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Alquria TA, Acharya A, Kabir B, Griffin IL, Tordik PA, Martinho FC. Clinical Investigation of Bacteriome in Primary Endodontic Infections with Apical Periodontitis. J Endod 2024:S0099-2399(24)00438-2. [PMID: 39147018 DOI: 10.1016/j.joen.2024.07.016] [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: 01/20/2024] [Revised: 06/07/2024] [Accepted: 07/05/2024] [Indexed: 08/17/2024]
Abstract
INTRODUCTION This study characterized the bacteriome in primary endodontic infection (PEI) with apical periodontitis (AP), identified core and rare bacteriome species and community diversity metrics, and analyzed the relationship between the bacteriome composition, diversity and features, and patient variables. METHODS Twenty-seven patients with PEI and AP were sampled. The DNA was extracted and quantified using qPCR. Raw V3-V4 amplicon sequencing data were processed with the DADA2 pipeline to generate amplicon sequence variants (ASVs), and taxonomic assignment of the ASVs up to the species level was done against the HOMD. Core bacteriome and differential abundance analyses were performed using ANCOM. Alpha diversity was determined using Chao1, Shannon, and Simpson indexes. LeFse analysis was used to identify abundant taxa. SECOM analysis estimated linear and nonlinear relationships among bacteria. RESULTS 24/27 root canal samples were analyzed, and 3 RCS were filtered out with a low read count. The bacterial phyla with top mean relative abundance were Bacteroidetes, Firmicutes, Synergistetes, Fusobacteria, and Actinobacteria. A total of 113 genera and 215 species were identified. The samples were gathered into three clusters. LeFse analysis identified differences in abundant taxa between distinct age, gender, symptomatology, and lesion size groups. SECOM distance analysis indicatedSlackia exiguaas the node with the highest degree. CONCLUSIONS The bacteriome in PEI with AP among the patients in this study was complex and displayed high microbial heterogeneity. Moreover, age, gender, symptomatology, and lesion size were associated with differences in bacteriome features in PEI with AP.
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Affiliation(s)
- Theeb A Alquria
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, US; Department of Restorative Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Aneesha Acharya
- Department of Periodontics and Oral Implantology, Dr D.Y. Patil Dental College and Hospital, Dr D Y Patil Vidyapeeth - Pune - India; Assistant Professor, Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong - SAR Hong Kong
| | - Binait Kabir
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Ina L Griffin
- Clinical Assistant Professor - Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Patricia A Tordik
- Clinical Associate Professor - Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Frederico C Martinho
- Clinical Associate Professor - Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland.
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Alquria TA, Acharya A, Tordik P, Griffin I, Martinho FC. Impact of root canal disinfection on the bacteriome present in primary endodontic infection: A next generation sequencing study. Int Endod J 2024; 57:1124-1135. [PMID: 38700876 DOI: 10.1111/iej.14074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 07/03/2024]
Abstract
AIM To investigate the bacteriome present in teeth with primary endodontic infection (PEI) and apical periodontitis (AP) and to determine quantitatively and qualitatively the impact of chemomechanical preparation (CMP) using 2.5% sodium hypochlorite NAOCl on the bacteriome found in PEI with AP using the Illumina MiSeq platform. METHODOLOGY Thirty-six paired samples from 18 patients were successfully sequenced and analysed. Samples were collected at two sampling times: before (s1) and after (s2) CMP using 2.5% NaOCl. The DNA was extracted from s1 and s2 samples and quantified using quantitative PCR (qPCR). All 36 samples were sequenced using the Illumina MiSeq platform. Raw V3-V4 amplicon sequencing data were processed with the DADA2 pipeline to generate amplicon sequence variants (ASVs). Alpha diversity metrics representing abundance (Chao1) and diversity and evenness (Shannon, Simpson) were computed. The paired-sample Wilcoxon's test was used to compare alpha diversity metrics and qPCR counts between s1 and s2. The PERMANOVA method (with 999 permutations) was applied to compare community composition between sample types (s1 versus s2) and between patient IDs. ALDEx2 (ANOVA-like differential expression tool for high-throughput sequencing data) to investigate differentially abundant taxa between s1 and s2. A paired-sample Wilcoxon's test was used to compare alpha diversity metrics and qPCR counts between s1 and s2. RESULTS The qPCR counts were significantly higher in s1 compared to s2 (p = .0007). The Chao1 index indicated no difference in alpha diversity (p < .7019); whereas Shannon (p = .0056) and Simpson (p = .02685) indexes showed higher values in s2. The PERMANOVA test using Adonis2 showed a significant effect of sample time on community composition (R2 = .0630, p = .012). Patient ID also showed a significant effect on community composition (R2 = .6961, p = .001). At the genus level, Dialister, Mogibacterium, Prevotella, and Olsenella were differentially enriched at s1, while Actinomyces, Stenotrophomonas_unclassified, Enterococcus_unclassified, and Actinomyces_unclassified were differentially enriched in s2. CONCLUSION The bacteriome present in teeth with PEI with AP is complex and diverse. CMP using 2.5% NaOCl showed a high quantitatively and qualitatively disinfectant impact on the bacteriome present in PEI with AP.
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Affiliation(s)
- Theeb Abdullah Alquria
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Aneesha Acharya
- Department of Periodontics and Oral Implantology, Dr D.Y. Patil Dental College and Hospital, Dr D Y Patil Vidyapeeth, Pune, India
- Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Patricia Tordik
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Ina Griffin
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Frederico C Martinho
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
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Elheeny AAH, Hussien OSE, Abdelmotelb MA, ElMakawi YM, Wahba NKO. A 12-month randomized controlled trial to assess the efficacy of revitalization of retreated mature incisors with periapical radiolucency in adolescents. Sci Rep 2024; 14:16366. [PMID: 39013938 DOI: 10.1038/s41598-024-66305-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 07/01/2024] [Indexed: 07/18/2024] Open
Abstract
The use of regenrative endodontics is restoring the health status of the root canals of retreated mature teeth is a novel approach. Therefore, the current trial aimed to compare the effectiveness of regenerative endodontic procedures (REPs) to non-surgical root canal retreatment (NS-RCR) in reducing periapical radiolucency over one year for the retreatment of mature incisors with periapical periodontitis. The secondary purpose was to assess clinical success and regain pulp sensibility. A parallel randomized controlled trial, 66 mature incisors with periapical radiolucencies were randomly divided into two equal groups and retreated with either REPs or NS-RCR. At baseline and after 6 and 12 months, teeth were assessed clinically and radiographically using a periapical index (PAI). The Mann-Whitney test was used to analyze nonparametric PAI scores. The Electric pulp test readings were analyzed using the repeated measure analysis of variance (ANOVA). Over the follow-up intervals, there was no significant intergroup difference in the PAI medians, the majority of the teeth displayed a reduction in periapical radiolucency. At the end of the follow-up period, the clinical successes for the REP and NS-RCR groups were 93.9% and 97%, respectively (p = 0.555). Positive pulp sensibility was recorded in 54.54% of cases in the REPs after 12 months. Both approaches showed a comparable diminishing of periapical radiolucencies and equivalent clinical results. A conventional, non-surgical endodontic retreatment may not always be necessary.
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Affiliation(s)
- Ahmad Abdel Hamid Elheeny
- Paediatric and Community Dentistry, Faculty of Dentistry, Minia University, Ard Shalaby, El Minia, Minya, 61519, Egypt.
| | | | | | - Yassmin Mohamed ElMakawi
- Paediatric and Community Dentistry, Faculty of Oral and Dental Medicine, Nahda University, New Bani Suef, Egypt
| | - Norhan Khaled Omar Wahba
- Paediatric and Community Dentistry, Faculty of Oral and Dental Medicine, Nahda University, New Bani Suef, Egypt
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Kahler B, Lu J, Taha NA. Regenerative endodontic treatment and traumatic dental injuries. Dent Traumatol 2024. [PMID: 38989999 DOI: 10.1111/edt.12979] [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: 03/15/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 07/12/2024]
Abstract
Pulp necrosis is the most common complication following dental trauma and is often associated with apical periodontitis. The management of these teeth is challenging in terms of large root canals, open apices, thin dentinal walls, and short roots. Over decades the conventional treatment for these teeth was calcium hydroxide apexification, a time-consuming procedure despite high success rates. Subsequently after the introduction of mineral trioxide aggregate and hydraulic calcium silicate materials single visit apical plug procedures became increasingly practiced with comparable success rates to the conventional apexification. The search continued afterward for a clinical procedure that may stimulate further root development and apical closure to avoid the long-term complication of root fracture after apexification. Regenerative procedures using stem cells derived from the apical papilla and blood clots as scaffolds were then introduced for the management of immature teeth, with variable protocols and success rates. This review will cover the evidence available and current position of regenerative endodontic procedures in traumatized immature teeth with apical periodontitis, in terms of clinical protocols, outcome, and potential prognostic factors.
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Affiliation(s)
- Bill Kahler
- Department of Restorative and Reconstructive Dentistry, School of Dentistry, University of Sydney, Camperdown, New South Wales, Australia
| | - Jing Lu
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Nessrin A Taha
- Conservative Dentistry Department, Jordan University of Science and Technology, Irbid, Jordan
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Alghofaily M, Almana A, Alrayes J, Lambarte R, Weir MD, Alsalleeh F. Chitosan-Gelatin Scaffolds Loaded with Different Antibiotic Formulations for Regenerative Endodontic Procedures Promote Biocompatibility and Antibacterial Activity. J Funct Biomater 2024; 15:186. [PMID: 39057307 PMCID: PMC11278440 DOI: 10.3390/jfb15070186] [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: 05/13/2024] [Revised: 06/17/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND This study investigated the biocompatibility and antibacterial efficacy of chitosan-gelatin (CH-G) scaffolds loaded with slow-releasing antibiotic formulations used in regeneration endodontic procedures (REPs). METHODS Scaffolds were fabricated using freeze drying and loaded with varying concentrations of augmentin or modified triple antibiotic paste (mTAP). High-resolution scanning electron microscopy (SEM) was used to characterize the scaffold, while drug release was monitored via UV-Vis spectrophotometry. Immortalized human mesenchymal stem cells (hMSCs) were cultured on CH-G scaffolds alone (control), either 0.1 mg/mL or 1 mg/mL of augmentin or mTAP, and 10 mg/mL calcium hydroxide (Ca(OH)2). Cell viability and proliferation were assessed using the Alamar Blue assay and SEM, respectively, and live/dead staining further corroborated cell viability. Antibacterial activity against Enterococcus faecalis was evaluated using the MTT assay and confocal laser scanning microscopy (CLSM). RESULTS Augmentin at 0.1 mg/mL appeared to promote better cell growth and attachment within the scaffolds than all other formulations, exhibiting acceptable viability. SEM revealed improved cell attachment in augmentin and mTAP groups compared to the Ca(OH)2 group. Augmentin at 1 mg/mL and mTAP groups significantly reduced viable bacteria compared to controls. Augmentin groups and mTAP at 1 mg/mL were highly effective in eliminating E. faecalis biofilms, with mTAP potentially causing more cell death within the remaining biofilm structures. CONCLUSIONS This study suggests that CH-G scaffolds loaded with augmentin and mTAP, particularly at a concentration of 1 mg/mL, offer promising advantages for REPs due to their biocompatibility, antibacterial efficacy, and ability to promote cell attachment. Further research may explore the long-term effects in clinical settings.
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Affiliation(s)
- Maha Alghofaily
- Restorative Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Aljowhara Almana
- College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia; (A.A.); (J.A.)
| | - Jenan Alrayes
- College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia; (A.A.); (J.A.)
| | - Rhodanne Lambarte
- Molecular and Cell Biology Laboratory, King Saud University Medical City, P.O. Box 60169, Riyadh 11545, Saudi Arabia;
| | - Michael D. Weir
- Department of Biomaterials and Regenerative Dental Medicine, University of Maryland School of Dentistry, Baltimore, MD 21201, USA;
| | - Fahd Alsalleeh
- Restorative Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
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Vieira WDA, de-Jesus-Soares A, Lopes EM, Gomes BPFA, Lima BP. Effect of supplementary sodium hypochlorite agitation techniques on an ex vivo oral multispecies biofilm during passive disinfection of simulated immature roots. Int Endod J 2024; 57:966-980. [PMID: 38387884 DOI: 10.1111/iej.14053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 02/24/2024]
Abstract
AIM To compare the effect of different sodium hypochlorite (NaOCl) agitation techniques on an ex vivo oral multispecies biofilm during passive disinfection of simulated immature roots. METHODOLOGY Extracted human teeth were prepared to simulate immature roots. They were infected with a dental plaque-derived multispecies biofilm and cultured for 14 days. The roots were randomly designated into four groups: (1) negative control (PBS), (2) 1.5% NaOCl (CNI), (3) CNI + Ultrasonic activation (UA), (4) CNI + EasyClean agitation (ECA), (5) CNI + XP-endo finisher agitation (XPF), and (6) positive control (6% NaOCl). Biofilm samples were collected from the root canals and used to determine the number of viable cells (colony-forming units), scanning electron microscopy, and 16S rRNA gene sequencing. The mean colony-forming units per mL (CFU/mL) were analysed using One-way anova. 16S rRNA sequencing data were analysed for alpha (observed OTUs, Shannon index, and Chao1) and beta diversity (Bray-Curtis dissimilarities). The LEfSe analysis was used to determine the effect of treatment procedures on the abundance of root canal microbiota. The significance was set at .05. RESULTS PBS and CNI samples had significantly higher CFU/mL counts than UA, ECA, XPF, and 6% NaOCl samples (p < .05). The pre-treatment, PBS, and CNI groups had significantly greater alpha diversity than the UA, ECA, XPF, and 6% NaOCl groups (p < .05). NaOCl agitation groups and the 6% NaOCl group achieved a more pronounced reduction in bacteria from the genera Fusobacterium, Actinomyces, Porphyromonas, and Capnocytophaga. CONCLUSIONS The effectiveness of passive disinfection protocols was enhanced by NaOCl agitation techniques, suggesting that this supplementary method can improve the outcome of revitalization procedures.
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Affiliation(s)
- Walbert de Andrade Vieira
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, Brazil
| | - Adriana de-Jesus-Soares
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, Brazil
| | - Erica M Lopes
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, Brazil
| | - Brenda P F A Gomes
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, Brazil
| | - Bruno P Lima
- Division of Basic Sciences, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
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Park KH, Ordinola-Zapata R, Noblett WC, Lima BP, Staley C. The effect of ultrasonic and multisonic irrigation on root canal microbial communities: An ex vivo study. Int Endod J 2024; 57:895-906. [PMID: 37983635 DOI: 10.1111/iej.13996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/22/2023]
Abstract
AIM To analyse the effect of ultrasonic irrigant activation (UIA) and the GentleWave (GW) multisonic irrigation (GW) with minimal instrumentation on the root canal microbial diversity in an ex vivo model that used extracted molars with a history of pulp necrosis. METHODOLOGY Twenty-three mandibular molars were prepared ex vivo for collection of superficial (surface control), pre-treatment and post-treatment samples 24 h after extraction. Samples were divided into two groups: UIA using 6% NaOCl (n = 11) and GW group (n = 12). All samples were processed using quantitative real-time polymerase chain reaction (qPCR) and 16S rRNA next-generation sequencing to measure microbial diversity before and after the antimicrobial treatment. For qPCR, a t-test (α = .05) was used to compare the log10 reduction. The Chao1 and Shannon indices evaluated alpha diversity. Differences in community composition (beta diversity) were evaluated by analysis of similarity (ANOSIM). Kruskal-Wallis test with Bonferroni corrections was performed to evaluate the differences in abundances genera in the samples. RESULTS Quantitative real-time polymerase chain reaction revealed an estimated 1.6 and 2.6 log10 reduction for UIA and GW groups respectively (p = .048). An average of 5 ± 4 and 3 ± 5 operational taxonomic units (OTUs) were found in surface's samples in the UIA and GW group respectively. These values were significantly lower (p < .001) compared to the number of preoperative OTUs in those groups (155 ± 79 and 187 ± 121). In assessing beta diversity, there were no significant differences found in pre-treatment samples (R = .090, p = .070 ANOSIM with Bonferroni corrections). Also, no significant differences in community composition were observed in post-treatment samples (R = -.05, p = .829). After treatment, there was a significant reduction of Eubacterium using conventional treatment with UIA and a significant reduction of Prevotella using minimal instrumentation with GW irrigation (p = .007 and p = .002 respectively). CONCLUSION Quantitative PCR analysis revealed a significant reduction in microbial load for GW group. Overall, diversity changes were similar between UIA and GW irrigation in this ex vivo model that used extracted teeth with a history of pulp necrosis. OTUs obtained from the surface sample were negligible and did not affect the statistical outcome of the study.
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Affiliation(s)
- Ki Hong Park
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ronald Ordinola-Zapata
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - W Craig Noblett
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Bruno P Lima
- Division of Basic Sciences, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christopher Staley
- Division of Basic & Translational Research, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
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Leveque M, Guittat M, Thivichon-Prince B, Reuzeau A, Eveillard M, Faure M, Farges JC, Richert R, Bekhouche M, Ducret M. Next generation antibacterial strategies for regenerative endodontic procedures: A scoping review. Int Endod J 2024; 57:804-814. [PMID: 37485747 DOI: 10.1111/iej.13958] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND The clinical results following regenerative endodontic procedures (REPs) vary according to numerous parameters, including the presence of bacteria. This limitation reduces the indications for REPs and calls for the development of next generation antibacterial strategies (NGAS) providing alternatives to current antibacterial strategies (CAS) such as double or triple antibiotic paste (DAP/TAP) and (Ca(OH)2). OBJECTIVES The present scoping review aims to describe the current trends regarding the use of such strategies and highlight future perspectives. METHODS Four databases (PUBMed, Cochrane, ClinicalTrials and Science Direct) were searched until 1st May 2023. RESULTS A total of 918 records were identified, 133 were screened and assessed for eligibility, and 87 articles were included. The findings show that (1) clinical studies are only available for CAS, (2) although next generation strategies are the most studied approach since 2017, they are all at the pre-clinical stage, (3) most of the next generation strategies use galenic forms which offer cell support and colonization and which simultaneously contain antibacterial molecules as alternatives to CAS and to antibiotics in general, (4) standardization is required for future research, specifically regarding the bacterial strains studied, the use of biofilm studies and the cellular behaviour assessments. CONCLUSION Although NGAS are promising strategies to improve REPs in the context of infection, the current evidence is mostly limited to pre-clinical studies. Further methodological improvement is required to allow relevant comparisons between studies and to reduce the time from bench to bedside.
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Affiliation(s)
- Marianne Leveque
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/Université Claude Bernard Lyon 1, Lyon, France
| | - Marie Guittat
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Lyon, France
- Service d'Odontologie, Hospices Civils de Lyon, Lyon, France
| | - Béatrice Thivichon-Prince
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/Université Claude Bernard Lyon 1, Lyon, France
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Lyon, France
- Service d'Odontologie, Hospices Civils de Lyon, Lyon, France
| | - Alicia Reuzeau
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/Université Claude Bernard Lyon 1, Lyon, France
| | - Matthieu Eveillard
- Département de Biologie des Agents Infectieux, CHU Angers, Angers, France
- Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, INCIT, Angers, France
| | - Marjorie Faure
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/Université Claude Bernard Lyon 1, Lyon, France
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Lyon, France
- Service d'Odontologie, Hospices Civils de Lyon, Lyon, France
| | - Jean-Christophe Farges
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/Université Claude Bernard Lyon 1, Lyon, France
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Lyon, France
- Service d'Odontologie, Hospices Civils de Lyon, Lyon, France
| | - Raphaël Richert
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Lyon, France
- Service d'Odontologie, Hospices Civils de Lyon, Lyon, France
- Laboratoire de Mécanique Des Contacts et Structures, CNRS/INSA, Villeurbanne, France
| | - Mourad Bekhouche
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/Université Claude Bernard Lyon 1, Lyon, France
| | - Maxime Ducret
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/Université Claude Bernard Lyon 1, Lyon, France
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Lyon, France
- Service d'Odontologie, Hospices Civils de Lyon, Lyon, France
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Botero T, Chrepa V, Shrestha A, Gibbs J, Hezaimi KA, Law A, Sedgley C, Hargreaves KM. Web-Based Survey on Regenerative Endodontic Practices among Members of the American Association of Endodontists. J Endod 2024:S0099-2399(24)00340-6. [PMID: 38906528 DOI: 10.1016/j.joen.2024.05.016] [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: 02/21/2024] [Accepted: 05/23/2024] [Indexed: 06/23/2024]
Abstract
INTRODUCTION The American Association of Endodontics (AAE) Regenerative Endodontics Committee reports here the web-based survey data of regenerative endodontic procedures performed by the AAE members from 2008 to 2019. METHODS The web-based survey consisted of 2 questionnaires, a revascularization and a follow-up, including clinical and radiographic data at 3, 6, 12 or >12 months after treatment. Data from demographics, etiology, clinical protocols, radiographic, and clinical outcome as perceived by the clinicians were recorded. From 927 entries, 184 full cases were submitted and 126 were suitable for radiographic analysis. The data were divided into cases with 6-12 months and cases with >12 months recall time. Descriptive statistics and univariate analyses were performed. RESULTS Predominantly patients were male (63%), average 10 years-old with anterior teeth (77.2%) due to trauma (69.6%). A wide variation in regenerative endodontic procedures protocols was reported by the AAE members. The most common clinical protocols used minimal instrumentation (75.5%), 2.5% or higher concentrations of sodium hypochlorite (83.7%), and antibiotic paste as intracanal medication (58.7%). The majority reported blood clot formation (56%) and most common coronal capping material was white mineral trioxide aggregates (50.5%). Increases in radiographic root length, and radiographic root area were proportional to the time lapsed after treatment. Overall, case outcomes were categorized by clinicians as successful (54.3%), uncertain (23.9%), and unsuccessful (3.8%). CONCLUSIONS This web-based survey provides a valuable perspective on case selection, clinical protocols, and perceived outcomes for regenerative endodontic procedures and supports the need for future higher level evidence studies.
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Affiliation(s)
- Tatiana Botero
- Cariology, Restorative Sciences and Endodontics Department, School of Dentistry, University of Michigan, Ann Arbor, Michigan.
| | - Vanessa Chrepa
- Department of Endodontics, Rutgers School of Dental Medicine, Newark, New Jersey
| | - Annie Shrestha
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Gibbs
- Division of Endodontics in Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mississippi
| | - Khalid Al Hezaimi
- Department of Endodontics and Periodontics, University of Southern California, Los Angeles, California
| | - Alan Law
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota; Private Practice, Lake Elmo, Minnesota
| | - Christine Sedgley
- Department of Endodontology, School of Dentistry, Oregon Health and Science University, Portland, Oregon
| | - Kenneth M Hargreaves
- Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Wikström A, Romani Vestman N, Rakhimova O, Lazaro Gimeno D, Tsilingaridis G, Brundin M. Microbiological assessment of success and failure in pulp revitalization: a randomized clinical trial using calcium hydroxide and chlorhexidine gluconate in traumatized immature necrotic teeth. J Oral Microbiol 2024; 16:2343518. [PMID: 38665416 PMCID: PMC11044761 DOI: 10.1080/20002297.2024.2343518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Aim To compare differences in the disinfection efficacy of calcium hydroxide (CH) and chlorhexidine gluconate (CHD) dressings in pulp revitalization (PR) of traumatized immature necrotic teeth; to investigate the microflora in successful/failed PR and whether bacterial persistence influences the outcomes of PR. Methods Microbiological assessment of the average bacterial load (CFU/sample) and bacterial diversity (taxa/sample) was performed on 41 teeth at three timepoints (S2-before, S3-after debridement and S5- after root canal dressing). Results The primary microflora was more diverse in successful cases than in failed. Decreases in CFU/sample and taxa/sample occurred S2 - S3, though new increases occurred at S5 in the CHD subgroup (successful and failed) and CFU/sample in the CH subgroup (failed). At S5, the successful cases showed more bacterial decreases. No specific species was associated with the outcomes with no statistical differences between the disinfection efficacy. Conclusions There were no statistical differences in CH and CHD efficacy. At S5, microflora persisted in both successful and failed outcomes, but the abundance and diversity increased significantly only in the failed cases. The successful outcomes presented higher diversity and higher decreases of the primary microflora at S5 than the failed outcomes. The abundance and diversity increased significantly at S5 only in failed cases.
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Affiliation(s)
- Alina Wikström
- Division of Orthodontics and Paediatric Dentistry, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Endodontics, Public Dental Health Services, Eastmaninstitutet, Stockholm, Sweden
- Centre of Paediatric Oral Health, Huddinge, Sweden
| | - Nelly Romani Vestman
- Department of Odontology, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | | | - David Lazaro Gimeno
- Department of Plant Physiology, Umeå Plant Science Centre, Umeå University, Umeå, Sweden
| | - Georgios Tsilingaridis
- Division of Orthodontics and Paediatric Dentistry, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
- Centre of Paediatric Oral Health, Huddinge, Sweden
| | - Malin Brundin
- Department of Odontology, Umeå University, Umeå, Sweden
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11
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Zou X, Zheng X, Liang Y, Zhang C, Fan B, Liang J, Ling J, Bian Z, Yu Q, Hou B, Chen Z, Wei X, Qiu L, Chen W, He W, Xu X, Meng L, Zhang C, Chen L, Deng S, Lei Y, Xie X, Wang X, Yu J, Zhao J, Shen S, Zhou X, Yue L. Expert consensus on irrigation and intracanal medication in root canal therapy. Int J Oral Sci 2024; 16:23. [PMID: 38429299 PMCID: PMC10907616 DOI: 10.1038/s41368-024-00280-5] [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: 11/05/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 03/03/2024] Open
Abstract
Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment. However, irrigant selection or irrigation procedures are far from clear. The vapor lock effect in the apical region has yet to be solved, impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes. Additionally, ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified. Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes. Indeed, clinicians have been aware of these concerns for years. Based on the current evidence of studies, this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions. The evolution of different kinetic irrigation methods, their effects, limitations, the paradigm shift, current indications, and effective operational procedures regarding intracanal medication are also discussed. This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication, thus facilitating a better understanding of infection control, standardizing clinical practice, and ultimately improving the success of endodontic therapy.
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Affiliation(s)
- Xiaoying Zou
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
- Center of Stomatology, Peking University Hospital, Beijing, China
| | - Xin Zheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuhong Liang
- Department of Emergency, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Chengfei Zhang
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Bing Fan
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jingping Liang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Clinical Research Center for Oral Diseases; National Center for Stomatology; Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology , Guangzhou, China
| | - Zhuan Bian
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qing Yu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xián, China
| | - Benxiang Hou
- Center for Microscope Enhanced Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Zhi Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xi Wei
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology , Guangzhou, China
| | - Lihong Qiu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Wenxia Chen
- College & Hospital of Stomatology, Guangxi Medical University, Nanning, China
| | - Wenxi He
- Department of Stomatology, Air Force Medical Center, The Air Force Medical University, Beijing, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liuyan Meng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chen Zhang
- Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Liming Chen
- Department of Endodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - Shuli Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yayan Lei
- Department of Endodontics, the Affiliated Stomatological Hospital of Kunming Medical University, Kunming, China
| | - Xiaoli Xie
- Department of Endodontology, Hunan Xiangya Stomatological Hospital, Central South University, Changsha, China
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Jinhua Yu
- Institute of Stomatology, Nanjing Medical University & Department of Endodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Jin Zhao
- Department of Endodontics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Song Shen
- Center of Stomatology, Peking University Hospital, Beijing, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
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Chan CY, Vishwanath V, Cheung HY, Cheng YTJ, Ki K, Airis Mok HM, Pudipeddi A, Lee AHC, Cheung GSP, Neelakantan P. Tissue Stabilization, Bacterial Adhesion, and Stem Cell Viability in Trans-cinnamaldehyde-conditioned Dentin. J Endod 2023; 49:1634-1640. [PMID: 37793567 DOI: 10.1016/j.joen.2023.09.011] [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: 07/14/2023] [Revised: 09/11/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023]
Abstract
INTRODUCTION This laboratory study aimed to evaluate the effect of trans-cinnamaldehyde (TC) conditioning on dentin tissue stabilization, bacterial adhesion, and stem cell toxicity. METHODS Dentin beams (n = 204) from extracted human molars were demineralized in phosphoric acid and treated with TC (2.5, 5, and 7.5%), 50% ethanol-water mixture (vehicle control) or 2.5% glutaraldehyde (GA) (positive control) for 30 minutes. Demineralized but untreated specimens served as the negative control. After treatment, collagen crosslinking was characterized by measuring the elastic modulus (Er) and hardness (n = 5). Biodegradation resistance was examined by determining the loss of dry mass (n = 8), hydroxyproline release (n = 4) and scanning electron microscopy (n = 2), after exposure to bacterial collagenase. Inhibition of bacterial adhesion was investigated by colony counting assay (n = 12) and scanning electron microscopy (n = 2). Viability of stem cells of the apical papilla on TC-conditioned dentin was determined using the Cell Counting Kit-8 assay (n = 8). Data were statistically analyzed using one-way analysis of variance (ANOVA) test followed by Dunnett's multiple comparisons at a significance level of 5%. RESULTS TC-conditioned dentin showed a concentration-dependent increase in Er and hardness. The Er and hardness of 5% and 7.5% TC-conditioned dentin were significantly greater than that of the negative control and vehicle control groups (P < .05). There was no significant difference in the biodegradation resistance between GA and 5% TC-conditioned dentin (P > .05). TC-conditioned dentin showed a well-preserved collagen fibril network with clear cross-banding, comparable to GA-conditioned dentin. All concentrations of TC inhibited bacterial adhesion on dentin, significantly greater than the negative control (P < .05). There was no reduction in viability of stem cells of the apical papilla viability on TC-conditioned dentin compared to the negative control (P > .05). CONCLUSIONS TC conditioning stabilized the dentin and protected it from enzymatic degradation. TC prevented bacterial adhesion on the dentin but maintained stem cell viability.
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Affiliation(s)
- Chi Yan Chan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | | | - Hoi Yin Cheung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | | | - Kei Ki
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | | | - Akhila Pudipeddi
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | | | - Gary Shun Pan Cheung
- Department of Dental Surgery, University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
| | - Prasanna Neelakantan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR; Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California.
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Zymovets V, Rakhimova O, Wadelius P, Schmidt A, Brundin M, Kelk P, Landström M, Vestman NR. Exploring the impact of oral bacteria remnants on stem cells from the Apical papilla: mineralization potential and inflammatory response. Front Cell Infect Microbiol 2023; 13:1257433. [PMID: 38089810 PMCID: PMC10711090 DOI: 10.3389/fcimb.2023.1257433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
Introduction Bacterial persistence is considered one of the main causal factors for regenerative endodontic treatment (RET) failure in immature permanent teeth. This interference is claimed to be caused by the interaction of bacteria that reside in the root canal with the stem cells that are one of the essentials for RET. The aim of the study was to investigate whether prolonged exposure of stem cells from the apical papilla (SCAP) to bacterial remnants of Fusobacterium nucleatum, Actinomyces gerensceriae, Slackia exigua, Enterococcus faecalis, Peptostreptococcaceae yurii, commonly found in infected traumatized root canals, and the probiotic bacteria Lactobacillus gasseri and Limosilactobacillus reuteri, can alter SCAP's inflammatory response and mineralization potential. Methods To assess the effect of bacterial remnants on SCAP, we used UV-C-inactivated bacteria (as cell wall-associated virulence factors) and bacterial DNA. Histochemical staining using Osteoimage Mineralization Assay and Alizarin Red analysis was performed to study SCAP mineralization, while inflammatory and osteo/odontogenic-related responses of SCAPs were assessed with Multiplex ELISA. Results We showed that mineralization promotion was greater with UV C-inactivated bacteria compared to bacterial DNA. Immunofluorescence analysis detected that the early mineralization marker alkaline phosphatase (ALP) was increased by the level of E. coli lipopolysaccharide (LPS) positive control in the case of UV-C-inactivated bacteria; meanwhile, DNA treatment decreased the level of ALP compared to the positive control. SCAP's secretome assessed with Multiplex ELISA showed the upregulation of pro-inflammatory factors IL-6, IL-8, GM-CSF, IL-1b, neurotrophic factor BDNF, and angiogenic factor VEGF, induced by UV-C-killed bacteria. Discussion The results suggest that long term stimulation (for 21 days) of SCAP with UV-C-inactivated bacteria stimulate their mineralization and inflammatory response, while DNA influence has no such effect, which opens up new ideas about the nature of RET failure.
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Affiliation(s)
| | | | - Philip Wadelius
- Department of Endodontics, Region of Västerbotten, Umeå, Sweden
| | - Alexej Schmidt
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | - Malin Brundin
- Department of Odontology, Umeå University, Umeå, Sweden
| | - Peyman Kelk
- Section for Anatomy, Department of Integrative Medical Biology (IMB), Umeå University, Umeå, Sweden
| | - Maréne Landström
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | - Nelly Romani Vestman
- Department of Odontology, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
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Demircan B, Demir P. 3D finite element analysis of stress distribution as a result of oblique and horizontal forces after regenerative endodontic treatment part II: comparison of material thickness. BMC Oral Health 2023; 23:869. [PMID: 37974115 PMCID: PMC10655308 DOI: 10.1186/s12903-023-03559-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/20/2023] [Indexed: 11/19/2023] Open
Abstract
AIM This study aimed to evaluate the stress distribution caused by secondary trauma forces after regenerative endodontic treatment (RET) using different thicknesses of coronary barrier material with three-dimensional finite element analysis(FEA). METHOD A control model was created using the tomography image of the immature maxillary central tooth with computer software.Study models were created with the modulus of elasticity and Poisson's ratio of the materials used in RET.Enamel, dentin, cementum, periodontal ligament, cortical, and cancellous bone were modeled. Coronary barrier materials were applied in 3 mm and 5 mm thicknesses (Model 1: control model, model 2:3 mm/Calcium Enriched Mixture(CEM), model 3:3 mm/Mineral Trioxide Aggregate(MTA), model 4:3 mm/Biodentin, model 5:5 mm/CEM, model 6:5 mm/MTA, model 7:5 mm/Biodentin). For the trauma force simulation, 300 N force in the horizontal direction was applied to the buccal surface of the tooth in the first scenario. For the second scenario, maximum bite force simulation, a force of 240 N in the oblique direction was applied to the palatal surface of the tooth. FEA was performed with Algor Fempro. The resulting stresses were recorded as Von Mises, maximum, and minimum principal stresses. RESULTS Lower stress values were obtained in 5 mm models compared to 3 mm models. However, the difference between them was insignificant. Lower stress values were obtained in all RET models compared to the control model. The lowest stress values in dental tissues and bone tissue were obtained in the CEM models. CONCLUSION This is the first study in which the stress caused by different thicknesses of CEM on dental tissues was evaluated with FEA. RET strengthens immature teeth biomechanically. CEM and Biodentin are more successful materials in stress distribution than MTA. Considering the cost of treatment, 3 mm material thickness is ideal for RET since there is no significant difference between the stress values resulting from the use of 5 mm and 3 mm coronary barrier material.
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Affiliation(s)
- Beril Demircan
- Department of Pediatric Dentistry, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, 38170, Kocasinan, Türkiye.
| | - Pınar Demir
- Department of Pediatric Dentistry, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, 38170, Kocasinan, Türkiye
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Leveque M, Bekhouche M, Farges JC, Aussel A, Sy K, Richert R, Ducret M. Bioactive Endodontic Hydrogels: From Parameters to Personalized Medicine. Int J Mol Sci 2023; 24:14056. [PMID: 37762359 PMCID: PMC10531297 DOI: 10.3390/ijms241814056] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Regenerative endodontic procedures (REPs) aim at recreating dental pulp tissue using biomaterials such as hydrogels. Their bioactivity is mostly related to the nature of biomolecules or chemical compounds that compose the endodontic hydrogel. However, many other parameters, such as hydrogel concentration, bioactive molecules solubility, and apex size, were reported to influence the reciprocal host-biomaterial relationship and hydrogel behavior. The lack of knowledge regarding these various parameters, which should be considered, leads to the inability to predict the clinical outcome and suggests that the biological activity of endodontic hydrogel is impossible to anticipate and could hinder the bench-to-bedside transition. We describe, in this review, that most of these parameters could be identified, described, and studied. A second part of the review lists some challenges and perspectives, including development of future mathematical models that are able to explain, and eventually predict, the bioactivity of endodontic hydrogel used in a clinical setting.
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Affiliation(s)
- Marianne Leveque
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/UCBL, 69007 Lyon, France; (M.L.); (M.B.); (J.-C.F.)
| | - Mourad Bekhouche
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/UCBL, 69007 Lyon, France; (M.L.); (M.B.); (J.-C.F.)
| | - Jean-Christophe Farges
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/UCBL, 69007 Lyon, France; (M.L.); (M.B.); (J.-C.F.)
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69008 Lyon, France; (K.S.); (R.R.)
- Service d’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
| | - Audrey Aussel
- BIOTIS—Laboratory for the Bioengineering of Tissues (UMR Inserm 1026), University of Bordeaux, Inserm, 33076 Bordeaux, France;
- UFR d’Odontologie, Université de Bordeaux, 33600 Bordeaux, France
- CHU de Bordeaux, Pôle de Médecine et Chirurgie Bucco-Dentaire, 33076 Bordeaux, France
| | - Kadiatou Sy
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69008 Lyon, France; (K.S.); (R.R.)
- Service d’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, 69622 Villeurbanne, France
| | - Raphaël Richert
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69008 Lyon, France; (K.S.); (R.R.)
- Service d’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
| | - Maxime Ducret
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/UCBL, 69007 Lyon, France; (M.L.); (M.B.); (J.-C.F.)
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69008 Lyon, France; (K.S.); (R.R.)
- Service d’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
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Santos LM, Cardoso PES, Diniz EA, Rahhal JG, Sipert CR. Different concentrations of fetal bovine serum affect cytokine modulation in Lipopolysaccharide-activated apical papilla cells in vitro. J Appl Oral Sci 2023; 31:e20230020. [PMID: 37493700 PMCID: PMC10382075 DOI: 10.1590/1678-7757-2023-0020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/13/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Fetal bovine serum (FBS) is the most used supplement in culture media; however, it may interfere with in vitro assays via effects on cell proliferation and cytokine production. The ideal FBS concentration for assays using apical papilla cells (APCs) remains unknown. Therefore, this study aimed to evaluate the effects of FBS on APC activation, cell viability/proliferation, and cytokine production. METHODOLOGY Human APCs were cultured, plated, and maintained in media containing increasing concentrations of FBS for 24 h, 48 h, 72 h, 7 days, and 14 days in the presence of Lipopolysaccharide (LPS - 1 µg/mL). At each time point, the cells were subjected to the MTT assay. The cytokines transforming growth factor (TGF)-β1, osteoprotegerin (OPG), and interleukin (IL)-6, along with the chemokine CCL2, were quantified using the enzyme-linked immunosorbent assay at the 24-h time-point. Statistical analysis was performed using two-way analysis of variance (ANOVA) followed by Tukey's post-hoc test (p<0.05). RESULTS In general, APCs exhibited increasing metabolic activity in an FBS concentration-dependent fashion, regardless of the presence of LPS. In contrast, FBS interfered with the production of all the cytokines evaluated in this study, affecting the response induced by the presence of LPS. CONCLUSION FBS increased APC metabolism in a concentration-dependent manner and differentially affected the production of TGF-β1, OPG, IL-6, and CCL2 by APCs in vitro.
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Affiliation(s)
- Letícia Martins Santos
- Universidade de São Paulo, Departamento de Dentística, Faculdade de Odontologia, São Paulo, SP, Brasil
| | - Patricia E Silva Cardoso
- Universidade de São Paulo, Departamento de Dentística, Faculdade de Odontologia, São Paulo, SP, Brasil
| | - Elisa Abreu Diniz
- Universidade de São Paulo, Departamento de Dentística, Faculdade de Odontologia, São Paulo, SP, Brasil
| | - Juliana Garuba Rahhal
- Universidade de São Paulo, Departamento de Dentística, Faculdade de Odontologia, São Paulo, SP, Brasil
| | - Carla Renata Sipert
- Universidade de São Paulo, Departamento de Dentística, Faculdade de Odontologia, São Paulo, SP, Brasil
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Hu X, Wang Q, Ma C, Li Q, Zhao C, Xiang K. Is Etiology a Key Factor for Regenerative Endodontic Treatment Outcomes? J Endod 2023:S0099-2399(23)00293-5. [PMID: 37285935 DOI: 10.1016/j.joen.2023.05.021] [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: 02/19/2023] [Revised: 05/29/2023] [Accepted: 05/29/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION This study aimed to evaluate treatment outcomes of regenerative endodontic treatment (RET) in nonvital immature permanent teeth due to developmental malformation and trauma, and to analyze the influence of etiology on the prognosis. METHODS Fifty-five cases were included and divided into a malformation group (n=33) and a trauma group (n=22). Treatment outcomes were classified as healed, healing and failure. Root development was evaluated in terms of root morphology and the percentage changes in root length, root width and apical diameter during a follow-up period of 12 to 85 months (mean 30.8 months). RESULTS The mean age and the mean degree of root development in the trauma group were significantly younger than that in the malformation group. The success rate of RET was 93.9% (81.8% healed, 12.1% healing) in the malformation group and 90.9% (68.2% healed, 22.7% healing) in the trauma group, showing no statistically significant difference. The proportion of type I-III root morphology in the malformation group (97%, 32/33) was significantly higher than that in the trauma group (77.3%, 17/22) (P<0.05), whereas there was no significant difference in the percentage changes of root length, root width and apical diameter between the two groups. Six cases (6/55, 10.9%) showed no significant root development (type IV-V) (1 in the malformation group and 5 in the trauma group). Six cases (6/55, 10.9%) revealed intracanal calcification. CONCLUSIONS RET achieved reliable outcomes regarding the healing of apical periodontitis and continued root development. The etiology seems to influence the outcome of RET. Malformation cases presented with a better prognosis than trauma cases after RET.
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Affiliation(s)
- Xiaoyan Hu
- Stomatologic Hospital & College, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China.
| | - Qingtong Wang
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Collaborative Innovation Center of Anti-inflammatory and Immune Medicine, Hefei, 230032, China
| | - Chenxue Ma
- Stomatologic Hospital & College, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Quanli Li
- Stomatologic Hospital & College, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Chunhui Zhao
- Stomatologic Hospital & College, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Kun Xiang
- Stomatologic Hospital & College, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
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Effects of sodium hypochlorite and ethylenediaminetetraacetic acid on proliferation, osteogenic/odontogenic differentiation, and mechanosensitive gene expression of human dental pulp stem cells. Tissue Cell 2022; 79:101955. [DOI: 10.1016/j.tice.2022.101955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022]
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Aminoshariae A, Azarpazhooh A, Fouad AF, Glickman GN, He J, Kim SG, Kishen A, Letra AM, Levin L, Setzer FC, Tay FR, Hargreaves KM. Insights into the October 2022 Issue of the JOE. J Endod 2022; 48:1229-1231. [PMID: 36162875 DOI: 10.1016/j.joen.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | - Amir Azarpazhooh
- Faculty of Dentistry University of Toronto, Toronto, Ontario, Canada
| | - Ashraf F Fouad
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Jianing He
- Texas A&M College of Dentistry, College Station, Texas
| | - Sahng G Kim
- Columbia University College of Dental Medicine, New York, New York
| | - Anil Kishen
- Faculty of Dentistry University of Toronto, Toronto, Ontario, Canada
| | - Ariadne M Letra
- Department of Oral and Craniofacial Sciences, Center for Craniofacial and Dental Genetics, University of Pittsburgh, School of Dental Medicine, Pittsburgh, Pennsylvania
| | | | - Frank C Setzer
- University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, Georgia
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