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Al Turkestani N, Zhang Z, Nör JE. Semaphorin 4D Induces Vasculogenic Differentiation of Dental Pulp Stem Cells. Dent J (Basel) 2023; 11:160. [PMID: 37504226 PMCID: PMC10378119 DOI: 10.3390/dj11070160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/25/2023] [Accepted: 06/23/2023] [Indexed: 07/29/2023] Open
Abstract
This work aimed to evaluate the effect of Semaphorin 4D (SEMA4D) signaling through Plexin B1 on the vasculogenic differentiation of dental pulp stem cells. We assessed the protein expression of SEMA4D and Plexin B1 in dental pulp stem cells (DPSC) from permanent human teeth and stem cells from human exfoliated deciduous (SHED) teeth using Western blots. Their expression in human dental pulp tissues and DPSC-engineered dental pulps was determined using immunofluorescence. We then exposed dental pulp stem cells to recombinant human SEMA4D (rhSEMA4D), evaluated the expression of endothelial cell differentiation markers, and assessed the vasculogenic potential of rhSEMA4D using an in vitro sprouting assay. Lastly, Plexin B1 was silenced to ascertain its role in SEMA4D-mediated vasculogenic differentiation. We found that SEMA4D and Plexin B1 are expressed in DPSC, SHED, and human dental pulp tissues. rhSEMA4D (25-100 ng/mL) induced the expression of endothelial markers, i.e., vascular endothelial growth factor receptor (VEGFR)-2, cluster of differentiation (CD)-31, and tyrosine kinase with immunoglobulin-like and EGF-like domains (Tie)-2, in dental pulp stem cells and promoted capillary-like sprouting in vitro (p < 0.05). Furthermore, Plexin B1 silencing abrogated the vasculogenic differentiation of dental pulp stem cells and significantly inhibited capillary sprouting upon exposure to rhSEMA4D. Collectively, these data provide evidence that SEMA4D induces vasculogenic differentiation of dental pulp stem cells through Plexin B1 signaling.
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Affiliation(s)
- Najla Al Turkestani
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA; (N.A.T.); (Z.Z.)
- Department of Restorative and Aesthetic Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Zhaocheng Zhang
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA; (N.A.T.); (Z.Z.)
| | - Jacques Eduardo Nör
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA; (N.A.T.); (Z.Z.)
- Department of Biomedical Engineering, University of Michigan College of Engineering, Ann Arbor, MI 48109, USA
- Department of Otolaryngology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
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Panda P, Mishra L, Govind S, Panda S, Lapinska B. Clinical Outcome and Comparison of Regenerative and Apexification Intervention in Young Immature Necrotic Teeth-A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11133909. [PMID: 35807193 PMCID: PMC9267570 DOI: 10.3390/jcm11133909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/24/2022] [Accepted: 06/30/2022] [Indexed: 12/12/2022] Open
Abstract
This systematic review aimed to evaluate interventions individually and compare the clinical outcome of young, immature teeth treated with regenerative endodontic therapy (RET) and apexification procedure. The protocol was registered with PROSPERO (International Prospective Register of Systematic Reviews), bearing the registration number CRD42021230284. A bibliographic search in the biomedical databases was conducted in four databases—PubMed, CENTRAL, EMBASE and ProQuest—using searching keywords and was limited to studies published between January 2000 and April 2022 in English. The search was supplemented by manual searching, citation screening and scanning of all reference lists of selected paper. The study selection criteria were randomized clinical trial, prospective clinical studies and observational studies. The search found 32 eligible articles, which were included in the study. The quality assessment of the studies was performed using the Cochrane risk of bias tool for randomized control trials and non-randomized clinical studies. The meta-analysis was performed using Review Manager software (REVMAN, version 5). The results indicated that a clinicians’ MTA apexification procedure was more successful compared to calcium hydroxide. In RET, apical closure and overall success rate is statistically same for both apical platelet concentrates (APCs) and blood clots (BC). Both interventions have similar survival rates; however, RET should be preferred in cases where the root development is severely deficient, there is insufficient dentine and the tooth’s prognosis is hopeless even with an apexification procedure.
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Affiliation(s)
- Pratima Panda
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (P.P.); (S.G.)
| | - Lora Mishra
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (P.P.); (S.G.)
- Correspondence: (L.M.); (B.L.); Tel.: +91-889-526-6363 (L.M.); +85-42-675-74-61 (B.L.)
| | - Shashirekha Govind
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (P.P.); (S.G.)
| | - Saurav Panda
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India;
| | - Barbara Lapinska
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland
- Correspondence: (L.M.); (B.L.); Tel.: +91-889-526-6363 (L.M.); +85-42-675-74-61 (B.L.)
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3
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Camilleri J, Atmeh A, Li X, Meschi N. Present status and future directions: Hydraulic materials for endodontic use. Int Endod J 2022; 55 Suppl 3:710-777. [PMID: 35167119 PMCID: PMC9314068 DOI: 10.1111/iej.13709] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hydraulic materials are used in Endodontics due to their hydration characteristics namely the formation of calcium hydroxide when mixing with water and also because of their hydraulic properties. These materials are presented in various consistencies and delivery methods. They are composed primarily of tricalcium and dicalcium silicate, and also include a radiopacifier, additives and an aqueous or a non-aqueous vehicle. Only materials whose primary reaction is with water can be classified as hydraulic. OBJECTIVES Review of the classification of hydraulic materials by Camilleri and the literature pertaining to specific uses of hydraulic cements in endodontics namely intra-coronal, intra-radicular and extra-radicular. Review of the literature on the material properties linked to specific uses providing the current status of these materials after which future trends and gaps in knowledge could be identified. METHODS The literature was reviewed using PUBMED, and for each clinical use, the in vitro properties such as physical, chemical, biological and antimicrobial characteristics and clinical data were extracted and evaluated. RESULTS A large number of publications were retrieved for each clinical use and these were grouped depending on the property type being investigated. CONCLUSIONS The hydraulic cements have made a difference in clinical outcomes. The main shortcoming is the poor testing methodologies employed which provide very limited information and also inhibits adequate clinical translation. Furthermore, the clinical protocols need to be updated to enable the materials to be employed effectively.
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Affiliation(s)
- Josette Camilleri
- School of DentistryCollege of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Amre Atmeh
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM)Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU)DubaiUnited Arab Emirates
| | - Xin Li
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
| | - Nastaran Meschi
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
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Alyahya SAS, AlMuhaya SFA, Alqahtani AN, Adwan TA, Aleisa AF, Alsabeh YS, Albishi AKA, Binmuqbil BA, Alqoair AI, Almaymoon HS. Comparison between Calcium Hydroxide and MTA When Used for Apexification: A Systematic Review. PHARMACOPHORE 2022. [DOI: 10.51847/foykshgw6q] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Shaik I, Dasari B, Kolichala R, Doos M, Qadri F, Arokiyasamy JL, Tiwari RVC. Comparison of the Success Rate of Mineral Trioxide Aggregate, Endosequence Bioceramic Root Repair Material, and Calcium Hydroxide for Apexification of Immature Permanent Teeth: Systematic Review and Meta-Analysis. J Pharm Bioallied Sci 2021; 13:S43-S47. [PMID: 34447040 PMCID: PMC8375928 DOI: 10.4103/jpbs.jpbs_810_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 11/10/2022] Open
Abstract
This systematic review aims to compare the success rate of Endosequence bioceramic root repair material (BCRRM), mineral trioxide aggregate (MTA), and calcium hydroxide for apexification of necrotic immature permanent teeth. Indexed Journals such as Google Scholar, PubMed, Scopus, Cochrane, Research Gate, Wiley Online Library, and other related journals were hand searched from inception till November 2020 and articles were selected for review based on PRISMA guidelines. Of the 410 studies that were identified, 150 articles were selected after title/abstract reading. After full-text reading and based on inclusion and exclusion criteria, 9 studies were finalized for systematic review. Clinical, radiographic success, and the time taken for apical barrier formation were reviewed. All the three materials had almost similar success rate in terms of clinical symptoms, but the time taken for apical barrier formation and also single visit treatment makes MTA and Endosequence BCRRM superior to calcium hydroxide. Studies comparing EndoSequence Root Repair Material and MTA are very limited and need further evaluation in the future.
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Affiliation(s)
- Izaz Shaik
- DMD Student, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Bhargavi Dasari
- DMD Student, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Rashmi Kolichala
- DMD Student, Sri Venkata Sai Institute of Dental Sciences, Hyderabad, Telangana, India
| | - Mina Doos
- Dental Surgeon, Faculty of Dentistry and Oral Medicine, Pharos University, Alexandria, Egypt
| | - Fida Qadri
- Dental Surgeon, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | | | - Rahul Vinay Chandra Tiwari
- Department of OMFS, Narsinhbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, Gujarat, India
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Xuan K, Li B, Guo H, Sun W, Kou X, He X, Zhang Y, Sun J, Liu A, Liao L, Liu S, Liu W, Hu C, Shi S, Jin Y. Deciduous autologous tooth stem cells regenerate dental pulp after implantation into injured teeth. Sci Transl Med 2019; 10:10/455/eaaf3227. [PMID: 30135248 DOI: 10.1126/scitranslmed.aaf3227] [Citation(s) in RCA: 266] [Impact Index Per Article: 53.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 12/19/2017] [Indexed: 12/11/2022]
Abstract
Pulp necrosis arrests root development in injured immature permanent teeth, which may result in tooth loss. However, dental pulp regeneration and promotion of root development remains challenging. We show that implantation of autologous tooth stem cells from deciduous teeth regenerated dental pulp with an odontoblast layer, blood vessels, and nerves in two animal models. These results prompted us to enroll 40 patients with pulp necrosis after traumatic dental injuries in a randomized, controlled clinical trial. We randomly allocated 30 patients to the human deciduous pulp stem cell (hDPSC) implantation group and 10 patients to the group receiving traditional apexification treatment. Four patients were excluded from the implantation group due to loss at follow-up (three patients) and retrauma of the treated tooth (one patient). We examined 26 patients (26 teeth) after hDPSC implantation and 10 patients (10 teeth) after apexification treatment. hDPSC implantation, but not apexification treatment, led to regeneration of three-dimensional pulp tissue equipped with blood vessels and sensory nerves at 12 months after treatment. hDPSC implantation increased the length of the root (P < 0.0001) and reduced the width of the apical foramen (P < 0.0001) compared to the apexification group. In addition, hDPSC implantation led to regeneration of dental pulp tissue containing sensory nerves. To evaluate the safety of hDPSC implantation, we followed 20 patients implanted with hDPSCs for 24 months and did not observe any adverse events. Our study suggests that hDPSCs are able to regenerate whole dental pulp and may be useful for treating tooth injuries due to trauma.
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Affiliation(s)
- Kun Xuan
- MS-State Key Laboratory, School of Stomatology, Fourth Military Medical University, Xi'an, China.,Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Bei Li
- MS-State Key Laboratory, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Hao Guo
- MS-State Key Laboratory, School of Stomatology, Fourth Military Medical University, Xi'an, China.,Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Wei Sun
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Xiaoxing Kou
- Department of Anatomy and Cell Biology, University of Pennsylvania School of Dental Medicine, Philadelphia, PA 19104, USA
| | - Xiaoning He
- MS-State Key Laboratory, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Yongjie Zhang
- MS-State Key Laboratory, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Jin Sun
- MS-State Key Laboratory, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Anqi Liu
- MS-State Key Laboratory, School of Stomatology, Fourth Military Medical University, Xi'an, China.,Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Li Liao
- MS-State Key Laboratory, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Shiyu Liu
- MS-State Key Laboratory, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Wenjia Liu
- MS-State Key Laboratory, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Chenghu Hu
- MS-State Key Laboratory, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Songtao Shi
- Department of Anatomy and Cell Biology, University of Pennsylvania School of Dental Medicine, Philadelphia, PA 19104, USA.
| | - Yan Jin
- MS-State Key Laboratory, School of Stomatology, Fourth Military Medical University, Xi'an, China.
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Kandemir Demirci G, Kaval ME, Güneri P, Çalışkan MK. Treatment of immature teeth with nonvital pulps in adults: a prospective comparative clinical study comparing MTA with Ca(OH) 2. Int Endod J 2019; 53:5-18. [PMID: 31397907 DOI: 10.1111/iej.13201] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 08/06/2019] [Indexed: 11/28/2022]
Abstract
AIM To evaluate and compare the influence of various predictors on outcomes of apexification using either mineral trioxide aggregate (MTA) or calcium hydroxide (CH) in permanent immature anterior teeth with necrotic pulps and periapical lesions of adults. METHODOLOGY Ninety immature teeth with necrotic pulps and periapical lesions on adult patients (aged 18-40 years) were treated with MTA (45 teeth) or CH (45 teeth) between 2015 and 2018. Patients of both groups were recalled for follow-up examinations after the first intervention at 1,3,6 and 12 months for the first year, every 6 months for the second year and every year thereafter until the end of the study (median 32.3 months). The treatment outcome based on clinical and radiographic criteria was assessed by calibrated examiners and dichotomized as 'healed+healing' or 'not healed'. The age, gender, stage of root development, preoperative signs and symptoms of apical periodontitis and size of periapical lesion were recorded. The cumulative success proportion and mean time were analysed with the Kaplan-Meier test. The generalized logrank statistic was used to describe prognostic clinical variables. Fisher's exact test was applied for the evaluation of the healing rates. RESULTS Thirty-nine of the 45 teeth treated with MTA were available for recall. Of these, 29 teeth (74%) revealed calcific apical barrier formation with complete resolution of periapical lesions, 7 teeth (18%) were healing, and 3 teeth (8%) had persistent disease. Thirty-four of the 45 teeth in the CH group were available for recall. Of these, 27 teeth (79%) had complete healing of periapical lesions and had calcific barrier formation, 4 teeth (12%) were healing, and the remaining 3 teeth (9%) had not healed. The survival rate of teeth treated with MTA was similar to the survival rates observed in teeth treated with CH (90% and 91%, respectively, P > 0.05). The generalized logrank statistic revealed that the cumulative success rate of both materials was not significantly different (P > 0.05). None of the tested predictors had an influence on the treatment outcomes of teeth in both groups (P > 0.05). CONCLUSIONS Apexification with both MTA and CH was associated with similar treatment outcomes. MTA may be proposed as a material for apexification treatment in immature teeth of adult patients due to the shorter treatment time associated with its use.
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Affiliation(s)
- G Kandemir Demirci
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - M E Kaval
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - P Güneri
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ege University, Izmir, Turkey
| | - M K Çalışkan
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
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Mounir MMF, Farsi JMA, Alhazzazi TY, Matar MA, El-Housseiny AA. Characterization of the apical bridge barrier formed following amelogenin apexification. BMC Oral Health 2018; 18:201. [PMID: 30514371 PMCID: PMC6280449 DOI: 10.1186/s12903-018-0641-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 10/15/2018] [Indexed: 12/18/2022] Open
Abstract
Background Recombinant amelogenin protein (RAP) is reported to induce complete root apex formation in dog model when used as apexification therapy. It also induces pulp regeneration in 85% of the treated group. Thus, the aim of this study was to investigate the nature of the remaining regenerated calcified tissues of the RAP group that showed no pulp regeneration compared to the calcium hydroxide treated group (CH). Methods A total of 240 dogs’ open apex root canals were used, after establishment of canals contamination. Canals were cleaned, irrigated, and filled with RAP as an apexification material and compared with CH. Treated teeth were assessed by H&E, trichrome staining, and/or immunohistochemistry technique, at 1, 3, and 6 months. Results A time-dependent increase in the calcified tissue barrier was observed in the apex of the RAP-treated group compared to the CH-treated group. The newly formed dentin in this RAP group was mainly tubular dentin and was functionally attached to the bone by periodontal ligament, while the CH group showed dentin-associated mineralized tissue (DAMT) associated with the newly formed apical barrier. Conclusions Out results suggest that RAP can be used as novel apexification material, resulting in a thickening and strengthening of the canal walls, and achieving apical closure.
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Affiliation(s)
- Maha M F Mounir
- Department of Diagnostic Oral Sciences, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia. .,Department of Oral Biology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Jamila M A Farsi
- Department of Oral Biology, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Turki Y Alhazzazi
- Department of Oral Biology, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Moustafa A Matar
- Department of Pediatric Dentistry, Faculty of Dentistry, Pharos University, Alexandria, Egypt
| | - Azza A El-Housseiny
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Pediatric Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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9
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Regenerative Endodontic Treatment or Mineral Trioxide Aggregate Apical Plug in Teeth with Necrotic Pulps and Open Apices: A Systematic Review and Meta-analysis. J Endod 2017; 43:1806-1820. [DOI: 10.1016/j.joen.2017.06.029] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 06/12/2017] [Accepted: 06/16/2017] [Indexed: 12/29/2022]
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10
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Maniglia-Ferreira C, de Almeida Gomes F, Vitoriano MDM. Intentional Replantation of an Avulsed Immature Permanent Incisor: A Case Report. J Endod 2017; 43:1383-1386. [DOI: 10.1016/j.joen.2017.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 02/08/2017] [Accepted: 03/09/2017] [Indexed: 01/09/2023]
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Nicoloso GF, Pötter IG, Rocha RDO, Montagner F, Casagrande L. A comparative evaluation of endodontic treatments for immature necrotic permanent teeth based on clinical and radiographic outcomes: a systematic review and meta-analysis. Int J Paediatr Dent 2017; 27:217-227. [PMID: 27529749 DOI: 10.1111/ipd.12261] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Dental trauma and deep caries are frequent findings in children and adolescents that may lead to pulp necrosis in young permanent teeth. As a consequence, the root stops its development, and managing these immature teeth becomes challenging due to the presence of open apexes and fragile dentinal walls. AIM We aimed to carry out a systematic review including a meta-analysis to compare the endodontic treatments available in the management of immature necrotic permanent teeth and determine which one provides the best clinical and radiographic outcomes. DESIGN The literature was screened via PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials databases until August 2015 to select randomized clinical trials that compared at least two different treatments regarding immature necrotic permanent teeth comprising clinical and radiographic success as outcome. Two reviewers independently performed the screening and evaluation of the articles. A total of 648 studies were retrieved from the databases, in which only 14 were selected to full-text analysis by the appliance of inclusion criteria. After the exclusion criteria, the remaining seven studies had their data extracted and assessed for bias risk. Pooled-effect estimates were obtained comparing clinical and radiographic success rates among MTA Versus other treatments. RESULTS Evaluation of clinical (Z = 2.32, P = 0.02, OR = 5.37, 95% CI: 1.29-22.23, I = 0%) and radiographic (Z = 2.45, P = 0.01, OR = 4.31, 95% CI: 1.34-13.82, I = 0%) outcomes favored the MTA (control group) when compared to other endodontic treatments (P < 0.05). No evidence of heterogeneity was detected among the studies (I < 50%), whereas a moderate risk of bias was identified in five of them. CONCLUSIONS Although almost all of the identified studies presented moderate risk of bias, MTA apexification seems to produce overall better clinical and radiographic success rates among the endodontic treatment available in immature necrotic permanent teeth.
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Affiliation(s)
- Gabriel Ferreira Nicoloso
- Specialist in Pediatric Dentistry, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Isabel Garcia Pötter
- Specialist in Pediatric Dentistry, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | | | - Francisco Montagner
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Luciano Casagrande
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
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12
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Mounir MMF, Matar MA, Lei Y, Snead ML. Recombinant Amelogenin Protein Induces Apical Closure and Pulp Regeneration in Open-apex, Nonvital Permanent Canine Teeth. J Endod 2016; 42:402-12. [PMID: 26709200 PMCID: PMC4766029 DOI: 10.1016/j.joen.2015.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 11/02/2015] [Accepted: 11/05/2015] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Recombinant DNA-produced amelogenin protein was compared with calcium hydroxide in a study of immature apex closure conducted in 24 young mongrel dogs. METHODS Root canals of maxillary and mandibular right premolars (n = 240) were instrumented and left open for 14 days. Canals were cleansed, irrigated, and split equally for treatment with recombinant mouse amelogenin (n = 120) or calcium hydroxide (n = 120). RESULTS After 1, 3, and 6 months, the animals were sacrificed and the treated teeth recovered for histologic assessment and immunodetection of protein markers associated with odontogenic cells. After 1 month, amelogenin-treated canals revealed calcified tissue formed at the apical foramen and a pulp chamber containing soft connective tissue and hard tissue; amelogenin-treated canals assessed after 3- and 6-month intervals further included apical tissue functionally attached to bone by a periodontal ligament. In contrast, calcified apical tissue was poorly formed in the calcium hydroxide group, and soft connective tissue within the pulp chamber was not observed. CONCLUSIONS The findings from this experimental strategy suggest recombinant amelogenin protein can signal cells to enhance apex formation in nonvital immature teeth and promote soft connective tissue regeneration.
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Affiliation(s)
- Maha M F Mounir
- Faculty of Dentistry, King Abdulaziz University (KAU), Jamaa District, Jeddah, Kingdom of Saudi Arabia; Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | - Yaping Lei
- Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry of USC, The University of Southern California, Los Angeles, California
| | - Malcolm L Snead
- Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry of USC, The University of Southern California, Los Angeles, California.
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13
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Bonte E, Beslot A, Boukpessi T, Lasfargues JJ. MTA versus Ca(OH)2 in apexification of non-vital immature permanent teeth: a randomized clinical trial comparison. Clin Oral Investig 2014; 19:1381-8. [PMID: 25467231 DOI: 10.1007/s00784-014-1348-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 10/27/2014] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The aim of this prospective randomized clinical trial was to compare mineral trioxide aggregate (MTA) with calcium hydroxide (CH) as materials for inducing root apex closure in immature necrotic permanent incisors. METHODS The design of this study has been extensively described in the authors' previous report. Children (n = 30), aged from 6 to 18 years and presenting a non-vital permanent incisor, were treated. Half of the group received treatment using MTA, the other half with CH. At recall visits after 6 and 12 months, the presence or absence of a calcified apical barrier was assessed using clinical and radiographic examinations. The anonymised radiographs were evaluated by two independent investigators. Statistical analyses were performed using a Fischer's test (p < 0.05 was used as the threshold for statistical significance). RESULTS Presence of a mineralized barrier was observed for 43.8% of the CH group and 64.7% of the MTA group at the 6-month examination. After 12 months, these figures were respectively 50 and 82.4% (p < 0.07). For both groups, pain and tenderness to percussion had disappeared at the 3-month examination. CONCLUSION Neither material showed a statistically significant difference at the 6-month examination. At the 12-month examination, the MTA group displayed better results in terms of apical closure. In the CH group, four out of 15 teeth exhibited coronal or radicular fractures after 12 months. CLINICAL RELEVANCE Apexification using MTA seems preferable to CH in order to early achieve the coronoradicular filling and to limit the risk of root fracture.
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Affiliation(s)
- Eric Bonte
- Department of Conservative Dentistry and Endodontics, Paris Descartes University, Sorbonne Paris Cité, INSERM UMR_S 1138, Cordeliers Research Center and Bretonneau Hospital, AP-HP, Paris, France
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Güven Polat G, Yıldırım C, Akgün OM, Altun C, Dinçer D, Ozkan CK. The use of platelet rich plasma in the treatment of immature tooth with periapical lesion: a case report. Restor Dent Endod 2014; 39:230-4. [PMID: 25110649 PMCID: PMC4125589 DOI: 10.5395/rde.2014.39.3.230] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 04/23/2014] [Indexed: 01/08/2023] Open
Abstract
This study describes the treatment of an immature permanent tooth with periapical lesion which was treated with regenerative approach using platelet rich plasma (PRP). The root canal of immature human permanent tooth with periapical lesion was gently debrided of necrotic tissue and disinfected with 2.5% NaOCl, and then medicated with triple antibiotic paste comprised of ciprofloxacin, metronidazole, and tetracycline. When the tooth was asymptomatic, PRP and mineral trioxide aggregate (MTA) were placed into the root canal. Six months after PRP treatment, radiographical examination revealed resolution of the radiolucency and progressive thickening of the root wall and apical closure. Our findings suggest that PRP can be used for the treatment of immature permanent teeth with periapical lesion, as part of a regenerative endodontic treatment procedure.
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Affiliation(s)
- Günseli Güven Polat
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Ceren Yıldırım
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Ozlem Martı Akgün
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Ceyhan Altun
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Didem Dinçer
- Department of Dermatology, Gulhane Medical Academy, Ankara, Turkey
| | - Cansel Köse Ozkan
- Center for Pharmaceutical Sciences, Gulhane Medical Academy, Ankara, Turkey
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15
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Yan M, Wu J, Yu Y, Wang Y, Xie L, Zhang G, Yu J, Zhang C. Mineral trioxide aggregate promotes the odonto/osteogenic differentiation and dentinogenesis of stem cells from apical papilla via nuclear factor kappa B signaling pathway. J Endod 2014; 40:640-7. [PMID: 24767557 DOI: 10.1016/j.joen.2014.01.042] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 01/26/2014] [Accepted: 01/27/2014] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Mineral trioxide aggregate (MTA) has been widely used in clinical apexification and apexogenesis. However, the effects of MTA on the stem cells from apical papilla (SCAPs) and the precise mechanism of apexogenesis have not been elucidated in detail. METHODS Multiple colony-derived stem cells were isolated from the apical papillae, and the effects of MTA on the proliferation and differentiation of SCAPs were investigated both in vitro and in vivo. Activation of nuclear factor kappa B (NFκB) pathway in MTA-treated SCAPs was analyzed by immunofluorescence assay and Western blot. RESULTS MTA at the concentration of 2 mg/mL did not affect the proliferation activity of SCAPs. However, 2 mg/mL MTA-treated SCAPs presented the ultrastructural changes, up-regulated alkaline phosphatase, increased calcium deposition, up-regulated expression of odontoblast markers (dentin sialoprotein and dentin sialophosphoprotein) and odonto/osteoblast markers (runt-related transcription factor 2 and osteocalcin), suggesting that MTA enhanced the odonto/osteoblastic differentiation of SCAPs in vitro. In vivo results confirmed that MTA can promote the regular dentinogenesis of SCAPs. Moreover, MTA-treated SCAPs exhibited the up-regulated cytoplasmic phos-IκBα and phos-P65, enhanced nuclear P65, and increased nuclear translocation of P65. When co-treated with BMS345541 (the specific NFκB inhibitor), MTA-mediated odonto/osteoblastic differentiation was significantly attenuated. CONCLUSIONS MTA at the concentration of 2 mg/mL can improve the odonto/osteogenic capacity of SCAPs via the activation of NFκB pathway.
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Affiliation(s)
- Ming Yan
- Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China; Endodontic Department, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jintao Wu
- Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China; Endodontic Department, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yan Yu
- Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yanping Wang
- Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Endodontics, Suzhou Stomatological Hospital, Suzhou, Jiangsu, China
| | - Lizhe Xie
- Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Guangdong Zhang
- Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China; Endodontic Department, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jinhua Yu
- Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Endodontics, Suzhou Stomatological Hospital, Suzhou, Jiangsu, China.
| | - Chengfei Zhang
- Comprehensive Dental Care, Faculty of Dentistry, University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Moro EDP, Kozlowski Junior VA, Alves FBT. Apexificação com hidróxido de cálcio ou agregado trióxido mineral: revisão sistemática. REVISTA DE ODONTOLOGIA DA UNESP 2013. [DOI: 10.1590/s1807-25772013000400012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: O propósito deste trabalho foi realizar uma revisão sistemática de estudos clínicos, que avaliaram a eficácia de hidróxido de cálcio [Ca(OH)2] e agregado trióxido mineral (MTA) na terapia de dentes despolpados com rizogênese incompleta. METODOLOGIA: Foram utilizadas as seguintes bases de dados: PUBMED, WEB OF SCIENCE, SCOPUS com a palavra-chave "apexification" e BIREME com as palavras-chave "apexification", "apexificação" e "apicificação", no período de junho de 1992 a julho de 2012, com publicações em inglês e português. A revisão considerou como critério de inclusão estudos clínicos que avaliavam comparativamente o uso de Ca(OH)2 e MTA na terapia de dentes permanentes humanos com rizogênese incompleta. RESULTADO: Por palavras-chave pesquisadas, foi encontrado um total de 2.322 estudos. Contudo, apenas três estudos satisfizeram os critérios de inclusão, ou seja, estudos clínicos controlados que avaliaram comparativamente o uso de Ca(OH)2 e MTA na terapia de apexificação em dentes permanentes aplicados em seres humanos. CONCLUSÃO: Os resultados demonstraram que igualmente MTA ou hidróxido de cálcio são indicados para a técnica de apexificação em dentes permanentes imaturos. Não obstante, o número reduzido de ensaios clínicos controlados é um obstáculo na busca da evidência científica e sinaliza para a necessidade de novos estudos clínicos longitudinais com ambos os materiais.
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Vijayran M, Chaudhary S, Manuja N, Kulkarni AU. Mineral trioxide aggregate (MTA) apexification: a novel approach for traumatised young immature permanent teeth. BMJ Case Rep 2013; 2013:bcr2012008094. [PMID: 23314456 PMCID: PMC3603607 DOI: 10.1136/bcr-2012-008094] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Here, we report a case of 9-year-old boy who came with a chief complaint of pain and fractured upper front teeth. Significant history of trauma was revealed 6 months before reporting, during playing at his school time. Proper diagnosis was made with the help of radiological investigations. The available treatment options were discussed with the patient's parents and root canal therapy, using mineral trioxide aggregate, as an apical barrier was carried out in his upper right front teeth. However, later on, the boy was aesthetically rehabilitated in relation to his fractured upper front teeth with the help of post and core and acrylic crown.
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Affiliation(s)
- Manisha Vijayran
- Department of Pedodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India.
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18
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Tate AR. Calcium hydroxide or mineral trioxide aggregate may be used for the apexification of immature teeth. J Evid Based Dent Pract 2012; 12:24-5. [PMID: 22326154 DOI: 10.1016/j.jebdp.2011.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
PURPOSE/QUESTION To compare the efficacy of mineral trioxide aggregate (MTA) and calcium hydroxide (CH) for the root-end induction of immature teeth. SOURCE OF FUNDING Information not available. TYPE OF STUDY/DESIGN Systematic review and meta-analysis of data. LEVEL OF EVIDENCE Level 2: Limited-quality, patient-oriented evidence. STRENGTH OF RECOMMENDATION GRADE Grade B: Limited-quality patient-oriented evidence.
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Affiliation(s)
- Anupama Rao Tate
- Oral Health Advocacy & Research, Department of Oral Health, Children's National Medical Center, 111 Michigan Ave. NW, Washington, DC 20010, USA.
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