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Patel S, Abella F, Patel K, Lambrechts P, Al-Nuaimi N. Clinical and radiographic features of external cervical resorption - An observational study. Int Endod J 2023; 56:1475-1487. [PMID: 37801348 DOI: 10.1111/iej.13968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/30/2023] [Accepted: 08/17/2023] [Indexed: 10/07/2023]
Abstract
AIM To determine the prevalence of symptoms, clinical signs and radiographic presentation of external cervical resorption (ECR). METHODOLOGY This study involved 215 ECR lesions in 194 patients referred to the Endodontic postgraduate Unit at King's College London or Specialist Endodontic practice (London, UK). The clinical and radiographic findings (periapical [PA] and cone beam computed tomography [CBCT]) were readily accessible for evaluation. A checklist was used for data collection. Inferential analysis was carried out to determine if there was any potential association between type and location of tooth in the jaw as well as sex, age of the patient and ECR presentation and radiographic feature. RESULTS Eighty-eight patients (94 teeth) were female and 106 patients were male (121 teeth), the mean age (±SD) was 41.5 (±17.7) years. Fifteen patients (7.7%) had more than one ECR lesion. The most affected teeth were maxillary central incisors (21.4% [46 teeth]) and mandibular first molars (10.2% [22 teeth]). ECR was most commonly detected as an incidental radiographic finding in 58.1% [125 teeth] of the cases. ECR presented with symptoms of pulpal/periapical disease in 23.3% [n = 50] and clinical signs (e.g. pink spot, cavitation) in 16.7% [36 teeth] of the cases. Clinical signs such as cavitation (14%), pink spot (5.1%) and discolouration (2.8%) were uncommon, but their incidence increased up to 24.7% when combined with other clinical findings. ECR was detected in the resorptive and reparative phases in 70.2% and 29.8% of the cases respectively. CONCLUSION ECR appears to be quiescent in nature, the majority being asymptomatic and diagnosed incidentally from PA or CBCT. When assessed with the Patel classification, most lesions were minimal to moderate in relation to their height (1 or 2) and circumferential spread (A or B). However, the majority of ECRs were in (close) proximity to the pulp. Symptoms and clinical signs were associated with (probable) pulp involvement rather than the height and circumferential spread of the lesion. Clinical signs were more frequently associated when ECR affected multiple surfaces.
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Affiliation(s)
- Shanon Patel
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
- Private Practice, London, UK
- Guy's & St. Thomas', NHS Trust, London, UK
| | | | - Kreena Patel
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Paul Lambrechts
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Nassr Al-Nuaimi
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
- Department of Restorative & Aesthetic Dentistry, College of Dentistry, University of Baghdad, Baghdad, Iraq
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Rodrigues CT, Jacobs R, Ezeldeen M, Vasconcelos KDF, Lambrechts P, Tanomaru Filho M, Pinto JC, Duarte MAH. How does nano-focus computed tomography impact the quantification of debris within the root canal system? Braz Oral Res 2023; 37:e059. [PMID: 37341232 DOI: 10.1590/1807-3107bor-2023.vol37.0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 01/05/2023] [Indexed: 06/22/2023] Open
Abstract
The aim of this study was to compare the quantification of hard-tissue debris by using micro-computed tomography (micro-CT) and nano-focus computed tomography (nano-CT) after root canal instrumentation. Ten mandibular molars containing an isthmus in the mesial root were scanned in a SkyScan 1172 micro-CT device with a voxel size of 12.8 µm and in a NanoTom nano-CT device with 5.5 µm. The mesial root canals were irrigated with 5 mL of saline solution at the orifice level, instrumented with Reciproc R25 files and a second scanning was performed by micro-CT and nano-CT devices for post-instrumentation images. DataViewer software was used for registering the pre- and post-operative micro-CT and nano-CT images. The root canal and the debris were segmented for quantitative analysis of the volume of the canal and volume of debris using CTAn software. Statistical analysis was performed using the T test for comparison between volume of the canal after instrumentation and volume of debris in both image modalities. The level of significance was set at p < 0.05. Nano-CT images showed higher values of debris when compared with micro-CT (p < 0.05) after root canal instrumentation. No difference was observed between the volume of the root canal after instrumentation in the two imaging methods used (p > 0.05). Nano-CT technology can be recommended as a more precise method for quantitative analysis of hard-tissue debris. Moreover, in Endodontic research it is a promising method, as it is capable of providing higher spatial and contrast resolution, faster scanning and higher image quality.
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Affiliation(s)
- Clarissa Teles Rodrigues
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
| | - Reinhilde Jacobs
- University Hospitals Leuven, Faculty of Medicine, Department of Imaging and Pathology, Leuven, Belgium
| | - Mostafa Ezeldeen
- University Hospitals Leuven, Faculty of Medicine, Department of Imaging and Pathology, Leuven, Belgium
| | | | - Paul Lambrechts
- University Hospitals Leuven, KU Leuven and Dentistry, Department of Oral Health Sciences, Endodontology, Leuven, Belgium
| | - Mario Tanomaru Filho
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | - Jader Camilo Pinto
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
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Torres A, Dierickx M, Coucke W, Pedano MS, Lambrechts P, Jacobs R. Ex-vivo and in-vivo validation of a novel measuring protocol for guided endodontics. J Dent 2023:104566. [PMID: 37263407 DOI: 10.1016/j.jdent.2023.104566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/23/2023] [Accepted: 05/27/2023] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES To (1) validate the use of a post-operative intraoral scan (IOS) versus Cone Beam Computed Tomography (CBCT), gold standard, on its ability to measure the accuracy of guided endodontics, and (2) present clinical data on the accuracy of guided endodontics. METHODS Four models, including 10 extracted teeth each, were created. Forty guided access cavities were planned on dentin to simulate pulp canal obliteration (PCO). Two operators performed guided access cavities. A post-operative CBCT and IOS were acquired. The deviation coronally, apically, and angular deviation was measured with CBCT and IOS. Clinical accuracy was measured using an IOS acquired immediately after drilling the access cavity with the aid of a guide. Data analysis was performed using multiway Anova and corrected for simultaneous hypothesis testing according to Tukey. P ≤ 0.05 was considered statistically significant. Descriptive statistics on the clinical accuracy of guided endodontics were performed. RESULTS Thirty-eight cavities were assessed with a mean length of 13.8 mm. No statistical difference between operators and methods was found for all parameters (P > 0.05). Thirty-three patients were treated with guided endodontics and measured using an IOS. Results show an average coronal, apical, and angular deviation of 0.2 mm, 0.45 mm, and 1.91° respectively. The average length of the access cavities was 12.5 mm. CONCLUSIONS An IOS can be used to measure the accuracy of guided endodontics. Clinical data showed high accuracy of guided endodontics with a mean apical deviation smaller than 0.5 mm and a mean angular deviation of less than 2°. CLINICAL SIGNIFICANCE The use of an IOS does not involve additional radiation exposure. A safety margin of at least 1 mm around the planned trajectory should be respected when planning the case to minimize the possibility of root perforation.
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Affiliation(s)
- A Torres
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - M Dierickx
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - W Coucke
- Certified Freelance Statistician, Heverlee, Belgium.
| | - M S Pedano
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - P Lambrechts
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - R Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Torres A, Dierickx M, Coucke W, Pedano MS, Lambrechts P, Jacobs R. In vitro study on the accuracy of sleeveless guided endodontics and treatment of a complex upper lateral incisor. J Dent 2023; 131:104466. [PMID: 36804580 DOI: 10.1016/j.jdent.2023.104466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/31/2023] [Accepted: 02/16/2023] [Indexed: 02/21/2023] Open
Abstract
PURPOSE The present study aims to assess the accuracy of sleeveless guided endodontics for root canal treatment of severe pulp canal obliteration (PCO) in 3D printed jaws. Additionally, the treatment of a complex lateral incisor is presented to illustrate the use of sleeveless guides in a clinical situation. METHODS Two cone-beam computed tomography (CBCT) volumes of an upper and lower jaw were selected to design 3D printed models with PCO. Virtual planning of the access cavities was performed from right to left second premolar. Then, the models were mounted into a phantom head to simulate an actual patient. Two operators with different levels of experience in endodontics performed guided access cavities. The handpiece was guided by guiding rails placed against each other on the sides of the tooth. A post-operative CBCT scan was taken for analysis. RESULTS Eighty-eight guided access cavities (44 per operator) were drilled on eight 3D printed models. The mean length of the access cavities was 15.3 mm, with a mean coronal and apical deviation of 0.5 mm and 0.7 mm respectively. The mean angular deviation was 1.5°. No statistically significant difference was found between operators for the three measured parameters. CONCLUSIONS This study demonstrates, within its limitations, that sleveless guides represent an accurate method for guided endodontic treatment. No statistically significant difference between operators was found when using the guide. CLINICAL SIGNIFICANCE This method offers a valuable alternative to conventional endodontic guides with similar accuracy results.
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Affiliation(s)
- A Torres
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium; Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - M Dierickx
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - W Coucke
- Certified Freelance Statistician, Heverlee, Belgium.
| | - M S Pedano
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - P Lambrechts
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - R Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Patel S, Krastl G, Weiger R, Lambrechts P, Tjäderhane L, Gambarini G, Teng PH. ESE Position Statement on Root Resorption. Int Endod J 2023. [PMID: 36942472 DOI: 10.1111/iej.13916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/23/2023]
Abstract
This Position Statement on root resorption represents the consensus of an expert committee convened by the European Society of Endodontology (ESE). The statement is based on current clinical and scientific evidence, as well as the expertise of the committee. The aim is to provide clinicians with authoritative information on the aetiology, histopathology, clinical presentation, and recommendations for management of root resorption. It is the intention of the committee to update this position statement at appropriate intervals as further evidence emerges.
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Affiliation(s)
- Shanon Patel
- Department of Endodontology, King's College London, UK
- Specialist Practice, London, UK
| | - Gabriel Krastl
- Department of Conservative Dentistry, Periodontology & Center of Dental Traumatology, Universitatsklinikum Wurburg Frauenklinik und Poloiklinik, Würzburg, Germany
| | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine Basel UZB, Basel, Switzerland
| | - Paul Lambrechts
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Leo Tjäderhane
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Finland & Oulu & University Hospital & University of Oulu, Oulu, Finland
| | | | - Peng-Hui Teng
- Department of Endodontology, King's College London, UK
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Mavridou AM, Rubbers E, Schryvers A, Maes A, Linssen M, Barendregt DS, Bergmans L, Lambrechts P. A clinical approach strategy for the diagnosis, treatment and evaluation of external cervical resorption. Int Endod J 2022; 55:347-373. [PMID: 35034370 DOI: 10.1111/iej.13680] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 11/30/2022]
Abstract
AIM To propose a clinical approach strategy on the diagnosis, treatment, and evaluation of external cervical tooth resorption (ECR) cases. To investigate and discuss the outcome of this approach. METHODOLOGY A clinical approach strategy on ECR was developed based on a retrospective observation study of 542 teeth. 47 teeth were excluded due to lack of clinical/radiographical information, and 182 were immediately extracted. This approach had three steps: diagnosis, treatment planning, and evaluation. During diagnosis, the medical, dental history and clinical/radiographical characteristics were evaluated. Depending on the resorption extent, ECR cases were categorized into four classes according to Heithersay's classification. During treatment planning, a treatment decision flowchart was prepared based on four main decisive criteria: probing feasibility, pain, location and extent of resorption (class), and existence of bonelike tissue. Three treatment options were applied: a) extraction, b) monitoring, or c) conservative treatment by external, internal, or combination of internal-external treatments. During evaluation, assessment of ECR progression, tooth survival and other factors like esthetics and periodontal attachment were performed. Descriptive statistical analysis of the outcome for up to ten years (for the overall clinical approach and for each individual treatment decision), was carried out with OriginLabs OriginPro 9 and Microsoft Excel 365. RESULTS A three-step strategy was developed on how to deal with ECR cases. Indicative examples of each treatment decision were presented and discussed. The overall survival rate of this strategy was 84.6% (3 years), 70.3% (5 years), 42.7% (8 years) and 28.6% (10 years). Higher survival rate was observed for external treatment decision than for internal. The success of each treatment decision depended on the extent of the resorption (class). The success of a treatment decision should be based on the long-term outcome, as a different evolution can be observed with time. CONCLUSIONS A clinical approach strategy was introduced on ECR pathosis. This strategy was not solely based on ECR class, as other important decisive criteria were considered. This step-wise approach, has a 70.3% survival rate with a mean of 5 years. This work will hopefully provide an incentive for a broader collaboration, to potentially establish a universally accepted ECR treatment strategy.
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Affiliation(s)
- A M Mavridou
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospitals Leuven, Leuven, Belgium.,Private practice, Proclin Rotterdam, Rotterdam, The Netherlands
| | - E Rubbers
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospitals Leuven, Leuven, Belgium
| | - A Schryvers
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospitals Leuven, Leuven, Belgium
| | - A Maes
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospitals Leuven, Leuven, Belgium
| | - M Linssen
- Private practice, Proclin Rotterdam, Rotterdam, The Netherlands
| | - D S Barendregt
- Private practice, Proclin Rotterdam, Rotterdam, The Netherlands
| | - L Bergmans
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospitals Leuven, Leuven, Belgium
| | - P Lambrechts
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospitals Leuven, Leuven, Belgium
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Meschi N, EzEldeen M, Garcia AET, Lahoud P, Van Gorp G, Coucke W, Jacobs R, Vandamme K, Teughels W, Lambrechts P. Regenerative Endodontic Procedure of Immature Permanent Teeth with Leukocyte and Platelet-rich Fibrin: A Multicenter Controlled Clinical Trial. J Endod 2021; 47:1729-1750. [PMID: 34400199 DOI: 10.1016/j.joen.2021.08.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/29/2021] [Accepted: 08/03/2021] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The aim of this nonrandomized, multicenter controlled clinical trial was to evaluate the impact of leukocyte-platelet-rich fibrin (LPRF) on regenerative endodontic procedures (REPs) of immature permanent teeth in terms of periapical bone healing (PBH) and further root development (RD). METHODS Healthy patients between 6-25 years with an inflamed or necrotic immature permanent tooth were included and divided between the test (= REP + LPRF) and control (= REP-LPRF) group depending on their compliance and the clinical setting (university hospital or private practice). After receiving REP ± LPRF, the patients were recalled after 3, 6, 12, 24, and 36 months. At each recall session, the teeth were clinically and radiographically (by means of a periapical radiograph [PR]) evaluated. A cone-beam computed tomographic (CBCT) imaging was taken preoperatively and 2 and 3 years postoperatively. PBH and RD were quantitatively and qualitatively assessed. RESULTS Twenty-nine teeth with a necrotic pulp were included, from which 23 (9 test and 14 control) were analyzed. Three teeth in the test group had a flare-up reaction in the first year after REP. Except for 2 no shows, all the analyzed teeth survived up to 3 years after REP, and, in case of failure, apexification preserved them. Complete PBH was obtained in 91.3% and 87% of the cases based on PR qualitative and quantitative evaluation, respectively, with no significant difference between the groups with respect to the baseline. The PR quantitative change in RD at the last recall session with respect to the baseline was not significant (all P values > .05) in both groups. The qualitative assessment of the type of REP root healing was nonuniform. In the test group, 55.6% of the teeth presented no RD and no apical closure. Only 50% of the 14 teeth assessed with CBCT imaging presented complete PBH. Regarding volumetric measurements on RD 3 years after REP for the change with respect to the baseline in root hard tissue volume, mean root hard tissue thickness, and apical area, the control group performed significantly in favor of RD than the test group (P = .03, .003, and 0.05 respectively). For the volumetric change 3 years after REP with respect to the baseline in root length and maximum root hard tissue thickness, no significant difference (P = .72 and .4, respectively) was found between the groups. The correlation between the PR and CBCT variables assessing RD was weak (root lengthening) to very weak (root thickening). CONCLUSIONS REP-LPRF seems to be a viable treatment option to obtain PBH and aid further RD of necrotic immature permanent teeth. Caution is needed when evaluating REP with PR.
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Affiliation(s)
- Nastaran Meschi
- Department of Oral Health Sciences, Endodontology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium; Department of Oral Health Sciences, BIOMAT-Biomaterials Research Group, KU Leuven and Dentistry, Leuven, Belgium.
| | - Mostafa EzEldeen
- OMFS IMPATH-Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Andres Eduardo Torres Garcia
- Department of Oral Health Sciences, Endodontology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium; OMFS IMPATH-Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Pierre Lahoud
- OMFS IMPATH-Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Gertrude Van Gorp
- Department of Oral Health Sciences, Endodontology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Coucke
- Freelance Statistical Consultant, Heverlee, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH-Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Katleen Vandamme
- Department of Oral Health Sciences, Restorative Dentistry, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, Endodontology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium; Department of Oral Health Sciences, BIOMAT-Biomaterials Research Group, KU Leuven and Dentistry, Leuven, Belgium
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Torres A, Boelen GJ, Lambrechts P, Pedano MS, Jacobs R. Dynamic navigation: a laboratory study on the accuracy and potential use of guided root canal treatment. Int Endod J 2021; 54:1659-1667. [PMID: 33991122 DOI: 10.1111/iej.13563] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 01/20/2023]
Abstract
AIM To evaluate 3D accuracy and outcome of a dynamic navigation method for guided root canal treatment of severe pulp canal obliteration (PCO) in 3D printed jaws. METHODOLOGY Three operators with different levels of experience in Endodontics performed navigated access cavities, using the Navident system (ClaroNav), in two sets (maxillary and mandibular) of 3D-printed jaw models with teeth presenting severe PCO. Models were mounted on a phantom to mimic a real clinical situation. After treatment, a postoperative high resolution Cone-Beam Computer Tomography (CBCT) scan (NewTom) was taken for each model and registered to the preoperative model. All access cavities were then segmented using 3-Matic Medical software 15.0 (Materialise). Length and volume of each access cavity were measured, and a comparison was done by measuring the distance deviation in mm at the coronal entry point, apical point, vertical deviation, total deviation and angular deviation of the access cavity in comparison with the virtual planning. Additionally, all access cavities were scouted with a size 10 K-file and inspected on the CBCT to confirm that the canal was located. Descriptive statistics for each parameter were performed. Normality of the data was assessed; data were transformed if needed to make it normally distributed. One-way analysis of variance (anova) was applied to assess differences between parameters for tooth type, jaw, and operators and corrected for simultaneous hypothesis testing according to Tukey. Significance level was set at .05. RESULTS After training with the system (28 cavities per operator), a total of 132 teeth and 168 access cavities (56 per operator) were prepared. All operators located a total of 156 canals, obtaining an overall success of 93% without a difference between operator experience (p > .05). The mean deviation at the apical point was 0.63 mm (SD 0.35) and was significantly lower in anterior teeth in comparison with molars (p < .05). The mean angular deviation from the planning was 2.81° (SD 1.53). CONCLUSION Dynamic navigation was an accurate approach for root canal treatment in teeth with severely calcified canals. However, the technique has a learning curve and requires extensive training prior to its use clinically.
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Affiliation(s)
- Andres Torres
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium.,Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Gerd-Jan Boelen
- Department of Oral Health Sciences, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Mariano Simon Pedano
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Rodrigues CT, EzEldeen M, Jacobs R, Lambrechts P, Alcalde MP, Hungaro Duarte MA. Cleaning efficacy and uncontrolled removal of dentin of two methods of irrigant activation in curved canals connected by an isthmus. AUST ENDOD J 2021; 47:631-638. [PMID: 34097337 DOI: 10.1111/aej.12534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 04/27/2021] [Accepted: 05/13/2021] [Indexed: 01/19/2023]
Abstract
The aim of this study was to compare the efficacy of UAI with ESI, sonic activation with Eddy® and syringe irrigation in removing debris, and dentin removal during canal irrigation. Twenty-four mandibular molars containing isthmus type V and with a mean curvature of 32.5º were instrumented and divided into three groups for final irrigation: UAI with ESI, sonic activation with Eddy and syringe irrigation. The samples were scanned in a SkyScan 1172 micro-CT device for pre-, post-instrumentation and post-irrigation images and analysis of dentin removal. Statistical analysis was performed using Wilcoxon, Kruskal-Wallis and Dunn tests. UAI and sonic activation significantly improved debris removal (P < 0.05). No significant difference was observed regarding dentin removal between the groups (P > 0.05), although higher values were found for UAI. Sonic activation with Eddy® showed to be an effective and safe device since it was able to remove debris without causing damage to the canal walls.
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Affiliation(s)
- Clarissa Teles Rodrigues
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Mostafa EzEldeen
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Oral Health Sciences, KU Leuven, Pediatric Dentistry and Special Dental care, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Paul Lambrechts
- Department of Oral Health Sciences, Endodontology, KU Leuven, Dentistry, University Hospitals Leuven, Biomaterials-BIOMAT, Leuven, Belgium
| | - Murilo Priori Alcalde
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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10
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Regnstrand T, Torres A, Petitjean E, Lambrechts P, Benchimol D, Jacobs R. CBCT-based assessment of the anatomic relationship between maxillary sinus and upper teeth. Clin Exp Dent Res 2021; 7:1197-1204. [PMID: 34021741 PMCID: PMC8638317 DOI: 10.1002/cre2.451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 05/05/2021] [Accepted: 05/05/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives To describe the relationship between maxillary sinus (MS) and upper teeth based on cone beam computed tomographic scans (CBCT). Materials and methods Based on CBCT maxillary imaging data of 147 patients, distance between MS and apices of canines and posterior maxillary teeth were assessed. Distances between tooth roots and sinus were classified into three groups: distant (>2 mm), close (<2 mm) or in contact with MS. Teeth with apical lesions and uncommon root configurations were excluded. Results In total, 1075 teeth of maxillary canines, upper premolars and upper molars were included in this study. Teeth most often in contact with MS were the second (89%) and first (81%) maxillary molar without any significant difference (p = 0.19). Roots most often in contact with MS were the mesiobuccal and distobuccal root of the second molar (85% and 76%; p = <0.01) followed by the palatal root of the first molar (73%). A fifth of the upper canines are situated less than 2 mm from MS. Conclusions More than four out of five upper molars (first and second) are in a close relationship to the MS. Knowledge of the anatomical relationship between posterior maxillary teeth and the MS is important for diagnosis and treatment in this area.
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Affiliation(s)
- Tobias Regnstrand
- Section of Oral Diagnostics and Surgery, Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Andres Torres
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Eline Petitjean
- Department of Oral Health Sciences, Endodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, Endodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Daniel Benchimol
- Section of Oral Diagnostics and Surgery, Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Reinhilde Jacobs
- Section of Oral Diagnostics and Surgery, Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
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11
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Held K, Lambrechts P, Voets T, Bultynck G. I scream for ice cream - TRPC5 as cold sensor in teeth. Cell Calcium 2021; 97:102419. [PMID: 33993004 DOI: 10.1016/j.ceca.2021.102419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/07/2021] [Accepted: 05/08/2021] [Indexed: 11/21/2022]
Affiliation(s)
- Katharina Held
- KU Leuven, Laboratory of Endometrium, Endometriosis and Reproductive Medicine, Department of Development and Regeneration, Campus Gasthuisberg O&N3 bus 611, 3000 Leuven, Belgium; Laboratory of Ion Channel Research, Department of Cellular and Molecular Medicine and VIB-KU Leuven Center for Brain and Disease Research, Campus Gasthuisberg O&N1 bus 802, 3000 Leuven, Belgium
| | - Paul Lambrechts
- KU Leuven, Department of Oral Health Sciences, St. Rafaël, Kapucijnenvoer 33, 3000 Leuven, Belgium
| | - Thomas Voets
- Laboratory of Ion Channel Research, Department of Cellular and Molecular Medicine and VIB-KU Leuven Center for Brain and Disease Research, Campus Gasthuisberg O&N1 bus 802, 3000 Leuven, Belgium.
| | - Geert Bultynck
- KU Leuven, Laboratory of Molecular & Cellular Signaling, Department of Cellular & Molecular Medicine, Campus Gasthuisberg O&N1 bus 802, 3000 Leuven, Belgium.
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12
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Rodrigues CT, Jacobs R, Vasconcelos KF, Lambrechts P, Rubira-Bullen IRF, Gaêta-Araujo H, Oliveira-Santos C, Duarte MAH. Influence of CBCT-based volumetric distortion and beam hardening artefacts on the assessment of root canal filling quality in isthmus-containing molars. Dentomaxillofac Radiol 2021; 50:20200503. [PMID: 33400563 DOI: 10.1259/dmfr.20200503] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES To evaluate the influence of artefacts in cone beam CT (CBCT) images of filled root canals in isthmus-containing molars. METHODS 10 teeth presenting canals with an isthmus were instrumented and filled with a thermoplasticised obturation technique. The teeth were scanned using a micro-CT device and two CBCT devices: 3D Accuitomo 170 (ACC) and NewTom VGi evo (NT), with different acquisition protocols: larger and smaller voxel size. Three examiners assessed the CBCT images for: (1) detection of filling voids; (2) assessment of under- or overestimation of the filling material and (3) resemblance of CBCT images to the reference standard. Analyses of Task 1 yielded accuracy, sensitivity and specificity for detection of filling voids. For tasks 2 and 3, statistical analysis was performed using Wilcoxon test. The level of significance was set at p < .05. RESULTS For Task 1, ACC showed higher sensitivity, whereas NT presented higher specificity. No significant difference was found between the protocols in ACC, however, for NT, differences between protocols were significant for all diagnostic values. In Task 2, visualisation of the filling was overestimated for NT, while for ACC, underestimation was observed. For Task 3, images with smaller voxel size were more similar to the reference image, for both CBCT devices. CONCLUSIONS Different artefacts compromise the detection of filling voids on CBCT images of canals in mandibular molars with isthmus. ACC and NT present rather similar diagnostic accuracy, even though artefact expression remains device-specific.
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Affiliation(s)
- Clarissa Teles Rodrigues
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Reinhilde Jacobs
- Department of Imaging and Pathology, Faculty of Medicine, OMFS IMPATH Research Group, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karla Faria Vasconcelos
- Department of Imaging and Pathology, Faculty of Medicine, OMFS IMPATH Research Group, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, Endodontology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium.,Biomaterials-BIOMAT, Leuven, Belgium
| | | | - Hugo Gaêta-Araujo
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Christiano Oliveira-Santos
- Department of Stomatology, Public Oral Health, and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
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13
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Torres A, Lerut K, Lambrechts P, Jacobs R. Guided Endodontics: Use of a Sleeveless Guide System on an Upper Premolar with Pulp Canal Obliteration and Apical Periodontitis. J Endod 2020; 47:133-139. [PMID: 33045264 DOI: 10.1016/j.joen.2020.09.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 11/27/2022]
Abstract
Guided endodontics has been used for the treatment of anterior teeth with a successful outcome. This approach is not only limited to anterior teeth because it can also be used for the treatment of premolars and molars. However, in such cases, space may be a limitation because a long bur has to be used in addition to the guide being placed on top of the teeth. The aim of this case report was to present a novel guided endodontics technique using a sleeveless 3-dimensional-printed guide. This design can reduce vertical space, allowing an open view of the tooth and irrigation during drilling. A 46-year-old female patient consulted the endodontic department with intermittent pain around tooth #5. Tooth #5 presented pain upon percussion and responded negative to a cold test. The initial periapical radiograph revealed an apical radiolucency with pulp canal obliteration. Clinically, there was no sinus tract. The tooth was diagnosed with pulp necrosis and symptomatic apical periodontitis. Guided endodontic treatment was performed with a sleeveless 3-dimensional-printed guide and long neck carbide bur with a head diameter of 1 mm to drill a minimally invasive access cavity up to the root canal. A completely healed apical area of tooth #5 was visible after 1 year on periapical radiographs. This technique seems to be a promising alternative in comparison with the conventional guided endodontic guide design for the negotiation of pulp canal obliteration in cases in which vertical space is limited.
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Affiliation(s)
- Andres Torres
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium; Department of Oral Health Sciences, University Hospitals Leuven, Endodontology, KU Leuven, Leuven, Belgium.
| | - Kathleen Lerut
- Department of Oral Health Sciences, University Hospitals Leuven, Endodontology, KU Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, University Hospitals Leuven, Endodontology, KU Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium; Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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14
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Moreno‐Rabié C, Torres A, Lambrechts P, Jacobs R. Clinical applications, accuracy and limitations of guided endodontics: a systematic review. Int Endod J 2019; 53:214-231. [DOI: 10.1111/iej.13216] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 09/06/2019] [Indexed: 12/28/2022]
Affiliation(s)
- C. Moreno‐Rabié
- OMFS‐IMPATH Research Group Department of Imaging and Pathology Faculty of Medicine University of Leuven LeuvenBelgium
| | - A. Torres
- OMFS‐IMPATH Research Group Department of Imaging and Pathology Faculty of Medicine University of Leuven LeuvenBelgium
- Department of Oral Health Sciences Endodontology University Hospitals Leuven Leuven Belgium
| | - P. Lambrechts
- Department of Oral Health Sciences Endodontology University Hospitals Leuven Leuven Belgium
| | - R. Jacobs
- OMFS‐IMPATH Research Group Department of Imaging and Pathology Faculty of Medicine University of Leuven LeuvenBelgium
- Department of Oral and Maxillofacial Surgery University Hospitals Leuven LeuvenBelgium
- Department of Dental Medicine Karolinska Institutet Stockholm Sweden
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15
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Nedeljkovic I, De Munck J, Vanloy A, Declerck D, Lambrechts P, Peumans M, Teughels W, Van Meerbeek B, Van Landuyt KL. Secondary caries: prevalence, characteristics, and approach. Clin Oral Investig 2019; 24:683-691. [PMID: 31123872 DOI: 10.1007/s00784-019-02894-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 04/03/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The objectives of this cross-sectional survey were to determine the prevalence of secondary caries (SC) in general population, to identify patient- and material-related factors which may affect the prevalence, and to describe some clinical characteristics of SC lesions. MATERIALS AND METHODS A total of 4036 restorations in 450 patients, who visited the university dental clinic for a regular (half) yearly checkup, were examined clinically (and radiographically) for the presence of SC. Clinical characteristics of the detected SC lesions (size, activity, and location) and the planned treatment were recorded. In addition, patients' caries-risk status was assessed according to the modified "cariogram" model. RESULTS In total, 146 restorations were diagnosed with SC, which gives an overall prevalence of 3.6%. Restorative material, restoration class, patient's caries risk, and smoking habits were shown to be important factors, as SC prevalence was significantly higher with composites, class II restorations, high-caries-risk patients, and smokers. Restorations' gingival margins were most frequently affected by SC. The largest number of restorations with SC (72%) was scheduled for the replacement. CONCLUSIONS Prevalence of SC was higher with composite than with amalgam restorations, irrespective of the patient's caries-risk status. Gingival margins of class II, including MOD restorations, seem to be the place of less resistance to SC development. Management of SC seems to place a considerable burden on the health care workforce and expenditure. CLINICAL RELEVANCE Secondary caries (SC) is considered to be the main cause of dental restoration failure and one of the biggest clinical challenges related to dental composites. Nevertheless, its prevalence in daily practice is still not clear, which impedes an accurate estimation of its impact on health care costs.
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Affiliation(s)
- Ivana Nedeljkovic
- Department of Oral Health Sciences, KU Leuven BIOMAT, University of Leuven & Dentistry University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Jan De Munck
- Department of Oral Health Sciences, KU Leuven BIOMAT, University of Leuven & Dentistry University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Anouk Vanloy
- Department of Oral Health Sciences, KU Leuven BIOMAT, University of Leuven & Dentistry University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Dominique Declerck
- Department of Oral Health Sciences, KU Leuven Population Oral Health Studies, University of Leuven & Dentistry University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, KU Leuven BIOMAT, University of Leuven & Dentistry University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Marleen Peumans
- Department of Oral Health Sciences, KU Leuven BIOMAT, University of Leuven & Dentistry University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences , Oral Microbiology, University of Leuven & Dentistry University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Bart Van Meerbeek
- Department of Oral Health Sciences, KU Leuven BIOMAT, University of Leuven & Dentistry University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Kirsten L Van Landuyt
- Department of Oral Health Sciences, KU Leuven BIOMAT, University of Leuven & Dentistry University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.
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16
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Meschi N, Hilkens P, Van Gorp G, Strijbos O, Mavridou A, Cadenas de Llano Perula M, Lambrichts I, Verbeken E, Lambrechts P. Regenerative Endodontic Procedures Posttrauma: Immunohistologic Analysis of a Retrospective Series of Failed Cases. J Endod 2019; 45:427-434. [PMID: 30833096 DOI: 10.1016/j.joen.2019.01.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 12/14/2018] [Accepted: 01/08/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Regenerative endodontic procedures (REP) are a novel treatment modality to restore the function of necrotic pulp tissue via stimulation or transplantation of stem cells into the root canal. This study aimed to investigate the immunohistologic outcome of 3 extracted teeth because of sequelae of trauma and unsatisfactory REP outcomes. METHODS Three immature permanent maxillary central incisors of 3 female patients (6-9 years) were extracted 5.5-22 months after REP. Additionally, 1 sound permanent immature central maxillary incisor of 1 of the included patients was extracted for orthodontic reasons. The teeth were immunohistologically stained with Masson's trichrome, neurofilament (NF), pan cytokeratin, dentin sialophosphoprotein, and Gram+/-. RESULTS The REP-teeth presented intracanalar vascularized connective/mineralized reparative tissue (RT), which was less organized than the pulp tissue of the sound tooth. Moderate to considerable calcification was observed below the Portland cement used during REP. In 1 case, the RT was NF+; in the 2 other cases, the periodontal ligament and apical granuloma/papilla were NF+. All teeth were Gram+/- negative; nevertheless, inflammatory cells were present in 2 cases. The pan cytokeratin and dentin sialophosphoprotein stainings were not specific enough for 2 cases. CONCLUSIONS This immunohistologic study of failed REP cases resulted in bacteria-free intracanalar RT and biomaterial-induced calcification. Nevertheless, the presence of inflammatory cells revealed a persistent inflammation. Hence, the clinical and radiographic signs were decisive for tooth survival and multidisciplinary outcome determination.
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Affiliation(s)
- Nastaran Meschi
- Department of Oral Health Sciences, Endodontology, Katholieke Universiteit Leuven, Leuven, Belgium; Biomaterials, BIOMAT, Leuven, Belgium.
| | - Petra Hilkens
- Laboratory of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Gertrude Van Gorp
- Department of Oral Health Sciences, Endodontology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Olaf Strijbos
- Department of Oral Health Sciences, Endodontology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Athina Mavridou
- Department of Oral Health Sciences, Endodontology, Katholieke Universiteit Leuven, Leuven, Belgium; Biomaterials, BIOMAT, Leuven, Belgium
| | | | - Ivo Lambrichts
- Laboratory of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Eric Verbeken
- Department of Translational Cell and Tissue Research, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, Endodontology, Katholieke Universiteit Leuven, Leuven, Belgium; Biomaterials, BIOMAT, Leuven, Belgium
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17
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Torres A, Shaheen E, Lambrechts P, Politis C, Jacobs R. Microguided Endodontics: a case report of a maxillary lateral incisor with pulp canal obliteration and apical periodontitis. Int Endod J 2018; 52:540-549. [DOI: 10.1111/iej.13031] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 10/15/2018] [Indexed: 12/14/2022]
Affiliation(s)
- A. Torres
- Department of Oral Health Sciences; University Hospitals Leuven, Endodontology; KU Leuven; Leuven Belgium
- OMFS IMPATH Research Group; Department of Imaging and Pathology; Faculty of Medicine; KU Leuven; Leuven Belgium
| | - E. Shaheen
- OMFS IMPATH Research Group; Department of Imaging and Pathology; Faculty of Medicine; KU Leuven; Leuven Belgium
- Department of Oral and Maxillofacial Surgery; University Hospitals Leuven; Leuven Belgium
| | - P. Lambrechts
- Department of Oral Health Sciences; University Hospitals Leuven, Endodontology; KU Leuven; Leuven Belgium
| | - C. Politis
- OMFS IMPATH Research Group; Department of Imaging and Pathology; Faculty of Medicine; KU Leuven; Leuven Belgium
- Department of Oral and Maxillofacial Surgery; University Hospitals Leuven; Leuven Belgium
| | - R. Jacobs
- OMFS IMPATH Research Group; Department of Imaging and Pathology; Faculty of Medicine; KU Leuven; Leuven Belgium
- Department of Oral and Maxillofacial Surgery; University Hospitals Leuven; Leuven Belgium
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18
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Schryvers A, Govaerts D, Politis C, Lambrechts P. Endodontic management of a maxillary first molar with two palatal roots: A case report. AUST ENDOD J 2018; 45:420-425. [PMID: 30338617 DOI: 10.1111/aej.12320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2018] [Indexed: 12/13/2022]
Abstract
This case report describes the endodontic treatment of a maxillary first molar with two palatal roots. Both of the palatal canals had separate canal orifices and separate foramina. A cone beam computed tomography scan was taken prior to treatment to visualise any abnormalities seen on a periapical radiograph. The shaping procedure of the root canal treatment was performed using reciprocating instruments. The obturation was performed using matched gutta percha points and a resin based sealer in a warm vertical compaction manner. Complete bone healing of the periapical area was visualised on intra-oral radiographs taken one year after the treatment. No canals were unfilled nor untreated.
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Affiliation(s)
- Alexander Schryvers
- Department of Oral Health Sciences, Endodontology, KULeuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Dries Govaerts
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, Endodontology, KULeuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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19
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Meschi N, EzEldeen M, Torres Garcia AE, Jacobs R, Lambrechts P. A Retrospective Case Series in Regenerative Endodontics: Trend Analysis Based on Clinical Evaluation and 2- and 3-dimensional Radiology. J Endod 2018; 44:1517-1525. [DOI: 10.1016/j.joen.2018.06.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 06/09/2018] [Accepted: 06/15/2018] [Indexed: 12/17/2022]
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20
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Patel S, Lambrechts P, Shemesh H, Mavridou A. European Society of Endodontology position statement: External Cervical Resorption. Int Endod J 2018; 51:1323-1326. [DOI: 10.1111/iej.13008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 08/27/2018] [Indexed: 12/14/2022]
Affiliation(s)
| | - S. Patel
- Endodontic Postgraduate Unit; King's College London Dental Institute; London UK
- Private Practice; 45 Wimpole Street London UK
| | | | - H. Shemesh
- Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - A. Mavridou
- Conservative Dentistry; KU Leuven; Leuven Belgium
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21
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Patel S, Mavridou AM, Lambrechts P, Saberi N. External cervical resorption-part 1: histopathology, distribution and presentation. Int Endod J 2018; 51:1205-1223. [PMID: 29704466 DOI: 10.1111/iej.12942] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 04/22/2018] [Indexed: 12/13/2022]
Abstract
External cervical resorption (ECR) is the loss of dental hard tissue as a result of odontoclastic action. It is a dynamic process that involves periodontal, dental and in later stages pulpal tissues. Over the last two decades, ECR has attracted increased interest; this is in part due to novel micro-CT and histopathological techniques for its assessment and also improved radiographic detection using CBCT. This literature review will cover the aetiology, potential predisposing factors, histopathology and diagnosis of ECR. Part 2 will cover the management of ECR.
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Affiliation(s)
- S Patel
- Department of Endodontology, King's College London Dental Institute, London, UK.,Specialist Practice, London, UK
| | - A M Mavridou
- Department of Oral Health Services, University of Leuven, Leuven, Belgium
| | - P Lambrechts
- Department of Oral Health Services, University of Leuven, Leuven, Belgium
| | - N Saberi
- Department of Endodontology, King's College London Dental Institute, London, UK
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22
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Meschi N, Fieuws S, Vanhoenacker A, Strijbos O, Van der Veken D, Politis C, Lambrechts P. Root-end surgery with leucocyte- and platelet-rich fibrin and an occlusive membrane: a randomized controlled clinical trial on patients’ quality of life. Clin Oral Investig 2018. [DOI: 10.1007/s00784-018-2343-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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23
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Curvers F, Meschi N, Vanhoenacker A, Strijbos O, Van Mierlo M, Lambrechts P. Ultrasound Assessment of Bone Healing after Root-end Surgery: Echoes Back to Patient's Safety. J Endod 2017; 44:32-37. [PMID: 29079054 DOI: 10.1016/j.joen.2017.08.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 08/20/2017] [Accepted: 08/26/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The aim of this study was to present ultrasound imaging (UI) techniques as promising and safe tools for the follow-up of root-end surgery (RES) in vivo. METHODS The study included 8 patients who underwent RES. All were followed up using UI at 1 week, 1 month, 2 months, 3 months, and 6 months (if necessary) after RES. The bony crypt was defined on the ultrasound image, and the following observations were made during follow-up: cortical bone interruption and surface area measurement of the residual echoic bony crypt image. RESULTS In all cases, the hypoechoic image became hyperechoic, indicating gradual bone healing of the crypt. Compared with baseline, at 3 months a remaining cortical opening of 51.2% (±12.6%) and a bony crypt surface area of 24.3% (±10.8%) was detected for all patients. For 50% of the patients, the echographic follow-up ended at 3 months because the ultrasound waves could no longer enter the bony crypt. For 4 patients who attended the 6-month recall, a remaining cortical disruption of 43.2% (±9.9%) and a bony crypt surface area of 17.2% (±7%) compared with the baseline was noted. CONCLUSIONS UI is a promising follow-up tool for RES. It helps clinicians understand the initial stages of bone healing, allows close healing monitoring, and is radiation free.
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Affiliation(s)
- Frederik Curvers
- Department of Oral Health Sciences, KU Leuven, University of Leuven, University Hospitals Leuven, Leuven, Belgium.
| | - Nastaran Meschi
- Department of Oral Health Sciences, KU Leuven, University of Leuven, University Hospitals Leuven, Leuven, Belgium.
| | - Anke Vanhoenacker
- Department of Oral and Maxillofacial Surgery, KU Leuven, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Olaf Strijbos
- Department of Oral Health Sciences, KU Leuven, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Maarten Van Mierlo
- Department of Oral Health Sciences, KU Leuven, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, KU Leuven, University of Leuven, University Hospitals Leuven, Leuven, Belgium
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Petitjean E, Mavridou A, Li X, Hauben E, Cotti E, Lambrechts P. Multimodular assessment of a calcified extraradicular deposit on the root surfaces of a mandibular molar. Int Endod J 2017; 51:375-385. [DOI: 10.1111/iej.12855] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 08/29/2017] [Indexed: 11/29/2022]
Affiliation(s)
- E. Petitjean
- Department of Oral Health Sciences; University Hospitals Leuven; KU Leuven; Leuven Belgium
| | - A. Mavridou
- Department of Oral Health Sciences; University Hospitals Leuven; KU Leuven; Leuven Belgium
- BIOMAT; Department of Oral Health Sciences; University Hospitals Leuven; KU Leuven; Leuven Belgium
| | - X. Li
- BIOMAT; Department of Oral Health Sciences; University Hospitals Leuven; KU Leuven; Leuven Belgium
| | - E. Hauben
- Department of Imaging and Pathology; Translational Cell & Tissue Research; University Hospitals Leuven; KU Leuven; Leuven Belgium
| | - E. Cotti
- Department of Conservative Dentistry and Endodontics; School of Dentistry; University of Cagliari; Cagliari Italy
| | - P. Lambrechts
- Department of Oral Health Sciences; University Hospitals Leuven; KU Leuven; Leuven Belgium
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Mavridou AM, Bergmans L, Barendregt D, Lambrechts P. Descriptive Analysis of Factors Associated with External Cervical Resorption. J Endod 2017; 43:1602-1610. [PMID: 28807370 DOI: 10.1016/j.joen.2017.05.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/03/2017] [Accepted: 05/30/2017] [Indexed: 01/19/2023]
Abstract
INTRODUCTION The aim of this study was to perform a descriptive analysis of the occurrence of external cervical resorption (ECR) in relation to the patients' characteristics (sex, age, and tooth type) and the potentially involved predisposing factors. METHODS This study includes data on 284 patients (337 teeth with evidence of ECR) referred to the University Hospital Leuven (Leuven, Belgium) and Endo Rotterdam (Rotterdam, the Netherlands) for diagnosis and treatment from 2010 to 2015. The medical history, existing radiographs, and dental records were available for evaluation. Each patient was then interviewed followed by a thorough clinical and radiographic examination. Intraoral pictures using a dental operating microscope and digital camera were taken during clinical examination. The radiographic examination consisted of digital periapical radiography and/or cone-beam computed tomographic imaging. A review of existing literature provided a potential predisposing factor checklist for ECR. The clinical data were correlated with the dental and medical history of each patient in an attempt to identify some potential predisposing factor(s) that could contribute to ECR. The frequency of the occurrence of ECR was correlated with tooth type, sex and age of the patient, and each 1 of the recorded potential predisposing factor(s). RESULTS From the examined teeth (337) with ECR, 175 (54%) were found in male patients and 162 (46%) were found in female patients. In 59% of the cases, more than 1 potential predisposing factor was identified. Most ECR cases were observed on maxillary central incisors (29%) followed by maxillary canines (14%), mandibular molars (14%), and maxillary premolars (11%). In addition, most ECR cases were observed on maxillary teeth (72%). The most frequently appearing factor was orthodontics (45.7%). Other frequently observed factors were trauma (28.5%), parafunctional habits (23.2%), poor oral health (22.9%), malocclusion (17.5%), and extraction of a neighboring tooth (14%). CONCLUSIONS The data indicate that ECR is not related to patient sex. ECR occurs most often in the maxillary central incisor. In the majority of the cases, more than 1 potential predisposing factor was identified, indicating that ECR may be mainly multifactorial. The most frequently appearing factors were orthodontics, iatrogenic or accidental trauma, and poor oral health. This information may be helpful in diagnosing ECR at an early stage when screening patients presenting with these predisposing factors.
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Affiliation(s)
- Athina M Mavridou
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospitals Leuven, Leuven, Belgium; Private Practice, Proclin Rotterdam, Rotterdam, The Netherlands.
| | - Lars Bergmans
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospitals Leuven, Leuven, Belgium
| | - Dick Barendregt
- Private Practice, Proclin Rotterdam, Rotterdam, The Netherlands
| | - Paul Lambrechts
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospitals Leuven, Leuven, Belgium
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Curvers F, Haes PD, Lambrechts P. Non-Surgical Endodontic Therapy as Treatment of Choice for a Misdiagnosed Recurring Extraoral Sinus Tract. Eur Endod J 2017; 2:1-6. [PMID: 33403325 PMCID: PMC7757942 DOI: 10.5152/eej.2017.17007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 02/27/2017] [Accepted: 04/10/2017] [Indexed: 12/29/2022] Open
Abstract
The purpose of this article is to present the treatment of an odontogenic cutaneous sinus tract with exuberant extraoral granulation tissue and its successful endodontic treatment and follow up with Cone-Beam Computed Tomography (CBCT). In this case, a 31-year-old woman was referred for management of a reddish nodule on her chin. Previous surgical and antibiotic intervention by the dermatologist had not resolved the problem. Profound clinical and radiological examination (including CBCT) revealed apical periodontitis of tooth 32 to be the cause of the recurring cutaneous sinus tract. Conservative non-surgical root canal treatment was performed. With the aid of a topical corticosteroid and supplemental antibiotic therapy, healing of the apical periodontitis and resolution of the granulation tissue was evident after 1 year both clinically and radiographically. This case report emphasises the need for more awareness by dermatologists and other medical practitioners for the differential diagnosis of extraoral sinus tracts. Correct diagnosis of the dental cause can prevent unnecessary and multiple antibiotic and surgical interventions. Antibiotic therapy should never be administered without addressing the underlying dental cause. Conservative non-surgical endodontic treatment is the treatment of choice for an extraoral sinus tract of endodontic origin.
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Affiliation(s)
- Frederik Curvers
- Department of Oral Health Sciences, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Petra De Haes
- Department of Dermatology, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, University of Leuven, University Hospitals Leuven, Leuven, Belgium
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Mavridou AM, Hauben E, Wevers M, Schepers E, Bergmans L, Lambrechts P. Understanding external cervical resorption patterns in endodontically treated teeth. Int Endod J 2017; 50:1116-1133. [DOI: 10.1111/iej.12744] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 01/11/2017] [Indexed: 01/30/2023]
Affiliation(s)
- A.-M. Mavridou
- Department of Oral Health Sciences; BIOMAT Research Cluster; KU Leuven & University Hospital Leuven; Leuven Belgium
- Private Practice; Endo Rotterdam; Rotterdam the Netherlands
| | - E. Hauben
- Department of Imaging and Pathology; KU Leuven & University Hospitals Leuven; Leuven Belgium
| | - M. Wevers
- Department of Materials Engineering (MTM); KU Leuven & University Hospitals Leuven; Leuven Belgium
| | - E. Schepers
- Department of Oral Health Sciences; BIOMAT Research Cluster; KU Leuven & University Hospital Leuven; Leuven Belgium
| | - L. Bergmans
- Department of Oral Health Sciences; BIOMAT Research Cluster; KU Leuven & University Hospital Leuven; Leuven Belgium
| | - P. Lambrechts
- Department of Oral Health Sciences; BIOMAT Research Cluster; KU Leuven & University Hospital Leuven; Leuven Belgium
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Castro AB, Meschi N, Temmerman A, Pinto N, Lambrechts P, Teughels W, Quirynen M. Regenerative potential of leucocyte- and platelet-rich fibrin. Part B: sinus floor elevation, alveolar ridge preservation and implant therapy. A systematic review. J Clin Periodontol 2017; 44:225-234. [PMID: 27891638 PMCID: PMC5347939 DOI: 10.1111/jcpe.12658] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2016] [Indexed: 11/21/2022]
Abstract
AIM To analyse the effect of leucocyte- and platelet-rich fibrin (L-PRF) on bone regeneration procedures and osseointegration. MATERIALS AND METHODS An electronic and hand search was conducted in three databases (MEDLINE, EMBASE and Cochrane). Only randomized clinical trials, written in English where L-PRF was applied in bone regeneration and implant procedures, were selected. No follow-up restrictions were applied. RESULTS A total of 14 articles were included and processed. Three subgroups were created depending on the application: sinus floor elevation (SFE), alveolar ridge preservation and implant therapy. In SFE, for a lateral window as well as for the trans-alveolar technique, histologically faster bone healing was reported when L-PRF was added to most common xenografts. L-PRF alone improved the preservation of the alveolar width, resulting in less buccal bone resorption compared to natural healing. In implant therapy, better implant stability over time and less marginal bone loss were observed when L-PRF was applied. Meta-analyses could not be performed due to the heterogeneity of the data. CONCLUSIONS Despite the lack of strong evidence found in this systematic review, L-PRF might have a positive effect on bone regeneration and osseointegration.
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Affiliation(s)
- Ana B. Castro
- Department of Oral Health Sciences, PeriodontologyKU Leuven & DentistryUniversity Hospitals LeuvenLeuvenBelgium
| | - Nastaran Meschi
- Department of Oral Health Sciences, EndodontologyKU Leuven & DentistryUniversity Hospitals LeuvenLeuvenBelgium
| | - Andy Temmerman
- Department of Oral Health Sciences, PeriodontologyKU Leuven & DentistryUniversity Hospitals LeuvenLeuvenBelgium
| | - Nelson Pinto
- Department of Oral Health Sciences, PeriodontologyKU Leuven & DentistryUniversity Hospitals LeuvenLeuvenBelgium
- Faculty of DentistryPostgraduate Implant ProgramUniversity of the AndesSantiagoChile
| | - Paul Lambrechts
- Department of Oral Health Sciences, EndodontologyKU Leuven & DentistryUniversity Hospitals LeuvenLeuvenBelgium
| | - Wim Teughels
- Department of Oral Health Sciences, PeriodontologyKU Leuven & DentistryUniversity Hospitals LeuvenLeuvenBelgium
| | - Marc Quirynen
- Department of Oral Health Sciences, PeriodontologyKU Leuven & DentistryUniversity Hospitals LeuvenLeuvenBelgium
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Coutinho E, Van Landuyt K, De Munck J, Poitevin A, Yoshida Y, Inoue S, Peumans M, Suzuki K, Lambrechts P, Van Meerbeek B. Development of a Self-etch Adhesive for Resin-modified Glass Ionomers. J Dent Res 2016; 85:349-53. [PMID: 16567557 DOI: 10.1177/154405910608500413] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The favorable self-adhesiveness of resin-modified glass ionomers (RMGIs) might be even further improved if the time-consuming and technically sensitive etch-and-rinse pre-treatment step with polyalkenoic acids could be avoided. We undertook this study to assess the effectiveness of an experimental self-etch adhesive for RMGIs that does not need to be rinsed off. Ultrastructural analysis and micro-tensile bond strength testing to enamel and dentin of a RMGI restorative material and a RMGI adhesive were performed after 4 different surface pre-treatments: no conditioning; 25% polyalkenoic acid; an experimental self-etch adhesive; and 37.5% phosphoric acid followed by the experimental self-etch adhesive. The use of an experimental self-etch adhesive increased the bond strength of RMGIs, especially after an additional conditioning step. Interfacial analysis showed the formation of a thin hydroxyapatite-containing hybrid layer. The self-etch technique enhances the user-friendliness of RMGIs and lowers their technique-sensitivity, while maintaining desirable characteristics of the conventional etch-and-rinse approach with polyalkenoic acids.
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Affiliation(s)
- E Coutinho
- Leuven BIOMAT Research Cluster, Department of Conservative Dentistry, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Catholic University of Leuven, B-3000 Leuven, Belgium
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De Munck J, Van Landuyt K, Peumans M, Poitevin A, Lambrechts P, Braem M, Van Meerbeek B. A Critical Review of the Durability of Adhesion to Tooth Tissue: Methods and Results. J Dent Res 2016; 84:118-32. [PMID: 15668328 DOI: 10.1177/154405910508400204] [Citation(s) in RCA: 958] [Impact Index Per Article: 119.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The immediate bonding effectiveness of contemporary adhesives is quite favorable, regardless of the approach used. In the long term, the bonding effectiveness of some adhesives drops dramatically, whereas the bond strengths of other adhesives are more stable. This review examines the fundamental processes that cause the adhesion of biomaterials to enamel and dentin to degrade with time. Non-carious class V clinical trials remain the ultimate test method for the assessment of bonding effectiveness, but in addition to being high-cost, they are time- and labor-consuming, and they provide little information on the true cause of clinical failure. Therefore, several laboratory protocols were developed to predict bond durability. This paper critically appraises methodologies that focus on chemical degradation patterns of hydrolysis and elution of interface components, as well as mechanically oriented test set-ups, such as fatigue and fracture toughness measurements. A correlation of in vitro and in vivo data revealed that, currently, the most validated method to assess adhesion durability involves aging of micro-specimens of biomaterials bonded to either enamel or dentin. After about 3 months, all classes of adhesives exhibited mechanical and morphological evidence of degradation that resembles in vivo aging effects. A comparison of contemporary adhesives revealed that the three-step etch-and-rinse adhesives remain the ‘gold standard’ in terms of durability. Any kind of simplification in the clinical application procedure results in loss of bonding effectiveness. Only the two-step self-etch adhesives approach the gold standard and do have some additional clinical benefits.
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Affiliation(s)
- J De Munck
- Leuven BIOMAT Research Cluster, Department of Conservative Dentistry, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Catholic University of Leuven, Kapucijnenvoer 7, B-3000 Leuven, Belgium
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Mavridou AM, Hauben E, Wevers M, Schepers E, Bergmans L, Lambrechts P. Understanding External Cervical Resorption in Vital Teeth. J Endod 2016; 42:1737-1751. [DOI: 10.1016/j.joen.2016.06.007] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 06/04/2016] [Accepted: 06/09/2016] [Indexed: 12/31/2022]
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32
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Castro AB, Meschi N, Temmerman A, Pinto N, Lambrechts P, Teughels W, Quirynen M. Regenerative potential of leucocyte- and platelet-rich fibrin. Part A: intra-bony defects, furcation defects and periodontal plastic surgery. A systematic review and meta-analysis. J Clin Periodontol 2016; 44:67-82. [PMID: 27783851 PMCID: PMC5248642 DOI: 10.1111/jcpe.12643] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2016] [Indexed: 12/20/2022]
Abstract
Aim To analyse the regenerative potential of leucocyte‐ and platelet‐rich fibrin (L‐PRF) during periodontal surgery. Materials and Methods An electronic and hand search were conducted in three databases. Only randomized clinical trials were selected and no follow‐up limitation was applied. Pocket depth (PD), clinical attachment level (CAL), bone fill, keratinized tissue width (KTW), recession reduction and root coverage (%) were considered as outcome. When possible, meta‐analysis was performed. Results Twenty‐four articles fulfilled the inclusion and exclusion criteria. Three subgroups were created: intra‐bony defects (IBDs), furcation defects and periodontal plastic surgery. Meta‐analysis was performed in all the subgroups. Significant PD reduction (1.1 ± 0.5 mm, p < 0.001), CAL gain (1.2 ± 0.6 mm, p < 0.001) and bone fill (1.7 ± 0.7 mm, p < 0.001) were found when comparing L‐PRF to open flap debridement (OFD) in IBDs. For furcation defects, significant PD reduction (1.9 ± 1.5 mm, p = 0.01), CAL gain (1.3 ± 0.4 mm, p < 0.001) and bone fill (1.5 ± 0.3 mm, p < 0.001) were reported when comparing L‐PRF to OFD. When L‐PRF was compared to a connective tissue graft, similar outcomes were recorded for PD reduction (0.2 ± 0.3 mm, p > 0.05), CAL gain (0.2 ± 0.5 mm, p > 0.05), KTW (0.3 ± 0.4 mm, p > 0.05) and recession reduction (0.2 ± 0.3 mm, p > 0.05). Conclusions L‐PRF enhances periodontal wound healing.
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Affiliation(s)
- Ana B. Castro
- Department of Oral Health Sciences, PeriodontologyKU Leuven & Dentistry, University Hospitals LeuvenLeuvenBelgium
| | - Nastaran Meschi
- Department of Oral Health Sciences, EndodontologyKU Leuven & Dentistry, University Hospitals LeuvenLeuvenBelgium
| | - Andy Temmerman
- Department of Oral Health Sciences, PeriodontologyKU Leuven & Dentistry, University Hospitals LeuvenLeuvenBelgium
| | - Nelson Pinto
- Department of Oral Health Sciences, PeriodontologyKU Leuven & Dentistry, University Hospitals LeuvenLeuvenBelgium
- Faculty of DentistryPostgraduate Implant ProgramUniversity of the AndesSantiagoChile
| | - Paul Lambrechts
- Department of Oral Health Sciences, EndodontologyKU Leuven & Dentistry, University Hospitals LeuvenLeuvenBelgium
| | - Wim Teughels
- Department of Oral Health Sciences, PeriodontologyKU Leuven & Dentistry, University Hospitals LeuvenLeuvenBelgium
| | - Marc Quirynen
- Department of Oral Health Sciences, PeriodontologyKU Leuven & Dentistry, University Hospitals LeuvenLeuvenBelgium
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Coutinho E, Yoshida Y, Inoue S, Fukuda R, Snauwaert J, Nakayama Y, De Munck J, Lambrechts P, Suzuki K, Van Meerbeek B. Gel Phase Formation at Resin-modified Glass-ionomer/Tooth Interfaces. J Dent Res 2016; 86:656-61. [PMID: 17586714 DOI: 10.1177/154405910708600714] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Ionic bonding between polyalkenoic acid and hydroxyapatite may explain the excellent bonding retention of glass-ionomers in clinical trials. We have here investigated the extent to which the self-adhesiveness of resin-modified glass-ionomers (RMGIs) can be attributed to this chemical bonding capacity. Therefore, the interaction of 3 RMGIs with tooth substrates was comprehensively characterized, with electron and atomic force microscopy correlated with x-ray photoelectron spectroscopy (XPS). Interfacial ultrastructural analysis for 2 RMGIs disclosed a shallow hybridization of hydroxyapatite-coated collagen, on which a submicron gel phase was deposited through reaction of the polyalkenoic acid with calcium extracted from the dentin surface. One RMGI, however, bonded to dentin without hybrid layer or gel phase formation. XPS indicated that polycarboxylic acids included in the RMGIs electrostatically interacted with hydroxyapatite. We conclude that the self-adhesiveness of RMGIs should be attributed to ionic bonding to hydroxyapatite around collagen, and to micro-mechanical interlocking for those RMGIs that additionally hybridize dentin.
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Affiliation(s)
- E Coutinho
- Leuven BIOMAT Research Cluster, Department of Conservative Dentistry, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Catholic University of Leuven, Leuven, Belgium
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Abstract
The current literature was reviewed to determine the impact of autologous platelet concentrates (APCs) on endodontic healing. All types of clinical study designs concerning any kind of endodontic treatment involving the application of APCs were included. Two independent reviewers searched three databases (PubMed, Embase, and Cochrane Library) for studies, complemented by hand search, until 16/1/2016. From the 423 identified records, 48 articles met the inclusion criteria. Selected randomized controlled clinical trials (RCTs) underwent Cochrane Collaboration's risk-of-bias assessment and data extraction. Only two RCTs showed low risk of bias. There was considerable heterogeneity between the RCTs with regard to the type of therapy, type of APCs, assessment method, and study quality, and therefore the data could not be analyzed quantitatively. The included case reports/series and non-randomized comparative studies underwent qualitative analysis with the revised Methodological Index for Non-Randomized Studies (MINORS) and data extraction. The two comparative non-randomized studies scored qualitatively high, though the MINORS-scores of the case series and reports were dispersed. APCs were involved in five endodontic treatment modalities, namely apexification, regenerative endodontic procedures, pulpotomy, apical surgery, and treatment of endo-perio/perio-endo lesions. APCs seem to accelerate postoperative bone healing, augment the patients' postoperative quality of life, aid further root development, and support maintenance/regaining of pulp vitality. No adverse events were reported. APCs in endodontic treatments seem to contribute to the healing of soft and hard tissues, though there is a lack of long-term high quality clinical trials and standardized treatment protocols.
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Affiliation(s)
- Nastaran Meschi
- a Department of Oral Health Sciences, Endodontology , KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Ana B Castro
- b Department of Oral Health Sciences , Periodontology, KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Katleen Vandamme
- c Department of Oral Health Sciences , Restorative Dentistry, KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Marc Quirynen
- b Department of Oral Health Sciences , Periodontology, KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Paul Lambrechts
- a Department of Oral Health Sciences, Endodontology , KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
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Galler KM, Krastl G, Simon S, Van Gorp G, Meschi N, Vahedi B, Lambrechts P. European Society of Endodontology position statement: Revitalization procedures. Int Endod J 2016; 49:717-23. [DOI: 10.1111/iej.12629] [Citation(s) in RCA: 186] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- K. M. Galler
- Department of Conservative Dentistry and Periodontology; University Hospital; Regensburg Germany
| | - G. Krastl
- Department of Conservative Dentistry and Periodontology; University of Würzburg; Würzburg Germany
| | - S. Simon
- Department of Oral Biology and Endodontics; University of Paris Diderot (Paris 7); Paris France
| | - G. Van Gorp
- Department of Oral Health Sciences, KU Leuven and Dentistry; University Hospitals Leuven; Leuven Belgium
| | - N. Meschi
- Department of Oral Health Sciences, KU Leuven and Dentistry; University Hospitals Leuven; Leuven Belgium
| | | | - P. Lambrechts
- Department of Oral Health Sciences, KU Leuven and Dentistry; University Hospitals Leuven; Leuven Belgium
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36
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Van der Veken D, Curvers F, Fieuws S, Lambrechts P. Prevalence of apical periodontitis and root filled teeth in a Belgian subpopulation found on CBCT images. Int Endod J 2016; 50:317-329. [DOI: 10.1111/iej.12631] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 03/15/2016] [Indexed: 12/19/2022]
Affiliation(s)
- D. Van der Veken
- Department of Oral Health Sciences; KU Leuven - University of Leuven; University Hospitals; Leuven Belgium
| | - F. Curvers
- Department of Oral Health Sciences; KU Leuven - University of Leuven; University Hospitals; Leuven Belgium
| | - S. Fieuws
- Leuven Biostatistics and Statistical Bioinformatics centre; KU Leuven - University of Leuven; Leuven Belgium
| | - P. Lambrechts
- Department of Oral Health Sciences; KU Leuven - University of Leuven; University Hospitals; Leuven Belgium
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Patel S, Durack C, Abella F, Roig M, Shemesh H, Lambrechts P, Lemberg K. European Society of Endodontology position statement: the use of CBCT in endodontics. Int Endod J 2016; 47:502-4. [PMID: 24815882 DOI: 10.1111/iej.12267] [Citation(s) in RCA: 185] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This Position Statement represents a consensus of an expert committee convened by the European Society of Endodontology (ESE) on the use of Cone Beam Computed Tomography (CBCT). The statement is based on the current scientific evidence, and provides the clinician with evidence-based criteria on when to use CBCT in Endodontics. Given the dynamic and changing nature of research, development of new devices and clinical practice relating to CBCT, this Position Statement will be updated within 3 years, or before that time should new evidence become available.
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Affiliation(s)
| | - S Patel
- Department of Conservative Dentistry, King's College London Dental Institute, London, UK; Specialist Practice, London, UK
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Meschi N, Hilkens P, Lambrichts I, Van den Eynde K, Mavridou A, Strijbos O, De Ketelaere M, Van Gorp G, Lambrechts P. Regenerative endodontic procedure of an infected immature permanent human tooth: an immunohistological study. Clin Oral Investig 2015; 20:807-14. [DOI: 10.1007/s00784-015-1555-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Accepted: 07/28/2015] [Indexed: 11/27/2022]
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Torres A, Jacobs R, Lambrechts P, Brizuela C, Cabrera C, Concha G, Pedemonte ME. Characterization of mandibular molar root and canal morphology using cone beam computed tomography and its variability in Belgian and Chilean population samples. Imaging Sci Dent 2015; 45:95-101. [PMID: 26125004 PMCID: PMC4483626 DOI: 10.5624/isd.2015.45.2.95] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 01/01/2015] [Accepted: 02/12/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose This study used cone-beam computed tomography (CBCT) to characterize mandibular molar root and canal morphology and its variability in Belgian and Chilean population samples. Materials and Methods We analyzed the CBCT images of 515 mandibular molars (257 from Belgium and 258 from Chile). Molars meeting the inclusion criteria were analyzed to determine (1) the number of roots; (2) the root canal configuration; (3) the presence of a curved canal in the cross-sectional image of the distal root in the mandibular first molar and (4) the presence of a C-shaped canal in the second mandibular molar. A descriptive analysis was performed. The association between national origin and the presence of a curved or C-shaped canal was evaluated using the chi-squared test. Results The most common configurations in the mesial root of both molars were type V and type III. In the distal root, type I canal configuration was the most common. Curvature in the cross-sectional image was found in 25% of the distal canals of the mandibular first molars in the Belgian population, compared to 11% in the Chilean population. The prevalence of C-shaped canals was 10% or less in both populations. Conclusion In cases of unclear or complex root and canal morphology in the mandibular molars, CBCT imaging might assist endodontic specialists in making an accurate diagnosis and in treatment planning.
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Affiliation(s)
- Andres Torres
- Department of Imaging and Pathology, OMFS-IMPATH Research Group, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- Department of Imaging and Pathology, OMFS-IMPATH Research Group, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Conservative Dentistry, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Claudia Brizuela
- Department of Endodontics, Universidad de los Andes, Santiago, Chile
| | - Carolina Cabrera
- Department of Endodontics, Universidad de los Andes, Santiago, Chile
| | - Guillermo Concha
- Department of Oral and Maxillofacial Radiology, Universidad de los Andes, Santiago, Chile
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Meireles AB, Vieira AW, Corpas L, Vandenberghe B, Bastos FS, Lambrechts P, Campos MM, Las Casas EBD. Dental wear estimation using a digital intra-oral optical scanner and an automated 3D computer vision method. Comput Methods Biomech Biomed Engin 2015; 19:507-14. [PMID: 26047162 DOI: 10.1080/10255842.2015.1043627] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The objective of this work was to propose an automated and direct process to grade tooth wear intra-orally. Eight extracted teeth were etched with acid for different times to produce wear and scanned with an intra-oral optical scanner. Computer vision algorithms were used for alignment and comparison among models. Wear volume was estimated and visual scoring was achieved to determine reliability. Results demonstrated that it is possible to directly detect submillimeter differences in teeth surfaces with an automated method with results similar to those obtained by direct visual inspection. The investigated method proved to be reliable for comparison of measurements over time.
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Affiliation(s)
| | - Antonio Wilson Vieira
- b Department of Mathematics , Universidade Estadual de Montes Claros , Montes Claros , Brazil
| | - Livia Corpas
- c BIOMAT, Department of Oral Health Sciences , Katholieke Universiteit Leuven , Leuven , Belgium
| | - Bart Vandenberghe
- c BIOMAT, Department of Oral Health Sciences , Katholieke Universiteit Leuven , Leuven , Belgium
| | - Flavia Souza Bastos
- d Department of Computational and Applied Mechanics , Universidade Federal de Juiz de Fora , Juiz de Fora , Brazil
| | - Paul Lambrechts
- c BIOMAT, Department of Oral Health Sciences , Katholieke Universiteit Leuven , Leuven , Belgium
| | - Mario Montenegro Campos
- e Computer Science Department , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil
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Hilkens P, Meschi N, Lambrechts P, Bronckaers A, Lambrichts I. Dental Stem Cells in Pulp Regeneration: Near Future or Long Road Ahead? Stem Cells Dev 2015; 24:1610-22. [PMID: 25869156 DOI: 10.1089/scd.2014.0510] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Although regenerative endodontic procedures have yielded an impressive body of favorable outcomes, the treatment of necrotic immature permanent teeth in particular remains to be a challenge. Recent advances in dental stem cell (DSC) research have gained increasing insight in their regenerative potential and prospective use in the formation of viable dental tissues. Numerous studies have already reported successful dental pulp regeneration following application of dental pulp stem cells, stem cells from the apical papilla, or dental follicle precursor cells in different in vivo models. Next to responsive cells, dental tissue engineering also requires the support of an appropriate scaffold material, ranging from naturally occurring polymers to treated dentin matrix components. However, the routine use and banking of DSCs still holds some major challenges, such as culture-associated differences, patient-related variability, and the effects of culture medium additives. Only in-depth evaluation of these problems and the implementation of standardized models and protocols will effectively lead to better alternatives for patients who no longer benefit from current treatment protocols.
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Affiliation(s)
- Petra Hilkens
- 1 Laboratory of Morphology, Biomedical Research Institute (BIOMED), Hasselt University , Diepenbeek, Belgium
| | - Nastaran Meschi
- 2 Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven , Leuven, Belgium
| | - Paul Lambrechts
- 2 Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven , Leuven, Belgium
| | - Annelies Bronckaers
- 1 Laboratory of Morphology, Biomedical Research Institute (BIOMED), Hasselt University , Diepenbeek, Belgium
| | - Ivo Lambrichts
- 1 Laboratory of Morphology, Biomedical Research Institute (BIOMED), Hasselt University , Diepenbeek, Belgium
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Mavridou AM, Pyka G, Kerckhofs G, Wevers M, Bergmans L, Gunst V, Huybrechts B, Schepers E, Hauben E, Lambrechts P. A novel multimodular methodology to investigate external cervical tooth resorption. Int Endod J 2015; 49:287-300. [PMID: 25819599 DOI: 10.1111/iej.12450] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 03/23/2015] [Indexed: 01/29/2023]
Abstract
AIM To introduce a multimodular combination of techniques as a novel minimal invasive approach to investigate efficiently and accurately external cervical resorption (ECR). METHODOLOGY One case of a central incisor with extensive external cervical resorption was selected to demonstrate the potential of a comparative novel study methodology. ECR diagnosis was based on clinical inspection, digital radiography and cone-beam computed tomography (CBCT). After extraction, the tooth was investigated using microfocus computed tomography (micro-CT), nano-CT and hard tissue histology. These techniques were compared for their accuracy and applicability to highlight their advantages and disadvantages. RESULTS Nano-CT was more effective than micro-CT and CBCT for detailed ex vivo exploration of ECR. The reparative tissue, pericanalar resorption resistant sheet (PRRS), pulp tissue reactions, resorption channels and their interconnection with the periodontal ligament space were accurately visualized by detailed processing and analysis of the nano-CT data set with Dataviewer and CTAn software. Nano-CT analysis provided better insight in the true extent of the resorption, based on quantitative measurements and 3D visualization of the tooth structure. Nano-CT imaging results were similar to hard tissue histology at the mineralized tissue level. To clarify the dynamic phenomenon of reparative tissue formation and substitution of the resorbed tissues, nano-CT needed to be associated with hard tissue histology. CONCLUSION Nano-CT is a fast and minimal invasive technique for the ex vivo analysis and understanding of ECR and is complementary with hard tissue histology. A combined approach of clinical and CBCT examination, with nano-CT and histological mapping measurements, can provide an ideal platform for future ECR imaging and exploration studies.
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Affiliation(s)
- A M Mavridou
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospital Leuven, Leuven, Belgium.,Private practice, Endo Rotterdam, Rotterdam, the Netherlands
| | - G Pyka
- Department of Materials Engineering (MTM), KU Leuven, Leuven, Belgium
| | - G Kerckhofs
- Department of Materials Engineering (MTM), KU Leuven, Leuven, Belgium.,Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, Leuven, Belgium
| | - M Wevers
- Department of Materials Engineering (MTM), KU Leuven, Leuven, Belgium
| | - L Bergmans
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospital Leuven, Leuven, Belgium
| | - V Gunst
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospital Leuven, Leuven, Belgium
| | - B Huybrechts
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospital Leuven, Leuven, Belgium
| | - E Schepers
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospital Leuven, Leuven, Belgium
| | - E Hauben
- Department of Imaging and Pathology, KU Leuven & University Hospital Leuven, Leuven, Belgium
| | - P Lambrechts
- Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven & University Hospital Leuven, Leuven, Belgium
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Esposito SA, Huybrechts B, Slagmolen P, Cotti E, Coucke W, Pauwels R, Lambrechts P, Jacobs R. A novel method to estimate the volume of bone defects using cone-beam computed tomography: an in vitro study. J Endod 2013; 39:1111-5. [PMID: 23953281 DOI: 10.1016/j.joen.2013.04.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Revised: 04/03/2013] [Accepted: 04/03/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The routine use of high-resolution images derived from 3-dimensional cone-beam computed tomography (CBCT) datasets enables the linear measurement of lesions in the maxillary and mandibular bones on 3 planes of space. Measurements on different planes would make it possible to obtain real volumetric assessments. In this study, we tested, in vitro, the accuracy and reliability of new dedicated software developed for volumetric lesion assessment in clinical endodontics. METHODS Twenty-seven bone defects were created around the apices of 8 teeth in 1 young bovine mandible to simulate periapical lesions of different sizes and shapes. The volume of each defect was determined by taking an impression of the defect using a silicone material. The samples were scanned using an Accuitomo 170 CBCT (J. Morita Mfg Co, Kyoto, Japan), and the data were uploaded into a newly developed dedicated software tool. Two endodontists acted as independent and calibrated observers. They analyzed each bone defect for volume. The difference between the direct volumetric measurements and the measurements obtained with the CBCT images was statistically assessed using a lack-of-fit test. A correlation study was undertaken using the Pearson product-moment correlation coefficient. Intra- and interobserver agreement was also evaluated. RESULTS The results showed a good fit and strong correlation between both volume measurements (ρ > 0.9) with excellent inter- and intraobserver agreement. CONCLUSIONS Using this software, CBCT proved to be a reliable method in vitro for the estimation of endodontic lesion volumes in bovine jaws. Therefore, it may constitute a new, validated technique for the accurate evaluation and follow-up of apical periodontitis.
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Gunst V, Mavridou A, Huybrechts B, Van Gorp G, Bergmans L, Lambrechts P. External cervical resorption: an analysis using cone beam and microfocus computed tomography and scanning electron microscopy. Int Endod J 2013; 46:877-87. [DOI: 10.1111/iej.12073] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 01/12/2013] [Indexed: 11/29/2022]
Affiliation(s)
- V. Gunst
- Department of Oral Health Sciences; Section Endodontics; BIOMAT Research Cluster; KU; Leuven; Belgium
| | - A. Mavridou
- Department of Oral Health Sciences; Section Endodontics; BIOMAT Research Cluster; KU; Leuven; Belgium
| | - B. Huybrechts
- Department of Oral Health Sciences; Section Endodontics; BIOMAT Research Cluster; KU; Leuven; Belgium
| | - G. Van Gorp
- Department of Oral Health Sciences; Section Endodontics; BIOMAT Research Cluster; KU; Leuven; Belgium
| | - L. Bergmans
- Department of Oral Health Sciences; Section Endodontics; BIOMAT Research Cluster; KU; Leuven; Belgium
| | - P. Lambrechts
- Department of Oral Health Sciences; Section Endodontics; BIOMAT Research Cluster; KU; Leuven; Belgium
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Palaniappan S, Celis JP, Van Meerbeek B, Peumans M, Lambrechts P. Correlating in vitro scratch test with in vivo contact free occlusal area wear of contemporary dental composites. Dent Mater 2012; 29:259-68. [PMID: 23140915 DOI: 10.1016/j.dental.2012.10.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 06/05/2012] [Accepted: 10/17/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The aims of this study are to determine the extent to which the ranking order for clinical Contact-Free-Occlusal-Area (CFOA) wear performance of composites correlates with the ranking based on in vitro scratch hardness, and to analyze the extent to which the microstructure influences the overall trend. MATERIALS AND METHODS The patient data and CFOA wear measurements of 16 Tetric-C, 17 Tetric-EC, 16 Gradia-DP, 18 Filtek Supreme, 19 Z100 restorations in 31 subjects (8 males, 23 females) of two randomized clinical trials were fitted in a mixed-effect model. The in vivo performance of the restoratives was summarized by ranking the estimated material-related coefficients in the model. Scratch tests on two specimens per composite were run at a constant speed of 0.05 mm/s under indenter with normal loads of 15, 25, and 35 mN. Scratch width, depth and hardness calculated by imaging the scratch tracks were summarized in a model, the material-related coefficients were ranked and correlated with that of in vivo ranking order. RESULTS The best in vivo model included as significant factors (p<0.0001) the variables material, time/month, cavity type, and jaw type. The CFOA wear ranking order - Filtek Supreme, Z100>Tetric-C, Tetric-EC>Gradia-DP-correlated closely (R(2)=0.991) with the order of scratch hardness - Z100>Filtek Supreme>Tetric-C, Tetric-EC>Gradia-DP. SIGNIFICANCE Scratch tests could roughly categorize a new material as to whether it will probably exhibit a high or low in vitro scratch resistance and/or clinical CFOA wear rate.
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de Almeida Neves A, Coutinho E, Cardoso MV, Lambrechts P, Van Meerbeek B. Current concepts and techniques for caries excavation and adhesion to residual dentin. J Adhes Dent 2011; 13:7-22. [PMID: 21403932 DOI: 10.3290/j.jad.a18443] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The advent of "Adhesive Dentistry" has simplified the guidelines for cavity preparation enormously. The design and extent of the current preparations are basically defined by the extent and shape of the caries lesion, potentially slightly extended by bevelling the cavity margins in order to meet the modern concept of minimally invasive dentistry. New caries excavation techniques have been introduced, such as the use of plastic and ceramic burs, improved caries-disclosing dyes, enzymatic caries-dissolving agents, caries-selective sono/air abrasion and laser ablation. They all aim to remove or help remove caries-infected tissue as selectively as possible, while being minimally invasive through maximum preservation of caries-affected tissue. Each technique entails a specific caries-removal endpoint and produces residual dentin substrates of different natures and thus different receptiveness for adhesive procedures. This paper reviews the newest developments in caries excavation techniques and their effect on the remaining dentin tissue with regard to its bonding receptiveness.
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Affiliation(s)
- Aline de Almeida Neves
- Leuven Biomat Cluster, Department of Conservative Dentistry, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Catholic University of Leuven, Belgium
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Neves AA, Coutinho E, De Munck J, Lambrechts P, Van Meerbeek B. Does DIAGNOdent provide a reliable caries-removal endpoint? J Dent 2011; 39:351-60. [PMID: 21334416 DOI: 10.1016/j.jdent.2011.02.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 11/16/2010] [Accepted: 02/12/2011] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES To compare mineral density of residual dentine after excavation with different caries-removal techniques and to evaluate the diagnostic potential of laser-induced fluorescence (LIF), measured by DIAGNOdent, as a tool to determine the caries-removal endpoint. METHODS Carious teeth were excavated by tungsten-carbide round burs (Komet), ceramic burs (CeraBurs, Komet), sono-abrasion (Cariex TC tips, Kavo), and by chemo-mechanical excavation using two enzyme-based solutions (exp. SFC-V and SFC-VIII, 3M-ESPE) or a sodium hypochlorite-based solution (Carisolv, MediTeam). The caries-excavated teeth were scanned by micro-CT (1172, Skyscan), after which the mineral density at the bottom dentine was correlated to LIF measurements at the same region. A micro-CT threshold for dentine caries was defined by comparison with surface-hardness measurements. The intensity of dentine staining was evaluated by analysing the component 'L*' in CIE-L*a*b-converted images from the excavated teeth. RESULTS No statistically significant difference in mineral density was found at the bottom of the cavities prepared with the different caries-excavation techniques, except for exp. SFC-V that left residual dentine with a significantly higher mineral density than when CeraBurs were used (Tukey-Kramer, p<0.05). Absence of residual caries was associated with darker staining of dentine. No significant correlation was found between the distance from the deepest cavity point to the pulp-chamber roof and LIF measurements. A strong negative correlation (R=-0.86, p<0.01) was however found between L* values and LIF measurements, indicating that staining in residual dentine leads to higher LIF measurements. CONCLUSIONS LIF measured by DIAGNOdent is influenced by staining in residual dentine. Therefore, its use to determine the caries-removal endpoint is doubtful.
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Affiliation(s)
- Aline A Neves
- Leuven BIOMAT Research Cluster, Department of Conservative Dentistry, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Catholic University of Leuven, Kapucijnenvoer 7, B-3000 Leuven, Belgium
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Palaniappan S, Elsen L, Lijnen I, Peumans M, Van Meerbeek B, Lambrechts P. Nanohybrid and microfilled hybrid versus conventional hybrid composite restorations: 5-year clinical wear performance. Clin Oral Investig 2011; 16:181-90. [DOI: 10.1007/s00784-010-0500-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Accepted: 12/27/2010] [Indexed: 10/18/2022]
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Gunst V, Huybrechts B, De Almeida Neves A, Bergmans L, Van Meerbeek B, Lambrechts P. Playing wind instruments as a potential aetiologic cofactor in external cervical resorption: two case reports. Int Endod J 2010; 44:268-82. [DOI: 10.1111/j.1365-2591.2010.01822.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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