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Bueno CRE, Sarmiento JL, Vasques AMV, da Silva ACR, Cintra LTA, Santos JMM, Dezan-Júnior E. Biocompatibility, Biomineralization and Induction of Collagen Maturation with the Use of Calcium Hydroxide and Iodoform Intracanal Dressing. J Funct Biomater 2023; 14:507. [PMID: 37888171 PMCID: PMC10607429 DOI: 10.3390/jfb14100507] [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: 08/28/2023] [Revised: 10/04/2023] [Accepted: 10/08/2023] [Indexed: 10/28/2023] Open
Abstract
Biocompatibility and biomineralization of root canal dressings are important requirements for periapical healing. This study evaluated the inflammatory response, biomineralization and tissue repair by collagen fiber maturation in the subcutaneous tissue of rats. Eighteen Wistar rats (n = 6) received subcutaneous implants: calcium hydroxide + propylene glycol [CH+P], calcium hydroxide + propylene glycol + iodoform [CH+P+I], iodoform + carbowax [I+Cwax] and carbowax [Cwax]. Extra empty tubes were used as a control [C]. After 7, 15 and 30 days, the implants were removed with surrounding tissue for staining of hematoxylin-eosin, Von Kossa, picrosirius red and without staining for analysis under polarized light. Results were analyzed via Kruskal-Wallis followed by Dunn testing for nonparametric data and ANOVA followed by a Tukey post hoc test for parametric data (p < 5%). At 7 days, all groups showed a moderate inflammatory reaction and thick fibrous capsule, except the [Cwax] group, with a severe inflammatory infiltrate (p < 0.05). After 15 days, all groups but control had a decrease in inflammatory response. At 30 days, all groups presented a mild reaction and thin fibrous capsule (p > 0.05). Only groups containing calcium hydroxide were found to be positive using Von Kossa staining and polarized light in all periods. At 7 days, all groups showed a higher proportion of immature fibers. At 15 days, the [CH+P] and [Cwax] groups increased their proportion of mature/immature fibers. At 30 days, only the [CH+P] group presented a significant prevalence of mature collagen fibers (p < 0.05). All groups showed biocompatibility, but only groups containing calcium hydroxide induced biomineralization. The addition of iodoform delayed tissue healing.
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Affiliation(s)
- Carlos Roberto Emerenciano Bueno
- Endodontic Section, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry (FOA), São Paulo State University (Unesp), Araçatuba 16015-050, SP, Brazil (A.M.V.V.)
| | - Jimena Lama Sarmiento
- Endodontic Section, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry (FOA), São Paulo State University (Unesp), Araçatuba 16015-050, SP, Brazil (A.M.V.V.)
| | - Ana Maria Veiga Vasques
- Endodontic Section, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry (FOA), São Paulo State University (Unesp), Araçatuba 16015-050, SP, Brazil (A.M.V.V.)
| | - Ana Cláudia Rodrigues da Silva
- Endodontic Section, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry (FOA), São Paulo State University (Unesp), Araçatuba 16015-050, SP, Brazil (A.M.V.V.)
| | - Luciano Tavares Angelo Cintra
- Endodontic Section, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry (FOA), São Paulo State University (Unesp), Araçatuba 16015-050, SP, Brazil (A.M.V.V.)
| | | | - Eloi Dezan-Júnior
- Endodontic Section, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry (FOA), São Paulo State University (Unesp), Araçatuba 16015-050, SP, Brazil (A.M.V.V.)
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DUMAN C, KALAOĞLU E, ŞİRİNOĞLU ÇAPAN B, EGİL E. Comparison of two aerosol-free caries removal methods - A Split Mouth Randomized Clinical Trial. CUMHURIYET DENTAL JOURNAL 2021. [DOI: 10.7126/cumudj.920058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Cui D, Yu S, Zhou X, Liu Y, Gan L, Pan Y, Zheng L, Wan M. Roles of Dental Mesenchymal Stem Cells in the Management of Immature Necrotic Permanent Teeth. Front Cell Dev Biol 2021; 9:666186. [PMID: 34095133 PMCID: PMC8170050 DOI: 10.3389/fcell.2021.666186] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/06/2021] [Indexed: 02/05/2023] Open
Abstract
Dental caries and trauma always lead to pulp necrosis and subsequent root development arrest of young permanent teeth. The traditional treatment, apexification, with the absence of further root formation, results in abnormal root morphology and compromises long-term prognosis. Regeneration endodontics procedures (REPs) have been developed and considered as an alternative strategy for management of immature permanent teeth with pulpal necrosis, including cell-free and cell-based REPs. Cell-free REPs, including revascularization and cell homing with molecules recruiting endogenous mesenchymal stem cells (MSCs), have been widely applied in clinical treatment, showing optimistic periapical lesion healing and continued root development. However, the regenerated pulp-dentin complex is still absent in these cases. Dental MSCs, as one of the essentials of tissue engineering, are vital seed cells in regenerative medicine. Dental MSC-based REPs have presented promising potential with pulp-dentin regeneration in large animal studies and clinical trials via cell transplantation. In the present review, we summarize current understanding of the biological basis of clinical treatments for immature necrotic permanent teeth and the roles of dental MSCs during this process and update the progress of MSC-based REPs in the administration of immature necrotic permanent teeth.
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Affiliation(s)
- Dixin Cui
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Sihan Yu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ying Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lu Gan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yue Pan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liwei Zheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Mian Wan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Different Approaches to the Regeneration of Dental Tissues in Regenerative Endodontics. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11041699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
(1) Background: The regenerative procedure has established a new approach to root canal therapy, to preserve the vital pulp of the tooth. This present review aimed to describe and sum up the different approaches to regenerative endodontic treatment conducted in the last 10 years; (2) Methods: A literature search was performed in the PubMed and Cochrane Library electronic databases, supplemented by a manual search. The search strategy included the following terms: “regenerative endodontic protocol”, “regenerative endodontic treatment”, and “regenerative endodontics” combined with “pulp revascularization”. Only studies on humans, published in the last 10 years and written in English were included; (3) Results: Three hundred and eighty-six potentially significant articles were identified. After exclusion of duplicates, and meticulous analysis, 36 case reports were selected; (4) Conclusions: The pulp revascularization procedure may bring a favorable outcome, however, the prognosis of regenerative endodontics (RET) is unpredictable. Permanent immature teeth showed greater potential for positive outcomes after the regenerative procedure. Further controlled clinical studies are required to fully understand the process of the dentin–pulp complex regeneration, and the predictability of the procedure.
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Tzanetakis GN, Giannakoulas DG, Papanakou S, Gizani S, Lygidakis N. Regenerative endodontic therapy of immature permanent molars with pulp necrosis: a cases series and a literature review. Eur Arch Paediatr Dent 2020; 22:515-525. [PMID: 32677019 DOI: 10.1007/s40368-020-00550-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 06/30/2020] [Indexed: 02/08/2023]
Abstract
AIM To present the application and the outcome of the regenerative endodontic therapy (RET) in a series of symptomatic immature mandibular molars with pulp necrosis and apical periodontitis and to review the relevant literature for the documentation of the procedure as a potential treatment option. METHODS Three young male patients were referred with pain in the left mandibular region resulting from pulp necrosis and apical periodontitis of the first permanent molar. Regenerative endodontic approach was performed for the complete resolution of the lesions and the thickening of the apical root canal walls. The databases of Medline, Pubmed and Google Scholar were also searched for articles in which a regenerative approach has been undertaken for the endodontic management of immature permanent molars with pulp necrosis and apical periodontitis. RESULTS Follow-up examinations showed that the teeth remained functional without any signs or symptoms. Final radiographic examination at 12, 18 and 36 months, respectively, revealed complete resolution of the lesions and complete apical closure in the two out of three cases. The search of the literature revealed the existence of only 25 clinical articles in which necrotic immature molars were treated by the regenerative approach. The total number of the treated teeth were 46. CONCLUSIONS Regenerative endodontic approach may be applied in posterior non-vital molar teeth with a possible favorable outcome. However, the literature support for the documentation of the procedure as a predictable and reproducible treatment option in posterior immature molar teeth is at present limited.
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Affiliation(s)
- G N Tzanetakis
- Department of Endodontics, Dental School, University of Athens, Greece Private, 421B Mesogeion Ave., Agia Paraskevi, 15343, Athens, Greece.
| | - D G Giannakoulas
- Department of Endodontics, Dental School, University of Athens, Greece Private, 421B Mesogeion Ave., Agia Paraskevi, 15343, Athens, Greece
| | - S Papanakou
- Department of Paediatric Dentistry, Dental School, University of Athens, Greece Private, Athens, Greece
| | - S Gizani
- Department of Paediatric Dentistry, Dental School, University of Athens, Greece Private, Athens, Greece
| | - N Lygidakis
- Department of Paediatric Dentistry, Dental School, University of Athens, Greece Private, Athens, Greece
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Regenerative Endodontic Therapy in the Management of Immature Necrotic Permanent Dentition: A Systematic Review. ScientificWorldJournal 2020; 2020:7954357. [PMID: 32765197 PMCID: PMC7374232 DOI: 10.1155/2020/7954357] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/22/2020] [Accepted: 06/27/2020] [Indexed: 12/25/2022] Open
Abstract
Materials and Methods The electronic databases PubMed and Google Scholar were used to search the literature for relevant studies after applying specific inclusion and exclusion criteria. Studies that fulfilled both the inclusion and exclusion criteria were included in this systematic review. The search was conducted by two independent reviewers following the PRISMA guidelines. Results Only 46 studies that fulfilled both the inclusion and exclusion criteria, which were conducted within the last 10 years, were included in this systematic review. These studies investigated different aspects of regenerative endodontic therapy including different types of scaffolds, intracanal medications, pulpal space/barriers, root maturation stage, follow-up duration, and updated studies on their use in the management of immature necrotic permanent teeth. Conclusions This review concluded the compiled data observed that endodontic regenerative therapy was more efficient in treating immature necrotic permanent teeth and offered a greater advantage that should lead to wider acceptance among endodontists for effective results compared to different treatment options. However, more clinical trials with a standardized protocol and defined clinical, radiographic, and histopathological outcomes with longer follow-up periods are warranted.
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Hafezi L, Sakhdari S, Moaiyedmohseni N. Morphology of the Roots and Canals of Mandibular Third Molars, Their Symmetry and Related Factors Using Cone-Beam Computed Tomography. IRANIAN ENDODONTIC JOURNAL 2019; 14:283-288. [PMID: 36794101 PMCID: PMC9923410 DOI: 10.22037/iej.v14i4.24837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 08/12/2019] [Accepted: 08/31/2019] [Indexed: 02/17/2023]
Abstract
Introduction Adequate knowledge about the anatomy of the roots and canals of mandibular third molars is imperative for a successful treatment. This study aimed to use cone-beam computed tomography (CBCT) to evaluate the morphology of the roots and canals of mandibular third molars and their symmetry. Methods and Materials Totally, 110 CBCT images of bilateral mandibular third molars were evaluated in terms of the number of roots and canals, canal type, isthmus location, location of accessory canals, degree of root curvature and its direction, age and sex of patients and the symmetry of variables in the right and left sides of the mandible. The descriptive statistics, t-test and chi-square test were applied to analyze data. Results Of all, 71.36% of mandibular third molars had two roots, 20.9% had one single root and 7.72% had three roots. The distal root had one single canal in 89.08%. The mesial root had one single canal in 44.25% and two canals in 49.42%. The Vertucci's types I (45.40%) and IV (34.48%) had the highest frequency in the mesial root while type I (91.95%) had the highest frequency in the distal root. The deviation of mesial root was towards the distal while distal roots were mainly straight. Conclusion The symmetry between the right and left mandibular third molars was significantly high. In case of encountering anatomical complexities in dental treatment of a mandibular third molar, dental clinicians should consider the high possibility of presence of the same condition in the contralateral mandibular third molar.
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Affiliation(s)
- Ladan Hafezi
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tehran Medical Science, Islamic Azad University, Tehran Iran
| | - Shirin Sakhdari
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tehran Medical Science, Islamic Azad University, Tehran Iran
| | - Negin Moaiyedmohseni
- Dentist, Private Practice; Tehran, Iran,Corresponding author: Negin Moaiyedmohseni, No 70, Foroozanfar St., Gisha St., Tehran, Iran. Tel: +98-912 6057142 E-mail:
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