Do alternative scaffolds used in regenerative endodontics promote better root development than that achieved with blood clots?

Applications of selected polysaccharides and proteins in dentistry: A review

In the last ten years, remarkable characteristics and a variety of functionalities have been created in biopolymeric materials for clinical dental applications. This review gives an overview of current knowledge of natural biopolymers (biological macromolecules) in terms of structural, functional, and property interactions. Natural biopolymers such as polysaccharides (chitosan, bacterial cellulose, hyaluronic acid, and alginate) and polypeptides (collagen and silk fibroin) have been discussed for dental uses. These biopolymers exhibit excellent properties alone and when employed with other composite molecules making them ideal for treatment of periodontitis, endodontics, dental pulp regeneration and oral wound healing. These biopolymers together with the composite materials exhibit better biocompatibility, inertness, elasticity and flexibility which makes them a leading candidate to be used for other dental applications like caries management, oral appliances, dentures, dental implants and oral surgeries.

Effectiveness of different supplementary protocols for remaining filling material removal in endodontic reintervention: an integrative review

The aim of this study was to perform an integrative review to identify the most effective supplementary protocols used after filling material (FM) removal and root canal reinstrumentation, during endodontic reintervention. The literature search was performed on the electronic databases PubMed and Latin American and Caribbean Health Sciences Literature (LILACS), using a combination of specific scientific descriptors. Selection criteria accepted articles published in English, Spanish and Portuguese languages, up to August 2021, involving in vitro and ex vivo studies. After applying the eligibility criteria, 46 articles were included for qualitative analysis. The tool for qualitative analysis of quasi-experimental studies of the Joanna Briggs Institute was used to determine the risk of bias of the included articles. The selected articles provided important data regarding the following supplementary protocols: sonic and ultrasonic activation of the irrigating solution; the use of ultrasonic inserts, XP-endo system instruments, and photon-induced photoacoustic streaming for mechanical debridement; and new devices as GentleWave system, and the self-adjusting file. Overall, all supplementary protocols demonstrated efficacy in removing the remaining FM. The implementation of various supplementary protocols can effectively remove the remaining FM from the root canal walls, although complete removal is not always achieved. However, it was not possible to determine the most effective protocol. Conversely, their association can enhance remaining FM removal. Remaining FM attached to root canal walls hinders proper chemical-mechanical preparation during endodontic reintervention. Supplementary protocols optimize the remaining FM removal, enhancing cleaning and disinfection of root canal.

Polymeric Scaffolds Used in Dental Pulp Regeneration by Tissue Engineering Approach

Currently, the challenge in dentistry is to revitalize dental pulp by utilizing tissue engineering technology; thus, a biomaterial is needed to facilitate the process. One of the three essential elements in tissue engineering technology is a scaffold. A scaffold acts as a three-dimensional (3D) framework that provides structural and biological support and creates a good environment for cell activation, communication between cells, and inducing cell organization. Therefore, the selection of a scaffold represents a challenge in regenerative endodontics. A scaffold must be safe, biodegradable, and biocompatible, with low immunogenicity, and must be able to support cell growth. Moreover, it must be supported by adequate scaffold characteristics, which include the level of porosity, pore size, and interconnectivity; these factors ultimately play an essential role in cell behavior and tissue formation. The use of natural or synthetic polymer scaffolds with excellent mechanical properties, such as small pore size and a high surface-to-volume ratio, as a matrix in dental tissue engineering has recently received a lot of attention because it shows great potential with good biological characteristics for cell regeneration. This review describes the latest developments regarding the usage of natural or synthetic scaffold polymers that have the ideal biomaterial properties to facilitate tissue regeneration when combined with stem cells and growth factors in revitalizing dental pulp tissue. The utilization of polymer scaffolds in tissue engineering can help the pulp tissue regeneration process.