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Yang J, Liu Z, Chen Z, Yang G, Yuan G. Application of Oxygen Saturation Test after Replantation of Avulsed Immature Permanent Teeth: A Prospective Observational Study. J Endod 2024; 50:954-961. [PMID: 38604473 DOI: 10.1016/j.joen.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION The evaluation of pulp status is crucial for avulsed immature permanent teeth after replantation. In addition to commonly used clinical and radiographic examinations providing clinical evidence, the oxygen saturation test may offer valuable assistance. The aim of this study was to analyze the efficacy of a pulse oximeter in evaluating pulp status in avulsed and replanted immature permanent teeth. METHODS A prospective observational study was performed including 51 avulsed and replanted immature permanent teeth. Routine clinical and radiographic examinations were performed and used as the basis for the diagnosis of pulp status during the 1-year follow-up period. Meanwhile, the oxygen saturation values of these teeth were recorded using a modified pulse oximeter at each visit. RESULTS Seven teeth completed pulp revascularization (success group), whereas 44 teeth failed to revascularize (failure group). Abnormal clinical and/or radiographic manifestations in the failure group were observed at an average period of 42.7 days, which was too late because a high incidence of inflammatory root resorption (43.18%) had occurred. For oxygen saturation tests, teeth in the success group showed an immediate postreplantation oxygen value of 70.71 ± 3.35, then an upward trend starting from the 2-week postreplantation visit, and a significantly increased final value of 81.86 ± 2.34 at the 1-year visit. In contrast, no increase trend was found for teeth in the failure group because abnormal clinical and/or radiographic manifestations emerged. CONCLUSIONS The oxygen saturation test is a reliable diagnostic method to evaluate pulp status of avulsed teeth as early as 2 weeks after replantation.
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Affiliation(s)
- Jinghui Yang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, Wuhan University, Wuhan, China; Department of Pediatric Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zhengyan Liu
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, Wuhan University, Wuhan, China; Department of Pediatric Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zhi Chen
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, Wuhan University, Wuhan, China
| | - Guobin Yang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, Wuhan University, Wuhan, China; General and Emergency Department, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Guohua Yuan
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, Wuhan University, Wuhan, China; Department of Pediatric Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, China; Frontier Science Center for Immunology and Metabolism, Wuhan University, Wuhan, China.
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Odabaşı Tezer E, Buyuksungur A, Celikten B, Dursun PH, Sevimay FS. Effects of Access Cavity Design and Placement Techniques on Mineral Trioxide Aggregate Obturation Quality in Simulated Immature Teeth: A Micro-Computed Tomography Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:878. [PMID: 38929495 PMCID: PMC11205533 DOI: 10.3390/medicina60060878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: In teeth with open apices, performing single session apexification is a challenging treatment due to the difficulty in handling mineral trioxide aggregate (MTA). Minimally invasive approaches in dentistry have also influenced the cavity designs in endodontics. Until now, different techniques have not been investigated in addition to manual condensation during the process of placing MTA in traditional (TradACs) or conservative (ConsACs) endodontic access cavities. The aim of this in vitro study was to compare and evaluate the obturation quality of MTA apical plugs placed with different techniques in TradACs or ConsACs. Materials and Methods: Sixty upper central teeth were divided into two main groups based on cavity design, and then each main group was further divided into three subgroups according to MTA placement techniques (n = 10): TradAC-manual, TradAC-manual + indirect ultrasonic activation, TradAC-manual + XP-endo Shaper (XPS), ConsAC-manual, ConsAC-manual + indirect ultrasonic activation, and ConsAC-manual + XPS. Subsequently, the porosity percentages in the MTA apical plug were analyzed using micro-computed tomography. The statistical analysis was performed using the Kruskal-Wallis H test and Mann-Whitney U test. Statistical significance was set at p < 0.05. Results: There were differences in volume of porosity percentages (%) according to cavity designs and MTA application techniques (p < 0.05). Except for the XPS group, more porosity was observed in ConsACs compared to TradACs. In TradACs, the significantly lowest open and total porosity was observed in the manual, ultrasonic, and XPS techniques, respectively. In ConsACs, the significantly lowest porosity was observed in the manual, XPS, and ultrasonic techniques, respectively (p < 0.05). Conclusions: In MTA obturation, cavity designs and application techniques had an impact on the MTA porosity. Creating an apical plug in ConsACs may result in more porosity compared to TradACs, especially when manual or indirect ultrasonic activation is preferred. Opting for the manual technique alone may be considered sufficient for controlling porosity for both TradACs and ConsACs.
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Affiliation(s)
- Emine Odabaşı Tezer
- Department of Endodontics, Faculty of Dentistry, Ankara University, Ankara 06560, Turkey; (A.B.); (B.C.); (P.H.D.); (F.S.S.)
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Rathi S, Nikhil V, Sharma A, Chandani R. Internal root resorption in permanent mandibular molars - A rare entity: Report of two cases. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:442-446. [PMID: 38779212 PMCID: PMC11108417 DOI: 10.4103/jcde.jcde_65_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: 03/11/2024] [Accepted: 03/14/2024] [Indexed: 05/25/2024]
Abstract
The cases presented here aim to highlight the occurrence of a very rare internal root resorption (IRR) of inflammatory type among mandibular molars (prevalence 0.01%-1%). Patients reported in the outpatient department with a chief complaint of pain in the lower posterior region of the jaws, on thorough clinical and radiological examinations a diagnosis of irreversible pulpitis was made and nonsurgical root canal treatment was planned using thermoplastic obturation technique along with the use of magnification, cone-beam computed tomography, endosonics, and intracanal medicament to attain a successful outcome. Six-month follow-up showed arrest of IRR. This report of two cases with a literature review discusses the etiology, prevalence of IRR, the clinical decision, and the therapeutic management. Early detection of such resorption is the key to successful management and preserves the integrity of the tooth.
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Affiliation(s)
- Shravan Rathi
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Vineeta Nikhil
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Ayushi Sharma
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Roshni Chandani
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
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Coste SC, Rodrigues MAF, Chaves JFM, Lima TCDS, Colosimo EA, Bastos JV. A retrospective cohort study of pulp prognosis in luxated permanent teeth: a competing risk analysis. Clin Oral Investig 2024; 28:187. [PMID: 38430349 DOI: 10.1007/s00784-024-05574-w] [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: 07/02/2023] [Accepted: 02/22/2024] [Indexed: 03/03/2024]
Abstract
AIM The present retrospective cohort study aimed to evaluate luxated permanent teeth for pulp prognosis and risk factors. METHODOLOGY Case records and radiographs of 224 patients, involving 427 luxated permanent teeth, referred for treatment at the Dental Trauma Center-School of Dentistry, Universidade Federal de Minas Gerais, (DTC-SD-UFMG) from 2014 to 2022, were assessed for pulp prognosis classified as vitality, necrosis and pulp canal obliteration (PCO). A competing risk survival analysis estimated the hazards of the three outcomes, and the effect of demographic, clinical and treatment variables was tested using a cause specific Cox regression model. RESULTS Pulp vitality was found in163 teeth (38.2%), pulp necrosis in 120 teeth (28.1%) and 55 teeth (12.9%) developed PCO. Pulp vitality decreased in the presence of concomitant crown fractures (HR 0.38 95% CI [0.2-0.8] p = 0.006). The risk of pulp necrosis (HR 0.62 95% CI [0.4-0.96] p = 0.03) was lower in cases with open apices but increased with concomitant crown fractures (HR 4.0 95% CI [2.6-6.1] p = 0.001) and intrusions (HR 2.3 95% CI [1.2-4.1] p = 0.007). Lateral or extrusive luxations (HR 3.0 95% CI [1.3-6.9] p = 0.001) and open apices (HR 2.4 95% CI [1.2-4.7] p = 0.01) showed higher rates of PCO. CONCLUSION Type of luxation, the diameter of the apical foramen, and the presence of concomitant crown fractures were main determinants of pulp prognosis after luxation injuries in permanent teeth. CLINICAL RELEVANCE Pulp prognosis after tooth luxation is dependent on the presence and direction of tooth displacement together with infection control. CLINICAL TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Sylvia Cury Coste
- Restorative Dentistry Department, School of Dentistry, Universidade Federal de Minas Gerais, R. Prof. Moacir Gomes de Freitas, 688, Pampulha, Belo Horizonte/MG, 31270-901, Brazil.
| | - Márcio Augusto Ferreira Rodrigues
- Statistics Department, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Brazil
- Institute of Mathematics & Statistics, Universidade Federal de Goiás, Goiânia, 74690-900, Brazil
| | - Júlia Ferreira Maciel Chaves
- Restorative Dentistry Department, School of Dentistry, Universidade Federal de Minas Gerais, R. Prof. Moacir Gomes de Freitas, 688, Pampulha, Belo Horizonte/MG, 31270-901, Brazil
| | - Thiago César da Silva Lima
- Restorative Dentistry Department, School of Dentistry, Universidade Federal de Minas Gerais, R. Prof. Moacir Gomes de Freitas, 688, Pampulha, Belo Horizonte/MG, 31270-901, Brazil
| | - Enrico Antônio Colosimo
- Restorative Dentistry Department, School of Dentistry, Universidade Federal de Minas Gerais, R. Prof. Moacir Gomes de Freitas, 688, Pampulha, Belo Horizonte/MG, 31270-901, Brazil
| | - Juliana Vilela Bastos
- Restorative Dentistry Department, School of Dentistry, Universidade Federal de Minas Gerais, R. Prof. Moacir Gomes de Freitas, 688, Pampulha, Belo Horizonte/MG, 31270-901, Brazil
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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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Najeeb S, Manekia FA, Sadiq MSK, Adanir N, Khurshid Z, Zafar MS, Heboyan A. The effect of fibroblast growth factor-2 on the outcomes of tooth replantation: A systematic review of animal studies. Sci Prog 2024; 107:368504241228964. [PMID: 38489928 PMCID: PMC10943733 DOI: 10.1177/00368504241228964] [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: 03/17/2024]
Abstract
Background/Aim: The ideal treatment of tooth avulsion is replantation. However, replanting teeth may lead to root resorption. Fibroblast growth factor-2 (FGF-2) is a cytokine that plays an important role in wound repair and tissue regeneration. Recently, FGF-2 has been studied a potential regenerative agent to prevent root resorption and ankylosis. The aim of this review is to analyze and summarize the currently available literature focusing on using FGF-2 based regenerative modalities to improve the outcomes of tooth replantation. Materials and Methods: An electronic search was conducted via PubMed/Medline, Google Scholar and ISI Web of Knowledge, using the Medical Subject Headings (MeSH) terms "Basic fibroblast growth factor," "Fibroblast growth factor-2," "tooth replantation," and "replantation" for studies published between January 2001 and June 2021. Data was extracted and quality assessment was carried using the ARRIVE guidelines. Results: Nine animal studies were included in this review. In six studies, FGF-2 had a favorable effect on the tissue regeneration around roots of replanted teeth when compared to other treatment groups. However, quality assessment of the studies revealed many sources of bias and deficiencies in the studies. Conclusions: Within the limitations of this study, it may be concluded that FGF-2 may improve the outcomes of delayed replantation of avulsed teeth. However, more long-term animal studies, with improved experimental designs, and clinical trials are required to determine the clinical potential of the growth factor in improving the outcomes of delayed tooth replantation.
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Affiliation(s)
- Shariq Najeeb
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Evidentia Dental Outcomes Research, Calgary, AB, Canada
| | | | - Muhammad Shahrukh Khan Sadiq
- Department of Oral Pathology, Bahria University Dental College, Bahria University Health Ciences, Karachi, Pakistan
| | - Necdet Adanir
- Department of Restorative Dentistry, College of Dentistry, King Faisal University, Al-Ahsa, Kingdom of Saudi Arabia
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Kingdom of Saudi Arabia
- Current affiliation: Center of Excellence for Regenerative Dentistry, Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madina Al Munawwarrah, Saudi Arabia
- School of Dentistry, University of Jordan, Amman, Jordan
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan
- Current affiliation: Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, Ajman, 346, United Arab Emirates
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Str. Koryun 2, Yerevan, Armenia
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7
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Gladwin L, Darcey J. The consequences of Dental trauma. Prim Dent J 2023; 12:72-82. [PMID: 38018673 DOI: 10.1177/20501684231213908] [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: 11/30/2023]
Abstract
Traumatic dental injuries pose a variety of complex ongoing issues to the dental practitioner. As dental injuries are commonly experienced at a young age, the treatment often takes place during adolescence or early in adulthood years at crucial development stages and very early in the life of the permanent successor. Therefore, the ability to correctly diagnose the injury, and follow an appropriate management plan should increase practitioners' ability to improve both the outcomes of dental trauma and long-term prognosis of the tooth.The consequences of dental trauma can be explored by taking into consideration the type of injury, which enables an assessment of the degree of insult to the pulpal tissues, neurovascular bundle, periodontal ligament and cemental cells. This has a direct influence on post-trauma complications. Early intervention, where indicated, and appropriate follow-up utilising international guidelines is imperative to identify changing diagnoses and act accordingly. This review paper will discuss the classification of traumatic injuries and their associated outcomes with management strategies for emerging disease including potential endodontic and restorative complexities and when to refer to secondary care.
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Affiliation(s)
- Lorna Gladwin
- Lorna Gladwin BDS, MFDS RCSEng, PGCertClinical Dentist in Restorative Dentistry, University Dental Hospital of Manchester, Manchester, UK
- James Darcey BDS, MSc, MDPH, MFGDP, MEndo, FDS Rest Dent RCSEd Consultant and Honorary Lecturer in Restorative Dentistry, University Dental Hospital of Manchester, Manchester, UK
| | - James Darcey
- Lorna Gladwin BDS, MFDS RCSEng, PGCertClinical Dentist in Restorative Dentistry, University Dental Hospital of Manchester, Manchester, UK
- James Darcey BDS, MSc, MDPH, MFGDP, MEndo, FDS Rest Dent RCSEd Consultant and Honorary Lecturer in Restorative Dentistry, University Dental Hospital of Manchester, Manchester, UK
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Némat SM, Kenny KP, Day PF. Special considerations in paediatric dental trauma. Prim Dent J 2023; 12:64-71. [PMID: 38018674 DOI: 10.1177/20501684231211413] [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: 11/30/2023]
Abstract
Traumatic dental injuries (TDIs) in the paediatric population are common and frequently seen in general dental practice. The management of TDIs can be challenging and, in most cases, the General Dental Practitioner is tasked with the initial assessment and emergency treatment. Patients and their families typically attend with elevated levels of distress, which is complicated by the limited dental experience of some children. Behaviour management is essential and helps prepare patients for dental care at both their emergency and follow-up appointments. Early and accurate diagnosis in combination with appropriate treatment contributes to favourable outcomes for traumatised teeth. Early discussions with or referral to paediatric dental teams for management of complex TDIs is encouraged, however shared follow-up care is beneficial over the long-term. In specific cases, initial dental treatment can be delayed by a few days to a subsequent appointment, allowing the dental team to book sufficient time for the treatment and for the patient and their families to prepare. Education of the patients and adults with parental responsibility is essential to manage expectations, explain likely complications and encourage attendance for long-term follow-up visits. This paper discusses the management of paediatric patients to aid the primary care practitioner in providing effective immediate and long-term care.
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Affiliation(s)
- Shimal M Némat
- Shimal M. Némat MChD, BChD, MFDS RCPS(Glasg) Specialty Trainee in Paediatric Dentistry, School of Dentistry, University of Leeds, UK
- Kate P. Kenny BDentSc, DClinDent, MPaedDent, FHEA, NIHR Doctoral Research Fellow, Specialist and Lecturer in Paediatric Dentistry, School of Dentistry, University of Leeds, UK
- Peter F. Day PhD, FDS (Paeds) RCS (Eng), FRCD (Canada), PGCLTHE, BDS, MFDS RCS (Eng), M Dent Sci, M Paed Dent RCS (Eng) Professor and Consultant in Paediatric Dentistry, School of Dentistry, University of Leeds, UK and Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, UK
| | - Kate P Kenny
- Shimal M. Némat MChD, BChD, MFDS RCPS(Glasg) Specialty Trainee in Paediatric Dentistry, School of Dentistry, University of Leeds, UK
- Kate P. Kenny BDentSc, DClinDent, MPaedDent, FHEA, NIHR Doctoral Research Fellow, Specialist and Lecturer in Paediatric Dentistry, School of Dentistry, University of Leeds, UK
- Peter F. Day PhD, FDS (Paeds) RCS (Eng), FRCD (Canada), PGCLTHE, BDS, MFDS RCS (Eng), M Dent Sci, M Paed Dent RCS (Eng) Professor and Consultant in Paediatric Dentistry, School of Dentistry, University of Leeds, UK and Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, UK
| | - Peter F Day
- Shimal M. Némat MChD, BChD, MFDS RCPS(Glasg) Specialty Trainee in Paediatric Dentistry, School of Dentistry, University of Leeds, UK
- Kate P. Kenny BDentSc, DClinDent, MPaedDent, FHEA, NIHR Doctoral Research Fellow, Specialist and Lecturer in Paediatric Dentistry, School of Dentistry, University of Leeds, UK
- Peter F. Day PhD, FDS (Paeds) RCS (Eng), FRCD (Canada), PGCLTHE, BDS, MFDS RCS (Eng), M Dent Sci, M Paed Dent RCS (Eng) Professor and Consultant in Paediatric Dentistry, School of Dentistry, University of Leeds, UK and Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, UK
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Tahir A, Caratela N, Niazi F, Ilyas N. Aesthetic management of discoloured incisors in children. Prim Dent J 2023; 12:83-90. [PMID: 37705478 DOI: 10.1177/20501684231197261] [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: 09/15/2023]
Abstract
Children can often present with discolouration of their teeth, commonly affecting their permanent maxillary central incisors. These opacities can often cause children to suffer with psychosocial and confidence related issues. With long waiting lists in secondary care, many children may face increased waiting times to receive aesthetic dental treatment. It is important that the dental professional is aware of the different causes of discolouration, the possible treatment options and when to consider a referral to secondary care.
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Affiliation(s)
- Aiman Tahir
- Aiman Tahir BDS (Hons), MFDS RCSEd Dental Core Trainee in Paediatric Dentistry Birmingham Dental Hospital, Birmingham, UK
- Nabeela Caratela BDS (Hons), MFDS RCS (Glas) Dental Core Trainee in Paediatric Dentistry/Oral Surgery Birmingham Dental Hospital, Birmingham, UK
- Fatima Niazi BDS (Hons), BSc (Hons) Dental Core Trainee in Paediatric Dentistry Birmingham Dental Hospital, Birmingham, UK
- Nabeel Ilyas BDS (KCL), MFDS RCS (Glas), PgCert (MedEd), MSc (KCL) M(Paed Dent) RCPS (Ed) FDS (PaedDent) Consultant in Paediatric Dentistry Birmingham Dental Hospital, Birmingham, UK
| | - Nabeela Caratela
- Aiman Tahir BDS (Hons), MFDS RCSEd Dental Core Trainee in Paediatric Dentistry Birmingham Dental Hospital, Birmingham, UK
- Nabeela Caratela BDS (Hons), MFDS RCS (Glas) Dental Core Trainee in Paediatric Dentistry/Oral Surgery Birmingham Dental Hospital, Birmingham, UK
- Fatima Niazi BDS (Hons), BSc (Hons) Dental Core Trainee in Paediatric Dentistry Birmingham Dental Hospital, Birmingham, UK
- Nabeel Ilyas BDS (KCL), MFDS RCS (Glas), PgCert (MedEd), MSc (KCL) M(Paed Dent) RCPS (Ed) FDS (PaedDent) Consultant in Paediatric Dentistry Birmingham Dental Hospital, Birmingham, UK
| | - Fatima Niazi
- Aiman Tahir BDS (Hons), MFDS RCSEd Dental Core Trainee in Paediatric Dentistry Birmingham Dental Hospital, Birmingham, UK
- Nabeela Caratela BDS (Hons), MFDS RCS (Glas) Dental Core Trainee in Paediatric Dentistry/Oral Surgery Birmingham Dental Hospital, Birmingham, UK
- Fatima Niazi BDS (Hons), BSc (Hons) Dental Core Trainee in Paediatric Dentistry Birmingham Dental Hospital, Birmingham, UK
- Nabeel Ilyas BDS (KCL), MFDS RCS (Glas), PgCert (MedEd), MSc (KCL) M(Paed Dent) RCPS (Ed) FDS (PaedDent) Consultant in Paediatric Dentistry Birmingham Dental Hospital, Birmingham, UK
| | - Nabeel Ilyas
- Aiman Tahir BDS (Hons), MFDS RCSEd Dental Core Trainee in Paediatric Dentistry Birmingham Dental Hospital, Birmingham, UK
- Nabeela Caratela BDS (Hons), MFDS RCS (Glas) Dental Core Trainee in Paediatric Dentistry/Oral Surgery Birmingham Dental Hospital, Birmingham, UK
- Fatima Niazi BDS (Hons), BSc (Hons) Dental Core Trainee in Paediatric Dentistry Birmingham Dental Hospital, Birmingham, UK
- Nabeel Ilyas BDS (KCL), MFDS RCS (Glas), PgCert (MedEd), MSc (KCL) M(Paed Dent) RCPS (Ed) FDS (PaedDent) Consultant in Paediatric Dentistry Birmingham Dental Hospital, Birmingham, UK
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Hristov K, Doitchinova L, Gateva N. Regenerative endodontic treatment of immature permanent teeth after mechanical instrumentation with XP-Endo Finisher. Folia Med (Plovdiv) 2023; 65:460-467. [PMID: 38351823 DOI: 10.3897/folmed.65.e80063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/18/2022] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION The traditional treatment of immature permanent teeth with necrotic pulp involves creating an apical barrier by using calcium hydroxide or an MTA plug for an extended period of time. A novel therapeutic approach called regenerative endodontic procedures (REP) is used to allow root development to continue.
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Abbott PV. Indications for root canal treatment following traumatic dental injuries to permanent teeth. Aust Dent J 2023; 68 Suppl 1:S123-S140. [PMID: 37908151 DOI: 10.1111/adj.12989] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 11/02/2023]
Abstract
The dental pulp may respond favourably or unfavourably to traumatic dental injuries. The most serious unfavourable responses are pulp necrosis and infection of the root canal system. These cause apical periodontitis and/or external inflammatory resorption of the tooth. The following injuries require root canal treatment as part of their emergency management-(A) complicated crown fractures (but some may be suitable for conservative pulp treatments, such as pulp capping, partial pulpotomy or pulpotomy), (B) complicated crown-root fractures, (C) supra-crestal coronal third root fractures and (D) injuries where pulp necrosis is predictable or highly likely to occur AND where there has been damage to the root surface and/or periodontal ligament with the aim of preventing external inflammatory resorption. This latter group of injuries are avulsion, intrusion, lateral luxation with a crown fracture, extrusion with a crown fracture (all in fully developed teeth) plus avulsion with a crown fracture and intrusion with a crown fracture (both in incompletely developed teeth). All other injuries should not have root canal treatment commenced as part of the emergency management, but they must be reviewed regularly to monitor the pulp for any adverse changes to its status, particularly pulp necrosis and infection of the root canal system.
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Affiliation(s)
- P V Abbott
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
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Lu J, Yang X, Zhao W, Lin J. Effect analysis of a virtual simulation experimental platform in teaching pulpotomy. BMC MEDICAL EDUCATION 2022; 22:760. [PMID: 36345029 PMCID: PMC9639308 DOI: 10.1186/s12909-022-03836-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The experimental teaching of pediatric dentistry is a bridge between theoretical study and clinical practice, and virtual simulation technology provides a new method of instruction. METHODS We built an experimental teaching platform using virtual simulation technology for vital pulpotomy that includes learning and examination modes. A total of 199 students majoring in stomatology in the fourth year at Sun Yat-Sen University were randomly divided into a control group (conventional teaching mode) and an experimental group (virtual simulation experimental teaching model). The teaching effect was evaluated by theoretical and experimental examination. RESULTS We found that both the theoretical and experimental scores of the experimental group were higher than those of the control group, and the theoretical scores of the experimental group after exposure to the virtual simulation experimental teaching platform were also higher than those before the class, with significant differences (P < 0.05). Feedback from the experimental group after the class indicated that the platform reinforced their theoretical knowledge and greatly improved their mastery of operational skills. CONCLUSIONS The application of a virtual simulation experimental teaching platform can effectively improve the teaching of pulpotomy.
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Affiliation(s)
- Jiaxuan Lu
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, No.56 Lingyuan West Road, Guangzhou, 510055 China
| | - Xin Yang
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, No.56 Lingyuan West Road, Guangzhou, 510055 China
| | - Wei Zhao
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, No.56 Lingyuan West Road, Guangzhou, 510055 China
| | - Jiacheng Lin
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, No.56 Lingyuan West Road, Guangzhou, 510055 China
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13
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Kahler B. Present status and future directions - Managing discoloured teeth. Int Endod J 2022; 55 Suppl 4:922-950. [PMID: 35188275 PMCID: PMC9790475 DOI: 10.1111/iej.13711] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 12/30/2022]
Abstract
Managing tooth discolouration involves a range of different protocols for clinicians and patients in order to achieve an aesthetic result. There is an increasing public awareness in the appearance of their teeth and management of tooth discolouration may be inter-disciplinary and involve both vital and nonvital teeth. Vital teeth can be easily treated with low concentration hydrogen peroxide products safely and effectively using an external approach and trays. For endodontically treated teeth, the walking bleach technique with hydrogen releasing peroxide products is popular. However, there is an association with external cervical root resorption with higher concentrations of hydrogen peroxide of 30%-35%. There are also regulatory considerations for the use of hydrogen peroxide in certain jurisdictions internationally. Prosthodontic treatments are more invasive and involve loss of tooth structure as well as a life cycle of further treatment in the future. This narrative review is based on searches on PubMed and the Cochrane library. Bleaching endodontically treated teeth can be considered a safe and effective protocol in the management of discoloured teeth. However, the association between bleaching and resorption remains unclear although there is likely to be a relation to prior trauma. It is prudent to avoid thermocatalytic approaches and to use a base/sealer to cover the root filling. An awareness expectations of patients and multidisciplinary treatment considerations is important in achieving the aesthetic result for the patient. It is likely that there will be an increasing demand for aesthetic whitening treatments. Bleaching of teeth has also become increasingly regulated although there are international differences in the use and concentration of bleaching agents.
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Affiliation(s)
- Bill Kahler
- School of DentistryThe University of QueenslandBrisbaneQueenslandAustralia,The University of Queensland Oral Health CentreHerstonQueenslandAustralia
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14
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Sugiaman VK, Djuanda R, Pranata N, Naliani S, Demolsky WL. Tissue Engineering with Stem Cell from Human Exfoliated Deciduous Teeth (SHED) and Collagen Matrix, Regulated by Growth Factor in Regenerating the Dental Pulp. Polymers (Basel) 2022; 14:polym14183712. [PMID: 36145860 PMCID: PMC9503223 DOI: 10.3390/polym14183712] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 08/25/2022] [Accepted: 09/02/2022] [Indexed: 11/16/2022] Open
Abstract
Maintaining dental pulp vitality and preventing tooth loss are two challenges in endodontic treatment. A tooth lacking a viable pulp loses its defense mechanism and regenerative ability, making it more vulnerable to severe damage and eventually necessitating extraction. The tissue engineering approach has drawn attention as an alternative therapy as it can regenerate dentin-pulp complex structures and functions. Stem cells or progenitor cells, extracellular matrix, and signaling molecules are triad components of this approach. Stem cells from human exfoliated deciduous teeth (SHED) are a promising, noninvasive source of stem cells for tissue regeneration. Not only can SHEDs regenerate dentin-pulp tissues (comprised of fibroblasts, odontoblasts, endothelial cells, and nerve cells), but SHEDs also possess immunomodulatory and immunosuppressive properties. The collagen matrix is a material of choice to provide structural and microenvironmental support for SHED-to-dentin pulp tissue differentiation. Growth factors regulate cell proliferation, migration, and differentiation into specific phenotypes via signal-transduction pathways. This review provides current concepts and applications of the tissue engineering approach, especially SHEDs, in endodontic treatment.
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Affiliation(s)
- Vinna K Sugiaman
- Department of Oral Biology, Faculty of Dentistry, Maranatha Christian University, Bandung 40164, Indonesia
| | - Rudy Djuanda
- Department of Conservative Dentistry and Endodontic, Faculty of Dentistry, Maranatha Christian University, Bandung 40164, Indonesia
| | - Natallia Pranata
- Department of Oral Biology, Faculty of Dentistry, Maranatha Christian University, Bandung 40164, Indonesia
| | - Silvia Naliani
- Department of Prosthodontics, Faculty of Dentistry, Maranatha Christian University, Bandung 40164, Indonesia
| | - Wayan L Demolsky
- Department of Oral Biology, Faculty of Dentistry, Maranatha Christian University, Bandung 40164, Indonesia
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15
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Queiroz AF, Hidalgo MM, Consolaro A, Panzarini SR, França AB, Melo ME, Poi WR. Effect of systemic antibiotic therapy on pulp repair following extrusive luxation and avulsion in a murine model: A histomorphological study. Dent Traumatol 2022; 38:397-409. [PMID: 35662418 DOI: 10.1111/edt.12771] [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: 12/17/2021] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIM The evidence for any benefit of systemic antibiotic therapy on pulp survival following extrusive luxation and avulsion is inconclusive. The aim of this study was to evaluate the effect of systemic antibiotic therapy with amoxycillin and tetracycline for 7 days on different aspects of dental pulp repair in a murine model. MATERIAL AND METHODS The right maxillary incisor of 180 4 to 8-week-old male Wistar rats underwent extrusive luxation or avulsion. The animals were then treated with saline solution (control), tetracycline, or amoxicillin administered intra-gastrically for 7 days, and euthanized at 7, 15, and 30 days post-operatively. The layer of odontoblast cells, reparative dentin deposition, Hertwig's epithelial root sheath, pulp necrosis, and periapical inflammatory infiltrate were histomorphologically analyzed and scored. Mann-Whitney, Kruskal-Wallis, and Dunn tests were used to compare mean scores for the different procedures, treatments, and times (p ≤ .05). RESULTS Significant differences were observed between luxated and avulsed teeth (p < .05). In luxated teeth, no differences were observed among treatments and times, except for more tertiary dentin deposition in the coronal third with the use of tetracycline compared with amoxicillin at 15 days (p < .05). In avulsed teeth, higher scores for the layer of odontoblast cells and lower scores for periapical inflammatory infiltrate at 7 days and pulp necrosis at 7 and 15 days were observed in the amoxicillin group compared to the saline and tetracycline groups (p < .05). At 30 days, however, no differences were observed among treatments. CONCLUSIONS The use of systemic antibiotic therapy with tetracycline or amoxicillin for 7 days did not contribute to pulp repair following extrusive luxation or avulsion in rats. However, the results warrant further research into the use of amoxicillin for a more extended period of time in cases of avulsion.
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Affiliation(s)
- Alfredo Franco Queiroz
- Dentistry Department, Universidade Estadual de Maringá, Maringa, Brazil.,Surgery and Integrated Clinic, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, Brazil
| | | | - Alberto Consolaro
- Pathology Department, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, Brazil
| | - Sônia Regina Panzarini
- Surgery and Integrated Clinic, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, Brazil
| | - Alline Batistussi França
- Surgery and Integrated Clinic, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, Brazil.,Dentistry Department, Centro Universitário de Maringá, Maringá, Brazil
| | - Moriel Evangelista Melo
- Surgery and Integrated Clinic, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, Brazil
| | - Wilson Roberto Poi
- Surgery and Integrated Clinic, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, Brazil
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Shah A, Peacock R, Eliyas S. Pulp therapy and root canal treatment techniques in immature permanent teeth: an update. Br Dent J 2022; 232:524-530. [PMID: 35459824 DOI: 10.1038/s41415-022-4139-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/05/2021] [Indexed: 11/09/2022]
Abstract
Background According to the Children's Dental Health Survey 2013, around one in ten children in Wales, Northern Ireland and England will have sustained dental trauma to a permanent incisor by the of age 15. Management of an exposed pulp in an immature permanent incisor is often urgent and has an impact on the long-term outcome of the tooth; therefore, it is essential that general dental practitioners feel confident in managing such a scenario to achieve an optimal outcome. This paper discusses the indications, technique, materials and outcomes.Aims This article aims to review the literature, which discusses various treatment modalities and materials for pulpal therapy and root canal treatment in the immature permanent tooth.Method Electronic searches were limited to English language, human studies, published within the past five years and the medical subject heading terms used were: direct pulp capping, apexogenesis, Cvek pulpotomy, full pulpotomy/pulpectomy, partial pulpotomy, apexification, non-vital pulp therapy and mineral trioxide aggregate apexification. Older, seminal articles identified through the references sections have also been included.Conclusion A number of options are available for the management of immature permanent teeth that have suffered an insult such as caries or trauma. This paper reviews the various methods of pulpal treatment, preservation therapy and root canal treatment options depending on the extent of the damage.
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Affiliation(s)
- Anika Shah
- Dental Core Trainee 3 in Paediatric Dentistry and Paediatric Oral and Maxillofacial Surgery, Birmingham Women's and Children's NHS Foundation Trust, UK.
| | - Rachel Peacock
- Dental Core Trainee 3 in Oral and Maxillofacial Surgery, Mid and South Essex NHS Foundation Trust, UK
| | - Shiyana Eliyas
- Consultant in Restorative Dentistry, St George's Hospital NHS Foundation Trust, UK
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17
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Khurshid Z, Asiri FYI, Najeeb S, Ratnayake J. The Impact of Autologous Platelet Concentrates on the Periapical Tissues and Root Development of Replanted Teeth: A Systematic Review. MATERIALS 2022; 15:ma15082776. [PMID: 35454469 PMCID: PMC9031947 DOI: 10.3390/ma15082776] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 02/06/2023]
Abstract
Introduction: In many cases, the replanted teeth may undergo resorption or ankyloses. Recent studies show that autologous platelet concentrates (APCs) may improve the outcomes of tooth replantation. The aim of this systematic review was to summarize and critically appraise the currently available literature on the use of APCs before tooth replantation. Methodology: An electronic search was conducted on the following research databases: PubMed/MEDLINE, ISI Web of Science, EMBASE and Scopus. The following medical subject heading (MeSH) keywords used were: ((tooth replantation) OR (replanted tooth) OR (teeth replantation) OR (replanted teeth)) AND ((autologous platelet concentrate) OR (platelet-rich plasma) OR (platelet-rich fibrin) OR (autologous platelet)). The studies’ data was extracted, and the research’ quality was rated using the CARE and ARRIVE protocols. Results: Ten case reports and three animal studies, one cell study and one study, which included both animal and in vitro experiments, were included in this review. In majority of the studies, APCs improved the outcomes of tooth replantation. However, there were various sources of bias in the most of the research, which may have influenced the results. Conclusions: Although majority of the studies indicate that APCs may improve outcomes of tooth replantation, majority of the studies contained numerous sources of bias. Additionally, the sample size of the included subjects is inadequate to predict the clinical efficacy of APCs in management of replanted teeth. Large-scale, multi-center and long-term studies are required to ascertain the efficacy of APCs in improve the outcomes of tooth replantation.
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Affiliation(s)
- Zohaib Khurshid
- Department of Prosthodontics and Dental Materials, School of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Correspondence: ; Tel.: +966-558420410
| | - Faris Yahya I. Asiri
- Department of Preventive Dentistry, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
| | - Shariq Najeeb
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada;
| | - Jithendra Ratnayake
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand;
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18
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Almutairi W, Al-Dahman Y, Alnassar F, Albalawi O. Intracanal calcification following regenerative endodontic treatment: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:3333-3342. [PMID: 35243550 DOI: 10.1007/s00784-021-04333-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 12/01/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Calcification is a common finding in endodontic cases after regenerative endodontic therapy (RET). We aimed to identify the prevalence of intracanal calcification after RET and to compare intracanal calcification outcomes in RET using either calcium hydroxide [Ca(OH)2] or antibiotics. MATERIALS AND METHODS We searched PubMed, Web of Science, ProQuest Dissertations & Theses, and Scopus databases for clinical, cross-sectional, case-control, and cohort RET studies published until May 2020 in the English language and reporting a calcified case after RET. The Cochrane risk-of-bias tool for randomized trials and Risk of Bias In Non-randomized Studies of Interventions were used for bias assessment. Meta-analyses were performed, overall and separately, for intracanal medicaments using a random-effects model with weighted inverse variance methods. Subgroup analysis was performed according to the calcification type. RESULTS Eight studies were included. The overall prevalence of intracanal calcification after RET was 30.7% (95% confidence interval [CI]: 0.15-0.45,[Formula: see text]=92.6%), 46.5% with Ca(OH)2 vs. 25.8% with antibiotic-based intracanal medicaments. Subgroup analyses for complete calcification outcome showed a higher prevalence of complete calcification in the Ca(OH)2 group (46.5%, 95% CI: 0.17-0.68,[Formula: see text]%) than in the antibiotic group (10%, 95% CI: - 0.04-0.43,[Formula: see text]%). CONCLUSIONS Based on the studies included, available evidence shows a statistically significant association between complete calcification and Ca(OH)2 paste as an intracanal medicament. Other contributing factors, such as blood clot formation and follow-up time, might also play an essential role in forming intracanal calcification. CLINICAL RELEVANCE This study highlights the significant association between complete calcification and Ca(OH)2 paste.
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Affiliation(s)
- Waleed Almutairi
- Department of Endodontics, College of Dentistry, Qassim University, Qassim, P. O. Box: 1162, Saudi Arabia.
| | - Yousef Al-Dahman
- Department of Endodontics, Eastern Riyadh Dental Center, Second Health Cluster in Riyadh, Ministry of Health, Riyadh, Saudi Arabia
| | - Faisal Alnassar
- Department of Restorative Dental Sciences, College of Dentistry, Majmaah University, Al Majmaah, Saudi Arabia
| | - Olayan Albalawi
- Department of Statistic, Faculty of Science, Tabuk University, Tabuk, Saudi Arabia
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19
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Zhou C, Yuan Z, Xu H, Wu L, Xie C, Liu J. Regenerative Endodontic Procedures in Immature Permanent Teeth With Dental Trauma: Current Approaches and Challenges. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2021.767226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
After dental trauma to immature permanent teeth (IPT), there can be pulpitis, necrotic, and periapical periodontitis, which will halt further root development. Traditional endodontic root canal treatments and apexification cannot revitalize the necrotic pulp to revitalize the tooth to promote further root development. As a consequence, IPT with thin dentinal walls can be prone to fracture and if a fracture occurs, the patient will likely suffer the loss of the tooth. In an attempt to save IPT, there has been a growing interest among dentists to use regenerative endodontic procedures (REPs) to revitalize a replace dental pulp to continue root development and strengthen the dentinal walls to help prevent a subsequent loss of the tooth. However, the effectiveness of REPs and the precise methods to successfully accomplish REPs are controversial. Therefore, the objective of this review is to compare the different approaches to REPs in case reports by highlighting their advantages and limitations.
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20
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Donnelly A, Foschi F, McCabe P, Duncan HF. Pulpotomy for treatment of complicated crown fractures in permanent teeth: A systematic review. Int Endod J 2022; 55:290-311. [PMID: 35076954 PMCID: PMC9304243 DOI: 10.1111/iej.13690] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/21/2022] [Accepted: 01/21/2022] [Indexed: 11/28/2022]
Abstract
Background Consensus on the treatment of choice for complicated crown fractures of teeth is limited. Recent guidance recommends vital‐pulp‐therapy; however, the preferred type is not specified. Higher success rates for pulpotomy compared to pulp‐capping have been documented, which suggests pulpotomy may be a preferable option for complicated crown‐fractures. Objectives The purpose of this systematic review was to determine the success rate of pulpotomy (partial and complete) on teeth that suffered complicated crown fractures. Participants: patients who have suffered a complicated crown fracture to an anterior permanent tooth. Intervention: pulpotomy (partial or complete). Comparator: pulp‐capping or root canal treatment. Outcome: combined clinical and radiographic success at or after 12 months. Methods A systematic literature using key search terms was conducted using PubMed, Web of Science and Cochrane‐Central‐Register‐of‐Controlled‐Trials (CENTRAL) as well as a grey literature search from inception to May 2021 and without language restricted to English. Strict inclusion criteria were applied. A standardized tool with defined criteria to assess the risk of bias in each study was used. For non‐randomized comparative trials, the Robins‐I tool was used while the Newcastle‐Ottawa scale was used for non‐comparative non‐randomized studies. Results Seven retrospective clinical studies were included. The studies reported high success rates for pulpotomy with overall success ranges for partial or complete pulpotomy ranging from 75% to 96%. One study compared the success rates of pulpotomy to an alternative treatment option pulp capping (90.9% vs. 67%, respectively). Due to the lack of homogeneity in the included studies, a meta‐analysis was not possible. Discussion This review highlights the limited evidence based for the current guidance on treatment of complicated crown fractures. The findings of the review indicate high success rates for pulpotomy; however, there is a moderate risk of bias and small sample sizes in the included studies with the result that the overall results should be interpreted with caution. Conclusion Within the limitations of this review, the benefits and high success rates reported for partial pulpotomy suggest this procedure, rather than pulp‐capping, should be considered as the treatment of choice for both immature and mature teeth that have suffered complicated crown‐fractures.
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Affiliation(s)
- Aisling Donnelly
- Faculty of Dentistry Oral & Craniofacial Sciences King’s College London London SE1 9RT
| | - Federico Foschi
- Faculty of Dentistry Oral & Craniofacial Sciences King’s College London London SE1 9RT
- University of Plymouth Peninsula Dental School Plymouth UK
- Department of Therapeutic Dentistry I. M. Sechenov First Moscow State Medical University Moscow Russia
| | - Paul McCabe
- Specialist Endodontist Oranmore Endodontics Oranmore Ireland
| | - Henry F. Duncan
- Division of Restorative Dentistry & Periodontology Dublin Dental University Hospital Trinity College Dublin Dublin Ireland
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21
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Markandey S, Das Adhikari H. Evaluation of blood clot, platelet-rich plasma, and platelet-rich fibrin–mediated regenerative endodontic procedures in teeth with periapical pathology: a CBCT study. Restor Dent Endod 2022; 47:e41. [DOI: 10.5395/rde.2022.47.e41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/19/2021] [Accepted: 01/03/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Swati Markandey
- Department of Conservative Dentistry and Endodontics, Dr. R. Ahmed Dental College and Hospital, Kolkata, India
| | - Haridas Das Adhikari
- Department of Conservative Dentistry and Endodontics, Dr. R. Ahmed Dental College and Hospital, Kolkata, India
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22
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Namsoy E, Serefoglu B, Hulsmann M, Caliskan MK. Influence of various application systems on the amount of extruded irrigant in simulated immature teeth with regard to gravity: An ex-vivo study. Niger J Clin Pract 2022; 25:1831-1837. [DOI: 10.4103/njcp.njcp_270_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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23
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de Andrade Vieira W, Oliveira MB, Machado LDS, Cericato GO, Lima IFP, Paranhos LR. Pulp changes from rapid maxillary expansion: A systematic review. Orthod Craniofac Res 2021; 25:320-335. [PMID: 34874608 DOI: 10.1111/ocr.12556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/06/2021] [Accepted: 12/02/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION This study aimed to systematically review the current evidence on the occurrence of pulp changes as side effects from orthopaedic rapid maxillary expansion (ORME) or surgically assisted rapid maxillary expansion (SARME). METHODS An electronic search was performed in eleven databases. The eligibility criteria included clinical studies assessing vitality, sensibility or dimensions of the pulp chamber of permanent teeth before and after ORME or SARME, without restrictions on publication year or language. The risk of bias was analysed with the NIH 'Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group' and the 'JBI for quasi-experimental studies' tool. The GRADE tool was used to assess the certainty of evidence. RESULTS The initial search resulted in 1,197 records, from which only seven before-after studies were included. There was a change in the pulpal blood flow (PBF) of maxillary incisors and canines up to 5 days after SARME, which gradually returned after 7 days to 3 months. After ORME, one study observed an increased PBF and one study observed a reduced PBF, which gradually returned after the end of expansion. Two studies observed that both ORME and SARME caused temporary changes in pulp sensibility. Three studies observed a significant reduction in the pulp chamber after ORME or SARME. The outcomes presented a very low certainty of evidence. CONCLUSIONS Although limited, the evidence shows that ORME and SARME caused temporary changes in pulp vitality and sensibility, with the possibility of inducing a reduction in pulp chamber dimensions.
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Affiliation(s)
- Walbert de Andrade Vieira
- Department of Restorative Dentistry, Endodontics Division, State University of Campinas - Unicamp, School of Dentistry of Piracicaba, Piracicaba, SP, Brazil
| | - Millena Barroso Oliveira
- Post-Graduation Program in Dentistry, Federal University of Uberlândia (UFU), Uberlândia, MG, Brazil
| | | | - Graziela Oro Cericato
- Post-Graduation Program in Dentistry, Faculdade Meridional- IMED, Passo Fundo, RS, Brazil
| | - Igor Felipe Pereira Lima
- Post-Graduation Program in Dentistry, Department of Oral Pathology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luiz Renato Paranhos
- Department of Community and Preventive Dentistry, Federal University of Uberlândia (UFU), Uberlândia, MG, Brazil
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Krastl G, Weiger R, Ebeleseder K, Galler K. Present status and future directions: Endodontic management of traumatic injuries to permanent teeth. Int Endod J 2021; 55 Suppl 4:1003-1019. [PMID: 34862800 DOI: 10.1111/iej.13672] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/02/2021] [Indexed: 12/26/2022]
Abstract
The prognosis of traumatized teeth depends largely on the fate of the pulp and its treatment. This review aims to update the present status on the endodontic management of traumatic injuries to permanent teeth and to identify relevant research areas that could contribute to an improvement in diagnosis and treatment of traumatized permanent teeth. Future research should pay greater attention to (1) diagnostic methods to assess the perfusion of the pulp and enhance detection of tooth cracks and initial signs of root resorption; (2) improved materials for vital pulp treatment; (3) studies focusing on type and duration of splinting after root fractures; (4) antiresorptive intracanal medication in case of posttraumatic pulp necrosis and infection-related resorption and (5) long-term data on the apical barrier technique compared to revitalization.
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Affiliation(s)
- Gabriel Krastl
- Department of Conservative Dentistry and Periodontology, Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany
| | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology, Center of Dental Traumatology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Kurt Ebeleseder
- University Clinic of Dental Medicine and Oral Health, Medical University Graz, Graz, Austria
| | - Kerstin Galler
- Department of Conservative Dentistry and Periodontology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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25
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Evaluation of Clinical and Radiographic Findings among Patients with Traumatic Dental Injuries Seeking Delayed Treatment. Int J Dent 2021; 2021:9549508. [PMID: 34471410 PMCID: PMC8405333 DOI: 10.1155/2021/9549508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/09/2021] [Accepted: 08/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background Time elapsed between trauma and treatment greatly influences the prognosis of traumatic dental injuries (TDIs). The aim of this study was to analyze clinical and radiographic findings related to complications of TDIs among patients seeking delayed treatment of such injuries. Materials and Methods 123 permanent teeth with a history of previous TDIs were included in the study. Clinical findings analyzed were the type of fracture, type and number of injured teeth, crown discoloration, and pulpal status of the injured tooth (pulpal diagnosis). The radiographic findings analyzed included pulp canal obliteration (PCO), root resorption (RR), and periapical radiolucency (PR). Statistical analysis included descriptive analysis. Results Tooth discoloration was the most common presenting complaint (53.65%), while fall (48.78%) was the most frequent cause of trauma. The range of time duration between trauma and presentation for treatment was 5 months to 30 years (average time 12.82 years). Pulp necrosis (PN) was the most common complication (90.24%). Almost half of the teeth with PN had fracture injury and discoloration along with a high frequency of PR (78.37%). Even teeth with a normal appearance were found to have a high incidence of PN (76.92%) and PR (53.84%). The crown discoloration was the second most frequent finding (48.78%). Many teeth (41.66%) with vital pulp were also discolored. Most of the teeth (79.31%) with yellowish discoloration and all teeth with brownish discoloration were nonvital. A high frequency of PN (90%) and PR (78.33%) was found in teeth with discoloration. PR was the most common radiographic finding (69.10%), while PCO and RR were observed in 17.88% and 21.13% of teeth, respectively. Conclusion The findings of this study support the fact that delayed treatment of TDIs leads to increased complications. PN was the most common complication followed by tooth discoloration, RR, and PCO among patients seeking delayed treatment after TDIs.
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Sui H, Lv Y, Xiao M, Zhou L, Qiao F, Zheng J, Sun C, Fu J, Chen Y, Liu Y, Zhou J, Wu L. Relationship between the difference in electric pulp test values and the diagnostic type of pulpitis. BMC Oral Health 2021; 21:339. [PMID: 34246278 PMCID: PMC8272274 DOI: 10.1186/s12903-021-01696-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 06/25/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND According to the diagnosis criteria of the American Association of Endodontists (AAE), sensitive responses to cold and/or heat tests of suspected teeth compared with those of control teeth can be used for the diagnosis of pulpitis, but the role of electric pulp test (EPT) is not mentioned. It is believed that EPT has some limitations in determining the vitality of the pulp. The aim of this study was to explore the association between the difference in EPT values and the differential diagnoses of reversible pulpitis (RP) and symptomatic irreversible pulpitis (SIRP) caused by dental caries. METHODS A total of 203 cases with pulpitis caused by dental caries were included. A diagnosis of pulpitis was made on the basis of the diagnostic criteria of AAE. Patient demographic and clinical examination data were collected. The EPT values of the suspected teeth and control teeth were measured, and the differences between them were calculated. The correlation between the difference in the EPT values and diagnosis of pulpitis was analyzed using univariate and multivariate logistic regression. RESULTS In the 203 cases (78 males and 125 females; 115 cases of RP, 88 cases of SIRP; 9 anterior teeth, 59 premolars, and 135 molars), the mean patient age was 34.04 ± 13.02 (standard deviation) years. The unadjusted (crude) model, model 1 (adjusted for age), model 2 (adjusted for age and sex), and model 3 (adjusted for age, sex, and tooth type) were established for the statistical analyses. In model 3 [odds ratio (OR) = 1.025; 95% confidence interval (CI) 1.002-1.050; P = 0.035], the difference in EPT values between RP and SIRP was statistically significant. However, the areas under the curve of predictive probability of the crude model, model 1, model 2, and model 3 were 0.565, 0.570, 0.585, and 0.617, respectively, showing that the model accuracy was low. The P-value for the trend in differences between the EPT values as a categorical variable showed that the differences in the EPT values, comparing RP and SIRP, were not statistically significant. CONCLUSIONS Based on the present data, the difference in EPT values was not sufficient to differentiate RP from SIRP.
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Affiliation(s)
- Huachao Sui
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Yangyang Lv
- Department of Endodontics, Wuxi Stomatology Hospital, Jiangsu, China
| | - Mo Xiao
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Liwen Zhou
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Feng Qiao
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Tianjin Medical University, Tianjin, China
| | - Jinxin Zheng
- Department of Endodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Cuicui Sun
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Jieni Fu
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Yufan Chen
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Yimeng Liu
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Jie Zhou
- Department of Stomatology, Wuqing People Hospital, Tianjin, China
| | - Ligeng Wu
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China.
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Gaviño-Orduña JF, Fernández-Guallart I, Caviedes-Bucheli J, Espadas-García M, López-López J. Regenerative endodontic procedure combined with apical surgery of a necrotic permanent incisor with extensive periapical lesion using plasma rich in growth factors (PRGF): A Case report with 6 years post-op evaluation using CBCT. J Clin Exp Dent 2021; 13:e620-e625. [PMID: 34188770 PMCID: PMC8223161 DOI: 10.4317/jced.58113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/23/2021] [Indexed: 01/09/2023] Open
Abstract
Background The aim of this case report is to describe the step-by step and outcomes of a treatment approach which simultaneously combines a Regenerative Endodontic Procedure (REP) and apical surgery using PRGF as treatment of a post-traumatic necrotic permanent central incisor with extensive periapical lesion and undeveloped apex in a 16 years-old patient.
Case description A 16 years-old patient with an extensive periapical lesion in the maxillary central incisor was treated with a combination of REP and periapical surgery in the same visit. A Bi- antibiotic paste (BAP) was used to priorly disinfect the canal, which was posteriorly sealed with MTA placed over a PRGF clot at the same time that the periapical lesion was surgically debrided, removed and grafted, The radiographic and CBCT follow-up results showed a complete healing of the radiolucent lesion, which was replaced with bone-like tissue in two years and well preserved until six years later.
Practical implications A combined approach of a Regenerative Endodontic Procedure and apical surgery using PRGF may be a good treatment modality in cases of extensive periapical lesions in necrotic teeth with open apexes. PRGF has shown to act as an ideal autologous matrix because it is stable, provides growth factors and bioactive molecules, and stimulates collagen production, angiogenesis, and cell differentiation. Key words:Regenerative endodontic procedure, open apex necrotic tooth, periodontal apical lesion, growth factors, apical surgery.
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Affiliation(s)
| | - Inés Fernández-Guallart
- DDs, MsC Dentist. Department of Odonto-Stomatology, School of Dentistry, University of Barcelona
| | - Javier Caviedes-Bucheli
- DDs, MsC Centro de Investigaciones Odontologicas (CIO) Pontificia Universidad Javeriana Bogota Colombia
| | - Manuel Espadas-García
- MD, DDS, Dentist. Department of Odonto-Stomatology, School of Dentistry, University of Barcelona
| | - José López-López
- PhD, MD, DDS, Dentist. University of Barcelona. Spain. Professor of Oral Patholoy. School of Dentistry, Barcelona University / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona 08907, Spain
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Briseño-Marroquín B, Ismael Y, Callaway A, Tennert C, Wolf TG. Antibacterial effect of silver diamine fluoride and potassium iodide against E. faecalis, A. naeslundii and P. micra. BMC Oral Health 2021; 21:175. [PMID: 33827520 PMCID: PMC8025376 DOI: 10.1186/s12903-021-01531-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 03/22/2021] [Indexed: 12/05/2022] Open
Abstract
Background The aim of this study was to determine in vitro the bactericidal potential of 38% silver diamine fluoride (SDF) alone, potassium iodide (PI) alone, and the two in combination (SDF + PI) against three bacterial species commonly found in root canal samples (Enterococcus faecalis, Actinomyces naeslundii and Parvimonas micra).
Methods The potential bactericidal rates for SDF, PI and SDF + PI against E. faecalis, A. naeslundii and P. micra were calculated as reduction of bacteria colony forming units. Results The bactericidal potential of SDF was at 99.97–100% against E. faecalis and 100% against A. naeslundii and P. micra. SDF + PI showed a 100% bactericidal effect against P. micra, 99.89–99.98% against E. faecalis and 99.98–100% against A. naeslundii. The bactericidal effect of PI was 99.51–99.98% against E. faecalis, 99.27–99.95% against A. naeslundii and 99.93–100% against P. micra. The differences between controls and bacteria exposed to the antibacterial agents were statistically significant (p < 0.05). Conclusions SDF had an effective bactericidal effect against the examined bacteria. However, the limitations of this in vitro study do not allow a recommendation of the employment of these solutions as root canal irrigants. Additional investigations are necessary to assess their endodontic clinical applicability.
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Affiliation(s)
- Benjamín Briseño-Marroquín
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.,Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Yasmine Ismael
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Angelika Callaway
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Christian Tennert
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland. .,Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
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Krastl G, Weiger R, Filippi A, Van Waes H, Ebeleseder K, Ree M, Connert T, Widbiller M, Tjäderhane L, Dummer PMH, Galler K. Endodontic management of traumatized permanent teeth: a comprehensive review. Int Endod J 2021; 54:1221-1245. [PMID: 33683731 DOI: 10.1111/iej.13508] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 03/05/2021] [Indexed: 12/15/2022]
Abstract
The pulp plays a key role in the treatment of traumatic dental injuries (TDIs) and is strongly associated with the outcome, particularly in severe cases. A correct pulp diagnosis is essential as it forms the basis for developing the appropriate management strategy. However, many TDIs are complex, and their treatment requires a profound knowledge of the physiological and pathological responses of the affected tissues. This comprehensive review will look at the dentine-pulp complex and its interaction with the surrounding tissues following TDIs. The literature up to 2020 was reviewed based on several searches on PubMed and the Cochrane Library using relevant terms. In addition to the recently revised guidelines of the International Association of Dental Traumatology, this article aims to provide background information with a focus on endodontic aspects and to gather evidence on which a clinician can make decisions on the choice of the appropriate endodontic approach for traumatized permanent teeth.
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Affiliation(s)
- G Krastl
- Department of Conservative Dentistry and Periodontology, Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany
| | - R Weiger
- Department of Periodontology, Endodontology and Cardiology, University School of Dental Medicine, Basel, Switzerland.,Center of Dental Traumatology, University School of Dental Medicine, Basel, Switzerland
| | - A Filippi
- Center of Dental Traumatology, University School of Dental Medicine, Basel, Switzerland.,Department of Oral Surgery, University School of Dental Medicine, Basel, Switzerland
| | - H Van Waes
- Department of Paediatric Dentistry, Clinic for Orthodontics and Paediatric Dentistry, University of Zürich, Zürich, Switzerland
| | - K Ebeleseder
- University Clinic of Dental Medicine and Oral Health, Medical University Graz, Graz, Austria
| | - M Ree
- Private Practice, Purmerend, Netherlands
| | - T Connert
- Department of Periodontology, Endodontology and Cardiology, University School of Dental Medicine, Basel, Switzerland.,Center of Dental Traumatology, University School of Dental Medicine, Basel, Switzerland
| | - M Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - L Tjäderhane
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.,Research Unit of Oral Health Sciences, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, University of Oulu, Oulu, Finland
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - K Galler
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
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30
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Rovira-Wilde A, Longridge N, McKernon S. Management of severe traumatic intrusion in the permanent dentition. BMJ Case Rep 2021; 14:14/3/e235676. [PMID: 33674288 PMCID: PMC7939001 DOI: 10.1136/bcr-2020-235676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Traumatic intrusion is considered one of the most severe luxation injuries to the permanent dentition. There are limited studies based on minimal evidence supporting suggested management protocols, owing to the rare occurrence of intrusion. The following case report details the multidisciplinary management and 18-month follow-up, in line with current UK guidelines, of a 23-year old adult male who sustained severe intrusion injuries to both permanent maxillary central incisor teeth. Timely, accurate diagnosis and subsequent appropriate management correlates with improved outcomes for traumatic injuries and it is therefore imperative those involved with the acute and long-term management of dentoalveolar trauma are aware of current guidelines.
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Affiliation(s)
- Alex Rovira-Wilde
- Institute of Clinical Sciences, University of Liverpool Faculty of Health and Life Sciences, Liverpool, UK
| | - Nick Longridge
- Institute of Clinical Sciences, University of Liverpool Faculty of Health and Life Sciences, Liverpool, UK
| | - Sarah McKernon
- Institute of Clinical Sciences, University of Liverpool Faculty of Health and Life Sciences, Liverpool, UK
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31
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Bratteberg M, Thelen DS, Klock KS, Bårdsen A. Traumatic dental injuries and pulp sequelae in an adolescent population. Dent Traumatol 2020; 37:294-301. [PMID: 33220150 DOI: 10.1111/edt.12635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/15/2020] [Accepted: 11/17/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIMS Traumatic dental injuries (TDI) occur frequently and may result in pulp sequelae. This includes pulp necrosis with infection, pulp canal obliteration and root resorption. The aim of this study was to assess the prevalence and risk factors of pulp sequelae after TDI among Norwegian adolescents. MATERIAL AND METHODS A retrospective longitudinal study, including historical clinical data, was conducted with 16-year-old pupils in western Norway. All first-grade pupils, born in 1997 (n = 5184), attending public high schools, were invited to participate and to respond to an electronically administered closed-ended questionnaire (response rate 39.6%, n = 2055). Consent was given to access the dental records in the Public Dental Health Service in Hordaland, where information regarding TDI (diagnosis and treatment) and radiographs were interpreted. Only TDIs to anterior teeth were recorded (canine to canine in the maxilla and mandible). Outcome variables of TDI were registered and analysed using logistic regression, Kaplan-Meier survival estimates and log-rank test. RESULTS The prevalence of TDI in the sample population was 16.4% (338 pupils), with a total of 637 teeth involved. The number of included teeth for analysis was 571 (90.5%). The prevalence of pulp necrosis with infection was 7.5%. Moderate and severe TDI was associated with a higher frequency of pulp necrosis with infection. Pulp canal obliteration and root resorption were found in 2.8% and 2.3% of teeth with TDI, respectively. Dental hard tissue injuries were more prone to the development of pulp necrosis than luxation injuries and combination injuries. The relationship between root development stage and development of pulp necrosis with infection was not statistically significant. CONCLUSIONS Occurrence of different pulp sequelae among teeth affected with TDI was low. Moderate and severe TDI were more at risk of developing pulpal complications and hard tissue injuries were at higher risk of developing pulp necrosis with infection.
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Affiliation(s)
- Magnus Bratteberg
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | | | - Kristin S Klock
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Asgeir Bårdsen
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
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32
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Arnold M. Reparative Endodontic Treatment of a Perforating Internal Inflammatory Root Resorption: A Case Report. J Endod 2020; 47:146-155. [PMID: 33065177 DOI: 10.1016/j.joen.2020.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 09/30/2020] [Indexed: 10/23/2022]
Abstract
The aim of this case report was to present a reparative treatment approach of an extensive internal inflammatory resorption with a lateral perforation and apical and lateral inflammatory lesions. Only the necrotic coronal part of the pulp was removed, and the vital pulp tissue within the resorption cavity and the apical part of the root canal was left uninstrumented. Bleeding was induced, and the blood clot was covered with mineral trioxide aggregate. Hard tissue repair and healing of the apical lesion could be observed in the 3-year recall.
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Affiliation(s)
- Michael Arnold
- Praxis für Endodontie und Zahnerhaltung, Dresden, Germany.
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Pereira AC, Oliveira MLD, Cerqueira-Neto ACCL, Gomes BPFA, Ferraz CCR, Almeida JFAD, Marciano MA, DE-Jesus-Soares A. Treatment outcomes of pulp revascularization in traumatized immature teeth using calcium hydroxide and 2% chlorhexidine gel as intracanal medication. J Appl Oral Sci 2020; 28:e20200217. [PMID: 32997087 PMCID: PMC7518246 DOI: 10.1590/1678-7757-2020-0217] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/17/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Pulp revascularization is an effective treatment for immature necrotic teeth. Calcium hydroxide has been used in pulp revascularization as an intracanal medication due to its antimicrobial action and the non-exhibition of crown discoloration and cytotoxicity for stem cells from the apical papilla. Our study aimed to investigate the clinical success and quantitative radiographic changes of root development in immature traumatized teeth using calcium hydroxide plus 2% chlorhexidine gel as intracanal medication. METHODOLOGY In this retrospective study, 16 patients were treated with a standardized pulp revascularization protocol. Calcium hydroxide and 2% chlorhexidine gel were manipulated in a 1:1 (v/v) ratio and inserted into root canals with Lentulo spirals (Dentsply Maillefer, Baillaigues, Switzerland). Patients were followed up for a period from 9 to 36 months for the evaluation of clinical and radiological data. Radiographic measurements of root length, root width, apical diameter, and MTA placement from the apex were quantified using software ImageJ. Wilcoxon test and t-test were used, according to nonparametric or parametric data, respectively, for changes over time in root length, root width, and apical diameter. RESULTS Fifteen teeth survived during the follow-up period (93.75%) and met the criteria for clinical success. Although the changes seem to be very small in many cases, significant increases in the average root length (14.28%, p<0.0001), root width (8.12%, p=0.0196), and decrease in apical diameter (48.37%, p=0.0007) were observed. MTA placement from the apex and age at the time of treatment was not significantly associated with the quantitative radiographic outcomes. CONCLUSIONS Pulp revascularization in traumatized immature teeth treated with calcium hydroxide plus 2% chlorhexidine gel as intracanal medication had high success and survival rates, showing periodontal healing and resolution of signs and symptoms. However, concerning the continued root development, the outcomes can still be considered unpredictable.
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Affiliation(s)
- Andrea Cardoso Pereira
- Universidade Estadual Campinas - UNICAMP. Faculdade de Odontologia de Piracicaba. Departamento de Odontologia Restauradora, área de Endodontia. Piracicaba, SP, Brasil
| | - Matheus Lima de Oliveira
- Universidade Estadual Campinas - UNICAMP. Faculdade de Odontologia de Piracicaba. Departamento de Diagnóstico Oral, área de Radiologia Oral, Piracicaba, SP, Brasil
| | - Ana Carolina C L Cerqueira-Neto
- Universidade Estadual Campinas - UNICAMP. Faculdade de Odontologia de Piracicaba. Departamento de Odontologia Restauradora, área de Endodontia. Piracicaba, SP, Brasil
| | - Brenda P F A Gomes
- Universidade Estadual Campinas - UNICAMP. Faculdade de Odontologia de Piracicaba. Departamento de Odontologia Restauradora, área de Endodontia. Piracicaba, SP, Brasil
| | - Caio Cezar Randi Ferraz
- Universidade Estadual Campinas - UNICAMP. Faculdade de Odontologia de Piracicaba. Departamento de Odontologia Restauradora, área de Endodontia. Piracicaba, SP, Brasil
| | - José Flávio Affonso de Almeida
- Universidade Estadual Campinas - UNICAMP. Faculdade de Odontologia de Piracicaba. Departamento de Odontologia Restauradora, área de Endodontia. Piracicaba, SP, Brasil
| | - Marina Angélica Marciano
- Universidade Estadual Campinas - UNICAMP. Faculdade de Odontologia de Piracicaba. Departamento de Odontologia Restauradora, área de Endodontia. Piracicaba, SP, Brasil
| | - Adriana DE-Jesus-Soares
- Universidade Estadual Campinas - UNICAMP. Faculdade de Odontologia de Piracicaba. Departamento de Odontologia Restauradora, área de Endodontia. Piracicaba, SP, Brasil
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Moccelini BS, Alencar NAD, Magno MB, Bolan M, Maia LC, Cardoso M. Is there an association between crown discoloration and pulp necrosis in traumatized per in vitro manent teeth? A meta-analysis. Braz Oral Res 2020; 34:e103. [PMID: 32901727 DOI: 10.1590/1807-3107bor-2020.vol34.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/15/2020] [Indexed: 11/21/2022] Open
Abstract
The present study aimed to identify the scientific evidence regarding the association between crown discoloration and pulp necrosis in traumatized permanent teeth. A systematic literature search was conducted in the PubMed/Medline, Lilacs/BBO, Scopus, Web of Science, Cochrane Library databases, and grey literature. Quality assessment and bias control were carried out according to the Fowkes and Fulton guidelines. Meta-analysis was performed, and the odds ratio was calculated with a 95% confidence interval. The quality assessment of the evidence was determined for the meta-analysis outcomes using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. From 2,702 studies identified, five articles met the inclusion criteria. One among these showed no methodological soundness and was excluded from the meta-analysis, and the remaining four studies were included in the meta-analysis. The total number of traumatized permanent teeth evaluated in the meta-analysis was 367. The results showed a positive association between crown discoloration and pulp necrosis in permanent teeth. Teeth with crown discoloration showed 23 times more chance to present pulp necrosis than teeth without crown discoloration (OR 23.82 [1.25, 452.87]; p = 0.03), with a very low certainty of evidence. There is a significant association between crown discoloration and pulp necrosis of traumatized permanent teeth. Due to the very low strength of evidence according to GRADE, this result should be viewed with caution.
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Affiliation(s)
- Bárbara Suelen Moccelini
- Universidade Federal de Santa Catarina - UFSC, School of Dentistry, Department of Pediatric Dentistry, Florianópolis, SC, Brazil
| | - Nashalie Andrade de Alencar
- Universidade Federal de Santa Catarina - UFSC, School of Dentistry, Department of Pediatric Dentistry, Florianópolis, SC, Brazil
| | - Marcela Baraúna Magno
- Universidade Federal do Rio de Janeiro - UFRJ, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Rio de Janeiro, RJ, Brazil
| | - Michele Bolan
- Universidade Federal de Santa Catarina - UFSC, School of Dentistry, Department of Pediatric Dentistry, Florianópolis, SC, Brazil
| | - Lucianne Cople Maia
- Universidade Federal do Rio de Janeiro - UFRJ, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Rio de Janeiro, RJ, Brazil
| | - Mariane Cardoso
- Universidade Federal de Santa Catarina - UFSC, School of Dentistry, Department of Pediatric Dentistry, Florianópolis, SC, Brazil
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35
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Ishak G, Habib M, Tohme H, Patel S, Bordone A, Perez C, Zogheib C. Guided Endodontic Treatment of Calcified Lower Incisors: A Case Report. Dent J (Basel) 2020; 8:dj8030074. [PMID: 32650552 PMCID: PMC7558261 DOI: 10.3390/dj8030074] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 06/29/2020] [Accepted: 07/02/2020] [Indexed: 12/27/2022] Open
Abstract
A 52-year-old female patient was diagnosed with chronic periapical periodontitis associated with severely calcified lower central incisors. Radiographic examination revealed no visible root canal in the coronal-third of the root. After choosing the guided endodontic treatment, an intraoral scan (Trios, 3shape, Copenhagen, Denmark), in conjunction with a cone beam computed tomography (CBCT) scan, was taken in order to design and fabricate a printed guide. Virtual implant software was used to visualize the surgical access into the sclerosed root canals. After locating the canals, the guide was removed, and the teeth were treated under a rubber dam. The guided approach allows predictable, efficient endodontic treatment of teeth presenting calcified canals, with minimal removal of sound dentine and less risk of root perforations.
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Affiliation(s)
- Georges Ishak
- Department of Endodontics, Saint Joseph University of Beirut, Beirut 1107-2180, Lebanon; (G.I.); (M.H.); (H.T.)
| | - Marc Habib
- Department of Endodontics, Saint Joseph University of Beirut, Beirut 1107-2180, Lebanon; (G.I.); (M.H.); (H.T.)
| | - Hani Tohme
- Department of Endodontics, Saint Joseph University of Beirut, Beirut 1107-2180, Lebanon; (G.I.); (M.H.); (H.T.)
| | - Shanon Patel
- Department of Restorative Dentistry, King’s College, London SE5 9RS, UK;
| | | | - Cyril Perez
- Université de Strasbourg, 6700 Strasbourg, France;
| | - Carla Zogheib
- Department of Endodontics, Saint Joseph University of Beirut, Beirut 1107-2180, Lebanon; (G.I.); (M.H.); (H.T.)
- Correspondence:
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Jain SD, Carrico CK, Bermanis I. 3-Dimensional Accuracy of Dynamic Navigation Technology in Locating Calcified Canals. J Endod 2020; 46:839-845. [DOI: 10.1016/j.joen.2020.03.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/23/2020] [Accepted: 03/10/2020] [Indexed: 12/13/2022]
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Rao Q, Kuang J, Mao C, Dai J, Hu L, Lei Z, Song G, Yuan G. Comparison of iRoot BP Plus and Calcium Hydroxide as Pulpotomy Materials in Permanent Incisors with Complicated Crown Fractures: A Retrospective Study. J Endod 2020; 46:352-357. [PMID: 32035640 DOI: 10.1016/j.joen.2019.12.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 12/11/2019] [Accepted: 12/21/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Calcium hydroxide has been used as a traditional pulpotomy agent for a long time but has some disadvantages. iRoot BP Plus (Innovative Bioceramix Inc, Vancouver, Canada) is a newly developed, ready-to-use calcium silicate-based bioactive ceramic with excellent bioactivity and sealing ability. However, whether iRoot BP Plus shows superiority over calcium hydroxide as a pulpotomy material on permanent incisors with complicated crown fractures remains unknown. METHODS This research included 205 permanent incisors with complicated crown fractures. These teeth were treated with pulpotomy and divided into 2 groups according to the pulpotomy material (105 treated with iRoot BP Plus and 100 with calcium hydroxide). Clinical and radiographic information was collected during the 12- to 24-month follow-up period. The formation of reparative dentin bridges and pulp canal obliteration were analyzed using radiographs in both groups. RESULTS The success rates for recall in the average follow-up period of 17.5 ± 4.4 months (12-24 months) after pulpotomy treatment were significantly different between the 2 groups, with 99% for the iRoot BP Plus group and 93% for the calcium hydroxide group. Reparative dentin bridges were observed in 92.4% of the iRoot BP Plus group and 90% of the calcium hydroxide group, but the difference was not significant. Pulp canal obliteration was observed in 2 teeth (2%) in each group. CONCLUSIONS The success rates obtained in our study indicate that iRoot BP Plus as a pulpotomy agent can be a suitable alternative to calcium hydroxide to manage complicated crown fractures.
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Affiliation(s)
- Qian Rao
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory for Oral Biomedicine of Ministry of Education, Department of Pediatric Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jin Kuang
- Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chuanxia Mao
- Tengzhou Central People's Hospital, Shandong, China
| | - Jing Dai
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory for Oral Biomedicine of Ministry of Education, Department of Pediatric Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Linying Hu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory for Oral Biomedicine of Ministry of Education, Department of Pediatric Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zhiyun Lei
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guangtai Song
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory for Oral Biomedicine of Ministry of Education, Department of Pediatric Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Guohua Yuan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory for Oral Biomedicine of Ministry of Education, Department of Pediatric Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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Yue W, Kim S, Jung HS, Lee JM, Lee S, Kim E. Differential Protein Expression in Human Dental Pulp: Comparison of Healthy, Inflamed, and Traumatic Pulp. J Clin Med 2019; 8:jcm8081234. [PMID: 31426363 PMCID: PMC6723928 DOI: 10.3390/jcm8081234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 08/14/2019] [Indexed: 12/19/2022] Open
Abstract
Trauma or injury to the dental pulp causes inflammation. This study compared the proteome of healthy pulp with inflamed pulp and traumatic pulp to identify the differentially expressed proteins in the diseased state. Five participants were grouped based on the pulpal status of the teeth: healthy, inflamed, or traumatic pulp. Pulp was extirpated and stored immediately in liquid nitrogen. Pulp tissues were subjected to 2-dimensional gel electrophoresis, and spot selection was performed. The selected spots were analyzed using liquid chromatography-tandem mass spectrometry and identified by correlating mass spectra to the proteomic databases. Fifteen spots showed increased expression in the inflamed and traumatic pulp. Annexin V, type II keratin, and hemoglobin levels were increased two-fold in the inflamed and traumatic pulp group and annexin V, mutant beta-actin, and hemoglobin were increased by ten-fold in the inflamed or traumatic pulp group, compared to levels in the healthy pulp group. Annexin V constituted two out of fifteen protein spots, and seemed to play a critical role in inhibiting inflammation and promoting the immune reaction. Further studies on this protein concerning its role in pulp repair are necessary to elucidate the underlying mechanisms.
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Affiliation(s)
- Wonyoung Yue
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul 03722, Korea
| | - Sunil Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul 03722, Korea
| | - Han-Sung Jung
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Oral Science Research Center, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul 03722, Korea
| | - Jong-Min Lee
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Oral Science Research Center, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul 03722, Korea
| | - Sukjoon Lee
- Department of Applied Life Science, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul 03722, Korea
| | - Euiseong Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul 03722, Korea.
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Kandemir Demirci G, Kaval ME, Güneri P, Çalışkan MK. Treatment of immature teeth with nonvital pulps in adults: a prospective comparative clinical study comparing MTA with Ca(OH) 2. Int Endod J 2019; 53:5-18. [PMID: 31397907 DOI: 10.1111/iej.13201] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 08/06/2019] [Indexed: 11/28/2022]
Abstract
AIM To evaluate and compare the influence of various predictors on outcomes of apexification using either mineral trioxide aggregate (MTA) or calcium hydroxide (CH) in permanent immature anterior teeth with necrotic pulps and periapical lesions of adults. METHODOLOGY Ninety immature teeth with necrotic pulps and periapical lesions on adult patients (aged 18-40 years) were treated with MTA (45 teeth) or CH (45 teeth) between 2015 and 2018. Patients of both groups were recalled for follow-up examinations after the first intervention at 1,3,6 and 12 months for the first year, every 6 months for the second year and every year thereafter until the end of the study (median 32.3 months). The treatment outcome based on clinical and radiographic criteria was assessed by calibrated examiners and dichotomized as 'healed+healing' or 'not healed'. The age, gender, stage of root development, preoperative signs and symptoms of apical periodontitis and size of periapical lesion were recorded. The cumulative success proportion and mean time were analysed with the Kaplan-Meier test. The generalized logrank statistic was used to describe prognostic clinical variables. Fisher's exact test was applied for the evaluation of the healing rates. RESULTS Thirty-nine of the 45 teeth treated with MTA were available for recall. Of these, 29 teeth (74%) revealed calcific apical barrier formation with complete resolution of periapical lesions, 7 teeth (18%) were healing, and 3 teeth (8%) had persistent disease. Thirty-four of the 45 teeth in the CH group were available for recall. Of these, 27 teeth (79%) had complete healing of periapical lesions and had calcific barrier formation, 4 teeth (12%) were healing, and the remaining 3 teeth (9%) had not healed. The survival rate of teeth treated with MTA was similar to the survival rates observed in teeth treated with CH (90% and 91%, respectively, P > 0.05). The generalized logrank statistic revealed that the cumulative success rate of both materials was not significantly different (P > 0.05). None of the tested predictors had an influence on the treatment outcomes of teeth in both groups (P > 0.05). CONCLUSIONS Apexification with both MTA and CH was associated with similar treatment outcomes. MTA may be proposed as a material for apexification treatment in immature teeth of adult patients due to the shorter treatment time associated with its use.
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Affiliation(s)
- G Kandemir Demirci
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - M E Kaval
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - P Güneri
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ege University, Izmir, Turkey
| | - M K Çalışkan
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
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40
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How standard deviation contributes to the validity of a LDF signal: a cohort study of 8 years of dental trauma. Lasers Med Sci 2019; 34:1905-1916. [PMID: 31093798 DOI: 10.1007/s10103-019-02791-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 04/16/2019] [Indexed: 10/26/2022]
Abstract
The aim of this cohort study was to document the potential of laser Doppler flowmetry (LDF) for diagnosing tooth vitality in traumatized teeth in a population of 88 referred patients with dental trauma over a period of 8 years (2011-2018). The main reason to refer was tooth discoloration (26%), and the main trauma cause was a traffic injury (35%). Taking into account that referral for LDF is best given within the week after trauma, 66% of referrals were overdue. In 73% of cases, root canal treatment could be avoided, and in 65%, the presence of a fixed orthodontic retainer showed beneficial for pulp recovery. Data of 394 teeth were collected and submitted to multilevel modelling statistics. As a general conclusion, both LDF perfusion and concentration values proved to be highly reliable in the appreciation of tooth vitality. The difference of variability of standard deviation and range of LDF measurements involving intra-subject control teeth showed statistically significant in discriminating between vital and non-vital pulps. In non-vital teeth, the diagnostic combination of LDF, sensibility tests and peri-apical X-ray is advised.
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Sarapultseva M, Sarapultsev A. Long-term results of crown fragment reattachment techniques for fractured anterior teeth: A retrospective case-control study. J ESTHET RESTOR DENT 2019; 31:290-294. [PMID: 30790430 DOI: 10.1111/jerd.12456] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 12/23/2018] [Accepted: 01/09/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Among the techniques used by pediatric dentists for the crown fracture is the fragment reattachment. The aim of this study was to evaluate the long-term survival of the tooth reattachment in comparison to the composite restoration technique. METHODS The study included 67 patients aged 7-9 years (males 38/56.7%; females 29/43.3%), with noncomplicated fractures of permanent teeth. The patients were divided into two groups; group A included 32 patients (males 18/56.2%; females 14/43.8%; total number of affected tooth 36), and group B comprised 35 patients (males 20/57.1%; females 15/42.9%; 36 affected tooth). In group A patients the reattachment was conducted after the trauma, and the direct composite restoration technique was used for patients in group B. All patients were evaluated for complications and pulp status for 5 years. RESULTS There were no significant differences (P > 0.05) in terms of the occurrence of complications observed between groups throughout the 5-year observation period. CONCLUSION Both methods provide similar results over the 60 months of observation. CLINICAL SIGNIFICANCE Reattachment technique has shown to be a reliable treatment option that might be considered as a primary technique when the fragment is saved after the trauma.
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Affiliation(s)
- Maria Sarapultseva
- Department of Pediatric Dentistry, Medical firm Vital EBB, Ekaterinburg, Russia
| | - Alexey Sarapultsev
- Institute of Immunology and Physiology (IIP) of the Ural Division of Russian Academy of Sciences, laboratory of immunopathophysiology, Ekaterinburg, Russia
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42
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Case Reports in Maxillary Posterior Teeth by Guided Endodontic Access. J Endod 2019; 45:214-218. [DOI: 10.1016/j.joen.2018.11.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 11/10/2018] [Accepted: 11/21/2018] [Indexed: 11/19/2022]
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Abstract
The aim of the study was to review literature data on incidence and outcomes of traumatic dental injuries (TDI) in pediatric population. A systematic search was conducted using Elibray, Pubmed/Medline, Scopus databases in October 2018. Reference lists were also hand-searched to identify additional literature. The most prevalent complication of TDI is pulp necrosis (PN) which triggers inflammatory root resorption (IRR). PN and IRR are however much more specific for mature permanent teeth. In immature teeth pulp revascularization may occur even after avulsion. Pulpectomy timing is well defined for mature teeth only. It is accepted that pulp extirpation should be performed in the first 10 days after trauma. In immature teeth no criteria exist with pulp electrosensitivity having very low negative prognostic value as drop of pulp sensitivity because of trauma not necessary indicate PN. Follow-up protocol for immature teeth with various TDI would be useful for proper timing of pulpectomy and prevention of IRR.
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Affiliation(s)
- M V Korolenkova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - M S Rakhmanova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Tziafas D, Kodonas K, Gogos C, Tziafa C, Papadimitriou S. EDTA conditioning of circumpulpal dentine induces dentinogenic events in pulpotomized miniature swine teeth. Int Endod J 2018; 52:656-664. [DOI: 10.1111/iej.13048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 11/21/2018] [Indexed: 11/28/2022]
Affiliation(s)
- D. Tziafas
- Hamdan Bin Mohammed College of Dental Medicine Mohammed Bin Rashid University of Medicine and Health Sciences Dubai United Arab Emirates
| | | | | | | | - S. Papadimitriou
- School of Veterinary Medicine Aristotle University of Thessaloniki Thessaloniki Greece
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Kahler B, Kahler SL, Lin LM. Revascularization-associated Intracanal Calcification: A Case Report with an 8-year Review. J Endod 2018; 44:1792-1795. [DOI: 10.1016/j.joen.2018.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/23/2018] [Accepted: 08/16/2018] [Indexed: 12/13/2022]
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Gibbon VE, Carlson KJ, Grimoud AM, Jashashvili T. Use of high resolution computed tomography to diagnose ante-mortem dental root fractures in archaeological samples. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2018; 22:143-148. [PMID: 30126700 DOI: 10.1016/j.ijpp.2017.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 10/11/2017] [Accepted: 10/11/2017] [Indexed: 06/08/2023]
Abstract
Dental root fractures are rarely documented in past human populations, but when they are observed, diagnosing ante-mortem events as causal factors can be difficult due to postmortem alteration. Can high resolution X-ray computed tomography (CT) improve our ability to diagnose if a dental fracture was caused ante- or post-mortem? To test this, a case study of two individuals with previously diagnosed dental root fractures were re-examined with high resolution CT to confirm or refute the original diagnoses. For individual 4170, use of high resolution CT supported the original diagnosis of an ante-mortem root fracture on the right mandibular central incisor that was made based on planar X-ray. With the new analyses, the root fracture was found to be associated with evidence of calcification, and with radicular and alveolar bone resorption, which are positive correlates of an ante-mortem origin. Resolving this level of detail of bone modification was not possible without using high resolution CT. For individual 4172, the use of high resolution CT enabled visualisation of fracturing and cracking throughout several molars and crowns of other teeth that were not evident in planar X-ray, suggesting that these fractures were likely produced by post-mortem taphonomic processes rather than ante-mortem events as originally diagnosed. In this case study, high resolution CT offered critical advantages compared to a planar X-ray approach, such as using 3D multiple slice views without superimposing alveolar bone and teeth as in planar X-ray imaging. This study demonstrates the potential of high resolution CT in confirming and refuting ante-mortem processes, and that visualisation of 3D structures is crucial for arriving at definitive diagnoses.
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Affiliation(s)
- Victoria E Gibbon
- Department of Human Biology, University of Cape Town, Observatory, Cape Town, South Africa.
| | - Kristian J Carlson
- Department of Integrative Anatomical Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Evolutionary Studies Institute, University of the Witwatersrand, 2050 Johannesburg, South Africa
| | - Anne-Marie Grimoud
- Université de Toulouse, 3 Chemin des Maraîchers, 31062 Toulouse Cedex 9, France
| | - Tea Jashashvili
- Evolutionary Studies Institute, University of the Witwatersrand, 2050 Johannesburg, South Africa; Molecular Imaging Center, Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Department of Geology and Palaeontology, Georgian National Museum, 0105 Tbilisi, Georgia
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Moccelini BS, de Alencar NA, Bolan M, Magno MB, Maia LC, Cardoso M. Pulp necrosis and crown discoloration: a systematic review and meta-analysis. Int J Paediatr Dent 2018; 28:432-442. [PMID: 29896799 DOI: 10.1111/ipd.12372] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The association between pulp necrosis and crown discoloration in traumatized primary teeth has not been clearly determined yet. AIM The study verified whether there is an association of pulp necrosis and crown discoloration in traumatized primary teeth through a systematic review and meta-analysis. METHODS A systematic literature search was conducted in PubMed/Medline, Lilacs/BBO, Scopus, Web of Science, Cochrane Library databases, and grey literature. A methodological quality assessment appraisal was independently conducted by two researchers. Random-effects models were employed, and heterogeneity was tested (I2 index/P ≤ 0.05). RESULTS Eight studies with low risk of bias were included in the analysis. A total of 1,494 traumatized primary teeth participated in the pooled meta-analysis. Diagnosis of pulp necrosis was evaluated in 1,414 teeth through clinical and/or radiographic analyses, and the analysis demonstrated a positive association (P = 0.0005/OR 8.37 [2.51, 27.90], I2 = 87%). Eighty teeth were diagnosed with pulp necrosis through endodontic access, and there was no statistically significant association (P = 0.36/OR 2.46 [0.36, 16.94], I2 = 54%). The pooled meta-analysis showed a positive association (P = 0.0003/OR 5.93 [2.24, 15.72], I2 = 83%). CONCLUSION The positive association between pulp necrosis and crown discoloration should be considered with caution once the diagnosis of pulp necrosis was performed by limited criteria.
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Affiliation(s)
- Bárbara Suelen Moccelini
- Department of Pediatric Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Nashalie Andrade de Alencar
- Department of Pediatric Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Michele Bolan
- Department of Pediatric Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mariane Cardoso
- Department of Pediatric Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Guided Endodontic Access in Maxillary Molars Using Cone-beam Computed Tomography and Computer-aided Design/Computer-aided Manufacturing System: A Case Report. J Endod 2018; 44:875-879. [DOI: 10.1016/j.joen.2018.02.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 01/26/2018] [Accepted: 02/06/2018] [Indexed: 11/23/2022]
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49
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Tzanetakis GN. Management of Intruded Immature Maxillary Central Incisor with Pulp Necrosis and Severe External Resorption by Regenerative Approach. J Endod 2018; 44:245-249. [DOI: 10.1016/j.joen.2017.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/08/2017] [Accepted: 11/09/2017] [Indexed: 12/14/2022]
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50
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Benoist FL, Seck A, Benoist HM. A 42-Month Follow-Up of Double Root Fracture of a Lateral Mandibular Incisor. Eur Endod J 2017; 2:1-5. [PMID: 33403345 PMCID: PMC7757962 DOI: 10.5152/eej.2017.17021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 06/21/2017] [Indexed: 01/01/2023] Open
Abstract
This case report describes the treatment of a double root fracture of a lateral mandibular incisor and its follow- up over 3.5 years. The reason for the consultation was a tooth mobility following a fall that had occurred 2 days earlier. A test of pulp vitality for tooth 42 was positive. Periodontal probing at the level of the gingival sulcus confirmed the intactness of the epithelial attachment. Retro-alveolar radiographic examination revealed a double root fracture of tooth 42. A semi-rigid extra-coronal splinting was performed and a light grinding of the incisal edge of tooth 42 was then carried out in light of the dislocation of the coronal fragment, and the occlusion was checked with a strip of articulating paper. The outcomes at 6 months revealed that pulp vitality was still preserved, consolidation of the apical fracture had occurred, and the coronal root fracture was starting to heal. The 1-year, 2-year and 3-year follow ups revealed preserved pulp vitality, an absence of a fracture line in apical images, and no root resorption. This case report provides evidence for the preservation of vitality in the setting of a double root fracture.
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Affiliation(s)
- Fatou Leye Benoist
- Department of Conservative Dentistry and Endodontics, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Anta Seck
- Department of Conservative Dentistry and Endodontics, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Henri Michel Benoist
- Department of Periodontics, University Cheikh Anta Diop of Dakar, Dakar, Senegal
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