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Aminsobhani M, HafeziMotlagh K, MahjourianQomi R. Management and saving a traumatized poor prognosis maxillary central incisor for 18 years: A patient-centered treatment. Clin Case Rep 2023; 11:e7905. [PMID: 37700776 PMCID: PMC10493242 DOI: 10.1002/ccr3.7905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/14/2023] Open
Abstract
Key clinical message With today's increasing desire to preserve natural teeth, managing teeth with a poor prognosis is a new challenge for clinicians. A dentist's attention to patient-centered care is essential, which improves dental outcomes. Abstract Nowadays, patients' interest in preserving their natural teeth has increased. In the patient-centered care model, the clinician should consider the patient's preferences and values in the treatment plan. This strengthens the patient's responsibility toward his own body, resulting in more patient satisfaction and effective cooperation. Therefore, the skill of saving teeth with a poor prognosis, in which there was no other choice but to extract them, becomes essential in patients who want to preserve their natural teeth. This case report presents the successful 18-year treatment and management of a maxillary central incisor of a 17-year-old male with a horizontal root fracture, who was incompletely treated in another medical center when the trauma occurred. The patient presented to us after 6 months. Due to the short length of the root, the patient underwent regenerative endodontic treatment first, but he did not attend follow-ups. Finally, after 8 years, the patient returned with symptoms of infection and periapical radiolucency. The apical part of the root was resorbed during this time. Finally, it was decided to place an apical plug with MTA. MTA was extruded from the apical part of the root canal during the placement of the apical plug. In the 1-, 2-, 4-, and 10-year follow-ups, the patient was completely asymptomatic, and the radiolucent periradicular lesion had healed. However, the extruded MTA was still present in the radiographic images without interfering with the healing process. Finally, the tooth has remained functional for 18 years.
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Affiliation(s)
- Mohsen Aminsobhani
- Department of EndodonticsDental Research CenterAJA and Tehran University of Medical SciencesTehranIran
| | - Kimia HafeziMotlagh
- Department of Oral MedicineSchool of DentistryTehran University of Medical SciencesTehranIran
| | - Reza MahjourianQomi
- Department of EndodonticsSchool of DentistryTehran University of Medical SciencesTehranIran
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Modaresi J, Nasr N. Nonsurgical Endodontic Management of Large Periapical Lesion with Cold Ceramic: A Literature Review and Case Series. IRANIAN ENDODONTIC JOURNAL 2023; 18:113-121. [PMID: 37152858 PMCID: PMC10155105 DOI: 10.22037/iej.v18i2.40184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/19/2023] [Accepted: 03/16/2023] [Indexed: 05/09/2023]
Abstract
Introduction The purpose of this review is to investigate the contribution of non-surgical endodontic treatment in the healing process of large periapical lesions as well as looking over other potential non-surgical endodontic treatment options. Materials and Methods two females and one male patient were referred to the private office, complaining of having pain in the anterior maxillary region which was pertinent to the presence of a large periapical lesion, and subsequently were managed by a non-surgical endodontic approach using cold ceramic. The archive of PubMed and Google Scholar databases was also searched for finding relevant articles in which a nonsurgical endodontic approach was performed to improve the healing process of large periapical lesions. Results Clinical examination of the case series subjects revealed no signs and symptoms following treatment while relative improvement of the lesion and apical closure was apparent in radiographs 7 months, 9 months, and 4 years subsequently. In twenty-two reviewed clinical trials, a total number of 107 teeth with large periapical lesions were treated by nonsurgical endodontic approaches using MTA, biodentine, gutta-percha, and bioceramic iRoot Bp plus. Complete healing occurred in 38 cases (35.5%) after 12-17 months. Conclusions Although surgical interventions have been used previously in the management of large periapical lesions, a nonsurgical endodontic approach with cold ceramic seems to be effective, leading to complete healing of the periapical lesion in treated subjects. Further clinical research is recommended to identify the effectiveness of cold ceramic for the treatment of extensive periapical lesions.
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Affiliation(s)
- Jalil Modaresi
- Department of Endodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nazanin Nasr
- Department of Endodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Corresponding author: Nasr Nazanin, Faculty of Dentistry, Daheye Fajr BLV, Imam Ave, Po Box: 89195/165 Yazd, Iran. E-mail:
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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.
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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:
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Li J, Chen L, Zeng C, Liu Y, Gong Q, Jiang H. Clinical outcome of bioceramic sealer iRoot SP extrusion in root canal treatment: a retrospective analysis. Head Face Med 2022; 18:28. [PMID: 36045447 PMCID: PMC9429671 DOI: 10.1186/s13005-022-00332-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background During the obturation procedure, sealer extrusion occurs in some cases. iRoot SP is a kind of bioceramic sealer with superior physicochemical and biological properties. This article reports the outcome of iRoot SP extrusion in root canal treatment and the potential factors associated with the outcome. Methods Ninety-nine patients and one hundred and eighty-five teeth treated between 2014 and 2020 were included in this retrospective study. All of the cases were filled with a single-cone technique and the iRoot SP sealer. The minimum follow-up visit period was 1 year. The outcome was evaluated by clinical examination and radiographic examination at recall and was classified as healed, healing (success), or not healed (failure). Results The overall success rate of all teeth was 96.8%. The success rate of adequately filled teeth was 97.3%, while that of iRoot SP extrusion was 95.8%; the difference was not statistically significant. Factors such as gender, age, tooth position, follow-up visit period, size of periapical lesion, treatment type and extruding sealer amount had no influence on the outcome of iRoot SP extruded teeth. Conclusions The results suggested that iRoot SP extrusion has no adverse effect on the outcome of root canal treatment, which may contribute to the endodontic treatment.
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Affiliation(s)
- Jing Li
- Stomatology Department, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Liuchi Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, 56 Ling Yuan Xi Road, Guangzhou, 510055, Guangdong, China
| | - Chunmei Zeng
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Yiwen Liu
- Department of Endodontics, Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Qimei Gong
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, 56 Ling Yuan Xi Road, Guangzhou, 510055, Guangdong, China.
| | - Hongwei Jiang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, 56 Ling Yuan Xi Road, Guangzhou, 510055, Guangdong, China.
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Prognostic Factors of Combined Periodontal and Endodontic Lesions: A Retrospective Study. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:5042097. [PMID: 36051933 PMCID: PMC9424022 DOI: 10.1155/2022/5042097] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/12/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022]
Abstract
Objective. This study used a retrospective method to explore the relevant factors affecting the prognosis of periodontal-endodontic combined lesions. Methods. According to the changes of subjective feelings and clinical indicators of affected teeth, selected patients were divided into an effective group and an ineffective group. The natural conditions (age, gender, and smoking status) of the patients and various clinical indicators at the initial and follow-up visits were collected, including the periodontal clinical indicators of the whole mouth and the clinical indicators of the affected teeth. The full-mouth periodontal clinical indicators include periodontal probing depth (PD), clinical attachment loss (CAL), sulcus bleeding index (SBI), and simplified oral hygiene index (OHI.S); clinical indicators of affected teeth include PD, CAL, SBI, mobility (TM), clinical crown-to-root ratio (CR), periapical index (PAI), and number of root canals. Results. There were 74 cases of endodontic combined treatment, with a total of 86 teeth. There was no significant difference in age and gender ratio between the effective group and the ineffective group, and the proportion of smoking patients in the ineffective group was significantly higher than that in the effective group
. At the initial diagnosis, there was no significant difference in the clinical indicators of the whole mouth between the effective group and the ineffective group. After a combined endodontic treatment, the clinical indicators of the two groups were significantly improved
. There was no significant difference in other periodontal clinical indicators between the two groups. Conclusion. The prognosis of nonsurgical treatment of periodontal and periodontal combined lesions is mainly correlated to the patient’s oral hygiene maintenance, as well as the loss of attachment, the degree of loosening, the clinical crown-to-root ratio, the periapical index, and the number of root canals.
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Deniz-Sungur D, Onur MA, Akbay E, Tan G, Daglı-Comert F, Sayın TC. Effects of calcium silicate cements on neuronal conductivity. Restor Dent Endod 2022; 47:e18. [PMID: 35692227 PMCID: PMC9160757 DOI: 10.5395/rde.2022.47.e18] [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: 11/27/2020] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives This study evaluated alterations in neuronal conductivity related to calcium silicate cements (CSCs) by investigating compound action potentials (cAPs) in rat sciatic nerves. Materials and Methods Sciatic nerves were placed in a Tyrode bath and cAPs were recorded before, during, and after the application of test materials for 60-minute control, application, and recovery measurements, respectively. Freshly prepared ProRoot MTA, MTA Angelus, Biodentine, Endosequence RRM-Putty, BioAggregate, and RetroMTA were directly applied onto the nerves. Biopac LabPro version 3.7 was used to record and analyze cAPs. The data were statistically analyzed. Results None of the CSCs totally blocked cAPs. RetroMTA, Biodentine, and MTA Angelus caused no significant alteration in cAPs (p > 0.05). Significantly lower cAPs were observed in recovery measurements for BioAggregate than in the control condition (p < 0.05). ProRoot MTA significantly but transiently reduced cAPs in the application period compared to the control period (p < 0.05). Endosequence RRM-Putty significantly reduced cAPs. Conclusions Various CSCs may alter cAPs to some extent, but none of the CSCs irreversibly blocked them. The usage of fast-setting CSCs during apexification or regeneration of immature teeth seems safer than slow-setting CSCs due to their more favorable neuronal effects.
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Affiliation(s)
- Derya Deniz-Sungur
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Mehmet Ali Onur
- Department of Biology, Faculty of Science, Hacettepe University, Ankara, Turkey
| | - Esin Akbay
- Department of Biology, Faculty of Science, Hacettepe University, Ankara, Turkey
| | - Gamze Tan
- Department of Biology, Faculty of Science and Letters, Aksaray University, Aksaray, Turkey
| | - Fügen Daglı-Comert
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.,Adult Restorative Dentistry and Endodontics, Oman Dental College, Muscat, Oman
| | - Taner Cem Sayın
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.,Private Practice, Fort Lauderdale, FL, USA
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Evaluation of a Novel Tool for Apical Plug Formation during Apexification of Immature Teeth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095304. [PMID: 35564699 PMCID: PMC9102688 DOI: 10.3390/ijerph19095304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 02/04/2023]
Abstract
The purpose of this study was to compare the sealing ability and time required for the formation of Biodentine and mineral trioxide aggregation (MTA) apical plugs, using three different delivery methods: an amalgam carrier (AC), the Micro Apical Placement (MAP) System or a novel tool using a modified cannula (MC). Materials and Methods: A total of 60 uniformed molar roots were divided into three main groups, according to the technique of apical plug formation: AC, MAP, and MC. Each group was divided into two subgroups, according to the filling material used: MTA and Biodentine. A timer was used to calculate the required time for apical plug formation. After setting the filling materials, the apical microleakage of the formed plugs was quantified using the dye extraction method and spectrophotometry. The differences between the groups were analyzed using the one-way ANOVA and LSD post hoc tests. The significance level was set at 0.05. Results: No significant differences were reported in the time required to form the apical plugs in all groups (p > 0.05). However, the apical plugs formed by the AC method had significantly higher microleakage than those formed using the MAP and MC methods (p < 0.05). Conclusion: Within the limitations of this study, the sealing ability of the apical plugs formed by the MC method is comparable to the MAP method and better than the AC method.
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Aminoshariae A, Primus C, Kulild JC. Tricalcium silicate cement sealers. J Am Dent Assoc 2022; 153:750-760. [DOI: 10.1016/j.adaj.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/05/2022] [Accepted: 01/09/2022] [Indexed: 01/22/2023]
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Radiographic differences observed following apexification vs revascularization in necrotic immature molars and incisors: a follow-up study of 18 teeth. Eur Arch Paediatr Dent 2022; 23:381-389. [PMID: 35129776 PMCID: PMC9167200 DOI: 10.1007/s40368-022-00692-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 01/10/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE To evaluate the effectiveness of apexification versus revascularization in the treatment of necrotic immature teeth and determine which strategy affords the greatest radiological success rate. METHODS An analysis was made of 18 teeth subjected to mineral trioxide aggregate (MTA) apical plugging and regenerative endodontic treatment, assessing healing of the apical lesions and the changes in root dimensions. RESULTS Significantly greater root growth was observed with revascularization in terms of the percentage change in length (12.75% at 6 months) and dentin thickness (34.57% at 6 months) (p < 0.05). There were no significant differences between the two treatments in terms of the apical healing scores after 6 months of follow-up (p > 0.05). CONCLUSION Apexification with an MTA apical plug and pulp regeneration are reliable treatments for non-vital immature teeth. The radiographic outcomes are comparable between the immature teeth subjected to MTA apexification versus those subjected to revascularization. The results of the present study indicate a greater increase in root length and width with regenerative endodontic treatment.
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Van Pham K, Tran TA. Effectiveness of MTA apical plug in dens evaginatus with open apices. BMC Oral Health 2021; 21:566. [PMID: 34749689 PMCID: PMC8573861 DOI: 10.1186/s12903-021-01920-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022] Open
Abstract
Background The present study aims to evaluate the effectiveness of mineral trioxide aggregate (MTA) application in treating dens evaginatus affected teeth with apical lesions and open apices using haemostatic collagen membrane to prevent the apical extrusion of MTA. Methods Twelve patients with 14 dens evaginatus affected teeth with apical lesions and open apices were treated with MTA apical plug and haemostatic collagen membrane. Clinical symptoms of subjective pain, pain of palpation, percussion, sinus tract, and the apical lesions' radiographic parameter were recorded at every 3-month interval up to 9 months after treatment. Paired t-test or Wilcoxon signed-rank test was used for statistical analysis with P < 0.05 as the threshold for considering results to be statistically significant. Results No patient experienced clinical symptoms 3 months after endodontic treatment. In addition, there was a significant difference in the dimensions of the apical lesions' before compared to 3 months after endodontic treatment. Conclusions The combination of MTA apical plug and haemostatic collagen membrane effectively treated dens evaginatus affected teeth with apical lesions, and open apices.
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Affiliation(s)
- Khoa Van Pham
- Department of Operative Dentistry and Endodontics, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam.
| | - Thu Anh Tran
- Department of Operative Dentistry and Endodontics, National Hospital of Odonto-Stomatology, Ho Chi Minh City, Vietnam
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Roy S, Kumari A, Chandra P, Agarwal R, Bankoti P, Ahmed F. Evaluation of Healing of Periapical Tissue in Permanent Incisors with Open Apices after Unintentional Extrusion of Mineral Trioxide Aggregate - A Retrospective Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2021; 13:S97-S100. [PMID: 34447052 PMCID: PMC8375778 DOI: 10.4103/jpbs.jpbs_570_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 09/26/2020] [Accepted: 09/27/2020] [Indexed: 11/04/2022] Open
Abstract
Aim The aim of the present study was to retrospectively assess the healing of periapical lesions in permanent central incisors with open apices after unintentional extrusion of mineral trioxide aggregate (MTA). Materials and Methods The clinical and radiographic records of 75 maxillary permanent central teeth treated by MTA apexification were evaluated. Teeth with unintentionally extruded MTA formed the study group (Group 1, n = 28), whereas the teeth with no MTA extrusion formed the control group (Group 2, n = 47). For both the groups, the records were analyzed for a follow-up period of 3 years. Results Complete healing (CH) was observed in 25 teeth in the study group, whereas all the teeth in the control group showed CH (P > 0.05). Within the study group, 6 teeth (21%) showed CH in the 6th month in Group 1, whereas in the control group, 34 teeth (72.3%) showed CH (P < 0.001). At the 1-year follow-up appointment, 19 teeth (67.8%) showed CH in Group 1, whereas 9 teeth (19.1%) showed the same result in Group 2 (P < 0.001). At the end of the 3-year follow-up period, it was noticed that in 21 (84%) teeth, extruded MTA remained unchanged, whereas it was reduced in 4 (16%) of them (P < 0.001). Conclusion Extrusion of MTA does not have a significant effect on the healing of the periapical lesion. However, it may lead to a delay in the healing of periapical healing. Patients should be informed about the complication and consequences of extruded MTA and should be kept on follow-up to observe periapical healing.
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Affiliation(s)
- Sonali Roy
- Department of Dentistry, Nalanda Medical College and Hospital, Patna, Bihar, India
| | - Archana Kumari
- Department of Dentistry, VIMS Pawapuri (Nalanda), Patna, Bihar, India
| | - Praveen Chandra
- Department of Prosthodontics, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Ritika Agarwal
- Department of Dentistry, Patna Medical College and Hospital, Patna, Bihar, India
| | - Pinki Bankoti
- Department of Dentistry, Institute of dental sciences, Bareilly, Uttar Pradesh, India
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Mathew AI, Lee SC, Rossi-Fedele G, Bogen G, Nagendrababu V, Ha WN. Comparative Evaluation of Mineral Trioxide Aggregate Obturation Using Four Different Techniques-A Laboratory Study. MATERIALS 2021; 14:ma14113126. [PMID: 34200233 PMCID: PMC8201240 DOI: 10.3390/ma14113126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 05/26/2021] [Accepted: 06/03/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to compare the density of mineral trioxide aggregate (MTA) as a root canal filling material in the apical 5 mm of artificial root canals. Forty transparent acrylic blocks with 30-degree curved canals were instrumented and allocated into four compaction technique groups (n = 10): Lawaty (hand files); gutta-percha (GP) points; auger (nickel–titanium rotary files in reverse mode); and plugger technique. Filled canals were weighed after setting the MTA to calculate difference in mass. Two postoperative radiographs compared radiopacity by measuring luminance variations at 0.5 mm, 1 mm, 2 mm, 3 mm, 4 mm, and 5 mm from the root apex. Obturation time was measured using a digital chronometer. The significance level was set to p < 0.05. The plugger group had a lower mass. Relative luminance was significantly higher for the Lawaty group than the plugger group at all examined apical levels. The relative luminance of the auger and GP groups were significantly higher than the plugger group at depths between 0.5 mm and 2 mm. Relative luminance was highest for the Lawaty technique at all depths between 0.5 mm and 4 mm. The Lawaty technique group was associated with increased obturation time compared with pluggers. Compacting MTA in curved canals with the Lawaty technique has the highest mass and radiopacity but requires more time.
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Affiliation(s)
- Abhishek Isaac Mathew
- Adelaide Dental School, University of Adelaide, Adelaide, SA 5000, Australia; (A.I.M.); (S.C.L.); (G.R.-F.)
| | - Silvia Chamin Lee
- Adelaide Dental School, University of Adelaide, Adelaide, SA 5000, Australia; (A.I.M.); (S.C.L.); (G.R.-F.)
| | - Giampiero Rossi-Fedele
- Adelaide Dental School, University of Adelaide, Adelaide, SA 5000, Australia; (A.I.M.); (S.C.L.); (G.R.-F.)
| | - George Bogen
- School of Dentistry, University of Queensland, Brisbane, QLD 4072, Australia;
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates;
| | - William Nguyen Ha
- Adelaide Dental School, University of Adelaide, Adelaide, SA 5000, Australia; (A.I.M.); (S.C.L.); (G.R.-F.)
- School of Dentistry, University of Queensland, Brisbane, QLD 4072, Australia;
- Correspondence:
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What is the best long-term treatment modality for immature permanent teeth with pulp necrosis and apical periodontitis? Eur Arch Paediatr Dent 2021; 22:311-340. [PMID: 33420674 PMCID: PMC8213569 DOI: 10.1007/s40368-020-00575-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 10/17/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To evaluate and assess the current knowledge about apexification and regenerative techniques as a meaningful treatment modality and to map the scientific evidence for the efficacy of both methods for the management of traumatised immature teeth with pulp necrosis and apical periodontitis. METHODS This systematic review searched five databases: PubMed, Web of Science, Cochrane Library, Ovid (Medline), and Embase. Published articles written in English were considered for inclusion. The following keywords were used: Regenerative endodontic treatment OR regenerat* OR revital* OR endodontic regeneration OR regenerative endodontics OR pulp revascularization OR revasculari* OR 'traumatized immature teeth'. Only peer-reviewed studies with a study size of at least 20 cases followed up for 24 months were included. Eligibility assessment was performed independently in a blinded manner by three reviewers and disagreements were resolved by consensus. Subgroup analyses were performed on three clinical outcomes: survival, success, and continued root development. RESULTS Seven full texts out of 1359 citations were included and conventional content analysis was performed. Most of the identified citations were case reports and case series. CONCLUSIONS In the present systematic review, the qualitative analysis revealed that both regenerative and apexification techniques had equal rates of success and survival and proved to be effective in the treatment of immature necrotic permanent teeth. Endodontic regenerative techniques appear to be superior to apexification techniques in terms of stimulation of root maturation, i.e. root wall thickening and root lengthening. Knowledge gaps were identified regarding the treatment and follow-up protocols for both techniques.
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Fakheran O, Birang R, Schmidlin PR, Razavi SM, Behfarnia P. Retro MTA and tricalcium phosphate/retro MTA for guided tissue regeneration of periodontal dehiscence defects in a dog model: a pilot study. Biomater Res 2019; 23:14. [PMID: 31485337 PMCID: PMC6712858 DOI: 10.1186/s40824-019-0163-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 08/19/2019] [Indexed: 01/07/2023] Open
Abstract
Objectives Retro MTA is a fast setting Calcium silicate cement used in endodontic regeneration procedures in recent years. Beta-tricalcium phosphate (β-TCP) is another common biomaterial used for bone augmentation procedures. The present pilot study was undertaken to evaluate and compare the efficacy of Retro MTA and a mixture of Retro MTA / β-TCP for periodontal tissue regeneration. Materials and methods In 4 beagle dogs, periodontal dehiscence type defects were created. In each side, one dehiscence defect was left empty as a control site and three treatment modalities were randomly applied for the others: Retro MTA covered with a collagen membrane, Retro MTA + β-TCP covered with a membrane and covering the defect with a membrane without any bone augmentation. After 8 weeks Animals were sacrificed and Histomorphometric and histologic analysis were conducted. Results Histologic analysis showed more cementum formation for both Retro MTA+ β-TCP (3.74 ± 0.34 mm) and Retro MTA group (3.24 ± 0.56 mm) compared to control group 1 (1. 15 ± 0.45 mm) and control group 2 (0.78 ± 0.65 mm). Formation of newly formed bone and cementum in the experimental groups were significantly higher as compared to the control groups (P < 0.0001). Conclusions Retro MTA or Retro MTA+ β-TCP covered with a collagen membrane resulted in regeneration of periodontal tissues. However, Retro MTA+ β-TCP showed tendency towards better results than the use of Retro MTA alone.
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Affiliation(s)
- Omid Fakheran
- 1Department of Periodontics and Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Birang
- 1Department of Periodontics and Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Patrick R Schmidlin
- 2Clinic of Conservative and Preventive Dentistry, Centre of Dental and Oral Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Sayed Mohammad Razavi
- 3Dental Implant Research Center and Department of Oral and Maxillofacial Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parichehr Behfarnia
- 1Department of Periodontics and Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Abstract
Pulpal necrosis in permanent teeth that have not completed their root development leads to teeth with a very short root, roots with very thin walls, and an inadequate crown-root ratio, which overshadows their survival prognosis. Currently, there are various therapies to treat immature permanent teeth with pulpal pathology such as the case of apexification. An electronic search was performed in the PubMed database (www.ncbi.nlm.nih.gov), Scopus (www.scopus.com), Cochrane (www.cochrane.org) to identify the clinical investigations related to evolution of the cases. The search of the literature of clinical studies on permanent teeth with open apex that present pulpar pathology and that need treatment, have been found 11 clinical studies of treatments with apexification. The apexification by calcium hydroxide has been applied for many years back to the present as a valid therapy to perform the treatment of apexification.
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Affiliation(s)
- Fabricio Guerrero
- Department of Odonto-Stomatology, Faculty of Dentistry, University of Barcelona, Barcelona, Spain
| | - Asunción Mendoza
- Department of Odonto-Stomatology, Faculty of Dentistry, University of Seville, Seville, Spain
| | - David Ribas
- Department of Odonto-Stomatology, Faculty of Dentistry, University of Seville, Seville, Spain
| | - Karla Aspiazu
- Department of Research, School of Medicine, Catholic University of Cuenca, Cuenca, Ecuador
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16
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Retrospective evaluation of healing of periapical lesions after unintentional extrusion of mineral trioxide aggregate. J Appl Biomater Funct Mater 2017; 15:e382-e386. [PMID: 28525679 DOI: 10.5301/jabfm.5000359] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND During the apexification procedure for teeth with open apices, mineral trioxide aggregate (MTA) may be unintentionally extruded. The aim of the present study was the retrospective evaluation of the healing of periapical lesions in permanent incisor teeth with open apices after the unintentional extrusion of MTA. METHODS The clinical and radiographic records of 55 maxillary permanent central teeth treated by MTA apexification were evaluated. Filled teeth with unintentionally extruded MTA were selected as group 1 (n = 21), whereas the teeth with no MTA extrusion were selected as group 2 (n = 34). For each tooth, the clinical and radiographic records from a 3-year follow-up were investigated. RESULTS Complete healing (CH) was observed in 19 teeth (90.4%) in group 1, whereas the same type of healing was observed in all 34 teeth (100%) in group 2 (p>0.05). At the 6-month follow-up appointment, 25 teeth (73.5%) showed CH in group 2, whereas 15 teeth (71.4%) showed CH at the 1-year follow-up in group 1 (p<0.001). At the end of the 3-year follow-up period, the amount of MTA extrusion was reduced in 17 teeth (85%) (p<0.05), whereas it was almost absent in 2 teeth (10%). CONCLUSIONS The unintentional extrusion of MTA does not prevent the healing of periapical lesions, but may be a delaying factor for periapical healing.
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17
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Regenerative Endodontic Treatment or Mineral Trioxide Aggregate Apical Plug in Teeth with Necrotic Pulps and Open Apices: A Systematic Review and Meta-analysis. J Endod 2017; 43:1806-1820. [DOI: 10.1016/j.joen.2017.06.029] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 06/12/2017] [Accepted: 06/16/2017] [Indexed: 12/29/2022]
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18
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Torabinejad M, Parirokh M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications. Int Endod J 2017; 51:284-317. [PMID: 28846134 DOI: 10.1111/iej.12843] [Citation(s) in RCA: 214] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/22/2017] [Indexed: 12/16/2022]
Abstract
Mineral trioxide aggregate (MTA) is a dental material used extensively for vital pulp therapies (VPT), protecting scaffolds during regenerative endodontic procedures, apical barriers in teeth with necrotic pulps and open apices, perforation repairs as well as root canal filling and root-end filling during surgical endodontics. A number of bioactive endodontic cements (BECs) have recently been introduced to the market. Most of these materials have calcium and silicate in their compositions; however, bioactivity is a common property of these cements. These materials include the following: BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA but without the drawbacks. In Part I of this review, the available information on the chemical composition of the materials listed above was reviewed and their applications for VPT was discussed. In this article, the clinical applications of MTA and other BECs will be reviewed for apexification, regenerative endodontics, perforation repair, root canal filling, root-end filling, restorative procedures, periodontal defects and treatment of vertical and horizontal root fractures. In addition, the literature regarding the possible drawbacks of these materials following their clinical applications is reviewed. These drawbacks include their discolouration potential, systemic effects and retreatability following use as a root filling material. Based on selected keywords, all publications were searched regarding the use of MTA as well as BECs for the relevant clinical applications. Numerous publications were found regarding the use of BECs for various endodontic applications. The majority of these investigations compared BECs with MTA. Despite promising results for some materials, the number of publications using BECs for various clinical applications was limited. Furthermore, most studies had several methodological shortcomings and low levels of evidence.
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Affiliation(s)
- M Torabinejad
- Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - M Parirokh
- Endodontology Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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19
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Altered Apical Morphology (Reverse Architecture): Use of Indirect Ultrasonic Technique for Orthograde MTA Placement in Maxillary Premolars. Case Rep Dent 2016; 2016:1046405. [PMID: 27313910 PMCID: PMC4895056 DOI: 10.1155/2016/1046405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/09/2016] [Accepted: 05/08/2016] [Indexed: 11/17/2022] Open
Abstract
Aim. To report the management and orthograde technique of MTA placement in case of reverse architecture maxillary premolars. Summary. Two cases of 17-year-old and 21-year-old female patients were referred to endodontic speciality for management of maxillary premolar having reverse architecture with wide immature open apex like a bell mouth. In both the cases, after control of intraradicular infection, it was decided to use MTA for apexification and obturation of canals. Orthograde placement of MTA is a challenging procedure in terms of length control and condensation especially in divergent irregular reverse architecture wide open apex. A novel technique with the help of finger plugger, sterilized paper point, and ultrasonic agitation for 3D compaction of MTA at apical reverse architecture was used. Thickening of the canal wall and complete apical closure were confirmed one year after the treatment.
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Sharifi R, Araghid A, Ghanem S, Fatahi A. Effect of temperature on the setting time of Mineral Trioxide Aggregate (MTA). J Med Life 2015; 8:88-91. [PMID: 28255404 PMCID: PMC5327716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Mineral trioxide aggregate (MTA) has numerous applications in dentistry due to various advantages. However, its long setting time has still remained a problem. The current study was conducted to investigate the effect of temperature (ambient and distilled water temperature) on the setting time of mineral trioxide aggregate (MTA). Materials and methods: This experimental study comprised of two parts. In the first part, MTA and distilled water samples were kept at ambient temperature for 24 hours (before mixing: effect of distilled water temperature on the setting time of MTA and after mixing: effect of distilled water and ambient temperature on the setting time of MTA), and analyzed and divided into three groups: group 1 (4°C), group 2 (37°C) and group 3 (90°C). The mixed samples were placed in the glass cylinders with an internal diameter of 8 mm and a height of 10 mm, and kept at 37°C temperature and 100% humidity. In the second part, the samples were prepared the same as those of the first part and divided into three groups according to the terms of maintenance: group 1 (4°C), group 2 (37°C) and group 3 (75°C). The mixed samples were then put in glass cylinders with an internal diameter of 8 mm and a height of 10 mm and the samples of groups 1, 2 and 3 were kept at 4, 37 and 75 °C, respectively. At the end of each part, the primary and final setting times were measured by Gilmore needle. Data were analyzed by SPSS using Kruskal-Wallis test (p<0.05). Results: The findings of this study showed a significant reduction of the primary and final setting time of MTA for the samples of both parts of the study with an increase in ambient temperature (p<0.05). Conclusion: This study indicated that increased ambient temperature caused a reduction in the setting time of MTA.
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Affiliation(s)
- R Sharifi
- Endodontics Department, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - A Araghid
- Endodontics Department, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - S Ghanem
- School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - A Fatahi
- Medical Biology Research Center, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
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An evaluation of the inflammatory response of lipopolysaccharide-treated primary dental pulp cells with regard to calcium silicate-based cements. Int J Oral Sci 2014; 6:94-8. [PMID: 24556955 PMCID: PMC5130057 DOI: 10.1038/ijos.2014.5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2013] [Indexed: 01/23/2023] Open
Abstract
This study compared the biological changes of lipopolysaccharide (LPS)-treated dental pulp (DP) cells directly cultured on mineral trioxide aggregate (MTA) and calcium silicate (CS) cements. DP cells were treated with LPS for 24 h. Then, the LPS-treated DP cells were cultured on MTA or CS cements. Cell viability, cell death mechanism and interleukin (IL)-1β expressions were analysed. A one-way analysis of variance was used to evaluate the significance of the differences between the means. A significantly higher IL-1β expression (2.9-fold) was found for LPS-treated cells (P<0.05) compared with DP cells without LPS treatment at 24 h. Absorbance values of LPS-treated cells cultured on CS cement were higher than a tissue culture plate. A significant difference (P<0.05) in cell viability was observed between cells on CS and MTA cements 24 h after seeding. At 48 h, a high concentration of Si (5 mM) was released from MTA, which induced LPS-treated DP cell apoptosis. The present study demonstrates that CS cement is biocompatible with cultured LPS-treated DP cells. MTA stimulates inflammation in LPS-treated DP cells, which leads to greater IL-1β expression and apoptosis.
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