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Iranian Endodontic Journal 2024This non-randomized clinical trial investigated the outcomes of full pulpotomy in adult molars with irreversible pulpitis, comparing those with calcified and...
INTRODUCTION
This non-randomized clinical trial investigated the outcomes of full pulpotomy in adult molars with irreversible pulpitis, comparing those with calcified and non-calcified pulp chambers over 6 and 12 months.
MATERIALS AND METHODS
A total of 101 adult permanent molars with irreversible pulpitis, in individuals over 12 years old, were categorized based on pulp chamber calcification observed in radiographic images by two endodontists. Subsequently, full pulpotomy procedures were performed, achieving hemostasis, and applying a 2 mm layer of calcium-enriched mixture (CEM) cement as a pulp covering agent. After 48 hours, the setting of the CEM cement was verified, followed by the application of a layer of resin-modified glass-ionomer. The tooth was then restored using amalgam. Clinical and radiographic evaluations were conducted at 6-month and 1-year follow-ups by blinded endodontists. Success rates were compared using Fisher's exact test and logistic regression tests with a significance level of 0.05.
RESULTS
Among the 97 patients with 6-month and 1-year follow-ups, all achieved clinical success. Radiographic success rates were 99% at 6 months and 96.9% at 1 year, regardless of pulp calcification. In the 6-month follow-up, success rates were 98.07% for non-calcified pulp chambers and 100% for calcified pulp chambers. At the 1-year follow-up, success rates were 96.1% and 97.8%, respectively. Statistical analysis showed no significant difference in radiographic success rate between the two groups at both follow-ups (>0.05).
CONCLUSIONS
Full pulpotomy using CEM cement is a successful treatment for adult permanent teeth with calcified and non-calcified pulp chambers presenting signs and symptoms of irreversible pulpitis up to a 1-year follow-up. This study provides compelling evidence that vital pulp therapy can be effectively employed in the pulpotomy of calcified teeth, at least in the short term.
PubMed: 38223838
DOI: 10.22037/iej.v19i1.43894 -
Dental Research Journal 2024The aim of the study was to investigate the morphometric parameters of dental pulp in open apices immature teeth in a sheep model after mechanical pulp exposure and...
BACKGROUND
The aim of the study was to investigate the morphometric parameters of dental pulp in open apices immature teeth in a sheep model after mechanical pulp exposure and restoration with reinforced zinc oxide-eugenol.
MATERIALS AND METHODS
In this experimental study, a total of 12 immature mandibular central incisors from six adult male sheep, weighing 30-40 kg and with the age of 1 year old with Merino race were examined. After anesthesia, the pulps of the teeth in the case group were mechanically exposed and then were restored with reinforced zinc oxide-eugenol and amalgam. In the control group, the teeth remained intact. The animals were sacrificed at intervals of 2, 4, 6, and 8 weeks (E2, E4, E6, and E8) in the case and 2 and 8 weeks (C2 and C8) in the control groups. Then, their teeth were removed with the surrounding supporting tissues and alveolar bones. Tissue processing and staining were done, and the sections were examined under a light microscope. The Kruskal-Wallis and Mann-Whitney tests were used to analyze the data and compare the changes between the two groups. < 0.05 was considered statistically significant.
RESULTS
In response to mechanical exposure, reparative or tertiary dentin was formed, and its thickness increased during the time of the study. The thickness of the odontoblastic layer in the E4 group was the highest amount. The pulp chamber diameter in the C2 group was significantly larger than the other groups, and the diameter of the apical foramen in the E8 was decreased significantly compared to the controls ( < 0.05).
CONCLUSION
In response to mechanical exposure and restoration with reinforced zinc oxide-eugenol, some morphometric parameters of the dental pulp changed significantly in the sheep model compared to the controls.
PubMed: 38476710
DOI: No ID Found -
Materials (Basel, Switzerland) Jul 2023Occlusal rest provides support for removable partial dentures (RPD). Rest seats are ideally prepared in enamel, but the abutment teeth might be restored or need...
Occlusal rest provides support for removable partial dentures (RPD). Rest seats are ideally prepared in enamel, but the abutment teeth might be restored or need restorations. This study compared the fracture strength of abutments restored with composite to amalgam restorations after rest seat preparation. Disto-occlusal cavities were prepared in 30 extracted human maxillary premolars. The specimens were allocated in three groups (n = 10) based on the type of restoration. All the specimens were exposed to thermomechanical aging followed by cycling loading. Fracture strength was tested using a universal testing machine, and then, the fracture mode was recorded. The data were analyzed using Kruskal-Wallis test with a significance level set at 0.05. The fracture mode was recorded as catastrophic or non-catastrophic. The fracture strength between all tested groups showed no significant difference. The highest and lowest fracture strength were recorded on amalgam and Tetric N-Ceram groups, respectively. Composite Tetric N-Ceram showed equal distribution of fracture sites on the restorative materials and teeth, it also displayed the highest number of non-catastrophic fractures unlike other groups where the fracture occurred more within the restorations. The fracture strength of composite was comparable to that of amalgam restorations with prepared rest seats.
PubMed: 37445144
DOI: 10.3390/ma16134830 -
BMC Oral Health Mar 2024This animal study sought to evaluate two novel nanomaterials for pulpotomy of primary teeth and assess the short-term pulpal response and hard tissue formation in dogs....
BACKGROUND
This animal study sought to evaluate two novel nanomaterials for pulpotomy of primary teeth and assess the short-term pulpal response and hard tissue formation in dogs. The results were compared with mineral trioxide aggregate (MTA).
METHODS
This in vivo animal study on dogs evaluated 48 primary premolar teeth of 4 mongrel female dogs the age of 6-8 weeks, randomly divided into four groups (n = 12). The teeth underwent complete pulpotomy under general anesthesia. The pulp tissue was capped with MCM-48, MCM-48/Hydroxyapatite (HA), MTA (positive control), and gutta-percha (negative control), and the teeth were restored with intermediate restorative material (IRM) paste and amalgam. After 4-6 weeks, the teeth were extracted and histologically analyzed to assess the pulpal response to the pulpotomy agent.
RESULTS
The data were analyzed using the Kruskal‒Wallis, Fisher's exact, Spearman's, and Mann‒Whitney tests. The four groups were not significantly different regarding the severity of inflammation (P = 0.53), extent of inflammation (P = 0.72), necrosis (P = 0.361), severity of edema (P = 0.52), extent of edema (P = 0.06), or connective tissue formation (P = 0.064). A significant correlation was noted between the severity and extent of inflammation (r = 0.954, P < 0.001). The four groups were significantly different regarding the frequency of bone formation (P = 0.012), extent of connective tissue formation (P = 0.047), severity of congestion (P = 0.02), and extent of congestion (P = 0.01). No bone formation was noted in the gutta-percha group. The type of newly formed bone was not significantly different among the three experimental groups (P = 0.320).
CONCLUSION
MCM-48 and MCM-48/HA are bioactive nanomaterials that may serve as alternatives for pulpotomy of primary teeth due to their ability to induce hard tissue formation. The MCM-48 and MCM-48/HA mesoporous silica nanomaterials have the potential to induce osteogenesis and tertiary (reparative) dentin formation.
Topics: Animals; Dogs; Female; Bicuspid; Dental Pulp; Dental Pulp Capping; Dentin, Secondary; Drug Combinations; Edema; Gutta-Percha; Hydroxyapatites; Inflammation; Oxides; Tooth, Deciduous
PubMed: 38468251
DOI: 10.1186/s12903-024-04098-9 -
Journal of Pharmacy & Bioallied Sciences Apr 2024The stainless-steel crown (SSC) is a durable restoration and has several indications for use in primary teeth such as following a pulpotomy/pulpectomy, fractured teeth,...
The stainless-steel crown (SSC) is a durable restoration and has several indications for use in primary teeth such as following a pulpotomy/pulpectomy, fractured teeth, teeth with developmental defects, or large multi-surface caries lesions where amalgam is likely to fail. Due to its durability and a lifespan like the primary tooth, it could well be the gold standard in restorative care. SSCs protect the crown from fracture, reduce the possibility for leakage, and ensure a biological seal. However, the placement of the SSC should follow a meticulous technique. There are some clinical situations where the SSC may fail, leading to plaque accumulation and gingivitis. This could be secondary to improper crimping of crown margins, which lead to poorly adapted SSC. In some clinical situations, ledge formation under the crown or failure to clean excess cement can contact the gingiva and cause gingival inflammation. This study was carried out on 41 children between the ages of 4 and 10 in Al Qassim region to study the effects of SSCs on gingiva and oral hygiene. The study also aims to establish the correlation between SSC adaptation and post-insertion inflammation. The plaque and gingival index were recorded at 3 months' post SSC insertion. Clinical examination was undertaken, and gingival index (Loe and Silness 1967) and plaque index (Silness and Loe 1967) were used to record gingival health and plaque accumulation, respectively. The result for post-inflammation and SSC adaptation showed that there was no statistically significant difference in post-insertion inflammation and crown adaptation (P value = 0.216). The result for pre-operative inflammation and post-operative inflammation shows that there is no significant difference in post-inflammation and adaptation (P value = 0.47). We found that oral hygiene care had a heightening effect and oral hygiene maintenance plays a key role in preventing gingival inflammation irrespective of the SSC adaptation over short periods of time (3 months).
PubMed: 38882832
DOI: 10.4103/jpbs.jpbs_1208_23 -
Cureus Jan 2024Mineral trioxide aggregate (MTA) is widely recognized as one of the most biocompatible materials for perforation repairs during root canal treatment (RCT)....
BACKGROUND/OBJECTIVES
Mineral trioxide aggregate (MTA) is widely recognized as one of the most biocompatible materials for perforation repairs during root canal treatment (RCT). Experimental evidence has consistently demonstrated MTA's superior sealing ability and biocompatibility compared to various dental materials, including amalgam, intermediate restorative material, zinc oxide eugenol cement, and resin-modified glass ionomer cement. This study aimed to assess the efficacy of MTA as a reparative material in iatrogenic furcal perforations during RCT.
MATERIALS & METHODS
A descriptive cross-sectional study was conducted from May 18, 2021, to November 17, 2021, at the Department of Operative Dentistry, Nishtar Institute of Dentistry, Multan, Pakistan. Seventy-six patients aged 18-60 years, of both genders, who developed iatrogenic furcal perforations during procedures were included. Patients with fractures or endo-perio lesions identified during clinical and radiographic examinations were excluded. Isolation was achieved using a rubber dam. The perforation site was cleaned and irrigated with 1% sodium hypochlorite to control hemorrhage and enhance visualization. Following the manufacturer's recommendations, the perforation site was sealed with MTA mixed with sterile saline.
RESULTS
The age range in this study was 18 to 60 years, with a mean age of 42.09 ± 9.69 years. Most patients (56.78%) were between 41-60 years old. Out of the 76 patients, 46 (60.53%) were male, and 30 (39.47%) were female, resulting in a male-to-female ratio of 1.5:1. The study found that MTA's efficacy as a reparative material in iatrogenic furcal perforations was observed in 61 (80.26%) patients. A 6-month follow-up revealed no periodontal ligament breakdown, demonstrating the efficacy of MTA as a reparative material in iatrogenic furcal perforations.
CONCLUSION
This study concludes that the efficacy of MTA as a reparative material in iatrogenic furcal perforations is remarkable and significant.
PubMed: 38425600
DOI: 10.7759/cureus.53206 -
Scientific Reports May 2024Despite advancements in vital pulp therapy (VPT), a subset of cases fails to achieve desired outcomes. This study based on a previous large-scale cohort study involving...
Despite advancements in vital pulp therapy (VPT), a subset of cases fails to achieve desired outcomes. This study based on a previous large-scale cohort study involving 1257 VPT-treated teeth, aiming to describe the demographic data and clinical characteristics of all failed cases and their management protocols. Clinical records/images of 105 failed cases treated by a single endodontist (2011-2022) were examined, including 10 extracted teeth. Asymptomatic cases with PDL widening received no intervention, while others underwent management protocols, including (selective) RCT and (tampon) re-VPT. These retreatments were assessed for success (defined as radiographic evidence of healing) and survival (characterized by the retention/function of the treated tooth) using Kaplan-Meier analysis. While 51.4% of all initial failures were diagnosed due to symptoms, 48.6% were symptom-free. Notably, failed cases with symptomatic irreversible pulpitis, and apical periodontitis/widened PDL before initial treatment significantly outnumbered asymptomatic cases and normal PDL, respectively (P = 0.001). Moreover, most of the initial failures were observed in teeth with composite resin rather than amalgam restorations (P = 0.002). The success and survival rates for the management protocols were 91.78% and 95.79%, respectively, over an average follow-up period of 36.94 (± 23.30) months. RCT and re-VPT procedures provide successful outcomes for managing unsuccessful VPTs.
Topics: Humans; Male; Female; Retrospective Studies; Adult; Middle Aged; Dentition, Permanent; Treatment Failure; Treatment Outcome; Pulpitis; Dental Pulp; Kaplan-Meier Estimate; Root Canal Therapy
PubMed: 38773252
DOI: 10.1038/s41598-024-62565-3 -
Cureus May 2024Silver amalgam, glass ionomer, resin-modified glass ionomer, compomers, light polymerized hybrid composite resin, and hybrid glass ionomer are among the most frequent...
INTRODUCTION
Silver amalgam, glass ionomer, resin-modified glass ionomer, compomers, light polymerized hybrid composite resin, and hybrid glass ionomer are among the most frequent restorative materials used as cavity-based or post-endodontics. Thus, to meet the needs of both patients and dentists, Cention N reimagines the traditional filling by integrating bulk placement, ion release, and durability into a dual-curing, aesthetically pleasing solution. Hoewver, we do not have enough information from studies comparing this hybrid restorative material's shear bond strengths to dentin to draw any firm conclusions. Cention N, zirconomer, and Vitremer are three hybrid tooth-colored restorative materials that were evaluated for their shear bond strength to dentin. This research aimed to compare and evaluate these materials.
METHODOLOGY
The purpose of this research was to use a universal Instron machine to measure the shear bond stress of three distinct hybrid tooth-colored restorative materials in relation to dentin. The research samples consisted of 45 extracted lower first premolars from humans. The teeth were then assigned into three groups of 15 samples each according to different color acrylic resin blocks, namely, group A (pink acrylic blocks), which had Cention in cement; group B (white acrylic blocks), which has zirconomer cement; and group C (violet acrylic blocks), which had Vitremer cement.
RESULTS
There was no statistically significant difference between the three groups and the normal distribution, as shown by the negligible values in the tests involving the three groups. Put simply, each of the three categories exhibits data that follows a normal distribution. This allows for further data analysis to be conducted using the parametric test of significance.
CONCLUSION
The shear bond strength of hybrid glass ionomer restorative materials has to be further investigated in both laboratory and living organism settings.
PubMed: 38864074
DOI: 10.7759/cureus.60123