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Huang X, Ge X, Fu W, Zhang Z, Xiao K, Lv H. Effects of Novel Nanoparticulate Bioceramic Endodontic Material on Human Dental Pulp Stem Cells In Vitro. Int Dent J 2024; 74:482-491. [PMID: 38431469 PMCID: PMC11123531 DOI: 10.1016/j.identj.2023.12.008] [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: 05/22/2023] [Revised: 12/13/2023] [Accepted: 12/22/2023] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVES This study aimed to investigate the in vitro effects of root canal filling and repair paste (nRoot BP) on human dental pulp stem cells (hDPSCs). METHODS The effects of nRoot BP and iRoot BP Plus on the adhesion, proliferation, migration, and differentiation of hDPSCs were examined in vitro for 72 hours. The adhesion of cells was observed using immunofluorescence rhodamine ghost pen cyclic peptide staining and scanning electron microscopy (SEM). Cell density and changes in migration area were measured under a fluorescence inverted microscope. Fluorescent quantitative PCR was performed to detect genes related to odontogenesis and osteogenesis. RESULTS Cells adhering to the surfaces of nRoot BP and iRoot BP Plus exhibited similar irregular polygonal morphologies, with cells extending irregular pseudopods to adhere to the materials. CCK-8 results indicated that the density of living cells for nRoot BP and iRoot BP Plus was lower than that of the blank control group at 3 and 5 days of culture. There was no significant difference in cell migration between the groups (P > .05). The migration ability of iRoot BP Plus and nRoot BP was similar to that of the control group. Both nRoot BP and iRoot BP Plus increased the expression of the RUNX2 gene, but there was no significant difference between the groups (P < .05). Furthermore, both nRoot BP and iRoot BP Plus downregulated the expression of the DSPP gene, with no significant difference between them (P > .05). CONCLUSIONS nRoot BP exhibited a slight inhibition of hDPSC proliferation but did not affect the adhesion and migration of hDPSCs. The impact of nRoot BP on the osteogenic and odontogenic differentiation of hDPSCs was similar to that of iRoot BP Plus.
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Affiliation(s)
- Xinhui Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Xinting Ge
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Weihao Fu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Zonghao Zhang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Kuancheng Xiao
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Hongbing Lv
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China; School and Hospital of Stomatology, Fujian Medical University, China.
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Sousa GH, Gonçalves RL, Figueiredo B, Dias VCM, Mendes ACS, de Cássia Bueno Melo V, Rodrigues AG, dos Santos Chaves HG. Exploring vital pulp Therapies: A bibliometric analysis of the most cited articles. Saudi Dent J 2024; 36:778-788. [PMID: 38766288 PMCID: PMC11096604 DOI: 10.1016/j.sdentj.2024.02.007] [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: 11/27/2023] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 05/22/2024] Open
Abstract
Aim The aim of this study was to identify and analyze the most cited articles on vital pulp therapies. Methodology Bibliographical data related to the abstract, citations, keywords, and other relevant information was extracted using different combinations of keywords. Further evaluation and visualization of the selected data were performed with the help of various tools, including MS Excel, Microsoft Word, Google open refine, BibExcel, and VOS viewer. An initial search revealed 91 documents, of which 40 were chosen for further analysis. We used the Kolmogorov-Smirnov test and Spearman correlation coefficient test, and our adopted significance level was p < 0.05. Results In total, the articles received 1,905 citations, with six of them receiving at least 100 citations. Among the top 40 articles, the United States of America (10 articles) and Ireland (6 articles) were the countries with the highest number of cited articles. The journals "Journal of Endodontics" (14 articles; 650 citations) and "International Endodontic Journal" (13 articles; 577 citations) published most of the articles among the 50 most cited ones. Duncan H. was the author with the highest number of works cited (11 articles; 339 citations). Of the articles, systematic reviews accounted for 32%, literature reviews for 14%, in vitro experimental studies for 12%, clinical trials for 8%. Among the biomaterials used in vital pulp therapies, mineral trioxide aggregate (MTA) was discussed in 37 articles (74%), followed by calcium hydroxide, mentioned in 30 studies (60%). Interestingly, the publication year did not demonstrate a significant impact on citation count. Conclusion The present study provided a detailed list of the top 50 most cited and classic articles on vital pulp therapies. This will help researchers, students, and clinicians in the field of endodontics with an impressive source of information.
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Affiliation(s)
- Gustavo Henrique Sousa
- Postgraduate Department in Endodontics, Faculdades Unidas do Norte de Minas, Campus Funorte – Montes Claros, MG, Brazil
| | - Rodolfo Lima Gonçalves
- School of Dentistry, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
| | - Barbara Figueiredo
- Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Vilton Cardozo Moreira Dias
- Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ana Carolina Soares Mendes
- Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Valéria de Cássia Bueno Melo
- Postgraduate Department in Endodontics, Faculdades Unidas do Norte de Minas, Campus Funorte – Montes Claros, MG, Brazil
| | - Adriana Guimarães Rodrigues
- Postgraduate Department in Endodontics, Faculdades Unidas do Norte de Minas, Campus Funorte – Montes Claros, MG, Brazil
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Gabriel EM, Priyadharshini SS, Sherwood IA, Deepika G, Ragavendran C, Murugadoss V. Treatment outcome of coronal pulpotomy and indirect pulp capping in mature permanent molars with symptoms of moderate pulpitis: A randomized clinical trial. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:434-441. [PMID: 38779201 PMCID: PMC11108425 DOI: 10.4103/jcde.jcde_63_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: 02/08/2024] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 05/25/2024]
Abstract
Aim This clinical trial aimed to compare the clinical success of coronal pulpotomy and indirect pulp capping (IPC) in managing symptomatic deep proximal caries in molars with moderate pulpitis over a 12-month period. Materials and Methods A total of 108 vital mature permanent molars with moderate pulpitis were randomly allocated to the IPC (n = 54) or coronal pulpotomy group (n = 54). Dycal and Biodentine were used as pulp-capping materials, followed by composite restoration. The absence of periapical infection and asymptomatic teeth that positively responded to the cold pulp sensitivity test (only in IPC) was considered posttreatment success at 12 months. Data from the study were analyzed using the Chi-square test and Kaplan-Meier survival analysis. Results There was a statistically significant difference between preoperative symptoms and the cold pulp sensibility test response (P = 0.000), indicating an association between symptoms and pulp sensibility. The average remaining dentine thickness (RDT) value was 0.48 ± 0.5 mm, with no statistically significant difference found between the location of caries and RDT (P = 0.084, P > 0.05). Compared to the IPC group, the pulpotomy group had a greater number of patients at 12 months after treatment that required no intervention. The Kaplan-Meier survival analysis revealed that the mean survival duration for pulpotomy was 48 weeks, and for IPC, it was 42.3 ± 2.35 weeks. Conclusion Coronal pulpotomy with Biodentine proved more effective in reducing symptoms, achieving radiographic success, and ensuring tooth survival compared to IPC with calcium hydroxide.
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Affiliation(s)
- E. Melvin Gabriel
- Department of Conservative Dentistry and Enodontics, C. S. I. College of Dental Sciences and Research, Madurai, India
| | | | - I. Anand Sherwood
- Department of Conservative Dentistry and Enodontics, C. S. I. College of Dental Sciences and Research, Madurai, India
| | - Geeth Deepika
- Department of Conservative Dentistry and Enodontics, C. S. I. College of Dental Sciences and Research, Madurai, India
| | - Chinnasamy Ragavendran
- Department of Cariology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
| | - Vaanjay Murugadoss
- Department of Conservative Dentistry and Enodontics, C. S. I. College of Dental Sciences and Research, Madurai, India
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ArakkalVettath MR, Alshehri Y, Alshehri FS, Alyeezadi M, Kumar P, Almuthhin M, Alzahrani EI, Alruwaili RHG. Apexogenesis of an Immature Permanent Molar with Irreversible Pulpitis Using Mineral Trioxide Aggregate Pulpotomy: A Case Report. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S1863-S1866. [PMID: 38882828 PMCID: PMC11174230 DOI: 10.4103/jpbs.jpbs_1109_23] [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: 10/26/2023] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 06/18/2024] Open
Abstract
Carious exposure of an irreversibly inflamed vital pulp in a young permanent tooth presents a significant clinical challenge to clinicians to maintain the vitality. Direct pulp capping, partial pulpotomy, and complete pulpotomy are the available procedures to treat young permanent tooth. Mineral trioxide aggregate and biodentine are currently the material of choice for these procedures. The present case report describes the successful apexogenesis of mandibular left first permanent molar using mineral trioxide aggregate. The 18-month follow-up of the case demonstrated clinical and radiographic success with absence of any signs and symptoms and continued root formation.
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Affiliation(s)
- Mohamed Rahoof ArakkalVettath
- Department of Pediatric Dentistry, Tabuk Specialist Dental Centre, Ministry of Health in Tabuk City, Tabuk, Saudi Arabia
| | - Yousef Alshehri
- Department of Pediatric Dentistry, Tabuk Specialist Dental Centre, Ministry of Health in Tabuk City, Tabuk, Saudi Arabia
| | - Faisal S Alshehri
- Department of Pediatric Dentistry, Tabuk Specialist Dental Centre, Ministry of Health in Tabuk City, Tabuk, Saudi Arabia
| | - Mazen Alyeezadi
- Department of Pediatric Dentistry, Tabuk Specialist Dental Centre, Ministry of Health in Tabuk City, Tabuk, Saudi Arabia
| | - Pavan Kumar
- Department of Pediatric Dentistry, Tabuk Specialist Dental Centre, Ministry of Health in Tabuk City, Tabuk, Saudi Arabia
| | - Muthhin Almuthhin
- Department of Pediatric Dentistry, Tabuk Specialist Dental Centre, Ministry of Health in Tabuk City, Tabuk, Saudi Arabia
| | - Eman I Alzahrani
- Department of Pediatric Dentistry, Tabuk Specialist Dental Centre, Ministry of Health in Tabuk City, Tabuk, Saudi Arabia
| | - Rola H Gadoe Alruwaili
- Department of Pediatric Dentistry, Tabuk Specialist Dental Centre, Ministry of Health in Tabuk City, Tabuk, Saudi Arabia
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Philip N, Suneja B. Minimally invasive endodontics: a new era for pulpotomy in mature permanent teeth. Br Dent J 2022; 233:1035-1041. [PMID: 36526777 PMCID: PMC9758046 DOI: 10.1038/s41415-022-5316-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/08/2022] [Indexed: 12/23/2022]
Abstract
Emerging clinical and histologic evidence is challenging the long-established dogma that root canal treatment (RCTx) is the only therapeutic option for preservation of vital mature permanent teeth diagnosed with irreversible pulpitis or carious pulp exposure. Vital pulp therapy procedures like pulpotomy are not only technically simpler and more economical, but also afford patients a host of other benefits over conventional RCTx. This narrative review provides an update on the contemporary understanding of pulp pathophysiology and defence mechanisms, the proposed new diagnostic terminologies for pulpal inflammation, and how the biological characteristics of hydrophilic calcium silicate cements have enabled consistent successful outcomes for pulpotomy-treated mature teeth. The paper also details the evidence base from clinical trials and systematic reviews conducted over the past decade and outlines the practical treatment considerations for pulpotomy in mature permanent teeth.
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Affiliation(s)
- Nebu Philip
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar.
| | - Bharat Suneja
- Baba Jaswant Singh Dental College and Hospital, Ludhiana, India
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Radwanski M, Caporossi C, Lukomska-Szymanska M, Luzi A, Sauro S. Complicated Crown Fracture of Permanent Incisors: A Conservative Treatment Case Report and a Narrative Review. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9090481. [PMID: 36135027 PMCID: PMC9495796 DOI: 10.3390/bioengineering9090481] [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: 07/19/2022] [Revised: 09/04/2022] [Accepted: 09/13/2022] [Indexed: 12/03/2022]
Abstract
Dental trauma may have a severe impact on the social and psychological wellbeing of a patient. Most cases of dental injuries involve anterior teeth, especially the maxillary upper incisors. Crown fractures, with or without pulp exposure, are the most common trauma in permanent dentition. There are many methods of management, in which the initial state of the pulp, the time since the injury, and the presence of an accompanying injury play a key role. This case report aimed at showing a possible conservative treatment after complicated tooth fracture that consisted of partial pulpotomy followed by adhesive reattachment of the tooth fragment using a technique based on heated resin composite. Such a specific procedure represents a conservative approach to traumatic coronal lesions, providing a suitable opportunity to maintain the tooth vitality, aesthetics, and function. Indeed, reattachment of tooth fragment using a composite/adhesive is a simple technique to achieve excellent results in terms of aesthetic and function.
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Affiliation(s)
- Mateusz Radwanski
- Department of Endodontics Chair, Conservative Dentistry, Endodontics Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland
| | | | - Monika Lukomska-Szymanska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland
- Correspondence: (M.L.-S.); (S.S.); Tel.: +48-426-757461 (M.L.-S.)
| | - Arlinda Luzi
- Group of Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain
| | - Salvatore Sauro
- Group of Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain
- Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
- Correspondence: (M.L.-S.); (S.S.); Tel.: +48-426-757461 (M.L.-S.)
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Cells and material-based strategies for regenerative endodontics. Bioact Mater 2022; 14:234-249. [PMID: 35310358 PMCID: PMC8897646 DOI: 10.1016/j.bioactmat.2021.11.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 10/29/2021] [Accepted: 11/09/2021] [Indexed: 12/21/2022] Open
Abstract
<p class = "Abstract" style = "margin: 0 cm; line-height: 32px; font-size: 12 pt; font-family: "Times New Roman", serif; color: rgb(0, 0, 0); "><span lang = "EN-US">The carious process leads to inflammation of pulp tissue. Current care options include root canal treatment or apexification. These procedures, however, result in the loss of tooth vitality, sensitivity, and healing. Pulp capping and dental pulp regeneration are continually evolving techniques to regenerate pulp tissue, avoiding necrosis and loss of vitality. Many studies have successfully employed stem/progenitor cell populations, revascularization approaches, scaffolds or material-based strategies for pulp regeneration. Here we outline advantages and disadvantages of different methods and techniques which are currently being used in the field of regenerative endodontics. We also summarize recent findings on efficacious peptide-based materials which target the dental niche.<o:p></o:p></span></p> Pulp infection necessitates removal of necrotic, inflamed and infected tissue. Materials used clinically are inert (such as gutta percha, mineral trioxide aggregate). Recent developments in materials (angiogenic hydrogels, stem cell composites) have tuneable bioactivity. Dental pulp regeneration may now be possible through the use of bioactive systems, that guide regeneration.
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Albaiti SS, Albishri RF, Alhowig MT, Tayyar WI, Alqurashi NF, Alghamdi FT. Partial Pulpotomy as an Applicable Treatment Option for Cariously Exposed Posterior Permanent Teeth: A Systematic Review of Randomized Clinical Trials. Cureus 2022; 14:e26573. [PMID: 35936176 PMCID: PMC9351822 DOI: 10.7759/cureus.26573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2022] [Indexed: 12/03/2022] Open
Abstract
The major focus of this systematic review is to assess how effective partial pulpotomy is in managing carious vital pulp exposures in permanent posterior teeth. An electronic search for studies published between January 2011 and December 2021 was conducted using the following databases: PubMed, Scopus, Google Scholar, and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria were followed during the search process. We selected human randomized clinical trials (RCTs) that investigated the success rate of partial pulpotomy for the treatment of cariously exposed vital permanent posterior teeth and the success rate of decayed exposed vital human permanent posterior dentition managed with a partial pulpotomy. Exclusively, randomized clinical trial papers were considered for assessment. The Cochrane Collaboration’s tool was applied to assess the risk of bias. Four papers were selected for the final analysis from the 321 identified during the initial search. Our results showed that after six, 12, and 24 months of follow-up, the success rate was 94%, 93%, and 90%, respectively. The preoperative pulp state was the only significant predictive factor. Teeth with the presumptive diagnosis of irreversible pulpitis had the worse outcome. The treatment outcome was not influenced by the final restoration, pulp capping agent, apex closure, or patient age. Finally, the available data indicated that partial pulpotomy showed a high success rate in treating cariously exposed permanent posterior teeth for up to 24 months. When assessing the effectiveness of a partial pulpotomy, six months of maintenance is deemed adequate. To enhance treatment success, additional clinical and radiological measures are needed.
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Vu TT, Nguyen MT, Sangvanich P, Thunyakitpisal P. Pulse Oximetry and Three-Dimensional Analysis in Evaluating Immature Permanent Teeth Apexogenesis: Two Case Reports. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2112271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Apexogenesis is a vital pulp therapy that aims to preserve pulp vitality and maintain root formation in not-fully-formed permanent teeth with exposed pulp from trauma or caries. To achieve success, reliable diagnostic tools are required to assess the pulp health and tooth development stage, design an appropriate treatment plan and evaluation, and follow-up. Pulse oximetry is a non-invasive method for monitoring pulp oxygen saturation, which corresponds to pulp vitality.
Case Presentation:
This case report describes the successful apexogenesis of two pulp exposure-immature permanent teeth treated with acemannan, an implantable natural biomaterial extracted from aloe vera. Based on pulp oxygen saturation level, clinical evaluation, and radiographic examination, the teeth were asymptomatic with preserved pulp vitality and continued root development.
Conclusion:
Therefore, as an auxiliary tool, pulse oximetry could be useful for diagnosis, treatment, and follow-ups of apexogenesis therapy.
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Vitali FC, Pires KM, Cardoso IV, Oliveira EVD, Bolan M, Martins Júnior PA, Cardoso M. Endodontic therapy in primary teeth: a bibliometric analysis of the 100 most-cited papers. Braz Oral Res 2022; 36:e049. [DOI: 10.1590/1807-3107bor-2022.vol36.0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 01/13/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | - Michele Bolan
- Universidade Federal de Santa Catarina – UFSC, Brazil
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Ahmed MI, El Hilaly Mohamed Eid G, Youssef HA. Clinical and Radiographic Assessments of Potassium Nitrate in Polycarboxylate Versus Mineral Trioxide Aggregate as Pulpotomy Biomaterials in Immature Mandibular First Permanent Molars: A Randomized Clinical Trial. J Endod 2021; 47:1672-1682. [PMID: 34478788 DOI: 10.1016/j.joen.2021.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The purpose of this study was to compare clinically and radiographically the effects of potassium nitrate in polycarboxylate cement and mineral trioxide aggregate (MTA) as pulpotomy agents in vital immature mandibular first molars. METHODS The trial design was a parallel randomized, 1:1 allocation ratio, with both the participants and the data assessor blinded. A total of 50 molars of 48 eligible children aged 6-9 years were studied. The children had mandibular immature first molars with extensive caries that revealed pulp exposure during caries excavation. Patients were randomly allocated equally into 2 groups in which potassium nitrate in polycarboxylate cement (the intervention group) and MTA (the control group) were used as pulpotomy biomaterials. The treated teeth were restored permanently. The primary outcome was clinical/radiographic assessment after 1 week, 6 months, and 12 months. The secondary outcomes were radiometric analysis at 6 and 12 months to determine dimensional changes during maturogenesis. The digital radiographs were imported to image processing software to perform radiometric measurements. Data were tabulated and statistically analyzed with significance set at P ≤ .05. RESULTS Only a single tooth failed at the 6-month recall, and another one was lost during recall in each group. Thus, the overall success rate for cases/group who finally attended the 12-month follow-up time point was 92% (23/25) with no statistically significant difference between the 2 groups. At the 12-month recall, successful cases showed root development with an increase in root length and a decrease in apical foramen width. Complete apical closure was observed in 65.2% of the roots in the intervention group and 52.1% in the control group. CONCLUSIONS The clinical and radiographic success reported in the present study reveals that potassium nitrate in polycarboxylate cement could be used as a biological and economic alternative to MTA as a pulpotomy agent in vital immature mandibular first molars. Further follow-up for longer periods is recommended.
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Affiliation(s)
| | | | - Hamdy Adly Youssef
- Faculty of Dentistry, Department of Endodontics, Cairo University, Cairo, Egypt
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Sanz JL, Soler-Doria A, López-García S, García-Bernal D, Rodríguez-Lozano FJ, Lozano A, Llena C, Forner L, Guerrero-Gironés J, Melo M. Comparative Biological Properties and Mineralization Potential of 3 Endodontic Materials for Vital Pulp Therapy: Theracal PT, Theracal LC, and Biodentine on Human Dental Pulp Stem Cells. J Endod 2021; 47:1896-1906. [PMID: 34425148 DOI: 10.1016/j.joen.2021.08.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/01/2021] [Accepted: 08/03/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The aim of this study was to assess the biological properties and mineralization potential of the new Theracal PT (Bisco Inc, Schaumburg, IL) compared with its predecessor Theracal LC (Bisco Inc) and the hydraulic silicate-based cement Biodentine (Septodont, Saint-Maur-des-Fossés, France) on human dental pulp stem cells (hDPSCs) in vitro. METHODS Standardized sample discs were obtained for each material (n = 30) together with 1:1, 1:2, and 1:4 material eluates. Previously characterized hDPSCs were cultured with the different materials in standardized conditions, and the following assays were performed: a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, a wound healing assay, Annexin-V-FITC and 7-AAD staining (BD Biosciences, San Jose, CA), reactive oxygen species production analysis, cell adhesion and morphology evaluation via scanning electron microscopy and immunofluorescence, quantification of the expression of osteo/odontogenic markers via real-time quantitative reverse-transcriptase polymerase chain reaction, and alizarin red S staining. Statistical significance was established at P < .05. RESULTS All of the tested dilutions of Theracal LC exhibited a significantly higher cytotoxicity and reactive oxygen species production (P < .001) and a lower cell migration rate than the control group (hDPSCs cultured in growth medium without material extracts) at all of the measured time points (P < .001). Both 1:4 Theracal PT and Biodentine-treated hDPSCs exhibited similar levels of cytocompatibility to that of the control group, a significant up-regulation of at least 1 odontogenic marker (Biodentine: dentin sialophosphoprotein (P < .05); Theracal PT: osteonectin and runt-related transcription factor 2 [P < .001]), and a significantly higher mineralized nodule formation (P < .001). CONCLUSIONS The newly introduced TheraCal PT offers an improved in vitro cytocompatibility and mineralization potential on hDPSCs compared with its predecessor, TheraCal LC, and comparable biological properties to Biodentine.
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Affiliation(s)
- José Luis Sanz
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, Valencia, Spain
| | - Anna Soler-Doria
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, Valencia, Spain
| | - Sergio López-García
- Hematopoietic Transplant and Cellular Therapy Unit, Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca, IMIB Arrixaca, University of Murcia, Murcia, Spain; Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - David García-Bernal
- Hematopoietic Transplant and Cellular Therapy Unit, Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca, IMIB Arrixaca, University of Murcia, Murcia, Spain
| | - Francisco J Rodríguez-Lozano
- Hematopoietic Transplant and Cellular Therapy Unit, Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca, IMIB Arrixaca, University of Murcia, Murcia, Spain; Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - Adrián Lozano
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, Valencia, Spain
| | - Carmen Llena
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, Valencia, Spain
| | - Leopoldo Forner
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, Valencia, Spain
| | - Julia Guerrero-Gironés
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, Murcia, Spain.
| | - María Melo
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, Valencia, Spain
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Yamada M, Nagayama M, Miyamoto Y, Kawano S, Takitani Y, Tanaka M, Ehara M, Nakao J, Ochiai T, Shibukawa Y, Yoshida T. Mineral Trioxide Aggregate (MTA) Upregulates the Expression of DMP1 in Direct Pulp Capping in the Rat Molar. MATERIALS (BASEL, SWITZERLAND) 2021; 14:4640. [PMID: 34443162 PMCID: PMC8400143 DOI: 10.3390/ma14164640] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/06/2021] [Accepted: 08/13/2021] [Indexed: 02/06/2023]
Abstract
Mineral trioxide aggregate (MTA) is an alternative endodontic material that predicts conductive or inductive calcified tissue formation from immature pulp mesenchymal stem cells (IPMSCs). The purpose of this study was to investigate whether MTA could promote reparative odontoblast differentiation via IPMSCs in the early phase of regeneration and compare with calcium hydroxide (CH). Direct pulp capping using calcium hydroxide (CH), MTA, and MTA with platelet-rich plasma (MTA + PRP) was performed on maxillary first molars of 8-week-old male Wistar rats (n = 36). After 3, 7, or 14 days, the teeth were analyzed for mineral density (MD) and volume of MD (VMD) via micro-focusing computed tomography (µCT), nestin, dentin matrix acidic phosphoprotein 1 (DMP1) immunohistochemistry, and real-time PCR for DMP1 mRNA expression. MTA stimulated the early phase differentiation of the IPMSCs into odontoblasts, with positive results for nestin and DMP1 compared with CH. Moreover, MTA + PRP stimulated calcified granule and dentin bridge formation through calcium mineral deposition, following the induction of DMP1 mRNA expression in IPMSCs. Our results suggested that the combination of MTA and PRP is an effective and clinically applicable method for activating endogenous dental pulp stem cells into odontoblasts in the early stages of pulp regeneration.
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Affiliation(s)
- Maiko Yamada
- Department of Endodontics, Division of Oral Functional Science and Rehabilitation, School of Dentistry, Asahi University, Mizuho, Gifu 501-0296, Japan; (M.Y.); (S.K.); (Y.T.); (M.T.); (T.Y.)
| | - Motohiko Nagayama
- Department of Oral Pathology, Division of Oral Pathogenesis and Disease Control, School of Dentistry, Asahi University, Mizuho, Gifu 501-0296, Japan; (Y.M.); (M.E.); (J.N.); (T.O.)
| | - Yuka Miyamoto
- Department of Oral Pathology, Division of Oral Pathogenesis and Disease Control, School of Dentistry, Asahi University, Mizuho, Gifu 501-0296, Japan; (Y.M.); (M.E.); (J.N.); (T.O.)
| | - Satoshi Kawano
- Department of Endodontics, Division of Oral Functional Science and Rehabilitation, School of Dentistry, Asahi University, Mizuho, Gifu 501-0296, Japan; (M.Y.); (S.K.); (Y.T.); (M.T.); (T.Y.)
| | - Yoshiaki Takitani
- Department of Endodontics, Division of Oral Functional Science and Rehabilitation, School of Dentistry, Asahi University, Mizuho, Gifu 501-0296, Japan; (M.Y.); (S.K.); (Y.T.); (M.T.); (T.Y.)
| | - Masashi Tanaka
- Department of Endodontics, Division of Oral Functional Science and Rehabilitation, School of Dentistry, Asahi University, Mizuho, Gifu 501-0296, Japan; (M.Y.); (S.K.); (Y.T.); (M.T.); (T.Y.)
| | - Michiko Ehara
- Department of Oral Pathology, Division of Oral Pathogenesis and Disease Control, School of Dentistry, Asahi University, Mizuho, Gifu 501-0296, Japan; (Y.M.); (M.E.); (J.N.); (T.O.)
| | - Juna Nakao
- Department of Oral Pathology, Division of Oral Pathogenesis and Disease Control, School of Dentistry, Asahi University, Mizuho, Gifu 501-0296, Japan; (Y.M.); (M.E.); (J.N.); (T.O.)
| | - Takanaga Ochiai
- Department of Oral Pathology, Division of Oral Pathogenesis and Disease Control, School of Dentistry, Asahi University, Mizuho, Gifu 501-0296, Japan; (Y.M.); (M.E.); (J.N.); (T.O.)
| | - Yoshihiro Shibukawa
- Department of Removable Partial Prosthodontics, Tokyo Dental College, Chiyoda-Ku, Tokyo 101-0061, Japan;
| | - Takakazu Yoshida
- Department of Endodontics, Division of Oral Functional Science and Rehabilitation, School of Dentistry, Asahi University, Mizuho, Gifu 501-0296, Japan; (M.Y.); (S.K.); (Y.T.); (M.T.); (T.Y.)
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Tran XV, Ngo LTQ, Boukpessi T. Biodentine TM Full Pulpotomy in Mature Permanent Teeth with Irreversible Pulpitis and Apical Periodontitis. Healthcare (Basel) 2021; 9:720. [PMID: 34204620 PMCID: PMC8231158 DOI: 10.3390/healthcare9060720] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/05/2021] [Accepted: 06/10/2021] [Indexed: 12/29/2022] Open
Abstract
Vital pulp therapy, including direct pulp capping and partial and full pulpotomy, is primarily indicated for immature or mature permanent teeth with reversible pulpitis. Mature permanent teeth with irreversible pulpitis are frequently treated with root canal therapy. This report presents two cases of full pulpotomy using BiodentineTM in mature permanent teeth with irreversible pulpitis and acute apical periodontitis. The periapical radiograph illustrated a deep carious lesion extended to the pulp with apical radiolucency lesion or widened periodontal ligament space. Full pulpotomy with a tricalcium silicate-based cement was chosen as the definitive treatment. After decayed tissue excavation under a rubber dam, the exposed pulp tissue was amputated to the level of the canal orifice with a new sterile bur. BiodentineTM was applied as the pulp capping agent after hemostasis was obtained and for temporary restoration. The clinical signs disappeared quickly after the treatment. After one month, the coronal part of the temporary restoration was removed, and a composite resin was placed over the capping agent as a final restoration. At two-year follow-ups, the teeth were asymptomatic. Radiographs showed healing of the periapical lesion and periodontal ligament. BiodentineTM full pulpotomy of mature permanent teeth with irreversible pulpitis and apical periodontitis can be an alternative option to root canal therapy.
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Affiliation(s)
- Xuan Vinh Tran
- Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City (UMP), 217 Hong Bang, 11 Ward, 5 District, Ho Chi Minh City 70000, Vietnam;
| | - Lan Thi Quynh Ngo
- Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City (UMP), 217 Hong Bang, 11 Ward, 5 District, Ho Chi Minh City 70000, Vietnam;
| | - Tchilalo Boukpessi
- UR 2496 Laboratory of Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry, Université de Paris, 1 rue Maurice Arnoux, 92120 Montrouge, France
- AP-HP Department of Dental Medicine, Charles Foix Hospital, 94200 Ivry sur Seine, France
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R R, Aravind A, Kumar V, Sharma S, Chawla A, Logani A. Influence of occlusal and proximal caries on the outcome of full pulpotomy in permanent mandibular molar teeth with partial irreversible pulpitis: A prospective study. Int Endod J 2021; 54:1699-1707. [PMID: 34101859 DOI: 10.1111/iej.13588] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 01/23/2023]
Abstract
AIM To assess the influence of occlusal and proximal deep carious lesions on the outcome of full pulpotomy performed in mandibular teeth with pulpal diagnosis of symptomatic partial irreversible pulpitis. METHODOLOGY Eighty deep carious mandibular molar teeth with clinical and radiographic diagnosis of symptomatic partial irreversible pulpitis without periapical rarefaction from patients of either gender between the age of 16-35 years were included. Depending upon the location of deep carious lesion, the teeth were distributed equally into occlusal (n = 40) and proximal caries groups (n = 40). Full pulpotomy was performed under local anaesthesia and aseptic conditions. The pulp tissue was removed until the root canal orifices, and 2.5% sodium hypochlorite (NaOCl) was applied to arrest pulpal bleeding. Mineral trioxide aggregate (MTA) was compacted over the radicular pulp. Teeth were restored with resin-modified glass ionomer cement (RMGIC) and bulk-fill composite resin. Pre- and post-operative pain was assessed at 24, 48 and 72 h using a 11-point Numerical Rating Scale (NRS). Patients were followed at 6 and 12 months for clinical and radiographic evaluation. Asymptomatic teeth without any radiographic evidence of periapical rarefaction were considered successful. The data were analysed using the Shapiro-Wilk W test, two-sample Wilcoxon rank-sum test, Pearson chi-square test, Fisher's exact test and Kappa coefficient. The significance level was predetermined at p < .05. RESULT An intergroup comparison revealed that the pre- and post-operative pain scores at 24, 48 and 72 h were not significantly different (p > .05). At the end of follow-up period (12 months), success of full pulpotomy in occlusal and proximal caries group was 95% and 92.5%, respectively (p = .644). For both groups, the combined success rate of full pulpotomy was 93.75%. CONCLUSION The site of carious lesions (i.e., occlusal or proximal) did not affect the clinical and radiographic outcome of full pulpotomy performed in mature permanent mandibular teeth with symptomatic partial irreversible pulpitis.
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Affiliation(s)
- Rechithra R
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Archana Aravind
- 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
| | - Sidhartha Sharma
- 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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Cobanoglu N, Alptekin T, Kitagawa H, Blatz MB, Imazato S, Ozer F. Evaluation of human pulp tissue response following direct pulp capping with a self-etching adhesive system containing MDPB. Dent Mater J 2021; 40:689-696. [PMID: 33563846 DOI: 10.4012/dmj.2020-145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study evaluated the human pulp tissue response following direct pulp capping with Clearfil Protect Bond (CPB) self-etching adhesive containing an antibacterial monomer MDPB. The pulps of third molar teeth were exposed by the removal of carious tissue. In an experimental group, CPB was applied to the exposed pulp and dentin. In the control groups, Clearfil SE Bond (CSE) or calcium hydroxide-based cement (CH) was applied to the exposed pulp surfaces. All teeth were filled with resin composite, extracted after 90 days, and the pulp responses were histologically analyzed. No severe inflammation or soft tissue disorganization was observed in CPB and CH groups. CSE group exhibited a disorganized odontoblastic layer and severe inflammatory infiltration. No hard tissue formation was observed in CSE group, and CH formed more of a hard tissue formation than CPB. CPB induced an acceptable healing response when directly applied to exposed pulps with bacterial contamination.
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Affiliation(s)
- Nevin Cobanoglu
- Department of Restorative Dentistry, Faculty of Dentistry, University of Selcuk
| | - Tuncay Alptekin
- Department of Restorative Dentistry, Umitkoy Polyclinic, Baskent Hospital
| | - Haruaki Kitagawa
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry
| | - Markus B Blatz
- Department of Preventive and Restorative Sciences, University of Pennsylvania
| | - Satoshi Imazato
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry
| | - Fusun Ozer
- Department of Preventive and Restorative Sciences, University of Pennsylvania
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Kang CM, Seong S, Song JS, Shin Y. The Role of Hydraulic Silicate Cements on Long-Term Properties and Biocompatibility of Partial Pulpotomy in Permanent Teeth. MATERIALS 2021; 14:ma14020305. [PMID: 33435588 PMCID: PMC7826652 DOI: 10.3390/ma14020305] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/06/2021] [Accepted: 01/06/2021] [Indexed: 11/16/2022]
Abstract
The use of hydraulic silicate cements (HSCs) for vital pulp therapy has been found to release calcium and hydroxyl ions promoting pulp tissue healing and mineralized tissue formation. The present study investigated whether HSCs such as mineral trioxide aggregate (MTA) affect their biological and antimicrobial properties when used as long-term pulp protection materials. The effect of variables on treatment outcomes of three HSCs (ProRoot MTA, OrthoMTA, and RetroMTA) was evaluated clinically and radiographically over a 48–78 month follow-up period. Survival analysis was performed using Kaplan–Meier survival curves. Fisher’s exact test and Cox regression analysis were used to determine hazard ratios of clinical variables. The overall success rate of MTA partial pulpotomy was 89.3%; Cumulative success rates of the three HSCs were not statistically different when analyzed by Cox proportional hazard regression analysis. None of the investigated clinical variables affected success rates significantly. These HSCs showed favorable biocompatibility and antimicrobial properties in partial pulpotomy of permanent teeth in long-term follow-up, with no statistical differences between clinical factors.
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Affiliation(s)
- Chung-Min Kang
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul 03722, Korea; (C.-M.K.); (J.S.S.)
| | - Saemi Seong
- Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul 03722, Korea;
| | - Je Seon Song
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul 03722, Korea; (C.-M.K.); (J.S.S.)
| | - Yooseok Shin
- Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul 03722, Korea;
- Correspondence: ; Tel.: +82-2-2228-3149; Fax: +82-2-313-7575
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Bissinger R, Müller DD, Reymus M, Khazaei Y, Hickel R, Bücher K, Kühnisch J. Treatment outcomes after uncomplicated and complicated crown fractures in permanent teeth. Clin Oral Investig 2021; 25:133-143. [PMID: 32705398 PMCID: PMC7785561 DOI: 10.1007/s00784-020-03344-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 05/14/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The objectives of this retrospective clinical study were to describe characteristics of crown fractures in permanent teeth and to investigate the survival of pulp vitality and restorations in uncomplicated and complicated crown fractures. MATERIALS AND METHODS This retrospective study collected information from patients suffering from dental trauma who were treated between January 2004 and June 2017. The study population consisted of 434 patients (253 males/181 females; mean age 20.7 years) with 489 uncomplicated and 127 complicated crown fractures. The Kaplan-Meier survival curves and Cox proportional hazard regression analyses were performed to explore the data statistically. RESULTS The mean observation time was 522 days. Uncomplicated crown fractures without luxation showed a higher success rate of 82.3% (345/419) than complicated crown fractures without luxation (72.3%, 73/101). An additional luxation in uncomplicated crown fractures resulted in significantly reduced success rates in terms of survival of the pulp and restoration. Direct restorations survived significantly better independent of the fracture mode than did adhesively reattached crown fragments. No superiority of mineral trioxide aggregate or calcium hydroxide as pulp capping agent in complicated crown fractures was documented. Approximately 85.5% of all complications occurred within 2 years after the accident. CONCLUSION The treatment of crown fractures resulted mostly in successful outcomes and only a moderate number of complications were observed. CLINICAL RELEVANCE Primary dental management of crown fractures should follow recently published clinical guidelines, and close monitoring over at least 2 years seems to be justified.
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Affiliation(s)
- Ricarda Bissinger
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Daniel David Müller
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Marcel Reymus
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Yegane Khazaei
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Katharina Bücher
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.
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Acemannan Used as an Implantable Biomaterial for Vital Pulp Therapy of Immature Permanent Teeth Induced Continued Root Formation. Pharmaceutics 2020; 12:pharmaceutics12070644. [PMID: 32650533 PMCID: PMC7407100 DOI: 10.3390/pharmaceutics12070644] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/24/2020] [Accepted: 07/03/2020] [Indexed: 01/07/2023] Open
Abstract
Direct pulp-capping, a vital pulp therapy, is used to protect and preserve pulp vitality by applying a biomaterial on the pulp exposure site. Acemannan, a polysaccharide extracted from Aloe vera, induces osteodentin-bridge formation to cover the exposure site in vivo. We evaluated the effect of acemannan sponges on partial pulpotomized permanent teeth with caries or accident-induced pulp exposure (n = 50). After removing infected dentin and inflamed pulp tissue, the teeth were randomly divided into acemannan or control (mineral trioxide aggregate (MTA) groups (n = 25). The teeth were examined immediately after treatment (baseline) and at 6- and 12-month follow-ups for clinical and cone beam computed tomography (CBCT) examination. The three-dimensional tooth length and root apex area were simulated to determine treatment success. We found that the overall success rate in the acemannan and MTA groups from baseline to 12-month follow-up was 90.91% and 95.65%, respectively, with no significant difference between the two groups (p > 0.05). In the success teeth in both groups, the root length increased, and the apex area significantly decreased (p < 0.05), indicating continued root formation. Our results suggest that acemannan is a promising low-cost biomaterial for partial pulpotomy treatment for immature permanent teeth requiring vital pulp therapy.
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Postendodontic Pain after Pulpotomy or Root Canal Treatment in Mature Teeth with Carious Pulp Exposure: A Multicenter Randomized Controlled Trial. Pain Res Manag 2020; 2020:5853412. [PMID: 32676136 PMCID: PMC7345601 DOI: 10.1155/2020/5853412] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 04/13/2020] [Accepted: 05/06/2020] [Indexed: 12/21/2022]
Abstract
This equivalence, randomized, clinical trial aimed to compare the postoperative pain of root canal therapy (RCT) with pulpotomy with mineral trioxide aggregate (PMTA) or calcium-enriched mixture (PCEM) in permanent mature teeth. In seven academic centers, 550 cariously exposed pulps were included and randomly allocated into PMTA (n = 188), PCEM (n = 194), or RCT (n = 168) arms. Preoperative “Pain Intensity” (PI) on Numerical Rating Scale and postoperative PIs until day 7 were recorded. Patients' demographic and pre-/intra-/postoperative factors/conditions were recorded/analysed. The arms were homogeneous in terms of demographics. The mean preoperative PIs were similar (P=0.998), the mean sum PIs recorded during 10 postoperative intervals were comparable (P=0.939), and the trend/changes in pain relief were parallel (P=0.821) in all study arms. The incidences of preoperative moderate-severe pain in RCT, PMTA, and PCEM arms were 56.5%, 55.7%, and 56.7%, which after 24 hours considerably decreased to 13.1%, 10.6%, and 12.9%, respectively (P=0.578). The time span of endodontic procedures was statistically different; RCT = 69.73, PMTA = 35.37, and PCEM = 33.62 minutes (P < 0.001). Patients with greater preoperative pain, symptomatic apical periodontitis, or presence of PDL widening suffered more pain (P=0.002, 0.035, and 0.023, resp.); however, other pre-/intra-/postoperative factors/conditions were comparable. Pulpotomy with MTA/CEM and RCT demonstrate comparable and effective postoperative pain relief.
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Yang Y, Xia B, Xu Z, Dou G, Lei Y, Yong W. The effect of partial pulpotomy with iRoot BP Plus in traumatized immature permanent teeth: A randomized prospective controlled trial. Dent Traumatol 2020; 36:518-525. [PMID: 32348009 DOI: 10.1111/edt.12563] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 12/18/2022]
Affiliation(s)
- YingTing Yang
- The Third Clinical Division of Peking University School and Hospital of Stomatology Beijing China
| | - Bin Xia
- Department of Pediatric Dentistry Peking University School and Hospital of Stomatology Beijing China
| | - Zheng Xu
- Department of Pediatric Dentistry The Center for Pediatric Dentistry University of Washington Seattle WA USA
| | - Guili Dou
- Department of Pediatric Dentistry Peking University School and Hospital of Stomatology Beijing China
| | - Yue Lei
- The Third Clinical Division of Peking University School and Hospital of Stomatology Beijing China
| | - Wei Yong
- Department of General Dentistry Peking University School and Hospital of Stomatology Beijing China
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Tozar KN, Erkmen Almaz M. Evaluation of the Efficacy of Erbium, Chromium-doped Yttrium, Scandium, Gallium, and Garnet Laser in Partial Pulpotomy in Permanent Immature Molars: A Randomized Controlled Trial. J Endod 2020; 46:575-583. [PMID: 32229029 DOI: 10.1016/j.joen.2020.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/07/2020] [Accepted: 02/09/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The use of the erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser in vital pulp therapy contributes to the formation of dentin bridges and a sterile zone as well as the maintenance of the vitality of the pulp. However, no prior studies have used the Er,Cr:YSGG laser in partial pulpotomy of immature permanent teeth. The aim of this study was to compare the efficacy of partial pulpotomy treatment using mineral trioxide aggregate (MTA) alone and MTA with the Er,Cr:YSGG laser in permanent immature molars. METHODS A total of 90 caries-exposed permanent immature molar teeth were included and randomly divided into 2 groups: the MTA group (n = 45) and the laser + MTA group (n = 45). In the MTA group, MTA was applied to the exposed area on the pulp after bleeding control. In the same session, the tooth was restored with a composite resin. In the laser + MTA group, before MTA condensation, the Er,Cr:YSGG laser was applied to the exposure area. Patients were recalled at 1, 3, 6, and 12 months after treatment. The Mann-Whitney U and chi-Square tests were used for statistical analysis. RESULTS The success rate (95.5%) of the laser + MTA group was similar to that of the MTA group (88.8%). There was no significant difference between groups in terms of the frequency of at least 1 pathologic clinical or radiographic failure at 12 months (P > .05). CONCLUSIONS Partial pulpotomy treatment showed a high success rate in immature permanent molars; however, the use of the laser did not contribute to the success rate compared with MTA alone.
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Affiliation(s)
- Kamile Nur Tozar
- Department of Pediatric Dentistry, Faculty of Dentistry, Kırıkkale University, Kırıkkale, Turkey
| | - Merve Erkmen Almaz
- Department of Pediatric Dentistry, Faculty of Dentistry, Kırıkkale University, Kırıkkale, Turkey.
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Biodentine™ Partial Pulpotomy of a Young Permanent Molar with Signs and Symptoms Indicative of Irreversible Pulpitis and Periapical Lesion: A Case Report of a Five-Year Follow-Up. Case Rep Dent 2019; 2019:8153250. [PMID: 31612085 PMCID: PMC6757253 DOI: 10.1155/2019/8153250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/31/2019] [Accepted: 09/03/2019] [Indexed: 12/16/2022] Open
Abstract
The purpose of this paper was to report the five-year success of Biodentine™ partial pulpotomy in a young permanent molar, with signs and symptoms indicative of irreversible pulpitis and periapical lesion, in a nine-year-old girl. Preoperative clinical examination revealed a large carious lesion of the left mandibular permanent first molar. The patient reported pain on percussion. The tooth responded positively to the electric pulp test and had lingering pain after cold testing. A periapical radiograph showed a deep carious lesion and periapical lesion. Based on the clinical and radiographical examination, the tooth had signs and symptoms indicative of irreversible pulpitis and periapical lesion. During caries removal, pulp exposure occurred, and 2-3 mm in depth of pulp tissue at the exposure site was removed. Haemorrhage was controlled within four minutes with 2.5% sodium hypochlorite-moistened cotton pellets. Biodentine™ was then applied as both a pulp dressing and a temporary restoration. At the following visit, composite resin was placed over the Biodentine™ as a final restoration. During a five-year follow-up, the tooth was asymptomatic, had positive responses to sensibility tests, and had no discolouration. Follow-up radiographs showed a dentine bridge and periapical healing.
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Elmsmari F, Ruiz XF, Miró Q, Feijoo-Pato N, Durán-Sindreu F, Olivieri JG. Outcome of Partial Pulpotomy in Cariously Exposed Posterior Permanent Teeth: A Systematic Review and Meta-analysis. J Endod 2019; 45:1296-1306.e3. [PMID: 31515048 DOI: 10.1016/j.joen.2019.07.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 07/03/2019] [Accepted: 07/11/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The current systematic review and meta-analysis aimed to evaluate the success rate of partial pulpotomy in treating permanent posterior teeth with carious vital pulp exposure. A secondary aim was to assess the prognostic factors using a meta-regression. METHODS An electronic search was performed for studies from January 1950 to November 2018 in the following databases: PubMed, ScienceDirect, and Cochrane. All searches were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Clinical studies evaluating the success rate of cariously exposed vital human permanent posterior teeth treated with a partial pulpotomy were selected. Only randomized clinical trials and prospective clinical studies were included for evaluation. The Newcastle-Ottawa Scale and the Cochrane Collaboration's tool were used to evaluate risk assessment. RESULTS From the 218 studies identified through the initial search, 11 studies qualified for the final analysis (5 randomized clinical trials and 6 prospective studies). The results of the meta-analysis indicate a success rate of 98% (confidence interval [CI]: 0.94-1), 96% (CI: 0.92-0.99), and 92% (CI: 0.83-0.97) after 6 months and 1 and 2 years of follow-up. Examining the probable prognostic factors using meta-regression analysis, only preoperative pulp status (P = .001) was identified as a significant factor, with studies including teeth with the presumptive diagnosis of irreversible pulpitis displaying significantly lower results. The final solution, pulp capping material, apex closure, and the age of the patient did not affect the treatment success rate (P > .05). CONCLUSIONS The available data suggest that a partial pulpotomy results in high success rates in treating cariously exposed permanent posterior teeth up to 2 years. Six months of monitoring can be considered an appropriate period when evaluating the success of a partial pulpotomy although more clinical and radiographic controls are essential to ensuring success.
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Affiliation(s)
- Firas Elmsmari
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Xavier-Fructuós Ruiz
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Queralt Miró
- Department of Basic Sciences, Biostatistics Unit, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Nancy Feijoo-Pato
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Juan Gonzalo Olivieri
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain.
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27
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Linas N, Faulks D, Hennequin M, Cousson PY. Conservative and endodontic treatment performed under general anesthesia: A discussion of protocols and outcomes. SPECIAL CARE IN DENTISTRY 2019; 39:453-463. [PMID: 31433510 DOI: 10.1111/scd.12410] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 07/11/2019] [Accepted: 07/12/2019] [Indexed: 11/27/2022]
Abstract
AIMS This work discusses the procedures and outcomes of restorative and endodontic treatments performed under general anesthesia, with examples from the Unit of Special Care Dentistry at the University Hospital of Clermont-Ferrand. METHODS AND RESULTS The restorative and endodontic treatment techniques used in the Special Care Unit are described. These techniques are compared to existing reports in the literature of treatment procedures under general anesthesia. Little evidence was found in the literature regarding sealants or restorative protocols. A few studies described root canal treatment and pulpotomy protocols carried out under general anesthesia, and the results of these met academic outcome standards. CONCLUSION Patients with equal needs should have equal access, equal quality of treatment and equal treatment outcomes, regardless of whether a facilitatory procedure is used to achieve treatment. The provision of restorative treatment under general anesthesia is essential to avoid an excessive number of extractions in patients unable to receive treatment in the chair. Restorative care provided under general anesthesia should be standardized and evaluated in the same way as treatment performed under local anesthesia. In this way, the provision of conservative dental care under general anesthesia could be promoted and the maintenance of a functional dentition encouraged.
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Affiliation(s)
- Natacha Linas
- Université Clermont Auvergne, CROC, F-63000, Clermont-Ferrand, France.,CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France
| | - Denise Faulks
- Université Clermont Auvergne, CROC, F-63000, Clermont-Ferrand, France.,CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France
| | - Martine Hennequin
- Université Clermont Auvergne, CROC, F-63000, Clermont-Ferrand, France.,CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France
| | - Pierre-Yves Cousson
- Université Clermont Auvergne, CROC, F-63000, Clermont-Ferrand, France.,CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France
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Cushley S, Duncan HF, Lappin MJ, Tomson PL, Lundy FT, Cooper P, Clarke M, El Karim IA. Pulpotomy for mature carious teeth with symptoms of irreversible pulpitis: A systematic review. J Dent 2019; 88:103158. [PMID: 31229496 DOI: 10.1016/j.jdent.2019.06.005] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/24/2019] [Accepted: 06/20/2019] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Management of carious teeth with signs and symptoms indicative of irreversible pulpitis is traditionally invasive, but emerging evidence suggests successful treatment outcomes with less invasive vital pulp treatment such as coronal pulpotomy. The objective of this systematic review is to determine whether coronal pulpotomy is clinically effective in treating carious teeth with signs and symptoms indicative of irreversible pulpitis. SOURCES MEDLINE; PubMed; Embase, Web of Science, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform and ClinicalTrials.gov were searched until December 2018. STUDY SELECTION Prospective, retrospective and randomised clinical trials investigating coronal pulpotomy or comparing pulpotomy to root canal treatment in permanent mature carious teeth with signs and symptoms indicative of irreversible pulpitis were included. Studies were independently assessed for risk of bias using Cochrane Systematic Reviews of intervention criteria and modified Downs and Black quality assessment checklist. DATA Eight articles were selected for analysis. The average success rate for coronal pulpotomy was 97.4% clinical and 95.4% radiographic at 12 month follow-up. This was reduced to 93.97% clinical and 88.39% radiographic success at 36 months follow-up. Results from the only comparative clinical trial showed pulpotomy to have comparable success to root canal treatment at 12, 24 and 60 month follow-up. CONCLUSIONS The evidence suggests high success for pulpotomy for teeth with signs and symptoms of irreversible pulpitis, however, results are based on heterogeneous studies with high risk of bias. Well-designed, adequately powered randomised controlled trials are required for evidence to change clinical practice. CLINICAL SIGNIFICANCE Management of carious teeth with irreversible pulpitis is traditionally invasive, but emerging evidence suggests potentially successful treatment outcomes with less invasive therapies such as coronal pulpotomy.
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Affiliation(s)
- Siobhan Cushley
- Centre for Dentistry, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Henry F Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Lincoln Place, Dublin, Ireland
| | - Mark J Lappin
- Centre for Dentistry, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Phillip L Tomson
- The University of Birmingham School of Dentistry, Institute of Clinical Sciences, 5 Mill Pool Way, Edgbaston, Birmingham, UK
| | - Fionnuala T Lundy
- The Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, UK
| | - Paul Cooper
- Oral Biology, The University of Birmingham School of Dentistry, Institute of Clinical Sciences, 5 Mill Pool Way, Edgbaston, Birmingham, UK
| | - Mike Clarke
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Institute of Clinical Sciences Block B, Belfast UK
| | - Ikhlas A El Karim
- The Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, UK.
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29
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Rahimi S, Salarinasab S, Ghasemi N, Rahbarghazi R, Shahi S, Salem Milani A, Divband B, Davoudi P. In vitro induction of odontogenic activity of human dental pulp stem cells by white Portland cement enriched with zirconium oxide and zinc oxide components. J Dent Res Dent Clin Dent Prospects 2019; 13:3-10. [PMID: 31217912 PMCID: PMC6571518 DOI: 10.15171/joddd.2019.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 02/05/2019] [Indexed: 11/24/2022] Open
Abstract
Background. The aim of this in vitro study was to investigate the effect of zinc oxide (ZnO) and zirconium oxide (ZrO2) microparticles (MPs) and nanoparticles (NPs) in combination with white Portland cement (WPC) on odontogenic capacity of human dental pulp stem cells over a period of 21 days.
Methods. Synthesized ZnO and ZrO2 particles were characterized using scanning electron microscopy and transmission electron microscopy. The viability of human dental pulp stem cells was measured by a 3-(4,5-dimethylthiazolyl-2-yl)-2,5- diphenyltetrazolium bromide assay at 7-, 14- and 21-day intervals after seeding on WPC disks enriched with ZnO and ZrO2 MPs and NPs. Odontogenic potential of ZnO and ZrO2 particles in combination with WPC was investigated by alkaline phosphatase (ALP) activity and ionized calcium level of supernatant culture media at different time intervals. Data were analyzed using one-way ANOVA and post hoc Tukey tests.
Results. All the materials exhibited cell viability over a 21-day period, except for WPC with ZnO NPs on day 7, although it was not statistically significant (P>0.05). The ALP activity and ionized calcium level increased in all the groups compared to the control group (P<0.05). ZnO NPs had superior effect on odontogenic activity and calcium ion release compared to ZnO MPs (P=0.046). There was no significant difference between ZrO2 MPs and NPs in odontogenic activity (P>0.05).
Conclusion. WPC enriched with ZnO and ZrO2 increased ALP activity and calcium ion release of human dental pulp stem cells over a period of 21 days in vitro.
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Affiliation(s)
- Saeed Rahimi
- Dental and Periodontal Research Center, Department of Endodontics, Faculty of Dentistry, Tabriz university of Medical Sciences, Tabriz, Iran
| | - Sadegh Salarinasab
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Negin Ghasemi
- Dental and Periodontal Research Center, Department of Endodontics, Faculty of Dentistry, Tabriz university of Medical Sciences, Tabriz, Iran
| | - Reza Rahbarghazi
- Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.,Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahriar Shahi
- Dental and Periodontal Research Center, Department of Endodontics, Faculty of Dentistry, Tabriz university of Medical Sciences, Tabriz, Iran
| | - Amin Salem Milani
- Dental and Periodontal Research Center, Department of Endodontics, Faculty of Dentistry, Tabriz university of Medical Sciences, Tabriz, Iran
| | - Baharak Divband
- Department of Inorganic Chemistry, Faculty of Chemistry, University of Tabriz, Tabriz, Iran
| | - Paria Davoudi
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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30
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Careddu R, Duncan HF. How does the pulpal response to Biodentine and ProRoot mineral trioxide aggregate compare in the laboratory and clinic? Br Dent J 2018; 225:sj.bdj.2018.864. [PMID: 30337724 DOI: 10.1038/sj.bdj.2018.864] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2018] [Indexed: 02/07/2023]
Affiliation(s)
- R Careddu
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Lincoln Place, Dublin 2, Ireland
| | - H F Duncan
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Lincoln Place, Dublin 2, Ireland
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31
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Awawdeh L, Al-Qudah A, Hamouri H, Chakra RJ. Outcomes of Vital Pulp Therapy Using Mineral Trioxide Aggregate or Biodentine: A Prospective Randomized Clinical Trial. J Endod 2018; 44:1603-1609. [PMID: 30292451 DOI: 10.1016/j.joen.2018.08.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/16/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Mineral trioxide aggregate (MTA) has been used in pulp capping of cariously exposed mature permanent teeth with promising results. The search for alternative materials that seal better and set faster than MTA and do not stain is ongoing. Biodentine (Septodont, St Maur-des-Fossés, France) exhibits these advantages but has not been tested yet for a prolonged duration in mature teeth. This study aimed to evaluate the clinical performance of Biodentine and white MTA (Angelus, Londrina, Brazil) in cariously exposed mature permanent teeth. METHODS This was a prospective longitudinal randomized controlled study of 68 vital permanent teeth with deep caries. Patients were randomly allocated into 2 study arms: Biodentine and MTA. Teeth were assessed clinically and radiographically before the procedure. Caries were excavated under local anesthesia; hemostasis was achieved after pulp exposure using sodium hypochlorite and capped with Biodentine or MTA. Clinical and radiographic follow-ups were performed by a blinded calibrated evaluator after 6 months and 1, 2, and 3 years. RESULTS There were no significant differences in the overall success rate between Biodentine and MTA; it was 93.3% (Biodentine = 93.1% and MTA = 93.5%) at 6 months. The overall success rate increased to 96.2% (Biodentine = 96.0% and MTA = 100%) at 1 year and to 100% at 2 years. At the 3-year follow-up, it decreased to 93.8% (Biodentine = 91.7% and MTA = 96.0%). CONCLUSIONS Biodentine and MTA have favorable and comparable success rates when used as direct pulp capping or pulpotomy material in permanent mature teeth with carious exposure. The remaining tooth structure and durability of coronal restoration might affect significantly the long-term success of vital pulp therapy.
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Affiliation(s)
- Lama Awawdeh
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan.
| | - Aladdin Al-Qudah
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Hanan Hamouri
- Department of Mathematics and Statistics, Faculty of Science and Arts, Jordan University of Science and Technology, Irbid, Jordan
| | - Rosalie Jean Chakra
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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Chen MS, Chen SH, Lai FC, Chen CY, Hsieh MY, Chang WJ, Yang JC, Lin CK. Sintering Pmperature-Dependence on Radiopacity of Bi (2-x) ZrxO (3+x/2) Powders Prepared by Sol-Gel Process. MATERIALS (BASEL, SWITZERLAND) 2018; 11:E1685. [PMID: 30208658 PMCID: PMC6165246 DOI: 10.3390/ma11091685] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 08/30/2018] [Accepted: 09/10/2018] [Indexed: 11/16/2022]
Abstract
Bismuth oxide (Bi₂O₃) is an effective additive used to enhance radiography resolution for dental materials. However, there are potential concerns regarding its biocompatibility and connection to tissue discoloration. In the present study, we modified the radiopacity properties of Bi₂O₃ with zirconium oxide (ZrO₂) using a sol-gel process and investigated the composition, as well as the effects of heat treatment temperature using Thermogravimetry analysis (TGA), differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FT-IR), transmission electron microscopy (TEM), and X-ray diffraction (XRD). The harvested Bi2-xZrxO3+x/2 particles showed that the dominant phase transferred from α-Bi₂O₃ to β-Bi7.38Zr0.62O12.31 after a heat treatment of over 750 °C for 2 h. As the x values of Bi2-xZrxO3+x/2 increased from 0.2 to 1.0, more zirconium oxide precipitated onto the particle surface, thus enhancing the surface roughness of particles. For sol-gel Bi1.8Zr0.2O3.1 powders (x = 0.2), the radiopacity values became 4.90 ± 0.23 and 5.83 ± 0.22 mmAl after a heat treatment of 500 °C and 750 °C, respectively.
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Affiliation(s)
- May-Show Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan.
- Department of Dentistry, Taipei Medical University Hospital, Taipei 11031, Taiwan.
| | - Shih-Hsun Chen
- Department of Mechanical Engineering, National Taiwan University of Science and Technology, Taipei 10607, Taiwan.
| | - Fu-Chih Lai
- College of Nursing, Taipei Medical University, Taipei 11031, Taiwan.
| | - Chin-Yi Chen
- Department of Materials Science and Engineering, Feng Chia University, Taichung 40724, Taiwan.
| | - Ming-Yuan Hsieh
- Department of Materials Science and Engineering, Feng Chia University, Taichung 40724, Taiwan.
| | - Wei-Jen Chang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
- Dental Department, Taipei Medical University, Shuang-Ho Hospital, New Taipei 235, Taiwan.
| | - Jen-Chang Yang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-52, Taiwan.
| | - Chung-Kwei Lin
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan.
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan.
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Kanaya S, Xiao B, Sakisaka Y, Suto M, Maruyama K, Saito M, Nemoto E. Extracellular calcium increases fibroblast growth factor 2 gene expression via extracellular signal-regulated kinase 1/2 and protein kinase A signaling in mouse dental papilla cells. J Appl Oral Sci 2018; 26:e20170231. [PMID: 29768523 PMCID: PMC5961930 DOI: 10.1590/1678-7757-2017-0231] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 11/20/2017] [Indexed: 11/21/2022] Open
Abstract
We previously reported that elevated extracellular calcium (Ca2+) levels increase bone morphogenetic protein 2 expression in human dental pulp (hDP) cells. However, it is unknown whether extracellular Ca2+ affects the expression of other growth factors such as fibroblast growth factor 2 (FGF2).
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Affiliation(s)
- Sousuke Kanaya
- Tohoku University, Graduate School of Dentistry, Department of Periodontology and Endodontology, Sendai, Japan.,Tohoku University, Graduate School of Dentistry, Liaison Center for Innovative Dentistry, Sendai, Japan
| | - Binlu Xiao
- Tohoku University, Graduate School of Dentistry, Department of Periodontology and Endodontology, Sendai, Japan
| | - Yukihiko Sakisaka
- Tohoku University, Graduate School of Dentistry, Department of Periodontology and Endodontology, Sendai, Japan
| | - Mizuki Suto
- Tohoku University, Graduate School of Dentistry, Department of Periodontology and Endodontology, Sendai, Japan
| | - Kentaro Maruyama
- Tohoku University, Graduate School of Dentistry, Department of Periodontology and Endodontology, Sendai, Japan
| | - Masahiro Saito
- Tohoku University, Graduate School of Dentistry, Department of Restorative Dentistry, Division of Operative Dentistry, Sendai, Japan
| | - Eiji Nemoto
- Tohoku University, Graduate School of Dentistry, Department of Periodontology and Endodontology, Sendai, Japan
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Taha NA, Abdulkhader SZ. Full Pulpotomy with Biodentine in Symptomatic Young Permanent Teeth with Carious Exposure. J Endod 2018; 44:932-937. [PMID: 29681479 DOI: 10.1016/j.joen.2018.03.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 02/25/2018] [Accepted: 03/02/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION This prospective study evaluated the outcome of Biodentine (Septodont, Saint Maur des Fosses, France) pulpotomy in young permanent teeth with carious exposure. METHODS Twenty permanent molar teeth in 14 patients with carious pulp exposure were treated with Biodentine pulpotomy. The age of the patients ranged from 9-17 years (12.3 ± 2.7 years). A preoperative pulpal and periapical diagnosis was established. After informed consent, the tooth was anesthetized, isolated via a dental dam, and disinfected with 5% sodium hypochlorite before caries excavation. Full pulpotomy was performed by amputating the exposed pulp to the level of the canal orifices, hemostasis was achieved via a cotton pellet moistened with 2.5% sodium hypochlorite, a 3-mm layer of Biodentine was placed as the pulpotomy agent, a Vitrebond liner (3M ESPE, St Paul, MN) was applied, and the tooth was subsequently restored. Postoperative periapical radiographs were taken after placement of the permanent restoration. Clinical and radiographic evaluation was completed after 6 months and 1 year postoperatively. Pain levels were scored preoperatively and 2 days after treatment. Statistical analysis was performed using the Fisher exact test. RESULTS Clinical signs and symptoms suggestive of irreversible pulpitis were established in all teeth and symptomatic apical periodontitis in 14 of 20 (70%). Two days after treatment, all patients reported complete relief of pain. All teeth were clinically successful at 6 months and 1 year postoperatively. Radiographically, immature roots showed continued root development; dentin bridge formation was detected in 5 of 20 teeth. Seven of 7 teeth with preoperative periapical rarefaction showed signs of healing; 1 tooth had signs of internal root resorption at 1 year with an overall success rate of 95% (19/20). CONCLUSIONS Young permanent teeth with carious exposure can be treated successfully with full pulpotomy using Biodentine, and clinical signs and symptoms of irreversible pulpitis are not a contraindication.
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Affiliation(s)
- Nessrin A Taha
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan.
| | - Sakhaa Z Abdulkhader
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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Treatment Outcomes of 4 Vital Pulp Therapies in Mature Molars. J Endod 2018; 44:529-535. [PMID: 29397215 DOI: 10.1016/j.joen.2017.12.010] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/29/2017] [Accepted: 12/07/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Vital pulp therapy (VPT) is a biological approach to minimally invasive endodontics. This randomized clinical trial aimed to evaluate and compare clinical and radiographic success of 4 VPTs (indirect pulp capping [IPC], direct pulp capping [DPC], miniature pulpotomy [MP], and full pulpotomy [FP]) using calcium-enriched mixture cement for deep caries management of mature permanent molars including teeth with clinical signs of irreversible pulpitis and the presence of apical periodontitis. METHODS Blinded participants (N = 302) were randomly allocated to 4 study arms. Random allocation was disregarded when visible pulp exposures did not happen after complete caries removal and the tooth was transferred to the IPC arm. Pre- and intraoperative data including vitality test results, pulpal/periapical status, and exposure type/location were recorded. Pain was measured using a numeric rating scale before treatment initiation up to 1 week postoperatively. Participants were followed up for 1 year. RESULTS The groups were homogenous in terms of age, sex, marital status, education, and practitioner; pre- and intraoperative conditions were similar in all arms and did not affect the long-term success. Preoperative pain and apical periodontitis were significantly different among arms (P < .05); however, it was not the case when the IPC group was excluded. After baseline pain adjustment, pain relief was continuous with similar patterns in all treatment groups. The 3- and 12-month success rates of the VPT techniques were comparable in the IPC (98.7% and 100%, respectively), DPC (98.4% and 94.7%, respectively), MP (98.4% and 91.4%, respectively), and FP (93.5% and 95.5%, respectively) arms, respectively (P > .05). CONCLUSIONS In deep caries management of mature permanent molars, the 4 VPTs were associated with favorable/comparable clinical and radiographic outcomes. The pulpal and periapical status as well as pulpal exposure type/location had no effect on treatment outcomes.
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Lipski M, Nowicka A, Kot K, Postek-Stefańska L, Wysoczańska-Jankowicz I, Borkowski L, Andersz P, Jarząbek A, Grocholewicz K, Sobolewska E, Woźniak K, Droździk A. Factors affecting the outcomes of direct pulp capping using Biodentine. Clin Oral Investig 2017; 22:2021-2029. [PMID: 29234957 PMCID: PMC5945752 DOI: 10.1007/s00784-017-2296-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 12/05/2017] [Indexed: 01/08/2023]
Abstract
Introduction This study aimed to evaluate the prognostic value of factors with regard to the treatment outcome of direct pulp capping using Biodentine (Septodont, Saint-Maur-des-Fossés, France), in permanent teeth in which the pulps were exposed during caries removal. Methods Between 2010 and 2014, 112 teeth with deep carious lesions underwent direct pulp capping. The patients were followed up at 2–3 months and 1–1.5 years with a routine examination on both recall visits. Periapical radiographs were taken at 1–1.5 years. Lack of patient complaints, positive reactions to cold and electric testing, no sensitivity to percussion, and no widening of the periapical ligament indicated success. The Fisher exact test was used for statistical analysis. The significance level was P = .05. Results Eighty-six teeth were available for 1–1.5 years follow-up. The overall success rate was 82.6%. Only age had a significant effect on the pulpal survival rate: the success rate was 90.9% in patients younger than 40 years and 73.8% in patients 40 years or older (P = .0480). Sex, initial or secondary caries treatment, occlusal or cervical/proximal caries, delayed placement of permanent filling, tooth position, and arch type did not influence the outcome. Conclusions A patient’s age influenced the outcome of direct pulp capping using this new calcium silicate cement. Clinical relevance Asymptomatic vital permanent teeth with cariously exposed pulp can be treated successfully by direct pulp capping using Biodentine.
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Affiliation(s)
- Mariusz Lipski
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University of Szczecin, Al. Powstańców Wlkp. 72, 70-111, Szczecin, Poland.
| | - Alicja Nowicka
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University of Szczecin, Szczecin, Poland.
| | - Katarzyna Kot
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University of Szczecin, Al. Powstańców Wlkp. 72, 70-111, Szczecin, Poland
| | | | | | - Lech Borkowski
- Department of Pediatric Dentistry, Silesian Medical University, Zabrze, Poland
| | | | - Anna Jarząbek
- Department of General Dentistry, Pomeranian Medical University of Szczecin, Szczecin, Poland
| | - Katarzyna Grocholewicz
- Department of General Dentistry, Pomeranian Medical University of Szczecin, Szczecin, Poland
| | - Ewa Sobolewska
- Department of Gerodontology, Pomeranian Medical University of Szczecin, Szczecin, Poland
| | - Krzysztof Woźniak
- Department of Orthodontics, Pomeranian Medical University of Szczecin, Szczecin, Poland
| | - Agnieszka Droździk
- Department of General Dentistry, Pomeranian Medical University of Szczecin, Szczecin, Poland
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37
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Taha NA. Reply to the editor. Int Endod J 2017; 50:1105-1106. [PMID: 28980725 DOI: 10.1111/iej.12828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- N A Taha
- Department of Conservative Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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Taha NA, Khazali MA. Partial Pulpotomy in Mature Permanent Teeth with Clinical Signs Indicative of Irreversible Pulpitis: A Randomized Clinical Trial. J Endod 2017; 43:1417-1421. [DOI: 10.1016/j.joen.2017.03.033] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 03/19/2017] [Indexed: 10/19/2022]
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39
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Mehrvarzfar P, Abbott PV, Mashhadiabbas F, Vatanpour M, Tour Savadkouhi S. Clinical and histological responses of human dental pulp to MTA and combined MTA/treated dentin matrix in partial pulpotomy. AUST ENDOD J 2017; 44:46-53. [PMID: 28833942 DOI: 10.1111/aej.12217] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2017] [Indexed: 01/05/2023]
Abstract
The aim of this study was to compare the responses of mineral trioxide aggregate (MTA) and combined MTA/treated dentin matrix (TDM) as direct pulp capping material. In this clinical trial study, 33 intact third molars in 11 healthy volunteers (three molars in each) were included. Partial pulpotomies were performed in a split mouth manner in two of the third molars in each patient randomly and the third tooth had used as TDM source. The coronal dentin was chopped to dentine chips and transformed to TDM using different concentrations of ethylene diamine tetraacetic acid (EDTA) solution. Pulps were directly capped by MTA alone or using a combination layering of MTA/TDM. Following 6-week clinical and radiological evaluations, each tooth was extracted and prepared for histological evaluation. There were no significant differences in the clinical and radiographic responses or in the quality of dentin bridges (P > 0.05). However, the dentin bridge was significantly thicker in MTA/TDM group than MTA group (P = 0.003). Using the combination of MTA/TDM as a pulp-dressing agent may form a thicker dentin bridge compared to MTA alone.
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Affiliation(s)
- Payman Mehrvarzfar
- Department of Endodontics, Dental Branch, Islamic Azad University, Tehran, Iran
| | - Paul V Abbott
- Clinical Dentistry, School of Dentistry, The University of Western Australia, Nedlands, WA, Australia
| | - Fatemeh Mashhadiabbas
- Department of Maxillofacial Pathology, Dental Branch, Shahid Beheshti University, Tehran, Iran
| | - Mehdi Vatanpour
- Department of Endodontics, Dental Branch, Islamic Azad University, Tehran, Iran
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Xuedong Z, Dingming H, Jianguo L, Zhengwei H, Xin W, Deqin Y, Jin Z, Liming C, Lin Z, Yanhong L, Jiyao L. [Vital pulp therapy of damaged dental pulp]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2017; 35:339-347. [PMID: 28853497 DOI: 10.7518/hxkq.2017.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The development of an expert consensus on vital pulp therapy can provide practical guidance for the improvement of pulp damage care in China. Dental pulp disease is a major type of illness that adversely affects human oral health. Pulp capping and pulpotomy are currently the main methods for vital pulp therapy. Along with the development of minimal invasion cosmetic dentistry, using different treatment technologies and materials reasonably, preserving healthy tooth tissue, and extending tooth save time have become urgent problems that call for immediate solution in dental clinics. This paper summarizes the experiences and knowledge of endodontic experts. We develop a clinical path of vital pulp therapy for clinical work by utilizing the nature, approach, and degree of pulp damage as references, defense and self-repairing ability of pulp as guidance, and modern technologies of diagnosis and treatment as means.
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Affiliation(s)
- Zhou Xuedong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Huang Dingming
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Liu Jianguo
- Dept. of Conservative Dentistry and Endodontics, Stomatological Hospital Affiliated to Zunyi Medical College, Zunyi 563003, China
| | - Huang Zhengwei
- Dept. of Conservative Dentistry and Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Wei Xin
- Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, China
| | - Yang Deqin
- Dept. of Conservative Dentistry and Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing 401147, China
| | - Zhao Jin
- Dept. of Conservative Dentistry and Endodontics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
| | - Chen Liming
- Guiyang Hospital of Stomatology, Guiyang 550002, China
| | - Zhu Lin
- Tibet Branch of West China Hospital of Stomatology, Lasa 850000, China
| | - Li Yanhong
- Hospital of Stomatology, Kunming Medical University, Kunming 650199, China
| | - Li Jiyao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Kaur M, Singh H, Dhillon JS, Batra M, Saini M. MTA versus Biodentine: Review of Literature with a Comparative Analysis. J Clin Diagn Res 2017; 11:ZG01-ZG05. [PMID: 28969295 DOI: 10.7860/jcdr/2017/25840.10374] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 06/08/2017] [Indexed: 11/24/2022]
Abstract
An ideal dental repair material should possess certain exclusive properties such as adequate adhesive ability, insolubility, dimensional stability, biocompatibility, bioactivity etc. New materials claiming better performance are continuously being introduced in the market to optimize the care of dental patients. Biodentine has been recently introduced as the "the first all-in-one, bioactive and biocompatible material for damaged dentin replacement". Manufacturers claim that Biodentine has noticeably shorter setting time in contrast to other silicate cements such as Mineral Trioxide Aggregate (MTA) and also has better mechanical and handling properties. This article is aimed to compare the properties of MTA and Biodentine analyzing the research work done in this field so far by various researchers all across the globe.
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Affiliation(s)
- Mandeep Kaur
- Senior Lecturer, Department of Conservative Dentistry and Endodontics, Gian Sagar Dental College and Hospital, Patiala, Punjab, India
| | - Harpreet Singh
- Professor, Department of Conservative Dentistry and Endodontics, Gian Sagar Dental College and Hospital, Patiala, Punjab, India
| | - Jaidev Singh Dhillon
- Professor, Department of Conservative Dentistry and Endodontics, Gian Sagar Dental College and Hospital, Patiala, Punjab, India
| | - Munish Batra
- Senior Lecturer, Department of Conservative Dentistry and Endodontics, Gian Sagar Dental College and Hospital, Patiala, Punjab, India
| | - Meenu Saini
- Senior Lecturer, Department of Conservative Dentistry and Endodontics, Gian Sagar Dental College and Hospital, Patiala, Punjab, India
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Lin HP, Tu HP, Hsieh YP, Lee BS. Controlled release of lovastatin from poly(lactic- co-glycolic acid) nanoparticles for direct pulp capping in rat teeth. Int J Nanomedicine 2017; 12:5473-5485. [PMID: 28814864 PMCID: PMC5546772 DOI: 10.2147/ijn.s138410] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Statin at appropriate concentrations has been shown to induce odontoblastic differentiation, dentinogenesis, and angiogenesis. However, using a carrier to control statin release might reduce toxicity and enhance its therapeutic effects. The aim of this study was to prepare poly(d,l-lactide-co-glycolide acid) (PLGA) nanoparticles that contain lovastatin for application in direct pulp capping. The PLGA–lovastatin particle size was determined using dynamic light scattering measurements and transmission electron microscopy. In addition, the release of lovastatin was quantified using a UV–Vis spectrophotometer. The cytotoxicity and alkaline phosphatase (ALP) activity of PLGA–lovastatin nanoparticles on human dental pulp cells were investigated. Moreover, a real-time polymerase chain reaction (PCR) assay, Western blot analysis, and an enzyme-linked immunosorbent assay (ELISA) were used to examine the osteogenesis gene and protein expression of dentin sialophosphoprotein (DSPP), dentin matrix acidic phosphoprotein 1 (DMP1), and osteocalcin (OCN). Finally, PLGA–lovastatin nanoparticles and mineral trioxide aggregate (MTA) were compared as direct pulp capping materials in Wistar rat teeth. The results showed that the median diameter of PLGA–lovastatin nanoparticles was 174.8 nm and the cumulative lovastatin release was 92% at the 44th day. PLGA–lovastatin nanoparticles demonstrated considerably a lower cytotoxicity than free lovastatin at 5, 9, and 13 days of culture. For ALP activity, the ALP amount of PLGA–lovastatin (100 μg/mL) was significantly higher than that of the other groups for 9 and 13 days of culture. The real-time PCR assay, Western blot analysis, and ELISA assay showed that PLGA–lovastatin (100 μg/mL) induced the highest mRNA and protein expression of DSPP, DMP1, and OCN in pulp cells. Histological evaluation of the animal studies revealed that MTA was superior to the PLGA–lovastatin in stimulating the formation of tubular dentin in an observation period of 2 weeks. However, in an observation period of 4 weeks, it was evident that the PLGA–lovastatin and MTA were competitive in the formation of tubular reparative dentin and a complete dentinal bridge.
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Affiliation(s)
- Hung-Pin Lin
- Department of Dentistry, MacKay Memorial Hospital.,Department of Dentistry, School of Dentistry, National Taiwan University
| | - Han-Ping Tu
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University and National Taiwan University Hospital
| | - Yu-Ping Hsieh
- School of Dentistry, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Bor-Shiunn Lee
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University and National Taiwan University Hospital
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Songsiripradubboon S, Kladkaew S, Trairatvorakul C, Sangvanich P, Soontornvipart K, Banlunara W, Thunyakitpisal P. Stimulation of Dentin Regeneration by Using Acemannan in Teeth with Lipopolysaccharide-induced Pulp Inflammation. J Endod 2017; 43:1097-1103. [PMID: 28477996 DOI: 10.1016/j.joen.2017.01.037] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 01/12/2017] [Accepted: 01/25/2017] [Indexed: 01/22/2023]
Abstract
INTRODUCTION This study investigated the effects of acemannan, a polysaccharide from Aloe vera, on human deciduous pulp cells in vitro and the response after vital pulp therapy in dog deciduous teeth. METHODS Human primary dental pulpal cells were treated with acemannan in vitro and evaluated for proliferation, alkaline phosphatase activity, type I collagen, bone morphogenetic protein (BMP-2), BMP-4, vascular endothelial growth factor, and dentin sialoprotein expression and mineralization. Osteogenesis-related gene expression was analyzed by complementary DNA microarray. Pulpal inflammation was induced in dog teeth for 14 days. The inflamed pulp was removed, retaining the healthy pulp. The teeth were randomly divided into 3 treatment groups: acemannan, mineral trioxide aggregate, and formocresol. Sixty days later, the teeth were extracted and evaluated histopathologically. RESULTS Acemannan significantly increased pulp cell proliferation, alkaline phosphatase, type I collagen, BMP-2, BMP-4, vascular endothelial growth factor, and dentin sialoprotein expression and mineralization approximately 1.4-, 1.6-, 1.6-, 5.5-, 2.6-, 3.8-, 1.8-, and 4.8-fold, respectively, compared with control. In vivo, partial pulpotomy treatment using acemannan generated outcomes similar to mineral trioxide aggregate treatment, resulting in mineralized bridge formation with normal pulp tissue without inflammation or pulp necrosis. In contrast, the formocresol group demonstrated pulp inflammation without mineralized bridge formation. CONCLUSIONS Acemannan is biocompatible with the dental pulp. Furthermore, acemannan stimulated dentin regeneration in teeth with reversible pulpitis.
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Affiliation(s)
- Siriporn Songsiripradubboon
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Dental Biomaterials Science Program, Graduate School, Chulalongkorn University, Bangkok, Thailand
| | - Sarunya Kladkaew
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Chutima Trairatvorakul
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Polakit Sangvanich
- Department of Chemistry, Faculty of Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Kumpanart Soontornvipart
- Department of Surgery, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Wijit Banlunara
- Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Pasutha Thunyakitpisal
- Research Unit of Herbal Medicine, Biomaterial and Material for Dental Treatment, Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
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A randomized controlled trial of various MTA materials for partial pulpotomy in permanent teeth. J Dent 2017; 60:8-13. [DOI: 10.1016/j.jdent.2016.07.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 07/22/2016] [Accepted: 07/26/2016] [Indexed: 11/22/2022] Open
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Katge FA, Patil DP. Comparative Analysis of 2 Calcium Silicate-based Cements (Biodentine and Mineral Trioxide Aggregate) as Direct Pulp-capping Agent in Young Permanent Molars: A Split Mouth Study. J Endod 2017; 43:507-513. [PMID: 28216271 DOI: 10.1016/j.joen.2016.11.026] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 11/29/2016] [Accepted: 11/30/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The purpose of this study was to compare Biodentine and mineral trioxide aggregate (MTA) for direct pulp capping in young permanent molars by clinical and radiographic evaluation in 7- to 9-year-old children. METHODS In 50 patients, 29 patients with bilateral asymptomatic first permanent molars with carious involvement were selected. According to split mouth design, these patients were then divided into 2 groups, Biodentine group (right side) and MTA group (left side). The pulp-capping procedure was performed by using Biodentine and MTA in 58 asymptomatic bilateral permanent molars with pulp exposure. At each recall (baseline, 6 and 12 months), treatment outcome was assessed clinically through pulpal sensitivity tests as well as radiographically to evaluate dentin bridge formation. RESULTS The study reported 100% success rate with both Biodentine and MTA at baseline and 6- and 12-month follow-up on the basis of clinical and radiographic parameters. These findings were statistically non-significant (P < .05) between both groups (Biodentine and MTA). Radiographically, dentin bridge formation was not evident with both groups at baseline, but it was evident after 6- and 12-month follow-up. These findings were statistically non-significant (P < .05) in both Biodentine and MTA groups. CONCLUSIONS This study reported 100% success rate with both MTA and Biodentine when used as direct pulp-capping agent in first permanent molars in 7- to 9-year-old children. The major limitations of the study were smaller sample size and short follow-up period.
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Affiliation(s)
- Farhin A Katge
- Department of Pedodontics and Preventive Dentistry, Terna Dental College, Navi Mumbai, Maharashtra, India.
| | - Devendra P Patil
- Department of Pedodontics and Preventive Dentistry, Terna Dental College, Navi Mumbai, Maharashtra, India
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Ashraf H, Rahmati A, Amini N. Vital Pulp Therapy with Calcium-Silicate Cements: Report of Two Cases. IRANIAN ENDODONTIC JOURNAL 2017; 12:112-115. [PMID: 28179936 PMCID: PMC5282391 DOI: 10.22037/iej.2017.23] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
This article describes successful use of calcium-enriched mixture (CEM) cement and Biodentine in apexogenesis treatment in two 8-year-old patients, one with immature permanent molar
diagnosed primarily with irreversible pulpitis and the other with partially vital maxillary central
incisor. After access cavity preparation, partial pulpotomy in molar and full pulpotomy in
central was performed, and the remaining pulps was capped with either Biodentine or CEM
cement, in each tooth. The crowns were restored with composite filling material at the following
visit. The post-operative radiographic and clinical examinations (approx. average of 16 months)
showed that both treated teeth remained functional, with complete root development and apex
formation. A calcified bridge was produced underneath the capping material. No further
endodontic intervention was necessary. Considering the healing potential of immature vital
pulps, the use of CEM cement and Biodentine for apexogenesis might be an applicable choice.
These new endodontic biomaterials might be appropriate for vital pulp therapies in an
immature tooth. However, further clinical studies with longer follow-up periods are
recommended.
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Affiliation(s)
- Hengameh Ashraf
- Endodontic Department, Dental School, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Afsaneh Rahmati
- Endodontic Department, Dental School, Hamedan University of Medical Science, Hamedan, Iran
| | - Neda Amini
- Dentist, Professional Trainee at University of Texas Health Science Center at Houston
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LEE M, KANG CM, SONG JS, SHIN Y, KIM S, KIM SO, CHOI HJ. Biological efficacy of two mineral trioxide aggregate (MTA)-based materials in a canine model of pulpotomy. Dent Mater J 2017; 36:41-47. [DOI: 10.4012/dmj.2016-121] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Myeongyeon LEE
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University
| | - Chung-Min KANG
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University
| | - Je Seon SONG
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University
- Oral Science Research Center, College of Dentistry, Yonsei University
| | - Yooseok SHIN
- Oral Science Research Center, College of Dentistry, Yonsei University
- Department of Conservative Dentistry, College of Dentistry, Yonsei University
| | - Seunghye KIM
- Department of Pediatric Dentistry, Institute of Oral Health Science, Ajou University School of Medicine
| | - Seong-Oh KIM
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University
- Oral Science Research Center, College of Dentistry, Yonsei University
| | - Hyung-Jun CHOI
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University
- Oral Science Research Center, College of Dentistry, Yonsei University
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Zanini M, Hennequin M, Cousson PY. A Review of Criteria for the Evaluation of Pulpotomy Outcomes in Mature Permanent Teeth. J Endod 2016; 42:1167-74. [DOI: 10.1016/j.joen.2016.05.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 05/13/2016] [Accepted: 05/15/2016] [Indexed: 10/21/2022]
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Bidar M, Moushekhian S, Gharechahi M, Talati A, Ahrari F, Bojarpour M. The Effect of Low Level Laser Therapy on Direct Pulp Capping in Dogs. J Lasers Med Sci 2016; 7:177-183. [PMID: 28144439 DOI: 10.15171/jlms.2016.31] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: The aim of this study was to determine the histologic effect of low level laser therapy (LLLT) with or without the use of mineral trioxide aggregate (MTA) on exposed pulp tissues of dogs. Methods: Twenty-five premolar teeth in three healthy mature dogs were randomly divided into five groups. In group 1, the pulp tissue was capped with MTA. In groups 2 and 3, before capping with MTA, the exposure site was irradiated by low power lasers at 630 nm (20 mW, 150 seconds, 7.5 J/cm2) and 810 nm (peak power 80 W, average power 50 mW, 1500 Hz, 50 seconds, 6.25 J/cm2) wavelengths, respectively. In groups 4 and 5, the exposure site was irradiated similar to that described in groups 2 and 3, but the pulp tissue was covered by gold foil instead of MTA. After 2 months, the animals were sacrificed and the samples were prepared for histologic evaluation. Results: There were differences in pulpal response and dentinal barrier formation among the study groups. The morphology of pulpal tissue and the integrity of dentinal barrier and formation of odontoblastic layer were more favorable in the first three groups. The occurrence of extensive and intense inflammation and necrosis was more frequent in groups 4 and 5. Conclusion: Under the conditions used in this study, the presence of MTA as a pulp capping material was more important than laser therapy in the success of direct pulp capping (DPC) treatment. MTA proved to be an effective material either alone or in combination with laser irradiation in vital pulp therapy.
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Affiliation(s)
- Maryam Bidar
- Dental Research Center, Department of Endodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Siavash Moushekhian
- Dental Research Center, Department of Endodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Gharechahi
- Dental Materials Research Center, Department of Endodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Talati
- Dental Research Center, Department of Endodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzaneh Ahrari
- Laser Research Center, Department of Orthodonthics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Hoshyari N, Labbaf H, Jalayer Naderi N, Kazemi A, Bastami F, Koopaei M. Biocompatibility of Portland Cement Modified with Titanium Oxide and Calcium Chloride in a Rat Model. IRANIAN ENDODONTIC JOURNAL 2016; 11:124-8. [PMID: 27141221 PMCID: PMC4841348 DOI: 10.7508/iej.2016.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/11/2016] [Accepted: 02/01/2016] [Indexed: 11/30/2022]
Abstract
Introduction: The aim of the present study was to evaluate the biocompatibility of two modified formulations of Portland cement (PC) mixed with either titanium oxide or both titanium oxide and calcium chloride. Methods and Materials: Polyethylene tubes were filled with modified PCs or Angelus MTA as the control; the tubes were then implanted in 28 Wistar rats subcutaneously. One tube was left empty as a negative control in each rat. Histologic samples were taken after 7, 15, 30 and 60 days. Sections were assessed histologically for inflammatory responses and presence of fibrous capsule and granulation tissue formation. Data were analyzed using the Fisher’s exact and Kruskal-Wallis tests. Result: PC mixed with titanium oxide showed the highest mean scores of inflammation compared with others. There was no statistically significant difference in the mean inflammatory grades between all groups in each of the understudy time intervals. Conclusion: The results showed favorable biocompatibility of these modified PC mixed with calcium chloride and titanium oxide.
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Affiliation(s)
- Narjes Hoshyari
- Endodontic Department, Dental School, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Labbaf
- Endodontic Department, Dental School, Shahed University, Tehran, Iran
| | | | - Ali Kazemi
- Endodontic Department, Dental School, Shahed University, Tehran, Iran
| | - Farshid Bastami
- Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Koopaei
- Oral Medicine Department, Dental School, Tehran University of Medical Sciences, Tehran, Iran
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