1
|
Sabeti MA, Saqib Ihsan M, Adami D, Hassani SN, Moushekhian S, Shafieian R, Salari Sedigh H, Ghoddusi J. Cell-Based Regenerative Endodontics for the Treatment of Irreversible Pulpitis: AnIn VivoInvestigation. J Endod 2024; 50:344-350. [PMID: 38142887 DOI: 10.1016/j.joen.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION This study aims to investigate the ability of umbilical cord mesenchymal stem cells (UC-MSC) to enhance the regeneration of pulp-dentin complex in immature permanent teeth with irreversible pulpitis. METHODS A total of 32 mandibular premolar teeth with immature apices in 5 dogs were used in this in-vivo randomized controlled trial (RCT). Eight healthy teeth without pre-existing pathosis served as the positive control samples and received no treatment, while in another 8 teeth, the pulp was completely extirpated (negative control). Class V cavities were prepared to induce inflammation in the remaining 16 teeth (groups 3 and 4) and the pulp was extirpated 2-4 mm short of the radiographic apex. Of the 16, the 8 teeth in group 4 received 1 mL of cord blood stem cells with a hydrogel scaffold. Blood clots were covered with mineral trioxide aggregates at the cementoenamel junction in the experimental groups, and teeth were filled with RMGI and composite. Three months later, block sections were removed for histologic evaluations for the evaluation of postoperative apical closure, degree of inflammation, and presence of normal pulp tissue. The data were statistically analyzed with the chi-square test (P < .05). RESULTS All teeth with complete pulp extirpation demonstrated pulpal necrosis with no postoperative closure of their apices, while apical closure was seen in all the teeth in the remaining groups. There was a statistically significant (P < .001) difference in the presence of inflammation and normal pulp tissue between the experimental groups. The teeth in group 3 showed normal pulp tissue extending to the level of MTA, but there was inflammation within the canal space. In contrast, the teeth in the UC-MSC group demonstrated organized, normal pulp tissue with no inflammation. CONCLUSION Based on these results, the regeneration of the pulp-dentin complex is possible with no inflammation when UC-MSCs are used and 2-4 mm of the apical pulp remains intact in immature teeth with irreversible pulpitis.
Collapse
Affiliation(s)
- Mohammad A Sabeti
- Advanced Specialty Program in Endodontics, Department of Preventive and Restorative Dental Sciences, University of California, San Francisco School of Dentistry, San Francisco, California.
| | - Mohammad Saqib Ihsan
- Advanced Specialty Program in Endodontics, Department of Preventive and Restorative Dental Sciences, University of California, San Francisco School of Dentistry, San Francisco, California
| | - Dina Adami
- Advanced Specialty Program in Endodontics, Department of Preventive and Restorative Dental Sciences, University of California, San Francisco School of Dentistry, San Francisco, California
| | - Seyedeh-Nafiseh Hassani
- Head of Stem Cells and Developmental Biology Department and Advanced Therapy Medicinal Product Technology Development Center (ATMP-TDC), Royan Institute for Stem Cell Biology & Technology ACECR, Tehran, Iran
| | - Siavash Moushekhian
- Dental Research Center, Department of Endodontics, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reihaneh Shafieian
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Salari Sedigh
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Jamileh Ghoddusi
- Dental Research Center, Department of Endodontics, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
2
|
Ja'apar SAN, Ichwan SJA, Mustaffa M. In vivo cytotoxicity analysis of bioceramic root canal sealers on zebrafish embryo. J Dent Res Dent Clin Dent Prospects 2023; 17:242-249. [PMID: 38584992 PMCID: PMC10998162 DOI: 10.34172/joddd.2023.39163] [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: 03/13/2023] [Accepted: 11/13/2023] [Indexed: 04/09/2024] Open
Abstract
Background This study evaluated the cytotoxicity of four bioceramic root canal sealers (RCSs) in vivo. The embryonic zebrafish characteristics, such as mortality, survival, hatching, and general morphology, served as the parameters for assessing cytotoxicity. Methods The RCSs, namely GuttaFlow Bioseal, MTA Fillapex, CeraSeal Bioceramic, and iRoot SP, were mixed according to the manufacturer's guidelines. The extract solution was prepared by immersing the set RCS into 1X dilution of E3 solution. Then, the extract solution was delivered into a Petri dish where zebrafish embryos were allowed to develop. Cytotoxicity was evaluated 24, 48, 72, and 96 hours after fertilization. Results The Kruskal-Wallis test showed that except for GuttaFlow Bioseal, the mortality, survival, and hatching of zebrafish embryos for the remaining three bioceramic RCSs were significantly different from the negative controls (P<0.05). Significant differences were also evident in the mortality, survival, and hatching of zebrafish embryos between GuttaFlow Bioseal and three other RCSs (P<0.05). Conclusion GuttaFlow Bioseal was less cytotoxic than other bioceramics RCSs; MTA Fillapex, CeraSeal Bioceramic root canal sealer, and iRoot SP root canal sealer exhibited comparable cytotoxicity.
Collapse
Affiliation(s)
- Siti Aisyah Nadirah Ja'apar
- Department of Biotechnology, Kulliyyah of Sciences, International Islamic University Malaysia (IIUM), Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, 25200, Kuantan, Pahang, Malaysia
| | - Solachuddin Jauhari Arief Ichwan
- Department of Fundamental Dental and Medical Sciences, Kulliyyah of Dentistry (KOD), IIUM, Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, 25200, Kuantan, Pahang, Malaysia
- Dentistry Programme, PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, BE1410, Brunei
| | - Musliana Mustaffa
- Department of Restorative Dentistry, KOD, IIUM, Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, 25200, Kuantan, Pahang, Malaysia
| |
Collapse
|
3
|
Brizuela C, Meza G, Toro P, Phillips D, Cabrera C, Dezerega A, Concha G. Regenerative endodontic procedure combined with non-surgical root canal treatment in an immature permanent maxillary molar: A 7-year follow-up case report. AUST ENDOD J 2023; 49 Suppl 1:462-469. [PMID: 36533889 DOI: 10.1111/aej.12719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 12/23/2022]
Abstract
The aim of this report is to present the results of a personalised endodontic treatment for an immature molar, using regenerative endodontic procedure (REP) combined with non-surgical root canal treatment (NSRCT), with 7 years of follow-up. The tooth#3 presented combined endodontic pathologies in each root, with different pulpal and periapical status. A REP in the palatal (P) canal and a NSCRT in the mesio-buccal (MB) and disto-buccal (DB) canals were performed. Absence of clinical signs/symptoms and continuous palatal root development with apical closure were observed over 4-years. After 5-years an apical lesion in the MB root was observed. Both MB canals were selectively retreated by completely filling them with TotalFill BC RRM Fast Set putty. After 7-years, the tooth remained functional and the apical lesion was resolving. The palatal root was completely mature. This case report reveals the potential for use of combined treatment approaches for immature multirooted teeth.
Collapse
Affiliation(s)
- Claudia Brizuela
- Biology and Oral Regeneration Research Center (CIBRO), Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
- Department of Endodontics, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Gastón Meza
- Biology and Oral Regeneration Research Center (CIBRO), Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
- Department of Endodontics, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Paulina Toro
- Department of Endodontics, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Domingo Phillips
- Department of Endodontics, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Carolina Cabrera
- Department of Endodontics, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Andrea Dezerega
- Department of Endodontics, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Guillermo Concha
- Department of Endodontics, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| |
Collapse
|
4
|
Chai R, Yang X, Zhang AS. Different endodontic treatments induced root development of two nonvital immature teeth in the same patient: A case report. World J Clin Cases 2023; 11:2567-2575. [PMID: 37123304 PMCID: PMC10130992 DOI: 10.12998/wjcc.v11.i11.2567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/01/2023] [Accepted: 03/22/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Pulp revascularization is a novel way to treat immature teeth with periapical disease, and the technique has become increasingly well established in recent years. By puncturing the periapical tissue, bleeding is induced, and a blood clot is formed in the root canal. The blood clot acts as a natural bioscaffold onto which mesenchymal stem cells from periapical tissue can be seeded and restore pulp vascularity, thus promoting root development as well as apical closure. Although the effect of pulp revascularization is ideal, there are certain requirements for the apical condition of the teeth. The apical barrier technique and apexification are still indispensable for teeth that cannot achieve ideal blood clot formation. In addition, a meta-analysis of several clinical studies concluded that pulp revascularization has no significant advantages over other treatments.
CASE SUMMARY A 10-year-old girl complained of pain in the right upper and lower posterior teeth for 2 d. Clinical and radiological examinations revealed that both the right maxillary and mandibular second premolars were immature with periapical radiolucency. The right maxillary second premolar was treated by pulp revascularization, while the right mandibular second premolar was treated by conventional apical barrier surgery after revascularization failed. The purpose of this report is to compare the different root maturation processes induced by the pulp revascularization and apical barrier techniques in the same patient in homonymous teeth from different jaws. Twelve months of follow-up showed that the apical foramen of both teeth presented a clear tendency to close; however, the tooth treated with pulp revascularization showed a significant increase in root length as well as root canal wall thickness.
CONCLUSION For the treatment of nonvital immature teeth, pulp revascularization showed a superior therapeutic effect in comparison with the apical barrier technique.
Collapse
Affiliation(s)
- Rong Chai
- Department of Stomatology, Xi'an International Medical Center Hospital Affiliated to Northwest University, Xi'an 710061, Shaanxi Province, China
| | - Xiu Yang
- Department of Stomatology, Xi'an International Medical Center Hospital Affiliated to Northwest University, Xi'an 710061, Shaanxi Province, China
| | - An-Sheng Zhang
- Department of Stomatology, Xi'an International Medical Center Hospital Affiliated to Northwest University, Xi'an 710061, Shaanxi Province, China
| |
Collapse
|
5
|
Rathinam E, Rajasekharan S, Declercq H, Vanhove C, De Coster P, Martens L. Effect of Intracoronal Sealing Biomaterials on the Histological Outcome of Endodontic Revitalisation in Immature Sheep Teeth-A Pilot Study. J Funct Biomater 2023; 14:jfb14040214. [PMID: 37103304 PMCID: PMC10144940 DOI: 10.3390/jfb14040214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/17/2023] [Accepted: 04/08/2023] [Indexed: 04/28/2023] Open
Abstract
The influence of intracoronal sealing biomaterials on the newly formed regenerative tissue after endodontic revitalisation therapy remains unexplored. The objective of this study was to compare the gene expression profiles of two different tricalcium silicate-based biomaterials alongside the histological outcomes of endodontic revitalisation therapy in immature sheep teeth. The messenger RNA expression of TGF-β, BMP2, BGLAP, VEGFA, WNT5A, MMP1, TNF-α and SMAD6 was evaluated after 1 day with qRT-PCR. For evaluation of histological outcomes, revitalisation therapy was performed using Biodentine (n = 4) or ProRoot white mineral trioxide aggregate (WMTA) (n = 4) in immature sheep according to the European Society of Endodontology position statement. After 6 months' follow-up, one tooth in the Biodentine group was lost to avulsion. Histologically, extent of inflammation, presence or absence of tissue with cellularity and vascularity inside the pulp space, area of tissue with cellularity and vascularity, length of odontoblast lining attached to the dentinal wall, number and area of blood vessels and area of empty root canal space were measured by two independent investigators. All continuous data were subjected to statistical analysis using Wilcoxon matched-pairs signed rank test at a significance level of p < 0.05. Biodentine and ProRoot WMTA upregulated the genes responsible for odontoblast differentiation, mineralisation and angiogenesis. Biodentine induced the formation of a significantly larger area of neoformed tissue with cellularity, vascularity and increased length of odontoblast lining attached to the dentinal walls compared to ProRoot WMTA (p < 0.05), but future studies with larger sample size and adequate power as estimated by the results of this pilot study would confirm the effect of intracoronal sealing biomaterials on the histological outcome of endodontic revitalisation.
Collapse
Affiliation(s)
- Elanagai Rathinam
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Paediatric Dentistry, Oral Health Sciences, Ghent University Hospital, 9000 Ghent, Belgium
| | - Sivaprakash Rajasekharan
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Paediatric Dentistry, Oral Health Sciences, Ghent University Hospital, 9000 Ghent, Belgium
| | - Heidi Declercq
- Tissue Engineering and Biomaterials Group, Department of Human Structure and Repair, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
- Tissue Engineering Laboratory, Department of Development and Regeneration, KU Leuven, 8500 Kortrijk, Belgium
| | - Christian Vanhove
- Medical Imaging & Signal Processing, Infinity Laboratory, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
| | - Peter De Coster
- Department of Reconstructive Dentistry and Oral Biology, Dental School, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
| | - Luc Martens
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Paediatric Dentistry, Oral Health Sciences, Ghent University Hospital, 9000 Ghent, Belgium
| |
Collapse
|
6
|
Towards a New Concept of Regenerative Endodontics Based on Mesenchymal Stem Cell-Derived Secretomes Products. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 10:bioengineering10010004. [PMID: 36671576 PMCID: PMC9854964 DOI: 10.3390/bioengineering10010004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/09/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
The teeth, made up of hard and soft tissues, represent complex functioning structures of the oral cavity, which are frequently affected by processes that cause structural damage that can lead to their loss. Currently, replacement therapy such as endodontics or implants, restore structural defects but do not perform any biological function, such as restoring blood and nerve supplies. In the search for alternatives to regenerate the dental pulp, two alternative regenerative endodontic procedures (REP) have been proposed: (I) cell-free REP (based in revascularization and homing induction to remaining dental pulp stem cells (DPSC) and even stem cells from apical papilla (SCAP) and (II) cell-based REP (with exogenous cell transplantation). Regarding the last topic, we show several limitations with these procedures and therefore, we propose a novel regenerative approach in order to revitalize the pulp and thus restore homeostatic functions to the dentin-pulp complex. Due to their multifactorial biological effects, the use of mesenchymal stem cells (MSC)-derived secretome from non-dental sources could be considered as inducers of DPSC and SCAP to completely regenerate the dental pulp. In partial pulp damage, appropriate stimulate DPSC by MSC-derived secretome could contribute to formation and also to restore the vasculature and nerves of the dental pulp.
Collapse
|
7
|
Kumar N, Maher N, Amin F, Ghabbani H, Zafar MS, Rodríguez-Lozano FJ, Oñate-Sánchez RE. Biomimetic Approaches in Clinical Endodontics. Biomimetics (Basel) 2022; 7:biomimetics7040229. [PMID: 36546929 PMCID: PMC9775094 DOI: 10.3390/biomimetics7040229] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/19/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
In the last few decades, biomimetic concepts have been widely adopted in various biomedical fields, including clinical dentistry. Endodontics is an important sub-branch of dentistry which deals with the different conditions of pulp to prevent tooth loss. Traditionally, common procedures, namely pulp capping, root canal treatment, apexification, and apexigonesis, have been considered for the treatment of different pulp conditions using selected materials. However, clinically to regenerate dental pulp, tissue engineering has been advocated as a feasible approach. Currently, new trends are emerging in terms of regenerative endodontics which have led to the replacement of diseased and non-vital teeth into the functional and healthy dentine-pulp complex. Root- canal therapy is the standard management option when dental pulp is damaged irreversibly. This treatment modality involves soft-tissue removal and then filling that gap through the obturation technique with a synthetic material. The formation of tubular dentine and pulp-like tissue formation occurs when stem cells are transplanted into the root canal with an appropriate scaffold material. To sum up tissue engineering approach includes three components: (1) scaffold, (2) differentiation, growth, and factors, and (3) the recruitment of stem cells within the pulp or from the periapical region. The aim of this paper is to thoroughly review and discuss various pulp-regenerative approaches and materials used in regenerative endodontics which may highlight the current trends and future research prospects in this particular area.
Collapse
Affiliation(s)
- Naresh Kumar
- Department of Science of Dental Materials, Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi 74200, Pakistan
- Correspondence: ; Tel.: +92-333-2818500
| | - Nazrah Maher
- Department of Science of Dental Materials, Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi 74200, Pakistan
| | - Faiza Amin
- Department of Science of Dental Materials, Dow Dental College, Dow University of Health Sciences, Karachi 74200, Pakistan
| | - Hani Ghabbani
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
| | | | - Ricardo E. Oñate-Sánchez
- Department of Special Care in Dentistry, Hospital Morales Meseguer, IMIB-Arrixaca, University of Murcia, 30008 Murcia, Spain
| |
Collapse
|
8
|
Expert consensus on regenerative endodontic procedures. Int J Oral Sci 2022; 14:55. [PMID: 36450715 PMCID: PMC9712432 DOI: 10.1038/s41368-022-00206-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/02/2022] [Accepted: 10/09/2022] [Indexed: 12/05/2022] Open
Abstract
Regenerative endodontic procedures (REPs) is a biologic-based treatment modality for immature permanent teeth diagnosed with pulp necrosis. The ultimate objective of REPs is to regenerate the pulp-dentin complex, extend the tooth longevity and restore the normal function. Scientific evidence has demonstrated the efficacy of REPs in promotion of root development through case reports, case series, cohort studies, and randomized controlled studies. However, variations in clinical protocols for REPs exist due to the empirical nature of the original protocols and rapid advancements in the research field of regenerative endodontics. The heterogeneity in protocols may cause confusion among dental practitioners, thus guidelines and considerations of REPs should be explicated. This expert consensus mainly discusses the biological foundation, the available clinical protocols and current status of REPs in treating immature teeth with pulp necrosis, as well as the main complications of this treatment, aiming at refining the clinical management of REPs in accordance with the progress of basic researches and clinical studies, suggesting REPs may become a more consistently evidence-based option in dental treatment.
Collapse
|
9
|
Minic S, Vital S, Chaussain C, Boukpessi T, Mangione F. Tissue Characteristics in Endodontic Regeneration: A Systematic Review. Int J Mol Sci 2022; 23:ijms231810534. [PMID: 36142446 PMCID: PMC9504778 DOI: 10.3390/ijms231810534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 12/01/2022] Open
Abstract
The regenerative endodontic procedure (REP) represents a treatment option for immature necrotic teeth with a periapical lesion. Currently, this therapy has a wide field of pre-clinical and clinical applications, but no standardization exists regarding successful criteria. Thus, by analysis of animal and human studies, the aim of this systematic review was to highlight the main characteristics of the tissue generated by REP. A customized search of PubMed, EMBASE, Scopus, and Web of Science databases from January 2000 to January 2022 was conducted. Seventy-five human and forty-nine animal studies were selected. In humans, the evaluation criteria were clinical 2D and 3D radiographic examinations. Most of the studies identified a successful REP with an asymptomatic tooth, apical lesion healing, and increased root thickness and length. In animals, histological and radiological criteria were considered. Newly formed tissues in the canals were fibrous, cementum, or bone-like tissues along the dentine walls depending on the area of the root. REP assured tooth development and viability. However, further studies are needed to identify procedures to successfully reproduce the physiological structure and function of the dentin–pulp complex.
Collapse
Affiliation(s)
- Sandra Minic
- URP 2496 Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), Laboratoire d’excellence INFLAMEX, UFR Odontology, Université Paris Cité, 92120 Montrouge, France
| | - Sibylle Vital
- URP 2496 Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), Laboratoire d’excellence INFLAMEX, UFR Odontology, Université Paris Cité, 92120 Montrouge, France
- Louis Mourier Hospital, AP-HP, DMU ESPRIT, 92700 Colombes, France
| | - Catherine Chaussain
- URP 2496 Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), Laboratoire d’excellence INFLAMEX, UFR Odontology, Université Paris Cité, 92120 Montrouge, France
- Bretonneau Hospital Dental Department and Reference Center for Rare Diseases of Calcium and Phosphorus Metabolism, AP-HP, 75018 Paris, France
| | - Tchilalo Boukpessi
- URP 2496 Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), Laboratoire d’excellence INFLAMEX, UFR Odontology, Université Paris Cité, 92120 Montrouge, France
- Pitié Salpétrière Hospital, DMU CHIR, AP-HP, 75013 Paris, France
| | - Francesca Mangione
- URP 2496 Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), Laboratoire d’excellence INFLAMEX, UFR Odontology, Université Paris Cité, 92120 Montrouge, France
- Henri Mondor Hospital, AP-HP, 94000 Créteil, France
- Correspondence:
| |
Collapse
|
10
|
Iranmanesh P, Torabinejad M, Saatchi M, Toghraie D, Razavi SM, Khademi A. Effect of Duration of Root Canal Infection on the Ability of Dentin-Pulp Complex Regeneration of Immature Permanent Teeth: An Animal Study. J Endod 2022; 48:1301-1307.e2. [PMID: 35933045 DOI: 10.1016/j.joen.2022.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Persistent infection is always considered the most important reason for the failure of dentin-pulp complex regeneration. The present study aims to evaluate the effect of the duration of root canal infection (from one to twelve weeks) on the ability of dentin-pulp complex regeneration. METHODS In this animal study, 64 roots of immature premolar teeth of four dogs were randomly divided into four groups. Positive control group; eight root canals treated with regenerative endodontic procedure (REP), negative control group; 12 infected root canals, intervention groups; 36 root canals infected with supragingival plaque (one, three, six, and 12 weeks) and treated with REP, an additional positive control group; eight normal roots. After three months, the teeth were investigated by radiographic images and immunohistochemical staining (CD31, CD34, S100 markers). In addition, DSPP gene expression was assessed using a real-time PCR technique. The results were analyzed at a significance level of 0.05. RESULTS Based on radiological evaluation among the intervention groups, the highest root canal development (length and width) occurred in the intervention group of one week, and the lowest radiological results were in the intervention groups of six and 12 weeks (One-way ANOVA, P <0.05). There was a significant difference between the groups in terms of CD31, CD34, S100 and, DSPP expression percentage (One-way ANOVA, P <0.05), in which the highest and lowest expression percentages belonged to the one- and 12 weeks groups, respectively, among the intervention groups. CONCLUSION This study demonstrated that long root canal infection decreased the ability of the body to regenerate dentin-pulp complex.
Collapse
Affiliation(s)
- Pedram Iranmanesh
- Department of Endodontics, Dental Research Center, School of Dentistry, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Masoud Saatchi
- Department of Endodontics, Dental Research Center, School of Dentistry, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Davood Toghraie
- Department of Mechanical Engineering, Khomeinishahr Branch, Islamic Azad University, Khomeinishahr, Iran.
| | - Sayed Mohammad Razavi
- Department of Oral and Maxillofacial Pathology and Dental Implants Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbasali Khademi
- Department of Endodontics, Dental Research Center, School of Dentistry, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| |
Collapse
|
11
|
Alghofaily M, Torabinejad M, Nosrat A. Regenerative Endodontic Treatment Using Periapical Blood or Circulating Blood as Scaffold: A Volumetric Analysis. J Endod 2022; 48:625-631. [PMID: 35218760 DOI: 10.1016/j.joen.2022.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/26/2021] [Accepted: 01/14/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Circulating blood is a readily available scaffold when enough bleeding cannot be induced from periapical tissues during regenerative endodontic treatments (RET). The aim of this investigation was to compare the radiographic outcome, linear and 3-dimensional volumetric, of RET using periapical blood or circulating blood as scaffolds in sheep immature mandibular incisors. METHODS Thirty-two immature sheep mandibular central incisors were randomly assigned to the following groups (n=8)- Positive control: the pulps were removed without any treatment; Periapical blood: RET was performed using periapical blood as scaffold; Circulating blood: RET was performed using circulating blood as scaffold; Negative control: intact teeth without any treatment. After 8 months micro computed tomography images of mandibular blocks were taken to assess the followings: root length; root thickness at mid-root and CEJ levels; and incidence of apical closure. Root structures were segmented, and root volumes were calculated and analyzed statistically. RESULTS RET using periapical blood and circulating blood resulted in increase in root length, root wall thickness at mid-root and CEJ levels, incidence of apical closure, and root volume (P<.05). There were no significant differences between RET groups and negative control group regarding linear measurements (i.e., root length, root thickness, and apical closure) (P>.05). Root volumes of the two RET groups were similar (P>.05) and were less than those observed in negative control group (P<.05). CONCLUSIONS There were no significant radiographic differences between RET groups using periapical blood and circulating blood as scaffolds. RET resulted in less root volume compared to normal root development.
Collapse
Affiliation(s)
- Maha Alghofaily
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Ali Nosrat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Baltimore, Maryland; Centreville Endodontics, Loma Linda, Centreville, Virginia.
| |
Collapse
|
12
|
Seck A, Ndiaye D, Niang SO, Leye Benoist F, Fioretti F, Toure B. Evaluation of complete pulpotomy with Biodentine® on mature permanent molars with signs and symptoms of symptomatic irreversible pulpitis: 12 months follow-up. J Endod 2021; 48:312-319. [PMID: 34974080 DOI: 10.1016/j.joen.2021.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Complete pulpotomy is the removal of the coronal portion of a vital pulp and is a means of preserving the vitality of the remaining root portion. The objective of this study was to evaluate the 12-month success rate of complete pulpotomy with Biodentine® on mature permanent molars with signs and symptoms of symptomatic irreversible pulpitis. MATERIALS AND METHODS A total of 68 molars diagnosed with symptomatic irreversible pulpitis in 68 patients aged 20 years and older were included in this study. The exclusion criteria were intraoperative clinical signs of pulp necrosis on the molar to be treated such as no bleeding, or uncontrollable pulp hemorrhage (more than 5 min of hemostasis) on at least one canal. A complete pulpotomy with Biodentine® was performed on molars with symptomatic irreversible pulpitis by the same operator and with the same protocol. At 12-month post-operative follow-up was conducted to evaluate clinical and radiological success. RESULTS A total of 66 patients received complete pulpotomy. Fifty-two could be examined at 12 months postoperatively. Clinical and radiological analysis at 12 months postoperatively revealed a success rate of 87% (45/52 molars) and a failure rate of 13% (7/52 molars). There was a relationship between age, tooth type, pre-operative periapical condition and treatment success with P<0.05. CONCLUSION Compliance with the indications and protocol for complete pulpotomy with Biodentine® on mature permanent molars with symptomatic irreversible pulpitis gives positive results at 12 month follow-up.
Collapse
Affiliation(s)
- Anta Seck
- Department of Conservative Dentistry and Endodontics, Department of Odontostomatology, Faculty of Medicine, Pharmacy and Odontology, Cheikh Anta Diop University, Dakar, Sénégal.
| | - Diouma Ndiaye
- Department of Conservative Dentistry and Endodontics, Department of Odontostomatology, Faculty of Medicine, Pharmacy and Odontology, Cheikh Anta Diop University, Dakar, Sénégal
| | - Seydina Ousmane Niang
- Department of Conservative Dentistry and Endodontics, Department of Odontostomatology, Faculty of Medicine, Pharmacy and Odontology, Cheikh Anta Diop University, Dakar, Sénégal
| | - Fatou Leye Benoist
- Department of Conservative Dentistry and Endodontics, Department of Odontostomatology, Faculty of Medicine, Pharmacy and Odontology, Cheikh Anta Diop University, Dakar, Sénégal
| | - Florence Fioretti
- University of Strasbourg, Faculty of Dental Surgery of Strasbourg, INSERM UMR 1260, Pôle de Médecine et Chirurgie Bucco-Dentaire des Hôpitaux Universitaires de Strasbourg, France
| | - Babacar Toure
- Department of Conservative Dentistry and Endodontics, Department of Odontostomatology, Faculty of Medicine, Pharmacy and Odontology, Cheikh Anta Diop University, Dakar, Sénégal
| |
Collapse
|
13
|
Oral Cavity as a Source of Mesenchymal Stem Cells Useful for Regenerative Medicine in Dentistry. Biomedicines 2021; 9:biomedicines9091085. [PMID: 34572271 PMCID: PMC8469189 DOI: 10.3390/biomedicines9091085] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 12/17/2022] Open
Abstract
The use of mesenchymal stem cells (MSCs) for regenerative purposes has become common in a large variety of diseases. In the dental and maxillofacial field, there are emerging clinical needs that could benefit from MSC-based therapeutic approaches. Even though MSCs can be isolated from different tissues, such as bone marrow, adipose tissue, etc., and are known for their multilineage differentiation, their different anatomical origin can affect the capability to differentiate into a specific tissue. For instance, MSCs isolated from the oral cavity might be more effective than adipose-derived stem cells (ASCs) for the treatment of dental defects. Indeed, in the oral cavity, there are different sources of MSCs that have been individually proposed as promising candidates for tissue engineering protocols. The therapeutic strategy based on MSCs can be direct, by using cells as components of the tissue to be regenerated, or indirect, aimed at delivering local growth factors, cytokines, and chemokines produced by the MSCs. Here, the authors outline the major sources of mesenchymal stem cells attainable from the oral cavity and discuss their possible usage in some of the most compelling therapeutic frontiers, such as periodontal disease and dental pulp regeneration.
Collapse
|
14
|
Functional Dental Pulp Regeneration: Basic Research and Clinical Translation. Int J Mol Sci 2021; 22:ijms22168991. [PMID: 34445703 PMCID: PMC8396610 DOI: 10.3390/ijms22168991] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/12/2021] [Accepted: 08/17/2021] [Indexed: 12/12/2022] Open
Abstract
Pulpal and periapical diseases account for a large proportion of dental visits, the current treatments for which are root canal therapy (RCT) and pulp revascularisation. Despite the clinical signs of full recovery and histological reconstruction, true regeneration of pulp tissues is still far from being achieved. The goal of regenerative endodontics is to promote normal pulp function recovery in inflamed or necrotic teeth that would result in true regeneration of the pulpodentinal complex. Recently, rapid progress has been made related to tissue engineering-mediated pulp regeneration, which combines stem cells, biomaterials, and growth factors. Since the successful isolation and characterisation of dental pulp stem cells (DPSCs) and other applicable dental mesenchymal stem cells, basic research and preclinical exploration of stem cell-mediated functional pulp regeneration via cell transplantation and cell homing have received considerably more attention. Some of this effort has translated into clinical therapeutic applications, bringing a ground-breaking revolution and a new perspective to the endodontic field. In this article, we retrospectively examined the current treatment status and clinical goals of pulpal and periapical diseases and scrutinized biological studies of functional pulp regeneration with a focus on DPSCs, biomaterials, and growth factors. Then, we reviewed preclinical experiments based on various animal models and research strategies. Finally, we summarised the current challenges encountered in preclinical or clinical regenerative applications and suggested promising solutions to address these challenges to guide tissue engineering-mediated clinical translation in the future.
Collapse
|
15
|
Nagendrababu V, Kishen A, Murray PE, Nekoofar MH, de Figueiredo JAP, Priya E, Jayaraman J, Pulikkotil SJ, Jakovljevic A, Dummer PMH. PRIASE 2021 guidelines for reporting animal studies in Endodontology: explanation and elaboration. Int Endod J 2021; 54:858-886. [PMID: 33492704 DOI: 10.1111/iej.13481] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/13/2022]
Abstract
Laws and ethics require that before conducting human clinical trials, a new material, device or drug may have to undergo testing in animals in order to minimize health risks to humans, unless suitable supporting grandfather data already exist. The Preferred Reporting Items for Animal Studies in Endodontology (PRIASE) 2021 guidelines were developed exclusively for the specialty of Endodontology by integrating and adapting the ARRIVE (Animals in Research: Reporting In Vivo Experiments) guidelines and the Clinical and Laboratory Images in Publications (CLIP) principles using a validated consensus-based methodology. Implementation of the PRIASE 2021 guidelines will reduce potential sources of bias and thus improve the quality, accuracy, reproducibility, completeness and transparency of reports describing animal studies in Endodontology. The PRIASE 2021 guidelines consist of a checklist with 11 domains and 43 individual items and a flowchart. The aim of the current document is to provide an explanation for each item in the PRIASE 2021 checklist and flowchart and is supplemented with examples from the literature in order for readers to understand their significance and to provide usage guidance. A link to the PRIASE 2021 explanation and elaboration document and PRIASE 2021 checklist and flowchart is available on the Preferred Reporting Items for study Designs in Endodontology (PRIDE) website (http://pride-endodonticguidelines.org/priase/).
Collapse
Affiliation(s)
- V Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - A Kishen
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - P E Murray
- Private Consultant, Fort Lauderdale, FL, USA
| | - M H Nekoofar
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - E Priya
- Division of Children and Community Oral Health, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - J Jayaraman
- Department of Developmental Dentistry, University of Texas Health School of Dentistry, San Antonio, TX, USA
| | - S J Pulikkotil
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - A Jakovljevic
- Department of Pathophysiology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| |
Collapse
|
16
|
Abstract
A loss of organs or the destruction of tissue leaves wounds to which organisms and living things react differently. Their response depends on the extent of damage, the functional impairment and the biological potential of the organism. Some can completely regenerate lost body parts or tissues, whereas others react by forming scars in the sense of a tissue repair. Overall, the regenerative capacities of the human body are limited and only a few tissues are fully restored when injured. Dental tissues may suffer severe damage due to various influences such as caries or trauma; however, dental care aims at preserving unharmed structures and, thus, the functionality of the teeth. The dentin-pulp complex, a vital compound tissue that is enclosed by enamel, holds many important functions and is particularly worth protecting. It reacts physiologically to deleterious impacts with an interplay of regenerative and reparative processes to ensure its functionality and facilitate healing. While there were initially no biological treatment options available for the irreversible destruction of dentin or pulp, many promising approaches for endodontic regeneration based on the principles of tissue engineering have been developed in recent years. This review describes the regenerative and reparative processes of the dentin-pulp complex as well as the morphological criteria of possible healing results. Furthermore, it summarizes the current knowledge on tissue engineering of dentin and pulp, and potential future developments in this thriving field.
Collapse
|
17
|
Impact of remnant healthy pulp and apical tissue on outcomes after simulated regenerative endodontic procedure in rat molars. Sci Rep 2020; 10:20967. [PMID: 33262423 PMCID: PMC7708843 DOI: 10.1038/s41598-020-78022-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/19/2020] [Indexed: 11/13/2022] Open
Abstract
When regenerative endodontic procedures (REPs) are performed on immature teeth diagnosed with pulp necrosis and apical periodontitis, various healing patterns occur. Furthermore, infected immature teeth with endodontic disorders often exhibit some remnant pulp and apical tissue. Therefore, this study investigated the impact of remnant healthy or fully functional pulp and apical tissue on healing patterns after REPs. Simulated REPs were performed on non-infected immature rat molars with different amounts of remnant pulp and apical tissue. Healing patterns in these teeth were assessed after 28 days. Teeth with 0.81–0.91 mm of remnant pulp healed with pulp-like tissue, dentin, and osteodentin-like dentin-associated mineralized tissue (OSD-DAMT); teeth with 0.60–0.63 mm of remnant pulp healed with pulp-like tissue and OSD-DAMT; teeth with 0.13–0.43 mm of remnant pulp healed with periodontal ligament (PDL)-like tissue, OSD-DAMT, and cementum-like dentin-associated mineralized tissue (CEM-DAMT); and teeth with disorganization of pulp and apical tissues at 0.15–0.38 mm beyond the root apex healed with PDL-like tissue, CEM-DAMT, and intracanal bone (IB). Loss of Hertwig’s epithelial root sheath was observed with IB formation. These results showed that four distinct healing patterns occurred after REPs, depending on the preoperative amount of remnant healthy pulp and apical tissue.
Collapse
|
18
|
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.
Collapse
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
| |
Collapse
|
19
|
Sabeti M, Golchert K, Torabinejad M. Regeneration of Pulp-Dentin Complex in a Tooth with Symptomatic Irreversible Pulpitis and Open Apex Using Regenerative Endodontic Procedures. J Endod 2020; 47:247-252. [PMID: 33045267 DOI: 10.1016/j.joen.2020.09.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/17/2020] [Accepted: 09/22/2020] [Indexed: 12/31/2022]
Abstract
Regenerative endodontic procedures are undertaken on permanent teeth with necrotic pulps and open apices in an attempt to resolve symptoms, to allow the continued development of the root(s), and to reestablish vitality. The available histologic analysis of these teeth has, in the majority of studies, shown that true regeneration of the pulp-dentin complex is not achieved. A recent investigation using an animal model outlined a procedure wherein pulpal amputation a few millimeters short of the apex followed by evoked bleeding allowed the complete regeneration of the normal pulp-dentin complex in immature vital teeth of ferrets. By implementation of this procedure, we report successful pulp regeneration outcome evidenced by continued root development and a positive response to pulp vitality tests in a maxillary central incisor with an open apex diagnosed with symptomatic irreversible pulpitis.
Collapse
Affiliation(s)
- Mohammad Sabeti
- Advanced Specialty Program in Endodontics, University of California, San Francisco School of Dentistry, San Francisco, California.
| | - Kory Golchert
- Advanced Specialty Program in Endodontics, University of California, San Francisco School of Dentistry, San Francisco, California
| | - Mahmoud Torabinejad
- Division of Endodontics, Department of Preventative and Restorative Dental Sciences, Loma Linda University School of Dentistry, Loma Linda, California
| |
Collapse
|
20
|
|
21
|
Tzanetakis GN, Giannakoulas DG, Papanakou S, Gizani S, Lygidakis N. Regenerative endodontic therapy of immature permanent molars with pulp necrosis: a cases series and a literature review. Eur Arch Paediatr Dent 2020; 22:515-525. [PMID: 32677019 DOI: 10.1007/s40368-020-00550-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 06/30/2020] [Indexed: 02/08/2023]
Abstract
AIM To present the application and the outcome of the regenerative endodontic therapy (RET) in a series of symptomatic immature mandibular molars with pulp necrosis and apical periodontitis and to review the relevant literature for the documentation of the procedure as a potential treatment option. METHODS Three young male patients were referred with pain in the left mandibular region resulting from pulp necrosis and apical periodontitis of the first permanent molar. Regenerative endodontic approach was performed for the complete resolution of the lesions and the thickening of the apical root canal walls. The databases of Medline, Pubmed and Google Scholar were also searched for articles in which a regenerative approach has been undertaken for the endodontic management of immature permanent molars with pulp necrosis and apical periodontitis. RESULTS Follow-up examinations showed that the teeth remained functional without any signs or symptoms. Final radiographic examination at 12, 18 and 36 months, respectively, revealed complete resolution of the lesions and complete apical closure in the two out of three cases. The search of the literature revealed the existence of only 25 clinical articles in which necrotic immature molars were treated by the regenerative approach. The total number of the treated teeth were 46. CONCLUSIONS Regenerative endodontic approach may be applied in posterior non-vital molar teeth with a possible favorable outcome. However, the literature support for the documentation of the procedure as a predictable and reproducible treatment option in posterior immature molar teeth is at present limited.
Collapse
Affiliation(s)
- G N Tzanetakis
- Department of Endodontics, Dental School, University of Athens, Greece Private, 421B Mesogeion Ave., Agia Paraskevi, 15343, Athens, Greece.
| | - D G Giannakoulas
- Department of Endodontics, Dental School, University of Athens, Greece Private, 421B Mesogeion Ave., Agia Paraskevi, 15343, Athens, Greece
| | - S Papanakou
- Department of Paediatric Dentistry, Dental School, University of Athens, Greece Private, Athens, Greece
| | - S Gizani
- Department of Paediatric Dentistry, Dental School, University of Athens, Greece Private, Athens, Greece
| | - N Lygidakis
- Department of Paediatric Dentistry, Dental School, University of Athens, Greece Private, Athens, Greece
| |
Collapse
|
22
|
Hsieh SC, Teng NC, Chu CC, Chu YT, Chen CH, Chang LY, Hsu CY, Huang CS, Hsiao GYW, Yang JC. The Antibacterial Efficacy and In Vivo Toxicity of Sodium Hypochlorite and Electrolyzed Oxidizing (EO) Water-Based Endodontic Irrigating Solutions. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E260. [PMID: 31936078 PMCID: PMC7013798 DOI: 10.3390/ma13020260] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/01/2020] [Accepted: 01/03/2020] [Indexed: 11/24/2022]
Abstract
The objective of this study was to evaluate the antibacterial efficacy against Enterococcus faecalis and Streptococcus mutans and in vivo toxicity using embryonic zebrafish assays of sodium hypochlorite (NaOCl) and electrolyzed oxidizing (EO) water (containing hypochlorous acid (HOCl))-based root canal irrigating solutions. METHODOLOGY Using 100 μL microbial count of 1 × 108 cfu/mL Enterococcus faecalis to mix with each 10 mL specimen of NaOCl or HOCl for designed time periods. The above protocol was also repeated for Streptococcus mutans. The concentration of viable microorganisms was estimated based on each standardized inoculum using a plate-count method. Zebrafish embryo assays were used to evaluate acute toxicity. RESULTS All the HOCl or NaOCl treatment groups showed > 99.9% antibacterial efficacy against Enterococcus faecalis and Streptococcus mutans. Zebrafish embryos showed almost complete dissolution in 1.5% NaOCl within 5 min. Both survival rates after being treated with 0.0125% and 0.0250% HOCl for 0.5 min or 1.0 min were similar to that of E3 medium. CONCLUSIONS Both NaOCl and HOCl revealed similar antibacterial efficacy (> 99.9%) against Enterococcus faecalis and Streptococcus mutans. While 1.5% NaOCl fully dissolved the Zebrafish embryos, both 0.0125% and 0.0250% HOCl showed little in vivo toxicity, affirming its potential as an alternative irrigation solution for vital pulp therapy.
Collapse
Affiliation(s)
- Sung-Chih Hsieh
- School of Dentistry, Taipei Medical University, Taipei 110-52, Taiwan; (S.-C.H.); (N.-C.T.); (C.-S.H.); (G.Y.-W.H.)
| | - Nai-Chia Teng
- School of Dentistry, Taipei Medical University, Taipei 110-52, Taiwan; (S.-C.H.); (N.-C.T.); (C.-S.H.); (G.Y.-W.H.)
| | - Chia Chun Chu
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-52, Taiwan; (C.C.C.); (Y.-T.C.); (C.-H.C.); (L.-Y.C.); (C.-Y.H.)
| | - You-Tai Chu
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-52, Taiwan; (C.C.C.); (Y.-T.C.); (C.-H.C.); (L.-Y.C.); (C.-Y.H.)
| | - Chung-He Chen
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-52, Taiwan; (C.C.C.); (Y.-T.C.); (C.-H.C.); (L.-Y.C.); (C.-Y.H.)
| | - Liang-Yu Chang
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-52, Taiwan; (C.C.C.); (Y.-T.C.); (C.-H.C.); (L.-Y.C.); (C.-Y.H.)
| | - Chieh-Yun Hsu
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-52, Taiwan; (C.C.C.); (Y.-T.C.); (C.-H.C.); (L.-Y.C.); (C.-Y.H.)
| | - Ching-Shuan Huang
- School of Dentistry, Taipei Medical University, Taipei 110-52, Taiwan; (S.-C.H.); (N.-C.T.); (C.-S.H.); (G.Y.-W.H.)
| | - Grace Ying-Wen Hsiao
- School of Dentistry, Taipei Medical University, Taipei 110-52, Taiwan; (S.-C.H.); (N.-C.T.); (C.-S.H.); (G.Y.-W.H.)
| | - Jen-Chang Yang
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-52, Taiwan; (C.C.C.); (Y.-T.C.); (C.-H.C.); (L.-Y.C.); (C.-Y.H.)
- Research Center of Biomedical Device, Taipei Medical University, Taipei 110-52, Taiwan
- International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-52, Taiwan
- Research Center of Digital Oral Science and Technology, Taipei Medical University, Taipei 110-52, Taiwan
| |
Collapse
|
23
|
Lin LM, Ricucci D, Saoud TM, Sigurdsson A, Kahler B. Vital pulp therapy of mature permanent teeth with irreversible pulpitis from the perspective of pulp biology. AUST ENDOD J 2019; 46:154-166. [DOI: 10.1111/aej.12392] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2019] [Indexed: 01/07/2023]
Affiliation(s)
- Louis M. Lin
- Department of Endodontics New York University College of Dentistry New York New York USA
| | | | - Tarek M. Saoud
- Department of Restorative Dentistry and Endodontics Faculty of Dentistry University of Benghazi Benghazi Libya
| | - Asgeir Sigurdsson
- Department of Endodontics New York University College of Dentistry New York New York USA
| | - Bill Kahler
- The University of Queensland School of Dentistry Brisbane Queensland Australia
| |
Collapse
|
24
|
Digka A, Sakka D, Lyroudia K. Histological assessment of human regenerative endodontic procedures (
REP
) of immature permanent teeth with necrotic pulp/apical periodontitis: A systematic review. AUST ENDOD J 2019; 46:140-153. [DOI: 10.1111/aej.12371] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Anna Digka
- Department of Endodontology School of Dentistry Aristotle University of Thessaloniki Thessaloniki Greece
| | - Dimitra Sakka
- Department of Endodontology School of Dentistry Aristotle University of Thessaloniki Thessaloniki Greece
| | - Kleoniki Lyroudia
- Department of Endodontology School of Dentistry Aristotle University of Thessaloniki Thessaloniki Greece
| |
Collapse
|