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Sheng K, Ding N, Zhao SM, Chen H, Lai GY, Wang J. Outcome of regenerative endodontic procedures in delayed replanted immature permanent teeth with apical periodontitis: A retrospective study. Int J Paediatr Dent 2024. [PMID: 39245892 DOI: 10.1111/ipd.13265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 08/10/2024] [Accepted: 08/24/2024] [Indexed: 09/10/2024]
Abstract
BACKGROUND Regenerative endodontic procedures (REPs) is effective for treating young permanent teeth with pulp necrosis. However, its efficacy on delayed replanted avulsed teeth is unclear. AIM This retrospective study aimed to assess the efficacy of REPs in treating delayed replanted immature permanent teeth with apical periodontitis. DESIGN Avulsed teeth receiving REPs were systematically screened based on predetermined criteria. This study assessed the REP outcomes, postoperative periodontal healing, and overall treatment efficacy. Samples were grouped by REP outcomes and root development stage, with Fisher's exact tests used to compare outcomes among different groups. RESULTS Among the included 17 teeth, 47.1% exhibited successful REPs and periodontal healing. Another 47.1%, due to replacement resorption or REP failure, were categorized as tooth survival. Healing of periapical lesions was observed in 88.2% of the cases, but only 41.2% demonstrated continued root development. Although differences were not significant (p = 0.05), teeth with continued root development had a higher rate of functional healing (85.7%) compared to those without (30%). CONCLUSION Within the limitations of this study, REPs presented reliable outcomes for treating delayed replanted immature permanent teeth with apical periodontitis mainly in periapical lesion healing. Teeth with continued root development after REPs exhibited a higher rate of functional healing. Further investigation is required to explore potential synergies between REP outcomes and periodontal healing.
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Affiliation(s)
- Kai Sheng
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Ning Ding
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Shi-Min Zhao
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Hui Chen
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Guang-Yun Lai
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jun Wang
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
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Eggmann F, Filippi A, Mukaddam K. Endodontic and restorative management of an adult with avulsion of multiple teeth: A case report with 5 years and 9 months of follow-up. Dent Traumatol 2024; 40:345-352. [PMID: 38031999 DOI: 10.1111/edt.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023]
Abstract
Simultaneous avulsion of four or more teeth is a rare event. This case report examines the dental care given to an adult who, during a bicycle accident, experienced the avulsion of a mandibular incisor as well as all of his maxillary incisors. In the immediate aftermath of the accident, four out of the five incisors were located, promptly collected, and stored in a tooth rescue box, all within a 20-min window. Replantation and splinting were performed on the day of the accident. Endodontic treatment involved sequential intracanal dressing with an antibiotic-corticosteroid paste followed by calcium hydroxide prior to root canal obturation. 3 months post-accident, signs of external replacement resorption (ERR) began to appear in all the replanted teeth. The gap created by the missing maxillary central incisor was managed with a three-unit fixed dental prosthesis, despite the onset of ERR in the incisors used as abutment teeth. Regular follow-ups showed a relatively slow ERR progression rate over a span of nearly 6 years. The patient expressed satisfaction with both the esthetic and functional outcomes. This case, marked by multiple avulsions, underscores the importance of immediate and appropriate intervention alongside the imperative for carefully considered long-term management strategies. Given the decelerated bone remodeling rate in adults, ERR generally progresses at a slower pace than in children. Accordingly, this case demonstrates the viability of retaining replanted teeth over the long term, even when these teeth have been subjected to nonphysiological storage for extended durations, a factor known to impede periodontal healing.
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Affiliation(s)
- Florin Eggmann
- Department of Periodontology, Endodontology, and Cariology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
- Center of Dental Traumatology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Andreas Filippi
- Center of Dental Traumatology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
- Department of Oral Surgery, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Khaled Mukaddam
- Department of Oral Surgery, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
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Ko MJ, Kim MS, Lee HS, Nam OH, Chae YK, Choi SC. Effects of Doxycycline-Loaded NO-Releasing Nanomatrix Gel on Delayed Replanted of Rat Molar. Gels 2024; 10:213. [PMID: 38667632 PMCID: PMC11049325 DOI: 10.3390/gels10040213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/06/2024] [Accepted: 03/14/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND/AIM Tooth avulsion and delayed replantation may cause inflammatory responses and root resorption of the tooth. The aim of this study is to investigate the effect of a doxycycline-loaded nitric oxide-releasing nanomatrix (DN) gel on the delayed replantation of avulsed rat teeth, with a focus on assessing the gel's potential to promote regeneration and inhibit complications associated with the replantation process. MATERIALS AND METHODS Twenty-four right maxillary first molars from male Sprague-Dawley rats were atraumatically extracted using sterile extraction forceps. The molars were dried for 1 h at room temperature (approximately 23 °C) and divided into four groups according to the root conditioning methods after extra-alveolar 60-min drying: Group 1, no root conditioning treatment prior to replantation; Group 2, soaking in 2% NaF solution for 5 min before replantation; Group 3, 5-min soaking in NO gel and injection of the gel into the alveolar socket; Group 4, 5-min soaking in DN gel and injection of the gel into the alveolar socket before replantation. The animals were euthanized four weeks after the operation and the specimens were evaluated histologically. RESULTS The use of NO gel alone showed better anti-inflammatory and periodontal effects than the control group, but it did not show a significant effect compared to the group using NaF. When using NO gel loaded with doxycycline, it showed a significant anti-inflammatory effect compared to the control group and showed a similar inhibitory effect to the group using NaF. CONCLUSIONS Within the limits of this study, in delayed replantation situations, the control of inflammatory resorption and replacement resorption is an important factor for achieving a better prognosis of replanted teeth. Root surface treatment with DN gel decreased root resorption after delayed replantation.
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Affiliation(s)
- Mi Ja Ko
- Children Loving Dental Clinic, Seosan 31978, Republic of Korea;
| | - Mi Sun Kim
- Department of Pediatric Dentistry, College of Dentistry, Kyung Hee University, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea;
| | - Hyo-Seol Lee
- Department of Pediatric Dentistry, College of Dentistry, Kyung Hee University, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea; (H.-S.L.)
| | - Ok Hyung Nam
- Department of Pediatric Dentistry, College of Dentistry, Kyung Hee University, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea; (H.-S.L.)
| | - Yong Kwon Chae
- Department of Pediatric Dentistry, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea;
| | - Sung Chul Choi
- Department of Pediatric Dentistry, College of Dentistry, Kyung Hee University, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea; (H.-S.L.)
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4
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Trauma Surgery. J Oral Maxillofac Surg 2023; 81:E147-E194. [PMID: 37833022 DOI: 10.1016/j.joms.2023.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
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Fuhrer Y, Eggmann F, Reichardt E, Filippi A. Head and dental injuries among farriers and hoof care practitioners: A nationwide survey in Switzerland. Dent Traumatol 2023; 39:38-43. [PMID: 36200728 DOI: 10.1111/edt.12794] [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: 06/28/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND/AIM There is a paucity of evidence on injuries sustained by farriers and hoof care practitioners, two professions exposed to unique occupational hazards. The aim of this study was to collect and examine data on occupational head/face and dental injuries among farriers and hoof care practitioners in a nationwide survey in Switzerland. MATERIALS AND METHODS Data on occupational head/face and dental injuries were gathered in a questionnaire-based, voluntary survey, which was mailed to all farriers and hoof care practitioners in Switzerland. The statistical analysis comprised multiple regressions with a nested design (α = 0.05). RESULTS The survey included 278 respondents (response rate of 78.1%). Head/face injuries were more frequently reported by farriers than hoof care practitioners (60.6% and 20.7%, respectively). Among full-time workers, farriers had a higher chance of an occupational head/face injury compared with hoof care practitioners (p = .007). The rate of dental injuries, mainly related to a horse kick, was 11.1% and 1.9% among farriers and hoof care practitioners, respectively. Negligence in wearing mandatory eye protection was reported by 37.5% of respondents. CONCLUSIONS Farriery and hoof care management entail a significant risk of occupational head/face and dental injuries. Preventive safety measures-eye protection in particular-and knowledge in dental first aid should be promoted among farriers and hoof care practitioners to decrease the frequency and severity of work-related injuries.
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Affiliation(s)
- Yvonne Fuhrer
- Department of Oral Surgery, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Florin Eggmann
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland.,Center of Dental Traumatology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Elisabeth Reichardt
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Andreas Filippi
- Department of Oral Surgery, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland.,Center of Dental Traumatology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
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6
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Pontell ME, O'Sick NR, Kalmar CL, Golinko MS. Pediatric Craniomaxillofacial Trauma. Pediatr Rev 2022; 43:665-675. [PMID: 36450635 DOI: 10.1542/pir.2021-005276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Matthew E Pontell
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Nicholas R O'Sick
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Christopher L Kalmar
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Michael S Golinko
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN.,Division of Pediatric Plastic Surgery, Cleft and Craniofacial Program, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN
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Kohsar AH, Yousefi MJ, Hali H. The Effects of Different Regenerative Treatments after Tooth Avulsion. CURRENT STEM CELL REPORTS 2022. [DOI: 10.1007/s40778-022-00218-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Bourgeois J, Carvalho JC, De Bruyne M, Declerck D, Eloot A, Leroy R. Antibiotics at replantation of avulsed permanent teeth? A systematic review. J Evid Based Dent Pract 2022; 22:101706. [DOI: 10.1016/j.jebdp.2022.101706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 11/15/2021] [Accepted: 02/16/2022] [Indexed: 11/26/2022]
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Safarzadeh S, Tahririan D, Entezam Z. Evaluation of teachers' knowledge about dental injuries in primary schoolchildren in the city of Isfahan. Dent Res J (Isfahan) 2022. [DOI: 10.4103/1735-3327.346400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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10
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Abella Sans F, Ribas March F, Zubizarreta-Macho Á, Boschini L, Roig Cayón M, Durán-Sindreu Terol F. Guided autotransplant of a first premolar to replace a maxillary ankylosed incisor using a custom-designed osteotome. J Am Dent Assoc 2021; 153:265-272. [PMID: 34930574 DOI: 10.1016/j.adaj.2021.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Autotransplantation is a highly successful technique to replace ankylosed teeth. The authors propose a modified therapeutic approach to guide the autotransplant of an immature maxillary premolar using a tooth-shaped osteotome. CASE DESCRIPTION A 9-year-old boy reported an avulsion of his maxillary permanent left central incisor with a delayed replantation. An autotransplant of the immature maxillary right first premolar into the position of the affected tooth was planned. A surgical 3-dimensional guiding template and a tooth-shaped osteotome were manufactured to prepare the neo-alveolus (referring to the creation or modification of an alveolus to house the tooth) modification. Although the donor tooth was placed in the recipient socket with the buccal side of the root fully exposed, the transplant outcome was successful. PRACTICAL IMPLICATIONS The use of 3-dimensionally designed surgical osteotome could improve accuracy and surgical handling of a donor tooth autotransplant, even with substantial bone defects in the recipient site.
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11
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Deferoxamine Reduces Inflammation and Osteoclastogenesis in Avulsed Teeth. Int J Mol Sci 2021; 22:ijms22158225. [PMID: 34360988 PMCID: PMC8348439 DOI: 10.3390/ijms22158225] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/28/2022] Open
Abstract
Replacement and inflammatory resorption are serious complications associated with the delayed replantation of avulsed teeth. In this study, we aimed to assess whether deferoxamine (DFO) can suppress inflammation and osteoclastogenesis in vitro and attenuate inflammation and bone resorption in a replanted rat tooth model. Cell viability and inflammation were evaluated in RAW264.7 cells. Osteoclastogenesis was confirmed by tartrate-resistant acid phosphatase staining, reactive oxygen species (ROS) measurement, and quantitative reverse transcriptase–polymerase chain reaction in teeth exposed to different concentrations of DFO. In vivo, molars of 31 six-week-old male Sprague–Dawley rats were extracted and stored in saline (n = 10) or DFO solution (n = 21) before replantation. Micro-computed tomography (micro-CT) imaging and histological analysis were performed to evaluate inflammation and root and alveolar bone resorption. DFO downregulated the genes related to inflammation and osteoclastogenesis. DFO also reduced ROS production and regulated specific pathways. Furthermore, the results of the micro-CT and histological analyses provided evidence of the decrease in inflammation and hard tissue resorption in the DFO group. Overall, these results suggest that DFO reduces inflammation and osteoclastogenesis in a tooth replantation model, and thus, it has to be further investigated as a root surface treatment option for an avulsed tooth.
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Amaro RG, Dos Santos LCM, Lima TCDS, Coste SC, Barbato Ferreira DA, Côrtes MIDS, Colosimo EA, Bastos JV. Pulp healing in immature replanted permanent teeth: A competing risk analysis. Dent Traumatol 2021; 37:447-456. [PMID: 33421350 DOI: 10.1111/edt.12652] [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: 07/21/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIM Tooth displacement during avulsion causes total rupture of the pulp's neurovascular supply. Revascularization and pulp healing may occur in immature teeth, which gives rise to the recommendation that root canal treatment may not be required. The aim of this study was to evaluate the prognostic factors for the pulp's response after replantation of young permanent teeth. METHODS Records from 117 patients with 133 replanted permanent immature teeth were reviewed, and pulp outcomes were classified as healing (hard tissue deposition on the dentinal walls followed by narrowing of the pulp lumen or ingrowth of bone-like tissue inside the pulp canal) or non-healing (pulp necrosis with infection). The effect of clinical and demographic co-variates on the hazards of both outcomes was assessed performing a competing risk model. RESULTS Pulp necrosis with infection was diagnosed in 78.2% of the teeth, and healing was observed in 12.8% of the teeth. A total of 12 teeth (9.0%) were censored due to prophylactic removal of the pulp or severe external root resorption caused by eruption of adjacent canines. The cs-Cox model demonstrated that the hazards of pulp healing increased in teeth with extra-alveolar periods <15 min (csHR: 7.83, 95% CI 1.76-34.80, p = .01), while the hazards of pulp necrosis with infection decreased (csHR: 0.31, 95% CI: 0.10-0.92, p = .04). Teeth replanted with Moorrees' stages 4 and 5 of root development had higher hazards of pulp necrosis with infection than teeth with stage 2 of root development (csHR: 2.23, 95% CI 1.11-4.50, p = .03; csHR: 2.89, 95% CI: 1.40-5.95; p = .01). CONCLUSIONS Pulp healing rarely occurred after replantation of young permanent teeth being associated with short extra-alveolar periods <15 min. Early stages of root development decreased the hazards of pulp necrosis with infection.
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Affiliation(s)
- Roberta Gabriela Amaro
- Dental Trauma Program, Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Thiago César da Silva Lima
- Dental Trauma Program, Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Sylvia Cury Coste
- Dental Trauma Program, Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Daniela Augusta Barbato Ferreira
- Dental Trauma Program, Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria Ilma de Souza Côrtes
- Dental Trauma Program, Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Department of Dentistry, Pontifical University of Minas Gerais, Belo Horizonte, Brazil
| | - Enrico Antonio Colosimo
- Departament of Statistics, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Juliana Vilela Bastos
- Dental Trauma Program, Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Stojanović S, Tijanić M, Burić K, Burić N, Spasić M, Todorović K, Stojković B, Jovanović M, Petrović M, Mitić D. Permanent tooth avulsion in children and adults: Therapeutic options for longer survival. ACTA STOMATOLOGICA NAISSI 2021. [DOI: 10.5937/asn2183213s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction: Permanent tooth avulsions (traumatic extraction; total luxation) are one ofthe most severe permanent tooth injuries and can occur as single injuries or associated with other dental injuries or injuries to the face and jaws region. They are defined as the luxation of teeth from the alveoli with complete rupture of periodontal fibres, or with one part attached to the rootcementum and the other to the alveolar bone, thus compromising the dental pulp, root cementum,and alveolar bone. The high prevalence and numerous negative consequences on the stomatognathic systems they have suggest permanent tooth avulsions should be regarded as an important public health problem. The aim: is to point out the therapeutic possibilities of permanent tooth avulsion that can ensure their longer survival in the oral cavity. Conclusion: The treatment strategy for avulsed permanent teeth is always based on limiting root canal infection and periradicular inflammation, shifting the balance from unfavourable (replacement resorption) to favourable (periodontal) healing. The success of therapy and periodontal healing depend on the duration and conditions of extraoral tooth preservation, the degree of damage to the periodontal ligament, and the condition of the pulp.
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Tričković-Janjić O, Janjić-Ranković M, Stojković B, Igić M, Stojanović S. Dry extraoral storage and delayed replantation of avulsed tooth: Therapy and outcome. ACTA STOMATOLOGICA NAISSI 2021. [DOI: 10.5937/asn2183175t] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction: The aim of this study was to present the therapeutic procedure and the outcome of replantation of the avulsed permanent central maxillary incisor, found at the site of high contamination, after an extraoral period of 15 hours and dry transport. Case report: By clinical examination it was determined that the root reached the full length, with parallel edges, which corresponded to the age of the girl-8.5 years. After carefully removing the necrotic periodontal ligament from the root of the tooth, extraoral endodontic treatment was performed. The pulp was removed, the multi-sessional intracanal medicament fillings were avoided and the definitive obturation of the root canal was performed. The tooth was returned to the alveolar socket and immobilized with a wire-composite splint. After replantation, the condition of the tooth was monitored. Replacement resorption and dentoalveolar ankylosis occurred after nine months, and then cervical inflammatory resorption led to tooth loss after three and a half years. Conclusion: The achieved result can be considered as a success because during this time the replanted tooth met the developmental, functional and aesthetic requirements, which is especially important in the period of intensive growth and development of the child.
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Orofacial Trauma on the Anterior Zone of a Trumpet's Player Maxilla: Concept of the Oral Rehabilitation-A Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249423. [PMID: 33339137 PMCID: PMC7765605 DOI: 10.3390/ijerph17249423] [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: 10/30/2020] [Revised: 12/11/2020] [Accepted: 12/12/2020] [Indexed: 12/26/2022]
Abstract
Background: The occurrence of an orofacial trauma can originate health, social, economic and professional problems. A 13-year boy suffered the avulsion of tooth 11 and 21, lost at the scenario. Methods: Three intraoral appliances were manufactured: A Hawley appliance with a central expansion screw and two central incisors (1), trumpet edentulous anterior tooth appliance (2) and a customized splint (3) were designed as part of the rehabilitation procedure. Objectively assessing the sound quality of the trumpet player with these new devices in terms of its spectral, temporal, and spectro-temporal audio properties. A linear frequency response microphone was adopted for precision measurement of pitch, loudness, and timbre descriptors. Results: Pitch deviations may result from the different intra-oral appliances due to the alteration of the mouth cavity, respectively, the area occupied and modification/interaction with the anatomy. This investigation supports the findings that the intra-oral appliance which occupies less volume is the best solution in terms of sound quality. Conclusions: Young wind instrumentalists should have dental impressions of their teeth made, so their dentist has the most reliable anatomy of the natural teeth in case of an orofacial trauma. Likewise, the registration of their sound quality should be done regularly to have standard parameters for comparison.
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Singletary EM, Zideman DA, Bendall JC, Berry DA, Borra V, Carlson JN, Cassan P, Chang WT, Charlton NP, Djärv T, Douma MJ, Epstein JL, Hood NA, Markenson DS, Meyran D, Orkin A, Sakamoto T, Swain JM, Woodin JA, De Buck E, De Brier N, O D, Picard C, Goolsby C, Oliver E, Klaassen B, Poole K, Aves T, Lin S, Handley AJ, Jensen J, Allan KS, Lee CC. 2020 International Consensus on First Aid Science With Treatment Recommendations. Resuscitation 2020; 156:A240-A282. [PMID: 33098920 DOI: 10.1016/j.resuscitation.2020.09.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This is the summary publication of the International Liaison Committee on Resuscitation's 2020 International Consensus on First Aid Science With Treatment Recommendations. It addresses the most recent published evidence reviewed by the First Aid Task Force science experts. This summary addresses the topics of first aid methods of glucose administration for hypoglycemia; techniques for cooling of exertional hyperthermia and heatstroke; recognition of acute stroke; the use of supplementary oxygen in acute stroke; early or first aid use of aspirin for chest pain; control of life- threatening bleeding through the use of tourniquets, haemostatic dressings, direct pressure, or pressure devices; the use of a compression wrap for closed extremity joint injuries; and temporary storage of an avulsed tooth. Additional summaries of scoping reviews are presented for the use of a recovery position, recognition of a concussion, and 6 other first aid topics. The First Aid Task Force has assessed, discussed, and debated the certainty of evidence on the basis of Grading of Recommendations, Assessment, Development, and Evaluation criteria and present their consensus treatment recommendations with evidence-to-decision highlights and identified priority knowledge gaps for future research. The 2020 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) Science With Treatment Recommendations (CoSTR) is the fourth in a series of annual summary publications from the International Liaison Committee on Resuscitation (ILCOR). This 2020 CoSTR for first aid includes new topics addressed by systematic reviews performed within the past 12 months. It also includes updates of the first aid treatment recommendations published from 2010 through 2019 that are based on additional evidence evaluations and updates. As a result, this 2020 CoSTR for first aid represents the most comprehensive update since 2010.
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Singletary EM, Zideman DA, Bendall JC, Berry DC, Borra V, Carlson JN, Cassan P, Chang WT, Charlton NP, Djärv T, Douma MJ, Epstein JL, Hood NA, Markenson DS, Meyran D, Orkin AM, Sakamoto T, Swain JM, Woodin JA. 2020 International Consensus on First Aid Science With Treatment Recommendations. Circulation 2020; 142:S284-S334. [PMID: 33084394 DOI: 10.1161/cir.0000000000000897] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This is the summary publication of the International Liaison Committee on Resuscitation's 2020 International Consensus on First Aid Science With Treatment Recommendations. It addresses the most recent published evidence reviewed by the First Aid Task Force science experts. This summary addresses the topics of first aid methods of glucose administration for hypoglycemia; techniques for cooling of exertional hyperthermia and heatstroke; recognition of acute stroke; the use of supplementary oxygen in acute stroke; early or first aid use of aspirin for chest pain; control of life-threatening bleeding through the use of tourniquets, hemostatic dressings, direct pressure, or pressure devices; the use of a compression wrap for closed extremity joint injuries; and temporary storage of an avulsed tooth. Additional summaries of scoping reviews are presented for the use of a recovery position, recognition of a concussion, and 6 other first aid topics. The First Aid Task Force has assessed, discussed, and debated the certainty of evidence on the basis of Grading of Recommendations, Assessment, Development, and Evaluation criteria and present their consensus treatment recommendations with evidence-to-decision highlights and identified priority knowledge gaps for future research.
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De Brier N, O D, Borra V, Singletary EM, Zideman DA, De Buck E. Storage of an avulsed tooth prior to replantation: A systematic review and meta-analysis. Dent Traumatol 2020; 36:453-476. [PMID: 32344468 DOI: 10.1111/edt.12564] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND/AIM It is crucial to store an avulsed tooth appropriately to preserve the viability of the periodontal ligament cells prior to replantation. The aim of this systematic review was to identify the best available evidence for the effectiveness of any technique available to laypeople for storing an avulsed tooth compared with storage in milk or saliva. METHODS The following databases were searched (September 2019): Cochrane Library, MEDLINE, and Embase. Two reviewers independently considered trial eligibility, then extracted and analyzed data, and assessed the risk of bias. The certainty of the body of evidence was appraised according to the GRADE methodology. RESULTS Out of 4118 references, 33 studies were included and reported 23 comparisons of which 10 were synthesized in a meta-analysis. The limited evidence available favors storing an avulsed tooth in Hank's balanced salt solution (pooled SMD 2.47, 95% CI [1.59;3.34], P < .00001), propolis solution (pooled SMD 1.73, 95% CI [1.12;2.33], P < .00001), oral rehydration salts (pooled SMD 4.16, 95% CI [2.10;6.23], P < .0001), rice water, and cling film compared with storage in milk. The cell viability rate was significantly lower in teeth stored in saline solutions (pooled SMD -4.35, 95% CI [-7.55;-1.14], P = .008), tap water, buttermilk, castor oil, GC Tooth Mousse, and turmeric extract than those stored in milk. There is insufficient evidence to recommend for or against temporary storage of an avulsed tooth in saliva compared with alternative solutions. The certainty of evidence was considered low to very low due to limitations in study design, indirect study populations and outcome measures, and imprecision. CONCLUSION Although milk was shown to extend the periodontal ligament cell viability before replantation compared with saline or tap water, the following media have also demonstrated efficacy at preserving the cell viability: Hank's balanced salt solution, propolis, oral rehydration salts, rice water, and cling film.
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Affiliation(s)
- Niels De Brier
- Centre for Evidence-Based Practice (CEBaP), Belgian Red Cross, Mechelen, Belgium
| | - Dorien O
- Centre for Evidence-Based Practice (CEBaP), Belgian Red Cross, Mechelen, Belgium
| | - Vere Borra
- Centre for Evidence-Based Practice (CEBaP), Belgian Red Cross, Mechelen, Belgium.,Cochrane First Aid, Belgian Red Cross, Mechelen, Belgium
| | - Eunice M Singletary
- Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | | | - Emmy De Buck
- Centre for Evidence-Based Practice (CEBaP), Belgian Red Cross, Mechelen, Belgium.,Cochrane First Aid, Belgian Red Cross, Mechelen, Belgium.,Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
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19
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Wang L, Jiang H, Bai Y, Luo Q, Wu H, Liu H. Clinical outcomes after intentional replantation of permanent teeth: A systematic review. Bosn J Basic Med Sci 2020; 20:13-20. [PMID: 30684952 PMCID: PMC7029209 DOI: 10.17305/bjbms.2019.3937] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 11/20/2018] [Indexed: 12/17/2022] Open
Abstract
This study aimed to systematically assess the outcomes of intentional replantation (IR) of teeth and to determine the survival rate, success rate, and prognostic factors related to the treatment. A search was conducted for all relevant English language articles published from January 2000 to October 2017. The search terms included "intentional replantation" and "teeth" according to the inclusion criteria. The Methodological Index for Non-randomized Studies (MINORS) was used to assess the methodological quality of included studies. Twelve studies were identified as relevant for the systematic review. In total, 896 patients with 905 teeth were examined for intentional teeth replantation. The success rate was greater than 90% in four studies (33.33%) and between 70% and 80% in five studies. At short-term follow-up (<6 months), the survival rate was approximately 90% in four studies. At longer-term follow-up (>36 months), the survival rates of teeth were slightly reduced in four studies, and tended to be stable after 48 months. In conclusion, the long-term success and survival rate of IR are likely dependent upon short extraoral time, reduced pocket depth, type of tooth, type of root-end filling material, and the prevention of atraumatic tooth root damage.
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Affiliation(s)
- Lin Wang
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
| | - Hua Jiang
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
| | - Yang Bai
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
| | - Qiang Luo
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
| | - Hao Wu
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
| | - Hongchen Liu
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China.
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20
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Shaikh MS, Ullah R, Lone MA, Matabdin H, Khan F, Zafar MS. Periodontal regeneration: a bibliometric analysis of the most influential studies. Regen Med 2020; 14:1121-1136. [PMID: 31957597 DOI: 10.2217/rme-2019-0019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Aim: The aim of the present study is to identify the most influential research articles and their main characteristics in the specialty of periodontal regeneration. Materials & methods: The Web of Science database advance search was performed in the subject category of 'Dentistry, Oral surgery and medicine' from January 2004 to October 2018 to retrieve citations data. Results: The majority of the articles were published in journals dedicated to the specialty of periodontology. Among the top-cited articles most emphasized study types were randomized control trials (n = 25) and reviews (n = 20). Conclusion: The present bibliometric analysis provides comprehensive information regarding the contributions made in the advancement of regenerative periodontal research. The authors from developed countries and affiliated with interdisciplinary/multicenter institutions have predominantly contributed.
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Affiliation(s)
- Muhammad S Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University Karachi, Pakistan
| | - Rizwan Ullah
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University Karachi, Pakistan
| | - Mohid A Lone
- Department of Oral Pathology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University Karachi, Pakistan
| | - Hesham Matabdin
- Department of Periodontics, Eastman Dental Institute, University College London, London, UK
| | - Fahad Khan
- Faculty of Healthcare & Medical Sciences, Anglia Ruskin University Cambridge, UK
| | - Muhammad S Zafar
- Department of Restorative Dentistry, Taibah University, Madina Munawwarra, Saudi Arabia.,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan
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21
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Navarro LB, Barchiki F, Navarro Junior W, Carneiro E, da Silva Neto UX, Westphalen VPD. Assessment of platelet-rich fibrin in the maintenance and recovery of cell viability of the periodontal ligament. Sci Rep 2019; 9:19476. [PMID: 31863001 PMCID: PMC6925300 DOI: 10.1038/s41598-019-55930-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 12/02/2019] [Indexed: 12/15/2022] Open
Abstract
This study analyzed the efficacy of autologous platelet-rich fibrin (PRF) in maintaining and recovering cell viability of the periodontal ligament (PDL). The PDL cells were isolated from 45 extracted teeth randomly distributed among 6 groups: 5 min, 1 h, 2 h, PRF 30 min, PRF 1 h and PRF 2 h. In the groups 5 min, 1 h and 2 h (n = 5), the teeth were kept dry in extra-alveolar times of 5 min, 1 h and 2 h respectively. The teeth of the groups PRF 30 min, PRF 1 h and PRF 2 h (n = 10) were kept dry at extra-alveolar times of 30 min, 1 and 2 h followed by immersion in PRF for 45 min. PDL cells were isolated by enzymatic digestion with type II collagenase and dispase, counted and analyzed for viability with Trypan blue vital dye in Neubauer chamber. The variables total number of cells and cell viability demonstrated that in the 5 min, 1 h and 2 h groups there was a decrease after the extra-alveolar dry times of 1 and 2 h. In comparison with the total number of cells, group 1 h, considered immediate reimplantation, did not present statistical difference when compared to the groups PRF 30 min, PRF 1 h and 2 h, a result that demonstrates that PRF assists in cell maintenance and recovery. PRF provided increased cell viability in relation to the different dry extra-alveolar times analyzed (p < 0.001). Autologous PRF presented effectiveness in maintaining and recovering PDL cells from extracted teeth and kept dry for up to 2 h.
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Affiliation(s)
- Lorena Bortolini Navarro
- Graduate Program, Dentistry Course, Life Sciences School, Pontifícia Universidade Católica do Paraná. Street Imaculada Conceição, 1155, Prado Velho 80.215-901, Curitiba, PR, Brazil.
| | - Fabiane Barchiki
- Core Cell Technology, School of Medicina, Pontifícia Universidade Católica do Paraná. Street Imaculada Conceição, 1155, Prado Velho 80.215-901, Curitiba, PR, Brazil
| | - Wilson Navarro Junior
- Dental Implant Research Institute of Parana, Rua Manoel Eufrasio, 1000 Juvevê, 80.540-010, Curitiba, PR, Brazil
| | - Everdan Carneiro
- Graduate Program, Dentistry Course, Life Sciences School, Pontifícia Universidade Católica do Paraná. Street Imaculada Conceição, 1155, Prado Velho 80.215-901, Curitiba, PR, Brazil
| | - Ulisses Xavier da Silva Neto
- Graduate Program, Dentistry Course, Life Sciences School, Pontifícia Universidade Católica do Paraná. Street Imaculada Conceição, 1155, Prado Velho 80.215-901, Curitiba, PR, Brazil
| | - Vânia Portela Ditzel Westphalen
- Graduate Program, Dentistry Course, Life Sciences School, Pontifícia Universidade Católica do Paraná. Street Imaculada Conceição, 1155, Prado Velho 80.215-901, Curitiba, PR, Brazil
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Mokhtari S, Hajian S, Sanati I. Complicated Crown-root Fracture Management Using the 180-degree Rotation Method. Int J Clin Pediatr Dent 2019; 12:247-250. [PMID: 31708624 PMCID: PMC6811941 DOI: 10.5005/jp-journals-10005-1625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Aim The aim of this article is to report a successful treatment of a complicated crown-root fracture. Background The management of complicated crown-root fracture in young patients is challenging as the fracture line is below the bone crest and the pulp is exposed. Treatment options include crown lengthening, orthodontic extrusion, and intentional replantation. Case description Here, a case of complicated crown-root fracture of tooth number 11 in a ten-year-old boy is presented. Intentional replantation with 180° rotation and slight extrusion and fixation was performed. In addition, root canal therapy was done and tooth was restored with a composite resin after four weeks. The patient was asymptomatic clinically and radiographically after three-year follow-up. Conclusion Intentional replantation with 180° rotation is a valuable treatment for crown root fractures. Clinical significance The management of complicated crown-root fracture using intentional replantation with 180° rotation can help to maintain natural dentition and interdental papilla. How to cite this article Mokhtari S, Hajian S, et al. Complicated Crown-root Fracture Management Using the 180-degree Rotation Method. Int J Clin Pediatr Dent 2019;12(3):247-250.
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Affiliation(s)
- Saeedeh Mokhtari
- Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Iman Sanati
- Department of Pedodontics, Private Practice, Tehran, Iran
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23
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Zare Jahromi M, Kalantar Motamedi MR. Effect of calcium hydroxide on inflammatory root resorption and ankylosis in replanted teeth compared with other intracanal materials: a review. Restor Dent Endod 2019; 44:e32. [PMID: 31485428 PMCID: PMC6713075 DOI: 10.5395/rde.2019.44.e32] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/25/2019] [Accepted: 06/13/2019] [Indexed: 11/11/2022] Open
Abstract
Calcium hydroxide (CH) is the gold-standard intracanal dressing for teeth subjected to traumatic avulsion. A common complication after the replantation of avulsed teeth is root resorption (RR). The current review was conducted to compare the effect of CH with that of other intracanal medications and filling materials on inflammatory RR and replacement RR (ankylosis) in replanted teeth. The PubMed and Scopus databases were searched through June 2018 using specific keywords related to the title of the present article. The materials that were compared to CH were in 2 categories: 1) mineral trioxide aggregate (MTA) and endodontic sealers as permanent filling materials for single-visit treatment, and 2) Ledermix, bisphosphonates, acetazolamide, indomethacin, gallium nitrate, and enamel matrix-derived protein (Emdogain) as intracanal medicaments for multiple-visit management of avulsed teeth prior to the final obturation. MTA can be used as a single-visit root filling material; however, there are limited data on its efficacy due to a lack of clinical trials. Ledermix and acetazolamide were comparable to CH in reducing RR. Emdogain seems to be an interesting material, but the data supporting its use as an intracanal medication remain very limited. The conclusions drawn in this study were limited by the insufficiency of clinical trials.
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Affiliation(s)
- Maryam Zare Jahromi
- Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
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24
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Nam OH, Cheon K, Kim MS, Lee HS, Choi SC. Evaluation of the periodontal and pulpal healing of replanted rat molars with doxycycline root conditioning. J Periodontal Implant Sci 2019; 49:148-157. [PMID: 31285939 PMCID: PMC6599750 DOI: 10.5051/jpis.2019.49.3.148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 05/16/2019] [Indexed: 11/08/2022] Open
Abstract
Purpose This study aimed to evaluate periodontal and pulpal healing in replanted rat teeth, preserved under different storage conditions, with or without root conditioning using doxycycline. Methods A total of 40 maxillary first molars extracted from 20 Sprague-Dawley rats were stored for different durations under different conditions (5 minutes in dry storage and 60 minutes in Hank's balanced salt solution [HBSS]) and subsequently replanted. The rats were divided into 2 groups based on the use of root surface treatment: the doxycycline group (root surface treated with doxycycline) and the control group (no doxycycline treatment). Eight weeks after replantation, the animals were sacrificed, and the teeth were evaluated using micro-computed tomography (micro-CT) and histomorphometric analysis. Results In the micro-CT analysis, the doxycycline group showed the same rate of occurrence of periapical radiolucency as was observed in the control group, but a lower degree of root resorption in teeth replanted after 60 minutes of storage in HBSS (P<0.05). In the histomorphometric analysis, the doxycycline group exhibited no improvement in either pulpal or periodontal healing of the replanted tooth after 5 minutes of dry storage, but showed a lower grade of surface root resorption (1.37±0.77) and inflammatory resorption in the teeth stored for 60 minutes in HBSS (1.33±0.71). Conclusions In conclusion, doxycycline improved the periodontal healing of replanted teeth stored for 60 minutes in HBSS, whereas doxycycline did not improve periodontal healing of replanted tooth after 5 minutes of dry storage. Within the limits of this study, doxycycline showed more favorable periodontal healing despite delayed replantation.
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Affiliation(s)
- Ok Hyung Nam
- Department of Pediatric Dentistry, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Kyounga Cheon
- Department of Pediatric Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mi Sun Kim
- Department of Pediatric Dentistry, Kyung Hee University Dental Hospital at Gangdong, Seoul, Korea
| | - Hyo-Seol Lee
- Department of Pediatric Dentistry, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Sung Chul Choi
- Department of Pediatric Dentistry, Kyung Hee University School of Dentistry, Seoul, Korea
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26
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Fagundes NCF, Bittencourt LO, Magno MB, Marques MM, Maia LC, Lima RR. Efficacy of Hank's balanced salt solution compared to other solutions in the preservation of the periodontal ligament. A systematic review and meta-analysis. PLoS One 2018; 13:e0200467. [PMID: 30005079 PMCID: PMC6044542 DOI: 10.1371/journal.pone.0200467] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 06/27/2018] [Indexed: 02/02/2023] Open
Abstract
This systematic review and meta-analysis (MA) aimed to verify the capacity of different storage media to preserve viability of periodontal ligament cells in comparison to Hank’s Balanced Salt Solution. The searches, selection process, data extraction and Risk of Bias control were conducted according to Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Five MA were conducted to compare the cell viability between milk versus Hank's balanced salt solution (HBSS) in a dichotomous (1) or continuous (2) data model; tap water versus HBSS (3); medicinal herbals versus HBSS (4); and saline solution versus HBSS (5). 693 potentially studies were identified, with 18 studies included in the qualitative and 8 studies included in the quantitative analysis. Most of the articles presented a low risk of bias. HBSS medium showed a superior ratio of cell viability compared to tap water (RR 0.26; 95% CI [0.21, 0.32]; p < 0.00001; I2 = 96%) and saline solution (RR 0.76; 95% CI [0.69, 0.84]; p < 0.0001; I2 = 99%). Herbal medicines showed a similar ratio of cell viability when compared to HBSS (RR 0.97; 95% CI [0.94, 1.00]; p = 0.08; I2 = 50%). Mixed results were observed between milk and HBSS: a superior ratio of HBSS was observed in an overall evaluation (RR 0.26; 95% CI [0.21, 0.32]; p < 0.00001; I2 = 96%), and a similar ratio was achieved when periodontal ligament (PDL) cells were removed prior to immersion in the solution (RR 0.94; 95% CI [0.87, 1.01]; p = 0.10; I2 = 0%) or rinsed in tap water or maintained in open air prior to immersion (RR 0.63; 95% CI [0.35, 1.12]; p = 0.11; I2 = not applicable). This systematic review and MA suggests that milk and herbal medicines could represent an alternative to HBSS. However, more studies are necessary to obtain a reliable conclusion.
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Affiliation(s)
- Nathalia Carolina Fernandes Fagundes
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém-Pará, Brazil.,School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Leonardo Oliveira Bittencourt
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém-Pará, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Márcia Martins Marques
- Department of Restorative Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
| | - Lucianne Cople Maia
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém-Pará, Brazil
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27
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Wang HH, Sarmast ND, Shadmehr E, Angelov N, Shabahang S, Torabinejad M. Application of Enamel Matrix Derivative (Emdogain) in Endodontic Therapy: A Comprehensive Literature Review. J Endod 2018; 44:1066-1079. [DOI: 10.1016/j.joen.2018.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 01/25/2018] [Accepted: 02/10/2018] [Indexed: 01/28/2023]
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Adnan S, Lone MM, Khan FR, Hussain SM, Nagi SE. Which is the most recommended medium for the storage and transport of avulsed teeth? A systematic review. Dent Traumatol 2018; 34:59-70. [PMID: 29292570 DOI: 10.1111/edt.12382] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIMS A wide variety of materials has been researched for their use as potential storage media for avulsed teeth, but it is essential to recognize the medium most recommended for improvement of the prognosis of avulsed teeth. The aim of this systematic review was to identify the most recommended medium to store and transport avulsed teeth based on the survival of periodontal ligament (PDL) cells as determined by in vitro studies. METHODS Only laboratory-based experimental studies on PDL cells found on adult permanent teeth were included. Data were collected using PubMed, CINAHL plus (EBSCO host), and the Cochrane Library, along with Google Scholar and a hand search. The key terms employed were permutations of [avulsed permanent teeth* OR dental avulsion* OR knocked out teeth*] AND [storage media* OR transport media* OR biological transport* OR PDL cell viability* OR PDL cell survival*]. A customized data extraction pro forma was used to extract the data and to evaluate the quality and risk of bias. RESULTS The initial search yielded 978 articles, but only 67 were selected. Milk was the most recommended individual medium followed by Hank's balanced salt solution. Among natural products other than milk, propolis and coconut water were most frequently recommended. Recommendations were based on maintenance of PDL cell viability followed by ease of availability, low cost, and long shelf life. CONCLUSIONS Natural products are more effective in maintaining the PDL cell viability compared to synthetic products. Some storage media recommendations were also based upon practical aspects. Although natural products other than milk have more recommendations as a group, milk is the most recommended storage medium individually, based not only on PDL cell viability, but also practical considerations.
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Affiliation(s)
- Samira Adnan
- Operative Dentistry, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Maham M Lone
- Operative Dentistry, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Farhan R Khan
- Operative Dentistry, Aga Khan University Hospital, Karachi, Pakistan
| | - Syeda M Hussain
- Operative Dentistry, Aga Khan University Hospital, Karachi, Pakistan
| | - Sana E Nagi
- Operative Dentistry, Aga Khan University Hospital, Karachi, Pakistan
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29
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Lee W, Stover S, Rasoulianboroujeni M, Sherman K, Fahimipour F, Dashtimoghadam E, Zito C, Jazayeri HE, Tayebi L. The efficacy of commercial tooth storage media for maintaining the viability of human periodontal ligament fibroblasts. Int Endod J 2017. [DOI: 10.1111/iej.12798] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- W. Lee
- Department of Surgical Services School of Dentistry Marquette University Milwaukee WI USA
| | - S. Stover
- Department of Surgical Services School of Dentistry Marquette University Milwaukee WI USA
| | - M. Rasoulianboroujeni
- Department of Developmental Sciences School of Dentistry Marquette University Milwaukee WI USA
| | - K. Sherman
- Department of Mathematics, Statistics and Computer Science Marquette University Milwaukee WI USA
| | - F. Fahimipour
- Department of Developmental Sciences School of Dentistry Marquette University Milwaukee WI USA
- Dental Biomaterials Department School of Dentistry Tehran University of Medical Sciences Tehran Iran
| | - E. Dashtimoghadam
- Department of Developmental Sciences School of Dentistry Marquette University Milwaukee WI USA
| | - C. Zito
- Department of Developmental Sciences School of Dentistry Marquette University Milwaukee WI USA
| | - H. E. Jazayeri
- Department of Developmental Sciences School of Dentistry Marquette University Milwaukee WI USA
| | - L. Tayebi
- Department of Developmental Sciences School of Dentistry Marquette University Milwaukee WI USA
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30
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Hasan MR, Takebe H, Shalehin N, Obara N, Saito T, Irie K. Effects of tooth storage media on periodontal ligament preservation. Dent Traumatol 2017; 33:383-392. [PMID: 28544606 DOI: 10.1111/edt.12351] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIMS An easily available tooth storage medium is required to preserve a tooth after avulsion. Milk and Hank's balanced salt solution (HBSS) are recommended as tooth storage media, and egg white is also reported to be comparable with milk. The aim of this study was to histologically and immunohistochemically evaluate the effect of different tooth storage media on the periodontal ligament (PDL) of extracted teeth. MATERIALS AND METHODS This experiment used HBSS, milk, and egg white as tooth storage media. A total of ninety-six 6-week-old male Sprague-Dawley rats were used in these experiments. In each experiment, six rats were used for each medium and for the control group. Extracted rat molar teeth were immersed in these three different storage media for 1 hour. In each medium, six samples (n=18) were fixed immediately, and the remaining samples (n=54) were subcutaneously transplanted. In the control group (n=24), the extracted teeth were fixed or transplanted immediately after extraction. At day 4, 1 and 2 weeks after transplantation, the teeth were examined by radiographic, histological, and immunohistochemical methods. The number of PDL cells in the storage media was also counted. RESULTS Teeth immersed for 1 hour in milk showed the thinnest PDL. Immunohistochemistry of periostin and CD68 labeling suggested degradation of the extracellular matrix in the PDL. In the media used for immersion, more PDL cells were observed in milk than in the other solutions. After transplantation, the HBSS and egg white groups maintained adequate thickness of PDL but in the milk group, thinner PDL and ankylosis were observed. CONCLUSION Adequate thickness of PDL was maintained in the egg white group, whereas the milk group showed disturbance in the PDL, which may lead to ankylosis.
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Affiliation(s)
- Md Riasat Hasan
- Division of Clinical Cariology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan.,Division of Histology, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan
| | - Hiroaki Takebe
- Division of Histology, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan
| | - Nazmus Shalehin
- Division of Histology, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan
| | - Nobuko Obara
- Division of Histology, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan
| | - Takashi Saito
- Division of Clinical Cariology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan
| | - Kazuharu Irie
- Division of Histology, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan
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Michl I, Nolte D, Tschammler C, Kunkel M, Linsenmann R, Angermair J. Premolar autotransplantation in juvenile dentition: quantitative assessment of vertical bone and soft tissue growth. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:e1-e12. [DOI: 10.1016/j.oooo.2017.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 01/16/2017] [Accepted: 02/13/2017] [Indexed: 10/20/2022]
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Lechner K, Connert T, Kühl S, Filippi A. Lip and tooth injuries at public swimming pools in Austria. Dent Traumatol 2017; 33:214-220. [PMID: 28231409 DOI: 10.1111/edt.12331] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIMS There is an increased risk of orofacial injuries in swimming pool facilities. Nevertheless, only a few studies have addressed this issue. The aim of this study was to identify the frequency of lip and tooth injuries at public swimming pools in Austria. A further aim was to examine which gender and age groups were affected, where and why these injuries occurred, and whether pool attendants had sufficient knowledge of dental first-aid measures. MATERIAL AND METHODS A total of 764 pool attendants in Austria were contacted by telephone and 689 participated in the study (90.2%). The attendants were interviewed retrospectively about accident occurrences in 2014 by a standardized questionnaire. Responses to the provision of first aid and choice of storage medium for avulsed teeth were subsequently evaluated. RESULTS The frequency of lip injuries was 19.0%, and tooth injuries were 11.3%. Male bathers (P < .05) and children under 12 years (P < .001) most frequently suffered injuries. The waterslide was the most common accident site. The most common cause of lip injuries was slipping on wet surfaces (39.0%), and for tooth injuries it was collisions with other persons or objects (each 28.1%). The pool attendants' responses were predominantly good or sufficient on first aid, with the exception of what storage medium to choose. Tooth rescue boxes were available in only 8.6% of all pool facilities. CONCLUSION Orofacial injuries are a frequently occurring problem in swimming pool facilities. The pool attendants' knowledge on first-aid care of tooth injuries could still be improved.
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Affiliation(s)
- Katharina Lechner
- Department of Oral Surgery, Oral Radiology and Oral Medicine, Center of Dental Traumatology, University Center for Dental Medicine Basel, Basel, Switzerland
| | - Thomas Connert
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine Basel, Basel, Switzerland
| | - Sebastian Kühl
- Department of Oral Surgery, Oral Radiology and Oral Medicine, Center of Dental Traumatology, University Center for Dental Medicine Basel, Basel, Switzerland
| | - Andreas Filippi
- Department of Oral Surgery, Oral Radiology and Oral Medicine, Center of Dental Traumatology, University Center for Dental Medicine Basel, Basel, Switzerland
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Gould TE, Piland SG, Caswell SV, Ranalli D, Mills S, Ferrara MS, Courson R. National Athletic Trainers' Association Position Statement: Preventing and Managing Sport-Related Dental and Oral Injuries. J Athl Train 2016; 51:821-839. [PMID: 27875057 DOI: 10.4085/1062-6050-51.8.01] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To provide athletic trainers, health care professionals, and all those responsible for the care of athletes with clinical recommendations for preventing and managing sport-related dental and oral injuries. BACKGROUND Participation in competitive sports continues to grow at both the interscholastic and intercollegiate levels. Therefore, exposure to, and the incidence of athletic-related injury, including orofacial injury, will also likely increase. At the time of this writing, the leading governing agencies for interscholastic (National Federation of State High School Associations) and intercollegiate (National Collegiate Athletic Association) sports require only protective orofacial equipment (eg, mouthguards) for 5 and 4, respectively, of their sanctioned sports. Although orofacial injuries represent a small percentage of all sport-related injuries, the financial burden associated with these injuries (eg, tooth avulsion) can exceed $15 000 over an adult life. Therefore, effective management of sport-related dental injuries is critical to the long-term financial, physical, and emotional health of people who have experienced dental trauma. RECOMMENDATIONS Based upon the current evidence regarding sport-related orofacial injury, we provide recommendations related to planning considerations, education, and mouthguard efficacy, material, fabrication, and care considerations. Additionally, suggested best practices for managing sport-related dental injury are also given for athletic trainers and other health care professionals.
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Affiliation(s)
- Trenton E Gould
- School of Kinesiology, The University of Southern Mississippi, Hattiesburg
| | - Scott G Piland
- School of Kinesiology, The University of Southern Mississippi, Hattiesburg
| | - Shane V Caswell
- Athletic Training Program, George Mason University, Manassas, VA
| | | | | | - Michael S Ferrara
- College of Health and Human Services, University of New Hampshire, Durham
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Nonoyama T, Shimazaki Y, Nakagaki H, Tsuge S. Descriptive study of dental injury incurred by junior high school and high school students during participation in school sports clubs. Int Dent J 2016; 66:356-365. [DOI: 10.1111/idj.12250] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Sharma M. In Vitro Periodontal Ligament Cell Viability in Different Storage Media. Braz Dent J 2016; 27:408-11. [DOI: 10.1590/0103-6440201602294] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 05/21/2016] [Indexed: 11/21/2022] Open
Abstract
Abstract The aim of this study was to evaluate the viability of periodontal ligament cells of avulsed teeth in three different storage media. Forty-five mature premolars extracted for orthodontic therapeutic purposes were randomly and equally divided into three groups according to the storage medium: milk (control), rice water and egg white. After placing extracted teeth for 30 min in storage media, the scrapings of the periodontal ligament (PDL) were collected in Falcon tubes containing collagenase in 2.5 mL of phosphate buffer saline and were incubated for 30 min and centrifuged for 5 min at 800 rpm. Cell viability was analyzed by Trypan blue exclusion. Rice water had a significantly higher number of viable cells compared to egg white and milk. There was no statistically significant difference between egg white and milk. Rice water may be able to maintain PDL cell viability of avulsed teeth better than egg white or milk.
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Sugaya T, Tomita M, Motoki Y, Miyaji H, Kawamami M. Influence of enamel matrix derivative on healing of root surfaces after bonding treatment and intentional replantation of vertically fractured roots. Dent Traumatol 2016; 32:397-401. [PMID: 26996758 DOI: 10.1111/edt.12270] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND/AIM The objectives of this study were to histopathologically evaluate cementum regeneration on root surfaces when an enamel matrix derivative (EMD) was used to bond a vertically fractured root and to evaluate the effectiveness of EMD in inhibiting root resorption. MATERIAL AND METHODS A total of 40 roots from 24 maxillary premolars in beagles were used. The root was vertically fractured using a chisel and mallet. Super-Bond was then used to bond the fractured root. In the experimental group, the root surface was treated with ethylenediaminetetraacetic acid and an EMD. The control group received no treatment. The root was then replanted in its original location. Histopathological observation and measurement using image-analyzing software were carried out after 8 weeks. RESULTS In the experimental group, shallow resorption cavities developed on the root planed surfaces with new acellular cementum appearing over them. In the control group, no new cementum was seen on the planed surfaces, and there was connective tissue joining the roots. In some of the samples, resorption and multinucleated giant cells were seen. The experimental group showed a significantly larger volume of cementum formation (P < 0.001), and the volume of root resorption was significantly smaller (P = 0.004). CONCLUSION When bonding and replanting tooth roots after a vertical fracture, the application of EMD was effective in regenerating cementum on root surfaces from which periodontal ligament had been lost in the area around the fracture line and in reducing the incidence of root resorption.
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Affiliation(s)
- Tsutomu Sugaya
- Department of Periodontology and Endodontology, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan.
| | - Mahito Tomita
- Department of Periodontology and Endodontology, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan
| | - Youji Motoki
- Department of Periodontology and Endodontology, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan
| | - Hirofumi Miyaji
- Department of Periodontology and Endodontology, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan
| | - Masamitsu Kawamami
- Department of Periodontology and Endodontology, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan
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Mohammadi Z, C Cehreli Z, Shalavi S, Giardino L, Palazzi F, Asgary S. Management of Root Resorption Using Chemical Agents: A Review. IRANIAN ENDODONTIC JOURNAL 2016; 11:1-7. [PMID: 26843869 PMCID: PMC4731525 DOI: 10.7508/iej.2016.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 06/28/2015] [Accepted: 10/24/2015] [Indexed: 11/30/2022]
Abstract
Root resorption (RR) is defined as the loss of dental hard tissues because of clastic activity inside or outside of tooth the root. In the permanent dentition, RR is a pathologic event; if untreated, it might result in the premature loss of the affected tooth. Several hypotheses have been suggested as the mechanisms of root resorption such as absence of the remnants of Hertwig's epithelial root sheath (HERS) and the absence of some intrinsic factors in cementum and predentin such as amelogenin or osteoprotegerin (OPG). It seems that a barrier is formed by the less-calcified intermediate cementum or the cementodentin junction that prevents external RR. There are several chemical strategies to manage root resorption. The purpose of this paper was to review several chemical agents to manage RR such as tetracycline, sodium hypochlorite, acids (citric acid, phosphoric acid, ascorbic acid and hydrochloric acid), acetazolamide, calcitonin, alendronate, fluoride, Ledermix and Emdogain.
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Affiliation(s)
- Zahed Mohammadi
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shaheed Beheshti University of Medical Sciences, and Iranian National Elite Foundation, Tehran, Iran
| | - Zafer C Cehreli
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | | | - Luciano Giardino
- Department of Periodontology, Endodontology, Pharmacology and Microbiology, Dental School, University of Brescia, Italy
| | - Flavio Palazzi
- Department of Odontostomatological and Maxillofacial Sciences, Federico II University of Naples, Italy
| | - Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Marão HF, Mao JJ, Casatti CA, Coelho PG, Ervolino E, Zhou J, da Silva VF, Panzarini SR. Effects of ovariectomy on periodontal tissues following tooth replantation. Arch Oral Biol 2016; 65:9-16. [PMID: 26828678 DOI: 10.1016/j.archoralbio.2016.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 12/21/2015] [Accepted: 01/16/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aim of the study was to analyze the effects of ovariectomy on periodontal tissues following immediate tooth replantation by histomorphometric, immunohistochemistry, and μCT analysis. MATERIALS AND METHODS Eighty wistar rats (Rattus norvegicus albinos) with normal estrous cycles were randomly divided into two groups: ovariectomized (OVX) and Sham. Two months after surgery, the rats' upper right incisor was extracted followed by immediate reimplantation. The animals were sacrificed after 28, 45, and 60 days healing time. Histomorphometric and immunohistochemical analysis were performed by evaluation of PCNA and TRAP straining. RESULTS The periodontal ligament was reinserted into the bone and cementum in the both groups. The immunohistochemical analysis revealed PCNA positive cells on the periodontal ligament in both groups at 28 days. Root resorption was noted at 45 days with immunoreactive cells for TRAP present in bone and tooth surface however no statistical differences between the groups were noticed. Histomorphometric analysis showed significant difference between groups in the periodontal ligament and root resorption parameters for the sub-items: intensity of chronic inflammatory infiltrate at 60 days (p<0.01), the organization of the periodontal ligament at 28 days (p<0.05), depth of root resorption at 45 days (p<0.05) and at 60 days (p<0.001). The μCT analysis showed multiple areas of bone resorption in association with OVX at 28 and 60 days with no significant differences between times in vivo. CONCLUSION The ovariectomy did not have significant influence in periodontal tissue parameters following tooth reimplantation.
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Affiliation(s)
- Heloisa Fonseca Marão
- Department of Surgery and Integrated Clinics, Aracatuba Dental School, Univ Estadual Paulista-UNESP, Rua José Bonifácio, 1193-Vila Mendonça, Aracatuba, SP 16015-050, Brazil.
| | - Jeremy J Mao
- Center for Craniofacial Regeneration, College of Dental Medicine, Columbia University, 630 West 168th St., New York, NY 10032, USA
| | - Cláudio Aparecido Casatti
- Department of Basic Science, Aracatuba Dental School, Univ Estadual Paulista-UNESP, Rodovia Marechal Rondon, KM 527/528, Campus Universitário, Aracatuba, SP 16018-805, Brazil; Biosciences Institute of Botucatu, UNESP Univ Estadual Paulista, Botucatu, SP, Brazil
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, 433 1st Ave., New York, NY 10010, USA; Department of Periodontology and Implant Dentistry, New York University College of Dentistry, 345 E 24th St, New York, NY 10010, USA; Division of Engineering, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Edilson Ervolino
- Department of Basic Science, Aracatuba Dental School, Univ Estadual Paulista-UNESP, Rodovia Marechal Rondon, KM 527/528, Campus Universitário, Aracatuba, SP 16018-805, Brazil
| | - Jian Zhou
- Center for Craniofacial Regeneration, College of Dental Medicine, Columbia University, 630 West 168th St., New York, NY 10032, USA
| | - Vanessa Ferreira da Silva
- Department of Surgery and Integrated Clinics, Aracatuba Dental School, Univ Estadual Paulista-UNESP, Rua José Bonifácio, 1193-Vila Mendonça, Aracatuba, SP 16015-050, Brazil
| | - Sônia Regina Panzarini
- Department of Surgery and Integrated Clinics, Aracatuba Dental School, Univ Estadual Paulista-UNESP, Rua José Bonifácio, 1193-Vila Mendonça, Aracatuba, SP 16015-050, Brazil
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Poi WR, Sonoda CK, Martins CM, Melo ME, Pellizzer EP, de Mendonça MR, Panzarini SR. Storage media for avulsed teeth: a literature review. Braz Dent J 2015; 24:437-45. [PMID: 24474282 DOI: 10.1590/0103-6440201302297] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 12/01/2013] [Indexed: 11/22/2022] Open
Abstract
Dental avulsion is the most severe type of traumatic tooth injuries because it causes damage to several structures and results in the complete displacement of the tooth from its socket in the alveolar bone. The ideal situation is to replant an exarticulated tooth immediately after avulsion because the extraoral time is a determinant factor for treatment success and for a good prognosis. However, it is not always possible. The success of replantation depends on a number of factors that may contribute to accelerate or minimize the occurrence of root resorption or ankylosis, among which is the type and characteristics of the medium used for temporary storage during the time elapsed between avulsion and replantation. Maintaining the tooth in an adequate wet medium that can preserve, as longer as possible, the vitality of the periodontal ligament cells that remain on root surface is the key to success of replantation. Recent research has led to the development of storage media that produce conditions that closely resemble the original socket environment, with adequate osmolality (cell pressure), pH, nutritional metabolites and glucose, and thus create the best possible conditions for storage. Although these storage media can now be purchased in the form of retail products, the most common scenario is that such a product will not be readily available at the moment of the accident This paper reviews the literature on the different storage media that have been investigated for avulsed teeth based on full-length papers retrieved from PubMed/Medline, Lilacs, BBO and SciELO electronic databases using the key words 'storage medium', 'transportation medium', 'avulsion', 'tooth avulsion', 'replantation', 'tooth replantation', 'milk' and 'propolis'. After application of inclusion and exclusion criteria, 39 papers were selected and critically reviewed with respect to the characteristics, efficacy and ease of access of the storage medium. The review of the literature showed that a wide array of types of wet storage media have been evaluated in laboratory studies and clinical reports, including cell and tissue culture solutions like Hank's Balanced Salt Solution (HBSS); medical/hospital products developed specifically for organ storage purposes, such as Viaspan® and Euro-Collins®; culture media, like Minimum Essential Medium (MEM); saline; natural products like water, saliva, bovine milk and its variations, propolis, green tea, Morus rubra (red mulberry), egg white and coconut water; rehydrating solutions, like Gatorade® and Ricetral, and even contact lens solutions. Based on the literature, it could be stated that, so far, apart from Based on the literature, it could be stated that, so far, apart from solutions designed specifically for storage and culture purposes, regular pasteurized whole milk is the most frequently recommended and with the best prognosis among other solutions that are likely to be available at the scene of an accident, such as water, saline or saliva. Its advantages include its high availability, ready accessibility, physiologically compatible pH and osmolality (fluid pressure) with the root-surface adhered PDL cells, presence of nutrients and growth factors. However, there is not yet a single solution that fulfills all requirements to be considered as the ideal medium for temporary storage of avulsed teeth, and research on this field should carry on.
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The biomechanical role of periodontal ligament in bonded and replanted vertically fractured teeth under cyclic biting forces. Int J Oral Sci 2015; 7:125-30. [PMID: 25214360 PMCID: PMC4817551 DOI: 10.1038/ijos.2014.51] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2014] [Indexed: 12/02/2022] Open
Abstract
After teeth are replanted, there are two possible healing responses: periodontal ligament healing or ankylosis with subsequent replacement resorption. The purpose of this study was to compare the fatigue resistance of vertically fractured teeth after bonding the fragments under conditions simulating both healing modes. Thirty-two human premolars were vertically fractured and the fragments were bonded together with Super-Bond C&B. They were then randomly distributed into four groups (BP, CP, CA, BA). The BP and CP groups were used to investigate the periodontal ligament healing mode whilst the BA and CA groups simulated ankylosis. All teeth had root canal treatment performed. Metal crowns were constructed for the CP and CA groups. The BP and BA groups only had composite resin restorations in the access cavities. All specimens were subjected to a 260 N load at 4 Hz until failure of the bond or until 2×106 cycles had been reached if no fracture occurred. Cracks were detected by stereomicroscope imaging and also assessed via dye penetration tests. Finally, interfaces of the resin luting agent were examined by scanning electron microscope. The results confirmed that the fatigue resistance was higher in the groups with simulated periodontal ligament healing. Periodontal reattachment showed important biomechanical role in bonded and replanted vertically fractured teeth.
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Bai J, Qin M, Zhao YM, Huang MW, Ji AP. Chemical removal of necrotic periodontal ligament on delayed replanted teeth by sodium hypochlorite: morphological analysis and microhardness indentation test of cementum. Int Endod J 2015; 49:393-401. [PMID: 26010894 DOI: 10.1111/iej.12467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 05/18/2015] [Indexed: 11/28/2022]
Affiliation(s)
- J. Bai
- Department of Oral Emergency; Peking University School and Hospital of Stomatology; Beijing China
| | - M. Qin
- Department of Pediatric Dentistry; Peking University School and Hospital of Stomatology; Beijing China
| | - Y. -M. Zhao
- Department of Pediatric Dentistry; Peking University School and Hospital of Stomatology; Beijing China
| | - M. -W. Huang
- Department of Oral and Maxillofacial Surgery; Peking University School and Hospital of Stomatology; Beijing China
| | - A. -P. Ji
- Department of Oral Emergency; Peking University School and Hospital of Stomatology; Beijing China
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Nizam N, Kaval ME, Gürlek Ö, Atila A, Çalışkan MK. Intentional replantation of adhesively reattached vertically fractured maxillary single-rooted teeth. Int Endod J 2015; 49:227-36. [PMID: 25726945 DOI: 10.1111/iej.12444] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 02/25/2015] [Indexed: 12/15/2022]
Abstract
AIM To evaluate the clinical outcomes of intentionally replanted maxillary single-rooted teeth with vertical root fractures (VRFs) after being repaired extraorally using 4-methacryloxyethyl trimellitate anhydride/methacrylate-tri-n-butyl borane (4-META/MMA-TBB) resin cement. METHODOLOGY Twenty-one root filled maxillary single-rooted teeth with VRFs were evaluated. After atraumatic extraction, fractured fragments were adhesively cemented. The teeth were then replanted and splinted to the neighbouring teeth for 2 weeks. Plaque index (PI), gingival index (GI), probing depth (PD) and clinical attachment level (CAL) were assessed at baseline, 6 and 12 months, and radiographic evaluations were made using PAI scores at baseline and 12 months. Mobility was evaluated using periotest values (PTV) at baseline, 1, 3, 6 and 12 months. Replanted teeth, contralateral teeth (control teeth) and adjacent teeth were analysed statistically using repeated measures one-way anova, unpaired t-tests and Wilcoxon matched-pairs signed-rank tests. RESULTS Two teeth were extracted in the first month after surgery. PI, GI, CAL and PD scores of the replanted teeth were significantly lower at 6 month (P < 0.0001 for all) and 12 month (P < 0.0001 for all) postoperatively when compared to baseline, but the values were not significantly different from those of the control and adjacent teeth. PTV of the test teeth increased significantly (P < 0.0001) after the intervention and decreased to baseline levels by month 12. PTVs were significantly higher (P < 0.05) at baseline, 1, 3 and 6 months in the test teeth when compared with the control teeth, but were not significantly different at month 12. PAI scores of teeth with VRF were significantly lower (P < 0.05) at 12 months compared with baseline. CONCLUSIONS Adhesive cementation and intentional replantation were an effective treatment modality for this group of vertically fractured maxillary single-rooted teeth. The clinical periodontal parameters decrease by month 6, and the mobility returned to the physiological limits of natural teeth 12 months after replantation.
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Affiliation(s)
- N Nizam
- Department of Periodontology, School of Dentistry, Turkey
| | - M E Kaval
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Ö Gürlek
- Department of Periodontology, School of Dentistry, Turkey
| | - A Atila
- Department of Periodontology, School of Dentistry, Turkey
| | - M K Çalışkan
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
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Delayed replantation of avulsed teeth: two case reports. Case Rep Dent 2015; 2015:197202. [PMID: 25810928 PMCID: PMC4355813 DOI: 10.1155/2015/197202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 02/20/2015] [Accepted: 02/20/2015] [Indexed: 11/17/2022] Open
Abstract
This case report presents two cases of delayed replantation of avulsed maxillary central incisors after an extended dry extra-alveolar period. Eight-year-old boy and 10-year-old boy presented with avulsed maxillary central incisors due to trauma occurring 27 and 7 hours earlier, respectively. Treatment guidelines for avulsed mature/immature permanent teeth with prolonged extra-oral time were carried out for the teeth and the extra-oral endodontic treatment was completed. After having been repositioned, the teeth were stabilized for 4 weeks and prophylactic antibiotic was prescribed. Clinical and radiographic controls were done after 18 months for Case I and 12 months for Case II. During the follow-up periods the teeth reported in these cases have remained in a stable, functional position but revealed clinical initial replacement resorption and ankylosis.
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Estrela C, Guedes O, Bandeca M, Borges Á, de Alencar AH, de Araújo Estrela C. Analysis of 261 avulsed permanent teeth of patients treated in a dental urgency service. JOURNAL OF DENTAL RESEARCH AND REVIEW 2015. [DOI: 10.4103/2348-2915.154644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kostka E, Meissner S, Finke CH, Mandirola M, Preissner S. Multidisciplinary treatment options of tooth avulsion considering different therapy concepts. Open Dent J 2014; 8:180-3. [PMID: 25352922 PMCID: PMC4209498 DOI: 10.2174/1874210601408010180] [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: 03/24/2014] [Revised: 07/24/2014] [Accepted: 08/27/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Avulsion of permanent front teeth is a rare accident, mostly affecting children between seven and nine years of age. Replanted and splinted, these teeth often develop inflammation, severe resorption or ankylosis affecting alveolar bone development and have to be extracted sooner or later. OBJECTIVES The purpose of this study was to evaluate different therapy concepts to create a structured concept for the treatment of avulsions. RESULTS Based on existing therapy concepts, a concept for different initial conditions (dry time, age, growth, tooth, hard and soft tissues) was developed and is presented here. CONCLUSION A great deal of research has been performed during recent years and guidelines for the management of avulsions have been published. With the help of this literature it is possible to identify the best treatment procedure for each tooth. CLINICAL RELEVANCE The prognosis of avulsed teeth can be improved by considering evidence-based therapy concepts. Resorption, ankylosis and tooth loss could be minimized.
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Affiliation(s)
- Eckehard Kostka
- Department of Operative and Preventive Dentistry, Assmannshauser Straße 4-6, 14197 Berlin, Germany
| | - Simon Meissner
- Department of Oral Medicine, Dental Radiology and Oral Surgery, Assmannshauser Straße 4-6, 14197 Berlin,
Germany
| | - Christian H Finke
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Assmannshauser Straße 4-6, 14197 Berlin, Germany
| | - Manlio Mandirola
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Assmannshauser Straße 4-6, 14197 Berlin, Germany
| | - Saskia Preissner
- Department of Operative and Preventive Dentistry, Assmannshauser Straße 4-6, 14197 Berlin, Germany
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Soares TRC, Luiz RR, Risso PA, Maia LC. Healing complications of traumatized permanent teeth in pediatric patients: a longitudinal study. Int J Paediatr Dent 2014; 24:380-6. [PMID: 24251824 DOI: 10.1111/ipd.12082] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Traumatic dental injuries (TDI) can affect soft and hard dental tissues and supporting structures in different ways and severity. AIM This study describes the complications associated with health in traumatized permanent teeth (TPT) over a 12-month period and assesses the relationships between TDI, involved tissues, and root development (RD). DESIGN The study enrolled 294 patients with 548 TPT. Data were collected on the TDI, RD, and the healing complication (HC) and when they were examined (03, 06, and 12 months). Frequencies are described and analyzed using the chi-squared test, relative risk (RR), and Mantel-Haenszel analysis (P≤0.05). RESULTS Healing complications were present in 201 (36.68%) teeth and were more frequently diagnosed 3 months (63.68%) after the TDI. Pulp necrosis was the most common HC (38.3%), and it was significantly associated with avulsion (P=0.023). Teeth with complete RD showed a tendency of developing HC over time, independent of TDI (P=0.05). HC in teeth with complete RD related to support tissue trauma (P=0.005) and avulsion (P<0.001) appeared more frequently after 3 months. CONCLUSION Healing complications are more common in teeth that have suffered trauma in supporting tissues and avulsion, especially in teeth with complete RD. The HC occur more frequently in the first 3 months, and a necrotic pulp was the most common complication.
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Affiliation(s)
- Thais R C Soares
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Silvestrin T. The role of implant dentistry in the specialty of endodontics. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/etp.12061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jamalpour MR, Soltanian AR, Tootunchi AS, Roshanipaian M. Temporary preservation of avulsed tooth in oral submucosal tissue: an experimental study in cat. Dent Traumatol 2014; 30:265-9. [PMID: 24618281 DOI: 10.1111/edt.12098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the ability of oral submucosal tissue to serve as a temporary storage medium for the maintenance of periodontal ligament (PDL) cell viability of avulsed teeth. MATERIALS AND METHODS Thirty cats were divided into five groups. After extraction of three teeth in each cat, one tooth was put in the depth of cat's oral submucosal tissue and the other two teeth were put in Hanks' balanced salt solution (HBSS) and tap water. The teeth were removed after 8, 24, 48, 72, and 168 h from their mediums and sent for laboratory processing and counting of vital periodontal cells. RESULTS Statistical analysis demonstrated that submucosal tissue kept PDL cells viable as good as HBSS. CONCLUSION This animal study showed that the efficacy of oral submucosal tissue in maintaining the viability of human PDL cells is similar to that of HBSS.
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Affiliation(s)
- Mohammad Reza Jamalpour
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
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Zanetta-Barbosa D, Moura CCG, Machado JR, Crema VO, Lima CADP, de Carvalho ACP. Effect of indomethacin on surface treatment and intracanal dressing of replanted teeth in dogs. J Oral Maxillofac Surg 2014; 72:127.e1-9. [PMID: 24331566 DOI: 10.1016/j.joms.2013.08.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 08/07/2013] [Accepted: 08/19/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE This study evaluated the healing process of teeth replanted after root treatment and intracanal dressing with indomethacin alone or indomethacin with calcium hydroxide (Ca[OH]2). MATERIALS AND METHODS Through a case-control study, 24 teeth of 6 adult dogs were extracted, dried, and divided into 4 groups according to the root surface treatment protocols performed before replantation and the intracanal medication used after replantation. In group 1 (negative control), root surfaces were treated by immersion in a 0.9% saline solution and then replanted. In the other groups, the roots were immersed for 10 minutes in Ca(OH)2 (group 2), indomethacin (group 3), or a solution of indomethacin and Ca(OH)2 (group 4). After 2 weeks, group 1 teeth were subjected to single-visit root canal treatment and obturation with gutta-percha and sealer consisting of zinc oxide and eugenol. The teeth in the other groups were subjected to intracanal dressing with the same material used for immersion. After an additional period of 28 weeks, the animals were euthanized and the jaws containing the replanted teeth were processed for histologic analysis. Histometric values were statistically analyzed, with significance set at a P value less than or equal to .05. RESULTS Group 1 exhibited significantly more normal periodontium than group 4 (P = .02). Total resorption was greater in group 4 than in group 1 (P = .02). No statistically significant difference in the percentage of surface resorption or in total inactive resorption was observed between the groups. CONCLUSIONS The findings of this study suggest that intracanal dressing and topical root treatment with Ca(OH)2 with or without indomethacin is not recommended for teeth dried for 50 minutes, but the use of indomethacin alone as root surface treatment for delayed tooth replantation deserves further study using longer drying periods. In addition, the present results suggest that a single-visit root canal, performed up to 2 weeks after replantation, might be indicated for teeth dried for up to 50 minutes.
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Affiliation(s)
- Darceny Zanetta-Barbosa
- Professor, Division of Buccal and Maxillofacial Surgery, Department of Oral Surgery, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil.
| | - Camilla Christian Gomes Moura
- Professor, Department of Histology, Federal University of Triângulo Mineiro; and Researcher, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Juliana Reis Machado
- Postdoctoral Student, Department of Pathology, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Virginia Oliveira Crema
- Professor, Department of Histology, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Cirilo Antônio de Paula Lima
- Professor, Department of Veterinary Surgery, School of Veterinary Medicine, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Antônio Cesar Perry de Carvalho
- Professor, Division of Buccal and Maxillofacial Surgery, Department of Oral Surgery, School of Dentistry, State University of São Paulo, Araçatuba, São Paulo, Brazil
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Expression of OPG, RANK, and RANKL proteins in tooth repair processes after immediate and delayed tooth. J Craniofac Surg 2014; 24:e74-80. [PMID: 23348347 DOI: 10.1097/scs.0b013e318270fbf6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study evaluated the immunohistochemical expression of OPG, RANK, and RANKL proteins in the repair after immediate and delayed replantation of rat teeth. Fifty-six Wistar rats (Rattus norvegicus albinus) had their maxillary right lateral incisor extracted and then replanted, according to the following conditions: group I (control; n = 8), teeth were not extracted; group II (n = 16), immediate replantation; group III (n = 16), delayed replantation without treatment; and group IV (n = 16), delayed replantation after root surface treatment (periodontal ligament removal and immersion in 2% acidulated-phosphate sodium fluoride) and calcium hydroxide intracanal dressing. Rats in group I were euthanized on the first day of the experiment, while the animals in the other groups were euthanized 10 and 60 days after replantation (n = 8/period). Hematoxylin and eosin-stained sections were obtained for histological analysis. The immunohistochemical analysis revealed expression of OPG and RANKL proteins in all groups and both postreplantation times, except for group II at 60 days. In the experimental groups, RANK expression was observed only at 10 days. In conclusion, there was strong immunostaining for the OPG-RANK-RANKL system at the earlier postreplantation time, suggesting a more effective participation of these proteins at the start of the healing process, as their expression decreased at 60 days.
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