RESUMO
INTRODUCTION: This multi-centered cohort study evaluated the radiographic outcomes of regenerative endodontic procedures (REPs) and apexification treatments (APEX) of immature teeth with endodontic disease. MATERIALS AND METHODS: This cohort study included a retrospective record review and prospective data collection of pediatric patients with teeth treated with REPs or APEX between 2005-2014. Data including the presence of a periapical lesion, external root resorption (ERR), obliteration, apical hard tissue, apical closure, intracanal calcifications, and radiographic root area (RRA) change based on measurements were collected/measured from radiographic images. Univariate and multivariate analyses were conducted. RESULTS: The cohort included 190 subjects (204 teeth (92 REPs; 112 APEX)). The frequency of pre-treatment periapical pathology was similar between cases in which the clinical treatment failed versus successful treatment cases. However, the frequency of pre-treatment ERR was higher in failed cases than in successful cases (p=0.007). The mean RRA change was greater than twenty percent in 21% of the REPs cases. In traumatized teeth, REP treatment resulted in less hard tissue formation than other endodontic disease etiologies measured by RRA (p=0.001). 53% of cases with ERR (16/30) showed signs of healing/arrest and were mostly treated with REPs (11/16). CONCLUSIONS: The presence of ERR negatively affected the treatment outcome. There was significant variability in RRA change in REPs. Signs of healing/arrest of the resorptive lesion were radiographically visible in many cases treated with REPs.
RESUMO
INTRODUCTION: The aim of this study was to evaluate the antibiofilm effectiveness of calcium hydroxide (Ca[OH]2) mixed with 0.02% silver nanoparticles (AgNPs) in comparison with 1 mg/mL triple antibiotic paste (TAP), Ca(OH)2, and 0.02% AgNPs against Enterococcus faecalis using confocal laser scanning microscopy. METHODS: Ninety dentin disks were prepared, sterilized, and inoculated with E. faecalis to establish a 3-week-old biofilm model. The samples received 1 mg/mL TAP, a mixture of Ca(OH)2 + 0.02% AgNPs, Ca(OH)2, or 0.02% AgNPs (n = 20/group). Specimens in each group were equally subdivided into 2 groups and incubated for 2 and 4 weeks. Untreated dentin disks (n = 10) were exposed to sterile saline solution and acted as a positive control. Sterile dentin disks (n = 10) were incubated anaerobically in brain-heart infusion broth and served as a negative control. At the end of each observation period, the specimens were stained with LIVE/DEAD BacLight dye (Molecular Probes, Eugene, OR) and analyzed with confocal laser scanning microscopy to determine the proportion of dead cells in the biofilm. Statistical analysis was performed using the generalized linear model repeated measure and Tukey tests (P < .05). RESULTS: A significantly greater proportion of dead cells was observed in the samples treated with 1 mg/mL TAP (90.39% and 99.41%) and a mixture of Ca(OH)2 + AgNPs (90.85% and 98.49%) than those in the samples treated with Ca(OH)2 (76.14% and 91.71%) and AgNPs (62.83% and 88.07%) at 2 and 4 weeks, respectively. A significant difference in the antibiofilm effectiveness was observed among the groups (P < .05), except for 1 mg/mL TAP and the mixture of Ca(OH)2 + AgNPs (P > .05). All medicaments showed a significant difference in antibiofilm efficacy at the 2 time points. CONCLUSIONS: The mixture of Ca(OH)2 + AgNPs showed a high antibiofilm effect and was not significantly different from 1 mg/mL TAP. Furthermore, long-term contact between intracanal medicaments and bacterial cells achieved significant antibiofilm efficacy.
