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Sarıyılmaz Ö, Uslu G, Sarıyılmaz E, Keskin NB. Evaluation of different irrigation activation techniques for the removal of various medicaments from a simulated internal resorption cavity: an in vitro study. Clin Oral Investig 2024; 28:491. [PMID: 39155361 DOI: 10.1007/s00784-024-05878-x] [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: 05/09/2024] [Accepted: 08/06/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVES This study aimed to assess the efficacy of different activation techniques in removing calcium hydroxide (Ultracal XS), Ledermix, and Bio-C Temp from simulated internal root resorption (IRR) cavities. MATERIALS AND METHODS 108 single-rooted maxillary incisors were prepared using Reciproc R50 files. Simulated IRR cavities, 2 mm in diameter and located 8 mm from the apex, were created. Ultracal XS, Ledermix, and Bio-C Temp were applied to the samples, grouped by irrigation activation techniques: Standard Needle Irrigation (SNI), EDDY, Passive Ultrasonic Irrigation (PUI), and XP-endo Finisher (XPF). Medicament removal efficacy was evaluated using a standardized scoring system. Statistical analysis was performed using the Kruskal-Wallis test. RESULTS XPF and PUI were more effective than SNI in medicament removal across the groups, with no significant difference. EDDY showed no significant difference than other groups. Ledermix was more effectively removed in all activation groups compared to Bio-C Temp. The XPF was superior in removing Ultracal XS compared to Bio-C Temp. However, none of the groups achieved complete medicament removal. CONCLUSIONS XPF and PUI techniques enhance medicament removal efficacy. Bio-C Temp was more difficult to remove from the IRR cavities than other medicaments. CLINICAL RELEVANCE Bio-C Temp could be removed from the canals less effectively compared to calcium hydroxide and Ledermix. Among the tested irrigation activation methods, XPF and PUI were found to be more effective at removing the tested medicaments.
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Affiliation(s)
- Öznur Sarıyılmaz
- Faculty of Dentistry, Department of Endodontics, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
| | - Gülşah Uslu
- Private practice, Idadent Oral and Dental Health Clinic, Çanakkale, Turkey
| | - Evren Sarıyılmaz
- Faculty of Dentistry, Department of Endodontics, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Neslihan Büşra Keskin
- Faculty of Dentistry, Department of Endodontics, Ankara Yıldırım Beyazıt University, Ankara, Turkey
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2
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Elmsmari F, González Sánchez JA, Delgado LM, Espina M, Duran-Sindreu F, García ML, Sánchez-López E. Development of clobetasol-loaded biodegradable nanoparticles as an endodontic intracanal medicament. Int Endod J 2024; 57:1147-1164. [PMID: 38687284 DOI: 10.1111/iej.14072] [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: 07/24/2023] [Revised: 02/15/2024] [Accepted: 04/03/2024] [Indexed: 05/02/2024]
Abstract
AIM The aim of current study is the development and optimization of biodegradable polymeric nanoparticles (NPs) to be used in the field of Endodontics as intracanal medication in cases of avulsed teeth with extended extra-oral time, utilizing PLGA polymers loaded with the anti-inflammatory drug clobetasol propionate (CP). METHODOLOGY CP-loaded nanoparticles (CP-NPs) were prepared using the solvent displacement method. CP release profile from CP-NPs was assessed for 48 h against free CP. Using extracted human teeth, the degree of infiltration inside the dentinal tubules was studied for both CP-NPs and CP. The anti-inflammatory capacity of CP-NPs was evaluated in vitro measuring their response and reaction against inflammatory cells, in particular against macrophages. The enzyme-linked immunosorbent assay (ELISA) was used to examine the cytokine release of IL-1β and TNF-α. RESULTS Optimized CP-NPs displayed an average size below 200 nm and a monomodal population. Additionally, spherical morphology and non-aggregation of CP-NPs were confirmed by transmission electron microscopy. Interaction studies showed that CP was encapsulated inside the NPs and no covalent bonds were formed. Moreover, CP-NPs exhibited a prolonged and steady release with only 21% of the encapsulated CP released after 48 h. Using confocal laser scanning microscopy, it was observed that CP-NPs were able to display enhanced penetration into the dentinal tubules. Neither the release of TNF-α nor IL-1β increased in CP-NPs compared to the LPS control, displaying results similar and even less than the TCP after 48 h. Moreover, IL-1β release in LPS-stimulated cells, decreased when macrophages were treated with CP-NPs. CONCLUSIONS In the present work, CP-NPs were prepared, optimized and characterized displaying significant increase in the degree of infiltration inside the dentinal tubules against CP and were able to significantly reduce TNF-α release. Therefore, CP-NPs constitute a promising therapy for the treatment of avulsed teeth with extended extra-oral time.
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Affiliation(s)
- Firas Elmsmari
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Department of Endodontics, Faculty of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Luis M Delgado
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Marta Espina
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, Barcelona, Spain
| | - Fernando Duran-Sindreu
- Department of Endodontics, Faculty of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Maria Luisa García
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, Barcelona, Spain
- Networking Research Centre of Neurodegenerative Disease (CIBERNED), Instituto de Salud Juan Carlos III, Madrid, Spain
| | - Elena Sánchez-López
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, Barcelona, Spain
- Networking Research Centre of Neurodegenerative Disease (CIBERNED), Instituto de Salud Juan Carlos III, Madrid, Spain
- Unit of Synthesis and Biomedical Applications of Peptides, IQAC-CSIC, Barcelona, Spain
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3
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Andreyashkina LY, Korolenkova MV, Vasilyev AV. [Treatment options for external inflammatory root resorption]. STOMATOLOGIIA 2023; 102:91-95. [PMID: 37622309 DOI: 10.17116/stomat202310204191] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
THE AIM OF THE STUDY Was to compare the efficacy of various treatment options for external inflammatory root resorption according to literature data. MATERIALS AND METHODS Literature was searched in electronic databases «eLibrary» and «PubMed» for key words «external inflammatory resorption treatment», «external inflammatory resorption management». Inclusion criteria comprised publications in Russian or English, clinical and experimental studies, full description of treatment protocol and obtained results. Studies with no full text, describing root resorption of orthodontic origin, clinical cases and clinical case series were excluded from the study. RESULTS The problem of external inflammatory root resorption is poorly described in the Russian scientific literature. There are no registered protocols for its prevention and treatment or therapeutic agents with proved efficacy available in Russia. The only accessible approach for external inflammatory root resorption remains timely pulp extirpation after dental trauma which importance is underlined by all authors involved in the field of dental trauma studies. MTA and calcium hydroxide being popular as intracanal medications still have significant inconveniences as they potentially provoke root dentine fractures or replacement resorption. CONCLUSION There is a need for elaboration and implementation of new prevention and treatment options for external inflammatory root resorption after dental trauma.
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Affiliation(s)
- L Y Andreyashkina
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - M V Korolenkova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
- Moscow Regional Research Institute named after M.F. Vladimirskiy, Moscow, Russia
| | - A V Vasilyev
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
- Research Centre for Medical Genetics, Moscow, Russia
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4
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Alhajj MN, Daud F, Al-Maweri SA, Johari Y, Ab-Ghani Z, Jaafar M, Naito Y, Prananingrum W, Ariffin Z. Effects of calcium hydroxide intracanal medicament on push-out bond strength of endodontic sealers: A systematic review and meta-analysis. J ESTHET RESTOR DENT 2022; 34:1166-1178. [PMID: 36239133 DOI: 10.1111/jerd.12974] [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: 07/05/2022] [Revised: 09/17/2022] [Accepted: 09/21/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the effect of calcium hydroxide intracanal medicament on the push-out bond strength of resin-based and calcium silicate-based endodontic sealers. METHODS A comprehensive search of was conducted for all relevant in-vitro studies. All randomized controlled in-vitro studies that evaluated the effect of calcium hydroxide on the push-out bond strength of resin-based or calcium silicate-based endodontic sealers were assessed. The variables of interest were extracted, and the risk of the included studies was evaluated. The standardized mean difference was calculated and the significance level was set at p value <0.05. RESULTS A total of 26 studies were eligible for analysis. There were 45 independent comparison groups and 1009 recruited teeth. The pooled data showed no significant difference in push-out bond strength between calcium hydroxide and control group in the resin-based group (SMD = 0.03; 95% CI = -0.55, 0.60; p = 0.93), and calcium silicate-based group (SMD = 0.02; 95% CI = -0.31, 0.35; p = 0.90). Most of the studies (21 out of 26) were at medium risk of bias and five studies showed a low risk of bias. CONCLUSION The available evidence suggests that calcium hydroxide used as intracanal medication does not influence the push-out bond strength of the resin- and calcium silicate-based endodontic sealers. CLINICAL SIGNIFICANCE The results of this meta-analysis suggest that calcium hydroxide used as intracanal medication does not influence the push-out bond strength of resin-based and calcium silicate-based endodontic sealers.
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Affiliation(s)
- Mohammed Nasser Alhajj
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia.,Department of Prosthodontics, Faculty of Dentistry, Thamar University, Dhamar, Yemen
| | - Fadhilah Daud
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | | | - Yanti Johari
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Zuryati Ab-Ghani
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Mariatti Jaafar
- School of Materials and Mineral Resources, Engineering Campus, Universiti Sains Malaysia, Penang, Malaysia
| | - Yoshihito Naito
- Department of Oral and Maxillofacial Prosthodontics and Oral Implantology, Institute of Health Biosciences, The University of Tokushima, Tokushima, Japan
| | - Widyasri Prananingrum
- Department of Dental Material Science and Technology, Hang Tuah University, Surabaya, Indonesia
| | - Zaihan Ariffin
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
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5
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George R, Wong M, White A, Jarrett J, Walsh L. Evaluation of the diffusion of triamcinolone and demeclocycline through the dentinal tubules and apical foramen: A mass spectrometry study. J Conserv Dent 2022; 25:420-425. [PMID: 36187869 PMCID: PMC9520650 DOI: 10.4103/jcd.jcd_206_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/10/2022] [Accepted: 05/17/2022] [Indexed: 11/30/2022] Open
Abstract
Aim: The aim of this study was to investigate the diffusion of triamcinolone and demeclocycline from an endodontic paste when used unmodified, versus when combined in equal parts with a calcium hydroxide paste, in terms of diffusion through the dentinal tubules versus through the apical foramen. Methodology: Medicaments were placed in endodontically prepared roots that were kept in vials of Milli-Q water. The five experimental groups in the study were (1) control – no medicament, (2) medicament containing triamcinolone and demeclocycline (T&D) and occluded apex, (3) T&D paste and patent apex, (4) T&D + calcium hydroxide (Ca(OH)2) occluded apex, and (5) T&D + Ca(OH)2 and patent apex. The triamcinolone and demeclocycline concentrations were measured with solid-phase extraction and ultra-high performance liquid chromatography–mass spectrometry, after 1, 3, 8, and 24 h, and after 1 week. Results: Most of the triamcinolone and demeclocycline diffused through the apical foramen, with sparse diffusion through the dentinal tubules. The T&D paste mixed with Ca(OH)2 in equal amounts showed greater than the expected 50% reduction in the diffusion of triamcinolone and demeclocycline from mass dilution alone (89% and 80%, respectively). Conclusions: These results stress the importance of maintaining apical patency, for allowing diffusion of active components of the drugs to target tissues in the periapical environment.
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6
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Abbott PV. Present status and future directions - managing endodontic emergencies. Int Endod J 2021; 55 Suppl 3:778-803. [PMID: 34958512 DOI: 10.1111/iej.13678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/20/2021] [Accepted: 12/26/2021] [Indexed: 11/28/2022]
Abstract
Endodontic emergencies are common in both general dental practices and specialist Endodontic practices. The aim of this review is to provide an overview of endodontic emergencies. Endodontic emergencies can be a result of many different conditions of the pulp, root canal and periradicular tissues. They may occur before endodontic treatment has been started, between appointments when treatment is being performed over multiple visits, or after endodontic treatment has been completed. In the latter situation, the emergency may be very soon after the treatment or it may occur many years later, in which case it is usually a new disease process as a result of the root canal system becoming infected. An emergency can be a stressful situation for both the patient and the dentist (or endodontist) as it is usually an unexpected event. It is incumbent on dental professionals to provide timely assistance to patients who have an emergency, and it is also important to allow sufficient time to manage the situation comprehensively. Management of endodontic emergencies should follow the principles of the 3D's - Diagnosis, Definitive dental treatment and Drugs - and in that sequence. An accurate diagnosis, the first "D", is essential so the appropriate treatment can be provided. Diagnosis requires a thorough understanding of the various conditions that can cause the emergency and this can be helped by having a comprehensive classification of the various conditions. The diagnosis should also direct the clinician to the appropriate definitive dental treatment, the second "D". Root canal treatment will not always be required as some cases can be managed conservatively. Other cases may require root canal re-treatment. The specific details of how the treatment is done can also vary, according to the diagnosis. The final "D" is Drugs - the use of drugs should also be dependent on the diagnosis and the dental treatment. Drugs should only be an adjunct following the treatment. The clinician must also differentiate between inflammation and infection in order to provide the appropriate treatment and to prescribe the appropriate medication for effective pain relief and resolution of other symptoms or signs such as swelling.
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Affiliation(s)
- Paul V Abbott
- UWA Dental School, The University of Western Australia, Western Australia, Australia
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7
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Krastl G, Weiger R, Ebeleseder K, Galler K. Present status and future directions: Endodontic management of traumatic injuries to permanent teeth. Int Endod J 2021; 55 Suppl 4:1003-1019. [PMID: 34862800 DOI: 10.1111/iej.13672] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/02/2021] [Indexed: 12/26/2022]
Abstract
The prognosis of traumatized teeth depends largely on the fate of the pulp and its treatment. This review aims to update the present status on the endodontic management of traumatic injuries to permanent teeth and to identify relevant research areas that could contribute to an improvement in diagnosis and treatment of traumatized permanent teeth. Future research should pay greater attention to (1) diagnostic methods to assess the perfusion of the pulp and enhance detection of tooth cracks and initial signs of root resorption; (2) improved materials for vital pulp treatment; (3) studies focusing on type and duration of splinting after root fractures; (4) antiresorptive intracanal medication in case of posttraumatic pulp necrosis and infection-related resorption and (5) long-term data on the apical barrier technique compared to revitalization.
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Affiliation(s)
- Gabriel Krastl
- Department of Conservative Dentistry and Periodontology, Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany
| | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology, Center of Dental Traumatology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Kurt Ebeleseder
- University Clinic of Dental Medicine and Oral Health, Medical University Graz, Graz, Austria
| | - Kerstin Galler
- Department of Conservative Dentistry and Periodontology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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8
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Amonkar AD, Dhaded NS, Doddwad PK, Patil AC, Hugar SM, Bhandi S, Raj AT, Patil S, Zanza A, Testarelli L. Evaluation of the Effect of Long-term Use of Three Intracanal Medicaments on the Radicular Dentin Microhardness and Fracture Resistance: An in vitro study. Acta Stomatol Croat 2021; 55:291-301. [PMID: 34658375 PMCID: PMC8514225 DOI: 10.15644/asc55/3/6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 08/01/2021] [Indexed: 11/01/2022] Open
Abstract
Objectives The aim of this research was to evaluate the effect of long-term use of three intracanal medicaments on the radicular dentin microhardness and fracture resistance. Material and methods A chemomechanical preparation was done using the Protaper rotary instruments up to F3. The teeth were stored in an incubator at 37°C at 100% humidity and were categorized in three groups by random allocation, namely: Triple Antibiotic Paste (TAP), Calcium hydroxide paste (Apexcal) and Ledermix. Following medicament application, the access openings of all teeth were sealed with 4 mm thickness of cavit. The samples were stored for periods of 1 week, 1 month and 3months. Two dentin cylinders measuring 5mm and 3mm were obtained from each sample. The cervical third was used for fracture resistance and the middle third was used for micro hardness evaluation. The microhardness testing was done using a Knoop microhardness tester, and the fracture resistance testing was done using the universal testing machine. Results Calcium hydroxide showed maximally negative effect on the physical properties of radicular dentin compared to TAP (p= 0.0100 at one month and Ledermix (p=0.0001 at one month). With an increase in the application time, there was an increased deterioration in the physical properties of radicular dentin. Conclusion Long-term placement of calcium hydroxide, Triple Antibiotic Paste, and Ledermix (p= 0.0001at 3 months) significantly affects the microhardness and fracture resistance of radicular dentin.
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Affiliation(s)
| | - Neha Sunil Dhaded
- Department of Conservative Dentistry and Endodontics, KAHER's V.K. Institute of Dental Sciences, Belagavi, India
| | - Preeti Kore Doddwad
- Department of Conservative Dentistry and Endodontics, KAHER's V.K. Institute of Dental Sciences, Belagavi, India
| | - Anand C Patil
- Department of Conservative Dentistry and Endodontics, KAHER's V.K. Institute of Dental Sciences, Belagavi, India
| | - Shivayogi M Hugar
- Department of Pedodontics and Preventive Dentistry,KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi, India
| | - Shilpa Bhandi
- Department of Restorative Dental Sciences, College of Dentistry; Jazan University, Jazan, Saudi Arabia
| | - A Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Alessio Zanza
- Department of Oral and Maxillofacial Sciences, Sapienza University, University of Rome, Italy
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University, University of Rome, Italy
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9
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Meng M, Chen Y, Ren H, Zhang Q, Chen S, Zhou X, Zou J. Effect of tetracyclines on pulpal and periodontal healing after tooth replantation: a systematic review of human and animal studies. BMC Oral Health 2021; 21:289. [PMID: 34090399 PMCID: PMC8180113 DOI: 10.1186/s12903-021-01615-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/09/2021] [Indexed: 02/08/2023] Open
Abstract
Background Pulpal and periodontal healing are two main concerns of delayed replantation of avulsed teeth. The objective of this review was to evaluate the effectiveness of topical and systemic application of tetracyclines on pulpal and periodontal healing after tooth replantation. Methods A comprehensive electronic search was conducted in six databases. This systematic review was carried out according to Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results After exclusion of 246 irrelevant papers, 14 animal studies and one human study were included in this review. The human study showed that avulsed permanent teeth treated with doxycycline did not show a better clinical outcome for pulp and periodontal healing compared with treatment with normal saline. As for animal studies, significant more pulpal healing was observed in immature teeth treated with topical doxycycline in two researches, while another one study showed that there is no difference between teeth treated with normal saline and teeth treated with doxycycline. Systemic doxycycline exerted no significant effect on pulpal revascularization illustrated by one research. Only one out of four articles illustrated the positive effect of systemic tetracyclines on periodontal healing. One paper reported that intracanal application of demeclocycline promoted favorable periodontal healing. Two articles showed topical doxycycline contributed to favorable periodontal healing, while five studies showed no significant effect of topical tetracyclines on periodontal healing. Conclusions As a result of data heterogeneity and limitations of the studies, the effect of topical or systemic application of tetracyclines on pulpal and periodontal healing is inconclusive. More studies are required to get more clinically significant conclusions.
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Affiliation(s)
- Mingmei Meng
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Yandi Chen
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Huidi Ren
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Qiong Zhang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Song Chen
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China. .,Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China.
| | - Jing Zou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China. .,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China.
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10
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Krastl G, Weiger R, Filippi A, Van Waes H, Ebeleseder K, Ree M, Connert T, Widbiller M, Tjäderhane L, Dummer PMH, Galler K. Endodontic management of traumatized permanent teeth: a comprehensive review. Int Endod J 2021; 54:1221-1245. [PMID: 33683731 DOI: 10.1111/iej.13508] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 03/05/2021] [Indexed: 12/15/2022]
Abstract
The pulp plays a key role in the treatment of traumatic dental injuries (TDIs) and is strongly associated with the outcome, particularly in severe cases. A correct pulp diagnosis is essential as it forms the basis for developing the appropriate management strategy. However, many TDIs are complex, and their treatment requires a profound knowledge of the physiological and pathological responses of the affected tissues. This comprehensive review will look at the dentine-pulp complex and its interaction with the surrounding tissues following TDIs. The literature up to 2020 was reviewed based on several searches on PubMed and the Cochrane Library using relevant terms. In addition to the recently revised guidelines of the International Association of Dental Traumatology, this article aims to provide background information with a focus on endodontic aspects and to gather evidence on which a clinician can make decisions on the choice of the appropriate endodontic approach for traumatized permanent teeth.
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Affiliation(s)
- G Krastl
- Department of Conservative Dentistry and Periodontology, Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany
| | - R Weiger
- Department of Periodontology, Endodontology and Cardiology, University School of Dental Medicine, Basel, Switzerland.,Center of Dental Traumatology, University School of Dental Medicine, Basel, Switzerland
| | - A Filippi
- Center of Dental Traumatology, University School of Dental Medicine, Basel, Switzerland.,Department of Oral Surgery, University School of Dental Medicine, Basel, Switzerland
| | - H Van Waes
- Department of Paediatric Dentistry, Clinic for Orthodontics and Paediatric Dentistry, University of Zürich, Zürich, Switzerland
| | - K Ebeleseder
- University Clinic of Dental Medicine and Oral Health, Medical University Graz, Graz, Austria
| | - M Ree
- Private Practice, Purmerend, Netherlands
| | - T Connert
- Department of Periodontology, Endodontology and Cardiology, University School of Dental Medicine, Basel, Switzerland.,Center of Dental Traumatology, University School of Dental Medicine, Basel, Switzerland
| | - M Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - L Tjäderhane
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.,Research Unit of Oral Health Sciences, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, University of Oulu, Oulu, Finland
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - K Galler
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
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11
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Eggmann F, Rihs J, Lenherr P, Weiger R, Krastl G, Zaugg LK. Spectrophotometric insights: calcium hydroxide influences tooth discolorations induced by short-term application of antibiotic/corticosteroid pastes. Clin Oral Investig 2020; 25:1141-1149. [PMID: 32712847 DOI: 10.1007/s00784-020-03414-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 06/15/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This in vitro study aimed to assess the influence of a calcium hydroxide dressing regarding the relative color change (ΔE) of enamel-dentin specimens previously exposed to antibiotic/corticosteroid pastes. MATERIALS AND METHODS Eighty bovine enamel-dentin specimens with a cylindrical central cavity were randomly allocated to four groups: NEG (empty), POS (blood), LED (Ledermix), and ODO (Odontopaste) (n = 20 each). The materials were applied and sealed with self-adhesive resin luting material. After 3 weeks, the materials were removed and a calcium hydroxide (Ca(OH)2) dressing was placed in all cavities. After a further 3-week storage period, the cavities were restored with resin-based composite. Spectrophotometric color measurements were taken over 6 months, and ΔE values were calculated. A Tukey's multiple comparison test was performed to assess significant differences within the treatment groups (p < 0.05). RESULTS Tooth discolorations were present after 3 weeks in LED (ΔE 29.14 ± 6.55) and POS (ΔE 18.05 ± 7.03); NEG and ODO remained color stable (ΔE 3.2 ± 1.36 and ΔE 2.3 ± 1.16). The 3-week Ca(OH)2 dressing decreased discolorations of POS (ΔE 15.93 ± 6.63; p = 0.37), whereas LED showed a further significant increase (ΔE 39.55; p < 0.0001). Between the end of the Ca(OH)2 dressing and the final restoration no significant color changes were observed in any group (p > 0.9). CONCLUSIONS Discolorations induced by LED progressed during the Ca(OH)2 dressing despite careful removal of all residues. CLINICAL RELEVANCE Calcium hydroxide might negatively affect the discoloring potential of Ledermix. This highlights the need for direct intracanal application methods of Ledermix ensuring a material-free access cavity or alternative antibiotic/corticosteroid pastes such as Odontopaste should be used.
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Affiliation(s)
- Florin Eggmann
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Jeremy Rihs
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Patrik Lenherr
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Gabriel Krastl
- Department of Operative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany
| | - Lucia K Zaugg
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland.
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Bourguignon C, Cohenca N, Lauridsen E, Flores MT, O'Connell AC, Day PF, Tsilingaridis G, Abbott PV, Fouad AF, Hicks L, Andreasen JO, Cehreli ZC, Harlamb S, Kahler B, Oginni A, Semper M, Levin L. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dent Traumatol 2020; 36:314-330. [DOI: 10.1111/edt.12578] [Citation(s) in RCA: 137] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - Nestor Cohenca
- Department of Pediatric Dentistry University of Washington and Seattle Children's Hospital Seattle WA USA
| | - Eva Lauridsen
- Resource Center for Rare Oral Diseases Copenhagen University Hospital Copenhagen Denmark
| | - Marie Therese Flores
- Department of Pediatric Dentistry Faculty of Dentistry Universidad de Valparaíso Valparaíso Chile
| | - Anne C. O'Connell
- Paediatric Dentitsry Dublin Dental University HospitalTrinity College DublinThe University of Dublin Dublin Ireland
| | - Peter F. Day
- School of Dentistry University of Leeds and Community Dental Service Bradford District Care NHS Trust Leeds UK
| | - Georgios Tsilingaridis
- Division of Orthodontics and Pediatric Dentistry Department of Dental Medicine Karolinska Institutet Huddinge Sweden
- Center for Pediatric Oral Health Research Stockholm Sweden
| | - Paul V. Abbott
- UWA Dental School University of Western Australia Nedlands WA Australia
| | - Ashraf F. Fouad
- Adams School of Dentistry University of North Carolina Chapel Hill NC USA
| | - Lamar Hicks
- Division of Endodontics University of Maryland School of DentistryUMB Baltimore MD USA
| | - Jens Ove Andreasen
- Department of Oral and Maxillofacial Surgery Resource Centre for Rare Oral Diseases University Hospital in Copenhagen (Rigshospitalet) Copenhagen Denmark
| | - Zafer C. Cehreli
- Department of Pediatric Dentistry Faculty of Dentistry Hacettepe University Ankara Turkey
| | - Stephen Harlamb
- Faculty of Medicine and Health The University of Sydney Sydney NSW Australia
| | - Bill Kahler
- School of Dentistry The University of Queensland St Lucia Qld Australia
| | - Adeleke Oginni
- Faculty of Dentistry College of Health Sciences Obafemi Awolowo University Ile‐Ife Nigeria
| | | | - Liran Levin
- Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
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13
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Mittmann CW, Kostka E, Ballout H, Preus M, Preissner R, Karaman M, Preissner S. Outcome of revascularization therapy in traumatized immature incisors. BMC Oral Health 2020; 20:207. [PMID: 32664918 PMCID: PMC7362656 DOI: 10.1186/s12903-020-01193-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/09/2020] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this retrospective analysis was to evaluate the clinical and radiological outcome of revascularization therapy in traumatized permanent incisors to determine whether this approach could be implemented into clinical routine. Methods A total of 16 traumatized incisors (either avulsion or severe luxation/intrusion) with open apices (> 1 mm) that underwent revascularization following a standardized protocol were analyzed with a mean follow-up of 22 months. Radiographs and clinical parameters (such as root length, pulp space, dentin wall width, apical foramen, alveolar bone loss, ankylosis/mobility, supra−/infraposition, discoloration, probing depth) were compared pre- and postoperatively and statistically analyzed. Results Over the follow-up period, 81.3% of the teeth survived revascularization and regained sensitivity, while 18.7% failed, as they had to be extracted due to serious root resorption. Regarding radiographic outcomes a significant difference could only be found in the decrease of apical foramina (p = 0.04). The other parameters showed no significant difference between pre- and postoperative measurements. More than half of the teeth (56.3%) developed root resorptions and 31.3% displayed signs of ankylosis and 92.9% developed discolorations during follow-up. However, 85.7% of the teeth maintained the bone level and outcomes of mobility showed a significant solidification. Conclusions Revascularization is a promising approach for the treatment of immature incisors to regain sensitivity and to enhance apical closure and at least to maintain alveolar bone in terms of a socket preservation. Further studies have to be performed to determine ideal conditions (type of trauma, age, width of apical foramen) for a revascularization.
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Affiliation(s)
- Carolina W Mittmann
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Assmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Eckehard Kostka
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Assmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Husam Ballout
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Assmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Mareike Preus
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Assmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Robert Preissner
- Institute of Physiology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Philippstrasse 12, 10115, Berlin, Germany
| | - Murat Karaman
- Institute of Physiology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Philippstrasse 12, 10115, Berlin, Germany
| | - Saskia Preissner
- Department Oral, Maxillary and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin. Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
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14
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Fouad AF, Abbott PV, Tsilingaridis G, Cohenca N, Lauridsen E, Bourguignon C, O'Connell A, Flores MT, Day PF, Hicks L, Andreasen JO, Cehreli ZC, Harlamb S, Kahler B, Oginni A, Semper M, Levin L. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol 2020; 36:331-342. [DOI: 10.1111/edt.12573] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Ashraf F. Fouad
- Adams School of Dentistry University of North Carolina Chapel Hill NC USA
| | - Paul V. Abbott
- UWA Dental School University of Western Australia Crawley WA Australia
| | - Georgios Tsilingaridis
- Division of Orthodontics and Pediatric Dentistry Department of Dental Medicine Karolinska Institutet Huddinge Sweden
- Center for Pediatric Oral Health Research Stockholm Sweden
| | - Nestor Cohenca
- Department of Pediatric Dentistry University of Washington and Seattle Children’s Hospital Seattle WA Australia
| | - Eva Lauridsen
- Resource Center for Rare Oral Diseases Copenhagen University Hospital Copenhagen Denmark
| | | | - Anne O'Connell
- Paediatric Dentistry Dublin Dental University Hospital Trinity College Dublin The University of Dublin Dublin Ireland
| | - Marie Therese Flores
- Department of Pediatric Dentistry Faculty of Dentistry Universidad de Valparaíso Valparaíso Chile
| | - Peter F. Day
- School of Dentistry Community Dental Service Bradford District Care NHS Trust University of Leeds Leeds UK
| | - Lamar Hicks
- Division of Endodontics University of Maryland School of DentistryUMB Baltimore MD USA
| | - Jens Ove Andreasen
- Department of Oral and Maxillofacial Surgery Resource Centre for Rare Oral Diseases University Hospital in Copenhagen (Rigshospitalet) Copenhagen Denmark
| | - Zafer C. Cehreli
- Department of Pediatric Dentistry Faculty of Dentistry Hacettepe University Ankara Turkey
| | - Stephen Harlamb
- Faculty of Medicine and Health The University of Sydney Sydney NSW Australia
| | - Bill Kahler
- School of Dentistry The University of Queensland St Lucia QLD Australia
| | - Adeleke Oginni
- Faculty of Dentistry College of Health Sciences Obafemi Awolowo University Ile‐Ife Nigeria
| | | | - Liran Levin
- Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
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15
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16
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Fouad AF. Microbiological aspects of traumatic injuries. Dent Traumatol 2019; 35:324-332. [PMID: 31125490 DOI: 10.1111/edt.12494] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 05/21/2019] [Indexed: 12/11/2022]
Abstract
After traumatic injuries to teeth, microorganisms may invade the compromised pulp tissue and initiate pulp infection and periapical inflammation. In addition to bone resorption that typically accompanies pulp necrosis, root resorption frequently occurs. Root resorption has several variants that may occur shortly after the trauma or at a later stage. The pathological changes seen after traumatic injuries to teeth are invariably linked to the presence of microbial irritants. The presence of bacterial biofilms in the dental pulp space can be treated with regenerative or therapeutic endodontic procedures. However, necrosis of periodontal ligament is usually terminal for the tooth involved. In this review, the sources of bacteria after traumatic injuries are discussed. The types and role of microorganisms involved in the pathogenesis of endodontic pathosis after traumatic injuries are presented, and contemporary approaches for the management of these conditions are reviewed. Contemporary antimicrobial strategies are discussed. The rationale for the use of systemic and topical antimicrobials is presented. Finally, novel approaches to the use of antimicrobial therapies, particularly in regenerative procedures, are reviewed.
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Affiliation(s)
- Ashraf F Fouad
- Department of Endodontics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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17
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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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18
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Mechanisms of Staining with Demeclocycline and Doxycycline Root Canal Medicaments. Eur Endod J 2018; 3:66-72. [PMID: 32161858 PMCID: PMC7006570 DOI: 10.14744/eej.2018.47966] [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] [Received: 01/29/2018] [Revised: 02/15/2018] [Accepted: 02/12/2018] [Indexed: 11/20/2022] Open
Abstract
Tetracyclines are a unique class of antibiotics which also have additional effects including anti-inflammatory, anti-resorptive and substantive within the root canal. There has been a long-held view that tetracycline medicaments discolour teeth and should be avoided. The evidence base around this topic was explored, including a review of the methodology used in laboratory studies. A search of PubMed, Medline and Scopus databases was conducted to identify studies of demeclocycline and doxycycline medicaments used in root canal therapy. An analysis of the methodology used in these studies was performed to determine if these replicate current clinical practice. The related literature on mechanisms of tetracycline stability and the effects of light, oxidation, moisture and chemical interactions was examined. Studies investigating the effects of Ledermix paste on segments of bovine dentine and avulsed or reimplanted teeth as well as combinations with other antibiotics were excluded from this review. Even though demeclocycline medicament pastes were introduced in 1962, the first laboratory studies of discolouration were not done until 2000. All later studies followed a similar approach, which included exposure to sodium hypochlorite for up to 30 minutes and storage in moist conditions with 100% humidity. Staining during dark storage and enhanced staining on exposure to light were reported, indicating multiple pathways of degradation of demeclocycline and its reaction products. Light, moisture and oxidation are the key factors which drive discolouration from demeclocycline. Clinical issues from tooth staining can be prevented by removal of medicament pastes from the access cavity, and placement of a sound interim restoration. Use of a doxycycline paste obviates concerns of staining. Laboratory assessments of the potential for staining should replicate in vivo conditions.
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19
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Maslamani M, Joseph B, Gabato S, Andersson L. Effect of periodontal ligament removal with gauze prior to delayed replantation in rabbit incisors on rate of replacement resorption. Dent Traumatol 2018; 34:182-187. [PMID: 29573129 DOI: 10.1111/edt.12398] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIM Delayed (dry storage > 60 minutes) replantation results in ankylosis and replacement resorption. It has been suggested to remove the non-viable periodontal ligament before replantation to possibly reduce the rate of replacement resorption. However there has been no study on the rate of replacement resorption after such measures. The aim of this study was to investigate if there was any difference in the rate of replacement resorption by either removing the periodontal ligament (PDL) with gauze or not removing PDL in teeth subjected to delayed replantation followed by healing for 2 or 6 weeks. MATERIALS AND METHODS Maxillary central incisors were extracted in 8 rabbits. In the right central incisors, the necrotic PDL was removed by dry gauze over the root surface. In the left eight extracted teeth PDL was left on the root surface. All extracted teeth were left to dry for 60 minutes. Extra-oral root canal treatment was performed before replantation. The rabbits were sacrificed after 2 weeks and 6 weeks respectively. Histologic processing and evaluation was done. RESULTS In the 2 weeks group, all teeth showed ankylosis. The cementum was intact, and fusion of the bone and root was generally seen without resorption of the root, whereas in the 6 weeks group regardless of whether PDL had been kept or not, ankylosis and osseous replacement of the dentin was seen. There was no evidence of inflammatory infiltrate in the sections examined. CONCLUSION Removal of PDL prior to delayed replantation may result in some initial protection of the cementum during the first few weeks. However, over longer times there seems to be neither protection of the dentin from ankylosis and osseous replacement, nor any influence on the rate of replacement resorption.
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Affiliation(s)
- Manal Maslamani
- Department of Restorative Sciences, Faculty of Dentistry, Kuwait University, Kuwait, Kuwait
| | - Bobby Joseph
- Department of Diagnostic Sciences, Faculty of Dentistry, Kuwait University, Kuwait, Kuwait
| | - Severino Gabato
- Kuwait Animal Resources Center - Health Sciences Center, Kuwait University, Kuwait, Kuwait
| | - Lars Andersson
- Senior Professor Oral and Maxillofacial Surgery, Faculty of Odontology, Malmö University, Malmö, Sweden
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20
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Qian H, Ding Y, Wu Y, Li S. The effects of three modified Hank's balanced salt solutions on root resorption of late replanted teeth: A pilot study. J Craniomaxillofac Surg 2018; 46:808-814. [PMID: 29545029 DOI: 10.1016/j.jcms.2018.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 02/01/2018] [Accepted: 02/13/2018] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate the effects of replanted rats' teeth that had been soaked in one of three modified Hank's balanced salt solutions (HBSSs) before replantation and after extended extra-oral dry time. MATERIALS AND METHODS Maxillary right incisors were extracted from 55 Wistar rats and kept dry for 30 or 60 min (n = 5 each). Afterwards, the pulp was extirpated and both the papilla and enamel organ were removed with a scalpel. Each group of teeth was soaked in one of three modified HBSSs or HBSS alone. After 30 min of immersion in solutions, the root canals were dried and filled with calcium hydroxide paste, and the teeth were replanted. After 8 weeks, animals were euthanized; then, specimens were processed as 5 μm-thick serial sections for histological examination and morphometric assessments. RESULTS The percentages of root resorption for the groups were found to be in the following order: HBSS3 (the bFGF group) > the HBSS only group > HBSS2 (the GSH group) > no soaking (the positive control group) > HBSS1 (the ALN group) for 30 min and the positive control group > the HBSS only group > HBSS2 > HBSS3 > HBSS1 for 60 min. The lowest incidence of resorption was observed in immediately replanted teeth (negative control). CONCLUSIONS The findings of this study suggest that soaking for 30 min in HBSS containing 1 mM alendronate can significantly inhibit root resorption for avulsed teeth that have been dried for 60 min.
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Affiliation(s)
- Hanyu Qian
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China
| | - Yunpeng Ding
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China
| | - Yangou Wu
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China
| | - Shengjiao Li
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China.
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Perin CP, Papalexiou V, Rodrigues Johann ACB, Ribeiro Mattos NH, Westphalen FH, Ditzel Westphalen VP. Evaluation of intracanal acetazolamide in late reimplanted rat teeth. Eur J Dent 2017; 11:417-421. [PMID: 29279664 PMCID: PMC5727723 DOI: 10.4103/ejd.ejd_191_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: The aim of this study was to evaluate the use of acetazolamide combined with different agents as intracanal medication in late reimplanted rat teeth. Materials and Methods: In 100 Wistar rats, divided into 5 groups of 20, one of the following medications was used: Acetazolamide liquid (AL); AL with calcium hydroxide powder (ALHC); acetazolamide powder with AL; acetazolamide powder with physiological solution; and calcium hydroxide with physiological solution (control). At 30 and 60 days after reimplantation, the animals were sacrificed, tissues were processed, and cuts were stained with hematoxylin and eosin. An optical microscope was used to determine the following: percentage of inflammatory root resorption (RRI); percentage of substitute root resorption (RRS); and presence of ankylosis. The data obtained was submitted for statistical analysis. Results: Group ALHC had a significantly higher RRS than the control group at 60 days (P = 0.01). Group AL showed significantly less ankylosis than the other groups, including the control, at 30 days. AL showed results similar to those of the control group with respect to RRS. Conclusion: Acetazolamide has the potential to be an effective intracanal medication.
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Affiliation(s)
- Camila Paiva Perin
- Departament of Endodontics Universidade Tuiuti do Paraná Curitiba, Paraná, Brazil
| | - Vula Papalexiou
- Departament of Endodontics Universidade Tuiuti do Paraná Curitiba, Paraná, Brazil
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22
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Heydari A, Tahmasbi S, Badiee M, Izadi S, Mashhadi Abbas F, Mokhtari S. The Effect of Root Coating with Titanium on Prevention of Root Resorption in Avulsed Teeth: An Animal Study. IRANIAN ENDODONTIC JOURNAL 2016; 11:309-314. [PMID: 27790261 PMCID: PMC5069908 DOI: 10.22037/iej.2016.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Introduction: Tooth avulsion is a real dental emergency. If immediate replantation is not performed, the avulsed tooth may be lost due to inflammatory or replacement resorption. This animal study aimed to evaluate the bone response to the titanium coating of the root surface as an artificial barrier, and prevention of resorption of avulsed teeth. Methods and Materials: This experimental study was conducted on four male dogs. The dogs were randomly divided into two groups for assessment at two and eight weeks. Four teeth were extracted in each animal. The root surfaces of the test group were coated with a titanium layer using the Electron Beam Deposition system. After 24 h, replantation of the teeth was performed. Two animals were sacrificed after two weeks and the remaining dogs were killed after eight weeks. The presence of inflammation, inflammatory resorption, replacement resorption, periodontal regeneration, periapical granuloma and ankylosis were evaluated through histological analyses. Results: Inflammatory root resorption was not present in any tooth except one tooth in the coated group after eight weeks. Replacement resorption was noted just in three of the non-coated teeth after two weeks and two teeth after eight weeks. The McNemar's test revealed that the frequency of replacement resorption in the non-coated group was significantly higher than the coated group (P=0.031). Conclusion: Based on the results of this study, it seems that coating the root surfaces of avulsed teeth with titanium may control the replacement root resorption.
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Affiliation(s)
| | - Soodeh Tahmasbi
- Department of Orthodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Badiee
- Dentofacial Deformities Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - SeyedSadra Izadi
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Fatemeh Mashhadi Abbas
- Department of Oral and Maxillofacial Pathology, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Mokhtari
- Dental School, Tehran University of Medical Sciences, Tehran, Iran
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Maslamani M, Almusawi A, Joseph B, Gabato S, Andersson L. An experimental model for studies on delayed tooth replantation and ankylosis in rabbits. Dent Traumatol 2016; 32:443-449. [PMID: 27241941 DOI: 10.1111/edt.12287] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2016] [Indexed: 11/26/2022]
Abstract
AIM To develop an experimental in vivo model to study dentoalveolar ankylosis and osseous replacement resorption after delayed replantation. MATERIALS AND METHODS The maxillary right incisors of eight rabbits were extracted and replanted, while the maxillary left incisors served as controls. A special technique for extraction was used, luxating the incisor laterally prior to extraction. Extra-oral root canal treatment was performed. In four of the eight replanted teeth, periodontal ligament was removed using gauze. All teeth were replanted after one-hour dry storage. A horizontal line was drilled on the labial enamel surface of the incisors to enable registration of possible subsequent infraposition. The rabbits were sacrificed after 1 week or 4 weeks, respectively. Percussion test of the teeth was carried out and infraposition was registered. Histological processing and evaluation were performed. RESULTS Percussion sound was normal after 1 week and high in the 4 week group; infraposition was noted in all replanted teeth in the 4-week group. Fusion between the bone and dentin was seen in some areas on the root already after 1 week, but there was little or no osseous replacement. Larger areas of ankylosis were seen in the 4-week group although not significant, but deeper progressive osseous replacement was noted in this group. There was no significant difference in ankylosis with regard to periodontal ligament removal or not. Pulp and periodontal tissues were normal in all control teeth. CONCLUSION The rabbit tooth model may be useful for experimental in-vivo studies on delayed replantation, subsequent ankylosis, osseous replacement and infraposition.
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Affiliation(s)
- Manal Maslamani
- Department of Restorative Sciences, Faculty of Dentistry, Kuwait University, Kuwait, Kuwait
| | - Ala Almusawi
- Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Kuwait, Kuwait
| | - Bobby Joseph
- Department of Diagnostic Sciences, Faculty of Dentistry, Kuwait University, Kuwait, Kuwait
| | - Severino Gabato
- Kuwait Animal Resources Center - Health Sciences Center, Kuwait University, Kuwait, Kuwait
| | - Lars Andersson
- Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Kuwait, Kuwait
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Dettwiler CA, Walter M, Zaugg LK, Lenherr P, Weiger R, Krastl G. In vitroassessment of the tooth staining potential of endodontic materials in a bovine tooth model. Dent Traumatol 2016; 32:480-487. [DOI: 10.1111/edt.12285] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2016] [Indexed: 12/24/2022]
Affiliation(s)
- Christian A. Dettwiler
- Department of Periodontology, Endodontology and Cariology; University Center for Dental Medicine; University of Basel; Basel Switzerland
| | - Mirella Walter
- Department of Periodontology, Endodontology and Cariology; University Center for Dental Medicine; University of Basel; Basel Switzerland
| | - Lucia K. Zaugg
- Department of Periodontology, Endodontology and Cariology; University Center for Dental Medicine; University of Basel; Basel Switzerland
| | - Patrik Lenherr
- Department of Reconstructive Dentistry and Temporomandibular Disorders; University Center for Dental Medicine; University of Basel; Basel Switzerland
| | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology; University Center for Dental Medicine; University of Basel; Basel Switzerland
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology; University of Würzburg; Würzburg Germany
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25
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Abbott PV. Prevention and management of external inflammatory resorption following trauma to teeth. Aust Dent J 2016; 61 Suppl 1:82-94. [DOI: 10.1111/adj.12400] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- PV Abbott
- School of Dentistry; The University of Western Australia; Western Australia Australia
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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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Evaluation of two formulations containing mineral trioxide aggregate on delayed tooth replantation: relevance of RANKL/RANK/OPG system. Odontology 2015; 104:211-9. [DOI: 10.1007/s10266-015-0204-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 03/10/2015] [Indexed: 11/26/2022]
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Nagas E, Cehreli ZC, Uyanik MO, Vallittu PK, Lassila LVJ. Effect of several intracanal medicaments on the push-out bond strength of ProRoot MTA and Biodentine. Int Endod J 2015; 49:184-8. [DOI: 10.1111/iej.12433] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 01/24/2015] [Indexed: 12/01/2022]
Affiliation(s)
- E. Nagas
- Department of Endodontics; Hacettepe University; Ankara Turkey
| | - Z. C. Cehreli
- Department of Pediatric Dentistry; Faculty of Dentistry; Hacettepe University; Ankara Turkey
| | - M. O. Uyanik
- Department of Endodontics; Hacettepe University; Ankara Turkey
| | - P. K. Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre - TCBC; Institute of Dentistry; University of Turku; Turku Finland
- City of Turku Welfare Division; Oral Health Care; Turku Finland
| | - L. V. J. Lassila
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre - TCBC; Institute of Dentistry; University of Turku; Turku Finland
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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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Barbizam JVB, Massarwa R, da Silva LAB, da Silva RAB, Nelson-Filho P, Consolaro A, Cohenca N. Histopathological evaluation of the effects of variable extraoral dry times and enamel matrix proteins (enamel matrix derivatives) application on replanted dogs' teeth. Dent Traumatol 2014; 31:29-34. [DOI: 10.1111/edt.12131] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Joao V. B. Barbizam
- Department of Endodontics; School of Dentistry; University of Washington; Seattle WA USA
| | - Rasha Massarwa
- Department of Endodontics; School of Dentistry; University of Washington; Seattle WA USA
| | - Lea Assed Bezerra da Silva
- Pediatric Dentistry Department; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - Raquel Assed Bezerra da Silva
- Pediatric Dentistry Department; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - Paulo Nelson-Filho
- Pediatric Dentistry Department; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - Alberto Consolaro
- Department of Stomatology; School of Dentistry of Bauru; University of São Paulo; Bauru Brazil
| | - Nestor Cohenca
- Department of Endodontics; School of Dentistry; University of Washington; Seattle WA USA
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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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von Büren A, Krastl G, Kühl S, Filippi A. Management of avulsions in Switzerland 2007-2010. Dent Traumatol 2013; 30:176-81. [DOI: 10.1111/edt.12080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Anja von Büren
- Department of Oral Surgery, Oral Radiology and Oral Medicine; Center of Dental Traumatology; University of Basel; Basle Switzerland
| | - Gabriel Krastl
- Department of Periodontology, Endodontology and Cariology; Center of Dental Traumatology; University of Basel; Basel Switzerland
| | - Sebastian Kühl
- Department of Oral Surgery, Oral Radiology and Oral Medicine; Center of Dental Traumatology; University of Basel; Basle Switzerland
| | - Andreas Filippi
- Department of Oral Surgery, Oral Radiology and Oral Medicine; Center of Dental Traumatology; University of Basel; Basle Switzerland
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Athanassiadis M, Jacobsen N, Nassery K, Parashos P. The effect of calcium hydroxide on the antibiotic component of Odontopaste and Ledermix paste. Int Endod J 2013; 46:530-7. [PMID: 23186004 PMCID: PMC3664018 DOI: 10.1111/iej.12021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 10/07/2012] [Indexed: 11/29/2022]
Abstract
AIM To investigate the chemical interaction of calcium hydroxide with the antibiotics demeclocycline calcium in Ledermix Paste and clindamycin hydrochloride in Odontopaste. METHODOLOGY Validated methods were developed to analyse the interaction of calcium hydroxide in two forms, Pulpdent and calcium hydroxide powder, with the two antibiotics. High-performance liquid chromatography (HPLC) was used to analyse the mixed samples of the pastes and calcium hydroxide. The concentration of demeclocycline calcium over 0-, 1-, 18-, 24-, 72-h and 7-day time-points was determined. The concentration of clindamycin hydrochloride over 1-, 6-, 24-, 72-h and 7-day time-points was determined. All tests with HPLC involved testing of the standard in duplicate alongside the samples. Linearity, precision and specificity of the testing procedures and apparatus were validated. Descriptive statistics are provided. RESULTS The antibiotics in both Odontopaste and Ledermix Paste were affected by the addition of calcium hydroxide. When mixed with calcium hydroxide powder, Odontopaste had a 2% loss of clindamycin hydrochloride over 7 days, but when mixed with Pulpdent, there was a 36% loss over 7 days. Ledermix Paste showed an 80% loss of demeclocycline calcium over 7 days when mixed with calcium hydroxide powder and a 19% loss when mixed with Pulpdent over the 7-day period. CONCLUSION The addition of calcium hydroxide to Odontopaste or Ledermix Paste results in reductions of the respective antibiotic over a 7-day time period.
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Nonsurgical endodontic retreatment of advanced inflammatory external root resorption using mineral trioxide aggregate obturation. Case Rep Dent 2012; 2012:624792. [PMID: 23304567 PMCID: PMC3530227 DOI: 10.1155/2012/624792] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 11/19/2012] [Indexed: 11/21/2022] Open
Abstract
Inflammatory external root resorption is one of the major complications after traumatic dental injury. In this case report, we describe treatment of a maxillary central incisor affected by severe, perforating external root resorption. An 18-year-old patient presented with a previously traumatized, root-filled maxillary central incisor associated with pain and sinus tract. Radiographic examination revealed periradicular lesion involving pathologic resorption of the apical region of the root and lateral root surface both mesially and distally. After removal of the root canal filling, the tooth was disinfected with intracanal triple antibiotic paste for 2 weeks. The antibiotic dressing was then removed, and the entire root canal was filled with mineral trioxide aggregate. The endodontic access cavity was restored with composite resin. After 18 months, significant osseous healing of the periradicular region and lateral periodontium had occurred with arrest of external root resorption, and no clinical symptoms were apparent.
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36
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Andersson L, Andreasen JO, Day P, Heithersay G, Trope M, Diangelis AJ, Kenny DJ, Sigurdsson A, Bourguignon C, Flores MT, Hicks ML, Lenzi AR, Malmgren B, Moule AJ, Tsukiboshi M. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol 2012; 39:412-419. [PMID: 22409417 DOI: 10.1111/j.1600-9657.2012.01125.x] [Citation(s) in RCA: 341] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Avulsion of permanent teeth is one of the most serious dental injuries, and a prompt and correct emergency management is very important for the prognosis. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the task group. The guidelines represent the current best evidence and practice based on literature research and professionals' opinion. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of avulsed permanent teeth.
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Affiliation(s)
- Lars Andersson
- Department of Surgical Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Kuwait City, Kuwait.
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Krastl G, Allgayer N, Lenherr P, Filippi A, Taneja P, Weiger R. Tooth discoloration induced by endodontic materials: a literature review. Dent Traumatol 2012; 29:2-7. [DOI: 10.1111/j.1600-9657.2012.01141.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lenherr P, Allgayer N, Weiger R, Filippi A, Attin T, Krastl G. Tooth discoloration induced by endodontic materials: a laboratory study. Int Endod J 2012; 45:942-9. [PMID: 22506849 DOI: 10.1111/j.1365-2591.2012.02053.x] [Citation(s) in RCA: 174] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To investigate the discoloration potential of endodontic materials using a bovine tooth model. METHODOLOGY Two hundred and 10 dentine-enamel cuboid blocks (10 × 10 × 3.5 mm) were prepared out of the middle thirds of bovine tooth crowns. Standardized cavities were prepared in the walls of the pulp chamber leaving 2 mm of enamel and dentine on the labial wall of the crown. The specimens were randomly assigned to 14 groups (n = 15). Endodontic materials were placed into the cavities as follows: group A: empty, group B: blood, group C: calcium hydroxide, group D: ApexCal, group E: Ultracal XS, group F: Ledermix, group G: triple antibiotic paste (3Mix), group H: grey MTA(GMTA), group I: GMTA + blood, group J: white MTA (WMTA), group K: WMTA + blood, group L: Portland cement (PC), group M: PC + blood and group N: AH Plus. The cavities were sealed with composite and stored in water. Standardized colour measurement (VITA Easyshade compact) was performed at the following intervals: prior to (T0) and after placement of the filling (T1), 1 week (T2), 1 month (T3), 3 months (T4), 6 months (T5) and after 1 year (T6). Colour change (ΔE) values were calculated. A two-way analysis of variance was used to assess significant differences between the endodontic materials. The mean values of all groups were compared using the Tukey multiple comparison test (α = 0.05). RESULTS Significant differences were detected amongst the experimental groups after 12 months (P < 0.0001). The lowest colour change values were observed in the groups N (AH Plus, 3.2 ± 1.5), A (empty, 3.8 ± 1.4), L (PC, 4.1 ± 1.7), C (calcium hydroxide, 4.7 ± 1.5), E (Ultracal XS, 5.1 ± 1.9) and J (WMTA, 7.9 ± 6.7). The most discoloration was measured in groups G (3Mix, 66.2 ± 9.9) and F (Ledermix, 46.2 ± 11.6). PC showed the best colour stability amongst the Portland cement-based materials; however, when contaminated with blood (group M), a significantly higher ΔE value (13.6 ± 4.2) was detected (P = 0.032). CONCLUSION Materials used in endodontics may stain teeth. Therefore, the choice of material should not rely solely on biological and functional criteria, but also take aesthetic considerations into account.
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Affiliation(s)
- P Lenherr
- Clinic for Reconstructive Dentistry and Temporomandibular Disorders, University of Basel, Basel, Switzerland
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Mori GG, Poi WR, Castilho LR. Evaluation of the anti-resorptive ability of an experimental acetazolamide paste for the treatment of late replanted teeth: a study in rats. Dent Traumatol 2012; 29:34-40. [DOI: 10.1111/j.1600-9657.2012.01131.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Athanassiadis M, Jacobsen N, Parashos P. The effect of calcium hydroxide on the steroid component of Ledermix and Odontopaste. Int Endod J 2011; 44:1162-9. [PMID: 21902701 PMCID: PMC3258417 DOI: 10.1111/j.1365-2591.2011.01940.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 07/27/2011] [Indexed: 11/28/2022]
Abstract
AIM To investigate the chemical interaction of calcium hydroxide with the corticosteroid triamcinolone acetonide in Ledermix Paste and in Odontopaste, a new steroid/antibiotic paste. METHODOLOGY Validated methods were developed to analyse the interaction of calcium hydroxide in two forms, Pulpdent Paste and calcium hydroxide powder, with triamcinolone acetonide within Odontopaste and Ledermix Paste. High-performance liquid chromatography (HPLC) was used to analyse the mixed samples of the pastes and calcium hydroxide. The concentration of triamcinolone acetonide within the pastes was determined over 0, 2, 6, 24 and 72-h time-points. All tests with the HPLC involved the testing of the standard with triplicate injections alongside the samples. All samples were tested in duplicate with each injected twice; therefore, four tests were performed for each investigation. Linearity, precision and specificity of the testing procedures and apparatus were validated. Descriptive statistics are provided. RESULTS In both pastes, there was a marked rapid destruction of the triamcinolone acetonide steroid upon mixing with calcium hydroxide. Odontopaste suffered a lower rate of destruction of the triamcinolone acetonide component than Ledermix Paste, but both pastes showed very similar degrees of steroid destruction after 72 h. When using calcium hydroxide powder with Ledermix Paste, the triamcinolone was destroyed entirely and immediately. CONCLUSION The addition of calcium hydroxide to Odontopaste or Ledermix Paste results in the rapid destruction of the steroid.
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Day PF, Gregg TA, Ashley P, Welbury RR, Cole BO, High AS, Duggal MS. Periodontal healing following avulsion and replantation of teeth: a multi-centre randomized controlled trial to compare two root canal medicaments. Dent Traumatol 2011; 28:55-64. [PMID: 21988960 DOI: 10.1111/j.1600-9657.2011.01053.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Non-setting calcium hydroxide (Ultracal XS(®) ) is recommended by the International Association of Dental Traumatology as the initial medicament following avulsion and replantation for mature teeth. There is experimental evidence to suggest Ledermix(®) , placed as an alternative inter-visit dressing may improve periodontal healing. AIM This study investigated, using a multi-centre randomized controlled trial, the effect of two root canal medicaments, Ledermix(®) and Ultracal XS(®) , on periodontal healing of avulsed and replanted teeth. MATERIAL AND METHODS Children were recruited if they fulfilled all inclusion criteria. Treatment followed a standardized protocol. Assessment of periodontal healing or ankylosis was made clinically and radiographically by an experienced, 'blinded', clinician at 12months. RESULTS Over 200 patients were assessed for eligibility at five centres. Twenty-nine patients were eligible for inclusion. Final analysis involved 22 patients with 27 teeth. Ankylosis was detected in four of the 12 teeth in the Ledermix(®) group and nine of 15 in the Ultracal XS(®) group. No significant difference between medicaments was found in the proportion of teeth or patients showing periodontal healing. DISCUSSION There was no significant difference in periodontal healing between the two medicaments at either a tooth or patient level. The numbers recruited fell short of an estimated power calculation. For patients meeting the inclusion criteria and completing the trial, periodontal healing was seen in 52% of teeth at the 12-month assessment between both groups. The only factor found to significantly influence the periodontal outcome was dry time.
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Affiliation(s)
- Peter F Day
- Leeds Dental Institute, Leeds Belfast Children's Hospital, Belfast Eastman Dental Institute, London, UK.
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Rödig T, Hirschleb M, Zapf A, Hülsmann M. Comparison of ultrasonic irrigation and RinsEndo for the removal of calcium hydroxide and Ledermix paste from root canals. Int Endod J 2011; 44:1155-61. [DOI: 10.1111/j.1365-2591.2011.01937.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Panzarini SR, Trevisan CL, Brandini DA, Poi WR, Sonoda CK, Luvizuto ER, dos Santos CLV. Intracanal dressing and root canal filling materials in tooth replantation: a literature review. Dent Traumatol 2011; 28:42-8. [DOI: 10.1111/j.1600-9657.2011.01023.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Day PF, Duggal MS, High AS, Robertson A, Gregg TA, Ashley PF, Welbury RR, Cole BO, Westland S. Discoloration of Teeth after Avulsion and Replantation: Results from a Multicenter Randomized Controlled Trial. J Endod 2011; 37:1052-7. [DOI: 10.1016/j.joen.2011.04.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Revised: 04/16/2011] [Accepted: 04/18/2011] [Indexed: 10/18/2022]
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46
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Andreasen JO, Andersson L. Critical considerations when planning experimental in vivo studies in dental traumatology. Dent Traumatol 2011; 27:275-80. [PMID: 21477104 DOI: 10.1111/j.1600-9657.2011.00983.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In vivo studies are sometimes needed to understand healing processes after trauma. For several reasons, not the least ethical, such studies have to be carefully planned and important considerations have to be taken into account about suitability of the experimental model, sample size and optimizing the accuracy of the analysis. Several manuscripts of in vivo studies are submitted for publication to Dental Traumatology and rejected because of inadequate design, methodology or insufficient documentation of the results. The authors have substantial experience in experimental in vivo studies of tissue healing in dental traumatology and share their knowledge regarding critical considerations when planning experimental in vivo studies.
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Affiliation(s)
- Jens O Andreasen
- Department of Oral and Maxillofacial Surgery, Resource Centre for Rare Oral Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.
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47
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Asgary S, Nosrat A, Seifi A. Management of Inflammatory External Root Resorption by Using Calcium-enriched Mixture Cement: A Case Report. J Endod 2011; 37:411-3. [DOI: 10.1016/j.joen.2010.11.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 11/08/2010] [Accepted: 11/12/2010] [Indexed: 11/28/2022]
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Abstract
Treatment of traumatized teeth generally occurs in two phases: short-term emergency treatment and stabilization followed by endodontic management and review. These authors recently reviewed the endodontic considerations in the treatment of traumatized permanent anterior teeth, and in this article review the early management of traumatized permanent teeth. Preoperative assessment and emergency management are emphasized, as is the treatment of immature teeth for which continued development of the root system must be encouraged. Factors influencing long-term prognosis are discussed and the influence of various management strategies evaluated.
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Affiliation(s)
- Alex J Moule
- School of Dentistry, University of Queensland, 141 Queen Street, Brisbane 4000, Queensland, Australia.
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Mohammadi Z, Abbott PV. On the local applications of antibiotics and antibiotic-based agents in endodontics and dental traumatology. Int Endod J 2009; 42:555-67. [PMID: 19467048 DOI: 10.1111/j.1365-2591.2009.01564.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Z Mohammadi
- Department of Endodontics, School of Dentistry, Hamedan University of Medical Sciences, Hamedan, Iran.
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50
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Kirakozova A, Teixeira FB, Curran AE, Gu F, Tawil PZ, Trope M. Effect of Intracanal Corticosteroids on Healing of Replanted Dog Teeth after Extended Dry Times. J Endod 2009; 35:663-7. [DOI: 10.1016/j.joen.2009.01.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Revised: 01/18/2009] [Accepted: 01/28/2009] [Indexed: 12/24/2022]
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