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O objetivo do presente estudo foi de comparar o diâmetro dos cones acessórios FM EL calibrados por duas réguas calibradoras com seus respectivos diâmetros nominais. Foram calibrados 80 cones de guta percha FM EL (Odous de Deus) utilizando duas réguas calibradoras das seguintes marcas: Prisma e Denco. Os cones foram divididos em 8 grupos (n=10) de acordo com a régua e com o diâmetro em que foram calibrados. Posteriormente, os cones foram fotografados e tiveram seus D0 mensurados através do software ImageJ. Após a realização da análise estatística utilizando-se os testes de Normalidade de Shapiro-Wilk e o teste t Student (Distribuição Normal), obteve-se os seguintes resultados: não houve diferença estatisticamente significativa com o valor de referência na régua prisma nos cones 40, isto é, em todas as outras situações encontrou-se diferença com os valores de referência. Quando foram comparados os valores das medianas e desvio padrão das duas réguas calibradoras também houve diferença estatisticamente significativa (p<0,05) nos cones 25, 35 e 40. Os cones acessórios FM EL (Odous de Deus) calibrados com a régua Denco diferiram dos diâmetros nominais da régua. Assim, deve-se estar atento à exatidão e precisão desses instrumentos a fim de se evitar possíveis erros de mensuração e interpretação capazes de comprometer o êxito da obturação no tratamento endodôntico.
The aim of the present study was to compare the diameter of the FM EL accessory cones calibrated by two calibrating rulers with their respective nominal diameters 80 FM EL gutta percha cones (Odous of God) were calibrated using two calibrating culers of the following brands: Prisma and Denco. The cones were divided in 8 groups (n=10) according to the ruler and the diameter in which they were calibrated. Posteriorly, the cones were photographed and nad their D0 neasured through the software ImageJ. After performing the statistical analysis using the Shapiro- Wilk Normality tests and the Student T test (Normal Distribution), the following results were obtained: there was no stastistically significant difference with the reference value in the prism rule in the cones 40, that is, in all other situations, a difference was found with the reference values. When the median values and standard deviation of the two calibrating rulers were compared, there was also a statistically significant difference (p<0,05) in cones 25, 35 and 40. The FM EL (Odous of God) accessory cones calibrated eita the Denco ruler differed from the nominal diameters of the ruler. Thus, one must pay attention to the accuracy and precision of these instruments in order to avoid possible errors of measurement and interpretation capable of compromising the success of filling in endodontic treatment.
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Objetivou-se investigar ex vivo o diâmetro anatômico e conicidade do canal mesiopalatino de primeiros molares superiores. Para tanto, trinta e três primeiros molares superiores humanos foram acessados, explorados para confirmação da existência do canal mesiopalatino, identificados, suas raízes mesiovestibulares seccionadas transversalmente em três níveis e, então, os fragmentos foram fotografados com microscópio digital, que permitiu a realização das determinações dos diâmetros anatômicos deste canal em cada amostra. Os resultados foram calculados em função dos valores médios e de desvio padrão dos diâmetros em cada nível, obtendo-se respectivamente 0,20 mm e ±0,09 mm (nível cervical), 0,20 mm e ±0,08 mm (nível médio) e 0,17 mm e ±0,06 mm (nível apical). Nas condições deste estudo, de acordo com caráter atrésico e baixa conicidade do conduto mesiopalatino, sugere-se a necessidade de uso de instrumentos de diâmetro de ponta mínimo de 0,25 mm e conicidade 0,03 para o seu preparo.
The aim was to investigate ex vivo the anatomical diameter and taper of the mesiopalatine canal of maxillary first molars. To this end, thirty-three human maxillary first molars were accessed, explored to confirm the existence of the mesiopalatine canal, identified, their mesiobuccal roots transversely sectioned at three levels and then the fragments were photographed using a digital microscope, which allowed the anatomical diameters of this canal to be determined in each sample. The results were calculated according to the mean and standard deviation values of the diameters at each level, obtaining 0.20 mm and ±0.09 mm (cervical level), 0.20 mm and ±0.08 mm (middle level) and 0.17 mm and ±0.06 mm (apical level) respectively. Under the conditions of this study, given the atresic nature and low taper of the mesiopalatine canal, it is suggested that instruments with a minimum tip diameter of 0.25 mm and a taper of 0.03 should be used for its preparation.
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Na odontologia a decisão do tratamento é exclusiva dos cirurgiões dentistas e suas percepções, incluindo filosofia de tratamento, fazendo com que a prática de novos conceitos, tratamentos ou técnicas dependam não apenas de sua lógica ou eficácia biológica. Sendo assim, este estudo teve como objetivo avaliar os parâmetros envolvidos na tomada de decisão de cirurgiões dentistas clínicos e especialistas para a realização do tratamento endodôntico em sessão única ou múltiplas sessões. Para tanto, este estudo contou com uma coleta de dados através de um questionário online, aplicado cirurgiões dentistas clínicos gerais e especialistas em endodontia. As respostas foram tabuladas e analisadas por meio de estatística descritiva. Os resultados revelaram que a maioria dos endodontistas e dos clínicos gerais prefere realizar tratamento endodôntico em sessão única, devido ao menor desperdício de material, além do melhor domínio da anatomia e tratamento em um único momento. O motivo mais comum para os endodontistas e clínicos gerais escolherem o tratamento com múltiplas visitas é para dentes com prognóstico duvidoso e os casos em que o profissional aguarda a remissão dos sintomas antes da obturação. Em conclusão, a maioria dos endodontistas e dos clínicos gerais preferiu realizar tratamento endodôntico em sessão única.
In dentistry, treatment decisions are made exclusively by dental surgeons and their perceptions, including treatment philosophy, which means that the practice of new concepts, treatments or techniques depends not only on their logic or biological efficacy. Therefore, the aim of this study was to evaluate the parameters involved in clinical and specialist dental surgeons' decision to carry out endodontic treatment in single or multiple sessions. To this end, data was collected using an online questionnaire administered to general dental surgeons and endodontic specialists. The answers were tabulated and analyzed using descriptive statistics. The results revealed that the majority of endodontists and general practitioners prefer to carry out endodontic treatment in a single session, due to less wastage of material, as well as better mastery of the anatomy and treatment at a single time. The most common reason for endodontists and general practitioners to choose treatment with multiple visits is for teeth with a doubtful prognosis and cases in which the professional is waiting for symptoms to remit before filling. In conclusion, the majority of endodontists and general practitioners preferred to carry out endodontic treatment in a single session.
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Humans , Male , Female , Root Canal Therapy , Clinical Protocols , Surveys and Questionnaires , Endodontics , Clinical Decision-MakingABSTRACT
INTRODUCTION: Root canal retreatment often employs organic solvents like chloroform, eucalyptol, and orange oil. However, studies comparing their effectiveness yield inconsistent results. The quantity of d-limonene, a crucial component in orange oil, varies depending on the oil production method. Cold-pressed orange oil has been observed to contain the highest d-limonene levels. This study investigates the comparative solvent effects of cold-pressed and steam-hydrodistilled orange oils on gutta-percha and GuttaFlow2, typically used components in root canal fillings. METHODS: Thirty-two discs (10 mm in diameter and 2 mm in thickness) were prepared using GuttaFlow and gutta-percha cones. The samples were weighed and then randomly divided into four groups (n=8) based on the type of solvent used. Each group was immersed in its respective solvent for 10 minutes. After exposure to the solvent, the samples were reweighed to determine the amount of material removed. RESULTS: The weight loss in the group treated with cold-pressed orange oil on gutta-percha was significantly higher than in other groups (GuttaFlow2 + cold-pressed orange oil, gutta-percha + steam hydrodistilled orange oil, GuttaFlow2 + steam hydrodistilled orange oil) (p<0.001, p<0.001, and p<0.001). CONCLUSION: According to the study findings, cold-pressed orange oil demonstrated a higher solvent effect on both GuttaFlow2 and traditional gutta-percha compared to steam-hydrodistilled orange oil. This indicates the significant impact of the production method of orange oil on its efficacy as a solvent in root canal therapy retreatment.
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Aim and background: The management of avulsed immature teeth poses a significant challenge to clinicians, as prolonged dry time before reimplantation may lead to replacement resorption or ankylosis. Case description: Recent studies have shown promising results with the use of an intracanal proprietary pharmaceutical preparation, followed by sealing of the orifice with mineral trioxide aggregate (MTA). Angiography suggested the presence of vascularized tissue after 1 year, indicating successful regeneration of pulpal tissue in the radicular area. Conclusion: Despite an unfavorable crown-root fracture leading to tooth extraction after 9 months, histological examination revealed regular root dentin formation, indicating a favorable outcome. Clinical significance: These findings offer hope for the management of avulsed immature teeth and underscore the importance of early intervention and appropriate treatment selection. How to cite this article: Rathi N, Agrawal A, Thosar N, et al. Regeneration of Pulp and Radicular Tissues in a Nonvital Avulsed Tooth with Open Apex: A Case Report. Int J Clin Pediatr Dent 2024;17(5):596-600.
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Objectives: This study aimed to investigate the endodontic characteristics of mandibular premolars with dens evaginatus (DE) that require endodontic treatment. Materials and Methods: Patients who underwent endodontic treatment were enrolled. The inclusion criteria were patients who underwent root canal treatment in the lower permanent teeth with DE and were followed up for at least 1 year. Preoperative clinical and radiographic variables were obtained. The frequency distribution of the preoperative variables was compared using the χ2 or Fisher's exact tests. The significance of the change in periapical health index (PAI) and root development stages before and after treatment was examined using the Wilcoxon signed-rank test. Results: A total of 150 teeth of 134 patients with an average age of 15.3 years were included. The percentage distribution comparison of the preoperative variables and obturation techniques revealed significant differences in pulpal and periapical diagnosis, and percussion, and especially regarding age, root development stage, and PAI. Age was the only statistically significant preoperative variable associated with root growth (p < 0.05). Conclusions: Approximately, 60% of DEs requiring endodontic treatment had immature roots. Age being the most significant predisposing factor, early treatment provides the greatest opportunity for full root development.
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Objectives: This study aimed to evaluate the color stability and solubility of Biodentine and NeoPutty in contact with different irrigation solutions. Materials and Methods: Biodentine and NeoPutty were set in cylindrical molds with 7 mm diameter and 1.5 mm high and immersed in distilled water, 17% ethylenediaminetetraacetic acid (EDTA), 2% chlorhexidine (CHX), 9% 1-hydroxyethylidene 1,1-diphosphonate (HEDP), and 5% sodium hypochlorite (NaOCl) solutions for 24 hours. The color change was measured with a spectrophotometer. The solubility values were calculated as the mass loss was expressed as a percentage of the original mass using an analytical balance with 10-4 g accuracy. Data were analyzed with Kruskal-Wallis followed by Mann-Whitney U tests, and 2-way analysis of variance test followed by Bonferroni corrections for pairwise comparisons for solubility and color stability with a 5% significance threshold, respectively. Results: Biodentine exhibited higher color changes compared to the NeoPutty contact with all solutions except distilled water (p < 0.05). Both hydraulic cements (HCs) showed higher discoloration values immersion in CHX followed by NaOCl. No statistically significant difference was found between Biodentine and NeoPutty regardless of irrigation solution in terms of solubility (p > 0.05). Solubility values were lower in the distilled water group compared to EDTA and CHX (p < 0.05). Conclusions: Tested HCs showed solubility and color changes at various rates. NeoPutty could be an appropriate material in aesthetic areas. The usage of HEDP as an irrigant solution can be considered suitable for various endodontic treatments due to its relatively lower solubility and discoloration values.
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Objectives: This study aimed to investigate the frequency and type of endodontic procedural errors in cases indicated for retreatment through cone-beam computed tomography (CBCT) analysis. Materials and Methods: The sample consisted of 96 CBCT scans, encompassing 122 permanent teeth with fully formed roots. Errors included perforation, instrument fracture, canal transportation, missed canals, and inadequate apical limit of filling. Additionally, potential risk factors were analyzed and subjected to statistical modeling. Results: The most frequent procedural error observed was the inadequate apical limit of filling, followed by canal transportation, perforation, missed canal, and instrument fracture. Statistically significant associations were identified between various procedural errors and specific factors. These include canal transportation and root canal wall, with the buccal wall being the most commonly affected; missed canal and tooth type, particularly the palatine and second mesiobuccal canal canals; inadequate apical limit of filling and root curvature, showing a higher deviation to the mesial direction in severely curved canals; inadequate apical limit of filling and the presence of calcifications, with underfilling being the most frequent; canal transportation and periapical lesion, notably with deviation to the buccal direction; and the direction of perforation and periapical lesion, most frequently occurring to buccal direction. Conclusions: CBCT emerges as a valuable tool in identifying procedural errors and associated factors, crucial for their prevention and management.
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This study aimed to evaluate and compare the shaping abilities and minimum dentin thickness of minimally invasive rotary instruments via micro-computed tomography. Twelve 3D-printed C-shaped canal models from a mandibular molar were divided into two groups, and root canals were prepared with either XP-endo Rise (XR) or TruNatomy (TN) systems. Pre- and post-preparation evaluations included canal volume, prepared area and minimum dentin thickness. No significant differences were found in canal volume change (XR: 22.66 ± 4.28%, TN: 23.02 ± 5.10%), prepared canal area (XR: 31.86 ± 10.72%, TN: 30.26 ± 11.59%) and minimum dentin thickness (XR: 0.30 ± 0.05 mm, TN: 0.28 ± 0.05 mm) between groups (p > 0.05). The canal volume change in the middle third was significantly higher than that in the coronal and apical thirds (p < 0.05) in both groups. In conclusion, XR demonstrated comparable shaping abilities and minimum dentin thickness to TN in preparing 3D-printed C-shaped canals.
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OBJECTIVES: To evaluate the reporting quality of Scoping Reviews (ScRs) in endodontics according to the PRISMA Extension Checklist for Scoping Reviews (PRISMA-ScR) and to analyse their association with a range of publication and methodological/reporting characteristics. METHODS: Pubmed, Scopus, and Web of Science databases were searched up to 31 January 2024 to identify scoping reviews in the field of endodontics. An additional search was performed in three leading endodontic journals. Study selection and appraising the quality of the studies was carried out independently by two reviewers. Each of the 20 PRISMA-ScR items were allocated a score of either 0, 0.5 or 1 to reflect the completeness of the reporting. An item-specific and overall percentage reporting quality score was calculated and reported through descriptive statistics across a range of publication, as well as methodological/reporting characteristics. A univariable and multivariable quantile regression was performed to identify the effect of publication and methodological/reporting characteristics (year of publication, journal, inclusion of an appropriate reporting guideline, and study registration) on the overall percentage reporting quality score. Association of reporting quality score with publication characteristics was then investigated. RESULTS: A total of 40 ScRs were identified and included for appraisal. Most of the studies were published from 2021 onwards. The overall median reporting quality score was 86%. The most frequent items not included in the studies were: a priori protocol registration (22/40 compliant; 55%), and reporting of funding (16/40 compliant; 40%). Other key elements that were inadequately reported were the abstract (7/40 compliant; 18%), the rationale and justification of the ScR (21/40 compliant; 52%) and the objectives of the study (18/40 compliant; 45%). Studies that adhered to appropriate reporting guidelines were associated with greater reporting quality scores (ß-coefficient: 10; 95%CI: 1.1, 18.9; p = .03). ScRs with protocols registered a priori had significantly greater reporting quality scores (ß-coefficient: 12.5; 95%CI: 6.1, 18.9; p < .001), compared with non-registered reviews. CONCLUSIONS: The reporting quality of the ScRs in endodontics varied and was greater when the ScR protocols were registered a priori and when the authors adhered to reporting guidelines.
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AIM: To evaluate the agreement between six currently available periapical radiography-based methods for measuring the root canal curvatures in mesial roots of mandibular first molars, assessed by two examiners with different proficiency levels. METHODOLOGY: Non-endodontically treated mesial roots of 41 human mandibular first molars were radiographed using the parallelling technique. Two independent observers (a specialist in endodontics and radiology and a final-year dental student) assessed their root canal curvature using the methodologies described by Schneider (1971, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 32, 271), Weine (1982, Endodontic therapy), Berbert and Nishiyama (1994, Revista Gaúcha de Odontología, 356), Luiten et al. (1995, Journal of Endodontics, 21, 26), Hankins and ElDeeb (1996, Journal of Endodontics, 22, 123) and Pettiette et al. (1999, Journal of Endodontics, 25, 230). Intra- and inter-examiner reliability was assessed using the intraclass correlation coefficient. The differences in curvature angle measured by the different methods were compared using the one-way anova for repeated measures test, followed by Tukey's post hoc analysis. The effect was calculated using the Cohen's d method. To determine the agreement between methods, the Bland-Altman analysis was used. The significance level was set at 5%. RESULTS: Agreement for the observers was excellent (>0.81) for the six methods considered. For the angle comparisons between methods, the maximum differences were for Schneider versus Weine (35.77°) and Luiten versus Hankins (35.14°), whilst the highest percentage of angles with a difference >10° were Weine versus Luiten and Berbert versus Pettiette (90%) and the comparison Weine versus Hankins presented with the lowest frequency (15%). Excellent agreement was found for five comparisons: Weine versus Luiten (0.940), Berbert versus Pettiette (0.917), Weine versus Pettiette (0.907), Luiten versus Pettiette (0.904) and Berbert versus Luiten (0.812). Compared to Schneider's method, the other methods showed a tendency of increasing difference as the angles became more acute. The other methods exhibited linear differences, remaining constant for smaller and larger angles. CONCLUSIONS: Reliability was excellent for all methods assessed separately. Maximum differences in curvature angles were found when comparing Schneider versus Weine and Luiten versus Hankins. Excellent agreement was found for Weine versus Luiten, Berbert versus Pettiette, Weine versus Pettiette, Luiten versus Pettiette and Berbert versus Luiten. In the presence of dilacerations, the method by Schneider was less sensitive.
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Endo-perio lesions are lesions involving pulp tissue with periodontal tissue. The bacterial infection of the pulp can spread to the furcation area through the accessory canal, causing damage to the furcation area. Regeneration therapy has good success when performed with flap surgery and is performed in cases of Grades I and II furcation involvement. Demineralized freeze-dried bone allograft (DFDBA) is a regenerating material that has osteoinductive and osteoconductive abilities. It has the advantage of successful treatment of bone defects. Biodentine is an agent used for direct pulp capping, root perforation and furcation repair, and apexification. It can bind and enter the dentinal tubules and create interlocking crystals with dentin. This case report presents the treatment of furcation involvement Grade II originating from endo-perio lesions by using DFDBA and Biodentine as regeneration materials with 6 months of follow-up.
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BACKGROUND: The dentinal debris produced during root canal preparation can be extruded through the apical foramen, which may cause undesired consequences, such as the postoperative inflammation of periapical tissues. OBJECTIVES: The aim of the present in vitro study was to evaluate the effect of glide path preparation on apical debris extrusion for the Reciproc®, WaveOne Gold® and One Curve file systems. MATERIAL AND METHODS: A total of 72 mandibular incisors were divided into 6 groups according to the nickel-titanium (NiTi) system used and glide path preparation: group Rp - Reciproc; group Rp-O - Reciproc after glide path preparation; group WG - WaveOne Gold; group WG-O - WaveOne Gold after glide path preparation; group OC - One Curve; and group OC-O - One Curve after glide path preparation. The preand post-instrumentation weight of Eppendorf tubes was measured. The pre-weight was subtracted from the post-weight to calculate the amount of apically extruded debris. The data was analyzed using the one-way analysis of variance (ANOVA) with the statistical program PASW Statistics for Windows, v.18.0. RESULTS: No statistically significant differences were found between the single-NiTi file systems with different kinematics in terms of apical debris extrusion, with or without glide path preparation (p > 0.05). CONCLUSIONS: The amount of apically extruded debris was not affected by the kinematics of different single-NiTi file systems. Moreover, creating a glide path had no effect on the apically extruded debris in straight root canals.
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Nickel , Root Canal Preparation , Titanium , Tooth Apex , Root Canal Preparation/instrumentation , Humans , Tooth Apex/surgery , Incisor , In Vitro Techniques , Equipment DesignABSTRACT
Background: The success of regenerative endodontic procedures (REPs) is significantly influenced by the choice of endodontic irrigant solution. However, the impact of these solutions on the viability of stem cells from the apical papilla (SCAP), a critical component of the REP, remains a subject of ongoing debate. Objective: This study aimed to investigate the effects of various endodontic irrigant solutions on the viability of stem cells from the apical papilla in an in vitro setting. Methods: A systematic literature search was conducted using databases such as PubMed/Medline, Scopus, the Cochrane Library, Web of Science, Embase, gray literature, and reference lists up to August 2023. The search was limited to in vitro studies investigating the impact of endodontic irrigant solutions on SCAP viability. The risk of bias in these studies was evaluated using the Joanna Briggs Institute's checklist. Results: Of the 131 articles retrieved, 14 were selected for review. The effects of eighteen different root canal irrigants, such as ethylenediaminetetraacetic acid, sodium hypochlorite, chlorhexidine, and citric acid, on the viability of SCAPs were evaluated. The risk-of-bias analysis showed a high risk in sample randomization and size justification but a low risk in other areas. Discussion: The effects of endodontic irrigant solutions on the viability of SCAPs are concentration dependent. Concentrations higher than 1.5% sodium hypochlorite, 2 % chlorhexidine, 10 % citric acid, and 2.5 % EDTA significantly reduced cell viability. However, additional research is necessary to determine the effect of these irrigants on tissue regeneration.
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Endodontic irrigation protocols are not only used to clean and disinfect the root canal system, but also to condition the canal wall dentine for subsequent root filling. In this study we tested whether a final irrigation step with saline solution or 80% ethanol improved root canal sealabilty by two popular sealers, an epoxy resin (AH Plus) and a hydraulic calcium silicate cement-based product (BioRoot RCS). Root canals in extracted single-rooted human teeth were instrumented and filled with a matched gutta-percha cone and sealer. During instrumentation and prior to root filling, sealer-specific irrigation protocols were applied. These involved a combined sodium hypochlorite/1-hydroxyethylidene-1,1-diphosphonic acid application, which was followed by irrigation with ethylenediaminetetraacetic acid (EDTA) for AH Plus. Protocols were followed by a 5-ml ultimate rinse with saline solution or 80% ethanol. No such final rinse was the control (N = 9). Canals were then dried with matched paper points. One week after root filling and storage of the teeth at 37°C in a humid environment, Rhodamine B was used to trace leakage. Two-way ANOVA revealed that the type of sealer had a significant (P < 0.05) impact on apical dye penetration while the final rinse did not (P > 0.05). AH Plus provided the slightly better seal (P < 0.05). Leakage occurred between the sealer and the dentin with AH Plus, and between the sealer-to-dentin as well as the sealer-to-gutta-percha interface with BioRoot RCS. In summary and under current conditions, there was no benefit from applying saline or ethanol as an ultimate rinsing solution prior to drying the canal with matched paper points.
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Ethanol , Root Canal Filling Materials , Saline Solution , Humans , Ethanol/administration & dosage , Saline Solution/administration & dosage , Root Canal Irrigants/administration & dosage , Epoxy Resins , Root Canal Preparation/methods , Root Canal Preparation/instrumentation , Root Canal Obturation/methods , Dental Leakage/prevention & control , Sodium Hypochlorite/administration & dosage , Calcium CompoundsABSTRACT
This study examined the root and canal morphology of mandibular anterior teeth (MA) in the Turkish sub-population using cone-beam computed tomography (CBCT), comparing the findings based on Vertucci's and Ahmed et al. classification systems. The CBCT images were acquired using the 3D Accuitomo CBCT device. Images that were deemed suitable for visualizing the roots, canals, and the complete pulp chamber and apex were included in the study. Vertucci and Ahmed et al. classification systems were employed to determine the root canal morphology. 500 CBCT images and 3000 teeth were analyzed. Type I (1MA1) was the most frequent, followed by Type III (1MA1-2-1). 3.8% of teeth could not be classified with Vertucci system. In canine teeth, Vertucci type III (1MA1-2-1) was significantly more prevalent in males than females (p = 0.038) and Type I (1MA1) was less frequent in individuals aged 41-50 (p < 0.05). Canal divergence/merging was the most common at the middle/apical level for central (15.5%) and lateral (10.3%) teeth, and at the coronal/middle level for canine teeth (1.9%). Bilateral similarity was high for all tooth groups (> 78%). One-third of mandibular incisor teeth have two canals, with a significant number exhibiting canal divergence/merging that was separated in the middle region and merged in the apical region. The Vertucci classification was found to be inadequate in some cases, while Ahmed et al. classification was able to classify all mandibular incisors with a single code. Ahmed et al. classification is a more useful system for classifying all MA.
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Background: Regenerative endodontic procedures allow reinforcement of root canal wall and continuation of root development, opening new therapeutic possibilities. The root canal system of infected teeth is colonized by a variety of microorganisms, which hinder the regenerative process, leading to treatment failure if not adequately addressed, thereby requiring careful attention to microbial control. Aim and Objective: The aim of the study was to assess the antimicrobial activity of advanced platelet-rich fibrin (A-PRF) and gold nanoparticles (AuNps) against Enterococcus faecalis. Materials and Methods: Intravenous blood (5-6 ml) was drawn from four healthy individuals, and A-PRF was prepared through centrifugation at 1500 revolutions per minute (rpm) for 14 min. A-PRF was doped with 3 µl of AuNps and centrifuged at 1000 rpm for 1 min. Antimicrobial activity was assessed using disk diffusion; inhibition zones were measured. For minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC), A-PRF + AuNps were added to the microbial broth at varying concentrations to determine growth inhibition and microbial death. Results: Disk diffusion assays revealed significant antibacterial effects against E. faecalis. Norfloxacin displayed the highest mean zone of inhibition (20.33 ± 1.53 mm), followed by the Test group (A-PRF + AuNPs) (19.33 ± 0.58 mm). Multiple comparisons indicated significant differences (P < 0.001). MIC of A-PRF + AuNPs against E. faecalis was 0.031 mg/ml, with MBC at 0.015 mg/ml. Conclusion: The addition of AuNPs to A-PRF offers the potential for sustained growth factor release while maintaining the sterility of the canal, leading to successful revitalization and regeneration. The combined use of A-PRF + AuNps shows promise for enhancing revascularization in necrotic immature permanent teeth.
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The mandibular second molar has one unique feature regarding internal anatomy: it tends to have a C-shaped configuration in many cases. In mandibular second molar teeth, it is a variance of racial predilection that is frequently observed. During negotiation, debridement, and obturation, the physician is frequently faced with difficulties due to the complexity inherent in this diversity of canal morphology. This case report describes the management of such canal variation, which requires a thorough knowledge of internal anatomy combined with detailed investigations and the operator's skill in cleaning and shaping the canal for better prognostic outcomes.
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Regeneration of dentin and preserving pulp vitality are essential targets for vital pulp therapy. Our study aimed to evaluate a novel biomimetic pulp capping agent with increased dentin regenerative activities. To produce demineralised dentin matrix (DDM) particles, human extracted teeth were ground and treated with ethylene diamine tetra-acetic acid solution. DDM particles were added to sodium alginate and this combination was dripped into a 5% calcium chloride to obtain DDM hydrogel (DDMH). The eluants of both DDMH and mineral trioxide aggregate (MTA) were tested using an MTT assay to detect their cytotoxic effect on dental pulp stem cells (DPSC). Collagen-I (COL-I) gene expression was analysed on DPSC exposed to different dilutions of pulp capping material eluants by real-time quantitative polymerase chain reaction. Acridine orange staining was used to monitor the cell growth over the tested materials. Agar diffusion assay was utilised to test the antibacterial effect of DDMH and MTA compared to controls. MTT assay revealed that neat eluates of DDMH promoted DPSC viability. However, neat eluates of MTA were cytotoxic on DPSC after 72 h of culture. Moreover, DPSC were capable of growth and attached to the surface of DDMH, while they showed a marked reduction in their number when cultured on the MTA surface for one week, as shown by the acridine orange stain. In DPSC cultured with DDMH eluates, the COL-I gene was overexpressed compared to those cultured with MTA eluants. DDMH had significant antimicrobial activity in comparison to MTA after 24 h incubation. This in vitro study showed that DDMH could be an alternative pulp capping agent for regenerative endodontics.
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INTRODUCTION: The three-dimensional (3D) dynamic navigation system (DNS; Navident, ClaroNav Technology, Toronto, ON) is a revolutionary technique in endodontics that offers superior precision and efficiency compared to existing techniques for post space preparation. AIM: The aim is to evaluate and contrast the efficacy and efficiency of the DNS with conventional post space preparation techniques. This assessment considers several parameters, notably canal deviation (global coronal and apical deviation and angular deflection), duration of the procedure, and total volumetric loss of instrumented root canal and volumetric loss of instrumented root canal above 4 mm from the apex. MATERIALS AND METHODS: Freshly extracted maxillary central incisors were chosen for this study. A total sample size of 60 (n) was included. The extracted teeth samples were divided into two groups: 3D DNS (group I; n = 30) and conventional techniques (group II; n = 30). The samples were taken, and 50% of the crown structure was reduced for post space preparation to ensure standardization between the two groups. The samples were root canal-treated and mounted in a 3D-printed maxillary cast. Preoperative micro-computed tomography (micro-CT) and cone-beam computed tomography (CBCT) were taken for both groups. For group I, post space preparation was conducted with the DNS, which provided comprehensive guidance. The procedure was stopped when post space preparation was 4 mm short of the apex, as indicated in the system display. For group II, post space preparation was done without the guidance of DNS. Time taken for the procedure was assessed using a timer; canal deviation was evaluated using CBCT analysis, and volumetric loss was estimated using micro-CT analysis. RESULTS: The dynamic navigation group achieves significantly more precise outcomes in post space preparation than the conventional technique. The DNS group has significantly lesser global coronal and apical deviation and angular deflection compared to the conventional group (p < 0.05). The DNS group has reduced the volumetric loss of instrumented root canals compared to the conventional group (p < 0.05). Furthermore, the DNS group requires significantly less time than the conventional method, with a mean difference of about 10.567 minutes (p < 0.05). CONCLUSION: Implementing dynamic navigation improves precision in post space preparation, with a notable reduction in canal deviation and volumetric loss and a decrease in procedure time compared to the conventional method.