Endodontic management of type IIIb dens invaginatus in central incisor: A case report.

We described a type IIIb dens invaginatus, its root canal treatment, and results on 3- and 12-month visits. Despite its significant challenges, proper endodontic therapy in such cases can cause positive prognosis and successful outcome.

Management of contralateral molar teeth with necrotic pulp and open apexes using platelet-rich plasma and vital pulp therapy.

Regenerative endodontics holds promising potential for the regeneration of living tissues in teeth with necrotic pulp and periapical lesion. Platelet-rich plasma can be easily prepared and used as an ideal scaffold for pulp regeneration.

Correlation between bone mineral density of jaws and skeletal sites in an Iranian population using dual X-ray energy absorptiometry.

BACKGROUND: The aim of the present study was to evaluate the relationship between the bone density of various regions of jaws and skeletal bones. MATERIALS AND METHODS: A total of 110 patients with a mean age of 55.01 ± 10.77 years were selected for the purpose of the present descriptive study. Dual X-ray Energy Absorptiometry (DXA) was carried out to determine bone mineral density (BMD) of the femur and lumbar vertebrae. Then all the subjects underwent DXA of the jaw bones and BMD values were determined at four jaw regions. Data were analyzed by SPSS 16 statistical software, and the correlation between the various BMD values was determined by Pearson's correlation coefficient. RESULTS: The results showed that 42.7% of females had normal BMD values in the femur, and in vertebrae, 20% were osteopenic and 37.3% suffered from osteoporosis, with statistically significant differences in the BMD values of the jaws between the three above-mentioned groups (P < 0.001). There was an increasing tendency toward osteopenia and osteoporosis with age. There was a positive correlation between BMD values of the femur and lumbar vertebrae and those of all the jaw regions under study (P < 0.005). There was a negative correlation (P < 0.01) between age and the BMD values of the femur, lumbar vertebrae and anterior maxilla. CONCLUSION: The bone density of the maxilla and mandible and presence of osteoporosis or osteopenia in these bones might reflect the same problem in skeletal bones.

The effect of MTAD, an endodontic irrigant, on fibroblast attachment to periodontally affected root surfaces: A SEM analysis.

BACKGROUND: Root surface debridement (RSD) is necessary to create an environment suitable for reattachment of the periodontium. Root surface conditioning may aid the formation of a biocompatible surface suitable for cell reattachment. BioPure™ MTAD (mixture of Doxycycline, citric acid and a detergent) is an endodontic irrigant with antibacterial properties and the ability to remove smear layer. It was hypothesized that MTAD may be useful for root surface conditioning. The efficacy of MTAD as a conditioner was measured by examining fibroblast attachment to root surfaces. MATERIALS AND METHODS: Thirty-two specimens of human teeth with advanced periodontal disease were used. The surfaces were root planed until smooth. Half of the specimens were treated with 0.9% saline and the other samples with Biopure MTAD. As a negative control group, five further samples were left unscaled with surface calculus. Human gingival fibroblast cells HGF1-PI1 were cultured and poured over the tooth specimens and incubated. After fixation, the samples were sputter-coated with gold and examined with a SEM. The morphology and number of attached, fixed viable cells were examined. The data was analysed using the Mann-Whitney-U statistical test. RESULTS: There was no significant difference between the numbers of attached cells in the experimental group treated with MTAD and the control group treated with saline. Little or no attached cells were seen in the negative control group. CONCLUSION: RSD created an environment suitable for cell growth and attachment in a laboratory setting. The use of MTAD did not promote the attachment and growth of cells on the surface of human roots following RSD.

Healing of apical periodontitis after endodontic treatment with and without obturation in dogs.

The principle of obturation of the root canal space is generally accepted. This belief has dominated the field of endodontics despite the absence of credible scientific evidence. Little information is available on the possible relationships between endodontic success and obturation of the root canal system. The present study compares the healing of instrumented and obturated versus instrumented and nonobturated root canal systems with apical periodontitis. Fifty-six root canals in 28 third and fourth bilateral lower premolar teeth with completely formed apices in seven mixed German Shepherd dogs were used. Apical lesions were created by accessing the canals, removing the pulp and leaving them open to the oral environment for 42 days. The teeth in the control group were instrumented, irrigated, and then obturated using a lateral condensation technique with gutta-percha cones and AH26 Plus as the endodontic sealer. The teeth in the experimental group were instrumented and irrigated without obturation. All teeth in both groups were sealed coronally. After 190 days, the animals were euthanized. Vital perfusion with 10% formalin through common carotid artery was performed. Thirty to 40 serial 5-microm thick sections were obtained from each root and stained with hematoxylin and eosin for histological evaluation by observer blinded to the treatment allocation. The control group showed less cementum and dentin resorption in comparison with test group (p < 0.5). No statistically significant difference was found in other parameters between the control and test groups (p > 0.05). The noteworthy finding of this study was that there was no difference in healing of apical periodontitis between the instrumented and obturated and instrumented and nonobturated root canal system. The success of endodontic treatment ultimately depends on the elimination of the microorganism, host response and mechanical closure (coronal seal) of treated root canals that may provide a potential for future bacterial contamination.