29/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Apical surgery with standard retrograde maneuvers may be challenging in certain cases. Simplifying apical surgery to reduce operating time and streamline retrograde manipulation is an emerging need in clinical endodontics. AIM OF THE STUDY The aim of the study was to compare the bacterial sealing ability of a calcium silicate-based sealer with the single cone technique combined with root end resection only, and calcium silicate-based sealer as a retrograde filling versus MTA retrofilling, and to analyze bacterial viability using confocal laser scanning microscope (CLSM). MATERIALS AND METHODS In this in vitro experimental study, 50 extracted human maxillary incisor teeth were instrumented and randomly divided into five groups: three experimental groups, a positive control group, and a negative control group (n = 10/group). In the experimental groups, the roots were obturated using the single cone technique (SCT) and a calcium silicate-based sealer. In group 1, the roots were resected 3 mm from the apex with no further retrograde preparation or filling. In groups 2 and 3, the roots were resected, retroprepared, and retrofilled with either a calcium silicate-based sealer or MTA, respectively. Group 4 (positive control) was filled with a single gutta-percha cone without any sealer. In group 5 (negative control), the canals were left empty, and the roots were sealed with wax and nail varnish. A bacterial leakage model using Enterococcus faecalis was employed to assess the sealing ability over a 30-day period, checking for turbidity and analyzing colony forming units (CFUs) per milliliter. Five specimens from each group were examined using CLSM for bacterial viability. Data for the bacterial sealing ability were statistically analyzed using chi-squared and Kruskal-Wallis tests. RESULTS The three experimental groups did not show significant differences in terms of bacterial leakage, or bacterial counts (CFUs) (P > 0.05). However, significant differences were observed when comparing the experimental groups to the positive control group. Notably, the calcium silicate-based sealer, when used as a retrofilling, yielded the best sealing ability. CLSM imaging revealed viable bacterial penetration in all the positive control group specimens while for the experimental groups, dead bacteria was the prominent feature seen. CONCLUSION Within the limitations of this study, it could be concluded that the bacterial sealing ability of calcium silicate-based sealer with the single cone technique combined with root end resection only and calcium silicate-based sealer as a retrograde filling were comparable with MTA retrofilling during endodontic surgical procedures.
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Affiliation(s)
- Mai M Mansour
- Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, 21527, Egypt.
| | - Sybel M Moussa
- Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, 21527, Egypt
| | - Marwa A Meheissen
- DMedical Microbiology & Immunology, Faculty of Medicine, Alexandria University, Alexandria, 21527, Egypt
| | - Mahmoud R Aboelseoud
- Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, 21527, Egypt
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14
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Liu SM, Peng L, Zhao YJ, Han B, Wang XY, Wang ZH. Accuracy and efficiency of dynamic navigated root-end resection in endodontic surgery: a pilot in vitro study. BMC Oral Health 2024; 24:582. [PMID: 38764019 PMCID: PMC11103819 DOI: 10.1186/s12903-024-04306-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 04/29/2024] [Indexed: 05/21/2024] Open
Abstract
BACKGROUND The operation accuracy and efficiency of dynamic navigated endodontic surgery were evaluated through in vitro experiments. This study provides a reference for future clinical application of dynamic navigation systems in endodontic surgery. MATERIALS AND METHODS 3D-printed maxillary anterior teeth were used in the preparation of models for endodontic surgery. Endodontic surgery was performed with and without dynamic navigation by an operator who was proficient in dynamic navigation technology but had no experience in endodontic surgery. Optical scanning data were applied to evaluate the length and angle deviations of root-end resection. And the operation time was recorded. T tests were used to analyze the effect of dynamic navigation technology on the accuracy and duration of endodontic surgery. RESULTS With dynamic navigation, the root-end resection length deviation was 0.46 ± 0.06 mm, the angle deviation was 2.45 ± 0.96°, and the operation time was 187 ± 22.97 s. Without dynamic navigation, the root-end resection length deviation was 1.20 ± 0.92 mm, the angle deviation was 16.20 ± 9.59°, and the operation time was 247 ± 61.47 s. Less deviation was achieved and less operation time was spent with than without dynamic navigation (P < 0.01). CONCLUSION The application of a dynamic navigation system in endodontic surgery can improve the accuracy and efficiency significantly for operators without surgical experience and reduce the operation time.
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Affiliation(s)
- Si-Min Liu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
- Fourth Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Li Peng
- Department of General Dentistry II, National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Yi-Jiao Zhao
- Center for Digital Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Bing Han
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Xiao-Yan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Zu-Hua Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China.
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15
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Wu M, Xu L, Xing F, Xiao R, Wu W. Novel self-setting cements based on tricalcium silicate/(β-tricalcium phosphate/monocalcium phosphate anhydrous)/hydroxypropyl methylcellulose: From hydration mechanism to biological evaluations. Int J Biol Macromol 2024; 267:131580. [PMID: 38688788 DOI: 10.1016/j.ijbiomac.2024.131580] [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: 01/10/2024] [Revised: 02/29/2024] [Accepted: 04/11/2024] [Indexed: 05/02/2024]
Abstract
Despite the clinical success of tricalcium silicate (TCS)-based materials in endodontics, the inferior handling characteristic, poor anti-washout property and slow setting kinetics hindered their wider applications. To solve these problems, an injectable fast-setting TCS/β-tricalcium phosphate/monocalcium phosphate anhydrous (β-TCP/MCPA) cement was developed for the first time by incorporation of hydroxypropyl methylcellulose (HPMC) and β-TCP/MCPA. The physical-chemical characterization (setting time, anti-washout property, injectability, compressive strength, apatite mineralization and sealing property) of TCS/(β-TCP/MCPA) were conducted. Its hydration mechanism was also investigated. Furthermore, the cytocompatibility and osteogenic/odontogenic differentiation of stem cells isolated from human exfoliated deciduous teeth (SHED) treated with TCS/β-TCP/MCPA were studied. The results showed that HPMC could provide TCS with good anti-washout ability and injectability but slow hydration process. However, β-TCP/MCPA effectively enhanced anti-washout characteristics and reduced setting time due to faster hydration kinetics. TCS/(β-TCP/MCPA) obtained around 90 % of injection rate and high compressive strength whereas excessive additions of β-TCP/MCPA compromised its injectability and compressive strength. TCS/(β-TCP/MCPA) can induce apatite deposition and form a tight marginal sealing at the dentin-cement interface. Additionally, TCS/(β-TCP/MCPA) showed good biocompatibility and promoted osteo/odontogenic differentiation of SHED. In general, our results indicated that TCS/(β-TCP/MCPA) may be particularly promising as an injectable bioactive cements for endodontic treatment.
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Affiliation(s)
- Meng Wu
- School of Mechanical Engineering and Rail Transit, Changzhou University, Changzhou 213164, PR China.
| | - Laijun Xu
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, PR China; School of Stomatology, Changsha Medical University, Changsha, Hunan 410219, PR China
| | - Fei Xing
- Department of Orthopedic Surgery, Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, PR China
| | - Rongjun Xiao
- School of Stomatology, Changsha Medical University, Changsha, Hunan 410219, PR China
| | - Wangping Wu
- School of Mechanical Engineering and Rail Transit, Changzhou University, Changzhou 213164, PR China
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Kriplani S, Sedani S, Patel A, Chandak M, Shirbhate U, Mahapatra J, Thakare A. Surgical Management of Radicular Cyst With the Use of Advanced Platelet-Rich Fibrin and Bone Graft: A Case Report. Cureus 2024; 16:e60742. [PMID: 38903292 PMCID: PMC11188004 DOI: 10.7759/cureus.60742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 05/21/2024] [Indexed: 06/22/2024] Open
Abstract
In addition to helping with wound healing, periapical surgery is performed to remove periapical disease. Concentrates of platelets have been applied extensively in endodontics and other fields of regenerative medicine. A periapical inflammatory lesion was found in a 35-year-old male patient who complained of pain in the maxillary anterior region and displayed slight edema in the same area. The lesion was treated with periapical surgery utilizing advanced platelet-rich fibrin (A-PRF). Mesenchymal stem cell processes of proliferation and differentiation can be induced by several types of platelet concentrates. Growth factors are released at the application site by platelet-rich fibrin (PRF) for a minimum of seven days. The activity of osteoblasts is stimulated by growth factors and secreted cytokines. Furthermore, the release of growth factors promotes fibroblast migration, which quickens tissue regeneration. In addition to helping with wound healing, periapical surgery is performed to remove periapical disease. The synthesis of fibrin networks laden with platelets and growth factors is made possible by PRF, which is subsequently used to accelerate bone regeneration and, consequently, to improve bone formation. In this instance, the best possible bone regeneration and repair were accomplished. After 12 weeks, 24 weeks, and 36 weeks, the patient was brought back for follow-ups. He was found to be asymptomatic, and the radiograph showed considerable periapical healing with nearly enough bone production.
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Affiliation(s)
- Simran Kriplani
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shweta Sedani
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aditya Patel
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Manoj Chandak
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Unnati Shirbhate
- Department of Periodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Joyeeta Mahapatra
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Akash Thakare
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Isufi A, Hsu TY, Chogle S. Robot-Assisted and Haptic-Guided Endodontic Surgery: A Case Report. J Endod 2024; 50:533-539.e1. [PMID: 38280513 DOI: 10.1016/j.joen.2024.01.012] [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: 09/03/2023] [Revised: 12/10/2023] [Accepted: 01/15/2024] [Indexed: 01/29/2024]
Abstract
There has been a significant increase in robot-assisted dental procedures in the past decade, particularly in the area of robot-assisted implant placement. The objective of this case report was to assess the initial use of the Yomi Robot's assistance and haptic guidance during endodontic microsurgery. The robot was used during the osteotomy and root-end resection of the first and second upper left premolars. The report aims to inform clinicians of the initial implementation of this cutting-edge technology in endodontics and its potential to enhance endodontic microsurgery. The Yomi Robot was used in performing osteotomy and root-end resection during apical surgery in a patient presenting with symptomatic upper left first and second premolars. The treatment procedure was decided after clinical examination, chart data, and radiographic examinations, which showed periapical lesions on both premolars, taking into consideration the failed endodontic retreatment on the first premolar, the post and ceramic coronal restorations on both teeth, and the desire of the patient to save them. The Yomi Robot system provides auditory, visual, and physical guidance to clinicians during surgery while using a cone-beam computed tomography scan for precision planning with greater accuracy and minimized potential for human error. Further studies are needed to prepare a protocol for robotic-guided procedures in endodontics.
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Affiliation(s)
- Almira Isufi
- Department of Endodontics, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts.
| | - Tun-Yi Hsu
- Department of Endodontics, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts
| | - Sami Chogle
- Department of Endodontics, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts
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18
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Mon A, Kim ME, Kum KY, Kwon HB. 3D finite element analysis of stress distribution on the shape of resected root-end or with/without bone graft of a maxillary premolar during endodontic microsurgery. J Dent Sci 2024; 19:837-845. [PMID: 38618133 PMCID: PMC11010716 DOI: 10.1016/j.jds.2023.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/29/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose Apical root resection pattern affects the stress distribution behavior in the apical region of the resected tooth. The purpose of the study was to compare the biomechanical responses of resected teeth between endodontic microsurgery (horizontal resection) and targeted endodontic microsurgery (round resection). Materials and methods Five different models were developed. The basic model without resection (NR) was regarded as the control model, and the others involved: horizontal resection without bone grafting (HN), horizontal resection with bone grafting (HG), round resection without bone grafting (RN), and round resection with bone grafting (RG) models. A static load of 100 N was applied to the buccal and palatal cusps of all the teeth in a 30° oblique direction. The maximum von-Mises stress and tooth displacement values were analyzed and compared. Results Both the HN and RN models exhibited lower stress distribution values on bone compared with the NR (control) model. Regarding maximum stress distribution at the root apex, the stress value of the RN model was slightly higher compared to the HN model, whereas the RG model displayed a slightly lower stress value in comparison with the HG model. For maximum tooth displacement value, there were no significant differences between the HN and RN models, as well as the HG and RG models. Conclusion The round resection pattern had comparable stress distribution behaviors at the root apex and tooth displacement values with the horizontal resection pattern. Targeted endodontic microsurgery might provide better biomechanical response of the resected tooth after root-end resection.
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Affiliation(s)
- Aein Mon
- Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Mi-El Kim
- Dental Research Institute and Department of Oral Anatomy, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Kee-Yeon Kum
- Dental Research Institute and Department of Conservative Dentistry, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Ho-Beom Kwon
- Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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Damor PR, Sharma S, Kumar V, Chawla A, Logani A. Topography of root-end surface after freehand and three-dimensional-guided apicoectomy procedure: A scanning electron microscope study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:424-428. [PMID: 38779202 PMCID: PMC11108421 DOI: 10.4103/jcde.jcde_77_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/03/2024] [Accepted: 03/06/2024] [Indexed: 05/25/2024]
Abstract
Background Dentinal microcracks formed during apical resection may lead to increased susceptibility to root fracture and improper sealing of apical preparation that may negatively influence the outcome of endodontic microsurgery. Aims This study was performed to analyze the root-end surface for dentinal microcracks using a scanning electron microscope (SEM) after resection with high-speed bur and trephine drill. Materials and Methods Thirty extracted single-rooted maxillary premolar teeth were selected and randomly distributed into two groups (n = 15). Working length was established using a #15 K-type file. Canals were prepared with a rotary Ni-Ti system to size 30/0.06 using endomotor, irrigated with 3% sodium hypochlorite, dried with paper points, and obturated with gutta-percha cones using a single-cone technique. All samples were mounted on preformed molds and poured using a mixture of sawdust and gypsum. In Group A; tungsten carbide bur was used to perform a freehand apicoectomy. In Group B; a trephine drill was used with a three-dimensional guide to perform 3 mm of root resection. Apicoectomy was performed in both groups under a dental operating microscope. Resected root ends were inspected for microcracks using SEM. The Shapiro-Wilk and Mann-Whitney U-test were used for statistical analysis. Results Microcracks were observed in all samples in both study groups. Trephine drill produced more microcracks on the resected root surface compared to the use of high-speed tungsten carbide bur with a statistically significant difference (P < 0.05). Conclusions The trephine drill used during targeted endodontic microsurgery produced more microcracks on the resected root dentine surface compared to the high-speed tungsten carbide bur used during freehand apicoectomy.
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Affiliation(s)
- Pradipkumar R. Damor
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Sidhartha Sharma
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Kumar
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Amrita Chawla
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Logani
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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20
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Harinkhere C, Patni PM, Jain P, Raghuwanshi S, Pandey SH, Bilaiya S. Comparison of the sealing ability amongst orthograde apical plugs of mineral trioxide aggregate plus, mineral trioxide aggregate repair HP, and Biodentine after root resection: a bacterial leakage study. Odontology 2024; 112:364-371. [PMID: 37632561 DOI: 10.1007/s10266-023-00847-4] [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: 01/30/2022] [Accepted: 08/15/2023] [Indexed: 08/28/2023]
Abstract
This study aimed to analyse the effect of root-end resection on the sealing ability of orthograde apical plugs of three root-end filling materials (MTA Repair HP, Biodentine, MTA Plus) using the bacterial leakage method and compare it with the retrograde root-end filling technique. Eighty-four extracted mandibular premolar teeth with single root and single straight canals were selected and randomly divided into two main experimental groups (n = 36) depending on the apical plug placement technique and a control: Group I: orthograde technique, followed by root-end resection; Group II: retrograde root-end filling technique; one control Group III (n = 12): obturation with gutta-percha, followed by root-end resection. Experimental groups were further subdivided into three subgroups A, B, and C (n = 12) depending on the three different root-end filling materials used. An apical plug of 3 mm thickness was obtained in both the experimental groups. The apical sealing ability was evaluated with the dual-chamber bacterial leakage method. Statistical analysis was performed using the Kaplan-Meier survival analysis test. By the end of 30 days, the occurrence of turbidity indicating bacterial leakage was 75% in MTA Repair HP, 83.3% in Biodentine, and 91.7% in MTA Plus samples. This trend of turbidity was similar in both orthograde and retrograde technique. The control group showed turbidity in all the samples (100%). More MTA Repair HP samples (25%) survived the 30 days observation period with no bacterial leakage compared to Biodentine (16.7%) and MTA Plus (8.3%). The sealing ability of already set root-end filling materials placed through the orthograde technique did not deteriorate after root-end resection. Also among three root-end filling materials, MTA Repair HP presented the lowest bacterial microleakage followed by Biodentine and MTA Plus, respectively.
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Affiliation(s)
- Chhaya Harinkhere
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India.
| | - Pallav Mahesh Patni
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Pradeep Jain
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Swadhin Raghuwanshi
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Sanket Hans Pandey
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Sakshi Bilaiya
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
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Villa-Machado PA, Restrepo-Restrepo FA, Tobón-Arroyave SI. Dynamically guided transantral piezoelectric endodontic microsurgery: A case report with technical considerations. Int Endod J 2024; 57:490-500. [PMID: 38243920 DOI: 10.1111/iej.14026] [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: 01/20/2023] [Revised: 09/01/2023] [Accepted: 01/08/2024] [Indexed: 01/22/2024]
Abstract
AIM Endodontic microsurgery (EMS) of maxillary molars may represent a complex challenge to the clinician due to the location of the roots and the proximity of the maxillary sinus floor. This report aimed to describe the simultaneous use of a computer-assisted dynamic navigation (C-ADN) system and piezoelectric bony-window osteotomy for the transantral microsurgical approach of a maxillary left first molar with adequate root canal filling and symptomatic apical periodontitis. SUMMARY This case report highlights the importance of C-ADN to carry out a minimally invasive buccal surgical access to palatal roots affected by apical periodontitis and provides a practical example to help clinicians make treatment decisions based on the available evidence. Clinical and tomographic evaluations were performed before the surgical procedure and at 24-month follow-up. This case was treated using a C-ADN system fitted to a piezotome for the buccal approach of the buccal roots, maxillary sinus membrane lifting, and for transantral location, root-end resection, cavity preparation, and filling of the palatal root. The navigation system allowed to achieve an accurate apical canal terminus location and root-end filling of the three roots with a minimally invasive piezoelectric crypt approach. At the 24-month follow-up examination, the patient remains asymptomatic, with normal periapical structures, and regeneration of maxillary sinus walls. It was concluded that the combination of dynamic navigation with piezoelectric bony-window osteotomy offers enhanced accuracy, tissue preservation, diminished risk of iatrogenic complications, and could maximize success and survival rates in transantral EMS.
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Kachari M, Adarsha MS, Meena N, Kumari A, Sudhanva ME, Vijayalakshmi L. Assessment of different irrigation techniques on the penetration depth of different sealers into dentinal tubules by confocal laser scanning microscope: An in vitro comparative study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:388-392. [PMID: 38779208 PMCID: PMC11108416 DOI: 10.4103/jcde.jcde_335_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/03/2024] [Accepted: 02/15/2024] [Indexed: 05/25/2024]
Abstract
Background The effective disinfection of the entire root canal system aids in the penetration of irrigants into the dentinal tubules further improving sealer penetration and achieving a three-dimensional seal in endodontically treated teeth. Various final irrigation techniques can be employed to achieve this goal. Therefore, this study intended to assess and compare the efficacy of three final irrigation techniques on the depth of penetration of two root canal sealers into dentinal tubules using confocal laser scanning microscope (CLSM). Methods Forty-eight single-rooted mandibular premolars were selected and decoronated to a length of 12 mm. All the samples were prepared using ProTaper Gold rotary files and divided into three groups: Group 1 - Conventional syringe irrigation (CSI), Group 2 - passive ultrasonic irrigation (PUI), and Group 3 - Pro-agitator tip system (PATS). Each group was divided into two subgroups: Subgroup A - AH Plus and Subgroup B - GuttaFlow Bioseal (GFB). Then, sealers were mixed with 0.1% rhodamine B dye and the samples were obturated. All the samples were sectioned at 2 mm and 5 mm from the apex and visualized under confocal laser scanning microscope (CLSM) (10×) for maximum mean penetration depth and percentage of sealer penetration. Statistical analysis was done using the independent t-test and one-way analysis of variance test, followed by Tukey's Post hoc analysis. Results PUI performed better in the apical third, whereas PUI and PATS showed comparable results in the middle third for both depth and percentage of sealer penetration. Among the two sealers, GFB performed better than AH Plus in both the apical and middle third. These values were statistically significant. (P < 0.05). Conclusion Final irrigation activation with PUI or PATS can significantly improve sealer penetration. The average depth of penetration of GFB both at the middle and apical third of the root was significantly superior to AH Plus.
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Affiliation(s)
- Megha Kachari
- Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College and Hospital, Bengaluru, Karnataka, India
| | - M. S. Adarsha
- Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College and Hospital, Bengaluru, Karnataka, India
| | - N. Meena
- Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College and Hospital, Bengaluru, Karnataka, India
| | - Anitha Kumari
- Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College and Hospital, Bengaluru, Karnataka, India
| | - ME Sudhanva
- Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College and Hospital, Bengaluru, Karnataka, India
| | - L. Vijayalakshmi
- Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College and Hospital, Bengaluru, Karnataka, India
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Dong X, Su Q, Li W, Yang J, Song D, Yang J, Xu X. The outcome of combined use of iRoot BP Plus and iRoot SP for root-end filling in endodontic microsurgery: a randomized controlled trial. Clin Oral Investig 2024; 28:188. [PMID: 38430316 DOI: 10.1007/s00784-024-05569-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/20/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVES Root-end filling is important for the clinical outcome of endodontic microsurgery. Our previous study showed that combined application of iRoot BP Plus Root Repair Material (BP-RRM) and iRoot SP Injectable Root Canal Sealer (SP-RCS) in root-end filling exhibited better apical sealing as compared to the application of BP-RRM alone. The aim of this randomized controlled clinical trial was to evaluate the effect of the combined use of BP-RRM and SP-RCS on the prognosis of teeth with refractory periapical diseases after endodontic microsurgery. MATERIALS AND METHODS 240 teeth with refractory periapical diseases scheduled for endodontic microsurgery were randomly divided into BP-RRM/SP-RCS group (n = 120) and BP-RRM group (n = 120). The patients were followed up at 3 months, 6 months, and 12 months after endodontic microsurgery. Pre- and post-operative clinical and radiographic examinations were performed to evaluate the treatment outcome. The 1-year success rate of endodontic microsurgery in BP-RRM/SP-RCS and BP-RRM groups was compared by Chi-square test. Factors that might impact the prognosis were further analyzed using Chi-square test or Fisher's exact test. RESULTS A total of 221 teeth completed the 12-month follow-up. The 1-year success rates of the BP-RRM/SP-RCS and BP-RRM groups were 94.5% (104/110) and 92.8% (103/111), respectively. The combined use of BP-RRM and SP-RCS achieved a clinical outcome comparable to BP-RRM alone (P = 0.784). Tooth type (P = 0.002), through-and-through/apico-marginal lesion (P = 0.049), periodontal status (P < 0.0001), and Kim's lesion classification (P < 0.0001) were critical factors associated with the 1-year success of endodontic microsurgery. CONCLUSIONS The combined use of BP-RRM and SP-RCS is a practicable method for root-end filling in endodontic microsurgery with a satisfactory 1-year clinical outcome. CLINICAL RELEVANCE The combined application of BP-RRM and SP-RCS in EMS is an effective root-end filling method with a satisfactory 1-year clinical outcome. TRIAL REGISTRATION This study was registered in the Chinese Clinical Trial Registry (ChiCTR2100052174).
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Affiliation(s)
- Xu Dong
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Stomatology, The First People's Hospital of Liangshan Yi Autonomous Prefecture, Xichang, China
| | - Qin Su
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wen Li
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jinbo Yang
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dongzhe Song
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing Yang
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xu
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Alkandari FA, Alotaibi MK, Al-Qahtani S, Alajmi S. The use of guided tissue regeneration in endodontic Microsurgery: Setting a threshold. Saudi Dent J 2024; 36:461-465. [PMID: 38525183 PMCID: PMC10960144 DOI: 10.1016/j.sdentj.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 03/26/2024] Open
Abstract
Aim We aimed to compare the radiographic outcomes of conventional and regenerative approaches in endodontic microsurgery (EMS) and set a critical defect size for healing in conventional and regenerative therapies. Methodology The study evaluated 53 root canal-treated teeth (33 patients) with periapical lesions. Among them, 19 teeth (35.8 %) were treated with regenerative treatment, whereas 34 teeth (64.1 %) were managed with the conventional approach. Conventional and regenerative approaches were performed by endodontic and periodontic residents under consultants' supervision. Healing was evaluated after a minimum period of 6 months by comparing pre- and post-operative cone-beam computed tomography (CBCT) findings. The radiographic interpretation was conducted by a single examiner who was not participating in the surgeries and was blind on the type of treatment prior to CBCT evaluation. New healing criteria were proposed owing to the limitations on the present criteria in evaluating endodontic surgery after regenerative treatment. Critical measurements were calculated for each approach based on periapical lesion dimensions. Results The regenerative approach presented significantly better healing than conventional treatment (mean, 1.21 and 1.59, respectively; p = 0.047). Based on the critical-point calculations, the conventional approach was effective in lesions of up to 3 mm depth and height, whereas the regenerative approach resulted in better healing rates in lesions with 3-9 mm depth and 3-6 mm height. Conclusions Performing the regenerative approach in EMS resulted in better healing rates than those of the conventional approach. The conventional approach is recommended for small periapical lesions, whereas the first had better results in larger lesions.
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Affiliation(s)
| | - Mazen K. Alotaibi
- Dental department, Periodontics Unit, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Sami Al-Qahtani
- Dental department, Periodontics Unit, King Saud University, Riyadh, Saudi Arabia
| | - Samhan Alajmi
- Kuwait Board of Endodontics, Kuwait Institute for Medical Specialties, Kuwait
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Nabeel M, Abu-Seida AM, Elgendy AA, Tawfik HM. Biocompatibility of mineral trioxide aggregate and biodentine as root-end filling materials: an in vivo study. Sci Rep 2024; 14:3568. [PMID: 38347030 PMCID: PMC10861467 DOI: 10.1038/s41598-024-53872-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 02/06/2024] [Indexed: 02/15/2024] Open
Abstract
This study evaluated the biocompatibility of mineral trioxide aggregate (MTA) and Biodentine (BD) as root-end filling materials. Six mongrel dogs were divided into two equal groups according to the evaluation period; group A: one month and group B: three months. Three premolars of the same quadrant in each arch were used, summing up 36 teeth (6 teeth/dog). These teeth were randomly subdivided into three subgroups according to the root-end filling material used: MTA, BD and no root-end filling material (control). Endodontic access cavities were performed for induction of periapical pathosis. After the infection period, root canal instrumentation and obturation were accomplished. One day after root canal procedures, root-end surgery was performed. Surgical access was achieved and the root-end was resected approximately 3 mm above the apex. Root-end cavity was prepared ultrasonically and filled with the tested materials. All samples were evaluated by radiography and histopathology (Inflammation and new hard tissue formation). Data were collected and subjected to statistical analysis. In group A, MTA subgroup exhibited significant higher mean inflammatory score than BD subgroup (P < 0.05) while no significant difference was recorded between MTA and BD subgroups in group B (P > 0.05). Regarding mean mineralization score, there was no significant difference between all subgroups in both groups A and B (P > 0.05). Biodentine exhibited favorable biocompatibility in the initial stage of healing than MTA and comparable biomineralization. Clinical relevance: Biodentine could be considered as an acceptable alternative to MTA in peri-radicular surgeries.
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Affiliation(s)
- Mohamed Nabeel
- Department of Endodontics, Faculty of Oral & Dental Medicine, Misr International University, Cairo, Egypt
| | - Ashraf M Abu-Seida
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Cairo University, Giza Squa, PO Box 12211, Giza, Egypt.
| | - Abeer A Elgendy
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Hossam M Tawfik
- Department of Endodontics, Faculty of Oral & Dental Medicine, Misr International University, Cairo, Egypt
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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de Araújo LP, Marchesin AR, Carpena LP, Gobbo LB, Ferreira NDS, de Almeida JFA, Ferraz CCR. Outcome of curcumin-based photodynamic therapy in endodontic microsurgery: A case report. Photodiagnosis Photodyn Ther 2024; 45:103994. [PMID: 38295923 DOI: 10.1016/j.pdpdt.2024.103994] [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: 01/11/2024] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/15/2024]
Abstract
INTRODUCTION Persistent apical periodontitis after root canal treatment may require surgical retreatment when non-surgical options are ineffective or impractical due to anatomical challenges or iatrogenic errors. Endodontic microsurgery (EMS) is a precise technique that aims to overcome extraradicular biofilm and root morphology issues. Photodynamic therapy (PDT) is an emerging supplementary disinfection approach that utilizes a photosensitizer agent and light to eliminate microorganisms through oxidative reactions. REPORT A 60-year-old male with persistent apical periodontitis in a left maxillary first molar underwent non-surgical root canal retreatment followed by surgical reintervention due to anatomical complexities. During surgery, PDT was performed using a novel curcumin-based photosensitizer agent. After the procedure, the tooth was retrofilled with bioceramic cement, and photobiomodulation was applied to enhance tissue healing. One year post-surgery, the patient exhibited complete periradicular repair and remained asymptomatic. DISCUSSION EMS is considered a last resort to salvage an endodontically treated tooth and has shown moderate success rates. PDT has demonstrated promise in improving periapical healing and reducing microorganisms. In this case, curcumin, diluted with 2 % chlorhexidine gel, served as an effective photosensitizer agent with antimicrobial properties. Moreover, performing photobiomodulation aided in cell recovery and reduced postoperative discomfort. CONCLUSION The proposed EMS treatment protocol with PDT using curcumin yielded positive outcomes in this case report. Further randomized clinical trials are necessary to assess the efficacy of this approach in EMS. Additionally, further research on curcumin-based photosensitizer agents encapsulated in nanoparticles and enhanced antimicrobial agents is recommended to refine this treatment protocol for routine use.
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Affiliation(s)
- Lucas Peixoto de Araújo
- School of Dentistry, Catholic University of Pelotas (UCPEL), Pelotas, RS, Brazil; Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil.
| | - Analu Rodriguez Marchesin
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Lucas Pinto Carpena
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas (UFPEL), Pelotas, RS, Brazil
| | - Leandro Bueno Gobbo
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Nadia de Souza Ferreira
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas (UFPEL), Pelotas, RS, Brazil
| | - José Flávio Affonso de Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Caio Cezar Randi Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
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Zheng C, Wu W, Zhang Y, Tang Z, Xie Z, Chen Z. A novel simplified approach for endodontic retrograde surgery in short single-rooted teeth. BMC Oral Health 2024; 24:150. [PMID: 38297251 PMCID: PMC10832180 DOI: 10.1186/s12903-024-03879-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 01/09/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND High technical thresholds, long operative times, and the need for expensive and specialized equipment impede the widespread adoption of endodontic microsurgery in many developing countries. This study aimed to compare the effects of a simplified, cost-effective, and time-efficient surgical approach involving orthograde obturation using biological ceramic material greater than 6 mm combined with apicoectomy for single-rooted teeth with short lengths with those of the conventional and current standard methods. MATERIALS AND METHODS Forty-five premolars equally categorized into three groups: conventional surgery group, standard surgery group, and modified surgery group. A µCT scan was used to calculate the volume of voids. A micro-leakage test and scanning electron microscope (SEM) were performed to assess the sealing effect. Additionally, four cases of chronic periapical periodontitis in the anterior region were selected, and the patients received either the modified approach or the standard surgery for endodontic microsurgery. RESULTS The volumes of voids in the apical 0-3 mm of the modified group and the standard group were comparable. The micro-leakage test and SEM examination demonstrated closely bonded fillings in the dentinal walls in both the modified surgery group and standard surgery group. The outcomes of the preliminary application of this modified procedure on patients were successful at the time of the follow-up cutoff. CONCLUSIONS The modified surgery group exhibited similar root canal filling and apical sealing abilities with the standard procedure for single-rooted teeth with short lengths (< 20 mm). The preliminary application of this modified surgical procedure achieved favorable results.
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Affiliation(s)
- Chen Zheng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, 310000, China
| | - Wenzhi Wu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, 310000, China
| | - Yulian Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, 310000, China
| | - Zhenhang Tang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, 310000, China
| | - Zhijian Xie
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, 310000, China.
| | - Zhuo Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, 310000, China.
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Jeong M, Kwon DH, Lee SJ. Computer guided root tip extraction and implant placement: A clinical report. J Prosthet Dent 2024:S0022-3913(23)00832-6. [PMID: 38185591 DOI: 10.1016/j.prosdent.2023.11.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 01/09/2024]
Abstract
Extraction of a residual root tip and implant placement can be challenging because of the complexity and invasiveness of the procedure. Improvised application of a guided implant surgery may avoid such challenges. This clinical report presents an innovative technique combining a 3-dimensionally printed surgical guide with conventional instrumentation for a residual root tip extraction in a minimally invasive and predictable way.
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Affiliation(s)
- Min Jeong
- Graduate student, Advanced Graduate Prosthodontics, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
| | - David H Kwon
- Commander, Department of Periodontics, Fort Meade DENTAC, Fort George G. Meade, Md
| | - Sang J Lee
- Associate Professor, Advanced Graduate Prosthodontics, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass.
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Dos Santos MM, Só GB, Siocheta G, Jahnke LT, Krabbe WM, Pinheiro LS, Só MVR, da Rosa RA. Interfacial adaptation of NeoMTA Plus, BioRoot RCS and MTA in root-end cavities: A micro-CT study. Microsc Res Tech 2024; 87:172-178. [PMID: 37732407 DOI: 10.1002/jemt.24421] [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: 05/09/2023] [Revised: 08/01/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023]
Abstract
AIM This study aimed to use the micro-computed tomography to evaluate the interfacial adaptation and the presence of gaps of NeoMTA Plus, BioRoot RCS, and MTA in the root-end cavities. METHODOLOGY Thirty standardized bovine roots measuring 15 mm in length were selected. Chemical-mechanical preparation was performed up to instrument #80 and obturation with the cold lateral compaction technique with cement based on zinc oxide and eugenol. The roots were kept at 37°C for 7 days. Afterward, apicectomy of the apical 3 mm and a root-end filling cavity was performed at 3 mm depth. Micro-computed tomography (micro-CT) was performed to measure the volume of the retroactivity. The roots were divided by stratified randomization into three groups according to the retro-end filling material: NeoMTA Plus, BioRoot RCS, and MTA. A new micro-CT was performed to assess the presence of voids in the root-end filling material and between it and the canal wall. One-way ANOVA and Tukey tests were performed using the BioEstat 4.0 program. RESULTS There was no difference in the initial volume values of the root-end cavities (p > .05). After the insertion of root-end filling materials, the most significant volumes of voids were observed in the NeoMTA Plus group (p < .05), with no difference for the BioRoot RCS and MTA Angelus groups (p > .05). CONCLUSION Micro-computed tomography showed that MTA and BioRoot RCS have better interfacial adaptation and presented fewer number of gaps than NeoMTA Plus when used as root-end filling materials. RESEARCH HIGHLIGHTS Micro-computed tomography evaluation of different root-end fillings materials.
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Affiliation(s)
- Murilo Mancio Dos Santos
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, Brazil
| | - Gabriel Barcelos Só
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, Brazil
| | - Giovana Siocheta
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, Brazil
| | - Leonardo Thomasi Jahnke
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, Brazil
| | - Wesley Misael Krabbe
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, Brazil
| | - Lucas Siqueira Pinheiro
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, Brazil
| | - Marcus Vinicius Reis Só
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, Brazil
| | - Ricardo Abreu da Rosa
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, Brazil
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Shen TC, Tu MG, Huang HL, Peng SL, Hsu JT. Analysis of mandibular molar anatomy in Taiwanese individuals using cone beam computed tomography. J Dent Sci 2024; 19:419-427. [PMID: 38303847 PMCID: PMC10829672 DOI: 10.1016/j.jds.2023.08.012] [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: 07/05/2023] [Revised: 08/14/2023] [Accepted: 08/14/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose Before periapical surgery in the mandibular posterior teeth is performed, the thicknesses of the buccal alveolar bone wall and buccolingual root might be a critical issue. This study aimed to assess the anatomical structure of the posterior region of the mandible in Taiwanese individuals using cone-beam computed tomography (CBCT). Materials and methods The CBCT images of 96 Taiwanese individuals (51 male and 45 female), which included 192 mandibular first molars and 192 mandibular second molars, were imported into medical imaging software to measure the buccal alveolar bone thickness and buccolingual root thickness at 3 mm above the root apex. Statistical analysis was conducted to examine the impact of tooth position, gender, and age on the anatomical position of mandibular molars. Results The buccal alveolar bone thickness at 3 mm above the root apex of the mandibular second molar demonstrates a significantly higher value when compared to that of the first molar. Nonetheless, concerning the buccolingual root thickness, no significant differences were observed between these two teeth. In addition, the buccal alveolar bone thickness and buccolingual root thickness at 3 mm above the root apex may not be influenced by gender and age. Conclusion The anatomical structures of the posterior region of the mandible in Taiwanese individuals exhibited variations between the mandibular first and second molars. However, these differences were not influenced by gender or age.
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Affiliation(s)
- Ting-Chun Shen
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Ming-Gene Tu
- School of Dentistry, China Medical University, Taichung, Taiwan
- Department of Dentistry, China Medical University Hospital, Taichung, Taiwan
| | - Heng-Li Huang
- School of Dentistry, China Medical University, Taichung, Taiwan
- Department of Biomedical Engineering, China Medical University, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University. Taichung, Taiwan
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Jui-Ting Hsu
- School of Dentistry, China Medical University, Taichung, Taiwan
- Department of Biomedical Engineering, China Medical University, Taichung, Taiwan
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Souza PHFD, Oliveira Santos-Junior A, Pinto JC, Tavares KIMC, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Effect of Endo-Z bur or Bladesonic ultrasonic tip on the adaptation of filling material. A micro-CT study. Braz Dent J 2023; 34:29-35. [PMID: 38133470 PMCID: PMC10759957 DOI: 10.1590/0103-6440202305474] [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: 04/18/2023] [Accepted: 10/11/2023] [Indexed: 12/23/2023] Open
Abstract
This study aimed to evaluate the effect of apicoectomy performed with a bur or an ultrasonic tip on the adaptation of the filling material to root canal dentin. Twenty human mandibular incisors were selected and prepared with a ProDesign Logic system up to diameter 40/.05. The root canals were filled with Bio-C Sealer (Angelus, PR, Brazil) using the single cone technique and were stored at 37ºC and 95% relative humidity for 7 days. After this period, the apicoectomy of the 3 millimeters of the root apex was performed using Endo-Z bur (Dentsply Sirona) or Bladesonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, Brazil) (n=10). The specimens were scanned by micro-computed tomography (micro-CT; SkyScan 1176) with a voxel size of 8.74 µm after obturation and after apicoectomy. The percentage of voids at the interface between the filling material and the root canal wall was evaluated in the apical 4 mm of the root after apicoectomy, besides the time cutting to both devices. The data obtained were submitted to paired and unpaired t-tests (α = 0.05). Endo-Z and Bladesonic increased the percentage of voids between the filling material and the dentin after apicectomy (p<0.05), and they were similar (p>0.05). Endo-Z has a shorter time to perform apicoectomy compared to Bladesonic (p<0.05). Apicectomies with Endo-Z or Bladesonic could harm the material/dentin interface, while the Endo-Z bur was faster than the Bladesonic ultrasonic tip.
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Affiliation(s)
- Pedro Henrique Fiorin de Souza
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Airton Oliveira Santos-Junior
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Jáder Camilo Pinto
- Departament of Dentistry - Centro Universitário Presidente Antônio Carlos - UNIPAC, Barbacena, MG, Brazil and Department of Dentistry - Centro Universitário Presidente Tancredo de Almeida Neves - UNIPTAN, São João del Rei, MG, Brazil
| | | | | | - Mário Tanomaru-Filho
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
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Jeong M, Radomski K, Lopez D, Liu JT, Lee JD, Lee SJ. Materials and Applications of 3D Printing Technology in Dentistry: An Overview. Dent J (Basel) 2023; 12:1. [PMID: 38275676 PMCID: PMC10814684 DOI: 10.3390/dj12010001] [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: 10/09/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
PURPOSE This narrative review aims to provide an overview of the mechanisms of 3D printing, the dental materials relevant to each mechanism, and the possible applications of these materials within different areas of dentistry. METHODS Subtopics within 3D printing technology in dentistry were identified and divided among five reviewers. Electronic searches of the Medline (PubMed) database were performed with the following search keywords: 3D printing, digital light processing, stereolithography, digital dentistry, dental materials, and a combination of the keywords. For this review, only studies or review papers investigating 3D printing technology for dental or medical applications were included. Due to the nature of this review, no formal evidence-based quality assessment was performed, and the search was limited to the English language without further restrictions. RESULTS A total of 64 articles were included. The significant applications, applied materials, limitations, and future directions of 3D printing technology were reviewed. Subtopics include the chronological evolution of 3D printing technology, the mechanisms of 3D printing technologies along with different printable materials with unique biomechanical properties, and the wide range of applications for 3D printing in dentistry. CONCLUSIONS This review article gives an overview of the history and evolution of 3D printing technology, as well as its associated advantages and disadvantages. Current 3D printing technologies include stereolithography, digital light processing, fused deposition modeling, selective laser sintering/melting, photopolymer jetting, powder binder, and 3D laser bioprinting. The main categories of 3D printing materials are polymers, metals, and ceramics. Despite limitations in printing accuracy and quality, 3D printing technology is now able to offer us a wide variety of potential applications in different fields of dentistry, including prosthodontics, implantology, oral and maxillofacial, orthodontics, endodontics, and periodontics. Understanding the existing spectrum of 3D printing applications in dentistry will serve to further expand its use in the dental field. Three-dimensional printing technology has brought about a paradigm shift in the delivery of clinical care in medicine and dentistry. The clinical use of 3D printing has created versatile applications which streamline our digital workflow. Technological advancements have also paved the way for the integration of new dental materials into dentistry.
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Affiliation(s)
- Min Jeong
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA; (M.J.); (K.R.); (D.L.); (J.D.L.)
| | - Kyle Radomski
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA; (M.J.); (K.R.); (D.L.); (J.D.L.)
| | - Diana Lopez
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA; (M.J.); (K.R.); (D.L.); (J.D.L.)
| | - Jack T. Liu
- Dexter Southfield, Brookline, MA 02445, USA;
| | - Jason D. Lee
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA; (M.J.); (K.R.); (D.L.); (J.D.L.)
| | - Sang J. Lee
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA; (M.J.); (K.R.); (D.L.); (J.D.L.)
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Chu T, Qin Q, Liu K, Zhao Y, Fu Y, Liu Q. Enucleation of jaw cyst combined with intentional replantation to retain cyst-involved teeth. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 125:101731. [PMID: 38097014 DOI: 10.1016/j.jormas.2023.101731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/09/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Jaw cysts often deeply involve adjacent tooth roots, making it difficult to preserve them. The purpose of this retrospective study was to investigate the effectiveness of an intentional replantation (IR) strategy combined with cyst enucleation in preserving cyst-involved teeth during jaw cyst removal. MATERIALS AND METHODS Fifteen patients with jaw cysts and deeply involved teeth were treated with IR and cyst enucleation. All patients received root canal therapy prior to surgery, except for one patient who received it during surgery. The involved teeth were extracted, and the root surface was carefully cleaned before IR and cyst enucleation. Patients were followed up for 12-14 months, with indicators including clinical complaints, replanted tooth stability, and root resorption. RESULTS No cyst recurrence was observed, and all replanted teeth survived with good local gingival condition and no marked swelling or recession. Radiographic findings showed clear periodontal space surrounding the replanted teeth. One replanted tooth exhibited slight root resorption due to occlusal trauma, but the resorption ceased after occlusal adjustment. CONCLUSIONS IR combined with cyst enucleation is an effective strategy for thoroughly cleaning jaw cysts and preserving teeth involved in the cyst.
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Affiliation(s)
- Tianshu Chu
- The Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, PR China
| | - Qingyan Qin
- The Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, PR China
| | - Kang Liu
- The Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, PR China
| | - Yitong Zhao
- The Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, PR China
| | - Yongzhen Fu
- The Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, PR China
| | - Qilin Liu
- The Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, PR China.
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Albagle A, Kohli MR, Kratchman SI, Lee SM, Karabucak B. Periapical healing following endodontic microsurgery with collagen-based bone-filling material: A randomized controlled clinical trial. Int Endod J 2023; 56:1446-1458. [PMID: 37695450 DOI: 10.1111/iej.13973] [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: 01/15/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023]
Abstract
AIM To evaluate two- and three-dimensionally the effect of resorbable collagen-based bone-filling material on periapical healing of endodontic lesions with four-wall defects following endodontic microsurgery (EMS). METHODOLOGY This parallel, randomized controlled superiority clinical trial involved 86 lesions with the strictly endodontic origin and four-wall defect morphology. EMS procedures were performed by calibrated postgraduate residents. Before flap closure, osteotomies were randomized to the control or treatment group. In the control group, the flap was repositioned with no material added. In the treatment group, a collagen-based bone-filling augmentation material was placed into the osteotomy. Clinical and radiographic examinations were completed after 12 months. Periapical healing was evaluated by blinded evaluators using periapical (PA) radiographs according to Molven's criteria and cone beam computed tomography (CBCT) scans according to PENN's 3D criteria. Cortical plate healing was scored according to the RAC/B index. The data were analysed using Fisher's exact test, Logistic regression models and Chi-squared test. The significance level was predetermined at p < .05. RESULTS Sixty-six cases were evaluated at the 12-month follow-up, with 30 and 36 cases in the control and treatment groups, respectively. Only the asymptomatic cases (control = 26, treatment = 32) were included in the radiographic evaluation. Twenty-three cases (88.5%) in the control and 28 (87.5%) cases in the treatment group demonstrated complete healing on PA radiographs (p = 1.000). On CBCT, 10 (38.4%) and 21 (65.6%) cases had completely healed in the control and treatment groups, respectively (p = .095). The re-establishment of the buccal cortical plate was detected in 12 (46.2%) and 22 (68.8%) cases in the control and treatment groups, respectively (p = .243). CONCLUSION Within the limitations of the present study, the use of collagen-based bone-filling material had no statistically significant effect on the periapical healing of endodontic lesions with four-wall defect following EMS at the 12-month follow-up when evaluated by PA radiographs or CBCT scans. However, the observed higher percentage of a re-established cortical plate in the treatment group could suggest a clinical benefit that is of interest after surgical endodontic treatment.
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Affiliation(s)
- Amenah Albagle
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Meetu R Kohli
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Samuel I Kratchman
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Su-Min Lee
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Bekir Karabucak
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Thomas AR, Mathew M, Nettemu SK, Mayya A. Resective and Regenerative Approach for an Unresolved Periapical Lesion: A Surgical Case Report With 24-Month Follow-Up. Cureus 2023; 15:e49717. [PMID: 38161818 PMCID: PMC10757505 DOI: 10.7759/cureus.49717] [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: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
The pulp and the periodontium are inherently interconnected, both anatomically and functionally. Conditions affecting the periodontium and the pulp can create challenges in diagnosis, treatment strategizing, and predicting outcomes. This case report outlines the combination of resection and regeneration techniques utilizing mineral trioxide aggregate (MTA) and bone grafting to address a persistent periapical lesion in a maxillary premolar. The treatment led to the effective alleviation of the patient's symptoms and successful regeneration.
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Affiliation(s)
- Anchu R Thomas
- Endodontics, Manipal University College Malaysia, Melaka, MYS
| | - Melwin Mathew
- Dentistry/Periodontics, Manipal University College Malaysia, Melaka, MYS
| | - Sunil K Nettemu
- Dentistry/Periodontics, Manipal University College Malaysia, Melaka, MYS
| | - Anoop Mayya
- Prosthodontics, Manipal University College Malaysia, Melaka, MYS
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Zhang MM, Fang GF, Wang ZH, Liang YH. Clinical Outcome and Predictors of Endodontic Microsurgery Using Cone-beam Computed Tomography: A Retrospective Cohort Study. J Endod 2023; 49:1464-1471. [PMID: 37633517 DOI: 10.1016/j.joen.2023.08.011] [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: 06/05/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 08/28/2023]
Abstract
INTRODUCTION The aim of this retrospective cohort study was to evaluate the clinical outcomes and identify the prognostic factors of endodontic microsurgery based on cone-beam computed tomographic (CBCT) scans. METHODS Patients who underwent endodontic microsurgery in teeth with asymptomatic apical periodontitis were included. The clinical outcomes were determined based on clinical and radiographic examinations after surgery 12-48 months. Radiographic healing was assessed on CBCT images by using the modified PENN 3-dimensional criteria and classified into 4 categories: complete, limited, uncertain, and unsatisfactory healing. Multivariate logistic regression was performed to detect outcome risk factors. RESULTS Of the 204 teeth in 173 invited patients, 148 teeth of 126 patients were examined at review. On CBCT images, 88 teeth (59.5%) showed complete healing, and 42 (28.4%) teeth showed limited healing. All these 130 teeth were asymptomatic and achieved a clinical success rate of 87.8%. Uncertain healing was observed in 9 teeth, one of which was symptomatic. The remaining 9 teeth were unsatisfactory healing on CBCT scans, including 6 teeth with clinical symptoms and 3 free. Lesion type and root-end filling quality were significant outcome predictors (P < .05). The risk of treatment failure for teeth with combined endodontic-periodontal lesions was 8.6 times higher than that for teeth with isolated endodontic lesions. Adequate root-end filling quality improved the probability of success by 5.3 times. CONCLUSIONS Based on CBCT data, an adequate performed endodontic microsurgery could have predictable success in teeth without periodontal involvement.
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Affiliation(s)
- Ming-Ming Zhang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Gao-Feng Fang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Zu-Hua Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Yu-Hong Liang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China; Department of Stomatology, Peking University International Hospital, Beijing, China.
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You JS, Jung GW, Oh JS, Moon SY, Lee WP, Jo HH. Volumetric evaluation of effects of platelet-rich fibrin and concentrated growth factor on early bone healing after endodontic microsurgery: a randomized controlled trial. BMC Oral Health 2023; 23:821. [PMID: 37899448 PMCID: PMC10613388 DOI: 10.1186/s12903-023-03530-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/11/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND This randomized controlled clinical trial compared the effects of platelet-rich fibrin (PRF) and concentrated growth factor (CGF) on early bone healing after endodontic microsurgery. METHODS Eighteen patients with an isolated periapical lesion < 10 mm in the maxillary anterior region were randomly assigned to three groups: control, PRF, or CGF. Endodontic microsurgery was performed and PRF or CGF membranes were placed over the bone defects in the experimental groups. The volume of the bone defect at postoperative one week, three months, and six months was evaluated using cone-beam computed tomography and Mimics software. The results were statistically analyzed using the Kruskal-Wallis test and post-hoc Mann-Whitney U test with Bonferroni correction. RESULTS At the three-month follow-up, the PRF and CGF groups showed significantly greater bone healing compared with the control group (p > 0.05). However, no significant difference was observed between the PRF and CGF groups. At the six-month follow-up, no significant differences were observed between the groups. CONCLUSIONS These results suggested that PRF and CGF promote early bone healing after endodontic microsurgery.
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Affiliation(s)
- Jae-Seek You
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
| | - Gyeo-Woon Jung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
| | - Ji-Su Oh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
| | - Seong-Yong Moon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
| | - Won-Pyo Lee
- Department of Periodontology, School of Dentistry, Chosun University, Gwangju, Korea
| | - Hyoung-Hoon Jo
- Department of Conservative Dentistry, School of Dentistry, Chosun University, 309 Phimun-daero, Dong-gu, Gwangju, 61452, Korea.
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Bieszczad D, Wichlinski J, Kaczmarzyk T. Treatment-Related Factors Affecting the Success of Endodontic Microsurgery and the Influence of GTR on Radiographic Healing-A Cone-Beam Computed Tomography Study. J Clin Med 2023; 12:6382. [PMID: 37835026 PMCID: PMC10573613 DOI: 10.3390/jcm12196382] [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: 08/01/2023] [Revised: 09/20/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
The primary objective of this retrospective study was to assess the correlation between treatment-related factors (resection angle, depth of retrograde filling, length of resected root and use of guided tissue regeneration-GTR) evaluated using cone-beam computed tomography (CBCT) scans and the treatment outcomes of endodontic microsurgery (EMS). The secondary purpose of this research was to evaluate the influence of the GTR technique on the radiographic healing state, taking into account the initial parameters of periapical lesions. In 161 cases, the local factors (volume of a lesion, bone destruction pattern, presence/absence of cortical bone destruction) were measured using preoperative CBCT images before undergoing EMS. At least one year after surgery, the outcome of EMS was classified as a success or a failure (based on radiographic and clinical criteria). Using postoperative CBCT, treatment-related factors (resection angle, depth of retrograde filling, and length of resected root) were measured. Additionally, the status of radiographic healing was evaluated (in accordance with modified PENN 3D criteria). Eighteen cases (11.18%) were classified as failures, and 143 were classified as successes (88.82%). Univariate analysis showed that there was no statistically significant influence of treatment-related factors on the healing outcome of EMS. An exact Fischer's test showed the significant impact of GTR on radiographic healing (P < 0.001) in apical lesions (P < 0.001), lesions with a volume between 100 mm3 and 450 mm3 (P < 0.009) and over 450 mm3 (P < 0.001), lesions with the destruction of one plate (P < 0.001), and lesions with the destruction of two plates (through and through) (P = 0.022). The use of GTR in apical lesions, lesions with volumes over 100 mm3, and lesions with the destruction of at least one plate is significantly associated with better radiographic healing.
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Affiliation(s)
- Daniel Bieszczad
- NZOZ Centrum Stomatologii s.c. Justyna Wichlinska, Jaroslaw Wichlinski, ul. 3-go Maja 16, 38-300 Gorlice, Poland; (D.B.); (J.W.)
| | - Jarosław Wichlinski
- NZOZ Centrum Stomatologii s.c. Justyna Wichlinska, Jaroslaw Wichlinski, ul. 3-go Maja 16, 38-300 Gorlice, Poland; (D.B.); (J.W.)
| | - Tomasz Kaczmarzyk
- Chair of Oral Surgery, Institute of Dentistry, Medical College, Jagiellonian University, ul. Montelupich 4, 31-155 Krakow, Poland
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Martinho FC, Griffin IL, Price JB, Tordik PA. Augmented Reality and 3-Dimensional Dynamic Navigation System Integration for Osteotomy and Root-end Resection. J Endod 2023; 49:1362-1368. [PMID: 37453501 DOI: 10.1016/j.joen.2023.07.007] [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: 06/06/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Augmented reality (AR) superimposes high-definition computer-generated virtual content onto the existing environment, providing users with an enhanced perception of reality. This study investigates the feasibility of integrating an AR head-mounted device into a 3-dimensional dynamic navigation system (3D-DNS) for osteotomy and root-end resection (RER). It compares the accuracy and efficiency of AR + 3D-DNS to 3D-DNS for osteotomy and RER. METHODS Seventy-two tooth roots of 3D-printed surgical jaw models were divided into two groups: AR + 3D-DNS (n = 36) and 3D-DNS (n = 36). Cone-beam computed tomography scans were taken pre and postoperatively. The osteotomy and RER were virtually planned on X-guide software and delivered under 3D-DNS guidance. For the AR + 3D-DNS group, an AR head-mounted device (Microsoft HoloLens 2) was integrated into the 3D-DNS. The 2D- and 3D-deviations were calculated. The osteotomy and RER time and the number of procedural mishaps were recorded. RESULTS Osteotomy and RER were completed in all samples (72/72). AR + 3D-DNS was more accurate than 3D-DNS, showing lower 2D- and 3D-deviation values (P < .05). The AR + 3D-DNS was more efficient in time than 3D-DNS (P < .05). There was no significant difference in the number of mishaps (P > .05). CONCLUSIONS Within the limitations of this in vitro study, the integration of an AR head-mounted device to 3D-DNS is feasible for osteotomy and RER. AR improved the accuracy and time efficiency of 3D-DNS in osteotomy and RER. Head-mounted AR has the potential to be safely and reliably integrated into 3D-DNS for endodontic microsurgery.
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Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland.
| | - Ina L Griffin
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Jeffery B Price
- Division of Oral Radiology, Department of Oncology and Diagnostic Sciences, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Patricia A Tordik
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
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Jia W, Jing H, Xia G, Angang D, Wei Z, Pengfei Z, Shujun R, Mengying M, Zhengwei H, Shensheng G. Utility of Ultrasonography for Diagnosing and Differentiating Periapical Granuloma from Radicular Cyst. Acad Radiol 2023; 30:2329-2339. [PMID: 37394410 DOI: 10.1016/j.acra.2023.05.039] [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: 02/17/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023]
Abstract
RATIONALE AND OBJECTIVES This study aimed to investigate the reliability and accuracy of high-resolution ultrasonography (US) for diagnosing periapical lesions and differentiating radicular cysts from granulomas. MATERIALS AND METHODS This study included 109 teeth with periapical lesions of endodontic origin from 109 patients scheduled for apical microsurgery. Ultrasonic outcomes were analyzed and categorized after thorough clinical and radiographic examinations using US. B-mode US images reflected the echotexture, echogenicity, and lesion margin, while color Doppler US assessed the presence and features of blood flow of interested areas. Pathological tissue samples were obtained during apical microsurgery and subjected to histopathological examination. Fleiss' κ was used to measure interobserver reliability. Statistical analyses were performed to assess the diagnostic validity and the overall agreement between US and histological findings. The reliability of US compared to histopathological examinations was assessed based on Cohen's κ. RESULTS The percent accuracy of US for diagnosing cysts, granulomas, and cysts with infection based on histopathological findings was 89.9%, 89.0%, and 97.2%, respectively. The sensitivity of US diagnoses was 95.1% for cysts, 84.1% for granulomas, and 80.0% for cysts with infection. The specificity of US diagnoses was 86.8% for cysts, 95.7% for granulomas, and 98.1% for cysts with infection. The reliability for US compared to histopathological examinations was good (κ = 0.779). CONCLUSION The echotexture characteristics of lesions in US images correlated with their histopathological features. US can provide accurate information on the nature of periapical lesions based on the echotexture of their contents and the presence of vascularity. It can help improve clinical diagnosis and avoid overtreatment of patients with apical periodontitis.
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Affiliation(s)
- Wang Jia
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Huang Jing
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Gong Xia
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (X.G., A.D.).
| | - Ding Angang
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (X.G., A.D.).
| | - Zhou Wei
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Zhang Pengfei
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Ran Shujun
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Mao Mengying
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Huang Zhengwei
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Gu Shensheng
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
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Majeed R, Elnawawy HM, Kutty MG, Yahya NA, Azami NH, Abu Kasim NH, Nabhan MS, Cooper PR, Camilleri J, Ahmed HMA. Physicochemical, mechanical and biological properties of nano-calcium silicate-based cements: a systematic review. Odontology 2023; 111:759-776. [PMID: 36864211 DOI: 10.1007/s10266-023-00786-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 01/17/2023] [Indexed: 03/04/2023]
Abstract
This systematic review evaluated the effects of nano-sized cement particles on the properties of calcium silicate-based cements (CSCs). Using defined keywords, a literature search was conducted to identify studies that investigated properties of nano-calcium silicate-based cements (NCSCs). A total of 17 studies fulfilled the inclusion criteria. Results indicated that NCSC formulations have favourable physical (setting time, pH and solubility), mechanical (push out bond strength, compressive strength and indentation hardness) and biological (bone regeneration and foreign body reaction) properties compared with commonly used CSCs. However, the characterization and verification for the nano-particle size of NCSCs were deficient in some studies. Furthermore, the nanosizing was not limited to the cement particles and a number of additives were present. In conclusion, the evidence available for the properties of CSC particles in the nano-range is deficient-such properties could be a result of additives which may have enhanced the properties of the material.
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Affiliation(s)
- Rabia Majeed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Hoda Mohamed Elnawawy
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Muralithran Govindan Kutty
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Noor Azlin Yahya
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Noor Hayati Azami
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Noor Hayaty Abu Kasim
- Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Mohamed Shady Nabhan
- Department of Removable Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Paul Roy Cooper
- Department of Oral Sciences, University of Otago, Otago, New Zealand
| | - Josette Camilleri
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Corbella S, Walter C, Tsesis I. Effectiveness of root resection techniques compared with root canal retreatment or apical surgery for the treatment of apical periodontitis and tooth survival: A systematic review. Int Endod J 2023; 56 Suppl 3:487-498. [PMID: 35920073 DOI: 10.1111/iej.13808] [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: 01/31/2022] [Revised: 07/24/2022] [Accepted: 07/29/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND To manage apical periodontitis in root filled maxillary and mandibular molars, root resection techniques may be employed to avoid the loss of the tooth. OBJECTIVES The objectives of the study were to systematically analyse the effectiveness of root resection techniques (root resection/crown resection/root amputation) for the management of apical periodontitis with non-surgical root canal retreatment or apical surgery by the evaluation of clinical and patient-related outcomes (PROMS), in human experimental studies and longitudinal studies. METHODS An electronic literature search in PubMed, MEDLINE via OVID interface, EMBASE and Cochrane Central, supplemented by a manual hand search of the grey literature, was performed up to 25th September 2021. Randomized controlled trials, comparative clinical trials and observational studies reporting on the outcome (tooth survival and patient-reported outcome measures with a minimum follow-up of 1 year) of root resection techniques for treating apical periodontitis were identified. The risk of bias was evaluated using the Newcastle-Ottawa scale. RESULTS From a total of 2098 reports, 36 were considered for further screening. Three retrospective studies, published between 2018 and 2020, were included in this systematic review. A high heterogeneity in terms of protocols, study design and the reported outcomes were observed. The risk of bias was scored as low to moderate. These three studies consisted of data from 305 resected teeth, from 254 patients, with a follow-up period of 1-16.8 years. Overall, 151 teeth were extracted during the follow-up period. In these studies, root resection treatment was carried out on 42 teeth exclusively for endodontic reasons. One of these studies reported 12 out of 23 teeth lost at follow-up. None of the studies reported on PROMS. DISCUSSION Although root resection techniques may be used for treating teeth with apical periodontitis, the data are limited. Furthermore, the studies are very heterogeneous and associated with high risk of bias. CONCLUSIONS Given the current level of available evidence, it is not possible to recommend, or dismiss, root resection techniques for managing apical periodontitis. REGISTRATION PROSPERO database (CRD42021260306).
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Affiliation(s)
- Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Clemens Walter
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - Igor Tsesis
- Department of Endodontics, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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Zhao D, Xie W, Li T, Wang A, Wu L, Kang W, Wang L, Guo S, Tang X, Xie S. New-designed 3D printed surgical guide promotes the accuracy of endodontic microsurgery: a study of 14 upper anterior teeth. Sci Rep 2023; 13:15512. [PMID: 37726360 PMCID: PMC10509208 DOI: 10.1038/s41598-023-42767-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 09/14/2023] [Indexed: 09/21/2023] Open
Abstract
We aimed to design a novel three-dimensional (3D) printed surgical guide and evaluate its accuracy in assisting endodontic microsurgeries. A new 3D printed surgical guide was designed by computer-aided design and computer-aided manufacturing (CAD/CAM) technology and applied to 7 patients who underwent endodontic microsurgeries of upper anterior teeth from 2020.01 to 2020.12 as the experimental group. 7 patients who suffered from endodontic microsurgeries operated by the same surgeon without using the surgical guide from 2019.01 to 2019.12 were selected as the control group. Cone beam computed tomography (CBCT) was performed more than 12 months after operation, and the accuracy of apical resection was compared between the two groups. The accuracy of the microsurgery focused on the length and angle of the root apical resection. In the study, CBCT data and oral digital scanning data were used to reconstruct 3D models of periapical lesions with soft and hard tissue information, based on which we designed the new 3D printed surgical guides. The guides were successfully applied to the apectomy in endodontic microsurgeries. The deviation of the apical resection length of the experimental group (0.467 ± 0.146 mm) was better than that of the control group (1.743 ± 0.122 mm) (P < 0.0001), and the deviation of the apical resection angle of the experimental group (9.711 ± 3.593°) was significantly less than that of the control group (22.400 ± 3.362°) (P < 0.0001). The 3D-printed surgical guide could effectively guide endodontic microsurgery and improve its accuracy by fixing both the position and the angle of apectomy. The new type of surgical guide could accurately localize the root apex and guide the apical resection.
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Affiliation(s)
- Dan Zhao
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Weige Xie
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Tianguo Li
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Anqi Wang
- Nanjing Tongren Hospital, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Li Wu
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Wen Kang
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Lu Wang
- Nantong Stomatological Hospital, The Affiliated Nantong Stomatological Hospital of Nantong University, Nantong, 226000, Jiangsu, People's Republic of China
| | - Shiliang Guo
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Xuna Tang
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Sijing Xie
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China.
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Baruwa AO, Martins JNR, Pires MD, Pereira B, Cruz PM, Ginjeira A. Management of Apico-marginal Defects With Endodontic Microsurgery and Guided Tissue Regeneration: A Report of Thirteen Cases. J Endod 2023; 49:1207-1215. [PMID: 37468061 DOI: 10.1016/j.joen.2023.07.009] [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: 05/20/2023] [Revised: 07/06/2023] [Accepted: 07/09/2023] [Indexed: 07/21/2023]
Abstract
The loss of periodontal tissue support and vertical buccal bone loss in apico-marginal defects can often be mistaken for features indicative of vertical root fractures and this study reports thirteen cases with persistent symptomatic apical periodontitis, apico-marginal defects, and large periapical lesions that were managed with endodontic microsurgery in conjunction with bone grafts and barrier placements with a follow-up period of up to 9 years. At the recall sessions, all cases were asymptomatic with radiographical success with only 2 cases exhibiting residual apical radiolucency, but with evident reduction in the lesion size, indicative of healing. This study highlights the potential of utilizing endodontic microsurgery combined with guided tissue regeneration that proved effective in stimulating the regeneration of periodontal tissue in cases of apico-marginal defects that can lead to favourable long-term outcomes.
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Affiliation(s)
- Abayomi O Baruwa
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.
| | - Jorge N R Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal; Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal; Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Mariana D Pires
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Beatriz Pereira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Pedro May Cruz
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - António Ginjeira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal; Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
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Chen C, Zhang R, Zhang W, Li F, Wang Z, Qin L, Chen Y, Bian Z, Meng L. Clinical and radiological outcomes of dynamic navigation in endodontic microsurgery: a prospective study. Clin Oral Investig 2023; 27:5317-5329. [PMID: 37530891 PMCID: PMC10492757 DOI: 10.1007/s00784-023-05152-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES This study was aimed at evaluating the clinical and radiological outcomes of novel dynamic navigation (DN)-aided endodontic microsurgery (EMS), with an analysis of potential prognostic factors. MATERIALS AND METHODS Forty-six teeth from 32 patients who received DN-aided EMS were included. Clinical and radiographic assessments were performed at least 1 year postoperatively. Two calibrated endodontists assessed radiological outcomes according to two-dimensional (2D) periapical radiography (PA) and three-dimensional (3D) cone-beam computed tomography (CBCT) imaging using Rud's and Molven's criteria and modified PENN 3D criteria, respectively. Fisher's exact test was used for statistical analysis of the predisposing factors. RESULTS Of the 32 patients with 46 treated teeth, 28 with 40 teeth were available for follow-up. Of the 28 patients, four (five teeth) refused to undergo CBCT and only underwent clinical and PA examinations, and the remaining 24 (35 teeth) underwent clinical, PA, and CBCT examinations. Combined clinical and radiographic data revealed a 95% (38/40) success rate in 2D healing evaluations and a 94.3% (33/35) success rate in 3D healing evaluations. No significant effect was found in sex, age, tooth type, arch type, preoperative lesion volume, preoperative maximum lesion size, presence/absence of crown and post, and the root canal filling state on the outcome of DN-aided EMS. CONCLUSIONS DN-aided EMS has a favorable prognosis and could be considered an effective and reliable treatment strategy. Further investigations with larger sample sizes are required to confirm these results. CLINICAL RELEVANCE DN-aided EMS could be considered an effective and reliable treatment strategy.
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Affiliation(s)
- Chen Chen
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Rui Zhang
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Zhang
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fangzhe Li
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zan Wang
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Li Qin
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yun Chen
- Suzhou Digital-Health Care Co. Ltd, Suzhou, China
| | - Zhuan Bian
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Liuyan Meng
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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Thanatipanont N, Louwakul P. Comparison of Marginal Adaptation, Surface Hardness and Bond Strength of Resected and Retrofilled Calcium Silicate-based Cements Used in Endodontic Surgery: An In Vitro Study. J Contemp Dent Pract 2023; 24:638-644. [PMID: 38152935 DOI: 10.5005/jp-journals-10024-3562] [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] [Indexed: 12/29/2023]
Abstract
AIMS This study compared the effects of orthograde and retrograde methods on marginal adaptation, surface hardness, and push-out bond strength (POBS) of three calcium silicate-based used in endodontic surgery. MATERIALS AND METHODS Ninety single-rooted human mandibular premolars were randomly assigned into six groups (n = 15/group): groups I and II, ProRoot mineral trioxide aggregate (MTA) with orthograde and retrograde methods; groups III and IV, Biodentine (BD) with orthograde and retrograde methods; groups V and VI, iRoot BP Plus (BP-RPM) with orthograde and retrograde methods. After obturation, the apical 3 mm of each root was sectioned into two 1-mm-thick root slices and evaluated for marginal adaptation using a scanning electron microscope, surface hardness using Vickers hardness tester and POBS using a universal testing machine. RESULTS Orthograde placement had a higher maximum gap width than retrograde placement (p < 0.05), but there was no significant difference among the tested materials (p > 0.05). Biodentine exhibited lower surface hardness than ProRoot MTA and iRoot BP Plus (p < 0.05), but there was no significant difference between ProRoot MTA and iRoot BP Plus (p > 0.05). Orthograde placement had higher POBS compared with retrograde placement (p < 0.05). Biodentine had higher POBS than iRoot BP Plus (p < 0.05), but no significant difference from ProRoot MTA (p > 0.05). The failure mode was mainly mixed for all the tested materials regardless of material type or placement technique. CONCLUSION The retrograde method had better marginal adaptation; however, the orthograde method provided better dislodgement resistance. Biodentine had lower surface hardness than MTA and iRoot BP Plus with both techniques, whereas iRoot BP Plus demonstrated lower dislodging resistance than BD. CLINICAL SIGNIFICANCE The current findings suggest that orthograde technique, a simpler periapical surgery, with ProRoot MTA provides potentially better surface hardness and POBS than BD and iRoot BP Plus in single-canal teeth.
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Affiliation(s)
- Napassorn Thanatipanont
- Department of Restorative Dentistry and Periodontology, Division of Endodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand, https://orcid.org/0009-0008-3013-7362
| | - Phumisak Louwakul
- Department of Restorative Dentistry and Periodontology, Division of Endodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand, Phone: +66-53-944457, e-mail: , https://orcid.org/0000-0003-1776-6697
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Singi SR, Ikhar A, Sibal A, Reche A, Madhu PP. Unveiling Hidden Canals: Middle Mesial Canal Prevalence in Mandibular First Molars Using Cone-Beam Computed Tomography Analysis in Central India. Cureus 2023; 15:e45944. [PMID: 37885509 PMCID: PMC10599634 DOI: 10.7759/cureus.45944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
Background The most frequent reason involving failure of root canal treatment in molar teeth is the inability to locate additional canals. While much research has been conducted on the morphology of mandibular molars, little is known about isthmuses and middle mesial (MM) canals in the Indian population. The primary aim of the present research was to determine the prevalence of MM canals and isthmuses of mandibular first molars in the Central India population using cone-beam computed tomography (CBCT) images. Methodology CBCT of 140 mandibular first molar teeth was analyzed from the institutional database images in the coronal, sagittal, and axial planes. Data concerning the number of root canals, the presence of middle mesial canals, and the presence of isthmus were noted. Information collected was transferred into an Excel sheet and analyzed using the Statistical Package for Social Sciences (IBM Corp., Armonk, NY, USA). Results Eight images (5.71%) revealed the presence of middle mesial canals with no statistically significant occurrence. The incidence of isthmi in the mandibular first molar was 84.3%, and the presence of isthmi in the coronal third was about 38.6%. This showed a considerable presence. Conclusion There is incidence of the middle mesial canal, which emphasizes the need to locate extra canals in patients undergoing root canal endodontic treatment. The implementation of CBCT will help identify the extra canal before the treatment. This will help ultimately in providing better patient care.
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Affiliation(s)
- Shriya R Singi
- Department of Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Anuja Ikhar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Akash Sibal
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Amit Reche
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Priyanka P Madhu
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
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Javed F, Zafar K, Khan FR. Outcome of intentional replantation of endodontically treated teeth with periapical pathosis: A systematic review and meta-analysis. AUST ENDOD J 2023; 49 Suppl 1:494-507. [PMID: 36354086 DOI: 10.1111/aej.12707] [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: 12/09/2021] [Revised: 08/02/2022] [Accepted: 10/23/2022] [Indexed: 11/11/2022]
Abstract
The purpose of the present review was to examine success, survival and failure following intentional replantation of endodontically treated teeth with existing periapical pathosis and to determine the factors that might affect the outcome of replantation. Clinical trials, longitudinal studies, case series with >10 cases and at least 1-year follow-up were included. The average rate of success following intentional replantation was 77.23%. Meta-analysis revealed the mean weighted survival to be 85.9% (95% CI: 79.6-91.2) Common complications include inflammatory root resorption (0%-27%) and ankylosis (0%-25%). Variables influencing successful outcome include extra alveolar dry time <15 min; root-end resection (2-3 mm) and cavity preparation (3 mm); manipulation of the tooth using the crown only; and use of an appropriate storage media. The review concludes that intentional replantation is a viable treatment option with acceptable survival rates for endodontically treated teeth with periapical pathosis.
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Affiliation(s)
- Faizan Javed
- Operative Dentistry & Endodontics, The Aga Khan University, Karachi, Pakistan
| | - Kamil Zafar
- Endodontics, Baqai Dental College, Karachi, Pakistan
| | - Farhan R Khan
- Operative Dentistry & Endodontics, The Aga Khan University, Karachi, Pakistan
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Li N, Zhang R, Qiao W, Meng L. Conservative endodontic microsurgery to protect critical anatomical structures-selective curettage: a case series. BMC Oral Health 2023; 23:615. [PMID: 37653381 PMCID: PMC10470014 DOI: 10.1186/s12903-023-03287-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/04/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Endodontic microsurgery has yielded highly successful outcomes in preserving teeth with persistent or recurrent cases of periapical periodontitis that could not be successfully treated by nonsurgical endodontic approaches. To avoid complications in conditions in which periapical lesions invade anatomical structures such as the nasopalatine nerve tube and mandibular canal, selective curettage has been proposed as an alternative choice of complete curettage in surgery. CASE PRESENTATION The 8 cases reported herein had undergone root canal treatment and/or retreatment but still presented with symptoms, such as recurring sinus tracts and persistent dull pain. The radiographic examination indicated a large area of radiolucency that was associated with the tooth and had invaded adjacent critical anatomical structures. The patients opted for selective curettage via endodontic microsurgery, and the lesions were histologically confirmed as periapical cysts or granulomas. The follow-up results for one year or more indicated that the affected teeth were clinically asymptomatic and exhibited complete or incomplete healing radiographically. CONCLUSION This case series provides clinical evidence for the feasibility of selective curettage in endodontic microsurgery, which can avoid complications caused by damage to the adjacent critical anatomical structures.
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Affiliation(s)
- Nan Li
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Rui Zhang
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Weiwei Qiao
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Liuyan Meng
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China.
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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50
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Rangics A, Répássy GD, Gyulai-Gaál S, Dobó-Nagy C, Tamás L, Simonffy L. Management of Odontogenic Sinusitis: Results with Single-Step FESS and Dentoalveolar Surgery. J Pers Med 2023; 13:1291. [PMID: 37763059 PMCID: PMC10532572 DOI: 10.3390/jpm13091291] [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: 07/16/2023] [Revised: 08/20/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVE Odontogenic sinusitis (OS) is a well-known and important border of specialties in otorhinolaryngology and dentoalveolar surgery. Odontogenic sinusitis can develop due to iatrogenic harm or odontogenic infection. The gold standard diagnostic method is clinical and radiological-CBCT (cone beam computed tomography)-examination. The treatment of this condition requires collaboration between ENT and dentoalveolar surgery specialists and can be non-surgical or surgical based on staging. This paper aims to share the results of our clinical study whereby complex therapy was administered by a dentoalveolar surgeon and an otorhinolaryngologist in cooperation. PATIENTS AND METHODS We conducted a retrospective study comprising 111 OS patients who underwent complex therapy between 2016 and 2023 at Semmelweis University, Budapest, Hungary. All patients were treated with concurrent FESS (functional endoscopic sinus surgery) and dentoalveolar surgery. Follow-up was based on symptoms, clinical examination and CBCT imaging. RESULTS Of the 111 patients, 107 were successfully treated with concurrent FESS and dentoalveolar surgery, and only 4 had further symptoms following the complex therapy and needed retreatment. CONCLUSIONS The complex, single-session therapy involving FESS and oral surgery is an effective treatment method, which is less invasive and associated with fewer complications compared to previous interventions, such as the Luc-Caldwell procedure.
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Affiliation(s)
- Anna Rangics
- Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary; (A.R.); (S.G.-G.); (C.D.-N.); (L.S.)
| | - Gábor Dénes Répássy
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary;
| | - Szabolcs Gyulai-Gaál
- Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary; (A.R.); (S.G.-G.); (C.D.-N.); (L.S.)
| | - Csaba Dobó-Nagy
- Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary; (A.R.); (S.G.-G.); (C.D.-N.); (L.S.)
| | - László Tamás
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary;
- Department of Voice Speech and Swallowing Therapy, Faculty of Health Sciences, Semmelweis University, 1085 Budapest, Hungary
| | - László Simonffy
- Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary; (A.R.); (S.G.-G.); (C.D.-N.); (L.S.)
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