Microrobotics for Precision Biofilm Diagnostics and Treatment.

Advances in small-scale robotics and nanotechnology are providing previously unimagined opportunities for new diagnostic and therapeutic approaches with high precision, control, and efficiency. We designed microrobots for tetherless biofilm treatment and retrieval using iron oxide nanoparticles (NPs) with dual catalytic-magnetic functionality as building blocks. We show 2 distinct microrobotic platforms. The first system is formed from NPs that assemble into aggregated microswarms under magnetic fields that can be controlled to disrupt and retrieve biofilm samples for microbial analysis. The second platform is composed of 3-dimensional (3D) micromolded opacifier-infused soft helicoids with embedded catalytic-magnetic NPs that can be visualized via existing radiographic imaging techniques and controlled magnetically inside the root canal, uninterrupted by the soft and hard tissues surrounding the teeth in an ex vivo model. These microrobots placed inside the root canal can remove biofilms and be efficiently guided with microscale precision. The proof-of-concept paradigm described here can be adapted to target difficult-to-reach anatomical spaces in other natural and implanted surfaces in an automated and tether-free manner.

DPSCs from Inflamed Pulp Modulate Macrophage Function via the TNF-α/IDO Axis.

Human dental pulp stem cells (DPSCs) can be isolated from inflamed pulp derived from carious teeth with symptomatic irreversible pulpitis (I-DPSCs), which possess stemness and multidifferentiation potentials similar to DPSCs from healthy pulp. Since macrophages-essential cell players of the pulpal innate immunity-can regulate pulpal inflammation and repair, the authors investigated the immunomodulatory effects of DPSCs/I-DPSCs on macrophage functions and their underlying mechanisms. Similar to DPSCs, I-DPSCs were capable of colony-forming efficiency and adipogenic and osteo/dentinogenic differentiation under in vitro induction conditions. I-DPSCs also expressed a similar phenotypic profile of mesenchymal stem cell markers, except a relatively higher level of CD146 as compared with DPSCs. Coculture of DPSCs or I-DPSCs with differentiated THP-1 cells, the human monocyte cell line, markedly suppressed tumor necrosis factor α (TNF-α) secretion in response to stimulation with lipopolysaccharides (LPS) and/or nigericin. However, unlike TNF-α, the secreted level of interleukin 1ß was not affected by coculture with DPSCs or I-DPSCs. Furthermore, DPSC/I-DPSC-mediated inhibition of TNF-α secretion by macrophages was abolished by pretreatment with 1-methyl-D-tryptophan, a specific inhibitor of indoleamine-pyrrole 2,3-dioxygenase (IDO), but not by NSC-398, a specific inhibitor of COX-2, suggesting IDO as a mediator. Interestingly, IDO expression was significantly augmented in macrophages and mesenchymal stromal cells in inflamed human pulp tissues. Collectively, these findings show that I-DPSCs, similar to DPSCs, possess stem cell properties and suppress macrophage functions via the TNF-α/IDO axis, thereby providing a physiologically relevant context for their innate immunomodulatory activity in the dental pulp and their capability for pulp repair.

Conventional and surgical endodontic retreatment of a maxillary lateral incisor with unusual anatomy.

AIM: To describe conventional and surgical endodontic treatment of a maxillary right lateral incisor with an unusual root dilaceration and to discuss the treatment outcome. SUMMARY: Root dilacerations refer to severe curvature or angulations that may occur anywhere along the length of a root. This anatomical deviation may present an unfavourable outcome if clinicians fail to recognize the difficulties. The following case report describes conventional and surgical endodontic treatment of a maxillary right lateral incisor with an unusual root dilaceration. *Root morphology may present a challenge for clinicians during root canal treatment. *Clinicians should be aware of the importance of surgical endodontics and be familiar with microsurgery principals and techniques.

Root canal treatment on a patient with zinc oxide allergy: a case report.

AIM: To describe successful root canal treatment of a patient with a true zinc oxide allergy and to discuss allergic reactions to dental materials. SUMMARY: Dental materials have been reported as aetiologic agents for both local and systemic allergic reactions. It is essential for the oral healthcare provider to recognize the clinical symptoms associated with allergic reactions and to modify dental treatment, if necessary, to prevent these reactions from occurring. This article describes an unusual case of a patient with an allergy to zinc oxide. To our knowledge, this is the first case of successful root canal treatment of a patient with confirmed zinc oxide allergy to be reported in the dental literature. KEY LEARNING POINTS: Medical and dental histories must be evaluated to prevent medical complications secondary to dental treatment. Any patient suspected of having an allergy to dental materials should be referred to a healthcare professional capable of performing and interpreting allergy tests prior to dental treatment.

Comparison of apical transportation between ProFile and ProTaper NiTi rotary instruments.

AIM: To use a newly developed radiographic technique to compare apical transportation and loss of working length (WL) between.06 taper ProFile Series 29 and ProTaper nickel-titanium (NiTi) rotary instruments in vitro. METHODOLOGY: Mesio-buccal canals of 40 extracted mandibular molars were randomly divided into two groups. Group 1 was instrumented with ProFile and group 2 with ProTaper instruments according to the manufacturers' directions. A specially constructed radiographic jig with a Schick digital radiographic system (Schick Technologies Inc., Long Island City, NY, USA) was used to take pre- and postoperative radiographs of the samples at predetermined angulations. Using AutoCAD 2000 (Autodesk Inc., San Rafael, CA, USA), the central axes of initial and final instruments were radiographically superimposed to determine the loss of WL and degree of transportation at D(0), D(1), D(2) and D(4) from the WL. Data were analysed using repeated-measures anova. RESULTS: A statistically significant difference in apical transportation was found at the D(4) level between the two groups (P = 0.05). There was no statistical significance regarding postinstrumentation change in WL between groups. Spearman's Bivariate Correlation analysis indicated no statistically significant relationship between the radius of curvature and transportation. CONCLUSION: The results indicate that both ProTaper and ProFile instruments are comparable to each other in regards to their ability to optimally enlarge root canal with minimal transportation and loss of WL in vitro.

Effect of nitric oxide synthase inhibitor (L-NAME) on substance P-induced vasodilatation in the dental pulp.

AIM: To investigate the vasodilator mechanisms of pulpal vessels, especially the involvement of nitric oxide (NO), during pulpal inflammation. METHODOLOGY: Eleven cats were prepared for intra-arterial administration of test agents through a lingual artery. The pulpal blood flow was measured by laser Doppler flowmetry from ipsilateral mandibular canine teeth. By using the NO synthase (NOS) inhibitor N(G)-nitro L-arginine methyl ester (L-NAME), the effects of L-NAME on various vasodilators, such as Substance P (SP)-, calcitonin-gene related peptide (CGRP)-, and papaverine-induced vasodilatation, were compared in vivo in 11 feline dental pulps. RESULTS: L-NAME pretreatment potentiates SP-induced vasodilatation for a duration of approximately 5 h. The increase of pulpal blood flow ranged from 91.47 to 109.91%, which was significantly different from SP injection alone (48.79%, P < 0.05). Other vasodilators such as CGRP and papaverine did not respond to L-NAME pretreatment. CONCLUSIONS: This study demonstrates that NOS inhibitor L-NAME administration alone has insignificant effects on pulpal blood flow, although L-NAME pretreatment can potentiate SP-induced vasodilatation, probably via increased activity in the enzyme guanylate cyclase. CGRP and papaverine did not respond to L-NAME pretreatment, indicating that they are not mediated via an endothelium-dependent mechanism.