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Manaktala M, Taneja S, Bhalla VK. Stress distribution in endodontically treated external cervical resorption lesions restored with MTA and biodentine - A finite element analysis. J Oral Biol Craniofac Res 2024; 14:415-422. [PMID: 38832294 PMCID: PMC11144738 DOI: 10.1016/j.jobcr.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/25/2024] [Accepted: 04/30/2024] [Indexed: 06/05/2024] Open
Abstract
Introduction Root resorption poses a significant challenge in dental practice, with external cervical resorption (ECR) being a common manifestation. ECR is often asymptomatic until advanced stages, complicating its diagnosis and management. Various factors contribute to its etiology, ranging from trauma to orthodontic treatment. The classification system proposed by Patel et al. (2018) offers a comprehensive framework for characterizing ECR lesions based on location and extent. Treatment strategies for ECR involve a combination of endodontic intervention and restorative techniques, with bioactive materials like mineral trioxide aggregate (MTA) and Biodentine emerging as promising options. However, the biomechanical behavior of teeth restored with these materials in the context of ECR remains underexplored. Materials and methods This study utilized finite element analysis (FEA) to assess stress distribution in teeth with simulated ECR lesions of varying sizes and locations, restored with MTA or Biodentine. Three-dimensional models of maxillary central incisors were generated based on CBCT scans, incorporating periodontal ligament and surrounding bone structures. Eight experimental models representing different ECR configurations were created and subjected to FEA using Optistruct software based on dimensional classification given by Patel et al., in 2018, A70 M & A70B: 1Ap, A130 M & A130B: 1Bp, B70 M & B70B: 2Ap, B130 M & B130B: 2Bp. All the models were tested for stress distribution by restoring the lesions with either M: MTA or B: Biodentine. Oblique load of 100 N was applied at 45°angle to the long axis 2 mm lingual to incisal edge. vonMises Stress distribution in enamel, dentine, restoration and at all the interfaces were observed. Results The analysis revealed that both MTA and Biodentine restorations exhibited uniform stress distribution around ECR lesions, with no significant differences based on lesion location or size. Maximum stress concentrations were observed around the restorations, particularly in subcrestal lesions. However, overall stress levels were comparable between MTA and Biodentine restorations, indicating similar biomechanical performance. Conclusion Finite element analysis provides valuable insights into the biomechanical behavior of teeth with ECR lesions restored with MTA and Biodentine. Both materials exhibit similar stress distribution patterns and offer adequate reinforcement against mechanical forces. Clinicians can confidently utilize MTA or Biodentine in the management of ECR, considering their favorable biomechanical properties and clinical outcomes. Further research is necessary to validate these findings and optimize treatment protocols for ECR.
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Affiliation(s)
| | - Sonali Taneja
- Dept. Of Conservative Dentistry and Endodontics, I.T.S Dental College, Ghaziabad, India
| | - Vidhi Kiran Bhalla
- Dept. Of Conservative Dentistry and Endodontics, I.T.S Centre for Dental Studies and Research, Ghaziabad, India
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Toledano-Osorio M, Aguilera FS, Muñoz-Soto E, Osorio E, Toledano M, Escames G, Medina-Castillo AL, Osorio MT, López-López MT, Vallecillo-Rivas M, Osorio R. Melatonin-doped polymeric nanoparticles induce high crystalline apatite formation in root dentin. Dent Mater 2021; 37:1698-1713. [PMID: 34544591 DOI: 10.1016/j.dental.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/04/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the effect of novel polymeric nanoparticles (NPs) doped with melatonin (ML) on nano-hardness, crystallinity and ultrastructure of the formed hydroxyapatite after endodontic treatment. METHODS Undoped-NPs and ML-doped NPs (ML-NPs) were tested at radicular dentin, after 24 h and 6 m. A control group without NPs was included. Radicular cervical and apical dentin surfaces were studied by nano-hardness measurements, X-ray diffraction and transmission electron microscopy. Mean and standard deviation were analyzed by ANOVA and Student-Newman-Keuls multiple comparisons (p < 0.05). RESULTS Cervical dentin treated with undoped NPs maintained its nano-hardness values after 6 m of storage being [24 h: 0.29 (0.01); 6 m: 0.30 (0.02) GPa], but it decreased at apical dentin [24 h: 0.36 (0.01); 6 m: 0.28 (0.02) GPa]. When ML-NPs were used, nano-hardness was similar over time [24h: 0.31 (0.02); 6 m: 0.28 (0.03) GPa], at apical dentin. Root dentin treated with ML-NPs produced, in general, high crystallinity of new minerals and thicker crystals than those produced in the rest of the groups. After 6 m, crystals became organized in randomly oriented polyhedral, square polygonal block-like apatite or drop-like apatite polycrystalline lattices when ML-NPs were used. Undoped NPs generated poor crystallinity, with preferred orientation of small crystallite and increased microstrain. SIGNIFICANCE New polycrystalline formations encountered in dentin treated with ML-NPs may produce structural dentin stability and high mechanical performance at the root. The decrease of mechanical properties over time in dentin treated without NPs indicates scarce remineralization potential, dentin demineralization and further potential degradation. The amorphous stage may provide high hydroxyapatite solubility and remineralizing activity.
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Affiliation(s)
- Manuel Toledano-Osorio
- University of Granada, Department of Stomatology, Colegio Máximo de Cartuja s/n, Granada 18071, Spain
| | - Fátima S Aguilera
- University of Granada, Department of Stomatology, Colegio Máximo de Cartuja s/n, Granada 18071, Spain
| | - Esther Muñoz-Soto
- University of Granada, Department of Stomatology, Colegio Máximo de Cartuja s/n, Granada 18071, Spain
| | - Estrella Osorio
- University of Granada, Department of Stomatology, Colegio Máximo de Cartuja s/n, Granada 18071, Spain
| | - Manuel Toledano
- University of Granada, Department of Stomatology, Colegio Máximo de Cartuja s/n, Granada 18071, Spain.
| | - Germaine Escames
- Faculty of Medicine, Department of Physiology, Biomedical Research Center, CIBERFES, Ibs. San Cecilio University Hospital, University of Granada, Granada, Spain
| | - Antonio L Medina-Castillo
- University of Granada, NanoMyP, Spin-Off Enterprise, Edificio BIC-Granada, Av. Innovación 1, 18016, Armilla, Granada, Spain
| | | | - Modesto T López-López
- University of Granada, Faculty of Science, Applied Physics Department, Av. Fuente Nueva s/n, 18071 Granada, Spain
| | - Marta Vallecillo-Rivas
- University of Granada, Department of Stomatology, Colegio Máximo de Cartuja s/n, Granada 18071, Spain
| | - Raquel Osorio
- University of Granada, Department of Stomatology, Colegio Máximo de Cartuja s/n, Granada 18071, Spain
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Melatonin-doped polymeric nanoparticles reinforce and remineralize radicular dentin: Morpho-histological, chemical and biomechanical studies. Dent Mater 2021; 37:1107-1120. [PMID: 33846017 DOI: 10.1016/j.dental.2021.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/15/2021] [Accepted: 03/28/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To investigate the effectiveness of novel polymeric nanoparticles (NPs) doped with melatonin (ML) in reducing dentin permeability and facilitating dentin remineralization after endodontic treatment. METHODS The effect of undoped NPs and ML-doped NPs (ML-NPs) was tested in radicular dentin, at 24 h and 6 m. A control group without NPs was included. ML liberation was measured. Radicular dentin was assessed for fluid filtration. Dentin remineralization was analyzed by scanning electron microscopy, AFM, Young's modulus (Ei), Nano DMA-tan delta, and Raman analysis. RESULTS ML release ranged from 1.85 mg/mL at 24 h to 0.033 mg/mL at 28 d. Both undoped NPs and ML-NPs treated dentin exhibited the lowest microleakage, but samples treated with ML-NPs exhibited hermetically sealed dentinal tubules and extended mineral deposits onto dentin. ML-NPs promoted higher and durable Ei, and functional remineralization at root dentin, generating differences between the values of tan delta among groups and creating zones of stress concentration. Undoped-NPs produced closure of some tubules and porosities at the expense of a relative mineral amorphization. Chemical remineralization based on mineral and organic assessments was higher in samples treated with ML-NPs. When using undoped NPs, precipitation of minerals occurred; however, radicular dentin was not mechanically reinforced but weakened over time. SIGNIFICANCE Application of ML-NPs in endodontically treated teeth, previous to the canal filling step, is encouraged due to occlusion of dentinal tubules and the reinforcement of the radicular dentin structure.
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Toledano M, Vallecillo-Rivas M, Aguilera FS, Osorio MT, Osorio E, Osorio R. Polymeric zinc-doped nanoparticles for high performance in restorative dentistry. J Dent 2021; 107:103616. [PMID: 33636241 DOI: 10.1016/j.jdent.2021.103616] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/19/2021] [Accepted: 02/21/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES The aim was to state the different applications and the effectiveness of polymeric zinc-doped nanoparticles to achieve dentin remineralization. DATA, SOURCES AND STUDY SELECTION Literature search was conducted using electronic databases, such as PubMed, MEDLINE, DIMDI, Embase, Scopus and Web of Science. A narrative exploratory review was undertaken. CONCLUSIONS Polymeric nanospheres (NPs) were efficiently loaded with zinc. NPs sequestered calcium and phosphate in the presence of silicon, and remained effectively embedded at the hybrid layer. NPs incorporation did not alter bond strength and inhibited MMP-mediated dentin collagen degradation. Zn-loaded NPs remineralized the hybrid layer inducing a generalized low-carbonate substitute apatite precipitation, chemically crystalline with some amorphous components, and an increase in mechanical properties was also promoted. Viscoelastic analysis determined that dentin infiltrated with Zn-NPs released the stress by breaking the resin-dentin interface and creating specific mineral formations in response to the energy dissipation. Bacteria were scarcely encountered at the resin-dentin interface. The combined antibacterial and remineralizing effects, when Zn-NPs were applied, reduced biofilm formation. Zn-NPs application at both cervical and radicular dentin attained the lowest microleakage and also promoted durable sealing ability. The new zinc-based salt minerals generated covered the dentin surface totally occluding cracks, porosities and dentinal tubules. CLINICAL SIGNIFICANCE Zinc-doped NPs are proposed for effective dentin remineralization and tubular occlusion. This offers new strategies for regeneration of eroded cervical dentin, effective treatment of dentin hypersensitivity and in endodontically treated teeth previous to the canal filling. Zn-NPs also do reduce biofilm formation due to antibacterial properties.
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Affiliation(s)
- Manuel Toledano
- University of Granada, Faculty of Dentistry, Dental Materials Section. Colegio Máximo de Cartuja s/n, Granada, 18071, Spain.
| | - Marta Vallecillo-Rivas
- University of Granada, Faculty of Dentistry, Dental Materials Section. Colegio Máximo de Cartuja s/n, Granada, 18071, Spain
| | - Fátima S Aguilera
- University of Granada, Faculty of Dentistry, Dental Materials Section. Colegio Máximo de Cartuja s/n, Granada, 18071, Spain
| | - María T Osorio
- University of Granada, Faculty of Dentistry, Dental Materials Section. Colegio Máximo de Cartuja s/n, Granada, 18071, Spain
| | - Estrella Osorio
- University of Granada, Faculty of Dentistry, Dental Materials Section. Colegio Máximo de Cartuja s/n, Granada, 18071, Spain
| | - Raquel Osorio
- University of Granada, Faculty of Dentistry, Dental Materials Section. Colegio Máximo de Cartuja s/n, Granada, 18071, Spain
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Endodontic Retreatment and Comprehensive Endo-Prosthetic of Premolars: A Case Report. JOURNAL OF BIOMIMETICS BIOMATERIALS AND BIOMEDICAL ENGINEERING 2020. [DOI: 10.4028/www.scientific.net/jbbbe.48.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background: The failure of endodontic treatment caused by failure of the restoration and bacterial invation. Alongside proper chemical and mechanical preparation and hermetic obturation of the root canal system, another essential factor is ensuring a permanent and hermetically-sealed restoration following endodontic treatment. Endodontic retreatment encompasses the efforts to salvage a failing previously endodontically treated tooth. As a result of advances in endodontic materials and adhesive systems, restorations in the form of fiber post and adhesively cemented crown are becoming a choice in cases of teeth that have extensive damage. Case: A case is presented a 45-year-old female was referred to Prof. Soedomo Dental Hospital with a complaint of pain in mandibular second premolar which was earlier endodontically treated. Clinical and radiographic examinations showed damaged restorations, gutta percha filling that are not hermetic and radiolucent on periapical. A successful endodontic retreatment premolar using rotary retreatment file and preparation with crown down technique using rotary progressive multiple tapering file, with comprehensive endo-prosthetic treatment using prefabricated fiber post and porcelain fused to metal crown. Conclusion: Clinical and radiographic evaluation after 6 months showed complete healing and good adaptation of the restoration. The outcomes of this case showed that failure of endodontic retreatment respond favorably to endodontic retreatment, with proper indication, prefabricated fiber post and porcelain fused to metal crown can provide an effective conservative and esthetic option for reinforcing endodontically treated teeth.
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Pai S, Bhat V, Patil V, Naik N, Awasthi S, Nayak N. Numerical Three-dimensional Finite Element Modeling of Cavity Shape and Optimal Material Selection by Analysis of Stress Distribution on Class V Cavities of Mandibular Premolars. J Int Soc Prev Community Dent 2020; 10:279-285. [PMID: 32802773 PMCID: PMC7402252 DOI: 10.4103/jispcd.jispcd_75_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/12/2020] [Accepted: 04/02/2020] [Indexed: 11/13/2022] Open
Abstract
Aim: Adhesive restoration does not depend primarily on the configuration of the shape of the cavity. Under varying loading conditions, it is essential to know the stress concentration and load transfer mechanism for distinct cavity shapes. The aim of this study was to evaluate and compare the biomechanical characteristics of various cavity shapes, namely oval, elliptical, trapezoidal, and rectangular shapes of class V cavities on mandibular premolars restored with amalgam, glass ionomer cement, and Cention N using three-dimensional (3D) finite element analysis. Materials and Methods: A 3D prototype of a mandibular premolar was generated by Digital Imaging and Communications in Medicine (DICOM) images obtained from the cone beam computed tomography and imported to 3D modeling software tool, SpaceClaim. The four distinct load magnitudes of 100, 150, 200, and 250N were applied as a pressure load perpendicular to the lingual plane of the lingual cusp of the occlusal surface (normal load) and at 45° to same (oblique load). The stress distribution patterns and the maximum von Mises stresses were analyzed and compared. Results: The occlusal stresses were distributed from the force loading point in an approximate actinomorphic pattern, and when the force load was close to the margin, the stress was much greater. Conclusion: Ovoid cavity showed lesser stress concentration and deformation for each of the tested restorative material.
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Affiliation(s)
- Swathi Pai
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal, Karnataka, India
| | - Vishal Bhat
- Department of Pharmacology, Melaka Manipal Medical College, Manipal, Karnataka, India
| | - Vathsala Patil
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - Nithesh Naik
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Swetank Awasthi
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Nithin Nayak
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Hydroxyapatite-based cements induce different apatite formation in radicular dentin. Dent Mater 2020; 36:167-178. [DOI: 10.1016/j.dental.2019.11.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 11/04/2019] [Accepted: 11/15/2019] [Indexed: 01/22/2023]
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Toledano M, Osorio E, Aguilera FS, Muñoz-Soto E, Toledano-Osorio M, López-López MT, Medina-Castillo AL, Carrasco-Carmona Á, Osorio R. Polymeric nanoparticles for endodontic therapy. J Mech Behav Biomed Mater 2019; 103:103606. [PMID: 32090933 DOI: 10.1016/j.jmbbm.2019.103606] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/19/2019] [Accepted: 12/23/2019] [Indexed: 11/16/2022]
Abstract
The effectiveness of novel polymeric nanoparticles (NPs) application in reducing dentin permeability and facilitating dentin remineralization after endodontic treatment was evaluated. The effect of undoped NPs, zinc, calcium and doxycycline-doped NPs (Zn-NPs, Ca-NPs and D-NPs, respectively) was tested in radicular dentin. A control group without NPs was included. Radicular dentin was assessed for fluid filtration. Dentin remineralization was analyzed by scanning and transmission electron microscopy, energy-dispersive analysis, AFM, Young's modulus (Ei), Nano DMA, Raman, and X-Ray Diffraction analysis. Ca-NPs and Zn-NPs treated dentin exhibited the lowest microleakage with hermetically sealed dentinal tubules and a zinc-based salt generation onto dentin. Zn-NPs favored crystallinity and promoted the highest Ei and functional remineralization at the apical dentin, generating differences between the values of complex modulus among groups. Ca-NPs produced closure of tubules and porosities at the expense of a relative mineral amorphization, without creating zones of stress concentration. The highest sealing efficacy was obtained in Zn-NPs-treated samples, along with the highest values of Young's modulus and dentin mineralization. These high values of Ei were obtained by closing voids, cracks, pores and tubules, and by strengthening the root dentin. When using undoped NPs or Ca-NPs, deposition of minerals occurred, but radicular dentin was not mechanically reinforced. Therefore, application of Zn-NPs in endodontically treated teeth previous to the canal filling is encouraged.
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Affiliation(s)
- Manuel Toledano
- University of Granada, Faculty of Dentistry, Dental Materials Section, Colegio Máximo de Cartuja S/n, Granada, 18071, Spain
| | - Estrella Osorio
- University of Granada, Faculty of Dentistry, Dental Materials Section, Colegio Máximo de Cartuja S/n, Granada, 18071, Spain
| | - Fátima S Aguilera
- University of Granada, Faculty of Dentistry, Dental Materials Section, Colegio Máximo de Cartuja S/n, Granada, 18071, Spain
| | - Esther Muñoz-Soto
- University of Granada, Faculty of Dentistry, Dental Materials Section, Colegio Máximo de Cartuja S/n, Granada, 18071, Spain
| | - Manuel Toledano-Osorio
- University of Granada, Faculty of Dentistry, Dental Materials Section, Colegio Máximo de Cartuja S/n, Granada, 18071, Spain.
| | - Modesto T López-López
- University of Granada, Faculty of Science, Applied Physics Department, Fuente Nueva S/n, Granada, 18071, Spain
| | - Antonio L Medina-Castillo
- NanoMyP, Spin-Off Enterprise from University of Granada, Edificio BIC-Granada, Avda. Innovación 1, Armilla, Granada, 18016, Spain
| | - Álvaro Carrasco-Carmona
- University of Granada, Faculty of Dentistry, Dental Materials Section, Colegio Máximo de Cartuja S/n, Granada, 18071, Spain
| | - Raquel Osorio
- University of Granada, Faculty of Dentistry, Dental Materials Section, Colegio Máximo de Cartuja S/n, Granada, 18071, Spain
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Toledano M, Muñoz-Soto E, Aguilera FS, Osorio E, Pérez-Álvarez MC, García-Menocal JAD, Toledano-Osorio M, Osorio R. The mineralizing effect of zinc oxide-modified hydroxyapatite-based sealer on radicular dentin. Clin Oral Investig 2019; 24:285-299. [DOI: 10.1007/s00784-019-02938-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/02/2019] [Indexed: 11/30/2022]
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