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Chethan M, Revathi K, M S, M R, Latha M, Kumar A, Kamal Badiyani B. The Effect of Intracanal Medicaments on the Healing of Apical Periodontitis. Cureus 2024; 16:e68068. [PMID: 39347159 PMCID: PMC11436751 DOI: 10.7759/cureus.68068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND Apical periodontitis is a prevalent inflammatory condition affecting the tissues surrounding the root apex of a tooth. The selection of appropriate intracanal medicaments for its management remains a topic of ongoing research. This study aimed to investigate the effect of calcium hydroxide and triple antibiotic paste on the healing of apical periodontitis. METHODS A total of 304 teeth from 215 patients with apical periodontitis were included in this observational study. Patients were randomly assigned to three groups: Group A (calcium hydroxide), Group B (triple antibiotic paste), and Group C (control). Baseline characteristics were recorded, and follow-up assessments were conducted at three, six, and 12 months. Parameters such as reduction in apical radiolucency, presence of periapical healing, bleeding on probing (BOP) percentage, clinical attachment level (CAL), and periodontal depth were evaluated. RESULTS At baseline, the three groups exhibited similar distributions of apical periodontitis parameters. Over the 12-month follow-up, Group A and Group B demonstrated a significant reduction in apical radiolucency compared to Group C (p < 0.05). The presence of periapical healing was more frequent in Group A (85%) and Group B (80%) compared to Group C (60%). Group A showed the lowest mean BOP percentage (15.2 ± 3.5), followed by Group B (18.6 ± 4.2) and Group C (22.1 ± 4.8). Similarly, Group A demonstrated the highest mean CAL (5.8 ± 0.9 mm) and the lowest mean periodontal depth (3.2 ± 0.6 mm). Group B exhibited intermediate values for CAL (5.2 ± 1.1 mm) and periodontal depth (3.6 ± 0.8 mm). CONCLUSION In this study, both calcium hydroxide and triple antibiotic paste demonstrated potential therapeutic effects in promoting healing and reducing apical radiolucency compared to the control group. Calcium hydroxide exhibited the most favorable outcomes, with a higher presence of periapical healing, lower BOP percentage, and superior CAL and periodontal depth measurements. These findings contribute to the understanding of intracanal medicaments' effectiveness in apical periodontitis management.
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Affiliation(s)
- Megha Chethan
- Department of Conservative Dentistry and Endodontics, KGF College of Dental Sciences and Hospital, Kolar, IND
| | - K Revathi
- Department of Conservative Dentistry and Endodontics, KGF College of Dental Sciences and Hospital, Kolar, IND
| | - Soubhagya M
- Department of Conservative Dentistry and Endodontics, KGF College of Dental Sciences and Hospital, Kolar, IND
| | - Rashmi M
- Department of Public Health Dentistry, KGF College of Dental Sciences and Hospital, Kolar, IND
| | - M Latha
- Department of Oral Pathology, KGF College of Dental Sciences and Hospital, Kolar, IND
| | - Amit Kumar
- Department of Public Health Dentistry, Interdental Multispeciality Dental Clinic, Mumbai, IND
| | - Bhumika Kamal Badiyani
- Department of Public Health Dentistry, Interdental Multispeciality Dental Clinic, Mumbai, IND
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Bingi SK, Sitamahalakshmi K, Jaya Nagendra Krishna M, Imran S, Krishnakumar G. A report on the impact of CGF on hard and soft tissues around endo-perio lesion. Bioinformation 2024; 20:483-486. [PMID: 39132246 PMCID: PMC11309119 DOI: 10.6026/973206300200483] [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: 05/01/2024] [Revised: 05/31/2024] [Accepted: 05/31/2024] [Indexed: 08/13/2024] Open
Abstract
There is an increased chance of further periodontal deterioration due to severe intrabony defect. There are s different patho physiologies for perio-endo lesions, ranging from quite basic to rather complicated but to make the right diagnosis, one must be aware of various illness processes also a careful history taking, examination, and the application of specialized tests can help achieve this. Each form of endodontic-periodontal illness has a different prognosis and course of therapy and all kinds of endo-perio lesions require endodontic and periodontal treatments are necessary for primary periodontal disease with subsequent endodontic involvement and real mixed endodontic-periodontal disorders. The severity of the periodontal disease and how well the patient responds to therapy will determine how these situations turn out. Because autologous platelet concentrates are enriched with growth factors, such as concentrated growth factor (CGF), they may enhance surgical outcomes. CGF is inserted into the appropriate intrabony defect following traditional flap debridement. Following flap surgery, the tooth in question had a root canal operation. Volumetric analysis was performed on both groups before to surgery and nine months after the procedure. It has been discovered that the defect area has a much larger bone volume due to the high levels of CGF, a regenerative and reconstructive growth factor that promotes early and high bone fill.
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Affiliation(s)
- Sai Krishna Bingi
- Department of Conservative Dentistry & Endodontics, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda, India
| | - K Sitamahalakshmi
- Department of Periodontology & Implantology, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda, India
| | - M Jaya Nagendra Krishna
- Department of Conservative Dentistry & Endodontics, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda, India
| | - Shaik Imran
- Department of Conservative Dentistry & Endodontics, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda, India
| | - Govardhani Krishnakumar
- Department of Periodontology & Implantology, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
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Chandak M, Chaudhari P, Jidewar N, Sarangi S, Ikhar A, Dass A, Suryawanshi T. Successful Management of a Tooth With an Endodontic-Periodontal Lesion Using a Bone Graft. Cureus 2024; 16:e58828. [PMID: 38800164 PMCID: PMC11116750 DOI: 10.7759/cureus.58828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
As periodontal and endodontic tissues have a close association, they come into close touch and have a lot of possible places for communication. In a clinical setting, this correlation promotes infection spread and results in the typical endo-perio lesion appearance. Because the two tissues are in close touch with one another, managing such lesions can be difficult. The success of treatment depends on a thorough examination and careful planning, with the sole focus on repair and regeneration. In these situations, bone graft materials with such characteristics have demonstrated encouraging outcomes. The treatment outcome along with a follow-up for a case of an endo-perio lesion with furcation involvement is shown in the accompanying case report. In treating such instances, a multidisciplinary approach is necessary, emphasizing regeneration.
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Affiliation(s)
- Manoj Chandak
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Payal Chaudhari
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Namrata Jidewar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swayangprabha Sarangi
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anuja Ikhar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Abhilasha Dass
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Tejas Suryawanshi
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Wong I, Ton A, Cassidy AJ, Fozzard N, Sharma LA, Love RM, Sharma A. A retrospective study on the prognostic factors and success, survival, and failure outcomes of treated endodontic-periodontal lesions. Clin Exp Dent Res 2024; 10:10.1002/cre2.848. [PMID: 38345476 PMCID: PMC10832312 DOI: 10.1002/cre2.848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/27/2023] [Accepted: 01/15/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES The objective of this retrospective study was to determine possible prognostic factors of endodontic-periodontal lesions and to compare success, survival, and failure outcomes of treated endodontic-periodontal lesions across different treatment modalities, demographic variables, and anatomical tooth variations. MATERIALS AND METHODS Data was collected from patient records in the patient management system (Salud, Titanium Solutions) from the Griffith University Dental Clinic between January 2008 and December 2021. The search strategy used the terms "endodontic periodontal lesion," "periodontal endodontic lesion," "endo perio lesion," "perio endo lesion," and "EPL." The 88 cases which met inclusion and exclusion criteria were analyzed. RESULTS The overall success rate was 46.6%, with 21.6% of teeth surviving and 31.8% of teeth failing. Bone loss extending to the apical third (OR = 0.3, 95% CI [0.104, 0.866]), and probing depths of 5-7 mm (OR = 0.147, 95% CI [0.034, 0.633]) and 8-10 mm (OR = 0.126, 95% CI [0.029, 0.542]) were associated with a statistically significant lower odds of success (p < .05). A history of no periodontal disease (OR = 7.705, 95% CI [1.603, 37.037]) was associated with a statistically significant higher odds of success (p < .05). CONCLUSION Practitioners should be aware of bone loss to the apical third, deep probing depths, and a history of periodontal disease as possible prognostic factors that can affect the success rate when treating endodontic-periodontal lesions. Further research with more stringent control over operator factors should be done to investigate these variables.
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Affiliation(s)
- Ingar Wong
- School of Medicine and DentistryGriffith UniversitySouthportAustralia
| | - An Ton
- School of Medicine and DentistryGriffith UniversitySouthportAustralia
| | - Amiel J. Cassidy
- School of Medicine and DentistryGriffith UniversitySouthportAustralia
| | - Nicolette Fozzard
- School of Pharmacy and Medical SciencesGriffith UniversitySouthportAustralia
| | | | - Robert M. Love
- School of Medicine and DentistryGriffith UniversitySouthportAustralia
| | - Ajay Sharma
- School of Medicine and DentistryGriffith UniversitySouthportAustralia
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Sobieszczański J, Mertowski S, Sarna-Boś K, Stachurski P, Grywalska E, Chałas R. Root Canal Infection and Its Impact on the Oral Cavity Microenvironment in the Context of Immune System Disorders in Selected Diseases: A Narrative Review. J Clin Med 2023; 12:4102. [PMID: 37373794 DOI: 10.3390/jcm12124102] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/09/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
The oral cavity has a specific microenvironment, and structures such as teeth are constantly exposed to chemical and biological factors. Although the structure of the teeth is permanent, due to exposure of the pulp and root canal system, trauma can have severe consequences and cause the development of local inflammation caused by external and opportunistic pathogens. Long-term inflammation can affect not only the local pulp and periodontal tissues but also the functioning of the immune system, which can trigger a systemic reaction. This literature review presents the current knowledge on root canal infections and their impact on the oral microenvironment in the context of immune system disorders in selected diseases. The result of the analysis of the literature is the statement that periodontal-disease-caused inflammation in the oral cavity may affect the development and progression of autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, or Sjogren's syndrome, as well as affecting the faster progression of conditions in which inflammation occurs such as, among others, chronic kidney disease or inflammatory bowel disease.
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Affiliation(s)
- Jarosław Sobieszczański
- Preclinical Dentistry Lab, Medical University of Lublin, Chodźki 6 Street, 20-093 Lublin, Poland
| | - Sebastian Mertowski
- Department of Experimental Immunology, Medical University of Lublin, 4a Chodźki Street, 20-093 Lublin, Poland
| | - Katarzyna Sarna-Boś
- Department of Dental Prosthetics, Medical University of Lublin, Chodźki 6 Street, 20-093 Lublin, Poland
| | - Piotr Stachurski
- Department of Pediatric Dentistry, Medical University of Lublin, 20-093 Lublin, Poland
| | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 4a Chodźki Street, 20-093 Lublin, Poland
| | - Renata Chałas
- Department of Oral Medicine, Medical University of Lublin, Chodźki 6 Street, 20-093 Lublin, Poland
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Alsharif SB, Bakhashwain K, Felemban O, Alsharif MB. Endo-Perio Relationship Knowledge, Understanding, and Confidence Among Dentists. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:195-201. [PMID: 36909354 PMCID: PMC9994628 DOI: 10.2147/amep.s401932] [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: 12/18/2022] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE Proper knowledge and confidence regarding Endo-Perio relationship plays an important role in correct clinical decisions and management of these conditions. The aim of this study is to assess dentists' knowledge and understanding, in addition, their confidence regarding Endo-Perio relationship, consequently, to investigate the prevalence of misconceptions. METHODS This cross-sectional study, conducted from December 2021 to March 2022, utilized voluntary anonymous questionnaire, distributed among general dentists, graduates of King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia, year of 2021 (n = 151). The questionnaire had two parts, demographic and 13 closed ended scientific questions to assess knowledge and understanding with 4 points Likert scale after each question to assess confidence and misconceptions. Descriptive statistics and Chi-square test at a statistical significance of P-value <0.05 were conducted to analyze the data using SPSS. RESULTS Total of 98 participants completed the questionnaire setting a response rate of (64.9%). Only (21.4%) had sufficient overall knowledge and understanding regarding Endo-Perio relationship with no significant association found between knowledge and gender (p = 0.8). A little more than one-third of our participants (37.83%) were overly confident; false confident, thus, had misconceptions. CONCLUSION Our study revealed that the majority of our participants had deficient knowledge regarding Endo-Perio relationship. Thus, to compensate for this reported deficiency, changing teaching strategies and implementing continuing education courses are suggested. More studies assessing the interaction between knowledge and confidence in different dental topics are needed.
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Affiliation(s)
- Shahad B Alsharif
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Omnia Felemban
- Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Majd B Alsharif
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Dong T, Zhang Y, Li X. Time-lapse between periodontal regeneration surgery and root canal therapy in sever combined periodontal-endodontic lesions. Saudi Dent J 2023; 35:191-196. [PMID: 36942208 PMCID: PMC10024095 DOI: 10.1016/j.sdentj.2022.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 12/27/2022] Open
Abstract
Objective The purpose of this study was to evaluate the time-lapse of periodontal regeneration surgery of combined periodontal-endodontic lesions (PEL) after root canal therapy (RCT) to guide the clinical treatment. Methods 26 patients (28 teeth) with severe combined PEL were equally divided into 4 groups (n = 7); the control group included patients who underwent periodontal regeneration surgery with no prior RCT and the remaining three experimental groups including patients who received periodontal regeneration surgery post-RCT either immediately or after 3 and 6 months. The probing depth, clinical attachment loss, and periodontal bone density were measured before or after 3, 6, and 12 months post-RCT, respectively. Results Periodontal regeneration surgery could improve the PD (Probing Depth), CAL (Clinical Attachment Loss), BD (Bone Mineral Density) values irrespective of whether the RCT was performed within 12 months or not. However, obviously improved PD, CAL and BD were observed when surgery was performed post-RCT. The time lapse between RCT and periodontal regeneration surgery had no obvious effects on the periodontal index in 3 months after the surgery. Moreover, these periodontal indexes tend to stabilize in 3 to 6 months after the surgery with no significant differences. Conclusion Although there were no obvious impacts of time lapse between RCT and periodontal regeneration surgery on the severe PEL, an earlier periodontal surgery might contribute to the healing of periodontal lesions.
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Affiliation(s)
- Tingyan Dong
- Department of Periodontology, Hexi Subsidiary Clinical-service of Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, China
| | - Yan Zhang
- Department of Oral and Maxillofacial Surgery, Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, China
- Corresponding authors at: Department of Periodontology, Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin, China and Department of Oral and Maxillofacial Surgery, Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin, China.
| | - Xinyue Li
- Department of Periodontology, Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, China
- Corresponding authors at: Department of Periodontology, Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin, China and Department of Oral and Maxillofacial Surgery, Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin, China.
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SANCAR B, TALAY GA. Treatment of Apical Periodontitis Induced BRONJ with Endodontic Treatment. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.972890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Bisphosphonate-related osteonecrosis of the jaw (BRONJ), which is one of the serious side effects of bisphosphonates, has an increasing clinical importance due to the widespread use of bisphosphonates in the treatment of many diseases such as osteoporosis, osteopenia, Paget's disease, osteogenesis imperfecta, and multiple myeloma. BRONJ can spontaneously develop in the jawbones. In addition, many factors such as tooth extraction, periodontal diseases, and local trauma can trigger BRONJ. In our case, it was detected that the lesion appearing like BRONJ in the left lower jaw of the 67-year-old female patient with a history of oral bisphosphonate use developed due to apical periodontitis resulting from the tooth numbered 34. Root canal treatment was administered to the relevant tooth of the patient, the fistula tract was closed after this treatment, and as a result of the CBCT examination, it was observed that the enlargement in the necrotic bone area stopped. In addition, the patient's complaints about the relevant tooth disappeared. As a result, endodontic treatment is an effective treatment approach in the treatment of BRONJ developing due to apical periodontitis. In order to avoid the risk of BRONJ, a detailed oral examination should be performed before starting the bisphosphonate treatment, and necessary endodontic, restorative and periodontal treatments should be followed.
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Affiliation(s)
- Bahadır SANCAR
- İnönü Üniversitesi Diş Hekimliği Fakültesi Ağız Diş ve Çene Cerrahisi Anabilim Dalı
| | - Gönen Aras TALAY
- İnönü Üniversitesi Diş Hekimliği Fakültesi Ağız Diş ve Çene Cerrahisi Anabilim Dalı
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Dos Santos Liberato SF, da Cruz Vegian MR, Abu Hasna A, de Alvarenga JA, Dos Santos JG, Tini ÍRP, Amêndola I, Junqueira JC, de Oliveira LD. Antibiofilm action of Persea americana glycolic extract over Acinetobacter baumannii and absence of toxicity in Galleria mellonella. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2022; 19:905-911. [PMID: 34265885 DOI: 10.1515/jcim-2021-0051] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 07/05/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This study aimed to evaluate the antibiofilm activity and toxicity of the glycolic extract of Persea americana "P. americana" over multidrug-resistant strains of Acinetobacter baumannii "A. baumannii" as alternative therapy to be investigated. METHODS A bacterial inoculum of each bacterial strain (4a, 5a, 9a, 12a, ATCC 19606) of A. baumannii was prepared and adjusted by the spectrophotometer. The microdilution broth method was performed to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). P. americana glycolic extracts were obtained of the tree stalk and leaves. The biofilm viability was tested by MTT assay after 5 min exposure. The toxicity of the extracts was tested by invertebrate model Galleria mellonella. The data were analyzed by ANOVA, Tukey test and log-rank method (α=0.05). RESULTS The extract showed an inhibitory and bactericidal action over all the tested strains with the lowest MIC value observed for the reference strain (3.12 mg/mL). The extract did not demonstrate toxicity in any of the tested concentrations (12.5, 25 and 50 mg/mL) in Galleria mellonella larvae, with a survival percentage above 80% after 168 h. CONCLUSIONS The glycolic extract of P. americana has microbicidal and antibiofilm activity on multidrug-resistant clinical strains of A. baumannii and showed low toxicity for the invertebrate model G. mellonella.
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Affiliation(s)
| | - Mariana Raquel da Cruz Vegian
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics division, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Janaína Araújo de Alvarenga
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Juliana Guimarães Dos Santos
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Ítalo Rigotti Pereira Tini
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Isabela Amêndola
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Juliana Campos Junqueira
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Luciane Dias de Oliveira
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
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Angerame D, De Biasi M, Lenhardt M, Porrelli D, Bevilacqua L, Generali L, La Rosa GRM, Pedullà E. Root-end resection with or without retrograde obturation after orthograde filling with two techniques: A micro-CT study. AUST ENDOD J 2022; 48:423-430. [PMID: 35665570 DOI: 10.1111/aej.12634] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/27/2021] [Accepted: 05/15/2022] [Indexed: 12/14/2022]
Abstract
To evaluate the filling ability of two orthograde obturation techniques followed by the apical resection with or without retrograde obturation through micro-computed tomography (CT). Thirty-two single-rooted permanent teeth were prepared and randomised into four groups (n = 8) according to the orthograde obturation technique (single cone technique [SCT] and mineral trioxide aggregate placement) combined or not with retrograde obturation. The volume of voids (VoV) within the entire endodontic space, the apical 3 mm, and 1 mm after root resection was calculated by micro-CT. Statistical analysis showed no significant difference among the groups regarding the total VoV in all root canals, as well as within the apical 1 mm after root resection. The SCT and apical resection without retrograde filling showed significantly better results in terms of VoV at the apical 3 mm after root resection. Within the study limitations, SCT associated with apical resection without retrograde preparation exhibited a similar or less amount of voids than the other groups.
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Affiliation(s)
- Daniele Angerame
- Clinical Department of Medical Science, Surgery and Health, University of Trieste, Trieste, Italy
| | | | - Massimiliano Lenhardt
- Clinical Department of Medical Science, Surgery and Health, University of Trieste, Trieste, Italy
| | - Davide Porrelli
- Clinical Department of Medical Science, Surgery and Health, University of Trieste, Trieste, Italy
| | - Lorenzo Bevilacqua
- Clinical Department of Medical Science, Surgery and Health, University of Trieste, Trieste, Italy
| | - Luigi Generali
- Endodontic Section, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), School of Dentistry, University of Modena and Reggio Emilia, Modena, Italy
| | - Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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Parirokh M, Hatami N. Conservative Treatment of an Infected Lateral Canal: A Case Report with a 4-Year Follow-up. IRANIAN ENDODONTIC JOURNAL 2022; 17:156-160. [PMID: 36704091 PMCID: PMC9869010 DOI: 10.22037/iej.v17i3.37496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/02/2022] [Accepted: 07/20/2022] [Indexed: 01/28/2023]
Abstract
Connective tissues in lateral canals mostly remain vital even after pulp necrosis of the main canals. However, lateral canals may become necrotic following the pulp necrosis of the main root canal or after root canal therapy. This case report presents a maxillary central incisor with a necrotic lateral canal and a sinus tract that initially showed healing following the primary endodontic treatment but showed infection after fiber-post placement and permanent restoration with composite resin. Tracing the sinus tract did not reveal the reason for the infection; however, cone beam computed tomography (CBCT) confirmed a lateral radiolucency of the maxillary right central incisor as the only reason for the return of the infection. A conservative re-treatment approach was performed, replacing the fiber post with gutta-percha and root canal sealer. Successful outcome was achieved with a conservative approach; however, it took some time for the sinus tract to heal. In the case of lateral canal infection, sealing the main root canal space could heal the lesion even without lateral canal negotiation. If the main root canal seal is disturbed, re-cleaning and obturating the main root canal could be successful.
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Affiliation(s)
- Masoud Parirokh
- Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Nima Hatami
- Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran
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12
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Sun P, Guo Z, Guo D, Wang J, Wu T, Li T, Liu J, Liu X. The Microbiota Profile Analysis of Combined Periodontal-Endodontic Lesions Using 16S rRNA Next-Generation Sequencing. J Immunol Res 2021; 2021:2490064. [PMID: 34825007 PMCID: PMC8610669 DOI: 10.1155/2021/2490064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/10/2021] [Accepted: 10/13/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The primary aim of this investigation was to analyze the microbiome in patients with combined periodontal-endodontic lesions. METHOD Patients with loose and/or painful teeth referred for treatment from March 2020 to December 2020 in the First People's Hospital of Jinzhong were recruited. Samples were collected from teeth diagnosed as chronic periodontics (PE), ulcerative pulpitis (PU), and retrograde pulpitis (RE). Genomic DNA was extracted. The quantitative polymerase chain reaction, targeting the 16S ribosomal RNA (rRNA), was adopted for the quantification of bacteria. Then, the V3-V4 hypervariable regions of the 16S rRNA gene were amplified and subjected to next-generation sequencing. The statistical analysis was performed by R software (V3.5.1). RESULTS A total of 57 qualified samples were collected from 48 patients and analyzed (7 PE, 21 PU, and 19 RE). By linear discriminant analysis effect size, Kingella and Barnesiella were significantly increased in the periodontal pocket of retrograde pulpitis (RE-PE), compared with PE. The relative abundance of Clostridiales Incertae Sedis XI, Fusobacteriaceae, Fusobacterium, Parvimonas, Micrococcaceae, and Rothia was significantly increased in the pulp of retrograde pulpitis (RE-PU) than PU and RE-PE. Prevotella, Leptotrichia, Porphyromonas, Streptococcus, and Fusobacterium are consistently at a high abundance, across PU, RE-PE, and RE-PU. CONCLUSION The current study highlighted the evidence that a specific microbial community is associated with the occurrence of retrograde pulpitis. The microenvironment of the root canal and pulp chamber will select microbiota. This study offered insights into the pathogenesis of retrograde pulpitis.
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Affiliation(s)
- Ping Sun
- The First People's Hospital of Jinzhong, Jinzhong City, 030600 Shanxi Province, China
| | - Zhiyong Guo
- Department of Oromaxillofacial-Head & Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - Daiping Guo
- The First People's Hospital of Jinzhong, Jinzhong City, 030600 Shanxi Province, China
| | - Jian Wang
- The First People's Hospital of Jinzhong, Jinzhong City, 030600 Shanxi Province, China
| | - Tingting Wu
- The First People's Hospital of Jinzhong, Jinzhong City, 030600 Shanxi Province, China
| | - Tingjun Li
- The First People's Hospital of Jinzhong, Jinzhong City, 030600 Shanxi Province, China
| | - Jiannan Liu
- Department of Oromaxillofacial-Head & Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - Xinhua Liu
- The First People's Hospital of Jinzhong, Jinzhong City, 030600 Shanxi Province, China
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13
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Al Madhoun A, Sindhu S, Haddad D, Atari M, Ahmad R, Al-Mulla F. Dental Pulp Stem Cells Derived From Adult Human Third Molar Tooth: A Brief Review. Front Cell Dev Biol 2021; 9:717624. [PMID: 34712658 PMCID: PMC8545885 DOI: 10.3389/fcell.2021.717624] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 09/15/2021] [Indexed: 12/13/2022] Open
Abstract
The fields of regenerative medicine and stem cell-based tissue engineering have the potential of treating numerous tissue and organ defects. The use of adult stem cells is of particular interest when it comes to dynamic applications in translational medicine. Recently, dental pulp stem cells (DPSCs) have been traced in third molars of adult humans. DPSCs have been isolated and characterized by several groups. DPSCs have promising characteristics including self-renewal capacity, rapid proliferation, colony formation, multi-lineage differentiation, and pluripotent gene expression profile. Nevertheless, genotypic, and phenotypic heterogeneities have been reported for DPSCs subpopulations which may influence their therapeutic potentials. The underlying causes of DPSCs’ heterogeneity remain poorly understood; however, their heterogeneity emerges as a consequence of an interplay between intrinsic and extrinsic cellular factors. The main objective of the manuscript is to review the current literature related to the human DPSCs derived from the third molar, with a focus on their physiological properties, isolation procedures, culture conditions, self-renewal, proliferation, lineage differentiation capacities and their prospective advances use in pre-clinical and clinical applications.
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Affiliation(s)
- Ashraf Al Madhoun
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman, Kuwait.,Department of Animal and Imaging Core Facilities, Dasman Diabetes Institute, Dasman, Kuwait
| | - Sardar Sindhu
- Department of Animal and Imaging Core Facilities, Dasman Diabetes Institute, Dasman, Kuwait.,Department of Immunology and Microbiology, Dasman Diabetes Institute, Dasman, Kuwait
| | - Dania Haddad
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman, Kuwait
| | - Maher Atari
- Biointelligence Technology Systems S.L., Barcelona, Spain
| | - Rasheed Ahmad
- Department of Immunology and Microbiology, Dasman Diabetes Institute, Dasman, Kuwait
| | - Fahd Al-Mulla
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman, Kuwait
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14
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Fageeh HN. Preliminary Evaluation of Proliferation, Wound Healing Properties, Osteogenic and Chondrogenic Potential of Dental Pulp Stem Cells Obtained from Healthy and Periodontitis Affected Teeth. Cells 2021; 10:cells10082118. [PMID: 34440887 PMCID: PMC8393753 DOI: 10.3390/cells10082118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/23/2021] [Accepted: 07/28/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Dental pulp tissue within the central cavity of the tooth is composed of dental pulp stem cells (DPSC). These mesenchymal stem cells have good proliferative as well as differentiation potential. DPSC has been isolated even from teeth with inflamed pulps and is found to retain their proliferative and differentiation potential. Little research is available about the viability and differentiation potential of DPSC obtained from teeth with periodontitis. In the present study, the aim was to compare the morphological features, stem cell marker (MSC) expression, proliferation rate, migratory and wound healing properties, osteogenic and chondrogenic differentiation potential of DPSCs obtained from periodontally healthy teeth (hDPSCs) and periodontitis affected teeth (pDPSCs). Methods: Dental pulp tissue was obtained from periodontally healthy volunteers (n = 3) and patients with periodontitis undergoing extraction of mobile teeth (n = 3). DPSC were isolated using the explant technique and cultured. All the experiments were performed at early passage (Passage 2), late passage (Passage 6) and after cryopreservation. Morphological features of the hDPSCs and pDPSCs were ascertained using microscopy. The expression of cell surface stem cell markers was assessed by the flow cytometry method. The proliferation and growth rate of the cells were assayed by plotting a growth curve from 0–13 days of culture. The migratory characteristics were assessed by wound scratch assay. Osteogenic and chondrogenic differentiation of the cells was assessed using standard protocols with and without induction. Results: DPSCs were successfully obtained from periodontally healthy teeth (hDPSC) and periodontitis-affected teeth (pDPSCs). The data suggests that there were no morphological differences observed in early passage cells between the two cohorts. Cryopreservation did change the morphology of pDSPCs. There was no significant difference in the positive expression of mesenchymal markers CD73, CD90 and CD105 in early passage cells. However, serial passaging and cryopreservation affected the marker expression in pDPSCs. A faint expression of hematopoietic stem cell markers CD34, CD45 and MHC class II antigen HLA-DR was observed in both the cell types. The expression of HLA-DR is upregulated in pDPSCs compared to hDPSC. A significantly slower growth rate and slower wound healing properties was observed in pDPSCs compared to hDPSC. In late passage and after cryopreservation, the migratory ability of pDPSCs was found to be increased drastically. There was no significant difference in osteogenic potential between the two cell types. However, the chondrogenic potential of pDPSCs was significantly lower compared to hDPSc. Yet, pDPSCs showed enhanced osteogenesis and chondrogenesis at late passage as well as after cryopreservation. Conclusion: The results of this novel study shed light on the isolation of viable DPSC from periodontitis-affected teeth. These cells exhibit a slower growth rate and migratory characteristics compared to their healthy counterparts. There was no difference in osteogenic potential but a reduction in chondrogenic potential was seen in pDPSCs compared to hDPSC. The findings reveal that DPSC from periodontitis-affected teeth presents an easy and viable option for regenerative medicine application. Some additional nutritive factors and protocols may be required to attain better regenerative benefits while using pDPSCs.
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Affiliation(s)
- Hytham N Fageeh
- Department of Preventive Dental Science, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
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15
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Regenerative Therapy Modality for Treatment of True Combined Endodontic-Periodontal Lesions: A Randomized Controlled Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126220. [PMID: 34201328 PMCID: PMC8227857 DOI: 10.3390/ijerph18126220] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/16/2022]
Abstract
The aim of this in-vivo study was to evaluate/compare the clinical periodontal parameters in patients with true combined endo-perio lesions (EPL), treated with gutta-percha (GP) and mineral trioxide (MTA) as an obturation material alone and with addition of bone grafting in such lesions. 120 Saudi patients (mean age = 41yrs) diagnosed with true combined EPL participated in this study. Group I (control group, n = 30) was treated with conventional endodontic treatment using GP for obturation. Group II (n = 30) was treated with conventional endodontic treatment using MTA for obturation. Group III (n = 30) was treated with conventional endodontic treatment using GP for obturation + grafting procedure to fill the bony defect. Group IV (n = 30) was treated with conventional endodontic treatment using MTA for obturation + grafting procedure to fill the bony defect. Clinical parameters (Pocket depth (PD); Clinical attachment loss (CAL); keratinized tissue width (KTW); gingival phenotype (G.Ph.) and Cone Beam Computed Tomography Periapical Index (CBCTPAI)) were recorded and compared at baseline, 3, 6, 12 months’ interval. For the groups III and IV, CBCTPAI showed significant difference (p < 0.0001) with the other groups at 6 months and 1-year interval. The group with MTA + bone graft showed 76% and 90% patients with 0 score at 6 months and 1-year follow-up, respectively. Comparison of mean values of PD among study groups at 3 months, 6 months and 1 year showed significant difference at 3 months, whereas the mean PD values of subjects in GP + bone graft showed significantly higher PD values than other 3 groups (p = 0.025). Use of GP and MTA for root canal obturation along with periodontal therapy and bone augmentation helps in resolving complex endo-perio lesions. Bone grafting in addition to obturation with MTA was found to be the best treatment strategy in management of EPL cases and is recommended for clinicians who are treating EPL patients.
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16
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Su WQ, Shi JH, Cheng Y, Lei L, Li HX. Periodontal treatment of furcation involvement at the mandibular first molar with a follow-up of 27 years. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2021; 39:347-354. [PMID: 34041886 PMCID: PMC8218268 DOI: 10.7518/hxkq.2021.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 03/19/2021] [Indexed: 11/21/2022]
Abstract
Due to the complicated anatomical structures in the furcation area of multirooted mandibular first molars, dental hygiene is greatly compromised once the furcation is involved in the periodontitis, leading to the unfavorable prognosis of teeth with furcation involvement. A patient came to a dental office with the chief complaint of "mobile mandibular posterior tooth" 27 years ago. The periapical film showed alveolar bone resorption at the root furcation of the right mandibular first molar. Flap surgery and fine supportive therapy were conducted. The patient was diagnosed with "furcation involvement Class Ⅲ" during a revisit three years ago. Satisfactory and healthy periodontal statuses were observed 2, 9, 24, and 33 months after the periodontal flap surgery plus tunneling procedures. A follow-up of 27 years in the present case demonstrated that a favorable prognosis of furcation involvement can be achieved after adequate periodontal treatment.
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Affiliation(s)
- Wen-Qi Su
- Dept. of Periodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
| | - Jia-Hong Shi
- Dept. of Periodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
| | - Yan Cheng
- Dept. of Periodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
| | - Lang Lei
- Dept. of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
| | - Hou-Xuan Li
- Dept. of Periodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
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17
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Lai WY, Wei CC, Wan L, Mai CH, Lin CL, Tsai JD. Allergic rhinitis and dental-supporting tissue diseases in children. Medicine (Baltimore) 2021; 100:e24780. [PMID: 33607828 PMCID: PMC7899888 DOI: 10.1097/md.0000000000024780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT The etiology of dental-supporting tissue diseases in children is multi factorial and not merely related to oral hygiene. Therefore, in the present study, we investigated the relationship between children <18 years old with allergic rhinitis (AR) and the risk of dental-supporting tissue diseases.Data from the National Health Insurance Research Database (NHIRD) of Taiwan were used to conduct a retrospective longitudinal cohort study. The study cohort comprised 378,160 patients with AR (AR group) and 378,160 patients without AR (non-AR group), who were selected through frequency matching based on age, sex, and the index year. The study patients were followed until dental-supporting tissue diseases occurrence, withdrawal from the National Health Insurance program, or December 31, 2013. Cox proportional hazards regression analysis was conducted to calculate the risk of dental-supporting tissue diseases in the AR group after adjustment for age, sex, and relative comorbidities.The adjusted HRs of periodontal, pulp, and periapical diseases in AR children were higher than those in the non-AR controls (1.51, 95% CI: 1.50 to 1.53; 1.06, 95% CI: 1.05 to 1.07, respectively). The AR to non-AR HRs of these inflammatory dental diseases were particularly higher in children <6 years old and in boys. The HRs of periodontal, pulp, and periapical diseases were greatest in those with >5 AR-related medical visits/year (5.57, 95% CI: 5.50 to 5.56; 4.06, 95% CI: 4.00 to 4.12, respectively).Children with AR had a greater risk of inflammatory dental-supporting tissue diseases, particularly those <6 years old with primary teeth, boys, and those with severe persistent AR.
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Affiliation(s)
- Wan-Yu Lai
- Department of Chinese Medicine, China Medical University Hospital
- School of Chinese Medicine, China Medical University
| | - Chang-Ching Wei
- Children's Hospital, China Medical University Hospital
- School of Medicine, China Medical University, Taichung
| | - Lei Wan
- School of Chinese Medicine, China Medical University
| | - Chen-Hao Mai
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua County
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital
- Institute of Biostatistics, China Medical University
| | - Jeng-Dau Tsai
- School of Medicine, Chung Shan Medical University
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
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18
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Ganesan K, Balagangadharan M, Sengoden T, Santhi B, Vasudevan M, Dhamodharan YT. Hemisection-A Challenge for Perio-endo Lesions: A Case Report. J Pharm Bioallied Sci 2020; 12:S631-S634. [PMID: 33149533 PMCID: PMC7595454 DOI: 10.4103/jpbs.jpbs_196_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/10/2020] [Accepted: 03/17/2020] [Indexed: 11/17/2022] Open
Abstract
The perio-endo lesions confront the clinician as far as diagnosis and prognosis of the affected teeth is concerned. Hemisection is the treatment choice for perio-endo lesions to preserve the remaining part of the molar having sound periodontium. It is a resection of periodontally involved root along with the associated crown portion. Prognosis and treatment of perio-endo lesions depend on the severity of bone loss, root trunk length, degree of root separation, curvature of root, ability to eradicate the osseous defect, and restorative and oral hygiene procedures. In this case report, root canal treatment and hemisection were successfully performed to treat advanced perio-endo lesions. By this way, natural tooth and surrounding structures were preserved and thereby cost was lesser than the other treatment alternatives.
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Affiliation(s)
- Kokila Ganesan
- Department of Periodontology, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | - Manovijay Balagangadharan
- Department of Periodontology, Vinayaka Mission's Sankarachariyar Dental College, Salem, Tamil Nadu, India
| | - Tamilselvi Sengoden
- Department of Periodontology, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | - Bharathi Santhi
- Department of Periodontology, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | - Menaka Vasudevan
- Department of Periodontology, Ragas Dental College, Chennai, Tamil Nadu, India
| | - YogeshKumar Thoppe Dhamodharan
- Department of Pedodontics and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
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19
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Makeeva MK, Daurova FY, Byakova SF, Turkina AY. Treatment of an Endo-Perio Lesion with Ozone Gas in a Patient with Aggressive Periodontitis: A Clinical Case Report and Literature Review. Clin Cosmet Investig Dent 2020; 12:447-464. [PMID: 33149696 PMCID: PMC7604462 DOI: 10.2147/ccide.s267933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/16/2020] [Indexed: 01/29/2023] Open
Abstract
The pulp and periodontium have obvious relationships that have been described in many studies. Pulp infections may affect periodontal tissues and vice versa. Teeth with endo-perio lesions have a worse prognosis than isolated endodontic or periodontal lesions. Elimination of endodontic and periodontal infections is essential for successful treatment, so co-operation between endodontists and periodontists is necessary. In this clinical case, a 44-year-old male presented with primary periodontal disease with secondary endodontic involvement in his lower right canine because of aggressive periodontitis. There was 10 mm of clinical attachment loss and 8 mm periodontal pocket mesial from the tooth and bone radiolucency periapical and lateral from the root. Periodontal therapy was followed by endodontic treatment. Periodontal therapy included root scaling and planing, treatment of the periodontal pocket with ozone gas, systemic antibiotics, oral hygiene instructions, and chlorhexidine rinsing. Endodontic therapy included root canal instrumentation with rotary endodontic files, irrigation, root canal treatment with ozone gas, and obturation with lateral compaction. Radiographs at a 6-month follow-up appointment showed complete healing of the periapical lesion and alveolar bone lateral to the root. Using an interdisciplinary approach to treat endo-perio lesions provides favorable clinical outcomes. Ozone therapy is beneficial for the successful treatment of endo-perio lesions with narrow periodontal pockets in patients with aggressive periodontitis and poor prognosis.
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Affiliation(s)
- Maria K Makeeva
- Conservative Dentistry Department, People's Friendship University of Russia (RUDN University), Moscow, Russia.,Therapeutic Dentistry Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Fatima Yu Daurova
- Conservative Dentistry Department, People's Friendship University of Russia (RUDN University), Moscow, Russia
| | - Svetlana F Byakova
- Therapeutic Dentistry Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anna Yu Turkina
- Therapeutic Dentistry Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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20
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Niemiec B, Gawor J, Nemec A, Clarke D, McLeod K, Tutt C, Gioso M, Steagall PV, Chandler M, Morgenegg G, Jouppi R. World Small Animal Veterinary Association Global Dental Guidelines. J Small Anim Pract 2020; 61:E36-E161. [PMID: 32715504 DOI: 10.1111/jsap.13132] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Dental, oral, and maxillofacial diseases are some of the most common problems in small animal veterinary practice. These conditions create significant pain as well as localized and potentially systemic infection. As such, the World Small Animal Veterinary Association (WSAVA) believes that un- and under treated oral and dental diseases pose a significant animal welfare concern. Dentistry is an area of veterinary medicine which is still widely ignored and is subject to many myths and misconceptions. Effective teaching of veterinary dentistry in the veterinary school is the key to progression in this field of veterinary medicine, and to the improvement of welfare for all our patients globally. These guidelines were developed to provide veterinarians with the information required to understand best practices for dental therapy and create realistic minimum standards of care. Using the three-tiered continuing education system of WSAVA, the guidelines make global equipment and therapeutic recommendations and highlight the anaesthetic and welfare requirements for small animal patients. This document contains information on common oral and dental pathologies, diagnostic procedures (an easily implementable and repeatable scoring system for dental health, dental radiography and radiology) and treatments (periodontal therapy, extractions). Further, there are sections on anaesthesia and pain management for dental procedures, home dental care, nutritional information, and recommendations on the role of the universities in improving veterinary dentistry. A discussion of the deleterious effects of anaesthesia free dentistry (AFD) is included, as this procedure is ineffective at best and damaging at worst. Throughout the document the negative effects of undiagnosed and/or treated dental disease on the health and well-being of our patients, and how this equates to an animal welfare issue, is discussed.
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21
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Louzada LM, Arruda-Vasconcelos R, Duque TM, Casarin RC, Feres M, Gomes BP. Clinical Investigation of Microbial Profile and Levels of Endotoxins and Lipoteichoic Acid at Different Phases of the Endodontic Treatment in Teeth with Vital Pulp and Associated Periodontal Disease. J Endod 2020; 46:736-747. [DOI: 10.1016/j.joen.2020.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/11/2020] [Accepted: 02/15/2020] [Indexed: 12/13/2022]
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22
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Yu X, Jiang H, Cheng G, Shang W, Zhang S. High levels of HIF-1ɑ in hypoxic dental pulps associated with teeth with severe periodontitis. J Mol Histol 2020; 51:265-275. [PMID: 32394128 DOI: 10.1007/s10735-020-09878-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/04/2020] [Indexed: 12/29/2022]
Abstract
In this study we investigated the expression of HIF-1ɑ in dental pulps of the teeth with severe periodontitis. The expression of HIF-1ɑ in dental pulps of the teeth with severe periodontitis was detected by immunohistochemistry, immunofluorescence and real-time PCR. Bone marrow macrophages (BMMs) were cultured under hypoxia in vitro. HIF-1ɑ, osteoclast-specific factors (NFATc1, CTSK and c-fos) and RANKL-induced osteoclastogenesis were evaluated by immunofluorescence, TRAP staining and western blotting. High levels of HIF-1ɑ protein were detected in dental pulps of teeth with severe periodontitis, whereas few positive HIF-1ɑ expressions were detected in healthy dental pulps. Hypoxia occurred in the dental pulps in response to heavy periodontitis. Many HIF-1ɑ-positive infiltratory inflammatory cells were observed around blood vessels. Tooth internal resorption was found in some teeth with severe periodontitis. The HIF-1ɑ levels were upregulated in BMMs under hypoxia, which also promoted osteoclast formation and resorption by NFATc1, CTSK and c-fos. Teeth with severe periodontitis show hypoxic dental pulps and increased potential of osteoclastic differentiation.
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Affiliation(s)
- Xijiao Yu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, People's Republic of China.,Department of Endodontics, Jinan Stomatological Hospital, Jinan, Shandong, People's Republic of China
| | - Huan Jiang
- Department of Endodontics, Jinan Stomatological Hospital, Jinan, Shandong, People's Republic of China
| | - Guannan Cheng
- Department of Orthodontics, Weihai Stomatological Hospital, Weihai, Shandong, People's Republic of China
| | - Wenzhi Shang
- Department of Endodontics, Jinan Stomatological Hospital, Jinan, Shandong, People's Republic of China.
| | - Shanyong Zhang
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, People's Republic of China.
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23
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Gadê-Neto CR, Rodrigues RR, Louzada LM, Arruda-Vasconcelos R, Teixeira FB, Viana Casarin RC, Gomes BPFA. Microbiota of periodontal pockets and root canals in induced experimental periodontal disease in dogs. ACTA ACUST UNITED AC 2019; 10:e12439. [PMID: 31313892 DOI: 10.1111/jicd.12439] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/24/2019] [Accepted: 06/25/2019] [Indexed: 12/21/2022]
Abstract
AIM To investigate the relationship between the microbiota of periodontal pockets (PP) and root canals (RC) in dogs submitted to experimental periodontal disease (ExPD). METHODS ExPD was induced by combining cotton and wire ligatures. After 125 days, microbiological samples were collected from PP and RC. Strains isolated from 19 teeth were submitted to DNA extraction, 16S rRNA gene amplification and gene sequencing. Pearson's χ2 - and Fisher's exact tests and McNemar's test were used when appropriate. RESULTS The number of species in PP was greater than in RC, with prevalence of obligate anaerobes and Gram-negative bacteria. In the PP predominated Fusobacterium necrophorum, Porphyromonas gingivalis, Prevotella loescheii, Campylobacter gracilis and Veillonella parvula. In the RC samples, 9 had microbial growth, with predominance of the following genera: Staphylococcus, Streptococcus and Neisseria. Eight genera were common to both sites in the same tooth. PP presented a greater number of species than the RC. No significant difference was observed in the species found in PP and RC in the same tooth. CONCLUSION Microbial composition of the RC could be modulated by the presence of periodontal disease, especially in cases of severe periodontal destruction. RC microbiota was less complex and diverse than the PP.
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Affiliation(s)
- Cícero R Gadê-Neto
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil.,Division of Endodontics, Potiguar University - UnP, Natal, RN, Brazil
| | - Ronaldo R Rodrigues
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Lidiane M Louzada
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Rodrigo Arruda-Vasconcelos
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Fabrício B Teixeira
- Department of Endodontics, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, IA, USA
| | - Renato C Viana Casarin
- Department of Prosthodontics and Periodontics, School of Dentistry at Piracicaba, University of Campinas, Piracicaba, SP, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
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Shukla S, Chug A, Mahesh L, Singh S, Singh K. Optimal management of intrabony defects: current insights. Clin Cosmet Investig Dent 2019; 11:19-25. [PMID: 30697083 PMCID: PMC6340362 DOI: 10.2147/ccide.s166164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Periodontitis is the most common condition, which causes bony defects. Intrabony defects thought not as common as the horizontal bone loss pose a risk of disease progression and thus should be managed optimally; however, it does not mean all the intrabony defects can be treated and all the mobile teeth saved! But, with the advent of new biomaterials prognosis of teeth can be improved. The objective of this article is to discuss old and new concepts toward the optimal management of intrabony defects.
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Affiliation(s)
- Sagrika Shukla
- Department of Dentistry (Periodontology), All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India,
| | - Ashi Chug
- Department of Dentistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | | | | | - Kuldeep Singh
- Department of Conservative Dentistry & Endodontics, RR Dental College, Udaipur, India
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AgCa-PLGA submicron particles inhibit the growth and colonization of E. Faecalis and P. Gingivalis on dentin through infiltration into dentinal tubules. Int J Pharm 2018; 552:206-216. [DOI: 10.1016/j.ijpharm.2018.09.066] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 09/04/2018] [Accepted: 09/27/2018] [Indexed: 12/11/2022]
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Bansal S, Tewari S, Tewari S, Sangwan P. The effect of endodontic treatment using different intracanal medicaments on periodontal attachment level in concurrent endodontic-periodontal lesions: A randomized controlled trial. J Conserv Dent 2018; 21:413-418. [PMID: 30122823 PMCID: PMC6080180 DOI: 10.4103/jcd.jcd_337_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Aim: The aim of this study is to evaluate the effect of different intracanal medicaments used during endodontic treatment on periodontal attachment level in concurrent endodontic-periodontal lesions without communication. Materials and Methods: Seventy-five teeth with combined endodontic-periodontal lesions were randomly assigned to 3 groups: Test Group I (calcium hydroxide [Ca(OH)2]), Test Group II (2% chlorhexidine + Ca(OH)2), and control group (no intracanal medicament). Root canal treatment (RCT) was performed using standard methodology. Teeth of test groups were medicated with respective medicaments for 10 days before obturation. Scaling and root planning was done 1 month after completion of RCT in all the groups. Clinical measurements, including probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded at baseline, 1, 3, and 6 months. Radiographic parameters, including periapical index (PAI) score and alveolar bone level, were measured at baseline and 6 months. Statistical Analysis: Data were analyzed using Friedman test, Kruskal–Wallis, and Wilcoxon signed-rank test. Results: Significant improvement in PD, CAL, %BOP, and PAI score (P < 0.05) was found in all the three groups from baseline to 6 months. However, there was no significant intergroup difference. No significant difference was observed from baseline to 6 months in marginal bone level within the three groups. Conclusion: Endodontic treatment before periodontal therapy results in attachment gain. Intracanal medicaments may not affect the healing of concurrent endodontic-periodontal lesions without communication.
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Affiliation(s)
- Shweta Bansal
- Senior Consultant Endodontist, HS Dental Institute Private Limited, Gurgaon, Haryana, India
| | - Sanjay Tewari
- Department of Conservative Dentistry and Endodontics, Postgraduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Shikha Tewari
- Department of Periodontics, Postgraduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Pankaj Sangwan
- Department of Conservative Dentistry and Endodontics, Postgraduate Institute of Dental Sciences, Rohtak, Haryana, India
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Periodontal and endodontic infectious/inflammatory profile in primary periodontal lesions with secondary endodontic involvement after a calcium hydroxide-based intracanal medication. Clin Oral Investig 2018; 23:53-63. [DOI: 10.1007/s00784-018-2401-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 02/22/2018] [Indexed: 12/19/2022]
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Betancourt P, Elgueta R, Fuentes R. Treatment of endo-periodontal lesion using leukocyte-platelet-rich fibrin. A case report. COLOMBIA MEDICA (CALI, COLOMBIA) 2017; 48:204-207. [PMID: 29662262 PMCID: PMC5896727 DOI: 10.25100/cm.v43i4.2140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Case Description: The main objective of this paper was to report the clinical effectiveness of leukocyte- platelet- rich fibrin (L-PRF) in the treatment of a combined endo-periodontal lesion of an upper first premolar. Clinical Findings: The tooth had a profound abfraction on the vestibular aspect and presented no mobility but revealed a deep pocket measuring of 11 mm on the mesial vestibular aspect and 14 mm on the mesial palatine aspect. The three dimensional image analysis showed total bone loss in the mesial aspect and an extensively bone loss of the vestibular aspect of the vestibular root. Treatment and Outcome: Endodontic treatment was performed and periodontal access surgery (surgical periodontal therapy) was done with the application of autologous L-PRF. Three month and 6 months after surgery, the cone beam computed tomography (CBCT) exams showed no bone regeneration in any aspect of the tooth. However, periodontal examination showed a significative improvement in the deepness of surcus. The mesial vestibular aspect had a deep pocket of 3 mm and 5 mm on the mesial palatine aspect showing a reduction in deepness of 8 mm and 9 mm, respectively. Clinical Relevance: The actual treatment for teeth with bad prognosis is the extraction and replacement with implants. Even though implants are capable of restore function and aesthetic, the abuse of this approach have led to the loss of teeth that could be successfully treated with a less invasive technique. The prognosis of teeth with endoperiodontal lesion is poor but could be enhanced with regenerative therapies. Until now there are no clinical trials and just four case report about the treatment of these teeth with platelet rich fibrin.
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Affiliation(s)
- Pablo Betancourt
- Research Centre in Dental Sciences (CICO), Facultad de Odontología, Universidad de La Frontera, Temuco, Chile
| | - Ricardo Elgueta
- Research Centre in Dental Sciences (CICO), Facultad de Odontología, Universidad de La Frontera, Temuco, Chile.,Facultad de Odontologia , Universidad Mayor, Santiago de Chile, Chile
| | - Ramon Fuentes
- Research Centre in Dental Sciences (CICO), Facultad de Odontología, Universidad de La Frontera, Temuco, Chile
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Role of Periapical Diseases in Medication-Related Osteonecrosis of the Jaws. BIOMED RESEARCH INTERNATIONAL 2017; 2017:1560175. [PMID: 29109954 PMCID: PMC5646299 DOI: 10.1155/2017/1560175] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 08/29/2017] [Indexed: 12/05/2022]
Abstract
Objective The present study aimed to investigate the role of periapical diseases in inducing medication-related osteonecrosis of the jaws (MRONJ) using an ovariectomized (OVX) mice model. Materials and Methods Twenty C57BL/6N female mice were randomly assigned to two groups. All mice were subjected to bilateral ovariectomy and then treated with oncologic dose of zoledronic acid (ZA) or vehicle for twelve weeks. Eight weeks after commence of drug administration, a pulpal exposure (PE) operation was performed on the first right lower molar to induce periapical periodontitis; the contralateral non-PE tooth was used as control. All animals were sacrificed four weeks after pulpal exposure, and the mandibles were harvested for radiological and histomorphometrical analysis. Results Micro computed tomography (μ-CT) examination demonstrated that periapical diseases significantly increased alveolar bone resorption, and the resorption was greatly attenuated by ZA treatment. Concurrent ZA therapy significantly increased bone density and histological osteocyte necrosis in the presence of periapical lesions. Conclusion ZA treatment reduced bone absorption resulting from periapical disease but increased the risk of developing MRONJ in the ovariectomized mouse model.
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Pourhajibagher M, Chiniforush N, Raoofian R, Ghorbanzadeh R, Shahabi S, Bahador A. Effects of sub-lethal doses of photo-activated disinfection against Porphyromonas gingivalis for pharmaceutical treatment of periodontal-endodontic lesions. Photodiagnosis Photodyn Ther 2016; 16:50-53. [DOI: 10.1016/j.pdpdt.2016.08.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 08/09/2016] [Accepted: 08/31/2016] [Indexed: 12/25/2022]
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Fujii R, Muramatsu T, Yamaguchi Y, Asai T, Aida N, Suehara M, Morinaga K, Furusawa M. An endodontic-periodontal lesion with primary periodontal disease: a case report on its bacterial profile. THE BULLETIN OF TOKYO DENTAL COLLEGE 2016; 55:33-7. [PMID: 24717928 DOI: 10.2209/tdcpublication.55.33] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The microflora in the periodontal pockets can affect the dental pulp and cause endodontic-periodontal lesions or retrograde pulpitis. Here we report an endodontic-periodontal lesion together with its bacterial profile. The lesion occurred in the maxillary right first molar of a 40-year-old woman who presented at our hospital complaining of a violent toothache since the previous night. Clinically, the tooth was caries-free and an electric pulp test showed it to be vital. The tooth showed signs of advanced periodontitis and the periodontal pocket was deep, reaching the apex of the palatal root. The clinical diagnosis was an endodontic-periodontal lesion with primary periodontal disease. Subsequent endodontic treatment comprised pulp extirpation and root canal filling, followed by periodontal treatment consisting of scaling and root planing. The tooth was finally restored with a full metal crown. No further signs of periodontal disease or periapical lesions have been observed to date. Bacteria were sampled from the root canal and periodontal pocket for a microbiological assessment using 16S rRNA gene-based PCR. Microbiologically, the profile of the bacterial species from the palatal root canal was similar to that from the periodontal pocket of the palatal root. Porphyromonas gingivalis, Fusobacterium nucleatum and Eikenella corrodens were detected in both samples. The occurrence of bacteria common to both sites in this patient further supports the proposition that periodontal disease is the definitive source of root canal infections. The present results suggest that a bacterial examination would be helpful in confirming and supporting the clinical diagnosis in such lesions.
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Affiliation(s)
- Rie Fujii
- Department of Endodontics and Clinical Cariology, Tokyo Dental College
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Hwang JJ, Park H, Jeong HG, Han SS. Change in Image Quality According to the 3D Locations of a CBCT Phantom. PLoS One 2016; 11:e0153884. [PMID: 27093639 PMCID: PMC4836729 DOI: 10.1371/journal.pone.0153884] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 04/05/2016] [Indexed: 12/22/2022] Open
Abstract
A patient's position changes in every CBCT scan despite patient alignment protocols. However, there have been studies to determine image quality differences when an object is located at the center of the field of view (FOV). To evaluate changes in the image quality of the CBCT scan according to different object positions, the image quality indexes of the Alphard 3030 (Alphard Roentgen Ind., Ltd., Kyoto, Japan) and the Rayscan Symphony (RAY Ind., Ltd., Suwon, Korea) were measured using the Quart DVT_AP phantom at the center of the FOV and 6 peripheral positions under four types of exposure conditions. Anterior, posterior, right, left, upper, and lower positions 1 cm offset from the center of the FOV were used for the peripheral positions. We evaluated and compared the voxel size, homogeneity, contrast to noise ratio (CNR), and the 10% point of the modulation transfer function (MTF10%) of the center and periphery. Because the voxel size, which is determined by the Nyquist frequency, was within tolerance, other image quality indexes were not influenced by the voxel size. For the CNR, homogeneity, and MTF10%, there were peripheral positions which showed considerable differences with statistical significance. The average difference between the center and periphery was up to 31.27% (CNR), 70.49% (homogeneity), and 13.64% (MTF10%). Homogeneity was under tolerance at some of the peripheral locations. Because the CNR, homogeneity, and MTF10% were significantly affected by positional changes of the phantom, an object's position can influence the interpretation of follow up CBCT images. Therefore, efforts to locate the object in the same position are important.
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Affiliation(s)
- Jae Joon Hwang
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyok Park
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University, Seoul, Korea
| | - Ho-Gul Jeong
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University, Seoul, Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University, Seoul, Korea
- * E-mail:
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Interdisciplinary management of an isolated intrabony defect. Case Rep Dent 2014; 2014:672152. [PMID: 25506437 PMCID: PMC4259138 DOI: 10.1155/2014/672152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 10/12/2014] [Indexed: 11/17/2022] Open
Abstract
The treatment of intrabony defects is a real challenge in molar teeth as it is chronic, slowly progressing disease which needs timely intervention. Periodontal inflammation associated with intrabony defect is not a separate entity as it secondarily affects the pulp causing retrograde pulpitis. However, treatment of these lesions will be complicated due to extensive bone loss. The tooth was endodontically treated followed by periodontal surgery to eliminate the deep periodontal pocket and promote bone fill in osseous defect. PepGen P-15 composited with platelet rich plasma was utilized for enhancing bone formation. The combination of these graft materials provides synergistic effect on bone regeneration.
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Sharma R, Hegde V, Siddharth M, Hegde R, Manchanda G, Agarwal P. Endodontic-periodontal microsurgery for combined endodontic-periodontal lesions: An overview. J Conserv Dent 2014; 17:510-6. [PMID: 25506135 PMCID: PMC4252921 DOI: 10.4103/0972-0707.144571] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 08/24/2014] [Accepted: 09/19/2014] [Indexed: 12/28/2022] Open
Abstract
Endodontic and periodontal microsurgery has surpassed the success rates for traditional endodontic and periodontal surgical procedures. Excellent healing results are being attributed to both the techniques, when employed, for isolated endodontic or periodontal defects. Combined endodontic-periodontal lesions have been referred to as a true challenge, requiring not only endodontic microsurgical management but also concurrent bone grafting and membrane barriers techniques. The prevention of epithelial downgrowth and regeneration of periodontal cementum, fiber, and bone seals the fate of these cases. Achieving primary closure with submergence of grafts has a positive effect on GTR outcome. New techniques of periodontal microsurgery, such as minimally invasive papilla preserving flaps with passive internal mattress suturing, have managed to obtain 90% primary flap closure over grafted sites. Root surface treatment and conditioning has also shown to be beneficial for GTR. Endodontic microsurgery for the combined lesion has not integrated these advances yet. These advances, along with a recently suggested treatment strategy, are ushering in the level next in management of the combined lesions. This article offers an overview of the combined lesion, the disease, its classification, treatment strategy, regenerative tools, microsurgical recommendations, and outcome studies.
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Affiliation(s)
- Ritu Sharma
- Department of Conservative Dentistry and Endodontics, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Vivek Hegde
- Department of Conservative Dentistry and Endodontics, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - M Siddharth
- Department of Periodontics, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Rashmi Hegde
- Department of Periodontics, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Gunsha Manchanda
- Department of Conservative Dentistry and Endodontics, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Pratul Agarwal
- Department of Conservative Dentistry and Endodontics, Sharda University, Greater Noida, Uttar Pradesh, India
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Karunakar P, Prasanna JS, Jayadev M, Shravani GS. Platelet-rich fibrin, "a faster healing aid" in the treatment of combined lesions: A report of two cases. J Indian Soc Periodontol 2014; 18:651-5. [PMID: 25425831 PMCID: PMC4239759 DOI: 10.4103/0972-124x.142467] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 02/10/2014] [Indexed: 11/22/2022] Open
Abstract
Anatomically the pulp and periodontium are connected through apical foramen, and the lateral, accessory, and furcal canals. Diseases of one tissue may affect the other. In the present case report with two cases, a primary periodontal lesion with secondary endodontic involvement is described. In both cases, root canal treatment was done followed by periodontal therapy with the use of platelet-rich fibrin (PRF) as the regenerative material of choice. PRF has been a breakthrough in the stimulation and acceleration of tissue healing. It is used to achieve faster healing of the intrabony defects. Absence of an intraradicular lesion, pain, and swelling, along with tooth stability and adequate radiographic bone fill at 9 months of follow-up indicated a successful outcome.
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Affiliation(s)
- Parupalli Karunakar
- Department of Conservative Dentistry and Endodontics, Panineeya Mahavidhyalaya Institute of Dental Sciences and Research Center, Hyderabad, Andhra Pradesh, India
| | - Jammula Surya Prasanna
- Department of Periodontics, Panineeya Mahavidhyalaya Institute of Dental Sciences and Research Center, Hyderabad, Andhra Pradesh, India
| | - Matapathi Jayadev
- Department of Conservative Dentistry and Endodontics, Panineeya Mahavidhyalaya Institute of Dental Sciences and Research Center, Hyderabad, Andhra Pradesh, India
| | - Guniganti Sushma Shravani
- Department of Conservative Dentistry and Endodontics, Panineeya Mahavidhyalaya Institute of Dental Sciences and Research Center, Hyderabad, Andhra Pradesh, India
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Jansson L. Relationship between apical periodontitis and marginal bone loss at individual level from a general population. Int Dent J 2014; 65:71-6. [PMID: 25412991 DOI: 10.1111/idj.12143] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
AIM To study the relationship between the presence of apical periodontitis in root-filled teeth and marginal bone loss (MBL) in individual subjects from a general population. MATERIALS AND METHODS The study was conducted on a sample of 1,152 dentate individuals (participants in an epdemiological investigation) who were subjected to clinical and radiographic investigations. The presence of root fillings and apical periodontitis were registered. MBL was measured mesially and distally at all roots. The MBL index of the subject was defined as the mean MBL value at all measurable points in the same individual. Multiple regression analysis was adopted to calculate the influence of the presence of apical periodontitis and potential confounders on the dependent variable, MBL index. RESULTS There was a significant correlation between MBL and the percentage of root-filled teeth and the percentage of root-filled teeth with apical periodontitis. The results of the multiple regression analysis showed that the relative frequency of root-filled teeth with apical periodontitis was significantly higher in subjects with more MBL, irrespective of age, number of remaining teeth, relative frequency of root-filled teeth and smoking habits. CONCLUSIONS A significant association between the presence of apical and marginal periodontitis in individual subjects was found. The mechanisms behind the associations between these diseases are unknown and this cross-sectional observational study did not permit distinction between cause and effect. It is hoped that future cohort studies may provide more knowledge about the biological actions behind the relationship between apical and marginal disease.
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Affiliation(s)
- Leif Jansson
- Departments of Periodontology, Public Dental Service at Kista and Skanstull, Stockholm County Council, Stockholm, Sweden; Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Nakahara Y, Ozaki K, Sano T, Kodama Y, Matsuura T. Assessment of Alloxan-Induced Diabetic Rats as a Periodontal Disease Model Using a Selective Cyclooxygenase (COX)-2 Inhibitor. J Toxicol Pathol 2014; 27:123-9. [PMID: 25352713 PMCID: PMC4110936 DOI: 10.1293/tox.2013-0064] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 02/06/2014] [Indexed: 02/03/2023] Open
Abstract
Several recent studies have reported that alloxan-treated rats with long-term
hyperglycemia can develop naturally occurring periodontal disease (PD). Our previous
studies detected dental caries in the same model. Therefore, these two lesions of
different etiologies are expected to occur concurrently. In this study, we evaluated the
use of diabetic rats as a PD model by employing a selective COX-2 inhibitor reported to be
effective against PD. Six-week-old female F344 rats were divided into 3 groups: intact
rats (control), alloxan-induced diabetic rats fed a standard diet (AL) and alloxan-induced
diabetic rats fed a diet containing 0.01% etodolac (AL+Et). The animals were euthanized at
26 weeks of age, and their oral tissues were examined histopathologically. Gingivitis,
marginal periodontitis and alveolar bone resorption were markedly enhanced along with
dental caries in the AL group compared with the control group. However, the COX-2
inhibitor had no effect on periodontal inflammation in the AL+Et group. In addition, in
the AL group, periodontitis was notably nonexistent around the normal molars, and
gingivitis was scarcely worse than that in the control group. In the diabetic rats, the
progression of periodontal inflammation was closely correlated with the severity of
adjacent dental caries, and marginal periodontitis was frequently continuous with apical
periodontitis. In conclusion, an alloxan-induced diabetic rat is not a model of PD but of
dental caries. It is probable that in this model, hyperglycemia may enable crown caries to
progress to apical periodontitis, while the associated inflammation may rostrally expand
to surrounding periodontal tissue.
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Affiliation(s)
- Yutaka Nakahara
- Department of Pathology, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka 573-0101, Japan
| | - Kiyokazu Ozaki
- Department of Pathology, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka 573-0101, Japan
| | - Tomoya Sano
- Department of Pathology, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka 573-0101, Japan
| | - Yasushi Kodama
- Laboratory of Clinicopathological Therapeutics, Faculty of Pharmaceutical Sciences, Hiroshima International University, 5-1-1 Hirokoshingai, Kure, Hiroshima 737-0112, Japan
| | - Tetsuro Matsuura
- Department of Pathology, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka 573-0101, Japan
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Pai AV, Khosla M. Root resection under the surgical field employed for extraction of impacted tooth and management of external resorption. J Conserv Dent 2012; 15:298-302. [PMID: 22876023 PMCID: PMC3410346 DOI: 10.4103/0972-0707.97966] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 03/10/2012] [Accepted: 03/13/2012] [Indexed: 11/24/2022] Open
Abstract
This case report illustrates determination of prognosis and immediate resection carried out, before completing the endodontic therapy, during the surgery employed for managing a nonperiodontal problem. This case showed external pressure resorption in the distobuccal root of maxillary second molar caused by the impingement of impacted third molar. Extraction of third molar was decided when healing was not seen, despite initiating endodontic therapy in second molar. Following elevation of flap and extraction of third molar, the poor prognosis due to severe bone loss around the resorbed root was evident. But due to strategic value of second molar, it was found beneficial to employ resection. Therefore, immediate resection was carried out in the same surgical field before the completion of endodontic therapy. This prevented the need for another surgical entry with its associated trauma to carry out resection separately later. Resection followed by the completion of endodontic therapy and full crown assisted in salvaging the remaining functional portion of the tooth and prevented the occurrence of distal extension with its potential drawbacks.
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Affiliation(s)
- Ar Vivekananda Pai
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences (Manipal University), Mangalore, India
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Jha P, Jha M. Management of congenitally missing second premolars in a growing child. J Conserv Dent 2012; 15:187-90. [PMID: 22557822 PMCID: PMC3339018 DOI: 10.4103/0972-0707.94577] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 10/05/2011] [Accepted: 12/06/2011] [Indexed: 11/23/2022] Open
Abstract
The second premolars have the highest incidence of congenital absence, after the third molars. The problem resides not in the prevalence of congenitally missing premolars but in the selection of a treatment plan that will yield the best results over the long term. The present study reports a case of a 14 year old female patient with bilaterally congenitally missing second mandibular premolars with associated crowding of teeth. The case has been managed using a multi-speciality approach, in which both deciduous mandibular second molars were sectioned and the distal half retained. The retained half was prepared to receive a full coverage restoration which was contoured as a premolar. The space created was then utilized to correct the crowding by fixed orthodontics. A two year follow up shows retained distal half of the deciduous mandibular second molar with correction of crowding and space closure.
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Affiliation(s)
- Padmanabh Jha
- Department of Conservative Dentistry and Endodontics, Subharti Dental College, Meerut, Uttar Pradesh, India
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