1
|
Setzer FC, Kratchman SI. Present Status and Future Directions - Surgical Endodontics. Int Endod J 2022; 55 Suppl 4:1020-1058. [PMID: 35670053 DOI: 10.1111/iej.13783] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
Endodontic surgery encompasses several procedures for the treatment of teeth with a history of failed root canal treatment, such as root-end surgery, crown- and root resections, surgical perforation repair, and intentional replantation. Endodontic microsurgery is the evolution of the traditional apicoectomy techniques and incorporates high magnification, ultrasonic root-end preparation and root-end filling with biocompatible filling materials. Modern endodontic surgery uses the dental operating microscope, incorporates cone-beam computed tomography (CBCT) for preoperative diagnosis and treatment planning, and has adopted piezoelectric approaches to osteotomy and root manipulation. Crown- and root resection techniques have benefitted from the same technological advances. This review focuses on the current state of root-end surgery by comparing the techniques and materials applied during endodontic microsurgery to the most widely used earlier methods and materials. The most recent additions to the clinical protocol and technical improvements are discussed, and an outlook on future directions is given. While non-surgical retreatment remains the first choice to address most cases with a history of endodontic failure, modern endodontic microsurgery has become a predictable and minimally invasive alternative for the retention of natural teeth.
Collapse
Affiliation(s)
- F C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - S I Kratchman
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| |
Collapse
|
2
|
Abstract
Root end resections play an important role in the success of periapical surgery. Beveling of the root end resections can vary significantly depending on the surgical technique, the root and canal morphology. The intention of this article was to clinically assess the root resections bevels and to estimate their relation to applied periapical surgeries. A prospective clinical study consisted of sixty periapical surgeries performed on teeth with chronic periapical lesions. Thirty periapical surgeries were performed in a conventional manner, while thirty were contemporary ultrasonic surgeries. Following the completion of strictly planned and performed intraoperative procedures, the resection bevels were assessed. To obtain the real bevel angles a compass was used. Root resections were significantly less beveled in all teeth operated with contemporary ultrasonic surgery, with mean values between 2.1° to 7.8°. The number of roots and their dilacerations didn't influence the root resection bevel. For comparison, root resections were significantly beveled in all conventionally operated teeth, with mean values of 46°. Due to the technical limitations of the conventional periapical surgery, mandibular premolars were exclusively operated with ultrasonic periapical surgery, with mean values of resection bevel not exceeding 20.7°. Significantly lesser resection bevel associated with ultrasonic periapical surgery contributes to root preservation and favorable surgical outcome.
Collapse
Affiliation(s)
- Marina Kacarska
- Faculty of Dentistry, Department of Oral Surgery, University Ss. Cyril and Methodius, Skopje
| |
Collapse
|
3
|
The use of Bioceramics as root-end filling materials in periradicular surgery: A literature review. Saudi Dent J 2018; 30:273-282. [PMID: 30202163 PMCID: PMC6128316 DOI: 10.1016/j.sdentj.2018.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 07/15/2018] [Accepted: 07/16/2018] [Indexed: 01/26/2023] Open
Abstract
Introduction Periradicular surgery involves the placement of a root-end filling following root-end resection, to provide an apical seal to the root canal system. Historically several materials have been used in order to achieve this seal. Recently a class of materials known as Bioceramics have been adopted. The aim of this article is to provide a review of the outcomes of periradicular surgery when Bioceramic root-end filling materials are used on human permanent teeth in comparison to "traditional" materials. Methods & results An electronic literature search was performed in the databases of Web of Science, PubMed and Google Scholar, between 2006 and 2017, to collect clinical studies where Bioceramic materials were utilised as retrograde filling materials, and to compare such materials with traditional materials. In this search, 1 systematic review and 14 clinical studies were identified. Of these, 8 reported the success rates of retrograde Bioceramics, and 6 compared treatment outcomes of mineral trioxide aggregate (MTA) and traditional cements when used as root-end filling materials. Conclusion Bioceramic root-end filling materials are shown to have success rates of 86.4-95.6% (over 1-5 years). Bioceramics has significantly higher success rates than amalgam, but they were statistically similar to intermediate restorative material (IRM) and Super ethoxybenzoic acid (Super EBA) when used as retrograde filling materials in apical surgery. However, it seems that the high success rates were not solely attributable to the type of the root-end filling materials. The surgical/microsurgical techniques and tooth prognostic factors may significantly affect treatment outcome.
Collapse
|
4
|
Abstract
A better understanding of endodontic disease and the causes of treatment failure has refined the role of surgery in endodontics. The advent of newer materials, advances in surgical armamentarium and techniques have also led to an improved endodontic surgical outcome. The aim of this article is to provide a contemporary and up-to-date overview of endodontic surgery. It will focus primarily on the procedures most commonly performed in endodontic surgery.
Collapse
Affiliation(s)
- B S Chong
- Professor/Honorary Consultant in Restorative Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London
| | - J S Rhodes
- Specialist in Endodontics, Poole, Dorset
| |
Collapse
|
5
|
Cintra LTA, Bernabé PFE, de Moraes IG, Gomes-Filho JE, Okamoto T, Consolaro A, Pinheiro TN. Evaluation of subcutaneous and alveolar implantation surgical sites in the study of the biological properties of root-end filling endodontic materials. J Appl Oral Sci 2010; 18:75-82. [PMID: 20379685 PMCID: PMC5349029 DOI: 10.1590/s1678-77572010000100013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2008] [Accepted: 05/22/2009] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to compare two methodologies used in the evaluation of
tissue response to root-end filling materials in rats. Material and Methods Forty rats were divided into 4 groups: in Groups I and II (control groups), empty
polyethylene tubes were implanted in the extraction site and in the subcutaneous
tissue, respectively; in Groups III and IV, polyethylene tubes filled with ProRoot
MTA were implanted in the extraction site and in the subcutaneous tissue,
respectively. The animals were killed 7 and 30 days after tube implantation, and
the hemi-maxillas and the capsular subcutaneous tissue, both with the tubes, were
removed. Specimens were processed and evaluated histomorphologicaly under light
microscopy. The scores obtained were analyzed statistically by the Kruskal-Wallis
test (p<0.05). Results There were no statistically significant differences between the implantation
methods (p=0.78033, p=0.72039). It was observed that the 30-day groups presented a
more mature healing process due to smaller number of inflammatory cells. Conclusion The present study showed no differences in tissue responses as far as the
implantation site and the studied period were concerned. Alveolar socket
implantation methodology represents an interesting method in the study of the
biological properties of root-end filling endodontic materials due to the
opportunity to evaluate bone tissue response.
Collapse
|
6
|
Dentin Enhances the Antibacterial Effect of Mineral Trioxide Aggregate and Bioaggregate. J Endod 2009; 35:221-4. [DOI: 10.1016/j.joen.2008.11.001] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2008] [Revised: 10/28/2008] [Accepted: 11/02/2008] [Indexed: 11/20/2022]
|
7
|
De Bruyne MAA, De Moor RJG. The use of glass ionomer cements in both conventional and surgical endodontics. Int Endod J 2004; 37:91-104. [PMID: 14871175 DOI: 10.1111/j.0143-2885.2004.00769.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The capacity to bond to dental tissues, especially to dentine, their long-term fluoride release and their biocompatibility make glass ionomer cements (GICs) advantageous for use in endodontics, as well as in restorative dentistry. This review provides information on the basic properties of GICs, such as adhesion, antimicrobial effects and biocompatibility, particularly as they relate to use in endodontics. Indications for the use of GICs in endodontics are orthograde root canal sealing, root-end filling, repair of perforations and root resorption defects, treatment of vertical fractures and maintenance of the coronal seal. The paper includes a review on each of these indications. It is concluded that in spite of the critical handling characteristics and the inconclusive findings regarding sealing ability and antimicrobial activity, there is substantial evidence to confirm their satisfactory clinical performance. Both soft tissue and bone compatibility make them suitable for use during endodontic surgery.
Collapse
Affiliation(s)
- M A A De Bruyne
- Department of Operative Dentistry and Endodontology, Dental School, Ghent University, Ghent University Hospital, Gent, Belgium.
| | | |
Collapse
|
8
|
Wesson CM, Gale TM. Molar apicectomy with amalgam root-end filling: results of a prospective study in two district general hospitals. Br Dent J 2003; 195:707-14; discussion 698. [PMID: 14718966 DOI: 10.1038/sj.bdj.4810834] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2001] [Accepted: 06/30/2003] [Indexed: 11/09/2022]
Abstract
AIM To determine the five-year success rates, site or sites of failure, prognostic indicators and lower lip morbidity associated with molar apicectomy using amalgam root-end filling. DESIGN Multicentre, prospective study. SETTING The departments of oral and maxillo-facial surgery in two district general hospitals. METHOD One thousand and seven molar apicectomy procedures, combined with amalgam root-end filling were expedited during the period 1974-1995. A five-year review of each operated tooth was carried out or attempted between 1979-2000. RESULTS Of the 790 (78%) operated molars successfully reviewed at 5 years or later 451 (57%) exhibited 'complete healing' and 39 (5%) 'uncertain healing'. Three hundred (38%) were classified as 'unsatisfactory healing' (failures), and these included 12 which were assumed to be of periodontal origin. Whilst longitudinal root fracture, perforation and/or infection in the furcation, periodontal disease or a non-restorable crown accounted for treatment failure and often the need to remove teeth subsequently, the study probably pointed to the apical ends of the roots rather than the furcation as being the major sites at which 'unsatisfactory healing' occurred. Mandibular first molars attracted the highest 'complete healing' rate (60%) and mandibular second molars the lowest (46%). 'Good' root canal treatment (RCT) at the outset improved the prognosis of a root-end filling (REF) whilst the absence of RCT compromised it. Cystic change pointed to a better prognosis than apical granulomatous change as did a deep compared with a shallow 'bone cuff'. Disease at the furcation suggested a worse prognosis. Teeth which showed 'complete healing' at 1 year had a 75% probability of maintaining this outcome at 5 years. Sensory disturbance of variable duration occurred in the lower lip following 20-21% of mandibular molar procedures. In the majority of cases (79-80%) this had remitted within 3 months. A permanent deficit occurred in 8 patients (1%) where the apicectomy could definitely be incriminated as causative. Four were associated with first molar apicectomy and four with second molar apicectomy. CONCLUSIONS Molar apicectomy with amalgam root-end filling attracts an overall 'complete healing' rate at 5 years of 57%, the results being best with mandibular first molars and worst with mandibular second molars. The prognosis is also better where there is 'good' initial orthograde root filling, an associated radicular cyst as compared with granulomatous change and where the buccal sulcus is deep rather than shallow. It is worse when orthograde root filling is absent and when there is disease in the furcation. 'Complete healing' at 1 year can be expected to be maintained at 5 years in 75% of cases. The commonest site of subsequent periradicular rarefaction seems to be 'apical' whilst failure at the furcation is probably comparatively rare. There is a threefold increase in the occurrence of permanent lower lip sensory impairment following second molar surgery in comparison with first molar surgery, the overall incidence being 1%.
Collapse
Affiliation(s)
- C M Wesson
- Queen Elizabeth II Hospital, Welwyn Garden City.
| | | |
Collapse
|
9
|
Chong BS, Pitt Ford TR, Hudson MB. A prospective clinical study of Mineral Trioxide Aggregate and IRM when used as root-end filling materials in endodontic surgery. Int Endod J 2003; 36:520-6. [PMID: 12887380 DOI: 10.1046/j.1365-2591.2003.00682.x] [Citation(s) in RCA: 172] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM To assess the success rate of the root-end filling material, Mineral Trioxide Aggregate (MTA). METHODOLOGY Referred adult patients were recruited using strict entry criteria and randomly allocated to receive MTA or IRM. A standardized surgical technique was employed: the root end was resected perpendicularly and a root-end cavity was prepared ultrasonically and filled. A radiograph taken immediately after surgery was compared with those taken at 12 and 24 months. Customised film holders and the paralleling technique were used; radiographs were assessed by two trained observers using agreed criteria. The results from 122 patients (58 in IRM group, 64 in MTA group) after 12 months and 108 patients (47 in IRM group, 61 in MTA group) for the 24-month review period were analysed using the chi2 test. RESULTS The highest number of teeth with complete healing at both times was observed when MTA was used. When the numbers of teeth with complete and incomplete (scar) healing, and those with uncertain and unsatisfactory healing were combined, the success rate for MTA was higher (84% after 12 months, 92% after 24 months) compared with IRM (76% after 12 months, 87% after 24 months). However, statistical analysis showed no significant difference in success between materials (P > 0.05) at both 12 and 24 months. CONCLUSIONS In this study, the use of MTA as a root-end filling material resulted in a high success rate that was not significantly better than that obtained using IRM.
Collapse
Affiliation(s)
- B S Chong
- Department of Conservative Dentistry, GKT Dental Institute, King's College London, Guy's Hospital, London, UK.
| | | | | |
Collapse
|
10
|
Hauman CHJ, Love RM. Biocompatibility of dental materials used in contemporary endodontic therapy: a review. Part 2. Root-canal-filling materials. Int Endod J 2003; 36:147-60. [PMID: 12657140 DOI: 10.1046/j.1365-2591.2003.00637.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Root-canal-filling materials are either placed directly onto vital periapical tissues or may leach through dentine. The tissue response to these materials therefore becomes important and may influence the outcome of endodontic treatment. This paper is a review of the biocompatibility of contemporary orthograde and retrograde root-canal-filling materials.
Collapse
Affiliation(s)
- C H J Hauman
- Department of Oral Rehabilitation, School of Dentistry, University of Otago, Dunedin, New Zealand.
| | | |
Collapse
|
11
|
Murray PE, About I, Lumley PJ, Franquin JC, Windsor LJ, Smith AJ. Odontoblast morphology and dental repair. J Dent 2003; 31:75-82. [PMID: 12615023 DOI: 10.1016/s0300-5712(02)00089-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES To investigate the changes in morphology and activity of pulp odontoblasts in response to cavity restoration variables and patient factors. METHODS Class V non exposed cavities were prepared in the intact 1st or 2nd premolar teeth of 27 patients, aged between 9 and 17 years-old. Following tooth extraction, the area of reactionary dentine and the area of the odontoblasts were measured using computerised histomorphometry. RESULTS The cytoplasm to nucleus ratio of the odontoblasts was found to increase beneath cut dentinal tubules, following the secretion of reactionary dentine. However, none of the patient or preparation variables were found to be correlated with changes in the odontoblast cytoplasm to nucleus ratio. CONCLUSIONS Morphological changes in human odontoblasts is directly related to their capacity to repair dentine injuries and provide pulp protection. Changes in odontoblast morphology reflect secretory activity.
Collapse
Affiliation(s)
- P E Murray
- Oral Biology, Indiana University School of Dentistry, Indianapolis, IN 46202-5186, USA.
| | | | | | | | | | | |
Collapse
|
12
|
Smith AJ, Tobias RS, Murray PE. Transdentinal stimulation of reactionary dentinogenesis in ferrets by dentine matrix components. J Dent 2001; 29:341-6. [PMID: 11472806 DOI: 10.1016/s0300-5712(01)00020-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Trans-dentinal stimulation of reactionary dentinogenesis may be mediated through cellular signalling by bio-active components released from the dentine matrix during injury. Understanding of these processes will be important to guide dentinal repair activity following restorative surgery. The purpose of this study was to investigate the effects of implanting isolated dentine matrix proteins within cavity preparations on dentinal repair activity and odontoblast survival using a controlled experimental animal model. METHODS Forty-five ferret canine teeth each had a standardised non-exposed cylindrical Class V cavity cut into the buccal dentine. Ten cavities were restored with zinc oxide eugenol, as a control. Two different lyophilised preparations of dentine matrix components were implanted on the axial floor of the remaining 35 cavities prior to filling with zinc oxide eugenol. After post-operative periods of 2, 7, 14, 28, and 90 days, the teeth were extracted and examined histomorphometrically and the data analysed statistically by analysis of variance tests. RESULTS The odontoblasts beneath the restored cavities responded to the presence of the two dentine matrix preparations by increasing the mean area of reactionary dentine secreted by 433 and 578%, and the numbers of odontoblasts remained stable. CONCLUSION Dentine matrix components can stimulate reactionary dentinogenesis in non-exposed cavity preparations. It will now be important to identify how this may be harnessed as a part of routine restorative surgery to optimise treatment outcomes with a biological basis.
Collapse
Affiliation(s)
- A J Smith
- Oral Biology, School of Dentistry, The University of Birmingham, Birmingham B4 6NN, UK.
| | | | | |
Collapse
|
13
|
About I, Murray PE, Franquin JC, Remusat M, Smith AJ. The effect of cavity restoration variables on odontoblast cell numbers and dental repair. J Dent 2001; 29:109-17. [PMID: 11239585 DOI: 10.1016/s0300-5712(00)00067-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Dentinal repair following cavity restoration is dependent on several parameters including the numbers of surviving odontoblasts. The purpose of this study was to examine the effects of cavity cutting and restoration treatments on post-operative odontoblast numbers. METHODS 353 Standardised non-exposed rectangular Class V cavities, were cut into the buccal dentin of intact 1st or 2nd premolar teeth of 165 patients, aged between nine and 25 years of age. Composite cavity restorations with various etching treatments were compared with resin-modified glass ionomer cements, enamel bonding resins, as well as polycarboxylate, calcium hydroxide, and zinc oxide eugenol materials. Following tooth extraction (20-381 days) for orthodontic reasons, the area of the reactionary dentine and the area of the odontoblasts was measured histomorphometrically. RESULTS Odontoblast numbers and dentine repair activity were found to be influenced more by cavity restoration variables, than the choice of cavity filling materials or patient factors. The most important cavity preparation variable was the cavity remaining dentine thickness (RDT); below 0.25mm the numbers of odontoblasts decreased by 23%, and minimal reactionary dentine repair was observed. CONCLUSIONS Odontoblast injury increased as the cavity RDT decreased. In rank order of maintaining odontoblast numbers beneath restored cavities with a RDT below 0.5mm, and using calcium hydroxide for comparison; calcium hydroxide (100%), polycarboxylate (82.4%), zinc oxide eugenol (81.3%), composite (75.5%), enamel bonding resin (49.5%) and RMGIC (42.8%). The vitality and dentine repair capacity of the pulp is dependent on odontoblast survival. Variations in the extent of odontoblast injury caused during operative procedures, may be the major underlying reason for the success or failure of restorative treatments.
Collapse
Affiliation(s)
- I About
- Faculté d'Odontologie, Université de la Méditeranée, Laboratoire, I.M.E.B, 27 Bvd Jean-Moulin, 13385, Cedex 5, Marseille, France
| | | | | | | | | |
Collapse
|
14
|
Murray PE, Lumley PJ, Ross HF, Smith AJ. Tooth slice organ culture for cytotoxicity assessment of dental materials. Biomaterials 2000; 21:1711-21. [PMID: 10905412 DOI: 10.1016/s0142-9612(00)00056-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of this work was to develop a tooth slice organ culture method to assess the response of the cells of the dental pulp to commonly used dental materials and products. Wistar rat tooth slices were grown in culture for two and ten days in the presence of dental materials. After culture, the tooth tissues were processed and the responses of the pulpal cells were analysed histomorphometrically. Cytotoxic cell destruction was observed following the direct application of test materials to tooth slices (n = 298) after 10 days in culture (MANOVA, P = 0.0001), whilst the restoration of prepared deep dentine cavities (n = 30), with test products, did not result in a significant amount of pulpal injury (MANOVA, P = 0.287). In rank order of causing pulpal injury, the test materials from the most to the least cell destructive, was; Salicylic acid. Calcium hydroxide, Kalzinol zinc oxide eugenol, high-mercury Amalgam, Prime & Bond, Dycal, Barium sulphate, Hypocal, Scotchbond, Calasept, Life and One-step. Tooth slice organ culture, provided a cytotoxicity screening method for dental materials, bearing a closer physiological resemblance to the clinical situation than cell culture screening methods. Tooth slice culturing may have the potential to replace some types of in vivo animal experimentation, as there is a clear need to reduce this form of testing.
Collapse
Affiliation(s)
- P E Murray
- School of Dentistry. The University of Birmingham. St. Chad's Queensway, UK
| | | | | | | |
Collapse
|
15
|
Murray PE, About I, Lumley PJ, Franquin JC, Remusat M, Smith AJ. Human odontoblast cell numbers after dental injury. J Dent 2000; 28:277-85. [PMID: 10722902 DOI: 10.1016/s0300-5712(99)00078-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES The purpose of this study was to measure the changes in odontoblast cell numbers in response to cavity restoration variables and patient factors, and the effect these factors have on dental repair by tertiary dentinogenesis. The number of vital odontoblasts is a critical factor for pulpal repair following restorative surgery, and yet little information is available on these cell numbers. METHODS Class V non-exposed cavities were prepared in the buccal surface of intact first or second premolar teeth of 27 patients, between 9 and 17 years of age. Following tooth extraction (28-163 days) the area of reactionary dentine and the area of the odontoblasts were measured histomorphometrically. RESULTS Patient factors, as well as cavity preparation and restoration variables, had little effect on the numbers of odontoblasts per pulpal unit area. However, the age of the patient did appear to have an effect on the reactionary dentine secretory capacity of odontoblasts per unit area, and on the relative number of odontoblasts beneath cut dentinal tubules. CONCLUSIONS Odontoblast cell numbers were maintained following the preparation of cavities cut into dentine with a 0.5mm residual dentine thickness. The repair capacity of the pulp-dentine complex would appear to be age dependent, this may explain differences in the success of various restorative treatments between patients.
Collapse
Affiliation(s)
- P E Murray
- Oral Biology, The School of Dentistry, The University of Birmingham, St. Chad's Queensway, Birmingham, UK
| | | | | | | | | | | |
Collapse
|
16
|
Murray PE, About I, Lumley PJ, Smith G, Franquin JC, Smith AJ. Postoperative pulpal and repair responses. J Am Dent Assoc 2000; 131:321-9. [PMID: 10715923 DOI: 10.14219/jada.archive.2000.0175] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Each year in the United States, the success of 10 million surgically restored carious lesions depends on a favorable tertiary dentin repair response to preparation, restoration and patient factor variables. The authors investigated the relationship between these variables and dentinal response. METHODS Standardized rectangular Class V restoration preparations were cut into the buccal dentin of intact first or second premolars of 27 patients without exposing the pulp and were restored. The patients were between 9 and 17 years of age. The treated teeth were scheduled for extraction for orthodontic reasons. After tooth extraction, the tertiary dentin was analyzed histomorphometrically. RESULTS The area of tertiary reactionary dentin was found to be correlated using linear regression analysis of variance with restoration residual dentin thickness (P = .0024), age of the patient (P = .0045), restoration floor surface area (P = .0266) and restoration width (P = .0415). The authors did not find a correlation with the premolar position (P = .0594), sex of the patient (P = .650), pulpal inflammatory reaction (P = .613) or the time elapsed since surgery (P = .531). Restoration with zinc oxide eugenol was found to negatively influence tertiary dentin matrix secretion (post hoc analysis of variance, P = .030). CONCLUSIONS The age of a patient at treatment, the choice of restorative material and the size of the restoration preparation are all factors that can positively or negatively affect the pulpal repair response. CLINICAL IMPLICATIONS Age of the patient affects dentin repair capacity and may be a factor in treatment planning decisions. Minimizing the cutting of dentin, especially the width and base of the preparation, reduces the probability of recurrent pulpal complications.
Collapse
Affiliation(s)
- P E Murray
- School of Dentistry, University of Birmingham, England
| | | | | | | | | | | |
Collapse
|
17
|
Whitters CJ, Strang R, Brown D, Clarke RL, Curtis RV, Hatton PV, Ireland AJ, Lloyd CH, McCabe JF, Nicholson JW, Scrimgeour SN, Setcos JC, Sherriff M, van Noort R, Watts DC, Wood D. Dental materials: 1997 literature review. J Dent 1999; 27:401-35. [PMID: 10399409 DOI: 10.1016/s0300-5712(99)00007-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
This review of the published literature on dental materials for the year 1997 has been compiled by the Dental Materials Panel of UK. It continues a series of annual reviews started in 1973. Emphasis has been placed upon publications, which report upon the materials science or clinical performance of the materials. The review has been divided by accepted materials classifications (fissure sealants, glass polyalkenoate cements, dentine bonding, dental amalgam, endodontic materials, casting alloys, ceramometallic restorations and resin-bonded bridges, ceramics, denture base resins and soft lining materials, impression materials, dental implant materials, orthodontic materials, biomechanics and image processing, resin composites, and casting investment materials and waxes). Three hundred and thirty three articles have been reviewed.
Collapse
|
18
|
Thompson JY, Bayne SC, Swift EJ, Stamatiades P. Dental materials citations: Part A, January to June 1997. Dent Mater 1997; 13:270-85. [PMID: 11696907 DOI: 10.1016/s0109-5641(97)80039-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE A search was conducted in biomedical journals published from January 1997 to June 1997 to identify all dental materials publications and sort them into major categories. METHODS Tables of contents for 79 journals for the period of January to June, 1997 were inspected and divided into 17 categories. Citations were analyzed by both frequency in journals and in categories, as well as compared to frequencies for previous years. RESULTS A total of 445 citations were detected in 79 journals for the period January 1997 to June 1997. Certain journals (n = 19) demonstrated a higher citation frequency (> or = 10 citations for 6 months) and represented 77.8% of all citations. The greatest number of citations continued to involve bonding (n = 97), resin-based restorative materials (composites; glass ionomers) (n = 95), prosthodontic materials (n = 51), and pulp protection/luting materials (n = 48). Frequencies by category were very similar to those for the last four years. SIGNIFICANCE The compiled literature citations provide a supplement for researchers and academicians seeking information in existing electronic databases.
Collapse
Affiliation(s)
- J Y Thompson
- Department of Operative Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA.
| | | | | | | |
Collapse
|
19
|
Chong BS, Pitt Ford TR, Kariyawasam SP. Short-term tissue response to potential root-end filling materials in infected root canals. Int Endod J 1997; 30:240-9. [PMID: 9477810 DOI: 10.1046/j.1365-2591.1997.00077.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The short-term tissue responses to two potential root-end filling materials, a light-cured glass ionomer cement (Vitrebond) and a reinforced zinc oxide-eugenol cement (Kalzinol), were compared with that to amalgam using a previously devised experimental model. In 24 premolar teeth of beagle dogs (47 roots), a collection of endodontic pathogenic bacteria was first inoculated into the root canals to induce periradicular lesions. On each root, an apicoectomy was performed and root-end cavities prepared to receive fillings of each material. The teeth and surrounding jaw were removed after 2 weeks (23 roots) and 1 week (24 roots); they were then prepared for histological examination. The tissue response to amalgam fillings after 2 weeks and 1 week was marked by moderate or severe inflammation on all roots, and extended to < or = 0.5 mm or > 0.5 mm in 15 out of 16 roots. In contrast, after 2 weeks, the majority of roots filled with Kalzinol showed little or moderate inflammation, while the tissue response to Vitrebond was the best of the three materials, and was also the least extensive. After 1 week, the overall best tissue response was with Vitrebond, followed by Kalzinol. The differences between materials for both time periods with either none or few inflammatory cells when compared with that with either moderate or severe inflammation were not statistically significant (P < 0.02). However, the differences between materials for both time periods with no inflammation or inflammation extending < 0.2 mm when compared with that with inflammation extending > 0.2 mm (< or = 0.5 mm or > 0.5 mm) were statistically significant (P < 0.01). Apart from amalgam, in which healing was marked by the persistence of a localized focus of inflammation adjacent to the root-end filling, even though there were intersample variations, there was little overall difference in the temporal and qualitative healing response to Vitrebond and Kalzinol. Both Vitrebond and Kalzinol have potential as root-end filling materials, as the tissue response was considerably more favourable than that to amalgam even in the short-term.
Collapse
Affiliation(s)
- B S Chong
- Department of Conservative Dentistry, United Medical and Dental Schools, Guy's Hospital, London, UK
| | | | | |
Collapse
|