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Manaktala M, Taneja S, Bhalla VK. Stress distribution in endodontically treated external cervical resorption lesions restored with MTA and biodentine - A finite element analysis. J Oral Biol Craniofac Res 2024; 14:415-422. [PMID: 38832294 PMCID: PMC11144738 DOI: 10.1016/j.jobcr.2024.04.012] [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: 02/29/2024] [Revised: 04/25/2024] [Accepted: 04/30/2024] [Indexed: 06/05/2024] Open
Abstract
Introduction Root resorption poses a significant challenge in dental practice, with external cervical resorption (ECR) being a common manifestation. ECR is often asymptomatic until advanced stages, complicating its diagnosis and management. Various factors contribute to its etiology, ranging from trauma to orthodontic treatment. The classification system proposed by Patel et al. (2018) offers a comprehensive framework for characterizing ECR lesions based on location and extent. Treatment strategies for ECR involve a combination of endodontic intervention and restorative techniques, with bioactive materials like mineral trioxide aggregate (MTA) and Biodentine emerging as promising options. However, the biomechanical behavior of teeth restored with these materials in the context of ECR remains underexplored. Materials and methods This study utilized finite element analysis (FEA) to assess stress distribution in teeth with simulated ECR lesions of varying sizes and locations, restored with MTA or Biodentine. Three-dimensional models of maxillary central incisors were generated based on CBCT scans, incorporating periodontal ligament and surrounding bone structures. Eight experimental models representing different ECR configurations were created and subjected to FEA using Optistruct software based on dimensional classification given by Patel et al., in 2018, A70 M & A70B: 1Ap, A130 M & A130B: 1Bp, B70 M & B70B: 2Ap, B130 M & B130B: 2Bp. All the models were tested for stress distribution by restoring the lesions with either M: MTA or B: Biodentine. Oblique load of 100 N was applied at 45°angle to the long axis 2 mm lingual to incisal edge. vonMises Stress distribution in enamel, dentine, restoration and at all the interfaces were observed. Results The analysis revealed that both MTA and Biodentine restorations exhibited uniform stress distribution around ECR lesions, with no significant differences based on lesion location or size. Maximum stress concentrations were observed around the restorations, particularly in subcrestal lesions. However, overall stress levels were comparable between MTA and Biodentine restorations, indicating similar biomechanical performance. Conclusion Finite element analysis provides valuable insights into the biomechanical behavior of teeth with ECR lesions restored with MTA and Biodentine. Both materials exhibit similar stress distribution patterns and offer adequate reinforcement against mechanical forces. Clinicians can confidently utilize MTA or Biodentine in the management of ECR, considering their favorable biomechanical properties and clinical outcomes. Further research is necessary to validate these findings and optimize treatment protocols for ECR.
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Affiliation(s)
| | - Sonali Taneja
- Dept. Of Conservative Dentistry and Endodontics, I.T.S Dental College, Ghaziabad, India
| | - Vidhi Kiran Bhalla
- Dept. Of Conservative Dentistry and Endodontics, I.T.S Centre for Dental Studies and Research, Ghaziabad, India
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Askerbeyli Örs S, Küçükkaya Eren S. Effects of different treatment modalities on biomechanical behavior of maxillary incisors with external invasive cervical resorption at different progression levels. Dent Traumatol 2023; 39:605-615. [PMID: 37424177 DOI: 10.1111/edt.12868] [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: 01/16/2023] [Revised: 06/12/2023] [Accepted: 06/18/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND/AIM This study aimed to evaluate the biomechanical behavior of maxillary incisors with external invasive cervical resorption (EICR) at different progression levels after receiving different modes of treatment under occlusal forces using finite element analysis (FEA). MATERIALS AND METHODS Three-dimensional (3D) models of intact maxillary central incisors were constructed and modified to include EICR cavities with different progression levels in the buccal cervical areas. The EICR cavities confined to dentin were repaired using Biodentine™ (Septodont Ltd., Saint Maur des Fausse ́s, France), resin composite, or glass ionomer cement (GIC) . Additionally, EICR cavities with pulp invasion requiring direct pulp capping were simulated as repaired using Biodentine only or 1 mm thick Biodentine and either resin composite or GIC for the rest of the cavity. Moreover, models with root canal treatment and EICR defects repaired using Biodentine, resin composites, or GIC were also generated. A force of 240 N was applied to the incisal edge. The principal stresses in the dentin were evaluated. RESULTS GIC showed more favorable results than the other materials in EICR cavities confined to the dentin. However, Biodentine alone resulted in more favorable minimum principal stresses (Pmin ) compared to other materials in EICR cavities with close pulp proximity. Exceptionally, the models localized in the coronal third of the root with a circumferential extension of the cavity >90° showed more favorable results for GIC. The presence of root canal treatment had no significant effect on stress values. CONCLUSIONS Based on this FEA study the use of GIC in EICR lesions confined to the dentin is recommended. However, Biodentine may be a better option for restoring EICR lesions close to the pulp with or without root canal treatment. Except when the circumferential extension of the cavity is >90°, the use of GIC may be more advantageous.
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Affiliation(s)
- Sevinc Askerbeyli Örs
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Selen Küçükkaya Eren
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Moga RA, Delean AG, Buru SM, Botez MD, Olteanu CD. Orthodontic Internal Resorption Assessment in Periodontal Breakdown-A Finite Elements Analysis (Part II). Healthcare (Basel) 2023; 11:2622. [PMID: 37830659 PMCID: PMC10572129 DOI: 10.3390/healthcare11192622] [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: 07/19/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/14/2023] Open
Abstract
This finite elements analysis (FEA) assessed the accuracy of maximum shear stress criteria (Tresca) in the study of orthodontic internal surface resorption and the absorption-dissipation ability of dental tissues. The present study was conducted over eighty-one models totaling 324 simulations with various bone loss levels (0-8 mm), where 0.6 N and 1.2 N were applied in the intrusion, extrusion, rotation, tipping, and translation movements. Tresca criteria displayed localized high-stress areas prone to resorption for all situations, better visible in the dentine component. The internal resorptive risks are less than external ones, seeming to increase with the progression of the periodontal breakdown, especially after 4 mm. The internal and external surface high-stress areas are strictly correlated. The qualitative stress display for both forces was almost similar. The rotation and tipping displayed the highest resorptive risks for the pulp chamber, decreasing with bone loss. The resorptive risks seem to increase along with the progression of periodontal breakdown if the same applied force is kept. The dentine resemblance to ductile based on its high absorption-dissipation ability seems correct. Tresca seems to supply a better predictability of the prone-to-resorption areas than the other failure criteria.
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Affiliation(s)
- Radu Andrei Moga
- Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Str. Motilor 33, 400001 Cluj-Napoca, Romania
| | - Ada Gabriela Delean
- Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Str. Motilor 33, 400001 Cluj-Napoca, Romania
| | - Stefan Marius Buru
- Department of Structural Mechanics, School of Civil Engineering, Technical University of Cluj-Napoca, Str. Memorandumului 28, 400114 Cluj-Napoca, Romania; (S.M.B.); (M.D.B.)
| | - Mircea Daniel Botez
- Department of Structural Mechanics, School of Civil Engineering, Technical University of Cluj-Napoca, Str. Memorandumului 28, 400114 Cluj-Napoca, Romania; (S.M.B.); (M.D.B.)
| | - Cristian Doru Olteanu
- Department of Orthodontics, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Str. Avram Iancu 31, 400083 Cluj-Napoca, Romania;
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Rajawat A, Kaushik M. Stresses in teeth with External Cervical Resorption defects restored with different Biomimetic cements: A Finite Element Analysis. J Endod 2023:S0099-2399(23)00364-3. [PMID: 37355164 DOI: 10.1016/j.joen.2023.06.010] [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: 04/01/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023]
Abstract
INTRODUCTION This study compared the stress distributions in teeth with simulated external cervical resorption defects restored with different restorative materials and identified areas of high stress concentration. METHODS A maxillary central incisor created in a scanned model using HyperWorks software served as control. External cervical resorption defects based on Shanon Patel's classification were created (1Bd/2Bd/3Bd) in the scanned model. The defects were restored using Mineral Trioxide Aggregate (MTA), Biodentine, Glass Ionomer Cement (GIC) and Bioaggregate. On all the models a force of 100 N was applied on palatal aspect, 2 mm incisal to cingulum directed at 45° along the long axis of the tooth. RESULTS The stresses generated in dentin and cementum is less, with a restorative material having high Young's modulus. For 1Bd defect, MTA and Bioaggregate showed least stresses in dentin and cementum respectively, whereas Biodentine had consistently lower stresses in dentin and cementum both. Larger defects like 2Bd and 3Bd restored with Bioaggregate exhibited minimum stresses in dentin and cementum. CONCLUSION Bioaggregate and Biodentine replace dentin with maximum stress and maximum strain. Elastic moduli similar to or higher than dentin are preferred for restoring cervical third resorptive lesions of the tooth.
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Affiliation(s)
- Akansha Rajawat
- Conservative Dentistry and Endodontics (Army College of Dental Sciences, Secunderabad), Practitioner, Ganga Singh Street, Dhauli Pyau, Mathura, Uttar Pradesh, India.
| | - Mamta Kaushik
- Conservative Dentistry and Endodontics, Professor and Head of Department, Department of Conservative Dentistry and Endodontics, Army College of Dental Sciences, Secunderabad, Telangana, India
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Küçükkaya Eren S. Clinical applications of calcium silicate-based materials: a narrative review. Aust Dent J 2023; 68 Suppl 1:S96-S109. [PMID: 37885314 DOI: 10.1111/adj.12986] [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] [Accepted: 10/04/2023] [Indexed: 10/28/2023]
Abstract
Calcium silicate-based materials are hydrophilic materials with biocompatibility and bioactivity properties. Despite many advantages, they might present some problems related to discolouration, setting time, manipulation and solubility depending on the composition of the product and the type of clinical application. Calcium silicate-based materials can be evaluated under two types according to their intended use: calcium silicate-based cements (CSCs) and calcium silicate-based sealers (CSSs). CSCs can be used in many endodontic procedures including perforation repair, resorption repair, apical barriers, guided endodontic repair, vital pulp treatment, endodontic surgery, root fractures and root canal filling as a core obturation material. CSSs are available for use with gutta-percha to obturate root canals using cold and warm techniques, including the sealer-based obturation technique. The purpose of this review is to evaluate the available literature on CSCs and CSSs and to provide up-to-date information and recommendations for their clinical applications.
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Affiliation(s)
- S Küçükkaya Eren
- Faculty of Dentistry, Department of Endodontics, Hacettepe University, Ankara, Turkey
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Chen J, Zhang J, Wang F. A finite element analysis of different postures and intra-abdominal pressures for the uterine ligaments in maintaining the normal position of uterus. Sci Rep 2023; 13:5082. [PMID: 36977774 PMCID: PMC10050321 DOI: 10.1038/s41598-023-32368-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
Uterine prolapse is a common gynecological disease, which seriously affects the quality of life and physical and mental health of elderly women. The aim of this study was to analyze the influence of different conditions (intra-abdominal pressure (IAP) and posture) on stress and displacement of uterine ligaments using the finite element method, and evaluate the contribution of uterine ligaments on uterus. The three-dimensional (3D) models of retroverted uterus and its accessory ligaments were established, loads and constraints were set in ABAQUS software, and the stress and displacement of uterine ligaments were calculated. The uterine displacement increased with the increase of IAP, and then the stress and displacement of each uterine ligament also increased. The uterine displacement was in the order of forward < upright < backward with different postures, and USL, CL and RL got larger values when the body was backward, while BL got a larger value when the body was forward. With the same condition, the stress of the uterine ligaments was in the order of USL > BL > CL > RL, and the displacement of the ligaments was in the order of BL > RL > USL > CL. The contribution of each uterine ligament changing with different IAP and postures was studied through finite element analysis, and the research results were consistent with the clinical data, which can provide a basis for exploring the mechanism of uterine prolapse.
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Affiliation(s)
- Jialan Chen
- Department of Gynecology, Shaanxi Provincial People's Hospital, Xi'an, 710068, People's Republic of China.
| | - Junfeng Zhang
- School of Mechanical and Electrical Engineering, Xi'an University of Architecture and Technology, Xi'an, 710055, People's Republic of China
| | - Fan Wang
- Department of Gynecology, Shaanxi Provincial People's Hospital, Xi'an, 710068, People's Republic of China
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Limjeerajarus N, Sratong-on P, Dhammayannarangsi P, Tompkins KA, Kamolratanakul P, Phannarus K, Osathanon T, Limjeerajarus CN. Determination of the compressive modulus of elasticity of periodontal ligament derived from human first premolars. Heliyon 2023; 9:e14276. [PMID: 36938472 PMCID: PMC10018569 DOI: 10.1016/j.heliyon.2023.e14276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/23/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Purpose There are two commonly cited modulus of elasticity of the human periodontal ligament (EPDL), i.e., 6.89 ✕ 10-5 GPa (E1) and 6.89 ✕ 10-2 GPa (E2), which are exactly 1000-fold different from each other. This study aims to clarify the ambiguity of the two EPDL used for simulations and determine a more accurate EPDL value of human first premolars using experimental and simulation approaches. Methods Numerical simulations using finite element analysis were performed to analyze PDL deformation under an average Asian occlusal force. To confirm the results, simple and multi-component, true-scale 3D models of a human first premolar were used in the simulations. Finally, a compression test using a universal testing machine on PDL specimens was conducted to identify the compressive EPDL of human first premolars. Results The simulation results from both models revealed that E1 was inaccurate, because it resulted in excessive PDL deformation under the average occlusal force, which should not occur during mastication. Although the E2 did not lead to excessive PDL deformation, it was obtained by an error in unit conversion with no scientific backing. In contrast, the compression test results indicated that the compressive EPDL was 9.64 ✕ 10-4 GPa (E3). In the simulation, E3 did not cause excessive PDL deformation. Conclusion The simulation results demonstrated that both commonly cited EPDL values (E1 and E2) were incorrect. Based on the experimental and simulation results, the average compressive EPDL of 9.64 ✕ 10-4 GPa is proposed as a more accurate value for human first premolars. Clinical significance The proposed more accurate EPDL would contribute to more precise and reliable FEA simulation results and provide a better understanding of the stress distribution and deformation of dental materials, which will be beneficial to precision dentistry, orthodontics and restoration designs.
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Affiliation(s)
- Nuttapol Limjeerajarus
- Office of Research Affairs, Chulalongkorn University, Bangkok, 10330, Thailand
- Research Center for Advanced Energy Technology, Thai-Nichi Institute of Technology, Bangkok, 10250, Thailand
| | - Pimpet Sratong-on
- Research Center for Advanced Energy Technology, Thai-Nichi Institute of Technology, Bangkok, 10250, Thailand
| | | | - Kevin A. Tompkins
- Office of Research Affairs, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Paksinee Kamolratanakul
- Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Krisadi Phannarus
- Dental Department, Queen Sirikit National Institute of Child Health, Bangkok, 10400, Thailand
| | - Thanaphum Osathanon
- Dental Stem Cell Biology Research Unit and Department of Anatomy, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chalida Nakalekha Limjeerajarus
- Center of Excellence in Genomics and Precision Dentistry and Department of Physiology, Chulalongkorn University, Bangkok, 10330, Thailand
- Excellence Center in Regenerative Dentistry, Chulalongkorn University, Bangkok, Thailand
- Corresponding author. Department of Physiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand.
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Luo X, Rong Q, Luan Q, Yu X. Effect of partial restorative treatment on stress distributions in non-carious cervical lesions: a three-dimensional finite element analysis. BMC Oral Health 2022; 22:607. [PMID: 36522633 PMCID: PMC9753429 DOI: 10.1186/s12903-022-02647-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Partial restoration combined with periodontal root coverage surgery can be applied to the treatment of non-carious cervical lesions (NCCLs) accompanied with gingival recessions in clinical practice. However, the feasibility of NCCL partial restorative treatment from a biomechanical perspective remains unclear. This study aimed to investigate the effect of partial restorations on stress distributions in the NCCLs of mandibular first premolars via three-dimensional finite element analysis. METHODS Three-dimensional finite element models of buccal wedge-shaped NCCLs in various locations of a defected zenith (0 mm, 1 mm, and 2 mm) were constructed and divided into three groups (A, B, and C). Three partially restored NCCL models with different locations of the lower restoration border (1 mm, 1.5 mm, and 2 mm), and one completely restored NCCL model were further constructed for each group. The following restorative materials were used in all restoration models: composite resin (CR), glass-ionomer cement (GIC), and mineral trioxide aggregate (MTA). The first principal stress distributions under buccal oblique loads of 100 N were analyzed. Restoration bond failures were also evaluated based on stress distributions at dentin-restoration interfaces. RESULTS When the partial restoration fully covered the defected zenith, the first principal stress around the zenith decreased and the maximum tensile stress was concentrated at the lower restoration border. When the partial restoration did not cover the defected zenith, the first principal stress distribution patterns were similar to those in unrestored models, with the maximum tensile stress remaining concentrated at the zenith. As the elastic modulus of the restorative material was altered, the stress distributions at the interface were not obviously changed. Restoration bond failures were not observed in CR, but occurred in GIC and MTA in most models. CONCLUSIONS Partial restorations that fully covered defected zeniths improved the stress distributions in NCCLs, while the stress distributions were unchanged or worsened under other circumstances. CR was the optimal material for partial restorations compared to GIC and MTA.
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Affiliation(s)
- Xin Luo
- grid.11135.370000 0001 2256 9319Department of Periodontology, Peking University School and Hospital of Stomatology, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081 China
| | - Qiguo Rong
- grid.11135.370000 0001 2256 9319Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Qingxian Luan
- grid.11135.370000 0001 2256 9319Department of Periodontology, Peking University School and Hospital of Stomatology, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081 China
| | - Xiaoqian Yu
- grid.11135.370000 0001 2256 9319Department of Periodontology, Peking University School and Hospital of Stomatology, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081 China
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Arıcan B, Sesen Uslu Y, Sarıalioğlu Güngör A. Resistance to fracture of simulated external cervical resorption cavities repaired with different materials. AUST ENDOD J 2022; 49:174-182. [PMID: 36354094 DOI: 10.1111/aej.12714] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/26/2022] [Accepted: 10/29/2022] [Indexed: 11/11/2022]
Abstract
The aim of the study was to evaluate the fracture resistance (FR) of teeth with simulated external cervical resorption (ECR) cavities repaired with different materials. Following the shaping of the 80 human permanent maxillary central incisors, standard ECR cavities were prepared and restored with a nanohybrid composite resin; a high viscosity GIC Equia Forte Fill; Biodentine; Biodentine + nanohybrid composite resin; MTA BIOREP; MTA BIOREP + nanohybrid composite resin. Then, the root canals were obturated with AH Plus and gutta-percha. The roots were embedded acrylic resin blocks and fracture strength test was applied. The highest FR was observed in the Biodentine group, while the lowest was in Equia group (p < 0.05). No significant results were observed among composite, Biodentine + composite, MTA BIOREP + composite and MTA BIOREP (p > 0.05). Biodentine may be a preferable material for repairing ECR cavities. Adding a composite layer on MTA BIOREP and Biodentine did not improve the FR of these materials.
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Affiliation(s)
- Burçin Arıcan
- Department of Endodontics, School of Dental MedicineBahçeşehir UniversityIstanbulTurkey
| | - Yesim Sesen Uslu
- Department of Restorative Dentistry, School of Dental MedicineBahçeşehir UniversityIstanbulTurkey
| | - Ayça Sarıalioğlu Güngör
- Department of Restorative Dentistry, Faculty of DentistryBezmialem Vakif UniversityIstanbulTurkey
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Gupta G, Agarwal A, Ansari AA, Singh RK. Non-surgical management of a large periapical lesion with internal resorption using PRF, hydroxyapatite and MTA. BMJ Case Rep 2022; 15:e248907. [PMID: 36113960 PMCID: PMC9486192 DOI: 10.1136/bcr-2022-248907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Periapical lesions of endodontic origin are caused by microbial infection of pulp. According to various studies, it is known that necrosis of pulp provides a favourable habitat for microbes to replicate and release various toxins into the periapical tissue leading to inflammation and formation of a periapical lesion. A variety of non-invasive methods to manage such lesions include conservative root canal treatment, aspiration-irrigation technique, decompression technique, calcium hydroxide therapy, lesion sterilisation and tissue repair therapy, and the apexum procedure. We present a case report describing non-surgical management of a large periapical lesion associated with a permanent central incisor displaying internal inflammatory resorption using platelet rich fibrin (PRF), bone graft and mineral trioxide aggregate (MTA).
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Affiliation(s)
- Geetika Gupta
- Department of Paediatric and Preventive Dentistry, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Abhilasha Agarwal
- Department of Paediatric and Preventive Dentistry, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Afroz Alam Ansari
- Department of Paediatric and Preventive Dentistry, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Rajeev Kumar Singh
- Department of Paediatric and Preventive Dentistry, King George Medical University, Lucknow, Uttar Pradesh, India
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Ordinola-Zapata R, Lin F, Nagarkar S, Perdigão J. A critical analysis of research methods and experimental models to study the load capacity and clinical behavior of the root filled teeth. Int Endod J 2022; 55 Suppl 2:471-494. [PMID: 35263455 PMCID: PMC9314814 DOI: 10.1111/iej.13722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/04/2022] [Indexed: 12/04/2022]
Abstract
The prognosis of root‐filled teeth depends not only on a successful root canal treatment but also on the restorative prognosis. This critical review discusses the advantages and limitations of various methodologies used to assess the load capacity or clinical survivability of root‐filled teeth and restorations. These methods include static loading, cyclic loading, finite element analysis and randomized clinical trials. In vitro research is valuable for preclinical screening of new dental materials or restorative modalities. It also can assist investigators or industry to decide whether further clinical trials are justified. It is important that these models present high precision and accuracy, be reproducible, and present adequate outcomes. Although in vitro models can reduce confounding by controlling important variables, the lack of clinical validation (accuracy) is a downside that has not been properly addressed. Most importantly, many in vitro studies did not explore the mechanisms of failure and their results are limited to rank different materials or treatment modalities according to the maximum load capacity. An extensive number of randomized clinical trials have also been published in the last years. These trials have provided valuable insight on the survivability of the root‐filled tooth answering numerous clinical questions. However, trials can also be affected by the selected outcome and by intrinsic and extrinsic biases. For example, selection bias, loss to follow‐up and confounding. In the clinical scenario, hypothesis‐based studies are preferred over observational and retrospective studies. It is recommended that hypothesis‐based studies minimize error and bias during the design phase.
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Affiliation(s)
- Ronald Ordinola-Zapata
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Fei Lin
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, 100081, China.,Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Sanket Nagarkar
- Park Dental Group, Minneapolis, Minnesota, and Clinical Research Assistant Professor (affiliated), Department of Restorative Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jorge Perdigão
- Division of Operative Dentistry, Department of Restorative Sciences, University of Minnesota, Minneapolis, Minnesota, USA
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Maiti S, Aparna J, Jessy P. Polyether ether ketone – As an alternative biomaterial for Metal Richmond crown-3-dimensional finite element analysis. J Conserv Dent 2021; 24:553-557. [PMID: 35558664 PMCID: PMC9089765 DOI: 10.4103/jcd.jcd_638_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 11/19/2021] [Accepted: 11/25/2021] [Indexed: 11/04/2022] Open
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Multidisciplinary Treatment Approach for Perforated Internal Root Resorption: Three-Year Follow-Up. Case Rep Dent 2019; 2019:5848272. [PMID: 31641540 PMCID: PMC6770450 DOI: 10.1155/2019/5848272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 07/19/2019] [Accepted: 08/30/2019] [Indexed: 01/26/2023] Open
Abstract
Internal root resorption (IRR) is described as a resorptive defect of the internal aspect of the root caused by odontoclastic activity associated chiefly with chronic pulp inflammation and trauma. An important variation to consider is the presence of a root perforation, although it is rare. This paper defines the use of CBCT in the diagnosis and combined nonsurgical and surgical multidisciplinary management and follow-up of a maxillary central incisor with perforating IRR in a 9-year-old female patient. At 3-year follow-up, clinical and radiographic findings of the case were satisfactory.
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