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Narayanam R, Cardoso LM, Dos Reis-Prado AH, de Carvalho ABG, Anselmi C, Mahmoud AH, Fenno JC, Dal-Fabbro R, Bottino MC. Antimicrobial Silk Fibroin Methacrylated Scaffolds for Regenerative Endodontics. J Endod 2024:S0099-2399(24)00442-4. [PMID: 39155022 DOI: 10.1016/j.joen.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 08/05/2024] [Accepted: 08/07/2024] [Indexed: 08/20/2024]
Abstract
INTRODUCTION Recognizing the necessity of novel disinfection strategies for improved bacterial control to ultimately favor tissue regeneration, this study developed and characterized antibiotics-laden silk fibroin methacrylated (SilkMA) scaffolds for regenerative endodontics. METHODS SilkMA-based solutions (10% w/v) containing Clindamycin (CLI) or Tinidazole (TIN) (0 - control; 5, 10, or 15% w/w) or the combination of both drugs (BiMix CLI/TIN 10%) were electrospun and photocrosslinked. Morphology and composition were assessed using scanning electron microscopy and Fourier-transform infrared spectroscopy. Additionally, swelling and degradation profiles were also determined. Cytotoxicity was evaluated in stem cells from apical papilla. Antibacterial efficacy was tested using direct and indirect contact assays against Aggregatibacter actinomycetemcomitans/Aa, Actinomyces naeslundii/An, Enterococcus faecalis/Ef, and Fusobacterium nucleatum/Fn. E. faecalis biofilm inhibition on dentin discs was specifically evaluated for BiMix-laden scaffolds. Data were statistically analyzed with a significance level of 5%. RESULTS Scanning electron microscopy revealed that all scaffolds had similar characteristics, including fiber morphology and bead absence. Fourier-transform infrared spectroscopy showed the incorporation of CLI and TIN into the fibers and in BiMix scaffolds. Antibiotic-laden scaffolds exhibited lower swelling capacity than the control and were degraded entirely after 45 days. Scaffolds laden with CLI, TIN, or BiMix throughout all time points did not reduce stem cells from apical papilla's viability. CLI-laden scaffolds inhibited the growth of Aa, An, and Ef, while TIN-laden scaffolds inhibited Fn growth. BiMix-laden scaffolds significantly inhibited Aa, An, Ef, and Fn in direct contact, and their aliquots inhibited An and Fn through indirect contact, with additional biofilm inhibition against Ef. CONCLUSIONS BiMix-laden SilkMA scaffolds are cytocompatible and exhibit antimicrobial effects against endodontic pathogens, indicating their therapeutic potential as a drug delivery system for regenerative endodontics.
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Affiliation(s)
- Ramyasaketha Narayanam
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan-School of Dentistry, Ann Arbor, Michigan
| | - Lais M Cardoso
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan-School of Dentistry, Ann Arbor, Michigan; Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP)-Araraquara School of Dentistry, Araraquara, São Paulo, Brazil
| | - Alexandre H Dos Reis-Prado
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan-School of Dentistry, Ann Arbor, Michigan; Department of Restorative Dentistry, Minas Gerais Federal University (UFMG)-School of Dentistry, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Beatriz G de Carvalho
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan-School of Dentistry, Ann Arbor, Michigan; Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP)-Sao Jose dos Campos School of Dentistry, São José dos Campos, São Paulo, Brazil
| | - Caroline Anselmi
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan-School of Dentistry, Ann Arbor, Michigan; Department of Morphology and Pediatric Dentistry, São Paulo State University (UNESP)-Araraquara School of Dentistry, Araraquara, São Paulo, Brazil
| | - Abdel H Mahmoud
- Department of Oral Biology and Pathology, Stony Brook University-School of Dental Medicine, Stony Brook, New York
| | - J Christopher Fenno
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan-School of Dentistry, Ann Arbor, Michigan
| | - Renan Dal-Fabbro
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan-School of Dentistry, Ann Arbor, Michigan
| | - Marco C Bottino
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan-School of Dentistry, Ann Arbor, Michigan; Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, Michigan.
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Kim M, Jeon S, Seo MS. Endodontic characteristics of mandibular premolar with dens evaginatus: a retrospective study. Restor Dent Endod 2024; 49:e28. [PMID: 39247643 PMCID: PMC11377877 DOI: 10.5395/rde.2024.49.e28] [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: 04/09/2024] [Revised: 06/15/2024] [Accepted: 06/16/2024] [Indexed: 09/10/2024] Open
Abstract
Objectives This study aimed to investigate the endodontic characteristics of mandibular premolars with dens evaginatus (DE) that require endodontic treatment. Materials and Methods Patients who underwent endodontic treatment were enrolled. The inclusion criteria were patients who underwent root canal treatment in the lower permanent teeth with DE and were followed up for at least 1 year. Preoperative clinical and radiographic variables were obtained. The frequency distribution of the preoperative variables was compared using the χ2 or Fisher's exact tests. The significance of the change in periapical health index (PAI) and root development stages before and after treatment was examined using the Wilcoxon signed-rank test. Results A total of 150 teeth of 134 patients with an average age of 15.3 years were included. The percentage distribution comparison of the preoperative variables and obturation techniques revealed significant differences in pulpal and periapical diagnosis, and percussion, and especially regarding age, root development stage, and PAI. Age was the only statistically significant preoperative variable associated with root growth (p < 0.05). Conclusions Approximately, 60% of DEs requiring endodontic treatment had immature roots. Age being the most significant predisposing factor, early treatment provides the greatest opportunity for full root development.
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Affiliation(s)
- Minjin Kim
- Department of Conservative Dentistry, Wonkwang University Daejeon Dental Hospital, Daejeon, Korea
| | - Sujin Jeon
- Department of Conservative Dentistry, Wonkwang University Daejeon Dental Hospital, Daejeon, Korea
| | - Min-Seock Seo
- Department of Conservative Dentistry, Wonkwang University Daejeon Dental Hospital, Daejeon, Korea
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Chotvorrarak K, Danwittayakorn S, Banomyong D, Suksaphar W. Intraradicular reinforcement of traumatized immature anterior teeth after MTA apexification. Dent Traumatol 2024; 40:389-397. [PMID: 38459664 DOI: 10.1111/edt.12947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 03/10/2024]
Abstract
This review article describes the methods and clinical recommendations for reinforcing traumatized anterior immature teeth with pulp necrosis treated with mineral trioxide aggregate (MTA) apexification. Traumatic injury can cause pulp necrosis and incomplete root formation in immature teeth. MTA apexification is the treatment of choice for necrotic immature teeth, particularly during the middle or late stages of root development. MTA apexification has a high success rate; however, failures due to cervical or root fractures occasionally occur. The risk of fracture is higher in immature teeth with thin root dentin, particularly those with external root resorption. Furthermore, the loading force from any parafunctional habit also increases fracture risk. Therefore, intra-radicular reinforcement may be necessary after MTA apexification. In vitro, intraradicular restoration with a resin composite/core build-up material or a prefabricated fiber post demonstrated better root reinforcement than root canal obturation materials (i.e., gutta-percha and sealer). However, the root-reinforcement effect of MTA orthograde filling in the entire root canal remains unclear. In vivo, the survival of fractured teeth with intraradicular restorations (resin composite/core build-up material or prefabricated fiber posts) is extremely high. Moreover, the survival of teeth with gutta-percha/sealer obturation or MTA orthograde filling and restoration with resin composite extending into the cervical third of the root canal approximately 1-2 mm below the cemento-enamel junction is acceptably high. Based on this evidence, the remaining tooth/root structure and loading force should be carefully examined when considering intra-radicular reinforcement of immature anterior teeth treated with MTA apexification.
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Affiliation(s)
- Kanet Chotvorrarak
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Danuchit Banomyong
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
- Private practice, Bangkok, Thailand
| | - Warattama Suksaphar
- Department of Endodontics, College of Dental Medicine, Rangsit University, Pathum Thani, Thailand
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Di T, Feng C, Wang L, Xu J, Du Y, Cheng B, Chen Y, Wu L. Enhancing Vasculogenesis in Dental Pulp Development: DPSCs-ECs Communication via FN1-ITGA5 Signaling. Stem Cell Rev Rep 2024; 20:1060-1077. [PMID: 38418738 PMCID: PMC11087358 DOI: 10.1007/s12015-024-10695-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Dental pulp regeneration therapy is a challenge to achieve early vascularization during treatment. Studying the regulatory mechanisms of vascular formation during human dental pulp development may provide insights for related therapies. In this study, we utilized single-cell sequencing analysis to compare the gene expression of dental pulp stem cells (DPSCs) and vascular endothelial cells (ECs) from developing and mature dental pulps. METHOD Immunohistochemistry, Western blot, and real-time polymerase chain reaction (RT-PCR) were used to detect fibronectin 1 (FN1) expression and molecules, such as PI3K/AKT. Cell proliferation assay, scratch assay, tube formation assay and were used to investigate the effects of DPSCs on the vasculogenetic capability of ECs. Additionally, animal experiments involving mice were conducted. RESULT The results revealed that DPSCs exist around dental pulp vasculature. FN1 expression was significantly higher in DPSCs from young permanent pulps than mature pulps, promoting HUVEC proliferation, migration, and tube formation via ITGA5 and the downstream PI3K/AKT signaling pathway. CONCLUSION Our data indicate that intercellular communication between DPSCs and ECs mediated by FN1-ITGA5 signaling is crucial for vascularizationduring dental pulp development, laying an experimental foundation for future clinical studies.
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Affiliation(s)
- Tiankai Di
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
- Department of Stomatology, No.969 Hospital, Joint Logistics Support Force of the Chinese People's Liberation Army, Hohhot, Inner Mongolia, 010000, People's Republic of China
| | - Chao Feng
- Center for Computational Biology, Institute of Military Cognition and Brain Sciences, Academy of Military Medical Sciences, Beijing, 100850, People's Republic of China
- Department of Clinical Laboratory, No.969 Hospital, Joint Logistics Support Force of the Chinese People's Liberation Army, Hohhot, Inner Mongolia, 010000, People's Republic of China
| | - Lulu Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Jinlong Xu
- Department of Stomatology, No.969 Hospital, Joint Logistics Support Force of the Chinese People's Liberation Army, Hohhot, Inner Mongolia, 010000, People's Republic of China
| | - Yang Du
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Baixiang Cheng
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Department of General Dentistry, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Yujiang Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
- Department of Neurobiology and Institute of Neurosciences, School of Basic Medicine, Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
| | - Lian Wu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
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Zhao B, Zhang Q, Yang H, Yu S, Fu R, Shi S, Wang Y, Zhou W, Cui Y, Guo Q, Zhang X. Peptide KN-17-Loaded Supramolecular Hydrogel Induces the Regeneration of the Pulp-Dentin Complex. ACS Biomater Sci Eng 2024; 10:2523-2533. [PMID: 38445444 DOI: 10.1021/acsbiomaterials.3c01376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Regenerating the pulp-dentin complex remains a decisive factor during apexification for immature permanent teeth. Peptide KN-17, which was modified based on the structure of cecropin B, could effectively interfere with bacterial growth and induce the migration of human bone marrow stromal cells (hBMSCs). This study aimed to investigate the effect of KN-17 on the tissue regeneration. To our surprise, KN-17 can significantly stimulate angiogenesis in vitro and in vivo, which may provide a guarantee for apical closure. Herein, a novel peptide/KN-17 coassembled hydrogel is developed via a heating-cooling process. Npx-FFEY/KN-17 supramolecular hydrogel can induce vessel development, stimulate odontogenic differentiation of human dental pulp stem cells (hDPSCs), and exert an antibacterial effect on Enterococcus faecalis (E. faecalis). Furthermore, coronal pulp excised rat molars are supplied with KN-17 or KN-17-loaded hydrogel and transplanted subcutaneously in BALB/c-nu mice. After 4 weeks, the hydrogel Npx-FFEY/KN-17 stimulates the formation of multiple odontoblast-like cells and dentin-like structures. Our findings demonstrate that the KN-17-loaded hydrogel can promote the regeneration of the pulp-dentin complex for continued root development.
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Affiliation(s)
- Borui Zhao
- School and Hospital of Stomatology, Tianjin Medical University, Tianjin 300070, China
| | - Qian Zhang
- School and Hospital of Stomatology, Tianjin Medical University, Tianjin 300070, China
| | - Houzhi Yang
- Tianjin Medical University, Tianjin 300070, China
| | - Shuipeng Yu
- School and Hospital of Stomatology, Tianjin Medical University, Tianjin 300070, China
| | - Rui Fu
- Tianjin Medical University, Tianjin 300070, China
| | - Shurui Shi
- School and Hospital of Stomatology, Tianjin Medical University, Tianjin 300070, China
| | - Yuanyuan Wang
- School and Hospital of Stomatology, Tianjin Medical University, Tianjin 300070, China
| | - Wei Zhou
- Immunology, Microenvironment & Metastasis Program, The Wistar Institute, Philadelphia, Pennsylvania 19104, United States
| | - Yange Cui
- Program in Gene Expression and Regulation, The Wistar Institute, Philadelphia, Pennsylvania 19104, United States
| | - Qingxiang Guo
- College of Chemical Engineering, Inner Mongolia University of Technology, Hohhot 010051, China
| | - Xi Zhang
- School and Hospital of Stomatology, Tianjin Medical University, Tianjin 300070, China
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Gill I, Mittal S, Kumar T, Keshav V. Open Apex and its Management: Review Article. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S31-S34. [PMID: 38595371 PMCID: PMC11000961 DOI: 10.4103/jpbs.jpbs_615_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 04/11/2024] Open
Abstract
During root development, the teeth are subjected to a variety of assaults. Due to this, the root stops forming and the closure of the apex does not take place. Root canal treatment becomes a major challenge in these cases because of the width of the canal and wide-open apices. Management of open apices includes apexogenesis in vital young permanent teeth and apexification, which is a method to induce a calcified barrier in the root. Newer concepts include regeneration and revascularization procedures, which still need to be experimented with further.
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Affiliation(s)
- Ikroop Gill
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Sunandan Mittal
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Tarun Kumar
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Vanita Keshav
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
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Ma L, Lai H, Zhao W. Evaluating the Effectiveness of a Virtual Simulation Platform for Apexification Learning. Dent J (Basel) 2024; 12:27. [PMID: 38392231 PMCID: PMC10887995 DOI: 10.3390/dj12020027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
The traditional teaching methods for apexification face difficulties in meeting dental students' practical training needs. Herein, we aimed to find optimal techniques of learning apexification and to evaluate whether a virtual simulation platform for apexification learning was effective. A virtual simulation learning platform for apexification was developed. Ninety-nine 4th-year dentistry students were classified randomly into the control group (Con, receiving conventional teaching) and the experimental group (Exp, receiving virtual simulation teaching). Theoretical tests before (test 1) and after the virtual simulation training (test 2) assessed the effect of learning. In the Exp group, a questionnaire was used to assess student understanding of the virtual simulation platform. In the Exp group, the test-2 scores were significantly better compared those in the Con group (p < 0.001). Furthermore, in the Exp group, the test-2 scores exceeded those of test 1 (p < 0.001). Feedback using the questionnaire covered the evaluation of the Exp group for the virtual reality platform and offered useful suggestions. Applying the virtual simulation learning platform had positive effects on improving learning quality related to apexification.
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Affiliation(s)
- Lan Ma
- Department of Pediatric Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou 510275, China
| | - Hongbin Lai
- Department of Pediatric Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou 510275, China
| | - Wei Zhao
- Department of Pediatric Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou 510275, China
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Xie F, Zhu C, Gong L, Zhu N, Ma Q, Yang Y, Zhao X, Qin M, Lin Z, Wang Y. Engineering core-shell chromium nanozymes with inflammation-suppressing, ROS-scavenging and antibacterial properties for pulpitis treatment. NANOSCALE 2023; 15:13971-13986. [PMID: 37606502 DOI: 10.1039/d3nr02930a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
Oral diseases are usually caused by inflammation and bacterial infection. Reactive oxygen species (ROS), which come from both autologous inflammation tissue and bacterial infection, play an important role in this process. Thus, the elimination of excessive intracellular ROS can be a promising strategy for anti-inflammatory treatment. With the rapid development of nanomedicines, nanozymes, which can maintain the intracellular redox balance and protect cells against oxidative damage, have shown great application prospects in the treatment of inflammation-related diseases. However, their performance in pulpitis and their related mechanisms have yet to be explored. Herein, we prepared dozens of metallic nanoparticles with core-shell structures, and among them, chromium nanoparticles (NanoCr) were selected for their great therapeutic potential for pulpitis disease. NanoCr showed a broad antibacterial spectrum and strong anti-inflammatory function. Antibacterial assays showed that NanoCr could effectively inhibit a variety of common pathogens of oral infection. In vitro experiments offered evidence of the multienzyme activity of NanoCr and its function in suppressing ROS-induced inflammation reactions. The experimental results show that NanoCr has optimal antibacterial and anti-inflammatory properties in in vitro cell models, showing great potential for the treatment of pulpitis. Therefore, the use of NanoCr could become a new therapeutic strategy for clinical pulpitis.
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Affiliation(s)
- Fei Xie
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Peking University, Beijing 100081, P.R. China.
| | - Chuanda Zhu
- Institute of Systems Biomedicine, School of Basic Medical Sciences, Beijing Key Laboratory of Tumor Systems Biology, Peking University Health Science Center, Beijing 100191, P.R. China.
- Department of Biochemistry and Biophysics, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, P.R. China
| | - Lidong Gong
- Institute of Systems Biomedicine, School of Basic Medical Sciences, Beijing Key Laboratory of Tumor Systems Biology, Peking University Health Science Center, Beijing 100191, P.R. China.
| | - Ningxin Zhu
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Peking University, Beijing 100081, P.R. China.
| | - Qiang Ma
- Institute of Environment and Sustainable Development in Agriculture, Chinese academy of Agriculture, Beijing 100081, P.R. China
| | - Yuanyuan Yang
- Institute of Systems Biomedicine, School of Basic Medical Sciences, Beijing Key Laboratory of Tumor Systems Biology, Peking University Health Science Center, Beijing 100191, P.R. China.
| | - Xinrong Zhao
- Center of Medical and Health Analysis, Peking University Health Science Center, Beijing 100191, P.R. China
| | - Man Qin
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Peking University, Beijing 100081, P.R. China.
| | - Zhiqiang Lin
- Institute of Systems Biomedicine, School of Basic Medical Sciences, Beijing Key Laboratory of Tumor Systems Biology, Peking University Health Science Center, Beijing 100191, P.R. China.
| | - Yuanyuan Wang
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Peking University, Beijing 100081, P.R. China.
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Kalaoglu EE, Duman C, Capan BS, Ocak M, Bilecenoglu B. Comparison of three different biomaterials used in in vitro molar apexification models. BMC Oral Health 2023; 23:434. [PMID: 37391750 PMCID: PMC10311754 DOI: 10.1186/s12903-023-03180-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/27/2023] [Indexed: 07/02/2023] Open
Abstract
OBJECTIVES New biomaterials had some advantages such as mixing and easier application as compared to traditional MTA in single step apexification method. This study aimed to compare the three biomaterials used in the apexification treatment of immature molar teeth in terms of the time spent, the quality of the canal filling and the number of x-rays taken to complete the process. METHODS The root canals of the extracted thirty molar teeth were shaped with rotary tools. To obtain the apexification model, ProTaper F3 was used retrograde. The teeth were randomly assigned into three groups based on the material used to seal the apex; Group 1: Pro Root MTA, Group 2: MTA Flow, Group 3: Biodentine. The amounts of the filling, the number of radiographs taken until treatment completion and the treatment duration were recorded. Then teeth were fixed for micro computed tomography imaging for quality evaluation of canal filling. RESULTS Biodentine was superior to the other filling materials according to time. MTA Flow provided greater filling volume than the other filling materials in the rank comparison for the mesiobuccal canals. MTA Flow had greater filling volume than ProRoot MTA in the palatinal/distal canals(p = 0.039). Biodentine had greater filling volume more than MTA Flow in the mesiolingual/distobuccal canals (p = 0.049). CONCLUSIONS MTA Flow was found as a suitable biomaterial according to the treatment time and quality of root canal fillings.
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Affiliation(s)
- Elif Ece Kalaoglu
- Faculty of Dentistry, Department of Pedodontics, Istanbul Gelisim University, Istanbul, Turkey.
| | - Canan Duman
- Faculty of Dentistry, Department of Pedodontics, Istanbul Atlas University, Istanbul, Turkey
| | - Belen Sirinoglu Capan
- Faculty of Dentistry, Department of Pedodontics, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Mert Ocak
- Faculty of Dentistry, Department of Anatomy, Ankara University, Ankara, Turkey
| | - Burak Bilecenoglu
- Faculty of Medicine, Department of Anatomy, Ankara Medipol University, Ankara, Turkey
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Li K, O'Dwyer R, Yang F, Cymerman J, Li J, Feldman JD, Simon M, Rafailovich M. Enhancement of acellular biomineralization, dental pulp stem cell migration, and differentiation by hybrid fibrin gelatin scaffolds. Dent Mater 2023; 39:305-319. [PMID: 36746694 DOI: 10.1016/j.dental.2023.01.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 01/16/2023] [Accepted: 01/31/2023] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The current in vitro study aims to evaluate cross-linked hydrogels with and without the addition of fibrin that could potentially be used in endodontic regeneration as a scaffold material. METHODS Synthesis of gelatin/fibrin scaffold, and performing nanoscale characterization using cryo-electron microscopy, dynamic rheology, and XRF for structure property relations; plating dental pulp stem cells and determining mineralization, migration, and differentiation using rt-PCR, XRF, and Raman spectroscopy. RESULTS Cryo electron imaging shows gelatin and fibrin, when gelled separately to form classical rectangular cross-linked networks, where the modulus scales inversely with the cube root of the mesh size. When gelled together, a network with a fundamentally different structure is formed, which has higher ductility and when placed as a scaffold in osteogenic media, produces twice the mineral content. Immunofluorescence, RT-PCR and Rahman Spectroscopy indicate that the hybrid gel enhances cell migration, induces odontogenic differentiation of dental pulp stem cells, and promotes formation of dentin. SIGNIFICANCE The mechanical properties of the hybrid gel scaffold enhance in-migration of stem cells and subsequent differentiation, which are critical for regenerative procedures. Under acellular conditions, placement of the hybrid gel enhances biomineralization, which would strengthen the root if used as a scaffold for endodontic regeneration. Our in vitro findings are consistent with previous in vivo studies which show improved mineralization when bleeding is induced into the canal, given that fibrin is a primary component in blood clotting. Therefore, insertion of the hybrid gelatin-fibrin scaffold could enable more reproducible and consistent outcomes if used for regenerative endodontic treatment (RET).
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Affiliation(s)
- Kao Li
- Department of Materials Science and Chemical Engineering, Stony Brook University, Stony Brook, NY 11794, USA; Shandong Institute of Petroleum and Chemical Technology, Doying, Shandong 257061, China
| | - Rita O'Dwyer
- Department of Periodontology, Division of Endodontics, School of Dental Medicine, Stony Brook University, NY 11794, USA; Department of Oral Biology and Pathology, Stony Brook University Medical Center, Stony Brook, NY 11794, USA
| | - Fan Yang
- Department of Materials Science and Chemical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Jerome Cymerman
- Department of Periodontology, Division of Endodontics, School of Dental Medicine, Stony Brook University, NY 11794, USA; Department of Oral Biology and Pathology, Stony Brook University Medical Center, Stony Brook, NY 11794, USA
| | - Juyi Li
- Department of Materials Science and Chemical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Jake D Feldman
- Department of Biology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Marcia Simon
- Department of Oral Biology and Pathology, Stony Brook University Medical Center, Stony Brook, NY 11794, USA
| | - Miriam Rafailovich
- Department of Materials Science and Chemical Engineering, Stony Brook University, Stony Brook, NY 11794, USA.
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Mousivand S, Sheikhnezami M, Moradi S, Koohestanian N, Jafarzadeh H. Evaluation of the outcome of apexogenesis in traumatised anterior and carious posterior teeth using mineral trioxide aggregate: a 5-year retrospective study. AUST ENDOD J 2022; 48. [PMID: 34699673 DOI: 10.1111/aej.12583] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/02/2021] [Accepted: 09/26/2021] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to evaluate the outcome of apexogenesis with mineral trioxide aggregate (MTA) in traumatised anterior and carious posterior teeth over 5 years. A comprehensive chart review was performed to obtain a retrospective of sequential previously completed cases with recalls. Clinical and radiographic data were collected for 97 vital immature teeth (40 traumatised anterior and 57 carious posterior teeth) pulpotomised (partial or full pulpotomy) using MTA with an average follow-up time of 5 years. Chi-squared test and Fisher's exact test were implemented to analyse data. The success rate in anterior teeth and posterior teeth was 82.5% and 96.4% respectively. Crown discolouration was observed in 25 (62.5%) anterior teeth. There was a significant difference between the number of successful and unsuccessful cases (P < 0.05) and there was no correlation between type of treatment and success/failure (P > 0.05). The success rate of apexogenesis using MTA in immature teeth was relatively high.
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Affiliation(s)
| | - Mahshid Sheikhnezami
- Dental Trauma Center, Academic Center for Education, Culture and Research, Mashhad, Iran
| | - Saeed Moradi
- Dental Material Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Hamid Jafarzadeh
- Dental Trauma Center, Academic Center for Education, Culture and Research, Mashhad, Iran.,Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
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12
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Ren H, Wen Q, Zhao Q, Wang N, Zhao Y. Atlas of human dental pulp cells at multiple spatial and temporal levels based on single-cell sequencing analysis. Front Physiol 2022; 13:993478. [PMID: 36267574 PMCID: PMC9578252 DOI: 10.3389/fphys.2022.993478] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
The dental pulp plays a crucial role in the long-term maintenance of tooth function. The progress of endodontic treatment and pulp tissue regeneration engineering has made pulp-regeneration therapy promising in clinical practice. However, the mechanisms of pulp regeneration and the role of dental stem cells in development and regeneration have not been fully elucidated. Bridging the gaps between clinical operation and basic research is urgently needed. With the application of single-cell sequencing technology in dental research, the landscapes of human dental pulp cells have begun being outlined. However, the specific cellular heterogeneity of dental pulp cells, especially that of dental stem cells, at different spatial and temporal levels, is still unclear. In this study, we used single-cell RNA sequencing analysis of pulp samples at four different developmental stages and combined the findings with immunohistochemical staining to explore the development of dental pulp and stem cells. The results revealed temporal changes in the proportion of pulp cells during development. For example, mononuclear phagocytes accounted for a higher proportion in early samples. Odontoblasts identified by DMP1 had a higher expression of ion channel-related and neurodevelopment-related genes. Subpopulations were identified in fibroblasts, odontoblasts, and mesenchymal stem cells. We identified a subclass of odontoblasts that expresses DGKI and RRBP1 present in early developmental samples. A population of earlier mesenchymal stem cells expressed the SEPTIN gene, which may have greater proliferative and differentiation potential. Furthermore, dental pulp stem cells can differentiate into two directions: mineralization and myogenesis. In summary, the specific cellular heterogeneity of dental pulp cells was revealed at different spatial and temporal levels. These findings may shed light on the mechanism of tooth development. The gene expression profile of developing pulp cells may help to select cells for regenerative engineering and improve the success of dental pulp regeneration.
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Affiliation(s)
- Huihui Ren
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPK Key Laboratory for Dental Materials, Beijing, China
| | - Quan Wen
- First Clinical Division, Peking University School and Hospital of Stomatology, Beijing, China
| | - Qingxuan Zhao
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPK Key Laboratory for Dental Materials, Beijing, China
| | - Nan Wang
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPK Key Laboratory for Dental Materials, Beijing, China
| | - Yuming Zhao
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPK Key Laboratory for Dental Materials, Beijing, China
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13
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Cytotoxicity and Efficacy in Debris and Smear Layer Removal of HOCl-Based Irrigating Solution: An In Vitro Study. J Funct Biomater 2022; 13:jfb13030095. [PMID: 35893463 PMCID: PMC9326542 DOI: 10.3390/jfb13030095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 12/10/2022] Open
Abstract
In the present study we evaluated the cytotoxicity of super-oxidized water on human gingival fibroblasts and its efficacy in debris and smear layer removal from root canal walls. Cultured gingival fibroblasts were exposed to super-oxidized water (Sterilox), which was diluted in Iscove’s modified Dulbecco’s medium (IMDM) at 30%, 40%, 50%, 60% and 70% concentrations. The control group was maintained in IMDM. The cell viability was evaluated by means of an MTT assay after incubation periods of 1 h, 2 h, 24 h and 48 h. Pathological cellular changes were also observed under fluorescence and phase contrast microscopes. The efficacy in debris and smear layer removal was evaluated in comparison to the conventional application of sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA). Forty maxillary premolars were randomly divided into two equal groups (n = 20) and shaped with ProTaper NEXT rotary instruments using Sterilox or NaOCl/EDTA for irrigation. Afterwards, roots were split longitudinally and examined under a scanning electron microscope. The results revealed that super-oxidized water and sterile distilled water have acceptable biological properties for endodontic applications at concentrations up to 50% (p > 0.05). Moreover, super-oxidized water is equally effective in debris and smear layer removal as compared to NaOCl/EDTA (p > 0.05).
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14
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Panda P, Mishra L, Govind S, Panda S, Lapinska B. Clinical Outcome and Comparison of Regenerative and Apexification Intervention in Young Immature Necrotic Teeth-A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11133909. [PMID: 35807193 PMCID: PMC9267570 DOI: 10.3390/jcm11133909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/24/2022] [Accepted: 06/30/2022] [Indexed: 12/12/2022] Open
Abstract
This systematic review aimed to evaluate interventions individually and compare the clinical outcome of young, immature teeth treated with regenerative endodontic therapy (RET) and apexification procedure. The protocol was registered with PROSPERO (International Prospective Register of Systematic Reviews), bearing the registration number CRD42021230284. A bibliographic search in the biomedical databases was conducted in four databases—PubMed, CENTRAL, EMBASE and ProQuest—using searching keywords and was limited to studies published between January 2000 and April 2022 in English. The search was supplemented by manual searching, citation screening and scanning of all reference lists of selected paper. The study selection criteria were randomized clinical trial, prospective clinical studies and observational studies. The search found 32 eligible articles, which were included in the study. The quality assessment of the studies was performed using the Cochrane risk of bias tool for randomized control trials and non-randomized clinical studies. The meta-analysis was performed using Review Manager software (REVMAN, version 5). The results indicated that a clinicians’ MTA apexification procedure was more successful compared to calcium hydroxide. In RET, apical closure and overall success rate is statistically same for both apical platelet concentrates (APCs) and blood clots (BC). Both interventions have similar survival rates; however, RET should be preferred in cases where the root development is severely deficient, there is insufficient dentine and the tooth’s prognosis is hopeless even with an apexification procedure.
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Affiliation(s)
- Pratima Panda
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (P.P.); (S.G.)
| | - Lora Mishra
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (P.P.); (S.G.)
- Correspondence: (L.M.); (B.L.); Tel.: +91-889-526-6363 (L.M.); +85-42-675-74-61 (B.L.)
| | - Shashirekha Govind
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (P.P.); (S.G.)
| | - Saurav Panda
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India;
| | - Barbara Lapinska
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland
- Correspondence: (L.M.); (B.L.); Tel.: +91-889-526-6363 (L.M.); +85-42-675-74-61 (B.L.)
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15
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Lu H, Lu J, Guo J, Zeng B, Zeng Q, Zhao W, Lin J. Radiographic outcomes and prognostic factors in nonvital immature permanent teeth after apexification with modified calcium hydroxide paste: a retrospective study. Clin Oral Investig 2022; 26:5079-5088. [DOI: 10.1007/s00784-022-04481-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 04/05/2022] [Indexed: 11/28/2022]
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16
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Gürcan AT, Bayram M. Children's dental treatment requirements of first permanent molars with poor prognosis. Clin Oral Investig 2021; 26:803-812. [PMID: 34240243 DOI: 10.1007/s00784-021-04059-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/26/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This retrospective study aimed to (i) survey the correlation between decayed, missing, filled teeth (DMFT), and presence of first permanent molars (FPMs) with poor prognosis and (ii) evaluate the treatment requirements. MATERIALS AND METHODS Seven hundred seventy-three children with fully erupted FPMs were included in this study. DMFT for the permanent dentition, FPMs, and Global DMFT were evaluated based on clinical and radiographic evaluation. The ratio of deep dentin caries (DDC) and apical lesion presence among FPMs, including treatment requirements, were analysed. Spearman rank correlation coefficient and t tests were used for statistical analysis. RESULTS The caries prevalence was found at 61.4%, where the mean DMFT was calculated as 1.89 ± 2.15. There was a positive correlation between DMFT values and age (rs = 0.27). On the other hand, there was a negative correlation between global DMFT values and age (rs = - 0.29). Regarding treatment needs of FPM with poor prognosis, 12.03% of the teeth needed pulpectomy, 8.93% pulpotomy, 8.93% pulp capping, and 5.3% extraction. Having higher DMFT values was correlated significantly (p < 0.01) with the presence of DDC (rs = 0.50) and apical lesion (rs = 0.34). Susceptibility to DDC and apical lesions was significantly higher at mandible than maxilla (p < 0.01). The correlation was significant between DMFT values and apical lesion presence (p < 0.01). CONCLUSION The ratio of FPMs with poor prognosis was found high in the study group. Treatment requirements of FPMs increased with age, and pulp interventions often took part in the majority. This study successfully concluded that higher DMFT values were correlated with the presence of DDC and apical lesion. CLINICAL RELEVANCE FPMs with poor prognosis demonstrate a risk factor for apical lesion presence.
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Affiliation(s)
- Aliye Tuğçe Gürcan
- Department of Pediatric Dentistry, School of Dentistry, Altınbaş University, 34147, Istanbul, Turkey.
| | - Merve Bayram
- Department of Pedodontics, School of Dentistry, Istanbul Medipol University, Istanbul, Turkey
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17
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Cui D, Yu S, Zhou X, Liu Y, Gan L, Pan Y, Zheng L, Wan M. Roles of Dental Mesenchymal Stem Cells in the Management of Immature Necrotic Permanent Teeth. Front Cell Dev Biol 2021; 9:666186. [PMID: 34095133 PMCID: PMC8170050 DOI: 10.3389/fcell.2021.666186] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/06/2021] [Indexed: 02/05/2023] Open
Abstract
Dental caries and trauma always lead to pulp necrosis and subsequent root development arrest of young permanent teeth. The traditional treatment, apexification, with the absence of further root formation, results in abnormal root morphology and compromises long-term prognosis. Regeneration endodontics procedures (REPs) have been developed and considered as an alternative strategy for management of immature permanent teeth with pulpal necrosis, including cell-free and cell-based REPs. Cell-free REPs, including revascularization and cell homing with molecules recruiting endogenous mesenchymal stem cells (MSCs), have been widely applied in clinical treatment, showing optimistic periapical lesion healing and continued root development. However, the regenerated pulp-dentin complex is still absent in these cases. Dental MSCs, as one of the essentials of tissue engineering, are vital seed cells in regenerative medicine. Dental MSC-based REPs have presented promising potential with pulp-dentin regeneration in large animal studies and clinical trials via cell transplantation. In the present review, we summarize current understanding of the biological basis of clinical treatments for immature necrotic permanent teeth and the roles of dental MSCs during this process and update the progress of MSC-based REPs in the administration of immature necrotic permanent teeth.
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Affiliation(s)
- Dixin Cui
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Sihan Yu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ying Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lu Gan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yue Pan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liwei Zheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Mian Wan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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18
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Pereira AC, Oliveira ML, Cerqueira-Neto ACCL, Vargas-Neto J, Nagata JY, Gomes BPFA, Ferraz CCR, de Almeida JFA, de-Jesus-Soares A. Outcomes of traumatised immature teeth treated with apexification or regenerative endodontic procedure: a retrospective study. AUST ENDOD J 2020; 47:178-187. [PMID: 33094527 DOI: 10.1111/aej.12447] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/22/2020] [Accepted: 09/15/2020] [Indexed: 11/30/2022]
Abstract
This study compares the clinical success rate and continued radiographic root development of apexification and regenerative endodontic procedure in traumatised immature permanent teeth, and proposes a method to evaluate apical convergence, namely apical angle. Clinical and radiological data were collected from 44 treated teeth (22 with apexification and 22 with regenerative endodontic procedure). The preoperative and follow-up periapical radiographs were analysed to calculate the percentage changes in root length, root width, apical diameter and apical angle. The success rates for complete healing with apexification and regenerative endodontic procedure were 86.36% and 95.45%, respectively. Radiographically, regenerative endodontic procedure showed significantly greater percentage changes in root width only (P < 0.05). Apexification and regenerative endodontic procedure provide satisfactory outcomes concerning clinical success rates. Continued root development in regenerative endodontic procedure was similar to apexification, except for root width. Apical angle allowed us to assess the convergence of the root canal walls.
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Affiliation(s)
- Andrea Cardoso Pereira
- Endodontics Division, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Matheus Lima Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Ana Carolina C L Cerqueira-Neto
- Endodontics Division, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Júlio Vargas-Neto
- Endodontics Division, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Juliana Yuri Nagata
- Department of Dentistry, Endodontics Area, Federal University of Sergipe - UFS, Lagarto, SE, Brazil
| | - Brenda P F A Gomes
- Endodontics Division, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Caio Cezar Randi Ferraz
- Endodontics Division, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - José Flávio Affonso de Almeida
- Endodontics Division, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Adriana de-Jesus-Soares
- Endodontics Division, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
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19
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Çırakoğlu S, Baddal B, İslam A. The Effectiveness of Laser-Activated Irrigation on the Apical Microleakage Qualities of MTA Repair HP and NeoMTA Plus in Simulated Immature Teeth: A Comparative Study. MATERIALS 2020; 13:ma13153287. [PMID: 32718044 PMCID: PMC7436115 DOI: 10.3390/ma13153287] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/10/2020] [Accepted: 07/17/2020] [Indexed: 01/09/2023]
Abstract
There are limited data regarding the potential effect of erbium, chromium: yttrium–scandium–gallium–garnet (Er,Cr:YSGG) laser-activated irrigation (LAI) on the microleakage qualities of calcium silicate-based cements. The objective of the present study was to assess the effect of LAI on the microleakage qualities of MTA Repair HP (MTA-HP) and NeoMTA Plus (Neo) used in root-end filling and to compare the antimicrobial effectiveness of MTA- HP. Two experimental sets were conducted: antimicrobial activity (agar diffusion test/at 24, 48 h) and microleakage (glucose leakage model/at 1st, 10th, 20th days). Antimicrobial activities of MTA-HP, Neo, Biodentine, ProRoot and MTA Angelus were evaluated, and inhibition zones were observed not only against a range of Gram-positive and Gram-negative bacteria but also against yeast at 48h. For microleakage evaluation, fifty teeth were prepared to simulate the clinical situation where the root-tips (apex) are open, and randomly divided into two experimental groups (n = 20/group) according to the cement type (MTA-HP and Neo), and two control (n = 5/group) groups. Each experimental group was further divided into two subgroups (n = 10/group) with respect to LAI: MTA-HP, L-HP, Neo, L-Neo. A statistical difference was only detected between Neo and L-HP groups on day 1. Subsequently, MTA-HP exhibited superior microleakage quality compared to Neo in the short-term. Er,Cr:YSGG laser-activated irrigation could be used as a reliable technique without creating adverse effects on the sealing abilities of MTA Repair HP and NeoMTA Plus.
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Affiliation(s)
- Serenad Çırakoğlu
- Department of Pediatric Dentistry, Faculty of Dentistry Near East University, 99138 Nicosia, North Cyprus;
| | - Buket Baddal
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, 99138 Nicosia, North Cyprus;
- Desam Institute, Near East University, 99138 Nicosia, North Cyprus
| | - Aylin İslam
- Department of Pediatric Dentistry, Faculty of Dentistry Near East University, 99138 Nicosia, North Cyprus;
- Desam Institute, Near East University, 99138 Nicosia, North Cyprus
- Correspondence: ; Tel.: +90-(392)-680-20-30; Fax: +90-(392)-680-20-25
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20
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Lee G, Chung C, Kim S, Shin SJ. Observation of an extracted premolar 2.5 years after mineral trioxide aggregate apexification using micro-computed tomography. Restor Dent Endod 2020; 45:e4. [PMID: 32483529 PMCID: PMC7239676 DOI: 10.5395/rde.2020.45.e4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 10/05/2019] [Accepted: 10/07/2019] [Indexed: 11/24/2022] Open
Abstract
Although numerous studies have been conducted on apexification using mineral trioxide aggregate (MTA), direct observation of extracted human teeth after the procedure has been rarely reported. This case report describes a mandibular premolar treated 2.5 years ago and extracted recently for orthodontic treatment. The tubercle of the right mandibular premolar of a 12-year-old boy with dens evaginatus was fractured and the pulp was exposed. The tooth was diagnosed with pulp necrosis and asymptomatic periapical abscess. During the first visit, copious irrigation was performed with 2.5% sodium hypochlorite. Calcium hydroxide paste was placed as an intracanal medicament. The sinus tract had disappeared at the second visit after 3 weeks. MTA was applied on to the bleeding point as a 4-mm-thick layer, followed by a 3-mm-thick gutta-percha filling and resin core build-up. After 2.5 years, the tooth and three other premolars were extracted for orthodontic treatment. The right and left mandibular premolars were scanned with micro-computed tomography to determine the root shape and canal anatomy. Irregular root growth was observed and the root outline of the right mandibular premolar differed from that of the contralateral tooth. Apexification with MTA leads to the formation of roots with irregular morphology, without any pulpal space.
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Affiliation(s)
- Gayeon Lee
- Department of Conservative Dentistry, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Chooryung Chung
- Department of Orthodontics, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Sunil Kim
- Department of Conservative Dentistry, Yonsei University College of Dentistry, Seoul, Korea
| | - Su-Jung Shin
- Department of Conservative Dentistry, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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21
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Jahromi M, Refaei P, Moughari AK. Comparison of the microleakage of mineral trioxide aggregate, calcium-enriched mixture cement, and Biodentine orthograde apical plug. Dent Res J (Isfahan) 2020. [DOI: 10.4103/1735-3327.276238] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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22
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Liu Y, Liu XM, Bi J, Yu S, Yang N, Song B, Chen X. Cell migration and osteo/odontogenesis stimulation of iRoot FS as a potential apical barrier material in apexification. Int Endod J 2019; 53:467-477. [PMID: 31622505 DOI: 10.1111/iej.13237] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 10/06/2019] [Accepted: 10/14/2019] [Indexed: 12/11/2022]
Abstract
AIM To investigate the in vitro biological effects of a nanoparticle bioceramic material, iRoot Fast Set root repair material (iRoot FS), on the proliferation, migration and osteo/odontogenic differentiation of human stem cells from the apical papilla (hSCAP), and to further explore the mechanism involved in osteo/odontogenic induction of iRoot FS. METHODOLOGY hSCAP were isolated and characterized in vitro. iRoot FS conditioned medium were prepared and used to treat hSCAP, while using mineral trioxide aggregate (MTA) conditioned medium as the positive control and regular medium as the negative control. MTT assay and BrdU labelling assay were performed to determine cell proliferation. Wound healing assay and transwell assay were conducted to evaluate cell migration. The osteo/odontogenic differentiation of hSCAP was evaluated by qPCR, Western blot and Alizarin red S staining. Wnt inhibitor was used for downregulating the expression level of β-catenin of hSCAP. RESULTS The cell proliferation of hSACP in the iRoot FS group was not significantly different compared with the control groups. The cell migration of hSCAP in the iRoot FS group was significantly increased than the MTA and negative control groups (P < 0.01). The expression levels of osteo/odontogenic markers and mineralization nodule formation of hSCAP in the iRoot FS group were significantly elevated (P < 0.01). Furthermore, iRoot FS enhanced the osteo/odontogenic differentiation of hSCAP by activating Wnt/β-catenin signalling. CONCLUSIONS iRoot FS promoted the cell migration of hSCAP and enhanced their oseto/odontogenesis potential via the Wnt/β-catenin pathway without cytotoxicity. iRoot FS had satisfactory biological properties and has potential to be used as an apical barrier in apexification or as a coronal sealing material in regenerative endodontic treatment.
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Affiliation(s)
- Y Liu
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China.,Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
| | - X M Liu
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China.,Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
| | - J Bi
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China.,Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
| | - S Yu
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China.,Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
| | - N Yang
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China.,Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
| | - B Song
- School of Dentistry, Cardiff University, Cardiff, UK
| | - X Chen
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China.,Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
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23
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Fracture resistance of simulated immature roots using Biodentine and fiber post compared with different canal-filling materials under aging conditions. Clin Oral Investig 2019; 24:1333-1338. [DOI: 10.1007/s00784-019-03014-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/08/2019] [Indexed: 12/27/2022]
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Belli S, Eraslan O, Eskitaşcıoğlu G. Effect of Different Treatment Options on Biomechanics of Immature Teeth: A Finite Element Stress Analysis Study. J Endod 2018; 44:475-479. [DOI: 10.1016/j.joen.2017.08.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/02/2017] [Accepted: 08/28/2017] [Indexed: 12/20/2022]
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He L, Zhong J, Gong Q, Kim SG, Zeichner SJ, Xiang L, Ye L, Zhou X, Zheng J, Liu Y, Guan C, Cheng B, Ling J, Mao JJ. Treatment of Necrotic Teeth by Apical Revascularization: Meta-analysis. Sci Rep 2017; 7:13941. [PMID: 29066844 PMCID: PMC5655000 DOI: 10.1038/s41598-017-14412-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 10/11/2017] [Indexed: 02/08/2023] Open
Abstract
Each year ~5.4 million children and adolescents in the United States suffer from dental infections, leading to pulp necrosis, arrested tooth-root development and tooth loss. Apical revascularization, adopted by the American Dental Association for its perceived ability to enable postoperative tooth-root growth, is being accepted worldwide. The objective of the present study is to perform a meta-analysis on apical revascularization. Literature search yielded 22 studies following PRISMA with pre-defined inclusion and exclusion criteria. Intraclass correlation coefficient was calculated to account for inter-examiner variation. Following apical revascularization with 6- to 66-month recalls, root apices remained open in 13.9% cases (types I), whereas apical calcification bridge formed in 47.2% (type II) and apical closure (type III) in 38.9% cases. Tooth-root lengths lacked significant postoperative gain among all subjects (p = 0.3472) or in subgroups. Root-dentin area showed significant increases in type III, but not in types I or II cases. Root apices narrowed significantly in types II and III, but not in type I patients. Thus, apical revascularization facilitates tooth-root development but lacks consistency in promoting root lengthening, widening or apical closure. Post-operative tooth-root development in immature permanent teeth represents a generalized challenge to regenerate diseased pediatric tissues that must grow to avoid organ defects.
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Affiliation(s)
- Ling He
- Columbia University Medical Center, Center for Craniofacial Regeneration 630W. 168 St, New York, NY 10032, USA
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, China
| | - Juan Zhong
- Columbia University Medical Center, Center for Craniofacial Regeneration 630W. 168 St, New York, NY 10032, USA
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Qimei Gong
- Columbia University Medical Center, Center for Craniofacial Regeneration 630W. 168 St, New York, NY 10032, USA
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, China
| | - Sahng G Kim
- Columbia University College of Dental Medicine, Division of Endodontics, New York, NY, USA
| | - Samuel J Zeichner
- Columbia University College of Dental Medicine, Division of Oral and Maxillofacial Radiology, New York, NY, USA
| | - Lusai Xiang
- Columbia University Medical Center, Center for Craniofacial Regeneration 630W. 168 St, New York, NY 10032, USA
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, China
| | - Ling Ye
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jinxuan Zheng
- Columbia University Medical Center, Center for Craniofacial Regeneration 630W. 168 St, New York, NY 10032, USA
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, China
| | - Yongxing Liu
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, China
| | - Chenyu Guan
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, China
| | - Bin Cheng
- Columbia University Mailman School of Public Health, Department of Biostatistics, New York, NY, USA.
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, China.
| | - Jeremy J Mao
- Columbia University Medical Center, Center for Craniofacial Regeneration 630W. 168 St, New York, NY 10032, USA.
- Columbia University College of Dental Medicine, Division of Oral and Maxillofacial Radiology, New York, NY, USA.
- Department of Pathology and Cell Biology, Columbia University Physician and Surgeons, 630West 168th Street 15-402, New York, NY 10032, USA.
- Department of Orthopaedic Surgery, Columbia University Physician and Surgeons, 630 West 168th Street PH10-102, New York, NY 10032, USA.
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Najeeb S, Khurshid Z, Sohail Zafar M, Zohaib S, Siddiqui F. Efficacy of Enamel Matrix Derivative in Vital Pulp Therapy: A Review of Literature. IRANIAN ENDODONTIC JOURNAL 2017; 12:269-275. [PMID: 28808449 PMCID: PMC5527198 DOI: 10.22037/iej.v12i3.12036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Introduction: Vital pulp therapy (VPT) aims to preserve the health and maintain life of the tooth pulp which has been compromised by caries, trauma or restorative procedures. Recently, enamel matrix derivative (EMD) has been introduced as a material for vital pulp therapy. The aim of this review is to critically analyze and summarize the available literature on EMD for VPT. Methods and Materials: Online databases (PubMED/MEDLINE, Google Scholar, ISI Web of Science, and Wiley-Online) were searched by using the following keywords in various combinations: Enamel Matrix Derivative, Emdogain, ‘Vital Pulp Therapy, ‘Apexogenisis’, Apexification, Pulp Capping, Endodontics, Dentine and Pulpotomy for studies indexed from January 1949 to April 2016. We used an English-limited search in Google.co.uk for the missing grey literature. All studies fulfilling the selection criteria were carefully reviewed for the focused question: “Does using EMD in VPT, compared with other materials, result in better clinical, radiographic and histological outcomes?”. Results: The primary search resulted in 18 articles of which, 14 articles (including 6 animal studies and 6 clinical trials and 2 case reports) met the inclusion criteria for this review and hence were included. The number of teeth tested in the animal studies ranged from 8 to 144 including pigs, rats and dogs teeth. A number of studies used EMD in the experimental group in comparison with calcium hydroxide, propylene glycol alginate (PGA) and MTA as a control. The observation period ranged from 1 to 2 months and 4 out of 6 animal trials reported more favorable outcomes with EMD while two studies reported comparable outcomes. Conclusion: Although EMD has potential for various applications in endodontics, studies conducted to date have failed to demonstrate any significant advantage of EMD over conventional VPT materials. Additionally, the 5-year and 10-year survival rate of EMD-treated teeth is not yet known. Hence, studies with a longer follow-up periods are required to deduce the long-term viability of teeth treated with EMD.
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Affiliation(s)
- Shariq Najeeb
- Restorative Dental Sciences, Al-Farabi Colleges, Saudi Arabia
| | - Zohaib Khurshid
- School of Metallurgy and Materials, University of Birmingham, Edgbaston, Birmingham, UK
| | | | - Sana Zohaib
- Department of Biomedical Engineering, College of Engineering, King Faisal University, Al-Hofuf, Saudi Arabia
| | - Fahad Siddiqui
- Division of Oral Health & Society, McGill College, Montreal, Canada
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Lin JC, Lu JX, Zeng Q, Zhao W, Li WQ, Ling JQ. Comparison of mineral trioxide aggregate and calcium hydroxide for apexification of immature permanent teeth: A systematic review and meta-analysis. J Formos Med Assoc 2016; 115:523-30. [DOI: 10.1016/j.jfma.2016.01.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 01/14/2016] [Accepted: 01/20/2016] [Indexed: 10/22/2022] Open
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Abstract
The most common root malformations in humans arise from either developmental disorders of the root alone or disorders of radicular development as part of a general tooth dysplasia. The aim of this review is to relate the characteristics of these root malformations to potentially disrupted processes involved in radicular morphogenesis. Radicular morphogenesis proceeds under the control of Hertwig's epithelial root sheath (HERS) which determines the number, length, and shape of the root, induces the formation of radicular dentin, and participates in the development of root cementum. Formation of HERS at the transition from crown to root development appears to be very insensitive to adverse effects, with the result that rootless teeth are extremely rare. In contrast, shortened roots as a consequence of impaired or prematurely halted apical growth of HERS constitute the most prevalent radicular dysplasia which occurs due to trauma and unknown reasons as well as in association with dentin disorders. While odontoblast differentiation inevitably stops when growth of HERS is arrested, it seems to be unaffected even in cases of severe dentin dysplasias such as regional odontodysplasia and dentin dysplasia type I. As a result radicular dentin formation is at least initiated and progresses for a limited time. The only condition affecting cementogenesis is hypophosphatasia which disrupts the formation of acellular cementum through an inhibition of mineralization. A process particularly susceptible to adverse effects appears to be the formation of the furcation in multirooted teeth. Impairment or disruption of this process entails taurodontism, single-rooted posterior teeth, and misshapen furcations. Thus, even though many characteristics of human root malformations can be related to disorders of specific processes involved in radicular morphogenesis, precise inferences as to the pathogenesis of these dysplasias are hampered by the still limited knowledge on root formation.
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Affiliation(s)
- Hans U Luder
- Center of Dental Medicine, Institute of Oral Biology, University of Zurich Zurich, Switzerland
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Is Pulp Inflammation a Prerequisite for Pulp Healing and Regeneration? Mediators Inflamm 2015; 2015:347649. [PMID: 26538825 PMCID: PMC4619968 DOI: 10.1155/2015/347649] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 06/05/2015] [Accepted: 07/14/2015] [Indexed: 12/16/2022] Open
Abstract
The importance of inflammation has been underestimated in pulpal healing, and in the past, it has been considered only as an undesirable effect. Associated with moderate inflammation, necrosis includes pyroptosis, apoptosis, and nemosis. There are now evidences that inflammation is a prerequisite for pulp healing, with series of events ahead of regeneration. Immunocompetent cells are recruited in the apical part. They slide along the root and migrate toward the crown. Due to the high alkalinity of the capping agent, pulp cells display mild inflammation, proliferate, and increase in number and size and initiate mineralization. Pulp fibroblasts become odontoblast-like cells producing type I collagen, alkaline phosphatase, and SPARC/osteonectin. Molecules of the SIBLING family, matrix metalloproteinases, and vascular and nerve mediators are also implicated in the formation of a reparative dentinal bridge, osteo/orthodentin closing the pulp exposure. Beneath a calciotraumatic line, a thin layer identified as reactionary dentin underlines the periphery of the pulp chamber. Inflammatory and/or noninflammatory processes contribute to produce a reparative dentinal bridge closing the pulp exposure, with minute canaliculi and large tunnel defects. Depending on the form and severity of the inflammatory and noninflammatory processes, and according to the capping agent, pulp reactions are induced specifically.
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Efficacy of Biodentine as an Apical Plug in Nonvital Permanent Teeth with Open Apices: An In Vitro Study. BIOMED RESEARCH INTERNATIONAL 2015; 2015:359275. [PMID: 26436090 PMCID: PMC4575981 DOI: 10.1155/2015/359275] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 07/28/2015] [Indexed: 11/17/2022]
Abstract
The aim of this study was to evaluate the apical microleakage of Biodentine and MTA orthograde apical plugs and to compare the effect of thickness of these biomaterials on their sealing ability. A total of eighty maxillary anterior teeth were used. The apices were removed by cutting with a diamond disc (Jota, Germany) 2 mm from the apical root end in an attempt to standardize the working length of all specimens to 15 ± 1 mm. Both materials were placed in 1–4 mm thickness as apical plugs root canal. Root canal leakage was evaluated by the fluid filtration technique. One-way ANOVA was used in order to determine normality of dispersal distribution of parameters; thereafter, results were analyzed by Kolmogorov-Smirnov test. Overall, between microleakage values of MTA and Biodentine regardless of apical plug thickness, no difference was observed. In terms of plug thickness, a statistically significant difference was observed between the subgroups of MTA and Biodentine (p < 0.05). The apical sealing ability of Biodentine was comparable to MTA at any apical plug thickness.
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Topçuoğlu HS, Kesim B, Düzgün S, Tuncay Ö, Demirbuga S, Topçuoğlu G. The effect of various backfilling techniques on the fracture resistance of simulated immature teeth performed apical plug with Biodentine. Int J Paediatr Dent 2015; 25:248-54. [PMID: 25263283 DOI: 10.1111/ipd.12137] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To evaluate the fracture resistance of simulated immature teeth that had been backfilled using different materials after using Biodentine as the apical plug material. DESIGN Seventy-five single-rooted teeth were divided into five groups (n = 15). The 15 teeth in group 1 served as a negative control group and received no treatment. The remaining 60 teeth were instrumented to a #6 Peeso reamer to obtain a standard internal diameter of 1.5 mm. The apical 4 mm of 60 teeth was filled with Biodentine. The backfilling was then performed on each group as follows: group 2--no backfilling (positive control), group 3--gutta-percha, group 4--fiber post, and group 5--Biodentine. Specimens were then subjected to fracture testing. The force required to fracture each specimen was recorded, and the data were statistically analyzed. RESULTS The mean fracture values of groups 1 and 4 were significantly higher than groups 2, 3, and 5 (P < 0.05). The values of groups 3 and 5 were significantly higher than group 2 (P < 0.05). CONCLUSIONS The backfilling with fiber post after an apical Biodentine plug provided the highest fracture resistance among all experimental groups.
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Affiliation(s)
| | - Bertan Kesim
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Salih Düzgün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Öznur Tuncay
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Sezer Demirbuga
- Department of Restorative Dentistry, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Gamze Topçuoğlu
- Department of Pedodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Heydari A, Rahmani M. Treatment of Dens Invagination in a Maxillary Lateral Incisor: A Case Report. IRANIAN ENDODONTIC JOURNAL 2015. [PMID: 26213545 PMCID: PMC4509963 DOI: 10.7508/iej.2015.03.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Dens invagination is a developmental anomaly requiring specific treatment approaches. Oehler's Type III dens in dente, extends into the root and perforates at the apical area or lateral surface of the root. In this case endodontic treatment of the invaginated tooth was carried out through the central lumen of the invagination with calcium hydroxide without manipulation of the main pulp canal, thereby leaving the tooth vital. The 18-month follow-up examinations were indicative of treatment success; the periapical lesion resolved completely and the tooth remained vital.
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Affiliation(s)
- Azar Heydari
- Endodontic Department, Dental School, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Mona Rahmani
- Endodontic Department, Dental School, Shahid Beheshti University of Medical Sciences , Tehran, Iran
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Li Y, Shu LH, Yan M, Dai WY, Li JJ, Zhang GD, Yu JH. Adult stem cell-based apexogenesis. World J Methodol 2014; 4:99-108. [PMID: 25332909 PMCID: PMC4202485 DOI: 10.5662/wjm.v4.i2.99] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Revised: 01/04/2014] [Accepted: 03/14/2014] [Indexed: 02/06/2023] Open
Abstract
Generally, the dental pulp needs to be removed when it is infected, and root canal therapy (RCT) is usually required in which infected dental pulp is replaced with inorganic materials (paste and gutta percha). This treatment approach ultimately brings about a dead tooth. However, pulp vitality is extremely important to the tooth itself, since it provides nutrition and acts as a biosensor to detect the potential pathogenic stimuli. Despite the reported clinical success rate, RCT-treated teeth are destined to be devitalized, brittle and susceptible to postoperative fracture. Recently, the advances and achievements in the field of stem cell biology and regenerative medicine have inspired novel biological approaches to apexogenesis in young patients suffering from pulpitis or periapical periodontitis. This review mainly focuses on the benchtop and clinical regeneration of root apex mediated by adult stem cells. Moreover, current strategies for infected pulp therapy are also discussed here.
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Alobaid AS, Cortes LM, Lo J, Nguyen TT, Albert J, Abu-Melha AS, Lin LM, Gibbs JL. Radiographic and clinical outcomes of the treatment of immature permanent teeth by revascularization or apexification: a pilot retrospective cohort study. J Endod 2014; 40:1063-70. [PMID: 25069909 DOI: 10.1016/j.joen.2014.02.016] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 01/28/2014] [Accepted: 02/20/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION This retrospective cohort study compared clinical and radiographic outcomes of endodontic treatment performed in immature nonvital permanent teeth by apexification (calcium hydroxide or apical barrier with mineral trioxide aggregate) versus revascularization. METHODS A comprehensive chart review was performed to obtain a cohort of previously completed cases with recalls. Clinical and radiographic data were collected for 31 treated teeth (19 revascularization and 12 apexification) with an average follow-up time of 17 months and a recall rate of 63%. Tooth survival, success rate, and adverse events were analyzed. Changes in radiographic root length, width, and area were quantified. RESULTS The majority of treated teeth survived throughout the study period, with 30 of 31 (97%) teeth surviving (18/19 [95%] revascularization and 12/12 apexification). Most cases were also clinically successful, with 27 of 31 (87%) meeting criteria for success (15/19 [78%] revascularization and 12/12 apexification; nonsignificant difference). A greater incidence of adverse events was observed in the revascularization group (8/19 [42%] vs 1/12 [11%] in apexification) (risk ratio = 5.1; P = .04; 95% confidence interval, 0.719-35.48). Although more revascularization cases than apexification cases showed an increase in radiographic root area and width, the effect was not statistically significant. CONCLUSIONS In this study, revascularization was not superior to other apexification techniques in either clinical or radiographic outcomes. Studies with large subject cohorts and long follow-up periods are needed to evaluate outcomes of revascularization and apexification while accounting for important covariants relevant to clinical success.
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Affiliation(s)
- Adel S Alobaid
- New York University College of Dentistry, New York, New York
| | - Lina M Cortes
- New York University College of Dentistry, New York, New York
| | - Jeffery Lo
- New York University College of Dentistry, New York, New York
| | - Thuan T Nguyen
- New York University College of Dentistry, New York, New York
| | - Jeffery Albert
- New York University College of Dentistry, New York, New York
| | | | - Louis M Lin
- New York University College of Dentistry, New York, New York
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