Clinical and Radiographic Outcomes of Regenerative Endodontic Procedures in Traumatized Immature Permanent Teeth: Interappointment Dressing or Single-Visit?

INTRODUCTION

More data are needed before affirming that single-visit approaches are effective and safe for regenerative endodontic procedures (REPs). This study compared clinical and radiographic outcomes of REPs between interappointment dressing or single-visit protocols.

METHODS

Twenty young patients presenting traumatized immature teeth with pulp necrosis were divided into 2 groups. Teeth were submitted to 6% sodium hypochlorite and 2% chlorhexidine irrigation and to 17% EDTA use before blood clot induction. In the interappointment dressing group (n = 11), calcium hydroxide was used with 2% chlorhexidine gel for 21 days before scaffold induction. In the single-visit group (n = 9), the scaffold was induced during the only appointment. Patients were followed up for 24 months. Primary, secondary, and tertiary outcomes were assessed by 3 independent evaluators. Preoperative and follow-up radiographs were assessed for quantitative measurements of the apical diameter, root width, root length, and cervical barrier placement and compared between groups using the t test or Mann-Whitney U test. Categoric variables were assessed with the G test and the Fisher exact test and continuous variables with the Mann-Whitney U test. Statistical significance was set at 5%.

RESULTS

One tooth showed persistence of infection. No difference was observed in cervical barrier placement (P > .05); between groups regarding primary, secondary, and tertiary outcomes (P > .05); and in parameters of quantitative radiographic outcomes (P > .05).

CONCLUSIONS

Completing REPs with an interappointment dressing or a single-visit protocol presented similar clinical and radiographic outcomes. A single-visit protocol of REPs using 6% sodium hypochlorite, 2% chlorhexidine, and 17% EDTA permitted satisfactory outcomes in necrotic immature permanent teeth.

Cytotoxicity assessment of antibiotics on Ctenopharyngodon idellus kidney cells by a sensitive electrochemical method

As emerging pollutants, antibiotics are ubiquitous in the environment and pose a threat to human health, giving rise to an urgent need to assess their biological toxicity. In the present study, a cell electrochemical method based on the bromocresol violet/carbon nanotubes/glassy carbon electrode (BCP/MWCNTs/GCE) was established to evaluate the cytotoxicities of sulfamethoxazole (SMZ), ciprofloxacin (CIP), and tetracycline (TC). BCP/MWCNTs/GCE has advantages due to its excellent electrocatalytic activity for the oxidation of electroactive species of the Ctenopharyngodon idellus kidney (CIK) cells. The half-maximal inhibitory concentration (IC₅₀) values of SMZ, CIP, and TC obtained by the electrochemical method were 831.51 μM, 354.98 μM, and 184.51 μM, which were lower than those of the traditional methyl-thiazolyl-tetrazolium (MTT) assay (907.47 μM, 414.87 μM, and 208.11 μM). These results indicate the higher sensitivity of the electrochemical method. This study provided a sensitive tool for the cytotoxicity evaluation of antibiotics in the environmental toxicology field.

The Effects of Intracanal Irrigants and Medicaments on Dental-Derived Stem Cells Fate in Regenerative Endodontics: An update

Regenerative endodontics is a biologically based treatment designed for immature permanent teeth with necrotic pulp to replace dentin and root structures, as well as dental pulp cells. This procedure has become a part of novel modality in endodontics therapeutic manner, and it is considered as an alternative to apexification. In the last decade, numerous case reports, which describe this procedure, have been published. This therapeutic approach succeeded due to its lower financial cost and ease of performance. Although the clinical protocol of this procedure is not standardized and the effects of irrigants and medicaments on dental stem cells fate remain somewhat ambiguous, however when successful, it is an improvement of endodontics treatment protocols which leads to continued root development, increased dentinal wall thickness, and apical closure of immature teeth. To ensure a successful regenerative procedure, it is essential to investigate the appropriate disinfection protocols and the use of biocompatible molecules in order to control the release of growth factors and the differentiation of stem cells. This is the first review in the literature to summarize the present knowledge regarding the effect of intracanal irrigants and medicaments on the dental derived stem cells fate in regenerative endodontic procedures.