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Mishra D, Arya A, Vamseekrishna KVN, Jahangeer B, Sachdeva M, Moses A. Evaluation and Comparative Analysis of Coronal Tooth Discoloration Induced by Four Endodontic Biomaterials Utilized in Regenerative Endodontic Procedures: An Ex-vivo Study. Cureus 2024; 16:e62874. [PMID: 39040777 PMCID: PMC11262750 DOI: 10.7759/cureus.62874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 06/14/2024] [Indexed: 07/24/2024] Open
Abstract
AIM This study aims to compare and evaluate the changes in color caused by four different biomaterials utilized as intracanal coronal barriers in the regenerative endodontic procedure at varying intervals of time. METHODS A total of 100 extracted mandibular single-rooted premolars were taken. Samples were standardized, and access cavity preparation was done. All the canals were instrumented and irrigated thoroughly. They were divided into five groups: A, B, C, D, and E (n=20), i.e., the control group, gray mineral trioxide aggregate (MTA), white MTA, Biodentine, and calcium hydroxide. Each group was further subdivided into two subgroups (n=10), where one subgroup was prepared with normal saline and the other was prepared with platelet-rich fibrin (PRF). Digital photographs were taken at baseline, immediately after the placement of biomaterials, after 72 hours, seven days, and six months, using a DSLR camera. The color evaluation was done using the Adobe Photoshop 2021 software using the CIE L*a*b color system. The data obtained were recorded and statistically analyzed using IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York). Continuous variables were analyzed using a one-way ANOVA test and post-hoc analysis. The P-value was set to be significant at <0.05. RESULTS Statistically significant variation was obtained in all four experimental groups regarding change in color (ΔE) over periods of 72 hours, seven days, and six months. At six months, all the experimental groups presented with a perceptible color variation (ΔE>3.3). CONCLUSION The color change was significant after six months in all groups. Biodentine produced the least color alteration, whereas gray MTA produced the highest.
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Affiliation(s)
- Divya Mishra
- Dentistry, Heritage Hospitals, Varanasi, IND
- Conservative Dentistry and Endodontics, Maharishi Markandeshwar College of Dental Sciences and Research, Mullana, IND
| | - Aishwarya Arya
- Conservative Dentistry and Endodontics, Awadh Dental College and Hospital, Jamshedpur, IND
| | | | - Bisma Jahangeer
- Conservative Dentistry and Endodontics, Private Practice, Kulgam, IND
| | - Mayank Sachdeva
- Conservative Dentistry and Endodontics, Ex-Servicemen Contributory Health Scheme (ECHS) Polyclinic, Kolkata, IND
| | - Aprajita Moses
- Conservative Dentistry and Endodontics, Awadh Dental College and Hospital, Jamshedpur, IND
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Kınay Taran P, Kara Ö. Prevention efficacy of dentin tubule sealing with Nd:YAG laser against tooth discoloration induced by vital pulp treatment. Int J Paediatr Dent 2024; 34:153-159. [PMID: 37649171 DOI: 10.1111/ipd.13117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/15/2023] [Accepted: 07/18/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND The discoloration potential of dental materials and applications such as vital pulp therapy also cause discoloration due to the presence of blood. Dentin tubule sealing methods could be used for the prevention of discoloration. AIM The purpose of this study was to evaluate the effect of sealing pulp chamber walls with Nd:YAG laser against discoloration caused by tricalcium silicate-based materials in the presence and absence of blood contamination. DESIGN Eighty-one extracted human maxillary incisors were prepared and randomly divided into nine groups according to the Nd:YAG laser application, the cement to be used (NeoMTA Plus/Biodentine), and the presence or absence of blood. The color measurements were obtained with a spectrophotometer at baseline and then at the sixth (T1) and 12th (T2) months thereafter. RESULTS Sealing with Nd:YAG laser and placing NeoMTA Plus or Biodentine on human blood significantly increased discoloration at T1 and T2 (p < .05). Similarly, without sealing the cavity and placing NeoMTA Plus or Biodentine on human blood significantly increased discoloration at T1 and T2 (p < .05). CONCLUSION Regardless of sealing the dentin tubules with Nd:YAG laser, NeoMTA Plus and Biodentine caused more discoloration in the presence of blood contamination.
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Affiliation(s)
- Pınar Kınay Taran
- School of Dentistry, Department of Paediatric Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Özlem Kara
- School of Dentistry, Department of Prosthodontics, Bezmialem Vakif University, Istanbul, Turkey
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Park SH, Ye JR, Asiri NM, Chae YK, Choi SC, Nam OH. Biocompatibility and Bioactivity of a Dual-Cured Resin-Based Calcium Silicate Cement: In Vitro and in vivo Evaluation. J Endod 2024; 50:235-242. [PMID: 37995904 DOI: 10.1016/j.joen.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 11/02/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023]
Abstract
INTRODUCTION This study aimed to assess the biocompatibility and bioactivity of a dual-cured resin-based calcium silicate cement in vitro and in vivo. METHODS For in vitro analyses, standardized samples were prepared using TheraCal LC, TheraCal PT, and ProRoot MTA. The amount of residual monomer released from TheraCal LC and TheraCal PT was assessed using liquid chromatography/mass spectrometry. Calcium ion release from the materials was evaluated using inductively coupled plasma-optical emission spectroscopy. Scanning electron microscopy and energy-dispersive X-ray spectroscopy were used to determine the calcium weight volume in the materials. For in vivo analysis, a rat direct pulp capping model with TheraCal LC, TheraCal PT, and ProRoot MTA groups (n = 16 per group) was used. The rats were euthanized after 7 or 28 days, and histological and immunohistochemical analyses (CD68 and DSPP) were performed. RESULTS Bisphenol A-glycidyl methacrylate and polyethylene glycol dimethacrylate release from TheraCal PT was lower than that from TheraCal LC (P < .05). Similar results were obtained for calcium-ion release and calcium weight volume, with ProRoot MTA showing the highest values. In the in vivo evaluation, TheraCal PT showed significantly greater hard tissue formation than TheraCal LC (P < .017). TheraCal PT showed lower CD68 expression and greater DSPP expression than TheraCal LC (P < .017). There were no significant differences in the expression of CD68 or DSPP between the TheraCal PT and ProRoot MTA groups. CONCLUSIONS Within the limitations of this study, the biocompatibility and bioactivity of TheraCal PT could be comparable to those of ProRoot MTA.
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Affiliation(s)
- Seung Hwan Park
- Department of Pediatric Dentistry, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center, Seoul, Korea
| | - Ju Ri Ye
- Department of Pediatric Dentistry, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center, Seoul, Korea
| | - Naif Mohammed Asiri
- Department of Pediatric Dentistry, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center, Seoul, Korea
| | - Yong Kwon Chae
- Department of Pediatric Dentistry, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center, Seoul, Korea
| | - Sung Chul Choi
- Department of Pediatric Dentistry, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center, Seoul, Korea; Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Ok Hyung Nam
- Department of Pediatric Dentistry, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center, Seoul, Korea; Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul, Korea.
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Ateş MO, Uğur Aydın Z. Evaluation of the effectiveness of different treatment approaches in preventing coronal discoloration caused by regenerative endodontic treatment. Clin Oral Investig 2023; 27:4595-4603. [PMID: 37243821 DOI: 10.1007/s00784-023-05085-0] [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: 01/18/2023] [Accepted: 05/21/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVES This study aimed to evaluate the effectiveness of Teethmate desensitizer, a dentin bonding agent (DBA), Nd:YAG laser, and Er:YAG laser, which provides dentin tubule occlusion in the pulp chamber with different mechanisms, in preventing tooth discoloration due to regenerative endodontic treatment. MATERIALS AND METHODS One hundred five extracted maxillary human incisors with single roots and single canals were included in the study. The apical third of each tooth was resected below the enamel-cementum junction (CEJ) to obtain a standard root length as 10 ± 1 mm. Root canal preparation was performed using the ProTaper Next files up to X5. Root canals were prepared with Gates Glidden (# 2-4) burs to simulate the immature root apex and an apical diameter of 1.1 ± 0.1 mm was obtained. The teeth were randomly divided into 7 groups (n = 15): DBA, Teethmate, Nd:YAG, Er:YAG, Biodentine, Blood, and Negative Control. Relevant dentin tubule occlusion methods were applied to DBA, Teethmate, Nd:YAG, and Er:YAG groups. Following dentin tubule occlusion procedures, Biodentine was placed on the blood clot after filling the root canals with blood up to 4 mm below the CEJ. No dentin tubule occlusion procedure was applied for Blood and Biodentine groups. Color measurement was performed with the spectrophotometer Vita Easyshade Advance before treatment, immediately after treatment, and at days 7, 30, and 90. Data were converted to L*a*b color values of Commission International de I'Eclairage (CIE L*a*b) and ΔE values were calculated. Two-way ANOVA and post hoc Tukey test (p = 0.05) were performed for statistical analysis. RESULTS A clinically detectable color change was observed in all groups except for the negative control (ΔE ≥ 3,3). It was observed that Biodentine used alone has a potential for discoloration. It was determined that as the contact time with blood increased, tooth discoloration increased. However, no significant difference was found between dentin tubule occlusion methods in preventing color change (p > 0.05). CONCLUSIONS It was determined that no dentin tubule occlusion method could 100% prevent discoloration caused by RET. CLINICAL RELEVANCE DBA and Teethmate, which do not have a significant difference in terms of preventing color change, are considered to be suitable for dentin tubule occlusion due to their ease of application and low cost compared to Nd:YAG laser and Er:YAG laser.
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Affiliation(s)
- Melis Oya Ateş
- Department of Endodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey.
| | - Zeliha Uğur Aydın
- Department of Endodontics, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
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Carvalho JA, Franco C, Proença L, Neves JA, Polido M, Mendes JJ, Azul AM. Spectrophotometric Analysis of Coronal Discoloration In Vitro Induced by Bioceramic Cements. Dent J (Basel) 2023; 11:180. [PMID: 37504246 PMCID: PMC10377855 DOI: 10.3390/dj11070180] [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: 05/07/2023] [Revised: 07/09/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023] Open
Abstract
The aim of this study was to evaluate and quantify, in vitro, the extent of coronal discoloration induced by bioceramic materials over time. In total, 44 human monoradicular teeth were divided into four groups (n = 11), according to the applied material: Negative control (NC); White MTA ProRoot® (WMTAP); Biodentine™ (BD); and TotalFill® BC RRM™ Putty (TF). Teeth were immersed in saline solution and incubated at 37 °C; the following periods of time were defined: before incubation: [t0]-without bioceramic material, t1-immediately after the bioceramic material placement; after incubation: t24h-24 h, t7d-7 days, and 30d-30 days. Descriptive and inferential statistical analysis were performed. Cochran's Q test was used to evaluate coronal discoloration across the different groups, while the Kruskal-Wallis test was employed to determine differences in discoloration among the groups at each time interval. Additionally, the Friedman test was applied to analyze the variations in discoloration within each group over time. A significance level of 5% was set. All experimental groups revealed coronal discoloration over time: NC (p = 0.001), WMTAP (p < 0.001), BD (p = 0.001), and TF (p = 0.006). No significant differences were observed between groups for each time interval (p > 0.05). The WMTAP group varied the most considering the intervals [t0-t1] and [t24h-t7d] (p = 0.037) compared to the remaining experimental groups.
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Affiliation(s)
- Joana A Carvalho
- Egas Moniz School of Health and Science, Monte de Caparica, 2829-511 Almada, Portugal
| | - Carlos Franco
- Egas Moniz School of Health and Science, Monte de Caparica, 2829-511 Almada, Portugal
- Egas Moniz Center for Interdisciplinary Center (CiiEM), Monte de Caparica, 2829-511 Almada, Portugal
| | - Luís Proença
- Egas Moniz School of Health and Science, Monte de Caparica, 2829-511 Almada, Portugal
- Egas Moniz Center for Interdisciplinary Center (CiiEM), Monte de Caparica, 2829-511 Almada, Portugal
| | - João Albernaz Neves
- Egas Moniz School of Health and Science, Monte de Caparica, 2829-511 Almada, Portugal
- Egas Moniz Center for Interdisciplinary Center (CiiEM), Monte de Caparica, 2829-511 Almada, Portugal
| | - Mário Polido
- Egas Moniz School of Health and Science, Monte de Caparica, 2829-511 Almada, Portugal
- Egas Moniz Center for Interdisciplinary Center (CiiEM), Monte de Caparica, 2829-511 Almada, Portugal
| | - José João Mendes
- Egas Moniz School of Health and Science, Monte de Caparica, 2829-511 Almada, Portugal
- Egas Moniz Center for Interdisciplinary Center (CiiEM), Monte de Caparica, 2829-511 Almada, Portugal
| | - Ana Mano Azul
- Egas Moniz School of Health and Science, Monte de Caparica, 2829-511 Almada, Portugal
- Egas Moniz Center for Interdisciplinary Center (CiiEM), Monte de Caparica, 2829-511 Almada, Portugal
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Tawfeek HA, El-Bardissy AAA, Abou El-Yazeed M, Youssef R, Abd Alsamad AM. Clinical and radiographic evaluation of NeoMTA versus conventional white mineral trioxide aggregate in revascularization of non-vital immature permanent anterior teeth (A randomized controlled trial). BDJ Open 2023; 9:17. [PMID: 37117192 PMCID: PMC10144882 DOI: 10.1038/s41405-023-00143-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/07/2023] [Accepted: 03/23/2023] [Indexed: 04/30/2023] Open
Abstract
OBJECTIVE To evaluate and compare clinically and radiographically the effect of using two different coronal plug materials (NeoMTA versus Conventional White mineral trioxide aggregate) in revascularization of non-vital immature permanent anterior teeth, with special reference to the assessment and evaluation of discoloration potential over a period of one year. METHODS Revascularization procedure was performed in (30) immature permanent non-vital anterior teeth which were randomly allocated to two equal groups (n = 15). NeoMTA was used as coronal plug material in the Experimental Group (N), while conventional White mineral trioxide aggregate (WMTA) was used as a coronal plug material in the Control Group (W). All treated teeth were evaluated clinically at 1 week, 1, 3, and 12 months and radiographically at 12 months. RESULTS The overall clinical and radiographic success rate of Groups (N) and (W) at the end of the 12-month follow-up period was 100%. The discoloration was detected in a single tooth (9.1%) in Group (N) and three teeth (27.3%) in Group (W) but the difference between groups was not statistically significant. CONCLUSIONS Both NeoMTA and conventional WMTA were successful coronal plug materials in the revascularization of non-vital immature permanent teeth achieving a high level of clinical and radiographic success. NeoMTA is a promising coronal plug material that can be used for revascularization procedures in the esthetic zone as it showed less discoloration potential compared with conventional WMTA, however, there was no statistically significant difference between both materials.
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Affiliation(s)
- Hala Ahmed Tawfeek
- Pediatric Dentistry, Orthodontics and Pediatric Dentistry Department, Oral and Dental Research Institute, National Research Centre, Giza, Egypt and Phd student in Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Giza, Egypt.
| | | | - Mohammed Abou El-Yazeed
- Pediatric Dentistry, Orthodontics and Pediatric Dentistry Department, Oral and Dental Research Institute, National Research Centre, Giza, Egypt
| | - Randa Youssef
- Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Giza, Egypt
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Lin HN, Wang LC, Chen MS, Chang PJ, Lin PY, Fang A, Chen CY, Lee PY, Lin CK. Discoloration Improvement by Mechanically-Milled Binary Oxides as Radiopacifier for Mineral Trioxide Aggregates. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7934. [PMID: 36431419 PMCID: PMC9695230 DOI: 10.3390/ma15227934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/02/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Mineral trioxide aggregates (MTA) have been widely used in endodontic treatments, but after some time, patients suffer tooth discoloration due to the use of bismuth oxide (Bi2O3) as a radiopacifier. Replacement of Bi2O3 with high energy ball-milled single (zirconia ZrO2; hafnia, HfO2; or tantalum pentoxide, Ta2O5) or binary oxide powder was attempted, and corresponding discoloration improvement was investigated in the present study. Bi2O3-free MTA is expected to exhibit superior discoloration. The radiopacity, diametral tensile strength, and discoloration of MTA-like cements prepared from the as-milled powder were investigated. Experimental results showed that MTA-like cements prepared using Ta2O5 exhibited a slightly higher radiopacity than that of HfO2 but had a much higher radiopacity than ZrO2. Milling treatment (30 min to 3 h) did not affect the radiopacities significantly. These MTA-like cements exhibited superior color stability (all measured ΔE00 < 1.0) without any perceptible differences after UV irradiation. MTA-like cements prepared using ZrO2 exhibited the best color stability but the lowest radiopacity, which can be improved by introducing binary oxide. Among the investigated samples, MTA-like cement using (ZrO2)50(Ta2O5)50 exhibited excellent color stability and the best overall performance with a radiopacity of 3.25 mmAl and a diametral tensile strength of 4.39 MPa.
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Affiliation(s)
- Hsiu-Na Lin
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei 105, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Ling-Chi Wang
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Center of Dental Technology, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - May-Show Chen
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Division of Prosthodontics, Department of Dentistry, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Pei-Jung Chang
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Graduate Institute of Manufacturing Technology, National Taipei University of Technology, Taipei 106, Taiwan
| | - Pin-Yu Lin
- Department of Optoelectronics and Materials Technology, National Taiwan Ocean University, Keelung 202, Taiwan
| | - Alex Fang
- Department of Engineering Technology and Industrial Distribution, Texas A & M University, College Station, TX 77843, USA
| | - Chin-Yi Chen
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Materials Science and Engineering, Feng Chia University, Taichung 407, Taiwan
| | - Pee-Yew Lee
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Optoelectronics and Materials Technology, National Taiwan Ocean University, Keelung 202, Taiwan
| | - Chung-Kwei Lin
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
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Comparative chemical properties, bioactivity, and cytotoxicity of resin-modified calcium silicate-based pulp capping materials on human dental pulp stem cells. Clin Oral Investig 2022; 26:6839-6853. [PMID: 36104606 DOI: 10.1007/s00784-022-04713-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 09/07/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES This study investigated the cytotoxicity, the residual monomer release, degree of conversion (DC), calcium ion (Ca2+) release, and crystal structure of TheraCal PT (ThPT) by comparison with TheraCal LC (ThLC) and mineral trioxide aggregate (MTA). MATERIALS AND METHODS The cytotoxicity of the cured materials was evaluated on human dental pulp stem cells (hDPSCs) isolated from third molars by the water-soluble tetrazolium salt (WST-1) method. The monomer release and DC of the resin-containing materials were analyzed by high-performance liquid chromatography (HPLC) and Fourier transform infrared (FTIR), respectively. The chemical composition and Ca2+ release of the materials were determined by scanning electronic microscopy-energy-dispersive spectroscopy (SEM-EDS), X-ray diffractometry (XRD), and inductively coupled plasma-optical emission spectroscopy (ICP-OES), respectively. Statistical differences were evaluated with one-way ANOVA, repeated measure ANOVA, and the Tukey test (p < 0.05). RESULTS MTA showed significantly lower cytotoxicity than either ThLC or ThPT after 1, 3, and 7 days (p < 0.05). TEGDMA release of ThPT is significantly higher than ThLC (p < 0.05). All materials showed calcium Ca2+ release, with MTA significantly higher than the others (p < 0.05). CONCLUSIONS MTA showed low cytotoxicity and high Ca2+ release compared to ThLC and ThPT. CLINICAL RELEVANCE The cytotoxicity and residual monomer release of ThLC and ThPT may raise concerns about the viability of hDPSCs. Further investigations with the use of in vivo research models are required to validate in vitro bioactivity properties and the potential adverse biological effects of ThLC and ThPT on hDPSCs.
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Camilleri J, Atmeh A, Li X, Meschi N. Present status and future directions: Hydraulic materials for endodontic use. Int Endod J 2022; 55 Suppl 3:710-777. [PMID: 35167119 PMCID: PMC9314068 DOI: 10.1111/iej.13709] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hydraulic materials are used in Endodontics due to their hydration characteristics namely the formation of calcium hydroxide when mixing with water and also because of their hydraulic properties. These materials are presented in various consistencies and delivery methods. They are composed primarily of tricalcium and dicalcium silicate, and also include a radiopacifier, additives and an aqueous or a non-aqueous vehicle. Only materials whose primary reaction is with water can be classified as hydraulic. OBJECTIVES Review of the classification of hydraulic materials by Camilleri and the literature pertaining to specific uses of hydraulic cements in endodontics namely intra-coronal, intra-radicular and extra-radicular. Review of the literature on the material properties linked to specific uses providing the current status of these materials after which future trends and gaps in knowledge could be identified. METHODS The literature was reviewed using PUBMED, and for each clinical use, the in vitro properties such as physical, chemical, biological and antimicrobial characteristics and clinical data were extracted and evaluated. RESULTS A large number of publications were retrieved for each clinical use and these were grouped depending on the property type being investigated. CONCLUSIONS The hydraulic cements have made a difference in clinical outcomes. The main shortcoming is the poor testing methodologies employed which provide very limited information and also inhibits adequate clinical translation. Furthermore, the clinical protocols need to be updated to enable the materials to be employed effectively.
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Affiliation(s)
- Josette Camilleri
- School of DentistryCollege of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Amre Atmeh
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM)Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU)DubaiUnited Arab Emirates
| | - Xin Li
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
| | - Nastaran Meschi
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
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Slaboseviciute M, Vasiliauskaite N, Drukteinis S, Martens L, Rajasekharan S. Discoloration Potential of Biodentine: A Systematic Review. MATERIALS 2021; 14:ma14226861. [PMID: 34832263 PMCID: PMC8619462 DOI: 10.3390/ma14226861] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 12/11/2022]
Abstract
The aim of this systematic review is to investigate the teeth discoloration potential of Biodentine. An electronic search in six databases (PubMed, Cochrane Library, LILACS, SCIELO, Web of Science, and Scopus) was conducted by three independent reviewers to identify eligible articles. The following search terms were used: ((discolo*, staining potential, color, colour, or spectrophotomet*), (teeth or tooth), and (Biodentine)). Methodology following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines was adopted for this investigation. At the end of the selection process, 30 articles were identified as eligible, of which 14 in vitro studies were included in this systematic review. Nine of the included studies evaluated the discoloration potential of Biodentine in the presence of blood. Within the limitations of this review, teeth discoloration using Biodentine is highly expected when material is placed in direct contact with blood during dental procedures. In the absence of blood, Biodentine causes less teeth color changes than MTA-based materials, but it is still unclear what clinically relevant results could be expected regarding the discoloration frequency and intensity induced by Biodentine.
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Affiliation(s)
- Monika Slaboseviciute
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, 08217 Vilnius, Lithuania; (M.S.); (N.V.)
| | - Neringa Vasiliauskaite
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, 08217 Vilnius, Lithuania; (M.S.); (N.V.)
| | - Saulius Drukteinis
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, 08217 Vilnius, Lithuania; (M.S.); (N.V.)
- Correspondence: ; Tel.: +370-610-41808
| | - Luc Martens
- Department of Paediatric Dentistry, Ghent University School of Oral Health Sciences, B-9000 Ghent, Belgium; (L.M.); (S.R.)
| | - Sivaprakash Rajasekharan
- Department of Paediatric Dentistry, Ghent University School of Oral Health Sciences, B-9000 Ghent, Belgium; (L.M.); (S.R.)
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Careddu R, Duncan HF. A prospective clinical study investigating the effectiveness of partial pulpotomy after relating preoperative symptoms to a new and established classification of pulpitis. Int Endod J 2021; 54:2156-2172. [PMID: 34490637 DOI: 10.1111/iej.13629] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 01/16/2023]
Abstract
AIM To prospectively investigate the outcome of partial pulpotomy after 1 year, using a hydraulic calcium silicate cement (HCSC) on symptomatic cariously exposed pulps in adult teeth. To compare the traditional American Association of Endodontists (AAE) pulpitis classification with the recently proposed Wolters classification system in predicting the likelihood of treatment failure. METHODOLOGY Sixty-two symptomatic adult teeth with deep and extremely deep carious lesions were classified according to the Wolters (mild/moderate/severe pulpitis) and the traditional pulpitis classification (reversible/irreversible pulpitis). Eleven teeth were excluded intraoperatively as there was no pulp exposure after non-selective caries removal. The remaining 51 teeth, regardless of diagnosis, were treated by partial pulpotomy, pulpal lavage with 2.5% sodium hypochlorite solution, haemostasis and HCSC application (Biodentine™) as a pulp capping material. A permanent restoration was placed during a second appointment 1-2 weeks later. Preoperative tenderness to percussion (TTP), bleeding time and material setting time were recorded as was preoperative and postoperative tooth colour under standardized conditions. Clinical review occurred at regular intervals with clinical/radiographic analysis at 12 months. Chi-square analysis and Fisher's exact test assessed different outcomes amongst the diagnostic categories; the Kruskal-Wallis and Wilcoxon rank-sum test assessed influence of pulp bleeding time, TTP or variation in setting time (p < .05). RESULTS Ten cases were lost to review, and a total of 41 teeth were reviewed at 1 year and classified as either "success," "successful but unresponsive to sensibility testing" or "failed." This included five severe, 17 moderate and 19 mild pulpitis according to Wolters classification or 23 reversible pulpitis and 18 irreversible pulpitis cases by the AAE classification. The majority of the 62 enrolled cases were "extremely deep" (n = 50), rather than "deep" (n = 12) caries with all failures occurring in the extremely deep group. Partial pulpotomy was 90% successful (100% reversible, 78% irreversible or 100% mild, 88% moderate, 60% severe pulpitis) with a significant difference in outcome between mild and severe pulpitis groups (p = .04). Only one, severe pulpitis/irreversible pulpitis, case failed painfully prior to the 1-year review appointment. Bleeding time (p = .26) and TTP (p = .61) did not influence treatment outcome, whilst Biodentine™ setting time was significantly longer than manufacturers' claim (p < .05). No teeth discoloured. CONCLUSIONS Partial pulpotomy using Biodentine™ was successful for treating symptomatic carious pulpal exposures after 1 year, but included cases where pulp vitality could not be confirmed. Within the limitations of this study, cases with signs and symptoms indicative of irreversible pulpitis were not less successful; however, Wolters classification highlighted severe pulpitis to be less successful than mild pulpitis, thereby providing a potential prognostic benefit in diagnostically subdividing pulpitis. Caries depth was an indicator of failure, whilst bleeding time and preoperative tenderness to percussion were not.
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Affiliation(s)
- Roberto Careddu
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Henry F Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Dublin, Ireland
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12
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Oliveira LV, de Souza GL, da Silva GR, Magalhães TEA, Freitas GAN, Turrioni AP, de Rezende Barbosa GL, Moura CCG. Biological parameters, discolouration and radiopacity of calcium silicate-based materials in a simulated model of partial pulpotomy. Int Endod J 2021; 54:2133-2144. [PMID: 34418112 DOI: 10.1111/iej.13616] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/19/2021] [Indexed: 12/15/2022]
Abstract
AIM To analyse the discolouration, radiopacity, pH and calcium ion release of Biodentine (BD), Bio-C repair (BCR) and Bio-C temp (BCT), as well as their biological effects on human dental pulp cells (hDPCs). METHODOLOGY Sixty-four extracted bovine incisors were prepared to simulate crown fractures with pulp exposure and open root apex. The roots were filled using a mixture of agar and blood (control), and BD, BCR or BCT were placed over this mixture. Colour assessment analyses of the samples were performed before and immediately after material insertion and repeated at 30 and 90 days, using a spectrophotometer. The colour change of each specimen was evaluated at the crown and calculated based on the CIELab colour space. Digital radiographs were acquired for radiopacity analysis. hDPCs were placed in contact with different dilutions of culture media previously exposed to such materials and tested for cell viability using the MTT assay. The pH and calcium ion release of all materials were measured after 24 h; the data were assessed using one-way analysis of variance (ANOVA). Cell viability was analysed by two-way ANOVA. Differences in colour parameters and wound-healing data were assessed by two-way repeated measures ANOVA (α = 0.05). Tukey's and Dunnett's tests were used to compare the experimental groups with the control group. RESULTS BCR had grater radiopacity and smaller colour alteration (ΔEab/ΔE00) than the other materials tested (p < .005; p < .001). No significant differences in pH were found amongst the tested materials (p > .05). BCT was associated with the largest release of calcium ions (p < .0001). BD had cell viability similar to that of the control at the lowest dilutions, and BCR was similar to that of the control, regardless of the dilution tested (p > .05). BCT had a lower percentage of viability than that of the control at all tested dilutions (p < .0001). Cell migration rates in BD and BCR were similar to those in the control group after 24 h and 48 h (p > .05), whilst BCT had larger voids than the control in both periods (p < .0001). CONCLUSIONS BCR, BCT and BD were associated with tooth discolouration. BCR had the lowest staining values, the highest radiopacity and viability greater than 80% hDPCs.
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Affiliation(s)
- Lilian Vieira Oliveira
- Department of Endodontics, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
| | - Gabriela Leite de Souza
- Department of Endodontics, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
| | - Gisele Rodrigues da Silva
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
| | | | | | - Ana Paula Turrioni
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
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13
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Spectrophotometric Analysis of Coronal Discolouration Induced by ProRoot MTA, Biodentine and MTA Repair HP Used for Pulpotomy Procedures. Eur Endod J 2021; 6:189-196. [PMID: 34650014 PMCID: PMC8461484 DOI: 10.14744/eej.2021.66375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To assess and quantify coronal tooth discolouration by ProRoot MTA, Biodentine and MTA repair HP as pulpotomy agents and to identify colour stability of these materials in presence of blood contamination. METHODS 120 human premolar teeth were used in the study. The teeth were sectioned horizontally 1 mm apical to the cementoenamel junction. A retrograde cavity extending within 2 mm of the incisal edge was prepared. The specimens were randomly distributed as; Control: Group 1, ProRoot MTA: Group 2, Biodentine: Group 3 and MTA repair HP: Group 4. The groups werefurther subdivided on basis of exposure to saline (subgroup A) or blood (subgroup B). The access was sealed with light cured Glass ionomer cemet and the specimens were stored in artificial saliva at 37°C. The Colour change was evaluated with a spectrophotometer at: day 0 (T0), day 1 (T1), day 7 (T7), 1 month (T30), 2 months (T60), and 6 months (T180). The colour measurements were recorded using the Commission Internationale de l'Eclairage L*a*b* value. RESULTS For all groups, there was a sharp increase in L* parameter at T1. At 6 months, Group 1B (Control + blood) showed maximum decrease in luminosity followed by Group 2A (ProRoot + saline) > Group 4B (MTA repair HP + blood) > Group 2B (ProRoot + blood). Group 3A (Biodentine + saline) showed the least amount of decrease in luminosity followed by Group 4A (MTA repair HP + saline) and Group 3B (Biodentine + blood). No significant difference was found in ∆E change between any of the groups from baseline to 180 days (P>0.05). CONCLUSION Relative to L* parameter, it was possible to observe a statistically significant decrease in luminosity in the Group1B (Control + blood) followed by ProRoot MTA (Group 2A and 2B) and MTA repair HP (Group 4A and 4B). Biodentine (Group 3A and 3B) showed least tooth discolouration in terms of L* parameter.
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14
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Influence of selective immunosuppressive drug regimens on the healing of exposed dogs' dental pulp capped with a recent calcium silicate-based cement. Clin Oral Investig 2021; 26:1417-1425. [PMID: 34370099 DOI: 10.1007/s00784-021-04116-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/30/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES In the clinical medicine, immunosuppressive drugs are used for an assortment of disorders, while their effect on the pulp healing is a controversial issue. This study evaluated the effect of different immunosuppressive drugs on the healing capacity of mechanically exposed dogs' dental pulps after direct pulp capping (DPC) with calcium silicate-based cement. MATERIALS AND METHODS Twelve healthy male dogs were randomly allocated into four equal groups, 3 dogs each: group I allocated as a control group where no drugs were received; group П given prednisone (Pred); group III given a combination of Pred and cyclosporine A (CsA); and group IV given triple dose including Pred, CsA, and mycophenolate mofetil (MMF) for 45 days before the operative procedures and until the dogs were euthanized. In each dog, 16 class V cavities were prepared on the labial surfaces of anterior teeth. Following mechanical exposure, the pulps were capped with Biodentine, calcium silicate-based cement. The pulpal tissues response to Biodentine was assessed 65 days postoperatively. RESULTS The pulp healing response was inferior in the Pred-CsA- and Pred-CsA-MMF-treated groups compared with the control and Pred-treated groups (P < 0.05). Non-significant difference was found between control and Pred-treated groups (P > 0.05). CONCLUSIONS Within the limitation of this study, DPC with calcium silicate-based cement performed under strict aseptic condition for traumatically exposed dental pulp can be considered as a successful treatment option for those who receiving Pred immunosuppressive therapy. Meanwhile, DPC with those receiving a combination of Pred, CsA, and/or MMF immunosuppressive drug regimens demonstrated unfavorable results. CLINICAL RELEVANCE Direct capping of mechanically exposed pulps with calcium silicate-based cement performed with special care for preventing infection considered a suitable strategic measure for preserving pulp vitality in patients receiving corticosteroid immunosuppressive drug.
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15
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Yeh CL, Bhorade R, Hsu TT, Chen CY, Lin CP. Mechanical assessment and odontogenic behavior of a 3D-printed mesoporous calcium silicate/calcium sulfate/poly-ε-caprolactone composite scaffold. J Formos Med Assoc 2021; 121:510-518. [PMID: 34266707 DOI: 10.1016/j.jfma.2021.06.025] [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: 06/08/2021] [Revised: 06/18/2021] [Accepted: 06/24/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND/PURPOSE Tissue engineering in dentistry has fundamentally changed the way endodontists assess treatment options. Our previous study found that quercetin-contained mesoporous calcium silicate/calcium sulfate (MSCSQ) could induce hard tissue defect region regeneration. This study focused on whether the MSCSQ scaffold could also be effective in regulating odontogenesis and dentin regeneration. METHODS In this study, we fabricated MSCSQ composite scaffolds using the 3D printing technique. The characteristics of the MSCSQ scaffold were examined by scanning electron microscope (SEM), and mechanical properties were also assessed. In addition, we evaluated the cell viability, cell proliferation, odontogenic-related protein expression, and mineralization behavior of human dental pulp stem cells (hDPSCs) cultured on different scaffolds. RESULTS We found the precipitation of spherical-apatite on the scaffold surface rapidly in short periods. The in-vitro results for cell behavior revealed that hDPSCs with an MSCSQ scaffold were significantly higher in cell viability as followed time points. In addition, the specific makers of odontogenesis, such as DSPP and DMP-1 proteins, were induced obviously after culturing the hDPSCs on the MSCSQ scaffold. CONCLUSION Our results demonstrated that MSCSQ scaffolds could enhance physicochemical and biological behaviors compared to mesoporous calcium silicate/calcium sulfate (MSCS) scaffolds. In addition, MSCSQ scaffolds also enhanced odontogenic and immuno-suppressive properties compared to MSCS scaffolds. These results indicated that MSCSQ scaffolds could be considered a potential bioscaffold for clinical applications and dentin regeneration.
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Affiliation(s)
- Chun-Liang Yeh
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Rupali Bhorade
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Tuan-Ti Hsu
- X-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Yu Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Chun-Pin Lin
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
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16
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de Jesus LS, Volpato CAM, Bortoluzzi EA, da Silveira Teixeira C, Rossetto HL, de Carvalho Panzeri Pires-de-Souza F, da Fonseca Roberti Garcia L. Tooth discoloration induced by the different phases of a calcium aluminate cement: One-year assessment. J ESTHET RESTOR DENT 2021; 33:999-1009. [PMID: 33929073 DOI: 10.1111/jerd.12739] [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: 01/19/2021] [Revised: 03/16/2021] [Accepted: 04/19/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess the discoloration of teeth treated with the different phases of calcium aluminate cement (CAC), in comparison with the conventional CAC and mineral trioxide aggregate (MTA). MATERIALS AND METHODS Fifty bovine incisors were prepared and filled. Two millimeters of the filling was removed to fabricate a cervical plug with the following cements (n=10): CA(CaO.Al2 O3 ); CA2 (CaO.2Al2 O3 ); C12 A7 (12CaO.7Al2 O3 ); CAC and MTA. The initial color measurement was performed and after 7, 15, 30, 45, 90, 180, and 365 days new color measurements were performed to determine the color (ΔE00 ), lightness (ΔL'), chroma (ΔC'), hue differences (ΔH'), and the whiteness index (WID ). RESULTS ΔE00 was significant for groups (p = 0.036) and periods (p < 0.05). The greater ΔE00 was observed after 365 days for CAC (12.8). C12 A7 (7.2) had the smallest ΔE00 . ΔL' and ΔC' were significant for groups and periods (p < 0.05). ΔH' was significant for periods (p < 0.05). After 365 days, significant reduction in lightness was observed for all groups. For CA, CA2 , CAC, and MTA groups, the WID values decreased over time (p < 0.05). CONCLUSIONS The tested cements changed the color behavior of the samples, resulting in greater teeth darkening over time. CLINICAL SIGNIFICANCE There is no long-term study assessing the discoloration induced by the different phases of CAC.
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Affiliation(s)
- Lucas Santos de Jesus
- Department of Dentistry, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Eduardo Antunes Bortoluzzi
- Department of Dentistry, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
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Elnaghy AM, Mandorah A, Hassan AH, Elshazli A, Elsaka S. Effect of surface treatments on push-out bond strength of calcium silicate-based cements to fiber posts. BMC Oral Health 2021; 21:131. [PMID: 33740953 PMCID: PMC7977572 DOI: 10.1186/s12903-021-01518-y] [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] [Received: 12/07/2020] [Accepted: 03/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the effect of surface treatments on the push-out bond strength of Biodentine (BD) and white mineral trioxide aggregate (WMTA) to fiber posts. METHODS Two brands of fiber posts were used: Reblida post; RP and RelyX post; RX. Each type of post (n = 80/group) was divided into four groups (n = 20/group) and exposed to surface treatment as follows: Control (no treatment), sandblasting (SB), hydrofluoric acid (HF), and TiF4 4 wt/v%. Each group was further subdivided into two subgroups (n = 10/subgroup) based on the type of CSCs used as follows: Subgroup A: BD and Subgroup B: WMTA. Push-out bond strength of BD and WMTA to glass fiber posts was assessed. Data were statistically analyzed using three-way ANOVA and Tukey's test. A Weibull analysis was performed on the push-out bond strength data. RESULTS BD showed higher bond strength than WMTA (P < 0.001). The push-out bond strength for posts treated with TiF4 4 wt/v% showed greater bond strength than the other surface treatments (P < 0.05). The BD/RP-TiF4 4 wt/v% showed the greater characteristic bond strength (σ0) (15.93) compared with the other groups. Surface treatments modified the surface topography of glass fiber posts. CONCLUSIONS The BD/RP-TiF4 4 wt/v% showed greater bond strength compared with the other groups. The TiF4 4 wt/v% surface treatment enhanced the bond strength of BD and WMTA to glass fiber posts than the other treatments. Surface treatment of fiber post with TiF4 4 wt/v% could be used to improve the bond strength with calcium silicate-based cements.
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Affiliation(s)
- Amr M Elnaghy
- Department of Endodontics, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt.
| | - Ayman Mandorah
- Department of Restorative and Dental Materials, Faculty of Dentistry, Taif University P.O Box 11099, Taif, 21944, Saudi Arabia
| | - Ali H Hassan
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Restorative Dental Sciences, Vision Colleges, Jeddah, Saudi Arabia
| | - Alaa Elshazli
- Department of Endodontics, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt
| | - Shaymaa Elsaka
- Department of Restorative Dental Sciences, Vision Colleges, Jeddah, Saudi Arabia.,Department of Dental Biomaterials, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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18
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Moazzami F, Sahebi S, Shirzadi S, Azadeh N. Comparative in vitro Assessment of Tooth Color Change under the Influence of Nano Fast Cement and MTA. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2021; 22:48-52. [PMID: 33718530 PMCID: PMC7921768 DOI: 10.30476/dentjods.2020.85057.1113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Statement of the Problem Tooth color changes followed by treatment with bioceramic materials are always a matter of concern. Purpose The aim of the present in vitro study was to compare tooth discoloration that occurs in human teeth filled with ProRoot WMTA (DENTSPLY Tulsa Dental Specialties, Tulsa, OK) and those filled with Nano Fast Cement (NFC) over the course of 3 months. Materials and Method In this experimental study, Thirty human intact premolars were obtained. The roots of all teeth were removed by a horizontal cut about 2 mm below the cementoenamel junction. The pulp tissues were removed using a barbed broach (Mani, Tokyo, Japan).The teeth were randomly divided to 3 groups (n= 10) including the control (no material), ProRoot WMTA and NFC. The experimental materials were condensed into the crowns and the teeth ends were sealed with light-cure glass ionomer cement (GC Corporation, Tokyo, Japan). The color was assessed at TBL (baseline; after preparation of the cavities but before placement of the materials), TPO (immediately after placement of the filling material and provisional restoration), T4 (after 4weeks of storage), and T12 (after 12weeks) of storage. Results The discoloration was evident in all teeth, immediately (TPO) after applying MTA and NFC. The highest ΔΕ was noted in WMTA at 12 weeks, followed by NFC; however, there was no significant difference between the discolorations induced by these two materials. Conclusion Similar levels of clinically observable tooth discoloration were detected by using either WMTA or NFC.
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Affiliation(s)
- Fariborz Moazzami
- Dept. of Endodontic, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Safoora Sahebi
- Dept. of Endodontic, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sareh Shirzadi
- Dept. of Endodontic, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Niloufar Azadeh
- Dept. of Orthodontic, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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19
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Different Approaches to the Regeneration of Dental Tissues in Regenerative Endodontics. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11041699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
(1) Background: The regenerative procedure has established a new approach to root canal therapy, to preserve the vital pulp of the tooth. This present review aimed to describe and sum up the different approaches to regenerative endodontic treatment conducted in the last 10 years; (2) Methods: A literature search was performed in the PubMed and Cochrane Library electronic databases, supplemented by a manual search. The search strategy included the following terms: “regenerative endodontic protocol”, “regenerative endodontic treatment”, and “regenerative endodontics” combined with “pulp revascularization”. Only studies on humans, published in the last 10 years and written in English were included; (3) Results: Three hundred and eighty-six potentially significant articles were identified. After exclusion of duplicates, and meticulous analysis, 36 case reports were selected; (4) Conclusions: The pulp revascularization procedure may bring a favorable outcome, however, the prognosis of regenerative endodontics (RET) is unpredictable. Permanent immature teeth showed greater potential for positive outcomes after the regenerative procedure. Further controlled clinical studies are required to fully understand the process of the dentin–pulp complex regeneration, and the predictability of the procedure.
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20
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Sun Q, Meng M, Steed JN, Sidow SJ, Bergeron BE, Niu LN, Ma JZ, Tay FR. Manoeuvrability and biocompatibility of endodontic tricalcium silicate-based putties. J Dent 2020; 104:103530. [PMID: 33220332 DOI: 10.1016/j.jdent.2020.103530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES The present study evaluated the indentation depth, storage modulus and biocompatibility of an experimental endodontic putty designed for endodontic perforation repair and direct pulp-capping (NeoPutty). The results were compared with the properties associated with the commercially available EndoSequence BC RRM Putty (ES Putty). METHODS Indentation depth was measured by a profilometer following indentation with the 1/4 lb Gilmore needle. Elastic modulus was evaluated using a strain-controlled rheometer. The effects of eluents derived from these two putties were examined on the viability and proliferation of human dental pulp stem cells (hDPSCs) and human periodontal ligament fibroblasts (hPDLFs), before (1 st testing cycle) and after complete setting (2nd testing cycle). RESULTS The ES Putty became more difficult to ident and acquired a larger storage modulus after exposure to atmospheric moisture. Biocompatibility results indicated that both putties were relatively more cytotoxic than the bioinert Teflon negative control, but much less cytotoxic than the zinc oxide-eugenol cement negative control. NeoPutty was less cytotoxic than ES putty in the 1st testing cycle, particularly with hDPSCs. Both putties exhibited more favourable cytotoxicity profiles after complete setting. CONCLUSIONS NeoPutty has a better window of maneuverability after exposure to atmospheric moisture. From an in vitro cytotoxicity perspective, the NeoPutty may be considered more biocompatible than ES putty. CLINICAL SIGNIFICANCE The experimental NeoPutty is biocompatible and is capable of reducing the frustration of shortened shelf life when jar-stored endodontic putties are exposed to atmospheric moisture during repeated opening of the lid for clinical retrieval.
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Affiliation(s)
- Qin Sun
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meng Meng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Jeffrey N Steed
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Stephanie J Sidow
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Brian E Bergeron
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Li-Na Niu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China.
| | - Jing-Zhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Franklin R Tay
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA.
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21
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Song W, Sun W, Chen L, Yuan Z. In vivo Biocompatibility and Bioactivity of Calcium Silicate-Based Bioceramics in Endodontics. Front Bioeng Biotechnol 2020; 8:580954. [PMID: 33195142 PMCID: PMC7658386 DOI: 10.3389/fbioe.2020.580954] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/31/2020] [Indexed: 12/14/2022] Open
Abstract
Endodontic therapy aims to preserve or repair the activity and function of pulp and periapical tissues. Due to their excellent biological features, a substantial number of calcium silicate-based bioceramics have been introduced into endodontics and simultaneously increased the success rate of endodontic treatment. The present manuscript describes the in vivo biocompatibility and bioactivity of four types of calcium silicate-based bioceramics in endodontics.
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Affiliation(s)
- Wencheng Song
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Wei Sun
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Lili Chen
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Zhenglin Yuan
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
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22
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Nam OH, Lee HS, Kim JH, Chae YK, Hong SJ, Kang SW, Lee HS, Choi SC, Kim Y. Differential Gene Expression Changes in Human Primary Dental Pulp Cells Treated with Biodentine and TheraCal LC Compared to MTA. Biomedicines 2020; 8:biomedicines8110445. [PMID: 33105546 PMCID: PMC7690278 DOI: 10.3390/biomedicines8110445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 12/14/2022] Open
Abstract
This study aimed to analyze the effects of pulp capping materials on gene expression changes in primary tooth-derived dental pulp cells using next-generation sequencing. Dental pulp cells were extracted and treated with mineral trioxide aggregate (MTA), Biodentine (BD), or TheraCal LC (TC). Cell viability assays were performed. Total RNA was extracted and analyzed through mRNA sequencing. Bioinformatic analysis of differential gene expression in dental pulp cells exposed to BD or TC versus MTA was performed. MTA, BD, and TC exposure had no significant effect on pulp cell viability (p > 0.05). Gene sets associated with inflammatory response (p = 2.94 × 10−5) and tumor necrosis factor alpha (TNF-α) signaling via the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway (p = 2.94 × 10−5) were enriched in all materials. In BD-treated cells, Wnt/β-catenin signaling (p = 3.15 × 10−4) gene sets were enriched, whereas enrichment of interferon gamma (IFN-γ) response (p = 3 × 10−3) was observed in TC-treated cells. In gene plot analysis, marked increases in receptor activator of nuclear factor kappa-Β ligand (RANKL) expression were seen in TC-treated cells over time. Despite the similar cell viabilities exhibited among MTA-, BD-, and TC-treated cells, patterns of gene networks differed, suggesting that diverse functional gene differences may be associated with treatment using these materials.
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Affiliation(s)
- Ok Hyung Nam
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul 02447, Korea
| | - Ho Sun Lee
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul 02447, Korea
| | - Jae-Hwan Kim
- Department of Pediatric Dentistry, School of Dentistry, Jeonbuk National University, Jeonju 54896, Korea
| | - Yong Kwon Chae
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul 02447, Korea
| | - Seoung-Jin Hong
- Department of Prosthodontics, School of Dentistry, Kyung Hee University, Seoul 02447, Korea
| | - Sang Wook Kang
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Kyung Hee University, Seoul 02447, Korea
| | - Hyo-Seol Lee
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul 02447, Korea
| | - Sung Chul Choi
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul 02447, Korea
| | - Young Kim
- Department of Oral Pathology, School of Dentistry, Chonnam National University, Gwangju 61186, Korea
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Chen SJ, Karabucak B, Steffen JJ, Yu YH, Kohli MR. Spectrophotometric Analysis of Coronal Tooth Discoloration Induced by Tricalcium Silicate Cements in the Presence of Blood. J Endod 2020; 46:1913-1919. [PMID: 32949559 DOI: 10.1016/j.joen.2020.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/03/2020] [Accepted: 09/10/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION New tricalcium silicate cements have been shown to induce less coronal discoloration. The purpose of this in vitro study was to evaluate the degree of color change induced by various silicate materials in the presence and absence of blood. METHODS One hundred human extracted anterior single-canal teeth were sectioned to standardized root lengths, accessed, and instrumented. Eight random experimental groups and 2 control groups were created wherein specimens were filled with experimental materials below the buccal cementoenamel junction as follows: EndoSequence RRM putty (Brasseler USA, Savannah, GA), EndoSequence RRM fast set putty (Brasseler USA), Biodentine (Septodont, Saint-Maur-des-Fossés, France), and white mineral trioxide aggregate (Dentsply Sirona, York, PA) either with the presence or absence of blood. Blood-only and saline-only samples were used for the positive and negative controls. After incubation in 100% humidity at 37°C, color changes were evaluated with a spectrophotometer (Ocean Optics, Dunedin, FL) on days 0, 30, 60, and 180 after material placement. Data were transformed into Commission International de I'Eclairage's L∗a∗b color values, and corresponding ΔE values were calculated. The 1-way analysis of variance test was performed for statistical analysis. RESULTS Discoloration was observed in all specimens in the presence of blood. There was no statistical significance when comparing different materials in contact with blood. Intragroup observation at various time points, Biodentine, and EndoSequence RRM fast set putty showed significant difference between the presence and absence of blood at 180 days (P < .05). CONCLUSIONS Contamination with blood of tricalcium silicate materials has the potential to cause coronal tooth discoloration.
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Affiliation(s)
- Stephanie J Chen
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Bekir Karabucak
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania.
| | - Joshua John Steffen
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Ya-Hsin Yu
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Meetu R Kohli
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
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Haikal L, Ferraz dos Santos B, Vu DD, Braniste M, Dabbagh B. Biodentine Pulpotomies on Permanent Traumatized Teeth with Complicated Crown Fractures. J Endod 2020; 46:1204-1209. [DOI: 10.1016/j.joen.2020.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/26/2020] [Accepted: 06/07/2020] [Indexed: 11/30/2022]
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Pulyodan MK, Paramel Mohan S, Valsan D, Divakar N, Moyin S, Thayyil S. Regenerative Endodontics: A Paradigm Shift in Clinical Endodontics. J Pharm Bioallied Sci 2020; 12:S20-S26. [PMID: 33149426 PMCID: PMC7595546 DOI: 10.4103/jpbs.jpbs_112_20] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/06/2020] [Accepted: 03/09/2020] [Indexed: 02/06/2023] Open
Abstract
Preserving the natural dentition in its normal form and function is one of the major goals of endodontic treatment. Re-establishing the lost vitality and development of root maturation in immature permanent teeth with pulp necrosis/apical periodontitis is quiet challenging clinically. The very basis of regenerative endodontics relies on the concept of tissue engineering using stem cells, biomimetic scaffold, and bioactive growth factors to regenerate the pulp tissue damaged by microbial infection, injury, or developmental defects. In clinical endodontics, this approach is referred to as a “paradigm shift.” Even though repair instead of true regeneration is achieved with current protocols, it is hoped that further research in the area of stem-cell-based tissue engineering will allow for true regeneration and improved treatment outcomes. The aim of this review is to discuss about the various aspects of regenerative endodontics, current clinical protocols, and the future of pulp regeneration techniques.
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Affiliation(s)
- Manoj Kumar Pulyodan
- Department of Conservative Dentistry and Endodontics, Sree Anjaneya Institute of Dental Sciences, Calicut, Kerala, India
| | - Sunil Paramel Mohan
- Department of Oral Pathology and Microbiology, Sree Anjaneya Institute of Dental Sciences, Calicut, Kerala, India
| | - Dhanya Valsan
- Department of Conservative Dentistry and Endodontics, Sree Anjaneya Institute of Dental Sciences, Calicut, Kerala, India
| | - Namitha Divakar
- Department of Conservative Dentistry and Endodontics, Sree Anjaneya Institute of Dental Sciences, Calicut, Kerala, India
| | - Shabna Moyin
- Department of Conservative Dentistry and Endodontics, Sree Anjaneya Institute of Dental Sciences, Calicut, Kerala, India
| | - Shamsheer Thayyil
- Department of Conservative Dentistry and Endodontics, Sree Anjaneya Institute of Dental Sciences, Calicut, Kerala, India
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Oliveira LV, Silva GR, Souza GL, Magalhães TEA, Barbosa GLR, Turrioni AP, Moura CCG. A laboratory evaluation of cell viability, radiopacity and tooth discoloration induced by regenerative endodontic materials. Int Endod J 2020; 53:1140-1152. [DOI: 10.1111/iej.13308] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/07/2020] [Indexed: 12/12/2022]
Affiliation(s)
- L. V. Oliveira
- Department of EndodonticsFederal University of Uberlândia Uberlândia Brazil
| | - G. R. Silva
- Department of Operative Dentistry and Dental MaterialsFederal University of Uberlândia Uberlândia Brazil
| | - G. L. Souza
- Department of EndodonticsFederal University of Uberlândia Uberlândia Brazil
| | | | - G. L. R. Barbosa
- Department of Stomatological Diagnosis School of DentistryFederal University of UberlândiaUberlândiaBrazil
| | - A. P. Turrioni
- Department of Pediatric School of Dentistry Federal University of Uberlândia Uberlândia Brazil
| | - C. C. G. Moura
- Department of EndodonticsFederal University of Uberlândia Uberlândia Brazil
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Interdisciplinary Approach to Treat Unusual Development of Dens Evaginatus: A Case Report. J Clin Pediatr Dent 2020; 44:112-115. [PMID: 32271657 DOI: 10.17796/1053-4625-44.2.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The present case report describes a rare case of dens evaginatus on the labial surface of mandibular incisor and interdisciplinary management including endodontic and periodontal treatment. A 10-year-old girl presented unusual whitish tubercle-like structure penetrated through the buccal gingiva of mandibular later incisor. In cone-beam computed tomographic view, pulpal tissue was extended from the principal root to the tubercle. Following full thickness flap reflection, the tubercle was carefully removed, resulting in dentin and pin-point pulp exposure. In order to prevent pulp necrosis and facilitate periodontal attachment to this area, Biodentine and enamel matrix derivative were applied. Gingival defect was compensated using a collagen matrix. Up to 2 years, harmonious gingiva state and no loss of tooth vitality were observed. In summary, dens evaginatus on mandibular later incisor could be successfully treated by means of interdisciplinary approach.
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Time-Dependent Response of Human Deciduous Tooth-Derived Dental Pulp Cells Treated with TheraCal LC: Functional Analysis of Gene Interactions Compared to MTA. J Clin Med 2020; 9:jcm9020531. [PMID: 32075286 PMCID: PMC7074006 DOI: 10.3390/jcm9020531] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 12/24/2022] Open
Abstract
Pulp capping material should facilitate hard tissue regeneration on the injured pulp tissue. TheraCal LC (TC) was recently developed. Although TC has shown reliable clinical outcomes after direct pulp capping, there are still remaining concerns regarding its detrimental effect on pulp cells. Therefore, this study aimed to identify the gene expression of human deciduous tooth-derived dental pulp cells exposed to TC compared to mineral trioxide aggregate (MTA). The cells were cultured and exposed to TC and MTA for 24 and 72 h. Next, total RNA was isolated. QuantSeq 3′ mRNA-sequencing was used to examine differentially expressed genes (DEGs) in exposed to TC and MTA. Functional analysis of DEGs was performed using bioinformatics analysis. In gene ontology (GO) functional enrichment analysis, cells in TC for 24 h presented significantly enriched immune response (p < 0.001) and inflammatory response (p < 0.01) compared to MTA. TC showed enriched positive regulation of cell migration at 72 h (p < 0.001). In Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, neuroactive ligand–receptor interaction (p = 1.19 × 10−7) and calcium signaling pathway (p = 2.96 × 10−5) were confirmed in the shared DEGs in TC. In conclusion, DEGs in TC may be involved in pathways associated with osteoclastogenesis and osteoclastic differentiation.
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Alghamdi F, Aljahdali E. Comparison of Mineral Trioxide Uggregate, EndoSequence Root Repair Material, and Biodentine Used for Repairing Root Perforations: A Systematic Review. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.589413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Aly MM, Taha SEED, El Sayed MA, Youssef R, Omar HM. Clinical and radiographic evaluation of Biodentine and Mineral Trioxide Aggregate in revascularization of non-vital immature permanent anterior teeth (randomized clinical study). Int J Paediatr Dent 2019; 29:464-473. [PMID: 30702789 DOI: 10.1111/ipd.12474] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 12/12/2018] [Accepted: 01/24/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To asses clinically and radiographically the effect of using two types of coronal plug materials in revascularization of non-vital immature teeth. METHODS A total of 26 necrotic immature permanent anterior teeth were enrolled for pulp revascularization using a double antibiotic mix for root canal disinfection. They were randomly divided into the following based on coronal plug materials used: Biodentine (Group I) and white Mineral Trioxide Aggregate (Group II; n = 13). Clinical and radiographic assessments were performed after 3, 6, 9, and 12 months. RESULTS When comparing the overall clinical successes and percentage of increase in root length between the two groups, there was no statistically significant difference (P > 0.05). There was a significant difference in the distribution of discoloration between the two groups. One case was reported in Group I, and seven cases were reported in Group II (P = 0.01). CONCLUSIONS Both Biodentine and Mineral Trioxide Aggregate were successful clinically regarding the resolution of signs and symptoms associated with the necrotic teeth.
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Affiliation(s)
- Mariam Mohsen Aly
- Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Sherine Ezz El-Din Taha
- Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Manal Ahmed El Sayed
- Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Randa Youssef
- Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Giza, Egypt
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Huang TH, Kao CT, Shen YF, Lin YT, Liu YT, Yen SY, Ho CC. Substitutions of strontium in bioactive calcium silicate bone cements stimulate osteogenic differentiation in human mesenchymal stem cells. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:68. [PMID: 31165270 DOI: 10.1007/s10856-019-6274-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 05/27/2019] [Indexed: 06/09/2023]
Abstract
Calcium silicate cements have been considered as alternative bone substitutes owing to its extraordinary bioactivity and osteogenicity. Unfortunately, the major disadvantage of the cements was the slow degradation rate which may limit the efficiency of bone regeneration. In this study, we proposed a facile method to synthesize degradable calcium silicate cements by incorporating strontium into the cements through solid-state sintering. The effects of Sr incorporation on physicochemical and biological properties of the cements were evaluated. Although, our findings revealed that the incorporation of strontium retarded the hardening reaction of the cements, the setting time of different cements (11-19 min) were in the acceptable range for clinical use. The presence of Sr in the CS cements would hampered the precipitation of calcium phosphate products on the surface after immersion in SBF, however, a layer of precipitated calcium phosphate products can be formed on the surface of the Sr-CS cement within 1 day immersion in SBF. More importantly, the degradation rate of the cements increased with increasing content of strontium, consequentially raised the levels of released strontium and silicon ions. The elevated dissolving products may contribute to the enhancement of the cytocompatibility, alkaline phosphatase activity, osteocalcin secretion, and mineralization of human Wharton's jelly mesenchymal stem cells. Together, it is concluded that the strontium-incorporated calcium silicate cement might be a promising bone substitute that could accelerate the regeneration of irregularly shaped bone defects.
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Affiliation(s)
- Tsui-Hsien Huang
- School of Dentistry, Chung Shan Medical University, Taichung City, Taiwan
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - Chia-Tze Kao
- School of Dentistry, Chung Shan Medical University, Taichung City, Taiwan
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - Yu-Fang Shen
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung City, Taiwan
- 3D Printing Medical Research Institute, Asia University, Taichung City, Taiwan
| | - Yi-Ting Lin
- School of Dentistry, Chung Shan Medical University, Taichung City, Taiwan
| | - Yen-Ting Liu
- School of Medicine, China Medical University, Taichung City, Taiwan
| | - Ssu-Yin Yen
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung City, Taiwan.
| | - Chia-Che Ho
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung City, Taiwan.
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Huang KH, Chen YW, Wang CY, Lin YH, Wu YHA, Shie MY, Lin CP. Enhanced Capability of Bone Morphogenetic Protein 2-loaded Mesoporous Calcium Silicate Scaffolds to Induce Odontogenic Differentiation of Human Dental Pulp Cells. J Endod 2019; 44:1677-1685. [PMID: 30409449 DOI: 10.1016/j.joen.2018.08.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 08/13/2018] [Accepted: 08/17/2018] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Calcium silicate bioceramics have been broadly used as reparative or grafting materials with good bioactivity and biocompatibility in dental application. It has been shown that applying a mesoporous process to calcium silicate gives it great potential as a controlled drug delivery system. METHODS The aim of this study was to investigate a novel osteoinductive scaffold by loading bone morphogenetic protein 2 (BMP-2) to mesoporous calcium silicate (MesoCS) and fabricating it as 3-dimensional scaffolds using fused deposition modeling combined with polycaprolactone. RESULTS The MesoCS/BMP-2 scaffold showed similar patterns to that of a calcium silicate scaffold in releasing calcium and silicon ions in a simulated body fluid (SBF) immersion test for 7 days, but BMP-2 continued releasing from the MesoCS/BMP-2 scaffold significantly more than the CS scaffold from 48 hours to 7 days. Adhesion and proliferation of human dental pulp cells cultured on a MesoCS/BMP-2 scaffold were also more significant than scaffolds without BMP-2 or mesoporous as well as the results of the test on alkaline phosphatase activity. CONCLUSIONS The results support that the novel 3-dimensional-printed MesoCS scaffold performed well as BMP-2 delivery system and would be an ideal odontoinductive biomaterial in regenerative endodontics.
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Affiliation(s)
- Kuo-Hao Huang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Wen Chen
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan; 3D Printing Medical Research Institute, Asia University, Taichung, Taiwan
| | - Chen-Ying Wang
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Hong Lin
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung, Taiwan; PhD Program for Medical Engineering and Rehabilitation Science, China Medical University, Taichung, Taiwan
| | - Yuan-Haw Andrew Wu
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Ming-You Shie
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung, Taiwan; School of Dentistry, China Medical University, Taichung, Taiwan; Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Chun-Pin Lin
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Advanced Research Center for Green Materials Science and Technology, National Taiwan University Hospital, Taipei, Taiwan.
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Six-Month Color Stability Assessment of Two Calcium Silicate-Based Cements Used in Regenerative Endodontic Procedures. J Funct Biomater 2019; 10:jfb10010014. [PMID: 30823393 PMCID: PMC6462979 DOI: 10.3390/jfb10010014] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 02/18/2019] [Accepted: 02/18/2019] [Indexed: 02/07/2023] Open
Abstract
AIM The purpose of the present study is to assess the color stability of two calcium silicate-based cements (CSCs) used in regenerative endodontic procedures (REPs). METHODS A total of 40 acrylic single-rooted transparent teeth, with immature apex, were used. Root canals were filled up to 3 mm below the level of the cementoenamel junction, with either saline solution (Mineral Trioxide Aggregate (MTA)/saline and Biodentine/saline) or blood (MTA/blood and Biodentine/blood). Subsequently, ProRoot MTA® or BiodentineTM was placed in the root canal to create a cervical barrier. Color measurement was carried out at four different evaluation periods (3 h, 72 h, 7 days, and 6 months). Shade analysis within the L* a* b* color space was performed and color variation (∆E) calculated. The significance level for statistical analysis was set at p < 0.05. RESULTS The four groups showed a significant decrease in L* values over time. The ΔE value increased over time for all groups but was not statistically significant for the Biodentine/blood group. Two-way ANOVA showed no interaction between the CSC and treatment (contact with saline solution or blood). CSC used was the factor responsible for ΔE over time, inducing statistically significant color variations from T3H to T7D (p = 0.04) and T3H to T6M (p < 0.01). After 6 months, MTA/saline had 5.08 (p = 0.001) higher ΔE than Biodentine/Saline and the MTA/blood had 3.65 (p = 0.009) higher than Biodentine/blood. CONCLUSIONS After 6 months, regardless of blood exposure, Biodentine exhibits superior color stability compared to MTA. Biodentine might be a suitable alternative to MTA as a cervical barrier material in REPs.
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Influence of ultrasonic agitation on bond strength, marginal adaptation, and tooth discoloration provided by three coronary barrier endodontic materials. Clin Oral Investig 2019; 23:4113-4122. [DOI: 10.1007/s00784-019-02850-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/12/2019] [Indexed: 10/27/2022]
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El Meligy OAES, Alamoudi NM, Allazzam SM, El-Housseiny AAM. Biodentine TM versus formocresol pulpotomy technique in primary molars: a 12-month randomized controlled clinical trial. BMC Oral Health 2019; 19:3. [PMID: 30612569 PMCID: PMC6322259 DOI: 10.1186/s12903-018-0702-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 12/20/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The objective of this clinical study was to prospectively compare the clinical and radiographic success rates of BiodentineTM pulpotomies versus formocresol pulpotomies in children vital primary molars. METHODS A randomized, split-mouth study design was used with a sample of 37 healthy children aged 4- to 8-year-old. A total of 56 pairs (112 teeth) of carious primary teeth, 1 pair per child, were selected for treatment. One tooth from each pair was randomly assigned to either the BiodentineTM pulpotomy group or the formocresol pulpotomy group. Children were followed-up at 3, 6 and 12 months for clinical evaluation and at 6 and 12 months for radiographic evaluation. Data were collected, tabulated and analyzed using Fisher exact and McNemar tests. The level of significance was set at P < 0.05. RESULTS At 12 months, the clinical success rates of both BiodentineTM and formocresol groups were 100%, while the radiographic success rates for BiodentineTM and formocresol groups were 100% and 98.1%, respectively. There was no statistically significant difference between both groups (P=1). The only observed radiographic failure was furcal radiolucency in the formocresol group at 12-month interval. Pulp canal obliteration was radiographically observed in 10/56 (17.9%) and 7/56 (12.5%) cases in the BiodentineTM and formocresol groups, respectively. CONCLUSIONS Both BiodentineTM and formocresol pulpotomy techniques demonstrated favorable clinical and radiographic outcomes over a 12-month period without any significant difference. TRIAL REGISTRATION Registered on NCT03779698 . Date of Registration: 18 December 2018.
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Affiliation(s)
- Omar Abd El Sadek El Meligy
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah, 21589 Kingdom of Saudi Arabia
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, 21521 Egypt
| | - Najlaa Mohamed Alamoudi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah, 21589 Kingdom of Saudi Arabia
| | - Sulaiman Mohamed Allazzam
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah, 21589 Kingdom of Saudi Arabia
- Dental Department, Comprehensive Specialty Clinics for Security Forces, P.O. Box 1666, AlRass, 51921 Qassim Kingdom of Saudi Arabia
| | - Azza Abdel Mohsen El-Housseiny
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah, 21589 Kingdom of Saudi Arabia
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, 21521 Egypt
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Fan ML, He LB, Li JY. [Recent advances in direct pulp capping materials]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2018; 36:675-680. [PMID: 30593117 DOI: 10.7518/hxkq.2018.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The long-term effect of direct pulp capping and pulpotomy is closely related to the type of pulp capping materials. Various kinds of direct pulp capping materials are available, such as calcium hydroxide and mineral trioxide aggregates. Diverse new pulp capping materials have been reported recently. The excellent performance of calcium silicates has attracted much attention in previous studies. Moreover, enamel matrix derivative (Emdogain), which is capable of regeneration and remineralization, and other materials with similar capabilities have shown potential for use in pulp capping.
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Affiliation(s)
- Meng-Lin Fan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Li-Bang He
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ji-Yao Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Careddu R, Duncan HF. How does the pulpal response to Biodentine and ProRoot mineral trioxide aggregate compare in the laboratory and clinic? Br Dent J 2018; 225:sj.bdj.2018.864. [PMID: 30337724 DOI: 10.1038/sj.bdj.2018.864] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2018] [Indexed: 02/07/2023]
Affiliation(s)
- R Careddu
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Lincoln Place, Dublin 2, Ireland
| | - H F Duncan
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Lincoln Place, Dublin 2, Ireland
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Kim SG, Malek M, Sigurdsson A, Lin LM, Kahler B. Regenerative endodontics: a comprehensive review. Int Endod J 2018; 51:1367-1388. [PMID: 29777616 DOI: 10.1111/iej.12954] [Citation(s) in RCA: 197] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/14/2018] [Indexed: 12/13/2022]
Abstract
The European Society of Endodontology and the American Association for Endodontists have released position statements and clinical considerations for regenerative endodontics. There is increasing literature on this field since the initial reports of Iwaya et al. (Dental Traumatology, 17, 2001, 185) and Banchs & Trope (Journal of Endodontics, 30, 2004, 196). Endogenous stem cells from an induced periapical bleeding and scaffolds using blood clot, platelet rich plasma or platelet-rich fibrin have been utilized in regenerative endodontics. This approach has been described as a 'paradigm shift' and considered the first treatment option for immature teeth with pulp necrosis. There are three treatment outcomes of regenerative endodontics; (i) resolution of clinical signs and symptoms; (ii) further root maturation; and (iii) return of neurogenesis. It is known that results are variable for these objectives, and true regeneration of the pulp/dentine complex is not achieved. Repair derived primarily from the periodontal and osseous tissues has been shown histologically. It is hoped that with the concept of tissue engineering, namely stem cells, scaffolds and signalling molecules, that true pulp regeneration is an achievable goal. This review discusses current knowledge as well as future directions for regenerative endodontics. Patient-centred outcomes such as tooth discolouration and possibly more appointments with the potential for adverse effects needs to be discussed with patients and parents. Based on the classification of Cvek (Endodontics and Dental Traumatology, 8, 1992, 45), it is proposed that regenerative endodontics should be considered for teeth with incomplete root formation although teeth with near or complete root formation may be more suited for conventional endodontic therapy or MTA barrier techniques. However, much is still not known about clinical and biological aspects of regenerative endodontics.
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Affiliation(s)
- S G Kim
- Division of Endodontics, Columbia University College of Dental Medicine, New York, NY, USA
| | - M Malek
- Department of Endodontics, New York University College of Dentistry, New York, NY, USA
| | - A Sigurdsson
- Department of Endodontics, New York University College of Dentistry, New York, NY, USA
| | - L M Lin
- Department of Endodontics, New York University College of Dentistry, New York, NY, USA
| | - B Kahler
- The University of Queensland School of Dentistry, Brisbane, Australia
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Rajasekharan S, Martens LC, Cauwels RGEC, Anthonappa RP. Biodentine™ material characteristics and clinical applications: a 3 year literature review and update. Eur Arch Paediatr Dent 2018; 19:1-22. [PMID: 29372451 DOI: 10.1007/s40368-018-0328-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 01/11/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Biodentine™ has frequently been acknowledged in the literature as a promising material and serves as an important representative of tricalcium silicate based cements used in dentistry. AIM To provide an update on the physical and biological properties of Biodentine™ and to compare these properties with those of other tricalcium silicate cements namely, different variants of mineral trioxide aggregate (MTA) such as ProRoot MTA, MTA Angelus, Micro Mega MTA (MM-MTA), Retro MTA, Ortho MTA, MTA Plus, GCMTA, MTA HP and calcium enriched mixture (CEM), Endosequence and Bioaggregate™. STUDY DESIGN A comprehensive literature search for publications from November 20, 2013 to November 20, 2016 was performed by two independent reviewers on Medline (PubMed), Embase, Web of Science, CENTRAL (Cochrane), SIGLE, SciELO, Scopus, Lilacs and clinicaltrials.gov. Electronic and hand search was carried out to identify randomised control trials (RCTs), case control studies, case series, case reports, as well as in vitro and animal studies published in the English language. CONCLUSIONS The enhanced physical and biologic properties of Biodentine™ could be attributed to the presence of finer particle size, use of zirconium oxide as radiopacifier, purity of tricalcium silicate, absence of dicalcium silicate, and the addition of calcium chloride and hydrosoluble polymer. Furthermore, as Biodentine™ overcomes the major drawbacks of MTA it has great potential to revolutionise the different treatment modalities in paediatric dentistry and endodontics especially after traumatic injuries. Nevertheless, high quality long-term clinical studies are required to facilitate definitive conclusions.
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Affiliation(s)
- S Rajasekharan
- Department of Paediatric Dentistry and special care, PAECOMEDIS Research Cluster, Ghent University, 9000, Ghent, Belgium.
| | - L C Martens
- Department of Paediatric Dentistry and special care, PAECOMEDIS Research Cluster, Ghent University, 9000, Ghent, Belgium
| | - R G E C Cauwels
- Department of Paediatric Dentistry and special care, PAECOMEDIS Research Cluster, Ghent University, 9000, Ghent, Belgium
| | - R P Anthonappa
- Paediatric Oral Health Research Group, School of Dentistry, The University of Western Australia, Perth, Australia
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Kahler B, Chugal N, Lin LM. Alkaline Materials and Regenerative Endodontics: A Review. MATERIALS 2017; 10:ma10121389. [PMID: 29206139 PMCID: PMC5744324 DOI: 10.3390/ma10121389] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 11/23/2017] [Accepted: 11/29/2017] [Indexed: 12/16/2022]
Abstract
Periapical health is the primary goal of endodontic treatment in mature and immature teeth. In addition, the goals of treatment of immature teeth with arrested root development include root growth to length and maturation of the apex, as well as thickening of the canal wall. These goals are valid for immature teeth that have been subjected to trauma and dental caries or that are the result of developmental anomalies that expose the tooth to the risk of pulp necrosis and consequently result in the cessation of root maturation. Regenerative endodontic procedures (REPs) have been described as a “paradigm shift” in the treatment of immature teeth with pulp necrosis and underdeveloped roots, as there is the potential for further root maturation and return of vitality. Treatment with REPs is advocated as the treatment of choice for immature teeth with pulp necrosis. REP protocols involve the use of alkaline biomaterials, primarily sodium hypochlorite, calcium hydroxide, mineral trioxide aggregates and Biodentine, and are the essential components of a successful treatment regimen.
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Affiliation(s)
- Bill Kahler
- The School of Dentistry, The University of Queensland, Brisbane 4072, Australia.
| | - Nadia Chugal
- School of Dentistry, UCLA, CHS A3-075, Los Angeles, CA 90095-1668, USA.
| | - Louis M Lin
- College of Dentistry, New York University, 345 East 24th Street, New York, NY 10010, USA.
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Lin LM, Kahler B. A review of regenerative endodontics: current protocols and future directions. J Istanb Univ Fac Dent 2017; 51:S41-S51. [PMID: 29354308 PMCID: PMC5750827 DOI: 10.17096/jiufd.53911] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 10/10/2017] [Indexed: 12/15/2022] Open
Abstract
This review outlines the biological basis and clinical
protocols currently used in regenerative endodontic
procedures (REPs) and discuss future directions in pulp
regeneration approaches. The treatment of immature teeth
with REPs has been described as a ‘paradigm shift’ as
there is the potential for further root maturation. Clinically,
REPs involve disinfection of the root canal system without
damaging the endogenous stem cell potential present in
the apical papilla and other tissues. These stems cells are
introduced into the root canal space by inducing a blood
clot followed by placement of an intracanal barrier to
prevent microleakage. The biological concept of REPs
involves the triad of stem cells, scaffold and signalling
molecules. Currently, repair rather than true regeneration
of the ‘pulp-dentine complex’ is achieved and further root
maturation is variable. However, may clinicians consider
the treatment of teeth with REPs as the optimal treatment
approach for immature teeth with pulp necrosis.
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Affiliation(s)
- Louis M Lin
- Department of Endodontics New York University College of Dentistry 345 East 24th Street New York, NY 10010 USA
| | - Bill Kahler
- School of Dentistry The University of Queensland Oral Health Centre 288 Herston Road, Corner Bramston Terrace and Herston Road Herston QLD 4006 Australia
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Torabinejad M, Parirokh M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications. Int Endod J 2017; 51:284-317. [PMID: 28846134 DOI: 10.1111/iej.12843] [Citation(s) in RCA: 201] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/22/2017] [Indexed: 12/16/2022]
Abstract
Mineral trioxide aggregate (MTA) is a dental material used extensively for vital pulp therapies (VPT), protecting scaffolds during regenerative endodontic procedures, apical barriers in teeth with necrotic pulps and open apices, perforation repairs as well as root canal filling and root-end filling during surgical endodontics. A number of bioactive endodontic cements (BECs) have recently been introduced to the market. Most of these materials have calcium and silicate in their compositions; however, bioactivity is a common property of these cements. These materials include the following: BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA but without the drawbacks. In Part I of this review, the available information on the chemical composition of the materials listed above was reviewed and their applications for VPT was discussed. In this article, the clinical applications of MTA and other BECs will be reviewed for apexification, regenerative endodontics, perforation repair, root canal filling, root-end filling, restorative procedures, periodontal defects and treatment of vertical and horizontal root fractures. In addition, the literature regarding the possible drawbacks of these materials following their clinical applications is reviewed. These drawbacks include their discolouration potential, systemic effects and retreatability following use as a root filling material. Based on selected keywords, all publications were searched regarding the use of MTA as well as BECs for the relevant clinical applications. Numerous publications were found regarding the use of BECs for various endodontic applications. The majority of these investigations compared BECs with MTA. Despite promising results for some materials, the number of publications using BECs for various clinical applications was limited. Furthermore, most studies had several methodological shortcomings and low levels of evidence.
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Affiliation(s)
- M Torabinejad
- Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - M Parirokh
- Endodontology Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Jung JK, Gwon GJ, Neupane S, Sohn WJ, Kim KR, Kim JY, An SY, Kwon TY, An CH, Lee Y, Kim JY, Ha JH. Bortezomib Facilitates Reparative Dentin Formation after Pulp Access Cavity Preparation in Mouse Molar. J Endod 2017; 43:2041-2047. [PMID: 29032823 DOI: 10.1016/j.joen.2017.07.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 07/12/2017] [Accepted: 07/24/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate in vitro and ex vivo roles of bortezomib, a proteasome inhibitor that binds to the active site of the 26S proteasome, in tertiary dentin formation. METHODS We established pulpal access cavity preparation that was treated with or without bortezomib before direct pulp capping with a calcium hydroxide-based material. We also analyzed bone morphogenetic protein (Bmp)- and Wnt-related signaling molecules using quantitative real-time polymerase chain reaction. RESULTS In the short-term observation period, the bortezomib-treated pulp specimens showed the period-altered immunolocalization patterns of nestin, CD31, and myeloperoxidase, whereas the control specimens did not. The bortezomib-treated group showed a complete dentin bridge with very few irregular tubules after 42 days. The micro-computed tomographic images showed more apparent dentin bridge structures in the treated specimens than were in the controls. Quantitative real-time polymerase chain reaction analysis showed up-regulated Bmp and Wnt. CONCLUSIONS These findings revealed that treatment with 1 μmol/L bortezomib induced reparative dentin formation that facilitated the maintenance of the integrity of the remaining pulpal tissue via early vascularization and regulation of Bmp and Wnt signaling.
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Affiliation(s)
- Jae-Kwang Jung
- Department of Oral Medicine, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Gi-Jeong Gwon
- Department of Biochemistry, School of Dentistry, Institute for Hard Tissue and Bone Regeneration, Kyungpook National University, Daegu, Korea
| | - Sanjiv Neupane
- Department of Biochemistry, School of Dentistry, Institute for Hard Tissue and Bone Regeneration, Kyungpook National University, Daegu, Korea
| | - Wern-Joo Sohn
- Department of Biochemistry, School of Dentistry, Institute for Hard Tissue and Bone Regeneration, Kyungpook National University, Daegu, Korea
| | - Ki-Rim Kim
- Department of Dental Hygiene, Kyungpook National University, Daegu, Korea
| | - Ji-Youn Kim
- Department of Dental Hygiene, Gachon University College of Health Science, Incheon, Seoul, Korea
| | - Seo-Young An
- Department of Oral and Maxillofacial Radiology, Kyungpook National University, Daegu, Korea
| | - Tae-Yub Kwon
- Department of Dental Materials, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Chang-Hyeon An
- Department of Oral and Maxillofacial Radiology, Kyungpook National University, Daegu, Korea
| | - Youngkyun Lee
- Department of Biochemistry, School of Dentistry, Institute for Hard Tissue and Bone Regeneration, Kyungpook National University, Daegu, Korea
| | - Jae-Young Kim
- Department of Biochemistry, School of Dentistry, Institute for Hard Tissue and Bone Regeneration, Kyungpook National University, Daegu, Korea.
| | - Jung-Hong Ha
- Department of Conservative Dentistry, School of Dentistry, Institute for Hard Tissue and Bone Regeneration, Kyungpook National University, Daegu, Korea.
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