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Al-Badri H, Al-Taee LA, Banerjee A, Al-Shammaree SA. An in-vitro evaluation of residual dentin retained after using novel enzymatic-based chemomechanical caries removal agents. Sci Rep 2024; 14:19223. [PMID: 39160198 PMCID: PMC11333480 DOI: 10.1038/s41598-024-69763-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 08/08/2024] [Indexed: 08/21/2024] Open
Abstract
To assess the biochemical, mechanical and structural characteristics of retained dentin after applying three novel bromelain-contained chemomechanical caries removal (CMCR) formulations in comparison to the conventional excavation methods (hand and rotary) and a commercial papain-contained gel (Brix 3000). Seventy-two extracted permanent molars with natural occlusal carious lesions (score > 4 following the International Caries Detection and Assessment System (ICDAS-II)) were randomly allocated into six groups (n = 12) according to the excavation methods: hand excavation, rotary excavation, Brix 3000, bromelain-contained gel (F1), bromelain-chloramine-T (F2), and bromelain-chlorhexidine gel (F3). The superficial and deeper layers of residual dentin were examined by Raman microspectroscopy and Vickers microhardness, while the surface morphology was assessed by the scanning electron microscope (SEM). A multivariate analysis of variance followed by Tukey's test (p > 0.05) was performed for data analysis. The novel formulations showed an ability to preserve the partially demineralized dentin that showed a reduced phosphate content with a higher organic matrix. This was associated with lower Vickers microhardness values in comparison to sound dentin and rotary excavation. The collagen integration ratio in all methods was close to sound dentin (0.9-1.0) at the deeper dentin layer. The bromelain-chloramine-T gel (F2) produced the smoothest smear-free dentin surface with a higher number of opened dentinal tubules. In contrast, dense smearing covering the remaining dentin was observed in the manual and rotary methods with obstructed dentin tubule orifices. The bromelain-contained formulations can be considered a new minimally invasive approach for selectively removing caries in deep cavitated dentin lesions.
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Affiliation(s)
- Huda Al-Badri
- Department of Conservative and Aesthetic Dentistry, Baghdad College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Lamis A Al-Taee
- Department of Conservative and Aesthetic Dentistry, Baghdad College of Dentistry, University of Baghdad, Baghdad, Iraq.
| | - Avijit Banerjee
- Centre for Oral, Clinical & Translational Sciences, Restorative Dentistry at the Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London/Guy's & St. Thomas' Hospitals Foundation Trust, London, UK
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Yang SY, Wang JZ, Fan H, Chen M. Adrenaline in pulp capping treatment of reversible pulpitis. World J Clin Cases 2024; 12:5024-5031. [DOI: 10.12998/wjcc.v12.i22.5024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/23/2024] [Accepted: 06/11/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND The role of epinephrine in the treatment of pulp capping in patients with reversible pulpitis is not clear.
AIM To explore the role of epinephrine in the treatment of pulp capping in patients with reversible pulpitis.
METHODS A total of 100 patients with reversible pulpitis who were treated in Anhui Jieshou People's Hospital from January 2020 to December 2021 were included in the study. They were categorized into an observation group (n = 50; treatment with adrenaline) and a control group (n = 50; treatment with zinc oxide eugenol paste). The 24-h postoperative pain, regression time of gingival congestion and redness, clinical efficacy, and incidence of adverse reactions were compared between the groups. Patients were further categorized into the ineffective and effective treatment groups based on clinical efficacy. Logistic multiple regression analysis explored factors affecting the efficacy of pulp capping treatment.
RESULTS A significant difference in 24-h postoperative pain was observed between the groups (P < 0.05), with a higher proportion of grade I pain noted in the observation group than in the control group (P < 0.01). The regression time of gingival congestion and swelling was lower in the observation group (2.61 ± 1.44 d and 2.73 ± 1.36 d, respectively) than in the control group (3.85 ± 1.47 d and 4.28 ± 1.61 d, respectively) (P < 0.05). The 2-wk postoperative total effective rate was lower in the control group (80.00%) than in the observation group (94.00%) (P < 0.05). The incidence of adverse reactions was not significantly different between the control (14.00%) and observation (12.00%) groups (P > 0.05). The proportion of adrenaline usage was lower (P < 0.05) and that of anaerobic digestion by Streptococcus and Fusobacterium nucleatum was higher in the ineffective treatment group than in the effective treatment group (P < 0.05). Logistic multiple regression analysis revealed adrenaline as a protective factor (P < 0.05) and anaerobic digestion by Streptococcus and F. nucleatum as risk factors for pulp capping in reversible pulpitis (P < 0.05).
CONCLUSION Adrenaline demonstrated therapeutic efficacy in pulp capping treatment for reversible pulpitis, reducing pain and improving clinical symptoms safely. It is a protective factor for pulp capping, whereas Streptococcus and F. nucleatum are risk factors. Targeted measures can be implemented to improve clinical efficacy.
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Affiliation(s)
- Si-Yun Yang
- Department of Stomatology, Anhui Jieshou People's Hospital, Fuyang 236500, Anhui Province, China
| | - Jin-Zhu Wang
- Department of Stomatology, Jiangsu Yancheng Maternal and Child Health Hospital, Yancheng 224000, Jiangsu Province, China
| | - Hao Fan
- Department of Stomatology, Anhui Jieshou People's Hospital, Fuyang 236500, Anhui Province, China
| | - Min Chen
- Department of Stomatology, Anhui Jieshou People's Hospital, Fuyang 236500, Anhui Province, China
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Wu YT, Lu PW, Lin CA, Chang LY, Jaihao C, Peng TY, Lee WF, Teng NC, Lee SY, Dwivedi RP, Negi P, Yang JC. Development of a zinc chloride-based chemo-mechanical system for potential minimally invasive dental caries removal system. J Dent Sci 2024; 19:919-928. [PMID: 38618085 PMCID: PMC11010630 DOI: 10.1016/j.jds.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/01/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose The chemo-mechanical caries-removal technique is known to offer advantages of selective dentin caries treatment while leaving healthy dental tissues intact. However, current sodium hypochlorite based reagents usually excessively damage dentin collagen. Therefore, the purpose of this study was to develop a novel chemo-mechanical caries-removal system to preserve the collagen network for subsequent prosthetic restorations. Materials and methods The calfskin-derived collagen was chosen as a model system to investigate the dissolution behavior of collagen under different operating conditions of chemical-ultrasonic treatment systems. The molecular weight, triple-helix structure, the morphology, and functional group of collagen after treatment were investigated. Results Various concentrations of sodium hypochlorite or zinc chloride together with ultrasonic machinery were chosen to investigate. The outcomes of circular dichroism (CD) spectra demonstrated stability of the triple-helix structure after treatment of a zinc chloride solution. In addition, two apparent bands at molecular weights (MWs) of 130 and 121 kDa evidenced the stability of collagen network. The positive 222 nm and 195 nm negative CD absorption band indicated the existence of a triple-helix structure for type I collagen. The preservation of the morphology and functional group of the collagen network on the etched dentin surface were investigated by in vitro dentin decalcification model. Conclusion Unlike NaOCl, the 5 wt% zinc chloride solution combined with ultra-sonication showed dissolution rather than denature as well as degradation of the dentin collagen network. Additional in vivo evaluations are needed to verify its usefulness in clinical applications.
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Affiliation(s)
- Yu-Tzu Wu
- Graduate Institute of Nanomedicine and Medical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Po-Wen Lu
- Graduate Institute of Biomedical Materials and Tissue Engineering, Taipei Medical University, Taipei, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Shuang Ho Hospital, New Taipei, Taiwan
| | - Chih-An Lin
- Graduate Institute of Nanomedicine and Medical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Liang-Yu Chang
- Graduate Institute of Nanomedicine and Medical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Chonlachat Jaihao
- Graduate Institute of Biomedical Materials and Tissue Engineering, Taipei Medical University, Taipei, Taiwan
| | - Tzu-Yu Peng
- School of Dentistry, Taipei Medical University, Taipei, Taiwan
| | - Wei-Fang Lee
- School of Dental Technology, Taipei Medical University, Taipei, Taiwan
| | - Nai-Chia Teng
- School of Dentistry, Taipei Medical University, Taipei, Taiwan
| | - Sheng-Yang Lee
- School of Dentistry, Taipei Medical University, Taipei, Taiwan
| | - Ram Prakash Dwivedi
- School of Electrical and Computer Science Engineering, Shoolini University, Himachal Pradesh, India
| | - Poonam Negi
- School of Pharmaceutical Sciences, Biotechnology and Management Sciences, Shoolini University, Himachal Pradesh, India
| | - Jen-Chang Yang
- Graduate Institute of Nanomedicine and Medical Engineering, Taipei Medical University, Taipei, Taiwan
- International Ph.D. Program in Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
- Research Center of Biomedical Device, Taipei Medical University, Taipei, Taiwan
- Research Center of Digital Oral Science and Technology, Taipei Medical University, Taipei, Taiwan
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Govind S, Jena A, Kamilla SK, Mohanty N, Mallikarjuna RM, Nalawade T, Saraf S, Khaldi NA, Jahdhami SA, Shivagange V. Diagnosis and Assessment of Dental Caries Using Novel Bioactive Caries Detecting Dye Solution. Biomedicines 2023; 11:biomedicines11020500. [PMID: 36831036 PMCID: PMC9953294 DOI: 10.3390/biomedicines11020500] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/26/2023] [Accepted: 01/29/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND The goal of materials should be early caries detection, removal of carious lesions, and reduction of dentin hypersensitivity. Thus, the study aims to determine the efficacy of a bioactive caries detecting dye (BCD) for the diagnosing and mechanical removal of occlusal and proximal dental caries. METHODS Patients with occlusal (A1, A2) and proximal carious lesions (B1, B2) were treated with the rotary technique and BCD solution on 120 teeth (n = 60 for each). Group 1: Excavation was performed using diamond points. Group 2: 0.5 mL of BCD solution was scrubbed for 20 sec and excavation was performed with a sharp spoon excavator. Post-excavation cavity volume analysis was performed using a 3D scanner. The time required, VAS for pain, VAS for facial expression, and sound eye motor scoring were scored during excavation. Post-restoration evaluation was performed at 3, 6, and 12 months (FDI criteria). RESULTS The chi-square test revealed that the A1 (197.90 30.97 s) and B1 (273.06 69.95 s) had significantly less mean procedural time than the A2 (292.13 44.87 s) and B2 (411.86 88.34 s). BCD (A2, B2) group showed good patient acceptance, less pain during caries excavation VAS (p = 0.001, FACE (p = 0.001), and SEM (p < 0.001) analysis than the rotary group. There was a statistically insignificant difference between groups immediately (p = 0.235), (p = 0.475) and after 24 h (p = 0.561), (p = 0.688). Color score, hardness of excavated surface, and caries removal score for occlusal and proximal groups showed insignificant differences between the groups. BCD group showed significantly less mean caries excavated volume for the occlusal group (p = 0.003) as compared to the proximal group (p = 0.417) evaluated by 3D scanner. Evaluation of restoration after 3-, 6-, and 12 months intervals (Occlusal caries group (p = 0.247), (p = 0.330), and (0.489) and Proximal caries group (p = 0.299), (p = 0.594), and (0.494)) was acceptable for both the groups. CONCLUSION BCD helps in identification of dental caries clinically, radiographically, and in effective removal of denatured teeth with less pain or sensitivity.
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Affiliation(s)
- Shashirekha Govind
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan (Deemed to be) University, Bhubaneswar 751003, India
- Correspondence: ; Tel.: +91-933-845-7955
| | - Amit Jena
- Department of Conservative Dentistry and Endodontics, Sriram Chandra Bhanja Dental College & Hospital, Cuttack 753007, India
| | - Sushanta Kumar Kamilla
- Department of Physics, Institute of Technical Education and Research, Siksha ‘O’ Anusandhan (Deemed to be) University, Bhubaneswar 751003, India
| | - Neeta Mohanty
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Siksha ‘O’Anusandhan (Deemed to be) University, Bhubaneswar 751003, India
| | - Rachappa M. Mallikarjuna
- Department of Paediatric Dentistry, Child Dental Health, Oman Dental College, Mina Al Fahal, Muscat, Wattayah 116, Oman
| | - Triveni Nalawade
- Department of Paediatric Dentistry, Child Dental Health, Oman Dental College, Mina Al Fahal, Muscat, Wattayah 116, Oman
| | - Sanjay Saraf
- Department of Oral Biology and Oral Pathology, Oman Dental College, Mina Al Fahal, Muscat, Wattayah 116, Oman
| | - Naseer Al Khaldi
- Consultant Prosthodontist, Al-Nahdha Hospital, Al Khuwair, Muscat 133, Oman
| | - Salma Al Jahdhami
- Specialist, Oral and Maxillofacial Surgeon, Al-Nahdha Hospital, Al Khuwair, Muscat 133, Oman
| | - Vinay Shivagange
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Chennai 600077, India
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Bratu DC, Nikolajevic-Stoican N, Popa G, Pop SI, Dragoș B, Luca MM. A Bibliometric Analysis (2010-2020) of the Dental Scientific Literature on Chemo-Mechanical Methods of Caries Removal Using Carisolv and BRIX3000. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060788. [PMID: 35744051 PMCID: PMC9231379 DOI: 10.3390/medicina58060788] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 11/30/2022]
Abstract
Reports in the literature have proposed and analyzed several minimally invasive techniques for caries removal in recent decades. In light of recent events surrounding the ongoing epidemiological context, concerns have been raised regarding the generation of aerosols during dental procedures. The aim of our research was to provide an overview of the scientific literature on the topic of chemo-mechanical caries removal (CMCR) methods, focusing on two products (Carisolv, BRIX3000), commercially available in Europe. A bibliometric analysis was used to investigate the scientific articles included in Web of Science (WoS) Core Collection database, published from January 2010 to December 2020. We analyzed the co-occurrence of all keywords (Author Keywords and the KeyWords Plus section), co-authorship and co-citation, using the free software VOSviewer. Our bibliometric analysis revealed a worldwide interest in the subject of chemo-mechanical methods of caries removal, which has transcended the area of pediatric dentistry. The analyzed studies have been conducted mainly in high-income countries that have developed sanitary policies regarding prevention and early treatment of carious lesions as a health priority.
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Affiliation(s)
- Dana Cristina Bratu
- Department of Orthodontics and Dento-Facial Orthopedics, Orthodontic Research Center, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania;
| | - Nicoleta Nikolajevic-Stoican
- Department of Pediatric Dentistry, Pediatric Dentistry Research Center, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania; (N.N.-S.); (M.-M.L.)
| | - George Popa
- Department of Orthodontics and Dento-Facial Orthopedics, Orthodontic Research Center, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania;
- Correspondence: (G.P.); (S.I.P.)
| | - Silvia Izabella Pop
- Department of Orthodontics, Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540142 Targu Mures, Romania
- Correspondence: (G.P.); (S.I.P.)
| | - Bianca Dragoș
- Research Center in Dental Medicine Using Conventional and Alternative Technologies, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, 9 Revolutiei 1989 Avenue, 300070 Timisoara, Romania;
| | - Magda-Mihaela Luca
- Department of Pediatric Dentistry, Pediatric Dentistry Research Center, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania; (N.N.-S.); (M.-M.L.)
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Alkhawaja HA, Al Haidar AH. Microleakage Evaluation of Glass Hybrid Restoration Following Usage of Papain-Based Gel and Ceramic Bur for Caries Removal: An In Vitro Study. DENTAL HYPOTHESES 2022. [DOI: 10.4103/denthyp.denthyp_48_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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