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Radwanski M, Caporossi C, Lukomska-Szymanska M, Luzi A, Sauro S. Complicated Crown Fracture of Permanent Incisors: A Conservative Treatment Case Report and a Narrative Review. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9090481. [PMID: 36135027 PMCID: PMC9495796 DOI: 10.3390/bioengineering9090481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/04/2022] [Accepted: 09/13/2022] [Indexed: 12/03/2022]
Abstract
Dental trauma may have a severe impact on the social and psychological wellbeing of a patient. Most cases of dental injuries involve anterior teeth, especially the maxillary upper incisors. Crown fractures, with or without pulp exposure, are the most common trauma in permanent dentition. There are many methods of management, in which the initial state of the pulp, the time since the injury, and the presence of an accompanying injury play a key role. This case report aimed at showing a possible conservative treatment after complicated tooth fracture that consisted of partial pulpotomy followed by adhesive reattachment of the tooth fragment using a technique based on heated resin composite. Such a specific procedure represents a conservative approach to traumatic coronal lesions, providing a suitable opportunity to maintain the tooth vitality, aesthetics, and function. Indeed, reattachment of tooth fragment using a composite/adhesive is a simple technique to achieve excellent results in terms of aesthetic and function.
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Affiliation(s)
- Mateusz Radwanski
- Department of Endodontics Chair, Conservative Dentistry, Endodontics Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland
| | | | - Monika Lukomska-Szymanska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland
- Correspondence: (M.L.-S.); (S.S.); Tel.: +48-426-757461 (M.L.-S.)
| | - Arlinda Luzi
- Group of Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain
| | - Salvatore Sauro
- Group of Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain
- Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
- Correspondence: (M.L.-S.); (S.S.); Tel.: +48-426-757461 (M.L.-S.)
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Mapara PN, Shashikiran ND, Gugawad S, Gaonkar N, Hadakar S, Taur S, Khade D. Comparative evaluation of calcium release of the apical plugs formed by mineral trioxide aggregate, Biodentine, and EndoSequence root repair material with and without 2% triple antibiotic powder: An in vitro study. J Indian Soc Pedod Prev Dent 2020; 38:132-137. [PMID: 32611858 DOI: 10.4103/jisppd.jisppd_74_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Apical plug formation by mineral trioxide aggregate (MTA), Biodentine, and EndoSequence root repair material (RRM) is an excellent alternative technique to the conventional apexification procedure. Several antimicrobial agents have been incorporated in MTA and Biodentine to boost their antimicrobial efficacy. Considering the polymicrobial nature of root canal infection, a combination of potent antimicrobials like triple antibiotic powder (TAP) would be needed to address the diverse flora encountered. Calcium release is the consequential factor in the clinical excellence of these cements. AIM The aim of the study was to evaluate and compare the calcium released from the apical plugs formed by MTA, Biodentine, and EndoSequence RRM with and without incorporation of 2% TAP. METHODS Ninety single-rooted teeth were divided into (n = 15) Group A: MTA + 2% TAP, Group B: MTA, Group C: Biodentine + 2% TAP, Group D: Biodentine, Group E: EndoSequence RRM + 2% TAP, and Group F: EndoSequence RRM to form the 4 mm apical plugs. Each sample tooth was then immersed in 10 ml of deionized water. Evaluation of calcium release was done on days 7, 15, and 30 using an atomic absorption spectrophotometer. Data were analyzed using one-way analysis of variance, post hoc test, and unpaired t-test. RESULTS Calcium released was maximum for Group E compared to Group F (P < 0.05), maximum for Group C compared to Group D, and was maximum for Group A compared to Group B (P < 0.05) at days 7, 15 and 30. CONCLUSION Incorporation of 2% TAP resulted in increased calcium ions released from MTA, Biodentine, and EndoSequence RRM.
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Affiliation(s)
- Pooja Nitin Mapara
- Department of Paedodontics and Preventive Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Satara, Maharashtra, India
| | - N D Shashikiran
- Department of Paedodontics and Preventive Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Satara, Maharashtra, India
| | - Sachin Gugawad
- Department of Paedodontics and Preventive Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Satara, Maharashtra, India
| | - Namrata Gaonkar
- Department of Paedodontics and Preventive Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Satara, Maharashtra, India
| | - Savita Hadakar
- Department of Paedodontics and Preventive Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Satara, Maharashtra, India
| | - Swapnil Taur
- Department of Paedodontics and Preventive Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Satara, Maharashtra, India
| | - Dhanshri Khade
- Department of Paedodontics and Preventive Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Satara, Maharashtra, India
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Ramezani G, Savadkouhi ST, Sayahpour S. The Effect of Chlorhexidine Mixed with Mineral Trioxide Aggregate on Bacterial Leakage of Apical Plug in Simulated Immature Teeth Using Human Fresh Saliva. J Int Soc Prev Community Dent 2017; 7:247-251. [PMID: 29026696 PMCID: PMC5629852 DOI: 10.4103/jispcd.jispcd_198_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 07/29/2017] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Apexification is a challenging treatment in necrotic open apices teeth and bacterial leakage is the main reason for the treatment failure. The aim of this study is to compare the effect of mixing mineral trioxide aggregate (MTA) with chlorhexidine (CHX) on microbial leakage in apexification treatment of simulated immature teeth. MATERIALS AND METHODS In this experimental study, 44 intact central incisors were selected based on inclusion criteria. The coronal and 2 mm of apical part of the specimens were removed till all root segments were 12 mm long. The apical parts of the teeth were prepared using Profile #40/0.06 (Dentsply Maillefer, Ballaigues, Switzerland) in the apical to coronal direction to simulate open apices. The specimens were separated into experimental groups (n = 40) and control groups (n = 4). Group 1 delivered a 5 mm apical plug by MTA/H2O and group 2 delivered an apical plug by MTA/CHX 0.12%. The positive control group had no apical barrier; on the other hand, the negative control group had an apical barrier and two layers of nail varnish on entire root surface. The microbial leakage assessment was done by a dual-chamber apparatus using fresh human saliva after 10-week follow-up. The turbidity of the lower chamber containing the Brain Heart Infusion (BHI) solution was analyzed based on the McFarland (0.5) standard which utilizes spectrophotometry results. Data analyses were done using Chi-square, Kaplan-Meier, and log-rank tests. RESULTS MTA/CHX group had lower microbial leakage percentage (P = 0.001) and longer time of leakage (P = 0.002) in compared with MTA/H2O group and the difference was statistically meaningful. CONCLUSION Based on the results of this study, MTA/CHX mixture can reduce the amount of bacterial leakage.
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Affiliation(s)
| | | | - Sahar Sayahpour
- Department of Pediatric Dentistry, Dental Branch, Islamic Azad University, Tehran, Iran
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Eskandarinezhad M, Shahveghar-Asl N, Sharghi R, Shirazi S, Shakouie S, Milani AS, Balaei E. Sealing efficacy of mineral trioxide aggregate with and without nanosilver for root end filling: An in vitro bacterial leakage study. J Clin Exp Dent 2017; 9:e27-e33. [PMID: 28149459 PMCID: PMC5268117 DOI: 10.4317/jced.53070] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 05/14/2016] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Various materials have been added to mineral trioxide aggregate to enhance its properties. This study was aimed to compare the sealing efficacy of MTA with and without nanosilver using bacterial leakage approach. MATERIAL AND METHODS Seventy canine teeth were prepared and obturated. Then, after apical resection, the root-end cavities were prepared by ultrasonic retrotips. Teeth were randomly divided into 4 groups containing two experimental groups (n=30) and two negative and positive controls (n=5). In group 1 and 2, root-end cavities were respectively filled with MTA and MTA with nanosilver (by 1% weight). Leakage assessment was carried out by bacterial leakage apparatus with Enterococcus faecalis species. Leakage comparison between experimental groups was done using Mann-Whitney test by Spss 16 software at significancy level of 0.05. RESULTS The median bacterial leakages for MTA and MTA with nanosilver were 19 and 2, respectively. The mean bacterial leakages for MTA and MTA with nanosilver were 30.06±28.67 and 9.66±14.25, respectively. Mann-Whitney test indicated that there was a significant difference in bacterial leakage day between two experimental groups (P=0.002). CONCLUSIONS Based on the findings of this in-vitro bacterial leakage study, adding nanosilver to MTA decreased its sealing ability. Key words:Root canal therapy, root canal obturation, root canal filling materials, nanosilver, MTA.
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Affiliation(s)
- Mahsa Eskandarinezhad
- Assistant professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Naiemeh Shahveghar-Asl
- Post-graduate student, Department of Pediatric Dentistry, Faculty of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Reza Sharghi
- Assistant professor, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sajjad Shirazi
- Research Fellow and Lecturer, Dental and Periodontal Research Center, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran; Assistant Professor, Department of Community Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sahar Shakouie
- Assistant professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin-Salem Milani
- Assistant professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Esrafil Balaei
- Assistant Professor, Department of Community Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Nikhil V, Jha P, Suri NK. Effect of methods of evaluation on sealing ability of mineral trioxide aggregate apical plug. J Conserv Dent 2016; 19:231-4. [PMID: 27217635 PMCID: PMC4872576 DOI: 10.4103/0972-0707.181938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Aim: The purpose of the study was to evaluate and compare the sealing ability of mineral trioxide aggregate (MTA) with three different methods. Materials and Methods: Forty single canal teeth were decoronated, and root canals were enlarged to simulate immature apex. The samples were randomly divided into Group MD = MTA-angelus mixed with distilled water and Group MC = MTA-angelus mixed with 2% chlorhexidine, and apical seal was recorded with glucose penetration method, fluid filtration method, and dye penetration methods and compared. Results: The three methods of evaluation resulted differently. The glucose penetration method showed that MD sealed better than MC, but difference was statistically insignificant (P > 0.05). The fluid filtration method resulted that Group MC was statistically insignificant superior to Group MD (P > 0.05). The dye penetration method showed that Group MC sealed statistically better than Group MD. Conclusion: No correlation was found among the results obtained with the three methods of evaluation. Addition of chlorhexidine enhanced the sealing ability of MTA according to the fluid filtration test and dye leakage while according to the glucose penetration test, chlorhexidine did not enhance the sealing ability of MTA. This study showed that relying on the results of apical sealing by only method can be misleading.
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Affiliation(s)
- Vineeta Nikhil
- Department of Conservative Dentistry and Endodontics, Subharti Dental College, Meerut, Uttar Pradesh, India
| | - Padmanabh Jha
- Department of Conservative Dentistry and Endodontics, Subharti Dental College, Meerut, Uttar Pradesh, India
| | - Navleen Kaur Suri
- Department of Conservative Dentistry and Endodontics, Subharti Dental College, Meerut, Uttar Pradesh, India
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Bidar M, Eslami N, Naghavi N, Fasihi Z, Attaran Mashhadi N. The effect of different concentrations of chlorhexidine gluconate on the compressive strength of mineral trioxide aggregate. J Dent Res Dent Clin Dent Prospects 2015; 9:1-5. [PMID: 25973146 PMCID: PMC4417486 DOI: 10.15171/joddd.2015.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 07/27/2014] [Indexed: 11/12/2022] Open
Abstract
Background and aims. Substituting chlorhexidine (CHX) for water has been shown to enhance antimicrobial activity of mineral trioxide aggregate (MTA). The purpose of this study was to compare the compressive strength of MTA mixed with distilled water, 0.12% and 0.2% chlorhexidine. Materials and methods. MTA was mixed according to manufacturer's instructions in group I (n = 20). In groups II & III, 0.12% and 0.2% CHX liquid was substituted for water, respectively. Samples were condensed with moderate force into 20 tubes with 1.5×5 mm dimensions and were allowed to set for 72 hours at 37°C in 100% humidity. After being removed from the molds, their compressive strength was determined using Instron testing machine. Each group was divided into two subgroups according to the time of testing (at 72 hours, and one week). Fractured surfaces of 4 specimens in each group were then evaluated under Scanning Electron Microscope (SEM) to determine their microstructure. One-way ANOVA, Tukey, and paired sample t-test was used for statistical analysis. P < 0.05 was set as significant. Results. There was no significant difference between three groups in terms of their compressive strength after 72 hours. However, the compressive strength of group II was significantly higher than group I (P = 0.034) and group III (P = 0.021) after one week. Crystalline microstructure was similar in all groups. Conclusion. Substitution of 0.012% chlorhexidine for water significantly increased the compressive strength of MTA at 1 week without significant change in crystalline structure.
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Affiliation(s)
- Maryam Bidar
- Professor of Endodontics, Dental Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Neda Eslami
- Assistant Professor of Orthodontics, Dental Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Neda Naghavi
- Assistant Professor of Endodontics, Dental Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Negin Attaran Mashhadi
- Student of Medicine, Member of Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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